Prairie Health & Wellness Newsletter — August 2025, Edition 20
Pillar of the Month: Purpose
The foundation upon which all 5 Pillars of Health stand upon.
A Word from Evan Monahan, APRN
A Functional Medicine Approach to Depression: Looking Beneath the Surface
As a nurse practitioner working in functional medicine, I see more and more patients coming in with symptoms of depression. Some are already on long-term antidepressants and are still not feeling like themselves. Many have been told it’s a ‘chemical imbalance’ or that they may need to stay on medication long-term or forever. I want to offer another perspective—one that sees depression not as a diagnosis to manage, but as a signal that something deeper needs attention.
Depression is complex. Yes, it can involve low dopamine or serotonin, but that’s only one small piece of the picture. What I often find is that depression is the body’s way of communicating an imbalance. Sometimes it’s brain inflammation. Other times, it’s a loss of purpose or disconnection. It could also be due to nutrient deficiencies or imbalances in gut health, hormones, or blood sugar. It could even stem from chronic sleep disruption or the weight of unprocessed trauma carried for years. More often than not, it’s a combination of several of these. It is our job to listen deeply to trace the roots of those imbalances—so we can help the mind and body heal at their core, not just silence the symptoms.
PHW’s Approach
Let’s talk about what this looks like in practice at PHW. When someone comes in with low mood, fatigue, irritability, anxiety, trouble sleeping, or brain fog, we start by asking a wide range of questions. We ask not only about their mood, but also about sleep quality, stress levels, digestion, sense of purpose, menstrual cycles, food cravings, and patterns of energy throughout the day. Starting with evaluating the pillars of health (sleep, stress, nutrition, detox, movement, and purpose), we identify areas of the lifestyle to support. Then, we’ll often run labs to check for common root causes. This can involve things like looking at thyroid levels (including antibodies), vitamin D, B12 and folate, omegas, copper and zinc levels, magnesium, iron stores (especially ferritin), and hormones like estrogen, progesterone, testosterone, and cortisol. We may also recommend stool testing to evaluate gut health and inflammation, or an organic acids test to check mitochondrial function and neurotransmitter markers.
Why do we recommend testing? Because depression often has physical drivers. For example, if your thyroid is underf unctioning, you might feel foggy, tired, and down. If your vitamin D is low (which is incredibly common), it can affect how your brain regulates mood. If your hormones are out of balance, it is hard to have good energy or feel like yourself. Gut health matters too: We make most of our serotonin in the gut, and if your microbiome is off, your mood often follows.
From there, we create a personalized plan. This often includes targeted nutrients, like omega-3s, vitamin D or D3K2, magnesium, and sometimes adaptogens like rhodiola or ashwagandha to support the stress response. In some patients, especially in perimenopause or menopause, we consider adding hormone support to help with mood, stress response, and sleep. We have a big toolbox in functional medicine, which enables us to create a plan that is tailored to the patient based on their individual needs.
Nutrition also plays a big role. We focus on whole, anti-inflammatory foods, plenty of leafy greens, berries, fatty fish, nuts, and colorful vegetables, and adequate protein based on weight and lean muscle mass. I recommend cutting back on sugar, processed foods, and alcohol, which can destabilize blood sugar and worsen mood swings. If we see signs of leaky gut or food sensitivities, we may do a short-term elimination diet to reduce inflammation and give the gut lining time to repair.
Movement and sleep are both incredibly important in regulating mood. Exercise is one of the most powerful antidepressants we have—it boosts endorphins, supports the mitochondria, and helps reset the nervous system. And what about good sleep? Non-negotiable. We work on calming the nervous system at night, often using things like magnesium, breathwork, and good sleep hygiene to help restore natural sleep rhythms.
Of course, we can’t talk about depression without acknowledging the emotional layer. Many people carry deep stress, loss, or trauma that hasn’t been adequately processed. I often refer patients to skilled therapists–especially those trained in somatic work, EMDR, or Internal Family Systems. These methods can restore a sense of safety within one’s body and foster a renewed connection to joy and purpose.
All of this is not to say that antidepressants are inherently bad: antidepressants can be a useful tool. Research shows they are most likely to be helpful in cases with recurrent Major Depressive Disorder, but they are not always a long-term solution. In fact, many patients stay on them for years (sometimes decades!) without a clear exit plan. The latest data shows that over 11% of U.S. adults are on antidepressants, and most stay on them for over five years. In functional medicine, we ask: Can we safely reduce or eliminate medication by supporting the body to heal from the inside out? With time, support, and a whole-body approach, the answer for many patients becomes yes!
If you or someone you love is struggling with depression, know this: you are not broken. Your symptoms are valid, and there are many paths to healing. You deserve to be seen, heard, and supported– body, mind, and spirit, and we are here to help!
Helpful Resources
For those looking to learn more or get support, here are some great starting points:
- The Body Keeps the Score by Dr. Bessel van der Kolk – Explores the effects of trauma on the body and brain.
- How to Do the Work by Dr. Nicole LePera – Offers practical tools rooted in cognitive behavioral therapy, mindfulness, and nervous system regulation to help heal emotional wounds and reset the nervous system.
- Insight Timer – A free app with guided meditations for stress, sleep, and emotional balance.
- HeartMath – A tool for nervous system and heart rate variability training.
To access these resources, click on the links below.
Guide MindBody Therapy
We are lucky to partner with Guide MindBody Therapy, where therapists passionately incorporate several MindBody practices aimed at healing the root causes of emotional challenges. Therapists at Guide MBT incorporate EMDR, Sand Tray, CBT, Ketamine, Somatic Experiencing, and Internal Family Systems as powerful tools for healing. PHW and Guide MBT share a common goal to bridge the gap between Mental Health and Physical Health with the understanding that they are vastly interconnected. If you are curious about ways that MindBody services could impact your healing, listen in as Dr. Davis welcomes Ashley and Bryan Brockus on the PHW Podcast to explore the impact of integrative healing — linked below with the Guide MBT website.
Supplement Highlight: Lithium MD
Lithium orotate may help regulate neurotransmitter activity, contributing to more stable moods, reduced symptoms of depression and anxiety, and a greater sense of calmness. It may also help those with frequent mood swings or irritability. Lithium is regarded as a neuroprotective agent, potentially shielding brain cells from damage and degeneration. It is important to note that lithium orotate is a supplement taken in very small doses, unlike prescription lithium (lithium carbonate or citrate) used for conditions like bipolar disorder.
MNRI Therapy
MNRI therapy involves exercises and techniques that are designed to stimulate and integrate primary motor reflexes. These exercises may involve movement, touch, and other sensory input and are tailored to each individual's needs and goals. MNRI therapy has the power to improve communication, cognitive development, and emotional, behavior, and nervous system regulation. MNRI therapy may help support individuals with a range of conditions, including autism, cerebral palsy, Down syndrome, learning challenges, and various neurological or sensory processing disorders.
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