Integrative Psychiatry: A More Thoughtful Approach to Mental Health Care

What if mental health care didn’t have to feel rushed, reactive, or one-size-fits-all?

In this episode of Therapist Unplugged, Laurie Poole is joined by psychiatrist Dr. Christian Monsalve for a grounded conversation about integrative psychiatry and what thoughtful care looks like in practice. Together, they explore why many high-functioning people continue to feel unsettled despite doing everything “right,” and how slowing down can support long-term stability without swinging to extremes.

If you’ve ever felt unsure about your mental health care, questioned whether medication adjustments were the whole answer, or wanted a steadier way to understand what’s happening beneath the surface, this conversation offers a more intentional perspective.

For more information about working with Dr. Monsalve, visit Verigrate Health at www.verigrate.com

🎙️ Therapist Unplugged is produced by The Montfort Group, a boutique therapy practice based in Plano, Texas, helping individuals, couples, and families build emotionally intelligent, connected lives.

Subscribe for real conversations with real therapists, because healing doesn’t happen in perfect soundbites.

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Transcript

Meet Dr. Monsalve & His Approach

Laurie Poole 0:00

Hello, everyone, and welcome to Therapist Unplugged. This is your host, Lori Poole. And I am so delighted for this episode. Our topic is integrative psychiatry, which is maybe a term that not a lot of our listeners, all 12 of them, are familiar with. Dr. Christian Monsalve came to our office a couple of months ago, I guess it is now, and educated us on his approach to psychiatry. We all got so excited that I invited him to join us for this episode today. And I want to share with you a little bit about his background because he really is a very unique clinician. And Dr. Monsalvi, thank you so much for coming and taking the time to talk with us today.

Christian Monsalve 0:48

No, Laura, I'm so happy to be here, to be here with you and your listeners and look forward to a lovely conversation.

Laurie Poole 0:54

Yes, absolutely. For our listeners, Dr. Monsalve is a board-certified psychiatrist who specializes in the care of high-functioning individuals with complex and sensitive clinical needs. We're going to talk about that. As founder and medical director of VeraGreat Health, his work focuses on precision psychiatry, integrating evidence-based medicine, functional assessment, and disciplined clinical strategy to support long-term stability, cognitive clarity, and oh my God, couldn't we all use some of that? And psychological resilience. His practice is intentionally selective, allowing for depth, continuity, and thoughtful decision-making beyond the constraints of traditional care models. In addition, he is a consultant of the ABC News Medical Unit and is involved in international academic and advisory activities with recognized contributions in ethics, psychotherapy, and global health. Wow, that is a very impressive resume, sir. I wonder if you is there anything that you would like to add to that description of your background and your specialty.

Christian Monsalve 2:10

Oh, Laurie, thanks so much. That was a very, very generous introduction. Um I, you know, I'm also fluent in Spanish and uh I see patients uh across the country right now in seven states. Um look forward to expanding in the future. Obviously.

Laurie Poole 2:26

Okay. Well, I I would love to start with um an explanation of what integrative psychiatry involves, because I think in my experience, often when I uh say to clients, you know, based on what you've shared today, why don't we do some evaluation for depression, for example? And um let's see if maybe we can get your baseline to go up a little higher, you know? And it's interesting to see the kinds of reactions that people have. They're um skeptical of medications, um, they're not sure what the difference is between a psychologist and a psychiatrist. Like there's still a lot of unknowns, I think maybe a little suspicion of psychiatry. And so maybe you could share with us what it means to be in integrative psychiatry and how that's different.

