nutritional psychiatry

“A catatonic woman awakened after 20 years. Her story may change psychiatry.” (Her schizophrenia was an untreated autoimmune disease)

June 16, 2023 By Trudy Scott 8 Comments

Today I’m sharing some highlights from a recent eye-opening article in the Washington Post: A catatonic woman awakened after 20 years. Her story may change psychiatry

Before she became a patient, April had been an outgoing, straight-A student majoring in accounting at the University of Maryland Eastern Shore. But after a traumatic event when she was 21, April suddenly developed psychosis and became lost in a constant state of visual and auditory hallucinations. The former high school valedictorian could no longer communicate, bathe or take care of herself.

April was diagnosed with a severe form of schizophrenia

April was hospitalized, medicated and eventually institutionalized. It got to the point where she no longer recognized her family and she became catatonic, “unmoving, unblinking and unknowing of where or who she was.”

Twenty years after April’s original diagnosis it was discovered that she has an autoimmune condition. Dr. Sander Markx is director of precision psychiatry at Columbia University and I have so much admiration for his dedication to the field and the fact that he facilitated this testing and discovery so long after meeting April, when he was a student:

Markx and his colleagues discovered that although April’s illness was clinically indistinguishable from schizophrenia, she also had lupus, an underlying and treatable autoimmune condition that was attacking her brain.

After months of targeted treatments – and more than two decades trapped in her mind – April woke up.

April’s transformation is truly heartwarming and it’s wonderful that the doctors plan to do similar testing and offer similar treatments for others living with schizophrenia who are in mental health institutions in New York State.

Researchers in other countries are making similar connections and it’s really exciting to read that they are recognizing that “underlying autoimmune and inflammatory processes may be more common in patients with a variety of psychiatric syndromes than previously believed.”

We can and should be doing better when looking for root causes

I believe we can and should be doing better when it comes to looking for root causes. Many individuals may have an autoimmune/inflammatory condition and many may have other root cause/s. If I was on an advisory panel these would be my recommendations:

Use this powerful outcome to really turn psychiatry on its head and screen for lupus and other autoimmune conditions in every single person with schizophrenia. Dr. Markx “believes highly sensitive and inexpensive blood tests to detect different antibodies should become part of the standard screening protocol for psychosis.”
Do the same for every single person with mental illnesses and illnesses with a behavioral aspect – including anxiety, depression, bipolar, OCD/obsessive compulsive disorder. ADD/ADHD, autism/ASD (autism spectrum disorders), developmental disorders and neurological disorders.
Go beyond autoimmune screening and do a comprehensive functional medicine and nutritional deficiency assessment for every single person, including low serotonin, low GABA, low vitamin D, low zinc, low vitamin B6, hormone imbalances (sex hormones, adrenals, thyroid health), gut health, liver health etc. This includes testing for infections (such as Lyme and strep), looking at toxin exposure (phthalates, mold, heavy metals) and medication side effects.

If you’re new to the concept of root causes and functional medicine/nutritional testing these two blogs will be helpful. They are specific to anxiety because I work with anxious individuals but much of it can also be applied to other mental health and even physical health conditions (like rheumatoid arthritis and say multiple sclerosis):

Functional medicine and nutrition for maintaining symptom resolution in the long term

As you read in the article, April received “short, but powerful “pulses” of intravenous steroids for five days, plus a single dose of cyclophosphamide, a heavy-duty immunosuppressive drug typically used in chemotherapy and borrowed from the field of oncology. She was also treated with rituximab, a drug initially developed for lymphoma.”

Incredibly, she recovered completely and was eventually discharged from the psychiatric hospital and has been living in a rehab center for 3 years. Unfortunately “she has recently regressed because she was not receiving adequate maintenance care.”

I see the next step for April and others like her, is maintaining resolution of symptoms in the long term. This is where functional medicine and nutrition shines.

