What is Integrative (Holistic) Psychiatry?
A blending of conventional and functional medicine approaches to target underlying root causes of symptoms and psychiatric illness. Incorporates leading-edge diagnostics, medication, nutraceutical, lifestyle modification, and psychotherapy techniques personalized to individual interests and needs.
Integrative Psychiatry combines conventional and functional medicine approaches into a whole-person (holistic) exploration of symptoms to identify the root causes of psychiatric symptoms using advanced laboratory and diagnostic analysis. Because the body (including the brain) reflects the external environment and visa versa this advanced approach allows for a more objective approach to lifestyle modifications and psychotherapeutic interventions. This approach looks deeper than conventional diagnostic labels (“Major Depressive Disorder”, “Social Anxiety Disorder”, etc.) to analyze less recognized causes of symptoms.
Illuminating the core domains in the image (above), the Integrative Psychiatry approach is more holistic. Treatment is tailored and personalized to each individual instead of a “one-size-fits-all” approach. Treatment options include medications, nutraceuticals (e.g., herbals and botanicals), therapy, and lifestyle modifications. Targeting problems with more precision will help you achieve holistic well-being.
Root Causes.
The brain and body are dynamically interrelated. A bodily-based abnormality impacts the brain and vice versa. The following are some common underlying causes of psychiatric illness that can be identified:
Vitamin and mineral imbalances such as vitamin D, B12, iron, magnesium, zinc, selenium, manganese, etc.
Adrenal dysfunction and cortisol (stress hormone) imbalances.
Imbalances in pregnanolone, progesterone, estrogen, testosterone, and DHEA.
Gut dysfunction includes intestinal barrier dysfunction, dysbiosis (overgrowth of fungus, bacteria, viruses, and parasites), and food allergies and sensitivities.
Detoxification impairment (phase 1 or phase 2) with buildup of toxic metabolic byproducts.
Thyroid dysfunction, including hypo- and hyperthyroidism and “subclinical” thyroid impairment.
Other metabolic abnormalities include mitochondrial dysfunction, high insulin, glucose dysregulation, high cholesterol, etc.
Inflammatory, infectious, or immune abnormalities.
Genetic abnormalities that contribute to any of the above areas.
Finding Root Causes.
An Integrative Psychiatry specialist considers advanced laboratory and diagnostic testing to explore root causes based on symptoms (phenotypic expression). Testing tends to be individualized but may include the following:
General vitamin and mineral labs.
Organic acid testing (OAT) to see a large view of most body systems (e.g., gut, mitochondria, vitamins and minerals, inflammation and oxidative stress, neurotransmitters, detoxification, etc.).
Hypothalamic-pituitary-adrenal (HPA, or stress axis) testing to evaluate cortisol and stress hormone activity.
Hypothalamic-pituitary-gonadal (HPG, or sex hormone axis) testing to evaluate pregnanolone, progesterone, estrogen, testosterone, and DHEA.
Comprehensive stool analysis to evaluate intestinal barrier activity, the gut microbiome, digestion, absorption, and signs of inflammation.
Advanced thyroid and cardiometabolic labs look at thyroid functioning, lipid (e.g., cholesterol) management, glucose regulation, and insulin activity.
Advanced infectious disease and autoimmune workups (e.g., Lyme testing, dental/nasal microbiome, chronic inflammatory response syndrome, mast cell activation syndrome, mold and mycotoxin testing, etc.).
Advanced psychiatric genetic testing.
Reflection of Root Causes.
Changes in the body systems (internal environment) reflect changes in the external environment, and vice versa. Using an advanced analysis of the brain and body and several interrelating factors, we can extend this into a more holistic consideration of the individual’s lifestyle (e.g., diet, exercise, stress management, sleep, relationships, occupational and academic performance, etc.). By simultaneously evaluating these internal and external systems, we can refine our targeting of underlying causes and contributing factors.
Treating the Whole Person.
Armed with this advanced analysis, an Integrative Psychiatric provider will help you with a tailored and personalized treatment plan that may include pharmaceuticals, nutraceuticals (e.g., herbals and botanicals), therapy, and lifestyle modifications. The Integrative Psychiatry specialist utilizes psychiatric medications (e.g., antidepressants, mood stabilizers, antipsychotics, stimulants, etc.) but in a much more guided way. Instead of having one option on the menu, Integrative Psychiatry brings a large toolkit of options to help with any situation. The goal is to provide a holistic treatment plan for your unique experiences instead of relying on guesswork, general population-based studies, and a one-size-fits-all approach. Ultimately, the Integrative Psychiatry practitioner aims to help you get in touch with your genuine Self and the qualities that this brings without being burdened by mind, body, and spirit imbalances. Our sights are on optimization, resilience, and wellness, not just disease eradication.
Putting it all Together.
We tend to look at experiences from a top-down approach divided into 3 phases. Refer back to the Integrative Psychiatry tree above.
In the first phase, we target problematic symptoms and syndromes significantly impairing functional capacity. In this first phase, we consider pharmaceuticals and nutraceuticals to stabilize symptoms. This can be thought of as the Tylenol for the fever, while we explore the source of the infection causing the fever. This first phase typically includes an examination of personalized labs and testing to identify key areas needing support (e.g., specific vitamins, micronutrients, et al. abnormalities). The leaves of the tree represent this first phase as it is the part of your experience that tends to be most visible in some way (i.e., impacting daily function).
In the second phase, we examine and treat body system alterations such as vitamin and micronutrients, genetic, gut, immune, metabolic, and hormonal changes contributing to symptoms. Several body systems make up the tree's trunk and impact one’s neurobiology. This phase works down to the roots (including genetic, vitamin, macronutrient, and micronutrient alterations). This phase may also incorporate therapy strategies aimed at trauma stored in the body.
In the third phase, we expand on personalized lifestyle interventions that support the body, mind, and spirit. We also incorporate ongoing therapy, body system work, and pharmaceutical/nutraceutical adjustment to maintain optimal health and wellness. In this phase, we focus on ways to build and strengthen the bridge between you and your goals and aspirations.
Some may be interested in only the first phase, whereas others may be interested in all phases. Also, there is some overlap among the phases. For instance, early use of lifestyle modifications (e.g., personalized sleep, exercise, relationship-oriented recommendations) may help tremendously during the first phase. We strive to help you establish an individual plan based on your needs and interests.
