Senior Lecturer in Health, Well-Being and Social Care, The Open University
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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.
Unbiased. Nonpartisan. Factual.
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.
Prescriptions for 64.7m items of antidepressants were dispensed in England in 2016, the highest level recorded by the NHS.
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 people eat a greater variety of foodstuffs than ever before – but it doesn’t follow that they 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.
Research has shown that supplements
like zinc, magnesium and vitamins B and D can improve the mental
capacity of people with Alzheimer’s.Shutterstock
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.
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