Behavioral health is an umbrella term used to describe mental health and substance use disorders, but it also refers to how lifestyle and stress can impact physical, emotional, and social well-being. While it’s difficult to know just how many people struggle with behavioral health issues, in 2021, an estimated one in four Americans (age 18 and up) struggled with a mental health illness. And nearly 47 million Americans (age 12 and up) met the criteria to be diagnosed with a substance use disorder.
While behavioral health disorders can occur in isolation, mental health conditions often accompany them. Commonly, patients with untreated mental illness turn to substances to help them feel better, but substance use ends up exacerbating or triggering another mental health disorder. Traditional treatments like cognitive behavioral therapy and pharmaceuticals offer some relief, but they often don’t address root causes like inflammation, glucose dysregulation, and poor gut health. Fortunately, top integrative treatments like meditation, yoga, art therapy, nutrition, exercise, and supplements can be used in combination with traditional therapy to offer patients the hope of long-term healing.
Understanding Integrative Therapy for Behavioral Health
Behavioral health encompasses mental health disorders, which include:
- Neurodevelopmental disorders (ADHD, Autism Spectrum Disorder)
- Post-Traumatic Stress Disorder (PTSD)
- Obsessive-Compulsive Disorder (OCD)
- Bipolar Disorder
- Disruptive behavior and dissocial disorders
- Eating disorders
Substance use disorders, characterized by the repeated use of a substance like alcohol, hallucinogens, inhalants, opioids, prescription medications, and illegal drugs, can also occur.
Behavioral health disorders can significantly disrupt a person’s life and interpersonal relationships, and the quality of life is often poor. Treatment usually includes some combination of psychotherapy, pharmaceuticals, and group support, but hospitalization is an option in severe situations. These can all be life-saving and effective in the short term, but they only take a patient so far in the healing process because they don’t address the root of the dysfunction.
Patients with behavioral health concerns may have many different factors underlying their symptoms. Common contributors include poor nutritional status, blood sugar dysregulation, chronic inflmmation, an altered stress response, and poor gut health. An integrative approach to behavioral health takes treatment a step further by targeting these root causes in an attempt to bring the body back into balance.
Integrative Treatment Options for Behavioral Health Concerns
Integrative providers take the entire person, including their lifestyle, genetics, history, nutritional status, sleep pattern, and stress level, into consideration to create a personalized plan for healing. With a combination approach, patients can experience vibrant health, optimal quality of life, and long-term healing. Over time, they may even be able to reduce some of the pharmaceutical treatments they require. Here are some of the top integrative treatments for behavioral health concerns.
1. Mindfulness Meditation
Mindfulness meditation is focusing your awareness on the present moment, which can help you release negative thoughts. Mindfulness meditation may help shift your body from the sympathetic nervous system (SNS - fight or flight) to the parasympathetic nervous system (PNS - rest and digest). Living in the SNS, which may be common in those with behavioral health issues, can create imbalances in the body, leading to chronic inflammation, poor immune system function, digestive dysfunction, mood changes, racing thoughts, depression, and anxiety. When you shift into rest and digest, you naturally feel more calm and emotionally balanced.
Mindfulness meditation may help to enhance self-awareness and emotional regulation by improving the default mode network (DMN) in the brain. Activating the DMN may help to reduce the automatic negative thoughts that are common in people with behavioral health issues. Mindfulness meditation can be incorporated into the daily routine by taking time to intentionally focus your awareness on present physical surroundings like the sound of the ocean or the birds in a forest, on your breath, or by completing a full body scan.
Yoga is the practice of moving the body through various poses to help bring the physical body, mind, and spirit into balance. In yoga, stress is thought to be the main culprit behind all diseases, including mental health disease. Research has found altered immune system function and a dysregulated stress response (with chronic release of cortisol) to be common in those with depression, bipolar disorder, psychosis, and schizophrenia.
Yoga may exert its beneficial effects on those with behavioral health issues by stimulating the vagus nerve, which is the major player in the PNS. By increasing vagal tone, yoga can support homeostasis (or balance) in the body. In addition to normalizing the stress response, yoga can help to lower inflammatory markers and improve digestive, metabolic, and immune system function. Yoga can increase levels of brain-derived neurotrophic factor (BDNF), a protein in the brain responsible for brain cell development and survival. Yoga has been found to be just as effective as prescription medication for treating depression and anxiety.
There are several forms of yoga, all of which will likely improve mental and physical health parameters. A few examples include restorative yoga (where poses are held for extended periods of time), which helps to support mind-body balance and reduce the stress response. Yoga Nidra (practiced lying down) promotes deep relaxation of the nervous system, similar to what occurs during sleep. However, you remain consciously aware of your surroundings. Ashtanga yoga (a vigorous form of yoga) requires flowing through various postures while focusing on breath and energy to focus the body’s energy.
