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Alan Matthew

Professor Judd Holder

Quarter Paper 2016

14 June 2016

The Importance Of Exercise & Nutrition In Battling Depression

Everyone in the world will go through a short phase, a day or two, of feeling sad, upset or

not feeling totally themselves. This is perfectly normal as it is impossible to remain in a positive

state of mind at all times in life. However, for many this feeling does not go away. For many, the

color leaves their life, food does not taste as good, activities that used to bring joy no longer do

and getting through each day is like wrestling your way out of quick sand. Depression is an

illness that affects more and more people every day, yet there is still a stigma attached to this

problem and many other mental health problems. There should not be. Many adults will go

through life suffering in silence because they are afraid and sometimes even ashamed that they

think the way they do or feel like they do. Would you feel ashamed if you broke your leg or

required stitches? Absolutely not. Depression is one of the most common mental disorders in the

United States that is often misinterpreted or misdiagnosed. Approximately 14.8 million

American adults suffer from depression currently and the number of people who suffer from this

illness appears to be growing instead of declining (Facts & Statistics). Also, suffering from

depression drastically increases the chance of developing other problematic health conditions

such as heart disease, obesity and sleep disorders. Not only is it distressing mentally,

economically the rise of depression is alarming. Medically, it costs roughly $210 billion annually

to treat depression which is expected to increase as more people develop the illness (Leahy). The

focus of this research paper is to identify the benefits of proper nutrition and exercise in battling

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the crippling effects of depression without the help of prescribed medication. Although

medication is favorable for some, exercise and nutrition is proven to not only reduce depression,

but it is also financially more viable for many.

Historical understanding of Depression

Depression has always been a mental health issue for the human race. The understanding

and knowledge of the illness has not always been as complex as it is today which resulted in

some questionable approaches of trying to heal or improve the problem. According to scholars,

the earliest recognition of depression was as far back as the second millennium B.C. however; it

was known as melancholia (Rasmi, Reiss & Dombeck). During this period, melancholia was

believed to be the result of “demonic possession” (Rasmi, Reiss & Dombeck) and was treated by

ministers, not medical professionals. It is important to understand that although the treatment

was wrong back then, melancholia was known to be a mental problem and not the result of any

physical ailment.

In the fifth century, B.C., this idea of demons and wicked spirits continued to be thought

of as the main reason behind melancholia. Many of the ancient Greeks and Romans believed that

exorcism would help people destroy their demons and evil spirits thus, used methods such as

torture and starvation to try and help (Rasmi, Reiss & Dombeck). Some doctors within the early

Roman and Greek community began to see depression as a genetic or mental problem which

resulted in different techniques to treat the problem. For instance, massages, baths and soothing

music were often prescribed to improve symptoms. One of the most famous Greek physicians in

the history of medicine, Hippocrates believed that the cause of depression was due to

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“imbalanced body fluids called humours (Rasmi, Reiss & Dombeck).” He categorized mental

issues into separate categories which included depression and brain fever. Hippocrates was of the

opinion that depression was the result of an excess of black bile within the spleen. In order to

resolve this, he would use bloodletting, a seemingly relaxing technique, as well as exercise and a

proper diet (Rasmi, Reiss & Dombeck). Historic Roman philosopher, Cicero had a differing

opinion to Hippocrates as he believed, like many other medical professionals, that melancholia

was triggered by distress and misery (Rasmi, Reiss & Dombeck).

As the Roman Empire regressed during the 5th century, so did the scientific understanding

of what caused any form of mental illness, including depression. As the Middle Ages began,

there was a mass paranoia about what caused melancholia. Christians and many other religions

began to see people who were mentally ill as infectious. They believed that witches and/or the

devil controlled them which resulted in more dubious techniques such as exorcisms and torture

methods like burning the person or drowning them (Rasmi, Reiss & Dombeck). These methods

were used by many but there was still a small minority who had different explanations such as

improper nutrition, anguish and/ or imbalanced bodily humors (Rasmi, Reiss & Dombeck).

When the Renaissance period began in Italy and spread throughout Europe, between the

14th and 17th century, mental illness and especially depression were viewed in two different ways.

