An Integrative Approach to Mental Health

Mental health includes emotional, psychological, and social well-being. It impacts how we think, feel, and act. When we have good mental health, we feel content, we can think clearly, and our moods feel well within our control.  

Mental illness is a condition in which someone's ability to think, feel, or act is impeded. Nearly 20% of adults in the U.S. will experience a mental illness this year. Approximately 4% will experience a serious mental illness that substantially interferes with or limits one or more of their major life activities.  

This article will cover common and effective functional medicine approaches for mental health conditions and the evidence-based, natural treatments for mental health disorders that will help you and your loved ones heal and thrive!

This article is the first in a 10-part series focusing deeply on mental health conditions and what people truly need in order to heal holistically.

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What is Mental Health?

According to the World Health Organization (WHO), "Mental health is a state of mental well-being that enables people to:

• Cope with the stresses of life.
• Realize their abilities (accomplish their goals).
• Learn well.
• Work well.
• Contribute to their community."

Optimal mental health depends significantly on having a healthy body, healthy habits, good psychological skills, and resiliency. There are many things that a person can do to optimize their health, including consuming a nutrient-rich diet, exercising, sleeping well, engaging in talk therapy, and more.

Common Mental Health Diagnoses That Integrative Medicine Can Help With

ADHD

Attention deficit hyperactivity disorder (ADHD) affects 15% of children and 8% of adults in the U.S. annually. It is one of the most common childhood disorders, often continuing through adolescence and adulthood. The National Institutes of Mental Health (NIMH) notes that the key symptoms of ADHD include:

• Difficulty staying focused and paying attention
• Difficulty controlling behavior
• Hyperactivity (over-activity)

ADHD Integrative Medicine Treatment Options

A functional medicine approach to treating ADHD is covered extensively in this article and begins with testing to find the root cause. These tests may include screenings for nutrient deficiencies, heavy metals, food sensitivities, and hormone imbalances. Treatments are then created to address each person's individual situation.

Integrative treatment for ADHD can be highly effective. Did you know, for example, that optimizing zinc can help some people reduce the need for ADHD medications by 37%? This can result in better symptom control with fewer side effects and is a beautiful example of how nutrition and pharmaceuticals can work together to give people incredible results.

Anxiety/Generalized Anxiety Disorder (GAD)

GAD is characterized by "excessive anxiety and worry about a variety of events or activities that happen more days than not, for at least six months." People with GAD find it difficult to control worry, which may cause impairment in social, occupational, or other areas.

Classic GAD symptoms can include excessive worry/knowing that worry is excessive, feeling restless or feeling tired all the time, frequently feeling irritable, having difficulty concentrating, startling easily, experiencing headaches and other pains that present with no known medical reason, frequent sweating, feeling lightheaded or out of breath, and going to the bathroom a lot.

GAD also frequently co-occurs with other medical disorders, including

• Digestive or bowel problems, such as irritable bowel syndrome or ulcers
• Headaches and migraines
• Chronic pain and illness
• Sleep problems and insomnia
• Heart-health issues

GAD Integrative Medicine Treatment Options

A functional medicine approach to treating GAD includes screening for nutrient deficiencies, including iron, magnesium, zinc, and more, as well as ruling out medical conditions like hyperthyroidism and anemia, which can worsen anxiety. Common lab tests to help identify the root cause of GAD may include a thyroid panel, CBC, CMP, and an iron panel; Some people may also require testing for food allergies and sensitivities and other health conditions that can increase feelings of anxiety. These tests can help reveal the root-cause issues and help develop a whole-person treatment protocol, including talk therapy, nutrition, supplements, exercises, and more, to improve symptoms and give a person much more control over their life and mood.

Libby is an excellent example of a client who used functional medicine to improve her Generalized Anxiety disorder. You can read her story here.

Panic Attacks

Panic attacks are those episodes of intense fear that accompany alarming physical symptoms like chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress. The NIMH notes that these episodes occur " 'out of the blue,' not in conjunction with a known fear or stressor." People with recurrent episodes of panic are diagnosed with panic disorder.

