Micro-Dosing for Depression: Research on Psychedelics for Mental Health

Micro-Dosing for Depression: Research on Psychedelics for Mental Health

This article is for informational purposes only.

My friend Nelson (not his real name) was depressed.

Depression frequently came in and out of Nelson’s life, but this last bout was the worst.

Severe job stress compounded by issues with his relationship sent Nelson into a downward spiral, leaving him broken, sobbing and exhausted after engaging in the simplest of tasks.

Sadness and a feeling of doom rushed in to greet him at the end of each sleepless night. Nelson gained weight, despite never truly feeling hungry. His face appeared sunken and swollen. Despite sleeping 14 hours a day, dark circles hung under his eyes.

Since focusing and concentrating on work was impossible, he asked his psychiatrist to help him apply for mental health leave. Nelson was granted sick leave, as well as a prescription for Effexor, and a recommendation to get as much rest as possible. 

After a year, Nelson felt worse. When rest and the medication weren’t working, he started exercising vigorously. He hired a nutritionist who cleaned up his diet, and he started taking fish oil and a B complex, among other supplements.

Even then, he still struggled. The hopelessness was still there. Returning to work at this point seemed impossible.

Nelson opened up to a friend about his struggles.

“I went through a similar thing a few years ago,” Nelson’s friend confessed. “And the thing that helped the most was micro-dosing.”

Micro-dosing, taking small doses of psychedelic substances, like LSD or psilocybin-containing “magic” mushrooms, entered the public consciousness in early 2015, after James Fadiman, PhD and author of The Psychedelic Explorer’s Guide, appeared on the Tim Ferris Podcast.

It involves taking a “sub-perceptual” dose of a hallucinogen, like LSD or Psilocybe cubensis “magic” mushrooms, that contain the hallucinogen psilocybin. A sub-perceptual dose means that, while these substances still exert effects, they don’t produce a noticeable hallucinogenic “high”.

According to Paul Austin at the The Third Wave, people micro-dose for two main reasons: to remove negative mood states, such as depression, anxiety, PTSD, addiction, and ADD; and to increase positive mood states such as flow, creativity, improved productivity and focus, and sociability. 

Micro-dosing has been used experimentally in individuals trying to quit smoking and to heal depression.

After listening to the podcast and reading some of the articles his friend sent him, Nelson managed to obtain capsules containing 200 mg of dried psilocybin mushrooms. Procuring these substances is still illegal, but Nelson figured he had nothing to lose.

When I caught up with Nelson, he was already a few weeks into his micro-dosing regimen. I asked him how he was doing.

“I’m actually feeling better than I have in months,” he told me, smiling. “I’m not passing out on the couch anymore. I wake up at 7 every morning without an alarm. I feel optimistic for the first time in months. And it seems to be consistent!

 

“This week I’ve managed to attend three social events and I seem… more motivated. My workout game improved too. Also, I’m not sure I’m ready to go back to work just yet but I’ve noticed my motivation has picked up. So much so that I’ve started taking free programming courses online. I—I can’t really believe it.”

Research on Psychedelics for Depression

 

Unfortunately, we can’t draw any sound conclusions from Nelson’s experience; scientific data from randomized control studies is still lacking. However, the growing collection of anecdotes on the benefits of micro-dosing for mental health and well-being has caught the attention of researchers.

Thomas Anderson, a PhD candidate at the University of Toronto, polled almost one thousand participants on social media channels and message boards, like Reddit, to gather some initial data on the benefits and drawbacks of micro-dosing hallucinogens. 

The micro-dosers that Anderson and his team polled reported higher levels of creativity, and improved mood and focus. They claimed to notice a reduction in depression and anxiety symptoms, increased motivation to eat right and exercise, cognitive enhancement, improved self-efficacy and heightened social functioning.

They reported that the main drawback they experienced was obtaining these substances, which are currently illegal in The US and Canada.

Although interesting, this self-reported data isn’t hard science. To increase objectivity, Anderson and his team presented the participants with tests of creativity (finding out how many uses they could find for common objects, for instance) and questionnaires that measured wisdom. The micro-dosers scored high on both these metrics. They also scored lower in tests that measured negative emotion.

Anderson and his colleagues plan to publish these preliminary findings in a series of papers. They are currently in the process of obtaining Health Canada approval for a controlled study. 

Psychedelic research was terminated in the 1960’s, leaving a massive knowledge gap of their therapeutic potential. But now, with the publication of Fadiman’s Psychedelic Explorer’s Guide and Michael Pollen’s even more recent How to Change Your Mind, psychedelics are receiving a fresh surge of interest, particularly for their mental health benefits.

One of the prominent names in this new-wave research community is Robin Carhart-Harris, PhD, at Imperial College London, who is investigating psilocybin as a treatment for severe depression.

Published in a 2016 issue of Lancet Psychiatry, Carhart-Harris administered two doses (one small and one moderate) of psilocybin, spaced one week apart, to twelve patients with Major Depressive Disorder. The doses were administered in a controlled, therapeutic setting, and symptoms were rated immediately after therapy, and then again at one and three months.

The study results were remarkable. Five of the twelve patients dropped from “severe depression” to “no depression” immediately after receiving the second dose. All of the study participants experienced an overall reduction in symptoms with five of the study participants remaining depression-free after three months.

Roland Griffiths, Phd, at John Hopkins, is involved in a number of studies examining psilocybin’s ability to induce mystical experiences in terminally ill patients.

In a 2016 randomized, double-blind, placebo-controlled crossover trial published in the Journal of Psychopharmacology, he and his team found that administering high-dose psilocybin to terminally ill cancer patients increased mood, quality of life and optimism, and decreased death anxiety. These benefits were sustained at the six month follow-up. Over 80% of the study participants claimed to experience greater life satisfaction and feelings of well-being.

How Psychedelics Work to Boost Mood

LSD, psilocybin, and other psychedelics, work like serotonin in the brain by acting on serotonin receptors, specifically the 5HT2A serotonin receptors.

Like psychedelics, anti-depressant medications, like SSRI and SNRI medications (Selective Serotonin and Selective Serotonin and Norepinephrine Re-uptake Inhibitors), Cipralex and Effexor, respectively, also work on serotonin pathways. However, these medications’ effects are limited: some people improve on them, while others feel no different, or even worse.

SSRI and SNRI medications activate 5HT1A receptors. According to Carhart-Harris, this makes a difference. In his paper on the “Bipartite Model of Serotonin Signalling” he proposes that these receptor pathways help people cope differently.

5HT1A receptors, acted on by anti-depressants, help with “Passive Coping”. They help individuals with depression tolerate the stress in their lives, be it a toxic work environment or destructive relationship—nothing has changed about the situation, you can just deal with it better. 

Psychedelic stimulation of 5HT2A receptors activate pathways involved in “Active Coping”: identifying and directly addressing sources of stress. Active coping might mean asserting boundaries at work or applying to new jobs. It might look like ending an unhealthy relationship. 

In other words, 5HT2A receptors stimulate neural pathways that reveal previously elusive solutions to problems. They do this by increasing a chemical called Brain-Derived Neurotropic Factor, or BDNF. 

BDNF promotes the growth of new brain cells and neural pathways in the brain. These processes, called “neurogenesis” and “neuroplasticity” , are essential for learning, creativity and memory. Research shows that increased neuronal plasticity benefits mood. 

Psychedelics also work by disconnecting the brain’s Default Mode Network. The Default Mode Network, or DMN, connects frontal areas of the brain, such as the Medial Prefrontal Cortex, with lower brain areas like the Posterior Cingulate Cortex.

When we’re daydreaming, stuck in traffic, sitting in a waiting room, or otherwise not actively engaged in a mental task, our DMN lights up. In these quiet moments, we lapse into a state of reflection and self-referential thinking. In other words, our minds wander.

If we’re in a good mood, this mind-wandering creates narratives, daydreams and fantasies about the future. If we’re depressed, it leads to rumination, negative over-thinking, and self-criticism, which worsens mood. 

