Functional medicine specialists Dr. Kabran Chapek, Dr. Eboni Cornish, and Dr. Mark Filidei from Amen Clinics recently hosted a webinar to answer questions about this unique field of medicine and how it relates to mental health. Here are some of the questions they answered during this popular online event.
“What is functional medicine and how can it benefit a mental health workup?”
Dr. Chapek: Functional medicine, also known as integrative medicine, involves looking at treating the root cause of psychiatric symptoms and looking at the whole person. For instance, inflammation can cause depression. In addition, brain injuries, specifically mild traumatic brain injuries, are a major cause of mental illness, but no one’s talking about it because you can’t see the injury.
For example, I had a patient who was a pastor. He was in a car accident and at the ER, he was told he was fine. But two weeks later, he couldn’t write a sermon because he was having difficulties with memory problems and couldn’t focus. That’s a classic example of how physical injury causes a mental health issue and a brain issue.
“How does functional medicine tie in with brain imaging in regard to mental health?”
Dr. Filidei: Brain SPECT scans are really helpful for us to determine if there is an underlying brain problem. If you come in for a mental health condition and your brain doesn’t look healthy, it means you have a brain problem that could be causing all of your psychological issues, or making your symptoms worse. Then as functional doctors, we try to figure out what’s causing your brain to look abnormal. There can be a lot of reasons.
For example, a 24-year-old patient who saw one of our New York psychiatrists was referred to me because their brain scan didn’t look good. It turned out the young man was a normal kid until he came home from college, then all of a sudden, he was having brain fog and anxiety. People thought it was simply because he was out of college and couldn’t find a job. In fact, he had jobs lined up, but he couldn’t do them. One of the questions I always ask patients is, “Have you ever been exposed to mold?” It turned out he was living in his family’s basement where they created a room, and guess what? That basement flooded every year, and there was mold they hadn’t seen. This was 100% mold-caused “mental illness.”
“What do chronic infections have to do with mental health?”
Dr. Cornish: I specialize in the treatment of fibromyalgia, chronic fatigue, chronic tick-borne diseases (such as Lyme disease), and other underlying infections, including pediatric autoimmune infections. Several years ago, a colleague’s daughter had severe neuropsychiatric symptoms but none of the psychiatrists she saw could figure out what was wrong. They gave her medications, but they didn’t help. Eventually, she was tested and screened, and it turned out she had a tick-borne illness. When the underlying infection was treated, her neuropsychiatric symptoms got remarkably better. At Amen Clinics, we’ve diagnosed hundreds of cases where infections were causing mental health symptoms.
“How can hormones affect mental well-being?”
Dr. Filidei: I keep telling a lot of my psychiatrist colleagues, “If you do one thing, try to optimize hormones because you could probably toss out half the medications your patients ‘need’ if their hormones are optimized.” You might go into your mental health practitioner saying, “I just have no energy. I have no motivation,” and they give you Prozac. In reality, you need your hormones optimized. So, that’s why we look at all those things and try not to miss it because the tragedy is misdiagnosing a hormone imbalance—or Lyme Disease or any of these things that we look for—and then getting drugged for it and labeled for it.
“How can low cortisol affect someone’s anxiety and depression?”
Dr. Chapek: Certainly, if cortisol— a stress hormone released by the adrenal glands—is too low, it can indicate adrenal hypofunction from chronic stress. Post-traumatic stress disorder (PTSD) can cause high cortisol putting you in a fight-or-flight state for months and years, but then eventually, the adrenals stop producing as much cortisol and become depleted. And this can certainly cause depression.
Dr. Filidei: As Dr. Chapek said, high or low cortisol is not good. Too much cortisol over too long a period is very damaging to your entire body. You’ll age faster. You’ll get sick more often. You’ll have direct atrophy of tissues and damage to your brain. After a while, you end up with low cortisol, which can worsen depression, worsen fatigue, and worsen energy.
“How do head injuries impact hormone function and mental health?”
