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STUDY: Mediterranean diet more effective in fighting depression than befriending in young men

Interesting study from scientists at the University of Technology Sydney, published in the peer-reviewed, American Journal of Clinical Nutrition.

Here’s the gist:

A group of young men (18-25 years old) took part in a 12 week trial, to look at the effectiveness of the Mediterranean Diet in treating symptoms of moderate to severe depression.

This kind of study is tricky, because it’s difficult to know what the placebo effect is.

After all, you can’t blind participants.

They know they’re eating a Mediterranean Diet, and the control group knows it’s not.

So the placebo effect is particularly acute in studies re: mood and diet.

However, the researchers did create a control group — one receiving “befriending therapy,” which is a type of social support.

Researchers found that, at the end of the 12 weeks, the MD group scored significantly better on quality of life measures and showed reduced symptoms of depression, compared to the placebo group.

In other words, the study suggests that the Mediterranean Diet is superior than befriending social support at reducing symptoms of depression and improving quality of life.

That’s the finding.

News Atlas has a really nice review of why the Mediterranean Diet might theoretically improve mood, and of course, it’s part of the growing trend of nutritional psychiatry.

However, keep in mind, that this study cannot say: “The Mediterranean Diet is likely to reduce symptoms of depression in young men.”

It is, in comparison to befriending social support therapy.

The Mediterranean Diet, though, does seem to have enormous health benefits and potential benefits for mood.

However, it’s so difficult to control for the placebo effect re: mood.

I strain to mention that because a) it’s important to be rigorous and a lot of headlines are running with “It reduces depression in young men!” which is disingenuous and b) if you’ve tried the MD, and it hasn’t helped, I want to say you’re not alone.

For some, it seems to really help. For others (including myself), I’ve found little difference.

But I do use tons and tons of olive oil, personally. Just for my health in general and because it’s delicious. And I fish it up, whole grain it up, and eschew processed foods when possible. Just because it’s healthy (But of course, always talk to your doctor about any diet).

[Painting: Olive Trees, Dali. Note the town of Cadaques, Spain yonder, where Dali lived in summer and a source of inspiration throughout life. And, accordingly, a popular pilgrimage of artists of every kind].

May 10, 2022

Vora: Listen to your anxiety

written by Christian Heinze

I’m currently enjoying Dr. Ellen Vora’s new book, The Anatomy of Anxiety, so much that I’m going to be quoting a lot from it in the coming months.

Near the beginning of her book, she talks about our desire to crush, soothe, to immediately rid ourselves of anxiety when it props up.

But sometimes, instead of shutting it up, we need to listen to it — particularly if it’s telling us something about ourselves.

Vora writes:

“When our lives don’t align with our values or capabilities, we can feel anxious — but this feeling can also serve as a critical indicator that we need a course correction.

…. maybe you are working in a job that fit your life when you were younger but now feels as if you took a wrong turn along the way; or you might feel unable to sit idly by as the planet continues to heat up and sea levels precipitously rise.

Whatever the issue, this is your body’s way of telling you, Please look at this.

When you listen closely, this anxiety can point you in the direction of actions you need to take as well as the unique contribution you are here to make.

…. I tell my patients that they should embrace these feelings rather than trying to suppress or avoid them.

Instead of asking, How can I stop feeling so anxious?, we should be asking, What is my anxiety telling me?

It is natural to reflexively resist this uncomfortable feeling…..but when we do this, we can miss out on critical guidance.

What if you could learn to tolerate your anxiety long enough to hear what change is necessary?

What if instead of fearing and fighting true anxiety, you invite it in and hear what it has to say?”

In her book, she distinguishes between “false anxiety” and “true anxiety,” even while admitting there are many forms that don’t fall neatly into those two categories.

False anxiety can be punishing and dreadful, and don’t let the term “false” fool you.

There’s nothing fake about the symptoms.

She simply means that, in her framework, “false anxiety” rises from a physiological level.

It can be enormously complicated, but as simple as drinking too much coffee and suddenly feeling anxious about everything.

In that case, you certainly feel terribly anxious, but it’s arising from a physiological imbalance.

However, “true anxiety” (as she calls it) has a message about your life that’s beyond the physiology of your body, and it’s important to pay attention to what it’s telling you.

