Preparing for the Holidays and Addressing Loneliness

In December of past years, I usually write about how to prepare for the holidays. I share strategies for managing the holiday season so that you enter January feeling prepared for the new year rather than exhausted from too much food and alcohol, and too little sleep. This year, I am going to refer you to past blogs, and the Holiday Anxiety eBook Natasha and I wrote a few years ago.

This holiday season I want to focus on creating a plan to address our loneliness or help people who are lonely.

Mostly, I write about protecting our power supply through what we eat, how we move our bodies, and getting enough sleep. I leave the “relationship” part of the diamond to the therapists, mentors and coaches. Not that I think that relationships are unimportant – in fact they are essential. I just focus on taking care of the body, brain and mind because they’re under represented.

But I also think that loneliness – especially around the holidays – is a relationship concept also under-discussed, or we think of it as part of depression. Dr. Vivek Murthy, who served as the 19th Surgeon General of the United States from December 15, 2014 to April 21, 2017, has been on a mission to bring this topic out into the open. Below are links to an article and podcast that I think are worth reviewing. Dr, Murthy is very articulate on how the increase in loneliness in recent years is predictive of poor physical and mental health and contributes to the breakdown of communities.

What I appreciate about Dr. Murthy’s discussion are his suggestions on how to address it. Primarily: find connection, protect family or personal time, and be curious about the wholeness of other people.

I have gone through periods of my life where I was desperately lonely, and other periods where I was alone but not lonely. Some of my loneliest times were when I had connections to lots of people, but no meaningful connections. One of those lonely times was when I was in medical school. Part of why I could not feel the connection that were available is because I was physically exhausted; I was disconnected from family and friends, and all curiosity was consumed by taking in information. However, I did try to address my loneliness before it spiraled into some other problems.

Now, as an naturopathic doctor, if you are experiencing loneliness I would ask you to look at and clarify the causes, and encourage you to address them.

• In my office one of the most common causes is fatigue. People are just too exhausted to tolerate deeper connections (relationships) due to physical health problems. One way to honor this truth, and still look for connections, might be find “lighter” connections by being in a community without expectations of the types of interactions that wear you out. Ideas for this include going to a coffee shop, sitting in the back of a church to listen to the music, going to an Al-Anon group, a Meetup group, or sitting in a library. What I have found is in the long term, time with screens fills time but doesn’t fill the heart or the need for in-person connection.

• Many people also find ways to connect in the form of service. When we help others, we often help ourselves. Volunteering at a food bank in your community, at your library, helping kids with homework, or at a retirement center talking with the elderly, are some ideas.

• Another approach is to create an event for connection. At one of my loneliest times, I said after an Aikido class “Hey, I am going to the Thai restaurant for dinner, anyone want to come?” The first night 5 people joined me and over time, Thai food became a Thursday ritual. During those shared meals, I met people who became lifelong friends.

• Be curious about people. It’s easy to think that other people have perfect lives and somehow aren’t as lonely as we are – but they too might appreciate connecting. This must be true of all the people who talk through an entire plane flight. I was a student at a school in the south for dyslexic medical students; it was a relief to share my dyslexic story with others. One of my fellow students was African American and I asked her “Is it different being in the south as an African American?” She answered, “Yes, it is.” From that simple question, we became walking buddies. I think she got some relief from her loneliness of being the only person of color in school, and for me – our conversations allowed me to explore what it meant to not meet the hyper-feminine expectations of the south.

• My last suggestion comes from Brene Brown’s Braving the Wilderness. Dr. Brown says that for us to have connection, we have to show people who we truly are. When we are accepted for who we are, for the similarities as well as the differences, then we can be our authentic selves and relax into that connection.

In summary, Dr. Murthy is right in his assertion that loneliness is detrimental to our health and the importance of addressing it. So: make a plan. Dare to be uncomfortable. Be willing to protect what is important to you. Start by finding the smallest of connections. Use the internet for find resources and education, such as listening to Dr. Murthy and reading Dr. Brown’s books.

I hope you have a good holidays,

Kristen

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• The Ezra Klein Show with Dr. Vivek Murthy “The Loneliness Epidemic”

• Forbes by Dan Schawbe “How to Solve the Work Loneliness Epidemic”

• Ted Talk by Guy Winch “Emotional First Aid for Loneliness”

Juice for Anxiety?

A participant in a recent training sent me a follow up email with a question about the Lizard Brain Treat. She gave me permission to share it here.

Hey Kristen, 

 Hope you had a safe travel home.

Thanks again for a great conference!  I have been getting more protein into myself this weekend and am feeling less irritable with my 4 yo daughter, so already showing benefits for the every 3 hour protein plan!  I also walked the half mile to work today vs driving! You have inspired me so much!

I was sharing some the info with my Mental Health colleagues today and they said “juice”? That has way too much sugar, what about fruit and nuts?  I said “Hmmmm, I’m not sure”, and had to look it up. I saw that you recommended just a ¼ cup juice, not a whole bottle…for lizard brain symptoms.  I also have a colleague who has diabetes, and he said, “I can’t have juice, no diabetic should have any juice.”  What words of wisdom do you have for that question?

Sincerely, Molly

Molly -

Thanks for doing the experiments. 

If people object to juice, they don’t have to use juice. I just find it effective in shifting a person’s mood immediately when they have lizard brain symptoms, such as anxiety, irritation, agitation, or early morning waking for 2 hours.

A ¼ cup of juice is not a lot of sugar. Remember, it is not just juice. We are also adding nuts or a protein source, since the juice will be burned quickly. 

I did a quick search:

·      Apple juice has 28 total carbohydrates in one cup, so ¼ cup has 7 grams of total carbohydrates

·      Granulated white sugar for 1 teaspoon is 4.2 grams of total carbohydrates. 

·      Dried cranberries have 26 grams of total carbohydrates in 1/3 cup. 

Note that dried fruit takes longer for the glucose to get to the brain since the sugar has to be released from the fiber.

Some people don’t have the control to drink only a ¼ cup of juice and will drink a full cup or more. This can be a problem. Additionally, sometimes when people are watching their carbohydrates, as with diabetes, it’s easier to eliminate this food category altogether.

I tell people who are opposed to juice and are anxious/irritable/early morning waking to try the juice to see if it works. If it works and helps them regain emotional balance or go back to sleep, then we work to find a food that will have an equivalent response. It is different for each person. Here are some of the solutions that have worked: dried cranberries, carrots, honey sticks, 1-2 large smarties.

The Smarties candy is an interesting one. It’s made of dextrose which converts quickly into glucose. The large ones are about the size of a penny.

My goal for the juice is to quickly get some glucose to the brain to turn off the adrenalin that is firing up the lizard brain. Here are some common scenarios where I find ¼ cup of juice (or equivalent) effective.

