The gut-brain connection has gotten the attention of researchers and functional medical practitioners. I discuss, briefly, what research has shown us in regards to the complex realm of the microbiome and how depression may be a result of inflammation in the brain, stemming from inflammation in the gut.
My name is Dr. Talia Marcheggiani and I am a naturopathic doctor and mental health expert in Toronto.
Today we’re going to talk about the gut-brain connection and how that can influence your mental health symptoms.
I think we intuitively know that the gut and brain are connected. When you feel mental symptoms of anxiety we immediately notice the effects on our gut.
During times of stress, we know that we have indigestion, we’re more predisposed to things like diarrhea and irritable bowel syndrome.
Even anatomically there’s a nerve, called the Vagus nerve, that directly connects the brain to our digestive system.
This nerve is responsible for putting into that “rest and digest” state.
When this nerve is stimulated, our bodies start to secrete digestive enzymes, saliva starts to be secreted and we’re able to break down our food and absorb the nutrients from the food that we’re eating.
A lot of research has been going on, that you might be aware of, about healthy gut bacteria. And more and more people, especially medical doctors, happily, are prescribing probiotics anytime someone is prescribed antibiotics for a bacterial infection.
Scientists have started to study more about these gut bacteria. We know we have, like, 5 lbs of gut bacteria, sitting in our digestive systems. Over 100 trillion cells, this is more than 10x the amount of cells we have in our physical bodies, and more DNA than we have in our body.
We’re more bacteria than we are human!
And these gut bacteria, we can’t survive without without them, they influence the very physiology we experience and they definitely impact our health.
These bacteria are responsible for helping us digest our food, and for our mental and emotional wellness as well as keeping our immune system in check.
So, a disbalance in bacteria, or an increase in that negative, bad bacteria and not good strains of healthy bacteria, can lead to diseases like autoimmune disease or multiple sclerosis, or things like chronic fatigue syndrome as we’re seeing in research.
Scientists are starting to study more about how the bacterial balance in our gut can influence our mood and mental health.
These gut bacteria can actually produce serotonin. So that’s the happy hormone in the brain. And you may have heard of serotonin, especially if you suffer from depression or anxiety because your doctor might have recommended a kind of medication called SSRIs, or Selective Serotonin Reuptake Inhibitors, or a similar drug, SNRIs, like Venlafaxine, which is a Selective Serotonin and Norepinephrine Reuptake inhibitors.
This is based on on the Monoamine Hypothesis that there is this chemical imbalance in the brain. That your body is either not making enough, or absorbing enough or reacting to serotonin enough.
When we’re given these antidepressants, the idea is that we’re recorrecting this brain imbalance and that’s as much of the story as we’ve got. We don’t know why these brain imbalances are around.
So I think that, if we’re going to stick with this hypothesis, which is still controversial in science, we should look to the gut bacteria because we know that gut bacteria produces a significant amount of serotonin and, if we’re blaming depression and anxiety on serotonin deficiencies, why not look at the gut and find out how we can influence the balance of healthy gut bacteria so that we’re producing enough serotonin. Especially if we’re relying on drugs to correct the imbalance and we don’t have enough serotonin for the drugs to work properly.
Gut cells on their own produce 95% of the serotonin in the body so basically every single chemical that we have in our brain is produced or exists in the gut.
So, we need to be able to feed the gut cells so that they’re producing healthy amount of hormone we need to experience a healthy mood and live our lives in ways that are stress-free and energized and happy so that we can effective in our lives.
Mentally and emotionally, you might know this “gut feeling” that we talk about in language and that’s kind of permeated throughout cultures. So, we know that when we have this feeling in the gut that, it’s almost like an intuition. Some people will say, “I just knew it, because I felt it in my gut.” And I think that we’ve always had this intuition. We’ve always had this connection between what our mental state, our thoughts, beliefs and emotions are telling us and what our gut is telling us.
We think that we think with our brains and that all of the mental symptoms we experience are happening at the level of the brain, but because of this tight gut-brain connection, we know that’s not true.
People that have done brain studies actually find that we have thoughts before we have brain activity a lot of the time so, I wonder if we’re actually thinking with our gut, which is a revolutionary and radical thought, but we’re finding more and more evidence for this in science.
You may have heard of the condition called “Leaky Gut” or the more official, scientific term is “Intestinal Permeability”. Our gut is really selective about what it absorbs for good reason. What happens, though, when we’re experiencing chronic stress, or we use a lot of antibiotics or maybe eat things like high-sugar foods, caffeine, or a lot of alcohol, we can cause gut inflammation, which starts to allow bacteria, food toxins, or whole proteins from food into the blood, into the body by breaking down the integrity of the gut.
So, when it comes to health, for most health conditions, especially when there’s a few symptoms that seem disconnected and it’s hard to find the relationship between them, naturopathic medicine and, now, functional medicine and, hopefully soon, conventional medicine, begins to look at gut health.
So if I’m sitting across from a patient who has a long list of health symptoms that seems like they’re not connected and has digestive symptoms—and 40-60% of the population, in general has some kind of digestive symptom, whether it be bloating after eating, feeling fatigued after eating, just feeling like your food is sitting in your stomach and not really moving through, GERD, so acid reflux, heartburn, diarrhea and constipation, or those IBS symptoms, gas and bloating—when I sit across from a patient with any of those symptoms, the first place we go, in terms of treatment, is to look at the gut.
So how do you keep your gut healthy? There’s a few things. The first is to eliminate anything that’s causing gut inflammation, so this could be excessive caffeine and alcohol, excessive refined sugars, antibiotics without doing a probiotic immediately after or during an antibiotic treatment, chronic mental and emotional stress, or physical stress, and food sensitivities: something we’re eating that’s causing our immune system to react and our gut to become inflamed.
Ensuring a proper bacterial balance by either supplementing with a probiotic or eating a variety of fermented foods such as kefir, yogurt, kombucha or saurkraut, and making sure that we’re eating a variety of whole foods: whole grains, fruits and vegetables, and healthy fibres that are going to feed that healthy gut bacteria.
So, when it comes to mental health, such as depression and anxiety, chronic mental stress, even things like bipolar, OCD, conventional medicine tends to just look at the brain and blame the brain on the host of symptoms that patients might experience.
Naturopathic medicine looks at the entire body. And since we know that the gut and brain are connected, and our patients are simultaneously experiencing mental health symptoms and digestive symptoms, we definitely have to treat the gut.
For more information, you can visit my website at taliand.com, or send me an email at connect@taliand.com.
I work at Bloor West Wellness Clinic in Bloor West Village, in Toronto.
When our minds are stressed, how do our bodies react? We experience something called “adrenal fatigue” that can closely mimic the symptoms of depression.
Hi, naturopathic doctor, Talia Marcheggiani, here. I’m a mental health expert and I’m at Bloor West Wellness Clinic and today we’re going to talk about the Stress-Depression Connection.
Most of us are stressed in North America. There’s a major stress epidemic. We know that anywhere from 70-90% of doctors’ visits are directly or indirectly attributed to stress and the symptoms that it causes in the body.
Most people are stressed, I think the estimate is 70% to 90% of North American women are experiencing some kind of chronic stress. Many are unaware of it and very few are doing anything about it or actively managing their stress through methods of self-care, relaxation techniques, and other therapies to lower the cortisol, or the stress hormones, that are producing that chronic stress in the body.
So, physiologically, when we get stressed, so, let’s say, you know, you’re in the paleolithic times, you’re walking through the forest and you encounter a giant bear running towards you. Our bodies would immediately start secreting epinephrine, or adrenaline, which is the first stress hormone. This is released from the adrenal glands, these pyramid-shaped endocrine or hormone glands, located on top of both of our kidneys. Epinephrine, or adrenaline, many of us have felt the effects of before, this makes our heart race, we start sweating, we start to, you know, you might feel like you have to go to the washroom, you might notice digestive effects. What will happen is, our blood vessels will dilate, our pupils will dilate, so that we can’t see fine detail but we can see movement much more easily so we can see the subtle movements of the bear lunging towards us and our body is primed for fight, flight or freezing so that we can get away from this immediate stressor, this threat to our safety and survival.
And really incredible things can happen when we’re in this hyper-arousal state, this sympathetic nervous system state.
A friend of mine was walking in Greece and she fell off a side walk, the side walk just ended, and in the fall, she fell off like cliff, and one of her arms broke so, she managed, in this superhuman ability, that all of a sudden she had, through the adrenaline that was coursing through her body to deal with this stress and surprise, she with the hand that wasn’t broken, grabbed the edge of the sidewalk and pulled herself to safety. And this was a woman, my friend, that can’t even do one pull-up she can’t do pushups, she doesn’t have the arm strength to, in a calm and not hyper-aroused state, perform that kind of physical act.
So, epinephrine and the stress response is amazingly powerful. This stress response can save our lives if called into action for the right reasons and at the right time.
However what’s going on in North America now, is that, especially in this modern society that we live in, with technology and all of the stressors that we’re encountering on a day-to-day basis and the pressures we put on ourselves, we’re in the hyper-arousal state far more often than normal.
Back when we were chased by bears and we had to respond physiologically to that stressor, we would have just, as soon as we reached safety or finished fighting the bear, or froze, played dead, so the bear would walk away, we would have returned back to a state of relaxation. I mean, our hearts would have continued to pound as we kind of got over that stressor, but eventually we would have returned to our rest and digest state, our parasympathetic state.
Back in those days we used to work an estimated 15 hours a week hunting, gathering food, um, in our paleolithic time, in our hunter-gatherer times, which is what our genes have evolved to succeed in—our genes haven’t evolved to catch up with the rapid change in the environment that we’ve created for ourselves and so we’re not used to working 40 to 80-hour work weeks and racing home, through traffic, to pick up the kids and do after school activities and finish up late assignments, getting to get after 12 pm and getting up at 6 am to do a workout so we can lose weight and all of the things that are filling our lives and causing us stress.
