Could you be as sane (or crazy!) as what you eat? This new (and fiercely controversial) arm of psychiatry contends that even the ultimate mind bending horror of schizophrenia is nothing more than a problem of vitamins and minerals. Our Cosmo investigator takes a searching, objective look.

     Joanie, a 28-year-old legal secretary, began to have temper tantrums directed at Tom, the man she'd been living amiably with for three years. During these outbursts, Joanne became physically violent, something she had never done before, once even chasing Tom out of their apartment with a butcher knife. These fits of rage would depart as inexplicably as they arrived, leaving Joanie distraught and sobbing. Shaken, particularly by the knife episode, she began seeing a psychiatrist. For several months, the analyst had Joanie explore her emotions about Tom, her parents, her job, her goals and expectations, but the puzzling rages continued. Joanie quit the psychiatrist and went instead to a clinic specializing in orthomolecular psychiatry, a new branch of medicine that treats mental disorders mainly through nutrition. In less than two weeks Joanie's devastating tantrums vanished and have not reoccurred.
     Merle was 29, the mother of three children, and had been acutely psychotic for almost five years. A succession of mental hospitals had tried every conceivable therapy -- insulin shock, electroshock, individual and group therapy, drugs, and tranquilizers every type. Finally, her doctors recommended a lobotomy, a dramatic operation that destroys part of the brain but sometimes makes patients more docile and manageable. Rather than allow this extreme operation, Merle's parents took her to an orthomolecular psychiatrist to try vitamin therapy. After only ten weeks on megadoses of niacin and other vitamins, plus thyroid extract, Merle fully recovered from her crippling psychosis and, except for one setback when an illness forced her to discontinue the vitamins temporarily, has so remained.
     Carl and Ellie's marriage had turned into a disaster. Their resentment of each other had grown so strong, they could not communicate rationally -- any attempt to talk turned into a bitter argument or a physical fight. They had no sexual activity for a year. Ellie was constantly exhausted and irritable: Carl had begun drinking heavily and was intoxicated nearly every night. Aware that their attitudes were becoming increasingly abnormal, they had each sought individual psychiatric help and gone jointly to a marriage counselor: neither approach had helped. At an orthomolecular clinic, both Carl and Ellie were found to have hypoglycemia, a condition brought on by their protein-poor, vitamin-poor, high carbohydrate diet. Put on a nourishing, sugar-free diet with megavitamin supplements, the couple began to improve quickly. Ellie became more cheerful and energetic. Carl stop drinking heavily, their fights almost totally ceased.

     Those are three of the many case histories orthomolecular psychiatrists can site as typical of the therapeutic results achieved by their new and controversial brand of psychiatry. How legitimate is this new psychiatric discipline? Well, I found on researching this article, that opinions differ widely. Those doctors who practice orthomolecular psychiatry are powerfully enthusiastic while most orthodox psychiatrists are resolutely against. When I mention the method to one psychoanalyst, a man I have known and respected for years he snorted in disdain. "A bunch of kooks and simplistic true believers." he said, "promoting the typical American delusion that mental help is something that comes in jars at the health-food store. Many of their patients feel they've been helped, of course- this happens in any placebo program." Then he added, "I have seen reports, though, indicating megavitamins do produce improvement in some schizophrenics. I hope that's true. Nobody else can work with those people, especially the paranoids."
     Another shrink, a classic Freudian, was even more terse. "Go ahead and write your puff piece for the vitamin lobby, if you want, but don't embroil me in it. No comment!"
     "Conservative nutritionists are also generally opposed to orthomolecular theories. Having helped set the "official" government nutrition standards, they naturally resist the notion that our national diet in any way causes vitamin deficiencies that might lead to mental and emotional problems." This point of view was stated by Dr. Jean Mayer, formerly Professor of Nutrition at Harvard and now president of Tufts University: "The average person who has the good fortune to live in the United States shouldn't worry about obtaining the proper variety and quantity of vitamins. The appropriate supply of calories from sufficiently varied foods of animal and plant origins almost always supplies the right amount of needed vitamins, too."
     Dr. Mayer's qualifying word "almost" is critical here. Are there some Americans who do not get significant vitamins for one reason or another, from their diets, and is it possible to become mentally unhinged because of a deficient diet? There are some "pros" and certainly many "cons" regarding this theory but as far as I can determine, there has not yet been a balanced study made of orthomolecular psychiatry. (From now on, let's call it OP.) I've visited OP clinics and practitioners, read their reports and case histories, and talked with their patients. Here, then, is my report.

