One in five Americans are faced with mental health disorders. When we talk about mental health treatment in traditional medicine, we typically think of medication and psychotherapy first. However, the functional medicine approach addresses lifestyle factors which can play a key role in prevention and treatment, as well as symptom improvement which comes through a functional medicine treatment plan. Our lifestyle and the habits we can automate and make consistent can legitimately improve health - physically, emotionally and mentally.
“When we talk about mental health treatment in traditional medicine, we typically think of medication and psychotherapy first. However, the functional medicine approach addresses lifestyle factors which can play a key role in prevention and treatment, as well as symptom improvement which comes through a functional medicine treatment plan.”
In this two-part series, first, I’ll cover the most common mental health issues and mood disorders. Then, in part 2, I’ll cover a functional medicine and integrative approach using lifestyle tools.
Most Common Mental Health Issues
It is a normal part of human life to experience different emotions and changes in mood. However, when more severe, mental health issues may require medical care and treatment. Let’s look at some of the most common mental health issues.
In the United States, the lifetime prevalence of anxiety disorders is about 16 percent, making it the most common mental health challenge.
Anxiety disorders encompass 12 different categories (according to the DSM-5), all of which share features of excessive fear, anxiety, and related behavioral disturbances. Examples include generalized anxiety disorder, social anxiety disorder, separation anxiety disorder, and phobias.
Anxiety symptoms may include:
● Worry and fear about common situations, disproportional to the situation itself
● Panic attacks
● Nervousness or restlessness
● Sense of danger or doom
● Increased heart rate
● Disrupted sleep or difficulty sleeping
● Impaired concentration
● Behavioral changes and avoidance
People with anxiety disorders are also more likely to have comorbid medical conditions, including chronic diseases like diabetes and heart disease, as well as mood disorders.
“People with anxiety disorders are also more likely to have comorbid medical conditions, including chronic diseases like diabetes and heart disease, as well as mood disorders.”
Mood disorders include depression, bipolar disorder, seasonal affective disorder, premenstrual dysphoric disorder (PMDD) among others. Let’s look at the first two.
Depression and anxiety may go together for some. Persistent forms of depression, lasting over 2 years per episode, have a lifetime prevalence of three to six percent in Western countries. Depression affects more women than men, likely because of the influence of sex hormones on brain health and neurotransmitters. Women may experience depression during times of hormonal transition, such as perinatal depression or perimenopausal depression.
Symptoms go far beyond being sad and interfere with the enjoyment of life. They include:
● Sad, “empty” or numb mood
● Decreased energy
● Loss of interest in life
● Suicidal thoughts
● Difficulty concentrating
● Changes in appetite
● Changes in sleep habits
● Body aches and pains
Bipolar depression or bipolar mood disorder includes features of depression as described above, as well as mania.
Symptoms of mania include:
● Decreased need for sleep
● Racing thoughts
● Distraction, lack of focus
● Risky behavior
● Elevated mood or euphoria
People may experience periods of depression, periods of mania, hypomania which isn’t as severe and doesn’t include psychosis, as well as mixed states where some symptoms of both depression and mania are experienced.
Like many diseases, bipolar is likely caused by a genetic predisposition, environmental factors as well as stress or trauma that can trigger disease onset. Women experience a different presentation of bipolar than men, which presents challenges in diagnosis and treatment. Changes in women’s hormones may coincide with the onset or relapse of the disease.
Comorbidities also exist with bipolar, where those with this mood disorder may also be more likely to have a chronic disease like diabetes and heart disease, thyroid disease, anxiety, migraine and suicide.
Lifestyle Can Help or Harm Mental Health
For symptoms discussed here, it’s important to receive a psychiatric evaluation and to obtain appropriate mental health services. You can start by having a conversation with your provider.
Unfortunately, lifestyle change is often missing from that conversation. One study reported that patients with mental health issues and diabetes risk factors received wellness information, including diet and exercise recommendations, in less than 50 percent of cases.
Lifestyle change has many benefits including:
● Improving quality of life
● Addressing root causes
● Reducing health care costs
● And minimizing the risk of chronic disease, which may exacerbate mental health concerns
Many lifestyle tools may help improve mental health. These include:
● Physical activity
● Social connection
● Stress management tools -especially relaxation and meditation techniques
● Connection with nature
● Eliminating alcohol, cigarettes and substance abuse
A healthy lifestyle is important for us all but may be particularly beneficial for those at risk for or currently experiencing mental health issues. Lifestyle tools can be used in conjunction with other treatments, and typically offer tangible benefits with little risk.
In Part 2 of this series, I’ll dive more into the functional medicine approach for mental health disorders.
1. Merlo, G., & Vela, A. (2021). Mental Health in Lifestyle Medicine: A Call to Action. American Journal of Lifestyle Medicine.
2. Aquin, J. P., El-Gabalawy, R., Sala, T., & Sareen, J. (2017). Anxiety Disorders and General Medical Conditions: Current Research and Future Directions. Focus (American Psychiatric Publishing), 15(2), 173–181.
3. Machmutow, K., Meister, R., Jansen, A., Kriston, L., Watzke, B., Härter, M. C., & Liebherz, S. (2019). Comparative effectiveness of continuation and maintenance treatments for persistent depressive disorder in adults. The Cochrane database of systematic reviews, 5(5), CD012855.
4. National Institute of Mental Health. Depression in Women: 5 Things You Should Know. Accessed 1/31/22.
5. Baldessarini, R. J., Vázquez, G. H., & Tondo, L. (2020). Bipolar depression: a major unsolved challenge. International journal of bipolar disorders, 8(1), 1.
6. Parial S. (2015). Bipolar disorder in women. Indian journal of psychiatry, 57(Suppl 2), S252–S263.
7. Xiang, X., Hernandez, R., & Larrison, C. R. (2015). Provider advice on exercise and diet among adults with comorbid serious psychological distress and diabetes or diabetes risk factors. The Diabetes educator, 41(2), 185–193.
8. Sarris, J., O'Neil, A., Coulson, C. E., Schweitzer, I., & Berk, M. (2014). Lifestyle medicine for depression. BMC psychiatry, 14, 107.
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