I think about Frederick Buechner’s description of “unexpected tears.”

We all cry at the loss of a loved one, but there have been times when I’m talking about something fairly pedestrian, and begin to shockingly choke up.

I had no idea I’d start crying before I said it, and yet there they are — the “unexpected tears.”

I’m certain you’ve had the same experience.

Buechner writes: “Whenever you find tears in your eyes, especially unexpected tears, it is well to pay the closest attention. They are not only telling you something about the secret of who you are, but more often than not, God is speaking to you through them of the mystery of where you have come from and is summoning you to where, if your soul is to be saved, you should go next.”

So the “true anxiety” of which Vora writes, and the “unexpected tears” that Buechner points to, can be enormously useful.

Horribly difficult, yes, particularly the anxiety portion.

But as I’ve been reading Vora’s book, I’ve been making a conscious effort to try to figure out what my anxiety is telling me beyond “IT’S TERRIBLE TO FEEL THIS WAY,” and ask, “But why am I?”

Sometimes, I can find a reason, other times, not. But it’s been useful.

Finally, on the topic of anxiety, I’d suggest this helpful new read from Dr. John Cottone, where he explains four types of anxiety: “situational,” “biological,” “psychological,” and “existential.”

He suggests that each requires a different form of care, and which type of therapy is particularly helpful.

April 25, 2022

Nouwen on our fear of death

written by Christian Heinze

Henri Nouwen, writing in The Inner Voice of Love (emphasis added).

“You are still afraid to die. That fear is connected with the fear that you are not loved.

Your question, “Do you Love Me?” and your questions, “Do I have to Die?” are deeply connected. You asked these questions as a little child, and you are still asking them.

As you come to know that you are loved fully and unconditionally, you will also come to know that you do not have to fear death.

Love is stronger than death; God’s love was there for you before you were born and will be there for you after you have died.”

Amen.

Think about that, over and over: “God’s love was there for you before you were born and will be there for you after you have died.”

Maybe you’re not afraid to die.

I am.

“But why? Don’t you believe in Christ, salvation, our resurrection, his love.”

Yes.

But I also have a depressive, pessimistic temperament, and an OCD and anxiety that leads me into relentless and self-destructive spiritual reflection.

The Good News? Really?

Our mental health battles can absolutely lay waste to any confidence or joy in our faith. They just can.

“Lord, help thou my unbelief” is a daily prayer.

And as Nouwen notes, we even asked this as a child: Am I really loved?

That’s all a child wants to know, and that’s all an adult wants to know.

And no matter how long we’ve been a Christian, we still ask ourselves: “Can God really love me?”

You and I know the answer, and we know the verses, and how the game of “encouragement” is played at church and how we feel forced to nod that “Yes, I’ve finally got it!’, and yet our minds are plagued by depressive feelings of worthlessness that imagines any kind of love for us, unimaginable.

But that’s our depression, not the Holy Spirit or Jesus, talking to us, lying to us, trying to talk us to the ground.

As Nouwen writes: “God’s love was there for you before you were born and will be there for you after you have died.”

Hold onto that. Hold onto Christ.

Oh, and even if you stop holding, he’ll hold you. Always and forever. Just as you would your own beloved child.

April 22, 2022

STUDY: Even just a small bit of exercise reduces depression risk

written by Christian Heinze

A new meta-analysis, published in JAMA, found — once again — that regular physical exercise reduces the risk of depression.

Haven’t I posted a million such studies?

Yes.

But here’s the key take-home.

People who experienced the greatest benefit were those who went from NO exercise to small doses.

For example, going from 0 walks to 1.25 hours, total, of brisk walks/week substantially lowered the risk of depression.

There was even more improvement for those who upped that number to 2.5 hours, but the greatest gain was that transition from couch potato to “Person who at least walks.”

Interestingly, if you exercised over the CDC’s recommended levels, you got no additional benefit.

To frame this in the context of another discipline (finance), the Return on Investment of Doing a Little Exercise is far greater than the ROI of being Gym Bro.

If you want more information on why exercise helps fight depression, Harvard Health has a nice read on it.

