What is Integrative Psychiatry?

Before we talk about integrative psychiatry, let’s zoom out just a bit to define integrative medicine as a whole. Integrative medicine is the act of including relevant complementary and/or alternative treatments into the care of patients based on their specific needs and goals. In integrative psychiatry we are applying the general principles of integrative medicine to the field of mental health.

Ok, but what does complementary or alternative treatment even mean?

Complementary means the combination of two or more therapies, like medication and psychotherapy. By using a combination of treatments, symptoms have the potential to be managed better. In integrative psychiatry, the list of complementary treatments is quite long and includes a variety of psychotherapy approaches, nutritional support, acupuncture, exercise support, behavioral adjustments, supplementation, mindfulness, meditation, and even massage therapy, aroma therapy, or reiki, to name a few.

In contrast, alternative means we use different treatment altogether. With integrative psychiatry, the list is very similar to the treatment options we have already discussed. In this instance, though, we are selecting a treatment that may be different from what is traditionally recommended. It is important to note that certain acute situations are not suitable for alternative treatments.

How integrative psychiatry works

Traditional psychiatry is pretty much one thing: medication. Integrative psychiatry is so much more. The process is not a straight line – you don’t come in sit down, receive a prescription and go on your way. The integrative psychiatry process is dynamic and one complete package:

(Note: there is no specific order to these components, each person will have a completely unique formula in their treatment plan)

· Psychotherapy:

Psychotherapy is one of the most important pieces of any mental health treatment plan. Integrative psychiatry is evidence-based. Psychotherapy is among the most effective treatments for any mental health diagnosis. I practice Acceptance and Commitment Therapy (ACT). Even in my 25 minute appointments we do at least a few minutes of therapy.

· Medication management:

Ahh, he’s pushing meds! Noo, give me a second to explain. Medication is important! It has a place in the treatment formula. Integrative psychiatry says medication can be good. Integrative psychiatry also says medication should not be the only ingredient in the formula. I prescribe cautiously – even the most effective medications have their downsides.

In summary: with integrative psychiatry we don’t rely only medications.

· Coaching:

This isn’t basketball or cheerleading. This is lifestyle coaching. Integrative psychiatry gives us the space to work on changing lifestyle factors like routines, developing goals, and building out our future. Traditional therapy suggests the provider limit sharing specifics, but with coaching we can be more collaborative.

· Supplementation:

Supplementation gets a bad rep. Some providers call it quackery. But again, the evidence is

clear, there are certain supplements that actually work. Using supplements like lithium orotate can make a big difference. And while supplements won’t work for everyone, some people stand to benefit tremendously from incorporating supplements into their lives. The integrative psychiatry approach gives us a platform to incorporate supplements safely into our treatment plans.

· Nutrition:

What we eat is critical to our physical AND MENTAL health. Using food as a way to impact mental health is a part of nutritional psychiatry by addressing inflammation and other bodily processes. If it is good for your heart, it is good for your brain. With integrative psychiatry we are empowered to assess our nutritional intake as part of the treatment plan. Believe it or not, some folks can improve drastically just by making changes to their nutritional intake.

· Exercise:

This is my favorite. There is growing evidence to support the use of exercise as a treatment for mental health diagnoses. I believe including exercise is a critical component of every integrative treatment plan. We’re not talking about Olympic athlete stuff here (unless that’s your thing). We’re talking about simple daily exercise that will drastically improve your overall mental health.

· Comprehensive testing:

There are so many tests we can run to take a look inside – most of traditional psychiatry just ignores this! With integrative psychiatry we are talking about all kinds of tests: genetic, hormonal, and how your body processes medication or nutrients. If we can pinpoint an underlying cause of the problem, we’re more likely to be able to overcome it!

· Any additional complementary/alternative treatments:

Maybe my second favorite. Things like mindfulness, yoga, acupuncture, and so on have a tremendous amount of evidence to support their use. Integrative psychiatry says USE THEM! If it is safe, there is little downside. Incorporating additional complementary/alternative treatments is what integrative psychiatry is all about.

