By Gary G. Kohls, MD

For the last decade of my professional life, I practiced what was best termed holistic mental health care, utilizing non-drug, nutritional approaches in aiding the recovery of patients who had various mental illness labels. Having had a number of successes early on in helping patients cut down or even get off certain drugs, my practice attracted, by word of mouth, many other patients who were also wanting to get off their psych drugs, medications that they had recognized as causing a large variety of serious adverse effects - or were addictive (ie caused withdrawal symptoms when they stopped taking the drugs or cut the dosage down). The observations that I made during that decade were many, but one of the most impressive ones was the effect of malnutrition on brain and mental health.

My chosen medical practice turned out to be complex and time-consuming – but very popular. It required a lot of face-to-face clinic time reassessing old diagnoses, obtaining histories, especially regarding past psychological traumas, past prescription or illicit drug use, nutrition, family history, etc. I routinely spent 90 minutes with new patients and often up to an hour with follow-up visits. That meant I could only see 6 – 8 patients per day. Hence I had to practice independently and solo, but that also meant that I was immune from pressures from some clinic director about my “productivity”. It also meant that my practice was only rewarding in a non-financial way.

Getting back to the major point of this column, I need to say that one of the things that impressed me most was how seriously malnourished most of my patients were. They were victims, just like most of the rest of us, of the seductive fast food industry and the commercial food industry that sold to them a lot of heavily marketed, high-profit, mass-produced, highly-processed, non-organic facsimiles of actual “food”. Not only were my patients eating poorly nourishing food, but they were also eating foods with dangerous additives in them that certainly were helping to make them feel ill, both mentally and physically.

Happily, another observation that I made was how much they improved, even to the point of cure, with appropriate changes in diet and targeted, short-term nutritional supplementation (along with psychoeducational psychotherapy and the gradual tapering down of medications).

Eating poorly nourishing food that has toxic additives in it will adversely affect our brains as well as our bodies

Initially my therapeutic recommendations tried to address the specific nutritional needs of my patient’s brains. Unfortunately, many of my patients were living in poverty and on Medical Assistance (which explains the common dilemma that many patients faced, that of continuing to ingest the free brain-altering prescription drugs versus purchasing healing food and supplements that they had to pay for out of their nearly empty pockets).

Many of my patients were subsisting on nutritionally deficient foods, eating highly processed, carbohydrate-laden foods that usually contained toxic preservatives, synthetic food dyes and chemical flavor enhancers like MSG, Splenda and NutraSweet. Most of my patients, like most of us Americans, had very little knowledge of what constituted good nutrition, so a lot of clinic time was spent teaching brain nutrition.

Having attended an American medical school back in the late 60s, I only heard a couple of lectures about nutrition (although I can’t recall learning anything from them). So I had to do a lot of research about brain nutrition myself. I learned that the brain is a high fat, high cholesterol (cholesterol is an essential component of the nervous system) organ that has heavy-duty nutritional requirements.

The brain represents less than 5% of body weight, but it utilizes 20 – 25% of the body’s glucose and oxygen. Brain cells die quickly if they are deprived of glucose or oxygen for just a few minutes. Likewise, chronic deprivation of certain nutrients can also cause temporary, reversible and even curable brain dysfunction that can be misdiagnosed as a mental illness “of unknown cause”. And certainly, chemicals that are toxic to brain cells, including many legal and illegal psychotropic drugs, can cause symptoms of brain dysfunction or “mental illness”.

Other important lessons that I applied to my practice I found in the neuroscience research literature, research that didn’t seem to ever appear in the mainstream medical journals that most prescribing physicians read. That research showed that psychoactive drugs are capable of causing certain amino acid depletions and, therefore, deficiencies that needed replacement, achievable only through dietary means. Certain important brain neurotransmitters, such as serotonin, dopamine and norepinephrine can only be manufactured by brain cells out of amino acids that are in the foods we eat. In addition to amino acids, (the building blocks of proteins), the brain needs vitamins, minerals, antioxidants and fatty acids, all obtainable from healthy food and/or nutritional supplements.

Therefore, many of my nutritional prescriptions were based on my assessment of the likelihood of dietary and/or drug-induced amino acid deficiencies. That required knowledge of how psychoactive drugs worked at the cellular level. Fortunately, nutritional therapy with food-based or food-derived substances is a thousand times safer than synthetic drug therapy, so therapeutic trials were often used.

One of the dramatic findings that became obvious after awhile was that, after even a short therapeutic trial of brain nutrient supplements, patients would often return, asserting that many of their physical problems had improved along with the mental symptoms. Migraine headaches, fibromyalgia, insomnia, bowel symptoms, fatigue symptoms, etc were unexpectedly getting better along as were many of their mental health symptoms.

