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Mitchell L. Gaynor M.D.
Mitchell L. Gaynor M.D.
Depression

Genes, Depression, and Anxiety

Steering your mood with food

While it’s natural for everyone to feel sad or nervous from time to time, individuals should seek help if they are experiencing profound sadness and intense nervousness for a long period of time. There is no exact science that prescribes either when someone should get over the loss of a family pet or when a person should stop fretting over an impending public speaking gig. In either case, individuals should not allow depression and anxiety to paralyze them.

Often times, what starts off as a few days of feeling sad or anxious can balloon into weeks, months, or even years of depression or anxiety. Without developing the appropriate coping mechanisms that allow you to acknowledge, accept, and manage problems, you are likely to develop anxiety and depressive disorders. Although some people with anxiety and depression can function in the beginning, the symptoms of these disorders will eventually affect their careers, health, and social lives.1,2

Factors that contribute to feelings of anxiety and depression are only the tip of the iceberg. So what’s really going on beneath that humdrum disposition?

Why So Glum?

Although depression is a mood disorder, anxiety is not. Rather anxiety affects your mood secondarily by causing you to worry excessively. Despite depression and anxiety being separate conditions, many of their symptoms—fatigue and decreased energy, sadness and nervousness, poor concentration, and trouble sleeping—overlap. So depression and anxiety occur more frequently together than they do in isolation.3

Of the precipitating factors that cause anxiety and depression, chemical imbalances in the brain is a big problem. Genes that produce mood-enhancing neurotransmitters are switched off by epigenes that are chemical tags serving as an intermediary between genes and the environment. Epigenes have the ability to turn on or turn off gene segments in ways that promote health or facilitate disease. Because of faulty chemical signaling in the brain, neural circuits go awry and lead to depression and anxiety. Which is why many antidepressant and antianxiety medications target certain neurotransmitters (brain chemical messengers). Here are some of the neurotransmitters that affect mental health:

Serotonin (5-HT) has analgesic effects and controls sleep, appetite, and mood. Research shows that 5-HT plays a role in the control of mood, depression, and even suicide.

Norepinephrine is a neurotransmitter that affects the cardiovascular system by constricting blood vessels and increasing blood pressure. It also appears to be involved in motivation and reward. Low levels have been linked to anxiety and depression.

Dopamine, an important neurochemical necessary for movement, affects motivation. It’s also plays a role in the brain’s reward center and may trigger substance abuse issues. In postmortem studies, dopamine levels were significantly deficient in the brains of those who had a diagnosis of severe depression.4

Gene Changes That Modify Your Mood

Epigenes are inheritable and environmentally modifiable tags. This is demonstrated largely in part by studies using identical twins who despite having the exact same genes develop epigenetic variations over the course of their lives.5

Stress is a normal bodily response that is good; it helps us to respond appropriately to danger or motivate us. Yet, when stress is persistent, it can lead to emotional problems such as anxiety and depression. Studies also show that stress can be transmitted transgenerationally through epigenetic changes.6 For example, glucocorticoid receptors (GCR) play a role in regulating stress hormones. And researchers found that depression during pregnancy led to highly methylated GRC genes (methylation is an epigenetic change that silences genes).7 In infants, the increase in methylation resulted in an excessive release of stress hormones in times of stress. These epigenetic modifications occurred in the fetus in response to maternal stress and continued well into the child’s adolescent years. Interestingly, weakened GCR activity has been linked to depression and obesity.

People with major depression disorder (MDD) often suffer from poor sleep and now researchers have made progress in figuring out why this happens. By examining the human brain tissue of non-depressed and depressed individuals, researchers were able to identify that the circadian-related genes were disrupted in the brain tissue of those who had a diagnosis of MDD.8 Using gene expression activity in the tissue, the scientists predicted the time of death (TOD) for depressed and non-depressed people and compared the time to the actual time of death. While the TOD was accurately estimated in those without depression, the time in those with depression was significantly off. In fact, the circadian rhythmic genes exhibited nighttime patterns in the daytime and vice versa.