Christian Monsalve 3:23

Absolutely, yeah. So first we can start that integrative psychiatry respects the foundation of psychiatry,

What Integrative Psychiatry Means

Christian Monsalve 3:30

the best of uh what evidence-based medicine there is. You know, first we have to define that psychiatry, it's an interdisciplinary discipline, but primarily it's a medical discipline, subspecialty, which focuses on problems of thoughts, moods, and behaviors. Example can include things like substance addictions or be other behavioral addictions, right? So it's a broad and fascinating field and integrative in the sense that it respects maybe the biomedical foundation, but it looks at other things and say, to what extent is nutritional optimization appropriate? To what extent is exercise an appropriate aspect of treatment? To what extent, you know, for the patient that for whom it's important, you know, integrating their spiritual life and commitments into their kind of their plan of care. It has a bigger umbrella that says, hey, where can we integrate and optimize all these different aspects of life to get more healing in the process for the patient and optimize their outcomes when maybe traditional medications can be helpful, but they don't suffice or for the patients that are maybe more medication hesitant, say, hey, how can we still serve them and work towards their health in a way that maybe respects their commitments if they, you know, want to try their modalities. And then the second part of your question was um I often get this question asked by friends or colleagues when I tell them what I do. Oh, it's the difference between a psychologist and a psychiatrist. First of all, we collaborate a lot together. There is some overlap in what we do, but traditionally, psychologists either earn a master's or a PhD in psychology. Some of them go purely the research route. So they kind of work on studies, they teach in university or academic settings, and some of them don't never see patients. For the clinical psychologist, which um is the one we do overlap with more, they do see patients, but one of the things they particularly specialize in very often is you know testing, things like uh very, very comprehensive autism testing. There's also testing for things like ADHD, which, you know, if if we're doing a full one, can be very long, and psychologists often specialize in that. Things like learning disabilities. Some of them subspecialize in um in kind of neurocognitive testing and kind of geriatric psychology. And so what that looks like is working a lot with the elderly population, encompassing the whole area of the dementias. And then psychiatrists are their medical doctors, they're they're physicians. Um, largely, you know, they get their MD or DO, depending on where they graduate from, and they're trained principally as physicians, looking at a biomedical model, biological model as a basis. And then they subspecialize in the thoughts, moods, and behaviors. There are some that work fully in research, you know, so they come like research scientists, physician scientists, and some of them don't see patients. They're kind of just working in the lab. Some of them fully see patients and they could focus on different areas, kind of women's, women's mental health, child, and adolescence, forensics, kind of working with you know, justice adjacent um kind of um area of of medicine. On mood disorders can include depression, bipolar disorder. Some focus more on psychotic disorders, you know, the schizophrenia kind of profile, some focus on addictions. And so, um, but that is all to say it's psychiatrists and psychologists and various mental health professionals, they often collaborate.

Laurie Poole 6:58

You know, I'm curious about um, in terms of the patients that you treat, have you noticed any trends of complaints of why patients come to see you? Like, is there something that's different this year? Like, is there in the last five years, has there been more anxiety? Are you seeing more depression and isolation? Like, are there have you noticed any trends or themes in the reasons why people seek your help?

Christian Monsalve 7:25

Yeah, no, good, good question. Um, there's a couple of things I notice. I think that for some people, there is maybe a sense of like, you know, hey, this medicine was very helpful for me over the course of the last year or even decades in some cases, and I just kept getting prescribed it, but now it's kind of I'm at a different stage of life and benefits are outweighing, maybe the side effects, and I want to come off it. For example, several decades ago, one of the most highly prescribed medications, not only in the US, but also in Europe, was Valium. Valium, yeah, Valium, the generic name is diazepam. It's a medicine that was prescribed for anxiety and uh and sleep difficulties. Some people became dependent on it, and it was kind of a bit difficult for them to come off. But now I think some of the patients that come to me are kind of they're like, hey, I'm more attentive to potentially the the risk of dependency or maybe having to you know get tolerance and then get used to higher and higher doses, but there's a trade-off with that. You know, I want to be in a situation where I'm not as dependent on this medicine, and my kids are getting older, for example, or you know, I want to join the kind of this retirement phase of life. And so, so people come kind of with those

Psychologist vs Psychiatrist Explained

Christian Monsalve 8:40

um those concerns and inclinations. I think on average, what I'm seeing is is motivated patients that, hey, I read this, or I read this, I'm kind of this potential side effect. How can I get to a good level but with not being as dependent on too many different treatments? And so I see that that trend a bit more, kind of a motivated, um uh, you know, well-intentioned patients.

