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Nutritional Considerations for Chronic Depression

Nutritional Considerations for Chronic Depression

On a pure physiological level, certain nutrients can help you experience a healthy nervous system and emotional balance. Foods that are heavily processed and/or full of artificial ingredients can cause physical damage to your nervous system and make it difficult for you to experience optimal emotional health.

Please keep in mind that I am writing about developing and maintaining the capacity to effectively deal with life’s challenges. Bouts of depression are normal - staying chronically depressed is not.

The nutrients that are most needed to promote a healthy nervous system and emotional balance are:

  1. Omega-3 fatty acids- EPA and DHA
  2. Vitamin D
  3. The entire spectrum of B vitamins
  4. Vitamin C
  5. Magnesium
  6. Calcium
  7. Iron

Omega-3 Fatty Acids

Although we do not yet fully understand exactly how two omega-3 fatty acids – EPA and DHA work in our bodies to prevent and treat chronic depression, many scientific studies indicate that both are essential for optimal nervous system and emotional health.

The healthiest sources of naturally occurring omega-3 fatty acids are:

  1. Fish oils – Including cod liver oil, fish oils provide rich amounts of EPA and DHA that are easily absorbed into your bloodstream. Because omega-3 fatty acids are inherently unstable when exposed to heat, light, and excessive processing techniques, it is important that you take fish or cod liver oil that is made by a quality manufacturer. I recommend all types of fish oil made by Carlson labs, but there are other manufacturers who make equally effective fish oil products. If you are unsure of which brand to take, you may consider visiting, a membership-only site that ranks various fish oil supplements according to independent laboratory testing for purity and freshness.
  2. Seaweed – All types contain naturally occurring EPA and DHA. Rather than spend big dollars on seaweed at a health food store, look to buy seaweed for reasonable prices from Asian grocery stores. For sheets of dried seaweed that you can eat with rice-like sushi rolls, be sure to read the ingredients to ensure that no MSG has been added. For long packages of dried, string-like seaweed that you can turn into soup, the list of ingredients should read "brown seaweed." Be sure to dunk the latter kind in a basin of water for an hour to allow the seaweed to rehydrate, and rinse several times before turning it into soup. Resource: Traditional Korean Seaweed Soup Recipe
  3. Eggs from free-range birds – When cooked over low heat or simply soft-boiled, eggs are easily digested by people who do not have an overt egg allergy. Soft boiling in water is the healthiest cooking method, followed by frying over low heat using olive oil, coconut oil, or organic butter if you can eat butter without experiencing discomfort.
  4. Walnuts – For optimal freshness of their naturally occurring omega-3 fatty acids, walnuts should be purchased whole, in their shells, and cracked open just before eating. If whole walnuts are unavailable, walnut halves will do, but be sure to store them in an air-tight container in the freezer when not in use to help preserve their delicate fatty acids. As is the case with all raw nuts, soaking them in a bowl of water for a few hours before eating can help to promote optimal digestion.
  5. Flax seeds and chia seeds – Should be freshly ground with a coffee grinder or powerful blender right before eating. Blending ground flax and/or chia seeds into fruit and green smoothies is an easy way to increase your daily intake of omega-3 fatty acids.
  6. Wild salmon, anchovies, and sardines – These fish are naturally rich in omega-3 fatty acids and known to be least contaminated with mercury and other environmental pollutants among different types of fish. Still, it is best for pregnant women and young children to limit their consumption of fish of any type to a few servings per month. Low temperature cooking methods like steaming and boiling are the healthiest ways of preparing all types of fish.
  7. Dark green vegetables and herbs – Kale, leafy lettuce, Swiss chard, broccoli, bok choy, collard greens, wheatgrass, purslane, super green food mixtures, and all other dark green vegetables provide omega-3 fatty acids that can be converted to EPA and DHA. Drinking juices made out of any of these vegetables is an excellent way of bolstering your intake of omega-3 fatty acids.
  8. White and red meat from land animals (chicken, turkey, lamb, cow, wild game) – These foods can be healthy sources of omega-3 fatty acids if they are cooked at low temperatures and if the animals are raised in free-range environments, and allowed to feed on foods that are natural to them. White and red meat are best prepared with a crockpot, within stews, or via steaming to ensure that they are not exposed to high cooking temperatures which can create harmful chemicals and ruin some of their nutrients.

