There is a Mental Health Crisis in the United States: Here is How Functional Medicine Can Help

Violent crimes, suicides, and mental health problems are on the rise.^1-4 They take over the headlines and dominate conversations. They might affect us directly, or our loved ones. Are these social problems something that we just put up with or can we change them?

Functional medicine has a number of effective treatments for mental illness. For behavioral problems, explosive rage, substance abuse, suicide, depression, and more, there are treatments that can improve symptoms dramatically without side effects.

Why don’t more people know about these natural mental health treatments? It’s a mystery because the science is clear that they can help. Read on to learn the ten critical areas necessary for brain health and resilience. We will explore the tests and treatments that clinicians and consumers need to know for stable mood, impulse control, and to feel happier and more at ease. These natural treatments carry no side effects and should be the first steps- not the last steps- when addressing mental health disorders. They can be used alone or in conjunction with medication. Share this information with practitioners, family, friends, and anyone who could benefit from natural treatments for a healthier brain.

We are living in trying times. Child and adolescent mental health was declared a national state of emergency in 2021. Depression, anxiety, and suicide rates are up, especially since the pandemic.^1-4  Mass shootings pepper the headlines. More than ever, we need to strengthen brain function so that we can endure stressors without hurting ourselves or others. We need to improve our resilience to crisis and stress.

Acts of violence, especially those taking place at schools, workplaces, or movie theaters are especially disturbing and tragic. Violent crime is the act of physical aggression against another, while suicide is physical aggression turned inward, toward oneself. While people who commit violent acts can have a mental illness, most people with mental disorders are not aggressive or violent.⁵  Substance use disorders actually show the highest rate of violence, higher than schizophrenia, bipolar disorder, or psychotic disorders.⁵

Image by S. Hermann & F. Richter from Pixabay

Perpetrators of mass acts of violence display mental-emotional symptoms beforehand, according to The Violence Project. They often have weathered a notable crisis in the months to years leading up to the crime, but psychosis is not usually a contributing factor.

Improving psycho-emotional health could help to reduce acts of aggression and violence. By building a healthier brain, each person has better resilience to stressors and crises. They can make better choices. Providing the brain with the nourishment it needs promotes a more stable mood, helps overcome substance addiction, calms down rage, can diminish suicidal thoughts, and could reduce acts of violence.

The Conventional Medical Approach to Mental Health Disorders

Conventional medicine addresses mental illness with a combination of medications, psychotherapy, and/or hospitalization if needed. For example, depression is treated with antidepressants and psychotherapy. Suicidal ideation, or the plans to commit suicide, is first treated with hospitalization to protect the person from doing harm to themselves. They might be given antidepressants if they have bipolar disorder or antipsychotic medications if they have schizophrenia. Patients who struggle with substance abuse are recommended to carry out a detoxification program in a hospital setting. They may be given medications to treat withdrawal symptoms, counseling, or antidepressants to address underlying anxiety or depression.

A Functional Medicine Approach to Mental Health

Functional medicine looks at root causes when addressing any illness. In order to have good mental health, each of us needs essential vitamins, minerals, amino acids, and fatty acids. We need to avoid foods that are ultra-processed and depleted of brain health nutrients. Hormones must be balanced because they keep our moods in check. Maintaining a healthy blood sugar throughout the day and getting enough sleep are vital to brain health.  Functional medicine sees the whole person when looking for root causes of brain dysfunction. Nutrition and metabolism and hormones are not the only things that need to be balanced for a healthy brain. Community, spirituality, and relationships are necessary. Fresh air and sunshine.

Image by Gerd Altmann from Pixabay

Functional medicine treatments can be used at the first sign of brain health problems to turn around depression, anxiety, behavioral disorders, or attention problems. Because they are generally recognized as safe, they can be used in conjunction with standard medical and psychotherapy treatments.

Because functional medicine address the root causes of an unhealthy brain, the treatments for brain health can improve a large variety of mental illnesses, not just one. Think of a garden as an example. When you improve the soil quality and provide sunshine and water and nutrients, every plant grows better. Likewise, when the brain gets all of the foundational nutrients it needs, many neuropsychiatric symptoms improve.

A Functional Medicine Approach Can Improve These Brain Health Imbalances:

• ADHD
• Aggression
• Anxiety
• Bipolar disorder
• Depression
• Explosive rage
• Irritability
• Schizophrenia
• Suicidal thoughts or tendencies
• Substance abuse and alcoholism
• Unstable mood
• Violence

How Junk Food Harms Our Brains

Photo by Ashley Green on Unsplash

Our brains require over 30 micronutrients to make neurotransmitters and dispose of them, according to Dr. Bonnie Kaplan, PhD and Dr. Julia Rucklidge, PhD, renowned research and clinical psychologists. Dr.s Kaplan and Rucklidge write that a whole foods diet leads to fewer depression and anxiety symptoms compared to those who eat a poor diet of ultra-processed food. The foods in question? Sweetened breakfast cereal, packaged snacks, and chicken nuggets, to name just a few.