The Basics of Orthomolecular Psychiatry
     Let's look at how OP operates, and what it's trying to accomplish. Though all OP practitioners are medical doctors and most have had psychiatric training, OP rejects the "psychiatric model" for curing mental problems. Instead, it uses a "medical model," looking for organic or biochemical, rather than psychological causes of disorders.
     Orthomolecular psychiatry is branch of orthomolecular medicine, a term coined by Dr. Linus Pauling. He defined the process as "the preservation of good health and the prevention of disease by varying the concentration in the human body of the molecules of substances that are normally present, many of them required for life, such as vitamins, essential amino acids, essential fats, and minerals."
     The human body according to OP, is biochemical factory, and when that factory does not receive enough raw materials (nutrients) or receives impure or polluted materials, malfunctioning results. Since the brain is part of the body, it cells can also be affected. Lack of nutrients and/or the pressure of pollution or poisoning in a susceptible individual (not everyone is necessarily susceptible) can cause what OP calls "Dysperceptions." A mental patient, says OP, is out of touch with reality because he can not perceive reality. His biochemically disordered brain views the world abnormally. Spatial perceptions may be disordered: small objects will appear immense or large ones tiny. Time may be alarmingly speeded up or frustratingly slowed down. The psychotic's own body may seem to swell of dwindle away or become terrifyingly brittle. To the delusion sufferer, other people appear peculiar in their behavior or motives; ordinary incidents are surprising, weird, or menacing. Crazy notions, perhaps, but the patient can't be talked out of them -- according to OP, only when the nutritional environment of the brain has been altered to correct the condition will the dysperceptions cease.
     This is not to deny that many mental disorders are triggered by stress, sudden shock or trauma, or an accumulation of disappointments and frustrations that make life too much to bear. OP maintains, nevertheless, that the primary causative factor in these cases is a biochemical one that was either preexistent or brought on by the stressful experiences. Under certain circumstances, according to the orthomolecular theory, the body appears to manufacture "psychedelic" substances that will unhinge the brain.
     The first experiments in OP were done over 30 years ago in Saskatchewan by two Canadian physicians, Doctors Abram Hoffer and Humphey Osmond. Earlier, researchers had noted that a chemical called adrenochrome was present in the blood and urine of schizophrenics. To test the effects of the compound, Doctors Hoffer and Osmond injected themselves with adrenochrome. Shortly after the injection, Dr. Osmond noticed that the ceiling had changed color and the lights had become brighter. Leaving the laboratory, he found himself out of touch with distance and time, and he had the disturbing sensation that the corridors outside seemed "sinister and unfriendly." "I felt indifferent toward humans," said Dr. Osmond, "and had to curb myself from making unpleasant remarks about them. We had coffee at a restaurant, and I became disturbed by the covert glances of a sinister looking man. . . ." Dr. Osmond became normal again when the effects of the chemical wore off. While he was under the influence of adrenochrome, he realized, his feelings and perceptions had been typical of those revealed to him by schizophrenics.
     Hoffer and Osmond experimented with other hallucinogens, such as mescaline and LSD, and after continued research, they discovered that the vitamin niacin was useful in mitigating the effects of hallucinatory drugs. Taking the next logical step, they found the same vitamin helped alleviate some symptoms of schizophrenia. Thus began the concept of "megavitamin" treatments.

