Self-compassion is the act of treating yourself as you would any other loved one: treating yourself with kindness vs. Self-Judgment.
Self compassion is a modality that is being researched for treatments for mental health conditions, preventing burnout, improving motivation, body image, resilience, and in clinical settings for the helping professions.
The leading expert on self-compassion, Kristen Neff, PhD, defines self-compassion in three ways:
Mindfulness
Invoking a sense of common humanity
Self-acceptance vs. self-judgement
This 3 minute self compassion break can be done in a moment of difficulty, such as in the presence of strong emotions, physical sensations, self-criticizing thoughts, or in the face of failure. It can be done on a daily basis or when difficulty is present.
Step 1:
Adopt a posture that invokes a sense of self compassion. The posture to adopt is traditionally placing hands on the heart, but can also be hands placed on the neck, or a mudra. Touch releases oxytocin, our “love hormone” which releases feelings of calm, love and connection, even when it’s our own hands being placed on our own body.
Step 2:
Either to yourself, or out loud, say these three sentences.
This is a moment of suffering. This is mindfulness, acknowledging that suffering is present and turning towards, as opposed to turning away from difficulty.
Suffering is a part of life. Other alternatives to this are: other people feel this way. This is invoking the sense of common humanity, reminding yourself that you are not alone and other people on earth have felt or are currently feeling this way.
May I give myself the compassion I need. This is setting an intention to be kinder to oneself. Other alternatives are: may I be kind to myself, or may I try to accept myself as I am.
For more on Self-Compassion, to access more of Kirsten Neff’s research, and for free resources, visit selfcompassion.org
Since publising the original article about the Mirena IUD on this blog, thousands of women have come out of the woodwork writing to me asking for help.
When I originally wrote the article, I was spurned on by my observations of the women in my practice who had experienced a rise in estrogen dominance and low progesterone after the insertion of their IUDs (which were often inserted to treat hormone imbalances!).
At that point I never imagined that so many women would be affected by the IUD, or that even more were suffering from so many hormonal symptoms that drastically affected their lives and health.
It makes sense: our society does not set us up for proper hormonal function.
Our diets are carbohydrate-heavy, promoting insulin resistance and blood sugar dysregulation, which impacts our ovaries’ ability to make estrogen properly.
An excess amount of body fat produces more estrogen in the body and acts as a reservoir for the toxic estrogens in our environment.
We lack many of the micronutrients necessary to process our hormones properly, such as vitamin D, B vitamins, magnesium, zinc, omega 3 fatty acids, glutathione, and amino acids.
Many of us have impaired or suboptimal liver function, or sluggish digestion, which keeps hormones in our bodies around longer than they should be.
A dysbiotic gut has the tendency to turn estrogen in the gut back “on”, putting it back into circulation when it was otherwise on its way out of the body.
Stress alters our hormonal function, including our ability to make progesterone, DHEA-S, convert thyroid hormones, and process estrogen properly.
Xenoestrogens in our food and environment, from plastics, fragrances, pesticides, and processed soy products, contribute to overall body burden of the hormones in our body, throwing off our delicate balance, and contributing to symptoms.
The result of all this is that many women suffer from hormonal imbalances.
10% of women have some form of PCOS, or Polycystic Ovarian Syndrome, characterized by the body’s inability to properly make progesterone or estrogen, instead making loads of male hormones, like testosterone. PCOS alters fertility, promotes weight gain, and causes things like unwanted facial hair growth, acne, and missed periods. PCOS is often connected to stress and insulin resistance.
Many women in my practice suffer from PMS or PMDD, experiencing often debilitating symptoms sometimes even two weeks before their periods begin. They might get migraines, intense cravings for sugar, and massive mood changes, such as anxiety, intense irritability, or devastating depression. Panic attacks can occur at this time as well. Many of them comment that their mood and personalities flip once their hormones levels reach a certain point, causing them to act like different people. This can jeopardize their relationships with spouses and children, coworkers, friends and family.
Tender and painful breasts, or breast lumps, are also common in many of these women.
Acne, weight gain, stress, fatigue, disrupted sleep, depression and anxiety are all symptoms I see in women with hormonal imbalances.
Many women have horrific cycles, experiencing painful and heavy periods that often cause them to miss days of work every month. Many of these women struggle to keep their iron levels in the optimal range, suffering from hair loss, fatigue and weakness.
Many women are diagnosed with fibroids, or endometriosis, or are concerned about their risk of female cancers like breast, ovarian, uterine and cervical cancer.
All of these symptoms are often linked to relatively higher levels of estrogens compared to progesterone, sometimes termed Estrogen Dominance by functional medical practitioners who look at the underlying causes of bodily imbalances.
I feel terrible that I can’t help more of the women who write to me. My license prevents me from giving advice to those who live abroad, especially to non-patients over the internet. It’s a shame, however, because oftentimes the solutions are relatively simple, despite how complicated many of these symptoms might seem.
I’m hoping that this article can provide some direction to many of the women who suffer.
Firstly, I want to state that I am not against birth control or even the Mirena IUD (or other IUDs, for that matter). The vast majority of women with the IUD tolerate it. For many women with debilitating heavy periods and endometriosis it can be the only viable solution that makes life tolerable.
In my social practice at Evergreen, many of the women I see experiencing homelessness, drug addiction, or PTSD from relationship trauma, rely on the efficacy of IUDs to prevent unwanted pregnancies. Their lives often don’t allow for them to remember to consistently take pills every month.
Many women don’t tolerate combination birth control because of a history of blood clots, female cancers, or migraine headaches associated with their periods, and therefore the Mirena IUD, which is progesterone only, is a safe alternative for preventing unwanted pregnancy.
That all being said, many women do suffer on the Mirena IUD (or other forms of birth control). They were perhaps put on the Mirena to deal with some of the above symptoms of hormonal imbalance, or for contraception. Many of them noticed that their symptoms became worse after insertion of the IUD.
How the Mirena IUD and Birth Control Works:
The Mirena works by secreting small amounts of progestins, a synthetic form of progesterone, into the uterus and surrounding tissues. While it is not fully known how the Mirena works, the end result is a suppression of ovulation. This results in either very light periods or a complete cessation of periods until the IUD is removed (after 5 years when its hormones run out).
It is important to say here that, while birth control can certainly treat the symptoms of hormonal imbalances, it does not correct them.
All forms of birth control, with their synthetic versions of the hormones estrogen and progesterone, simply induce further hormone imbalances in the body. They introduce versions of hormones that may suppress or alter symptoms (such as heavy and painful bleeding, or acne), but the versions of hormones are not fully recognized by the body and therefore don’t fully replace all the hormones’ important functions, such as mood regulation, immunity, or blood sugar balance.
The effects of both altering the body’s natural hormonal balance, while ignoring the underlying cause of hormonal issues, is often what causes symptoms to continue or worsen.
For example, women with PCOS are prescribed birth control to manage acne or promote monthly periods. However, when women with PCOS miss periods, it is because they are not ovulating. The missed periods are not the problem; the lack of ovulation is.
Despite that, many women with PCOS experiencing amenorrhea (or missed cycles) will be prescribed birth control. However, birth control does not address the underlying cause of amenorrhea. It simply further suppresses ovulation (because its main purpose is to prevent unwanted pregnancy).
The periods you get while on birth control are not periods. Periods from birth control are withdrawal bleeds. After 21 days of taking hormonal pills, pills are stopped or replaced with placebo pills. The withdrawal of hormones in the pills induces a bleed that resembles a period, but is not one.
Hormonal contraception does not correct hormonal imbalance, it imposes further hormonal imbalance to manage symptoms. This is not always bad!
But it is an important difference.
Many women do require symptom suppression, particularly if their symptoms are severe. Many individuals in my practice experience periods so heavy that the only way for them to get through the month is with an IUD. Genetic variability in how our bodies process hormones can make us susceptible to intense hormonal symptoms, through no fault of our own.
In my opinion, however, it is important to attempt to address the underlying cause and to set our bodies up for better hormonal regulation, making as many changes as our lifestyles will allow.
What You Can Do About It:
If you are like any of the people I described above who seek my help, there are a few things that you can do to get started on correcting hormones.
Working With a Professional:
The first thing I advise is finding a licensed naturopathic doctor or functional medicine practitioner who understands hormones, can order lab tests, and will address the underlying cause of your hormonal imbalances by taking the time to fully understand your body and lifestyle.
This practitioner might be a naturopathic doctor (you can find one in North America by looking one up at naturopathic.org), or a medical doctor, a chiropractor, or a highly skilled nutritionist or nurse practitioner. Research this person well, read their articles, and perhaps book in with them for a complimentary meet and greet.
Testing:
I often test patients using simple blood tests, on day 21 of their cycles (or about 7-9 days before they expect their next period).
I will test their blood, looking for anemia, will test iron and B12 levels, homocysteine (to gauge their ability to methylate), vitamin D, cholesterol (to see if their diets are promoting proper hormone synthesis), estradiol, estrone (the more toxic, problematic estrogen), progesterone, free testosterone, a thyroid panel, fasting glucose and fasting insulin (to calculate insulin resistance using something called the HOMA-IR), HbA1C (to look a long-term blood glucose control), FSH and LH (two hormones made in the brain that talk to the ovaries and orchestrate the menstrual cycle), DHEA-S, to name a few.
Some women will require more testing. Others will require less.
These labs are interpreted from a functional perspective. Even though you are in the “normal” ranges (which take into account the entire population, many of which are not healthy—they are seeing their doctors, after all!), these blood markers may not be optimally balanced, giving us an opportunity to correct things before they go further.
Testing allows us to match symptoms to underlying imbalances and to be able to properly direct treatment protocols. Women with estrogen dominance may be experiencing high levels of estrogen and normal progesterone, which indicates a body burden of estrogen or impaired liver and digestive system clearance. Other women may be experiencing normal levels of estrogen but low progesterone, indicating a failure of their bodies to ovulate, due to high stress, and PCOS (or the Mirena IUD and birth control pill).
Other options for hormonal testing are month-long salivary hormone testing, or DUTCH testing, which looks at hormone breakdown in the urine. I sometimes run these tests, but find that blood testing is useful, accurate, and more cost-effective.
Treatment:
Once you understand your individual hormonal situation through testing (and through working with a practitioner who is putting the testing together with your symptoms and health history), your practitioner may recommend a variety of treatments.
I personally combine diet and lifestyle with key herbal and nutritional supplements, to target what is going on under the surface with my particular patients.
These treatments may include herbs that boost ovulation, aid liver detoxification, or regulate the stress response. I might recommend nutraceuticals that encourage methylation, or aid in hormone production.
My treatments take into account the individual’s symptoms, labs, diet, lifestyle, and any other health issues she may be facing like fatigue, digestive disturbances, or poor sleep.
What You Can Do Today:
Barring more individualized assessment and advice, there are some best lifestyle practices that can help most women balance their hormones better, whether they are still using birth control to control and address their hormonal symptoms or prevent pregnancy.
Diet:
When it comes to diet and hormone support, we need to ensure that we are balancing blood sugar, boosting liver detoxification pathways, promoting hormone synthesis, and supporting digestion, especially if experiencing constipation.
Consume more leafy greens: kale, spinach, collards, beet greens, arugula, etc. Eat 1-2 cups of these foods every day. Leafy greens contain active folate, which boosts methylation and detoxification. They also contain magnesium which is essential for hormonal regulation as well as 300 other important biochemical reactions in the body that balance mood and hormones.
Consume more cruciferous vegetables: broccoli, cauliflower, brussel sprouts, cabbage, bok choy, etc. Eat 1-2 cups of these foods every day. Crucifates help the body make glutathione, and contain indole-3-carbinole, which helps eliminate excess estrogens from the body. Broccoli sprouts are potent players in these pathways. Consume them as often as possible.
Ensure adequate dietary fibre intake: I often recommend ground flaxseeds or chia seeds in smoothies, avocados, fruits and vegetables and legumes (if tolerated) to make sure that women are having regular bowel movements to clear excess estrogens out of the body. 2 tbs of ground flaxseed (or more) every day can help balance estrogen levels and promote daily bowel movements.
Balance blood sugar: consume protein, fat and fibre at every meal. Avoid refined starches and flours. Avoid all sugar, even natural sugar like maple syrup, coconut sugar, cane sugar, honey, agave, etc. Try stevia or avoid sweets. Limit carbs (grains, legumes, root vegetables like potatoes or sweet potatoes, to 1/2 cup to 1 cup per meal). Only consume whole grains like quinoa, buckwheat, steel cut oats, millet, and teff. Cook them yourself!
Avoid soy, particularly processed soy, like vegan burgers, or soy milk.
Consume omega 3 fatty acids in fatty fish like salmon and sardines, or nuts and seeds like flax and chia seeds, walnuts, and pumpkin seeds. Get 2-4 tablespoons of these nuts and seeds every day and 3-4 servings of fatty fish a week.
Consume animal products: eggs contain choline, which is essential for liver function, meat contains vitamins B6 and B12, which are essential for hormonal regulation and production. Cholesterol in animal products are the backbones of our sex hormones. Iodine, found in animal foods, regulates estrogen balance in the body. If possible, try to obtain organic animal products from pastured or free-range animals to boost omega 3 intake, to lower your impact on the environment, and to promote animal welfare.
Other Lifestyle Practices:
Boost progesterone production by managing stress:
Establish a self-care routine: plan regular vacations, even small outings, do meditation or yoga, take breaks from work, spend quality time with family, have a plan to get your work done on time, ask for help.
Sleep! Aim for at least 8 hours of sleep, and try to get to bed before 12am. Practice good sleep hygiene by avoiding electronics before bed, keeping the bedroom as dark as possible, and setting a bedtime and wake time, even on weekends. Body scan meditations and some key supplements can be helpful for resetting circadian rhythms. Regulating blood sugar can have a major impact on improving sleep. Talk to your functional medicine doctor or naturopathic doctor for individualized sleep solutions.
Eliminate exposure to toxic estrogens and boost estrogen clearance:
Avoid exposure to xenoestrogens: whenever possible use natural body products, deodorants and shampoos, or “edible” body products for face and hair. Avoid plastic water bottles and plastic food containers. Use natural cleaning products around the house. Avoid fragrances and processed foods, especially processed soy.
Encourage sweating: get regular exercise or engage in regular sauna therapy. If you don’t have access to a sauna, epsom salt baths can also work—anything that helps you sweat. Heat therapy has also been shown to benefit mood and the stress response.
Heal your digestion: make this a priority with your naturopathic doctor, so that you can absorb the nutrients from the foods you’re eating as well as encourage daily bowel movements and optimal microbiome balance.
Maintain a healthy weight: body fat is metabolically active and can increase overall estrogenic load. Work with your naturopathic doctor to manage your weight. We often attempt to lose weight to become healthy, however I find my patients have far more success (and fun!) getting healthy in order to lose weight. Healthy weight loss often involves managing stress, sleeping 8 hours a night, avoiding sugar and processed foods, and regulating blood sugar, as well as encouraging proper sweating and liver detoxification.
Want to balance your hormones, energy and mood naturally? Check out my 6-week foundational membership program Good Mood Foundations. taliand.com/good-mood-learn
Humour me for a moment. Take a moment to imagine your “happy place”—the place you feel most at home. Where are you? What are you doing? Who is there with you?
What are the sights, sounds, smells, tastes, and sensations that fill the air and tickle your skin? What are the internal bodily sensations you notice when you find yourself here, in this place? What emotions do you feel?
I’ll venture some guesses: you feel calm, at peace, safe, energized, connected, and integrated. If you turn your attention to your breathing you probably notice that it’s slow, deep, restorative. That head cloud of frenzied thoughts and worries that you tend to spend your time in might have cleared. Your sense of “self” has probably moved out of your head and into your body.
Maybe, through doing this short exercise, you’ve come home to yourself, even just a little.
1) Understand what “self-care” means.
A friend recently shared a Collegehumor video with me depicting three women in a nail salon, bragging about what horrible things they’ve done, from eating 13 glazed donuts in a single sitting, to “enslaving the entire office”, in the name of their own self-care. Because, according to the video, “You can be terrible if you call it ‘Self-care’”.
Humorous? Perhaps. An accurate depiction of self-care? Well, no.
I asked followers of my Facebook page to tell me what the phrase “Self-Care” means to them. They enthusiastically replied:
“Silence. No social media, or anything electronic.”
“Floating in water—buoyant, effortless.”
“Being kind and gentle to myself.”
“Meditation and time to oneself.”
“Eating healthy foods.”
“Respecting your body.”
“Epsom salt baths.”
“Peace.”
