Some orthomolecular psychiatrists appear to have been dramatically successful in helping some patients with certain mental or emotional problems. But because psychonutrition is still a borderline discipline, it is an area where controversies abound and results are often open to question. Many physical conditions can be influenced greatly by nutrition. Among these are the metabolic disorders diabetes and hypoglycemia, both of which can affect a person's emotional life (see Chapter 8). In addition, relationships have recently been discovered between lowered blood pressure, reduced cholesterol and triglyceride levels, and a diet high in fiber. A thiamine (vitamin B1) deficiency--which causes pellagra, a chronic disease that leads to skin lesions and gastrointestinal distress--can produce depression, mania, and paranoia. Another example is pernicious anemia, in large part due to vitamin B12 shortage, which can cause moodiness, difficulty in remembering and concentrating, violent behavior, depression, and hallucinations. But the fact that many physical disorders, some of which can cause psychological disturbances, are treatable in part through nutrition does not, unfortunately, imply that emotional disorders in general can be treated by means of diet. This may be the case for some individuals for whom special diets can influence a specific biochemical imbalance. But research is just beginning to develop tests that can detect these sensitive individual variations. Once they can be identified a more difficult step has to be made: to determine how this information can be used to select an effective treatment. Nutritionists and physicians agree that good physical and mental health depend on a combination of proper body weight, adequate exercise, good diet, and decreased stress. But beyond this, an emotionally disturbed person who seeks help through dietary therapy--for example, through megavitamin doses--should realize that he or she is really involved in _self-experimentation_. Some orthomolecular psychiatrists may be very talented in treating some of their patients. These patients are very fortunate; it is hard to avoid saying they are lucky. The main problem that faces this new area of psychonutrition is one of general reliability and credibility. {239} PART III IMPORTANT QUESTIONS {241} 17 LOCATING A THERAPIST America is overcrowded with helpers; there are so many helpful people out there, they are literally bumping into each other, and must be regulated by laws and organizations to keep them from helping so much that the average client in need of help isn't torn to shreds. Paul G. Quinnett, _The Troubled People Book_