Boost Your Mood

Poor sleep and stress are risk factors for depression and anxiety. But food, however, can vastly improve mood. In my latest book, The Gene Therapy Plan, which is scheduled for release in April 2015, I offer healthful dietary tips to elevate mood and control anxiety. These tips are backed by science-based medicine that I've been using for over 20 years to treat my patients. The following are some foods to elevate your mood:

Watermelon, which ranks 34 out of 51 fruits and vegetables listed on the Environmental Working Group’s (EWG) pesticide list, contains loads of vitamin B6—a nutrient involved in regulating mood and sleep.

Apples rank No. 1 on the EWG list; however, you shouldn’t forgo eating them. Apples contain a compound that is an essential anti-inflammatory agent and helps to maintain healthy brain function—quercetin. Whenever feasible, opt for organic fruits and vegetables. If buying organic produce isn’t always an option for you, don’t skip out on eating fruits and vegetables. Instead take special care in washing any fruit and vegetable you buy.

Eggs are a good source of protein and contain amino acids that produce dopamine.

Omega-3 fats, a protector of heart health, have been shown to improve depression and anxiety. Coldwater fish (e.g., cod, salmon, and haddock) and seeds (e.g., pumpkin seed and flaxseed) are great sources of omega-3 fats.

Honey increases insulin. The hormone allows tryptophan—an amino acid in certain foods that promotes sleep and relaxation—to enter the brain readily.

Asparagus is a good source of folate. Low folate levels have been linked to depression. Alternatively, try these other folate-rich foods: spinach, turnip greens, broccoli and Brussels sprouts.

Green tea contains mood-boosting phytochemicals such as theanine, which has a calming effect and promotes concentration and focus.

Turkey contains tryptophan; it’s an amino acid involved in the production of melatonin and other sleep-related chemicals in the body. Other sources of tryptophan include chocolate, chickpeas, and chicken.

Vitamin D3 enhances mood and energy. Low vitamin D levels aren’t that uncommon. Because sun exposure is the best way to get vitamin D, this becomes increasingly more difficult during the months in which daylight is less. Foods that contain vitamin D are eggs, mackerel, salmon, and tuna. Since most people are deficient in vitamin D, ask your doctor to check your levels.

Other mood-enhancing activities include physical activity and meditation. Next time you’re feeling stressed, depressed, or anxious, try going for a walk or hike, socialize with friends or family, get lost in a hobby, or soak in a nice warm bath.

References:

1. Mendlowicz MV, Stein MB. Quality of life in individuals with anxiety disorders. The American journal of psychiatry. 2000;157(5):669-682.

2. Wells KB, Stewart A, Hays RD, et al. The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. Jama. 1989;262(7):914-919.

3. Bakish D. The patient with comorbid depression and anxiety: the unmet need. Journal of Clinical Psychiatry. 1999.

4. Dunlop BW, Nemeroff CB. THe role of dopamine in the pathophysiology of depression. Archives of General Psychiatry. 2007;64(3):327-337.

5. Fraga MF, Ballestar E, Paz MF, et al. Epigenetic differences arise during the lifetime of monozygotic twins. Proceedings of the National Academy of Sciences of the United States of America. 2005;102(30):10604-10609.

6. Pembrey M, Saffery R, Bygren LO, et al. Human transgenerational responses to early-life experience: potential impact on development, health and biomedical research. Journal of medical genetics. 2014:jmedgenet-2014-102577.

7. Radtke KM, Ruf M, Gunter HM, et al. Transgenerational impact of intimate partner violence on methylation in the promoter of the glucocorticoid receptor. Transl Psychiatry. 2011;1:e21.

8. Li JZ, Bunney BG, Meng F, et al. Circadian patterns of gene expression in the human brain and disruption in major depressive disorder. Proceedings of the National Academy of Sciences. 2013;110(24):9950-9955.

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About the Author
Mitchell L. Gaynor M.D.

Mitchell L. Gaynor, M.D., is a clinical assistant professor of medicine at Weill Cornell Medical College.

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