You'll be surprised to know that the most popular answer, at the latest American Psychiatric Association (APA) 2016 Annual Meeting, was not a new fancy overpriced drug, but improved nutrition.
Scientists have developed a new evidence-based scale that rates animal- and plant-based foods that nourish the brain and improve depressive symptoms. They compiled a list of what they call "brain essential nutrients" that affect the treatment and prevention of depression.
Key nutrients include long-chain omega 3 fatty acids, magnesium, zinc, calcium, fiber, and vitamins B1, B9, B12, D, and E. Possible mechanisms by which these foods may boost brain function include neuronal membrane stabilization and anti-inflammatory effects.
Food that was found to be the most beneficial includes:
dark leafy green vegetables, berries, and other phytonutrients rich plants, 8-10 servings a day
game meats or meat from grass-fed and pastured animals
nuts (pecans, walnuts, and peanuts)
seeds (flaxseeds, hemp seeds, and chia seeds)
lentils and small red beans
bivalves (mussels, clams, oysters)
mollusks (octopus, squid, snails)
fish (salmon and sardines). Although it is recommended that patients eat 8 to 12 ounces of fish a week, it is important to choose fish that are lower in mercury. As such, individuals should limit consumption of shark and swordfish
Another approach is "intermittent fasting" or "Fasting Mimicking Diet" (FMD) to help control depression and bipolar disorder. This type of fasting increases production of ketones, which are a "cleaner" fuel source for the brain. A ketogenic diet has similar effect on the brain as FMD.
Please be careful with a vegetarian diet and especially a vegan diet, which lack of vitamin B12. A deficiency of this vitamin can lead to depression, anemia, and eventually to irreversible damage to neurons, causing brain fog, cognitive decline, learning disabilities, as well as heart disease, infertility, autoimmune disease, and premature aging. The latest research, using the most sensitive markers showed that 83% of vegans and 68% of vegetarians were vitamin B12 deficient. A common myth among vegetarians and vegans is that it’s possible to get B12 from plant sources like seaweed, fermented soy, spirulina, brewer’s yeast, etc., but many of those plant foods don't contain vitamin B12, but actually contain B12 analogues, called cobamides, which block the intake of and increase the need for true vitamin B12.
There is a strong correlation between eating no meat and higher rates of depression, anxiety and a worse quality of life. A case report of 30 vegan mothers found that 60% of their offspring had developmental delays and that 37% had brain atrophy.
And never forget our friendly bacteria, microbiome. Consuming probiotics, especially so called psychobiotics, can increase levels of neurotransmitters like tryptophan, dopamine and serotonin, and also increase the tissue levels of omega-3 fatty acids, which have been linked to a positive mental outlook and reduction in mental distress. Levels of other anti-inflammatory fatty acids, such as gamma-linolenic acid, also increase when co-administered with probiotics.
Finally, probiotics and the overall profile of the intestinal microbiota can influence tissue levels of mood-regulating minerals, such as magnesium and zinc. The best way to get probiotics is thru fermented food.
For more information on how to approach your health without chemicals, please schedule an appointment with Dr. Koganski at 215-750-7000 or www.newtowninternalmedicine.com
 New 'Brain Food' Scale Flags Best Nutrients for Depression - Medscape - May 26, 2016.
 Hallahan B, et al. Essential fatty acids and mental health. The British Journal of Psychiatry Mar 2005, 186 (4) 275-277
 Selhub E M, et al. Fermented foods, microbiota, and mental health: ancient practice meets nutritional psychiatry. J Physiol Anthropol. 2014; 33(1)