low serotonin

Pathological Demand Avoidance (PDA) in children with autism – how much is behavioral and how much is due to low serotonin?

June 9, 2023 By Trudy Scott 14 Comments

Pathological Demand Avoidance (PDA) is a condition associated with Autism Spectrum Disorder (ASD). It is a rare behavioral phenotype of ASD that is characterized by an overwhelming or obsessional need to resist or avoid demands, which can often lead to sensory overwhelm causing meltdowns and violent outbursts.

Although children in general may often try to avoid demands, children with PDA engage in avoidant behaviors at a greater level.

The key underlying factor is the extreme levels of anxiety associated with a loss of control, which can feel like a panic attack. Because of high levels of anxiety, they will often respond with a “No” even to tasks or activities that they normally enjoy and can spend a great deal of energy trying to gain control of situations and people.

(from an Australian PDA article: What is Pathological Demand Avoidance (PDA) and how can we address it? so I changed the spelling of behavioural and characterised to be American)

This is a typical overview of PDA and the common recommendations (as outlined in the above article) are all behavioral interventions: be an active listener and build trust, depersonalize requests, provide indirect praise, use humor and so on. Many parents find these helpful but the biochemical imbalances that trigger these behaviors are being ignored and/or there is a lack of awareness. I’d like to change this so more children and teens get quick relief.

There may be many different root causes such as low serotonin, low GABA, low blood sugar, gluten sensitivities, low zinc, low vitamin B6, low vitamin D, toxins, infections, phenols, salicylates etc. Today I’m going to discuss low serotonin and my rationale for reaching this conclusion. It’s also one of the quickest root causes to confirm (more on that below).

My rationale for proposing that Pathological Demand Avoidance (PDA) in children with autism is related to low serotonin

If we take the description above, all of these symptoms are classically found when a child (or adult) has low serotonin:

Extreme levels of anxiety
Can feel like a panic attack
Overwhelm
Meltdowns and violent outbursts
Loss of control
Spending a great deal of energy trying to gain control of situations and people (i.e. controlling)
Obsessional need to resist (any kind of obsessing is common when serotonin is low)

The second reason I suspect low serotonin with PDA is the timing of these behaviors i.e. later in the day. The article mentions that “A child with PDA can be very calm, cool and compliant at school and behave much worse at home. This is not because of incompetent parenting but because they have reached their tolerance levels and need to release that suppressed anxiety.”

This may well be a factor, however low serotonin symptoms are recognized as being more severe in the afternoon/evening when serotonin levels start to decline. If these children have low serotonin then it makes sense that these symptoms would start to increase once they get home.

My third reason is that low serotonin is common in autism/autism spectrum disorder (ASD).

Low serotonin is common in autism/autism spectrum disorder (ASD)

This paper, Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism, summarizes it as follows: “The disruption of the serotonergic system is one of the most consistent observations associated with autism. Serotonin in the brain promotes prosocial behavior and correct assessment of emotional social cues.”

Their recommendations are vitamin D and tryptophan supplementation which they say “may be a simple method of increasing brain serotonin without negative side effects.”

Testing for low levels of vitamin D and supplementing accordingly is important.

Are there other low serotonin symptoms and using a trial of tryptophan to confirm

As mentioned above, low serotonin is also one of the quickest root causes to confirm. As always, regardless of the diagnosis, we assess for low serotonin by rating symptoms on a scale of 1 to 10 (with 10 being most severe) and do a trial of tryptophan (chewed or a capsule opened on to the tongue). You will have your answer very quickly because we rate improvements in symptoms in the next 5 to 30 minutes.

In addition to the above symptoms we also look for these: worry-in-your-head and ruminating type of anxiety, phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, insomnia and afternoon/evening cravings for carbs and sugar.

Lidtke is the only brand of tryptophan that I recommend simply because I see it work so well and because of quality issues with tryptophan in the past. Here are the Lidtke tryptophan products I recommend:

Lidtke Chewable Tryptophan 100 mg is a good for doing a trial and works when lower doses are needed as with children.
Lidtke Tryptophan 500 mg can be used for doing a trial. I open the capsule and use 100mg for a child. Going forward this product is helpful when higher doses are needed, especially at night. When opened it doesn’t taste very good but can be mixed with inositol or even glutamine powder or mashed banana.

You can read more on this blog: Tryptophan for the worry-in-your-head and ruminating type of anxiety, see the full list of low serotonin symptoms here and find the tryptophan products on the supplements blog here.

If you’re new to PDA, the DSM and low serotonin/other biochemical factors

Professor Elizabeth Newson was a developmental psychologist known for her work with children in the autism spectrum. This is her 2003 paper on the topic – Pathological demand avoidance syndrome: a necessary distinction within the pervasive developmental disorders

It’s not part of the DSM-5, the standard classification of mental disorders used by mental health professionals in the United States. This article, A Brief History of Pathological Demand Avoidance, offers a good backstory and shares why families want it to be part of the DSM.

Whether or not it becomes a distinct condition or autism subtype in the DSM, I’d like to see low serotonin (and likely low vitamin D) being recognized as one root cause. And acknowledging that there may be many other biochemical/nutritional approaches that should also be explored.

These symptoms are listed in the above article, in addition to avoidance behaviors, and all could fall into typical low serotonin symptoms:

verbal and physical aggression when feeling loss of control
self-injurious behavior
property destruction
refusal to participate in self-care such as bathing or brushing teeth (is this depression?)
inability to attend social events (is this fear and social anxiety?)
controlling what noises are allowed in a home, such as no music, or only certain music
inability to allow parents to have friends visit the home (is this also controlling?)
are often combative with siblings
issues with food, what to eat, when to eat, who to eat with
conflict with siblings

As mentioned above we also look into low GABA and low blood sugar (trials of GABA and glutamine will give quick confirmation too), gluten sensitivity, low zinc, low vitamin B6, toxins, infections, phenols, salicylates and so on. Of course, Nutritional and Dietary Intervention for Autism Spectrum Disorder is crucial.

Some success stories and connecting the dots with low serotonin

These two success stories illustrate how successful tryptophan and GABA can be and also how quickly they offer relief:

This blog post illustrates similar low serotonin symptoms and end-of-the-day timing in adults with Alzheimer’s – Sundowning in Alzheimer’s and dementia: melatonin/tryptophan for the agitation, restlessness, anxiety, disturbed sleep and aggression. It’s low serotonin that is the cause, regardless of the diagnosis.

