What Is Integrative Mental Health? A Guide Into The Rapidly Emerging Therapy
There are myriad ways that people can deal with emotional suffering, from drugs to psychotherapy to lifestyle changes. Within each of these broad approaches, there are then much more specific avenues to take — a specific drug, school of therapy, or dietary change that provides the improvements in mental health someone is looking for.
The biomedical model of mental health seeks to focus on biology, correcting emotional dysregulation through drugs that affect the brain. However, pharmaceutical companies and many mental health professionals promote the idea that depression, for instance, is due to a “chemical imbalance”. But there is no evidence to support this now widely held belief.
As Dr. Jonathan Rottenberg states, “Yes, biological factors are important to understanding depression but it is a mistake to think that these chemicals are what cause, maintain, or exacerbate suffering.”
Also, not everyone responds well to medications that boost neurotransmitters like serotonin. For example, nearly half of patients with major depressive disorder (MDD) do not find adequate relief from antidepressants.
Therefore, psychiatrists have pushed for the biopsychosocial model. This integrates biological, psychological, and social factors into our understanding of mental health. But arguably this model is not broad enough. After all, the factors that influence our psychological health are numerous and varied. This is where integrative mental health comes in.
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Defining Integrative Mental Health
Integrative mental health differs from the traditional biomedical approach in the following ways.
- It includes lifestyle factors like diet, movement, and stress, as these can often be an underlying cause of illness.
- It blends conventional and complementary approaches to address symptoms in the most effective way.
- Integrative mental health strives not to rigidly adhere to one particular paradigm over another. Integrative mental health combines approaches that include different modalities, like psychotherapy, traditional Chinese medicine (TCM), nutrition, and bodywork.
Both the biomedical and biopsychosocial models leave out many of these evidence-based methods for improving people’s mental health.
Like the biopsychosocial model, integrative mental health sees different factors that interact in a way that impacts our overall mental health. But to reiterate, integrative mental health includes many more factors than those psychiatrists will traditionally look at.
In the integrative mental health model, these elements include the below.
- Nutrition and gastrointestinal (GI) health
- Spiritual and cultural beliefs and practices
- Environmental factors
- Family and social connections
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In Defense Of Integrative Mental Health
Supporters of integrative mental health argue that many factors influence mental health. In essence, each individual is to experience lasting and meaningful healing in different ways, not a one-size-fits-all approach.
We can’t just focus on drugs because social and cultural factors are at play. If some individuals only attend psychotherapy to seek relief from suffering, they may be neglecting how an unhealthy lifestyle is affecting their mood.
But if you only pay attention to diet and exercise, while ignoring how trauma and childhood experiences impact you today, then you may not achieve the kind of well-being and growth you want.
James Lake, MD, the author of Integrative Mental Health Care: A Therapist’s Handbook (2009), states in an article for Psychology Today:
“Integrative mental health care is a rapidly emerging paradigm that combines prescription medications, psychotherapy and a range of evidence-based CAM [complementary and alternative] therapies. Highly purified natural products are now widely used to treat depressed mood and other mental health problems. Omega-3 essential fatty acids derived from fish oil, kelp or flaxseed oil have beneficial effects at many levels in the body and brain and are commonly recommended by family doctors and psychiatrists to increase the beneficial effects of antidepressants, mood stabilizers, and other psychotropic medications.”
Indeed, integrative mental health aims to combine treatments that are effective, based on an individual’s needs. There is justification for including some complementary and alternative medicines (CAMs) and other approaches promoted by the integrative mental health model.
Let’s now examine all of the factors included in the model and the reason why they deserve attention.
Nutrition And GI Health
What we eat, the supplements we take, and the state of our gut health can all impact our mental health. Promising research has found the following.
- Omega-3 fatty acids, found primarily in fish oil and certain marine algae, can effectively alleviate depression. Two omega-3 fatty acids — EPA and DHA — are thought to have the most potential for helping people with mood disorders.
- The best diet for mental health appears to be a whole-food diet with lots of fruits, vegetables, and unprocessed protein, with minimal junk food and sugar.
- Our gut microbiome is connected to our mental health. Promoting gut health through fermented foods (e.g. kimchi, sauerkraut, kefir) could help alleviate issues like depression and anxiety.
- Vitamins with a link to mental health include folic acid (vitamin B9), thiamin (vitamin B1), vitamin B12, and vitamin D.
The evidence on how sleep affects our mental health is strong. Studies show that various mental health conditions often have an association with poor sleep, which itself can worsen a person’s well-being.