• Slowing down anxiety and panic attacks

• Irritable teenager who is frustrated

• Waking in the early morning with thoughts racing

• Not hungry in the morning at waking

• Really groggy in the morning at waking

Hopefully that is helpful. Kristen

Update on our forthcoming workbook

We thought it might be fun to share some of our experiences in writing this workbook. Writing and publishing a book is seems to be an iterative process where we keep running into ourselves in unexpected ways, bumping up against beliefs that we might not have previously been fully aware of. Here are my reflections this month:

Now that we are fully in the process of working with editors from New Harbinger Publishing, I find myself wondering how attached I should be to every word. First, you need to know that I’m dyslexic. My strongest emotional memories of school are of teachers bleeding red ink all over my papers. “Great concept: Poor grammar. You must do a draft!” even though I always did multiple drafts. Second, Natasha loves constructing sentences, so I have her backing me up.  The process we have co-developed is that I do content and she weaves it into something useful. However, I can tell I am struggling with what I think it means to be a writer.  Will a writer fight for every word, every detail? I trained in Aikido for 22 years to learn that I cannot control every detail, I can only choose my direction or intention. Can this be true for writer? Is this just true?

Like the tenets of my medicine, I do value just showing up in my inconsistently consistent way. I value trying and failing and trying again with more knowledge. I have learned that what’s more important to me in this process is that I like myself while I’m in the midst of it rather than revisiting how I used to hate myself for my sentence structure and spelling. I realize that this should be an additional tenet: I want the readers of our book to do just a little better with food, sleep, and exercise and still like themselves. And as I ask them to risk the unknown, I will also take risks in areas that are hard for me, and keep to liking myself for doing it.

Tenets for Practice that Put the Client at the Center

I just finished a two-day training in Minnesota. Participants kept coming up to me and saying how much they appreciated my approach. What is that approach? How might it be different than other methods? What does it mean to be client-centered? What is the humanistic approach? Would mindfulness practitioners call this approach mindfulness? I tried to get clearer on what people are experiencing because all I experience is me.

I do have some tenets that I hold on to:

• Don’t try to be smarter than God or Evolution. I embrace the fact that I understand very little of what’s happening for individual. However, I can set up experiments to test for what might be true.

• Trust people to tell you close enough to the truth. Again, I don’t have to know everything. I just have to know what they are willing to try and what they won’t.

• Encourage being inconsistently consistent. Perfection is always a prison. How I have seen people change is to try, stop, make new intension, try again, don’t make it, succeed for a little while, stop, try again, miss, change it up, learn, try, fail, pout, feel anxious, try again, and so it continues. What I have learned most from martial arts is to get up after every fall.

• Willpower resides in our responsive brain. If we are not fed, we are reactive and can’t be responsive. Our anxiety, irritation, and agitation will escalate until we fuel our bodies.

• Human physiology is common to all humans. The details of our choices arise from our past experiences, our current circumstances, and what our holds us back. But the physiology happens for everybody’s body.

• Be curious about how the underlying physiology drives behavior. If someone is living in the complex world of homelessness, they might need to drink soda all day long to feed their pre-frontal cortex so that they can be responsive instead of reactive. Change comes from being responsive to one’s situation. Drinking soda all day is not a sustainable long-term behavior, but it may be what’s needed to get a toe hold on a new path.

• Most of us cannot DO a food program. We make moment to moment decisions about how and what to feed ourselves based on what’s available. Having have some basic knowledge about what will be useful in-the-moment can be empowering and help us gain some understanding of what our possibilities are.

• My job is to witness and to constructively add to people’s lives. Telling people to stop a behavior or to change is akin to suggesting a massive mountain climb. Teaching the skills needed for change and doing experiments along the way so people can begin to feel better in a single moment provides a more sustainable pathway for change.

Most of these tenants are not unique to learning and healing. I think the connection to how physiology impacts and drives our behavior is important and sometimes lost to the drama of life.

The workbook that Natasha and I are writing describes how the physiology of glucose control can impact how we experience all forms of anxiety. I have witnessed that attending to the physiology helps not only anxiety, but other conditions as well: PTDS, OCD, night terrors, 3 am waking, fatigue, depression, ADHD, and others. It also supports effective decision making, creativity, and sustaining energy levels throughout each day.

If you have been using food to help yourself or the people you connect to feel better, we would love to hear how addressing glucose control has positively impacted different behavioral symptoms. How has understanding the ways in which protein and carbohydrates influence behaviors been helpful? Please take this 1-minute survey.

In the Light of Summer, Improve Your Sleep Habit

It’s summer and a great time to start new sleep habits. With the sun out longer and the weather warmer, I find that I’m more interested in moving my body, being outside, and socializing… and not watching a screen. Is it the same for you? Some people are the opposite, and that’s ok. Summer is still a good to time to reset our sleep patterns. The beauty of improving your sleep habits is that you will have a new you!

First - are you and your family members getting enough sleep? If your home has little ones, check out the table below to learn how many hours they need to sleep. When developing brains (and adult brains) get enough downtime, they have more ability to learn, better memory, more balanced moods, and less anxiety.

Recommended Sleep Hours form the National Sleep Foundation

• Newborns (0-3 months): 14-17 hours each day

• Infants (4-11 months): 12-15 hours

• Toddlers (1-2 years): 11-14 hours

• Preschoolers (3-5): 10-13 hours

• School-aged children (6-13): 9-11 hours

• Teenagers (14-17): 8-10 hours

• Younger adults (18-25): 7-9 hours

• Adults (26-64): 7-9 hours

• Older adults (65+): 7-8 hours

When trying to get enough sleep, it’s helpful to anchor one end or the other of your sleep time. If you are a night owl try, to always get up about the same time. Yes, it will hurt the first few mornings, but if you prioritize sleep your body will be happy to go to bed earlier. If you are a morning person, don’t get out of bed until it is time to get up. I’m a morning person and my brain will wake me at 5 am because the sun is up. I encourage my thinking self to stay quiet and stay in bed until 6am. Otherwise I can’t complete sentences after 8:30pm .

Since the sun is out and the weather is nice, turn off the screens. Turning off the screen at least 30 minutes before bed helps with falling asleep and having restful sleep. Develop a list of what else to do before going to bed. Here are some ideas:

• Play board games or cards

• Paint, draw, sketch

• Listen to music, play music

• Sit outside and actively notice colors, sounds, plants, growth, seeds

• Play with pets

• Walk around the block

• Listen to a non-emotionally charged podcast or a calming story

• Knit, bead, sort

• Stretch, yoga, walk

Remember that your brain encodes what you do right before bed. So if you are reading or watching stories with psychopaths killing people… your brain is going to deeply encode that. A few years ago, I noticed that I was watching NCIS before bed. Almost all the stories included someone getting killed. I decided to take the summer off from reminding my brain that people get murdered. Three weeks after stopping fear-based entertainment, I had about 3 days of intense nightmares - all of them, in part, from NCSI story lines. After the purging of fear, I found that I was more curious about people and their stories outside my office. Maybe my survival brain was a little more interested in people because I was not consistently reminding myself that people are going to get killed in the next episode. Over the years, science and experience suggest that our brain does not separate stories from life. So maybe we should monitor what we tell ourselves about the world, particularly before sleep.

