A Holistic Approach to Mental Healthby Naveen Thomas, M.D., M.P.H.
Editor’s Note: The terms “integrative” and “psychiatry” are well known, but “integrative psychiatry?” Now an emerging field in mental health, the practice aims to bring together the best of two worlds: conventional psychiatry and holistic practices. Atlanta integrative psychiatrist Naveen Thomas offered to tell Natural Awakenings readers all about it.
Integrative psychiatry is an approach to mental health that is dedicated to addressing root causes of mental health symptoms rather than merely suppressing them with medications. It seeks to blend the best of conventional psychiatry with the best practices outside of it. To understand it better, let’s compare the experience of visiting a traditional psychiatrist with a visit to an integrative psychiatrist.
When a person goes to a conventional psychiatrist and describes their symptoms, the psychiatrist usually makes a diagnosis using the Diagnostic and Statistical Manual of Mental Disorders, now in its fifth edition (DSM-5). Typically, the doctor will find a medication treatment that corresponds with the diagnosis and then will prescribe psychiatric medications, often indefinitely, to mitigate the symptoms. A psychotherapy referral might also be given.
This approach is not necessarily a bad thing, and it can greatly reduce suffering in many cases. However, it has some very significant limitations. Simply suppressing symptoms without addressing their root causes can be a recipe for an unfulfilled life and can be an invitation for new problems—such as debilitating side effects from the medications—to arise. For example, if one principle root cause of a patient’s depressive symptoms is nutritional deficiencies, such as very low Vitamin D or iron levels, using one or more anti-depressants to provide mood relief without addressing the nutritional deficiency is not likely to be successful in the long term.
Some common root causes underlying problematic symptoms include imbalances in the gut environment, unresolved emotional trauma, relationship disturbances, nutritional imbalances, genetic vulnerability, hormonal imbalances, environmental toxins and chronic infections—to name a few. This list admittedly can be overwhelming, and it often requires a team approach to address the underlying issues effectively.
Drawing from the best of both worldsIf a person sees a skilled integrative psychiatrist, they will likely have a very different experience. The psychiatrist will conduct a thorough mental and physical health history but will also initiate a search for root causes and start to formulate a comprehensive treatment plan. They might want to obtain both conventional and specialty labs tests as well as assess diet and lifestyle habits. They might suggest intervention, such as inclusion of certain dietary supplements, or lifestyle changes. If necessary, integrative psychiatrists might choose to use psychiatric medications, but they often will opt to use the fewest number possible, at the lowest effective doses and with the least-burdensome side effects.
This approach might also include interventions such as recommending meditation, yoga, biofeedback or other self-regulating modalities. As a general rule, this approach requires more time and resources. Since insurance companies generally won’t compensate the integrative psychiatrist for this extra work, it’s likely that the vast majority of integrative psychiatrists have opted out of the insurance model.
The integrative psychiatrist will conduct a thorough mental and physical health history but will also initiate a search for root causesIf you see an integrative psychiatrist, please bring the courage to think outside the box and to try approaches that you might not have heard of. Although everyone wants quick release from suffering and discomfort, patience and perseverance are often necessary if one wants to do the deeper, meaningful work of true healing. The eventual payoff can be monumental; you may experience positive changes in areas of your life that you had not dreamed possible.
Dr. Thomas practices holistic psychiatry in Atlanta but will be relocating to Boulder, Colorado in the near future. He has a fellowship in Integrative Medicine and recently completed training in Ketamine Assisted Psychotherapy. For more information, visit ClarityPsychiatry.com