|Dr. Reba Peoples, MD
Mental Health Expert
A 42-year-old woman who, for the sake of this article, we’ll call Lisa came to my clinic with a long history of severe depression, chronic fatigue syndrome and fibromyalgia. The traditional approach which included antidepressant medication didn’t seem to help, leaving her feeling frustrated and hopeless. Was she destined for a joyless life of pain, fatigue and depression?
Like Lisa, many people struggle with symptoms of anxiety, depression or other mental health concerns that are only mildly relieved by medications. They may switch from medication to medication – desperately hoping to find the right combination of medications that will finally help them feel better.
The problem with this approach is that it ignores that fact that, in many cases, what we call disease isn’t a disease by itself, but a symptom of another underlying problem. In fact, there are many things that can contribute to symptoms of depression, anxiety and other emotional challenges. Functional psychiatry is a branch of functional medicine that aims to identify and treat the root causes of emotional illness, not just the symptoms.
Functional medicine gives us the tools to reveal these factors and address them with lifestyle changes. Although prescription medications may still be needed for some cases, they can be used as a part of a holistic patient-centered approach, rather than the sole solution.
Back to Lisa’s story, it turned out that some of the foods she was eating were causing inflammation in her body which were contributing to her symptoms. After her diet was modified and the inflammation in her body was under control, she began to have more energy, her chronic pain became more manageable, and for the first time since we met, her eyes were bright with hope and excitement about her future. In her case, it appeared that the depression was indeed a symptom of a larger problem that originated in the gut.
In this article, we’ll go over some of the fundamentals of functional psychiatry, including the S.M.A.R.T method, five practical guidelines that can help you conquer stress and achieve emotional wellness.
The 3 Pillars of Functional Psychiatry
Tapping into the power of the mind-body-spirit connection
Think about a three-legged stool. If any of its legs do not function properly, the entire stool topples. Similarly, if one of the three pillars of functional psychiatry is out of balance, your entire emotional wellness may be affected.
Functional Psychiatry Pillar I: Lifestyle
All your lifestyle choices act as “input” to your system. From the foods you eat, the information you feed your brain with, to the people around you; all of these choices can directly or indirectly affect your emotional health.
Ask yourself: do lifestyle choices support my emotional wellness or do they create more problems?
The term lifestyle includes things within our control such as sleep, exercise, and diet, but also external factors from our environment that are outside our control that can affect our stress levels and mental health.
Functional Psychiatry Pillar II: Physiology
While your physical and mental health may not always seem clearly related, the two are deeply connected.
Gut health issues for example, can impair the ability to adequately process nutrients from your diet or make all the neurotransmitters you need to feel your best.
Other common physical issues that can impact mental well-being may include:
- Nutritional deficiencies
- Chronic inflammation
- Untreated chronic infections
- Chronic stress
- A reduced ability to detoxify chemicals, toxins or stress hormones
- Hormone imbalances such as adrenals or thyroid
Functional Psychiatry Pillar III: Spirituality
The third pillar of functional psychiatry is about your identity, the meaning of your life and your life’s purpose. Are you living a life that is in alignment with your values, or do you feel that something is always missing?
You can do all the yoga in the world, meditate daily, and eat the healthiest diet; if you’re not in alignment with who you are meant to be on the planet, you may always struggle with emotional health.
S.M.A.R.T: Five Practical Guidelines to Prioritize Wellness
Addressing the three pillars of functional psychiatry in one’s life may not always be easy. In our fast paced world, we often don’t find the time to do enough for our health, not to mention our emotional wellness.
To help my patients prioritize emotional health in their lives, I developed the S.M.A.R.T method. It’s a simple guide that consists of five key factors you can control, that play a key role in mental health.Becoming aware of these areas in your life and how they affect your emotional wellness offers powerful insights to help you better understand your true self, allowing you to build a life you truly enjoy.
Not sleeping enough has shown to not only affect physical health, but to also have a big impact on mental health. Sleep plays a key role in the body’s ability to repair, detoxify and regulate stress hormones. Having enough sleep is essential for us to function and feel our best every day, both physically and mentally.