In summary, three things we can do to improve our sleep and the sleep of the people we are connected to are:

First, be in bed for the time that is appropriate for your age.

Second, move screen time away from bedtime and don’t use it while in bed.

Third, develop a robust list of activities that you can do before bed that supports your happiness.

Minimal Metrics for Exercise

In 2018, my blog focused primarily on anxiety. This year I am thinking more about movement and mental health. A good starting place is identifying the minimal metrics for movement and how achieving these metrics can support mental health.

So, I spent some time reviewing the most recent studies for exercise.

What is definitive?

Exercise reduces dementia and reduces all causes of death. For mental health in general, cognitive functioning exercises in studies don’t always show that it is helpful. They have not shown that they decline cognitive functioning. Ok. Exercise dose not always helps to be smarter. But for depression, the research is clear: exercise is an excellent therapy on its own and in conjunction with other therapies. Exercise increases neuroplasticity, improves how the autonomic and endocrine systems respond to stress, improves sleep, improves self-esteem, …the list goes on. So, we can definitely say now that exercise is good for both the brain and body.

How much movement do the studies say is needed?

When people exercise three times a week for 12 to 24 weeks, there is a dramatic reduction of depression, and if the exercise continues, there is a reduction in recurrence. That sounds great! And… those people were selected and paid to be in the studies.

Beyond the studies and in my office

When people can feel that movement improves how they feel, then it becomes a useful tool for treating energy and mental clarity in the moment. I believe that part of treating depression, mental health, pain, and other diseased states, is to provide people with tools that move them towards resilience moment to moment. If a person has a tool that can help them feel better now, today, or later today, we can build experiences that move us away from depression, fatigue, low self-esteem, anxiety, pain, or whatever their points of suffering are. Why does this work? When people can experience change that they are in control of, and learn the value of the process, they have a model of change that can then apply to other things in their life.

But how do you actually get someone who is depressed moving?

At my last PESI training in Richmond, VA, I posed this question to the group of around 90. I like to start with the smallest possible metric, in large part because it is doable. And since I am all about being able to feel what’s going on in the body, I first asked everyone to do an experiment. You, the reader, can do the same experiment now.

The Minimal Movement Experiment

1. Check-in and rate your energy level at this moment, using the scale below.

Now stand up. Choose one of the three possible movements that you will do four times. Here is a video of me squatting, marching and flapping my hands, in case you want to see what I am talking about.

• Chair squats – have a chair behind you and sit down as though you are going to take a seat. Just as the chair touches you, stand back up;

• March in place – with your knees coming up as high as it is comfortable; or

• Overhead hand clap – raise both arms in the air and bring your hands together comfortably over your head. Clap your hands together if that sounds like fun.

Remember one of these, just four times.

3.  Sit back down and re-rate your energy level.

The majority of people in my training reported feeling at least 10% better. So, if you were initially at 6 (out of 10), you might now be at 7… in less than 30 seconds! What could you do with 10% more energy? Do you get up to snack or drink coffee at work when you might just need to move your body a little bit to get some energy and mental clarity?

Where can the experiment be done?

Certainly, YOU can do this experiment anywhere: at the office, in the bathroom, when you get off the couch from watching TV. Additionally, you can try this experiment with clients who present with fatigue or who are kinesics learners. I offer it as a mindfulness exercise for people with childhood history of trauma, as a way got them to learn to listen to their bodies. It is a small enough dose that it is unlikely to make fatigue worse. Maybe nothing is noticed, but they tried something new. I also like to give it to my clients as homework (“Since the exercise was helpful in my office, I would like you to try it when you have been sitting for more than three hours.”)

Throughout the year, I will write more about how to use movement as a way to improve energy and mental clarity.

References:

Medina JL, Jacquart J, Smits JAJ. Optimizing the Exercise Prescription for Depression: The Search for Biomarkers of Response. Curr Opin Psychol. 2015;4:43-47. doi:10.1016/j.copsyc.2015.02.003. Link to study.

Belvederi Murri M, Ekkekakis P, Magagnoli M, et al. Physical Exercise in Major Depression: Reducing the Mortality Gap While Improving Clinical Outcomes. Front psychiatry. 2018;9:762. doi:10.3389/fpsyt.2018.00762. Link to Study.

New Study: Nutrition is a Cost Effective Tool for Major Depression

Since Felice Jacka’s landmark study in 2010, accumulating evidence shows that poor nutrition contributes to depression and anxiety. For years studies have shown the importance of B vitamins, omega 3 fats in the form of EPA and DHA, and individual amino acids for correcting depression. Dr. Felice Jacka pioneered research demonstrating that whole food nutrition counts for adults and adolescents in treating depression and anxiety.

A new study (SMILES) provides evidence that that nutrition is a cost-effective treatment for major depression. The prospective research comes from Australia and New Zealand where they enlisted 67 adults meeting the criteria for a poor-quality diet and major depression. These individuals were randomized in one of two arms of the study: nutrition support (33 people) or social support (34 people). The nutrition arm provided up to seven sessions with a nutritionist, and the social support provided the same amount of time and emotional intensity. The study took into consideration both healthcare costs and time lost at work from major depression. Below is a summary of the significant findings of the study.

Nutritional intervention: 33 people received 7 sessions with a nutritionist for support enacting the Mediterranean diet

Positive Findings

• Higher remission rates of major depression

• Lower missed paid and unpaid work days

• Lower use of health care services

• Overall health care costs on average was $940 lower

• Lost productivity costs were $1589 lower

Downside costs

• Higher cost of session delivery, travel and food costs

Social Support: 34 people received seven sessions of social support. No nutritional changes.

Positive Findings

• Lover cost of session delivery, travel and food costs

Negative findings

• Lower recovery rates and lower remission rates of depression

• More use of allied professionals occupational therapists, such as: physiotherapists, osteopaths dentists, podiatrists, orthodontists

• More lost productivity due to missed paid and unpaid work days.

• Higher health care costs and lost productivity costs

Although this is a small study, the accumulating scientific evidence suggests that nutrition provides support for depression as a therapeutic tool. Additionally, major depression increases the risk of diabetes, cardiovascular disease, and obesity. All of these conditions are costly to the person, negatively impact productivity at work, drive health care costs up, and have studies associated with them that show nutrition can slow or reverse the disease. When we are connected to a person suffering from depression helping them take action to address the depression can be life-changing.

The typical therapeutic tools for major depression are psychotherapy, medications, and maybe mindfulness. If nutrition is going to be referred to, we have to create a path that lowers the shame. Most people believe that they should be able to improve their diet on their own and recognize that they don't--causing shame.

I want to review some options for getting traction when examining a person’s diet, used in the context of a therapeutic ally or psychotherapist.

