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What We Do

 
 

Optimize Psychiatry is... 

Personalized

A root cause analytical approach to your unique biochemistry, genetics & psychological factors which works to recognize and align your physiology, neurology, and psychodynamics 

Holistic

Functional & Integrative medicine, scientifically informed, whole body focused, incorporating insights from various disciplines within and outside of medicine

Self-actualizing

Focused on helping you to be your best self across life domains, insight-oriented, future-driven change aligned with your deepest values 

We strive to optimize:

  • BIOCHEMISTRY

    Medications, supplements, botanicals for mood and anxiety disorders, ADHD, OCD, PTSD, disorders of dependency, insomnia, psychosis

    Adaptations for genetic and environmental drivers of dysfunction

    Physical health (rule out and/or treat hidden medical contributors or causes of mental/emotional dysfunction)

    Microbiome-gut-brain axis & gastrointestinal contributors to health

    HPATG axis (hypothalamic-pituitary-adrenal-thyroid-gonadal relationships and downstream effects impacting mental/emotional/physical wellness)

    Metabolic function

    Bio-energetic function (mitochondrial drivers of function or dysfunction)

    NeuroREgenerative properties

    Detoxification (metals, molds, environmental exposures, dietary exposures)

  • PSYCHOLOGY

    Value-based goals and achievement

    Personal insight and reflection

    Sense of personal meaning, purpose, fulfillment

    Adaptive coping (trauma, recent life changes, stressors)

    Cognition

    Emotional stability

  • LIFESTYLE

    Relationships with self and others

    Diet and intake

    Stress insight and management

    Sleep function

    Work, love and play

    Spiritual connection

 

Why We Do What We Do

Conventional psychiatry has seen some amazing advancements in the recent past, yet what it lacks is hard to contest. Psychiatry in general suffers from a lack of true objective measures for diagnosis and even for treatment. It relies on a consensus-based confirmation of diagnoses (i.e. the various editions of the Diagnostic and Statistical Manual of Mental Disorders or DSM), which are based on collections of symptoms and organized accordingly.1 We do not object to a clinically-based (i.e. judgment of an educated, trained clinician) method of diagnosis, but do not think it fully encompasses the human experience, let alone the individual experience. Notably, the bodily and cultural systems are acknowledged in the “bio-psycho-social model”, but are rarely elaborated upon or explored with objective measures such as laboratory testing. Frankly, there isn’t enough manpower or enough hours per physician to offer in-depth analysis and construct a personalized treatment plan for each person’s genetics, personal and developmental history and current problems across multiple systems. The mainstay of psychiatry, SSRI antidepressants, have been shown to have a non-significant advantage over placebo for depression when all studies are examined collectively, except among those with very severe symptoms for whom there is a small, but measurable benefit.2 Modern medicine is doing the best it can with the given resources. Such resources tend toward measures of faster turnaround, which require the least amount of physician time (i.e. Rx prescribing); visits have become shorter3 leaving time for most psychiatrists to offer a psychotropic prescription or two (or more), the greater use of algorithmic formulas that decrease human error, but also limit cognitive flexibility and are subject to bias.4 Psychiatrists are increasingly pushed toward “med management” and discouraged from offering therapy in order to achieve higher reimbursement rates for shorter visit times.5 The previous role of the psychiatrist as physician-therapist is an aging model, as insurance companies lobby for therapy to be left to social workers, counselors, and psychologists, with psychiatrists expected to function as “prescribers” only.6 Sadly, psychiatry in its typical manifestation is rarely curative7 and the standard of care medicines are known equally for their side effects as they are for their benefits.8 It appears that those who are lucky enough to have sought, found, and maintained treatment often cycle through therapy and psychopharmacology without finding their way to where they’d like to be (living a life of meaning, enjoying day-to-day existence, feeling healthy in body, mind, and spirit).
We believe that psychiatry and medicine in general can do better. We have access to effective tools to help people recover, but the challenge has always been in finding the RIGHT tool for each individual. One-size-fits-all just doesn't cut it. This is why Optimize Psychiatry takes a personalized, precision-based and eclectic approach to mental health treatment and why we strive to get real, significant results for our patients. Why would we settle for less, when we can choose to strive for optimal wellness?

1 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
2 Kirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J., & Johnson, B. T. (2008). Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS medicine, 5(2), e45. https://doi.org/10.1371/journal.pmed.0050045
3Olfson M, Marcus SC, Pincus HA. Trends in office-based psychiatric practice. Am J Psychiatry. 1999;156(3):451-457. doi:10.1176/ajp.156.3.451
4Obermeyer Z, Powers B, Vogeli C, Mullainathan S. Dissecting racial bias in an algorithm used to manage the health of populations. Science. 2019;366(6464):447-453. doi:10.1126/science.aax2342
5 Appointment Length, Psychiatrists’ Communication Behaviors, and Medication Management Appointment Adherence Mario Cruz, Debra L. Roter, Robyn F. Cruz, Melissa Wieland, Susan Larson, Lisa A. Cooper, and Harold Alan Pincus Psychiatric Services 2013 64:9, 886-892
6The Fate of Integrated Treatment: Whatever Happened to the Biopsychosocial Psychiatrist? Glen O. Gabbard and Jerald Kay American Journal of Psychiatry 2001 158:12, 1956-1963
7McMahon, F. J., & Insel, T. R. (2012). Pharmacogenomics and personalized medicine in neuropsychiatry. Neuron, 74(5), 773–776. https://doi.org/10.1016/j.neuron.2012.05.004
National Estimates of Recovery-Remission From Serious Mental Illness Mark S. Salzer, Eugene Brusilovskiy, and Greg Townley Psychiatric Services 2018 69:5, 523-528
8Carvalho AF, Sharma MS, Brunoni AR, Vieta E, Fava GA. The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature. Psychother Psychosom. 2016;85(5):270-288. doi:10.1159/000447034
Moncrieff, J. (2020). Persistent adverse effects of antidepressants. Epidemiology and Psychiatric Sciences, 29, E56. doi:10.1017/S2045796019000520


How We Do It

Optimize Psychiatry Triadic System (OPTS)

The Optimize Psychiatry Approach to Mental Health Treatment 

Step 1: Meet with you and get to know your concerns, strengths, goals, and areas of potential growth 

Step 2: Discuss with you whether any labs would be appropriate to obtain some objective data and assess whether any underlying nutritional or hormonal deficiencies or imbalances may be contributing or causing the dysfunction, and evaluate any appreciable inflammatory mediators 

Step 3*: Build a personalized, practical, efficient, and holistic treatment plan to address concerns with the Optimize Psychiatry Triadic System (OPTS) approach to wellness: three modulators of biochemistry (may include medications, nutraceuticals, herbs or botanicals), three modulators of psychology (may include one or more forms of psychotherapy, value assessment, insight development, neurolinguistic programming, or specific skills training), and three modulators of lifestyle (may include dietary modifications, exercise or movement plans, stress reduction/relaxation/sleep protocols, social prescriptions, spiritual practices, or habit evaluation and reprogramming).  From this foundation, we can build or replace any elements as needed as we continue to work together.  

*Most of the time, we will at least initiate Step 3 on our first visit together even if we are still gathering data.  Some aspects of Step 3 will likely require modification once we have more objective data (i.e. laboratory or genetic testing) and more input from you after you have had time to trial the initial treatment plan.  We will continue to modify and adjust this plan over time as we find the right fit for your biochemical, psychological, and lifestyle needs.  

To ensure that our time together is effective and targeted to your goals, we measure and track progress according to the parameters and goals that you establish and that we will help you to clarify early on in treatment.    

We have designed and developed a system to address mental health issues that is targeted, comprehensive, evidence-based, holistic, efficient and effective.  The Optimize Psychiatry Triadic System (OPTS) incorporates the main drivers of health or disease--Biochemistry, Psychology, & Lifestyle--and breaks these areas into three primary personalized and essential components for the individual, which when realigned, result in access to the inner self, or the Optimized Self, represented by the innermost triangle.  


Why Triangles & Threes? 

Things that come in threes are naturally very memorable and fit naturally into the rhythms of daily life.  We are so attached to the number three, that there exists a “rule of threes” in a multitude of disciplines, including art, architecture, design, mathematics, computer programming, writing and the art of rhetoric.  From an early age, we have been taught to remember things that come in threes: Musketeers, Stooges, little pigs, mice and bears, kings, wise men, and wishes.  We frequently separate time into parcels of three, such as “past, present, and future”, trimesters of labor and education, or our three common mealtimes.  We also order in threes with first, middle, and last, learn our “ABCs” as well as “reading, writing, and ‘rithmetic” and we recognize three primary colors.  The simplest geometric shape is the triangle, which is also the symbol for change in physics, the letter delta which is also a point of diverging waters, and is associated with feats of human capabilities such as the ancient pyramids.  It is a symbol of symmetry, harmony, balance, and interconnectedness.  

We do not adhere to a “rule of threes” exactly, but whenever possible we strive to make use of this number’s psychological properties.  Although it may be theoretically ideal to make lots of changes to current unhealthy lifestyle practices and to take a multitude of potentially beneficial supplements, it is far more realistic, efficient, and sustainable to choose a combination of three potent and effective approaches from each main driver of mental health that is likely to work for you specifically.  Three things are memorable, three things are doable. 

We understand that all systems, whether they exist within or outside of a person, ultimately affect one another; this is one principle of Optimize Psychiatry’s holistic treatment method.  Whenever possible, we suggest interventions that offer benefits in multiple areas of your life, rather than treating each issue as a problem estranged from the system that it exists within.  We try to maximize the benefit of each change that we select together.  For instance, if you are struggling with memory issues in addition to low mood, we would select a biochemical treatment that has evidence of improving both of those issues.   The outcome of this approach is simple, personalized, memorable, manageable and effective treatments.  

We provide a holistic, personalized, evidence-based approach to treatment from a multi-dimensional perspective. Some people call it Functional Medicine, Integrative Medicine, or “Mind-Body” Medicine (however, we think that the use of the term “mind-body” implies that there is a division between the two and neglects to consider other facets of the human experience of wellness or the lack thereof). We thoroughly explore where you are and where you want to end up and check in with your progress to get there using measures that you decide upon. We use all the data available to us, a compilation of any history you provide across multiple domains, objective measures such as lab testing, genetic data, or information obtained from elimination diets. We use whatever tools are helpful and that have the lowest potential for harm (side effects). We frequently make use of various psychotherapy modalities, nutraceuticals, supplements, herbs, botanicals, phytonutrients, neurolinguistic programming, EMDR, multiple forms of meditation, stress management techniques, spiritual engagement, specialized or medical diets, and when appropriate, pharmaceutical medications. We take freely from scientific evidence and interesting studies that may inform our diagnostic process or treatment protocols. Most of all, we strive to encourage and build your own insight and allow that to guide much of the process.

(Please feel free to check out our FAQs for more specifics.)