Fuel for Thoughts: Preventing Night Terrors

For years, I had a consistent dream of a bear chasing me. I would wake with my heart racing. I didn’t want to go back to sleep for fear of the bear returning.

How do I fix a problem when I am not even conscious for the event? I started to look for patterns.

I noticed that when I went out with friends and had a drink with dinner, the bear would predictably visit. I noticed that when I had a late dinner with lots of protein and no alcohol, the bear was absent. I moved into a new apartment in the summer and it was hot, so I left the bedroom door open for a cross breeze. No bear. It cooled down and I closed the bedroom door while I slept…bear. Open door, less likely bear. I started a list of what seemed to make a difference. Open door, protein at night, limit alcohol at night: the bear dream was more manageable.

I started seeing a therapist to address some anxiety about being dyslexic and in medical school. When my therapist showed me how turn into my anxiety instead of trying to ignore it or avoid it, my dream changed. One night, instead of running from the bear, I turned to face it and said “What?!” The bear just stopped and sat down in front of me. I had a sense that I had found a new best friend. Now, I can trust my anxiety to tell me when something is off, and I can look with curiosity until I understand my discomfort.

Later as I started to study the physiology of mental health and how the brain works, I could see why my observations helped. Not getting random hits of adrenaline due to dropping blood glucose from alcohol or not eating protein is helpful.

We all have ancient brains that will scan our environment for safety and make sure we are not being approach by lions (or bears). We all need to figure out what our bodies and brains need to feel safe., especially while asleep.  Nightmares and night waking are a chance to listen deeply for what we need, observe our patterns, and do experiments to learn more about what the body and brain need. Please read the Short Cuts post for more ideas about how to improve sleep. 

Short Cuts for Improving Sleep

There is a spectrum of sleep disturbances that can affect us: such as nightmares, anxiety dreams, sleep terrors, fitful sleeping, awake in the early morning for two hours (“3AM Committee Meetings"). If you suffer from having your brain wake you up or sleep through horrible stories, you may have tried various prescription medications only to find that maybe you don’t remember not sleeping well but still feel tired and groggy.

I suggest trying an experiment to prevent hypoglycemia and keep you brain oriented to the safety of today. This might help you reduce your medications or prevent the use of medications.

Let’s create check list of things that are likely to decrease sleep disturbances:

• Go to bed at about the same time every night and wake at about the same time every morning.
• Sleep in a relatively quiet space
• Sleep in relative darkness
• Turn off screens one hour before bed
• Have any alcohol and dessert shortly after dinner, not on its own away from a meal
• Have a consistent ritual to indicate that it is time for sleep (drink a cup of herbal tea, take a bath, read a book, play a game of cards…whatever works for you).
• Remove screens from the bed room; alarm clocks can replace smart phones.
• Rule out sleep apnea at a sleep clinic

If the above list is basically being adhered to and sleep disturbances still occur, try the following experiments:

1. Eat protein before bed, such as a piece of turkey or a couple spoonful’s of cottage cheese. This will stabilize your blood sugar. One cause of sleep disturbances is dropping blood glucose and the resulting sudden release of adrenaline.
2. Have a Lizard Brain Treat ready: a ¼ cup of juice and one handful of nuts will often help you get back to sleep within 30 minutes rather than 2 hours. For early morning nightmares, if they are consistent, and you wake to go to the bathroom, have the juice and nuts - this will keep your blood glucose up and prevent an adrenaline release by keeping your brain fueled. Try this for at least 5 to 7 days to see if it works.
3. Work with a therapist to address how you understand anxiety and any past trauma.
4. Create cues of safety during sleep. The problem and blessing of sleep is that you are not time oriented. In your brain, the past can be present and the future can be worried about. Historic memories can replay past trauma or only parts of past trauma, such as the emotions, the sounds, or the sensations. Creating a sensory experience that your brain can monitor will help indicate that it is the present moment and safety is being sustained through the night can help. This takes a little internal work to overcome what your “rational brain” will say. I have clients who just keep asking “what do I need to feel safe while sleeping?” Some women have put a lock on their bedroom door even though the house is locked and they have a large dog. One person tied a string to the door of the bedroom and to a vase that would break and wake them up. Sometimes it just helps to take a flat sheet and wrap yourself in a cocoon. Playing sounds of the ocean might help.

