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Help for Anxiety – Naturally
Anxiety is certainly part of the human condition. We are, after all, animals with very few physical defences, so we need an alarm system to keep us safe. The physical responses to fear make us ready to run from predators, fight back, or in some cases freeze and “play dead”. When that normal fear response becomes a regular pattern of anxiety, it can be overwhelming. In my practice, I regularly talk with patients who are experiencing a level of anxiety that is distressing to them. Once people experience anxiety, they often become afraid of experiencing it again, and go to great lengths to avoid trigger situations. The good news is that there are very effective tools for breaking free of the cycle of anxiety without having to limit your life.
As a physician, my first inclination is to rule out physical causes of anxiety, such as certain medications or health conditions. The most obvious physical trigger is caffeine intake. People who are prone to anxiety are wise to avoid caffeine as its effect on the body magnifies nervous tension. Another very common trigger, especially in young people, is low blood sugar or hypoglycemia. Skipping meals or eating refined flour and sugars can cause a sudden drop in blood sugar. When that happens, the brain tells the adrenal glands to release adrenaline, which causes rapid heart rate, sweating, and anxiety. Thyroid conditions, both hyper and hypo, can contribute to anxiety. Patients love that I am able to run up to six blood tests to rule out thyroid conditions as opposed to the one test that is generally covered by MSP. Blood tests can also help to identify anemia, B vitamin or vitamin D deficiencies, all of which can affect brain chemistry profoundly. I often hear from patients that the hormone balancing work we do helps their mood and anxiety levels.
Relaxation techniques are an important part of learning to deal with anxiety. Meditation is simply learning to observe your mind and make choices about where it is focusing. Mindfullness Based Stress Reduction is a program that has been rigorously studied to show superior benefits to anxiety over medication. Adding an element of self- compassion into your daily self-talk practice takes the process deeper and is very effective. Dr. Kirsten Neff’s Ted Talk is a good place to start to explore the practice of self-compassion.
Learning strategies for dealing with life stresses such as relationship issues, future uncertainties, past trauma, addiction and more can help to reduce anxiety. Counselling and personal development work isn’t just for people with mental illness, it’s for anyone who wants to live life more fully and be the best they can be. Cognitive Behavioural Therapy is a set of incredibly practical life skills for anyone wanting to be more clear and calm in their lives. The website anxietybc.com is one of the best on the subject.
As a naturopathic physician, I also offer my patients natural medicines that help to heal the nervous system, balance brain chemistry, and normalize the adrenal stress response. These herbs, vitamins and amino acids can be the leg up that people need to get a handle on stress.
Often a person with anxiety can feel overwhelmed by how their mind and body reacts to stress, and with help, they can develop confidence in their ability to be resilient in the face of life challenges.
Dr. Deidre Macdonald is a naturopathic physician who has practiced in downtown Courtenay for 20 years. www.getwellhere.com 250 897-0235.
Think Straight, Feel Great: The Gut Brain Connection
Have you ever had a ”gut wrenching experience?” Have you felt butterflies in your stomach, or had a “gut feeling?” We all have experienced the influence that our thoughts and feelings can have on our stomach, but research is now showing that our guts can influence our mood, behaviour and thinking more that we had previously realized.
The stomach and intestines are so rich in nerves that the gut’s nervous system, the enteric nervous system, has been called the “second brain.” Surprisingly, there are about 100 million nerve cells in the gut, as many as there are in the head of a cat. Nervous stress can affect digestion from a number of angles including reducing blood flow to the digestive organs, altering secretion of digestive juices, changing gut motility, increasing the leakiness of the intestine and, most importantly, altering the intestinal bacterial lining called the microbiome.
The enteric nervous system also informs our state of mind. “A big part of our emotions are probably influenced by the nerves in our gut,” says Dr. Emeran Mayer, a professor from U.C.L.A. It turns out that the main cranial (brain) nerve for controlling the digestion, the vagus nerve, uses 90% of its fibers to send information from the intestines to the brain. Electrical stimulation of the vagus nerve, a useful treatment for depression, may mimic these signals. The enteric nervous system, like the brain, uses neurotransmitters like serotonin and dopamine. In fact, 95% of the body’s serotonin is found in the bowels. So is there a link between impaired digestive function and mental or emotional disorders? The link is clear in autism and research suggests a link in depression, schizophrenia and more conditions of the mind.
