The Shocking Link Between Hydration and Mental Health | CEU Webinar

You. Hey there everybody, and welcome to today's Live Counselor Education webinar on an entirely new topic. Today we're talking about the importance of hydration and quality hydration on mental health. And this isn't something I think any of us probably learned in graduate school. So I'm hoping this will provide you another holistic al not alternative, but additive, I guess, in your treatment planning. Today we're going to identify the prevalence of dehydration and how to recognize it in ourselves as well as our clients. Explore symptoms of depression or anxiety that might be caused by dehydration, reflect on how hydration might be contributing to mood, cognitive and behavioral disorders and learn about water contaminants, including endocrine disruptors, and how they can contribute to physical and mental health issues even in properly hydrated people. For those of you who haven't been here before or who haven't been here for a while, just reviewing the pieces Model this is my holistic model that I use when I teach physically. We need to recognize the impact that a lack of sleep has on emotions and cognition. We need to recognize the impact that poor nutrition has on our emotions and our cognition and our ability to get good sleep. Without adequate nutrients, our body can't make the hormones and neurotransmitters and everything necessary to keep the body factory running. All of the lack of sleep, lack of proper nutrition, those are stressors which will trigger the HPA axis when hormones or neurotransmitters are out of whack. That is considered a stressor by the body and that will trigger the HPA axis, contributing to sleep dysfunction, inflammation, mood and cognitive issues. And inflammation, whether it is due to an injury which is generally localized or it's systemic, can contribute to irritability at the very least. And when it becomes systemic, it's highly correlated with increases in anxiety and depression. So anything that is considered a stressor on the body is going to trigger that HPA axis, which, when that goes on chronically, goes on sort of unchecked. With chronic stress, we do see an increase in systemic inflammation. Interpersonal is our relationships with others and our desire to engage with them. And intrapersonal is how we feel about ourself and how we feel about our ability to do things that we want to do emotionally. Well, you know what that means. Cognitively involves your perception of the world. Whether you see it as a scary negative place or a good place, whether you are able to use your executive functioning skills like planning and organizing and problem solving. And some of those cognitive distortions but when a person is struggling, for example, with sleep deprivation or inadequate nutrition, which impacts sleep, your ability to get good quality sleep, then that will increase ruminations, that will increase intrusive thoughts. So we can start seeing how all of these things are interconnected. When the body isn't healthy, ain't nothing else going to be totally healthy either. Now, environmentally, this is what we really think about as more of a tertiary consequence of a lot of things. But environmentally, as we talk about hydration today, we're going to talk about how dehydration can contribute to low energy, fatigue, difficulty sleeping, and those things can contribute to cognitive difficulties, which if we're having difficulty thinking clearly, solving problems, planning, that can impact our ability to learn, that can impact our relationships, and that can impact our ability to be in an environment that we want. And we're not going to talk a lot about spirituality today, but it is part of the model. And spirituality simply refers to our sense of connection and our values. Symptoms of mood disorders and dehydration, depression. These symptoms are common to both of those things. And we've talked, when we talked about thyroid issues, when we talked about gonadal hormone imbalances, we talked about how there are symptoms that are transdiagnostic symptoms that are common to a lot of different things, whether it's emotional, behavioral or physical. So symptoms of mood disorders and dehydration include fatigue, you're not getting enough water, then your body has a hard time sending messages out and it disrupts your circadian rhythms. We're going to talk about all these in depth sleep changes, increased pain. Remember your, your body is a fluid system, and when there's not enough fluid, there's not enough lubrication, which can cause increases in pain. But we also see some other effects of actual heightened pain perception in people who are dehydrated. Interesting. Reduced immunity, low mood, low motivation, brain fog, and difficulty concentrating. So as we go through, I want you to think about how hydration may be impacting the people with whom you work. Now, it's not going to be a be all, end all. They're not going to come to you with clinical depression and you say, hey, you just need to drink more water. That's not what I'm saying. What I am saying though, is just like the person with hypothyroid, no amount of talk therapy is going to get them hydrated. And if that is impairing the system's ability to function efficiently and effectively, then they're not going to reach maximal gains in treatment. 