Sleep patterns are challenging to change because for the most part our conscious observer mind is asleep and is only receiving partial information. So when deciding to do a sleep experiment be sure to try it for at least 5 to 7 days. If the experiment works, try to be consistent for at least 6 months to rewire the new sleep habit.

Eat to Support Sleep

This month we are discussing how to improve sleep. Eating protein before bed can help with nightmares, night terrors and night waking.

But what kind of protein and how much?

If we look at the Optimizing Brains Chart (page 2), we see that 3 ounces (about the size of a deck of cards) of any kind of meat or fish is about 20 grams of protein, which is roughly what a person can absorb and muscle can use in an hour.

For sleep we may not need that much. I suggest starting with 2 ounces (not quite a deck of cards), or 10-12 grams of meat or fish protein. I usually just have people have meat without anything else.  For vegetarian sources, 2 tablespoons of nut butter, or ½ cup of quinoa or cottage cheese often does the trick.

Short Cuts: Use a hand blender to support physical and mental health

The key to eating better is having the right tools to prep food quickly and deliciously. To get my clients to eat more veggies, I often encourage salads. For the busiest individuals, they can buy a package for pre-washed lettuce, add a tomato, a couple of canned artichoke hearts, and ½ avocado, plus a link of sausage cooked over the weekend or a can of skipjack tuna. Add salad dressing and it is good to go.

Making my own salad dressing keeps me from getting bored of salads. One day it is apple cider vinegar, garlic, mustard and olive oil. Another day, it is tahini, apple cider vinegar or lemon, tamari, garlic, graded ginger from a jar, and water. Great with baked cauliflower. Third options is red wine vinegar, olive oil, handful of cilantro, garlic. All of these come together in less than 5 minutes by having a hand blender.

• Here are some ideas to inspire yummy experimentation with salad dressings.

The short cut that makes the biggest difference for me is using a plug-in hand blender. I tried the cordless blenders and then I never had power when I needed it. I have had the Cuisinart version for years, but you can buy cheaper ones - they all seem to work. What’s awesome about hand blenders is that it takes 3-5 minutes to make the best salad dressing, so quick that you can easily make a different one every time. As a bonus, hand blenders help make great soups in the wintertime too.

How a hand blender helps support mental health:

• When cooking is easier, we do the self-care of feeding ourselves well more often. Eating at home generally offers healthier choices, particularly if we make it ourselves.

• Ideally we should be eating 5 or more cups of veggies every day to nourish our bodies; Salads generally have 3-5 cups, and we’re more likely to eat them with good-tasting dressings.

• Cooking for ourselves is a chance to decide if we like something or not. We get to experiment. We set our own standards for the day. We get to practice creativity and how to recover from small failures (by learning which combinations of ingredients we don’t like). Salad dressings are a cheap and recoverable place to start. You can try a new dressing quickly with the hand blender and if you don’t like it, throw it out and try again.

• Hand blenders cost $20-40 and is a tool for self care.

Again if we are going to cook more, we have to make it easier.

Here is an example of what I am taking about:

Be sure to write in your questions on how to do the self-care for better mental health. Feel free to write anonymously ("I have a friend…")

Food of the Month: Apple Cider Vinegar Decreases Inflammation

Spring is here! My salads are back. I always feel better when I am eating more salads.

When I was in college I found a book in the library that had a series of questions written to a doctor in the early 1900s and posted in a newspaper. The answer to many of the various problems was to include 1-2 tablespoons for apple cider vinegar in the diet. This is part of how I got started in natural medicine: it made sense to me that diet impacts health because I know that I feel better when I add some acidity (apple cider vinegar, lemon juice, or lime juice) to my diet a few times a week.

I have been poking around PubMed, the free-to-all medical literature search engine, to piece together why apple cider vinegar has been used throughout history for both physical and mental health. This year in the Journal of Food Medicine (see links below), apple cider vinegar has been shown to reduce malondialdehyde levels. Malondialdehye levels are a marker for inflammation. Studies have demonstrated that it is elevated in major depression, social anxiety, ADHD, schizophrenia, and bipolar, as well as cardiovascular disease and diabetes.