The ISNPR shared this about Nutritional psychiatry in 2015 in a letter published in World Psychiatry, the official journal of the World Psychiatric Association:

In addition to dietary modification, we recognize that nutrient-based (nutraceutical) prescription has the potential to assist in the management of mental disorders at the individual and population level.

In other words, diet and nutrient-based approaches need to be included for mental health treatment and for prevention. One of many examples is the ketogenic diet which has been shown to reduce auditory hallucinations and delusions in those with schizophrenia. Another is the low carb diet helping to reduce bizarre intrusive thoughts. And the SMILES trial was the first randomized controlled trial to show that dietary improvement can actually treat depression.

Specific nutrients can be very powerful too. One example is a case where a woman in my community experienced a drastic reduction in intrusive thoughts, anxiety and fears (and better sleep) with GABA, tryptophan, 5-HTP and the pyroluria protocol (zinc, vitamin B6 and evening primrose oil). More on the blog. Intrusive thoughts can be alleviated with a similar combination of nutrients and by addressing hormonal imbalances too.

These blogs/research illustrate a few of the many root causes of schizophrenia and psychosis other than lupus:

When it comes to autoimmunity in general I refer you to the work of Dr. Tom O’Bryan, Dr. Izabella Wentz, Dr. Terry Wahls, Dr. Amy Myers and others who teach about using functional medicine and diet for reversing a number of different autoimmune conditions.

The above approaches can all be explored and used when individuals are initially diagnosed too. But keep in mind that there is no one size fits all and it’s a matter of finding the root causes for each person.

We are moving in the right direction and there is hope but…

We are moving in this direction, awareness is growing and there is hope. But I know we can get there sooner.

What Dr. Markx and his colleagues have discovered and shared with the world will hopefully help us get there much more quickly.

(You can read the whole story here and a similar transformation experienced by Devine Cruz.)

I’m thrilled for April and Devine and their families, and appreciate them sharing these stories with the world. Let’s hope their stories do change psychiatry!

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), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

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.

Does this heartwarming story give you hope for psychiatry?

What do you feel we should be doing to advance nutritional psychiatry even more quickly?

Can you or a family member relate to this and what did you discover in terms of testing and nutritional support/functional medicine?

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.

Too much GABA causes a tingling niacin-like flush sensation (in the brain and body). It’s awful and very uncomfortable!

February 18, 2022 By Trudy Scott 104 Comments

GABA, used as an amino acid, helps to raise GABA levels and ease physical tension-type anxiety. There are many misunderstandings on the best and most effective ways to use GABA and this can lead to unpleasant symptoms. One common thing I see is that too much GABA causes the brain and body to react with a tingling niacin-like flush sensation that is very uncomfortable and often described as awful.

Too many people stop using GABA for this reason. And then they lose out on the wonderful calming benefits of this amino acid. Some folks actually push through and continue with the unpleasant tingling sensation because they don’t know better and because they are also getting some of the calming benefits of GABA (I share an example of this below). Neither situation is ideal.

I recently received a GABA question on the blog on this very topic. It was from a licensed acupuncturist in California, USA (let’s call her Dr. M):

When I used to take GABA for my stress, my body/brain reacted with a tingling sensation.

It was so awkward and uncomfortable.

I thought it was only me, but when I prescribed GABA to my patients, they also felt the same sensations.

Can you tell me why this reaction occurred?

Thank you so much for your generosity and deep research.

Because this is such a common question that I get, I’m sharing it and my responses to use it as a teaching opportunity.

Too much GABA can cause this uncomfortable tingling niacin-like flush or sensation

I responded sharing that it can happen when too much GABA is used or if GABA is not needed. I typically hear of this happening when 500mg to 750mg is used to start. It’s also often described as a niacin-like flush. With GABA, 125mg is a typical starting dose and it’s always used as a sublingual or capsule opened onto the tongue. We slowly go up from there based on symptoms and the final dose is unique to each person’s needs. You may end up using 500mg or more but it’s a slow approach to get there.

