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Tag Archive for: anxiety

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Food & Mood; These Dietary Recommendations are Positively Uplifting!

Food and Mood – These Dietary Recommendations are Positively Uplifting!

July 11, 2024/in Nutrition/by Kaplan Center

The connection between nutrition and your physical health is unequivocal. Excessive sugar consumption can lead to obesity and is also linked to inflammation and other chronic diseases such as diabetes; a high intake of unhealthy trans-fats increases your risk of future cardiac events; deficiencies in essential vitamins can accelerate cellular degeneration, thereby heightening your susceptibility to cancers and other serious illnesses. While these connections may appear simplified, their validity is well-supported by scientific evidence.

Yet despite the growing body of research illustrating the connection between a nutritious diet and enhanced mood and cognitive function, your dietary habits are often disregarded as a factor contributing to your emotional distress.

Research is increasingly confirming that inflammation of the central nervous system is a key factor in many chronic conditions, including mental health disorders such as anxiety, depression, and more severe disorders such as Major Depressive Disorder. Eating foods that are high in sugar and saturated fats can elevate inflammatory markers in your body and impact mental health by exacerbating anxiety, depression, and mood fluctuations. Dietary changes aimed at reducing inflammation and oxidative stress, as well as enhancing the gut microbiome — crucial for nervous system development and function — can substantially enhance your mental well-being.

If you would like to discuss strategies on how to improve your nutritional intake to optimize your mental and overall health, please give us a call today at 703-532-5892. We use a functional medicine approach to treatment; our goal is to treat the “whole you” so that all areas of your health are improved.

In the meantime, as the old saying goes, “you are what you eat,” so with your emotional wellbeing in mind, here are some dietary tips on how you can improve your mood and mental health.

1. Incorporate more foods rich in B-vitamins (B12, B6, Folate). B-vitamins are involved in a number of important processes in the brain: they support cellular energy production, proper functioning of the nervous system, red blood cell formation, DNA formation, and the regulation of hormones. Studies show that deficiencies in certain B vitamins can result in an increased risk of depression.

Foods rich in B vitamins include beans, lentils, raw spinach, asparagus, romaine lettuce, broccoli, avocado, fish, shellfish & eggs.

 
2. Talk to us about supplements. Even if you think you have a relatively healthy diet, supplements can provide additional support to your immune system and lower your risk of developing a host of inflammatory conditions, including depression.

Vitamin D (serotonin synthesis), vitamin C, magnesium (stress support), vitamin E (mood regulation), CoQ10, glutathione, and Omega-3 are additional examples of supplements with clinical applications in depression, anxiety and other mental health disorders.

 
3. Eat foods that provide gut support. One of the many neurotransmitters used by the brain is serotonin. Among its many functions, serotonin is involved in regulating mood. We now know that as much as 95% of serotonin is produced in the intestines so maintaining the integrity of your gut microbiome with a proper balance of good and bad bacteria will help keep the production of serotonin in balance as well.

Regularly eating foods like fermented vegetables, sauerkraut, miso, and bone broth will keep your gut microbiome stocked with good bacteria.

 
4. Eat high protein foods at every meal to support neurotransmitter production. Your body produces neurotransmitters by utilizing nutrients in the food you eat, primarily amino acids. For example, serotonin is a byproduct of the amino acid tryptophan; noradrenaline is made from the amino acid tyrosine, which is also converted to dopamine. Serotonin, noradrenaline (aka norepinephrine) and dopamine belong to a group of neurotransmitters called monoamines that play a major role in mood & cognitive function.

High protein foods like raw nuts, cold water fish, beans, and eggs, consumed on a regular basis, will ensure that your body is getting enough of the building blocks it needs to produce these important chemical messengers that will keep your mood stabilized.

 
5. When snacking, always balance carbs with fats and protein. Keeping your carbohydrate and protein intake in balance will help stabilize mood and mental clarity and while avoiding the peaks and valleys of blood sugar levels that can also lead to other serious conditions like insulin resistance and pre-diabetes.

What does a complete protein and carb combination look like? Try combinations like: hummus with celery, bell peppers and/or carrots; apple, pear, or banana with almond butter (or any nut butter); sunflower seeds and raisins.

Read: Snack on This!
 
6. Saffron and turmeric may support people with anxiety & depression. Foods with turmeric and saffron have for ages been eaten for medicinal support. A study published in Journal of Affective Disorders, reported that a treatment of curcumin (the active ingredient in turmeric) and saffron were effective at easing anxiety and depressive symptoms in people with major depressive disorder.

The anti-inflammatory and antioxidant properties in turmeric and saffron help calm inflammation. Add them to your foods for flavor and anti-inflammatory benefits.

While more severe mental health conditions may necessitate treatments such as psychotherapy and medication, especially if your emotional well-being poses a risk of harm to yourself or others, your diet remains as an effective healing resource. When complemented by other strategies that address inflammation, such as exercise, meditation, and stress-reduction techniques, the result can be a brighter and more positive perspective on your life.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

References:

Gorbachev D, Markina E, Chigareva O, Gradinar A, Borisova N, Syunyakov T. Dietary Patterns as Modifiable Risk Factors for Depression: a Narrative Review. Psychiatr Danub. 2023 Oct;35(Suppl 2):423-431. PMID: 37800271.

Ma Q, Xing C, Long W, Wang HY, Liu Q, Wang RF. Impact of microbiota on central nervous system and neurological diseases: the gut-brain axis. J Neuroinflammation. 2019 Mar 1;16(1):53. doi: 10.1186/s12974-019-1434-3. PMID: 30823925; PMCID: PMC6397457.

Marx W, Moseley G, Berk M, Jacka F. Nutritional psychiatry: the present state of the evidence. Proc Nutr Soc. 2017 Nov;76(4):427-436. doi: 10.1017/S0029665117002026. Epub 2017 Sep 25. PMID: 28942748.

Petridou ET, Kousoulis AA, Michelakos T, Papathoma P, Dessypris N, Papadopoulos FC, Stefanadis C. Folate and B12 serum levels in association with depression in the aged: a systematic review and meta-analysis. Aging Ment Health. 2016 Sep;20(9):965-73. doi: 10.1080/13607863.2015.1049115. Epub 2015 Jun 8. PMID: 26055921.

Elizabeth Lipski, Digestive Wellness: How to Strengthen the Immune System and Prevent Disease through Healthy Digestion, 3rd ed. (New York: McGraw-Hill, 2004)

Roth W, Zadeh K, Vekariya R, Ge Y, Mohamadzadeh M. Tryptophan Metabolism and Gut-Brain Homeostasis. Int J Mol Sci. 2021 Mar 15;22(6):2973. doi: 10.3390/ijms22062973. PMID: 33804088; PMCID: PMC8000752.

Lopresti AL, Drummond PD. Efficacy of curcumin, and a saffron/curcumin combination for the treatment of major depression: A randomised, double-blind, placebo-controlled study. J Affect Disord. 2017 Jan 1;207:188-196. doi: 10.1016/j.jad.2016.09.047. Epub 2016 Oct 1. PMID: 27723543.

meditation for stress

Why Meditation Is One of The Most Important Things You Can Do for Heart Health: A Doctor Explains

April 8, 2024/in Meditation/by Gary Kaplan, DO

Despite medical advances, heart disease remains the number one cause of death for both men and women in the United States. This is a startling reality, especially given how preventable it is for those of us that are not genetically predisposed. Stress, along with smoking, sedentary habits, and a poor diet are some of the main lifestyle-related risk factors that increase your chance of developing the condition.

This article looks specifically at stress as a risk factor for heart disease, and meditation as a natural and proven method to mitigate its effects.

How The Stress-Response System Works

Whether it’s related to work, health, money, relationships, or some other life event or situation, stress eventually finds its way into your life. Thankfully, your body is well equipped to handle stressful situations thanks to the autonomic nervous system (ANS). The ANS is dedicated to regulating processes such as increased heart rate and shallow breathing, which kick in when you begin to experience stress or anxiety.

The stress-reaction process is truly an amazing and efficient one: when your body is under stress the amygdala in the brain fires up and sends an alert that there is a stressor, then the sympathetic nervous system is activated and prepares your body to “fight or take flight.” Your adrenals then go to work, supplying your body with cortisol and adrenaline, completing the trifecta of the stress-response process.

Typically the stress-response system is self-limiting, and when the stressor is gone, cortisol and adrenaline levels subside, and allostasis or stability is restored to your body. However, when the stress-reaction process is repeated multiple times over a relatively short period, stress becomes chronic, and the system breaks down. This is called “allostatic load,” which often results in an increase in physiological issues that compromise your immune system, inducing illness, and even accelerating disease processes such as diabetes, cancer, and heart disease.

Questions? Give Us a Call!

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Why Meditation Can Help Your Heart

The practice of meditation for stress relief has become more widely accepted as a complementary treatment to conventional medicine. As research affirms its positive psychological and physiological effects on the body, the attitude of “it can’t hurt” has shifted to “it can help.” According to an NIH survey done in 2017, next to yoga, meditation is the second most used mind-body therapy in the U.S.

How Lowering Stress Promotes Heart Health

A regular meditation practice can play a role in reducing cardiovascular disease by:

  1. Lowering blood pressure. When left untreated high blood pressure can lead to stroke and heart disease. In 2021, a systematic review and meta-analysis that looked at six studies concluded that Mindfulness Based Stress Reduction (MBSR) contributed to a reduction in both systolic and diastolic blood pressure in hypertensive and prehypertensive participants.
  2. Releasing feelings of stress and tension. Meditating quietly even for just a few minutes a day can restore feelings of calm and peacefulness. In a 2021 study on nursing students, researchers reported a significant reduction of anxiety and stress after engaging in mind-body techniques such as meditation over a period of time.
  3. Improving sleep. Evidence shows that mindfulness meditation can be successfully used for the treatment of insomnia.
  4. Improving the response to emotional stimuli. After an 8-week period, the researchers in this 2016 study reported “…MBSR led to changes in the amygdala consistent with improved emotion regulation.”
  5. Boosting the immune system. After an 8-week period, the researchers in this study in Psychosomatic Medicine reported “demonstrable effects on brain and immune function.”
  6. Reducing inflammation. Inflammation plays a major role in heart disease. Chronic inflammation is involved in all stages of atherosclerosis, the process that leads to cholesterol-clogged arteries. Practicing a mind-body therapy such as meditation, in adjunct with dietary and exercise programs, can help reduce underlying inflammatory processes.

The bottom line: Meditation is a practice that you can do anywhere at any time, alone in the privacy of your own home, or in the company of others. As with many things in life, getting started is the hardest step. Private consultations with a trained practitioner can be a wonderful way for you to take that first step or to enhance an existing practice.