Clinically, I use it to help start digestion for various GI challenges. A little cider vinegar in water before a meal increases the gastric acid in the stomach and gets digestion going. I have also had patients use it, along with garlic and ginger, to prevent colds and flus.

But, lets get back to spring salads and using apple cider vinegar.

Braggs Organic Apple Cider Vinegar is the only one that I have found that is both unfiltered and unpasteurized. I also like Trader Joes’ Organic Apple Cider which is unfiltered but pasteurized.

I love making my own salad dressing because then I know what is in it and I can use olive oil which is better than the oils often used in commercial salad dressing. And I can make any number of salad dressings with lots of different flavors!

Benefits of using apple cider vinegar:

1.      Dressing salads results in eating more veggies.

2.      Mixed with water, it makes a good stomach elixir for digestive problems. Mix 1 tablespoon in 1/8 cup of water before meals. Try this for 5 days to see if gastric reflux decreases and energy and mental clarity increases. Over time it will also help the absorption of iron and B12.

3.      Mixed with water, ginger and honey, it helps slow down or prevent colds. Mix 1-2 tablespoons in a cup of hot water with grated ginger and 1 tablespoon for honey, drink 1-3 times at first symptoms of a cold.

4.      It lessens nigh-time leg cramps. Mix 1 -2 tablespoons in a cup of hot water with grated ginger and 1 tablespoon for honey. Try for one week to see the effects.

Although these seem like a large range of challenges, apple cider vinegar works because it decreases inflammation – a driving force behind these and many other ailments.

Let us know how you use it and how it works for you. 

References:

• Apple Cider Vinegar Attenuates Oxidative Stress and Reduces the Risk of Obesity in High-Fat-Fed Male Wistar Rats
• Assessment of oxidative stress parameters of brain-derived neurotrophic factor heterozygous mice in acute stress model

Fuel for Thoughts: Panic Attacks in High Functioning People

Have you ever known someone who seemly had it all together? And then, she or he seemed to spiral downward with anxiety and depression, even though it seemed out of character. Brad Stulburg, a published author on productivity and performance, recently published an article on his experience with anxiety and panic attacks. I have been following his blog lately because he encourages mindfulness, sleep, and exercise for executives. His anxiety and panic attacks are completely new phenomena to him. He writes candidly about the impact this had on his life and his advice toward the path out.

I was intrigued when Brad shared about the day of his first panic attack: his hadn’t fed his body well during the day, and after exercise he had an alcoholic drink and snacked on potatoes chips. We’ve all done it. You meet some friends at a bar for a drink after a long day and there is no real food available. This combination set up the event of his hypoglycemia (low blood glucose for the brain) and - in my opinion - a shot of adrenaline that was at a survival dose rather than risk taking/excitement dose.

This combination made his amygdala (the reactive/lizard part of the brain) hyper-sensitized to adrenalin. Emotionally, there was no good story about why his adrenalin hit was so high – no attack, no accident. So his brain is trying to find an emotional meaning for the event, when perhaps it was his physiology that was the driver of the adrenaline.

Exercise + refined carbs + alcohol + normal aging process = big release in insulin + sharp drop in glucose + big release in adrenaline = Anxiety and Panic attacks. 

This day of poor self-care set in motion his reactive brain trying to be in charge of his mind, and he has been working hard ever since to regain and maintain his mental health. This can happen to anyone. His example illustrates the importance of nutrition for taking care of one's body to maintain a stable brain and mind. His courage to share his experience helps us all know that we can return to health.

Question: How can we create food safety nets for ourselves and others? Can we keep protein bars or nuts in our bags? Or throw a box of protein bars into the truck of our teenager? Can we ask to meet at bars that have food? 

Share your thoughts by commenting below.

Short Cuts: Experiments to feeling better

We often think that feeling better takes a lot of time and energy. This idea is certainly supported and promoted by the weight loss industry! But there is a difference between feeling better today, next week, and weight loss. It’s also important to understand that sustained weight loss is very complicated. However, what if our goal is just to have 10 to 15% more energy and mental clarity? This is very possible right now, with a little experimentation.

