Which fad diet have you chosen to follow this year? One that helps you lose weight, or one that cures your mental health problems? Chances are that if you’re really following food trends, you’ll be discarding the piles of ‘clean eating’ recipe books in your kitchen in favour of a whole new swath of literature on dieting for mental health. There’s the ‘Mad Diet’, which promises ‘easy steps to lose weight and cure depression’, the ‘Anti-Anxiety Diet’, which is a ‘Whole-Body Programme to Stop Racing Thoughts, Banish Worry and Live Panic-Free’, or ‘Food and Mood: Eating Your Way Out of Depression’. Just like the clean eating trend that came before, each mental health diet has its own mantras. Gluten continues to be the biggest threat to sanity, according to many of these self--appointed psychiatric chefs, but there are also problems with dairy, sugar and fats. And like so many diets that require you to buy a book in order to understand them, the claims are impossibly big.
Of course, the food quacks aren’t the only ones cashing in on the current interest in mental health. It’s the new marketplace for people wanting to make a fast buck out of the fears of vulnerable consumers, just as fad diet proponents have been doing for years with those who are unhappy with their bodies. Everyone wants to lose a few pounds, and now that the stigma around common mental illnesses such as depression and anxiety is lifting, so everyone wants to have good mental health. And there are plenty of businesses hoping you’ll try to spend your way out of a mental black hole using their products. The amount of stuff available is so overwhelming — and expensive — that it’s a wonder people with mental illnesses have any time or money to do anything else at all.
As someone who has written a fair bit about mental illness after being diagnosed with post-traumatic stress disorder a few years ago, I find myself being bombarded with some of these products from people hoping I’ll give them a good write-up. I was recently invited on a press trip to a ‘mental health retreat’ which would cost thousands of pounds for members of the public to attend. It sounded both luxurious and totally pointless. Unless it promised me a couple of years’ worth of counselling, medication with better research behind it than the current selection of drugs on offer to people with mental illnesses, and a psychiatrist I didn’t have to wait a year to see, I couldn’t see how this would be any different to a normal holiday. And yes, I’ve been offered a fair few diet books about food and mood, too.
Like all good quacks, the makers of these products sell their wares using a whiff of science. We know the risk of some illnesses, including cancers, dramatically reduces as a result of lifestyle choices. I’ve just finished writing a book examining the evidence for the power of the outdoors in helping to treat even the most serious mental illness, and there is research suggesting that you are less likely to develop depressive symptoms or clinical depression if you are physically active. It can even increase the size of the hippocampus, the part of the brain dealing with knowledge, memory and emotions, which shrinks in patients with mental illnesses such as schizophrenia.
The problem is that people who want to make money extrapolate even the smallest pieces of evidence-based research to make claims far beyond the realms of possibility. When it comes to physical illness, there have always been charlatans claiming diet can cure all manner of affliction: just ask a cancer patient how many times they’ve been asked if they’ve tried turmeric rather than chemotherapy. Now mental health is attracting its own cohort of swindlers.
One of the reasons that mental health is so susceptible to money-makers is that it is so poorly understood. There is far less research into psychiatric disorders than there is into cancer, for instance. We don’t know what causes most mental illnesses. Even NHS-recommended treatments for them have a very small evidence base. Drugs for depression haven’t really changed for 40 years. Medication for psychotic illnesses is so thuggish it contributes to a shortened life expectancy. There are such long waiting lists for treatment that many NHS trusts have had to close them. Being stuck on a list doesn’t pause your illness, and so people become desperate for another solution as they deteriorate and their lives appear to blow up. Where there is uncertainty, quackery thrives.
The unhelpful things that people end up saying to someone who has a mental illness always begin with the words: ‘Have you tried…?’ Their suggestions, meant kindly, are part of our ‘self-care’ culture which suggests you just need to try harder, have more bubble baths and eat more avocados in order to recover from the sort of trauma that your psychiatrist has warned you may take years or even your whole lifetime to deal with. If you end up being sectioned, or needing to increase your dose of medication, is it really because you failed to fork out for a ‘mental health retreat’, or because mental illnesses are crafty bastards with more cunning than even the most unscrupulous retailer?
Of course, there is one way we could spend our way out of mental illness, and the quackery engulfing it: if we had better research into what makes us ill, and how to treat it. If people were able to see qualified professionals about their illnesses in a reasonable amount of time, then they would be less likely to resort to Google and a diet book that promised they could eat themselves better. The problem is that this would require the government to admit that mental illnesses aren’t currently approached with the same seriousness as physical ones. And that might prove even harder than persuading someone that their herbal tea isn’t as powerful as they claim.