Psychiatry Redefined was founded on the understanding that numerous quantifiable genetic and biochemical components underlie mental illness. For many years, research has been building that shows this to be true. From vitamin D to inflammation, there are measurable factors that contribute to mental health symptoms. As such, a paradigm shift has started to occur, a shift that will transform the practice of psychiatry. Psychiatry Redefined is helping to lead this new paradigm, bringing providers together to transform the practice of psychiatry.
The Subjectivity of Psychiatry
For many years, psychiatry has diagnosed psychiatric conditions without objective testing or imaging. Traditional psychiatry has long relied on checklists and rating scales created by a group of experts who decide on what constitutes a mental illness. These arbitrary symptom lists change over time, complicating diagnostics and ignoring underlying imbalances that can be tested, measured and resolved.
And since these checklists are subjective descriptions, they don’t identify the underlying pathology of the mental health condition. Yet each subjective mental health diagnosis has its “go-to” medications:
- Depressed patients get antidepressants
- Anxious patients get anxiolytics
- Patients struggling with psychosis get antipsychotics
If patients continue to struggle with additional mental health symptoms, mental health providers will generally shoehorn the patient into another subjective diagnosis and add additional medications. This often develops into a laundry list of drugs in the hope that it will somehow improve the patient’s condition through polypharmacy. Unfortunately, research has not supported this approach (Stassem 2022).
At its core, the problems with modern psychiatry are rooted in this inherent subjectivity. Diagnosis and treatment efficacy are based on checklists and subjective symptom rating scales, making psychiatry the “measureless medicine.” To fix the problem, modern psychiatry’s approach needs to be expanded beyond its subjective foundations. We need more than checklists.
A Misguided Approach…
While solutions exist through Integrative and Functional Medicine, mainstream psychiatry is pushing a misguided approach to further entrench a broken system. A recent viewpoint, published in JAMA Psychiatry, effectively outlines the challenges (Farber 2023). The authors describe how there are over 280 measurement tools for assessing the subjective symptoms of depression in a patient. With different researchers using different metrics, research outcomes are incomparable. Money is wasted as a comprehensive understanding of the literature is virtually impossible due to the incongruities between basic assessment methods.
To solve the measureless problem, a proposal has been put forward that would establish a certified checklist that everyone doing research, at a minimum, must include in their assessment of subjects for each specific diagnosis. While this is arguably a step in the right direction, the proposal has major pitfalls and does not eliminate the problem of subjectivity. In a real sense, it enshrines a certain core subjectivity that everyone is supposed to accept as our best understanding of each mental health condition.
Our patients deserve better than this.
The Solution Already Exists: Psychiatry Redefined
We have long recognized that mental health symptoms have numerous physiological causes. Nutrient deficiencies, hormonal status, inflammation, infections, food allergies, toxicities, the microbiome and other “test-able” factors that can measured, have a powerful influence on mental health. In many cases, these underlying factors cause or contribute significantly to a patient’s symptoms.
Rather than using subjective symptom lists, objective testing should be the core of diagnostics to help establish the underlying causes of a patient’s condition. By measuring, addressing and resolving these core components—as taught by Psychiatry Redefined—mental health is no longer measureless.
With a precision, whole-person approach, we can replace symptom management with root-cause solutions.
As I’ve seen over the course of treating thousands of patients, healing and recovery are often attainable treatment goals through lab testing, and precision and functional medicine. By using a Functional approach, we can effectively transform psychiatry into precision psychiatry, dramatically improving outcomes.
Precision Psychiatry Training
We’re excited to continue embracing and training clinicians in a new paradigm of care that moves beyond checklists and leads psychiatry into the future. Our patients are demanding more, and with precision psychiatry we can provide them with more effective solutions. If you want to transform your mental health practice and learn more about a precision psychiatry, consider joining our Fellowship.
Our Fellowship training covers nine critical clinical areas to move you beyond traditional psychiatry and polypharmacy. The curriculum lays a solid foundation in precision and functional medicine, while giving you an advanced clinical tool kit for treating mental health symptoms with a personalized approach. Plus, you get access to the Psychiatry Redefined private community where you’ll find a robust forum to discuss cases and treatments with community mentors, peers and faculty.
Dr. Madrigal, a previous fellow, described her own experience: “I feel more confident that I’m offering my patients a better approach, the best really, and I can make my approach more scientific and accurate.”
If you want to learn the latest functional interventions to use with your patients, join our next Fellowship session starting January 2024.
Interested, but have questions? Click here to book a private discovery phone call with me or our faculty to learn more and see if this program is right for you!
Are you ready to learn precision medicine interventions to help your patients find lasting wellness?
Enroll now in our Fellowship for all mental health professionals. Book a private call with our faculty to learn more!
References
Farber GK, Gage S, Kemmer D. A Collaborative Effort to Establish Common Metrics for Use in Mental Health [published online ahead of print, 2023 Aug 2]. JAMA Psychiatry. 2023;10.1001/jamapsychiatry.2023.2282. doi:10.1001/jamapsychiatry.2023.2282
Stassen HH, Bachmann S, Bridler R, et al. Detailing the effects of polypharmacy in psychiatry: longitudinal study of 320 patients hospitalized for depression or schizophrenia. Eur Arch Psychiatry Clin Neurosci. 2022;272(4):603-619. doi:10.1007/s00406-021-01358-5