“Rest.”
“Hygge.” (a Danish word that is roughly translated as “warm and cozy”)
“Yoga.”
“Commitment.”
“Masturbation.” (There’s one in every crowd.)
In essence, their responses boiled down to, “Self-care is feeling good, taking care of myself, and taking care of my body, by engaging in activities that feel nourishing while reducing external stress and overwhelm.”
Put even more simply, self-care is the act of practicing self-compassion, whatever that might look like to you.
2) Understand the impacts of stress.
The relationship between self-care and stress is important. According to The American Institute of Stress, about 75% of us have significant physical and psychological stress in our lives.
This stress takes a toll; it produces physical, mental and emotional symptoms, sending us into emergency rooms with panic attacks, and drugstores with prescriptions for pain, anxiety, or anti-hypertensive medications.
Stress lands us in doctor’s offices, pouring over junky magazines waiting to discuss our latest health complaint—digestive issues, mental health issues, fatigue, autoimmune disease, metabolic syndrome, chronic pain, weight gain, and so on.
Our bodies have a built-in stress response to save our lives when triggered by a life-threatening danger. Now, this fight-flight-freeze mechanism is chronically set off by the abundant stressors in our modern era—traffic, deadlines, relationship woes, artificial lighting, and in-laws.
When our body encounters a stressor, one of the hormones it releases is cortisol.
Cortisol affects every system in the body; it elevates blood sugar, heart rate, and blood pressure. It suppresses the immune system, redistributes fat, shrinks certain areas of our brain involved in learning and emotional regulation, causes painful muscle contraction, impairs digestion, and affects our sleep.
Managing stress involves two main goals: lowering external stressors, and managing internal perceived stress by boosting our physical, mental, and emotional resilience. Self-care is our armour against the internal and external stress we put up with daily.
3) Make a list of your nourishing and depleting daily activities.
Let’s try an exercise from Mindfulness-Based Cognitive Therapy. Write down a list of routine activities in your typical day: hauling yourself out of bed, brushing your teeth, eating breakfast, sitting in traffic, working, exercising, making dinner, and so on.
Decide if each activity is nourishing, depleting, or neutral. In other words, does this activity fill your cup or drain it?
For instance, I find that breakfast is nourishing, but less so when I scroll through Facebook feeds or answer emails while eating it. Coffee immediately feels nourishing to me but, hours later, caffeine-fuelled and wired, I often feel more depleted than if I had opted for an herbal tea, or hydrating water instead.
4) Find out what brings you pleasure or mastery.
To get a deeper understanding of your day, determine if the activities that nourish you provide you with pleasure, mastery, or both.
Pleasurable activities feel good in our bodies, and minds when we do them. They bring us positive emotions like safety, calm, peace, happiness, joy, excitement, gratitude, and awe. Sleeping, eating, laughing with friends, cuddling with my dog, and consuming art, are all activities that give me pleasure.
Activities of mastery give us a sense of accomplishment and achievement. We feel that we are developing ourselves and moving closer towards an important goal. When we engage in activities that give us a sense of mastery, we experience our lives to be rich in meaning. Checking things off a to-do list gives me a sense of accomplishment. So does making strides at work, and taking a course, or studying.
5) Make some changes to your list.
Oftentimes, patients recoil in horror when they realize that their lists contain only depleting and neutral activities. There are no activities in their day that nourish them: either through pleasure or self-development. I ask them:
Are there any depleting activities that you can stop doing?
Are there more nourishing activities that you can start doing?
How can you make a depleting activity feel more nourishing?
Self-care and self-compassion are the agents through which we answer these questions.
6) Set healthy boundaries.
Before we can reduce the invasion of depleting activities in our lives, we must learn to prioritize our needs. Many of us put others’ needs first. We ignore the advice of every flight attendant—we put on everyone else’s oxygen mask before our own. Before long, we run out of air.
In order to nourish ourselves, we need to learn to create healthy boundaries around our energy and time; we need to say “no.” Author Cheryl Strayed writes, “No is golden. No is the kind of power the good witch wields… [It involves] making an informed decision about an important event in your life in which you put yourself and your needs and your desires front and centre.” When we say no to the people, activities, commitments, and responsibilities that drain us, we say “yes” to ourselves.
Think of your list of depleting, nourishing and neutral activities. What activities, if you could just say “no” to them, would bring you immense relief? What would saying no to those activities allow you to say yes to instead?
7) Recognize perceived stress.
Whether or not external events elicit a stress response in our body depends on our perception. Stressful events are woven into how harmful and uncontrollable we perceive them to be, rather than their intrinsic capacity to cause us harm.
Our perception of stress can be influenced by biochemical factors, such as our levels of neurotransmitters, and hormones. It can also be influenced by our mindset, our capacity for resilience, and how far into burnout we’ve begun to drift.
Lowering our perception of stress requires that we practice the skill of mindfulness: being aware of how external situations affect our thoughts, emotions, body sensations, and behaviours. It also requires that we pay attention to our internal physiology: our hormones and circadian rhythms, and inflammation levels, to support our body’s physical capacity to deal with stress.
8) Practice Mindfulness.
A tarot reader friend of mine once said, “It is impossible to be healthy in this day and age without mindfulness.” She was probably right.
Mindfulness helps us lower our perception of stress. It is the act of bringing attention to the present moment, intentionally, without judgement. Through mindfulness we can be intentional about our behaviours: how often we exercise and what it feels like, what certain foods feel like in our bodies, and what activities we engage in.
Mindfulness also allow us to parse out our overwhelmed, worried, personalizing, catastrophizing, black-and-white, future-telling, and negative, thoughts from our body sensations and emotions. We realize that our thoughts are just that—thoughts. Thinking something doesn’t necessarily make it so.
Research shows that mindful meditation strengthens the connections between the rational brain and the emotional brain. It helps us develop awareness of our moment to moment experience. It connects us to our bodies and our emotional states.
There are many different mindfulness techniques. You can do sitting meditations, standing meditations, and walking meditations. You can do mindful yoga. You can wash the dishes mindfully.
However, the simplest way to begin a mindful practice is to sit or lie down in a comfortable position, with an relaxed and alert posture, and focus on the experience of breathing.
Focussing on the breath helps us practice bringing our awareness to the present moment. As we learn to ride the waves of our breathing, we eventually learn to ride the waves of stress that sometimes lap gently at our floating bodies, and other times rock us to our core.
With mindfulness we can begin to relax our resistance to the waves. As Jon Kabat Zinn says, “You can’t stop the waves, but you can learn to surf.” Mindfulness is the surfboard that carries you.
9) Practice self-soothing.
Self-soothing helps us regulate our emotions in the presence of external stressors. Dialectical Behaviour Therapy teaches self-soothing as a means of returning to the “Window of Tolerance”.
When we’re in the Window of Tolerance we’re not in fight, flight or freeze. We aren’t depleted, disconnected and dissociated. We feel relaxed and safe, but also alert and focussed. We are present, in control of our bodies. Self-soothing allows us to enter the window of tolerance by boosting the hormone oxytocin, which helps us feel calm, nurtured, and connected.
To boost oxytocin:
Lie or sit in a comfortable position, place your hands on your chest and breathe slowly and deeply.
Connect deeply with a trusted other: a person in your life, a pet, or an entity (God, your higher self, a deceased loved one, etc.).
Use body weights or heavy blankets on your body.
Recite believable affirmations of self-love.
Ask someone you trust for a hug.
Boost pleasure through engaging the senses: listen to soothing music, savour delicious food, look at beautiful images, touch soft fabrics, and use aromatherapy and calming essential oils, like lavender.
Poet Mary Oliver tells us, “You do not have to be good… You only have to let the soft animal of your body love what it loves.”
Self-soothing requires practicing mindful awareness to recognize if you’re slipping outside your Window of Tolerance. It also involves implementing nourishing rituals that “the soft animal of your body” loves, to release oxytocin, and return to feelings of calm.
10) Balance blood sugar to balance your mood.
Our blood sugar is complexly intertwined with our other hormones, like insulin and cortisol, but also our neurotransmitters, like serotonin, epinephrine and dopamine, which influence our mood.
More than 1 in 3 American adults has pre-diabetes. This indicates an impairment in our body’s ability to control blood sugar, which throws mood and hormones off balance.
One of the main life-saving actions of the body’s stress response is to regulate glucose in the blood. Fluctuations in blood sugar can trigger cortisol and stress hormone release. Stressful events can also wreak havoc on our body’s ability to control blood sugar. Regulating blood sugar, therefore becomes a priority for managing our body’s internal stress cues.
To balance blood sugar:
Eat a full 20 to 30 g serving of protein and healthy fat at each meal.
Eat a large, protein-rich breakfast that contains at least 200 calories’ worth of healthy fats: 1 avocado, a handful of nuts or seeds, coconut oil, full fat yogurt or kefir, 3 eggs, etc., within an hour of waking.
Eat snacks that contain 10-15 g of protein. A great snack for balancing blood sugar is a 1/4 cup of pepitas, or raw pumpkin seeds. Rich in protein, fibre and healthy fats, they also contain zinc and magnesium, two important minerals for balancing mood and supporting stress hormones.
Ensure that every meal contains gut-loving fibre: eat 2-3 cups of vegetables at every meal.
Avoid refined sugars and flours wherever possible.
Experiment with Time-Restricted Feeding, leaving at least 12 hours of the day open where you consume only water and herbal teas, to give the digestive system a rest. For example, if you have breakfast at 7am, finish your dinner by 7pm, to allow 12 hours of fasting every night.
11) Calm your stress response through healing your circadian rhythms.
The body’s stress response is tightly connected to our circadian rhythms. Cortisol, the stress hormone, follows a predictable daily pattern, rising within an hour of waking in the morning, and then falling throughout the day. Low cortisol levels at night coincide with the rise in melatonin, our sleep hormone.
Morning fatigue, afternoon crashes, and waking at night, all point to a flattened or altered stress response that has negatively impacted our body’s circadian rhythms. Sleep is also the greatest reset for the stress response. We build up our metabolic reserve and internal stress resilience every night when we rest.
To heal your circadian rhythms:
Expose yourself to bright, natural daylight soon after waking.
Eat a large, fat and protein-rich breakfast within an hour of waking.
Avoid exercising too close to bedtime.
Keep blood sugar stable.
Practice sleep hygiene: keep your bedroom dark and cool, and reserve your bed for sleep and sex.
Avoid blue light after 7 to 8 pm. Wear blue light-blocking glasses, use a blue light-blocking app on your devices, such as F.Lux, or simply avoid all electronics in the evening, switching to paper instead.
Try to get to bed before midnight, as the deepest sleep occurs around 2 am.
Talk to your naturopathic doctor or natural healthcare professional about melatonin supplementation or other natural remedies to help reset your sleep cycle.
12) Manage Inflammation and nurture your microbiome.
Cortisol, the stress hormone, is an important anti-inflammatory. High levels of inflammation have been associated with mental health conditions like depression and anxiety.
Keeping inflammation levels low not only reduces our need for stress-hormone-signalling, but keeps us healthy. Most chronic conditions, like cardiovascular disease and diabetes, are associated with inflammation.
To keep inflammation levels low:
Eat a variety of anti-inflammatory colourful fruits and vegetables.
Avoid processed oils like soy and corn oil, whose omega 6 fatty acids are known to contribute to inflammation.
Eat healthy fats from avocados, fish, coconut, olives, nuts, seeds and grass-fed animals.
Avoid processed foods and fried foods wherever possible.
Nurture your gut health by eating lots of fibre, and consuming fermented foods, like kefir and sauerkraut.
Our gut is the seat of the immune system. Keeping it healthy is a powerful preventive measure for keeping inflammation levels low. Our gut bacteria also play a role in our mood and stress-hormone regulation. Therefore, keeping them healthy and happy is essential for boosting our internal resilience against external stressors.
13) Recognize that balance doesn’t exist.
None of us are born cool and collected. Those of us who seem to “have it together” are simply quick to respond to life’s tendency to fall apart. Balance doesn’t exist; as soon as we feel like we have the details our lives lined up, a sharp gust of wind sends them tumbling in all directions. Therefore prioritizing self-care becomes an ever-evolving balancing act that we must commit ourselves to through nurturing our internal resilience.
A poem by Kelly Diels says it best, “when your love knocks you down or your weak ankles trip you up, stop worrying about balancing—‘cuz you’re not — and bounce.”
I talk about root causes of anxiety, the most common mental health condition, and what to do about it from a functional medicine perspective.
Hi, everybody, Dr. Talia Marcheggiani here. I’m a naturopathic doctor who practices in Bloor West Village, in Toronto and today I’m going to talk to you guys about the roots of anxiety.
Anxiety is the most common mental health condition. It affects about 18%of North Americans and it encompasses a wide range of different diagnoses including generalized anxiety disorder, panic disorder, OCD, phobias, PTSD and depression, and social anxiety. It’s a huge umbrella of different conditions. So the first thing I do when I meet my patients is try to understand how anxiety manifests for them. The word anxiety means very little to me. What I care about is how the symptoms are manifesting in my individual patient in front of me and how it affects their life. So, I’ll ask them what does it mean when you tell me that you have anxiety? Walk me through a situation when your anxiety gets triggered, tell me what it’s like to live inside your shoes, inside your head, what kind of things do you worry about? What goes on in your body? And, how do you know that you have anxiety? Did you decide that you had that diagnosis or did someone else give it to you and what do you feel or think about having that diagnosis? Do you agree with it? Do you disagree? Do you have any doubts? The symptoms of anxiety encompass the body because it affects our nervous system, every single bodily organ is affected, potentially, by anxiety and some people have some of the symptoms or all of them and sometimes very few, just the mental and emotional symptoms, and many of us don’t even identify with having chronic anxiety or anxiety disorders or anxiety symptoms.
First of all, we have the mental symptoms. People with anxiety will commonly experience worrisome thoughts, anticipatory anxiety, so, being worried about the immediate future or the distant future. They might feel irritable or excited, they may have depressed mood. A lot of the people I see with anxiety have this kind of “chilled out” demeanour because it’s very common for someone who’s got a high level of anxiety in their body to dissociate a little bit from those feelings and appear very calm. They kind of describe it as a duck on a pond. On the surface, you see this calm animal, just floating along, but when you look under the water you see the duck legs busily working away and so that’s how a lot of people will describe their mind. They say, on the surface I’m really calm, but once you look under the surface, you see that there’s a lot of mental activity and a lot of worry that’s happening.
There may be fears, such as specific fears, such as phobias, or just general fears, like in the case of generalized anxiety disorder, or fears may be triggered in certain situations like in the case of social anxiety. Insomnia is very common, an overactive and busy mind is very common, fatigue is another common symptom as well as difficulty concentrating, memory loss, brain fog. So all of these conditions that show that the person who’s experiencing anxiety and who is dealing with anxiety is distracted and focused on other things, rather than what’s right in front of them. So a lot of the time my patients will describe an inability to feel present and feel connected and enjoy the moment. Their mind is always on something else. Sometimes the anxiety is based around specific concerns and sometimes it’s just very general and it doesn’t really matter what’s going on in someone’s life, there’s this sense of impending doom that they’re dealing with on a daily basis. Anxiety and depression are very common, they’re comorbid mental health conditions, and it’s very difficult to tell the difference a lot of the time. There’s a hypothesis that they’re similar conditions, or the same condition, but one is a more extraverted, so that would be anxiety, version of depression, which is a more introverted and internalized manifestation of the same disease process. This is still a hypothesis, but it makes some sense and it resonates with a lot of people that I talk to.
Then we have the bodily symptoms of anxiety. A lot of people will experience muscle tension, aches and pains. This is typically in the shoulders where they carry their worries or they’ll find themselves tensing their muscles without being aware of it. They may experience twitching, and they experience pain from the tight muscles. There’s also sensory symptoms, such as ear ringing, hot and cold flushes, changes in vision, tingling, numbness, muscle cramps. It’s very common to have cardiovascular symptoms, such as a racing heart or heart palpitations and this often occurs in people who have panic attacks, which often sends them into the emergency room, because it can be difficulty breathing, racing heart, chest pains, sweating, all these kinds of autonomic symptoms that one might experience if they were having a cardiovascular event, can occur in someone with anxiety or panic disorder. It can be really frightening.