Laurie Poole 9:03

It sounds as though maybe on some level, with accessibility information to patients are better informed, they'll do, they'll do the research or they'll read something on the internet, they'll see something on the news, you know, when things come up. And God knows we all get all the advertising, you know, when you're watching television, you know, side effects may include and so I think that gets a lot of people thinking, oh my God, what's gonna what's gonna happen to me on this medication? But but in addition to that, I wonder if there isn't also uh more of a trend these days to think about mind-body connection, you know, and how uh our health is affected by our mental health, our physical health is affected by our mental health, and vice versa. And things like exercise, diet, inflammation, those are pretty basic things, but but we don't necessarily think of them in the context of how changes in lifestyle can actually improve your overall mood, your emotional responses, the ability to kind of ground yourself, you know, that that actually the body has some built-in biofeedback systems that you can use um to help in those moments of distress. And I'm wondering if that's something that you get into with your with your patients.

Christian Monsalve 10:30

Yeah, Laura, you actually touch on a great point. Absolutely. So, yes, I'd say that there is interest in those those topics. You know, I give I give one example. Um, one of the things that I find fascinating is for the brain, you can think of exercise as fertilizer for the brain. So, for example, you know, uh you and I both grew up in grew up in pretty cold places, places with cold winters. Yes, yes, yes, for sure.

Laurie Poole 10:56

Yeah.

Christian Monsalve 10:57

And so, you know, in the winter and colder climates, um, you know, the the trees are bare. The the brand, you know, the branches are just bare, there's no flowers, there's no, there's no leaves. And so it's so we can think of um the brain and neurons, which are kind of the the basic unit of the brain, kind of like these branches that they connect to each other as a tree in the winter. And what exercise does is it helps release in the body a BDNF. So how it functions is kind of it's you pour fertilizer on the brain on these branches and then they they blossom. So it's like spring. Oh, and the flowers come out, the connect, the leaves come out, and there's just more contact points on the tree. So similarly in the brain, there's more contact points. And so we're able to think more clearly, our brain is just more connected, we're able to kind of make more rapid connections. And so in practice, what that looks like is like it's as if it were a treatment against anxiety, plus a treatment against depression, plus a treatment that improves our focus and attention. And so, in a way that's of course, that's natural that has very low side effects, right? There's always the risk of injury with exercise, you know, the time, the volitional aspect, you know, getting up, and of course, but generally it's it's almost free, right? Exercise is almost free.

Laurie Poole 12:16

I'm really curious, is it any kind of exercise or is it you know aerobic versus weight training versus something else?

Christian Monsalve 12:24

Both forms have good evidence and their support, and there's always the debate, like, hey, exactly how much time, exactly how much time. I think the general understanding is that any exercise is better than none. And there's yes, there's incremental benefits to a certain point, but general recommendations are about 150 minutes. So that would be like five 30 minute sessions, five days a week of moderate intensity exercise,