Possible Experiments

1. First, I am going to refer to our previous blog about Hope Rising by Chan Hellman, Ph.D. When someone is stuck in depression it is possible that they are missing some important tools. Dr. Hellman discusses that for Hope to exist we have to have both Waypower and Willpower to achieve our goals. In other words, we need to have a path with small achievable steps laid out, and we need willpower which is a personal investment in our goal and good nutrition to keep us in our pre-frontal cortex (the "smart brain") and out of our the limbic system (the "lizard brain"). So when I am discussing the causes of depression with someone, I try to identify whether they know what the next couple of steps are toward a goal -- any goal, or if they do not have the will power to move forward. If they don't have the willpower and their diet is low in nutrients, I will start doing 3-day experiments with food or movement/exercise. (See my handout on 3 Days of Protein to increase energy and mental clarity).

2. From a motivational interviewing perspective, giving them a choice on what they are willing to try to address their depression and then set a time to see if the therapy helped. For example, I will go see a nutritionist 7 times over 12 weeks. I will walk every day for 10 minutes for 30 days.. The activities can include medication, nutrition, mindfulness, movement/exercise, or a gratefulness diary, to name a few. Put a timeline on how long you will try that path before trying another path.

3. At the start of a relationship, or when a client reports a particularly bad day, simply ask, “What did you eat yesterday?” The brain needs fuel just like the body and sometimes what and when we eat or don’t eat has an influence on how we feel. One child therapist I know asks the parents when they meet, "What is happening in the home?" She always follows up with questions about what the child has been eating. She barely has to comment on the cereal, pizza and mac and cheese pattern for them to notice the relationship between the food quality and their child's behavior. Our intention of healthy meals easily becomes lost in the busyness of life.

4. If a person is stuck in their depression, ask if they are willing to do an experiment for 3 days to change their nutrition. We have a video and a handout on increasing protein to improve energy and mental clarity. Note that some people may not be able to notice a difference until they go back to their original diet.

5. Find a good referral for nutrition in your area. There are many professionals that can discuss nutrition. Here are some professionals to approach possible referrals: nutritionists, acupuncturists, naturopathic physicians, and health coaches, to name a few. One of the important questions to ask is if the person is comfortable helping someone improve their diet without the goal of losing weight. If the depressed person is overweight, I find that it’s important to focus first on having more energy and mental clarity and feeling better day-to-day before embarking on losing weight. Often the loss of fat can make an individual feel bad because fat contains hormones, heavy metals, and other toxins. The release can overwhelm the liver and cause fatigue and distress. Without the right context, this can be confused with depression even though it is a physiological response to losing fat from their body.

We all know that when we feel better, and have more energy and mental clarity, work and life don’t seem as overwhelming and those small steps towards a goal are more accessible. Better management of anxiety and depression through nutritional interventions is a cost-effective way to improve both quality of life and productivity. What are the first steps that businesses can take support their employees on this path?

The Ecocycle as a Tool to Help Reach Your Goals

Adapted from Brenda Zimmerman, EdgeWare & Getting to Maybe http://www.liberatingstructures.com/31-ecocycle-planning/

If you have been following this blog, you may know that in the new year I like to break out the Ecocycle from Liberating Structures. I think it’s such a helpful tool in recognizing where you are at in the process of change. New Years is often a time where we consider new projects. For this newsletter I would like to consider the emotions that are common at each stage of the Ecocycle. Different people are attracted to different stages (and sometimes get stuck in particular stages).

First there is the Conception (Germination) stage. This is the stage where we have a wish for something new, an idea of a possibility, or simply a change that is going to happen but has no structure or resources yet. When we look at the Ecocylce, it can be tempting for our thoughts to jump over to what this new idea or project will look like in the Maturity stage. The brain just wants to step over to maturity and skip following the path around the infinity sign. This is where many New Year Resolutions start and end. I want to exercise more, to change my diet, a new job, to clean my closet, etc. Some people love the conception stage. So many possibilities. It’s exciting to think of beginning, but frustrating that it takes time and effort to move beyond conception.  

The next step in the Ecocycle is the Poverty Trap. This is where we need to understand what we need in order to move the goal into action. Using the Rising Hope language, this is where we convert our wish into a hope. For us to hope for something we need both a path where we can achieve small steps towards our goal and the willpower to do it. In using the Ecocycle this past year to monitor my own change, I realized that as I think about moving something from conception (a wish) to birth (a hope), I need to understand the number of times I need to do something before I feel comfortable just showing up to do it. From other beginnings in my life, I know that it often takes more than 7 to 10 times before my habit brain stops resisting the novelty. Note this does not necessarily make it easier, I just don’t experience so much resistance. This is where willpower comes in. If I really hope to achieve my goal, I need to just do it at the frequency that I commit to, until it becomes familiar and comfortable. Part of this stage is also identifying the time period and resources that I will need to do it. 

The third stage is Birth. Regardless of whether we’re talking the birth of a new project, a new self-care routine, or a child, the pleasure of the experience comes from seeing that our hope will have manifestation in the world.  However, beginnings can be intermittent or distracted, and we may want to stop just as we’re getting traction. For example, the hopes of “I will attend and finish a beginner’s yoga class”, “I will eat a cup of veggies at each meal for a month”, or “I will turn off the electronics at 8 pm for a week” are not going to feel good compared to our established habits. However, there is a pleasure in keeping the commitment to ourselves and the outcome of it manifesting in our lives.

For changes that support our health, different people are attracted to different stages of the Ecocyle. I see a lot of people who can get through conception, the poverty trap and into the birth stage. They can see that the changes they are making to how they move, sleep or eat is helpful to how they feel, and their energy and mental clarity. However, moving to the Maturity stage, where the behavior is mostly automated, is where they get off the cycle. The reason for stopping varies from person to person, but what is generally true for everyone is feeling ok about not doing the new behavior perfectly. Moving something to maturity means tolerating being consistently inconsistent. Yes, I would love to say that I’m going to commit to doing something everyday - however, as an adult, things come up. So, the question is: what do I need to keep returning to it? For me, I need some social support. This is why lifestyle or personal changes around food, sleep and movement are so hard. We’re usually doing it on our own, within our social groups. Finding a class, an online group, or a therapist who will support our change can be key. The reason support is so helpful is that part of pushing something to maturity is overcoming obstacles, stumbling and starting again. If it’s just our willpower we can feel exhausted from pushing on our own. However, if we focus on what is attracting us to our goals, it is often easier to feel motivated to stick with it. In this stage, it’s really important to name what parts we are grateful for and why, every time we are successful.

The next stages of the Ecocycle are the Rigidity Trap and Creative Destruction. The Rigidity Trap is when we have done something over and over and it is automated AND it’s uncomfortable when we deviate from it. For example, my form of exercise for a long time was Aikido. Overtime I saw that my brain resisted going to a yoga class, going to a gym or any other form of exercise. As I aged I saw that I would benefit from cross training and I needed to add activity that would increase muscle mass. My rigidity resisted going to a fitness class on the days that I trained. After I worked my way through the conception and birth phases with the fitness class and it was approaching maturity, it was easier to swap a fitness class for an Aikido class during the week. But I had to enter into a little creative destruction, where I had to let something else in my routine go (in this case, my TV night) to start something new.

