In a pre-pandemic world, people looked at the New Year as an opportunity for positive change, growth and a clean slate. However, as we approach the end of this year I’m seeing many of my friends and patients entering the New Year with high levels of stress and anxiety.
On the surface, the source of this anxiety is clear: we’re facing another round of news headlines warning of new Covid-19 strains like Omicron, we’re struggling with ambiguous timelines around returning to the workplace, and many of us feel like we have no ability to plan for the future any more. And our symptoms – brain fog, exhaustion, lack of sleep and overall burnout – seem pretty clear too.
But the true root cause of the mental unease and recurring anxiety so many of us are suffering from may not be in our heads.
As a doctor, and as a healthcare CEO overseeing the care of tens of thousands of patients through my practice Parsley Health, I have repeatedly observed how physical conditions in the body masquerade as anxiety, depression and even burnout.
In many cases, physical culprits – ranging from blood sugar disorders and nutrient deficiencies to thyroid imbalances and food allergies– are actually sabotaging a person’s best efforts to find mental and emotional wellbeing. More and more of these physical problems are going undiagnosed or unrecognized today - 26 percent of Americans don’t have a primary care doctor with that number declining per decade, which means that they are not proactively looking at their health beyond the surface. The result is that many people are suffering and feel like they’re hitting a wall with their mental health, as the common mental health solutions fail to address the root cause of their concerns.
Two long years of this pandemic have left many of us working from home, staring at screens for hours, managing daily cortisol spikes from doom scrolling and eating or drinking in ways that fuel the physical conditions that harm our mental wellbeing. Across my practice I’ve seen not just a rise in anxiety – which, according to one study, is up 26 percent globally since the start of the pandemic – but also a rise in the physical conditions that disguise themselves with symptoms like anxiety and burnout.
So what do you do about it? There are five simple steps you can take to address the physical roadblocks that may be preventing you from achieving peak mental health.
Too many chronic conditions hide in plain sight. According to the CDC, six in 10 Americans suffer from a chronic condition, and tens of millions more have one they don’t know about yet. Medicine needs to be proactive to work, and even your doctor may not be connecting the dots between your mental and physical health. Talk to your doctor about testing you for common chronic conditions that could be fueling your anxiety. Specifically you’ll want them to test for:
Thyroid hormones - make sure they’re not too low or too high
Blood sugar and insulin - ensure you’re not on a blood sugar roller coaster ride daily
Markers of inflammation and autoimmune disease - anxiety, depression and burnout can be key symptoms of inflammation or undiagnosed autoimmune conditions
Level of key nutrients like B12, folate and Vitamin D3 - when these are low your mood can suffer
Gut health and microbiome analyses - most of your neurotransmitters are produced in the gut, so if you’re having digestive troubles this can severely impact mood
Food allergies like wheat and dairy can throw your gut health into a spin
Stress hormones like cortisol influence whether you’re in fight or flight mode
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Move your body to train your brain
Our bodies are designed to process emotions through movement, or the opposite, to store what we feel in the tense muscles of our neck, jaw, shoulders and hips. Chronic stress can also impair our immune systems making us more likely to develop autoimmune disease and cancer. This is one of the reasons that regular exercise is essential to boosting mental health. One study showed that 95 percent of psychiatric patients reported better mood after exercise (compared to an NIH study showing only 40-60 percent of patients reported improvement after 4-6 weeks on antidepressants).
But how you exercise also matters. Doing hour-long HIIT workouts every single day may actually going to tell your brain that indeed, you are running from a lion, and worsen your state of constant fight or flight. For peak mental health, it’s important to cross train with a balanced mix of cardio, strength building and controlled, nervous-system relaxing movement like yoga and qigong. Taking injuries and the unique needs of your body into account, it’s best to start with 20 minute exercises, six days a week, alternating between activities like yoga, aerobic exercise and weights so your body can rest, release and recharge.
Food is medicine for your mood
What we eat matters. And the choices we make three times a day, seven days a week will determine how well our bodies produce neurotransmitters and hormones, manage stress and build healthy brain connections. We often talk about the importance of “healthy” fats. What this means is choosing omega-3s over omega-6s. The latter is found in high amounts in vegetable oils and can increase inflammation in the body. According to a recent study, the average American ratio of omega-6 to omega-3 fats hovers somewhere around 20:1, when it should be no higher than 4:1 – what it once was before the addition of vegetable oil to our regular diets. While your body needs some omega-6s, in excess it can harm brain cells, ratchet up neuroinflammation, and reduce the body’s ability to use serotonin.
So even if you produce plenty of serotonin, your brain can’t use it when it's inflamed. A good way to guarantee your body is getting omega-3s and other nutrients you need is to shift to a plant-based paleo diet, inclusive of extra virgin olive oil, 50 percent leafy green vegetables, methylated B12-rich foods like salmon and eggs, and fermented foods such as sauerkraut and kimchi to fortify your microbiome.
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Sleep is when your brain takes out the trash
Many people claim they can run on five hours or six hours of sleep a night. However, studies have found that as humans we actually need at least eight to nine hours of restful sleep every night. Lack of sleep can make you more vulnerable to Alzheimer’s, and mental/emotional instability, as well as more susceptible to poor decision making.
Sleep is about more than resting your body; sleep is literally when your brain takes out the trash, by clearing neurotoxins and other cognitive debris accumulated throughout the day. Plus, sleep is how your brain processes emotions. When you’re sleep deprived, your amygdala (the part of your brain regulating emotions) goes into overdrive, meaning your brain stops being able to discern between crisis and non-crisis, meaning you’re likely to overreact and feel irritable, angry, confused, sad, or any number of other unpleasant emotions. A study at UC Berkeley discovered that just one night of poor sleep can drive up anxiety by 30 percent. In short, when you miss out on sleep, your brain just can’t function properly. So, be sure to go to bed before 10 p.m. every night – no matter when you wake up. You’ll feel the difference.
Reevaluate your relationship with tech
According to Pew Research Center, more than 70 percent of people who own a smartphone (which is 80 percent of all Americans) refuse to move more than five feet away from their devices. In addition, the average American spends an average of 11 hours a day staring at a screen, says Nielsen. This addiction to technology has led to an increase in depression, anxiety, loneliness, low self-esteem, and even self-harm. It’s not just bluelight that impairs our sleep; screens actually trigger our cortisol fight-or-flight response, leaving us in a state of hyperarousal with no natural bedtime cues. In order to get our most restful sleep I suggest limiting tech before bed. This means no tech after 9 p.m. setting a one hour daily limit and waiting 30 minutes before looking at tech in the morning.
For most people, regardless of the origins of their anxiety or burnout, addressing these concrete physical barriers to mental health can feel like a relief. There is so much we can do every day to cultivate positive mental health and emotional wellbeing. Don’t fret if you’ve hit a wall in 2021 working on your mental health, there’s more you can do, and it just may start with your body.
Dr. Robin Berzin is the Founder and CEO of Parsley Health, America's leading holistic medical practice designed to help women overcome chronic conditions. Her new book, State Change, will be published by Simon Element in January 2022.