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The Current State of Mental Health Care in the USA: Conventional vs Holistic Approaches

By Health_Freedoms at Nov. 3, 2015, 9:40 a.m., 4760 hits

Observations from Ira L. Goodman, M.D., FACS, ABIHM, FAARM, ABAARM


One of the many advantages of living in San Diego is the plethora of medical meetings

that rotates through. Last month I was invited to attend 2 back to back international

Mental Health conferences, which were remarkable more for their contrasting styles

than for their similar content.


The first was PSYCHCONGRESS which was held at the San Diego Convention Center.

It is one of the two large psychiatric meetings held annually and it attracted over 3000

attendees, mostly conventional psychiatrists. It was, as expected, heavily sponsored by

Big Pharma including lavish exhibits hawking every conceivable psychotropic drug in all

their varieties. The exhibit hall must have taken days to set up with custom carpeting,

cappuccino stands, “food” stands ( mostly items I would never consider consuming),

large video displays, attractive reps summoning passers-by into their areas, and even

street artists performing-anything to get the attention of their marks- the ones writing the

prescriptions. Even the poster area was basically one study after another comparing

one drug to another praising the sponsor’s product. There was one exhibit featuring a

folic acid product, but other than that there was basically no mention of anything like

diet, nutraceuticals, HRT, energy medicine, exercise, or lifestyle in the exhibit hall.

However, the lectures did have token coverage of lifestyle and one even mentioned the

microbiome but it was very rudimentary. There was one interesting moment when a

high functioning schizophrenic got up in front of 2000 psychiatrists and told her life story

which included multiple meds, hospitalizations, discrimination, and accomplishments.

She received a standing ovation when she thanked the psychiatrists . The patient

remarkably graduated from Yale Law school. and wrote a book. Apparently there are

rare schizophrenic patients who manage to overcome this disease. I also learned

something about the drug prazosin which is an alpha blocker typically used for BPH and

hypertension but can be used off label for PTSD and insomnia at very low doses. There

are now studies supporting this off label indication. Other than that I could not wait to

get out of this conference.. It was biased and commercial- not an atmosphere of

intellectual discovery or honesty.


The second meeting was the IMMH conference (Integrative Medicine for Mental

Health), an annual event attracting about 400 attendees from a variety of disciplines. I

fully admit to a functional medicine bias but this conference was one of the best I have

been to in years. Almost every lecture was on point, informative, and even enlightening.

The exhibits were a cornucopia of useful devices, supplements, home aids, and cutting

edge new companies displaying their wares. Each lecture was followed by a lively

question session which usually took thirty minutes or more as well as audience

discussions in separate groups. There were many fascinating topics covered including

integrative medicine for depression and anxiety, HRT and metabolic treatments for

mental health, food allergies, the microbiome effect on mental health, lithium as an

agent for cognitive function and mood, the latest thinking on autism, metabolic disorders

mimicking psychosis and other mental disorders, multiple sclerosis, cognitive decline,

and a new inflammatory marker PLA2. I cannot possibly report on all the lectures

adequately in this relatively small report but I will mention a few items of special interest.

One is the increasing use of low dose lithium (1-20mg po) for many different mental

disorders including cognitive decline, mood elevation, manic depression , and anxiety.

As most readers probably know, lithium has been used for years by conventional

psychiatry for bipolar disorder in doses of 300-600 mg/d with several significant side

effects. However these side effects can be mitigated with low doses of the drug and

lithium levels are not even measurable in the serum. Nevertheless, clinical benefits are

almost always evident including the avoidance of standard of care drugs which can be

very dangerous for a number of reasons. The beverage 7-UP used to have low dose

lithium in it until 1950. Lithium has a molecular weight of 6.94 so it was rounded off to 7

and the beverage was frequently advertised as a mood elevator, hence the name 7 UP.

In areas of the country with high lithium soil content, epidemiological studies show fewer

suicides and victims of depression. It is a naturally occurring element typically found in

hair sample even without supplementation. Several physicians (including Jonathan

Wright) have been using it for cognitive decline prophylaxis and mood elevation. This

mineral is worthy of any functional medicine practitioner’s toolkit.


Another noteworthy item I learned at this conference was the about the new

inflammatory marker PLA2 (phospholipase A2) which is measured in the urine by The

Great Plains Laboratory (although other labs are sure to follow). There are ten types of

PLA2 produced, nine of which are measurable in the urine and only one measurable in

the serum since the molecule is too large to make it through the kidneys ( lipoprotein

associated PLA2). The LpPLA2 that most functional medicine practitioners and some

cardiologists use is the one associated with vascular inflammation and is supposed to

portend a CV event. The other nine PLA2 molecules can indicate brain inflammation as

well as inflammation elsewhere. The exciting thing is that a new product called CDP

choline can reduce high PLA2 levels and presumably brain inflammation as well. It can

be used in many neurological degenerative conditions and even as a prophylactic

nutraceutical for brain health. This is cutting edge material developed and researched

by Dr William Shaw who gave several clear and convincing lectures at the IMMH

conference. His work on the association between Tylenol (acetaminophen) and autism

is groundbreaking and well worth viewing. Dr. Daniel Amen also gave a well received

lecture on his work with SPECT brain scans pointing out that psychiatry is the only

specialty that still practices like they did over 100 years ago without looking at the organ

they claim to be experts in. Dr Rouzier gave an excellent talk on the association

between hormone deficiencies (specifically testosterone and thyroid) with a number of

mental health issues.


I was a little disappointed that neither meeting mentioned the work of Robert Whitaker

that he describes in his 2 books Anatomy of an Epidemic and Psychiatry under the

Influence. Whitaker postulates that the introduction of psychotropics (starting with

thorazine in the 50s) resulted in dramatic increases in the incidence and severity of

mental health disorders due to the perturbation of the neurotransmitter levels which

results in permanent changes in receptor density and sensitivity in the brains of treated

patients. This creates a situation that leads to greatly increased recurrences of the

mental disorders the drugs temporarily ameliorate. This is exactly what is seen

epidemiologically. Neither meeting mentioned the work by Kirsch in his book The

Emperor’s New Drugs in which he proves that psychotropics work no better than

placebos. A more complete description of these 2 books is beyond the purview of this

article but I wanted to mention them here since they are highly relevant to any serious

student of this subject.


As an Advanced Fellow in Functional Medicine, Board Examiner, and author I found

these two conferences fascinating. Clearly my bias is toward less invasive, less toxic,

and more effective treatments in anything I am called upon to treat. This should be the

same motivation of any physician but the forces of industry create a cognitive

dissonance that seems almost impossible to overcome. It is my hope that the readers of

this article will be motivated to resist commercial influences and make logical choices

based on evidence and unbiased thinking.

— Last Edited by Health_Freedoms at 2015-11-03 09:41:09 —

 
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