INTEGRATIVE + ONLINE PSYCHIATRY + HOLISTIC HEALTH

Tag: integrative approaches

Rooster crow morning wakeup

COVID-19 Wake Up Call

The current COVID-19 pandemic is a wake-up call to understand all the contributing factors, and steps needed to protect ourselves and future generations from recurrences and the devastation.

Hopefully, soon, COVID-19 will peak and subsides. Its rapid spread and lethality have had a devastating and tragic effect on the most vulnerable people and the vital infrastructure of our society. 

When the final analysis is done, what will be learned and taken away as practical ideas or as more profound wisdom? Some useful areas of interest and inquiry may focus on

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The Heart Addiction Connection

“This heart will one day find you a sweetheart. This soul will one day take you to the beloved. Seize your pain as a blessing. Your pain will one day lead you to healing.” Rumi

Buddy fell from grace into the heart of darkness – the heartless realm of near oblivion and emptiness.
© Dmytro Sidelnikov/ 123RF.com addict lying alone in dark after taking heroin and pills
© Dmytro Sidelnikov/ 123RF.com, over-dose

I met Buddy when I was working in a West Coast emergency room. He came into the ER looking pale and barely breathing.

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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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Holistic Approach to High Blood Pressure 2018

High blood pressure (BP) can be alarming when found during a medical visit or at any other time.

High blood pressure readings may be a wakeup call to take affirmative steps for your health. Natural holistic approaches, and integrative treatments, whether you are on medications or not, can help lower BP and bring benefits to important areas of your life, health, and wellbeing. Unnecessary medication use can carry the risk of falls, hip fractures, and drug-related mental and physical side effects; and more frequent visits to doctors’ offices and hospitals. A significant proportion of the U.S. national health care expense goes to treating high blood pressure. Inaccurate blood pressure measurements lead to overdiagnosis of hypertension, treatment, and use of unnecessary medications (1–4).

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scared businessman is falling into office chaos, Copyright: nomadsoul1 / 123RF Stock Photo

HELP FOR ADHD – ATTENTION – FOCUS

People with attention, focus, or ADHD difficulties can be at a disadvantage in work, academic, and social situations.

ADHD (Attention-Deficit Hyperactivity Disorder or also referred to as ADD – Attention Deficit Disorder), when diagnosed, allows for a workplace or school accommodations under ADA laws (American Disability Act).  Many with less apparent attention/focus (including ADHD) problems may not be considered impaired or disabled, even though they struggle to maintain focus and attention. When someone with focus or attention issues is in a positive fit with their life situation – operating within their capacity, they are often creative, talented, and productive citizens.

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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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huge hurricane over florida - hurricanes, depression, and recovery

Hurricanes, Depression, and Recovery

“Hurricanes, Depression, and Recovery” article is a story of one person’s tragedy from severe depression and hurricane losses. Experiencing a larger force of nature brought him not only to a deeper understanding of his life but to healing and recovery. The hurricane calamity also affected the multitude of people living in the same destructive path. The devastating hurricane or a storm can be compared to depressive illness: both need a path to recovery. A story presents one man’s journey of despair and loss, to redemption and healing.

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addictions, OD with pills

Addictions Uncovered

addictions, OD with pills

Current statistics show the immensity and seriousness of unrecognized substance abuse disorders and addictions.

An integrative psychiatry perspective looks beyond labels, symptoms, or a few illness characteristics to find understanding and positive treatment options for addictions.

Several questions arise about addictions.

  • Who is addicted and how is addictive illness defined?
  • Who is at risk?
  • How does addiction become a destructive disease with health and social consequences?
  • What are the indicators and early signs of addiction?
  • What are integrative psychiatry approaches to addiction, brain change, and neuroplasticity?
  • What resources are available if substance use is a problem?

How serious is the problem?

In a 1999 substance abuse survey, 14.8 million Americans used illicit drugs at least once during the prior month. About 3.5 million were dependent on illicit drugs, and an extra 8.2 million were dependent on alcohol. Only 8.1% of people with alcohol use disorders actually receive needed treatment. An estimated 30% of primary care patients with alcohol use disorders did not receive treatment. In 1992 alone, the total economic cost of addictions, alcohol, and drug abuse was estimated to be $245.7 billion – including:

  • Expense of treatment and preventive programs
  • Related health care costs
  • Reduced job productivity and loss of earnings
  • Increased crime with resulting personal and public costs
  • Social welfare needs

An addiction epidemic now exists to heroin, morphine and other prescription opioid pain relievers.

