Stress, anxiety and depression are some of the most frequent conditions seen by health care specialists. According to the National Institute of Mental Health (NIMH), in the year 2020 alone, approximately 21 million adults (equating to 8.4% of the US population) experienced at least one major depressive episode.
Similarly, anxiety disorders have affected approximately 31.1% of US adults at some point in their lives, underscoring the magnitude of these conditions.
Typical symptoms of anxiety and depression:
While symptoms of anxiety and depression may vary across individuals, they commonly manifest as follows:
Symptoms of anxiety:
Excessive worry or fear
Restlessness or a constant sense of unease
Fatigue or low energy levels
Difficulty concentrating or experiencing a foggy mind
Panic attacks, accompanied by intense fear or discomfort and physical symptoms
Symptoms of depression:
Pervasive feelings of sadness or a persistently low mood
Loss of interest or pleasure in activities once enjoyed
Changes in appetite and weight (significant weight loss or gain)
Sleep disruptions (insomnia or excessive sleepiness)
Fatigue or decreased energy levels
Feelings of worthlessness
An integrative medicine approach
So, what is the integrative and functional medicine approach to addressing mental health conditions such as anxiety and depression?
The approach is rooted in uncovering the intricate web of underlying causes and imbalances that contribute to these ailments. An integrative medicine doctor will take a holistic perspective, acknowledging the interconnectedness of various bodily systems, including the profound influence of the gut-brain axis, hormone equilibrium, immune system functionality, and the delicate dance of neurotransmitter harmony.
Key aspects of this approach include:
Unveiling and tackling root causes: Identify and address the deep-seated origins of anxiety and depression. Common culprits encompass chronic stress, traumatic experiences, genetic predispositions, hormonal imbalances, gut dysbiosis, nutrient deficiencies, inflammation, and environmental factors.
Nurturing a balanced gut microbiome: There is a profound link between the gut and the brain, recognizing how imbalances in gut bacteria can contribute to mental health disorders. Most people are unaware that over 80% of serotonin, a key brain neurotransmitter, is produced in the gut. Our comprehensive approach involves optimizing gut health through tailored dietary modifications, judicious use of probiotics and prebiotics, and addressing any underlying gut infections or dysfunctions.
Addressing nutrient deficiencies: Certain vital nutrients, such as omega-3 fatty acids, B vitamins, magnesium, zinc, and vitamin D, play pivotal roles in brain health and neurotransmitter equilibrium. Targeted supplementation and dietary adjustments are critical to rectify deficiencies and replenish the body's nourishing reserves.
Harmonizing inflammation: Incessant inflammation within the body can be a contributing factor to mental health disorders. Identifying and mitigating sources of inflammation, including poor dietary choices, food sensitivities, chronic infections, or environmental toxins, constitutes a vital step in reducing its detrimental impact on mental well-being.
Restoring hormonal balance: Hormonal imbalances, whether stemming from thyroid dysfunction or irregularities in sex hormones, can profoundly influence mood disorders. Our approach involves addressing these imbalances through personalized hormonal support and tailored lifestyle modifications, fostering a harmonious interplay between the body's intricate chemical messengers.
Embracing balance and stress management: Chronic stress remains a significant instigator of anxiety and depression. At Dignity Integrative, we emphasize stress reduction techniques such as mindfulness practices, meditation, yoga, exercise, sufficient sleep, and relaxation strategies to aid in managing stress levels and restoring equilibrium.
Restful sleep: Sleep is restorative for your body and your mind. Insomnia affects up to 30% of adults, with approximately 6% to 10% experiencing severe symptoms. Anxiety and depression often coexist with sleep disorders. It is estimated that up to 90% of individuals with depression experience sleep disturbances, and around 50% of individuals with insomnia also have a comorbid mental health condition such as anxiety or depression.
The role of insulin resistance in mental health
Insulin resistance deserves special consideration in this discussion as close to 50% of the US population can be classified as obese.
Insulin resistance is a metabolic condition characterized by the body's reduced ability to respond to the hormone insulin, leading to impaired glucose uptake by cells. While the primary association of insulin resistance is with conditions like obesity, type 2 diabetes, and cardiovascular disease, emerging research suggests a potential link between insulin resistance and mental health conditions such as anxiety and depression. This connection is complex and multifactorial, involving various biochemical pathways. Let's explore some of the key mechanisms involved:
Inflammation: Insulin resistance is associated with chronic low-grade inflammation in the body. This inflammatory state can lead to changes in neurotransmitter levels and impair the functioning of brain regions involved in mood regulation, potentially contributing to anxiety and depression.
Neurotransmitter dysregulation: Insulin resistance may impact the levels of key neurotransmitters in the brain, such as serotonin and dopamine, which are crucial for mood regulation. Altered insulin signaling can disrupt the balance of these neurotransmitters, potentially leading to mood disorders.
HPA axis dysregulation: The hypothalamic-pituitary-adrenal (HPA) axis plays a crucial role in the body's stress response. Insulin resistance may dysregulate the HPA axis, resulting in abnormal cortisol levels and increased stress response. Chronic activation of the stress response can contribute to anxiety and depression.
Brain-derived neurotrophic factor (BDNF): BDNF is a protein that promotes the growth and survival of neurons. Insulin resistance has been associated with reduced BDNF levels, which may impair neuroplasticity and neuronal function in brain regions implicated in mood disorders.
Oxidative stress: Insulin resistance is linked to increased oxidative stress, which occurs when there is an imbalance between the production of reactive oxygen species (ROS) and the body's antioxidant defense mechanisms. Oxidative stress can damage neurons and disrupt neurotransmitter systems, potentially contributing to mental health conditions.
Holistic Treatment for Anxiety and Depression
Proper treatment of anxiety and depression involves correction of root cause imbalances and targeted supplementation.
The most overlooked prevention and treatment strategy of anxiety and depression is exercise. The research indicates a strong correlation between physical activity/exercise and improved mental health outcomes. The impact of daily movement far outweighs the use of SSRIs and other antidepressant medications as evidenced by the following:
A meta-analysis of 49 studies found that exercise interventions significantly reduced symptoms of anxiety across a variety of populations, including those with clinical anxiety disorders. (Asmundson et al., 2013)
A study published in the Journal of Clinical Psychiatry found that regular exercise was associated with a 25% reduction in the odds of developing an anxiety disorder over a five-year period. (Hoffman et al., 2010)
A systematic review and meta-analysis of 25 studies revealed that exercise was effective in reducing symptoms of depression, with moderate-intensity aerobic exercise showing the most significant benefits. (Schuch et al., 2018)
According to a large cohort study published in JAMA Psychiatry, individuals who engaged in regular exercise had a 26% decreased risk of developing depression over a five-year period compared to those who were inactive. (Harvey et al., 2017)
3. Combined Anxiety and Depression:
A review of 11 randomized controlled trials concluded that exercise interventions had a moderate-to-large effect in reducing symptoms of both anxiety and depression. (Jayakody et al., 2014)
In a study published in the American Journal of Preventive Medicine, individuals who engaged in regular exercise were 43% less likely to develop a mood or anxiety disorder compared to those who were inactive. (Mammen & Faulkner, 2013)
While mental health conditions are extremely common the use of an integrative approach provides both a framework to determine the specific root cause as well as a strctured way to treat the imbalances found. It moves us from the pharmacologic based approach to a more holistic, and effective, way to optimal mental and physical health.