stress is an inevitable part of our day to day lives in varying intensities and it affects our body and mind adversely. Both physical and mental or emotional stress have detrimental impact on the body systems & organs. The physiological response to stress also varies from person to person.

      Stress is a response of body towards challenges. Mild degree stress has some positive results as it helps to face challenges and complete some task in a time bound manner. In accidents, mild degree stress helps to escape from dangerous circumstances. But persistent and prolonged stress takes a toll on our health. Stress may cause physical as well as mental illnesses. Depression and other comorbidities are common in people who had undergone prolonged stress.

    Acute stress is very common in our day to day life and it last for a short time as we see in examination funk, in some accidents and when somebody attempts something for the first time in life, as in anticipatory anxiety and stage fears. Chronic stress last for a long period of time and its causes are myriad including marital discord, individual conflicts, business failure, divorce, death of beloved, betrayals, love failures etc.

Chronic stress may lead to a trail of ailments such as:

High blood pressure, heart disease, diabetes, obesity, depression or anxiety, skin problems such as acne or eczema, menstrual problems.

 Stress can cause many types of physical and emotional symptoms, even though you may not be aware that all these ailments are a sequel to stress.

 Symptoms following a prolonged stress exposure are listed below:

·        Forgetfulness

·        Frequent  body pains

·        Headaches

·        Low energy, depressive mood& poor concentration

·        Sexual dysfunctions

·        Stiffness and pain of neck

·        Feeling of fatigue or tiredness

·        Unrefreshed or reduced sleep hours

·        Excessive sleepiness ,drowsiness

·        Falling into alcoholic intake or use of drugs

·        Weight loss or gain

Link between stress, anxiety &depression.

 Stress and depression have a bidirectional relationship as stress may lead to depression and vice versa. The chances of having depression are much higher in persons with anxiety disorder. Nearly half of the people with major depression also suffer from severe and persistent anxiety.

 The co-occurrence of anxiety and depression is very common. One can easily trigger the other, with anxiety often preceding depression.

People with post-traumatic stress disorder (PTSD) are prone to developing depression.

 The current research states that depression is caused by a combination of genetic, biological, environmental and psychological factors. While it may occur at any age, it often begins in adulthood.

 Symptoms of depression with anxiety may be manifested with:

·        Irrational worries or fears that persist

·        Vague physical symptoms, such as fatigue, headaches, rapid heartbeat, labored breathing or abdominal pain

·        Sleep disturbed, keep awake.

·        Changes in eating habits — either too much or too little

·        Difficulty in making decisions or concentrating

·        Forgetfulness, difficult to remember things

·        Constant feelings of sadness or worthlessness

·        Lack of interest in activities or hobbies

·        Feeling tired and fatigued. Crankiness

·        Inability to relax and live in the moment

·        Suffering from panic attacks, including the sense of losing inner control.

How to manage co-occurring stress, anxiety and depression?

·        Cognitive Behavioral Therapy (CBT) –

     CBT is often used to treat people with both disorders. Fears, anxieties and tendencies toward depression are managed by searching out the root causes and some creative instructions are provided to help them feel better.

·        Antidepressant medications –

     Often combined with CBT, these may be prescribed in treating anxiety and depression. Selective serotonin reuptake inhibitors (SSRIs) are new antidepressant drugs that produce fewer side effects than their predecessors.

·        Exercise – This can be very effective for both disorders. Physical activity causes feel-good chemicals "endorphins "  to be released in the body. This aids in mind relaxation and sense of wellbeing.

Do swimming, running, walking and some aerobics.

Healthy eating - nutrient rich balanced diet

·        Relaxation techniques –

     This typically involves meditation or mindfulness. These techniques can often help to remedy both disorders and improve quality of life.

      Depression- foods to eat & avoid

          Healthy eating for depression

   A healthy eating pattern or diet may help to reduce the impact of depression as nutrients have key roles in the production of neurotransmitters and in maintaining the health of nerve cells. Include the following nutrient rich foods in the diet for reducing depressive mood:

Foods rich in vitamin B12

Vitamin B-12 and other B vitamins play a key role in producing brain chemicals that affect mood and other brain functions [ neurotransmitters]. Low levels of B-12 and other B vitamins such as vitamin B-6 and folate may be linked to depression.

Milk,cheese , meat, fish-salmon, trout,  eggs  ,clams, shiitake mushroom and yougurt are good sources of vitamin B12 .

Foods rich in folates

It has been observed that patients with depression have low blood folate levels also. Research studies show that depressive symptoms are the most common neuropsychiatric manifestation of folate deficiency.

•       Dark green leafy vegetables

•       Turnip greens, spinach, romaine lettuce, asparagus, Brussels sprouts, broccoli, black-eyed peas, mustard greens, green peas,

•       kidney beans

•       Canned tomato juice

•       Fresh fruits-Oranges, Grapefruit, Papaya, Banana, Avocado

•       cantaloupe

•       Beans

•       Peanuts

•       Sunflower seeds

•       Whole grains

•       Liver

•       Seafood

•       Eggs

•       Fortified foods and supplements

•       Dungeness crab

•       hard-boiled egg

•       beef liver.

     Foods rich Omega 3 fatty acids

     Studies have revealed that diets lacking omega-3 PUFA lead to impaired neural function.  Clinical studies have shown with clear cut evidence that omega-3 fatty acids can effectively treat depression. 

     The two omega-3 fatty acids, eicosapentaenoic acid (EPA) & docosahexaenoic acid (DHA), found in fish oil, have been found to  reduce depression in humans. Reduction in the consumption of omega-3 fatty acids from fish and other sources also may cause major depression. Therefore, consumption of oily fish needs to be promoted in people predisposed to depression. 

Some important minerals rich foods to reduce depression

     Selenium

 Studies with selenium reveal that selenium improves mood and diminishes anxiety. Brazil nuts, fish, ham, meat, eggs, cottage cheese, brown rice, mushrooms, spinach, lentils, sun flower seeds and cashew nuts are good sources of selenium.

·       zinc

Research shows that oral zinc can  help antidepressant therapy in depressed patients. Zinc also protects the brain cells against the potential damage caused by free radicals. Zinc is available from food such as legumes, shellfish, meat, seeds and nuts.

·        Depression is comparatively low in people who consume traditional diet that tend to be high in vegetables, fruits, unprocessed grains, fish and seafood, and contain only modest amounts of lean meats and dairy. 

Foods to avoid in depression

Avoid junk foods & alcohol to mitigate depressive mood. Artificial sweetners, refined foods, such as white bread and soda, may increase mood changes. Alcohol slows down brain activity and changes mood towards depression. So stay away from drinking alcohol.

•       

References

1.    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738337/

2.    https://pubmed.ncbi.nlm.nih.gov/17066209/

3.    https://pubmed.ncbi.nlm.nih.gov/12559660/

4.    https://pubmed.ncbi.nlm.nih.gov/12906343/

5.    https://pubmed.ncbi.nlm.nih.gov/12906343/

6.    https://pubmed.ncbi.nlm.nih.gov/10835899/