Natural Ways To Beat Anxiety Without Taking Pills: Holistic Healing

Foreign like to welcome everybody today's presentation on revolutionary approaches for anxiety treatment. I'm your host, Dr. Donnelly Snipes. I don't know how revolutionary these are necessarily going to be. They are some things that we are starting to look at, but they are certainly alternatives to this typical cognitive behavioral therapy and take a benzo sort of approaches. In today's presentation, we're going to examine the root causes of anxiety symptoms and identify emerging treatments to address these issues. Too often we look at a mental health issue as a one size fits all. If you've got depression, we do this. If you've got anxiety, we do this. And what we miss, and this is one of the revolutionary things, what we miss is what's going on under the hood. Each person who has depression may not have the same symptoms. Each person who has anxiety may not have the same symptoms. And symptoms are what's causing the problem. And we need to look at what the person's symptoms are and what's causing those symptoms and address those issues. Anxiety, just kind of brief overview. Is a sympathetic stress response. In our autonomic nervous system, we have the sympathetic stress response. That's our fight or flight, freeze, fawn or flop, but that's our stress response. Our parasympathetic nervous system is our rest, digest and repair. The way I remember it is our nervous system has sympathy for us when we're being chased by a lion and gives us the energy to run away. That's how I tried to remember it when I was in graduate school. When a person's nervous system detects that there might be a threat, it doesn't mean there is. It means there's some trigger or stimulus in the environment that told the person, hey, there might be a threat. Whether it's a smell of smoke or a particular sound or whatever might trigger a memory of a time when they were in danger before. That can cause a person to have their sympathetic nervous system, their fight or flight response triggered. Well, that's great in the short term. It's like when your smoke alarm goes off, it gives you energy to get up and see if there's a problem and if not, turn off the smoke alarm. So when your nervous system detects what might be a threat, it dumps hormones and neurochemicals to give you energy and motivation to fight or flee or fawn, freeze or flop. And I include those because every time I say fight or flee, people add the other three. So I'm just going to include all five of them. But fawning is a way of fighting, if you want to think about it that way. If I fawn over somebody, please don't leave me. I'll do whatever because of my abandonment anxiety. That is a way I'm fighting. I'm trying to control the situation. Freezing is, in my opinion, sort of similar to fleeing. I'm just going to pretend you don't see me, and hopefully you'll go right on by. And then flopping is when your nervous system gets completely dysregulated and you just don't have the energy to even get upset about it. It's just like, whatever, forget it. I'm just gonna lay down and get wet out here in this rainstorm. When you've determined you, the human being using your prefrontal cortex have determined the threat is gone or actually never existed. The parasympathetic nervous system, which is rest, digest and repair, kicks in. Great system. So now all of those stress hormones, they can be re uptaken and gaba and some of our calming neurotransmitters can be secreted so we can relax. Unfortunately, when people have been feeling vulnerable, stressed, or threatened for too long, the sympathetic nervous system becomes dominant. The sympathetic nervous system gets stronger, if you will, and the parasympathetic nervous system, which is driven in large part by the vagus nerve, becomes weak and has difficulty turning off the stress response. When our stress response is active, we persistently feel unsafe. So we're hypervigilant, we're tense, we're scanning. Think about how you would feel if you were a soldier in a foxhole. You pay greater attention to threats or perceived threats. So I'm not noticing the good things. I'm noticing all the threats. So it seems like my environment is much scarier, and I'm much more powerless and unsafe than maybe I actually am. And I'm going to perceive events through what I call a threat lens. When. When something happens, if somebody gives me a dirty look, if I'm feeling anxious and I'm afraid of abandonment, then I'm going to say, oh, they're mad at me, they're rejecting me. So I'm perceiving events through this lens that conforms to the way I feel. Feeling unsafe, feeling powerless. So let's talk about some of these anxiety symptoms, because in order to figure out the effective treatments, we need to understand the symptoms. One of the first ones is being easily fatigued. When we're anxious, we tend to not sleep well. Think again, soldier in a foxhole. He ain't gonna get really good sleep, so he may have difficulty falling asleep or staying asleep or have restless, unsatisfying sleep. He doesn't actually get down into deep sleep. It's just these little bits of light sleep and REM sleep. If you don't get deep sleep, you're gonna wake up the next morning and have some wicked brain fit fog. Because your brain clears out a hormone called adenosine during deep sleep. When adenosine is high, sleep pressure, as they call it, is high. We get tired, we have brain fog. When adenosine is low, we tend to be more alert and able to think more clearly. So people are easily fatigued. And I think all of us have had times where for whatever reason, we weren't sleeping well for multiple days. And you can kind of attest to how it