Eating a whole-foods diet with the micronutrients that the brain needs influences irritability, explosive rage, and unstable mood. The evidence is overwhelming and has been shown in a dozen studies from countries like Canada, Spain, Japan, and Australia, the researchers say.

Dr. David Brady, a licensed naturopathic medical physician, echoes that sentiment. Even in a country of abundance like the United States, he points out that people can still be malnourished. He says eating ultra-processed convenience or “junk” foods devoid of nutrients and high in calories, instead of whole foods, contributes to the epidemic of chronic illness, including mental illness.

Amino Acids Fuel the Brain and Neurotransmitters

In people struggling with mental health, aggression, substance abuse, depression, or suicidal thoughts, using nutritional supplements to balance amino acids and neurotransmitters is a top priority.

Amino acids are the building blocks for mood chemicals that the brain, spinal cord, and whole body use to function properly. In addition to making feel good mood chemicals like serotonin or dopamine, amino acids themselves also act as neurotransmitters.

Where do these important brain chemicals come from? Healthy proteins in the diet. But eating high quality protein is not always enough. If your digestive tract isn’t working well to break down and absorb your protein, then your brain may be starving nonetheless. Protein can be going in and going out, without being used. That is just one way gut health can influence brain health.

L-Tryptophan is necessary for brain health. With this amino acid, the body can make serotonin and melatonin. Serotonin is important for mood, sleep, sexuality, and appetite regulation.

Symptoms of Low Serotonin Include:

• Alcoholism
• Anxiety
• Depression
• Insomnia
• Migraine
• Suicidal thoughts
• Violence

Phenylalanine is another critical amino acid for brain health and stable mood. It provides the building blocks to make the neurotransmitters norepinephrine, epinephrine, and dopamine. Why do these matter? Norepinephrine (or noradrenaline) is involved in attention, and impulsivity. It gets us ready for fight-or-flight when we sense danger. You’ve heard of an “adrenaline rush.” Adrenaline, or epinephrine, is essential for fight-or-flight and our stress response. The neurotransmitter dopamine is a major player in the brain, affecting movement, memory, attention, and problem-solving. Dopamine drives our motivation and our desires. If any of these neurotransmitters are too low, it can cause depression, fatigue, and sleep problems. It can be a sign that the body’s stress hormone, cortisol, is out of balance (discussed later). High levels can be a problem, too.

Even beyond the select amino acids and neurotransmitters mentioned here, the brain needs all of the essential amino acids to produce healthy levels of brain chemicals for a stable mood, stress resilience, and to cope with crisis.

Wondering how to measure amino acid and neurotransmitter levels? See our testing recommendations at the end of this article.

B Vitamins for Mood and Stress Response

When your mood is low, it could mean that your B vitamins have run dry. B vitamins help make neurotransmitters and amino acids that operate in the brain. However, they are not stored in the body, so we need a constant supply of them. The B vitamin folate, or methylfolate, is used to treat major depressive disorder. It improves the efficacy of antidepressant therapy, especially in those who are not getting better.⁶ Vitamin B6 has been used in the treatment of schizophrenia^7,8 and epilepsy. B vitamins are known to support the stress response. The adrenal glands use B vitamins, as you’ll see in the section on cortisol. People who have depression, schizophrenia, or high stress may benefit from higher doses of B vitamins for a period of time.

The Brain Is Made of Fat, So Dig In

The evidence is overwhelming for the role of essential fatty acids in a healthy brain. However, 95.7% of Americans have suboptimum levels of omega-3 fatty acids.⁹ Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are important for memory, learning, brain development, and cognition.¹⁰ They also can promote a positive mood, focus, attention, and social development.¹¹ They slow down brain aging.¹² If eating fish or flax seeds is not part of your daily routine, then other supplements for these vital fatty acids are necessary.

Image by Pete Linforth from Pixabay

Balance Cortisol and Bounce Back from Stress

We all know that a serious stressor can send us into a tailspin. Unfortunately, stress and trauma are unavoidable parts of life. One of the important ways to build up a person’s resilience to stress and trauma is to make sure the body has healthy levels of stress neurotransmitters and hormones.

Cortisol is one stress hormone that, when out of balance, can cause a host of mental health symptoms.