I asked Dr. M to share which product/s she used, the dosing and let me know if she does better with a lower dose.

As expected she was using too high a dose (and hadn’t done a trial of a lower dose). She responded with this feedback:

The GABA I used for me and my patients is from Pure Encapsulations. This GABA contains 700 mg per capsule, which may be too much for the start.

Which brand would you recommend for practitioner use?

I responded by confirming that 700 mg GABA is way too much to start for most people.

What product and how much to use instead of 700 mg GABA

I like the Pure Encapsulations product but I actually feel the companies are partially at fault for having such high dose products, stating “1 capsule daily, between meals, or as directed by a health professional” on the label, and not educating practitioners and consumers about this issue.

With a product like this I have clients open up the capsule and start with 125 mg GABA powder on the tongue and increase from there as needed.

I also shared the other GABA products I use in case she would prefer to try something like the Source Naturals GABA Calm product I frequently use with clients.

This is a lozenge that contains 125 mg GABA, 5 mg magnesium, 50 mg glycine, 25 mg tyrosine and 20 mg taurine. This is my most popular and most effective form of GABA I use with my clients. [Note: this product is a lozenge with 125mg GABA and is not to be confused with the Source Naturals, GABA Calm Mind, 750 mg tablets]

I’m waiting for feedback from her to hear how using less of the 700 mg GABA (opened up and divided out) or how using another GABA product works for her and her patients.

I do appreciate Dr. M for asking a tough question like this and being open to me sharing so everyone gets to learn.

Where did Dr. M learn about GABA and some resources for additional practitioner education

I did ask Dr. M where she learned about using GABA and if the recommendation was to use a high dose like this. I’m genuinely curious to know so I can help guide further education in the use of GABA.

Of course, I encouraged her to get my book “The Antianxiety Food Solution” and read the chapter on the amino acids. And to consider signing up for the amino acid training for practitioners. There are many nuances and best practices when using the amino acids. And it’s an opportunity to interact with me and other practitioners who are also using the amino acids.

If you’re a practitioner, I’m hoping this question, my feedback and these resources are helpful for you.

Similar niacin-like flush experienced by Holly

As mentioned above this is a very common issue because most GABA products are 500mg and up and folks hear how amazing GABA is for physical anxiety and use a high dose without understanding they need to start low and use only what they need.

I shared my discussion with Dr. M in a Facebook post and Holly responded with what happened to her when she switched from GABA Calm (which has 125 mg GABA) to a 750 mg GABA product:

I experienced the niacin-like flush when I tried to go from GABA Calm [mostly dissolved in my mouth] to a pill form and didn’t realize the dosage would be way too high all at one time. The pill was 750 mg GABA [and swallowed with food], so it wasn’t going to work well anyway.

The flush lasted about 15-20 minutes. It was awful. I was sure I was going to throw up every time.

It took me a couple of weeks to figure out the cause. My therapist recommended your website and book and those helped me understand when to take it and why it would help.

When I eliminated the 750 mg GABA pill the symptoms completely went away.

Now I stick to GABA Calm. I take one in the morning and one before bed and sometimes one midday.

I appreciate Holly for sharing and I’m glad her and her therapist figured it out.

Resources if you are new to using GABA as a supplement

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

In case you’re new to the low GABA-type of anxiety, with low GABA levels you may experience physical-tension and stiff-and-tense-muscles, panic attacks, more physical tension in certain settings like public speaking or driving. You will often have the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods.

Insomnia can also be caused by low GABA and you’ll experience physical tension in bed at night rather than the ruminating thoughts which is the low serotonin type of insomnia (although it’s not uncommon to experience both.) GABA also helps with muscle spasms and pain relief when muscles are tight.

If you suspect low levels of GABA or low serotonin 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 team you or your loved one is working with.

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 GABA products that I use with my individual clients and those in my group programs.

