Mental health illnesses are prevalent, and the numbers continue to rise globally. In fact, some call mental illness the pandemic of the 21st century. From 2007 to 2017, there was a 13% increase worldwide, and roughly 20% of the global population has some type of psychological illness. Suicide is the second leading cause of death among 15-29-year-olds, and people with severe mental health conditions may die up to 20 years earlier than they should because of preventable conditions like obesity and diabetes. 

Neuropsychiatric illnesses are a significant challenge to our conventional healthcare system. While current treatment options, like pharmaceuticals, are effective to a certain extent, they can come with serious side effects and often don’t get to the root cause of the dysfunction. 

The evolution of integrative mental health approaches requires us to zoom out and view the body as one interconnected system. In the case of mental health illness (and all chronic illnesses), there’s some miscommunication in the body that needs to be addressed in order to restore optimal function. In this article, we’ll share why and how we can bridge the gap between traditional psychiatry and root-cause medicine to give patients the hope of more complete recovery.

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Traditional Psychiatry: Benefits and Limitations

Psychiatry is a type 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 determine the mental and physical causes of brain health symptoms.  

Conventional psychiatric treatments usually include a combination of prescription medications (including antidepressants, antipsychotics, sedatives, anxiolytics, hypnotics, mood stabilizers, and stimulants) and psychotherapy (including cognitive behavioral therapy or psychoanalysis). Electroconvulsive therapy (ECT) may also be prescribed. 

Prescription medications for mental health conditions can be effective for some people. But they can take weeks to work and come with serious adverse effects, like weight gain and increased chronic disease risk. But they also interfere with other medications and nutrient levels and can cause withdrawal symptoms when stopped abruptly. 

Psychotherapy (talk therapy) establishes a relationship between provider and patient to help patients learn how to eliminate or better control their mental health symptoms. Psychotherapy can take many different forms but commonly focuses on teaching patients how to change their behaviors and thought patterns, explore past trauma and solve problems in a healthy way. 

Research suggests that psychotherapy can be a very effective option for many different mental health disorders. For example, when psychotherapy is used (along with pharmaceuticals), in those with bipolar disorder, the recurrence of mental health symptoms is reduced. Psychotherapy reduces depressive symptoms and can prevent the development of major depression. 

While both medications and talk therapy can reduce mental health symptoms and improve quality of life, they don’t often address the root causes of mental health illness. So, patients don’t have the opportunity to fully recover. A root-cause approach, however, may offer more complete healing. 

Root Cause Medicine: An Overview

Whereas allopathic medicine identifies and treats symptoms and disease states (typically with medications), root-cause medicine aims to zoom out and instead understand the underlying causes of dysfunction. For example, instead of prescribing an oral hypoglycemic for high blood sugar levels, root-cause practitioners look for what’s causing the glycemic dysfunction and then develop a targeted plan (that may still include medication) to reverse the underlying process to restore normal endocrine and metabolic function.  

The principles of root cause medicine include seeing patients as unique, which requires practitioners to investigate and understand how genetics, biochemistry, and lifestyle come together to impact a person’s health and quality of life. So, instead of viewing body systems as separate entities, root-cause medicine takes a holistic view of the body as one interconnected system. When dysfunction occurs in a subsystem, it’s a reflection of a larger miscommunication in the body that needs a personalized treatment approach.

Root-cause practitioners complete thorough background assessments in order to map a patient’s unique story and better understand why disease 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 causes of disease symptoms. When root causes are uncovered, practitioners can better personalize the treatment plan to the individual. The beauty of root-cause medicine is the ability to incorporate traditional treatment options along with complementary and integrative approaches to improve 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 increases the risk of chronic pain, obesity, dementia, and diabetes. Evidence also shows that people with severe mental illness (like schizophrenia) don’t live as long as their healthy counterparts due to preventable (and oftentimes reversible) chronic health conditions.

While poor mental health can impact physical health, having a chronic disease, like autoimmunity, heart disease, diabetes, cancer, or dementia, also significantly increases 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. But 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 root cause of mental health symptoms. Micronutrient testing like the one by SpectraCell Laboratories can help to determine specific nutrients of concern for an individual patient, which allows the practitioner to tailor meal plans and supplement recommendations.

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 negatively 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 bring blood sugar to optimal levels. 

Hormone Testing

Hormonal alterations are 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 negatively impact mental and physical health. Testing for heavy metal exposure can identify and monitor exposure to heavy metals.