Disrupting the DMN allows old thought patterns to fall away, opening up novel possibilities.

Activating Flow States

Shutting off the DMN can help us enter a state of Flow. Flow states occur when we are completely immersed in an activity so worthwhile that our sense of time and self cease. When in flow, we toe the limits of our talents, making these states incredibly rewarding and enriching. They are the antithesis to depressive and anxious mood states.

Psychedelic substances, along with other practices like meditation, help put us in a state of flow. These states are characterized by elevated levels of serotonin and dopamine and calming and focussing alpha brain wave oscillations. When in them, we become capable of incredible things.

In The Psychedelic Explorer’s Guide, James Fadiman writes about “Clifford”, a premed student. Clifford shares,

“I was taking a biology course to prepare for medical school, and we were studying the development of the chick embryo…I realized that in order to stay alert, a tiny dose of LSD could be useful.

 

“With that in mind, I licked a small, but very potent, tablet emblazoned with the peace sign before every class. This produced a barely noticeable brightening of colours and created a generalized fascination with the course and my professor, who was otherwise uninteresting to me.”

Due to some health issues, Clifford ends up missing the final exam. His professor agrees to a make-up. Before the exam, Clifford pops the rest of the now-tiny LSD tablet into his mouth.

The make-up exam consists of drawing the complete development of the chick from fertilization to hatching—the entire course.

“As I sat there despondently, I closed my eyes and was flooded with grief. Then I noticed that my inner visual field was undulating like a blanket that was being shaken at one end. I began to see a movie of fertilization!

 

“To my utter amazement, I was able to carefully and completely replicate the content of the entire course, drawing after drawing, like the frames of animation that I was seeing as a completed film!

 

“It took me an hour and a quarter drawing as fast as I could to reproduce the twenty-one-day miracle of chick formation. Clearly impressed, my now suddenly lovely professor smiled and said, ‘Well, I suppose you deserve an A!’ …the gentle wonder of life was everywhere.”

While impressive, Clifford’s account, like Nelson’s, is merely an anecdote. Far more research is warranted. 

Micro-Dosing for Mood

Micro-dosing allows individuals to tap into the 5HT2A receptor-stimulating, BDNF-increasing, DMN-uncoupling, and flow state activating benefits of psychedelics, without the mind-stabilizing effects.

At a sub-perceptual doses there are no weird colours and visuals, alternate realities, or ego deaths. Micro-dosers report that the world merely appears brighter, or that they feel “sparklier”—they experience greater well-being. Otherwise, they can proceed with their lives normally.

Fadiman’s micro-dosing protocol consists of taking a tenth of a full dose, about 10 to 20 mcg of LSD, or 200 to 500 mg of dried-weight psilocybin mushrooms, every three days. This means that if the first dose is taken on Monday (Day 1), then the second dose is taken on Thursday (Day 4). According to Fadiman, spacing doses avoids tolerance, keeping the doses effective.

Participants are encouraged to engage in their daily activities: working, eating, sleeping and exercising normally.

Fadiman recommends participants keep a record of mood, cognition, motivation and productivity. People often report that they feel the best on Day 2, the day after taking a micro-dose.

Drawbacks to Micro-Dosing

In my role as a naturopathic doctor, I can’t recommend or counsel on the use of psychedelic substances for the treatment of any health condition. While the scientific interest in their use as therapeutic agents is growing, these substances are illegal to obtain and possess, and there is a lack of solid research on their safety and efficacy.

As of right now, the only way to legally access psychedelic therapies is through research. MAPS, the Multidisciplinary Association for Psychedelic Studies, often lists recruitment opportunities for ongoing studies. Thomas Anderson, at the University of Toronto, is in the stages of obtaining Health Canada approval for a randomized control trial on the benefits of micro-dosing in healthy volunteers.

Like all therapies, there are risks to taking these substances, even at low doses. While LSD and psilocybin confer a low risk for addiction and are ten times less harmful than alcohol (the harm scores of LSD and psilocybin are 7 and 5, respectively, compared to 72 for alcohol), they are not completely benign.

Psychedelics can aggravate schizophrenia, psychosis, dissociation, severe anxiety, and panic. They can also interact with medications and supplements that act on serotonin pathways. Their effects at high doses can be disorienting and oftentimes unpleasant: in the studies that showed positive benefit, they were administered under careful supervision, in a therapeutic set and setting.

Our society’s mental health is in crisis. As a clinician who focuses on mental health, I am always excited to learn of new therapies that have the potential to heal mood. With Canada’s 2018 legalization of cannabis, gateways are opening for future uses of psychedelics as medicine. Perhaps with more research and advocacy, we’ll one day see micro-dosing of psychedelic substances as a safe and effective mainstay therapy for promoting mental and emotional well-being. 

5 Key Nutrients for Depression

5 Key Nutrients for Depression

When it comes to improving mood, most of us will do anything, including taking boatloads of pills.

One of the challenges I face as a naturopathic doctor is choosing which supplements to prescribe my patients; in the realm of natural medicine we have what seems like an infinite amount of options.

I can prescribe herbs for regulating the stress response, calming inflammation, or Zen-ing out the brain. I can prescribe amino acids, like 5HTP, which help regulate chemicals in the brain. I can recommend the hottest new products, like collagen, or a greens powder, or the newest Superfood. There are also a host of nutrients that the brain and body need for optimal functioning.

I try to keep my list of supplement recommendations to a maximum of 5, letting diet and lifestyle do the rest of the heavy-lifting. This means that I work in layers. When I see a new patient, I start by prescribing nutrients that fill in nutritional gaps. Perhaps my patients are showing signs of deficiency, based on their health histories, diet diaries or blood results; Or perhaps they just need a bit more nutrient support in the face of physical, mental, emotional and environmental stressors. After they start to notice improvement, we might move on to clearing more layers using herbs or therapies, like acupuncture or Mindfulness-Based Cognitive Therapy.

Naturopathic medicine does not believe in one-size-fits all treatment plans. If I see two patients with depression on the same day, both may receive entirely different plans. I base my recommendations on the person and her unique biography and biology, not the condition. However, because I try to keep my supplement suggestions to a minimum, when I work with patients with depression, I find these 5 nutrients continue to appear on my list.


1. Fish Oil

While most anti-depressant therapies target the brain, we know that depression isn’t simply a brain disorder. Depression is a complex condition impacted by our genes, physical health, social and physical environments, early childhood traumas, current stressors, nutrients status, and many other factors. Our minds and bodies are connected and therefore depression is as much a product of the health of our bodies and our environments, as it is of our brains.

Mounting evidence shows that inflammation in the body plays a major role in depression. Since the 90’s, scientist have found inflammatory cytokines (immune system molecules that cause inflammation), like IL-6 and TNF-a, elevated in depressed individuals.

When pro-inflammatory substances, like lipopolysaccharide (LPS) or interferon-a, traditionally used to treat hepatitis C, are injected into healthy individuals they cause symptoms of depression like lack of motivation and pleasure, and feelings of sadness.

Anti-inflammatory substances are effective anti-depressants. The omega-3 fatty acid eicosapentaenoic acid, or EPA, found in fatty fish like salmon and sardines, is a well-known anti-inflammatory nutrient. One study found that supplementing with EPA prevented depressive symptoms in individuals who were injected with interferon-a.

Fish oil contains the omega-3 fatty acids EPA and docosahexaenoic acid, or DHA. Both of these marine omegas are found in certain fatty fish, which can be remembered by the acronym SMASH: sardines, mackerel, anchovy, salmon and herring (also trout). Fish oil supplements combine EPA and DHA. DHA is a component of our brain mass. It is needed for developing the brain and nervous system of growing babies, and is indicated in pregnant and breastfeeding women. EPA confers the anti-inflammatory benefits.

A meta-analysis composed of 15 randomized control trials involving almost 1000 participants, found that fish oil was an effective therapy for treating depression as long as the fish oil contained over 60% EPA relative to DHA.

Another review of three studies, showed that omega-3 fish oil supplementation reduced depressive symptoms in children and adults by 50%.