Then there’s gastrointestinal symptoms, so there’s definitely a connection between IBS and anxiety. And those of us who don’t necessarily suffer from anxiety but have experienced nervousness, which I’m sure we all have, will notice that our gut is definitely affected and we may have looser bowels, bloating, difficulty digesting, or we might not have an appetite or want to eat. And this all common in people who have chronic anxiety. Genitourinary symptoms, such as frequent urination, or frequent thirst, often leading people to think that they have diabetes. Also, there might be a delay in urination, so you feel like you have to go to the washroom, you go to the toilet and then there’s a moment where you can’t really go, and you’re trying to wrestle with yourself, which is really common. So urinary hesitancy, it’s called. And then we have the autonomic, so the symptoms that are related to the autonomic, or automatic, nervous system, such as a dry mouth, dilated pupils, sweating or flushing, and this also related to our GI symptoms.
So, these are just a few of the anxiety symptoms. And, as you can see, they affect pretty much every single system in the body. Our nervous system, which is what is affected in anxiety, consists of our brain, our spinal cord and all of our nerves. Nerves that go to and from different body organs and our nervous system is divided into the voluntary and the involuntary, or autonomic, nervous system and our autonomic nervous system is divided into the sympathetic and parasympathetic nervous systems. So our sympathetic nervous system is the “fight or flight” nervous system. This gets turned on when we sense an immediate danger and our body is primed to respond to that danger.
The parasympathetic nervous system is turned on when we’re sleeping and digesting, and when we’re a state of otherwise calm, when there is no danger around. You can think of these two systems as a seesaw. One gets turned on while the other gets turned off and our body should be able to toggle back and forth between these two arms of the autonomic nervous system easily and without getting stuck in either one and depending on the situation and what’s going on. So imagine that you’re walking through the forest, and you’re feeling calm, and you’re feeling at peace, and then you look down at what you think is a stick on the ground that starts to move, your autonomic nervous system is going to kick you into the sympathetic, fight or flight, response. In this response your body will be primed to either fight, flight, run away, or freeze. And these three responses are what will get us away from the danger or meet that impending danger and this is what our body will respond with in order to ensure our survival when there are dangerous situations that we’re faced with.
Once that danger’s gone, we’ve either fought, flown, or frozen and the danger has forgotten about us and left, we’ll return to the parasympathetic nervous system. We need the parasympathetic nervous system turned on when we’re eating and when we’re sleeping. If we have problems, so if we get stuck in that fight or flight response for too long, either because we perceive there to be danger, or our body simply can’t switch back into the parasympathetic state, we’re going to have problems with feeling relaxed, sleeping soundly, and digesting our food properly.
Those of us who are experiencing chronic stress, our nervous system is just taxed, and we’re in the sympathetic nervous response far longer than we should be, because we’re constantly facing deadlines, or we have a lot more responsibility and a lot less control, on our plate, we’re going to experience this feeling of chronic stress. This will exacerbate someone who’s already got a predisposition towards anxiety. There’s a hypothesis, or personality theorists hypothesize that some of us are just born with a higher level of neuroticism as part of our constitutional tendencies. So I see that a lot of anxiety will run in families, especially in female patients, many of them will have grown up with a mother who suffered from anxiety. So there’s definitely a nature component to the nature-nurture debate in terms of what causes anxiety. So, while we can’t really affect our nature, or our genetics, we can affect how those genes are expressed and we can look at the environmental factors that might trigger those genes to be expressed. So that’s what I’m here for. My goal as a naturopathic doctor is to take a full assessment, understand what someone’s symptoms of anxiety are, what the external factors, the environment of their life is like, and look for potential causes that might be exacerbating the anxiety, making it difficult for them to function and perform and live the life that they know they can live. Living a life that’s full of abundant health.
So, the first cause that I want to talk about is chronic stress. when we’re stressed out, like I described when we encounter that snake in the grass, our body will release hormones called norepinephrine and epinephrine. Those are our fight or flight hormones. Those are short-lived, and when those run out, our body starts to make cortisol. Cortisol is a more long-term stress hormone. However, when we’re stuck in that sympathetic state our body becomes, well a theory is that our body becomes unable to produce as much cortisol for long periods of time, that our adrenals get “fatigued”. Another theory is that our brain stops responding to cortisol and we develop a kind of cortisol resistance. And this we’ll see with a lot of brain fog, memory loss, difficulty concentrating, there’ll be a lot of weight gain, especially around the abdomen, and people will experience a lot of inflammatory symptoms, so that’s when we’ll see joint pain and muscle aches and, potentially, worsening of depression as cortisol can kind of motivate us and get us going, because, if you think about it, when we’re in a state of fight, flight or freeze, that’s an action-oriented state, once our body stops responding to that, we enter this kind of burnout and exhaustive phase.
What’s more, once our body stops responding to cortisol, in order to maintain that sympathetic tone, to stay in that fight or flight state, that for whatever reason our body is turned on to, we start to make those catecholamines, norepinephrine and epinephrine again and that contributes to those symptoms of anxiety. So essentially what anxiety is is a high cortisol, high norepinephrine state, where we have that racing heart, we have those tense muscles, we’re looking for danger and our body, for one reason or another, expects that there’s some kind of danger that it needs to defend itself against.
So, not all stress is bad stress. You think of a new mom, she’s full of love and all these feel-good hormones, but the lack of sleep, the added responsibility, all of the things that having a new baby might mean to her and her life, are going to contribute to more stress hormones going through her system. And so I’ll ask a lot of my patients if they’re stressed and, even though I’m kind of getting a sense of high stress from them in terms of their level of busyness, and their level of downtime and just the demands on them in their day-to-day life, a lot of them will say that they don’t feel stressed, that they love their job. So it’s not about whether you love your job, or whether or not you love the things that are, basically, getting piled onto your plate, it’s your body’s perception of those things. So, our body does well when it has enough down time, it has enough restful sleep, and it gets enough breaks. So that keeps that toggle from the sympathetic nervous system, to the parasympathetic nervous system, fluctuating in a healthy way, without getting in one or the other.
Another common cause of anxiety that I see, or definitely a factor that exacerbates anxiety symptoms, is blood sugar imbalance. So, when we wake up in the —a lot of us wake up in the morning and we have cereal, or we have those packaged oatmeals. So, in North America we eat high-carb, high-sugar breakfasts, or we skip breakfast, or we just eat a lot of carbs and sugar in general throughout the day. When you eat a food that’s high on the glycemic index, that contains a lot of easily digestible carbs or refined flours and sugar, we get this immediate spike in blood sugar, as those sugars are absorbed directly into our blood stream. When we get this high level of sugar, we might feel a lot of energy, we might feel really good, we get a lot of dopamine release, and it feels pretty awesome, we get a lot of immediate energy that our body can use. But then, because our body wants to maintain a certain level of blood sugar, what gets released next is a hormone called insulin. Insulin helps that glucose, that sugar, get inside of our cells, where we can use it for energy. If our blood sugar shoots up too high our body sends more insulin into the blood stream to lower that sugar. Sometimes it sends too much insulin and our blood sugar plummets, we get hypoglycaemia symptoms: dizziness, “hangry”, irritability, weakness, fatigue, you’d kill someone for a piece of toast kind of situation, and carb cravings, and we respond by eating more carbs and the cycle begins again. That can exacerbate anxiety because our energy levels are going to be rising really quickly and falling really quickly. Stress hormones are going to get triggered everytime we enter a hypoglycaemic state. And, because cortisol also releases sugar into the blood, so cortisol and insulin work together. Going through this eb and flow of blood sugar, basically riding the blood sugar rollercoaster, is going to exacerbate and mimic a lot of the anxiety symptoms that I described. So a lot of people I talk to, when they’re experiencing anxiety, oftentimes, during the day when they’re experiencing anxiety, it’s between meals, or it’s after a high carb, high sugar meal. And, so a big part of managing their anxiety, or at least creating a terrain where their mental health can function optimally, and their emotional wellness has a chance to function optimally, is to get their blood sugar nice and level. And this means adding protein and fat to every single meal, lowering those refined carbohydrates, beginning each day with a high-fat, and high-protein breakfast. Nutrient deficiency is another really big cause that I look for when it comes to anxiety. So, the happy hormone, serotonin, which is implicated in both depression and anxiety, that’s what the antidepressant and anti-anxiety drugs like cipralex or prozac act on, so those selective-serotonin re-uptake inhibitors. This is a hormone that gives us a feeling of satisfaction, it gives us a feeling of uplift, it’s often what tanks when we crave carbs, and so eating carbohydrates kind of perks our serotonin levels up. In order to make serotonin, we need an amino acid called tryptophan, which we get from protein, and we need the vitamins B6, magnesium, B12, and zinc, and iron. And those take tryptophan and turn it into another amino acid called 5HTP, which then gets turned into serotonin. And then, once we have enough serotonin, that gets turned into melatonin, which helps us sleep and regulates our circadian rhythms. So any break in either of those pathways is going to result is us having lower levels of serotonin and melatonin available to our nervous system for us to have proper mental and emotional regulation. When we’re stressed out, our demand for those nutrients goes up, because our adrenal glands are also sucking in a lot of those nutrients to make cortisol and the catecholamines. Protein is super important, not just for blood sugar regulation, but to give us the amino acids that we need to make the proper neurotransmitters. So, I mentioned serotonin, I also mentioned norepinephrine and epinephrine and other ones include dopamine, GABA, which is a nervous system calming neurotransmitter, glycine, another nervous system calming neurotransmitter, and a good source of glycine is collagen, or gelatin, which I’ve mentioned in other videos. See the “8 Foods for Mental Health”, and tyrosine, which makes dopamine and also makes the catecholamines. So we need tryptophan, which makes serotonin and melatonin, we need GABA, which makes GABA, and that calms our nervous system down, we need tyrosine, which makes dopamine, this is a feel-good hormone that helps us seek rewards and feel motivated, and energized, also tyrosine gets made into thyroid hormones, again, which helps us feel energized and keeps our energy levels stable and our metabolism revved up, and the catecholamines, norephinephrine and epinephrine, which we need for that fight or flight response and that we’re going to be burning through a lot more quickly when we’re in that fight or flight response. And then glycine, another nervous system-calming amino acid. And glycine also helps balance the nervous system. Typically we don’t suffer from protein deficiency in North America, but I see it more and more, especially low-quality sources of protein. So, chicken nuggets, yeah they have chicken in them, but they only have about 10 grams of protein and a ton of trans fats and a lot of processed carbohydrates. So, although we might be eating hamburgers and chicken fingers and omelettes on waffle, we’re not necessarily getting enough good sources of protein. So, ensuring protein from things like legumes, nuts and seeds, clean animal products, fish, like salmon, and white fish, are all really important and I often suggest people get 30 grams of protein per meal, so three times a day, but it depends on your weight, it depends on your energy demands and it depends on your lifestyle and how stressed out your are, because our demands for protein definitely go up during stress. It also depends on how level your blood sugar is and if you’re getting those hypoglycaemic symptoms, sometimes those people need to increase their protein, while decreasing some of the carbohydrates, especially those refined carbohydrates, and give their body more fibre-rich carbohydrates that the body has to work harder to extract and release into the bloodstream. Another really common cause, or contribution, or exacerbation to anxiety is iron deficiency. So I see this a lot in menstruating women. It’s not super common in young men to have iron deficiency, but women who are menstruating every month, especially women with heavy periods, and who are experiencing fatigue, definitely need to get their ferritin levels tested. So, ferritin, in our blood, will tell us what our iron stores are like. So, how much iron we have available to our tissues. Iron is useful for participating in lots of different chemical reactions in the body, as part of normal metabolism, but it’s also important for caring oxygen to our tissues and oxygen is what we need in a process called oxidative phosphorylation, which gives us energy. So, no oxygen, no energy. And what will happen is, if we lower levels of iron in our blood and lower levels of oxygen, our heart starts to beat faster in order to send more volumes of blood to our tissue. So, it figures, if, with each heartbeat, i’m not sending as much oxygen, if I just double up my heartbeats, I might send double the amount of oxygen and try to meet the demands of the tissues that I’m sending oxygen to. You can kind of figure out, then that quick heartbeat mimics those heart palpitation symptoms of anxiety and can trigger some anxiety symptoms. Iron’s also go this grounding affect. It gives us this nice, level energy. And there’s a very specific feeling to iron deficiency fatigue that a lot of women may have experienced. It’s not quite like a sleepiness, or a lethargy, it’s a very specific feeling of just depletion. So it’s important to get ferritin checked and then find a kind of iron that you can take every day to build your levels up, at least for a few months, and one that’s easily absorbed.
So, another reason why iron might be low is in the case of leaky gut, or malabsorption syndrome, so this can occur in somebody with inflammatory bowel disease, or celiac disease, where the intestinal cells are just not able to absorb as many nutrients, or somebody with IBS, so, just generally sluggish digestion, inefficient digestion, perhaps a lack of stomach acid, or a lack of those digestive enzymes that help us absorb our food. IBS and leaky gut are other common symptoms and causes of anxiety. So it’s kind of a chicken or an egg situation. Our gut bacteria produces serotonin, dopamine. We’ve got about 5 trillion in our gut, and that’s about 10x more cells than we have in our bodies. For the most part, when it comes to a cell-to-cell basis, we have 10x more gut bacteria than we have cells. So we’re more gut bacteria than us. Our gut bacteria, there’s good ones, there’s bad ones, we haven’t been able to isolate all of them, there’s very little, relatively, that we know about the microbiome, but a lot more research is coming out, especially in the area of mental health. We know that these gut bacteria can make their own neurotransmitters. They can even specifically ask for food, so a lot of people with sugar cravings have a dysbiosis going on where the gut bacteria need those refined carbohydrates and that sugar, in order for them to grow. And so they’re sending out ghrelin, or hunger-stimulating signals to try and get us to eat more sugary foods. Our gut bacteria also make most of the serotonin in the body and our gut cells also make most of the serotonin in the body. So if we have unhealthy gut cells, they’re not going to be able to regulate our nervous system. And if we have an imbalance in gut bacteria, again we won’t be able to regulate our nervous system, because we won’t be producing those neurotransmitters that we need to balance and to be able to toggle seamlessly between the parasympathetic and sympathetic nervous systems. The gut is also where a lot of our immunity lies. And our immune system is going to be the cause of low-levels of inflammation, especially if there’s a little bit of autoimmunity or food sensitivities, or allergies going on. Low levels of inflammation are going to affect our brain. So there is a hypothesis that depression is caused by low-grade inflammation in the brain. We don’t have pain receptors in our brains, so we ‘re not able to detect inflammation in the way you would with an inflamed knee. If you injured your knee or had arthritis in your knee, and you would notice that your knee was red, and swollen and it would hurt to touch and you wouldn’t be able to walk on it. We don’t get those symptoms in our brain because of the lack of pain receptors and so how brain inflammation might manifest is brain fog, difficulty concentrating, depression, anxiety, mental chatter, negative self-talk, negative thoughts, those symptoms that are really common, mental symptoms, in something like depression and anxiety.
There’s a lot more we need to research about this, but there’s something called LPS, lipopolysaccharide, that’s produced by some of the “bad” gut bacteria. When rats were injected with lipopolysaccharide, or when human volunteers were injected with lipopolysaccharide, we mimic the symptoms of depression. When those same patients and rats were given EPA, which is a very anti-inflammatory fatty acid that’s from fish, marine sources like salmon and sardines, the depression symptoms went away. There’s also some studies in depression with prednisone and corticosteroids, which lower inflammation really rapidly. They come with a host of side effects, so that they’re not that great of a remedy for depression, but they actually lowered depressive symptoms. There’s a lot of a connection, that we’re noticing, between inflammation and depression and anxiety and we’re just not sure to the extent that inflammation causes depression. I tend to think that, probably most cases of depression and anxiety have some kind of inflammation present, especially when we consider that just chronic, turned on, sympathetic nervous system and high levels of cortisol is going to contribute to a cortisol resistance in the brain and increase neuroinflammation, especially in the hypothalamus.
We also know, as I mentioned before that symptoms of anxiety and symptoms of IBS often go hand in hand. And so, a lot of the anxiety symptoms that people will get are looser bowels, bloating, loss of appetite, just difficulty digesting their food. And a lot of symptoms that people with IBS will get are anxiety. And one of the treatments for IBS are selective-serotonin re-uptake inhibitors, which, you guessed it, are also drugs that treat anxiety.
