Treating the Cause A Naturopathic Approach to Healing

Treating the Cause; A Naturopathic Approach to Healing with Psychosomatic Medicine Tia Trivisonno ND, MSOM, LAc NYANP 2016

The Mind-Body Connection The lotus blossom symbolizes the Enlightenment out of the sea of the subconscious into the brilliant light of the knowledge of the true Self.

About Dr. Trivisonno Graduate of the National College of Natural Medicine where she earned her Doctor of Naturopathic Medicine and Masters of Science in Oriental Medicine degrees Currently resides in New York City, practicing with Dr. Michael Gurevich MD at Holistic MD in Glen Head, Long Island Specializes in the gut-brain connection, chronic illness and mental health Certified in Nambudripad’s Allergy Elimination Technique, NAET™ Certified in the Bioresonance Analysis of Health, BAH™ Receiving advanced training in Autonomic Response Testing, ART™, and Neural Therapy Member of the American Association of Naturopathic Physicians and Director of the Board for the New York Association of Naturopathic Physicians, NYANP Holistic MD: 997 Glen Cove Ave, Glen Head NY 11545 516 -674 -9489 www. holisticmd. org

Overview & Learning Objectives Working to change the paradigm in the diagnosis and treatment of mental illness and chronic disease The issues we face: Increased diagnosable mental illness, an epidemic of chronic disease, over prescribing and the urgent need for holistic naturopathic intervention! Fact versus fiction: The medications - what the public has been lead to believe vs. what the research actually shows Factors involved in the global epidemic of chronic disease: increased toxicity and underlying infections, altered immunity due to loss of beneficial flora, chronic inflammation Treating the cause: The Gut-Brain axis, the microbiome, stress response & the vagus nerve, dealing with our emotions Individualized treatment: Holistic Psychiatry and the natural approach, cases & testimonials

A Growing Epidemic of Mental Illness with a Trend of Medications from the Womb to the Grave

The Paradigm of Psychiatry Under the Microscope Key issues to consider in the treatment of psychiatric care: The biology of mental disorders remains unknown There is an ever increasing number of diagnosed, partly due to changes in diagnostic criteria over the past few decades… losing our sense of “normal” Medications may induce certain symptoms or disorders they are meant to treat Long term use of psychiatric medications perpetuates the chronicity of mental illness as well as side effects associated with other diseases

Understanding the Current Paradigm For the past 60 years our thinking about mental health has been largely determined by the Diagnostic and Statistical Manual of Mental Disorders, DSM The disease model: In the 1980’s there was a movement within psychiatry to label mental illness as a biological disease with an underlying etiology that could be traced to a chemical imbalance.

The DSM-V “Abandon Hope, All Ye Who Enter Here”

The Current Paradigm What we as a society currently believe: A survey done in 2006 showed that > 80 % of Americans believed mental illness was caused by a chemical imbalance in the brain Mental illness could therefore be treated with medications that could potentially correct these imbalances Source: Anatomy of an Epidemic, The History and Science of a Failed Paradigm of Care, Robert Whittaker, April 2016

A Lack of Scientific Evidence for this Claim “We have hunted for big simple neurochemical explanations for psychiatric disorders and have not found them. ”--Kenneth Kendler, Psychological Medicine, 2005 “Elevations or decrements in the functioning of serotonergic systems per se are not likely to be associated with depression. ” --NIMH, 1984 J. Maas, “Pretreatment neurotransmitter metabolite levels and response to tricyclic antidepressant drugs. ” Am J Psychiatry 141 (1984): 1159– 71. “There is no clear and convincing evidence that a monoamine deficiency accounts for depression; that is, there is no real monoamine deficit. ”--Stephen Stahl, Essential Psychopharmacology, 2000 Source: Anatomy of an Epidemic, The History and Science of a Failed Paradigm of Care, Robert Whitaker, April 2016

The Current Paradigm of Diagnosis “Disorders” like anxiety, depression, and ADHD are a list of symptoms rather than a biological process. The DSM is black and white, allowing for only “normal” or “disordered. ” The DSM V has widened the diagnostic criteria for mental illness creating a state of hyperinflation of diagnosed mental illness and a “national drug overdose” of medications. ~Allen Frances, M. D. Saving Normal

When Normal becomes Diagnosable…

Chronic Disease & Mental Illness, the Meds Manic-Depressive Disorder (now Bipolar) used to be a rare condition The conventional approach to treating Bipolar Disorder involves life-long medications management with side effects that may promote obesity, diabetes, hypothyroidism and kidney disease, perpetuating an overall trend toward chronic ill health The DSM IV had a separate diagnostic category for people with Manic Depression who had been treated with antidepressants Every year that a person is treated for depression with antidepressants, the statistical chances for a manic episode “mood switching” increases cumulatively, it occurs in approximately 6% to 8% of patients with unipolar MDD who receive treatment with an antidepressant Source : //www. psychiatrictimes. com/bipolar-disorder/switching-mood -depression-mania-antidepressants#sthash. Efrqi. Fzd. dpuf

The Meds… Oppositional Tolerance Chronic administration of psychiatric medication disturbs neurotransmitter functions in a manner that is both substantial and long-lasting The brain responds to the medication with a series of compensatory adaptations, increases receptors at the post synaptic neuron, in order to respond to the changing environment After a few weeks the brain begins to function in a manner that is “qualitatively as well as quantitatively different from the normal state” Hyman, S. “Initiation and adaptation: A paradigm for understanding psychotropic drug action. ” Am J Psychiatry 153 (1996): 151 -61. Anatomy of an Epidemic, The History and Science of a Failed Paradigm of Care Robert Whitaker, April 2016

SSRI’s & Antidepressants Prozac®, Zoloft®, Paxil®, Luvox®, Celexa®, Effexor®, Wellbutrin® Not really “selective” neurotransmitters are connected by complex circuitry and function interdependently SE include: akatheisa, bruxism, tardive dyskinesia, dystonia, overstimulation of the nervous system to the point of psychosis/mood switching, depression & suicide.

Are Antidepressants a Solution for Depression? Anatomy of an Epidemic, The History and Science of a Failed Paradigm of Care, Robert Whitaker, April 2016

Benzodiazepines & other Sedatives Xanax®, Valium®, Klonopin®, Ativan® Suppresses CNS function and potentiates the neuronal inhibitory activity of GABA SE include: cognitive dysfunction, short term memory loss confusion and delirium, loss of impulse control including agitation, psychosis, violent behavior toward self or others, rebound sx associated withdrawal from the medication, anxiety, insomnia, depression

The Xanax Study for Panic – What was Reported Anatomy of an Epidemic, The History and Science of a Failed

What the Data Really Looks Like… Anatomy of an Epidemic, The History and Science of a Failed Paradigm of Care, Robert Whitaker, April 2016

Neuroleptics or Antipsychotics Zyprexa®, Risperdal®, Haldol®, Clozapine®, Geodon®, Seroquel®, Abilify®, Thorazine® Blockade of D 2 receptors, therapeutic window varies btwn substances SE from blockade include: prolactin levels, extrapyramidal motor disturbances and akathesia, dysphoria, cognitive impairments, aggravation of depressive “negative” sx. Other SE include c/v and cerebrovascular mortality, metabolic and sexual SE

Disturbing Statistics, A Call to Action for Naturopaths! 1 out of every 5 U. S. adults uses at least one drug for a psychiatric problem 11% of all adults took an antidepressant in 2010 4% of our children are on a stimulant 4% of our teenagers are on an antidepressant 25% of nursing home residents are given antipsychotics Since 2005 there has been an eightfold increase in psychiatric medication use for active duty troops More emergency room visits and deaths are due to legal prescription drugs rather than illegal street drugs Psychiatric medications are now the largest revenue producer for the pharmaceutical industry Source: Frances MD, Allen, Saving Normal New York, NY: Harper Collins, 2013

What is the Solution to this Crisis in Care? A Return to Our Roots The Principles of Naturopathic Medicine: First Do No Harm Identify and Treat the Cause Prevention Doctor as Teacher The Healing Power of Nature Treat the Whole Person

