stress reduction, anxiety and burnout: moving from survive to thrive

Stress. Anxiety. Burnout.

Moving From Survive to Thrive!

Dr. Erin Wiley NDNaturopathic Doctor

Clinic DirectorIntegrative Health Institute

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Why?

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Let’s Talk About Stress

• Stress can make us feel sick– Headaches, inflammation, muscle pain and tension,

indigestion, acid reflux, acne, PMS. fatigue

• Stress can affect our mood– Anger, frustration, poor concentration, loss of focus,

addiction to coffee, alcohol, drugs and medications

• Stress causes disease– Diabetes, heart disease, cancer, arthritis, anxiety

and depression

• Stress can kill

© Integrative Health Institute 2010

What we will cover

• Introduction to Your Endocrine System• The Contributors to Anxiety, Stress and Burnout• How to Build Healthy Hormone Balance• Case Studies - Connecting With Experience

What is Hormone Balance

• Relationship between the Endocrine System and the Nervous System

• Symphony• Feedback loops and dynamic

relationships• Instructing every cell in the body

what to do and when to do it

Endocrine System

Symphony

Circadian Rhythm

The Stress Response

Hans Selye

Feed Back

Hormones act at a Cellular Level

Just because something is common does not make it

normal !

Symptoms of Hormone Imbalance

• Fatigue or an inability to concentrate

• Weight Gain • An inability to loose

weight despite exercise• Headaches and

Migraines• Night sweats• Early Menopause or

Andropause• Infertility• Decreased libido

• Irregular Periods• Painful periods• Moods Swings• Anger Irritability• Heart palpitations• Acne• Anxiety and panic• Insomnia• Depression

Stress. Anxiety. Burnout

• Chronic stress disrupts your endocrine system

• Overtime your system can burn out

• This leads to the symptoms of anxiety, overwhelm and exhaustion

What brings our body out of balance?

Contributors to Anxiety and Depression

• Stress• Chemicals and Toxins• Sugar• Inflammation• Body Fat

Stress

• Stressor: anything the body has to adapt to• Cortisol • Where the mind goes the body will follow• The relaxation response• Deep breathing, living in the moment, yoga,

meditation, exercise, sleep• Training your mind ex: Olympic Athletes

Chemicals and Toxins

• Chemicals and toxins disrupt our hormone balance

• Found in our foods as preservatives, dies, artificial flavor, growth hormone, heavy metals, and pesticides.

• Found in our cosmetics as dyes, fragrance and preservatives.

• www.ewg.org

Sugar

• What does it mean to spike your blood sugar?

• The average Canadian consumes 23.1 Kg of sugar per year

• Insulin cycle• 2-3 pm crash

Inflammation

• Inflammation is an immune response• Creating the conditions of inflammation in the

contribute to diseases associated with inflammation

• Ex: – Food sensitivities– Menstrual pain– Chronic muscle and joint pain– Is a state of hormone imbalance itself!

• When we are inflamed we can’t lose weight!

Inflammation and Anxiety

• Inflammation causes dopamine levels to rise which can lead to insomnia, and feelings of anxiety and agitation

Body Composition

• Ratio of body fat to lean body mass

• Fat cells produce chemical messengers (adipokines) that promote inflammation, insulin resistance, dyslipidemia, hypertension and other negative health consequences.

• Visceral Adiposity

A Vicious Cycle

• Stress - Cortisol• Visceral adiposity- Adipokines• Inflammation - Prostaglandins• Blood sugar - Insulin• All signal the body to store body

fat and burn muscle mass

How to Build Healthy Hormone Balance

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Nutrition Take Home Message

• Balance Blood Sugar–Reduce insulin and cortisol

• Repair the damage–Anti-oxidants fight oxidative stress

The Trouble with Sugar

• Insulin– Promotes the storage

of body fat– “Hibernation hormone”– Makes you feel

sluggish– The more

carbohydrates you eat, the more insulin you make

– Cause type 2 diabetes

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Understanding Insulin Once sugar enters bloodstream

• Pancreas releases insulin• Insulin transports sugar (glucose) into cells• Relative secretion (more sugar=more insulin)

Once absorbed sugar can go 3 ways;1.Immediate use as fuel2.Stored as glycogen in muscle or liver3.Stored as fat*

Insulin stimulates appetite byBlocking hormone Leptin (supresses appetite)Causing spike in dopamine (reward seeking signal)

– Eat to get pleasurable rush!