Patient Trends And Med Hesitancy

Christian Monsalve 12:50

kind of a safe, a safe kind of um amount for most people. But yes, both strength training, um, both um uh endurance training have have good research for them. You know, it's like you took a little bit of Prozac and a little bit of Ritalin, right? Instead of taking it, you do it in exercise, you take away the potential side effect profile of that medicine, might not be that right medicine for a specific person based off their genetic biochemical makeup, but you kind of um you also get that there's a point where you kind of get like almost a natural high, right? So like if you've been, if you run, if you go running and you hit the 20-minute, 30 minute mark, for some runners that that kind of are way more intentional about, they describe kind of this nice little this great feeling. And it's kind of all these chemicals being released in our body, healthy chemicals, you know, other things like norepinephrine, um, dopamine that don't explain everything, but they're a big part of that story, the kind of motivation, attention, mood. And so um, yeah, I think there's more of um interest and receptivity to say, how is it that exercise makes me feel good? But also, how can I function at the highest level and kind of have kind of optimal brain health so that I can not only perform professionally, but also you know, be more present for their families and their community, their friends, uh, in particular for anxiety. I think we have so many good non-medication treatments at the top. A lot of executives have um, they have to have really good health regimens. They have to like to perform at a certain level. And many of them have personal trainers. And I always tell people any exercise is better than none. But if you could do it any time of the day, in particular against anxiety, I'd recommend it in the morning. And the reason I do is because it helps keep the brain more steady, right? And so you can think of a threshold, right? So if I'm an anxious person and there are things that make me nervous, well, I only need to get kind of to like 20% of my threshold if I don't do anything, if I don't exercise to kind of get unsettled. But if I do exercise, what I do is I activate the parasympathetic um part of my nervous system, which is kind of the part that calms us down, the part that uh turns on when after we have a great meal, or have just relaxing at home. And so exercise, it activates that part. And so if I were to exercise in the morning, that 20% threshold that would be my baseline for getting nervous um without exercise now becomes, and this is just uh, you know, a relative number, now becomes 50%. So, in other words, way more resilient. Uh, there has things have to be way more intense to make me nervous. And that is, I think, for a lot of people, it is more motivating in the long term. And I think exercise is one common threshold that everyone can recognize as kind of okay, like there's good here, but you know, why is it, right?

Laurie Poole 15:44

You hear that exercise is the number one medicine, I think is is so important for people to know because you know, I, for example, as a therapist, can sit for six to seven hours a day in a chair listening to people talk, you know, and then I hear that sitting is the new smoking, and I'm thinking, oh my God, I'm done for. But but it is, it's it, it's um, it makes you feel so well, I can only speak from my own experience, but uh, I always feel much, much better, more grounded. And yes, like I can tolerate a whole lot more uh when I train in the morning versus the days that I don't. So I think that's that's a really important message. What about nutrition? I have had clients who have done the cleansing and they eliminate all kinds of food, and then when they get back onto it or they start to introduce things back into their intake, they uh they'll say, Oh, I've been feeling a little bit more anxious. And it can be um, you know, often or sometimes directly related to maybe refined foods as opposed to whole and more natural foods. I wonder if you have any thoughts about that or if that's something that's part of your practice.

Christian Monsalve 16:59

Of course, of course, yeah. So nutrition is fascinating because it it does highlight how biochemically unique every human person can be. There are things that the body can make on its on its own, but they are essential, for example, vitamins and minerals that the body cannot produce and it has to get from the outside. In order to get to optimum levels, hopefully, hopefully, we are you know eating the right food sources, whether sources are getting kind of high quality supplementation intentionally, right? But we often we don't know. We don't know if we're eating everything we need to. In practice, what does it look like? And again, I'm not a reductionist, you know, I don't reduce everything to neuroscience and biology because I think you know there's so many fascinating kind of