This blog illustrates another mechanism for these types of disruptive behaviors: Christmas tree phenols as a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms? There is a serotonin connection when there are phenol issues too.

Resources if you are new to using amino acids as supplements

If you are new to using amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA, low serotonin and low endorphins).

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs. You can find them all in my online store.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), if you need serotonin support, the Serotonin QuickStart Program is a good place to start. This is a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening. We take a deep dive into product options including Lidtke products and others if you’re not able to access Lidtke.

If you also have low GABA symptoms, the next step to get help is the GABA QuickStart Program.This is also a paid online/virtual group program where you get my guidance and community support. Another option is the budget-friendly GABA QuickStart Homestudy program.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Now I’d like to hear from you

Have you been told your child may have Pathological Demand Avoidance (PDA)? Have you only been offered behavioral change tools and how have they helped?

Has low serotonin (and other biochemistry imbalances) been discussed too?

What symptoms does your child have and are things worse later in the day?

Has tryptophan helped reduce the above low serotonin symptoms in your child? How much helps and how quickly?

Or do you find 5-HTP works better? If yes, how much helps and how quickly?

What other biochemical changes have helped?

If you’re a practitioner, are you hearing about increased discussion of Pathological Demand Avoidance (PDA) and do you address low serotonin with your clients/patients?

Feel free to post your feedback and questions here in the comments.

Would using 5-HTP or tryptophan help when you crave sugar (as a sort of antidepressant) late afternoon/evening?

June 2, 2023 By Trudy Scott 29 Comments

Would using 5-HTP or tryptophan also help when you crave sugar (as a sort of antidepressant) late afternoon/evening? ~ Kimberley

This question was posed in response to my recent blog post about using tryptophan or 5-HTP to help with alcohol cravings/addiction in the late afternoon/evening – to help you wind down and relax, improve mood and sleep, and also as a reward/treat.

I said yes it is often the same cause when it happens late afternoon/evening and when there are other low serotonin symptoms like low mood, anxiety, worry, insomnia etc. When serotonin is low we self-medicate with wine, sugar, carbs, gluten, dairy and chocolate etc. in order to feel good, get a mood boost and reduce stress. 5-HTP or tryptophan stops the sugar cravings, acts as an antidepressant (improving mood) and eases other low serotonin symptoms too.

It turns out Kimberley was craving sugar late afternoon: “it’s definitely late afternoon for me, while I’m making dinner. Maybe it’s time to go back on 5-HTP.”

And then 2 days later she posted how quickly 5-HTP helped when she added it back mid-afternoon:

I was taking a break from tryptophan/5-HTP and realized after reading this post that that might be a mistake! So I added 5-HTP back in mid-afternoon and my sugar cravings are almost completely gone. It’s funny how I forget the symptoms of low neurotransmitters. Thanks for reminding me!

5-HTP works quickly when it’s low serotonin

How wonderful are these results for Kimberley. I never get tired of hearing feedback like this! I appreciate her sharing and giving me permission to share as a blog so you get to learn and be inspired too.

It’s not unusual for 5-HTP to work this quickly and when it does it’s a clue that the symptoms are related to low serotonin and that she found the ideal dose for her needs.

Kimberley had good results with 5-HTP in the past so she went back to what had worked for her before and it worked for her again.

But do keep in mind, some folks do better with 5-HTP and some do better with tryptophan so it’s a matter of doing a trial of each one each.

50 mg 5-HTP: the sadness and despair lifts in a few minutes

A week later she kindly came and shared additional details in the comments of the tryptophan/ 5-HTP alcohol cravings blog, saying:

It’s possible that I was already in the middle of my daily, mid-afternoon chocolate chip binge when I saw your post

I took a 50 mg 5-HTP along with my mid-afternoon Endorphigen capsule, and within just a few minutes I felt the sadness and despair that I often feel in the late afternoon, start to lift. I was astonished at how quickly it worked! I didn’t open the capsule, or chew it, I just swallowed it with water and had a snack afterwards. I really can’t thank you enough for asking that question because I was really struggling with low mood and sadness almost every day.

Even though KImberley had used 5-HTP with success in the past, she was still astonished how quickly it worked and how effective it was. She was also surprised she had forgotten her prior low serotonin symptoms:

Up until January I had taken 5-HTP in the mid-afternoon and then Tryptophan at bedtime, but I wanted to try a program to support my thyroid. That program told me that too much serotonin is often at the root of gut damage, so I weaned myself off of the 5-HTP and tryptophan. I didn’t really notice much difference, except the daily sugar cravings.

I’m not sure how I could so easily forget the symptoms of low serotonin, but I did.

Your question really was a God-send for me, Trudy. It reminded me that there was an option for feeling better (in fact, MUCH better than sugar makes me feel) that didn’t involve something that’s not good for me.

And I really did feel remarkably better the same day, and those results have continued.

Thanks again, Trudy, for continuing to bring these topics up. Some of us are forgetful and need reminding. Usually, when you have symptoms of low serotonin there are enough other issues going on in your life that it’s easy to overlook the obvious. So I’m very grateful that you asked the question, because I feel so much better able to deal with my circumstances now that I’m back on the 5-HTP. Blessings to you!

I am curious about the program that told her too much serotonin is often at the root of gut damage and if they suggested stopping 5-HTP and tryptophan. It doesn’t make any sense to me. I’ll report back when I learn more about this.

More tired during the day and a headache: what to consider

She did mention “I’m finding myself more tired during the day and have also had a headache for the last few days.” I would suspect chocolate/caffeine withdrawal may have caused her headache.

With feeling more tired I’d also watch the dose of 5-HTP. She may find less is better for her needs.

She is also trying tryptophan at bedtime so that may be making her more tired the next day. Doing one amino acid at a time is often the best way to know how each one is affecting you.

Finding what works for your unique needs

Here are some other amino acid/sugar cravings blog posts that illustrate how we all have unique needs and different biochemical imbalances:

The individual amino acids glutamine, GABA, tryptophan (or 5-HTP), DPA and tyrosine are powerful for eliminating sugar cravings, often within 5 minutes

The individual amino acids glutamine, GABA, tryptophan (or 5-HTP), DPA and tyrosine are powerful for eliminating sugar cravings, often within 5 minutes. It seems that this wonderful benefit – over and above the anxiety-reducing and mood-boosting benefits – is often overlooked or poorly understood.

