" All it takes is a beautiful fake smile to hide an injured soul and they will never notice how broken you truly are.
According to the Mental Health Foundation Depression is the predominant mental health problem world wide. Globally it was the second cause of years lived with a disability, and in 26 countries it was the primary driver of disability.
So what about the UK? Well, 19.7% of people in the UK aged 16+ showed symptoms of anxiety or depression (22.5% were females and males 16.8%).
The Mental Health Foundation also reports that 43.4% of adults think that they have had a diagnosable mental health condition at some point in their lives, yet the 2016 report states that 36.3% of those who self-identified as having a mental health condition have never been diagnosed by a professional.
Now this fascinated me. Why is that the case? Is it because that we are blind to the symptoms and signs of depression, and not recognising it in ourselves or others when it arises? Is it that we are ashamed to seek help? Perhaps we lack confidence that the help actually offered can alleviate our symptoms.
The truth is I don't know for sure, but what I can tell you with complete confidence is that there is a growing body of evidence showing us ways to help alleviate depression, and some clear signs that we can all look out for.
A Definition of Depression & Symptoms
Depression is a clinical medical mood disorder that impacts the way you feel, think and act. This can persist for weeks, months or years.
Some forms of depression can develop under specific circumstances, or present slightly different symptoms. Here are a few of the different types of depression
While some of the forms of depression mentioned above are conditions in their own right, lets explore the individual nature of each form.
Persistent depressive disorder
A depressed mood that lasts for at least two years or more. This form of depression is often characterised by major depression with periods of less severe symptoms.
Not to be confused with the "Baby blues" that women can experience after birth. Women with postpartum depression can experience full blown depression during pregnancy as well as after the birth.
Extreme sadness, exhaustion, and anxiety that these women experience, mean that they are unable to adequately care for not only the child, but themselves, on an emotional level, as well as ADL's (Activities of Daily Living).
This is when a person has depression accompanied by a form of psychosis. Whether this is a false fixed belief (delusion) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The themes of the delusions or hallucinations work to support the depression.
Seasonal Affective Disorder (SAD)
A form of depression linked to the winter months, lack of sunlight, and reduction in vitamin D uptake. This form of depression lifts during the spring and summer months, and increased vitamin D uptake. During the winter months, social withdrawal, increased sleep, and weight gain are often typical.
Premenstrual Dysphoric Disorder
Similar to PMS but differing in severity. It occurs 1 - 2 weeks prior to the start of a period and causes severe depression, irritability, panic attacks, mood swings, food cravings or binge eating, joint pain and inflammation. There are a host of other symptoms, which usually subside 2 - 3 days after a period starts.
While a medical condition in it's own right, Bipolar is characterised by periods of low moods (which meet the criteria for depression) often labelled Bipolar Depression. The difference being that a person with Bipolar also experiences a euphoric state or irritable moods. While this is not an exhaustive list of differences, it gives you an insight.
Clinical Considerations & Medical Management
Genetic and epigenetic factors can play a significant role, with modfications of genes interacting with each other and environmental factors to increase the potential for depression.
Then there is neurotransmitter synthesis. Two families of neurotransmitters that play an integral role
Insufficient intake (or excessive excretion) of amino acids, B Vitamins, Zinc, Magnesium, and Vitamin C can lead to a functional neurotransmitter deficiency.
The Gut-Brain Axis - beneficial gut bacteria metabolise glutamate into GABA, and influence serotonin signalling among other things.
Guilia Ender's book, GUT is worth checking out if you want to learn more, and practical things you can do to improve gut health.
The hyper-secretion of cortisol by the adrenal glands is common in the depressed state, and can lead to corticosteriod receptor signalling being impaired, impacting depression and adrenal fatigue.
Get the basics right - reduce stimulants and sugar intake, this includes alcohol, caffeine (and smoking)
Increase wholefood intake - increase your vegetables and your fruit intake (think 5/7 a day as your base level). Get adequate protein intake, the dietary reference intake (DRI) is a minimal of 0.8g of protein, however this can be inadequate if you are physically active, or ill and in a state of repair. The International Society of Sports Nutrition (ISSN) recommend 1.4 - 2.0g per kg of bodyweight per day for exercising individuals.
Omega 3 Fatty Acids - Have been shown to potentially decrease the symptoms of depression, this could be through regulation of inflammation and cell membrane function . Vegan sources of omega 3 fatty acids include algae oil.
Probiotics - particular strands such as Lactobacilli and Bifidobacterium metabolise glutamate into GABA and influence serotonin signalling . Serotonin is a chemical which contributes to a sense of wellbeing and happiness.
Zinc & Vitamin D - Have been shown to support neural growth in the brain, and significantly lower symptoms of depression . Supplementing with Vitamin D in the winter months, when exposure to sunlight is inadequate can prove beneficial. Food Sources of zinc include,
5 - HTP - is required so serotonin synthesis (your wellbeing and happiness chemical).
B Vitamins - are cofactors for nerutotransmitter synthesis and can reduce the risk of depression. Neruotransmitters are essentially chemicals that allow nerves and different parts of your brain to communicate effectively. This is not an exhaustive list, but food sources include,
Exercise has been shown to improve depression and mood 
Getting quality, consistent restful sleep has also been shown to improve mood. I'm sure you've noticed how irritable, short tempered or fatigued you feel when you don't get enough sleep.
Seeing a therapist or support group can also be useful. There are also mental health charities and organisations such as Mind, or The iAM Project which can assist you in different ways.
If you need to, get in touch with your doctor who may be able to point you in the direction of services you can use. Sometimes medication can be either a short term or long term solution to manage symptoms depending on your situation - there is no shame in that.
Getting out in nature has also been shown to be effective for reducing depression. The growing research field known as ecotherapy, has shown a strong connection between time spent in nature, and reduced stress, anxiety and depression 
I've personally found keeping a journal helps me to dump all the thoughts from my mind onto a page, so that my mind becomes less cluttered, I use the Mood Cards which I think are a great tool for writing, or even just sharing what's going on for you.
As challenging as it can be at times, and as much as we want to be alone, human contact can also help us. Our social, living or relationship situation can all impact our ability to manage our depression. Making small changes, over time can have a powerful impact.
I recently saw in a meme online that what people view as the causes of depression include,
You and I both know that this is just plain wrong. There are many factors from genetic, social, life circumstances, economic, cultural, and political systems that can lead to a person experiencing depression.
Depression is not personal failure, and there are things you can do to alleviate the symptoms. Remember that.
 Kraguljac et al. Efficacy of omega-3 fatty acids in mood disorders - a systematic review and meta-analysis. Psychopharmacol Bull. 2009; 42 (3): 39-54.
 Foster, McVey Neufeld. Gut-brain axis: how the microbiome influences anxiety and depression. Trends Neurosci. 2013; 36 (5): 305-12.
 Lai et al. The efficacy of zinc supplementation in depression: systematic review of randomised controlled trials. J Affect Disord. 2012; 136(1-2): e31-9.
Khoraminya et al. Therapeutic effects of vitamin D as adjunctive therapy to fluoxetine in patients with major depressive disorder. Aust N Z J Psychiatry. 2013; 47 (3): 271-5.
 Lynette L. Craft, Ph.D. and Frank M. Perna, Ed.D., Ph.D., The Benefits of Exercise for the Clinically Depressed,
 Harvard Health, July 2018, Sour mood getting you down Get Back To Nature: https://www.health.harvard.edu/mind-and-mood/sour-mood-getting-you-down-get-back-to-nature.
According to the Mental Health Foundation 2016 report, one third of all people with a mental health problems have sought no professional help at all.
By 2030 the Mental Health Network estimates that there will be 2 million more people in the UK with mental health problems. The stigma around mental health is slowly starting to loosen it's grip, but the fact remains that over the course of our lifetime, most of us will experience some form of mental health challenge (I know I certainly have). This is the norm, not the exception.
Access to services, from waiting periods, to financial costs, and often the type of help offered can stop people from seeking the help that they need. So when I learned about the iAM Project I was excited to be a part of something that makes a difference at grass-roots level.
The iAM Project has been up since July 2019, but it's been years in the making, and was established by my childhood friend Mark Donald. We've had some amazing times together over the past 27 years, and also some tough ones. We've faced our own challenges and have supported each other through them. You'll learn more about over time, to give you a better understanding of where we're coming from.
Physical activity has always played a key part in keeping us grounded. We know the benefits. The science is there to support it, and we wanted to share that with you, alongside the vast other mental hygiene tools and methods we've picked up over the years.
The iAM Project events have gotten off to a great start already, all of which are free to attend, but require booking. The feedback so far has been fantastic.
As an Ambassador I'll be delivering powerful information on how to support yourself when facing a mental health challenge, how to improve your quality of life, and also Coaching on exclusive iAM Projects which you can attend at no cost to you.
If you want to learn more, please do check out the website, then head on over to instagram and give them a follow.
Remember, better quality of life and good health is your birth right.
Your body. Your Mind. Your Rules.
Attachment to the outcome is what often makes people quit their journey. When faced with challenges, changing life circumstances, or a dip in commitment, with the fear of failure lurking ahead, they simply throw the towel in and give up. We then come up with a really good reason to justify our actions.
Listen, we've all done it at some point in our lives. You've done it, I've certainly done it in the past, until I learnt a better way.
Now what I am about to say will probably piss a lot of people off (and I'm ok with that).
The truth is that you can't control the outcome. So stop thinking you can.
Read that bit again.
