in Healthy Eating

This article is a continuation of the first one, it focuses more on the mental health perspective.

Article guide

Considering I’ve delved into the basics of creatine and its uses about cognitive functioning in my last post, I won’t be stating them in this one. For a short overview about creatine, its health benefits, and its risks when it comes to cognitive performance, I suggest reading the first article.

This one focuses on the other side of health. Namely, our mental health. I’ve previously mentioned how people, who were diagnosed with bipolar disorder, reported increased manic symptoms after they started following a regime of creatine supplementation. But this little piece of information represents only a fraction of current research about creatine and mental health.

 

Creatine deficiency

I’d like to start with two defects, one being an error in creatine synthesis, and the other a creatine transporter defect. In the first one, our body isn’t able to produce creatine itself, and in the second the transporter malfunctioning prevents uptake of creatine into muscle and brain cells. But more importantly, people who have either of these defects are much more susceptible to brain cell death, abnormalities in one of the cellular components, developmental delays, speech and language impairments, autism, and epilepsy. Not something to be taken lightly. [12]

I’m mentioning these effects, because they are a testament to how important proper and optimal creatine production/levels actually are in our bodies.

Interestingly, when people with the creatine synthesis defect receive supplementation between 0.3 – 0.8 g/kg per day, there are visible cognitive and behavioural improvements. Such doses are very high for an average person though, and not really recommended. People with the transporter malfunctioning, however, do not witness such improvements. [34]

 

Stress

Stress is more important than you realize. Psychological stress is associated with impairments in energy metabolism. This increases the susceptibility of our brain cells to oxidative stress, a very dangerous imbalance, where it’s more likely your body won’t be able to combat damage done to cells as effectively as it could otherwise.

Moreover, chronic psychological stress is one of the most important factors which precede psychiatric disorders. [567]

There are a few general ideas how creatine supplementation can be beneficial. Mitochondrial dysfunction, one of the possible consequences of stress, might be partly reversible with creatine supplementation. Another possibility is creatine’s safeguarding ability. It prevents oxidative damage through its antioxidant activity. [8]

However, it’s important to stress (no pun intended) that these things haven’t been studied in humans on a large scale. While there are smaller human studies, the mechanisms have been mostly studied in mice. Therefore, randomized controlled trials will give us more insight into the real potentials of creatine for the treatment of certain mental disorders.

 

Schizophrenia

Many of you have probably heard of schizophrenia. It’s most commonly characterized by psychotic episodes. These are events where the person experiences an alteration in their thoughts, they can lose sense of reality, hallucinate, become disorganized, irregular patterns of speech become present, as well as catatonic behaviour and other symptoms.

Some of the neural underpinnings of schizophrenia are impairments in neuronal density, metabolic function, and cellular integrity in different parts of the brain. [9]

All of these can lead to a lessened ability of one’s brain cells to effectively communicate. And to no surprise, schizophrenic patients seem to have abnormalities in their creatine-phosphocreatinte pathways within the emotional and executive brain regions. In some of them, they have even observed a connection between creatine metabolism and cognitive functioning.

Another interesting finding are lower phosphocreatine levels found in frontal brain regions of people who have schizophrenia, as well as their first-degree relatives(!). [1011]

With all that said, in one study where people with schizophrenia were supplemented with creatine, their symptoms did not improve [12]. Possibly due to the heterogeneity of their symptoms and the underlying causes. We must keep in mind that scientists have recently uncovered that schizophrenia is a combination of eight distinct genetic disorders and thus represents a colourful variety of symptoms which can be manifested in someone.

 

Major depressive disorder (MDD)

As any other mental disorder, MDD and its clinical symptoms should be taken seriously. At the same time, it’s probably one of the more generally known disorders because many people like to equate feeling “depressed” with being diagnosed with major depressive disorder. Well, it doesn’t work that way. MDD is an illness with attributable symptoms which last over a certain time period, as any other illness. While feeling depressed is (usually) only a temporary state.

In any case, creatine seems to be a promising therapeutic agent for MDD.

Patients with treatment-resistant depression, a type where the conventional approach doesn’t seem to be very effective, were ordered to add a 3-5 g supplementation of creatine for four weeks in one study. They reported an improvement in mood. [13]

In another study, adolescents were ordered to supplement with 4 g of creatine daily for 8 weeks. Their depressive symptomatics improved, as well as the phosphocreatine concentrations in their brains. [14]

There are a few clinical trials underway to see whether there would be further improvements in depressive symptoms in people with depression.

 

Bipolar disorder

Another severe illness is bipolar disorder. It’s characterized by one manic episode, a period when you’d be extremely confident, reckless, euphoric etc., and by a depressive episode. This results in shifts between mood states, ranging from so-called highs (manic states) to lows (depressive states).

So far, there has been one study which assessed whether creatine supplementation would be helpful. Contrasting the findings of depression, it seemed that creatine might have induced a manic episode in two people with bipolar disorder after three weeks of their supplementation regime. Therefore, resulting in a mood shift probably caused by creatine. [15]

However, it was one study and only two patients from this one study. You can guess by yourselves that these results aren’t highly representative for a grander scale of people.

 

Anxiety disorder

Interestingly, anxiety disorders are the most common class of mental disorders in the US, they affect around 18% of the population. [16]

So far, one study assessed the connection between this disorder and creatine. People with treatment-resistant posttraumatic stress disorder (PTSD) saw improvements in their symptoms. The ones, who were depressed at the same time, benefited the most from the supplementation. [17]

 

Summary

As we can see, research with creatine and different mental illnesses is an ongoing and hot topic to study. Creatine does show promising results in some disorders as a side treatment, while showing less impressive results in others. Further investigation will surely shed more light here and enable us to make claims about it with greater certainty.

One more thing, before you click away.

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  • Jackson

    As someone with bipolar disorder, creatine certainly can affect moods. It triggered my first episode, and after taking it again (not realizing the initial correlation) I noticed a nearly immediate shift.

  • South_Texas_MF

    I just started taking it again after a long time off. And I definitely notice a psychological effect. It makes me a bit jittery and anxious. Hopefully this goes away after a week or 2.

  • Tyler

    I’ve never noticed any odd mood changes in me after taking Creatine. In fact, quite the opposite. But I’d imagine erratic mood changes can occur if one is taking too much of this, doesn’t need it, or is mixing it with other substances that have caffeine in it. It could make you edgy.

  • Both of this is very interesting. Have both of you perhaps considered logging down the changes in a diary? It would be interesting to observe the changes with time. Although it’s obviously not the smartest idea to pursue taking creatine if you presume it triggered a manic episode.

  • It’s hard for me to comment on this because I’ve yet to read studies that would study erratic mood changes with high substances; would probably also be slightly difficult to get ethics clearance for a study like that. Interesting (adverse) sinergies could occur though if taken with other substances; I wouldn’t find that particularly surprising.