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3/12/2011
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IntegrativeTherapiesforAnxiety
HenryEmmons,MDConsultingPsychiatrist,PennyGeorgeInstituteforHealthandHealing
www.partnersinresilience.com
WhyZebrasDontGetUlcers
Becausetheydontsufferfrom chronic stress
ButPeopleDo
Weveevolvedtobesmartenoughtomakeourselvessick.
RobertSapolsky
TheCostsofAnxiety 1in5Americansperyear
30%lifetimeprevalence
40millionAmericansperyearwithdiagnosableconditions
CostsUSeconomy$50Billionperyearinlostproductivity
TheSpiralofFearImhavingRound2ofPTSD.Ihaventsleptin7months!DiagnosedwithCancer2ndEpisodein9years Sleepingmedshadhelpedinpast
Nowsleepingonly34hours Numerousdoctors
6medtrialsunhelpful
Sleepstudy
Isthereanyhopeforme?
Fearreactionlockedintheonposition
Anormalresponsegoneawry
Keptalivebythinkingtoomuchandsleepingtoolittle
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BreakingtheCycleUnlockthebrain
Improvesleep
Dampenthestresshormones
BvitaminsMagnesium 5HTP
MelatoninTryptophan
Within5daysfeltdramaticallybetter
Thenlookatimprovingresilience
Resilience
Keepingthetankfull.
Letfoodbeyourmedicineandmedicinebeyourfood.
Hippocrates
AResilientDietin7Words
Eatfood.
Nottoomuch.Mostlyvegetables.
MichaelPollan
Eatwhole,naturalfoodsWhattodo: Why:
Buyunprocessed,organicfoodasmuchaspossible
Higherinmicronutrientsfromsoil
Lessprocessingleavesmorenutrientsinthefood
Morefiberreducesbloodsugarfluctuation
Fewerchemicalsfromfarmingandfoodprocessing
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EatawidervarietyoffoodsWhattodo: Why:
Eatmoreseasonal,localfoods
Discovernewkindsofmeats,vegetables,grains,nutsandseeds
Closertohowweevolvedtoeat.
Greaternumberofnutrients
Lesslikelihoodoffoodsensitivitieslikeglutenintolerance
EatfewertoxicfoodsWhattodo: Why:
Avoidfoodwithchemicaladditives
Besurecertainfruitsandvegetablesareorganic
Buyhormonefreemeatanddairy
Avoidcertainseafoodproducts
Somechemicalsareneurotoxic
Certainproduceisknowntocarrymorerisk
Hormoneswillimpactbrainfunction
Oceansarepolluted;notallfisharesafetoeat.
EatbrainprotectivefoodsWhattodo: Why:
Lookforcolorfulfruitsandvegetables(beans,darkberries,leafygreens)
Eatacruciferousvegetabledaily:e.g.Broccoli,caulif lowerandcabbage
Phytonutrientsarepotentantioxidantsthatreducethenegativeimpactofstress
Thesehelpthebodydetoxify
EatbrainnourishingfoodsBuilddietaroundcomplexcarbohydrates.
Eatonlymodestamountsofleanprotein.
Getplentyofhealthyfats,mostlyomega3:Oliveoil;nuts;seeds,fish
Aplantbaseddietimprovesbrainhealthandlongevity.
Needsomeproteinforaminoacids,butlessthanweusuallyeat.
Neuronsaremostlyfattycells;needhealthyfatstofunction,aswellasreduceinflammation
BasicSupplements MultivitaminorBComplex Takehalfthedosetwicedaily Lookforminimum50mgB6perday
Omega3 1000mgFishOiltwicedaily And/or2T.groundflaxseed
VitaminD3 20004000IUdailyfromOctoberthroughApril
Calcium/Magnesium: 1000mgCalcium(womenonly)/500mgMagnesium(menandwomen)
TherapeuticSupplement:Ltheanine
Derivedfromgreentea
Supportsdopamineandnorepinephrinefunction
Mayimprovefocus
Canalsocalmandhelpsleep
100200mgtwicedaily
Usejustatnightifsedating
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TherapeuticSupplement:NAC
Nacetylcysteine
600mgupto3or4timesdaily.
Apotentantioxidant
MayhelptreatOCD.
