For DOs, treating patients with mental illnesses is a natural application of the osteopathic emphasis on treating the mind and spirit as well as the body. Mental disorders are common in the U.S.: Eighteen percent of adults had a mental illness in 2014, and 20% of American children have had or currently have one, according to data from the National Institute of Mental Health.
William J. Resch, DO, an osteopathic psychiatrist in Columbus, Ohio, says the holistic emphasis of his osteopathic training laid the foundation for his current practice approach. “We can’t focus only on neurotransmitters when diagnosing and treating mental health,” Dr. Resch says. “We also have to look at each patient’s past experiences, physical health and the socioeconomic, cultural and spiritual issues that are affecting him or her.” Here’s a look at how three DOs do just that.
When treating patients with lower-grade depression and anxiety, Dr. Resch urges them to think broadly about ways to improve their mental health. “Patients are frequently eager to try medication as a quick fix, but that can only go so far,” he says. “We often have to look beyond medication to other behaviors that can help you be the best ‘you’ you can be.” For example, he says, patients can nurture their mental wellbeing through physical activity, cultivating healthy relationships and learning to manage stress effectively.
Connecting patients with psychotherapy is another useful tool in addressing behavioral health issues. “As DOs, we know people have the innate ability to heal themselves by the way they think, act and make choices, and therapy encourages that natural tendency toward healing,” Dr. Resch says. Through therapy, patients can develop healthy coping mechanisms, gain motivation to make changes and learn to break negative, repetitive patterns of thinking.
Exercise and diet
Patients with mental health concerns can also benefit from regular exercise and proper nutrition, DOs agree. A 2014 study of children and teens found that an unhealthy diet was linked with poorer mental health.
Because mental and physical health problems often go hand in hand, improvements in diet and exercise can yield double benefits, says Mark Schury, DO, the program director of the family medicine residency at McLaren Oakland hospital in Pontiac, Michigan. “If a patient has diabetes or chronic pain, they can suffer depression or anxiety, which in turn can make it harder for them to manage their health,” Dr. Schury says. “Feeling better always starts with diet, nutrition and exercise.”
‘The whole picture’
In some cases, physical health problems can unleash symptoms that mimic those of a mental health disorder. DOs’ approach to care makes them especially adept at diagnosing such cases, Dr. Resch notes. “I’ve lost track of how many times I’ve discovered that an undiagnosed medical problem, such as a thyroid disorder or renal impairment, was masquerading as depression,” he says.
Psychiatrist Ronald Paolini, DO, is also a frequent witness to the powerful connection between the mind and the body. Dr. Paolini works at Fort Gordon, an Army base in Georgia, where he primarily treats soldiers who’ve had concussions, many of whom have interrelated behavioral and physical health issues.
To gain more insight into patients’ overall health, Dr. Paolini makes a habit of walking patients from the waiting room to his office to observe their demeanor in a more casual setting. “If I’m treating a patient for PTSD and he also has pain, I have to look at the whole picture,” Dr. Paolini says. “Whether it’s pain or marital or financial problems, you have to understand what the patient is living with before you can address their behavioral health effectively.”