The ripple effect happens when one action leads to the genesis of another. In functional medicine, it is believed that the root of these effects lies even before birth. In this episode, distinguished psychiatrist and functional medicine enthusiast Dr. Deborah Simkin graces us with her presence to talk about the importance of addressing the root causes of internal and emotional issues and breaking down the differences between integrative and functional medicine. She sits with our host Timothy J. Hayes to discuss how psychological determinants start forming during fetal development and how environmental stresses play a big role in a child’s gene formation. Listen in as Dr. Deborah Simkin shares non-traditional ways you can treat and address developmental damage and move past deep-seated trauma.
Watch the episode here
Listen to the podcast here
Dismantling Developmental Trauma: The Magic Of Integrative And Functional Medicine With Dr. Deborah Simkin
Dr. Deborah Simkin, MD is a board-certified child, adolescent, and adult psychiatrist who practices functional or integrative psychiatry and sports psychiatry. She is a distinguished fellow with the American Academy of Child & Adolescent Psychiatry and a diplomate of the American Board of Integrative and Holistic Medicine. She is certified in Functional Medicine by the Institute of Functional Medicine and she is also board certified in neurofeedback by the Biofeedback International Certification Alliance. Dr. Simkin, thank you so much for joining us. It is delightful to see you.
Thank you. I’m so glad to be back.
I want to direct people to the fact that we have already done an interview where we did an intro. I would like to have you tell us a little bit about what are the differences that someone would have experienced if they came to you right after you became a psychiatrist. How that changed after you had integrative and functional medicine training so we could get an idea of what the actual patient therapeutic experience differences might be from one to the other.
It was in 1991 that the Institute of Functional Medicine started and that is when I started my child training. I did not know what it was and it’s expanded a lot. During my training, we had some good instructors in terms of psychodynamics, psychotherapy, family therapy, CPT, or child development. As physicians, we were being oriented towards DSM and filling out these little boxes that said, “You are depressed.
We now have a little bit more information. We started having neuroimaging and we can see the brain in a way we had not seen before. We started thinking, “How could we use medications knowing what is going on to increase serotonin?” It was all pharmacological. Everything I did outside of what everyone else would do who is trained as a psychologist like you or a social worker had to do with biological psychopharmacology. If I had somebody come in, I might do a child depression rating scale.
I was trained to do and look at the development of the child but I will expand on why that did not become important until later. When it came in, I saw, “You have got 45 on a child depression rating scale. I know if I give you Zoloft that it will block the channel where serotonin normally goes into a neuron. The serotonin levels will go up and about 3 or 4 weeks later, your depression may go away.”
We started to believe that because this was the future, it’s how we had to look at everything. It was very cold and you know how I am about relationships and trying to connect to patients. I felt like I became a robot because it was checking the boxes and throwing meds at people. This amazing thing happened when I was learning neurofeedback about circuitries.
I came across Tom Insel’s work. As you probably know, he was the former head of NIMH who came up with the Research Domain Criteria. I did not like DSM. I thought we needed to know more. What he said was that antidepressants do not work. We have got to stop using DSM, stop looking at symptoms, and be more oriented to what happens when a child is born, what environmental insults can occur, what genes are affected by that, and what does that do to certain cells and circuitries in the brain?
We have to design everything based on looking at a timeline and the antecedence. What are the genes that this kid came into the world with? What are the environmental insults that will trigger this? What will be the things that will mediate it, in other words, perpetuate it? You are looking at a timeline, environmental insults, environment, how it influences genes, and how those genes influence cells. Those cells then produce molecules and those molecules have an effect. Instead of throwing a drug at something, maybe we need to start looking at how they got there.
You can’t have empathy if you don’t understand how that person got there.
Even before I heard about integrative medicine or functional medicine, I was listening to him and I connected with that. It made sense to me because I was doing a lot of neurofeedback at the time and part of the interventions you can use for this is looking at circuitry. It has a lot of domains. For instance, one part of a domain might be negative valence. Within that, you can look at what is the effect of genes on the body and on the development of a child for acute stress versus potential stress versus sustained stress. You can start looking at subdividing this out and you can figure out what is happening that is causing this person to be where they are.
