Updated: Jun 16, 2020
It's Wednesday which is a perfect day for a midweek mental health check in. I recently did a Q & A with high school athletes on nutrition. I was asked a great question about how mental health medications such as SSRI's can influence nutrition. Medications surrounding mental health are often stigmatized, but I like spreading awareness on the aspects or side effects of medications not commonly spoken about. Starting medications can be scary and a big accomplishment in it of itself for those coping with mental illness, so know that you are not alone. Below are some points that can be helpful to be aware of regarding your gut and diet: 1. SSRI stands for selective serotonin reuptake inhibitors. They are a class of drugs that target the neurotransmitter in your body called serotonin, more commonly known as the happy chemical because of its impact on mood regulation. The mechanism of SSRI's is not fully understood. However, they are believed to increase the level of this neurotransmitter in the brain by limiting how much serotonin is reabsorbed into neuronal cells. This makes serotonin more available to bind to receptors and enhance mood.
Antidepressants or anti-anxiety medications are often stereotyped as "happy pills." However, it is important to know right off the bat that they are not. They do not "change" who you are. They are really meant to bring you back to your baseline self, as mental illness can really cloud this in individuals. For this reason, it is normal to still experience the highs and lows of life. It is not "not normal" to still have a tough day while on a medication, and it should not deter you from stopping or cause you to abruptly stop. (It is extremely important to always seek medical guidance to wean off an SSRI.) On the other end of medication myths, they do not make you an emotionless zombie. They can help minimize feelings of sadness and hopelessness, but do not make you out of touch with your emotions. They can do wonders to get you to a place that allows you to function without daily debilitation. 2. SSRI's can influence your appetite and for some, your metabolism. Don't forget about the gut-brain axis. The gut is now being referred to as our second brain. Think about your "gut feeling," "butterflies in the stomach," etc. This is a key reason why so many SSRI side effects impact the gut and transitioning onto them can cause nausea, upset stomach, or stool changes. In addition, a large majority of serotonin receptors are found in the gut. It is common to notice sudden appetite increase once starting a medication. This may lead to a slight weight gain, while some do not experience weight changes at all. Everyone's body reacts differently. Weight changes also depend on multiple factors like your physiology, which specific medication you take, or your baseline habits. This fact alone often makes people hesitate. But it is important to put things into perspective: would you rather live to your full potential with something like 5 extra pounds, or continue to be fighting internal battles? GI side effects also typically subside as your body adapts and are not something to worry about experiencing for the entire duration you are on a med.
From a food perspective, serotonin is also produced after sweet or starchy carbohydrates are eaten- there's a biological reason for being a carb lover! For this reason, low carb diets are typically not recommended for the average individual if taking a med like an SSRI. (Low carb diets are also not recommended for the average individual not on an SSRI.) 3. SSRI's do interact with other medications or drugs. The most common in our dietary intake- alcohol. It is important to consider your alcohol intake once starting a new medication. More than 1-2 servings on occasion is not recommended. Drinking can counteract the benefits of your medication, which does not help in treating symptoms. Alcohol acts as a depressant, and that is often what SSRI's are trying to work against to begin with. Not to mention all of the other general health reasons to drink moderately. Always make sure your prescribing doctor knows all other prescription, over-the-counter medications, supplements, or herbs you are taking. This matters for your own health! Do not fear telling health professionals, because at the end of the day it is for your own sake.
Medications are most effective when used in conjunction with other important behaviors including a balanced diet, regular exercise, sufficient sleep, a healthy support system, a therapy outlet and so on. These areas are key to focus on as they all work together for whole body nourishment. The importance of balancing them all together never leaves us! Always remember that your brain is an organ that requires just as much care as any other organ for optimal health and quality of life. Do not feel shame in needing a medication. It does not make you weak, a failure, or any other stigma you have heard. Self awareness is an underrated strength and what allows us to progress and grow into our best selves.