There is a misguided belief out there that there are only two ways to treat “mental illnesses.” Those two ways are “medically,” meaning the use of pharmaceutical medications or other means of altering the brain, and “psychologically,” meaning through various types of therapy. If you've found your way to this site, it's likely you've wondered about other options. The missing link is a vast and mostly unexplored area that goes far beyond these two approaches, the approach that truly links the mind with the body. The work I do with patients aims to address "mental health" by encompassing the entire human being.
Debunking the medical model.
There are numerous medical causes of mild and severe mental illness. Most of these are not tested for before a label like “unipolar depression” or “bipolar II” or “ADHD” is given. If you have been given such a diagnosis and have not been tested with several thyroid tests, for heavy metal toxicity, for gluten sensitivity, for vitamin and mineral deficiencies, or hormone imbalances, and instead have been give a prescription with little or no testing, you have NOT been offered true medical care for mental illness.
Psychiatry, as Daniel Amen, MD, has elegantly pointed out, is the only medical specialty that does not do any actual imaging or testing of the organ that it treats. All diagnoses are based on symptom pictures. These are amassed and generalized to create symptom and behavior categories that have become the DSM, the medical manual that is standardly used to make psychiatric diagnoses. Unlike any other field of medicine, these diagnoses are not made on any kind of actual pathology. Thus, the medical model of mental illness falls short, even by medical standards.
I am a big believer in the importance of neurotransmitter balancing. However, the neurotransmitter model is a very presumptive and narrow model of understanding the mind and body that does not take into account why the neurotransmitters became imbalanced in the first place. It is essential when looking medically at the mind, to look at the whole person. For example, someone who might be taking an SSRI (selective serotonin uptake inhibitors) might believe that he or she has a serotonin deficiency. What she or he might not know is that the majority of serotonin in the human body is in the gut, and that nutrition plays a key role in maintaining optimal levels of circulating serotonin.
Nutrition. Most of us are not aware of how much our brain function relies on what we eat. Some estimates show that 4% of schizophrenia is caused by gluten sensitivity alone. Depression and anxiety can be caused by sensitivity to certain foods, by alcohol and caffeine (even in small amounts) and by blood sugar imbalances. Many of us have been fed a lifetime of steroids and antibiotics, which can cause serious long-term gut disorders which can manifest as fatigue, brain fog, and insomnia. Food additives and sugar intake are linked to hyperactivity. Environmental and food toxins disrupt endocrine systems, causing blood sugar imbalances, hormone imbalances, and thyroid problems. These can lead to obesity, fatigue, infertility, and a variety of mood and mental disorders.
Deficiency States. The quality of what we eat is just as important as what we don’t eat. As our soil becomes more and more deplete of nutrients, so does our food. Michael Pollen noted that 100 years ago, apples had iron in them. Now they do not. We may feel as if we are eating more and more, but we may actually be getting fewer and fewer nutrients. Many nutrient imbalances contribute to mental illnesses. Copper and zinc imbalances are a leading finding in postpartum depression. B12, B6, B3, and folate deficiencies are common and can contribute to depression, fatigue, and even psychosis. Vitamin D has been getting a lot of attention lately. Deficiency of vitamin D, found in roughly 50% of Portlanders, can contribute to seasonal mood disorders.
Other causes of deficiency states can be genetic. Some common genetic metabolic disorders that can contribute to mental illness and mood disorders include pyroluria, which disrupts the ability to utilize zinc and B6, and a mutation in the gene that metabolizes folate (MTFR gene mutation).
Food allergies and mental health. More and more research has been linking food allergies to mental diagnoses. You might think you would know if you have a food allergy. Unfortunately, it is not always obvious. Sometimes reactions are subtle; fatigue, mood swings, occasional constipation or diarrhea. Reactions can take up to three days to begin and can continue reacting for weeks after the food has been eaten. For example, gluten, a protein found in most grains and especially high in wheat, may take 6-8 weeks to stop having a physiologic and immunologic reaction in the human body.
Autism has been found to often be an issue of gluten and/or dairy intolerance, for example. Celiac’s disease, an autoimmune reaction to gluten, has been linked to bipolar disorder, ADHD, and schizophrenia.
How can our foods have become so toxic to us? There are a number of theories. One, our food has become greatly altered in the last 100 years, with the process of hybridization and genetic modification. We, too have changed and migrated. We no longer eat the foods our ancestors adapted to. The foods we eat are not only from all over the world, but they are often complex, highly processed, and treated with pesticides, herbicides, hormones, antibiotics, fertilizers, additives, and preservatives. Many of the foods Americans commonly eat are not really foods at all, like soda and candy. Our bodies have been barraged by a multitude of dietary changes. Many bodies reject even the most basic of foods as toxic. This rejection process can dramatically affect how our brains, emotions, and bodies work.
We are all individuals. There is no one right diet for everyone. Some people can have lattes and scones for breakfast and remain emotionally well. Others will not find this to be true. It is important to figure out what your optimal diet is.
Hope. It is possible, and important, to take steps toward health. It may not only save your brain but save your life as well. There are gentle ways to fundamentally alter your body chemistry through diet and nutritional supplements, through learning what will work best for you, and slowly replenishing your body. Other ways include using energetic medicines like homeopathy, and retraining the brain through meditation techniques like biofeedback. It can be a life-changing path, one that takes patience and dedication, but will ultimately give you your life in return.
Relationship. A partnership between a practitioner and a patient is important. I have always relied upon the wisdom of my patients to help guide the healing path. Together we can set realistic goals and learn optimal approaches for your wellness. Please feel free to call to discuss options or set up an appointment.
Integrative Mental Health
Dr. Elissa Mendenhall, ND
Naturopathic Physician
Portland, Oregon