When it comes to supplementing with fish oil for depression, it’s the EPA that counts, not the DHA. Also, more fish oil seems to be better than less. Studies that showed the best anti-depressant actions dosed participants with at least 1 gram of EPA per day. Some studies gave patients 2 grams of EPA or more per day. Supplements that showed the most benefit contained higher amounts of EPA relative to DHA.

A 100-gram serving of wild Atlantic salmon contains about 400 mg of EPA, while farmed Atlantic salmon, surprisingly contains more: 700 mg of EPA per 100 grams. While consuming fatty fish, like sardines, and pasture-raised, rather than grain-fed, animals can increase our dietary ratio of omega 3 to omega 6, which has general health benefits, supplementation with a high-EPA fish oil is probably necessary to supply the 1 to 2 grams of EPA per day that have been shown to reduce depression.

2. An Active B Complex

B vitamins are cofactors for thousands of reactions in the body. Cofactors are “helpers”. They help enzymes and cellular process work—without these helpers, important jobs just don’t get done. This can have major implications for our mental health.

For example, the vitamins B6 and folate are needed to convert the amino acids tryptophan and 5HTP to serotonin, the “happy hormone”. Serotonin is a neurotransmitter responsible for managing mood: soothing depression and anxiety; and regulating appetite, memory, and sexual desire. Serotonin is the main target of conventional anti-depressant therapies, SSRI (selective serotonin reuptake inhibitor) medications, which raise brain levels of this chemical.

Both B12, which is important for energy production and neuronal health, and folate, which is important for DNA repair, detoxification and reducing inflammation, have been found to be low in patients with depression. A B12 deficiency, resulting in fatigue, memory loss and low mood, can also mimic the symptoms of depression.

It’s important to supplement with an active form of the B vitamins. This means buying and consuming a B complex or multivitamin that contains B12 and folate in their active forms: methylcobalamin and methyl-folate (or 5-methyltetrahydrafolate, or 5-MTHF), respectively.

Individuals who have a genetic mutation that prevents them from efficiently converting folic acid (a synthetic vitamin found in cheap supplements and fortified grains, like wheat and rice) to active folate, are highly represented in the major depressive disorder population. This gene is called MTHFR C677T and is associated with lower blood levels of folate and an increased risk of depression. To learn more about folic acid and MTHFR mutations, read my article here.

B vitamins are also needed by the mitochondria, the “powerhouses” of our cells. By helping our mitochondria work properly, they help reduce inflammation, boost energy production and promote antioxidant synthesis.

We can find B vitamins in egg yolks and liver. The only dietary sources of B12 are found in animal foods, making it difficult for vegans and vegetarians to get without supplementing. Folate is abundant in leafy greens.

Physical, mental, emotional and environmental stressors create a higher demand for the B vitamins. The B vitamins are water soluble, excreted in the urine and not stored. Therefore, to support neurotransmitter synthesis and energy levels in my depressed patients, I often prescribe a good-quality B complex supplement to complement their diets.

3. Magnesium

Because my clinical focuses are mental health, hormones and digestion, I prescribe magnesium to virtually every patient I see—magnesium is an important nutrient for all of these conditions.

Like the B vitamins, magnesium is a cofactor. It’s involved in helping with over 800 chemical process in the body that simply won’t get done without it. We need magnesium to make cellular energy in the mitochondria, to produce neurotransmitters, like serotonin, and to repair DNA, among many other jobs.

Due to soil deficiency, low intake, stress and decreased absorption, it’s estimated that about 40 to 60% of North Americans are magnesium deficient. Only 1% of the magnesium in our bodies is present in blood. Blood levels don’t reflect the body’s magnesium stores, and so testing for deficiency is unreliable.

Magnesium is a potent muscle relaxer. Deficiencies show up wherever muscles are contracted, rather than relaxed: this can include constipation because of poor intestinal motility, muscle aches and pains, frequent urination due to contracted bladder muscles, menstrual cramps, and headaches and high blood pressure from constricted blood vessels. Insomnia, anxiety and sensitivity to loud noises can also all be signs of a magnesium deficiency. PMS, insulin resistance and sugar cravings are all further indications for magnesium supplementation.

Magnesium can be obtained from leafy greens like spinach and chard. However, most individuals need to supplement to stock up their magnesium levels, particularly if experiencing stress, fatigue, anxiety or depression. Like the B vitamins, magnesium is water soluble, excreted in the urine in response to stress.

A 2017 randomized control trial published in PloS One, found that 248 mg of magnesium chloride decreased the PHQ-9 score of those with mild-moderate depression by almost 5 points. This result compares to standard anti-depressant medications. Despite the relatively low dose and inferior form of magnesium, the effects were well-tolerated and benefits were seen in 2 weeks.

I prescribe magnesium glycinate, a much better-absorbed form, before bed to help patients sleep better. This means starting with 100 to 200 mg per night and increasing by that amount every 3 to 4 days or until patients are having a bowel movement on waking—this is called “prescribing to bowel tolerance”.

A side effect of taking too much magnesium is loose stools, or soft stools that fall apart in the toilet on flushing, which can be corrected by lowering the dose. I personally take about 900 mg of magnesium at night to manage my stress, mood, energy levels and muscle tension.

4. Vitamin D

About 70 to 90% of North Americans are deficient in vitamin D, which acts like a steroid hormone rather than an actual vitamin, and regulates over one thousand genes in the body. Our skin makes vitamin D when it comes into contact with UVB radiation from the sun. Those of us who live in northern climates with limited sun exposure don’t make enough vitamin D and need to supplement, especially during the Winter months.

Vitamin D is needed to regulate the gene Tryptophan Hydroxylase 2, which converts the amino acid tryptophan (a component of protein that can only be obtained from diet and is found in foods like turkey and pumpkin seeds) to serotonin in the brain.

Low vitamin D concentration has been associated with depression, however researchers aren’t sure if the relationship is causal: does low vitamin D status put someone at risk for developing depression? Or do depressed individuals have low vitamin levels in their bodies because of some other factor?

Studies have failed to show that taking vitamin D supplements impacts depression. I also haven’t found vitamin D to impact my patients’ moods as a solo therapy. It’s likely that nutrients like vitamin D acts as part of a network, in conjunction with other vitamins, like magnesium, which is responsible for converting supplemental vitamin D into the active form. Vitamin D is a fat-soluble vitamin, and taking it in chalky tablet form may not raise levels. I prescribe vitamin D3, the active form of the vitamin, in drop form. Vitamin D drops are suspended in fats like coconut or flax oil, which makes them easier for the body to absorb.

Whether a case of the chicken or the egg, when it comes to vitamin D and mood, we know that supporting vitamin D status is essential for achieving optimal health, managing immune function, reducing inflammation, reducing the risk of osteoporosis, and regulating mood, given vitamin D’s role in serotonin synthesis.

The Framingham study found that patients who had low levels of vitamin D had poorer mental functioning and reduced volume of a brain region called the hippocampus, which is responsible for memory formation and mood regulation. Reduced hippocampal volume is a risk factor for and consequence of major depression.

There is a “sweet spot” to optimal vitamin D levels; because it’s a fat-soluble vitamin and can be stored, too much vitamin D may be as bad as too little. Therefore, I like to measure my patients’ blood levels in the Fall to determine the right dose for supplementation. 4000 IU a day is a good, safe dose for most people during the Winter months.

5. Zinc

Zinc is the catalyst for hundreds of enzymes in the brain, including making serotonin, norepinephrine and dopamine, all of which are brain chemical targets of anti-depressant therapies.

There is a major concentration of zinc in the hippocampus, a brain region affected by depression. Studies show that zinc plays a role in supporting neurogenesis (the creation of new brain cells) by stimulating Brain Derived Neurotrophic Factor (BDNF). BDNF creates new brain cells and boosts mood. Anti-depressants may work by increasing brain levels of BNDF, protecting the brain against stress.

