Mental Health and Your Metabolism

Exploring the Promise of Metabolic Psychiatry and The Mood-Boosting Powers of Your Plate

By Kelley Herring

With the pressures of modern life and our collective divesture from ancestral living, conditions like depression, anxiety, and mood disorders are becoming increasingly more common.

In fact, the World Health Organization (WHO) estimates that over 264 million people of all ages suffer from depression, with around 284 million suffering from anxiety disorders globally.

These numbers represent a significant uptick in mental health disorders compared to previous decades, indicating a pressing need to address our mental health as a society.

Unfortunately, modern psychiatry has struggled to yield favorable outcomes while missing the potential root causes. The good news is that a new promising field is on the horizon for mental health… and it all starts with the food on your plate.

In today’s article, you’ll discover the unimpressive improvement rates and concerning risks of commonly prescribed psychiatric drugs … the new research that demonstrates how your mental health is closely tied to your metabolic health… and the simple and effective dietary strategies you can use to boost your mental well-being by remodeling your metabolism!

Modern Psychiatry: Nothing to Be Happy About

You may already know that millions of Americans take psychiatric medications every day in the hopes of alleviating symptoms of depression, anxiety, bipolar disorder, schizophrenia, and other psychiatric disorders.

In fact, the National Center for Health Statistics revealed that between 2015 and 2018, approximately 19.4% of adults aged 18 and older reported taking a prescription psychiatric drug every day.ⁱ

What’s more, the use of these drugs is on the rise.

In fact, overall prescription psychiatric drug use is increasing, with the use of antidepressants soaring by nearly 65% between 1999 and 2014 among adults in the United States.ⁱⁱ

But are these drugs really effective… or even safe?

Let’s take a look at the statistics on some of the commonly prescribed psychiatric drugs:

Selective Serotonin Reuptake Inhibitors (SSRIs)

• Only around 30-40% of patients with depression experience significant improvement when treated with SSRIs.ⁱⁱⁱ
• Placebo response rates in SSRI trials for depression can be as high as 40-50%, suggesting that a substantial portion of the reported benefits may be attributed to the placebo effect.^iv
• The long-term effectiveness of SSRIs in preventing relapse remains questionable, with a significant number of patients experiencing recurrence despite continued treatment.^v

Anti-Anxiety Medications

• Benzodiazepines, a common class of anti-anxiety medications, are associated with concerns regarding tolerance, dependence, and withdrawal symptoms.
• While benzodiazepines provide rapid relief of anxiety symptoms, their long-term efficacy is uncertain, and they are not recommended for prolonged use due to the risk of addiction and cognitive impairment.^vi

Antipsychotic Medications

• Antipsychotic medications are a cornerstone in the treatment of schizophrenia and other psychotic disorders. However, studies suggest that their efficacy may be modest, with response rates ranging from 40% to 60%.^vii
• Furthermore, antipsychotic medications are associated with a range of adverse effects, including weight gain, metabolic abnormalities, and movement disorders, which can compromise long-term adherence and quality of life.^viii

Given these disappointing results, we have look more critically at the theories that shape how we are diagnosing and “treating” mental health concerns.

Mental Health: A Matter of Chemical Imbalance or Energy Malfunction?

For years, common mental health conditions – like schizophrenia, depression, and bipolar disorder – have been scrutinized through the narrow lens of chemical imbalances.

The theory of chemical imbalances in the brain suggests that mental health disorders arise from irregularities or imbalances in neurotransmitters – the chemical messengers that transmit signals between neurons.^ix

For example, in depression, it’s believed that a deficiency of the neurotransmitters serotonin and/or norepinephrine leads to symptoms such as low mood, loss of interest or pleasure, and fatigue. In anxiety disorders, it’s thought that excessive activity of norepinephrine may cause feelings of worry, fear, and unease.^xi

The chemical balance theory has served as the basis for the development of pharmacological treatments – such as selective serotonin reuptake inhibitors (SSRIs) for depression and serotonin-norepinephrine reuptake inhibitors (SNRIs) for anxiety disorders – which target these neurotransmitters.

However, given the lack of favorable outcomes from these drugs, coupled with the global increase of mental health issues, we now know that the relationship between neurotransmitter levels and mental health disorders is far more complex than originally proposed.^xii

Metabolic Psychiatry: Mend Your Metabolism, Boost Your Mental Machinery

Enter metabolic psychiatry, a dynamic new field that challenges the conventional approach by peering into the inner workings of the brain’s energy dynamics.

Considering the brain’s voracious appetite for energy, it makes sense that the fuel it receives plays a pivotal role in shaping our moods and behaviors.

Unlike many other organs in the body, the brain relies primarily on glucose, a type of sugar derived from carbohydrates, as its main source of energy. Glucose serves as the primary fuel for powering the brain’s intricate neural networks and sustaining its myriad functions, including cognition, memory, and emotional regulation.

But there’s another fuel source that the brain can utilize: ketones. Ketones are produced when the body breaks down fats, particularly during periods of low carbohydrate intake or fasting. Unlike glucose, which provides a rapid but relatively short-lived burst of energy, ketones offer a steady and sustained source of fuel for the brain.

What sets ketones apart is their remarkable efficiency in providing energy to the brain. While glucose is akin to a high-octane fuel, providing quick energy but also prone to fluctuations, ketones act more like a slow-burning, long-lasting fuel. This difference in energy metabolism can have profound effects on brain function and mood stability.

