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A Functional Approach to Children and Mood

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  • A Functional Approach to Children and Mood

While often very adaptable, children are just as vulnerable to mood imbalances as adults. Sometimes, these feelings can be more intense and dificult to manage. A holistic and functional approach can be helpful to understanding the underlying cause of any changes in mood and how you might address these.

What do mood changes look like in a child?

Children may have thoughts and feelings that are dificult to articulate, so it is helpful to look for signs of mood issues. Symptoms may include: sadness, guilt, loss of interest in activities, sleep disturbances, changes in appetite, decreased energy, dificulty concentrating, hypersensitivity to failure, irritability or aggression. Some of these symptoms may be intense and require review by a qualiied specialist.

There may be many underlying aspects why a child may experience anxiety, depression or changes to mood that should be explored.

Gut-brain axis

The gut-brain axis describes the complex bidirectional communication between the gut and the brain and includes the interaction of the microbiome of the gut in this process.[1-4] It is inluenced by the immune system and is often linked to mood concerns such as depression and anxiety.[1-4]

Children may complain of stomach aches associated with mood concerns and it is important to consider the impact of stress and mood on the gut. Probiotics and herbs such as chamomile, lemon balm, slippery elm, licorice, fennel, and St Mary’s thistle may be beneficial.

Sugar dysregulation and diet

Sugar dysregulation may be associated with anxiety and depression. Studies suggest that consuming a diet high in reined carbohydrates is associated with mood changes including depression.[6,7] A diet high in red meat, takeaway, reined foods and sugary foods are associated with depressive symptoms while a diet rich in fruit, vegetables, ish and wholegrains is protective against these symptoms.[5,6,8]

Poor sleep

Sleep problems amongst children is simultaneously part of the criteria for, and a contributing factor to, mood disturbances. Insuficient or poor quality sleep is also linked to gastrointestinal disturbances,[12] poor blood glucose regulation[9,10] and varying nutrient levels (e.g. low levels of vitamin B12 or magnesium).[11,13] Other important considerations may be reviewing levels of histamine and glutamine in the diet, levels of stress and bedtime routine. Lemon balm, passionlower and chamomile may be beneicial to assist with sleep.

Food intolerances, immune system and inlammation

Food intolerances may increase histamine levels.[16] Abnormal histamine levels have been associated with brain inlammation and mood disorders.[14,15] Studies suggest there is also an association between allergies, low-grade inlammation and depression.[14,15,17-19] Supporting effective histamine metabolism may be beneicial to balancing histamine levels.

Pathogens and infections

Pathogens may affect mood. Research suggests an association between streptococcal infections and neuropsychiatric disorders such as acute obsessive-compulsive disorder;[21] an anxiety-mood disorder in children. This is called paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections or PANDAS.20 Other infections may also impact mood and may therefore be necessary to review possible infections.[22] Consider antimicrobial and antiparasitic herbs that are suitable for children such as calendula, cinnamon, echinacea, elderberry, garlic and thyme.

Methylation

Methylation is an important biochemical process in the body, part of which produces S-adenosylmethionine (SAMe); an important methyltransferase which is utilised for neurotransmitter synthesis.[26] Low folate and vitamin B12 – important cofactors in the methylation cycle – are also associated with low mood.[23,24] As a result of these factors, poor or imbalanced methylation may affect mood.

Insufficient or suboptimal vitamins and minerals

Consider the levels of these nutrients and their possible contribution to low-mood in children.

Nutrient

Association

Vitamin B12

Reduced intake of vitamin B12 is associated with mental health concerns in adolescence. Low serum folate and vitamin B12 is associated with depression.[23,24]

Zinc

Low plasma zinc has been linked with anxiety and zinc supplementation may assist depression.[27-29] 

Vitamin B6/pyridoxal-5-phosphate (P5P)

Important for neurotransmitter synthesis and tryptophan metabolism.  low vitamin B6 is associated with depression and anxiety.[30]

Magnesium

Studies suggest a high intake of magnesium is associated with reduced mental health concerns in adolescence.[25]

Omega-3 fatty acids

A diet low in omega-3 fatty acids has been associated with depression and children may benefit from increasing foods rich in these.[31,32]

Vitamin D

Low vitamin D may be associated with depression.[33,34] 

Environmental toxins 

Consider the impact of accumulation of environmental factors when reviewing children and mood. Lead and mercury levels are particularly associated with depression, anger and anxiety.[35]

Gene variants

Increasing research demonstrates associations between gene variants, or single nucleotide polymorphisms (SNPs), and mental health concerns. Reviewing SNPs associated with biochemical pathways or systems may aid the prioritisation and initiation of further pathology testing where required.

