the nuance

The Cellular Link Between Mental Illness and Metabolic Disease

A Harvard psychiatrist argues that mitochondrial dysfunction underlies both.

Markham Heid
THE NUANCE
Published in
6 min readOct 21, 2022

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Photo by National Cancer Institute on Unsplash

At age 33, Tom had spent most of his adult life struggling with schizoaffective disorder. He experienced daily hallucinations and delusions and was plagued by anxiety and depression.

Medications helped him control some of his symptoms, but they also caused him to gain weight. Heavy to begin with, he put on more than 100 pounds. He didn’t want to see another doctor, and so he asked his psychiatrist for help. They tried several diets without success before they gave the ketogenic diet a shot.

Within a few weeks, Tom had begun to lose weight. To his doctor’s surprise, his psychiatric symptoms also mellowed. After two months on the diet, these changes were even more dramatic. Eventually Tom lost more than 150 pounds, and his mental state improved to the point that he could move out of his father’s house and live on his own.

“I was flabbergasted,” recalls his psychiatrist, Christopher Palmer. “This man had a psychotic disorder that had resisted more than a decade of treatment. Nothing in my knowledge or experience suggested that the ketogenic diet would treat his symptoms.”

‘Once you do a deep dive into the science of mitochondria, you can connect the dots to what causes mental illness.’

Palmer, MD, is a neuroscientist and assistant professor of psychiatry at Harvard Medical School. In his new book Brain Energy, he tells Tom’s story and describes how that clinical experience led him to explore the connection between metabolic dysfunction and mental disorder.

“This is not a book about weight loss or the ketogenic diet,” he says. Rather, it’s an exploration of the underlying cellular and metabolic mechanisms that could explain how the ketogenic diet was able to help a person like Tom find relief from his psychiatric symptoms. This exploration has helped Palmer develop what he calls a novel theory for mental illness

“The overall theme of the book is that mental disorders are metabolic disorders of the…

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Markham Heid
THE NUANCE

I’m a long-time contributor at TIME and other media orgs. I write mostly about health. I grew up in Michigan, but these days I live in southwest Germany.