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Nutrition solutions for psychological stress after a natural disaster

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There is much that can be done nutritionally in support of psychological stress and PTSD (post-traumatic stress disorder) during and after a natural disaster. I’ve written this blog for you if you’ve been impacted by the recent storm and flooding due to Hurricane Harvey in the Houston area (the pictures of people returning home are so sad), and for everyone impacted by Irma and about to be impacted by Irma. This is for you if

  • you had to be rescued and had to evacuate your home, are displaced and/or saw neighbors in trouble, have lost your belongings and home – and anything else that may have happened during this natural disaster
  • you have been involved in on-the-ground rescue efforts or working online helping with rescue efforts and you have working long hours, not getting enough sleep and likely not eating well
  • you had a loved one in trouble and feared for their lives
  • and if you’re on observer feeling distressed by what you have witnessed

You may be feeling on edge and anxious about the future, fearful about losing your job, worried about expenses and the chemical soup of flood waters you were exposed to, exhausted and yet not able to sleep, feeling overly emotional and weepy, having nightmares and flashbacks and feeling frazzled.

I wasn’t even in Texas and my contribution was a very small one, helping online rescue efforts from Australia via a volunteer rescue group created by McCall McPherson, but I felt really burned out after just a few days and quite distressed by some of the rescues we were trying to facilitate. I have had to really walk my talk and implement some of what I’m sharing here even though I would consider myself resilient because my nutrient balance is good.

B-Complex for everyone

My first recommendation is a B complex and if this is all that can be managed it would be my first choice for everyone. In fact, if you live in an area prone to hurricanes, flood, fires etc. I’d recommend being on a B complex all the time.

My colleagues Bonnie Kaplin and Julia Rucklidge published this paper in 2015: A randomised trial of nutrient supplements to minimise psychological stress after a natural disaster. They share that:

After devastating flooding in southern Alberta in June 2013, we attempted to replicate a New Zealand randomised trial that showed that micronutrient (minerals, vitamins) consumption after the earthquakes of 2010-11 resulted in improved mental health. Residents of southern Alberta were invited to participate in a study on the potential benefit of nutrient supplements following a natural disaster.

Fifty-six adults aged 23-66 were randomised to receive one of the following for 6 weeks:

  1. vitamin D as a single nutrient
  2. a B-Complex formula or a
  3. broad-spectrum mineral/vitamin formula

The study participants monitored changes in depression, anxiety and stress via self-reporting. All of the above 3 groups showed substantial decreases on all measures. However, those consuming the B-Complex and the broad-spectrum mineral/vitamin formula showed significantly greater improvement in stress and anxiety compared with those consuming the vitamin D alone, with the results being similar for the group using the B-Complex and the broad-spectrum mineral/vitamin formula.

The authors report that:

The use of nutrient formulas with multiple minerals and/or vitamins to minimise stress associated with natural disasters is now supported by three studies.

Further research should be carried out to evaluate the potential population benefit that might accrue if such formulas were distributed as a post-disaster public health measure.

I would love to see either a B-Complex or broad-spectrum mineral/vitamin formula be given out to everyone as part of relief efforts for all natural disasters.

The B-Complex used in the study was made by Douglas labs but other similar B-Complex products would be fine too.  I happen to use Designs for Health B Supreme with my clients.

The broad-spectrum mineral/vitamin formula in the study was EmpowerPlus made by TrueHope.

From: A randomised trial of nutrient supplements to minimise psychological stress after a natural disaster

Vitamin D based on levels

In the above study, some participants in the vitamin D group did see benefits and it’s likely to have been those who were low in vitamin D at the time of the flooding since other research supports a connection between low vitamin D and anxiety and depression. I like to see vitamin D results before recommending supplementation.

Serotonin, GABA and endorphin support based on symptoms and a trial

As well as a B-complex and/or vitamin D, I’d also consider the following neurotransmitter support on a case by case basis, and after doing the amino acid questionnaire and a trial of each amino acid:

  • Serotonin support with Lidtke tryptophan or Lidtke Tryptophan Complete or Lidtke Combat Stress (a tryptophan product formulated for stress support) – especially if you’re feeling sad, worried, resolving to try and feel positive, imagining the worst, feeling fearful and having problem sleeping. I blogged about tryptophan products last week.
  • GABA support for physical tension and an increased need to self-medicate with alcohol in order to stay calm. New research shows that reduced plasma levels of GABA observed in PTSD could be considered as a possible biomarker for PTSD severity. This is not something I typically look at but it’s something I will be considering going forward. I blogged about some specific GABA products earlier this week.
  • Endorphin support with Lidtke DPA if you’re feeling especially emotional and weepy.

Serotonin and GABA play a role in stress resilience and when we have enhanced stress resilience mechanisms we have the ability to adapt more successfully to stressful situations like natural disasters.    

Additional adrenal support if needed

The adrenals are part of the hypothalamic-pituitary axis (HPA) and also need nutritional support after stress and trauma. I recommend a good adrenal support product with rhodiola, Vitamin C, pantothenic acid, eleuthero and ashwagandha. Designs for Health Adrenotone is a good product.

If it’s known that cortisol levels are high then the addition of Seriphos and/or a lactium product (such as Biotics Research De-Stress) helps to lower high cortisol, reduce anxiety and help with insomnia.

Additional pyroluria support if needed

It is well known that pyroluria symptoms are made worse in times of heightened stress. If you are on protocol for pyroluria, additional zinc and vitamin B6/P5P is likely going to be needed short-term too.

Essential oils

Essential oils like lavender and citrus are wonderful for the stress, anxiety and sleepless nights. An animal study reports that passively inhaling orange essential oil could potentially reduce PTSD symptoms in humans

 

Some other considerations include the following once things start to get back to some kind of normal:

I would recommend a similar approach for any natural disaster or in fact for any other traumatic event, always working individually with each person.  

If you have found some approach to be particularly useful for you please do share it.

And if you have any connections for getting this information into the hands of public health officials and non-profits offering aid please let me know. I feel that protocols similar to this one need to be made available to everyone subjected to a natural disaster.

I wish you and your families much healing and a speedy recovery.

Additional resources

I added these additional resources from colleagues after September 20, 2017:

If you have links to additional useful resources please let me know and I’ll add them.

World Benzodiazepine Awareness Day 2017: Awareness and Anxiety Nutrition Solutions

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World Benzodiazepine Awareness Day 2017 was celebrated earlier this week on July 11th. The organization recommends that everyone should watch and share this short informative video: The risks of taking benzodiazepines (Klonopin, Xanax, Ativan) as prescribed. It could save your life or the life of someone you know.

This is what W-BAD shares about benzodiazepines and Z-drugs that are used as prescribed:

Benzodiazepines (Xanax, Klonopin, Ativan, Valium, Librium, and others) as well as Z-drugs (Ambien, Lunesta and others), which are similar, have the most debilitating withdrawal reactions in all of medicine.

This happens in regular, everyday people who are taking the medications exactly as their doctor prescribed. It also happens to people on what they think are “low doses” and is not just a “high dose” problem. This happens because the prescribing guidelines for this class of drug recommend short-term use only (less than 2-4 weeks), yet doctors are prescribing them for much longer. Even worse, these unsuspecting patients are given no warning (or informed consent) by their doctor about these risks and dangers before taking the prescription past the recommended timeline. The patients think the drugs are “safe” because they are prescribed when they are actually quite dangerous medications that are capable of inflicting sometimes severe and life-threatening withdrawal syndromes which are known, for some people, to persist for many years.

W-BAD shares these stats about how common it is to see physical dependence, adverse effects, and withdrawal:

Experts and studies estimate that as many as 60% of people taking benzodiazepines for more than the recommended 2-4 week time period will develop physical dependence, adverse effects, and withdrawal

60% is actually a conservative percentage, as some other sources indicate that “50-80% of people regularly taking benzodiazepines (even in ‘low dose’) for longer than a few months will develop a physical tolerance to the drug and become dependent, resulting in difficulty stopping benzodiazepines because of withdrawal symptoms”.

30% of long-term users will experience severe withdrawal or adverse effects which may include seizures, hallucinations, psychosis, akathisia, and sometimes suicide or death (people are especially at risk for severe withdrawal if they over-rapidly taper or cold-turkey their benzodiazepine/Z-drug).

The tapers to discontinue these medications, once you’ve taken them past 2-4 weeks and depending on dose, can last many months or years. I see this all the time in my practice.

About 10-15% of people who withdraw will develop a protracted withdrawal syndrome which can potentially persist for many years (there are anecdotal reports of it persisting up to five, seven, and even ten years post-cessation.). Others, even after a slow, gradual reduction of the benzodiazepine or Z-drug will experience withdrawal that lasts for up to 18 months post-cessation.

Physical dependence is a physical condition, a state of adaptation in the body caused by chronic use of a tolerance forming drug, in which abrupt or gradual drug withdrawal causes withdrawal.

