INTEGRATIVE + ONLINE PSYCHIATRY + HOLISTIC HEALTH

Category: Bipolarity

Collage of pictures with the theme of looking deeper than the accepted medical treatment and diagnoses treatment as with ADHD, NVLD, ASD. Making the right choices for your health.

ADHD: a misdiagnosis, label, or a lost opportunity for the best treatment

ADHD may be a developmental visual-spatial disorder (DVSD)

Apr 24, 2025

Parents conflict over the treatment of their son, diagnosed with ADHD

A close friend and colleague sent me an email asking if I could assist a psychotherapist with a troubled family that needed support from someone knowledgeable in both medication and non-medication approaches. When I spoke with the therapist, it reminded me of the significant polarization regarding the best approach, such as modern medical science versus holistic medicine, as well as the advocacy for more natural and lifestyle interventions. I realized that bridging this gap in a troubled family would be challenging.

In the news today, the same type of conflict steals the headlines, with people railing against science, research, and vaccines that have saved many from the scourges of epidemics, death, and disability. I was one of the fortunate survivors of polio as a child, before the polio vaccine. Yet I know multitudes were not so lucky and were afflicted with lifelong disabilities or died prematurely. The situation surrounding polio and vaccines has been a modern-day miracle for many.

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Turbulent hurricane

Storms and Mental Health

Mary’s Challenges

Mary1 had a history of mood swings, depression, anxiety, and PTSD from childhood sexual abuse. Her years growing up were in a chaotic and disruptive home, especially after her alcoholic father deserted her and her mother. She had experienced a hard time growing up with parental neglect, physical, and emotional abuse. Her post-traumatic stress disorder (PTSD) returned after the hurricane with a vengeance.

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ecstatic women's face doing Yoga

Yoga & Eastern Influence on Holistic Healthcare

An Awakening Fall

As a nine-year-old boy, while enjoying the warmth of the midday sun, I was easing my way out onto a branch of a wild apple tree. It was in a deserted field with the sweetest green apples I had ever tasted. These weren’t like the shiny red ones you can buy at the local store. The tree’s singular presence in an untamed field of weeds and wildflowers made it an even more tempting challenge to climb.

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Lightning in a thunderstorm and natural disaster

Crises, Career, and Mental Health

My journey from crises to a career in medicine and mental health began early in life.

Growing up in the rural countryside, I loved to run and play, in the open fields and woods, with my friends and dog. I became good at swimming and other sports. Even though polio was in the news with pictures of children paralyzed from the untreatable illness—there was no effective treatment or vaccine. I felt invincible and in robust health. But with a turn of fate, the virus found me one summer day.

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COVID-19 and Mental Health Crises Book

If a mental health crisis or the pandemic has affected your life, then this book is written for you.

COVID-19/Mental Health Crises: Holistic Understanding & Solutions

In his timely book, now published, Ronald R. Parks, MPH, MD, examines the impact of COVID-19 or other forms of crisis, loss, or tragedy on individual mental health.

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Promise of Light on other side of a Wood Bridge of wood bridge in deep forest crossing water stream and glowing light at the end of wooden ways; Copyright: khunaspix / 123RF Stock Photo

Expert Mentoring – A Key to Restoring Mental & Emotional Health

Escalating mental health, emotional or related health issues may signal the need for mentoring or guidance.

When help is needed, it can be difficult to find the outside expert support you need. Developing your own personal self as a resource can also be a challenge.

A person in distress often recognizes that their customary coping mechanism and level of support are inadequate. The dependence on learned ways of dealing with adverse life events often does not help for an overload of stressors and emotional turmoil. The experience for some is like being entrapped in a swirl of thoughts, painful emotions and images. Before distress reaches too high a level, is the time to reach out to others for help and guidance.

