In The Myth of Sisyphus, Camus wrote that weariness awakens consciousness, that “Everything begins with consciousness. Nothing is worth anything except through it.”
In the last few months, I’d been weary—sleeping, eating, exercising, commuting, working, preparing for more work, sleeping, and repeat—but I didn’t feel any consciousness awakening, and I still felt like I was waiting for that “everything”, or at least something, to begin.
I wanted to immerse my bare hands in the soil of life—to feel the softness of joy, the moisture of awe, and the cool warmth of peace, between my fingers. I wanted to feel alive: for my soul to urgently thrust itself into each morning, as if the spinning world depended on it.
Instead, I was stuck in traffic.
In the world of natural health junkies, spiritual community dwellers, and backpacking hippies, a Ten-Day Vipassana Retreat is a right of passage. My friends, colleagues and fellow travellers all assured me that the experience changed them. They all reflected on their ten days spent in the woods in silence, sitting for excruciatingly long hours, as catalysts for growth. They’d burned off dead and stagnant parts of their egos, let go of their cravings, and emerged shiny, with a renewed zest for all their lives had to offer.
Listening to their stories, I imagined myself in their places: sitting mute and contemplative in the dark. Through eliminating all input, I expected the Universe (with a capital U, naturally) to reveal rich meaning beneath its monotonous surface. Plus, I heard the food was good.
So, I signed up. A few months later, with a backpack filled with drab clothes and a meditation cushion, I was driving to the Dhamma Torana Vipassana centre, located outside of Barrie, Ontario.
A sleepy hippie greeted me as a I pulled into a virtually empty, gravel parking lot at the entrance to the centre.
I got out of my car and smiled at him, “I’m here for the Vipassana retreat.”
“Yeah, man,” He replied with eyebrows raised, as if searching his brain for what I was referring to. “Hey, though, do you mind parking your car closer to that truck? There’s going to be a lot of us trying to fit in here.”
I looked around for evidence of this meditation-hungry crowd. Instead, there were a handful of cars parked, including a large black pick-up truck and my own.
“Sure,” I said, “Do you mind just watching my bag?”
I squeezed my car up against the truck. Now we were two cars huddled side-by-side in the large, empty lot. It looked ridiculous but, you know, we were a community now.
“I couldn’t lift the bag,” Said the hippie-turned-parking-attendant, half-apologetically. He’d left it on its side in the dirt. The bag contained two pairs of pants, two t-shirts, some shampoo, and meditation cushion. It probably weighed three pounds.
I smiled tightly at him, hoisted the bag onto my shoulder, and made my way to the registration house to get my room key. Then I headed over to the women’s side of the property to find my cabin.
The cabin was a tiny room containing two beds separated by a shower curtain. I was supposed to share with a roommate, but she hadn’t arrived yet.
How do you room with someone you can’t talk to or look at? I prayed that my roommate wouldn’t show up and that I’d get the room to myself.
I put my things away and headed to the dining hall for dinner.
We were told to hand over our electronics, writing materials, and other valuables. I handed over my car keys so that I wouldn’t be tempted to escape. As my things were being placed into bins, I felt like Austin Powers preparing to be cryogenically frozen.
In fact, the retreat centre, while beautiful, had prison-like undertones. Signs declaring “Course Boundary” stopped you from exploring—or going back to the parking lot. Days later I would stare at that sign longingly, dreaming of the freedom represented by my car. Men and women were segregated into completely separate areas of the property. We weren’t allowed to talk and make eye contact once the silence was imposed. We were also told not to bring flashy, tight or flamboyant clothes and so many of use looked like prisoners: heads down, attention turned inwards, clothes dark, loose and drab.
Dinner was vegan food. It was good. However, having been a recovering vegan in the past, I wondered if I’d finish the retreat like the parking volunteer, too weak to lift my own three-pound bag.
After dinner we were given a speech on the rules: no talking, texting, touching, making eye contact, gesturing, wearing tight clothing, doing yoga, running, writing, reading, sunbathing, killing (even mosquitos), sex, drugs, rock ‘n’ roll (or any other music, for that matter), alcohol, eating dinner (just some fruit for newbies), and so on. No Phone, no pets, no cigarettes. It was going to be a long ten days.
I couldn’t wait.
I wondered what amazing insights would emerge from these ten days of spacious silence.
It was time for the first meditation, after which we would observe the Nobel Silence. We settled onto our assigned cushions. I had brought my own meditation cushion and saw that others had brought their own supplies too. Many brought intricate contraptions for sitting: meditation benches, special blankets, chairs, back rests, and knee pads. Rather than preparing to sit for an hour, it looked like they were readying themselves to enter the Earth’s orbit.
The meditation started. The teacher of Ten-Day Vipassana retreats, S.N. Goenka, is dead and so instruction is delivered by a series of tapes he’d recorded, presumably, while still alive.
One of the two assistant teachers pressed play and Goenka’s chanting began. Goenka’s would be the only voice I’d really hear for ten entire days, and it had an alarming amount of vocal fry.
I fidgeted throughout the hour of our first meditation. My meditation practice up until that point consisted of daily thirty-minute sits. I don’t think I’d ever sat for an hour. In fact, after twenty minutes, I’d usually experience numbness in both legs that sent me crawling around on all fours painfully trying to restore blood flow. During this first hour I kept crossing and uncrossing my legs. It wasn’t just me; silence in the hall was punctuated by the cacophony of restless shuffling.
Five more minutes of chanting followed by a gong finally signalled the end of my antsy misery. I slowly and silently got up, keeping my eyes inoffensively cast in front of me, and shuffled, among the tribe of other zombies, out of the hall and back to my quarters. It was barely 9 pm, but I flopped exhausted onto my little bed and immediately fell asleep.
The next day, loud gonging heaved me into the pitch-dark early morning. It was 4:15 am. I dressed in the dark, shuffled to the bathroom to brush my teeth, and headed to the meditation hall for the first two-hour meditation of the First Day.
The schedule was terrifying. We were to wake at 4:15 in the morning to sit for the first meditation, two hours, at 4:30. A gong would then signal breakfast for 6:30 am, after which we’d sit for another hour of meditation. Then we were to return to the meditation hall or go to our rooms and sit for two more hours. Lunch was at 11:00 am, followed by another break. Then, four hours of meditation followed by a snack break, where new students were allowed to eat fruit and drink tea. There was no dinner.
After the snack break, was another hour-long meditation, then a discourse where we were to watch Goenka lecturing—the only entertainment of the day. Then more meditation—45 minutes. Bedtime was 9:30 pm. Lights were to be out by 10 pm. With the first wake-up gong sounding at 4:15 in the morning, and nothing to do in the evenings, I doubted that the early bedtime would be a problem.
The first thing I did was count: eleven hours of meditation. Each day I was to spend eleven hours sitting on a cushion, keeping my back straight, and watching my breath. Besides eating, and walking in the forest during breaks, that was to be my life for the next ten days. How was I going to handle this?
“I think you’ll make it to day seven and then decide you’ve had enough,” a skeptical friend had told me before I’d left. I’d been insulted. Now I doubted my own convictions. Day Seven seemed very far away.
Most of my friends had told me that they’d wanted to leave by Day Three.
By Day Two, however, I was done. My legs and back ached and, halfway through the second day, I decided that I couldn’t do another second of meditation. “I can’t do this anymore!” I exclaimed in my head. Besides Goenka’s, the Voice in My Head was the only voice I’d had access to for the last two days. And it happened to be mistaken. I kept on.
During my 32 years on the planet, I don’t believe I’d spent a day without communicating in some way, shape or form with another human being. Since I could put words together, I hadn’t spent a day in silence. Since I could read and write, there wasn’t a day in which I hadn’t engaged with some form of written text.
I missed it. While taking bathroom breaks, I stared intently at the sign outlining the shower rules. I fascinatedly read about using the hair catcher while showering. I read how we were to clean it out after and dump any hairs in the garbage. I studied the rules about drying and squigeeing the shower walls after use. “With Metta,” The notice signed off. With Metta. Withmettawithmettawithmetta. I read the words over and over again. Bathroom reading. It might as well have been War and Peace.
I expected the days to soak me in serene silence. I was wrong. As it turned out, my head was louder than an elementary school cafeteria during lunch hour. But, unlike the lunch break, there was no end to the noise.
“I eat brown food in the morning with brown tea and green food for lunch with green tea,” My inner monologue babbled gaily. It was true: breakfast was always oatmeal and prunes, which I accompanied with black tea. Lunch was a green salad and some soup or curry. I ate it with green tea. “Maybe I can be vegan,” The Voice in My Head chattered, optimistically, “The food here is so good. I could eat like this all the time. I don’t even miss dinner! Maybe I should start doing more intermittent fasting. I wonder if they sell a recipe book, oh, I can’t wait for breakfast tomorrow morning!”
And, “What colour pants am I going to wear tomorrow? The brown ones or the black ones? Brown or black? Black or brown? Should I wear the brown ones with the white shirt and the black ones with the blue shirt? Or the blue ones with the—” I’ll spare you the rest.
I had entire conversations with people in my head. I wrote, rewrote, and edited monologues, conversations and imaginary dramas. I crafted responses from the characters I was arguing with. I practiced my lines and honed them.
I humbly discovered that it was not a chaotic world, filled with sensory distractions, that stifled some creative genius locked somewhere within; the chaos was removed and no genius emerged. Instead, when left to its own devices, my mind became a shallow simpleton bouncing senselessly to topics like the clothes I was wearing, the things I was eating, and people I was dating. How disappointing.
During the eleven hours of meditation, my mind and body rebelled. Every itch, twitch and irritation, mental or physical, would send me crossing and uncrossing my legs, refolding my hands, opening my eyes, and stretching my neck—anything to avoid actually meditating.
My only reprieve was meal times. I would wait for them, like Pavlov’s dog, salivating in anticipation of the gong that would release me from the hell of sitting.
On Day Three, however, I noticed something different. I was sitting in meditation and I wanted to move: do something, like cross my legs a different way. I felt tension and frustration rise within as I resisted the urge. The resistance was like a boulder to push against. It had edges, viscosity. I couldn’t push anymore. I relaxed, softened. I opened.
And with that, the resistance popped. I felt immediate relief.
It was as if my mind and body were wrapped in a crumpled fabric. Each knot and wrinkle resembled an agitation, a restlessness, a mania that arose from within my physical and emotional self. Pushing up against these wrinkles would only tighten them, causing more agitation. But, when I began to breathe, to dissolve their solidity, they began to soften, and pop, like bubble wrap. The fabric began to iron out. I was calm.
I started to notice bigger knots: my relationship with uncertainty, for instance, that seemed too monstrous to pop, however the mini bubbles of impatience started to disappear as they arose, one by one.
Openness.
Openness provides relief from suffering.
Maybe I could survive this.