Symptoms of Imbalanced Cortisol:

• Anxiety
• Agitation
• Depression
• Drug and alcohol addiction
• Fatigue
• Insomnia
• Paranoia
• Weight gain, especially around the middle

Made by the adrenal glands, cortisol helps to wake you up in the morning and puts you to sleep at night. It will spike in a stressful situation and trigger a fight-or-flight response. Cortisol works together with other neurotransmitters and hormones to turn on the stress response and end it when the danger has passed. It does this through its role in the hypothalamic-pituitary-adrenal (HPA) axis. We mentioned norepinephrine, epinephrine, and dopamine above and they are also key players in the HPA axis. When cortisol is chronically elevated, it can crash, leaving patients exhausted, depressed, and unable to cope with life. This is commonly referred to as “adrenal fatigue,” adrenal dysfunction, or HPA axis dysfunction.

Hormonal Balance and the Brain

Move aside stress hormones; sex hormones must be balanced for good mood, energy, and a healthy response to stress. These powerful substances can transform a person’s brain, body, and metabolism. Imbalanced levels of hormones can cause depression, anxiety, fatigue, aggression, hopelessness, and insomnia. These hormone imbalances can get in the way of a healthy sexual relationship.

Testing a person’s hormone levels with a urine or salivary test is generally considered far better than a standard blood test. Once low or high hormone levels are identified, bioidentical hormone replacement therapy and nutritional and herbal supplements are used to get hormone levels into the normal ranges.

Don’t Let Gut Dysbiosis and Food Sensitivities Get You Down

The majority of functional medicine practitioners take a hard look at gut health and food sensitivities when there are stubborn mental health challenges. Popular quotes such as “all disease begins in the gut,” or “the gut is the second brain,” help to get across the idea that the brain relies on gut health. Bacterial overgrowth, inflammation, poor digestion, parasites, and more can make it impossible for a person to feel good. Food sensitivities can cause fatigue, angry outbursts, attention problems, hyperactivity, mood swings, and more. These individuals might be resistant to typical treatments for mental health because the root causes are hidden from view. Gut symptoms such as heartburn, diarrhea, abdominal pain, or constipation serve as a clue that the gut is involved in symptoms such as depression, anxiety, insomnia, or attention deficit hyperactivity disorder (ADHD).

Diagnostic Solutions Laboratory’s GI-MAP stool test and IgG Food Explorer can help identify gut health problems that contribute to mental disorders.

Other Vital Needs for Brain Health

If you have ever felt “hangry” then you know all too well that you need balanced blood sugar for a healthy mood and brain. Integrative psychiatrists Dr. Hyla Cass, MD and Dr. Ellen Vora, MD address blood sugar balances first in all of their patients complaining of brain health problems. It’s perhaps too commonsense to make the headlines, but eating whole foods with healthy protein, fats, and complex carbohydrates can cure depression, anxiety, irritability, energy problems, and sleep disturbance. Exercise, sunshine, fresh air, and sleep are other necessities for a healthy brain, but we cannot expand on them here.

We are not just physical and biochemical beings. We are psycho-emotional and spiritual beings. A comprehensive approach to mental health must go beyond balancing the chemicals in the brain and spinal cord. It must address other needs such as feeling loved, belonging, having a purpose, connecting with community, and connecting with nature.

Functional Medicine Testing and Treatments to Improve Brain Health and Resilience

Testing

The following tests are available to determine levels of these brain-healthy nutrients, neurotransmitters, and hormones. Work with an integrative and functional medicine practitioner to test and correct these lab findings.

Photo by National Cancer Institute on Unsplash

• Plasma amino acids
• Neurotransmitters
• Serotonin (urinary 5-hydroxyindoleacetate)
• Norepinephrine and epinephrine (urinary vanilmandelate)
• Dopamine (urinary homovanillate)
• B vitamins in blood or urinary B vitamin functional markers
• Salivary cortisol
• Red blood cell fatty acids
• Salivary or urine sex hormones
• Stool testing such as the GI-MAP stool test
• IgG food sensitivities
• IgE food allergies
• Fasting blood glucose and insulin

The OMX Organic Metabolomics test from Diagnostic Solutions measures neurotransmitters, amino acids, B vitamins, and urine cortisol, making it an excellent all-in-one panel for uncovering hidden causes of mental illness.

Natural Treatments for Brain Health

• Choose a whole-foods diet with healthy protein, fats, vegetables, complex carbohydrates, and fiber.
• Start the day with breakfast and eat regularly throughout the day, paying attention to blood sugar swings.
• Eat the rainbow of fruits and vegetables.
• Avoid ultra-processed foods such as cereal, packaged snacks, crackers, sweets, chicken nuggets, and refined flours.
• Use activated B vitamins such as methylfolate, methylcobalamin, or pyridoxal-5-phosphate, based on test results.
• Take a balanced amino acid mixture containing tryptophan and phenylalanine, based on test results.
• Eat low-mercury, fatty fish daily or take a high-quality supplement of omega-3 fatty acids EPA and DHA.
• Use adrenal and stress support supplements based on testing.
• Take a high-quality multivitamin mineral.
• Get 7-8 hours of sleep each day.
• Get physical activity every day if possible.
• Find ways to lower your stress that work for your schedule, such as mindful meditation, breathing exercises, yoga, naps, reading, or prayer.
• Work with an integrative and functional medicine provider to balance hormones, if needed.
• Work with an integrative and functional medicine provider to address imbalances of gut microbiota and food sensitivities.

