Psychiatric Healing Centers: Debra L Bunger MD, Executive Director | Exploring Natural and Pharmaceu
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keywords: description:Exploring Natural and Pharmaceutical Solutions for Maximum Brain Wellness Skip to primary contentSkip to secondary contentGrowing up, I was the kid who saved half their box of crackerjacks for later. Too much sugar was, well, too much. Sometimes I would forget to eat the other half of the box, too.
Even as an adult, I never really ate a lot of sugar; even in the anything goes including six beers at one setting days. I liked carbs, like everyone else. But eating granola out of the box while studying was as out of control with sugar as I ever got.
Somewhere over the years, that changed. Sugar did something to me it had never done before. It suddenly had the power to control me. Read on.
After giving up dairy, more or less, a couple of years ago, I searched for a natural, healthy, non-dairy coffee creamer. (Yes I gave up dairy; no I didnt give up coffee.) Coconut oil was pretty good. Coconut milk was better, although even it did not turn my coffee the right shade of tan. Then along came SO Delicious coconut mild coffee creamer Barista style French vanilla, and I thought I had arrived.
SO Delicious coffee creamer is so delicious. It is the perfectg coffee creamer for many, many people, I am certain! It has a wonderful list of ingredients: organic coconut milk, natural flavors, and just the slightest amount of cane sugar to make it a touch sweet. And theres the rub.
After starting to use SO Delicious mild coffee creamer Barists style French vanilla, I suddenly realized that I just LOVED coffee. I started drinking two or more large cups every morning and sometimes another mid-day. After work, I might have a mixture of caf and decaf. At night, I might make a whole pot of decaf to drink while watching the Warriors games. Each cup with just a splash of SO Delicious nild coffee creamer Barista style French vanilla. Mmm,mmm good!
Sometimes, while standing in front of the refrigerator, when I was thirsty, I might just have a little drink of it, right out of the carton.
Then when I would run out, I would hesitate about putting it on the grocery list, because deep inside I knew that something was not right. But my partner, noticing that I went through it pretty quickly and realizing that I must really like it, and happy that he was pleasing me, would buy ever more cartons, never wanting me to run out again! Sometimes there were three pints in the fridge at a time to make sure I did nto have to go without. I drank more and more coffee and went through them faster and faster.
This, gentle reader, is addiction.
Sugar is the most addictive substance known. rats who will starve themselves to death for heroin or Meth, will give up both for sugar. We all were born with a love of sugar: breast milk is basically sugar water with lots of vitamins, minerals and immune system boosters. So the Grocery Manufacturers Association has us. Sugar is in everything. If you dont believe me, just look at the ingredients of any processed food that you buy, or as I prefer to call them, food-like substance.
Somewhere between saving half of my crackerjacks for later and So Delicious coconut mild coffee creamer Barista style French vanilla, something in my body changed.
In my twenties, as a fit and muscular runner, I read an article in Shape magazine that started like this: It is the saddest thing in the world to realize that you can never eat again. That resonated with me then, and still does. It has been a long time since I could eat whatever I wanted.
After I used up the last carton, and mustering up all of my courage, I forced myself to tell my partner not to buy any more SO Delicious Mild Coffee Creamer Barista style French vanilla. He did not ask why, so I am guessing that he knew why. I went back to coconut milk, coconut oil, and a touch of stevia for my coffee, even though it made it the wrong color.
Just like that I quit drinking decaf during the Warriors games.
Just like that I quit drinking coffee after work.
Just like that I started feeling better.
The resolution of all addictions starts with the same thing: honesty with yourself. I cant eat sugar. It makes me high. It makes me feel great for a while. Then I need another fix. You may not be as addicted to sugar as I am, but may I humbly suggest that you give it up for a couple of weeks and see how you feel. See what it is like to have your blood sugar even all of the time. You may be amazed at the results.
The high price of practitioner supplements has bugged me for a long time. How could a supplement in a naturopath or a chiropractors office cost three times as much as the identical supplement at Walgreens or Walmart? Is this just another consumer rip off?
I was wrong.
What I found out is that there is a lot of junk out there. Really bad stuff. I read that 40% of supplements on Amazon.com, for example, are actually fake: just cornstarch in capsules with the correct labels. But the information that really gave me pause was from an educational talk that I attended last year at the annual conference of the Northern California Psychiatric Society.
It seems a research group testing the effectiveness of St. Johns Wort, an herb used widely in Europe to treat depression and which is also readily available here, gathered many different brands of St. Johns Wort for the study. They were quite surprised to find that some of the brands of St. Johns Wort contained none of the herb at all. You read that right. The bottles labeled St. Johns Wort contained no St. Johns Wort whatsoever!