I went into integrative medicine and learned there are other ways we can intervene besides drugs. There are other things we can do that are natural. That maybe means we do not need to use a drug but I came across functional medicine. Functional medicine is the way to unite the RDoC with what functional medicine was about. You were going to look at antecedents, triggers, mediators, and environmental effects.
You were going to follow a timeline and look at every trigger that occurs and how it affects that child at that stage of their development and what else it’s going to do to all the other systems in the body. You were going to try to see, “Based on where you are now, rather than throw a drug, even a supplement or do meditation, what else can I look at here that tries to get you at the pre-disease state?” That is very different.
When you use an acronym there that most people are not going to be aware of, the RDoC, to integrate RDoC. What is RDoC?
It’s Research Domain Criteria. That is where you can have all these domains like negative valence. You can look at the environmental insults, genes that are turned on, and how it influences every system in the body to try to pinpoint every system and change it back to where it was before.
The functional medicine approach integrates that with what?
The functional medicine approach is that. Let me give you an example of what I mean. There is a wonderful child psychiatrist who used to be on our committee. His name is Robert Hendren. He has this wonderful way of looking at what we have been doing and what we need to do. He looks at the layers of the Earth. At the bottom of the layer of the Earth are your genes. Those genes affect cells, those cells affect physiology and that affects circuits. You have behavioral manifestations and that is the grass. That is what we’ve been doing with drugs. We have been treating the grass. We have not gotten deeper.
If I were going to now look at a child as compared to before, before I get their developmental history but then I would look at these little checkboxes and I would throw medication at them. I would do the other things too like family medicine because I love that. I’m looking at family therapy or cognitive behavioral therapy and later meditation.
The difference now is that when I do a developmental history, I start prenatally and I’m going to look at, “Did that person have stressors in their life while they were pregnant?” Why is that important? For instance, even stresses prenatally can change the microbiome in a child when they are born. If that changes and you happen to have a gene for Retts’ disorder, that could demethylate that particular gene. It gets expressed. Now, you have got a full-blown Rett’s disorder.
We are not quite where we can go prenatally and start changing this but we are getting the information to maybe intervene in a way where some other disorders may not have to happen. For instance, I will look at whether a child was born by C-section or vaginally because if you are born by C-section, you do not get the normal microbes within the vaginal areas of the mother. If you are not breastfed, the same is true.
You and everybody in the United States do this but we introduced solid food about six months and it is cereal. Cereal sprayed with Roundup, which is a wheat killer that acts as an antibiotic in our body. Why is that important? Developmentally, at that stage, the gut is fragile and that change in the microbiome may have an effect on the priming of our fight and flight mechanisms.
How are our HPA or hypothalamus and the pituitary gland going to react under stress? A change in the microbiome, I might have somebody who, on a scale of 0 to 10, would have normally reacted on an 8 but now they are reacting on a 40 because there is something that happened at 6 months in their life.
Now going forward, what happens if you have environmental insults that are sustained? You have adverse childhood experiences and at what age does that happen? At every age, you have to be successful, succeed and be able to do something developmentally there that lets you go to the next stage.
Between 3 to 7, that is the stage where we are egocentric. We do not share, “I’m not going to share. I am the center of the world.” You also think that you are the reason why things happen. Not only may you have a trauma now that turns on genes that never would have been turned on before. You also have a developmental aspect here that is affecting who you think you are, what you are responsible for, and your self-esteem. That is going to be carried to the future.
We know that if you get certain types of developmental trauma that are sustained, it has to be chronic. I will use one gene as an example. It is called FKBP5. When it gets turned on, what happens is you have all these receptors on your fight and flight mechanism in your HPA axis that normally would shut down when you get excited because your cortisol level goes up. It tells you your HPA axis, “You do not need to be overactive now. Calm down.” What that gene does when it gets expressed because of chronic stress is it lowers the number of receptors responsible for responding to that. Now, it can’t respond so it stays overactive.
What else am I going to start looking at? I’m going to look at what are things that we are doing that are perpetuating some of this. I already know I have a kid who does not have a good microbiome because maybe the history and the stress in his life may have turned on genes that now do not allow that person to respond appropriately. I also have somebody now with this developmental damage who thinks he is responsible for all the trauma that occurred to him or her and he is pulling that forward. Now, what else are you doing to perpetuate that?
