When I first heard Dr. William Walsh present his work on five different biotypes of depression at a conference in 2017, I have to admit that it went in one ear and out the other. At that time, my approach to medicine was—and still is to a great extent—very much about the person: heart, heart, heart.
Then I encountered Dr. Walsh’s work again during my integrative neurology training, and something clicked. The curtains opened.
What caught my attention was not simply the idea of using nutrients in mental health. It was the possibility that very different biochemical patterns could contribute to very different behaviors and psychiatric symptoms—and that identifying those patterns might change how we approach an individual.
I was particularly struck by Dr. Walsh’s work with children with severe behavioral and emotional disturbances. His experience suggested that, particularly when these problems are recognized early, addressing underlying biochemical imbalances may give some children a very different trajectory. Equally important was his observation that giving the wrong supplements for a person’s biochemical pattern can sometimes be counterproductive rather than helpful.
I was also profoundly touched by several cases presented in our classes. One involved a young woman with schizophrenia who returned to class about 10 weeks later, socializing, passing her exams, and no longer experiencing the visual or auditory hallucinations she had previously experienced. Seeing a case like this presented in the context of biochemical assessment and individualized treatment made a lasting impression on me.
That was different from the way I had thought about mental health before.
Considering how many children and adults suffer from significant anxiety, panic, depression, ADHD, and other psychiatric symptoms, the possibility that some individuals could experience meaningful improvement by addressing specific nutritional and biochemical factors caught my attention. His work with copper and zinc was one example that particularly stayed with me.
In my own practice, I work everyone up even if they do not come specifically with emotional complaints, because I have seen significant biochemical abnormalities in many of my patients, sometimes profound. I have seen, for example, a copper level twice the normal range in a patient with severe rheumatoid arthritis who was on the threshold of death. Reducing the copper level was followed by normalization of inflammatory parameters over the following months, this was the first time ever that this had been the case in decades..
The Walsh approach also has implications for neurological conditions such as Alzheimer’s disease, Parkinson’s disease, ALS, multiple sclerosis, and others. His work has also influenced approaches to postpartum depression, anxiety, and psychosis. Walsh-trained OB/GYN practitioners have explored relationships between elevated estrogen and certain metals. Coming from a medical background in which I have always seen emotional and physical health as closely connected, it makes sense to me that there would be a mutual relationship: improvement in emotional health can have stabilizing effects on physical health, and improvement in physical health can affect emotional health.
I have since had the privilege of learning from Dr. Walsh during this later part of his career, when decades of research and clinical experience have shaped and refined his work. I have often told my patients how fortunate we are to have encountered him at this point in his journey. As Dr. Walsh increasingly focuses his time on research, I find myself especially grateful for what he has contributed to the field and to the practitioners who have had the opportunity to learn from him.
Dr. Walsh is a scientist and pioneer in nutritional psychiatry and biochemical individuality. His work has focused on an important question: Could measurable differences in body chemistry help explain why people with similar psychiatric symptoms can respond very differently to treatment?
A central concept in his work is biochemical individuality. Two people may have the same psychiatric diagnosis yet have very different underlying biochemical patterns. In the Walsh approach, laboratory findings are considered alongside symptoms, history, and other clinical information rather than assuming that one treatment should work equally well for everyone.
Some of the biochemical areas investigated include copper and zinc status, folate and other B vitamins, iron, methylation-related pathways, and markers associated with oxidative stress. These nutrients participate in processes involved in neurotransmitter synthesis, energy metabolism, and gene regulation.
What I find most valuable in Dr. Walsh’s work is the recognition that the person matters as much as the diagnosis. A diagnosis describes a pattern of symptoms. Looking more closely at biochemistry may provide additional information about the individual behind those symptoms.
After incorporating this approach into my practice, I continue to find that principle both scientifically interesting and clinically important: there is no single biochemistry shared by everyone who carries the same diagnosis. I am forever grateful for having had the opportunity to learn from Dr. Walsh through his classes and training programs during the last several years.
Image: The Scream by Edvard Munch, Norwegian Expressionist and Symbolist, painted during a time of profound social and cultural upheaval. Munch’s work focused heavily on deep psychological themes, anxiety, and human emotion.
