The patient, a 48-year-old real estate professional in treatment for anxiety and mild depression, revealed that he had eaten three dozen oysters over the weekend.
His psychiatrist, Dr Drew Ramsey, an assistant clinical professor of psychiatry at Columbia University, was impressed: “You’re the only person I’ve prescribed them to who came back and said he ate 36!”
But shellfish are not the only food he is enthusiastic about.
Ramsey is a pioneer in the field of nutritional psychiatry, which attempts to apply what science is learning about the impact of nutrition on the brain and mental health.
Ramsey argues that a poor diet is a major factor contributing to the epidemic of depression, which is the top driver of disability for Americans aged 15 to 44, according to a report by the World Health Organization.
Together with Samantha Elkrief, a chef and food coach who sits in on many of his patient sessions, he often counsels patients on how better eating may lead to better mental health.
The irony, he says, is that most Americans are overfed in calories yet starved of the vital array of micronutrients that our brains need, many of which are found in common plant foods. A survey published in 2017 by the Centers for Disease Control and Prevention reported that only 1 in 10 adults meets the minimal daily federal recommendations for fruit and vegetables — at least 1 1/2 to 2 cups per day of fruit and 2 to 3 cups per day of vegetables.
Nutritional psychiatrists like Ramsey prescribe antidepressants and other medications, where appropriate, and engage in talk therapy and other traditional forms of counselling. But they argue that fresh and nutritious food can be a potent addition to the mix of available therapies.
Americans routinely change what they eat in order to lose weight, control their blood sugar levels and lower artery-clogging cholesterol. But Ramsey says that it is still rare for people to pay attention to the food needs of the most complex and energy-consuming organ in the body, the human brain.
The patient Ramsey was seeing that day credits the nutritional guidance, including cutting down on many of the processed and fried foods and fatty meats that used to be part of his diet, with improving his mood and helping him overcome a long-term addiction to alcohol.
“It’s one part of the whole package that helps alleviate my depression and helps me to feel better,” he said.
Research on the impact of diet on mental functioning is relatively new, and food studies can be difficult to perform and hard to interpret, since so many factors go into what we eat and our general well-being.
But a study of more than 12,000 Australians published in the American Journal of Public Health in 2016 found that individuals who increased the number of servings of fruits and vegetables that they ate reported that they were happier and more satisfied with their life than those whose diets remained the same.
Interestingly, the same benefits did not accrue to those who ate canned fruits and vegetables. “We think this is due to the higher nutrient content of raw fruits and vegetables, particularly B vitamins and vitamin C, which are vulnerable to heat degradation,” said Tamlin Conner, a study author and senior lecturer at the University of Otago.
One of the first randomized controlled trials to test whether dietary change may be effective in helping to treat depression was published in 2017. In the study, led by Felice Jacka, a psychiatric epidemiologist in Australia, participants who were coached to follow a Mediterranean diet for 12 weeks reported improvements in mood and lower anxiety levels. Those who received general coaching showed no such benefits.
A Mediterranean diet, rich in whole grains, legumes and seafood as well as nutrient-dense leafy vegetables that are high in the fibre, promotes a diverse population of helpful bacteria in the gut.
“Our imaging studies show that the brains of people who follow a Mediterranean-style diet typically look younger, have larger volumes and are more metabolically active than people who eat a more typical Western diet,” said Dr Lisa Mosconi, the director of the Women’s Brain Initiative at the Weill Cornell Medical Center in New York. Such brain benefits may be protective against the onset of dementia, she said.
Mosconi noted that “there is no one diet that fits all” but advises patients to cut out processed foods, minimize meat and dairy and eat more whole foods like fatty fish, vegetables and whole grains and legumes to cut the risk of developing degenerative brain diseases associated with aging.
She and Ramsey both recommend “eating the rainbow,” that is, consuming a wide array of colourful fruits and vegetables like peppers, blueberries, sweet potatoes, kale and tomatoes.
Such foods are high in phytonutrients that may help to reduce harmful inflammation throughout the body, including the brain, and promote the growth of new brain cells throughout our adult years, they say.