Sleep must be a priority. The first step to improve sleep quality is to avoid common sleep inhibitors and cultivate good sleep hygiene:
- Keep the same night & morning routine. We are all creatures of habit and can greatly benefit from creating healthy habits around sleep as well. Try to go to sleep and wake up the same time every day. Follow the same morning routine and at bedtime. When your body gets used to your schedule and rituals, it is programmed and knows when it is time to wake up or sleep.
- Limit blue light exposure at night. Blue light from electronic devices can trick your brain into thinking it is daylight which can suppress melatonin production, keeping you awake or disrupting your sleep.
- Keep your sleeping environment dark, cool and quiet. The goal is to be as comfortable as possible and avoid interruptions as night.
- Be conscious about what you watch or read at night. Watching news before bedtime can increase your stress levels making it hard for you to fall asleep. Try to engage in relaxing activities that calm your mind instead.
Stress & Mental Wellness
While everyone experiences stress from time to time, the way we perceive stress and react to it can be very different for each individual. Therefore, to improve your mental health it is important to be mindful about the degree that stress affects you.
Stress is our body’s natural response to danger when we feel that we’re being threatened. While most people are more familiar with the fight or flight stress response, there are actually four different ways we respond to stress:
- Fight. Face the threat and fight back.
- Flee. Run away to avoid the conflict.
- Freeze. Stay completely still and do nothing.
- Fawn. Make yourself small in order to “fly under the radar” and avoid attention. Think about an animal huddled in a corner shivering, pulling itself into a ball to appear smaller in order to signal the other animal that they are not a threat.
While these stress responses are entirely different, they can all save our life if used in the right moment. Just think of our ancestors sprinting away or hiding from a saber-toothed tiger.
Our stress response often presents a problem, however, when we deal with modern life stressors. Even though these are not life-threatening events, we may find ourselves getting emotionally stressed too often or developing destructive behaviors that are initially meant to protect us but can hurt us in the long run.
It is therefore essential to look into the different stressors in our lives and how we react to them.
You don’t have to actively fight or flee to be affected by emotional stress. Even if you decide to freeze and do nothing when dealing with a stressful situation in your life, your emotional health may still be impacted. For example, people who default to the freeze stress response, frequently end up developing avoidant behaviors such as overeating, drugs or alcohol abuse to numb their emotions. This automatic “defensive mechanism” is intended to avoid the overwhelming emotions caused by stressful events. But, always coping in this way can have a significant negative impact on emotional and physical health.
Symptoms of Chronic Stress
Constant stress response over a prolonged period of time can affect both your physical and mental health, although you might not always realize it.
So, it is important to pay attention to these warning signs and avoid treating them individually. Some of the common signs of chronic stress may include:
- Sleeping issues
- Weight gain
- Substance abuse and addiction
- Insulin resistance and type II diabetes
- Poor immune health, susceptibility to viral infections such as cold and flu.
These may not always seem related, but when you are not managing your stress, the body and mind may find other ways to cope or numb the negative feelings. To truly improve mental and physical wellbeing, we have to become aware of our stress and coping mechanisms, so we can put healthier habits in place.
Our ancient ancestors walked an average of 14,000 steps a day. The average American, on the other hand, walks less than 5,000 steps.
More and more studies show an alarming link between a sedentary lifestyle, poor mental health and chronic disease. On the flip side, the research also suggests that 20-30 minutes of moderate exercise 4 times per week, is as effective as an antidepressant for mild to moderate cases of depression.
So simply walking more can have an important impact on both your physical and mental health.
The Active Couch Potato
Many people who work out daily and then go back to their sedentary lifestyle for the rest of the day, are surprised to learn they may also be at risk. Our bodies are designed to move, and the constant sitting is linked to poor health outcomes, even if you exercise regularly. It may not be realistic to walk 14,000 steps a day like our ancestors did, but there are still plenty of ways we can move more throughout the day.
Consider using a standing desk, getting up every 30 minutes to walk around, or climbing the stairs when possible. You want to do anything you can to bring more movement into your life to support your physical and emotional health.