Get guidance in the GABA QuickStart Program

If you don’t feel comfortable reading my book, doing the low GABA symptoms questionnaire and doing trials of GABA on your own, you can get guidance from me in the GABA Quickstart Program.

We have an active and engaged community in the private Facebook group and there are 2 live Q & A calls with me.

One of the recent participants shared this lightbulb moment after starting with GABA Calm in the day and then shifting to 250 mg GABA at night only:

Listening to the GABA Quickstart made me realize something about the Source Naturals GABA Calm with the bit of tyrosine. I bought the NOW GABA powder and last night took 250mg (1/8 tsp and I have tiny measuring spoons) and woke up great.

I think I found my dose of GABA and I don’t think after my trial I’m a GABA in the day girl.

Have you used a high dose of GABA to start (or switched to a higher dose like Holly did) and experienced this unpleasant niacin-like flush?

How much caused this tingling sensation for you and how unpleasant was it? Did you push through and continue using the high dose? Or did you figure it out and use less? How long did it take you to figure it out?

Maybe you quit using GABA because of something like this – do you now feel inspired to try again?

If you’ve had success with using GABA please do share too.

If you’re a practitioner where did you learn about using GABA and was the recommendation was to use a high dose like 500 mg or 750 mg to start?

Feel free to ask your questions here too.

Be sure to share which product you used, how much you used and if you have low GABA symptoms.

A lifetime of horrible and bizarre intrusive thoughts eliminated by a low carb/high fat diet (not as strict as keto) – a case study and research

February 11, 2022 By Trudy Scott 26 Comments

Intrusive thoughts are a symptom of anxiety, are more common than you’d expect and it’s not just you who experiences them. Today’s case study illustrates the power of diet: a low carb/high fat diet (not as strict as keto) completely eliminated a lifetime of horrible and bizarre intrusive thoughts for one woman. Read examples of her actual intrusive thoughts below and check out the supporting research and other case studies.

Ruthie suffered from intrusive thoughts as a child and most of her adult life, and assumed everyone did too. As a child, she would share some of her bizarre thoughts with other children, and they would stare at her and tell their parents. Her own parents became extremely concerned believing she might do one of these bizarre things. Her husband would sometimes look at her in horror when she asked certain questions. As an adult, she was told she was “unusual in a nice sort of way-haha!” This is how she described some of her intrusive thoughts:

They took the form of either myself or family members doing horrible/bizzare things or I would get in the car to go someplace and imagine one of the other drivers on the road doing something bizarre and my mind would follow it right through to the end result of what the individual caused to happen. I would arrive at my destination not remembering any part of my drive, my mind was so busy.

She goes on to share some of her postpartum experience with intrusive thoughts:

Everyone thought I had postpartum depression with my first child but it was the intrusive thoughts that had put me into a panic regarding her care. It was wonderful when a therapist told me it was the intrusive thought component of OCD and I could put a name to it.

It was the greatest delight of my life, when both children grew bigger and stronger than me so I knew, even though I knew I would never hurt them, they had the chance to defend themselves!

For her, eating high fat/low carb has eliminated her lifetime of intrusive thoughts:

Fast forward to discovering the low carb/high fat (LCHF) eating plan (not as strict as keto) and my intrusive thoughts have been gone for almost 2 years now (unless I become overtired).

It is a simply horrid disorder to have. I am just glad now it is well known but it really upsets me that it is being treated with dangerous psychotropic drugs that can do more harm than good when diet changes could be the solution.

I asked if she had ever used GABA or tryptophan (covered in part 1) or any other nutrients during any of the really bad periods and if any of it had helped. She shared that tryptophan gave her dreams that were too vivid and “by the time I was aware of GABA as a possibility, I had changed my diet and my problems had basically been resolved.”

She also confirmed her LCHF diet is predominantly gluten/grain free except the occasional splurge. I suspect these splurges may contribute to her feeling overtired and factor into her intrusive thoughts showing up again.

These are powerful results and I’m thrilled for her. I also appreciate her willingness to share and for allowing me to include her story.