The issue with many of the women that I work with, many of the people that I work with, is that we don’t really notice that we’re under stress, like a lot of people will say that they don’t feel stressed and then the signs and symptoms that they’re bodies are exhibiting point me in a direction of some kind of stress response.
So, I described what adrenaline/epinephrine do. But our body doesn’t have a very big reserve of adrenaline and epinephrine, so when we’re in that fight or flight response for prolonged periods of time, the adrenal glands, those pyramid-shaped glands on top of the kidneys, they start to secrete another hormone, called cortisol.
Cortisol has some similar effects, but it’s better for prolonged periods of stress. Cortisol kind of makes us feel alert, it gives us this grounded energy so we can be effective when we have these daily things thrown at us. So, when we wake up in the morning, we feel kind of groggy and then we start to feel alert, maybe we have a quick workout or cold shower or we eat something, we start to feel like we’re becoming alive, we’re greeting the day. That’s cortisol starting to build up in our bodies and prepare us for the things that we have to do, for the mental tasks, or the physical tasks, or the juggling of all the tasks that we have coming up for us in that day.
Cortisol is a good thing. We want to have cortisol because without it, we can’t perform, we can’t be who we need to be. And we can’t bring ourselves into the world and do the things that we’re supposed to do that day.
The problem is, of course, and I’ve already mentioned this, is when stress is prolonged and when stress is taking over more than 50% of our day and our bodies are in that fight or flight state for more time than they’re in the rest and digest state.
Some of the effects of being in this state and, as I mentioned, a fair amount of us are this state most of the time, or have to be. Some of the effects are high blood pressure, high cholesterol, heart diseases, even some cancers, suppressed immunity, things like skin issues, hormonal imbalances, such as infertility, or PCOS or endometriosis, changes in eyesight, changes in hearing, hair loss, acne, impotence, and various other symptoms. And, of course, depression and mental illness.
One of the effects of cortisol is that it can lower serotonin, which is the feel-good, the happy neurotransmitters that our brain secretes and dopamine, another neurotransmitter that promotes feelings of well-bring and happy mood and also helps with that motivation and reward cycle.
Cortisol also controls inflammation and, when we have too much of it, it suppresses inflammation, but once we start to become deficient in cortisol, inflammation can increase and when our body’s relying on cortisol all the time, the balance of cortisol can get thrown off and we can have highs and lows of cortisol in the body.
We know that there is an implication in inflammation and mood, so cortisol is often at the root of excess inflammation or inflammatory symptoms.
There’s also a condition that’s not really recognized in conventional medicine, but naturopathic doctors recognize, as well as functional doctors. So functional doctors and naturopathic doctors, we don’t really work with diseases that you come in with, I mean we work with those too, but where we really excel is when we’re looking at the patterns and the symptoms and the blood work showing disease processes before they actually become diseases. And I think depression and most mental health conditions fall in that area because we know that there’s no blood tests for things like depression. Direct blood tests, I mean. There’s no real diagnostic criteria beyond the subjective criteria that’s in the DSM V. So, when somebody’s depressed, we have to rely on a variety of symptoms and then I can order some blood tests to rule out why someone might be feeling that, but it’s not a disease like diabetes where you run lab tests and you can infer from those lab tests directly what’s going on in the person’s blood and in their body and in their cells. And, of course, the result or the solution for depression is much different than diabetes, especially type I diabetes where it’s an insulin deficiency, you inject insulin and the disease is managed.
With things like depression, we have to reason backwards and try and understand what might have led to those symptoms or what’s going on in the person’s body that’s causing this imbalance that’s causing the symptoms to arise.
So, back to adrenal fatigue. So, when patients come in, and they’re experiencing prolonged stress that begin with something called the resistance phase. So this is when you’re feeling like life is busy you have a lot on your plate, but it almost, you almost thrive in this situation. It feels kind of good. You feel like you’re in control, you feel motivated and you feel like you’re getting things done. You might be tired at the end of the day, you might not be sleeping as well as you could. And you’re definitely not feeling zen. You’re not feeling relaxed and like a Buddhist monk most of the time. You’re feeling that there’s pressure on you, but you’re coping. Things are ok. This is called the Resistance Phase. And this means that your body is producing enough cortisol to deal with the daily tasks at hand.
After months to years of this, however, if this prolonged and we’re not taking enough breaks to allow our bodies to replenish, we can experience something called Adrenal Fatigue. This is when our body’s not able to produce the cortisol needed to cover those daily tasks. So remember how I said that cortisol kind of makes us feel alert and alive and ready to deal with the day ahead of us. In Adrenal Fatigue we’re not able to activate that stress response when we need it because we’ve had it turned on all the time. It’s almost like the gas tank’s empty and we’re kind of sputtering to get it going again. We’re trying to get our car to run on the fumes that are leftover. And, we might call this Burnout, this is another word for it, is burnout.
And so, in adrenal fatigue, and this is a really common situation that often leads to depression and also often has symptoms that actually mirror or overlap with depression. In adrenal fatigue, first of all, the main symptom is just feeling tired, fatigued. There are sleep disturbances. We feel weak, we feel unmotivated, and one of the key symptoms is that we’re not relieved by exercise.
So a lot of my patients will tell me, “I want to exercise, I know I should exercise but I just don’t have the energy to exercise.” And I’ll ask them, “do you feel like you are able to push yourself to do some exercise, like go for a brisk 30-minute walk or even, you know, a quick jog. How do you feel afterwards?” And if they tell me they feel like it depletes them more, this is often a sign that they’re in that burnout phase, they’re in adrenal fatigue.
Because when you’re in a resistance phase, exercise can kind of boost your cortisol a little bit, so if you’re still able to make it, it feels pretty good because it kind of revives you and it perks you back up. But if you’re in an adrenal fatigue situation, you just don’t have the cortisol reserves to get through that exercise, to get through that workout and to feel good afterwards. So that’s one of the symptoms.
How cortisol is supposed to work in a healthy person that has adrenal glands that aren’t depleted, is when you wake up in the morning, your cortisol begins and it’s high. And that’s why you test blood and salivary cortisol in the morning as soon as you get up. So that means you wake up and you feel like you’ve slept pretty well and you’re ready to start the day, you feel alert. You’re not groggy, you don’t wish that you could just stay in bed for the rest of the day.
Throughout the day your cortisol will gradually decline. It might have a few dips and usually perks up with eating or exercise. So if you have a protein-rich, or carbohydrate-rich meal, your cortisol can come back up and that’s around meal-times you’ll feel a little bit more alert. And your cortisol will decline until bedtime when you feel tired and you feel ready to go to sleep and it will stay low throughout the night so you won’t be waking up at night. You’ll feel rested and if you have one of those sleep trackers or a Fitbit, it will show you that you have restful sleep and that you spend a lot of your time in REM sleep or deep wave sleep. And then the cycle starts again, you wake up, your cortisol starts to peak and gets higher again.
When our cortisol cycle is off. When we’re in adrenal fatigue or even the end stages of stress resistance, which proceeds that burnout adrenal fatigue stage and often proceeds depression. The resistance phase is more associated with anxiety, burnout is more associated with depression.
When we’re in that burnout phase, we’re not able to get the cortisol up in the morning so you wake up feeling exhausted. You will often even have a crash, you might kind of get going and ready to go or you might just be used to having that level of energy, on a scale of 1 to 10, you might be anywhere from a 3 to a 7. Around 10 am, though, you’ll notice a dip in your energy, so a lot of people will have this kind of energy crash around 10 am and then they get a second wind, they can kind of go. A very typical thing that happens is around 3-4 pm, 2-4pm, after lunch, there’s a massive energy crash and we’re still at work, most of the time, those of us that work 9-5 and so you’re at work and you’re just feeling exhausted.
And then people kind of get a second wind and another thing that happens, which is not great, is that you get a second wind right before bedtime. When you’re supposed to be going to sleep, you feel this kind of “tired and wired”, like you’re not able to, you know, wind yourself down to get a restful night’s sleep. You feel like you need to be up and on your electronics and doing some work, catching up on some things that you need to get done.
And eventually you might go to bed and usually this happens close to midnight or after midnight, and then most people will have a cortisol spike in the middle of the night between 2 and 4 am where you wake up and are unable to fall back asleep. And thus the cycle begins again where you had a spike in the middle of the night, your sleep’s been broken, you’re tired again in the next morning.
So how do we get out of this cycle? Because, you know, depression has low mood, depression has low motivation, depression has changes in weight and metabolism and appetite and these feelings of sadness and adrenal fatigue and burnout have a lot of those same symptoms. There’s not motivation, you’re gaining weight in the abdomen, you’re immune system is thrown off, you’re feeling just this general malaise and muscle pain and exhaustion and sadness and low mood and low self-worth and all of these things that we see in depression.
So how do we solve this? So the first thing we do is, if possible, we try and manage stress, to establish self care routines and this is a process that we need to work towards, it doesn’t happen in one visit, in a day it takes a few months to a few years to rebuild and reestablish. We make sure that we’re living a balanced life and we’re managing our cortisol and we also might prescribe supplements and herbs to stimulate cortisol production and to help our bodies manage stress and to help our adrenal glands work more optimally. And this often has a dramatic shift in mood after a few months. I have personal experience with this myself and it’s amazing. In a few months you look back to where you were and you notice big shifts.
It’s also necessary to make sure that blood sugar is not spiking throughout the day because cortisol and blood sugar are tightly interconnected. If our blood sugar drops, our body needs to create cortisol to bring it back up and likewise, if our blood sugar is high, this is a stress on the body and it can affect the cortisol balance. If our blood sugar is nice and steady and we’re eating enough fats and proteins to keep our neurotransmitters and our hormones productive and in production in the body, we notice a more even mood and energy level and this is really important so I go over nutrition and how to plan meals, especially in the morning with a protein and fat-rich breakfast.
