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Can a Psychiatrist Really Help Someone with Addiction?

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Maybe yes, but not so much. Let me tell you why

When someone realizes that he/she has an addiction problem, he/she may start to look for the “why.” Often times, there are underlying mental health issues at play, contributing to his/her gravitation toward certain substances. Then a psychiatrist is a logical place to look for answers.

What would happen at a psychiatrist’s office? Psychiatrists are trained to automatically catalog a person’s various symptoms into a DSM categories, make a diagnosis, and treat with one of the medications in his medication arsenal which he obtained during his residency training and the self-motivated reading/learning after that. What are these medications?

Antidepressants, antipsychotics, mood stabilizers, anti-anxiety medications, and psychostimulants. These are the major categories that would cover 99% of psychiatric practices. That’s how they are trained. That’s how I was trained. We are to quickly diagnose, and treat. But wait, before treating, there’s one thing psychiatrists do check, and that is the thyroid function. Somehow thyroid has been granted this special status as if it’s the only organ in the entire body that affects the brain. What about the rest of the body? The adrenal gland, the ovaries and testes, the liver, the digestive system, or the inflammation that may be raging throughout the body? Or the lacking of nutrients that are crucial in thousands of biochemical functions in the body? What about the genetic makeup of a person? Can he even produce the right chemicals or utilize certain nutrients? No, none of these are checked.

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I’m speaking as someone who practiced psychiatry dutifully just the way I was trained. I saw hundreds of patients, spending more time with them than most of my colleagues, because I wanted to understand every aspect of my patients; yet, I did not have the tools to accurately and comprehensively assess their biological functions. I did pay attention to their life experiences, psychological makeup, and lifestyle factors, but that was not enough. I was not seeing the kind of results I wanted, and I was not getting the kind of satisfaction from being a doctor that’s making fundamental impact on someone’s life. I would give them a medication, they may feel a little less depressed or anxious or moody, but they are still achy, tired, obese, mentally foggy, not to mention the various other problems such as chronic pain, uterine fibroids, fibromyalgia, intestinal irregularities, erectile dysfunction, muscle cramps and repeated infections. Are all these completely separate issues? Are there no unifying underlying causes? That question, is what’s NOT asked in current psychiatric training.

So what will happen when a doctor does not look at what’s happening in the rest of your body? You could be deficient in certain micronutrients. For example, Folate, Vitamin B6, Magnesium, Zinc, Carnitine, Serine, Glutamine, Choline and antioxidant status could affect a person’s ADHD symptoms; Carnitine, Chromium, Folate, Inositol, Choline, Serine, Copper, Magnesium, Selenium, Zinc, Vitamin B6, B3, D and E could all affect anxiety symptoms; Similarly, a lot of the above and biotin, Vitamin B2 and B12 can affect a person’s depression symptoms. We can go on along with same vein regarding fatigue and insomnia. The bottom line is that our body is a complex universe, intricately linked by thousands of enzymatic reactions all happening at the same time, and they all require the assistance of various essential nutrients.

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Unfortunately, in this day and age, it is rather challenging to obtain adequate amounts of all these nutrients, if not impossible, considering that none of us is eating like a scientist, picking the right food in the right amount, day in and day out, especially since our food sources have become depleted of nutrients due to the depletion of our soil and the current food industry practices. A good example is myself, who is keenly interested in nutrition, exercises regularly, and eats healthier than just about everybody I now, yet found out I am low on Vitamin B5, A, C, D, plus a few trace minerals. I would have never known if I didn’t run the test.

And what about the hormones? The only hormone a psychiatrist will check is a person’s TSH (thyroid stimulating hormone), which has a “normal range” that is way too broad, thus missing numerous cases of of insufficient thyroid functioning. A more accurate tests for thyroid function is free T3 and free T4 (although most of the biological functions in the body is accomplished by T3). And then there is the reverse T3 your body produces more of under stress, and reverse T3 look so much like the real T3 that it blocks the T3 receptors, without exerting any of the biological effects of T3. Beyond that, there are various antibodies related to thyroid gland, and they could affect thyroid functions as well. But none of these are tested by a regular psychiatrist, only the TSH, before the initiation of a psychotropic medication.

And we haven’t even talked about the adrenal gland, and the sex hormones, and how all of them can have profound impact on our energy level, mood, attention, memory, motivation and drive, anxiety level, or our cognitive functioning. In addition, there are intricate nutrient-hormone interactions, and micronutrients can profoundly affect our hormonal health.

A lot of psychiatric symptoms could also be a result of heavy metal toxicity or other toxins in our environment, but that is not taken into account in a regular psychiatric practice either.

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In this day and age, it is rather challenging to obtain adequate amounts of nutrients

Also, we have lives within ourselve 10 times the number of microorganisms compared to the number of our own cells, and they have formed a symbiotic relationship through millenniums of evolution, and their imbalance or disturbance can exert a profound effect on our health. There has been increasing evidence of the gut-brain connection, where scientist have proven that microbes in ones gut can affect the myelination process in ones brain. Optimizing gut health is essential for brain health as well.

The list of factors that can affect a person who suffers from addiction can go on.

So will one really find the answers at a typical psychiatrist’s office trained in a typical U.S. psychiatry residency? I wish I could say yes.

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