Psychiatric Pretenders

Are you crazy? Did you really mean to say that to Mark as you were leaving the office. Probably not, you’re just having a bad day he’ll understand. You just get a bit “hangry” around 3pm. Time to get a cheeky bit of chocolate to pick you up- no-one will know that the fitness kick you have been raving about will be on the back burner for another day.

Poor Mark got his head bitten off for no reason! (Well you might have had a reason-he is a bit annoying- but still this is not how you want to act).

Does this sound familiar?

Everyone is pretty au fait with the term “Hangry” where you are irritable because you need to eat.

When your blood sugar falls, the hormones cortisol and adrenaline (epinephrine) are released in an attempt to raise it back to normal. Your body thinks it’s in an emergency and so it sends these hormones/neurotransmitters to deal with it.

But those hormones also happen to lead to irritability. Not only are they at play here but Neuropeptide Y also helps create a hungry feeling when your body needs more food—and it's  linked to aggression as well…which explains why poor Mark copped it.


At these times we often go for the quick sugary fix, as our body is wanting us to get sugar in as fast as possible. But being quick acting these food sources then cause a spike in blood glucose levels that inevitably leads to another crash—and you'll be acting like a crankpot all over again. Your body particularly craves sugar as it helps the brain uptake neurotransmitters faster. So… it’s kind of not your fault that chocolate was oh so tempting (not to mention when you crave chocolate you are really craving magnesium which helps calm the nervous system & muscles).


You’re not really crazy, that’s a relief… your blood glucose drop just made you feel that way for a moment.



But what are some other “psychiatric pretenders” that may show themselves as depression, anxiety, fatigue & brain fog?

Here are the top 5:

  1. Blood sugar instability

  2. Gluten Intolerance

  3. Medications e.g. PPI (proton pump inhibitors that are used to treat reflux)

  4. B12 deficiency

  5. Thyroid autoimmunity

This doesn’t mean that other things don’t contribute or cause these conditions. But these states/substances can make you act like or seem to have mood instability.


Sugar is the most important and prevalent. If it is out of whack it may lead you to be accidentally diagnosed as having: anxiety, poor concentration, ADHD, panic attack &, bipolar disorder. It has an addictive potential that is unparrelled. It gives you the short term gain for the long term suffering, especially if it’s from processed foods- thats one hell of a roller coaster for your body to go on.

Gluten can cause symptoms in celiacs and non-celiacs. You can have sensitivity or intolerance but not necessarily “celiac disease” which is much more severe. Eating gluten can leave you foggy, depressed and it is linked to autoimmune conditions such as lupus and MS.

The NEJM reported a case where a 37yr old female with a restraining order was admitted to hospital with thyroid symptoms. She was found to be gluten intolerant (not celiac) and after being put on a gluten free diet for 2 months she was off all psychiatric medication and back to her baseline.

Gluten increases abdominal bloating and pain, stomatitis, depression and brain fog. Gluten also has an emotional effect on us, people blindfolded in another study knew when they were eating gluten. It has an almost “opiate” like action on us.

But why is it only a problem now when we have been eating it since baby Jesus was born? There are a few theories:

  • our internal ecology has shifted: being “too clean” and our soil no longer has its own ecosystem due to all the chemicals, antibiotic use, non-natural births meaning we aren’t getting exposed to mums bacteria and having that establish itself in us.

  • lost relationship with bacteria that break down gliaden in ways we humans can’t

  • permeability of gastrointestinal tract due to dangerous chemicals on wheat which in turn send alarm bells to your brain

  • refined starches with vegetable oils that are sprayed with glycoside and powerful herbicides- that are also not good for your cells

  • GMO crops - need I say anymore here!!!

  • problems with lab tests- they are often not completely accurate in diagnosis and have lots of shortcomings. You can have the “perfect poo” and not have any gastrointestinal symptoms from gluten but your manifestations of intolerance maybe purely mental.

Medications can affect mood. Most obviously mood/anxiety medications i.e. psychotropics, antidepressants, anxiolytics etc. as they are affecting neurotransmitter balance. This can be a good and sometimes a bad thing. Have you read the side effects to a lot of antidepressants?! They are often given indiscriminately without looking at what specific imbalance you have or what other factors are contributing. This is not to bash medications but they need to be used judiciously.

Oral contraceptive pills (OCP) can alter mood- and that’s all types of pills not just high dose oestrogen ones. Not only that but the OCP can:

  • decrease libido

  • bind more thyroid hormone and sex hormones including testosterone

  • deplete Vitamin B6, Zinc, Selenium, Phosphorous and Magnesium.

But let’s not forget about “Statins” which are a group of cholesterol lowering medications that affect the brain ability to think clearly and function. Cholesterol is needed by the body and brain- even some of the so called “bad” cholesterol it does in fact use. Everything has its place its all about balance rather than this is good and that is bad. In fact your brains dry weight is 60% fat! So you can see why we need some.

PPI’s (proton pump inhibitors) which are a class of antacid medications can decrease Vitamin B12 and affect the microbiota. Once the microbiota is out you can have psychological imbalances not to mention methylation issues and homocysteine recycling.

Don’t forget vaccines, antibiotics, pain killer and xenoestrogens can also affect neurological homeostasis.


B12 deficiency can lead to depression symptoms. 27% of severely depressed women are B12 deficient. There was a case report of a 52year old woman that was post menopausal and in a catatonic state. She was a vegetarian and found to be low in B12. When she was given 2 injections of B12 she returned to baseline and could interact with others and the world around her. B12 is notoriously hard to absorb, you need good stomach acid levels to release it from food and even if you are eating animal food sources rather than plants (animal sources are easier to absorb) you can struggle to get levels up orally. If severely deficient B12 requires injections. A well functioning gut is needed in order to absorb B12 and may require some healing first. If you want to get some B12 in while you are having your guts (gastrointestinal tract) improved sublingual formulations of B12 are your best option apart from injections as it bypasses the stomach.

Thyroid autoimmunity can also affect mood balance. The best way to know if this is a problem for you is to get tested and not just for TSH. Unfortunately fluoride in the water supply doubles your risk of developing hypothyroidism as its an antagonist to iodine. If you have any nutrient deficiencies you also will have impaired production of thyroid hormones i.e. Iron, Iodine, Tyrosine, Zinc, Selenium, Vitamin E, Vitamin B2, Vitamin B3, Vitamin B6, Vitamin C and Vitamin D. Other factors that also inhibit proper production include: Stress, infections, trauma, radiation, medications, fluoride, toxins such as pesticides, mercury, cadmium, lead and autoimmune disease such as celiacs. Now there is some good news there are facts that help improve thyroid sensitivity at the cellular level and these include Vitamin A, Exercise and Zinc. We can talk about reverse T3 (rT3) and T3 to T4 conversion another day., don’t want to overload you here.

Think you might have one of these pretenders?


There is lots we can do about them so don’t feel overwhelmed by this information. Its intended to inform you; once you know what a problem is you can do something about it. The first step is knowing.

Your body’s ability to heal is greater than anyone permitted you to believe.

You are not broken or a victim to your genes. Your body is trying to get you back on track. You just need to find out what things you can do to put it in a healing position.

Ask me to find out how… xo