A low carb/high fat (LCHF) / Ketogenic diet study

Most of the LCHF diet research focuses on weight loss and improvement of metabolic markers for conditions like diabetes. However, there is some promising new research on mental health.

This 2020 paper is one example – Ketogenic Diet: A Dietary Modification as an Anxiolytic Approach?

Diets with low amounts of carbohydrate consumption (low-carb) seem promising both for weight mass optimization among mentally ill patients and for their possible anxiolytic effect.

A diet is characterized as being low-carb high-fat (LCHF) when fat comprises >70% of the daily calorie consumption, with sugars [or carbs] being 5–15%, and the rest of the calorie intake being made up of proteins.

This paper discusses anxiety and the role of serotonin, GABA/glutamate imbalance, hypothalamic-pituitary-adrenal axis and elevated cortisol, inflammation and oxidative stress, the microbiome and leaky gut.

It also covers some ways LCHF diets may reduce anxiety: via impacts on the microbiome (with GABA being produced by good bacteria in the gut), by reducing inflammation and oxidative stress, and by providing omega-3 fatty acids and healthy oils (such as olive oil). The inclusion of real whole foods (i.e. no processed junk foods) with quality protein and zinc-rich foods such as oysters, low glycemic index carbohydrates and leafy greens as a source of magnesium, all contribute too.

The authors do mention canola oil which I do not recommend. And contrary to their mention of egg whites, I recommend the entire egg.

Their conclusion includes these statements:

In our mind, the LCHF diet is a promising, well-accepted diet regimen which has an impact on anxiety disorders…

The evidence mentioned in this paper should encourage psychiatrists to recommend LCHF diets as advice somewhere between psychotherapy and pharmacology, or as an add-on to those two.

And I’ll add this: let’s consider LCHF instead of psychotherapy and pharmacology. As you heard Ruthie share above and as you’ll read below, diet changes alone can have profound effects.

Dietary changes alone can be profound for many folks

I’ve blogged extensively about diet in the past: ketogenic diets, the omnivore or Paleo diet and grain-free diets. Diet provides the foundation of any anxiety nutritional program but many people don’t realize or acknowledge that dietary changes alone can be profound for many folks.

I’ll typically hear something like this: “My anxiety [or depression or intrusive thoughts] are too severe for only diet to make a difference. I’m someone who really does need medication.”

As you’ll see below, diet alone can make a huge difference and is often the only thing that needs to change:

Ketogenic diet: reductions in auditory hallucinations and delusions, better mood and energy, and weight loss

Two schizoaffective patients of Dr. Chris Palmer, a psychiatrist from Harvard’s McLean Hospital in Belmont, Massachusetts, tried a ketogenic diet for weight loss. As well as losing weight, they experienced reductions in auditory hallucinations and delusions, had a better mood and had more energy. I review the 2018 study and offer my insights in this blog.

An “omnivore” like diet or Paleo diet is associated with reduced anxiety and depression

This type of diet is also referred to as a cave-man type of diet. Even though this 2018 study was only showing associations and not a cause-and-effect, it’s still very encouraging to see new research in the field of nutritional psychiatry, further supporting the results we see in clinical practice.

Paleo and grain free diets: anxiety and depression success stories

I share many success stories in this blog. Here is an example from one woman: “Three days after I stopped eating grains, my chronic depression lifted and has never returned (it’s three years later now).”

Integrative Medicine Approach to Pediatric Obsessive-Compulsive Disorder and Anxiety

I write about a 2016 study where gluten was found to be the cause of a childhood case of obsessive-compulsive disorder (OCD). Intrusive thoughts are common with OCD and a gluten-free diet (and some other interventions) led to a “marked reduction of OCD symptoms and anxiety along with marked improvement of social behavior and school work.”

This is a small selection of many similar articles on the blog.

My book as a resource if you are new to nutritional psychiatry

If you are new to nutritional psychiatry, do read this blog: Nutritional medicine in modern psychiatry: position statement by ISNPR.