In the past decade, pain medicine prescriptions, like opiates, have increased 300%. It is estimated that two million people in the United States have substance use problems – most are from opioid pain relievers. About 26% of individuals, who are prescribed opioids for pain, develop opioid use disorders (Dr. Mercola, 2016).   “In 2015, 52,404 Americans died from drug overdoses; 33,091 of them involved an opioid and nearly one-third of them, 15,281, were by prescription,” (Mercola, 2017); (SAMHSA); (Elinore F. McCance-Katz, MD, Ph.D., 2015).

Physicians and dentists in the past were taught to treat pain with drugs, which are now known to cause addiction. Patients were led to believe that pain would be controlled with a low risk of future addiction. As a result, we are now in a national healthcare crisis. In North Carolina, since 1999, more than 13,000 individuals have died from pain medication overdoses. Last year, North Carolina dispensed nearly 10 million opioid prescriptions (DHHS Secretary Mandy Cohen, MD, 2017).

“Since 1999, opioid overdose deaths have quadrupled, and opioid prescriptions have increased markedly – almost enough for every adult in America to have a bottle of pills. Yet, the amount of pain reported by Americans has not changed. Now, nearly 2 million people in America have a prescription opioid use disorder, contributing to increased heroin use and the spread of HIV and hepatitis C. As many as 1 in 4 receiving long-term opioid therapy in primary care settings struggle with opioid addiction.” (LETTER FROM THE SURGEON GENERAL, 2017 – The Surgeon General’s Call to End the Opioid Crisis)

Addiction to refined carbohydrates, sugar, is now a major costly health crisis, contributing to obesity, diabetes, heart disease, and other significant health issues. Though a major problem, it is often overlooked, especially with the massive marketing of the sweetened products and their ready availability – as in soft drinks, and at many food outlets and restaurants. Some of the characteristics of sugar addiction are similar to cocaine addiction.

Addictions defined.

The American Society of Addiction Medicine, 2017 (ASAM) defines addiction as a “primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.” Addictions present characteristically in several ways:

  • Pathologically pursuing of reward and relief by substance use and other behaviors
  • Inability to consistently abstain
  • Impairment in behavioral control
  • Craving
  • Diminished recognition of significant problems with one’s behaviors and interpersonal relationships
  • Dysfunctional emotional response
  • Cycles of relapse and remission

The Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) from the American Psychiatric Association replaced the term addiction with “substance use disorder.” The replacement was done because of the term, “addiction’s” uncertain definition and possible negative connotations. Also, it was felt that “substance use disorder” would be a more neutral term and describe a wider range of dysfunction, from mild to the severe state of “chronic relapsing compulsive drug taking and alcohol use.” However, the word “addiction” is still commonly employed in the USA and other countries where there is the persistence of severe substance abuse problems.

The DSM-5 describes alcohol and opioid in a similar manner as both are considered “use disorders with a problematic pattern of use leading to clinically significant impairment or distress.”

The manifestation is demonstrated by at least two significant occurrences within a 12 month period:

  1. The substances are taken in larger amounts or over a longer period than was intended
  2. There is a persistent desire or unsuccessful effort to cut down or control the substance use
  3. Lots of time is spent in activities necessary to get the substance, use the substance, or recover from its effects
  4. Craving or a strong desire to use the substance
  5. Continued use, despite having persistent or recurrent social or interpersonal problems, caused or exacerbated by effects of the substance
  6. Important social, occupational, or recreational activities are given up or reduced because of the substance use
  7. Recurrent substance use in situations in which it is physically hazardous
  8. Continued use despite knowledge of having a persistent or current physical or psychological problem that is likely to have been caused or exacerbated by the substance
  9. Tolerance, which develops, is defined as a need for markedly increased amounts of the substance to achieve the desired effect. Also, there is the occurrence of a diminished effect with continued use of the same amount of the substance
  10. The withdrawal shows the characteristics withdrawal syndrome for the particular substance
  11.  Related substances are used to relieve or avoid withdrawal symptoms (American Psychiatric Assoc. Publishing 2013) (DMS-5)

There are many factors that can increase the risk of developing an addiction.

A family history of addiction can increase the likelihood of substance use disorders in relatives. A National Co-morbidity Survey showed that individuals with a mood disorder are 2.3 times more likely to have a substance use disorder than those without a mood disorder. For bipolar disorder, there is 9.7 addiction, depressiontimes greater chance of having alcohol dependence and 8.4 times higher chance of having another type of drug dependence problem. Trauma-related conditions, as the experience of a traumatic childhood or adult life events, are found to be a common substrate in addiction illness. Attention deficit (ADHD), anxiety, obsessive-compulsive, and schizophrenic disorders are associated with higher rates of substance abuse. Recognition and treatment of any condition that can potentiate or put one at risk for addiction need attention as soon as possible (see reference and resource page).

