3/12/2011

1
IntegrativeTherapiesforAnxiety
HenryEmmons,MD
ConsultingPsychiatrist,PennyGeorgeInstituteforHealthandHealing
www.partnersinresilience.com
WhyZebrasDontGetUlcers
Becausetheydontsuffer
fromchronic stress
ButPeopleDo
Weveevolvedtobesmart
enoughtomake
ourselvessick.
RobertSapolsky
TheCostsofAnxiety
1in5Americansperyear
30%lifetimeprevalence
40millionAmericansper
yearwithdiagnosable
conditions
CostsUSeconomy$50
Billionperyearinlost
productivity
TheSpiralofFear
ImhavingRound2ofPTSD.Ihavent sleptin7
months!
DiagnosedwithCancer
2
nd
Episodein9years
Sleepingmedshadhelpedinpast
Nowsleepingonly34hours
Numerousdoctors
6medtrialsunhelpful
Sleepstudy
Isthereanyhopeforme?
Fearreactionlockedintheonposition
Anormalresponsegoneawry
Keptalivebythinkingtoomuchandsleeping
toolittle
3/12/2011
2
BreakingtheCycle
Unlockthebrain
Improvesleep
Dampenthestress
hormones
Bvitamins
Magnesium
5HTP
Melatonin
Tryptophan
Within5daysfelt
dramaticallybetter
Thenlookatimproving
resilience
Resilience
Keepingthetank
full.
Letfoodbeyourmedicineand
medicinebeyourfood.
Hippocrates
AResilientDietin7Words
Eatfood.
Nottoomuch.
Mostlyvegetables.
MichaelPollan
Eatwhole,naturalfoods
Whattodo: Why:
Buyunprocessed,
organicfoodasmuch
aspossible
Higherinmicronutrients
fromsoil
Lessprocessingleavesmore
nutrientsinthefood
Morefiberreducesblood
sugarfluctuation
Fewerchemicalsfrom
farmingandfoodprocessing
3/12/2011
3
Eatawidervarietyoffoods
Whattodo: Why:
Eatmoreseasonal,local
foods
Discovernewkindsofmeats,
vegetables,grains,nutsand
seeds
Closertohowweevolvedto
eat.
Greaternumberofnutrients
Lesslikelihoodoffood
sensitivitieslikegluten
intolerance
Eatfewertoxicfoods
Whattodo: Why:
Avoidfoodwithchemical
additives
Besurecertainfruitsand
vegetablesareorganic
Buyhormonefreemeatand
dairy
Avoidcertainseafood
products
Somechemicalsare
neurotoxic
Certainproduceisknownto
carrymorerisk
Hormoneswillimpactbrain
function
Oceansarepolluted;notall
fisharesafetoeat.
Eatbrainprotectivefoods
Whattodo: Why:
Lookforcolorfulfruitsand
vegetables(beans,dark
berries,leafygreens)
Eatacruciferousvegetable
daily:e.g.Broccoli,
caulif lowerandcabbage
Phytonutrientsarepotent
antioxidantsthatreducethe
negativeimpactofstress
Thesehelpthebodydetoxify
Eatbrainnourishingfoods
Builddietaround
complexcarbohydrates.
Eatonlymodest
amountsofleanprotein.
Getplentyofhealthy
fats,mostlyomega3:
Oliveoil;nuts;seeds,
fish
Aplantbaseddiet
improvesbrainhealth
andlongevity.
Needsomeproteinfor
aminoacids,butless
thanweusuallyeat.
Neuronsaremostlyfatty
cells;needhealthyfatsto
function,aswellas
reduceinflammation
BasicSupplements
MultivitaminorBComplex
Takehalfthedosetwicedaily
Lookforminimum50mgB6perday
Omega3
1000mgFishOiltwicedaily
And/or2T.groundflaxseed
VitaminD3
20004000IUdailyfromOctoberthroughApril
Calcium/Magnesium:
1000mgCalcium(womenonly)/500mgMagnesium(menandwomen)
TherapeuticSupplement:
Ltheanine
Derivedfromgreentea
Supportsdopamineand
norepinephrinefunction
Mayimprovefocus
Canalsocalmandhelpsleep
100200mgtwicedaily
Usejustatnightifsedating
3/12/2011
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TherapeuticSupplement:NAC
Nacetylcysteine
600mgupto3or4
timesdaily.
Apotentantioxidant
MayhelptreatOCD.