“Whether you think you can, or you think you can’t, you’re right.”
It is estimated that the average person has 50,000 thoughts every day, out of which 65% are negative. These automatic negative thoughts (also called ANTS) can impact how we view ourselves and the world, and they can affect how we see our future.
Just like you would take action if you saw ants crawling all over your kitchen counter, it is also essential to properly address the ANTS in your mind. The practice of mindfulness and being present in the moment offers powerful tools to help you become aware of these negative thoughts and replace them with more positive affirmations.
Recognition of Identify
We are all unique individuals with a distinctive set of likes, talents and skills. You are no different.
Ask yourself: Are your values aligned with your current life, or is there anything in your life that is holding you back from truly being your authentic self?
In order to live a life you truly enjoy, it is essential to take time to self-reflect so you can better understand what it is that is important to you and what you want your life to look like.
Tailor Your Input
The inputs into your system play a key role in your mental health. In other words, what you put inside your body and mind can have a major impact, for example:
- Diet. Do the foods you eat nourish you, or do they contain toxins and artificial ingredients that can damage your body and mind?
- Skin care products. The average American is exposed to hundreds of chemicals from their personal care products. Some of these chemicals can be absorbed through the skin and may be toxic to your body and brain.
- Information. Every day, we are bombarded with more and more information, much of which can trigger a stress response and negatively affect our emotional health. It is therefore important to be careful and mindful about the information you “feed” your brain.
- Your relationships. Are you spending your time with people who support you, or do they make you feel worse?
The Best Diet for Mental Health
Diet can be very personal and greatly depends on the individual. While one size diet doesn’t fit all, there are a few guidelines anyone can benefit from:
- Real whole foods. The basic approach to a healthy diet is to eat real food as close to nature as possible. Limit processed foods, which means if something comes in a bag, a box or a can, it probably should not go into your body.
- Colorful fruits and vegetables, these are high in health promoting phytonutrients.
- Green leafy vegetables are rich in minerals and vitamins that are essential for healthy mind and body.
- Probiotics & fermented foods support a healthy gut microbiome and a healthy gut-brain balance. Our gut hosts billions of bacteria that modulate our immune system and help produce hormones that play a key role in our mood and mental health.
- Try to eat organic when possible to avoid pesticides and other toxins that can impact your mental wellness.
- Refined sugars, processed foods and additives.
- Pro-inflammatory foods. Especially gluten and dairy which cause issues for many people.
Personalize your diet: It is important to work with a qualified health practitioner and tailor your diet to you. Very often, a specialized diet is required to address individual symptoms and imbalances.
For example, some people can have too low cholesterol levels due to genetics or statin drugs. Since cholesterol is the backbone for building several key hormones for brain health, these people may be at higher risk for having depression, suicidal thoughts or other mental health issues.
Supplements for Mental Health
Just like the diet, supplements should always be tailored to the individual. In my practice, we test for nutritional deficiencies and build the supplementation plan based on the tests results. With that said, there are some core nutrients that many people are deficient in that can have a significant impact on mental health, these include:
- B Vitamins.
- Vitamin D.
Always be careful about the quality of the supplements you are taking. Since there is no federal governing body that regulates nutritional supplements, there’s no guarantee you will be getting high quality nutrients from all supplements.
Stick with quality brands that are GMP certified, as those are supplements that have gone through rigorous standardization processes.
The objective of functional psychiatry is to find and address the root causes of emotional illness. As a part of our approach, I work in collaboration with my patients and tailor the treatment based on their preferences, often with natural and alternative approaches.
There are cases, however, where prescription medications may still be needed. We may be able to possibly reduce the dosage over time using functional approaches, but some people will need to keep taking medication long-term in order to support their mental health.
There are many things within your control that you can do to feel your best and live a life you truly enjoy. Whatever it is that you might be struggling with at the moment, functional psychiatry offers tools to identify and address the root cause of your issues with a well-rounded treatment tailored to you.
I hope you find this total-wellness approach to mental health helpful. I wish you the very best success in your journey to wellness.