43% of adults drink less than four cups of water a day, suggesting a high potential for chronic dehydration. Now, they didn't even bother to try to add on to that. Okay, you've got, you're drinking four cups of water a day or less, and you're drinking all these caffeinated beverages, which are diuretics, which contribute to fluid loss and intensify dehydration. Other issues contributing to chronic dehydration. And that's what we're really talking about today. We're not talking about when you get a little dehydrated after working out or if you've got the flu and you know you have some subsequent dehydration, yes, it's going to impact you during that period. But what we're talking about today, really, is the chronic dehydration that, at least in my estimation, in my guess, at least 45 to 50% of the U.S. population experiences. I also want you to think about with children who are in school all day long. They're not able, a lot of them are not able to have water bottles with them and drink as they go through. So are they getting dehydrated during the day? And if so, how is that contributing to their mood, their behavioral, their cognitive issues? Just a thought. So anyway, back to the PowerPoint. Other issues contribute, contributing to chronic dehydration, consumption of caffeine. Caffeine is a diuretic. Alcohol is a diuretic. It's going to cause you to lose fluid. If you're not getting enough, then you're going to become deficient. The more salt you eat, the more your body takes fluid from your tissues in order to balance that out. It likes to maintain homeostasis. So people who eat a lot of salt typically drink a lot more water. Heat. When you get hot, you sweat in order to maintain your body temperature. That's just how things happen. However, when you're in a dry climate, maybe, you know, low humidity, you may be outside and sweating and not even notice it because you're not feeling sweaty, you're not feeling sticky, but you're still losing a lot of water. When it's humid outside, you're more aware of your sweat. But it's important to understand that people who are exposed to heat will need more water because they're going to lose water through body thermoregulation. It's also important to remember, we covered this in the video on heat and mental health, that people who take certain medications, including SSRIs, your antidepressants often have more difficulty regulating. Regulating their body temperature. Some of the medications that people take, like antipsychotics and mood stabilizers and diabetes medications, are actually diuretic in nature. Oh, I'm jumping down ahead of myself. It is, again, important for us to recognize the impact because what doctor have you ever been to or ever known who's written a prescription for an antipsychotic and said, hey, this might dehydrate your client? Make sure they're getting enough water or for blood pressure medications or diabetes medications, and even talked about water with diabetes. They talk about sugar, they talk about salt, they talk about what you're eating, but not what you're drinking. Kidney disease can also contribute to chronic dehydration and just being older. As we age, for some reason, we tend to have less thirst. And thankfully, I haven't hit that place yet. I'm thirsty all the time. But a lot of older adults just don't get thirsty often enough and they can become dehydrated. Likewise, as we get older, we have more difficulty conserving fluids in our body. So as people age, if you're dealing with a geriatric population, that's really important because fluid is required to flush out the. The toxins, the byproducts from any medications they're taking, or just the typical byproducts of digestion and living. And if they don't have enough going through, then that system's going to get clogged up and they're start going to start feeling poorly. And physical activity can contribute to chronic dehydration. If you work out a lot or if you work outside, maybe you're a roofer or working in the, you know, outside doing something, you're losing a lot of fluid. And people who work outside, especially when it's hot, often struggle to get rehydrated or and stay hydrated throughout the day. And so they can be subject to chronic dehydration. Signs of dehydration. Thirst. I know, really imagine that. But thirst is something that we often ignore. We're like, I'm a little thirsty. Or hunger pangs is another, because our brain can confuse hunger and thirst, Especially if the hunger pangs are for cravings for things like iceberg lettuce. I know I'm dehydrated if I start craving iceberg lettuce because it's like 70% water or something. If your urine is dark or you're not urinating much at all. And this is something we can look at in infants and young children who can't really communicate as well if their urine starts becoming darker or a lot stronger, paying attention to how much they're actually drinking. If you have dry mouth, fatigue, headaches, dizziness, especially on standing dry or flushed skin, all of these can be a sign of dehydration. So paying attention if you normally get up and you get dizzy, if you get up too fast, well, that might be something else. It may just be the way you're wired. But if suddenly you're noticing when you stand up, you're like, whoa. Consider whether you've had enough water. When you get a headache, consider whether you've had enough water and or too much caffeine. Potential signs of an emergency. If you have extreme thirst, you're just parched and confusion. That can be the two of those things together can be a sign or extreme thirst and a persistent rapid heart rate. When you're dehydrated, your body perceives it as a stressor and it has more difficulty moving blood through your system. So your blood pressure is going to be altered and your heart rate is like, also going to be altered. Physical impact of chronic dehydration. We already talked about them a little bit, but headaches and fatigue, these are common symptoms of for people who struggle with anxiety or depression. You know, a lot of people who are anxious grind their teeth or clench their jaw, which can contribute to headaches. So that may be doing it, but it also may be partly due to not enough water and I'm going to get very thirsty. Throughout this, they also found that people who are even mildly dehydrated made significantly more driving errors, including lane drifting and late braking. As and we're on the same level in terms of impairment as people who were driving at the legal limit for blood alcohol. That was really kind of interesting. So we know that sleep can make you drive poorly, just