was difficult to think clearly and how everything felt so much more humongous and overwhelming. People tend to feel restless, keyed up or on edge and hyper vigilant. When I played tennis in high school, we would get in trouble, rightly so, if we were on the baseline standing flat footed, because that means we weren't ready to spring into action. We needed to be bouncing on our toes. And the same sort of thing happens when we're hypervigilant and we're anxious. We tend to maintain those muscles in a position where they're sort of coiled up and ready to spring into action at any moment to keep us safe. So, yeah, we're going to be easily fatigued. It's hard to sleep when you're paying attention, when you're scanning, when you're trying to figure out what's that noise or, and, or when your muscles are tense. Irritability is another symptom of anxiety. Well, irritability is part of that fight or flight reaction. Of course we're going to be irritable if we're not feeling safe, if we're feeling powerless, if everything we do feels overwhelming. Difficulty concentrating or your mind going blank. In fight orf flight, you're not operating on autopilot. You're not. You are operating autopilot, not your wise mind. When you're in fight or flight, your brain is saying, get away from the hungry lion. Not time to focus on driving, not time to focus on the Excel spreadsheet in front of you or the CEU class that you're attending. It is time to get the heck out of here so we can stay safe. Or it's time to fight so we can feel safe, so we can take our power back. As I mentioned, sleep disturbances cause brain fog and make it More difficult to control, intrusive thoughts and ruminations. We that's a documented side effect of sleep deprivation. When people are anxious, what do they often have? Intrusive thoughts, ruminations, negative perceptions, difficulty thinking, using their wise mind, fact based reasoning. Because they're in fight or flee, they don't feel safe. When somebody is anxious for a prolonged period of time, we start seeing the sympathetic nervous system become dysregulated. So the stress response becomes dysregulated. And I've referred to this before as flat to frantic or flat to furious. But when we're talking about anxiety, it's flat to frantic to get the stress response to activate when it's just been persistently bombarded by stress hormones. Just like when the system is persistently bombarded by insulin or by alcohol, the receptors start to kind of numb, numb it out. They're like, I'm not going to pay attention, I'm not going to activate because I'm just not. So in order to get those receptors to activate, the body has to dump a tsunami of stress hormones. So it's overwhelming those receptors and they can't help but engage. So you have this tsunami. Instead of just the usual trickle, this results in more intense reactions up to and including panic. So as people have longer episodes of generalized anxiety, abandonment anxiety, whatever an is prompting their anxiety, as that goes on for months or heaven forbid, years, their nervous system is getting progressively disregulated and likely what you're going to see is an intensification of their emotional responses in response to the same stressor. So what would have elicited a 2 last year now elicits a 6 because that sympathetic nervous system has gotten dysregulated in terms of panic. A lot of these are going to sound very familiar when you think of the stress response. Palpitations, racing heart, brain's trying to get blood through the system so we can run. Sweating, trembling or shaking, shortness of breath, feelings of choking, chest pain or discomfort. When you're sitting still and your heart is beating like this, the brain says that doesn't make sense, there's something wrong. And a lot of times people tense up and they can start to feel sort of a shortness of breath. The trembling or shaking can be a result of the stress hormones and the blood sugar. When we trigger that stress response, we trigger the release of blood sugar. When we trigger a huge stress response, we trigger a huge release of blood sugar. And so obviously when people start experiencing significant variations in their blood sugar, they may have palpitations or trembling and shaking, nausea or abdominal distress. We're going to talk about some of why this occurs in, in a few minutes. But again we're supposed to be doing fight or flee, not rest and digest. So the system says we need to get rid of everything that is trying to be processed right now because we ain't got time to focus on that. Dizziness, lightheadedness, chills or heat sensations. When your stress response kicks in, you're going to have a response. And if you are, have gone through menopause, for example, those hot flashes, that's actually your HPA axis, your stress response kicking in as a result of imbalances and hormones going ah, something's wrong and you can feel your yourself get hot. It's a sympathetic stress response. You can also a lot of times when that happens, you're starting to feel your heart race. So a lot of people when they go through menopause may experience panic like symptoms because of the stress of the imbalances of the gonadal hormones. Numbness or tingling sensations, a sense of derealization or depersonalization. Kind of like you're in a dream, you're in, in virtual reality. It's not actually happening. A fear of losing control or going crazy or a fear of dying. Well, when you've got these symptoms, it's easy to feel like you've got, you're, you're gonna die. You know, you can't catch your breath, your heart's racing, you can't seem to get your own body under control. And one of the we, we need to look at what's causing those