For instance, all the processed food we eat in this country does what? It destroys the microbiome. How are you adding to this? The way we eat and deal with stress causes that gut to stay inflamed. When that gut gets inflamed, what happens is it opens and allows large molecules to get into the bloodstream that is not supposed to be there. What happens then is that your vagal nerve is stimulated, your blood-brain barrier opens up and all of these inflammatory cytokines are getting into your brain. What effect does that happen? There is inflammation in the brain now.
I have already got an HPA axis that was overactivated but all that inflammation in the brain now is not allowing me to produce normal neurotransmitters. You can’t produce norepinephrine, serotonin, or dopamine. If your gut is breaking down, you can’t absorb normal nutrients like B12 or B6 and that is necessary to also produce neurotransmitters in the brain.
One person may have tried so hard that they’ve gone through several doors and ended up wanting to close it shut.
What happens then is that we also have these microglia or white blood cells in our brain. Its normal responsibility is to clean up debris during deep REM sleep. Now that they take on a different purpose because of the inflammation, they no longer are the guys who go around and collect the garbage. Instead, they are producing more inflammatory garbage, cytokines, or molecules and they started attacking our own neurons.
Now, we have got multiple things going on in the brain and I’m continuing to not deal with stress well. I’m continuing to eat all the wrong foods. I’m not getting enough sleep. I’m also contributing to that deep REM sleep not working well. What happens is that it perpetuates everything that is going on. What I love about functional medicine is that every time you do this throughout your life, you are producing antibodies.
These antibodies are going to cross to react at some point. They are going to attack your joints and you get rheumatoid arthritis. They are going to attack your thyroid and you get Hashimoto’s hypothyroidism. You are going to get insulin resistance so you end up with diabetes. The inflammation causes plaques to collect on the lining of your arteries. You end up with high blood pressure, strokes, heart disease, and some forms of cancer. There is a link now to the microbiome, inflammatory molecules, and cancer.
What do I need to do when you walk into my office? It is different from me doing a child depression rating scale, clicking it off, and throwing medicine at you. I’m going to look at your history. I’m going to explain it to you and educate you on what happened and what you are doing to perpetuate that. I would then ask, “Do you want to change it? Do we want to do something now that maybe will arrest what is going on? Not only because you are depressed but every other system in your body now is involved. If you are motivated, we can get to a pre-disease state.”
There are some forms of meditation they have discovered that remethylate the FKBP5 gene goes back to normal. We have got to look at everything and every rock. The thing about functional medicine, I would say it is harder because when I started my training someone would come in and I would say, “They are depressed.” I would throw an antidepressant at him and see him in three weeks. This requires a lot more work and a lot more detective work to figure out what is going on.
I feel like I’m using my skills as a medical doctor now more than I ever did before. When I went to take the course on Functional Medicine, I had to relearn all of my internal medicine again. I could not be a specialist with the brain. I had to know it all. You can’t have somebody come in, say they are depressed, and not address the fact that now he has got diabetes. They are overweight, their blood pressure is going up and they are not getting any better. If we do not change it, they may have an early death.
One of the things that I appreciate about this from the beginning of our talking was, you said you ask these things, you do an assessment, you figure out where the person is, you give them all options and you ask them, “Do you want to get better?” Getting better is going to take an act of participation on the part of both you and the patient.
Functional medicine improves the doctor-patient relationship. Even in medical school, when I was on rounds, you would see a patient, talk about him and go back and tell him what you are going to do. You did not explain why. You did not try to educate the person so that they could have more of an active role but that requires time.
What was happening in the early ‘90s is we were starting to have more insurance plans. People were getting paid less. There was even less emphasis on the doctor-patient relationship because, in order to make money, I got to see you for fifteen minutes and get to the next one to make enough money. You have to slow down. That is why I love this so much.
Yes, it takes more of my time. An evaluation with me is two hours. I can’t do that in 45 minutes. If a patient comes in, I may not take insurance. However, what I will do is I won’t charge him more than I would for an hour, even though I’m taking more time. I will help them to file their insurance and get reimbursed because it makes more sense for me to do it that way in order to serve them well.
The other piece that I like is that you are talking about educating the patient. Many people I know who work with integrative medicine or holistic medicine approach understand that a critical piece is to have the patient educated about what is going on in them, what they might do, what their options are, what the cost and the benefit analysis is. As I talk to more people that do this work whether it is functional medicine or integrative medicine, the doctors themselves, that is one of the things they like about it. They are getting an engagement and connection with the patient that they did not get in the traditional approach.