So another common cause that fits really well into my practice, my focus is on mental health and hormones, and these two areas overlap, probably more than they don’t overlap, it hormonal imbalance. So, especially in women, men have their own host of issues when it comes to hormonal imbalance, but women, because our hormones are cycling and going through different phases all month long, we’re more susceptible to problems with proper hormone regulation, especially in the face of female endocrine disorders such as PMS, PMDD, PCOS, all of the acronyms, endometriosis, fibrocystic breasts, and just dysmenorrhea, so painful and heavy menstruation, or irregular cycles. So all of these point to symptoms of hormonal imbalance. Estrogen and progesterone are the two female hormones and they do have effects, yes on the ovaries, and they control ovulation, they control building up of our uterine lining and shedding of the uterine lining, when those two hormones fall away, and that causes our period to occur, so they definitely control our fertility, but they also have affects on other tissues in the body. One of those tissues, one of those organs, is our brain, our nervous system, so estrogen can work a little bit like serotonin and, so what you might notice, right before your period when your estrogen levels drop, or women that are going through menopause and have a drop in estrogen levels, is you’ll get irritable, you’ll get depressed, and you’ll crave carbs like crazy. And a lot of women get something called premenstrual dysphoric disorder, where they have fluctuations in their estrogen levels. So, lowering of estrogen, or insufficient estrogen, may cause some of those more depressive anxiety symptoms, progesterone acts like a GABA agonist, which, I mentioned before, is a calming neurotransmitter. So, lower levels of progesterone, and I see this in a lot with women who have something called “estrogen dominance”, I have another video on this, and women with PCOS as well, and women who have high estrogen symptoms, or conditions such as endometriosis and fibroids, and fibrocystic breasts, and those kind of symptoms, or conditions where estrogen levels tend to be high, and progesterone levels tend to be low or deficient, they’ll often have anxiety with these symptoms. And lower levels of progesterone, especially premenstrually, often are related to low mood and anxiety, and cravings. So, looking at hormones, especially when the patient sitting across from me has a lot of menstrual issues, and irregular cycles and all of the other things I mentioned, I’ll definitely look into hormones and promote proper estrogen detoxification and building up of progesterone. A common cause of low progesterone is being in that fight or flight state. So, now I’m starting to reveal how this web interconnects, how everything is tangled together and how cortisol and blood sugar all relate to everything. So, cortisol, it uses the same precursor to make progesterone, and, when our body needs more cortisol, it will steal progesterone from the system to make cortisol. Because our body has to prioritize sometimes, and getting away from that snake in the grass, and saving our life is more important than making babies to our body in the short-term. So, we suffer in the long-term if that snake in the grass never goes away and we’re always kind of worried about juggling all the things in our lives. But a lot of women who are chronically stressed, or are in that sympathetic nervous state, will have lower levels of progesterone, so doing a lot of adrenal support is one of the ways that we help their bodies build up some progesterone.
And then, finally, I think I mentioned before, there’s a reason that we have anxiety, it’s not an irrational fear. A lot of the time when I sit across from patients, the things that they’re worried about are legit things to worry about. Maybe they’re out of work, or there’s financial worries, maybe there’s just so much on their plate that it’s difficult to find any time for themselves, or make ends meet, maybe they’re unhappy with their career, they’re relationship is in jeopardy. There’s all kinds of things that people deal with on a daily basis. And then, that being said, there’s also people who are just primed to be more neurotic than others, based on that spectrum of neuroticism in terms of personality and constitutional predisposition. And I think we know this, there’s some people who are just a little bit more anxious than others and that diversity in human personality probably helped us evolutionarily and so I think there was obviously an evolutionary advantage for someone who’s nervous system was a bit more responsive. Those people could get away from danger, they were expecting danger more often, and they probably ended up surviving and passing their genes on to their ancestors more readily than those who were way too laid back and didn’t think about danger and got themselves into risky situations.
So, those who are a little bit more neurotic may be predisposed to negative thinking, over-estimating the negative outcomes of certain events or maybe engaging in critical self-talk. Especially in the case of post-traumatic stress disorder, PTSD, there’s definitely a connection between early childhood trauma, or just trauma in adulthood, some of these experiences can teach us to turn our nervous system on, or to get triggered more easily as a way of surviving in the future. There’s different areas of psychotherapy that deal with these phenomena, and they term them different ways, but they can be called core beliefs, or certain mental schemas, so when our brain experiences very strong emotions, the amygdala wires those emotions down in implicit memories. They’re really tightly wired and those memories get triggered again whenever there’s a situation that reminds us of the situation that wired down those responses. It might be a certain smell, or a certain sound, or a certain song, something that activates those memories, that may not be conscious, because the amygdala is pre-verbal, will trigger those feelings of fear and prime our body to respond. And the problem is that we’re surrounded by potential stimuli all the time that can trigger that. And so, really understanding what triggers anxiety symptoms, where those triggers may have come from, and bringing those memories up to the cognitive, cerebral cortex and rational mind, so that we can help dissolve those memories, is a big part of psychotherapy and how we manage anxiety with psychotherapy. Especially if we think the cause of anxiety may be related back to some sort of childhood trauma or implicit memory that was consolidated.
Those are some root causes of anxiety that I would look for as a naturopathic doctor, among many others. What an intake will look like is a 90-minute conversation with the person in front of me where I get to know them, and understand the environment surrounding the phenomena of their symptoms, the symptoms themselves, and all of the other different factors that might be contributing to the anxiety that they’re displaying. So, I’ll ask about period health, I’ll ask about sleep, I’ll ask about their energy levels, I’ll ask about any other physical symptoms they might be experiencing, their digestion, what their stress levels are like. We’ll go through a review of systems, looking at every single organ system and trying to create a tabulation of how anxiety might be manifesting for them, and we may even explore what their core beliefs are, or implicit memories are in future visits. And we’ll talk about diet. And then I’ll make some recommendations as I begin to understand what those root causes of anxiety might be. So we’ll look at whether they may be experiencing nutrient deficiencies, leading to an imbalance in proper neuroendocrine production, if there might be some inflammation going on, if they may be experiencing some digestive issues, or some hormonal imbalances, or if there’s chronic stress going on in their life. And so what we’ll do is, once we find out the causes, we’ll engage in some psycho-education, so I really believe in empowering my patients to understand their bodies, to be able to notice when things are triggering them, to notice what exacerbates their anxiety, what makes it better, and to develop a self-care plan where we’re eating right, we’re thinking right, we’re exercising right and we’re getting enough rest, if possible.
So that’s the gist of it, that’s Root Causes of Anxiety, my name is Dr. Talia Marcheggiani, I work in Bloor West Village in Toronto.
I talk about contrast showers for boosting immunity, lowering inflammation, mood, pain and weight loss.
Hello everyone, my name is Dr. Talia Marcheggiani, I’m a naturopathic doctor and today I’m going to talk about hot and cold contrast showers. As naturopathic doctors, one of our modalities is hydrotherapy. Hydrotherapy comes from naturopathic medicine’s roots, using hot and cold water to make changes to circulation, hormonal functioning and immune functioning. I’m going to talk about some of the science behind hot and cold contrast showers.
This is something I recommend to my patients to increase their immune activation, decrease autoimmunity, improve mood and hormonal functioning, as well as increase circulation and there’s some evidence that it might help with weight loss as well.
So, firstly, things like exercise and hot and cold therapies induce a little bit of stress. There’s two kinds of stress: distress, which is sort of that chronic, cortisol-fuelled stress that a lot of people come in with, in a state of burnout that’s causing things like inflammation, and mental-emotional illness, and autoimmune issues, and dysbiosis, and then there’s something called eustress, which is more like exercise, cold therapy: short, small bursts of stress that actually up-regulate proteins and genes in our body to combat stress. These genes are involved in DNA repair, increase antioxidant synthesis, and the antioxidants that our body makes are far more powerful than the ones that you’re going to get from food or supplements.
So, by upregulating these genes, we can protect ourselves from cancer, neurodegenerative disease, and other chronic diseases. It’s really powerful stuff, this is called a “Hormetic” response, hormesis, where small stressors mount bigger responses by the body than is needed to deal with those stressors and overall we’re better off; there’s this net beneficial effect. This is one of the proposed mechanisms for some of the antioxidants or flavonoids in green leafy vegetables. It’s not that they provide us with antioxidants, it’s that they encourage our body to make antioxidants due to the small, toxic load that they present to us. And so there’s some evidence that getting short bursts, or longer bursts of cold, very cold, will increase a hormone called norepinephrine. Norepinephrine is involved in depression and mood. Norepinephrine is a catecholamine and it increases the sympathetic nervous system, which is that fight or flight nervous system. When boosted in small amounts, it can actually elevate mood and so a lot of anti-depressant medications also induce, or inhibit the reuptake of norepinephrine. So these are called SNRIs and they include things like Venlafaxine and Cymbalta. So there’s some evidence that norepinephrine increases 2-3 times after only 20 seconds of immersion in cold water. There’s a connection between norepinephrine lowering pain and inflammation and increasing metabolism and there’s some anecdotal evidence and one study, at least, was done to show that cold immersion therapy actually decreased symptoms of depression.
There’s also these things called hot and cold shock proteins, heat shock proteins and cold shock proteins. So, for example, one is called RBM3, which is a cold shock protein, and these proteins can actually help increase longevity and they can actually help decrease incidences of neurodegenerative diseases and neurodegeneration, so something like Alzeimer’s disease or Parkinson’s disease, which can help us with health longevity, so staying healthier into our later years.
We know that inflammation is one of the drivers of the aging process. Probably the primary driver of the aging process, and one of the main factors in chronic, debilitating disease, and, especially in my focus, mental health, there’s more and more researching coming out that inflammation, low levels of inflammation in the brain, is the main cause of mental health conditions, such as depression, and anxiety, bipolar disorder, OCD, ADHD. There’s these low levels of inflammation that contribute to the symptoms of low mood and by increasing norepinephrine, through small bursts of cold and increasing those cold shock proteins, we’re actually able to combat these mental health conditions. Norepinephrine decreases inflammation by decreasing a cytokine called TNF-a that is known to increase inflammation in the body and in the brain. TNF-a can cross the blood brain barrier and it can inhibit serotonin synthesis and it can actually also increase neuro-inflammation, causing symptoms of mental health disorders.
There’s some studies that cryotherapy, for rheumatoid arthritis actually decreased pain significantly. And there’s also some studies that being in cold water, that cold shock, can actually increase the immune system activation. It’s good to increase our immune system activation if our immune cells are behaving properly. If our immune cells are attacking ourselves, then we want to decrease the immune response. But having higher levels of lymphocytes, especially cytotoxic T lympthocytes that are involved in killing cancer cells, is a very positive thing and that’s been shown to increase in people that underwent cryotherapy, or really acute, short exposure to intense cold.
There’s also an ability to lose weight when exposed to cold, over the long term. There’s a man called Ray Cronise who lost over 80 lbs by just habitually exposing himself to mildly cold temperatures. And one of the mechanisms for this weight loss is through non-shivering thermogenesis, in which the cells in the mitochondria uncouple proteins that make energy and they dedicate all the stored energy in fat to making heat. Kind of like cutting your bike chain. So instead of biking, you’re not moving forward, but you’re generating energy and you’re generating heat. And so our body will do this when it’s slightly cold that it can increase heat. Our body is always striving to maintain constant temperature, between 1 or 2 degrees. This process is regulated by norepinephrine, which rises acutely as soon as we’re exposed to just a few seconds of cold. This can be 40-50 degree water. And then I already mentioned that short, cold exposure can increase the production of antioxidants. Our mitochondria are constantly creating reactive oxygen species and reactive nitrogen species. This is just a product of normal cell metabolism. These become toxic, though and damage DNA if our body doesn’t also produce anti-oxidants to clear out those reactive oxygen species and reactive nitrogen species. The cold induces a little bit of a stress that increases our metabolism that increases the reactive oxygen and nitrogen species in our mitochondria and therefore our body is incited to up-regulate the enzymes that create those powerful anti-oxidants that I talked about that are far more powerful than the ones that you can get from food: vegetables, fruits, vitamin C supplement. A couple of these enzymes are glutathione reductase and superoxide dismutase, which are very powerful to our cells.
There’s some evidence that hot and cold therapy can increase muscle mass, can increase muscular strength and aerobic endurance. So this is great for athletes post-workout to lower inflammation and improve muscle regensis. And then, it can also increase something called mitochondrial biogenesis, which is the production, or the replication of more mitochondria in the tissues, especially the muscle tissue. So our body will increase the mitochondria content, the mitochondrial mass, in muscle tissue under certain conditions. These conditions are mainly fasting, exercise, and hot and cold shock.
So, what I’ll recommend to my patients, somebody who’s suffering from low immunity, so they’re getting frequent colds and flus, or maybe autoimmunity, or maybe just general inflammation and pain, brain fog sluggishness adrenal fatigue, that kind of sluggish lethargy from depression. So it’s more the sluggish depression, I’ll recommend hot and cold showers.
So what you do is, in your shower, either during your shower, during your regular cleaning routine, or after your shower is done, and you’ve already washed your hair and everything, you’re going to turn the water on to a reasonably hot temperature, so not so hot that it’s scalding, and you’re going to leave that hot water on for 30 seconds to 1 minute. When that’s done, you’re going to turn the shower to as cold as you can tolerate. So with my patients I often coach them to start with a lukewarm temperature before going whole hog and doing cold. And this is just to coax the body into that stress response that we want, that short, quick stress response that’s going to do all those good things: up-regulate anti-oxidant production, increase norepinephrine, decrease inflammation, increase mitochondria synthesis, burn fat. So you’re going to try and make it as cold as possible, for 20 to 30 seconds, and then you’re going to cycle back and forth at least 5 to 10 times, always end on cold, and then, when you’re done, towel off and keep warm.
There’s some evidence that doing this before bed can actually increase REM sleep and help you sleep more soundly without waking up in the middle of the night. We all know that a good sound sleep is going to set the tone for the next day and your energy for the next day. And then there’s also some evidence that doing this in the morning can increase your energy and alertness throughout the day, so it’s almost like this same practice at different times of day impacts our circadian rhythms differently and can give us more of what we want: either more profound sleep or more daytime energy.
So, that was hot and cold showers, my name is Dr. Talia Marcheggiani and you can check out my website at taliand.com or contact me at connect@taliand.com . A lot of this research came from Dr. Rhonda Patrick at foundmyfitness.com .
I talk about the supplements I take on a daily basis and their indications.
Hey, Everybody, my name is Dr. Talia Marcheggiani and I’m recording to you guys from my kitchen in Toronto. And this video is about the supplements that I take as a naturopathic doctor and health experimenter. When it comes to making treatment plans for my patients I prefer to focus on the Therapeutic Order, so starting with the foundations of health, which usually means making adjustments to diet and lifestyle and if possible using food prescriptions and functional foods to help heal the body as opposed to relying on supplements. And this is just from clinical experience and from a cost-benefit perspective. So, of course it’s better to get these nutrients from food sources, because, when you eat a pile of kale, like a big plate of leafy greens, you’re getting all of the vitamins that we know about: the magnesium, the fat-soluble vitamins, like A, D, E, and K, some iron, and all of the flavonoids, and anti-oxidants that are present in that big pile of greens, but you’re also getting a lot of nutrients that we haven’t been able to isolate and that we don’t know is present in those foods. Some of those nutrients may act synergistically. And so it’s always better to get things from their whole-food source, I think. That’s the philosophy that I come at when it comes to health and healing. And I’m always looking for the obstacles to cure. Ideally I’m prescribing something like magnesium to replenish a magnesium depletion or to compensate for a diet that may be inadequate for magnesium, or to replenish magnesium deficiency. So I’m not a big fan of prescribing a ton of supplements, and I think my patients appreciate that, because of the cost and the annoyance of taking a lot of things. That being said, there is definitely a benefit to supplementing with vitamins and minerals and other sort of functional supplements to improve optimal health. We’re trying, obviously, to eat a diet that meets the recommended daily nutrition intake for all the vitamins and minerals that the body needs to function optimally, but there’s some evidence that increasing these levels and taking higher doses of these vitamins and minerals may actually help our body perform properly. So, if you take something like vitamin C, if someone is completely deficient in vitamin C that will manifest as a disease called scurvy, where you’ve got loose gums, or you’re experiencing problems in creating collagen. You’re getting sore on the skin, there’s skin issues, there’s gum issues. And then there’s an adequate amount of vitamin C, where you’re not seeing those symptoms, and then there’s having optimal vitamin C, where your body is able to not just meet its daily requirements for all of the chemical reactions that it needs for us to feel our best, and look our best, but now it’s got an abundance of vitamin C and now it’s able to really divert a lot of the vitamin C that it’s getting to increase energy, to boost immunity, to target cancer cells, to exert an anti-oxidant effect, to accommodate all of the free radicals we might be exposed to, living in our modern times.
