Welcome to Fullscript’s integrative medicine education series. Discover how integrative medicine improves patient outcomes and why it’s being adopted by forward-thinking practitioners across North America.
Mental health disorders are on the rise. According to the World Health Organization (WHO), conditions such as depression and anxiety have increased more than 25% since 2019, adding to the nearly one billion people who were already living with a mental disorder globally. (20) In the United States alone, it’s estimated that as many as 21% of adults have experienced some form of mental illness in 2020. This represents one in five adults. (22) Yet over half of people in need of mental health care don’t receive any type of treatment. (31)
Among those who do seek professional help, conventional practitioners typically rely on medications like antidepressants or antipsychotic drugs, psychotherapy (talk therapy), or both. While these approaches may provide some benefit, research suggests that these therapies may not be as effective as once thought. (13)(16)(23)(29) Fortunately, taking an integrative medicine approach may provide a more holistic—and more effective—solution for those in need of mental health care.
Integrative medicine for mental health
People, including many conventional health practitioners, often view mental health as separate from physical health. Integrative medicine takes a different approach. Instead of only treating the mental and emotional symptoms, certified mental health integrative medicine providers use a whole-body approach that addresses all aspects of a patient.
This includes not only their mental health, but their underlying physical health, beliefs, environment, social support, and more. (28) The practice of taking a comprehensive view of the whole person instead of a set of symptoms or behaviors is gaining traction as studies increasingly link physical conditions, diet, environmental exposures, and social interactions to a variety of mental health issues. (19)
For instance, emerging evidence suggests that bacterial imbalances in the gut (dysbiosis), non-celiac gluten sensitivity, and inflammation have been linked to anxiety and depression. (6)(10) And immune dysfunction (e.g., infections and inflammation) has been shown to change the way neurotransmitters function in the brain and may contribute to schizophrenia. (30)
Unhealthy habits like eating a Western diet, lack of exercise, poor sleep, and smoking have also been shown to increase the risk of developing a variety of mental health problems, including anxiety, attention deficit/hyperactivity disorder (ADHD), bipolar disorder, depression, and even schizophrenia. (4)(14) By focusing on all facets of the patient, a mental health integrative medicine practitioner can uncover the root causes or contributing factors that may be missed in traditional mental health treatment.
Did you know? Not only do mental health problems negatively impact a person’s overall quality of life, those suffering with severe mental health conditions are more likely to die prematurely. (21)
What is a certified mental health integrative medicine provider?
Certified mental health integrative medicine providers are psychologists, behavioral health professionals, naturopaths, medical physicians, nurse practitioners, nurses, and physician assistants who receive additional training and certification in an integrative and complementary approach to treatment. Certification can be attained through a number of private organizations as well as some colleges and universities. (7)(8)
These certified providers are trained to use the most appropriate, evidence-based complementary and alternative treatments that safely and effectively address each patient’s mental health challenges. These therapies may also be used in conjunction with conventional medical treatments like psychotherapy or medication. By taking a whole-body, individualized approach to mental health, a certified mental health integrative medicine provider works with the patient with an eye on improving outcomes and helping them to regain their mental health and well-being. (15)
Mental health integrative therapies
Mental health integrative medicine providers have an array of alternative, evidenced-based therapies available to treat various conditions, either alone or in combination with conventional treatment. These include:
- Acupuncture (1)(2)
- Diet modification/nutrition (25)
- Dietary supplementation (12)(25)
- Equine (horse) therapy (12)
- Exercise (12)
- Herbal remedies (25)
- Mindfulness meditation (12)
- Tai chi (12)
- Therapeutic massage (9)
- Yoga (12)
Evidence for these therapies is growing. For example, in one four-week study, 105 people diagnosed with an anxiety disorder were randomly placed into one of three groups:
- one group received anti-anxiety medication (a selective serotonin reuptake inhibitor or SSRI) only,
- another group received an SSRI plus a series of acupuncture treatments, and
- the third group received an SSRI and sham acupuncture (needles are not inserted into established acupuncture points). (27)
At the end of the study, those in the acupuncture group experienced the greatest improvement in their anxiety compared to the other two groups. This may have been due to a greater reduction in cortisol levels (stress hormone). (27)
Another study of 60 patients with schizophrenia found that those who received an omega-3 supplement (fish oil) along with their antipsychotic medication experienced fewer psychotic symptoms than those only receiving the drug treatment. (18)
Similar evidence for dietary supplementation was found in a group of patients with bipolar disorder. A study found that supplementing with N-acetylcysteine reduced depressive episodes in bipolar patients who initially had low amino acid levels. (5) Other research suggests that supplements such as saffron, 5-HTP, St. John’s wort, and probiotics may also provide effective antidepressant benefits. (3)(17)(24)(32)
Nutrition is another significant tool in a mental health integrative medicine provider’s arsenal. Research reports that a diet high in essential nutrients like vitamins, minerals, and omega-3 fatty acids (fish oil) may have a beneficial effect on a wide range of mental health disorders. (26) On the flip side, some emerging evidence suggests that a diet high in ultra-processed food may increase the risk of anxiety and depression. (11)
If you are curious about trying integrative mental health care—whether you are currently receiving treatment or considering treatment—look for a certified mental health integrative medicine provider with experience in treating your specific condition. You may be able to find a provider in your area from one of the following online databases:
- Integrative Medicine for Mental Health: Find a Practitioner
- MindHealth 360: Global Database of Integrative Mental Health Practitioners
- Psychology Today: Find an Integrative Psychiatrist
When choosing any type of mental health provider, Mental Health America recommends asking a number of questions during your initial appointment, including:
- What are your credentials?
