Enter nutritional (or food) psychiatry. It's a relatively new field—people have only been studying the link between one's diet and risk (or treatment of) mental health conditions for about 10 years. But the research produced in the past decade of research is extremely compelling. A 2013 study found that following the Mediterranean diet is associated with a reduced risk of depression; a 2017 study found that people with moderate to severe depression who ate a Mediterranean diet for 12 weeks had more improvement in their symptoms than people who didn't change their diets; a 2018 meta-analysis found that people who improved their diets by replacing high-sugar foods with more nutrient-dense, fiber-rich foods like vegetables saw a small improvement in depression symptoms.
Since the foods we eat affect our well-being more than we realize, more and more mental health professionals are turning to food as part of their diagnosis toolkit to help treat a number of issues, including depression, anxiety, and low self-esteem. Here's what you need to know.
What is nutritional psychiatry?
“The goal of nutritional psychiatry is to incorporate food into mental health treatments in a responsible way,” explains Columbia University-based psychiatrist, farmer, and Well+Good Council member Drew Ramsey, MD. “It’s trying to understand how people nourish themselves, and to prescribe certain foods that will help to make sure their brain is optimized in the best possible way.” For instance, he might ask a client to incorporate more seafood into their diet if they suffer from anxiety, because the omega-3s found in seafood have been linked to reducing those symptoms.
"What we eat affects how we feel, what our energy level is, how well we think and interact, and how well we sleep. If one of the major links in this chain is broken, then everything else will certainly be affected too." —Gavi Hollander, DO
Other food psychiatrists, like Gavi Hollander, DO, primarily look at food and medication as a means to treat her patients after diagnosis. “I would say traditional psychotherapy can be used in tandem with food psychiatry, and this more ‘holistic’ approach would give the best results,” she says. “On a daily basis, what we eat affects how we feel, what our energy level is, how well we think and interact, and how well we sleep. If one of the major links in this chain is broken, then everything else will certainly be affected too.”
However, don't take this to mean that the only solution for mental health issues is eating more salmon filets. In addition to food, Dr. Ramsey might also recommend talk therapy (or psychotherapy), supplements, and medication, depending on the patient's individual needs. “Food can be a starting point for a conversation about mental health, but it is rarely ever the sole treatment," he says.
"It’s important to remember that diet and exercise are not everything,” adds Dr. Hollander. “When an individual is dealing with moderate to more severe symptoms of mood disruption, inability to sleep, or impairments in daily functioning, then conventional medications may play an important role in helping that individual restore functioning and well-being.”
How is this different from seeing a regular dietitian or a psychiatrist?
A registered dietitian certainly has a lot of training and expertise when it comes to making individualized food recommendations. But they likely aren't looking at nutrition primarily through a mental health lens, says Dr. Ramsey. "I would argue that seeing a nutritionist is different as they focus more on medical conditions like diabetes and weight loss." On the other hand, a therapist, psychiatrist, or other mental health expert might not be as focused on food—they might start with talk therapy, medication, or other strategies like EMDR or CBT, depending on the patient's needs.
Who could benefit from seeing a nutritional psychiatrist?
“Anyone who would like to take a more comprehensive look at their mental health, as well as their daily diet and self-care routine, may experience a benefit from working with a nutritional psychiatrist,” says Dr. Hollander. A person already going to talk therapy, for example, might consider working with a nutritional psychiatrist to help supplement their mental health treatment.
"Food can be a starting point for a conversation about mental health, but it is rarely ever the sole treatment." —Drew Ramsey, MD
However, food psychiatry is not for people who suffer from eating disorders, says Dr. Ramsey. “I have a strict screening process when it comes to my patients because nutritional psychiatry is not a treatment for eating disorders,” he says. Incorporating the recommended food guidelines might also be triggering. Instead, people with a history of eating disorders should seek other recommended means of treatment, such as working with a therapist trained in disordered eating.
Where can you find a food psychiatrist?
Since nutritional psychiatry is a really new field, there isn’t one single credential to work toward. Instead, food psychiatrists typically complete their residency in mental health, and then obtain additional nutritional degrees to supplement. It's probably a good bet to look for mental health professionals who have also gotten training in food and nutrition from a reputable program.
Dr. Ramsey is hoping to make it easier for mental health professionals of all stripes to be better equipped to incorporate food in their practices. He's teaching a clinical food psychiatry training in October at the Omega Institute, which will be open to mental health professionals including psychologists, clinical social workers, and counselors.
By looking at mental health as a puzzle that can be fixed through several factors, food psychiatry aims to start having a holistic conversation about something that’s so often stigmatized. “If I’m having a conversation with someone about how often they eat salmon, for instance, and then the conversation switches to stress or anxiety, we’ve opened up the doors to talk about mental health in a way traditional psychotherapy doesn't always do,” says Dr. Ramsey. In this way, the food can be a starting point toward getting further treatment—and that's the most important thing.
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