So, that being said, I do my own self-experimentation with vitamins and minerals, and there’s a few things that I’ll take on the regular, that I’ll take all the time, and then there’s other things that I might play around with, just to see what it’s like to take the medicine. Depending on what it is, I think doctors should taste their own medicine every now and then to know what the effect is on their patients and what their patients’ experience would be, experimenting with these vitamins and minerals.
So, the first thing I take, and this is something that I started taking in school, is a B complex. And a B complex contains all of the B vitamins. Some people get confused, they’ll refer to their B12 supplement as a B complex or they’ll refer to a B complex as B12, or they’ll get confused about all of the different B vitamins. In this product there are all of the B vitamins, from B1 all the way to folate. These B vitamins are cofactors in thousands of chemical reactions in the body. We need vitamin B6, for example, to make serotonin out of tryptophan and 5HTP, those are all the amino acids that are present in the pathway to synthesize serotonin and without B6 we’re not able to make serotonin, no matter how many of those building blocks, tryptophan building blocks, may be present in the body. So, if we’re deficient in these cofactors, our body is just not able to function properly. And we burn through B vitamins a lot more quickly when we’re under stress and some people have higher requirements for them. And some people have an issue metabolizing certain forms of B vitamins. So, for example, there’s some people that have an issue taking folic acid, which is often thrown into a lot of our grains and cereals, that are fortified and lots of multivitamins and taking that folic acid and making it into its active form, about 40%of people have a genetic polymorphism that reduces their ability to methylate and to make active folate and, therefore, they need to supplement with the activated from of folate otherwise the folic acid that’s in all of their foods starts to build up in their tissues and there’s some evidence that that can cause problems.
I showed you which B vitamin I use. I use the AOR brand and one thing to look for in a B vitamin is, what is the form of folate in it? So, you want to look for one that has L-5-MTHF or that’s the methyl-tetrahydrafolate, that’s the active form of folate. And you also want to look at the B12, what’s the form of B12? So there’s 3 different forms of B12: cyanocobalamin, hydroxycobalamin and methylcobalamin. Cyanocobalamin is the synthetic form and, for the same reason that people have a problem activating folate, they may have a problem activating B12 and using it. And it’s the methylated form, methylcobalamin, that crosses the blood brain barrier, and that would have effects on depression and anxiety, and help with cognitive decline, and energy and all of those things. So, it’s important to look for a B vitamin that’s got those activated forms of the B complex. And you also want one that has adequate forms and that will be better absorbed. And so, taking a B complex is not something that you can overdose on readily because it’s water-soluble, so you may notice, as you start to take it, that your body starts to up-regulate the receptors to absorb them, for the initial weeks of taking it, you might have really yellow pee. And that’s normal, that shouldn’t cause any issues, but it’s one side effect that sometimes surprises people when your first morning urination is highlighter neon yellow.
The other thing that’s a staple in my supplement regime is magnesium. So, magnesium is, again a cofactor in tons of chemical reactions, and one of the really important functions that magnesium has is in DNA repair and also in mitochondrial function. So, mitochondria are the furnaces in our cells. Without magnesium, our DNA won’t have that ability to repair itself, which can cause us to allow DNA mutations or issues with DNA replication to go unnoticed and that can cause problems such as cancer down the line. It’s not that you’re deficient in magnesium one day and that manifests as symptoms, it’s something that will manifest over time, over decades of having just insufficient magnesium to achieve optimal health. So, you might be meeting your general needs where you’re not outwardly deficient in magnesium but, you’re not getting those levels to really have your body functioning at its best. Magnesium deficiency can manifest as symptoms, as physical, clinical symptoms in people and a big one is tense and tight muscles. Magnesium is a skeletal muscle relaxant and a smooth muscle stimulant. So what that means is that, if you’re the kind of person that has got really tense shoulders, lots of muscle knots, lots of aches and pains, that are muscular in nature, magnesium can help relax that skeletal muscle. And if you’re the type of person that suffers from menstrual cramps, or constipation, then magnesium is helpful for getting things moving and stimulating motility of the digestive tract and relaxing the uterus as well. Magnesium, there’s been some studies showing that magnesium can be beneficial for headaches, and that is probably due to its muscle-relaxant properties. Magnesium is also a great remedy for fatigue and, like B vitamins we burn through magnesium a lot more quickly when we’re stressed. 40% of people have a diet that it is inadequate to obtain their optimal levels of magnesium. This may be because we’re not eating enough leafy greens, which is a really great source of magnesium. It’s about 2 cups of spinach or chard a day to get the 300 mg of the magnesium, and also from soil depletion. So, when crops are not rotated, and the soil’s not replenished, the next round of crops are grown in a soil that’s depleted and therefore those plants aren’t absorbing the nutrients that were then going to enter our bodies after we eat those plants. And from this soil depletion, it’s hypothesized that that’s why our magnesium levels are so low. Also, a diet that’s high in processed sugar increases our magnesium needs, and a lifestyle that’s high in stress also increases our magnesium needs, as we need it to make stress hormones.
So, B complex and magnesium.
I often recommend to my patients to take magnesium before bed because of the skeletal muscle-relaxant properties, it helps to calm the body and the mind. There’s different forms of magnesium and the forms are prescribed based on what your therapeutic goals are. So, something like a magnesium citrate will be prescribed for somebody who’s tending more to the constipation, because it can help draw water into the bowels and have a bit of an osmotic laxative effect. So, it doesn’t sort of stimulate the bowels, like a laxative would, like sennakot, but it will draw water into the bowels to kind of flush the system out. That can be problematic over the long-term so do that under the supervision of a doctor or naturopathic doctor. And then, for people that are really sensitive to those laxative effects of magnesium, they may want to go with a magnesium that’s conjugated to an amino acid such as glycine. And so I often recommend magnesium glycinate, because a lot of us are also deficient in glycine. Another good source of glycine is collagen, or gelatin, and glycine has this sort of relaxant and modulating effect on the nervous system, and so it can be great for depression and anxiety, more so for anxiety because of its calming effect on the brain.
So, another supplement that I take is zinc. So, this is not the best form of zinc, I just picked this up because it was cheap and I could find it—I think I got this one at Bulk Barn, this is a zinc citrate. Even better absorbed form is zinc picolinate, so there’s a study that shows that that’s the best-absorbed form of zinc, which is appropriate for somebody that experiences nausea when they take zinc, which goes away in a few minutes, but it kind of sucks to have so, if that’s happening to you, then going with a more absorbable form of zinc, or taking zinc with food. A zinc deficiency manifests as dry skin, and depressed immune system, so you’re getting infections a lot more often than the average person. But inadequate levels of zinc can manifest as hair loss, leaky gut, depression and anxiety. Zinc helps us with neurogenesis, so it actually helps us make BDNF, brain-derived neurotropic factor, which is a chemical that our brain uses to make new neurons, and to promote resilience against stress. It sort of protects the brain against mental and emotional stress. And I also prescribe it for cystic acne and hormonal acne. And zinc is a really good remedy for PMS and heavy menstrual periods and vegetarians are often deficient in zinc.
4th is a fish oil. So a fish oil is combined with two kinds of omega 3 fatty acids: EPA and DHA.The one I use has got a 5:1 ratio for EPA. So, EPA is the anti-inflammatory omega 3, the anti-inflammatory fish oil. DHA is the fish oil that we use to build up our brain tissues. Most of our brain mass is made of fat and it’s mostly this kind of fat, DHA. So there’s some good studies that, because of its anti-inflammatory properties, EPA can help increase symptoms of depression. And this is probably because there’s some evidence that depression, like other mental health conditions, is an inflammatory condition in the brain. We don’t have pain receptors in our brain, so if our brain is experiencing even a small level of inflammation, it can kind of go undetected. It may just manifest as negative thoughts, mental chatter, low mood, lower or impaired neurogenesis. We’re not experiencing that acute, sharp memory that we’re used to, maybe we’ve got some brain fog, maybe we’re having trouble recollecting names and those kind of things. And there’s a little bit of evidence that it can be heart healthy as well. Our diet is really rich in omega 6 fatty acids. These are the more, inflammatory—this is sort of a general statement—they’re little bit more on the inflammatory side. I think our diet is about 10:1 omega 6:omega 3. And that’s mainly because we’re consuming animal products from animals that are not fed their natural diet, so for example cows should be eating grass, but we’re feeding them corn, which tends to make the fat in their meat more composed of the omega 6 fatty acids, and also because we’ve been told to avoid saturated fats and to eat a lot of industrial seed oils, like canola oil and corn oil, and vegetable oil, which is just corn oil, and soy oil. And so, these kind of oils are also rich in omega 6, those kind of pro-inflammatory fats. It’s been shown that our ancestors, our hunter-gatherer ancestors, had a diet that was more 1:1, for omega6:omega3. So, supplementing with omega 3 fish oils or eating fish a few times a week, those fatty fish I mentioned in other videos, decreases that ratio of omega 6 to omega 3. I also take NAC. And the reason I take NAC is I did a genetic test that showed that I have impaired phase II liver enzymes. So my body has a little bit of difficulty making glutathione, which helps detoxify all of the toxins and free radicals that pass through my body, all of the hormone metabolites. So, no matter how clean I live, if I’m using natural cleaning products, natural body care products, I’m still exposed to toxins, as we all are: there’s car exhaust outside, we’re consuming things that are wrapped in plastic, so no matter how perfect you try and be, you’re still going to be exposed to things. And so, to encourage my body to make more glutathione, I give it NAC, which is a precursor to making glutathione, the antioxidant. NAC helps with liver detoxification, so it also helps decrease symptoms of hormone metabolites, that estrogen dominance, that I also talk about in other videos, and it can also help with detoxifying the brain, so neurons. And that’s through its antioxidant effects and it kind of cleans out mitochondria. So you imagine if you’re running your car in your garage, the process of your car metabolizing, so spending its fuel, is creating some chemicals that are coming out of the exhaust pipe. And if your garage door is closed, all of those chemicals are filling the garage. And so, taking NAC is a little bit like opening a window, it’s just helping your body get rid of all of those toxic metabolites from performing its chemical duties. So I’ll take NAC and I’ll recommend NAC for mental health conditions, especially OCD and bipolar disorder. And sort of on that note, I also take something called estro-adapt. And it doesn’t have to be this product, there’s many other products that are similar to this, estroadapt has DIIM and calcium d-glucarate. Both of those are chemicals that help the body metabolize estrogen. So I’ve talked about estrogen dominance and other videos and the estrogen is not just one hormone, it’s a group of hormones and that there’s also these xenoestrogens, so these estrogens that are toxins in our environment that exert estrogenic effects. So, some of these include fragrances, and bisphosphenol A, BPA, that’s found in plastic, that has received a lot of media attention, what DIIM and calcium d-glucarate do is help us with normal estrogen processing. So, estrogen, when don’t need it any more, when it’s already done its thing, or those more toxic forms of estrogen, they’re conjugated in the liver, so the liver makes them inactive and then they’re dumped into the colon, where they’re removed from the body. And what happens if any of those steps are impaired, so if your liver is sort of overburdened processing other things, or you’re not able to process those hormones as well, is you’re going to have a higher level of metabolites in the body, or if you’re constipated, or if you’ve got a dysbiosis situation happening, and some pathogenic gut bacteria that aren’t able to keep estrogen conjugated, so they sort of put it back into it’s active form and the body reabsorbs it, which is not what you want. You want to get rid of those toxic estrogens.
So what I’ll recommend is doing a detox twice a year, Spring and Fall is a great time to do a detox and I’ll do another video on detoxification because our body can detoxify pretty effectively. It takes care of all of our detoxification needs, but sometimes it helps to give it a little bit of a boost, and so a product like this, with DIIM and I3C, or indole-3-carbinol, which is not in this product, or calcium d-glucarate, is really helpful for lowering those estrogen toxicity symptoms, which could be heavy menstrual periods, anxiety before your period, PMS, hormonal acne, irregular periods, weight gain, especially around the hips and a predisposition to female cancers, such as breast cancer. Another way you can get this from diet is from green leafy vegetables. So those are all the crucifates, broccoli, cauliflower, cabbage, brusselsprouts, chard, spinach, kale, all of those vegetables are really rich in I3C and DIIM and those help us clean estrogen from our body. Finally, I take an adaptogen. So, adaptogens, this is Withania complex, they’re herbs that literally just help the body adapt to stress. So my two favourites are withania, or ashwaghanda, and rhodiola. And I like taking them together, this complex doesn’t have rhodiola in it, but it does have ginseng, which is a little bit more stimulating. It’s got withania, it’s got ginseng, and it’s got licorice, and it has skullcap, which is a little bit more calming, nervous system calming. And, so what withania does, these just help us against the pro-aging and pro-inflammatory stress effects. So, they help sort of protect our tissues against stress, they protect our brain against stress, they can help calm the body down, they help the adrenal glands function more optimally, and rhodiola in particular, helps increase BDNF, just like zinc, so it increase brain-derived neurotropic factor, NAC also does this as well, and there’s a connection between low levels of BDNF and depression and anxiety and mental health conditions. The low levels of BDNF may be from nutrient deficiencies, or it could be from inflammation in the brain and that inflammation could be just a stress resistance. So, the stress hormone is coursing through our body 24/7 and our brain sort of stops responding to them as well, kind of like a diabetic, a type II diabetic, stops responding as effectively to insulin, an a resistance develops and, since those stress hormones have an anti-inflammatory effect, when you start becoming resistant to them, inflammation ensues. And so what withania and rhodiola do is just help calm down that inflammation. I’m a big fan of herbal medicine because in addition to sort of its active medicinal properties, herbs are also flavonoids, and have really important nutrients, like I talked about that big pile of leafy greens, we’re not exactly sure what is in these nutrients. We just know that, as a whole, they work really well. And so they’re flavonoids, they’re also anti-inflammatory, they’ve got anti-oxidants, as well as their medicinal properties that we can isolate and study. So I like herbs, it sort of brings us closer to nature, it puts a piece of nature into our body and some of that intelligence of nature, rather than just one supplement or one ingredient would do. And, because we’re so stressed out, and not all stress is bad. You think of a new mom, she just had a baby, she’s full of love and joy, but there’s sleep-deprivation, there’s all these kind of thoughts, and new responsibilities that are filling her life, so she’s stressed out, but she’s not full of negativity and negative thoughts. And so that’s still stress, the body still perceives that as stress. Some signs of stress are waking up in the middle of the night wide awake, inability to fall asleep, that tired and wired feeling, feeling like you’re getting an energy crash around 2-4pm, feeling a little bit more tired than usual, feeling a little bit more burnt out, feeling a little bit of ennui, and lack of motivation, so a lot of those signs of depression are actually present in someone who’s chronically stressed out: lots of mental chatter, lots of negative thinking and irritability can also be signs of stress. It manifests differently in every single person and so I’ll go through a full work-up to see how stressed out somebody is feeling and what their state of stress is. And there’s a difference between perceived stress and how stressed out you think you are, and actual, physiological stress and what the body’s under. And being in a state of inflammation, as well as riding the blood sugar roller coaster can also increase our physiological stress.
Finally, I take 5HTP. And I take this before my period, so I don’t take it all the time. I may take a couple hundred mg of it before bed, just to help with sleep. And, so 5HTP is a precursor to make serotonin. A lot of women will experience a dip in serotonin right before their period, sometimes up to a week before, so these women will experience irritability, those mental and emotional PMS symptoms, cravings for sugar, inability to sleep, worsening of depression and anxiety right before their period. And so sometimes they can benefit from 5HTP, which is an amino acid. 5HTP needs magnesium and B6 to work properly, though. So, we need to make sure the body has got adequate amounts of those nutrients, either through supplementation or diet, so that it can take that 5HTP and make it into serotonin. 5HTP crosses the blood brain barrier and so that sort of helps us get it into our brains where it can be made into serotonin. And the good thing about amino acids, like NAC and 5HTP and some of the other ones I mentioned in my amino acid video, is that they work pretty quickly, so sometimes they can exert their effects within hours and sometimes even within a matter of days, whereas something like fish oil can take months to be incorporated into the cell membranes and change the fatty acid profiles of our cells.
Even B vitamins work pretty quickly as well. So, these are what I take. You’re going to need something different, maybe less things, maybe more things. Some of these things are things that I experiment with, and sometimes I’ll do a wash. So, a lot of the time, if my patients are on a ton of things and they come in in that state, I’ll wash them, we’ll have them stop a few things, see if symptoms return, see what their baseline of health is. Because sometimes we just need a boost and to just take these things for a few years or months, and then our body gets back on track, sometimes we need some continual support throughout our lives. And so, everyone is different, everybody has different individual biochemical needs and everyone has different challenges with getting diet into their life and exercise and meeting those foundational health needs. And so someone who is a little bit more challenged in that department, who’s got a really busy and stressful lifestyle may need more nutritional support, someone who’s in a chronic disease state, recovering from more serious health issues may need more support and someone who’s having trouble maintaining their minimal nutritional requirements through diet may need some more support.
