Mental health is not separate from physical health. The brain is an energy-intensive organ that depends on a continuous supply of oxygen and nutrients, healthy mitochondrial function, glucose regulation and communication with the rest of the body. When those systems are strained, mood, cognition, motivation and stress resilience may also be affected.

That is the central theme of a 2025 Perspective by Andreazza and colleagues in Nature Mental Health. The authors reviewed research across neuroscience, psychiatry and metabolic medicine and proposed that altered energy metabolism is an important feature—often described as a “hallmark”—of several psychiatric disorders. They also outlined questions that researchers must answer before metabolic approaches can be matched reliably to individual patients.

What Is Brain Energy Metabolism?

Every thought, emotion and action requires energy. Neurons use adenosine triphosphate, or ATP, to maintain electrical signaling, communicate across synapses and repair cellular damage. Much of that ATP is generated by mitochondria through oxidative phosphorylation. Cells can also make smaller amounts of energy through glycolysis, which breaks down glucose in the cell’s fluid compartment.

Both pathways are normal and necessary. Problems may emerge when energy production becomes inefficient, the balance between pathways shifts in an unhelpful way, or oxidative and inflammatory stress interfere with cellular function. Because the brain stores relatively little energy, it is especially sensitive to disruptions in supply and use.

Looking for care that considers the whole picture?

CareSync Psych integrates psychiatric assessment, medication management and metabolic-health considerations when clinically appropriate.

Book a Psychiatric Appointment

What Did the 2025 Paper Find?

The article is a scholarly Perspective that synthesizes prior research; it is not a randomized clinical trial and does not prove that a single metabolic intervention treats mental illness. Its value is in connecting findings from multiple areas and defining a research agenda.

1. Bioenergetic changes appear across diagnoses

The authors describe evidence of altered energy production, mitochondrial function and redox biology in major depressive disorder, bipolar disorder and schizophrenia. Some studies suggest a shift away from efficient mitochondrial energy production toward greater reliance on glycolysis, with potential effects on lactate, acidity, inflammation and neural function. The strength and pattern of these changes vary by diagnosis, illness stage, tissue and individual.

2. Metabolic differences are not explained only by medication

Some psychiatric medications can affect appetite, weight, lipids and glucose regulation. Lifestyle and social factors can also influence metabolic risk. However, the paper notes that metabolic abnormalities have been observed in medication-naïve people experiencing first-episode psychosis and were described before modern psychiatric medications existed. This supports a more complex, bidirectional relationship rather than a simple medication-only explanation.

3. Insulin signaling may be one important bridge

Insulin does more than control blood glucose. In the brain, it participates in synaptic signaling and plasticity. The authors discuss how impaired insulin signaling may interact with inflammation, oxidative stress and psychiatric symptoms. They also stress that insulin resistance in the brain is not identical to insulin resistance measured in the rest of the body; routine blood tests cannot directly tell us how insulin is functioning inside the brain.

4. The same diagnosis may have different metabolic profiles

Psychiatric diagnoses are heterogeneous. Two people with depression, for example, may have very different sleep patterns, medication effects, inflammatory burden, eating behaviors and cardiometabolic risks. The paper proposes that future treatment may be guided partly by a person’s metabolic pattern—not solely by a symptom label—but that validated biomarkers and larger trials are still needed.

Accessible psychiatric care across five states

Telehealth appointments are available for eligible patients located in Florida, Arizona, Washington, Texas and Iowa at the time of the visit. In-person appointments are available in Central Florida.

Contact CareSync Psych

Which Treatments Are Researchers Studying?

The authors describe a broad “probe–perturb–personalize” framework for studying how a person’s metabolic system responds to an intervention. Potential areas of research include exercise, sleep, dietary patterns, time-restricted eating, ketogenic interventions, GLP-1 receptor agonists, metformin, intranasal insulin and compounds that influence mitochondrial or redox biology.

These options do not have equal evidence, risk or clinical readiness. Some are established treatments for nonpsychiatric indications but remain investigational for direct psychiatric use. Others, particularly restrictive dietary interventions or fasting, can create meaningful risks for people with eating disorders, diabetes, pregnancy, kidney or liver disease, certain medication regimens, or other medical conditions.

What This Can Mean in Real-World Psychiatric Care

Metabolic psychiatry expands the assessment; it does not abandon the foundations of mental health treatment. Depending on the individual, a thoughtful evaluation may consider:

• Current symptoms, diagnosis, functioning, safety and treatment goals
• Psychiatric and nonpsychiatric medications, including metabolic side effects and interactions
• Sleep quality, circadian rhythm, energy, nutrition, movement and chronic stress
• Weight trajectory, blood pressure and relevant personal or family medical history
• Appropriate laboratory data, coordinated with primary care or specialists when needed
• History of restrictive eating, binge eating, purging or other eating-disorder symptoms
• Evidence-based psychotherapy, behavioral support and realistic measures of progress

This broader view may be especially useful when symptoms and metabolic concerns overlap, when a medication is affecting weight or glucose regulation, or when a patient wants to improve physical health without destabilizing mental health. It may also help clinicians avoid “diagnostic overshadowing,” in which physical symptoms are mistakenly attributed to a psychiatric condition.

Mental health and metabolic health deserve one coordinated conversation.

Start with an individualized assessment—not a one-size-fits-all protocol. We can review symptoms, medications, health history, lifestyle factors and appropriate next steps together.

Request a Metabolic Psychiatry Evaluation

What the Research Does Not Yet Prove

The enthusiasm around metabolic psychiatry should be matched by scientific humility. The paper highlights important limitations: psychiatric conditions and metabolic changes are diverse; central metabolism is difficult to measure; dietary trials are difficult to blind; adherence can affect outcomes; and early studies may attract participants who are especially motivated and expect improvement.

Current evidence does not justify telling patients that mitochondrial dysfunction or insulin resistance is the sole cause of their psychiatric symptoms. It also does not support abruptly stopping psychiatric medications, starting a restrictive diet without screening, or using supplements and metabolic medications without appropriate medical oversight.

The most responsible interpretation is hopeful but measured: metabolism is a meaningful part of the mental-health picture, and future research may help clinicians match treatments more precisely. These approaches are most likely to add to—not universally replace—established psychiatric care.

Questions to Ask Your Psychiatric Provider

• Could any of my medications be affecting appetite, weight, sleep, glucose or lipids?
• Are there metabolic or medical contributors that should be evaluated?
• Would laboratory testing or coordination with primary care be appropriate?
• How can I improve sleep, nutrition or activity without worsening anxiety, mood symptoms or disordered eating?
• How will we track both psychiatric outcomes and physical-health outcomes?

Choose the visit format that fits your location.

Meet by secure telehealth from FL, AZ, WA, TX or IA, or schedule an in-person visit in Central Florida. Availability and clinical appropriateness are confirmed during scheduling.

Check Appointment Availability

Explore Whole-Person Mental Health Care

Learn how CareSync Psych™ brings together psychiatric evaluation, medication management, psychotherapy, metabolic health assessment and behavioral support. Telehealth is available in Florida, Arizona, Washington, Texas and Iowa, with in-person appointments available in Central Florida.