Mental disorders are a growing crisis and are the leading cause of disability on the planet. Although we have many treatments to offer, they fail to work for far too many people.
If you think this is too pessimistic, it’s important to note that depression is now the single most disabling illness—above heart failure, back pain, cancer, and other conditions—even though we have dozens of antidepressants, different types of psychotherapy, electroconvulsive therapy, transcranial magnetic stimulation, ketamine, and other treatments available. Although the problems with access to mental health care might explain some of these increases, even when people get treatment, it often fails to put illnesses into full and lasting remission.
Why can’t we do better?
In the end, it’s because no one can answer a fairly simple question, “What causes mental illness?” Instead of a full and complete answer, we only know some of the factors involved, which include neurotransmitters, genetics, hormones, inflammation, substance use, trauma, adverse childhood experiences, and stress. How do all of these fit together? Again, no one knows.
In the just released book, Brain Energy, I argue that mental disorders are metabolic disorders of the brain. This new theory integrates decades of clinical, neuroscience, genetic, and metabolic research. It includes all of the biological, psychological, and social factors that we know play a role in mental illness and combines them into one unifying theory.
This new understanding answers questions that have long plagued the mental health field, but also offers new treatments, ones that come with the hope of long-term healing as opposed to just symptom reduction. This new understanding also helps us understand the connections between mental health and physical health.
What is Metabolism?
Although many people think metabolism is “burning calories” and related to weight, it’s actually much more than that. Metabolism is the process that all living organisms use to convert food into energy or building blocks for proteins, membranes, and other cell parts. It is fundamental to the definition of life. When there are problems with metabolism, there will be problems in the way cells function. I argue that metabolic dysfunction in brain cells can explain all of the symptoms of mental illness.
Although metabolism is extraordinarily complex and involves numerous chemical reactions and pathways, it turns out that there is an easier way to understand metabolism, and that is through tiny organelles in most of our cells called mitochondria. They are the primary regulators of metabolism. Doing a deep dive into the science of mitochondria helps us understand all of the factors related to mental illness.
For example, mitochondria play a critical role in the production and regulation of neurotransmitters, such as serotonin, dopamine, and GABA. They also play a key role in the production of key hormones, such as cortisol, estrogen, testosterone, and progesterone. Mitochondria actually help to control the expression of genes in the cell nucleus and they also play key roles in inflammation.
By better understanding the science of metabolism and mitochondria, we can finally connect the dots of mental illness.
The much more exciting news about this theory, in my view, is that it opens the door to new treatments. Interventions such as diet, exercise, stress reduction, sleep management, and reducing substance use can effectively treat mental disorders in many people.
You might be thinking that this is nothing new; we already knew most of that. However, understanding the details of this science can lead to new and surprising treatments, such as dietary interventions to treat disorders like schizophrenia and alcoholism, which on the surface don’t seem like they are related to diet. Some patients with schizophrenia have experienced full and lasting remission of symptoms off antipsychotic medications for years now, as highlighted in this Psychology Today post.
A New Day for Mental Health
The brain energy theory of mental illness leads to a new day in the mental health field. Clinicians will be able to offer new treatments and interventions. Patients and clients have many more options for treatment, some that they can pursue on their own. Researchers can advance the field by better understanding the underlying metabolic causes of mental disorders and identifying new treatments. There is finally a new and exciting source of hope for the millions of people suffering.
This article was originally written by Christopher M. Palmer, M.D., a Harvard psychiatrist, author of Brain Energy, and researcher working at the interface of metabolism and mental health, for Psychology Today.