- Are you licensed in this state?
- What level of education do you have?
- Do you have a particular approach, expertise, or training?
- What experience do you have treating people with my condition?
- Are you available outside of business hours?
- Will I be able to contact you in case of emergency?
- Do you deal directly with my insurance plan or do I need to?
- How much will treatment cost me? Am I responsible for a co-payment?
- Are you willing to communicate with my other doctors and therapists to coordinate care?
The bottom line
Integrative mental health care takes a whole-body approach to treating patients with mental health disorders. It employs an array of evidence-based therapies that can include acupuncture, herbal remedies, mind-body therapy, nutrition, and supplements as an alternative or complement to conventional mental health treatment. If you think integrative mental health care might be right for you, research the options in your area and do your due diligence when choosing a certified mental health integrative medicine provider.
- Amorim, D., Amado, J., Brito, I., Costeira, C., Amorim, N., & Machado, J. (2018). Integrative medicine in anxiety disorders. Complementary Therapies in Clinical Practice, 31, 215-219.
- Amorim, D., Amado, J., Brito, I., Fiuza, S.M., Amorim, N., Costeira, C., & Machado, J. (2018). Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research. Complementary Therapies in Clinical Practice, 31,31-37.
- Ansari, F., Pourjafar, H., Tabrizi, A., & Homayouni, A. (2020). The effects of probiotics and prebiotics on mental disorders: A review on depression, anxiety, alzheimer, and autism spectrum disorders. Current Pharmaceutical Biotechnology, 21(7), 555-565.
- Aucoin, M., LaChance, L., Cooley, K., & Kidd, S. (2020). Diet and psychosis: A scoping review. Neuropsychobiology, 79(1), 20-42.
- Bortolasci, C.C., Turner, A., Mohebbi, M., Liu, Z.S., Ashton, M., Gray, L., Marx, W., … Walder, K. (2021). Baseline serum amino acid levels predict treatment response to augmentation with N-acetylcysteine (NAC) in a bipolar disorder randomised trial. Journal of Psychiatric Research, 142,376-383.
- Busby, E., Bold, J., Fellows, L., & Rostami, K. (2018). Mood disorders and gluten: It’s not all in your mind! A systematic review with meta-analysis. Nutrients, 10(11), 1708.
- Certificate in integrative mental health. University of New Hampshire. https://training.unh.edu/course/certificate-integrative-mental-health
- Certified integrative psychiatric provider fellowship program. Integrative Psychiatry Institute. https://psychiatryinstitute.com/fellowship-program-g2020/?npclid=CjwKCAjwwdWVBhA4EiwAjcYJEHIER0W6N0vtCzxTf-jP0CBqXqHq-yVLxvU-Yxj7t6RN-CJQojulqRoCBvkQAvD_BwE&utm_source=google&utm_medium=cpc&utm_term=integrative%20medicine%20psychiatry&utm_campaign=Brand&gclid=CjwKCAjwwdWVBhA4EiwAjcYJEHIER0W6N0vtCzxTf-jP0CBqXqHq-yVLxvU-Yxj7t6RN-CJQojulqRoCBvkQAvD_BwE
- Chen, S.C., Yu, B.Y., Suen, L.K., Yu, J., Ho, F.Y., Yang, J.J., & Yeung, W.F. (2019). Massage therapy for the treatment of attention deficit/hyperactivity disorder (ADHD) in children and adolescents: A systematic review and meta-analysis. Complementary Therapies in Medicine, 42, 389-399.
- Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017). Gut microbiota’s effect on mental health: The gut-brain axis. Clinics and Practice, 7(4), 987.
- Coletro, H.N., Mendonça, R.D., Meireles, A.L., Machado-Coelho, G., & Menezes, M.C. (2022). Ultra-processed and fresh food consumption and symptoms of anxiety and depression during the COVID – 19 pandemic: COVID Inconfidentes. Clinical Nutrition ESPEN, 47, 206–214.
- Complementary health approaches. National Alliance on Mental Illness. https://www.nami.org/About-Mental-Illness/Treatments/Complementary-Health-Approaches
- Dragioti, E., Karathanos, V., Gerdle, B., & Evangelou, E. (2017). Does psychotherapy work? An umbrella review of meta-analyses of randomized controlled trials. Acta Psychiatrica Scandinavica, 136(3),236-246.
- Firth, J., Solmi, M., Wootton, R.E., Vancampfort, D., Schuch, F.B., Hoare, E., Gilbody, S., … Stubbs, B. (2020). A meta-review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry : Official journal of the World Psychiatric Association (WPA), 19(3), 360–380.
- Integrative medicine for mental health (IMMH). https://www.immh.org
- Ivanov, I. & Schwartz, J. M. (2021). Why psychotropic drugs don’t cure mental illness-but should they? Frontiers in Psychiatry, 12, 579566.
- Jacobsen, J., Krystal, A.D., Krishnan, K., & Caron, M.G. (2016). Adjunctive 5-hydroxytryptophan slow-release for treatment-resistant depression: Clinical and preclinical rationale. Trends in Pharmacological Sciences, 37(11), 933–944.
- Jamilian, H., Solhi, H., & Jamilian, M. (2014). Randomized, placebo-controlled clinical trial of omega-3 as supplemental treatment in schizophrenia. Global Journal of Health Science, 6(7 Spec No), 103–108.
- Lake, J., Helgason, C., & Sarris, J. (2012). Integrative Mental Health (IMH): paradigm, research, and clinical practice. Explore (NY), 8(1), 50-7.
- Launch of the WHO world mental health report: Transforming mental health for all departments of mental health and substance use – 17 June 2022. (2022). World Health Organization. https://www.who.int/director-general/speeches/detail/launch-of-the-who-world-mental-health-report–transforming-mental-health-for-all-department-of-mental-health-and-substance-use—17-june-2022
- Mental health. (2022). World Health Organization. https://www.who.int/health-topics/mental-health#tab=tab_1
- Mental health by the numbers. (2022). National Alliance on Mental Illness. https://www.nami.org/mhstats
- Migone P. (2017). The influence of pharmaceutical companies. Research in Psychotherapy (Milano), 20(2), 276.
- Ng, Q.X., Venkatanarayanan, N., & Ho, C.Y. (2017). Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis. Journal of Affective Disorders, 210, 211-221.
- Nguyen, S.A. & LAvretsky, H. (2020). Emerging complementary and integrative therapies for geriatric mental health. Current Treatment Options in Psychiatry, 7(4), 447–470.
- Rao, T.S., Asha, M.R., Ramesh, B.N., & Rao, K.S. (2008). Understanding nutrition, depression and mental illnesses. Indian Journal of Psychiatry, 50(2), 77–82.
- Sabbagh, Gol A., Rezaei, Ardani A., Farahmand, S.K., Dadgarmoghaddam, M., Ghorani, V., Rezaei, S., & Khorsand, A. (2021). Additive effects of acupuncture in alleviating anxiety: A double-blind, three-arm, randomized clinical trial. Complementary Therapies in Clinical Practice, 45, 101466.
- Shah, A.K., Becicka, R., Talen, M.R., Edberg, D., & Namboodiri, S. (2017). Integrative medicine and mood, emotions and mental health. Primary Care, 4(2), 281-304.
- Smith, B.L. Inappropriate prescribing. (2012). American Psychological Association. https://www.apa.org/monitor/2012/06/prescribing
- Sperner-Unterweger, B. & Fuchs, D. (2015). Schizophrenia and psychoneuroimmunology: an integrative view. Current Opinions in Psychiatry, 28(3), 201-6.
- The state of mental health in America. (2022). Mental Health America. https://www.mhanational.org/issues/state-mental-health-america
- Tóth, B., Hegyi, P., Lantos, T., Szakács, Z., Kerémi, B., Varga, G., Tenk, J., … Csupor, D. (2019). The efficacy of saffron in the treatment of mild to moderate depression: A meta-analysis. Planta Medica, 85(1), 24-31.