Mar 3rd 2018

Why nutritional psychiatry is the future of mental health treatment

by Joyce Cavaye

Senior Lecturer in Health, Well-Being and Social Care, The Open University

A lack of essential nutrients is known to contribute to the onset of poor mental health in people suffering from anxiety and depression, bipolar disorder, schizophrenia and ADHD. Nutritional psychiatry is a growing discipline that focuses on the use of food and supplements to provide these essential nutrients as part of an integrated or alternative treatment for mental health disorders.

But nutritional approaches for these debilitating conditions are not widely accepted by mainstream medicine. Treatment options tend to be limited to official National Institute for Care Excellence (NICE) guidelines which recommend talking therapies and antidepressants.

Use of antidepressants

Antidepressant use has more than doubled in recent years. In England 64.7m prescriptions were issued for antidepressants in 2016 at a cost of £266.6m. This is an increase of 3.7m on the number of items prescribed in 2015 and more than double than the 31m issued in 2006.

A recent Oxford University study found that antidepressants were more effective in treating depression than placebo. The study was led by Dr Andrea Cipriani who claimed that depression is under treated. Cipriani maintains that antidepressants are effective and a further 1m prescriptions should be issued to people in the UK.

This approach suggests that poor mental health caused by social conditions is viewed as easily treated by simply dispensing drugs. But antidepressants are shunned by people whom they could help because of the social stigma associated with mental ill-health which leads to discrimination and exclusion.

More worrying is the increase in the use of antidepressants by children and young people. In Scotland, 5,572 children under 18 were prescribed antidepressants for anxiety and depression in 2016. This figure has more than doubled since 2009/2010.

But according to British psychopharmacologist Professor David Healy, 29 clinical trials of antidepressant use in young people found no benefits at all. These trials revealed that instead of relieving symptoms of anxiety and depression, antidepressants caused children and young people to feel suicidal.

Healy also challenges their safety and effectiveness in adults. He believes that antidepressants are over-prescribed and that there is little evidence that they are safe for long-term use. Antidepressants are said to create dependency, have unpleasant side effects and cannot be relied upon to always relieve symptoms.

Nutrition and poor mental health

In developed countries such as the UK we eat a greater variety of foodstuffs than ever before – but it doesn’t follow that we are well nourished. In fact, many people do not eat enough nutrients that are essential for good brain health, opting for a diet of heavily processed food containing artificial additives and sugar.

The link between poor mental health and nutritional deficiencies has long been recognised by nutritionists working in the complementary health sector. However, psychiatrists are only now becoming increasingly aware of the benefits of using nutritional approaches to mental health, calling for their peers to support and research this new field of treatment.

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 from our food 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 B and D3 can help improve people’s mood, relieve anxiety and depression and improve the mental capacity of people with Alzheimer’s.

Magnesium is one of most important minerals for optimal health, yet many people are lacking in it. One study found that a daily magnesium citrate supplement led to a significant improvement in depression and anxiety, regardless of age, gender or severity of depression. Improvement did not continue when the supplement was stopped.

Omega-3 fatty acids are another nutrient that is critical for the development and function of the central nervous system – and a lack has been associated with low mood, cognitive decline and poor comprehension.

The role of probiotics – the beneficial live bacteria in your digestive system – in improving mental health has also been explored by psychiatrists and nutritionists, who found that taking them daily was associated with a significant reduction in depression and anxiety. Vitamin B complex and zinc are other supplements found to reduce the symptoms of anxiety and depression.

Hope for the future?

These over-the-counter" supplements are widely available in supermarkets, chemists and online health food stores, although the cost and quality may vary. For people who have not responded to prescription drugs or who cannot tolerate the side effects, nutritional intervention can offer hope for the future.

There is currently much debate over the effectiveness of antidepressants. The use of food supplements offer an alternative approach that has the potential to make a significant difference to the mental health of all age groups.

The emerging scientific evidence suggests that there should be a bigger role for nutritional psychiatry in mental health within conventional health services. If the burden of mental ill health is to be reduced, GPs and psychiatrists need to be aware of the connection between food, inflammation and mental illness.

Medical education has traditionally excluded nutritional knowledge and its association with disease. This has led to a situation where very few doctors in the UK have a proper understanding of the importance of nutrition. Nutritional interventions are thought to have little evidence to support their use to prevent or maintain well-being and so are left to dietitians, rather than doctors, to advise on.

But as the evidence mounts up, it is time for medical education to take nutrition seriously so that GPs and psychiatrists of the future know as much about its role in good health as they do about anatomy and physiology. The state of our mental health could depend on it.


Joyce Cavaye, Senior Lecturer in Health, Well-Being and Social Care, The Open University

This article was originally published on The Conversation. Read the original article.