On Day Three Impatience and I got to know each other. Impatience has been a theme in my life, a low-level agitation that manifests in restlessness: my desire to connect on social media, to distract with technology and day-dreaming, to tweeze hairs and do dishes instead of doing work, and to lurch through life with my head pushed forward, oblivious to my surroundings.
I moved through life like I ate: inhaling a fresh spoonful before swallowing the first. I wasn’t tasting my food. I wasn’t tasting life.
During one particularly turbulent moment in meditation, when a wave of impatience hit, so did a series of images: family weddings, babies being born, pets passing away, family members passing: images of events that had not yet occurred, but almost certainly would. I was racing towards the future, which would bring me both wonderful experiences and inevitable pain. And, of course, at the end of it all would be the end of me. What was the rush?
I brought my attention back to my breath. Some more knots in my mind’s fabric opened.
On Day Four I recognized that, at the heart of this impatience was a craving for certainty. Underneath that craving: fear.
What I am afraid of? I asked the blackness.
Almost immediately, from some depths of my psyche, the answer surfaced.
I’m afraid to suffer.
Suffering, the Buddha’s first Nobel Truth. Life is suffering, or Dukkha. Like every other being who had ever lived, as long as I was alive I would suffer. If I craved certainty, then this was it.
We began to practice Vipassana on Day Four. For the past three days, my entire world had been reduced to the rim of my nostrils where my breath passed. The technique of focussing on the breath at the nostrils is called Anapana, and its goal is to sharpen and focus the mind.
Vipassana, or the development of equanimity regarding the impermanence of nature, and the truth of suffering, focusses on body sensations. We first began to scan the body from the tips of the toes to the top of the head (“Staaart from. the. topofthehead. Top of. Thehead,” Chirped Goenka’s voice on the recordings), a relatively simple technique in theory that proved to be excruciating in practice.
If the first few days had introduced me to the manifest agitations and disquiets in my body and mind, Day Four presented me with the full-on war raging within. For three hours a day we were to resist the urge to move. My body was on fire.
Demons in my head commanded me to move, get up, scream. Others shouted at me to stay still. Still others urged me to quit. Amidst their shouts was harrowing physical misery.
I felt like I was under the Cruciatus Curse. In fact, the whole retreat was starting to seem like a JK Rowling novel, or some other Hero’s Journey. I had set out to conquer evil only to find that all evil came from within, and was now being asked to face it bravely, conjuring up a Patronus of equanimity to protect me from being consumed by this hellish fire.
“The only difference between a Ten-Day Silent Vipassana Retreat and a Harry Potter novel is that ‘He Who Must Not Be Named’ is literally everything,” I thought, sardonically.
From Days Four to Five, I emerged from every sitting broken and exhausted. Being on Day Five was like reaching the middle of a claustrophobic tunnel. I was halfway through and still had just as far to go. I scanned the deadpan faces of the crowd during mealtimes to see if anyone else had spent the last hour being electrocuted.
Goenka said the sensations of fire and electricity were Sankaras, mental cravings that embed themselves in our physical bodies and cause suffering. An intense sensation was simply one of these Sankaras floating to the surface of the body. If we met it with “perfect equanimity”, it would be eradicated, and we would be cleared out for our next incarnation.
These body sensations—the sharp, twitching, numb, searing, blinding, and even pleasurable— were a representation of nature itself. Sensations arise in the body and pass away; they are impermanent, Anitya. Through first being aware of them, and then meeting them with openness, without clinging or aversion, we can be free from suffering.
“Maintain perrrrrrfect equanimity. Perrrrrrfect equanimity, with the understanding of Anitya.
“Anitya…. Anitya….” Goenka’s recordings crooned.
Sapiens author Yuval Noah Harari, also a long-time Vipassana practitioner, states, “Meditation is about getting to know the most ordinary, daily, natural patterns of the mind, body and emotions, to observe reality as it is. If you can observe, to some degree, reality as it is, without running away to stories and fictions, you will be a more peaceful and happy person.”
Well, I certainly wasn’t happy.
On Day Five I was being burned at the stake. Someone had lodged a red hot poker into my right flank, just to mess with me. “I will never be able to walk again,” My mind blabbered, “This is torture. I’m becoming permanently injured. I can feel the meniscus in my knees slowly tearing—“
Goenka’s chanting began, indicating we had five more minutes of this hell. I relaxed, even though we still had five more minutes of this hell. The mind is a ridiculous thing.
—Donnnnng….
Freed by the beautiful, beautiful music of the gong, I sprang up. I expected to hobble, in pain, clutching at my back, working out stiffness in my knees. I anticipated the inevitable sharp pain that would appear in my ankles as I took my first step.
Yet, as I walked out of the meditation hall to stand in the July sun, I noticed that there was not a twinge of pain, a tightness, nor an ache to be found. My body felt perfectly fine. On the contrary, I actually felt great: light and supple. It felt like I was floating.
Hm.
By the time Day Six arrived, I was greeting the pain like an old friend. I noticed that discomfort came, not from the sensations themselves, but from the mind’s anticipation of and resistance to them. If I expected an arising sensation to be painful, I would brace myself against it, creating tension. And, after the sensation had faded, my mind would still grip it, creating a story of aversion.
So, I stopped calling it pain. Instead, it was a series of sensations: numbness, vibration, tingling, spark, heat, radiation, burning, but not pain. I noticed the sensations that disappeared as soon as they materialized, like shooting stars across my back. Others were solid, like clumps of cement hanging out in my body for the entire hour. I now easily sat for an hour without moving, watching this orchestra of sensations transpire across my flesh.
The war was ending. I was winning.
I was free.
Four days to go.
Anitya.
Sometimes impermanence isn’t fast enough.
On Day Seven, I settled into meditation, welcoming it now. I dropped into my breath, and began practicing Vipassana, sweeping my attention over my body, observing the sensations that were present, just as Goenka instructed.
Curiously, the sensations dissolved. There was no sensation, there were no Sankaras, there was no body. I could still feel the line where my lips met, and where my hands came together in my lap. Other than these two black outlines drawn in space, I had dissolved into ether, the atoms of my body emitting a subtle vibration that merged with those that surrounded it.
It wasn’t surprising. For the last seven days I’d been eating oatmeal and meditating in the woods without speaking to anyone. Now my entire body was evaporating. Nothing was surprising anymore.
I later learned that this phenomenon was called a “Free Flow”. It results from absolute openness: from a mind that is both equanimous and subtle. Solidity dissolves, and what is left is the vibration of atoms, all transient, anitya. All impersonal, Anatta.
The Three Buddhist Marks: Anitya, Anatta, Dukkha.
Impermanence, Non-Self, Suffering.
Now that I was One with, whatever it was I was one with, I figured I might as well seek some spiritual answers. Or at least make a wish or something.
I thought of what I most wanted in the world. “I want connection,” I told the Universe, “I want deep, connected relationship.”
Amidst the vibrations, something answered. A simple, Why?
Hm. Why, indeed? I’d never entertained the question.
I want to be loved, emerged my answer, from I-didn’t-know-exactly-where, since I was currently nothing. It was like my heart was speaking instead of my head. The utterance arose out of space, before dissipating, like smoke rings from a caterpillar’s hookah. Then, there was silence.
The energy, or entity, or my Higher Self, whoever I was talking to, seemed amused at my naivety. I could feel her compassionate chuckle vibrating into the atoms that buzzed where my body had once sat.
You already are,
the amused response manifested from the darkness into which I was dispersed.
You already are.
And, at that moment, nothing seemed more true. Nothing can give us what is already in our basic nature.
Gorf is a man of his age, which, in his case, happens to be the Stone Age.
Yes, Gorf is a caveman.
And, perplexingly, Gorf suffers from insomnia.
Gorf wakes up sluggish, long after the sun has risen, wishing he had a snooze button to smash.
He struggles through the day, exhausted. In the early afternoon, he sucks glycogen from the raw meat of a fresh kill to get an extra blood sugar boost.
Gorf prays for someone to discover coffee and refined sugars so that he can join the ranks of modern zombies getting through their 3 pm slumps with artificial pick-me-ups.
When the sun sets, Gorf feels depleted, but also restless and wired. He frustratedly tosses on his bed of mammoth skins beside the dying embers of his campfire while his family snoozes on.
Wide awake at 2 am, Gorf knows that the next morning he’ll begin the cycle again, his body completely out of sync with the Earth’s rhythms. Such is the cursed life of a Prehistoric Insomniac.
If this story seems preposterous, it’s because it probably is. Whatever we imagine prehistoric humans to be, insomniacs is not high on the list.
Those of us who have spent a night outside—whether it was a weekend camping trip or longer—might remember how deeply we slept under the darkness of the starry night sky and how refreshed we woke when the sun began to warm our faces in the early morning.
The closer we get to nature, the better our bodies seem to align with the Earth’s light and dark rhythms.
Now, if we took poor Gorf, dressed him in a suit, and dumped him in a desk chair in an office building in any major modern city, we might believe his claim to insomnia.
Now that Gorf is one of us, his eyes are exposed to bright lights at night as he slogs away at his computer, answering emails, or surfing social media pages into the late hours.
During the day, Gorf now spends his time indoors, where light exposure is 400 times less than that of a bright sunny day.
On bright days when he has a chance to get outside, Gorf protects his fragile eyes with dark glasses.
Welcome to the modern industrial lifestyle, Gorf. Don’t forget to help yourself to the coffee and cookies.
Our Body’s Circadian Rhythms
Our body runs on a 24 hour clock, which is orchestrated by an area in the hypothalamus of the brain called the Suprachiasmatic Nucleus (which we will refer to as “the SCN” from now on).
Our organs, body tissues and cellular processes, from our digestive function, hormones, mood, body temperature, metabolism, sleepiness and wakefulness, cellular repair, to detoxification, among others, have different objectives for certain times of day. The SCN coordinates these functions with the Earth’s daily cycles.
The SCN runs without the aid of outside influence, however several zeitgebers, German for “time givers”, or environmental cues, tell our internal clock what time of day it is to sync our internal and external worlds. The most important zeitgeber is light, which directly activates the SCN through a pathway that connects the retina in our eyes to the hypothalamus (the retinohypothalamic tract).
In our bodies, timing is everything. The more we are able to sync our cycles with the environment, the better our body organs function. Working against circadian rhythms by engaging in activities like sleeping and eating at the wrong time of day can negatively affect our health, decrease our lifespan, and make us miserable (like poor, sad Gorf in his dimly lit office).
The digestive system, for example, is wired to break down, absorb and convert food energy into fuel during the day and repair and regenerate itself at night.
At night, the pineal gland, located in the brain, releases melatonin, a hormone produced in the absence of light, to help us sleep. However, exposure to bright lights before bed can impede the natural release of melatonin, preventing restful sleep.
Science shows that healthy circadian rhythms equal optimal metabolic health, cognitive function, weight, energy levels, cardiovascular health, immune function, digestive health, coordination and mental health. Regulating our circadian rhythms can increase our health-span.