Plasma zinc concentrations are lower in major depressive disorder. Animal studies also show that depleting zinc can lead to major depression.

Zinc supplementation has been shown to boost mood. A study of 50 overweight or obese patients were assigned to receive either 30 mg of zinc or placebo. After 12 weeks, the group who received zinc experienced a greater reduction in the severity of their depression and an increase in the levels of BDNF in their brains.

Zinc is also an important nutrient for supporting the immune system and managing inflammation.

Besides depression, other signs of zinc deficiency include skin issues, like dry skin and acne, infertility, issues with gut membrane integrity (leaky gut), hair loss, low testosterone, poor immune function and fatigue.

Dietary sources of zinc are harder to come by for vegans and vegetarians, who are at a higher risk for developing a zinc deficiency. Zinc can be found in red meat, shellfish, lentils and pumpkin seeds.

I typically prescribe zinc the way I prescribe iron, in pulse doses: I recommend that patients work their way through a bottle of zinc (taking 30 to 100 mg per day), while we assess whether symptoms improve. Unlike iron (which we can measure more accurately by looking at its storage molecule ferritin), zinc can’t be accurately measured in blood. Like magnesium, zinc deficiency in the body’s tissues may be present long before low zinc levels show up in blood.


While this list can be a great tool for anyone interested in supporting their mood through boosting nutrient status, keep in mind that this information is not a substitute for medical advice.

I believe it’s essential to work with a naturopathic doctor, or a functional medical doctor, who can make the appropriate recommendations for your individual health needs. A personalized consultation that assesses your diet, blood work, health history and specific symptoms, can help you hone your list to come up with a dynamite nutrient plan that’s specifically tailored to you.

Maintaining Perfect Equanimity: My 10-Day Vipassana Retreat

Maintaining Perfect Equanimity: My 10-Day Vipassana Retreat

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.

 

Here Comes the Sun: How Circadian Rhythms Can Heal Our Mental Health and Hormones

Here Comes the Sun: How Circadian Rhythms Can Heal Our Mental Health and Hormones

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.

Even pain and cancer growth follow a circadian rhythm.

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.

Similarly, more research shows that eating before bed can lead to adverse health effects and cause us to gain weight. 

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.

Some Like it Hot: Using Heat to Heal Depression

Some Like it Hot: Using Heat to Heal Depression

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.

 

21-Day Blood Sugar Reset

21-Day Blood Sugar Reset

Introducing a 21-Day Blood Sugar Reset 

The Low Carb, High Fat or “Ketogenic” Diet has been touted as a health solution for weight loss, mental health, hormonal health, as well as a treatment for insulin resistance, diabetes, childhood seizures, migraines, and dementia.

It consists of eating foods like meat, fish, and non-starchy vegetables, and plenty of healthy fats from avocados, coconut, olives, nuts and seeds, while avoiding starchy foods like grains, legumes, fruit and root vegetables.

Our bodies and brains can use two main types of fuel: sugar and fat.

In this 21-day challenge we will teach our bodies to burn fat for fuel.

Some argue that fat is a “cleaner” fuel source than carbohydrates.

Ketone bodies, produced from fat have been shown to decrease inflammation, improve mitochondrial function—our cells’ power supply—and boost cognition. Ketone bodies also keep us full for longer, our brain sharp and focussed, and our energy abundant and sustained.

Many are introduced to low carb diets through their weight loss journeys. When we restrict carbohydrates, our bodies burn dietary fat and body fat for energy. Furthermore, less dietary carbohydrates means less insulin release. Insulin is our storage hormone, that prevents our bodies from breaking down fat, possibly impeding weight loss. When we cut out carbs we reduce our insulin levels, helping to heal insulin resistance, and helping our bodies shed fat.

To be perfectly honest, I don’t believe in diets,

particularly trendy diets that have names and followers, like groupies at a rock concert.

I believe that how we eat has a LOT to do with our individual biochemistry, our genes, our gut bacteria, our culture, our preferences, our job, our family, our free time, our individual health goals and health challenges.

Diet (or since diet is often a trigger word, but honestly all I mean by it is “way of eating”, or daily nutritional practice), is highly individualized. There is no one-size-fits-all diet.

HOWEVER, I do believe in resets.

I believe all adults could do well with a dedicated amount of time: 14 days, 20 days, 30 days, etc.: in which we really examine our relationship with food. In which we strip our diets down to the bare bones and examine our blood sugar, food sensitivities, food addictions, tendencies to emotionally eat, taste buds, etc.

After all, the human “diet” is essentially meat and vegetables. What happens when we strip all the fluff away? What might we discover about our bodies and minds? About our habits? About ourselves?

This way of eating restores metabolic flexibility, gets us burning fat for fuel (in addition to carbs when you add them back in after the 21 days). It helps us manage blood sugar, which is implicated in chronic stress, acne, diabetes, and hormonal disruption to name a few conditions and symptoms.

Obviously this challenge is not for those who struggle emotionally with food and need more one-on-one focused support, but it is an excellent way to be held accountable, to take on a challenge in which you’re given all the tools you need to do the discovery work.

You might discover that this is the best eating style for you.

You might restore your insulin sensitivity but discover that you need some carbs, or certain carbs, to feel your best.

You might discover hidden food sensitivities that have been plaguing you with inflammation for years.

For more information visit taliand.com/programs/

Reflections on Being a Patient

Reflections on Being a Patient

I will never get annoyed at a patient’s “lack of compliance” again.

Health care is scary, even when you know what you’re doing. When it’s your own health, putting yourself in the hands of a professional is not easy.

Yesterday I had an initial consult for myself with a nutrition specialist. She’s well-known in her field, super-academic, in her 70s, and has published books and papers.

She knows her stuff. She’s also really helped a friend of mine and the referral came from him. I had every reason to trust her and feel good about putting myself in her hands.

However, I was nervous getting ready to see her. I filled out a diet diary… what would she think? What would she say about my blood work? Would she be nice? Would she be understanding? Would we get along?

Survival instincts kick in.

We talked about a few things in the first visit (which cost an arm and a leg, but will be worth it if I’m left feeling great) and she prescribed some supplements for me to take.

I left, kind of satisfied. Ready to get on with our journey, with a list of things to pick up, dosages to tweak, things to consider and instructions to book again in 3 to 4 weeks.

Ok.

I woke up this morning, in the early hours tossing and turning, thinking to myself, “I don’t want to take vitamin E!” And “Did she truly understand my concerns?” And “what are all these supplements treating?” and “did she really hear me out?” And, “is all this going to actually help?”

The impulse to not trust, to run and hide, to override her assessment and recommendations with my own were overwhelming. (And, of course, as someone who does what she does for a living, the struggle to overcome this is real, we’re “experts” on the body, but it’s nice to let someone else give direction for a change, especially someone with 30+ more years’ experience).

Still, trusting is hard.

Being aware of the impulse to run and avoid, while also resisting the impulse, is hard.

I have people who neglect booking a follow-up even when they know that we still have lots of work to do.

I have people who don’t fill out diet diaries for fear of actually taking a hard look at their food intake.

I have people who email me that “nothing is working” when in fact they haven’t started taking their nutrients and supplements yet.

And, guess what, as frustrating as that may be (because ultimately, I want people to have success! I want people to heal), I’m doing the same thing.

Jeez, being in the patient chair is mighty humbling.

I highly recommend it to all my health practitioner colleagues out there.

And, yes, now I’m taking vitamin E. I’ve decided to just trust. (But I’m still taking my own multi-vitamin… hey, doctors make the worst patients… amiright?)

A Letter to Myself at 32

A Letter to Myself at 32

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”.

And answering it is your life’s process.

Volunteering at the Evergreen Yonge Street Mission

Volunteering at the Evergreen Yonge Street Mission

An interview outlining my adventures providing free naturopathic medicine to street youth at the Evergreen Yonge Street Mission health centre, originally featured in Pulse, a publication for members of the Ontario Association of Naturopathic Doctors.

What is the Evergreen Yonge Street Mission?

