I believe that physicians want to get to the core causes, but there is a debate over how to do that or what is necessary. In the United States, when you go to your primary physician under insurance and report symptoms of a mental health issue, they are going to try to figure out the diagnosis and prescribe medication. Before they do that, they are going to give you the standard blood work and most likely run a thyroid test on you if your symptoms are that of depression. Tests I believe you noted in a previous post.

A more thorough general practitioner is going to go deeper than that, and rule out other issues that may not be included within our standard blood work. The problem is that most insurances will not pay for the extra labwork or your doctor is going to have to jump through loop holes. I personally believe that our standard protocol is driven by insurance companies with lots of money and their own experts to keep insisting on what evidence we should be following while ignoring any contradictory evidence.

There are also debates because evidence, research, can also be interpreted differently. Vitamin E use to be prescribed to ease the effects of antipsychotics, then there was a controversy over whether using Vitamin E could be dangerous. I don't know what the recommendations are today.

There is also a controversy over what the standard treatment for thyroid disorder should look like. Presently our traditional doctors will test for T4 as I stated in an earlier post. There is evidence that supports testing for both T3 and T4, but there is a debate on whether or not this is necessary. In our community, when symptoms don't seem to abate, then it may be worth looking at T3. However, you will have a hard time convincing most primary care physicians to break protocol.

There are many deficiences in nutrition that could also produce symptoms that appear to be depression...Zinc, Folate, Chromium, Iron, Vitamin D, Vitamin B, etc.

I keep reading or hearing that most Americans are deficient in Vitamin D. I had been treated for depression for years before it was realized that I actually have bipolar II disorder when I had a breakdown. It has been an awful struggle. I couldn't get anyone to hear that the antidepressants made me feel worse, not better, because I would go from not being able to get out of bed, to having energy (of the agitated irritable type). I still felt depressed. It turns out that the antidepressants were throwing me into a mixed state that wasn't recognized by the experts, sometimes even making me obsess over suicide. I eventually would go off the antidepressants until the next time I couldn't get out of bed, but trust me, the prescribers were not too happy with this. It gets you labeled as non-compliant, blamed, and shamed. Only my therapist supported my decision, so each time I couldn't get out of bed, I would go to a new pdoc, and get the same results. It occurred to me at the time of my breakdown that maybe there had been other things going on with me for which I had never been tested. I have a great relationship with my primary doctor, but she flat out told me that the chances of an American being deficient in these areas would be very slim because our diet covers all of this. She also told me that testing T3 was not necessary. In otherwords, she is following the standard protocol. I have trouble pushing for what I want, reassurance that there are not other things going on that have contributed to years of suffering, you know, because the doctors had gotten it wrong in my case.

I too have thought about going to someone who uses a functional medicine approach because I know I will get the thorough lab workup that I want - the reassurance that there isn't anything else going on. I cannot afford to pay out of pocket on a social service salary. Although our SAD diet may cover all of these things, my primary care physician is aware that I have horrible nutrition with an eating disorder NOS. I see her monthly to support caring for my nutrition, but when asked which type of nutritional plan she recommends, she is happy with the one that I can live with that keeps my blood sugar in check. One of the issues over which Dr. Hyman and his colleagues seem to be in agreement is gluten and wheat. There is evidence of a link between gluten and schizophrenia, so I think we should be listening.

I have recently taken a nutritional course for nursing studies, and questioned the instructor. Trained in our standard ways, she told me that it was nonsense. Yet there is evidence supporting it.

So personally, I have begun listening, as are many "traditional" physicians like Dr. Oz, to what these other evidence trained physicians who practice functional medicine are saying.