A naturopathic mental health doctor has expertise in holistic mental health care. For some naturopathic doctors, this interest evolves over time, but my practice has always focused on mental health.
When I was in naturopathic school, working with patients in my clinical rotations, mental health–related cases interested me much more than other areas of medicine. I studied conditions like anxiety, depression, and insomnia. Over time, I explored more serious mental health conditions, like bipolar disorder, schizophrenia, obsessive–compulsive disorder, and post-traumatic stress disorder, seeking mentorship from doctors to learn more. I wanted to specialize in mental health while still attending to the health of the entire person.
Taking a Whole-Person Approach to Mental Health
My first meeting with a patient comprises a two-hour consultation. The length and depth of the initial consult are two distinguishing differences patients notice right away, especially in comparison with conventional doctors appointments. We talk about everything. What was their upbringing like? When did the symptoms start? What are the potential contributing factors? We also discuss genetics, medical history from childhood, substance use, immune health, lifestyle, diet, digestive function, and hormonal challenges. Each of these topics has its role in the person’s emotional well-being. Although my practice is cash pay, patients receive paperwork for possible insurance reimbursement. Without the limitations of an insurance-based practice, I can delve into a patient’s history and conduct a very detailed intake session.
I ask them about their home and work environments and whether they are in potentially toxic or abusive relationships. I examine the entire picture chronologically and gather information about past treatments. We review previous and current medications and counseling interventions and how they have responded. I ask about natural therapies like nutritional supplements, acupuncture, herbal medicines, or homeopathic medicines.
Personalizing a Naturopathic Treatment Plan
Once I have a patient’s holistic history, I analyze the information and establish a naturopathic care plan. I order laboratory tests, including standard panels covered by insurance. In some cases, I suggest specialty testing.
After the first appointment, many people respond similarly. It is often the first time they have shared their story with someone, and the experience of feeling and being heard is transformative. Focusing on all aspects of a patient’s health makes them feel whole.
An early priority is ensuring the person is well nourished and removing or reducing known obstacles to their health. I may recommend nutritional supplements, dietary changes, or lifestyle improvements to help restore their body to a place where they can heal. Homeopathic medicines are a big part of my practice, and I suggest a homeopathic remedy for almost every patient as a central part of the treatment plan. We may also discuss a counseling referral if additional service is needed.
I can prescribe certain medications, confer with an individual’s existing psychiatrist about medicine, or refer patients to a psychiatrist. In Arizona, Naturopathic doctors cannot prescribe stimulant attention-deficit/hyperactivity disorder medications or antipsychotics. Many of my patients benefit from these medications, and I collaborate with their care providers to help manage this aspect of care.
Naturopathic Doctors Work with Psychiatrists
I frequently work in tandem with psychiatrists. The relationship looks different depending on the psychiatrist’s trust and confidence in naturopathic medicine. With a few exceptions, most are open to working together. Many psychiatrists do not know about naturopathic medicine, and some are misinformed. I work to earn their trust by showing my respect. We obtain authorization to share records, and I often call them to discuss progress. We both do our part to help a mutual patient.
When patients take mental health medications, there are often questions about dosing and side effects. A person who improves on the holistic treatment protocol may benefit from a reduced dose of prescription medication. For instance, on a high dose of an antipsychotic like olanzapine, a patient may tell me they are experiencing unwanted fatigue or weight gain. I assess their mood stability and overall health before suggesting natural treatments to address the primary symptoms and potentially mitigate a drug’s side effects. Over time, the patient may work with their psychiatrist to reduce medications and even taper off.
I frequently review a patient’s baseline before and during naturopathic treatment and assess their response. For example, if an individual is sleeping too much or feels very fatigued, overmedication may be an issue. On the other hand, a patient may experience more consistency in mood and sleep patterns, less depression, and no mania for extended periods. When dose changes are necessary because a patient’s baseline health has improved, a conversation with their prescriber typically follows.
Capturing a Full Picture to Identify Root Causes
As we now know, brain health is connected to digestive health and the gut microbiome, inflammation, hormone balance, genetic mutations, thyroid disorders, nutrient depletion, immunity, and poor cellular function. Medication use, toxin exposure, and environmental pollutants can also affect mental health and cognitive function. However, psychiatry rarely focuses on the full spectrum of physiological factors influencing a patient’s health.
I recently saw a new patient with chronic anxiety and self-described depression. She wasn’t expressing deep sadness, hopelessness, or suicidal thoughts; she simply felt tired and wanted to sleep all the time. I asked if her depression might be exhaustion and burnout. When we talked, she described a chaotic and unstable childhood. With a significantly dysregulated family who fought often, she constantly tried to numb her emotional distress. She developed an eating disorder and a substance use disorder. Her tendency for perfectionism and overworking to validate her self-worth had led to burnout and fatigue.
The patient was also experiencing abdominal discomfort whenever her anxiety flared. During our visit, I discovered a candida overgrowth in her intestinal tract. Candida produces many inflammatory chemicals that irritate the nervous system, resulting in anxiety and fatigue that looks like depression.
My treatment protocol included a homeopathic remedy for the underlying trauma-related anxiety and perfectionism, a plan to address the candida overgrowth, nutritional supplements, healthy diet changes, and meditation and mindfulness practices. With her gut and nervous system functioning correctly, my patient’s body and mind will be more capable of maintaining balance. Once she starts to improve, we will begin to taper her medication.
It is not always appropriate for my patients to go off their medications completely. An integrated approach is often beneficial for severe cases of bipolar disorder, obsessive–compulsive disorder, and schizophrenia. Patients continue taking some amount of medication while incorporating natural treatments to support their overall health. As naturopathic doctors, we aim to improve patients’ quality of life. If a combination of prescription and natural medicine will produce the best outcomes, that is what we recommend.
Expanding Awareness of Naturopathic Care Objectives: PsychANP
The Psychiatric Association of Naturopathic Physicians (PsychANP) encourages conversations on natural mental health treatment. We aim to improve collaborative care by expanding awareness about naturopathic doctors: how they are trained, standards of practice, and ways they help patients reach their health goals. Naturopathic doctors are a valuable asset in any healthcare setting where safe, holistic treatment options for optimal mental health care are the priority.