Stress Reduction, Anxiety and Burnout: Moving from Survive to Thrive
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Transcript of Stress Reduction, Anxiety and Burnout: Moving from Survive to Thrive
Stress. Anxiety. Burnout.
Moving From Survive to Thrive!
Dr. Erin Wiley NDNaturopathic Doctor
Clinic DirectorIntegrative Health Institute
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Why?
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Let’s Talk About Stress
• Stress can make us feel sick– Headaches, inflammation, muscle pain and tension,
indigestion, acid reflux, acne, PMS. fatigue
• Stress can affect our mood– Anger, frustration, poor concentration, loss of focus,
addiction to coffee, alcohol, drugs and medications
• Stress causes disease– Diabetes, heart disease, cancer, arthritis, anxiety
and depression
• Stress can kill
© Integrative Health Institute 2010
What we will cover
• Introduction to Your Endocrine System• The Contributors to Anxiety, Stress and Burnout• How to Build Healthy Hormone Balance• Case Studies - Connecting With Experience
What is Hormone Balance
• Relationship between the Endocrine System and the Nervous System
• Symphony• Feedback loops and dynamic
relationships• Instructing every cell in the body
what to do and when to do it
Endocrine System
Symphony
Circadian Rhythm
The Stress Response
Hans Selye
Feed Back
Hormones act at a Cellular Level
Just because something is common does not make it
normal !
Symptoms of Hormone Imbalance
• Fatigue or an inability to concentrate
• Weight Gain • An inability to loose
weight despite exercise• Headaches and
Migraines• Night sweats• Early Menopause or
Andropause• Infertility• Decreased libido
• Irregular Periods• Painful periods• Moods Swings• Anger Irritability• Heart palpitations• Acne• Anxiety and panic• Insomnia• Depression
Stress. Anxiety. Burnout
• Chronic stress disrupts your endocrine system
• Overtime your system can burn out
• This leads to the symptoms of anxiety, overwhelm and exhaustion
What brings our body out of balance?
Contributors to Anxiety and Depression
• Stress• Chemicals and Toxins• Sugar• Inflammation• Body Fat
Stress
• Stressor: anything the body has to adapt to• Cortisol • Where the mind goes the body will follow• The relaxation response• Deep breathing, living in the moment, yoga,
meditation, exercise, sleep• Training your mind ex: Olympic Athletes
Chemicals and Toxins
• Chemicals and toxins disrupt our hormone balance
• Found in our foods as preservatives, dies, artificial flavor, growth hormone, heavy metals, and pesticides.
• Found in our cosmetics as dyes, fragrance and preservatives.
• www.ewg.org
Sugar
• What does it mean to spike your blood sugar?
• The average Canadian consumes 23.1 Kg of sugar per year
• Insulin cycle• 2-3 pm crash
Inflammation
• Inflammation is an immune response• Creating the conditions of inflammation in the
contribute to diseases associated with inflammation
• Ex: – Food sensitivities– Menstrual pain– Chronic muscle and joint pain– Is a state of hormone imbalance itself!
• When we are inflamed we can’t lose weight!
Inflammation and Anxiety
• Inflammation causes dopamine levels to rise which can lead to insomnia, and feelings of anxiety and agitation
Body Composition
• Ratio of body fat to lean body mass
• Fat cells produce chemical messengers (adipokines) that promote inflammation, insulin resistance, dyslipidemia, hypertension and other negative health consequences.
• Visceral Adiposity
A Vicious Cycle
• Stress - Cortisol• Visceral adiposity- Adipokines• Inflammation - Prostaglandins• Blood sugar - Insulin• All signal the body to store body
fat and burn muscle mass
How to Build Healthy Hormone Balance
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Nutrition Take Home Message
• Balance Blood Sugar–Reduce insulin and cortisol
• Repair the damage–Anti-oxidants fight oxidative stress
The Trouble with Sugar
• Insulin– Promotes the storage
of body fat– “Hibernation hormone”– Makes you feel
sluggish– The more
carbohydrates you eat, the more insulin you make
– Cause type 2 diabetes
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Understanding Insulin Once sugar enters bloodstream
• Pancreas releases insulin• Insulin transports sugar (glucose) into cells• Relative secretion (more sugar=more insulin)
Once absorbed sugar can go 3 ways;1.Immediate use as fuel2.Stored as glycogen in muscle or liver3.Stored as fat*
Insulin stimulates appetite byBlocking hormone Leptin (supresses appetite)Causing spike in dopamine (reward seeking signal)
– Eat to get pleasurable rush!
