Often the last thing a person with depression wants to think about is eating healthy. Either they don't consume enough calories or they eat junk foods. When I've treated those with depression, the focus frequently has been on setting small food-related goals.

The reason this is an important focus is that one of the hallmark symptoms of depression is lack of energy and one of the keys to energy is food. If they don't consume enough calories the depression will only be compounded.

It is difficult for a person to focus when they are starving or deprived of certain nutrients that junk food can't provide. Therefore, the cognitive part of therapy that focuses on the thinking styles cannot be effective until the health of the person is improved.

When a person is severely depressed it can be difficult to help them eat more nutritiously. Sometimes it can help if a family member prepares meals but even then some people don't eat enough. I encourage my clients to at least consume several high calorie nutrient dense drinks each day if they aren't eating. Or to eat nutritious protein bars if they are eating junk food so they at least get some healthy nutrients in their diet.

If nothing else, try to get them to take some vitamin C. When people aren't eating properly for more than a month they can get scurvy. Although we think of scurvy as a disease of malnutrition in the developing world, the elderly and people with depression can suffer from it due to unhealthy eating habits. The initial symptoms of scurvy are lack of energy, fatigue and soreness in the arms or legs.

I've frequently found that helping clients with these small changes in food consumption and nutrition can improve their energy level enough that we can make some inroads on the depression through cognitive therapy. Recent research confirms that attention to physical health in addition to mental health concerns improves outcomes of therapy (Sofko et al., 2016).