After some creative destruction, we’re back to the Conception stage. As I re-read what I have written, I can see that I have focused on the hard parts of change. I don’t want to scare people off because there is a great deal of individual pleasure in working through the Ecocycle and in seeing that we are capable, courageous to keep showing up for, and that we can each be self-determined. These qualities show up in our small successes, just knowing that we kept trying and kept moving forward is worth tracking. What helps me know that I am making progress is having a visual map of it. I have an Ecocycle in my office that I use to track the progress I make toward my goals by using post-it’s to track the stage each goal is in.

The Science of Hope Applied to Holiday Eating

As we move into the holidays and start planning the 60-day sprint, I am reflecting on what has helped me through crunch times and sprints this year. HOPE made a difference.

In October, I was blessed to speak at the Kitsap County Resilience Summit. The keynote speaker was Chan Hellman Ph.D. from the University of Oklahoma. For the last decade he has been researching hope with individuals with high ACES (Adverse Childhood Events Scores). His new book, Hope Rising: How the Science of HOPE Can Change Your Life, will be available on Amazon in late November. I highly recommend it!

Here is a summary. He distinguishes hope from wishes. “Hope is the belief that a thriving future is possible and that you have the power to make it so. A wish is something that has no steps towards making it real and that you don’t have any influence over.” (p31 Hope Rising).

So let’s set our goals and raise our HOPE to get through the holidays with a little more self-compassion and self-care, and enter the new year with renewed resilience.

According to Dr. Hellman we need two things to raise our hopes and move toward them. Willpower and Waypower. Willpower is a combination of personal motivation for the goal and fuel supply for the brain to have the energy and mental clarity to stay focused on the goal and hold onto the hope. Waypower is the pathway to get it done. It’s the small little steps of success that lead you down the path toward your goal. We often need support from others for both the willpower and the waypower. I love the definition of hope used at Camp HOPE, a camp for children surviving domestic violence, that is shared in this book. Hope is “believing in yourself, believing in others, and believing in your dreams.”

So what are your holiday hopes? Do you have steps identified along a path to achieve them? Are they really goals that you, personally, want for you or your family? Which ones are you sure of? Which ones do you need to strengthen your Hope Plan around?

Here are some Hopes that I often hear people talking about for the Holidays:

• Seeing family or having solitude

• Going hiking, seeing a holiday show

• Cooking traditional or non-traditional food

• Seeing the holiday lights

• Not over eating

• Managing holiday winter depression

For those who want to learn more, here is a link to a presentation given by Chan Hellman on this topic, titled Pathways of Hope. He also has a number of videos on YouTube.

10 Tips For A More Enjoyable Holiday Season

It is never too early to create a plan to build willpower and practice waypower for your holiday eating, especially if your desire is to weather the season feeling your best and without unreasonable weight gain.

These 10 tips may serve as a thoughtful steps through the challenges that come during the most food-seductive time of year.

1. For the months of November, December and January, mark the days on your calendar for “free eating” - a time to enjoy eating whatever you want.

2. When sugar cravings are especially high during the holidays, turn to protein: eat protein every 3 hours.

3. This is the time of year when exercise routines are often disrupted, so plan shorter workouts such as 10 minutes of walking, complete 20 squats, do a 20-count of plank, or 10 sit ups. I like calisthenics because I can break up the exercise routine throughout the day and still receive the benefits.

4. In early December make an appointment for after January 15th to meet with a friend for a walk, see a nutritionist or exercise person of choice and start a new routine. By mid-January you’ll know what your goals are for the New Year and will be open to assistance and ready for action.

5. Include on your gift list a fitness band (a step-tracker, or other similar device) along with time from a tech savvy family member or friend to assist you in setting up the gadget. Fitbit and Jawbone are two programs that I have observed as really excellent, but there are others as well. Don’t forget: walking 10,000 steps a day changes health. This level of movement prevents diabetes, improves the quality of most sleeping and supports positive mental health. Increasing your daily movement will be far easier than you might imagine, when using one of these convenient programs.

6. Commit to eating a protein-rich breakfast daily.

7. Consider purchasing a full spectrum light for where you eat breakfast. It is a less expensive alternative is buying a full spectrum lightbulb for a lamp you already have.

8. Be outside at least 10 minutes a day, even on rainy or cloudy days.

9. Thoroughly enjoy food that you are eating, regardless of what it is. Stop to notice the taste, color, texture, and what you really like about it. Don’t feel guilty; guilt comes with no benefits. Have a plan to get your eating back on track the next day.

10. If you are tired, try a 20- to 40-minute nap.

For more Waypower ideas, check out our Holiday book, Surviving the Holidays, available on Amazon.

What diet types contribute to depression and anxiety?

I am reluctant to write this post. I’m sure I’m going to make a few people mad. In last month’s Connectors Meeting there were questions about how different diet types contribute to mental health concerns. When a person's diet choice restricts food categories, they can find over time that their diet is contributing to increased anxiety and depression. This is because a diet that limits food groups can lead to nutrient deficiencies if health metrics are not carefully monitored through diagnostic labs.

In this post I’ll review some things to watch out for when eating significant amounts of highly processed foods, following vegetarian or vegan diets, and keto/paleo/Atikins types of diets.

Highly Processed Food Diets

Diets high in processed foods have been shown to increase depression and anxiety. These are diets with lots of white foods (bread, rice, potatoes, pasta, muffins, bagels, chips, sweets, fast food). With this diet, when I look at an individual's labs what I typically see are deficiencies in nutrients that help to synthesize dopamine and serotonin. Common deficiencies are protein, B vitamins, magnesium, zinc, omega 3, Vitamin D3, and fiber. Additionally, there is increased inflammation as indicated by elevated C-reactive protein (CRP) levels. Inflammation contributes to depression, fatigue, bipolar, cardiovascular disease, dementia, and diabetes, to name a few concerns. Dr. Felice Jacka provides a whole body of research about the impact of diet on mental health. Here is her seminal paper: Association of Western and traditional diets with depression and anxiety in women.

Vegetarian/Vegan

When I see vegetarians and vegans in my office, they tend to be very anxious individuals and the anxiety often leads to depression. I’m not saying that all vegetarians and vegans struggle with anxiety and depression. Rather, that individuals who are anxious and depressed and vegetarian tend to have higher levels of anxiety and depression due to nutrient deficiencies. Their anxiety is often caused by fluctuations in blood sugar levels because of the low carbohydrate to protein ratio in many of the foods they typically consume.

For example, let’s consider a bean burger. Beans have some protein and some carbohydrates. The bread is all carbohydrates. So this bean burgers contain a lot of carbs and not a lot of protein

Clinically, I have seen anxiety decrease significantly when we assure that they are getting enough protein throughout the day (8 grams per 20 pounds of body weight or at least 65 grams divided throughout the day for anyone over 140 lbs.)