There are early warning signs of drug and alcohol abuse.

  1. Increased drinking or use of other drugs
  2. Changes in job or school performance
  3. Changes in attitude and mood as depression, irritability, suicidal threats, or actions
  4. Unexplained changes in eating, sleeping habits, physical appearance, physical complaints, blackouts, or temporarily memory loss
  5. Behavioral problems as dishonesty, sexual promiscuity, and stealing
  6. Change in relationships especially with new friends known to drink or use drugs
  7. Alcohol on breath, slurred speech, staggering, appearing spaced out
  8. Missing alcohol, medications, or money from around the house
  9. The presence of drug paraphernalia as pipes, pill boxes, etc.

Recognition, early interventions, and treatment are critical.

The goal would be to reduce pain and suffering and the staggering cost to society. Because addictions can switch, all types of addictions need early recognition and intervention. Examples would be compulsive eating, gambling, the Internet, computer, sexual, and pornography addictions (see Addiction Reference and Resources page); (Hugh Myrick, MD, 2016).

There are valuable screening tools and questionnaires that are available to identify addictions. The AUDIT for alcohol (WHO) and the SBIRT (SAMSHA) for alcohol and substance abuse are helpful (Marc Schuckit, MD, 2014).

It is useful to learn how the brain develops, perpetuates addictions, and how it can heal itself. There are robust mechanisms in our nervous systems and brain that serve positive purposes. Theses critical brain operations are for survival, food, shelter, reward, gratification, and reproduction. The same processes are also the miraculous pathway for the achievement of success and accomplishments. Misdirection can occur however into debilitating addiction and substance use disorders (William Yvorchuk, MD, 2015).

New findings in brain research give promise for successful addiction treatment.

The brain can adapt, change, and lay down new neurocircuitry (nerve pathways).  Less used neurocircuitry are removed in a healing and regenerative process. Information is needed about the brain’s operations, functioning, and influencers. The application of gained knowledge in neuro research can lead to positive treatment outcomes. The goal would be for prevention, restoration of health, and addiction recovery.

“Neuroplasticity” is the descriptive name for the ability of the brain to change. This process represents the changes that can occur with training and to positive addiction treatment programs. Change in neurotransmitter patterns can result in new positive habits and behaviors. The training, repetition of positive experience in supportive social settings supports these brain changes (Ron Parks, MD, 2016); (Frank Lawlis 2015).

Other approaches as trauma-oriented therapies as EMDR and Spiritual Emergence are potentially valuable additions to treatment programs. The Center for Spiritual Emergence,  as an example, aims to help people live to their fullest potential. A transpersonally-based, systems-oriented, body-centered, and trauma-integrated approach is provided to foster healing and spiritual emergence from spiritual emergencies, mental health issues, and substance use disorders. The physical, emotional, mental, social, and spiritual dimensions of patients’ concerns as well as health and wellness are addressed as a pathway to wholeness.

Integrative and comprehensive approaches to addiction treatment are essential.

A thorough approach to addiction treatment looks at environmental, child to adulthood influences, psychosocial factors, trauma, and neuro-developmental issues. The importance of how other factors affect brain processes and human behavior need continuing investigation.

An intervention or treatment program can be set-up once a qualified individual or program completes an addiction assessment. An Integrative Psychiatrist and Addiction Specialist addition to the treatment team is recommended as there is a high degree of co-existing problems. Co-existing issues may need attention before addiction treatment can be successful or sustained. Treatment needs to be done for contributing medical and mental health concerns. Areas of concern may be nutritional, hormonal, allergy, immune, metabolic problems, trauma, behavioral, psychological, or emotional related conditions. Early medical interventions may look at nutritional deficiencies, inflammation, digestive, hormone, or metabolic problems as insulin resistance, early diabetes, or thyroid problems. Deficiencies of minerals or vitamins such as magnesium, copper, zinc, amino acids, essential fatty acids, B6, B12, or folic acid all can be corrected with appropriate assessment. (see Ten Holistic Steps for Mental Health)

Integrative psychiatry and addiction programs may include:

  • Education
  • Counseling
  • Psychotherapy
  • Inpatient rehabilitation
  • Outpatient programs
  • Partial hospitalization
  • Halfway houses
  • Cognitive behavioral therapy
  • Motivational interviewing
  • 12-step  programs
  • Mutual help groups
  • Mind-body-spiritual and sensory-based therapies
  • Natural complementary therapies

Possible medication augmentation can be considered, especially when other interventions are not successful. Drugs that help reduce cravings and relapses are most effective for opioids and tobacco. The medications currently available are only moderately effective for alcohol and minimally useful for stimulants, cannabis, inhalants, other substances (Petros Levounis, 2015).