like alcohol can make you drive poorly. But now we know that dehydration, because of its impair impairment, impairing impairment of the nervous system's communication system, can also make us much more prone to have more difficulty in, in driving. Our reaction times are a lot slower. There's increased pain. And in people who are depressed and or who have anxiety, they often complain of increased pain. Part of that is due to changes in the serotonin system, but part of it is also due to muscle tension or maybe not moving around enough. We also see the same thing in dehydration when, as I mentioned earlier, your body is a fluid environment. So if it's not well lubricated, there may be More pain. They also did find that your pain receptors tend to become more sensitive when you're dehydrated. And there was no explanation in the research for that. For those of you who are taking this for CEUs, I have a 47 page document. I know in your class that you can look through and find all of the references and stuff if you're interested in perusing that a little bit more. But if you're working with someone who has chronic pain, consider whether they are drinking enough fluid. If they are, great. If they're not. All right, what can we do? Impaired ability to regulate your temperature. Well, everything's got to move around in order for your body to regulate your temperature. So if you don't, if you're not hydrated enough, that's going to be a problem. Chronic dehydration may contribute to more serious conditions like urinary tract infections, kidney stones, and some people will say renal failure. Other articles said, no, not so much. People who are in pain, people who are uncomfortable because they can't regulate their temperature, people who are tired, who are having headaches, they are going to likely struggle with mood issues. They're likely going to struggle with cognitive issues. How well do you think when you have a splitting headache and you're exhausted? I know I don't think very well that way. Nutritional status is also impacted by hydration. Water helps break down food and makes nutrients more accessible for absorption. It's all mushed up into a paste, if you want to think about it that way. Hydration is needed for the production of saliva. That makes sense. Which initiates digestion and motility. When you eat food, when you're chewing it, you're actually starting to break it down and the saliva has enzymes in it that help facilitate that process. If you're too dehydrated to facilitate that process, then it gets down to the gut microbiome and they've got a lot more work to do and it's not going to be as efficient. Dehydration can also slow down digestion and reduce the body's ability to absorb essential nutrients. Many minerals and vitamins are also water soluble. They need to dissolve in water. You have fat soluble vitamins and water soluble vitamins. And if there's not enough water, then those vitamins are just going to be excreted. Water is also required to transport nutrients into the bloodstream for distribution throughout the body. So once it's water is used in order to break everything down, but then water also carries it throughout your body. And if you don't have enough water, the transport system is going to be all messed up. In other videos we've talked about how nutrition is important for mood because your hormones and your neurotransmitters are made from the foods that you eat. Those foods are broken down into their amino acids and everything else, and then they're reassembled as hormones and neurotransmitters. So if your body is not getting the nutrient nutrients it needs, then no matter how much you are eating, quote, eating well, if it can't process those foods, if it can't absorb those foods, then it's not going to be able to make the nutrients at the hormones and neurotransmitters that you need to feel happy and healthy and maintain. Your immune system, the nervous system is also impacted. Your brain is about 75% water. Decreased energy production in the brain happens when we become dehydrated, which leads to fatigue and sluggish cognitive processes. Think about, well, electrical impulses travel through fluid and your nervous system communicates with electrical impulses. So if there's not enough fluid or if the fluid's all gummed up, those signals are not going to transmit nearly as effectively. So it's going to be harder to think clearly. A lot of times when we're, I'm guilty of this at work and having sluggish thinking, what do we do? We go get coffee and we think, oh, just a little caffeine, give me a jolt and I'll be able to think clearer. Well, okay, that may be it, but it also could be that you're dehydrated. So consider opting for at least trying to hydrate a little bit. There's impaired ability to transmit receive information which affects both the physical, cognitive and emotional functioning. When you're dehydrated, that entire nervous system is. It's kind of like going from driving on a paved road to driving on a, a dirt road, not even a well packed dirt road and it takes you longer to get there. There's a lot more bumps and you're trying not to kind of lose control. As I mentioned, increased perception of pain, increased pain due to reduced fluid cushioning and joints and HPA axis activation. Remember, the HPA axis is your stress response system. This results in hormonal imbalances and contributes to chronic stress conditions. When our HPA axis is chronically elevated, it changes the gut microbiome, it changes the neurotransmitters and hormones that are made and in what proportion that they're secreted. Because the HPA axis is the fight orf flight. And if we are in a threat state, then we're going to produce neurochemicals and, and things in order to help us get safe. And if we just continue to not feel safe, that stress situation is going to continue. Medications are also impacted when people are dehydrated. There are altered concentrations of medications in the bloodstream potentially