Nutrition and mental health

wordcloud_Nutrition(2)

“Most behaviour change requires a certain amount of skill and desire by itself is simply not enough” Brian Colbert

Patrick Holford

“My first recommendation to someone with Manic Depression would be a full consultation with a nutritionalist” … who will “give you a personally tailored nutritional strategy to help relieve your symptoms” Patrick Holford [1].

“If mood changes are not owing to any drug intake (caffeine, alcohol or cocaine), the possibility of food allergy or hypoglycaemia (low blood sugar) should be carefully investigated. If your blood sugar levels are in serious imbalance, severe mood swings can result”. He also discusses the condition pyroluria which is linked to depleted B6 and zinc.

“A hyperactive thyroid can induce mania, while an underactive thyroid can trigger depression, so thyroid function is well worth investigating”. Lack of light and SAD (Seasonal Affective Disorder) can lead to Depression. A light box might be a good investment. Under the guidance of a nutrition therapist he mentions the use of of amino acid tryptophan. If a person is on medication they would need to watch out for any contraindications when it comes to taking supplements at the same time.

Eating oily fish or taking fish oils can have benefits for the brain, heart, skin and immune system. There are 2 types of Omega-3 fats. DHA and EPA. EPA can help with Depression. Flaxseed oil is a vegetarian alternative [1].

James Greenblatt MD

High homocysteine levels in the blood can increase the likelihood of suffering from Depression.
“Several important, mood associated vitamins and minerals (folate, vitamins B12 and B6, and zinc) are responsible for the conversion of homocysteine to the non-harmful cysteine”… “
By embracing the concept of biochemical individuality, that every patient is different. That their genetic, biochemical and nutritional status impacts how a person feels, and how, in turn, they are treated, we are able to make well informed decisions about how to help” James Greenblatt MD [2].

Is depression a kind of allergic reaction? [3]

“Both cytokines and inflammation have been shown to rocket during depressive episodes, and in people with Bipolar, to drop off in periods of remission”….”A diet rich in trans fats and sugar has been shown to promote inflammation, while a healthy one full of fruit, veg and oily fish helps keep it at bay. Obesity is another risk factor, probably because body fat, particularly around the belly, stores large quantities of cytokines” … “stress, particularly the kind that follows social rejection or loneliness, also causes inflammation, and it starts to look as if depression is a kind of allergy to modern life – which might explain its spiraling prevalence all over the world as we increasingly eat, sloth and isolate ourselves into a state of chronic inflammation” [3]. Curcumin which is a component of turmeric has anti-inflammatory properties and also Omega-3.

Allergies can cause mental and physical health symptoms. An allergic reaction can lead to inflammation in the body.

Antibiotics

“Several studies have also found an association between the receipt of antibiotics and an increased incidence of psychiatric disorders, perhaps due to alterations in the microbiome” [4]. “While animal models focus on the bacterial composition of the intestinal tract, studies to date in individuals with psychiatric disorders also point to the possible role of viruses and fungi”.

Alcohol

Sometimes people with mental health difficulties may have resorted to unhelpful coping mechanisms in dealing with their problems eg drinking too much. Dual Diagnosis is a term used to refer to cases where a person has both a mental health issue and addiction issues. This usually leads to a worsening of symptoms. Alcohol can fuel Manic Depressive symptoms. It can make the highs higher or the lows lower.

The person may need assistance in dealing with such a problem and needs to want to stop or want to change their habit. There is help out there for people who want to make such changes so that they can have a better quality, more productive life e.g. Alcoholics Anonymous meetings [5]. You don’t need to be an alcoholic to attend such services. There is also a good Allen Carr book on how to control alcohol [6].

My own journey

I am currently taking a magnesium supplement as I suffer with insomnia [7]. I know that I have a problem with inflammation in my body and I’m working on it. I noticed after my last antibiotic that my mood went a bit ‘high’. I took a course of probiotics, which doctors should recommend.