Check it out. Google Fake St. Johns Wort and see how many articles you find about companies, some of which I thought were reputable, who were knowingly selling these fake versions of the herb. GNC, Walmart, Walgreens and Target all have been investigated, and all were accused of selling fake supplements.
Let me be quick to add that in a perfect world, we would not need supplements. My patients are surprised when I tell them that my main source of for example, is the bacteria on unwashed organic vegetables. But it is a toxic world out there. Many people get most of their calories from food like substances instead of food. Some are choosing wellness for the first time. They very likely will need supplements. These are the people to whom I am talking.
So in regards to expensive supplements being a rip off: I stand corrected. As with all things, you get what you pay for. If you think health is expensive, try sickness.As I move my practice toward Wellness, instead of only treating brain disorders with medications, I will begin carrying supplements. I have decided that I will carry the best, most pure, most effective, most ethical brands that I can find even if they cost a few more dollars. After all, health is your most important financial asset, and investing in your health is your absolutely best and most important investment; and the one with the greatest returns.
I recommend you start with bone broth. (Mushroom broth for vegans!)This is cooking on my counter right now!
When someone is newly committed to a healthier lifestyle, to maximize both their health and longevity, (and health into longevity!) , they often do not know where to start. Kelly Brogan, MD, a holistic psychiatrist whom I greatly admire, starts with diet. My understanding is she tells all of her new patients to go completely gluten free, dairy free, sugar free and processed-foods free for 30 days in a row, before returning to her. I think having those criteria will truly make her practice successful. But many of my patients simply are not going to do all that right off the bat. I didnt.
I do all of those things now, although I sometimes cheat and use Palm sugar if I am out of Stevia. I probably drink too much coffee, too, and don’t eat enough salad. But I am light years ahead of the days when I was drinking three sodas per day and eating fast food. I’m thinner, too.
I think it is okay to slide gradually into good health, and one place I recommend starting is with bone broth.
You can buy a good quality bone broth from grass fed or pastured animals for about $12.00 or about $1.00 per ounce. Or you can make it for approximately well nothing. I have a batch going on the kitchen counter most of the time This is what I do:
I have a slow cooker dedicated to bone broth. (It is okay to have two slow cookers; they are cheap!) Cooking bone broth smells wonderful, like you are cooking a roast, perhaps. You have that down home feeling from the delicious smells in your home. And bone brother is so good for you! Look:
1. Bone broth promotes bone health, digestive health, and skin health and beauty.
2. It contains Vitamin A
3. It is high in Glycosaminoglycans for joint health
4. It is high in minerals to strength your immune system
5. It is high in gelatin, which is great for healing an inflamed or leaky GI tract.
6. It is a good source of collagen, for youthful appearing skin.
7. It is high in glycine to improve sleep and memory.
Here is how to do it:
First save all your bones from high quality grass fed or pastured animals. (Really, organic is worth the money. Save your money on the broth.) In my freezer, we have separate bags for beef bones, pork bones, chicken bones, lamb bones, and shrimp tails. (Yes.) We add the bones from the meat after each meal, including – should I tell you? – from everyone’s plate, to the appropriate freezer bag.
Choose a bag of bones, and put them in your slow cooker. The bones do not have to reach the top. I usually add what my cookbook calls aromatics – an onion cut in half, 2 carrots or so cut in half, and a lot of celery, because I love the smell and taste of cooked celery; all organic if possible. Personally, if these vegetables are organic, I may not wash them at all, unless they have visible dirt on them. That’s just me, and I am very rarely sick. Fill the slow cooker with filtered water. Add herbs if you like, like fresh thyme or parsley. Add a tablespoon or so of a good quality apple cider vinegar to acidify, which helps pull the minerals out of the bones. Turn it on low and forget it. (Add water about once a day or after you get a cup out to drink.)
I usually take the vegetables out after about a day; that is about as much as they can take without looking too tired to be contributing much.
Total cost: maybe $3.00. Maybe less. If I add wild mushrooms, which I might do, maybe more. By ladling out bone brother and adding back water, this will usually last me about a week. So roughly 240 ounces of bone broth made this way will cost you about $0.04 per ounce. If you add in the cost of doing the physical labor, including cleaning the slow cooker afterwards, (which will not be that hard), at $120 per hour, (Hey! Why not?) the total cost comes to $15.00. The same amount of purchased would be about $240.00. Pretty good savings. That will buy a lot of grass fed beef.
It costs roughly 25 times as much to buy as to make yourself, including labor! Of course, if you are eager to get started you can purchase fine bones at your local high quality market. So that might raise the cost slightly.
