Dr Jim’s Blog: Mental health is not just about childhood experiences;
Or current stressors; or badly managed thoughts…
Mental health is related to diet and nutrition, inner dialogue, physical exercise, re-framing of experience, and sleep science…Etc…
In science as well as popular culture, the body and mind have long been pulled apart, and treated as separate entities.
And when they are treated as being connected – as in the modern psychiatric theory of ‘brain chemistry imbalances’ causing negative moods and emotions, the ‘brain chemistry’ in question is taken to be unrelated to how you use your body; what you eat; how well you sleep.
It is assumed to be ‘special brain chemistry’ – separate and apart from Lifestyle Factors – which can only be fixed by consuming dangerous drugs!
In the immediate future, lifestyle counselling practice will be a novel service offering for counselling and psychotherapy clients who have realized that:
# the body and mind are intimately connected;
# that the body-mind is an open system, permeated by a whole range of lifestyle factors which can be managed well, or mismanaged,
# which results in excellent or poor mental health, physical health, and personal happiness.
In the pages of our popular book on lifestyle counselling, we have presented:
– a summary of our previous bookabout the impact of diet and exercise on mental health and emotional well-being;
– a chapter which integrates psychological theories of emotion with physical sources of distress – for the emotions of anger, anxiety and depression – and recommends treatment strategies;
– a chapter on the negative effects of sleep insufficiency on our thinking, feeling and behaviour;
– a chapter on how to re-frame any problem, using our Six Windows Model (which includes some perspectives from moderate Buddhism and moderate Stoicism) – but excludes the extreme forms of those philosophies of life!);
– a chapter on how to divine and assess the counselling client’s multiple sources of emotional disturbance, using our Holistic-SOR Model;
– and a chapter on how to set about teaching lifestyle change to counselling and therapy clients.
Dr Jim’s Blog: “What’s wrong with my counselling client?” Lifestyle factors complicate counselling-psychological assessments…
Copyright (c) Jim Byrne, September 2018
Many of the human tragedies that clients bring to our counselling and psychology consulting rooms have pure social-psychological roots. These include:
– childhood abuse or neglect;
– traumatic experiences later on;
– stress and strain of difficult lives;
– relationship problems;
– and the normal human responses to losses, failures, threats, dangers, frustrations and insults; and so on.
We also see our fair share of
– attachment problems;
– personality distortions (or mal-adaptations to parents and others);
– and retreats from an intolerable reality.
But all of this is now complicated by the existence of
– widespread consumption of junk food;
– disruption of normal sleep patterns by economic stress and new technologies which destroy melatonin;
– plus adoration of sedentary lifestyles;
– and various other lifestyle factors that
# precipitate problems of anger, anxiety and/or depression, in their own right; or
# magnify emotional disturbances that have psychological roots.
Because of this changed reality, which has come upon us in the past couple of decades, in the main, we now need to be able to spot the contribution of lifestyle factors to emotional and behavioural disturbances which may or may not be otherwise psycho social in origin.
We have done a lot of research on the multiple sources of human disturbance; and compiled that in a book, titled Lifestyle Counselling and Coaching for the Whole Person: Or how to integrate nutritional insights, exercise and sleep coaching into talk therapy.
Dr Jim’s Blog: Understanding the links between anger, anxiety and depression – on the one hand – and nutrition and physical activity – on the other…
Copyright (c) Jim Byrne, September 2018
Renata and I did a lot of research and reflection on the subject of the impact of diet and exercise upon mental health and emotional wellbeing.
We did this work because we wanted to consolidate and expand our pre-existing level of understanding of the part that nutrition and exercise play in the emotional well-being of our coaching and counselling clients, so that we can help them as much as possible; and also to inform a wider audience of a range of helpful research studies.
Our overall aim is to put an end to the false assumption that the body and mind are separate entities, which can be treated in isolation from each other (by medicine, on the one hand, and by psychotherapy on the other).
The complexity of human body-minds
Human beings are very complex; indeed the most complex entities in the known universe. But that does not mean we cannot hope to come to understand ourselves better than we currently do.
There are, for example, some identifiable factors which contribute to the makeup of human personality; and there is now a good deal of research which needs to be added to the psychological model of the human being.
We can learn to better understand our body-brain-mind interactions with our social environments, and this can enable us to understand ourselves and our clients, and to help them, and ourselves, more effectively.