As a patient, why give integrative psychiatry a try?

Integrative psychiatry a space where patients are viewed as individuals and are not funneled into one-size-fits-all treatment plans. In integrative psychiatry, patient individuality is celebrated. To state it simply, I do not try to fit patients into a box when developing a treatment plan.

Here are a few integrative psychiatry fundamentals that give you an idea of what you can expect working with me:

1. Each patient is unique, their treatment should be too

I know this sounds like a broken record at this point, but it bears repeating. I do not have a copy and paste approach to the management of depression or anxiety. In integrative psychiatry, no two patients should have identical treatment plans.

2. Root causes should be uncovered, if possible.

Some diseases have unknown causes – but many can actually be explained by taking a look under the surface. Integrative psychiatry demands that we look at potential root causes. This helps us find out what works and what doesn’t work and is often completely forgone in traditional psychiatry.

3. As long as it is safe and evidence-based, we can try it.

Let’s say you heard yoga was helpful in the management of anxiety and that you want to give it a try, we will find a way to make this a part of your treatment. (FYI, loads of evidence support this claim).

4. A strong relationship with a patient is the key to success.

Integrative psychiatry asks the provider to know the patient inside and out knowing that there is no possible way to effectively treat someone with 10 minute interactions every three months. Getting to know each other is crucial to integrative psychiatry.

5. Let’s fill in the gaps.

I work to get to know you, like really really know you. You’ll be asked about your beliefs, bowel movements, what you ate, and maybe even last time you had sex. Integrative psychiatry seeks to treat the whole person. How can we do that if we leave large gaps in what we share with our provider? It might feel invasive, I get it! Please know that I will never judge and I will constantly work to make our time together comfortable and casual.

6. The best answer might actually be the traditional one.

Integrative psychiatry is not quackery – it is still science-based. If the right answer is seemingly traditional, that is okay. You can bet we will still fill in the gaps and include complementary approaches too, but many times the best answer includes the use of medication as the foundation of a treatment plan.

That sounds great, what else should I expect?

As with any field of medicine, integrative psychiatry requires a good fit between patient and provider. The patient should look for a provider that feels like a good fit. After all, being comfortable enough to share highly personal information is part of the integrative psychiatry process, even more so than traditional psychiatry.

I tell folks looking for a new psychiatric provider to view it as a job interview. Maybe you’re a woman looking for a female provider – in that case, I wouldn’t be a good fit! Or maybe you’re a small business owner struggling with anxiety – bingo, I might be the one (I am a serial entrepreneur and I work with lots of small business owners)! The bottom line is finding someone with whom you can see yourself forming a connection.

After you have found a provider who practices integrative psychiatry, be ready to commit yourself financially and to the integrative process. In many cases, you’ll be paying for these services out-of-pocket. The integrative psychiatry model requires a ton more time per patient. In fact, for a 50 minute appointment, I spend an average of 30 minutes before and 30 minutes after each appointment reviewing information, sending you a follow-up summary, and working behind the scenes to give you the best care I can.

You should expect to put in the work, too. My approach to integrative psychiatry is very hands on and I tend to give lots of actionable “homework” like journaling or other assignments. If you’re not ready to devote the time and energy into healing, you may want to ask yourself if this approach is for you.

Integrative psychiatry is the most holistic form of psychiatry and offer patients the best chance for long-term success.

- While integrative psychiatry can benefit any patient, it is best suited for depression, anxiety, ADHD, and bipolar spectrum disorders

- Integrative psychiatry is not magic. Integrative psychiatry is the use of evidence-based treatment options in a methodical, comprehensive way.

- Integrative psychiatry takes into account each patient’s entire picture, including physical health, environmental factors, and lifestyle, to contextualize their mental health.

- The interplay between physical and mental states is increasingly the focus of research and is part of the basis for practicing in an integrative way.

- Integrative psychiatry is not anti-medication. When prescribed judiciously, medication has a place in an integrative practice. At best, medication is just one piece of a comprehensive integrative treatment plan.