INTEGRATIVE PSYCHOTHERAP: Holistic Methods for Easing Depression

As a physician, you know how common it is to encounter patients with depression. In fact, emotional issues may be a significant factor in many of your patients’ health concerns. Whether or not there are complicating medical issues, depression itself can leave your patient struggling to function in a grey fog of hopelessness and anxiety. Add another medical illness to the equation, and the healing process becomes much more complicated. It can become difficult to figure out how to help patients when both mind and body are affected.

Your patients are not alone--one in six people in the United States will experience some degree of depression or anxiety in their lives. Clinical depression is a severe and persistent condition that requires professional help, often in the form of prescription medications that can help lift the dark mood and correct chemical imbalances. But prescription medication is just one of many available treatment options for managing depression, and patients challenged by less severe emotional shifts may function well without a trip to the pharmacy. With or without chemical intervention, there’s a lot your patient can do to battle the blues.

The main goal for your patient, and really for any of us, is to find joy, love, humor, meaning and connection in life. Blocks to happiness may be based in biochemistry, hormonal shifts, poor relationships, unhealthy perspectives, past traumas, other health concerns--the list goes on. Finding and addressing these causes while also building on what is functioning well in the individual is a recipe for success in the treatment of depression.

As an integrative medicine physician at the Sutter Pacific Medical Foundation’s Institute for Health & Healing in Greenbrae, our approach allows me the time to understand the unique combination of physical, mental, emotional and spiritual aspects in a patient’s life. In partnership with the patient, I find what will offer relief from the oppression of sadness while also empowering them to engage in their own healing.

My first step is to conduct a 60-90 minute assessment in a safe and nurturing environment to find the roots of complex health issues. This assessment builds upon the standard medical evaluation with an in-depth exploration of contributing factors, such as biochemistry, genetics, stress, sleep habits, diet, emotions, coping skills, meaning and purpose, and work and family life.

I then collaborate with the patient to develop a personal care plan that may include various lab tests, medications, herbs or supplements, along with the services of our other integrative specialists. Their services include psychotherapy, nutrition, acupuncture, Chinese medicine, chiropractic, craniosacral therapy, homeopathy, massage therapy, lymph drainage and bodywork. Our team acts as a bridge between allopathic and integrative approaches, with the recognition that these treatments can enhance each other if done well.

For depression, integrative psychotherapy seeks to explore and transform those limiting patterns, traumas and beliefs that may block or inhibit the patient. Approaches may include insight-oriented inquiry, lifestyle changes, eye movement desensitization and reprocessing (EMDR), emotional freedom technique (EFT), expressive arts, and guided imagery.

The Institute can bill PPO and POS insurance and Medicare for medical visits, acupuncture, chiropractic and integrative psychotherapy. Insurance plans may not cover all services, and they may have a cap on the number of allowed visits for some treatments, like acupuncture, chiropractic and psychotherapy. We strongly encourage patients to contact their insurance company to learn about their plan, co-pays and whether they have met their annual deductible.

In any care plan, it is often worthwhile to start with the basics of self-care. Our team teaches patients healthy habits in order to help resolve issues that may be inhibiting their healing. Improved self-care benefits just about every aspect of a person’s health and well-being. With mild episodes of depression, or as a complementary approach to the treatment of severe depression, we might suggest the following steps for self-care, all of which can be reinforced by an empathic practitioner.

Optimize your physical health

• Make sure you are eating a healthy diet to fuel your body properly.
• Get enough sleep for your body to rest and repair.
• Reduce stress chemicals in the body via exercise, relaxation techniques and massage.
• Move your body as much as possible with exercise, dancing or walks. This is even more important when feeling stressed but is often the first thing to go during rough times.
• Deal with chronic pain as effectively as possible and then relax into whatever pain remains.
• Use supplements as needed to offset deficiencies and support healing.
• Optimize your emotional and spiritual health
• Dig into the feelings that may be behind the depressed state: guilt, traumas, anxiety.
• Connect with others: open up to a counselor, a trusted friend or a support group to help air those emotions that need release.
• Learn and practice a mind/body technique, such as mindfulness, meditation, prayer or biofeedback.
• Spend time in nature--a powerful mood lifter.
• Consciously increase the laughter and play in your life: watch comedies, play a game.
• Hug and smile as much as possible.
• Minimize depressive activities. Avoid TV news shows or serious dramas for a while to give your nervous system a rest.
• Help/give to others--a surprisingly successful way to feel good even if your own problems remain.
• Explore your own sense of purpose. Ask the big questions and see your life from a higher perspective.
• Expand your joy. Focus more on what makes you happy and lifts you up.
• Create something positive even in small ways: cook a good meal or decorate a corner in your home.
• Create a space in your home that is just for you, that is filled with mementoes and meaningful objects that remind you of what is important and joyful in your life. Inhabit that space regularly.
• Practice daily gratitude for the small or large parts of your life that you love.

Create community

• Find a supportive network of people. Reach out to family, current friends and acquaintances.
• If your community is small or nonexistent, build a new one. Consider taking a class, joining a volunteer group, softball league, spiritual community or other interest group.
• Instead of isolating, spend more time with others, even in small doses.

These subtle shifts in focus--from “what’s wrong” to “what’s right and what’s possible”--can be powerful tools for lifting a patient out of a depressed state. With the guidance of an integrated team, your patients can have a role in their own healing, learning to practice and enjoy healthy habits to last a lifetime. Finding joy is worth the exploration.

---

Dr. Roberts, a family physician with additional training in integrative medicine and psychotherapy, is the lead physician at the SPMF Institute for Health & Healing in Greenbrae.

Email: RobertMX@sutterhealth.org

For more information about the Institute for Health & Healing, or to make a referral, visit www.myhealthandhealing.org  or call 415-461-9000.