Integrative Approach
Where physical and mental health meet
Physical and behavioral symptoms are clues. They carry important information about health and well-being.
What an integrative approach means
An integrative approach views physical and behavioral symptoms as clues, providing critical information about health and well-being. Rather than separating mental and physical health, it evaluates the whole person. By identifying underlying contributors and connecting these systems, care moves beyond symptom management toward greater regulation, resilience, and sustainable well-being.
I have created an outpatient therapy practice that provides an integrative approach to mental health. You can find me there.
Learn more about CornerstoneResearch
Information Is Power
We are embarking on an exciting time in mental health. Research continues to show how infection, inflammation, the immune system, and the gut can affect mood, behavior, and thinking, and it is opening the door to better explanations and more treatment options for mental health conditions.
These studies show links between physical and mental health, whether through causation, correlation, or exacerbation. The research is ongoing and offers an exciting frontier for caring for the whole person.
Anxiety
Gut microbiome
- The gut microbiota in anxiety and depression: a systematic reviewSimpson et al., Clinical Psychology Review, 2021
- The gut microbiota-anxiety connection: evidence, mechanisms, and therapeutic strategiesBjørklund, Butnariu, Dadar, and Semenova, Current Medicinal Chemistry, 2025
- Reproducible microbiome composition signatures of anxiety and depressive symptomsKouraki et al., Computational and Structural Biotechnology Journal, 2023
- Immune cells mediated the causal relationship between the gut microbiota and anxiety disorders: a Mendelian randomization studyLi et al., Journal of Affective Disorders, 2025
Inflammation
- Altered serum interleukin-17A and interleukin-23A levels may be associated with the pathophysiology and development of generalized anxiety disorderMamun-Or-Rashid et al., Scientific Reports, 2024
- MRI markers of neuroinflammation in untreated patients with subclinical generalized anxiety disorderBarkó, Kelemen, and Kéri, Journal of Neural Transmission, 2026
- Neuroinflammation-associated alterations of the brain as potential neural biomarkers in anxiety disordersWon and Kim, International Journal of Molecular Sciences, 2020
Metabolism, diet, and environment
- Metabolic profile and long-term risk of depression, anxiety, and stress-related disordersChourpiliadis et al., JAMA Network Open, 2024
- Psychological symptoms in COVID-19 patients: insights into pathophysiology and risk factors of long COVID-19Thye et al., Biology, 2022
- Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analysesLane et al., BMJ, 2024
- A state-of-the-science review of the effect of damp- and mold-affected housing on mental healthGatto, Mansour, Li, and Bentley, Environmental Health Perspectives, 2024
- Associations of indoor musty odors with depression and anxiety symptoms in Chinese older adults: a nationwide studyWang et al., BMC Public Health, 2025
- The impact of mold exposure on anxiety symptoms in older adults: a moderated mediation model based on CLHLSZhang et al., Ecotoxicology and Environmental Safety, 2024
- Mold inhalation causes innate immune activation, neural, cognitive and emotional dysfunctionHarding et al., Brain, Behavior, and Immunity, 2020
- Aflatoxin B1 induces anxiety-related neurotoxicity through brain-region-specific EGFR/AKT signaling: evidence from integrative network toxicology and Mendelian randomizationChen et al., Applied Biochemistry and Biotechnology, 2026
- M6A-mediated hippocampal BDNF deficiency contributes to aflatoxin B1-induced neurotoxicityXu et al., Journal of Agricultural and Food Chemistry, 2025
- Effects of mycotoxins on neuropsychiatric symptoms and immune processesRatnaseelan et al., Clinical Therapeutics, 2018
- Consumption patterns and eating behaviors of schoolchildren associated with mental health problems: a Brazilian nationwide study2025
Depression
Gut microbiome
- Gut microbiome-wide association study of depressive symptomsRadjabzadeh et al., Nature Communications, 2022
- Characterizing the role of the gut microbiota-inflammation-brain axis in major depressive disorder: an integrative multi-omics studyZhao et al., NeuroImage, 2026
- Alterations in fecal microbiota composition and cytokine expression profiles in adolescents with depression: a case-control studyCheng et al., Scientific Reports, 2025
- The neuroactive potential of the human gut microbiota in quality of life and depressionValles-Colomer et al., Nature Microbiology, 2019
- Leaky gut biomarkers in depression and suicidal behaviorOhlsson et al., Acta Psychiatrica Scandinavica, 2019
Inflammation and immunity
- The role of inflammation in depression: from evolutionary imperative to modern treatment targetMiller and Raison, Nature Reviews Immunology, 2016
- Inflammation and its discontents: the role of cytokines in the pathophysiology of major depressionMiller et al., Biological Psychiatry, 2009
- Advancing an inflammatory subtype of major depressionMiller, American Journal of Psychiatry, 2025
