Depression & Anxiety · Nutritional Psychiatry

synergy · 1

• ↔Fats & Omega-3

  Mocking 2016 Translational Psych meta (N=1233, 13 RCT): EPA ≥60% of total omega-3 at ≥1 g/d × 8-12 wk as SSRI augmentation → MDD remission + small-to-moderate improvement (SMD 0.40). SMILES 2017 Mediterranean diet includes ≥2 fish meals/wk.

  REVIEW · ARCT · A

regulates · 4

• ↔Insomnia

  The strongest comorbidity in psychiatry: insomnia independently predicts depression relapse; depression is the single strongest chronifier of insomnia. CBT-I alone improves mild-moderate depression; SSRIs alone don't always fix insomnia. Treat both.

  GUIDE · AGUIDE · A

• ↔IBS

  Gut-brain axis is bidirectional: 40-60% of IBS patients have depression/anxiety; anxiety/depression independently provokes IBS symptoms. Shared serotonin (95% gut + 5% brain). Treating one often treats both — but SSRI/TCA dosing in IBS differs from psychiatric use.

  GUIDE · AGUIDE · A

• ←Exercise as medicine

  Cooney 2013 Cochrane d = -0.62 (moderate-large), matching SSRI monotherapy. Mechanism: myokines (irisin / BDNF) + DMN reorganization + HPA normalisation. Acceptable as first-line for mild-to-moderate MDD.

  REVIEW · A

• ←Hashimoto's

  Hypothyroid mimic of depression: fatigue + anhedonia + weight gain + slowed cognition — every classic depressive feature can come directly from hypothyroidism. Checking TSH before treating depression is clinical bedrock; Hashimoto patients have 2-3× depression rate.

  GUIDE · AGUIDE · A

contrast · 1

• ≠Ashwagandha

  Chronic stress keeps cortisol high, damaging the hippocampus and blunting HPA feedback. Ashwagandha is sold against exactly that axis, but it is an adjunct signal, not first-line care for depression or anxiety.

  REVIEW · ARCT · B