3. Art Therapy for Emotional Expression
Art therapy is a creative therapeutic approach that allows people to express themselves through various art-based activities. Art therapy has been shown to improve cognitive function, emotional well-being, and sensorimotor function. Whereas traditional psychotherapy for behavioral health disorders requires patients to speak (which can be tough for some to do), art therapy allows for working through emotions nonverbally. By focusing on the creative process, patients may experience improved physical and mental health parameters, including quality of life, health, and overall well-being.
Most of the studies on art therapy are small but overall tend to suggest a benefit, especially when used as an adjunct to traditional treatment. One randomized controlled trial of older women with MDD and a meta-analysis of cancer patients found including art therapy significantly improved depression and anxiety scores.
Art therapy is ideally directed by a credentialed art therapist who tailors the activity to the patient based on their specific situation or diagnosis. Art therapy for people with anxiety may include painting, whereas art therapy for anger might be working with clay. But any type of art, like poetry, singing, and woodworking, can be used in art therapy sessions.
4. Nutrition's Impact on Mental Well-being
Nutrition can significantly impact mental health and mood. A wholesome dietary pattern can reduce inflammation and oxidation, improve gut microbiome and immune system health, positively impact epigenetics, and control blood sugar levels, but it also encourages the healthy production of various hormones and neurotransmitters that travel along the gut-brain axis to promote great brain function. The standard Western diet, on the other hand, does the opposite by promoting chronic low-grade inflammation, disrupting hormonal cues and blood sugar regulation, and creating dysbiosis in the gut, all of which can negatively impact brain function.
Depression studies have found a poor diet and micronutrient insufficiency to significantly increase risk, and chronic inflammation, leaky gut, and dysbiosis have been found to disrupt normal gut-brain communication, leading to mood changes and psychiatric disorders.
Unfortunately, there’s no one-size-fits-all nutrition plan that will work for every person with behavioral health concerns. Providers must recognize that just as poor nutrition can lead to mental health and substance use issues, behavioral health disorders can make it difficult to make and stick with healthy nutrition and lifestyle choices. With that in mind, the major goals of any nutrition plan in the behavioral health context are to control inflammation and blood sugar, ensure adequate nutrient intake, and support a diverse gut microbiome.
Ideally, the meal plan will be tailored to the individual since personal food sensitivities can create inflammation. But overall, people with behavioral health concerns may benefit from an anti-inflammatory dietary pattern, like the Mediterranean diet.
The Mediterranean diet focuses on a variety of fruits, vegetables, beans, nuts, legumes, seeds, seafood, and healthy fats like olive oil. This meal pattern also encourages the moderate use of whole grains, poultry, eggs, dairy, herbs, and spices. Like any anti-inflammatory diet, it significantly limits the consumption of ultra-processed foods, added sugars, inflammatory oils, and refined grains. Adherence to the Mediterranean diet is associated with improved mood, memory, and cognition, so people who follow this type of meal pattern tend to have a lower risk of dementia and depression.
In addition, twelve nutrients of concern have been identified when it comes to depression, so ensuring the adequate intake of food sources of folate, iron, long-chain omega-3 fatty acids, magnesium, potassium, selenium, thiamine, vitamin A, vitamin B6, vitamin B12, vitamin C, and zinc may be especially helpful for preventing and reversing depressive symptoms.
Implementing an anti-inflammatory diet for a patient who is currently following the standard Western diet is likely to lead to significant symptom improvement. However, for patients who already tend to follow a whole-food diet, it may be necessary for the practitioner to tailor a therapeutic elimination diet.
5. Dietary Supplements and Behavioral Health
Dietary supplements, including herbal preparations, can be an important component of the treatment plan for behavioral health concerns. However, recommendations need to be tailored, and it’s extremely important to speak with a healthcare provider before adding any dietary supplement due to the potential for interactions with medications and/or negative side effects.
Omega-3 polyunsaturated fatty acids may have important benefits for people with behavioral health symptoms since they can combat inflammation, improve the function of the hypothalamic-pituitary-adrenal axis (HPA-axis), and enhance neuroplasticity.
Gut microbiome imbalances seem to be common in people with behavioral health challenges, so probiotics may be an option. Probiotics have been found to improve the balance of microbes in the gut, reduce inflammation, improve immune system function, and increase BDNF.
Saffron is a spice that’s been found to improve both anxiety and depression. In fact, saffron has been found to be as effective as popular antidepressant medications. It’s thought to work by altering the neurotransmitter serotonin, lowering inflammation and oxidation, and modulating the HPA axis.
