Summary: Researchers know that changes in gut microbiota have an adverse impact on mental health management. These changes are among the significant reasons for the rise of common mental health problems. Using germ-free mice, researchers can now understand the role of different types of gut microbiota in mental health. Additionally, they can also start using gut microbiota to manage mental health issues. It means that science can now progress from developing the understanding to practical application.

Different types of mental illnesses like anxiety, depression, amyotrophic lateral sclerosis (ALS), and various neurodegenerative diseases are rising. However, science has been struggling to explain why these mental health disorders have been rising so briskly in the last few decades. It now appears that most adults are living with one or another common mental health problems.

It is pretty easy to guess that it has much to do with a fast-changing environment. These diseases used to be rare just a century back. So, it means that fast-changing environmental factors and lifestyles predispose humans to mental health issues.

However, perhaps the bigger question remains: What kind of environmental and lifestyle changes are causing a rise in mental health issues, what is the role of various such changes, and what is the underlying mechanism? 

It is not easy to understand, as tens of factors are implicated in the rise of mental health issues. One such factor contributing to the increase in mental health issues is dysbiosis or severe changes in the gut microbiota. It has been seen that painkiller addiction helps in the rise of such cases as well. 

Studies show that changes in gut microbiota may affect physical and mental health. But, understanding what changes cause these health disorders is challenging. There are trillions of microorganisms living in the gut, and health disorders occur due to minor changes in their population. Therefore, understanding these small changes in the population of gut microbiota is very challenging. Nonetheless, researchers have been making some progress.

To understand how gut microbiota influences mental and physical health, researchers use so-called germ-free mice. These are mice that lack any kind of gut microflora. Then by introducing gut microflora in these mice, researchers can see the impact of different types of microbiota on mental and physical health. This helps us understand how and what changes in the gut microbiota are harmful and suggests ways of normalizing gut microbiota.

Researchers now know that gut microbiota produces neurotransmitters, short-chain fatty acids, bile acids, vitamins, lactate, and many other bioactive compounds, thus impacting health. They are now also learning to appreciate the importance of various bioactive compounds produced by gut microbiota, modulating their levels by tweaking the gut microbiota.

In the future, researchers think that understanding how to use microbiota to alter the production of various bioactive compounds may help manage most mental health disorders, from depression, and amyotrophic lateral sclerosis (ALS), to autism spectrum disorder (ASD).

There are many good things about such a therapy. First, it is a more natural way to treat mental health disorders. Such methods may work slowly, but they can provide prolonged relief without causing any significant side effects.

Moreover, it is vital to understand that though there are hundreds of medications to treat mental health disorders, they work only in a small number of cases. Additionally, these drugs cause severe side effects.

Just take the example of depression. There are tens of drugs to treat the condition. Yet, these drugs barely work in less than half of all cases. It means that medications almost completely fail to help in more than 50% of the cases. Even worse, they have many side effects, they help slowly, and people must take these medications for long, sometimes even lifelong.

Unlike medical drugs, novel therapies like using gut microbes may provide prolonged relief. Moreover, once the healthy gut population has been reinstated, one can start living without the need to take any medications. Thus, such an approach is not only safe, but it also helps mental health management. 

It is therefore suggested to take expert help in case of common mental health problems. Telehealth addiction treatment offered by Addictionology Center helps you in mental health management right in the comfort of your home. 

Summary: In the US, more than a million suicides are attempted each year, causing more than 45000 deaths, most of which are young adults. Yet, there is no known effective treatment to reduce suicides significantly. Now a new study shows that a simple measure of using a folic acid supplement may reduce suicide risk by as much as 44%.

This is a very unusual and accidental finding of one of the new studies showing that folic acid may considerably reduce suicide risk.

it has long been known that vitamins are associated with better mental health, brain health, and energy levels, especially vitamin Bs. However, no one thought that it could reduce the suicide rate in such a significant manner, particularly in the case of opioid addiction treatment. Suicides or attempted suicides are generally associated with depression, and almost close to 5% of US adults are living with the condition. Each year about 12 million think of suicide and 10% of them attempt it, and it results in more than 45,000 deaths every year.

