Blog : Exeter Practice Integrates Naturopathic Techniques with Traditional Medicine for Optimum Mental Health

By Amanda | Jul 22, 2014 | in

BY HEIKKI PERRY
Green Alliance Correspondent

While treatment of mental illness has progressed during the last few decades, patients who rely solely on traditional psychiatric care overlook the benefits that naturopathic treatment can produce.

Naturopathic doctors take a different approach to treating mental illness than traditional medical doctors do, and when that approach is coordinated with a medical doctor’s treatment, the synergy can produce more benefits than either discipline alone can offer.

Naturopathic medicine is a distinct primary health care profession, emphasizing prevention, treatment, and optimal health through the use of therapeutic methods and substances that encourage individuals’ inherent self-healing process, according to the American Association of Naturopathic Physicians. The practice of naturopathic medicine includes modern and traditional, scientific, and empirical methods.

Starry Brook Natural Medicine is a naturopathic practice in Exeter, N.H. that provides health care with an approach that integrates with traditional medicine. Physical exams, intakes, and treatment plans are guided by the patient's desires. Treatment and therapies range from prescriptive medicines, acupuncture, herbs, nutrition, and homeopathy or a combination.

The practice offers treatments for a variety of mental illnesses, including borderline personality disorder; bipolar disorder; anxiety; depression; obsessive compulsive disorder; agoraphobia; eating disorders; and trichotillomania.

New Hampshire has narrow rules on prescribing psychotropic drugs. They are chemical substances that cross the blood-brain barrier and act primarily upon the central nervous system, where they affect brain function, resulting in alterations in perception, mood, consciousness, cognition, and behavior. So, while Starry Brook’s Dr. Robyn Giard can prescribe some psychotropic drugs — such as Lithium and benzodiazepines — she mostly refers outside the practice to psychiatrists who can prescribe other medications to treat mental illnesses.

But Starry Brook seeks answers beyond prescribing drugs to find mental health for its patients. Dr. Giard conducts a thorough evaluation of all aspects of a patient’s life, including diet, exercise and spirituality, while also relying on traditional medical techniques.

“One of the most important things I do is look at a blood panel,” she says. “What I’ve been finding is not every patient remembers, or their provider might not be on top of looking at, the liver panel and kidney function. Some of the mental illness-treating psychotropic drugs have a deleterious effect on the liver and the kidneys. So it’s really important that that monitoring is in place. I always request that the patient allow me to communicate with the psychiatrist so that any labs can be provided to the psychiatrist as well.”

After receiving lab results, and conducting a cross-check of any drug interactions to ensure a patient’s medications are not causing harm, Giard inquires whether the patient has received talk therapy or has engaged in cognitive behavioral therapy. If not, Dr. Giard will recommend such treatments.

“One of the research studies shows that people on medications actually do better in the long term when medication is also coupled with therapy,” says Dr. Giard. “So, that’s always one of the things I try to work on with people. Now, not everybody is comfortable, or OK, seeing a therapist. And that’s where we try to implement some other resources for them.”

Other resources include referrals for a provider who performs “biofeedback,” a non-drug technique a patient can use to learn to control his or her body's functions, such as the heart rate, giving the patient the power to use thoughts to control the body.

Another is hypnotherapy, which, Dr. Giard says, “is really a nice way of teaching people how to slow their breath, take a step back from a scenario and relax themselves. I have found that to be very, very helpful.”

Starry Brook also has a yoga therapist to whom it refers patients to learn how to move their body in a comfortable way, which can improve a patient’s mental-emotional state.

“Then we look for any big rocks in the room,” Dr. Giard says. “Is a person eating at McDonald’s every day? If they are on medications we check to see which nutrients are depleted.”

Medications can deplete nutrients in the body, which is problematic because specific nutrients, such as the B vitamins, act as co-factors in the production of neurotransmitters in the brain. “So, if your antidepressant is depleting your B vitamins, and you’re on birth control, suddenly that antidepressant is not working so great anymore. So, we look at adding those back in, and they can actually help make a medication more effective,” says Dr. Giard.

Dr. Giard also examines what she calls “a whole slew of learned behaviors” that people with mood disorder exhibit. One of them is “poor boundaries,” in which patients have a challenge saying “no” to others’ requests or demands, leading to significant anxiety-inducing incidences. For example, a patient’s inability to say “no” to an employer who wants him or her to stay ever later at work, can cause the patient to lose sleep because of exhaustion.

“So, we teach patients to really evaluate the situation and be able to say “no” in a way that’s not aggressive or irritating to others,” says Dr. Giard, adding that employers demanding their employees work longer hours “is a big problem in the United States. Employers are asking more and more of their employees, and employees do not having enough down time.”

“It’s OK to take vacations, it’s important to take vacations, and when you’re on vacation don’t use your cell phone,” Dr. Giard tells her patients, which speaks to a larger problem.

“From every different perspective — from maternity leave, paternity leave, sick time — it’s not really a healthy setup right now,” she says about the American work culture. “But there are ways of managing it.”

Dr. Giard works with patients — many of whom feel they are addicted — on email management. “That really helps people because it keeps them away from their screen, it helps them interact with other people. And that’s one of the things that is impacting mental health today is that we’re not interacting with each other as much as we used to do. There’s less touching. There’s less eye-to-eye communication, so there are more arguments popping up because people are not able to read tone in an email. There are a variety of behavioral changes that we look at that really make a huge difference in a person’s life.”

Starry Brook has started to incorporate more acupuncture for the treatment of patients with mood disorders, receiving good feedback from my patients about it. “It’s a little challenging when we can’t incorporate herbs — there are some herbs … that are contraindicated with some medications. But I find, for the most part, that people with acupuncture and Chinese herbs do really, really well. And they’re able to sustain mood improvement long after treatment, which is key.”

Ensuring that supplements are not contraindicated with medications can be more difficult than one expects: Recent press reports indicate that some supplements do not necessarily have the ingredients its bottles purport to contain. Dr. Giard has worked for a supplement distributor monitoring claims, becoming quite familiar with quality controls.

“There are a lot of bad supplements out there, and I did, unfortunately, see firsthand some patients harmed by supplements with very poor quality control,” she says. “So, having the health-care provider guide patients towards supplements that have high levels of quality controls is important.”

A 2013 law requires New Hampshire insurers to provide coverage for services delivered by naturopathic doctors if those services would be covered when provided by other primary care providers. Starry Brook is an in-network provider with Blue Cross Blue Shield, Cigna, Aetna, Harvard Pilgrim and United Healthcare.

“We’ve been very lucky because we are one of the few integrative practices that accept all the major insurers except Medicare. We’ve been getting referrals from other naturopathic practices as well as therapists and psychiatrists in the area,” Dr. Giard says.

Dr. Giard does caution that potential patients should check with their individual policy because not all policies cover naturopathic care. Still, naturopathic care can be very effective.

“I had a patient recently who had very severe agoraphobia, and we tried some biochemical intervention with some success, not 100 percent,” says Dr. Giard. “So, we decided to incorporate some acupuncture, and after the first session, there was a remarkable improvement. And by eight sessions, this patient was driving over bridges and traveling with ease.”

Starry Brook is a Business Partner of the Green Alliance, a union of local sustainable businesses promoting environmentally sound business practices and a green co-op offering discounted green products and services to its members.

For more information about Starry Brook Natural Medicine, click here.

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