Before the Prescription: 5 Hidden Physiological Causes of Poor Mental Health You Should Rule Out

When experiencing symptoms like depression, anxiety, brain fog, or low energy, many people turn to psychiatric medications for relief. While these can be effective in some cases, they shouldn’t necessarily be the first step. Mental health is intricately linked to physical health, and imbalances in the body can mimic or worsen psychiatric symptoms. Before committing to medications, it's essential to explore potential underlying causes that might be contributing to your symptoms.

Here are five key factors to rule out first:

1. Anaemia

Anaemia, particularly iron-deficiency anaemia (although it can be caused by B12 and folate deficiency), is a common yet often overlooked cause of fatigue, low mood, and cognitive difficulties. Iron plays a crucial role in oxygen transport to the brain, and a deficiency can leave you feeling exhausted, irritable, and foggy-headed. Women of childbearing age, vegans, and individuals with digestive issues are at higher risk. A simple blood test can detect anaemia, and treatment often involves dietary changes or supplements rather than psychiatric drugs.

2. Blood Sugar Imbalances

Fluctuations in blood sugar levels can wreak havoc on your mood and mental clarity. Hypoglycaemia (low blood sugar) can trigger anxiety, irritability, and even panic attacks, while chronic high blood sugar contributes to brain fog and fatigue. Diets high in refined carbs and sugar make the problem worse. Stabilising blood sugar through balanced meals, adequate protein, and healthy fats can significantly improve emotional stability and energy.

3. Chronic Inflammation

Inflammation isn’t just a concern for your joints or muscles — it also affects your brain. Growing research links systemic inflammation to depression, anxiety, and cognitive decline. Inflammatory markers such as C-reactive protein (CRP) can help identify if this is a factor. Causes of inflammation include poor diet, chronic stress, infections, and autoimmune diseases. Lifestyle changes like reducing processed foods, increasing omega-3 intake, eating a blood sugar balancing diet and getting regular exercise can reduce inflammation and improve mental clarity.

4. Gut Bacteria Imbalances (Dysbiosis)

Your gut and brain are deeply connected through the gut-brain axis. An imbalance in gut bacteria — known as dysbiosis — can lead to the production of neurotoxins and inflammatory compounds that affect your mood and cognition. Symptoms like bloating, irregular bowel movements, and food sensitivities may indicate a gut issue. Probiotics, prebiotic-rich foods, and reducing sugar intake can help rebalance your microbiome and, in turn, support better mental health.

5. Hypothyroidism

An underactive thyroid (hypothyroidism) can cause depression, fatigue, memory problems, and mood swings. It is especially common in women and can go undiagnosed for years if only basic tests are run. A full thyroid panel — including TSH, free T3, and free T4 — is essential to rule this out. If hypothyroidism is the root cause, thyroid hormone replacement can bring significant mental health improvements without the need for psychiatric medications.

Conclusion

While psychiatric medications can be life-saving for some, they’re not always the first or best solution. Mental health symptoms often have physical roots, and treating these underlying issues can lead to lasting improvements — sometimes even eliminating the need for medication. Always work with a healthcare provider to thoroughly evaluate your physical health before starting psychiatric treatment. Ruling out these five common causes is a smart and empowering place to begin.