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Food Fact

Did you know: prior to the last century, refined

sugar and trans fat were practically absent from

the human diet

Sugar

The average Canadian consumes 23.1

Kg of sugar per year

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Where is Sugar found in our diet?

• Cereal

• White bread, bagels, buns, pizza crust

• Pasta, fries, rice

• Sports drinks, pop, juice, coffee (latte)

• Candy, chocolate

• Processed foods

How Much Insulin Have You Made Today?

Cortisol

• Stress/steroid Hormone– Increases blood sugar– Causes central fat

deposition– Leads to insomnia– Causes type 2 diabetes– Water retention– Decreased bone

formation– Immune suppression

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Nutrition to Reduce Insulin and Calm Cortisol

• Protein and Healthy Fats• Whole Grains and the Glycemic

Index

Protein

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Protein

• Amino acid building blocks for your muscles

• Regulates blood sugar and makes you feel full

• Make weight loss easy!• Protein is used daily for building, repair,

and energy Dose= 1-1.5g/kg body weight/day

Healthy Fats

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Make healthy..

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And Healthy skin!

Healthy Fats• Eat fat burn fat!• Fat-free means chemical compensation• Fat makes you full and satisfied • Without fat, your brain, your hormones, and

your compensation mechanisms for stress will be compromised

Dose: • Cold Water Fish x2-3 weekly• 2 tbsp extra-virgin olive oil daily• Fish Oils daily 3,000mg EPA/DHA• ½ med avocado x3 weekly

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Oxidative Stress

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Anti Oxidants at Work

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Berries!

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Antioxidants

1. Blackberries2. Walnuts3. Strawberries4. Artichokes5. Cranberries6. Raspberries7. Blueberries

From: World’s Healthiest Foods Top 7 list

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Case Study - Endocrine Stress

• Breakfast - Coffee (low energy)• Lunch - 1pm• Energy Crash - 3pm• Sugar Craving - Craving

carbohydrates• Energy Crash • Dinner - over eating late at night

Case Study - Anxiety

• Skip breakfast (no time, did not sleep well)• Muffin and Coffee (feel great, cortisol up)• Anxiety sets in, need to eat candy all day at desk to

maintain focus• Can’t drink water (will have to pee)• Lunch no appetite, want a nap but to anxious to sleep• At home starving = fast food, crash on the couch

exhausted and can’t imagine exercising• 10pm: 2nd wind, get work done, but then can’t fall

asleep• Perhaps some wine? Sleeping pills?

Case Study - Is this healthy?

• Breakfast - Oatmeal (at your desk at work)

• Lunch - Sandwich and fruit• Energy Crash - cookies and diet coke• Dinner - Chicken, rice, salad

• Ratio Carbs 9: Protein 2: Healthy fat 1:Veggies 2

What does that look like?• Divide your plate into 3 sections:

50% is vegetables25% is mixed whole grains or starch25% is protein source – poultry, fish,

beans, soy products

Protein

Whole grains

Veggies

Healthy hormone balance starts with breakfast

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Snacks

• Cottage cheese• Hummus and veggies• Nuts and seeds• Raw Brownie• Protein energy balls• Apple and almond butter

Lunch

• Chicken Salad• Split pea soup• Quinoa salad• Bean salad• Kale salad with goat cheese

Dinner

• Veggies, meat, and whole grains or beans and legumes

• Broccoli, coconut chicken and 1/2 cup brown rice

Sample Menu

• Breakfast - Protein smoothie• Snack - Hummus and veggies• Lunch - Cobb salad (hardboiled egg)• Snack - Raw brownie• Dinner - Talapia, kale salad, baked

sweet potato• Carbs 3: Protein 5: Healthy Fat 4:

Veggies 8

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Brain Gut Connection

• Eliminate food sensitivities– Most common presentation: gluten, dairy,

soy, eggs, sugar– Characterized by an IgG mediated immune

response– Leading to dysbiosis and in imbalance in

healthy flora that modifies the Th1/Th2 response

• Food sensitivities cause systemic low grade inflammation

Clinical Nutrition

• Fish Oil: EPA and DHA– Omega 3 fatty acids are anti-

inflammatory– DHA structural component of the brain– EPA the primary anti-inflammatory

omega 3 fatty acid in the brain– When omega 3 fatty acid levels are low

in the brain increased neuro-inflammation occurs

Fish Oil• Key points:

– Therapeutic dose for inflammation: greater than 2 grams (2000mg/day) of EPA

– Therapeutic dose for improved mood: No less than 1000mg of EPA per day. Ratio: significantly more EPA than DHA (6:1)

– Outstanding safety profile!!!!– Can we get enough from diet?– What about flax oil?

Probiotics

• It is well established that probiotics decrease inflammation

• But what about the brain GUT connection?

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Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the

vagus nerve.

• In mice: Lactobacillus Rhamnosus reduced inflammatory markers, lowered corticosteroid hormone release, and elevated GABA

• A direct effect on neurotransmittersProc Natl Acad Sci U S A. 2011 Sep 20;108(38):16050-5. Epub 2011 Aug 29.

Exercise• Research has shown that exercise is an

effective treatment for anxiety and mild to moderate depression.

• Japan “shinrin-yoku” meaning forest bathing - Dr. Marc Berman Journal of Affective Disorder

• Dr. Mike Evans: 23 1/2 Hours - What is the single most important thing you can do for your health

Exercise, Inflammation and Stress

Research:• Exercise not only decreased the levels of pro-

inflammatory cytokines IL-6, TNF-a, and C-reactive protein but also simultaneously enhanced the concentrations of anti-inflammatory cytokines IL-4, IL-10 and TGF-b when compared with controls

Lakka TA, et. Al. Effect of exercise training on plasma levels of Creactive protein in healthy subjects: the HERITAGE Family Study. Eur Heart J 2005;26:2018–2025.

Exercise• 20-30 minutes per day• 3-5 days a week• From Walking, Yoga, to Strength

Training• Running for Anxiety• Challenge your intensity• Follow Your Exercise Progression -

Accountability

Detoxification

• Neurotoxic and Hormone Disrupting Chemicals can be found in our environment:– Pesticides, solvents, BPA, Phthalates

• Top strategies:– Quit smoking, clean indoor air quality– Eat Organic– Choose safe cosmetics and cleaning products– www.ewg.org/skindeep

Phase 1 and Phase 11

Type 4: A Healthy Stool

The Stress Response

Caution: Perfection

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Finding Balance

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Stress Reduction

• Mindfulness Meditation• Yoga• Tai Chi• Qi Gong• Prayer

Case Studies

• Alison- social phobia after apartment was sprayed for bed bugs

• Brenda -chronic migraine headaches, anxiety and IBS

• Melanie - Am I 16 again? PMS, acne, and anxiety.

• Cara- it’s summer and I am burnt out?• Diane- Caring for aging parents and

young kids, why am I anxious public speaking?

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Simple Steps in Therapeutic Order

• Eat Breakfast and small frequent meals• Eat vegetables (50%+)• Avoid sugar• Choose whole grains• Move your body daily• Make time for yourself• Go to bed by 10pm

Stages of Change

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Lifestyle Change It takes 45 days to change a habit or incorporate a new one

5 10 15 20 25 30 35 40 45

Opportunity

• An Integrative Approach– Address the root cause, support optimal

body hormonal balance, focus on recovery and repair

– Synergy: Diet, Exercise, Stress Reduction– Anti-inflammatory Supplements: Fish Oil

and Probiotics– Talk to your Naturopathic Doctor about

detoxification, food sensitivity testing, botanical medicines and nutritional supplements

The Beginners Mind - Meditation

• In the beginners mind there are many possibilities, but in the experts mind there are few - Shunryu Suzuki

• This weekend invite an awareness to see things just as they are, fresh and new, as if for the first time. What can you see, learn, and experience new today simply by having the intention of the beginners mind. Imagine going through life seeing the world, as fresh and happy as a child.

© Integrative Health Institute 2010

Integrative Health InstituteDr. Erin Wiley ND

Integrative Health Institute46 Sherbourne St, 2nd Floor

T: 416 260 6038www.integrativehealthinstitute.ca