Nutrition and Mental Illness
My son was diagnosed with an anxiety disorder as well as OCD (Obsessive Compulsive Disorder). I consulted a naturopath who suggested that some of my son’s psychological problems could be due to his diet. Is this possible?
Your question is very relevant given that psychological and psychiatric disorders have increased significantly in recent decades. Statistics show that 29% of Quebecers are struggling with anxiety disorders or major depression.(1) Imagine - almost a third of the population! The situation is no better in the rest of Canada (2) or for our neighbors to the south. (3)
Some of this increase is due to better diagnostic techniques as well as a greater use of health care professionals in the general population. Indeed, among past generations, the diagnosis of psychological or psychiatric disorders was taboo. Since families and individuals were less likely to admit to this type of problem or seek help from a health professional, they were often not included in the statistics. Regardless, today about a third of the population is affected by "mental" problems.
A Bit of History
A Canadian psychiatrist, Dr. Abram Hoffer, was among the first to practice Orthomolecular Psychiatry (4). Hoffer, and before him Pauling and Gould (5), used natural or normal molecules (ortho molecules), dietary changes and high doses of vitamins and minerals to treat psychiatric disorders. Nobel Prize winner Linus Pauling’s research validated this approach. Pauling, generally considered the father of biochemistry, believed it made more sense to use natural molecules rather than artificial ones to treat health problems. Since the brain needs these natural molecules to function normally, Hoffer, Pauling and others thought it made sense to prescribe them when the brain was not working well. Pauling gave this practice the name, "Orthomolecular Psychiatry". (6)
Other researchers went much further with using this orthomolecular approach in both psychiatry and in medicine in general. Carl Pfeiffer, a psychiatrist at Princeton University in the United States, developed a comprehensive theory about the role nutrition plays in mental health. His magnum opus, " Mental and Elemental Nutrients" which, although a bit dated, is an essential resource for understanding how nutrition can play a role in mental health. His disciple, the neurobiologist Eric Braverman, pushed Pfeiffer’s assumptions even further with his research into amino acids. One of his books "The Edge Effect" explains his biochemical approach. These researchers demonstrated the effects of proper nutrition in both individuals suffering from anxiety, depression and neurosis as well as in cases of bipolar disorder and schizophrenia.
Orthomolecular psychiatry, or the use of natural molecules in the treatment of mental disorders, was adopted by some holistic doctors. Unfortunately, most physicians ignored this approach. Thus, it gained momentum among naturopaths (naturopathic doctors and licensed naturopaths) and holistic nutritionists as well as chiropractors and osteopaths.
Food and the brain... What is the connection?
A doctor friend - a well-meaning individual, but one who could benefit from reading a few editions of Vitalité Québec – said to me one day, "Come on, what you eat does not go to the brain!" I reminded him that how the brain reacts depends on substances in the food we eat. All brain and nerve activities are conditioned by substances derived from the food we consume. Thus, a deficiency in one of these substances can reduce brain activity.
What’s more, an excess of certain substances can have a detrimental effect on brain activity as well. Since my friend is the father of two young children, I suggested he do the following experiment, that every evening he feeds his children two tablespoons of table sugar. His reaction was immediate ... "No way! I’d never get them into bed! They’ll be bouncing off the walls!" In this way, I made him realize that a particular food, sugar in this case, could indeed have a stimulating effect on the central nervous system.
Yes, what we consume can affect our brain or our mood. When he was a clinical professor of medicine at the medical school of the University of California at Los Angeles (UCLA), Dr. Melvyn Werbach, noted, "It is clear that nutrition can powerfully influence cognition, emotion and behavior. "(9)
In an article like this, it is impossible for me to list all the factors that influence behaviour. Therefore, I will target several to fully establish nutrition role in cases of mental illness. Before I continue, let me state one important caveat. All mental, psychological or psychiatric problems are not necessarily due to poor nutrition. Furthermore, even when poor nutrition is a factor, it does not mean that it is the only one. Indeed, in some cases nutrition can be a precipitating or aggravating factor without being the root cause of the problem. Finally, even for those whose mental problems are essentially nutrition-based, it is often useful, even necessary, to work in conjunction with a healthcare professional to ensure optimal results and minimal symptoms. Thus, psychological or psychiatric care is not superfluous.