Allergies and Mindwarps
     Another cause of mental abnormality, OP believes, is allergic reaction. Industrial civilization fills our air, water, and food with countless substances that can be chemically harmful. Most of us are relatively immune to the noxious trace substances we breathe and ingest, but some are less resistant and become hypersensitized to certain substances.
     Dr. Marshall Mandell, medical director of the Alan Mandell Center for Bio-Ecologic Diseases, in Norwalk, Connecticut, contends he has demonstrated that many cases of so-called mental illness were actually allergic reactions of the brain to such everyday substances as cleaning fluid, gasoline fumes, even ordinary foods like corn, wheat, and milk. One of his cases was a young man who repeatedly flew into violent rages and beat up his mother. Dr. Mandell fasted the boy for several days, where upon the symptoms cleared up, and he became cheerful, reasonable, and cooperative. The doctor began testing him with "provocative doses" (tiny traces) of various materials. The boy continued to be cheerful until Dr. Mandell tried an extract of egg protein, which caused such a violent reaction the patient had to be physically restrained.
     In his investigations, Dr. Mandell has been able to trigger thousands of these "cerebral allergies," frequently recording the patients reactions in motion pictures. Therapy consists of avoiding the offending allergen(s), taking desensitization treatments, and supplementing the diet with vitamins and minerals.
     One thing OP cannot do at present is predict or explain why some people are nutritionally vulnerable and others are not. Why is it necessary for certain patients to remain on an extravagantly nourishing diet augmented with huge doses of extra vitamins, while many of us "normal" folk remain happy healthy, and cheerful on a food intake deplorably deficient by any standard?
     Perhaps the answer to that question is in what Dr. Roger J. Williams of the Clayton Foundation Bio-Chemical Institute calls "biochemical individuality," Dr. Williams, a noted nutritionist not identified with the orthomolecular movement, has shown that each person contains a different internal chemistry, with its own singular susceptibilities and resistances. In the days of the sailing ships, for instance, seamen had to subsist, for long periods, on vitamin-C-deficient diets. Some men fell mildly ill with scurvy, some became so sick they died, while others were entirely free of symptoms!

The Hypoglycemia Connection
     Certainly one of the most common, and most obvious, nutritional problems with emotional side effects is hypoglycemia (low blood sugar), a disturbance in the metabolism of sugar implicated in many physical and mental problems. The list of possible symptoms is long, varied, and mostly awful: relentlessness, insomnia, irritability, nightmares violent and bizarre behavior, jealousy and suspicion, loss of sex drive, crying spells, "nervous breakdown," etc. Not surprisingly, perhaps, hypoglycemia is found in many mental patients. Dr. Roberts Miers of California reported he discovered 95 percent of alcoholics he tested had low blood sugar (though in fairness, it must be pointed out that low blood sugar may be caused by alcoholism as well as be the cause of it) and Trenton, NJ. psychiatrist, Dr., Jack Ward reported the problem in 60 percent of his schizophrenic patients and 80 percent of the manic-depressives. Other researchers have repeatedly noted that overconsumption of sugar and resultant disturbances of sugar metabolism are frequent in childhood schizophrenia.
     Hypoglycemia appears to succumb easily to OP therapy, and successes with this pervasive malady have led to what may be somewhat overreactive opinions. But, there is more evidence leading medical authorities toward optimistic views of OP's future applications.