Take a look at my article, “Buyer’s Guide to the Best, High-Quality Supplements for You and Your Family,” to learn more about selecting quality supplements.

Build Resilience and Brain Health

Our brains are secretly starving. While this is not the only factor in violent crimes, it is a contributor, just as it contributes to mental health problems throughout the world. Amazing results happen when giving the brain what it needs to work: amino acids, tryptophan, B vitamins, fatty acids, balanced hormones, whole foods rich in nutrients, optimizing gut health and sleep and exercise. These areas of intervention can be adopted and promoted by health professionals and consumers alike. These natural treatments carry no side effects and should be the first steps- not the last steps- when addressing mental health disorders. Laboratory testing is available to practitioners to find out a patient’s biochemical imbalances. High-quality supplements that nourish the brain can improve brain biochemistry and turn lives around without the need for medication. This is a low-risk approach that brings success to countless patients of functional medicine. Everyone deserves to know about these natural solutions to prevent and treat depression, suicidal thoughts, substance abuse, aggression and violence. It builds mental-emotional resilience in times of crisis, reduces the risk of hurting oneself or others, and can save lives.

About Diagnostic Solutions Laboratory

Diagnostic Solutions Laboratory bridges the gap between healthcare providers and the clinical laboratory by offering cutting-edge laboratory tests such as GI-MAP, OMX (Organic Metabolomics), IgG Food Explorer, IgE Allergy Explorer, CytoDX, and GenomicInsight. Designed to identify underlying root causes of symptoms and disease, our test results give practitioners the tools needed to formulate personalized treatment protocols for optimized patient outcomes. Our commitment to education and service ensures both practitioners and their patients will benefit from the latest research.

References

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3. Ettman CK, Cohen GH, Abdalla SM, et al. Persistent depressive symptoms during COVID-19: a national, population-representative, longitudinal study of U.S. adults. Lancet Reg Health Am. 2021:100091.
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7. Miodownik C, Lerner V, Cohen H, Kotler M. Serum vitamin B6 in schizophrenic and schizoaffective patients with and without tardive dyskinesia. Clin Neuropharmacol. 2000;23(4):212-215.
8. Shiloh R, Weizman A, Weizer N, Dorfman-Etrog P, Munitz H. [Antidepressive effect of pyridoxine (vitamin B6) in neuroleptic-treated schizophrenic patients with co-morbid minor depression–preliminary open-label trial]. Harefuah. 2001;140(5):369-373, 456.
9. Murphy RA, Yu EA, Ciappio ED, Mehta S, McBurney MI. Suboptimal Plasma Long Chain n-3 Concentrations are Common among Adults in the United States, NHANES 2003-2004. Nutrients. 2015;7(12):10282-10289.
10. Chang JP, Su KP, Mondelli V, Pariante CM. Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies. Neuropsychopharmacology. 2018;43(3):534-545.
11. Hibbeln JR, Davis JM, Steer C, et al. Maternal seafood consumption in pregnancy and neurodevelopmental outcomes in childhood (ALSPAC study): an observational cohort study. Lancet. 2007;369(9561):578-585.
12. Lin PY, Chiu CC, Huang SY, Su KP. A meta-analytic review of polyunsaturated fatty acid compositions in dementia. J Clin Psychiatry. 2012;73(9):1245-1254.

Cass Nelson-Dooley, M.S.

Cass Nelson-Dooley, MS, is a researcher, author, educator, and laboratory consultant. She studied medicinal plants in the rain forests of Panama as a Fulbright Scholar and then launched a career in science and natural medicine. Early on, she studied ethnobotany, ethnopharmacology, and drug discovery at the University of Georgia and AptoTec, Inc. She joined innovators at Metametrix Clinical Laboratory as a medical education consultant helping clinicians use integrative and functional laboratory results in clinical practice. She owns Health First Consulting, LLC, a medical communications company with the mission to improve human health using the written word. Ms. Nelson-Dooley is an oral microbiome expert and author of Heal Your Oral Microbiome. She was a contributing author in Laboratory Evaluations for Integrative and Functional Medicine and Case Studies in Integrative and Functional Medicine. She has published case studies, book chapters, and journal articles about the oral microbiome, natural medicine, nutrition, laboratory testing, obesity, and osteoporosis.