I’m just flying home from a four-day gathering of 475 warriors, and I am energized and hopeful.
The gathering was the Integrative Medicine for Mental Health’s (IMMH) annual conference, and the warriors were mental health providers from around the world. These medical and allied health professionals- and some psychotherapists – came together as part of a movement to educate their peers and the public about a new way of thinking in regard to mental health issues.
Some were new to the field and hopeful of learning a “better way” of treatment, while others were seasoned elders, old pros at an integrative treatment model that has been in the making for over 50 years.
After attending more than 20 lectures and talking to dozens of attendees, I felt the general sentiment was deep frustration with the current “one pill, one ill” medical model that is the current standard of care within psychiatry (an approach that allows for mental illness diagnoses based solely on a clinical interview, without physical exam or diagnostic testing.)
In one lecture, the presenter had a powerpoint slide with three bullet points, capturing the frustration with the mental health status quo:
• “Did you know that psychiatry is the only field of medicine that doesn’t test the organ it treats?”
• “Psychiatry is basically practiced the same way it was in 1865 when Abraham Lincoln was depressed!”
• ISN’T IT TIME FOR A CHANGE???
A Paradigm Shift Has Already Happened, But Only Around The Edges
That speaker at the IMMH conference was preaching to the choir. This is a group that has already changed, treating mental health issues in an integrative way, even if their psychiatric peers and much of the public is still unaware.
In fact, the shift was already happening back in the 1950s (more than 60 years ago) with the birth of the Orthomolecular Psychiatry movement and the pioneering work of Drs. Abraham Hoffer, Linus Pauling, and other out-of-the-box-thinking practitioners.
They were brazen enough to ditch a “One Flew Over The Cuckoo’s Nest” mode of treatment, common in psychiatry at the time, in favor of prescribing high doses of vitamins to help conditions like schizophrenia. They also conducted research to identify biochemical biomarkers linked to various mental health conditions including depression.
One such marker that has been used for over 50 years and is still in use today is Pyroluria, which is the primary root cause of 15 percent of cases of depression (and involves low levels of zinc, B6, and the Omega-6 fat GLA.)
The movement has gone through various names throughout the years, including “Alternative Medicine” or “Complementary Medicine,” and is now more commonly referred to as “Integrative” or “Functional” Medicine.
It’s a comprehensive approach that uses diet, stress management, and targeted medical testing to identify and address underlying physical drivers of mental health conditions.
This approach currently has much research support and is now being embraced by a bigger percentage of the public and an ever-increasing group of professionals, as the large number of attendees at IMMH attests. (Seven years ago, at the first IMMH conference, there were 50 practitioners, and this year there were ten times that.)
In fact, the American Psychiatric Association (APA), the major professional organization of psychiatrists, now has a caucus dedicated to education in Integrative Medicine.
Mental Health at a Crossroads
Thing are pretty interesting in the field right now.
Mental health issues are at an all-time high. Psychiatrists and other mental health professionals are busier than ever. The most recent statistics I could find were from April 2014, which show that more than 78 million Americans were taking psychiatric medications, with over 41 million people on antidepressants.
In fact, there aren’t even enough psychiatrists to meet the demand.
Business is good!
All this is happening at the same time that psychiatry is under fire. Here are just a few examples:
-In 2013, Dr. Thomas Insel, who was then director of the highest governmental agency for mental health, the National Institute for Mental Health (NIMH), called into question the Diagnostic and Statistical Manual (DSM,) the book that every mental health professional uses to diagnose patients. At that time, he said,
“The weakness of the manual is its lack of validity. Unlike our definition of Lymphoma or AIDS, the DSM diagnoses are based on consensus about clusters of clinical symptoms, not any objective laboratory measures….patients with mental disorders deserve better.”
-Many researchers have also begun to cast doubt on how well psychiatric medications actually work. A large 2010 meta-analysis (a study looking at the combined results of many studies) found that SSRI antidepressants like Prozac, Zoloft, and Celexa work NO better than placebo for mild and moderate depression. They were able to get a truer picture of the data than ever before. In addition to including published studies, they also included studies pharmaceutical companies chose not to publish because the results were not positive. To this point, a 2002 article in the Washington Post states,
“In the majority of the trials conducted by drug companies in recent decades, sugar pills have done as well, or better, than antidepressants. Companies have to conduct numerous trials to get two that show positive results, which is a minimum for FDA approval. The makers of Prozac had to run five trials to obtain two that were positive.
-Clinical trials are revealing the merits of the placebo effect to the extent that pharmaceutical companies now see developing new SSRIs as too big a risk, because it’s increasingly harder to show that these drugs work better than a sugar pill.
News of the dangers of many classes of psychiatric medications is also mounting. Antidepressants have been linked to increased suicidal and homicidal tendencies.
It has been over 10 years since the FDA forced antidepressant makers to put a “black box warning” on these medications, citing dangers of SSRI use (including mania, suicidality, and aggression) in people 25 years old and younger.
For a dramatic picture of the dangers of SSRI medication, see SSRIStories.org. This very powerful website has organized over 6000 media accounts of homicides and suicides linked to antidepressant use (please be aware it’s not for the faint of heart).