The genes that may be useful to review in children with mood concerns include: 

GUT-brain axis

Gene

Name

Association

FUT2

Fucosyltransferase 2

Associated with bacterial attachment to intestinal mucosa; gastrointestinal diversity and vitamin B12 absorption.

HLADQ2/DQ8

Human Leukocyte Antigen

Associated with gluten intolerance. There may be an association between gluten intolerance and mood such as anxiety and depression.36,37

Fatty acids and brain function

Gene

Name

Association

BDNF

Brain-derived neurotrophic factor

Involved in neuroplasticity. Lower BDNF activity is associated with increased risk of mood dysfunction and depression.

FADS1

Fatty acid desaturase 1

Involved in omega-6 and omega-3 fatty acid metabolism.

Neurotransmitter synthesis

Gene

Name

Association

MAO

Monoamine oxidase A

Involved in the metabolism of neurotransmitters dopamine, serotonin and noradrenalin. It is associated with aggression and anxiety.

COMT

Catechol-o-methyl transferase

Involved in metabolism of catecholamine such as dopamine, adrenalin, noradrenaline. May be associated with altered levels of these neurotransmitters and influence anxiety and depression.

GAD1

Glutamic acid decarboxylase 1

Involved in the conversion of glutamate an excitatory neurotransmitter to gamma-aminobutyric acid, an inhibitory neurotransmitter. May be associated with mood related disorders.

AANAT

Serotonin N-acetyltransferase

Involved in the synthesis of melatonin and may be associated with delayed sleep onset. 

DAO

Diamine oxidase

Involved in the degradation of histamine.

Methylation

Gene

Name

Association

MTHFR

Methylenetetrahydrofolate reductase

Converts folate to methylfolate. Provides the methyl group needed to convert homocysteine to methionine.  Methionine is required for the production of SAMe, important for neurotransmitter production and synthesis.

Detoxification

Gene

Name

Association

GSTP1

Glutathione S-transferase P1

Involved in phase II detoxification and may play a role in the detoxification of harmful substances including modifying methylmercury metabolism.38

Nutrients

Gene

Name

Association

FUT2

Fucosyltransferase 2

Associated with bacterial attachment to intestinal mucosa; gastrointestinal diversity and vitamin B12 absorption.

TCN2

Transcobalamin 2

Associated with binding to vitamin B12 and transporting into cells.

PEMT

Phosphatidylethanolamine N-methyltransferase 

Involved in enzyme that catalyses phosphatidylethanolamine to phosphatidylcholine.  Low choline is associated with anxiety.

VDR

Vitamin D receptor

Binds to an active form of vitamin D and facilitates its function. 

Mood concerns in children have a number of possible aetiologies and as part of a naturopathic and functional medicine approach, all of these aspects should be explored for optimal health outcomes for children.

References

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  2. Carabotti M, Scirocco A, Maselli MA, et al. The Gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems.  Ann Gastroenterol. 2015 Apr-Jun; 28(2):203-209. [Full Text]
     
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Lisa_McDonald's picture
Lisa McDonald

Lisa is a qualified clinical Naturopath with a special interest in nutrigenomics, methylation, MTHFR, chronic fatigue, mental health, gut health and biotoxin/mould illness (Chronic Inflammatory Response Syndrome - CIRS).

Following her Naturopathic qualification, Lisa completed further study with Seeking Health Institute, MTHFR Support Australia, GAPS and Fitgenes. Lisa also holds a Psychology degree and a Masters of Management. Presently, Lisa is completing Dr Richie Shoemaker’s Physician Certification program in Chronic Inflammatory Response Syndrome (CIRS) (mold/biotoxin illness) as well as qualifications in Nutritional and Environmental Medicine with ACNEM.

Currently, Lisa holds a position on the board of ARONAH (Australian Register of Naturopaths and Herbalists) whilst also running her clinical practice in Sydney. You can find Lisa at www.indigosagehealth.com.au