There is a large body of research that suggests vegetarians have better physical health then omnivores. Vegetarians tend to have lower body mass index and cardiovascular disease. However, an Australian study with 9113 participants indicated that vegetarians and vegans have more anxiety and depression then omnivores.

Here are two more studies that may be of interest:

• Vegetarian diet and mental disorders: results from a representative community survey

• Food and Nutrient Intake and Nutritional Status of Finnish Vegans and Non-Vegetarians

For vegetarians, the labs that I carefully look at are total protein, Omega 3, ferritin (iron stores), B vitamins, and Vitamin D3. In my client base, vegetarians and vegans tend to carry less muscle mass and more fat mass.

For vegans, I will also look to see what their primary sources of fats are. The addition of coconut milk and oil can help with fatigue caused by a lack of cholesterol in their diet; consuming enough cholesterol is important because it helps synthesize hormones.

Keto/Paleo/Atkins

I am going to make a “no duh” statement… But it’s one we often forget: Weight does not determine health.

High-fat mass can impact health, but it’s not everything. I’m far more concerned about an individual's ability to be self-compassionate, eat primarily health-sustaining foods, engage in some level of regular movement or exercise, sleep well, and have healthy labs.

I have seen a number of individuals who started on a keto diet (low carbohydrate with high protein and high fat) to lose weight. However, after the initiation phase of just meat and fat, they did not add fruits or veggies back into their diets for years. They explain that primary reason for staying with this phase is because adding back fruits and veggies caused them to gain back the weight they had lost. This is true, because when we do quick weight loss programs it’s hard to not do quick weight gain as well. However, there are some serious health consequences not eating fruits and vegetables.

One of the consequences is that they became very low in B vitamins and Vitamin K. For women following this type of dietary restrictions, they started having heavy menses because their blood was not clotting well. This then also led to iron deficiency, which contributed to their story of depression/fatigue.

Check out these articles:

• Intravenous iron for the treatment of fatigue in non-anemic, premenopausal women with low serum ferritin concentration

• Dietary and supplement treatment of iron deficiency results in improvements in general health and fatigue in Australian women of childbearing age.

In conclusion

Diets that support physical health do not always support mental health. Diets that are low in nutrient dense foods can contribute to mental health concerns through presentation of depression/fatigue and hypoglycemia/anxiety. When someone is considering medications or has tried medicines without the expected positive impact, it’s worth suggesting that they ask their primary care providers for a laboratory workup for fatigue. Going to a naturopathic physician, nutritionist, or acupuncturist to have their diet evaluated for deficiencies that could be contributing to their mental health status is also a good option.

Here are some additional resources:

• Handout: Getting Enough Protein/Optimize Your Brain

• Handout: Getting Enough Protein for Vegetarian and Vegans

• Handout: Fruit and veggie All Stars

• Worksheet: Factors to consider before changing your diet

• Worksheet: Snap Shot of Anxiety

• Blog on labs

• Webpage: Labs & Mental Health: CRP

• Webpage: Labs & Mental Health: Ferritin

Is this the Diet for Me? Is it for you?

Intention

There is a lot of information on the internet and from our friends and family about new diets to try. There are systems such as weight watchers, Nutrisystem, and 30/10. There are diets that tend to be based on values: vegetarian, vegan, and paleo. There are also styles of diet, like the Mediterranean Diet and DASH; and there are diets based on convenience. Then we also factor in things like culture, economics, family traditions, personal preferences, personal health history, time in life, gender, exercise pattern and age. How do we know what is “right” for us?

So from the start, we can say that every diet is personal to the individual. What works for us when we’re 20 years old may not work for us when we have kids, a different job, or a change in where we live. “Diet” is not a box we stay in for life, it’s a dynamic choice that we make every day.

I want to start a discussion on how to know if your diet is working for you and if you make a change in your diet, how (and when) do you know that it’s a going to work for you.

One step that people often miss is considering their intention for your diet. It seems so obvious, but we actually use our diet for lots of things: to nourish our ourselves, for entertainment, to connect to family and friends, to drug ourselves in to a sugar coma, to manage our emotions, to celebrate. If we change our diet, we may be trying to change our intention about what our diet will do for us.

I believe the main goal of any diet, 80% of the time, should be nourishment, and to provide long-term and short-term health and mental clarity. Then, 20% is for celebration and connection. It’s natural to use food to manage our emotions - it works so well - but we should be working to diversify our options to self soothe.

What does it mean to have a diet that nourishes our bodies? It’s important to protect our power supply. This means that we need to meet our basic nutritional needs: Are we getting enough amino acid/protein, fats, carbohydrates, fiber, vitamins and minerals, and – importantly - is there diversity in what we’re eating?

When we make changes to our diets, we should have a sense of how the nutrient content might also be changing, and how the body will respond to that change. Our bodies work hard to maintain homeostasis. If we cut our calories, the body’s natural response is to slow the metabolic rate. This is why quick weight loss diets fail: cutting significantly back on calories signals that there is famine (which means we need to hold on to our fat stores), and it also exposes our brains to stress hormones which makes us anxious, irritable or not present to our daily lives, particularly if we have a history of trauma.

Social Interactions

Eating food together is an ancient way of interacting. Depending on our jobs, families, and economics, we have more or less ability to be in control of what we eat. When we are changing our diets, we need to consider the impact our new diet will have on our ability to engage in social events. We also need to understand and be prepared to advocate for our dietary needs. Another way of thinking about this is how we can be responsible for our own choices, so that other don’t have to guess at what we need. We also need to have clear plans in place to handle holidays and special events, so that we can still enjoy the social aspects without having our diets derailed.

Personal History

In my clinical office, I often work with individuals who have significant trauma histories in their childhoods. An amazing study on the impact of Adverse Childhood Events (ACEs) shows that individuals who have had a number of traumatic events in childhood are at risk for chronic diseases such as diabetes, cardiovascular disease and obesity. These disease risks can be lowered by our diet choices in adulthood. It’s helpful for individuals with trauma histories to have clear intentions for their diets. Restrictive diets rarely work, because the restrictions often get tangled up with feelings of being deprived. Instead, changing to a diet where they notice that they feel better (in their bodies and minds), and occasionally testing if a new routine is helpful, seems to be more effective because part of recovering from trauma is choice. Being forced - even by one’s own self - is just another trauma.

Shallow end, Deep end

Some people wade into pools from the shallow end and some just jump into the deep end. Generally, if you are going to jump all in to a radical diet change it is worth having some outside support, or a way of reflecting back an accurate picture of how the change in diet is affecting you.

What skills do you need to change your diet? How do you know if it’s working for you, and when should you check back in with yourself to be sure that it continues to meet your intentions? What if your needs or intentions change?

Listen to or watch the Connectors Group webinar - and download the handout to help you assess whether a diet is a good fit for you.

• Podcast

• Video

• Handout

Not Hungry in the Morning?

You or someone you know may not be eating breakfast. "I’m just not hungry." Or you have breakfast when you get to work – 2 hours later. Just to be clear, breakfast is the meal that breaks the sleep fast, and your body expects to receive food within one hour of waking. 

