Healing Mental Health Naturally - Why You Need to See a Holistic Psychiatrist
You’ve been feeling tired for months. You can barely muster up the energy to do what you used to. You’re often on the verge of crying, feeling like life is overwhelming and nothing you do can change it. You finally decide to go to your conventional primary care doctor (aka an MD or DO with no training in treatment approaches outside of those taught in medical school and residency) to ask for help. She has you fill out a 9-question screening questionnaire and asks you about your mood, appetite, sleep, and energy in the last two weeks. She says it sounds like you’re depressed and writes you a script for an antidepressant. After the 20-minute appointment you walk out wondering if this is the right move.
Here’s what well-meaning but time-strapped, conventional primary care doctors don’t do when someone comes to them with these types of symptoms:
Testing to check for medical causes of depression like:
protein indigestion
abnormal lithium, magnesium, zinc, or copper levels
methylation imbalances
low vitamin B12, vitamin D, omega 3, or iron levels
thyroid abnormalities, obstructive sleep apnea and Celiac disease
Ask if you’ve had physical symptoms like constipation or diarrhea, heartburn, joint pains, or brain fog/difficulty concentrating
Take a thorough history: timeline of your symptoms throughout your life, family medical and psychiatric history, and specific questions about other psychiatric symptoms that might make an antidepressant the wrong choice for you
Ask about your alcohol, nicotine, or caffeine intake. Nor do they emphasize that these substances are more than likely impacting your mood negatively when you’re withdrawing in between “doses”.
Ask about your sleep. They likely don’t emphasize that inadequate sleep is a major cause of symptoms such as feeling overwhelmed and emotional mood swings. If they did, maybe they prescribed a sleeping pill. I doubt they went over the long list of behavioral changes, free of cost and medication, that can be implemented to help sleep.
Ask about your diet. They don’t tell you that blood sugar swings from high to low, too little protein, too much sugar and processed food, and inadequate vitamin and mineral intake are closely tied to your symptoms. They definitely don’t review your diet with you or give you a tangible plan to change how you feed yourself.
Ask about your support systems, at home, in your social circle, and at work.
Ask how often you’re using screens while multitasking - scrolling while simultaneously talking to people, working, spending time with your family, watching TV. They likely don’t let you know that our phones, with the notifications and email, news app, Twitter, instagram, etc. are hijacking our brains, leaving us feeling frantic, frazzled, and overwhelmed. Nor do they give you concrete actions steps to change that.
Tell you about the potential side effects of antidepressants. They seldom tell you that our bodies become tolerant to these medications, meaning if you skip a dose you will likely feel “off” both mentally and physically. This results in sick days needing to be taken from work and vacations ruined due to missed doses. It also means that the dose needs to be decreased slowly to avoid physical and emotional symptoms when you want to come off it.
Let you know the long-term plan - are you supposed to stay on an antidepressant forever?
Let you know that there are many different things contributing to your symptoms, not just low serotonin levels that antidepressants adjust. They don’t let you know that there are treatments other than antidepressants for your symptoms.
As someone who got my MD and completed a 4-year residency in psychiatry, I empathize with conventional doctors. I know that their employers tell them they need to see patients in 20 minutes because insurance companies are paying less and less for doctor’s visits. I know that they got less than 5 hours of education on nutrition in medical school. I know they got no education on movement and exercise in med school. I know that they were trained to prescribe medication for almost everything. So was I.
Medical school is broken up into 2 years in a classroom and 2 years seeing patients in a hospital. Then psychiatrists undergo 4 years of training through a residency program.
When I got out of the classroom and into hospitals and clinics I saw people struggling with their health, both mental and physical, come in for treatment over and over. I quickly realized that our healthcare system doesn’t tell people that medications are not the only thing required to treat their conditions. It’s not conveyed that most medical conditions have many contributing factors that need to be evaluated for and addressed. Because of this, many patients took medications but didn’t see results so stopped them, stayed on medications that had bad side effects, or worse, took medications but continued to get worse over time.
I often felt patients’ sadness when their conventional doctors said that nothing else besides medication could help them feel better. Worse yet, they’d need to stay on them forever and they may or may not even work.
That’s when I looked for other ways to help people struggling with their health, both mental and physical. Turns out there’s more to medical care than prescriptions, who knew!
