It wasn’t that long ago that it was thought that the brain health had little to do with the health of our body – that is physical and mental health were entirely separate. It was our genetics, predisposition or a life event that caused our (fill in the gaps) depression, anxiety, stress, sadness, flat mood, behavioural problems. Well, that’s all in the past, and today there is an explosion of recognition of how biology and psychology interplay. Read on to find out more about the latest thinking in the ways the environment and physiology play in mental health and what we can do about it.
However, before I carry on, the cause and treatment of mental health can be complex – one size doesn’t fit all – so the first thing I want to make sure you are aware of is that the psychological treatment of mental health issues from psychiatric or counselling sessions and in some cases medication, are valid and important. The information I provide below is not to be used to instead of but to enable you to have the latest information at your fingertips. That means that you are your mental health provider can make the best health choices for your situation.
Biology and mental health 101
So, what we now know is that both body constitution factors – the unique way our body responds and acquired and environmental factors may play a part in mood imbalances.
- Body constitution factors
May include biological factors we are born with or inherited from our parents such as;
- Methylation ability. It is believed that genetic mutations may lead to abnormalities in the methylation. Methylation is a vital metabolic process that happens in every cell and every organ in your body, taking place a million times a second. Life would not exist without it. Think of billions of little on/off switches inside your body that control everything from your stress response and how your body makes energy from food to your brain chemistry (the making of neurotransmitters) and detoxification. If there’s a problem with methylation, it is thought that a number of different psychiatric symptoms may arise. These symptoms are thought to be because a person is an “overmethylator” vs an “ undermethylator.” We can do tests (such as the MTHFR Mutation SNP test or a histamine test) to see if you have this mutation Then we can treat accordingly.
- Pyrrole disorder, also known as pyroluria, kryptopyrrole, Mauve disorder, or kryptopyroluria is a biochemical imbalance involving an abnormality in haemoglobin (the stuff red blood cells are made of) synthesis leading to the overproduction of hydroxyhempyrolin (HPL). This HPL binds zinc and vitamin B6, preventing their use by the body and excretion in the urine and hair. It is thought to be a genetic or acquired condition. In short, there are three main nutrients not properly absorbed in the pyroluric sufferer:
- vitamin B6
Deficiencies of these can cause a debilitating combination of symptoms that will vary from person to person. B6, in particular, is necessary for the creation of red blood cells increases energy levels and thinking. A deficiency of B6 will often cause inflammation, depression, and sometimes anaemia. Magnesium is a muscle relaxant, and a deficiency can be the cause of muscle tension, sleeplessness, constipation issues, and even nervous twitching. Zinc, on the other hand, is vital for concentration, memory, and good digestion, and when lacking, can lead to anorexia, leaky gut syndrome and digestive disease.
Both zinc and vitamin B6 are essential for the production of neurotransmitters such as serotonin (our happy hormone), melatonin (our sleep hormone), GABA (our relaxation hormone), and acetyl choline (important for memory). They are also very important in the production of cortisol (our anti-inflammatory and stress hormone). Pyrrole disorder is seen in children, adolescents and adults previously diagnosed with ADHD, autism, Asperger’s syndrome, anxiety, depression, Tourette syndrome, behavioural disorders, learning disorders, and fears/phobias.
Genetics and Neurotransmitters. Low or high levels of neurotransmitters are seen in various mental health disorders, such as depression, attention-deficit hyperactivity disorder (ADHD), Parkinson’s disease and panic attacks. It is well documented that there is a genetic variance of neurotransmitters (such as serotonin and dopamine) and how they are carried in the body. This difference seems to contribute to the behaviour and neuropsychiatric disorders. Although we are unable to easily test for gene expression of these transmitters in the clinic one of the functional tests we can do is a neurotransmitter profile via a urine test – we test for six neurotransmitters: serotonin, GABA, dopamine, noradrenaline, adrenaline and glutamate. These neurotransmitters are the most researched about their effects on mood disorders, hormones, sleep, glucose/insulin balance, pain perception, appetite and cognitive function. We may also wish to test for histamine another important neurotransmitter which is important when looking at how well our patients are methylating.
- Dysbiosis (or the imbalance of microorganisms in our digestive system) It is great to see that scientists have caught up with the fact that gut function – in particular, the make-up of the population of microorganisms in our digestive system is key to our mental health. Recent studies indicate that altering gut microflora with probiotics or diet may cause emotional or behavioural changes. A nutritionist or naturopath will ensure gut, and liver function is optimal (checking for inflammation, infection, dysbiosis, SIBO, food insensitivities, Candida and so forth) and treat accordingly when a patient has mental or mood imbalances.
- Gilbert’s syndrome. Gilbert’s Syndrome is an inherited condition that is caused by certain gene mutations that are passed down through family generations. Typically it is mild and is characterised by the inability of the liver to process bilirubin but can sometimes be associated with psychiatric illness.
