Carbohydrate Intake and Depression – Q&A
Question: I’m a 45 year old female. I currently weigh 221lbs. I’ve lost 30lbs in the last three months. My protein intake is roughly 120 to 130 grams per day. I’m limiting my carb intake to 180 to 200 grams a day. I suffer from life long depression and I find that when I limit by carb intake I slowly slide into a depressed state after two or three months (it’s happening to me now). My sleep is disturbed, I develop anxiety I’m bitchy as hell and I’m dragging ass. Is there a correlation between carb intake and production of neurotransmitters? If so, how can I eliminate the effect lower levels of carbs is having on me? Any information is greatly appreciated.
Answer: Dieting in general tends to lower serotonin in the brain and this can cause depression in susceptible people. Interestingly, this effect seems to be more likely to occur in women than men (women being more susceptible to depression in general). In my experience, low carbohydrate/higher proteins diets tend to be even worse in this regards for reasons I’ll explain now.
First and foremost, nutrient intake per se affects the production of neurotransmitters with the effects being both direct and indirect.
In a very direct way, specific amino acids are the precursors for specific neurotransmitters in the brain. Tryptophan is a precursor for serotonin in the brain and the amino acid tyrosine (as well as phenylalanine which converts into tyrosine in the body) is the precursor for dopamine (and subsequently adrenaline/noradrenaline).
As an extreme example of this, researchers will sometimes use something called acute tryptophan depletion (accomplished by providing an amino acid solution containing all of the amino acids except tryptophan) to drastically lower brain levels of serotonin. This is used to test various things but, among other things, it tends to cause acute depression in those who are susceptible. However, this is a pretty extreme type of intervention, decreasing blood tryptophan levels massively (by about 80%); in dieting, tryptophan levels only drop by about 10%.
As usual, it gets more complicated. The different amino acids have different transporters in the body and some amino acids use the same transporter; this means that different amino acid can compete for transport.
Specifically relevant to this topic is the fact that both the branched chain amino acids (BCAAS), tyrosine and phenylalanine and tryptophan all use a transporter called the Large Neutral Amino Acid (LNAA) transporter. Again, this means that they compete for transport, meaning that levels of the different amino acids can affect the transport of the other. Which means that the relative amounts of the different amino acids will impact on how much is getting into a specific tissue in the body; in this case the brain.
If there is a large amount of tryptophan relative to the other LNAA, there will be greater serotonin production in the brain; if there is less tryptophan relative to the other LNAA, there will be less tryptophan transport into the brain and impaired serotonin production.
This brings us to one potential problem with higher protein intakes per se: most dietary proteins contain a lot more LNAA than they do tryptophan. One exception is a derivative of whey called alpha-lactalbumin which has the highest tryptophan content of any dietary protein; recent studies have found that consumption of this protein can increase the ratio of tryptophan to the LNAA in the bloodstream, increasing brain serotonin synthesis. For comparison, while most dietary proteins may ony contain about 2 grams of tryptophan per 100 grams, alpha-lactalbumin contains nearly 5 grams of tryptophan per 100 grams.
As well, there is an interaction with the carbohydrate intake of the diet. Diets very high in carbohydrates and low in protein are known to raise plasma tryptophan and serotonin levels (which is probably why such diets make some people sleepy and dopey). It’s worth mentioning that unless dietary protein is taken to exceedingly low levels (below 5% of total calories), the real-world impact of high-carbohydrates and low-protein isn’t that massive in terms of its effect on serotonin levels in the brain.
However this may explain why some people who are prone to depression tend to crave low-protein/high-carbohydrate foods at certain times (stress, seasonal affective disorder), they are trying to self-medicate themselves and improve serotonin levels.
In any case, let me explain why carbohydrates can impact on all of this since this will help clear up why lowering carbohydrates can cause problems.
The reason is this, the uptake of some of the LNAA (especially the branched chain amino acids) are insulin sensitive; for example, when insulin levels go up, blood levels of the BCAA go down. This shifts the tryptophan:LNAA ratio towards tryptophan such that more gets transported into the brain, potentially increasing serotonin production.
