Mental Health Tips to Avoid Burnout

Hey everyone, today, we're gonna go deep within your mental habits and your mental health. And we're going to turn everything that you have thought that is true on its head and give you ways to take what you currently are doing and make it powerful make it a resource for you, where your mental health is as good as every other aspect in your life even more so. And watch what happens. I have Dr. Ellen Vora MD she is a board certified psychiatrist, acupuncturist and yoga teacher. And she is the author of the anatomy of anxiety. She takes a functional medicine approach to mental health. And considering she really wants to have the whole person all of you not just one part. And she addresses in balance at the root. She received her received her BA from Yale University and her MD from Columbia. And I'm so excited to break this down understand how mental health is becoming an epidemic in our society, and what we can do about it and what you can do about it if you are feeling the pressures right now as well. This is going to be an amazing opportunity to hear from one of the top experts in the industry.

You're listening to the ReLaunch podcast and I'm your host Hillary DeCesare, best selling author, speaker and transformational coach widely recognized in the worlds of neuro psychology and business launches, which cultivated the one and only three HQ method helping midlife women. Yep, that's me to rebuild a life of purpose, possibility and inspiring business ventures. Each week, we'll be diving into the stories that brought upon the most inspirational relaunches while sharing the methods and the secrets that they learned along the way, so that you too can have not just an ordinary relaunch, but an extraordinary relaunch.

Dr. Ellen Vora thank you so much for being here, and I'm really excited to kind of break down what's really going on. So welcome to the show.

Oh, Hillary, thank you for having me here. I'm excited for our conversation.

So Alan, there's so much that we're hearing these days. And it's become it's it really has become like the pandemic there more and more people are raising their hand saying, Yeah, this is a problem. And, you know, it started long before the Olympics, but that really kind of, you know, made it come to a forefront and, you know, famous tennis players and really every single sport that's happening, we're getting it in the corporate world, we're getting it in I mean, pretty much you name it. Right? So can you help us just break down? What's going on? And then I'm super interested in your specific relaunch journey. But let's just start with like, you know, what's going on in the world?

Yeah, I mean, I think that one thing that's easy to point to is that we are slowly seeing a process of D stigmatizing mental health, and we are a little bit more comfortable coming forward and talking about it. But I do not think that that accounts for the precipitous rise in levels of depression and anxiety. I think that that rise is real. And we are under a whole host of new pressures and modern life. And I think some of them affect us on the level of our physical bodies, and some of them affect us on more of a psycho spiritual level. But we're really struggling and it's nearly universal these days.

So are you finding that is the Is it because of what's gone on in the last two to three years, the pandemic or are you attributing this to something even even bigger than that? Because was it happening already before we went, you know, into this crisis state.

It was happening already before. I mean, long before the pandemic, I was being called into corporations to talk about the epidemic of burnout and the increasing rates of depression anxiety. But then, of course, the pandemic came in and added a precipitous rise in in the levels of how we're taking psychiatric medications and seeking help for our mental health and I think The pandemic did a number of things. And we all know it was a collective trauma. There was collective grief to grapple with, there was all of the ways that we were hyperpolarized. We were isolated at home, and living with stress, and sometimes turning to things like whether it's binging on TV shows or binging on processed foods or alcohol, but we were trying to self soothe and in many ways that just made our mental health worse. And we didn't have the things that usually fill our cup, like our happy hours, or basketball pickup games and the things that helped keep us in tact before.

So when all of this is happening, and you said, you know, in terms of let's just start with, how did you get into this line of work? And then there's so much here that I want to unfold. But where did your journey start to even have this be something like, Hey, I need I'm passionate, I need to be involved in this.

Yeah, I mean, my journey was a messy trajectory in so many ways that I wish they usually are, right. But to simplify it a bit, I mean, I was an English major who found herself in medical school. So somebody could have saved me a lot of trouble and said, you will end up as a psychiatrist so that I just could have skipped out contemplating should I go into orthopedic medicine or dermatology Now, if you're into the gray areas, and the complexities of the human experience, psychiatry is probably where you belong. But then I was a psychiatrist who was deeply disenchanted with the current state of treatment, I felt like we had so much room for improvement, I wasn't always convinced, by that original principle of do no harm. I wasn't sure I was doing no harm by putting people at a cocktail of medications. But I was very convinced that I wasn't helping them thrive. So from a place of crisis, I sought out other approaches to supporting human health and well being. And that really is my relaunch.

And then you ended up it was it afterwards that you got involved in acupuncture?

