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By Meleni Aldridge, executive coordinator & Melissa Smith, outreach and comms officer
“Every 20 secs someone will commit suicide in 2020”.
Those words are from Dr James Greenblatt at the recent summit on nutritional psychiatry attended by Melissa and Meleni. They’re hard to forget. Especially as the greatest increase in suicide rates in recent years has been seen in 10 to 14-year-old girls. In the US, this age group has seen a 200% rise in suicide rates in the 16 years between 2000 and 2016. Plus, many of these were screened and often medicalised.
This article does not aim to cover the complex range of issues, including social and emotional factors that contribute to the increasing rates of suicide. The primary focus of this article is the need for a nutritional psychiatry approach in addressing our mental health crisis, which is sorely missing from conventional psychiatry.
Given it’s International Stress Awareness week, we thought it pertinent to share some of the leading-edge information from the summit on suicide. Hosted by our friends at The Integrative Health Summit, an annual practitioner education event, this year focused on Nutritional Psychiatry: Rethinking the Role of Food, Nutrients & Microbes in Mental Health. The sobering take home was that the mental health tragedy unfolding before our eyes is largely preventable and we all need to become more aware, vigilant and proactive.
Anorexia and suicide
Dr James Greenblatt characterised suicide as the “hidden global epidemic” that’s gathering ever greater momentum. Did you know that suicide is now one of the leading causes of death globally? And those suffering from anorexia nervosa (AN) are 31 times more likely to commit suicide? When you also hear Dr Greenblatt’s clinical view that the use of micronutrient supplementation as a preventative measure is the single most important intervention in combatting AN, you realise how straight forward and low cost some of the early interventions could be if spotted early enough.
Dr Greenblatt has found that zinc deficiency is particularly prevalent in AN patients and went so far as to say that supplementation “brings them back to life”. It was also revealing that zinc deficient animals develop very similar symptoms to human AN sufferers. If you force-feed a zinc deficient primate, it will die, underpinning one of the reasons why re-feeding efforts are often unsuccessful in AN patients, if the micronutrient deficiencies haven’t been addressed first.
Dr Greenblatt’s presentation majored on this one micronutrient, going as far as saying that the single most common micronutrient need in prepubescent girls (who are most at risk of developing AN) is zinc. Less well known is that zinc deficiency is associated with meat aversion (zinc is essential for formation of hydrochloric acid and for the effective working of digestive enzymes). It is also associated with a reduction in taste and smell sense (involved in our desire to eat), nausea and bloating during refeeding, depression, problems sleeping and difficulty paying attention. Let alone being a co-factor in the essential fatty acid (EFA) conversion pathway, which affects brain chemistry. And then there’s its crucial and well known role in the immune system; kids with weakened immune systems are more likely to be given antibiotics routinely. These wipe out the gut microbiota, which in turn links back to brain function, given the vagal gut-brain connection.
Genes, environment and drugs
Whilst the role of drugs such as statins and anti-depressants in driving suicidal thoughts is now well known, less accepted is that a low intake of fats and low cholesterol, is directly correlated with psychosis and an increased risk of suicide. Dr Greenblatt has direct clinical experience of seeing how supplementation with fish oils reduces rates of psychosis. He has found low levels of essential fatty acids (EFAs) in the majority of his patients suffering from mental illness and eating disorders. So many people are eating damaged fats through poor dietary choices, which are altering the basic make-up of the human brain making it less able to cope with the stresses of modern life. Yet, there are still very few psychiatric programmes that test for EFA levels and recommend their supplementation.
It’s not just young girls who are taking their own lives. There has been a 30-40% rise in suicide rates across all ages, genders and races in the US in recent years. Around 60% of the brain is fat and cholesterol is crucially important to make every steroid hormone in the body (a few 100!), including the feel-good ones like serotonin and oxytocin.
Greenblatt referenced 40 years of research tracking low cholesterol as a risk factor for suicide. This is because low cholesterol levels correlate with an increase in suicide ideation. In people with high suicide ideation and low cholesterol, the risk of a successful suicide is as high as 85%.
Yet, there is no concept in conventional medicine of having a cholesterol level that is too low and statins are still being prescribed in vast quantities for prevention purposes. The same applies to dietary fats; governments want people to consume less than 35% total fat by energy in the diet (which we argue is too low for most people) and imply ‘the lower the better’. The science does not support this!
A normal cholesterol level is considered to be 4.5 - 5.1 mmol/L (175 - 200 mg/dL). Most suicide victims exhibit very low levels around 1.78 - 3 mmol/L (69 - 119mg/dL). The target cholesterol level for patients on statins with a risk of coronary disease is around 2 mmol/L (77 mg/dL) demonstrating just how big the disconnect is between our body’s biological needs and the drug-based target set by the biomedical establishment.
