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Authors: Charles Spender

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In the same experiment, a low-protein diet (10% casein by calories) did not change the level of activity of the rats, but it did reduce the level of dopamine in the striatum [
329
]. This observation points to a possible dysphoric effect (lowering of mood by a low-protein diet). Additionally, there is a growing body of evidence of the important role of dopamine in depression [
467
,
468
]. For example, mutations in dopamine-related genes occur more frequently in people who are prone to depression. Electroconvulsive therapy, which is a highly effective antidepressant treatment, increases the release of dopamine by neurons in the brain [
469
]. The above observations suggest that a low-protein diet may contribute to symptoms of depression. A high-protein diet produces changes that are consistent with an antidepressant effect in laboratory animals.

The $64,000 question is whether a similar high-protein diet can have an antidepressant effect in humans. Existing studies on humans are inconsistent. High-protein diets containing large amounts of cooked meat can worsen mood in healthy subjects [
110
,
111
,
114
-
117
], but may improve mood in obese subjects [
277
]. Nobody studied the effects of the Atkins diet on patients with clinical depression. According to my personal experience, this diet does not have antidepressant properties and may have negative effects on a depressed person. The Atkins diet (a low-carb diet) can lower mood to some extent during the first few days of the induction phase, but afterwards mood becomes normal. In contrast, a diet that contains a
normal
amount of carbohydrates and large amounts of cooked red meat, in my experience, worsens mood gradually. These are effects on normal mood. If I feel depressed, the Atkins or any other diet containing large amounts of cooked meat tends to make me even more depressed. One study showed that the Atkins-type diet caused a relapse of symptoms of anxiety in a patient who has been in remission [
118
]. We saw in the previous section that these negative effects on mood may have to do with the small amounts of mutagens that are always present in cooked meat and fish. Therefore, a high-protein diet should contain no muscle meats in order to have antidepressant properties.

Pasteurized dairy contains no mutagens and is a suitable source of protein of good quality (better than plant protein). We saw in the previous section that raw nuts tend to lower mood (the mechanism is unknown), and therefore they cannot serve as a source of protein for a prospective antidepressant diet. Cereal grains, such as wheat, are a good source of protein, but cooked grains contain small amounts of Maillard reaction products, which may explain the sedative effect of this type of food. Sedative drugs are usually a bad idea for depressed patients. On the other hand, raw water extract of wheat (or other whole grains) is free from Maillard reaction products. Consequently, the wheat extract (
Appendix I
) can be a good source of protein for the prospective antidepressant diet.

This brings us to the “
antidepressant diet
,” which we discussed a few times in earlier chapters. It consists of:

 

  • 25-75% (by weight): pasteurized low-fat milk, kefir or buttermilk and unsalted unprocessed cheese;
  • 0-40%: raw water extract of wheat (buckwheat or oats will do); if this diet excludes water extract of grains, some people may need to take
    dietary fiber supplements
    with each meal that contains large amounts of cheese;
  • 10-25%: fruits and vegetables or juices that are free of additives.

 

People allergic to cow milk may consider using goat milk instead, and lactose-intolerant people may consider special lactose-free dairy. The antidepressant diet is safe and belongs to the category of raw high-protein diets. (We saw in Chapter One that chemical differences between raw and pasteurized milk are negligible, whereas the latter is safer.) Juices can be pasteurized and fruits and vegetables can be cooked by boiling or steaming (this includes boiled potatoes). The diet does not allow nuts, cooked grains, legumes, and any artificial ingredients (food additives, dietary supplements, seasonings, salad dressings, junk food, etc.). If you are taking any medication, you need to continue taking the medication after discussing the safety of this diet with a qualified health care professional.

Low-fat milk or the related dairy products should not contain artificial vitamins or added calcium. You can overdose on these dietary supplements with the amounts of dairy present in this diet. A grown man can drink up to 4 liters (a gallon) of milk or cultured milk per day; the amounts are smaller for women. The staple food in this diet consists of unsalted unprocessed cheese mixed with low-fat cultured milk (buttermilk or kefir) and sweetened with fruit juice if necessary. An antidepressant diet based on milk and excluding cheese is also possible. You can add wheat extract, raw, boiled or steamed fruits and vegetables to each meal without restrictions.

In the context of this unbalanced diet, (uncultured) milk can cause abdominal pain or discomfort (upset stomach) if you consume it in the same meal with other foods. The best way to consume milk is to drink it on an empty stomach 30 minutes before a meal. In the context of balanced diets (such as the modified high-protein diet and the diet recommended by food pyramids) milk does not cause any problems. If you use the antidepressant diet frequently, then you may stop having problems with milk, regardless of how you consume it.

The definition of a high-protein diet is a diet that provides more than 0.8 grams of protein per kilogram of body weight per day. The antidepressant diet described above provides the amount of protein around 1.0 g/kg. Increasing the amount of cheese in this diet will increase the amount of dietary protein further. An antidepressant diet based on high-fat dairy also works. The wheat extract is optional, but it will make the diet more balanced and it seems to prevent mild physical fatigue that may result from high consumption of dairy.

I am a healthy subject who has never had a diagnosis of a mood disorder, although I have had undiagnosed episodes of depression. Nowadays, I can become depressed once or twice a year. These episodes fulfill the diagnostic criteria of a major depressive episode [
340
], except the duration is always less than one week. An official diagnosis requires the duration of at least two weeks.

