Anxiety is not a fixed condition but a symptom communicating imbalance and unmet needs; true anxiety serves as an inner compass signaling when something requires attention (such as misalignment in relationships, work, or community), while false anxiety stems from physical imbalances in the body (like unmet needs for rest, nourishment, movement, and proper breathing) that can be addressed through lifestyle changes and understanding the body's wisdom, rather than being a life sentence or genetic destiny.
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We’ve Been Thinking About Anxiety All Wrong | easeAdded:
I don't think any of us are here wired to be depressed or anxious. I think again that that's those are symptoms communicating imbalance and unmet needs.
>> I don't want to have to rely on medicine for the rest of my life.
>> No, no, no, no. Before you feel hopeless, before you feel any type of despair, I want people to know there are many paths up this mountain. Maybe I should also gasha and do an infrared sauna. Maybe I should meditate infrared sauna. Should I drink electrolytes? like [music] we have this overwhelm around wellness practices. We are now fighting back against a world that's taken us so far from our basic needs. And I think especially in this age of AI, there's an assault on truth, on [music] how we can trust what we're seeing with our own eyes. I think we need other mechanisms for feeling what's real and feeling what's true. And I think that happens first in our physical bodies.
Should I lead us into a little meditation? So, this is just my practice now. Anytime I'm about to sit down and write or record a podcast or give a talk, >> I want to make sure that I'm in alignment with my intention. And so it's helpful to even just identify for myself. You might want to identify for yourselves. What is your intention in this moment? Usually mine is some compilation of I want to be of service and I want to be in service of everyone's highest and greatest good >> and [clears throat] then I'll take let's take us into it. Y >> So go ahead and find a comfortable seated position.
You can allow your eyes to close if that's comfortable. And if it feels more comfortable for anyone listening to just have a soft gaze, that's okay, too.
And just allow your breath to feel easy, nothing forced.
And simply observe what it feels like to be sitting here in this moment, supported by the chair, supported by the floor, feeling your body brimming beneath the surface. And see if you can cultivate a stance of loving awareness.
You can even repeat to yourself, I am loving awareness.
This is from Ramdas where he would sometimes repeat continuously, I am loving awareness.
And [snorts] finally, just calling in support from source, the divine, ancestors, whatever feels resonant, and asking all of them to work through us and allow us to be in service of everyone's highest and greatest with reverence, with gratitude.
And so it is. And then whenever you're ready, you can allow your eyes to blink open.
It's nap time [laughter] >> and now we go to sleep.
>> That was I love that mantra that you have.
>> Yeah, that's just the language that makes sense to me. But this can be completely individual, but I think it is helpful and actually powerful to name that to say, well, what are we doing here? Right? Like what is this for? Is this to make money? Is this to inflate our ego? Like sometimes it's helpful to make it explicit. No, no, no.
Like yes, we need our like our physical bodies need their needs met. We're all on our journey of learning and growth, but really when we show up to do our work, make our contribution, the point of that is to be of service, >> to be in service of everyone's highest and greatest.
>> Oh, I love that so much. And like usually when I meditate or pray, I like to ask God to like allow me to be a vessel >> is what I like to say. And I know that you said that before too.
>> I say let your words flow through me, >> which is similar to what you said, but we all have like our own different language, which I love. I love that.
>> And we, you know, and each of us can mix it up all the time.
>> And yeah, I think it's all powerful. I think in my opinion, in my experience, it actually does change what occurs. I almost feel it tangibly like then I start to feel that moving through me and means I can show up and do my work better.
>> Yeah. I like love even how quick that was to just kind of like take that breath and like reset and reconnect cuz sometimes I feel like I want to set time to just like meditate or have a clear intention or just start my day right by like aligning myself and just taking a breath and being like I'm here like I'm present. It's okay. And I also am such a like lover of meditation. And like I feel so connected to myself after. I try to do it as often as I can, but sometimes you just get caught up in life with literally work and then like >> my dog, my pets, my family. So, I like that I'm able to kind of like be like I can even just set aside 2 minutes >> or like 3 minutes to just like come back to me.
