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February 4 - April 8, 2025
Not only do mental disorders have strong bidirectional relationships with one another, many metabolic and neurological disorders also have strong bidirectional relationships with mental disorders.
(obesity, diabetes, cardiovascular disease) and two neurological disorders (Alzheimer’s disease and epilepsy).
And whether people with these conditions who are experiencing mental symptoms get diagnosed with a “mental” disorder is up to clinicians, who have the discretion to attribute these mental symptoms to the “organic” illnesses. In the end, though, the symptoms are the same regardless of what cause they are attributed to.
People with schizophrenia are three times more likely to develop diabetes.1 People diagnosed with depression are 60 percent more likely to develop diabetes.
People with diabetes are two to three times more likely to develop major depression. Furthermore, when they get depressed, the depression lasts four times longer than it does in those without diabetes. At any given time, about one in four people with diabetes has clinically significant depression.
One study followed people diagnosed with schizophrenia and bipolar disorder for twenty years. When they were first diagnosed, the majority were not obese. Twenty years later, 62 percent of those with schizophrenia and 50 percent of those with bipolar disorder were obese.5 The obesity rate at the time for all adults in New York State, where the study was conducted, was 27 percent.
Children with autism are 40 percent more likely to be obese.
people with serious mental illness were three times more likely to be obese than people...
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They found that all people with ADHD, whether treated or not, were more likely to develop obesity. Even though the primary treatment for ADHD is usually a stimulant medication, which generally suppresses appetite, the people with ADHD who were treated with stimulants were still more likely to develop obesity than those without ADHD. Those who didn’t take stimulants were even more likely to become obese.
People who are obese are 25 percent more likely to develop depression or an anxiety disorder and 50 percent more likely to develop bipolar disorder. One study found that weight gain around the time of puberty was associated with a fourfold increase in the risk of depression by age twenty-four.
people with obesity have been found to have altered connections between brain regions as well as alterations in a region of the brain called the hypothalamus10 that are common in people with mental disorders.
depression affects the heart.
In people who have never suffered a heart attack, experiencing major depression increases the risk of having a future heart attack by 50 to 100 percent.12 In people who have already suffered a heart attack, being depressed doubles the chances that they’ll have another heart attack in the next year.
People diagnosed with schizophrenia and bipolar disorder are 53 percent more likely to develop prem...
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On average, they lose between thirteen and thirty years from their normal lifespans.
All mental disorders—even mild or common ones, like anxiety disorders or ADHD—are associated with shortened lifespans.
Although suicide rates are definitely higher in the mentally ill, the early deaths in this group are primarily due to heart attacks, strokes, and diabetes—metabolic disorders.
Obesity in midlife, diabetes, and heart disease all increase the risk of developing Alzheimer’s. So do the risk factors for metabolic disorders, like smoking cigarettes, high blood pressure, high cholesterol, and a lack of exercise.
Having depression earlier in life doubles a person’s chances of developing Alzheimer’s disease.19
Twenty to forty percent of children with epilepsy also have an intellectual disability, ADHD, or autism diagnosis.23 Anxiety disorders are also common in those with epilepsy, occurring at a three- to sixfold higher rate compared to the general population.
Interestingly, the suicide attempts often occurred before the epilepsy diagnosis.
psychiatric diagnoses—across the board—are extraordinarily common with epilepsy.
Later in life, a diagnosis of major depression increases the chances of having an unprovoked seizure sixfold.31
people with diabetes more likely to have seizures unrelated to severe hypoglycemia?
people who are extremely underweight or overweight were 60 to 70 percent more likely to develop epilepsy than people of a normal weight.35
women who are obese during pregnancy are more likely to give birth to children who go on to develop epilepsy, with rates increasing as the mothers get heavier. Women with a BMI greater than 40 have an 82 percent higher risk of having children with epilepsy—almost double the risk in the general population.36
By and large, many believe these conditions arise from negligence—that they’re the fault of the diagnosed.
What it really comes down to, in the eyes of many, is simple—these are issues of willpower and discipline.
rates of all these disorders have been skyrocketing over the past fifty years. Obesity, diabetes, cardiovascular disease, and mental disorders.
But is it possible that instead of being excuses, answers like “It’s too hard” and “I don’t have enough energy” are actually clues giving us important information? Could inertia and lack of motivation be symptoms of a metabolic problem? Is it possible that these people literally don’t have enough energy?
metabolism involves the production of energy inside cells. As you’ll see in the coming chapters, people who have metabolic or mental illnesses have been found to have deficits in energy production inside their cells. These people are telling the truth. They really don’t have enough energy. It’s not a motivational problem. It’s a metabolic one.
Mental disorders—all of them—are metabolic disorders of the brain.
mental disorders are metabolic disorders of the brain.
This theory ties together medical disciplines that most people think are unrelated—psychiatry, neurology, cardiology, and endocrinology.
Metabolic abnormalities have consistently been found in people with mental disorders, even those who don’t yet have the already-recognized metabolic disorders of obesity, diabetes, or cardiovascular disease.
Essentially all the risk factors for mental and metabolic disorders are the same.
All the symptoms of mental disorders can be tied directly to metabolism, or more specifically, mitochondria, which are the master regulators of metabolism.
All current treatments in the mental health field, including biological, psychological, and social interventions, likely work by affecting metabolism.
But people with metabolic disorders are also more likely to develop innumerable other illnesses not usually viewed as metabolic. These include liver problems, kidney problems, nerve problems, brain problems, hormonal problems, joint problems, gastrointestinal problems, autoimmune problems, and even cancer.
The point is that metabolic problems are not simple, nor are they avoidable through sheer willpower. Medication is only one of many, many possible causes.
Metabolism is the process of turning food into energy or building blocks for growing and maintaining cells, as well as the appropriate and efficient management of waste products.
Metabolism allows some cells to grow and thrive and lets others shrivel up and die in a complex cost-benefit analysis that prioritizes healthy and advantageous cells over those that might be old, weak, or simply more expendable.
our metabolism is constantly changing to keep up with the shifts around us.
metabolism is the body’s battle to stay alive.
The neurons are “nerve cells,” and the glial cells are often thought of as support cells to the neurons.
Although the brain makes up about 2 percent of the body mass, it uses about 20 percent of the body’s total energy at rest. Brain cells are exquisitely sensitive to disruptions in energy supply, and when there’s a metabolic problem somewhere in the body, the brain usually knows.
If there is a metabolic problem in the brain itself, the signs and symptoms can take just about any form. Sometimes they are obvious, such as confusion, hallucinations, or a complete loss of consciousness. Other times, they are more subtle, like fatigue, trouble concentrating, or mild depression.
You might notice that brain symptoms dominate the above list of effects, even though the hypoglycemia is occurring throughout the entire body.
a paradoxical and interesting way to think about diabetes is as an energy shortage, or a deficit in energy production.
Metabolism is affected by numerous factors. It is always changing. And it is different in different cells of the body at different times.