One group believed that the mentally ill had to be executed as they could spread their illness

whereas the other group believed the theories that Hippocrates asserted and thought the mentally

ill should be treated using medical methods (Rasmi, Reiss & Dombeck). Scholar, Robert Burton

published a book in 1621 known as “The Anatomy of Melancholy” where he discussed the

psychological and social causes of depression and how it should be treated. His

recommendations included proper nutrition, exercising, travel, music and distraction. This book

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is still available today and is considered one of the great modern narratives.

The Age of Enlightenment began in the 18th century and continued through to the start of

the 19th century. With this new era, came a new idea about what depression was. Many believed

it was hereditary, which created weak characters. This led to many people being shunned or put

in jail. Due to this, many people who had a mental illness would either become homeless or put

in asylums (Rasmi, Reiss & Dombeck). As this era progressed, so did the understanding and

diagnosis of depression. Many doctors believed that aggression was to blame for the underlying

cause of depression which resulted in a diagnosis of soothing music, proper nutrition, and talking

about the symptoms with a close friend, relative or a doctor.

The search for proper knowledge continued and in 1895, Emil Kraeplin, a German

psychiatrist distinguished the differences between depression and schizophrenia. Around the

same time, the psychodynamic theory was created which studies “personality in terms of

conscious and unconscious forces, such as unconscious desires and beliefs (Definition…

Psychodynamic Theory.” This was a common treatment for depression during this time.

Sigmund Freud, an Austrian neurologist believed melancholia was a natural reaction to a loss.

This could be a real loss such as the death of a family member, or a symbolic loss such as failing

to achieve something that was important to you. He was of the opinion that the underlying

resentment or anger over loss made a person’s ego fragile which can cause self-destruction

(Rasmi, Reiss & Dombeck). Dr. Freud believed that psychoanalysis, making unconscious

feelings conscious, was the best treatment for depression (Rasmi, Reiss & Dombeck).

It was in the early 1950’s when understanding and scientific evidence became clearest,

after hundreds of years of disagreement as to whether depression was physical or mental, which

resulted in scientists splitting depression in to two separate categories. The first was known as

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Endogenous depression which was a result of genetics and several other physical difficulties.

The other was called neurotic depression which comes from a substantial change in life. For

example, loss of a loved one or loss of a job (Rasmi, Reiss & Dombeck). It was also in the

1950’s when medication began to treat patients for depression. This became the main source of

treatment and around the same time, more methods of therapy such as behaviorism and

cognitive-behavioral became useful (Rasmi, Reiss & Dombeck).

Nowadays, when knowledge and scientific evidence is at an all-time high, many doctors

understand that depression can be caused by various causes at the same time. It does not always

have to be one or the other. This has resulted in having more than one way to treat the problem

(Rasmi, Reiss & Dombeck). It is interesting to see how depression has been understood and

treated throughout time. It has not always been treated properly or fully understood, but it is

fascinating to know that no matter what the time period or era, many doctors thought that proper

nutrition and exercise could help ease the symptoms of depression.

Why do people develop depression?

As is evident by the developments and understanding throughout history, depression is a

complex issue. Every single person on earth is different, which means those affected by the

illness can have numerous reasons as to why. To combat and defeat depression, it is imperative

that the person understands their symptoms and look to receive treatment that suits them best.

However, finding the correct solution can be a case of trial and error which often makes people

disheartened, potentially making them more depressed. In USA, depression is a problem that 1 in

10 Americans will develop and 350 million people worldwide suffer from (Depression

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Statistics). So, why do people develop depression?

There are many reasons as to why depression is prevalent in American adults such as

significant life events, family history, drug and alcohol use, poor nutrition, and the type of

personality the individual has. Distressing life events seems to be the biggest cause of mental

illness because of the approach that the person uses to process what happened. Examples of

distressing life events include the death of a family member, losing a job, divorce or even a

sudden change of routine can be classified in this category. When going through these changes in

your life that cause stress, cortisol which is known as the stress hormone increases while other

hormones such as dopamine decrease (Bruno). If this cycle continues for an extended period of

time, depression can be developed. No one knows why some develop depression after a

significant life event, while others do not. Many researchers believe it may be dependent on the

way the person was raised and how they saw their own parents react to something stressful.

Family history and genetics are other factors that may increase the chances of developing

depression. It was estimated that if someone has a parent who has or has had depression, they are

almost 3 times more likely to be affected as well at some point in their life (All about

depression). Scientists have never been sure if the problem was hereditary or if the family

environment was the culprit but recently it has been determined that a susceptibility to

depression can be inherited from your parents (All about depression). Not only are you more

likely to develop depression, but there is also a chance of developing bipolar disorder because of

those who have bipolar disorder, almost 50% of them have a parent that has had depression (All

about depression).

