Updated: Apr 5
For the past century or more, the world of medicine as been dominated by a biomedical model of human health. This model holds the position that depression and mental disorders are primary brain diseases. This means that the problem is seen to exist mostly within the brain, and that it is to be solved by medications that target the presumedly faulty brain.
This is the founding model for our local cultural understanding of mental illnesses such as depression and anxiety. This perspective shapes not only how doctors treat patients, but also how patients see themselves. When they meet a certain amount of criteria in the DSM, a diagnostic textbook, they are generally given a diagnosis, and led to understand that their brain dysfunction needs to be corrected by external forces. Psychotherapy is sometimes included in this model, but is often not emphasized or used enough.
While it is true that some people with mental health concerns do have primary brain diseases as the model suggests, and these people benefit from medication and supplementation directed at the brain, many others have what is called a functional problem. The issues are not necessarily originating in the brain even though that is where the symptoms are manifesting. The origin of the issue can be poor diet, lack of essential nutrients, blood sugar disregulation, inflammation, gut dysbiosis (less-than-ideal microbiome in the gut), relationship or situational issues, trauma, hormonal issues, poor behavioural adaptation to stress, neuronal hyper-activation, poor sleep, and the list goes on.
We know that all our symptoms, reactions and behaviours are connected. Being depressed, for example, makes it hard to eat and exercise enough, meaning we don’t give our body what it needs to overcome depression. And yet, patients are not always given the help and information they need to correct these functional issues as well as the biomedical issues. This is the reason that the model can be disempowering for patients.
The biomedical model isn’t wrong, but it’s not “fully right”, either. It’s only sufficient for a small percentage of people. Others need a broader model that investigates functional, multi-system issues that lead to, or contribute to, symptoms of mental illness. This new perspective can include pharmaceuticals for some (along with supplementation and other interventions) as symptom management and attenuation while the root causes and underlying factors are investigated and addressed as much as possible.
This is the integrative biopsychosocial model that is blossoming in medical and psychological circles in recent years. It is the approach that I use in the treatment of mental health concerns. My goal is to help people to begin to manage their symptoms enough to sit down with their experience, feelings, choices, and behaviours, to learn how to make changes that help their body heal itself, from the roots up.
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Gabbard, G. O., & Kay, J. (2001). The fate of integrated treatment: whatever happened to the biopsychosocial psychiatrist?. American Journal of Psychiatry, 158(12), 1956-1963.
Pauling, L. (1968). Orthomolecular psychiatry: varying the concentrations of substances normally present in the human body may control mental disease. Science, 160(3825), 265-271.