Sleep is a big part of healing and recovery and I need to make it a priority. I need to stay self-aware of anything that can impact the quality of my sleep. I found this interview between sleep expert Dr Guy Meadows and Dr Rangan Chatterjee helpful [8].

I’m also taking Krill oil and have changed to a more vegetarian based diet, while reducing dairy. Mental / physical health requires daily work, planning and dedication. But the idea of becoming healthier, more balanced, with more energy to get through the day is a good motivator.

References

[1] 500 Health and Nutrition Questions Answered by Patrick Holford, 2004 ~
https://www.amazon.co.uk/500-Health-Nutrition-Questions-Answered/dp/0749924934

[2] Can a Simple Blood Test Solve Depression? Testing for Homocysteine Can Help in Depression Treatment by James Greenblatt MD
https://www.psychologytoday.com/us/blog/the-breakthrough-depression-solution/201110/can-simple-blood-test-solve-depression

[3] Is depression a kind of allergic reaction? by Caroline Williams, 2015 ~

https://www.theguardian.com/lifeandstyle/2015/jan/04/depression-allergic-reaction-inflammation-immune-system

[4] The microbiome, immunity, and Schizophrenia and Bipolar ~

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503102/

[5] Alcoholics Anonymous ~
http://www.alcoholicsanonymous.ie/

[6] Allen Carr’s Easyway to Control Alcohol, 2009 ~
https://www.amazon.com/Allen-Carrs-Easyway-Control-Alcohol/dp/1848374658

[7] Magnesium – How it affects your sleep ~
https://www.thesleepdoctor.com/2017/11/20/magnesium-effects-sleep/

[8] Episode 11: Good Sleep Habits and Sleep Misconceptions with Dr Guy Meadows ~
https://drchatterjee.com/guymeadows/

Other useful information

* The Breakthrough Depression Solution: A Personalized 9-Step Method for Beating the Physical Causes of Your Depression, James Greenblatt MD, 2011
https://www.amazon.com/Breakthrough-Depression-Solution-Personalized-Physical/dp/1934716553

* New research suggests gut microbiome plays a role in Bipolar ~

http://www.psypost.org/2017/05/new-research-suggests-gut-microbiome-plays-role-bipolar-disorder-48953

* Action plan for Bipolar ~ http://www.foodforthebrain.org/nutrition-solutions/bipolar-disorder/action-plan-for-bipolar-disorder.aspx (magnesium is discussed)

* Think Twice: How the Gut’s “Second Brain” Influences Mood and Well-Being ~

www.scientificamerican.com/article/gut-second-brain/

* Omega-3 fatty acid supplementation in patients with recurrent self-harm. Hallahan et al 2007 ~
http://bjp.rcpsych.org/content/190/2/118

* Mood disorders and complementary and alternative medicine: a literature review ~ “Low levels of vitamin D have been identified in patients with major depressive and other mood disorders”, Quereshi et al, 2013 ~ www.ncbi.nlm.nih.gov/pmc/articles/PMC3660126/

* Vitamin D: a potential role in reducing suicide risk? Tariq et al, 2011 ~

https://www.ncbi.nlm.nih.gov/pubmed/22191178

* The Feel Good Factor: 10 Proven Ways to Feel Happy and Motivated by Patrick Holford, 2010

www.amazon.com/Feel-Good-Factor-Proven-Motivated/dp/0749953160

* Antibiotic exposure and the risk for depression, anxiety, or psychosis: a nested case-control study

https://www.ncbi.nlm.nih.gov/pubmed/26580313
(Recurrent antibiotic exposure shown to increase risk of anxiety & Depression)

 

 

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An Open Dialogue around ‘Psychosis’

“The deepest hunger of the human heart is to be understood” Stephen Covey

Psychosis_hand

Cabiria, 1914 (from a silent movie by Giovanni Pastroni). Trying to capture how terrifying Psychosis sometimes feels like, which is difficult and the clip that goes with this photo reminded me of the experience.