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Food Fact
Did you know: prior to the last century, refined
sugar and trans fat were practically absent from
the human diet
Sugar
The average Canadian consumes 23.1
Kg of sugar per year
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Where is Sugar found in our diet?
• Cereal
• White bread, bagels, buns, pizza crust
• Pasta, fries, rice
• Sports drinks, pop, juice, coffee (latte)
• Candy, chocolate
• Processed foods
How Much Insulin Have You Made Today?
Cortisol
• Stress/steroid Hormone– Increases blood sugar– Causes central fat
deposition– Leads to insomnia– Causes type 2 diabetes– Water retention– Decreased bone
formation– Immune suppression
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Nutrition to Reduce Insulin and Calm Cortisol
• Protein and Healthy Fats• Whole Grains and the Glycemic
Index
Protein
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Protein
• Amino acid building blocks for your muscles
• Regulates blood sugar and makes you feel full
• Make weight loss easy!• Protein is used daily for building, repair,
and energy Dose= 1-1.5g/kg body weight/day
Healthy Fats
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Make healthy..
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And Healthy skin!
Healthy Fats• Eat fat burn fat!• Fat-free means chemical compensation• Fat makes you full and satisfied • Without fat, your brain, your hormones, and
your compensation mechanisms for stress will be compromised
Dose: • Cold Water Fish x2-3 weekly• 2 tbsp extra-virgin olive oil daily• Fish Oils daily 3,000mg EPA/DHA• ½ med avocado x3 weekly
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Oxidative Stress
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Anti Oxidants at Work
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Berries!
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Antioxidants
1. Blackberries2. Walnuts3. Strawberries4. Artichokes5. Cranberries6. Raspberries7. Blueberries
From: World’s Healthiest Foods Top 7 list
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Case Study - Endocrine Stress
• Breakfast - Coffee (low energy)• Lunch - 1pm• Energy Crash - 3pm• Sugar Craving - Craving
carbohydrates• Energy Crash • Dinner - over eating late at night
Case Study - Anxiety
• Skip breakfast (no time, did not sleep well)• Muffin and Coffee (feel great, cortisol up)• Anxiety sets in, need to eat candy all day at desk to
maintain focus• Can’t drink water (will have to pee)• Lunch no appetite, want a nap but to anxious to sleep• At home starving = fast food, crash on the couch
exhausted and can’t imagine exercising• 10pm: 2nd wind, get work done, but then can’t fall
asleep• Perhaps some wine? Sleeping pills?
Case Study - Is this healthy?
• Breakfast - Oatmeal (at your desk at work)
• Lunch - Sandwich and fruit• Energy Crash - cookies and diet coke• Dinner - Chicken, rice, salad
• Ratio Carbs 9: Protein 2: Healthy fat 1:Veggies 2
What does that look like?• Divide your plate into 3 sections:
50% is vegetables25% is mixed whole grains or starch25% is protein source – poultry, fish,
beans, soy products
Protein
Whole grains
Veggies
Healthy hormone balance starts with breakfast
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Snacks
• Cottage cheese• Hummus and veggies• Nuts and seeds• Raw Brownie• Protein energy balls• Apple and almond butter
Lunch
• Chicken Salad• Split pea soup• Quinoa salad• Bean salad• Kale salad with goat cheese
Dinner
• Veggies, meat, and whole grains or beans and legumes
• Broccoli, coconut chicken and 1/2 cup brown rice
Sample Menu
• Breakfast - Protein smoothie• Snack - Hummus and veggies• Lunch - Cobb salad (hardboiled egg)• Snack - Raw brownie• Dinner - Talapia, kale salad, baked
sweet potato• Carbs 3: Protein 5: Healthy Fat 4:
Veggies 8
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Brain Gut Connection
• Eliminate food sensitivities– Most common presentation: gluten, dairy,
soy, eggs, sugar– Characterized by an IgG mediated immune
response– Leading to dysbiosis and in imbalance in
healthy flora that modifies the Th1/Th2 response
• Food sensitivities cause systemic low grade inflammation
Clinical Nutrition
• Fish Oil: EPA and DHA– Omega 3 fatty acids are anti-
inflammatory– DHA structural component of the brain– EPA the primary anti-inflammatory
omega 3 fatty acid in the brain– When omega 3 fatty acid levels are low
in the brain increased neuro-inflammation occurs
Fish Oil• Key points:
– Therapeutic dose for inflammation: greater than 2 grams (2000mg/day) of EPA
– Therapeutic dose for improved mood: No less than 1000mg of EPA per day. Ratio: significantly more EPA than DHA (6:1)
– Outstanding safety profile!!!!– Can we get enough from diet?– What about flax oil?