Again, I always tell people to pay for a consult with a functional medical doctor or a naturopathic doctor to figure out what your supplement regime would be. I see a lot of people in healthfood stores kind of going it alone and, not to say that you can’t get great information from the internet, but it may result in your taking a lot of things that you don’t really need, spending a lot of money that’s not targeting a specific health concern or meeting your higher levels of nutritional requirements. And also the form of the supplements and the dosing is something that’s individualized, that we need to talk about. So, there was a Marketplace study with CBC that showed that a lot of these vitamins and minerals that aren’t from professional brands and aren’t 3rd party tested don’t actually contain what they say they contain. This is specifically a problem with herbal remedies. So, if you have any questions leave me a comment below my video and you can check out my website at taliand.com .
I talk about 5 essential tools for caring for your mental and emotional health. These are powerful self-care practices that can help balance your mind and emotions.
Hello, everybody, my name is Dr. Talia Marcheggiani. I am a naturopathic doctor with a focus in mental health and hormonal health.
Despite the increasing amount of research into mental health conditions and psychiatric conditions, and the increase in interventions and early recognition and pharmaceutical therapies that come with mental health diagnoses, we’re actually seeing more debility in mental health outcomes: more debility, more morbidity. So we’re seeing worsening of outcomes even though we’re applying more interventions.
So, how could this be? You expect that the better the drugs that we’re developing, the less disease we should encounter, if those drugs are actually working to counteract the disease process. We’re not seeing that in the realm of mental health, especially when it comes to the common conditions such as depression and anxiety.
And when it comes to disease in the west, we’re not really winning the war against disease. So, things like cardiovascular disease, cancer, hormone imbalances such as diabetes, hypothyroidism, mental health conditions such as depression and anxiety, ADD and ADHD, infertility, neurological disease such as MS and Parkinson’s, autoimmune disease, such as, again, MS and things like Hashimoto’s Thryoiditis and myasthenia gravis, and immunodeficiencies such as HIV. All of these diseases are on the rise, all of these chronic, lifelong diseases. And so, despite these advances in research and drug development, we’re not seeing an improvement in our ability to manage these diseases or prevent them.
And there is obviously not one simple solution to this problem, but one thing I want to point our attention to is this increase in stress and this connection to stress and the diseases that I mentioned. Obviously it’s not just one cause, that would simplify the entire system to an almost ludicrous degree, but there is an estimation that 75-90% of hospital visits are either directly or indirectly related to stress.
And some of the symptoms of stress, so chronic stress or even acute stress, are an increased heart rate, elevated blood pressure, elevated blood sugar, decreased memory and cognition, disrupted levels of serotonin, leading to depression and anxiety, disrupted levels of the other hormones such as dopamine and norepinephrine, and addiction to stress, so a chance in the opioid receptors and the brain structure, altered hormone synthesis, increased inflammation, altered gut flora, etc., etc., and a change in the immune system. So, basically, every system of the body is affected by stress. And being in a prolonged, acute state of stress is lethal to the body.
So, we can look at the rise of cardiovascular disease and diabetes and the fact that stress increases our heart rate and increases our blood pressure and increases our blood sugar. And we can make some of those connections between the symptoms of stress and the diseases that are increasing in our society.
When it comes to mental health, we see how our neurotransmitters and our brain structure and our gut and our immune systems are affected by chronic stress and we can infer that some mental health conditions are either caused by or aggravated by this chronic stress situation. And, so, by not addressing stress and by not looking into stress and finding healthy ways to manage it, we’re doing ourselves a disservice in the management of these diseases and the prevention of them,
So, there’s a few theories that connect—there’s that Monoamine Hypothesis when it comes to mental health, that people with depression and anxiety have this inherent brain imbalance. So they don’t make enough serotonin, or their brains for some reason aren’t responding to serotonin. Again, it’s a very reductionistic model because it reduces all of the experience of depression and anxiety and conditions such as ADD and ADHD and bipolar down to one single neurotransmitter and it oversimplifies the entire system and the entire constellation of symptoms that people can experience and the life situations surrounding these conditions and the fact that they’re comorbid with things like stress and poverty and childhood trauma and those kinds of things.
But there’s some other theories that we can look at, and some other kind of pieces of the puzzle that we can add to create a more inclusive narrative. So there’s a theory called the Mind-Body Theory and this kind of arises as a counteraction, or a counter-philosophy to what Descartes discovered or decided that he discovered, which was that the mind and body are separate entities—this dualistic hypothesis. We know absolutely that that’s not true but our mind and body are completely connected and that our mind probably doesn’t reside only in our brain because our nervous system extends throughout the entire body and our minds are also inter-relational, so they’re a product our environments and our relationships with other people as well.
We know that the gut is the second brain, for the amount of neurons that it inhabits and the neurotransmitters that influence its function. Our gut health affects our mood depending on how healthy it is. And we call this connection, another word for it, a more scientific word, is “Psychoneuroimmunology”. This is the connection between the immune system, the nervous system, and our psychology, our mood: our thoughts and emotions. So, we know that everything in the body is interconnected and you can’t prescribe an antibiotic and not expect that there’ll be sequelae or consequences, or side effects that affect a different body system. And we see that all the time now, but we have to understand how tugging on one thread in this interconnected web is going to affect another piece of it further down the line.
There’s also this Energetic Model of mental health, and that’s that the emotions have their own energy. There’s this theory that the emotions can manifest as physical symptoms and we see this in the work of Gabor Mate, who writes extensively about stress and addictions and mental health, in his book “The Body Says No”. He talks about how the health of our thoughts and emotions impact our physical stress. And so it’s not just that our thoughts and emotions can impact our mental health, but also our physical health and might set the stage for us to get conditions like cancer, or autoimmune disease, and all of the other diseases that I mentioned.
So, when it comes to stress and our mental health and emotional wellbeing, we need to take a proactive approach. Just like we do with getting vaccinations, and preventing colds and flus, and getting proper nutrition, and exercise and all of that, we need to be strategic about how we manage our stress.
The World Health Organization defines mental health as “A state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” So, notice that this definition isn’t simply the absence of disease and it’s not necessarily a normalizing—being “happy” or not having a diagnosis. This definition is about realizing one’s potential and experiencing emotional “wellness”, for lack of a better word. So, an ability to cope with life’s stressors and to live a life of meaning and purpose.
So I want to talk about 5 tools that are really important for establishing a self-care and emotional wellness routine, for improving mental health. These strategies may not be sufficient enough for more serious psychiatric conditions, but I believe that they form the foundation of proper lifestyle strategies to help with increasing our emotional wellness and our ability to cope with life’s stressors.
So the first one I want to talk about is something called “Self-Care”, which is becoming kind of a buzzword in high-stress communities such as universities, and even some offices and corporations. So, one of the first things I want to talk about is the power of saying “No”. Sometimes saying No, especially for more agreeable individuals, and a lot of the time for women, saying no is a difficult thing for us to do.
When I give this presentation to a group I always ask them, “Why is it hard for you to say no? What would happen if you didn’t say no? Let’s say a friend invites you out and you’re just not feeling it, or you’re invited to a baby shower and it’s just more than you can handle and you wish you could say no, but you don’t.” And, one thing that everybody says is that they’d feel guilty, if they said no. This is sort of universal. And so I ask them, “What would happen if you didn’t say no? What would happen if you went along with it, even if you just didn’t have the energy to devote to this commitment?” And people say that they’d feel resentment. And so when it comes to deciding what things to take on and what things to discriminate against in terms of the tasks that we take on, the commitments that we make, we’re kind of stuck between this dichotomy between feeling guilt and resentment spectrum. One of my mentors, Gabor Mate, in his book “The Body Says No”, talks about when faced with this choice between guilt and resentment, especially when we’re more prone to guilt-avoidance by saying yes more often than maybe we should, he said “choose guilty every time”, because the feeling of guilt, and obviously this isn’t a hard or fast rule, but the feeling of guilt is more indicative that you’re taking care of yourself.
His theory as well is that resentment tends to build up in the body and contributes to the cause of more disease such as cancer and this cancer personality that he writes about is the woman that will say yes to things and is scared to say no out of guilt. So, resentment is far more damaging for the body and therefore, when trying to avoid guilt, maybe move towards guilt, especially when you know that you might be taking on more than you should. And also pay attention to the idea that when we say yes to things we’re saying no to other things. So, we’re always saying “no” and “yes”. We only have 24 hours in the day and so, by saying yes to that baby shower that you’d rather not go to, what are you saying no to? Are you saying no to doing a yoga class for you, or getting extra sleep, or saving your money for a family vacation? So, paying attention to those commitments that we make. There’s a great article online called “The Law of F- Yes! Or No.” And this law is, if you’re faced with a decision and you’re not feeling like this, “F- Yes!”, then say no and save that time and save those commitments for something else that you’re more enthusiastic about.
When it comes to self-care, there’s another great article that talks about the BACE method, so that’s BACE. And this stands for these 4 pillars of self-care. And the first one of body-care. So that’s making sure you have a healthy diet, that you’re supporting yourself nutritionally, that you’re getting movement in, that you’re sleeping enough. A is acceptance, just allowing the emotions, and that self-care, that self-love to come through. C is connection, so establishing those interpersonal relationships and prioritizing them, especially relationships that feel nurturing, where you can be your authentic self. And E is enjoyment, finding activities that are fun and cause a sense of enthusiasm and enjoyment in your life. And this is something that’s often a problem for a lot of adults with lots of responsibilities that, when I ask them to rate on a scale of 1 to 10 how much fun they have, or how satisfied they are with the amount of fun in their life, they often rate it pretty low.
A lecture that I attended, there was a woman who was talking about self-love and improving self-worth and recommends asking oneself this: “what would someone who loves themselves do? Or say?” and that can be pretty powerful for just examining how our internal dialogue is manifesting and how we’re talking to ourselves and treating ourselves. Would someone who loves themselves eat that? Or say that? Or do that activity or say yes to that commitment? And, you know, just sitting with that question can be really helpful for changing some behaviours, or adding perspective to our daily lives.
There’s also this, lastly in the realm of self-care, there’s this idea of Wu Wei, which is a Taoist idea, which is translated roughly into the art of “effortless action”. In our society we’re kind of educated to pair action with effort. So, we don’t feel like we deserve success unless our success was the result of a massive amount of effort that we’ve put in, and stress. And, according to wu wei, this idea that action is objective, we can measure it, but effort is subjective. So, you can see if you’re performing an action, but the perception of effort behind it is this kind of subjective and thought-based experience. So, we can do the laundry or DO the laundry. We can do laundry from a place of self-love and self-care, like “I want to care for my clothes, and to have nice clothes to wear tomorrow and I’m going to do this for myself and I’m going to be mindful as I do it”. And I’m going to do this out of necessity, but also out of a natural drive that’s coming from this place within. Or I can have laundry on my to-do list that’s causing me stress. So, sometimes even wu wei is about doing less and not feeling guilty for that.
The second tool for emotional wellness is journalling and writing. This is one of my favourites. So, journalling allows us to keep a record, to get creative, and to engage in self-expression. And when we write we engage both sides of our brains: the motor centres, the language centres, the centres that are involved in language perception and in language generation, also our visual centres. So, a lot of the brain is lit up in the act of writing and that can help integrate some of our deeper thought processes.
Writing down things leads to clarity and focus. We’re forced to deepen our thought processes and remove ourselves from some of the cognitive loops we might be engaged in. We can complete our thoughts and reach their inevitable, often ridiculous conclusions and this kind of comes from some core beliefs, or, we call them “automatic thoughts.” Like, “I’m a failure” or “I’m worthless”. Those kind of things that our brain generates based on past experiences that may not be relevant anymore to who we are now. Through writing we’re forced to look inside of ourselves, to causes and explanations for how we feel. We’re also able to express ourselves and rid the body of pent up emotions, such as anger and aggression and sadness, shame.
I often recommend that people write a letter. Especially if there’s someone in the past that’s done damage to them, or hurt them. Someone that they miss, sometimes remembering somebody through a letter: sometimes people wish that they could communicate with someone who’s passed away or is no longer in their life anymore and, through this letter-writing, you’re able to.
I also have people write letters to themselves from the perspective of their personality at age 80, and this can sometimes provide perspective for patients who are depressed and young, because it gives them an idea; it increases the perspective of their lives. And sometimes I have people personify and anthropomorphize their problems or addictions and write letters to that or write letters from that and through that process can learn a lot about the relationship between themselves and alcoholism, for example.
There’s another great activity I like called the “God Jar”, for people that have constant worries or wake themselves up at night and process things or who are anxious about the future—The God Jar or the Wish Jar. And so, you get a mason jar and little pieces of paper and you write things that you’re worried about or things that you’re anxious about or thinking about and you scrunch them up and throw them into this jar and, in essence, symbolically, you’re giving those problems to “God”, or to the universe or you’re just simply filing them away for later use. And this is sort of a subconscious, or conscious, dumping of your problems, especially if you don’t have immediate control over them. I mean, in the middle of the night you’re not going to be able to finish your taxes when you’re supposed to be sleeping, or solve a problem at work. And that can often worsen our problems, when we’re not getting enough sleep. Then I sometimes have people open up that jar 6 months later and take a look at some of the things they’ve written and that can also generate feelings of accomplishment and achievement and perspective when you find out that those things that you were so worried about 6 months ago are no longer even relevant and you barely remember them. So, it’s pretty powerful.
Another great exercise is something called a Gratitude Journal. And there’s a Ted Talk about this that, for 21 days, and I like to tell people to do this for a full month, 28 days. If you write 3 things that you’re grateful for at the end of the day for 21 days, it actually changes your brain structure and helps you see things in a more positive light and focus on the blessings, rather than the things that you lack. Our brains have a negative bias. So, they’re wired to pay attention to the things that we’re missing out on and that we’re lacking and when we focus on and acknowledge the things that are going right for us, it can sort of change our perspective. And, throughout the day, as you’re doing this exercise, you’re going to be paying attention to things that you’re going to have to write down later, so you’re paying attention to the things that went well, that you want to include in your gratitude journal. And this can have profound effects.
There’s some studies about journalling. And there was a study that showed that patients with HIV or AIDS, who wrote about their life for 30 minutes had an increased CD4 T cell count—and that’s the cells in the body that are affected by the HIV virus. So, by simply writing about their lives, something profound, it wasn’t just a grocery list. But writing something profound about their lives, such as sharing their life story, actually increased their immune system’s ability to function in the face of the HIV virus.
And then, similarly, there was another study in patient with rheumatoid arthritis—this is an autoimmune condition—they had these patients write for 20 minutes a day, for 3 days, and they found that their symptoms went down and their immunoreactivity went down. So we’re seeing these two studies, and we’re not exactly sure of the causal effect, these studies are a little bit correlative and very difficult to control for, because patients who are in the study, subjects know if they’re writing in their journal or not. But these studies were controlled against people who were just kind of mindlessly writing about grocery lists. So, it was writing about more profound concepts and sort of outlining a significant life event, or life story, or significant events that were happening in the day that had an emotional charge to them.
So, we find that engaging in journalling, even 20 or 30 minutes a day, can actually modulate the immune system. So, if you have a immunodeficiency issue, like HIV, it can increase immunoreactivity, and if you have an autoimmune disease like rheumatoid arthritis, or asthma, if can lower that immunoreactivity and inflammation. So there’s this evidence that journalling and our thoughts and emotions are directly impacting our immune system and our immune system’s ability to function and balance itself.
The third tool for mental and emotional wellness is interpersonal support. And, being a naturopathic doctor who does a lot of counselling in my practice, I tend to favour psychotherapy and counselling as a form of social support for people that don’t feel that they can be authentic or have that deep connection with people in their lives.
