Mind-body resilience for women: A focus on depression

8 Complementary And Integrative Therapies That Might Help Schizophrenia

Schizophrenia — a serious mental health condition characterized by hallucinations, delusions, and thinking problems — can be tough to treat. Antipsychotic medication and psychotherapy are the first-line treatments for schizophrenia, but many people like to try complementary and integrative therapies, too, to help improve their symptoms.

While these therapies shouldn't replace standard medication and psychotherapy, they can be helpful additions to a comprehensive treatment plan, according to Erik Messamore, MD, PhD, an associate professor of psychiatry at Northeast Ohio Medical University and medical director of the university's Best Practices in Schizophrenia Treatment Center in Rootstown, Ohio.

That said, approach complementary and integrative therapies with caution. Some approaches are backed up by more scientific evidence than others, and although many can be helpful, not all approaches are necessarily harmless, adds Dr. Messamore.

"There's no such thing as a no-risk intervention, even with integrative treatments," he says.

That's especially the case when it comes to taking any supplements. Over-the-counter products like dietary supplements aren't regulated by the U.S. Food and Drug Administration (FDA). That means that the FDA hasn't vetted claims that appear on the labels of these products or assessed their quality.

Because schizophrenia is a complex disease with various underlying causes, patients may have different responses to the same modality, adds Messamore. What's more, certain complementary and integrative therapies could interact with medicines you take and cause negative reactions. Messamore recommends talking with your doctor before trying any complementary therapy.

Here are eight complementary and integrative tools that studies show may be helpful if you or a loved one have schizophrenia.

Remember, it's a good idea to talk to your doctor before adding any complementary therapy to your treatment regimen to make sure the approach won't interfere with medication or other therapies you're currently taking or following and how to do it safely (such as what dose of supplement to take or how often to do the intervention).

1. Omega-3 Fatty Acids

Omega-3 fatty acids are a group of healthy fats that support heart and brain health, according to Cleveland Clinic. People with schizophrenia may be prone to low levels of omega-3s in their blood, which appears to be linked to worse cognition and social functioning, according to one study published in May 2018 in Schizophrenia Research: Cognition.

Some research suggests that omega-3 supplements may have specific benefits for people with schizophrenia. Most studies point to a specific type of omega-3 fatty acid known as eicosapentaenoic acid (EPA) as the most beneficial for schizophrenia, Messamore says. The researched dosages associated with positive outcomes ranged from 750 to 2,000 milligrams (mg) of EPA a day, he adds.

In a review published in July 2020 in Lipids in Health and Disease, researchers reported that omega-3 supplements may lessen the severity of schizophrenia symptoms in teens and young adults, especially those with low levels of omega-3s like EPA and DHA in their blood. Omega-3s may also help prevent psychosis from happening in teens at high-risk of developing schizophrenia, the authors of the review noted.

"Omega-3 supplementation strikes me as a relatively low-risk intervention that may have cardio-protective effects and a variety of favorable mental health effects," says Messamore.

2. Vitamin Supplements (if You Have a Deficiency)

"We see a large range of nutritional deficiencies in people with schizophrenia," says James Greenblatt, MD, an integrative psychiatrist and founder and chief medical officer of Psychiatry Redefined, an educational platform for clinicians about functional, integrative, and metabolic psychiatry. "Whether they are due to underlying genetic reasons or due to poor diet is unclear."

Specifically, research suggests people with schizophrenia may be more likely to have low levels of vitamins B9, B12, C, E, and D.

A review of 18 studies published in February 2017 in Psychological Medicine found that vitamin B supplementation may help lessen psychiatric symptoms in some people with schizophrenia. However, research has shown mixed results for the benefits of vitamin C, vitamin E, and vitamin D supplements.

Your doctor can help you determine if you have any nutritional deficiencies and whether you could benefit from vitamin supplements, says Dr. Greenblatt. "There are objective tests for all of these," he explains. "And, addressing these nutritional deficiencies can really improve quality of life."

3. Dietary Changes

Increasing evidence shows that diet and nutrition play a key role in schizophrenia, and that certain dietary interventions may reduce schizophrenia symptoms, according to a review published in August 2023 in Nutritional Neuroscience.

Specifically, diets rich in plant foods and high-quality proteins have been found to help lessen the risk of schizophrenia symptoms, the authors of the review noted.

One review published in October 2020 in Clinical Nutrition Research suggests that anti-inflammatory diets — like the Mediterranean diet or the Dietary Approaches to Stop Hypertension (DASH) diet, for instance — may be beneficial for schizophrenia, since inflammation may be a potential risk factor for schizophrenia. Anti-inflammatory diets may also aid with weight loss, which can lessen common medication side effects like weight gain, per the same review.