Below you’ll find some additional studies that demonstrate the positive effects of meditation, as well as yoga (which incorporates many of the wonderful elements of meditation), on cardiovascular health.

  • Association Between Mind-Body Practice and Cardiometabolic Risk Factors: The Rotterdam Study.
  • Meditation and coronary heart disease: a review of the current clinical evidence.
  • Systematic Review of Yoga Interventions to Promote Cardiovascular Health in Older Adults.
  • Yoga as an Alternative and Complementary Therapy for Cardiovascular Disease: A Systematic Review.

In the battle against stress and even heart disease, there is a lot you can do! By being proactive now, you can bring about changes that can make a significant difference in how you feel, both physically and emotionally, in the very near future.


We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article first appeared in Dr. Kaplan’s column on MindBodyGreen.com. Reviewed and updated April, 2024.

Human_Optimization_Podcast

LISTEN NOW: Why You Are Still Sick

December 4, 2023/in Long Covid, Wellness/by Kaplan Center

Dr. Kaplan was a recent guest on the Human Optimization Podcast with host Lisa Pitel Killah, BCHHP, FDN-P, hTMAP.

In this podcast, Dr. Kaplan and Lisa discuss

  • How inflammation influences chronic pain and depression/anxiety symptoms
  • What are “microglia”, how they influence inflammation, and what sets them off
  • How stress and adverse events in childhood can impact your immune system
  • What it means to have a brain on fire
  • The importance of finding the root cause(s) of your symptoms to get to the bottom of why you are still sick
  • Supplements and medications that are effective in treating long COVID and other chronic illnesses
  • The importance of a healthy gut and good sleep hygiene, and so much more!

Listen now: Episode #77: Why You Are Still Sick

 

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Dealing with Anxiety

8 Commonly Overlooked Causes Of Anxiety and Depression

May 17, 2023/in Conditions, Mental Health, Wellness/by Gary Kaplan, DO

With the right treatment, people seeking relief from depression or anxiety can live happy, productive lives. But if you’re one of the many Americans seeking relief from depression or anxiety, you’re no doubt aware of just how elusive successful treatment can be. It is estimated that as many as 30% of depressed patients do not respond to treatment, raising an important question: could it be that we’re thinking about — and therefore treating — these conditions in the wrong way?

A growing body of research suggests that depression and anxiety might not be mental disorders in and of themselves, but rather symptoms of a physical inflammation stemming from increased microglial activity in the brain. Microglia are the immune cells of the Central Nervous System (CNS) and are responsible for producing inflammatory chemicals in response to infection or other CNS damage.

This gives the medical community and those living with these debilitating conditions new hope. In thinking about depression and anxiety as symptoms, we’re afforded new insights into potential root causes, as well as alternative methods of treatment.

Here are eight often-overlooked causes of depression and anxiety that you should consider:

1. Celiac disease or gluten intolerance.

About 1% of Americans have celiac disease, an autoimmune disorder caused by the body’s negative reaction to gluten, the protein found in wheat, barley and rye. And gluten intolerance — also called non-celiac gluten sensitivity — is estimated to impact six times as many Americans.

While we don’t yet understand the mechanism of gluten intolerance in the body, the impact can be very similar to that seen with celiac disease. While intestinal complaints are most common, research is showing that some people with these conditions may, in fact, present with anxiety and depression as the only symptoms.

You can test for celiac disease with a simple blood test. The only way to test for gluten intolerance is to go gluten-free for six weeks and watch for any improvement. (Before making any major dietary changes, make sure to consult your provider or a registered dietitian.)

2. Sleep apnea.

There are two types of sleep apnea. Obstructive sleep apnea is the more common form and occurs when the soft tissue in the back of the throat collapses, thereby blocking the airway during sleep. Central sleep apnea, although not as common, is a result of the brain forgetting to tell the body to breathe. Studies confirm the relationship between sleep apnea and depression.

If you get plenty of sleep but never feel quite rested, or you find yourself often nodding off, a first step you can take is to answer the 8 questions on the Epworth Sleepiness Scale. If your score is equal to or higher than 10, the results should be discussed with your provider.

3. Lyme disease.

Lyme and other tick-borne diseases are becoming increasingly prevalent. While the most common symptom is joint pain, these diseases can also be associated with depression and anxiety disorders (affective disorders).

This link between Lyme disease and neuropsychiatric disease was first documented in 1994 in the American Journal of Psychiatry and has been widely documented since, but the potential connection is frequently overlooked when diagnosing those with psychiatric illness. If you are suffering from chronic pain and a mental disorder, this diagnosis should be considered.

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4. Unhealthy diet.

A study published in PNAS (Proceedings of the National Academy of Sciences of the United States of America) confirmed that “…frequent fried food consumption is strongly associated with a higher risk of anxiety and depression.”

On the other hand, eating a diet high in omega-3 fatty acids (fish oils, walnuts, and flaxseed) and antioxidants (colorful fruits, berries, and greens including spinach, broccoli, and collards) can help provide the brain with the nutrients it needs to repair free radical damage and optimize function.

5. Thyroid disease.

Both an under-functioning thyroid (hypothyroidism) and an over-functioning thyroid (hyperthyroidism) can present as depression or anxiety — not to mention other symptoms like weight changes and exhaustion. If you suffer from depression or anxiety, you may wish to have your thyroid hormone levels checked to rule out any disorder.

