Chronic Pancreatitis and Depression – What’s the Link?
If you suffer from chronic pancreatitis have you noticed a change in your mood since developing this condition? It’s probably no coincidence if the answer is yes. A recent US study investigating the link between depression and chronic pancreatitis found that more than half of the 692 participants with non-alcoholic pancreatitis (52%) displayed symptoms characteristic of significant depression. The scores for pain experienced by those people with significant depressive symptoms were considerably higher, while their rating of their quality of life was notably lower. Both of these factors could have contributed to feelings of low mood or may have been a consequence of depression itself, though other factors may well influence someone’s state of mind in pancreatitis. However, there may be more natural ways to lift your mood than relying on antidepressants alone.
Explaining the link
Besides increasing incidence and severity of pain in chronic pancreatitis, gastrointestinal symptoms such as nausea, vomiting, diarrhoea and fat malabsorption are often present and are not only distressing, but can impact on other activities. It may become harder for you to work or socialise with these digestive symptoms, leading to feelings of isolation, which itself can have a negative impact on the way you feel. These symptoms may often be related to what you have eaten, making mealtimes no longer an occasion to look forward to owing to the possible side-effects that eating may bring on. Poor appetite may be an independent symptom and together these can impair dietary intake, which can adversely affect your mood further owing to malnutrition and a lack of certain nutrients that usually promote mental well-being. These can all compound pre-existing depression, with low mood an increasing problem among seniors. Medical management of pain and these digestive symptoms may help to lift your spirits, but what steps might you be able to take yourself to lift your mood?
Opt for slow release carbohydrates
The automatic response to feeling low for many of us is to reach for a sugary pick-me-up, but this only tends to provide a short-term boost. If you have already developed diabetes as a consequence of chronic pancreatitis you will probably already be limiting your intake of sugary foods, but all of us can benefit by choosing those carbohydrates that release their sugars more slowly. This is because the brain cells are fuelled by glucose and prefer a slow steady supply over the day to function optimally. Good slow release options include oat-based cereals, granary bread, pasta, brown rice, new and sweet potatoes, non-starchy vegetables and pulses. Base meals around these foods and for snacks choose low GI fruits and yoghurt.
Increase omega-3 intake
If you do not suffer from fat malabsorption or take pancreatic enzyme replacements to help you digest the fat in your diet, including oily fish such as sardines, mackerel or salmon will provide a source of omega-3 fatty acids. People with a low intake of these essential fatty acids are more likely to be depressed and increasing intake of these improves mood when depressive symptoms are present. They are thought to be beneficial as omega-3s are an important component of brain cells. If you cannot include oily fish at least weekly in your diet, other dietary sources of these oils include walnuts, linseeds and rapeseed oil, though these do need to be used more frequently to offer benefit. Omega-3 supplements are another option and may be better tolerated if you malabsorb fat.
Choose foods rich in B vitamins
Certain B vitamins are also linked to a brighter mood, particularly folate and vitamin B12. They are thought to lower levels of homocysteine, which at increased levels is associated with depression. Foods rich in folate include green leafy vegetables, pulses, nuts and berries. However, if you have a poor appetite, these are all high in fibre and you may find them too filling, so fortified breakfast cereals, yeast extract and orange juice may all be easier for you to include in your diet. Vitamin B12 is only sourced from foods of animal origin, with meat, fish, eggs and dairy produce all providing a good source. If you avoid all of these foods, opt for those items to which the vitamin has been added such as breakfast cereals, dairy-free milks and yeast extract, though you may still require a B12 supplement to fully meet your needs.
Spend time in the sun
Although feeling the sun’s warm rays on your skin provides you with a lift in itself, this isn’t the only benefit of spending more time outdoors. Exposing our skin to sunlight is essential for the production of vitamin D, as few foods (other than oily fish, eggs and those items to which the vitamin has been added) contain this nutrient. This is important to mood, as a deficiency of vitamin D is linked to low mood and an increasing number of us are becoming deficient as we are spending less time outdoors and when we do go out we’re more likely to apply sunscreen which inhibits production of the sunshine vitamin. Between April and October just 10 to 15 minutes of sun exposure daily without sun block is sufficient for most people to meet their vitamin D requirements.
Take regular exercise
Physical activity releases the body’s feel good chemicals known as endorphins, which naturally help to lift your mood. While this might be referred to as a runner’s high, contrary to popular belief you don’t need to engage in strenuous activity to achieve this boost to your mood, as within half an hour of even gentle exercise you should begin to feel the benefits. Outdoors activity seems to offer even greater benefits to mental well-being, with research showing that exercising outside can improve someone’s state of mind in just 5 minutes.
Published by Lilly Boon