Another diet being studied for schizophrenia is the ketogenic diet (aka the "keto diet"). A strict medical diet involving low carbohydrate and high fat intake, the keto diet was originally developed to treat childhood epilepsy, according to research. It's also gotten very popular in the wellness world for weight loss, though the diet can be difficult for many people to stick to in the long term because of how restrictive it is.

One small study, published in July 2022 in Frontiers in Psychiatry, showed that adults with severe mental health conditions who were admitted to psychiatric hospitals who followed a keto diet experienced significant improvements in depression and psychosis symptoms. They also had improvements in their physical health, including blood pressure, weight, blood sugar, and triglyceride levels.

That said, more research is needed to confirm the potential benefits and risks of the keto diet for people with schizophrenia. Bear in mind that the keto diet might not be right for everyone. If not done properly, it can actually be harmful to your heart health, for instance, due to its high saturated fat content, according to Harvard Medical School.

Be sure to talk to your doctor or a registered dietitian before making any significant changes to your diet. They can help you figure out whether certain dietary interventions could be right for you and how to safely try them.

4. Exercise

It's no secret that exercise can do wonders for mental health, and people with schizophrenia are no exception to its mood-boosting benefits, research shows. "I think that there's not a better antidepressant available than exercise," says Greenblatt. "It has many positive benefits across all mental health."

Along with mood, studies show that exercise can improve other schizophrenia symptoms, quality of life, and cognition, among other things, according to a review published in February 2019 in Psychopharmacology Bulletin. What's more, exercise can help lessen potential side effects of antipsychotic medications, like weight gain, the same review showed.

In general, the Centers for Disease Control and Prevention (CDC) recommends that adults aim to get 150 minutes of moderate to intense exercise each week. This could be split into smaller time chunks, such as 30 minutes a day, five days a week. And that's appropriate for most adults with schizophrenia, too, according to research.

If that feels like too much for you at first, try starting smaller. Medication side effects (particularly their sedating effects) can be a unique barrier that stops people with schizophrenia from feeling like they have the energy to exercise, Greenblatt says. Talk to your doctor if you feel the side effects of your medication make it difficult for you to exercise. They can help you figure out a plan that works for you.

5. Yoga

Stress can worsen schizophrenia symptoms like hallucinations and delusions, according to the National Alliance on Mental Illness, which is why it's key to keep your stress levels at bay. You can help cut stress by practicing relaxation techniques like yoga.

A study published in August 2021 in the journal Frontiers in Psychiatry found participants with schizophrenia who practiced yoga reported experiencing confidence, relaxation, and heightened awareness of impending and improved symptoms.

6. Mindfulness

Mindfulness is another relaxation technique that can help with managing stress and schizophrenia symptoms, research shows. Interventions that incorporate mindfulness — focusing on what's happening within and around you in the present moment without judgment — may reduce the severity of symptoms in people with schizophrenia, according to a meta-analysis of nine studies published in January 2021 in the Journal of Advanced Nursing.

7. Melatonin Supplements

Melatonin, aka the "sleep hormone," is a chemical that your brain makes in response to darkness and indeed, helps signal to the body when it's time to sleep, according to the National Center for Complementary and Integrative Health. Prior research has suggested that people with schizophrenia might have lower levels of melatonin in their bodies than the general population.

In a review published in August 2021 in the World Journal of Psychiatry, researchers analyzed 15 studies on melatonin. Results showed that taking melatonin supplements along with antipsychotic medication helped improve sleep issues, which are common in people with schizophrenia. Melatonin also lessened the severity of medication side effects, such as weight gain and tardive dyskinesia (repetitive involuntary movements of the face, torso, or other body parts).

Some experts theorize that the anti-inflammatory and antioxidative effects of melatonin might explain why melatonin may improve symptoms of schizophrenia.

While there's no official recommended dosage for melatonin, in general a dose of 1 to 3 mg appears to be safe, according to Johns Hopkins University. But before adding a supplement like melatonin to your treatment regimen, talk to your health provider to make sure it won't interact with any medications you're taking.

8. N-Acetyl Cysteine Supplements

N-acetyl cysteine (NAC), derived from the naturally occurring amino acid cysteine, is a synthetic supplement commonly used for various conditions, including schizophrenia, according to Mount Sinai.

Recent research has shown it also may help improve memory among people with schizophrenia. Cognition problems, including memory and concentration issues, are common among people with the condition, per the American Psychiatric Association.

One review, published in December 2019 in the Australian and New Zealand Journal of Psychiatry, found that long-term supplementation with NAC (along with standard treatment) significantly improved schizophrenia symptoms and working memory.