Another advantage to making it yourself is it is already hot! At the end of the week, I often pour what is left in a mason jar or two, but warming that up from the refrigerator just is not as inspiring as ladling it out of the slow cooker.
You can drink it as is, but I usually add a little flair. I add 1-2 tablespoons of Thai Kitchen organic coconut milk (my favorite brand) , a couple of tablespoons of turmeric (which I grow myself, but that is for a different blog post) fresh ground pepper (for flavor and to make the turmeric more easily absorbed by the GI tract) and salt (because food tastes better when it is properly salted.) In at least one study, one teaspoon of coconut milk improved cognitive functioning. That is one teaspoons total; not one teaspoon per day! Turmeric is a great anti-inflammatory, and so good for you in so many way. I eat or drink turmeric almost every day, I probably take a pain medication once per year or less. I don’t have any pain, and very little inflammation.
There you have it. An easy and delicious change to make on the way to better health. Cut back on coffee or other drinks and add a cup or two of bone broth every day. A great first step toward a healthier diet; healthier you!
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Kelly Brogan MD wrote the book I wish I had written. Now I am going to completely change the way I practice Psychiatry. I was already cutting through some of the questionable rhetoric and studies funded by the very pharmaceutical companies which stood to benefit from the research. But Kelly cut to the chase. For those of you who are willing to do the work, you are going to feel much, much better, much more quickly, and save a bundle on healthcare. Enjoy.
http://kellybroganmd.com/amindofyourown/?ref=140
Lamotrigine (Lamictal) has been one of my main ‘go to’ pharmaceuticals for many years. It is a great choice for people who are depressed or have mood instability and need medication, but whose symptoms do not fit neatly into the diagnostic boxes of either depression or bipolar disorder. It does not have the main side effects that people most dislike about psychiatric medications: weight gain, sexual side effects and sedation. Its primary risk is that of an allergic reaction. However, like many other medications, it can interfere with folate pathways resulting in low L-Methylfolate, so when a patient’s insurance covers it, or when they can afford to pay for it out of pocket, I usually prescribe L-Methylfolate to go with lamotrigine. Unfortunately, since L-Methylfolate is technically a medical food instead of a pharmaceutical, insurance companies often will not pay for it. This means that sometimes my patients do not get optimal care for financial reasons.
Below is a list of medications which are known to possibly interfere with folate metabolism:
Anticonvulsant medications used to control seizures and other conditions such as lamotrigine (Lamictal®), valproate/divalproex sodium(Depakote®), and carbamazepine (Carbatrol®, Epitol®,Tegretol®)Methotrexate (Rheumatrex®, Texall®) which is commonly used for psoriasis and rheumatoid arthritisSulphasalazine (Azulfidine®) for inflammatory bowel disease and rheumatoid arthritisOral contraceptives (birth control pills)Metformin (Fortamet®, Glucophage®, Glumetza®) is used to treat type 2 diabetesFluoxetine (Prozac®, Sarafem®) is an antidepressant that works as a serotonin reuptake inhibitor (SSRI)Niacin (Niaspan®, Slo-Niacin®) and fenofibrates (Tricor®, Trilipix®) are commonly used to lower cholesterolWarfarin (Coumadin®) is an anticoagulant that prevents blood clots due to irregular heartbeat, prosthetic heart values and heart attack.Isotetrinoin (Accutane®, Amnesteem®, Claravis®, Sotret®) a retinoid medication for severe acneSome disease states have been associated with low folate as well. These are the best known:
DiabetesAtrophic gastritisCrohn’s diseaseColitisRenal failureHypothyrodismAlso, L-Methylfolate in the brain decreases with age. Below is a rough schematic of how L-Methylfolate helps your brain to make neurotransmitters, the chemicals which determine your mood and focus, among other things. Note how much more efficient L-Methylfolate is than folic acid in making neurotransmitters, and all the places in the process where something can go wrong. For example, some studies indicate that 70% of people with depression and 98% of people with autism have a genetic error in MTHFR; the green box near the bottom of the schematic. If you have that genetic error, your body cannot easily make L-Methylfolate. This is important because L-Methylfolate is a precursor for all of the neurotransmitters that are implicated in depression and many other psychiatric disorders.
There are places where you can order a simple saliva test to find out if you have a genetic MTHFR abnormality. One of these is 23andme.com. The test costs around $100. You also may want to just take L-Methylfolate to see if you feel better; side effects seem to be mild and in studies are less than that from placebo. If you are taking Lamictal (lamotrigine) or one of the other medications listed above, you may want to take L-Methylfolate anyway. If your insurance covers Deplin, the name brand for the pharmaceutical L-Methylfolate, or generic L-Methylfolate, you may want to discuss with your practitioner whether or not you should be taking that instead of or in addition to your other medications.