6. Medications.

It’s also possible that regular medications may be causing or worsening your depression or anxiety. Beta-blockers used to treat high blood pressure are known to cause depression, and acne-fighting Accutane, birth control pills, and even statins all list depression as a possible side effect.

If you take medication regularly, I recommend talking with your provider about the chances that your medication is bringing you down or making you anxious.

7. Toxic mold exposure.

Exposure to certain indoor molds can result in a wide range of symptoms, including depression, ADHD, difficulty concentrating, fatigue, chronic sinus infections, and various pulmonary and neurologic issues. If you fear that you’ve been exposed to indoor molds, it’s critical that you speak with a physician who is familiar with mold toxicity disorder.

8. Coffee.

Several studies have demonstrated a link between coffee consumption and heightened anxiety. While most people can tolerate one to two cups of coffee per day without issue, if you are prone to anxiety, you may want to rethink your morning pick-me-up. Try cutting out coffee altogether for at least two months and observe whether or not your mental state changes as a result.

This article first appeared in Dr. Kaplan’s column on MindBodyGreen.com in September 2015. It was reviewed and updated in May 2023.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Additional Resources

Harding CF, Pytte CL, Page KG, Ryberg KJ, Normand E, Remigio GJ, DeStefano RA, Morris DB, Voronina J, Lopez A, Stalbow LA, Williams EP, Abreu N. Mold inhalation causes innate immune activation, neural, cognitive and emotional dysfunction. Brain Behav Immun. 2020 Jul;87:218-228. doi: 10.1016/j.bbi.2019.11.006. Epub 2019 Nov 18. PMID: 31751617; PMCID: PMC7231651.

Temple JL, Bernard C, Lipshultz SE, Czachor JD, Westphal JA, Mestre MA. The Safety of Ingested Caffeine: A Comprehensive Review. Front Psychiatry. 2017 May 26;8:80. doi: 10.3389/fpsyt.2017.00080. PMID: 28603504; PMCID: PMC5445139.

depression_pain

Is Depression Ever Just Depression?

May 10, 2023/in Inflammation, Long Covid, Mental Health/by Gary Kaplan, DO

A modified model for understanding depression and anxiety ought to involve a whole person, integrative approach.

Public acts of violence seem to fill the news media streams these days and are typically followed by outcries for greater access to mental health care for those that need it most. And although almost all individuals with serious mental illness are not dangerous, many of the perpetrators of these heinous crimes later turn out to have a documented history of depression or mental illness, which often went untreated.

So, what can we do to stop the anguish? What is it that we are missing?

The Cost of Failure

Unfortunately, the number of Americans affected by serious depression and anxiety disorders is enormous, as are the costs to society due to failure to treat and/or treatment failure. Tens of millions of Americans suffer from depression, including chronic, low-grade depression (dysthymia) and anxiety. 21 million of those Americans have been diagnosed with major depressive disorder (MDD), the leading cause of disability for people ages 15 to 44.

The cost of failing to effectively treat these conditions is not just the individual’s inability to complete college, hold a job or cultivate positive relationships; it also includes the toll taken on an entire family and community when a despairing person takes their own life. And in other cases, the costs of acts of public violence – in terms of suffering, municipal expenses, personal medical and legal expenses, and lost human potential – are immeasurable.

Michael, a 17-year-old high school student, came to see me with a long history of hospitalizations after attempting to take his own life. Despite undergoing intensive psychiatric treatment, he remained depressed and suicidal. Like 40 percent of those who suffer from major depressive disorder, Michael was not responding to treatment.

When contemplating a situation like Michael’s, the question “What am I missing?” is never far from my mind. Statistics show that only about one-third of patients with MDD respond to antidepressant medication, with about the same number responding to psychotherapy alone. If we combine the two approaches the numbers improve slightly, but the fact remains that most people with MDD respond only partially to medical interventions, with almost half remaining entirely unresponsive.

A Central Nervous System in Turmoil

There is a mountain of scientific research demonstrating that neuropsychiatric conditions such as depression, anxiety disorders, and possibly bipolar disease are, in a very high percentage of cases, the result of inflammation occurring in the brain.

There is a great deal of research linking generalized inflammation to heart disease, chronic pain, and obesity. Inflammation in the body takes many forms: When we have an allergic response to pollen or food, our bodies’ inflammatory response includes the release of histamine, which makes our eyes itch and noses run; we see the inflammation associated with a skin wound when the white cells of our immune system respond to a bacterial infection. Inflammation in our brains, however, is unique in that it is mediated by tiny cells called microglia.

Microglia are the innate immune system of the central nervous system (CNS). Their job is to respond to trauma and damage to the brain. In response to brain injury, the microglia release a virtual symphony of chemical mediators that orchestrate the destruction of bacterial invaders, the elimination of damaged neuronal tissue, and the initiation of the repair process.

After responding to an assault on the brain, microglia typically return to a resting state. But ongoing and cumulative assaults to the brain will cause the microglia to remain chronically up-regulated, causing them to continuously spew out inflammatory, tissue-destroying chemicals. Examples of ongoing assaults include fever, physical assault, and emotional trauma. It can also be infections like Lyme disease or COVID-19.

Since the beginning of the COVID-19 pandemic, researchers have been studying how the SARS-CoV-2 virus affects the CNS as well as other body systems. What they are finding out is that it too heightens the activity of microglia leading to the release of inflammatory cytokines and a sequence of damaging events that can affect the brain and have other long-term effects on health.