Yeah, it was in medical school, actually, and I had never even received acupuncture. But it was one of my earliest intuitive hits was, I need to study acupuncture. And thank goodness I did, because it really revitalized my passion for healing. And it gave me something that felt true. I felt like it was such an aha moment to realize, for so long Eastern modalities of treatment understood that the brain is not separate from the body that every part of us is, in a delicate web interwoven, and that our psycho spiritual health is in a bi directional relationship with our physical health.

What's really interesting is that I had a father who was an orthopedic surgeon, a grandfather, who was an orthopedic surgeon. And so I went, you know, first year in school, college, I might pre med I'm doing this, and then realize, you know, what, it is not for me, this is not what I want. And the only thing that would allow me to still get out of college in four years was to go for psychology. And it really opened up a lot, and I ended up getting in the business world. But it's interesting when you're talking about, you know, we Medicaid, we Medicaid and Medicaid, and I have heard and perhaps, you know, the the real scientific, you know, what's going on there? Why is mid life in terms of, you know, it seems like more and more of the midzone these, you know, people that are anywhere from 35 to 55. Why is this group of people taking more of the antidepressant anxiety, prescriptions than any other group? Or at least that's what I read is a true is that really what's happening and why

it is true. And I feel like I could write an entire book just in response to this one question. But to simplify it a little bit. I think that it is it is a population that is under a unique amount of pressure, and but also uniquely capable of asking for help. And I think that if you even just compare it to a similar age group of men, sometimes they're struggling in the same way, but there isn't as much of cultural permission to admit that something's not right. Maybe there's more of a tendency to suppress or turn to things like alcohol. And it's less comfortable to say, I'm really struggling here. I'm depressed or I'm anxious, and I want to seek out help. And I think that the tricky thing there is that once we've sought out help, what happens how does our system catch us when we've asked for help? And that's where I feel like we have so much room for improvement.

Yeah, it was interesting, because when I was going through massive relaunches, I'm separated and I've got these young kids and I'm running businesses and I'm trying to put it all together I went and did acupuncture. And the fruit was interesting because the first doctor that I went to that I'm like, I'm overwhelmed. Like, I've, you know, things in my life, I've never felt like things were so off skier like, they were like, we're really there's something not right. And the first doctor was like, let me give you this antidepressant. And I'm like, I don't want that. I don't want to take that. And so I saw out acupuncture, I did it, I loved it. I did it for almost six months. And by the end when I was, you know, done with it, I wanted to keep going, right? Because it's so good. And there's that one, I'm like, well, I could do this. And I want to, you know, let's, let's clear this one. And let's do all this other guy loved it. But it's interesting. So are you saying that more? Do you believe that women are more apt to have mental health issues? Or is it that women are more apt to talk about it?

I think it's actually both. And I think that, you know, to your point that you went and you said, Hey, I'm I'm overwhelmed. And what's on offer is medication. And I think that that's such an interesting problem and a predicament that we've gotten ourselves into, where it relates to even managed care. And the fact that we're now at a point where, when we go to see a provider, the part that's been squeezed out of that patient practitioner connection, and relationship is time. And so you know, I don't even know where to place the blame. But it's not the patient's fault. It's not really even the practitioners fault. They have maybe eight minutes with a patient, the patient says, I'm overwhelmed, I'm depressed, I'm anxious. They're starting to cry in your office, and you just think I really want to help this person. But what can I possibly accomplish in eight minutes, we can't even get to the full story, we can't let them feel heard or witnessed. We can't understand the root causes of their mental health issues. Pretty much all we can accomplish in that time is to write them a prescription and hope that that's the right fit for the ways that they're suffering.

Oh, that just like, breaks my heart when I hear that, because, you know, there's so many, there's so many different ways that we could be working through this. What is the difference? If you're feeling like you are, like I was overwhelmed, stressed anxiety, you know, feeling like every single corner, there's yet another relaunch. The difference between going to a psychologist and a psychiatrist, I think people get that confused a lot of times,

yes. And I think if we could run the whole thing backwards, we would probably give them much more distinguished names, because there is a big difference. But the names are almost they seem interchangeable. So a psychologist or a therapist is someone who's not going to prescribe medication, but they're usually going to be trained in a particular discipline of psychotherapy. And you're basically going to be going for some form of talk therapy, whether it's cognitive behavioral therapy, or internal family systems or more psychodynamic psychotherapy, or there's a number of others. A psychiatrist, on the other hand, this is a practitioner who went to medical school and psychiatry residency. And what distinguishes us is that we do, we wheeled to the prescription pad, and we can write a prescription for psychiatric medication. We're also thinking about your mental health with a little bit more of an eye towards possible medical issues that can play a role. For example, we're trained to think is it depression, or is it hypothyroidism. But importantly, because we did so much training to become physicians, I would argue we did most of us less training to become therapists. And so sometimes we have shorter visits, they might have a little bit less of that tendency to go into depth and less focused on talk therapy, a little bit more focused on medication management.