In November 2014 I went to the launch of the lengthy report “Understanding Psychosis and Schizophrenia” by the British Psychological Society (BPS) in London. There I got to meet and hear from some of the top experts and clinical Psychologists in the UK. A revised version was published in 2017 [1].

‘Psychosis’ is a loss of touch with reality, which is usually temporary. Because the general population don’t understand it, they can overreact. The person themselves may feel quite confused & scared. Especially if it’s their 1st experience. It can involve unusual perceptions e.g. the person feels they are under attack from evil and the need to protect themselves. In my experience, how I protected myself was influenced by religious upbringing. I even started to go to Latin mass to try and calm my brain down. While some would have frowned upon that at the time, for me it was a coping mechanism. I only occasionally go to a church these days. Usually to light a candle and to sit in silence for a while.

As an example of one of my “psychotic breaks”, in my last experience I decided that the town I live in, which is prone to flooding as it is built on a river, was going to become immersed in water. I checked into a hotel that was a few stories high & took a bus to a ‘safer’, inland county. At the time I was frightened. It wasn’t based on reality but could have been based on news reports and worries about climate change. Stress and lack of sleep would have been a trigger, plus the fact that I was still going through drug withdrawal. It took at least two years to get the main effects of long term use of prescribed psychotropic drugs out of my system and I was left with long term sleep issues, the effects of which I still feel to this day.

Psychosis can be triggered by anti-depressant use and severe lack of sleep / stress [2]. I had been on anti-depressants for anxiety / panic attacks for 3 years when I had a ‘psychotic break’ in August 2008. Other illicit drugs can also trigger psychosis e.g. skunk cannabis [3].

Trying to make sense of the symptoms can help. In the context of the person’s life. As through making sense of experiences or learning to process them, a person is more likely to recover.

Usually the people around you will not understand and might not be supportive. I went through my last ‘psychotic break’ alone (2012). I would not recommend that but maybe getting through it alone is why I no longer fear it. There was also a Spiritual aspect to the experience and I wish I kept notes at the time to give me more insight into what I was going through. In my terrified state, particularly at night time, with no support around me, I used the online work of Sean Blackwell to help me through. “Bipolar or Waking up?” [4, 5, 6]. I do believe this was more of an awakening and a spiritual journey. A part of my own evolution as a soul on this planet.

A significant percentage of people hear voices and for many this is not a problem. If the person hears voices that are distressing or ask them to harm themselves or others and the person finds this overwhelming, they would need help and support in coping with the voices. There are people who have managed to integrate their voices into their lives, without been affected negatively by them e.g. Eleanor Longden [7] , Jacqui Dillon [8] and Rai Waddingham [9]. Dutch Psychiatrist Dr Marius Romme has also done a lot of great work in the Hearing Voices Movement [10]. Some children also hear voices and may need support.

Others experience hallucinations. If the hallucinations affect a persons quality of life, including ability to work, sleep and relate with others, the person may need help in dealing with their experiences.

Open Dialogue

I’m a believer in the Open Dialogue approach, where the person should be involved as much as feasibly possible in decision making about their care or treatment plan [11, 12].

Open Dialogue includes the gathering of clinicians, family members, friends and other relevant persons for a joint discussion. It was started in Lapland by Jaakko Seikkula et al. It is also used in other countries eg the Parachute project in New York [13]. In West Cork a successful pilot project was implemented [14, 15]. It would be great to see widespread use of this approach. If a more traditional, backward approach is used it can lead to more dysfunction within a family and the fracturing of relationships, sometimes long term, in my experience. It is important to get the approach right at the start. Not everyone will want family involved in their care.

I write more about the trauma of what happened me in 2008 in the blog Anti-depressants are great, until you have an Adverse Drug Reaction, where I outline some of the things that would have helped at that crucial time. Because of the way people in ‘psychosis’ are treated, I ended up with Post Traumatic stress for the past decade, which is only starting to ease recently. It has improved via therapy and hard work on my self, but it is something that will probably always be there are a protective force in my life. A necessary hyper vigilance and a lack of trust in others!

