Psychotropic Medications Explained: A Holistic Approach to Mental Health Treatment

When we look at psychiatry in particular, we’re trying to modulate different neurotransmitters in the brain. I often describe it as mixing a stereo: some people’s treble is too high, others’ bass is too low. What we’re doing when we prescribe psychotropic medications—whether they’re stimulants, antidepressants, anti-anxiety meds, antipsychotics, or mood stabilizers—is essentially attempting to tune the neurotransmitters so the brain functions in a way that helps the patient.

It’s never just about taking a pill—it’s about creating a comprehensive plan that may also include therapy, exercise, diet, and supplements.

But here’s the catch: if patients don’t understand what’s going on in their brain or why they’re taking a particular medication, they won’t buy into the process. Compliance is a challenge—patients, even the most committed ones, typically take their medications only about 80% of the times directed by their prescriber. That’s why I make it a priority to explain what’s happening in the brain and how medications fit into the bigger picture.

When patients understand, they tend to feel more empowered and become more active participants in their treatment. It’s never just about taking a pill—it’s about creating a comprehensive plan that may also include therapy, exercise, diet, and supplements. This holistic approach often makes all the difference in achieving meaningful, lasting results.

Your brain is an intricate network powered by neurotransmitters—chemical messengers that influence everything from your mood to your ability to focus. When we think about neurotransmitters, it’s really the big five that we deal with most often in psychotropic medications. These neurotransmitters play a critical role in mental health, and understanding them is key to understanding how treatments work. For instance:

1. Dopamine: Think of this as the “reward” chemical. It makes you feel good when you achieve something or experience something pleasurable.
2. Norepinephrine: This is your “get stuff done” chemical. It’s like adrenaline, helping with focus and follow-through.
3. Serotonin: Often called the “feel-good” neurotransmitter, serotonin is key to happiness and calm. Interestingly, 90% of your serotonin receptors are in your gut, so diet and probiotics play a huge role in mental health.
4. Glutamate: This is your brain’s universal excitatory neurotransmitter. High levels of glutamate can make you feel like you’re constantly running from a lion—common in PTSD. Treatments like ketamine can sometimes help calm the nervous system and promote brain repair. A universal excitatory neurotransmitter, glutamate plays a critical role in learning, memory, and brain function. However, when levels are too high—often seen in conditions like PTSD—it can feel like your brain is stuck in fight-or-flight mode, constantly running from a perceived threat. Exciting new research is emerging on how to lower glutamate levels to calm the nervous system and promote brain repair. Medications like Spravato (esketamine) and a newer antidepressant called Auvelity, which I frequently prescribe, specifically target glutamate to reduce its levels. By calming the nervous system, these treatments encourage neuroplasticity—the brain’s ability to repair and rewire itself. This makes glutamate a particularly fascinating neurotransmitter, not only for its role in stress responses but also for its potential to unlock the brain’s healing capabilities.
5. GABA: If you think of anxiety as a bright light, GABA dims it. This is what medications like benzodiazepines target, but they can create dependency, so we have to be careful.

Understanding these neurotransmitters gives you insight into why you might feel the way you do and how treatments work to help.

When I meet a patient, I’m essentially mapping their brain. I ask about their symptoms, their family history, and what they’ve tried in the past. I’m looking for patterns—too much dopamine? Too little serotonin? Maybe high glutamate?

This helps me tailor treatment to their unique needs. For instance, someone with ADHD might be low on dopamine and norepinephrine, in which case it might be appropriate to consider a stimulant to help with focus and motivation. On the other hand, someone with anxiety might need a different approach, perhaps targeting GABA or serotonin.

I always ask my patients what’s bothering them the most. Maybe they’re struggling with concentration, or maybe it’s their sleep. Whatever it is, we build a plan together to address their priorities.

While medications can help, there are plenty of things that can boost your brain chemistry naturally. These natural means may include:

• Exercise is one of the best ways to increase dopamine and improve focus, especially for ADHD.
• Meditating for just 13 minutes a day can have effects similar to stimulants. I like to explain it to my patients this way: your brain is like a cart being pulled by a horse, and ADHD is the horse. Without a driver, the horse leads the cart in all directions, causing chaos. When it has the desired effect, meditation acts as the driver, giving you the executive functioning and willpower needed to regain control and stay on track. It’s a simple yet powerful tool for improving focus and reducing impulsivity.
• Keeping a clean, balanced diet is crucial. Patients are often advised to avoid things like red dye, which can worsen ADHD symptoms, and consider adding fish oils and probiotics.
• Using mind-body practices like Yoga, tai chi, and balance-focused activities like rock climbing can strengthen the cerebellum, which is often underactive in ADHD.

Selecting the right medication can be a nuanced process. It’s not just about the symptoms—it’s about the person. I ask questions to understand their history and make a “mental map” of their brain. Is their motivation too low? Is anxiety their main concern?

I also consider their goals. What’s the most debilitating issue they want to address? Maybe it’s sleep, or maybe it’s concentration. Once I know that, we make a plan together. It’s always collaborative.

At the end of the day, my goal is to empower my patients. I want them to understand their brains, their treatments, and how they can take an active role in their recovery.

When patients know what’s going on in their brains—whether it’s ADHD, anxiety, or substance use—they’re more likely to say, “I don’t want to feel this way anymore. What can I do to change it?” And that’s often where real healing begins.

At the end of the day, my goal is to empower my patients. I want them to understand their brains, their treatments, and how they can take an active role in their recovery.

I firmly believe that mental health treatment is a partnership. By giving my patients the tools and knowledge they need, I help them take charge of their journey—and that’s the most rewarding part of my work.