I like doing experiments for my health. It allows me to evaluate if a new behavior is worth continuing and also when to use it most effectively. There are lots of little experiments that can improve how you feel, in as little as 10 minutes or just a few days. And this means you might then have the energy to do more to feel even better.

For example, years ago I discovered that if I exercised in the morning my dyslexic brain worked better. With more experiments I discovered that it takes about 20 minutes of walking or 15 minutes of stretching, weight lifting and balance exercises to see a benefit at the end of the day. When it is beautiful out, I go for a walk; when it is raining I work out in my living room.

Every experiment has to have a definable benefit. Not just “because I should”. For me, when I work out in the morning, I can get my clinical notes done with the patient in the room or in the time before my next patient. When I don’t exercise, I spend 45-60 minutes charting at the end of the day. On my non-clinical days, I spend less time wondering around the internet looking for heartwarming videos and more time on my own passions. It took a month of morning work outs for me to see the correlation. Now that I see it, I can see that the benefit is immediate.

Here is a pdf that outlines some short cuts to feeling better. I invite you to choose one to experiment with. Let me know how it goes, or share your own short cuts, by commenting below.

Food of the Month: Dark Berries

Dark Berries: Raspberries, Blueberries, Cherries, Blackberries

This month’s theme it about how to help your brain recover more quickly from stress. One of my favorite foods to add to a client’s diet is dark berries. I am not going to get all geeky about the names of the chemicals that help your brain. You can look those up if you need them. What I am going to highlight is some of the great things they do for you when you consume them consistently.

Clinically, clients report better memories and a clearer ability to see in their minds. For example, the color of your car is ______? You can see your car even if the car is not actually in the room that you’re in, right? Eating berries helps the brain visualize concepts colors, and thoughts. Additionally, studies show that dark berries also:

• improve memory and the connections of nerves in the brain

• help prevent some cancers and cardiovascular disease

• are high in fiber, without a lot of carbs

• are high in antioxidants, which help reduce inflammation and protect cells from oxidative stress damage.

I’m often asked if it’s important to eat only organic berries. Organic assures that they have not been sprayed with pesticides, but some farms are not certified organic but don’t spray. It’s the residual pesticides that you want to avoid, so ask your grocers and if you can’t get non-sprayed berries, be sure to rinse them well before eating.

How much to eat? Fresh or frozen, 1 cup a day is not too much. Dried berries and juices are denser so limiting these forms to ¼ to ½ cup per day is a good rule of thumb. These serving sizes are about 15 to 20 grams of carbs. If you are trying to stabilize your glucose and prevent hypoglycemia, pairing the berries with 1/4 cup of nuts or ½ cup of Greek-style yogurt is a good idea. This will give you a carb to protein ration of 2-3 to 1. 

How to help your brain recover more quickly

Have you ever thought about how important our brain is for getting through our day? Our brain is involved in everything we do: sensing, breathing, thinking, walking, speaking, interacting, choosing… to name a few. Research is showing that movement/exercise is one of the best activities we can do to support and heal our brains. Exercise prevents and improves brain-related diseases such as:

• addiction
• ADHD
• major depression
• Alzheimer's disease
• plus most physical health diseases such as cardiovascular disease, diabetes, and cancers.

When we sit and think all day we are using just a small part of our brains. What if when we are tired and unclear mentally, it is because the part of our brains we have been using at work is just tired and the other parts are just waiting to be used?

I have recently been introduced to this idea. A few years ago, I was in a motor vehicle accident that disrupted my vision and balance. Now, when I over-use those nerves beyond their current capacities, I get symptoms of fatigue, visual changes, nausea, neck pain and tinnitus. For a while, it was recommended that I stop and do nothing when this happens, because everything is related to vision and balance. When I had to spend a long time in a car, for example, it would take days to recover.

Another idea is that I can switch and use non-tired parts of my brain. My Z-health trainer, Jennifer Nerio at TAISO Fitness, has shown me over and over again that if I use other parts of my brain that are not tired my symptoms resolve faster. Now, doing movement on the ground can help me recover in minutes rather than days.

