We invite you to join a study of Bipolar Disorder patients who have failed conventional psychiatric treatments, are interested in a holistic approach and will consider getting off medication.
Most doctors believe that Bipolar Disorder requires life-long medication. However, many people with Bipolar Disorder continue to have symptoms despite taking several medications. It is a well-known fact that medications are expensive and can cause multiple harmful side effects.
The proposed study will examine the use of integrative and holistic therapies for the treatment of Bipolar Disorder while patients stop the use of medications. The goal is to restore health and well-being without medications. Individualized integrative/holistic treatment modalities (IHTM) may include the use of vitamins, minerals, herbal supplements, and homeopathic remedies. It may also include detoxification therapies administered by mouth or injection. In addition, doctors may recommend lifestyle and behavioral changes, such as gluten free diets, regular sleeping hours, and exercise. Patients may also practice guided imagery and meditation, and receive acupuncture. Treatment is tailored to each person and his/her symptoms. The study will examine the effects of IHTM on symptoms of bipolar disorder, safety, cost, and quality of life.
Participants in the study have already decided to receive IHTM from their psychiatrist for the management of bipolar disorder for clinical reasons. People who wish to take part in the study will be asked to complete a series of questionnaires prior to IHTM, at 1, 2, and 3 months after IHTM, and every three months thereafter until completion of the study at 3 years. The questionnaires will be completed on a computer, and will assess mood, unusual thoughts, experiences, or behaviors, side effects, medical expenses, and overall quality of life.
Subjects with Bipolar Disorder, aged 16-65 years, who have not been effectively treated with medication and who plan to receive IHTM, may be eligible to enroll in this study. Subjects will be enrolled and tested at HolisticMD, the outpatient practice of the researcher.
This study will raise awareness within the psychiatric community of the difficulties of treating Bipolar Disorder with medications, and hopefully will point the way to new holistic and integrative treatment strategies.
What is Bipolar Disorder?
Bipolar Disorder is defined as the psychiatric condition characterized by mood instability, with episodes of mania, hypomania or irritability and depression.
The term Bipolar Disorder was first coined in 1980 with the creation of DSM III (Diagnostic and Statistical Manual of Mental Disorders, 3-rd edition). It replaced a rare, intermittent condition historically known as Manic-Depressive disorder. DSM III was seeking to better define psychiatric conditions by giving every psychiatric disorder a list of specific symptoms by which the condition is characterized. Terms denote a condition with two poles: mania and depression.
Initially, only those patients who suffered from severe manic symptoms were included: those who had severe grandiosity (for example, thinking they are The Messiah or Jesus Christ); those who talked with pressure and very fast with mind racing; those who were unable to sleep or able to sleep just a couple of hours but still felt they were refreshed; those who spent money lavishly even though they did not have it; or those who became hypersexual.
However, in subsequent editions of DSM, Bipolar Disorder was “watered down” to include patients who had no symptoms of mania, but were irritable or angry; those with milder symptoms, called hypomania; those whose manic symptoms were caused by medications; even those with no obvious symptoms but doctors just suspected they had Bipolar Disorder.
As the definition of Bipolar Disorder was being “watered down”, the number of patients diagnosed and treated for this condition rapidly grew, gradually erasing the line of what is “Normal” and what is “Abnormal”. Manic-Depressive illness had been a rare condition, manifesting in just one out of 100,000 people before DSM III; Bipolar Disorder has become a common place condition today. Some studies indicate that one in 20 people is suffering from Bipolar Disorder presently.
During my residency in the 1980’s, I worked in a very busy psychiatric hospital in Elmhurst, NY and I saw only a few patients suffering from Manic-Depressive illness. In my busy private practice today, every third or fourth new patient has been diagnosed with Bipolar Disorder. What is happening?
What is the cause of Bipolar Disorder?
Conventional psychiatry is not interested in this issue. A widely accepted conventional wisdom is that Bipolar Disorder has an idiopathic etiology, meaning it is not known what causes it. Conventional psychiatrists are concerned with diagnosing it and administering medication to reduce disease symptoms. There is a strongly held opinion that this is genetic, an inherited condition. Even though no gene was ever proven to be found as causing it. Chemical imbalance is another presumption which is never looked for by conventional psychiatrist or proven to be a factor.
In our view there are multiple causes of the Bipolar Disorder epidemic:
1. The most important factor is a change of definition of what constitutes Bipolar Disorder by the American Psychiatric Association. Manic-Depressive Disorder was a severe, life altering condition with profound consequences. Bipolar Disorder is defined in almost banal terms thereby giving doctors great leeway to diagnose it. After diagnosis is made, doctors are encouraged to place patients on medications to reduce their symptoms.
2. Being on medications creates a cycle of chronic mood instability, side effects, use of other medications, and frequent changing of the medication.
3. Antidepressants and stimulants can cause mood instability and symptoms of mania which is diagnosed as Bipolar Disorder.
4. Being on a stimulant or other medications since childhood, people lose their ability to naturally regulate their mood, causing ongoing symptoms of irritability, explosiveness, poor concentration and insomnia; “graduating” ADHD to Bipolar Disorder patients.
5. Illicit substance abuse can create an unstable mood, insomnia and psychosis, which often is diagnosed as Bipolar Disorder.
6. Chronic infections, such as those caused by Lyme spectrum disorders (tick transmitted conditions), or parasite and fungus often go undiagnosed and when accompanied by chronic inflammation manifested as mood swings, depression and fatigue, can be diagnosed as Bipolar Disorder.
7. Food sensitivity, particularly to gluten containing grains (wheat, rye and barley), or sensitivity to milk, sugar and other foods, can create mood instability diagnosed as Bipolar Disorder.
8. Changes in the intestinal bacterial flora due to poor diet, frequent use of antibiotics and hormones can create mood instability, insomnia, irritability and other symptoms, which can be diagnosed as Bipolar Disorder.
9. Gastro Intestinal conditions, like SIBO (Small Intestinal Bacterial Overgrowth), chronic constipation, or GERD (Gastroesophageal Reflex Disease) with frequent use of anti-acid medications can create issues with disturbance in absorption and elimination from our gastrointestinal tract, our biggest internal organ, thereby creating mood instability that can be diagnosed as Bipolar Disorder.
10. Poor dietary habits, reliance on junk food, creates symptoms of obesity, hypoglycemia (low blood sugar), irritability, poor concentration and insomnia, which can be diagnosed as Bipolar Disorder.
11. Endocrine irregularities, like PMS, menopausal issues, hypothyroidism (low thyroid functioning) and others, often manifest multiple mood related symptoms and can be diagnosed as Bipolar Disorder.
12. Nutrient deficiency, particularly in minerals like zinc or magnesium, or vitamin deficiency, such as B12, can present with unusual symptoms and mood swings and can be diagnosed as Bipolar Disorder.
13. Disregard to normal requirements for sleep-wake cycle, or chronic sleep deprivation, leading to irritability, poor concentration, depression, anxiety and insomnia which can be diagnosed as Bipolar disorder.
14. Chronic stress caused by high rhythm of life triggering chronic adrenal fatigue with its multitude of symptoms that include irritability, insomnia and depression, can be diagnosed as Bipolar Disorder.
15. Post-Traumatic Stress caused by severe emotional traumas, such as sexual abuse and rape, or being bullied, can lead to severe mood swings and many other symptoms, which can be diagnose as Bipolar Disorder.
16. Heavy metal toxicity, such as mercury, can create multiple symptoms, including chronic mood irregularities, insomnia and manic-like symptoms, which can be diagnosed as Bipolar Disorder.
17. Many other conditions and factors causing mood instability can be diagnosed as Bipolar Disorder.
In summary, what has been often diagnosed as Bipolar Disorder is a constellation of symptoms arbitrarily defined by American Psychiatric Association. It is a condition which can be caused by multiple factors. The conventional approach with its focus on medications is interested primarily in short term symptom reduction. The Holistic Psychiatric approach searches for the causes of mood instability, eliminates them, tapers medication and restores patients to health and stability.
Initial visit and what to expect
Preparing for the initial interview you will complete our specially designed questionnaire which allows us to be thorough and scientific in finding out what you have done before, what worked and what failed. Filling out this form may take 30 to 60 minutes. It is very important and will make it easier for us to help you if you fully complete the forms.
Our initial goal is to find out what has happened? What has created your mood instability? The individualized interview along with the questionnaire allows us to develop intuitive and emotional understanding of your issues.
Next we use individualized energetic testing, such as ART (Autonomic Response Testing) or BAH (Bioresonance Analysis of Health). We order additional laboratory testing and review records from your previous doctors.
At the end we discuss our findings, put into perspective your whole life, previous diseases, traumas and treatments. We will talk over our plan and outline recommendations.
One of our support staff will further discuss recommendations with you, give you a written outline of the plan, provide you with appropriate supplements and make follow up appointment.
Holistic Psychiatry approach to Bipolar Disorder
There is no single “magical bullet”, or pill which will get you well. Restoring your health is our goal. To achieve it we need to work together as a team: you are the athlete, we are your coach.
We use multiple treatment methods synergistically in an individualized manner, adjusting it to your needs, at a particular time of your healing process based on our comprehensive assessment.
Life style changes are critical in helping you get well. We will discuss exercise and proper sleep and wake regimens. Diet is also very important and key to good health. We will recommend a proper individual diet and will discuss ways to eat.
Practicing Positive psychology helps to change your outlook on life, become proactive and let go of negative thoughts. Meditation and spirituality support you in gaining perspective on your life and learning better ways to regulate your moods.
Psychotherapy and Energy Psychology: There are many ways to resolving past emotional traumas. Psychotherapy is one of them. In addition we use ACMOS, APN, PSE, Bio-modulator, Energy-Psychology, Systemic Family Constellation, writing and creative assignments.
Supplementation: We use supplementation with vitamins, minerals, amino acids, herbs and homeopathic remedies assisting in the process of detoxification, improvement of organ function, regulation of mood, sleep and other functions. Supplements as a rule have mild or no toxicity or side effects. In the initial stages they are combined with medications, gradually substituting them for the medications as you taper.
Neural Therapy is one of the most effective, but underutilized treatment modality in the US. It helps to regulate the autonomic nervous system which controls the function of all our internal organs. It works decisively with few side effects.
Acupuncture is an ancient/conventional treatment modality which effectively regulates the function of all body organs, mood and sleep. It works effectively with multiple other holistic treatments.
Intravenous therapy is a highly effective treatment approach, helping people exhausted by long term treatment to regain resilience and return to normal mind-body functioning.
Medications reduction and elimination: All psychotropic medications create a state of physical and psychological dependence. When they are rapidly stopped or discontinued it creates a severe withdrawal reaction which can cause multiple severe symptoms. Therefore, it is essential to decrease medications very slowly. This process may take many weeks, months or even years. The tapering process requires discipline and patience. We will work to assist you by improving your overall health and resilience.
Can we work with your psychiatrist?
No, it does not work. Psychiatry is quite an empiric and inaccurate profession. Even conventionally trained, Board Certified Psychiatrists agree on DSM 5 diagnosis in less than 30% of the cases. There is even less agreement on treatment options. To compound it, what we do in our clinic is far out of the scope for most conventional psychiatrists. They often look at our approach as a voodoo science, discouraging their patients from using anything non-conventional. In the past, we have tried to share cases and work in conjunction with other psychiatrists, but it never worked. We strongly suggest that you choose one approach and stick with it. If you are satisfied with the results of the Conventional Psychiatry approach, you should continue and be compliant with your doctor’s recommendations. If not, let’s work together as a team and follow our recommendations.
Can we work with your social worker, psychologist or other healthcare professional?
Yes, we can. Many health practitioners are a good source of referrals for us. They are familiar with our approach and our success rates. We share our findings and strategies and assist each other in helping you.
Conventional approach to Bipolar disorder
The conventional approach sees Bipolar Disorder as a life-long, untreatable condition which cannot be cured and should be managed. The key aspect of management is medication.