People with a panic disorder can become socially isolated as they worry about when the next attack might happen. They try to prevent future attacks by avoiding triggering situations, places, people, or behaviors that they've come to associate with panic attacks. Thankfully, several effective treatment options are available to resolve panic disorders using a root cause approach.

Panic Attack Integrative Medicine Treatment Options

A functional medicine approach to treating panic attacks is covered extensively in this article. Typically, the approach starts with screening for common nutrient deficiencies that impact people with panic disorder. Testing also goes further, looking at the thyroid, cholesterol, estrogens and hormones, histamines, heavy metals, food allergies, and food sensitivities, on top of standard labs like a CBC and CMP. Armed with the information from these tests, patients and doctors can work together to design a holistic plan to heal the root cause of their panic disorder symptoms. This plan could include any number of evidence-based approaches to panic disorder treatment, including CBT and DBT therapy, pharmaceutical medications, biofeedback, mindfulness and meditation practices, dance and art therapies, exercise, and more.

You can read an example of one patient - Mary - who healed her panic attacks in just a few weeks using an individualized functional medicine plan here.

Post-Traumatic Stress Disorder (PTSD)

PTSD can occur in anyone of any age "following exposure to an extremely threatening or horrific event or series of events." The WHO characterizes PTSD as a disorder characterized by the following symptoms, which "persist for at least several weeks and cause significant impairment in functioning:

• Re-experiencing the traumatic event or events in the present (intrusive memories, flashbacks, or nightmares)
• Avoidance of thoughts and memories of the event(s) or avoidance of activities, situations, or people reminiscent of the event(s)
• Persistent perceptions of the heightened current threat"

More than 7 out of every 100 people will experience PTSD at some point in their lives. Children and teens may present with different symptoms than adults. According to the NIMH, while teens may show "disruptive, disrespectful, or destructive" behaviors, "symptoms sometimes seen in very young children (less than six years old) can include:

• Wetting the bed after having learned to use the toilet
• Forgetting how to or being unable to talk
• Acting out the scary event during playtime
• Being unusually clingy with a parent or other adult"

PTSD Integrative Medicine Treatment Options

Treating PTSD requires a multi-faceted, holistic approach. This approach typically includes therapy, community and family support, lifestyle changes, medications, complementary and alternative approaches like yoga, acupuncture, and more. Evidence suggests that common functional medicine modalities like nutrition, homeopathy, mindfulness therapies, and more can be effective in helping people to manage PTSD. Emerging therapies for PTSD even include EMDR and psychedelic-assisted therapy.

People with PTSD are at increased risk of deficiencies in antioxidant nutrients like vitamin C, E, B6, selenium, magnesium, and omega-3 fatty acids. A functional medicine doctor may help someone test for these deficiencies and design a plan to get them a nutrient-rich diet to optimize their antioxidant status and reduce symptoms.

Common lab tests to help identify the root cause of PTSD symptoms like hyperarousal, insomnia, anxiety, and more may include a thyroid panel, CBC, CMP, nutrient panel, heavy metals, microbiome analysis, cortisol testing, urine porphyrins, and more.

With a comprehensive plan, people with PTSD can reduce their responses to triggers, regain control of their internal environment and become empowered to heal in any circumstance. It's an incredible feeling that's well within reach with the right team and support!

Obsessive-Compulsive Disorder (OCD)

OCD is a disorder that often emerges in childhood or young adulthood and can persist for years. Its hallmarks are uncontrollable, recurring thoughts, called obsessions, that can lead to repetitive behaviors, known as compulsions. People with OCD can present with obsessions, compulsions, or both.

The NIMH explains that "although everyone worries or feels the need to double-check things on occasion, the symptoms associated with OCD are severe and persistent. These symptoms can cause distress and lead to behaviors that interfere with day-to-day activities. People with OCD may feel the urge to check things repeatedly or perform routines for more than an hour each day as a way of achieving temporary relief from anxiety. If OCD symptoms are not treated, these behaviors can disrupt work, school, and personal relationships and can cause feelings of distress."

