Integrative Psychiatry for children

Res Ipsa Loquitur (Latin for “the thing speaks for itself”)

Pardon my pun here. But let me give you an example to illustrate my point.

I saw this bright young 6 year old girl in my practice. Let’s call her Hope. Hope came in with her mother with complaints of severe anxiety that began with a definite stressor at school. A care-free child before this incident, Hope now became clingy, weepy, crying for hours in the morning and refused to go to school.

Pardon my pun here. But let me give you an example to illustrate my point.

I saw this bright young 6 year old girl in my practice. Let’s call her Hope. Hope came in with her mother with complaints of severe anxiety that began with a definite stressor at school. A care-free child before this incident, Hope now became clingy, weepy, crying for hours in the morning and refused to go to school.

The behavior had persisted for quite some months, prompting a visit to a psychiatrist who started Hope on Zoloft, a pretty standard treatment. No response after 4 weeks, so they added Buspar for the anxiety and also referred her to a therapist. Still not better. So Hope’s mom consulted me.

As per conventional psychiatric diagnosis, Hope meets the criteria for generalized anxiety. But here’s what I found based on the integrative psychiatry approach. My focus of evaluation was her diet and gut function (because when in doubt, heal the gut and change the diet).

It became clear that Hope was consuming the classic diet of high calorie, low in nutrient SAD (Standard American Diet). Gradually her gut integrity was compromised and her digestive fire was diminished (in Ayurvedic terms).

My recommendations were:

  • Elimination diet (a diet that does not trigger the immune system)
  • Ayurvedic herbs to improve her digestive fire (comprised of common herbs found in most Indian kitchens)
  • Fish oil to heal the gut and brain
  • Remove all artificial and processed foods
  • Continue psychiatric meds for the time being.
  • Probiotics to be added at a later date

Four weeks later I received an email from Hope’s mom. By about 3 weeks’ time, Hope showed dramatic improvement in anxiety, school refusal, sleep; basically all indicating a response to “treatment.” Until, that is, she spent the weekend at her dad’s home. He did not believe in this approach and gave her the usual highly processed junk food. Hope came back home Sunday evening and on Monday morning, unfortunately, the anxiety, school refusal and crying; was back with a vengeance.

In essence, this was an elimination diet followed by food re-introduction challenge.

Res ipsa loquitur…the thing speaks for itself.