The Art and Science of Treating Individual Mental Health Concerns
By: Dr. Nicole Roberts, ND
Considering this is my favourite topic to speak about, it oddly enough is not something I often write about. Rather it tends to be a conversation I have in-person within patient visits or over the phone with prospective patients and patient’s parents on a regular basis.
I’ve been having the conversation so much in fact, that I began to feel as though it was important to write some of this down to better share the impact that natural medical treatments can have for those with Depression, Anxiety, ASD, ADHD, Bipolar, Schizophrenia, OCD, Concussion Recovery and other brain-based conditions.
Before we talk about the ART of treating patients within this medical system, let’s discuss the science.
As a mega-nerd, I could get lost in discussing the ins and outs of the biochemistry behind mental health for days on end, but in the essence of making this article readable, we’ll keep it short and sweet here!
With mental health, we always look at the role the gut-brain axis is playing. Bacterial, fungal and viral cells that live within the human microbiome outnumber our human cells 10:1 - it is folly to believe that the gut microbiota do not have an incredible amount of control over the way we think and feel. Research is finally catching up in this department and the gut-brain axis has become a pinnacle of targeted treatment in the functional medical community. Read MORE HERE; How Anxiety, Depression & Autism Symptoms Can Come From Our Gut
Uncover hormonal & neuropeptide systems that may be contributing to mental health, from the thyroid & sex hormone levels to cortisol, insulin, GABA, neuropeptide Y and more.
Correcting overt micro and macronutrient deficiencies; optimizing ratios for the individual’s biochemistry.
We need to understand the Biochemistry, which is highly governed by the genetic SNPs we have inherited and the epigenetic changes induced by our environment (diet, lifestyle, stress, etc) to understand the nutritional support that will maximize results and lead to mental wellness.
SNPs are short for Single Nucleotide Polymorphisms. Remember Grade 9 science class and DNA structure? If not, don’t worry! A nucleotide is a building block of DNA or RNA (adenine, thymine, guanine, and cytosine + sugar and phosphoric acid). SNPs represent a slight difference in the nucleotide pairing that may be replicated into the genetics of many more cells.
When SNPs arise on multiple genes in key biochemical pathways, the biochemistry may have a tough time creating certain proteins and thus enzymes that catalyze necessary reactions in cells. From a more macro perspective, this can change our levels of neurotransmitters, hormones, detoxification pathways and how we use certain nutrients.
SNPs may not create symptoms of disease until our cells are put into the pressure cooker called LIFE. Stress, poor sleep habits, high carbohydrate diets, gut microbiome injuries (which could happen with something as small as regular drinking out of cups with dishwasher residue that weed down our healthy bacterium, leaving room for symbiotic strains that produce excessive levels of brain disrupting compounds), take advantage of our SNPs and change our biochemistry leading to symptoms that continue to get worse.
One of the most common SNPs that is discussed in mainstream literature is the MTHFR SNP. MTHFR gene codes for the enzyme methylenetetrahydrofolate reductase which produces folate & SAMe to regulate methylation; this supports the function of over 200 other genes. MTHFR functions has a number of other effects on cellular biochemistry as well and SNPS on MTHFR can play a role in Autism, Hypothyroidism, Miscarriages, Down syndrome, Irritable Bowel Syndrome, Asthma, Heart Defects, AND MORE. Oh so much more.
While MTHFR gets all the press, there are a number of other SNP pathways I look at when it comes to treating patients with mental health concerns, including COMT (catechol-O-methyl transferase), PEMT (phosphatidyethanolamine N-methyltransferase), GAD (glutamic acid decarboxylase), MAO (monoamine oxidase), IDO (indoleamine 2, 3 dioxygenase) and SUOX (sulfite oxidase).
Now that we’ve laid some the scientific ground work, we can cycle back to the ART of treating patients.
This refers to how I create treatment plans for the individual sitting in front of me. By learning about their past as well as their current reality, their personality, their home life, their fears, I am better able to craft treatment that molds around them. That patient is the epicentre of healing, and all roads need to lead back to them and their experience. I love that this whole process is characterized by the term “the art of healing” because it truly is an art. Creativity and thinking-out-the-box is essential when it comes to individualized medicine.
The treatment of a 17 year old with depression is not going to look the same as the treatment of depression in a 37 year old mom of two.
When I learn about a person’s life and the years the lead up to the worsening of their mental health symptoms, I am gathering information about the epigenetic factors that have impacted their genes, thus influencing their biochemistry.
For example, Patient X is 41 years old. She is incredibly smart, has always had a Type - A like personality and initially thrived in a career where she had to mentally put together pieces, make quick assessments and lightning-fast decisions for many years. Now, 15 years into her career, which has been compounded by juggling motherhood to 2 twin 6 year old boys, and entering into a perimenopausal decade, her mind feels fried. Brain fog and hazy thinking has begun to hold her back at work, her sleep is limited to 5 hours a night (if that) and she has slowly developed a growing sense of anxiety that has her mind racing, flitting from thought to thought. Increasingly, Patient X is feeling like her mental health and ability to show up for her life and her family is spinning out of her control.
Patient X’s story already tells me quite a bit about what genetic SNPs she may be carrying and how her environment took advantage of them. Without functional testing, I am able to make specific nutritional recommendations to create “work arounds” for her biochemical pathways and alleviate brain fog and anxiety while we design a more sustainable lifestyle for Patient X.
In some instance Functional Testing can be incredibly informative for individual patients. This is a whole topic on it’s own and will be addressed in a separate article.
While this article only scratches the surface of what we can do from a natural medical perspective, it is glimpse into the vastness of treatment possibilities that exist for those with mental health concerns. This is what is so incredible about working in the field of natural medicine; watching customized treatment plans impact lives profoundly.
Dr. Roberts, ND
has a naturopathic practice focusing on mental health & brain health in Richmond Hill and midtown Toronto, ON. Having struggled for a decade with Anxiety, OCD, Depression and multiple Eating Disorders in her teen and young adult years, this experience inspired Dr. Roberts work in the brain health field.