September 14th, 2006 was a day of celebration for me on two accounts. My first son was born and I received my board results. As well as feeling excitement, I also felt a strong instinct to provide for my growing family. For nine months, I set to work at a clinic in Tacoma. After the commute became too burdensome, I found an opportunity to work at a mental health clinic in Edmonds and was employed there for six years.
When I first graduated from Bastyr, I never considered working in mental health. When I think back, however, I became interested in natural medicine from a desire to feel my best. I noticed when my body felt well and healthy because I felt happier and more like my best self. When I transitioned into the mental health field, I realized I had come full circle – promoting optimal physical health in order to improve mental symptoms. I’ve heard colleagues say they found themselves working in areas or specialties they never planned on entering when they graduated, but in the end found it had been the best thing they could have done. That pretty much sums up my story as well.
Spending six years working in a residential mental health treatment program enabled me to gain invaluable experience helping patients with a variety of severe psychiatric illnesses. I was able to see how powerful and effective natural medicines are in treating mental health conditions such as eating disorders, depression, anxiety bipolar disorder, and addiction issues.
Due to the severity of the conditions found in the patient population, natural medicines were often integrated with more conventional medications and treatments. It was helpful to see that the appropriate use of conventional pharmacological approaches can be lifesaving.
The patient population was fascinating and challenging, and working alongside a team of counselors, psychiatric nurse practitioners, naturopathic doctors and psychiatrists felt similar to my student clinician days at Bastyr. Helping a wide variety of individuals struggling with eating disorders, depression, anxiety, bipolar disorder, and additional issues was extremely rewarding.
In February of this year, I began working at The Amen Clinic in Bellevue. I first heard about Dr. Daniel Amen at Bastyr during Dr. Laurie Mischley’s class on Alternative Lab Testing. She had recently toured his clinic and reported that he uses a type of nuclear medicine scan to image the brains of his patients. The SPECT (single photon emission computed tomography) scan is a functional scan of the brain that measures blood flow. This scan is used as part of a comprehensive assessment process that includes a battery of psychological diagnostic tests, a two-hour intake, and then a two-hour visit with the physician to review results and come up with a treatment plan. I think of the use of brain scans now, as I do other forms of lab testing and imaging, and find it extremely helpful in making a more accurate diagnosis. We often order labs and imaging to help in understanding how best to help patients, so it makes sense to look at the brain as well.
I have found that the Amen Clinic’s method, which is a Bio/Psych/Social/Spiritual model, is consistent with many of the principles of naturopathic medicine. The treatment approach is to use supplements and counseling, and then reassess before moving to higher force interventions like prescription medications. The brain scan is a powerful evaluation tool, pointing out areas of over-activity or under-activity, and is eye opening for patients. It also helps target treatments more effectively.
To cite an example, a doctor referred to me a young man who was suffering from severe anger management problems, as well as paralyzing anxiety. He had a pattern of getting in trouble with police, and tended to be defiant and obstinate in his relationships. This 25 year old patient had been smoking marijuana every day for the past ten years. He also had difficulties with attention and focus. When he saw the areas of hypo-perfusion or “holes” in his brain, he was immediately more invested and motivated to stop using cannabis to calm his anxiety and irritability. He came to this conclusion, despite the fact that he, himself, was a grower of cannabis and socialized, almost exclusively, with other marijuana users. Providing palpable evidence of damage can break through a patient’s denial in seconds. Typically, it would have taken many hours and sessions to get to that place. I also noticed an area that appeared to be a smooth indentation pushing into his cerebellum, which could have indicated a cyst or tumor, so I ordered an MRI (Magnetic Resonance Imaging). It turned out to be a mega cisterna magna, which is a prominence of the retro-cerebellar space. This may have been contributing to his symptoms. Using a combination approach to reduce areas of over-activity, his anger and irritability subsided and his anxiety levels also diminished.
Scanning a patient’s brain seems to be especially helpful for complicated cases and patients that have tried many different medications. Some aging patients, concerned about memory loss, are now interested in being evaluated in this way. They understand that a SPECT scan can indicate dementia five to ten years before symptoms even occur.
The field of psychiatry is an area that has yet to catch up with other areas of medicine, with respect to the use of advanced laboratory testing, imaging, and treatment options. As medicine progresses and mental health care becomes more advanced, naturopathic medicine will continue to help patients become their best selves.