>> Yeah.
>> And it doesn't have to be like a whole like hour meditation.
>> I mean, an hour is great, but it has to be realistic for us. And I think the fact that I've made this practice such a bite-siz piece means that I do it constantly.
>> So in the end, you know, I think there's something holy about about >> opening in that way and and just being receptive, putting yourself into that frequency, I think is very powerful. So even though I never sit down and meditate for 20 minutes, it's not for an hour, but I'm in that receptive state probably 30 times a day. And I think that that adds up over the course of a lifetime.
>> No, it definitely does. If being present is so important, if you're able to like close your eyes and be present, feel like spending that quality time with yourself, >> which is really important. And also in like big cities like New York City where everything is literally moving and everyone's in a rush. Everyone's nice but everyone's in a rush. [laughter] Um cuz it's so true there's things always like constantly moving. Life >> is crazy for everyone. It's important to be able to have that moment with yourself and sometimes an hour is not realistic. I feel like nowadays in the digital age and online, anxiety and the term anxiety is something that I feel like I was aware of since I was probably in middle school or high school.
>> It was just like a term that I would like hear older people talk about.
>> And as I, you know, started going to school and like growing up and my brain started developing, I was like, okay, I'm very much aware of anxiety. But there's just kind of like this like fine line where like anxiety gets thrown like the word anxiety gets thrown around a lot.
>> Could you help us start by defining what anxiety actually is and explaining what it means to have an anxiety disorder?
>> Mhm. I can certainly talk about how I was trained to think about anxiety, but over the course of 14 years in practice, my view of anxiety has evolved quite a lot. And I was trained to identify these disorders to say here's diagnostic criteria and there's an umbrella of anxiety disorders. And within that there's things like generalized anxiety disorder, a kind of pervasive 247 state of worry and tension and difficulty relaxing, difficulty falling asleep.
Some people have social anxiety which is triggered in social settings and there's a lot of fear of judgment, fear of what it what it feels like to be perceived by people and how that can be activating.
>> There's um post-traumatic stress disorder, PTSD. It's an anxiety disorder um with hyperarousal with flashbacks and liyic activation. And then there are things like OCD, obsessivecompulsive disorder, panic disorder, which can have agorophobic features or not. So I was really taught to think about it as there are these disorders. Our understanding of the mechanism is that it had a lot to do with things like serotonin, sometimes trauma, sometimes social factors.
And that's all well and good. That started me off in my career. And I was categorizing patients according to their diagnoses or according to their symptoms and diagnostic criteria and I've really moved away from looking at anxiety in that way. Let's say let's boil it down physiologically and then let's boil it down more psychosspiritually. I think physiologically your body's in a stress response.
>> There's cortisol, there's adrenaline, these classic stress hormones and that creates a state of activation. Some of us are experiencing that in a really um pronounced way that's a a distinction from the baseline. So a panic attack would be almost like your baseline is calm and then suddenly it's 0 to 60.
You're in a a very peak stress response with things like lightadedness or dizziness and tunnel vision, tingling in the hands and feet, shortness of breath.
You can even feel heart palpitations.
And then there's often a thought that goes along with it like I'm going crazy or I'm gonna have a heart attack or I'm gonna lose my mind. And people can feel very stuck, very trapped or suffocated in a panic attack. That's a very pronounced version of a stress response.
But there's a lot of lowgrade stress responses too. So something that we might call generalized anxiety disorder might be a person whose body is in a lowgrade state of a stress response much of the time. That's the physiologic mechanism. Psychospiritually, I think anxiety is rich. There's a lot that goes into it, but maybe at its essence, it's what I like to call the inherent fragility of walking this earth in a human body.
>> You're right.
>> The fact that this is an impermanent experience, >> that everything is impermanent, that >> there will be a point when we all die, that we lose the people that we love, that we might even suffer. And I think that we can go our day-to-day lives avoiding thinking about that, but it's there.
>> It's there.
>> And I think a lot of us have anxiety because we have not really made right with our relationship to that inevitability.
