A Holistic Psychiatry Approach to Depression and Anxiety
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I’m a psychiatrist. I’ve devoted my education and career to treating mental health conditions with the singular goal of helping you reach your fullest potential.
I wholeheartedly advocate for prescribing psychiatric medication if that will be the best route to ease your suffering.
However, as a holistic psychiatrist, I’ve found there are many different treatments that are effective with fewer negative side effects.
You may read “holistic” and think: natural, boring, ineffective, and non-scientific.
The first two are true.
The latter two are wildly false.
My approach to psychiatric care begins with lab work, studying the very real function of your brain and body.
I evaluate your physical health, which is a fundamental predictor of your mental well-being.
I examine your nutrition, exercise, and sleep patterns to determine how your body is causing your brain to suffer.
Treatment begins with balancing these physical disruptions, alongside or in place of psychiatric medication.
It’s a you-sized prescription, not a one-size-fits-all pill.
In a world where instant gratification trends upward as fast as depression, anxiety, and suicide, it’s no wonder psychiatric medication is prolific. It seems like a simple, efficient solution. This seemingly straightforward route to feeling better appears the most desirable…at first.
The reality is most people are suffering just as much as they were before they started taking meds.
Here’s proof:
Many doctors blame depression and anxiety symptoms on a single chemical imbalance of serotonin in the brain.
They fix that imbalance with medication.
If this were serving people well, we would not be seeing the highest rates of depression, anxiety, and suicide in recorded history (Gallup).
Antidepressants, the mainstay of treatment for depression and anxiety, are not as effective as they’re made out to be.
Research shows that after 14 weeks on an antidepressant, only 37% of patients are no longer depressed, and only 50% find them partially helpful (Rush 2004). Of the one-third of people who were no longer depressed after 14 weeks of antidepressant treatment, 82% became depressed again in the next 12 months, while still taking psychiatric medication (Pigott 2015).
The odds for successful short- or long-term treatment with only an antidepressant aren’t great.
On top of that, 75% of people taking psychiatric medication experience side effects (Pillinger 2023). These range from impaired ability to concentrate, weight gain, sexual dysfunction, and numbing of positive emotions to worsening of depression symptoms, suicidal thoughts, seizures, and abnormal bleeding (Lexapro medication insert).
Worse still, many find themselves unable to stop these medications, even if they wanted to, due to intolerable physical and emotional withdrawal symptoms.
Surely, this is not always the case. There are patients, some of mine included, who have been helped by medication. I consider that a success.
But it’s troubling nonetheless that our current medical model of treating depression and anxiety focuses primarily on the chemical imbalance theory, for which medication is the only answer.
This one-dimensional approach ignores the fact that depression and anxiety are multifactorial conditions.
They result from a combination of different contributors, both physical and non-physical.
Hence, my holistic approach to the brain and body.
If you’re looking to avoid psychiatric medication, have tried one or several to little effect, or want to come off meds entirely, I’m here to tell you there’s hope outside of medication.
Okay, let’s get into it:
Broadly speaking, depression and anxiety symptoms result from a combination of two overarching domains - The Physical Domain and The Non-Physical Domain.
What the heck are those?
The Physical Domain
Metabolism Dysfunction (metabolism refers to all the biochemical reactions that occur within the body to maintain life)
Brain and Body Neglect (like inadequate nutrition, exercise, and sleep)
The Non-Physical Domain
Distressing experiences, past and ongoing
Disempowering thought patterns
Weak support systems
Lack of purpose or meaning
And more, but we’ll leave it here for now.
When people go to therapy, which domain is (usually) being treated? The Non-Physical.
It doesn’t make sense to me that most psychiatrists ignore The Physical Domain.
Let me show you why.
The Physical Domain is like a block of code in the operating system of your body.
If one line malfunctions, the whole program could break.