I guess I’m unique because I’m in practice by myself. I’m available 24 hours a day, 7 days a week but I find because I do make myself available, less people call me. Many of my patients have told me, “I might feel anxious but the fact is, I know I can call you. I do not let my anxiety not get so much out of control because I know if I need you, I can get you.” I think that offers a different way to do medicine too.
We have gotten into hospitalists who come in for one week, they see all these patients, they leave and there is no ability to be cohesive or get to know the patients. The doctors do not even go into the hospital anymore. They let the hospitalists do everything. It is not that I think these people want to do that. It is what is being driven by insurance companies. Unfortunately, we are going to have to figure out a way.
My husband always said, “Physicians and psychologists should form their own union.” We never have because we could have the strength to say, “No, we are not going to go there.” There has always been this ethical thing that we are supposed to take care of the patient so we should not form a union because that looks like we are taking care of ourselves. If fact, if we did it in that way to advocate so insurance companies can’t monopolize what we do is we are protecting our patients but I do not think that is ever going to happen.
One of the things that pop into my mind when you say that is how many different aspects of psychology social work and psychiatry there are? There are factions out there that think they have got the one approach and that it has to be done this way. There would be a lot of them and there always have been, ever since I have been in the field. There is a lot of infighting between the social workers, the psychologists, the psychiatrists, the power grabs, etc.
It is a complex system and it does not work well for the patient, which is why I’m heartened to hear about more people getting into the functional medicine approach or the integrated medicine approach because that is geared to, “How can I figure out what is going on with this patient at a cause level and help them make changes in their own lives to get the results they want?”
The whole idea of functional medicine is centered on three things, trying to get the person to their best spiritual, mental and emotional state. Where do we ever hear about that in medicine? You are looking at that and the core to this is your relationships. What do you do every day of your life that is not becoming meaningful because you are not making your relationships meaningful?
It can start with you and the doctor. The doctor can say, “Look at what we are doing. Does this feel good? Maybe you should do a little bit of this with everybody and yourself. You are capable. You are doing it with me.” Make sure they get if they need family therapy or couples therapy. That is done. I tend to use my own life stories when I interact with patients.
Take time to understand more about the process, the stages you need to go through, and what you’re doing in your relationships.
One of the things I always say to patients when they come in because I see the child and the parents are there. I end up seeing the family because everybody says, “I think I want to come in and do this.” One of the things I love to tell couples is no one before we get married sits down and says, “Just as kids go through development stages, couples go through development stages.” Your first stage is you do not have any frontal lobes. There is no judgment, “This person is perfect. There is nothing wrong with them.”
The second phase is, “This is good. It feels good. It is a little dopamine.” The third stage, which I always refer to as the seven-year itch is you wake up one morning, “I’m not really sure I like this person.” For them to understand that is normal and that is where the real work comes in.
Often, that gets acted out with each other and you can’t have empathy if you do not understand how that person got there. I always tell them, “It is not couples therapy. It is couples education.” Hopefully, you can capture them before it gets bad that one of the couples thinks about marriage as going through doors. Unfortunately, when they get to that stage, one person may have tried hard that they have gone through several doors now, they want to close it shut and they can’t do it anymore. You hopefully can get it before that happens.
Once you do that, it is incredible because the highest form of love occurs. I do not know that everybody ever gets to that because they are not told, “This is going to happen. It is okay. It is healthy. Just go and get some education about it so you can understand each other better. You will figure out that this is going to get even better.”
I can sit next to my husband now and I can feel his presence. It is something special we could not have had in that first phase. I always tell a story and I will share it here. I was coming up in a Cajun Irish family where it was very enmeshed. If you did not leave and buy the house next door, you were betraying the family. I had an overprotective mother. If you hover too much, the message you give is that the person can’t do it themselves. That influenced my self-esteem. She is a good mom. She did not do anything terribly wrong but it did have an effect on me.
On the other hand, my husband, when I met him, was the most hilarious person I had ever met. He had grown up with a family where the mother was working and the father never showed any affection. If he did not like the meal, when he got home, he dumped the food on the floor. My husband was on the streets of New Orleans at age thirteen fending for himself. He was a straight-A student and never had any problems in school. I think that was due to the cushion that was provided by his grandparents.
