As more mental health practitioners embrace a holistic view of wellness, the role of food and diet is gaining more attention. Numerous studies show a link between healthier diets and lower incidences of depression, anxiety, and other mental health issues.
In their efforts to develop individualized wellness plans, clinicians often work collaboratively with food professionals who can help a person based on their specific needs. Food professionals may include nutritionists, registered dietitians, and others who promote healthy cooking.
If you think your food may be impacting your mood, start with a food assessment and then discuss it with your therapist.
How to Keep a Food Journal
The idea behind keeping record of what you eat is to notice whether there seems to be a correlation between what you’re eating and how you feel.
- Note the specific foods you eat and how you feel after eating them. What does your typical day look like? Keep track of the times you eat and how you feel right after eating, as well as an hour after finishing your meal. At the end of your day, note how energetic or lethargic you are, whether you exercised, and for how long.
- Track snacking patterns and ask yourself what triggers them. Are you snacking because you’re hungry? Or because you’re stressed or bored? Cognitive behavioral therapy can help process these patterns.
- What are your thoughts/feelings/family messages toward food? Are there certain thoughts or associations you have around specific foods? It may be helpful to discuss this with your therapist to explore your childhood memories regarding food.
- If you notice yourself binging or restricting your food intake, check in with yourself to see if there are messages around self-worth and value based on weight. Many people struggle with these issues based on images and messages in the media, and it may be helpful to talk through these in the safe space of a therapist’s office.
Finding a Nutrition Professional to Work with You
Many traditional counseling programs do not educate practitioners about the role of food in mental health. It’s important to do some research on your own and ask your therapist to explore these issues with you. Ask about your therapist’s credentials, training, and experience working with similar cases to yours.
Tell your therapist you’re concerned about your dietary habits, and are looking for a referral to someone who can guide you on nutrition advice. Your therapist may be able to help find someone with a culinary or nutrition degree to provide counsel or classes.
Just as there are different types of mental health professionals, nutritionists, registered dietitians, and chefs generally have different training.
- Nutritionists: Training can vary from nutrition sciences courses in college to certificate programs in nutrition. When you speak to a nutritionist, talk about your specific concerns and ask whether they have expertise working with people in your situation.
- Registered dietitians: Registered dietitians spend several years receiving training in medical concerns related to nutrition. If you have a medical condition that requires a specific meal plan, a registered dietitian may have the greatest knowledge and training base to assist you with those concerns.
- Chefs: Working with a personal chef who comes to your house (or offers community classes) is a great fit for many people who want to get healthy but don’t know where to start in the kitchen.
Practical Applications in Dietary Counseling
Many traditional diets or other means of restrictive eating are not healthy or sustainable ways to live. The following are some food takeaways from the so-called Blue Zones, regions of the world where people have the longest lifespan:
- Fill your plate with the rainbow: Eating more colors throughout the day generally means you’re consuming an assortment of phytonutrients and antioxidants.
- Eat several pieces of fruit per day and aim for 1 pound of vegetables: Higher consumption of fruits and vegetables is associated with a longer lifespan.
- Consume more whole grains instead of processed: Whole grains are often affordable and include quinoa, barley, millet, and brown rice.
- Eat 1 cup of beans per day: Whether in a bean salad, hummus, or mixed in with rice, research shows that longevity is linked to eating a cup of beans every day.
- Limit sugar consumption: If you have a sweet tooth, keep frozen bananas and berries on hand to make smoothies. You can also indulge in medjool dates or dark chocolate.
- Keep healthy frozen soups/meals on hand: Families often find it easier to stick to a pattern when they have healthy options on hand. Keep frozen veggies, healthy soups, and pre-made dinners at the ready for busy evenings.
- Have plenty of healthy snacks available: These may include apple slices, pretzels, berries, whole grain toast with peanut butter, and fruit smoothies.
Across studies, people’s levels of mental wellness increased with more whole grains, fruits, and vegetables, and fewer processed foods, meats, and dairy items.
Case Examples: Common Mental Health Issues and Food
In the following accounts, names and other identifying information have been changed to protect confidentiality.