Despite so much progress in science, mental health disorders are increasing. There are tens of drugs to treat depression, yet none seems to work in all cases. Anti-depressants are moderately effective in treating depression. But, even worse, they fail to help in many instances.

In the new study published in the journal JAMA Psychiatry, researchers were looking for a possible association between depression risk and the use of various medications, a subject that is poorly explored yet.

For the purpose of the study, researchers analyzed the data of close to a million patients. They used the drug refill data to see if there is any association between the intake of various drugs and suicide risk. To understand this, they almost analyzed the patients’ use of close to 1000 drugs. To their surprise, their analysis showed that folic acid appears to be associated with significantly lower suicide risk.

Therefore, they decided to focus particularly on folic acid, also known as vitamin B9. The role of vitamin B-complex in brain health is known. Therefore, folic acid is often prescribed during prenatal care as it is essential for fetal brain development and reduces the risk of certain congenital disabilities.

For this purpose, they collected data from 866,586 patients who were given folic acid between 2012 to 2017. Since folic acid is more commonly prescribed to women, overwhelming numbers of those who took folic acid were women (80%).

When they analyzed the data, they found that people who took folic acid had a significantly lower suicide risk. However, since most patients who used folic acid were pregnant women, it is easy to understand such findings. Pregnant women are the least likely to commit suicide.

Nonetheless, researchers decided to move forward with their study and analyze the data of males. They were amazed to see that in men, folic acid intake reduced suicide risk by almost 44%, even after adjusting for various other confounding factors. These are incredible findings, as folic acid is readily available and is quite safe for prolonged use2.

There were some other interesting findings in the study, like a linear relationship between folic acid intake and reduced risk of suicides. The study found that folic supplementation for each month reduced suicide risk by about 5% and maxed out at about 44%. That is a massive benefit.

Since folic acid has many health effects similar to cyanocobalamin or vitamin B12, the researchers also decided to see if vitamin B12 could also help reduce suicide risk. However, they did not find any correlation between vitamin B12 intake and suicides. Hence, it appears that this benefit is unique to folic acid.

These findings have huge clinical relevance and must be tested in further well-designed clinical trials. It is vital to understand why folic acid is so helpful in preventing suicides. It is also essential to explore its role in treating depression.

If these findings are confirmed in clinical trials, then folic acid may emerge as a cheap and safe treatment for depression and preventing suicides, and it may help save thousands of lives.

Summary: Depression is one of the leading mental health issues. Moreover, no two patients living with depression are the same. Many people are also living with anxious depression. Such patients are challenging to manage with a traditional therapeutic approach. A new study using transcranial magnetic stimulation (TMS) shows that it can be quite helpful in relieving the symptoms of both anxiety and depression.

Depression is a widespread mental health disorder in the United States that affects people of all ages. According to the National Institute of Mental Health, over 15 million adults in the US experience at least one major depressive episode each year. Depression can significantly impact an individual’s quality of life, negatively impacting work, relationships, and overall well-being. Therefore, it is essential to understand the causes of depression to identify effective treatment options.

Though depression is a common health issue, it remains poorly understood. Hence, despite the availability of tens of medications for managing depression, its treatment is far from satisfactory.

In fact, many people living with depression do not respond well to pharmacological treatment. Doctors often describe this as resistant depression. Not only that, antidepressants may instead cause many side effects, and in some cases, they might even make depression worse. That is why doctors are always looking for novel and safer ways to manage depression.

To further make things difficult, many people are living with major depression disorder (MDD) complicated by anxiety and thus called anxious depression. Such individuals are particularly challenging to treat. They often require prolonged medical treatment, and yet many do not respond well to the therapy. Such kind of severe anxious depression may cause significant disability.

Even if a patient responds to the medical drugs, it generally takes quite a long time to gain disease remission. Therefore, most patients suffering from anxious depression must continually take medications even if remission has been achieved. 

In recent years, Transcranial Magnetic Stimulation (TMS) has emerged as an effective and safe treatment for depression and anxiety. Moreover, this kind of treatment is very safe and rarely causes any side effects. 