Exercise As Brain Fertilizer

Christian Monsalve 17:45

higher-level aspects of human, human behavior, human nature. But to the extent that biology can teach us about humans and neuroscience, you know, I'm receptive to learning as much as I can because that's the it's a big part of the story. So in the brain, you know, there are neurotransmitters or kind of little chemicals that make us feel different ways. And the body, it's like a kitchen, right? It's like to make a Caesar salad, if I'm missing the croutons or the cheese, the Parmigiano Reggiano cheese, or I'm missing the Caesar dressing dressing, I can't quite have that traditional Caesar salad. So each of those ingredients are things we have to get from the outside. And if I don't have enough of folate, of vitamin B6, a vitamin B12, a vitamin D, um, I'm not gonna produce the quality of salad that I should be producing. But the problem is that, you know, sometimes it's easy to not eat well. You know, we can easily kind of just go to work, commute back home, have like a sedentary lifestyle, and maybe the and the easiest thing is just to get food that's quick, but it might not be kind of the most nutrient-rich, dense food possible. And so very gentle, very gentle over time, um, what happens is that we can have nutritional depletion. And the most common deplete, like suboptimal levels that I see, especially among patients in the US, uh, I see low vitamin D. The vitamin D is actually a hormone, it's a bit of a misnomer. Um, one of the ways to help activate it, you know, is through sunlight. And so our vitamin D is low, it's very often correlated with depression. That's kind of one example. And then there's other ones, but your question also got to kind of the question of maybe sensitivities and allergies. For some people, certain foods can affect kind of their mood and attention. And so some people might have particular sensitivity to dairy, for example. And it's not until they remove it or they kind of tailor a diet specific that they see, like, oh wow, my child is performing better at school because they can focus more, or I just don't feel as kind of irritable all the time. For difficult cases, there are things like the ketogenic diet, which is a more high-fat diet and fewer carbs. That for some people who have maybe have a hard time getting results in other areas, that can be an intervention that kind of improves their presentation. And for context, the ketogenic diet was kind of first used in medicine in a pediatric population that had um seizures and epilepsy. And they noticed that um the kids that were given that that kind of diet, they had a reduction in the amount of seizures. And so there's just kind of so many new little Yeah, yeah, no, it's fascinating. And it's it's kind of a bit mind-blowing, right? Because you hear you think a diet, a specific kind of food regimen as medicine, like it is big picture integrative thinking that I think is very attractive to not only clinicians like us, but also um, you know, families, parents. For sure.

Laurie Poole 20:47

Absolutely. Um, I'm wondering about other forms of um therapy uh in terms of what you find works with clients. Like if you have a client who says, Look, I'm open to supplements, but I really don't want to be on medication. I'm thinking about some of this stuff is a little bit woo-woo, but I'm thinking about things like Reiki, right? Energy. Um, I'm thinking about um CBT cognitive behavioral therapy, which has been identified as, I guess, one of the premier forms of dealing with depression in terms of what can be measured. I might argue differently, but I think that it's largely identified as a pretty effective way of managing anxiety, depression, et cetera. I'm just wondering if you have any, you know, other practices that you incorporate with your clients, like mindfulness, meditation. Maybe you recommend yoga, other elements into your therapy as an integrative practitioner?

Christian Monsalve 21:55

So I always try to tailor it to kind of the position where they're at and give me a. Their kind of their preferences and their commitments. So for patients that are part of religious and spiritual communities, there is really interesting, uh strong research by Tyler, Dr. Tyler Vanderweel. He's an epidemiologist. One of the studies is that found that over long-term period, uh, those individuals attend religious services regularly. They tend to have lower levels of suicide, substance abuse, and depression. And so, for example, so if I have uh if a patient comes to me and says, hey, I'm part of this religious community, it's an important part of my life, my family's, but I'm really, really struggling with this substance or with alcohol, you know, I'll share that study with them. For for the right patient, it can be motivating. It can be really motivating. I'm always open to different forms of um different therapeutics, right? If it works, I'm all for it. And so, for example, massage therapy, it can, it's tricky, I think, with insurance coverage sometimes. Um, but with that said, so for some people, it it just it just works. And they they you know, they say it, it's just they swear by it. There's some patients for whom like dance, like ballroom dance or partner dancing, like you know, clap classical dancing, you release a lot of dopamine in activities like that. It's a very form of exercise, plus it has kind of the social element that much of other exercise doesn't. And for some people, it's kind of just like it just keeps them healthy because it keeps them engaged throughout life. It kind of expands their social network. But yeah, I'm always open to learning more. I I don't know everything, and I'm always open to kind of new treatment modalities that that could be helpful for patients.