St John’s Wort
St. John’s Wort is an herbal supplement used for anxiety, OCD, and other behavioral issues. It’s also been found to be as effective for depressive symptoms as traditional pharmaceuticals. St. John’s Wort may work by altering serotonin levels, but it may not be as helpful for people who have MDD. Serious side effects can result when taking this herbal supplement, so it’s very important to only use it under the guidance of a qualified provider.
Cannabidiol (CBD) is one of many cannabinoids from the Cannabis sativa L. plant. It’s been found to improve anxiety symptoms, possibly by lowering inflammation and oxidation. Small human trials have found it may be helpful for reducing opioid cravings in those with addiction. The National Institutes of Health HEAL Initiative is currently studying CBD in a large clinical trial for the treatment of opioid addiction.
6. The Role of Physical Activity on Behavioral Health
Exercise is an extremely important aspect of physical health. It’s estimated that physical inactivity increases the risk of more than 40 chronic diseases, but it’s also intimately linked with poor mental health and cognitive decline. When you’re sedentary, you can’t take advantage of the wonderful benefits of exercise, which include increased nutrients and oxygen to the brain, lower levels of inflammation and stress, increased BDNF, improved gut health, and healthy neurotransmitter production.
Various studies have found exercise to improve mood, decrease the symptoms of anxiety and depression, and improve cognition, but it also supports an overall sense of well-being and better self-esteem. People with behavioral health disorders are often prescribed pharmaceuticals that have side effects like weight gain, high blood sugar, and elevated lipids. Exercise is a great way to offset some of those side effects.
If you’re sedentary, the easiest way to start improving your physical fitness is to walk as often and as much as you can. Walking in nature for as little as 10-20 minutes may have added mental health benefits. Once you create a healthy base with walking, consider branching out into more aerobic types of activities like jogging, running, high-intensity interval training, swimming, biking, or rowing for at least 150 minutes each week. Resistance training is another valuable form of physical activity that can be incorporated into the weekly routine. Meeting with an exercise professional for a formal exercise program based on individual needs is a good idea.
Using Functional Medicine Labs To Support an Integrative Treatment Plan For Behavioral Health
Investigating the underlying causes of mental health and substance use issues is imperative for creating a comprehensive plan for healing. There are several functional medicine labs that can help providers uncover root causes they may need to target. Here are a few.
Food Sensitivity Testing
The Array-10 Multiple Food Immune Reactivity Screen by Cyrex Laboratories is a food sensitivity test that measures the body’s immune response to various foods. Commonly, sensitivities to food proteins can lead to inflammation. The Array-10 analyzes blood samples for IgG and IgA antibodies against common food proteins. If food sensitivities are present, providers can personalize the diet to lower inflammation, which may help to improve behavioral health symptoms.
Comprehensive Stool Test
The GI-MAP stool test by Doctor’s Data analyzes markers of gastrointestinal health like dysbiosis, adequacy of digestive enzyme production, and levels of inflammation. Providers can use this information to personalize a gut healing plan to improve the gut-brain connection.
Hyperglycemia can cause inflammation and mood alteration. The Diabetes Panel from Vibrant America measures important biomarkers like fasting insulin, fasting glucose, and hemoglobin A1C. If these levels are suboptimal, practitioners can tailor nutrition and lifestyle recommendations to help normalize blood sugar and lower inflammation.
An imbalanced omega-6 to omega-3 ratio is indicative of inflammation. The Omega-3 Index Complete from Ayumetrix can give practitioners insight into the percentage of EPA and DHA in the blood. A low amount of EPA and DHA is associated with behavioral health concerns like depression. If the omega-3 index is suboptimal, practitioners can personalize the nutrition and supplement plan to improve it.
The SpectraCell Micronutrient Test analyzes 31 vitamins, minerals, and other nutrients to determine nutritional deficiencies. Poor nutrient status is associated with behavioral health concerns. Practitioners can use this test to determine which nutrients a patient may need to highlight in their meal plan.
Behavioral health concerns like depression, anxiety, and substance abuse are common in the United States. They can disrupt daily life and make it difficult to maintain a healthy foundation. Traditional treatments like psychotherapy, pharmaceuticals, and group support can be very helpful for symptom management. But these traditional options don’t often lead to long-term success on their own, likely because they don’t address the underlying causes of the dysfunction.
An integrative approach to behavioral health symptoms addresses the underlying factors in a specific person. Commonly, chronic inflammation, glucose dysregulation, poor nutrient status, gut dysfunction, and uncontrolled stress are at the heart of miscommunication in those with behavioral health disorders. This is where an integrative approach using nutrition, art therapy, mindfulness meditation, yoga, dietary supplements, and exercise can help to restore balance and promote optimal quality of life and long-term healing.
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