Why would someone not be hungry in the morning? It’s not because you ate a big meal in the evening. I know when I have my Thanksgiving meal at noon; I am hungry again before bed. 

So why don’t you feel hungry when you wake up? If your glucose (brain fuel) level dropped too low while you were sleeping, your liver would have already received the signal to deliver a cocktail of hormones that tells the body to make fuel for the brain – and part of the cocktail is adrenaline. When adrenaline is in the system, we tend not to feel hungry. Historically, adrenaline signaled that someone or something was trying to hurt us and we should run; running and eating are not tightly wired together. 

Clinically, the short-term consequences of skipping breakfast happen about 8 hours later. You might be fatigued, and your lizard brain takes charge. This increases the likelihood that you will overeat, have more alcohol before or at dinner than planned, and have passive evenings.

What are the long-term consequences of skipping breakfast?  When we skip breakfast, we set up a cascade of stress hormones that are working to maintain our fuel supply. The most recent studies suggest that not eating breakfast causes:

• increased calorie intake during the day,

• Increased stress/inflammatory hormones, such as cortisol and insulin,

• increased weight gain and adipose tissue/body fat,

• increased cholesterol and blood pressure, and

• increased cardiovascular disease.

What to do about the fact that you just don’t feel hungry? Typically, a quarter cup of fruit juice or some other quick-acting sugar, such as a teaspoon of honey, will get your body to send the hunger signal within 20 minutes. Then, you can have breakfast. For the people who are not eating because they are jumping out of bed to go to work, try putting a protein shake in the refrigerator the night before so you can grab it on your way out in the morning. If you do this for about a week, you might find that your hunger signal kicks in more easily in the mornings. 

Do you skip breakfast? Try the experiment of starting your day with food that has protein (14-20 grams) + carbs + fiber + fat. This Shortcuts post has some ideas for breakfast. Observe the following changes:

• less anxiety, irritation, and agitation in the mornings

• more energy and mental clarity in the day

• less overdoing intake of sugar, alcohol, or snacking 8 hours after waking

• better sleep

• increased ability to participate in after-work activities that are important to you.

Tell us about your experience on the Dynamic Paths Facebook page or add a comment to our blog. 

Shortcuts to a Quick Breakfast

• Ready-to-drink protein shake (Odwalla Protein Shake or Orgain protein shake) with an apple

• Protein bar: Cliff, Zing, Stinger, or high-protein Kind bars

• High protein Greek yogurt (Fage, Chobani) with walnuts, almonds or cashews and raisins, an apple or 1/2 a banana

• Apple, carrot and/or celery with 4 Tbsp of nut or seed butter (almond, cashew, or tahini)

• Whole eggs: 1-2 scrambled/boiled/fried with a handful of veggies and toast or sweet potato

• Breakfast burrito with scrambled eggs, veggie sausage or refried beans, a handful of veggies, and cheese

• Make own protein shake with whey or rice protein powder, dark berries, chocolate powder, coconut milk and water

•  My favorite –  Dinner!

Share your favorite breakfast ideas by commenting below!

Who's in Charge - Your Brain or Your Mind?

What is the difference between your brain and your mind? Dr. Dan Siegel has been very helpful by distinguishing the difference in his many books. Here’s how I think about the difference: the brain is the hardware that keeps track of information, repeating behaviors and keeps us alive; the mind is software that can manipulate the information in response to the present moment. The brain is powered by the body and by the input and output about our environment and relationships from our senses. The mind arises from our brain, body, and relationships, and provides the observational self.

I am grateful for everything that my brain automatically takes care of... breathing, brushing my teeth, driving my car home when I am tired, putting clothes on in the mornings. These are habits that support the functioning of my life. Of course, we can have good habits and bad habits. Another way of thinking about behaviors is who is choosing the behavior and for what reason? Is it our brain or is it our mind?

Let's do an exercise to demonstrate changing a habit that the brain is in charge of: brushing your teeth. Let's imagine that you are going to do whatever it takes to not brush your teeth for three days. You can use breath mints or chew gum, and we can acknowledge that your teeth will not rot in the three days.  Ok, don't stop reading, I know that you are not going to do this exercise. The point is that when the brain is in charge of this behavior, it takes a lot of energy to change that wiring and we will feel uncomfortable in the process.

Many things can get wired in as a brain-habit that we may want our minds to stay in charge of. Food is an example. One day I had a handful of chocolate chips after lunch. Then, it happened another day and another day. Eventually, my brain decided that the rule was handful of chocolate after a meal. Ok, lunch and dinner... sometimes breakfast. I often eat and then leave the house and because what happens together wires together, my brain rule began to ask me if I needed a handful of chocolate chips to leave the house. Sure why not? Ok now my brain is asking for chocolate after every meal and as I prepare to leave the house. At some point, my mind said "Hey, have you noticed that I’m eating chocolate chips 3 to 6 times a day? My brain said " I just need them."

Having a habit hard-wired into your brain means that those wired circuits need to be used and if you stop the behavior your brain make you feel uncomfortable, anxious, or agitated just like you would if you tried to stop brushing your teeth.

Now there is a tug-of-war between my brain and body and my mind. Sometimes my mind says "no chocolate chips," but if I am not paying attention they just get grabbed before I have a chance to decide. I could just decide to not buy chocolate chips but I’ve tried that in the past and I just replace the habit/addiction with something else that’s in the house. 

When I want to make sure I’m not in a brain rut, I apply the choice of three: when we have three choices, we make better choices (check out the book Brain Rules by John Medina). So, if I need a signal that a meal is done, here are my three choices:

1. chocolate (but not everyday),

2. a piece of fruit, or

3. a moment of silence about the meal, where I relive the meal - particularly if it was a meal that I would like to make more of. By reviewing the meal, I am signaling that is should be remembered and I am increasing gratitude.

When I am leaving the house, I try not be on the phone, and to stop to see if I have everything. I found that the chocolate grab also helped slow me down so that my brain had time to remind me that I forgot to something. So stopping to review and breathe is also helpful and it gives me time to ask myself "do I have everything?"  I have not created three options here because the brain has about 7 slots to juggle everything making one of three choices when I know I am in a rush will just assure that I leave more thing I need at home, so I just try to be mindful about leaving.

Meals and exercise are good opportunities to slow down, where we can practice being mindful of our choices rather than run by brain-driven rituals. Having 3 options that we try and cover each week will also increase the variety of nutrients that we eat or the ways we move our bodies; making sure we don’t get bored has the added benefit of preventing burnout on any particular food or exercise.

One of the things you’ll notice is that I treat my brain and my body as if they are good friends who are always traveling with me. They each have their individual jobs but none of us get to dominate the discussion.

I wonder if anyone else has a committee? How do you experience your brain and mind?  Feedback on this article is welcome

Short Cuts: Ways to keep your mind in charge of your brain

We all need routine to make our busy lives efficient. We need to put things on autopilot to function. But sometimes we become too efficient. Part of what governs what the brain does is “what happens together wires together”. As the behavior happens hundreds to thousands of times, it becomes a brain-habit and we feel uncomfortable if we deviate from it.