Vitamin D

As is the case with omega-3 fatty acids, we do not know exactly how vitamin D helps to prevent and treat depression. We only know that multiple studies indicate that people who are low in vitamin D have a much stronger tendency to develop depression compared to people who have adequate amounts of vitamin D in their system.

For now, the best guess as to why vitamin D is important for preventing and treating depression is that it can elevate the level of serotonin in the brain, which is essentially what antidepressant drugs aim to do.

Four healthy sources of natural vitamin D are:

  1. Exposure to UV-B rays from natural sunlight – Is truly the healthiest source of vitamin D, since your body knows when you have made enough and will not produce excess amounts. In general, UV-B rays are only able to create adequate amounts of vitamin D in your skin from about 10 am to 2 pm. If you live at a higher latitude and your winter climate is generally cold and devoid of sunshine, it is likely that you cannot produce adequate amounts of vitamin for about half of the year.
  2. Cod liver oil – If it is produced by a reputable manufacturer, cod liver oil provides naturally occurring vitamin D. For Carlson cod liver oil, it is safe to say that most people do well with about one teaspoon per 50 pounds of body weight per day. The only way to ensure that you do have too much vitamin D in your system is to do a blood test with your health care provider. In general, the vast majority of people living in industrialized countries are deficient in vitamin D.
  3. Wild salmon and sardines – Like cod liver oil, are excellent sources of both naturally occurring vitamin D and omega-3 fatty acids. Again, it is important that pregnant women and children limit their consumption of all types of fish to a few servings per month to avoid potential exposure to dangerous levels of mercury and environmental pollutants. For this reason, cod liver oil that has been screened for environmental contaminants is a healthier choice than actual fish.
  4. Organic egg yolks – They contain only about 1/20th the amount of vitamin D that cod liver oil and wild salmon do, but are still a healthy food choice that can help to prevent and treat depression because they contain both vitamin D and omega-3 fatty acids.

The Entire Spectrum Of B Vitamins

B vitamins play numerous critical roles in protecting the health of your nervous system and supporting the basic, everyday metabolic processes of each of your brain cells. Of particular importance are vitamins B6 and B12.

Vitamin B6, also called pyridoxine, helps your body produce serotonin and other chemicals that are essential to the health of your brain.

Vitamin B12, also called cobalamin, helps your body create and maintain myelin, which is a protective insulating sheath of fat that needs to surround your entire nervous system in order for your brain, spinal cord, and nerves to work properly.

The best food sources of B vitamins are:

  1. Brown rice – Provides vitamin B1, B3, and folate. For optimal digestion and to prevent the development of mineral deficiencies, it is best to soak brown rice in water for a few hours before cooking with fresh water – 2 cups of water for each cup of brown rice.
  2. Oats – Are an excellent source of vitamin B1 and folate. Oats are also a relatively good source of vitamin B6. Of all the varieties of oats on the market, the best choice is steel-cut oats, which are whole oat groats that have been cut into small pieces. No heat is used to make steel-cut oats, which translates to better nutrient preservation than other processing techniques that produce rolled oats or quick oats. If you have to choose between rolled oats and quick oats, choose the rolled variety. Rolled oats are made with a steaming process that does not destroy many nutrients, while quick oats are made with dehydrating and pre-cooking processes which typically leave oats nutrient-depleted. As is the case with brown rice, it is best to soak oats in water for a few hours before preparing them to eat.
  3. Other whole grains – Quinoa, millet, and buckwheat are also high in multiple B vitamins and are best prepared using the method described above to cook brown rice.
  4. Grass-fed beef and beef liver – Are excellent sources of multiple B vitamins, particularly vitamins B12 and B2. Flesh and organ meats should be eaten in moderation due to their protein density. They should be cooked with low-temperature methods, preferably boiling.