Does that mean that you'll never achieve what you want? Am I saying that there is not point in having goals or even trying? Of course I'm not saying that, but here is what I am saying.
You can't always control the outcome, there are often far too many variables involved (from other peoples actions, to changing circumstances) but you can control your behaviour and thus influence the outcome, and thus making your desired outcome more probable. It's a concept I share with my coaching clients to help them achieve deep, consistent change. Let me give you an example.
What I want you to notice is that behaviour goals are specific action steps that you commit to take on a regular basis, that can lead to the outcome you want.
Keep this in mind, behaviour goals are small manageable tasks that are within your control. They are things that you can do right now, or in the near future. Most importantly they are things you can do consistently and regularly.
Below is a tool that you can use, it was inspired by a similar model by Precision Nutrition that I use with Nutrition Coaching clients to help them stay on track, and achieve success.
Jot this model down some where you will see it on a regular basis (maybe in your journal or diary).
In the first circle write down the outcome that you want to achieve, ask yourself "What is my desired goal?". Then in each of the circles write down 1 - 2 action steps that you will do to push you in the direction of your desired outcome. These are your behaviour goals. Notice how each circle feeds into the other, with your daily tasks connecting to your overall desired outcome.
Here are some top tips.
I'll leave you with this,
Cultivate only the habits that you are willing should master you.
A deep sense of persistent worry or fear that can overwhelm us, make us feel powerless, want to run away and hide, or have us shut down. These are just some of the feelings that travel with anxiety.
Fear is a normal short-term response to stress. Anxiety can be characterised as a disproportionate response to a situation that's persistent even when the stressor is removed. This sensation can also arise for no apparent reason. It can be mild or severe. What many people do not also realise, is that anxiety can be specific to a situation or trigger, or general.
With General Anxiety Disorder (GAD) people feel anxious most days about a wide variety of situations or issues.
Stress (specifically, distress) can be a causative factor in anxiety attacks, and can result in various hormonal and metabolic imbalances. Anxiety can develop after trauma, such as abuse, divorce, abandonment, injury or car accident to name but a few.
What you probably didn't realise is that the Mental Health Foundation 2016 report indicated there were over 8.2 million cases of anxiety reported the UK and that number is set to rise. Anxiety can be the the main symptom in conditions such as panic disorders, phobias, PTSD (Post Traumatic Stress Disorder), and even depression.
But what are the symptoms?
Symptoms of Anxiety
Symptoms can vary for each individual, here are some of the common symptoms of anxiety
So how can we best deal with anxiety? Most people will need an integrated approach to deal with their anxiety. By tackling it from different angles, chances are that you will find a right way for you.
Nutritional Management & Clinical Considerations
Nutrition may not be the be the only tool in your box to tackle anxiety, but beyond the standard advice of "eat healthily" there is a wealth of scientific literature that supports specific nutritional protocol. These findings are based on the potential biochemical mechanisms of anxiety. Let's explore these together.
Neurotransmitters - are chemicals which essentially help pass messages from one nerve to another, which target other specific neurons, cells, muscles or glands. Neurotransmitter dysregulation is thought to be a contributing factor to anxiety.
Gamma-aminobutyric acid (GABA) is the main calming and inhibitory neurotransmitter that balances the excitatory action of Glutamate released during the stress response (Glutamate is an amino acid and the primary excitatory neurotransmitter in the brain).
GABA also acts on two other important hormones in the stress response, namely Corticotropin Releasing Factor (CRF) and AdrenoCorticotropic Hormone (ACTH) secretion. It has the ability to modulate excess adrenaline, noradrenaline and dopamine, it also influences seratonin levels. So what does all this actually mean in real terms? Well, GABA is associated with feelings of relaxation and happiness, while low levels are associated with anxiety, depression and insomnia.
Methylation - is a metabolic cycle that is important for neurotransmitter synthesis. Impaired methylation can result in elevated homocysteine, a by product which has neurotoxic properties.
Gut Dysfunction - this includes allergies, intolerances, inflammation, and the state of your gut lining (intenstinal permeability), may also be a contributing factor, as digestive problems are strongly associated with anxiety.
Nutrient Deficiencies - low levels of B vitamins, and minerals such as magnesium and zinc have been linked to anxiety.
So what does this look like for our nutrition? What can we do on a day to day practical level?
Taurine - is a potent activator of GABA receptors.
L-Tryptophan - is a precursor for seratonin and melatonin, so can potentially help modulate cycles of sleep and awakefullness. 
L-Theanine - Blocks binding of glutamic acid to receptors and reduces stress response. , .
Lemon Balm - (also known and common balm, or balm mint) is part of the mint family, but has a lemon fragrance. It inhibits GABA transaminase, which breaks down GABA. It helps to reduce anxiety, stress and insomnia.