– we are affected (emotionally and physically) by our diets;
– the amount of exercise we do;
– our self-talk (or ‘inner dialogue’);
– our sleep patterns;
– our family of origin;
– and all the patterns of behaviour we observed and experienced in our development;
– plus our current relationships, and environmental circumstances: e.g. our housing accommodation; the educational opportunities we had; our social class position; and our opportunities for employment (or earning a living).
Since expanding our understanding of this complexity of human functioning, we have developed new approaches to perceiving our clients; and assessing the complex nature of their presenting problems in the consulting room.
We have also produced a page of information on this research, and the book that resulted from it: How to Control Your Anger, Anxiety and Depression: Using nutrition and physical activity.
Dr Jim’s Counselling Blog: Walking the talk of the holistic self-care movement…
Managing my mind by the use of exercise, diet, meditation and self-talk…
Copyright (c) Jim Byrne, 2018
My wife, Renata Taylor-Byrne, sometimes reminds me of the important principle of ‘extreme self-care’.
I didn’t learn any such principle in my family of origin, where the main message was to ‘behave yourself’; and to uncritically go along with the dominant trend of social pressure!
Over the years, I have woken up to the problem of (physical and emotional) stress, and how unmanaged stress leads to all kinds of mental, emotional and physical health problems. Also, because I developed a problem with Candida Albicans overgrowth – a gut dysbiosis problem – decades ago, I had to become clear about the importance of managing my diet – especially the elimination of sugary foods and alcohol.
At a certain point this morning, I found myself exercising, and wondering if this information would be helpful in motivating some of our website readers (meaning you!) to shift to following the principle of ‘extreme self-care’. So here I am, following up on that thought, as a contribution to your health and happiness.
I got up this morning, at the same time as Renata, and got some salad ingredients out of the fridge, and put them on one side to warm up to room temperature. (While that was happening, I checked my emails and website traffic, and so on).
When the salad ingredients had warmed up enough, I chopped them up and put them into two bowls. They consisted of:
4 leaves of Romaine lettuce (chopped very small)
a quarter of a yellow pepper (diced)
a quarter of a red pepper (diced)
four inches of cucumber (halved and sliced)
a quarter of a red onion (diced)
8 green olives
2 black olives
2 ozs of petit poise
6 fine beans (chopped small)
2 tsps of Maca powder
2 desert spoons of flaxseed
2 desert spoons of mixed pumpkin and sunflower seeds
8 whole almonds
2 ozs of pickled beetroot
This meal was so much more exciting and enjoyable than a bowl of cereal, or a full ‘English’ (fried) breakfast; or waffles with maple syrup! Truly enjoyable! However, it would not be a good idea to eat the same breakfast every day. Varity is important for gut bacteria and the available range of nutrients!
On my own bowl, I also added some fermented cucumber (instead of kimchi, which I had yesterday), and some Miso (the brown rice variety).
I then ate this as my breakfast, with a mug of green tea.
(In case I am beginning to sound like Saint Selfless, I had a cafetiere of exotic coffee while I was processing my emails!)
Meditation and physical exercise
When we had finished breakfast, I read some brief quotes – about living in the moment, in the main – to set the mood for our Zen meditation, which we did for 30 minutes. And then Renata led our Chi Kung (Chinese exercise) session, which lasted about 20 minutes. Then we did a couple of minutes of the Plank (from Pilates) – for core strength – and then I did three sets of press-ups (30 presses in each set), and three sets of sit-backs (for 30 seconds in each set), for arm and stomach strength, and for hips and lower back.
The sun was shining in the front and back of the room in which we meditated and exercised, and we had Mozart playing in the background for the exercise session. Divine!
At the end of this time, I was as relaxed, happy and de-stressed as a person could be, and all set for another session on the computer, working on promoting our book on diet and exercise.
The book is called: How to control your anger, anxiety and depression using nutrition and physical exercise; and it is available at amazon, at the following links:
If you want to order the book from another Amazon outlet, then please go to the webpage listed below, and order it from one of the other links (in Europe, Australia, Canada, etc.), which are listed there.
Renata has just completed a little 2-minute video introduction to this book, here:
Please take a look and see what you think.
If you would like some more information about the book (or to order it from a non-UK/US outlet), you can find a good introduction on our webpages. Just click the following link: Diet, Exercise and Mental Health.***
That’s all for now.
