Healing Anxiety – An Integrative Approach

By: Dr. Joanna Rosenfeld ND

 

1 in 4 Canadians will suffer from some form of anxiety disorder in their lifetime. Feeling anxiety, or fear, is a normal part of our physiology but it becomes a problem when anxiety interferes with relationships, the ability to go to work or school, and other aspects of daily life.

 

Symptoms of Anxiety

The symptoms of anxiety are diverse, and can sometimes be difficult to recognize. Mental symptoms include excessive worry, insomnia, recurrent thoughts, nervousness and a sense of doom. There are also a myriad of physical symptoms – changes in body temperature, changes in digestion, frequent urination, muscle tension, rapid heart rate, chest pain, excessive sweating and more.

 

Conventional Approach

First line pharmaceutical treatment for anxiety can involve medications to increase levels of “feel-good” neurotransmitters in the body, such as serotonin, or medications that increase the inhibitory neurotransmitter, GABA, to help “chill out”. These can work for some individuals, but medications alone don’t provide a holistic treatment plan. The side effects of weight gain, insomnia or excessive sleepiness and decreased sexual function are often limiting factors in their use.

Naturopathic Approach

Naturopathic Doctors don’t look at mental health as a condition occurring solely in the brain, that doesn’t affect, or have an effect, on the rest of the body. Anyone who has had anxiety before a big test and felt butterflies in their stomach, or felt their heart race, can tell you that anxiety manifests throughout the body.  Below are just some of the ways Naturopathic Doctors can help address your anxiety.

 

Cause: Stress

Stress is a natural response to a perceived threat. During times of stress our body activates the “fight or flight” division of the nervous system. This increases adrenaline and cortisol in the body: creating many of the symptoms listed above – increased heart rate, increased blood pressure, increased breathing rate, muscle tension and mental worry. It’s easy to see how elevated levels of stress can cause, or contribute, to anxiety.

Solution: Increase the amount of time you spend in the “rest and digest” division of the nervous system. Deep breathing, yoga, meditation and low key exercise all help to decrease high levels of cortisol in the body.

 

Cause: Hypoglycemia

You haven’t eaten anything for a long time, and you have been surviving on coffee for most of the day to reach a deadline. Panic sets in, along with irritability and maybe you even start feeling lightheaded. Irregular eating habits, combined with coffee, and surviving on office baked goods can set the stage for erratic blood sugar levels and major aggravations of anxiety.

Solution: You may not have a huge appetite if you aren’t feeling great, but try to consume some nutrient dense foods throughout the day, even if it’s just a few bites every hour. Having proteins and healthy fats, and avoiding processed carbohydrates will help keep your mood and energy levels stable.  Good examples include a protein smoothie, hearty soups or stews, homemade trail mix, veggies with hummus and boiled egg with veggies.

 

Cause: Lack of Sleep

Not getting enough quality sleep can be a trigger for any number of mental health conditions. Feelings of anxiety can also keep you wide awake at night, creating a vicious anxiety/insomnia cycle.

Solution: Create a calming bedtime ritual – journaling, meditation, yoga poses and baths, are just a few examples of ways we can turn on our parasympathetic “rest and digest” nervous system. Dim the lights in your house around 9pm to help signal melatonin production and avoid screens for 1 hour before bed to keep melatonin levels elevated

 

Cause: Nutrient Deficiencies

Many vitamins and mineral are important in the formation and function of neurotransmitters and are depleted by medications, stress and poor diet. These include all of the B vitamins, magnesium, zinc, iron and probiotics. The neurotransmitters are made of amino acids, derived from proteins, so adequate protein levels in the body are important for formation of serotonin, dopamine, GABA and all of the other neurotransmitters. Up to 90% of our serotonin is made in the digestive tract, so you can see how diet is so important in mental well-being.

Solution: Testing nutrient levels is important and often times correcting nutrient deficiencies can have a huge effect on mood. Your ND will sit down with you and make sure your nutrition provides all the correct nutrients, and that your digestion is working optimally to absorb nutrients from food.