All these observations made me more and more certain that what constituted our all-American diet was a major cause of sickness that ran the gamut of disorders of body, mind and spirit.

Malnourished children are mentally less healthy than well-nourished children

Among the many studies in the literature was one that proved that malnourished children had increased symptoms of aggression, delinquency, violence and antisocial behavior. It was actually published in the peer-reviewed American Journal of Psychiatry.

Briefly stated, compared to well-nourished children in a control group, “the malnourished children showed a 41 percent increase in aggression at age 8, a 10 percent additional increase in aggression and delinquency at age 11 and a 51 percent increase in violent and antisocial behavior at age 17. Researchers also found that the more indicators of malnutrition there were, the greater the antisocial behavior.

“While social class did not play a significant factor in behavior, intelligence level did, (One of the authors of the study) said. ‘Poor nutrition, characterized by zinc, iron, vitamin B and protein deficiencies, leads to low IQ, which leads to later antisocial behavior,’ he said. ‘These are all nutrients linked to brain development.’

“Although this study was done in another country, the nutritional statistics in the U.S. indicate serious implications. According to the author, 7 percent of U.S. toddlers suffer from iron deficiency, a number that jumps to between 9 percent and 16 percent in adolescent and female groups, and rises to between 19 percent and 22 percent in black and Mexican American females. ‘This is a problem in America. It's not just a problem in the far-away Indian Ocean,’ the author said. ‘If it's causal, there's an intervention implication there. At a societal level, should parents be thinking more about what kids are eating?’

“Although the author acknowledges that there is more to antisocial behavior than nutrition, he says ‘we argue that it is an important missing link. Biology is not destiny. We can change the biological disposition to antisocial and aggressive behavior.’”

Having dealt with over 1,200 malnourished patients who had been labeled with mental illness diagnoses, I agree with that assessment.

My message to readers is that no matter what the diagnosis is, and no matter what the modality of treatment is, proper nutrition is essential. It may not be sufficient, but it is essential.

Good advice for everybody

So I always told my patients “Eat as organic as you can afford, as vegetarian as you can tolerate, eat as much home-grown food as you can but be sure to ingest adequate amounts of high-quality protein. And if you are uncertain of the nutritional quality of your diet, consider supplementing it with Omega-3 fatty acids (fish/flaxseed oil), a high quality multiple vitamin/mineral supplement, B-complex vitamins and extra magnesium.” And, equally importantly, I would also warn about ingesting the known toxic synthetic no-calorie sweeteners, Splenda and NutraSweet, both of which, interestingly enough, have insecticide properties.

In my lectures and seminars on brain nutrition and mental ill health, I always show this slide on how to shop for food:

1. If you can't pronounce the ingredients on the label, don't eat it.
2. If it wasn't available hundreds of years ago, don't eat it.
3. If it has a long shelf life, don't eat it.
4. If it's heavily marketed, don't eat it.
5. If it’s man-made (synthetic), don't eat it.

Caveat:

As desperate and motivated as were many of my patients, not everybody was able to quit their medications. In my experience, the likelihood of any given patient being able to get off their psychotropic drugs was related to these non-nutritional, drug-related factors: the duration of drug use, brain damage that might have occurred, the nature of any illicit drugs that were used, how high were the dosages of the drugs used, how addictive were the drugs used, what combination of drugs had been used, the age of onset of initial drug use and, of course, the ability to afford - or stay on - proper nutritional therapy. The patients who had been on anti-psychotic drugs long-term somehow had the poorest prognosis of any other drug group.

Disclaimer

The above article may have contained information about the risks associated with certain psychiatric drugs.
If you are taking one or more psychotropic drugs, DO NOT suddenly stop taking them.

Some people can experience serious, even life-threatening reactions during the discontinuation of such drugs.

Any attempt to get off such medications should be done under the guidance and supervision of a qualified health care practitioner who has an understanding of the possible dangers of drug usage, the symptoms that can occur during drug withdrawal and the nutritional and mental health support that is needed.

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Gary G. Kohls, MD, Duluth, MN

MMental health-related essays: http://www.ihealthtube.com/aspx/search.aspx?sp=GARY+G.+KOHLS&displayType=articles Mental health-related videointerviews of Dr. Kohls available at http://www.ihealthtube.com/aspx/search.aspx?sp=GARY+G.+KOHLS&displayType=videos and http://www.youtube.com/results?search_query=gary+kohls&aq=f