Vitamin C

Vitamin C plays an important role in the conversion of an amino acid called tryptophan to serotonin, which is essential to the health of your nervous system. It is best to obtain your vitamin C from foods that are naturally rich with it, not from synthetic supplements. If you would like to include a vitamin C supplement in your diet, I recommend that you find a food-based vitamin C supplement – acerola cherry powder and amla berry powder are two good examples of food-based vitamin C supplements. Goji berries are also an excellent concentrated source of the full vitamin C complex.

Healthy food sources of vitamin C include:

  1. Sweet red peppers – Are best eaten raw and are easily digested by most people. If you cannot find an organic source of sweet red bell peppers, be sure to wash them well with running water to minimize consumption of pesticides that can be on the outer skin.
  2. Strawberries – Should be eaten raw and should also be organic, if possible. As is the case with sweet red bell peppers, be sure to give them a thorough rinse with running water before eating.
  3. Oranges & grapefruits – Be sure to brush your teeth after every meal of oranges and/or grapefruits. Their citric acid can cause dental cavities in a hurry if they are left in contact with your teeth.
  4. Brussels sprouts, collard greens, cabbage, and broccoli – Most people extract the greatest number of nutrients, including vitamin C – out of these green vegetables when they are lightly cooked. Cooking helps to break down their fiber, which makes it easier for your digestive tract to gain access to the nutrients within these vegetables. Steaming is best, followed by boiling in water for a few minutes.
  5. Cantaloupe – A nutrient-rich cantaloupe will have a relatively firm skin and a sweet aroma toward its ends. Cantaloupes will ripen to this stage if you leave them out in your kitchen for a day to a few days.
  6. Tomatoes – Can be eaten raw or cooked for the purposes of providing your body with vitamin C.


Magnesium is essential to preventing and treating depression because it plays a critical role in allowing proper nerve signaling within your nervous system. A magnesium deficiency can in and of itself cause depression.

The healthiest food sources of magnesium are:

  1. Brown rice – As mentioned before, be sure to soak brown rice in water for a few hours before cooking – two cups of water for every cup of brown rice.
  2. Raw almonds - Soaking raw almonds in water for a few hours before eating them can significantly improve your ability to fully digest them. It is best to eat only up to one to two small handfuls of raw almonds per day. A small serving every other day is optimal for most people.
  3. Swiss chard and spinach – Lightly steamed or boiled in water are the best cooking methods for these greens. Spinach shouldn’t be eaten every day, as naturally occurring acid in spinach can weaken your teeth.
  4. Lima beans, cooked – Although it is best to buy dry lima beans, soak them in water overnight, and then cook them for an hour or two the next day, canned lima beans are also a relatively healthy source of magnesium and other health-promoting nutrients. If you use the canned variety, be sure to rinse them thoroughly in water and dunk them in boiling water for a minute or two to ensure complete removal of any preservative residues that remain on their skins.
  5. Avocados – Should always be eaten raw. If you do not enjoy eating raw avocados on their own, try them with a whole grain dish like brown rice or quinoa. They have a natural, buttery consistency that makes them a natural pairing with a hearty grain dish. Another option is to make fresh guacamole out of avocados and eat it with your favorite crackers or baked corn chips.


Calcium is one of the most important minerals needed by your central nervous system for proper nerve signaling.

