Adrian Lopresti

Increasing evidence suggests that major depressive disorder is associated with mitochondrial dysfunction, and consequently, increased oxidative stress. In this chapter, the role of mitochondria and how they potentially influence physiological processes associated with depression are reviewed. Research on mitochondrial disturbances in adults with depression is also summarized and possible causes for these disturbances are presented. In particular, a focus is placed on lifestyle, environmental, nutritional, and biological influences on mitochondrial function. More specifically, the role of stress, hypothalamus-pituitary-adrenal axis activity, sleep disturbances, diet, nutrients, exercise, gut microbiota, and pharmaceutical medications on mitochondrial activity are discussed. Many of these areas are problematic in people with depression and present as plausible options to improve both depression and mitochondrial function.

Major depression is a debilitating condition affecting approximately 10% of the population. While primary treatments comprise pharmaceutical and/or psychological interventions, efficacy rates are far from ideal, reaching treatment remission rates of only 20-40%. Diet and exercise are two lifestyle factors that are commonly associated with major depression and have the potential to increase treatment efficacy. In this chapter, epidemiological and interventional studies on diet and exercise in major depression will be reviewed with a particular emphasis on their role in the prevention and treatment of this disorder. The influence of diet and exercise on dysregulated biological pathways associated with depression will also be summarized, namely, their impact on neurotransmitter balance, oxidative stress, inflammation, neurogenesis, and hypothalamus-adrenal-pituitary (HPA) axis regulation.