The corollary to that is that when carbohydrates are reduced (and high quality dietary protein is increased), there is the potential for serotonin levels to be reduced. Between the increased intake of LNAA from most high-quality proteins, decreased clearance of them due to reduced insulin levels and the overall effect of dieting in general on plasma tryptophan levels, this all adds up to problems for people at risk for depression.
Which is a long way of answering your question with a resounding yes.
Both dieting in general and low carbohydrate/higher protein diets in specific can cause issues with depression in susceptible people. I do find it a bit surprising that what I consider fairly moderate intakes of both protein and carbohydrates are causing you to experience this but some of it may depend on the depths of depression you experienced (e.g. your genetic susceptibility).
It may also explain why it takes a good 2-3 months for your symptoms to show up, a very low carbohydrate (e.g. 100 grams per day or less) and/or higher protein diet would probably cause things to go south that much faster.
Ok, so that’s what’s going on, what are the solutions? I wouldn’t tend to generally recommend lowering dietary protein and increasing carbohydrates (higher protein diets having a number of benefits in terms of weight and fat loss) but, depending on the specifics of your situation (e.g. training, etc.) that might be one option.
Assuming it isn’t, here are some things to consider:
1. Add the protein I mentioned above, alpha-lactalbumin to your daily protein intake. High in tryptophan, it will help support serotonin synthesis. Consuming some near bedtime might help with sleep, taking it at other times throughout the day may help with overall mood. In this context, I’d note that having a relatively higher carb/lower protein meal at dinner time may help with some of the sleep issues.
2. Consider supplementing with 5-hydroxytryptophan. 5-HTP is another precursor to serotonin in the brain that many have used to deal with depression and sleep problems. Doses seem to vary significantly but 50-100 mg taken up to three times daily may be worth considering to keep serotonin levels from falling while dieting.
3. Given that your symptoms only show up after 2-3 months of dieting, I’d strongly suggest taking a full diet break (discussed in detail in A Guide to Flexible Dieting) between periods of active dieting. Basically, perhaps every 2 months, take 2 weeks to raise calories and carbohydrates to restore brain serotonin levels back to normal. Then you can enter another phase of active dieting, stopping before the depression really sets in to take another full diet break. I think you get the idea.
I hope that helps and good luck.
Glad you skipped the “peak X” part. Remember “Peak X free” tryptophan and 5-HTP? I shit you not, it would say that on the supplement facts label.
On a more constructive note I’d just like to throw out there that I too am someone who will reliably experience moderate depression on a very low carbohydrate diet and have tried ameliorating the depression with 5-htp and then SSRI’s (I really suggest avoiding the latter) with no relief. Eventually I tried Stablon (which works in part by increasing the re-uptake of 5HT; effectively lowering serotonin) to which I responded beautifully. This could mean that 5HT precursor availability was not the underlying issue at play, or another neurotransmitter system was out of whack (dopamine or norepinepherine). I didn’t try tyrosine or phenylalanine, and the data on the conversion rate and resultant efficacy is equivocal anyway. Either way I’m positive that near ketogenic diets heavily influence my mood.
Eventually I realized that I don’t need to subject myself to VERY low carb ketogenic diets anyway (check out Lyle’s articles on is a calorie a calorie) and since I ceaselessly get depressed when I do I figured why bother. I’ve since found that Stablon is just remarkable in that is an activating anxiolytic and it improves my mood and enriches my life so much that it’s a staple in my regiment now.
Chris
It gets a lot more complicated than this as long-term changes in brain serotonin levels impact on receptor number and sensitivity. Lowering brain serotonin levels with Stablon *might* have ended up increasing receptor sensitivity, meaning that the same lowered levels send a better signall.
It gets real complicated (I don’t dare claim to but to half understand it) when you start looking at pre- and post-synaptic receptor number and everything else.