Brain inflammation can produce a wide range of symptoms including depression, anxiety, chronic pain, difficulty focusing and concentrating, fatigue, and sleep disturbances.

Further compounding the issue is the fact that a solid understanding of the role of microglia in brain health is sadly lacking among most medical professionals, with the result that they continue to treat what are in fact “symptoms” as separate and unique “diseases.”

Looking Beyond the Symptoms

A better framework, where physicians look beyond the symptoms, involves giving priority to the discovery of the root causes of an individual’s depression or anxiety. This primarily requires an understanding of what caused the microglia to up-regulate.

Research has shown that anything that can damage neuronal tissue can be a trigger. So, an exploration of a patient’s depression may include asking them about possible traumatic head injuries, psychological traumas (acute events and chronic stress), infections (as mentioned above, tick-borne diseases, other bacteria, and viruses like Covid-19), and even biotoxins that may have entered the body from exposure to toxic molds, celiac disease, and hypoxia (usually related to sleep apnea). The list of triggers is long, and as such, the process of identifying the possible underlying causes of the disease requires putting together a thorough medical health timeline for each patient. By using this approach, treatment options expand due to the greater understanding of the origin of the illness, thereby increasing prospects for recovery.

As for Michael, my 17-year-old patient who was depressed and suicidal, it turned out that he has celiac disease. But how could a food allergy be related to his depression? Celiac disease is far more than an allergy to gluten – it is a very serious autoimmune disorder that’s triggered when even the smallest amount of gluten is ingested. As we know, with autoimmune disorders the immune system mistakenly attacks the body’s normal cells. In the case of celiac disease, when gluten is consumed the immune system goes into attack mode and causes damage to the healthy villi of the gut lining. Villi are responsible for absorbing nutrients and keeping food particles and toxins from entering the bloodstream. When the gut lining is compromised and toxins enter the bloodstream, widespread inflammation can occur, and this inflammatory response can affect more than the digestive system – it can cause inflammation in the brain. Research shows that people with celiac disease are at greater risk of neurological damage and mental health issues in addition to other serious chronic health conditions.

Michael, now gluten-free, is no longer depressed and he has re-engaged in life. He continued with antidepressant medications for a period of time, but slowly weaned himself from them under medical supervision (it takes time for the brain to heal after the assault is removed). His life has been changed, for the better, forever.

It is my hope that, with a modified model for understanding depression and anxiety, involving a “whole” person, integrative approach, more patients will be correctly diagnosed and treated, as Michael was. In his case, and I suspect in many more, we’re learning that all too often, depression is not just depression.

This article originally appeared in US News and World Reports, May 12, 2015. It was reviewed and updated in May 2023.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Additional references

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Depression: How effective are antidepressants? [Updated 2020 Jun 18]. 

Mohammadkhanizadeh A, Nikbakht F. Investigating the potential mechanisms of depression induced-by COVID-19 infection in patients. J Clin Neurosci. 2021 Sep;91:283-287. doi: 10.1016/j.jocn.2021.07.023. Epub 2021 Jul 20. PMID: 34373041; PMCID: PMC8289699.

strengthen_your_immune_system

5 Ways to Strengthen a Weakened Immune System

June 29, 2021/in Inflammation, Treatments/by Kaplan Center

We have heard it a million times before. One of the keys to maintaining a robust immune system is lowering inflammation. An article published on MDLinx online mentions several ways we may unknowingly be weakening our immune system. Factors discussed in the article include:

  1. Eating foods that contain too much fructose
  2. High daily stress levels
  3. Lack of adequate sleep (…starting to sound familiar?)
  4. Sunburn
  5. Loneliness

None of the items above are particularly surprising – we know what’s good for our bodies (not fructose!) and our minds (definitely not stress) – so how does the immune system become compromised?

When inflammation goes awry

Inflammation is one of our body’s defense mechanisms; it’s a normal, healthy, and necessary biological function. When the body identifies a threat or a foreign invader, it releases inflammatory chemicals to initiate the repair process. But under repeated “assaults” it can remain in a state of heightened inflammation and this is when the trouble begins.

When the body is constantly producing inflammatory chemicals, the function of the Central Nervous System which controls most bodily functions is undermined and can compromise other systems like the immune system. When the immune system is weakened, the cells that are meant to help fight infection become damaged, and the body’s ability to fight disease is diminished. One can literally get caught in a debilitating cycle of cellular degeneration and dysregulation.

The items mentioned above, as well as any of the following, can contribute to a cycle of sustained inflammation when left untreated:

  • Undiagnosed bacterial or viral infections
  • Exposure to mold or other toxins
  • Physical trauma/concussions
  • Surgery
  • Undiagnosed food intolerance
  • Nutritional deficiencies
  • Anxiety disorders/ PTSD
  • Narcotic medications

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Reversing the cycle

If you notice that you’re often sick, fatigued, or have frequent digestive issues, it may be a red flag that your immune system is weakened. With a better understanding of how inflammation may be contributing to your condition, the next step is to initiate practices and, if necessary, seek treatments that will calm the inflammatory cycle. Here’s what helps:

  1. TRY AN ELIMINATION DIET. For six weeks, avoid all foods with wheat, soy, milk, and milk products (foods that often trigger allergies or sensitivities that promote inflammation). Eat only fresh fruits, vegetables, brown rice, fish, chicken, and eggs—these foods, in general, are the least likely to cause inflammation. After six weeks, add back one category of food—such as dairy—per week. Note whether these foods have a negative effect on your energy, mood, or level of pain. If so, eliminate that food from your diet entirely.
  2. MEDITATE. A 2020 review looking at the effects of mindfulness meditation on the immune system concluded that “mindfulness meditation appears to be associated with reductions in pro-inflammatory processes, increases in cell-mediated defense parameters, and increases in enzyme activity that guards against cell aging.”
  3. SLEEP. Make adjustments to your sleep environment and aim for at least 7 hours of sleep per night. This is at minimum what your body needs to be able to carry out important repair functions like reducing inflammation, tissue repair, and hormone production.
  4. CUT BACK ON OTC MEDICATIONS. Non-steroidal anti-inflammatory drugs (NSAIDs) like Advil, Motrin, and Aleve can cause gastrointestinal issues like intestinal ulcers and bleeding when taken chronically to manage pain. NSAIDs can also increase the risk of heart attack or stroke in patients with or without heart disease or risk factors for heart disease. Taking pain relievers routinely to manage pain may actually cause your pain to worsen; the body begins to forget how to fight it on its own. Use OTC medications sparingly and try alternative therapies such as yoga and acupuncture as well as anti-inflammatory supplements* like turmeric.
  5. WHEN YOU NEED TO SEE A PHYSICIAN, CONSIDER ONE WHO PRACTICES FUNCTIONAL MEDICINE (FM). In looking for clues that may be contributing to symptoms of illness or disease a Functional Medicine physician will systematically assess and optimize six major areas of health, including the immune system. In doing so, FM doctors have a more complete picture of one’s overall health and underlying conditions or deficiencies that may be causing inflammation. FM doctors utilize several modes of treatment, including stress reduction & management, mind-body tools, improving nutrition, healing your gut, supporting detoxification, exercise, acupuncture, herbs/botanicals, IV Therapy, supplements, manual medicine, and when needed, medication.

*Ask your physician about any potential side effects or interactions before taking any new medicinal herbs and supplements.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Stress and Covid-19

Life, Stress and COVID-19

August 10, 2020/in COVID-19, Long Covid, Mental Health/by Jodi Brayton, LCSW

It’s safe to say that the last few months have been very challenging. Whether you’re a stay-at-home parent, a business owner, a waitress or a student, it’s quite likely that over the past weeks, something in your life has fundamentally changed. In small ways and large, we’ve all been affected by COVID-19.

New stresses may have appeared. Old routines have been forgotten only to be replaced by new ones. These sudden changes can leave many feeling anxious or stressed. So, while it’s important to recognize the unfamiliar ground that we suddenly find ourselves on, it’s equally important to pay attention to our stress levels and our health.

What’s Keeping You Up at Night?

The answer to this question will differ from person to person. Yet when asked, many patients will respond with answers that revolve around the same themes:

  • Current stressors – COVID-19 has added even more stress to our daily lives.
  • Prior wounds – Current events may act as a trigger for past life events and bring back uncomfortable memories.
  • Loneliness or feelings of isolation.
  • Chronic illness that has been made worse in recent months.

Some of these themes and how we can help are explored in greater detail below:

  • Finding New Coping Mechanisms
    COVID-19 has taken away many activities that we previously used to help deal with stress. Left unchecked, chronic stress can have significant impacts on our health. Stress raises the level of cortisol in our body while simultaneously reducing the levels of DHEA. This means we age faster, gain weight, and worsen existing health problems. Now more than ever, it’s critical that when dealing with high levels of stress, we find effective ways of dealing with it.
  • Safety and Security
    Feelings of safety and security also play a role in our overall well-being. The unexpectedness of COVID-19 has made us all feel less safe and more helpless. This can present with many different emotions or behavior that we wouldn’t otherwise turn to.
  • Social connections and isolation
    Meaningful connection with other people is not a luxury but essential to our survival. Human beings are social creatures. Apart from the sense of community and belonging that we naturally crave, we also get a sense of self-worth from our interactions with those around us. The isolation that COVID-19 has imposed on us can increase anxiety and reduce our ability to cope with it.True, meaningful social interactions can counteract the negative effects of isolation. In fact, studies show that those with more meaningful social connections tend to sleep better, have an improved mood and lower rates of depression. Unfortunately using social media and texts does not compensate for face to face interactions. 

Steps You Can Take to Deal with Your Stressors

  • Talk therapy — discussing problems with a licensed professional can help patients unwind and keep a healthy perspective.
  • Meditation / Yoga – These activities are much healthier outlets than drinking alcohol or overeating. Meditation and Yoga are great relaxation tools to use.
  • Psychotherapy – Talking with an objective observer can relieve anxiety, decrease depression, and help individuals make choices that are more beneficial to their cognitive and emotional health.Therapy can also help patients deal with high stress levels and learn effective coping techniques such as guided imagery, autogenic biofeedback, HRV and self-hypnosis.Knowingly or unknowingly many of us carry past childhood traumas. These traumas can affect the way we lead our lives as adults. A therapist can help patients confront these traumas in a safe and secure environment. Ultimately, healing these traumas can make living easier today, and in the future.

Our Approach to Treatment

At The Kaplan Center, our staff members use a comprehensive and flexible approach that is designed to help each individual person heal themselves. Healing involves the mind, body and spirit. All techniques are tailored to individual needs and designed to help people effectively manage distress, dysregulation and build confidence.