GABA for ending sugar cravings (and anxiety and insomnia)

For Melissa, an unexpected result was that she stopped craving sugar (chocolates, ice cream and truffles) after about a week of taking GABA for her travel anxiety.

It’s a matter of finding what works for your sugar cravings and unique needs. GABA worked for Melissa and yet 5-HTP works for Kimberley – for their sugar cravings.

Here is the tryptophan/5-HTP alcohol cravings blog that started the discussion: Tryptophan had the added benefit of turning me completely off alcohol when I took it to improve mood and sleep during perimenopause. In this case, tryptophan helped Victoria quit the wine that she was self-medicating with in order to feel good and relax.

Resources if you are new to using amino acids as supplements

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

Low GABA can cause physical tension and overwhelm, affect sleep and cause stress eating. If you also have low GABA symptoms, the next step to get help is the GABA QuickStart Program. This is also a paid online/virtual group program where you get my guidance and community support. Another option is the budget-friendly GABA QuickStart Homestudy program.

Wrapping up

Now I’d love to hear from you ….

Has 5-HTP helped reduce your cravings and/or feelings of despair and sadness? How much helps and how quickly?

Or do you find tryptophan works better for you? If yes, how much helps and how quickly?

What sugary food/s do you self-medicate with in order to feel good?

If you’re a practitioner, do you use this approach with your clients/patients?

Feel free to post your feedback and questions here in the comments.

“I’m In An Abusive Relationship That I Will Never Walk Away From”: tryptophan, a gluten-free diet, lithium and other nutritional solutions

March 10, 2023 By Trudy Scott 16 Comments

This mom’s story really struck a nerve for me… “I’m in an abusive relationship that I will never walk away from.” She shares this …

I can’t exactly pinpoint when I first felt the shift between our dynamic. One minute, things were as they always were. Before I could blink, though, I found myself engrossed in an alternate reality that resembled less and less of life as I knew it with each passing week. Trickles of rage and anger bubbled to the surface, threatening to break through until they could no longer be harnessed. I’ve been riding the waves ever since.

I currently exist in a heightened state of fear and anxiety, unsure of what each day will bring. When I wake each morning, I silently hope that today will be a “good” day; that he won’t be angry. That he won’t hurt me. Sometimes I’m lucky, and I get my person back. Other times, it feels like I’m living in a battle ground.

Her story really struck a nerve for me because of what she is going through but also because NO solutions are provided for her son. Stories like this help create awareness, make you feel less alone, create empathy and better understanding – which is important – but we want to offer nutritional solutions to families who are dealing with this.

(You can read her entire story on the ScaryMommy blog.)

Functional medicine and nutritional psychiatry as a solution

My heart goes out to this mom, this young man and the rest of the family. My hope is that this mom and all mom’s in similar situations are open to functional medicine, nutritional psychiatry and the power of food and nutrients to dramatically reduce and in many cases reverse behavioral issues like this in the child.

Sugar, caffeine and junk food must go and a gluten-free diet will very possibly make a difference. Having her son eat for blood sugar control is key too. It may also mean switching to a low-salicylate and/or, low-oxalate and low histamine diet. And addressing low lithium, low zinc, low vitamin D, low vitamin B12, high copper, low magnesium and/or low vitamin B6. Low serotonin and low GABA are common and this is where I would start with this young man (more on this below). They may also need to address his gut health/parasites, infections (like Lyme), PANS/PANDAS, mold toxicity, metals and environmental toxins etc.

I’ll highlight many of these in this blog and share links for further reading, plus the approaches I may consider. The important thing to recognize is that there is not one-size-fits-all.

Address low serotonin and low GABA

For a mom in the midst of all this, it can seem overwhelming and very daunting but when you start by addressing low serotonin and low GABA it becomes so much easier. Her son gets some relief very quickly and all the root causes can be figured out and addressed one by one. It also gives mom and the family a much-needed glimmer of hope. As I mentioned above, this is where I would start.

These are clues from her story as to why we’d want to look into and address low serotonin: her son’s explosive anger and rage, the physical and mental abuse, threats to hurt himself (self-harm) and his mother and siblings, and being argumentative.

You can see how the above fits into the list of low serotonin symptoms here. The amino acid that addresses low serotonin is tryptophan or 5-HTP and you can expect to see results in a few days.

I worked with an 11 year old girl with explosive rage issues (and anxiety, cravings & insomnia) and chewable tryptophan started to turn things around very quickly. You can read more about this here.

If he has low GABA symptoms of physical tension and anxiety, we’d do a trial of GABA next.

A gluten-free diet and eating for blood sugar control

The next change I’d make is to have him start to make dietary changes, starting to switch to gluten-free eating and real whole food. As you can see from the above blog, a gluten-free diet and getting the 11 year old off the sugar made a big difference too. Tryptophan helped with this process, making it easy to break the addiction and not feel deprived.

Gluten issues (celiac disease and gluten sensitivity) are typically associated with gut issues but the psychiatric symptoms are less recognized. This 2023 paper, Psychiatric and Neurological Manifestations of Celiac Disease in Adults states that “Celiac disease is associated with mood disorders, such as manic-depressive disease, schizophrenia, and bipolar disorder, as well as other disorders such as depression and anxiety.”

In this blog I share how gluten was found to be the cause of a childhood case of obsessive-compulsive disorder. Symptoms resolved on a gluten-free diet.

Having him starting to eat for blood sugar stability may help with the irritability and mood swings, and may also help with his rageful outbursts.

Low dose lithium orotate for the rollercoaster of emotions

Next I’d likely explore the possibility of low dose lithium orotate as something that may help this young man too. The hallmark of low lithium is a rollercoaster of emotions and this mom shares how there are really good times amongst the really tough times. I use this lithium questionnaire with clients. In addition to the ups and downs, these are clues that he may benefit: he’s rebellious, exhibits disruptive behavior and aggressiveness, is irritable, restless and engages in risky behavior.

Next steps: explore all the possible root causes and do nutritional testing

We’d want to explore all possible root causes and next steps would be decided based on his specific situation. Here is a list of 60+ root causes that I work through and the nutritional/functional testing that I do with my clients. You can replace anxiety with anger/rage in the blogs – for some people their symptoms show up as rage and for others it’s anxiety.

