In the early nineties, a 38-year-old patient named Marianne came to me complaining that her antipsychotic medication had made her gain more than twenty extra pounds of weight. The medication also made her chronically tired and restless. She wanted to look for an alternate way to treat her schizophrenia and said that she was willing to “try anything.” And that’s what we did.

I had read in the medical literature that some cases of schizophrenia resolved with high doses of B vitamins, and some with high doses of fish oils. We tried that approach along with many other vitamins and minerals and nothing seemed to make a significant difference.

I delved deeper into my research and learned that there had been cases reported all the way back to the 1950s of schizophrenia that resolved with elimination of gluten. Gluten is a group of proteins found in wheat, rye, barley, and spelt and known to cause inflammation and autoimmune disease in some people.

When the immune system reacts to a perceived threat, such as the gluten proteins, it makes antibodies to the gluten. Those antibodies may attack parts of the body—including the brain—whose proteins resemble the gluten protein. This autoimmune response can cause significant harm.

Although Marianne’s celiac test came back negative, the research showed that many people have gluten sensitivity that doesn’t show up on routine blood tests.

In some people, gluten sensitivity can manifest as a neurological disease affecting primarily the brain, and can cause or exacerbate “brain fog,” profound fatigue, depression, anxiety, OCD, bipolar illness, schizophrenia and other mental conditions.

I shared my literature search with Marianne. With cautious optimism, she agreed to eliminate gluten from her diet for six weeks.

To make sure that the experiment had validity, I asked her to avoid eating at restaurants and to avoid all packaged and processed foods, such as salad dressings, sauces, and soups. In the list of ingredients, the gluten that’s used as flavoring is usually disguised under another name.

I also asked Marianne to begin the experiment by removing all traces of gluten that could still be bioactive in her intestinal tract. For three days before bedtime, Marianne used Bentonite clay and psyllium husks to clean out her intestines.

Well before the six weeks were over, Marianne stopped her antipsychotic medication and noticed that the symptoms of schizophrenia that she had lived with since she was 18 years old had completely resolved. The delusions, anxiety, compulsive behavior, and suicidal thoughts disappeared and never returned as long as she stayed on her diet.

To her delight, she also noted that the chronic rash on her body disappeared, her energy increased, her cognitive abilities sharpened, digestion improved, and she lost all of the weight that she had gained due to her medication.

Shortly after Marianne’s dramatic improvement, I began asking all of my patients with mood disorders and mental illness to try a six-week trial off all gluten-containing foods. A high percentage of those patients noticed an improvement in their symptoms.

My research also revealed that milk protein, called casein, can cause inflammation in the brain—and elsewhere—and can even lead to auto-immune disease, much like the gluten proteins.

Yet another source of inflammation of the brain is sugar, along with simple carbohydrates that turn quickly to sugar like bread and pasta. Inflammation leads to multiple brain-related problems such as “brain fog,” headaches, fatigue, anxiety, depression, and other mood disorders.

Eventually I asked all of my patients with mental illness to avoid not only gluten during the six-week trial, but also all dairy products and simple carbohydrates, including sugar. Most of the patients who were able to complete the six-week trial noted a significant reduction in their symptoms—including symptoms that extended beyond the brain. Some of the patients said that they felt better than they ever had in their lives.

The challenge is trying to help people stay off the dairy and the gluten—especially the teenagers. The proteins in the cow dairy and the gluten can trigger the opiate receptors in the brain and create an addiction. Some of my patients go into withdrawal when they try to stop the dairy and the gluten.

Prevalence of mental illness

Mental illnesses are very common in the US. According to the National Institute of Mental Health, about 25% of American adults and about 13% of American children are diagnosed with a mental disorder during a given year.

Mental health problems are one of the most common reasons that people file for Social Security disability in the US. 

There are more than 200 classified forms of mental illness. Some of the more common disorders include depression, anxiety, bipolar disorder, obsessive-compulsive disorder, and schizophrenia.

Anxiety disorder is the most common mental illness in the United States, according to the National Institute of Mental Health. Forty million adults—18% of the population—struggle with anxiety.

Anxiety and depression often go hand in hand. About half of those with depression also experience anxiety. Many people suffer from more than one mental disorder at a given time. 

Conventional Mental Health Treatment 

Psychiatry has made great strides in the last half century in the treatment of mental illness. The use of psychotropic medications has helped millions of people with mental illness, but the medications do not heal the underlying problems, and they can have serious side effects.

Antidepressants are commonly prescribed to patients with anxiety and depression, despite the fact that studies have shown them to be not much more effective than placebos. They are also associated with multiple side effects, including sexual dysfunction, “emotional flatness,” sleep disorders, progression into more severe and/or chronic mental health problems, and difficulty withdrawing off the medication—even when it is no longer needed.

According to the U.S. National Institute of Mental Health, 11 percent of Americans over the age of 12 are on antidepressant drugs. Among middle-aged women, 1 in 4 is on antidepressants.