Our Liver, Muscles and Adrenal Glands Also Have Clocks
While the SCN is the chief executive officer of the circadian cycle, other organs, such as the liver, muscle and adrenal glands, help regulate our body’s rhythms through peripheral clocks.
These clocks register cues from the environment and report back to the SCN.In turn, the SCN tells the organs what jobs they are supposed to be performing according to the time of day.
Dr. Satchin Panda, PhD, a researcher at the Salk Institute, is discovering how important our eating times are for setting our circadian clock.
The first bite of our breakfast tells our liver clock to start making the enzymes and hormones necessary to digest our food, regulate our metabolism, and use the food we eat throughout the day to fuel our cells.
A few hours later, our digestive system requires relief from food intake to invest its resources into repair rather than spending precious resources on digesting food.
Dr. Panda found that restricting a “feeding window” to 8 to 12 hours in mice and human participants (for example, eating breakfast at 7 am and finishing dinner no later than 7 pm), allowed the system to digest optimally, left time for the system to repair itself at night, and also acted as a powerful circadian regulator.
New research suggests that food is a potent zeitgeber, which has the power to regulate our circadian rhythms. This suggests that eating at the right time of day can heal our adrenal glands and sleep cycles.
Fasting for 10 to 16 hours at night, or “Time Restricted Eating”, helps optimize health and increase lifespan in mice. In human participants, it improves sleep and results in modest weight loss.
According to Dr. Panda, we become more insulin resistant at night, which means that late-night snacking makes us more likely to store the calories we consume as fat.
Consuming calories in a state of insulin resistance can also predispose use to metabolic syndrome and type II diabetes.
In addition to light and food intake, rest and movement are important zeitgebers. Therefore, engaging in these activities at the right time of day has the potential to promote physical and mental health.
Circadian Rhythms and the Stress Response are Tightly Connected.
If the internet is any indicator, it seems that everyone is suffering from the modern illness of “adrenal fatigue”, or HPA (Hypothalamic-Pituitary-Adrenal) axis dysfunction
Because of the stress of our modern lifestyles, our adrenal glands and brains are no longer able to regulate the stress response.
This leads to a host of symptoms that wreck havoc on the entire body: fatigue, anxiety, sugar cravings, and insomnia. It also negatively impacts digestion, hormone production, and mood.
Our adrenal glands make cortisol, the “stress hormone”, a hormone involved in long-term stress adaptation but also in wakefulness, motivation, reward, and memory.
Deficiencies in cortisol signalling can result in issues with inflammation and depression. Too much cortisol floating around in the body can cause weight gain, cardiovascular issues, such as hypertension, and metabolic syndrome.
Cortisol has a circadian rhythm of its own. Our cortisol levels rise within an hour of waking; 50% of the total cortisol for the day is released in the first 30 minutes after we open our eyes. This rise in cortisol wakes us up. It allows us to perform our daily activities in a state of alert wakefulness.
Cortisol levels decline steadily throughout the day, dipping in the evening when melatonin rises.
A flattened or delayed rise in morning cortisol results in grogginess, brain fog and altered HPA axis function throughout the day. Elevated cortisol in the evening cause us to feel “tired and wired” and affect sleep. Waking at night, especially in the early morning between 2 and 4 am can be due to cortisol spikes.
Our adrenal glands help regulate our circadian rhythms through the production of cortisol. Both the adrenals and the SCN communicate with each other as early as 2 in the morning to ready the system to generate the waking response a few hours later.
Psychiatrist Dr. Charles Raison, MD says, “The most stressful thing you do most days is get up in the morning. Your body prepares for it for a couple of hours [before waking by activating] the stress system. The reason more people die at dawn [than any other time] is because it’s really rough to get up.”
Waking up is a literal stress on the body.
However, we need the stress response to get through our day effectively and healthy HPA axis function and optimal mood and energy are a result of properly functioning circadian rhythms.
Without these rhythms functioning properly we feel tired, groggy, tense, and depressed. Like Gorf, we need sugar and caffeine to help us through the day.
Circadian Rhythms Affect Our Mental Health
In nearly everyone I work with who suffers from anxiety, depression, or other mental health disorders, I see disrupted circadian rhythms and HPA axises.
Many of my patients feel exhausted during the day and wired at night. They have trouble getting up in the morning (or stay in bed all day) and postpone their bedtime. Most of them skip breakfast due to lack of hunger, and crave sweets after dinner, which further throws off the circadian cycle.
Lack of sleep can disrupt circadian rhythms leading to obesity, depression, diabetes and cardiovascular disease. Even two nights of shortened sleep can affect cortisol production and the HPA axis, worsening mood and energy levels.
Depression severity on the Hamilton Depression Rating Scale (HDRS) falls by 6 full points when sleep is restored, which is enough to bring a patient from moderate/severe depression to mild. In comparison, the standard medication SSRIs, like cipralex, only drop the HDRS by 2.
Bipolar disorder is particularly affected by a misaligned circadian clock. In an interview, Dr. Raison claims that a single night of missed sleep has brought on episodes of mania in his bipolar patients. Their moods level once the sleep cycle is restored.
Our mood is tightly connected to our circadian rhythms and sleep.
Circadian Rhythms and Chinese Medicine
Thousands of years ago, the Chinese developed the Theory of Yin and Yang to describe the dynamics nature, including the cycles of night and day.
Yin and yang (symbolized by a black-and-white circle with dots) represent the process of change and transformation of everything in the universe.
Yang, represented by the white part of the circle, is present in things that are hot, light, awake, moving, exciting, changing, transforming and restless.
Yin is present in material that is cold, dark, soft, inhibited, slow, restful, conversative, and sustaining.
Yin and yang are dependent on each other. Yin feeds into yang, while yang feeds and transforms into yin. Everything in nature consists of a fluctuating combination of these two states.
The circadian cycle transforms the yin night into the yang of daytime.
Yang zeitgebers such as food, light, and physical and mental activity, help stimulate yang in the body, which helps us feel energized, light and motivated.
Before bed, yin zeitgebers like darkness, rest and relaxation help our bodies transition into the yin of night, so that we can sleep restfully.
Lack of sleep and relaxation can deplete our body’s yin energy, causing yin deficiency. Individuals with yin deficiency feel fatigued, anxious, and hot, experiencing night sweats, hot flashes, and flushed skin. Conventionally, yin deficiency can look like burnout compounded by anxiety, or peri-menopause.
Out-of-sync circadian rhythms can result in yang deficiency resulting in morning grogginess, an insufficient rise in morning cortisol, and a failure to activate yang energy throughout the day.
Yang deficiency is characterized by the build-up of phlegm in the body, leading to weight gain, feelings of sluggishness, slow digestion, bloating, weakness, and feeling foggy, pale and cold. Yang deficiency symptoms can look like depression, chronic fatigue syndrome, IBS, estrogen dominance, hypothyroidism, or obesity and metabolic syndrome.
In Chinese medicine, the organs have specific times of activity as well.
The stomach is most active from 7 to 9 am, when we eat our breakfast, the most important meal of the day according to Traditional Chinese doctors. The spleen (which in Traditional Chinese Medicine operates much like the Western pancreas) is active from 9 to 11 am, converting the food energy from breakfast into energy that can be utilized by the body.
According to the Chinese organ clock, the liver is active from 1 to 3 am. Individuals with chronic stress, insomnia and irritability, sometimes called “Liver Qi Stagnation”, frequently wake up restless during those early morning hours.
Entraining our circadian clock with environmental cues can help us remain vital by balancing the flow and transformation of yin and yang energies in the body.
Healing the Circadian Clock:
When I work with patients with depression, anxiety and other mental health conditions, or hormonal conditions such as HPA axis dysfunction, one of our goals is to heal circadian rhythms.
This involves coordinating our internal rhythms with the Earth’s night and dark cycle by setting up a series of routines that expose the body to specific zeitgebers at certain times of day.
How to Heal Your Circadian Rhythms
Morning Activities: Increasing Yang with movement, light and food:
1. Expose your eyes to bright light between the hours of 6 and 8 am. This stimulates the SCN and the adrenal glands to produce cortisol, which boosts mood, energy and wakefulness in the morning and can help reset the HPA axis.
2. Have a large breakfast high in protein and fat within an hour of waking. The intake of a meal that contains all of the macronutrients wakes up the liver clock. This activates our metabolism, digestive function, blood sugar regulation, and HPA axis.
Consider eating 3 eggs, spinach and an avocado in the morning. Or consume a smoothie with avocado, MCT oil, protein powder, berries and leafy greens.
Eating a breakfast that contains at least 20 grams of protein and a generous serving of fat will help stabilize blood sugar and mood throughout the day while obliterating night-time sugar cravings.
3. Move a little in the morning. Morning movement doesn’t necessarily have to come in the form of exercise, however, it’s important to get up and start your routine, perhaps making breakfast and tidying, or having an alternate hot and cold shower (1 minute hot bursts alternating with 30 seconds cold for 3 to 5 cycles).
Muscle movement triggers another important peripheral clock that helps entrain our circadian cycle with the day.
4. Turn on lights in the morning, especially in the winter time. Spend time outside during the day, and avoid using sunglasses unless absolutely necessary so that light can stimulate the SCN. Consider investing in a sunlamp for the winter, particularly if you suffer from seasonal affective disorder.
5. Consume most of your supplements in the morning, with breakfast. Taking adaptogens (herbs that help reset the HPA axis) and B vitamins can help promote daytime energy and rebalance our morning cortisol levels. This, of course, depends on why you’re naturopathic doctor has recommended specific supplements, so be sure to discuss supplement timing with her first.
Night Routine: Increasing Yin with dark and stillness:
1. Maintain a consistent sleep and wake time, even on the weekends. Retraining the cycles starts with creating a consistent routine to get your sleep cycle back on track.
2. Try to get to bed before 11pm. This allows the body to reach the deepest wave of sleep around 2 am. It also allows for 7 to 8 hours of continuous sleep when you expose your eyes to bright lights at 6 to 8 am, when cortisol naturally rises. Of course, this sleep routine will vary depending on personal preferences, lifestyles and genetics.
It’s important to first establish a routine that will allow you to get at least 6 hours of continuous sleep a night. If you suffer from chronic insomnia, working with a naturopathic doctor can help you reset your circadian cycle using techniques like Sleep Restriction Therapy to get your body back on track.
3. Avoid electronic use at least an hour before bed. Our smartphones, tablets, computers and TVs emit powerful blue light that activates our SCN, confusing all of our body’s clocks. Blue light also suppresses melatonin release, making us feel restless and unable to fall asleep.
For those of you who must absolutely be on electronics in the late hours of the evening, consider investing in blue light-blocking glasses, or installing an app that block blue light, such as F.lux, on your devices. These solutions are not as effective as simply turning off electronics and switching to more relaxing bedtime activities, but can be a significant form of harm reduction.