 

Cause: Hormonal Imbalance

Hormones are the body’s messengers and will communicate to all cells of the body. The thyroid hormone, which is responsible for our metabolism can also have a huge effect on our mood – levels that are too low can contribute to depression and lethargy, while elevated levels of thyroid hormones can increase anxiety.

For women, it is important to have a balance of estrogen to progesterone. Due to medications, environmental toxins and food choices it is common to see a relative excess of estrogen and deficiency of progesterone. Progesterone is our calming hormone, so it makes sense that low levels would lead to more anxiety and irritability.

Solution: Based on your symptoms and lab tests recommended by your ND to assess your hormone levels, you can address these imbalances to achieve optimal mental and physical wellbeing.

 

Cause: Cognitive Distortions

The way we view a situation can greatly increase anxiety. These mental patterns and habits are established early in life, and create ways of thinking that are not always helpful. These patterns can be a result of trauma, or conditioning early in life.

Solution: Learning to identify behavioural and thought patterns through techniques such as cognitive behavioural therapy (CBT) can be a way to help change well-established mental schemas. A counsellor or therapist can help establish more positive ways of handling situations and relationships to decrease anxiety.

Fertility Over 40

Are women having babies later in life? Yes indeed.

In Europe, the percentage of births to moms over 40 has increased from 1.6-3% since the late 1980s. In the US, 2.6% of births are to women over 40. In fact, women over 40 are the only group whose birth rate is on the rise!

Women who give birth after 40 have higher rates of college education, are more likely to read to their children, are 58% less likely to get ovarian cancer than women who have never had children, and do not experience the “motherhood penalty” of lost wages incurred by younger Mom’s.

The challenges for women over 40 include a decline in the total number and quality of eggs, as well as the higher rates of Down syndrome, autism, developmental delay, and food allergies. Special considerations for older Mom’s therefore include the ability to get pregnant, Mom’s health and ability to sustain a pregnancy, and health of the offspring.

When I asses a fertility in women over forty, a complete history and appropriate lab work is critical, particularly labs for thyroid antibodies, fasting blood glucose, iron status, vitamin D levels and a serum hormone panel at days 3 and 21 of their cycle.

Ovarian reserve is the biggest concern to a woman’s fertility over the age of 40. It indicates reproductive potential-the number and quality of oocytes, response to ovarian stimulation, and likelihood of achieving pregnancy.

Aging’s Effects on Eggs and Supportive Naturopathic Measures

1. Decrease androgen production:

Age related decline in the ovaries’ production of testosterone results in increase insulin sensitivity. Note: Women with PCOS see less of a decline in ovarian response with aging. Supplementation with testosterone is therefore beneficial.

Likewise, production of DHEA drops about 50% from age 25-45. In my experience low dose supplementation is a better option over high dosing which results in a high rate of side effects and only a modest ovarian response.

DHEA significantly lowers miscarriage rates, especially in women over 35 and markedly improves anti-mulerian hormone (AMH) values.

Aromatase inhibitors are used to block the conversion of testosterone to estradiol. Naturopathic alternatives to the drugs Letrozole and Anastrozole include resveratrol, quercetin, visum, garcinia, green tea and grape seed extract. Noteable testosterone supporting herbs include tribulus and maca.

2. Oxidative stress:

With aging, ovarian tissue undergoes age-related changes at a different rate from other organ tissues. Dysfunctional ovarian metabolism is the result of free radicals directly damaging ovarian fats, proteins and genetic material.

Strong scavengers of these specific radicals include melatonin, green tea, polyphenols, and N-acetyl cysteine.

3. Mitochondrial function

Ovarian cells depend on the mitochondria for their energy. The oocyte has the highest number of mitochondria of any cell.

Supportive measures here include, but are not limited to: CoQ10 & Alpha-lipoic acid – there is a significant age-related decline in ovarian tissue of both these nutrients with age.

