functional medicine and nutritional genomics - American Association ...
functional medicine and nutritional genomics - American Association ...
functional medicine and nutritional genomics - American Association ...
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AAPI’S NUTRITION GUIDE TO OPTIMAL HEALTH: USING PRINCIPLES OF FUNCTIONAL MEDICINE AND NUTRITIONAL GENOMICS<br />
physiological boost‛ – something beyond the<br />
holistic approaches already tried. At this point, I<br />
may well use the natural ‚precursor‛ supplements<br />
that directly increase the levels of the<br />
neurotransmitters serotonin, <strong>and</strong> norepinephrine,<br />
including S-adenosylmethionine (SAMe) <strong>and</strong><br />
tryptophan <strong>and</strong> the herb St. John’s Wort. While<br />
these can also produce side effects similar to<br />
those of drugs, they are usually far less severe.<br />
I do not regard the use of these precursors as<br />
signs of treatment failure, but as necessary, quite<br />
often temporary, therapeutic aides. Clearly these<br />
are supplements that dietitians <strong>and</strong> nutritionists can<br />
effectively use.<br />
Only when these supplements, together with the<br />
rest of my approach, do not work, or if my<br />
patient explicitly requests it, do I refer her for<br />
pharmacological therapy. And, I continue to work<br />
with her while she sees a psychopharmacologist.<br />
Except in cases where people have dehabilitating<br />
chronic illnesses that may well become terminal,<br />
the time people in my practice spend on drugs is<br />
almost always relatively brief.<br />
A spiritual perspective informs my work from my<br />
first moments with each person. Not an explicit<br />
religious orientation, this perspective encompasses<br />
an appreciation for the yet unrevealed potential of<br />
each person, a sense of sacred connection within<br />
each of us to something larger than ourselves,<br />
<strong>and</strong> moments of inexplicable grace that can<br />
transform each person’s work with me <strong>and</strong> on<br />
their own.<br />
Not long ago on a phone call, Theresa reminded<br />
me of this dimension of her life <strong>and</strong> of our work<br />
together. She had moved through her depression<br />
in two months of weekly sessions with me, without<br />
neurotransmitter precursors or drugs. She had<br />
continued to see me once every month or two for<br />
‚refresher sessions‛ for another three years. Then,<br />
two years ago, she moved away to take a<br />
position at a law school. I had watched her grow<br />
over the years into a peacefulness which she had<br />
never before known -meditating regularly, doing<br />
yoga, taking time for herself. Now we were<br />
catching up <strong>and</strong> she was looking back on our<br />
work together. ‚My depression <strong>and</strong> the sad<br />
111<br />
state of my spiritual life were two sides of the<br />
same coin,‛ Theresa reflected. First, I needed to<br />
look at myself psychologically to see that I was<br />
depressed, that mine were ordinary human<br />
problems. I wasn’t this bad, immoral woman,<br />
sleeping with guys who didn’t love me, drinking<br />
too much <strong>and</strong> smoking pot. I just needed to see<br />
how what I did <strong>and</strong> the sad confused way I felt<br />
connected to my childhood—to that lonely little girl<br />
with her desperate desire to please. And I needed<br />
to get my life on a track that worked for me. But,<br />
she continued, ‚I also needed to feel my spiritual<br />
side. And by that I mean the heart, or the soul,<br />
or the divine in me."<br />
Through her work with me, as well as meditation,<br />
yoga, <strong>and</strong> dance, Theresa said, she began to<br />
develop ‚some emotional radar…to sense what I<br />
was feeling—whether anxious, sad, angry—to know<br />
if something was off-kilter. I learned that I didn’t<br />
need to fight it, that it was okay just to let myself<br />
feel the pain—it was just passing feelings, <strong>and</strong> not<br />
something fundamentally wrong with me. I no<br />
longer,‛ Theresa goes on, ‚have the feeling that I<br />
won’t get what I want. I have what I want.‛ Here<br />
she emphasizes that wonderful, present tense<br />
word, so different from all the past-tense terms of<br />
loss <strong>and</strong> longing that marked her depression, ‚I<br />
feel whole <strong>and</strong> happy as I am. If I find a<br />
‘significant other’… that would just add to it.<br />
I thank Theresa out loud, <strong>and</strong> silently, too, for<br />
sharing with me what is possible. Freud wrote<br />
about replacing neurotic with ordinary unhappiness.<br />
Psychopharmacologists praise the restoration of the<br />
‚pre-morbid personality.‛ Theresa is showing me,<br />
telling us, what it means to move from being<br />
terribly, chronically, depressed to feeling blessed<br />
every day.<br />
Excerpts from this article are taken from the<br />
following book:<br />
Gordon, James S. (2008) Unstuck: Your Guide<br />
to the Seven-Stage Journey Out of Depression.<br />
New York: Penguin Press.<br />
James S. Gordon, a Harvard educated psychiatrist,<br />
is a world-renowned expert in using mind-body<br />
2012