Schizophrenia, Supplements as an Additional Treatment
“Schizophrenia affects our entire society and has no bias.”1 About 1% of the population globally have schizophrenia, meaning it affects approximately 1 in every 100 people, making it more prevalent a condition than diabetes, alzheimer's disease, or multiple sclerosis, for example.2 Living with schizophrenia can, however, be a very different existence for each individual. One could say this is true for all of us; that ‘reality’ is completely subjective and based on our own individual ‘experience’ and ‘perception ‘of what is ‘real’. Author, Philip K Dick, ponders: “What about the world of a schizophrenic? Maybe it’s as real as our world. Maybe we cannot say that we are in touch with reality and he is not, but should instead say, His reality is so different from ours that he can’t explain his to us, and we can’t explain ours to him.”3
For some people schizophrenia can be a very scary, confusing, tiring and insular experience. The following quotes from people with schizophrenia describing their experience helps to get some sort of understanding of what it can be like:
“What was real and what was not? I couldn’t tell the difference any longer and it was exhausting.”
“Sometimes I feel thoughts are being put in my head and that people are reading my thoughts.”
“Sometimes I am in a different time zone or move between periods of history in different lives.”
“More recently my symptoms have included voices outside my head, feelings that people are talking about me and spying on me.”4
Others who have schizophrenia may experience it in different ways and are able to adjust to and in some cases embrace the positives of their experience.
What is Schizophrenia?
Schizophrenia is a mental health condition; an illness related to the mind which affects the way you think. The medical definition of schizophrenia is based on the assumption of a shared reality that the majority of us are able to function within and share a similar understanding of what is ‘real’ and what is not. Schizophrenia is considered a severe long-term mental health condition and described as ‘a type of psychosis. This means the person may not always be able to distinguish their own thoughts and ideas from reality.’6 Schizophrenia is defined medically as being characterised by ‘severely impaired thinking, emotions, and behaviors.’7
The term schizophrenia derives from two Greek words that translate to "split mind" referring to the ‘splitting apart of mental functions’ described by Eugen Bleuler, a Swiss doctor, in 1908, as being central to schizophrenia.8 As noted on the NHS website; this doesn’t equate to a "split personality"; nor should it be associated with temperamental or violent behaviour.9
The symptoms of schizophrenia are generally categorised into ‘positive’ and ‘negative’.
Positive symptoms include any change in behaviour or thoughts, such as:
- Hallucinations. This could include hearing voices or sounds; or seeing things that other people can’t see.
- Delusions. This can include paranoid delusions. Beliefs or ways of seeing that aren’t shared by the majority as ‘true’ or ‘real’. Irrational beliefs or thoughts.
- Confused thoughts (thought disorder). Perceive, interpret or process things differently to the majority.
‘The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion and behaviour.’ 10
Negative symptoms tend to be characterised by withdrawal or the inability to function and respond in the same way, for example, schizophrenia can make people seem lacking in emotion and vacant. Symptoms can include:
Socially withdrawn: This can include being disinterested in joining in socially; disinterested in joining in with activities, including relationships and sex; Not wanting to leave the house; Feeling uncomfortable with people; Unable to initiate conversations or feeling there's nothing to say.
- Unable to communicate/disorganised speech. Struggle to finish complete thoughts and sentences.
- Lack of interest or care in appearance and personal hygiene.
- Lack of motivation and vigour for life.
- Lack of concentration.
- Changes in sleeping patterns. Difficulty sleeping.
- Vacant. Schizophrenia may make people appear listless, ‘in another world’; lacking in emotion; Unable to connect with others; Feeling disconnected from own feelings.
- Body function, in particular, movement, can be affected. For example, restlessness and involuntary movement. Poor coordination and judgement.
Lack of empathy. Schizophrenia may make people appear to be unable to understand and react to the emotions of others, making them seem uncaring and selfish.11
Living with Schizophrenia
We all need supportive people in our lives to help us through the everyday challenges; those with schizophrenia will benefit immensely from having a support system in place, made up of family, friends, medical and support staff and so on.