Looking in on OP Therapy
     Let's say you're going to try the orthomolecular approach to dealing with a mental problem. You can do so either by going to an individual physician or to an OP clinic. The individual may be more flexible in addressing himself to your particular problem, the clinic more impersonal and insistent on putting you through a thorough battery of tests. I'll describe the clinical approach, which I experienced at the Brain Bio Center in Princeton, New Jersey, since it tells more about the therapy. (Currently, the Center is working at full capacity and is not taking new patients).
     First you'll be asked to answer a long questionnaire filled with statements to be marked true or false. Some of the statements seem perfectly rational ("I can judge distances easily,") while others seem odd ("I often think of prehistoric animals.")
     Next, you're asked to produce a urine sample, and a technician takes a sample of your blood (rather a large sample because many tests will be done on it). A lock of your hair may be tested for mineral content. You may also be given an EEG (brain-wave test), and a "glucose tolerance" test (to determine if you have blood-sugar problems). Finally, a psychiatrist asks why you've come to the clinic. You tell him (let's say) that you've been unhappy and depressed lately, with frequent unaccountable crying spells. The psychiatrist notes this but makes no attempt to delve into whatever emotions or conflicts might be causing the depression. He asks how and when these problems began and what sort of previous treatment, if any, you've had. Then, he begins to take a medical history. Some of the questions are the familiar ones every doctor asks -- childhood diseases, the state of your bowels, etc. -- others are minutely concerned with your diet: Do you salt your food heavily? Do you crave sweets?
     At the end of the interview, the OP practitioner gives you a preliminary, refillable prescription consisting of several vitamins and minerals, to be taken with a high-protein, low-carbohydrate diet. Later, when all the lab tests are done, you'll return for a definitive prescription designed to correct any biochemical imbalances the tests may have turned up. You may be told, for instance, to take large doses of vitamin C and niacin together with B6 and zinc, and also to cut out sugar and eat frequent protein snacks. That's all. No "talking therapy," no reliving of childhood traumas. As you leave, you'll be given an appointment two or three months hence. The doctor will check up on your progress, then and then may make adjustments in your vitamin and mineral intake.
     Were you severely psychotic, of course, you would receive closer attention on your first visit, and subsequent visits would include counseling, perhaps even a stay at a "halfway house" while waiting at get well enough to go home. Generally, counseling in an OP clinic tends to be matter of fact and practical: "If you find yourself hallucinating, Louise, go get some member of the family and tell them about it. Don't just stay alone in your room." or: "You're getting better now, Cindy, so you'll have to start behaving like everybody else. The next time your sister goes downtown to shop, go along."

How Effective is OP?
     Regardless of what established medical and psychiatric circles my think, the OP people feel they are in the midst of medical revolution in which exciting new discoveries are being made almost daily. These enthusiasts may or may not be right. Certainly in immense amount of research is being conducted by OP practitioners and clinics. At The Brain Bio Center, for instance, Director Carl C. Pfeiffer M.D. and his staff have made impressive clinical findings-the discovery of "mauve factor" schizophrenia (a previously unknown form of the disease), demonstrations of the importance of trace minerals in mental illness, evaluation of the usefulness of histamine, specimen, spermidine, and other substances in making diagnostic tests.
     At the North Nassau Mental Health Center, in Manhasset, New York, one of the world's largest psychiatric clinics, employing 15 psychiatrists as well as psychologists, social workers, and research technicians, Director Dr. David R. Hawkins has demonstrated what he feels is proof that orthomolecular techniques are much more effective than conventional methods in treating schizophrenia. Prior to 1966, his clinic used the methods of orthodox psychiatry and the average schizophrenic patient was seen about 150 times a year. Since then, North Nassau has switched to the orthomolecular approach, and schizophrenic patients require only about one-tenth the attention they previously did, approximately 15 visits a year, and show a dramatically improves recovery rate (over 75 percent as compared with less than 40 percent previously) with fewer relapses.
     More than 100 other physicians in the United States and Canada -- reputable M.D.'s -- all have reported similarly positive results. Many recoveries have been validated by orthodox psychiatrists who had previously treated and diagnosed the patients. Some have received wide publicity. In his book, The Eden Express, Mark Vonnegut, the son of novelist Kurt Vonnegut described his experience with schizophrenic delusions. Standard psychotherapy was unable to help him, and most of his doctors said his case was hopeless. Then Vonnegut went to the Brain Bio Center and "the biochemists said otherwise. They fixed me up with embarrassingly inexpensive, simple, nonprescription pills. Vitamins mostly."
     There seems to be no doubt that OP is able to help schizophrenics. I have seen case histories and statistics and have talked to recovered patients. The evidence is too persuasive to be casually dismissed.

