Maximizing Spring Break for mental health

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

  • Many college students look forward to the month of March and spring break, as a way to take time off from school and relax, to recharge for the second half of the spring semester, etc.
  • There are healthy and unhealthy options to keep in mind when considering a rejuvenating spring break.
  • This is important because unhealthy choices during spring break could create more problems for the rest of the semester.

What are unhealthy spring break patterns to avoid?

  • Excessive alcohol, including short term, binge drinking, has been shown to impact brain functioning (1 ), and grades (2), depression (3 ), increased risk of sexual assault (4 ). this can also increase your anxiety for the weeks and months to follow.

Low risk drinking recommendations can be found here (17 )

  • Cannabis use can worsen depression and suicidal ideation (5 ), brain functioning (6,7 ), sleep (8) and anxiety (8 ).
  • Sleep deprivation can impact academic performance (9, 10 ).
  • Consider minimizing caffeine intake since excessive caffeine intake can impact stress (11), and sleep (12, 13).

What are healthy spring break options to consider?

  • Catch up on sleep.
  • Rest your brain. If you’ve been studying intensely, reading, writing, analyzing, etc. it may be useful to rest those areas of the brain by doing different types of activities.
  • Minimize screen time, if possible. If you’ve spent a lot of time doing schoolwork on your computer, it may be useful to rest that part of your brain by doing different types of activities that don’t involve screens.
  • Eat well to fuel yourself properly and for optimal mental health. Examples include plenty of fresh fruit, vegetables, nuts, lean meats, etc. (14). This might also enhance recovery.
  • If you’ve spent a lot of time indoors, spending time outside, safely and to a point may be helpful for mental health ( 15, and 16).
  • Reduce isolation by spending time with others, if possible.
  • Other options include hiking/camping/other activities in nature, playing recreational sports, traveling to museums, art exhibits, beaches, shows, etc.
  • You might improve your mental health by doing something good in the community where you travel through programs like BUCK-I-SERV, and other service trips, etc. (18)

Tips on how to stay safe during spring break:

  • Since the number one cause of death in young adults is accidents, it may be wise to minimize/avoid high risk-hazardous activities (19).
  • Very useful link for Travel safety tips for spring break (20).

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Zeigler DW, Wang CC, Yoast RA, Dickinson BD, McCaffree MA, Robinowitz CB, et al. The neurocognitive effects of alcohol on adolescents and college students. Prev Med. 2005;40:23–32.
  1. https://u.osu.edu/emotionalfitness/2014/09/12/does-alcohol-use-impact-your-grades/
  2. Boden JM1, Fergusson DM. Alcohol and depression. Addiction. 2011 May;106(5):906-14. doi:10.1111/j.1360-0443.2010.03351.x. Epub 2011 Mar 7.
  1. https://u.osu.edu/emotionalfitness/2015/10/21/study-alcohol-impacts-sexual-assault/
  2. Gobbi G, Atkin T, Zytynski T, et al. Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood: A Systematic Review and Meta-analysis. JAMA Psychiatry. Published online February 13, 2019. doi:10.1001/jamapsychiatry.2018.4500
  3. Doss MK et al. Δ9-Tetrahydrocannibinol at retrieval drives false recollection of neutral and emotional memories. Biol Psychiatry 2018 May 9; [e-pub]. https://doi.org/10.1016/j.biopsych.2018.04.020.
  4. Schuster RM, Gilman J, Schoenfeld D, et al. One month of cannabis abstinence in adolescents and young adults is associated with improved memory. J Clin Psychiatry. 2018;79(6):17m11977 .
  5. Hser YI, Mooney LJ, Huang D, et al. Reductions in cannabis use are associated with improvements in anxiety, depression, and sleep quality, but not quality of life. J Subst Abuse Treat. 2017;81:53-58.
  6. http://u.osu.edu/emotionalfitness/2017/12/31/poor-sleep-and-poor-grades-might-go-together/
  7. Phillips AJK, Clerx WM, O’Brien CS, et al. Irregular sleep/wake patterns are associated with poorer academic performance and delayed circadian and sleep/wake timing. Scientific Reports.                2017;7:3216. doi:10.1038/s41598-017-03171-4.
  1. http://u.osu.edu/emotionalfitness/2017/04/19/study-caffeine-stress-and-brain-function/
  2. T. Roehrs, T. Roth. Caffeine: sleep and daytime sleepiness. Sleep Med Rev, 12 (2) (2008), pp. 153–162.
  3. 13. H.P. Landolt, E. Werth, A.A. Borbely, D.J. Dijk. Caffeine intake (200 mg) in the morning affects human sleep and EEG power spectra at night. Brain Research, 675 (1–2) (1995), pp. 67–74.
  4. http://u.osu.edu/emotionalfitness/2018/06/28/food-choices-to-improve-depression/
  5. Avery DH, Kouri ME, Monaghan K, Bolte MA, Hellekson C, Eder D. Is dawn simulation effective in ameliorating the difficulty awakening in seasonal affective disorder associated with  hypersomnia? J Affect Disord. 2002 May;69(1-3):231-6.
  6. https://www.cdc.gov/cancer/skin/basic_info/sun-safety.htm
  7. http://u.osu.edu/emotionalfitness/2018/02/26/alcohol-and-grades/
  8. http://u.osu.edu/emotionalfitness/2017/11/22/mental-health-benefits-of-volunteering/
  9. https://www.cdc.gov/family/springbreak/index.htm
  10. https://www.limcollege.edu/safety/are-you-prepared/spring-break

 

 

 

 

Food choices to improve depression

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

A 2017 systematic review of 21 studies  across 10 countries looking at food pattern and depression found that there was an association between food pattern and depression (1).

What food patterns were found to have an DECREASED risk of depression? 