If your insurance does not cover it, I have found a pharmaceutical grade source of L-Methylfolate for about $30 per month, which is significantly less (half or less) than the cost of either Deplin or L-Methylfolate at the pharmacy if your insurance does not cover it. You can also find L-Methylfolate at natural food stores, but the dose is so small that I have not found it to be useful or cost effective.
Since I found this affordable source of L-Methylfolate, I have recommended it to many patients, especially those taking lamotrigine. I usually recommend taking it for a month or two and deciding if it has a positive effect on mood. Many have told me that they felt like the addition of L-Methylfolate has made a big difference on their mood and overall well being. Of note is that it actually has fewer side effects than placebo; probably because it has virtually no side effects and it tends to make many patients actually feel better!
To find out more, please contact our office at
Tel: Aptos 831-708-2919. San Jose: 408-440-1011 Monterey: 831-717-4987 Text: 831-278-1727
This supplement is not available without an assessment by Dr. Bunger or one of her colleagues.
Website: DebraLBungerMD.com.
Basic Self Care: Step 1, Easy Diet Changes
Americans don’t take very good care of themselves. We have access to the best food and the best exercise equipment, but we also have access to the worst temptations. Almost everyone is stressed. So called “comfort foods,” such as mashed potatoes or macaroni and cheese, are high in carbohydrates and stimulate insulin, which is damaging to our tissues. But there is a loss in giving these foods up. As a patient of mine once said, “I really miss eating a big meal of junk food and then having a carb nap.”
People who are tired, foggy brained and low on motivation, will often go see their doctor, who will prescribe an antidepressant. Sometimes all these people really need is a period of a great diet to heal their brains and bodies. But people need to learn to think of food as medicine.
I knew that eating right was a good idea and would help you live longer, but when I changed my diet myself, I found out that the benefits go far beyond that. Although I do not have an autoimmune condition, I have had unexpected benefits from the paleo autoimmune diet myself, beyond just weight loss. My mood is definitely improved; stress does not affect me as much. I can also think better – I noticed I could do calculations in my head faster, or hold my own in a debate. (Other people noticed that as well!) But most interesting to me was that my motion sickness, which I had had since I was a little kid, largely went away!
A great diet will improve your mood, stamina, concentration, memory, ability to think well, and will decrease your stress. It will likely make you feel better in other unexpected ways as well.
What constitutes a good diet?
Let’s start with protein. A protein serving is 3-4 ounces of meat or 3 eggs, which is about 20 grams of protein per meal. I recommend meat that is as natural as possible. It is better for you and much better tasting as well. Vegetarians need to conscientiously combine protein to make sure they get 60 grams per day. (I have deep appreciation for the beliefs of some vegetarians, but I often have to nag them to be conscientious about their protein intake. I also do not think it is a coincidence that there are many more vegetarians in my practice than the number in the general population would predict. A vegetarian diet is likely the best one for your heart. It is not the best one for your brain, which needs protein to synthesize neurotransmitters.)
Most of your calories should come from fat. Surprised? Fat does not make you fat. Good fats are fish oil, coconut oil (for cooking), olive oil, avocado oil, animal fats, and if you can tolerate them, seed oils like sesame and walnut. There was a study that showed that one teaspoon (not one teaspoon per day – one teaspoon!) improved the cognitive functioning of the participants. No medication can claim that!
For an adequate Omega 3 supply, you should eat fatty fish three times per week. If you can’t do that, like at my house where my family won’t eat fish, take 1000 to 2000 mg of fish oil every day. (Vegetarians can take flaxseed oil instead, but the ratio of Omega 6 to Omega 3 is not as good.) Eggs are also a good source of Omega-3 fatty acids, especially if they come from organically raised chickens.
Bad fat is as bad for you as good fat is good for you. You should eliminate trans-fatty acids from your diet completely! Most packaged chips or baked goods have some.
Antioxidants and Carbohydrates
Last week I told the story of the significant disappointment I had eating my first bag of organic popcorn after three months on the paleo autoimmune diet. It tasted so – dead. You really don’t need grains at all. You can easily get all of your carbohydrates from vegetables and a few fruits every day. These same fruits and vegetables, in addition to being loaded with essential nutrients, serve as antioxidants.
Some of the waste products from the biochemical reactions which turn food into energy are free radicals. Organic fruits and vegetables prevent free radicals from damaging your body. In other words, eating fruits and especially vegetables will keep you young. The bulk of your calories should come from fat, but the bulk of your food should come from vegetables and a few fruits.