(P.S. Regarding the painting, you wouldn’t naturally think of these two nobodies as exercising, but according to studies, just moving from the couch to walking like these nobodies would help

And that’s the point. It’s a really easy thing to do, but oh I know — do I ever — that when you’re depressed, you don’t even care about feeling better. So it’s not that easy to do when depressed. But it is. But it’s not. You get it).

April 22, 2022

“Lighten our darkness”

written by Christian Heinze

N.T. Wright, in his book Surprised by Hope, quotes this Anglican prayer, which is for all humans, and maybe people like you and me need to say it more than the others.

Lighten our darkness, we beseech thee, O Lord;

and by thy great mercy

defend us from all perils and dangers of this night;

for the love of thy only Son,

our Savior Jesus Christ. Amen.

Yes.

I especially like:

“Defends us from the perils and dangers of this night.”

You and I have faced many nights where the dangers are entirely in our minds, and yet they are as real as though a marauder were at our doorstep, ready to rob us of everything, including our lives.

This isn’t the insomnia of “How can I face work tomorrow?”

It’s the insomnia of “How can I face a sun tomorrow that so many are thrilled to see, yet for me, it’s just another day to remember a night is coming? What is wrong with me? God, why won’t you just make this a little easier? It would be better for everyone. Not just me. But everyone. Why don’t you want this? Everyone does.”

And you can’t sleep, but a dream is all you want, because at least a dream is elsewhere.

For us, these are the dangers and the perils of the night.

“Pray like David on these nights,” someone might tell us.

Well, which prayers of David?

Because he found both refuge in God, at night, and sometimes, complete bewilderment and agony while talking to him.

For the dispositionally positive Christian, it’s awfully easy to forget that the Bible is full of lament from the saints, questions that aren’t resolved.

Cherry-picking the encouraging verses and forgetting the inexplicable “why’s” might make us feel better for a moment, but they don’t truly satisfy, because we always come back to the “why’s,’ because we are human.

And the Bible is aware of our humanity, and that’s why it’s not a Hallmark movie (ugh), but a book filled with desperation, love, death, stuff we can’t explain because it’s so depressing, and stuff we can’t explain because it’s so beautiful — in short, everything we know that is true about human life.

If the Scriptures promised total peace, the answer to every question, and unmarred joy on earth, why would we need a heaven?

So until then, we pray, “Defends us from all perils and dangers of this night.”

And until then, we also look for professional help with our condition, as well.

So…

Find a psychiatrist here.

Find a therapist here.

If you’re having thoughts of harming yourself or others, please call the National Suicide Lifeline at 1-800-273-8255.

[Painting: Virgil’s Tomb by Moonlight, Joseph Wright of Derby]

April 18, 2022

The tragedy of calorie counts on restaurant menus

written by Christian Heinze

Amy Jones has a terrific read on the UK’s new policy to require that restaurants and cafes with more than 250 employees put calorie counts on their menus.

The plan, of course, is to fight obesity, which is associated with a plethora of medical problems.

The question is — will this initiative accomplish its intended goal?

The clearest evidence, Jones notes, that this policy is ineffective comes from a large, longitudinal study in the United States, which suggested that most people don’t change what they eat, or the portions they consume, based on calorie counts in restaurants.

In other words, it doesn’t seem to help with the obesity problem.

In fact, Jones suggests that it’s more likely that it will exacerbate eating disorders.

A BEAT survey of individuals with experience of eating disorders found that 93% thought that calorie labelling on menus would have a ‘negative’ or ‘very negative’ effect, with some respondents arguing that, even for those without diagnosed disorders, such labelling risked encouraging obsession over calories and anxiety around eating.
This belief is borne out by the data. A recent study found that 1 in 10 dieters who calorie counted became bulimic, with participants admitting to behaviours such as skipping eating for days after a ‘binge’, eating ice and misusing laxatives. Such negative effects aren’t just limited to anorexia and bulimia — for those with binge eating disorder, the inclusion of calorie counts on menus has actually been found to increase calories consumed.

So there’s the theoretical and empiric case against mandating calorie counts on menus.

For the anecdotal perspective, you can read this account from a school teacher whose anorexia has been made worse by the new policy.

