What I love about Dr Brogan is her journey through conventional medicine to her current position. Having trained as a Medical Doctor, specialising in Psychiatry (working primarily with pregnant patients) and completing a PhD in Neuroscience from MIT, Kelly came to the educated conclusion that the key to health is a complex array of environment, physical and mental factors.
Her “eye-opener”, like a lot of conventional medics who enter the uncertain field of lifestyle medicine, was when she fell sick herself. After reversing her Hashimoto’s Thyroiditis using nutrition, exercise and mindfulness practice she was a convert and a new career trajectory was set.
Highlighting some scary statistics in psychiatry, Kelly set the tone for how important a radical change in thinking is. 11% of Americans are affected by depression, 25% of those being women of reproductive age and its recognised as the leading cause of disability. Not to mention the 8000% increase in children 0-19 yr being treated for bipolar, a ‘silent’ epidemic.
The uncomfortable truth is that a lot of us conventional medics use ‘the gold standard of practice’ and ‘medical consensus’ to shield how we treat patients rather than examining the data ourselves. And in my opinion it’s entirely reasonable. Not all of us are statisticians or confident examining academic papers to make our own judgments. Using my personal experience as a General Practitioner, our guidelines and protocols are a massive help to streamline our treatments in an incredibly overstretched NHS.
But unfortunately this has to change. What has come to light is the quality of research underpinning our standards of care aren’t as solid as we thought. This viewpoint has snowballed since Fiona Godlee (BMJ editor) made her controversial statement that “Most drugs do not work in patients” and started a drive to tackle ‘too much medicine’ in healthcare.
The first half of Dr Brogan’s talk was a systematic break down of why a reliance on psychotropic medications to treat mental conditions is likely not the best root of treatment. By treating depression as a ‘disease’ we’ve paved the way of how we use drugs to modulate specific pathways. Changing our perspective from Brain and Body being separate allows us to create a completely new way of treating disease.
When we dissect the literature we really need to take a fresh perspective on whether SSRIs are beneficial enough to warrant the incredible number of people on them? Are we manufacturing disease, with the 1 in 20 people who become bipolar as a side effect? Does the benefit really outweigh the social and physical cost? Should we be informing our patients who demand anti-depressants better and would they want to be on them considering the lack of long-term data on functional benefit?
So what do we have in our arsenal to treat conditions that are on the rise and dominated by an expectation that we should be treating with pills (at least according to medical consensus and treatment protocols). Exercise, meditation, sleep and more importantly food. Kelly believes a cultural shift is what we need. Managing expectations by educating our patients that lifestyle change is the biggest component of health and yes, that includes mental health. The caveat is that it takes effort and the majority of patients without adequate support may struggle.
She also advocated Kundalini yoga, a specific form of yoga and breathing techniques tailored to specific ailments. If a doctor with a qualification in Neuroscience from MIT thinks it’s beneficial I’ll certainly be looking more into this!
I’ll be chatting more about opinions on nutrition and mental wellbeing with a psychiatrist and good friend of mine later this month. We’ll be talking about the different foods and evidence base practices to beat mental health problems beyond the prescription of medications!