Schizophrenia: Nutrition and Alternative Treatment Approaches

Introduction

I was diagnosed with paranoid psychosis sometime in 2002. Over the coming years, the symptoms recurred and this led to paranoid schizophrenia. As I am generally a very curious and academically oriented person, I also read a lot about this illness and topics related to it in popular and academic literature and on internet fora. I tried many of the mainstream and alternative approaches towards treatment. I hope that some of the insights gained will help further the treatment of this illness in the future.

My search for alternative approaches to manage this illness has helped me stay in stable full-time employment (since 2005) and to improve my general wellbeing and happiness and avoid hospitalization. While, for a couple of times, I tried to cope without medication, I am now using medication regularly (Risperidone between 2 and 4 mg, Citalopram 20 mg). I found that medication is necessary for keeping me stable. However, I also found that medication alone did not provide me the levels of wellbeing and functioning that I could achieve by complementing them with additional approaches such as good nutrition, staying off of stimulants as far as possible, and regular exercise.

This article will first present a short description of my first episode in 2002. It will then discuss my diet at the time and since then, and then go on to discuss a range of various alternative and dietary treatments that I have tried and how I benefitted from them.

First Episode

The year 2002 was a time when I was extraordinarily lonely. I had no friends, no partner, no contact to my family. I was living poorly: never eating outside, no social or leisure activities. I just worked and was pursuing spiritual interests. Sometime in this year, I had 3 experiences, which then I perceived as “revelations.” This happened within a couple of days, as far as I remember. On the first day, I thought someone told me about my life. I was alone in my room. Mentally, I was led until I was in “space” and broke through some border. However, I “fell down” and knew I had forgotten something. It was cold then and I cried. On the second day, a “spirit” led me to a village near my city. I perceived this “spirit” as a voice in my head. Everything seemed to be very spiritual and in flow: the light, the traffic, the people; everything seemed to be in great harmony, much more as is normally experienced. The people seemed to behave towards me as if they were “telepathic”; that means, they looked at me when I thought about them. Even the buses seemed to arrive just when I needed them, which was very unusual in my city. I did not just go somewhere, I followed an “inner guidance.” I did not know where that would lead me. I ended up in a church, looking at the only candle in the altar. On the third day: The “spirit voice” led me again outside of town. It led me to a place where the sun seemed to be shining exceptionally bright. Everything was extraordinarily peaceful. I found another church, but the door was closed. Then I walked through the neighborhood and found the names of people I knew on the doors. I don’t think they lived there, but their names were there. I passed an advertisement with people chopping food and it looked like people drumming the beat. I imagined it to be a sign intended for me that I should be more energetic. And the spirit told me: “Now this!” I was led back through the traffic to town. I passed a bridge (the spirit told me: “When you pass the bridge it starts!”), passed a radio shop and arrived in a city street, a shopping street. The spirit told me: “Hold your breath when you are outside in the cold. And every now and then go into a shop and warm up. Buy something.” I did what it said and visited all the shops and strolled around. Then it was over. That is all I remember. I did not dream this. For a long time I kept the trousers that I bought then. This was followed by a period of increasing paranoia and more voices. I became dysfunctional, which led me to lose my job, and I became increasingly depressed. My parents soon after that brought me to see a doctor in a psychiatry unit in hospital. I was prescribed Risperidone, initially 8 mg.

A Dietary Approach to Improvement

At the time of the initial episode, I had a relatively poor diet of purchased sandwiches, pasta, and large amounts of coffee. I had before that also dabbled around with very restricted diets, avoiding all fat and eating only limited calories, often from sugary snacks. I did not initially smoke but started to smoke (again) after this episode. I am since then a nicotine user. I consumed large amounts of wheat and generally ate unhealthily. I did drink moderately. After initiation of medication, I gained 20 kg in weight due to poor nutrition. I also since then consumed extreme amounts of caffeine, both from coffee and colas.

In the decade since my initial episode, I had repeated recurrent episodes, one of more than 6 months duration (in 2010). Since 2011, I have much improved. I am still experiencing occasional symptoms, but they are usually of short duration (less than 3 days). In the decade since my diagnosis, I tried various diets—from a protein-rich fad diet, to gluten-free and milk-free, to vegetarianism and finally veganism. I am currently playing around with raw veganism. In the last year, I have also been a pescatarian (vegetarian who consumes fish). I drink moderately and since 2005 use nicotine only in the form of nicotine gum. I used to drink excessive amounts of caffeine but have for some months now restricted this to one cup a day plus decaffeinated beverages. For several years now, I limit the amount of sugar I use and consume large amounts of fresh vegetables and fruits. I have lost the additional weight and am now at an ideal weight.

I believe that my diet not only helps me take control over my weight but also in some way over my positive as well as negative symptoms. Even though I am now consistently on medication, I control what I take into my body to achieve even better results. Over the past decade, with dietary adaptation, I have substantially increased my wellbeing and general life satisfaction. I am now much better adapted socially, I participate in various activities, such as walking, and am succeeding professionally (I have just been promoted in my job). This all happened while my medication was reduced and then stayed at a very low level. In the years following the first episode, a couple of times I stopped medication. Each time led to a recurrence of the symptoms, with varied content. Since 2011, I am continuously on medication. I have had regularly recurrent episodes even then. However, they have increasingly been very short term (a couple of days at the most). I have never been hospitalized and live independently, even in a foreign country.