Environmental Toxin Testing

Exposure to environmental toxins can impact the mental health of some people. If toxin levels are elevated, practitioners can personalize a plan to reduce exposure and enhance detoxification.

Nutritional Psychiatry 

We often think of food as innocuous, but food is 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 prevent and/or reverse mental health symptoms.

Since brain structure and function rely on appropriate levels of nutrients (carbohydrates, fats, proteins, vitamins, minerals, and water), it only makes sense that inadequate nutrient levels can negatively impact brain function. Studies have found insufficient levels of micronutrients to significantly increase the risk of depression, and a poor diet exacerbates mood disorders like anxiety and depression. The impact of a poor dietary pattern on mental health may be related to the upregulation of 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 contributes to mental health symptoms.

But just as a poor diet can lead to or make mental health symptoms worse, a wholesome dietary pattern can reduce inflammation, improve the gut-brain axis, regulate blood sugar, and encourage the production of hormones and neurotransmitters. Nutritional psychiatry offers hope that food can become our ally in the fight against mental health illness.

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 take sleep, physical activity, stress, and environment into consideration.

Sleep’s role in mental health is complex, but a disrupted circadian rhythm (the sleep-wake cycle) is associated with mental health illness and is one contributor to neurodegenerative diseases. Suboptimal sleep is also closely tied to poor physical health, so patients get into this vicious cycle where poor sleep is both a cause and consequence of mental and physical illness. Encouraging patients 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, cold, quiet environment can create a healthy sleep foundation.

It’s well-known that exercise is important for physical health, but it’s also a potent treatment for mental health symptoms. 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 people with non-severe depression. New exercisers may want to start out 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 imperative to educate patients on effective stress management techniques. Some evidence-based strategies include mindfulness meditation, art therapy, and yoga. These types of therapies help to switch patients from the sympathetic nervous system (fight or flight) to the parasympathetic nervous system (rest and digest), which helps to 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 negatively impact mental and physical health. Educate patients on how to avoid toxins and use nutrition and supplements to help promote natural detoxification. An additional environmental concern is the lack of adequate sunlight. People with mental health challenges may spend more time indoors under harsh, artificial lighting, which can negatively impact mood and exacerbate poor mental health. Sunlight is crucial for supporting healthy serotonin (a neurotransmitter important for depressive symptoms) and melatonin (a hormone that’s involved with circadian rhythm) levels, so patients 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 medicine leaves a lot on the table for many patients. While symptom relief is top of mind, the overall goal should always be to help the patient reach an optimal quality of life, and medication and therapy alone often don’t provide that type of result. 

Collaborative mental health treatment, on the other hand, takes the entire person into consideration and offers a personalized, comprehensive treatment plan that addresses the underlying causes of symptoms. This takes the focus off of the disease and places it on the specific patient. So, instead of matching a drug for a symptom, we’re asking why the symptom is there and then creating a plan to reverse that process. Integrative psychiatry and root cause medicine in this way can make traditional treatments more effective, reduce the need for psychiatric medications (and hospitalizations), lead to complete healing, and allow the best opportunity for patients with mental health issues to experience vibrant health.

Challenges and Future Directions 

While incorporating root-cause medicine into standard mental health treatment sounds wonderful, there are some challenges in integrative psychiatry. First, the field of psychiatry itself seems to be shrinking, so it’s imperative that other healthcare providers become well-trained in how to deliver integrative mental healthcare. 

In addition, there’s a need for more well-designed clinical trials that showcase the impact of root-cause medicine on mental health outcomes to increase the buy-in of traditional providers. Many people with mental health symptoms use complementary and alternative methods with great success. They often report better physical, emotional, cognitive, social, and spiritual functioning, fewer symptoms, and better overall wellness. However, less than half of those who use these therapies share that information with their provider for fear of the stigma that’s sometimes associated with alternative options. 

Finally, mental health symptoms exist on a spectrum, and patients with the most serious mental illnesses are often incapable of implementing diet and lifestyle recommendations consistently. This is why the future of mental health treatments must blend the best of both worlds. Treatment needs to be personalized based on root causes and a person’s ability and access to alternative options. 

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Summary

Mental health illness is a significant global issue that only continues to worsen. Our current treatment model provides less than stellar results for many patients. However, those who are embracing integrative mental health strategies that address root causes often experience enhanced results. Mental health treatment requires open-mindedness and collaboration to bring both traditional and root-cause approaches to all patients with mental health challenges.