Research suggests NAC interacts with the neurotransmitter glutamate and has antioxidant and anti-inflammatory effects, which could all lead to improved cognition.

Be sure to talk to your health provider before adding NAC to your treatment regimen. Very high doses (more than 7 grams of cysteine) may be toxic, according to Mount Sinai.

The Wisdom Of Complementary Or Alternative Medicine

Mind-body medicine should not be an 'alternative,' nor should complementary and integrative medicine be something doctors are not exposed to during their training." —Dr. Bernie Siegel

Source: andreas160578/ Pixabay

Those being treated for a life-altering illness by modern, or "conventional," medicine often find the approach dehumanizing. As passive recipients of care, they are identified by their diseases and the focus is on the amelioration of symptoms.

As a result, many will turn to "alternative" medicine to explore a more holistic approach that includes mind/body techniques. Unfortunately, these alternative methods of treatment are sometimes frowned upon by Western medicine, leaving patients to wander these territories alone.

Even worse, some are led to believe that their efforts to maintain health through these practices are a fool's errand.

The American Cancer Society refers to complementary and alternative medicine (CAM) as "terms used to describe many kinds of products, practices, and systems that are not part of mainstream medicine." Later they state that "you may not hear about these treatments from your doctor."

According to the National Institute for Health (NIH), "Complementary and alternative medicine is a categorical term that covers a broad range of over 100 healing philosophies, approaches, and therapeutic modalities." NIH goes on to explain that "When the various 'CAM' therapies are used instead of conventional/allopathic therapies, they are referred to as alternative; when used in conjunction with conventional treatment to supplement or augment the therapeutic outcome, they are considered to be complementary."

The National Center for Complementary and Alternative Medicine (NCCAM) classifies CAM therapies into 5 major groups:

Alternative medical systems.

Biological medicine.

Energy medicine.

Manual medicine.

Mind/body medicine.

The understanding that all illnesses are linked to body and mind goes back centuries and holistic practices have existed as long as there have been people in need. The fact that the CAM model of treatment often remains in the muddy waters of "unconventional" seems misguided.

Minus the blessing of the medical profession, many people find themselves adrift in these waters when it comes to adding methods to treat the whole, not just the parts. When not being brushed aside by the obligatory, "We can't recommend that as a treatment," those interested in thinking outside of the conventional box are often looked upon as foolhardy.

During my cancer treatment, I routinely encountered other patients professing the benefits of whatever tools were a part of their recovery. The information and promises were overwhelming, contradictory, and confusing. It was challenging to decide when the search for alternatives turned into a fool's errand and how to determine which ones were simply money grabs by peddlers taking advantage of a suffering soul.

I started the cancer journey with a "more is better mentality." Once the boxes were checked for the traditional methods of surgery, chemo, and radiation therapies, I pulled out my mind/body menu and looked at it like a starving man at a sushi bar. Here is the complete list of my holistic helpers:

Hatha Yoga

Biblio-therapy

Laughing Yoga

Meditation/Mindfulness

Vitamins

Herbal supplements

Qi Gong

Yoga Nidra

Aromatherapy

Smudge Stick Ceremonies

Reiki

Bio-Energy Healing

Pet therapy

Tele-psychotherapy

Prayer/Mantras

Therapeutic massage

I realized it was traditional medicine, and the skills of the professionals involved, that removed the tumor growing in my chest and destroyed any remnants. The addition of complementary practices was used, in part, to provide relief from the side effects and restore a sense of wellness.

Whereas chemo drained me of energy and threw my system into a tailspin, yoga helped to return a sense of balance both literally and figuratively. I still remember the feeling of accomplishment when, only a week after open heart surgery, I was able to stand in a tree pose. If there was even the slimmest chance that any, or all, of the above practices would also decrease the chances of cancer's return, that would be the icing on the cancer-free cake.

Another bonus of jumping on the nontraditional bandwagon is the liberation that comes from no longer being a passive recipient of treatment. Doing things for the mind, body, and spirit feels much better than having things done to these vital systems. Additionally, many of these practices can be shared, eliminating the sense of solitary confinement many patients experience.

Integrative Medicine Essential Reads

With so many opportunities for misinformation, false promises, and profiting from someone else's suffering, I developed a litmus test for whatever crossed my radar. Here is the checklist I came up with to eliminate the wheat from the chaff:

1. If it cost more than a 60-minute massage session, it was a "no go," as I found that in most cases, 60 minutes of massage was hard to beat for relaxation and stress reduction.

2. If it came with a promise to cure cancer, it was filed away with the same methods that promised to end aging, regrow hair, or create limitless wealth.