- Depression: Samantha is a 19-year-old college student who seeks counseling at the end of her first semester. She reports feeling down and depressed but cannot figure out why her mood has changed. Away from home for the first time, Samantha is overwhelmed with the options at her dining hall, and finds the closest pasta-and-pizza takeout store that accepts her meal plan. Samantha frequently starts the day either skipping breakfast or having a donut. Every lunch and dinner, Samantha gets the same mac ’n’ cheese or pepperoni pizza. In therapy, she explores whether the food she’s eating may impact how she’s feeling. Her therapist recommends that Samantha seek nutrition advice in addition to therapy. Samantha works with a nutritionist at her school’s health clinic who helps her identify on-campus eateries that have more fruits and vegetables. Samantha discovers that by starting her day with oatmeal, diversifying her choices, and having more fruits and vegetables, she has more energy. With just a few simple dietary changes, she makes progress with her therapist and is able to form more social connections, alleviating her depression symptoms.
- Anxiety: Robert is a 38-year-old father who is raising 3-year-old and 6-year-old daughters alone. He seeks counseling due to experiencing anxiety on a daily basis, and reports it is highest around meal times. He is unsure what to feed his daughters, and reports that lately they reject anything he tries to feed them. He finds therapy helpful for a few months, but expresses to his therapist that he wishes he knew someone who could teach him quick, easy, and healthy cooking tricks. Robert’s therapist recommends a chef in his town who offers weekly cooking classes. Robert gains skills and confidence from the class, and also has the chef come to his house a few times to help formulate individualized meal plans. Robert reports improvement in his daughters’ attitude toward him and food, lessening his anxiety.
- Anorexia: Sarah, 16, has been struggling with anorexia nervosa for two years. On the advice of a pediatrician, her parents bring her in for therapy. Sarah has several health-related issues related to her anorexia, including fainting easily, inability to stay awake during class, and not getting her period recently. Her therapist recommends a registered dietitian to work as part of their team to help Sarah come up with a meal plan that gives her the nourishment she needs to recover from her eating disorder, which can have serious or even fatal outcomes.
Resources to Help Put Healthy Habits into Practice
Diet changes take time to adjust to. Since behavior changes and modifications can be difficult, here are some resources to help you transition to healthier eating habits.
- Cooking courses at your local college: Many community colleges and technical schools offer continuing education courses for adults who want to learn healthier eating habits.
- Eating support groups: Many people struggle to eat right on a busy schedule. Find or form a Meetup group or other support group online.
- Local library: Find both behavioral change and nutrition books that will help you make informed decisions about eating.
Take it one day at a time and attempt to incorporate a new healthy choice each week. In addition to talking to a therapist and any dietary advisers, always consult a medical doctor before making major changes to your diet or if you have a medical condition that requires medication.
- Academy of Nutrition and Dietetics. (2016). Nutrition Care Process. Retrieved from http://www.eatrightpro.org/resources/practice/nutrition-care-process
- Baranowski, T. (2012). School-based obesity-prevention interventions in low-and middle-income countries: Do they really work? American Journal of Clinical Nutrition, 96, 227-228.
- Gregor, M. (2015). How not to die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease. New York, NY: Flat Iron Books.
- Jacka, F.N., Kremer, P.J., Berk, M., de Silva-Sanigorski, A.M., Moodie, M., Leslie, E.R., et al. (2011). A Prospective Study of Diet Quality and Mental Health in Adolescents. PLoS ONE 6(9): e24805. doi:10.1371/journal.pone.0024805.
- Lally, P., van Jaarsveld, C.H., Potts, H.W., & Wardle, J. (2010). How are habits formed: Modelling habit formation in the real world. European Journal of Social Psychology 6(40), 998-1009.
- Murphy, S. (2013). Are You What You Eat? Counseling Today: A Publication of the American Counseling Association. Retrieved from http://ct.counseling.org/2013/02/are-you-what-you-eat/
- Natural Gourmet Institute. (2016). Chef Training Program. Retrieved from https://ngihca.edu
- Oddy, W. H., Robinson, M., Ambrosini, G.L., O’Sullivan, T.A., et al. (2009). The Association Between Dietary Patterns and Mental Health in Early Adolescence. Preventative Medicine 4(1), 39-44.
© Copyright 2016 GoodTherapy.org. All rights reserved. Permission to publish granted by Laura Morse, MEd, LCPC, NCC, therapist in Lancaster, Pennsylvania
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