symptoms. Is it an imbalance in gonadal hormones? Is it an imbalance in thyroid hormones? Is it dysregulation in the autonomic nervous system and a weak vagus nerve vagal tone? That needs to be addressed. Or is it something h, here's a little hint about where we're going. Is it something in the gut? In the gut microbiome. As I mentioned earlier, our traditional treatments, cognitive behavioral therapy. Let's talk about what your thoughts are that are triggering your stress response and reframing those thoughts. Let's now the behavioral part we generally ignore and that's a bad thing. We need to help people adjust their lifestyle behaviors to also support a stress free lifestyle. Because remember, stress is not just mental stress. It's not just thoughts or unpleasant emotions. Stress is also physical stress on the body. And when people have a lot of physical stress on the body, they may be more prone to anxiety because physical stress triggers that Stress response just the same as emotional stress does. The body's saying something wrong and we need to fix it. Ssri, your traditional antidepressants are often used for things like generalized anxiety. And then you've got your benzodiazepines, These are your Xanaxes, your volumes that are used generally on a as needed basis. But they have a lot of side effects. They are associated with risks of developing dementia and with long term use. And they do have a high addiction potential. So what alternatives do we have? If I'm struggling with anxiety and I don't want to take benzos, if I'm struggling with anxiety and I don't want to take antidepressants and cognitive behavioral therapy, as I'm approaching it right now, just isn't working. What else can I do? And that's where we start talking about treatment resistant anxiety or depression. It's when clinicians throw up their hands and they go, well, the traditional treatment isn't working. So basically it must be you, your, your anxiety is treatment resistant. No, it's not. No, it is not. What is happening is we're missing what's causing that symptom. There are a few new treatments out there and last week when we talked about emerging treatments on depression, we talked a lot about transcranial magnetic stimulation. It's showing a lot of promise for a variety of disorders including anxiety, depression and ptsd. The downside is it's one of those things that you have to go to a doctor's office and, and, you know, experience the protocol. It's not painful. It actually can in some people help improve their cognitive functioning in addition to everything else. But it is, you know, it's a treatment out there. Some people may embrace it, some people may not. Ketamine and esketamine. Now, ketamine is a drug that is, was originally used as a veterinary tranquilizer on the street. It's called Special K. And ketamine has strong, strong dissociative effects. They did some research starting about 10 years ago that found that people who were acutely suicidal who were administered ketamine in the ER had a significant reduction in, in their suicidality. So everybody was like, oh, this is the next big thing. No, no, no, hold up, hold up. Yes, it does show some short term benefits in acute issues and for treatment resistant depression. I hate that word or phrase. However, let's look at it a little bit further. Esketamine was developed because people tended to chase the dissociation or antidepressant effects. The euphoria that they felt after the infusions, which led to them getting frequent infusions with very little long term benefit. And in most cases ketamine is. I think in all cases ketamine's not covered by insurance and it's really stinking expensive. And esketamine is starting to be prescribed. I don't know, I. There's a very narrow band of people for whom insurance will reimburse for esketamine. High dose or frequent use of ketamine may impair cognition and lead to mood swings. Now the esket, as opposed to the ketamine, which is a IV infusion, Esketamine can be administered through a nasal spray. And again, it has its place, it has its purpose, but it's not going to solve the problem. It's not going to address whatever's going on under the hood that is causing those symptoms. We need to figure out why, where or why the nervous system is dysregulating vagal tone. And again, we talked about this some with depression last week. Treatments that increase vagal tone inhibit cytokine production. Cytokines can be inflammatory or anti inflammatory, but treatments that increase vagal tone inhibit an inflammatory cytokine production. I think I'll get into this more in a few minutes. Vagal afferent fibers in the gut. So vagal nerves in the gut influence neurotransmitters involved in mood and anxiety disorders. So when the vagus nerve in the gut gets the signal that hey, there's a problem, it sends a message to the brain that says, hey, there's a problem and creates an entire cascade of increased stress response. In addition to transcutaneous vagus nerve stimulation, using a device that you attached to your ear is the way a lot of people do it or on your skin. That's one way to stimulate the vagus nerve. Meditation and biofeedback are also ways to help people learn how to strengthen their vagus nerve. When they their heart rate goes up. Whether it's because they've been exercising or cleaning the house or because they're stressed, when their heart rate goes up, they practice intentionally bringing it back down as quickly as possible. And they can measure at home different parameters. Their heart rate is obviously easy to measure. They can also measure their blood pressure. And when the vagus nerve activates that parasympathetic response, blood pressure goes down