Laurie Poole 23:34

Okay. Um, I I'm really always interested too on how trauma affects mood, depression, uh, how it affects the nervous system. Because, you know, I guess we all have some form of trauma, whether it's it's a small T or a big T, trauma is largely also how someone defines, right? How someone reacts to an event, which I think is an interesting or an experience, which is a different way of thinking of trauma, you know. And so I'm curious about the relationship between trauma, the nervous system, and then how and and then how that gets presented, you know, with anxiety and and depression, getting back to some of the more familiar. I mean, I think a lot of us here, we hear narcissism, we hear that's that's the term of the of the decade. Everybody's narcissistic. And then there is, you know, the anxiety and the depression and so on. But the actual like getting to the trauma and I guess that integrative approach. Anyway, I'm I'm using way too many words to ask my question, which is what do you think that relationship is in terms of what you see come into your office?

Christian Monsalve 24:48

I think it's fair to say no matter who you are, how much success one's had in one life, everyone has had disappointments in life and has had things that have maybe marked them, right? Whether it's a you know rough death of a family member or a disappointment, illness. Every human has had potential trauma. Obviously, some some much more severe and unjust than others, but I think there's there's an element where most people by adulthood can can relate to kind of this topic. For some people, some of them can't quite let it go, right? They can't, they it just it just stays with them and they and they like perseverate. They think about it very often. It just scars them, right? Almost like an like it's kind of this

Morning Workouts For Anxiety

Christian Monsalve 25:30

imprint in their brain. And so what that looks like for some people is uh there might be certain reminders, right? Kind of like, oh, some like you know, uh this work environment, I just it's really bad, or this group of friends, you know, or this person. What happens in the brain is that we have an alarm. Our alarm is called the amygdala. It's a funny name, but we have the the alarm, and that alarm is there and it should be there, and it should should only go off when appropriate. So for example, I'm by myself, lost, I'm in a random city, took a wrong turn, I go down an alley at two in the morning, and there's a group of 20 people approaching me, yelling at me, insulting me, uh, that alarm should go off, right? It, you know, as humans, like you know, we we developed in such a way that that alarm should go off for the right reasons. And and if it goes off then, and you know, kind of, okay, I gotta get out of here for my safety, it's working the right way. Good. But for people, many people, especially those, including those that have experienced trauma, that alarm fires more often than it should and in inappropriate moments that can subsequently cause problems. Think of like a kind of heights, for example. You're at a rooftop and the door shuts behind you, and kind of you're kind of on the balcony, and you can't quite get in, your heart starts racing, your blood pressure goes up, you start sweating. Basically, that amygdala has already been firing. It's saying, like, oh, this is kind of a threat. And by you trying to kind of come on in the room, you're telling that that amygdala, the alarm that, hey, this is a problem. Yes, keep firing, keep firing, this is a problem. If you were to kind of eventually be let back in and this were to happen again, the amygdala would fire even more fast next time. But instead, if what you did is like, okay, this is uncomfortable, but I'm gonna stay outside and just kind of try to breathe as well as I can and say, hey, this is a learning opportunity for me to teach the brain that this is uncomfortable, but it's not a threat. What it does is they you're teaching the brain like, hey, I don't have to fire as much, right? Next time you get locked out, it'll fire, but it'll fire way way less. Eventually you get to a point where that alarm becomes extinct. With some patients, they're able to kind of shut down that alarm response. Some people, you know, with the help of medical like benzos, what they do is they should just shut down the alarm, right? So once the benzo effect comes off, the alarm's still gonna fire, but it's why that's why every that's why people love benzos.

Laurie Poole 27:56

Yeah, because it just shuts everything down, and you're like, oh, this feels so good.

Christian Monsalve 28:02

Yeah, yeah. Ideally in the long term, yes. Ideally, uh, you know, we can kind of teach the brain kind of to not uh hire as much. And from a neuroscience, the goal is to make the prefrontal cortex stronger. That is to say, it'd say, hey, make it kind of temper and dominate instead of the amygdala kind of calling the shots. And so sometimes that takes time, that takes you know, attention for some people, and but absolutely, absolutely. Um trauma is very serious. Some people have and suffered unjust suffering. Um, but fortunately, I think that there have been enough hopeful um cases and research and kind of people interested in this space where there's a lot of room for healing for a lot of people, even if it takes years. I think for the majority of cases, there's there's reason for hope.

