1. Art and Diseño

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NUTRIENTS / CONFIDENT COOK / HONESTLY, DARA / WORTHY GOODS
Whole-Body
Psychiatry
Mental health is not all in our heads. Nutrition is an oft-ignored — yet incredibly effective —
way to manage mental illness, including schizophrenia.
By Kristin Ohlson
ILLUSTRATIONS: STUART BRADFORD
R
obert Hedaya tried everything in mainstream
psychiatry’s toolbox to
treat a patient with panic
disorder, including cognitive behavioral therapy and a series of
prescribed medications. She was still
having attacks after a year, though, so
Hedaya went back to the lab to look at
her case from a different perspective.
“Early in my training in psychiatry
at Georgetown, I figured out that the
way things look depends on the lens
you use,” says Hedaya, MD, ABPN,
DFAPA, founder of the National
Center for Whole Psychiatry and
clinical professor of psychiatry at
Georgetown University School of
Medicine. “If you use a low-powered
lens to look at mental illness, you look
at communities and culture. If you
use a medium-powered lens, you look
at family systems. If you use a highpowered lens, you look at molecules.”
He revisited the patient’s blood
work and saw that her red cells were
larger than normal. He did a literature
search and found that a deficiency in
B12 could be the cause, so he began a
series of B12 injections. Within days,
the panic attacks were over.
Now, Hedaya practices what he
calls “whole psychiatry.” New patients
undergo a four-hour workup, in which
Hedaya examines all the factors that
have combined to cause a break in a
person’s mental health. Unlike his colleagues in mainstream psychiatry, he
conducts extensive lab work to look
for disruptions in basic body systems
that might manifest as mental illness,
while also looking into psychological,
social, and spiritual factors.
“These are the same [disruptions]
that underlie the chronic illnesses of
Western society,” he explains. “Take
inflammation, for instance: In one person, it might show up as diabetes, in
another person as cardiovascular disease, in someone else as depression.”
Integrative psychiatrist and author
Hyla Cass, MD, concurs. “Psychiatry
is the only specialty that doesn’t test
the organ involved, namely the brain,”
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NUTRIENTS
she says. “If you have heart disease
or hepatitis or diabetes, doctors
will perform lab tests to monitor
the system in question and treat
accordingly. But if your inflamed brain
shows symptoms of mental illness,
all of a sudden they don’t consider
the brain an organ anymore — they
think we have to talk people out of
that illness. Talk therapy and even
the psychiatric medications can be
helpful, but first we have to approach
the biochemical root cause.”
Hedaya and Cass are part of a
growing number of mental-health
professionals who find the mainstream approach to mental illness
insufficient. Many psychiatrists
spend less than an hour evaluating a
new patient and base their diagnosis
and treatment plan on the symptoms
that the patient reports and that
they themselves see during the
exam. Sometimes they will order
scans to make sure a physical
disorder — like a mass in the brain
— isn’t causing the symptoms, but
mostly they match the symptoms
to a medication and, sometimes,
recommend psychotherapy.
Integrative psychiatrists, on the
other hand, might use these medications to stabilize a patient who is in a
crisis state. Their overall goal, however, is to treat the underlying health
issues through nutrition, supplementation, and lifestyle changes.
Treating the Whole Person
Curing patients with vitamins, as
Hedaya did with the woman suffering
panic attacks, is not new. In fact, this
approach was the breakthrough treatment in mental health in the 1950s.
Canadian physician and medical
researcher Abram Hoffer began treating
people with schizophrenia using niacin, or vitamin B3, and claimed a cure
rate of 75 percent — meaning, he said,
that these people were well enough to
go back to work and pay taxes instead
of needing to be supported by society.
In 1968, Nobel Prize–winning scientist
Linus Pauling — the great champion
of megadose vitamin C — coined the
term “orthomolecular,” which means
42 / EXPERIENCE LIFE / March 2014
In one person,
inflammation
might show up
as diabetes, in
another person
as cardiovascular disease, in
someone else
as depression.”