4. Fast for at least 2 to 3 hours before bed. Avoid late-night snacking to give the body a chance to rest and to signal to the peripheral digestive clocks, such as the liver clock, that it’s now time to rest and repair, rather than digestive and assimilate more food.
Avoiding food, especially carbohydrate-rich food, at night can also manage blood sugar. A drop in blood sugar is often a reason why people wake in the early hours of the morning, as blood sugar drops spike cortisol, which wake us up and off-set our entire circadian system.
5. Engage in relaxing activities in dim lighting. Turn off powerful overhead lights, perhaps lighting candles or dim reading lights, and engage in at least 30 minutes of an activity that feels restorative and relaxing to you. This might include taking an epsom salt bath, reading a book while enjoying an herbal tea, doing yoga or meditation, or cuddling with a partner.
Taking this time helps us step out of the busyness of the day and signals to the body and its clocks that it’s time to sleep.
6. Take nighttime supplements before bed. I often recommend sleep-promoting supplements like prolonged-release melatonin (which is a powerful circadian rhythm and HPA axis resetter), magnesium or phosphatidylserine, before bed to help my patients’ bodies entrain to the time of day. Talk to your ND about what supplements might be right for you.
If you suffer from chronic stress and mood disorders, do shift work, or are dealing with jet lag, you may need to engage in these routines diligently for a few months to get your circadian cycles back on track.
These practices can also be beneficial at certain times of year: daylight savings time, periods of stress and heightened mental work, and the transition of seasons, especially early Spring and Fall.
Finally, consider working with a naturopathic doctor to obtain and individual plan that can help you reset your body’s rhythms.
I will die in here today, I thought to myself, as I sat hunched and cramped in an oven-hot temazcal, or sweat lodge, somewhere on the Mexican pacific.
The straw flap covering the opening of our sweaty mud hut was thrown off momentarily by someone outside, flooding our hellish cave with light. I gazed hopefully at the entrance: were we getting water? Were they letting in fresh air? Was it finally over?
It was none of those things. Instead of relief, they were increasing the heat; a pile of hot rocks appeared at the door.
“Gracias, Abuelita“, said our leader, Marciano, receiving a giant steaming rock with metal tongs and pulling it inside the hut. The change in temperature was immediate. The heat coming off the rocks was like fire. I struggled to breathe.
Marciano is Spanish for martian, abuelita an affectionate term for “grandmother”. Did he know what he was doing, this martian? Was there even enough oxygen in here for all of us? I am not related to these rocks, I thought.
“Gracias, Abuelita,” We numbly replied, thanking the rocks and fanning ourselves with imaginary cool air.
The hut was crowded with ten people. I had to sit hunched over and there was no space to lie down. If I wanted to leave, everyone else would have to get out first. The combination of darkness, stifling humidity, claustrophobic quarters and angry heat was almost intolerable. Sweat was pouring so profusely off my body that I had become one with it.
Every cell of my body was on fire with craving: water, space to lie down, fresh oxygen, freedom.
Whenever I thought I couldn’t stand another moment, the heat intensified.
The tiny flap in the door opened again. Another grandmother rock from Mars? No, it was water! My heart flooded with gratitude until I realized that the tiny glass being passed around was for all of us to share.
I will die in here.
I will never again complain of ice and snow.
This is supposed to be therapeutic?
When it was over, I emerged gasping desperately for air and water. After chugging a bucketful of water, I dumped another on my scorching hot skin. I swear it emitted a hiss.
I had survived! However, as my body cooled, I realized that I had done more than survive. Despite my resistance throughout its entirety, the sweat lodge had left me feeling absolutely elevated.
The feelings of energized calm lasted well into the next few days. My brain seemed to work better, evidenced by an elevation in the fluency of my Spanish.
It was amazing.
Current research shows that heat therapy, like sweat lodges and saunas, can indeed be therapeutic. Subjecting the body to high temperatures can improve the symptoms of major depressive disorder as effectively as the leading conventional therapies, such as medication.
Intrigued by the cultural practices of using intense heat to induce transcendental spiritual experiences (the Native American sweat lodges and Central American temazcales, for instance), a psychiatrist name Dr. Charles Raison decided to investigate heat as a therapy for improving mental and emotional well-being.
Raison and his team, in their 2016 JAMA Psychiatry study, took 60 randomized individuals suffering from major depressive disorder, and subjected them to a standardized questionnaire, the Hamilton Depression Rating Scale (HDRS), which quantifies depressive symptoms. The treatment group received Whole Body Hyperthermia, an average of 107 minutes in an infrared heating chamber that heats core body temperatures to 38.5 degrees celsius.
The placebo group spent the same amount of time in an unheated box that was nearly identical (complete with red lights and whirring fans). 71.5% of the study participants who were put in the sham heating chamber believed that they were receiving the full heat therapy.
After one week of receiving the single session of heat therapy, the active group experienced a 6 point drop on the HDRS. This decrease outperformed even the standard anti-depressant treatment, selective serotonin re-uptake inhibitor medications (according to a 2017 meta-analysis SSRI medications drop patients only 2 points on the HDRS), and lasted for 6 weeks.
Previous fMRI research has shown that heat sensing pathways in the skin can activate brain areas associated with elevated mood, such as the anterior cingulate cortex (the ACC is also activated during mindfulness meditation). The raphe nucleus, which releases serotonin, our “happy hormone”, is also activated by this skin-to-brain thermoregulatory pathway.
Heat is also thought to calm immune system activation present in the brains of individuals suffering from depression. People with depression tend to have higher body temperatures than non-depressed people. This is possibly due to the present of inflammatory cytokines, such as TNF-a and IL-6, that increase inflammation and fever and have been shown to negatively impact mood. Perhaps heat therapy acts by “resetting” the immune system.
Furthermore, when the body is exposed to high temperatures, it results in the release of heat shock proteins. Heat shock proteins respond to short, intense stressors: hot, cold, and even fasting conditions. They have a variety of effects on our hormonal systems. Some can reset the body’s stress response, correcting the cortisol resistance that is present in the brains of depressed individuals. One particular heat shock protein, HSP105, has been shown to prevent depression and increase neurogenesis (the creation of new brain cells) in mice.
Reduced neurogenesis in the hippocampus is a risk factor and side effect of depression. It is thought that traditional anti-depressants, in addition to altering brain levels of serotonin, may exert some of their effects through inducing brain-derived neurotrophic factor (BNDF), a growth factor that encourages the development of new brain cells.
Conventional theories tell us that depression is a disorder resulting from a chemical imbalance in the brain requiring medication to “correct” that imbalance. However, an overwhelming amount of research tells us that this is simply incorrect: depression is a complicated condition stemming from multiple causes.
Naturopathic doctors focus on the whole person. We look at how an individual’s symptoms are expressed within the context of their biology, physiology, psychology, and social and physical environments. We know that, when it comes to a condition like depression, every body system is affected. We also know that the health of our digestive and hormonal systems are essential for optimal mood.
Naturopathic doctors have also traditionally used hydrotherapy, the therapeutic application of hot and cold water, to benefit digestion, boost detoxification pathways, and regulate the immune system.
Therefore, as a naturopathic doctor, the idea that heat exposure can have a profound effect on depressive symptoms makes sense. However, as a clinician, I’ve found it difficult to convince my patients suffering from depression to try heat therapy. Perhaps it’s because the remedy seems so simple it borders on insulting—sweat for an hour and experience profound changes to a condition that has debilitated me for months? Get out of here.
I get it.
However, research suggests that since depression is a multi-factorial condition, it deserves to be addressed with a variety of therapies: diet, sleep hygiene, exercise, nutrition, and psychotherapy, to name a few. Heat therapy can be another important one.
So, here are some suggestions for implementing heat therapy without having to do a sweat lodge:
If you have access to a sauna, us it! Alternate 15 to 20 minute stints that induce sweating with 60-second cold rinses in a shower. Cycle back and forth for up to an hour.
Go to a hot yoga class a few times a month.
Exercise. Exercise has been shown to induce temperature changes that are similar to heat therapy. This may be why exercise has been so well studied for its mental health benefits.
Take epsom salt baths regularly. Add 1 to 2 cups of epsom salts to a warm bath and soak for 20 minutes or more, or to the point of sweating.
Try Alternate Hot and Cold Showers: alternate between one-minute bursts of hot water and 30-seconds of cold for about 3 to 5 cycles.
Self-compassion is the act of treating yourself as you would any other loved one: treating yourself with kindness vs. Self-Judgment.
Self compassion is a modality that is being researched for treatments for mental health conditions, preventing burnout, improving motivation, body image, resilience, and in clinical settings for the helping professions.
The leading expert on self-compassion, Kristen Neff, PhD, defines self-compassion in three ways:
Mindfulness
Invoking a sense of common humanity
Self-acceptance vs. self-judgement
This 3 minute self compassion break can be done in a moment of difficulty, such as in the presence of strong emotions, physical sensations, self-criticizing thoughts, or in the face of failure. It can be done on a daily basis or when difficulty is present.
Step 1:
Adopt a posture that invokes a sense of self compassion. The posture to adopt is traditionally placing hands on the heart, but can also be hands placed on the neck, or a mudra. Touch releases oxytocin, our “love hormone” which releases feelings of calm, love and connection, even when it’s our own hands being placed on our own body.
Step 2:
Either to yourself, or out loud, say these three sentences.
This is a moment of suffering. This is mindfulness, acknowledging that suffering is present and turning towards, as opposed to turning away from difficulty.
Suffering is a part of life. Other alternatives to this are: other people feel this way. This is invoking the sense of common humanity, reminding yourself that you are not alone and other people on earth have felt or are currently feeling this way.
May I give myself the compassion I need. This is setting an intention to be kinder to oneself. Other alternatives are: may I be kind to myself, or may I try to accept myself as I am.
For more on Self-Compassion, to access more of Kirsten Neff’s research, and for free resources, visit selfcompassion.org
This is one of my favourite exercises from Mindfulness Based Cognitive Therapy, or MBCT, and just one exercise in an 8-week course directed at those who suffer from depression and anxiety.
This exercise helps us practice staying with difficult thoughts, emotions, and body sensations, teaching us to turn towards difficulty, rather than turning away.
It is better to do this exercise when difficulty is already present.
Try to use a 10 lb weight, not a 100 lb weight. However, in many situations, we don’t get to choose. If the practice is particularly intense, you can perhaps focus on the breath, or open your eyes and let go of the practice.
Note: this video is to support a mindfulness practice and to use in conjunction with help from a licensed mental health professional.
Since publising the original article about the Mirena IUD on this blog, thousands of women have come out of the woodwork writing to me asking for help.
When I originally wrote the article, I was spurned on by my observations of the women in my practice who had experienced a rise in estrogen dominance and low progesterone after the insertion of their IUDs (which were often inserted to treat hormone imbalances!).
At that point I never imagined that so many women would be affected by the IUD, or that even more were suffering from so many hormonal symptoms that drastically affected their lives and health.