I wish you a happy and healthy life, and the wisdom to engage in extreme self-care! J
Renata’s Coaching Blog: Developing resilience when you’re working on the front line in your job:
Coping with stress, anger, anxiety and depression…
Sleep, diet and exercise are critical…
Dealing with people is very enjoyable, and very demanding at the same time, isn’t it? Especially when you are dealing with people who are suffering from all the trials and tribulations that life has thrown at them.
How do you stay strong? You need all your energy to communicate with them and not become drained. And three of the most challenging conditions to deal with are the problems of anxiety, anger and depression, whether it’s experienced by yourself or other people.
My work is about helping others to grow in strength, creativity and happiness. I do that in several ways: face to face coaching; and writing blogs; and (more recently) writing books.
We’ve put in some significant and surprising research findings which are therapeutic, because they show how we can better manage our energies and emotions so that we are stronger in ourselves. But also these findings can be used to help others.
I’m just about to begin the final proof-reading of that book, and then it will be available to you, via Amazon.
Moving on to sleep, relaxation and mediation
But as I mentioned in my last blog, I have now been reading Matthew Walker’s book called “Why we sleep”, which was published in September of this year. And I have been so shocked and stunned – by the many research findings that he quotes about why sleep is so important – that I have decided to write about his key findings, and to summarise them for everyone. I have also identified several other books which must be taken into account, and I have begun to do that research work and note taking.
I also intend to include research findings about the power of meditation and relaxation techniques in the book, because those three strategies are closely related; and support each other.
Sleep, meditation and relaxation techniques can transform our experience of anger, anxiety and depression. This book will describe the ways that our resilience can be greatly enhanced by adequate sleep, daily meditation, and sound approaches to relaxation.
I’ll let you know when both books become available.
The Sleep/Meditation/Relaxation book will not be finished until I have found several ways to help you to put some new strategies into your life, to strengthen you, and to enhance the quality of your life.
Here is part of Walker’s message:
“Sleep is the single most effective thing we can do to reset our brain and body health each day”. (Walker 2017).
In the meantime, I strongly recommend Walker’s book, because, as he states, the importance of our sleep hasn’t been properly communicated to us by scientists. And when you look at the bare facts of the negative impact of the lack of sleep on us, it can be a real shock!
So if you want to live your life on a full tank of gas, then improving the quality of your sleep will make a big difference. If you have teenagers, the section of his book where he explains the needs of teenagers for more sleep than adults, is excellent and very helpful.
See what you think of his book (and I swear I haven’t got any shares in his publishing company!)
So now, I must get back to proofreading our Diet and Exercise book; and then back to the sleep research!
If you need any help or support, you know where I am!
Dr Jim’s Blog: Health and happiness are the most important goals in (a moral) life
It’s been quite a while since I posted a blog, because I’ve been extremely busy. I am still very busy, finishing off the writing of a new book, but I thought it was about time I shared some ideas with the world. The main theme of this blog is health and self-healing, using food and physical exercise.
Several days ago I constructed the index section on diet and nutrition, and type of diets. And, by finishing time last Friday, 20th, I had just completed a section on Essential fatty acids (EFAs). And today, Monday 23rd, I will begin to work on the index entries for the section on physical exercise.
Last Thursday, I turned my body, suddenly, while leaving my feet relatively stationary, and pulled a muscle in my back. Did I run to the doctor? No! Did I get some ‘painkillers’ from the chemist? No!
Why did I not go to the doctor? Because the doctor would have simply recommended “painkillers”!
Why did I not buy my own painkillers from the chemist? Because most of the painkillers used today are what are called NSAIDs (non-steroidal anti-inflammatory drugs). And the problem with NSAIDs is that they cause ‘leaky gut syndrome’, which not only allows whole molecules of food to enter the bloodstream, and trigger various forms of inflammation in the body (paradox of paradoxes!), but they also compromise the blood/brain barrier, which can precipitate mood disturbances!
So, what did I do with my terrible back pain? I got out my copy of ‘Body in Action’, by Sarah Key, and did five of her exercises for improving the functioning of the muscles and joints in the lower back. (I’ve done this several times in the past, and I know it always works).
I did the exercises on Thursday and Friday, and by Saturday the back pain had gone – completely!
