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I have just returned from presenting on alternatives to pharmaceuticals for children and adolescents at an innovative conference held at Monmouth University entitled A Bitter Pill to Swallow: Creating New Pathways and Alternatives to Medication in Child and Adolescent Mental Health. There is growing dissatisfaction with psychotropics for many reasons including poor efficacy and damaging side effects. In the next several months I will focus on the role of nutrition in mental well being
Most of the clients with PTSD with whom I have worked with have experienced depression, anxiety, sleep problems, pain, and digestive problems. Many of them also show symptoms of dissociation as well as eating disorders, addictions, seasonal affective disorder (SAD), premenstrual syndrome (PMS), and menopausal or andropausal symptoms. PTSD ages with the individual; what may be PMS experienced in the thirties can become severe menopause in the fifties; what is depression in the forties is exacerbated when estrogen drops in the fifties; what is fitful sleep in the forties is chronic insomnia by the sixties, when melatonin reserves are low. Treatment thus becomes both preventive and preparatory for aging with PTSD.
Stress and trauma affect all aspects of physical function: blood glucose levels, brain metabolism, energy, and alteration of brain structures where neurons misfire or fail to communicate. Stress disrupts the autonomic functions which normally signal digestive enzyme release and stress and dysregulates hormones—all of which affect mood, cognition, sleep, and immune function. PTSD and its sequelae of depression, anxiety, insomnia, eating disorders, self harm, and addictive behaviors can be treated effectively using diet, nutrients, and botanicals. Every person can benefit from a holistic approach to restore mental health without the use of pharmaceuticals.
The question the clinician must answer is: Who will choose to or be able to benefit from this approach?
Not everyone is willing or able to afford what is required. Quality foods and nutrients are often expensive, and the time required for food preparation and detoxification can be demanding. Only a small percentage of people will be able to make the sustained commitment required intensively over several years and then for lifetime maintenance. But the rewards are worth it and they promise good health.
People with depression, anxiety, and PTSD have often had unsatisfactory results with pharmaceuticals used to manage symptoms or they may have experienced intolerable side effects. Often they look to their therapist or physician for information about alternatives and the therapist may need to liaise with other providers. Nutrition and self-medication pose special challenges for treatment. Clients often self prescribe nutrients and herbs and may withhold information about her/his activities from other practitioners because she may know about or be concerned about possible biases. Thus I always ask a client about her/his use of OTC medications, nutrients and herbal medicines and let them know that many are effective. It also provides an opportunity to discuss finetuning a protocol that is individual specific.
Possessing scientific knowledge about the efficacy of alternative approaches will support the client who wants to avoid, reduce, or eliminate pharmaceutical use. The therapist is often called upon to:
• support a client’s desire to find alternatives to pharmaceuticals by having working knowledge of the options for treatment;
• discuss the range of alternatives to pharmaceuticals where either the side effects or low efficacy warrant a change;
• provide referrals to a competent nutritional therapist or botanical consultant if the client is self prescribing and requires professional analysis.
There are a number of principles to follow with clients:
Principle 1: There Is No One Diet for Everyone
In psychotherapy, we treat the individual, not the illness. In nutrition, individuals have unique needs and require different nutrients and foods to address specific requirements. The term biochemical individuality is a concept that explains the biochemical and metabolic differences among people and their wide variations in response to nutrition. The three major principles of biochemical individuality are as follows: (1) there is no one diet for everyone, (2) Dietary needs can change throughout the life cycle, and (3), nutrition must focus on the individual , not the disease.
This principle will apply to both dietary approaches as well as nutrients and botanicals.
In the blog posts that follow I will discuss basic principles and approaches to the use of nutrition.