There’s evidence that loneliness is the new epidemic, especially in our society and, as social animals, connecting with others is part of our biology, part of who we are. Through therapy, what I really like about it, is it can help us reframe the past and our personal identity. We can start to identify some automatic thoughts and core beliefs, which are deep-seated beliefs that may not serve us anymore in the present and may actually be contributing to feelings of low mood or behaviours that are unwanted. It can also allow us to rewrite our life story, so, looking back on the past and reframing certain events, from the perspective of someone maybe with more resources and power. For example, someone with a history of trauma may have an idea of powerlessness and being victimized and, in every single story of trauma that I’ve encountered, people have always responded in some way. Either psychologically, mentally, emotionally, if not in action, and sometimes just recognizing these responses changes our whole perception of the event and our identities in the present, our ability to act in the present. So, there is evidence that stress is related to our perception of things that happen, not actually what happened. So, for example, imagine somebody that’s just broken up with their girlfriend and they were very in love. And you can image what their mental and emotional state would be like. Maybe the next day they don’t feel like getting out of bed, there’s clothes all over the floor, they haven’t brushed their teeth, they’re feeling extremely sad, and crying. And nothing has changed biologically in this person, but the situation surrounding their life has changed. Then imagine that this person wakes up the next day and they’re in this state of low mood and depression. And they get a phone call. And it’s their girlfriend saying, “you know, I’d like to get back together, I made a mistake, I’m in love with you and I don’t want to be broken up anymore.” So you can imagine that this person’s mood is going to change rapidly as the situation changes. And so, there is a change in their circumstances, but not in their physical biology.
And sometimes, in past events, there’s the story that our minds create around what happened, and then there’s the actual events that happened. So you might call your partner and they don’t pick up the phone, and we start to create a story about why that is. Maybe it’s because they don’t love us anymore, they want to break up with us, that we’re worthless, that no one’s ever loved us, that we’ll never find love, that we’ll always be alone. But, in actuality, we don’t know those things and the only thing that’s happening is they’re just not picking up the phone and there’s thousands of explanations for that.
We perceive situations based on our personal histories, our physical conditions, our state of minds, etc., and things that we’ve learned in the past and also our core beliefs. So, we filter our experiences through our perceptions and our identities and personalities and so, by understanding more about these things, we can understand why we pick out certain events and draw conclusions from the connection between those events rather than others. There’s some people that, when they fail a test, they just think, “Oh, it was a hard test, or maybe I didn’t study hard enough.” And there’s others that think “I’m a failure, I’ll never pass anything, there’s no point in trying, I’m dropping out of school.” And so it’s not just the event but our perception of the event that change our thoughts, mood and behaviours.
Another great thing that therapy and social support can do, is help us identify our passions and purpose in life. So there’s a psychological that I really like to listen to called Jordan Peterson that talks about how the purpose of life is not necessarily well-being and happiness, because happiness is a state that can be derived chemically, through doing things like cocaine, or substance abuse, and happiness might just be a disposition that certain people embody better than others and that life is suffering. And this is present in Buddhist philosophy that no matter how we live, we’re going to encounter events that are devastating for us, and that are hard for us to deal with. And so, in those situations, we’re not going to feel happy, so what’s going to drive us? What’s going to push us forward? What’s going to keep us going in those times and so his theory or idea is that we should look for what makes it worth it: what adds meaning to our life. What is our potential in life? What is our purpose? What gives us that sense of meaning such that, when we encounter these situations of suffering and hopelessness that we’re able to continue on. So, having a direction for our lives, and having a sense of identity and purpose that gets us up in the morning and makes us move forward, even when we’re not particularly feeling happy that day.
Therapy and social support are also great for just self-acceptance. So, having other people mirror back to us who we are and how we’re being in the world.
The 4th tool for emotional wellness is mindfulness and meditation, so very very powerful tools. It’s arguably very difficult to be healthy in this day and age without some form of mindfulness meditation, or meditation practice to combat the increase in stress that we encounter in our society. So, mindfulness is—there’s many different techniques, but the main tenant is just taking the perspective of the compassionate, detached observer to our thoughts, emotions and physical sensations. So, when we split our mind or watch our thoughts, we can get a better sense of awareness of how emotions and thoughts arise in our body, pass through our bodies, and how we’re not them—that there’s this observer role that we can also take, that we can watch ourselves from.
Mindfulness allows us to stay in the present and reframe certain situations and just slow time down so that we’re not victims to the whims of our biology, that we’re able to understand it a little bit more. And there’s a great resource on the internet called “Mindfulness-Based Stress Reduction” that’s a secular kind of meditation by a man in Massachusetts called Jon Kabat Zinn and you can download body scan meditations or take a course in MBSR in your town. I highly recommend them; they’re really great for developing mindfulness practice.
There’s also yoga, and qi gong and tai qi, and these kind of integrated, mindfulness-based and physical exercises that can help slow us down, bring us into the present and help us observe our minds and emotions a little bit better. And there’re amazing for managing stress. There’s good evidence building about them helping us deal with stress and manage our mental health conditions.
And the 5th tool for mental and emotional wellness is to look at that mind-body connection that I mentioned before. The mind-body theory sees our thoughts and emotions as energy that can impact our cellular biology, from that idea of psychoneuroimmunology. And there’s increasing evidence about this and how calming our thoughts down, doing some mindfulness meditation, can affect our heart-rate and can affect our blood pressure, and journalling can affect how our immune system responds.
There’s this idea that if our thoughts and emotions aren’t processed properly they can become trapped and stagnated in the body and contribute to disease. So, Gabor Mate mentioned that resentment can build up and lead to things like cancer. It’s one of his theories that he’s observed through working with patients.
We know that there’s this connection between physical manifestations of symptoms and physical conditions and certain emotional causes. In medicine we know this because every time a study is done, a randomized control trial, two groups need to be divided amongst the subjects. One is given a placebo, an inert pill. And this idea that someone who believes they’re taking medicine will notice a positive effect, is something that we just take for granted, but we build into every single study that we do, if it’s a good study. So, this idea that you can take a pill, believe it’s helping you, and actually physically notice a change in your body is really remarkable. And this just proves that there’s this connection between the mind and body, that we can further explore and exploit.
So, there’s things like herbal remedies that help our body increase our cells’ resilience to stress and help manage the stress hormone cortisol. And these are some herbs called adaptogens. So, they literally help us adapt to stress. And these are things like withania or ashwaghanda, rhodiola, ginseng, even nervine herbs like St. John’s Wort and skullcap can help balance our neurotransmitters and our stress hormones and lower inflammation in the body.
Doing self-care things like getting a massage, or getting acupuncture can help. And there’s a study that compares acupuncture to Prozac, so getting one acupuncture session a week for 6 weeks was actually comparable to Prozac for decreasing symptoms of depression and anxiety.
In my practice I always address diet and gut health and just make sure people are absorbing their nutrients, that they’re guts are producing the proper amounts of neurotransmitters, that there’s the proper bacterial balance, that there’s no inflammation being caused by a gut dysregulation. And we also want to remove those external stressors that can be contributing to an impaired digestive system. So, there is this saying that “we are what we eat,” but more accurately, we are what we absorb, because you can eat a lot of stuff, but, depending on how you’re digestion is functioning, we might not be absorbing all of it and incorporating it into our body, into our cells.
So, inflammation in the gut, caused by a bacterial imbalance, or food sensitivities can impact our health and we have some evidence that depression and anxiety can be caused by some latent levels of inflammation in the brain. And we know that there is an impact on gut health and increasing levels of inflammation and also stress. And really lowering that stress response, healing the gut, can have huge impacts on our mood. Establishing routine, and sleep are major pillars. So, I don’t think I’ve ever encountered a patient who felt mentally healthy when they had disrupted sleep. A lot of the time having a ritual around sleep and getting into a routine and waking up at the same time every day, really working on getting deep sleep—so avoiding electronic use before bedtime, trying to get as many hours before 12 am of sleep as possible, so preferably having a 10pm bedtime or winding down around 10 pm. Doing things like teas, or hot baths, or reading a book before bed or doing some yoga or stretches or meditation before bed to teach the body that it’s time to start relaxing is really important and has huge impacts on health, on our mood, on our emotional wellness, our ability to cope with stress, our ability to heal from stress, and our ability to balance inflammation and the immune system.
There’s evidence that exercise—I mean exercise is arguably the first-line therapy for someone with depression, especially someone under the age of 24. Instead of reaching for pharmaceutical interventions, such as selective-serotonin reuptake inhibitors, more psychiatrists are recommending exercise to young patients, which is wonderful. I’m so happy about that! And, so 30 minutes of a moderate to intense form of exercise such as weight training, or running or moving your body, can help release some of those trapped emotions, as well as boost those neurotransmitters and help our body increase its resilience against stress.
And then, finally, I just want to point out that making sure that we’re supporting our neurotransmitter synthesis through diet is really important. So, making sure that we’re getting enough magnesium, zinc and B vitamins, and proteins and amino acids, which are all helping us create the neurotransmitters like serotonin and dopamine that are going to impact our mood and mental health. So, we can journal, but we are physical beings, and we are a product of our biology. So, by supporting that biology through proper nutrition, we’re able to incorporate those nutrients and create the proper components of our body for proper mental and emotional wellness.
So, I also like to ask people this miracle question. So, this is the final thing that I’m just going to conclude on. The Miracle Question is from a modality called “Solution-Focused Therapy”. And this question is, “if you woke up tomorrow and all of your issues were completely gone, you woke up in an amazing 10 out of 10 state of energy and physical well-being and mental and emotional well-being, what would be possible for you? What would your day look like?” If you can stand in that place and sort of write down what you’re aiming at, what you’re aiming towards, it helps set the stage for taking the proper actions that preserve your mental and emotional wellness. And it also helps you stand in a new territory, one that’s not of disease or illness, but one of possibility.
And, finally, I was at this free meditation circle as we were talking about self-love, and we were talking about how difficult it can be to love oneself. Because, oftentimes we have these core beliefs that drive our psyches and oftentimes these core beliefs are negative. And so what was said was that it’s often hard to stand in a place of self-love when you’re intent on changing things and you’re not happy with where you are now. And so, he said, the person running the meditation said, “self-love is like a garden. So, you can nourish the soil and water the seeds, but you can’t actively force the garden to grow.” So what you can do is, you can take care of the things you love in yourself, all the things that you have in your right now, rather than trying to be somewhere that you’re not currently at. And this is kind of like when you have, for parents out there, if you have a child, you love your 4-year old child, and you don’t put expectations on them that you would a 25-year old. So, you’re loving your 4-year old at where they’re at, but also recognizing that this is somebody who is developing and so you’re loving their potential to develop, just as you’re loving their 4-year old incarnation, their 4-year old manifestation of their personalities. So you’re loving their potential to grow, just as you love the seeds that you’ve planted in your garden, but you’re also loving things where they’re at. And through that act of self-love and tending to the garden, or tending to your child, you’re encouraging that growth and development in the directions that you want.
My name is Dr. Talia Marcheggiani. I’m a naturopathic doctor and I work in Bloor West Village, in Toronto.
The 6-2-6 breath is a yogic breathing technique that can help calm the mind, benefitting feelings of anxiety and overwhelm.
Hello. My name is Dr. Talia Marcheggiani. I’m a naturopathic doctor and mental health professional. I focus my practice on mental health and emotional wellness. I’m just at home right now with my dog, Coco, and we’d like to show you a very quick meditation that you can do.
This is a great thing to do. It’s something I teach my patients to do when they’re feeling overwhelmed or stressed out at work. It’s a great way to combat anxiety and depression as well as a really great way to dive into a meditation practice if you don’t already have your own practice.
Encouraging patients to engage in mindful activities like meditation is indeed a valuable strategy for mitigating stress and promoting mental well-being. As individuals navigate the challenges of modern life, finding effective coping mechanisms becomes increasingly crucial in combating anxiety and depression. Moreover, incorporating meditation into daily routines not only offers a reprieve from stress but also serves as a gateway to cultivating a deeper sense of mindfulness and self-awareness.
For those seeking additional support in managing stress, exploring natural remedies such as CBD presents a promising avenue for relaxation and stress relief. Whether used in conjunction with meditation or as a standalone remedy, CBD flower represents a natural alternative that aligns with the ethos of mindfulness and self-care. By embracing complementary strategies that prioritize mental well-being, individuals can embark on a journey towards greater resilience and balance in the face of life’s stressors.
I also find just spending 3 to 5 minutes a day to sit and focus on the breath, especially deepening the breath, is a great way to dive into meditation and establish your own meditation practice.
So all you have to do is start by either sitting in a chair with your back straight and your feet flat on the floor or in a cross-legged position. You can put your hands on your knees, but what I like to do is tell people to start with their hands on their lower abdomen. That way we can practice moving the breath into the lower abdomen, feel the abdomen rise and fall with the breath, and thereby ensure that we’re sending our breaths down into the belly as we breathe.
It’s called the 6-2-6 Breath. It’s very simple, so all you do is breathe in for a count of 6, hold the breath for a count of 2 and breathe out for the count of 6. By lengthening our inhales and exhales we’re able to stimulate the vagus nerve, which activates the parasympathetic nervous system. This is the “rest and digest” arm of the autonomic—think “automatic”—nervous system in the body. When we’re in a state of stress, overwhelm or depression, we’re usually in a sympathetic of “fight or flight” state and by calming and deepening the breath we’re also able to calm the body, establish a sense of safety within the body, and calm the mind and emotions.
So I want everyone to just close your eyes and breathe in. Start by deepening your breaths. You should feel your hands rise and fall as you breathe.
So when you’re ready let’s begin our inhale for the count of 6. So, inhale, 3, 4, 5, 6, and pause for 2, exhale 3, 4, 5, 6. Pause, 2. And inhale 3, 4, 5, 6. Pause, 2, and exhale, 3, 4, 5, 6. Pause, 2, inhale, 3, 4, 5, 6. Pause, 2, exhale, 3, 4, 5, 6. Pause, 2, inhale, 3, 4, 5, 6, pause, 2, exhale, 3, 4, 5, 6.
So you can continue doing this breath. I recommend spending 3 minutes just settling into the breath and body. You can do this while at work. You can do it at home, you can do it before bed to calm the body down, to help with a more restful sleep. I like how it helps us move out of the space of overwhelm, stress and anxiety, centre into our body and establish more possibilities for clarity and for ways to move forward in overwhelming situations.
Let me know what you think, try it yourself and leave your comments or questions below. You can also follow my blog at taliand.com.
In this video I talk about the Japanese art of Shinrin-Yoku, or “forest bathing” and how incorporating this practice into your routine can set you up for improved mental health and stress management.
Hello, everybody, my name is Dr. Talia Marcheggiani and I’m recording to you guys from the Humber River in Toronto. It’s December 24th, so it’s Christmas Eve Day and I’m just walking my dog, Coco, and I just wanted to make a quick video to talk to you guys about the benefits of something called Forest Bathing.
So, Forest Bathing is a concept that originated in Japan. In Japanese it’s called, and I’m going to butcher this pronunciation: “Shinrin-yoku”. And this is a practice to relieve stress, which is taken on by the Japanese and is also something that’s gaining more recognition in Western society as well.
One of the theories of the prevalence of chronic stress and symptoms like adrenal fatigue and the hormone dysregulation that comes with that and the mental health issues that come with that is our disconnection from nature. And, so, taking some time—and I recognize sometimes just starting with an hour a week, but optimally three hours a week, of time where you’re just slowly exploring nature and walking in a natural setting such as this. And this is just near Old Mill station in Toronto, and there’s many places like this if you look at Discovery Walks Toronto online you could find tons of really cool places to explore that are a TTC ride away.
And, so, being in a natural setting decreases the stress hormone cortisol as well as increases our ability to get some physical activity. The reason I’m recording it now in December is because a lot of my patients will tell me that they’re really active in the summer months, but when it comes to winter, or when winter months set in, they tend to stay indoors. And the temperature regulation that comes with getting outside, put on a toque, put on a park and some water-proof boots—these are not the best—put on some water-proof boots, a toque, parka, some mittens, and get outside. It helps our body deal with the cold, the decrease in temperature and it can increase our thyroid and our immune system. So, actually getting outside, even when you don’t really want and your intuition is telling you to stay indoors, is actually a good idea for your immune system.
And the stress that comes with the holiday season and this time of year, getting outside becomes more important than ever. So being in a natural setting, in the trees, increases the amount of negative ions that you’re surrounded by, and so when we’re surrounded by technology or are in indoors, stressful environments, there are more positive ions.
Being outside increases your serotonin and oxytocin levels. So, those are your feel-good hormones and it decreases your cortisol. So I just wanted to say hi to everybody and to maybe inspire some of you go for a walk, either today or Christmas Day, and get some Shrinrin-yoku, some much-needed forest bathing.
Having a dog obviously helps. “Coco, Coco, Hey! Look!” Having a dog obviously helps because you’re forced to get outside but even just taking yourself, your kids, your family out, is a great thing to do. Get some snowshoes on, some cross-country skiis, or just some water-proof boots and head out onto the trails.
Happy Holidays. My name is Dr. Talia Marcheggiani and I hope to see you guys outside.