leading to either sub therapeutic or toxic levels. We talked about this again in the video on Heat with people who take antipsychotics and mood stabilizers. Those classes of medications are extremely sensitive to blood plasma levels and, or blood levels. And when the person becomes dehydrated, then basically the blood volume is shrunk. It's kind of like when you evaporate water from, from a sauce or something, all of a sudden the volume goes down, which means there's more of it. And we found in Florida that people who were homeless or who had lack of access to adequate air conditioning and stuff in the summer would typically have more episodes where they'd have psychotic symptom breakthroughs because their medication was becoming imbalanced. We also would see this in people who were on those types of medications, who were very active, whether it was they were out gardening in their own yard or they had a job that involved physical labor. If they got dehydrated, they would start to have symptom breakthroughs. We can also see reduced kidney function in people when they're dehydrated because the kidneys use water to flush stuff out. And if there's not enough water, then you know, you got sludge instead of whatever. But that can lead to reduced excretion and accumulation of drugs in the body. If the, there's not, not enough water to push out the, the lithium or the Valium or whatever medication the person is taking, then it can build up and become toxic. Additionally, who knew dehydration had all these impacts? Additionally, when people are dehydrated, there's reduced melatonin production. Serotonin levels are altered. Serotonin is needed to make melatonin, and water is needed for the chemical reaction to convert food to serotonin to melatonin. So there's a reduced melatonin production. We know that people need melatonin to help them get sleepy. And we also know that in the morning, cortisol levels are the highest. And as they decline throughout the day, when they get to their lowest point, melatonin is secreted. But if there's no melatonin to be secreted or not enough, then it's going to start to mess up the circadian rhythms, too. Altered vasopressin levels are also evidenced when people are dehydrated. Vasopressin is a hormone that actually reduces urine output and it, it increases at night. Why? So we can sleep through the night without having to get up to go pee. However, in people who are dehydrated, there may be altered vasopressin levels and there may be changes in that, so they actually do have to get up and pee more in the night, which I'm not exactly sure why, but that's what the research said. Circadian rhythm disruption can occur due to impaired ability to regulate body temperature, potentially disrupting the sleep wake cycle. Remember, circadian rhythms are not just set by light levels. They're also set by environmental and body temperature. We need to be cool to go to sleep. And if the person is having difficulty regulating their heat, whether it's because of dehydration or hot flashes or something else, then that can impair their circadian rhythms, which is going to throw the entire system out of whack. That's like taking a factory and somebody just sneaks in and sets the clock ahead two hours. And nobody knew that then. Everything that was supposed to be done at 10 is getting, you know, it's, it's just a mess. Disrupted circadian rhythms lead to altered melatonin release. And dehydration has also been shown to reduce the sleep phases. Remember, you've got the light sleep and then you've got deep sleep and REM sleep, and each of those phases is actually squished when people are dehydrated. In terms of immunity, water is essential for the circulation of immune cells and the proper functioning of the lymphatic system. If you want to flush out some of those byproducts, some of those toxins, some of those germs and bad things that your immune system killed, that's great, but you got to have the water to flush them. Hydration also maintains your mucosal barriers, which are your first line of defense against pathogens in your respiratory and your digestive tracts. So think about the mucosal membranes in your nose and in your digestive system. If they start getting all dried up and cracked, then they're not protecting you from the viruses and harmful pathogens. When that happens, you get sick. When you get sick, there's increased inflammation, and nobody's mood is good when they're sick. But people who are chronically dehydrated tend to get sick a lot more often, which can, because they feel Frustrated that they're getting sick all the time. Can also contribute to mood and anxiety and self esteem issues. Inflammation can be increased due to pain signaling and an inability to flush out those toxins. And pain can also be increased because dehydration can cause muscle cramps and spasms. We all know that's uncomfortable and as I mentioned, heightened sensitivity to pain. And I think this is finally hormones. Cortisol is your stress hormone and it is elevated in response to dehydration. Makes sense. I told you. When the body's systems are out of whack, when it's not getting enough nutrients, when the sleep is not quality, when there is dehydration so the system is not adequately lubricated, if you will, that's perceived as a stressor by the body factory which will trigger the stress response. That HPA axis and one of its main chemicals that it secretes is cortisol. So when people are dehydrated, they are stressed, they've got those stress hormones already chugging through their veins. This can, when cortisol levels are high, whether it's because of dehydration or something else, I think we've all had high cortisol levels at one time or another. It impacts people's stress levels because you're already starting stressed, you're starting up here. So then when something happens you go up here instead of starting down here with not feeling stressed at all and just going up to here. So we have increased stress