- Childhood trauma. Child abuse is a serious national and global problem that cuts across economic, racial and cultural lines. In addition to harming the immediate wellbeing of the child, maltreatment and extreme stress during childhood can impair early brain development and metabolic and immune system function, leading to chronic health problems. As a consequence, abused children are at increased risk for a wide range of physical health conditions including obesity, heart disease, and cancer, as well as psychiatric conditions such as depression, suicide, drug and alcohol abuse, high-risk behaviours and violence.They are also more susceptible to developing post-traumatic stress disorder (PTSD)-a severe and debilitating stress-related psychiatric disorder-after experiencing other types of trauma later in life.
Part of the explanation is that child abuse can leave marks, not only physically and emotionally, but also in the form of epigenetic marks on a child’s genes. This can alter fundamental biological processes and adversely affect health outcomes throughout life.
- Heavy metal toxicity. Exposure to heavy metals and their accumulation in our bodies can lead to a wide variety of mental health issues. These heavy metals from Mercury and Cadmium through to Aluminium and Lead may be passed through from mother to child or through environmental and food exposure during our lives. Toxic metal exposure can result in a wide array of common mental health disorders that can mimic many psychiatric “diseases” – not only the results of the metals toxicity but indirectly as these metals can block the body’s use of minerals such as zinc, iron, copper, B vitamins and so forth which are essential for health. Some of the metal-related neuropsychiatric symptoms include memory loss, cognitive impairment, attention deficit disorder, fatigue, irritability, aggressive and violent behaviour, bipolar disease, obsessive-compulsive disorder, depression, anxiety, and panic attacks. The first signs of heavy metal toxicity may include fatigue or mood change with abnormal blood tests such as liver readings, B12, iron or zinc with no easy explanation. We can test for heavy metals using functional tests (such as urine, hair or the Oligoscan).
- Acquired or environmental factors
Life throws many things at us – those out of and those within our control. The acquired factors that we now know may play a part in our mental state include;
- Stress and trauma (including childhood trauma)
- Sex hormone imbalances
- Illicit drug taking
- Acidosis Poor diet which may take our body into an acid state (acidosis)
- Gastrointestinal dysbiosis as above but acquired through diet and lifestyle – such as eating a predominantly processed poor diet, alcohol consumption, gut infections and excess antibiotic use
- Thyroid and HPA axis (responsible for the stress response) imbalances
- Nutritional deficiencies (such as B vitamins, Vitamin D, iron, protein…) and excess
- Chronic inflammatory conditions
- Sleep issues
How do we find out and treat what is going on?
During an initial health consultation, your qualified natural healthcare provider (Registered naturopath or integrative Doctor) may use questioning and perhaps questionnaires (such as DASS21 to measure depression, anxiety and stress scores, methylation score or others) to assess your psychological state and to collect information about your overall physical health. This information may include sleep patterns, diet and eating and drinking patterns, alcoholic consumption, underlying illnesses (from diabetes to thyroid dysfunction), gut function, signs of inflammation, and nutrient deficiencies. Then it may be recommended that you go for blood tests or functional tests to provide a fuller picture but this may not always be necessary.
Tests may include;
- Blood tests – from female or male sex hormones (testosterone, oestrogen, progesterone, prolactin), CRP, pyrroles, thyroid, parathyroid, B12/folate, iron, blood sugars, complete blood count, cortisol, serum histamine, vitamin D….
- Functional tests – DUTCH hormonal, cortisol and melatonin, adrenocortex profile, methylation, Fitgenes genetic profiling, gut function (including SIBO, stool samples…), heavy metal and environmental toxins and nutrient deficiencies, neurotransmitters, food and environmental allergies pyrroles, and so forth
Once we have a full picture, we can then develop a programme – including lifestyle, diet and herbs or nutrients to get you back on track. We may also wish to refer you through to a mental health specialist such as a counsellor, psychologist or psychiatrist for further evaluation to provide a holistic approach to treatment.
Contact Sheena Hendon today to find out more about how we can get you back on the road to well health
Information sources and references
Malan, Stefanie & Valles-Colomer, Mireia & Raes, Jeroen & Lowry, Christopher & Seedat, Soraya & Hemmings, Sian. (2017). The Gut Microbiome and Mental Health: Implications for Anxiety- and Trauma-Related Disorders. OMICS: A Journal of Integrative Biology. 22. 10.1089/omi.2017.0077. https://www.ncbi.nlm.nih.gov/pubmed/28767318
Mehta D, Klengel T, Conneely KN, Smith AK, Altmann A, Pace TW, Rex-Haffner M, Loeschner A, Gonik M, Mercer KB, Bradley B, Müller-Myhsok B, Ressler KJ, Binder EB. Childhood maltreatment is associated with distinct genomic and epigenetic profiles in posttraumatic stress disorder. Proceedings for the National Academy of Sciences, 110(20):8302-7. 2013. [PubMed]