This reminded me that I used this same concept when I was in medical school.  I would study, study, study and when I could not study any more, I would do 10 pushup or sit ups. By doing movement that I was familiar with - most importantly movement that I was not seeking improvement with, I was able to rest the neuro-nets that I was using for studying.  By the end of the set of muscle movement, I could go do more reps of mental movement on gross anatomy.

Where can you do cross training for the brain when you are intellectually or emotionally tired, remembering that the movement should be something that feels safe and comfortable?

If you are curious and want to glance through more science about the overlap of cognition, emotions and movement, I suggest the Wikipedia article on the “Neurobiological effects of physical exercise”. If you want to get more in depth, I recommend the book Spark: the revolutionary new science of exercise and the brain. 

On-The-Go Protein Sources

Sometimes, between meetings or when on the road, I need a protein snack to get me through until I can site down for a meal. If I know I'll be having that meal in an hour or two, something with 8-10 grams of protein is ideal. If it's going to be longer than that, I'll reach for something with closer to 20 grams of protein as a one-off meal replacement.

Protein bars that have between a 1:1 - 3:1 ratio of calculated carbs to protein, are made with real ingredients (meaning I can pronounce and recognize all the words), no artificial sweeteners (manitol, stevia, aspartame), and - for me - no gluten, are ideal. 

Remembering that calculated carbs are total carbs minus fiber, here are some of my favorite protein bars that meet the above criteria*. I have indicated which flavors I like, but note that there are some variations in nutritional values among the different flavors - so don't forget to read the label!

•  Stinger Protein Bars (Mint Almond) - 17 grams calculated carbs, 10 grams protein, less than 2:1 calculated carbs:protein ratio. Gluten free, but not hypoallergenic, Has chocolate! 

•  Zing Bars (Double Nut Brownie) - 14 grams calculated carbs, 10 grams protein, less than 2:1 calculated carbs:protein ratio. Gluten free, soy free. vegan. Has chocolate!

•  Square Bars (Toasted Coconut Crisp) - 21 grams calculated carbs, 10 grams protein, 2:1 calculated carbs:protein ratio. Gluten free, dairy free, soy free but not hypoallergenic.

•  Clif Bars (Chocolate Chip Peanut Crunch) - 34 grams calculated carbs, 10 grams protein, ~ 3:1 calculated carbs:protein ratio. Has chocolate!

•  Clif Builders (Vanilla Almond) - 26 grams calculated carbs, 20 grams protein, close to 1:1 calculated carbs:protein ratio. With 20 grams of protein, this is more of a meal replacement than snack - but you can always break it up into chunks.

•  Rise Protein Bars (Almond Honey) - 16 grams calculated carbs, 20 grams protein, less than 1:1 calculated carbs:protein ratio. With 3 ingredients (almonds, honey whey protein) - this is as simple as it gets! Gluten free, soy free.

•  Kind Protein Bars (Double Dark Chocolate Nut) - 12 grams calculated carbs, 12 grams protein, 1:1 calculated carbs:protein ratio. Has chocolate! 

Other great on-the-go snacks are:

•  Krave Jerky (beef or turkey, flavored or not) - 10-11 grams calculated carbs, 10-11 grams protein, 1:1 calculated carbs:protein ratio,. Some choices are gluten free. Chewable!

 • Trader Joe's Nut Packs- Protein to Carb ratio will vary. Getting the individual packs will limit the unchecked grazing and prevent eating a pound of nuts -- which can be done in a day. 

Post a comment below to share some of your favorite on-the-go protein snacks.

*Note: I am not affiliated with these brands in any way.

Food of the Month: Cashews

Throughout 2018 I am going to highlight a food or product that helps us fuel our brain and body. 

If you don’t know about The World’s Healthiest Foods website, I love it. George Meteljan has done a great job describing the benefits of individual foods and why they are healthy for us. He mostly focuses on physical health. I will add to this and describe why the food also promotes good mental health. 

Cashews 

If you enjoy cashews, a handful of them as a midday snack is a great fuel to stabilize the brain before you go home to the kids. First, it's a good protein source with almost 8 grams of protein per 1/4 cup. It's also loaded with good (unsaturated) fats which not only help your heart but also help the myelin sheath of your brain. The big bonus to cashews is that they are high in copper and magnesium. I am often thinking about whether an individual is getting the right nutrients to synthesize dopamine and serotonin and both of these minerals are needed for the synthesis of neurotransmitters for our brain. 