If you 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 the chapters on diet, sugar and blood sugar control, gluten and grains, and caffeine/alcohol so you have the foundation in place. Who knows, it may be the only changes you need to make to eliminate your intrusive thoughts and other anxiety symptoms!

Be sure to share it with the health team you or your loved one is working with.

If you are new to using the the amino acids GABA or 5-HTP/tryptophan as supplements, I cover this and pyroluria in part 1: Intrusive thoughts are a thing with anxiety: low GABA, low serotonin, pyroluria (low zinc & vitamin B6) and hormone imbalances as possible causes. Be sure to read the many comments and especially Kimberly’s feedback – she combined everything in the above blog and saw wonderful results.

As I mentioned in part 1, let’s talk about intrusive thoughts so we don’t have to feel alone and so we can find solutions. And share your success with nutritional solutions when something works for you. Share it with your friends, your health practitioner, researchers and on this blog.

Did you know intrusive thoughts are a thing, or did you think it was just you? And what kind of intrusive thoughts have you had?

Are you surprised that a LCHF/keto or similar diet could have such a profound impact?

Has a dietary approach alone helped you eliminate your intrusive thoughts or other anxiety symptoms? Or has diet, in conjunction with amino acids such as GABA and tryptophan helped?

What else has helped eliminate or reduce your unwanted intrusive thoughts?

Feel free to ask your questions here too.

Trauma: fluctuating between a high anxiety panic state and a low energy freeze response (with low endorphins and a numbing feeling)

October 22, 2021 By Trudy Scott 10 Comments

The freeze response in trauma is not well understood and is a low energy state. When the anxiety has become so high or severe it triggers a low energy or freeze state in order for you to survive. There is also the feeling of numbness and being disconnected when in the freeze state and this eventually becomes the default pattern that the nervous system has been wired into. Healing can start with somatic work and using a functional medicine and nutritional psychiatry approach to address the biological underpinnings of trauma.

Dr. Aimie Apigian, MD, MS, MPH discusses all this and much more in her interview on the Anxiety Summit 5: Gut-Brain Axis.

And then Dr. Aimie interviews me and we discuss how folks with low endorphins are often in the freeze state. These folks are more emotionally sensitive to everything and because of this they experience much more stress. They also experience a feeling of numbness and feel disconnected. The encouraging news is that the amino acid DPA (d-phenylalanine) helps ease the low endorphin symptoms while they are recovering. More on all this below.

The freeze response in trauma is not well understood and is a low energy state

Let’s start with this interview with Dr. Aimie – Biology of Trauma and the Freeze Response. This is what we cover:

Identifying the freeze response and symptoms when anxiety is high
The role of the microbiome, neurotransmitters, oxidative stress, mitochondria and cortisol
Somatic work when in the chronic freeze state: containment hugs and marking your territory

Dr. Aimie explains that the freeze response in trauma is not something that’s been really well understood:

When we talk about just trauma and mood, and stress even, it’s like we still lump everything in that fight, flight, or freeze response. And the fight and flight response could not be more different than the freeze response.
On a biological level, they are completely different biology states, which means that it is humanly impossible to be in both of those states at the same time. So when we look at this freeze response, okay, so what is it? If it’s not fight or flight, what is it?

She shares how the anxiety has been become so high or severe it triggers a low energy or freeze state in order for you to survive:

When we look at what it is, it’s when the anxiety has become so high that the body is not able to sustain that level of both anxiety, but it’s really an energy level.
Because anxiety is a high energy state and it triggers this response in the body where it says, “Ooh, this is unsustainable,” and in order to survive, for our best interests, it would be better for us to go into a low energy state.
And it feels like giving in, giving up. It feels like giving up the fight because the body just goes into this, I kind of call it like, it shifts down into first gear.
You’re no longer zooming along in fifth or sixth gear, you just kind of shift down into first gear and now you’re just going through life.