And, finally, things like bodywork and things like, if not psychotherapy, then things to help with the life stressors that are going on, directly addressing those things. Even helping with the body stress response, the body’s perceived response because a lot of the time we have stress stored in our thoughts and emotions in the head, which is what addressed usually with many forms of psychotherapy. But oftentimes we also store stress in the body and so I find that acupuncture can be really affective and there’s studies that show that acupuncture actually outperforms Prozac in some 6-week trials as well as acupuncture can also help the brain move into that parasympathetic rest and digest state.
So, from 4-6 sessions of acupuncture can really shift us into a more relaxed state and help us with that stress response that we often be stuck in.
So, for more information, visit my website. I’m at TaliaND.com, or you can send me an email at connect@taliand.com. I work at Bloor West Wellness in Toronto. And if you want, leave your questions or comments below and we’ll start the discussion. Thanks, bye! 🙂
It seems like the world is falling apart. These days more than ever.
Race wars, weapons, war, wealth concentrated into the hands of a few, and violence, Facebook is filled with videos that fill our heads and hearts with a complicated mixture of sadness, anger, anguish, confusion, frustration, enrage, injustice and a deep-felt sense of powerlessness. We struggle through these events to go on living—to go about our lives in a dignified fashion, to pay our rent, to engage our relationships, to find happiness and satisfaction in our lots in this world. It seems like the world is ending, and yet we still have our daily responsibilities. Our cynicism is engaged; our idealism is crumbling. Many of us feel hope leaving our bodies. Many of us feel frustration morphing into despair.
Stress is estimated to be the number one cause of disease. As a naturopathic doctor, my role often involves cleaning up the debris from chronic, long-term stress responses gone haywire. Oftentimes my patients don’t even perceive the stress they’re under. “I’m type A! I thrive under stress and pressure”, some will tell me. Other times the people I work with are so far in a state of overwhelm it’s all they can do to keep moving forward with their daily routines.
The World Health Organization estimates that 75-90% of doctor’s visits are attributed to by stress. I would estimate that 100% of the people I work with have on-going stress in their lives.
We doctors know that some people, the “Type B’s” in society, are more susceptible to stress. We know these people, we may even be one of them ourselves: the sensitive individuals, the intuitives, the feelers, the artists, empaths, activists and light-workers. We are individuals who are often drawn to artistic and healing professions, who care deeply about relationships, people, feelings and soft-ness in this world. We often find ourselves pushed up against hard edges, struggling to pay bills and cope with cruelty and injustice. We face daily struggles and the pain of living a disconnected, yet intricately interdependent life in modern-day society. Some natural doctors have terms us “parasympathetic dominants”—people whose nervous systems tend to get stuck in the parasympathetic (as opposed to stress-fuelled sympathetic) arm of the autonomic nervous system (the “automatic” nervous system).
We often feel overcome with a sense of overwhelm when faced with packed schedules, high stakes jobs that affect others, achievement-oriented striving and the prioritization of money and numbers over people. In this world of deadlines, assertion, aggression, fear, war and material wealth, we can often feel like we don’t fit in. We can suffer from burnout.
Burnout, “adrenal fatigue” or “parasympathetic dominance” happens when our stress response becomes depleted. It is characterized by naturopathic doctors as fatigue, excessive needs for sleep and quiet, lack of motivation, disrupted sleep schedules, difficulty losing weight, sluggish digestion, bloating and IBS, headaches and brain fog, poor memory, hormonal imbalance resulting in heavy or irregular periods, PMS, infertility and acne. Mental illness can begin to surface or worsen in this state, resulting in depression, anxiety, or even bipolar disorder and psychosis. The narrative of the mad, artistic genius, burdened by the weight and troubles of the world, surfaces to mind—the creative genius who is too sensitive for this world. We run the risk of becoming irritable, and losing some of our natural compassion as we drift off into exhausted survival mode.
Many of the people I work with are these sensitive individuals, myself included, and I’m proud to help this population. Through healing the sensitive feelers, we heal the world. The world needs a little more softness and more compassion. It needs people who can pick up on emotional nuances and care deeply about others. It needs people who listen, who feel, who create and share their versions of the human experience to teach others. Through the artists, we experience the depths of our own humanity. Through the artists, we see our pain and, through seeing our pain, we can begin to heal it. It is important that we can find fulfilling work and lives that nurture us, so that we may have the energy to extend our gifts to the world.
Healing parasympathetic dominance in my practice often manifests first as establishing a therapeutic relationship. We crave openness, time and space to explore emotional nuances and engage our natural sense of curiosity. We crave being deeply heard and felt. As a doctor, I do my best to listen, not just to the words, but the space between them, and the symptoms of the body. We look for root causes to issues so that we can establish lifestyle patterns that nurture us.
Creating a clean, nutritious diet: With lean protein, usually meats that stimulate metabolism and manage stress, healthy fats, anti-inflammatory nutrients and lots of fruits and vegetables, especially berries and leafy greens, we can begin to re-feed ourselves and heal inflammation.
Gentle, nurturing movement: I often suggest exercise that blends into the lifestyles of my patients, that works with them. Slow, meditative walking for an hour a day is a wonderful, scientifically proven method of bringing down stress hormone levels. It also creates space in the day for contemplation and integration.
Restful sleep: Through sleep hygiene and some strategically dosed supplements, improving sleep allows the body to repair itself and rest. Those suffering from burnout may need more sleep. Dealing with the guilt that can arise through sleeping in and saying no to non-essential activities to prioritize sleep is often a psychological hurdle in those who feel best when they are nurturing and giving to others, and not themselves.
Self-care: Journalling, meditation and engaging in creative pursuits are helpful armour in allowing one to integrate, express and stay open, energized and creative.
Nurturing mental health and emotions: Speaking to family and friends or a trained therapist or naturopathic doctor can allow us to dive more deeply into our own psyches. When we explore the corners of our mind we are able to heal mental-emotional obstacles to health and learn more about ourselves and others and alter the way we engage in the world. Opening ourselves up to deep-seated anger, fear and sadness is essential to clearing this repressed emotions and improving our experience in the world. My favourite forms of talk therapy are Narrative Therapy and Coherence Therapy. Both involve openly engaging the emotional and mental experience of the other to alter core beliefs and narratives and explore possibilities for living a preferred life experience.
Through the times we are facing, I urge us all to band together, embrace the healers and artists among us and engage in deep, nurturing self-care. Journal, spend time with friends and create. Take time from your activist pursuits and political readings to reflect, to meditate, to get some healing acupuncture and to cry or express anger. Feel the emotions that arise during this time. Take the time to listen to the narratives that emerge. Eat a diet filled with protein, try to keep to a sleep schedule, if possible. Nurture yourself and the complicated emotions that are arising within you and others.
We need you to help us through this time. It is people like you who can heal others, but only if you strive to heal yourself as well.
We all have a critic inside of our heads. Through talking to people, I’ve been able to form more complete pictures of what these critics look like. I’ve found them to be as varied as the heads they inhabit, with personalities and characteristics of their own.
Some critics speak in fragments, muttering key words in people’s ears: fat… failure… loser… always…be… alone. Some are quite articulate, forming complex arguments. All inner critics, however, are sharp in their cruelty and ingenious in the way they intrude into our thoughts and convince us of our lack of worth.
Our inner critics were born out of a need for protection. The inner critic’s job is to spare us shame and pain. If it criticizes us before we have the chance to say or do the “wrong” thing, it can help us avoid social humiliation, rejection and isolation. However, the disparaging, constant stream of criticism often leads to depression, low self-esteem and negative identity conclusions in many people–a strong critical voice has the power to convince the person it talks to that he or she is wrong. The critical voice in our heads has the power to poke holes in the social armour of our self-esteem, diminishing the good feelings we have about ourselves and destroying our sense of personal value, self-worth and resilience.
There are many ways to develop a healthy relationship with the critical inner voice and address issues of low self-worth and low self-esteem. One of these ways is to strengthen other, more positive voices, that serve to give us a balanced view of ourselves. Self-help books and feel-good memes emphasize the importance of positive affirmations.
“Write down ten things you love about yourself before you go to bed every night!”
“Recite ‘I am beautiful, healthy and happy’ five times each day!”
“Write ‘I love you!’ and ‘You’re awesome!’ in lipstick in the bathroom mirror and look at it every morning before you to go to work!”
“Paper your workspace with feel-good Post-it notes!”
The suggested ways of talking to ourselves are endless. A sample:
According to Guy Winch, PhD and author of Emotional First Aid, research shows that positive affirmations can be very effective at raising self-esteem. However, their efficacy only applies to a certain group of people (like Jessica here). Affirmations can boost the morale of those who already have high self-esteem and a high sense of self-worth. In people who struggle with strong critical voices, depression and feelings of self-loathing, positive affirmations only result in making them feel worse.
Science tells us that we accept statements and ideas when they fall into our current belief system. Therefore, people with healthy levels of self-worth, who already believe that they are loved, good at their jobs and successful, will reinforce those feelings through reciting positive affirmations about themselves. However, my patients struggling with issues of self-esteem will comment that when they feel unattractive, unloved or unworthy, reciting the opposite sentiments as affirmations (“I am beautiful, loved, worthy!”) only reinforces their current feelings of unworthiness and unattractiveness. When a positive affirmation doesn’t overlap with the beliefs we hold about ourselves, we will reject it, thereby failing to convince or persuade ourselves to feel otherwise. Trying to force oneself into feeling a positive emotion can often only serve to remind us of how unhappy we are actually feeling.