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Meditation, mindfulness, happiness - zen garden with massage stones and waterlily

Meditation – Mental Health Essential

Meditation, Mindfulness, or Introspective Practices

have well proven their value in holistic mental health work for mood, anxiety, addiction, and health issues. Meditation can be an essential tool for happiness and mental health. Enhancement of longevity and decrease in brain aging has also been demonstrated as an added benefit. In many other areas, there are proven benefits as in work, school, athletic performance, sleep, and creativity. The mere awareness in meditation – that thoughts and emotion are of a changing and transient nature – is enlightening for those felt imprisoned by harsh negative thoughts and emotions.

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53669229 - beautiful colorful butterfly sitting on female hand, close-up - thyroid gland is like a butterfly in the anterior region of the neck

Thyroid, Mood, and Health

The Thyroid Gland (Butterfly Shaped), Autoimmunity, Mood, and Health

The association of mood, thyroid dysfunction, and autoimmunity is a possible contributing and treatable element in mood disturbances. Integrative Psychiatry encourages looking beyond labels, symptoms, and diagnosis. An integrative approach cautions against premature jumping to treatment with what is favored, familiar, or expedient. Integrative Psychiatry fosters awareness of complexity and the possible presence of underlying and correctable factors.

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Spiritual Emergence, Recovery

Neuroplasticity – Recovery & Transformation

post 0716 pasque-flower-edited

Recovery and Transformation are often felt to be impossible for individuals with addictions or mental health problem as depression, anxiety, Post-Traumatic Stress Disorder, and other stress or painful conditions.

There is new hope with the advances in neuroplasticity, neuroscience and its technology to identify, modify or change neuro-circuitry, behavior, responses and reactions. Progress in better understandings of the psychology of the human mind and behavior have contributed to greater success in overcoming what was known previously, which in the past was considered hopeless and beyond the reach of those who had been affected by unrelenting, disabling conditions. The study of other healing methods and traditions, as the 12-Step-Programs for addictions, also has led to more successful integrative treatment programs.

As in the first two steps of 12-Step-Programs, for addiction recovery, there must first be the acceptance of the disease as such, and realization of the impossibility of recovery without profound change. Pursuing treatment on a superficial level for an addiction or any other persistent or chronic illness often fails, such as making limited attempts to make cosmetic changes in one personal way, learned habits, or in the expectation that medication will help. To the person afflicted, life has become unmanageable, and the individual “me” admits to being powerless to make the deep changes needed for recovery. The nature of the illness often has led to feeling hopeless, helpless and powerlessness.

The reason for repeated failures or relapses is that a person unsuccessfully tries to use what was learned from earlier life as:

  • non-effective coping
  • use of manipulation and attempts to control others and the environment
  • efforts to rebuild failing relationships to fulfill unmet needs for nurturance, love, and acceptance
  • repeated ineffective efforts to feel sufficient, empowered and adequate

To recover and transform, one has to get beyond ego, personality, habits, reactions, and behaviors.

If there comes a realization of the powerlessness to change the existing status quo, the opportunity exists to embrace the insight that there are the greater potentiality and possibilities beyond a person’s individual ways and self-identity. When one can’t find any viable alternatives from the repertoire of prior failed actions and behaviors – one has “hit the wall” or “rock bottom” – survival is threatened, the need to tap into a greater “well of resourcefulness” hopefully becomes apparent. After running out of the “customary” choices for survival, there has to be a willingness to let go of the old and embrace options out of the larger sphere of positive possibilities – turning one’s life over to a “higher power.”

The idea for acceptance of a higher power is confusing to some that come to 12-Step-Programs, who may associate this with earlier life negative religious experiences or associations with an abusive authoritarian or dominating figure, especially if there has been traumatic abuse. Gaining flexibility to explore and invest in behaviors or practices to bring about recovery and transformation is what is needed. When stuck in an inflexible state of a rigid self, one needs to shift from an unproductive personal belief about power and control existing in the limitation of individual development and programming since birth, to the realization that there is much more: a greater potentiality, a higher resource beyond the personal limitations and rigid entrapments.