TMS involves applying magnetic pulses to specific areas of the brain to stimulate neural activity. Since magnetic pulses are of very low energy, they do not cause any harm. TMS is not just good for managing mental health issues, and it is also good for boosting regenerative processes. Since it has many beneficial health effects, it has become the subject of much research.

Now a new study shows that TMS is not just good for resistant depression. It is also quite useful for managing anxious depression.

The new study aimed to determine whether transcranial magnetic stimulation (TMS) could help patients with major depressive disorder (MDD) and moderate-to-severe anxiety symptoms. The study looked at 1,820 patients who had been diagnosed with MDD and had completed the Patient Health Questionnaire-9 (PHQ-9) and the Global Anxiety Disorder-7 scale (GAD-7) before and after receiving at least one TMS treatment between May 2016 and January 2021.2

The study found that patients with anxious depression significantly improved after receiving TMS treatment. In addition, their symptoms of both anxiety and depression improved significantly. On average, there was a 50% or greater reduction in both GAD-7 and PHQ-9 scores. 

The study concluded that routine TMS treatment delivered in diverse clinical settings could lead to marked anxiolytic and antidepressant effects in patients with anxious depression. 

Though researchers have long known about the benefits of TMS in depression, now they understand that it is also good for complex patients displaying the signs of both depression and anxiety.

Summary: Ketamine is an anesthetic and can also reduce pain sensation. However, its use to treat depression is new. Studies show that few ketamine infusions can provide prolonged relief from depression. However, some doctors have raised concerns regarding the risk of ketamine abuse. Fortunately, a new study in rodents shows that ketamine is not addictive. It does cause an increase in dopamine. However, any such upsurge is short-lived and thus does not appear enough to cause addiction.

Ketamine is an anesthetic, and it is also known to help with pain. However, its use in managing depression is new. There is significant interest in ketamine treatment for depression as the studies show that it may help provide prolonged relief, unlike traditional antidepressants.

However, conversely, it is no secret that ketamine is also a club drug, a substance of abuse. It causes euphoria at higher dosages. Therefore, doctors worry that its frequent use may put their patients at risk, and many might become addicted to it. 

But some experts think that though it is psychotropic, it does not appear addictive. After all, it has been available for a long time, and there are not many people addicted to ketamine. Now, a new study shows that though it may stimulate the reward pathway, it also affects some other brain pathways that help prevent ketamine abuse.

Addiction vs. Dependence

Before discussing the risk of addiction further, it is vital to understand that addiction and dependence are two different things. Addiction is when one seeks a substance despite its negative health consequences. Addiction is a kind of behavioral disorder. For instance, opioid addiction treatment is carried out when abuse of opioids begins to produce negative effects on the body.  

Dependence, on the other hand, causes withdrawal syndrome on discontinuation of the use of the substance. In addition, dependence often causes severe physical signs. Drugs that cause dependence may affect most people who use them regularly.

Although most people may become dependent on some substances after their prolonged use, the same is not true for addiction. Studies show that only some people become addicted. Moreover, addiction only affects a small number of people.

For example, studies show that only one-fifth of cocaine users are really addicted to it. And for opiates, this rate is about 30%. In a recent study, researchers tried to understand the risk of addiction to ketamine.

Ketamine has a short-lived impact on the reward pathway

Generally, people get addicted to substances as they increase the levels of the pleasure molecule dopamine. For example, cocaine can boost the brain’s dopamine level for a long time. However, after some time, it would start falling, and thus a person would seek the drug to increase dopamine level again.

In the new study, researchers used a special device that allowed mice to self-administer ketamine. They found that it increased dopamine levels in mice, so they repeated the self-administration. However, they found dopamine levels elevated due to ketamine also falling quite quickly, unlike many other drugs of abuse.

Ketamine also seems to have the effect that prevents reward pathway stimulation

Researchers wanted to know why, unlike other drugs of abuse, ketamine treatment for depression causes such a short-lived increase in dopamine levels. They found that ketamine increased dopamine by inhibiting NMDA receptors. However, it also modulated other receptors, called the D2 receptors, that act as a brake on the rapidly increasing dopamine. 

