Complementary, Alternative, & Integrative Approaches in Mental Health Care

SPECIAL REPORT: INTEGRATIVE MEDICINE

Psychiatry, as conventionally practiced, is being influenced by increasing openness to non-Western healing traditions in the context of accumulating research evidence for select complementary and alternative medicine (CAM) modalities and growing demands for more personalized care.

Individuals who seek psychiatric care for depressed mood, anxiety, and other common mental health issues are increasingly concurrently seeking CAM options via Chinese medical practitioners, naturopathic doctors, herbalists, chiropractors, homeopathic physicians, energy healers, etc.¹ At the same time, increasing numbers of physicians are being trained in CAM approaches and incorporating CAM into their medical practice.²

Collectively, these trends have resulted in rapid growth of integrative mental health care, a collaborative care model that incorporates modalities from psychiatry and CAM and focuses on the whole person; one that has the dual objectives of optimizing well-being and treating specific mental health problems.

This Psychiatric Times™ Special Report contains concise reviews of selected CAM modalities. In addition, this issue’s continuing medical education article reviews CAM interventions for mental health problems associated with the COVID-19 pandemic. The CME article reviews and discusses progress on CAM interventions for enhancing resilience and well-being during prolonged periods of social isolation during lockdowns, and for treating depressed mood, anxiety, and other mental health problems associated with the pandemic.

For instance, data from studies of the neurobiological mechanisms of mind-body medicine support the notion that mind-body practices (eg, tai chi, qigong, yoga, and meditation) enhance general well-being and alleviate symptoms of stress, anxiety, depressed mood, and other common mental health problems These beneficial effects are mediated by neural and physiological mechanisms. As you will read, further research is needed to determine which interventions are most effective for specific disorders and to identify the physiological and neural processes that mediate beneficial effects.

The use of herbals is another common practice that is noted in this Special Report. Widely used herbals typically have bioactive components that mediate complex effects involving multiple neurotransmitter systems; regulate gene expression; and have anti-inflammatory, antioxidant, or endocrinologic effects. In contrast, psychotropic medications are synthetic molecules designed to have discrete modulatory effects on specific neurotransmitter systems.

There is evidence that patients with posttraumatic stress disorder (PTSD) and complex trauma also leverage integrative medicine and nutrition. Dietary modification, nutraceuticals, hydrotherapy, exercise, body-centered therapies and sleep hygiene, and psychedelics are among the 17 components of integrative approaches to PTSD.

Although these pieces just scratch the surface of CAM use in psychiatry, hopefully it provides you with preliminary insights and inspiration.

Dr Lake is a board-certified adult psychiatrist with more than 25 years’ clinical experience. He is an adjunct fellow at the National Institute of Complementary Medicine Health Research Institute, Western Sydney University, Australia. He founded and chaired the American Psychiatric Association’s Caucus on Complementary, Alternative and Integrative Medicine from 2004 through 2010, and has chaired symposia and workshops at American Psychiatric Association conferences and other national and international conferences on complementary, alternative, and integrative mental health care.

Dr Lake is the author or editor of 5 textbooks on alternative and integrative mental health care and a 10-volume series of self-help books on alternative and integrative treatments of depressed mood, anxiety, attention-deficit/hyperactivity disorder, bipolar disorder, and other mental health problems.

References

1. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report. 2008;(12):1-23.

2. Posadzki P, Alotaibi A, Ernst E. Prevalence of use of complementary and alternative medicine (CAM) by physicians in the UK: a systematic review of surveys. Clin Med (Lond). 2012;12(6):505-512.