Dr. Winch offers an alternate 3-step exercise, which reminds me in many ways of Narrative Therapy as it aims to build on one’s preferred identity. The exercise is based on increasing the aspects of our identity we already believe of ourselves. It takes about 20 minutes and requires writing. Writing helps us process the information on both sides of the brain, properly integrating and enforcing these more balanced thoughts about ourselves. The exercise only works when you write your thoughts down.
Step 1: Choose a specific situation in which you feel bad or unworthy. Perhaps you have a test coming up and feel unprepared or convinced that you’ll fail. Perhaps there is a date you’re going to go on but you feel ugly and unworthy of someone’s time or attention. Maybe you feel unpopular and have come to the conclusion that you are a bad friend. Using context is important for creating an alternate voice to that our the critic.
Step 2: Once the context has been selected, write down a list of things—traits or behaviours you exhibit—that you have to offer that you believe are valuable to the situation. This list should be exhaustive. Perhaps you would make a good date because you are generous, always offering to pay. Perhaps you’re loyal or you care about others. Perhaps you remember important dates and make your partner feel special on his or her birthday. Perhaps you’re a good student because you get to class on time or study for an hour after class instead of watching movies. Perhaps you always take notes in class and often share them with others. Focussing on even the tiniest detail of what you have to offer the situation will help you in the creation of your list. If you can’t think of anything positive about yourself, pretend that you are writing it for a friend. What would your friend have to offer if he or she were faced with the same context and self-defeating thoughts as you?
Step 3: Choose one of the items on your list and write a short essay on why these traits or qualities are important to the context you are in. Why is being thoughtful (remembering birthdays, for instance) important for dating? How have you managed to manifest this trait in the past? How will you manifest this trait or behaviour in the future? Write about how this trait has been valued by others or might be of value to others in the context that you’re in. Focusing on specific details helps to flush out the narrative of how this trait has helped shaped your identity. Again, if you are unable to write about yourself, continue to write as if it were about a friend, sticking to more general ideas. Then put the paper aside, pick it up 24 hours later, and read it as if it were about you.
Writing a short, detailed essay about what we know we have to offer and why these offerings are worthwhile can help to build a more balanced view of ourselves and the qualities we bring to the world. Narrative exercises serve to strengthen what we already know about ourselves, thickening the preferred identity stories that either fail to get told or get drowned out by the dominant stories of negative labels and personal failings. The aim is not to shut up the inner critic, but to strengthen the voices that oppose it, balancing and creating a dynamic sense of self.
When a successful person is asked to share the secrets of his or her success, the unanimous response is that success requires “effort” and “hard work”. Other popular euphemisms are that success demands “sweat, blood and tears” or “1% inspiration, 99% perspiration”. In grade school we’re lectured on working harder and reprimanded for not trying hard enough. Put in the time and effort to get the grades that will land you the job that will require similar or increasing levels of time and effort. Olympic athletes are lauded as modern-day heroes for their early mornings, punishing workouts and restricted diets. Our society reveres those who put in 80-hour work weeks, despite their implausibility, as we all need to sleep, eat and defecate, which take up hours that are obviously not spent working. It’s a shame to some that we’re limited by these earthly, time-consuming bodies that have been the disdain of capitalism since it’s inception. I see more youth in my practice, who are already bearing the weight of society’s expectations. They are working hard, as instructed, and this “hard work” is taking a physical, mental and emotional toll on their lives. But what can they do? Success requires effort, goes the mantra of our times.
This effort shows up on faces and in bodies. Our minds exhaust us with chastising inner talk; teeth clench, jaws grind and shoulders hunch around ears, creating a new neck-less species, The Hard Worker, inhabiting the earth in increasing numbers.
70% of people today admit to being under stress. When I asked my patients if they feel “stressed”, many shrug, deny or tell me their stress is nothing that they can’t handle, and then proceed to rank their stress levels as 6 out of 10 or higher, 10 being a hair-pulling, crazy-eyed, stressed-out-of-their-wits state—I find it significant that being more than halfway to our limits still qualifies us as not being stressed.
It’s likely that admitting to stress and overwhelm is a weakness in our effort-driven society. If the bodies we inhabit fail to perform, we’ll be replaced by someone more able-bodied, or someone more able or willing to push their limits and sacrifice their health for short-term success—or maybe a machine. Machines don’t need paid vacation or sick leave. While the future seems bleak, it certainly helps with the healing business, as 75-90% of doctor’s visits are either directly or indirectly stress-related. We know that stress has the power to wreck havoc on the body, contributing to diseases, inflammation, decreased immunity, proliferation of cancer and premature aging. We know that stress is implicated in the rising incidence of mental health conditions. We know that things can’t go on as they are, the system is simply not working.
And so when modern society is failing us, it helps to turn to ancient ideas, before it all went wrong, such as Taoist philosophy, to look for answers. The Taoist principles of wu wei, or “effortless action”, tell us that action does not always originate from effort and stress. Effective actions, like creativity and good ideas, can occur spontaneously and of their own accord.
In a society where relentless growth and production are imperative for the survival of the economy, it’s hard to image any action in the absence of sheer effort. Incessant production can’t rely on the eb and flow cycles of natural inspiration and creativity to dictate when, how much or how hard we work. And yet, this perhaps says more about the societal necessities of the work available to us, and our enjoyment (or lack thereof) of such work, than it does about human inspiration. I’ve been planning this blogpost for a while and although it might have been written sooner if set to a deadline, I’ve eventually gotten around to it; here it is. It is a fact that when things need to get done, they will. The doing might happen later than we’d like it to, and yet it still happens, inspired by a genuine desire or necessity, rather than pressure-cooker of stress.
I’m often asked, as a doctor, to help support my patients’ bodies in periods of intense stress—”periods” that have gone on for years with no apparent end in sight. While there are several remedies that can help the body recuperate from the wear and tear of effort or help the adrenal glands secrete more cortisol to continue producing more and faster, there’s also only so much that can be squeezed out of tired organs. Oftentimes, as I’ve written before, the path to healing is paved with introspection and a serious reconsideration of lifestyle. Can we continue to produce and strive at our current rates and still expect to feel fit, healthy and energized? We can build faster computers and smarter phones but our bodies are very much limited to the tools nature has slowly evolved over time, including the natural medicines available to us. Perhaps our lifestyles, like the economy and the stress on the environment, are simply unsustainable. Perhaps it’s time to question how many of the activities in our lives are worth the effort.
While it may not be possible to quit our jobs, pack up and move to the Bahamas, perhaps there are small nooks in our routines where wu wei might fit and flourish. It may be possible to ease up on our own expectations of ourselves, or give up some of our conventional ideas of success. After all, is the journey to success worth slogging if we won’t be happy or healthy when we get there? Finding space in our lives to allow action to arise spontaneously may be crucial in doing the necessary, healing work of stress-management.
Applying wu wei might mean examining the intentions behind our actions and our current lifestyles. Here are some questions to ask yourself.
When is effort appropriate and when is it wasted?
Where am I trying to get to? What is my definition of success?
Is there a day/afternoon/hour in my week when I can “schedule” unscheduled time?
Are there tasks I can ease up on, laundry for instance, that I can trust will get done on their own time?
Can I agree to forgive myself when I fail to meet deadlines or choose to take a day off?
What would it feel like to stop paddling and let the current carry me for a while? Can I do this at work? At home?
In what area of my life could I allow myself a little more room to breathe?
What are my top ten values in life? What goals align with those values? What actions would help me move closer to those goals? How much does thinking of those actions excite or inspire me?
Today, I’m 30, working on my career as a self-employed health professional and a small business owner and living on my own. I’ve moved through a lot of states, emotions and life experiences this year, which has been appropriate for closing the chapter on my 20’s and moving into a new decade of life. I’ve experienced huge changes in the past year and significant personal growth thanks to the work I’ve been blessed to do and the people who have impacted me throughout the last 30 years. Here are 30 things this past year has taught me.
Take care of your gut and it will take care of you. It will also eliminate the need for painkillers, antidepressants, skincare products, creams, many cosmetic surgeries, shampoo and a myriad of supplements and products.
Trying too hard might not be the recipe for success. In Taoism, the art of wu wei, or separating action from effort might be key in moving forward with your goals and enjoying life; You’re not falling behind in life. Additionally, Facebook, the scale and your wallet are horrible measures to gauge how you’re doing in life. Find other measures.
If you have a chance to, start your own business. Building a business forces you to build independence, autonomy, self-confidence, healthy boundaries, a stronger ego, humility and character, presence, guts and strength, among other things. It asks you to define yourself, write your own life story, rewrite your own success story and create a thorough and authentic understanding of what “success” means to you. Creating your own career allows you to create your own schedule, philosophy for living and, essentially, your own life.
There is such as thing as being ready. You can push people to do what you want, but if they’re not ready, it’s best to send them on their way, wherever their “way” may be. Respecting readiness and lack thereof in others has helped me overcome a lot of psychological hurdles and avoid taking rejection personally. It’s helped me accept the fact that we’re all on our own paths and recognize my limitations as a healer and friend.
Letting go is one of the most important life skills for happiness. So is learning to say no.
The law of F$%3 Yes or No is a great rule to follow, especially if you’re ambivalent about an impending choice. Not a F— Yes? Then, no. Saying no might make you feel guilty, but when the choice is between feeling guilty and feeling resentment, choose guilt every time. Feeling guilty is the first sign that you’re taking care of yourself.
Patience is necessary. Be patient for your patients.
Things may come and things may go, including various stressors and health challenges, but I will probably always need to take B-vitamins, magnesium and fish oil daily.
Quick fixes work temporarily, but whatever was originally broken tends to break again. This goes for diets, exercise regimes, intense meditation practices, etc. Slow and steady may be less glamorous and dramatic, but it’s the only real way to change and the only way to heal.
When in doubt, read. The best teachers and some of the best friends are books. Through books we can access the deepest insights humanity has ever seen.