So there's a big thing going on at the school systems and universities and I, again, read an article about kids getting prescribed Adderall. And it's kind of this you know, oh, you're really you've got ADHD or you've got some form, you know, we need to give you Adderall help you focus, they'll help you focus. Is that Is that are you seeing that that's being prescribed more these days than it was? Or are we just through the media hearing more about it?

It is being prescribed more and I don't know whether or not this is apocryphal but I once heard that part of the naming for the brand name of this of this stimulant is add for all almost as a marketing approach to make sure that everyone feels like this applies to them. And I want it'd be really careful to follow that statement. The fact that I am a psychiatrist, I'm overwhelmingly convinced of true blue neuro divergence, and true blue ADHD and ADD this exists in our population. I also think that we are a bit quick to diagnose it and prescribe medication. But for me, what's more interesting is that even when we're talking about True Blue ADHD, that is on the rise. And so what's happening there, because our genes don't change in a course of a matter of decades, it they change slowly, over long, sweeping periods of time. So this clearly has where there's a genetic predisposition, the environmental influences are playing a role. And I actually consider that to be hopeful. Because there's something we can do about that, even if we can't change our genetic predispositions for mental illnesses.

So with that said, you know, if we've got kids that are, you know, they seem depressed, they seem like they are, you know, more anxious than they normally are. What do you recommend? What is the, you know, is, what's the next step for people because I know that the, what I'm, and I'm also reading this and getting ready to talk to you, i real i realized that, oh, my gosh, we talk about real launches that are going on with, you know, men and women in 30s 40s 50s 60s. And above. But it's the 20 somethings that are also really struggling. And so what are you recommending in terms of because yeah, I think we're the quick fix generations now. Right? We just want to just, I don't want to talk about it. Just tell me what I can take to help me feel better. And I know that that's something that you know, you're seeing a lot and you've got some thoughts around that. Can you share with us? What What should we do or parents are listening, and we're trying to figure out like, what, what do we do?

Yeah, and I would say, you know, if the quick fix really were effective, and didn't come with a host of side effects, or withdrawal effects, I would be on board with it. I don't think there's anything morally wrong with a quick fix, we actually just don't happen to have perfectly efficacious quick fixes. So it's a bigger conversation. But I agree that the 20 Somethings the young people, they are struggling most of all these days. And let's say we had a teenager with depression, anxiety, ADHD, there's probably a genetic predisposition. But as we say, in functional medicine, the genes loads the gun, but the environment pulls the trigger. So I'm always going to do some sleuthing and try to understand what are the environmental influences that are contributing to these symptoms, sleep is a really important place to start looking, because we know on a population wide level we are sleeping less than we used to we're chronically sleep deprived. It has to do with our devices, the blue spectrum light of modern life, how addictive it is to doom scroll, and and our social media apps that make us stay awake later than we otherwise would. And with a child, you even I look at things like breathing, are they mouth breathing, or nose breathing while they sleep at night, it's preferable to breathe through the nose, that allows for more restful and restorative sleep so that they can focus and have a clearer mind, better attention, but also brighter outlook and more resilience during the day. But these days, we have an increasing amount.

Before before you continue. How can you if you notice your child is a mouth breather? How do you how do you change that?

Yeah, so their nose breather? It's a there are ways to change it. And a lot of it starts with why are they breathing through the mouth. And it could be a lot of reasons. It can even be things like a dust mite allergy or dairy intolerance, but often has to do with facial structure. And that has to do with our soft diets processed food, mouth breathing itself contributes to facial structure that that is conducive to mouth breathing. So something as simple as a little bit of surgical tape placed vertically over the mouth can start to help train someone to breathe through the nose.

So when you're saying face structure, you're what exactly is that?

We're experiencing a narrowing of the palate. And so then it's harder for oxygen to travel up through the nasal airways. And so what we need to do is actually change our facial structure. There are certain kinds of physical therapists and dentists who can support that also some orthodontists so there are things we can do, it's actually easier to change in childhood.