The Healing Power of Nature

Identify and Treat the Cause “The origin of brain disease is in many cases predominantly dietary. ” ~David Perlmutter MD The Brain Maker “A well-functioning gut with healthy gut flora holds the roots to our health. And, Just as a tree with sick roots is not going to thrive, the rest of the body cannot thrive without a well-functioning digestive system. ” ~ Dr. Natasha Campbell-Mc. Bride, Gut and Psychology Syndrome, GAPS

Diet-Microbe Interactions in the Gut Effects on Human Health and Disease 2015, sciencedirect. com

Microbes & the Mind BACTERIA THAT MAKE BRAIN CHEMICALS Type of bacteria Neural messengers Bacillus Dopamine, norepinephrine Bifido-bacterium Gamma-aminobutyric acid Enterococcus Serotonin Escherichia Norepinephrine, serotonin Lactobacillus Acetylcholine, GABA Streptococcus Serotonin Source: T. G. Dinan et al/J. Psych. Res. 2015

The Gut-Brain Axis Bidirectional communication between the CNS and enteric nervous system via the vagus nerve Links emotional and cognitive centers of the brain with peripheral intestinal functions Microbes on the mucosal surface of the intestines modulate the immune response as well as brain development and behavior The brain under stress influences the composition of the microbiota via the HPA axis The communication is based neurotransmitters, cytokines, neuropeptides, hormones and growth factors mediating the relationship between the CNS and immune system to maintain homeostasis

Purity of Mind & Spirit, the Role of the Gut in Classical Chinese Medicine. “The heart is the sovereign of all organs and represents the consciousness of one’s being. It is responsible for intelligence, wisdom, and spiritual transformation…the small intestine receives the food and further extracts, absorbs, and distributes it throughout the body, all the while separating the pure from the turbid…however decision making is the king’s job. If the spirit is clear, all the functions of the other organs will be normal. It is in this way that one’s life is preserved and perpetuated, just as a country becomes prosperous when all it’s people are fulfilling their duties. If the spirit is disturbed and unclear, the other organs will not function properly. This creates damage. The pathways and roads along which the qi flows will become blocked and health will suffer. The citizens of the kingdom will also suffer. These are the relationships of a kingdom. ” ~Qi Bo, The Sacred Teachings. The Yellow Emperor’s Classic of Chinese Medicine 3, 000 BCE

Prevention, Nature Cure Philosophy, Our Naturopathic History Every acute disease is the result of a healing and purifying effort of nature The primary cause of germ activity is the morbid terrain where they can breed and multiply in the gut Based on the fundamental principles of nature, it is NOT the goal of the physician to “kill germs” with drugs or vaccines but to purify the organism of systemic toxins, waste, morbid accumulations and disease, which furnish the terrain for development and overgrowth of germs ~ Henry Lindlahr MD 1862 -1924

Nature Cure, Treat the Whole The original pioneers of the Nature Cure movement in the early 1900’s stressed the significance of the gut brain connection and viewed the body as an energetic, electromagnetic system: The brain was considered to be the most powerful and active electromagnetic battery in the body, with vital force being transmuted into nervous, intellectual, and emotional energy Health was dependent on the perfect balance of positive and negative elements derived from the mineral kingdom and largely dependent upon the correct combination of food extracted and assimilated from the gut.

Body out of Balance, Dysbiosis Modification of intestinal permeability allows for endotoxins to circulate through systemic blood flow Lipopolysaccharide (LPS) is a potent pro-inflammatory endotoxin on the wall of gram negative bacteria that can alter neuronal activity in the limbic system and activate microglia contributing to chronic inflammation in the CNS and peripheral responses that may trigger cytokine production in the brain Gut microbiota modulate the differentiation of immune cell subsets to maintain homeostasis between the host and the microbes and regulate the development of lymph Certain specific bacteria are better equipped to survive in the inflamed gut rather than the commensals that dominate the healthy individual Microbiota Regulation of the Mammalian Gut-Brain Axis (http: //dx. doi. org/10. 1016. bs. aambs. 2015. 02. 001)

Inflammation and Chronic Disease, Loss of Friendly Flora Source: https: //advancingschizophreniatherapeutics. files. wordpress. com/2015/01/diet. jpg

Toxicity and the Modern World, our Children Autism Spectrum Disorder: 1 in 68 Children (1 in 42 boys – 1 in 189 girls), in the 1980’s 1 in 5, 000 Diagnosed Anxiety Disorder: 1 in 8 kids Depression: 10 -15 % of children and teens at any given time Respiratory Disorders: 8. 3 million U. S. Children Skin Allergies, eczema: 9. 5 million U. S. children Diagnosed food allergies: 6 million U. S. children Insomnia: 10 % of kids Source: Optimal Kids, Anne Zauderer DC & Ron Hunninghake MD Riordan Clinic, April 2016

Holistic Psychiatry Body & Mind MD and ND work together as a team, combing their expertise to treat complicated psychiatric cases who have failed the conventional methods (treatment resistant) Innovative approach that is patient specific utilizing advanced energetic testing methods - Bioresonance Analysis of Health™ (B. A. H. ), Autonomic Response Testing™ (A. R. T) based on the principles of quantum physics Goals of care: stabilize the patient, titrate medications using the natural approach, address the underlying causes - chronic infections, toxicity, endocrine imbalance, the nervous system, immune support/modulation, psychological trauma and the emotions

Treating the Cause the Holistic Approach Chronic infections: Lyme and co-infections, mycoplasma, EBV, dental infections and other viruses or bacteria that disrupt the gut and contribute to toxicity Address pathology in the gut: IBD, IBS, SIBO, celiac & gluten intolerance, H. Pylori, leaky gut, parasites, food sensitivities Address insomnia Balance the endocrine & nervous systems Support and empower the patient to balance emotions

Individualized testing Bioresonance Analysis of Health, BAH™ Creator: Thomas K. Szulc MD

Energy Medicine & the Vital Force BIORESONANCE “The field is the sole governing agency of the particle” ~Albert Einstein

Quantum based Medicine is Patient Specific The field is comprised of waves - constructive interference enhances or amplifies a frequency, destructive interference will negate the frequency Amplify a healing frequency through resonance with an appropriate remedy or negate a frequency in the treatment of diseases like a parasitic or other microbial infection

Principles of Classical Chinese Medicine & Quantum Mechanics The most profound healing occurs when the microcosm, the human being, is in a state of balanced and harmonious expression of the macrocosm, or universe Humanity is a direct reflection of nature and to understand the organizing principles of the natural world serves to benefit mankind Every event in the universe exists in a state of flux, chaos, or disharmony, seeking harmony and balance…by definition the state of balance that is achieved is only temporary Transformation is a constant in the natural world & the space where information is exchanged between two elements plays a vital role in the attainment of harmony

Quantum Mechanics and Bioresonance The Microcosm: the Cell The cell membrane is “a liquid crystal semiconductor with gates and channels” ~Dr. Bruce Lipton It receives information from the environment via biochemical and energetic signaling pathways Receptors are antennas that recognize environmental signals and read the milieu 3 factors that block cell signaling pathways are trauma, toxins and the emotions.

Treating the Emotions to transform suffering & Promote Self-Healing Teaching our patients to build resilience…. “No mud, no lotus” ~Thich Nhat Hanh

The Emotions of the “Wu Xing” 5 Phase Elements and Balance Treating the emotions according to Chinese medicine Fire: Heart, Small Intestine & Pericardium, Triple Burner - Joy, creativity /Anxiety Earth: Stomach, Spleen- Nurturing/Worry Metal: Lung, Large Intestine - Grieving and letting go/depression guilt Water: Bladder, Kidney - Awe, humility/Fear Wood: Liver Gall Bladder - Assertion, courage, strategy/Anger, resentment

Treating Emotional Conflicts CHAKRA 1 Independent Lack of concentration Loss of control Extremely self-controlled CHAKRA 2 Hectic Perseverance Show of strength CHAKRA 3 Isolated Suppressed emotions Wanting more Craving good feelings CHAKRA 4 Mental overexertion Withdrawn

Emotional Conflicts CHAKRA 4 introverted Apprehensive Panic, anxiety CHAKRA 5 Emotional emptiness, shock Misunderstood, victim CHAKRA 6 Faint-hearted Self-sufficient Physical-overexertion Restless Tense Uneasiness, depression CHAKRA 7 Mistrust Materialistic Unwilling to face reality Wrong thinking

Treatment Modalities All doses are patient specific and closely monitored to tolerance level Herbs and supplements most commonly used in treating Bipolar Disorder: Amino acids, BCAA, choline bitartrate, lithium orotate, inositol NAD to titrate patients off certain medications and substances: 100 mg/m. L – 14 m. L 1 spray 10 mg/nostril or 20 mg total; 2 -10 x/day *when titrating meds switching to liquid form of med is best whenever available so that process can be gradual St john’s wort & sam-E for depression, GABA, passion flower, lemon balm for anxiety Botanical formulas for detox Homeopathy and drainage, UNDA, PSE remedies

Treatment Modalities Acupuncture and Neural Therapy to promote homeostasis within the organism via the nervous system plexus’ Biomagnet Therapy developed by Dr. Goiz for terrain restoration IV therapy: nutrient protocols, phospholipid membrane support, detox through minor and major autohemolitic therapy, UVB, ozone The emotions: Applied Psycho-Neurobiology, Family Constellation therapy, 5 element Acupuncture, homeopathy, Psychosomatic energetic therapy, writing and drawing assignments, counseling

Case Presentation EM Pt first PTC in 2010 at age 19 for depression and psychosis. Her issues began in 2008 when she was under a lot of stress completing her honors program and was preparing for a trip to Central America. She was treated with chloroquine x 1 month and also given cipro, 3 months later she hospitalized for psychosis and mania. She was treated with ativan, klonopin, geodon, lithium and risperdal Pt became more stable after working with Dr. Gurevich but had some persistent anxiety and depression, hx of insecurity and intrusive thoughts Other factors: Lyme dz, parasites, SIBO, hormonal imbalance

Case Presentation EM Pt tx’d with Dr. Klinghardt’s Lyme Protocol, oral chelation Antimicrobial herbs for SIBO and parasites, Specific CHO diet, NAET™ Drainage protocol for hormonal support, homeopathics for acute anxiety/depression Acupuncture, counseling, Psychosomatic Energetic remedies Titrated off risperdal with lithium orotate, sam-E, amino acid support One mild relapse that required a short course of medication dt lyme infection which exacerbated anxiety, insomnia and mild psychosis tx’d successfully Pt is medication free since 2013 and has been accepted to graduate school and will be studying natural medicine!

Case Presentation KF 45 y/o F PTC with a 20+ year hx of G/I complaints including hiatal hernia, reflux with vomiting after meals nightly before bed, delayed gastric emptying, alternating constipation with loose stool and food sensitivities. She has had a full Gastro work up has been told her sx are “all in her head” Celiac and food allergy tests were (=) ROS significant for hypothyroidism, pituitary adenoma and insomnia. Mental health hx significant for psychological trauma. Father was an alcoholic who committed suicide when she was 6. She suffered sexual abuse at age 11 and abused alcohol in her teens and had anorexia and bulimia. She coped with her stress by overachieving. Meds: synthroid, lexapro for anxiety and depression, pepcid, prilosec and tums Initially unable to sleep without forced vomiting dt fear she would have reflux in her sleep.