Whilst genes are involved in our potential for inheriting SNPs (single nucleotide polymorphisms) that may affect pathways that drive mental equilibrium, they also drive our suicidal tendencies. The heritability of suicide risk may be as high as 55% from clinical experience findings. Hence the need to check the family history for suicide or attempted suicide. A family history of substance abuse and biopolar disorder can also be a factor.
True upstream, health creative medicine functions on a biological and ecological, not a pharmaceutical, model of treatment.
Nourishing your mental health
Conventional medical treatments for mental health disorders still rely largely on targeting molecules in the brain with drugs in an attempt to suppress them, reduce their production or break chains of biochemical communication. This pharmaceutical model of treatment neglects to view the body holistically as the connected, complex system it is, complete with an array of feedback systems in which interference in one system has knock-on effects on one or more other systems. Drug side effects are a direct expression of these knock-on effects.
So severe is the extent of the mental health epidemic that even children are being prescribed psychiatric medication in ever greater numbers, with little effort being applied to looking for nutritional, lifestyle, psychosocial and emotional imbalances first.
We may have access to a greater variety and range of foods than ever before, but it doesn’t mean that we are receiving the nutrients we need for optimal health. The dramatic rise in ultra-processed foods has been accompanied by an avalanche of mental health problems, which isn’t coincidental.
In the US military, suicide rates are acknowledged conservatively as the loss of one service veteran an hour. Recognising the link with low omega 3 levels, the military has now produced two foods - a pound cake and fettuccini alfredo - which have added DHA. DHA is being used as a predictor of suicide, with low levels translating into a risk for suicide of 62% as opposed to those with the highest levels. Tellingly, the vast majority of these soldiers had not seen combat, so the suicides cannot be put down to PTSD alone. It’s why Dr Greenblatt called for practitioners to monitor their patient’s fatty acid levels more closely, recommending 3 months for a proper ‘oil change’ where appropriate.
Nutritional psychiatry offers a new paradigm in the treatment of mental health disorders. One that recognises the essential role of what we eat (or don’t), how we live and our genetic inheritance in treating and preventing mental health disorders.
Practical safeguards for your mental health
- Eat a diverse range of real, whole, unprocessed food to nourish your brain, your gut and your body
- Work with a qualified functional or integrative medicine health professional to establish if you have any nutrient deficiencies or genetic predisposition that may affect your ability to utilise the nutrients in your diet effectively
- Prioritise sleep and use it to revitalise your brain
- Keep moving daily. Exercise is powerful, evolutionary medicine too. Our HIIT & Gravity health hack videos show how to incorporate activity into your day that doesn’t take huge amounts of time
- Become an adept stress ‘surfer’ and use our top tips in our stress health hack to manage your stress more effectively
- Use intermittent fasting to balance your blood sugar, become metabolically flexible, rest your digestion, burn excess fat and carry out some much-needed cellular housekeeping (autophagy is also a factor in avoiding suicidal tendencies)
- Keep your gut happy - your microbes can be true partners in maintaining mental health balance if you treat them right
- Reduce EMF exposure from cellular devices, especially for children
- Take time out as our brains and entire neurological system is not adapted for the kind of constant stimulation that we are all exposed to in this new fast-paced, digital world
- Sleep in pitch darkness, avoid blue light before bedtime and consider supplementing with melatonin.
Comments
your voice counts
06 November 2019 at 10:04 pm
I find it very hard to accept that zinc deficiency is more important than factors such as loss , low self worth and so on in AN I remember zinc deficiency, hydrochloric acid deficiency,and lack of taste and hunger in AN being talked about in nutritional circles 30 years ago. I’m sure it plays a role as does good diet , and a good nutritional start in life but it could be tempting to some to see it as a quick fix.
08 November 2019 at 12:05 am
Thanks so much Katie for bringing this up. I've updated the article to clarify that the focus was specifically on the role that nutritional psychiatry can and should be playing in addressing mental health problems, not to address the full range of complex suicide risk factors. We agree, there's much more to it and everyone is individual, but we hope that Dr Greenblatt's extensive clinical experience can help bring much needed change.
Best wishes
Meleni
09 January 2020 at 2:52 pm
Of course zinc deficiency isn't the only micronutrient that may be related to AN, but once AN takes hold, it's inevitable that micronutrient deficiencies will occur.
