How can we do it better?
Recent statistics report that our suicide rates continue to climb. Psychiatric hospitals are bursting at the seams, mental health hospitals are understaffed and staff are overwhelmed. It’s difficult unless you are in the most urgent need of care to get psychiatric help. The burden is often left to families to cope with the struggling person - if the struggling person is lucky enough to have a family member to support them.
It’s all a little depressing (no pun intended). What’s so wrong with what we are doing? And how can we do it better?
Mental health (or more specifically) mental illness is caused by a wide range of contributing factors. Everything from childhood trauma, genetics, coping skills, physical health, environmental influences, nutritional intake and the food you’re eating (or not eating).
Unfortunately, the treatment approaches to mental illness are not nearly so broad or wide. If you seek help because you are feeling; down, sad, anxious, depressed or otherwise not 100% mentally well, you will (usually) be offered one of two options - an antidepressant (which may do wonders if all you need is extra serotonin or adrenalin)) and / or if you are lucky - talking therapy. (If you are a woman - you may also get offered the oral contraceptive pill - go figure).
We have two bullets in psychiatry: Talk. Medicate. And not an awful of a lot outside of these two practices.
We tend to treat every depressed person as the same. If a doctor treated every person who came into their clinic with a sore stomach the same way (an antacid and suggestion to avoid spicy food for example) - he would soon figure out (much like our psychiatric treatments) that many people won’t respond well. Thankfully, there are tests, examinations and procedures to identify what might be causing the pain and with this knowledge, we can move forward.
We don’t (or can’t) do this when the pain is in someone’s head. And we don’t actually stop and ask “why is this person depressed?”
Picture courtesy of tinekerose.com
Here are just some of the things that are associated with mental illness or can affect or worsen mental health:
Inflammation, chronic disease, loneliness, poor diet, food intolerance’s, unstable blood sugar levels, job dissatisfaction, low levels of omega-three, high intake of trans-fats, MSG (recent study discovered this), zinc deficiency (common post-natally and in teenagers), deficiency in vitamin B6, B12, D, folate, selenium (which our New Zealand soils are terribly deficient in), magnesium, iodine. Childhood trauma, life events, IBS, IBD (Crohn’s, Ulcerative colitis), celiac disease, hypo or hyperthyroidism, hashimoto’s (not often investigated for and certainly under recognised), gut dysbiosis, parasites (eg toxoplasmosis), alcohol (and other drug consumption), poor diets, poor vegetarian or vegan diets (sometimes a vegan diet simply isn’t right for someone), iron deficiency, cigarette smoking, medications such as Roaccutane, beta-blockers, proton pump inhibitors (Losec, Omeprazole), the oral contraceptive pill…
You get the picture.
So as much as there are many contributions to mental illness - there are a number of ways that mental health can be supported. This may not provide a cure by any means (although in some cases it does) - but these factors are certainly worth considering and introducing as part of a Mental Health Care Package. (Even the drug companies are recognising that the battle of medication for mental illness is not one they are likely to win see Psychiatric Drug Development: Diagnosing a Crisis.)
Prevention and education
We have a very strong push for ‘suicide prevention’. However, I do feel that we are possibly missing out on the true focus - which is: preventing people from becoming depressed or anxious in the first place. And if a person does become depressed/anxious, asking the “why” question. Why is this person depressed/anxious? What is the underlying cause? Stopping someone who is depressed from committing suicide is only half the battle. Ensuring that people are living lives worth living should actually be the focus of our Mental Health campaign. A person who is no longer suicidal but remains mildly or severely depressed or unhappy is not really winning. We end up chasing our own tail. We should be focusing at the top of the cliff, rather than being the ambulance at the bottom.
While we are helping to build more resilient children and adults with such techniques as mindfulness which I wholeheartedly embrace, we appear to be missing many other aspects of contributors to mental ill health. It’s not always psychologically driven, nor as simple as ‘balancing neurotransmitters’.
Ironically in other health issues - we also seem to have our focus on the treatment of the illness rather than prevention of the illness. The cancer foundation were recently raising money (Daffodil Day) with a sausage sizzle. How is it that we are raising money to help research and cure a disease - by actually selling a product (barbecued, processed meat) directly related to causing the disease? It’s a small example - but it seems to be where we are stuck.
Diet and Nutrition
If you asked your psychiatrist or other health professional whether any extra vitamins and minerals (either in the form of supplements or in food sources) would help improve your mental state, the answer would also likely be ‘no’. Yet there are plenty of studies which would suggest otherwise.
Studies which have looked at changing a depressed persons’ diet from a SAD (in this case a ‘Standard Australian Diet’) to a Modified Mediterranean diet found that thirty-two percent of depressed people were no longer depressed.
Micro-nutrients in a number of studies have been found to be helpful - this would be especially so if the person is deficient in specific vitamins (which is not often tested for). Professor Julia Rucklidge has been doing studies on micro-nutrients and its effect on PTSD and ADHD with positive results.
Auckland University recently did a study which found that a probiotic supplement reduced the likelihood of post-natal depression.
Dietary exclusion - ie taking out specific foods may also make a difference - there are studies linking psychosis to gluten & dairy and OCD being ‘caused’ by MSG and other neurotoxins. There are studies linking junk food to lower mood and high trans fats to increased aggression and poorer mental health.
Nutrition is a hugely ignored component when it comes to mental health and yet can have a significant influence on a persons well-being. There are numerous studies supporting this, unfortunately these components are not addressed at all during a persons treatment for any form of mental illness. We are missing a huge opportunity to make a real difference by not encouraging or modifying a persons diet as a first line of treatment.
Lifestyle
There are numerous other lifestyle factors which may influence mental health. Exercise has the potential to reduce the incidence of depression by about 30%. Being exposed to sunlight and the outdoors has been shown to improve mood. Reducing alcohol consumption, stopping smoking, as well as the well known components around reducing loneliness and increasing social support. (See my other blog here on some alternative treatments for mental health).
Treatment
Some of these options may be seem as ‘soft’ options of treatment - however each small part may have a big part to play in supporting someone to recover from illness relating to mental health. Mental illness is complex, and yet, some of the most basic strategies may be what is needed to get some people out of depression and get them well.
Good food. Extra vitamins. Sunshine. Exercise. Social and emotional support. Psychological work, building resilience, mindfulness skills. Full testing and treatment of nutritional deficiencies and physical health conditions. Getting people to understand the why and the research behind the how these factors influence mental health and mental illness recovery.
And yes medications when necessary.
We currently have a broken mental health system, which can not keep up with catching the people who fall. Why not move our focus to a wellness model of care - and increase or treatment options from the two components (medication and talk therapy) to a multitude of treatment options which stops them from falling in the first place?
Helen Duyvestyn, Registered Nurse, Life Coach
Helen is a registered nurse with a Master's in Health Science and a Life Coach, specialising in mental health from a holistic perspective. She is passionate about supporting people to have optimal mental health and well-being.
Based in New Zealand, Helen is available for speaking and workshops on mental health & well-being and one-on-one appointments.
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