But What About the "Neurotic?"
     One of the things I wanted to find out from the OP practitioners was how they handled the sort of person who is not the desperately ill psychotic but who simply feels that he or she needs help coping with life. The OP people seemed curiously unresponsive to my questions. They would say, "Yes, that's interesting, isn't it," then offer me statistics on the zinc-copper imbalance in our national diet. At first, I was puzzled by their lack of concern about the milder "neurotic" symptoms. Then, I realized they were not really focused on any symptoms of an emotional or behavioral nature. The emotional problems are important only when they point to a biochemical disorder that can be corrected, thus eliminating those symptomatic problems.
     This lack of interest in emotional factors is reflected in the fact that OP practitioners are less dependent on "talk therapy." Although many OP physicians were originally trained in orthodox psychoanalytic techniques, they no longer see those methods as the primary treatment. "I don't believe psychotherapy is appropriate as the initial treatment of schizophrenia." says Dr. Allan Cott, a well-known OP practitioner in Manhattan. "The patient with a biochemically disturbed brain is not capable of understanding or benefiting from the insights offered by conventional therapy. After the biochemical problems are alleviated, the patient is better able to benefit from congenital psychiatric therapy should it be indicated." Dr. Phillip Bonnet of Brain Bio Center says, "Talking therapy isn't the major emphasis of my work at the center. I use what works in my patients best interest."
     Encountering such a complete reversal of the psychiatric dogma I was used to, I began to feel that the OP people were too drastic and absolute in their thinking. Having moved from the psychiatric to the biochemical "model", they now seem to assume that the former is no longer in any way, valid or applicable. The position leaves little room for a wide range of very human problems. Can a bottle of vitamin pills offer you emotional first aid after a sudden shock or bereavement, help you sort out conflicting emotions, confront you with truth's you have been avoiding, or show you how to fight false fears? Can eating something be more beneficial to the human beings mind and spirit than the expert aid and support of a fellow human? To say that all mental illness is biochemical is to deny, in a way, there is a mind as well as a brain. Orthomolecular theory not withstanding a significant majority of reputable doctors and their patients firmly believe that orthodox psychiatry and talking therapy have not gone bankrupt and are still helping those many people whose problems do not originate in a simple shortage of B vitamins.

Who Needs OP?
     Despite the angry words exchanged in a growing debate, there is not yet much competition between OP and talking therapy, nor should there be.
     There is, in fact, not that much overlapping of the conditions each discipline is best equipped to treat. OP's most notable successes have been with schizophrenia, alcoholism, drug addiction, and childhood hyperactivity, none of which is easily solvable by talk therapy but which appear to respond dramatically to biochemical methods. My nonexpert opinion is that someone suffering from any of those problems might be well advised to try OP first. Likewise, fits of groundless anxiety, fear, depression, anger, and periods of senseless suspicion and jealousy toward friends or love ones would all indicate orthomolecular therapy. But for someone with problems of a more conscious nature -- wanting to know what to do with ones life, and inability to make friends, troubling and insurmountable convulsions -- orthodox psychiatric help probably makes more sense.

