Most of us understand the connection between nutrition and conditions like obesity, heart disease, and diabetes. There is also a good understanding that certain nutrients, such as vitamins and minerals, are essential for optimal health and that nutrient deficiencies lead to health problems.

Even though nearly one in five US adults lives with a mental health condition, far fewer people know the link between nutrition and mental health. Poor nutrition affects our brain's structure and function and the production of hormones and neurotransmitters.

Many Americans do not reach the required micronutrient intakes, and it's been estimated that only 10% of adults get enough fruits and vegetables. These essential vitamins and minerals are especially deficient in patients with mental health conditions.

Keep reading to learn more about essential nutrients that impact mental health conditions like depression, anxiety, and sleep disorders.

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Common Mental Health Conditions

Anxiety and depression are two of the most common mental health conditions affecting 9-18% of US adults. At the same time, sleep disorders "contribute to or exacerbate mental health conditions and can be a symptom of other mental health conditions." Nutrient deficiencies can play a role in these mental health conditions.

If you are suffering from a mental health condition, it can be caused or exacerbated by medication side effects, a thyroid imbalance, obstructive sleep apnea, or adrenal disorders, among many others. It's essential to see a healthcare provider for a history, physical exam, medication review, and appropriate blood tests to rule out something else that might be causing a change in your mental health.

Depression

The American Psychiatric Association describes depression as:

• Feeling sad or having a depressed mood.
• Loss of interest or pleasure in activities once enjoyed.
• Changes in appetite — weight loss or gain unrelated to dieting.
• Trouble sleeping or sleeping too much.
• Loss of energy or increased fatigue.
• Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others).
• Feeling worthless or guilty.
• Difficulty thinking, concentrating, or making decisions.
• Thoughts of death or suicide.

Standard medical treatment of depression includes antidepressant medications, sometimes accompanied by psychotherapy.

Anxiety

Symptoms of generalized anxiety include "persistent and excessive worry that interferes with daily activities." Physical symptoms like fatigue, difficulty sleeping, muscle tension, and restlessness often accompany worry. Standard medical treatment of anxiety includes antidepressants or anxiolytic medications, sometimes coupled with psychotherapy.

Sleep Disorders

Restorative sleep is one of the pillars of a healthy lifestyle and is essential to our physical and mental well-being. Poor sleep, also known as insomnia, is a mental health condition that also occurs in those with depression and anxiety. Standard medical treatment for insomnia includes melatonin, sleep medications, relaxation techniques, and sleep hygiene.

Top Nutrient Deficiencies That Affect Mental Health

Omega-3 Fatty Acids

Omega-3s, found in fish and certain plant-based oils, play a key role in brain function and have been linked to a reduced risk of depression and anxiety. Over two-thirds of US adults do not consume enough essential fatty acids to meet their nutritional needs.

B-Complex Vitamins

The eight B vitamins can be obtained from various foods:

• B1 (Thiamine): Whole grains, nuts, seeds, legumes, and pork
• B2 (Riboflavin): Milk, yogurt, cheese, leafy greens, and eggs
• B3 (Niacin): Meat, fish, poultry, nuts, and whole grains
• B5 (Pantothenic acid): Meat, fish, poultry, whole grains, and legumes
• B6 (Pyridoxine): Meat, fish, poultry, whole grains, and fruits
• B7 (Biotin): Egg yolks, nuts, seeds, and whole grains
• B9 (Folate): Leafy greens, fruits, and legumes
• B12 (Cobalamin): Meat, fish, poultry, milk, and eggs

These essential vitamins help our bodies to generate new red blood cells, produce energy from food, and are necessary for brain and nervous system function. Deficiencies in several of the B vitamins have been associated with depression, anxiety, and sleep disturbances.

Iron

This micronutrient allows us to carry oxygen in our red blood cells and synthesize myelin (the fatty coating on neurons) and neurotransmitters; in fact, iron deficiency is associated with an inadequate level of serotonin. This could be a contributor to depression. Iron deficiency anemia is also associated with anxiety and sleep disturbances.