One of the barriers to change relates to deep held core beliefs of:

  1. not being safe
  2. not being loved
  3. not being enough
  4. not being worthy – burdened with guilt and shame

Arriving at a place of great despair, a “dark night of the soul,” there is a need of letting go of the established, old limiting “ego identity.” Embracing spiritual attunement becomes the only viable option, with an acceptance that there is a greater field of possibilities and potentialities, where love, acceptance, and inclusion prevail. Embracing the essence of being – the higher power – allows for profound empowerment and motivation for the steps required for transformation – restoration of “sanity” as identified in the 2nd of the 12 Steps.

Spiritual emergence

is the experience of personal awakening, beyond the constriction and restriction, set by the trained and programmed part of the mind (the ego) – to a higher level of perception, realization, and functioning. A new developing integrative addiction treatment program in Asheville, NC – Center for Spiritual Emergence (see their website) – describes spiritual emergence as a “natural opening and awakening that many people experience as a result of coming to terms with the difficulties of life, through an established faith tradition, as a result of systematic spiritual practices or through unexpected peak experiences.  Spiritual emergences gently allow one to experience and embrace their natural connection to the transcendent domain, forever changing their limiting self-concepts into a more integrative, awakened self”.

Psychoneuroplasticity (PNP)

as presented by Lawlis in his well-done book – Psychoneuroplasticity Protocols for Addictions (Lawlis et al. 2015) is portrayed as an evidence-based science with restorative, rehabilitation, and transformational tools and applications. PNP is founded on post 0716 edit mindset-developments in neuroscience, neural therapies, rehabilitation medicine, addiction and other integrative approaches to mental health treatments.  Though the book focuses on evidence-based treatment approaches for addiction, it is very applicable to the care of other mental health issues and problems and supports the value of integrative approaches and therapies. Brain plasticity is based on the understanding of brain activity, neuronal circuitry, and the ability for the stimulation, modification, retraining, and growth of nerve cells and their complex networks.

Positive brain plasticity can be helpful in many problematic areas as:

  • cognitive processing, worries, physical pain, migraines
  • emotions, depression, anger, reactiveness, stress
  • anxiety, fear, phobias, obsessiveness, distractibility
  • alertness, focus, arousal, ADHD, brain fog, fatigue
  • PTSD, sleep disturbance, addictions, cravings, over-weight

To set the stage for healing, recovery, transformation, and neuroplasticity, any difficulties in above noted areas, may need to be addressed early on. Several are discussed in greater detail below.

Anxiety and fear

can be a disabling condition and a major interference with life and productivity and can act as a barrier to recovery from other mental health condition, including addictions and other health problems. The following can contribute to anxiety or panic like conditions:

  1. unmanaged stress
  2. prior life losses and trauma
  3. lack of adequate parenting or an early life nurturing environment
  4. adverse effects from medication and drugs
  5. life-threatening physical illness

Resulting impairment can become chronic with only temporary relief, if any, from drugs or use of substances that could be harmful to one’s health and well-being. Studies of brain waves often will show high-frequency beta waves in localized regions of the brain suggesting increased activation and the need to retrain and repair the brain’s neural networks to more relaxed frequencies and a healthier state. Mental health professionals sometimes will label people as having other mental health conditions or personality disorders, like borderline personality disorders, because they have not been able to grow and mature emotionally. The behaviors and personality may be related to earlier life abuse, persistent severe anxiety, and feelings of being overwhelmed – resulting in resistance or the inability to resolve severe chronic anxiety that blocks healthy development around their families, social network, and peers.

Traumatic life events

can lead to post-traumatic stress disorder (PTSD), which can either be of a simple type where there has only been one major traumatic event or complex where there have been multiple accumulative traumas. A person’s life development can get stuck in a time-relation to an earlier trauma. Integrative type treatment protocols and therapies focusing on treatment of  trauma, as those presented by Lawlis (Lawlis et al. 2015) have the potential to bring relief by relieving the emotional connection to trauma memories and supporting positive brain changes and plasticity . The use of neurofeedback type treatments as the BAUD (bioacoustical utilization device) can disrupt the reconsolidation of traumatic memory and has been shown to relieve symptoms of PTSD (RESET Therapy). Relaxation or stress-reducing therapies, music, meditation practices, breathing techniques, nutritional diet, neuro-biofeedback and skill development can be a part of neuroplasticity enhancing protocols. Other sensory or trauma-focused therapies as EMDR, are also utilized to form new and healthy neuro-circuitry and response patterns.