On the fourth Friday of every month, I leave my Bloor West Village practice for a few hours and head down Yonge Street.

Just south of Gerard, I stop at a rather unimpressive-looking building tucked between fast-food restaurants and strip clubs, where an admittedly intimidating crowd of young people are smoking and laughing loudly, hoodies drawn.

I nod to them briefly before heading past them, through a glass-paneled doorway.

The entrance is crowded. Youth and tattooed counselors blast rap music out of large headphones. Some of them have notebooks, writing lyrics.

Beyond them is an open area where food is being served; more young people sit at round tables, finishing hot catered lunches, or drinking coffee. A few are involved in some community project or other, conspiring excitedly in groups. Everyone seems to be embracing a perplexing combination of busyness and inertia.

I smile at them and rush downstairs to the basement, past the career centre to the unglamorous health centre where my tiny office is located.

The Evergreen Yonge Street Mission (YSM) is a drop-in centre for street-involved youth aged 18 to 24 that offers afternoon programming, including a hot lunch, career services, daycare, community-based art projects, and drop-in healthcare centre.

The health centre is run by nurse practitioners and staffed by volunteer health professionals: adolescent health specialists, family doctors, Sick Kids residents, dentists, hygienists, acupuncturists, chiropractors, physiotherapists, social workers, psychiatrists and, of course, two naturopathic doctors, Dr. Leslie Solomonian, and myself.

Youth drop in during health centre hours and sign up for 30-minute appointments with the practitioner of their choice.

How did you start working with the Mission?

I first visited the Evergreen YSM for a launch party for the second issue of Street Voices, a magazine for and by street-involved youth. A friend of mine had volunteered to do most of the graphic design and illustration work for the issue and brought me along.

At the party, while eating tiny sandwiches, I noticed a message board advertising YSM services. Naturopathic medicine was listed under health services provided at the centre. I took down the number of the health centre, and gave them a call the following week.

By February 2015, I was volunteering two Fridays a month.

Why did you decide to get involved with the Mission?

I came across Evergreen at the beginning of my naturopathic career. I’d just obtained my license in 2014, and was looking for a way to balance the cost of living and running a practice with providing access to naturopathic services.

Naturopathic medical services have the potential to be very cost-effective; our profession was built on the foundations of clean air, food, and water as vehicles for healing. Nature cure, lifestyle therapies, and in-house treatments like acupuncture can all be very inexpensive to administer.

Unfortunately, the cost of education, licensing fees, and practice overhead all conspire to bring up the cost of naturopathic services, making it difficult for those without third-party insurance coverage to afford them.

When I first started my practice, I tried to find various solutions to this problem. I dabbled in sliding scales but quickly started to notice burnout and resentment polluting my therapeutic relationships. Separating cost, value and worth, while accurately assessing need, complicated things for me—I found it very difficult to lower my rates while still recognizing the value I was offering.

Dispensing with sliding scales at my main practice while offering free services to a marginalized population felt like a satisfactory compromise: I could build my practice, pay for my groceries, and give back, while maintaining clear boundaries.

What type of naturopathic care do you provide at the YSM?

There are a few ways that my YSM practice differs from my practice in Bloor West Village.

Firstly, visits are shorter. The YSM suggests keeping visits to 30 minutes to serve as many patients as possible. Keeping visits short is a challenge for me, considering appointments in my Bloor West practice run 60 to 90 minutes.

Secondly, therapeutic options are limited. Patients don’t have the cash to buy supplements. Making significant dietary changes is impossible for most to tackle. Therefore, I try to offer therapies in the clinic: acupuncture, B12 shots, homeopathic remedies, and counseling, to reduce the work between appointments.

Sometimes we have supplements to dispense—Cytomatrix generously donated last year. At times we’ve been able to offer things like magnesium, vitamin D, iron, immune support, adaptogens, and sample packs of various probiotics.

Treatment plans often require a bit of innovation. For example, I teach patients how to use the probiotic samples to make coconut yogurt using canned coconut milk from food banks. We talk about how to follow an anti-inflammatory diet while eating at a shelter.

Thirdly, there are many obstacles that prevent patients from attending appointments in the first place. I try to treat each visit as a stand-alone encounter—a new patient I see at Evergreen may never come back. This means I focus on stress-reduction and providing as much benefit as possible in the 30-minute session.

What does a typical visit look like?

Visits can differ greatly depending on the particular needs of the patients I see.

Sometimes new patients come in asking specifically for trigger-point release acupuncture.

One patient came in with her friend so they could Snapchat their first acupuncture session amidst violent giggling.

Some patients come to talk about their struggles and share their stories.

Sometimes patients come in to read me their rap or poetry.

Sometimes patients just come in to sleep—the flimsy chiropractic table we use serving as a quiet, 30-minute refuge from the street. Sometimes we do a mindfulness practice. Other times we say very little, or nothing at all.

Others come for full intakes, with complicated psychiatric cases, or PCOS, or chronic diarrhea. I try to hand out any supplements that might be useful, and to give practical recommendations.

Sometimes patients with part-time jobs have a little money that they can spend on things like St. John’s Wort, magnesium, or vitex.

I have to be extremely economical with my therapies, which I feel is a helpful skill to have as an ND in general—I learn what simple treatments have the biggest impact on certain conditions. This helps me resist the temptation of loading patients down with complicated, expensive treatment plans.

What are some strategies for working with this population?

When working with street-involved youth, I’ve found it helpful to humbly take a step back and listening first before jumping in with solutions.

A de-centred practitioner posture can be particularly helpful in a population experiencing homelessness, violence, complex trauma, addiction, teen pregnancy, abuse, conflict with authority, and severe psychiatric illnesses, among other complex challenges—it’s not always clear what to do, what might best help the individual in front of me, and deferring to their experience is often the wisest first step.

De-centring positions the clinician as a guide, facilitator, or someone of service to the patient. This means that I offer my tools: an ear, acupuncture, vitamin D, or a sanctuary of silence, and let my patients choose whatever they want for their 30-minute appointment.

Another helpful skill is being interested in all my patients’ stories, even the ones that aren’t being told about them.

In Narrative Therapy this is called “double-listening”. Accompanying every story of illness, addiction, label of mental illness, or history of trauma, is a parallel story of strength, courage, generosity, and overcoming tremendous obstacles.

I can be a witness to the alternative stories, which are often begging to be told.

Sometimes addiction, self-harm, or other seemingly “destructive” behaviours, may be hidden coping mechanisms that serve as powerful lifelines for survival. Listening between the lines can highlight certain skills and strengths of those who suffer.

A mentor of mine, when faced with an “angry” client, always asks, “What are you protesting?” With that simple reframing question she often uncovers previously hidden stories of belief in fairness, advocacy for justice, courage, and resilience.

Patients tell me about their issues, but also about their beloved pets, how they wish they could be a better father to their children than their fathers were to them, family loyalty in the face of abuse, their dreams for the future, the steps they’ve taken to confront a friend’s addiction, their hopes for a healthier romantic relationship, and many other stories. These narratives depict the complex facets of their identities: street-youth, yes, but also loving parents, friends, budding entrepreneurs, and gifted artists.

One patient who’d recently been diagnosed with schizophrenia told me about the voices in her head. I asked her what the voices said when they spoke to her.

She looked at me, stunned.

“No one’s ever asked me that before.”

This question led us to an important discussion about how she’d turned to writing poetry and her faith to help her stop using methamphetamine. The voices, while often unpleasant, were keeping her sober in their own complex way, she realized.

Through paying careful attention to these stories, patients can reframe and foster preferred identities.

Do you have any stories in particular?

There are many stories of resilience at Evergreen. I have had the opportunity to watch one of my patients transform his life over the past couple of years.

With a criminal record for assault, anger management issues, difficulty holding a job, a mild learning disability, and a history of complex trauma, this individual picked up the pieces of himself, slowly.

The last time I saw him he had completed a yoga teacher training, begun classes at U of T, and was getting ready to move out of the shelter he’d been living in, into his own small apartment.