TherapeuticSupplement: Taurine
500mgonceortwice
daily
Improves
glutamate/GABA
function
TherapeuticSupplement: Inositol
Driedbeanscontain
inositol.
5001000mg2 to3
timesdaily.Studiesuse
1218gperday.
OftenconsideredaB
vitamin,itcaneffectively
treatpanic,OCDand
phobicanxiety.
TherapeuticSupplement:GABA
250750mgupto3times
daily
Doesnotcrosseasilyinto
thebrain,soother
measuresmayhavemore
effectonGABA
TherapeuticHerb:Rhodiola
100500mg
Anherbaladaptogen,
thismayimprovethe
bodysgeneralresponse
tostress
TherapeuticHerb:Passionflower
Gentlesleepand
antianxietyaid
12droppersfulor
freezedried
capsulesbeforebed,
orupto4timesa
day
3/12/2011
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TherapeuticHerb:ValerianRoot
12droppersfulinasmall
amountofwaterbefore
bedorupto4timesper
day
Theenergyofthemindisthe
essenceoflife.
Aristotle
TheEnergyThieves
InsulinResistance
Inflammation
FoodSensitivity
InsulinResistance
Starvinginaworld
ofexcess
InsulinandtheBrain
Sugarshavemultiple effectsonthebrain.
Insulin sensitivity isrequiredtoproducedopamine.
Excesssugarsandneurotransmission.
Highsugarintakecanpromoteaggression,anxiety,
hyperactivityandfatigue.
Postprandialdysmetabolism
Inflammation
Brainonfire.
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InflammationandtheBrain
Hypothalamicpituitaryadrenal (HPA)axis
hyperactivity(thestressresponse)
Effectsthyroidfunction
Effectsserotonin anddopamine, glutamateand
GABA.
Inflammatory messengerssignal thebrain toproduce
neurochemical, neuroendocrine, neuroimmune, and
behavioralchanges.
FoodSensitivity
Ahiddensourceof
inflammation
ModifiedEliminationDiet
Wheat
Corn
Dairy1(milk,cream)
Dairy2(cheese,yogurt)
Nightshadevegetables
Tomatoes
Potatoes
Peppers
Eggplant
10Daysoffall.
1daychallenge(1ata
time)
2daysoff(observe)
Keeprotatinguntilall5
categorieshavebeen
challenged.
Avoidreactivefoodsfor
23months.
Sometimesthecurefor
restlessnessisrest.
ColleenWainwright
NaturalSleep
Sleepproblemsare
acommontrigger
Thereisnowayto
recoverfullyunless
sleepimproves
NaturalSleep:Howmuch?
Averagein1900
Averagetoday
Timing
Naps
3/12/2011
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NaturalSleep:WhatHelps? NaturalSleep:WhatHelps?
NaturalSleep:WhatHelps?
DawnSimulator
Northernlighttechnologies.
com
NaturalSleep:WhatHelps?
SublingualMelatonin
Useplainmelatoninfor
troublefallingasleep
Addothercomponents
fortrouble staying asleep
NaturalSleep:WhatHelps?
Passionflower:
Gentlesleepaid
Useasatincture,
teaorfreezedried
capsule
NaturalSleep:WhatHelps?
Ltheanine
100200mgatbedtime
Maybeaddedtoother
supplements
3/12/2011
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NaturalSleep:WhatHelps?
Ltryptophan/5HTP
Aminoacidprecursorto
serotonin
Ltryptophanismoresedating
than5HTP
5001000mgatbedtime(or50
100mgof5HTP)
CautionifonanSSRI
ThePsychologyofMindfulness
Mindfulness(Vipassana)
(TheMindRunRampant)
Heartfulness(Metta)
(TheIllusionofSeparation)
Thepracticeofseeingand
acceptingthingsastheyreally
are
Learningtodolessharm
Thepracticeoflearningto
lovewell
Cultivatingalargerself
Mindistheforerunnerofallthings.
Beginwithmind.
The Dhammapada
TheNatureofMind
We are what we think.
All that we are arises with our thoughts.
With our thoughts we make the world.
Speak or act with an impure mind
And trouble will follow you
As surely as the wheel follows the ox that draws the cart.
We are what we think.
All that we are arises with our thoughts.
With our thoughts we make the world.
Speak or act with a pure mind
And happiness will follow you
As closely as your shadow, unshakable.
