What every therapist needs to know about the new natural remedies for mental health By Howard Rosenthal, EdD on 10/15/14 - 11:57 AM

Yesterday I was doing some research at a local library. A bus full of middle school children on a field trip was letting the students out in front of me. I made my way around the facility for a good twenty minutes when I overheard a frustrated woman struggling with her computer. She bolted from her computer terminal and marched up to a librarian and asked her for technical assistance.

"I don't have a clue," the librarian candidly responded, "go ask one of those eighth graders."

Welcome to the new age. An age in which the average eighth grader might know more than us about our computer and definitely knows more than we do about our cell phones. But there is another societal dynamic which is somewhat analogous, but decidedly more important. This is the first generation of psychotherapy clients who are often better informed about natural mental health remedies than their therapists.

The object of this blog is not to rectify the lack of knowledge. That journey might entail reading scores of books, perusing endless articles, and watching enough You Tube videos to give you severe eye strain. The idea herein is merely to provide you with enough information so that when a client mentions a natural approach you won't wrongly think he or she has lapsed into speaking a foreign language.

Finally, since the data in this area are so voluminous, not to mention controversial, I will merely give you enough information to fit on the head of a pin. Ready? Let's do this.

St. John's Wort (SJW), an herbal remedy, has become the darling of the alternative mental health treatment movement. Incidentally, that's wort, not wart, so you need not see a dermatologist. Wort is Old English for plant. Your more educated clients may refer to it as "hypericum" the scientific name, but thanks to this blog, you'll know they are referring to good old St. John's Wort. In some statistical studies St. John's Wort ran neck and neck with prescription counterparts for depression and anxiety. Detractors often point out that St. John's Wort can cause sun sensitivity, but so can antibiotics and pain relief medications.

SAMe (Typically enunciated SAMMY) was discovered in Italy many years ago. This nutraceutical has been used for depression, fibromyalgia and arthritis in other countries with a high degree of success. The key selling point is that SAMe often works faster than prescription medicines and negative side effects are extremely rare.

5 HTP or 5-Hydroxytryptophan. This super star is reputed to be superior to psychiatric medicinals in terms of raising serotonin levels in the brain. Some folks also insist it can help you shed a few pounds and swear it works wonders as a sleep aid. Rumors abound that athletes involved in extreme endurance sports have used it for years to counteract the depression brought on by very high levels of aerobic exercise.

Increase your exposure to sunlight or full spectrum lighting. Psychiatrist Dr. Norman Rosenthal (no relation to this author) first described Seasonal Affective Disorder (SAD) which afflicts 7 million women and a rather large number of men. SAD is a type of depression which manifests itself when the days get darker and shorter limiting one's sun exposure. Alternative mental health practitioners worry that the recommendation to wear sunscreen at all times and to avoid the sun has made individuals more prone to SAD. For those who cannot spend time in the sun, full spectrum lights and phototherapy devices are available. Word of warning: Your friendly neighborhood dermatologist who is determined to prevent cancer and related skin damage is not a fan of this theory!

Vitamin D, or should I say hormone D. Cutting edge theory asserts that vitamin D is not a vitamin, but a hormone. Appropriate levels of this nutrient, um I mean hormone, help fight mood disorders and seemingly drastically boost the immune system. The problem: It is possible that traditional government recommendations were way too low. Some clients now ingest 10 to 125 times the amount of vitamin D suggested by Uncle Sam just a few years ago. Interestingly enough, even mainstream physicians who initially scuffed at this idea are now routinely insisting that patients get their vitamin D levels checked. Skeptics warn that we don't know the long term effects of taking such high doses. Zealots, insist that a day on the beach is the equivalent of taking a handful of vitamin D pills. Stay tuned, this one should get interesting.

Fish Oil to raise Omega 3 EPA/DHA levels. In at least one research study, the experiment was stopped because bi-polar subjects receiving fish oil were progressing much better than those who did not, and quite frankly it didn't seem fair to the group who was not ingesting the supplement.
Many therapists have heard the rumor that kids living in fishing towns have lower levels of ADHD and adults residing in these areas suffer from fewer bouts of depression and anxiety. Fish oil, in addition to its ability to stabilize one's mood, also theoretically promotes cardiovascular health and is often championed as beneficial for eyes, skin and joints. As of late, a couple of anecdotal reports indicate massive dosages might even help in cases of seemingly incurable brain trauma (e.g., after an auto or mining accident). The prescription to "eat more fish" is likely not the ideal since our waters are polluted. Moreover, studies in this area use fish oil capsules (not a generous helping of salmon) to enhance scientific rigor and the ability to regulate the dosage.

Supplement critics warn us that fish oil capsules can contain mercury and other toxic heavy metals. This argument may have been true at one time (and early on seriously good fish oils cost an arm and a leg), however, in this day and age, even many low cost drug store brands boast pharmaceutical grade processing and "mercury free" capsules. New research seems to indicate that the urban legend suggesting that fish oil can make one bleed to death is . . . well . . . just that; an urban legend.

