Why you should care
Almost 20 percent of Americans have a mental illness. Could a simple change in diet offer relief?
For as long as he could remember, Jeff says, “I always kind of wished I would die.” As a teenager, the Northridge, California, native turned to pot and crystal meth, and for years swung between bouts of deep depression and flights of mania. It wasn’t until he was 43 that a psychiatrist diagnosed him with bipolar disorder.
Thanks to meds, today Jeff, who didn’t want his last name used, is stable, self-assured, effervescent even. But a cheaper solution without pernicious side effects might have been hiding in his cabinet — that is, his kitchen cabinet. Recent research suggests that eating right might stave off more than heart disease and diabetes; it could prevent mental illness and even treat it. Studies have found that omega-3 fatty acids can lower schizophrenia risk, for example, while nutrient cocktails have lowered anxiety in earthquake survivors. This nascent food-for-thought movement could have major effects for the nearly one in five American adults who suffer from mental illness, gaining them access to treatment without the ugly trade-offs many psychiatric drugs require, like weight gain and listlessness.
Sarris envisions therapists asking clients about not only their moods, but also their sleep, exercise and eating habits.
Although “alternative” healers have recommended nutrients for years, “the Western medicine community pooh-poohed it for a really long time,” says Eva Selhub, a Boston-based primary care physician and author of Your Health Destiny. That’s begun to change as more scientists dig into so-called nutritional psychology: establishing research agendas, teasing out the links between food and mood and building research institutions. It’s all part of a broader shift toward integrative medicine, which aims to treat not just the illness, but the whole person — mind, body and spirit.
Jerome Sarris, a senior research fellow at the University of Melbourne’s psychiatry department, finds the historical mind-body schism “stupefying.” In a review article published in The Lancet in January, he writes that nutrition is as crucial to psychiatry as it is to cardiology or gastroenterology. He envisions therapists asking clients about not only their moods, but also their sleep, exercise and eating habits. They might recommend dietary changes or nutritional supplements instead of, or alongside, medication.
The best-case scenario, Sarris says, is that such approaches will take at least a decade to permeate mainstream practice. With medication already available, funding agencies are loath to support research on nutrients, says Julia Rucklidge, a clinical psychology professor at the University of Canterbury. Scientific journals have also hesitated to publish such work, believing “no one would be interested.” Still, at least 11 studies related to nutrition and mental health are currently funded by the National Institute of Mental Health or its integrative health affiliate. And a spokesperson for the New England Journal of Medicine notes in an email that it has published “a handful” of studies on nutritional and dietary supplements.
Advocates say the time is ripe for a shift in mental-illness treatment. While drug development has vastly lowered the number of deaths due to heart disease and cancer, the rate of suicides — 90 percent of which stem from mental illness — remains at a staggering 41,000 per year in the U.S. “Why are we continuing to see medications as an acceptable and viable way to treat people who have serious mental illness?” Rucklidge says. Researchers predict that mental illness rates will only rise as more people adopt a sedentary lifestyle and sugary, fatty Western diet.
Indeed, study after study has pointed to a balanced diet as a prevention tool. A trial published in BMC Medicine in 2013 found that a modified Mediterranean diet lowered the risk of developing depression three years later. Now, scientists want to know whether dietary changes can also treat depression with the recently launched “SMILES” trial, comparing participants randomly assigned to a dietary intervention versus a support group.
Supplements could also offer relief. Research has linked vitamin D deficiency to a twofold increase in schizophrenia risk and hinted at folate as a possible antidepressant. Combinations of nutrients that more completely meet our body’s needs might prove even more effective. In a trial of adults suffering from anxiety or stress after the 2011 Christchurch earthquake, Rucklidge found that those who popped a nutrient formula experienced steep declines in psychological symptoms. And amid growing evidence that gut bacteria can influence brain health, preliminary trials have also shown that probiotics — “good” bacteria — can boost mood and cognitive function.
To be sure, other trials have also reported that participants given nutrients fared no better than those given a placebo (although Rucklidge notes that they involved nonpsychiatric patients who “don’t have room to get any better”). And while nutrients likely have only mild side effects, they might still pose some risks. Plus, eating healthy requires motivation, but “these disorders … sap people of their will,” Jeff says.
Still, Sarris and Rucklidge hope that the groundswell of nutritional psychiatry papers, organizations and conferences will put nutritional psychiatry on the map. “I’m hopeful,” Rucklidge says. “I’m starting to get people on board thinking that maybe that crazy lady at the university is right.”