From an environmental and nutritional perspective, several factors can affect health or mental balance. Here, I will limit myself to the impact of vitamin and mineral deficiencies. In an upcoming issue of I will address other major causes such as hypoglycemia, food intolerance and the state of the gastrointestinal tract.
A nutrient is a substance that is absolutely necessary for life. It is used up by the body, so it must be replaced continuously. This is why we eat. It is also why we can feel physically and mentally weak when we haven’t eaten for a long time.
These nutritional substances can be categorized in different ways, but I would like to use the standard formula. A nutrient can be energetic (it is used as a source of energy), structural (it is used to form the structure, such as skin and bone) or it can be a metabolic regulator (it is used to trigger or stop an activity).
Let me use the analogy of a car, certainly not the best analogy, but it will suffice. My car is filled with gasoline and when the gas is burned, energy is produced to drive the motor. Gasoline is an energy element. The car also has spark plugs. They are necessary to "turn on" the gas that is then burned to produce energy. The spark plugs have a metabolic effect. Finally, the car’s frame is made of metal and its body is made of plastic, thus they are structural elements.
Nutritionally, some substances have one, two or three of these functions. Proteins (made up of amino acids) are used to form our structural proteins, they can be used as an energy source and they are involved in the metabolism as basic enzymes or hormones.
At the mental level, several nutritional deficiencies can cause subtle or obvious symptoms - depending on the individual and the type or severity of the deficiency. Unfortunately, even if our current diet is enough to prevent classic deficiency diseases, it is often not sufficient to ensure optimum physical and mental health. (10) Moreover, it is often the case that certain individuals need more nutrients than others due to their biochemical individuality. (11) For example, European research has confirmed that some individuals require much more magnesium than the average person due to genetic factors. (12) Therefore, it is quite possible that an individual has normal blood results yet still lacks the level of nutrients needed to maintain optimal health.
Here is a brief overview of the most important nutrients: (13)
It is important to note that a deficiency of any of the B vitamins can cause mental symptoms. A growing number of studies associate a deficiency of B-complex vitamins with depression as well as bipolar disorder and schizophrenia. (14)
Vitamin B6: Deficiencies in vitamin B6, as well as in vitamins B1 and B2, have been associated with an increase in symptoms in psychiatric patients. (15) According to some studies, patients with psychiatric disorders need much higher levels of pyridoxine (vitamin B6) than the general population. Supplementation effectively helps improve certain psychiatric symptoms. (16) Some studies also suggest that autistic children have a need for a significantly higher intake of vitamin B6 than the average population. (17) Although autism is not a mental illness, these studies nevertheless suggest a link between a lack of vitamin B6 and behavioural disorders.
Vitamin B12: Vitamin B12 deficiency can cause depression, paranoia and hallucinations. (18) Unfortunately, B12 deficiencies are quite common in older people as well as vegetarians who do not follow a balanced diet.
Vitamin B3: Of all the vitamins, vitamin B3 is the one most studied by orthomolecular physicians. This largely due to the role this vitamin plays in the treatment of schizophrenia – a link that was first discovered by Canadian psychiatrist Abram Hoffer.(19) As far as anxiety is concerned, researchers have found that vitamin B3 has effects similar to benzodiazepines (Clonazepam, Diazepam, Oxazepam, Xanax, Zopiclone, etc.) (20) minus the side effects, it goes without saying. Doctors in Italy have used Vitamin B3 to help patients wean themselves from these types of drugs. (21)
A number of minerals and trace elements have been shown to have significant effects on mental health. Here again, I will list a few to give you an idea of the impact that proper nutrition can have on behaviour.
