Integrative Medicine Provides Hope For Treating Depression, Other Mental Illnesses
|Speaker: James Greenblatt, MD
Author: Answers to Appetite Control,
The Breakthrough Depression Solution,
and Answers to Anorexia
Walden Psychiatric Associates Explains How Patient-Centered Approach Can Boost Recovery
Antidepressants have been a huge success – for the drug companies that sell them, not for the patients who take them.
Speaking at, “Integrative Medicine for Depression,” a public presentation at Black Rock Country Club in Hingham, James Greenblatt, M.D., chief medical officer of Walden Behavioral Care in Waltham and Walden Psychiatric Associates in Hingham, said that because of direct-to-consumer-advertising, patient demand is such that 15 non-depressed patients are prescribed antidepressants for each depressed person who is prescribed antidepressants.
Among those who are depressed, antidepressants alone rarely result in successful treatment, he added. In the “polypharmacy highway” of Zooloft, Prozac and Palix, 40% of patients relapse within 15 weeks, 20% become incapacitated or commit suicide, and 66% have residual symptoms.
In a study of 1,829 individuals taking antidepressants, 60% felt emotionally numb, 62% reported sexual difficulty, 42% had a reduction in positive feelings, 39% reported caring less about others and 55% had a withdrawal effect.
“We can do better,” Dr. Greenblatt said. “Despite the dozens of antidepressants available, millions of people who seek treatment for depression often fail to find long-lasting relief from their symptoms. Integrative medicine, which focuses on the whole person and makes use of all appropriate therapeutic approaches, can be more effective.”
Tenets of Integrative Medicine
Integrative medicine can be used to treat not only depression, but other psychiatric disorders, including anxiety, attention deficit hyperactivity disorder (ADHD), post traumatic stress disorder (PTSD) and eating disorders.
The five tenets of integrative psychology, Dr. Greenblatt said, are:
· Focus on each individual’s unique personality, environment and metabolism.
· Care for the whole patient, not just the disease.
· Understand the interconnections of the human body and mind.
· Restore health instead of simply reducing symptoms.
· Increase the body’s nutrient reserves to promote long-term health.
He quoted Ralph Snyderman, M.D., who said, “What we have now is a ‘sick care’ system that is reactive to problems. The integrative approach flips the system on its head and puts the patients at the center, addressing not just symptoms, but the real causes of illness. It is care that is preventive, predictive and personalized.”
Start With Medical Testing
One problem today is that medical treatment for mental disorders differs from treatment of all other medical specialties, according to Dr. Greenblatt.
“Psychiatrists typically do not use objective measurements to guide treatment of mental or addictive illness,” he said. “Why is psychiatry different?”
Medical testing of blood, urine and saliva assays, as well as tissue analysis, X-rays, MRIs, CT scans and other tests can be used to determine deficiencies in patients, as well as substances they should avoid.
Deficiencies of vitamins, minerals, fatty acids, amino acids and other substances can be an important factor in a patient’s mental well-being, according to Dr. Greenblatt. Likewise, avoiding certain foods, pollen, dust, dander, chemicals, and various toxins, such as lead and mercury, can result in improved health.
For example, hundreds of studies show that low folate, a B vitamin, is associated withincreased incidence of depression, poor response to antidepressants and a higher relapse rate.
Likewise, a deficiency of vitamin B12 can result in a variety of mental and physical problems. Mental symptoms of B12 deficiency include irritability, apathy, personality changes, depression, memory loss, dementia, hallucinations and violent behavior. Physical symptoms include clumsiness, weakness, pernicious anemia, chronic fatigue, tremors, G.I. tract problems, and a diminished sense of touch and pain.
In one study involving two male vegetarians with depression, both failed to respond to at least three trials of antidepressants and both were found to have a deficiency of vitamin B12. After treatment with 1000 mg per day of Vitamin B12, both patients improved within three to four weeks.
As another example, Dr. Greenblatt said that low dietary intake of omega-3 fatty acids is linked to depressed mood, hostility and impulsive behavior. In controlled clinical studies, depressed patients randomly assigned to receive omega-3 fatty acids demonstrated greater improvement compared with a placebo, and a higher proportion of patients – 44% versus 18% – achieved full remission in Omega 3 group versus the placebo group.
Taking amino acid supplements and probiotics, which add beneficial bacteria to the gastrointestinal tract, can help individuals live healthier and reduce mental health issues, according to Dr. Greenblatt. Probiotics normalize stress responses and are associated with significant changes in blood flow to brain regions involved in central processing of emotion and sensation.
In addition, Greenblatt said, individuals need to take care of themselves by getting sufficient sleep, exercising and eating a healthy diet.