Many patients find the psychotherapy component and its use of biofeedback techniques that involve measuring skin temperature, blood pressure and heart rate simple, fun, and effective.

Modalities that may be used include: Eye Movement Desensitization & Reprocessing (EMDR), Psychodynamic psychotherapy, Sensorimotor psychotherapy, mindfulness, HRV biofeedback, Interactive Guided Imagery and Self-Hypnosis. All these techniques help clients connect to their mind’s bodies and emotions.

In particular, EMDR is a therapy that helps heal wounds from disturbing life experiences. It has been extensively researched and proven highly effective at helping people heal from distressing life experiences, including PTSD, anxiety, depression and panic disorders. Since our emotional well-being is tied with our physical (somatic) state.

EMDR is especially helpful because it uses a body-based technique called bilateral stimulation using eye movements, taps or tones. This stimulation helps a person adaptively process information that may be incorrectly stored in the mind and body. That incorrect storage can make past memories feel like they are happening in the present and people re-experience the same awful feelings (shame, fear, anxiety, and anger) along with the same negative beliefs about themselves. The brain feels as if that past distressing event is happening at the current time. EMDR therapy corrects the storage problem so that past painful memories associated with past traumas lose their charge.

Patients can react to stimuli in the present without the past interfering. The healing that occurs when that information is stored in a more functional part of our brain is a permanent fix. EMDR heals trauma and attachment wounds and allows people to take back their lives.

As we try to navigate our lives into a new semblance of normal, stress, illness and mental health shouldn’t be forgotten. One reason to consider seeing a psychotherapist is that speaking to a professional can relieve anxiety, decrease depression, and help you see how to make choices that are more beneficial to your cognitive and emotional health.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Gentle Yoga Poses for Back, Neck and Hips

May 13, 2020/in Wellness/by Kaplan Center

Yoga is a wonderful tool to alleviate stress, which in turn can improve both your mental and physical health. Taking just a few minutes each day to gently move and stretch your body can make a big difference. Here are some gentle yoga poses to try at home, demonstrated by Laura Dorsett, MTS, RYT500.

Seated Pigeon Pose

This gentle stretch opens up the hips, glutes, and lower back.

Eagle Arms Posture

Eagle Arms helps to release tension in the head, neck and shoulders.

Runners Lunge/Yogic Lunge

Yogic Lunge opens up the hips and releases the lower back.

Seated Spinal Twist

Seated Spinal Twist gently loosens strained muscles in the back to revitalize the spine and posture.

Three Part Breath (Dirga Pranayama) with Dr. Lisa Lilienfield

March 25, 2020/in Lifestyle, Meditation, Wellness/by Kaplan Center

Dr. Lisa Lilienfield guides us through a wonderful breathing exercise called Three-Part Breath (Dirga Pranayama).
The “three parts” are the abdomen, diaphragm, and chest.

Do this anytime to ease feelings of fear, tension, and stress in the body.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

 

The Science of Breathing (Pranayama) and Its Positive Effects on Health

March 22, 2020/in Meditation/by Lisa Lilienfield, MD

Stress is an inevitable part of life and will always be there, but the overwhelming amount of bad news is causing anxiety levels to skyrocket. How we respond to it is a key factor in maintaining good health.

In this article, I plan to explore healthy ways to live with stress, by focusing on breathing techniques called Pranayama that can help to change our negative response to stress.

What is Allostatic Load?

We have physiological responses to stress that are important for survival. It is only when these responses become chronic that we suffer what is termed allostatic load, leading to an increase in diseases such as heart disease, cancer, stroke, and diabetes. Consider the following process:

  1. When crises or urgent situations occur, the amygdala, a structure in the brain with an influential role in fear and aggression at the sense of danger, fires to alert the brain to do something;
  2. The sympathetic nervous system (SNS) is activated; breathing picks up, the heart beats faster, blood rushes away from organs like the digestive tract into the muscles, and we “fight or take flight;”
  3. If the sense of danger persists then structures in the middle part of the brain (called the Limbic System) such as the hypothalamus & pituitary stimulate the adrenals to pour out cortisol and adrenaline (HPA Axis).

If this system is fired up repeatedly, over time this allostatic load will take a toll on the body.

Today’s stressors are far different than those of the past, even the very recent past. We are living in confusion about what we can and cannot do, the fear of losing our jobs, our health, and the health of a loved one – this on top of the more subtle stressors of everyday life. The result is a heightened and prolonged state of anxiety that needs to be addressed in some way other than constant worry and sleeplessness. We need to explore ways to mitigate the effects of the amygdala and HPA axis, which is involved in the neurobiology of mood disorders and functional illnesses.

Questions? Give Us a Call!

703-532-4892 x2

Autonomic Nervous System

The autonomic nervous system (ANS) consists of the sympathetic nervous system (sometimes referred to as the “fight or flight system”) and the parasympathetic nervous system (PNS), which returns us to a relaxed resting state. The PNS is under the control of the vagus nerve. Nerve fibers from the central nervous system go to the organs in the abdomen, thorax, throat area, and to the heart; and fibers from the organs go back into the central nervous system to convey what is going on internally. Nerve fibers send branches into the limbic system of the brain that stimulate or inhibit the stress response. All these structures control internal perceptions, threats, and affective states.

The most advanced part of the vagus nerve is the myelinated vagus, found only in mammals. The myelinated vagus enhances the calming PNS, which slows the heart rate, lowers blood pressure, and repairs, restores, and promotes feelings of safety. The variability of the heart rate is a reflection of PNS activity and can be measured as an indication that the vagus nerve is firing, leading to a calming, resting, restorative state.

