Mood, anxiety and sleep disorders can be drivers of addiction, and can worsen treatment adherence and relapse. Nutritional therapy addresses these underlying disorders at a biochemical level. Addcounsel’s Deborah Colson explains.
Nutritional Therapy is an evidence-based approach to addressing underlying biochemical imbalances which may lead to depression, anxiety and sleep issues that in turn predispose, precipitate or perpetuate substance use disorders. This approach recognises the contribution that can be made from a broad range of biochemical factors. To take a phrase coined by Dave Brailsford of British Cycling, it is “the aggregation of minimal gains” meaning that we tweak the biochemistry at every point possible, and each tweak will contribute a small amount of improvement on its own, but these multiple small improvements can add up to a significant total improvement.
There is good evidence to support the role of a range of nutrients including omega-3 fatty acids, the minerals zinc and magnesium, and vitamins including vitamin D, folate (vitamin B9) and vitamin B12. Omega-3 fatty acids are highly anti-inflammatory and play a role in the structure and function of the brain. Zinc has anti-depressant properties. Magnesium is known as ‘nature’s tranquiliser’ and can reduce anxiety and improve sleep. These nutrients are frequently found to be deficient when measured in blood tests. Nutrient deficiencies may be due to inadequate intake (many people have a less than ideal diet and the modern diet has become less nutrient-dense due to intensive farming, food miles and other factors), biochemical individuality (that is, some individuals have a genetically determined greater need for some nutrients) or higher nutrient expenditure (for example a high-stress lifestyle, or depletion through a history of substance use).
Polyphenols (typically the substances which give plant foods their striking colours) may have antidepressant properties too. A Mediterranean-style diet featuring higher levels of plant-based food will lead to an increased consumption of polyphenols along with other micronutrients, especially antioxidants. Antioxidant nutrients such as selenium and vitamin E have neuroprotective properties.
A ‘whole food dietary pattern’ has been shown to reduce risk for depression, whilst a more ‘processed food dietary pattern’ increases risk. Elevated blood sugar levels (even within the normal range) also increases the risk for depression. Reducing processed foods, sugars and refined carbohydrates, and increasing whole foods including vegetables and pulses, and healthy sources of fats from olive oil, nuts and avocadoes provides higher levels of nutrients and supports healthier blood sugar levels which reduce cravings too.
There is significant interplay between gut flora and the gut-brain axis, and studies have demonstrated benefits from probiotic supplementation on mood, cognition and psychological distress. Whole foods including vegetables and pulses, and fermented foods such as kim-chi, sauerkraut and yogurt can contribute to balanced gut fora. Imbalanced gut flora may also increase levels of inflammation throughout the body and brain. This is significant because chronic, low-grade inflammation is a likely contributor to depression.
A Mediterranean-style, whole food dietary pattern, with reduced intake of sugar and refined carbohydrates, along with an increase in anti-inflammatory nutrients (including omega-3 fatty acids, antioxidants and vitamin D) helps to tackle inflammation and thereby supports mood.
The good mood neurotransmitter serotonin is made from amino acid precursors (L-tryptophan and 5-HTP), and evidence supports intake of these precursors to improve mood. Amino acids are the natural components of protein-rich food. The amino acids L-tyrosine and DL-phenylalanine are the precursors to dopamine and noradrenalin – neurotransmitters associated with mood, motivation and reward. Nutrient co-factors vitamins B3 and B6, are required for the transformation of amino acids into neurotransmitters. Other amino acids including L-taurine, L-theanine and L-glycine can have a calming effect which may reduce and anxiety and improve sleep.
The herb St John’s Wort (Hypericum) is shown to be similarly effective as standard antidepressants, and have fewer side effects than standard antidepressants, in people with depression. Good evidence also supports the use of bright light therapy (light boxes) for seasonal and non-seasonal depression, with a similar level of effectiveness to that typically found in antidepressant drug trials.
The nutritional therapy approach is informed by research evidence, clinical expertise, and the preferences of the individual to provide a personalised nutrition and lifestyle programme. Lab tests can be used to assess nutrient status and other biochemical factors. Dietary supplements may be used to address any nutrient shortfall in the short-term whilst improvements to dietary intake are made. Drug-nutrient interactions are carefully managed.
Most people benefit from nutritional therapy, including those who already think they eat a healthy diet. In reality, most people don’t eat as well as they would like to think they do, and many will have individual factors which affect their nutritional status and brain chemistry. Nutritional therapy works well alongside other therapies, and indeed, other therapies may be more effective in someone whose brain biochemistry is in better balance. People typically experience improvements in their physical health as a side-effect of a nutritional therapy programme. We find that people are increasingly interested in utilising a wide range of therapies to support their recovery, especially approaches which they consider to be ‘natural’.
Deborah Colson, Addcounsel
MSc DipION mBANT CNHC
Deborah has been specialising in nutritional approaches to support psychiatric and neurological health, including addition recovery since 2002. Nutritional Therapy is an evidence-based therapy, which complements medicine and other therapies. It involves managing nutritional and biochemical factors which contribute to substance use disorders and other issues, with a practical, personalised plan for each individual that takes into account their unique lifestyle and dietary preferences, their nutritional status, genetic predisposition and psychosocial factors.
Operating from Mayfair, we provide a multi-disciplinary service for those experiencing behavioural health disorders.
Our service is unique and offers:
- Each family has their own dedicated team of specialists
- We provide safe and effective detoxification services at a patient’s home or private accommodation
- Treatment is provided on a one to one basis
- We own the care plan and orchestrate and deliver the entire process
- We have a long-term perspective on supporting the family
- We have international delivery capabilities for aftercare and recovery maintenance
Our approach leverages the strength of nearly 40 carefully chosen professionals who form part of our team. Working collaboratively, we deliver our solutions through our ‘Recovery Route’ framework.
The capability to orchestrate an innovative solution which considers the complexities of a wealthy, internationally dispersed and culturally disparate group, requires significant levels of financial and operational resource. Addcounsel is backed by a high net worth family whose principal is the CEO of the business.
Addcounsel is a CQC registered provider of services covering substance misuse and mental health.