>> Holy moly, >> that makes sense.
>> And it's not to say we need a death wish. Like, it's more that we just need to grapple with these bigger questions of life. An ability to make meaning out of what's occurring here. And I think anxiety has a lot to do with when we haven't lived those questions and we're just kind of pushing it into the closet and avoiding it.
>> Interesting. If anxiety feels more intense, does that mean that we still just like constantly have this thought about like death in a sense? It's like an existential >> Yeah.
>> POV of life. You know, in in my book, The Anatomy of Anxiety, I break anxiety into two types into false anxiety and true anxiety. So that psychosspiritual thing we just talked about the inherent fragility of walking the earth in a human body that's true anxiety and that's where sometimes our true anxiety is not a problem. It's not something out of balance. It's really just our inner compass nudging us. It's tapping on us and saying hey like you know something's out of alignment here.
>> Something requires your attention. Maybe you need to course correct something. So sometimes we have a lot of strong true anxiety, a feeling of I am not in the right relationship or in the right job or I need to change some things in my personal life or my community needs me to show up in a different way or the world at large needs me to help course correct in some way that seems synced up with my personal passions and interests because I don't think we need to be every kind of activist. I think that's actually generating quite a lot of anxiety because there's a lot of problems in the world. We're at a point now where we can be on social media aware of everything that's wrong in every corner of the world. The human brain did not evolve to be able to triage that much disaster. So we need to know what syncs up with our personal gifts and passions and what really matters to us and that's where we focus our energy often on a local level. But that's where if we have really strong anxiety, maybe we have a strong true anxiety that's saying, you know, you need to show up in this way. But my hot take is that so much of the suffering and all the ways that we're all so anxious these days, it's what I would call false anxiety. That is what's getting most of us out of balance.
>> And what is false anxiety for people who don't know?
>> So false anxiety, that term, sometimes I regret that term, [laughter] but you know, I know how it can be, it can land as a sort of invalidating statement like your anxiety is not real. That's not what it means. Your anxiety is all too real, right? This lifealtering suffering.
>> But I call it false anxiety because of >> the fact that >> it is related to a state of imbalance and it doesn't have to be happening. And if we can address that state of physical imbalance, it's happening in the physical body. Then we can eliminate all of this unnecessary suffering. So false anxiety is just anxiety that >> it's not our deep essence. It's not our inner compass. It's not inevitable. It's a state of imbalance in the physical body. We do best to just address it and then we'll walk away from all that anxiety.
>> Yeah. I I feel like the way that I'm understanding is we all kind of have this feeling and knowing that we are more than just like the physical human body. Call it a soul, call it consciousness.
And sometimes we get so trapped up in feelings like anxiety that literally physically ground us in our body and like stress us out that we forget that we're also this other thing. What you're kind of saying is like if you're able to come back to like your presence and your like consciousness, then you realize that anxiety is just in the body and that's something that can be controlled.
Like it's not all defining like it's something that also can be fixed.
>> Yeah. Yeah. So where you started there I think are like the deeper questions of all of this and [laughter] I'm with you on that. Like are we as spirit like a an eternal transcendent consciousness that's having a physical experience. I believe I tend to believe that. Um but in having that physical experience here we are with a meat suit.
>> Yeah. Literally that gives us anxiety.
because well that that is prone to anxiety in the modern environment >> and certain past environments too. But I think that's what's happening here is that this meat suit has a lot of needs.
It has a need for fuel. It has a need for rest. It has a need for like it's an elaborate house plant in many ways. It needs healthy soil. It needs sunshine.
It needs good water. I think in modern life, our poor little house plants are shriveled up in unhealthy soil and deprived of sunshine and often quite dehydrated. We don't have our meatsuits needs met and that's generating so much of the world's anxiety.
>> And so it's really about understanding what keeps this physical body in a state of balance.
>> What are its needs? How do we meet those needs? How do we not get in the way?
because the design of it is actually really good.
>> Like with the exception of the knee joint and menopause like I think the design of the human body is very good but um we are often getting in the way of its processes and we're failing to meet the body's needs and I think that's generating a lot of stress responses which then subjectively show up as I have anxiety.
