Mental health is having a moment, and it’s about time! For too long our mental wellbeing has been ignored or underestimated, but now people are becoming more accepting and supportive of psychological issues and more willing to seek treatment.  We’re healing, growing, and setting the foundation for a balanced brain and life. 🧠

One of the biggest shifts is the increased variety of tools available to us for mental health support. Take it from someone who has tried many of them. I have been on and off psychiatric medications since the ripe age of 13, some of which I’ve benefited from, others not so much. And I’ve spent the better part of a decade finding ways to heal and calm my nervous system through lifestyle changes and wellness tools.

One approach recently piqued my interest: Functional psychiatry. I was fascinated by the idea of practitioners taking a whole-body, functional medicine approach to psychiatry and mental health by focusing on the root of the issues, not just the symptoms. So let’s dive into what functional psychiatry is, what treatments it offers, how to find practitioners, and more.

What is functional psychiatry?

Dr. Achina Stein is a board-certified psychiatrist, Clinical Director of the Healing Depression Project, and Amazon international bestselling author of “What If It’s NOT Depression? Your Guide to Finding Answers and Solutions.” She describes functional psychiatry as “an approach to mental health that focuses on finding the root causes of symptoms in the body, that also affect the brain – and ultimately the mind. We (functional psychiatrists) believe that everything is connected and that the body has the tools to heal itself, but it needs support by removing the barriers to healing.”

Dr. Stein recounts a patient who had multiple infections that kept coming back, causing extreme fatigue, joint pain, severe anxiety, insomnia, and brain fog. When the patient was asked what happened just before the symptoms started, she couldn’t remember. These infections required multiple rounds of antibiotics over the course of ten years. During the exam, Dr. Stein saw that the patient had nine mercury fillings and a cap on one tooth. The patient then immediately remembered that she had had a bad toothache before the start of the infections. Stein explained that hidden infections in the mouth can wear down the immune system, opening the body up to further attack. Ultimately the patient was seen by a biological dentist who was able to resolve most of her symptoms and put her on a path to healing. This is not an uncommon scenario, and you can probably see why psychiatric medications would not resolve this situation, especially without addressing the underlying causes first.

Treatment will look different for every patient, but some of the most common tools Dr. Stein uses are: 

  • Lab tests using blood, urine, and stool.
  • Using anti-inflammatory foods to restore nutrient depletion.
  • Finding and removing toxins.
  • Teaching people to recognize and respond differently to emotional and physical stressors.
  • Balancing hormones.
  • Assessing and fixing digestion.
  • Health coaching to increase awareness of internal rhythms to help improve sleep, stay active, and recognize how your environment affects your mind, body, and soul.

It’s not that functional psychiatrists don’t prescribe medications to their patients, they just understand that there’s a whole human with a complex story and background behind their symptoms. 

“One of the biggest tools in functional psychiatry is performing labs and looking at them through a patient-centered, functional medicine lens to see the big picture and not just individual symptoms.”

Just ask Megan Langworthy, a psychiatric nurse practitioner based in Portland, OR, specializing in precision medication management. As a functional psychiatry provider, she aims to find out what’s “upstream of symptoms” versus just slapping on a band-aid. One of the biggest tools in functional psychiatry is performing labs and looking at them through a patient-centered, functional medicine lens to see the big picture and not just individual symptoms. Functional psychiatry is “data-driven and evidence-based” and labs give providers insight into their patient’s gut health, hormones, and other key indicators that may point to the underlying cause behind symptoms. 

Langworthy explains that “the body is always trying to keep us in balance. If we can figure out what’s going on upstream we’re decreasing the amount of work the body has to do on a daily basis.” Mental health symptoms may have to do with trauma, the microbiome (gut health), hormonal imbalances, or some other inflammatory process. But when it comes to mental health, “the body will always prioritize healing the vital organs over what’s going on above the neck”.

Essentially, if you’re having gut health issues, then your body is going to focus on healing your microbiome over creating the neurotransmitters needed for cognition. That’s one of the reasons there’s such a strong connection between your gut and mental health.

“If you keep throwing medications at mental health symptoms as band-aids, but your hormones are out of balance, nothing is going to stick.” 

– Megan Langworthy, PMHNP

So while Langworthy does prescribe psychiatric medications in her practice, she sees them as just one of the many tools available. “If you keep throwing medications at mental health symptoms as band-aids, but your hormones are out of balance, nothing is going to stick.” 

What stood out to me about Langworthy’s approach is the amount of care and intention she gives her patients. She knows that when she uses the right tools in a timeline that makes sense for each patient, their symptoms will improve. Megan also stresses the importance of preparing her patients for the adjustment period when their symptoms start to subside. This is meant to decrease panic, fear, and anxiety while envisioning and articulating what they want for their future. 

