A family member recently told me how she cured her agonizing nocturnal leg cramps. "I was skeptical just like you," she began, "But by putting a bar of soap down by my feet at night the cramps disappeared."
Her friend apparently employs a more advanced technique, slipping travel soaps into her socks. I then offered to sell her a sachet of bath salts that's 100% effective in preventing vampire attacks.
Another family member urged me to stop eating dehydrated pea pods because they're made of "an extract from beaver anal gland." Naturally, this declaration led to a lively family debate. "Where are all these beavers housed? Are there factory workers tasked with expressing captive beaver butts?"
Weeks later, my daughter was told the same thing at school. A classmate's parent, a naturopath, told her class that "blue raspberry flavouring" was another by-product of poor indentured beavers.
If you choose to believe these preposterous claims without critical appraisal, that's up to you. No harm done (more on the placebo effect in a future blog).
It pains me to hear the nonsense my patients are subjected to by sometimes well-meaning, yet utterly uninformed, self-taught mental health experts. Their lack of scientific training is merely a preamble ("I'm no doctor but..."). They speak with enthusiasm and authority as they peddle supplements, homeopathic tinctures, detox enemas and antioxidant smoothies, with the goal of liberating my patients from their evidence-based treatments and dollars from their wallets.
There is little regulatory oversight hindering those who claim that costly, completely useless products are beneficial for serious illnesses. These charlatans take advantage of ailing, vulnerable patients and their families to enrich themselves and Health Canada is doing little or nothing to protect consumers.
Here are my top 10 "If you just did/took/believed...you'd be better" comments and some sober second thoughts about their scientific basis:
1. "If you just exercised more...."
There is evidence supporting the benefits of exercise for mental and physical health. Just thirty minutes of mild to moderate intensity activity, like a brisk daily walk, is worthwhile. Yoga also has a growing pool of research supporting its benefits, although like all exercise it is difficult to study in a well-controlled manner. The trouble is, even perfectly well people struggle to exercise. When someone is mentally ill, motivation to do anything is often severely impaired.
2. "If you just detoxed...."
Whether taking a detoxifying drink, enema or foot bath, there is zero evidence that detoxing does anything beneficial, except to enrich those who sell these products. We are designed to naturally detoxify (think diarrhea). Our bodies remove waste, fight infections and regulate nutrients, oxygen, water, and whatever else the detox promises to normalize or equalize. Using pseudoscientific mumbo-jumbo, purveyors of detoxification treatments are modern day snake-oil salesmen.
3. "If you just ate a healthy diet...."
There is emerging evidence highlighting the importance of diet in the development, treatment and prevention of mental illness. Mental illness increases the risk of obesity and some medications worsen that risk. Regrettably, dieting rarely works and diet myths abound. It's difficult to stick to a structured, healthy diet when you're perfectly well. It's all but impossible when you're acutely ill.
4. "If you just took a supplement...."
The majority of us get all the vitamins and nutrients we need from our diet, even if it's not perfect, so supplements are usually expensive and unnecessary. However, using supplements in psychiatry is an active area of research. Occasionally, a specific vitamin or mineral supplement is required, and this is easily measurable.
5. "If you just stopped your psychiatric medication...."
Please don't stop your medication based on what someone who doesn't treat mental illness says; talk to your doctor (see my July 12 blog)
6. "If you just smoked pot...."
There is abundant evidence that THC can provoke the early onset of psychotic disorders and even induce psychosis. Some employ pot to manage anxiety and insomnia. The risks of THC for a vulnerable brain, side effects of chronic use like amotivation, the lack of research evidence, and the fact that THC, like alcohol, impairs driving and other activities that require mental acuity all counter claims that pot is a medical panacea (see my April 8 and April 26 blogs)
7. "If you just saw a homeopathic healer...."
Homeopathy is hogwash, but don't take my word for it. The book "Bad Science" skillfully debunks the myth of homeopathy. Aisles in pharmacies dedicated to homeopathy give it undeserved and dangerous credibility.
8. "If you just prayed/meditated more...."
If you have faith, whatever it is, for heaven's sake use it. There is some evidence to show the benefits of faith for mental and physical health. Mindfulness and meditation also have demonstrated health benefits.
9. "If you just talked to a therapist...."
Every interaction with a patient should be therapeutic, by instilling hope and offering education and guidance. There is robust evidence to support various psychotherapeutic interventions, including cognitive-behavioral therapy (CBT). A good fit with your therapist is essential and a bad therapist can be worse than no therapist, so check out the College of Psychologists website for registered practitioners and look for a therapist with a Masters or PhD.
10. "If you just got more sleep...."
Sleep is a powerful, positive force for wellness. Sleeping well is unquestionably beneficial for mental and physical health. It plays a protective role in dementia and is required for effective learning. Unfortunately, depressed patients commonly experience insomnia or sleep excessively and struggle to normalize their sleep patterns.
To summarize, if you are struggling with a mental illness there is evidence that exercise, a healthy diet, sleep, skilled psychotherapy, praying/meditating and, if necessary, taking medication prescribed by a knowledgeable, empathic doctor, may benefit your mental health. No enemas or beaver exploitation required.
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