Browse articles by author

More Essays

Dec 4th 2021
EXTRACT: "Planting more forests is a potent tool for mitigating the climate crisis, but forests are like complex machines with millions of parts. Tree planting can cause ecological damage when carried out poorly, particularly if there is no commitment to diversity of planting. Following Darwin’s thinking, there is growing awareness that the best, healthiest forests are ones with the greatest variety of trees - and trees of various ages."
Nov 19th 2021
EXTRACTS: "At a time when the struggle between authoritarianism and democracy is so intense, if not fateful for the future of democracies, NATO and the EU must warn these countries [Editor's note: Poland and Hungary, EU and NATO, Turkey NATO] that they are on the precipice of being kicked out if they do not change their governing practice. They must be required to restore the principles of democracy by upholding universal human rights and abiding the rule of law, or else they will forfeit their membership and suffer from the consequences of their crimes." ------ "A narcissistic leader, such as Trump, whose hunger for power seems to know no limit, has happily sacrificed the good of the country on the altar of his twisted ego. America’s democracy cannot be repaired unless he and those who helped him are held accountable and face the weight of the law."
Nov 18th 2021
EXTRACT: "Many people who go through intense trauma, for example, become deeper and stronger than they were before. They may even undergo a sudden and radical transformation that makes life more meaningful and fulfilling. Indeed, research shows that between half and one-third of all people experience significant personal development after traumatic events, such as bereavement, serious illness, accidents or divorce. Over time, they may feel a new sense of inner strength and confidence and gratitude for life and other people. They may develop more intimate and authentic relationships and have a wider perspective, with a clear sense of what is important in life and what isn’t. In psychology, this is referred to as “post-traumatic growth”. "
Nov 11th 2021
EXTRACT: "Notably, Murdoch thinks that really knowing or understanding another person is a difficult task: “It is a task to come to see the world as it is”. According to the Freudian psychology Murdoch subscribes to in The Sovereignty of Good, humans are prone to “fantasy” – refusing to face the truth because it can damage our fragile egos."
Nov 9th 2021
EXTRACT: "People do not believe false information because they are ignorant. There are many factors at work, but most researchers would agree that the belief in misinformation has little to do with the amount of knowledge a person possesses. Misinformation is a prime example of motivated reasoning. People tend to arrive at the conclusions they want to reach as long as they can construct seemingly reasonable justifications for these outcomes."
Oct 28th 2021
EXTRACTS: "Brood with me on the latest delay of the full release of the records pertaining to the murder of President John F. Kennedy in Dallas on November 22, 1963. That was 58 years ago." -----"Mark my words: ...... No one who remembers 1963 will live to see the US government admit the full truth about Kennedy’s murder. And the American people’s faith in democracy will continue to fade. There is only one way to prevent this, and that is to release every record, withholding nothing – and to do it now."
Oct 27th 2021
EXTRACT: "..... we may defy the warnings of modern medicine, convinced of our own superiority. Researchers at the University of Chicago Divinity School reported half of their participants, all of whom indicated some religious affiliation, agreed with the statement “God will protect me from being infected”. To cope with our dread of death, we delude ourselves into thinking we are invincible: death might happen to other people, but not to me."
Oct 22nd 2021
EXTRACT: "Wes Anderson’s new film The French Dispatch is about the final issue of a magazine that specialises in long-form articles about the goings-on in the fictional town of Ennui-sur-Blasé. The film is an anthology of shorts representing three of the articles. A piece by the magazine’s art critic (Tilda Swinton) explores the life and late success of the abstract artist Moses Rosenthaler (Benicio Del Toro). Talented from a young age, Rosenthaler pursued art with a dogged determination that drove him to slowly lose his mind." ---- "Like everything else, mental illness is understood within the context of its time. In their study of melancholy and genius Born Under Saturn, the art historians Margot and Rudolf Wittkower show how Renaissance artists embraced mental alienation. This was shown by a withdrawn, slothful gloom. Such heavy sadness was considered both the symptom and the price of divine inspiration." ---- "Today, the association of creativity and mental illness often implies regression from an adult and orderly state of mind to one that is primal, impulsive, or infantile. The artist in Anderson’s film is such an example: he is noisy, impetuous, and extravagantly mad. And it is while he is at his “maddest” that he paints his best work." ---- "Here I explore the work of four painters whose work has been shaped by various mental illnesses, highlighting how the idea of the “mad artist” need not be tied up with a loss of control but rather a bid to gain it."
Oct 21st 2021
EXTRACT: "So much of Succession holds a mirror to real life, and the way that Logan Roy’s hand-picked board members allowed these abuses to continue by turning a blind eye to them is a good example. We have just published research that shows that public companies whose directors are chosen by their CEOs are statistically more likely to be involved in corporate misconduct, along with various other shortcomings. So why does this happen, and what should be done about it? "