Case Presentation KF Pt was tested for SIBO: peak H 2 production 31 ppm She began herbal antimicrobial protocol: berberine to bowel tolerance, garlic, soluna protocol for detox support, digestive enzymes, liquid minerals. Vinegar packs for acute cramping and castor oil packs for support. Specific CHO diet emphasize foods high in vitamin A and take slippery elm bark powder esophageal support Acupuncture and moxa therapy weekly, pt progressed… Two months into tx pt was hospitalized for an acute viral gastroenteritis and given IV abx Once pt was stable, resumed tx

Case Presentation KF Pts case was further complicated by C Diff for which she was tx’d with vancomycin Once diarrhea stopped tx was resumed began NAET™ to address food sensitivities and dietary restrictions, bloating and pain improved but vomiting persistent Pt is referred to Dr. Gurevich for neural therapy to address persistent reflux & use of acid blocking medication Pt has a “lightning response” with a strong emotional reaction and is able to discontinue tums and H+ blockers and reflux stops Counseling and acupuncture with moxa and NAET weekly Pts bowel movements have been normal and she has had no vomiting for 11 months. Insomnia is improving, she recently changed her career for the better and has been successfully tapering Lexapro without any rebound anxiety or depression

Testimonial I first came to Holistic MD on the recommendation of a close friend because I had been suffering from gastrointestinal issues for 30 years. Traditional doctors had diagnosed me with gastroparesis, a motility disorder, a hiatal hernia and delayed gastric empting (likely due to an eating disorder during adolescence), had prescribed Prilosec, Tums and other acid blockers, and had recommended a diet comprised of soothing foods (heavy in dairy and carbohydrates). Their treatment plan was not helpful as I still could not digest food, and as a result, I was vomiting twice a day and was underweight. My gastroenterologist, after my second “normal” colonoscopy, finally said he thought it was “all in my head. ” Dr. Trivisonno spent over an hour with me on my first visit, listening to my story as no physician had ever done. She diagnosed me with SIBO, small intestinal bacterial overgrowth, and recommended a totally different diet, the Specific Carbohydrate Diet. She performed acupuncture on me, a treatment I had tried once before and had abandoned quickly due to a horrible experience. Dr. Trivisonno was gentle and caring, and made me feel at ease. The diet she recommended, along with the herbs she prescribed, eased many of my GI symptoms almost immediately. A few months into treatment with her, I developed c-diff (from a short stay in a hospital for a viral gastroenteritis), and because of her care, managed to cure that horrible infection. Resetting once again, I continued with the weekly acupuncture, feeling stronger and stronger every week…

Testimonial con’t Neural therapy with Dr. Gurevich was another turning point for me. I was still vomiting daily on the SCD diet due to my body’s automatic response to want to push food back up. I finally agreed to try the treatment both Drs. Gurevich and Trivisonno recommended. I had a “lightening response” to my first treatment. It completely eliminated my body’s automatic inclination to push food back up, and I stopped throwing up overnight. I also went off of Prilosec and all acid blockers, and instead, began taking HCL, a stomach acid supplement. It turned out that the advice of traditional doctors had eliminated my body’s natural ability to digest food by eliminating all of my stomach acid! Dr. Gurevich and his neural therapy was the miracle treatment I was looking for, and it changed my life. Probably saved it. I continue to see Dr. Trivisonno weekly for acupuncture and dietary advice. Her herbal remedies are continuing to help my GI system heal and normalize. I also see Dr. Gurevich monthly for neural therapy to help promote motility in my digestive track, and, now, to treat a longstanding pituitary adenoma I have had for over 15 years. It is my goal to get off my SSRIs and thyroid medication in the near term as my overall wellness improves. I feel confident in the care I receive from Drs. Trivisonno and Gurevich, and I feel “heard” in a way I never imagined I could from people in the medical profession. 02/2016 ~KF

Thank You!

References Banis MD, Reimar. New Life Through Energy Healing The Atlas of Psychosomatic Healing. Nevada City, CA: Artemis Books, 2008. Frances MD, Allen. Saving Normal. New York, NY: William Morrow, 2013 Kirchfeld, Friehelm & Wade Boyle. Nature Doctors. Portland, OR: Buckeye Naturopathic Press, 1994 Lindlahr MD, Henry. Philosophy of Natural Therapeutics. Essex, England: The CW Daniel Company Limited, 1975. Ni Ph. D, Maoshing. The Yellow Emperor’s Classic of Medicine. Boston, MA: Shambala, 1995 Whitaker, Robert. Anatomy of an Epidemic. New York, NY: Broadway Paperbacks, 2010 www. madinamerica. com www. breggin. com Psychiatric Drug Facts