>> We were talking literally yesterday or two days ago. We both were like, I've been in my head so much, like not so feeling my body.
>> And then we were like, oh, we're we're getting anxious like because we were kind of not neglecting our body, but like not paying attention to like, okay, we need water, we need food, and like >> we're just constantly working.
>> But that's interesting that you said that because when you're too much in your mind, you can not focus on like what your body needs and then creates >> a loop.
>> Yeah. Literally yesterday we were talking about how we like had just gotten off a flight and we were working cuz we had a bunch of things we like needed to turn in and >> and then I was like you have to like work and show up and be a good daughter and also like meditate but drink water like don't forget to drink water and like there's so many things that you need to keep in mind. Sometimes I wish that kind of like tommo tommois and like little like pets online there's like a bar that tells you like >> what they need they need water they need food >> your relationships like relationships are down you need to socialize a little bit go to the bathroom [laughter] >> I wish we had that >> I have three things to say in response to this we'll see if I can keep track of it the bullet points are the [laughter] second bullet point is um oh I remember the wellness industrial complex. So, keep me on track with all that. So, with the Tomaguchi, I remember when I had my daughter and she was a baby, you'd be like, "Okay, this baby's cranky. Why?"
And over time, I came to realize I needed to keep a list on the fridge cuz there's a finite list with a baby. It's like, "Is she tired? Is she hungry? Does she need to be burped? Does she have a wet diaper?" Like, you kind of have to, is she teething? But somehow, I would never have the presence of mind when I was just like faced with she's upset about something. What is it? That was a relatively simple list for an eight-month-old. We adults, we are just oversized toddlers in so many ways, but we also have a certain list like the little animal. And it's like ultimately we need rest, we need nourishment. I think we do need sunshine, we do need movement, we need community, we need a lot of different micronutrients.
And um once we start to meet those needs, some physical, some more psychosspiritual, we're pretty well. And this ties in with the wellness industrial complex because I think anybody these days like who's listening to these kind of podcasts like we're in certain ways inundated with wellness to-dos. We know we have to do all the things. It's like oh maybe I should also gouasha and do an infrared sauna. Maybe I should meditate in the infrared sauna.
Should I drink electrolytes? Like we have this overwhelm around wellness practices. And I think that it's sometimes important to recognize it's become so overwhelming partly because of capitalism and the wellness industrial complex, but partly because we are now fighting back against a world that's taken us so far from our basic needs. If you think about organic food, used to be that's just what food was.
But as we've taken on larger industrial practices and chemical fertilizers, now you need to kind of make it fancy and bougie to get back to food that's just growing. We are building back the village in so many ways.
>> The other day I saw something on Tik Tok that was like basically a full body MRI scan. It just made me think about the fact that like there's so much going on in our bodies and it's kind of hard to keep track on your own. as much as like you can be so in tune with your body nowadays, there's so many factors. So, even kind of going back to like anxiety and how that's something that our body is essentially telling us like there's a need that isn't met.
>> Yeah.
>> This needs a little more like attention.
>> Yeah.
>> How can we like figure out how to like understand our bodies and like >> be aware of what we need?
>> The full body MRIs to me, it's not a no-brainer. That's that's actually not such a simple question because there's such a thing as incidental. There's um things that you'll pick up that are incidental findings on a full body MRI that you didn't know you had that won't necessarily be consequential, but once you know you have it, then there's stress that comes with that. There's sometimes invasive procedures and decision trees around should we intervene or not. And I think that um it also for me it's a practice that reinforces this idea that we don't know our bodies. External instruments know our bodies. And of course there's a time and a place for scans and preventive med like I get it. But there's also I think a hotline to our own internal state that we need to dust dust off and strengthen that we've gotten very atrophied with tuning in. We need to be full body MRI scanning ourselves all the time. But from a a perspective of tuning in the idea of like relying on something external is complicated and like not the best thing to do because even in doing like when I stumbled across this video, this Tik Tok, I was like, "Oh, I need an MRI scan." And it was almost like this sense of panic a little bit like I was like, "Oh, I want to see what's going on in my body." And that is me like already kind of getting ahead of myself and having like this anxiety over something that I'm not even like sure of. And I think that like that just shifts the focus to like fearbased rather than like let me like just like tune in with myself and see how do I feel right now.