And here are some links for further reading:

Bartonella infection in mom and both sons: anxiety, panic attacks, insomnia, inconsolable crying, irritability, ADHD, rage and pain
Christmas tree phenols as a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms? (dietary salicylates – a type of phenol – can cause similar issues)
Sex and Aggression Characteristics in a Cohort of Patients with Pediatric Acute-Onset Neuropsychiatric Syndrome “Among patients with PANS, males exhibit more aggressive behavior when compared with females” (typically the clue it may be PANDAS/PANS is sudden onset of symptoms, although it’s not the case in all instances)
Neuropsychiatric Lyme Disease by Dr. Suruchi Chandra Lyme disease “can remain dormant for years and then later mimic a number of psychiatric illnesses, including anxiety disorders, mood disturbances, psychosis, and autism-like behaviors.”

This is not a conclusive list but a good start for seeing what the possibilities may be. Feel free to search the blog for more on some of the above and some of the other factors mentioned above and in the 60+ root causes blog.

As you can see above, we start with the simple changes – amino acids and a few simple dietary changes (all covered in my book) and lithium orotate – and then continue to dig deeper.

Mom and the other children need nutritional/trauma support too

This mom and the other children need support too – from family and community, from a therapist who specializes in trauma – and with GABA/tryptophan, adrenal support and B vitamins. You can read more about nutritional solutions for psychological stress here.

Resources if you are new to using tryptophan or GABA as supplements

If you are new to using tryptophan or GABA as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA and low serotonin).

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues (which include rage/anger/irritability/self-harm).

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support.

Have you found tryptophan, GABA and/or lithium orotate to help in a situation like this?

What about a gluten-free diet and eating for blood sugar control?

What bigger root causes were found to be contributing factors too?

If you have questions and other feedback please share it here too.

Does 5-HTP (an amino acid) cause nightmares or does it help prevent nightmares (and also support low serotonin symptoms)?

October 7, 2022 By Trudy Scott 24 Comments

How do you do with using the amino acid 5-HTP for supporting your low serotonin symptoms of anxiety, worry, ruminating, fears, depression and insomnia? Does it help or does it cause nightmares? On a recent Facebook thread someone shared that 5-HTP causes really bad nightmares, so she had to stop using it. A few others posted saying 5-HTP also caused them nightmares. I’ve not had any clients report nightmares, so I was surprised to hear this feedback. However, most folks on the same Facebook thread shared that 5-HTP works very well for them and does not cause nightmares. There is also research that supports the use of 5-HTP for night terrors. I suspect it may have to do with low vitamin B6 and share more on that below.

Here is her experience with 5-HTP and nightmares and some of my feedback:

I don’t know how anyone takes 5-HTP. The horrific nightmares I got from taking it made me stop 50 mg. I tried 3 times thinking it was a fluke and it happened every time. Too scary for me.

My first try was suggested from my Naturopath, Metagenics SeroSyn. 200 mg. First morning waking up I had a nightmare so bad I can’t even share it. I also woke up feeling unable to wake up, drugged almost. So I waited, did more research and googled 5-HTP and nightmares just to see if there was a connection. I found it. I read to lower the dosage. So I went to Pure Encapsulations 50 mg. Same thing happened. I tried 2 more times, same thing happened. When I researched, I found so many people talking about “vivid dreams” and after my last attempt the dream was so real I thought my son was in my home when I woke up and had to process reality from my dream. That did it for me. Now I’m terrified of it. Just my own experience. I did get help from depression though! But I cannot go through one evil for another. Now I’m stuck looking for help and answers.

I thanked her for sharing and agreed it does help to do a few experiments to be sure it was the 5-HTP. I also shared that I would not consider the Metagenics SeroSyn a good 5-HTP to test because of all the other ingredients. But it also happened with Pure Encapsulations 50 mg 5-HTP – that was a good test to confirm.

I also shared that some folks do better on 5-HTP and some on tryptophan so if 5-HTP did help with low serotonin symptoms then I’d consider a trial of tryptophan especially since she did say using the 5-HTP helped with her depression.

We would also look for other ways to support serotonin – saffron, turmeric, St. John’s Wort, theanine (it supports GABA, serotonin and dopamine) and of course diet (real whole food, quality animal protein, no gluten/sugar/caffeine, fermented foods, organic vegetables and fruit, healthy fats etc), gut health and more.

I’d also look into and address low zinc and low vitamin B6 as both are needed to make serotonin and the other neurotransmitters. More on low vitamin B6, pyroluria and nightmares below.

Here is some of the feedback from other folks who also had issues with 5-HTP:

5-HTP didn’t mix well with my body either. Taken at night, horrible dreams, and 50mg Pure Encapsulations formula in the morning made me feel so dark, spaced out and terrible nausea.
I appreciate this post. I had nightmares from a magnesium supplement that included 5-HTP! Now I know I’m not alone.

And here is some of the feedback from folks who do well with 5-HTP (the majority of those who responded):

I take 100 mg of 5-HTP in the morning (Natural Factors) and about 350 mg of tryptophan before bed (Lidtke). It works well for me. No nightmares although I do dream a lot. Mostly noticed improvement in mood and ruminating thoughts. Also taking Sam-e which also helps.
I take chewable natural factors Tranquil Sleep. It contains other ingredients (like theanine) as well but it’s really easy to dose. If I take 2 it’s too much. I get weird dreams and a headache. So 1 1/2 it is.
5-htp helped me so much! But I had to take it in the morning. 250mg was perfect for me. I was using this for my debilitating anxiety which would keep me in flight or fight all day and I would ruminate. Really helped me along with therapy. I no longer need it.
I’ve just started taking 50mg 5-HTP at night. It’s a micronized version I buy from a compounding chemist in Australia. No negative side effects so far.
Grateful for the reminder … I did great on 5-htp myself. Have had all dose amounts, given at different times too. I deal with chronic pain and trauma/stress.
My sister gets anxiety on 5-HTP but it helps me so much! I have not tracked regular consumption compared to my sleep (I get too much REM without it and wake up exhausted). I also no longer need it as a daily and can take it as needed. I take 200mg, forget the brand but it’s a single ingredient.
I take 50 mg of 5-HTP from Seeking Health and do very well on it. It has helped me with depression, worry, fear, more energy and motivation and no nightmares.
I take the Now brand, 100mg at bedtime along with the same brand of L theanine. No nightmares and I’ve been doing this for about 5 years.
I use 50mg Seeking Health 5-HTP and I love it. It gives me energy and motivation, helps with intrusive thoughts and anxiety. I’ve used the Jarrow brand in the past without results. No nightmares. P5P, on the other hand, I cannot take. It gives me such clear, vivid nightmares I would wake up crying. Never again.