It makes sense: our society does not set us up for proper hormonal function.
Our diets are carbohydrate-heavy, promoting insulin resistance and blood sugar dysregulation, which impacts our ovaries’ ability to make estrogen properly.
An excess amount of body fat produces more estrogen in the body and acts as a reservoir for the toxic estrogens in our environment.
We lack many of the micronutrients necessary to process our hormones properly, such as vitamin D, B vitamins, magnesium, zinc, omega 3 fatty acids, glutathione, and amino acids.
Many of us have impaired or suboptimal liver function, or sluggish digestion, which keeps hormones in our bodies around longer than they should be.
A dysbiotic gut has the tendency to turn estrogen in the gut back “on”, putting it back into circulation when it was otherwise on its way out of the body.
Stress alters our hormonal function, including our ability to make progesterone, DHEA-S, convert thyroid hormones, and process estrogen properly.
Xenoestrogens in our food and environment, from plastics, fragrances, pesticides, and processed soy products, contribute to overall body burden of the hormones in our body, throwing off our delicate balance, and contributing to symptoms.
The result of all this is that many women suffer from hormonal imbalances.
10% of women have some form of PCOS, or Polycystic Ovarian Syndrome, characterized by the body’s inability to properly make progesterone or estrogen, instead making loads of male hormones, like testosterone. PCOS alters fertility, promotes weight gain, and causes things like unwanted facial hair growth, acne, and missed periods. PCOS is often connected to stress and insulin resistance.
Many women in my practice suffer from PMS or PMDD, experiencing often debilitating symptoms sometimes even two weeks before their periods begin. They might get migraines, intense cravings for sugar, and massive mood changes, such as anxiety, intense irritability, or devastating depression. Panic attacks can occur at this time as well. Many of them comment that their mood and personalities flip once their hormones levels reach a certain point, causing them to act like different people. This can jeopardize their relationships with spouses and children, coworkers, friends and family.
Tender and painful breasts, or breast lumps, are also common in many of these women.
Acne, weight gain, stress, fatigue, disrupted sleep, depression and anxiety are all symptoms I see in women with hormonal imbalances.
Many women have horrific cycles, experiencing painful and heavy periods that often cause them to miss days of work every month. Many of these women struggle to keep their iron levels in the optimal range, suffering from hair loss, fatigue and weakness.
Many women are diagnosed with fibroids, or endometriosis, or are concerned about their risk of female cancers like breast, ovarian, uterine and cervical cancer.
All of these symptoms are often linked to relatively higher levels of estrogens compared to progesterone, sometimes termed Estrogen Dominance by functional medical practitioners who look at the underlying causes of bodily imbalances.
I feel terrible that I can’t help more of the women who write to me. My license prevents me from giving advice to those who live abroad, especially to non-patients over the internet. It’s a shame, however, because oftentimes the solutions are relatively simple, despite how complicated many of these symptoms might seem.
I’m hoping that this article can provide some direction to many of the women who suffer.
Firstly, I want to state that I am not against birth control or even the Mirena IUD (or other IUDs, for that matter). The vast majority of women with the IUD tolerate it. For many women with debilitating heavy periods and endometriosis it can be the only viable solution that makes life tolerable.
In my social practice at Evergreen, many of the women I see experiencing homelessness, drug addiction, or PTSD from relationship trauma, rely on the efficacy of IUDs to prevent unwanted pregnancies. Their lives often don’t allow for them to remember to consistently take pills every month.
Many women don’t tolerate combination birth control because of a history of blood clots, female cancers, or migraine headaches associated with their periods, and therefore the Mirena IUD, which is progesterone only, is a safe alternative for preventing unwanted pregnancy.
That all being said, many women do suffer on the Mirena IUD (or other forms of birth control). They were perhaps put on the Mirena to deal with some of the above symptoms of hormonal imbalance, or for contraception. Many of them noticed that their symptoms became worse after insertion of the IUD.
How the Mirena IUD and Birth Control Works:
The Mirena works by secreting small amounts of progestins, a synthetic form of progesterone, into the uterus and surrounding tissues. While it is not fully known how the Mirena works, the end result is a suppression of ovulation. This results in either very light periods or a complete cessation of periods until the IUD is removed (after 5 years when its hormones run out).
It is important to say here that, while birth control can certainly treat the symptoms of hormonal imbalances, it does not correct them.
All forms of birth control, with their synthetic versions of the hormones estrogen and progesterone, simply induce further hormone imbalances in the body. They introduce versions of hormones that may suppress or alter symptoms (such as heavy and painful bleeding, or acne), but the versions of hormones are not fully recognized by the body and therefore don’t fully replace all the hormones’ important functions, such as mood regulation, immunity, or blood sugar balance.
The effects of both altering the body’s natural hormonal balance, while ignoring the underlying cause of hormonal issues, is often what causes symptoms to continue or worsen.
For example, women with PCOS are prescribed birth control to manage acne or promote monthly periods. However, when women with PCOS miss periods, it is because they are not ovulating. The missed periods are not the problem; the lack of ovulation is.
Despite that, many women with PCOS experiencing amenorrhea (or missed cycles) will be prescribed birth control. However, birth control does not address the underlying cause of amenorrhea. It simply further suppresses ovulation (because its main purpose is to prevent unwanted pregnancy).
The periods you get while on birth control are not periods. Periods from birth control are withdrawal bleeds. After 21 days of taking hormonal pills, pills are stopped or replaced with placebo pills. The withdrawal of hormones in the pills induces a bleed that resembles a period, but is not one.
Hormonal contraception does not correct hormonal imbalance, it imposes further hormonal imbalance to manage symptoms. This is not always bad!
But it is an important difference.
Many women do require symptom suppression, particularly if their symptoms are severe. Many individuals in my practice experience periods so heavy that the only way for them to get through the month is with an IUD. Genetic variability in how our bodies process hormones can make us susceptible to intense hormonal symptoms, through no fault of our own.
In my opinion, however, it is important to attempt to address the underlying cause and to set our bodies up for better hormonal regulation, making as many changes as our lifestyles will allow.
What You Can Do About It:
If you are like any of the people I described above who seek my help, there are a few things that you can do to get started on correcting hormones.
Working With a Professional:
The first thing I advise is finding a licensed naturopathic doctor or functional medicine practitioner who understands hormones, can order lab tests, and will address the underlying cause of your hormonal imbalances by taking the time to fully understand your body and lifestyle.
This practitioner might be a naturopathic doctor (you can find one in North America by looking one up at naturopathic.org), or a medical doctor, a chiropractor, or a highly skilled nutritionist or nurse practitioner. Research this person well, read their articles, and perhaps book in with them for a complimentary meet and greet.
Testing:
I often test patients using simple blood tests, on day 21 of their cycles (or about 7-9 days before they expect their next period).
I will test their blood, looking for anemia, will test iron and B12 levels, homocysteine (to gauge their ability to methylate), vitamin D, cholesterol (to see if their diets are promoting proper hormone synthesis), estradiol, estrone (the more toxic, problematic estrogen), progesterone, free testosterone, a thyroid panel, fasting glucose and fasting insulin (to calculate insulin resistance using something called the HOMA-IR), HbA1C (to look a long-term blood glucose control), FSH and LH (two hormones made in the brain that talk to the ovaries and orchestrate the menstrual cycle), DHEA-S, to name a few.
Some women will require more testing. Others will require less.
These labs are interpreted from a functional perspective. Even though you are in the “normal” ranges (which take into account the entire population, many of which are not healthy—they are seeing their doctors, after all!), these blood markers may not be optimally balanced, giving us an opportunity to correct things before they go further.
Testing allows us to match symptoms to underlying imbalances and to be able to properly direct treatment protocols. Women with estrogen dominance may be experiencing high levels of estrogen and normal progesterone, which indicates a body burden of estrogen or impaired liver and digestive system clearance. Other women may be experiencing normal levels of estrogen but low progesterone, indicating a failure of their bodies to ovulate, due to high stress, and PCOS (or the Mirena IUD and birth control pill).
Other options for hormonal testing are month-long salivary hormone testing, or DUTCH testing, which looks at hormone breakdown in the urine. I sometimes run these tests, but find that blood testing is useful, accurate, and more cost-effective.
Treatment:
Once you understand your individual hormonal situation through testing (and through working with a practitioner who is putting the testing together with your symptoms and health history), your practitioner may recommend a variety of treatments.
I personally combine diet and lifestyle with key herbal and nutritional supplements, to target what is going on under the surface with my particular patients.
These treatments may include herbs that boost ovulation, aid liver detoxification, or regulate the stress response. I might recommend nutraceuticals that encourage methylation, or aid in hormone production.
My treatments take into account the individual’s symptoms, labs, diet, lifestyle, and any other health issues she may be facing like fatigue, digestive disturbances, or poor sleep.
What You Can Do Today:
Barring more individualized assessment and advice, there are some best lifestyle practices that can help most women balance their hormones better, whether they are still using birth control to control and address their hormonal symptoms or prevent pregnancy.
Diet:
When it comes to diet and hormone support, we need to ensure that we are balancing blood sugar, boosting liver detoxification pathways, promoting hormone synthesis, and supporting digestion, especially if experiencing constipation.
Consume more leafy greens: kale, spinach, collards, beet greens, arugula, etc. Eat 1-2 cups of these foods every day. Leafy greens contain active folate, which boosts methylation and detoxification. They also contain magnesium which is essential for hormonal regulation as well as 300 other important biochemical reactions in the body that balance mood and hormones.
Consume more cruciferous vegetables: broccoli, cauliflower, brussel sprouts, cabbage, bok choy, etc. Eat 1-2 cups of these foods every day. Crucifates help the body make glutathione, and contain indole-3-carbinole, which helps eliminate excess estrogens from the body. Broccoli sprouts are potent players in these pathways. Consume them as often as possible.
Ensure adequate dietary fibre intake: I often recommend ground flaxseeds or chia seeds in smoothies, avocados, fruits and vegetables and legumes (if tolerated) to make sure that women are having regular bowel movements to clear excess estrogens out of the body. 2 tbs of ground flaxseed (or more) every day can help balance estrogen levels and promote daily bowel movements.
Balance blood sugar: consume protein, fat and fibre at every meal. Avoid refined starches and flours. Avoid all sugar, even natural sugar like maple syrup, coconut sugar, cane sugar, honey, agave, etc. Try stevia or avoid sweets. Limit carbs (grains, legumes, root vegetables like potatoes or sweet potatoes, to 1/2 cup to 1 cup per meal). Only consume whole grains like quinoa, buckwheat, steel cut oats, millet, and teff. Cook them yourself!
Avoid soy, particularly processed soy, like vegan burgers, or soy milk.
Consume omega 3 fatty acids in fatty fish like salmon and sardines, or nuts and seeds like flax and chia seeds, walnuts, and pumpkin seeds. Get 2-4 tablespoons of these nuts and seeds every day and 3-4 servings of fatty fish a week.
