Is It Really Just “In Your Head”?

A New Story About Mental Health

We talk a lot about a mental health crisis. Services are overwhelmed, waiting lists are long, and more people than ever are being prescribed medication for depression and anxiety. In my clinic, I am seeing more and more people struggle with significant anxiety and depression.

But what if the real crisis isn’t in our minds at all?

What if the problem is the way we’re treating mental health?

Chronic, low-grade inflammation can make the brain feel foggy, heavy, irritable or depressed.
Shifting hormones — especially thyroid, cortisol, and female hormones during perimenopause — can completely alter mood, sleep and motivation.
And unstable blood glucose (the spikes and crashes that come from stress, skipped meals and ultra-processed foods) can mimic anxiety, trigger irritability and uneven energy.
These are physiological stress signals — and once you see them on paper, they suddenly make sense.

The Current Model: Fast, Symptom-Based, and Often Shallow

For many people, the journey looks like this:

1. You tell a doctor or mental health professional you feel low, anxious, numb or exhausted.
2. They ask some questions, perhaps give you a questionnaire to tick off your symptoms.
3. You leave with a label (depression, anxiety, etc.) and a prescription.

Medication and therapy can be very helpful. They absolutely have a place.

But imagine going to a doctor with chest pain and being given tablets without any tests. No bloods, no ECG, no scan. You’d probably feel uncomfortable with that.

Yet in mental health, we do this all the time.

Most of the time, nobody checks:

• whether your thyroid is working properly
• if you’re low in vitamin B12 or vitamin D
• what your blood sugar is doing
• whether your brain actually has the nutrients it needs to function well

We treat the symptoms, not the reasons.

A Different Question: Why Do I Feel This Way?

Functional psychiatry (or functional mental health) starts from a different place.

Instead of asking only, “What label fits these symptoms?” it asks:

What is driving this person’s distress?

That might include:

• life events, trauma, relationships and stress
• but also hormones, genetics, nutrition, sleep patterns, gut health, infections and more

It doesn’t throw away medication or therapy. It simply adds another layer: how the body and brain are working underneath the diagnosis.

Simple Things We Often Miss

Here are a few very ordinary blood tests that can make an extraordinary difference.

1. Vitamin B12 – “Normal” Isn’t Always Enough

Low B12 can cause:

• low mood
• anxiety
• fatigue
• brain fog

Many people are told their B12 is “normal”, even when it’s at the low end of the range and they feel awful. When B12 is properly corrected, people often notice a huge lift in energy, motivation and mood.

2. Vitamin D – Sunshine for the Brain

Vitamin D is not just for bones. It helps your brain make serotonin – one of the key chemicals involved in mood and sleep.

Low vitamin D has been linked with higher rates of depression, anxiety and even dementia. Most people don’t get enough of it, especially in countries with long, dark winters and indoor lifestyles.

Checking and optimising vitamin D is simple, cheap and often life-changing. Even if you are supplementing, vitamin D levels in some individuals can remain low and knowing your numbers can make a huge difference.

3. Homocysteine – A One-Number Warning Light

Homocysteine is a small blood marker with a big message. When it’s raised, it usually means you’re low in certain B vitamins (B6, B12 and folate).

High homocysteine has been linked with:

• higher risk of depression
• memory problems and dementia
• cardiovascular disease

Again, it’s something we can measure and improve.

4. Cholesterol & Omega-3 – Your Brain Is Mostly Fat

The brain is rich in fat and cholesterol. We hear a lot about high cholesterol, but low cholesterol and very low omega-3 levels can also be a problem.

Low levels have been associated with:

• unstable mood
• higher risk of depression
• increased risk of self-harm in some studies

Omega-3 fats (from oily fish like salmon, mackerel, sardines, or from supplements) help brain cells communicate properly and support a calmer, more stable nervous system.

It’s Not Just What You Eat… It’s What You Absorb

You can eat a beautiful diet and still be undernourished at the cellular level if your body isn’t digesting properly.

For example, if you don’t make enough stomach acid or digestive enzymes, you might:

• struggle to break down protein
• miss out on amino acids (the building blocks of brain chemicals)
• become low in key nutrients like B12, iron or zinc

Someone might be told they have “treatment-resistant depression” when in reality, their brain simply isn’t getting what it needs from the food they eat.

