Conditions like anxiety and depression don’t just affect the mind, they ripple through every aspect of life, from relationships to work to overall well-being. Traditional treatments don’t help everyone, and many people are searching for new and effective ways to care for their mental health. Evidence-informed integrative therapies are emerging as powerful allies, offering tools to support resilience and healing.
Person-centered approaches to treatment
“First, we have an orientation toward the whole person,” says Alex Tan, ND, PMHMP, former president of the Psychiatric Association of Naturopathic Physicians (PsychANP). “When we think of mental health, we also think of other things that could [affect] mental health, like biological and psychosocial systems. We think about health conditions that may [affect] mental health, such as gastrointestinal and hormone issues. It gives us a [three-dimensional] view of our patients. And they like that because we’re whole people. We’re not just our brains or psyche.”
Naturopathic medicine offers a full suite of tools for treating behavioral health conditions. “We’re very adept at exercise prescriptions, behavioral activation, and motivational interviewing,” says Dr. Tan. We get a lot of training in building empathy with patients and using a supportive tone and approach.”
Getting to the root cause of illness
Naturopathic medical education includes training in the basic sciences and clinical sciences. Medical detective work is also a crucial part of diagnosis. Traditionally, conventional medicine has focused on addressing one pathway at a time. When treating depression with SSRIs (selective serotonin reuptake inhibitors), it’s the serotonin pathway. “As NDs,” notes Dr. Tan, “we are very aware that the root causes of illness don’t involve just one pathway. It’s a combination of different pathways. We’re not just bags of serotonin! So even in a field like psychopharmacology, our intuition to think of multiple pathways makes sense.”
Spending quality time with patients
Naturopathic doctors spend more time with patients compared to conventional doctors1Chamberlin SR, Oberg E, Hanes DA, Calabrese C. Naturopathic practice at North American academic institutions: description of 300,483 visits and comparison to conventional primary care. Integr Med Insights. 2014;9:7-15. https://journals.sagepub.com/doi/10.4137/IMI.S14124. Dr. Tan says this aspect of naturopathic care is particularly valuable in his specialty. “Mental health needs time. We need to get to know our patients and do counseling. The time we devote to patients makes us well suited to address mental health.”
A whole person path to eating disorder recovery
PsychANP board member Lachlan Crawford, ND, is the director of Integrative Medicine at Walden Behavioral Care, an inpatient and residential facility in New England specializing in eating disorders and psychiatric conditions. Dr. Crawford specializes in treating eating disorders by taking the time to truly understand her patients, exploring the fears and beliefs that drive their behaviors. She uses integrative medicine in collaboration with other healthcare practitioners to provide comprehensive, personalized care.
Genetic factors and nutritional deficiencies
Similar to other mental health conditions, eating disorders have genetic and environmental contributing factors that we collect through life, including trauma and other mental health conditions, such as anxiety, obsessive–compulsive disorder, and depression.2Yilmaz Z, Schaumberg K, Halvorsen M, et al. Predicting eating disorder and anxiety symptoms using disorder-specific and transdiagnostic polygenic scores for anorexia nervosa and obsessive-compulsive disorder. Psychological Medicine. Published online March 4, 2022:1-15. doi:10.1017/s0033291721005079 Dr. Crawford looks at nutritional deficiencies that may contribute, including levels of zinc and other minerals, essential fatty acids, and B vitamins. She may also track blood sugar levels throughout the day, as that can sometimes drive feelings of anxiety, cravings, avoidance, and distress while eating.
The gut–brain axis and mental health
Dr. Crawford always considers digestive health when treating her patients. “Think about the gut lining as an essential organ that drives mental health,” she says. “We’re learning a lot about the gut–brain axis—how things that happen in the gut affect the brain and how the brain affects what is happening in the gut. I look to see if there has been any injury, history of an autoimmune condition, or digestive issue. Once I see if there is a root cause to heal, I support the gut microbiome through food, probiotics, prebiotics, or whatever combination is going to work for that person.”
Heart rate variability biofeedback
Another tool of Dr. Crawford’s is heart rate variability biofeedback. “You use a very simple heart rate monitor that gives a visual display of what’s going on for your nervous system,” she explains. “You learn what helps you regulate your own internal nervous system so you can understand that when you feel stressed, you have the ability to calm yourself down. The integration of all of these tools is really important, which is why I love the naturopathic and integrative approach to eating disorders.”
How is behavioral health care changing?
According to Dr. Tan, mental health is part of primary care, an area in which NDs are thoroughly trained.3Naturopathic Medicine. Psychiatric Association of Naturopathic Physicians. Accessed January 6, 2023. https://www.psychanp.org/naturopathic-medicine. When asked about the future of integrative, collaborative mental health care, Dr. Tan says the outlook is bright. “Our patients have made it clear that it’s a need. They’re asking for it.”
Footnotes
- 1Chamberlin SR, Oberg E, Hanes DA, Calabrese C. Naturopathic practice at North American academic institutions: description of 300,483 visits and comparison to conventional primary care. Integr Med Insights. 2014;9:7-15. https://journals.sagepub.com/doi/10.4137/IMI.S14124
- 2Yilmaz Z, Schaumberg K, Halvorsen M, et al. Predicting eating disorder and anxiety symptoms using disorder-specific and transdiagnostic polygenic scores for anorexia nervosa and obsessive-compulsive disorder. Psychological Medicine. Published online March 4, 2022:1-15. doi:10.1017/s0033291721005079
- 3Naturopathic Medicine. Psychiatric Association of Naturopathic Physicians. Accessed January 6, 2023. https://www.psychanp.org/naturopathic-medicine