We got to what I call the twelve-year itch. I had always listened to him because I was shy. He had learned to put up walls and he would not let me in emotionally. I knew something was wrong. You know how important relationships and emotional connection is to me. I finally said, “We have got to go see someone,” and we did.
He does not mind me sharing this. I’m proud of him for doing this. After about nine months, the psychiatrist was fabulous. He said, “Ron, you can take on the world. You had to but if you do not let this woman in, you are going to lose her.” That was like what we all hear about that corrective emotional experience. All of a sudden, a spark goes off, and suddenly, I start to see my husband crying. I have never seen him crying in twelve years. He says, “I thought that if my parents could not be there for me, there was something wrong with me. I thought if I let you in, you would see that and not want me.” That was incredible.
That is why I tell those stories because I can say to people, “This does not have to be scary but it gives you so much understanding.” On the other hand, now Ron is ready to give it, I’m angry that he did it to me for twelve years, I’m having nothing to it. We go back in and the psychiatrist says, “You have got what you wanted. What is wrong?” I said, “I’m so angry at him for twelve years for not doing this.” He got very quiet and he folded his arm. He said, “You are the one that allowed it.” I’m angry at me.
As you said, “It is the education.” If you can understand more about the process, the stages we need to go through, and the things that we are doing in these relationships that we are blind to. We have got these blinders on. We can’t see all this stuff out here.
The American culture does not want you to. We are going to focus on everything but ourselves. We do not know how to deal with stress. We are eating all the wrong foods. It is more motivating to say to a family, “Let me tell you why these processed foods are doing this to you.” You tell them about the gut getting inflamed. Look at the effect on the brain and not producing neurotransmitters. Eventually, those antibodies are attacking other systems in your body and you are getting diabetes.
Once they understand that, it is a lot more motivating than saying, “You are overweight. Your BMI is up. Go on a diet.” That is not motivating at all. Everything we do in functional medicine whether it is working with couples or trying to reverse the disease or get it where it was before, has to do with us being able to motivate patients by education and not talking down to them.
I love what you were saying earlier that for so long, a lot of the fields started getting into fights. What functional medicine does is it respects all fields. It is not a triangle. The doctor is not at the top and everybody else is being dictated to. It is a circle. Everybody important in that circle has to come forward and share their expertise because I can’t do it all.
I need the people around me who are good at what they do to do what they do because I can’t. I have to respect them as much as I would like them to respect me. It takes a village and functional medicine tends to do that. If I became an endocrinologist, I’m just the endocrinologist. I’m not looking at everything else that has to go on and I’m going to stay with blinders but it limits us and our ability to connect with other colleagues as well.
What would you say is the big difference between the integrative medicine training you got and the functional medicine training? What is added or what is different?
When I did it, it was in its infancy. Integrative for me was looking at ways to use supplements or techniques like meditation as an adjunct to what you are doing. If you get too much into this supplement, vitamin D3, the normal range is 30 to 100 but in order to get rid of depression, it should be more like 60 to 80. That is one intervention.
Going back to what medicine was before, “I see that. Let me give you vitamin D3.” It is now looking at the damage that may have occurred because your vitamin D3 was down and the inflammation affected every system. We do not do that as much in integrative medicine. You have to go back and be the person looking at high blood pressure. You have to be the person looking at diabetes and you have to be running tests to see where their blood vessels are.
You become a little bit of a cardiologist. You are going to see how much the plaques have developed in the arteries. We are going to start talking about how do we reverse that? What do we do that is going to affect that system? When you are decreasing inflammation there, you start losing weight. Maybe you were prediabetic before because of the inflammation but suddenly you do not need Metformin. I don’t like it. I use something else. I use a supplement. I’m trying to get every system to a pre-disease state. That is different from what we do in integrated medicine. The more that people talk about it, we are tending to start doing this.
The world wants you to focus on everything but yourself.
I have heard a lot of different people talk about this merging and they are learning from each other. The more I do an integrative approach, the more I realize that functional medicine could be integrated with what I was taught in the integrative model. I have heard people say what you were talking about. A nice thing to be able to say is, “Here is a medication to take because you have got this list of symptoms but I could give this supplement, exercise, and meditation instead of this medication.” That might help get to the same place but it still has not looked at what was the overall cause that was feeding that and that would be the functional medicine approach.