Nutrients as Tools, Not Just “Supplements”

We’re used to thinking of medication as powerful and nutrients as “nice extras”.

In reality, some nutrients can act a bit like gentler medicines when used in the right way for the right person – especially when we have tests to guide us.

For example:

• Vitamin B3 (niacin) has been used to support people coming off alcohol or sedatives.
• Targeted B vitamins can bring down high homocysteine and support mood and memory.
• Correcting low vitamin D can improve mood, energy and sleep quality.

The key difference is that we’re working with the body, not just trying to override its signals.

What About Quick-Fix Treatments Like Antidepressants?

Treatments like anti-depressants can be incredibly helpful for some people with severe, long-standing depression. For others, it doesn’t help, or the benefits don’t last.

The concern many clinicians have is not antidepressants itself but the way it’s sometimes used: offered quickly, often repeatedly, without any attempt to explore deeper causes or look at nutrition, hormones, sleep, trauma or metabolism.

In a healthier model, treatments like anti-depressants are one option in a much bigger toolkit, not the main event.

What You Can Do as a Patient (or Parent or Friend)

You don’t have to memorise all the science. You can however start asking different questions.

If you or someone you love is struggling with mood, anxiety, fatigue or brain fog, you might gently ask your clinician:

• Could we check some basics like vitamin D, B12, folate, iron and thyroid function?
• Is it worth looking at my homocysteine?
• Do you think my diet, digestion or blood sugar might be affecting my mood?
• Is there anything we can measure – not just guess about – that might give us more clues?

You’re not rejecting medication or therapy by asking these things. You’re simply saying:

“I’d like us to understand why this is happening, not just put a label on it.”

And always ask for copies of your results rather than having them dismissed as normal.

A New Story About Mental Health

The old story says:

You’re depressed. Your brain chemistry is faulty. Here’s a pill.

The newer story sounds more like:

You’re having a hard time.
Let’s understand your life and your biology.
Let’s check whether your brain has what it needs to function well.
Let’s build a plan that includes your mind, your body, and your circumstances.

Mental health is never just “all in your head”.
Your brain is part of your body. Your body is part of your life.

When we finally start treating it that way, real healing becomes possible.

Is It Really Just “In Your Head”?Why We Need a New Way of Thinking About Mental Health

We talk a lot about a mental health crisis. Services are overwhelmed, waiting lists are long, and more people than ever are being prescribed medication for depression and anxiety. In my clinic, I am seeing more and more people struggle with significant anxiety and depression.

But what if the real crisis isn’t in our minds at all?

What if the problem is the way we’re treating mental health?

Chronic, low-grade inflammation can make the brain feel foggy, heavy, irritable or depressed.
Shifting hormones — especially thyroid, cortisol, and female hormones during perimenopause — can completely alter mood, sleep and motivation.
And unstable blood glucose (the spikes and crashes that come from stress, skipped meals and ultra-processed foods) can mimic anxiety, trigger irritability and uneven energy.
These are physiological stress signals — and once you see them on paper, they suddenly make sense.

The Current Model: Fast, Symptom-Based, and Often Shallow

For many people, the journey looks like this:

1. You tell a doctor or mental health professional you feel low, anxious, numb or exhausted.
2. They ask some questions, perhaps give you a questionnaire to tick off your symptoms.
3. You leave with a label (depression, anxiety, etc.) and a prescription.

Medication and therapy can be very helpful. They absolutely have a place.

But imagine going to a doctor with chest pain and being given tablets without any tests. No bloods, no ECG, no scan. You’d probably feel uncomfortable with that.

Yet in mental health, we do this all the time.

Most of the time, nobody checks:

• whether your thyroid is working properly
• if you’re low in vitamin B12 or vitamin D
• what your blood sugar is doing
• whether your brain actually has the nutrients it needs to function well

We treat the symptoms, not the reasons.

A Different Question: Why Do I Feel This Way?

Functional psychiatry (or functional mental health) starts from a different place.

Instead of asking only, “What label fits these symptoms?” it asks:

What is driving this person’s distress?

That might include:

• life events, trauma, relationships and stress
• but also hormones, genetics, nutrition, sleep patterns, gut health, infections and more

It doesn’t throw away medication or therapy. It simply adds another layer: how the body and brain are working underneath the diagnosis.

Simple Things We Often Miss

Here are a few very ordinary blood tests that can make an extraordinary difference.