Oct 10th 2021
EXTRACT: "Born in Zanzibar in 1948, Gurnah came to Britain in the 1960s as a refugee. Being of Arab origin, he was forced to flee his birthplace during the revolution of 1964 and only returned in 1984 in time to visit his dying father. Until his retirement, he was a full-time professor of English and postcolonial literatures at the University of Kent in Canterbury."
Oct 7th 2021
EXTRACT: "As the 25th James Bond film No Time to Die hits the cinemas, we are once again reminded of the way that disability is depicted negatively in Hollywood films. The new James Bond film features three villains, all of who have facial disfigurements (Blofeld, Safin and Primo). If you take a closer look at James Bond villains throughout history, the majority have facial disfigurements or physical impairments. This is in sharp contrast to the other characters, including James Bond, who are able-bodied and presented with no physical bodily differences. Indeed, many films still rely on outdated disability tropes, including Star Wars and various Disney classics. Rather than simply being part of a character’s identity, the physical difference is exploited and exaggerated to become a plot point and visual metaphor for villains" ----- "The British Film Institute (BFI) was the first organisation to sign up and has committed to stop funding films that feature negative representations depicted through scars or facial differences – a step in the right direction."
Oct 5th 2021
EXTRACT: "The trillions of microbes inside of our gut play many very important roles in our body. Not only does this “microbiome” regulate our metabolism and help us absorb nutrients from food into the body, it can also influence whether we are lean or obese."
Sep 16th 2021
EXTRACTS: "Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurised chamber. In the chamber, the air pressure is increased two to three times higher than normal air pressure. It is commonly used to treat decompression sickness (a condition scuba divers can suffer from), carbon monoxide poisoning,......" ---- "Blood flow to the brain is reduced in people with Alzheimer’s. This study showed increased blood flow to the brain in the mice receiving oxygen therapy, which helps with the clearance of plaques from the brain, and reduces inflammation – a hallmark of Alzheimer’s." ----- "The researchers then used these findings to assess the effectiveness of oxygen therapy in six people over the age of 65 with cognitive decline. They found that 60 sessions of oxygen therapy, over 90 days, increased blood flow in certain areas of the brain and significantly improved the patients’ cognitive abilities – improved memory, attention and information processing speed."
Sep 14th 2021
EXTRACT: "Hollywood for years called on Charles Boyer to typify one French look –  bedroom eyes, sly maneuverings, the dismissive look. A face of another type, the massive mug and narrow eyes of Charles de Gaulle, provides the same disdain of the foreigner but also a superiority based on his belief in his own destiny."
Sep 12th 2021
EXTRACT: "The burden of loneliness for older people is intimately connected to what they are alone with. As we reach the end of our lives, we frequently carry heavy burdens that have accumulated along the way, such as feelings of regret, betrayal and rejection. And the wounds from past relationships can haunt people all their lives."
Sep 5th 2021
EXTRACT: "Gardens help restore the ability to concentrate on demanding tasks, providing the perfect space for a break when working from home in a pandemic. Natural things – such as trees, plants and water – are particularly easy on the eye and demand little mental effort to look at. Simply sitting in a garden is therefore relaxing and beneficial to mental wellbeing."
Aug 17th 2021
EXTRACT: "Whether or not a person achieves remission, reducing blood sugar levels is important in managing the negative effects of type 2 diabetes and reducing risk of complications. But when it comes to choosing a diet, the most important thing is to pick one that suits you – one that you’re likely to stick to long term."
Aug 10th 2021
EXTRACT: "In our latest study, we show that by taking the microbiome from young mice and transplanting them into old mice, many of the effects of ageing on learning and memory and immune impairments can be reversed. Using a maze, we showed that this faecal microbiota transplant from young to old mice led to the old mice finding a hidden platform faster."
Aug 3rd 2021
EXTRACT: "Fukuyama argued that political struggle causes history. This struggle tries to solve the problem of thymos – an ancient Greek term referring to our desire to have our worth recognised. This desire can involve wanting to be recognised as equal to others. But it can also involve wanting to be recognised as superior to others. A stable political system needs to accommodate both desires." .... "Counter-dominant spite can weaken liberal democracies. During the 2016 Brexit referendum, some people in the UK voted Leave to spite elites, knowing this could damage the country’s economy. Similarly, during the 2016 US presidential election some voters supported Donald Trump to spite Hillary Clinton, knowing his election could harm the US. "
Jul 31st 2021
EXTRACT: "If we want to live in a world that is good for pollinators, as well as the rest of us, big changes are needed in our environment, and our food system. This is why many beekeepers change their diet and their shopping, eating more locally grown vegetables that aren’t treated with pesticides. ...... Being willing to buy fruit and vegetables that may have the occasional insect living in it is better for us and for nature. To live more harmoniously with the natural world, we need to relax about larvae in the lettuce and slugs in the spinach."