>> Exactly. And even that fear of like, I should get that MRI or once you get it, you're waiting for your results. Like all of that chemical stew of fear that we bathe our bodies in, it's material that has an impact on our health. And so we just don't want to approach it lightly. It's not to say none of us should ever get an MRI. It's more that um we need to weigh all of those costs and benefits. And fear matters a lot and our own relationship to our bodies matters a lot. I like to bolster our ongoing dialogue with ourselves and our trust of our bodies. I think our bodies are actually very good at communicating to us states of imbalance. That's a big part of how I look at mental health differently than how I was trained. I was trained to say, you know, this constellation of symptoms is what we call depression, is what we call anxiety. As though that's a thing, as if that's really an entity like you have depression, you have anxiety. I think depression and anxiety are themselves symptoms. Those are not the final verdict. Those are the beginning of the inquiry. It's it's not telling us what you have, which would sort of imply now that we know what you have, we know what to do to heal you or cure you. Those those terms don't tell us how we cure you. Those are symptoms. They're not telling us what you have. They're telling us here's how your body is communicating to us about imbalance. And it's at that point we roll up our sleeves and start doing the reconnaissance and the digging and say, "Okay, so why are you exhibiting this symptom of anxiety or this symptom of depression? What is the body communicating?" Growing up, I was always like a very like fidgety child. Like I was always like talking in class or like grabbing things. And like there was a time where I had like even counselors tell my mom and like pull my mom in and be like we think she might have like ADHD cuz she's always like talking and touching things. Um she's great but like she's like a little distracted.
>> And my mom was very much like the type of mom that was like I don't want to put my child on medication. She's also very Mexican so she's like I come to the United States and they're like saying that she has like ADHD and now she has to get on medication. Like that's just like a lot. M >> so she was just kind of like okay let's like see where this goes I will offer her like support so growing up that kind of started getting complicated because I kind of was going undiagnosed it like escalates the problem a little bit like things you know you're not diagnosed so like you start noticing other things kind of like trickle into your life so I started experiencing like anxiety and depression and when I first had that like side effect of like or like was experiencing anxiety and depression. I remember just being so not healthy with my body.
>> I was not getting enough sleep at all. I was like not eating my three meals a day. I was not going outside and getting exercise and walking. Um and these were all like things that a human being needs to be happy. Mhm.
>> And it kind of like reminds me of what you're saying with like anxiety and depression being side effects of the fact that like something is kind of lacking. Anyways, I ended up going to a really great doctor and he basically gave me anxiety medication and he also told me he was like, "This is just as important as the medication. You need to be eating three meals a day. You need to walk. You need to go Yeah. You have to go exercise for an hour every single day. like it's just as important as taking the medicine. Have seen such a change and shift over the last like 2 years that I've been on it. Um and you know like listening to the doctor's orders but [laughter] but um it did kind of like bring me back to what my mom was initially saying and I don't want to have to rely on medicine for the rest of my life. And I think that that's what my mom was kind of like afraid of and feared a little. It was like, okay, she starts a medicine, but then this is something that she'll have to take for a while and the side effects of that. I think right now I'm at a place where I'm like, this has helped me so much and I'm so happy that I was able to get this diagnosis and get something that was able to like change my life and help me.
>> Um, but I don't want to have to rely on it for the rest of my life and have to like take a pill every single night. I know you talk in your book a little bit about like holistic healing and how you've had some of your patients who you've been able to get them off of the medications that they were on naturally and transition naturally.
