CMHIMP Certified Integrative Mental Health Professional Nutrition
CMHIMP Certified Integrative Mental Health Professional Nutrition
| Integrative Treatment: Cognitive Function, Attention & Focus |
| Assessment | Co-occurring disorders; gum inflammation, B-12 levels | Herbs | Huperzine, gingko, vinpocetine, Melissa (inhalation of essential oil) |
| | Herbal | |
| Digestion | Slow Glucose Uptake, ehance EFAs emulsion, gut function | Detoxification | Hydrotherapy; Hot & cold alternating, stimulates blood flow, Coffee Enemas, Liver Flush, Sleep (glymphatics) |
| Digestion and Mental Health | Detox and Handouts |
| Culinary Medicine | Higer protein/fats/ complex carbs, Organic eggs, spinach, Green Tea powder/Chocolate Coffee | Yoga & Exercises | Exercise aerobic, High intensity; Balance (Bosu), Pranayama, Brain Training; Neurofeedback Lumosity |
| Culinary Medicine | Yoga, Sound, Oxygen and Handouts | Mind, Body, Spirit interventions |
| Nutritional Therapies | Fish Oil/Krill/GLA 1-5 grams, Lithium orotate, Taurine, Lutein (enhances memory), B12 methycobalamin | Somatics | Cranial Sacral, grounding treatments, feet & hands |
| Nutritional Therapies | Nutrition Essentials | Somatic, Energy Therapies
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| Integrative Treatment: ADHD |
| Assessment | Sedentism, stress (complex trauma), learning style, food allergies/sensitivities, circadian rhythm, hypoglycemia | Herbs | Rhodiola tea (Focus), VHP (Anxiety), Vertiver Oil (essential) inhaled, Cedarwood Oil (essential) inhaled |
| | Herbal | |
| Digestion | Stabilize hypoglycemia, enhance microbiome, identify digestive problems from chewing to elimination | Detoxification | Heavy metals, restore leaky gut with muciliagnious foods & herbs, magnesium sulfate baths |
| Digestion and Mental Health | Detox and Handouts |
| Culinary Medicine | Eliminate refined foods, Emphasize protein and fats, Fish oil | Yoga & Exercises | Kinesthetic; disciplined with meaning (martial arts, fencing), Breathing, Bodywork, Watsu, Cooking & food prep/ body boundaries, right nostril pranayam |
| Culinary Medicine | Yoga, Sound, Oxygen and Handouts | Mind, Body, Spirit interventions |
| Nutritional Therapies | B Complex, Fish oil (1-5 gms) H-Adjusted Free Amino Acides, L-Tyrosine for dompamine support, probiotics | Somatics | Rocking, Blue light blocking glasses at night, reduction of screen time |
| Nutritional Therapies | Nutrition Essentials | Somatic, Energy Therapies
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| Integrative Treatment: Anxiety |
| Assessment | Nijmegen Scale (hyperventilation), Symptoms of HVS; sighing, neck tension, chest pain | Herbs | Kava, Valerian-Hops- Passionflower Skullcap (anxious depression), 1/2 c. Dark Beer (hops), CBD oil |
| Nijmegen Scale | Herbal | |
| Digestion | Fermented foods support gut function, GABA | Detoxification | Fiber Flush: colon; Skin Brush |
| Digestion and Mental Health | Detox and Handouts |
| Culinary Medicine | Vinegars, meats, bone broths, oatmeal, celery. Reduce dietary stressors, caffeine, sugar, etc. | Yoga & Exercises | Breath retraining & aerobics: Scalene stretch, Flying Dragon, Wood chopper, HA breath |
| Culinary Medicine | Yoga, Sound, Oxygen and Handouts | Mind, Body, Spirit interventions |
| Nutritional Therapies | GABA support; Lactium (de-stress), B-complex vitamins/magnesium | Somatics | Bodywork therapies/ Rocking, Light touch, neck and diaphragm |
| Nutritional Therapies | Nutrition Essentials | Somatic, Energy Therapies
See also Alternative Medications for Anxiety (bodymindspiritsuccess.blogspot.com) |
| Integrative Treatment: Bipolar Disorder |
| Assessment | MTHFR genetics, Assess for causes of lability, rule out hypoglycemic food allergies, inflammatory diet, e.g. sugar | Herbs | Licorice Root, hops |
| | Herbal | |
| Digestion | Reset circadian rhthm, Chrono nutrition, eat meals early in the day, light at night | Detoxification | Hydrotherapies, coffee enemas |
| Digestion and Mental Health | Detox and Handouts |
| Culinary Medicine | Protein, vegetables, low-glycemic | Yoga & Exercises | Mid day light exposure |
| Culinary Medicine | Yoga, Sound, Oxygen and Handouts | Mind, Body, Spirit interventions |
| Nutritional Therapies | Core Nutrients: B-vitamins and Minerals, Lithium Orotate, Inositol 5-20gms | Somatics | Rocking on side that needs relaxation, right brain, left brain |
| Nutritional Therapies | Nutrition Essentials | Somatic, Energy Therapies
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HBOT=Hyperbaric Oxygen Treatment
| Integrative Treatment: Depression |
| Assessment | Multiple factors: leaky gut, inflammation, NT function, oxidation, mitochondrial, co-occuring TBI, PTSD, ACE's | Herbs | St. John's Wort, rhodiola & coffee, increase dopamine |
| | Herbal | |
| Digestion | Assess for GERD, hypoactive elimination | Detoxification | Liver flushes, coffee enemas |
| Digestion and Mental Health | Detox and Handouts |
| Culinary Medicine | Green papaya salad, chocolate, raw butter, raw soaked almonds, fermented foods, Spinach (lutein), figs | Yoga & Exercises | Aerobic exercise, Yoga, Emphasize right nostril, pranayama |
| Culinary Medicine | Yoga, Sound, Oxygen and Handouts | Mind, Body, Spirit interventions |
| Nutritional Therapies | Refer to Nutritional Therapist table, Amino acid, adrenal support | Somatics | Stimulating pressure, deep reflexology, abominal, rocking, 10th cranial nerve, HBOT/ Ketamine therapy |
| Nutritional Therapies | Nutrition Essentials | Somatic, Energy Therapies |
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| Treatment Resistant Depression: TRD |
| Option | Rationale | | Limitation |
| Extending Antidepressant Trial | Delayed time to response amongst populations with TRD | Modest evidence base supporting the strategy. Unlikely to be acceptable to most patients with TRD. |
| Switching antidepressants | Mechanistically dissimilar antidepressants from different classes may offer improved health outcomes for TRD in some cases. Especially appropriate when index antidepressant class is poorly tolerated. | Modest evidence base supporting the strategy. Newly initiated antidepressant will require at least 4 weeks before outcome can be assessed. |
| Combining antidepressants | May target symptoms not responding to index antidepressant (e.g. fatigue, cognitive, impairment, sleep problems). May improve tolerability via antidote of emergent adverse events (e.g. buproprion for antidepressant-induced sexual dysfunction) | Limited evidence in TRD. Potential for drug-drug interactions. Decreased adherence with polypharmacy regim. Greater cost of treatment. |
| Ketamine | Acute efficacy established in TRD. Beneficial effects on suicidality. Rapid onset of symptomatic improvement. Greater efficacy in TRD with higher number of prior antidepressant failures. | Insufficient long-term efficacy, tolerability and safety data. Access to treatment limited in many jurisdictions. Specialized personnel required for safe administration. Long-term safety profile in TRD not established. |
| Esketamine (Spravato blog post) | Acute and maintenance efficacy established in TRD. Beneficial effects on suicidality. Rapid onset of symptomatic improvement. Greater efficacy in TRD with higher number of priror antidepressant failures. Superiority of SGA (i.e. quetiapine XR) in acute and maintenance. | Access to treatment limited in many juridisctions. Acquisition cost. Recommendation to co-prescribe with newly initiated antidepressant in TRD. |
| McIntyre et al World Psychiatry 2003 |
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| Treatment Resistant Depression: TRD |
| Option | Rationale | | Limitation |
| Second- generation antipsychotics (SGAs) | Scalable and accessible treatments. Evidence established for olazapine-fluoxeine combination. (Zyprexa-Prozac) | With the exception of olanzapine-fluoxetine combination, studied in partial responders than TRD. Short and long-term tolerability concerns. |
| Electroconvulsive therapy (ECT) | Highly effective in acute and maintenance treatment of TRD. Superiority to IV Ketamine suggested by available evidence. Efficacy in TRD across the span. | Relative lack of availability in many jurisdictions. Stigma and lack of acceptability to many patients with RD. Tolerability concerns (e.g. memory deficits). |
| Repetitive transcranial magnetic stimulation (TMS) | Shown to be effective in TRD. More acceptable to patients than ECT. Accelerated protocol demonstrates significant remission rates within 1 week. Tolerability advantages compared to ECT (.e. persisting cognitive deficits not observed). | Relative lack of availability in many jurisdictions. Inferiority to ECT in TRD with non-accelerated protocols. Insufficient long-term data in TRD. |
| Vagus nerve stimulation | Proven efficiency in TRD in persons with extensive antidepressants failure histories. Treatment does not need to be administered ona daily basis. | Not available i most countries globally. Complexity of procedure limits scalability. Complications of implant. Cost of treatment. |
| Psychotherapies | Evidence supports efficacy when used adjunctively in TRD. Opportunity to target commorbidities. Facilitate coping strategies with improved effects on patient-reported outcomes. Highly acceptable to persons with lived experience of TRD. Opportunity to tailor treatment targeting specific therapeutic outcomes. | Lack of availability of treatment or adequately trained provider. Low adherence to therapy. Lack of evidence as standalone treatment in TRD. |
| McIntyre et al World Psychiatry 2003 |
| Integrative Treatment: PTSD |
| Assessment | Identify 3-Stage: Self care, Process, Wounded healer | Herbs | Natural anxiolytics, Adaptogens, licorice, Citrus aromatherapy |
| | Herbal | |
| Digestion | Decrease dissociation, Enhance mindful eating, Transform self medication behaviors, Ease digestion | Detoxification | Decrease dissociation, Skin brushing, Hyrdrotherapies: warm & cold packs, HBOT |
| Digestion and Mental Health | Detox and Handouts |
| Culinary Medicine | Protein, sea salt, colors of the Brainbow, Bone/chicken broths, collagen broths, anti-inflammatory spices | Yoga & Exercises | Balance hard aerobic exercise early, yoga & meditation mid & later, anaerobic |
| Culinary Medicine | Yoga, Sound, Oxygen and Handouts | Mind, Body, Spirit interventions |
| Nutritional Therapies | Glandulars: Liver, brain & hypothalamus, B-complex, Taurine (if HBP), Lithium | Somatics | Differentiate Touch vs Needles, Acupuncture / Bodywork & body oriented psychotherapies, Rituals, Self Belly massage |
| Nutritional Therapies | Nutrition Essentials | Somatic, Energy Therapies |
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| Integrative Treatment: Seasonal Affective Disorder |
| Assessment | Seasonal Pattern Assessment Questionnaire (SPAQ), Regulate circadian rhythm, phase delayed | Herbs | St. John's Wort, coffee, green tea, rhodiola |
| SPAQ | | Herbal | |
| Digestion | Chrono Nutrition, carb metabolism/ substitutions of refined carbs and sugars | Detoxification | Coffee enemas, Liver flush, Skin brushing |
| Digestion and Mental Health | Detox and Handouts |
| Culinary Medicine | Healthy fats & proteins, improve fats quality, Whey protein | Yoga & Exercises | Interval training / aerobics early in day; yoga, sound therapies, HA breath |
| Culinary Medicine | Yoga, Sound, Oxygen and Handouts | Mind, Body, Spirit interventions |
| Nutritional Therapies | Methylcobalamin (B-12), Melatonin (.5 mg), 5 HTP (Tryptophan at night) | Somatics | Morning light therapy, eliminate sun glasses, Cranial sacral, visceral manipulation |
| Nutritional Therapies | Nutrition Essentials | Somatic, Energy Therapies |
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