If the benefits don’t outweigh the sacrifice, you’ll never give up dairy, coffee, wine, sugar and bread for the long term. That’s probably perfectly ok. Let it go.
Patients trust you and then they heal themselves. You learn to trust yourself, and then your patients heal. Developing self-trust is the best continuing education endeavour you can do as a doctor.
Self-care is not selfish. In fact, it is the single most powerful tool you have for transforming the world.
Why would anyone want to anything other than a healer or an artist?
Getting rid of excess things can be far more healing than retail therapy. Tidying up can in fact be magical and life-changing.
It is probably impossible to be truly healthy without some form of mindfulness or meditation in this day and age.
As Virginia Woolf once wrote, every woman needs a Room of Own’s Own. Spending time alone, with yourself, in nature is when true happiness can manifest. Living alone is a wonderful skill most women should have—we tend to outlive the men in our lives, for one thing. And then we’re left with ourselves in the end anyways.
The inner self is like a garden. We can plant the seeds and nurture the soil, but we can’t force the garden to grow any faster. Nurture your garden of self-love, knowledge, intuition, business success, and have faith that you’ll have a beautiful, full garden come spring.
Be cheap when it comes to spending money on everything, except when it comes to food, travel and education. Splurge on those things, if you can.
Your body is amazing. Every day it spends thousands of units of energy on keeping you alive, active and healthy. Treat it well and, please, only say the nicest things to it. It can hear you.
If you’re in a job or life where you’re happy “making time go by quickly”, maybe you should think of making a change. There is only one February 23rd, 2016. Be grateful for time creeping by slowly. When you can, savour the seconds.
Do no harm is a complicated doctrine to truly follow. It helps to start with yourself.
Drink water. Tired? Sore? Poor digestion? Weight gain? Hungry? Feeling empty? Generally feeling off? Start with drinking water.
Do what you love and you’ll never have to work a day in your life. As long as what you love requires no board exams, marketing, emailing, faxing, charting, and paying exorbitant fees. But, since most careers have at least some of those things, it’s still probably still preferable to be doing something you love.
Not sure what to do? Pause, count to 7, breathe. As a good friend and colleague recently wrote to me, “I was doing some deep breathing yesterday and I felt so good.” Amen to that.
As it turns out, joining a group of women to paint, eat chocolate and drink wine every Wednesday for two months can be an effective form of “marketing”. Who knew?
“Everyone you meet is a teacher”, is a great way to look at online dating, friendships and patient experiences. Our relationships are the sharpest mirrors through which we can look at ourselves. Let’s use them and look closely.
Being in a state of curiosity is one of the most healing states to be in. When we look with curiosity, we are unable to feel judgment, anxiety, or obsess about control. Curiosity is the gateway to empathy and connection.
Aiming to be liked by everyone prevents us from feeling truly connected to the people around us. The more we show up as our flawed, messy, sometimes obnoxious selves, the fewer people might like us. However, the ones who stick around happen to love the hot, obnoxious mess they see. As your social circle tightens, it will also strengthen.
If everyone is faking it until they make it, then is everyone who’s “made” it really faking it? These are the things I wonder while I lie awake at night.
Happy Birthday to me and happy February 23rd, 2016 to all of you!
According to Statistics Canada, 1 in 4 people suffer from a mental health condition in Canada. Most of these individuals will fall between the cracks of a medical system that is not equipped to deal with the rise of stress and mood disorders, such as depression.
Naturopathic doctors understand that the mind and body are connected. Science has long established the relationship between the digestive system and mood, often termed the “Gut-Brain Connection” and the connection between the mind, mental health and the immune system, even establishing an entire field termed “psychoneuroimmunology”, linking depression to inflammation in the brain and body. However when it comes to our conventional healthcare model, mental health conditions are treated as separate from the rest of the body. In mainstream medicine, depression is largely treated as a brain chemical imbalance. It is thought that deficiency in the “happy” chemicals in the brain, like serotonin and dopamine, influence mood and must be “corrected” with anti-depressants. Despite emerging science about the brain, emotions, and mood, mental health conditions are commonly viewed as something that has “gone wrong” in the brain.
This reductionist approach to mental health often overlooks the intricate interplay between various physiological systems and their collective impact on mental well-being. For instance, conditions like ADHD are frequently discussed in terms of specific symptoms and brain function, yet they also involve broader aspects of cognitive and emotional regulation. One notable challenge associated with ADHD is time blindness, where individuals struggle to perceive and manage time effectively. This symptom highlights the complexity of ADHD and underscores the need for a more holistic view of mental health, recognizing that these conditions cannot be fully understood by focusing solely on brain chemistry.
Integrating a more comprehensive approach to mental health, such as the one advocated by Healing Psychiatry of Florida, can offer significant benefits. By addressing ADHD time blindness alongside traditional treatments, this approach acknowledges the multifaceted nature of mental health issues and emphasizes the importance of considering how various factors—both physiological and psychological—interact. This broader perspective not only enhances treatment effectiveness but also supports individuals in managing their conditions in a more integrated and compassionate manner.
As awareness grows regarding the interconnectedness of mental and physical well-being, there’s an increasing demand for holistic approaches to health and wellness. Online certification programs in holistic health and wellness, such as those offered by https://it.scholistico.com, play a pivotal role in equipping individuals with the knowledge and skills to address the multifaceted nature of human health. These courses delve into various modalities and disciplines, including naturopathy, nutrition, mindfulness, and integrative medicine, providing a comprehensive understanding of how different aspects of life impact overall wellness.
By embracing a holistic perspective, these certification programs empower students to adopt a more holistic approach to health care, recognizing the intricate interplay between physical, emotional, and spiritual well-being. With a curriculum grounded in evidence-based practices and emerging research, students gain insights into alternative therapies and lifestyle interventions that complement conventional medical treatments. As society increasingly acknowledges the limitations of the traditional medical model in addressing mental health concerns, the availability of online certification courses in holistic health and wellness serves as a beacon of hope, fostering a new generation of practitioners committed to holistic healing and compassionate care.
Most treatments for depression and anxiety are based on the low-serotonin theory of depression, which roughly states that depression is due to decreased production of certain neurotransmitters, such as serotonin, in the brain. Following this model, drugs are prescribed to artificially change neurotransmitter levels. While we understand that anti-depressant medications such as selective serotonin and selective serotonin and norepinephrine re-uptake inhibitors (SSRIs and SNRIs) work better than placebo (in about 40-60% of cases), scientists don’t know for certain why they have an affect. When starting SSRI and SNRI drugs, patients experience an immediate increase in neurotransmitter levels in the brain, however, it takes 2-4 weeks before there are noticeable changes to mood. This points to the fact that the proposed mechanism (increasing neurotransmitter levels) may not in fact be how these drugs work. However, it is in the interest of the pharmaceutical companies manufacturing such drugs to perpetuate the idea that anti-depressant medications are “restoring” the natural chemical balance in the brain, despite lack of evidence that this is the case.
This is furthered by a paper published by the Neuroscience and Behavioural Reviews last year that challenges the low-serotonin theory of depression, stating that improvement on SSRI medication might be the body overcoming the effects of the drug, rather than the drug assisting patients in feeling better (1). This may explain why patients feel worse in the first few weeks of starting anti-depressant medication. The authors venture to say that anti-depressant medication may in fact be creating an obstacle to cure in patients with depression, making it harder for patients to recover in the short-term. The authors of the study argue that most forms of depression provide an evolutionary advantage by providing the body with natural and beneficial adaptations to stress (1).
Since we understand that our digestive system and immune system are linked to our mood and overall functioning, it becomes imperative that we learn how to fuel our brains, improve digestion, balance inflammation and take proactive measures against our increasing levels of stress.
Getting help for a mental health disorder first involves removing the stigma and discrimination around mental health—depression, anxiety and other mood disorders are not signs of weakness, they are common conditions that a large portion of the population is dealing with daily. Next, it is important to seek help from a trusted practitioner who will take the time to listen to your case, treat your body as a whole entity, not just a collection of organs, and connect with you as a person, not just your symptoms or diagnosis. The following are some proposed and effective methods of working with depression and mental health conditions.
1. Healing the gut.
Science has largely started referring to the digestive system as the “second brain”, due to its possession of something called the Enteric Nervous System, a collection of millions of nerve cells that control digestive function and communicate directly with the brain. Because of this intricate connection, research has shown that irritation to the digestive system, through bacterial overgrowth, gut inflammation and a variety of other mechanisms, can trigger significant changes to mood (2,3). Since 30-40% of the population suffers from digestive symptoms such as bloating, flatulence, GERD, IBS, constipation, diarrhea and IBD, this connection is important. Additionally, emerging research is showing the link between beneficial gut bacteria and mood, establishing the fact that certain probiotics are capable of producing neurotransmitters and thereby contributing to mood and mental functioning (2,3).
Naturopathic medicine has long established a connection between the gut and brain when it comes to health, recognizing that conditions such as IBS are aggravated by stress, depression and anxiety and treating the digestive concerns with patients with depression by prescribing quality probiotics and identifying and removing food sensitivities among other things. In addition, not only is gut function important for regulation of the nervous system and, in turn mood, a healthy digestive system is required for proper absorption of the amino acids and micronutrients necessary for synthesizing neurotransmitters.
2. Essential nutrients and adequate nutrition.
If the body doesn’t possess the building blocks for building hormones and neurotransmitters, it won’t make them. While SSRI medication keeps brain serotonin levels elevated, it also depletes the vitamins and minerals responsible for producing serotonin. Supplementing with quality brands and correct doses of vitamins B6, folate and B12, as well as magnesium and zinc and ensuring adequate protein intake, is essential to treating mental health conditions and mood. Some sources state that 70-80% of the population is deficient in magnesium. Since magnesium is needed for production of a variety of hormones and neurotransmitters, a deficiency can cause an array of symptoms from low mood and muscle pain, to insomnia and fatigue. Getting put on high-quality, professional grade vitamins and minerals at therapeutic doses should be done under the care of a licensed professional, such as a naturopathic doctor.