Magnesium

Magnesium is a mineral necessary for hundreds of bodily functions. Deficiency is associated with depression, and magnesium supplementation may benefit mild anxiety and sleep.

Zinc

Like magnesium, zinc has roles in hundreds of enzymatic reactions and is necessary for optimal health. Research is ongoing to investigate the role of zinc deficiency and depression. Supplementation of zinc, along with standard antidepressant treatment, can be effective in improving depression.

Selenium

Selenium is a mineral required in trace amounts; it has vital roles in hormone regulation, DNA synthesis, and protecting our cells from infections and oxidative stress.

Inadequate selenium intake is associated with sleep difficulty, and supplementation with selenium reduces depression symptoms.

Whole-Food Carbohydrates

Whole-food carbohydrates are found in fruits, vegetables, whole grains, and legumes. These are rich sources of vitamins, minerals, and antioxidants that are important for maintaining overall health and well-being. The fiber present in whole-food carbohydrates also feeds our gut flora.

Diets that have inadequate intake of whole-food carbohydrates promote depression, possibly because "feel good" brain chemicals like serotonin are produced in response to carbohydrate intake, so if carbohydrate consumption is low, the body will make less serotonin.

Another way fiber and whole-food carbohydrates may optimize mental health is due to the effect on our gut flora. When gut bacteria ferment dietary fiber, they make "short-chain fatty acids" (SCFAs) that have important roles in several bodily functions. Low SCFA absorption in the gut worsens insomnia, and new research points towards SCFAs playing a role in anxiety and depression.

Protein

Proteins, made of building blocks called amino acids, are present in every cell in the body. Neurotransmitters like dopamine and serotonin are made from the amino acids tyrosine and tryptophan, respectively. A recent study looked at protein intake and depression and found that people with low intake had a significantly higher risk for depression. Another study found that increased tryptophan intake, specifically from plant sources, improved sleep quality.

How to Test for Nutrients

Omega-3s

There are blood tests to determine omega-3 levels and the omega-6:omega-3 ratio.

B Vitamins

All of the B vitamins can be evaluated in blood tests. Vitamins B12 and B9 (folate) are often ordered together.

The organic acid urine test from Great Plains Laboratory is very useful when addressing depression or anxiety because it evaluates several of the B vitamin metabolites and neurotransmitter levels.

Iron

A routine CBC with differential is an excellent place to start to assess for anemia. Iron and TIBC should be measured to determine iron deficiency and ferritin for low iron stores.

‍Magnesium

Serum magnesium helps assess for high magnesium levels but may not detect a mild deficiency. If you have a high index of suspicion for a magnesium deficiency, then an RBC magnesium may be more accurate.

Zinc

Serum zinc levels can be inaccurate if albumin levels are low or inflammatory markers (like ferritin, CRP, and ESR) are elevated. Similar to magnesium, if you have a high index of suspicion for a chronic zinc deficiency, then an RBC zinc may be more accurate.

Selenium

An RBC selenium blood test better reflects long-term selenium status and may be more helpful than a serum selenium test to detect a chronic selenium deficiency.

Gut Health

The GI360 Microbiome is an excellent test to look at gut health and dysbiosis states that may be contributing to mental health disorders like depression and anxiety. The comprehensive stool analysis from Great Plains Laboratory evaluates the gut flora and SCFAs. Low SCFA levels are associated with mental health conditions.

Protein

Serum albumin and prealbumin are good markers to assess malnutrition and protein deficiency.

Summary

Common mental health issues like depression, anxiety, and sleep disruption have various underlying causes, but nutrient deficiencies might contribute to or worsen them.  

Omega-3s, B vitamins, minerals, carbohydrates, and protein intake are associated with altered mental health making nutrient testing an essential tool for addressing the root cause of your mental health condition. Interpretation of tests by a qualified health care provider can guide appropriate treatment.

Mental Health Hotline

If you are reading this article because you're facing a severe mental health crisis, please call or text the Suicide and Crisis Lifeline at 988 to connect with a mental health professional. Veterans can press 1 to connect directly to the Veterans' Crisis Lifeline.