Why All Psychiatrists Should Practice Integrative Medicine

By Janet Settle MD

I’ve been studying and applying integrative medicine in my psychiatric practice for 20 years. In the early days, I felt a little sheepish introducing myself to teachers and fellow students as a psychiatrist. I went to training after training never meeting another psychiatrist. There were no dedicated courses intended for psychiatrists. In my fellowship program, the 24-hour course on neurology and psychiatry didn’t even have a psychiatrist on the faculty. Now, that’s changing and I see more and more psychiatrists and mental health practitioners actively engaged in the world of integrative medicine.

It turns out that psychiatry is the perfect venue for practicing integrative medicine. Why?

1. Patients with multi-system treatment resistant symptoms of “mysterioma” roll downhill into psychiatric offices, the final common resting ground of “difficult to treat patients.” As one specialty after another completes a negative work-up and “clears” the patient, the pressure on the patient to see the psychiatrist mounts. These patients arrive having seen numerous doctors and with treatment resistant symptoms of fatigue, pain, brain fog, depression/anxiety. They carry diagnoses of irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, hypochondriasis, migraine, depressive/bipolar disorder.
2. Patients who don’t respond to conventional treatments are referred to psychiatric practices. These patients are more likely to have undiscovered and untreated root causes of their symptoms. Of course, treatment response doesn’t mean that the underlying cause has been addressed. The MAO or serotonin theory of depression has been pretty thoroughly debunked. But those who don’t respond are ripe for a new treatment angle.
3. Like other chronic diseases, psychiatric syndromes are lifelong. The lifelong burden in cost and side effects of lifelong pharmacologic treatments is tremendous. Empowering people with alternative treatments is gratifying for all.
4. Treatment of root physiologic causes reduces current and future psychiatric symptoms and benefits the health of all organ systems.
5. Treatment of root psychospiritual causes reduces current and future psychiatric symptoms and improves the health of all organ systems.