What is Integrative Psychiatry?

Understanding the Root Causes of Anxiety, Depression, Stress, and Brain Health

"Why do I feel this way?"

Maybe you've asked yourself that question after being told that your lab results are "normal". Perhaps you're anxious, irritable, unable to concentrate, gaining weight, sleeping poorly, or simply not feeling like yourself.

Or perhaps you've been given a diagnosis- a "label" -but still find yourself wondering:

Why is this happening to me?

That question is often where Integrative Psychiatry begins.

Rather than looking at mental health symptoms in isolation, Integrative Psychiatry asks what may be happening throughout the whole person. Sleep, nutrition, hormones, metabolic health, inflammation, genetics, medications, relationships, lifestyle, stress, and environment can all influence how we think, feel, and function.

As a physician board certified in Psychiatry and Integrative Medicine, my goal is not to simply identify a diagnosis. It is to understand your story, your biology, and the circumstances that brought you here —and then work collaboratively with you and any other members of your clinical team to develop an individualized path toward optimal wellness and healthspan.

What is Integrative Medicine?

Integrative Medicine is sometimes confused with “alternative, functional or complementary medicine,” but they are not quite the same thing.

Building on the high scientific standards of conventional medicine, Integrative Medicine incorporates evidence-informed approaches from functional medicine and mind-body medicine to care for the whole person.

As an Integrative Medicine physician, I draw from conventional medicine, functional medicine, nutrition and lifestyle interventions, and mind-body approaches. The goal is not to choose one “type” of medicine over another. It is to thoughtfully integrate our diagnostic and treatment tools, using the best available options with your individuality and goals as the focus.

Principles of Integrative Medicine:

Integrative Medicine is more than adding supplements, nutrition, or complementary therapies to conventional medical care. Our principles shape how we think about health and healing. They include:

1. Partnership-Healthcare is a partnership between physician and patient. Establishing a healing human relationship is vital for patient and provider alike. Ultimately, as the patient we are experts of our own bodies and health. As providers, we are the patient's consultant and facilitator. The word physician originates from the term teacher.

2. Whole person-Consider all factors influencing health, wellness, and disease-including mind, body, and spirit. We practice medicine which is not to be confused with practicing medication.

3. Healing- Utilize appropriate traditional and alternative techniques to support the body's inherent healing capabilities. Broaden the individual's healing journey to include the health of our families, communities, and the planet. Healing achieves its greatest impact when it includes connections with ourselves, others, and our environment.

4. Do no harm- Favor less invasive and less harmful interventions when appropriate, while treating the whole person. Match the relative risks of the interventions with the relative impairment caused by the symptoms.

5. Good science-Medicine is to be grounded in good science, driven by inquiry, and open to critical consideration of new paradigms. Those who cannot change their minds cannot change anything.

6. Walk the walk don't just talk the talk-As ABOIM physicians we hold ourselves and each other accountable for practicing what we teach. The health and well-being of the entire medical team is essential.

   
   

What Makes Integrative Psychiatry Different?

Psychiatry has traditionally diagnosed many conditions by identifying patterns of symptoms and giving those collections of symptoms names—such as major depression, generalized anxiety disorder, ADHD, or bipolar disorder. These diagnoses provide a useful common language, but a diagnostic label does not necessarily tell us why those symptoms are occurring.

Increasingly, research is helping us understand mental health through neurophysiology, immunology, genetics, metabolism, inflammation, hormones, and the complex signaling systems of the brain.

Integrative Psychiatry asks another question:

What is happening in the brain and body that may be producing these symptoms?

Someday, I hope to see our syndrome-based psychiatric diagnoses complemented—or perhaps even replaced—by more precise diagnoses reflecting underlying biology. For example, what we now call a bipolar disorder might eventually be differentiated into conditions involving mechanisms such as calcium-channel instability or glutamate sensitivity. What we now call ADHD may ultimately prove to represent several biologically distinct pathways to similar symptoms of inattention and impaired concentration.

Such a shift in psychiatric diagnosis would require substantial changes in our insurance reimbursement models and would also impact the research databases and FDA approvals tied to our current DSM diagnostic model.

Is Integrative Psychiatry "anti-medication?"

No. Psychiatric medications can be extremely valuable and in some circumstances, lifesaving. Often, medication may help a patient lifestyle changes, develop a healthier outlook on life and acquire resiliency skills that they ultimately need.

The goal is to use the right tools for the right person.

A Different Way of Asking the Question

Conventional medicine has become extraordinarily sophisticated at asking:

“What disease or disorder does this person have, and how do we treat it?”

Integrative Medicine adds another important question:

“Why is this happening in this particular person—and what does this person need to become healthier?”

We need both.

For me, that is the heart of Integrative Psychiatry: combining the scientific rigor of conventional medicine with curiosity about the whole person and the biology underlying the symptoms. It means working collaboratively to develop a plan that is evidence-informed, individualized, and sustainable, with a focus on effective prevention, early intervention, and treatment.

Sometimes the most important question isn't simply:

"What is my diagnosis?"

It is the question you may have been asking all along:

"Why do I feel this way—and what can I do to feel better?"