The most commonly prescribed antidepressants belong to a class of drugs called SSRIs—selective serotonin reuptake inhibitors. This class includes Prozac, Paxil, Lexapro, Celexa, and Zoloft.

One of the major problems with SSRI antidepressants is the risk of homicide and suicide. If you buy Prozac or Paxil, or any of the other SSRIs, the insert inside the box warns that some people are prone to suicidal or homicidal behavior on the medication—especially children and teens.

New research suggests that the young people most at risk have a genetic intolerance to SSRIs, which may have been a factor in many school shootings. Dr. William Walsh, PhD studied this phenomenon and noted that 42 of the 50 major school shootings in the US since 1990 were done by teens or young adults taking an SSRI.

To learn more, you can visit www.WalshInstitute.org.

If you saw a mainstream psychiatrist or psychotherapist for a mental illness, or a mood disorder like anxiety or depression, the therapist would probably have focused on your past and present problems and discussed with you the family dynamics in your early years and your current relationships. While this approach can be very beneficial for some people, many people remain plagued by their symptoms in spite of talk therapy and in spite of psychotropic medication.

Not all mental and mood disorders are related to psychological problems. 

Nutritional psychiatry 

For many years, the medical field did not fully acknowledge the connection between mood and food. I had two hours of instruction in nutrition in medical school. The class was an elective. We learned about scurvy, pellagra and beriberi, and a few other uncommon diseases related to profound deficiencies of certain vitamins. 

It’s only recently that mainstream medicine, with its heavy focus on medications, is starting to recognize the connection between food and general health, including mental health. 

In recent times, the field of nutritional psychiatry has been attracting a growing number of psychiatrists and other mental healthcare providers. Finally there are glimmers of recognition in mainstream medicine that what you eat directly affects the structure and function of your brain and ultimately your mood and behavior.

Now that we have access to nutritional testing and genetic testing, the recommendations for diet and supplements can be customized for each person.

When I consult with patients who have mental disorders that have not responded to psychotherapy, I look for physiological causes that might be contributing to their distress.

My search for underlying causes of chronic conditions in my patients, including mental illness, always begins with a careful evaluation of the diet and the supplements. Sometimes simply making changes in the kind of foods that people eat and the supplements they take can bring significant improvements in their physical, mental and emotional states.

If the patient is still symptomatic, I test for heavy metals, and I request that the patient get their home or workplace tested for gas leaks, toxic chemicals and molds—all of which can cause profound depression and anxiety. I also review general life style practices like exercise, time in nature, sun exposure, maintaining a regular sleep schedule, getting enough oxygen while sleeping, and maintaining social connections.

Although we don’t know the exact cause of most mental illnesses, results of research on the subject suggest that they are caused by a combination of factors, including genetics, biology and physiology, psychological trauma, brain injury, unrelenting stress, and environmental factors like diet, heavy metals, toxic chemicals, and mold exposure.

Mental illness is not a result of a character defect, and recovery from mental illness is not a matter of will power and self-discipline.

Inflammation in the Brain 

Inflammation in the brain can create a whole constellation of symptoms, including headaches, anxiety and depression, irritability, and mental illness. And we now know that chronic inflammation can also lead to early onset dementia and other degenerative diseases of the brain, including MS and Parkinson’s.

There are many causes of inflammation in the brain. Foods play a major role in either helping or harming the brain. In order to thrive, the brain needs adequate amounts of the beneficial fats like avocados, nuts, seeds, olives, olive oil, sardines, anchovies, Alaska salmon, and coconut oil. The brain burns fat for fuel. Fat works more efficiently than burning glucose for fuel. The brain also needs plenty of antioxidants, minerals, and other nutrients found in fresh vegetables, fruit, nuts and seeds, seaweed, and legumes.

What foods cause inflammation? 

Below is a list of foods that tend to cause inflammation in many people:

• Any food that you are allergic or sensitive to—the most common ones being gluten, dairy, corn, and soy.

• Simple sugars like fructose and glucose.

• Simple carbohydrates that turn to sugar quickly, as found in foods made from milled grains, such as bread, pasta, crackers, cookies, boxed cereals, chips and tortillas.

• GMO foods found predominantly in corn, soy, and sugar beets. There is a rapidly growing list of other non organically grown crops that are being genetically modified.

• Non organically grown foods that have been sprayed with pesticides, like glyphosate—the active ingredient in RoundUp. Glyphosate has many harmful effects on our bodies, one of which is to interrupt the pathway that produces tryptophan, the amino acid that converts to serotonin. Serotonin is the neurotransmitter that helps to regulate mood and social behavior. Glyphosate also destroys the beneficial bacteria in the gut.