3. Fish oil.
A meta-analysis in 2014 concluded that fish oils are effective at treating low mood and even patients diagnosed with major depressive disorder (4). Since the brain requires the fatty acids EPA and DHA found in fish to function, ensuring adequate intake of fatty fish or using a high-EPA supplement at an effective dose is a cornerstone of natural treatment for depression. The ratio of EPA:DHA is important, however, so ensure you’re receiving a prescription from a licensed naturopathic doctor (not all brands on the market are created equally and some products may even negatively impact mood). Another proposed mechanism of action for fish oil benefitting mood is in its anti-inflammatory properties. Emerging research has suggested that depression may be correlated with low-levels of brain inflammation.
4. Healing the adrenals.
According to evolutionary biology, depression may be a necessary adaptation to stress that promoted our survival and ability to pass on our genes. Since about 70% of the population identifies as being significantly stressed, it is no wonder that the number of mental health conditions is also rising. Naturopathic medicine and other alternative health fields recognize a collection of symptoms caused by prolonged, chronic stress that they term “adrenal fatigue”. Adrenal fatigue is characterized by high levels of prolonged mental, emotional and physical stress, low energy, insomnia, food cravings, and depressive symptoms such as low mood, apathy and lack of enjoyment in previously enjoyed activities, changes to sleep, weight, appetite and energy levels. Whether symptoms of chronic stress are misdiagnosed as mild to moderate depression in people, or whether lifestyle stress is the cause of physiological depression, there is often a significant stressor that complicates symptoms of low mood in most people. Using herbs, nutrition and stress-reduction techniques is important for improving resilience, as is taking steps to decrease the amount of stress present in one’s life. Researching and experimenting with various self-care practices is also important for managing low mood and promoting mental health.
5. Mind-body medicine.
Mind body medicine involves working with the body’s energetic healing forces to remove obstacles to cure and ensure the smooth flow of energy throughout the body. The main modalities that naturopathic medicine uses for these purposes are acupuncture, homeopathy and working with meditation and visualizations. While some reject these streams of healing as being pseudoscientific, there is a growing body of research to back them up. A study by the Journal of Alternative and Complementary medicine showed that acupuncture was as effective as medication at reducing depression after six weeks (5). Mind-body medicine works by integrating our thoughts, emotions and physical sensations to give us more awareness about the body as well as provides us with powerful tools for managing stress.
6. Counselling.
We know that counselling is a preferred first-line treatment for depression and other mood disorders and that counselling and medication in combination is far better than medication alone. While there are a variety of psychotherapeutic models and styles, research suggests that the therapeutic relationship is one of the most powerful determinants of positive health outcomes (6). Therefore working with a clinician that you trust, connect and resonate with is the first step to finding effective therapy. Cognitive Behavioural Therapy (CBT), a style of therapy based on changing ingrained and habitual thoughts, beliefs and behaviours that may be contributing to low mood, is one of the main therapeutic modalities for depression and is supported by a number of studies. Motivational Interviewing is another counselling model that helps patients work through and change addictive behaviours and has substantial evidence behind it.
In addition to established therapeutic approaches like Cognitive Behavioral Therapy (CBT) and Motivational Interviewing, there’s growing recognition of the importance of specialized interventions tailored to specific mental health challenges. For individuals grappling with complex issues such as trauma or relationship difficulties, psychosexual therapy can offer a targeted and effective means of support. This form of therapy delves into the intricate interplay between psychological and sexual health, addressing concerns that may have profound impacts on overall well-being. Moreover, it’s crucial to acknowledge the role of holistic approaches in promoting mental wellness. In essence, the landscape of mental health treatment is diverse and evolving, offering a spectrum of options to meet the unique needs and preferences of each individual on their path to healing and growth.
When seeking therapy, it’s essential to consider not only the specific therapeutic model but also the fit between the therapist and the individual seeking help. For instance, someone in New York City might specifically search for cbt therapy nyc to find therapists trained in this evidence-based approach within their local area. However, beyond geographical considerations, finding a therapist with whom one feels a genuine connection and trust is crucial for therapy to be effective. This connection forms the foundation of a therapeutic relationship that can support individuals in navigating their mental health challenges and achieving meaningful change.
7. Mindfulness.
More and more research is coming out about the Buddhist practice of mindfulness meditation for preventing depression, managing stress, working with mood disorders and preventing relapse in major depressive disorder. Recent evidence published in JAMA has shown that Mindfulness-Based Cognitive Therapy (MBCT), a form of secular mindfulness meditation was just as effective as medication for treating mild to moderate depression (7). Mindfulness involves looking inward, without judgment at the thoughts, feelings and physical sensations produced by the body. Practicing it cultivates the skills of awareness, attention and presence. According to Jon Kabat-Zinn, one of the founders of MBCT, “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgementally. It’s about knowing what is on your mind.” Mindfulness improves mood by allowing participants to better understand their own emotional states without getting caught up in identifying with negative emotions and belief systems.
If you or a friend or family member is suffering from a mental health condition, it is important to be educated about options. Naturopathic medicine is a great first-line option for those who have been newly diagnosed with a mood disorder, as well as a preventive measure for those simply dealing with stress, and a great complement to those who have been living with a mental health condition for some time and are already on medication. I work with children, adolescents, adults, pregnant patients, postpartum women and patients dealing with addictions. I have additional training in motivational interviewing, mindfulness-based stress reduction, narrative therapy and CBT and structure my visits to allow for more time for counselling. Contact me for more information on how to work with me.
References:
Andrews, PW, Bharwani, A, Lee, K.R., Fox, M, Thomsom, JA. Is serotonin an upper or a downer? The evolution of the serotonergic system and its role in depression and the antidepressant response. Neuroscience & Biobehavioral Reviews, 2015; 51: 164
Dinan, T, Cryan, J. Regulation of the stress response by the gut microbiota: Implications for psychoneuroimmunology. Psychoneuroimmunology (2012) 37, 1369-1378
Wang, Y. Kasper, LH. The role of micro biome in central nervous system disorders. Brain Behav. Immun. (2014).
Grosso G, Pajak A, Marventano S, et al. Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials. Malaga G, ed. PLoS ONE. 2014;9(5):e96905. doi:10.1371/journal.pone.0096905.
Sun, H, Zhao, H, Ma, C, Bao, F, Zhang, J, Wang, D, Zhang, Y. and He, W. Effects of Electroacupuncture on Depression and the Production of Glial Cell Line–Derived Neurotrophic Factor Compared with Fluoxetine: A Randomized Controlled Pilot Study. The Journal of Alternative and Complementary Medicine. September 2013, 19(9): 733-739.
Siegel, D. The Mindful Therapist. Mind You Brain, Inc. New York: 2010.
Goyal, M, Singh, S, Sibinga, ES, et al. Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis. JAMA Intern Med.2014;174(3):357-368. doi:10.1001/jamainternmed.2013.13018.
I’ve come to see my migraines as an internal measuring device for wellness, or rather, lack of wellness—kind of like a very painful meat thermometer. From time to time I get bouts of low energy compelling me to spend more time doing low-key activities. However, quick browses through Facebook show me busy colleagues achieving great things and I feel guilty about my relative inaction. A little voice pipes up. “Your body is telling you to rest”, it says. “But if you just started doing things, you’d probably feel more motivation”, voices another, its opponent, the devil on my shoulder. A war ensues and then a headache settles it all. I take it easy for a while, while I’m literally knocked out of commission, in the dark, on the couch with an icepack on my head.
L came to me for fertility, which is another litmus test for good health. When the body is struggling against some sort of imbalance or obstacle to wellness, it will not spend its resources readying eggs, ovulating and ripening uteruses. Our bodies protect us from the metabolic demands of having a pregnancy, which in our current stressed-out, unwell states we probably wouldn’t be able to handle, by simply not getting pregnant in the first place. And so, infertility is a nice entry-way to healing—patients are motivated to examine the effect of their lifestyles on their wellbeing.
The problem was, however, that L barely had time to make and attend her appointments. When she did manage to come in, she was in a rush. She’d often cancel follow-ups because she hadn’t followed through with the previous visit’s plan, even though it had been weeks before. She also reported working 50-hour weeks and staying up early into the morning to work on projects. I wondered, if she couldn’t even make an hour-long appointment with her naturopathic doctor, how would she manage growing and then giving birth to and then raising a brand new human? L simply might have not been ready to heal. Something in me fought to give her my professional assessment; in order to have the baby she wanted, she might have to give up, or significantly let up on, the demands of her job. However, how could I have made such a statement? I held my tongue and tried my best with the modalities at my disposal. We did acupuncture, CoQ10, PQQ and herbal remedies. We worked on sleep and did stress management with adaptogens. In a few months, despite the high demands of her lifestyle, L was pregnant. She still has trouble keeping her appointments with me. L’s body may now be functioning fine, but is it thriving?
Workplace wellness programs teach employees how to survive the 60+ hour workweeks in the office by doing yoga at lunch and eating healthier cafeteria food. They’re taught about stress management and, in the best of cases, given adaptogens and B-vitamins to help their bodies’ sails weather the stress-intensive storms of office life. It’s a great investment, these programs proclaim, because employees are happier, more efficient at their work and take less sick days. Workplace wellness programs keep their employees functional but, I wonder, can anyone really be well working that many hours a week?
When it comes to the health strategies we promote as a profession, how many of them are geared towards healing and how many of them are really just there to help us function?
