Rethinking Mental Health: Could Mental Health Conditions Be a Metabolic Disease?
For decades, we’ve been told that depression, anxiety, bipolar disorder, and other mental health conditions stem from a “chemical imbalance” in the brain. But what if that is not the whole story? A growing number of scientists and physicians are challenging this long-held belief. They argue that mental health isn’t just psychological or neurochemical—it may actually be deeply connected to your metabolism. In this blog, we’ll explore metabolic psychiatry, food as medicine for the brain, and practical steps you can take if you or someone you love is struggling with mental health.
What Is Metabolic Psychiatry?
Metabolic psychiatry is a quickly emerging field that looks at how energy production in our cells—especially the brain’s cells—impacts mental health. The brain is one of the most energy-hungry organs in the body. If it isn’t getting fuel properly, or if the mitochondria (the cell’s “power plants”) aren’t functioning well, mental symptoms can appear. Leading the way are researchers and practitioners such as Dr. Shebani Sethi at Stanford University and Dr. Christopher Palmer at Harvard University. Dr. Sethi coined the term “metabolic psychiatry” and runs a clinic using nutrition and metabolic strategies to treat patients. Dr. Palmer, author of “Brain Energy”, has shown how changes in metabolism can directly trigger or relieve psychiatric symptoms. At Johns Hopkins, clinical trials are underway using metabolic approaches to slow cognitive decline and address psychiatric disorders. To further understand this new field, we have to look at why current treatments are falling short.
Why Are Current Treatments Failing?
Here’s a staggering truth: only about 6% of people living with mental health conditions ever receive effective treatment. Despite decades of antidepressants, antipsychotics, and mood stabilizers, recovery rates remain painfully low. One reason may be that the current system is too siloed—treating each diagnosis separately rather than seeing mental health as an interconnected whole. Traditionally, psychiatry views disorders like depression, schizophrenia, and PTSD as separate conditions. But research now shows that these conditions overlap far more than we realized. Scientists now talk about a “p-factor,” a single underlying risk factor that cuts across all mental health conditions – similar to a common denominator. Instead of every disorder being separate, they may share a common root.
Some researchers believe this “p-factor” or root is metabolic dysfunction. When cells can’t produce or use energy properly, it can manifest as a variety of psychiatric symptoms. Others point to unresolved trauma as a primary driver. In reality, both biology and life experience play a role, but the metabolic model offers a powerful explanation for why so many mental health conditions share similar risk factors and treatment challenges.
So, If the problem is Metabolic, the Solution May be as Well
When we talk about metabolism in the brain, we mean how neurons get and use energy. A metabolic problem occurs when mitochondria are weak or starved, leading to brain cells that can’t communicate effectively. That impacts mood, memory, focus, and resilience. Your gut is essentially a neurotransmitter factory, producing the very chemicals that determine your emotional state and mental clarity. Neurotransmitters—like serotonin, dopamine, and GABA—are all built and regulated through metabolic pathways. Interestingly, 90% of serotonin, 50% of dopamine, and 100% of GABA is made in the gut, not the brain. This helps explain why gut health is so connected to mental health. Common antidepressants, such as SSRIs, don’t actually “fix” a chemical imbalance. Instead, they change how serotonin is transported and recycled in the brain. Many psychiatric drugs also interact with cellular metabolism, including mitochondrial function, which may be one reason they help some patients but not others. This is why dietary approaches are gaining traction.
Food as Brain Medicine
The ketogenic diet, originally developed to treat epilepsy, is now showing promise in psychiatric conditions and Alzheimer’s Disease. By shifting the brain’s fuel source from glucose to ketones, the diet can stabilize energy supply and reduce inflammation. Patients with depression, bipolar disorder, schizophrenia, and even dementia have reported remarkable improvements—even when nothing else has worked.
Metabolic Health: The Common Denominator of Diabetes, Obesity, and Alzheimer’s
Looking at mental health through a metabolic lens also ties it to other conditions such as diabetes, obesity, and Alzheimer’s. These conditions share common pathways: poor glucose control, mitochondrial dysfunction, and chronic inflammation. Just as metabolic health influences how long we live, it may also dictate how well our brains function along the way. Protecting metabolic health—through nutrition, movement, sleep, and stress management—isn’t just about preventing heart disease. It’s also about protecting our minds, our mood, and our memories. This further proves that IT’S ALL CONNECTED.
What Can You Do If You or Someone You Know Is Struggling?
If you or a loved one has tried treatment after treatment without success, you are not alone. Remember: only a small percentage of people with mental health conditions currently receive effective help. But new options are emerging, and you don’t have to give up hope.
1. Seek Out Specialists in Metabolic Psychiatry
Look for clinics or providers who incorporate a metabolic approach. Leaders in the field include those listed below. Keep in mind that if you don’t live near these centers, you can search for psychiatrists, functional medicine doctors, or integrative health practitioners who take a “whole person” approach when treating mental health.
Harvard’s Dr. Christopher Palmer, who is pioneering brain-energy models of mental health.
Stanford’s Dr. Shebani Sethi, who runs the world’s first metabolic psychiatry clinic.
Johns Hopkins, where clinical trials are exploring nutritional and metabolic interventions for psychiatric and cognitive disorders.
2. Ask About Labs and Biomarkers
It can be eye-opening to run tests that explore your metabolic health. Common markers to request include:
Fasting glucose, insulin, and hemoglobin A1C (blood sugar regulation)
Lipid panel (cholesterol and triglycerides)
Inflammatory markers (like CRP)
Vitamin D, B12, folate, and thyroid function
Sometimes, advanced testing of mitochondrial function or nutrient deficiencies may also be useful
3. Consider Nutritional Strategies
Food is fuel for your brain. While every person’s needs differ, here are some evidence-based approaches:
Reduce ultra-processed foods and added sugars that disrupt blood sugar and energy balance.
Prioritize whole foods—vegetables, leafy greens, healthy fats, nuts, seeds, and quality protein.
Explore metabolic therapies like a low-carb or ketogenic diet under medical supervision, especially if traditional treatments have failed.
Support gut health with fiber-rich foods and fermented foods, since so much of your serotonin, dopamine, and GABA is made in the gut.
4. Build Lifestyle Foundations
Healthy movement, sleep, and stress management habits are so important for improving metabolic health. Consider building your lifestyle around these health priorities:
Regular activity to improve insulin sensitivity and mitochondrial health
Deep, restorative rest to help regulate brain energy systems
Meditation, breathwork, and time in nature to reduce metabolic stress
The Last Bite
This blog was packed full of information. So as you process it all, I want to leave you with this. The idea that mental health is a metabolic disorder isn’t just a theory—it’s changing lives right now, as you are reading this. From Harvard to Stanford to Johns Hopkins, doctors are proving that treating metabolism can heal the mind. For those who have tried treatment after treatment without success, this new field offers real hope. It means there may finally be answers for you—or someone you love—beyond simply managing symptoms.
By looking at mental health through a whole-person lens, we open the door to personalized, root-cause solutions. From targeted nutrition and gut health strategies to advanced metabolic testing and lifestyle changes, these approaches are helping people reclaim their mood, focus, behaviors, and quality of life.
It’s time we rethink mental health—not as a mysterious chemical imbalance, or only as the scars of trauma, but as a powerful interconnected system, where biology, metabolism, and environment all play a role.