We are all unique and there is clearly no one-size fits all.

Low vitamin B6 can cause nightmares or poor dream recall

It’s well recognized that low vitamin B6 can cause nightmares or poor dream recall. In this study, Effects of Vitamin B6 (Pyridoxine) and a B Complex Preparation on Dreaming and Sleep (which was randomized, double-blind and placebo-controlled), 100 participants from across Australia were given 240 mg vitamin B6 (pyridoxine hydrochloride) before bed for five consecutive days. Other study participants were given a B complex. This is the outcome of the study:

vitamin B6 significantly increased the amount of dream content participants recalled but did not significantly affect dream vividness, bizarreness, or color, nor did it significantly affect other sleep-related variables
participants in the B complex group showed significantly lower self-rated sleep quality and significantly higher tiredness on waking

This vitamin B6/dream recall research is of particular interest to me because of my work with pyroluria, a social anxiety condition which responds really well to supplementation with zinc, vitamin B6 or P5P (pyridoxal-5-phosphate) or a combination of both, and a few other key nutrients. Here is the pyroluria questionnaire.

One of the classic signs of pyroluria is poor dream recall, stressful or bizarre dreams, or nightmares, signs which the late Carl Pfeiffer, MD attributed to low vitamin B6 status. He suggested that your dreams and dream recall serve as a good indicator of your need for vitamin B6. You should dream every night and you should remember your dreams. They should be pleasant – the kind of dreams where you wake up and want to close your eyes and continue dreaming.

Could it be that folks who get nightmares with 5-HTP, happen to also have pyroluria? Or perhaps they simply have low vitamin B6 status? I have all my anxious clients supplement with vitamin B6 and/or P5P and this may be why nightmares with 5-HTP was news to me.

5-HTP can increase cortisol – does this affect nightmares?

There is research and clinical evidence supporting that, for some individuals, 5-HTP can raise cortisol. I’ve blogged about this here:

This is not always the case. Someone in the same Facebook thread shared this: “My cortisol measured above the reference range, but 5-HTP is the only thing I’ve found that’s helping me sleep recently.”

I’m not aware of a high cortisol-nightmare connection but it’s possible. In one study, nightmares triggered high cortisol the next morning, but I donut this has relevance in this situation.

5-HTP induces long-term improvement of sleep terrors in children

There clearly is a subset of folks who don’t do well with 5-HTP and yet there is evidence that it can actually improve sleep terrors. In a small open label clinical trial of 45 children, it was found that 5-HTP was able to “modulate the arousal level in children and to induce a long-term improvement of sleep terrors” (in the majority of children in the trial). There were 34 male and 11 female children ranging in age from 3.2-10.6 years.

After the first visit, L -5-HTP was administered (2 mg/kg per day) at bedtime to 31 randomly selected patients for a single period of 20 consecutive days. After 1 month of treatment, 29/31 (93.5%) of patients showed a positive response. In the comparison group without drug therapy, after 1 month, the episodes disappeared only in four children (28.6%) while ten children (71.4%) showed the persistence of episodes with the same frequency as before. After 6 months, 26/31 (83.9%) of children treated with L -5HTP were sleep terror-free, while in five children (16.1%) sleep terror episodes persisted. Of the children in the comparison group, ten (71.4%) continued to show sleep terrors at 6-month follow-up.

If we assume a 10-year-old weighs, 70lb or close to 32kg, they would have been given 60mg 5-HTP (i.e. 2 mg/kg).

Typical adult dosing of 5-HTP is 50mg twice a day, mid-afternoon and evening. For a 10-year-old we may start with a quarter of this dose i.e. 12.5mg or 25mg 5-HTP twice a day, for a total of 25mg or 50mg a day – which is close to what was used in this study.

You can read more about this in the paper here: L -5-Hydroxytryptophan treatment of sleep terrors in children

Resources if you are new to using 5-HTP and other amino acids as supplements

If you are new to using any of the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low serotonin and low GABA).

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

How do you do with 5-HTP for low mood, worry-type of low serotonin anxiety, cravings, PMS, negative self-talk, anger/rage/irritability, insomnia, ruminating thoughts, winter blues etc? Does it help?

Or does it give you nightmares that are bad enough that you have had to stop?

Please share how much you used? And if tryptophan or other serotonin support helped instead?

Did the addition of vitamin B6 or P5P help prevent the nightmares when using 5-HTP?

And do you have pyroluria or suspect you may have it? Do you have high cortisol?

If you’re a practitioner I’d love to hear your experiences with 5-HTP and nightmares.

If you have questions please share them here too.

Teen with anxiety, low self-esteem and insomnia: how to do a one-off trial of tryptophan to figure out if she has low serotonin

August 20, 2021 By Trudy Scott 23 Comments

A mom asks for advice for her teenage daughter who has anxiety, low self-esteem issues, insomnia, experiences negativity and has phobias. She wants to know if serotonin support may help and where to start. I share my feedback confirming that these are low serotonin symptoms and that I would do a trial of tryptophan. I go deeper in this blog and also go into detail about how I would do a one-off trial (or evaluation) of tryptophan if I was working with this family. I also share why I’d look into low GABA, seasonal allergies and the birth control pill. And I discuss the importance of being proactive given the increasing suicide and self-harm in this age-group, with the pandemic compounding the increase.

Here is the question that Maria asked about her daughter:

My 13-year-old teen has always suffered from insomnia, sometimes light, sometimes a bit heavier, depending on the period. She has suffered from asthma from a young age, even if this issue has improved enormously, it is sometimes present, specially during spring time as she is allergic to different plants. She would suffer from sugar cravings in the past as we were trying to change her diet. Things are going better in this respect as well; however, negativity, phobias, low self esteem and anxiety are always present for her.

Are these signs of low serotonin? How could we help her feel better? Should serotonin pills be applied directly? Would this make the system dependent on it? If amino acids should be supplemented, how should we do this, considering her age?

I responded that yes, negativity, phobias, low self esteem and anxiety (the worry type) are signs of low serotonin. Insomnia can also be caused by low serotonin especially if her daughter is lying awake, overthinking and worrying about things.