 

Summary

Naturopathic Medicine offers a wide range of treatment options to help support the key parameters affecting fecundity over age 40. Using clinical signs and lab findings, we are able to determine treatment based on oxidative stress, mitochondrial dysfunction, low androgens and other challenges to fertility.

Whether the diagnosis is poor egg quality or Premature Ovarian Failure, Naturopathic Medicine can be utilized as sole therapy or adjuvant to fertility treatments.

 

 

-Article prepared by Dr. Adatya

 

 

Imago Relationship Therapy: How it works for singles

Vancouver Marriage and Family Counselling – By Grace McDonald

What distinguishes Imago Relationship Therapy from other types of therapy it that it provides an immediate, positive impact on relationships and tools to manage conflict in a way that feels safe and supportive. Imago consists of several important principles: we are born in relationship, wounded in relationship, and heal in relationship.

 

Imago is also helpful for those of us who are single. Imago invites singles to do some self-growth work, while possibly feeling broken-hearted, wanting a new relationship, or wanting to restore love in your relationship. We can all relate to feeling despair, disillusionment, and disappointment in love.

Whatever your heartbreak, whatever your history, you can learn about what you need to know and what you can do to greatly improve your chances for finding and keeping love!

Imago gives us all something to think about, as it offers an enlightening perspective on being single. Singlehood needs to be accepted, understood, and encouraged. Singlehood is a time to explore life and people, learn who we are, take responsibility for ourselves, and identify our desires and needs. Singleness can be beneficial what ever your age.

It is a time for healing, re-establishing priorities, becoming happy with yourself, developing friends and interests, possibly going to therapy, and learning how to live and care for yourself. In addition, singlehood is a stage in your growth, and when you successfully work through this stage, then you are ready to be in a long-term, committed relationship. It’s then that you will know yourself, be able to be intimate, and can take on the responsibilities of partnership.

 

Culturally and historically, having long years of singlehood is a relatively new social standard. There is often pressure to get married, and many people go from childhood straight into marriage. So it makes sense that it’s hard to know how to use singlehood well. Some of us struggle with the reality that we married too young, before getting to know ourselves as a single person; without a clear sense of direction and what we want in life.

 

This perspective helps you understand why you either haven’t found partnership or have experienced failed attempts in partnership. It’s in this perspective, we learn about how to authenticate singlehood as a part of our culture and educate singles of the purpose and benefits of this time of life.

 

Regardless what stage you’re at during your single life, (and applicable for those of you in relationships!) here are four things you can to do in preparation, as part of the process of mindfully discovering your single self:

  1. Educate yourself about relationships!
  2. Educate yourself about yourself!
  3. Train yourself in relationship skills!
  4. Change your behaviors and defenses that keep you from keeping the love you find!

A key Imago principle states that human beings have an unconscious yearning for partnership. Relationship is essential for our fulfillment, to feel whole, and we all have an innate powerful desire for committed relationship. You first work on yourself and make the necessary changes, then do the same work on your relationship. When you become healthier and more mature, you meet a healthier and mature lover.

 

So, once you have successfully gone through the single stage, and experienced self-growth, and are ready to be in relationship, pick someone who is self-aware (like you) and willing to do work necessary for lasting love! By doing this work, it will be easier to find a partner who is able to commit to loving you for the long-term.

 

(This information is based on the book, Keeping the Love You Find by Harvelle Hendrix)

 – Article Prepared By Grace McDonald RMFT, RCC

Stay Mine Valentine: How to keep your relationship healthy

Have you ever considered, the reasons you are attracted to you partner may be the same reasons you disagree?

We are attracted to the differences between our partner and ourselves yet the differences often bring conflict. The attraction and the conflict mean you’ve found the right person

Attracted to your spouse?

Part of our attraction to our partner is to once again feel our wholeness and aliveness because the attraction represents a need to connect to lost parts of the self.

Our behavior and our defenses represent our unmet needs. We fall in love because of certain qualities the other person possesses that meet those needs. However, the quality changes after time, and that same quality represents the lost part of the self.