Through his own remarkable resilience, and some support he was able to receive at Evergreen, he was able to get himself onto an amazing and exciting path. Seeing potential realized is an amazing experience.

Like tending to a garden of souls; you might help plant seeds, or tend to the soil in very simple, minimal ways, and yet amazing things bloom.

What benefits has this work brought to you as an ND?

I believe working with diverse populations enriches practitioner experience. It reminds me to stay open to experiences, personalities, viewpoints, and unique patient histories.

Listening helps me calm the “righting reflex”: the reflex to jump quickly to a solution in order to soothe my own discomfort of sitting with the agony of uncertainty.

I notice in my own practice when I take a more de-centred stance, roll with resistance, and really pay attention to my patient’s preferences and intuition, I am better able to assist them in healing. Not only does letting the patient take the lead result in better outcomes, it also reduces the burden of (impossible) responsibility by shifting the locus of control, preventing burnout.

I struggle with this in my own practice at times; I frequently feel pressure to prove myself. Working at Evergreen helps remind me that we can’t necessarily help everyone for everything in every circumstance.

All of our patients surpass incredible external and internal obstacles to arrive at our offices and face still more difficulties between visits. Trying to recognize and work with these struggles as best we can, taking small but meaningful steps in and between visits, and acknowledging that sometimes it’s about planting seeds of change, which may take months or even years before they’re ready to bloom.

No matter how impatient I might be feeling with a patient’s progress, I try to remember that steps are constantly being taken in the direction of healing.

What are some challenges?

Like any novice practitioner I am accompanied by two familiar acquaintances: self-doubt and second-guessing. These two friends take their place beside me both in my Bloor West practice and at Evergreen.

Celebrating small victories has been important, but so has staying humble. As the mantra goes: the patient heals them-self.

I try to remember this when I’m either feeling too self-congratulatory or too down on myself.

Funding for supplements, energy, avoiding burnout, and being productive with time, are all familiar challenges I also routinely experience.

I always wish I had more time, better and more exciting remedies to dispense, and more energy to really immerse myself in the dedication community work demands.

I try to take the stance of simply being of service while trying to remain free of expectation.

How can other NDs wanting to do similar work get involved?

If you’re interested in working with marginalized populations, the first thing to do is get in touch with local shelters, such as Covenant House or Eva’s Place.

Many shelters offer satellite health services, such as massage therapy. Perhaps start by offering acupuncture, or other forms of bodywork. Acupuncture is an accessible modality that is cost-efficient and fits well with a drop-in model—patients derive benefit from the session and aren’t expected to make significant lifestyle changes or purchase supplements, both of which may be impossible.

Often stress-relief is the first primary goal of care, as is creating a safe space and nurturing trust between the clinician and community.

If you’re willing to offer your services for free there are many populations in Toronto and the GTA that could benefit greatly from naturopathic care.

How can we help?

The YSM is currently accepting donations to help build their new location, and complete their new health centre. Visit https://www.ysm.ca/donate/ to make a one-time, or monthly donation, and help a great cause.

If you would like to donate supplements, acupuncture needles, homeopathic, or herbal remedies please contact me!

Preventive Medicine: 9 Root Causes of Disease

Preventive Medicine: 9 Root Causes of Disease

I often get emails like this, “Dear Doctor, please tell me your favourite natural cure for anxiety”, to which I often reply:

Dear, Anxiety,

Imagine you are a gardener, tending to your garden. You are a skilled gardener: you tend lovingly to your plants every day and you care deeply for their welfare.

You are the perfect gardener in every way, except for one: for some reason you don’t know anything about soil.

No one has ever taught you about the damp, dark soot that envelopes the roots of your beloved plants, kindly offering to them its protection, water, and nutrients.

You are a gardener, but are innocently oblivious to the fact that soil must be nurtured by millions of microbes, and that nutrients in the soil must be replenished. You have no idea that the other plants sharing the soil with your garden form a complex network of give and take, depositing nutrients into it, while greedily sucking others away.

Now, as this soil-ignorant gardener, imagine your surprise when, despite your care and attention, the plants in your garden wither and die, bearing no flowers or fruit.

Imagine your frustration when your efforts to prop up tired stems fail. You apply water and fertilizer to buds, leaves and stems. You stand by, powerless, as your garden dies.

Notice the weeds taking over your garden, which you lop off at their stems, unaware that their roots reside deep inside the earth.

When the weeds pop up again and again, you slash at them, burn them, and you curse the skies.

“Why me?”

Why you, indeed.

You are unaware of root gardening, soil gardening, just as many of us are unaware of root medicine—soil medicine.

You see, Anxiety, there are many natural remedies that can help.

However, tossing natural pills at twitching nerves, imbalanced blood sugar, unregulated stress responses, and various nutrient deficiencies, might be as naive a practice as spray painting your roses while they wilt in sandy earth, beneath their red paint.

It might be akin to prescribing anxiety medication or a shot of vodka to calm your trembling mind; you might feel better for a time, propped up with good intentions, before collapsing in the dry soil encasing you.

With no one to tend to your roots you eventually crumple, anxiety still rampant.

“Why me?” You curse the skies.

Rather than asking, “Why me?” it might help to simply start asking, “Why?”

While it is important to understand the “What” of your condition—What disease is present? What is the best natural cure for anxiety?—naturopathic doctors are far more interested in the “Why”.

As Dr. Mark Hyman, functional medical doctor, asks:

Why are your symptoms occurring?

Why now?

And why in this way?

Naturopathic doctors prescribe natural remedies for conditions such as anxiety, it’s true. However, naturopathic medicine is a medicine that first tends to the soil.

Naturopathic doctors first look for and addresses the roots of symptoms, working with the relationships that exist between you and your body, your food, the people in your life, your society, your environment—your soil.

Healing involves taking a complete inventory of all the factors in your life that influence your mental, physical, and emotional wellness. It requires looking at the air, water, sunlight, nutrients, stressors, hormones, chemicals, microbes, thoughts and emotions that our cells bathe in each day.

Healing means looking closely at the soil that surrounds us. It requires asking, What are the roots that this condition stems from? And, What soil buries these roots? Does it nourish me?

Do I nourish it?

The causes of disease can be interconnected and complex. Very often, however, there are common root networks from which many modern-day chronic health conditions arise.

Starving Gut Bacteria.

It was Hippocrates, the father of medicine, who first proclaimed that “All disease begins in the gut.”

Our digestive systems are long, hollow tubes that extend from mouth to anus, and serve as our body’s connection to the outside world. What enters our digestive system does not fully become the body until the cells that line that digestive tract deem these nutrients worthy of entering.

Along their 9 metre-long, 50-hour journey, these nutrients are processed by digestive enzymes, broken down by trillions of beneficial bacteria, and sorted out by the immune cells that guard entrance to our vulnerable bodies.

Our immune cells make the judgement call between what sustains us, and what has that potential to kill us. For this reason, about 70% of our immune system is located along our digestive tract.

Our gut bacteria, containing an estimated 30 trillion cells, outnumber the cells in our body 3 to 1. Science has only just begun to write the love story between these tiny cells and our bodies. These bacteria are responsible for aiding in the digestion of our food, producing essential nutrients, such as B vitamins and fat-soluble vitamins, and keeping our intestines healthy.

However, this love story can turn tragic when these little romantics are not properly fed or nurtured, or when antagonists enter the story in the form of pathogenic bacteria or yeast.

Our microbiome may impact our health in various ways.

Studies are emerging showing that obese people have different gut profiles than those who are normal weight. Our gut bacteria have a role in producing the hormones that regulate hunger, mood, stress, circadian rhythms, metabolism, and inflammation. They regulate our immune system, playing a role in soothing autoimmune conditions, and improving our ability to fight off infections and cancer.

Psychological and physical stress, inflammation, medication use, and a diet consisting of processed food, can all conspire to negatively affect the health of our gut. This can lead to a plethora of diseases: mood disorders, psychiatric illness, insulin resistance, cardiovascular disease, chronic pain and inflammation, obesity, hormonal issues, such as endometriosis, autoimmune disease, and, of course, chronic digestive concerns such as IBS, among others.