I discovered functional, integrative, nutritional, lifestyle, orthomolecular, and mind-body medicine. I loved the different ways these treatment approaches helped people feel better, mentally and physically, most often without prescription medication and their side effects.
Let’s run through some of the medical approaches listed above so you can get an idea how different they are from conventional medicine:
Functional medicine focuses on using lab work to uncover the underlying causes of a symptom. For example, depressive symptoms can be caused by blood sugar dysregulation, thyroid abnormalities, obstructive sleep apnea and Celiac disease. Protein indigestion, abnormal lithium, magnesium, zinc, or copper levels, methylation imbalances, low vitamin B12, vitamin D, omega 3, or iron levels may also play a role. It emphasizes that “normal” lab results do not indicate that someone is healthy or feeling well. Functional medicine uses narrower lab work ranges that represent optimal health instead of conventionally used result ranges, which are based on averages of large groups that include many sick people.
Integrative medicine is an approach to healthcare that includes practices not traditionally part of conventional medicine. These include herbs and supplements, meditation, wellness coaching, acupuncture, massage, movement, resiliency, and nutrition. It “integrates” conventional approaches and complementary therapies to achieve health and healing.
Nutritional medicine brings to attention the impact of the food we eat on our mood/thought and physical symptoms. The Standard American Diet is calorie dense, but nutrient-deficient and chemical-laden, resulting in a decline of our metabolic processes, aka all of the biochemical reactions keeping us functioning. The brain is the most metabolically active organ utilizing ∼20% of the total body resting metabolic rate, and thus shows the first signs of nutritional deficiencies.
Lifestyle medicine uses therapeutic lifestyle interventions to help people feel better. It works through six pillars: plant-based nutrition, physical activity, stress management, avoidance of risky substances, restorative sleep, and social connections.
Orthomolecular medicine takes the approach that each person has individualized nutrient needs. So just because Mrs. S needs 500 mg of Vitamin C daily to feel well mentally, emotionally, and physically doesn’t mean Mr. R has the same need. Tens of thousands of patients struggling with their mental health have been treated with personalized doses of nutrients, such as SAMe, vitamin B6, zinc, folic acid and vitamin B12.
Mind-body medicine appreciates that mental health isn’t restricted to our heads. Rather our minds and our bodies are intricately linked. Since mental health symptoms present with both mental (mood and thought) and physical symptoms, we can and should approach treatment from both angles.
Conventional medicine has a time and place AND it has its limits. It is spectacular for addressing discrete issues like appendicitis. It’s not good at addressing chronic conditions especially those with symptoms in different organ systems. It separates treatment by organ system as if the whole body doesn’t work together. People often have a cardiologist, an endocrinologist, and a gastroenterologist. Each of those doctors focuses on their own organ system (i.e. heart, hormones, digestive tract), but doesn’t zoom out to see if they might all be connected. This most often leads to subpar results for the patient.
Since psychiatric conditions are chronic and symptoms are wide ranging, conventional medicine doesn’t do the best job at helping those struggling. Addressing psychiatric symptoms well requires a much wider scope approach than “here’s an antidepressant, let’s see if it works for you”. There are many different things contributing to mental health symptoms, not just low serotonin that antidepressants adjust.
In my practice, I use all of the above treatment approaches, including my MD medical training, with every patient. I call it “holistic psychiatry”. I take the best of my conventional medical training (4 years of medical school + 4 years of psychiatry residency) and combine it with non-conventional treatments from functional, integrative, nutritional, lifestyle, orthomolecular, and mind-body medicine. The result is a wide-scope approach to mental health. I go beyond the “pill for an ill” approach of conventional medicine. Rather I aim to find and modify the underlying cause of symptoms, from low stomach acid preventing proper food digestion to your daily habits and relationships. I don’t give out a diagnosis and pill and hope for the best. I evaluate each person as a whole in order to provide the most comprehensive treatment path to feeling better, whether that includes psychiatric medications or not.
This holistic treatment approach has been helpful to many, especially to those who:
Have been failed, partially or wholly, by psychiatric medication
Experience medication side effects
Want to avoid psychiatric medication
Want to come off psychiatric medication
Want more options for mental health treatment aside from medication
Brain-Body Psychiatry was created to bring you better mental health treatment through holistic psychiatry.
We all need support, guidance and accountability in making changes to positively impact our mental health.
Brain-Body Psychiatry partners with you to guide you to your full potential.
With care,
Dr. Luisa Cacciaguida
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.