- Central-peripheral neuroimmune dynamics in psychological stress and depression: insights from current researchFeng et al., Molecular Psychiatry, 2025
- Autoimmune diseases and severe infections as risk factors for mood disorders: a nationwide studyBenros et al., JAMA Psychiatry, 2013
- Current position and future direction of inflammation in neuropsychiatric disorders: a reviewUpthegrove, Corsi-Zuelli, Couch, Barnes, and Vernon, JAMA Psychiatry, 2025
Nutrients, diet, and infection
- Dietary nutrient deficiencies and risk of depression (review article 2018-2023)Zielińska et al., Nutrients, 2023
- Zinc in depression: a meta-analysisSwardfager et al., Biological Psychiatry, 2013
- Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analysesLane et al., BMJ, 2024
- Ultra-processed foods and human health: the main thesis and the evidenceMonteiro et al., The Lancet, 2025
- Association between junk food consumption and mental health problems in adults: a systematic review and meta-analysisEjtahed et al., BMC Psychiatry, 2024
- A state-of-the-science review of the effect of damp- and mold-affected housing on mental healthGatto, Mansour, Li, and Bentley, Environmental Health Perspectives, 2024
- Associations of indoor musty odors with depression and anxiety symptoms in Chinese older adults: a nationwide studyWang et al., BMC Public Health, 2025
- Lyme borreliosis and associations with mental disorders and suicidal behavior: a nationwide Danish cohort studyFallon, Madsen, Erlangsen, and Benros, American Journal of Psychiatry, 2021
- Neuropsychiatric symptoms and tick-borne diseasesDelaney, Murray, and Fallon, Current Topics in Behavioral Neurosciences, 2022
- A multimodal neuroimaging study of brain abnormalities and clinical correlates in post treatment Lyme diseaseMarvel et al., PLOS ONE, 2022
- Higher prevalence of antibodies to Borrelia burgdorferi in psychiatric patients than in healthy subjectsHájek et al., American Journal of Psychiatry, 2002
OCD
Gut microbiome
- Human microbiota from drug-naive patients with obsessive-compulsive disorder drives behavioral symptoms and neuroinflammation via succinic acid in miceZhang et al., Molecular Psychiatry, 2024
- Changes in the stool and oropharyngeal microbiome in obsessive-compulsive disorderDomènech et al., Scientific Reports, 2022
- Implication of microbiota gut-brain axis in the manifestation of obsessive-compulsive disorder: preclinical and clinical evidenceKamble and Dandekar, European Journal of Pharmacology, 2023
- The gut microbiome and inflammation in obsessive-compulsive disorder patients compared to age- and sex-matched controls: a pilot studyTurna et al., Acta Psychiatrica Scandinavica, 2020
Inflammation
- Exploring the role of interleukin-1β and interleukin-6 in the pathophysiology of obsessive-compulsive disorderSarmin et al., PLOS ONE, 2024
- Association of granulocyte macrophage colony-stimulating factor and interleukin-17 levels with obsessive-compulsive disorder: a case-control study findingsSarker et al., Scientific Reports, 2023
- Inflammation in obsessive-compulsive disorder: a literature review and hypothesis-based potential of transcranial photobiomodulationCoelho, Salvi, Vieira, and Cassano, Journal of Neuroscience Research, 2024
Infection
- Association of streptococcal throat infection with mental disorders: testing key aspects of the PANDAS hypothesis in a nationwide studyOrlovska et al., JAMA Psychiatry, 2017
- A nationwide study in Denmark of the association between treated infections and the subsequent risk of treated mental disorders in children and adolescentsKöhler-Forsberg et al., JAMA Psychiatry, 2019
- Association between streptococcal infection and obsessive-compulsive disorder, Tourette's syndrome, and tic disorderMell, Davis, and Owens, Pediatrics, 2005
- Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 casesSwedo et al., American Journal of Psychiatry, 1998
- Therapeutic plasma exchange and intravenous immunoglobulin for obsessive-compulsive disorder and tic disorders in childhoodPerlmutter et al., The Lancet, 1999
- Multidisciplinary clinic dedicated to treating youth with pediatric acute-onset neuropsychiatric syndrome: presenting characteristics of the first 47 consecutive patientsFrankovich et al., Journal of Child and Adolescent Psychopharmacology, 2015
- Evaluation of basal ganglia and thalamic inflammation in children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection and Tourette syndrome: a positron emission tomographic (PET) study using 11C-[R]-PK11195Kumar, Williams, and Chugani, Journal of Child Neurology, 2015
- Antibodies from children with PANDAS bind specifically to striatal cholinergic interneurons and alter their activityXu et al., American Journal of Psychiatry, 2021
- Autoantibody biomarkers for basal ganglia encephalitis in Sydenham chorea and pediatric autoimmune neuropsychiatric disorder associated with streptococcal infectionsChain et al., Frontiers in Psychiatry, 2020
- Association of pediatric acute-onset neuropsychiatric syndrome with microstructural differences in brain regions detected via diffusion-weighted magnetic resonance imagingZheng et al., JAMA Network Open, 2020
- Th17 lymphocytes drive vascular and neuronal deficits in a mouse model of postinfectious autoimmune encephalitisPlatt et al., PNAS, 2020
ADHD
Gut microbiome
