Mental Illness

One in five Canadians are likely to be diagnosed with a mental illness sometime during their lifetime.

There have been alarming increases in diagnosis, prescriptions and spending in the area of mental health care over the past decade. A front-page article in the January 9th issue of the Washington Post revealed that treatment for depression in the US has more than tripled during the last 10 years. The economic costs to society and the personal and emotional costs to people and families are enormous.

Prescription medications are generally the first line option given to most patients who suffer from some kind of mental imbalance. Ironically, because of side-effects or poor treatment outcomes, a high number of patients eventually refuse treatment. This response, in turn, may put a patient at risk for relapse. Surprisingly, patient responses or clinical effectiveness for antidepressant medications have not changed in over 50 years, despite marketing claims. Newer medications may in fact present newer dangers. For example, Glaxo-Smith Kline, the makers of the antidepressant drug Paxil, recently lost a 6.4 million dollar settlement after an American jury decided that the medication was largely to blame for a family killing.

According to Harvard Medical School psychiatrist Joseph Glenmullen, these types of antidepressant medications (SSRIs) may increase the risk of suicide, anxiety and agitation. Withdrawal reactions may also plague people who reduce, discontinue or change their antidepressants, and it is possible to confuse withdrawal symptoms with a depressive episode or relapse. In addition, there are numerous people taking several types and combinations of psychiatric medications. The research in this area is extremely poor and the risks and dangers are even more uncertain. Fundamentally, we do not know how these medications work.

It is important to investigate effective yet less harmful ways of treating mental imbalances. It is equally important to find potential triggers or to explore both conventional and unconventional reasons that may help explain the disturbance. For example, low cholesterol levels are associated with an increased risk of suicide; infections that cause strep throat can actually lead to obsessive-compulsive disorder and Tourette's syndrome in children; and hormone imbalances can cause or worsen depression and anxiety. Following is a list of factors to consider.

The Gut

People are surprised when they find out that the highest concentrations of neurotransmitters in the body are found in the gut and not the brain. Over 60 percent of brain-type chemicals can be found there, according to German research. Celiac disease, for example, a condition where people cannot properly tolerate the natural food chemical "gluten," can lead to brain disturbances. Epilepsy and schizophrenia symptoms have improved or disappeared when the gluten chemical has been removed from the diet in sensitive individuals.

Psychiatrists do not normally screen for this problem. In fact, one of my patients with a 10-year history of relapsing bipolar disorder and symptoms of chronic loose stools improved dramatically and did not require further hospitalizations by simply removing gluten from the diet. I suspect the patient had a sub-clinical celiac problem. The bottom line to remember is that there are foods, food dyes, additives and other chemicals that, when ingested, can be troublesome for both the gut and mind.

The Diet

Did you know that the brain is composed of 60 percent fat and 65 percent water? I do not mean fat from hamburgers but fat from fish, nuts, seeds and vegetables. A study in Finland correlated depression symptoms with how often fish was eaten. Last year, a landmark study in a popular psychiatry journal showed that people with bipolar disorder given fish oils did better than those who did not.

It is important to eat proper foods that ensure proper nourishment for the mind and body. Good quality fats and proteins from whole foods, fish, vegetables, nuts and seeds are ideal. Try to avoid or minimize refined foods and grains because they generally contain less good fats, protein, fibre, vitamins and minerals. The more organic food the better. Healthy eating also stabilizes blood sugar levels. By eliminating sugar from the diet, I promise you will have a healthier mood.

Allergies and Environmental Exposures

Allergies and environmental chemicals have a definite effect on mood and mental balance. Several psychiatric medications are, in fact, antihistamines. Environmental exposures to household cleaners, perfumes or carpets may produce symptoms similar to a panic disorder. In addition to environmental chemicals, heavy metals such as arsenic, lead and mercury may also interfere with the chemistry of the mind and body.

Children with high lead levels can exhibit lower IQ scores, learning disabilities and hyperactivity. Mercury has been linked to Alzheimer's disease and other neurological problems. Last year, a coalition of public interest groups sued the American Dental Association, claiming that the association has misled the public about the dangers of mercury in tooth fillings. Overall, it is important to identify and eliminate any harmful agents to the body and mind.

Hormones

New evidence suggests that antidepressant medications may actually stimulate hormones. Low levels of thyroid hormone, testosterone, DHEA or imbalances of estrogen and progesterone can severely disrupt mental functioning. All patients should be screened by saliva and blood hormone testing and according to physical signs and symptoms.

Infections

Chronic infections can disrupt mental health, including infections in the teeth and jaw. I have seen autistic children show signs of clinical improvement when appropriately tested and treated for fungal infections. A recent infectious agent, the Borna virus, has been strongly linked to chronic fatigue syndrome, depression and schizophrenia. As you can see, having a healthy immune system is vital for good mental health. Moreover, it is important to be screened for potential infectious agents.

Medications

Improperly prescribed medications can lead to both minor and major mental imbalances. I remember treating a patient with insomnia by simply switching the timing of her thyroid medication. The patient was inappropriately taking the medication at night instead of in the morning, which interfered with her sleep. Consequently, the patient no longer needed tranquilizers. In addition, it is important to be aware of medications that can interfere with vitamins and other nutrients. For example, Aspirin may interfere with vitamin C, and birth control pills may interfere with vitamins B₆ and B₁₂.

Nutrition

Low levels of vitamins B₃, B₆, B₁₂ and folic acid have been linked to depression, dementia, mania and schizophrenia. Low iron can easily produce symptoms of depression or can enhance jitteriness in patients taking antidepressants. I have seen female patients with no apparent signs of anemia in the blood but yet have shown low iron levels on standard blood tests. An imbalance or deficiency of any single nutrient can easily produce mental symptoms.

A good multivitamin and mineral supplement plus B vitamins in the right doses can have profound effects on mood. Folic acid has actually been shown to enhance Prozac when combined together and to act as an antidepressant all by itself in the right dose. I have also found that the intravenous use of specific nutrients to be quite helpful in acutely ill patients. In fact, I have had several patients who have not slept for several days fall asleep on the chair immediately after receiving intravenous nutritional treatment.

Exercise

Physical activity of some kind has profound antidepressant properties and provides great stability to both the body and mind. In a study group of elderly patients diagnosed with major depression, 60 percent no longer met the criteria for depression after 16 weeks of performing a brisk 30-minute walk or jog three times a week.

Expression and Creativity

I am often amazed at the intellectual and creative abilities of my patients with apparent mental disturbances. It is vital for all people to have creative outlets to express their gifts. Techniques such as the Emotional Freedom Technique (EFT) and Eye Movement Desensitization and Reprocessing technique (EMDR) may be helpful for people that are "stuck." EFT is an emotional or psychological form of acupuncture that utilizes meridian points to help heal negative or blocked experiences. EMDR is an innovative approach to psychotherapy designed to both alleviate and reprogram negative experiences.

Summary

It is important to be well informed when considering treatment for mental disturbances. It is equally important to properly screen for both conventional and unconventional causes. Proper diet and nutrition, exercise, sunlight and rest are great starting points. Identify food and environmental allergies, and environmental exposures. Pay close attention to medications, nutritional deficiencies and imbalances, infections and underlying diseases. Respect the body and the mind's creative abilities.

Mental Illness Stats

About 300,000 Canadians currently suffer from a mental illness, about one percent of the population, according to the Canadian Mental Health Association. One in five people, or close to six million Canadians, is likely to be diagnosed with a mental illness sometime during their lifetime.

It is estimated that:

• schizophrenia affects about one percent of Canadians
• mood disorders affect 10 percent, and
• anxiety disorders affect 12 percent.