Dr. Chapek: I recently wrote a book called Concussion Rescue, which is a handbook of the method we use at Amen Clinics to help patients heal from head injuries. In it, I reveal that 25% to 50% of people with brain injuries have damage to the pituitary gland, which is your master hormone gland in the brain. This can cause low thyroid, low adrenal, and low testosterone, among other hormonal issues. And these can lead to a wide range of psychiatric symptoms. In fact, many of the football players we have treated at Amen Clinics and many other people with a history of brain injury have low testosterone or low growth hormone. It’s staggering.
“Can environmental toxins impact your immune system and psychological health?”
Dr. Cornish: Our environment is so toxic—from our foods to our air, to our water, to chemicals and mold. You name it. We’re all toxic. How does someone look with toxins in the brain? It’s across the board. They can look normal, or they can have invisible symptoms, or they can look like they have dementia. It’s all different extremes. In children, it can appear as pediatric autoimmune neuropsychiatric syndrome, diseases, and associative disorders, which are known as PANS or PANDAS.
“When bloodwork is recommended, what do you test for?”
Dr. Chapek: We perform a functional medicine panel, which looks for inflammatory markers, deficiencies, and metabolic measurements. That covers a lot, but we can also do additional labs, such as hormone testing, toxicity testing looking for mold, and testing looking for Lyme and other infections. This information, in combination with brain imaging and a complete personal history, can be so helpful in finding the root causes of symptoms so we can find the best solutions.
Depression, anxiety, panic attacks, and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever, and waiting to get treatment until the pandemic is over is likely to make your symptoms worsen over time.
At Amen Clinics, we’re here for you. We offer mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples, as well as in-clinic brain scanning to help our patients. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.
As a senior Chinese American, I also believe in traditional Chinese Medicine such as Acupuncture. May I ask why Medicare would not include it as part of their legitimate deductions? Thank you.
Beverly Hong-Fincher, PhD.
Comment by Beverly Hong Fincher — May 29, 2020 @ 8:28 AM
Does your office accept health insurance to cover scans?
Comment by Michele — June 4, 2020 @ 6:48 PM
HMMMMM… You have so little info on Alzheimers. Especially Early Stages where if there is a chance to stabilize it…. That’s the only chance of preventing further degradation. WHILE I do have an APOE status… of 3/4… Science indicates that there are people that have a 4/4 status……. that don’t progress to later stages of the disease. And of course… that’s my Goal.
IF you have little or nothing to contribute, due to the biology of the situation fine. But the condition is becoming more and more prevalent as the population ages. And I see very little info that you are offering. ??? I realize that that is a bit of an overstatement, but where there is high correlation with dementia and the other conditions….. more integration /correlation of info would be helpful. I was very fortunate to receive an early diagnosis which provides some time. So general input from your perspective would be helpful to many people.
Comment by Alyce Laconi — June 6, 2020 @ 5:01 AM
Hello Alyce, thank you for reaching out. We have many resources regarding Alzheimer’s and dementia in our blog – https://amenclinics.com/blog/category/memory-issues/. Additionally, we do have a Memory Rescue Program at our clinics – https://amenclinics.com/memory-rescue-program/ – that is based on the guidance of Dr. Amen’s book – https://brainmd.com/book-memory-rescue. We hope this information is helpful!
Comment by Amen Clinics — June 15, 2020 @ 2:02 PM
Hello Michele, Amen Clinics is an out-of-network provider. We do not bill insurance and are not Medicare, Medicaid, or Medi-Cal providers. At the end of the evaluation, patients are given a superbill containing applicable diagnosis and billing codes, which can then be submitted to insurance companies for possible reimbursement. For Medicare, Medicaid, or Medi-Cal patients, you will not be able to file claims with them, and you will not receive reimbursement. Our doctors and therapists are not affiliated with any insurance plans or networks. As a result, insurance carriers will regard fees and treatment incurred at the Amen Clinics as an out-of-network procedure. Please check with your insurance provider for any mental health benefits.
Comment by Amen Clinics — June 15, 2020 @ 2:10 PM
My father (74) has been suffering from brain problems for the last 6 years. He has been diagnosed with amyloid angiopathy based on MRI (not a biopsy). He has lesions in various parts of his brain. Since there is no known/proven cure for amyloid angiopathy, he is getting worse every day. Do you have any experience with similar cases? Thank you
Comment by GUL BIRSEN — June 15, 2020 @ 2:16 PM