NUTRITION AND MENTAL HEALTH

A PRESS RELEASE from Medical Express (http://medicalxpress.com/) from January 28 (but just showing up in my inbox!) is a press release from the University of Melbourne. That’s in Oz, of course.

http://medicalxpress.com/news/2015-01-diet-nutrition-essential-mental-health.html

“Diet and nutrition essential for mental health” publicizes a recent article by Jerome Sarris and a gaggle of colleagues, including the inimitable Felice Jacka. The article itself is called “Nutritional therapy as mainstream in psychiatry.” It appears in Lancet / Psychiatry.

  • Is nutritional therapy mainstream?

Well of course it clearly is not. The title is aspirational, if not delusional. Psychiatrists write scripts for drugs, not for food. The psychiatric community hooked its wagon to the weak horse of biology. Too bad.

The problem with drug treatment is that it hasn’t lived up to its billing. The antidepressants, the moneymaker for the mental illness industry, are barely better than placebo. In fact, with mild and moderately depressed patients, they are exactly the same as placebo, according to a fairly well-known analysis in 2010 in JAMA Psychiatry.

(http://jama.jamanetwork.com/article.aspx?articleid=185157)

Now you may ask,”Lynn, how do you define ‘mild’ and ‘moderate’ depression.”

Well, you should call me “Dr Johnson” but we will let that go. <grin, wink>

Mild is define as a score of 10 – 17 on the Beck Depression Inventory or on the Center for Epidemiological Services-Depression scale (CES-D). Moderate depression is between 18 – 26. Above 27 or so and we are looking at a severe depression.

I never use the Hamilton because of observer bias. The Hamilton is a scale where the doctor rates the patient. Not as pure or reliable as a self-rating like the Beck or the CES-D. In my not-quite-humble opinion.

Where was I? Oh, yes, drugs versus food.

Felice Jacka has published some remarkable studies showing that around seven helpings of fruits and vegetables a day significantly improves the mood and mental health of youth around the age of 19. Google them on scholar.google.com.

Another star contributing to this article is Almudena Sanchez-Villegas, a Spanish researcher (Universidad de Navarra) who has published some very large studies showing that the risk of depression is significantly reduced simply by adhering to a Mediterranean diet.

Read the article here: 

http://www.researchgate.net/publication/271385360_Nutritional_medicine_as_mainstream_in_psychiatry

Will the psychiatrists join in the nutrition-focused treatment movement?

Don’t bet on it.

There is a quote I read when I was thirteen. I had a newspaper route and spent all the money I made on books from Science Fiction Book Club. In a long forgotten book there was one sparkling short story about an expedition to Mars. The punch line in the story was “And everyone knew it but the Fools at the Top.” The trouble is that academic psychiatry is betting all in on the biological explanation, and emphasizing drugs as the answer. The research money doesn’t come from the Department of Agriculture (which, IMHO, is a creature of corporate farming and an enemy of family farming) to emphasize Rainbow diets. No, it comes from the drug houses looking for the next blockbuster.

The Academy is producing psychiatrists wedded to the drugs-as-therapy model. They are ignoring a vast area of intervention in lifestyles, and frankly, they tend to ignore psychotherapy, if not in principle, certainly in practice.

The Role of Inflammation in Mental Health

Yet there is some truth in a biologically informed approach. Inflammation plays a part in mental illness.* Eating right (and, exercise, and a number of other lifestyle changes) will reduce inflammation.

(*See: http://www.medscape.org/viewarticle/837038  Note that Medscape requires you register, but it is free. The article shows the effect of Celebrex on depression. Take two aspirin and feel better in the morning?)

Lifestyle changes are showing up over and over as valid interventions. My mission is to share these insights with non-medical therapists. We do all the psychotherapy anyway, and lifestyle prescriptions fit right in.

My colleague, Zak (Allen) Zaklad has some good results with clients who will pursue Tai Chi. A lifestyle change. Others have success with Yoga. A similar lifestyle change. There are many pathways to mental health.

In case you were wondering about the science fiction short story, it was by someone I had never heard of, C. S. Lewis. I had not remembered the quote correctly, but I was able to track it down. Lewis’ short story, “Ministering Angels” contains this statement: “Anyone,’ said the other, ‘except the Fools at the Top could have of course foreseen it from the word ‘go.'”

https://archive.org/details/MinisteringAngels

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2 Comments

  1. Christine March 9, 2015 at 12:14 pm - Reply

    This blog is so true about conventional medicine not knowing how nutrients affect mood. Functional medicine practitioners use food, herbs and lifestyle interventions along with counseling and have great success with mood disorders. I find many people who go to their medical doctors with depression/anxiety and their medical doctors send them to psychiatrists and neither of them ask the patient, what are you eating, how are you living? But even sadder, is that many patients don’t want to change their diet or lifestyle. The patients who come to see me may be taking psychotropics from a psychiatrist, but they are not happy about it and they are highly motivated to make the changes they need to make to feel better. The public needs to know there is an alternative. Conventional medicine is wonderful when you need an antibiotic, a surgery or get in a car accident. But for most chronic, degenerative diseases (including mood disorders) functional healthcare is a much better choice. That tool box consists of nutrition, exercise, lifestyle modifications and counseling. Thanks for the great job you do Dr. Johnson!

    • Dr.J March 10, 2015 at 8:44 am - Reply

      Christine is on the cutting edge here. I will not give up my psychotherapy skills, but it looks more and more like what we eat has about the same impact as good psychotherapy! Why not use both?

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