Recently I told my daughter, a super taster (who can taste things in food that the rest of us can’t taste, so she is also labeled a “picky eater”,) that when we are out of kale for my morning smoothie, I think I actually notice a difference in how I feel. She said the same thing was true of her, even though kale is bitter and not something she would normally like!
If all you do is add some fresh, organic vegetables to your diet, it is likely you will feel better.
A few days ago I went out for breakfast for my birthday, and I invented a new kind of Eggs Benedict, one of my favorite foods: Spinach, Salmon and avocado topped with poached eggs and Hollandaise sauce. It was delicious! It took a few months, but I no longer have any interest in foods that are not nutrient dense, because they do not seem to make me feel good immediately, like nutrient dense foods do. But if you are eating doughnuts in the morning, a roast beef sandwich in the afternoon, and a hamburger and fries at night, where do you start? I have a few ideas.
Do not go on a diet. Do not count calories. Has it worked so far? And for how long? Nuff said. Don’t even try to limit your portions. Just eat until you are comfortably full. If you are stressed out, eat more. It will turn out okay over the long haul.Give up processed foods. Just stop. Anything that comes in a box. Anything with ingredients you can’t pronounce. Anything with such a long list of ingredients that you don’t have time to read them all. I have gotten to the point that if I look at the back of a product – say, coconut milk – if it says much more than “coconut milk, water” I stop reading and put it back. (You should consider the same thing for your personal hygiene products and cosmetics, by the way.)Recognize that just like good running shoes cost money, so does food, so prepare your budget. You can save money on food by buying at the Farmer’s Market (a fun outing) and growing some of your own (also fun, and very peaceful and relaxing, and for a later post), but until the new apple tree bears fruit you are going to have to spend some money. You are worth it. “If you think health is expensive, try sickness.”Gather some paleo recipes, because you are going to give up potatoes and rice. I know, I know. You can do it. I did it. My daughters did it. Maybe you can add them back later. In the mean time you can learn how to make sweet potato fries made in good fat, cubed turnips in stew, and “riced” cauliflower for rice. These foods are delicious, but you will not get the same carb high off of them. That is the point.If you are a sugar addict like most of us, buy some stevia sweetened snacks. Buy some stevia for your coffee or tea. Do not even consider the Aspartame, Sucralose or Saccharin versions, which are just short of poisonous. Buy the most delicious gourmet chocolate sweetened with stevia that you can find. There are sodas called Zevia that you can try if you are a soda addict. I don’t eat these things myself, but I did. They are transition foods, and because they are sweet and delicious but will not give you a sugar high, you will not only love them, but also will find them easier to give up in the future. One day you will say “I’m not paying that for a candy bar when I have blueberries growing at home.” I promise! Notice that I said you will give them up – not that I will nag you to! You will do it on your own as you feel healthier.Same with gluten. If you aren’t quite ready to give up bread, cookies, cakes, and crackers, buy the gluten free version – for now: Gluten free and stevia sweetened. There are brands that are delicious, but you won’t believe the cost! Last year on Mother’s Day, I had sugar-free, gluten-free chocolate chip cookie dough “ice cream,” made with stevia, gluten free dough, and coconut milk. It was really good, and really expensive, and I haven’t had any since!Limit your fruits to five per day. When I tell people that they usually laugh. Most people don’t eat even one per day! But as you give up sweets, fruits become more interesting. There is a little bit of effort involved in leveling out your blood sugar, so try not to substitute fruits for doughnuts. At least not beyond five fruits per day. Berries are the best: they are lower in fructose and full of vitamins.Add vegetables. Any. Anywhere. My daughter could not believe how delicious tomatoes are on hamburgers when I convinced her to try them. Try to eat a salad every day. Or do what I did – and what I highly recommend – and give in to the infomercial that you are watching at 1:00 AM sprawled out on the couch, about the Nutribullet, because it is going to change your life. I bought one and it did. I usually have half a smoothie every morning and the other half later in the day. It is a great way to start the day. The Nutribullet costs less than $100 and is a breeze to clean. My morning smoothie consists of kale, avocado, coconut kefir, blueberries, and strawberries; and ginger, cilantro or whatever I have on hand. It is mildly sweet, and by drinking it I am consuming 5 or so fruits and vegetables first thing in the morning. A great way to start the day.That’s not so bad, right? Add a 20 minute walk after work and on the weekends (I tell my patients to just put on their running shoes and walk out the front door!) and you are well on your way to healthy living. More soon!