I have learned as much as I can about what is helpful when a person is in distress. I’ve dedicated several years to learning via reading, listening to audio/visual presentations (of experts I respect), courses, conferences and various short training sessions. A summary version of what happened to me can be found under Other Relevant Resources at the end of this blog.

During my first ‘psychotic break’ (where I had not harmed myself or others) I needed:

  • truth and honesty about the anti-depressant drug I was on & its adverse effects (2)

  • An Open Dialogue approach

  • Re-assurance that my stay in the hospital was temporary ( the survival part of my brain was convinced I would be there for a very long time, possibly forever. This left me in a very distressed and agitated state and naturally so)

In places like Finland, where they employ the Open Dialogue approach and where prescribed psychoactive drugs are not the main form of treatment, they have proven that recovery is possible. They use early intervention and involve the person in decision making. In general, instead of the person ending up on disability, they go back to being productive members of society.

Below is now 89 yr old Prof Ivor Browne giving a talk in the National College of Ireland in 2015. As opposed to being “anti-drug”, Prof Ivor Browne believes in using the lowest dosage of tranquilizing drugs possible for as short a time as possible. Ivor explained that people need help in understanding the psychotic process. He also recognises the importance of therapeutic relationships, personal friendships and loving relationships, when it comes to healing from trauma and distress. What are referred to as “Anti-psychotics” e.g. Olanzapine, as mainly major tranquilizers.

Anti_psychotics

For people to have “Recovery spaces”, they need to be with supportive people who can tolerate, be patient and interact with the person in ‘Psychosis’. Soteria is a network of people in the UK promoting the development of drug-free and minimum medication therapeutic environments for people experiencing ‘psychosis’ or extreme states [16]. If a person is a carer for someone in emotional distress e.g. a family member, the long term goal should be to enable the person they are caring for.

The public have learned to associate the word ‘psychosis’ with violence and there is not necessarily a link, unless drugs or alcohol are involved [17, 18]. That can include prescribed psychotropic substances or withdrawal from these drugs [19].

People in distress need hope that they can recover and heal. Education from reliable, unbiased sources is an important part of that healing journey. As are supportive and understanding people who can hold space for the person in distress. These support networks also need education around Psychosis, what is helpful and what is not. Being judgemental, getting into arguments with the person, being critical and dismissive of their experience is usually unhelpful. Trying to stay calm and creating a calm space for the person, where they are not over stimulated, might be helpful. Everyone is an individual and has their own unique journey and experience.

Note: This blog is not medical advice and is mainly based on my own experience. But also on my extensive interest and learning in the whole area. Do not stop or change prescribed psychotropic drugs without advice, due to the dangers of withdrawal. Any changes need to be made slowly, under the supervision of an expert in this field. At the start of my journey I was never given that advice from the ‘experts’ I was dealing with and this delayed my healing journey.

Minor and major tranquilizers did help me at times e.g. with sleep, which can help restore some normality. But overall, in hindsight, I found that the large cocktail of drugs I was on (over a 3 year period) fueled symptoms, as opposed to ‘curing’ them. “The ethical use of psychotropic drugs is perhaps the single most important aspect of Psychiatric care that requires urgent attention” Dr Phil Thomas [20, 21].

References

[1] Understanding Psychosis and Schizophrenia, revised version 2017 ~

https://www.bps.org.uk/system/files/user-files/Division%20of%20Clinical%20Psychology/public/CAT-1657.pdf (Edited by Anne Cooke)

[2] Antidepressant-associated Mania and Psychosis resulting in Psychiatric admissions. Yale study (2001) www.ncbi.nlm.nih.gov/pubmed/11235925

[3] Smoking skunk cannabis triples risk of serious psychotic episode, says research, 2015 ~

https://www.theguardian.com/society/2015/feb/16/skunk-cannabis-triples-risk-psychotic-episodes-study