--The Dhammapada
Mindfulness
Awareness
Momenttomoment
Intentional
NonJudgingandAcceptance
Slowingdown,honoringtherhythmsofnature
Observingthemindfromaringsideseat
AdventitiousSuffering
Somesufferingis
inevitable
TheSecond
Arrow
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TheNatureofMind
Reactivity Emotion
Grasping
Rejecting
Disconnecting
Fear
Anger
Flat/Dull
Consequences
Disconnectionfromselfandothers
Agitation
Fear
Anxiety
SelfDestructiveBehaviors
Depression
ReliefFromSuffering
Wecantransformsufferinganddevelopthe
capacityforjoy.
Thekeyismindful,nonjudgingacceptance
Mindfulnesspracticesdeveloptheskillsand
habitualwaysofbeingpresentinthisfulland
liberatingway.
TheMedicineofMindfulness
FoundationsofMindfulness
Mindfulnessofbody/breath
Mindfulnessofmind
Mindfulnessofemotion
MindfulnessPractices:formalandinformal
Seatedandwalkingmeditation(formal)
Mindfulnessindailyliving(informal)
CalmingtheMind
Mindfulnessofbodyandbreath
Pausing:MindfulBreathing
Mindfulnessmeditation
Recognizingmonkeymind,wildmind,puppy
mind
Developingobservingself
Thoughtstend,then,toawaken
theirmostrecentaswellastheir
mosthabitualassociates.
WilliamJames
3/12/2011
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FavoriteFlavors
Reactivity Emotion
Grasping
Aversion
Denial
Fear
Anger
Flat/Dull
TurnTowardtheFeeling
Tears are the river of life washing away the old to make way
for the new. -Unknown
Experiencingemotionsasbodysensation
Ridingthewave
Droppingthestoryline
Stayingwiththeexperience
Impermanence
Let everything happen to you: beauty and terror.
Just keep going. No feeling Is final.
-Rilke
EmotionalStorms
EmotionalSteadiness
Grounding
NonAttachment
Opportunitiesfor
Mindfulness
Loveisthegreatwork
Thougheveryheartisfirstan
apprentice.
Hafiz
3/12/2011
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ALargerContainer SelfAversion
I am now the
most miserable
man living.
-Abraham Lincoln
January 1, 1841
AcceptanceofSelf
Halfofanypersoniswrongandweakandoffthe
beatenpath. Half!
Theotherhalfisdancingandswimmingand
laughingintheinvisiblejoy!
Rumi
CaringAboutOthers
Bekind.Everyoneyoumeetisfightinga
greatbattle.
PhiloofAlexandria
CultivatingaGoodHeart
HeartOpeningPractices:GettingBeyondtheSmall
Self
Lovingkindnessmeditation
BeginningwithSelf
Extendingandenlargingthecircle
Wecanlivewithoutreligionand
meditation,
butwecannotsurvivewithouthuman
affection.
TheDalaiLama
3/12/2011
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TheIllusionofSeparation
SharedSuffering,SharedJoy
There is no house
like the house of
belonging.
~ David Whyte
CultivatingDeepConnections
Dissolvingtheboundaries
SympatheticJoy
CreatingourHouseofBelonging
Connectionwithourinnerwisdom
Connectionwithsourcesofspiritualnourishment
EncounteringSoul
"This is the first,
wildest, and
wisest thing I
know, that the
soul exists, and
that it is built
entirely out of
attention.
-Mary Oliver
TheBenefitsofMindfulness
Practice
Clearmind
ObservingSelfbuffer
Freedomfromhabitualselfharming
Fullpresenceinthemoment
Recognizingimpermanence
Hope
TheBenefitsofMindfulness
Practice
Selfacceptance:thecoreofresilience
Acceptanceoflifeasitis sufferingandall
Greatercapacityforjoy,aonelearnstoliveinthe
presentmoment,ratherthanthepastorthefuture
Asenseofconnectionwithself,others,andthelarger
orderofthings
3/12/2011
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SpiritualExperienceandFruits
Fromfeartocourageandempowerment
Fromanxietytopeaceofmind
Fromjudgingtocompassion&empathy
Fromisolationtoconnectionwithself&others
Fromdespairtohopefulness
Fromshametofreedomfromselfconsciousness
FROMSMALLSELFTOTHEUNIVERSAL
Whatstheonethingyoucando?
ThereIsOneThingWeCanDo
Thereisonethingwecando,andthehappiest
peoplearethosewhocandoittothelimitof
theirability.Wecanbecompletelypresent.We
canbeallhere.Wecangiveallourattention
totheopportunitybeforeus.
MarkVanDoren
ForMoreInformation
Goto:
www.partnersinresilience.com
Orwww.henryemmonsmd.com