Delusions, disorganized speech, abnormal motor behavior, and hallucinations are some of the symptoms of psychotic disorders like schizophrenia, schizoaffective disorder, narcissistic disorder, and bipolar disorder.
These mental health disorders are severely debilitating conditions with an estimated worldwide prevalence of approximately 4.6 people per 1000.
Antipsychotic medicines are usually recommended as the first line of treatment for psychotic states.
They reduce hallucinations and delusions and help people think more clearly, but most importantly, such medications may improve long-term prognosis. Because untreated psychotic states can result in irreversible structural brain damage.
However, medications are not the only line of therapy useful for managing psychotic states, and the side effects of anti-psychotic medication may further lead to nutrient deficiencies.
To help support you or your loved ones manage mental health and psychotic states, here are some dietary and supplement considerations.
The human brain has a very high energy demand and consumes an immense amount of energy relative to the rest of the body. The brain needs a large amount of carbohydrates in order to function effectively. The choice of carbohydrates is critical for brain health.
Nutritional deficiencies critical to human health may result from insufficient intake or absorption are now a recognized risk factor for psychiatric disorders. [1,2]
High intake of nutritionally lacking foods is predictive of poor mental health, whereas a healthy diet reduces risk. [3-7]
Patients who experience psychotic states have been found to have ongoing inflammatory processes, higher levels of oxidative stress, mitochondrial dysfunction, decreased synaptic plasticity and neurogenesis, demyelination, and autoimmune diseases—all of which can contribute to disease progression. [8-10]
Disturbances in energy balance has also been linked to the pathobiology of several mental diseases, and so dietary management along with supplementation is becoming an important strategy for treating all psychiatric disorders.
So which dietary interventions and supplements support the management of psychotic states?
1. Reduction of saturated fat consumption
Fats are vital components of both neurons and glial cells. The types of fats consumed, saturated or unsaturated fats, have been proposed to play a huge role in brain function.
A 2019 study showed that relative to controls, patients with first-episode psychosis who were not taking antipsychotic medication consumed more saturated fat and had maladaptive eating patterns. [11]
To reduce the amount of saturated fats consumed I recommend reducing the consumption of animal products to a maximum of twice a week, and reducing processed foods rich in unhealthy fats to a bare minimum.
Choose healthy fats instead including olives, avocado, coconut, peanuts, cashews, almonds, Brazil nuts, pumpkin seeds, tahini or sesame seed paste.
Instead of animal products, be sure to increase your consumption of all types of legumes to supply sufficient healthy protein.
2. Consumption of healthy carbohydrates
In a large study of patients with manic depression or schizophrenia, the rate of diabetes was found to be significantly higher than in the general population. [12-14]
Processed grains and refined sugar are the worst types of carbohydrates for human consumption, not only due to lack of nutrients, but also in the way they ate grown and processed as well as the effects they lead to in the body.
When consumed with saturated fats on a regular basis, which is very common in the modern world, the likelihood of suffering from diabetes increases to 95%.
On the other hand, healthy carbohydrates are crucial for healthy functioning of the brain and lowered risk for suffering from mental illness.
For maximum effectiveness, consume at least three small meals a day that include a portion of healthy carbohydrates including whole oats, whole grains in the form of pasta, bread, buckwheat, or couscous, different types of whole grain rice, quinoa, oven baked potatoes and sweet potatoes, and beets.
3. Boost dietary antioxidant levels
Research shows that there is an association between deficits in antioxidant levels and increased psychotic episodes. Oxidative stress leads to grey matter loss and functional and cognitive impairment. [15]
Flavonoids are powerful antioxidants with demonstrated beneficial effects on human vascular function, on psychotic episodes and on improving memory and learning.
Foods richest phytochemicals called flavonoids include grapes, green tea (rich in the polyphenol EGCG – epigallocatechin-3-gallate), cocoa and wild blueberries.
