By Dr. Kelly Brogan MD, Holistic Psychiatrist
Those who know me would say I’ve always had “issues with authority”.
Fiercely motivated by my insistence on being a know-it-all, I have an incredible hunger for information. This brought me to the most real-life application of information there is: health and medicine.
I spent the better part of a decade working to master the “science” of medicine as it applies to the brain and now practice as a perinatal/women’s health psychiatrist. Along this arduous path, I learned about chemical imbalances and medication mechanisms to fix them, side effects and medications to fix those, and medications for when none of that worked.
Then I learned about how to help women decide whether to stay on these habit-forming medications or “wing it” during their pregnancy and lactation. But I don’t practice this type of medicine anymore. My ultimate goal for all of my patients is to never have to see me, or any other doctor, ever again. These days, Healthy Home Economist messages about optimal diet, safe consumerism, and trust in the human body make me nod with like-minded love … I’ve come a long way.
My Light Bulb Moment
Always curious about alternative medicine, I didn’t see the light until I was prescribed my first medication for my first diagnosis – postpartum hypothyroidism. Having never had to put any effort into my well-being (no exercise, yes all-nighters, McDonald’s, and candy), it was dissonant to appreciate that I had something wrong inside me when I looked, pretty much, the same as always.
Sure, I had been forgetful and tired, but I had just completed a decade of medical training and had a baby. I wanted to “get rid of this”, so I went to a naturopath and she introduced me to the interconnectedness of the gut, hormones, and immune system. She helped me to ask, “why” my thyroid was being attacked, and gave me tools to heal. A certification and thousands of hours of obsessive learning since, I now understand that health is more than the absence of symptoms. It is the reliance on a comprehensive well-spring of resilience.
Sir William Osler said “the person who feels on awakening that life is a burden or a bore has been neglecting his machine, driving it too hard, stoking the engines too much, or not cleaning out the ashes and clinkers” and Hippocrates said “let food be thy medicine”.
Functional medicine, and my ongoing training in this enlightened field, endeavors to expose the root causes of chronic medical problems, and has been the “aha!” moment of my past 5 years.
My Grievances with Conventional Medicine
How do we attempt to understand escalating rates of autoimmunity, mood disorders, allergies, diabetes, asthma, arthritis, developmental delays, and autism? We can ignore the “check engine” light for a couple of figurative weeks, but eventually, we have to look under the hood, take out the tools, and get to work from the inside out. We must ask, “why?”, not just express passive concern and commit to maintaining a medication-buoyed new, and highly-suboptimal, normal.
As I fell in love with holistic medicine, I fell out of love with conventional approaches, and the divorce is now finalized. Here are some of my grievances:
“Unfortunately in the balance between benefits and risks, it is an uncomfortable truth that most drugs do not work in most patients” Before this quote appeared in the British Medical Journal this year, I had already begun to explore the evidence that, when you incorporate suppressed data and industry-funded and ghost-written papers, there really isn’t much to support efficacy of most medications and medical interventions, particularly in obstetrics and psychiatry.
Our acute interventions for the management of chronic diseases are dangerous, and given the first bullet point, the risks will often outweigh the benefits. Discussions such as this paper on mitochondrial-damaging effects of medications, highlight some mechanisms of toxicity. Rampant side effects, and the third leading cause of death worldwide, should be enough to convince most people to think twice before picking up that prescription. Many in Functional Medicine use the analogy of Whack-A-Mole to describe the symptom-suppression-disease-perpetuating model of conventional medicine. The acid-blocker for indigestion caused by poor diet that causes depression because of B12 malabsorption, for example.
Lifestyle interventions heal chronic disease. Yes, diet, elimination of toxic exposures, management of stress, sleep, and exercise is truly all that the doctor ordered. We have evidence to prove this, yet we don’t preach it. The sophistication of these interventions can never be replicated with pharmaceuticals.
When I moved into private practice and began to have the opportunity to work with women longitudinally, and to exist in their philosophical space, beholden to their preferences, I felt severely limited by the black & white version of treatment that my training had prepared me to offer.
I began to learn about other evidence-based natural alternatives to treatment of mood and anxiety disorders in pregnancy and postpartum – light box therapy, vitamin D, B vitamins, essential fatty acids, SAMe, cranial stimulation, and acupuncture. This knowledge expanded my toolbox, but didn’t always help me to offer patients what I was longing to provide – a path to healing, a way back home to themselves. In some patients, I needed to learn more personalized diagnostic methods to help me apply traditional natural healing strategies in an effective way.