Consume animal products: eggs contain choline, which is essential for liver function, meat contains vitamins B6 and B12, which are essential for hormonal regulation and production. Cholesterol in animal products are the backbones of our sex hormones. Iodine, found in animal foods, regulates estrogen balance in the body. If possible, try to obtain organic animal products from pastured or free-range animals to boost omega 3 intake, to lower your impact on the environment, and to promote animal welfare.
Other Lifestyle Practices:
Boost progesterone production by managing stress:
Establish a self-care routine: plan regular vacations, even small outings, do meditation or yoga, take breaks from work, spend quality time with family, have a plan to get your work done on time, ask for help.
Sleep! Aim for at least 8 hours of sleep, and try to get to bed before 12am. Practice good sleep hygiene by avoiding electronics before bed, keeping the bedroom as dark as possible, and setting a bedtime and wake time, even on weekends. Body scan meditations and some key supplements can be helpful for resetting circadian rhythms. Regulating blood sugar can have a major impact on improving sleep. Talk to your functional medicine doctor or naturopathic doctor for individualized sleep solutions.
Eliminate exposure to toxic estrogens and boost estrogen clearance:
Avoid exposure to xenoestrogens: whenever possible use natural body products, deodorants and shampoos, or “edible” body products for face and hair. Avoid plastic water bottles and plastic food containers. Use natural cleaning products around the house. Avoid fragrances and processed foods, especially processed soy.
Encourage sweating: get regular exercise or engage in regular sauna therapy. If you don’t have access to a sauna, epsom salt baths can also work—anything that helps you sweat. Heat therapy has also been shown to benefit mood and the stress response.
Heal your digestion: make this a priority with your naturopathic doctor, so that you can absorb the nutrients from the foods you’re eating as well as encourage daily bowel movements and optimal microbiome balance.
Maintain a healthy weight: body fat is metabolically active and can increase overall estrogenic load. Work with your naturopathic doctor to manage your weight. We often attempt to lose weight to become healthy, however I find my patients have far more success (and fun!) getting healthy in order to lose weight. Healthy weight loss often involves managing stress, sleeping 8 hours a night, avoiding sugar and processed foods, and regulating blood sugar, as well as encouraging proper sweating and liver detoxification.
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If you’re reading this because something about your experience with Mirena hasn’t been fully explained, and you want a clearer, calmer way to understand what your hormones are doing over time, I created Rhythm & Flow, an integrative hormone education course.
It’s not about fixing yourself or chasing symptoms. It’s an orientation to how hormonal systems work across cycles, contraception, stress, and life stages, so changes stop feeling random and start making sense.
I often encourage my patients to write a letter to themselves on their birthdays for the following year using a website called FutureMe.org, where you can post-date emails to yourself to any date in the future. This exercise is great to do on any day, really. Tomorrow is my birthday. I’ll be 32. Here is my letter.
This is it.
This is your life.
As Cheryl Strayed wrote, “The f— is your life. Answer it.”
There are some things that you thought were temporary, mere stepping stones on your way to someplace better, that you now realize are familiar friends, ever present in their essence, but varying in their specific details.
For instance:
1) You will ride buses.
You will never escape the bus. For a while taking the bus was seen as a temporary stop on your way to something else (a car?). You took the bus as a pre-teen, excited to finally be allowed to venture to parts of town alone. As a student, you took the bus to the mall, laughing at the ridiculousness of Kingston, Ontario, once you’d left the protective bubble of the student community, completely inappropriately, yet affectionately (and ignorantly) called The Ghetto.
You will visit other ghettos, also by bus, that are far more deserving of their names. However these ghettos will instead have hopeful names such as El Paraiso, or La Preserverancia. Those who live there will persevere. So will you.
Buses will take you over the mountains of Guatemala, to visit student clients in Bogota, Columbia. To desirable areas of Cartagena. You’ll ride them through India. They will carry you through Asia, bringing you to trains and airports.
You’ll ride buses as a doctor. You’ll ride the bus to your clinic every day.
Sometimes, on long busy days in Toronto, it’ll seem like you’ll spend all day trapped in a bus.
The bus is not a temporary reality of your life. The bus is one of the “f—s” of your life. You’ll learn to answer it. You’ll learn to stop dissociating from the experience of “getting somewhere” and realize you are always somewhere. Life is happening right here, and sometimes “right here” is on the seat of a bus. Eventually you start to open up, to live there. You start to live in the understanding that the getting somewhere is just as important as (maybe more than) arriving.
We breathe to fill our empty lungs. Almost immediately after they’re full, the desire to empty them overwhelms. Similarly, you board a bus to get somewhere, while you’re on the bus, you start to understand.
You’re already here.
Maybe you’ll graduate some day, to a car.
But sooner or later, you’ll board a bus.
And ride it again.
2). You’ll experience negative emotion, no matter who you are or what your life circumstance.
Rejection, worthlessness, sadness, and heart break, are constant friends. Sometimes they’ll go on vacation. They’ll always visit again.
You will never reach the shores of certainty. You will never be “done”. You may take consolation in momentary pauses, where you note your confidence has found a rock to rest its head against. But you’ll grow bored of your rock (it is just a rock, lifeless, after all). You’ll then dive back into the deep waters of doubt, risk despair, and swim again.
Happiness isn’t a final destination. Instead, it’s a roadside Starbucks: a place to refuel, and maybe passing through is an encouragement you’re headed in the right direction.
3). The people in your life are like wisps of smoke.
They will come and go. Some of them will simply whiff towards you, visiting momentarily. Their names you’ll hardly remember. You’ll share ice cream and one deep, healing conversation about love that you’ll remember for years to come. You’ll reflect on this person’s words whenever you consider loving someone again.
You’ll remember the ice cream, the warm sea breeze, the thirst that came afterwards, the laughter. But it will be hard to remember his name… David? Daniel? You won’t keep in touch, but you’ll have been touched.
There will be others who come to seek your help. You might help them. You might not. They might come back regardless, or never return. Many times it will have nothing to do with the quality of your help. Or you.
Sometimes the smoke from the flame will thicken as you breathe oxygen into it. People will come closer, you’ll draw them in, inhale them.
Sometimes you’ll cough and blow others away.
You’ll wonder if that was a wise choice. You’ll think that it probably was.
Does a flame lament the ever-changing smoke it emits? Does the surrounding air try to grasp it? Do either personalize the dynamic undulations of smoke, that arise from the candle, dance in the fading light and dissipate?
Flames don’t own their smoke. They don’t seem to believe that the smoke blows away from them repelled by some inherent deficiency in them. Flames seem to accept the fact that smoke rises and disappears, doing as it’s always done.
4). Not everything is about you.
There will be times when failure lands in your lap. You’ll wonder if it’s because there is some nascent problem with you, that only others can see. These failures will tempt you to go searching for it.
You’ll find these faults. These deficiencies. In yourself, in others, in life itself.
You’ll wonder if it explains your failures. You’ll wonder why the failures had to happen to you.
You think that people can smell something on you, that your nose is no longer able to detect, like overwhelming perfume that your senses have grown used to, but that assaults the senses of others around you.
Failure and rejection, cause your heart to ache. Your heart aches, as all hearts do. The hearts of the virtuous, famous, heroic, and rich ache just as hard. The hearts of those who have committed evil deeds also split apart. (The only hearts that don’t may be the truly broken, the irredeemable. And those people are rare.)
You will experience joys. Your heart will mend and break, a thousands times.
And it has nothing to do with you.
5). Success is not a final destination.
There are no destinations. You will ride buses, you will feel happy, you will feel joy. You will try. You will succeed.
And you won’t.
You’ll pick up the pieces of your broken heart. You will mend them. You will flag down the next bus.
You will board it.
You will grasp—you can’t help it. Grasping will only push the wisps of smoke away, causing it to disappear in your hands. This will frustate you, but you’ll keep doing it.
Over and over.
And failing.
You’ll grasp some more and come up empty, thinking that it is because something is wrong with me. There is lots wrong with you.
There is lots right with you.
Most things have nothing to do with you. (That might be just as painful to accept
But healing as well.)
No one said healing didn’t hurt. Sometimes it f—ing hurts! But, as Cheryl Strayed wrote, “the f— is your life”.
Mindfulness philosophy tells us that our thoughts and emotions are simply phenomena that arise in our bodies and minds: they are not us.
Those of us who suffer from depression and anxiety tend to enter cycles of over-thinking. The mind wanders and engages in self-focused rumination that feeds negative emotions, worsening mood.
While ruminating, we think about the causes and consequences of our depression; we reflect on mistakes we’ve made in the past, we dwell on our perceived personal faults, and we speculate about how we’ll fare negatively in the future.
This kind of rumination becomes a scratch-itch cycle that causes us to feel worse.
However, learning to engage the contents of self-focussed mind-wandering as a non-judgmental observer may be the key to stopping this cycle.
Those who are able to step back and become aware of awareness or think about thoughts, as opposed to getting lost in them, tend to have better control over their thought processes as a whole, and thus their emotions. Mindfulness involves taking a non-judgmental, curious stance about the contents of the mind, as an impartial witness.
Studies show that mindfulness, or taking this non-judgmental, curious stance, can change brain areas associated with rumination, and emotional regulation.
This fall I took a course to obtain a facilitator certificate for Mindfulness-Based Cognitive Therapy (MBCT), an evidence-based 8-week program that aims to treat depression and anxiety through imparting mindfulness skills. Because of the growing evidence base on the benefits of mindfulness for stress and mental health, the facilitator program attracts many medical professionals.
One of the course participants, a psychiatrist, didn’t like me. I noticed her frowning in my direction every time I spoke. She deliberately avoided and ignored me, talking to everyone else in the course but me.
As the only naturopathic doctor in the group, the other participants showed some curiosity towards my field. When I answered their questions, the psychiatrist’s face seemed to twist into a subtle expression of disgust and disapproval.
She thought I was a quack, a hack; I didn’t have enough training. She assumed I wasn’t qualified enough to provide care to those who suffer from mental health concerns. I could feel her judging energy from across the room every time I lifted my hand to answer a question, or make a comment. Her deploring gaze scrutinized my every move.
I was a naturopathic doctor and she, a psychiatrist. We had emerged from different worlds, philosophies, and backgrounds—we were from incompatible ends of the mental health professional spectrum. Of course she didn’t approve of me: it was only to be expected.
We were spending all day meditating, and this is the story my mind had decided to write.
At the end of day 3 of the course, with days of evidence selectively compiled to support my story about this disapproving psychiatrist’s opinion of me, I left class to head for the bus stop. Waiting for the same bus was no one other than my nemesis.
Great, I thought. I smiled at her, stiffly.
She smiled at me.
“Talia, right?” She asked.
I nodded: yes, Talia.
“You’re the naturopath, right?” She inquired, brows kneaded together in a frown.
I nodded again, bracing myself. Are we really going to do this here?