Indoor pineapple we are growing from pineapple top; indoor papaya tree in the background
Popcorn used to be an evening treat most nights. I am particular about it as well, cooking a certain kernel size of a certain organic brand in coconut oil in an on stove hand cranked popper, then adding melted butter and sea salt in my opinion perfect popcorn! My 3 months on a strict paleo autoimmune diet ended April 1. Because I love popcorn so much, I decided to add it back first.
If you have an autoimmune illness, you need to follow the autoimmune protocol nearly perfectly for several months to achieve good, even remarkable, results. I have my own problems, but an autoimmune disorder is not one of them, so after 3 months of clearly improved health, I decided to add back popcorn.
A friend told me about a movie he recommended that I see. Fortunately, it was playing at a theatre which served organic popcorn with organic butter! What a way to break my popcorn fast!
You probably know where this is going. The fabulous organic popcorn with organic butter and sea salt was okay. While better than eating cardboard, it was nothing compared to an avocado. Yes I ate it all, probably out of habit and hoping that each bite would provide the magic I was used to. But it didnt. Sometime in the last three months I became someone who came to love and even crave nutrient dense foods.
I didnt see this coming. Three plus months ago, popcorn was perhaps the hardest thing to give up. But now my body actually craves salads and green smoothies. Imagine that.
Most people can probably get away with ignoring the needs of their body to some extent in their twenties and maybe thirties, although I dont recommend it. But at some point it becomes time to take care of ourselves. About the time you realize you really do need to invest in a good workout shoe is the time to seriously invest in a good diet: mostly plants, good fats (animal, coconut oil, olive oil), minimum fructose, natural meats and fish.
Also, health takes time! Again, in your twenties, you can stay up all night studying for a test and crash the next day, but at some point you have to make self care a priority. I am setting a personal goal of devoting 10% of my waking hours to health. That is about 100 minutes a day. That will include exercise and meditation, but it will also include looking for recipes in paleo cookbooks and cooking more at home, walking places instead of driving, taking time to get to know the farmers at the farmers market. It will include planning a garden of healthy delicious foods that we actually will eat and thrive on. As I tell my patients, remember to make self care a priority!
I thank Datis Kharrazian for the inspiration and references for much of this post and heartily recommend his books.
Keeping Your Brain Healthy
Your brain is part of your body; your moods and ability to think well are as much related to your brain’s connection to the rest of your body as it is to the things you go through every day. Your brain, is, in fact a secondary organ, evolved to take care of your genes and keep them going. It is affected by your experiences, but it is also affected by your lifestyle, diet and general health.
Forgetfulness, loss of enthusiasm for life, and exhaustion after tasks, are not normal aging. These are signs of brain deterioration. If you have these symptoms, you will probably not receive a diagnosis if you go see your physician, but the process is beginning.
As we get a bit older, many of us start to think about our cardiovascular health. So we start walking for exercise, and taking fish oil and Coenzyme Q10. All good. Being fit enhances the experience of being alive. If you are fit, you can hike further without resting. You can play tennis or golf. You can stand in front of the stage of a great band for hours without your back and legs hurting. Or you can spend a whole day at Disneyland without being exhausted.
But really, the most important organ to take care of is your brain! Don’t you want to be able to think way into old age? When you become too old to scuba dive, don’t you want to have clear vivid memories of past scuba trips? Of course you do!
There are countless examples of people who lived into old age with their brains sharp, who, when they died; were found to have the plaques in their brains identical to people who died of Alzheimer’s disease! It is not the plaques per se that determine your risk of Alzheimer’s. It is the overall health of your brain.
Even before your first appointment with a psychiatrist, you would benefit from doing a few things to maximize your brain health. This post covers the most basic: Every healthy brain needs oxygen, glucose and stimulation.
Oxygen
Your brain uses about a third of the Oxygen you breathe. In order to get adequate Oxygen to your brain, a lot of things need to go right. For example, if you are anemic, you cannot get adequate Oxygen to your tissues, including your brain. So if you have anemia it needs to be addressed. There are many types of anemia, but to treat iron deficient anemia, you must make sure you are getting enough iron in your diet. Pernicious anemia is anemia related to inadequate dietary Vitamin B12. Although I appreciate the philosophy behind vegetarianism, a vegetarian has the responsibility of being a conscious eater, and needs to make sure they are getting enough protein, iron and B12, to maximize their brain health.
If you have any circulation problems, these need to be addressed. If you have poor circulation to your feet, you very likely have poor circulation to your brain as well. If you aren’t getting good blood flow to your brain, you aren’t getting enough oxygen to your brain. Exercise, even something as simple as walking, can help with circulation issues, and will flood your brain with oxygen.
Asthma should be under good control. Often asthma symptoms can be decreased or eliminated by changing your diet. For years I ignored the fact that I get slightly short of breath every time I eat cashews. I miss cashews, but I breathe much better now.
