Depression linked to vitamin deficit on the rise in city

Mumbai: If you thought depression was only about the mind, think again. Many a time, the genesis of the world's most common mental illness lies in your food plate, say doctors. 

    They call it the vitamin theory of depression: skip taking vitamin B12 and increase your risk of depression, or so goes the new psychiatric advice on the occasion of the World Mental Health Week, which ends on October 10. 
    Studies in medical journals have already linked low levels of vitamin B12 to depression. "The link is known, but not widely recognised,'' says city psychiatrist Harish Shetty. But a dose of vitamin B12 supplements or injectables can brighten up the lives of those with the blues. 
Know Your B12 
Vitamin B12 is a member of the vitamin B complex. It contains cobalt, and so is also known as cobalamin 
It is necessary for the synthesis of red blood cells, the maintenance of the nervous system, and growth and development in children 
Its deficiency can cause anaemia. Vitamin B12 neuropathy, involving the degeneration of nerve fibres and irreversible neurological damage, can also occur 
Meat, liver, eggs, shrimps, and dairy products like cheese are valuable sources of this vitamin 
For vegetarians, it is best to increase their intake of milk or take vitamin B12 in a tablet form as a supplement. Fortified breakfast cereals are particularly good source. Soya milk is another source Poor eating habits aiding depression 
Mumbai: Doctors are particularly worried about the growing numbers of people who are afflicted by depression that is linked to vitamin B12 deficiency. Says Harish Shetty, consulting psychiatrist with Hiranandani Hospital in Powai, "There is a sudden increase in the number of kids and adults with B12 deficiency reporting mood swings and learning issues.'' 
    They come to him with reports of falling grades, crying spells, sadness, anger and suicidal intent. As a matter of routine, they are put through blood tests, including an assessment of B12 levels. "Very often, those with depression have a deficiency of vitamin B12,'' he adds. One can blame this growing trend either on poor dietary habits in urban centres—the culture of fast food and high-calorie drinks. 
    What isn't yet established beyond doubt is whether is it low levels of B12 that leads to depression or vice-versa? "We need focused studies to establish this,'' says endocrinologist S Joshi, who consults at Lilavati Hospital. 
    The experience of Jatin Mehta (name changed) underlines the vitamin theory of depression. Seven years ago, the then 15-year-old Jatin's doctor parents took him to neurologists to understand why their son was listless, both at school and at home. "After nearly two years of running around, a doctor told us to check the B12 levels, and sure enough they were low. Within two weeks of taking my first vitamin B12 shot, I started feeling better,'' says Jatin. 
    Now his parents are amazed that their boy, who battled dyslexia and depression as a highschooler, is now on the verge of completing his Masters degree in medicine. As a resident doctor, his working day stretches to over 19 hours, managing scores of patients as well as his own studies. But as every quarter draws to a close, Jatin feels his interest levels flagging and a sense of helplessness taking over. "I then know that it is time for the B12 shots that I take once every three months,'' says Jatin. 
    Joshi points out that Indians, as a rule, are deficient in Vitamin B12. "It is mainly vegetarians whose diet is deficient in the vitamin. Its deficiency affects neurological function,'' he says. It is only in the last few years that doctors are exploring the nutritional angle to depression which roughly affects 5% of thepopulation. "It is well known that anaemic persons can get depressed. But there is new research to show that people with vitamin and folate deficiency could get depressed. Nutritional deficiencies affect not only the poor but even the upper class,'' says Shetty. 
    Incidentally, the American Journal of Psychiatry (2007 issue) propagates the homocysteine hypothesis of depression. Homocysteine is an amino acid whose high levels suggest heart disease. However, homocysteine levels get high because there is a deficiency of vitamin B12 and folate in the body to process this amino acid. "Homecysteine causes heart disease, which causes depression,'' says the authors of the homocysteine hypothesis of depression, adding that the theory needs further validation. 
    What is the way to battle this deficiency? In their book, Stop Depression Now, Columbia University psychiatrist Richard Brown and Baylor University neuropharmacologist Teodoro Bottiglieri had suggested that that all psychiatric patients should take a daily megadose of 1 mg of oral vitamin B12. For those who cannot absorb vitamin B12 directly, doctors recommend injections. 
DARKER SECRETS OF DIET Signs, symptoms and health problems associated with vitamin B12 deficiency 
    Anemia, fatigue, weakness, constipation, loss of appetite and weight loss 
    Deficiency also can lead to neurological changes such as numbness and tingling in the hands and feet 
    Additional symptoms of vitamin B12 deficiency are difficulty in maintaining balance, depression, confusion, dementia, poor memory and soreness of the mouth or tongue 
Depression is a serious illness that should be distinguished from the feeling of sadness that one feels after, say, the loss of a relative or friend 
    Causes 
It is a result of a combination of genetic, biochemical, environmental and psychological factors Symptoms (At least 5 of these symptoms for at least 2 weeks) Feeling sad or empty Decreased interest or pleasure in activities Appetite change with weight loss/gain Decreased or increased sleeping Fatigue or loss of energy Feeling worthless or guilty Being either agitated or slowed down Difficulty in thinking or concentrating Recurrent thoughts of death/suicide 
In children A child with depression may pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die Older children may sulk, get into trouble at school, be negative and irritable, and feel misunderstood