and heart rate goes down. Gut bacteria also affect the activity of the vagus nerve. So if the gut microbiome is unhealthy, then it's Going to regularly be sending signals to the brain saying, there's something wrong. So the gut microbiome is now emerging as a treatment target for depression, anxiety, ptsd, and even autism spectrum disorders. The microbiome influences mood and the autonomic nervous system. Our mood and our thoughts influence the microbiome. When we're stressed, then it triggers the stress response, which changes the environment and the composition of the microbes in our gut. When we are happy, we have a different environment and composition of microbes in our gut. When we're stressed for too long, then those pathogenic, if you will, microbes tend to multiply and become dominant in our gut, which makes it harder again. Just like the parasympathetic nervous system has a hard time turning off the sympathetic nervous system, the changing of the guards, the switching of the microbes that are working, becomes much more difficult because there are more pathogenic or stress microbes than there are relaxation microbes. This bidirectional communication between the gut and brain is managed by the endocrine system, hormones, the immune system, which helps regulate inflammation, the autonomic nervous system, that stress response, and the enteric nervous system, the gut and the nerves that are in the gut that say, things are going well, or, you know, I've got dyspepsia. The gut secretes peptides now. So this is interesting. We've got the microbes, but then the gut also secretes peptides which are basically amino acids, but which play a crucial role in regulating immune responses, microbial diversity. So which microbes are actually thriving and multiplying in the gut? Gut barrier integrity. So when the gut microbes do their job, the byproducts, the toxins, the waste goes out of our system and doesn't leak out into our bloodstream. So we want that gut barrier and integrity to maintain itself and neurotransmitter production. We talked again last week. We talked about how the gut produces more than 90% of our serotonin, a whole lot of our dopamine, and that is then dispersed through our body. Gut peptides can bind receptors on immune cells and the vagus nerve, thereby altering the gut brain communication. So these peptides can actually kind of lop on to the vagus nerve and alter its signaling, which is really cool. But it's also a problem. If your gut microbiome is out of balance and your gut is secreting the wrong peptides, then we've got a problem. Gut peptide concentrations vary according to the composition of the intestinal microbiome. Peptides, like I just said, the peptides that are being secreted from the gut alter which microbes are going to survive and which microbes are being called into action, if you will. And the microbes that are there also alter the peptides. So the microbes that are there, if it's really over an overabundance of the, we'll call them stress microbes, then it's going to alter which peptides are being secreted by the gut and attaching to the vagus nerve, which alters what the vagus nerve is telling the brain. Stress and anxiety both alter peptides and microbes. When you get stressed, they call in a different crew to work in your gut than what's going on when you're not stressed. And that's not exactly literal. That's a metaphor, of course. Peptides are an emerging intervention for mood disorders. Currently, very few are available for human use, so improving microbiome health and peptide activity are essential. There are a lot of ways we can do this naturally, and you've heard me go on my diet tribe before, I'm going to do it again. About how some of the supplements that are available online may not be the healthiest for us because, for example, if you take a mega dose of magnesium, if you're deficient in magnesium and that gets you into the good range for you, then great. But if you're not deficient in magnesium and you end up with too much magnesium, it actually impairs the ability of other nutrients to, to be absorbed and do their job, like calcium. So too much is not it. We want that Goldilocks principle, what's just right, not too little, not too much. Peptides are the same way we can take peptides. And in some cases, research is showing that, yes, they're effective, but they have some unpleasant side effects. And, and some of those side effects can potentially cause immune system disruption. And they're hypothesizing. They haven't done a whole lot of studies yet, but it also could lead to cancer because some of the peptides say, hey, cells, don't destroy your. Don't destroy yourselves. Even if you are, you know, malignant, don't destroy yourselves. And we don't want that. We want the body to destroy the, the malignant cells and to maintain the healthy cells. So let's talk about some of these peptides. We have all heard, I think everybody by now about GLP1 glucagon, like peptide, which is in OIC and, and some of those other medications that people are flocking to and that the medical establishment is Starting to say, it treats everything. You can use this for everything almost. And that make, that makes me scratch my head when they start so quickly saying, well, it can be used to reduce alcohol cravings, it can be used to reduce anxiety, it can be used to reduce weight, it can be used to reduce insulin resistance. Okay, let, let's back up and figure out what's going on and let's also consider what else might be going on. However, GLP1 is a peptide we have and it's one you can enhance naturally. It helps reduce inflammation, it helps improve sleep. When we are not chronically stressed, our body is