Lyle
I’m right there with you on the “know enough to be dangerous” with the neurochem stuff. Yeah pre and post synaptic down regulation and sensitization, synapse NT levels and downstream changes all play a part indeed. The whole low serotonin thing and the ultra simplistic re-uptake blocking diagrams seem to have been marginalized and may not even be clinically relevant to the efficacy of the SSRI’s (if in fact there really is any).
FWIW, 5HT sensitization issues aside, Stablon may also work by up-regulating dopaminergic transmission due to the inhibition of the inhibiting serotonergic neurotransmission (which is inhibiting both physiologically in neurons and specifically in the PFC). But you’re right, the whole scene is arduously complex to understand.
Everything writtten above is well over my head.
I have a different experience. (I believe) limiting some carbs (rice, bread, pasta, potato) from my diet results in me feeling mentally sharp and less prone to dwell on problems for an extended period of time.
Cheers,
Serotonin is very strange (and seemingly contradictory) in what it does. I’ll be damned if I can quite wrap my head around some of it’s apparently divergent behavioral manifestations at high and low levels.
But high levels of serotonin signalling can cause anxiety and worry along with some obsessive tendenciies (which may be what you’re describing) in which case lowering levels could be beneficial. As noted in the Q&A, it’s primarily people prone to depression per se that are at risk for what I’m talking about.
Thanks for a great article and a great reminder of something I try to think about (but forget). Maybe this was implicit, but what about a very-low-fat diet for this issue? If I limit fats to a handful of nuts and the fish fat for the most part, it leaves more cal for carbs. Is this problematic? Also, are some forms of carbs better than others?
Lyle,
Great stuff, as always. I truly appreciate what an excellent continuing education resource you are, so thank you for your efforts.
I dont know but, i have the contrary problem, when i eat to much carbohydrates i really feel depresed, sleepy, etc…,im not follow a ketogenic diet or something like that, i eat around 160gr of carbs per day but most of them come from veggies, fruits and a little starchy like oats, and i have to say, nothing give me more energy and fullness than eating a lot of veggies, .
Awesome article, Lyle. It’s why I continuously say to people that your writing is my favorite to read. It’s always completely science based, but with real world application. You have the single best science:real world ratio in your writings of all the nutrition articles/blogs I read (which is a lot).
I always feel smarter after reading your articles haha.
I’m someone with a history of depression who’s been chipping away at fat loss for a little under a year and a half. For about half a year I’ve been attempting to eat higher protein/lower carb than my usual eating pattern.
Thanks very much for this article. It pulled together some things that I had been trying to make sense of in my own dieting experiences. It especially helped me get a perspective on why I sometimes feel driven to eat carby fatty foods when I’m down or stressed.
Can you recommend any sources of alpha-lactalbumin? Also is there a reason L-Tryptophan didn’t come into the discussion?
I should clarify that I meant L-Tryptophan in supplement form.
You can get alpha-lactalbumin at trueprotein.com
And while tryptophan can be used, it has to be taken far away from protein containing meals to have an impact which can be a problem at bedtime (you have to eat dinner very early). 5-htp avoids those problems so far as I know.
How does this discussion relate to someone on your Ultimate Diet 2.0 (where there are low carbs half of the week and then a massive carb load on Day 4)? Does the carb load day replenish the chemicals/neurotransmitters related to depression, or is the carb load only sufficient to replenish the glycogen-depleted muscles?
This is a very good question.
I do not currently have a very good answer much beyond a hunch that it certainly doesn’t hurt and probably helps. It seems like the issues that occur (and keep in mind that the effect of serotonin on overall signalling and such has both long and short term effects as the system modulates itself) are longer term and I do wonder if bumping up serotonin with the weekend periods of normal eating doesn’t prevent problems in the long-term.
Lyle
Lyle, awesome explanation of the chemical reactions when reducing carbs and increasing protein. I always knew this was a possible side-effect when dieting but was lucky not to experience it to higher degrees as some others have.
There’s no mention of fat in the discussion and I recall from Tom Naughton’s movie Fathead that not eating enough fat is linked to depression, which he repeats on his blog here. This is the relevant quote:
Without saturated fat in the diet, your body has a difficult time absorbing the vitamins and other nutrients from your food. Your brain is made mostly of saturated fat and cholesterol, and without these essential fats, you are more likely to experience brain malfunctions, such as depression, or attention deficit disorder, or epilepsy.