TherapeuticSupplement: Taurine
500mgonceortwicedailyImprovesglutamate/GABAfunction
TherapeuticSupplement: InositolDriedbeanscontaininositol.
5001000mg2 to3timesdaily.Studiesuse1218gperday.OftenconsideredaBvitamin,itcaneffectivelytreatpanic,OCDandphobicanxiety.
TherapeuticSupplement:GABA
250750mgupto3timesdaily
Doesnotcrosseasilyintothebrain,soothermeasuresmayhavemoreeffectonGABA
TherapeuticHerb:Rhodiola
100500mg
Anherbaladaptogen,thismayimprovethebodysgeneralresponsetostress
TherapeuticHerb:Passionflower
Gentlesleepandantianxietyaid12droppersfulorfreezedriedcapsulesbeforebed,orupto4timesaday
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TherapeuticHerb:ValerianRoot
12droppersfulinasmallamountofwaterbeforebedorupto4timesperday
Theenergyofthemindistheessenceoflife.
Aristotle
TheEnergyThieves
InsulinResistance
Inflammation
FoodSensitivity
InsulinResistance
Starvinginaworldofexcess
InsulinandtheBrain Sugarshavemultipleeffectsonthebrain.
Insulin sensitivity isrequiredtoproducedopamine.
Excesssugarsandneurotransmission.
Highsugarintakecanpromoteaggression,anxiety,hyperactivityandfatigue.
Postprandialdysmetabolism
Inflammation
Brainonfire.
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InflammationandtheBrain Hypothalamicpituitaryadrenal (HPA)axishyperactivity(thestressresponse)
Effectsthyroidfunction
Effectsserotoninanddopamine,glutamateandGABA.
Inflammatorymessengerssignalthebraintoproduceneurochemical,neuroendocrine,neuroimmune,andbehavioralchanges.
FoodSensitivity
Ahiddensourceofinflammation
ModifiedEliminationDietWheat
Corn
Dairy1(milk,cream)
Dairy2(cheese,yogurt)NightshadevegetablesTomatoesPotatoes
PeppersEggplant
10Daysoffall.
1daychallenge(1atatime)
2daysoff(observe)Keeprotatinguntilall5categorieshavebeenchallenged.
Avoidreactivefoodsfor23months.
Sometimesthecureforrestlessnessisrest.
ColleenWainwright
NaturalSleep
Sleepproblemsareacommontrigger
Thereisnowaytorecoverfullyunlesssleepimproves
NaturalSleep:Howmuch?
Averagein1900
Averagetoday
Timing
Naps
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NaturalSleep:WhatHelps? NaturalSleep:WhatHelps?
NaturalSleep:WhatHelps?
DawnSimulator
Northernlighttechnologies.com
NaturalSleep:WhatHelps?
SublingualMelatonin
Useplainmelatoninfortrouble falling asleep
Addothercomponentsfortrouble staying asleep
NaturalSleep:WhatHelps?
Passionflower:
GentlesleepaidUseasatincture,teaorfreezedriedcapsule
NaturalSleep:WhatHelps?
Ltheanine
100200mgatbedtime
Maybeaddedtoother
supplements
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NaturalSleep:WhatHelps?
Ltryptophan/5HTP
Aminoacidprecursorto
serotonin
Ltryptophanismoresedating
than5HTP
5001000mgatbedtime(or50
100mgof5HTP)
CautionifonanSSRI
ThePsychologyofMindfulness
Mindfulness(Vipassana)(TheMindRunRampant)
Heartfulness(Metta)(TheIllusionofSeparation)
Thepracticeofseeingandacceptingthingsastheyreallyare
Learningtodolessharm
Thepracticeoflearningtolovewell
Cultivatingalargerself
Mindistheforerunnerofallthings.Beginwithmind.
TheDhammapada
TheNatureofMindWe are what we think. All that we are arises with our thoughts. With our thoughts we make the world. Speak or act with an impure mind And trouble will follow you As surely as the wheel follows the ox that draws the cart.
We are what we think. All that we are arises with our thoughts. With our thoughts we make the world. Speak or act with a pure mind And happiness will follow you As closely as your shadow, unshakable.