better able to reduce inflammation. When we have inflammation, our body registers that as a stress response. When we have that stress response, then we're already primed and it's going to be easier to trigger an anxiety response. So GLP1s reduce inflammation, improve sleep, increase dopamine release, and have been shown to help reduce mental fatigue. Not necessarily physical f fatigue, but mental fatigue, which I thought was a little bit interesting. But if we go back and we say, well, what was causing the mental fatigue? Was it because the person had inflammation in their system so their stress response was staying on and they weren't getting adequate quality sleep? So when they woke up they weren't feeling rested and then everything felt overwhelming, which was that mental fatigue. So you can see how there, there's a lot going on under the hood. Peptide YY regulates satiety, gut motility, inflammation, deep sleep and modulates dopamine and serotonin signaling. So peptide YY is another great one that we really want to have in our system and, you know, functioning well. And I'm going to tell you how to increase these in a couple of minutes. CCK Cholecytokinin is an anti inflammatory, enhances sleep, reduces anxiety by increasing GABA release and reduces fatigue, anhedonia and irritability by altering dopamine receptor sensitivity. Remember, dopamine is our motivation chemical. It's our I want to do that again or I want to do that period neurochemical. So when dopamine is low, we tend to feel tired, sluggish, unmotivated and hedonic. GABA is our natural calming, it's our natural volume. And when our GABA is increased, when that parasympathetic nervous system kicks in, then anxiety goes down. It's, that's the entire function. Well, not in the entire function, but that's one of the main functions of GABA in our system. So we recognize again that by reducing inflammation and improving sleep there's less stress and when there's less stress on the body, then the parasympathetic nervous system can kick in and we can turn down that stress response. We can increase GABA and reduce some of the stress hormones. Gin. A lot of people think of it only as your hunger and satiety satiety hormone and, and your hunger hormone. It regulates dopamine and serotonin, promoting deep and REM sleep and improving energy, mood and motivation. It interacts with the suprachiasmatic nucleus which helps regulate circadian rhythms and suppresses an overactive HPA axis which reduces cortisol and inflammation that contribute to stress and emotional disregulation. Do you sense a theme here? Most of these improve sleep and help regulate neurotransmitters so people can be less stressed. So cortisol can do its job, can and produ and we produce less inflammatory cyto kindes and that produces an improvement in mood. Chronic stress increases cortisol, that's one of our main stress hormones. So chronic stress increases cortisol which blunts grant HPA axis suppression and amplifies hunger signals. So when we're under stress, the Galen or ghrelin is not able to blunt the HPA axis as well. When we're under, when cortisol is high, ghrelin lose its, loses its ability to suppress that HPA axis and it also again amplifies hunger signals, which is interesting and it can be correlated a little bit with, you know, why people want to eat when they get stressed. One of my favorites, oxytocin, our bonding hormone. But it does so much more. It is a huge, huge part of our anti inflammatory toolkit if you will. Oxytocin reduces cortisol, which promotes deep sleep. So you're clearing out the adenosine, you're going to be able to relax enough to get that deep sleep. And it improves the sensitivity of glucocorticoid receptors which reduces inflammation. As I mentioned earlier, when we're chronically stressed, the body is sending cortisol out like constantly so the receptors become less receptive, less sensitive to that, to, to cortisol. And when those glucocorticoid receptors are, are not responding to the cortisol then we start to see increased inflammation. So we're seeing a reduction of cortisol stress hormone. As cortisol goes down, our ability to produce melatonin and get sleep goes up. So we're seeing cortisol goes down, we're seeing sleep improve and we're seeing less stress overall. In the body, which means that those glucocorticoid receptors aren't getting overwhelmed all the time, and they can start healing and becoming sensitive again. When they're sensitive again, then they're able to reduce inflammation. Oxytocin boosts dopamine, improves energy and social connectedness. Oxytocin also boosts gaba, which reduces anxiety and stress. So let's. Let's just think about it. That bonding hormone, whether you're petting a dog or getting a hug from somebody, a lot of times when oxytocin is released, we start feeling more relaxed, and people are like, okay, oxytocin makes you relax. No, oxytocin boosts gaba. That helps you relax. But, yes, it is a player. We have to have it. Oxytocin can be boosted by touch. It can be boosted by doing nice things for people. There are a lot of ways we can boost oxytocin. So how do we increase these peptides naturally without trying to figure out if there's a way we can manage to get them even though they're not actually labeled for human use? Don't do that. Increase fiber. Prebiotics are insoluble fibers that are used by gut bacteria for fuel. Potato starch. It's one of my favorites. I use potato starch instead of corn starch to thicken sauces and things. So that's one easy way to get insoluble fiber. Oats, green bananas. Not sure I'd recommend that one. Legumes and inulin. Inolin is found in a lot of protein bars, but it's also very high in chicory