World Mental Health Day

Every week, one in six people will experience a common mental health condition, such as anxiety or depression, and shockingly, one in five adults have considered taking their own life at some point (2014 Adult Psychiatric Morbidity Survey). Mental health problems are one of the main causes of the overall disease burden worldwide and mixed anxiety and depression is estimated to cause one fifth of working days lost in Britain.

In 2018, there were 6,507 deaths in the UK as a result of suicide, with the highest rates observed in Scotland, followed by Wales and then England. Men accounted for three quarters of these deaths (mentalhealth.org.uk/statistics) and this may in part be a result of men being less likely to seek help for their mental health condition than women. This is not helped by the outdated and dangerous view that they should “man up”, rather than admit that they are suffering. Please avoid using this term and correct others if you hear this being said.

There are far too many issues surrounding mental health to explore here so I will be focusing on the common mental health conditions of anxiety and depression and things we can all do to try and improve our mental health and also how to help others. The main topics discussed will be alcohol, physical exercise, and nutrition.

Alcohol and mental health:

Mental health problems not only result from drinking excessively but they can also cause people to drink too much and therefore they may find themselves caught in a vicious cycle. If they are feeling anxious and/or depressed, they may have a drink to temporarily elevate their mood or to help them sleep, thereby essentially self medicating. However, although it may be easier to get to sleep initially, our bodies need to work harder to break down the alcohol in our system and this can result in disrupted sleep which will then affect our energy levels and our mood. Some people may drink to forget past traumas and alcohol can numb the emotions evoked when remembering such events as it depresses the central nervous system. However, it can also intensify or reveal repressed feelings and if these are invoked whilst under the influence of alcohol, it can increase the risk of not only personal safety but that of others.

Regular consumption of alcohol decreases the level of serotonin in the brain and this is a key chemical in depression. The vicious cycle then begins where one drinks to relieve depression, however their serotonin in then depleted further and more alcohol is consumed to try to elevate mood, with an ongoing negative effect on serotonin levels. If you are concerned about your own alcohol consumption or that of someone close to you, please ask for help from a medical professional, eg your GP, or visit https://www.nhs.uk/live-well/alcohol-support/ where you can find information on alcohol support services in your area.

Physical activity:

Being physically active doesn’t necessarily mean joining a gym or going to classes; it just means moving more and finding a form of exercise that will raise your heart rate but where you can still hold a conversation. This can include brisk walking, jogging, downloading an​exercise app to do at home, dancing around your house to your favourite music, or even playing an active computer game.

Physical activity has been shown to improve quality of sleep, reduce the risk of depression and can also improve social skills if the chosen form of exercise involves meeting new people, for instance, joining a rambling or running club. The important thing to remember if you are thinking of starting a new exercise regime is to talk to your doctor to ensure that you are able to do so safely, and remember to take things at your own pace. If you are currently feeling unwell as a result of mental health problems, you may not feel ready to begin exercising and that is okay. It may be difficult when others are encouraging you to exercise, telling you that it will make you feel better but only you can decide that and if you need to focus on other things first, you can start to incorporate exercise into your regime when you are feeling better.

Food and mood:

Regular meals

It is important to eat regularly, with the aim being to have three meals a day with healthy snacks in-between. Your body needs carbohydrates which are broken down into glucose and this is what is used by your brain and all the cells in your body for energy. Your brain uses 20% of all this energy so it is vital to ensure an adequate supply. Carbohydrates are found in foods such as bread, pasta, rice, breakfast cereals and fruit and vegetables and these types of foods should be included with every meal. Lack of carbohydrates can lead to fatigue, dizziness, “brain fog” and feelings of weakness and those following restrictive diets may be at risk of this. It is also important to be aware that once your body has the glucose supply it needs for energy, it cannot use any excess so your carbohydrates should be consumed ideally in the form of wholegrains (eg wholemeal bread, brown rice/pasta, wholegrain breakfast cereal), rather than energy drinks which are not only full of sugar but also contain a whole host of other ingredients such as caffeine. Including a wholegrain based breakfast will ensure that your blood glucose levels are topped up at the start of the day and this may be in the form of a bowl of porridge, wholemeal toast topped with peanut butter or poached eggs or a bowl of cereal such as weetabix or bran flakes.

Tryptophan

This is one of the essential amino acids (the building blocks of protein) that must be consumed in the diet and it is needed to create serotonin. This is an important chemical that is used by the brain to regulate mood, behaviour and cognition, so the more foods eaten that are rich in tryptophan means the more serotonin is available to be used by the brain. Such foods include animal products such as turkey, meat, fish and eggs, as well as a range of plant based sources such as tofu, pumpkin and sunflower seeds, almonds, cashews, pasta and potatoes.

Caffeine

Caffeine is often used to boost concentration and energy levels and initially this may be achieved. However, the more caffeine that is consumed, the more that is needed to achieve the same effect and it can result in the person becoming jittery and unable to sleep and this will then negatively affect not only mood but also food choices as we are more likely to reach for “instant energy” foods such as cakes, biscuits and sweets.​The current NHS guidelines are to keep caffeine intakes below 400mg per day for healthy adults and a maximum of 200mg per day in pregnancy. 400mg is the equivalent of about 4 mugs of instant coffee, but it is important to be aware that this can be consumed in one mug of some coffees sold in high street chains. You can find out the caffeine content of your favourite high street drink on most of their websites. It is also worth noting that there is caffeine contained in cocoa beans, therefore chocolate and chocolate products such as ice cream and chocolate based cereals will contain caffeine.

Vitamins and minerals

If you are following a restrictive diet, or are simply not getting all the vitamins and minerals that your body needs, you may be at risk of deficiency and there are some that are known to have an effect on your mood. The British Dietetic Association (BDA) have produced a food and mood fact sheet that can be accessed here: https://www.bda.uk.com/foodfacts/foodmood.pdf Such vitamins and minerals include B vitamins, such as thiamine, riboflavin, niacin, B12 and folate. A deficiency in B vitamins can result in feelings of depression, irritability and tiredness and food sources include fortified breakfast cereals, fruit and vegetables and animal products.

Iron is an important mineral involved in carrying oxygen throughout the body and is needed for a healthy immune system, the production of energy and mental cognition. A deficiency can lead to you feeling weak, tired and lethargic. Food sources include red meat, poultry and fish, lentils, beans and, fortified cereal. For maximum absorption, avoid drinking tea and coffee with meals and snacks containing iron. Selenium is another mineral that may be linked to negative mood states, such as depression. The body only needs a small amount of selenium daily and this can be achieved by eating one brazil nut. Other sources include meat, fish, seeds and wholemeal bread.

In summary, mental health disorders affect so many of us and although the information here will not prevent or cure, it can help you to make improvements to your diet and lifestyle in order to be able to cope better with things. It is so important to be able to talk about mental health and to seek help when it is needed. Always talk to someone if you are worried about yourself or someone close to you, either a close friend, a family member or a medical professional. Do not ignore it if you feel someone is struggling and do not be afraid to ask them if they are okay; sometimes that is all that is needed to open up communication. There should be no stigma involved in mental health and there should always be support there when it is needed. Please visit: https://www.mentalhealth.org.uk/your-mental-health/getting-help where there is a myriad of information and a page on “Getting help”, with a list of contact details of services and organisations who can offer help and support directly.