title: Integrative medicine: Breaking down silos of knowledge and practice an epigenetic approach.
abstract: The future of medicine is discussed in the context of epigenetic influences during the entire life course and the lived experiences of each person, avoiding as much as possible the "medicalization" of the individual and taking a more humanistic view. The reciprocal communication between brain and body via the neuroendocrine, autonomic, metabolic and immune systems and the plasticity of brain architecture provide the basis for devising better "top down" interventions that engage the whole person in working towards his or her welfare. The life course perspective emphasizes the importance of intervening early in life to prevent adverse early life experiences, including the effects of poverty, that can have lifelong consequences, referred to as "biological embedding". In the spirit of integrative, humanistic medicine, treatments that "open windows of plasticity" allow targeted behavioral interventions to redirect brain and body functions and behavior in healthier directions. Policies of government and the private sector, particularly at the local, community level, can create a supporting environment for such interventions. See "Common Ground for Health: Personalized, Precision and Social Medicine McEwen & Getz - https://www.youtube.com/watch?v=IRy_uUWyrEw.
authors.affiliation: Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY 10065. Electronic address: Bruce.McEwen@rockefeller.edu.
authors.forename: Bruce S
authors.initials: BS
authors.lastname: McEwen
mesh_terms: D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology; D000818:Animals; D003866:Depressive Disorder / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology / Q000628:therapy; D044127:Epigenesis, Genetic; D057890:Epigenomics / Q000379:methods* / Q000639:trends; D000070497:Healthy Lifestyle; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D055048:Integrative Medicine / Q000266:history* / Q000379:methods / Q000639:trends; D033183:Interdisciplinary Communication; D008016:Life Change Events; D001523:Mental Disorders / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D026441:Mind-Body Therapies / Q000639:trends; D009473:Neuronal Plasticity; D011203:Poverty / Q000523:psychology; D057285:Precision Medicine / Q000379:methods / Q000639:trends; D055500:Resilience, Psychological; D009626:Terminology as Topic; D035703:Therapies, Investigational / Q000639:trends
keywords: Adverse childhood experiences; Depression; Humanistic medicine; Multi-morbidity; Resilience