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Depression as a black dog that comes in and lays down beside you at night

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Trevor King’s interview about his journey with depression – on That Vitamin Summit – is not to be missed if you are depressed, have ever suffered with depression or if you have a loved one or friend with depression. He shares how he feels a sense of complete hopelessness at times:

It descends like a black cloud that makes me almost sort of retreat into myself. And my eyes will know and I don’t want to take the world in. I don’t want to get out of bed at times. Actually, that’s one of the things that … one of the only things that actually helps me, is going to bed and lying down.

Winston Churchill famously described it as this black dog who’d come in and lay beside him at night.

“From the moment my eyes opened in the morning, I am engaged in a battle. I must protect myself with armor against ongoing, negative, intrusive thoughts that flood into my brain, while sending my prefrontal cortex, which is the home of logical thought, the green light to make decisions and take charge of my brain’s limbic system. That is, before the fear center completely spazzes out. I spend more time and energy chasing and maintaining good health than I do in any other aspect of my life. My marriage, family or work. Because I know that everything meaningful and good around me depends on a stable base. And I hope and pray that one day, I don’t have to fight so hard for my sanity.”

He talks about how he is affected by sugar and low blood sugar, and how he’s found some benefits with niacin, chromium, magnesium and tryptophan (when he’s consistent with taking them!).

Trevor actually talks about the GABA interview I did with him a few days earlier and how he’s very interested in what he learned. He is planning to do a trial of GABA to see if it can help him further.

Here is a snippet from my interview on GABA (so do tune in to this interview if you’re new to my work and the targeted amino acids):

GABA is really quite profound. When I had my anxiety, GABA was my lifesaver. It completely turned my life around. Within three days of using GABA, the panic attacks stopped and the anxiety started to go down, and then I had to look for all the other root causes. It worked immediately so I’m a complete believer, just because I’ve experienced it myself. You’ll hear a lot of people say GABA won’t work. It doesn’t cross the blood/brain barrier so it’s not going to have an impact.

We’ve now got research showing that there may be ways that it crosses the blood/brain barrier. We’ve also got research showing that we have GABA receptors in various parts of our body. We’ve got a lot in our muscles, and with low GABA symptoms you’ll have physical tension.

The beautiful thing is it works. It works quickly, and if you have these low GABA symptoms, which is the physical anxiety, which could be panic attacks. It could be stress eating, it could be drinking to calm down. If you are the kind of person who needs wine to wind down at the end of the day, that’s a big sign that you may need GABA. You take the GABA and you just feel this physical tension release from you, you know you’re onto something good.

I just wish I’d known about his struggles with depression at the time of our interview – I would have talked more about tyrosine for dopamine support (for curl up in bed depression) and DPA for endorphin boosting (for low endorphins weepy depression). 

I did discuss gluten and would consider this especially since his daughter has issues with it. I talked about low serotonin and mentioned Lidtke tryptophan.  If someone doesn’t do well on another brand I’d have them trial the Lidtke brand.  I’d also look into SIBO – I have SIBO and rice and grains make me feel flat and low and I see this often with clients.  Finally I’d look into lithium orotate for keeping an even mood. 

Trevor shares these wise words at the end of his interview:

You do find that when you actually bite the bullet and share it with people,

people are very, very understanding. And actually, you’re amazed that many people have been there themselves.

I could not agree more which is why I’ve always shared my journey with anxiety. I appreciate him for being willing to share his story with depression!

If you’re not already registered here is the registration link for That Vitamin Summit

Feel free to post questions or feedback below – and share your story with anxiety or depression if you feel drawn to do so

Anxiety, depression, GABA and cortisol: effects of Lactobacillus ingestion

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We now know that good bacteria or probiotics have the potential to alter brain chemistry and have an impact on anxiety and depression. You may recall my interview with Professor Ted Dinan on a prior Anxiety Summit – Microbes in the gut and psychobiotics as a potential treatment for anxiety and depression. He shared his paper and this definition of Psychobiotics: a novel class of psychotropic.

…we define a psychobiotic as a live organism that, when ingested in adequate amounts, produces a health benefit in patients suffering from psychiatric illness. As a class of probiotic, these bacteria are capable of producing and delivering neuroactive substances such as gamma-aminobutyric acid and serotonin, which act on the brain-gut axis.

