Case Study Excerpt: Treating Anxiety with Natural Medicine

Patient Information

Zoe is a 15-year-old girl living in the suburbs of San Francisco.  Ever since she was young, Zoe has been prone to anxiety.  However, after staying home from school during the pandemic, Zoe became very socially anxious, in part due to the cystic acne she developed during that time.

• Problems: Anxiety, acne, trouble sleeping, trouble concentrating
• Height: 5’3”
• Weight: 100 pounds
• BMI: 17.7
• Total cholesterol: 160 mg/dL
• HDL cholesterol: 50 mg/dL
• Blood pressure systolic: 110 mmHg
• Blood pressure diastolic: 70 mmHg
• Non-fasting glucose: 100 mg/dL

Care Plan: Jaquel Patterson, ND, MBA, IFMCP

As a naturopathic physician who works in family medicine, about  40 percent of Jaquel Patterson, ND, MBA, IFMCP’s patients are under the age of 18, a growing number of which are presenting with anxiety and depression. With patients like Zoe, Dr. Patterson takes the time to get a detailed health history and find the root cause of their issues, emphasizing the functional medicine philosophy of “test, don’t guess.” 

For Zoe’s initial care plan, Dr. Patterson would begin with general bloodwork, particularly focusing on minerals such as iron and ferritin, due to potential deficiencies linked to Zoe’s diet. She would also conduct hormone and metabolic testing, including a complete blood count, a complete metabolic panel, A.M. cortisol (for sleep issues), and a hormone panel, checking levels of FSH, LH, estrogen, progesterone, testosterone, DHEA.

Dr. Patterson would assess Zoe’s red blood cell count (RBC) and nutrient levels, including magnesium, zinc, vitamin A, and vitamin D. She would also investigate potential food sensitivities and environmental factors like mold exposure. Additionally, Dr. Patterson may conduct a neurotransmitter test involving urinary tests four times a day to check cortisol levels and neurotransmitters (dopamine, serotonin, norepinephrine, epinephrine, glutamate, and tryptophan).

Depending on Zoe’s family’s budget, Dr. Patterson would suggest stool testing, focusing on strains like lactobacillus and Bifidobacterium, given Zoe’s poor diet and mental health issues. If Zoe’s anxiety seemed unrelated to situational factors, Dr. Patterson would consider testing for conditions such as PANS/PANDAS, Lyme disease, and Bartonella.

Dr. Patterson’s treatment plan for Zoe would most likely include:

Supplements for Cortisol Regulation

• Nighttime: Phosphatidylserine and herbs like magnolia and passionflower to support gamma-aminobutyric acid (GABA), mental health, and sleep. 
• Morning: Licorice root to increase cortisol half-life and Rhodiola to support neurotransmitters and energy. 

Dietary Adjustments

• Increase protein intake to support neurotransmitter production, considering Zoe has a slightly low BMI. Hydration: 
• Increase water intake to 64 oz per day. Technology Reduction: 
• Reduce social media use by 30 minutes per day. 

Mental Health Support

• Amino acid supplementation to support neurotransmitter production. 
• Encourage participation in online dance classes to address social anxiety and foster connections. 
• Discuss therapy history e.g., cognitive behavioral therapy (CBT) and support systems with Zoe’s father. 
• Develop a plan for increasing social activities and addressing loneliness.

Dr. Patterson’s overall goal would be to develop a comprehensive plan that addresses both Zoe’s physical and mental health, focusing on her diet, lifestyle, and social connections. Dr. Patterson would make ongoing adjustments to the treatment plan based on Zoe’s test results and progress.

About the Expert:

Dr. Patterson is a nationally recognized naturopathic physician, success coach, 3x Amazon best-selling author, and Forbes contributor. She owns a successful multi-disciplinary medical practice, Fairfield Family Health, in Connecticut. She has over 16 years of clinical experience with a focus on Lyme disease, autoimmune conditions, integrative psychiatry and environmental medicine. She is a sought-after speaker and published in places like USA Today, New York Magazine, Forbes, CBC, Fox, NBC and ABC. She has also completed additional post-doctoral training and is certified with the Institute for Functional Medicine and functional medicine for psychiatry and ADHD with Psychiatry Redefined.  She is active in leadership within the profession, serving as the past President for the American Association of Naturopathic Physicians and currently serves on the board for the American Academy of Environmental Medicine.

Editor’s Note: This is an excerpt from the case study, Addressing Anxiety in Teenage Patients. To access the full text, click here.