How to Ground Your Energy When Feeing Anxious

The last couple of years have been hard on everyone.  The pandemic has caused so many disruptions in our lives – lost jobs and income, friends and loved ones becoming ill, children home from school and missing socialization, feeling more isolated and less connected.  It’s no wonder that an even greater number of people have reported feeling anxious. 

Talk therapy, supplements, exercise and medication are beneficial solutions for curbing anxiety.  There are also practical strategies you can utilize when experiencing anxiety.

1)  Box Breathing – If you’ve ever practiced meditation then you know how helpful mindful breathing can be to calm your nervous system.  Close your eyes and then breathe slowly in for four counts.  Hold your breath for four counts and then exhale slowly for four counts. At the bottom of the exhale count to four while doing nothing.  Repeat this process for a total of four times.  Once completed you should feel much more relaxed and centered.

2) Name Objects in Your Line of Vision – If your thoughts are spiraling out of control you can change your state of mind by simply naming objects that you see.  Keep doing this as long as you need to until you feel your energy begin to mellow.  This works because you are changing which hemisphere of your brain is being used, moving from the emotional side to the logical side. 

3) Mantras – Taking the time to recite a mantra is valuable for grounding feelings of anxiety.  Some examples are “I am safe”, “I am peaceful”, “I am loved” or “With every breath I feel myself relaxing”.  Write down your own affirmations that resonate with you the most and then say them repeatedly when you’re feeling anxious.

4) Gratitude – We cannot be in a state of fear or anxiety and be in a state of calm or peace a the same time.  Pausing to “count your blessings” will transition your energy into a more relaxed vibration. Write down five things you are grateful for or if you can’t write them down, list them in your mind.

The next time you find your heart beating fast or your mind racing, try practicing these strategies to ground your energy.

The next time you find your heart beating fast or your mind racing, try practicing these strategies to ground your energy.

If you or someone you know can benefit from working with our health coaches please contact our office to make an appointment. 

In health,
Sara Yadlowsky, FMHC

Neurofeedback Therapy

Robert Baric, DC

We have invited several expert practitioners to educate our practice community on approaches to healing that are complementary to Functional Medicine. Our expert this week is Robert Baric, DC who will educate us on Neurofeedback. Neurofeedback is quite different from “biofeedback” with which you may be familiar. Dr. Baric is board certified in neurofeedback and has over 26 years of clinical experience. His passion for health and wellness has emerged throughout the years as he continues to deliver the most up to date knowledge to his patients, while providing them with impactful treatment in addition to neurofeedback, including nutrition, acupuncture, chiropractic techniques, and other applied therapies. I will hand off the microphone to Dr. Baric.
 


 
 Neurofeedback Therapy: A Compliment to Traditional Medicine
Amidst 56 years of positive research and clinical trials in neuropsychology, neurofeedback has emerged as a modality of complementary therapy that is “evidence based”. Neurofeedback therapy has gained increasing popularity due to its non-invasive properties and the sizable body of research supporting its efficacy, along with it being an alternative to traditional pharmacological treatment. Essentially, neurofeedback is EEG-biofeedback, where a method of retraining brain waves through operant conditioning is utilized. Various conditions like ADHD, depression and anxiety, addiction, and insomnia are all cognitive disorders that can negatively impact an individual’s brain waves.

 The first step to neurofeedback therapy is an initial brain scan that determines if a patient is a suitable candidate for neurofeedback therapy. A quantitative electroencephalogram (qEEG) shows brain activity and function allowing professionals to understand what ailments may be present and what can be done to mitigate symptoms at the root of the problem. The qEEG process takes just 45 minutes, recording brain waves with the eyes closed and opened. The results are then analyzed and a customized training protocol is created specifically tailored to the patient. Treatment includes monitoring the dysfunctional area while rewarding the preferred wave formation, with the reward being a TV show of the patient’s choice.  Brain waves are monitored, and using operant conditioning, stimuli are adjusted to guide the brain waves back into a healthy pattern.  If accepted as a patient, most individuals experience a marked improvement by sessions 10-15, most conditions requiring 40 sessions to finalize neuroplastic changes.
  
There are multiple conditions for which neurofeedback is impactful, with few being the most prominent throughout my years of experience. 
 
 Depression and Anxiety
The zeitgeist proves the need for complementary treatment options for individuals suffering with depression and anxiety. Approximately 33.7% of the population suffers with anxiety related disorders in their life, often comorbid with depression (1).  The Journal of Clinical Psychopharmacology yielded results showing significant improvement in patients symptoms of depression with neurofeedback (2). Similar results were shown in patients with anxiety disorders, with the Journal of Industrial Psychology exhibiting results where neurofeedback therapy was deemed essentially as effective in reducing symptoms of anxiety as medication (3). 
 
 ADHD 
Children and adults suffering with ADHD recognize notable improvements in their focus and attention after a series of neurofeedback treatment. When a group of students received either neurofeedback or pharmacological support, evidence showed those in the neurofeedback group improved in executive control to a greater extent than the pharmacological support group (4). A plethora of research supports the decrease of ADHD symptoms in both children and adults. 
 
 Insomnia
Brain waves play a significant role in the ability to sleep. If a patient is unable to enter into a restful and deeply restorative state, there could be a misalignment in brain waves causing a patient to feel unwell and never feel rested. Medications can be utilized to aid in sleep, but frequently result in a feeling of grogginess upon waking. Neurofeedback actually tackles the problem at hand at the root by retraining the brain waves in order to get quality sleep without the use of medications. 
 
For issues involving the brain and cognition, it is essential to tackle the issue from multiple directions, utilizing multiple forms of treatment.  As a pain-free and relaxing process, neurofeedback will maximize its growth throughout the coming years. Neurofeedback will continue to provide millions of individuals with a fully customized treatment plan to ensure optimal brain health, and alleviate years of morbid symptoms.

If there are any questions about neurofeedback please reach out through email or phone and MyBrainDr would be happy to discuss any inquiries. 
 
Email: admin@mybraindr.com
Phone: 919-721-4800
Website: www.MyBrainDr.com

Magnificent Magnesium

Frances Meredith, MD

In the times of COVID, so many nutrients seem to be in the news these days from quercetin to Zinc, to Vitamin D.  Overlooked I believe is the nutrient essential for every cell and every process in our body including immune readiness: Magnesium!

Magnesium is a cofactor for over 300 enzymatic reactions, supporting DNA and RNA synthesis, cell growth and reproduction. Magnesium enters the energy cycle as a cofactor in at least 12 different steps in the process, and is essential for the little batteries in every cell, our mitochondria, to transport electrons and create energy. It is necessary for bone growth and strength, stabilizing the cell membrane, and maintaining normal nerve and muscle function.

Magnesium sits within the cell, balancing all of our cells, keeping calcium outside the cell from overstimulating cellular activity in all parts of the body. For example, Mag balances Calcium in the NMDA glutamate receptor, controlling its opening, avoiding “neuroexcitation”.  Thus, lack of Magnesium sets the stage for nerve overactivation, hyperexcitability (think chronic anxiety, chronic pain, chronic states of inflammation created by lack of Magnesium). When we are Mag deficient this NMDA glutamate receptor activates. This is good for survival when we are under intense stress, but not something we want to live with on a day in and day out basis.

Low Magnesium can express itself in so many ways including fatigue, muscle cramping/tension, PMS, headaches, especially migraines, constipation, insomnia, tinnitus, brain fog, heart arrhythmias, anxiety and depression, TMJ, ADHD, and blood sugar issues. Sound familiar?  If that’s not enough, Magnesium deficiency is implicated in diabetes, osteoporosis, and hypertension. It is a natural “calcium channel blocker” (think drugs that do this such as amlodipine used for hypertension). The lower the Magnesium levels the greater the progression of Alzheimer’s. Fibromyalgia improves with Magnesium treatment. Increasing Magnesium intake is correlated with a decrease in stroke, diabetes, heart failure, fracture risk and all-cause mortality. Sounds like we all need more, yes?

Why are we so deficient? The answer lies both in the disruption of our food chain and the breakdown of our food choices. The soil is now deficient in Magnesium due to lack of crop rotation, pesticide use and overproduction; in addition, the use of fertilizer heavy in nitrogen and phosphate blocks the plants’ ability to absorb Magnesium.  Further, as foods are processed, Magnesium is leached out. The end product: less for us.

Testing for Magnesium is easy, with red blood cell levels being the most accurate form of testing. Body signals, however, are much more important than a test result. Symptoms such as myofascial and muscular tightness/tension/cramping, sluggish bowels, and low energy point to low Magnesium and a trial of Magnesium is warranted even without checking a blood level.

So how can we optimize Magnesium for all of the cells in our body to “sing”? It is clear that plant-based Magnesium is much more effective than the mineral in supplement form. This is due to the fact that Magnesium is at the heart of chlorophyll, responsible for the green pigment in our green foods. Plant based Magnesium is very absorbable and is already charged, essential for its function. The big winners for high magnesium are pumpkin seeds, spinach, almonds and cashews. This great link from Cleveland Clinic lists the magnesium content of many foods.

https://my.clevelandclinic.org/health/articles/15650-magnesium-rich-food

 Magnesium in supplement form can be very helpful, and must be attached to a “chelator” to get across the intestinal border. They are best taken with food to improve stability. Magnesium comes in forms including glycinate, citrate, theonate, asparate, orotate, and oxide, with different benefits associated with the specific chelators.

For example, the Mag oxide form is only minimally absorbed and very unstable, drawing water into the intestinal tract, helpful for severe constipation or impaction but not helpful to get Magnesium into cells elsewhere in the body. In contrast the Magnesium glycinate is more stable, better absorbed and better for anxiety or insomnia. Mag citrate is helpful for intestinal motility/constipation as well as energy as it plugs directly into our “Krebs cycle” to create energy.

In addition, optimal intestinal absorption is necessary, with Magnesium absorbed mostly in the ileum of our small intestines. Therefore, if things go awry in the ileum, our ability to absorb Magnesium (as well as other nutrients) will be impacted (think leaky gut, small intestinal bacterial or fungal overgrowth).

Sounds like most everyone would be better off with a little more Magnesium! If any of the above-mentioned symptoms or conditions apply to you, your functional medicine provider at Carolina Total Wellness would be most happy to discuss this with you.

Your Partner In Health

Frances T. Meredith, MD

Health Benefits of Napping

By: Susan D. Denny, M.D., MPH

With the hectic pace of day-to-day life, many people don’t get the recommended amount of sleep each night. According to the National Sleep Foundation, adults typically need between seven and nine hours of sleep per night in order to function at their best. Getting a few less hours for even a few nights in a row can have the same effect as staying awake for 24 hours straight. And, over time, chronic sleep debt can contribute to fatigue, increased stress levels, reduced attention span, and declined cognitive performance.

One way to combat the effects of sleep deprivation—and repay some sleep debt—is to incorporate daytime napping into your schedule. The length of the nap and type of sleep you get during that nap help determine its potential health benefits. The table below identifies these benefits.

Nap Duration  and  Potential Health Benefits

10-20 minutes:
 Reduces sleepiness; improves cognitive performance; increases alertness, attention, and energy levels; improves mood; improves motor performance; reduces stress levels

20-30 minutes:
Enhances creativity; sharpens memory

30-60 minutes:
Sharpens decision-making skills, including memorization and recall; improves memory preservation

60-90 minutes:
Rapid eye movement (REM) sleep, which is critical for problem solving; helps make new connections in the brain; enhances creativity; reduces negative reactivity; promotes happiness
 

The following is a list of tips and tricks to help you make the most of naptime:

  • Choose a dark, quiet, comfortable place where you can relax.
  •  Try to limit the amount of noise and light in the room, and make sure the temperature is comfortable.
  •  Choose a time that works for you, and aim to nap at that time each day to establish a routine. You may find that restricting your naps to early afternoon (between 1:00 pm and 3:00 pm, or an hour or two after lunch) is less likely to interfere with your nighttime sleep patterns.
  •  Set an alarm on your cell phone, watch, or computer so you don’t sleep for too long.
  •  If you’re napping at the office, try closing your door and hanging a sign that says, “will return in 20 minutes.” Alternatives to this are napping in your car or on an outdoor bench.
  • Wherever you nap, bring along something that you associate with sleep. Some ideas include a sleep mask, neck pillow, relaxing playlist and headphones, cozy blanket, warm socks, and lavender essential oil to dab on your pulse points.
  • Keep in mind that longer naps may be accompanied by sleep inertia, or a period of grogginess that sometimes follows sleep. Give yourself time to wake fully before returning to any activity that requires a quick or sharp response.

 Your Partner In Health!
Susan D. Denny, MD, MPH

Health Benefits of Napping

Susan D. Denny, MD, MPH
“No day is so bad it can’t be fixed with a nap.” — Carrie Snow

With the hectic pace of day-to-day life, many people don’t get the recommended amount of sleep each night. According to the National Sleep Foundation, adults typically need between seven and nine hours of sleep per night in order to function at their best. Getting a few less hours for even a few nights in a row can have the same effect as staying awake for 24 hours straight. And, over time, chronic sleep debt can contribute to fatigue, increased stress levels, reduced attention span, and declined cognitive performance.

One way to combat the effects of sleep deprivation—and repay some sleep debt—is to incorporate daytime napping into your schedule. The length of the nap and type of sleep you get during that nap help determine its potential health benefits. The table below identifies these benefits.

Nap Duration  and  Potential Health Benefits

10-20 minutes:
 Reduces sleepiness; improves cognitive performance; increases alertness, attention, and energy levels; improves mood; improves motor performance; reduces stress levels

20-30 minutes:
Enhances creativity; sharpens memory

30-60 minutes:
Sharpens decision-making skills, including memorization and recall; improves memory preservation

60-90 minutes:
Rapid eye movement (REM) sleep, which is critical for problem solving; helps make new connections in the brain; enhances creativity; reduces negative reactivity; promotes happiness

  The following is a list of tips and tricks to help you make the most of naptime:

Choose a dark, quiet, comfortable place where you can relax. Try to limit the amount of noise and light in the room, and make sure the temperature is comfortable. Choose a time that works for you, and aim to nap at that time each day to establish a routine. You may find that restricting your naps to early afternoon (between 1:00 pm and 3:00 pm, or an hour or two after lunch) is less likely to interfere with your nighttime sleep patterns. Set an alarm on your cell phone, watch, or computer so you don’t sleep for too long. If you’re napping at the office, try closing your door and hanging a sign that says, “will return in 20 minutes.” Alternatives to this are napping in your car or on an outdoor bench.

Wherever you nap, bring along something that you associate with sleep. Some ideas include a sleep mask, neck pillow, relaxing playlist and headphones, cozy blanket, warm socks, and lavender essential oil to dab on your pulse points.

Keep in mind that longer naps may be accompanied by sleep inertia, or a period of grogginess that sometimes follows sleep. Give yourself time to wake fully before returning to any activity that requires a quick or sharp response. 

Your Partner In Health!
Susan D. Denny, MD, MPH

Upper Airway Resistance Syndrome

By: Frances Meredith, M.D.

“Sleep is the best meditation”    – Dalai Lama
We all know sleep is precious. The world is a wonderful place when we awaken after a night of good sleep. Lack of sleep not only leaves us with lack of energy for our day, but also puts us at risk for many health issues from flares of autoimmunity to Alzheimer’s disease.
 