Laurie Poole 28:54

Wow, that's that's that's really great news because it's trauma can be that kind of work can be the work of a lifetime, depending on the person, their resilience, and all the factors that go into recovery. It brings me to a question about psychedelics, because we're hearing more and more about the use of psychedelics in psychiatry. Now, I was a teenager in the 70s, so acid, quote unquote, mesk, also known as mescaline, mushrooms, all kinds of things. It was a dope smoking, uh hallucinogenic

Food, Deficiencies, And Mood

Laurie Poole 29:30

generation uh in Montreal in my day. Um so I'm really curious about you know what your what your thoughts are in terms of psychedelics that has now been uh introduced into psychiatry by some practitioners.

Christian Monsalve 29:47

You know, one of the exciting things is that for context, like it is very difficult to study the brain in comparison to the heart, right, or the cardiovascular system, right? We know so many things about the heart, we can easily get blood samples, whereas to get a brain sample or to get cerebral spinal fluid, it's way more risky, super risky, but it's way too much. But also, even if we know things about the brain, we don't always know how that clinically applies, right? So we can learn a lot, but we can't translate from the bench, the scientific research friends to the bedside, right? Or the or the or the couch. With that said, uh compared to other fields, there are relatively fewer kind of innovations in psychiatry, but this field of psychedelics as applied to potential treatments is exciting because it represents a potential new breakthrough, or at least application towards uh clinical care in a specialty where it's just harder to have like major significant advances. And then the other part is that you know, we talk about kind of defenses or it can take months or years of work for people to really, really open up and really to get to the heart of things, build that trust relationship in the context of therapy. One of the potential promises of psychedelics is that it can kind of accelerate therapy to the extent where you can really potentially start talking about the heart of the matter without potential reservation, without these defenses, in a way that just like accelerates therapy by potentially by ear. So that's how some Oh my goodness. That's how some if if that is potential a potential hope, right? You can just break down those defenses and just in and get at the heart. There was a uh a piece published in in JAMA, which is one of the um more most selective, um, so journal of the American Medical Association, one of the most selective journals to to publish in uh in the US and medicine, probably the world. And they and I interviewed um some of the um some of the people involved with it and kind of experts in this area um last summer. Researchers developed for this study an uh oral disintegrating form, an oral form of LSD basically. And and it was the first, in some of the ways, the in some ways the first study to have not included talk therapy, but that had found that you can have reduction and anxiety sustained at the three-month measure point from just um just a very small dose of LSD. And so that is potentially, I mean, there's potential promise. And now it's it's still kind of advancing, you know, they're at going to a you know phase of trial because you know, in early stages you can get promising results, but then when you get to larger groups, it doesn't pan out. But so it's not there. So um I'm you know, I'm you know, if something can be helpful to patients, I'm I'm I'm open to it. Technically, in the majority of the country, it's not an allowed treatment. You know, all these things are kind of very experimental research settings. And so I know there are some municipalities where um there is a little more permissiveness in this area, but legally, outside research settings, it's technically very, very difficult for still, yeah.

Laurie Poole 33:11

It's still it's still new territory, like so many other things, right?

Christian Monsalve 33:16

And then yeah, and then the um the other part is you know, I think with with good reason and intention, these things, if they are to be approved, they're generally for clinical purposes under clinical supervision. I think there's always the potential miss risk for misinterpretation, as with other areas of, you know, people see some of these studies, they're like, oh, well, I'll just use recreationally, right? Outside the context of this one. I think so, I think in the long term, um, it the it's it, I mean, I don't know how this gets you know done from a policy perspective, but how do you bring out the best of therapeutic potential while also minimizing the risk for um inappropriate abuse, potentially, right? Um, and so um, but yeah, no, it's it's a potentially, it's it can potentially be a very promising area. You know, I'm always cautious, right? Because sometimes research doesn't quite pan out, but it is uh it is an exciting area to kind of to stay on top of. But yes, there is a lot of innovation research and funding going into this area as a potential um other therapeutic for for um for brain health.