Magnesium helps calm, and thus organizes nerve activity; it can help with depression, anxiety and sleep. Copper helps convert dopamine to norepinephrine and serotonin into melatonin. In my office, I check for copper deficiency. People with overt copper deficiency will be able organize chaos and complete tasks (dopamine characteristics), but they don’t get any pleasure out of doing it (low level of norepinephrine). Sometimes they also have problems sleeping.

Since high levels of copper can cause problems for both physical and mental health, if I am going to supplement I do it carefully. I would not recommend supplementing copper without lab work. However, increasing copper through food sources is a different story. When we eat whole foods and have a diversity of foods in our diets, it's challenging to overdose on nutrients. If you don’t like cashews, feel free to eat other nuts as a snack. All of them have a healthier profile than the sugar-carb treats that are so easily shared at work. 

Do you have favorite foods, or foods or products that you're curious about? Post a comment below to let me know what you're interested in learning more about.

Mental Illness or Nutrient Deficiencies?

Fuel for Thoughts

    Dr. Felice Jacka

What is fueling the epidemic of mental health? Twelve years ago when I started my clinical practice in Seattle with the idea that food affected mood, people just did not think food was that powerful. Now there is the beginning of a growing movement. The understanding of impact of food and nutrients on mental health is much more common. For instance, the International Society for Nutritional Psychiatry has been started by Dr. Felice Jacka, who was one of the first researchers to show that a processed food diet increases the risk of depression and anxiety.

What if the 22% of women between 40 and 60 years old are on an antidepressant are not suffering from depression but from a nutrient deficiency such as glucose control fluctuations because they don’t eat protein until dinner? Or an iron deficiency because they had 3 children and are now peri-menopasual and have heavy menses. Iron is needed to circulate oxygen in the body and synthesize dopamine and serotonin.

I have created a list of citations that explore how food affects our mood and decision making. Additionally, there is a review for Felice Jacka’s papers that Ashely Lions helped me create. 

If someone you connect to is challenged by lack of energy and mental clarity you, as a curious and kind person, could ask the following:

• "Have you asked your primary care provider to work you up for fatigue? I understand that if you go in and say you are depressed or anxious, they will give you a pill. But if you say you have fatigue, they will do basic lab work.” 
• “I have heard that nutrition is really important for feeling good, can you talk about what you're eating and maybe see if we can find some areas where you can take small steps to see if you feel better? Or maybe your could see a nutritionist?

Do you "sheet cake"?

I laughed pretty hard when I watched Tina Fey's sheet caking skit on SNL's Weekend Update. It perfectly captured the way many of us (at least from time to time) use sugar to calm our anxiety.

The physiology that explains why this works can be found here, but in short: the sugar in sheet cake gives us a readily available glucose source that tells our lizard brains that everything is going to be ok.

What's missing from the skit is the ensuing sugar crash, which can leave us feeling even worse than before.

For a longer-lasting fix to calm anxiety, eat your favorite source of protein first. Then go ahead and indulge in that sheet cake if you still want it. I'm guessing the speed at which you eat - and the quantity you eat - will be less than without the protein. By focusing on adding protein with carbs,  mostly complex carbs but sometimes sheet cakes, you can avoid the sugar hangover and not let the stress of the night before move with you into the next day. 

What's impacting your anxiety?

In July's Connectors Group we reviewed the Snapshot of Anxiety Assessment handout introduced in June's webinar, , hearing stories of how Connectors have used this tool and answering questions. 

We then discussed my new handout, What Impacts Anxiety (WIA),  a worksheet that captures information about anxiety in a format that helps us see the daily pattern of how the symptoms of anxiety show up in our lives.

The focus of this handout is on learning how meeting the needs of your body, which is the power supply for your brain, impacts energy, anxiety and mental clarity. Since food, sleep, exercise, and our environment impact your body’s ability to create a stable platform for your brain and mind to work, they can be significant drivers to improve fatigue and anxiety.