My mother tells a story about my childhood where she is standing in the kitchen, preparing dinner. I stand below her, tugging at her shirt, and begging for food.
“I’m hungry”, I say, according to her recollection of that moment and many others like it; she says that as a child I was always preoccupied with food. My constant yearning for something munch got to the point where every time she tried to cook dinner, I’d follow her to the kitchen, like a hungry dog, and persistently beg for food. I was insatiable, she claims. But, as an adult looking back I wonder, insatiable for what?
I remember that moment, but from the third person perspective. So I wonder if it’s as past events sometimes go, where the telling of a memory from an outsider’s perspective serves to reshape it in the imagination. I can feel the emotions, however, watching my 4-year old form tugging on my mother’s clothing, her body towering over me, her face far away. She stands at the stove. I remember feeling full of… what was that yearning? Was it for food? Was it hunger for physical sustenance or nutrition from some other source? I wonder if the constant, nagging hunger was an articulation, in 4-year old vocabulary, of the need for something else: attention, affection or reprieve from boredom. I remember being told at one point that my favourite show was on and felt some of the anxiety of missing what I was lacking dissipate: a clue.
As a child, adults occupy the gateway to food. As adults, the gateways take on another form. Perhaps it is anxiety about body shape or the guilt of knowing that eating too much of a certain kind of thing isn’t nutritious. Perhaps the barrier to sustenance is financial. However, when I stand now in the kitchen, bent over the fridge, arm slung over the open door, contemplating a snack, I know that I am making a choice. And, for myself, as for many others, it’s not always clear whether the call to eat is hunger and physiologically based.
In the west, we have an abundance problem. More and more adults are reaching obese proportions. Metabolic diseases of excess like diabetes and cardiovascular disease are increasing and more and more women are experiencing the hormonal dysregulation that can come from carrying more body fat.
While I don’t recommend aspiring to the emaciated standard that we see plastered on magazines, Pinterest ads or runways, I do think that, for many people, balancing energy intake with energy output could be beneficial for optimal health and hormonal signalling. Body fat is metabolically active. It also stores toxins and alters that way our body metabolizes and responds to hormones, insulin being just one example, estrogen being another. Therefore, conditions like PCOS, infertility, diabetes, PMS and dysmenorrhea, or certain inflammatory conditions might benefit from a certain amount of weight loss.
An addition here: this post is not about body-shame or even necessarily about weight loss per se. It’s about overcoming emotional eating patterns that might even derive from the same disordered patterns that manifest in anorexia or bulimia. The goal of this post is to bring more awareness to how we operate within the complex relationships many of have with food and with our own bodies.
There are many reasons why we eat and physiological hunger is only one of them. Tangled up in the cognitive understanding of “hunger” is a desire for pleasure, a desire to experiment, to taste, to experience a food, to share with family and friends, to enjoy life. There are also deeply emotional reasons for wanting food: to nurture oneself, as reward, to combat boredom and to smother one’s emotions like anxiety, depression, ennui, yearning for something else— we often eat to avoid feeling.
Health issues aside, I believe that Emotional Eating (as it’s so-called) is problematic because it dampens our experience of living. By stuffing down our emotions by stuffing our faces we prevent ourselves from feeling emotions that it might be beneficial for us to feel in order to move through live in ways that are more self-aware, mature, self-developed and meaningful. While some emotional reasons to eat might be legitimate (acknowledging your beloved grandmother’s hard work by having a few bites of her handmade gnocchi, for instance), many of the reasons we eat linger below the surface of our conscious mind, resulting in us suffering from the consequences of psychological mechanisms that we are unaware of. I believe in making choices from a place of conscious awareness, rather than a place of subconscious suffering.
In heading directly into the reasons I am tempted to emotionally eat, I’ve learned quite a lot about myself. I’ve ended up eating less, as I’ve become more aware of the non-hunger-related reasons that I reach for a snack, but that doesn’t have to be the end goal for everyone. I believe that just understanding ourselves through uncovering and analyzing the emotions that influence our everyday behaviours can have life-changing effects; it allows us to know ourselves better.
As I work through the process of understanding why I overeat, I’ve realized there are a few steps to address. I believe that there are layers to the reasons we enact unconscious behaviours and first, it is important to untangle the physiological from the emotional reasons for eating, understand what real hunger feels like, address the “logical” reasons for overeating and then, when ready, head straight into the emotions that might cause overeating to occur
Distinguishing between physiological hunger and emotional hunger:
The first step, of course, is to distinguish between physiological/physical hunger—the body’s cry for food, calories and nourishment—and emotional hunger. Typically, physiological hunger comes on slowly. It starts with a slow burn of the stomach, growling, a feeling of slight gnawing. It grows as the hours pass. For some it might feel like a drop in blood sugar (more on this later): feeling lower energy, dizzy and perhaps irritable. Physiological hunger occurs hours after the last meal, provided the last meal was sufficient. Usually, if one drinks water at this time, the physiological hunger subsides and then returns. Essentially, eating a meal or snack will result in the hunger vanishing and returning again still hours later.
Emotional hunger, however, is different. It starts with an upper body desire to eat. It might be triggered by commercials, social situations, or certain strong emotions. There might be cognitive reasons to eat (“I might be hungry later” or, “Oh! We’re passing by that taco place I like!”) that are not directly guided by the physical desire for sustenance. Emotional eating is often felt in the mouth, rather than the stomach. It might be brought on by the desire to taste or experience the food, rather than to fill oneself. The cravings might be specific, or for a certain food-source, such as cookies (this is not a hard and fast rule, however). Emotional hunger does not vanish from drinking water. Emotional hunger comes on suddenly, and is often not relieved by eating the prescribed amount of food (having a full meal); oftentimes we finish lunch only to find ourselves unable to get the cookies at the downstairs coffee shop out of our heads.
2. Settling hormonal reasons for overeating: serotonin, insulin, cortisol:
Not all physiological hunger, however, is experienced as the slow, gnawing, slightly burning, grumbling stomach sensation described above. Sometimes we experience the need to eat because our blood sugar has crashed, or our neurological needs for serotonin have gone up. We might eat because stress hormones have caused blood sugar to spike and then crash. We might also experience certain cravings for food because our physiological needs for macronutrients; like carbs, fat or protein; or micronutrients, like sodium or magnesium, have not been met.
Therefore, it becomes essential to address the hormonal imbalances and nutritional deficiencies that might be causing us to overeat. Oftentimes, getting off the blood sugar rollercoaster is the first step. This often involves a combination of substituting sugar and refined flours for whole grains, increasing fats and protein, and, of course, avoiding eating carbohydrate or sugar-rich foods on their own. It often involves having a protein-rich breakfast. I tend to address this step first whenever my patients come in and express feeling “hangry”: irritable and angry between mealtimes.
Often drops in brain-levels of serotonin cause us to crave carbohydrate-rich foods. This is very common for women experiencing PMS. In this case, balancing hormones, and perhaps supplementing with amino acids like l-glutamine, tryptophan and 5-HTP, can go a long way.
One of the questions I ask my patients who crave a snack at 2-3 pm (a mere 2-3 hours after their lunchtime meal), assuming their lunch contained adequate nutrients, is “Do you crave, sugar, caffeine, salt or a combination of the above?” Cravings for sugar or salt at this time might indicate a drop in cortisol and give us a clue, combined with the presence of other symptoms, that this person is in a state of chronic stress, burnout or adrenal fatigue. In this case, it is essential to support the adrenal glands with herbs, nutrients, rest, and consuming adequate protein during the afternoon crash.
Finally, when it comes to cravings for foods like chocolate, meat or nuts, or even specific vegetables (when living in South America I would experience over-whelming cravings for broccoli, funnily enough), I find it important to identify any nutrient deficiencies. It is common to experience a deficiency in something like magnesium, iron, selenium, zinc, and the fat-soluble vitamins A, D, E and K; and our bodies will do their best to beg us for the specific foods they’ve come to learn contain these nutrients. Either consciously eating more of these foods (like brazil nuts in order to obtain more selenium), preferably in their healthiest form (such as dark chocolate, as opposed to milk chocolate, to obtain magnesium), or directly supplementing (in the case of severe deficiency), often results in the cravings diminishing.
3. The Hunger Scale and food diaries:
One of the first things I have patients do is understand the Hunger Scale. There are a variety of these scales on the internet that help us cognitively understand the stages the body goes through on its quest to ask for food and it’s attempt to communicate fullness. Being able to point to certain levels of hunger and fullness and pinpoint those physiological feelings on the Hunger Scale allows us to further flush out the subtleties between a physical or emotional desire for food.
Food diaries, I find, can help bring more awareness to one’s daily habits. Oftentimes, keeping a food diary for a few weeks is enough for some patients to drop their unwanted eating behaviours altogether. Other times, it can help us detect food sensitivities and unhealthier eating patterns or food choices. It also helps me, as a practitioner, work off of a map that illustrates a patient’s diet and lifestyle routines in order to avoid imposing my own ideas in way that may not be sustainable or workable for that particular individual.
A word about diet diaries, however: when recording food for the purpose of uncovering emotional eating behaviours, I often stress that it is important to record every single food. Sometimes people will avoid writing in their diary after a binge, or outlining each food eating when they feel that they’ve lost control, writing instead “junk food”. Guilt can keep us from fully confronting certain behaviours we’d rather not have acted out. However, I want to emphasize that the diary is not a confession. It’s not, nor should it be, an account of perfect eating or evidence that we have healed. Keeping a diet diary is simply a tool to slow down our actions and examine them. It’s a means of finding out how things are, not immediately changing them into what we’d like them to be. This is an important reminder. The best place to start any investigation into being is from a place of curiosity. Remember that the point of this exercise is to observe and record, not necessarily to change, not yet; it is very difficult or even, I would argue, impossible to completely eradicate a behaviour if the reasons for engaging in that behaviour escape our conscious awareness.
Therefore, recording food allows us to begin to poke at the fortress that contains the subconscious mind. We start to slow down and uncouple the thoughts and emotions from the actions that they precede and, in doing so, develop some insights into how we work. It can also help to start jotting down other relevant points that might intersect with what was eaten. These pieces of information might include time of day, where you were, what thoughts were popping into your head, and how you felt before and after eating the food. As we observe, more information begins to enter our conscious experience, allowing us to better understand ourselves.
4. Pealing back the layers: Understanding the “practical” and logical reasons for overeating:
One of the things that I have noticed, through my own work with addressing emotional eating, is that there are often layers to the “reasons” one might overeat. Some of the first layers I encountered were cognitive, or seemingly “logical” reasons. For example, I noticed that before eating without hunger I might justify it by thinking “I need to finish the rest of these, I don’t want them to go to waste”, or “I’ll finish these in order to clean out the container”, or “I should eat something now so I won’t be hungry later”, or “I didn’t eat enough (insert type of food) today so I’ll just eat something now, for my health”, or “If I don’t have some (blank) at so and so’s house, she’ll be offended”.
When looking more closely into these justifications, I found them to be flawed. However, they were logical enough for me to eat for reasons other than to satisfy a legitimate, physiological yearning for nutrients. It’s interesting to see how the mind often tries to trick us into certain behaviours and how we comply with its logic without argument.
5. Addressing the practical reasons: Planning:
In order to address the first layer of rationale for eating when not hungry, I decided to do the following: I would plan my next meal and either have it ready in the fridge, or pack it with me to go, and then I would wait all day until I was hungry enough to eat it. I would repeatedly ask myself, every time I thought of reaching for my portions, “Am I hungry now?” And would answer that question with, “Is there a rumbling in my stomach? No? Then it’s not time to eat.”
I found it would often be a several hours later before my body would genuinely ask for the food. I also found that eating satisfied the physical hunger often much sooner than it took me to finish the food. I realized how I often eat much more food and much more often, than I genuinely need.
However, holding off eating until physical hunger arises takes a conscious effort that is often unsustainable. Few of us can move through our busy lives constantly asking ourselves how hungry we are and when, and then have food at the ready to satisfy that hunger with appropriate, healthy choices. Therefore, I used this practice as a mere stepping stone to move through the deeper layers of emotional eating. By addressing the rational and logical reasons for overeating, I was able to get in touch with the deeper, emotional (and, arguably, real) reasons for which I was eating without hunger.
6. Pealing back the layers: Understanding the deeper, emotional reasons for overeating:
For a while I would wake up, make myself a coffee, and then wait until I felt hungry. Sometimes the feeling would arise in a few minutes, sometimes it would take hours. Depending on what I’d eaten the previous day and what my activity levels were, I would often not get hungry until well into the afternoon. However, the thoughts of eating something would frequently persist. And when the thoughts came up, whereas before they would be satisfied by me having something to eat, I now resisted them. When I resisted the thoughts, their associated emotions would strengthen. I then decided to journal before reaching for food, especially when I wasn’t sure if I was actually hungry or not.
Journalling can help us pull up, process and make sense of some of our emotions. I would write about what I might be feeling—what I might be asking for that wasn’t food. Through doing this, emotional reasons for hunger began to surface. The more I held off eating, the stronger and more clear the emotions became. It was a deeply uncomfortable process. This is why we emotionally eat—removing the emotions is often far more pleasant than dealing with them.
Emotions that surfaced were anxiety, ennui, boredom, loneliness and sometimes even anger. However, boredom and a listless, almost nihilistic, sense of ennui were among the two most common emotions I realized that eating medicated for me. For me, eating was entertainment. It broke up the monotony of the day and gave my senses something to experience. It gave my body something to do: chewing, tasting and digestion. Not eating made that sense of boredom grow stronger.
7. Addressing the emotional reasons: Nurturing and preventing:
Knowing more about the root emotional causes for overeating allowed me to work more closely with the source of my behaviour. I find that the closer we get to the source, to the roots, the more effective we are at removing the weeds, or behaviours, from our lives. I knew now that if I didn’t want to overeat, I would have to prevent myself from getting bored. I would have to have checklists of things to do. I would stay active and engaged in life: in my work, my friendships, and the other non-food-related things that brought meaning to my life.
During this time, I did more yoga and meditated. I journaled and wrote. I also meditated on boredom. I traced it back to where I might have felt it in my life before and noticed themes of boredom in my childhood. I realized that the child tugging on her mother’s shirt and asking when dinner was ready was probably a child who needed something to do, a child who was bored.
8. Pealing back the layers further: Working directly with core emotions:
Going even further, we can begin to peal back the layers of the emotional reasons for overeating in order to avoid replacing one “addiction” with another—such as replacing overeating with over-busying oneself, distraction or overworking. I began to find other emotions that ran deeper than mere boredom. I also realized that whenever I had felt boredom in the past, there was a threshold, often filled with discomfort, that I would eventually surpass. Once surpassing this threshold, a well of creativity, or a plethora of interesting insights, would spring forth. I remember as a child I would create stories, or lie on my bed and stare that the ceiling of my bedroom, contemplating the nature of the universe. These beautiful moments had been made possible by boredom and my courage to not distract myself from it.
Working with a therapist, or doing some deep inner work, we can access the core beliefs and emotions that might cause these emotional reasons for overeating to exist. Oftentimes we encounter core beliefs whose effects spill out into other areas of our lives, preventing us from living fully and consciously. Working through these beliefs can be deeply satisfying and help us experience transformational self-growth.
9. Setbacks: Understanding Change Theory:
Finally, engaging in this process of self-discovery doesn’t follow the same pattern in every person. Some people may find that their reasons for overeating are dissolved as soon as they start recording the foods they eat (this is surprisingly common). Others might find that years of working with a therapist have resulted in a mere dent in their ability to eat in response to hunger and to stop unwanted eating behaviours. In most everyone progress is not linear.
Change Theory and the Stages of Change schema depicts the alteration of behaviours as cyclical, rather than linear. As we move through the stages, we enter a cycle of pre-contemplation, contemplation, planning, action and maintenance. Sometimes we fall out of the cycle and relapse. Many people working with behavioural changes and addictions prefer to rename relapse “prolapse”, claiming that prolapse is a necessary stage for continuing the cycle of change and that much is to be learned from failing at something. It is through observing how the world produces unexpected results, and then attempting to understand the unexpected while trying again, where learning takes place. We don’t really learn if we don’t fail.
Sometimes addictive behaviours, emotional eating included, worsen at a time when someone is on the verge of making a massive breakthrough. Sometimes poking at a new layer of the source of unwanted behaviour accompanies an exacerbation in the practice of that behaviour. Having curiosity and self-compassion throughout the process is essential. Savouring the increased self-awareness that comes with any effort to effect change in one’s life is part of the enjoyment of the experience.
