Bell Let's Talk day is a wonderful way to put Mental Health in the spotlight.
I am very passionate about Mental Health from a holistic standpoint. I believe in education, options, awareness, and recovery. I have chosen to focus my practice on Mental Health after experiencing the pain it brings myself. Furthermore, the field is overdue for a transformation. Integrative or Holistic Psychiatry is finally beginning to bridge the gap in Mental Health care. The gap that leaves people in a medication induced state without resolving deeper issues or factors which have contributed to their mental illness; the gap that has not addressed the ever increasing rates of mental health illness; the gap that has not addressed the soaring rates of long-term disability as a result of mental illness; the gap the misses the body-mind connection, that misses the whole person, the whole picture. For decades, we have been approaching mental illness from the standpoint of a chemical imbalance in the brain. However, what is often overlooked and swept under the rug is the fact that these are really only "theories". This means that they have not been proven to be the sole cause of mental illness, yet physicians and the public are told that it is fact. For example, depression, one of the largest causes of mental illness and disability world wide, is treated most commonly with a drug called an "SSRI" - A Selective Serotonin Reuptake Inhibitor. Serotonin is a neurotransmitter in the brain that has roles in mood regulation. It has long been hypothesized that serotonin, or lack of serotonin, is the cause of depression. So, in order to treat depression, one takes a medication that allows serotonin to remain active in the brain longer, thus resolving the concern. It would really be great if that were the case. It would be wonderful. However, our brains are plastic, and our bodies are homeostatic. This means two things: - The brain changes itself - The brain likes balance So when you give the brain a chemical, that stops it from taking up a neurotransmitter at the rate/speed it likes - the brain compensates. It finds a way to re-balance. This means, that over time, the drugs become less effective, it means people suffer from side effects of the drugs when the dose continues to increase over the years, and it means that the brain is forced to change in a way that actually makes it harder for us to have naturally balanced moods and brain chemistry. What's even worse, is that long term outcomes and rates of recovery have continued to decline over the decades of psychiatric medication use. For example, from Robert Whitaker's "Anatomy of an Epidemic" he writes the following: "A century ago, fewer than two people per 1,000 were considered to be “disabled” by mental illness and in need of hospitalization. By 1955, that number had jumped to 3 .38 people per 1,000, and during the past 50 years, a period when psychiatric drugs have been the cornerstone of care, the disability rate has climbed steadily, and has now reached around 20 people per 1,000. Psychiatric drugs perturb normal neurotransmitter function, and while that perturbation may curb symptoms over a short term, over the long run it increases the likelihood that a person will become chronically ill, or ill with new and more severe symptoms". To demonstrate this, with some figures: - Pre-drug era: 50% of people hospitalized for their first episode of manic-depressive illness [bipolar disorder] were free of symptoms long term, with only 15-20% becoming chronically ill, and 75-90% had no cognitive decline long term -Today, bipolar patients suffer with more episodes of mania and depression, they are more likely to be rapid cyclers, with only 33-40% having regular employment. Many also show long term cognitive impairment. The National Institute of Mental Health's Carlos Zarate states: “In the era prior to pharmacotherapy, poor outcome in mania was considered a relatively rare occurrence. However, modern outcome studies have found that a majority of bipolar patients evidence high rates of functional impairment.” This is why we need alternatives, why we need to look at root cause, and why we need to treat the whole person. The drug based model can be life saving, help with stabilizing acute symptoms, and be extremely powerful for emergency settings and initial treatment - but it just is not addressing long term concerns, or helping people recovery. Evidence suggests that if anything, the drugs often worsen outcomes. So what does the alternative/holistic/integrative approach look like?
It understands that we are the sum of our biological-psychological-social-spiritual realms, and that, in order to really address mental health concerns, acknowledging these other areas is incredibly important! If you or someone you know is struggling with a mental health concern, let's talk about whether a more holistic approach could benefit you! Yours in health and happiness, Dr. Ashley
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July 2017
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