“the right molecule,” to describe this
method of treatment.
The ’50s also saw the introduction of the prescription drug Haldol
and other such medications, and they
were widely embraced by the medical
profession over the years. But recently,
there has been growing frustration
with drug therapy among doctors as
well as patients — the cure rate is
abysmal and the side effects so vicious
that even patients who feel better
don’t want to continue the regimen.
According to Steven Carter, director of the International Society for
Orthomolecular Medicine, those who
advocate for high-dose vitamin treatments, as opposed to drug therapy,
use nutrients that occur naturally in
the body. And there are 40 essential
nutrients that need to be balanced
according to someone’s individual
biochemistry.
“Medications can be quick,” says
Jonathan Prousky, ND, MSc, editor of the Journal of Orthomolecular
Medicine. “They will quickly subdue
someone and make them docile,
which makes people think they’re
getting better. But they’re not getting
better. I’ve never met a patient on an
antipsychotic medication who was
living a thriving, flourishing life. I’ve
never seen it.”
There is a relative scarcity of
research into the healing properties
of vitamins and nutrition, because,
frankly, there’s little profit to be made
from these discoveries — unlike
the money flowing from new FDAapproved drugs. Even worse, there is
not enough awareness of the existing
research, says Jeffrey Becker, MD, a
Los Angeles psychiatrist and practitioner of functional medicine who
specializes in schizophrenia.
Still, Becker and others are
gathering this research and crafting multilayered treatment strategies that are proving effective even
with schizophrenia, one of the most
intractable and complex of mental illnesses. “With schizophrenia, it’s as if
the dream world is penetrating your
everyday consciousness,” he says. “All
of us have the capacity to ‘hear voices’
— we do it in our dreams. In this disorder, it happens when it shouldn’t.”
Scientists believe that numerous
genetic flaws create the propensity
for schizophrenia, which may then
be triggered by some form of stress,
such as illness or extraordinary
environmental pressures. In
addition, people with schizophrenia
and other mental illnesses often
have lifestyles that compound the
biochemical storm within. They
frequently overuse stimulants and
they smoke, which inactivates
vitamin B6, depletes other nutrients,
and increases oxidative stress. And
they often have poor diets.
Integrative psychiatrists approach
schizophrenia and other mental illness by treating the whole person,
examining their problems through the
different lenses that Hedaya describes.
They urge them away from drugs,
alcohol, and smoking; encourage exercise and a good night’s sleep; suggest
healthy ways of connecting to other
people, nature, and a spiritual practice;
and combat biochemical imbalance
with an array of supplements and
other nutritional interventions (see
next page for specific nutritional tips).
(continued on page 44)
Nutrition for
Schizophrenia
What follows is a series of nutritionbased strategies integrative psychiatrists
use to treat schizophrenia, one of the most
perplexing of mental diagnoses.
Fatty acids:
Our brains are
60 percent fat
and require a
diet rich in fatty
acids to maintain
the integrity of
cell walls. “Fats
embed themselves within the brain and
ensure that the nerves and other circuitry
function at a better level,” says Jonathan
Prousky, ND, MSc. Chronic schizophrenics show higher levels of oxidative stress
and cell-membrane breakdown in the
frontal cortex and other parts of the brain,
as well as lower levels of fatty acids in
those areas. That observation, along with
evidence that omega-3 supplementation
can reduce the incidence and severity
of psychosis, leads many clinicians to
prescribe fish oil or other sources of
omega-3s.
Niacin: Everyone requires a
certain level of
niacin, or vitamin
B3, in his or her
diet, but people
with schizophrenia may not only
be niacin deficient, they may be niacin
dependent, meaning that they require a
high dose — up to 3 grams or more daily
— to function normally. Andrew Saul,
PhD, editor in chief of the peer-reviewed
Orthomolecular Medicine News Service,
says that Canadian physician and medical
researcher Abram Hoffer recommended
pairing high doses of B3 with up to 10,000
grams of vitamin C, divided into smaller
doses throughout the day to increase
absorption. “Vitamin C is the body’s
most important antioxidant,” Saul says.