By improving sleep, you can improve your mental health. Strategies that help include cognitive-behavioral therapy (CBT) and having good sleep hygiene. The latter would include the below.
- Maintaining a steady sleep schedule
- Using relaxation techniques like meditation
- Avoiding caffeine in the evening
- Dimming your lights and putting away electronic devices an hour or more before bed
- Maximizing comfort and support from your bed
- Blocking out excess light and sound
The impact of chronic or long-term stress can be significant, negatively affecting both our physical and mental health. This kind of stress, as well as stressful life events, are have a close link to depression and anxiety. Likewise, they can exacerbate mental health conditions like schizophrenia.
Things that can make us extremely stressed include:
- Losing a job
- Money problems
Ways of relieving stress and, therefore, improving our mental health include:
- Leading a more stress-free lifestyle
- Building supportive relationships
- Eating healthily
- Exercising regularly
- Practicing mindfulness meditation
- Good sleep hygiene
Traumatic events are often at the root of many mental health conditions, including depression, post-traumatic stress disorder (PTSD), borderline personality disorder (BPD), and eating disorders. By prioritizing psychotherapeutic approaches that focus on trauma, people can address an essential cause of their distress.
Spiritual And Cultural Beliefs, And Practices
Our cultural beliefs can negatively impact our mental health. For instance, mental health stigma, which makes us feel afraid and ashamed of our emotional distress, can encourage feelings of isolation and even further suffering.
Social or cultural expectations also have an effect on how we feel: as a case in point, a society that associates beauty with thinness can contribute to the development of eating disorders.
However, what we believe can also improve our mental well-being. Research shows that having spiritual beliefs and practices can help many patients. On the other hand, spirituality can sometimes worsen people’s mental health.
In terms of common spiritual practices, there is evidence that mindfulness meditation can be effective in the treatment of depression.
There are many environmental factors that can worsen our mental health, typically by increasing our stress levels. These factors include aspects of our physical environment and major life events, such as the following.
- The death of a loved one
- A dysfunctional family life
- Changing jobs or schools
- Abusing substances or living with a parent who does so
- Living in a noisy environment
- Living in a highly populated city, which can feel lonely
- A lack of urban green spaces or natural surroundings nearby
Family And Social Connections
Humans have been called an “ultra-social animal“. For evolutionary reasons, we depend on others for our happiness. People who have a social connection to family, friends, or their community experience fewer mental health problems than people who do not.
Meanwhile, isolation is a strong predictor of emotional distress, and it can worsen many conditions.
Based on all of the above factors, it would seem unwise for mental health professionals to ignore them when addressing the emotional suffering of an individual. While not every one of these elements will be relevant in this respect, it’s still important to take an integrative approach.
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Possible Criticisms Against Integrative Mental Health
Ideally, integrative mental health will focus only on evidence-based treatments. As well as including psychiatric drugs, effective alternative drugs could be included. These includes things such as psilocybin, ayahuasca, ketamine, MDMA, and 5-MeO-DMT.
Then there are completely different treatments, such as transcranial magnetic stimulation (TMS therapy), which can also be effective for treating major depression, treatment-resistant depression, anxiety, and PTSD. Another is magnetic therapy for depression.
However, because integrative mental health can include CAMs, some of these alternative treatments may not be evidence-based. As Lake writes:
“While some CAM modalities are strongly supported by research findings from large well-designed studies however many CAM therapies are widely used in the absence of strong evidence…so-called “energy” therapies, including Reiki, qigong, Healing Touch, and energy psychology are widely used to treat mental health problems. Energy therapies pose complex challenges to contemporary Western-style research methods.”
The science journalist Jo Marchant states in an article for Nature that “Like many alternative therapies, these practices perform no better than placebos in clinical trials.”
However, Marchant stresses that this doesn’t mean they have no therapeutic value. After all, the placebo effect can be powerful, triggering responses often identical to those created by drugs.
On the other hand, if the placebo effect is what is driving these benefits, patients should be aware of this. There may be much more effective and reliable options available.
Integrative mental health is a new paradigm that holds a great deal of potential. Its broad nature does mean that an individual may have to commit to a long and complicated journey of trying to improve their well-being.
At the same time, so many factors affect how we think, feel, and behave. Therefore, should one treatment fail, all hope is not lost.
By emphasizing the principle of integration, mental health professionals can address emotional distress in a more holistic way. Since our well-being is made up of many interlocking parts, this approach — its proponents argue — should be more effective than traditional techniques.
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Lead image via Pixabay – Brian D’Cruz, Hypno Plus