With individualised treatment, self-help, and support, many people manage their symptoms and are able to live satisfying and rewarding lives. Statistic show that over time for most people, the condition improves or symptoms lessen.12 Statistics also show, however, that approximately 80% of those with schizophrenia experience some sort of relapse of symptoms within five years.13
Lifestyle choices and changes
Lifestyle choices can help those with schizophrenia to adjust to and manage to live with the condition. Managing diet; maintaining a healthy lifestyle; exercising; seeking support; and being active in managing stress, for example, can all help lessen the symptoms of schizophrenia and bring about a sense of autonomy and self-esteem.
Exercise can help manage the symptoms of schizophrenia in a number of positive ways. It can provide an opportunity for social integration. Being part of a team can help the schizophrenic to deal with other social situations more easily and can foster vital feelings of belonging. Working together as a team for a shared goal can help bring about feelings of connection and with this empathy. Indeed some studies have shown that exercise can bring about an improvement in social interest.
Exercise can help to Improve mental health, mood and psychological well being; increase motivation; reduce stress; and bring about feelings of well-being. Exercise can help us to feel more energetic and less lethargic. It can help improve feelings of self esteem.14
Some research has shown a link between undertaking an exercise routine and an improvement in symptoms of schizophrenia, such as apathy, lethargy and social withdrawal. And research has shown an increase in social engagement, improved behaviour patterns and increased self esteem in people with schizophrenia when they engage in a programme of exercise.15
Stressful situations happen; we all experience different levels of stress at different times in our lives brought about by varying situations and events and we all need to find our own coping mechanisms to deal with it. People who have schizophrenia can experience heightened levels of stress and feel anxious or stressed more regularly so finding ways that work for the individual to alleviate stress and strategies for dealing with and diffusing it are a great idea in terms of general well-being.
Rest and relaxation are vital. We live in a fast-paced and busy world and often the onus is on ‘action’. It’s so important to ensure we allow ourselves to rest and relax and de-stress. It’s perfectly acceptable and more than this it's essential to do absolutely nothing sometimes. Also finding relaxing activities that bring about a sense of calm and contentedness can really help with managing everyday life.
Managing the causes of stress wherever possible can naturally help to alleviate stressful situations. Being organised; keeping our spaces tidy, organising our time and so on, can help reduce stress and help us to feel like we are ‘on top of things’. Ensuring we get enough sleep and sticking to regular sleeping patterns can make such a big difference to how we feel physically (energywise) as well as how we feel emotionally and mentally.
Exercise is a great stress-buster and a regular exercise regime can significantly help bring about feelings of vitality, health, well-being, increased energy levels, a sense of calm, a sense of well-being. Exercise makes us feel good! Further to this exercise helps us to relax and helps us to sleep better too. Sleeping difficulties is one of the symptoms experienced by people with schizophrenia.16
Drugs, including alcohol are thought to have a negative effect on mood in some people and can be a trigger of depression and psychosis. It’s widely accepted that illegal/street drugs, in particular psychoactive drugs, may make some of the symptoms schizophrenia worse. Drugs and alcohol can also react badly with antipsychotic medicines, often prescribed to people with schizophrenia to help manage the condition.17 Cigarette smoking has been shown in some studies to worsen the symptoms of schizophrenia while also causing oxidative stress to the body. Although smoking is unhealthy and can cause critical oxidative stress leading to chronic illnesses, many studies have found a positive link between nicotine and its benefits to cognitive function and schizophrenia.18 Other medical advice and research, however, argues that smoking can increase symptoms of brain dysfunction and psychosis.19
People with schizophrenia tend to withdraw socially and can find it difficult to mix with other people, especially in public social situations. With support from family and friends and a will to be proactive in integrating socially, ‘social support’ can really help to lift spirits and provides the opportunity to experience vital social and emotional as well as physical connections with others. Partaking in a social activity, such as a hobby or sport in a socially support environment can help to foster feelings of belonging and value and self worth. Sometimes the thought of interacting socially is much worse than the actuality of it and it can be that the more we allow ourselves to do something that at first feels uncomfortable the easier it will become over time as we gain confidence and gain a feeling of familiarity and ease. We are naturally social beings. When feeling socially withdrawn and insular, being around people in a social situation can be exactly the right tonic.20
A varied, balanced, healthy diet including plenty of fresh fruits and vegetables; fibre rich food; and whole foods containing essential vitamins and minerals; as well as high levels of fish oil and essential omega fatty acids, is crucial for every one of us and can help us to stay fit and healthy and to feel good both physically and mentally.