Dr. Emily Deans, a clinical instructor in psychiatry at Harvard Medical School, cautions that a plant-only diet may carry some risks.
Some large observational studies suggest, for example, that strict vegetarians and vegans may have somewhat higher rates of depression and eating disorders than those who eat a more varied diet.
Those on a meat-free diet may also need to take supplements to provide missing nutrients. “Some of the key nutrients for the brain, like long chain omega 3 fatty acids and vitamin B12, are simply not found in vegetable only diets,” says Deans.
Samantha Elkrief, the food coach who assists Ramsey, adds that it’s not just what we eat but the attitudes that we bring to our food that contribute to mental well-being.
“I want to help people find the foods that give them joy, that make them feel good,” she says.
“It’s about slowing down and becoming more mindful, noticing your body, noticing how you feel when you eat certain foods.”
Public officers above 58 years and with pre-existing conditions told to work from home: The Standard
Head of Public Service Joseph Kinyua. [File, Standard]
In a document from Head of Public Service, Joseph Kinyua new measure have been outlined to curb the bulging spread of covid-19. Public officers with underlying health conditions and those who are over 58 years -a group that experts have classified as most vulnerable to the virus will be required to execute their duties from home.
However, the new rule excluded personnel in the security sector and other critical and essential services.
“All State and public officers with pre-existing medical conditions and/or aged 58 years and above serving in CSG5 (job group ‘S’) and below or their equivalents should forthwith work from home,” read the document,” read the document.
To ensure that those working from home deliver, the Public Service directs that there be clear assignments and targets tasked for the period designated and a clear reporting line to monitor and review work done.
SEE ALSO: Thinking inside the cardboard box for post-lockdown work stations
Others measures outlined in the document include the provision of personal protective equipment to staff, provision of sanitizers and access to washing facilities fitted with soap and water, temperature checks for all staff and clients entering public offices regular fumigation of office premises and vehicles and minimizing of visitors except by prior appointments.
Officers who contract the virus and come back to work after quarantine or isolation period will be required to follow specific directives such as obtaining clearance from the isolation facility certified by the designated persons indicating that the public officer is free and safe from Covid-19. The officer will also be required to stay away from duty station for a period of seven days after the date of medical certification.
“The period a public officer spends in quarantine or isolation due to Covid-19, shall be treated as sick leave and shall be subject to the Provisions of the Human Resource Policy and procedures Manual for the Public Service(May,2016),” read the document.
The service has also made discrimination and stigmatization an offence and has guaranteed those affected with the virus to receive adequate access to mental health and psychosocial supported offered by the government.
The new directives targeting the Public Services come at a time when Kenyans have increasingly shown lack of strict observance of the issued guidelines even as the number of positive Covid-19 cases skyrocket to 13,771 and leaving 238 dead as of today.
SEE ALSO: Working from home could be blessing in disguise for persons with disabilities
Principal Secretaries/ Accounting Officers will be personally responsible for effective enforcement and compliance of the current guidelines and any future directives issued to mitigate the spread of Covid-19.
Uhuru convenes summit to review rising Covid-19 cases: The Standard
President Uhuru Kenyatta (pictured) will on Friday, July 24, meet governors following the ballooning Covid-19 infections in recent days.
The session will among other things review the efficacy of the containment measures in place and review the impact of the phased easing of the restrictions, State House said in a statement.
This story is being updated.
SEE ALSO: Sakaja resigns from Covid-19 Senate committee, in court tomorrow
Drastic life changes affecting mental health
Kenya has been ranked 6th among African countries with the highest cases of depression, this has triggered anxiety by the World Health Organization (WHO), with 1.9 million people suffering from a form of mental conditions such as depression, substance abuse.
Globally, one in four people is affected by mental or neurological disorders at some point in their lives, this is according to the WHO.
Currently, around 450 million people suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide.
The pandemic has also been known to cause significant distress, mostly affecting the state of one’s mental well-being.
