The gut/brain axis connects our diets to our mental health, and has been heavily studied over the last 30 years).
And yet, the ‘old guard’ of medicine claims there is no treatment connection between the two. You need psychoactive medications and prescription drugs to treat mental illness — right?
The answer is more nuanced than many would like to admit.
But rather than take it directly from me, I’d like you to take a look for yourself.
Article Overview
- What you eat has a direct impact on your mental health, including conditions like depression, anxiety, and cognitive decline.
- Dietary intervention can achieve remission rates comparable to antidepressants while avoiding the side effects that come with long-term medication use.
- Reducing ultra-processed food, cutting sugar and refined carbs, and eliminating alcohol may help improve mental health conditions.
What we know about food and mental health
There’s quite a bit of research linking our gut health and our brain health. This is the gut-brain axis, also referred to as the enteric nervous system, with studies reaching back as far as 1921. Today, we know that what you eat and how you feel are a closely interconnected duo — essentially a bidirectional highway between your nervous system and your brain.
Some quick facts for you to ‘digest’ here:
- Around 95% of your body’s serotonin, also known as the ‘happy hormone,’ is produced in the gut. It serves a slightly different purpose than the serotonin produced in your brain, but “it is capable of locally activating afferent nerve endings that are connected directly to the central nerve system,” which means it can still have an impact on your mental wellbeing.
- Any time there are significant changes to your gut microbiome composition, there is a relatively measurable impact on your mental function. Some studies suggest that changes to your microbiota could directly affect conditions like Alzheimer’s, dementia, and social anxiety.
- Approximately 75% of psychiatric inpatients have an unhealthy diet (read: compared to the Mediterranean diet). Not only do they typically have a higher body mass index, but they may also consume more sugar than the average person, especially in the case of schizophrenia.
As you can see, the link between nutrition, metabolic health, and mental health is much stronger than what some medical professionals might lead you to believe. The question is, does it replace psychiatric prescriptions? And does one root cause overrule the other?
Do you really need drugs to treat mental health issues?
That depends on one thing: you.
As with any other diagnosis, medication can and will address your symptoms. Suffering from a cold? Something like TheraFlu can probably help you get more comfortable. But will it address the root of your flu? Yes and no.
Mental health drugs are no different. They are psychoactive substances, after all, which means they’re designed to modify normal mental states and behaviour. Some studies even suggest that “there is no evidence that antidepressants work by correcting a chemical imbalance, that antidepressants have mind-altering effects, and that evidence suggests they produce no noticeable benefit compared with placebo.”
It’s important to note that many mental health drugs also come with side effects, some of which directly affect your heart. Studies show the average cardiovascular Q risk rises 14% over three years on SSRIs, as well as long-term health effects such as dyslipidemia, impaired fasting glucose, and ischemic heart disease.
As a heart surgeon, I never tell my patients what to do. I simply state the facts, give them options, and provide education around each. My hope is that they’ll pick a treatment option that has their best interests in mind.
So I let research do the talking.
The SMILES trial found that 32.3% of participants achieved remission from depression through dietary changes alone (compared to 8% of the control group). The STAR*D trial, the largest and most influential antidepressant trial ever conducted, found that one-third of its participants reached remission after a similar period of time.
So what does this tell us? That dietary intervention achieved a comparable remission rate, without daily pills and without side effects.
And if you’ve already tried medication before, as well as therapy and other lifestyle interventions, there’s no reason not to consider making changes to your diet.
How to use food to treat mental illness
There’s no one-size-fits-all diet for mental illness. That largely comes down to your personal needs, specific diagnoses, and existing gut microbiota. That said, I can give you a few places to start, and you can learn more in my book: Stay Off My Kitchen Table.
Reduce processed food
You’ll probably not be surprised to hear that ultra-processed food is directly linked to higher risks of depression, anxiety, and other mental health disorders. Cutting as much out of your diet as possible is a great way to see better results in your mental health.
A gut populated with healthy microbiota (i.e., fed by whole, real foods) will communicate very differently with your brain than one inflamed by seed oils and added chemicals. Stick to foods with five ingredients or less, and try cooking at home as much as possible.
Eat less sugar and carbs
A diet high in sugar is directly associated with increased risk of depression, not to mention heart disease, type 2 diabetes, and Alzheimer’s. Heavy carb intakes have a similar outcome: “higher Caloric Ratio of Carbohydrate Intake (CRC) is associated with increased depressive symptoms in US adults.”
I highly recommend opting for keto or carnivore diets to start, but any low-carb diet is a fit (so long as it’s on the proper human spectrum). Continue this for 30 days, and monitor how you feel. I highly recommend keeping a journal to monitor changes in your mood and behavior.
Eliminate alcohol
While you might think that alcohol makes you happier or more ‘steady,’ the truth is it’s doing much more harm than good.
I highly recommend eliminating alcohol from your routine altogether, even if you only drink a few times per week. Instead, consider replacing it with healthier habits or routines.
You can learn more about the dangers of alcohol on your metabolic health here.
What about other things outside of diet?
Your mental health could be suffering from a number of reasons. And while medications certainly exist, they may not always be the right fit for your health goals. Leaving my own opinions out of it, they can objectively lead to worse health conditions, including weight gain, poor heart health, and additional psychological side effects.
Nothing is truly a panacea for mental health. Like anything else, your treatment protocol should be holistic and involve your entire self, not just a single part of it.
Still, from a clinical perspective, there are many other modalities directly tied to improved mental health. I’d encourage you to explore the following resources for more information: