What is your position at SohoMD?
In earnest, I don’t know what my position is actually called here - Chief Troublemaker Maybe.
I can tell you I am a naturopathic doctor and acupuncturist. I help support the creation of the integrative care model here at SohoMD.
Why do you enjoy working with SohoMD?
Gosh, where do I begin… I have been in private practice for the last 19 years focusing on learning how to effectively use natural medicines for mental health care. I have loved my work, but in private practice here in New York, there was a bit of isolation to it.
I have been with SohoMD for a year now. It is truly a living dream to be here at SohoMD in the midst of like-minded people who have patient health and happiness as the center of the mission. Then we all look to elevate each other in the process of working towards common patient goals.
The learning is exponential in this team approach, where Dr. Jospitre has created a culture of support and intellectual pursuit. I am getting paid to learn, create, and do what I love. There is honestly nowhere else I would want to be. I wake up every morning thankful to be a part of the SohoMD family.
What inspired you to work in mental health care and what are some of the most rewarding aspects of your work?
In the 1990s, I spent a few years researching at the National Institutes of Health (NIH) in Bethesda, Maryland. There, I worked in the Clinical Neuroendocrinology Branch of the Mental Health Institute. That is where I studied the hypothalamic pituitary adrenal axis, and how stress can affect the brain, which can in turn affect the body.
After graduating from naturopathic medical school in 2003, I started a practice in NYC where most of my patients were coming into the office on some kind of medication and were looking for natural options.
At that time, my mentor, a psychiatrist from NIH asked me if I could write a chapter about complementary medicines for depression for a textbook published by Wiley called "The Biology of Depression".
In that chapter, I found all the available research and compiled it, and realized this work is fascinating and needs more clarification.
So, I made mental health care a focus in my practice and wrote the first full professional textbook on integrative depression care in 2008 called "Healing Depression".
Every day is unique and a privilege to meet a patient who trusts me enough to share their lives, their fears, and their vulnerabilities with me. There is no greater honor someone can give you. Then, every day I learn something new: about a mechanism of a drug, a genetic variant that affects mood, a new way to use an ancient herbal remedy - all towards the idea of bringing better mood to our patients
Finally, to see a light go on for a patient, knowing there are options and hope as they better understand their illness and the possibilities for their care - it’s an amazing feeling.
What is your favorite self-care activity?
Sleep! Followed by playing the drums and then exercising.
(Yes, I play the drums as a self-care activity.)
How do you approach the process of creating individualized treatment plans for your clients and what strategies do you find to be the most effective?
Developing individualized treatment plans is really going to depend on the patient. The first step is taking a very good intake and spending some time getting to know the patient. Then we take their laboratory tests and get a good sense of their physiology, and finally dig down to learn what’s going on with sleep, diet, and lifestyle - and of course what their stressors are.
Then we prioritize what is possible to change and what is necessary so that we give the body what it needs to start the healing process. For everyone that will be different.
Can you share a particularly challenging case you have worked on, and how did you navigate it with your client?
Here is a brief case study on Sandra.
Sandra was a 55-year-old suffering from bouts of depression and anxiety for the past two years. She heard from two psychiatrists it was “menopausal depression” and shuffled her through a few different meds.
She was referred to me because Zoloft seemed to help the anxiety, but the depression was not getting better. After taking her history, I learned she had issues with her digestive system for some time - her blood work confirmed this.
This suggested to me it was a factor in her digestive and mood issues. C-Reactive Protein was found to be positive, suggesting there was a lot of inflammation in her body. However, her hormonal panels were relatively normal for a woman her age.
We started a plan to remove products such as gluten and dairy products while increasing healthy lean proteins, fish, vegetables, and healthy oils. I also put her on some St. John’s wort and Fish oil to support the thyroid. Within 8 weeks, Sandra’s depression all but disappeared and her anxiety reduced greatly (some anxiety occasionally spurred on by some stressors with her children).
In Sandra’s case, it was not menopause or even hormonal issues causing her pain, instead, it centered around digestion and inflammation affecting her thyroid and brain neurotransmitters.
What do you think are some of the most common misconceptions people have about natural therapies, and how do you address these in your work?
One main misconception about natural therapies is that “if it is natural, it must be safe.” In fact, natural therapies are generally quite safe, but that is not completely true across the board.
That is why I strongly recommend when a patient has a medical concern they work with a knowledgeable practitioner.
Another misconception is some people believe if they are using natural medicines they don’t ever need to use conventional care.
My thought is that it really depends on the patient. Some drugs can be life-saving and that type of care is needed in cases like that, then we bring in the natural therapy slowly and help the patient get to the place where hopefully they can lower the necessary medication, or even get to a place without it.
It is never a good idea to stop taking your conventional medication without speaking to your prescribing physician. Drugs work quickly and have a strong effect - natural medicines are gentler and often take more time as they heal and nourish the body.
How do you incorporate feedback from clients into your practice and how do you ensure that you are providing the best possible care?
My patients teach me every day. Any feedback is welcome.
If I have a patient with a thought or concern, and the next day another patient expresses this too. I let the patient know I heard them and consider their thoughts seriously.
I also like to let the patient know that they are the boss, not me or any doctor, for they know their body the best, and we are working for them. My hope is that my patients feel a sense of working together, versus simply a more patriarchal doctor-patient relationship. Where the doctor gives orders and the patient follows them with little discussion or explanation.
In fact, the word doctor comes from the phrase from the Latin “docere” which means “to teach”. It is the doctor’s job to teach the patient about their body and about their health for the greatest understanding, and that goes along with the healing process.
How do you envision the future of mental healthcare, and what role do you see yourself playing in shaping that future?
No question, SohoMD is the future of mental healthcare. Right now, mental health medicine is fractured into conventional psychiatric care, therapy, and natural medicine care. In the future ‘medicine’ is going to be the flawless combination of the two: the combination of science with the age-old tradition of understanding how natural care can heal the body.
The founders of SohoMD are the vanguard of this movement and they have the vision to bring these fractured pieces together for the best care a patient can get. I am proud to be a part of that vision, to help bring a process where natural and functional medicine can not only co-exist peacefully with conventional psychiatric care but elevate it for the best patient healthcare experience possible.
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