We tend to fall in love with someone with the same amount of baggage, and we all bring baggage into our relationship.

How to make your relationship even better:

  • Express your love to your partner: “One thing I appreciate about you is…One reason I fell in love with you is…One thing I love about being in a relationship with you now is…”
  • Listen to your partner. Demonstrate your listening by reflecting back what you hear your partner saying to you.
  • Validate your partner. “I hear what you are saying, and it matters to me.”
  • Empathize with your partner: “I imagine you may be feeling…”

How Counselling can help your relationship (even if you’re not having problems!)

One of the forms of therapy we use is called Imago. It allows for the couple’s experience to evolve from voicing frustrations about your partner to noticing and sharing your own self-struggles and experiencing and re-experiencing connection and differentiation.

You reflect on yourself, and how you affect your partner and how what you say makes you more or less connected to your partner, and how you wish would respond.

The Science of Imago and why it works:

Through Imago practice, the dialogue rewires the reptilian or automatic responses in the brain, causing us to behave defensively, to become learned and intentional behavior and communication.

You reflect on yourself, and how you affect your partner and how what you say makes you more or less connected to your partner, and how you wish would respond.

– Advice offered by Grace McDonald, RMFT

*The information contained is intended for educational purposes and is not intended to diagnose, treat or prevent illness or disease.

Help for People Who Want it: Counselling & Psychotherapy

I would like to dispel some misconceptions about counselling and psychotherapy (words that will be used interchangeably here):

 

1) Going to psychotherapy doesn’t mean that you are psychotic or that you will be diagnosed as a psychopath. “Normal” people go for counselling and psychotherapy to feel supported and get help with their lives.

 

2) Going for counselling or psychotherapy doesn’t mean anything is wrong with you. Sometimes there are obstacles between how your life is now and how brilliantly sane you really are. Then we work to remove those obstacles. Whether or not there are obstacles it also helps, categorically, to have someone to see your brilliant sanity and reflect it back to you.

 

3) I am not, as a Registered Clinical Counsellor, going to prescribe medications. Although medications are helpful for some peoples’ mental, emotional, and physical wellbeing, you will need to speak to your doctor or psychiatrist if you are seeking pharmacological or medical support. If you feel it would be particularly supportive to see additional healthcare professionals (i.e., acupuncturists, herbalists, massage therapists, chiropractors, naturopaths, etc.), with your written consent I am happy to consult with them and work as part of a team on behalf of your wellbeing. In psychotherapy, the therapeutic relationship is the medicine.

 

4) Psychotherapy does not have to be about finding what’s wrong with you or your life. Psychopathology is what we, as psychotherapists, call “what’s awry” in peoples’ personalities and moods. Psyche means, “the vital principle or animating force within living beings, and pathology means, “a departure or deviation from a normal condition.” (Normal is more accurately described as “commonly accepted” here). Sometimes there are things awry and we can work to improve those conditions. That doesn’t change the fact that you are fundamentally and brilliantly sane, and that that sanity can justifiably be the focus of psychotherapy.

 

5) Psychotherapy is most accurately translated as “healing of the mind, spirit, and animating principle.”  

 

Everyone needs support sometimes. It can help to talk to someone who is going to listen and be there just for you. A counselling or psychotherapy session is just that – a time just for you. 

 

It can be equally helpful for you to have a therapist who can be a reliable source of comfort not because then you will have to depend on them, but because then you can depend on them. When you have a counsellor, you can count on having a stable, warm and kind force in your life. You don’t need to do it alone. 

 

What you find has been wounded in relationship can be, and some would say needs to be, healed through relationship. A psychotherapeutic relationship is a healing relationship.

 

You can use the counselling session to explore your thoughts, feelings, sensations and emotions. This is a time when you can feel your way through your whole life, whether your experiences seem to be positive, negative or neutral. You may just begin to feel as though you are living more fully!

 

Marlise Meilan, M.A., R.C.C., Contemplative Psychotherapist (Buddhist Mental Health Therapist).