She tells The Mirror:

“I think everybody in recovery struggles to go out as it is, and I think they push themselves to go out and gain that love of food back.
“But if the topic of conversation is now going to be calories and comparing what people are eating, it’s just going to set so many back Now I’m scared to go out for meals.”

The long story short — calorie counts will probably affect only one portion of the population: the ones who need to stop counting calories.

Eating disorders are the most dangerous psychiatric conditions.

Physically, they can be acutely dangerous, leading to numerous health problems, including ultimately organ failure.

And their affect on mental health is similarly tragic.

According to one study, an individual with anorexia nervosa is 18x more likely to die by suicide than other individuals in their cohort.

And roughly 20% of anorexia victims take their own life, in response to their disease.

Those numbers are staggering (and other eating disorders can be nearly as deadly).

Unfortunately, calorie counting is so deeply embedded in the population’s consciousness that measures promoting it are still ubiquitous.

And, now, the UK is upping the ante.

This, despite the fact that calorie-counting has been proven to be both ineffective and dangerous in battling obesity.

In 2020, Harvard Health put forth an urgent plea to “stop counting calories.”

I worry that the growing medical consensus (and evidence) that counting calories is dangerous will be branded “woke,” and ignored my massive swaths of the population.

Swaths that are oblivious to the tragic consequences of eating disorders.

However, I am encouraged that a growing number of nutritionists are pointing out the dangers of calorie counting.

If you or anyone else you know struggles with an eating disorder, The National Eating Disorders organization has a tremendous team that can help support you in both acute crisis and set you on the path to healing.

April 13, 2022

Raymond Carver’s tombstone

written by Christian Heinze

If you walk by the great poet and short story writer’s tombstone in Port Angeles, Washington (or, more easily, see it on Google images), you’ll find inscribed his poem, “Late Fragment.”

“Late Fragment“, Raymond Carver

And did you get what
you wanted from this life, even so?
I did.
And what did you want?
To call myself beloved, to feel myself
beloved on the earth.

Some are so fortunate, others not.

And when you or I fall into our funks, it’s easy to question everything good, and certainly, to feel “beloved” is the greatest good there is.

A few things on that.

First, I’d recommend this read by Janna Lim on the relationship between pessimism and depression.

They’re not the same thing, but certainly associated with one another, and very often, our pessimism — the thing that keeps us from allowing us to feel beloved — stems from childhood.

A “pessimistic attributional style” develops where we expect that “the happy moments won’t last long and negative events will return.”

My favorite “pessimistic attributional style” song is “Miserabilism” by the Pet Shop Boys.

It seems to me
There’s something serious beginning
A new approach found
To the meaning of life
Deny that happiness
Is open as an option
And disappointment
Disappears overnight
Say that love
Is an impossible dream
Face the facts
That’s what it’s always been
Relax
What you see is what you see
And what you get
Is a new philosophy

Fun song, huh?

Sometimes I quote the lyrics to a friend and they say, “Well, that’s miserable,” as if they’ve never thought of it, and it’s somewhat astonishing to me because I feel I’ve known those words since before they were written.

Psychology Today has a very interesting read on pessimism, and it’s a complex topic that tends to run with depression, but there’s something called “depressive realism,” and I think that’s what “Miserabalism” is getting at.

In my circle of depressed friends, we often use our “depressed realism” as a coping mechanism for the fact we do live in a world where happiness and pain seem to come and go with brutal indifference.

Acknowledging that is okay for me, fixating on it is not.

Because “depressed realism” can quickly become “deep depression,” and that’s when we don’t even recognize the moments of happiness and if we, by odd chance do, we don’t trust it.

We almost run from it, because we see the end of it before the end of it comes.

And this all comes back to the point of feeling “beloved” and the remarkable armor it provides.

To feel “beloved on earth,” as Carver wrote, is beyond anything you will find on earth, and to feel truly beloved must come from an unconditional love, and time itself is often the only proof of it you’ll find.

When Jesus says to forgive one another, 70×7, he’s urging us to a) offer unconditional love, but only because b) we’re his disciples, and that’s what he gives us.

Jesus would never call us to love in a way he doesn’t.