levels, more difficulty regulating mood and changes in overall energy metabolism. People tend to, when cortisol is high, you're dumping more blood sugar because you're preparing for that fight orf flight. So it's going to alter blood sugar levels and eventually may contribute to fatigue. All right, so we've talked about the physical effects and remember in the pieces format it's physical, interpersonal, emotional, cognitive. The interpersonal effects are not obviously direct effects of dehydration. But think about it, how you decide how the following things will impact your desire to interact with others and impact your self self esteem and your self efficacy. We've already determined that dehydration contributes to increased pain, fatigue, sleeping difficulties, alterations and hormone levels, increased activation of the stress response, reduced motivation because dopamine is going down, irritability, attention deficits and brain fog. It's more difficult to think clearly because those synapses just aren't firing quite right. So when you've got any of these going on, let alone all of them going on, how much do you really want to hang out with your friends. For me, I'm, I'm probably going to withdraw a little bit. I'm probably going to be like, ugh, I just ain't got it in me. How is that going to affect a person's self esteem when they feel like that? A lot of these things are invisible. It's not like when you have a broken arm and people can see, oh, that's a broken arm, that must hurt. They can't see what's going on inside you. So people may start feeling guilty about not being able to do what they want to do. They may start feeling like they can't live the life that they want. They don't have that self efficacy, which contributes to a sense of hopelessness and helplessness, depression, and potentially it may increase their sense of vulnerability and threat within the world. In terms of the emotional impact, again, think about how these things that we've already talked about impact your motivation, your mood and your guilt. If you've got increased pain, it hurts to do anything. How motivated are you to get up and go to work, or even to get up and do things that you like to do? Probably not as motivated if you're exhausted, if you're not sleeping well, altered hormones, all of those same things apply. And all of those things are going to impact people's mood, how they feel about things, which is going to alter certain hormones and neurotransmitters, which will impact dopamine, which is going to impact motivation. Dopamine is our main motivation neurochemical and it's important to recognize how all of these things can relate to some extent to people's nutrition and hydration status and their sleep. You all know I'm big on making sure people get adequate sleep in terms of cognition. How easy is it to pay attention, to concentrate on what you're doing, to learn, you know, when you're at school, or to plan, to organize, to problem solve all those executive functioning things. When you are exhausted, in pain, you feel like crap. I mean, let's just summarize it like that. It's not easy. So not only are the synapses not firing as well, which contribute to cognitive impairment, but in general, the person just may not feel well, which is going to make it harder for them to focus on anything cognitive when they're just like, ah, I want to go back to bed. A tertiary effect, maybe the person's attendance and performance at work and at school, when they've got all those issues going on, it's going to be harder for people to perform on an A level, on their A level, when that's going on. So yeah, every, we all have days where we're not on our A game, no doubt. But if somebody is constantly on their C or their D game, that's going to impact their self efficacy, their belief that they can get and keep a job. That's going to impact their performance at work or at school. If they're having pain, then it may be more difficult for them to move around and they feel a lot more trapped because they can't get out and do the stuff that they want. If they are getting sick a lot more easily because their lymphatic system's not working well because they're under stress. And we know when people are under chronic stress, the immune system is impaired, so they're getting sick more often, which makes them feel like, hey, I can never catch a break. I just can't. I don't remember the last time I had a good day. All of those things can contribute to a person's ability to achieve their goals, to maintain an environment that they find healthy and comfortable. Now, hydration itself is important, but it's also important to recognize the impact of low quality hydration. There are a lot of contaminants in our water that can impact our body. And depending on where you are, it may be better or it may be worse. You can go to your local water authority or wastewater authority, wherever you send your water bill, and they will have a water quality report so you can look at that and see where they are in terms of meeting EPA guidelines. It's important to recognize though that people who are on well water don't have any regulation. And well water tends to be far more contaminated than water that's going through the processing plants. However, even water that goes through processing plants has in most cases some level of lead, arsenic, nitrate, chlorine or chloramine. Chlorine, as we know, is used for disinfection. They decided that chlorine had too many bad side effects, so they started introducing chloramines. Chloramines are actually harder to get out of the water and are more corrosive to the pipes, which contribute to leaching of lead. But mercury, herbicides and pesticides, microorganisms, pharmaceuticals. Yeah, there's Prozac in your water. Did you know that? I didn't until I started doing this research. Perfluorinated compounds, microplastics and BPA is not in the water. But a lot of people who drink from water bottles that are not BPA free may be subject