1. Vitamin B12 – “Normal” Isn’t Always Enough

Low B12 can cause:

• low mood
• anxiety
• fatigue
• brain fog

Many people are told their B12 is “normal”, even when it’s at the low end of the range and they feel awful. When B12 is properly corrected, people often notice a huge lift in energy, motivation and mood.

2. Vitamin D – Sunshine for the Brain

Vitamin D is not just for bones. It helps your brain make serotonin – one of the key chemicals involved in mood and sleep.

Low vitamin D has been linked with higher rates of depression, anxiety and even dementia. Most people don’t get enough of it, especially in countries with long, dark winters and indoor lifestyles.

Checking and optimising vitamin D is simple, cheap and often life-changing. Even if you are supplementing, vitamin D levels in some individuals can remain low and knowing your numbers can make a huge difference.

3. Homocysteine – A One-Number Warning Light

Homocysteine is a small blood marker with a big message. When it’s raised, it usually means you’re low in certain B vitamins (B6, B12 and folate).

High homocysteine has been linked with:

• higher risk of depression
• memory problems and dementia
• cardiovascular disease

Again, it’s something we can measure and improve.

4. Cholesterol & Omega-3 – Your Brain Is Mostly Fat

The brain is rich in fat and cholesterol. We hear a lot about high cholesterol, but low cholesterol and very low omega-3 levels can also be a problem.

Low levels have been associated with:

• unstable mood
• higher risk of depression
• increased risk of self-harm in some studies

Omega-3 fats (from oily fish like salmon, mackerel, sardines, or from supplements) help brain cells communicate properly and support a calmer, more stable nervous system.

It’s Not Just What You Eat… It’s What You Absorb

You can eat a beautiful diet and still be undernourished at the cellular level if your body isn’t digesting properly.

For example, if you don’t make enough stomach acid or digestive enzymes, you might:

• struggle to break down protein
• miss out on amino acids (the building blocks of brain chemicals)
• become low in key nutrients like B12, iron or zinc

Someone might be told they have “treatment-resistant depression” when in reality, their brain simply isn’t getting what it needs from the food they eat.

Nutrients as Tools, Not Just “Supplements”

We’re used to thinking of medication as powerful and nutrients as “nice extras”.

In reality, some nutrients can act a bit like gentler medicines when used in the right way for the right person – especially when we have tests to guide us.

For example:

• Vitamin B3 (niacin) has been used to support people coming off alcohol or sedatives.
• Targeted B vitamins can bring down high homocysteine and support mood and memory.
• Correcting low vitamin D can improve mood, energy and sleep quality.

The key difference is that we’re working with the body, not just trying to override its signals.

What About Quick-Fix Treatments Like Antidepressants?

Treatments like anti-depressants can be incredibly helpful for some people with severe, long-standing depression. For others, it doesn’t help, or the benefits don’t last.

The concern many clinicians have is not antidepressants itself but the way it’s sometimes used: offered quickly, often repeatedly, without any attempt to explore deeper causes or look at nutrition, hormones, sleep, trauma or metabolism.

In a healthier model, treatments like anti-depressants are one option in a much bigger toolkit, not the main event.

What You Can Do as a Patient (or Parent or Friend)

You don’t have to memorise all the science. You can however start asking different questions.

If you or someone you love is struggling with mood, anxiety, fatigue or brain fog, you might gently ask your clinician:

• Could we check some basics like vitamin D, B12, folate, iron and thyroid function?
• Is it worth looking at my homocysteine?
• Do you think my diet, digestion or blood sugar might be affecting my mood?
• Is there anything we can measure – not just guess about – that might give us more clues?

You’re not rejecting medication or therapy by asking these things. You’re simply saying:

“I’d like us to understand why this is happening, not just put a label on it.”

And always ask for copies of your results rather than having them dismissed as normal.

A New Story About Mental Health

The old story says:

You’re depressed. Your brain chemistry is faulty. Here’s a pill.

The newer story sounds more like:

You’re having a hard time.
Let’s understand your life and your biology.
Let’s check whether your brain has what it needs to function well.
Let’s build a plan that includes your mind, your body, and your circumstances.

Mental health is never just “all in your head”.
Your brain is part of your body. Your body is part of your life.

When we finally start treating it that way, real healing becomes possible.

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