Could there be any relevance? For example perhaps there happens to be a relationship between carbohydrate intake and fat intake for this person.
Dietary fat intake would have to be pretty absurdly low for nutrient absorption to be an issue and, for the record, neither saturated fat nor cholesterol are essential nutrients as humans can synthesize both.
A search on medline for ‘saturated fat and depression’ turned up pretty much nothing in humans to support that claim.
Certainly a low w-3 intake can be associated with depression with dozens of papers on that topic.
Lyle
FWIW, DH’s mood issues cleared up when he ditched the gluten. I tried the diet along with him and in addition to fixing my migraine problem, my moods seem more stable, particularly pre-menstrual. We are eating, “very low carb” as it is defined here.
Hi Again – sorry for the long delay – but I recently came across this paper:
http://bjp.rcpsych.org/cgi/content/abstract/175/3/259
“Association of low serum total cholesterol with major depression and suicide”
I am not sure whether dieting alone can cause cholesterol to become low enough to impact on brain function in this way, but I have certainly read that cholesterol-lowering drugs have been associated with higher rates of suicide.
it is possible the 5-htp can be causing me to plateau. i’ve dieted a few times before to get 20-10lbs off (during college, after college and now after quitting smoking b/c i put the weight back on) and i’ve never hit a plateau so early on. its been 7 weeks and i haven’t lost any weight in the 17 days. i am doing everything by the book, the way i always have, and its always worked. only thing is i started taking 5-htp about 3 weeks ago and now no weight loss, i have been having very vivid dreams and waking up during the night as well. is it possible 5-htp is NOT helping, but harming my weight loss goals?
I can’t think of any way that this would be the case offhand but that doesn’t mean it’s not possible. The easiest test would be to simply drop it and see what happens. Also consider that weight loss is rarely linear, there are often stalls and drops (there is an article on the site about whooshes along with other stuff about water balance) and women often have bigger issues due to the vagaries of the menstrual cycle. So it’s not uncommon for weight to stabilize and then suddenly drop by a large amount overnight.
Thanks for the great info. I get very depressed on a low carb diet but thought it was “just me”… I crave pasta and comfort food and always feel better afterward. Now I know the reason behind my cravings.
Depression from LOW carbing? That is very strange.
Back in 2005, I dealt with severe anxiety (and sometimes depression, both serotonin disorders) that I treated WITH a low-carb paleo diet. Like clockwork, eating carbs in excess (Over 100-150g) and especially from bad sources like grains would result in a panic attack 48 hours later. It took my a while to figure it out because of the delay, but I kept a food journal for months and found that correlation. After five years of getting my serotonin in balance, I can now tolerate high carbs post workout without too many ill effects.
I wonder if the OP is really experiencing depression from lowering carbs, or withdrawal from wheat: http://heartscanblog.blogspot.com/2010/11/why-do-morphine-blocking-drugs-make-you.html
Also, how about tanning once a week and supplementing with Vitamin D? Does wonders for depression, especially of the seasonal variety.
I used to be on two antidepressant medications (Cymbalta and Mirtazipine) at very high dosage, which kept my depression at bay. At various times, I tried to lower the dosages, but my depression would sneak back up, so I kept the dosages high. Then I discovered Robb Wolf and went paleo, pretty low carb (most days 45-70g of carbs; on workout days, with sweet potatoes, the carbs are higher). After a number of weeks on paleo, I was able to get off of all my medications, and I have ZERO depressive symptoms. It has been amazing. And my carb intake is really low 4-5 days per week, and the other days are only moderately high in carbs.
I used to mock paleo, but it has worked wonders for my life.
And if anecdotes were science….
Great article. I can relate completely as I suffer horribly on a low carb diet with moderate depression, severe brain fog and severe insomnia. The only time I slept is after a refeed.
