When people hear the words “holistic” or “integrative,” this may conjure up many different images, both positive and negative. I consider myself to be a psychiatrist who utilizes holistic and integrative concepts in both the diagnosis and treatment of my patients. I thought it would be a good idea to explain these how these concepts apply to mental health and my practice.
The Wiktionary definition of “holistic” is “relating to a study of the whole instead of a separation into parts.” If you imagine attempting to diagnose and treat a human being, you can see how this concept could be applicable. For example, let’s consider the case of a patient who has something called “diabetic peripheral neuropathy.” This is a complication of diabetes, which can cause pain and tingling in the feet. If a patient came to a doctor and complained of foot pain, the doctor could focus on the foot alone. They could ask questions about the foot, examine the foot, and provide a pain cream to apply to the foot. However, this would be doing the patient a huge disservice, as the real cause of the foot pain is diabetes, which is diagnosed using a blood test. In addition, diabetes can be treated, and this treatment could potentially improve the foot pain. Simply applying a cream to the foot would miss the true cause of the pain, would likely not help, and would likely lead to the patient only becoming more and more sick.
The same is true of mental health complaints. If a patient comes to me and complains that they are feeling depressed, but I don’t ask them about their family life, or what toxic habits they may have, or what their relationships are like, I may not diagnose and treat their problem appropriately. In addition, as with the analogy above, if I simply write them a prescription for an antidepressant medication, I may be attempting to treat a symptom, but end up completely missing the cause. Hence the depression may not improve, and may continue to worsen.
Dr. Alice Lee provides an excellent definition of holistic psychiatry on her website:
Holistic Psychiatry values each individual as a unified whole, consisting of mental, emotional, physical, spiritual, social, and environmental forces that simultaneously and equally affect health and well-being. A holistic psychiatrist is trained in the use of conventional, nutritional/ functional/ orthomolecular medicine, and mind-body/energy medicine, to heal individuals at all levels of being, to restore a state of optimal mental and physical health, as naturally and efficiently as possible.
Okay, so what does “integrative” mean?
The Arizona Center for Integrative Medicine provides a great definition for “integrative medicine” on their website:
Integrative Medicine (IM) is healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies.
In addition, they list the “Defining Principles of Integrative Medicine:”
- Patient and practitioner are partners in the healing process.
- All factors that influence health, wellness, and disease are taken into consideration, including mind, spirit, and community, as well as the body.
- Appropriate use of both conventional and alternative methods facilitates the body’s innate healing response.
- Effective interventions that are natural and less invasive should be used whenever possible.
- Integrative medicine neither rejects conventional medicine nor accepts alternative therapies uncritically.
- Good medicine is based in good science. It is inquiry-driven and open to new paradigms.
- Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount.
- Practitioners of integrative medicine should exemplify its principles and commit themselves to self-exploration and self-development.
As you might be able to see now, the principles of integrative medicine apply equally well to physical as well as mental health and healthcare.
Let’s use the patient example above to show how one could use a holistic and integrative approach to the diagnosis and treatment of a patient.
The patient is a 44 year old woman named Anna who came to see me complaining of depression. I take a holistic approach and ask Anna about all aspects of her life. I find out that Anna’s depression began after she was raped when she was 38. At that time she became so overwhelmed by what happened that she was barely able to sleep. Her entire health then began to deteriorate. Anna stopped dancing, which she previously enjoyed doing daily. She started eating lots of junk food and stopped cooking her own meals. She withdrew from her family and friends and eventually lost her job. Anna became very scared of leaving her apartment and hence hadn’t gone outside in months. She was feeling overwhelmed and hopeless and even started having thoughts of death.
With this example, it is possible that an antidepressant medication may help with some of Anna’s symptoms. However, if that was her only type of treatment, there is a chance that her symptoms might not improve, and they could potentially even become worse. Utilizing a holistic and integrative approach to her treatment might look something like this:
- Engaging Anna in psychotherapy so that she could talk about her trauma and her associated thoughts and feelings
- Improving Anna’s diet to cut down on junk food and increase her intake of foods which have been shown to reduce depressive symptoms
- Helping Anna get back into dancing, which has been shown to have a variety of mental health benefits
- Starting Anna on supplements such as Omega-3 fatty acids to improve her mood and melatonin to improve her sleep
- Incorporating other treatments such as acupuncture or EMDR to help with Anna’s depressive and trauma-related symptoms
- Helping Anna to re-connect with her friends, family and her community
Utilizing this type of comprehensive approach is much more likely to help Anna, than is simply prescribing an anti-depressant alone.
I hope this sheds some light on why I use a holistic and integrative approach with all my patients at Free Range Psychiatry.
Have more questions? Feel free to shoot me an email, anytime: [email protected]