Studies have shown that people with schizophrenia often have difficulty maintaining healthy eating habits and tend to eat food with high fat content and less dietary fibre.21 This means that they often experience more physical health conditions and issues such as poor diabetes; heart health; obesity; high blood pressure; and respiratory problems.22 One study argued that over 75% of people with schizophrenia will also have a chronic physical ailment or disease.23 Diabetes is particularly common in those with schizophrenia accounted in some studies to poor diet/malnutrition, not enough exercise and smoking.24
Further to this, diet and susceptibility to mental health issues have been linked with a particular interest in the correlation between a deficiency in dietary nutrients and mood.25 Malnutrition and deficiencies in certain essential nutrients could be factors that contribute to causing mental illness, such as schizophrenia as well as exacerbating symptoms. Coupled with this is the trend that psychiatric symptoms can result in/lead to poor nutrition, which in turn can affect recovery. 26
Consuming essential omega 3 and 6 fatty acids is thought to be helpful for those with schizophrenia. Considered ‘brain food’, research has shown links between essential omega 3 and 6 fatty acids and improved cognitive function. Containing brain supportive omega fatty acid eicosapentaenoic acid, EPA , which has been shown in studies to have a positive effect on behavior and mood.27 These essential fatty acids are generally good for us and considered crucial for maintaining a healthy heart, mainly because they contribute to normal blood cholesterol levels; have the ability to stop blood clotting; and contribute towards a healthy and regular heart rhythm. Salmon, tuna, mackerel and halibut are good sources as well as avocado, sunflower oil, flax, linseed oil and walnuts.
Increasing antioxidant intake by consuming a variety of fruit and vegetables and supporting diet with an antioxidant rich supplement can help to maintain general health and help the body to fight damaging free radicals. Supplements such as Vitamin C, Vitamin E and Coenzyme Q10 all have potent antioxidant capabilities. Reducing oxidative stress on the body such as avoiding pollutants, like cigarette smoke, is advised.
Ensuring we get adequate amounts of all essential vitamins in our diet, in particular B Vitamin rich foods, such as vegetables and fruits, whole grains, beans, nuts, seeds is essential for everyone and research indicates there could be a link between a deficiency in the B Vitamins and negative symptoms of schizophrenia. Green vegetables, beans, lentils, nuts and seeds are all rich in folic acid and Vitamin B12 can be obtained from dairy produce, meat, fish and eggs.
Supplements for Schizophrenia
Research has shown that some supplements can be beneficial for people with schizophrenia and that a combination of nutrients can help reduce certain symptoms in some mental health conditions, such as schizophrenia, by improving cognitive processing, for example, and that correcting deficiencies can improve brain metabolism and psychopathology. 28
Vitamin B complex
Research has shown the Vitamin B complex (the 8 essential water-soluble B Vitamins) could support brain metabolism and be a beneficial treatment for schizophrenia. 29 Whilst many of the B vitamins work in tandem, each has its own specific benefit to our health.The Vitamin B series can significantly reduce symptoms of schizophrenia according to research funded by the Medical Research Council and University of Manchester.30
Essentially B Vitamins are crucial nutrients needed by the body for growth, development, and a range of other important functions. The Vitamin B complex supports the promotion of normal energy metabolism leading to a reduction in fatigue (Vitamins B1,B2,B6,B12); normal nervous system function leading to overall improvement of psychological function (Vitamins 1,B2,B3,B6,B8,B9,B12); blood flow to active tissues (Vitamin B3) and can also prevent oxidative stress, caused by free radicals; and offers support and maintenance of the immune system; all beneficial capabilities with regard to symptoms of schizophrenia.
Eating foods rich in vitamin B such as broccoli, bananas and tomato juice in addition to taking the B vitamin complex can assist with the overall effects.
Other benefits of the Vitamin B complex include support and maintenance of: skin; mucous membranes; vision; iron metabolism; red blood cell production; and the digestive system.