root. If you drink a lot of chicory tea, you may notice if you drink too much, you start getting, you know, kind of an upset stomach. That can be your body saying, okay, too much inulin, Too much inulin here. Inulin can cause digestive upset in large amounts, but in small amounts, it is really useful for feeding those gut microbes. Now, remember, microbes are infinitesimal, so you don't need a whole bunch of to feed them. We also need to increase soluble fibers from fruits and vegetables. Things that you actually have to chew, not your juices. You know, your apples, your celery, your broccoli. Great sources of fiber. Probiotic strains, lactobacillus and bacterium species have been found to alter the vagus nerve signaling in the gut. And part of that is because it's. As our probiotics take over, as our good microbes take over, it alters which peptides are being released by the gut nervous system and which signals are being sent to the brain belongum. And when you see a B period and then a name, it stands for Bifidobacterium. And then the specific type of Bifidobacterium with L that means Lactobacillus and the type type and then bacteria, bacteroids, fragilis. Those are particular strains that have been studied a lot and have been found to have mood improving benefits. You can get these probiotics in fermented foods like kefir, yogurt, especially Greek yogurt, sauerkraut, kimchi, brine, fermented pickles, not the ones that are fermented in vinegar, in brine, which is salt water, miso and tempe. So you can, if you incorporate these into your diet, you can feed that bacteria and improve the bacterial composition in your gut. There are probiotics for sale online, but it's important to make sure you know what you're getting. And a lot of them will include other herbs and various things which may or may not be contraindicated with any other medications you're taking. So read the label, always read the label. And yes, just like everything else, it is possible to get too much of any one of these omega 3 fatty acids. We want to get those that from your fatty fish, from your olive oil, avocados. They help reduce gut inflammation and, and enhance GLP1 Recep receptor sensitivity. So you know, double whammy. It is reducing inflammation and helping to promote that GLP1 consume polyphema phenols. Those are the chem. Some of the chemicals, if you will, that are found in really colorful fruits and vegetables, berries, dark chocolate and most colorful fruits and vegetables. Your oranges and not the fruit orange, but your orange. Foods like carrots and sweet potatoes don't have as much in the way of polyphenols as your berries and your chocolate, your blues and, and your blacks and your purples. Tomatoes have a chemical in in them called lycopene which is a very powerful antioxidant, but it's not technically a polyphenol. So have a range of foods, at least three colors on your plate at every meal. Magnesium rich foods like dark leafy greens and pumpkin seeds help balance that gut microbiome. And you can get, if, if you pay attention and you eat whole foods, you can get all of the vitamins and minerals you need through healthy organic foods. And vitamin D plays a critical role in regulating gut peptides, oxytocin production, immune function, inflammation, HPA axis regulation and influences circadian rhythms. All of these things affect the gut peptides. So if you're having difficulty, maybe somebody appears to have, you know, a lot of inflammation. Maybe they're petting their dogs all the time and they're doing whatever they can to increase their oxytocin. But if vitamin D is not available, then the body has a hard time making everything work. We need all of the ingredients, so making sure people are getting enough vitamin D. Older people often cannot synthesize enough vitamin D from the sun because their skin is thinner and they don't manufacture it as well, if you will. And those of us who are living at higher latitudes, I think also often suffer from not getting enough UV light to to process enough vitamin D, which is why a lot of our dairy products are enriched with vitamin D. And many times doctors will recommend to people to take a vitamin D supplement. Vitamin D is one of those things they test for in a full blood panel. So it should be a no brainer when you get your annual physical to determine is my vitamin D level where it should be? For me, intermittent fasting is another approach in addition to eating healthy foods, making sure you're getting the right vitamins and those sorts of things. Intermittent fasting itself increases beneficial gut bacteria, particularly bifidobacterium and ackermansia, which enhance gut barrier function and lower systemic inflammation. Well, that makes sense. If the toxins aren't seeping out into our bloodstream, we're going to have less systemic inflammation. It also increases paracet, a key microbiome modulator linked to improved gut integrity and neurotransmitter balance back to that gut integrity. It also reduces pro inflammatory inflammatory cytokines which contribute to anxiety and neuroinflammation. It enhances vagus nerve stimulation, promoting parasympathetic activity and reducing anxiety. One of the things we need to look at with intermittent fasting for a lot of people is for a lot of people, number one, start gradually but don't go too long. You don't need to overdo it. 12 hours is generally where most people start. So they eat dinner, finish eating dinner at 6pm and they don't eat again until 6am that's the minimum for intermittent fasting. But that'll do the job. A lot of people will push that window up. So they're fasting for 16 hours and they're only eating for eight hours. But if going that long