Mental health challenges are common, and the numbers continue to rise globally. Some refer to mental health issues as a significant concern of the 21st century. From 2007 to 2017, there was a 13% increase worldwide, and roughly 20% of the global population experiences some type of psychological challenge. Suicide is the second leading cause of death among 15-29-year-olds, and individuals with severe mental health conditions may have a reduced lifespan due to preventable conditions like obesity and diabetes.
Neuropsychiatric challenges present a significant issue for our conventional healthcare system. While current treatment options, such as pharmaceuticals, can be effective to some extent, they may come with side effects and often do not address the underlying causes of the issues.
The evolution of integrative mental health approaches encourages viewing the body as an interconnected system. In the case of mental health challenges (and all chronic conditions), there may be miscommunication in the body that needs to be addressed to support optimal function. In this article, we’ll explore how bridging the gap between traditional psychiatry and root-cause approaches can offer hope for more comprehensive support.
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Traditional Psychiatry: Benefits and Limitations
Psychiatry is a field of medicine that focuses on the “diagnosis, treatment, and prevention of mental, emotional, and behavioral disorders.” Psychiatrists (whether medical doctors or doctors of osteopathic medicine) are trained to identify the mental and physical factors contributing to brain health symptoms.
Conventional psychiatric treatments often include a combination of prescription medications (such as antidepressants, antipsychotics, sedatives, anxiolytics, hypnotics, mood stabilizers, and stimulants) and psychotherapy (including cognitive behavioral therapy or psychoanalysis). Electroconvulsive therapy (ECT) may also be considered.
Prescription medications for mental health conditions can be helpful for some individuals. However, they may take time to work and can have adverse effects, such as weight gain and increased risk of chronic conditions. They may also interact with other medications and nutrient levels and can cause withdrawal symptoms if stopped abruptly.
Psychotherapy (talk therapy) involves building a relationship between provider and patient to help individuals learn how to manage their mental health symptoms. Psychotherapy can take many forms but often focuses on helping individuals change behaviors and thought patterns, explore past experiences, and solve problems in a healthy way.
Research suggests that psychotherapy can be a beneficial option for various mental health challenges. For example, when used alongside pharmaceuticals, psychotherapy may help reduce the recurrence of symptoms in individuals with bipolar disorder. It may also help manage depressive symptoms and support mental well-being.
While both medications and talk therapy can help manage mental health symptoms and improve quality of life, they may not always address the underlying causes. A root-cause approach, however, may offer more comprehensive support.
Root Cause Medicine: An Overview
Whereas allopathic medicine often focuses on identifying and managing symptoms and disease states (typically with medications), root-cause medicine aims to understand the underlying factors contributing to dysfunction. For example, instead of prescribing an oral hypoglycemic for high blood sugar levels, root-cause practitioners explore what may be causing the glycemic imbalance and then develop a targeted plan (which may still include medication) to address the underlying process and support normal endocrine and metabolic function.
The principles of root-cause medicine include viewing patients as unique individuals, which requires practitioners to investigate and understand how genetics, biochemistry, and lifestyle factors come together to impact a person’s health and quality of life. Instead of viewing body systems as separate entities, root-cause medicine takes a holistic view of the body as an interconnected system. When dysfunction occurs in a subsystem, it may reflect a larger miscommunication in the body that requires a personalized approach.
Root-cause practitioners conduct thorough background assessments to map a patient’s unique story and better understand why symptoms are present. While traditional lab testing is often used and can be helpful, root-cause practitioners also incorporate integrative and functional tests like hormone panels, comprehensive stool testing, and advanced cardiac profiles to identify early dysfunction and the underlying factors contributing to symptoms. When root causes are identified, practitioners can better personalize the plan to the individual. The advantage of root-cause medicine is the ability to incorporate traditional treatment options along with complementary and integrative approaches to support patient outcomes.
The Mind-Body Connection
Whether you recognize it or not, we’ve all experienced the effects of the mind-body connection. It’s the urge to run to the bathroom before public speaking or the fatigue you feel after a particularly stressful day. The mind and body are in constant communication with each other via various chemical messengers regulated by neural pathways.