Drugs and alcohol are perhaps the most dangerous way that a person can develop

depression. Often, people who are going through difficult times will turn to alcohol, drugs or

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both to improve their mood as these substances affect the central nervous system (All about

depression). What people do not realize is that although it may improve symptoms in the short

term, in the long term the symptoms will likely deteriorate even more. This can then lead to

heavier use which could cause alcohol poisoning, drug overdose or even death. Turning to these

substances for relief from your symptoms is a dangerous ploy that could require treatment for not

only depression, but substance abuse also (All about depression).

Improper nutrition is perhaps the simplest yet the most underutilized way to improve

symptoms of depression. It may be too simple to suggest that nutrition is the only reason for

indications of depression however; it has been proven that nutritional deficiencies can be a

reason for the depressed feeling. The average American diet is from poor sources and most

families eat fast food between 2 and 3 times per week. Not only is this hurting your bank

account, it is also damaging your health. Nutritional deficiencies such as omega 3 fatty acids and

Vitamin D are common within most of the American population. Omega 3 Fatty Acids are

imperative for proper brain function, including memory and mood whereas Vitamin D is just

starting to be recognized as an epidemic (All about depression). Other common deficiencies that

are linked to depression include, folate, Vitamin B complex and Amino Acids. So perhaps

instead of prescribing drugs, maybe Doctors should look at a person’s diet first.

Finally, personality styles can increase or reduce chances of developing depression.

Unfortunately, you cannot decide who you are. People who are known as worriers and tense tend

to be at the highest risk of developing depression. Someone who is very harsh on themselves

tend to have lower self-worth and people who are considered perfectionists tend to never be

satisfied with what they have achieved. Both of these personality traits can lead to depression

(All about depression). As is evident, depression can develop from numerous sources. This is

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why it such a difficult mental health problem to deal with because of the trial and error. Many

people develop depression because of multiple reasons which means there are multiple ways to

treat it. However, everyone is different and just because one way helps one person, the same

method might not help another.

How Can Exercise & Nutrition Help With Depression?

When most people think of exercise and proper nutrition, they tend to think of losing

weight, getting fit, and having that dream body. Although these are all true if you work hard

enough, many forget or do not realize the benefits that exercise and nutrition have on the mind.

Many who are seeking help for their symptoms of depression often turn to their doctor or a

psychiatrist and most go with the hope that the doctor will provide a magic pill that will make all

their troubles go away. Unfortunately, this is not the case and many of the medications that are

prescribed can cause more side effects than benefits. Although medication is an effective source

of relief for some, proper nutrition and exercise is a method that is underutilized by many

medical professionals today. Although there is no perfect solution for everyone, studies are

starting to show the incredible effects that exercise does have on the way we think.

James Blumenthal, a neuroscientist specializing in depression from Duke University

recently completed an experiment where he had 156 clients who suffered from mild to moderate

depression (Clear). In this experiment, he split the patients in to three groups. The first group

were on prescription medication only. The clients were prescribed Zoloft which is a common

drug used for depression, anxiety and obsessive-compulsive disorder. In 2011, just over 37

million prescriptions of Zoloft were used to treat problems such as these (Clear). The second

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group were to exercise three times per week while also being prescribed the same dosage of

Zoloft as group one. Exercise sessions were to last approximately 45 minutes. The final group,

group three were to use exercise only. The stipulations were the same as group two as they had

to exercise 45 minutes per session, three times per week (Clear). This experiment lasted four

months and each of the patients were monitored closely by the medical professionals involved.

After the four months were complete, the researchers found that the results were similar between

each of the three groups, to their surprise. The researchers decided that progress using the three

groups should be monitored longer term which yielded some very interesting results. The

patients were left to make their own choice for the following six months. Either continue on the

path that they were own, or try something of their own accord (Clear). Once the six months were

over, researchers found that the patients in group three, the exercise only group had significantly

better long term results than group one and group two. In group one and group two, many of the

patients had relapsed back in to depression, 38% and 31% respectively. In group three, only 8%

of the patients failed to see improvement in their symptoms (Clear). This is a success rate of over