Lactobacillus rhamnosus - There are many different strains of gut bacteria. Lactobacillus rhamnosus may help to modulate the stress response and anxiety. It prevents bad bacteria from colonizing, and encourages the growth of healthy gut bacteria. 
Every Day Nutrition
Antioxidants - Anxiety is associated with low levels of antioxidants. Vitamins A, C & E have been shown to alleviate symptoms, and so too has selenium. 
B-Vitamins support energy and homocysteine metabolism, stress control and neurotransmitter synthesis. 
Zinc - is a co-factor in methylation, and synaptic transmission (communication between nerves). 
Essential Fatty Acids - have been shown to reduce anxiety and lower cortisol. 
Magnesium - Has been shown to improve sleep patterns, and HPA Axis over activity. Chronic stimulation of the HPA (Hypthalmic - Pituitary -Adrenal) Axis can contribute to ongoing anxiety symptoms. 
Getting foods abundant with these key nutrients, or careful supplementation could prove beneficial.
The ability to catch the signs of anxiety as they arise, or identifying triggers is a powerful step in being able to deal with it. Self regulation is about being able to recognise, and use this information to put your self care plan in action.
Get in Touch With You
This could writing down what anxiety feels like for you, the direct sensations you experience within your body (making a mental note too), now some of you reading this may already know, but see if there is any other sensations you can add to the list.
For those of you that are unsure, I invite you to ask yourself "How do I know when I don't have anxiety?" write down those answers. This will enable you to contrast and get a sense for when you do experience anxiety.
Are there person, places, situations or things that trigger your anxiety? Now this doesn't mean that you'll automatically avoid these things. Just that you can now make a conscious decision whether or not you want to expose yourself to these triggers, and if you do, put a plan in place to minimise the effects. Never stay where you are not comfortable and does not serve you. You have every right to leave situations or people.
Habit & Ritual
As part of our self care there are often things that we already do that help us to feel better within ourselves. This can be anything from daily meditation, breath work, seeing a therapist, eating healthy most of the week, massages, meeting up with friends, keeping a diary, writing, or regular exercise, whatever it is for you, jot that down. This is all part of your self care plan.
As part of my own mental hygiene I keep track of the things I do, and notice if parts of my self care habits and rituals start to slip. There is a strong chance that if I don't put these things into practice my mental wellbeing will take a hit.
You can use a diary to track things, I use a combination of a journal and also Today I Did It Right workbook/ diary which I think is brilliant, but decide for yourself.
Anxiety is something that can have a devastating impact on our lives if we let it, but it doesn't need to stop you from living a full and vibrant life if you want to. There will be challenges, and while they may seem overwhelming at the time, they can often be reduced and managed better with the right comprehensive approach, that is a good fit for you.
I know that anxiety comes and it goes, it's like a hurricane that leaves a mess in it's wake. But if you are looking for a Coach to work alongside you and your therapist, who can help you improve your wellbeing, your nutrition, your training and emotional mastery, book in some time with me for a Complimentary Coaching Call to see how I can help you.
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 Schaechter, Wurtman. Serotonin release varies with brain tryptophan levels. Brain Research. 1990; 532 (1-2): 203–10.
 Kimura et al. L-Theanine reduces psychological and physiological stress responses. Biological Psychology. 2007; 74 (1): 39- 45.
 Unno et al. Anti-stress effect of theanine on students during pharmacy practice: positive correlation among salivary α-amylase activity, trait anxiety and subjective stress. Pharmacology, Biochemistry and Behavior. 2013; 111: 128-35.
 Cases et al. Pilot trial of Melissa officinalis L. leaf in the treatment of volunteers suffering from mild to moderate anxiety disorders and sleep disturbances. Mediterranean Journal of Nutrition and Metabolism. 2011; 4 (3): 211-18.
 Bravo et al. Ingestion of Lactobacillus strain regulates emotional behaviour and central GABA receptor expression in a mouse via the vagus nerve. Proceedings of the National Academy of Sciences. 2011; 108 (38): 16050-55.
 Alramadhan et al. Dietary and botanical anxiolytics. Medical Science Monitor. 2012; 18 (4): RA40-RA48.
 Bottigilieri et al. Homocysteine, folate, methylation, and monoamine metabolism in depression. Journal of Neurology, Neurosurgery and Psychiatry. 2000; 69 (2): 228-32. 28
 Cope, Levenson. Role of zinc in the development and treatment of mood disorders. Current Opinion in Clinical Nutrition and Metabolic Care. 2010; 13 (6), 685-89.
 Yehuda et al. Mixture of essential fatty acids lowers test anxiety. Nutritional Neuroscience, 2005; 8 (4): 265-67.
 Held et al. Oral Mg(2+) supplementation reverses age-related neuroendocrine and sleep EEG changes in humans. Pharmacopsychiatry. 2002; 35 (4): 135-43.