I’m looking at the timeline and utilizing what I think is instead of using criteria on DSM, it is looking at that research domain criteria. What happened to you developmentally? What were the environmental insults? What genes were turned on? What did you bring into this world? What did you continue to do? What are the other triggers that occurred in that timeline? What are you doing now to perpetuate this?
You stay in a disease state, it affects every system in your body and now you are chronically ill. I believe that chronic illness is going up in this country even though we have one of the best healthcare systems out there, we are not teaching or talking about what got you there. We can’t talk about, “We are going to do medication. That is great.”
If I have somebody who has been traumatized and now I get FKBP5 genetic workup on them, I know that it would be not meditation that is good for people to decrease stress. In this case, meditation for that patient may cause that gene to get remethylated. We are going to get more specific about what interventions work and why.
If you look at all the research, particularly on ACEs, on Adverse Childhood Events, you will note that most psychological and medication interventions do not work. They do work for someone who has adult-onset PTSD but not with people who have childhood trauma. Why? It is because of the genetics involved. That genetics now does not allow that person to traditionally respond to it because that meditation you are doing is not settling down that HPA axis as much as it should. All those receptors that would have normalized are gone because that gene got expressed.
There are all kinds of experiences most of us have had with people who meditate and they like it. They learn to meditate. As long as they are on the meditative pillow, it is fabulous. As soon as they get in the car and start driving someplace and somebody drives in a way that they do not want, they are back to road rage.
If the thing that is feeding my rage is unresolved trauma, simple meditation is not the only thing I need. I need some trauma resolution work, awareness of the role of trauma, the system of inflammation, the belief system, and the triggers that I have freeloaded in me. Every time I create one of those and place it in a neutral situation, now I’m inflamed and enraged. My mind is telling me, “I’m enraged because of this outside thing.”
If you look at the ACEs’ study that was done, they did a great job. He has followed them out for several years and the people with adverse childhood events have a much higher percentage of chronic disease and early death. Why? It is because lots of things we’re doing for them are not working because we are not looking at the effect of trauma on that person and what it does. Not only because it is unresolved but what is it unto the brain and cause neuroinflammation because the guts are breaking down. I’ve got diabetes on top of that and I’ve got genes now that do not allow me to respond as well.
It is an exciting time. We are going to be able to look at individualizing what integrative techniques we have used with the patient based on much more than the fact that, “I know if your vitamin D3 levels are down, I need to bring it up. I might bring it up but why is it that your depression is still there but other people get to 60 to 80 and their depression is gone?” It is not a one size fits all.
If I were you in that situation, I would put on my detective hat and start searching out, “What are the other causes at a functional medicine cause level?” As you said, “That is exciting.” In me, I can use that to generate optimism and excitement.
I do not think that only MDs have to do this. I think psychologists can do this. It is so much that has to be done. The more of us in that circle that know about this and can educate our patients about it, the more work we are going to be able to do together that will help the patient. I may not have the time because I’m not going to see them every week like you but I want to be a part of that team and that input. You can give me back things that help me.
The other thing I like about the Institute of Functional Medicine is not just for MDs. They have courses that psychologists can do on integrative nutrition. They are starting to incorporate more of the fields. Eventually, we will all be doing this with our patients. Maybe we won’t be talking about side effects like I have to do informed consent. You can contribute because you can say, “Based on your timeline, let’s see what you have been doing. You have been to fifteen people and why it does not work.” It is not you.
I have more options to offer them where they can go explore and find their own answers. It is exciting. It is great that you were willing to share with us. I have to wrap this up and thank you again for being willing to take the time with us. My brain is bubbling over with other ideas for different topics we can explore in the future.
I love working with you. You are wonderful.
It is easy for me because I do not have to talk that much. Thank you so much for being here. I look forward to our next time together and I’m greatly appreciative of what you do.
Thank you. You are wonderful and continue with your work.
Take care. Bye-bye.
Dr. Deborah Simkin, MD is a board-certified child, adolescent, and adult psychiatrist who practices functional or integrative psychiatry and sports psychiatry. Dr. Simkin is a distinguished fellow with the American Academy of Child and Adolescent Psychiatry and a diplomate of the American Board of Integrative and Holistic Medicine.
