Nourishment
There is now ample evidence demonstrating a direct connection between the gut and the brain, often referred to as the gut–brain axis.
As a psychiatrist, my goal has been to improve the mental health of my patients by whatever means possible. For most of my career, that has been done by prescribing medications, and to a lesser extent, either implementing or referring patients to various talk therapies, including CBT, DBT, psychodynamic psychotherapy, and the like. However, in part due to my background in studying exercise physiology and having a personal interest in nutrition, sociology, and various other disciplines, I have often wondered how these other domains could help improve the quality of life of my patients.
Recently, there has been more research done on the role of nutrition, physical activity, social supports, and spirituality in mental health. The emerging evidence base is consistent with my intuition that eating a nutritious diet, regularly moving your body, having strong social supports, and nurturing your spiritual self can meaningfully augment conventional treatments such as medication and talk therapy. While this may seem obvious to the layperson, as clinicians we often pay lip service to these areas. We may say, “you should eat a more balanced diet,” “get more exercise,” or “give your friends a call,” yet these recommendations are rarely implemented with the same rigor as a medication regimen. As a result, they are often not sustained or nurtured over time.
To address this gap, I developed a treatment approach that systematically targets these overlooked domains of mental health care. This approach is called the 5-Pillars, and they are, in no order:
There is now ample evidence demonstrating a direct connection between the gut and the brain, often referred to as the gut–brain axis.
Physical activity does not mean becoming a CrossFit champion, running ultramarathons, or exercising intensely every single day.
Humans are social creatures by our very nature. We build communities not only for physical survival but also for psychological wellbeing.
Spirituality is often misunderstood as synonymous with religion, but in mental health care it is far broader.
The fifth pillar includes the treatments most commonly associated with psychiatry: medications and psychotherapy, but with precision and a personalized treatment approach.
No single pillar is sufficient on its own. Medications without lifestyle change often plateau. Lifestyle change without biological support can feel overwhelming. Spiritual exploration without symptom relief may feel inaccessible.
When all five pillars are addressed together, care becomes more comprehensive, humane, and effective. Just as importantly, this model is empowering. Patients are not passive recipients of care; they are active participants. Many aspects of the 5-Pillars can be implemented immediately and refined over time with professional guidance. Ascend Psychiatry exists to help patients do exactly that—systematically, compassionately, and effectively.