“Dr. Hoffer believed that, in addition to
many other important properties, vitamin
C prevented the oxidation of adrenaline
to adrenochrome [which Hoffer believed
could cause psychotic behavior].”
N-acetyl
cysteine:
Glutathione
is a master
antioxidant, and
it’s produced
within the body
instead of being
absorbed from food. Glutathione helps
protect the body from metabolic wear
and tear and is especially protective in
the brain, a metabolic hot spot where 20
percent of the body’s calories are burned.
Research shows that the brains of people
with schizophrenia have dangerously
low levels of glutathione. One of L.A.
psychiatrist Jeffrey Becker’s first steps
when treating a schizophrenic patient is
to test glutathione levels. If they are low, he
starts the patient on a supplement called
N-acetyl cysteine, or NAC, an antioxidant
molecule that provides raw material for
the production of glutathione. (For more
on the importance of this antioxidant, see
ELmag.com/glutathione.)
B6, B12, and
folic acid:
Many people with
schizophrenia
have malfunctions in a critical
metabolic process
called methylation, in which life-giving carbon is passed
from vitamins to DNA, fats, proteins, or
other molecules. Methylation is essential for health throughout the body and,
among other things, affects the building
of protein from amino acids and proper
gene expression. In the brain, it provides
some of the necessary building blocks for
neurotransmitters, which are the chemical messengers that ferry signals among
neurons as well as other cells in the body.
Disruptions to methylation are caused by
problems in a gene called methylenetetrahydrofolate reductase (MTHFR), which
regulates chemical reactions involving folic
acid. When people have two bad copies
of this MTHFR gene, they suffer a wide
range of problems, including schizophrenia,
depression, cancers, spontaneous abortion,
and others. Treated with the active form
of folic acid — 5-MTHF or 5-methyltetra­
hydrofolate — along with B6 and B12
(often injected), many people with schizophrenia feel relief from their symptoms.
Zinc: Copper
from new water
pipes, lead from
old paint — it’s
hard to live
in this world
without exposure
to the heavy
metals that can compromise or destroy
brain cells. Our bodies are designed to
try to get rid of the metals, but people
with schizophrenia often have toxic
levels of three or more heavy metals.
This makes the body’s metal-removing
protein, metallothionein, work overtime,
which winds up depleting zinc — a good
metal that helps us transcribe proteins
and create neurotransmitters. “Some
people may not be taking in the essential
nutrients or protein to make enough
neurotransmitters in the brain,” says
Becker. “When neurotransmitter levels
are low, electricity levels are low in the
brain. It’s a dim bulb.” For these reasons,
many integrative psychiatrists treat their
patients with zinc supplements.
Blood sugar:
A diet of 60 to 70
percent healthy
fats, 20 to 25
percent protein,
and 15 to 20
percent carbs
balances blood
sugar and helps avoid the kind of bloodsugar spikes that can rattle an already
fragile brain.
Food
sensitivities:
Integrative
mental-health
practitioners
check their
schizophrenic
patients for
food intolerances that might manifest as
inflammation in the brain.
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(continued from page 42)
The good news is that when
problems of the brain are treated
with a whole-body approach,
issues in other parts of the body
often resolve. “Sometimes their
skin clears up,” says naturopath
Ray Pataracchia, ND. “Their
energy level picks up. I had one client who said that everyone at work
teased him because his abdomen
looked like a basketball. When I
treated him, his digestion improved
and the ‘basketball’ went away.”
Not everyone seeking help
for his or her own mental illness
or that of a loved one can find a
clinician committed to this wholebody treatment, but any committed clinician can learn the science
behind these approaches. “All this
is complicated, but it’s not rocket
science,” says Becker. “It should
be taught to psychiatrists, but it’s
not. I had to learn it all on my
own; most of the information is
out there on PubMed.”
