Depression

Summary
It is always important to have a healthy diet. This means a diet that includes enough vitamins and minerals, and plenty of fruit, vegetables and whole grains. Improving your diet could help with your mood. Unfortunately depression is often associated with a disinterest in food and cooking and you may be reliant on someone else to make sure you eat properly. However it is done it is as important as in any other health problem to make sure the right nutrients are available.

The NHS Eatwell Guide shows that to have a healthy, balanced diet, people should try to:

• eat at least 5 portions of a variety of fruit and vegetables every day (see 5 A Day)
• base meals on higher fibre starchy foods like potatoes, bread, rice or pasta
• have some dairy or dairy alternatives (such as soya drinks)
• eat some beans, pulses, fish, eggs, meat and other protein
• choose unsaturated oils and spreads, and eat them in small amounts
• drink plenty of fluids (at least 6 to 8 glasses a day)

If you’re having foods and drinks that are high in fat, salt and sugar, have these less often and in small amounts.

Try to choose a variety of different foods from the 5 main food groups to get a wide range of nutrients.

Summary
Self-help books and audio aids can be helpful for people with depression. There are many books to choose from, and they seem to work even better with support from a professional.

Evidence
Research has shown that this sort of self-help can be useful for some people with depression. But it isn’t for everyone and it takes some effort and good reading skills.

Safety
There are no safety issues.

Cost
You will need to pay for the books but the cost is one-off.

Further information
The Depression Alliance has a list of recommended self-help books dealing with depression.

Summary
It’s common sense to try and take your mind off gloomy thoughts. But researchers have found that thinking pleasant thoughts really can lift a low mood, for a while at least.

When looking for a distraction, try to do something that’s good for your health, rather than, for example, simply sitting in front of the TV, eating ice cream and smoking. It is all too easy to end up over-eating and treating your body badly when you are feeling low and tired. But exercise can be a healthy, enjoyable distraction, as can gardening or voluntary work.

It’s also well known that having a pet can improve low mood, although that doesn’t mean it can cure depression. Humour (watching a funny video) improves mood for a while, but it’s probably not going to work if you try to beat depression with humour alone. Listening to music can help lift mood for a short time (up to an hour, according to the research that’s been done). But there is no evidence to show that it helps for longer than this, or that it benefits people with clinical depression. Another study found that group singing improves people’s mood. Is it the singing or the getting together with other people that helps? We don’t know, and it doesn’t matter, because any of these ways of feeling more alive, or all of them, could become valuable parts of your ‘beating depression toolkit.’ The important thing is to try an activity and see whether it works for you.

Evidence
There is good evidence that distraction helps lift mood in the short term, particularly if the alternative to it is thinking about being depressed or dwelling on feeling low, as people tend to do. A number of distractions have been tested in research, including things like describing pictures or playing a board game. Deliberately thinking pleasant thoughts, or imagining peaceful, beautiful scenes can help too.

Safety
There are no safety problems, but don’t try to distract yourself when you should be concentrating on something else, for example when driving.

Cost
Many of the activities described above are free or cost very little.

Further information
See the other pages in this Depression sections for different suggestions for healthy distractions.

Summary
Compared to 100 ago when people didn’t have cars, washing machines or TV most of us don’t work hard with our bodies. Our lifestyles are relatively lazy – a trend that science tells us is bad for our health. Being more active does more than keep you fit. Importantly for low mood and depression, it triggers brain chemicals that lift your mood and can generate a real sense of wellbeing. It makes your heart and lungs work better, tones your muscles and strengthens bones and joints. It also stimulates circulation to your brain and internal organs and boosts the immune system. It helps protect against osteoporosis. It can also be a very good way of meeting people, and it definitely makes a difference to all sorts of health problems.

So it’s good to get outdoors: one study found that after a walk in the country people were much less depressed than those who spent the same time walking round a shopping centre. So perhaps where you get active is important as well as how much. Green spaces could be good for your mood!

Evidence
Getting more active, even just a half hour’s walk every day, helps reduce depression symptoms in adults. Even a single session of exercise seems to lift mood.

Safety
If you’re not used to being active, start off slowly and build up gradually, doing a bit more every other day. If you feel worse, cut back, and increase your activity more slowly. If you think it isn’t helping or that you’re getting worse in any way, check with your doctor. Anyone with severe osteoporosis, arthritis, acute back pain or recent injuries should first get advice about exercise from a doctor or physiotherapist.

Cost
You can exercise at home for nothing, remember walking and gardening are both forms of exercise. There will probably be a small cost, if you join an organised programme.

Further information
Natural England is one of several organisations that organise walking schemes designed to help people improve their health. Walk4Life Programme has about 600 local groups, and around 40,000 people take part in short local walks every week. Find out about Green Gyms where volunteers take on voluntary projects outdoors. Many local councils organise Health Walks for people who want to get active in company.

Check your local leisure centre for exercise classes. See also the Classes section for more information.

Summary
Many people who feel depressed say they get tense and have problems sleeping. Relaxation skills can help with this. This technique teaches you to notice muscular tension and learn to relax your muscles to release the tension. Progressive relaxation works by tensing and relaxing various muscle groups in your body, starting from your feet and working your way up. At each level, try to notice how it feels when your muscles are tense, and how it feels when you let go and relax. Gradually you will get used to the feeling of relaxation and learn how to make it happen at will. As with most relaxation methods, you need to start by finding a quiet, relaxing place to practise. Put yourself in a comfortable position, whether standing, sitting or lying, and start by allowing your out-breath to get softer, longer and deeper.

Evidence
Learning relaxation techniques can be helpful for people who feel depressed. Researchers who collected together all the experimental evidence on using relaxation techniques for depression concluded that the people who used them said they helped them feel better. But relaxation techniques don’t seem to help as much as psychological treatments do.

Safety
These techniques are generally safe unless you have a severe or long-standing mental health problem.

Cost
Once you have learned the relaxation techniques, there are no costs. There are many books and audio aids available and some people find it useful to join a class initially.

Summary
There are several self-help programmes on the internet that aim to lift depression by helping you learn to think in more positive ways. These often adapt features of cognitive behavioural therapy (CBT) from their usual treatment setting to a self-care form.

Evidence
Some research has been done on these approaches. They seem to work better if they are used in session with a professional. However there is now established benefits in doing them alone too.

Safety
It is important to choose a programme that has been properly tested. Do some online homework to see which are the most independently rated.

Cost
Most of the available approaches online require a subscription.

Further information
One self-help programme that has been tested in research studies is MoodGYM. Another is the Beating the Blues programme. There are cheaper or free apps available as well, some assessed by NHS website.

Summary
While there is no ‘magic diet’ that works for everyone whose mood is low, eating right can help you feel better. Some people say that certain foods affect their mood. Sometimes keeping a tight rein on fast sugars can reduce excessive fluctuations in blood sugar levels that are linked to emotional and mood upsets. If you have problems with digestion as well as mood, keeping a food diary might help you find out whether certain foods make you feel worse. Write down what you eat and make a note of how you feel a couple of hours afterwards, bearing in mind that you might feel the effects of certain foods some time after you have eaten them.

Evidence
Some people have found that avoiding certain foods (such as sugar, wheat or dairy foods) has helped their mood, but there isn’t much clinical research to help us decide about this. 

Safety
It can be quite difficult to exclude certain foods and still have a balanced diet. If you want to make big changes to what you eat, it may be important to see a dietician. They can help you make sure you are still eating a healthy diet and getting all the nutrients you need.

Cost
Eating a healthy diet and excluding some foods need not cost you anything. But if you consult a dietician there will be a charge, unless this is a service provided by your GP’s practice.