Currently on a ketogenic diet and feeling great with none of the above problems. I have been taking 5-htp with l-tyrosine twice a day at high doses. I started low and titrated up until the symproms resolved. My understanding is that 5-HTP and Dopamine use the same enzyme to convert the amino acid precursors to serotonin and dopimine. Taking one without the other can deplete neurotransmitters. Some claim this to be the main reason for amino acid repletion failure.
It’s true that anecdotes aren’t science. The whole article was based on taking some anecdotes, and forming an ad hoc explanation for why that might be, right? I think that’s fine for hypothesis generation.
You can add me to the pile of opposite anecdotes. The lower the amount of carbohydrate I eat, the better my depression. Even on a very low carb diet, I was often depressed (though not as badly as with more carbs) and tried many medications without much improvement. It wasn’t until I went to an all meat diet that my symptoms completely disappeared. Now I am medication-free, and have a happier, more stable mood than ever in my adult life. (I’m 37.)
I find this discussion a little fluffy!
Carbohydrates are discussed as if there is only “one kind” with the same effects. There are several type of carbohydrates.
To the person who asked the question, I recommend that you read more about carbs. They’re not just starches!
Add me to the list of people for whom low carb proved disastrous for brain chemistry. Mental illness runs in my family (and perhaps not coincidentally, low cholesterol– HDL is great from my exercise, but LDL is about 1/3 what is considered normal) and I have been on Wellbutrin for about ten years. It manages my depression in conjunction with counseling. In ’07-’08, I lost weight with standard caloric restriction/exercise, and then in ’08-’09 decided to push it that last bit lower by going low carb. Something snapped, I started binge eating sugar, and in the course of getting stable again put on all but 5 pounds that I’d lost.
In the past year I’ve slowly taken twenty-odd pounds back off with “balanced diet,” caloric restriction and exercise. For myself, I know I need to have vegetable/fruit, whole grain, and protein at every meal, dessert with every lunch/dinner, and a small snack of low-GI toast at bedtime to keep my brain chemistry balanced. The consistent, regular, balanced, routine meals are what work best for my brain, and therefore, my body.
I’m not suggesting that anybody else would be better off this way, but I just get really tired of being made to feel like a failure. Low carb failed me, not the other way around. The real failure would be in knowing what worked best for myself and stubbornly ignoring those facts.
Lyle,
I’ve just discovered your site and have been absorbing everything I can, and I’d like to complement you on the fascinating job you’ve done. This article in particular is highly fascinating and it may be relevant to a somewhat different issue I’ve been having with serotonin.
Last year, I was diagnosed with an adult onset tic disorder, (Tourrette’s in everything but name given that I didn’t really display noticeable tics until I was 23, but identical in all other symptoms and treatment benefits.) This led to me ceasing to take adderal and beginning to take risperidone, zoloft, and a few other things at various points (none of which i’ve been taking for the last several months.) In short, the effect of these medication changes led me to a 20-25 lb weight gain over the last year (I’m assuming this given that all other factors were relatively equal.)
Cut to now, I’ve been doing a fairly faithful south beach diet regimen for the last 4 weeks (very low carb, frequent portions), and exercising 5-6 days per week (weights and cardio). I’ve lost 12 pounds from 4 weeks ago. However, one unwanted change is that my tics, which have been relatively low in frequency for the past several months, have increased dramatically during the last week or so. The usual drivers for my tic increases are sleep loss and anxiety, but i can’t claim to have experienced any significant change in either of those factors.
While the causes of Tourrette’s are a subject of ongoing research, there is evidence that it is related to problems in dopamine and/or serotonin management. After reading this article, I’m seriously considering supplementing with that alpha-lactalbumin you mentioned. If I go through with it, I’ll try to report back with my results. I think it’ll make a fairly interesting experiment if my tic levels decrease.
Anyway, thanks again for some very thought provoking articles.
Andrew
Thank you very much for this wonderful information. I’ve first read about this in Readers Digest about the link between dieting and depression. I was looking for a related one for proof and more info, then I stumbled into your work. Saving this at my Categorian and linking this to my article, thank you very much sir.