If you, or a significant other, such as a spouse, friend or employer, see early signs of addiction, do not ignore, as you may inadvertently be a contributor to the severity of the problem.

With the dramatic rise in death from heroin overdoses and the devastating effects of both drugs and alcohol on individuals, families, and children – addiction is a problem that can’t be ignored. Seek help and information for both recognition and treatment of addictions to prevent serious consequences.

Find resources locally, in your community, or on the Internet. Seek out or consult with:

  • Health care providers or your primary care physician
  • Addiction specialists, treatment centers, or programs
  • Integrative psychiatrists or, holistic health practitioners
  • Twelve step programs as Alcoholics Anonymous or Narcotics Anonymous
  •  Other resources as listed under addictions on our Resource page (see below)

The Substance Abuse Mental Health Service Administration (SAMHSA) can be contacted 24 hours a day at 1-800-622-HELP

By Ron Parks, MD & edited by Shan Parks

Questions:

What would be your first step if addiction is a concern for you or a significant other? Comment below.

References & Resources:

See: Addiction References & Resources

Steps to Health

Ten Holistic Steps for Mental Health

Ten Holistic Steps for Mental Health

by Ron Parks, MD & edited by Shan Parks

Steps to HealthTake the steps for your emotional, mental, and physical health.

The failure to get positive results can be from following an inappropriate program for your needs. Consider exploring some complementary or alternative options that can bring positive improvement. The goals of broadening your personal program would be for you to regain optimal health, fitness, and well-being.

The following 10 step can begin your journey:

  1. Review available information on holistic or integrative strategies for health improvement or illness recovery.

I encourage you to seek more information. Participate in making choices in any areas concerning your health, especially when there are needs for treatment or intervention. Being proactively involved is essential to improving your health.

Find educational materials or services that may be available from either your current health care providers or in your community. Other sources of information may be from trusted and reliable media sources as the Internet, blog sites, or from printed materials.

  1. Choose preferably Integrative Medicine, Psychology, Psychiatry, or Holistic Therapy Programs.

Get the help you need. Consultations with other medical or health care practitioners especially those with a more holistic and integrative orientation are recommended.

Rather than a narrow focus, addressing only a few symptoms or one aspect of the entire person— an active, validating, caring, and holistic approach helps the whole person. Selection of a broader, integrative program is essential, in my opinion, for optimal progress and improvement.  Click on the following:  Integrative psychiatry, medicine, and holistic therapies

refuge, journey to fullfilment, health

  1. Be open and receptive to integrative care that looks at underlying causes, triggers, and risk factors.

The goal would be to eliminate or reduce any contributors that interfere with you being successful with your health and well-being goals.

Significant, “co-occurring” problems in your current life or from unresolved past issues, if unrecognized, may interfere with your health recovery or with your ability to make progress towards your health goals.Some areas that may be missed or ignored, in your health care evaluations or program, that may need attention, are:

  • interpersonal conflicts, recent divorce, or failed relationships
  • stress overload
  • lack of skills as with planning and time management
  • job, career loss, or a financial crisis
  • a move or loss of home
  • the death of a significant other or loved one
  • auto accidents, recent surgery, or hospitalization for a serious illness or injury history, history of other traumas, traumatic stress disorder symptoms, traumatic brain injuries
  • early life abuse, neglect, sexual abuse, rape
  • emotional or mental health issues as anxiety, panic, fatigue, depression, bipolarity, ADHD, obsessive-compulsive problems, developmental issues, Asperger’s
  • drug, alcohol abuse, or addictions
  • eating disorders and obesity
  • unrecognized health and illness related problems
  1. Choose natural alternatives and a healthier lifestyle, as this is often the better and safer choice for you to reach your goals.

Embracing a healthy lifestyle will decrease health problems and offers you the opportunity for improved health and longevity. Awareness and support of the mind, body and spiritual dimensions are essential for wellness, healing, and prevention of illness.

Receive the benefit of support from a holistic practitioner, a group, an educational program, a teacher, or a coach. You are entitled to have the guidance and services needed to feel better and to do better!

