A recent report published in the journal Neuropsychobiology describes the case of a 34-year-old woman with major depressive disorder whose symptoms improved following the initiation of an elimination diet.

The patient, who had a long history of depression, had been previously treated with venlafaxine but had discontinued pharmacotherapy due to side effects. As she had shown an interest in trying nonpharmacologic interventions, she was prescribed a hypoallergenic diet where foods were eliminated and then reintroduced one at a time in order to identify possible reactions.

During this time, the patient reported that when she eliminated certain foods (ie, wheat, soy, dairy, eggs, coffee, among others), her mood improved and she had fewer crying episodes. However, during the reintroduction phase, she noted that dairy consumption led to low mood symptoms, while eating gluten and dairy resulted in headaches, gas, bloating and abdominal discomfort. The patient was also prescribed fish oil supplementation, intramuscular vitamin B12 injections, and exercise which were all associated with improvement in mood.

The patient continued to eliminate foods, however oftentimes she reported that the diet was hard to maintain. During those periods, she reported worsening of mood as well as constipation and headaches. However, when she did follow the diet, she noticed subsequent improvements in mood. Serum IgG testing revealed wheat, casein, and yeast to be highly reactive, which the authors reported, motivated the patient to continue her hypoallergenic diet.

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In their discussion of the case, the authors described several mechanisms that may explain the connection between food sensitivities and mental health. These included inflammation, which may cause a reduction in serotonin levels and could potentially make patients less responsive to drug therapy, as well as a direct effect caused by certain food constituents (ie, cow’s milk has been shown to stimulate opioid receptors and trigger histamine release). 

“Food hypersensitivity reactions may play a role in the development or progression of mood disorders and the systematic identification of food triggers using an elimination/reintroduction diet may be a valuable tool in assessing and treating mood disorders,” the authors concluded. They added that “this case demonstrates the difficulty of maintaining lifestyle changes as the patient relapsed to her prior diet several times.”

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