In recent years, the focus on mental health has greatly increased, and people are being more proactive in finding ways to care for their mental wellness. As a result, more and more people are leaning towards holistic psychiatry to reduce dependence on psychotropic mind-altering medications. Today’s guest is Dr. Jennifer Giordano, an Integrative Psychiatrist at Free Range Psychiatry. Jennifer is passionate about helping people who want to take an active role in their health. In this episode, she discusses in-depth how this approach to treatment has helped many, underscoring its importance for those who need to taper off medication. Join your host Timothy J. Hayes for this informative conversation on mental health care.
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Incorporating Holistic Psychiatry To Support Mental Wellness With Jennifer Giordano
Dr. Jennifer Giordano is a holistic psychiatrist who uses an integrative approach to wellbeing. She is passionate about helping people who want to take an active role in their health and avoid decreasing or stopping using psychiatric medications.
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Thank you so much for joining us here.
Thank you for having me.
I was hoping you could start us off by telling us a little bit about how you’ve got into the work you do and what drives your passion for it.
I am a holistic psychiatrist. I was traditionally trained as a psychiatrist. I went to medical school and did a residency. I always inclined health. Health being sought and achieved through natural ways, I was somebody who studied diet a lot on my own, anywhere from Atkins diet to be 100% vegan. I researched that on my own, on the side because a lot of people don’t necessarily realize or understand that there’s not a lot of education or training regarding nutrition in medical school.
They think that doctors have studied that, while we haven’t, for the most part. I had a natural inclination of passion toward that. I’m one of those people that were open to the idea of using supplements and looking at the wisdom from other ancient healing modalities. My friend was an acupuncturist and I was curious about that. I delve deeply into the Yogic Sciences. I spent some time in India, learning about that.
I always had an openness and an inclination toward being as healthy and naturally as possible. You have that aspect of me, and then I did the traditional Western medically-based side of training where it’s the approach of better living through chemicals, which they have their place. I’m so glad that we have antibiotics and we can be under an anesthetic when we are going to have our gallbladder out. In the mental health arena and realm, we use them in some interesting ways.
I’m putting those two things together as 2/2 of myself. Somehow magically, I stumbled on this practice called Free Range Psychiatry founded by Dr. Kendra Campbell, who also has the same inclination. I came across their website and I saw that she had written a blog article about herself that she drinks her daily smoothie, does her yoga and meditation. That very much fits my profile and similar things that I do. I started working for Free Range back in 2020. Before that, I had my private practice, which was very small and I always had that outlook but didn’t have it, so systematically and methodically developed as it has been through Free Range.
Kendra is a voracious researcher. She has the stamina and patience of reading through all of these clinical trials and studies. She’s one of the most well-researched physicians I have ever met in terms of her understanding of the whole landscape of all kinds of studies. She’s also one who’s open to the consideration of holistic natural ways of being healthy and well. For me, finding that practice was serendipitous.
I was essentially looking for a job and had googled something completely different. I popped her website, which I liked the name of it. Free Range Psychiatry sounded fascinating. I’m like, “What is that? I have heard of free range chicken.” That caught my eye and ear. I looked at her website. It seemed very intriguing and then I was like, “There’s no way she’s hiring,” but there was a tab that said Job Postings. In my opinion, this practice is a brilliantly designed approach through the method that she uses or has put together for being able to meet people who are interested in the holistic approach. She does it beautifully.
With holistic psychiatry, the approach is more of medicine as a last resort rather than the first and only option.
I worked with a lot of people at various points in their lives that the common desire and drive is that they want a little bit more than just medicine. Medicine still is on the table. There are plenty of patients in the practice who are on medications but our approaches more of that medicine as a last resort rather than the first and only option. We try to use it in that light as minimally as possible.
We also meet a lot of people who reached a point in their life where they feel like they want to come off of medication but I have had very difficult times doing. That is starting to be more and more of the people that we see. Maybe they need medicine many years ago. They have done a lot of work and life circumstances have changed. They have grown and evolved, then they try to go off their Zoloft or Paxil.
They have an extraordinarily difficult time in doing so because, in terms of the information that we have about tapering, it’s very minimal. It’s not a huge thing to be studying how to come off these medicines. The effort, energy, and the financial support of learning about the medications and studying them so that they can be made available have been well funded and supported but then the other end of it coming off. Tapering is like a bit of a black box for the medical community.
I think about Peter Breggin‘s book specifically about that. When I interviewed him, he said, “One of the biggest things to get people to understand is there isn’t a standard formula for everybody but doctors have trained in terms of the medications. ‘Here’s the medication, how it works, and the doses you should give. You should increase if it’s not working here. You decrease if you want to go off.’ Sometimes, there are certain individual brain chemistry reactions to these medications that they have been on a while.” They need to titrate down in sometimes almost molecular decreases and otherwise have the rebound effect or the horrible effects. That’s not very well known. Some people rail against that and say, “That’s not the appropriate approach.”
How we are taught in med school and through residency is that approach of decreasing the medication dose in half. Even tapering off of medicine is not so much broached but reduces it in half for a couple of weeks and then stops. I finished with somebody who it took them a year to come off of Cymbalta or worse, we tell a patient to cold turkey it, and then they experienced a horrible withdrawal effect from it, which is not acknowledged for some reason in the Western traditional medical community. I do feel that will change inevitably because of what has come forward and continues to because of the boon of the internet.
What has come up through that are ginormous peer-based support communities and people have organized them so well. It has become such an organized conversation. It’s become a great resource of information about what’s happening with people. The data, which is helpful to have as any kind of practitioner provider trying to help people, understanding the data and the human patterns that are going on relative to tapering these medications, is coming out via another way.
Maybe it’s not double-blind clinical trials but it’s coming out through the internet and because it comes out of people have these experiences and they feel passionate about it as in they suffered and struggled so much that they naturally want to help other people and say, “If you are going through this horrible experience, here’s what happened to me, how I’ve got through it and what I learned.” It’s more of this information. Support is coming out through a pay-it-forward mode or mentality.
There is such an unjustifiably and skepticism about a case study. The case study is useful at a certain level but if not, that research double-blind or randomized trials. When you have a well-organized network from the internet, you get lots of case studies. You’ve got something. It may be only 25% of the population that’s on Cymbalta that needs 1 or 2 years to go off of it but they still need that. It makes me think of all the years that I would work with patients and they were given these non-addictive tranquilizers because that’s what they were called when they first came out. “It’s wonderful. This stuff isn’t addictive.”
Every once in a while, I would have a patient who would say, “I can’t take that.” The doctor said it’s the lowest dose possible. Between the patient and I, I always said, “Ask the doctor if it’s okay if you cut that lowest dose possible. There’s a 0.25-milligram pill. What if you cut that in half?” The doctors know that you won’t feel anything but it’s perfect or even 25% of the 0.25 milligrams.
Holistic Psychiatry: Just the openness that our systems can vary, that our responses to these psychotropic mind-altering medications and our experience of them may differ, is astounding.
For some highly sensitive people, it does the trick. I have worked with people who have been fired by their doctor because the doctor says, “You are playing fantasy world. The level of that pill can’t do anything for you.” They’ve got to go find another doctor that recognizes they have a sensitivity to this substance that the doctor is not aware of as possible.
The heartbreaking part is we see a lot of people who have heard that who faced that projection and utter invalidation of their experience. Even with the openness to that, our systems can vary that our response to these psychotropic minds altering medications that our experience of them may differ. This openness to that is astounding to me. It’s funny because I can understand it. I lived in that world. That’s how we are taught but having some flexibility and openness to consider, hear the person and the patient and have the willingness to be a little bit flexible like, “Maybe when we can consider a slower taper or one at non-traditional doses.”
Here’s the tough thing manufacturers don’t necessarily make it the easiest thing to do these kinds of tapers. Some make it extra difficult. Thank goodness for compounding pharmacies. I am so grateful and indebted in gratitude to some of the compounding pharmacies out there for doing it because essentially, compounding pharmacy means you can call them up and request any dose of a medicine that you want or need. They have been lifesavers.
I don’t know many people who would prefer to be on any medicine at all. In the ideal view of ourselves, most of us don’t want to be on medicine if we don’t have to be. In the cases where you have these people who are on the medicine, maybe neat or utility is no longer there because of their life circumstances, how they have gone, the work they have done, grown and evolved as a human but then having this experience of feeling trapped on medicine because they don’t have the support. First of all, they don’t have someone believing them that when they cut their Lexapro dose in half, they felt horrific, brain zaps, shaking, upset stomach and insomnia.
Secondly, even if they believed that there’s an approach or an openness to figuring out, “Let’s figure out what is going to work for you.” It’s so incredibly gratifying to support people going through this process. It has been amazing and fulfilling to be a part of people’s lives and help support them when they felt very much isolated, scared or unsupported. It’s amazing to be able to be there and help them get to where they want to go.
You mentioned Free Range Psychiatry. It struck my brain as there’s a format, structure, and procedure that is well refined. Can you tell us a little bit about that? How is it different from if I walk into a psychiatrist in town here?
Before a person comes to us, we have them fill out a pretty in-depth intake form that we review beforehand and start developing a wellness plan before we even meet. That’s where it starts. We spend one hour together in that first appointment so that by the time we meet, I already know as much as I can about that person on paper. We get to spend that time in that first appointment, painting the picture, more so helping me understand, and then we can dive into this wellness plan.
We have a wellness plan template that we use to develop an individualized unique wellness plan for each person who comes to see us because not everybody is going to want to do the same things in terms of lifestyle or holistic approach things when it comes to diet, exercise, stress reduction and psychotherapy. We designed that individually for each person and it’s done digitally. We use intakeQ, which is a helpful and handy platform.
We have a portal through, which we share that wellness plan so the patient then has access to it afterward. You know how you leave a doctor’s appointment and you are like, “What did he say? What was that recommendation?” It’s all there. It’s all written out, all the things, even the specific, the Amazon link to that supplement or the Amazon link to that book. Even fundamentally before that, Kendra has designed a fellowship program that all the psychiatrists go through, where she’s organized a wonderful set of modules to help educate the psychiatrist on a lot of the holistic, integrative topics.
We know we have all gone through the basics of psychiatric training, so they fundamentally have but then there’s all this other stuff about diet, nutrition, therapy, yoga, meditation, and tapering from medications. She provides a lot of that education and training through a beautifully designed fellowship program that we go through.
Most of us, in our ideal view of ourselves, don’t want to be on medicine if we don’t have to be.
You do it at your own pace and everything is virtual. By the time you start getting into seeing patients, the psychiatrist is feeling equipped and prepared. All the holistic stuff in learning about tapering would be stuff that we would maybe have picked up along our way in the journey. Kendra’s formalized it more so and helped make it easy to get up to speed and understand a lot more. There are literature and things that are out there about the supplements and doing various lab tests of what they could need. It’s nicely designed.
I remember I was interviewing Dr. Jodie Skillicorn, and she talked about how she got through her psychiatric residency. She went out there and was all excited to help people. She’s got the list of symptoms and drugs. She knows how to pair the two together. That’s what she learned in med school. Somebody introduced her to Robert Whitaker’s book, Anatomy of an Epidemic. She said, “I can’t do this.” She had to go out on her own and try to reeducate herself into things other than just throwing medicines at symptoms.
She eventually built something for herself and wrote the book, Healing Depression Without Medication. I imagine what you are talking about if you get into a functional medicine program or prearranged psychiatry program, it’s a lot easier because somebody has researched to compile the system of tools for you.
Kendra has a lot of patients to go through all that and bet all that. I find sifting through the research tedious and painful. To be able to go into a resource that’s she sifted through the noise and her mind works that way, which is I’m grateful for sifted through the noise and pulled out the relevant. As you are referring to her experience similarly, when you try to educate yourself about how to understand more about what we can do and how we can help other human beings, it’s wonderful that someone has organized the information and look that. You are going to have a whole spectrum of information out there but look at that stuff that’s solid in its background research and all of that.
You mentioned the book, Anatomy of an Epidemic. That’s part of this fellowship program, part of ours in the very beginning of it. Once you read that book, it’s like taking the red pill in the Matrix. You can’t go back. You can’t unsee what you have seen. As a psychiatrist, once you have practiced enough, and then you read about the reality of things and get that information, education, and studies about what’s going on with a house like a Tropic started their evolution through our use of them, you can’t unsee that.
If you are like most people I have talked to in the field, then that matches what your personal experience has been. There’s a small percentage of people that they have taken medication, feel great and that’s all they need, “Goodbye. Thank you. I will see every six months to renew.” They get on with their life. The studies overall indicate that the longer you are on those things, the more adverse effects you are going to get or the higher rate of, “It’s working and I need another one. I’m hopping from med to med.”
How much better our lives can be if we learn living skills and like the functional medicine approach, paying attention to our sense of purpose in life, love, community, health, and sleep, not just how much I’m eating salty foods but that whole picture of the human. It opens a new world of possibilities for helping people.
That’s when a person is a good fit when they are feeling open to all and having that realization like, “Maybe it’s not just medicine that I want or need.” It is that percentage who that is what they want and needs. That’s perfect and wonderful. There’s a huge percentage of people who have that inclination and intuition of like, “Maybe I do want to look at these other things and aspects of my humanness to look at and support myself in being healthy and well in consideration of those things.”
I don’t want to be too negative but I have heard people say to me that they have met with their psychiatrist for 3 to 4 minutes every 3 or 6 months. Meanwhile, they are taking psychotropic medication. It’s altering the chemicals in your brain. That’s what they do. It’s like, “What is this model?” It’s a lot of bits reductionistic that you are your brain chemistry. You are not the complexity of what it is to be human with community, love, a sense of purpose, and how we take care of our physical organism, the mechanism of it as well.
Holistic Psychiatry: The curtain is starting to be pulled back on what medication is and its implications.
It’s wonderful when you find somebody who wants to do some work. I remember David Grand and his book talks about how great it is for him to work with athletes because they approach the therapy the way they would approach their athletic training and the whole body, whether they are going to do research or follow through the assignments.
When you find somebody who wants to recognize, they aren’t just a biological machine that if they put certain stuff in there, they function better. The body, mind, and brain do not separate. If you start looking at the whole system approach, you get very different results. Sometimes you don’t need as many meds. Sometimes, you don’t need any meds after you have learned. I remember the story of Eric, who began the SameHereGlobal.org network. Are you aware of that network?
Yes. I’m a part of it.
In Eric’s story, he had a mental health crisis. He went to a doctor and came up with either 3 or 5 meds from that first visit. It was several years of slogging through that before he met somebody who said, “Let me teach you a breathing technique.” He said it transformed his life so much. That’s how he started the SameHereGlobal.org network. The use of tools is phenomenally powerful. It may not be as quick as, “Take this pill and a half an hour later, I feel differently,” but the effects can be cumulative and better, long-lasting over time.
There are no side effects from a breathing technique. You are not going to get addicted to it. You can’t overdose on it.
One of my favorite teachers is Dr. Michael Rice. He says, “This whole thing about side effects are word games. It’s not the side effects. It’s the effects of the pill you took.” You get some of them that you say, “We want these. These are bad. We don’t like these.” We will call them side effects but I wouldn’t have those effects if I didn’t take the pill.
Main effects or side effects are a language thing to help people accept, “You are going to feel pretty miserable if you have watched any of these ads for drugs on TV. Remember, your hands may fall off but don’t take it if you are allergic. This can help with this problem.” The side effect is not a side effect. It’s just an effect. Your hands wouldn’t have fallen off if you didn’t take the pill.
It seems to be dawning on us as human beings. If you look back on when Prozac came out and the other things that they use in terms of tranquilizers, we had this idea of, “This miracle of better living through chemicals.” The curtain is starting to be pulled back about what it is and its implications of it. People are waking up to that. We have had people who have been on Prozac for twenty years, so it’s starting to come to light and people are figuring it out as we do as humans. We end up ultimately, usually, always coming to what’s the reality of the matter. Very much it’s coming to our awareness a lot more and more.
Can you tell us a little bit about how people get involved with you or somebody else at Free Range Psychiatry? What are the treatments? Is this all virtual? Do you have an office where you see people in person? Tell us about that.
This is all virtual. All of our meetings are through Zoom. It’s easy to find us and connect to us at FreeRange.org. For those who want to have a chat, tell us a little bit about what you are looking for and we can tell you about our approach. We have the option for a free fifteen-minute consultation. That’s how a lot of people end up having their first interaction.
You don’t have to go through it alone. There is hope. There is help.
Our website is a great resource to learn more, even scheduling appointments. You can do it right through there. It’s super easy. You can go to that section. When you click Book Now, it will show my schedule. Everything has gotten very convenient digitally. It’s very accessible to people, which is handy for us as providers because we don’t all live in the same place, and then handy for patients as well, so being able to connect.
It’s all done virtually. With limitations on licensing, do you only get to see people in the state you are located in?
I can see people in other states like Michigan, New York, New Jersey, Florida and Virginia. In some cases, because of COVID, there have been some regulations in some states where they have allowed Telemedicine to happen while there’s the declaration of the emergency for COVID. That has also opened some doors and being able to connect with others in other states, depending on their state’s particular regulations and licensing rules.
How many different psychiatrists are working for the FreeRange.org group?
I’m not sure how many are in the fellowship. There are 5 of us in the fellowship and 2 of us seeing patients. Thank goodness you guys exist. We hear that a lot from several people with who we ended up having interaction. Unfortunately, it’s like a handful of practices around the nation that have a holistic approach. Hopefully, someday that will be a lot more but it seems it’s few and far between to find this approach with practicing psychiatrists.
If you take a breath and think about, “Here’s something that we haven’t even talked about yet that I would like to get in this interview,” what would that be?
We covered the main thing, this different approach, and openness to a different school of thought or train of thought about mental healthcare. That’s my number one thing that I would want people to know because there are so many people out there who have this inclination or sense of, “I’m not sure if I need this medicine or I feel trapped on this medicine.” There is hope.
That was the word I was to use. As soon as I asked that question, what popped into my head is, have you told people you want them to know there’s hope? There are good things that can help you other than what you have been told.
There is hope and help. A lot of people think, “Am I crazy?” You are not. Your intuition is trying to tell you something and point you somewhere. There are a lot of other people who are going through what you are going through, feeling scared and intimidated. I have a person who tried various providers telling her that she was crazy or, “There’s no way you may be experiencing these withdrawal effects.” The courage and strength that it takes to advocate for yourself at that level in the face of this institution of medicine and medical providers.
The MDs that some people think of as minor deities telling you are crazy.
Holistic Psychiatry: A huge percentage of people have that inclination or intuition that they want to look at other aspects of their humanness to support themselves in being healthy and well.
This person is so high functioning, insightful, a wonderful contribution to the community and humanity. You think, “What does this person have to go through?” For others to know, you don’t have to go through it alone. There is hope and support. Things are possible. That’s probably the main, biggest thing I would want anyone to know.
I greatly appreciate your taking the time to share with us. It’s wonderful to learn a little bit more about Free Range Psychiatry and your team. You have Danny, who is also doing a podcast. Psychiatria is the name of her podcast. We are also going to have an episode with her where she tells us about her story, her podcast, and what she’s learned. I’m very grateful that you are willing to take the time and share with us.
It was such a pleasure. I’m grateful to be able to be here. Thank you for mentioning Danny and her podcast. She’s a wonderful human being. I’m glad she will also be on this as well. That’s wonderful.
We will stay in touch. Stay healthy and have a great New Year.
Thank you. You too as well.
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Dr. Jennifer Giordano is a holistic psychiatrist who uses an integrative approach to wellbeing. She is passionate about helping people who want to take an active role in their own health and avoid decrease or stop using psychiatric medications. Having struggled with anxiety and panic attacks earlier in her life, she knows what it feels like and that there is a way through and out of struggling with those symptoms. She looks at mental health challenges as an opportunity for a person to learn, grow and delve deeper into one’s truth. She helps people realize what it is like to be a human being and fully realize one’s potential.
Her goal for assessment and treatment is not to prescribe medications forever but to be a health partner, collaborator, and guide to optimizing the overall medical, physical, mental, and spiritual wellbeing of her patients. She utilizes an approach to patient care that is functional, integrative, holistic, individualized, creative, and in many ways, non-traditional. Dr. Giordano is passionate about exploring what it is to be a human being and helping other people be peaceful, joyful and free. She is known for her free spirit, nature-loving lifestyle, and wedding flashmob dancing.
Important Links:
- Jennifer Giordano
- Peter Breggin – Past Episode
- intakeQ
- Jodie Skillicorn – Past Episode
- Anatomy of an Epidemic
- Healing Depression Without Medication
- SameHereGlobal.org
- Book Now
- Psychiatria
About Jennifer Giordano, MD
Dr. Jennifer Giodano is a holistic psychiatrist who uses an integrative approach to well-being. She is passionate about helping people who want to take an active role in their own health and avoid, decrease, or stop using psychiatric medications.