When someone becomes physically dependent to benzodiazepines (or Z-drugs), they are also at risk for developing tolerance. With benzodiazepines/Z-drugs, specifically, when the receptors in the brain become adapted or accustomed to the action of the original dose of BZ, more of the drug is needed in order for the desired therapeutic effect (or the original effect at the original dose) to be achieved. This means that the drug loses its effectiveness and the person taking it can begin to experience withdrawal symptoms while still taking the prescribed dose of the drug.

It’s very unfortunate that some of the very same symptoms that are trying to be addressed by these medications are now amplified or seen for the first time:

Some common symptoms of tolerance include increasing anxiety, panic attacks, development of agoraphobia for the first time, interdose withdrawal (withdrawal symptoms emerging in between doses), as well as a plethora of other physical/neurological/psychological symptoms.

Visit the website World Benzodiazepine Awareness Day to learn more and to get involved:

By spreading the word about taken-as-prescribed benzodiazepine risks, harms, and dangers, W-BAD (World Benzodiazepine Awareness Day) hopes to bring awareness to the general public and the medical community about this problem before more people are needlessly harmed. Please help share this video with everyone you know and, together, we can prevent more victims of iatrogenic (caused by medicine) dependence, withdrawal, and injury from prescribed benzodiazepines and Z-drugs.

There are some heartbreaking stories on the Facebook page (an excellent resource) :

W-BAD acknowledges Professor Malcolm H. Lader for guiding them in providing information that appears throughout the website and in handout materials. Prof. Lader first described benzodiazepine withdrawal syndrome as a potential brain injury in the scientific literature, and also campaigned around the world to get everyone from politicians to royalty to listen.

Here is some guidance with slow tapering protocols from W-BAD (and never stop cold-turkey).

For additional resources this is the blog post I published last year: World Benzodiazepine Awareness Day – say NO to Benzodiazepines for anxiety!

Awareness and nutrition solutions

I do love that this awareness is being created. It is so needed for those who are prescribed these medications and currently taking them, for anyone who may consider a future prescription, and for everyone in the medical profession, as well as all integrative and functional medicine practitioners and nutritionists.

All this awareness creates the perfect opportunity to offers nutrition solutions too, so we can address:

  • the initial root cause/s of your anxiety which led to your prescription of this medication to start with
  • the anxiety you now experience even through you were prescribed these medications for something else (such as pain)
  • your current biochemistry and nutritional status to facilitate an easier taper from the benzodiazepine with the least withdrawal effects
  • your current biochemistry and nutritional status so you don’t get anxiety in the future, once you have completed the taper

And if you are considering a benzodiazepine prescription in the future you are now informed about the dangers and have nutritional resources too.

When I am working with someone who has been prescribed a benzodiazepine, I get them nutritionally stable BEFORE they even consider a benzodiazepine taper.

I use amino acids like GABA and tryptophan, melatonin and niacinamide to make the taper easier and so we can balance brain chemistry before tapering and then during the taper (all under the supervision of the prescribing doctor and using the Ashton taper protocol).

Dr. Jonathan Prousky, talks about his success with benzodiazepine tapers on a prior Anxiety Summit interview – using melatonin, niacinamide, Neurapas Balance, rhodiola and GABA.

There is also a big focus on diet (real food/often a Paleo diet, no additives, organic, healthy fats, no gluten, no sugar, no caffeine, quality grass-fed/wild protein), addressing high cortisol if needed, addressing low zinc, low iron, low vitamin B6, low B12 and looking at gut health. Lifestyle and stress reduction is important and we look at and address all possible 60+ underlying factors/causes.

This is all covered in detail in my book “The Antianxiety Food Solution” (on amazon here) The basics plus advanced topics (like fluoroquinolone antibiotic issues when on benzodiazepines and more) are also addressed on the Anxiety Summits.

I feel very strongly about providing this nutritional support and sharing how helpful it is because organizations like W-BAD and Benzobuddies.org (as much as love them) advocate for no nutrient support suggesting it won’t help or could make symptoms worse. I will admit that some people who are tapering are very sensitive and in these situations very very tiny amounts (as small as a pinch in some instances) of some of the nutrients may be a better option, always only doing one thing at a time to make sure it’s helping and not making symptoms worse, and doing functional medicine tests. Using essential oils, light therapy, gentle detox, Heartmath and yoga are wonderful to start with, in conjunction with all the diet changes.

Please share your benzodiazepine story and what has helped you taper more easily and recover.

If you’re a practitioner please share what approaches you have used to help your clients or patients taper more easily.