At this stage in my career, I often have to gauge what my patients want. There are some people who come in ready to heal. They want to search for and address the real root cause of disease, no matter how elusive it may be. They are also willing to do what it takes to get better, even if it means a significant lifestyle shift. Sometimes these patients are at a point where things have gotten so bad that they have no other choice, however some of them simply intuit that the symptoms arising may be conveying a greater message; in order to be truly healthy, things might have to change. Most patients, however, come in looking to “feel better”—they simply want their symptoms to go away so they can get back to their daily lives, lives that might have made them sick in the first place. In our pharmaceutical-based Therapeutics and Prescribing exam, the goal of therapy in the oral cases was always to “restore functioning”, as if our patients were simply pieces of machinery; our parts are worn, maybe broken and we’ve gone decades without a decent oil change, but the factory declares we must get back to work as soon as possible and so we break out the duct tape. With this mindset, however, are we simply placating our bodies long enough to keep working until we eventually succumb to the next thing, a debilitating headache instead of mild fatigue, or something even worse? How long can we go suppressing symptoms or getting our bodies into decent enough shape before we realize that what we really need is some honest-to-goodness authentic healing?
Jiddu Krishnamurti, Hindu philosopher and teacher once said, “It is no measure of health to be well-adjusted to a profoundly sick society.” How much of our health marketing and wellness efforts are aimed at cleaning out the cogs in a jammed up machine so that they can go on turning smoothly again? The thought that real healing might mean dismantling the entire machine might be too radical for our society to handle. How can we address the problem of making a living if we acknowledge the fact that our lifestyle, or job, might be making us sick?
A therapist I work with (doctors need healing too!) once told me that mild to moderate depression is a sign that something in your life needs changing. “Look at the symptoms of depression,” She told me one afternoon in her office, “You lose the energy and motivation to keep going with your routine. You stop being social; all of your energy turns inwards. You focus your attention on your self and your life so that you can examine what about it is making you unhappy. Then you change it.” Then you change it, a scary thought. No wonder a tenth of the population opts for anti-depressant medication, which in some cases might be the medical equivalent of dusting oneself off and heading back to work. And, while they seem like more benign options, St. John’s Wort, B12 injections and 5HTP may not be that different.
A friend and I were talking about this very topic. He remarked that at a fitness retail store he worked at he’d often ask his female customers, “What will you be needing these yoga pants for today: form or function?” When I laughed at the shallowness of it all, he protested, “Well, some people are just going to use them to sit in coffee shops while others want to actually work out. What’s going to make your butt look great won’t necessarily be the best choice at the gym. I had to know their motivations.” Are most of our wellness efforts aimed at making our butts look great or are they filling a functional purpose?
I wonder if I should follow my friend’s lead and outright ask my patients, maybe on their intake forms, “Are you looking to truly heal today or do you just want to feel better and get back to work?”—form or function? Being candid with them, might help me decide when to schedule follow-up appointments. At any rate, it would definitely open up a conversation about expectations surrounding decent time-frames for seeing “results” and what true healing might look like for them. The trouble is, restoring functioning, if not easier, is more straight-forward. You make some tweaks to diet, correct some nutritional deficiencies and boost the adrenals or liver. It’s the medical equivalent of filling in potholes with cheap cement—it might not look pretty, but now you can drive on it. Healing, however, is more complex. It’s more convoluted, hard to define and get a firm grasp on. It is also highly individual. It might mean ripping up the entire road, plumbing and all, and building a new one or, even better, planting grass and flowers in the road’s place and nurturing that grass on a daily basis. Healing might be creating something entirely new, something that no one has ever heard of or seen before. Creating is scary. Creativity takes courage, and so does healing.
No matter what it might look like, I believe healing begins with a conversation and a willingness to look inwards, without judgement. Healing also requires an acceptance of what is, even if the individual doesn’t feel ready to take actions to heal just yet. Healing deserves us acknowledging that something is a band-aid solution. Healing definitely demands listening, especially to the body. Therefore, healing might begin in meditation. It might start with a mind-searing migraine that lands you on the couch and the thought, “What if, instead of reaching for the Advil, I just rested a little bit today?” Healing might just start there and it might never end. But, if it does, who knows where it might end up?
Premature Ovarian Failure no longer bears that name. It’s not a failure anymore, but an insufficiency. POF becomes POI: Premature Ovarian Insufficiency, as insufficiency is apparently a softer term than “failure”. For me, it’s another telling example of how our society fears the names of things, and twists itself into knots of nomenclature and terminology rather than facing pain head-on. In this case, the pain is derived from the simple fact that the ovaries do not respond to hormones, that they for some reason die at an early age and cause menopause to arrive decades before it’s due, leading to infertility and risk of early osteoporosis.
Insufficiency, for me at least, fails to appease the sensitivity required for naming a problem. It reminds me of a three-tiered scoring system: exceeds expectations, meets expectations, insufficient performance. These reproductive cells have not been up to task. They’ve proven to be insufficient and, in the end, we’ve labelled them failures anyway—premature ovarian disappointments. Our disdain for the bodies we inhabit often becomes apparent in medical jargon.
What expectations do we have for our organs, really? For most of us that they’ll keep quiet while we drink, stay up late and eat what we like, not that they will protest, stop our periods, make us itch or remind us that we are physical beings that belong here, to this earth, that we can sputter and shut down and end up curb side while we wait for white coats to assist us. Our organs are not supposed to remind us of our fragile mortality. When it comes to expectations overall, I wonder how many of them we have a right to.
In one week I had two patients presenting with failures of sorts. With one it was her ovaries, in another it was his kidneys, first his left, now his right. Both of them were coming to me, perhaps years too late, for a style of medicine whose power lies mainly in prevention or in stopping the ball rolling down the hill before it gains momentum. When disease processes have reached their endpoint, when there is talk of transplant lists and freezing eggs, I wonder what more herbs can do.
And so, when organs fail, I fear that I will too.
In times of failure, we often lose hope. However, my patients who have booked appointments embody a hope I do not feel myself, a hope I slightly resent. In hope there is vulnerability, there is an implicit cry for help, a trust. These patients are paying me to “give them a second opinion”, they say, or a “second truth”.
I feel frustration bubble to the surface when I pore over the information I need to manage their cases. At the medical system: “why couldn’t they give these patients a straight answer? Why don’t we have more information to help them?” At my training: “Why did we never learn how to treat ovarian insufficiency?” At the patients themselves: “Why didn’t he come see me earlier, when his diabetes was first diagnosed?” And again at the system: “Why do doctors leave out so much of the story when it comes to prevention, to patient power, to the autonomy we all have over our bodies and their health?” And to society at large: “Why is naturopathic medicine a last resort? Why is it expensive? Why are we seen as a last hope, when all but the patients’ hope remains?”
Insufficiency, of course, means things aren’t enough.
I feel powerless.
There is information out there. I put together a convincing plan for my patient with kidney failure. It will take a lot of work on his part. What will get us there is a commitment to health. It may not save his kidneys but he’ll be all the better for it. My hope starts to grow as I empower myself with information, studies some benevolent scientists have done on vitamin D and medicinal mushrooms. Bless them and their foresight.
As my hope grows, his must have faded, because he fails to show for the appointment. I feel angry, sad and slightly abandoned—we were supposed to heal together. Feelings of failure are sticky, of course, and I wonder what story took hold of him. was it one that ended with, “this is too hard?” or “there is no use?” or “listen to the doctors whose white coats convey a certainty that looks good on them?”
A friend once told me, the earlier someone rejects you, the less it says about you. I know he’s never met me and it’s not personal, but I take it personally anyways, just as I took it personally to research his case, working with a healing relationship that, for me, had been established since I entered his name in my calendar. In some way, like his kidneys, I’ve failed him. Since we’re all body parts anyways, how does one begin to trust another if his own organs start to shut down inside of him? Why would the organs in my body serve him any better than the failing ones in his?
I get honest with my patient whose ovaries are deemed insufficient (insufficient for what? We don’t exactly know). I tell her there aren’t a lot of clear solutions, that most of us don’t know what to do–in the conventional world, the answer lies mainly in estrogen replacement and preserving bone health. I tell her I don’t know what will happen, but I trust our medicine. I trust the herbs, the homeopathics, nutrition and the body’s healing processes. I admit my insufficiency as a doctor is no less than that of her ovaries, but I am willing to give her my knowledge if she is willing to head down this path to healing with me. Who knows what we’ll find, I tell her, it might be nothing. It might be something else.
It takes a brave patient to accept an invitation like the one above; she was offered a red pill or a blue pill and took a teaspoon of herbal tincture instead. I commend her for that.
There aren’t guarantees in medicine but we all want the illusion that there are. We all want to participate in the game of white coats and stethoscopes and believe these people have a godlike power contained in books that allows them to hover instruments over our bodies and make things alright again. Physicians lean over exposed abdomens, percussing, hemming and hawing and give us labels we don’t understand. The power of their words is enough to condemn us to lives without children, or days spent hooked up to dialysis machines. We all play into this illusory game. They tell us pills are enough… until they aren’t. This is the biggest farce of all.
I can’t participate in this facade, but I don’t want to rob my patient of the opportunity for a miracle, either. We share a moment in the humility of my honesty and admission of uncertainty. I know my patients pay me to say, “I can fix it.” I can try, but to assert that without any degree of humility would be a lie. How can one possibly heal in the presence of inauthenticity? How can one attempt to work with bodies if they don’t respect the uncertain, the unknown and the mysterious truths they contain? In healing there is always a tension between grasping hope and giving in to trust and honestly confessing the vulnerability of, “I don’t know.”
For my patient I also request some testing—one thing about spending time on patients’ cases and being medically trained is that you get access to information and the language to understand it. I notice holes in the process that slapped her with this life-changing diagnosis.