Research published by Dinan, Cryan and their teams also found benefits of Lactobacillus rhamnosus on stress, anxiety and depression type behaviors in mice. This is older research (published in 2011) but it’s the first time I’ve shared it on the blog. I talk about this paper in the upcoming Microbiome Medicine 2 Summit so I like to share study excerpts and links to the study.

The write up in Science Daily is a good one – Mind-Altering Microbes: Probiotic Bacteria May Lessen Anxiety and Depression

…mice fed with Lactobacillus rhamnosus JB-1 showed significantly fewer stress, anxiety and depression-related behaviours than those fed with just broth. Moreover, ingestion of the bacteria resulted in significantly lower levels of the stress-induced hormone, corticosterone.

The part that I find fascinating is the effects of Lactobacillus on GABA receptors in the brain (GABA is your main calming neurotransmitter):

The researchers also showed that regular feeding with the Lactobacillus strain caused changes in the expression of receptors for the neurotransmitter GABA in the mouse brain, which is the first time that it has been demonstrated that potential probiotics have a direct effect on brain chemistry in normal situations.

In this paper the authors discuss the vagus nerve and the three-way communication:

…the vagus nerve is the main relay between the microbiome (bacteria in the gut) and the brain. This three way communication system is known as the microbiome-gut-brain axis and these findings highlight the important role of bacteria in the communication between the gut and the brain, and suggest that certain probiotic organisms may prove to be useful adjunct therapies in stress-related psychiatric disorders.

What is even more fascinating is this:

the neurochemical and behavioral effects were not found in vagotomized mice

What does this mean? When the researchers severed the vagus nerve in the test mice – removing the communication between the gut and the brain – they found that the behaviors and stress hormone levels reverted back to the way they had been i.e. the vagotomized mice were more anxious, more stressed, more depressed and had higher corticosterone levels.

You can find the abstract of the paper here: Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve.

What does this mean for you? It means that good bacteria in your diet could well improve your anxiety and depression symptoms and even have an impact on your adrenals and cortisol levels. This could be in the form of a good probiotic and should always include fermented foods like sauerkraut, kimchi, kombucha, yogurt and kefir (if dairy is tolerated), water kefir (if dairy is not tolerated).

Have you observed an improvement in your anxiety and stress levels since adding a probiotic or fermented foods into your diet?

Paleo and grain free diets: anxiety and depression success stories

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I recently reached out to my community to hear your diet-depression or diet-anxiety success stories in anticipation of the new SMILES diet depression trial, published last month and which I covered in a blog post last week. In that post I promised to share some real-life success stories on how diet changed people’s lives for the better!

I also shared that everyone who responded with success stories was following a more “evolved” diet than those who participated in the SMILES trial (the first randomized controlled diet depression study where ONE THIRD of the dietary intervention group saw improvements in their depression symptoms by switching from processed/junk food to real food with no specific dietary restrictions!).

What do I mean by a more evolved diet? Each of them was eating a real foods or traditional non-processed diet that was gluten-free, mostly or all grain-free and various permutations of the Paleo or cave-main diet.

The anxiety and depression success stories

Alice from Cape Town shared this about banting, a Paleo-type dietary approach that does include dairy products and has been popularized in South Africa by Professor Tim Noakes:

Three days after I stopped eating grains, my chronic depression lifted and has never returned (it’s three years later now). I had been a vegetarian most of my life, discovered in my early 50s that I was gluten intolerant, went off grains, started banting (Cape Town craze!) and have never felt better. Gut, mood, bones, energy, skin … all better!

Andrea shared this about her diet-mood results, also with a grain-free and high fat diet:

I happened upon a fat loss diet that had me cut out grains, most dairy, and sugar while focusing on mostly meat, fish, fats from nature such as butter, olive, and coconut oils. Nuts, seeds, and legumes were allowed too. These rules made it so I had to avoid processed foods. There was one day a week of eating anything.

Within 6 weeks I was shocked that I got much much more than fat loss. My depression, anxiety, mood swings, sleep issues and all but one pesky health symptom was left disappeared. I was stronger, faster, and felt energy I never remember having.

Holly shared how she healed severe depression and anxiety by changing her diet:

Over the course of a year and a half, I was given 10 different psychiatric diagnoses and cycled through 10 different medications. I discovered the healing power of diet completely by accident, and it changed my life. I now live with no diagnoses and no symptoms.

I started with the Whole30 (strict paleo), then went paleo, dabbled with a ketogenic approach, and now I eat a modified paleo diet, with some rice and goat dairy.

Krysti shared how diet reduced her severe mood swings and panic attacks:

I was dx with bipolar at 18 years old. Suffered panic attacks and the random severe mood swings that made absolutely no sense. I was sad for days to weeks only to be followed with unrealistic overly-exuberant highs where I had the energy of a toddler on sugar and the signature grandiose thoughts that I could simultaneously fly and conquer the world and do all the things! For a day. Then the next day felt numb. And resorted back to “cutting” just to feel something. I never cut for attention. In fact not even my closest friends knew I did it. It was for me and I hid it.

…my oldest sister introduced me to Paleo. I was soon dx celiac, cut out grains and have been med and *mostly* mood swing/manic free ever since. No panic attacks. I have never felt more emotionally stable. Even through the death of my youngest sister and big life events, my emotions have been that of a normal person. Explicable. Expected. Level. No extremes.

You can read their entire inspiring diet-depression stories and other ones in the comments on this blog.

Thanks to Alice, Andrea, Holly and Krysti for sharing your wonderful and very hopeful stories! It warms my heart and I know it inspires my community!  

And here is my story again:

For me it was anxiety and panic attacks that resolved when I made dietary and other nutritional and lifestyle changes.   I had been eating a vegetarian diet for a few years and I suspect the non-organic/GMO processed soy products (soy milk, soy yogurt, soy “butter” etc) were a big issue for me and damaged my gut.  When I added back quality animal protein (grass-fed red meat, wild fish, pastured eggs and chicken), switched to organic produce, added healthy fats and removed gluten my mood improved dramatically.  Now I eat a combination of a Paleo/SCD /low FODMAPS/low oxalate diet. 

During the severe anxiety and panic attacks I also needed additional support in the way of the targeted amino acids GABA (this was a life-saver and stopped the panic attacks in a few days) and tryptophan, plus zinc, vitamin B6, evening primrose oil, a good multi and B complex and adrenal support.  I still continue with some of these basic nutrients today.

My health issues have been complex as I’ve also had to deal with heavy metals, poor gut health and much more so I had what I call “a perfect storm” and yet diet has had such a huge impact for me!

Getting off medications

Lead researcher Professor Felice Jacka was quoted in an ABC article saying this in response to the SMILES trial:

people suffering from depression should not replace therapy and drug treatments with the Mediterranean diet.

Based on my experience working with clients and feedback I receive on the blog, finding the ideal diet and addressing all nutritional deficiencies often allows my clients to work with their doctors on eliminating all their depression and antianxiety medications. Other medications also go by the wayside: pain meds, high blood pressure meds, allergy meds, reflux meds etc.

What is Paleo?

I had the pleasure of hearing Australian Chef Pete Evans at an all-day Sydney event earlier this year, in celebration of the launch of his new book The Complete Gut Health Cookbook, with co-author Dr. Helen Padarin. He is a big time Paleo advocate and this is what he said on stage at the start of his presentation and wonderful day of cooking demos:

Paleo is basically a meat and 3 vegetables – it’s that simple!

To expand on this a bit…this means quality animal proteins like grass-fed red meat, wild fish, pastured eggs and chickens, organic vegetables (typically lower carb) and fruit, soaked nuts (if tolerated), bone broths, fermented vegetables and broths, and health fats like coconut and avocado. Many in the Paleo community say no to dairy and butter but I do find that some of my clients do fine with small amounts and some people do better with fermented dairy like kefir and yogurt or goat/sheep and even camel milk rather than cow’s milk.

I also got to meet both Pete and Helen at the book signing – they are both wonderful and very down-to-earth!

Meeting the famous (and very down-to-earth) Chef Pete Evans at the book signing

Can you imagine my surprise when Pete invited me on to stage to welcome me to Australia and share a bit about my work with diet and anxiety!?

Here is a 5 minute clip of me on stage with Pete and Helen where we talk about:

  • How what we eat has a direct impact on our brains and how we feel
  • How our gut bacteria make some of our brain chemicals like serotonin and GABA when we consume fermented foods [and other foods rich in amino acids and organic produce]
  • The term “psychobiotics” coined by Dr. Ted Dinan ie. good bacteria that improve our mood
  • Kelly Brogan’s wonderful work around depression and diet and medication tapering, and her great book A Mind of Your Own
  • How quickly can diet lead to anxiety and depression symptoms improving and allowing you to get off medications? …biochemical individuality, diet alone, addressing gut health, adding fermented foods, addressing low zinc and other root causes, looking at gene defects
  • Real food, liver, rooibos tea, herbs
  • My story of anxiety and panic attacks and changing from a vegetarian diet to a modified Paleo diet
  • The Anxiety Summit and my book The Antianxiety Food Solution as resources

 

As you’ve read with these success stories and heard me say on Pete’s stage, many people can do it with diet alone (even if their anxiety is very severe), many need additional nutritional support, and many need the targeted individual amino acids to get immediate relief from their anxiety or depression while they are looking for all their root causes. Many also need the amino acids to break their gluten and sugar addictions. But making the dietary changes are the foundation!

Stay tuned for more about Pete Evans, some of his recipes and gut healing protocols and the unfortunate grilling he’s been getting in the Australian media for advocating a Paleo diet! In the meantime, I will say that all his books come highly recommended!

In case you’re wondering about the research on the Paleo diet, while we don’t have a study that’s looking directly at anxiety and depression, we do have these papers on the overall benefits of a Paleolithic diet:

And in this paper co-authored by Professor Felice Jacka – Nutritional psychiatry research: an emerging discipline and its intersection with global urbanization, environmental challenges and the evolutionary mismatch, they mention

a potential evolutionary mismatch between our ancestral past (Paleolithic, Neolithic) and the contemporary nutritional environment.

We do, of course, have many studies supporting a diet-mood connection:

And Professor Felice Jacka shared this during our interview on The Anxiety Summit: The Research – Food to prevent and treat anxiety and depression? 

One of the hypotheses that I had during the Ph.D. was that increased intake of animal foods would be toxic and would be associated with more mental disorders.

This did not turn out to be the case: In our study, out of every single dietary food grouping that I looked at including vegetables, fruits, salads, beans, etc the strongest correlate of mental health was red meat intake [grass-fed red meat of course.]

Consistently, women who have less than the recommended intake of red meat seem to be in an increased risk for common mental disorders [like anxiety and depression] and bipolar disorder.

She was referring to the results of her Ph.D. paper that was published in the American Journal of Psychiatry in 2010: “Association of Western and Traditional Diets with Depression and Anxiety in Women.”

Have you changed your diet to a Paleo way of eating and observed a reduction or elimination of anxiety or depression? Was a dietary change enough or did you need to address brain chemical imbalances and other nutritional deficiencies too?

If you’re a practitioner, have you seen results like this with your clients or patients?

 

SMILES diet depression trial: reduced depression and anxiety

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The SMILES trial, A randomised controlled trial of dietary improvement for adults with major depression was recently published BMC Medicine. It is the first randomized controlled trial to test whether dietary improvement can actually treat depression. Yes, we’re using dietary improvement and treat in the same sentence!

The objective was to determine if “structured dietary support, focusing on improving diet quality using a modified Mediterranean diet model” would have an impact on mood. The outcome is very exciting:

‘SMILES’ was a 12-week, parallel-group, single blind, randomised controlled trial of an adjunctive dietary intervention in the treatment of moderate to severe depression. The intervention consisted of seven individual nutritional consulting sessions delivered by a clinical dietician. The control condition comprised a social support protocol to the same visit schedule and length.

The results indicate that dietary improvement may provide an efficacious and accessible treatment strategy for the management of this highly prevalent mental disorder, the benefits of which could extend to the management of common co-morbidities.

These encouraging results were seen in participants who switched from a junk food diet to a real foods diet. Of the 67 who were enrolled in the study, the majority were using some form of therapy: psychotherapy and medications combined or psychotherapy only or medication only. There were 31 in the diet support group and 25 in the social support control group. Participants had to have been eating this diet in order to be accepted into the study:

a poor (low) intake of dietary fibre, lean proteins and fruit and vegetables, and a high intake of sweets, processed meats and salty snacks.

The dietary approach followed by participants in the study intervention group was the ‘ModiMedDiet’ which is based on the Australian Dietary guidelines and the Dietary Guidelines for Adults in Greece.

The primary focus was on increasing diet quality by supporting the consumption of the following 12 key food groups (recommended servings in brackets): whole grains (5–8 servings per day); vegetables (6 per day); fruit (3 per day), legumes (3–4 per week); low-fat and unsweetened dairy foods (2–3 per day); raw and unsalted nuts (1 per day); fish (at least 2 per week); lean red meats (3–4 per week), chicken (2–3 per week); eggs (up to 6 per week); and olive oil (3 tablespoons per day), whilst reducing intake of ‘extras’ foods, such as sweets, refined cereals, fried food, fast-food, processed meats and sugary drinks (no more than 3 per week). Red or white wine consumption beyond 2 standard drinks per day and all other alcohol (e.g. spirits, beer) were included within the ‘extras’ food group. Individuals were advised to select red wine preferably and only drink with meals.

The dietary composition of the ModiMedDiet was as follows: protein 18% of total energy; fat 40%; carbohydrates 37%; alcohol 2%; fibre/other 3%.

Here are the reasons I’m excited about this research:

  • It’s the first randomized controlled diet depression study and ONE THIRD of the dietary intervention group saw improvements in their depression symptoms.  This was just diet alone and switching from processed/junk food to real food with no specific dietary restrictions!
  • Participants also reported improvements in anxiety symptoms.
  • The authors even addressed the cost factor, stating it was more affordable to eat this way ($112 per week vs $138 per week).
  • The authors address the fact that the dietary intervention group was able to make these dietary changes “despite the fatigue and lack of motivation” that we so commonly see with depression.
  • I’m optimistic about it paving the way for making dietary approaches part of the standard of treatment for mental health conditions. The paper suggests the addition of “clinical dieticians to multidisciplinary mental health teams.”  I’d like to add that these dieticians, together with nutritionists and health coaches would need to be well versed in functional medicine approaches.
  • According to an article on ABC, one participant continued the Mediterranean diet after finishing the study and is now doing a diploma in health science. How inspiring is this? When we get results like this we want to share them with everyone!  

These are very encouraging results and we applaud the positive results of this SMILES study which are truly groundbreaking.

Let’s also be aware of where we are headed with future research and how we can improve on the trial diet.  The researchers conclude with this comment about future research:

The scaling up of interventions and identification of the pathways that mediate the impact of dietary improvement on depressive illness are also key imperatives

Professor Jacka recently shared this paper on how personalized dietary interventions successfully lower post-meal glucose i.e. how certain foods can affect two people quite differently because of our unique gut bacteria. She said that she wants to do a similar personalized nutrition study for depression if they are successful in obtaining NHMRC funding.

Here are some questions I’ve been asked about this SMILES trial (and I’m sharing here in case you have similar questions):

  • why did only one-third of the study intervention group see improvements?
  • why was wheat and other grains included?
  • why was low fat dairy and lean meats emphasized?
  • why was there no mention of grass-fed meat, wild fish, healthy fats like butter and coconut oil, pastured eggs or chickens or quality organic fruits and vegetables?

The ideal dietary approach for anxiety, depression and any health condition is always one that high quality, is personalized and takes into account biochemical individuality. With the removal of gluten, grains and the inclusion of the other dietary changes mentioned above, plus addressing all nutritional imbalances I expect we will see more than one-third of the dietary group experiencing improvements in depression in future trials.  

I truly appreciate the work of Professor Felice Jacka and her team and look forward to seeing more studies like the SMILES trial, using a personalized approach and quality foods that include grass-fed red meat and wild fish, plus pastured eggs or chickens, and healthy fats; and organic produce as a baseline. 

And then future trials that also look at the impacts of these dietary changes on anxiety and depression: gluten and/or grain removal;  removal of high histamine foods and high oxalate foods;  a low FODMAPs diet; the specific carbohydrate diet/SCD; a Paleo diet and so on – all based on biochemical individuality. We know these diets works in clinical practice and now we just need the research to back this up.  In part 2 of the blog, I share some incredibly inspiring diet-depression and diet-anxiety Paleo success stories.

In summary:

  • a simple change like switching from junk to real food can have a major impact on your depression and anxiety – ONE THIRD of the dietary intervention group saw improvements in their depression symptoms and many also saw reduced anxiety. This is profound! 
  • you may need to make additional dietary changes (gluten-free, grain-free, low FODMAPs i.e. avoiding or adding certain foods based on your biochemical individuality) and always add healthy fats and focus on quality
  • you may also need to address brain chemical imbalances with amino acids supplements, address gut health, adrenal issues, low zinc, low vitamin B6, low vitamin D etc. too

Are you encouraged by this research?

And have you made similar dietary changes to those done in the SMILES trial and seen a reduction in your anxiety and depression?

Have you removed gluten or grains and made additional dietary changes, and added supplements and seen even more benefits?

Note: to avoid confusion I’ve used the Australia spelling of “randomised” and “fibre” in the quoted sections and the US spelling “randomized” elsewhere in the blog.

The Evolution of Psychiatry: integrative psychiatry, anxiety and the thyroid

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James Maskell is the founder of The Functional Forum and this month the theme was The Evolution of Psychiatry. It was such a great episode so I’m sharing it with you here today.

The first presentation was by Janet Settle, MD and Will Van Derveer, MD. They took the stage and presented on the fundamentals of integrative psychiatry, covering root cause-based psychiatry. Together with Scott Shannon, MD, they are also now offering their “Psychiatry Masterclass” training program to other doctors.

This presentation included:

  • The foundations of truly effective, root-cause focused mental health system
  • Typical unresolved physiological dysfunctions that manifest as mental illness
  • Concrete steps for creating the mental health centers of the future

Here is a sampling of what they covered. Isn’t it wonderful to see a slide titled “Integrative Psychiatry Model” and with physiologic root causes listed?

The section on child abuse, trauma and psychospiritual root causes was enlightening:

They cover MDMA- and ketamine-assisted psychotherapy and I look forward to learning more from them about these approaches. However, until I learn more I’m wary of these approaches because of the side-effects. Based on the work I do with targeted individual amino acids I would use them before even considering MDMA or ketamine.

You can watch the entire video presentation here:

 

Next up was Thyroid Pharmacist, Dr. Izabella Wentz, returning to the Functional Forum stage for her first keynote. Dr. Izabella is a dear friend and one of my favorite thyroid experts and she covered the connections between thyroid health and depression and anxiety, looking at proven protocols to address the underlying causes.   Her presentation is titled “The Misdiagnosis Machine: How Thyroid Problems Mimic the Symptoms of Mental Illness.”

Dr. Izabella shares the symptoms of the autoimmune attack on the thyroid gland. As well as fatigue, weight gain, gut issues and apathy, you can experience mood symptoms such as anxiety, OCD-like symptoms and mood swings.

You can watch the entire video presentation here (and listen for a mention of my name and how commonly I see anxiety with clients with thyroid symptoms):

 

If you enjoyed Dr. Izabella’s presentation you don’t want to miss her upcoming documentary called The Thyroid Secret. I’m thrilled to have been invited to contribute on my expertise on anxiety and how this ties back to thyroid health. You can read more about it and find a few snippets from my interview here.

 

Dr. Izabella also has a new book that will be released next month: Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back. I have a review copy and it’s brilliant! I’ll be sharing more via a book review and interview with Dr. Izabella, taking a deep dive into infections and Hashimoto’s, so stay tuned for that.

I hope you’ve enjoyed these two presentations! For me, hearing presentations like these gives me so much optimism for the future of mental health!

I’d love to hear what has inspired you?

If you’re a practitioner and would like to attend a live Functional Forum meeting in the future or tune in online, you can register here to be notified. James and his team also offer excellent practice resources for functional medicine practitioners. We appreciate him for what he is doing for functional medicine via the Functional Forum!

 

 

Interview: Heal Your Pain Now + the fear-pain connection

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If you struggle with chronic pain from an injury, autoimmune disease, fibromyalgia, joint pain, arthritis, anxiety, depression or have tried everything without success, Heal Your Pain Now provides natural solutions to eliminate pain and return you to a life worth living.

I recently had the pleasure of interviewing Dr. Joe Tatta, physical therapist and nutritionist, author of this wonderful new book and a dear friend!

You can watch the interview here:

 

And here is a summary from our great interview:

What is chronic pain – it’s about protection. Acute pain like an ankle sprain tells you to rest and heal; chronic pain – persists beyond 3 months and is less about protection and more about the brain being in a hyper-sensitive state.

The human body has innate ability to heal i.e. the body has a natural anti-inflammatory process and tissue will heal in 3 months. After those 3 months it becomes less about the actual tissue and more about what is going on centrally in the brain and nervous system.

Central sensitization or the hyper-sensitive brain: we have a neural signature specific to you and your pain experience.

It’s based on what you believe about pain, are told about pain, your memories, your emotions, input from body (such as tightness), your thoughts, touch and sound.

With central sensitization pathways light up in the brain causing pain and in some instances those pathways never quiet down. The more we can be educated about pain the faster we can release this central sensitization and the pain.

An example: You and I had backpain – my life: mom is a nurse, my backpain comes and goes, I can move a little, I go to work, do some chores and basic exercise; in your life your grandmother had really bad back pain, was in a wheelchair and said back pain is the worst pain you could ever have. This may make your pain persist. Fear causes pain to persist over a long period of time.

Fear and pain: it can be actual fear or perceived; fight or flight – muscles tense around the spinal column; blood is shunted away from the spinal muscles because you’re getting ready to run or fight; when it’s persistent there is no blood flow and no healthy nutrients going to the spinal muscles; cortisol levels become elevated – they are inflammatory and very powerful at laying down memory patterns (which can make pain persist).

When you lessen fear you promote relaxation and in general pain disappears very fast.

When you hear all this the brain repatterns – you’re doing a mini cognitive behavior session just listening to and watching the video of us interacting! (I love this!)

Myth: chronic pain has to be chronic – no! Replace the word chronic with persistent because language is really important for creating these pain memories.

Myth: imaging studies like xrays and MRIs are correlated with pain. Often we see intense pain with normal xrays, sometimes no pain with awful rays.

There is also the emotional aspect – when someone in a white coat holds up that xray and says you have this issue it can start that fear response and the pain can be worse.

This fear pain connection is fascinating and I asked if it common knowledge

  • The average physician only receives 4 hours of pain science education in 12 -16 years of education – most of what they learn focused on medications, injections and surgery. We currently have a biomedical model (xray and injection or surgery, injections or medications) but we are moving to a biopsychosocial model (movement, nutrition, mindset, the brain)
  • The book has 40 pages of evidence based research (if you’re a practitioner and would like access to the papers let me know in the comments and Dr. Joe can get them to you)
  • I suggest using the book to educate yourself and your doctor

Medications prescribed for pain: Opioids (oxycontin, codeine, morphine) #1 drug prescribed for pain. CDC and NIH: You should not prescribe opioids as first line of treatment for chronic pain. They are highly addictive – 3 million addicted to them; 2 million die each year; opioid-induced hyperalgesia – the more you take the more pain sensitivity you have and the more medication is needed.

Side effects: constipation caused by opioids and you’re prescribed medications for the constipation; called OIC (opioid induced constipation) – changes the microbiome, fecal matter is bound up, you get leaky gut, inflammation starts in gut and there are impacts on neurotransmitter production like GABA and serotonin (and then increased anxiety and depression).

Other medications used are SSRIs – depression looks very similar to pain in the brain – when you heal the gut you can balance serotonin

Gabapentin and NSAIDs and benzodiazepines are also prescribed.

The book covers ALL pain – any chronic (or persistent) pain that has been around for 3 months or longer

Nutrition: diet is the #1 way to reduce inflammation – food is medicine approach; 100% whole food (if it comes in a box or a can or is made by man it has no place in your diet especially if you have chronic pain); farm-raised beef, wild fish, fruit and vegetables, healthy fats i.e. a modified Mediterranean diet.

Then use a gut-healing protocol for removing inflammation and addressing autoimmunity – remove gluten, dairy and sugar. In 3-7 days people see their pain decrease from 8/10 to 2/10.

“I don’t think I have arthritis and I don’t think I need this Aleve – I think it was the gluten I was eating”

If you slip a little and have some gluten then you realize you can’t even have any and you’re educating yourself that food is medicine. It’s very powerful

With gut healing, if you have autoimmunity take out eggs and GMOs (soy and corn) too; there is more clinical evidence around nightshades – if you can heal the gut you can often tolerate small amounts.

The ketogenic diet is last phase: 65% – 75% fat, 5% carbs (from fibrous vegetables) and the rest is protein. It’s awesome to regulate blood sugar, helps central sensitization (we know because those with seizures do really well on a ketogenic diet). With seizures glutamate is high and GABA low and the ketogenic diet helps balance out these in your brain and calms the nervous system and decreases pain; upregulates ATP (energy molecule) which helps with pain. Brain fogs goes away.

The ketogenic diet is not for someone with type 1 diabetes, who is pregnant or in acute adrenal fatigue

Do a trial of 3-4 weeks and cycle into ketosis every 4-6 months.

Intermittent fasting tricks body into thinking body is starving.

A big plane flies over at the 41 minute mark! Enjoy the laugh with us!

With intermittent fasting do a 14-16 hour fast overnight, say 6pm to 9am the next day

Mini-fasts: protein shake in the morning or evening – the meal is smaller; or use bone broth – healing for gut and collagen for your joints!

Supplements: omega-3s (2000 to 4000mg); curcumin (in oil – really important to help absorption); vitamin D 5000-10,000 IU; some kind of proteolytic enzymes; GABA for pain and anxiety and central sensitization.

If this feels overwhelming and you feel you need more support (in addition to reading the book) Dr. Joe does have a group program

It’s called Heal your Pain Heal your Life  – 6 week process, a Facebook group group, Q and A calls, and social support (which is huge if you have pain and can’t get out of house, or if others can’t relate to your pain, plus for the community support)

Movement, sedentary syndrome, sit rise test: movement is medicine and has to be in your life in some form. Even 5 minutes twice a day can help. It sends signal to your brain “I can move a bit and I’m safe”, you build confidence and fear decreases, releases endorphins, quiets down the nervous system

Sit rise test – cross your legs and lower yourself down to the floor without your hands and then stand back up. It indicates a long life-expectancy; they are not sure why – cardio effects? Balance? It tests strength and vitality; if you can’t do it – practice each day. Third world cultures sit on the floor to communicate – when you move joints in full range it lubricates them.

I’m a climber, skier, mountain biker, windsurfer and have had many injuries and worked with wonderful physical therapist and yet I have learned so much from Dr. Joe and this book! I will use it for prevention of injuries and pain and for the next time I am injured and in pain.

Dr. Joe ended by saying

Keep moving forward, we’re going to change the pain paradigm and give people their lives back!

This is the book summary:

In Heal Your Pain Now, Dr. Joe Tatta teaches you how to regain control of your life by breaking the cycle of persistent pain. Following Dr. Tatta’s program, you learn the role of the brain in pain–and how to use your brain to STOP your pain; how nutrition can eliminate the inflammation in your body, which is exacerbating your pain; and how to overcome Sedentary Syndrome and choose the best movement strategy. Dr. Tatta provides quizzes, self-assessments, meal plans, shopping lists, recipes, and exercises to support you throughout the program.

As I mentioned in the interview I really appreciate the very unique perspective Dr. Joe brings to healing from pain. His expertise from the physical therapy and movement world is so beautifully meshed with the power of nutrition! He covers the foundational information for eating an anti-inflammatory diet, an excellent gut healing protocol, healing supplements and with much fascinating reading on intermittent fasting and the ketogenic diet.

Dr. Joe explains these concepts brilliantly: the brain in pain, central sensitization, myths around pain and the biospychosocial model of pain. With the work that I do with anxious women like you (and men too), the pain connection to fear is very relevant; and the fact that stress, anxiety, post-traumatic stress disorder (PTSD), or depression are danger signals that can actually make the pain worse depending on how “sensitive” your nervous system has become.

Also, since many of the same pain medications are also often prescribed for anxiety, this book is a wonderful resource for someone with both pain and anxiety. But best of all, this book offers real solutions for everyone suffering from any kind of pain, and a solid understanding of the mechanisms.

I’m sure you’d like access to what we talked about during the interview:

 

Please let us know which parts of this really resonated with you and what you’re looking forward to implementing for your pain.