to BPA leaching, especially if they're leaving their water bottles that have, that are made with BPA in a hot car or in a hot area until they can eat their lunch or whatever that increases the leaching of bpa. How big of a problem are these contaminants? The US Environmental Protection Agency estimates that there are millions of lead service lines across the country with the potential to affect a significant portion of the population. Now obviously, we're just talking about lead here. In 2016, the American Waterworks association estimated that there were about 6, 6.1 million lead service lines in the U.S. a lot of those lead service lines are in metro areas and low income environments where the local governments haven't had the money to replace the lead lines. How big of a problem is it for you? Well, the first thing is to consider whether you're on city water or well water. Now you can make a lot of arguments for well water, but city water is regulated, so at least you're aware of that and you can get your water tested. But the direct effects, people who drink water that have contaminants in it often don't drink as much water. And we all have been there where you've gone to a water fountain or something and you've consumed the water or you've even just lifted it up and you, it smelled awful and you're like, nah, I'm not drinking that. We need to pay attention to that. Filtered water tends to do a lot better at reducing the chlorines, the chloramines and all those other contaminants that not only contribute to infl. Inflammation but, but icky taste. And once we started filtering our water, I was not a believer. But we started filtering our water about a year ago and I can't drink coffee that's made with unfiltered tap water anymore. And I know that sounds awfully snitty, but it just, it doesn't taste the same. It has this weird aftertaste. When I go to the gym, they have allegedly one of those water filters. I don't think it's ever been changed. And, but I can smell the chlorine just emanating out of that water that was supposed to be filtered and it doesn't taste as good. People who ingest these contaminants have inflammation due to the presence of toxins which, those contaminants are toxins which cause oxidative stress and increased autoimmune conditions. In terms of the immune system, arsenic is one of the worst offenders for Immunosuppression, it actually alters the immune system functioning. The altered cortisol response is a result of these toxins being registered as invaders and triggering the stress response, leading to an altered cortisol response. There are known alterations in reproductive hormones and fertility in people who drink, you know, really uncon, really, really bad water. How much and at what level does it start causing fertility problems or reproductive issues or estrogen dominance? It depends on what studies that you look at. But it is interesting to note, and it's worth, I think, trying going for a month using filtered water and see how you feel. Some people may think they don't feel any different. Okay. Most people, when they are properly hydrated, report they feel a lot better. There's an altered production of neurotransmitters. We already talked about that. You can't break down the food that is needed in order to piece together the neurotransmitters. Then you're not going to be able to produce the neurotransmitters. If you're in fight or flight, you're going to produce different neurotransmitters and hormones in different proportions than you are when you're in rest and digest. There's a disruption of the gut microbiome. Those bacteria in our gut, they're very finicky and they have a particular job. And if somebody comes on the production floor when they're at work, and that's not, you know, somebody who's supposed to be there, they'll walk off the job. You know, that's not exactly what's happening. But when we ingest a lot of these things, especially chlorine, for example, that kills not only bad bacteria, but when you drink, it can kill some of the good bacteria in your gut. It can disrupt the microbiome. And they also have found with some of these contaminants, an increase in insulin resistance. It actually alters the way your body handles insulin. Cognitively, there are attention deficits, cognitive and cognitive deficits that are associated with a lot of these, especially lead. And, and a lot of people again think, well, we don't have lead anymore. The only thing there's lead in is paint from houses that were made in the 1960s or something. No, that's not true. As I mentioned, there are millions of foot feet of piping in the United States that are still lead. And those lead pipes are going to your kids schools, they're going to some of the older government buildings, and they're going to the houses in a lot of the low Income areas where, you know, buying filtered water may not even be an option. But that's just a whole different soapbox I could get on the People who are exposed to some of these, especially lead, may experience reduced academic achievement and cognitive deficits. Think about the kids, you know, are they getting enough water so they can stay hydrated and they can think clearly while they're at work, at work, at school? But even if they are getting enough hydration, are they getting contaminants in their water that they're drinking that are impairing their ability to focus, to think clearly and contributing to systemic inflammation? In terms of adults, there is an increased risk of neurodegenerative diseases from some of these contaminants, especially in higher levels. Indirect effects of water contamination. Physically, people feel more pain. Now that's a direct effect, but it also can be an indirect effect because of inflammation. There can be sleep disruption due to hormone changes and HPA axis dysregulation. When your hormones are all over the place, go natal hormones are all over the place. You may have more difficulty sleeping, you may have more flat hot