Ryan Sheridan, NP
Managing Depression with Traditional Psychiatry vs Integrative Psychiatry
Updated: Dec 5, 2022
This can be a heavy topic, understandably! My goal is to help shed light on the role of exercise in the treatment and prevention of depression. Please don’t take my words as a diagnosis. If you’re feeling depressed or think you’re depressed, please make an appointment to see a mental health provider to help you.
Think about it... is tradition always good?
Tradition can be fun and well... for things like holiday meals and football rivalries. But should we follow tradition instead of the latest evidence when it comes to our health or mental health? Understanding the differences between traditional and integrative psychiatry can be helpful to know, especially when it comes to common mental health concerns like depression. Depression is a condition that has plagued mankind for centuries - and we have really only just begun to learn why depression happens and how to effectively treat it.
What is depression?
By definition, depression is a mood disorder that causes feelings of sadness, hopelessness, and a loss of interest in activities that were once enjoyable. However, depression can be hard to define because it can look and feel different for everyone – anyone who has had depression knows this to be true. From a clinical perspective this can make it challenging to diagnose. We have tools like the DSM-5 to help, but tools are only as good as who is using them. Some people are not outwardly depressed, some people have other mental health disorders that might make identifying depression challenging, and still others may have a physical condition that causes symptoms of depression. All this is to say that a comprehensive evaluation is the only way to determine if you or anyone has depression.
How does traditional psychiatry treat depression?
Prescriptions. And more prescriptions. Psychotherapy may be used, but probably include prescriptions as well. At first, someone with depression will likely be prescribed a selective serotonin reuptake inhibitor (SSRI) like Lexapro. For some people that does the trick, but many others go on to take a cocktail of antidepressants, mood stabilizers, and antipsychotics in hopes of a cure. Hopefully psychotherapy is a part of that plan, but most psychiatrists only provide medication management. That’s it. Traditional psychiatry doesn’t really
provide much more than pills. Important pieces like psychotherapy and other treatments are referred to other providers are skipped altogether.
There is a reason for that – the traditional model of psychiatry simply doesn’t have the time or bandwidth to create a more comprehensive treatment plan for all patients.
I also want to be clear: I am by no means suggesting that psychiatrists or any traditional providers are do anything wrong! I just don’t believe this is the optimal approach to the management of depression – or any other mental health diagnosis.
Then how does integrative psychiatry treat depression differently?
Easy: in integrative psychiatry we just don’t throw all of our weight behind prescriptions. We use medication as a piece of the puzzle. Yes, I believe in and prescribe medication. But I also believe if we can help someone’s depression without, or with fewer prescriptions, why wouldn’t we? The integrative psychiatry approach says prescriptions should be used prudently and asks us to also use complementary and alternative treatments… like exercise, nutrition, and supplements!
What can you expect with integrative psychiatry?
Improving depression is a journey - one that is going to have ups and downs. Healing is not linear, but is more like a roller coaster. With a comprehensive integrative approach, you can expect to have a number of irons in the fire at once. Plan on psychotherapy to be a big part of a treatment plan for depression. Also, it is important to be your own advocate: look at the data, do your own research, and find evidence-based depression treatments that appeal to you. If you are interested in yoga, talk to your provider about using yoga as one of your complementary treatments (FYI yoga is actually effective at treating depression and anxiety for some people).
Don't expect to get more out of your treatment experience than you put into it. If your plan is to take a pill and hope for the best, an integrative approach might not be the best use of your time. The integrative approach asks the patient to be an active participant in their treatment and care. As an integrative provider, I expect my patients to be ready to give it their best effort, even for depression. This can sound scary or overwhelming, but I reassure my patients that I am here for support and together we can achieve their goals.
Do expect that an integrative treatment plan for depression will be highly individualized. Depression looks different for everyone, so their treatment plans should look different too! Come with an open mind, expect to try to new thing, and hear new ideas.
Traditional psychiatry and integrative psychiatry differ in a few key ways. With integrative psychiatry, depression is addressed holistically. Medication may be a piece of the puzzle, not the entire focus. Complementary and alternative treatments empower individuals to engage in effective treatments to enhance prescription efficacy or avoid medication altogether. Feeling down or depressed? You owe it to yourself to feel better - find an integrative provider who can address your concerns in a personalized way!
If you have questions about integrative psychiatry, are interested in seeking care, or are interested in learning about how to practice integrative psychiatry, please reach out to me via email at email@example.com. Feel free to repost this blog, just give me a backlink!