Probiotics
• It is well established that probiotics decrease inflammation
• But what about the brain GUT connection?
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Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the
vagus nerve.
• In mice: Lactobacillus Rhamnosus reduced inflammatory markers, lowered corticosteroid hormone release, and elevated GABA
• A direct effect on neurotransmittersProc Natl Acad Sci U S A. 2011 Sep 20;108(38):16050-5. Epub 2011 Aug 29.
Exercise• Research has shown that exercise is an
effective treatment for anxiety and mild to moderate depression.
• Japan “shinrin-yoku” meaning forest bathing - Dr. Marc Berman Journal of Affective Disorder
• Dr. Mike Evans: 23 1/2 Hours - What is the single most important thing you can do for your health
Exercise, Inflammation and Stress
Research:• Exercise not only decreased the levels of pro-
inflammatory cytokines IL-6, TNF-a, and C-reactive protein but also simultaneously enhanced the concentrations of anti-inflammatory cytokines IL-4, IL-10 and TGF-b when compared with controls
Lakka TA, et. Al. Effect of exercise training on plasma levels of Creactive protein in healthy subjects: the HERITAGE Family Study. Eur Heart J 2005;26:2018–2025.
Exercise• 20-30 minutes per day• 3-5 days a week• From Walking, Yoga, to Strength
Training• Running for Anxiety• Challenge your intensity• Follow Your Exercise Progression -
Accountability
Detoxification
• Neurotoxic and Hormone Disrupting Chemicals can be found in our environment:– Pesticides, solvents, BPA, Phthalates
• Top strategies:– Quit smoking, clean indoor air quality– Eat Organic– Choose safe cosmetics and cleaning products– www.ewg.org/skindeep
Phase 1 and Phase 11
Type 4: A Healthy Stool
The Stress Response
Caution: Perfection
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Finding Balance
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Stress Reduction
• Mindfulness Meditation• Yoga• Tai Chi• Qi Gong• Prayer
Case Studies
• Alison- social phobia after apartment was sprayed for bed bugs
• Brenda -chronic migraine headaches, anxiety and IBS
• Melanie - Am I 16 again? PMS, acne, and anxiety.
• Cara- it’s summer and I am burnt out?• Diane- Caring for aging parents and
young kids, why am I anxious public speaking?
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Simple Steps in Therapeutic Order
• Eat Breakfast and small frequent meals• Eat vegetables (50%+)• Avoid sugar• Choose whole grains• Move your body daily• Make time for yourself• Go to bed by 10pm
Stages of Change
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Lifestyle Change It takes 45 days to change a habit or incorporate a new one
5 10 15 20 25 30 35 40 45
Opportunity
• An Integrative Approach– Address the root cause, support optimal
body hormonal balance, focus on recovery and repair
– Synergy: Diet, Exercise, Stress Reduction– Anti-inflammatory Supplements: Fish Oil
and Probiotics– Talk to your Naturopathic Doctor about
detoxification, food sensitivity testing, botanical medicines and nutritional supplements
The Beginners Mind - Meditation
• In the beginners mind there are many possibilities, but in the experts mind there are few - Shunryu Suzuki
• This weekend invite an awareness to see things just as they are, fresh and new, as if for the first time. What can you see, learn, and experience new today simply by having the intention of the beginners mind. Imagine going through life seeing the world, as fresh and happy as a child.
© Integrative Health Institute 2010
Integrative Health InstituteDr. Erin Wiley ND
Integrative Health Institute46 Sherbourne St, 2nd Floor
T: 416 260 6038www.integrativehealthinstitute.ca