Sharpening the saw
Rest and recuperation are very important parts of my self-management of health program. So, on Saturday afternoon, and Sunday afternoon, I had a siesta (of three hours each time). I had been feeling tired because of overworking on the index of our new book on how to control anger, anxiety and depression, using diet and exercise systems.
I also had a restful evening with Renata, and I was in bed by 9.45pm.
By 5.45am today (Monday 23rd Oct) I was fully rested, and so I got up and made my breakfast. A solid bowl of chunky salad.
Food for health and mood control
I chopped up the following ingredients into small chunks, of perhaps 3 or 4 mm at the widest point:
3 oz of red cabbage; 6 oz of cucumber; 1 spring onion; 1 organic carrot; half an organic apple; and put them into a soup bowl.
Then, I added a teaspoon of Maca powder; a dessertspoon of ground flaxseed; two dessertspoon’s of mixed seeds (sunflower, pumpkin, ???), ten almonds, three walnuts, four hazelnuts; ten blueberries; 2 ozs of cooked beetroot (diced); two small tomatoes (halved); and half a kiwi fruit (diced).
I then added some brown rice miso, and some sauerkraut.
After consuming that breakfast, I meditated for 30 minutes.
Physical exercise for health and strength and mood control
Let me now describe the exercises that I went on to do, after meditating:
Then I did my own press-ups and sit backs, for about 5 or 6 minutes.
I then moved on to do fifteen minutes of my old Judo Club calisthenics (or whole body warm up exercise), which combine strength training, stretching of muscles, and aerobic exercise, all in one.
Then ten minutes of Zhan Zhuang (pronounced Jam Jong, and meaning ‘Standing like a tree’). These are body poses which work on our postural muscles, affecting strength and speed and balance. They create a calm and happy mental state. And they also relax the body and establish whole-body connection.
Finally I did some strength training using the Powerspin rotator, to build arm, shoulder and upper body strength.
This is clearly a time-consuming start to the day, compared with a bowl of cornflakes, a cup of coffee, and a brisk scratching of the head!
So why do I do it?
Because, I value my health above all things. Without my physical health, I am unlikely to be happy. And I am unlikely to be emotionally stable.
The people who do the least exercise, and who eat the worst diets, have the worst physical and mental health outcomes. (I have not seen a general medical practitioner for more than thirty years! And I am not about to start now!)
Most people leave their health (physical and mental) to chance, and to the vague belief that there are people who can “fix them up” when they fall apart. Sadly this myth is totally misleading. Once you’ve ruined your health – from sedentary lifestyle, poor sleep, and inadequate diet (such as one based on junk food, or an unbalanced diet, or too much alcohol [over the government limit], caffeine, sugary foods, gluten, and other toxic substances) – and/or from long-term conflicted relationships – it is then ruined! And a ruined body-brain is a burden to haul through life!
It takes self-discipline to get on a good diet, and to begin to do regular physical exercise, and to go to bed and have eight hours sleep, without mobile phones or laptops or tablets, and so on. But the alternative to developing that self-discipline is a life ruined through serious illness, emotional distress, and early death.
Some people will argue with me, and insist that there are some things called “medicines” (and “surgeries”) which can be used to resuscitate their body-brain-mind once they have allowed it to fall into ill-health. The editors of What Doctors Don’t Tell You, strongly disagree with that fantasy! See the article titled ‘Don’t trust me (I’m Big Pharma).***
POSTSCRIPT ONE: Of course, it takes time to build up expertise in ‘extreme self-care’; and it’s a good idea to do that one step at a time. Gradually, over a period of time, this will build up into significant changes, and huge improvements in health and happiness. And you don’t ever have to adopt the kind of ‘monkish’ approach that suits me. Some simple changes in what you eat, and how you exercise your body (brisk walking for 30 minutes per day is enough!), will make a huge difference over time. You can find out more about how to begin these small, easy steps in our book: How to control your anger, anxiety and depression, using nutrition and physical activity.
If you want me to help you to figure out how to live a happier, healthier, more emotionally buoyant life, then please contact me:
POSTSCRIPT TWO: If you are a coach, psychologist, counsellor or psychotherapist, and you want to begin to teach your clients about the importance of lifestyle factors in the maintenance of good mental health (or emotional wellbeing) then you might be interested in our book entitled Lifestyle Counselling and Coaching for the Whole Person, which is an expansion of the Holistic Counselling book, including the inclusion of a Lifestyle Factors Questionnaire. (This book can also be used by self-help enthusiasts!)