Glucose
The brain needs glucose – a form of sugar to function. But if you have either hypoglycemia or insulin resistance (or frank diabetes) your brain is not getting enough glucose to function for much of the day. If you have hypoglycemia, you need to eat often enough to keep your blood sugar stable. I wonder how many young adults are diagnosed with depression or bipolar disorder when what they really have is mood instability, including irritability; due to hypoglycemia from a junk food diet.
If you have insulin resistance, you have plenty of glucose circulating, but it is not getting into your cells. Insulin resistance is diagnosed by lab tests, but if you routinely get sleepy after a meal, you likely have some degree of insulin resistance. The first step in addressing insulin resistance is giving up the sugar and processed foods that are pervasive in our society. If you still get sleepy after a meal, the next step is cutting back on the carbs, and eating less overall. The only thing that you should feel after a meal is a significant decrease in hunger. If you feel tired, or short of breath, or anything else, something is wrong with the amount or quality of food you ate.
For both hypoglycemia and insulin resistance, you should eat a moderate to low carbohydrate diet. Most of us live from sugar high to sugar low, and think that hunger is the low and should be replenished with some form of sugar. Many of us don’t even know what hunger feels like! A diet with a minimum amount of processed foods, sugar, and grains; and with lots of vegetables, moderate fruit, moderate (not high!) protein, and lots of good fats like coconut oil, olive oil and animal fat, will help to balance your blood sugar so you can think even right after a meal! If you are overweight, this diet can help you lose weight, too, which can dramatically lower your insulin resistance.
Stimulation
Everything you do well, you once could not do at all. But as your skill improved – whether skiing, crocheting or playing guitar you developed more and more connections between the neurons in your brain.
Let’s say that in your forties you decide to learn how to juggle. Let’s say you take a juggling class, and everyone else in the class is a teenager. Who do you think will learn to juggle the quickest? Right – the teenagers. But who do you think will be able to learn a new juggling routine the fastest? The teacher. Even though the teacher may be older than the oldest adult in the class, he can easily learn a new routine because his “juggling neurons” have so many connections.
A few years ago, a new friend asked me what I do well. What an odd question! And how hard it was to think of much! In my twenties, I would have had a whole list. I came in second in my age division in a running race. I played piano like a star. I loved and was really good at Math.
I have kept up my skills in Psychiatry, but not so much in many other things. Piano pieces which were easy for me to play at age 13 are very difficult now. I can’t even help my daughter with her Chemistry homework now, and I was a Chemistry major in college!
When I started studying for my Holistic Medical Boards, I was not confident that I could even still learn this much new information! But as I put in the hours, I re-learned how to learn. The Boards were five months ago and suddenly I am addicted to learning. My “learning neurons” developed multiple new connections, making learning new material easier and easier.
The lesson here is: Stimulate your brain regularly! Start playing piano again. Or take up a new hobby. Take a class. If you wish, buy one of the new brain apps and do the exercises. Do not live life passively, falling asleep eating chips in front of TV every evening. Take care of your brain and keep learning!
I have three offices in the Bay area: Aptos. Monterey and San Jose. If you would like to have a more thorough evaluation, please feel free to make an appointment.
The news in the medial literature about sleep isnt good. Not sleeping well shortens your life. So does taking sleeping pills. If you cant sleep, what are you supposed to do?
Although according to Wikipedia, Edison did not invent the lightbulb, he did invent the first commercially practical incandescent light in 1879. When we started lighting our homes in the evenings, we started sleeping an average of two hours less per night.
Our evolution as a species has not kept up. We really need that extra two hours.
Most people need 7-9 hours of sleep per night, and more toward nine than you might think. Although you may be able to function on less sleep; and sadly, most people do; some of the essential things that happen to your body during sleep will be compromised if you do not get the full amount that your body needs. For example, the way muscle tone is increased, is at least a two step procedure: when you lift weights, you are actually causing small tears in your muscles. Then those tears are healed during sleep. If you dont sleep well, that hard workout may have been almost pointless.
Most people know about sleep hygiene, but not everyone practices it, so Ill review that here first.
Your bedroom should be cool, probably in the 60s or so.
Your bedroom should be pitch black dark . This is unrealistic for most of us, so I recommend that you wear a sleep mask to block out all light. If you require a nightlight for going to the bathroom at night, it should be some kind of yellow light.
You should use your bed only for sleep and intimacy. Dont take your laptop to bed with you! Your sleeping brain needs to think of your bed as a place to sleep.
Your bed and bed linens should be very comfortable. Dont skimp on this! Comfort here is much more important than style.