Lithium was the first medication marketed for the management of Manic-Depressive illness. It is a bit out of fashion now since pharmaceutical companies lost their patent on its sale and its side effects have become better known. The majority of patients develop thyroid issues, obesity, kidney problems and multiple other issues. It is a dangerous medication if it exceeds a certain level in the blood. Therefore, frequent blood testing is a must. It shows effectiveness in preventing manic symptoms in only 20% of patients when used on its own. It is, however, the only medication that has some long-term effects on preventing suicidal thoughts and mania.
Mood stabilizers are a poorly defined category that includes some anticonvulsant medications like Depacote, Tegretol, Lamotrigine and Neurontin. At best, there is scientific evidence of their short effectiveness for patients in a manic state. But in all well controlled studies they fail to show effectiveness over several months. The side effects are multiple, ranging from obesity, loss of equilibrium, sedation, tiredness, menstrual cycle issues and many others.
Atypical or second generation antipsychotic medications like Zyprexa, Risperdal, Seroquel, Geodone, Abilify and others, have been approved and promoted for the treatment of Bipolar Disorder. However, they are effective at best in severely manic patients only for a short time. There is little evidence in their long term use. Side effects are multiple, some severe and life-threatening: obesity, hormonal irregularities, sedation and many, many others.
Antidepressant medications (Prozac, Zoloft, Paxil, Cymbalta, Effexor, Celexa, Lexapro, Wellbutrin and others) are supposed to be prescribed for short periods of time when a patient is depressed. But in many cases patients stay on them indefinitely. They contribute to mood instability and manic episodes. They have multiple side effects.
Benzodiazepines (Valium, Zanax, Klonopin, Ativan, Librium, etc.), prescribed as sleeping medications, for anxiety, insomnia and agitation are habit forming and have multiple side effects.
For detailed information on side effects of medications you are taking go to: http://www.pdr.net/full-prescribing-information , or http://www.drugs.com,
As a rule, one medication rarely works on its own in controlling symptoms of Bipolar Disorder. By some studies 40 to 80% of doctors prescribe 3 or more medications. Most of the combinations (drug cocktails) rarely work for a long time. Therefore, they are frequently changed.
Psychotherapy and supplements have been shown to be quite effective. Surprisingly, most of the studies do not test them on their own merits, but as an adjunct to medications.
Benefits of being part of the study
You will have a personal benefit of helping to prove the effectiveness of the holistic, medication- free approach over long term medication management.
1. You will bypass a 3-4 month waiting list to become Dr. Gurevich’s private patient.
2. You will be offered a unique opportunity to get off psychotropic and other medications, resolve emotional and physical symptoms and return to a healthy life.
3. You will be provided with a personal coach to guide you in your recovery process, free of charge for the first year.
4. You will receive a discount on the initial visit of $200 and at the end of the three year study you will receive additional $500 for your care in our office.
5. Some of the tests and supplements may be provided free of charge or at a reduced cost.
6. You will be provided with personalized care and 24 hour access.
7. We will strive to prevent your relapse or a psychiatric hospitalization.
Who is eligible to be enrolled in the study?
Patients who are 16 to 65 years old, are fluent in English and have normal IQ.
Patients who have been diagnosed as suffering from Bipolar Disorder for one year or longer, who have taken two or more conventional medications, or other treatment modalities, like ECT, without achieving remission and/or experienced significant side effects.
All patients are self- paid. We do not accept any insurance. Therefore, you will need to pay for all care and supplements. There will be some discounts and free testing offered. Private coaching will be free for the first year. We will provide you with a medical bill, which may be reimbursed by your insurance plan.
The fee for an initial appointment is paid in advance. If you become enrolled into the study, you will receive a credit of $200. Depending on the difficulty of your condition, services and supplements you need may cost $1500 to $5000 per month for the first six months, sometimes longer. Expenses are generally lower in subsequent months. After a year or two in treatment, visits are on a monthly or less frequent basis and the need for supplements will be significantly reduced.