That's really interesting. One of the things you said was about the blue spectrum light. What about having your phone next to you when you're sleeping? What is what what are the what are the pitfalls there? How is that helping me not sleep as well.

So the blue light that the screen emits suppresses our melatonin, it makes it harder for us To get sleepy, but also the fact that it's so engineers ingeniously designed to make us scroll endlessly, and to doom scroll, so we feel surrounded by threat and danger, and we don't feel safe to surrender into sleep. So my recommendation is to not even bring the phone into the bedroom.

So interesting. So about I'd say, probably two or three years ago, I decided, because between my husband II and my phone that were lighting up the room, and I'm one of those weird people, that it ends up you know, I sleep kind of with my eyes slit open a little. Before we go into this massively important story to the blue light and sleep, we do have to take a quick break. So when we come back, we're going to hear more about what you can do to have a better night sleep. This episode is brought to you by my very own labor of love my most recent book relaunch. This book is a collection of my stories, other stories and is a motivational guide to living a new three h q lifestyle, sparking your heart to ignite your life. It's available for purchase via Amazon, get ready to try on the three HQ method that I've been using for years throughout my entire life. Reaching the next level in all areas, both professionally and personally. Get your copy today at www dot the relaunch book.com. Welcome back. And I am here with Dr. Ellen Vora we are right now talking about what's really happening with mental health, but also how this affects your sleep, how it affects your life, how it affects your relationships, and how it will affect if you don't do certain things. It can, it can actually impede you from the things that you're really wanting, especially as we're going into goal setting and 2023. And what we're trying to achieve. So before we took the break, I was mentioning the fact that I sleep with my eyes open isolated, they're not like wide open. I'm not like weird, weird person. But my eyes are definitely like cracked a bit. And I'm not going to say which one of my children has this. But you know, she's listening. She knows she too has it. And so when I have a phone, or some device or my husband's phone, and we have it in the room, and there's any type of light, I immediately wake up. So a few years ago, I decided I'm going to get yes, you're hearing this right, I'm gonna get eye patches. And I'm gonna start to sleep with these eye patches. So you know, yeah, it's really I feel like I'm back girl, you know. But the thing is, it worked. Like it's incredible. The sleep that I'm having, like, I don't think I mean, it's a game changer for me. It really is. So Dr. Ellen, what about I knew what you were talking about that blue light? What what is it about that light? That that really causes us to be like, I can't sleep I gotta grab my phone. I need to but yeah, as you said, which I which I love the whole do my notes that I need more? What am I missing? So what is that? What is it about that that kind of makes us go crazy?

Yeah, so our circadian rhythm our sleep wake cycle is cued by a number of different things activity level temperature when we eat food, but primarily the lion's share. It's cued by light. And this is actually a brilliant design, because on that proverbial Savanna of evolution, it was by definition light out during the day, and by just finish and dark out at night, and that orchestrates our hormonal Millia. Whether we're in cortisol state during the day, we can feel awake and alert, or that we secrete melatonin at night, which helps us feel sleepy. And in modern life, the script has flipped. We're indoors during the day and then at night, we're doomed scrolling, and our brain is getting these mixed messages. Thanks. Why sure I'm tired. I've been awake for a long time. It's probably bedtime. We pull out our son our phone, and it might as well be as though it's saying to the brain, good morning, the sun is rising, and it suppresses melatonin so one of the best things we can do to support sleep is to get very strategic about our light cues. And that starts first thing in the morning, making sure we get actual sunshine into our actual eyeballs. That starts the clock. People call it a circadian walk. It's not through sunglasses, it's not through a car windshield. It's the real thing. And then after sunset through

a window or do we have to be outside it actually

has to be outside to really be white have a Mmm, all of these will decrease the way the wavelengths of light are getting into our eyes into a part of our brain called the suprachiasmatic nucleus. So it has to be the real thing. And importantly, if you wear glasses that have a blue lens filter, like for screens, you want to take the glasses off for a moment and let the real sun get into your eyes. But then what happens?

Now I finally get why, you know, in in cities that have a lot of rain, we always hear about, you know, higher levels of depression, because what you're recommending is, and I live in Boulder, Colorado, you're recommending, Hey, wake up, and if there is sun rising, go out. And just, is it okay, if we close our eyes and not look directly at the sun, but just close our eyes and let that let those those rays at least hit your body?