Exciting research has emerged on the role of the bacteria in our guts and how it affects the brain. I recently attended the annual national conference of the Canadian Association of Gastroenterologists. Exciting research was presented on what is considered the most important work being done in the field of biology today. The Human Microbiome Project is an international collaboration to map the DNA of the trillions of bacteria that live in the human body. These bacteria are a critical determinant of digestion function, immune function, prevention of autoimmune disease and, as it turns out, mood. Changes in the intestinal microbiome can have profound consequences on our physical and mental health.
For instance, people with Irritable Bowel Syndrome have different wiring in their gut-brain connection. It has long been established that people with IBS have an amplified perception of pain from the intestines. Research now shows that it is their altered intestinal microbiome that is responsible for messing with the nerve signals from the gut.
In animal models, alterations in microorganisms of the intestines have been show to influence brain function including memory and anxiety. Studies on mice show that changes to gut bacteria can actually affect behaviour. If you take the gut bacteria from bold mice and put it into shy mice, the shy mice become bold and vice versa. Mice treated with good bacteria (probiotics) exhibit less anxiety and show changes in the hippocampus of the brain. They have more brain growth factors necessary for learning and higher thinking.
Researchers have found that people with major depression have alterations in their small intestine microbiome. Namely, they show signs of Small Intestine Bacterial Overgrowth (SIBO). My patients with SIBO often have been told they have Irritable Bowel Syndrome and suffer from bloating, constipation or diarrhea, fatigue, fibromyalgia and more. A simple breath test can help diagnose SIBO; with a long term complex treatment regime, relief of both physical and mental symptoms can be achieved.
Antibiotics significantly alter the delicate and complex intestinal microbiome. Not only does this disturbance have an impact on digestion and the immune system, but it has also been shown to affect behaviour. Mice that are given antibiotics are more daring, having lost their natural instinct to hide from predators. Studies have shown that post antibiotic mice have impaired learning. Also, changes in the critical areas of the brain, the amygdale and hippocampus, have been demonstrated with antibiotic use. Since 30% of human newborns are exposed to antibiotics before they even go home from the hospital, and with many more children are given antibiotics in childhood, the implications for brain development and learning are disturbing.
Stress can also alter the microbiome, leaving us more vulnerable to bowel issues, inflammatory conditions and mental effects of these changes. When mice are separated from their mothers at a young age, their microbiome changes and they are more likely to develop inflammatory bowel issues later in life.
There are other digestive factors that have a ripple effect on the brain. Food allergies can activate immune cells called mast cells. These mast cells can release inflammatory chemicals that can have an impact on the brain causing mood, energy, and learning issues. For some people with celiac disease, the autoimmune response to gluten in common bread and pasta products can cause calcifications of brain tissue that can be devastating.
If you are suffering from both digestive issues and mood issues, there may be more of a link that you had previously thought. Treating the digestive issues by correcting the underlying cause may open up doors to improved mood and mental clarity. Naturopathic physicians have a long history of working with patients to enhance the digestive system, through optimal diet, avoidance of food allergies, enhancement of the intestinal microbiome and much more. Don’t let your guts get you down. Take charge of your mental and physical health.
Mental Health and Naturopathic Medicine
The Integrative Approach to Mental Health
One’s mental health is a reflection of both the mind and the body. There are effective, long term strategies to improve mood, increase energy, decrease anxiety, and balance neurotransmitter function. Creating an individualized program to address the underlying causes of mood and mental disorders is a powerful path towards greater health and happiness.
When I am working with a patient who is suffering from mental health issues such as depression, anxiety, of psychiatric illness, the first step is to do a thorough health assessment. The brain is an organ like the liver, heart and lungs. For the brain to function optimally, it needs to be supported by a healthy physical body. Much insight can be gained through a good history, physical exam, and assessment of lab work. Getting to know the patient, their goals, and their history helps us to co-create a program to enhance mental and physical health.
