Mental Health Answers
Mental Health Answers
How a Metabolic Approach Ended My Bipolar Symptoms
Your Social Anxiety Might Be Trauma — And It's Treatable
Where do mental health disorders come from?
There isn't one clean answer to this question. While people with these disorders tend to share common symptoms, the combination of factors contributing to those symptoms is unique to each individual. Below are some common models explaining where these issues come from. It's possible that your symptoms stem from more than one.
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Where do mental health disorders come from?
Brain Energy Theory
Three months after changing my diet and sleep, my bipolar symptoms vanished — and they haven't come back. A newer framework, developed largely by Harvard psychiatrist Dr. Christopher Palmer, proposes that mental disorders are fundamentally metabolic in nature — problems with how brain cells produce and use energy. Under this view, mitochondrial dysfunction sits underneath many of the conditions we currently treat as separate diagnoses. This helps explain why so many people with mental health disorders also struggle with metabolic issues like irritable bowel syndrome, migraines, diabetes, seizures, and trouble focusing. This knowledge changed my life. After living with bipolar disorder for most of my life, I have been symptom-free since early 2024. Three months into a metabolic health protocol — for me, that meant a ketogenic diet along with consistent, sufficient sleep — my bipolar symptoms, migraines, focus difficulties, and IBS all vanished. I was able to work with my doctor to wean off my bipolar medication, and none of the symptoms have returned. If you're suffering from a mental health disorder, a metabolic health protocol is worth considering. What this suggests: sleep, exercise, nutrition (including therapeutic ketogenic approaches), and stress management aren't add-ons to treatment. In many cases, they are the best treatment.
The book that explains it all: Brain Energy by Chris Palmer.
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Ongoing research proving the efficacy: Metabolic Mind
Learn about the keto diet: The Charlie Foundation
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The Chemical Imbalance Model
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​This is the classic theory most people have heard about. It posits that depression, anxiety, and other conditions stem from imbalances in brain chemicals like serotonin, dopamine, and norepinephrine. It's the model behind most psychiatric medications, and for many people, those medications genuinely help. The theory has been challenged in recent years — the brain is far more complex than a simple "low serotonin equals depression" picture — but the core insight, that brain chemistry matters, remains foundational. The chemical imbalance and brain energy models actually fit together. ​ Neurons need a tremendous amount of energy to make neurotransmitters and release them at the right place and time. That energy comes from mitochondria — "the powerhouse of the cell" — which have to traffic through the neuron to reach the synapses where firing happens. When metabolic health is poor, mitochondrial function suffers, and the brain chemistry that depends on it starts to falter. In other words: a chemical imbalance can be downstream of an energy problem. This is where medication becomes a window of opportunity. At the bottom of a depressive episode, picking up a new diet, sleep schedule, and exercise routine can feel impossible. Medication can lift symptoms enough to give you the bandwidth to put those metabolic changes in place — changes that, over time, may address the underlying issue. What this suggests: medication can be a meaningful part of treatment, especially for moderate to severe symptoms, but it doesn't have to be lifelong. A psychiatrist or prescribing provider can help determine whether it's the right fit — and when it might be time to taper.
Choice Theory
The brain is creative. It will find ways to meet your needs for survival, love and belonging, power, freedom, and fun — even when those ways look a lot like illness. Dr. William Glasser, the founder of Choice Theory, argued in his book that many mental health symptoms emerge when these core needs go unmet, and that the symptoms themselves are the brain's attempt to cope. Glasser describes a young woman who began hearing voices just as she was about to start medical school. Rather than treating the symptoms as a disease, he got to know her — and discovered that she had been secretly dreading med school. What she actually loved was substitute teaching. When she chose that path instead, the voices stopped, and they didn't come back. I've seen the same pattern in my own work. Clients who endure long periods of isolation can develop delusions — the brain needs connection, and it finds a way to manufacture one. Clients who have lost faith in the possibility of real intimacy sometimes turn to compulsive sexual behavior; the underlying need for connection is still there, but it's being met through a substitute that ultimately deepens the loneliness. Depression, anxiety, and even psychotic symptoms can be understood as creative — though costly — attempts to meet a need or regain a sense of control. Someone who feels chronically unloved may slip into depressive patterns that pull care from others or excuse them from painful social situations — even though those same patterns deepen the very disconnection underneath. What this suggests: healing often begins with identifying which needs are going unmet and finding more effective, less costly ways to meet them. In Glasser's terms: change what you want, or change what you're doing to get it.
Learn more: Glasser Institute for Choice Theory
The book that explains it all: Choice Theory: A New Psychology of Personal Freedom
Trauma​
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Trauma is any past event that causes present-day distress, and it can drive a wide range of mental health disorders — anxiety, depression, panic, addiction, attachment problems, chronic shame, and more. The category isn't limited to combat or assault. Anything that overwhelmed your nervous system at the time it happened — neglect, bullying, a difficult medical procedure, a sudden loss, a chronically critical parent — can leave a footprint in the brain. Here's the simple version of what's happening. Your brain is built to process experiences and file them away: that happened, I learned this from it, here's how it connects to everything else I know. When something overwhelms the system, that filing process breaks down. The memory gets stored raw — locked away with all the original sights, sounds, body sensations, emotions, and beliefs intact, and disconnected from the rest of your adaptive memory. It becomes a kind of isolated network in the brain. When a present-day cue (a smell, a tone of voice, a facial expression) touches that network, the original distress fires off as if the event were happening right now. That's why someone can be functioning fine in their adult life and still feel six years old in certain situations. EMDR (Eye Movement Desensitization and Reprocessing) is one of the most well-researched approaches for getting those unprocessed memories moving again. While the client briefly holds a traumatic memory in mind, the therapist guides them through bilateral stimulation — eye movements, alternating taps, or tones. Something about this process appears to mimic what the brain does naturally during REM sleep, allowing the isolated memory network to connect with the broader adaptive networks around it. The memory doesn't disappear — it just stops dominating the present. Over time, the person can think about what happened without the body bracing for it. In my own work, I've watched clients move through memories they'd been avoiding for years and come out the other side genuinely lighter — not because they convinced themselves to feel differently, but because the brain finally finished a piece of processing it had been waiting to do all along. What this suggests: trauma isn't just a memory of something bad — it's a memory the brain hasn't finished metabolizing yet. With the right approach, that processing can resume, and the present-day symptoms it was generating often resolve along with it.
Find an EMDR Therapist: EMDRIA
The book that explains it all: Getting Past Your Past by Francine Shapiro
What to take from this.
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If you're trying to understand your own experience or someone else's, the most honest answer is that it's almost certainly a combination. Effective treatment usually means layering interventions — addressing brain chemistry, unmet needs, metabolic health, and trauma history together rather than picking one and ignoring the others. If symptoms are interfering with your daily life, relationships, or sense of safety, working with a counselor or other mental health professional can help you sort through which threads matter most for you.