The argument against fish oil: Cult biologist Dr. Ray Peat -- who proponents say is 100 years ahead of his time -- says the omega 3 fatty acids in fish, EPA/DHA are anything but essential. Simply put, Dr. Peat does not recommend fish oil citing studies indicating it actually hinders the immune system. Surgeon and former Olympic rowing champion, Dr. Caldwell B. Esselstyn Jr., the cardiologist who nursed Bill Clinton back to health after his life-threatening heart problems, is famous for yelling "no oils" in his popular lectures. Okay Dr. E, we get the point!

If you, or your clients, do purchase fish oil, it is best to stick to brands packaged in dark glass or plastic bottles and keep the supplement refrigerated to avoid rancidity. Finally, be acutely aware that the number of milligrams on the front of the bottle -- generally a huge selling point (say 1200 mg) -- has nothing to do with the actual milligrams of the beneficial omega-3 content (which might be 324 mg or some such number). Always scope out the label that graces the back of the bottle to determine the actual omega 3EPA/DHA content.

Niacin vitamin B3 therapy. All-right, here's a question that I'm betting not a single reader can answer correctly: How did Bill Wilson (aka Bill W) co-founder of AA cure his longstanding anxiety? If you said, "duh, he used AA," then you are absolutely, positively wrong! (Nice try though.) Question number 2: What did Bill Wilson say he wanted to be remembered for on his death bed? If you said, "AA" congratulations, you are zero for two!

Bill Wilson loved AA and believed in it with all his heart and soul. He used it to help his own drinking problem. Nonetheless, AA did nothing to help his debilitating anxiety and depression. What did help? Seriously large dosages of vitamin B3, also known as niacin. Bill Wilson spent nearly the last third of his life trying to get AA groups to promote niacin as a treatment for alcoholism, depression, anxiety, and even schizophrenia. It never happened and worse yet the saga has been virtually absent from all the major sources on addiction treatment.

Why didn't Bill W.'s ideas catch on? That's a story for another blog. But the short answer is that high dosages of niacin cause a flush that can be painful and downright scary. Many folks experiencing the flush end up in the ER not knowing it is likely a positive thing! Multivitamin pills rely on small doses of the nutrient or niacinamide to avoid this problem. Modern timed release or so-called "flush free" niacin supplements sold by health food stores and prescribed by physicians to help control cholesterol may or may not have the mood stabilizing effects of pure niacin. By the way, Bill W wanted to be remembered for his contributions to niacin therapy.

Probiotics. These are supplements that promote healthy bacteria in the intestinal tract. Many practitioners are convinced probiotics can be helpful in an array of mental health and digestion disorders; especially autism spectrum disorder. Probiotics have virtually no negative side effects, but some brands require refrigeration or freezing temperatures to survive. Like automobiles, television sets, and vacuum cleaners, every brand claims to be the best, so it's difficult to make a purchase decision.

Eliminate wheat. Wheat and mental illness(most notably schizophrenia) have a longstanding relationship. Although mainstream medicine insists wheat is healthy (if not a required food group), newer research posits that ingesting wheat based products has a detrimental effect on one's blood sugar, emotional state, and might even be implicated in Alzheimer's. The problem may not be so much the wheat itself, but the fact that today's wheat has been hopelessly genetically altered. Or to put it a different way, this isn't your father's whole wheat bagel! The bun that graced a 1970s fast food burger bears no resemblance to the bun you wolfed down for lunch. Proponents of the new don't eat wheat theory, feel strongly that whole grain, 7 grain, gluten free whatever (!!!) products may be just as bad if not worse for you than the run of the mill white bread type foodstuffs.

Take a look at David Perlmutter, M.D.'s book Gain Brain if you think I am exaggerating.

Strategies to boost cholesterol. Say what? Al-right, I'll admit it. I save the most controversial alternative strategy for last. Although most doctors are prescribing statin drugs to lower your so-called bad LDL cholesterol, a number of avant garde thinkers point out that higher may be better. If your cholesterol is below the 160 mark, your physician will give you a big hug and a smooch. But some research shows that if you have low cholesterol your chances of suffering from a major depression or committing suicide goes through the roof. The brain, as they point out, is basically cholesterol. Proponents of the cutting edge, increase your cholesterol theory if you want better mental health, have gone as far as suggesting that a minimum requirement for cholesterol should be added to the food charts in the near future. There is also the issue of longevity. Older adults in good health seem to have elevated cholesterol.

It would be an understatement to say that the aforementioned information seems totally the opposite of what we have been told for years.

I think I'm going to end here, because the eighth grader next door just returned home from school and I have a cell phone question. I wonder if he knows much about DHEA, pregnenolone, or NADH to combat depression my clients have been pondering over. It couldn't hurt to ask.

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