Here are some tangible examples of malfunctions that are directly linked to mental illness:
Blood sugar dysregulation and insulin resistance
Low vitamin D, omega-3 fatty acids, or iron levels
Abnormal magnesium, zinc, copper, iron, or lithium levels
High mercury or lead levels
Protein indigestion
Intestinal bacterial imbalance
Methylation imbalances and low B vitamins, including B12 and B9
Thyroid dysfunction
Celiac disease and gluten intolerance
Specific food intolerances
Sleep apnea
These all fall under Metabolic Dysfunction.
They cause your body to fail to complete certain tasks, which can ultimately show up in your life as depression and anxiety.
Without lab work, there’s no correcting these very specific lines of broken code.
Now let’s take a step back.
What about big-picture Brain and Body Neglect?
Low nutrient diet
Insufficient sleep
Insufficient water intake
Insufficient movement
Inadequate stress recovery (reflected as low heart rate variability)
Exposure to toxins (from seed oil-laden processed foods to pesticides)
Addictions (to social media, the news, and substances like caffeine, alcohol, nicotine, and cannabis)
Every human on planet Earth suffers from at least one of these. They’re universal.
So.
What do we do with all of these possible contributors to depression and anxiety?
We screen for them.
We need to know which contributors are part of your mental health picture, and just as importantly, which are not.
The results guide the creation of the treatment plan.
Since everyone’s combination of contributors is unique, and since there’s usually more than one origin for depression/anxiety symptoms, this leaves the door open for multiple treatment starting points.
That is ridiculously exciting.
More options than just a pill that may or may not work and that will likely cause side effects.
Through clinical experience and research, I have found addressing The Physical Domain first to be most effective.
It’s the most direct place to start.
That’s not to say we neglect The Non-Physical Domain. Not at all.
By treating The Physical, we support changes to The Non-Physical.
Think about it: The body is the common denominator in The Non-Physical Domain. No matter whether we change our environment, thought patterns, or support systems, our brain and body come with us.
We are physical beings, reliant on functional brains and bodies.
Thus, it is crucial to support optimal brain and body function for optimal mental health.
PLUS - there are no negative side effects to taking good care of your physical self.
In the case of mental health treatment, the most strategic treatment route is the most desirable, whether it involves medication or not.
Keep in mind: the work in each domain is never fully done; rather, it evolves.
Physical and Non-Physical components play a role in depression and anxiety at all times, and to varying degrees (even within one person).
Truth be told, the combination of those components changes over the course of your life.
The goal for your treatment is to support where you are now AND change with you.
Not just raise or lower your dosage.
This is a glimpse into a holistic psychiatrist’s treatment approach.
It is a framework, a place to start.
It’s been helpful to many, especially to those who
Want to avoid psychiatric medication
Have experienced little to no benefit from psychiatric medication
Have medication side effects
Want to come off psychiatric medication
Want more options for mental health treatment aside from medication
I created Brain-Body Psychiatry to bring you better mental health treatment through holistic psychiatry.
We all need support, guidance, and accountability in making and sustaining positive changes.
Brain-Body Psychiatry provides the tools and takes the time to guide you to your full potential.
If you’re interested in this approach, I am very excited to work on this together.
With care,
Dr. Luisa Cacciaguida
TL;DR
Mental Health is not separate from Physical Health.
Modern medicine medicates America, neglecting this fact.
I’m a holistic psychiatrist who is changing the approach to treating depression and anxiety.
Starting with: taking a deep dive into understanding how your body is making your mind suffer.
Do you have blood sugar dysregulation?
Are you lithium deficient?
Do you have celiac disease?
What about your sleep and exercise patterns?
Most psychiatrists will never order lab work or screen for lifestyle contributors to examine these possibilities, which are all linked to depression and anxiety.
This is the first step I take to building your treatment plan.
Most importantly, I’m removing the one-size-fits-all pill as the only course of action.
Disclaimer:
This blog post is intended to be informative and does not replace individual medical advice. Always consult with your healthcare provider or a professional for any personal medical decisions or concerns you may have. Everyone's health situation is unique and should be evaluated by a healthcare professional.
This blog post is designed as a general guide. This is not a substitute for personalized medical advice, nor is a patient-physician relationship established in this blog post.