Research shows that ketones offer distinct advantages over glucose in terms of brain health. For instance, studies show that ketones possess powerful neuroprotective properties, helping to safeguard neurons from oxidative stress and inflammation, which are implicated in various neurological disorders. Additionally, ketones enhance mitochondrial function, the powerhouse of cells responsible for generating energy, thereby promoting overall brain health and mental energy.Iv

While we’ve long known about the ketogenic diet’s impressive results in neurological disorders like epilepsy and Alzheimer’s, a groundbreaking new trial at Stanford Medicine illuminates its potential in the realm of serious mental illnesses like schizophrenia and bipolar disorder.^xv

Dr. Shebani Sethi, M.D., founder and director of the metabolic psychiatry clinic at Stanford Medicine, witnessed the remarkable transformation of a patient with treatment-resistant schizophrenia upon adopting a ketogenic diet. This moment sparked her mission to uncover the relationship between metabolic interventions and mental health.

In their recent pioneering trial, Dr. Sethi and her team enlisted 21 individuals struggling with schizophrenia or bipolar disorder, all battling metabolic abnormalities. These participants, already on antipsychotic medications, embarked on a ketogenic journey for four months. Their diet was made up of a rich assortment of whole, unprocessed foods comprising 10% carbohydrates, 30% protein, and 60% fat, without the burden of calorie counting.

The results were nothing short of astonishing. Participants witnessed a transformative 10% reduction in body weight, an 11% shrinkage in waist circumference, and a host of metabolic improvements, from blood pressure to insulin resistance.

But the most profound changes were observed in their mental well-being. Participants on the keto diet reported a staggering 31% enhancement on the global impressions scale, with remarkable strides in sleep, mood, and overall life satisfaction reported by the majority. ^xvi Dr. Sethi says:

“The participants reported improvements in their energy, sleep, mood and quality of life… They feel healthier and more hopeful.”

What’s more, the Stanford trial had a high adherence rate among participants, serving as a testament to the viability of the ketogenic diet as a therapeutic option for mental health issues.

Delicious Meals to Boost Your Metabolism & Mood

By restoring our metabolism, we can make significant strides towards enhancing both our brain function and mental well-being, highlighting the undeniable connection between our physical and mental states.

Here are a few ideas to get you started with a mood-boosting ketogenic diet:

• Pastured Pork Breakfast Sausage, Poached Eggs & Asparagus
• Roasted Pasture-Raised Chicken Thighs with Olives and Zucchini
• Grass-Fed Beef Burgers with Paleo Mayo in Lettuce Wraps
• Grass-Fed Ribeye Steaks with Cauliflower Mashers and Mixed Green Salad
• Wild Salmon with Hollandaise and Steamed Broccoli

Don’t forget to check out our Discover Blog for more thought-provoking articles!

---

 

References:

1. Curtin, S. C., Warner, M., & Hedegaard, H. (2019). Increase in suicide in the United States, 1999–2018. NCHS Data Brief, (362), 1-8.
2. Pratt, L. A., Brody, D. J., & Gu, Q. (2017). Antidepressant use among persons aged 12 and over: United States, 2011–2014. NCHS Data Brief, (283), 1-8.
3. Kirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J., & Johnson, B. T. (2008). Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine, 5(2), e45.
4. Kirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J., & Johnson, B. T. (2008). Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine, 5(2), e45.
5. Geddes, J. R., Carney, S. M., Davies, C., Furukawa, T. A., Kupfer, D. J., Frank, E., … & Cohen, L. S. (2003). Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. The Lancet, 361(9358), 653-661.
6. Nardi, A. E., Lopes, F. L., & Valença, A. M. (2013). Current treatment strategies for panic disorder. Expert Opinion on Pharmacotherapy, 14(2), 143-151
7. Leucht, S., Leucht, C., Huhn, M., Chaimani, A., Mavridis, D., Helfer, B., … & Davis, J. M. (2017). Sixty years of placebo-controlled antipsychotic drug trials in acute schizophrenia: systematic review, Bayesian meta-analysis, and meta-regression of efficacy predictors. American Journal of Psychiatry, 174(10), 927-942.
8. Leucht, S., Leucht, C., Huhn, M., Chaimani, A., Mavridis, D., Helfer, B., … & Davis, J. M. (2017). Sixty years of placebo-controlled antipsychotic drug trials in acute schizophrenia: systematic review, Bayesian meta-analysis, and meta-regression of efficacy predictors. American Journal of Psychiatry, 174(10), 927-942.
9. Delgado, P. L. (2000). Depression: The case for a monoamine deficiency. Journal of Clinical Psychiatry, 61(Suppl 6), 7-11.
10. Nutt, D. J. (2008). Relationship of neurotransmitters to the symptoms of major depressive disorder. The Journal of Clinical Psychiatry, 69(Suppl E1), 4-7.
11. Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications. Cambridge University Press.
12. Insel, T. R., & Wang, P. S. (2010). The STAR*D trial: revealing the need for better treatments. Psychiatric Services, 61(1), 97-98.
13. Maalouf, M., Rho, J. M., & Mattson, M. P. (2009). The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies. Brain Research Reviews, 59(2), 293-315.
14. Bough, K. J., & Rho, J. M. (2007). Anticonvulsant mechanisms of the ketogenic diet. Epilepsia, 48(1), 43-58.
15. Gasior, M., Rogawski, M. A., & Hartman, A. L. (2006). Neuroprotective and disease-modifying effects of the ketogenic diet. Behavioral pharmacology, 17(5-6), 431–439.
16. Sethi, S., Wakeham, D., Ketter, T., Hooshmand, F., Bjornstad, J., Richards, B., Westman, E., Krauss, R. M., & Saslow, L. (2024). Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial. Psychiatry Research, 335, 115866.