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With the spread of the COVID-19 pandemic attributed to the novel Coronavirus disease, millions have been affected globally with over 14 million infections and half a million deaths as to date. This has brought about uncertainty coupled with difficult situations, including job loss and the risk of contracting the deadly virus.
In Kenya the first Coronavirus case was reported in Nairobi by the Ministry of Health on the 12th March 2020. It was not until the government put in place precautionary measures including a curfew and lockdown (the latter having being lifted) due to an increase in the number of infections that people began feeling its effect both economically and socially.
A study by Dr. Habil Otanga, a Lecturer at the University of Nairobi, Department of Psychology says that such measures can in turn lead to surge in mental related illnesses including depression, feelings of confusion, anger and fear, and even substance abuse. It also brings with it a sense of boredom, loneliness, anger, isolation and frustration. In the post-quarantine/isolation period, loss of employment due to the depressed economy and the stigma around the disease are also likely to lead to mental health problems.
The Kenya National Bureau of Statistics (KNBS) states that at least 300,000 Kenyans have lost their jobs due to the Coronavirus pandemic between the period of January and March this year.
KNBC noted that the number of employed Kenyans plunged to 17.8 million as of March from 18.1 million people as compared to last year in December. The Report states that the unemployment rate in Kenya stands at 13.7 per cent as of March this year while it stood 12.4 per cent in December 2019.
Mama T (not her real name) is among millions of Kenyans who have been affected by containment measures put in place to curb the spread of the virus, either by losing their source of income or having to work under tough guidelines put in place by the MOH.
As young mother and an event organizer, she has found it hard to explain to her children why they cannot go to school or socialize freely with their peers as before.
“Sometimes it gets difficult as they do not understand what is happening due to their age, this at times becomes hard on me as they often think I am punishing them,”
Her contract was put on hold as no event or public gatherings can take place due to the pandemic. This has brought other challenges along with it, as she has to find means of fending for her family expenditures that including rent and food.
“I often wake up in the middle of the night with worries about my next move as the pandemic does not exhibit any signs of easing up,” she says. She adds that she has been forced to sort for manual jobs to keep her family afloat.
Ms. Mary Wahome, a Counseling Psychologist and Programs Director at ‘The Reason to Hope,’ in Karen, Nairobi says that such kind of drastic life changes have an adverse effect on one’s mental status including their family members and if not addressed early can lead to depression among other issues.
“We have had cases of people indulging in substance abuse to deal with the uncertainty and stress brought about by the pandemic, this in turn leads to dependence and also domestic abuse,”
Sam Njoroge , a waiter at a local hotel in Kiambu, has found himself indulging in substance abuse due to challenges he is facing after the hotel he was working in was closed down as it has not yet met the standards required by the MOH to open.
“My day starts at 6am where I go to a local pub, here I can get a drink for as little as Sh30, It makes me suppress the frustration I feel.” he says.
Sam is among the many who have found themselves in the same predicament and resulted to substance abuse finding ways to beat strict measures put in place by the government on the sale of alcohol so as to cope.
Mary says, situations like Sam’s are dangerous and if not addressed early can lead to serious complications, including addiction and dependency, violent behavior and also early death due to health complications.
She has, however, lauded the government for encouraging mental wellness and also launching the Psychological First Aid (PFA) guide in the wake of the virus putting emphasis on the three action principal of look, listen and link. “When we follow this it will be easy to identify an individual in distress and also offer assistance”.
Mary has urged anyone feeling the weight of the virus taking a toll on them not to hesitate but look for someone to talk to.
“You should not only seek help from a specialist but also talk to a friend, let them know what you are undergoing and how you feel, this will help ease their emotional stress and also find ways of dealing with the situation they are facing,” She added
Mary continued to stress on the need to perform frequent body exercises as a form of stress relief, reading and also taking advantage of this unfortunate COVID-19 period to engage in hobbies and talent development.
“Let people take this as an opportunity to kip fit, get in touch with one’s inner self and also engage in reading that would help expand their knowledge.