This book provides some clear guidelines regarding those foods which need to be excluded from your diet, in order to be healthy and emotionally well. It also contains lots of stimulating ideas to help you to produce your own ‘personalised diet’ and exercise plan. And we have expanded Part 6 to provide a comprehensive guide to how to change any habit, so that readers can actually make the kinds of changes to diet and exercise approaches that appeal to them.
If you’re one of those individuals who has been waiting for the book to be published, then you can get the paperback here, for less than £10.00 GBP!
This book has proved to be popular with both self-help enthusiasts and with professional counsellors and psychotherapists, who want to be able to help clients whose disturbances are partly or wholly caused by problems with their nutritional or exercise approaches.
There is now a growing consensus that there is a significant link between diet/nutrition – on the one hand – and ‘mental health’ or emotional wellbeing – on the other. (For example, see Mental Health Foundation; and Mind UK.
I first began to take this emerging insight into account in dealing with my clients, perhaps twelve or more years ago. Out of my curiosity about this link, I created what I called my Stress and Anxiety Diet.***
Last year, Renata wrote a substantial document on the link between diet and emotional disturbances. This we published as Appendix E to our book on Holistic Counselling: (Please see Holistic Counselling in Practice.***)
Moving on: I recently reviewed Part 1 of a three part webinar on ‘Nutrition and Mental Health’, by Dr Bonnie Kaplan, a professor in the Cumming School of Medicine, University of Calgary, Alberta, Canada.
In her webinar, Dr Kaplan reviews 2,600 years of folklore and modern science to explore the link between nutrition and mental health.
The science of nutritional deficiency
In the realm of science, she presents evidence that, just as deficiencies in single nutrients can cause physical diseases (e.g. scurvy), they can also cause psychological/psychiatric symptoms.
She begins her science section with a look at the dire consequences of citrus deficiency: the development of a disease called scurvy, which killed 40% of the crews of ships that sailed without lemon juice. In 1774, citrus was shown, in a randomized control trial of six potential treatments, to be superior. But it took 264 years before citrus was made routinely available to all sailors.
Subsequent studies showed that single nutrient deficiencies could, and would, cause psychiatric symptoms, of which Kaplan mentions four:
The widespread recognition that these psychiatric conditions can be caused by single nutrient deficiencies is beyond dispute. As Dr Kaplan points out, the DSM acknowledges that niacin deficiency can cause neurocognitive disorders.
How do we know that most so called psychiatric symptoms are not a result of single or multiple vitamin or mineral deficiencies? Or a result of nutritional deficiencies plus dehydration? Or nutritional deficiencies, sugar overload, and inflammation due to grain allergies? The answer is: We Don’t!
But there is a growing field of nutritional medicine emerging which seems to cohere around one central theme: Food is the best medicine! (Brogan, 2016[i]; Perlmutter, 2015[ii]; Ross, 2002[iii]; Enders, 2015[iv]).
[i] Brogan, K. (2016) A mind of your own: The truth about depression and how women can heal their bodies to reclaim their lives. London: Thorsons.
[ii] Perlmutter, D. (2015) Brain Maker: The power of gut microbes to heal and protect your brain – for life. London: Hodder and Stoughton.
[iii] Ross, J. (2002) The Mood Cure: Take charge of your emotions in 24 hours using food and supplements. London: Thorsons.
[iv] Enders, G. (2015) Gut: The inside story of our body’s most under-rated organ. Scribe Publications.
Vitamin B3 deficiency and the disease of Pellagra
The most obvious symptom of Pellagra is rough skin, or dermatitis of an extreme form. According to Dr Kaplan, this disease was first described in 1735 in Spain. But it was not until 1914 that Dr Joseph Goldberger realised that Pellagra was not an infectious disease, but that it was in fact linked to diet. By 1937, it was precisely linked to niacin (or Vitamin B3) deficiency. As a result, some governments began to fortify food with vitamin B3, to prevent this disease.
However, as mentioned earlier, Pellagra symptoms were not restricted to the skin, but also affected the brain-mind of the victim, causing mental disturbances sufficiently sever for sufferers to be admitted to psychiatric hospitals. And Dr Kaplan cites one American hospital which estimated that 1 in 5 admissions from 1930-32 were solely due to Pellagra psychosis.