While it may be difficult to conceive of how the mind (which is not a physical entity) could interact with the physical body, research suggests a bi-directional mind-body relationship exists wherein mental health issues impact the physical body and vice versa. Anger, hostility, chronic stress, social stressors, anxiety, depression, and pessimism have all been found to significantly increase the risk of cardiovascular disease. Depression may increase the risk of chronic pain, obesity, dementia, and diabetes. Evidence also shows that people with severe mental health challenges (like schizophrenia) may have a shorter lifespan compared to their healthy counterparts due to preventable chronic health conditions.
While poor mental health can impact physical health, having a chronic condition, like autoimmunity, heart disease, diabetes, cancer, or dementia, may also increase the risk of mental health symptoms like depression. This increased risk is related, in part, to physical health’s impact on mental well-being but may also be the result of physical changes to brain structure and function.
Functional Medicine Labs to Assess Mental Health
Traditional labs can provide some insight into root causes. For example, a standard thyroid panel can determine if altered levels of thyroid hormone are contributing to mental health symptoms like depression and brain fog. However, there are usually multiple contributing factors when it comes to poor mental health, so here are some functional medicine labs to consider.
Micronutrient Testing
Altered levels of nutrients may be one factor contributing to mental health symptoms. Micronutrient testing, such as the one by SpectraCell Laboratories, can help identify specific nutrients of concern for an individual, allowing practitioners to tailor meal plans and supplement suggestions.
Comprehensive Stool Testing
Alterations in digestive health can have implications for mental well-being. A comprehensive stool test, like the GI-Map by Diagnostic Solutions, can provide valuable information about digestion, absorption, immune system function, and microbial imbalances that may be impacting the gut-brain axis.
Glucose Regulation Testing
Glucose dysregulation can impact inflammation levels in the body as well as affect mood. Identifying early glucose dysfunction, or poor glucose control, allows providers to personalize diet and lifestyle changes to support optimal blood sugar levels.
Hormone Testing
Hormonal alterations may be linked to mental health symptoms. Comprehensive hormone testing can help practitioners better understand how hormonal imbalances may be contributing to symptoms. The DUTCH Complete test by Precision Analytical provides information about sex and adrenal hormones and their metabolites and also includes information about cortisol, organic acids, melatonin, and 8-OHdG.
Neurotransmitter Testing
Urine neurotransmitter testing can help practitioners assess the health of the nervous system. The NeuroBasic Profile by Doctor’s Data tests for inhibitory and excitatory neurotransmitters like serotonin, dopamine, GABA, and glutamate to provide information about nervous system imbalances.
Heavy Metal Testing
Heavy metal exposure can impact mental and physical health. Testing for heavy metal exposure can help identify and monitor exposure to heavy metals.
Environmental Toxin Testing
Exposure to environmental toxins can impact the mental health of some individuals. If toxin levels are elevated, practitioners can personalize a plan to reduce exposure and support detoxification.
Nutritional Psychiatry
We often think of food as innocuous, but food provides information for the body. Every bodily process requires nutrients on some level, and ultimately, food is how we survive and thrive. Nutritional psychiatry aims to highlight the impact that nutrition can have on mental health and provide evidence-based guidance on how to use food and nutrients to support mental well-being.
Since brain structure and function rely on appropriate levels of nutrients (carbohydrates, fats, proteins, vitamins, minerals, and water), it makes sense that inadequate nutrient levels can impact brain function. Studies have found insufficient levels of micronutrients to be associated with an increased risk of depression, and a poor diet may exacerbate mood disorders like anxiety and depression. The impact of a poor dietary pattern on mental health may be related to increased inflammation, altered hormonal cues, blood sugar dysregulation, and gut-brain axis disruption.
The gut-brain axis and nutrition is an exciting area of research. We now understand that the gut microbial community is vital for overall health and brain function. The microbes within us exist in a symbiotic relationship where we provide them with food, and they digest that food to, in turn, provide us with energy, nutrients, and signaling molecules (like neurotransmitters) that travel to the brain. The brain then sends out messages to the rest of the body to help maintain balance. When the gut environment is disrupted (via poor diet or other factors), miscommunication can occur along the gut-brain axis, which may contribute to mental health symptoms.
But just as a poor diet can lead to or exacerbate mental health symptoms, a wholesome dietary pattern can help reduce inflammation, support the gut-brain axis, regulate blood sugar, and encourage the production of hormones and neurotransmitters. Nutritional psychiatry offers hope that food can become an ally in supporting mental well-being.