Studies have been conducted to try and discover competent treatments for the negative symptoms of schizophrenia; particularly in the area of in vitamins, nutrients and amino acids, for example ,and their active capabilities. One such study concentrated on the effects of folate and Vitamin B12 supplementation in schizophrenia, due to the fact that negative symptoms have been linked to reduced blood folate levels. A clinical study was conducted over a period of 16 weeks where a dose of 2 mg of folic acid and 400 μg of vitamin B12 was given to a randomized group of outpatients with chronic schizophrenia who were mentally stable but continued to have negative symptoms despite being on a course of antipsychotic medication. The results found that ‘Folate plus vitamin B12 supplementation can improve negative symptoms of schizophrenia, but treatment response is influenced by genetic variation in folate absorption’.31
Research has shown that Vitamin B complex could have a positive effect on reducing movement disorders such as akathisia (extreme restlessness) and tardive dyskinesia (involuntary movements) associated with schizophrenia.32
Vitamin B complex combined with folic acid can help normalise metabolism; particularly useful for schizophrenia because B12 metabolism is altered in some people with schizophrenia.33
A study conducted by researchers at Massachusetts General Hospital has shown Vitamin B complex to have a positive impact on symptoms characteristic of schizophrenia namely apathy, withdrawal, and the inability to display emotion.34
The Vitamin B complex formulation provided by Oxford Vitality contains Vitamin B1, B2, B3, B5, B6, B12, D-Biotin, Folic Acid and Inositol.35
Folic Acid is an essential B vitamin which helps to break down macronutrients that are crucial in helping the organs in the body work properly. The body is unable to produce or store large amounts of Folate easily, hence, why it’s readily available and recommended as a supplement. There are natural sources of Folic acid, these include, dark green leafy vegetables (kale and spinach), soya beans, kidney beans, broccoli, cabbage, avocado, cereals and barley.36 Particularly useful as a supplement for those with schizophrenia due to findings which link the negative symptoms with reduced blood folate levels.
5-HTP is a vital naturally occurring compound in the body and is the most important active ingredient of the Griffonia Simplicifolia plant. Griffonia Simplicifolia is a vine plant that best grows on mountain slopes and termite hills of Central and West Africa. It’s been employed in this part of the world for centuries as a traditional herbal medicine, esteemed for its therapeutic and healing properties for a range of diseases. 5-HTP converts directly into serotonin and melatonin in the human brain. These are neurotransmitters which are believed to help mood, brain activity, appetite, concentration, and regulate sleep patterns. 5-HTP is thought to help aid insomnia; The conversion of 5-HTP into serotonin and melatonin in the brain can help promote a healthy sleep pattern. Melatonin has been cited as the hormone that helps regulate our wake-sleep cycle. Try coupling this with Green tea tablets, a great source of theanine which can help improve sleep; and these two supplements could help alleviate one of the symptoms of schizophrenia and enable some shut eye.37
The body uses Chromium in minute quantities, and so is considered as a “trace” mineral. Egg yolk, red meat, cheese, wholegrain cereals, brewer’s yeast and thyme are all natural food sources of Chromium. The Chromium levels in these foods are very low, however, ranging between 1 and 13µg (micrograms).
Chromium Picolinate, the form of Chromium used in these supplements lays claim to two major therapeutic benefits. These are to help with the maintenance of blood glucose levels and to aid the metabolism of macronutrients (Protein, Carbohydrate, and Fat). Evidence has shown that it increases protein synthesis, lowers blood fat concentration and helps to maintain blood glucose concentrations. Greater concentrations of glucose inside the cells creates perfect conditions for energy production, specifically in the muscles, which can help alleviate symptoms of fatigue characteristic of schizophrenia.
The product is available from Oxford Vitality in two strengths of 500mcg and 1000mcg, and 6 size quantities, to tailor to your requirements. The tablet size is a small 6mm, with a tablet weight of 150mg, for easy consumption.38
Ginkgo Biloba tablets.
Ginkgo Biloba is a rich source of the flavonol Kaempferol. The active compounds of the Biloba seeds are called Ginkgolides and Bilobalides. These compounds provide a beneficial list of therapeutic actions, namely their effects on cognitive function.
This ample source of kaempferol is thought to help maintain mental well being and memory function, while helping to protect against cognitive decline, typically associated with the ageing process but also a symptom of schizophrenia. This benefit is brought about by contributing to normal circulation to the brain, and thus increasing brain performance and reactivity. Ginkgo is rich in antioxidants, that scavenge potentially damaging free radicals, protect cellular integrity, reduce oxidation and ill health.