Much of this psychosis was caused by over-reliance on maize as the staple of the ‘poor man’s diet’.
What does this tell us about the stigma of ‘mental illness’? Are we misrepresenting nutritional deficiencies as ‘madness’?
My own mother was hospitalized for depression when I was about twelve years old. The one thing I know for sure about those years is this: We were all seriously malnourished! (Of course, we must not get into the trap of swapping one ‘single cause’ of emotional distress for another. We subscribe to a holistic model, in which diet, exercise, self-talk, relaxation, meditation, sleep pattern, family of origin, current relationships, environmental stressors, economic circumstances, housing circumstances, and so on, all play a role in determining the individual’s capacity to regulate their emotions; and certainly there were a lot of stressors [financial and relational] in my mother’s life at that time!)
Nutritional treatment of emotional problems
Dr Kaplan, in 2007, co-authored a paper on Vitamins, Minerals and Mood. This is what the abstract said:
“In this article, the authors explore the breadth and depth of published research linking dietary vitamins and minerals (micronutrients) to mood. Since the 1920’s, there have been many studies on individual vitamins (especially B vitamins and Vitamins C, D, and E), minerals (calcium, chromium, iron, magnesium, zinc, and selenium), and vitamin-like compounds (choline). Recent investigations with multi-ingredient formulas are especially promising. However, without a reasonable conceptual framework for understanding mechanisms by which micronutrients might influence mood, the published literature is too readily dismissed. Consequently, 4 explanatory models are presented, …. These models provide possible explanations for why micronutrient supplementation could ameliorate some mental symptoms.”
Dr Kaplan next moves on to present the result of the Minnesota Starvation Experiments, from 1950, which demonstrated that, when a group of normal, healthy students were deprived of a nutritious diet, and placed on 50% of normal nutritional levels, they developed symptoms of depression, hysteria, irritability, self-mutilation, apathy and lethargy, social withdrawal, and inability to concentrate. (Keys, et al, 1950).
The link between nutrition and mental health is therefore, quite clearly, beyond dispute.
End of Part 1. To be continued in Part 2.
PS: Soon after posting this blog, I got this response on Facebook:
Shannon Joy Glasser “I changed to a vegan diet about a year and a half ago, and I have experienced SIGNIFICANT improvements in my health, depression and anxiety. I’m a firm believer!”
PPS: And there are now randomized controlled trials (RCTs) which demonstrate dietary changes are more effective than social support interventions for reducing and eliminating the symptoms of depression:
Wernicke’s encephalopathy (or Wernicke’s disease) is the presence of neurological symptoms caused by biochemical lesions of the central nervous system after exhaustion of B-vitamin reserves, in particular thiamine (vitamin B1).
Korsakoff syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1). Korsakoffsyndrome is most commonly caused by alcohol misuse, but certain other conditions also can cause the syndrome.
Psychiatric manifestations of vitamin B12 deficiency: a case report.
Psychiatric manifestations are frequently associated with pernicious anemia including depression, mania, psychosis, dementia. We report a case of a patient with vitamin B12 deficiency, who has presented severe depression with delusion and Capgras* syndrome, delusion with lability of mood and hypomania successively, during a period of two Months. Source: https://www.ncbi.nlm.nih.gov/pubmed/15029091
(*Capgras Syndrome, also known as Capgras Delusion, is the irrational belief that a familiar person or place has been replaced with an exact duplicate — an imposter (Ellis, 2001, Hirstein, and Ramachandran, 1997).)
Myxoedema psychosis, more colloquially known as myxoedema madness, is a relatively uncommon consequence of hypothyroidism, such as in Hashimoto’s thyroiditis or in patients who have had the thyroid surgically removed and are not taking thyroxine. Source.***
A deficiency disease caused by a lack of nicotinic acid* or its precursor tryptophan in the diet. It is characterized by dermatitis, diarrhoea, and mental disturbance, and is often linked to over-dependence on maize as a staple food. ***
(* nicotinic acid noun BIOCHEMISTRY: A vitamin of the B complex which is widely distributed in foods such as milk, wheat germ, and meat, and can be synthesized in the body from tryptophan. Its deficiency causes pellagra.)
 Kaplan, B.J., Susan G. Crawford, Catherine J. Field and J. Steven A. Simpson (2007) Vitamins, minerals, and mood. Psychological Bulletin, Sept; 133(5): Pages 747-760.