Lifestyle Factors and Mental Health
Nutrition can significantly impact mental and physical well-being, but other lifestyle factors are equally important. Lifestyle changes for mental wellness should consider sleep, physical activity, stress, and environment.
Sleep’s role in mental health is complex, but a disrupted circadian rhythm (the sleep-wake cycle) is associated with mental health challenges and may contribute to neurodegenerative conditions. Suboptimal sleep is also closely tied to poor physical health, creating a cycle where poor sleep is both a cause and consequence of mental and physical challenges. Encouraging individuals to improve their sleep quality by creating a healthy sleep routine, avoiding food intake within a few hours of bedtime, and sleeping in a dark, cool, quiet environment can help establish a healthy sleep foundation.
It’s well-known that exercise is important for physical health, but it’s also a valuable tool for supporting mental health. Aside from benefits for the physical body, moving in healthy ways can improve mood, reduce depressive symptoms, boost energy and self-confidence, reduce stress, and improve sleep. In fact, one meta-analysis comparing exercise to antidepressants found exercise to be as effective as antidepressant medications in individuals with non-severe depression. New exercisers may want to start with a moderately intense walk several times per week and then build up to incorporate other cardiovascular exercises (swimming, biking, jogging) and resistance training.
Unmanaged stress is a risk factor for both mental and physical health conditions, so it’s important to educate individuals on effective stress management techniques. Some evidence-based strategies include mindfulness meditation, art therapy, and yoga. These types of therapies can help shift individuals from the sympathetic nervous system (fight or flight) to the parasympathetic nervous system (rest and digest), which helps balance the chemical messengers traveling to the brain and body.
Research is shedding light on how toxin exposure (i.e., air pollution, heavy metals, and pesticides) can impact mental and physical health. Educating individuals on how to avoid toxins and use nutrition and supplements to support natural detoxification can be beneficial. An additional environmental concern is the lack of adequate sunlight. People with mental health challenges may spend more time indoors under artificial lighting, which can impact mood and exacerbate mental health challenges. Sunlight is important for supporting healthy serotonin (a neurotransmitter important for mood) and melatonin (a hormone involved with circadian rhythm) levels, so individuals should be encouraged to spend time outdoors in natural light if possible.
Integrating Traditional and Root Cause Approaches
There’s no question that pharmaceuticals and talk therapy can provide some relief from mental health symptoms. However, simply using the traditional approach without incorporating root-cause strategies may not fully address the needs of many individuals. While symptom management is important, the overall goal should be to support an optimal quality of life, and medication and therapy alone may not always achieve that result.
Collaborative mental health treatment, on the other hand, considers the whole person and offers a personalized, comprehensive plan that addresses the underlying factors contributing to symptoms. This shifts the focus from the condition to the individual. Instead of matching a drug to a symptom, the approach asks why the symptom is present and then creates a plan to address that process. Integrative psychiatry and root-cause strategies can enhance the effectiveness of traditional treatments, potentially reduce the need for psychiatric medications (and hospitalizations), and offer the best opportunity for individuals with mental health challenges to experience improved well-being.
Challenges and Future Directions
While incorporating root-cause strategies into standard mental health treatment is promising, there are challenges in integrative psychiatry. First, the field of psychiatry itself appears to be shrinking, so it’s important for other healthcare providers to become well-trained in delivering integrative mental healthcare.
Additionally, there is a need for more well-designed clinical trials to demonstrate the impact of root-cause strategies on mental health outcomes to increase acceptance among traditional providers. Many individuals with mental health symptoms use complementary and alternative methods with positive results. They often report better physical, emotional, cognitive, social, and spiritual functioning, fewer symptoms, and improved overall wellness. However, less than half of those who use these therapies share that information with their provider due to concerns about stigma associated with alternative options.
Finally, mental health symptoms exist on a spectrum, and individuals with the most serious mental health challenges may find it difficult to consistently implement diet and lifestyle recommendations. This is why the future of mental health treatments should blend the best of both worlds. Treatment needs to be personalized based on root causes and an individual’s ability and access to alternative options.
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Summary
Mental health challenges are a significant global issue that continues to grow. Our current treatment model may not provide optimal results for everyone. However, those embracing integrative mental health strategies that address root causes often experience enhanced outcomes. Mental health treatment requires open-mindedness and collaboration to bring both traditional and root-cause approaches to all individuals facing mental health challenges.
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