Obsessions can take many forms. Common obsessions include:

• Fear of germs or contamination
• Fear of forgetting, losing, or misplacing something
• Fear of losing control over one's behavior
• Aggressive thoughts toward others or oneself
• Unwanted, forbidden, or taboo thoughts involving sex, religion, or harm
• Desire to have things symmetrical or in perfect order

Compulsions to find relief also show up in many ways. Common compulsions are:

• Excessive cleaning or hand washing
• Ordering or arranging items in a particular, precise way
• Repeatedly checking things, such as the door is locked or the oven off
• Compulsive counting

OCD Integrative Medicine Treatment Options

A functional medicine approach to treating OCD starts with testing focusing on neurotransmitters, micronutrients, and the immune system to get to the bottom of what's causing the disorder. Glutamate, for example, is the most abundant excitatory neurotransmitter in our body and regulates learning, memory, and anxiety levels that can be altered in people with OCD. Functional treatment to balance glutamate and other neurotransmitters like serotonin and GABA can be part of a comprehensive plan to help people with OCD find relief. A nutrient-rich diet and targeted supplement approach can help people optimize their neurotransmitter levels naturally and effectively, as Dr. Carrie Jones covered recently on the RUPA podcast.

For people with a subset of OCD-like conditions triggered by immune activity (for example, PANDAS), a functional medicine approach to autoimmune conditions can work to quell autoimmune activity and reduce symptoms.

In my clinical experience, our clients with OCD respond to a whole-person plan that includes both traditional and integrative health interventions. These include therapy, pharmaceuticals, nourishing foods, supplements, and complementary and alternative therapies like acupuncture and mindfulness meditation.

Depression

Depression (also called major depressive disorder or clinical depression) is a serious mood disorder that can cause symptoms "that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working." At least 16 million adults in the U.S. had at least one major depressive episode in the past year. A depressive episode is characterized by experiencing some of the following symptoms "nearly every day, for at least two weeks:

• Persistent sad, anxious, or 'empty' mood
• Feelings of hopelessness or pessimism
• Feelings of irritability, frustration, or restlessness
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies and activities
• Decreased energy, fatigue, or feeling 'slowed down'
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, early morning awakening, or oversleeping
• Changes in appetite or unplanned weight changes
• Thoughts of death or suicide, or suicide attempts
• Aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not ease even with treatment
• Suicide attempts or thoughts of death or suicide"

Not everyone who is depressed experiences every symptom. The severity and frequency, how long they last, and the stage of illness can vary significantly from person to person. The good news is that no matter your symptoms, there's hope for improving symptoms of depression and getting back to feeling happy and full of life!

Depression Integrative Medicine Treatment Options

A functional medicine approach to treating the root causes of depression is extensively covered in this article. It includes testing for micronutrient deficiencies, hormone imbalances, heavy metals, and food sensitivities. Robust testing will result in an individualized plan consisting of food-as-medicine, eliminating allergens and sensitivities, supplements, hormone replacement, and lifestyle changes for optimal intake of nutrients and micronutrients.

Bipolar Disorder (I & II)

Bipolar disorder affects 2.6% of adults in the U.S. each year. It is usually diagnosed during the late teen years or early adulthood. It can sometimes present in children, but less frequently.  

Bipolar disorder is a group of three types of mood disorders involving abnormal, uncontrolled mood changes, activity, concentration, and energy. Symptoms can range from mild to severe and often impact a person's ability to live, work, and care for themselves or others. Some people may experience both manic ("up") and depressive ("down") symptoms in the same episode; this is called a mixed features episode.

According to the NIMH, "people with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and uncharacteristic behaviors, often without recognizing their likely harmful or undesirable effects." These mood episodes can last up to several days or weeks and include:

Manic Symptoms:

• Feeling up, high, elated, or irritable
• Feeling jumpy, wired, or more active
• Less need for sleep
• Talking fast about several different things at once
• Racing thoughts
• Ability to do many things at once without tiring
• Excessive need for food, drinking, sex, or other activities
• Feeling important, talented or powerful

Depressive Symptoms:

• Feeling down, sad, or anxious
• Feeling slowed down or restless
• Trouble falling asleep
• Waking too early or sleeping too much
• Talking slowly, having difficulty finding what to say, or forgetting a lot
• Difficulty concentrating or decision-making
• Difficulty with simple tasks
• Lack of interest in activities
• Feeling hopeless or worthless
• Thinking about death or suicide

