Integrative Psychiatry for Depression and Bipolar

In desperation, she weaned her child off his meds and started him on a regimen of vitamins and supplements. This nearly resulted in Andrew getting kicked out of school, but she stayed the course and was happy to report that her son had just been awarded the most joyful kid in his class.

Tricia was speaking at a two-day conference, Non-Pharmaceutical Approaches to Mental Disorders staged in Pasadena May 31-June 1, 2003 by a nonprofit organization, Safe Harbor. The need for such a conference can best be underscored by contrasting it to the six-day American Psychiatric Association’s annual meeting which took place two weeks earlier in San Francisco. That conference featured hundreds of workshops and symposia, many underwritten by pharmaceutical companies, with just one session (to this writer’s knowledge) on vitamins and supplements.

Fortunately, mainstream psychiatry and alternative therapies don’t have to be either-or choices. As Lewis Mehl-Madrona MD, PhD of the University of Arizona, a half Cherokee raised in tribal shaman traditions and author of Coyote Medicine and Coyote Healing, told the Safe Harbor conference, "whatever works is good medicine." He has coined the term, integrative psychiatry, to describe the combined medical-alternative approach he is implementing at the University of Arizona.

Dr Mehl-Madrona is working on a study that will randomize patients into the full gamut of alternative therapies on the hypothesis that people will get better regardless of the type of treatment, that their relationship to their healer and their belief in getting better will play key roles. He cited his own study of Reiki on asthma patients whose results were simply too good to be believed. "We didn’t do a study of Reiki," he told the Safe Harbor conference. "We did a study of the culture of Reiki," which began in the waiting room, where people met and were introduced to new friends and new therapies and lifestyle choices.

Even in the psychiatric literature, he stated, we know the drug is not responsible for the total effect.

In the Cherokee view, he related, anything you do changes your chemistry. Watching horror movies, he said, down-regulates cytokines (involved in the immune system) while watching the Marx Brothers up-regulates cytokines within 15 minutes.

"Whatever the ceremony," he concluded, using the term in a therapeutic sense, "I am bigger than I thought I was, I can expect more from myself."

At the same conference, Kathleen Crowley introduced a new concept, procovery. A deep needle biopsy that struck the sciatic nerve was part of her descent into pain and madness, recounted in her book, The Day Room. The intense chronic pain is still with her and will always be. What changed was when an insightful doctor prompted her into the revelation that she could never go backward - to how she had been before - but that she could move ahead. Hence the title of her latest book, The Power of Procovery.

Kathleen told the Safe Harbor conference that procovery is about attaining a productive and fulfilling life, regardless of the limitations of symptoms. As she explains on her website: "The fundamental focus of procovery is one of moving forward when you can no longer move back, of letting go of what was and rebuilding new dreams."

Part of the process involves the recognition that big problems don’t necessarily require big solutions. "Small changes," she says, "can have big impact." Another important rule is "just start anywhere." Where do we start? is a proposition that tends to immobilize us. "Whether it’s number one or number five or number 30 on the task list," she advises, "whether it’s getting a goldfish or getting a job, just start anywhere."

Many of the leading so-called alternative practitioners are firmly-grounded in western medicine. The patients who find their way to the Pfeiffer clinic in Illinois, for example, are given an extensive battery of tests to determine body toxins and nutrient deficiencies and how the body methylates substances prior to the formulation of a treatment plan based on diet and supplements. And Gunnar Heuser MD, PhD of UCLA is as western as they come, a neurotoxicologist who happened to acquire a hyperbaric chamber. Not only is the treatment hi-tech, but he sends his patients for before and after brain scans.

On the flip side of the coin, simply by prescribing lithium to their bipolar patients, most psychiatrists are already engaged in "natural" treatment. Omega-3 is making headway in many practices, and there is sure to be something growing by the side of the road that will one day be met with equal enthusiasm.

In the meantime, shamanism lives. When this writer asked a number of psychiatrists at the 2003 APA meeting what they found worked best in treating patients with bipolar, several of them replied establishing a trusting relationship with the patient. Getting the patient to buy into one’s treatment (and by extension healthy lifestyle choices), in other words, dramatically enhances one’s chances of recovery, whether it is medication we are talking about or acupuncture.

Hopefully, the day will come when people like Tricia can turn to their psychiatrists for expert care on natural supplements and diet as well as meds. Fortunately, Tricia’s son turned out fine. What we didn’t hear about at the Safe Harbor conference were the patients who tried the same thing and wound up in the hospital, case studies for what happens when people go off their meds but also an indictment on a profession that knows more about Seroquel than vitamin C. In 2003, the APA turned down a proposal for a research task force for unconventional therapy. The good news is that the proposal was entertained in the first place. All in good time ...

Purchase Lewis Mehl-Madrona's  Coyote Healing: Miracles in Native Medicine from Amazon.com.

Purchase Kathleen Crowley's  The Power of Procovery in Healing Mental Illness: Just Start Anywhere from Amazon.com.