Breathing & Respiration

Breathing involves the movement of air in and out of the lungs, and respiration involves a gas exchange between the lungs and the blood. As the diaphragm and the chest muscles contract on inspiration, the diaphragm moves down, the ribs expand and oxygen moves into the lungs. On expiration, the diaphragm and chest muscles relax and carbon dioxide moves out of the body, into the atmosphere.

For the most part, control of the breath is automatic and involuntary. The respiratory center in the brain stem is responsible for breath rate control, and there are receptors in the aorta that detect changes in the blood to regulate the respiratory rate. For example, with exercise, carbon dioxide levels go up, and the receptors in the aorta stimulate the respiratory center to increase the respiratory rate, decrease carbon dioxide and increase oxygenation. However, if breathing is shallow and fast, as is common in the stress response, hyperventilation occurs, which lowers carbon dioxide too much, leading to dizziness, unease, and anxiety.

There are aspects of breathing that we control in a voluntary and conscious manner via the cortex of the brain. Speaking, singing, and playing wind instruments are good examples. Also, stress and emotional stimuli may induce accommodation of breathing as mentioned previously.

Pranayama

Pranayama (yogic breathing) involves the voluntary control of the breath, and is practiced widely in yoga and meditation, but is something that anyone can do. Slow Pranayama appears to shift the autonomic nervous system from the fight or flight sympathetic to the calming parasympathetic state and has been shown to positively affect immune function, hypertension, asthma, and stress-induced psychological disorders. Examples of Pranayama include:

  • Ujayi breath – Used during yoga poses, inhaling and exhaling through the nose while creating a slight constriction in the throat;
  • 3 part breath (Dirga) – Inhaling and expanding the belly, then the lower rib cage, then upper rib cage;
  • Alternate Nostril Breathing (Nadi Shodhana) – Exhaling then inhaling starting with the left side then exhaling and inhaling on the right;
  • Bellows Breath (Bhastrika) – Quick thrusts of the belly in on exhalation, which really works the diaphragm. The emphasis on the diaphragmatic breath is important because most people over-utilize chest muscles and don’t get adequate breath, thereby creating shallow breath and inadequate oxygenation.

Medical benefits of Pranayama

There are several studies that show the medical benefits of Pranayama. One study showed improvement in pulmonary function tests in patients with asthma and emphysema after practicing yoga and Pranayama for 45 min a day over the course of two months. Several studies have supported Bhastrika Pranayama in enhancing “parasympathetic tone.” Another study showed the benefits of Alternate Nostril Breathing in increasing parasympathetic tone by measuring heart rate variability and expiration-inhalation ratios. A pilot study with chemotherapy patients showed improvement in mood and sleep after Pranayama, and numerous other studies support the benefits of Pranayama in depression and anxiety.

In sum, Pranayama is accessible to all and can be used with meditation, or on its own, to stimulate the parasympathetic nervous system. This is something we all could use more of, leading us toward greater health and a sense of well-being.

References

C. Collins, “Yoga: Intuition, preventive medicine, and treatment,” Journal of Obstetric, Gynecologic, and Neonatal Nursing (1998): 27 (5) 563-568.

A. Dhruva, C. Miaskowski, D. Abrams, M. Acree, B. Cooper, S. Goodman, and F.M. Hecht, “Yoga breathing for cancer chemotherapy-associated symptoms and quality of life: results of a pilot randomized controlled trial.” Journal of Alternative & Complementary Medicine (May 2012); 18(5):473-9. doi: 10.1089/acm.2011.0555. Epub 2012 Apr 23.

J. Gallego, E. Nsegbe, and E. Durand, “Learning in respiratory control,” Behavior Modification (2001): 25 (4) 495-512.T. Pramanik, H. Sharma, S. Mishra, A. Mishra, R. Prajapati, and S. Singh, “Immediate Effect of slow pace bastrika pranayama on blood pressure and heart rate.” Journal of Alternative & Complementary Medicine (March 2009).

A. Guz, “Brain, breathing and breathlessness,” Respiration Physiology (1997): 109, 197-204.P. Sangupta “Health Impacts Of Yoga & Pranayama; a State of the Art Review,” International Journal of Preventative Medicine (July 2012) Vol. 3 Issue 7, p444.

R. Jerath, J.W. Edry, V.A. Barnes, and V. Jerath, “Physiology of long pranayamic breathing: Neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system,” Medical Hypothesis (2006): 67, 566-571.

G.K. Pal, S. Velkumary, and Madanmohan, “Effect of short-term practice of breathing exercises on autonomic functions in normal human volunteers,” Indian Journal of Medical Research (2004): 120, 115-121.

T. Ritz and W.T. Roth, “Behavioral intervention in asthma,” Behavior Modification (2003): 27 (5), 710-730.

R. Soni, K. Munish, K. Singh, and S. Singh, “Study of the effect of yoga training on diffusion capacity in chronic obstructive pulmonary disease patients: A controlled trial,”International Journal of Yoga (July 2012): 5(2):123-7. doi: 10.4103/0973-6131.98230.

R. Sovik, “The science of breathing – The yogic view,” Progress in Brain Research (2000): 122 (Chapter 34), 491-505.

J. Willmore and D. Costill, Physiology of Sport and Exercise, 3rd ed. (Champaign: Human Kinetics, 2004)

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

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