If you’re looking for the same level of support in a provider, she says to look for one that makes you feel hopeful about your healing and your future. Her goal is not to work with patients for years on end, it’s to help them be independent, restore vitality, and resolve their symptoms in a timely manner.

What are the benefits of functional psychiatry?

There’s a good chance that you’re one of the many people dealing with mental health conditions on this planet. If you are, we feel you! Functional psychiatry may be helpful for those who want to feel more like themselves and better overall. 

“Functional psychiatry gives people who are struggling with mental health disorders the tools to get to the root of their symptoms.”

Functional psychiatry gives people who are struggling with mental health disorders the tools to get to the root of their symptoms. This aims to create a lasting effect versus just putting a bandaid on symptoms – whether or not pharmaceuticals are used. Many psychiatric medications, like SSRIs used for depression and anxiety, can cause dependency and unpleasant symptoms when someone tries to go off of them. Functional psychiatry helps people avoid this by using medications only when necessary. 

Pharmaceuticals absolutely have a role in many people’s mental health journey, but should not necessarily be used as the first or only line of treatment, except for in acute cases. People who are drawn to functional psychiatry may not respond to psychiatric medications, have experienced side effects from them, or have a personal preference not to take them. Whatever their reasons are, these patients want personalized treatment with the ability to choose a plan that feels right for them. A functional psychiatry approach can be used to treat a wide range of issues like chronic depression and anxiety, chronic fatigue syndrome, chronic Lyme, long-hauler COVID-19, and autism spectrum disorders.

Finding a functional psychiatrist

Let’s address the elephant in the room. Functional psychiatry is not covered by insurance in the U.S. So while it’s incredible that providers are able to spend time performing thorough intakes and really getting to know a patient, these services are not accessible for a lot of people. 

Whether or not you’re paying out of pocket, you want to find a practitioner that puts you at ease and can address your particular concerns. The Institute for Functional Medicine, Integrative Psychiatry Institute, and Integrative Medicine for Mental Health websites all have databases that let you search for practitioners in your area. While you may be able to work with a provider remotely, you typically need to work with one within your state due to licensing.

If you do decide to seek out a functional psychiatrist, here’s one tip for guiding the conversation with your new provider. Consider this: If you had a magic wand what are the top three symptoms you would want to get rid of? Hearing your provider’s feedback on these three symptoms and their experience in treating them can help you gauge if they’re someone who can support you in reaching your goals.

Your functional psychiatry toolkit

Whether or not you have the resources to see a functional psychiatrist, our experts gave us a few tools and small changes you can make to feel better in your daily life.

Langworthy explained the importance of trying to limit your intake of foods grown with Round-Up, an herbicide containing glyphosate that is illegal in many parts of the world. This neurotoxic substance is found in many domestic whole wheat breads as well as wine, and “organic” doesn’t necessarily mean a product is Round-Up free. She suggests looking closely at labels and when buying wine, opting for one that they don’t spray at all. Limiting the ingestion of Round-Up may help reduce the burden on your liver so that your body has more energy.

Another simple tool she recommends? Pausing two or three times a day to take in a really deep breath. This helps slow down time and connects us to the idea of “breathing in nutrients.” Most people are used to shallow breathing, but when you don’t fully engage your diaphragm, it can make you feel anxious and short of breath. Breathing deep into your abdominals allows you to take in more oxygen while also releasing more carbon dioxide, helping to slow the heartbeat and decrease stress levels. You can even try this right now!

“Remember that it takes time to heal. There’s no such thing as an instant fix.”

One of Dr. Stein’s biggest tips is to stay hydrated: “Wilted plants need water, so do we!”

Finally, remember that it takes time to heal. There’s no such thing as an instant fix. Functional psychiatry aims to get to the root of your issues, and it can take time for change to happen on a deep level. But taking your time helps to create long-lasting solutions versus masking symptoms with quick-fix tools. Try to have grace with yourself and the process.
For more practical tools you can check out Dr. Stein’s book “What If It’s NOT Depression? Your Guide to Finding Answers and Solutions” and YouTube channel, podcast, and Instagram. Megan Langworthy, PMHNP-BC, is open to new virtual patients in Oregon, Washington, and New York.

Natasha Weiss is a Pacific Northwest-based health and wellness copywriter and full-spectrum doula. When she’s not typing away, she loves immersing herself in bodies of water, wandering through ancient forests, and anything and everything to do with food. You can learn more about her work on natashaweiss.com or connect on Instagram.