Hence, they found that it is this dual mechanism that helps prevent permanent changes in the brain, unlike other drugs. Therefore, ketamine does not cause long-term behavioral changes. The increase in dopamine levels is for such a short time that it is not enough to cause addiction. The researchers concluded that there is almost zero addiction risk of ketamine in rodents.

Of course, these are still early findings. Nonetheless, it provides the basis for further studies. There is a need to find out if this is also true for humans. Considering that quite often, what works in rodents also works in humans, it is likely that it does not cause addiction. Even if it does cause, any such effect is probably quite low.

Summary: In recent years, a field called nutritional psychiatry has been emerging fast as researchers realize that those living with mental health disorders may benefit from dietary changes. Moreover, mental health issues are challenging to treat with medications, often requiring prolonged treatment, thus causing multiple adverse effects. Dietary measures can help overcome stress, anxiety, depression, and more.

It has been rightly said that you become what you eat. Your diet can influence mental health in multiple ways. It can directly affection the production of neurotransmitters, cause mood changes, influence circadian rhythm, affect gut microflora, and more.

Since diet can influence mental well-being and mood, it also means that one can use food to manage mental health disorders. Thus, anyone living with depression, anxiety, and other mental health issues must make dietary changes.

The importance of diet in mental health cannot be neglected, considering that most mental health issues tend to be chronic and even lifelong.

In recent years, nutritional therapy in psychiatry has gained significant importance as researchers have discovered a few things. Science has discovered that the gut produces 90% of serotonin, one of the most vital neurotransmitters affecting mood and mental health. Similarly, science has realized the role of gut bacteria or microbiota in mental well-being. The gut is so crucial for mental health that researchers are now calling it the second brain. They understand that the “gut-brain” axis can influence various brain functions.

Diet and depression

There are numerous studies showing that diet can increase the risk of depression. Those living with the metabolic disorder are also more likely to develop depression. Thus, studies also confirm that certain dietary choices may be suitable for managing depression. Dietary measures are especially useful in mild to moderate depression.

One of the good ways to manage depression is to switch to the Mediterranean diet. Studies show that consuming whole grains, fresh vegetables, and legumes may help. At the same time, reducing the intake of processed foods is also good for mental health.

One of the landmark trials HELFIMED has shown that the Mediterranean diet rich in vegetables, nuts, whole grains, lean meat, and dairy product can help significantly reduce depression, especially when combined with fish oil or omega-3 supplements.

Diet for stress and anxiety

Stress and anxiety are pretty common mental health issues. Compared to depression, they might be less severe, but they have a higher prevalence.
Studies show that specific food choices may increase the risk of stress and anxiety. Thus, to reduce these mental health issues, experts recommend reducing the intake of alcohol, caffeine, and added sugars.

Those living with anxiety should especially try to lower their sugar intake. Studies show that sugar can be quite addictive and can even cause withdrawal syndrome. Further studies show that consuming excessive saturated fats may also cause mental health issues.

Foods that are especially good for improving mental health are foods that reduce inflammation, like dietary fiber-rich fruits and vegetables, unsaturated fats, and probiotics-rich fermented foods like yogurt, kimchi, and more.

Other things to consider

Prevention is better than treatment. Thus, researchers say that for a healthy life, one should focus on increasing the intake of certain nutrients like omega-3 fatty acids, vitamin B-complex, iron, magnesium, zinc, and vitamin C. Fruits, nuts, seeds, and seafood can be really good to get your daily supply of these vital nutrients.

Secondly, one should consume foods rich in pro and prebiotics like yogurt, buttermilk, garlic, onions, asparagus, barley, oats, and so on.

Further, it is good to consume antioxidant-rich berries. Berries are often associated with romantic moods, and it now appears they really help. In addition, berries are the richest source of specific vitamins like vitamin C and antioxidants.

Finally, remember that disruption in circadian rhythm is one of the reasons for the higher prevalence of mental health issues. Hence, eat meals at regular intervals and at a fixed time of the day to avoid any disruption in the circadian rhythm. Apart from sleep, also regularize your sleep time.

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Medical Disclaimer: Keep in mind that the content provided is not direct medical advice for patient care, but is provided for thoughtful discussion.