Healthy food sources of calcium are:

  1. Canned sardines and canned wild salmon – Do not be shy about eating bones that come with these food products.
  2. Chinese cabbage, spinach, bok choy, broccoli, and kale – For optimal extraction of calcium and other nutrients from these vegetables, it is best to steam them before eating. If you choose to boil them in water before eating, consider having some of the water as soup, as calcium can leech into boiling water.
  3. White beans, red beans, and pinto beans – If you use canned varieties, be sure to rinse them well and boil them for a minute or two before eating to ensure removal of preservatives that are sometimes added to canned beans.
  4. Sesame leaves and sesame seeds – Both are readily available for reasonable prices at Korean grocery stores. Resource: Health Benefits of Sesame
  5. Organic, unpasteurized dairy – Should only be consumed if you know that your body can handle dairy without any health problems like nasal congestion, joint inflammation, digestive issues, and skin rashes.
  6. Broths and soups made with organic bones – For centuries, Chinese and Korean people have relied upon mineral-rich broths made out of chicken or beef bones for their primary source of calcium.


Because iron is essential to your ability to deliver oxygen to your cells, being deficient in iron can cause you to experience many symptoms that are related to being depressed, the most common of which are fatigue and impaired mental and motor skills (mainly in children).

Healthy food sources of iron include:

  1. Beef liver – If possible, it should be from a grass-fed cow or at least one that is raised in a natural setting (not factory-farmed). If beef liver of this variety is not available, then factory-farmed beef liver is acceptable to eat on occasion, as it is extremely dense in iron and other nutrients. Beef liver should be steamed, boiled, or lightly sautéed with no more than medium-level heat.
  2. Spinach – In order to extract as much iron out of spinach as possible, it is best to cook it. Steaming is best. If you boil spinach, drink the water or use the water to make a soup and have that as well, as iron and other minerals can leech into cooking water.
  3. Lima beans – It is fine to use canned lima beans; just be sure to give them a thorough rinse before eating. You can boil them for a minute or two after rinsing them to ensure maximal removal of preservatives. If you cook dried lima beans, be sure to soak them in water overnight, as this will make them easier to cook and extract nutrients from when you digest them.
  4. Lentils – As recommended with lima beans, dried lentils should be soaked overnight before being cooked to allow for optimal extraction of nutrients during digestion.
  5. Potato with skin – Steaming is the cooking method that best preserves the nutritional value of potatoes. Cut potatoes into small pieces to decrease cooking time.

Part 1: Understanding and Overcoming Chronic Depression
Part 2: How Do You Know That You Are Depressed?
Part 3: Nutritional Considerations for Chronic Depression
Part 4: Mind-Body Exercises to Help You Transcend Chronic Depression
Part 5: How to Use Physical Exercise and Acupressure to Address Chronic Depression


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Dear Dr. Kim,
Regarding your advice to brush one's teeth straight after eating citrus fruits, I believe that dentists advise these days that one should wait 30 to 45 minutes after eating anything acidic (including soft drinks, wine, pickles, etc.) so the surface of the teeth can reharden (with the help of the saliva) after being softened by the acidic food/drink.
There is a chart available on the internet that shows the time required by teeth to reharden so that brushing them does not wear away the valuable outer layer of the tooth surface unnecessarily.
I once had a boyfriend who told me I should brush my teeth immediately after eating breakfast with orange juice instead of before eating breakfast, so I did that for a year, and when I went to my dentist, she told me the practice had worn away 20 years' worth of my tooth enamel and had made my gums recede so much. I was only in my early 30s and it was a shame that I'd weakened my teeth in that way.
Apparently a way to encourage the teeth to reharden a little quicker than just waiting for the normal post-meal saliva to help them reharden is to eat a piece of cheese or a spoonful of plain yogurt as the last item in the meal.
In any case, no matter what I eat and drink at any time of day, I always wait 45 - 60 minutes before brushing my teeth now.
One dentist who explains this extensively online is a British dentist based in New York State named "Dr. Ellie" (her last name is Phillips or Philips) -- but I've seen this concept mentioned on many dentists' websites as well as the site of the Canadian Dental Association (or a similarly-named organization) (they had a webpage about the concept the last time I looked at their site, which was about 5 years ago).