As Hippocrates long knew, one doesn’t have to dig for long to uncover an unhappy gut microbiome as one of the primary roots of disease.

Our gut has the power to nurture us, to provide us with the fuel that keeps our mood bright and our energy high. However, if we fail it, out gut also has the power to plague our cells with chronic inflammation and disease.

To be fully healthy, we must tend to our gut like a careful gardener tends to her soil.

This involves eating a diet rich in fermented foods, like kefir, and dietary fibre, like leeks, Jerusalem artichokes, and black beans. It also means, consuming flavonoid-rich foods like green tea, and cocoa, and consuming a colourful tapestry of various fruits and vegetables.

Healing our gut requires avoiding foods it doesn’t like. These may include foods that feed pathogenic bacteria, mount an immune response, kill our good bacteria, trigger inflammation, or simply those processed foods that fail to nurture us.

To heal ourselves, first we must feed out gut.

Confused Circadian Rhythms.

For hundreds of thousands of years, all of humanity rose, hunted, ate, fasted, and slept according to the sun’s rhythms.  

To align us with nature, our bodies contain internal clocks, a central one located in brain, the suprachiasmatic nucleus, which is susceptible to light from the sun, and peripheral clocks located in the liver and pancreas, which respond to our eating patterns.

Our gut bacteria also respond to and influence our body’s clocks. 

However, the invention of electricity, night shifts, and 24-hour convenience stores, means that our bodies can no longer rely on the outside world to guide our waking and sleeping patterns. This can confuse our circadian rhythms, leading to digestive issues, insomnia, daytime fatigue, mood disorders, and problems with metabolism, appetite, and blood-sugar regulation.

Dr. Satchin Panda, PhD, a researcher at the Salk Institute in California, found that mice who ate a poor diet experienced altered circadian rhythms. However, he found that when these mice were fed the same diet in accordance with their natural rhythms, they weighed less, had lower incidences of diabetes and cardiovascular disease, had better cognitive health, and lived longer.

These findings indicate that perhaps it is not what we eat but when that may impact our health.

Perhaps it is that an unnatural diet disconnects us from nature, or that this disconnection tempts us to choose non-nutritive foods, but the research by Dr. Panda and his team reveals the importance of aligning our daily routines with our bodies’ natural rhythms in order to experience optimal health.

According to Dr. Panda’s findings, this involves eating during an 8 to 12-hour window, perhaps having breakfast at 7am and finishing dinner early, or simply avoiding nighttime snacking.

For many of us, this may involve making the effort to keep our sleep schedules consistent, even on weekends.

For most of us, it involves avoiding exposure to electronics (which emit circadian-confusing blue light) after the sun goes down, and exposing our eyes to natural sunlight as soon after waking as possible.

Nature Deficit Disorder.

Nature Deficit Disorder is a phrase, coined by Richard Louv, in the 2005 book, Last Child in the Woods.

According to Louv, a variety of childhood problems, especially mental health diagnoses like ADHD, are a direct result of our society’s tendency to increasingly alienate children from nature.

With most of humanity living in cities, nature has become a place we visit, rather than what immerses us. However much modernization might remove us from nature, our bodies, as well as the food, air, water, sunlight, and natural settings they require to thrive, are products of nature, and cannot be separated from it.

A Japanese practice called Shinrin-Yoku, or “Forest Bathing”, developed in the 1980’s to attempt to reconnect modern people with the healing benefits of spending time in a natural setting. There is an immediate reduction in stress hormones, blood pressure, and heart rate when people immerse themselves in natural environments, such as a forest. 

Whether we like it or not, our roots need soil. It is possible that the components of this soil are too complex to manufacture. When we try to live without soil, essential elements that nourish us, and the various relationship between these elements are left out.

When we remove ourselves from nature, or ignore it fully, we become like gardeners oblivious to the deep dependency their plants have on the soil that enshrouds them.  

Connecting with nature by spending time outside, retraining our circadian rhythms, connecting with our food sources, and consuming natural, whole foods, may be essential for balancing our minds, emotions, and physical bodies.

A Lack of Key Building Blocks.

Our bodies are like complex machines that need a variety of macro and micronutrients, which provide us with the fuel, building blocks, vitamins and minerals that we need to function.

As I child, I would play with Lego, putting together complex structures according to the blueprints in the box. When I discovered that a piece was missing, I would fret. It meant that my masterpiece would no longer look right, or work. If I was lucky, I might find a similar piece to replace it, but it wouldn’t be the same.

After looking long and hard for it, sometimes the missing piece would turn up. I’d locate it under the carpet, my brother’s bottom, or lodged in a dark corner of the box. Often our bodies don’t get that lucky.

Nutrients like vitamin B12, perhaps, or a specific essential amino acid, or a mineral like magnesium, help our body perform essential steps in its various biochemical pathways.

These pathways follow our innate blueprint for health. They dictate how we eat, sleep, breathe, and create and use energy. They control how our bones and hair grow. They control our mood and hormones. They form our immune systems. These pathways run us.

Our bodies carry out the complicated instructions in our DNA to will us into existence using the ingredients supplied from food. If our bodies are missing one or several of these ingredients—a vitamin or mineral—an important bodily task simply won’t get done.

Dr. Bruce Ames, PhD, theorized that when nutrient levels are suboptimal, the body triages what it has to cove tasks essential to our immediate survival, while compromising other jobs that are important, but less dire.

For example, a body may have enough vitamin C to repair wounds or keep the teeth in our mouths—warding off obvious signs of scurvy, a disease that results from severe vitamin C deficiency. However, it may not have enough to protect us from the free radicals generated in and outside of our bodies. This deficiency may eventually lead to chronic inflammation, and even cancer, years later.

According to Dr. Ames’ Triage Theory, mild to moderate nutrient deficiencies may manifest later in life, as diseases that arise from the deprivation of the building blocks needed to thrive.

In North America, despite an overconsumption of calories, nutrient deficiencies are surprisingly common.

25-50% of people don’t get enough iron, which is important for the transport of oxygen, the synthesis of neurotransmitters, and for proper thyroid function.

One third of the world’s population is deficient in iodine, which affects thyroid health and fertility.

Up to 82% of North Americans are vitamin D deficient. Vitamin D regulates the expression of over 1000 genes in the body, including those involved in mood regulation, bone health, immunity, and cancer prevention.

Vitamin B12 is commonly deficient in the elderly, vegans and vegetarians. It is important for lowering inflammation, creating mood-regulating neurotransmitters, and supporting nervous system health. Deficiency in vitamin B12 can result in fatigue. Severe deficiency can lead to irreversible nerve damage, dementia, and even seizures.

Magnesium is an essential mineral involved in over 300 chemical reactions, including mood and hormone pathways. Over 40% of North Americans do not consume enough magnesium, which is found in leafy green vegetables.

Our bodies have requirements for fats, which make up our brain mass and the backbone of our sex hormones, and protein, which makes up our enzymes, neurotransmitters and the structure of our body: bones, skin, hair, nails, and connective tissue.

Our gut microbiota require fibre.

Our cells need antioxidants to help protect us from the free radical damage from our own cells’ metabolism and our exposure to environmental toxins.

We certainly are what we eat, which means we can be magnificent structures with every piece in place, thriving with abundance and energy.

Despite reasonably good intentions, we can also suffer from nutrient scarcity, forced to triage essential nutrients to keep us from keeling over, while our immune health, mood, and overall vitality slowly erode.

A Body on Fire: Chronic Inflammation.

When we injure ourselves—banging a knee against the sharp edge of the coffee table, or slashing a thumb with a paring knife—our immune systems rally to the scene.

Our immune cells protect us against invaders that might take advantage of the broken skin to infect us. They mount an inflammatory response, with symptoms of pain, heat, redness, and swelling, in order to heal us. They recruit proteins to the scene to stop blood loss; they seal our skin back up, leaving behind only a small white scar—a clumsiness souvenir.