Examples of this are: We eat the same thing for breakfast every day, we always watch a show at 7pm, we have alcohol with every dinner, we do only one form of exercise… However, if we maintain three options for any given activity, we are more likely to vary our choices and not get bored and stop or consistently turn to addictive foods, screens, or substance.

So what are your three go-to options for breakfast, lunch, snacks, dinner, before bed activities, and ways of moving your body?

To help you with the meal and snack options, we have handouts for omnivores and for vegetarians.

Food of the Month: Blueberries

"Eat fresh non-sprayed dark berries, such as blueberries."

Traditional medicine (medicine older than the last 100 years) says dark berries, such as blueberries, are good for lots of conditions: vision, prevention of varicose veins, improvement of memory, slow the progression of heart disease, diabetes, and prevention of urinary tract infections, to name a few.

When I started naturopathic medical school, more than 20 years ago, the pushback to traditional medical statements about one fruit helping so much was How can one small fruit do so much? My response was the same as for any medication: It’s what’s in it.  Why would a pill be more powerful than what our body has consumed for thousands of years? 

Now we know a lot more about blueberries and if you search Pubmed, you’ll see that they are starting to be treated as a medicine. Blueberries are full of compounds that help with inflammation, help with glucose control, prevent the breakdown of acetylcholine (a neurotransmitter that helps us see colors and objects in our imagination), prevent cancer... the list continues. The World's Healthiest Foods website has a great description of the science if you are interested..

Many people are talking to me about memory; blueberries and other dark berries have been my go-to medicine to help.  A quick look through Pubmed found an article about a study where the treatment group got blueberry juice 2 weeks before receiving general anesthesia and the control group did not. It was found the group who drank the blueberry juice had better attention and memory after receiving general anesthesia than the control group.

Ok good to remember for our next planned surgery, but there are other places where chemicals affect our brain. Blueberries help protect us in any place where we are exposed to volatile chemicals: panting a house, being in a home with chemical air fresheners, working on machinery, being in an area with forest fires… If you can smell it and it’s annoying to you, you can try some yummy blueberries. And there a good treat to improve your memory in general.

My favorite ways of eating blueberries:

By themselves: First, make sure they are organic or non-sprayed. The pesticides are not helpful because these are some of the chemicals you are trying to avoid. Second, wash with cold water. Third, pick them up and place in your mouth. Yum!

In yogurt: Mix together plain, full-fat greek yogurt, almond extract and vanilla extract to taste, pecans, blueberries.

In any salad!

It’s also interesting to notice if blueberries count as a carbohydrate for you. It is ok if it doesn’t, you have to consider your whole health and where you are on the spectrum of need for sweet taste. But can it be enough carbs for a salad or the yogurt? For me, some days they are and some days they are not.

Fuel for Thoughts: CrazyWise and Connection

The other night I went to a showing of CrazyWise, the documentary by Phil Borges and Kevin Tomlinson. They examined the question of why the recovery rate for mental illness in industrial countries is one third, and in developing countries two thirds? Think about that for a moment. All our medications and skilled providers plus billions of dollars is not working!

Often what we see in the US as mental illness, such as depression, anxiety, or hearing voices, is seen as a calling in other countries - an experience to learn more about yourself. It might mean that you will become a healer because to understand yourself you have to understand the fundamental nature of being human. Within the countries with higher recovery success rates, the people in the person's community will connect with them. Again, let’s think about this for a moment, when a person is struggling their community comes together or someone experienced wants to be curious with that person about what they might need to understand about their self.  They offer connection and compassion.

Part of the problem in the western world is that we are in denial about the prevalence of Adverse Childhood Events (ACE). In some communities, it's above 50%. An adverse childhood event is an event that is beyond the comprehension of a child (abuse, neglect, divorce, illness, addiction). Really these are beyond the comprehension of adults as well, but for children, it threatens their nervous system in a way that can set a person up for mental illness, addictions, and physical health challenges such as diabetes, obesity, and cardiovascular disease.

What I loved about CrazyWise is that the movie is not saying that medications are bad. They are suggesting that the path forward is connection. Rather than labeling someone in crisis as ill, let’s think about how to get that individual more connected. Evidence-based studies are showing that community helps with addictions, psychotic episodes, homelessness, depression, anxiety, and the list continues.

The path away from mental illness is connection: how we each connect to our bodies, ourselves, other people, and nature.

As an experiment, think about what your connections are. Can you draw a map of your connections? Maybe a thin line for loose connections and a think line for strong connections. Are they all people? What about animals, plants, places, food, activities, art, crafts, books, communities... Where do you put our energy and where do you receive our energy?

Short Cuts: Artichoke Recipe Ideas

Here are my favorite quick and easy artichoke recipes:

Super quick: 1 can artichokes, in water (from Trader Joe's for the discount). Drain. Eat!

A slightly longer shortcut, toss together the following.

• 1 can of water-packed artichokes, drained

• Fresh squeezed lemon juice, to taste

• 1-2 TBS of olive oil

• Salt and pepper to taste

Option 1: add chopped garlic in with the lemon and olive oil

Option2: instead of olive oil, mix the lemon juice, salt and pepper into a cup of greek yogurt then toss with the artichoke hearts. Snipped scallions optional.

Salad Idea:

• 1  can of water-packed artichokes, drained

• 1 can of garbanzo beans or white beans, drained

• 1 jar of fire roasted red peppers,drained drained

• Olives

• Feta

• Place artichoke mix on a bed of arugula

Food of the Month: Artichokes

When I am talking to people who say they dislike veggies, I always ask are there a few that they like. If they can’t think of any, I start naming veggies that they might like. 

I usually start with artichokes. Most people, but not all, like artichokes. Usually, the expense comes up. “Well, they are over $4 per can at the market.” Yes, and at Trader Joe's, artichokes canned in water are less than $3 per can and they will not rot in a week. How many veggies have gone to waste by not eating them in time? Fresh is better, of course. But we are looking to do a little better than what we we're currently doing and trying to create sustainable behavior.

Plus they are super healthy for you. I like them in terms of helping with energy and mental clarity for a number of reasons:

First, they are high in antioxidants such as Vitamin C and A.

Next, they are great for our liver in that they help the liver produce bile. Bile helps our us absorb fat soluble vitamins such as A, D, E, and K. Bile also helps kill bacteria that is on our food and neutralize the acid from our stomach so that it does not injure our small intestine.

Lastly, and back to food and mood, artichokes are high in fiber. Fiber is one of the mechanisms that help with glucose control. However, there seem to be other mechanisms at work because they're more effective at this than can be accounted for by the amount of fiber. Probably because it supports the liver.

The take-home message is to put canned artichokes in the kitchen cabinet for when you are in a rush and won't otherwise get your veggies in.

Here's a study about artichokes for further reading.