And so when I find my wife forgiving me, over and over, for the same sins that exhaust us both, but never seem to exhaust her love, that’s when I can somehow believe that kind of love is possible from God.

And that’s the kind of disciples Jesus wants us to be. The ones that prove his love is possible.

And that’s why I always go back to quoting authors like Brennan Manning and Henri Nouwen, who are merely quoting Christ and the Scriptures when they relentlessly note that we are eternally, unconditionally, forever “beloved” by Christ.

John Eagan writes: “The basis of my personal worth is not my possessions, my talents, not esteem of others, reputations, not kudos of appreciation from parents and kids……I stand anchored now in God before whom I stand naked, this God who tells me ‘You are my son, my beloved one’.”

God would not have sent his son to die for you, if he did not love you as deeply as his own son.

That’s the Good News and it seems so good that we often find it the “Too Good To Be True News.”

It is so hard for depressed people to accept they are beloved by anyone or anything — let alone the God of the universe.

I sometimes pray to God, “You know I don’t really believe you love me, but please love me nonetheless.”

And he does.

Imagine your child, for a second.

Let’s say he’s depressed and doubts you and everyone else’s love. Does that affect how you feel about him?

No, in fact, if anything it makes your heart break and long for your child’s happiness more than anything, because you love them so much.

You can see their pessimism and depression getting in the way of that, and it doesn’t make you say, “Fine, if you don’t believe it, then guess what, I DON’T love you!”

No! That’s not how it works in a parent-child relationship.

A good parent loves their child no matter the child’s misconceptions, brought on by their depression or pessimism.

If we don’t see ourselves as beloved by God, we are still as beloved as Christ himself.

I don’t know if I’ll ever be able to believe that here on earth.

But I’m guessing that once this earth is over, Christ himself will stand with me, overlooking paradise and say simply with a smile, “See?”

And I’ll finally see Revelation 21:4, not as a collection of words or a painting that’s impossible to reach, but I’ll be in the painting myself.

“There will be no more death or mourning or crying or pain, for the old order of things has passed away.”

And then I’ll see just how beloved I was all along.

You will, too.

God will prove the pessimist in us wrong, just as he did at every turn while on earth.

April 11, 2022

Genetically similar children more likely to have anxiety, depression

written by Christian Heinze

University of Queensland researchers have finished studying the genetics of 64,641 children, ages 3-18.

And yes, that’s the largest such study in the world.

What did they find?

Well, you can read Neuroscience News’ rundown, but here’s their money sentence:

“Children who had similar levels of anxiety and depression were also alike, genetically.”

Further, the researchers noted that these genetics often overlapped with adults who had depression and anxiety in previous studies.

In other words, this supports the multitude of research that seems to be continually finding specific genes associated with depression and anxiety.

In fact, as far back as 2013, researchers had pegged at least 11 genes that put individuals at an increased risk of developing anxiety disorders.

A 2016 review suggested that panic disorder, social anxiety disorder, and generalized anxiety disorder were all linked to specific genes.

And a 2019 study found that PDE4B variants were associated with stress-related and anxiety disorders.

I could go on, and on, and on….. because every year, multiple studies find new genes associated with the etiology of psychiatric disorders.

In keeping with the caps-lock nature of genes, I will say this…

None of these genes are named the YOU ARE DEPRESSED BECAUSE OF A LACK OF FAITH gene.

Or, the YOU ARE ANXIOUS BECAUSE YOU DON’T JUST ‘GIVE IT TO GOD’ ENOUGH gene.

You’re not responsible for your genetics, and yet your genetics are roughly 40% responsible for your anxiety disorder (that’s the current estimate, although some studies suggest it’s as high as 67%).

The point is — if a Christian shames you for your anxiety or depression, remind yourself: You’re not responsible for your condition.

We are, however, responsible for how we react to that shaming from Random Happy Exhorting Christian.

They are obliviously cruel in pinning your condition on something else. But that’s on them.

We don’t get to choose our genetics, but we can choose how we react.

I will often tell people about these studies, but if they dismiss it as “fake, secular science,” then it’s time to remember that the Proverbs has a lot to say about shutting up when it’s clear someone doesn’t want to hear the truth.

And so we move on, and an estimated 25% of Christians with mental health conditions will move on to a different church because they feel so misunderstood at their own.

