Updated: Sep 10
Psychiatry, Treatment Resistant
Dr. Bruce Kehr
My dear reader. In a recent blog post, I lamented that we psychiatrists have let many of our patients down by practicing a symptom-oriented, prescription medication-driven, one-size-fits-all treatment approach that leaves far too many of our patients continuing to struggle with chronic emotional problems. They become treatment-resistant and need a different approach to healing.
Holistic psychiatry, also known as integrative psychiatry or holistic mental health, focuses on each patient as a unique individual who has an “embodied mind.” By that, I mean that a patient’s capacity to feel good, have a normal range of human emotional expression, and be cognitively intact is not just a function of what goes on in their brain—it is far more complex than that.
Human Life Is Comprised of a Vast Information System Inside Us
Holistic or integrative psychiatry recognizes that inside our bodies, brains, and the cells that comprise them is a vast and enormously complex and integrated “information system” and that the myriad different components of the system are constantly talking to each other. It considers the interplay between the mind, body, emotions, and spirit in understanding and addressing mental health concerns.
Think this is just a lot of New Age hype? Read on to discover some mind-blowing examples of just how this works in us humans—and why we need to take this approach in any patient who is not recovering their mental health.
You Become What Has Been Transplanted Inside You
Consider this for a moment: For decades now, studies have demonstrated that patients who undergo heart transplants and receive a donor heart begin to adopt the personality characteristics and food preferences of the (now deceased) donor.
You know that familiar expression, “It’s a gut feeling”? A major study in the journal Nature Communications found that species of bacteria you have in your gut microbiome can have a profound effect on your risk of developing depression.
Of the 39 trillion “bugs” in your gut microbiome, the following bacterial species were identified as more abundant in depressed patients:
Additionally, these species of bacteria were depleted in depressed patients:
Ruminococcus gauvreauii group
Numerous studies have shown that fecal transplantation of healthy microbes into patients with depression and anxiety improved their symptoms. In contrast, transplanting unhealthy microbes into patients without these symptoms caused them to develop anxiety and depression.
Holistic Psychiatry in the Treatment Resistant Patient: Evaluate and Treat the Whole Person
Holistic psychiatry can be based on what is known as root cause analysis of all of the forces and factors that shape our mental health, as depicted in the infographic below. On the left-hand side are the “internal factors,” and below are the “external factors.” All of these factors can be addressed by a collaborative team approach involving a psychiatrist, a nutritionist, and a psychotherapist. A number of sophisticated, cutting-edge diagnostic tests can help delineate many of these root causes.
Holistic Psychiatry Uncovers the Root Causes of Treatment-Resistant Depression, Anxiety, OCD, or PTSD
Feel free to watch this webinar, entitled “Root Cause Psychiatry and the Treatment-Resistant Patient,” which illustrates how we treated two of our patients with treatment-resistant psychiatric conditions.
What are some of the domains we test for in holistic psychiatry?
Whether we want to understand genes related to mood or anxiety disorders, genetic drivers of autism spectrum disorders, or the prevention and treatment of cognitive decline and dementia, companies such as IntellxxDNA and Genomind provide actionable solutions.
Brain Health, Inflammation, and Autoimmunity
Anti-brain antibodies that are associated with infections such as strep, Lyme, EBV, and COVID can be detected by the Cunningham Panel. Inflammatory cytokines that help “set the brain on fire” can be detected by IncellKINE.
The 30 trillion cells in our body all affect how we feel and function. Tests such as NutrEval and Metabolomix assess mitochondrial function, oxidative stress and free radicals, methylation, omega 3 fatty acids, micronutrients, and more.
The 39 trillion microbes in your body are so important that I’ve written more than 50 blog articles about them. Tests such as the Gut Zoomer and GI Effects can search for “bad bugs” (pathogens), leaky gut syndrome, inflammation, maldigestion, and lack of production of essential molecules.
Immunologic and Infectious Disease Testing
A variety of tests can assess whether a dysregulated immune system may be affecting mental health, depending on the patient’s history and presenting problems.
To learn more about how we practice holistic psychiatry here at Potomac Psychiatry, visit our Root Cause Psychiatry page and our Nutritional Brain Health page, or feel free to contact us for a no-cost 15-minute consultation.