I exchanged a few emails with a journalist working on an article about Depression and Back Pain. He was wondering if the 2 conditions are related (they are) - and whether controlling one would help the other (YES!)...
Here are some of the questions he sent with my comments...
Hope you enjoy them!
Shawn
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Shawn M. Talbott, Ph.D.
Nutritional Biochemist and Author
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-The Cortisol Connection - Why Stress Makes You Fat and Ruins Your Health (Hunter House) - http://www.cortisolconnection.com/
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-A Guide to Understanding Dietary Supplements - an Outstanding Academic Text of 2004 (Haworth Press) - http://www.supplementwatch.com/
Why do those with back pain often have depression?
Back pain and Depression are a classic “chicken or egg” situation – where you often don’t know what came first = because back pain can lead to depression and depression can lead to back pain. Often, the best solution is to treat BOTH conditions at the same time because they share some of the same underlying biochemistry – inflammation and cortisol exposure are both too high and need to be rebalanced.
If you have back pain, what can you do to fight depression?
To fight BOTH back pain and depression at the same time, you need to reduce inflammation AND reduce cortisol at the same time. In a recent study presented at the American Society for Nutrition scientific conference (April 2010), controlling inflammation and cortisol at the same time helped improve Vigor (mental/physical energy) and reduce tension more than controlling either inflammation or cortisol on its own. This is because inflammation can set off a stress reaction in the body and stress can set off an inflammatory reaction – so even if you do a good job of controlling one aspect of your metabolism (take a pain killer for example), the stress in your life can start the inflammation/pain cycle all over again.
We run a program here in Utah, that teaches people about the link between stress and health (especially fatigue, weight gain, and depression – all linked to cortisol and inflammation). Some of the “standard” recommendations to combat stress apply - such as being physically active, eating balanced meals, getting enough sleep, etc. But, we also educate people about the “top five” ways to resist the detrimental health effects of stress and stress-related pain such as low back pain:
1. Have an “outlet” (a hobby or some diversion outside of work)...
2. Do whatever you can to make the sources of your stress more “predictable” or learn to develop more “control” over those stressors - this means to identify patterns related to when your stressors might appear...
3. Hang out with friends (avoid social isolation) - tough times are always easier when you’re around other people...
4. Learn to tell the difference between “big” issues and “little” issues...
5. Look on the bright side (really) - as simplistic as it sounds, the fact that you can look to “what is improving” in a given situation can help to psychologically buffer the stress in others areas...
Our program generally reduces perceived stress levels and stress hormones by about 15-20%, while mood and energy levels are increased by about 50% and indices of inflammation are controlled by almost 60%. Our work has been presented at numerous recent scientific conferences and is outlined in several of my books (see below).
What role does diet play in depression?
Diet plays a HUGE role in depression! When we’re depressed, our appetite changes – specifically, we tend to crave sweet/salty/fatty foods (“junk” food) due to the specific signaling in the brain where cortisol is telling the brain to “seek out sugar” (most of us know this as “stress eating” and it happens the same in depression). When we eat “better” foods – such as lean proteins, whole sources of carbohydrates, fresh fruits/veggies, omega-3 fats (fish), etc., we short-circuit the junk food cravings and have better control of our appetite (fewer cravings), feel fuller for longer (due to better control of blood sugar), and have higher energy levels and sharper mental focus.
Can you provide me with a list of 6 to 8 foods that seem to have depression-fighting properties, and how each one seems to help?
Some of my favorite “anti-stress” and “anti-pain” foods are:
Fatty Fish, such as mackerel, bluefish, wild salmon, and tuna are rich in omega-3 fatty acids that improve circulation, reduce inflammation, and reduce the risk of heart disease. Unfortunately, fish sticks, fried fish, and many low-fat white fish (including many farmed salmon) do not contain appreciable amounts of omega-3 fatty acids.
Low-Fat Dairy is the richest dietary source of two powerhouse nutrients, calcium and vitamin D – as well as specific peptides (short protein chains) that indce a sense of well-being and relaxation. You already know that calcium and vitamin D are important for bone health, but calcium also helps to boost metabolic rate (increasing the number of calories you burn each day) and vitamin D delivers potent anti-cancer activity.
Green Tea is a rich source of two health-protecting nutrients, catechins and theanine. The anti-cancer effects of catechins (a type of flavonoid) are almost unmatched in the natural world (turmeric comes close - see below), with dozens of human studies showing a reduced risk of a variety of cancers in those who drink the most tea (4 cups to 10 cups daily). Theanine is an amino acid naturally found in tea leaves that provides an anti-stress relaxation benefit to tea drinkers. The presence of theanine in green tea is thought to be responsible for the observation that caffeine intake in coffee drinkers (without theanine) is more apt to result in tension as opposed to the “relaxed alertness” more common to tea drinkers (despite similar caffeine intake).
Mangosteen is a small purplish fruit grown in Southeast Asia where it is known as the “Queen of Fruits” for its use in traditional medicine to hasten healing. Anti-inflammatory compounds known as Xanthones have been shown to improve gastrointestinal function, control pain and significantly reduce markers of inflammation such as C-reactive protein (CRP - an index of heart disease risk). The best way to consume mangosteen is as a whole-fruit juice, which will contain higher xanthone content because the xanthones are concentrated in the pericarp, just under the peel.
Turmeric can indeed be considered one of the “spices of life” because of its profound anti-inflammatory activity. Famously used in spicy Indian and Thai dishes, the active compounds (turmerones and curcuminods) have been associated with a wide range of health benefits including cancer prevention and pain reduction.
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