Folks Who Suffer Mental Illness Should Eat Their Veggies

Recently, I was meeting with a young person who was struggling with depression and self-actualization, and between comments, they took a big sip of Dr. Pepper, a soda containing 40 grams of sugar. Sugar tastes great and may provide a jolt of energy, but it also contributes to inflammation by releasing cytokines, which damage cell growth.

In mid-May The Economist showed the connection between autoimmune disorders and mental illnesses like attention deficit hyperactivity disorder, autism spectrum disorder, and schizophrenia. This misattribution often arrives in the therapy office, too, where patients with depression or anxiety are also poorly nourished or affected by personal dietary choices. For instance, two of my recent patients arrived with anxiety and insomnia, and after much discussion about their caffeine levels, they finally took a week off. One of those patients felt his issue was resolved and he moved on. The other has far less anxiety and no insomnia.

I have yet to see a patient struggling to transition to adulthood or those with depression make healthy dietary choices. They also don’t seem to get physical movement. This has an impact on what neuroscientist Lisa Feldman Barrett calls “body budget,” how our bodies regulate chemicals and hormones, including ones associated with how we feel, think, and behave. As therapists, we often focus on emotions, which Dan Siegel terms as the value-appraising part of cognition. According to Barrett’s research, we use emotions to predict how to regulate and allocate energy to keep ourselves safe and in homeostasis. Within this context, emotions stem from interoception, the “sensations from your internal organs and tissues, the hormones in your blood, and your immune system,” which allocates energy throughout the body.

As signals bounce around the body and the brain, the mind labors to make sense of things in ways that Barrett notes are “personally meaningful.” By now, all of you cognitive theory folks out there are nodding: hunger, anger, loneliness, and tiredness are the clues that one may need to halt, lest one mistake these unpleasant sensations for unpleasant emotions or overweight automatic negative thoughts. But what if hunger is sated by a standard American diet, termed SAD because the overly processed, high-carb intake is linked to wide-ranging health consequences, affecting how we think and feel? As Barrett illustrates, “You are the architect of your experience” and “believing is feeling.” What someone may be feeling is malnourishment. Thus, context and self-awareness are great antidotes.

However, sometimes we can reverse-engineer things by using cognitive dissonance to our advantage. Rather than work on the emotions and changing thoughts, change behaviors and allow the brain to change its own mind. Focusing on sleep, diet, and exercise could be a simple access point for working with those experiencing a delayed transition to adulthood because it could give them a way to engage with chores around the house while improving their body budget. First, you could implement a gradual morning workout schedule, where the person wakes up at a set, consistent time and does a simple lap around the block. Next, we could find ways to implement meal planning as a way to gain self-efficacy.

Neuroscientist Kirk Nylen has shown how ketogenic and low-carb diets garner “huge improvements in mood.” His randomized control trials had better results for folks who had no success with “medications, talk therapy, trans-cranial stimulation and electroconvulsive-shock therapy.” A simple diet like one by Michael Pollan or Mark Bittman, where one eats unprocessed food and mostly plants (but not too much), would provide better nutrition throughout the day while improving not only one's body budget but also a sense of meaning and purpose. The effects of this would likely compound over time as the budget becomes a surplus. As the behavior becomes ritualized, the mind may also follow in a fruitful direction.