Expert Profile - Andrew Pleener
Dr. Andrew Pleener
MD, FAIS, Integrative Psychiatrist
Dr. Andrew Pleener’s Bio:
Dr. Pleener is the Founder & Director of #SameHere Psych Alliance. Prior to his work with #SameHere, he had been involved in humanitarian efforts including co-creating and directing a makeshift Psychiatric Trauma Center on the Island of St. Maarten during Hurricane Irma in 2017. The clinic served as the main source of medical treatment and shelter for the cities of Cupecoy and Maho from the time of impact throughout military evacuation. He was featured in Newsday and Central Florida Lifestyle Magazine for these efforts. In 2019, he founded Regional Psychiatry to serve Central Florida with an Integrative approach to patient care. Dr. Pleener is a diplomat of the American Board of Psychiatry & Neurology (ABPN), and a Fellow of the American Institute of Stress (FAIS).
What life events or challenges that you’ve experienced (could be minor, could be major) – whether you’ve experienced them directly or via someone close to you, have had any type of impact on your desire to pursue a career in psychiatry?
My inspiration to start an Integrative Psychiatry practice originated from two personal childhood experiences. I used to observe my father, a Family Practice physician who specialized in weight loss management, nutrition & stress reduction. Growing up I watched overweight individuals come to his clinic looking for guidance. Many of his patients had developed diabetes, heart disease, obstructive sleep apnea, fatigue &/or depression, directly related to their weight. A majority of them were already prescribed metformin, CPAP machines, cholesterol lowering meds, & anti-depressants to treat these comorbidities, & my father would often ask ‘but did anyone try to help them lose the weight that caused these issues in the first place? He’d say ‘Let’s get to the source, not just cover up the side effects.’ Shadowing my father gave me the opportunity to watch him treat individuals with a combination of medical management integrated with exercise & dietary modifications. As they lost the weight over time, he would slowly taper them off the other medications. This made me realize that lifestyle change, plays a key role in helping others regain control of their lives.
Another personal story occurred during my adolescence. My family vacationed to Kenya & Tanzania. My mother returned from the trip with nausea, diarrhea, & abdominal bloating that persisted for weeks. She ended up testing positive for the parasite: campylobacter. After undergoing intensive medication management we were told she was cured, however over the next subsequent months, she began to develop depressive symptoms. She experienced fatigue, malaise, insomnia & poor concentration. Her appetite was reduced due to nausea. Multiple specialists including infectious disease physicians & Gastroenterologists evaluated her quickly & reassured her that she was perfectly “normal.” She was diagnosed with Depression, Anxiety, Irritable Bowel Syndrome (IBS) & referred to psychiatrists for med management. Another year went by & my mother’s symptoms were not resolved. She had lost over 30 lbs from lack of appetite, & struggled to get out of bed. She underwent colonoscopy, endoscopy, & more stool studies in the hopes that a root cause would be found. We eventually contacted the African Consulate who referred my mother to a tropical disease specialist in Manhattan. He discovered she had an additional parasite called Entamoeba Histolytica. After treatment with anti-protozoal drugs all of her symptoms resolved. Her energy came back, her depression & anxiety completely resolved, & her weight gradually normalized. Therefore, the takeaway once again for me, was – it’s not necessarily the symptoms of things like depression – the question is what’s the root cause!
How did those events impact you emotionally/morally? How, if at all did those events impact the way you view how our current system teaches us to treat patients with mental health challenges?
In addition to the stress and trauma I personally lived through watching my mother’s health decline over that two year period, the experience itself made me realize that we should not be so quick to slap a diagnostic label on a person. There are many underlying causes to someone’s psychiatric symptoms that warrant a thorough investigation (more than a 20-minute one-time diagnostic evaluation). Although sometimes there is a true need for medication, we do not always need to immediately jump to that decision right away as medications can have serious negative side effects. Regardless of chief complaint, everyone deserves a thorough investigation into the root cause with collaboration of care across multiple specialties. Many times medication can act as a band-aid dampening symptoms, while the real underlying cause is left undiscovered. Sometimes the solution is as simple as a lifestyle change.
When and why did you decide to actually focus on practicing Integrative Psychiatry, specifically, and how was your decision shaped by the experiences above?
I chose to enter the medical field because I wanted the opportunity to help ease the suffering of others.
After facing many challenges in my own life (observing my mother’s health decline, watching my parents divorce, having to relocate away from a home I loved), I could not help but notice similarities between many of the symptoms I developed (anxiousness, light sensitivity, indigestion, poor sleep, low energy, fatigue, brain fog) to the overall symptoms my mother felt during her illness, and that my father’s patients felt during their struggles with weight, cholesterol, sleep apnea etc.
This relationship between medical problems influencing mental health and vice versa made me realize that a “Mind-Body-Connection” exists. As I started my psychiatry residency training, I began to discover more literature supporting how stress and trauma impact our central nervous system on a physical level. Through educating myself on how to reduce my own stressors, and heal myself through combinations of exercise, nutrition, mindfulness, breathing, sleep hygiene, my physical symptoms resolved, and overall wellbeing improved.
What methods or practices do you utilize to help individuals get/feel better?
Active Listening, Thorough history and medical workups Educating patients on the Mind Body Connection, Incorporating lifestyle changes when needed(diet, exercise, nutrition, sleep hygiene), Utilizing STARR exercises in combination with conventional methods on a case by case basis.
How did people react when you share this Integrative/Holistic approach with them – whether it be patients or other doctors?
It’s been amazing how positively patients & their families have embraced this approach. People feel more hopeful, more supported, less stigmatized, & more motivated to engage in treatment knowing that our mutual goal is to uncover the true root cause of their symptoms while restoring baseline functioning & minimizing medication dependence as much as possible.