- Gut microbiome and attention deficit/hyperactivity disorder: a systematic reviewGkougka et al., Pediatric Research, 2022
- A systematic review on the associations between attention-deficit/hyperactivity disorder and gut microbiomeDias et al., Journal of Psychiatric Research, 2025
- Association between attention-deficit/hyperactivity disorders and intestinal disorders: a systematic review and meta-analysisNg et al., Scientific Reports, 2025
- Gut microbiota signature in treatment-naïve attention-deficit/hyperactivity disorderRicharte et al., Translational Psychiatry, 2021
- Gut microbiota and plasma cytokine levels in patients with attention-deficit/hyperactivity disorderWang et al., Translational Psychiatry, 2022
- Association between gut microbiota and emotional-behavioral symptoms in children with attention-deficit/hyperactivity disorderLee et al., Journal of Personalized Medicine, 2022
- Perturbations in gut microbiota composition in psychiatric disorders: a review and meta-analysisNikolova et al., JAMA Psychiatry, 2021
Inflammation and infection
- Peripheral blood inflammatory markers in patients with attention deficit/hyperactivity disorder (ADHD): a systematic review and meta-analysisMisiak et al., Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2022
- Neuroinflammation as a risk factor for attention deficit hyperactivity disorderDunn, Nigg, and Sullivan, Pharmacology, Biochemistry, and Behavior, 2019
- Identification of immune cells and circulating inflammatory factors associated with neurodevelopmental disorders by bidirectional Mendelian randomization and mediation analysisLiu et al., Scientific Reports, 2025
- A nationwide study in Denmark of the association between treated infections and the subsequent risk of treated mental disorders in children and adolescentsKöhler-Forsberg et al., JAMA Psychiatry, 2019
Diet and food dyes
- Potential impacts of synthetic food dyes on activity and attention in children: a review of the human and animal evidenceMiller et al., Environmental Health, 2022
- The association between junk foods consumption and attention deficit hyperactivity disorder in children and adolescents: a systematic review and meta-analysis of observational studiesKhazdouz et al., European Child and Adolescent Psychiatry, 2025
- Early ultra-processed foods consumption and hyperactivity/inattention in adolescenceFerreira, Marin, Vitolo, and Campagnolo, Revista de Saúde Pública, 2023
- Ultraprocessed food consumption and behavioral outcomes in Canadian childrenKavanagh et al., JAMA Network Open, 2026
- Attention-deficit/hyperactivity disorder is associated with increased consumption of ultra-processed foods among childrenNamimi-Halevi et al., Pediatric Research, 2026
Bipolar Disorder
Inflammation and immunity
- Peripheral levels of C-reactive protein, tumor necrosis factor-α, interleukin-6, and interleukin-1β across the mood spectrum in bipolar disorder: a meta-analysis of mean differences and variabilitySolmi et al., Brain, Behavior, and Immunity, 2021
- A meta-analysis of blood cytokine network alterations in psychiatric patients: comparisons between schizophrenia, bipolar disorder and depressionGoldsmith, Rapaport, and Miller, Molecular Psychiatry, 2016
- A unified model of the pathophysiology of bipolar disorderMagioncalda and Martino, Molecular Psychiatry, 2022
- Postmortem evidence of brain inflammatory markers in bipolar disorder: a systematic reviewGiridharan et al., Molecular Psychiatry, 2020
- Biomarkers, inflammation, and bipolar disorder: association between the improvement of bipolar disorder severity and the improvement in C-reactive protein levelsCuomo et al., Frontiers in Psychiatry, 2021
- Autoimmune diseases and severe infections as risk factors for mood disorders: a nationwide studyBenros et al., JAMA Psychiatry, 2013
- Inflammation-related biomarkers in major psychiatric disorders: a cross-disorder assessment of reproducibility and specificity in 43 meta-analysesYuan et al., Translational Psychiatry, 2019
Gut microbiome
- Microbiota-gut-brain axis mechanisms in the complex network of bipolar disorders: potential clinical implications and translational opportunitiesOrtega et al., Molecular Psychiatry, 2023
- Multi-omics analyses of serum metabolome, gut microbiome and brain function reveal dysregulated microbiota-gut-brain axis in bipolar depressionLi et al., Molecular Psychiatry, 2022
- Gut mycobiome and neuropsychiatric disorders: insights and therapeutic potentialHadrich et al., Frontiers in Cellular Neuroscience, 2024
- The role of gut microbiota in various neurological and psychiatric disorders: an evidence mapping based on quantified evidenceZang et al., Mediators of Inflammation, 2023
Nutrients
- Nutrition and bipolar disorder: a systematic reviewGabriel et al., Nutritional Neuroscience, 2023
- The role of vitamin D in bipolar disorder: epidemiology and influence on disease activityCereda, Enrico, Ciappolino, Delvecchio, and Brambilla, Journal of Affective Disorders, 2021
- Micronutrient-immune interactions in mood and psychotic disorders: a case-control study of vitamin C, iron, zinc, magnesium, and peripheral blood cell indicesShahini et al., Scientific Reports, 2026
Suicide Risk
If you or someone you know is struggling, call or text 988, the Suicide and Crisis Lifeline.
