Root Cause Psych: Looking Deeper than Symptoms
A specialised, investigative approach to psychiatry that looks beyond symptoms to understand what may be driving them.
What is Root Cause Psychiatry?
Root Cause Psychiatry is a specialised, emerging approach to mental health care that looks beyond symptoms alone and asks a deeper question: why are these symptoms happening? Rather than focusing only on diagnoses and medications, this approach explores underlying biological factors such as inflammation, nutrition, metabolism, and body–brain communication that may influence how the brain functions.
This perspective reflects a growing shift in psychiatric research toward understanding mental health through biological systems, not just symptom checklists. Root Cause Psychiatry does not replace standard psychiatric care; it builds on it by offering a more personalised, investigative lens, especially for individuals whose symptoms have been persistent, complex, or difficult to treat.
Why Some People Don’t Fully Respond to Standard Treatment
Many people benefit from traditional psychiatric treatments, including therapy and medication.
For others, symptoms may persist, return, or only partially improve, even after appropriate care.
Factors such as inflammation, nutrient processing, metabolism, stress physiology, and immune signalling may affect treatment response.
Root Cause Psychiatry is often considered when symptoms are ongoing, complex, or treatment-resistant.
By looking more closely at individual biology, this approach helps explain why the same treatment may work well for one person but not another.
Why Traditional Psychiatry Misses This
Laboratory reference ranges are designed to detect clear medical disease, not necessarily what is optimal for brain function. As a result, a test can appear “normal” while still being associated with mental health symptoms.
Vitamin B12 is a well-studied example. Standard B12 ranges were developed to diagnose pernicious anemia and severe neurologic disease, yet research shows that psychiatric and cognitive symptoms can occur at levels considered normal by these standards. In such cases, blood values alone may not reflect how well the vitamin is functioning at the cellular or brain level.
Root Cause Psychiatry considers lab results in the context of symptoms and clinical response, recognizing that the brain may have different functional requirements than other organ systems.
The Importance of Expertise In Lab Reviews
Root Cause Psychiatry relies on objective testing to understand what may be driving symptoms beneath the surface. Because this approach focuses on biological pathways such as nutrient status, inflammation, metabolism, and hormone function. For many, testing is essential to guide care accurately and safely. Root Cause Psychiatry applies a psychiatry-specific, functional interpretation of results, always in the context of symptoms and clinical judgment, to inform individualised treatment decisions.
Root Cause Psych Evaluations: What We Offer and How They Help
Root Cause Psychiatry uses targeted clinical protocols designed to explore specific biological pathways that research suggests may influence mental health in some individuals. These protocols are not applied broadly or automatically. Each is considered only when clinically appropriate, based on labs, symptoms, history, and careful individualised evaluation.
Our Current Root Cause Psychiatry protocols include:
Ashwagandha – addressing stress physiology and HPA-axis dysregulation in select cases
T3 Augmentation – exploring thyroid-related contributors to depressive symptoms. Regular thyroid testing may appear normal hence we employ the use of reverse T3 to look deeper
Sulforophane – supporting antioxidant and cellular protective pathways (primarily relevant to autism spectrum disorder)
Leucovorin (Folinic Acid) – addressing cerebral folate deficiency and folate receptor–related pathways (primarily relevant to autism spectrum disorder)
Inositol – targeting signaling pathways involved in anxiety, mood, and compulsive symptoms
Magnesium + Vitamin B6 – supporting neuromuscular, autonomic, and stress-related regulation
Zinc – addressing immune, neurotransmitter, and inflammatory balance
Probiotics – supporting mental health through the gut–brain axis
Bright Light Therapy – addressing circadian rhythm and seasonal or non-seasonal mood patterns
Vitamin B12 – exploring functional B12 status when standard ranges may not reflect brain need.
Iron – addressing fatigue, cognitive drag, sleep fragmentation, and low-drive patterns that can persist even when standard blood counts look normal
Vitamin D – supporting mood, energy, and sleep stability in deficiency or seasonal patterns, with dosing guided by appropriate lab interpretation
Inflammation Based Depression – exploring whether low-grade inflammation may be contributing to depressive symptoms, stress sensitivity, or reduced treatment response in select cases
Each protocol has its own evidence base, indications, and safety considerations, which are reviewed in detail on their individual pages. These approaches are always used alongside standard psychiatric care, with ongoing monitoring and reassessment.
Next Steps, If You’re Curious
If you are interested in this approach, please schedule an appointment with one of our prescribers. They will review your history, discuss your symptoms, guide testing, and create a personalised plan to support your mental health safely and effectively.
We are here to answer your questions and provide thoughtful, professional care every step of the way.
References:
Rossignol DA, Frye RE. Cerebral Folate Deficiency, Folate Receptor Alpha Autoantibodies and Leucovorin (Folinic Acid) Treatment in Autism Spectrum Disorders: A Systematic Review and Meta-Analysis. J Pers Med. 2021 Nov 3;11(11):1141. doi: 10.3390/jpm11111141. Erratum in: J Pers Med. 2022 Apr 29;12(5):721. doi: 10.3390/jpm12050721. PMID: 34834493; PMCID: PMC8622150.
Frye RE, Sequeira JM, Quadros EV, James SJ, Rossignol DA. Cerebral folate receptor autoantibodies in autism spectrum disorder. Mol Psychiatry. 2013 Mar;18(3):369-81. doi: 10.1038/mp.2011.175. Epub 2012 Jan 10. PMID: 22230883; PMCID: PMC3578948.
Douglas J Lanska MD MS MSPH. Cerebral folate deficiency. In: Lewis SL, Editor-in-Chief. MedLink Neurology. San Diego: MedLink, LLC. Available at www.medlink.com. Updated: December 1, 2025.
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