Could you have this “silent” sleep problem unrecognized by many doctors?
All of us are familiar with obstructive sleep apnea. A less known condition often referred to as sleep apnea’s “silent sister”, also can cause the same daytime fatigue and can contribute to many health issues as well. This condition is known as Upper Airway Resistance Syndrome or UARS and can be due to a naturally narrowed airway (often in someone thin or ideal body weight), a tongue falling back into the airway, or loose throat tissue. This causes “micro awakenings” occurring throughout the night, often without snoring or the sufferer even realizing it. This causes fatigue, increased stress responses often with sensitivity to emotional triggers, light, sound, and/or weather changes. It can also cause low testosterone, tension headaches, anxiety and depression.
 
Many doctors have yet to hear about UARS. The first step is to suspect it with daytime fatigue or any of the symptoms listed above, and bring it up with a provider familiar with the condition. Testing can then be ordered, such as a home sleep apnea test and a peek in your mouth and airway as an initial evaluation. An in-lab study is more sensitive, however a home study can often pick it up and is certainly much easier especially during COVID times. Treatment can then be designed including a dental appliance or CPAP which has gotten so much more user friendly in the last several years.
 
If ongoing daytime fatigue is an issue for you call 919-999-0831 to schedule an initial visit or bring it up with your provider at CTW. Optimizing sleep is just one of the many factors that a Functional Medicine provider will investigate that supports optimal energy and brain function, but without it, life just doesn’t look as sweet.
 
Your Partner in Health!
 Frances Meredith, MD

Ten Tips To get A Better Night’s Sleep

By: Sara Yadlowsky, FMHC

Most of us know how important it is to get a good night’s sleep.  Seven to nine hours of quality restorative sleep is ideal.  But this type of sleep sometimes eludes us.  Here are ten tips to help with more and better sleep.

  • Preparing for the next day can alleviate some of the stress that keeps us up at night.  You can get a jumpstart on the next day by packing your lunch, picking out an outfit, bathing at night instead of the morning and jotting down a to-do list.
  • Shut down your devices at least 2 hours before bed.  If you must be on your phone or computer try wearing blue blocker glasses that keep the blue light out of your eyes.  This blue light that is emitted from our electronics suppresses the release of melatonin which is the hormone that makes us sleepy.
  • Try a supplement to help you get to sleep faster and stay asleep longer.  Some examples:  magnesium, melatonin, L-Theanine, passionflower, valerian and CBD oil. Start with the minimum dose and work up as some people are more sensitive to these supplements than others.  Certain calming essential oils such as lavender, chamomile and eucalyptus are also very beneficial to quality sleep.
  • Create a bedtime routine.  Try to do roughly the same thing every night before bed to help signal to your body that it’s time to sleep.  Relaxing ideas are meditation, a hot shower or bath, light stretches, journaling and reading a good book that’s not too thought provoking. 
  • Get some exercise during the day.  Any type of movement helps you sleep better at night.  Exercising outside is particularly helpful due to sunlight exposure. Be careful not to exercise too close to bedtime as this can raise your cortisol levels and make it harder to fall asleep. 
  • Try some 4-7-8 breathing after you get into bed and turn off the light.   Place the tip of your tongue on the back of your front teeth, breathe in through your nose to a count of 4, hold your breath for a count of 7 and exhale slowly through your mouth to a count of 8. Repeat this 4 times.  This breathwork is fantastic for calming your nervous system.
  • As much as possible go to sleep and wake up at the same time each day.  This will help train your biological clock.  Our bodies crave a consistent schedule when it comes to sleep.
  • Finish all eating 3 hours prior to going to sleep.  This allows digestion to occur while you are still awake and prevents insomnia and heartburn. 
  • In the winter try sleeping with a hot water bottle instead of an electric blanket.  It will keep you warm and help you to fall asleep more quickly.
  • Make the last thing you do before falling asleep a list of 5 “wins” for the day.  Five things that happened that felt good or five accomplishments.  When you make this the last thing you focus on you sleep more soundly and wake up in a better frame of mind.