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”.
I am so glad to hear that there is one awesome highly educated psychiatrist being curious enough to go beyond her conventional training in pursuit of finding more holistic ways to approach mental health. I suffered a nervous breakdown/anxiety/panic/depression following extensive and prolonged trauma after the birth of my daughter. The medication I was given saved my life as I suicidal and not functional at all. But I wonder…would vitamin IVs, herbs, acupuncture, rest, therapy done the same? I feel that the medication has ultimately weakened me. It’s 3 yrs later and I’m going to start weaning and I am terrified. I look forward to your post on weaning off of these medications. It is a process I do not take lightly as I have tried before and failed. I have been on the Weston Price path for 5 years so I hope that I am strong enough (yay for butter, cod liver oil and liver :)) to finally rid myself of these toxins I ingest daily. To all others out there suffering with mental health issues, I sympathize and wish you all wellness.
thanks for writing this really HELPFUL article together with the great links…very eye opening. I have been taking DIATOMACEOUS earth for about two weeks now and am really amazed at its effect including my mood lifting so much I cannot praise it highly enough. People, try it. I am now patient, interested and feel good!!! I also discovered Dr Wallach and have ordered his product ‘tangy tangering’ which has 90 nutrients – minerals, vitamins, amino acids that are vital to health, and they are in colloidal form ie bio- available. see his video here http://www.youtube.com/watch?v=qMYIJlmeSFM. to everyone’s health – I have been suffering for so long, all unnecessarily, I realise. thanks again
If only there were more physicians like you in this world. I would love to have someone like you to visit here in Dallas, TX.
Kelly Brogan MD
Stay tuned for my next post (pending Sarah approval) on hypothyroidism!
Hi Kelly, would you be able to briefly outline what lifestyle changes did help with your hypothyroidism?
I am not a doctor and do not wish to be but really am glad we have them but….I figured out, after many, many years, doctor visits and prescriptions and lots and lots of money, what was wrong with me all by myself. This in turn led to hours and hours of studying and studying to be a master herbalist. My problem was gluten and grains, mostly gluten. All this has taught me to LISTEN to my body and myself. That is what I tell almost everyone I meet. You have to start somewhere, so just start, one baby step at a time.
I also have very strong opinions on health, doctors, medicine. These opinions get me sighs, eye rolls, cussed at, yelled at, etc. Normally the person doing one of the above has just asked my opinion. Irony, huh? My answer was not what they want to hear nor is it easy. I am asking them to make some pretty difficult lifestyle changes. But, I believe with everything I have that if we do not make changes we are going to suffer some extremely severe consequences, soon. I have started to come to the conclusion that that is exactly what it is going to take also, extreme consequences.
Thank you for this post. I have meet one other doctor that had this type of transformation. His body was falling apart and his training wasn’t helping so he got help from the alternative field and now practices conventional in emergencies with the ultimate goal of alternative, lifestyle measures being the end medicine. That is truly the best of both worlds. Conventional medicine for the traumas and emergencies and alternative for the chronic lifestyle diseases.
It is super encouraging to hear how you changed your perspective, and I think the medical community is greatly benefited from having more and more people like you who are willing to part with conventional wisdom!
It must be hard sometimes, though, when your patients are the ones who are resistant to changing their own perspectives on the idea that doctors should simply be handing out magic pills for everything.
Gabriella in Santa Barbara, CA
Dear Dr. Brogan –
As a 76 year old woman who has spent many years reading and researching on my own (without the benefit of a MIT education or med school education) about what works or does not work in the human body, I am very sympathetic with your journey to “medical enlightenment”. I wish more doctors had your curiosity because that would result in a much better care and treatments for patients ONLY WHEN SUCH TREATMENT IS ACTUALLY NEEDED.
In my view, two things are quite essential for doctors to do.
1. LISTEN to your patients and USE simple language while addressing them. In your own article, you use the following sentence: “…I began to have the opportunity to work with women longitudinally, and to exist in their philosophical space, beholden to their preferences..”
What does the above quote mean? So, if you want to disseminate useful information to people, PLEASE use a language EVERYONE can understand. You are not addressing a medical symposium of peers!
2. I have learned that going back to investigate how the human body REALLY WORKS is paramount. What today’s doctors learn in med. school is what the pharmaceutical companies want them to learn and trust. So, every doctor should go back to Human Biology 101 and find out why the drugs they so often prescribe do not work at best, are dangerous and life-threatening at worst. AND LEARN about the RIGHT DIET and how important it is for people’s well-being!
I agree with you that Dr. Natasha McBride’s research on the impact of the microbiome of the digestive system of the body is something that should be known by all of us in every American family. Our children and grandchildren would greatly benefit from this knowledge!
Thank you, Dr. Brogan. With my best wishes for a continuing success, Gabriella
Kelly Brogan MD
Thanks for the feedback and for the powerful comments. I’ll try to answer these questions:
1. I will do a future post on how to support oneself when weaning off of antidepressants. This is a big part of my practice. Peter Breggin MD has a number of books on this. I would encourage consultation with a functional medicine doctor who can look at the whole body and mind at once. Here are some referral options:
2. You can still typically heal thyroid after many years, although the shorter time on hormone, the easier. I recommend this book as a starter http://www.thyroidbook.com/. Here is another consideration: http://www.wilsonssyndrome.com/
3. For someone going to medical school, I would recommend Functional Medicine certification after specialization or becoming a Naturopath instead! It does confer a special insight to criticize an industry that you were raised in, so I’m not sure I would trade my particular path (even though residency was single-handedly responsible for my adrenal fatigue!)
Dr. Brogan, thanks so much for this information.