[4] Am I Bipolar or Waking Up? Sean Blackwell, 2011 ~

http://www.amazon.com/Am-I-Bipolar-Waking-Up/dp/1461178258

[5] Sean Blackwell’s work ~ www.youtube.com/user/bipolarorwakingup

[6] Corrina Rachel speaking to Sean Blackwell about Bipolar ~

www.youtube.com/watch?v=WLIeS6idzD4

[7] TED video by Eleanor Longden (Voice Hearing) ~

www.ted.com/talks/eleanor_longden_the_voices_in_my_head?language=en

[8] Jacqui Dillon (Voice Hearing) ~

www.rte.ie/radio1/doconone/radio-documentary-sounds-mad-hearing-voices-psychology.html

[9] Rai Waddingham ~ http://www.behindthelabel.co.uk/

[10] Hearing Voices Network ~ www.hearing-voices.org

[11] OPEN DIALOGUE: an alternative Finnish approach to healing psychosis (by Daniel Mackler) ~

https://www.youtube.com/watch?v=HDVhZHJagfQ

[12] A collection of resources on Open Dialogue and Open Dialogue practices ~

http://willhall.net/opendialogue/

[13] New York ‘Parachute’ programme for people with acute mental distress lands in the UK ~

https://www.theguardian.com/society/2015/oct/20/parachute-therapy-psychosis-new-york-uk

[14] Mental health pilot focus of Finnish film ‘Open Dialogue’ ~

http://www.irishexaminer.com/ireland/mental-health-pilot-focus-of-finnish-film-open-dialogue-393492.html

[15] A fresh approach to mental health ~
http://www.irishexaminer.com/lifestyle/features/a-fresh-approach-to-mental-health-396031.html

[16] Soteria ~ www.soterianetwork.org.uk

[17] ‘Mental disorders’ are neither necessary nor sufficient causes of violence ~ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/

[18] Dispelling the Myth of Violence and Mental Illness ~

https://psychcentral.com/archives/violence.htm

[19] Prescription Drugs Associated with Reports of Violence Towards Others

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0015337

[20] Psychiatry in Context : Experience, Meaning & Communities by Dr Philip Thomas

https://www.amazon.com/Psychiatry-Context-Experience-Meaning-Communities/dp/1906254729

Dr Philip Thomas highlights the limitations of neuroscience in explaining Psychosis or distress. He also explores how Racism plays a key role in many black people’s experience of Psychosis.

[21] My review of this book ~ www.goodreads.com/user/show/46943899-anne

This review was published in the Journal of Critical Psychology, Counselling and Psychotherapy (Volume 16, Number 1, March 2016)

Other relevant Resources

* ‘I was unaware of potential adverse effects to my prescribed antidepressants’

https://www.independent.ie/life/health-wellbeing/mental-health/aines-story-i-was-unaware-of-potential-adverse-effects-to-my-prescribed-antidepressants-31218347.html

* One woman’s account of suffering from Psychosis ~

www.todayfm.com/One-womans-account-of-sufferinbg-from-psychosis

* Course ~ Caring for People with Psychosis and Schizophrenia (pharma funded which influences the advice given) ~

https://www.futurelearn.com/courses/caring-psychosis-schizophrenia

* Intervoice (International Hearing Voices Projects) ~ www.intervoiceonline.org

* Hearing Voices Network Ireland ~
http://hearingvoicesnetworkireland.ie/

* The Icarus Project ~ http://theicarusproject.net/

* CRAZYWISE – Official Extended Trailer ~ https://www.youtube.com/watch?v=iKfQd0bk214 

* Peter Lehmann “Recovery from Psychosis and Depression by Taking Psychiatric Drugs versus Recovery by Coming off Psychiatric Drugs”

www.peter-lehmann-publishing.com/articles/lehmann/pdf/recovery-from.pdf

* 8 Tips to Help Stop Ruminating ~
www.psychcentral.com/blog/archives/2014/02/16/8-tips-to-help-stop-ruminating