I shared that the body does not get dependent on the amino acids and I’d consider a trial of tryptophan to address her symptoms.

Doing a one-off trial/evaluation of tryptophan based on her symptoms

If I was working with this family, I would help this mom figure out for sure if her daughter has low serotonin by reviewing the low serotonin symptom list with her, and helping her rate them on a scale of 1-10 with 10 being the worst.

This can often be challenging for a 13-year old: giving the symptoms a severity rating and being able to identify exactly how she feels. Her ratings may also be reflective of where she is in her cycle at the time and may fluctuate more in the month if her cycle is not yet regular. Working together with mom we can hopefully figure this out. If not, we do the best we can with the information we have.

The next step is picking one or two symptoms that are easy to measure the day we do the initial trial or evaluation. For this young girl I’d pick anxiety/worry and negativity and ask her some questions that would help us assess before and after results of the one-off trial /evaluation of tryptophan:

For anxiety and worry she may say it’s also a 9 and give me this example: “I’m really worried about performing in the concert – I keep thinking about it all day long and at night.”
For negativity she may say it’s a 9 and give me this example: “I really don’t think I’m good enough to be in the dance class.”

Both tryptophan and 5-HTP can raise serotonin but I like to start with tryptophan. I typically start with 100mg Lidtke chewable tryptophan in children/teens so I’d have her chew one tablet and then check back in the next 2 to 5 minutes (or maybe a little longer for some folks).

This is the kind of feedback I’m looking for:

With regards to anxiety and worry she may say: “Gosh, I completely stopped thinking about the concert. I’m not worrying about it at all. Now that you ask I’m thinking about it again but I think my worry/anxiety is about a 5 now.”
With regards to negativity she may say: “I think I feel better about being in the dance class. I think I can do it. My negativity feels like it’s a 5 or 6”

Since this teen responded so well, I’d have her start taking tryptophan midafternoon and evening (away from protein) and we’d increase if needed, each week, and based on her symptoms.

I have everyone keep a food mood and supplements log and mom could help her do this too.

GABA, seasonal allergies and the birth control pill

I also always assess low GABA when someone is anxious (especially if she also has physical anxiety, tension, stiff muscles) and has insomnia. We’d do the same one-off trial with a product like GABA Calm (or similar) once we’ve established a good dose of tryptophan for easing her symptoms.

This mom also mentioned Spring time allergies so I also shared this blog with her: 5-HTP and/or tryptophan to help with increased anxiety, panic attacks and depression caused by spring allergies. Depending on the season, her daughter may score higher on some of the low serotonin symptoms.

I’d also want to know if her daughter is on a birth control pill (often prescribed at this age for acne) because it can contribute to anxiety and depression.

Being proactive is wise given the rise in suicide and self-harm in this age group

Being proactive about addressing low serotonin symptoms quickly is wise given the rise in suicide and self-harm in this age group. This 2021 Italian study discusses the role of emotional dysregulation when it comes to and self-injurious thoughts and behaviours in high-school students:

Overall, 11.1% of adolescents reported self-harming behaviours without suicide ideation or attempts, 6.4% declared having thought to suicide without acting a suicide attempt or self-harm, 1.4% declared having attempted suicide and really thought to take away their life.

Unfortunately, the pandemic has also made things worse for many adolescents. This study reports that Canadian adolescents appear to be experiencing “higher rates of self-harm thoughts and behaviours relative to before the pandemic.”

It’s important to keep in mind that pre-teens and teens may not be willing to admit that they are engaging in self-harm like cutting or burning, or thinking about taking their lives.

Resources if you are new to using the amino acids as supplements

If you are new to using the amino acids tryptophan/5-HTP or GABA as supplements and want to know more in case you need them in a future situation, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the low serotonin and low GABA symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low serotonin or low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable.

It also covers all the basics of a healthy diet. It’s a comprehensive approach – amino acids AND diet. I’d also want to know what her diet is like right now – gluten-free, sugar-free, caffeine-free, eating protein at breakfast for blood sugar control, real whole foods, grass-fed red meat, wild fish, fermented foods etc?

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acid products that I use with my individual clients and those in my group programs.

Thanks to this mom for asking the question and allowing me to use it as a teaching tool for my community. Let’s get her daughter and all teens feeling their best again.

Can you relate to the question this mom asked? Does it sound similar to what your daughter is experiencing right now or a client/patient?

Do you do a one-off trial /evaluation like this to find out if serotonin support is needed? Or have you done this in the past with your daughter, family member or yourself?

What are the before and after questions (and symptom ratings) and did tryptophan help?

Feel free to post any questions here too.

Twisties, nervousness and demons at the Olympics: Outpouring of love and support for Simone Biles for taking care of her mental health

July 30, 2021 By Trudy Scott 10 Comments

Simone Biles at a training session at the Rio 2016 Summer Olympic Games (Salty View / Shutterstock.com)

There has been an incredible outpouring of love and support for gymnast Simone Biles, as she withdrew from the 2020 Olympics Women’s Team final on Tuesday and All-Around Individual Final on Wednesday. This was due to the twisties, nervousness and mental demons. I’ve decided to gather some of this admiration into a blog post as a testament to Simone who I adore and respect even more than I did before today. I want this to be all about the love and support, but in order to tie it all together, I share more on the twisties (and anxiety), being vulnerable and taking care of yourself, nutritional psychiatry, using amino acids and mental health advocacy below.

Before we get into all that, here is an ET video that explains some of the backstory leading up to this:

Simone shares that she feels good physically but emotionally, her feelings vary by the day. She also talks about the stress of the Olympics and being the star gymnast and that she feels she has the weight of the world on her shoulders.

You’ll also see and hear the love and support she gets from her team members and fellow gymnasts. Two-time Olympian, Aly Raisman, says this about Simone: “She is human too and sometimes people forget that. She is doing the best she can.”

The love and support continued to show up all over social media (and is still showing up)! What follows are some of my favorite posts and mentions.

The love and support – Simone Biles already won

Women Hold Up Half The Sky, a community that empowers women to find their voice and celebrates women in their diversity, shared this powerful post when Simone withdrew:

“Simone Biles already won” and how she has “shattered records to become the world’s most decorated gymnast, has four moves named for her and fought on behalf of abuse survivors.”