Laurie Poole 34:24

All right, in closing. And I think I think that whole area of the hallucinogenics is something that we will see unfold. Here's a question for you, which isn't a general one, but I think it's an important one. What can we all do to improve our mental health? Is there one thing in particular that we can do to improve our mental health?

Christian Monsalve 34:47

There's multiple things, and perhaps multiple ways to answer that, but I think movement is one uh thing that's accessible to a lot of people that has good, good downstream implications for brain health or mental health. And so um, whether it's the form of, you know, for some people, jogging is it, for some people playing pickleball, um, for some avoids dance, for some people just going on walks. I think that's one of the best things because you don't think about it necessarily for mental health, but it is you release so many, so many good chemicals, if you will, in your body. And especially it's just very easy. You know, we we do a lot of remote work, you know, we're um, you know, in the US and and we kind of can live often a very sedentary lifestyle. And we should also be very, very intentional about still giving uh our bodies the movement they need because you know, we uh life looked very different centuries ago, right? We we had to move around. That is that is one thing. And I think expressing gratitude um is for many, many people very, very um cathartic. So what I mean by that is we're very lucky. I think you know, most of your listeners are probably in North America, and so we're you know, we're very lucky, like we we're in a very well-resourced part of the world. Uh, many of us have access to education, you know, professional opportunities, and not everyone has that, that, that, that fortune, that you know, that that um social kind of uh uh educational um economic opportunity. And so I think for a lot of healthy people that I've seen and and and mentors I've learned from, both within healthcare and outside

Therapy, Spirituality, And Bodywork

Christian Monsalve 36:30

of healthcare, they're very intentional about uh thinking and reflecting on things to be grateful for at maybe at the end of the day to themselves. I think that's a very, very healthy practice, right? Because, you know, we um we can often get um you know caught up in our minds, kind of competition, just comparing the best to the best. But on the whole, you know, for the majority of us, you know, we we have a roof over our heads, we are able to make a living, provide for our families, um, have an education, and still have, you know, recreation, right? Go to go to a game, right? Take a vacation with family, which is something that you know not everyone in the world has, unfortunately. And so I think that those little things can be very, very grounding and kind of can just put things into context. Yeah, yeah.

Laurie Poole 37:16

So I think there's also something about the practice of gratitude. You're right, it gives you perspective and it can be more of a focus to, oh my goodness, you know, I'm I'm I'm all bent out of shape over this thing over here, but then I'm looking about all the things I'm grateful for, and I think, wow, that wasn't so bad, you know, and uh and so it's a it's a really good practice uh to employ. Well, I can't thank you enough for your time today. I know we've gone over, and I um I guess lastly, I want to ask, how can listeners find you if they would like to make an appointment with you or take a look at your website? Um, how can they best do that?

Christian Monsalve 37:56

Yeah, um, so they can find me. Uh they can go, you know, uh Christian Monsalve M D, but uh my practice is Verigreat Health. Um, and that's V-E-R-I-G-R-A-T-E. And the website is verigreat.com. And the the origin of the name is kind of uh Veritas Truth and Integration, kind of integrating truth into the person, truth of science and psychology and all these disciplines. And um, so yeah, I'm happy to happy to be a resource, but also I have I have trusted colleagues all over the country. So depending on where listeners are, I'm happy to uh recommend uh trusted colleagues all over the country who who might be appropriate um when so. Um no, and Lori, it was so delightful to get to chat with you. I'm I'm so happy that we got to spend this time together and look forward to staying in touch.

Laurie Poole 38:49

Thank you very, very much. I know our our listeners will enjoy learning more about psychiatry and how you approach it and the importance of overall good health and the connection between mind and body. Very, very important stuff. So thank you so much for your time today.

Christian Monsalve 39:06

It was a delight, Laurie.

Laurie Poole 39:08

Thank you. Bye bye.