She is certified in Functional Medicine by the Institute of Functional Medicine and she is also board certified in neurofeedback by the Biofeedback International Certification Alliance. She is the Co-Chair of the American Academy of Child & Adolescent Psychiatry, the Committee on Integrative Medicine. Dr. Simkin trained at Harvard’s McLean and Mass General Hospitals in child and adolescent psychiatry.
Following her residency, she served as Chair and Co-Chair of the American Academy of Child & Adolescent Psychiatry Committee on Substance Abuse. In that position, she set up a liaison between the AACAP and the National Institute on Drug Abuse at the National Institute of Health. This was done to increase research among child and adolescent psychiatrists.
She also set up a liaison between the National Center for Complementary Alternative Medicine, soon to be renamed the National Center for Complementary and Integrative Health at the National Institutes of Health to increase interest in research. Dr. Simkin has served as an Associate Professor at Dartmouth Medical School, Clinical Assistant Professor while teaching residents at LSU School of Medicine, Department of Psychiatry, Adjunct Associate Professor while at the University of South Alabama, and is an Adjunct Associate Professor in the Department of Psychiatry at the University of Emory Medical School.
- American Academy of Child & Adolescent Psychiatry
- Institute of Functional Medicine
- Biofeedback International Certification Alliance
- National Institute on Drug Abuse
- National Center for Complementary and Integrative Health
About Dr. Deborah Simkin
Dr. Simkin, M.D. is a board certified Child, Adolescent and Adult Psychiatrist who practices Functional or Integrative Psychiatry and Sport Psychiatry. Dr. Simkin is a Distinquished Fellow with the American Academy of Child and Adolescent Psychiatry (AACAP) and a Diplomate with the American Board of Integrative and Holistic Medicine. She is certified in Functional Medicine by the Institute of Functional Medicine and she is also board certified in neurofeedback by the Biofeedback International Certification Alliance.
She is co-chair of the AACAP’s Committee on Integrative Medicine.
Dr. Simkin trained at Harvard’s McLean and Mass General Hospitals in Child and Adolescent Psychiatry. Following her residency she served as chair/co-chair of the American Academy of Child and Adolescent Psychiatry’s (AACAP) Committee on Substance Abuse. In that position she set up a liaison between AACAP and the National Institute of Drug Abuse (NIDA) at the National Institute of Health (NIH) to increase research among child and adolescent psychiatrists. She also set up a liaison between the National Center for Complementary and Alternative Medicine or NCCAM (soon to be re-named the National Center for Complementary and Integrative Medicine or NCCIM) at NIH and AACAP to increase interest in research.
Dr. Simkin has served as Assistant Professor while at Dartmouth Medical School, Clinical Assistant Professor while teaching residents at LSU School of Medicine Department of Psychiatry, Adjunct Associate Professor while at the University of South Alabama (USA) and is presently Adjunct Assistant Professor in the Department of Psychiatry at the University of Emory Medical School. While at USA she served as residency director and became a member of the Society of Professor’s in Child and Adolescent Psychiatry. She presently teaches Complementary and Integrative Medicine in Psychiatric Disorders at the University of Emory. She has won many teaching awards while at LSU and USA.
She has authored many chapters, including chapters with Joel Lubar, PhD, Professor Emeritus at the University of Tennessee (who is the pioneer of neurofeedback for use with ADHD in the United States) and Robert Thatcher, PhD (who was the project manager at NIH when the correlations between quantitative EEG was done with neuoimaging, such as, PET scans). She also served as Co-Editor of the Adolescent Section in the American Society of Addiction Medicine’s Textbook on Addiction Medicine and served as Co-Editor for the Child and Adolescent Psychiatric Clinics of North America’s two volume textbook on Alternative and Complementary Therapies for Child and Adolescent Psychiatric Disorders. Her co-editor for the latter was her former mentor at Harvard, Charles Popper, M.D. She has recently published 2 articles on the gut-brain-axis. One entitled “Microbiome and Mental Health, Specifically as It Relates to Adolescents” and one she wrote with her distinguished C0-Chair, Gene Arnold, entitled “The Roles of Inflammation, Oxidative Stress and the Gut-Brain Axis in Treatment Refractory Depression in Youth: Complementary and Integrative Medicine Interventions”.
Love the show? Subscribe, rate, review, and share!
Join the On Your Mind Community today: