Reclaiming Your Life: The Benefits Of Functional Medicine To Our Mental Health With Dr. Achina Stein

 

Understanding how people think is such a complex thing. That’s where psychiatrists and psychologists help. Dr. Achina Stein, our guest in today’s episode, is an osteopathic physician and has been in the medical practice as a psychiatrist for over 25 years. She experienced the struggle when her son had a health crisis in 2010. Having a background in this field, she understands the limitations of treatment with medication and continually searches for other treatment modalities. This event in her life led her to find functional medicine that resolved all of her son’s health problems and her own. Listen and understand more about people’s mental health, specifically in dealing with anxiety and depression!

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Reclaiming Your Life: The Benefits Of Functional Medicine To Our Mental Health With Dr. Achina Stein

Dr. Achina Stein is an osteopathic physician who graduated from Rowan University School of Osteopathic Medicine in 1990, formerly known as UMDNJ School of Osteopathic Medicine. She has been in practice as a board-certified psychiatrist for many years. Her osteopathic roots set her apart from conventional psychiatrists because of her use of osteopathic philosophy and bio-psychosocial treatment approach.

Propelled by her son’s health crisis in 2010, she found functional medicine, which resolved all of his health problems as well as her own. Since then, she’s been practicing functional medicine. She is certified by the American Board of Integrative and Holistic Medicine and is a certified practitioner for the Institute of Functional Medicine.

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Thank you for joining us here, Dr. Stein. It’s a pleasure to see you finally.

It’s a pleasure meeting you too. We’ve been on some audio calls and some groups that we are mutually connected with. It’s finally great to sit down with you and have this conversation.

I’m delighted that you are willing to share with our audience. I was hoping you could start us off by telling us about how you got into the work you do and what drives your passion for it.

It’s a little bit of a journey, but I’ll start from the beginning. Before I started doing the work that I had been doing, I was a traditional psychiatrist and worked for about twenty years. I graduated from medical school with a DIO degree. I did a medical internship followed by three years of a psychiatry residency and basically hit the road as a typical traditional psychiatrist. I have worked in the prison system, the community mental health system and was in private practice. I was doing psychotherapy along with medications. I had a pretty busy practice.

There was a point where I was looking for options to help my patients because there was a small group of patients that weren’t getting well. I searched for alternative ways of healing. I looked into the integrative medicine realm. That’s why I’m connected to the group that we are connected to. During that time, I had a family health crisis, specifically, my son, who was fourteen at the time, had a severe mental health breakdown.

He became acutely depressed seemingly overnight after having some sadness about missing his friends. My husband is a professor and he was on sabbatical. We had taken the kids out of school. My family originated in India. He spent two months in India and in France. We homeschooled them. My husband’s sabbatical was in France. He had missed his friends and he had a little bit of a tiff with his brother, which was not a big deal. That happens with siblings. Suddenly, he disappeared.

We were in a two-bedroom studio apartment and he couldn’t have gotten very far. I happened to look out the window. He had climbed out the window onto a ledge. We were five stories up, and he wanted to jump. That was extremely frightening to me. Especially, being a psychiatrist, I felt completely blindsided by it. There was no evidence that this was going to happen at all, but in retrospect, there was lots of evidence, but not in the classic typical mental health way.

 

What we did, as a traditional psychiatrist, I kept him safe to make sure he wasn’t going to do anything like that again. Once we got home, which was only a couple of weeks later, I had him see a traditional psychiatrist and he was put on medication. It started with one, then the 2nd, 3rd, 4th one. He is on four medications. He was no longer in crisis. He was a little bit better in terms of his depression. He had a lot of anxiety. He was having trouble sleeping at night and also had a diagnosis of attention deficit. All of this literally occurred overnight. He went from a kid who had no symptoms or symptoms in the realm of normal and then suddenly the surge of symptoms.

I was wondering this to this day. If there was one symptom that he had that made me think, “There has got to be something else going on here,” that was the fact that he could no longer read. He went from a kid who had a photographic memory and could not read a book. We couldn’t figure out why. I took him to multiple doctors. They basically gave him exercises to fix his vision in some sense and what they found was that he had diplopia.

The only thing that they recommended was doing eye exercises. It’s like, “Why did this happen?” That was the question. I couldn’t figure out why it happened. I was extremely frustrated. Nobody was giving me answers. He was on four medications. He was definitely not my son. He is fourteen years old. Serendipitously, because I was doing the search for more training as an integrative doctor, I happened to come across this gentleman by the name of Edward Levitan, who is a functional medicine doctor.

I attribute my work to starting with him because I started with him just curious, “Do you mind if I shadow you to learn what you are doing because I’m curious?” When I started shadowing him, I said, “I have to bring my son here.” It’s because the people that were coming in were very similar to my son’s experience and then they were getting well. I shadowed him for a good 4 to 6 months before I was like, “I have to bring my son.”

Sure enough, he saw him and did some testing. If you want to know what we did, we can go into that but the long story short is that he got him well. He was able to ultimately not only come off of all of those medications eventually, but he felt better than he ever had then before this episode occurred. Those things that when I say, “He felt better than he ever had,” were symptoms of severe constipation from early childhood, like 1 to 2 years old, to the point where he sat on the toilet like a bird to have bowel movements. I was told to give him laxatives, which I never did.

He was the kid that we always waited for outside the bathroom and he needed to sit there for one hour. That was just who he was. The other thing that he had was severe eczema to the point where his hands looked like it was part-dinosaur. In fact, we would joke because he loved dinosaurs, his hands were so wrinkled like it was reptilian. He loved the idea of being part-dinosaur when he was four years old.

Those were the symptoms that were indications of inflammation in his body. The other thing was that he was a restless kid. He didn’t have an attention deficit. He had motor restlessness. Whenever we sat at the table, he would suddenly stand up. He always had to fidget with his hands, but he had no problems with attention in terms of his mind. He was the con kid who would be rocking in storytime. The teachers would say that he is not paying attention. I said, “Did you ask him? Let him rock. He’s rocking, but that doesn’t mean he’s not attending. If you ask him what he heard, he’ll tell you like that.”

These were all things that were there and we figured, “That’s just him. So what?” Little did we know that those were early signs of inflammation in his body affecting his brain, skin, gut and they were low levels of symptoms that came to head when he hit puberty. Puberty is a major time when your body is remodeling and it requires a great deal of energy to do that. When your immune system is handling constipation, these skin issues and whatever is causing the restlessness that suddenly, when it’s going through this remodeling, it goes caput because it can’t handle all of that.

With the brain being the most vulnerable organ, at least for him and his eyes being vulnerable as well, because he had vision problems, but like lots of people have vision problems, there’s a variety. He had more than the average person. He had thicker glasses. I think his eyes were probably more vulnerable in his case. The way you know what a person’s vulnerability is by looking at the family history.

If you have autoimmune issues, then it’s going to come out as an autoimmune issue. If you have skin issues in the family, it’s going to come out in that way. For him, it was these four areas and it affected his brain. It came out that he’s vulnerable in terms of his brain because there’s depression on both sides of the family from a genetic standpoint. It came to a head and his immune system went caput. He had this explosion of symptoms at the time of puberty and that’s why he had this “new-onset” a new diagnosis, so to speak.

The way to know a person’s vulnerability is by looking at their family history.

If you look at his whole history, that’s always been brewing. It exploded. You can see that thing happening in the real world outside of us like, “Why do bridges collapse? Why do houses get condemned?” It’s the same thing. It happens in the body. It’s looking at all of the factors. Let me back up a little bit. One of the diagnoses that came clear that we did not know is that he had a celiac disease but you don’t have to have a celiac disease to have these kinds of things. There’s another condition called non-celiac gluten sensitivity.

The very first thing that we do as functional medicine doctors, and that’s what I do, is functional medicine soup to nuts. That’s mostly what I practice. I do psychotherapy in my practice, but I usually put people, especially when it comes to brain issues, on a very gluten, dairy and sugar-free diet for the very first month because those things are very inflammatory in this country. There are reasons for it that I won’t get into right now, but that was the very first thing that we did because he has celiac disease, but we would have done that anyway, even if he didn’t. That was major for him.

Because he had celiac disease, what happens is that your gut is so inflamed for so long that you become nutrient-deficient because it’s an inflammatory disorder. The other reason, even if he didn’t have that, he would have become nutrient deficient because of the foods he chose. He ate only white food. There are a lot of kids who are very picky eaters. He did not eat any vegetables at all.

He only ate white foods like milk products, pasta, popcorn, corn products and if there was a vegetable that he did eat, it would have been probably broccoli. Thankfully it was a healthy vegetable and one of the good vegetables. The other thing he ate a lot of was potatoes like baked potatoes and French fries. It was a lot of pasta mostly and rice is another white food.

He became nutrient-deficient for those reasons. There’s a proper food plan. It should be high, healthy fats, high protein, lots of vegetables with phytonutrients, which provide a lot of vitamins and low on carbs. He was the opposite for many years. When that combination of celiac disease occurs and having a poor diet which, many people have that diet, it’s called the Standard American Diet. The other thing was lots of processed foods and sugar and not sugar in the sweet sense. It’s just that all of our processed foods are full of sugar.

You don’t have to be chewing on a bag of candy to get a lot of sugar in this country.

Those two things alone did him in. There are things like chronic infections and stress that are other factors that play a part but for him, that was the combination that did him in. Within two months of changing his diet, he became significantly better. In fact, when we took out the gluten and the dairy, we moved to soy and corn. We added in lots of vegetables and healthy fats, but we found that after doing some food sensitivity testing that he was sensitive to soy.

We pulled out the soy and that’s when his symptoms really improved at that point. Concurrently, we’re adding lots of vitamins, lots of nutrients, because he was depleted and also giving him probiotics and repairing the gut lining. There are lots of demulcents and ingredients that are part of repairing that we give to repair the gut lining, like short-chain fatty acids and things like DGL.

There are things that you can give to heal the gut lining, like Zinc carnosine. There’s a whole list, but that’s where we started. There were other things that we did as well, but eventually, he was able to come off of all four medications within a year. The double vision took about two years to improve and get better because what happens is that when you have inflammation in the body, the reason the double-vision occurred was because the cranial nerves of the eyes got inflamed. Once the inflammation in the body comes down, everything calms down, including the very sensitive nerves, the inflammation to his very sensitive nerves, the cranial nerves. All of those things went away.

In your own words, for the audience, you would let us know how you would define the difference between the traditional psychiatric training that you got and the functional medicine training that you now have?

I was trained to do the biopsychosocial approach, looking at biology. I’m looking at the psychology and social aspects of a person. The biology is ruling out the typical causes of depression like hypothyroidism and B12 deficiency, folate deficiency. Those are examples. There are a whole host of things that we would potentially look at.

There’s a very small amount of blood work that’s typically done to rule out some major things that could cause depression, anxiety and psychosis. Looking at the psychology, the inner workings of the person’s mind, whether or not there are internal conflicts or they are having anxiety depression that’s due to stressors and helping them manage those emotions and maybe understanding the underpinnings with the dynamics by using psychodynamic psychotherapy or looking at how your thoughts are connected to your emotions and using CBT or dialectical behavioral therapy or learning how to regulate emotions.

There’s the social aspect like family dynamics, your work relationship with people around you, how society affects you and things like that. At least that’s the way I was trained. We use medications to suppress symptoms. I was trained that medications treat the problem, but I don’t feel that it treats the problem. I feel that it suppresses symptoms and it helps you to manage symptoms because if you stop the medications, then the symptoms will come back. You need to have the medications in order to manage or control them. We were told that this was it. Once you have a mental illness or mental health issues, that’s permanent. I know for a fact that is not the truth.

I have treated many people and have been able to take them off of medications. However, it depends on how early you catch it. If you catch it early in having these symptoms, there is a higher likelihood of being able to reverse the symptoms to the point where you can come off medications. If someone’s been on medications for decades and they have been in and out of the hospital and had no ECT or TMS, had years of therapy and all of these things that happen, the brain matter changes on a hard drive sense. I’m not saying it’s impossible to reverse that. I think it’s harder because so much has changed. Once a house is a 100-year-old home, it requires a lot more work in renovating and remodeling than something that’s a couple of years old.

How long something has been present and whether or not there are still symptoms present, reversing that is much harder because the thing about functional medicine is that it takes work to make these changes. It’s an investment of time and energy. It’s developing habits to change your lifestyle and diet. There’s a learning curve and it’s a journey. It’s not a quick fix.

It’s something that is certainly doable, but you have to be willing to do the work. You have to be able to see that there is a light at the end of the tunnel and have to want that. Having a vision of who and where you want to be down the line in the future and having hope and perseverance that you can and will make it. It does take some internal willpower to be able to do those kinds of things.

It’s not for everyone. Some people don’t have the resources to do that, whether it’s external or internal, but there are other people who are like, “I don’t want to take medication. I don’t want to live like this. I will find the resources. I’m going to do it.” There’s no judgment to your life or that person’s life. It’s up to them to decide where they want to be, what they want to do and being able to have the willpower to do it.

If they don’t, they don’t, but then it’s looking for resources to help them. It doesn’t have to happen quickly. People can start very slowly at their own pace making one change and seeing how that goes and a month later, making another change and seeing how it goes. I have had people get better over a couple of years. This doesn’t have to be a couple of months.

I have heard you ask the question, “What if it’s not depression?” I seem to remember you have a book and a podcast. If people want to find out more about that, what’s the underpinning of the meaning behind the question, What if it’s NOT depression?.

It’s important to talk about how lifestyle can absolutely change your mental health symptoms.

The reason I wrote the book was for the person who those from a doctor to doctor, don’t feel well. They have had some things that happen in their life. They might be a multitasking-mom with several kids and they are married with a full-time job. It might be an Oreo cookie, where they are sandwiched between their kids and parents.

Maybe a parent might die and then they have to handle the estate and the other parents. They take on more tasks and they are drowning. The stress of that ad you might not eat well. You are not taking good care of yourself, some of the habits that you might have had like going to the gym drop-off. You are just going under. That is the classic story of then going to the PCP.

They have blood work done, “Your blood work’s normal. You must be depressed.” It’s a conclusion that’s drawn as almost like a wastebasket diagnosis because the PCP has 10 to 15 minutes with you. They don’t have the ability to do a whole history like I do, where I give a 39-page intake. I prep for meeting with you because I look over the intake. I put all your history on a timeline. I will sit with you for two hours. We put on our Sherlock Holmes and Watson caps.

We dive in. It’s like, “What went wrong? What happened? What shifted?” It’s an eye-opening experience. I’ve had patients cry in my office like, “Finally, somebody gets me and understands what went wrong and can give me answers.” I give them a lengthy treatment plan to be able to follow that’s written specifically for them.

Why did I write the book? It’s for that person who is like, “I don’t think it’s depression. You are telling me it’s depression. I don’t think I need this medication,” but they’re not given any other alternatives, unfortunately. It’s not even that they are given this diagnosis of depression through a thorough evaluation. The PCP might do a PQ 8 or 9. It’s a quick quiz.

It’s a little inventory. If you answer enough of these in one direction, we give you the label.

To me, that’s not appropriate. Psychiatric diagnosis should not be done without a thorough medical evaluation and without doing a thorough psychiatric evaluation. Unfortunately, the way the system is, we don’t have enough psychiatrists to do that. This is a systems problem for sure.

When you talk about a systems problem, they are trained to do what you are now trained to do in terms of functional medicine. Even if we had more psychiatrists that were trained the way you were originally, they wouldn’t be doing this anyway. It’s not just a numbers issue. It’s an actual systemic error problem.

I wrote this book because it’s for that person who is offered medication. They don’t think that they are depressed, but they want alternatives and they are not given any alternatives even if they ask for an alternative. This is one thing that is a big pet peeve of mine. Many conventional doctors are taught that improving your sleep will improve your mood. Exercising will improve your mood. There are all sorts of interventions that they are fully aware of. They’re trained.

They might not be trained on how to do it, but they are trained about the research and then can offer it but those things are not offered and the number one reason why is because, “They are not going to do it anyway, so why bother telling them?” That to me is egregious as far as I’m concerned because I think it’s our job as doctors to offer the options and explain to them the research and why you’re recommending it. If they say, “I don’t want to do it. I’m not going to do it. I’ll try,” but they still don’t do it, then it’s on the patient.

 

It’s our responsibility as doctors to make the recommendation and to take the time. We often go to conferences and we learn how to write, at least I did, an exercise prescription. Especially for the person who says, “I don’t want to take the medication,” but I think it should be offered here, “You could take this medication,” and talk about the benefits and risks of that.

Exercise is equal to the benefits and equal to taking it, especially if they’re not suicidal and they don’t have severe or moderate to severe depression and if it’s a mild depression. It’s important to talk about how lifestyle can absolutely change your symptoms and make them better. You are going to feel better, not just in your mood. You are going to feel in your whole body.

The effects of exercise compared to the effects of medication. I’m intentionally leaving out the word side because it’s a mind game to talk to people about the side effects of medication because they are just the effects of the medication. In the mind game, the word game is, “These are the main effects because we like these and these are the side effects,” but they’re just the effects. The effects of medication versus the effects of exercise, there isn’t any question.

If you listed them for people and said, “I’m not going to tell you what’s what, but here’s one treatment you could have and here are the effects of it. Here’s another treatment you can have and here are the effects of that.” People would take this every time. When you uncover it and they say, “It’s exercise?” They want the benefits. They want the effects of the exercise and they don’t want the effects, especially when you take the word side off of there.

They don’t want the main and side effects of this other stuff. What I like about the training you are getting and the approach you’re taking is it’s cutting through all of that for people. It’s helping them see a wide range of options that they wouldn’t see if they went to see a traditionally trained allopathic, conventional psychiatrist or a medical doctor.

Depression is a symptom that is included in a cluster of other symptoms that comes together as a diagnosis. They created these syndromes where the DSM does not connect to any root causes. In fact, in the DSM 3, they chose to talk about causes. They took it right out, but we are well aware of many causes and even more so in the last few years, where a major root cause for depression is inflammation. What I do is find the root causes of the inflammation and it lands in five categories. It’s foods, chronic infections, particularly in the gut, toxins and stress, all of which affect your hormones, particularly cortisol. Cortisol levels go up and when cortisol levels rise, then all of the sex hormones go down.

When you think about our society and how it is, how our food system is, how we are surrounded by toxins, all of those things affect our bodies and where the barriers that protect us shut down, particularly our immune system, then you get not infected but burdened. Your immune system becomes burdened by infections that make your body their home.

The immune system has to deal with that as well. You are constantly being taxed from all angles. No wonder our rates of depression and anxiety, autism and infertility rates have skyrocketed. Nobody thinks about why this is happening on a societal level. It’s different now than many years ago. It’s the alternative health world that’s talking about it all the time. In fact, we are screaming. It is the traditional world that’s not connecting the dots.

I was going to correct you too, because you keep saying no one is talking about it. I met you because we were on a webinar where more people are signing up for these webinars, learning these trainings, talking about exactly the things you are talking about now and getting educated about how they can help people look for a cause something at a cause level. That’s why I’m thrilled that you were willing to be on the show so we can get the message out there to even more people.

I was speaking to someone else and I was telling them, “Don’t worry. The system will change. It takes a good 10 to 15 years for it to be common practice once it’s in the literature for it to be in practice as this is the way we do things.” There was a time when acupuncture wasn’t accepted. Now, it’s like a mainstay. There was a time when Reiki was voodoo and now it’s a mainstay. It’s being used on the cancer floors. It’s become part of certain traditional disciplines like the cancer units. Functional medicine is being taught in more medical schools now.

Functional medicine develops habits to change your lifestyle and diet.

There are lots of doctors and other medical providers that are rushing to get trained. It’s been years since I have been to a functional medicine conference because of COVID. The thing that you’ll see at a conference are people standing at the back of the lecture hall at the last lecture with their suitcase sitting next to them.

They’re standing, writing notes, getting every word for every minute that they could possibly get before they had to rush off to get into a taxi to get their plane. That’s how much people want this to change. They want this information. I have been to other traditional conferences where people go to lectures by Sunday if it was like a Thursday to Sunday, the halls are empty. It starts off good, but then less people show up. That’s not the case in a functional medicine conference.

I like to give people a chance to talk about something, maybe an aspect of your work or a special interest you have that we haven’t even touched on yet. What might that be?

One thing that I have noticed in doing functional medicine, is that there are people who see therapists in conjunction with working with me. There have been times when as they are working with me, they find that as we are cleaning up their gut, getting them nutritionally sound, changing their diet and they are feeling better and better, they start moving forward in their psychotherapy as well. Areas that they have been stuck on, basically certain issues where they are spinning their wheels, they finally move forward.

There’s this concept of when you have trauma, that trauma lives in the body. The somatic therapies that are out there to have trauma, where do you locate it in your body and trying to move and massage that out of your body. I find that doing the gut restoration that I do with most of my patients helps to move some of that trauma or those conflicts that they are stuck on, whether it’s from the past or current issues. It’s amazing what a difference it makes. It’s all connected.

When I first started doing functional medicine, I saw that psychotherapy is almost handling a separate piece. Now that I have been doing this work for many years, I have noticed that the brain is totally connected, not just hardware, but the software as well to your gut and vice versa. It is intricately connected to your whole body. You can’t separate the mind from the brain or the spirit. People shift spiritually as well.

The energy takes to process your emotions, to do the work, go home and do some journaling, writing or pick up a worksheet process when you’re triggered takes energy. As you were talking about, most of the people that come to you are so depleted energetically because the body is working hard to keep minimal immune system function going and working with the nutrient deficit. As you restore that, that you give them more energy, it makes good sense that they naturally start making more progress in therapy. Thank you so much for joining us. It’s a delight. I look forward to finishing your book. Can you tell people about your podcast?

It’s What if It’s Not Depression? With Dr. Achina Stein. People can find my book on Amazon. They can get it on Kindle and it’s also on audiobook. My episodes on my YouTube channel are about interviewing experts about the various root causes of depression and anxiety and also alternative ways of healing other than medications and psychotherapy.

Thank you so much for joining us. I greatly appreciate it. I look forward to finishing your book.

Thank you for having me.

 

You are totally welcome and deserving.

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Dr. Achina Stein is an osteopathic physician who graduated from Rowan University School of Osteopathic Medicine in 1990, formerly known as UMDNJ School of Osteopathic Medicine. She has been in practice as a board-certified psychiatrist for many years. Her osteopathic roots set her apart from conventional psychiatrists because of her use of osteopathic philosophy and bio-psychosocial treatment approach.

Propelled by her son’s health crisis in 2010, she found functional medicine, which resolved all of his health problems as well as her own. Since then, she’s been practicing functional medicine. She is certified by the American Board of Integrative and Holistic Medicine and is a certified practitioner for the Institute of Functional Medicine.

She is a former clinical assistant professor of psychiatry and human behavior of The Warren Alpert Medical School of Brown University. Dr. Stein is a distinguished fellow of the American Psychiatric Association, a fellow of the American College of Neuropsychiatry and she was awarded the Exemplary Psychiatrist Award by NAMI in Rhode Island in 2008. Dr. Stein is presently in private practice in Rhode Island and is co-owner of Functional Mind, LLC.

Her book, What If It’s NOT Depression?: Your Guide to Finding Answers and Solutions, launched in February of 2020 and became an international bestseller in three categories on Amazon Kindle. It’s also available as an audiobook and print book. She has a companion program to her book called What If It’s Not Depression?. It’s a boot camp. It’s there to provide an alternative to medication for people with chronic and mild depressive-like symptoms that do not respond to antidepressant medications.

Important Links:

• Dr. Achina Stein
• What if it’s NOT depression?
• What if It’s Not Depression? With Dr. Achina Stein
• Amazon – What If It’s NOT Depression?: Your Guide to Finding Answers and Solutions
• YouTube – What if It’s Not Depression? With Dr. Achina Stein
• Functional Mind, LLC

About Achina Stein, MD