90%. The researchers attribute this to the change you see in yourself while exercising. It alters

your mindset as you can see progress which subconsciously proves to yourself that you can

become healthier. Although medication does and can work, exercising “proves a new identity to

yourself (Clear)” which medication is not capable of doing. The researchers believe that

subconsciously, the patients who were on medication only, thought that they had not earned their

relief whereas those who were exercising, worked really hard to improve. Self-confidence goes a

long way in the process of defeating depression which is something medication will not give

you. Medication will alleviate symptoms of depression, but long term it will not help establish a

more self-confident identity (Clear). Researchers in this experiment also found that the longer

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you exercise, the symptoms of depression will decrease significantly. For example, if you walk

or jog for 50 minutes, your chances of developing depression will decrease by 50% (Clear). The

important thing to understand from this experiment is that self-confidence and an identity that

you are comfortable with are imperative to long term results and a happy life. Small daily

improvements, that are consistent with what you want to achieve can lead to a happier and stress

free life (Clear).

Many researchers, since the start of the twentieth century have been studying the

relationship between exercise and depression. Studies throughout this century have always

provided positive results when a patient performs the exercise at a sensible intensity level,

resulting in a higher heart rate. Many believe that this creates an antidepressant effect on the

body which is something to be looked at more closely (Craft & Perna). In another study, thirty

depressed individuals were allocated to an exercise group that acted similarly to a social support

group. The exercising involved walking between twenty and forty minutes, three times a week

for a total of six weeks. The researchers found that most symptoms of depression were reduced

for up to a period of three months. The alternative group who were not to exercise, the placebo

group did not see any improvement. This study also highlighted the longer lasting effects of

aerobic exercise on the symptoms of depression, compared to medication (Craft & Perna).

Although many of the studies involve aerobic exercise which is when oxygenated blood is

pumped to the heart, the effects of resistance training were also studied by researchers. Again,

results were positive as symptoms of depression did decrease however; it seems as though

aerobic exercise is more beneficial (Craft & Pern).

According to many physiologists, there are several reasons as to why symptoms of

depression are reduced when or after exercising including a thermogenic effect, release of

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endorphins, a distraction from your thoughts, and in increase in brain neurotransmitters (Craft &

Pern). Physiologists believe that the thermogenic effect, an increase in the bodies temperature,

helps reduce depression. They believe that an increased core temperature and an increase in

temperature of specific parts of the brain, including the brain stem, results in the muscles

relaxing and tension reducing (Craft & Pern). It is similar to the feeling of relaxation when

taking a warm bath. The second theory that many physiologists believe in regarding depression,

is the release of endorphins during and after exercise. Endorphins are associated with happiness

and satisfaction. The phrase ‘Runner’s High’ is often used after an athlete completes a long race

as it presumed that endorphins have been released to give that feeling of accomplishment. They

are often released during and after exercise nevertheless; this theory has come under some

scrutiny as some do not believe the release of endorphins is due to exercising (Craft & Pern).

Another theory provided by many physiologists discusses how exercise can distract a person

from their depressing thoughts and feelings. Not only exercise, but social interaction and writing

a journal has shown to help distract someone with depression from their thoughts. The results of

this theory are generally mixed but exercise is the one common denominator in improving

symptoms significantly (Craft & Pern). Finally, an increase in brain neurotransmitters, including

norepinephrine and dopamine, as the result of exercise, is a theory that physiologists are excited

about. These neurotransmitters are often reduced when an individual is depressed however; it is

thought that during exercise these are more readily available. Again, results are unknown but

research continues (Craft & Pern).

Proper nutrition is another key component that is often underutilized when battling the

symptoms of depression. It may not be as beneficial as exercise is on its own, but proper

nutrition and exercise is a combination that can alleviate depression very effectively. What you

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put in your body affects your mood and attitude. So it should be obvious that in order to be in a

positive frame of mind, humans should eat whole foods that are as close to nature as possible,

instead of eating processed, sugary and foods that are high in salt. Many processed foods have

aspartame in them which has been connected to depression. This artificial sweetener is known to

decrease serotonin which controls a person’s craving’s and mood (Mitchell). Although there are

many foods and beverages to include in your diet, there are many that you should limit or

completely cut out. Alcohol should be limited. Heavy use can lead to anxiety, and panic attacks.

Alcohol is also known to reduce serotonin, which can increase your chances of depression

(Mitchell). Alcohol is often used to alleviate symptoms of depression by people who are

desperate in the short term but long term, it can cause addiction or even alcohol poisoning as the

person builds a tolerance. Caffeine is another source that should be limited as again, it inhibits

your bodies ability to produce serotonin. It also increases the likelihood of insomnia, anxiety and

depression (Mitchell). Finally, avoiding foods that are low in nutrients but high in calories should

be a priority. Unfortunately, this the cheapest food available at supermarkets so is a staple in

many American family’s diets. These foods, that include ice cream, chocolate, and cookies, are

filled with refined sugars which give a person a quick period of feeling energized, before they

crash as their blood sugar level spiked and dropped quickly. It is essential that a stable blood

sugar level is achieved to avoid weight gain and/or increased chance of developing depression.

In order to be healthier and feel healthier, it is recommended that a person eats foods that have

nutritional benefits, aide sleep and improve their frame of mind. Foods that are high in folate can

reduce symptoms of depression such as almonds, chicken, spinach and fish. Foods that provide

Vitamin D, useful in reducing some mental disorders, such as Orange juice, milk, and

supplements are highly beneficial. Sun exposure is also a great source of Vitamin D. Omega 3

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Fatty Acids are essential in establishing proper brain function and sources include most types of

fish and supplements (Mitchell).

If a person can establish an exercise routine that they enjoy and will stick with, as well as

a healthy diet then it is likely that their life will improve. Exercise and nutrition are effective

tools in battling the symptoms of depression. Research shows that exercise and nutrition can

provide relief from depression over the long term. Medication is effective as well however; most

medications have multiple side effects and the same medication does not work for everyone

which can result in some trial and error before finding a suitable type.

Financial Implications Of Depression

Depression is not only a strain on someone’s mental health, it is also a massive financial

burden. Depression is increasing within the United States which means economically, this mental

health issue will continue to drain the economy but also the patients bank account. Proper

nutrition and an exercise routine may help lessen the economic burden on everybody involved.

It is important to understand the financial implications of mental illness as a whole within

the USA. With the recent increase in gun massacres across the country, many are wanting the

availability of mental health treatment to be increased. If services are easier to access, then

maybe people who have problems will go and speak to a specialist before they commit an awful

crime or ruin their lives. In the United States, mental health care makes billions of dollars every

year but this massive industry still cannot help everyone who needs it. This is mainly because of

two reasons which are cost and the stigma attached to mental health. $113 billion is spent on

mental health care within the United States, which is approximately 5.6% of the total health care

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expenditure (Kliff). Much of the money for mental health goes to prescription medications and

outpatient facilities which is the result of the Community Mental Health Centers Act of 1963

(Kliff). This bill determined that patients would respond better to treatment if they were in a

more comfortable setting, rather than an inpatient facility (Kliff). Many who suffer from a mental

illness can simply not afford to seek treatment. According to a study from 2009, there was

approximately 15.7 million people in the United States who underwent mental health treatment,

and one quarter of them said that they were the main financier (Kliff). Many who looked for

outpatient services paid up to $5,000 (Kliff). These numbers are too high considering most

Americans do have some sort of health insurance. Unfortunately, many insurers have restrictions

for mental health issues. Finally, budget cuts are often made to mental health services within

certain States, and between 2009 and 2011, roughly $1.8 billion was removed from mental health

budgets (Kliff). It is evident that mental health is a problem financially in the United States and

more has to be done for problems to be treated effectively.

Depression is one of the biggest mental health issues in USA. Adults with depression will

lose approximately 5.6 hours of productivity for every week that they are depressed, due to a

diminished ability to focus, and it is estimated that around 80% of people with depression have

their day to day routines compromised (Leahy). Being absent from work or short term disability

accounts for 50% of the lack of job productivity and a depressed employee will take between one

and four sick days in any given month (Leahy). It is also suggested that someone with depression

is almost ten times more likely to not have a job (Leahy). From one study, it was found that

people who have suffered with depression from an early age tend to make less money, have less

education and partake in less days at work each year. It is projected that mental health problems

from an early age can result in seven weeks of not working, 20% less potential earnings and if a

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family has one member who suffers from depression, they can lose up to $300,000 within a

lifetime (Leahy). The damming statistics continue as people with depression are less likely to get

married and can lose out on as much as $10,400 a year by the age of fifty. Depression is also

estimated to decrease a person’s earnings, within their lifetime, by 35%. If you were to include

every adult with depression in USA, it is estimated that almost $2.1 trillion of earning’s would be

lost in a lifetime (Leahy). It is also important to remember; this figure overlooks the yearly rise

in cost of medical treatment that everyone has to pay. Depression will not only ruin lives

mentally, but economically people are losing out on a lot of money. It is projected, due to the

increase in medical costs and less productivity in the workplace, $83 billion is spent on

depression annually which is more than the military spent when going to Afghanistan (Leahy).