A Crash Course in Orthomolecular Theory
     Vitamin deficiencies, one of the common cause of mental-emotional aberrations according to OP, are primarily caused by poor eating habits. As is endlessly pointed out, Americans eat far too much refined sugar, refined flour, and animal fat, not enough fresh fruits, vegetables, and whole grains. (Even those who should know better eat badly. A study of the diets of doctors found that one out of five were not getting the daily minimum requirement of niacin (vitamin B-3), a vital brain nutrient.) However, there are causes of deficiency other than poor diet.
     Unusual stress can cause extra demand for some chemicals needed for normal functioning, and this demand will exhaust stored bodily supplies of those chemicals. Menstruation and childbirth are culprits for many women, depleting substances like B-3, B-6, and zinc, the loss of which may cause painful emotional upsets, or lead to the well known "post-partum depression". Toxins such as industrial pollutants, or drugs and medicines with toxic side-effects, can cause vitamin C deficiency since C combines with toxins to combat them and is destroyed in the process.
     Naturally, all the vitamins and nutritive trace minerals are needed for general health, but particularly vital to our emotional well being are: B vitamins: B-1, B-3, B-6, pantothenic acid, folic acid, and B-12; vitamin E; vitamin C; minerals: calcium and potassium; trace minerals (needed in tiny amounts): zinc and magnesium.
     A normally balanced diet provides OP people with adequate supplies of these vitamins, but a condition known as vitamin dependency sometimes exists in which a patient needs large doses of a particular vitamin. For instance, the average daily requirement of niacin is about 15mg., yet , as Dr. Pfeiffer of the Brain Bio Center points out, many schizophrenics need from 200 to 500 times this amount to stay free of symptoms. These people are "niacin dependent", and cannot possibly get enough of the vitamin form food alone. "When you use niacin in such large doses, it acts more like a drug than a vitamin," says Dr. Cott. "That's why I don't think laymen should experiment with megavitamin therapy on their own. They should consult a physician first."
     Another villain in mental-emotional symptoms is mineral poisoning. Copper, for instance, is a trace mineral essential, in small amounts, to the production of red blood cells. In larger amounts, however, the mineral acts as an intoxicant and brain stimulant. Abnormality high levels of copper are found in many schizophrenics, women with post-partum psychosis, and hyperactive children. Unfortunately, we have too much copper in our environment. Much plumbing is done with copper pipes, and acidic water will leach trace amounts of the mineral from the pipes and put it into your stomach. Compounding the problem is the fact that our national diet is deficient in zinc, a mineral that helps prevent copper excess. OP practitioners will prescribe zinc and vitamin B-6 to bring down elevated copper levels.
     Other extremely dangerous metals not easily dealt with are lead and mercury. Lead is poisons in any quantity and known for producing hyperactivity and brain damage in children. Common sources of lead are lead based paint, fumes from autos (though the increasing use of lead-tree fuel is slowly alleviating airborne lead) , and news print. Mercury poisoning can cause psychosis, paralysis, convulsions, and blindness, and is usually incurred through excessive breathing of coal fumes, accidental contamination from broken batteries or thermometers, and from rare occasions of eating fish highly polluted by certain industrial wastes.

The OP Controversy
     Despite certain spectacular successes, the work of OP practitioners and researchers is still not widely accepted by the medical and psychiatric establishments. Few state mental hospitals, for instance, will allow the use of megavitamins and other nutrients within their walls. Medicaid refuses tot pay for OP therapy because it is not the "standard" treatment. However, California has recently changed its medical assistance policy to include orthomolecular methods. Men like Dr. David Hawking of the North Nassau Mental Health Center and Dr. Pfeiffer of the Brain Bio Center cannot get foundation grants for equipment and research and must rely on donations from grateful patients, while others in the field face similar problems.
     Nevertheless, there have been some crossovers from the opposition. Dr. Robert Naiman, a well known "establishment" psychiatrist, has said, "I'm for everything that helps anybody. Orthomolecular therapy's apparently helping, so I am delighted it is in the field." Not long ago, Dr. Ben Burston, assistant professor of psychiatry at the Yale Medical College, sent a 26-year-old male patient, described as a "intractable schizophrenic," to the Brain Bio Center. The man is now recovered, as a married, and is leading a reasonably happy, normal life. Says Dr. Berston: "I'm not so committed to my magic that I can't try anyone else's."

The Authors "Objective" Report
     After months of exposure to OP, its physicians, patients, and research reports, I have seen what appears to be ample evidence that orthomolecular therapy can help relieve or cure schizophrenia, autism, and other conditions in which "craziness" is due to biochemical disorders. OP has made what seemed likely to be discoveries of great importance in the biochemical field and will no doubt make many more, some which could eventually revolutionize medicine itself.
     I don't believe, however, that OP can or should replace conventional psychiatry. To think that would be to believe, simplistically, that clarity of mind is a necessary by-product of biological health. The human mind is an instrument of mysterious, marvelous complexity, not a straight forward functioning muscle like the stomach or heart. Psychiatrists have long been trying to deal with this labyrinthian organ through "talk therapy" and other analytical methods, often with success, but sometimes with heartbreaking frustrating failure. The fact that some aberrations once thought to be mental now seem to be fundamentally biochemical will help strengthen psychiatry, not discredit it -- once the orthomolecular therapists and the analysts learn, as they must, to cooperate with each other.