between meals causes people additional stress, then it's not what we want to do. If it makes them hangry that's not what we want to do. So encouraging people, if they're going to do intermittent fasting, of course to talk to their doctor and especially if they've got diabetes. Intermittent fasting can be helpful, but it needs to be done correctly and carefully. Intermittent fasting also increases microbial metabolites which enhance GABAergic and serotonergic signaling in the brain. When people are going through intermittent fasting, then the gut microbiome actually produces more product, if you will, and that, that those products that are being produced enhance GABA and serotonin. Intermittent fasting increases GLP1, which enhances dopamine and serotonin release, enhancing mood stability. There again, if you're trying to do intermittent fasting and it's just really killing your mood, probably need to back it down a little bit and look at what works for, for you as an individual. Intermittent fasting reduces HPA axis over activation, lowers CORT cortisol levels and anxiety. And when that happens, over time it's going to reduce inflammation because the glucocorticoid receptors are going to become more sensitive again and better able to control that systemic inflammation. Intermittent fasting modulates appetite and metabolism, reduces blood sugar spikes that contribute to stress and mood swings. When we get stressed, as I mentioned earlier, a little stress triggers a little bit of blood sugar so we can handle the threat. A huge stressor or a huge stress response triggers a huge release of blood sugar into the system, which can and and usually does alter a person's mood. Not only when it's initially secreted and you have that spike, but then when you crash, you crash hard. Intermittent fasting also boosts peptides YY and cholecytokinin, which suppresses excessive cortisol release, stabilizes circadian rhythms and the stress response. One of the things, remember we've talked about circadian rhythms. One of the things that sets circadian rhythms is your activity. And if you are eating at the same eating and stopping eating at the same time or roughly the same time each day, that's one mechanism that helps set your circadian rhythms. Intermittent fasting enhances GABA signaling, promoting relaxation and neural and reduced neural excitability. It increases gin release which promotes dopamine release and neuroplasticity, reducing anxiety and improving motivation. It also reduces nighttime ghrelin spikes, preventing stress induced late night eating and anxiety. A lot of people find when they start intermittent fasting, when they used to find that they were getting hungry at 7 o', clock, 10 o' clock at night, that starts Going away. It aligns the gut microbiome function with circadian rhythms, improving sleep and mood regulation. So the right microbe crew can be in there when it's time to relax and get to sleep. And it enhances the melatonin GABA interactions, promoting deep sleep and relaxation. Sleep is another intervention. I know, right? Is it a symptom or is it an intervention? Both sleep problems are a symptom. Sleep itself is an intervention because sleep deprivation are risks for depression, mental disorders, heart disease, insulin resistance and high blood pressure. Why insulin resistance? Because when we're sleep deprived, our body secretes too much blood sugar, which means that our insulin receptors are constantly being bombarded. And so when we get quality sleep, our insulin receptors become more sensitive again. And that's good. Heart disease and hypertension are often related to systemic inflammation. Well, when we're chronically stressed, not only are our insulin receptors resistant, but our cortisol receptors are resistant. So by reducing that stress, we're helping reduce inflammation. And that can help people relax enough to get quality sleep. Sleep loss is associated with changes in the gut microbiome and peptide signaling that increases inflammation. Sleep loss correlates with cognitive inflexibility. Now, I want you to think. Think of a time when you've been not getting good sleep because you're sick or you've got a new baby or a new puppy or whatever, but you haven't gotten good sleep for a few days and see how many of these things s ring true for you. Sleep loss correlates with cognitive inflexibility. Interpretation biases. You interpret things as more negative or more overwhelming or more stressful. Judgment biases about what's threatening or what you can do. Negative attribution styles. More worry, more rumination. Biased attention to threat. You're sleep deprived, which means you don't have as much energy, which means you're vulnerable. So your brain says, hey, you're vulnerable because you're kind of groggy. You need to pay more attention to all the threats that are around so they don't catch you by surprise. And interestingly enough, misperception of sleep deficit. When people are sleep deprived, they often don't realize they're sleep deprived. Caffeine or no caffeine. They don't realize how sleep deprived they are and how much it's impacting them. Greater improvements in sleep quality led to greater improvements in cognitive function, anxiety and depressive symptoms. Improving sleep. Have that sleep routine where. Well, daily routine, ideally where you're eating about the same times each day you are getting up and going to bed about the same time each day and you have a wind down routine, whatever that looks like for you. Reduce blue light and brightness in your environment. Two hours before bed. Make sure you have cool temperatures to sleep with. Use intermittent fasting if doctor approved. They've shown it improves