Yes, importantly, you want to sort of look in the general direction of the sun blink a little bit, squint a little bit, you don't need to be you certainly don't want to be hurting your eyes and staring directly at the sun. But you do want to be taking in that morning sunlight. And if it's overcast or rainy, you need even more time outside in the morning. And then what happens after sunset is also critically important. And we used to be surrounded by moonlight and fire. And these days, it's the psychedelic light show of modern life. We have ambient light pollution and screens and overhead lighting. So there are a couple options here to protect the circadian rhythm, you're welcome to throw your phone into the ocean and move off the grid and raise chickens and homestead that's a great solution. Short of that I think blue blocking glasses are a pretty good harm reduction strategy. And it can block some of that blue spectrum light and then you're not suppressing your melatonin quite so potently.

And so you're recommending we wear these blue blocker glasses, as we are working on computer

throughout the day, most of all, sunset until bedtime. Oh,

interesting. I was gonna say it's going to be a little difficult given that you know, even this show is a live show. But we are on video if I'm wearing my my very fancy blue blocker glasses. And I was also laughing when you were telling the story about you know Delic directly. It's like a medical warning, don't look directly into the sun. And so you remember when you were young and the Eclipse, and you would make the cups and the teacher always said, but don't look, and there will always be the wise guy that I looked. I looked I looked. So I want to moving into you mentioned at the very beginning about burnout. And that this has reached this all time high, and that we really are a generation of just we're exhausted, we're burned out. What are you recommending to your patients? And what are you seeing that actually works in regards to not getting to that place of burnout?

Yeah, so there are some pipe dream wishes like that we had better work life boundaries that we weren't always in positions that were understaffed and boundary lists, and we were working all the time. These are nice things to work towards saying less doing less or saying no and doing less. But what I find is a really effective intermediate strategy is to focus on the foundational aspects of our physiology. It's things like getting enough sleep, nourishing our bodies, and moving our bodies and having some connection with nature. When we do this, then at least our physiology helps us be resilient in the face of our stressors. And when we're not doing this, our own physical body becomes one more stressor, one more source of burnout in our lives. So I actually like to focus on the physical body first, and that's foundational, and then we can handle the stresses when it comes to burnout. I think it's also critically important just to recognize, we're living in the attention economy, which means our attention is the commodity being competed for by smart companies. They've done their homework, they know behavioral psychology, and they prey on our fear response and instill uncertainty and doubt and controversy, which makes us rubber neck and we give an increasingly large share of our attention. They get more clicks, more ad revenue, but our mental health and our burnout is the collateral damage. So it behooves us to navigate the information landscape eyes wide open consciously self lovingly, and make sure that we're not just handing our attention over to every shiny fear mongering sensationalized headline.

That is so powerful because there was so much there. When you talk about physical body and we've discussed sleep. What are you recommending people? You know, what, what should they be doing? How many times a week how long to really help our mental health?

Yeah, I think people should be sleeping seven times a week. But I think that with sleep, I think it's earlier bedtime. is getting a little more conscious around the effects of caffeine and alcohol are asleep called her bedroom being strategic about light with movement. It's really, I'm a realist about this, we could talk about what's optimal, but I think much more effective is to talk about how do we make it realistic. And that's where I think we need to lower our standards around exercise, and just figure out what small thing can we do? Can we take a walk after dinner? Can we put on Whitney Houston and dance in our living room for a couple minutes, it's whatever is truly achievable and sustainable. With nourishment. It's its own delicate balance, where we need to use food from a place of self love as an opportunity to nourish our bodies and brains give us the nutrients that we need without creating inflammation and blood sugar swings. So it's a delicate balance to strike. Well, first off,

ya had me with the whole Whitney Houston dance. I mean, right there. That's, that's my my love. That's my love workout right there. But as you said about food, are there because there's so many different diets, and I've had many discussions about this, but are there are there foods that actually help give us brain power that help reverse all of the, you know, the what we're what we're doing to it with, you know, the, as you said, all the distractions and this, this economy of just you know, what's next thing you know that, is there something is there something you recommend that we make sure we're having in our diet?

Well, I love answering that question and going off on things like bone broth or chicken liver pate, which I think is Mother Nature's multivitamin. There's so many foods that are nutrient dense, but really we gala liver

pate, wow. That's a big one.

