As a mental health advocate, I am often asked what has helped me in my recovery. This is no idle question. People want to know the answer to this question to help themselves or others. With this in mind, I wish to share how attention to nutrition has changed and, indeed, transformed my life in recent months.
After I was diagnosed with schizophrenia in 2008, I gained weight due to the medications I was taking. My appearance was affected and I did not feel very attractive as a woman.
What was worse was that my cognition seemed to be impaired: I could not focus, not even enough to read a newspaper article. I was devastated by this, because reading used to come so easily to me. I was told by medical professionals to lower my expectations of myself. I was told by people close to me that I would have to compromise on my dreams.
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Over the past few years, I have been managing my illness and practising self-care. A combination of exercise and a healthy diet has helped me to manage my weight. What helped significantly and most of all in terms of weight management, though, was adjusting the dosage of my medication under the supervision of a psychiatrist. My self-esteem increased as friends commented on my improved appearance.
IMH pharmacists comment that some medications, such as certain antidepressants, antipsychotics, and mood stabilisers, are associated [1] with weight gain, though not everyone taking these medications will be affected. Medication-associated weight gain can be caused by an increase in food intake or a reduction in energy expenditure.
To reduce medication-associated weight gain, one can:
- Reduce intake of fatty food, sweets & sugary drinks
- Exercise regularly (at least half an hour three times a week)
- Eat smaller, more frequent meals & eat slowly
- Switch to other medications that are likely less to cause weight gain
But can there be hope in the area of cognitive impairment? Let me share that in recent months, I have been feeling better than before. I feel that I have more energy. I am able to concentrate better on and complete tasks. I am able to read and write with ease and competence. I am able to hold conversations more easily with other people, strengthening my relationships with others. I am able to learn and grasp ideas more quickly.
This transformation in my life, I believe, is not accidental. In the past two months, on the advice of a doctor, I began a regular and deliberate intake of omega-3 fatty acids. I believe that this intake has contributed to a substantial difference in my quality of life.
According to research by neuroscientists, there is a growing body of evidence that omega-3 fatty acids is an appropriate dietary supplementation which can play a partially therapeutic effect, even in more severe patients, improving some behavioural aspects and, mainly, reducing the cognitive deterioration.[2] Further, omega-3 has been observed to prevent the onset of symptoms similar to schizophrenia.[3]
In addition, it seems to be common knowledge that our eating habits can have an effect on our physical health and they may have some effect on our mental health. While it is not clear what the causes of mental illness are, and trying to sift out causes from a complex web of cause-effect relationships between the mind, brain, nutrition, exercise, medications, environment, genetics, interpersonal relationships and many other factors is tricky, it seems easy enough to hypothesise a link between what we eat and our states of mind. If we do not give weight to having a well-balanced diet, then we may be nutritionally deficient. This may cause the brain to function less effectively, which leads to worse mental health and, possibly, mental illness.
I recently connected with a dietician and physiotherapist to get their expert advice on nutrition and mental health. My sense from them is that good eating habits are important to enhancing our physical and mental wellbeing, but that there is insufficient evidence to support targeted eating for mental health. In other words, there is no clear evidence that there are specific foods we can eat to improve our mental wellbeing.
While I appreciate this cautious take on the link between nutrition and mental health, evidence from research as well as my personal experience prejudices me to the view that there must be a link between omega-3 fatty acids and cognitive functioning.
Because of my experience in the past months, I believe that paying attention to nutrition is a critical step to recovery. And this transformative action has given rise to a more optimistic and positive state of mind. Because of the improvements in my ability to think, I am, these days, more hopeful and motivated about the future and how I can contribute to society. I am even hopeful that if this mental wellbeing continues, I may one day no longer have to compromise on my dreams.
[1] Taylor, D., Paton, C., & Kapur, S. (2012). Antipsychotic induced weight gain. In
The Maudsley: Prescribing Guidelines in Psychiatry (11th ed., pp. 126-131). UK: Willey-Blackwell.
[2] Marano G1, Traversi G, Nannarelli C, Mazza S, Mazza M. 2013.
Omega-3 fatty acids and schizophrenia: evidences and recommendations. Clin Ter. 164(6):e529-37
[3] Zugno AI, Chipindo HL, Volpato AM, Budni J, Steckert AV, de Oliveira MB, Heylmann AS, da Rosa Silveira F, Mastella GA, Maravai SG, Wessler PG, Binatti AR, Panizzutti B, Schuck PF, Quevedo J, Gama CS. 2014.
Omega-3 prevents behavior response and brain oxidative damage in the ketamine model of schizophrenia. Neuroscience. Feb 14;259:223-31