• Processed foods found in boxes, cans, or packages tend to create inflammation. They are usually made with sugar and gluten for flavoring, combined with other harmful ingredients including trans fats, artificial sweeteners like sucralose and aspartame, artificial colors, and monosodium glutamate (MSG). Cans are usually lined with hormone-mimicking chemicals—even the ones that say they are BPA-free.

• Hydrogenated fat, oxidized and rancid fats, and highly processed vegetable oils like corn, soy, and canola.

• Artificial sweeteners. Aspartame is known to be one of the causes of depression in some people.

• Alcohol

The Mood-Gut Connection 

A strong connection exists between the gut and mental health. The gut is “the second brain.” It is lined with nerve cells that produce neurotransmitters. Both the gut and the brain originated from the same tissue during fetal development. As the fetus develops, one part of this tissue becomes the brain and central nervous system, while the other part develops into the enteric (intestinal) nervous system. The enteric nervous system contains many of the same cells found in the brain.

The brain and the gut remain in constant contact via the vagus nerve, the longest nerve in the body. The vagus nerve extends from the brain all the way down to the intestines.

The gastrointestinal tract is lined with millions of neurons and plays a direct role in regulating mood. About 95% of serotonin is made in the lining of the gut. This neurotransmitter helps regulate mood, sleep, and appetite, and it also inhibits pain.

The production of neurotransmitters in the gut is influenced by the billions of beneficial bacteria that make up the intestinal micro biome. These bacteria up or down regulate the immune system as needed, which means that they can increase or decrease the reactivity of the immune system according to their best interests which happen to coincide with our best interests. The bacteria modulate inflammation, they protect you against harmful bacteria, they help you absorb nutrients from food, and they communicate directly with the brain.

The beneficial gut bacteria also protect the lining of the intestinal wall and decrease the permeability of the gut. Permeability allows bacterial toxins and partially digested food to cross over into the blood stream where they can trigger inflammation and cause associated psychiatric symptoms.

The bacteria may determine how we react to certain foods. When the gut is irritated or inflamed, the gut bacteria send signals to the rest of the body, including the brain.

The gut flora affect far more than merely digestive health, they affect the health of the entire body. An unhealthy gut micro biome can certainly affect mood and mental health.

Our diets play a major role in determining what bacteria are most active in our guts. If you want to support your brain and your mental health, you need to help support the health of your gut.

How do we support our micro biome?

–Eat pesticide-free food. The pesticides kill the beneficial bacteria.

–Eat whole foods, unprocessed.

–Stay away from sugar and simple carbohydrates. Not only do they cause inflammation, they also feed yeast and other fungus and harmful bacteria..

–Take probiotics and eat fermented foods like raw sauerkraut, pickles, and kimchi. Researchers have recently been exploring the relationship between probiotics and anxiety levels, perception of stress, and overall sense of wellbeing. Animal research found that mice engaged in obsessive-compulsive behaviors were pacified when given a strain of probiotics called Bacteroides fragilis.

–Probiotics need appropriate food to survive. Feed the probiotics large quantities of high fiber foods, like “above-ground” vegetables—as opposed to the starchy vegetables that grow below the ground. The starchy vegetables (complex carbohydrates) have their benefits. They turn to sugar more slowly and can help stabilize the mood and calm anxiety.

–Try to avoid killing the beneficial bacteria by limiting the use of antibiotics to only when they are absolutely necessary. Consider alternative measures first—if possible—because antibiotics destroy the micro biome. It can take up to a year to restore the disrupted colonies.

A healthy gut increases the chance of having a healthy mind.

Experiment on yourself 

Try taking out all sugars and simple carbs, processed foods, grains and dairy products—with the exception of butter (it has no casein)—and eating only organic food for six weeks and see how you feel. At the end of the six weeks, go for a day or two back to the old way of eating and observe what you feel like physically and emotionally. What you discover can be a real revelation.

When you first begin the six-week elimination diet, you might feel flu-like and achy from withdrawal. These symptoms usually last only a few days. If you have a heavy “die off” reaction from yeast or other fungal overgrowth, it’s possible the symptoms might last a little longer.

After six weeks on this diet, slowly introduce foods back into your diet, one by one, and see how you feel. Observe for at least 24 hours each food you reintroduce because some reactions are delayed. For example, after reintroducing dairy into your diet, you might notice increased congestion the next day, or joint pains, or weight gain from fluid retention.

Some of my patients notice a big drop in their sense of wellbeing when they reintroduce some of the foods that had been eliminated.

Conclusion 

What we eat makes a huge difference to our overall health, including our mental health.

Fortunately there is a rapidly growing group of doctors being trained in “functional medicine,” a new field that recognizes the important role that nutrition plays in healing. Whether you are able to find a doctor with this training or not, I urge you to take matters into your own hands and take a hard look at what goes into your body each day.

One of the most rewarding experiences I have in my medical practice is seeing how much my patients improve in mind and body and overall mental health when they become conscious of their eating habits.

In the next post in this mental health series I’ll be talking about the role of supplements. Stay tuned!