Oxford Vitality’s Ginkgo Biloba comes in a manageable and easy to swallow 8mm tablet in a variety of six different sizes to suit your needs.39
Inositol or Vitamin B8. Its active compound is called myo-inositol. It’s found in lecithin oil, liver, brown rice, cereals, and green leafy vegetables. It primary role in the body is to help breakdown fats. This is particularly useful in areas such as the brain and heart where fat deposits are harmful to health. Additionally, Inositol can function as a neurotransmitter, thus aid nervous system function.40
Manganese is a mineral that’s present naturally in the body in very small amounts. Natural sources of Manganese include garlic, raspberries, watercress, spinach, turmeric, brown rice, green vegetables, oats and beetroot. Manganese has a whole host of health benefits including its role as a co-enzyme which helps the body’s metabolism, specifically assisting with the metabolism of fats and carbohydrates. On top of this it’s great for maintaining healthy bones and the formation of connective tissue as well as regulating blood sugar levels, absorbing unwanted calcium and helping the thyroid gland to function properly. Manganese can also contribute to the reduction of oxidative stress, which protects the cell's integrity and reduces disease.
The tablets provided by Oxford Vitality contain 14mg of bio-available ingredients, this is in coherence with the UK Department of Health’s (DoH) guidelines. The Manganese tablet is a small 8mm diameter tablet, and very easy to swallow. There are 6 quantities to chose from for your tailored nutritional requirements.41
In addition to the above range of supplements beneficial to those with schizophrenia, Vitamin E could have beneficial effects on glycemic effects of antipsychotics; the medication often given to manage the symptoms of schizophrenia and fat-soluble Vitamins A, D, and E have been shown to have inflammatory regulation activity in the brain.42
Research continues on the link between nutrients and positive activity on the brain which can help to improve mental health, brain functioning and metabolic health.
It’s clear that a deficiency in essential minerals, vitamins, nutrients and amino acids can have a negative effect on cognitive function, mood and physical energy. The right combination of supplements, coupled with a healthy, varied and balanced diet, a regular exercise routine and the right individualised treatment can help manage some of the symptoms of schizophrenia, resulting for many in the ability to live a full, active, socially integrated and rewarding life.
For more information on the types, symptoms and diagnosis of schizophrenia, you can visit HealthMatch.
Please note that Oxford Vitality does not claim to cure or treat schizophrenia with supplements. It simply is providing you with research on schizophrenia and therapeutic treatments for this disorder.
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15 Penedo F, Dahn J, 2006, Exercise and Wellbeing: A Review of Mental and Physical Health Benefits Associated with Physical Activity, published in Current Opinion in Psychiatry.
19 Does cigarette smoking contribute to schizophrenia? http://www.medicalnewstoday.com/articles/296639.php
21 Fuller Torrey, E, 2001, Surviving Schizophrenia, Quill, p137.
22 Burton N, 2012, Living with Schizophrenia, Acheron Press, p86.
23 Mitchell A, Malone D, 2006, Physical Health and Schizophrenia, published in Current Opinion in Psychiatry. Retrieved from: https://www.livingwithschizophreniauk.org/advice-sheets/exercise-schizophrenia/
24 Peet M, Diet, Diabetes and Schizophrenia: Review and Hypothesis, British Journal of Psychiatry, April 2004.
25 Hoobler BR. Symptomatology of Vitamin B deficiency in infants. Journal of the American Medical Association. 1928;91:307–10. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3046018/#b1-imi-2008-033
26 Vitamin deficiencies and mental health: How are they linked?
Current Psychiatry. 2013 January 4. Drew Ramsey, MD: http://www.mdedge.com/currentpsychiatry/article/64985/depression/vitamin-deficiencies-and-mental-health-how-are-they
29 Vitamin deficiencies and mental health: How are they linked? http://www.mdedge.com/currentpsychiatry/article/64985/depression/vitamin-deficiencies-and-mental-health-how-are-they
Vitamin B6 as add-on treatment in chronic schizophrenic and schizoaffective patients: a double-blind, placebo-controlled study: https://www.ncbi.nlm.nih.gov/pubmed/11838627
Randomized multicenter investigation of folate plus vitamin B12 supplementation in schizophrenia: https://www.ncbi.nlm.nih.gov/pubmed/23467813
31 Randomized multicenter investigation of folate plus vitamin B12 supplementation in schizophrenia. (Roffman JL, Lamberti JS, Achtyes E, Macklin EA, Galendez GC, Raeke LH, Silverstein NJ, Smoller JW, Hill M, Goff DC): https://www.ncbi.nlm.nih.gov/pubmed/23467813