Further, WIA can be used with other interventions to track improvement of the symptoms of anxiety, such as the introduction of medications, mindfulness, exposure therapy, and observing anxiety levels in different environments or around different people.

The WIA Handout can help you with the people you connect with understand their anxiety better, may they be clients, family members, teenagers and most importantly out selves. 

Connectors Group Discussion: What Impacts Anxiety July 2017

• Introduction: 0-0:21 minutes
• Review of the Snapshot of Anxiety Assessment and Q&A: 0:21-20:28 minutes
• Introduction of the new tool, What Impacts Anxiety: 20:28-34:17 minutes

This webinar is also available as a Podcast.

If you find this blog helpful, please tap on "Like", post comments or consider sharing it. Thank you. 

Snapshot of Anxiety Assessment

In June, the Connectors Group discussed one of the assessments I developed for the book I am writing on Addressing the Physical Causes of Anxiety. The handout Snapshot of Anxiety Assessment reviews how to distinguish anxiety from functional hypoglycemia.

As I discuss different chapters from my book with Connectors, I am very interested in getting your feedback. As you watch the 22 minute excerpt from June's Connectors Group webinar, please let me know what you think, reply to the following questions in the comments section below, or email me.

• How is the Snapshot of Anxiety Assessment helpful?
• What new perspective will this Assessment offer your clients?
• What type of client would this help? Are there clients you would not use this with?
• What are the obstacles to integrating this into your practice?
• How likely are you to use and share the Snapshot of Anxiety Assessment?

Dr. Kristen Allott, June 9, 2017 (22.30 minutes)

1. Introduction: 0-1.11 minutes
2. Part 1: GAD-7: 1.11-3.19 minutes
3. Part 2: Mind – Brain – Body Symptoms: 3.19-6.30 minutes
4. Part 3: Global Symptoms: 6.30-13.00 minutes
5. Part 4: Functional Hypoglycemia Score or the “It’s not in your head – it’s in your body” Score: 13.00-17.37 minutes
6. Identify what’s most important to you about reducing anxiety: 17.37-22.28 minutes

This webinar is also available as a Podcast.

If you find this blog helpful, please tap on "Like", share your comments or consider sharing it. Thank you. 

Estrogen: changing the brain and body from menarche to menopause

In May's Connectors Group webinar, guest speaker Dr. Miranda Marti* of Whole Life Medicine discussed estrogen. Estrogen heralds changes not just in the physical body but in mood and libido. It also has the power to shift focus for relationships and careers, and change the salience of what the brain finds rewarding and reassuring.  For some women, these natural fluctuations of estrogen throughout life are experienced with grace, while other women may find themselves driven wild or to despair. 

Dr. Marti discussed why this occurs and how we can support hormonal changes, whether they be monthly cycles or the perimenopausal transition, with ease. The recorded webinar with slides is provided below in three parts. The full audio is available as a podcast.

In Part 1, Dr. Marti explains:

• How estrogen levels change over a lifespan,
• The different ways in which estrogen and progesterone affect brain function, and
• How estrogen and serotonin-melatonin interact.

Dr. Miranda Marti, May 12th, 2017 (17:04 minutes)

In Part 2, Dr. Marti talks about:

• Estrogen-dominant conditions,
• 5 steps to balance estrogen, and
• Answers questions from participants

Dr. Miranda Marti, May 12th, 2017 (23:34 minutes)

In Part 3, Dr. Marti explains:

• Anxiety and the Vagus Nerve, and the Connection with Urinary Incontinence
• 3 Steps for urinary Incontinence
• And important differences between Vaginal Estrogen vs. Hormone Replacement Therapy

Dr. Miranda Marti, May 12th, 2017 (12:10 minutes)

---

*Dr. Miranda Marti is a naturopathic physician and acupuncturist specializing in the connections between women’s health, digestive health (the 2nd brain) and mental health. In addition to her private practice at Whole Life Medicine in Kirkland, WA, she leads wellness groups at a Seattle-based drug and alcohol recovery program and is adjunct faculty for the Bastyr University Health Psychology Department.

