What is Nutritional Psychiatry and how it could change your life
Diet is as important to psychiatry as it is to cardiology, endocrinology and gastroenterology’ Sarris et.al 2015.
We all know that what you eat can affect your gut and make your skin look better, but did you know that what you eat not only can make your body feel its best, but food can also really improve your mental health too. “Nutritional psychiatry means using food, supplements, vitamins, exercise, meditation, etc., in conjunction with standard psychiatric medications to optimize the potential of all treatments,” explained Dr. Sheldon Zablow MD, a nutritional psychiatrist and author based in San Diego.
Nutritional psychiatry is a growing area which supports the importance of diet and nutrition as part of an integrated or alternative treatment for mental health disorders. More specifically it looks at how single foods, nutrients, supplements, and more recently over all dietary patterns might prevent and treat psychological disorders.
The area of psychiatry treats mental health conditions such as anxiety, PTSD, Alzheimer’s, eating disorders, insomnia, depression, panic attacks, OCD and addictions. This is not in any way a complete list but many of these conditions are usually treated by seeing a psychiatrist. They can diagnose, prescribe medications and suggest various forms of therapy.
Even though medications for these conditions can be very helpful, unfortunately there are quite a lot of side effects. Such as gastrointestinal, weight gain, nausea, loss of libido which can carry on for years after stopping the medication, reduced bone mineral density, headaches. A recent study led by Paul Andrews at McMaster University found that taking anti-depressants increases one’s risk of death with 33 percent and the risk of a cardiovascular even by 14 percent. A 2016 article in Scientific American publicized the results of a Nordic Cochrane study which suggested that antidepressant treatment was causing increases in suicidality and aggression. Research published in The Lancet also showed that most anti-depressants on the market are ineffective for children and teens with major depressive disorders and some may even be unsafe for young children. Supporting your teen with other measures should probably be the first port of call before looking at medication as only one out of 14 antidepressants was more effective at relieving symptoms of depression in young people than a placebo pill.
Andrews and his colleagues explain the ways that antidepressants affect broad systems throughout the body. “While each AD probably has a distinct symptom profile, there is good reason to suspect that they all degrade the functioning of some adaptive processes in the body.” SSRI/SNRI affect the serotonin system, which impacts numerous bodily processes and ‘could potentially degrade many adaptive systems’ says Andrews. SSRI’S are more commonly known as Prozac, Lexapro, Celexa, and Zoloft. A 1994 article showcased the evidence of “the likelihood that psychotropic drugs actually worsen, at least in some cases, the progression of the illness which they are supposed to treat.”
It’s not surprising that people who suffer from various mental health conditions are looking for new types of support. Especially since according to a 2015 study, more than two-thirds (69%) of those prescribed an antidepressant do not actually meet the criteria for the diagnosis of major depressive disorder and as an NIMH study -National Institute of Mental Health - in 2006 found that 85% of untreated depressed patients recovered spontaneously within one year.
EAT THE RAINBOW FOR BRAIN HEALTH
This is where nutritional psychiatry comes in. Looking at food to support mental health and optimising your sleep, specific nutrients that support various stages in life, pregnancy health and nutrition are all ways that could help and support mental health conditions. The use of food supplements and diet has the potential to make a huge difference to the mental health of all ages.
The link between poor mental health and nutritional deficiencies has long been recognised by nutritionists working in the complementary health sector. Medical education has traditionally excluded nutritional knowledge and its association with disease. This has led to a situation where not many doctors in the UK have a proper understanding of the importance of nutrition. It is now known that many mental health conditions are caused by inflammation in the brain which ultimately causes our brain cells to die. This inflammatory response starts in our gut and is associated with a lack of nutrients such as magnesium, omega-3 fatty acids, probiotics, vitamins and minerals that are all essential for the optimum functioning of our bodies.
Recent research has shown that food supplements such as zinc, magnesium, omega 3, and vitamins B6 and D3 can help improve people’s mood, relieve anxiety and depression and improve the mental capacity of people with Alzheimer’s. One study showed that high intake of zinc correlated with significantly lower rates of depression with a reduction about 30-50 %. Poor levels of B6 and Zinc can also reduce our ability to produce GABA (a hormone that calms us) and acetylcholine (a multi-functional hormone particularly related to cognition, memory and brain function) and when we are stressed B6, and Zinc will be further depleted.
Various nutrients, such as tryptophan, vitamin B6, vitamin B12, folic acid (folate), phenylalanine, tyrosine, histidine, choline, and glutamic acid, are also essential for the synthesis of neurotransmitters like serotonin, dopamine, and norepinephrine. These neurotransmitters are involved in regulating mood, appetite, and cognition, thus highlighting the importance of adequate nutrient intake for optimal mental health, Growing evidence links a diet that includes high antioxidant components, such as the Mediterranean diet which mainly focuses on unprocessed wholefoods, has big benefits to cognitive function.
PERSONALISED NUTRITION AND FUNCTIONAL TESTING
The next step should be to create psychiatric interventional studies based more on a personalised medicine approach, using biomarkers i.e., nutrient deficiencies, inflammation, genomic assessment, microbiome analysis and a persons’ dietary patterns and the needs of an individual macro i.e., protein, fat, carbohydrates and micronutrient i.e. vitamins and minerals.
Dr. William Walsh, the author of Nutrient Power pub 2012, is a scientist that paved the way for nutrition-based psychiatry and nutritional medicine. His interest in this area began in the 70’s when he organized a prison volunteer program that led to studies researching the causes of violent behaviour. Over the next 30 years, Dr. Walsh developed biochemical treatments for patients with behavioural disorders, ADHD, autism, depression, anxiety disorders, schizophrenia, and Alzheimer’s disease that are used by doctors throughout the world. His approach recognizes that nutrient imbalances can alter brain levels of key neurotransmitters, disrupt gene expression of proteins and enzymes, and cripple the body’s protection against environmental toxins. For example, dysregulated copper can be a leading factor in postpartum depression. In pregnancy, copper rises to compensate for the fetus and after the birth, the mother’s copper should go down and when it doesn’t this can result in PPD.
FINDING THE ROOT CAUSE
Dr. Walsh focuses on methylation as DNA methylation is linked to silencing or “turning off” genes. Overall, increasing methylation reduces the expression of genes, including those that make reuptake proteins. When properly implemented, increasing methylation can serve as a very beneficial therapy for those suffering from undermethylated depression. This method essentially does the same thing that conventional medications do, but they start from the root cause. Antidepressants target and block SERT proteins, but don’t address the underlying methylation issues.
Dr Walsh also did a lot of study around pyrroles and found that kryptopyrroles may also bind to biotin, manganese, chromium, magnesium, omega 6s (arachidonic acid) and other important nutrients, excreting them from the body via the kidneys causing further nutrient deficiencies. Pyrroles are present in many areas of the body: your blood, bone marrow, and your spleen. They are metabolic byproducts of making haemoglobin and other blood chemicals and typically, pyrroles are quickly cleared out through blood and urine, but when they are not, the increased levels can cause major behavioural disorders. Pyrrole levels can be found out via a simple urine test.
There is plenty of emerging scientific evidence that suggest there should be a much bigger role for nutritional psychiatry in mental health within conventional health services. Trying to figure all this out by yourself can be overwhelming, so support for nutritional intervention from the GP and mental health services is essential if the burden of mental ill health is to be reduced. More information needs to be out there to highlight the connection between food, inflammation and mental illness. Nutritional psychiatry is not intended to replace prescription medication, but rather to support a treatment plan and help patients heal using every route possible. Working alongside a Nutritional therapist can be a start as they can advise about the correct functional testing, supplements and diet.