The next step is to address possible underlying causes of physical and mental issues. When the body is supported to function at its best, there is greater balance in the body and mind. Each of the following medical issues can profoundly affect mood and mental functioning.
Nutritional deficiencies – Patients receive coaching on how to optimize their food intake, focusing on creating a diet that fuels the brain at every meal. Specific nutrients are required for optimal functioning of the neurotransmitters that govern mood and more.
Hormone balance – Changing levels of estrogen, progesterone, testosterone and more can affect our mood and both mental and physical functioning. Naturopathic programs to enhance hormone function naturally or with bio-identical hormones can provide a much needed boost.
Thyroid levels – Assessing the thyroid is a complex task requiring detailed knowledge of the biochemistry of the body. Often low thyroid levels are missed, and this common cause of mood disorders is overlooked. Naturopathic strategies to optimize thyroid function help to increase mood, energy, mental acuity and more.
Digestive Issues – Without optimal digestive function, the brain function will be compromised. The digestive organs are where we take in the nutrients essential for neurotransmitter function. It is also where we eliminate waste and toxins from the body. Many patients experience better mood, greater mental acuity, and increased energy when their digestive concerns are addressed in a real and lasting way.
Food allergies – Many people don’t know that there are foods they eat that are creating fatigue or worse symptoms. In fact, at least 30% of people with schizophrenia are allergic to gluten (celiac disease), vs. only .3% or the total population. Celiac disease can decrease circulation to the brain, cause atrophy of parts of the brain, and cause calcifications of the brain. Proper assessment of celiac disease and coaching on the complexities of gluten elimination, are essential for recovery in these people.
Adrenal function – The adrenal glands produce hormones like adrenalin and cortisol that are intimately linked with brain function and nervous system regulation. Chronic stress, chronic pain, excess stimulants and allergies can all deplete or deregulate the adrenal glands. With a program of lifestyle changes, pain management, and natural medicines, the adrenal glands can become better regulated. Anxiety is reduced, energy is enhanced and mental processes are optimized.
Pain – Chronic pain is a major source of depression for many people. Naturopathic physicians are trained in physical medicine and can assess and treat chronic pain with a variety of techniques. Laser therapy is an excellent choice for degenerative and arthritic issues, as well as other muscle / tendon / nerve issues. A program to reduce inflammation in the body can help to reduce pain and enhance health.
Sleep Issues: Insomnia can rob you of your vitality and push a delicate nervous system seriously out of balance. Many people can overcome insomnia through good sleep habits, relaxation techniques, behavioural therapy and natural medicines. Pharmaceutical medicines are a last resort and are associated with a significant increase in pre-mature death from cancer and other causes.
The next step in overcoming mental health issues is stress management coaching and counselling. I’ve spent many years developing a powerful tool kit for helping patients manage stress and enhance their resilience to life’s challenges on the physical, emotional and spiritual planes. For instance, at the Macdonald Centre for Natural Medicine, I lead weekly relaxation classes. During this nine week series of noon-hour classes participants experience guided visualization for self healing and mindfulness training. Alternatively, patients can enjoy individualized relaxation sessions. During these one-on-one sessions, I discuss the patient’s particular stresses then guide them through an individualized relaxation and visualization session. Patients feel relaxed and refreshed and come away with practical tools for coping with daily life. More in-depth trauma counselling, addiction counselling and marriage counselling is available through an in-house referral to a trained counsellor.
Finally, there are natural and pharmaceutical medicines that can enhance the nervous system and balance neurotransmitters. I work with patients to help them assess all their treatment options, from herbal medicine, amino acid therapy, nutritionals and pharmaceutical medicines.
Dr. Deidre Macdonald is a licensed naturopathic physician who has been practicing for 16 years in downtown Courtenay. She received her psychology degree from UBC and her medical doctorate from an accredited naturopathic medical school in Portland, Oregon. For more information contact her office at (250) 897-0235 or via this website.
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The Macdonald Centre for Natural Medicine
448 10th Street Courtenay, B.C.