Holistic Solutions for Anxiety & Depression in Therapy - Peter Bongiorno.pdf

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HOLISTIC SOLUTIONS FOR ANXIETY
& DEPRESSION
IN THERAPY
Combining Natural Remedies with Conventional Care
PETER B. BONGIORNO
W. W. NORTON & COMPANY
New York • London
A Norton Professional Book
This book is dedicated firstly to the patients who teach me something valuable everyday.
Their courage is my inspiration. I want to also dedicate this book to the mental health
practitioners that I have the honor to work with in order to create a true team care
approach. Together, we have learned that working in an integrative fashion truly creates
the best results. Finally, this book is co-​dedicated to the tireless laboratory and clinical
researchers running trials and pouring over statistics to learn how lifestyle and natural
medicines work. Without that hard and often unrewarded work, the information for this
book would not be available.
Contents
Acknowledgments
Introduction: Why Holistic Care for Anxiety and Depression?
ONE
ARE HOLISTIC APPROACHES RIGHT FOR YOUR CLIENT?
TWO
ASSESSING CONTRIBUTING LIFESTYLE FACTORS
THREE
ASSESSING CONTRIBUTING INTERNAL FACTORS
FOUR
EFFECTIVE SUPPLEMENTS FOR ANXIETY AND DEPRESSION
FIVE
MIND-BODY MEDICINE
SIX
WORKING INTEGRATIVELY WITH MEDICATIONS
SEVEN
MAKING RECOMMENDATIONS AND DESIGNING TREATMENT PLANS
APPENDIX ONE
Top Seven CAM Recommendations You Can Offer Your Clients
APPENDIX TWO
Blood Test Recommendations
APPENDIX THREE
CAM Referrals and Resources
APPENDIX FOUR
Supplements for Anxiety and Depression
APPENDIX FIVE
Homeopathics Commonly Used for Depression and Anxiety
APPENDIX SIX
Example Diet and Lifestyle Diary
References
Index
Introduction
Why Holistic Care for Anxiety and Depression?
Insanity: doing the same thing over and over again and expecting
different results.
About a year before writing this book, I worked with a 42-year-old father of two;
let’s call him Jason. Jason came in for his sixth monthly follow-up visit. He had
been dealing with depression for most of his adult life. An avid athlete in his youth,
by the time he was twenty-four he began to experience low mood and low-grade
depression. This was around the time he started having severe difficulties in his
family life, specifically discussing difficulties with his drug-addicted brother and
aging alcoholic parents. He suddenly began to have a very hard time playing
soccer, a game he loved. For almost two decades he avoided athletic events and
fought the “dark cloud,” as he put it, that kept him from enjoying sports, going out
dancing, or even just being social with friends. While functional at his job as an
engineer, he was labeled “dysthymic” by his psychiatrists and bounced from
medication to medication, with equivocal results. At the time we began to work
together, he was also working with a psychotherapist, as well as a
psychopharmacologist, and believed he would always be somewhat depressed, for
that was his “nature.”
Jason’s most recent therapist decided to refer him to me for a more holistic
view and to see if there were any physical reasons that might be contributing
Jason’s mood challenges. After taking his full history and completing a round of
blood tests, we learned that Jason’s vitamin D and ferritin (iron storage) levels
were abysmally low. We also found out through the blood tests that he had a low-
grade reaction to gluten (a protein from wheat) that was likely contributing to the
slightly high inflammation in his body. I referred him to a hematologist and
gastrointestinal doctor to check on the low iron. Once it was clear that no
gastrointestinal or hematologic problems were the cause of low iron, I encouraged
him to eat more iron-containing foods and gave him low doses of an easy-to-
absorb iron supplement with herbs that help absorption. I also recommended
vitamin D3 and had him avoid all gluten and wheat products. We also adjusted his
sleep schedule and added more vegetables and anti-inflammatory foods (e.g., fish
and olive oil) to his diet. After working with these recommendations for about 4
months, his mood gradually lifted. He even went back to working out, and now he
is excitedly considering getting back on a local men’s soccer team this coming
summer. I suspect he will be able to wean off his current medications within the
next few months.
Jason had difficulty absorbing iron. His vitamin D was low because he avoided
the sun after his medical doctor told him sunlight would cause skin cancer, even
though he had no known increased risk for skin cancer. Because he did not have
digestive issues, laboratory tests for gluten sensitivity were never performed. After

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