The feeling of numbness and being disconnected when in the freeze state

In addition to the low energy state, this is where Dr. Aimie talks about the feeling of numbness and being disconnected when in the freeze state:

Now you’re just going through your day, you feel a little numb, you feel a little disconnected.
But the trigger for that freeze response originally comes from the anxiety level, which really becomes a level of fear, terror, panic.

Dr. Amie also shares how this becomes the default pattern that the nervous system has been wired into:

And people can have what I call a strong pull towards the freeze response so that they no longer are even aware of the fear and the terror.
They just feel anxiety and boom, they go straight into the freeze response because it has just become that default pattern that the nervous system has been wired into.

The biology of trauma and somatic work

She goes on to discuss the biology of trauma and the role of the microbiome, neurotransmitters, oxidative stress, mitochondria and cortisol in contributing to the freeze response (i.e. making you more susceptible to trauma) and as factors we can address in order to facilitate recovery and healing.

Dr. Aimie also describes the somatic work she does with her patients who are in the chronic freeze state: exercises like containment hugs and marking your territory. She shares that “I want people to experience their nervous system. I want them to know what it feels like, be able to actually recognize which state of the nervous system they are in at any given moment in time, and be able to feel what that feels like in their body, because then that’s how we teach them how to shift that.”

In her work and in this interview, Dr. Amie brings the world of trauma recovery and somatic work to the functional medicine and nutritional psychiatry world. It’s an eye-opening interview you don’t want to miss.

The connection between the trauma freeze response and low endorphins

Also featured in the summit is another interview where Dr. Aimie happens to interview me on this topic: Glutamine, DPA and Tyrosine for Anxiety and Sugar Cravings. We cover the following:

Sugar addiction: impacts on the microbiome, tryptophan metabolism, zinc & B vitamins
Glutamine for intense sugar cravings, anxiety & support of the microbiome/mucosa
DPA for comfort/reward cravings, pain & acute stress; tyrosine for focus & calm energy

It’s during this interview that I make the connection between the trauma freeze response and low endorphins when we are discussing the last bullet above.

As a reminder, these are the mood symptoms of low endorphins:

Heightened sensitivity to emotional pain
(and also Heightened sensitivity to physical pain)
Crying or tearing up easily

And these are the ways sugar cravings often show up when you have low endorphins:

Eating to soothe your mood, or comfort eating
Really, really loving certain foods, behaviors, drugs, or alcohol
Craving a reward or numbing treat

As I share about the endorphins and how I use the amino acids DPA and/or DLPA to boost endorphin levels, I remember how Dr. Aimie discussed the numbing effect when someone is in the freeze state and it made me think about endorphins. So I ask Dr. Amie if she finds that folks with low endorphins are often in the freeze state.

Dr. Amie says most definitely yes and shares that with the low endorphins, people in the freeze state really are more emotionally sensitive to everything and because of this they experience much more stress:

From my perspective, working with a lot of the trauma response … they are much closer … to that line of overwhelm.
So most definitely, yes. And it’s that comfort, right? It’s that self-soothing, and it’s the numbing effect. The numbing effect of reaching for food when you’re not hungry. It’s just for numbing the emotional sensitivity that you have with low endorphins.
Endorphins really affect the stress levels and then mood, and then inflammation? It starts this cascade of changes in their biology because of the low endorphins and the increased amount of stress that they experience with that sensitivity.

This discussion tied in perfectly to the study I had to share: The Role of Beta-endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism.

In this 2020 paper, the authors discuss beta-endorphins in the context of reward-centric behaviors, pain, neuroinflammation, immune function and also how endorphins attenuate (or reduce the effects of) the acute stress response. They also share how endorphins exert a regulatory effect on serotonin levels.

I find the latter link to serotonin very interesting and will be digging deeper into this in another blog post. I’ll also be digging into the low endorphins aspect of the trauma freeze response in the coming months. And I want to learn more about the somatic work that Dr. Aimie uses – to experience some of it myself and to bring to my community i.e you! I do love that I also get to learn so much when I do these interviews.