I have to mention that when I have episodes (and this still sometimes happens), I tend to eat unhealthily again, I tend to abuse coffee, sometimes drink too much and smoke. I have developed a plan for myself to respond to future episodes by drinking only herbal teas and water, abstaining from smoking and alcohol, and maintaining a healthy diet. I believe this will help me to improve further.

Gluten-Free and Other Diets

Schizophrenics often nourish themselves very poorly. This is for one related to the inability to care for anything complex, like shopping or cooking, when symptomatic. This is also related to the commonly poor financial situation of schizophrenics due to unemployment. Hospitalization also restricts the dietary choices of the experiencers. Diet, however, is little discussed in the literature on schizophrenia. This is unfortunate, as it is possible that much could be achieved with dietary interventions. The only more in-depth discussion of a dietary approach to the illness I am aware of is related to the gluten question.¹

I have tried the gluten- and milk-free approach short term. While I am not 100% confident that I achieved a total elimination of gluten, I did not notice any significant differences. In the test period, few symptoms occurred. However, this was within a period when I had few symptoms generally. I also tested for food allergies in the negative. What occurs to me, however, is that the observation that patients increase their wheat consumption before or in an episode is true in my case. In an acute episode, I usually have a restricted diet of cheese sandwiches mainly. This could well contribute to the symptoms. It would be beneficial to test this approach when I am more symptomatic. Currently, due to my veganism, I avoid milk usually, but not completely. I also consume little amounts of wheat, as I restrict my intake of bread and pasta and cake with the intention not to gain weight.

In addition, I have experienced poor nutrition out of financial restrictions as well as the inability to care for it due to my symptoms. Since 2008 however, I have tried various healthy eating regimens, among them vegetarianism, pescatarianism (vegetarianism with fish consumption), and veganism as well as raw veganism (foods are not cooked). I found any healthy regimens that include lots of fruit and vegetables and restrict the use of sugar and unhealthy fats particularly beneficial. It did not matter so much for my wellbeing if meat or fish were included in reasonable amounts. However, I experienced worse symptoms when I was on a poor diet of precooked curries, packed sandwiches, and prepared lunches. At that time, my anxiety and general symptoms were much worse than when I prepared my own food. It is difficult to decide, which came first, the wellbeing or the food. However, I am convinced that a healthy diet without many preservatives and sugar helps my wellbeing. I found no ill effects of the vegan or raw vegan diet on my symptoms. I also have to state, though, that neither vegetarianism nor a high-protein diet helped me to totally eliminate episodes. After an early trial in 2007 with a high-protein diet (which went initially very well), I relapsed and had a serious and long episode. However, this co-occurred with an initial refusal to take medication and then switching short term to a new medication (Abilify). I am a vegetarian since about 2012 and have recently turned vegan. Since I became vegetarian, my episodes have become much shorter and more manageable and the negative symptoms are much improved.

The Orthomolecular Approach

The orthomolecular approach recommends large gram doses of specific vitamins and claims this can even heal schizophrenia.^2–4 I have tried the orthomolecular approach for about 5 years from 2009 to 2013 inclusive. I took Niacin, Vitamin C, and Omega 3 oils in large doses, partially combined with additional vitamins and minerals. I found partial remedy in it. Initially, I tried it while at the same time refusing medication. This led to a serious relapse. I went back on my previous level of Risperidone. After 5 years long-term treatment with vitamins and Omega 3 oils in addition to medication, this still did not prevent the recurrence of symptoms. I did not experience any ill effects of the supplements either, apart from very rare stomach upsets when taking too much Niacinamide. I had myself regularly tested for liver problems, but none did occur. I have stopped this approach last year. However, I find that I now experience higher levels of wellbeing compared to the time before I started, that I am more productive in my work, and, even though I still have occasional episodes, that these are much shorter in duration. In addition, I feel significantly less anxious and also much less depressed.

Coffee, Alcohol, and Nicotine

Sufferers of schizophrenia tend to abuse, in particular, caffeine and nicotine, but also alcohol. Inpatients of hospitals have been observed to eat coffee from the container with a spoon and cigarette consumption is abnormally high in the population affected by this illness.⁵ Edelman argues that all these contribute to the development of symptoms.⁶ Previous studies indicate that caffeine indigestion is positively correlated to schizophrenic symptoms.^7,8 One study that I am aware of has investigated if a reduction in caffeine would help with symptoms but did not come to a positive conclusion.⁹

I tried to limit my intake of all the above named substances. I have limited my alcohol intake to below the recommended daily intake, I drink only one cup of caffeinated coffee per day and have occasionally totally abstained from coffee. I drink relatively large amounts of decaffeinated coffee at the moment. I don’t smoke but use nicotine gum (long term). Like many of the mentally ill, I find it very hard to impossible to stop this habit.

What has helped me significantly so far was the reduction of my caffeine intake as well as the control of alcohol consumption. Excesses in this regard in my case nearly always lead to increased symptoms. Decaffeinated beverages do not have this effect. Also, moderate amounts of alcohol do not produce any negative effects. Episodes in my case usually follow a time of high coffee consumption and sometimes co-occur with short-term relapse in smoking cigarettes and drinking more.