But then, time-space cracked and split open, revealing an alternate universe to the one in my own head. Her face melted into a warm grin, “Oh, I love naturopaths!” She exclaimed warmly.
She went on to describe her wonderful encounters with the members of my profession who had attended to the various personal health concerns she’d faced.
“I’m so interested in holistic health for managing mental health concerns,” She said, before leaning in a bit, conspiratorially, and adding in hushed tones, “You know, psychiatry doesn’t work.”
I stood there, dumbfounded.
Her particular opinions about psychiatry aside: not only was the entire story I’d written and held onto for the past few days wrong, it was way wrong. I had fabricated an entire story in my head, corroborated by what I had been convinced was real evidence. The realization of how avidly I’d bought into this story, as if it were simple fact, was earth-shattering.
My story, had just been that: a story, conjured up by thoughts. These thoughts bore no relationship to reality at all, no matter how convincingly they had presented themselves.
It rare to have the opportunity to experience our mental constructs and biases topple so dramatically. The mind has a tendency to rationalize away any evidence contrary to our beliefs—”Well, I only passed because I got lucky”, or “The test was easy”, or “She said she liked my hair—liar”.
Very few of us entertain the idea that our thoughts and emotions don’t represent our ultimate reality.
According to Mindfulness Theory it helps to think of our minds as movie screens and our thoughts, emotions, and body sensations as contents of the movie. We can watch the action, identify with the characters, and follow the plot with invested interest. The movie can inspire thoughts and emotions within us, both positive and negative. The movie can grip us; we might lose ourselves in the drama, forgetting that we are mere witnesses to it.
It can help to remember that we are not the movie. Sometimes it’s helpful to remember that we’re not even acting in the movie.
No matter how deeply the film may move us, we can always take the stance of movie-going witness. We can take various perspectives in relation to the drama on screen. We can immerse ourselves in the drama, losing our sense of self completely. We can remember that we are audience members, enjoying a film. We can ignore the movie altogether and laugh to a friend sitting beside us. We can be aware of the contents of the movie theatre, the people sitting around and behind us, or the sticky floor under our feet. We can even leave the theatre, which we will certainly do once the credits roll—it’s just a movie after all, a distraction from the reality of our lives.
In the way that we approach the contents on a movie screen, we can take various stances towards the contents of our minds.
Meta-awareness is the act of remembering that we are movie watchers—the act of becoming aware of awareness itself. When we practice meta-awareness, we take a non-judgmental view of our thoughts and emotions, watching them arise in our bodies and minds like the drama in a movie arises onscreen.
We can easily identify with the tens of thousands of thoughts that appear on the movie screens of our lives. We may be convinced that we’re unloveable, that we’re failures, or that life is hopeless, simply because these particular thoughts have appeared in our mind’s screen. We can also identify with positive thoughts, such as the idea that we’re excellent swimmers, or good fathers.
Our thoughts may reflect reality—we may have the thought that if we step into a pool of water our feel will get wet—but simply having a thought does not create reality itself.
While taking the bus that day, I realized that I had unwittingly cast my psychiatric colleague as the guest-star of People Who Are Judging Me, an episode in Unloveable: The Series, which is a piece of entertaining fiction that my mind has written, directed, produced, and cast me as the lead in. I often forget that I’m simply an audience member watching the movie of my mind’s creation—this movie is not necessarily the truth about my life.
Research has identified a network in the brain called the Default Mode Network (DMN), that connects the lower brain areas, like the amygdala and hippocampus, with higher brain centres in the prefrontal cortex. The DMN is active when our minds are wandering and is particularly active when those with depression are ruminating and engaging in narrative self-referencing: or attributing one’s self as the cause of (negative) events in one’s life—for example, interpreting an expression on someone’s face to be a look of disgust and assuming it’s because they disapprove of your profession.
Meditation, particularly practicing meta-awareness, can produce shifts in the DMN that decrease rumination. Practicing meta-awareness allows us to rescue our identities from the tyranny of thought. We watch and detach from thought, watching them rise and fall in the mind without clinging to them. By becoming aware of our thoughts and emotions and taking a curious attitude towards them, we can break the cycle of rumination, thereby supporting our mental health. Observing thoughts, rather than becoming lost in their drama, allows us to feel and behave independently of them.
For example, simply having the thought, “I’ll always be alone,” doesn’t have to produce a negative emotion, if I recognize it as just a thought.
We might reframe the thought “She hates me” to be: “I just had a thought that this person hates me. It’s just a thought that I have no way of knowing for certain is true. I will smile warmly at her anyways. I might be completely wrong.”
Or, we can do nothing, waiting until the thought “She hates me” passes through the screen of our minds.
We can turn off this particular movie, and put on a new one. After all, we can’t stop the flow of thoughts: there will always be others to take their place.
Lesson learned: I am not my thoughts.
And: some psychiatrists are way more hippy than I am.
Estrogen levels in the brain and body affect our brain’s levels of dopamine and norepinephrine, two neurotransmitters that are implicated in mood disorders like depression, psychosis and anxiety.
Our brain has several built-in recycling processes to keep us level-headed. When neurotransmitters (brain chemicals that have mood-regulating effects) are finished with their tasks, enzymes recycle them, breaking them down into their chemical parts to be reused again at a later date. This process controls the level of chemical nervous system stimulation in our brains and keeps our moods regulated.
You’re at home, late a night, working on an important assignment, driven by the excitement of the topic at hand. Your brain is flooded with dopamine, a brain chemical that is connected to positive mood and motivation, pleasure and reward; dopamine pathways are activated when we’re engaged in a task that is pleasurable and rewarding, when our lives are flooded with meaning and we’re working towards a goal. Dopamine, however can also be connected to psychosis, conditions like schizophrenia and bipolar disorder, and also be linked to impulsive behaviour, aggression and irritability, when over-expressed.
Typing happily, you near the end of your assignment. Suddenly, your computer screen goes dark. Your heart begins to race, your skin prickles and you’re overtaken by anxiety, panic and fear. Your body is releasing norepinephrine, a chemical connected to stress, anxiety and the “Fight or Flight” response, but that also allows us to feel alert and energized. Your heart pounds as your reboot your computer. You are hyperaware of the sounds and smells around you. Your skin prickles and your breathing is loud and rapid.
You exhale with relief as your computer screen lights up again, revealing that your assignment is unharmed. Stress drains out of your body, and your norepinephrine levels fall. You begin to tire; it’s time for bed. You add some finishing touches to your work, hit “save” and turn in for the night. The stress and motivation you felt only hours before dwindle, as the neurotransmitters responsible for these responses are swept out of your synaptic clefts and recycled.
When our brains have had enough stimulation of dopamine (mood, reward, pleasure, but also aggression, irritability, impulsivity and psychosis) and norepinephrine (stress and anxiety, “Fight or Flight”, but also alertness and energy), both get recycled through COMT, which pulls them out of circulation, breaks them down into their chemical parts, and reassembles them for later use.
We all have variability in how fast our COMT enzyme works, based on the expression of the COMT genes in our DNA. Some of us have slower COMT genes, meaning that our brain levels of dopamine and norepinephrine tend to be higher than other people’s, as our ability to clean up and recycle these hormones is slowed. This might result in an individual (depending on other genetic and lifestyle factors) who is at a higher risk of mental health conditions like psychosis or bipolar disorder, or someone who is more irritable, prone to aggression, or stress intolerant.
Others have more COMT gene expression, resulting in a faster enzyme that clears dopamine and norepinephrine more quickly, resulting in lower brain levels of these neurotransmitters. If other factors are present, these individuals may be more at risk for mental health conditions such as depression, low mood, lack of motivation, or susceptible to addictions.
Beyond genetics, there are several environmental and biological factors that may affect the speed of the COMT enzyme. One of these factors is estrogen. Estrogen slows the COMT enzyme down by as much as 30%. This means that when estrogen levels are high (seen in many women around ovulation or premenstrually, or in women with generally high estrogen levels, termed “Estrogen Dominance”, COMT performs more slowly and dopamine and norepinephrine levels remain elevated.
Depending on the extent of the problem, women with high estrogen often experience anxiety and irritability and a low tolerance for stress. On the more severe end of the spectrum, some women experience conditions such as PMDD (Premenstrual Dysphoria Disorder) or PMS-induced psychosis, resulting from abnormally high brain levels of dopamine and norepinephrine due to high estrogen. These conditions probably result from a combination of high estrogen, slowed COMT and other genetic and lifestyle factors. Xenoestrogens from environmental toxins, or birth control pills may also slow COMT and further exacerbate some of the symptoms of estrogen dominance.
Conversely, women with lowered levels of estrogen, such as those with amenorrhea (missed menstrual cycles) from various causes—PCOS is one, so is the birth control pill, especially progestin-only pills, or hormonal IUDs—or women who are peri-menopausal or menopausal, will have a faster COMT enzyme. This means that dopamine and norepinephrine will be cleared from the brain more quickly. Low levels of these neurotransmitters may result in depression: low mood, low energy and lack of motivation. On the extreme end, low levels of dopamine in the brain may result in conditions like Parkinson’s. Currently, research is being done on estrogen-replacement therapy as a treatment for Parkinson’s because of its ability to increase brain dopamine levels through slowing COMT.
When it comes to birth control pills, which are combination of synthetic estrogen and synthetic progesterone (“progestins”), or just straight progestin, either in pill-form or in a hormonal IUD, effects can be unpredictable. There is evidence that oral contraceptive use, especially progestin-only contraception, can exacerbate anxiety and depression, especially in teens. The pill acts by suppressing ovulation and suppressing natural hormone production, which may result in low levels of naturally-occurring progesterone and estrogen, which can slow COMT. However, the synthetic estrogens from the pill may interact with COMT, speeding it up in some women. Therefore the effects of specific forms of birth control on individual women is hard to predict; if functional medicine and genetic research tells us anything, it’s that there is no one-size-fits-all when it comes to striking the right hormonal balance.
Estrogen also has effects on another enzyme, called MAO-A, that recycles serotonin, the “Happy Hormone”, often implicated in depression and anxiety. Like COMT, estrogen slows down MAO, reducing the speed at which the body breaks down serotonin, resulting in higher brain serotonin levels. Drops in estrogen around and before a woman’s period, or low estrogen levels, may result in feelings of depression. Many women report feeling depressed and craving carbs and sugar around their periods. This is often related to a drop in serotonin as estrogen levels fall right before menses. Drops in serotonin levels due to drops in estrogen levels after childbirth may explain postpartum depression, according to some researchers.
The link between estrogen and its effects on COMT and MAO hint at the complexities of the body and brain’s hormonal milieu and its implications for hormonal regulation and mental health. Mental wellness is a complex state involving a variety of factors: hormones, enzymes and neurochemical pathways that are affected by our environment, our genetics and our hormonal predispositions. This is why I believe in taking a functional approach to mental health, seeing our mental health symptoms for what they are: symptoms, and making efforts to uncover underlying causes rooted in lifestyle, genetics and our environment. I believe the way to address symptoms is to trace them back to their source.