Depression

can interfere with recovery and be due a multitude of factors including:

  • response to negative life events, chronic stress, trauma, and losses
  • low self-esteem
  • genetics, nutritional deficiencies, and medical illness
  • toxic environmental exposure including to drugs and alcohol

With depression there may be associated: ruminations and obsessional thought, as seen in OCD (Obsessive Compulsive Disorder); anxiety; loss of productivity; feelings of loss of control; loss of interest in things; a downward spiral of increasing depression and development of suicidal thinking, which can lead to loss of life or complication with other medical illness. If suicidal thinking occurs, immediate help should be sought from mental health professionals.

The brain, if studied with EEG brain wave studies in identified areas of the brain, will show a pattern of under activation and low voltage waves. Neuroplasticity focused protocols look for healthy interventions to bring these areas of the nervous system back online and restore responsive feelings, energy, joy and happiness without the individual resorting to using potentially dangerous drugs or chemicals. Intervention may include therapies as noted above including:

  • neurofeedback or neuro-therapies, BAUD
  • psychotherapies including trauma-focused therapies as EMDR
  • exercise, nutritional diet, supplements
  • sound, rhythm, aroma, movement, and dance therapy
  • mindful meditation, breathing techniques
  • social network development with active peer support
  • coping, relapse prevention, and social skill development

Cyclic patterns of disturbed emotions and behavior

can interfere with recovery. These can present as periods of irritability, rage, heightened anxiety, obsessiveness, sleep disturbance, periods of dramatic increase in activity and hyper focus alternating with times of fatigue, depression, loss of motivation and loss of interest in things. These patterns are sometimes labeled as being in the Bipolar Spectrum (see Dr. Parks article) but can also be related to PTSD and prior accumulative trauma. Many of the above-noted treatments and others are considerations to correct altered behavioral pattern, skill deficits, dysfunctional brain patterns, and neuro-circuitry.

Consider broader integrative or neuroplasticity related approaches if you or a loved one has difficulties with any the above-discussed symptoms or conditions. Seek out competent and well-trained health care practitioners trained in these areas.

Written by Ron Parks, MD, edited by Shan Parks

Question:

What symptoms or conditions do you or a significant other have that may be helped by one of the above-discussed approaches? I would be interested in your comments or opinions. Please respond below.

Pampas Grass in natural setting

Bipolar Holistic Treatment – Part 2

A Holistic integrative approach to the study and treatment of Bipolar Illness — BPI (also referred to as Bipolar or Manic-Depressive Disorder) offers a better path to disease understanding, treatment and prevention. See prior post “Holistic Approach to Bipolar Illness”.

Ben is not doing well with his bipolar illness.

Ben* is on several medications prescribed by his psychiatrist and has just come back from a recent psychiatric hospitalization for his bipolar disorder. He had been hospitalized after he had an emergency room visit for a suicide attempt, after he had taken an overdose of his medications. Prior to that, he had progressively worsening depression with feelings of hopelessness, helplessness and had lost interest in almost everything. He felt that there was no help for him as his mood cycling illness was only getting worse – even with all the medications he was taking. The medications made him feel like a “Zombie.” He was sleeping less with frequent violent nightmares that had woken him up multiple times during the night. He had periods of severe depressed mood when he would stay in bed for most of the day. He would have then have some days of feeling relatively fine.  He then would experience periods of feeling – super “hyped-up” –  full of energy with little need for sleep, talkative with racing thoughts, craving sex and food all the time, feeling like he was a famous rock star, and spending huge amounts of money on things he really didn’t need. He had lost all of his recent jobs and was now divorced from his second wife.