flashes, you may have more difficulty staying in good quality sleep when your thyroid hormones are wonky. That also may contribute to sleep disruption. And just that HPA axis when it is activated, when you're under stress through inflammation or toxins or whatever else. When you're under stress, your body is not saying, hey, relax, I got it, go to sleep. See you in the morning. Your body's saying you need to stay at least a little bit alert because there's a threat here. We need to figure out how to fix it. Enter and intrapersonally. Well, and again, we already went through this to a certain extent when we talked about hydration. But when people don't feel well, when they can't do the things that are important in their rich and meaningful life, a lot of times it negatively impacts their self esteem. They think they should be able to do these things and since they can't, they feel bad about themselves and it reduces their self efficacy. They start believing I can't do it. There's just I can't. When this happens, when people start feeling bad about themselves and incapable of improving their situation, we see mood disorders, but we also see social withdrawal because others don't quite get where they're coming from. They don't believe, maybe they invalidate the person's struggle which may cause them to withdraw even more. And there can be impairment in social relationships when people are exhausted and in pain and you know, feeling crappy and depressed. Well, yeah, there. There may be more arguments. Hey, you said you were going to go do this with me. Well, yeah, I said that, but I just. I ain't got it in me. So there can. You can start having tension in relationships because people who are dehydrated, people who have a disrupted hormone balance, may not only have lower motivation, but they may have much lower energy. We, in the video on depression, we talked about how people who have clinical depression, it actually. They have psychomotor slowing. It actually feels like you are walking through water or something. You feel heavier. It feels harder to do absolutely anything that involves moving your body. Been there, done that. Burn the T shirt. And it's important to understand that because a lot of people, they're like, well, you're the same weight you were two weeks ago. Why is it harder to do today? It just is. It just is. Emotionally, there can be a lot of irritability in people who don't feel well, and it can lead to what Hayes calls dirty discomfort. And again, we've talked about this a lot. Dirty discomfort is when you start getting angry or anxious or frustrated about being irritable or about feeling unmotivated. You're intensifying or increasing the number of unpleasant emotions. So not only do I feel bad, I feel guilty and angry and depressed. Well, that's a lot more to deal with than just feeling, you know, unmotivated. And there's difficulty with emotion regulation. HPA axis, again, when that HPA axis, that stress response is activated for too long, it becomes dysregulated. And we start seeing what they call glucocorticoid resistance, which means the body doesn't respond to cortisol the way it normally does. It kind of ignores it. It's like, I. I just don't have it in me. But then when there's enough cortisol, eventually the body goes, oh, I get it. There's an emergency. So people go from feeling flat, just kind of not responding to anything, to furious or frantic. And that is a direct behavioral sign of emotional disregard of emotional dysregulation and HPA axis dysregulation. Cognitively, people may start feeling pessimistic. And environmentally, we see job instability and reduced opportunities. A child, for example, who grows up in an environment where they're dehydrated and malnourished and all those things, they have difficulty focusing and learning at school, which ultimately relates, translates into reduced opportunities when they get older because they weren't able to acquire that information as they were growing up. So what do we do to increase water use? There's a lot of things, you know, a lot of people are like, I don't like water, it's icky. Okay, well, in my opinion, there are better tasting waters than others. But once you start getting the, some of the toxins out, it's a whole lot easier. Tastes a whole lot better, and it smells a whole lot better. Putting ice in it, in my opinion, makes a world of difference. I'm not big on room temperature plain water, even if it's filtered, so that makes a big difference. Some people squeeze lemon in it and that can be useful flavor packets. Now, some people will use like Crystal Light or something that has its own issues because it has the coloring and the artificial sweeteners they do have on Amazon and other places. You can get freeze dried flavor crystals. I don't remember exactly what they're called, but it's orange juice or lemon juice that's been freeze dried. There's no sweetener in it and there's no coloring in it, so it adds a little hint of flavor, but it doesn't have all the bad stuff. Infusions are another thing people can do. You get a picture and they have a special little thing that you stick in the pitcher and you put fruit or whatever you want to in the center column and it gradually infuses the water with whatever flavor that is, whether it's grapes or strawberries or I don't know what you put in it. But in terms of coffee, tea and soda, most of us are not going to give that up. Let's just be real. Switching to decaf or at least starting to cut down your caffeine can be helpful because then you're not expediting the diuretic process. Chicory is an alternative to coffee that they actually use over in France. Evidently it has a unique flavor, but it is definitely an alternative. And it is naturally decaffeinated. There's no chemical or other decaffeination process. It has to go through herbal tea, lots of them out there. And using filtered water when you make these things will also help reduce those inflammatory contaminants. So if