MAGNESIUM: Those who have read my book, Syndrome S, (22) know how I like to emphasize the impact magnesium has on stress adaptation as well as general good health. Magnesium is involved in over 300 enzyme systems in the body. It is essential to produce energy and for the normal activity of nerves and muscles. But it is its neurobiological effects that are of interest here.
The prestigious journal, Psychology Today, published an article in which the author, Dr. Emily Deans, describes how magnesium works to calm anxiety, reduce depression and improve one’s sense of well-being. This psychiatrist also noted that the food we eat today provides much less magnesium than in the past. (23)
Another study by two doctors, one of them a psychiatrist, suggests that magnesium is an essential supplement for psychiatric patients. (24) And, yet another study by Dr. Eby reports that magnesium supplementation accelerates the recovery of patients suffering from major depression. (25)
Magnesium deficiency is also associated with anxiety (26) and obsessive-compulsive disorders (27). Some authors even suggest that magnesium may play a role similar to that of lithium (28) in some affective disorders - without the latter’s side effects.
"There is also considerable accumulating evidence to suggest alterations to some brain functions in both normal and pathological conditions may be linked to alterations in local magnesium concentration."(29)
ZINC: Zinc, just like magnesium, is involved in more than 300 enzyme systems in the body. It is well-known for its positive effects on immune health, fertility and prostate health. However, few people are familiar with its effects on mental health. In fact, studies show that zinc helps the brain manage the stress response and can therefore be of great help in the treatment of major depression. (30) In 1983, Dr. Carl Pfeiffer noted the importance of zinc as well that of manganese, another trace element, in the treatment of schizophrenia. (31)
CHROMIUM: Chromium raises the production of glucose tolerance factor, or GTF, making it one of the most important nutrients needed to balance blood sugar. I will discuss this further when address the role hypoglycemia plays in mental diseases. Nevertheless, I would like to note a few points about this often-neglected trace element.
In a study of patients suffering from atypical depression, 70% of patients taking chromium experienced a reduction in symptoms versus 0% for those in the placebo group. (32) Another study with placebo showed that supplementing with chromium had the effect of reducing carbohydrate cravings in patients with depression.
Despite the fact that I have only scratched the surface, it is clear that nutrition, an element usually neglected in the prevention or treatment of mental illness, should be at the forefront of any clinical approach. In the next issue of Vitalité Québec, I will shed light on the role hypoglycemia and food intolerance play in the onset or exacerbation of these diseases, diseases which reduce the quality of life of many individuals.
(1) Chiffres de 2001, rapport annuel de la Direction de la santé publique – Agence de la
santé et des services sociaux de Montréal, lien sur le site de la FMM
(2) Upshall, Phil éd. Maladie Mentale et Toxicomanie au Canada, La société pour les troubles de l'humeur au Canada (2009)
(3) Latham, Tyger Mental Illness on the Rise in the U.S. Psychology Today, 18 may (2011)
(4) Hoffer, Abram History of Orthomolecular Psychiatry, Orthomolecular Psychiatry, Vol. 3, No. 4, (1974)
(5) Gould, J.: The Use of Vitamins in Psychiatric Practice. Proc. Roval Soc. Med. 47, 215, 1954.
(6) Pauling L.: Orthomolecular Psychiatry. Science 160, 265, 1968.