Connectors Group

This Group is part of my online education for individuals and teams who want to improve their mental and physical lives. Research shows that when we develop healthy habits around eating, sleeping and moving our bodies, we have improved decision making, creative problem solving and health.

The Connectors Group consists of a wide range of people who are in positions to help other people navigate their lives better: mental health therapists, executive coaches, psychiatric nurse practitioners, supervisors and project managers, lawyers, teachers, and community organizers.

The group has been meeting on the 2nd Friday of every month, from 7:30-8:30 Pacific time, for over a year now. We cover topics such as:

• Challenges and Q&A about how to successfully connect with friends, family and colleagues
• How many of your buckets are full?
• What makes anxiety worse
• How to prevent colds and flus and how to feel better quicker if you do get sick
• Using the EcoCycle to Plan for the New Year
• How to interpret food labels - How do you know if something is healthy for you or not?
• How the Mind, Brain, Body and Relationship work together to support our lives as creative responsive individuals who live in a rapidly changing world. 
• Why it is essential to support our power supply (our Body): how and what we need to eat to have a stable Brain, a clear Mind, and connected Relationships
• Open discussion about Mind, Brain, Body and Relationship connections

May's Connectors Group (on May 12th) will be lead by guest Dr. Miranda Marti, who will be talking about Estrogen: changing the brain and body from menarche to menopause. Estrogen heralds changes not just in the physical body but in mood and libido. It also has the power to shift focus for relationships and careers, and change the salience of what the brain finds rewarding and reassuring.  For some women, these natural fluctuations of estrogen throughout life are experienced with grace, while other women may find themselves driven wild or to despair.  Dr. Marti will discuss why this occurs and how we can support hormonal changes, whether they be monthly cycles or the perimenopausal transition, with ease.

Addressing the Physical Causes of Anxiety

In February-March of this year I held a live online 3-part training Addressing the Physical Causes of Anxiety. We work with our anxiety and other people’s anxiety all the time. Anxiety can create challenges at work or within our family. We know what questions to ask about what makes us emotionally anxious; but what if part of the cause of our anxiety or the anxiety of the people around us is physical?

The recorded webinars and handouts from the three sessions is now available:

1. Naming and Taming Anxiety

2. Eating to Reduce Anxiety

3. What to Ask Your Doctor

Everyone who purchases this program will receive updated materials and will be able to interact with me about this content, by email, through 2017.

Based on the key educational points that I review with my individual clients, this content represents a value over $700. Your cost for the full online training package: $150

Why eat protein?

In the fast pace of today's world, we all want to have more energy and mental clarity. Many of us get paid for our ability to think and make effective decisions within a tight timeline or schedule. Studies show that our ability to concentrate, have self control, assess a situation, and creatively problem solve for good decision making is determined in large part by the physical resources our brain.

Small frequent meals that contain protein help the brain synthesize dopamine and serotonin, and stabilize blood glucose to help you feel better. It is also important to eat vegetables, fruits, and whole grains.

Benefits of eating enough protein
• Less fatigue, particularly in the afternoons
• Better sleep
• More energy
• Hungry less often
• Better, more stable moods
• Higher metabolism from having a higher muscle mass

In this video, Dr. Allott talks about:

• How food affects the brain, energy levels and mental clarity,

• How to differentiate among trauma, anxiety and hypoglycemia, and

• How to differentiate between depression and fatigue

Included in this is an overview of some key research, the physiology involved, and some tools that can be used to help people who need a little more bandwidth to lower anxiety and depression, decrease fatigue and end early morning waking insomnia.

How practice affects brain function

Here's an interesting TED-ED video on the value of practice, what makes good practice, and how practice actually improves brain function. Lots of things can be practiced, from music to knitting to developing a healthier diet or new habit.

Key elements of practice are (nearly) daily repetition, constant curiosity about how to do something better, and working at the edge of a know skill set without jumping in too deep.

Importantly, by going through the process of trying something, messing up or finding room for improvement, and trying again, practicing gives us skills to deal with anxiety in other areas of our lives as well.

Mastering any physical skill takes practice. Practice is the repetition of an action with the goal of improvement, and it helps us perform with more ease, speed, and confidence. But what does practice actually do to make us better at things? View full lesson.