Patients and their families
shouldn’t be shy about pushing
their clinicians to look beyond the
latest wonder drug and try to incorporate some orthomolecular strategies. “Patients should compel their
doctors to prescribe vitamins,”
says Andrew Saul. “Manage the
doctor; don’t let the doctor manage you. It’s your body, your life,
and the doctor works for you.”
Kristin Ohlson is a writer and author
in Portland, Ore. Her new book is The
Soil Will Save Us: How Scientists,
Farmers, and Foodies Are Healing the
Soil to Save the Planet.
WEB EXTRA!
For more on functional
medicine, visit ELmag.com/
fmextras.
PODCAST!
Tune in to hear senior editor Anjula
Razdan’s podcast with integrative psychiatrist Jeffrey Becker at
ELmag.com/beckeraudio.
44 / EXPERIENCE LIFE / March 2014
Mental Health
for Everybody
Just as we should follow a daily regimen that keeps our hearts, skin, and other organs
flourishing, we should also be mindful of nourishing our brains, even if we don’t suffer
from mental illness. The following tips are designed to keep the jewel in our crowns
healthy, and — since everything is connected — may well clear up other problems
below the neck.
Eat more healthy
fats: Good sources
of omega-3 fatty
acids are salmon,
herring, sardines,
and anchovies, as
well as pastureraised meats and
eggs, flaxseeds,
walnuts, and
omega-3 fish-oil
supplements,
especially those
containing
eicosapentaenoic
acid (EPA).
Get more protein:
A healthy brain
depends on the
steady creation
of neurotransmitters. The basic
building blocks for
these transmitters are amino
acids that come
from the protein in
our diets. Experts
suggest that 20 to
25 percent of our
diets should come
from high-quality
protein like meat,
eggs, dairy, beans,
and legumes. And
it’s a good idea
to begin the day
with a solid helping
of protein. “I tell
people to have dinner for breakfast,”
says naturopath
Ray Pataracchia.
“You might get
sick of eggs every
day, so you have
to change it up and
be inventive.”
Avoid sugar
highs: The brain
has an enormous
need for glucose,
and our blood supplies this essential
fuel as it circulates
through the brain.
This supply needs
to be slow and
steady, without the
peaks and valleys
caused by simple
sugars found in
junk food. Stick
to the complex
carbohydrates
found in vegetables, whole grains,
and many fruits.
when our bodies
battle infection
and illness. A
steady stream of
cortisol and other
stress hormones
can weaken
neurotransmitters.
Protect them with
vitamins C and
B — especially
niacin, or B3 —
which together
can regulate and
protect these neurotransmitters. The
official minimum
daily-requirement
numbers, says
natural-health educator Andrew Saul,
PhD, are laughably
low: “For someone
with a reasonably
good diet, a couple
hundred milligrams
of supplemental B3
would be wise.”
Buffer stress
with B and C
vitamins: Stress
bombards even
the most ordinary
lives, both from
the outside — a
hectic schedule, an
angry coworker,
commuting to
work in heavy
traffic — and from
the inside, such as
Stay connected:
Robert Hedaya,
MD, at the National Center for
Whole Psychiatry,
compares human
beings to neurons:
The more connections one neuron
has with other
neurons, the more
vibrant it is. When
the connections
are severed, a
solitary neuron
can shrivel and die.
Similarly, humans
need a connection
with other humans
and with nature
to flourish.
Develop a
spiritual practice:
“Fear creates
stress,” Hedaya
says. “Whatever
it is that you’re
stressed about,
your cognitive
framework is
going to treat
things as more or
less stressful.
With a spiritual
practice, you
develop the
perspective that
there is meaning to
life and that we’re
not alone. I think
the importance
of this is highly
underrated in the
psychiatric field.
If you feel as if
everything in life
is up to you,
that’s a lot of
pressure. When
you add to that
the way that so
many people live in
isolation, that’s a
toxic recipe.”