Simone is one of many young female gymnasts who were sexually abused by disgraced former USA Gymnastics doctor Larry Nassar. This article in Elle covers her story and goal to be an advocate for other young girls.

We are just as proud of you today as yesterday

Jen Hatmaker, New York Times bestselling author of “Simple and Free” posts this lovely uplifting message, ending with:

I’ll tell you what, Simone Biles, the only thing withdrawing from the team competition told me is that absolutely nothing is more important than your mental health, and rather than push through until you had an utter breakdown emotionally or physically, you had the strength of character to step down. The watching, expectant eyes of the whole world are a heavy burden none of us understand.

Your IG caption on July 7th said: “Whatever is good for your soul, do that.” And you did. Well done.

Because this life is a long game, little sister. No matter what everyone is telling you, this is NOT your one moment. It sure isn’t. Most of your moments are ahead of you in fact, and you get to choose how you want to live them.

We are just as proud of you today as yesterday, and we will be proud of you for all your tomorrows. Catch your breath, girl. You are already a champion.

I wholeheartedly agree, nothing is more important than her metal health. Too often we put on a brave face and push through. Simone didn’t and for that we are super-proud of her – for her own physical and mental health, and for being a role model to girls and women around the world.

Simone Biles and Naomi Osaka are the role models I want for my girls

Diary of a Mom, mother, intersectional advocate, believer in the power of community, posted this beautiful message about strength, bravery, vulnerability and Simone and Naomi being role models for her daughters:

I have long admired Simone Biles, but I am now officially in awe of this young woman.

We knew she was strong. We knew she was brave. But, by god, the courage and resolve that she has shown in the last two days are just BEYOND.

To stand firmly in one’s own humanity and to say, from that incredibly vulnerable place, “My safety comes first,” should not have to be a radical act, but it is. Oh, how it is. In the world in which we live (and far more so in the rarified air of elite competition), it is not just radical, it’s revolutionary.

Simone Biles and Naomi Osaka are the role models I want for my girls. Women who know their worth. Who declare and own and defend their *inherent* value – not based on what they can do but on who they are. Women who achieve incredible things not despite their perfectly human limitations but precisely *because* they are willing to acknowledge and respect them.

Yes, these are the role models I want for my girls.

Bravo, Simone.

#GOAT

I applaud this strong woman and amazing athlete

Mary Kay Irving, Therapist/Care Coordinator at Boulder Community Health and Owner at Boulder Center for Health and Nutrition, shares this message.

I applaud this strong woman and amazing athlete for prioritizing her own needs….i.e.. mental health needs. #destigmatizementalhealth #mentalhealthawareness

I also applaud Simone and support her decision to take care of her mental health needs no matter how hard it must have been for her!

Simone is an absolute legend!

My friend and colleague Dr. Jessica Drummond, a functional nutrition and integrative women’s health expert, and founder of Integrative Women’s Health Institute, says Simone is an absolute legend:

Simone is an absolute legend. The fact that she landed this AT ALL is AMAZING. I was a gymnast for 13 years. You have to be able to just “feel it” in the air or you literally crash because there’s no awareness of where the floor/ apparatus is. Literally anyone else would have had a serious physical injury from this challenge to her nervous system in mid-air… especially with the amount of pure power that Simone throws around.

This is so great for people, especially our youth athletes, to see

Another friend and colleague, Beth Jones who is a Female/Teen Athlete Wellness & Mindset Coach, posts this.

I’m grateful for athletes like Simone Biles and Naomi Osaka who are coming forward (and professionals as well) to normalize mental health as a key piece of sports training and recovery.

I could not agree more.

In this post, Beth also shares Simone’s press release video where she fully advocates for her mental health and personal performance, keeping the team dynamic in mind, and also sets a wonderful example for young athletes

Sometimes you need to hear it from the GOAT’s mouth.

My understanding is that she hasn’t made a final decision regarding continuing competition in the individual event finals. She has an amazing support staff around her, including mental health specialists, who can help her make the best decision for her. I also wanted to share this video – it’s her interview explaining the decision in her own words.

She is fully advocating for her mental health and personal performance, while also keeping the team dynamic in mind. This is so great for people, especially our youth athletes, to see – there are not a lot of athletes who will speak candidly in this way.

I’m glad that athlete mental health is finally getting some of the recognition it deserves – think about how much stress and frustration not being scored on your achievements (link in comments) must have been for her on top of everything else.

The mindset that mental “injury” creates absolutely ties into, not only performance but injury prevention. The level of skill that all Olympic athletes are competing at is so high and second-guessing or not being fully focused leads to injury.

Thank you for finding your voice and staying true to yourself.

Tyler Gordon, a 14-year old artist who seeks to inspire through the stories of heroes in his work, tweeted this sweet message with his painting of Simone:

Dear Ms. @Simone_Biles Thank you for finding your voice and staying true to yourself. I know it was hard, scary, and you probably felt alone. But you powered through and are still the peoples champion!

This young man is kind-hearted and has talent! You can actually watch him painting Simone here.

Unfortunately, there have been way too many negative comments. I believe these are people who don’t understand mental health. You don’t have to have broken your back to have compassion for someone who has but there are still too many people who can’t understand mental health or have empathy until they have experienced it or see a loved one experiencing it. I’m hopeful all this media attention will help create more awareness, compassion and kindness.

The twisties and how stress and anxiety can play a role

In case you are new to this term (like I was until this week), this article explains what the twisties are – Simone Biles Mentioned Having ‘the Twisties’ – Here’s What That Means, and Why It Can Be Dangerous in Gymnastics:

The twisties is an informal term used to refer to a certain kind of mental block that a gymnast can experience as they are in the air during a twisting skill. When someone gets the twisties, there is a disconnect between the brain and body, Jamie Shapiro, PhD, a certified mental performance coach who is the co-director of the Masters in Sport and Performance Psychology program at the University of Denver

In this same article, Dr. Shapiro, a former gymnast herself, shares how this loss of control can have both physical and mental implications:

Physically, the twisties can make a gymnast unable to perform the skills as they were previously able to.

Mentally, that inability to perform the skills can cause anxiety, exacerbating the mental block.

Allie Wagener, PhD, a licensed psychologist who specializes in sport and performance psychology at Premier Sports Psychology and is also a former gymnast shares how dangerous this can be in terms of injuring yourself when “you don’t know where you are in the air and you don’t know how to land.” It’s also terrifying for the gymnast and that worry and fear about it happening again can make things worse.

