If you went by the headlines, you’d be forgiven for thinking that we’d found a cure for depression. Last week, a study in the Molecular Psychiatry journal claimed that eating a Mediterranean diet—one rich in oily fish, grains, and vegetables—could “protect” against depression, prompting numerous breathless news stories, and a few questionable comment pieces claiming a little olive oil and few trips to Puglia could cure your mental illness. The Mediterranean diet has long been touted as nutritionally beneficial, but can a serious mental illness really be cured through food alone?
Olive oil and wholegrains aren't the only foods promised to protect against depression. Search Google News for the word “depression,” and you’ll find endless “cures”: Try a ketogenic diet! How about vegetarianism or an all-fruit diet? Or even a carnivore diet, favoured by controversial psychologist Jordan Peterson and recommends eating nothing but meat? Simple.
Many “wellness” chefs and food bloggers also link their diets to improved mental health. As Ruby Tandoh notes in the Guardian, wellness influencers Jasmine and Melissa Hemsley have promoted the work of Dr. Natasha Campbell-McBridge, whose diet book claims to “treat” autism, attention deficit disorder, dyslexia, dyspraxia, depression, and schizophrenia. Goop founder Gwyneth Paltrow says celery is a “healing food.” Celery.
In fact, the truth about food and mental health is far more complex.
“Diet and healthy lifestyle—including someone’s sleeping pattern, how active they are, and whether they go out and get fresh air and natural light—can make a big impact in terms of mental health,” Priya Tew from Dietitian UK says. “If someone's surviving off crisps and chocolate and only eating one meal a day, then it can definitely make a big difference to switch to a different diet, [by] eating regularly, [and] having wholegrains and oily fish.”
“But it's not going to fix everything for everyone,” she adds.
Understanding the breadth of the issue is key, Andy Bell, deputy chief executive at the Centre for Mental Health in London tells me. Bell is currently helping launch Equally Well, a new campaign to support the physical health of people with a mental illness.
“People living with a severe mental illness—schizophrenia, bipolar disorder, personality disorders—have a life expectancy that is 15 to 20 years shorter than average,” Bell explains. “It’s huge—it dwarves any difference between one geographical area and another, and actually we know that a large proportion of people with mental illness are living with one, two, or three physical health problems all at the same time.”
The reasons for the shorter life expectancy, Bell says, is down to so-called “lifestyle illnesses,” though he’s keen to stress he dislikes the term. “It’s a mix of things. It’s partly due to the tragic loss of life by suicide, partly the fact that the medications you take can sometimes damage your physical health. But it’s also down to the fact you have the use of alcohol and food as self-medication for the distress people are living with.”
This notion of a “lifestyle illness,” he tells me, is fundamentally flawed. “We have illnesses that are actually very often about the social and economic circumstances we live in, and I think we tend to gloss over that and blame people for the things they experience in their life, without really understanding what's behind it.”
“We have illnesses that are actually very often about the social and economic circumstances we live in, and I think we tend to gloss over that."
As the NHS also points out, food and mental illness are linked in other ways too—ones that could have impacted the outcome of the Molecular Psychiatry study on diet and depression. One of these is a person's ability to cook a healthy meal. Tew encourages her clients to food prep, buy healthy frozen meals, or ask for support from friends and family with cooking. Of course, for those with mental health issues, this isn’t always possible.
“It’s really important to look after yourself when you're unwell, whether that's physical or mental health, but it's the hardest time for you to do that,” she says. People feeling depressed are far less likely to prepare food or even eat. When you're struggling with dark thoughts, batch-cooking a three-bean chili for the week ahead probably isn’t an option.
Food, like mental health, is also a political issue, as Bell notes. “A large majority of people living with a mental illness are on a very, very low income, and if you’re on a low income it can be harder to eat well.”
“And we know that if you put out health messages, it’s more likely to be received well by people on higher income. So [talking about health and diet] can actually increase inequalities. If you just put out a bunch of messages, generally it only reaches people who are better off, have more time, and have more opportunities to make healthy choices. You see the gap widening.”
Not shaming people for their relationship to food is also key to outing myths about diet and mental health. “We need to understand the emotional role food has in our lives, fundamentally,” Bell says. “What is it that leads people to eat unhealthily and have a poor diet? Some of that is not having access to healthy food, poverty, and all those factors.”
“We need to look at diet as being a mental and physical health issue—one that cuts across both."
“But some of it is to do with poor emotional health and wellbeing,” he continues. “We need to look at diet as being a mental and physical health issue—one that cuts across both. Unless we have an understanding of the psychological basis of a poor diet, then I don’t think we’re ever going to understand what it is that leads people to serious poor health.”
Eating healthily is obviously good for both physical and mental health—the British Dietary Association suggests eating breakfast and a diet containing wholegrains, fruit, vegetables, and protein. But no diet plan, no one foodstuff, is a panacea; nor will it provide a magic “cure” for depression or any other mental illness, many of which require management through a combination of medications, therapy, and lifestyle choices.
Mental illness is multi-faceted, based on a complex web of social, economic, biological, psychological, and political factors. When media reports, influencers, or celebrities insinuate that the key to perfect mental health is simply eating the right combination of foods, it’s up to us to call bullshit.