So zinc and many other micronutrients may end up exacerbating the condition and preventing its improvement. As the mother of a young woman who had severe AN requiring several inpatient admissions some years ago, I am aware of the lack of importance given to nutrition by the NHS when 're-feeding' the patients, as I visited her there and took part in some of her meals. They were mostly highly-refined, carbohydrate-based 'junk' designed to 'fatten up' the patients with little regard, so it seemed, to improving their undoubtedly poor nutritional status. They were given some supplements but they were not very good quality nor provided more than the basic vitamins and minerals.
As a result of all the intervention (and likely poor diet), my daughter developed severe depression during her admission and shortly after discharge and once readmitted, in combination with various cocktails of antidepressants, steadily got worse (suicidal) and no attempt was made to improve her nutritional status. I was told that this time she was admitted for 'major depression' and they only looked into nutritional status for those admitted with eating disorders!!
Only after my research into the conditions and with my continued persistence did they agree to give her good quality multivitamin/mineral supplements, magnesium supplementation, natural vitamin D3 and Omega3 EFAs (that I provided to ensure they were bioavailable and 'food source'). I had read a lot of articles by the head of Lincolnshire CAMHS at that time, Professor Sami Timimi, which pointed me in that direction - and made me very unpopular with my daughter's psychiatrists!!
Thankfully my daughter is now recovered and understands the importance of nutrition for her future career in psychology.
10 January 2020 at 8:14 am
Hello, thank you for sharing your daughter's story. She was very fortunate you were able to give her such amazing support through her treatment and recovery process. It's great to hear she's made a good recovery and is in a position to be able to use her experiences to help other young people.
We think nutrition should be given a much higher level of importance across all healthcare systems as part of a system focusing on health creation and true prevention rather one that simply manages the symptoms of disease.
Warm wishes
Melissa
10 November 2019 at 3:16 pm
I started to write - as one who lost a beloved to suicide - not recently.
But I stopped and write instead that I do not connect or relate to what you are saying. Or is it the way in which is is framed?
I am not seeking sympathy nor to use my own experience to deny anyone else's'.
The nature of the subject can of course be fed into studies and statistics - as can life itself.
But the heart of the matter is relational - within ourself and among ourselves - both as one. Environments, exposures and toxicities are part of the physical framework as well as our cultural or social manipulations or consequences such as profit driven psychopharma feeding from a model of external causation and conflict management in support of 'lifestyle choice' portrayed as freedom.
Dispiriting is the opposite of inspiring. Breath once meany and felt Life - and still can if we tune in - but tuning instead to a thing-driven world becomes a war or siege under things that are imbued with meanings and associations of inner conflicts that by nature extremely conflicting and thus forbidden to bring to surface given over to escape or evasion.
Natural healing is a synchrony of natural being - which is not IN the body or world of things - but though it - as shared worth and meaning. When you love what you are doing it comes through in the space between the lines and the lilt of manner of your unique presence and contribution to the whole. But when we identify in a stuckness or struggle that only intensifies by all attempt to overcome or escape it - we can only seek love, life, health or wholeness OUT THERE in a world of disconnected things - that all the king's horses and men can never put together again - but they can generate a huge budget and remake the Economy on the basis of 'seek and do NOT find' while always keeping a carrot in front and never letting you forget the stick.
Epidemic used to be used for infectious disease - (or toxicities flagged up to infection that the body induces to drive out) - or am I mistaken?
But the business model of using fear of infection (or anything else!) to promote private agenda at other's expense is deceit that disempowers and dis-inspires by false premises - acted from as if true.
I see a ladder of growing that for example embodies self-caring by setting a new pattern of choice and behaviour that may be exercise, activity, interest or diet or all that and more - but does not equate the things themselves as the giver of health. 'Money cant buy me love' - but we can use it to facilitate conditions in which love arises of itself. When love of life springs forth from us to our world we know a healing within. The outer symptoms may disappear, fade or cease to be a defining 'identity' - but we are not in such a moment at odds with our own nature or 'getting in our own way'.
If we say it that way we wouldn't suffer it so, but the mind is also the capacity to set a narrative by which to justify seeing it some OTHER way - as if to escape a fear taken as truth itself.
How can anyone get through to one who cant but misinterpret everything?
Perhaps to be with them in a willingness for the inner conditions from which an appreciation spontaneously extends.
Everyone knows the difference between being truly accepted and being judged. And no one can accept someone truly whom they have first judged.
I still ended up writing more than I intended - but not so much in illuminating the self-hatred that in one form or another works a withholding and withdrawal from a hateful or meaningless life. Perhaps socially invisible in some sort of masking of outer conformity - that may even seem successful. But regardless the misuse of the word - if we don't know and share in love - what can possibly substitute - and how could it ever be enough?
Thanks for the comment box!
And for your attention.
Your voice counts
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