Use DPA to ease the weepiness and need to numb out with comfort food or behaviors

For now, if you have experienced trauma and recognize being in the freeze state, and you feel numbed out and disconnected, and also relate to the above other low endorphin symptoms, I would do a trial of DPA (the amino acid d-phenylalanine) and see how you do. It will likely help ease some of the low endorphin symptoms while you are recovering.

Keep in mind that you can also have low endorphin symptoms without having experienced trauma. I see this with many of my clients and it’s not uncommon to also have low serotonin worry and low GABA physical anxiety symptoms too..

In both instances, I would do a trial of DPA (I like the Lidtke Endorphigen product) and see how you do. If it is low endorphins you’ll ease the weepiness and need to numb out with comfort food or behaviors (such as endless scrolling on social media). You can expect to see results in 5-10 minutes when the DPA is opened onto the tongue.

To recap, be sure to tune in to these 2 interviews to see how it’s all connected and to hear more about trauma, the biology of trauma and how to use amino acids to balance neurotransmitters:

Aimie Apigian, MD, MS, MPH – Biology of Trauma and the Freeze Response
Trudy Scott, CN – Glutamine, DPA and Tyrosine for Anxiety and Sugar Cravings

These interviews dove-tail well with this topic of trauma, the freeze response and neurotransmitters:

Navaz Habib, DC, AFMCP – Vagus Nerve Activation to Reduce Anxiety (because vagus nerve activation habits speed trauma recovery)
My other amino acid interview, Cravings and GABA & Tryptophan: Gut-Anxiety Connections (because the amino acids help to support low serotonin and low GABA which is common with trauma)
Evan Brand, CFMP, NTP – Floatation Therapy for Anxiety and PTSD (because floatation therapy is gentle and yet effective)
Eric Zielinski, DC – Essential Oils for Anxiety and Digestion (because essential oils are well tolerated and effective)
David Jockers, DNM, DC, MS – Fasting for Anxiety and Gut Health (he talks about the effects of fasting on endorphins and serotonin)

I encourage you to tune in if you have:

Anxiety & feel overwhelmed & stressed by little things
Panic attacks &/or obsessive thoughts or behaviors
Social anxiety/pyroluria
Phobias or fears (flying, spiders or even driving on a highway)

And also if you suffer from…

Food sensitivities, IBS/SIBO, parasites or gallbladder issues
Constipation, diarrhea, bloating, gas, pain & other digestive issues
Leaky gut, a leaky blood-brain barrier or vagus nerve issues

You’ll also benefit if you are also an emotional eater with intense sugar cravings (and know you suffer from low blood sugar), experience insomnia, low mood, PMS, poor focus and/or low motivation.

This is THE online event to learn about the powerful individual amino acids – GABA, theanine, tryptophan, 5-HTP, glutamine, DPA and tyrosine – to quickly ease anxiety and help with gut symptoms while you are dealing with other root causes which take longer to address. (They also help with cravings as with this example, and sleep and immunity).

With research-based anxiety nutritional solutions and practical steps, you can determine your root causes, ease your anxiety and prevent it from coming back so you can feel on top of the world again!

If you are a practitioner, please join us too and find advanced solutions for your clients or patients too!

You’ve heard me say the Anxiety Summit has been called “a bouquet of hope!” My wish for you is that this summit is your bouquet of hope!

I hope you’ll join me and these incredible speakers, be enlightened and find YOUR solutions!

Here’s to no more anxiety and you feeling on top of the world again!

Can you relate to the freeze state and fluctuating from a high energy anxiety/panic state?

When you’re in the freeze state do you feel numb and disconnected?

Have you had success with somatic work? And also using a functional medicine approach to healing?

Also let us know if you’ve benefited from using DPA to help ease the low endorphin symptoms?

Feel free to post your 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.