In addition to his regular psychiatrist, his family encouraged him to see and work with a holistic, integrative health care practitioner and therapist. It was uncovered that he also had a significant alcohol problem (as did his bipolar and alcoholic mother), a history of severe early life trauma – probably PTSD, severe gluten sensitivity, and autoimmune thyroid disease with thyroid imbalance. When he was directed to specific treatment and therapy programs for his bipolar illness, his PTSD, alcoholism, nutritional problems and thyroid disease; he was then able to work closer with his regular psychiatrist.  His medications were reduced, and for the first time he began to sleep better with less mood cycling. His new therapy work also helped him to identify and work through some painful childhood issues. He also felt that he regained his spiritual connection.

*(To protect confidentiality, the above is a composite of some clinical experiences and does not represent an actual person or any prior patients).

Finding a better model for helping BPI.

A broader open health-care model offers the potential for improved research, diagnosis and treatment of BPI. All disciplines can be included in an integrative model – including biochemistry, nutrition, psycho-pharmacology, psychiatry,  genetics, spirituality, psychology, sociology, physiology, endocrinology, environmental medicine and complementary mind/body/spiritual therapies. Effective outcomes can happen with patience, and the commitment to finding a suitable care and treatment program.

Early recognition, comprehensive assessment and an integrative approach to treatment – including natural therapies – can help bipolar sufferers improve their chances of stabilization, improvement in relationships, and productivity and work. As proper assessment and diagnosis can be of critical importance, seeking out skilled and experienced health-care practitioners is important – such as a psychologist, a psychiatrist, and/or a holistically oriented health-care provider who is trained in mental health work.  People with bipolar illness are sometimes misdiagnosed as having just depression or other conditions – and treated as such – often resulting in a poor treatment outcome.  These individuals would have responded better to a broader holistic and integrative type of treatment program that had benefited Ben’s recovery as described above.

Every individual is unique in their treatment needs.

Woman with Bipolar Disorder
©Sangolrl/Dollar Photo Club—Balancing Act.

Any individual who has difficulties with mood changes is unique regarding their treatment needs.  BPI can be influenced by factors as:

  • a person background
  • earlier life experiences, exposures or trauma
  • current lifestyle, nutrition, environment
  • individual medical issues, genetics
  • personality
  • psychological or addiction issues
  • traumatic brain injury

A person’s capacity to grow in awareness, learning, and to succeed with lifestyle changes will influence the choices and success of any selected treatment. As there are many individual differences as well as variation in the type and severity of bipolar conditions, the needs and type of treatment will vary or differ from person to person.

Natural non-medication approaches

Some of the non-medication or more natural approaches would be:

  1. improving lifestyle, nutrition, exercise and sleep
  2. addressing environmental issues
  3. stress management
  4. individual or group psychotherapy
  5. avoidance of alcohol and substance abuse
  6. education, behavioral, family, cognitive or trauma therapy
  7. other complementary mind-body-spiritual oriented programs.

Other complementary practices or therapies would be:

  • relaxation training, yoga
  • Oriental Medicine, acupuncture
  • religious, meditation and spiritual practices
  • regular exercise and sleep
  • use of fish oil, rich in EPA and DHA – has been shown to complement other treatments of BPI.

There is a body of work suggesting that nutrition and certain dietary programs can help in treatment of mood disorder, as a diet:

  1. high in healthy fats
  2. high in vegetables, rich in minerals and anti-oxidants
  3. adequate in good quality protein
  4. low in sugar and starches
  5. that avoids gluten (found in wheat, rye and barely — felt to be a trigger in some people for inflammation and auto-immune diseases). (see Grain Brain)

Specially designed light boxes, if carefully used under the guidance of an experienced health-care provider, are sometimes useful (especially if there is a seasonal component to the depression and mood cycling). Assessment and correction for any nutritional, metabolic, hormonal (as thyroid deficiencies), allergic or environmental problems need to be considered.