I wanted to understand more about the “twisties” in gymnastics and asked Jessica Drummond how similar are they to the yips, which happen in golf or baseball, and which I know are closely tied to increased anxiety/stress. The stress/anxiety can be a trigger and then having the yips make your anxiety and fears worse. Jessica confirmed this about the twisties:

Yes, it’s sort of a loop that can get stuck – get lost in the air (cognitive, proprioceptive, vestibular) –> realize how dangerous that is/ was/ could be –> fear –> stress –> exacerbates the original brain-based issue.

I encourage you to read the entire article to see how stress and anxiety, racing/negative/distracted thoughts, fear of failure, high expectations and even focal dystonia (involuntary muscle spasms) can play a role.

The experts also mention a number of possible techniques to help (like progression, focusing on a different skill, using simple cue words to “keep you focused on the skill rather than the fear”), speaking with a sports psychologist and taking a break.

There is no mention of “nutritional psychiatry” as a possible solution (and I share more on this below).

What Simone has shared – I’m a little bit more nervous

Right now, we don’t know exactly why Simone experienced the twisties or if any of the above apply to her, but we do know some of what she has shared with the media up until now.

In this article Simone said she wasn’t physically injured but fighting some mental demons and had experienced a little injury to her pride. She said that “after the performance I did I just didn’t want to go on,” saying it was all in her head. Simone also emphasized the need to protect her body and mind, saying “I have to focus on my mental health and not jeopardize my health and well-being.”

An article in Women’s Health Magazine reports her comments at a press conference after the USA team won the Silver medal. Simone shared how she just doesn’t trust herself as much as she used to, wasn’t having as much fun as usual and admitted that “I’m a little bit more nervous when I do gymnastics.”

It was here that she announced that she had the twisties.

Around this time USA Gymnastics announced Simone had withdrawn to focus on her mental health. They also offered their support:

We wholeheartedly support Simone’s decision and applaud her bravery in prioritizing her well-being. Her courage shows, yet again, why she is a role model for so many.

A place for “nutritional psychiatry” and “anxiety nutrition solutions”

My hope is that more and more “nutritional psychiatry” and “anxiety nutrition solutions” (like the use of GABA, tryptophan and other amino acids) will make it into the world of professional (and recreational) sports. I’d like to see this embraced by athletic coaches, registered dieticians and psychologists working with athletes, and hopefully some of the athletes themselves.

Research shows that elite young athletes have high psychological demands:

Elite young athletes have to cope with multiple psychological demands such as training volume, mental and physical fatigue, spatial separation of family and friends or time management problems may lead to reduced mental and physical recovery.

The paper concludes that:

Future research should focus on sports medical and sports psychiatric interventional approaches with the goal to prevent anxiety and depression as well as teaching coping strategies to young athletes.

I recently blogged about how the amino acid tyrosine erased severe performance anxiety in a female musician – to such an extent that she had no more shaking, sweating, panic attacks or passing out. Much of this could be applied to an athletic performance where low dopamine is a factor.

This recent blog resonated with many in my community: What if overthinking, fear, anxiety and worry (caused by low serotonin) is holding you back instead of low motivation/low dopamine? Much of this could also apply to athletes with the twisties or yips with low serotonin as a root cause.

My book, The Antianxiety Food Solution, is a great place to start with the foundations of eating to reduce anxiety (real whole food, no gluten, no caffeine, no sugar, eating for blood sugar control and gut health) and more advanced interventions (like using the amino acids GABA, tryptophan, 5-HTP, tyrosine, DPA and glutamine for balancing brain chemistry, and addressing low zinc and vitamin B6 for pyroluria/social anxiety.)

All this is clearly very needed, and the research and awareness are growing in leaps and bounds, but as Beth Jones, Female/Teen Athlete Wellness & Mindset Coach, shares, what an amazing shift it would be if we could add more “nutritional psychiatry” into the sports psych training:

Coming from 20 years working in sports med with athletes, I keep coming back to wishing there was a degree that combined sports psychology & nutrition (functional & fueling). I started looking into the more mental aspects of performance and healing and then also bringing in more nutrition aligned with healing needs about 15 years ago, but it was all on my own.

What I’ve been learning from you has given me some new tools to share, but you’re right in that they are not well known. I know our US Olympic Committee has amazing health professionals in all areas that work as a team approach for our athletes, but I wonder how many of the RDs are actually having conversations with the mental health team and collaborating taking all of the athlete-specific nuances into consideration.

I know my own therapist suggested that I not pursue sports psych because of the lack of support among therapists out there, but what an amazing shift it would be if we could add more nutritional psychiatry into the sports psych training? Trying to forge a path in this area on my own, but it’s a lot of bush-whacking and little progress.

Beth raises some excellent points and as I said above, hopefully more and more of the “anxiety nutrition solutions” and “nutritional psychiatry” will make it into professional and recreational sports.

It’s ok to say you’re not ok mentally

Simone has noticed and embraced the love and support she’s been receiving. She tweeted this:

The outpouring [of] love & support I’ve received has made me realize I’m more than my accomplishments and gymnastics which, I never truly believed before

She is way more than her accomplishments and gymnastics.

Naomi Osaka penned an article in Time magazine with this title: ‘It’s O.K. Not to Be O.K.’ She wrote this shortly after she withdrew from the French Open to tend to her own mental health. Naomi’s openness has inspired Simone to speak out.

When athletes like Simone and Naomi prioritize their own mental health and are public about it, they are paving the way for it being ok to say you’re not ok mentally. Through their honesty and vulnerability, they have become role models and mental health advocates, and we applaud them for that.

But most of all we applaud them both for taking care of their mental health!

What love and support can you share for Simone and Naomi? Feel free to post in the comments.

Does this motivate and inspire you to be more open about your own anxiety and mental health challenges (if you have not been open yet)?

If you’re an athlete (professional or recreational), does any of this resonate with you and have the amino acids or diet helped you with your anxiety?

If you work with athletes (professional or recreational), I’d love to hear if this resonates with you and if you’re using nutritional psychiatry approaches with them to help ease their anxiety?

If you have connections to athletes (professional or recreational), or coaches, dieticians or psychologists who work with athletes, please share this blog and my work, so we can get nutritional psychiatry resources and anxiety nutrition solutions into their hands and help more athletes.