Unfortunately, due to the rise of depression, the costs are getting higher every year. But, this can

be decreased if proper treatment is put in place. Economically, it makes a lot of sense to create an

environment where depression can be cured more effectively. Medication and cognitive

behavioral therapy are solutions that are currently used most often so, maybe more doctors and

medical professionals should look in to the benefits of exercise and nutrition to try and

discontinue this constant rise in costs. Depression leads to other problems such as heart disease,

obesity and sleep disorders which are often caused by inactivity, according to Centers For

Disease Control & Prevention (CDC). They estimated that Medicare and Medicaid spend

approximately $84 billion per year on these conditions. They also predicted that almost $80

million in medical costs would be saved annually if people became more active (Leahy).

Exercising and eating the correct foods results in less prescribed medication per year and visiting

the hospital less.

Conclusion

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It is quite evident that depression is a major problem in the United States of America.

Over 14 million Americans currently suffer from this mental health issue with numbers

appearing to increase instead of decrease. This research paper aimed to recognize how nutrition

and exercise can play an important role in reducing the crippling effects of depression, while

limiting prescribed medication. It was also a goal to prove that exercise and nutrition was

financially more feasible for many.

The history of depression is a fascinating and intriguing one. It was originally known as

melancholia and throughout history, reasons as to why people developed this illness varied. In

the fifth century, many believed melancholia was the result of evil spirits which resulted in the

person undergoing torture and starvation. Opinion continued to differ until Sigmund Freud, an

Austrian neurologist in the 19th century determined that depression was the result of a loss. From

there, understanding improved to the point where scientists understood that depression could be

the result of several sources and not just one.

There are several reasons why people develop depression including significant life

events, family history, drug and alcohol use, poor nutrition, and the type of personality the

individual has. Life events such as the death of a family member or loss of a job can trigger

symptoms of depression while your genetic makeup can play a significant role. If you have a

family member who has had depression, then you are more likely to develop it. Drugs and

alcohol with depression is a dangerous combination. Often, people turn to drugs and alcohol for

short term relief but long term, problems increase considerably. Poor nutrition includes

deficiencies that people do not realize that they have that can contribute to depression and

finally, the type of personality that a person has can decide if they will have depression. People

who are tightly wound and/or have high expectations tend to be susceptible to depression.

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Exercise and proper nutrition can play a vital role in defeating depression. In a recent

study, it was found that in the long term, patients who used exercise to alleviate symptoms of

depression had the lowest rate of relapse compared to patients who used medication and patients

who combined both exercise and medication. Although medication can help with depression, it is

claimed that exercises alters the mindset as the patient can see healthy progress, which

subconsciously highlights that they can improve whereas with medication, you do not have to

work to improve, and an identity will not be created.

Financially, mental health issues and depression in particular are a major burden on the

health industry. A person who has depression at work loses much productivity which results in a

loss of thousands of dollars over the course of their lifetime. It also limits the opportunity for

promotions and you are more likely to take sick days if depressed. Depression also leads to other

health problems such as heart disease which increases financial responsibilities.

Depression is an illness that can be cured. There are many options for people suffering

from this disorder to utilize however; to reduce costs and potentially increase long term success,

nutrition and exercise has to be exploited more.

Works Cited

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June 2016.

Clear, James. "Exercise and Depression: The Truth About Natural Depression

Remedies." Exercise & Depression. N.p., 2013. Web. 13 June 2016.

Craft, Lynette L., and Frank M. Perna. "The Benefits of Exercise for the Clinically

Depressed." Primary Care Companion to The Journal of Clinical Psychiatry. Physicians

Postgraduate Press, Inc., 2004. Web. 13 June 2016.

Gaynor, Mitchell, M.D. "Diet and Depression." Psychology Today. N.p., n.d. Web.

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Kliff, Sarah. "Seven Facts about America’s Mental Health-care System." Washington

Post. The Washington Post, n.d. Web. 13 June 2016.