Nutritional Therapies

Graphics courtesy of Formula HealthOpens in new window Nutritional therapies involve using dietary regiments or supplements to treat various conditions, including mental health disorders. Dietary supplements may include vitamins, fish oils, minerals, amino acids, herbs, or other botanicals. Dietary regiments may include functional foods, such as chocolate, cranberries, soy, or nuts, for their specific properties or functions.

Whole diet therapy may involve restricting or eliminating certain foods (e.g., saturated fats, carbohydrates, gluten, sugar, caffeine) or increasing intake of other foods (e.g., protein).

Nutritional therapies may be employed instead of, or in addition to, standard pharmaceutical treatments. Mental health disorders that have been treated nutritionally include major depressive disorder (MDD)Opens in new window, bipolar disorderOpens in new window, obsessive-compulsive disorder (OCD)Opens in new window, anxiety disordersOpens in new window, insomniaOpens in new window, fatigue, and schizophreniaOpens in new window.

Nutritional therapies have also been used to treat conditions such as autistic spectrum disordersOpens in new window and attention-deficit hyperactivity disorder (ADHD)Opens in new window and to improve cognitive function (e.g., memoryOpens in new window).

In 1968, renowned chemist Linus PaulingOpens in new window published a controversial article about orthomolecular psychiatryOpens in new window, a biochemical model that explored nutritional therapies for mental diseases (Hoffer, 2008). Pauling’s theories led to the popular megavitamin therapiesOpens in new window of the 1970s.

While orthomolecular psychiatry was dismissed by mainstream mental health professional organizations (e.g., American Psychiatry Association), the theory sparked interest and further exploration into nutritional therapies for mental health disorders. Some of these therapies include supplemental vitamins or glycine for schizophrenia, kava kava (Piper methysticum)Opens in new window for anxiety, valerian (an herb)Opens in new window and melatoninOpens in new window (a pineal hormone) for insomnia, ginsengOpens in new window and ephedraOpens in new window for fatigue, and ginkgo bilboaOpens in new window to improve memoryOpens in new window (Elkins, Marcus, Rajab, & Durgam, 2005).

The neurotransmittersOpens in new window (chemical messengers in the brain) serotonin, dopamine, noradrenaline, and gamma-aminobutyric acid have been implicated in depressionOpens in new window, bipolar disorderOpens in new window, and schizophreniaOpens in new window.

Some individuals with mood disorders (e.g., depression, bipolar disorder) have been shown to have deficiencies of some of these neurotransmitters (Lakhan & Vieira, 2008). Chemicals or substances that the body converts into other substances (e.g., neurotransmitters) are known as precursorsOpens in new window.

The amino acid tryptophanOpens in new window is a precursor to the neurotransmitter serotoninOpens in new window. TryptophanOpens in new window is found naturally in foods such as milk and turkey. TyrosineOpens in new window (and sometimes its precursor, phenylalamineOpens in new window) is converted into dopamineOpens in new window and noradrenalineOpens in new window. Dietary supplements containing tyrosine and phenylalanine increase arousal and alertness.

MethionineOpens in new window is a precursor of S-adenosylmethionine (SAMe)Opens in new window, which facilitates the production of neurotransmitters in the brain (Lakhan & Vieira, 2008). Utilizing dietary supplements with the goal of increasing neurotransmitters, use of dietary supplements may influence neurotransmitter synthesis, affecting mood and behavior (Young, 1996).

Some studies have found that omega-3 fatty acidsOpens in new window, which naturally occur in fish, may alleviate symptoms of MDDOpens in new window, bipolar disorderOpens in new window, and schizophreniaOpens in new window (Freeman et al., 2006).

Omega-3 fatty acids can cause some side effects (e.g., gastrointestinal distress) and may not be suitable for individuals taking anti-blood clothing medications.

Individuals with bipolar disorder or depression have been found to have deficiencies in vitamins C and B (folate), magnesium, taurine, and omega-3 fatty acids (Lakhan & Vieira, 2008). Increasing tryptophan intake has been suggested as a means to treat symptoms of depression and OCD (Lakhan & Vieira, 2008).

St. John’s wortOpens in new window (Hypericum perforatum) is an herb that has been much studied for the treatment of depression. It has been found to be useful in the treatment of mild to moderate depression but not for severe depression.

St. John’s wort (or other substances that increase serotonin) with standard antidepressant medications (e.g., selective serotonin reuptake inhibitors), there is a risk of causing a potentially severe reaction known as serotonin syndromeOpens in new window (Natural Standard Research Collaboration, 2009).

Several herbs and dietary supplements have been found to interfere or interact with prescription medications, including St. John’s wortOpens in new window, garlicOpens in new window, glucosamineOpens in new window, ginsengOpens in new window, saw palmettoOpens in new window, soyOpens in new window, and yohimbeOpens in new window (National Center for Complementary and Alternative Medicine, 2007).

Food allergies and food sensitivitities have been implicated in emotional, behavioral, and developmental disorders including learning disabilities, ADHD, depression, and autism.

Some diets used to treat these conditions include eliminating sugar, caffeine, processed foods, food additives, food coloring, or fruits and vegetables. A glutenfree, casein-free (GFCF) diet—sometimes used to treat individuals with autism—eliminates all dairy products (which contain casein) and wheat products that contain gluten. Studies of the effectiveness of nutritional therapies show mixed results (Shaw, 2008).

Claims about treatments or miracle cures conditions may be appealing to people who are seeking relief or are disenchanted with the mainstream medical establishment. Some people try nutritional interventions because they do not like the side effects associated with pharmaceutical medications. Others may use nutritional interventions because they are perceived as more natural, because they may cost less than pharmaceutical medications, or because of lack of access to health care services.

There is considerable controversy about the risks and benefits of nutritional therapies. The U.S. Food and Drug Administration (FDA)Opens in new window classifies herbs (such as St. John’s wort) as dietary supplements. FDA requirements for testing dietary supplements differ from those of pharmaceutical drugs.

Dietary supplements can be sold without requiring studies on dosage, safety, or effectiveness. Possible risks of utilizing nutritional therapies include difficulty regulating dosage, lack of supervision by a heahth care professional, side effects, or interaction with other medications.

In an attempt to treat symptoms, an individual may not be pursuing treatment for the correct diagnosis or may neglect to consider using established treatments.

While more medical and mental health practitioners are being trained in integrative approaches—combining standard medical and pharmaceutical treatment with complementary and alternative treatments (CAM)—not all health practitioners are familiar with CAM. This may make it difficult to recommend effective dosages of nutritional supplements. It may be difficult to avoid dangerous drug interactions when combining CAM (including nutritional supplements) with standard pharmaceutical treatments.