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