Gut microbiome
- The gut-brain axis and inflammatory mediators in suicide and mental disorders with high suicide rates: a review of current evidenceShamabadi et al., Dialogues in Clinical Neuroscience, 2026
- An exploratory analysis on the association between suicidal ideation and the microbiome in patients with or without major depressive disorderChen and Wu, Journal of Affective Disorders, 2025
- Novel insights into gut microbiota alterations in major depressive disorder with suicidal ideation: a metagenomic analysisHe et al., Frontiers in Microbiology, 2026
- Characterization and correlation of gut microbiota in major depressive disorder patients with suicidal ideationLi et al., BMC Psychiatry, 2026
- Continuous alterations in the gut microbial landscape associated with suicidal ideation in first-episode drug-naïve major depressive disorderLiang et al., CNS Neuroscience and Therapeutics, 2026
- Leaky gut biomarkers in depression and suicidal behaviorOhlsson et al., Acta Psychiatrica Scandinavica, 2019
Inflammation and the kynurenine pathway
- Inflammation and nitro-oxidative stress in current suicidal attempts and current suicidal ideation: a systematic review and meta-analysisVasupanrajit et al., Molecular Psychiatry, 2022
- Neuroinflammation, stress-related suicidal ideation, and negative mood in depressionHerzog et al., JAMA Psychiatry, 2025
- Assessing the relationship between suicidality and inflammatory biomarkers: C-reactive protein/albumin and neutrophil/albumin ratios in an inpatient settingElbay, Erdil, and İlhan, BMC Psychiatry, 2025
- Multi-system biomarkers of suicide risk in major depressive disorder: integrating erythroid parameters, composite inflammatory indices, and metabolic dysregulationFu et al., BMC Psychiatry, 2025
- Role of inflammation in suicide: from mechanisms to treatmentBrundin et al., Neuropsychopharmacology, 2017
- Suicide, neuroinflammation and other physiological alterationsBengoechea-Fortes, Ramírez-Expósito, and Martínez-Martos, European Archives of Psychiatry and Clinical Neuroscience, 2024
- Investigation of the relationship among cortisol, pro-inflammatory cytokines, and the degradation of tryptophan into kynurenine in patients with major depression and suicidal behaviorMessaoud et al., Current Topics in Medicinal Chemistry, 2021
- The correlation of inflammation, tryptophan-kynurenine pathway, and suicide risk in adolescent depressionYang et al., European Child and Adolescent Psychiatry, 2025
- An enzyme in the kynurenine pathway that governs vulnerability to suicidal behavior by regulating excitotoxicity and neuroinflammationBrundin et al., Translational Psychiatry, 2016
Nutrients and infection
- The association between plasma omega-3 fatty acids and suicidal ideation/self-harm in the United Kingdom BiobankFranco et al., Lipids in Health and Disease, 2025
- Lipids and suicide riskSublette, Current Topics in Behavioral Neurosciences, 2020
- The association between vitamin D serum levels, supplementation, and suicide attempts and intentional self-harmLavigne and Gibbons, PLOS ONE, 2022
- Risk of suicide, suicide attempt, and suicidal ideation among people with vitamin D deficiency: a systematic review and meta-analysisYu et al., BMC Psychiatry, 2025
- Association between serum zinc levels and suicidal ideation in US adults: a population-based cross-sectional studyHuang et al., Journal of Affective Disorders, 2023
- Lyme borreliosis and associations with mental disorders and suicidal behavior: a nationwide Danish cohort studyFallon, Madsen, Erlangsen, and Benros, American Journal of Psychiatry, 2021
Working together
If you have questions about how these connections may apply to your family, I would be glad to talk.
staci@cornerstonetherapy.com