Try to go to bed at about the same time every night and get up at the same time every morning seven days a week.
Other things you can do to help yourself sleep:
Stop drinking caffeine by 11:00 AM, and cut back on caffeine if you are sensitive.
Do not drink alcohol before going to bed. Alcohol actually increases the risk of waking up in the middle of the night.
Try to spend 30 minutes or so outside, looking at the blue sky, in the morning or lunchtime. I try to eat lunch outside whenever I can. This helps trigger your brains natural melatonin cycle.
At dusk, or a couple of hours before you go to bed, put on some yellow glasses to block the blue light part of the spectrum. Blue light is the part of light which suppresses melatonin. Wearing these glasses helps to normalize your melatonin cycle. There are several kinds of yellow or amber safety glasses available on Amazon for about $5.00 a pair.
To prevent yourself from having racing thoughts when you go to bed, take a few minutes to write before you go to bed. Think about the things you need to do and make a rough plan of when you will do them. Write down any reminders for things you are afraid you might forget. Then go deeper: write about the things you really care about, your joys, disappointments, fears. Getting these things out of your sleep-deprived head and on paper will help you sleep better, and help you feel better overall.
Try to avoid sleeping pills, even over the counter ones. Even melatonin should be used only occasionally.
Try an Epsom salt bath. I used to give my girls a bath just before bed so they could sleep better. Everyone knows that kids sleep better after a warm bath. Its true for adults too, and the Magnesium in the Epsom salts will help to relax you. (Why did we ever give up bedtime baths anyway?)
After your bath, try giving your feet, legs, hands, arms, ears and face a self massage with a carrier oil with a few drops of lavender or other essential oil.
These rituals take time, and time is at a premium for most of us. But a few minutes for yourself at the end of the day is a great investment. It reminds you of your own self worth. It fulfills the behest I often say to my patients at the end of our session: Remember to make self care a priority. You also will not believe how much better you feel if you teach your body to sleep 8 or 9 hours every night.
My answer is probably not. The really amazing thing is that wheat in its current form is even considered a food: it is that bad for you.
Wheat today is not the wheat you ate as a child, and is even less like the wheat your grandparents ate. It has not technically been genetically modified, but it has been so altered in the last 100 years that many researchers refer to it as new wheat. A particularly toxic version, very common in processed foods, has been shown to cause a severe immune response in many people.
Even though there are whole industries dedicated to flour (gluten), like bakeries and sandwich shops, it is still that bad for you. Even though some people cannot fathom going even a meal without a bread product yes it is still that bad for you.
I started to summarize all the ways that gluten is bad for you on a cellular level, but after the eighth way I became overwhelmed. Remember that glue comes from gluten and we were never meant to eat and digest glue.
Many people with celiac disease, the most severe form of gluten intolerance, have no intestinal symptoms, but instead have symptoms in their thyroid, joints, skin or brain. The most common manifestation of gluten sensitivity is the brain and nervous system.
I recently read four books by unrelated cutting edge authors in the field of autoimmunity and brain health. They all say the same thing: practitioners all over the country are astonished by what a profound therapeutic effect a strict (important) gluten free diet has on all types of neurological disorders. That would include forgetfulness and brain fog (if you are older) and ADHD type symptoms (if you are younger) as well as multiple sclerosis, or other serious illnesses. All describe adhering to a strict gluten free diet as one of the most important things you can do for overall health.
I know more about celiac disease than many people because my daughter has it. As a child, I witnessed her stagger and become confused if she accidentally ingested gluten. But I did not learn about celiac disease from her doctor. In fact, most doctors dont know much about celiac disease at all! Your average neurologist does not know that gluten can cause significant neurological disease.
But what if your doctor did suspect you had gluten intolerance and had you tested, and your tests came back negative? Your doctor likely only ordered (and your insurance company would only pay for) 2 antibody tests, but there are at least 10 antibodies that should be tested for. You could be at risk of a false negative, meaning your test shows you are not gluten intolerant, when you actually are.
If you simply must eat gluten, so you want to find out if you are gluten intolerant, you must do the whole test. It is only available through one lab and costs several hundred dollars out of pocket. (Your insurance company likely will not pay.) Even if this test comes back negative, since wheat is so modified, whos to say you wont become gluten sensitive in the future?
One more bit of advice: if you go gluten free, dont go overboard substituting other grains. Try to add more colorful fruit and vegetables instead. I frequently substitute avocados for croutons on restaurant salads. Yum!
Melissas Gluten Free graduation cake, baked by my talented cousin, Helen Best.
Yours in Health
TAGS:MD Bunger Director Executive Healing Psychiatric Debra Centers
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