3. If the person peddling it looked like the poster child for "Don't let this happen to your body," I passed on claims to "restore health."

4. If the only evidence for success were anecdotes from the same people who have been taken up in UFOs, met Bigfoot, or got rich dealing in crypto-currency, I would politely refuse and add them to the block sender list.

5. If the source was a book that had the words secret, hidden, or forbidden in its title, it was given a pass in favor of the latest Stephen King novel.

Perhaps the best news about complementary methods is one does not have to understand, or even believe in, the mechanisms at work to benefit from them. Additionally, traditional methods of treatment have been around for thousands of years and according to the World Health Organization, WHO, represent, "The sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures."

For many, that puts these practices squarely in the category of pseudoscience or snake oil. If pushed on the issue, I will admit I've no scientific proof that anything on the above list aided in my passage from cancer patient to cancer survivor. And while I know that some would argue that they played no role at all and that to think otherwise is simply fooling myself, my response is, "It feels awesome to be a cancer-surviving fool."

Ayurvedic Doctor Shares Weight Loss-Friendly Foods To Eat

Ayurveda, a traditional Indian system of medicine, suggests that weight loss can be achieved through a balanced diet, regular exercise, and lifestyle modifications tailored to an individual's unique constitution (dosha). Dosha refers to that which can cause problems, meaning "fault" or "defect" and constitutes three elements vāta, pitta, kapha, also known as wind, bile, and phlegm. 

Ayurvedic approaches emphasise whole foods, herbal supplements, and mindful eating practices to support sustainable and holistic weight management. In an interaction with the OnlyMyHealth team, Dr Kriti Soni, Head of R&D, Kapiva, Delhi, lists some foods that are considered great for weight loss, as per Ayurveda. 

Also Read: Vitamin B12 Deficiency May Affect Your Walking Style; Here's How

Ayurveda And Weight Loss

"At the heart of Ayurveda's weight loss philosophy lies the principle of balance and harmony within our bodies. The journey begins with adopting a Sattvic diet, one that embraces nature's bountiful offerings," says Dr Soni, adding,  "Incorporate an array of fresh fruits, nourishing vegetables, wholesome grains, and balanced proteins to nourish your body while promoting healthy weight management."

A study published in the Journal of Alternative and Complementary Medicine found that a whole-systems Ayurvedic medicine and Yoga therapy helps with weight loss. 

"Participants lost an average of 3.5 kg during the 3-month intervention. Weight loss at 3 and 6 months post-intervention increased to an average of 5.6 kg and 5.9 kg, respectively. Participants who lost 3% of their body weight during the 12 week intervention, lost on average an additional 3% during the follow-up period. Psychosocial outcomes also improved. No additional services were provided to participants during the follow-up period," the study's results highlighted. 

Weight-Loss Friendly Foods, As Per Ayurveda

Here is a list of foods that help with weight loss:

Triphala

A powerful blend of Amalaki, Bibhitaki, and Haritaki, Triphala takes centre stage as a natural aid for weight loss. Its detoxifying properties gently cleanse the body, while its metabolism-boosting effects enhance the body's ability to burn calories more efficiently. 

Guggulu

Derived from the resin of the Commiphora mukul tree, Guggulu is a prized Ayurvedic remedy for thyroid support and metabolic enhancement. This potent ingredient has been hailed as a game-changer in controlling cholesterol levels and maintaining a healthy weight, making it an invaluable addition to any weight management regimen.

Trikatu

Comprising Ginger, Black Pepper, and Long Pepper, Trikatu is a fiery trio that sets metabolism ablaze, supporting weight management. Additionally, it aids in the natural elimination of bloating, making it an effective and natural way to improve digestive health.

Also Read: Sabudana Is A Popular Indian Fasting Staple: But Should Diabetics Consume It?

Fenugreek

As a trusted ally in curbing appetite, Fenugreek works wonders for digestion and supports healthy weight loss. Its natural properties help manage cravings and promote a balanced approach to eating.

Turmeric

It contains curcumin, a powerful anti-inflammatory compound known for its ability to aid in insulin sensitivity and promote fat metabolism. Including turmeric in the diet may support healthy weight management and overall well-being.

Aloe Vera

The detoxifying champion, Aloe Vera, offers nourishment to the body while maintaining smooth bowel movements, a vital aspect of effective weight management. Its cleansing properties contribute to overall digestive health, supporting the body's natural detoxification processes.

"By incorporating these Ayurvedic superfoods into your diet, you can harness the potent benefits of nature to support your weight management goals. However, it's essential to consult with a healthcare professional or Ayurvedic expert to personalise your approach and ensure safe and effective results," Dr Soni concludes. 

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