  1. Begin a healthy diet and nutrition. Choose:
  • more whole and plant-based foods
  • organic foods when possible
  • avoid process foods with sugar and chemical additives
  • eat vegetables, beans, whole grains (preferably gluten free), greens, fruits, nuts, healthy fats (as avocado, olive oil, fats in nuts and seeds)
  • if not vegetarian, when possible, choose organic, free range chicken, beef, or fish from a healthy ocean or natural unpolluted water source

Get advice from a holistically oriented nutritionist or health coach. Instead of using prescription and over-the-counter medications which are frequently used to treat symptoms – when drugs are not indicated (check with your holistic health care provider first) – consider natural alternatives and the taking of nutritional supplements such as vitamins, minerals, digestive enzymes, amino acids, essential fatty acids, and herbs. Research first and get good advice from a trusted resource or a holistic health care provider.

 

assorted vegables

  1. Exercise is crucial in maintaining health and promoting wellness and illness recovery.

Different types of exercise are encouraged per preferences and ability. Extensive research on exercise has confirmed its value in reducing risks of:

  • heart disease
  • hypertension
  • mood disturbance
  • cancer
  • dementia
  • obesity
  • diabetes
  • stress and sleep related illness

Only exercise to your capacity. If you are just not sure where to start or if there is any potential for stroke, heart attack, or other adverse consequences — get an exercise prescription or advice from a health care provider or a personal trainer.

swimmer, exercise

A variety of exercises in your program will give you the best overall training effect and prevent boredom:

  • biking
  • walking, running, biking, and hiking
  • weight training
  • dancing, aerobic classes
  • swimming
  • yoga
  • qigong
  • tennis and other individual or team sports

Any active movement is helpful and beneficial. There are calming, stress reducing, focusing exercises — like meditation, which can be a fantastic addition to you and your program.

  1. Optimize and improve your poor sleep or insomnia.

Avoid getting into sleep debt or sleep deprivation (not getting enough sleep). Sleep disturbances have been associated with significant medical problems:

  • obesity
  • diabetes
  • accidents
  • poor work, and school performance
  • mood disturbances

Sleeping dogA good start is to reduce stress, over-stimulation, and activity overload. Do meditative or deep relaxation exercises. Improve moods, reduce anxiety and worry. If there is significant mood or anxiety problems, see an appropriate healthcare professional or therapist for assessment and treatment if indicated. See Dr. Parks’ articles at http://ronparksmd.com/ on related topics. If daytime sleepiness or history of loud snoring occurs, see a sleep specialist — as a sleep disorder as sleep apnea may need to be recognized and treated. See, Sleep Disorder article.

  1. Have a thorough evaluation by an integrative healthcare provider if there is any possibility of other hidden health issues.

These may compromise your recovery or interfere with reaching your health goals. Sometimes imbalances in the body can result in illness or health compromise. Lab work or testing may be indicated as diagnostic tests for:

  • allergies, anemia, diabetes, heart disease, infection
  • hormonal imbalances as found in thyroid, adrenal, ovarian, or testicular problems
  • auto-immune or inflammatory illness
  • early cancer
  • nutritional status tests for deficiencies in vitamins minerals
  • elimination diets or digestion function tests
  1. Check out for environmental factors that may play a role in health and disease.

Overload, sensitivities, or reactivity, to or with toxic environmental substances and chemicals can impair health or hinder recovery. These may be present in air, chemical fumes (perfumes, pesticides, industrial chemicals), soil contamination, or in use of certain pesticides or food additives. There is a growing concern about the use of genetically modified foods.  Visit American Academy of Environmental Medicine.

landscape, fullfilment, completion, wellbeingToxicity in the environment can include “toxic” or irritating relationships, excessive noise, intrusiveness, or disruptions by others as in your workplace or where you live.

Other toxic situations may be the lack of a quiet sleep or rest place, excessive electronic or radio-frequency disturbances and exposure (TV, radios, cell phones, microwave).

Consult with reliable sources of information and with an integrative health care provider who has expertise in the areas of environmental health.

  1. Recognize the importance of spirituality in your life.

Study, reflect and apply the wisdom from the great world spiritual, religious philosophies, and practices. Allow your personal faith to be an important part of your transformation into a more positive state of health, well-being, and illness recovery.

Water Lilly SpiritualityWhen stuck, for example, in states of depression or despondency — when traditional mental health service used alone have not helped — surrounding oneself with an inspirational support group can bring about a release from stifling patterns of personal thoughts and beliefs. Shifts can occur towards a better emotional and spiritual attunement and adjustment to life’s demands and conflicts.

Positive outcomes happen in many different types of religious or spiritually oriented support or practice groups. Finding healthy activities – that bring joy, purpose, fulfillment, meaning, and gratification to your daily lives – can open the doors of the spirit and promote health.

QUESTION – COMMENTS:

What would your first step be to improve your health or recovery?

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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