When her labs come back, we find she might not have ovarian insufficiency after all. Doorways to hope open up and lead us to rooms full of questions. There are pieces of the story that don’t yet fit the lab results. I give her a list of more tests to get and she thanks me. I haven’t fixed her yet, but I’ve given her hope soil in which to flower. I’ve sent her on a path to more investigations, to more answers. And, thanks to more information in the tests, I’ve freed her and her ovaries from the label of “failure” and “insufficient” and realized that, as a doctor, I can free myself of those labels too. The trick is in admitting, as the lab results have done in their honest simplicity, what we don’t know.
For the moment, admitting insufficiency might prove to be sufficient in the end.
According to James Altucher, author and entrepreneur, it is possible to reinvent yourself in 5 years. In his book, The Power of No, he tells us how to reinvent our lives by first saying a big, fat No to all the things that don’t serve us—toxic friendships and relationships, stagnant 9-5’s, harmful behaviours, negative thought patterns and, well, just things we simply don’t want to do—in order to free up our lives for greater happiness, abundance and creativity.
It is now the end of May. For me, May has been a month of reinvention. For the past 10 years it has been the month of closing and good-byes, specifically the end of the school year. The Canadian College of Naturopathic Medicine class of 2015 has graduated, as I did last year. Last week my Facebook feed was infiltrated with pictures of flowers, long black gowns and tearfully heartfelt thank-yous to the friends and family that got my colleagues through their gruelling 4 years of naturopathic medical education. Last year that was me—I remember the black gowns, the face-ache from smiling, drinking a little too much at grad formal and winning an award (“Most Likely to Write a Best Seller”—complete with misspelling of “bestseller”) while eating Portuguese chicken at my house afterwards with my friend F and his family. This year, one year later, I watch these events from afar. May 2014 offered new beginnings and chance for reinvention. I was dating, enjoying the sunshine, looking forward to a trip to India, looking forward to beginning a practice as a naturopathic doctor. Mostly, last May was about the death of one life—that of a naturopathic student—and the birth of a new one: a complete reinvention.
This year the rest of my life stretches before me like one long expansive road. My career is underway. My dating life is stagnant. The next steps are more like small evolutions rather than massive, monumental milestones. I most likely will not don a black gown again, but I can reinvent myself by following the 20 steps below. I can always check back into these practices when I’m feeling stuck, alone or afraid. When life is not going my way, there is always a chance to begin a reinvention of some sort. And, I remind myself, my current reinvention is likely well underway. Since I graduated last May, I have been in the process of reinventing: just 4 more years left until I complete my obligatory 5. While 4 years sounds like a long time, I know from experience that 4-year cycles turn over within the blink of an eye.
What stage are you on in your own personal reinvention? Wherever you are, follow these steps to reinvent yourself:
1) Say no. Say no to all the things that you don’t want to do. Say no to things that cause you harm: emotional harm, mental harm, physical harm, loss of time, loss of money, loss of sleep. We need to say no first before we can free up the time and energy to say yes to the things that we actually want. In fact, say “no” to all the things you aren’t saying “F#$% YES!” to. Read this article for more information.
2) Re-examine your relationships. Who doesn’t make you feel good? Who makes you doubt yourself? Who do you feel will reject you if you act like your true self around them? Gracefully begin to distance yourself from these relationships. You might feel lonely for some time, but loneliness is sometimes a good thing.
3) Clear out your junk. Get rid of everything you don’t use, don’t like and don’t need. Marie Kondo, in the Life-changing Magic of Tidying Up, tells us to donate, trade, sell or dispose of everything we own that doesn’t bring us joy. I think that that is a wonderful litmus test to decide what we should be holding on to. Personally, one thing that did not bring me joy was an awful old desk in my room. It was uncomfortable and ugly. I replaced it with a free desk someone I knew was throwing away. I also donated 7 garbage bags of things: books, clothes and keepsakes from when I was a child. Since then, I feel like my room has been infused with a little bit more joy. Remove all your joyless items from your life and observe how your energy changes.
4) Sit in silence. This could be meditation, staring at the wall, chanting or simply breathing. Do it with eyes closed or open. I start at 20 minutes of meditation—a meditation teacher I had told me to always use a timer to increase self-discipline—and work up to 30 some days and an hour on really good days. Start with 5 minutes. Sitting in silence helps to quiet the mind and bring us back to the present. You’ll be amazed at what you discover when you sit in silence. Read some books on meditation or take a meditation course for specific techniques, but simply sitting in silence can offer amazing benefits as well.
5) Explore the topics that interested you as a child. When I got back into painting in 2008, after getting a science degree when I’d always been interested in the art, my life changed a little bit. I started a blog in 2011; it happens to be the one you’re reading now. Get back into whatever you were passionate about as a child, even if it’s just a cartoon you used to watch.
6) Start a gratitude jar. Once a day write down something that you are grateful for—use as much detail as possible—and toss it in a jar or shoebox. When you’re feeling low, open up the jar and read the messages you’ve left yourself. I also tried a similar exercise with things I wanted to manifest or achieve. A few months later I read my entries and realized I’d achieved every single one. It’s amazing what kind of energy glass jars can attract.
7) Read. According to James Altucher, you need to read 500 books on a given topic in order to become an expert on something. You have 5 years to reinvent yourself, so start your reading now. Read one book and then, from that book, read another. It’s interesting where reading trails can lead us. I read one book, which mentions another book, read that book and then end up in a new world I never knew existed. I personally feel a little anxious when I don’t have a book beside my bed, but if you’re new to reading, start small. There are two books that I’ve already mentioned in this blog post; start from either of them and then go from there. The next on my list is The Artist’s Way, by Julia Cameron, which was mentioned in The Power of No. Who knows where that one will lead me.
8) Get 8-9 hours of sleep a night.
9) Eat your vegetables, especially leafy greens. Avoid sugar, moderate alcohol and caffeine. Eat healthy protein and healthy fats (if you don’t know what those are, welcome to my blog! browse more of my articles on healthy eating or book an appointment with a naturopathic doctor like me!—shameless self promo).
10) Exercise. Enjoy some movement every day.
11) Exercise your idea muscle. According to James Altucher, creativity is a muscle that we need to exercise lest it atrophies, like any other muscle. He recommends getting a journal and writing 10-20 ideas in it every day. They don’t have to be good ideas, just any ideas. Removing the filter of self-judgement is important for allowing creativity to flourish. We need to strengthen that muscle.
12) Get some psychotherapy. Start dealing with childhood wounds and meeting your inner critic. Address your erroneous beliefs about yourself, the world and the past. Contact me to learn where to get quality psychotherapy in Toronto at an affordable price.
13) Expand your social circle. If you find that after following step 2 your social circle has gotten smaller, start to find ways to expand it. My favourite way to reinvent my social interactions, and thus begin to reinvent my life, is to look up a meetup.com group and start attending. If you’re not sure about a meet-up group you’ve attended, give it 2 more tries before deciding not to go back. In 3 tries, you’ve either made new friends and connections or decided that the energies of the group aren’t right for you. Online dating is another cool place to start meeting people outside your social sphere and getting over social anxieties.
14) Establish a self-care routine. What would someone who loved themselves do every day? Try to do at least some of those things every day. It could be going for a 15-minute walk before doing the dishes. It could be doing the dishes rather than leaving a messy kitchen for your more tired future self. Think about what things will make you feel good and then do them. Most of the time this involves bubble baths—light some candles while you’re at it. Read this article on self-care to learn more.
15) Write a Have-Done List. Instead of writing a list of things you have to do today—your standard To-Do List—write a list of things you’ve done at the end of every day. This fills people with a sense of accomplishment from looking at everything they’ve done. It definitely beats the stress and anxiety of looking at the list of things that must get done looming before them.
16) Treat other people as if it were their last days on earth. We’ve all been told to “live each day on Earth as if it were your last.” But what if you lived as if each day on Earth were everyone else’s last? You’d probably treat them a little more nicely, be open with them, be honest with them and not gossip or speak badly about them. You might appreciate them more. The idea is James’, not mine, but I like it. I think it’s a good rule for how to treat people.
17) Pay attention to what you’re jealous of and what you despise in others. The things we are jealous of in others are often our disowned selves. If I’m jealous of my friend’s Broadway debut I’m probably disowning a creative, eccentric and artistic side of myself that it’s time I give love and attention to. The things we’re bothered by in others often represent our shadow sides, the negative things we disown in ourselves. I used to tell myself the story that my ex-boyfriend was selfish; he took care of his needs first. However, maybe I just needed to start taking care of my own needs or come to terms with my own tendencies towards selfishness. Our negative emotions in relation to others can provide us with amazing tools of enlightenment and prime us well for our own personal reinventions.
18) Let go of the things that were not meant for you. Past relationships, missed opportunities, potential patients that never call back, “perfect” apartments, etc. Say good-bye to the things you don’t get. They’re for somebody else. These things are on their own journeys, as you are on yours. If you miss one taxi, know that there are other, probably better, ones following it. So, rather than wasting time chasing after the missed taxi, meditate on the street corner until the next one comes along.
19) Listen. Ask questions. Show curiosity. When someone finishes speaking to you, take a breath and count to 2 before responding. It’s amazing how your relationships change when engaging in the simple act of listening. I love the Motivational Interviewing technique of reflective listening. In reflective listening, we repeat back the other’s words while adding something new that we think they might have meant, looking for the meaning between the person’s—your friend’s, patient’s or client’s—words. I find that this has helped the person I’m speaking with feel truly listened to. If I get the meaning wrong, it gives the other person a chance to correct me and thereby ensure that we’re really communicating and understanding each other. This one simple tool—reflective listening—has transformed my naturopathic practice and interviewing skills.
20) Be patient. Personally, I’m terrible at this. But, like you, I’ll try working on the other 19 steps while I wait for the next stage of reinvention to take hold. I’ve ordered my next book from the library. See you all in 4 years.
