An introductory blog discussing the rationale for a nutritional and lifestyle approach within clinical psychology.
Chronic or acute illness with psychological features like anxiety and depression, stress and burnout, fatigue and “brain fog”, fibromyalgia, irritable bowl syndrome, allergies, insomnia and alcohol use, are all growing concerns in todays time unlike ever before in history. But is it true that these are growing epidemics or is there more to this story?
These types of chronic problems provide the individual affected and their health professionals with useful information. Your body may have something to tell you about whether your diet or lifestyle is working for you - and if the message isn't heeded at first it may start to get louder. Messages from your body may include daily fatigue, loss of zest for life, upset stomachs or susceptibility to colds, memory changes, feelings of overwhelm, irritability, or that you are no longer who you used to be.
Your diet and lifestyle form the recipe for everything that occurs in your body. This includes energy activity, the formation of your gut health, and the neurotransmitters which shape your thoughts, feelings, and drive behaviours i.e. psychological functioning. In other words, we are each physically and psychologically constructed by what goes in our mouth/stomach and how well we absorb nutrients from this. Reasons for insufficient functioning can include eating foods that are low in nutrients such refined sugars, poor quality fats, which are often found in highly processed food. In addition, unknown food allergies, sensitivities, and intolerances (e.g. gluten and dairy), and blood-sugar instability will cause suboptimal functioning. In some cases gut dysbiosis can occur – which means that the stomach has become inflamed and has a reduced capacity for digestion, and is thus unable to absorb the vital nutrients that are needed to function well. Improperly digested food particles may pass through into the bloodstream where they are not designed to go, causing unpleasant reactions and symptoms (also known as intestinal permeability or “leaky gut”). Some of these symptoms can present as mood and anxiety difficulties as well as cognitive changes like "foggy" brain functioning and memory impairment.
Long term exposure to suboptimal nutrition for any of these reasons may cause a raft of problems. This may further lower a person's threshold for coping with life challenges or stressors, thus becoming a vicious cycle.
There are also challenges to wellness from daily lifestyle or your environment. This can include exposure to the many toxins in our current society from pesticides on food, ingredients in skin care and cleaning products, alcohol and certain medications (such as recurrent antibiotic use, the pill, and steroids). These too can impact on digestion and absorption of nutrients. The degree of stress as well as exposure to illness can tip the balance from from managing inadequate food intake and toxin exposure to suddenly (or slowly over time) experiencing a range of physical, emotional, and cognitive symptoms. These may leave an individual feeling tired and flat, that they are just not themselves anymore, or in many cases suffering from a chronic health problem.
Traditional considerations of food and nutrient absorption, and steady lifestyle toxin exposure is not usually a significant focus in psychological assessment or treatment. Some areas are considered, such as ruling out thyroid conditions in depression or mania, checking for b12, iron, Vitamin D, and magnesium deficiencies in anxiety and mood difficulties. However there are many other things to consider. There also tends to be a synergistic effect which means that different toxins and deficiencies can compound each other - this can lead to a more serious problem then if just one toxin or deficiency was present alone.
In addition to traditional psychological theories about what causes psychological difficulties, psychological wellness can be produced or worsened by what goes in our mouths and the degree of toxins that we are exposed to. Unfortunately, the "convenience" foods that comprise the staple of many NZ kitchens are far removed from the foods that we have traditionally consumed, and many Kiwi's will not even be aware of what optimal functioning for them could feel like.
The exploration of how to eat for optimal functioning is an area of booming activity amongst many health practitioners and research scientists. This is great, however there are sometimes conflicting messages sent out by various different disciplines or sources, and not all of them are experts in reading and interpreting research. It’s little wonder that many people are confused, overwhelmed, or indifferent to their food choices.
This also applies to health practitioners attempting to use such information to help the clients they want to assist. Many individuals with chronic health symptoms are searching for information and guidance themselves. The area of nutritional and environmental medicine (NEM) is a field attempting to bring an evidence base and skill set to this work, which is happening one step at a time.
NEM asks two important questions which guide the way forward – “how are this persons cells functioning (the absorption of sufficient nutrients for which is vital)?” and “why is this health concern happening for this person?” There are three main aims - to prevent and cure, to be whole-person centred (holistic), and to treat the cause not just manage symptoms.
NEM fits into clinical psychology which considers the evidence base for any intervention applied. Clinical psychologists are experts in assessing the questions “why this person, what and why this problem, why now, and what will help.” Psychologists also have expertise in understanding and effecting motivation and behaviour change as well as a range of therapy techniques for various experiences.
There are many evidence-based low risk nutrition and lifestyle interventions that can be tested out that in many cases will improve psychological functioning. Adding this piece to assessment and therapy may be very important to resolving or improving your current difficulties, whether these are anxiety or mood related, or something else entirely. Are you up for optimising your physical and psychological functioning?