I have been interested in mental health throughout my medical career. I studied counselling both in the USA and in Australia, have always maintained my ‘upskilling’ in mental health, and even worked for Mental Health Queensland as an outreach G.P.
We now have overwhelming evidence that the model of mental health in terms of inadequate neuro-transmitters is flawed and simplistic. There are chronic environmental stressors – prenatally and antenatally – which work to change our immune responses, our metabolic responses and our hormonal responses, and these all collaborate to create the end result which is the symptomatology of depression, anxiety, or even psychotic illness.
Integrative medicine seeks to uncover the stressors and rectify them, modulate the immune, inflammatory response, work with metabolic and hormonal pathways to optimise neurotransmitter signalling and thereby change the experience of the patient.
There is also a large body of evidence which supports the notion that the gut microbiome is highly influential in mood stability. This is an area which is extremely rewarding to work on with my patients, and there is an excellent test, done through PCR technology, which enables me to know exactly what the microbiota constitutes and then to provide a protocol to improve it; though this test is not currently covered under Medicare.
I am very concerned about the frequency with which SSRIs etc are prescribed and the difficulty that patients have when they try to withdraw from them. This is an area of particular focus with my patients and I have much experience with protocols to safely wean off such medication without experiencing rebound side effects.