For a more comprehensive analysis of the dangers of all classes of psychiatric medications, go to Mad In America and Dr. Peter Breggin’s website. His latest book Medication Madness takes a critical look at the role of psychiatric medication in cases of violence.
The most amazing thing to me is that this scathing criticism of psychiatry has been going on for more than a decade and it’s just business as usual in the offices of most psychiatrists and therapists.
I work in the mental health field every day, and nobody is talking about it — neither providers nor patients. It is really surreal!
It’s Time for a Change
How long can mental health go on this way? How long should it?
From my vantage point, Integrative Medicine really does have a chance to move our field out of the mess it’s in.
Four Things Integrative Medicine Does Better
This isn’t to say there aren’t good practitioners within conventional psychiatry (there most certainly are), but as a whole, an integrative approach offers a big step forward.
Here are a few of the pillars of integrative medicine that make mental health treatment better:
1) It treats every(body) as unique
An integrative approach embraces the term “Biochemical Individuality,” which asserts that ALL of us are different and need different amounts of micronutrients (vitamins and minerals) to live optimally. These difference are based on genetic difference and functional impediments..
Advanced functional nutritional testing allows practitioners to understand each patient’s nutritional and treatment needs more fully.
The ability to have such an accurate picture of someone’s physical needs leads to personalized medicine tailored to each person.
If we really accept and follow the idea of “Biochemical Individuality,” it will definitely question the “one pill, one ill” mentality.
2) It uses food first
Most integrative practitioners start with food (or at least make food a big part of their treatment plan). They know that the right food can heal your mental health issues. Sometimes that’s all it takes!
Dr. Kelly Brogan, an integrative psychiatrist who presented at the IMMH conference I just attended, shared that the very first thing she does with patients is put them on an elimination diet. It’s all she does in the first month of treatment, and if patients aren’t willing to do it, she refuses to work with them.
It’s also what I do. I have each of my patients follow an elimination diet, and I sometimes do IgG food allergy testing to identify foods that may be triggering symptoms.
I can’t tell you how often we find one or even several foods that are making the symptoms worse, and once removed, symptoms improve.
3) Stress management is a major healing tool
For decades we have known that stress is a major factor in all chronic health conditions. Recent research has shown that stress causes the rise in systemic inflammation which has been shown to cause depression, anxiety, and other mental health symptoms.
The integrative approach to mental health understands that, without modulating the stress response, it is much more difficult to address mental health symptoms, so stress management is part of every mental health protocol.
4) It addresses the “root cause” of symptoms
The job of the integrative practitioner is to work as a “clinical detective” to find what’s causing the symptoms.
Usually this is done through targeted medical testing to identify these causes. Sometimes what’s identified are simple vitamin or mineral deficiencies (like low zinc/ high copper, low vitamin D or B12). At other times, the findings are more complex issues like autoimmunity or GI problems.
But the intent is to identify what’s causing the symptom and then to do what’s necessary to support the body in healing.
A mentor of mine, Charles Gant, says “Unless you test, you guessed.”
So What’s Next?
If you are a mental health clinician interested in moving your practice in a more integrative direction, first off, I applaud you. It will be a challenging but very rewarding process and nobody will thank you more than your patients!
Here here are some resources to get you started:
- Mood Cure by Julia Ross, MA
- Ultramind Solution, Dr. Mark Hyman, MD
- Anti-Anxiety Food Solution, Trudy Scott, CN
Webinars: Check out Great Plains Lab Webinar library. They have a very comprehensive collection of videos addressing various mental health issues using an integrative medicine approach. I have listened to dozens of these and have learned things I use every day with clients.
Conferences: The Integrative Medicine for Mental Health Conference (the best conference in the field) happens every September.
If you are someone suffering from a mental health issue and have not gotten your needs met in the conventional system (or you want to learn more for a family member), I honor your journey and want to encourage you to remember that there is help out there!
Here are some resources to help you navigate finding the help you need:
Books: I would suggest the same books that I suggested for the professionals. Check out the Mood Cure, Anti-Anxiety Food Solution and Ultramind Solution.
Databases to find Integrative mental health clinicians:
Online Free Summit focused on Mental Health:
A host chooses a topic and interviews 20 or so experts on different facets of the subject (one of the best resources for up-to-date information).
The Anxiety Summit, hosted by my friend, Trudy Scott: Focuses on natural treatment of anxiety, but much of the information is applicable to other mental health issues.
This limited list of resources is a beginning. If you take the first step with openness and curiosity, it will lead to other steps….remember there is help out there!
If you liked what you read, please pass it on to others who would benefit. If you would like more information, go to my website and add yourself to my mailing list and become part of my Facebook community:
In good (mental) health,
Dr. Josh Friedman has more than 25 years experience in mental health as a client, psychologist, and functional nutrition practitioner. After working in the field for a few years, he realized how many people were still struggling with depression and other mental health issues even after years of therapy and medication. Over time he became increasingly uncomfortable with the limitations of standard psychiatric treatment and knew there had to be a better way. Over the past decade and a half, he has committed himself to learning as much as he could about the root causes of mental health symptoms. To share this information and to help people get unstuck, he started Alternative Mental Health Solution.