Editor's note: This popular story from the Daily Briefing's archives was republished on April 17, 2020.

Nutritional psychiatrists have long suspected that certain vitamins, minerals, and foods may help lessen the symptoms of depression and anxiety. Now, an article in the World Journal of Psychiatry has rounded up the evidence in one place, Kathleen Squires writes for the Wall Street Journal.

6 steps to building an integrated behavioral health program

How nutrition and mental health connect

Nutritional psychiatrists believe that many people's mental health is linked to the bacteria that grow in the gut, Squires writes.

Primer: Here are 9 innovative behavioral health care delivery models

According to Uma Naidoo—who is a psychiatry instructor at Harvard Medical School, culinary instructor at Cambridge School of Culinary Arts, and director of nutritional and lifestyle psychiatry at Massachusetts General Hospital—an imbalance of good and bad bacteria in the gut "causes inflammation and an imbalance of the important hormones and neurotransmitters—melatonin and serotonin—in the brain."

To remedy this imbalance, Naidoo and Drew Ramsey, assistant clinical professor of psychiatry at Columbia University, recommended eating fermented foods, as they bring "good bacteria," or probiotics, to the digestive system, which can help ease anxiety.

But Squires notes that the link between foods consumed and mental health is indirect, and no food is guaranteed to benefit any particular patient.

Similarly, Naidoo emphasized that food is not a complete solution to mental health conditions. Rather than simply asking what her patients are eating, Naidoo said she asks "how they're sleeping, what they're doing for exercise, what they're doing to be mindful, along with traditional forms of therapy."

The foods that can help manage anxiety and depression

In a paper published in the World Journal of Psychiatry, Ramsey and Laura LaChance, from the Centre for Addiction and Mental Health in Toronto, identified 12 key nutrients in helping manage anxiety and depression:

Assess social needs with this phone survey script

• Folate (vitamin B9);
• Iron;
• Long-chain omega-3 fatty acids;
• Magnesium;
• Potassium;
• Selenium;
• Thiamine (vitamin B1);
• Vitamin A;
• Vitamin B6;
• Vitamin B12;
• Vitamin C; and
• Zinc.

With that in mind, Naidoo and Ramsey recommended the following nutrient-dense foods for helping manage anxiety and depression:

• Beans—small red beans, for example, which contain B vitamins, iron, magnesium, and thiamine;
• Fermented foods—including kimchi and pickles, which contain probiotics;
• Fruits—including avocados and berries, which contain B vitamins, magnesium, potassium, and vitamin C;
• Leafy greens—including spinach and kale, which contain B vitamins, iron, magnesium, zinc, and vitamins A  and E;
• Legumes—including lentils, which contain B vitamins, iron, magnesium, and zinc;
• Meats—including grass-fed beef and organ meats, which contain B vitamins, iron, vitamin A, and zinc;
• Nuts and drupes—including cashews and walnuts, which contain B vitamins, magnesium, omega-3 fats, selenium, and vitamin E;
• Oils—including olive and fish oil, which contain omega-3 fats and vitamin E;
• Seafood—including anchovies, clams, and wild salmon, which contain B vitamins, iron, magnesium, omega-3 fats, selenium, and zinc;
• Seeds—including chia and sunflower seeds, which contain magnesium, omega-3 fats, vitamins B1 and E, and zinc;
• Spices—including ginger and turmeric, which contain magnesium and vitamins B1, B6, C, and E; and
• Whole grains—including farro, quinoa, and wild rice, which contain iron, magnesium, selenium, vitamin B1, and zinc (Squires, Wall Street Journal, 7/26).

Six steps to integrate behavioral health with other care

Behavioral health issues can exacerbate other health conditions and make patients less likely to comply with important care plan aspects. Since most patients are diagnosed in the primary care setting, integrated behavioral health models can ensure patients follow through with referrals to mental health care.

Download our toolkit to find resources to effectively address six critical components of an integrated behavioral health program.

Download the Toolkit