For many women, treating depression, anxiety and stress-intolerance may involve balancing estrogen levels and healing the menstrual cycle. For others it may involve supporting genetic susceptibilities with lifestyle changes, finding a birth control method that balances (or coming off entirely), and reducing exposure to xenoestrogens, supporting estrogen detoxification pathways, and addressing women’s health conditions such as irregular menses, and conditions like PMS, fibroids, endometriosis and PCOS.
I talk about 8 functional foods that can help calm inflammation, boost neurotransmitter synthesis and restore common nutrient deficiencies that might contribute to low mood and mental health conditions.
My name is Dr. Talia Marcheggiani. I’m a naturopathic doctor with a focus in mental health and emotional wellness as well as hormonal health and hormone balancing, and today I’m going to deliver a short video about some foods that you can add to your diet to help your mental health.
These are all medicinal foods that act like prescriptions, like anti-depressants, that you can just add to your diet. So, a lot of these foods are recommended based on the idea that depression is an inflammatory condition in the brain. There’s more and more research that shows that there’s low levels of inflammation in people who have depression and anxiety and other mental health conditions like bipolar disorder, schizophrenia, ADD, ADHD and even sub-diagnostic symptoms, such as brain fog and cognitive disruptions. So all of these are a result of some kind of inflammation in the brain. And so a lot of these foods are working to heal depression and anxiety with their ant-inflammatory properties.
And so the first thing that’s recommended to eat are lots of anti-inflammatory fats. These are omega 3 fatty acids such as fish oil. So you can either increase the amount of fish oil by having fatty fish three times a week. You can remember what a fatty fish is by the acronym SMASH. And SMASH stands for sardines, mackerel, anchovy, salmon and herring, and also trout, so SMASHT. And these kinds of fish are rich in the omega 3’s EPA and DHA. Our body can make EPA, but some of us have impaired ability to make it. And so supplementing is necessary for a lot of these people. If you’re looking for a fish oil, make sure you look for one that has a higher amount of EPA compared to DHA. This is very important, because studies on depression are very favourable for fish oil supplementation, but the ratio of EPA to DHA has to be at least 3:1 or higher, and the higher the ratio, the higher the amount of EPA relative to DHA, the better the anti-depressant effects, and the mood-regulating effects. So, fish oil actually showed positive outcomes treating bipolar disorder and schizophrenia, so there’s a mood-stabilizing effect as well. And we think because our brain is made up largely of DHA and EPA, but also the anti-inflammatory effects are very helpful for mood and emotional balancing and mood balancing.
Coconut oil is also another great oil you can add to your diet. Coconut oil is a saturated fat, but it’s rich in something called Medium Chain Triglycerides. So these are saturated fats that the body uses readily for energy. So they don’t go through the normal process of digestion that other fats have to go through. They’re absorbed in our lymphatic system. So we get those fats, the energy from those fats, right away.
Coconut oil is very anti-bacterial and anti-fungal, so it can help regulate bacterial balance in our gut and it can give you a boost of energy. There’s also some evidence that being in ketosis, so this means relying on fats for energy, as opposed to carbohydrates, and, to an extent, proteins. Being in ketosis, so burning fat for fuel: body fat or dietary fat, has a mood-stabilizing effect. And so you might read about intermittent fasting, Ketogenic diet. I wouldn’t recommend doing that without working with a functional medicine practitioner, nutritionist or a naturopath, because there are some negative downsides to doing those kinds of diets prolonged, without supervision, but there is some growing evidence for that. But one thing you can do is add coconut oil to a morning smoothie, or eat a couple of tablespoons in the morning, even looking at some Bulletproof coffee recipes, that can also help with keeping your mood steady or your energy high in the morning.
Staying on the topic of fats and nuts, something that is really great for mental health are Brazil nuts. And Brazil nuts are high in a nutrient called selenium, which our body needs to create an anti-oxidant, the main anti-oxidant in our body, glutathione. You may have heard me talk about n-acetyl cysteine, NAC, which is an amino acid that I often recommend for people with bipolar disorder, for schizophrenia and, to an extent, depression and anxiety, and especially personality disorders, like borderline personality. There can be a very strong mood-stabilizing effect with NAC. And that’s probably because—we’re not exactly sure why that is—but it’s probably because NAC is the precursor to what our body uses to make glutathione, but we can’t make glutathione without selenium. So two brazil nuts a day, and they’re really delicious and fun to eat, they’re big nuts—two brazil nuts a day gives you the 200 mcg of selenium that’s the therapeutic dose. It’s also helpful for thyroid health.
Another thing I tend to recommend and am recommending a lot more in my practice is collagen, specifically gelatin, but for the more health-food minded people, going with a collagen hydrosylate supplement from grass-fed meat is something that I often recommend. But, for most people and myself, I just throw some gelatin that you can buy at Bulk Barn, into a shake or into a seed bowl, or into something that I’m eating like oatmeal, or I’ll make jello out of it.
So, gelatin is really rich in collagen, so it’s made from the hooves of animals, and collagen has a gut-stabilizing effect, so it can help heal the gut. A lot of us suffer from something called “leaky gut” in which inflammation in the gut makes its way to the rest of our body and can affect our brain. Leaky gut can often result in “leaky brain”, resulting in inflammation in the brain and then mental health symptoms. So, collagen helps to repair the gut barrier and the blood-brain barrier. It’s also very anti-inflammatory because it’s high in an amino acid called glycine, which is a calming neurotransmitter as well as an amino acid. It can also help balance the immune system. So anyone that has a low level of autoimmunity, or maybe your immune system is on the sluggish side and you’re getting colds and flus and infections more readily than others, collagen is a great supplement for that. Because our main sources of protein: meat, legumes, whole grains, nuts and seeds, don’t contain a lot of glycine. We’re pretty glycine deficient in our society because we’re not eating that much gelatin, we’re not getting as much bone broth. And so you can get collagen from from making bone broth, from stewing bones and accessing that bone marrow, or you can get it from something like gelatin, which is from hooves, from the collagen-rich membranes, the cartilages, of animals. There’s also fish collagen for more pescatarian-oriented people.
Collagen is also really great for anti-aging, for treating hair loss, for skin and for cellulite. So, all aesthetic things that might bring someone in to my practice, but also really great for mood balancing. A good source of protein as well.
You can either just throw it into a shake, mix it into some water or make your own jello. And I make jello by boiling some fruit, about a cup of blueberries in water. I boil it until the blueberry juice is extracted, then I add a couple tablespoons of gelatin and then I put it in the fridge until it’s hard. And you have a natural jello you can serve to your kids. It’s pretty good.
Another great food to help balance your mood and mental health is turmeric. Turmeric, or curcumin, as it’s scientifically called, is a spice that is used mostly in India. It’s a yellow spice, it stains things yellow: your clothes, your counter, your intestines. It has very very strong anti-inflammatory benefits. It also helps the liver detoxify, it’s been shown to have anti-cancer properties, it’s a really powerful, nutrient-rich plant, root. So studies have shown that two grams per day of turmeric actually outperformed Prozac for treating depression and probably this is due to its anti-inflammatory properties in really lowering inflammation in the brain, which we know is really one of the underlying roots of depression. The way that we get to that inflammation is different in every person with depression, but there is this kind of common thread of inflammation that’s going on in every case of mental health condition, mental illness. So, adding turmeric to foods, or supplementing with turmeric, is a great way to combat that inflammation and keep moods balanced.
Some other foods you might want to add to your diet are foods that are rich in zinc. So, these are mainly things like pumpkin seeds. You’ve got to get around two cups, though, of pumpkin seeds, to get a decent therapeutic dose of zinc, or oysters. Or you can supplement with zinc. Zinc, again, is anti-inflammatory, it can help heal the gut. We need it to make neurotransmitters and enzymes that our brain needs to rebalance mood. And there’re also some studies that zinc increases something called BDNF. BDNF is a chemical in the brain that help with neurogenesis, this is the creation of new neurons in an area of the brain called the hippocampus. So you may have heard “you can’t teach and old dog new tricks” or that our neurons never regenerate once we reach a certain age, and this is not true because new research has shown that we do have neurogenesis, something called neurogenesis, that increases and changes and grows new neurons even as we age. And so anyone suffering from brain fog or really high amounts of cognitive stress, or mental illness, maybe benefit from zinc as that increases the neurogenic abilities of the brain. It’s also very anti-inflammatory and it can help with leaky gut and leaky brain situations. Vegetarians, unfortunately, are often deficient in zinc just because we get most of it from animal products and animal sources, but really upping your pumpkin seed intake might get you to a therapeutic level of zinc or you can supplement as well.
Another really great addition to your diet to help balance mood and to improve your mental and cognitive health are fermented foods. So, these include things like kefir, kombucha, kim chee, saurkraut, and yogurt, if you do dairy. These things, they contain probiotics, and studies show that it may be better to supplement or to add fermented foods to your diet rather than supplementing with a probiotic, and this is obviously an individualized recommendation that would have to be made by a doctor, but adding fermented foods to your diet, especially if you make them at home and ferment them at home, like you make your own kombucha or your own kefir, that can actually boost the probiotic capacity of your gut. Probiotics actually make neurotransmitters, they make things like serotonin, and the calming neurotransmitter GABA and they can help us digest our food, like gluten, as well as combat inflammation and regulate our entire immune system. It’s also important to feed those probiotics with something called resistant starch that you can find in carbohydrates that have been cooled to room temperature after they’ve been cooked, so, for example brown rice that’s after it’s been cooked as been cooled to room temperature, potato starch, green bananas, black beans, and jerusalem artichokes. These are all starches that bacteria feed on and that keeps them populated in the gut. Coconut oil tends to kill more pathogenic bacteria and therefore can promote a healthy bacterial balance.
And lastly, I’m going to talk about leafy greens. So, adding a cup of spinach, or two cups of spinach or chard to your diet will give you the amount of magnesium you need. Magnesium has a calming effect on the body. We need it to make the neurotransmitters like serotonin, dopamine and melatonin, to help with sleep. Magnesium also can help balance mood and help us with stress. A lot of us suffer from stress. It can also make our brain more resilient to stress, as stress is one of the major causes of neuro-inflammation in people with mental illness and this can be stress from a significant trauma, it can be psychosocial stress, interpersonal stress, the stress of being out of work, even long-term chronic stress or burnout from school and work and things like that. So, two cups of spinach gives you your daily magnesium serving. You can also get it from chocolate but you need to eat quite a bit of chocolate.
So, in boosting your mental health, or in promoting mental and emotional wellness, you can add all of these foods to your diet and balance your inflammation, feel good and nourish yourself.
In The Myth of Sisyphus, Camus wrote that weariness awakens consciousness, that “Everything begins with consciousness. Nothing is worth anything except through it.” 
