For decades, the phrase alternative medicine has carried an unfortunate implication: either–or. Either you choose conventional medicine—or you choose something outside it. Either prescriptions or nutrients. Either psychiatry or biology.
But when it comes to mental health—and especially depression—that framing is no longer accurate. And it may never have been helpful.
A better phrase is: Enhance your care.
That means supplementing your conventional care with non-drug options. It does not mean substituting non-drug options for conventional care.
That’s the core idea behind functional psychiatry, a medical approach that integrates conventional psychiatric care with evidence-based nutrition, metabolic testing, and personalized biology. It’s not a rejection of psychiatry. It’s psychiatry expanded. Or, as I like to say, psychiatry redefined.
Functional psychiatry doesn’t ask patients to abandon antidepressants, psychotherapy, or medical supervision. Instead, it asks a deeper, more practical question:
How to we find the factors that are getting in the way of healing—and how do we fix them?
The Limits of Symptom-Only Psychiatry
Conventional psychiatry has helped millions of people. Antidepressants, mood stabilizers, psychotherapy, and crisis interventions save lives every day. No serious functional psychiatrist disputes that.
But there’s also a hard truth: for a large percentage of patients, standard treatment doesn’t go far enough.
Up to two-thirds of people with depression don’t respond adequately to their first antidepressant. Many don’t respond to the second or third. Others improve partially—only to relapse months or years later. Too often, the clinical response is to add another medication, and then another, without ever asking why the first one didn’t work.
Functional psychiatry starts where conventional care often stops: with biology.
Not biology in the abstract—but measurable, correctable biological factors that influence how the brain actually functions: nutrient status, inflammation, hormone balance, metabolic health, gut integrity, genetic variation, sleep quality, and more.
Depression is not “all in your head.” It’s in your body, too.
First Test, Then Treat
The organizing principle of functional psychiatry is simple and deeply medical: first test, then treat.
Rather than guessing which medication might work, functional psychiatry uses laboratory testing to identify underlying biological contributors to depression. As I mentioned a moment ago, these commonly include nutrient deficiencies (particularly the nutrients that are the building blocks of neurotransmitters), blood sugar dysregulation, chronic inflammation, gut dysfunction, and poor sleep.
Two people may both meet criteria for major depressive disorder, yet have entirely different biological drivers. Treating them identically makes little sense.
This recognition and address to biochemical individuality is at the heart of functional psychiatry. It is personalized medicine, at its best.
Supplementing Medications—Not Replacing Them
One of the most persistent myths about functional medicine is that it’s “anti-medication.” In reality, the opposite is true.
Functional medicine—and functional psychiatry—often improves medication outcomes.
Correcting nutrient deficiencies can increase the effectiveness of antidepressants, reduce side effects, and make tapering safer when deprescribing is appropriate—a fact proven by scientific research and clinical experience. Magnesium may reduce anxiety and improve sleep. Vitamin D supports serotonin synthesis. Zinc and folate influence neurotransmitter signaling and mood regulation. Amino acids can directly support neurotransmitter production.
These are not alternatives to medication. They are adjuncts—biological supports that help medications work as intended.
For many patients, this integrated approach means fewer drugs, lower doses, and better outcomes. For others, it means finally responding to treatment after years of frustration.
Either way, it’s good medicine.
A Turning Point in the Evidence
In recent years, academic research has begun to catch up with what integrative clinicians have observed clinically for decades: biology matters profoundly in mental health.
Studies linking vitamin D deficiency to depression and ADHD. Research connecting low zinc and folate status to suicide risk. Data showing that metabolic interventions like the ketogenic diet can dramatically improve mood disorders.
These findings are not fringe. They come from respected institutions and peer-reviewed journals. The conversation has shifted.
Which brings us to one particularly striking example.
Low-Dose Nutritional Lithium and Brain Health
When most people hear “lithium,” they think of a powerful psychiatric drug used at high doses to treat bipolar disorder. But there is another form of lithium—low-dose nutritional lithium—that exists naturally in trace amounts in food and water and is required for optimal brain function.
Emerging research suggests that low-dose lithium, especially in the form of lithium orotate, may play a critical role in brain health, neuroprotection, and even the prevention of neurodegenerative disease.
A landmark Harvard-led study published in Nature in August, 2025 demonstrated that low-dose lithium reversed Alzheimer’s-like pathology and restored memory function in animal models. Unlike pharmaceutical lithium, these doses were tiny—closer to nutritional levels than drug therapy.
Epidemiological studies have long shown that regions with higher natural lithium levels in drinking water have lower rates of dementia (and suicide). Now we’re beginning to understand why.
Lithium supports neurogenesis, reduces neuroinflammation, stabilizes mitochondria, and enhances cellular resilience. It helps protect the brain at a foundational level—long before symptoms appear.
This is not an argument to abandon conventional Alzheimer’s treatments. It’s an argument to expand our toolkit. To recognize that prevention and early intervention matter—and that nutrition and trace minerals belong in that conversation.
Again: supplement, not substitute.
Good Medicine, Not Alternative Medicine
Labeling functional psychiatry as “alternative” medicine is increasingly inaccurate. There is nothing alternative about testing, correcting deficiencies, supporting metabolism, or personalizing care. These are core medical principles.
Functional psychiatry doesn’t reject psychiatry’s past. It builds on it.
It keeps what works—medications, psychotherapy, crisis care—and adds what’s been missing: a rigorous focus on the biological foundations of mental health.
For patients, this integrated approach offers something invaluable: hope grounded in science.
Not the false hope of the next miracle drug. But the practical hope that comes from understanding your own biology—and finally addressing the obstacles to healing.
That’s not alternative medicine.
That’s just good medicine.
Dr. James Greenblatt, MD, is a functional psychiatrist, founder and medical director of Psychiatry Redefined, and author of eight books on mental disorders and wellness. Dr. Greenblatt is a dual board-certified psychiatrist and internationally recognized pioneer in functional and integrative psychiatry who is widely regarded as the leading expert on the clinical application of low-dose lithium for mental health. His new book is Finally Hopeful: The Personalized, Whole-Body Plan to Find and Fix the Root Causes of Your Depression (Jan 13, 2026 | Rodale Press).
Be the first to comment