The three types of bipolar disorder are characterized by the degree of manic, depressive, or less severe manic periods called hypomanic episodes:

• Bipolar I: Manic episodes that last most of the day, almost every day, for at least seven days, or manic symptoms so severe that they lead to hospitalization. In many cases, there are also depressive episodes that last at least two weeks. A person with bipolar 1 may also experience depression with mixed features — manic and depressive symptoms at the same time. Someone who experiences four or more episodes of mania or depression within a year is considered to have "rapid cycling."
• Bipolar II: A pattern of depressive episodes and hypomanic episodes that are less severe than bipolar 1 manic episodes.
• Cyclothymic disorder (or cyclothymia): Recurrent hypomanic and depressive symptoms that are not as intense nor last as long to fit into the definitions for hypomanic or depressive episodes

Sometimes a person might experience symptoms of bipolar disorder that do not match the three categories listed above, referred to as "other specified and unspecified bipolar and related disorders." Although the symptoms may vary over time, bipolar disorder usually requires lifelong treatment. Following a prescribed treatment plan can help people manage their symptoms and improve their quality of life.

Bipolar Integrative Medicine Treatment Options

A functional medicine approach to treating bipolar disorder is covered in this article. The first step includes root-cause testing, including thyroid, cortisol, hormones, total antioxidant capacity, micronutrients, oxidative stress biomarkers, blood sugar, and more. The results of these tests, along with each person's unique history, genetics, lifestyle, preferences, and symptoms, will inform a personalized treatment plan. Along with pharmaceutical medications, functional medicine treatments like exercise, food-as-medicine nutrition and supplements, and therapy and mindfulness can improve symptoms of bipolar and help people who live with it to thrive!

Conventional Treatment for Mental Health

Conventional treatment for mental health typically involves a combination of medications and therapy. The specific treatment plan will depend on the individual's specific condition and needs and may employ medications, therapy, or both.

Medications: The most common conventional medications used for mental health conditions are antidepressants, antipsychotics, and mood stabilizers:

• Antidepressants are used to treat depression, anxiety, and other mood disorders
• Antipsychotics can be used to help manage the symptoms of psychosis
• Mood stabilizers are used to treat mood disorders, such as bipolar disorder, which is characterized by extreme swings in mood

Therapy: Sometimes known as psychotherapy or talk therapy, therapy is another conventional treatment for mental health disorders. Some of these are:

• Cognitive-behavioral therapy (CBT), which helps individuals to identify and change negative thought patterns and behaviors
• Interpersonal therapy (IPT), which focuses on relationships and communication
• Dialectical behavior therapy (DBT), which helps individuals to manage their emotions and improve their relationships
• Family therapy can be used to help people with mental illness build close, supportive relationships with their loved ones and reduce stress in their homes

When considering conventional therapies, It's essential to work closely with a healthcare practitioner to determine the most appropriate treatment plan for your specific mental health condition. Practitioners should know that when conventional treatments stall or fail, then there are integrative approaches that can make a difference.

Integrative Medicine Treatment for Mental Health

Integrative modalities for addressing mental health disorders include nutrition, acupuncture, herbal medicine, homeopathy, mindfulness therapies, meditation, hypnosis, yoga, exercise, and more. Functional medicine treatment for mental health disorders generally involves finding the root cause of symptoms and designing an individualized treatment plan to address them. Functional medicine treatment modalities can be used alongside traditional treatment approaches to give people optimal results.

You can read real-life examples of exactly how functional medicine doctors have successfully treated people with mental health disorders using an integrative approach. One example is Libby's story of healing from GAD. Another is Mary's story of healing from panic disorder.

Summary

An integrative approach to mental health is one way to bring all the pieces together and create a comprehensive plan to tackle mental health disorders so folks can thrive. These plans might include any combination of psychotherapy, mindfulness, coaching, psychiatric treatment, medications, supplements, nutrition, herbal medicine, acupuncture, homeopathy, and more. An excellent functional medicine approach starts with individualized assessment and testing, then a personalized plan to heal the root cause and remove the barriers to healing. The end result is helping people create a life filled with joy, productivity, and happiness!