sleep. Hydrate early so you're not getting up at 2am to go pee. Address light noises and other sleep disruptors. I've shared with you all before. I am horrible about letting my animals sleep in the bed. And Brewster right now will get cold in the middle of the night and he'll get up and he'll turn around and he'll throw his covers off and he needs to be covered back up again. So if you have sleep disruptors or maybe you have somebody you share a bed with who tosses and turns and kicks you all night accidentally of course. My daughter used to do that when she was a toddler. Weighted blankets can actually trigger the release of oxytocin and help suppress cortisol and increase gaba. For people who find that helpful. Some people find weighted blankets to feel oppressive and that doesn't work. If it's stressful, don't do it and reduce cortisol levels. That means 2, 3, 4 if you can. Hours before bed. Don't be getting into things that are going to stress you out. Stay off of Twitter, stay out of social media. You know, if you want to do something mindless online, go to, you know, shorts or something that are going to make you laugh. But stay away from something that's going to trigger a cortisol spike. Sadly, there really aren't a lot of new non pharmacological treatments for anxiety that are even currently under investigation. In my research in PubMed, the current standouts of of emerging treatments are much more holistic in nature. Instead of necessarily addressing specifically the anxiety thought or the particular stimulus in the environment that triggers the anxiety. We're starting to look at healing the nervous system and healing the body so it can better respond to stressors. We do that by strengthening vagal tone, improving sleep and improving the gut microbiome and peptide signaling through nutrition, stress reduction and potentially intermittent fasting. And then of course, as I mentioned, transcranial magnetic stimulation is cutting edge if you will. That is one that's out there that they're showing a lot of promise with. And it's nothing like the old electroconvulsive therapy. Nothing like that at all. It's a very benign experience. And, and again, it is showing a lot of promise for people who are willing to consider that. Are there any questions? Adriana's right. Antibiotics do kill both harmful and beneficial bacteria. They go in and just wipe them all out. So you've got those microbes in there and the antibiotic will go in and wipe out either gram negative bacteria, gram positive bacteria, or all the bacteria. And they've shown that people who take antibiotics have a disrupted microbiome up to two years after taking antibiotics, which I think is just mind boggling. And definitely somebody points out that they are eating a plant based diet that's high in polyphenols and they're still having trouble sleeping. So my question would be, okay, what else is going on? What else is going on under the hood that might be contributing to sleep disruption? And just starting to get really curious about whether it is racing thoughts, whether it is gonadal hormones or thyroid hormones or circadian rhythm disruption. There are a lot of things that can happen that cause stress on the body, which is going to make sleep difficult. And then when sleep becomes difficult, everything else seems more difficult and it's this negative downward spiral. And, and Cheryl, you're right. Antibiotics can trigger mood problems. And, and I, I say this with caution. There are some studies, and, and I haven't looked at all the studies by any means. I'm not necessarily advocating for it, but there are some studies that have shown that in people with autism spectrum disorders there may be a particular bacteria that is too plentiful and by taking a particular type of antibiotic, it improved their symptoms. Now what else is going on? Because you can't just take a pill, an antibiotic that kills one particular type of, of microbe. So what else are we doing when we wipe those out? But yes, it does impact mood. Antibiotics alter the microbiome, that alters the peptides, which alters the signaling on the vagus nerve to the brain. So great discussion you guys had in the chat room. I'm just reviewing some of these. Yes, Cheryl makes another good point that suddenly changing your diet can lead to mood symptoms. Because the system, the, the body factory gets used to certain inputs and when you change those inputs, it throws the system out of whack. Think about apps on your computer or something. When you get used to how something goes and you know which where to click and everything goes just fine and then they update the app and everything's in a different place and it takes you a minute to get reoriented and to effectively and as efficiently move through that process or app as before. The same sort of thing for our, for our system when we stop providing it the same inputs, it needs to restructure its processes to adapt. I encourage people, if they're going to change their diet, to do it gradually, not to suddenly cut out all anything. You know, just start weaning off of it a little bit at a time. So maybe in a month, they're not consuming as much of it anymore. Thank you so much, Michelle. I am glad you enjoy the videos. Oh, Brewster, come here. Come here, boo. Come here. Say hi to the people. Come on. Yeah, come on. We got to come a little farther. There you go. First, it was sleeping on my. In the easy chair behind me. So he's like, why did you wake me up, Mama? But this is our Boo Bear, and he's still doing pretty well. He doesn't know he's sick, so that's all we can hope for at this point. I do appreciate everybody being here and look forward to seeing you next.