Also higher plasma vitamin C in newly diagnosed schizophrenia patients receiving vitamin C supplementation (n = 40) were associated with greater symptomatic improvement over 8 weeks, so it is suggested to consume foods rich in vitamin C such as citrus fruit, brussels sprouts., potatoes, peppers, berries, blackcurrants and broccoli.
To avoid oxidative stress, you should also limit processed foods, exercise regularly, avoid pollutants, and quit smoking.
4. Increase foods and lifestyle habits that increase BDNF
In high levels of oxidative stress, above the cells buffering capacity, brain plasticity and cognitive function are impaired, probably due to a reduction in BDNF activity.
BDNF has been a relatively new focus of research of schizophrenia and depression. Low levels of BDNF in the plasma are also associated with impaired glucose metabolism and type II diabetes. BDNF is found to be reduced in the brain of patients with schizophrenia. [16-22]
Watch my video on how to increase BDNF levels naturally here:
5. Consume foods that prevent leptin resistance.
Like BDNF, leptin facilitates synaptic plasticity in the hippocampus [23] Watch my video on how to prevent leptin resistance here.
6. Avoid stimulants
A case study investigated stimulant-induced psychosis. The research concluded that people with a history of psychotic episodes should avoid synthetic and natural stimulants. [24]
Amphetamine, methamphetamine, and other stimulants inhibit dopamine uptake. In high and excessive doses, stimulants cause insomnia, irregular heartbeat, erratic behavior, and psychotic states.
Also natural stimulants like coffee, and foods high in sugar should be avoided. Sugar stimulates the brain, producing addiction-like effects and impaired cognitive function.
7. Increase essential fats
Polyunsaturated fatty acids are thought to play a large role in supporting optimum brain function. PUFA’s are capable of maintaining the optimal function of cholinergic neurons [25]
A recent study on the benefits of essential fats on psychotic disorders found that omega-3 supplementation effectively reduces symptoms. Patients with psychotic states such as those with schizophrenia have been found to have a lower level of polyunsaturated fatty acids in their brain’s frontal cortex. [26]
Omega 3 PUFS’s are very supportive for patients with mood disorders and should be consumed as a supplement regularly. I recommend a plant based omega 3 fatty acid source to prevent any contamination with toxic metals and other pollutants found in almost all fish currently available. [27]
You may also increase your levels of omega 3 PUFSa’s by consuming walnuts, flax or chia seeds daily added to oats, soups or sprinkled on salads.
8. Supplement with B vitamins
Blood levels of B vitamins are significantly reduced in psychiatric disorders. Folate (B9) and B12 are often deficient in schizophrenia, and are associated with symptom severity. Furthermore, B-vitamin supplementation can significantly reduce symptoms of schizophrenia and reverse some neurological deficits associated with the disorder. This is perhaps due to the neuroprotective properties of these nutrients, or the ability of B vitamins to lower homocysteine levels, which adversely affects mental health. [28-34]
Vitamin B3 (niacin) is also essential in alleviating psychotic episodes. [35]
A study on the relation between niacin and psychiatric manifestations concluded that niacin deficiency is a contributing factor in schizophrenic patients. Therefore, adequate niacin / Vitamin B3 supplements should be taken with food to prevent an upset stomach. Niacin can be toxic to the liver at high doses and should not be taken by people with existing liver issues. It is best taken in low doses as part of a B complex supplement.
9. Supplement with Vitamin D
Vitamin D is implicated in schizophrenia onset and is associated with worsened physical and mental health outcomes.
A few studies examined correlations between vitamin D and psychiatric symptoms all of them finding some link between low vitamin D levels and worse mental health state. [36-48]
Takeaway
Research shows there is an association between symptoms of psychotic disorders and diet and nutrient levels. Therefore, patients with mental illnesses and psychotic episodes should be proactive about choosing foods and supplements that can help manage psychotic states which can improve not only immediate functioning, but also long-term prognosis. Any supplement treatment should aim to be low dosage and ongoing.
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