Not everyone's favorite go to but it is so nutrient dense, doesn't take a lot. But I think it's important to pan out and just to recognize, the food we need is the one that has the nutrients we haven't typically been getting. So we need a balance, we need to I think of it like a nutritional scavenger hunt, we need to check a lot of different boxes. So I prefer a broader prescription of generally err on the side of eating real food, avoiding fake food, trying to eat a balanced eat a lot like the way our great, great, great, great grandmother tried to eat. And I'm always with an eye towards nutrient density, but also just an awareness that our body will communicate to us when it needs, we just have to discern is it telling us a craving for real food or for a drug like food. And if it's telling us I need a juicy steak, or I need a pile of mashed potatoes, that's probably a craving for real food. It's something our body needs. If it's like, you know, what I need right now is some pizza. It's probably a drug craving. And so we just need to discern the difference. And then follow those cravings, because they'll guide us towards the nutrients that we need.

I love when you said the great, great, great. So my grandmother always had a See's Candy at 10am in the morning, every day of her life. And I'm like, I could do that too much should I? So when we are looking at, you know this concept that you can actively get more sleep, you can you give us some great tip there, we can eat better, we can exercise based on you know, just even the movement of our body. And we go ahead, we do that. And what happens when we're really exercising because I again, I read something that said that when we exercise sometimes by exercising, it releases something in our body that actually makes you feel less depressed or anxious. It actually like there's something that's going on. Can you explain that? Yeah,

when we exercise, we release endorphins, it changes our serotonin neurotransmission it increases the drive for sleep. So we sleep more deeply at night. I actually just think of this as through human evolution, we had no choice but to be active. So we're we're built and optimized to have that be part of of how everything cycles in our body. It also importantly, regulates how our body metabolizes glucose, which is itself an independent issue when it comes to risk for dementia, diabetes, obesity and all of the mental health issues.

So I want to ask you in regards because a lot of people now are taking they're taking something to get to sleep, whether it's Ambien, whether it's like I don't even know what like a sleeping Z or whatever they're called something. They're terrible or whether it's marijuana, whatever it is, what does this do to your sleep? What do or is it bad for you to take? those things because sometimes you know when I go on vacation and we're traveling international Ambien works like a charm, but is that what's it doing to me?

Yeah, so almost want to decouple jetlag from the day in day out getting to sleep. And for the day in day out these sleep aids, prescription sleep aids like Ambien or Lunesta, or the benzodiazepines, like Klonopin or Xanax, they actually uniformly are problematic. And part of the issue is that they increase our risk for dementia. They they increase all cause mortality. But there is also just the fact that while they help us not feel conscious, they don't actually create healthy sleep architecture. So that's not real sleep. It's not truly rejuvenating and restful. And they also are quite habit forming. And so there can be for some people difficulty getting off of them. When it comes to jetlag. It's such a one off issue that I think it's worth supporting that but I prefer melatonin as a way of telling the brain now it's bedtime. And then in general, for most of my patients, I like them to supplement with something like magnesium glycinate, which is supportive of sleep, it also helps with anxiety and headaches, and menstrual cramps and a whole host of other issues. But without any dark side, it does have a problematic

magnesium glycinate. Can we take that daily?

Or can we can?

And so you just would add that is it a pot powder that you would just add to your food? Yeah, there's

a lot of formulations, you could take it as a powder or a tablet or capsule and take it at bedtime. And you can work with your doctor about what the right dose is for you. But there's a pretty wide margin of error and you figure out what is relaxing without causing loose stool is usually a good dose for somebody.

Okay, so we do have to go on a break. But here's a question I want to just throw out. We have all heard, there is an uprise and uptick in hallucinogenic type of therapy. And I want to go there and see does it work. So we'll touch on that when we come back. This episode is brought to you by my very own labor of love my most recent book relaunch. This book is a collection of my stories, other stories and is a motivational guide to living a new three h q lifestyle, sparking your heart to ignite your life. It's available for purchase via Amazon, get ready to try on the three h q method that I've been using for years throughout my entire life reaching the next level in all areas, both professionally and personally. Get your copy today at www dot the relaunch book.com Welcome back and we are talking to Dr. Ellen Vora. And we're gonna go there, we're gonna go to the place where we've all heard about hallucinogenic type of therapy. We've heard about drugs to help us, you know, the marijuana and different types of drugs to help us sleep better help us relax. And so, Dr. Allen, I want to know what is what's really going on here. Why has this all of a sudden, people are really leaning into even like the calamine and I mean, there's so many different types of drug therapies that are no longer just that prescription from pharmaceuticals, help us understand and which ones work?