you're making herbal tea, might as well use filtered water while you're doing it. Another thing that you can do for if you have a lot of chlorine in your water and you're just, you're not ready to take the step and get a water filter. All right, I get it. You can bubble your water. And what I did for a long time before I switched over I got a little. One of those little fish bubblers that has the little bubbling stone. And I would take a gallon jug of water, and I'd put the little fish bubbler in there, and I would let it bubble overnight. Chlorine. Not chloramine, but chlorine, and evaporates a lot more quickly or evaporates when it's exposed to air. So agitating the water, keeping it at room temperature, are all ways to more rapidly reduce the chlorine. If you've got chloramines in your water, you're kind of out of luck. You have to filter those out. They do not evaporate, and you can't boil them out, so you're kind of out of luck there. The other thing to consider is the cost benefit. How much money are you spending being sick and on medications for headaches and pain and everything else? And how much money are you spending if you're buying water from the grocery store? Because you already know you can't tolerate your tap water. But if you're buying water from the grocery store, in every instance that I've ever come across, the water filters are a lot cheaper than having to go to the grocery store and get those by, you know, about 75% in most cases, even for the really good water filters. But if you're not sure, try the experiment. Drink the recommended amount of water each day for two weeks or maybe a month. A month is better, gives you more time. But two weeks. And make sure not to drink it too close to bed. Sucking down one of these things at right before you go to bed, not a good idea. I've done it. Not what you want to do, because then you're up every two hours. But during that period, track your energy levels, your how well you sleep, your skin, health. And I know that's not something we talked about, but I had my students at UF do this experiment one time, and that was by far the most common comment on their research papers, was that their skin actually improved. It looked better. It had a better glow. There was less breakouts. So, you know, okay, you know, that works for a lot of people. Bloating and abdominal distress. Do you feel better when you're adequately hydrated? What is your reaction time like now? You may or may not be able to judge that your cognition, how. How much brain fog do you have, and what's your mood like now? Most people are not going to track all of these. They'll pick two or three that they want to track. But it is interesting to look at retrospectively to see, hmm, what's going on. Another thing I didn't mention early in the presentation was another test you can do to see if you are dehydrated. If you've got animals, you've probably seen your vet do this to them in their, in, in their exams. But if you pick up, pinch up your skin here, if it bounces back right away, you're probably pretty well hydrated. If you pick it up and it just kind of hangs there and slowly goes back down, that's a sure sign that you're probably dehydrated. So that's something else that you can look at with yourself. Or if you have somebody in your household that maybe has dementia, that can't communicate effectively how they're feeling, what their needs are, you know, that's one of those things that you can do if they'll let you to determine what their hydration status is. Water, like sleep, is an often overlooked intervention in physical and behavioral health settings and schools. How many issues could be minimized or mitigated if kids were actually well hydrated with non toxic water? I don't know. I don't know. But I think there's probably an argument for that. Even mild dehydration can contribute to many symptoms commonly associated with anxiety and depression and worsen pain and autoimmune issues. Stress increases in stress, increases autoimmune systems, they go hand in hand. Increase in that HPA axis is going to lead to a greater likelihood of triggering of autoimmune symptoms. The seemingly intractable nature of these symptoms because people don't know what's causing them. You know, they keep going to the therapist and talking and still not feeling better. They go to the doctor, they throw medications at them, still not feeling better. So people start to feel helpless and hopeless and may start also feeling anxious that life's never going to get better and angry at the people who don't understand or who aren't living with this condition. We do want to encourage patients to use filtered water and carry a water bottle with them, ideally a water bottle that has a filter in it that they can refill instead of putting more plastic bottles in landfills. But I digress. So this is something that's pretty easy. Most patients are not going to balk at us, asking them to consider carrying around a water bottle with them and see if it helps them. Just like sleep, most patients aren't going to say, well, no, I don't want to get better sleep. So that's one of those interventions that's super important for reducing inflammation and improving cognitive functioning and all that, and reducing HPA axis over activation. But it's one we don't talk about nearly enough. And as I mentioned, if people are not getting enough nutrients, they can't make the neurotransmitters and the hormones. But they may be eating a great diet. But if they're dehydrated, their body can't take advantage of those nutrients. So helping them see, you know, let's, let's put be curious. Let's examine what's going on. Everybody have an absolutely amazing day. I will be putting out some shorter videos on particular contaminants and that may be present in your water, just to educate you a little bit more about each one and their effects and ways that you can avoid them. So look for those in the coming weeks. And I will see you next Wednesday. There.