First, we will take a look at the effects of this diet during a normal mental state. This diet does not change internal mood or activity level. Physical fatigue may increase slightly. The antidepressant diet based on raw dairy (not safe) has the same effects on me and does not offer any significant advantage. When I am on the antidepressant diet, the work capacity is good in general and attention control is good. Social interactions become easier, and solving day-to-day problems also becomes easier. These effects may take 2-4 days to manifest themselves. There is a tendency for procrastination in regards to writing tasks. This diet may increase sweating. One may have to take showers more frequently (warm showers) and change clothes several times a day. Washing under arms with soap several times a day also helps. Antiperspirants can leave stains on clothes but are also an option. Another possible side effect is the feeling of heaviness/fatigue in the legs. You can reduce this problem by means of cold showers for the legs, if you use this procedure several times a day.

Because the antidepressant diet cannot elevate normal mood directly, it carries a
low
risk of hypomania. Nonetheless, internal mood may become elevated as a result of a significant positive event, in which case you need to discontinue the antidepressant diet. In most cases, hypomania is an undesirable mental state that you need to avoid.
One or more
of the following signs and symptoms can serve as a signal that you may be having a hypomanic episode: a persistent feeling of euphoria or excitement; the need for sleep dropped below 5 hours a day; the activity level increased to unusual levels, so that you are constantly moving about, pacing the room or unable to relax and sit still; argumentativeness and low self-control; flood of ideas or racing thoughts; grandiose ideas or plans (nondelusional); excessive libido; and hyperhedonia. These criteria are based on my own experience (a healthy subject without a history of bipolar disorder). They are different from the diagnostic criteria for hypomania in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) [
340
]. Criteria in the DSM-IV-TR serve the purpose of diagnosis of bipolar disorder, whereas the above criteria are designed to detect hypomania in a healthy person who is leading an overly stimulating lifestyle. Nonetheless, the DSM-IV-TR criteria may serve the latter purpose too. If you have a history of depression or bipolar disorder, you need to see your doctor if you suspect that you are having a hypomanic episode. If you do not have a history of mood disorders, my advice is to switch to the depressant diet. Also stop using cold and hot hydrotherapy (Chapter Two). A hot environment (Chapter Two) can help to calm down and will be beneficial; hot hydrotherapy will not be helpful. In most cases, the state of hypomania is undesirable because it can lead to foolish business deals, excessive spending, overly optimistic decisions, and activities that have a high potential for painful consequences [
340
]. In rare situations, this mental state can be beneficial as we will see in the next section.

When I feel depressed, the antidepressant diet has a rapid beneficial effect, in that it can normalize internal mood within 2 to 3 days. Noticeable improvements can materialize already on day one. The combination of the antidepressant diet with cold or hot hydrotherapy (Chapter Two) is even more effective. (In my experience, adapted cold showers are beneficial, whereas sudden cold showers are not effective when mood is depressed.) The following regimen works well: an adapted cold shower in the morning (can include an optional head-out hot shower), the same in the afternoon, and a head-out hot shower at night.

As for the scientific evidence, some studies show that dairy products can improve mood [
865
,
898
] and that depressive symptoms correlate with low consumption of dairy [
829
,
859
]. One study shows that a milk protein called lactalbumin causes a pronounced increase in the synthesis of serotonin in the brain [
835
]. These data support the effectiveness of the antidepressant diet proposed in this book. The beneficial effects of this diet involve both biological and psychological effects. This diet improves mental clarity, and I start seeing solutions to depressing problems. As a result, the mood improves due to psychological factors: the reduced amount of negative life experiences. (There are several studies showing that increased consumption of fruits, vegetables, or dairy correlates with better cognitive abilities [
838
,
876
,
892
,
899
,
901
,
940
], including one randomized controlled trial [
887
].) This diet has a positive effect on internal mood, i.e. how a person feels mentally, but the effects on external mood (
observable positive affect
) are inconsistent and unpredictable. In particular, this approach may make a person less joyous and less emotional outwardly or less talkative in some situations and more talkative and joyous in others. My personal view is that external mood is irrelevant, whereas internal mood is important for subjective well-being. Based on my personal experience, the antidepressant diet is effective in mild and moderate depression but may not be effective in severe depression. On the other hand, a raw high-protein diet based on raw meat has stronger antidepressant properties. It is effective in severe depression, according to my latest experience in May of 2011, as described at the end of
endnote D
. As mentioned earlier, this ancestral diet is not safe because it carries a risk of infectious disease.

Nobody has proven the effectiveness of the antidepressant diet in clinical trials. Yet the theory presented above and my preliminary data suggest that this diet should be useful as an antidepressant therapy. If you have a diagnosis of depression or suspect that you are clinically depressed, it is best to seek professional help instead of experimenting with unproven remedies. If some patients who are reading these lines wish to try the antidepressant diet, this diet is most likely compatible with conventional antidepressant treatments, such as pharmacotherapy and psychotherapy (I have never tried those). Thus, you can use the diet in combination with these two treatments, but you need to talk to your doctor about the safety of this combination. Researchers who wish to test this diet in a clinical trial can use a study protocol similar to the one described in
endnote L
. In this case, it is best to explain to the patients the difference between external and internal mood in order to prevent wrong expectations about this approach. Many classes of antidepressant drugs also have antianxiety effects [
449
]. Therefore, the antidepressant diet should also be effective in some anxiety disorders,
X
if someone organizes clinical trials and proves it to be beneficial in depression.

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