Yeah. So in many ways, this starts from a place where my field of psychiatry is in crisis. We've known now for a while that for some people, our treatments are effective, but for many millions of people, they're not getting adequate relief of their symptoms with the conventional treatments. And this is perhaps most disturbingly true with our PTSD population. And we just don't have effective treatments. So from this place of crisis, we've, we've sought a new approach to treatment using psychedelic substances like psilocybin, ketamine, MDMA, and these are actually very promising lines of treatment. And of course, the caveats apply. They're not for everyone they are sometimes contra indicated they are sometimes even if they're indicated, you have to be intentional about preparation around the set and setting about how you're facilitating work with these medicines and then integration afterward. So there's a lot that goes into making these safe and effective. It's not a silver bullet, of course, nothing is ever going to be but they are we have enough data to suggest that they're very promising new line of treatment and so it's reason to keep studying them and just start making them accessible to people that need relief from their symptoms. I love the ways that they're effective. I think it's a really interesting, it sheds light on mental health. Both in general, because part of how they're effective rhymes with our current treatments, they're active on our serotonin receptors. They also help with neurogenesis or they allow us to grow and change and adapt. And that can be very helpful. But there's an interesting dimension,

hold on to how they actually help us grow. And then we'll go into the early, early part, but how do they how do they help us grow?

So we have a lot of data on ketamine, for example, and how it can help us secrete a substance called BDNF, which stands for brain derived neurotrophic factor, which promotes neurogenesis and neuroplasticity, which are sciency terms for basically saying you have a window of time after ketamine treatment, when the brain is more likely able to take on new pathways make new synaptic connections, people liken it to shaking up a snow globe. It's like the dust can settle in a different way. And so what I find most exciting about why these treatments seem to be effective is something called the mystical experience hypothesis, which shows us that the degree to which someone has a mystical experience in ceremony is actually correlative with the antidepressant effect. And that's very interesting, because it's completely different from our current treatments, our current treatments are not working by inspiring a framework, or a new framing of something with a state of awe or connection. They're working on a very biochemical basis. But these medicines seem to work biochemically and in terms of reframing, and I find that that's really compelling. My colleague will sue puts it best, he says, These are not just tools for healing trauma, they're agents for making spirituality palatable to our starving Western world.

That's really good. So people might be listening, saying, Alright, interesting. Like, how could this help me? I'm, I'm not depressed? I'm not, you know, overly anxious, but I do. You know, I'd love to have that secondary result from it. Right? Are you seeing people want to take this for other reasons? And can you get the same results without medical supervision. So

there's, there are a lot of different movements within the psychedelic movement. Right now, as a psychiatrist, I'm very focused on how these might be indicated for mental health issues. There are certainly movements happening right now, which are more focused on taking people that are already well, but helping them achieve a greater sense of fulfillment or purpose in their lives or just feeling more connected. And so I don't really think there's anything inherently wrong with that. I always want these medicines to be treated not only with caution, and done with quite a bit of care and preparation and integration, but also approached with reference. And I think it's important to just give them the respect that they're due. There's a lot of history of tradition and indigenous populations working with these medicines as more of a religious practice. And I just want us to maintain that, that sacredness and reverence as we approach them. But I think that as long as someone's doing this safely, and I think it's really important to emphasize integration, because we can go and have a big experience and think, wow, okay, this changed my life. But that effect can fade quickly, if we're not showing up whether it's with journaling, or in therapy or with an integration coach, and really galvanizing the learnings and helping integrate them into our daily lives. That's, I think, where it starts to move the needle.

Who would you if you want to go and explore this more? Are there different types of do psychologists do this? Or is this just psychiatrists? So there's

a lot of different ways to approach this in the United States. Currently, ketamine is mainly our legal psychedelic, and there are treatment centers where you can do an IV ketamine infusion, or for some people I am or, which is like an intramuscular, injection or even taking it orally. Sometimes it's with a psychiatrist, sometimes it's an anesthesiologist administering it. And then there are places around the world where psychedelics like psilocybin, or Ayahuasca are illegal. It's places like Brazil, Peru, Costa Rica, Jamaica, the Netherlands. So there are ways to do this above board and legally, which I think is generally recommended just to make sure that this is someplace that's really taking a lot of precaution.

So let's talk about micro dosing. What is it? Is it effective? Is it is it something that you recommend or not?

So, I think it's very tempting to want to say okay, the Lexapro isn't helping me. Let's keep that same framework, but switch over to psilocybin and the active ingredient magic mushrooms. So I think it's very tempting to say my new antidepressant will be mushrooms and take it daily and a small dose like that. What I have observed in my practice is that macro dosing, or the occasional periodic bigger ceremony with a larger dose seems to have a bigger impact on someone's overall baseline of depression than daily micro dosing. But I've certainly had patients benefit from micro dosing, I don't think there's anything inherently wrong with it. But I've found, I usually point people towards periodic macro dosing just for a bigger impact.

