I didn't expect that trying holistic medicine, integrative medicine in particular, would cause any conflict with my psychiatric care. My introduction to the idea came through a friend I have known since childhood, someone I have admired for years for the way she prioritizes her mental health and self-care. She agreed to refer me to a practitioner of integrative medicine and licensed acupuncturist. I asked for a referral after a migraine headache that lasted for a five straight days; something was obviously out of balance, traditional medicine was not working (the triptan prescription I had for migraines was not touching the headache), and I was out of ideas. As soon as I began talking about my migraines and told the story of my lifelong struggle with anxiety, depression and trauma, it became clear that I couldn't use a holistic approach to deal with chronic migraine unless I also addressed the anxiety that seems to exacerbate the headaches.
The idea behind this particular holistic treatment is to use amino acid supplements and nutritional changes to heal the damage done to my body and brain by years of trauma and medication. I do know that my heart draws me to this work, and the more I learn, the I want to yell, “YES! THAT! that is what is for me!”
Allow me to pause for clarification: when I say that damage has been done to my body and brain by my medication, I'm not referring to any weird theory about medication being toxic and "unnatural." Meds saved my life. Meds keep me functional, today. I am pro-meds, when prescribed and taken by communicative, cooperative doctors and patients. Any doctor will admit that there are downsides to the kinds of medication I take, a benzodiazepine called clonazepam/Klonopin (generic/Brand) and a selective serotonin re-uptake inhibitor (SSRI) called venlafaxine HCL ER/Effexor XR--"benzos" and Effexor are both notorious for causing chemical dependency, which is NOT addiction, but which leads to withdrawal-like symptoms when we try to stop taking them. There are no clinical studies outlining the effects of SSRI use for long periods of time (10 years or more), but it does seem that SSRIs decrease serotonin made by our bodies and brains. Click that last link for more information about how SSRIs work--particularly if you think that they increase serotonin production, because they don't cause our bodies and brains to make more "happy" chemicals. They just change the way those chemicals get used.
Now, what exactly is the work that I'm doing? First: a change in diet. This Monday, 13 days into my gluten-free, sugar/sweetener-free, soy-free, cow's milk-free, low-glycemic diet, I began taking amino acid supplements in large doses. Why am I swallowing stuff you've probably only heard about in the context of food and nutrition to help with my brain? Because one way to get to the brain is through the fatty acids that cross the "blood-brain barrier." This is exactly what amino acids do, among other things. Why such large doses? The Franklin Institute piece I just linked to explains that "The fact is, if amino acids reach your brain at all, it should be considered a success. Not only do brain cells compete with body cells for amino acids (body cells pull amino acids from the bloodstream more easily), amino acids must pass the protective blood-brain barrier."
Another pause for another clarification: as the super helpful site I just quoted goes on to explain, "Food is your best source of amino acids. Be cautious about trying to manipulate your intake with individual amino acid supplements." Please, do NOT read this blog post and go out and buy a lot of amino acid supplements from a drugstore and start popping them. I'm about to go into just how intense this gets, and trust me--you do not want to do this by yourself. If you're curious about it, start by eating better. More protein, the right kind of protein, balanced with the right carbohydrates, etc. Again, all on this site, here, which my practitioner agrees is a great resource. I will not post the details of the diet I'm following, because I really needed help feeling ok while making such big changes so quickly. High anxiety and increasingly bad migraine headaches warranted the kind of action I'm taking, in my opinion. But I'm paying an expert to help me, and she's worth twice what she's getting.
I talked about the plan with my psychiatrist before I began the holistic treatment; I would take large doses of amino acid supplements. I might need to slowly taper my dose of my SSRI as my body became more efficient at creating and using neurotransmitters, serotonin and dopamine. I thought we were on the same page, and I thought we agreed that she would help me, should I start to feel symptoms resembling a mild overdose of my medication. I thought that she would tell me which medication might cause those symptoms and taper my dose of that one. We met for 30 minutes. She had two weeks to return a call from my holistic care provider. I began my course of supplements, and everything played out exactly as it had been explained to me. I suddenly felt gastrointestinal discomfort, as well as neurological symptoms such a sensitivity to light and sound, headache, and a really uncomfortable sensation not unlike a mild electric shock. I should say shocks, plural, because these don't stop until the medication is adjusted. The strangest part was that it felt like withdrawal from the days when I had no insurance and would miss doses of Effexor while waiting for a cheap, mail-order pharmacy to ship my meds, ever so slowly (it was American and legal, just slow). I left a message with my psychiatrist in the middle of the afternoon on a Thursday. I was surprised when she called me back that evening, and it sounded like she was in a car. Imagine my surprise when her response to my included the questions, “Why are you calling me?” and “Why not just stop taking the supplements?” The entire point of this course of treatment was to see what my body did with the supplements; everything else could change, a little bit, but all the time and money I had invested in this would go to waste if I simply stopped taking the supplements!
I felt awful by the time I was actually speaking to my prescribing physician on the phone. She hadn't done any research at all into my treatment plan, let alone spoken with my new practitioner; neither of us was in any position to discuss anything. I made it clear that it was important to me that she make the phone call and do the research. She made it clear to me that she would not change her mind, no matter what “so-called science” she heard. She also made it clear, however, that she would oversee my treatment, even if I asked her to drop my Effexor dose against her advice.
We disagree, so far, about what's best for me; my prescribing physician is still an important part of my team, however, and it's extremely important that I communicate openly with her. I am interested in integrativemedicine, not in abandoning traditional medicine for another path. When I decided to taper my dose, after thinking about it over night, she called in my new prescription. When I took the new dose, I felt no shame about the idea of calling her, should I feel I had made a mistake.
Tomorrow, I will have been on my new, lower dose of Effexor for one week. I will still be taking the same dose of Klonopin I've been taking for two years. I will also continue the amino acid supplements and keep in close contact with the newest member of my health care team, my integrative medicine practitioner. I am attracted to this entire plan because communication between me and all members of this team, no matter how prestigious the letters that follow their names. As long as we all stick to our own areas of expertise, we can integrate all the treatment plans I want to try, safely. Honestly, I feel great. I feel safe. I feel confident.