(7) Pfeiffer, Carl Équilibre Psycho-Biologique et Oligo Aliments, Équilibres (1988)
(8) Braverman, Eric Un cerveau à 100% Thierry Souccar (2008)
(9) Werbach, Melvyn Nutritional Influences on Mental Illness, Third Line Press (1991)
(10) Cheraskin, E. Diet & Supplementation: Keys to Optimal Health. Academy of Science (2005)
(11) Williams, R. J. Biochemical individuality : the basis for the genetotrophic concept Keats Pub. (1998)
(12) Didier Chollet, Paul Franken, Yvette Raffin, Jean-Georges Henrotte, Jean Widmer, Alain Malafosse, Mehdi Tafti, Magnesium Involvement in Sleep: Genetic and Nutritional Models, Behavior Genetics September Volume 31, Issue 5, pp 413-425 (2001)
(13) Ramsey, Drew and Philip Muskin Vitamin deficiencies and mental health: How are they linked? Current Psychiatry Vol 12, No. 1 (2013)
(14) E. Siobhan, Mitchell Nelly Conus and Jim Kaput B vitamin polymorphisms and behaviour: Evidence of associations with neurodevelopment, depression, schizophrenia, bipolar disorder and cognitive decline Neuroscience & Biobehavioral Reviews, Vol. 47: 307-320 (2014)
(15) Carney MW, Ravindran A, Rinsler MG, Williams DG. Thiamine, riboflavin and pyridoxine deficiency in psychiatric in-patients. Sep; 141:271-2 (1982)
(16) M. H. Lader Handbook of Psychiatry: Volume 2, Mental Disorders and Somatic Illness, Cambridge University Press (1983)
(17) Adams JB1, George F, Audhya T. Abnormally high plasma levels of vitamin B6 in children with autism not taking supplements compared to controls not taking supplements J Altern Complement Med. 2006 Jan-Feb;12(1):59-63.
(18) Patrick J. Skerrett Vitamin B12 deficiency can be sneaky, harmful Harvard Health Publications January 10 (2013)
(19) Hoffer, Abram Orthomolecular Medicine for Physicians Keats Publ. (1997)
(20) Jonathan E. Prousky Niacinamide’s Potent role in Alleviating Anxiety with its Benzodiazepine-like Properties: A Case Report Journal of Orthomolecular Medicine Vol. 19, No. 2 (2004)
(21) Pelton, Ross and LaValle, James Drug-Induced Nutrient Depletion Handbook, Lexi Comp; 2nd edition (2001)
(22) Crisafi, Daniel Syndrome S : How to avoid, manage, and reverse the negative health effects of stress, Chat (2014)
(23) Deane, Emily Magnesium and the brain, the original chill pill, Psychology Today June 12, 2011
(24) Barbara Bartlik, Vanessa Bijlani, Magnesium: An Essential Supplement for Psychiatric Patients Psychiatry Advisor July 22 (2014)
(25) Eby GA, Eby KL. Rapid recovery from major depression using magnesium treatment. Med Hypotheses, 67(2):362-70 (2006)
(26) S.B. Sartori, N. Whittle and N. Singewald Magnesium deficiency induces anxiety and HPA axis dysregulation: Modulation by therapeutic drug treatment Neuropharmacology. Jan; 62(1): 304–312 (2012)
(27) Marcos T. Mercadante, Maria C. Rosario-Campos, Lucas C. Quarantini, Fabio P. Sato The neurobiological bases of obsessive-compulsive disorder and Tourette syndrome Journal de Pediatria 0021-7557/04/80-02-Suppl/S35 (2004)
(28) H. Murck Magnesium and Affective Disorders, Nutritional Neuroscience Volume 5, Issue 6 (2002)
(29) Vink, R., Nechifor, M. Magnesium in the Central Nervous System, University off Adelaide Press (2011)
(30) Swardfager W1, Herrmann N, McIntyre RS, Mazereeuw G, Goldberger K, Cha DS, Schwartz Y, Lanctôt KL. Potential roles of zinc in the pathophysiology and treatment of major depressive disorder. Neurosci Biobehav Rev. Jun;37(5):911-29.(2013)
(31) Pfeiffer, Carl et LaMola, Scott Zinc and Manganese in the Schizophrenias. The Journal of Orthomolecular Medicine Vol. 14, 1st Quarter (1999)
(32) Davidson JR, Abraham K, Connor KM, McLeod MN. Effectiveness of chromium in atypical depression: a placebo-controlled trial. Biol Psychiatry. Feb 1;53(3):261-4 (2003)
(33) Docherty, John P. A Double-Blind, Placebo-Controlled, Exploratory Trial of Chromium Picolinate in Atypical Depression: Effect on Carbohydrate Craving Journal of Psychiatric Practice 11(5) : 302-14 (2005)