It’s no longer a place of worship. It’s a place where they feel worthless.

But God knows the truth.

And think of that phrase, again, “God knows.”

He knows all about the genes the scientists do, and the million more they haven’t found, and he knows how hard it is for you to do the “easy” things, because you just weren’t wired the way your Exhorting Christian Neighbor was.

One more thing.

I often think of the shared suffering of the thief on the cross and Christ.

Only they understood the agony of the afternoon, and in that shared suffering, they talked of paradise together — the way two soldiers often talk of home during the worst of times.

Jesus knows, and you know the agony.

And sometimes, that’s all I need to know to keep going.

Find a psychiatrist here, via Psychology Today.

Find a therapist here, via Psychology Today.

[Photo: The PDE4B gene, via EMW, Wikipedia]

April 10, 2022

Holistic psychiatrist talks about blood sugar spikes and anxiety (and more)

written by Christian Heinze

Dr. Ellen Vora has a new book out, The Anatomy of Anxiety: Understanding and Overcoming the Body’s Fear Response,” and CNN has a great new interview with her.

I’d highly recommend reading the whole interview, but here’s an interesting take from Vora on the relationship between our anxiety and blood sugar.

And note: she’s got major academic cred, with a B.A. from Yale and M.D. from Columbia.

Vora:

Oftentimes, I like to start with stabilizing blood sugar because it has such a quick impact on our day-to-day anxious feelings.
The modern American diet is built on a foundation of refined carbs and milkshakes disguised as coffee drinks.
We end up on this roller coaster of blood sugar spikes chased by insulin, followed by blood sugar crashes that can feel identical to anxiety.
Stabilizing blood sugar offers powerful relief from both anxiety and the sense of doom and unease that many people carry in the pit of their stomach.
The definitive solution, to eat a blood sugar-stabilizing diet with fewer refined carbohydrates and more protein and healthy fats, is a lovely strategy.
But if that’s 180 degrees from how you’re eating now, here’s a short-term fix: Every few hours, eat a spoonful of sunflower, almond or other nut butter, ghee or coconut oil.
This creates a safety net that can blunt any blood sugar crash. Many patients have told me this intervention alone stopped their panic attacks.

There’s all sorts of other interesting stuff in the interview (And I should note that her book is #1 on Amazon right now for depression).

For example, we’ve all heard about how animals go into fight-or-flight in response to anxiety, and so do we.

But she also notes that animals have certain rituals once the stressful event has subsided — to help them ease back into their, um, animal-routine.

For example, she says an antelope shakes after it’s chased, and a goose flaps its wings in a certain way after its trauma.

We’ve all seen that in those nature documentaries.

Yet after a panic attack, what do we do?

Wouldn’t it make sense to find something equivalent to the goose flapping its wing?

I’ve probably lost cynical folks with that. But it makes, sense, no?

Every person is different, so every one might have their own flap, and I love that sentence.

Anyhow, again, it’s a great interview.

Now… if you’re a regular reader, you know that I’m completely and utterly grateful and dependent on medication for treatment.

But I also know exercise has helped me, mindfulness meditation is helping, and many other things that come from the holistic wing of the medical world.

Also, every person is different, so talk to your doctor for help, first and foremost.

Oh, speaking of which.

Find a psychiatrist here, via Psychology Today.

Find a therapist here, via Psychology Today.

And find spiritual salvation here, via the words of Christ: Jesus: “I am the way, the truth, and the life. No one comes to the Father except by me.”

If you’re having thoughts of harming yourself or others, please call the National Suicide Lifeline at 1-800-273-8255.

April 8, 2022

Things have been really busy

written by Christian Heinze

Hi all, I haven’t posted in a few weeks.

Family sickness, and starting the process of moving into a new place — on top of all the familiar demands.

When things get extra busy or demanding, I have to pare down other stuff as much as possible lest I enter a depressive or anxious funk, so that’s what I’ve been doing. Paring. Which includes posting.

Prophylactic-posting-paring. There, there’s a new phrase for you.

Call it a blogger’s mental health thing.

Thanks for understanding!

Hopefully, things have quieted for a bit, and posting will get regular.

April 8, 2022

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