And that would be with medical supervision. Exactly. Okay. And then what about all of these different levels of marijuana with, you know, you get like higher levels of certain, you know, THC, CBD sativa, I mean, all these different what, what is your recommendation there? Because it's so interesting over time, we have things illegal, then there are legal, that's like, you know, for us that, you know, grew up in the 70s. We heard, you know, don't go there. It's so bad. It's so bad. It's so bad. And now it's like, hey, it's not bad. It's not bad. It's not bad, everyone should be doing it. And so what exactly are the benefits? And it sure seems like a tremendous, tremendous amount of people are really leaning into this now.

So when it comes to cannabis, I really look to the herbalist perspective, which is it's not that any given substance is inherently good. And then more is always better. It can be good medicine, it can be bad medicine, it depends on the alchemy with that person and the indication. I've had patients for whom it's a less harmful alternative to taking an NSAID for period cramps or taking a sleeping aid or a benzodiazepine for anxiety. I've also had patients for whom they get into habit of daily use. And I think it actually takes them out of their lives and makes them not as engaged, not as productive, not as happy. And I think that these days, what we're looking at is these strains that are so potent, and it's nothing like the cannabis that was being passed around in a joint in the 1960s, or 70s. It's very potent. And I'm especially concerned about younger brains ingesting high levels of this very potent cannabis strains. I think that it comes with a risk of psychosis. And I think that you'd want to wait until you're older than, say 19. And I generally think it can be good medicine, but I've never had a patient who's using it daily, where I thought it wasn't creating some degree of harm.

So you have written the anatomy of anxiety. And this book really walks through some of the things that you can do, what are the tips that really we could pull from the book right now that today we could start to

incorporate the central thesis is that we should think of anxiety as two types of anxiety, what I call false anxiety, which is physical anxiety, it's based in the body and it's avoidable. And within that, it's really helpful to identify all these aspects of modern life that are tipping our physiology out of balance, generating a stress response. And then we experienced that subjectively as anxiety, whether that's a blood sugar crash, or sleep deprivation, or sensitivity to caffeine, a hangover, inflammation, GI distress, all of these are creating a lot of unnecessary suffering. Then I also explore true anxiety, which is purposeful anxiety. It's not something to pathologize it's not something to suppress. It's not what's wrong with us, it's actually what's right with us when we are viscerally connected to what's wrong in the world around us. So to actually have our true anxiety be something that we slow down and listen to and honor and translate that anxious feeling into purposeful action, then we don't feel quite so mired in that anxious feeling. We feel imbued with purpose.

That's so good. So as we wrap, how can people get in touch with you and hear more about what you're doing these days? I'm

fairly active. Over on Instagram. I'm at Ellen vora, MD. and my website is Ellen faora.com.

Wow, that's so good. Well, you've given us so much to think about today, so many nuances and I love the key takeaways I love when you can sit there and it's not like you know, you got to go do these crazy things very or keep it very simple. You just sit you know, you're really got to be focused, you got to be aware, and you've given us some really great places that we can go we can try if we're ready to do something in the alternative space as well. So really informative. Thank you, Dan. Thank you Dr. Helen for being here today. And for for sharing this and for writing that book on the anatomy of anxiety, because it is so prevalent today and people need to realize that, you know, it's not it's not a bad thing, right? I think that too many people think so. If you were to give, you know, kind of a last message to our listeners, what would you say?

I think if you had to prioritize only one thing above all else, it's actually connecting with community. And I think as human beings we're hardwired for humanity. we're social creatures. When we feel held in community, we feel safe. When we feel isolated and disconnected on some level to our DNA, it feels like it's a matter of life or death. So that's worth prioritizing above everything else. And, and I think that you even have my permission to have a later bedtime or eat the wrong foods or just as long as we are prioritizing, connecting with the people that we love.

Connecting seem to always, you know, make us feel better. The problem is, is that so many times we recoil, right? I don't feel good, I don't want to talk to anybody. And you gotta you gotta go against it, do a relaunch flip, as we call it, and figure out you know, I want to get out our I want to be in a better state of mind. So that was really terrific. Thank you again, so much. We're going to be back next week. And we continue to observe and Notice and share re launch stories that have truly impacted the outcome of what people are doing. So bye for now, relaunch, re launch right now. Make it today, and live now. Love now. Thanks again, everyone. See you next time.