--The Dhammapada
MindfulnessAwareness
Momenttomoment
Intentional
NonJudgingandAcceptance
Slowingdown,honoringtherhythmsofnature
Observingthemindfromaringsideseat
AdventitiousSuffering
Somesufferingisinevitable
TheSecondArrow
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TheNatureofMindReactivity Emotion
Grasping
Rejecting
Disconnecting
Fear
Anger
Flat/Dull
ConsequencesDisconnectionfromselfandothersAgitationFearAnxietySelfDestructiveBehaviorsDepression
ReliefFromSuffering
Wecantransformsufferinganddevelopthecapacityforjoy.
Thekeyismindful,nonjudgingacceptance
Mindfulnesspracticesdeveloptheskillsandhabitualwaysofbeingpresentinthisfullandliberatingway.
TheMedicineofMindfulnessFoundationsofMindfulnessMindfulnessofbody/breathMindfulnessofmindMindfulnessofemotion
MindfulnessPractices:formalandinformalSeatedandwalkingmeditation(formal)Mindfulnessindailyliving(informal)
CalmingtheMind Mindfulnessofbodyandbreath Pausing:MindfulBreathing Mindfulnessmeditation
Recognizingmonkeymind,wildmind,puppymind
Developingobservingself
Thoughtstend,then,toawakentheirmostrecentaswellastheirmosthabitualassociates.
WilliamJames
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FavoriteFlavorsReactivity Emotion
Grasping
Aversion
Denial
Fear
Anger
Flat/Dull
TurnTowardtheFeelingTears are the river of life washing away the old to make way
for the new. -Unknown
Experiencingemotionsasbodysensation
Ridingthewave
Droppingthestoryline
Stayingwiththeexperience
Impermanence
Let everything happen to you: beauty and terror. Just keep going. No feeling Is final.
-Rilke
EmotionalStorms
EmotionalSteadiness
Grounding
NonAttachment
Opportunitiesfor
Mindfulness
Loveisthegreatwork
Thougheveryheartisfirstanapprentice.
Hafiz
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ALargerContainer SelfAversion
I am now the most miserable man living.
-Abraham Lincoln January 1, 1841
AcceptanceofSelf
Halfofanypersoniswrongandweakandoffthebeatenpath. Half!
Theotherhalfisdancingandswimmingandlaughingintheinvisiblejoy!
Rumi
CaringAboutOthers
Bekind.Everyoneyoumeetisfightingagreatbattle.
PhiloofAlexandria
CultivatingaGoodHeartHeartOpeningPractices:GettingBeyondtheSmall
Self
Lovingkindnessmeditation
BeginningwithSelf
Extendingandenlargingthecircle
Wecanlivewithoutreligionandmeditation,butwecannotsurvivewithouthumanaffection.
TheDalaiLama
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TheIllusionofSeparation SharedSuffering,SharedJoy
There is no house like the house of belonging.
~ David Whyte
CultivatingDeepConnections
Dissolvingtheboundaries
SympatheticJoyCreatingourHouseofBelonging
Connectionwithourinnerwisdom
Connectionwithsourcesofspiritualnourishment
EncounteringSoul
"This is the first, wildest, and wisest thing I know, that the soul exists, and that it is built entirely out of attention.
-Mary Oliver
TheBenefitsofMindfulnessPractice
Clearmind
ObservingSelfbufferFreedomfromhabitualselfharming
Fullpresenceinthemoment
Recognizingimpermanence
Hope
TheBenefitsofMindfulnessPractice
Selfacceptance:thecoreofresilience
Acceptanceoflifeasitis sufferingandallGreatercapacityforjoy,aonelearnstoliveinthepresentmoment,ratherthanthepastorthefuture
Asenseofconnectionwithself,others,andthelargerorderofthings
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SpiritualExperienceandFruits
Fromfeartocourageandempowerment
Fromanxietytopeaceofmind
Fromjudgingtocompassion&empathyFromisolationtoconnectionwithself&others
Fromdespairtohopefulness
Fromshametofreedomfromselfconsciousness
FROMSMALLSELFTOTHEUNIVERSAL
Whatstheonethingyoucando?
ThereIsOneThingWeCanDo
Thereisonethingwecando,andthehappiestpeoplearethosewhocandoittothelimitoftheirability.Wecanbecompletelypresent.Wecanbeallhere.Wecangiveallourattentiontotheopportunitybeforeus.
MarkVanDoren
ForMoreInformationGoto:
www.partnersinresilience.com
Orwww.henryemmonsmd.com