A genetic biochemical problem that can be improved with nutrition, called hypomethylation is worth assessing – as there is evidence that it affects the expression of bipolar symptoms – and if treated can bring benefits and improve outcomes. Methylation is also relevant to drug-nutrient interaction in the treatment of BPI and is one of possible underlying factors that can contribute to medications not working effectively. (see  “Bipolar Disorder” by Vinitsky and Parks, Advancing Medicine with Food and Nutrients, 2nd edition, Chapter 32, Dec. 2012, CRC Press)

Medication considerations

Some of the conditions or consideration for medication interventions and treatment are:

  • worsening of BPI with poor response to non-medication approaches
  • development of thought or cognitive impairment such as psychotic symptoms with delusion, hallucination or dangerous behavior, especially when accompanied by poor judgment and risk of self or other harm
  • actual or imminent need for a safe protective environment — psychiatric hospitalization
  • lack of capacity or willingness to follow non-medication treatment regimens or protocols
  • personal choosing of medication treatment over non-medications (after being fully educated about all options, including therapy programs or natural alternatives – other than medications) about risk of using medication vs. not taking them, potential for adverse immediate or long-term risks, or side effects from medication

According to some studies, those with bipolar disorder – not treated with appropriate medication or a mood-stabilizing agent when needed – have a significant increase risk of a more chronic condition, more frequent relapses of the illness and more severe outcomes – as suicide*.  More than 50 percent of people will abuse drugs or alcohol if the disorder is not recognized or treated.

Concerns about medication and risk:

  1. potential for short term, long term, or potential side effects: including weight gain, diabetes, metabolic problems, high blood pressure, heart disease, abnormal restlessness and/or involuntary movement disorders of face, mouth and limb (mostly a risk with anti-psychotic medication and possibly from some of the antidepressants)
  2. potential for making mood cycling worse or triggering more severe episodes of mania or psychosis.

So it is important for the individual to be educated about the use medication, benefits and risk – weighing the potential benefits of medication being helpful – especially in a well designed comprehensive treatment program – vs. risks of medication use and side effects.

There are several classes of medications considered when felt necessary in BPI, including:

  1. Anti-depressants: as citalopram and sertraline, which are selective serotonin re-uptake inhibitors – SSRIs that increase the amount chemical nerve factors (neurotransmitters) that helps relieve depression
  2. Anxiolytics (anxiety reducing medication) such as: benzodiazepines such as clonazepam and lorazepam that support the neurotransmitter GABA which helps relieve anxiety
  3. Mood Stabilizers as lithium, valproate and lamotrigine that helps to balance and stabilize brain activity and neurotransmitters (active brain chemicals) which sometimes have an antidepressant effect – as lamotrigine
  4. Antipsychotic Medication as: aripiprazole, risperidone, and lurasidone: helps to eliminate or reduce psychotic thoughts, which is abnormal or disturbed thinking as delusions and hallucination, helpful in reducing agitation, helpful with mood stabilization and sometimes helpful in reducing depression; read more: nimh.nih.gov/health

Fantastic sunset
©Allk Mullkov/Dollar Photo Club—Beauty in Nature.

Appreciating the many facets of BPI, the varied presentation and potential for adverse impact on people’s lives underscores the importance of early recognition, thorough assessment, and initiation of comprehensive and holistic/integrative treatment as outlined above. Effective treatment of BPI sufferers can potentially bring a return to a more stable, functional, fulfilling and productive life.

*If you or some one you know is thinking about self harm or suicide, seek help immediately (Call your doctor, 911 or go to a hospital ER, or Call the 24-hour National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

Article by Ron Parks, MD; edited by Shan Parks

For additional help and resources check below links:

(psych.com/guides)

(dbsalliance.org/)

(NIMH on Bipolar Disorder)

(adaa.org/)

Question:

What would be your consideration and options if you feel that you or a significant other has difficulty with a bipolar illness? I would be interested in your comments.

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