  • The study authors (1) found that high intakes of fruit, vegetables, fish, olive oil, low-fat dairy, antioxidants, and whole grain was associated with a decreased risk of depression (1)
  • Another review found that seafood, vegetables, fruit and nuts based food patterns was associated with a reduced risk of depression. (2)
  • A study of 15,980 adults over 10.8 years found that higher consumption of fruits and nuts, while lower consumption of fast food led to a reduced depression risk (3).

What food patterns were found to have an INCREASED risk of depression? (1)

  • The study authors (1) found that high consumption of red and/or processed meat, refined grains, (added sugars)/sweets, high-fat dairy products, butter, potatoes and high-fat gravy was associated with an increased risk of depression (1).

Are there clinical studies where food pattern was used to TREAT depression? 

Yes. The HELFIMED (4) and SMILES trials (5) used food as a treatment of depressive disorders.

How effective was this?

In both of these trials (4,5), the improvement was almost 50%, which is comparable to some therapies and some antidepressant medications; and benefits lasted for several months afterwards.

What are some caveats?

  • These studies show that nutrition can be helpful to improve depression, but further study is needed.
  • Nutritious food choices DO NOT have to be expensive food choices, and in many cases whole foods can be more affordable than processed foods.
  • For some people, good nutrition is not enough replace counseling or medications, but can be a useful addition.
  • Different people can be healthiest on different styles of eating, depending on a variety of factors.
  • Even with good food choices, it is important to get enough calories; and not engage in restriction or disordered eating behaviors.
    • TDEE calculators and this chart may be helpful in estimating daily calorie needs.
  • Individuals with eating disorders should seek professional assistance via nutritionist, eating disorder specialist, etc. when considering nutritional adjustments.
  • The Food Pantry at OSU is another useful resource.

Any other resources to improve nutrition?

How is your nutrition? What is the quality of your food choices? Are you eating enough or too much food? Are you eating foods that worsen or improve depression?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Li, Ye & Lv, Mei-Rong & Wei, Yan-Jin & Sun, Ling & Zhang, Ji-Xiang & Zhang, Huai-Guo & Li, Bin. (2017). Dietary patterns and depression risk: A meta-analysis. Psychiatry Research. 253. 10.1016/j.psychres.2017.04.020.
  2.  Martínez-González MA1, Sánchez-Villegas A2. Food patterns and the prevention of depression. Proc Nutr Soc. 2016 May;75(2):139-46. doi: 10.1017/S0029665116000045. Epub 2016 Feb 22.
  3. Fresán, U., Bes-Rastrollo, M., Segovia-Siapco, G. et al. Does the MIND diet decrease depression risk? A comparison with Mediterranean diet in the SUN cohort. Eur J Nutr (2018). https://doi.org/10.1007/s00394-018-1653-x
  4. Natalie Parletta, Dorota Zarnowiecki, Jihyun Cho, Amy Wilson, Svetlana Bogomolova, Anthony Villani, Catherine Itsiopoulos, Theo Niyonsenga, Sarah Blunden, Barbara Meyer, Leonie Segal, Bernhard T. Baune & Kerin O’Dea (2017) A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED),Nutritional Neuroscience,  DOI: 10.1080/1028415X.2017.1411320 
  5. Jacka FN, O’Neil A, Opie R, et al. A randomised controlled trial of dietary improvement for adults with major depression (the “SMILES” trial). BMC Medicine. 2017;15:23. doi:10.1186/s12916-017-0791-y.

Does Omega 3 supplementation help with depression?

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Omega 3 supplements are widely available over the counter and are sold with various claims.

There are many studies looking at omega 3 supplementation for different conditions such as depressed mood, bipolar disorder, schizophrenia, adhd, etc.

My self and many psychiatrists will often discuss potential benefits of EPA fish oil Omega 3 supplementation in certain cases.

A recent meta analysis (study of studies) looked at omega 3 supplements and major depressive disorder, a specific type of depressive disorder (1).

What did the study involve?

  • The study authors (1) looked at 1,955 studies, the study authors identified 1233 individuals from 15 studies with major depressive disorder who were given omega 3 supplements.
  • Study authors (1) factored out studies with design flaws, limitations, or other biases.

What were some of the results (1)?

  • After adjusting for many variables, taking potential publication bias into account, this review article found that Omega 3 fatty acids were found to be helpful for Major depressive disorder. (1)
  • Higher doses of EPA Omega 3’s were associated with better outcomes.(1)
  • Participants taking EPA Omega 3’s with antidepressant also benefited. (1)
  • DHA (another type of Omega 3) to EPA ratio and DHA dose did not make a difference in Major Depressive disorder symptoms. (1)

What are some caveats about Omega 3 from fish oil?

  • Omega 3s from non seafood sources may not have the same brain impact has seafood based omega 3’s.
  • Not all antidepressants have been studied with EPA Omega 3 supplements.
  • Long term effects of high dose EPA (which is a sub-type of Omega 3) is not known.
  • At this time, there is not a widely standardized way predict who will see mood benefits from Omega 3 supplementation.
  • While the exact dose of EPA Omega 3’s have not been identified for everyone, the studies cited in this review (1)used a dose range of upto 4400mg per day.
  • To prevent any interactions with your medications, it may be best to check with your prescriber before starting fish oil Omega 3 supplementation.
  • Medicine and supplements are not a replacement for unhealthy lifestyle habits.
  • This was a helpful study for individuals with major depression, and further study is warranted for other conditions and combination of conditions.

What are some additional resources?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Mocking RJT, et. al. Meta-analysis and meta-regression of omega-3 polyunsaturated fatty acid supplementation for major depressive disorder.  Translational Psychiatry (2016) 6, e756; doi:10.1038/tp.2016.29 Published online 15 March 2016