Our inflammatory response is truly amazing.

One the danger has been dealt with, the immune response is trained to turn off. However, when exposed to a stressor, bacteria, or toxin, for prolonged periods, our immune system may have trouble quieting. Chronic issues can contribute to chronic inflammation.

Scientists argue that an inflammatory response gone rogue may be the source of most chronic diseases, from heart disease, cancer, and diabetes, to schizophrenia and major depressive disorder. 

The gut is often the source of chronic inflammation as it hosts about 70% of the immune system. When we eat something that our immune system doesn’t like, an inflammatory response is triggered. This can cause digestive issues such as inflammatory bowel disease, celiac disease, and the more common irritable bowel syndrome. It can also lead to more widespread issues like chronic pain, arthritis, migraines, and even mood disorders like Bipolar.

Ensuring optimal gut health through nurturing the gut microbiome, and eating a clean diet free of food sensitivities, is essential for keeping the body’s levels of inflammation low.

Constant Fighting and Fleeing.

Like inflammation, our stress response is essential to our survival.

When facing a predatory animal, our body is flooded with stress hormones that aim to remove us from the danger: either through fighting, fleeing, or freezing. Our stress response is affectionately called our “Fight or Flight” response.

However, like inflammation, problems arise when our stress response refuses to turn off. Traffic, exams, fights with in-laws, and other modern-day struggles, can be constant predators that keep us in a chronically stressed-out state.

Chronic stress has major implications for our health: it can affect the gut, damage our microbiome, alter our circadian rhythms, mess with mood and hormones, and contribute to chronic inflammation. Stress gets in the way of our ability to care for ourselves: it isolates us, encourages us to consume unhealthy foods, and buffer our emotions through food, alcohol, work, and drugs.

We also know that stress has a role in the development of virtually every disease. Like chronic inflammation, it has been found to contribute to chronic anxiety, depression, digestive concerns, weight gain, headaches, heart disease, insomnia, chronic pain, and problems with concentration and memory, among others.  

Discomfort with Discomfort.

To assess its impact on health, it helps to determine between two key types of stress: distress, the chronic wear and tear of traffic, disease, and deadlines, and eustress.

Eustress is beneficial stress—the short-lived discomfort of intense exercise, the euphoric agony of emotional vulnerability, or the bitter nutrients of green vegetables—that makes the body more resilient to hardship.

Whenever I feel discomfort, I try to remember the ducks.

Several years ago, on a particularly frigid winter day, I was walking my dog. Bundled against the cold wind, we strolled along the semi-frozen lake, past tree branches beautifully preserved in glass cases of ice. Icebergs floated on the lake. So did a group of ducks, bobbing peacefully in the icy waters.

With nothing to protect their thin flippers from the sub-zero temperatures, they couldn’t have felt comfortable. There couldn’t have been even a part of them that felt warm, cozy, or fed.

There was no fire for them to retreat to, no dinner waiting for them at home, no slippers to stuff frozen, wet flippers into. This was it. The ducks were here, outside with us, withstanding the temperatures of the icy lake. A part of them must have been suffering. And yet, they were surviving.

Far from surviving, the ducks looked down-right content.

I think of the ducks and I think of the resilience of nature.

We humans are resilient too. Like the ducks, our bodies have survived temperature extremes. Our ancestors withstood famine, intense heat, biting cold, terrible injury, and the constant threat of attack and infection, for millenia. You were born a link on an unbroken chain of survivors, extending 10,000 generations long.

Our bodies have been honed, over these hundreds of thousands of years, to survive, even thrive, during the horrendous conditions that plagued most of our evolutionary history.

Investigations into the human genome have revealed genes that get turned on in periods of eustress: bursts of extreme heat or cold, fasting, and high-intensity exercise. When our body encounters one of these stressors, it activates a hormetic response to overcome the stress. Often the response is greater than what is needed to neutralize the threat, resulting in a net benefit for our bodies.

These protective genes create new brain cells, boost mitochrondria function, lower inflammation, clear out damaged cells, boost the creation of stem cells, repair DNA, and create powerful antioxidants. Our bodies are flooded with hormones that increase our sense of well-being.

It’s like the old adage, “What doesn’t kill you makes you stronger.”

Our bodies were made for discomfort. In fact, we have entire genetic pathways waiting to kick in and heal us as soon as they experience hardship.

There are a growing number of studies on the healing power of small troubles. Fasting may have a role in treating autoimmune diseases, decreasing the signs of aging, and as an adjunct therapy for cancer; sauna therapy boosts detoxification and may prevent dementia; cryotherapy, or exposure to extreme cold, has the potential to heal arthritis and autoimmunity; and High Intensity Interval Training has been shown to boost cardiovascular health more than moderate-intensity exercise.

Plants may benefit us through flavonoids, which, rather than serving as nutrients, act as small toxins that boost these hormetic pathways, encouraging the body to make loads of its own, powerful antioxidants to combat these tiny toxins.

Mindfully embracing discomfort—the bitter taste of plants, the chilly night air, the deep growling hunger that occurs between meals—may be essential for letting our bodies express their full healing potential.

Not Minding Our Minds.

Our ability to withstand powerful emotions may have healing benefits.

Many of us avoid painful feelings, allowing them to fester within us. We buffer them with excess food, or drugs, leading to addictions. Mindfulness can help us learn to be with the discomfort of the emotions, thoughts and physical sensations that arise in the body as inevitable side effects of being alive.

Research has shown that mindfulness can help decrease rumination, and prevent depressive relapse. It also helps lower perceived stress. How we perceive the stressors in our lives can lower the damaging effects they have on us. Research shows that those who view their life stressors as challenges to overcome have lower stress hormone activation, and experience greater life satisfaction.

According to Cognitive Behaviour Therapy (CBT), our thoughts create our emotions. Becoming more aware of our thoughts, through CBT or mindfulness, allows us to identify which thoughts may be limiting us or exacerbating our reactions to stressful situations.

When we learn to observe our thoughts, we create some distance from them. We become less likely to see the dismal thoughts in our minds as absolute truths.

Practicing mindful meditation, CBT, or cultivating positive thoughts, such as engaging in a daily gratitude practice, may improve our resilience to chronic stress.

Inattention.

According to Stephen Cope, yoga teacher and author of The Great Work of Your Life, “You love what you know deeply. Get to know yourself deeply”. We get to know things deeply by paying attention to them.

Georgia O’Keefe’s admiration for flowers, or Monet’s adoration of landscapes, is apparent to anyone who sees their work. In order to commit images to canvas, the artists gets to know their subject matter deeply. Their art celebrates what they took the time to pay attention to, and eventually came to love. 

As a naturopathic doctor, I believe that healing begins with attention. When we become aware of our bodies, we begin to know them deeply. Awareness allows us to respond to symptoms lovingly, the way a mother learns to skillfully attend to her baby’s distinct cries.

When I first meet a new patient, the first thing I have them do is start to pay attention.

We become curious about their symptoms, their food intake, their sleep patterns, their habits and routines, the physical sensations of their emotions, the thoughts that run through their heads.

Through paying attention, with non-judgmental curiosity, my patients start to understand their bodies in new ways. They learn how certain foods feel in their bodies, how certain sleep habits affect their energy levels the next day, and how specific thoughts contribute to their feelings.

Once we begin to open up this dialogue with our bodies, it becomes impossible not to answer them with love. It becomes hard not to eat, sleep, and move in ways that convey self-respect.

A gardener who pays deep attention cannot ignore the obvious—her plants have roots, embedded in soil. The gardener quickly learns, through careful observation, that the health of this soil is vital to the health of her plants.

And so, back to the original question, “What is your favourite natural cure for anxiety?”

My favourite remedy isn’t a bottle of pills we reach for, it’s a question we reach for from within:

“What do I need to heal?”

After asking the question, we wait.

We wait for the answer to emerge from some primal place within, just as a gardener waits for new buds to rise out of the mysterious depths of the dark, nutritious soil.

 

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