In my practice I see women with debilitating anxiety, insomnia, paranoia, suicidality, obsessions, intrusive rituals, and anorexia. I can offer them the option to take a medication, likely laced with unstudied artificial dyes and preservatives, with largely pharma-manipulated data for its efficacy, and risks of short and long-term side effects, or, alternatively, we can work to uncover what is keeping their body in this state of sickness through the taking of a lifestyle-oriented history and thorough diagnostics aimed at exposing what’s going wrong where the rubber meets the road – where their genes are interfacing with their environment. Bodies want, and are built, to heal themselves. But toxic environments, diets, and stress get in the way and conspire with genetic vulnerabilities in an undercover operation called epigenetics.
When I care for the women in my practice and my family in my home, I default to this principle: we must make an effort to unburden our bodies, and if we expose ourselves to a “modern” intervention, it should be because we have considered all of the known and unknown risks. I try to inspire this transformation in my patients and those around me. I try to convince them that, just because you can’t see it doesn’t mean it isn’t happening, or it doesn’t matter. Invest in prevention and the excitement of taking control of your health. Coming from a place of conservative conventionalism around health, here are 3 critical steps I had to engage to change what I thought I knew, for the better:
#1 Tolerate the Internal Resistance
I would recommend to those skeptical of the imperatives of holistic living to explore the vehement dismissal and condescending rejection of these practices that arises in them when they hear words like “organic”, “vitamin” or “BPA”.
When I was in conventional medical training, I was instructed to tell people that vitamins are dangerous, and that exercise was not “evidence-based”.
It would annoy me when patients wanted to talk about non-medication options for sleep. That visceral response meant something – it meant that I was threatened by these inquiries and opinions and that I didn’t have the tools to properly inform anything but a paternalistic reply. If you don’t need the tools of holistic health, best of luck to you…odds are that you do, though, so notice that reaction, sit with it and look at it with curiosity.
#2 Explore the Primary Sources
Having learned a lot about the corruption and manipulation of peer-reviewed data by pharmaceutical companies and the FDA, I have come to question the intellectual utility of gold-standard trials. That being said, many wise folks have amassed convincing bodies of non-industry funded evidence to support their health choices: everything from the safety of raw milk, to homebirth, to the benefits of turmeric for depression.
Read these primary sources, turn to trusted curators of this information, and see what the other side is saying. I now have strong opinions on just about everything related to health, medicine, and wellness, and, even still, I force myself to read papers that argue for counterpoints to my beliefs. Know thy enemy as well as you know yourself.
#3 Walk the Walk
Sometimes it takes implementing small changes – exercising 15 minutes a day, meditating 10, eliminating flour, eating more healthy fat and less sugar – to prove it to yourself that some of these ideas may be worthwhile.
I can share a hundred articles on the dangers of sugar and gluten with my patients, but if I get them to do the experiment of eliminating it for a month, they will demonstrate to themselves that this may be a path to a different level of health and wellness. These days, I am a crusader for this experience of life. I have cured myself of postpartum autoimmune disease, and I am raising two crunchy home-grown girls. I feel the power and I hope it inspires.
It takes a lot to abandon the position of passive engagement with the environment, physicians, and regulatory agencies – we want to believe that we are being taken care of, that our doctors know best, and we would never be led down a path of harm. I am proof that taking health into your own hands and learning that health comes from carefully and thoughtfully choosing what your body and mind come into contact with is a sure path to vibrant health. Share this with someone in your life who looks at you like you’re certifiable when you ask them not to microwave your lunch in a plastic container.
Tell them I say, “I’ve been there, but here, the grass is oh so much greener”.
About The Author
As an undergraduate at M.I.T., Dr. Kelly Brogan studied Cognitive Neuroscience and worked with Harvard undergraduates to create a public forum for the discussion of alternative medicine, directing conferences for the Hippocratic Society.
She attended Cornell Medical School where she was awarded the Rudin Scholarship for Psychiatric Oncology and began her work in Reproductive Psychiatry, which she went on to train in during her residency at NYU/Bellevue.
A strong interest in the interface of medicine and psychiatry led her to pursue a fellowship in Consultation Liaison/Psychosomatic Medicine at NYU/Bellevue/VA Hospital. Since that time, she remains on faculty and has focused her efforts on her private practice where she cares for women across the life cycle including pregnancy and postpartum.
A passion for holistic living, environmental medicine, and nutrition are the bedrock of her functional medicine practice. She has published in the field of Psycho-Oncology, Women’s Health, Perinatal Mental Health, Alternative Medicine, and Infectious Disease. She is Board Certified in Psychiatry, Psychosomatic Medicine, as well as Board Certified in Integrative and Holistic Medicine.