>> I mean, I've never framed ADHD this way before actually, but in hearing you describe it, sometimes I do think there's a little true and false within ADHD as well. And to me, there's no question that there is such a thing as like true blue ADHD. Now, do I think it's actually a disorder, something pathological? I don't I think it's a normal and meant to be aspect of the neurode divergence of human brains. Like I think we need all types of humans and we need the person who's like I'm focused and then we need the person who's like I am taking in a lot of data right now. [laughter] Sometimes I'm hyperfocused on one particular very rewarding thing. So there is true blue ADHD. No question. Is it pathological inherently? I don't think so. Is it a mismatch for our modern school and work environments? Often in different ways for boys and girls, but I think that there is also sometimes some false ADHD that's happening. And it will often happen with someone who has that intrinsic ADHDness underneath, but they're more symptomatic than they need to be. And that can relate to things like inflammation, like zinc and magnesium levels. But the thing I see overwhelmingly most common is that it's related to breathing. And um in particular, how someone's breathing overnight while they're sleep.
>> So more times than I could possibly count, there's someone who is breathing through their mouth rather than their nose during the day, but also while they sleep at night, they're not getting adequate oxygenation or sufficiently restful sleep. And then their brain is basically so exhausted that it kind of stems itself into hyperactivity during the day and it struggles with executive function because it's not a rested brain during the day. you see all the symptoms of ADHD exaggerated by this chronic sleep deprivation that's the result of disordered breathing. So that >> when someone has ADHD like a child, I always want them to be evaluated for airway for how they're breathing and just to make sure we're setting them up for success to breathe through their nose, especially while they sleep. And not to say we're curing ADHD with that.
Sometimes someone still requires medication, but often they're less symptomatic. And I think that's it has a profound impact on their overall well-being, mental, physical health on into the rest of their life.
>> Yeah.
>> Wow.
>> So, in terms of medication and that whole journey, I think, you know, I don't know exactly what went through your mom's mind in that moment, but part of where I have a just a different relationship to psychiatric medications than my colleagues is that it's the implication that mental health is a fixed trait. that we're basically saying you are someone who is wired to have anxiety or depression. You are someone who has a genetic chemical imbalance, but don't worry, we can fix it with a pill. I just don't buy that that's the makeup of the human genome. I don't think any of us are here wired to be depressed or anxious. I think again that that's those are symptoms communicating imbalance and unmet needs. And so I have much more of a growth mindset around depression and anxiety. I think that it's not a fixed trait. It's not a genetic chemical destiny. It is something communicating imbalance.
Sometimes it's necessary to add a medication as a bridge to pull somebody out to get them doing okay in their life while we do that work of understanding what's the physical imbalance, what's the psychospiritual unmet need. But I don't approach that decision lightly about whether or not to start someone on a medication. My only hesitation around starting someone on a medication is what can happen when if and when they want to get off of that medication.
>> So that's what gives me pause because for some people they can get off of a psychiatric medication no big deal and that's beautiful and wonderful but for a lot of folks and I think it's underappreciated and underdiagnosed.
There's um a lot of post SSRI sexual dysfunction. There's a lot of um people having subacute withdrawal for many months after getting off of a medication. The discontinuation process is generally harder than we appreciate >> and it needs to be approached in a really careful way. You want to go so much more slowly than people typically know to do, including the prescribers.
So sometimes I'll I'll still hear in the community that a prescribers saying, "Okay, you want to get off a medication." Usually they'll discourage it, but then if you, you know, reluctantly they'll agree to support it and they'll say, "Why don't you cut the dose in half, take that for two to four weeks, and maybe cut it in half again and then go off of it?" And that's woefully too rapid. That's not a safe way to approach it. And I would like to work with a compounding pharmacy. That's a pharmacist that's going to actually use the sort of ground down powder of the medication so that they're siphoning out the exact amount of medication and reducing it about 10% of the original dose per month. So it's typically taking a minimum of a year >> and that's just for one medication. So if you're on multiple medications then you wouldn't really want to approach them all at the same time. You would do a year to get off of one, a year to get it off another. And I know that people can feel discouraged by that information. But the whole idea of this is that it's not even a process you have to think about that much. You just get your prescription every month from the compounding pharmacy, take it in the background. Don't even overthink like, uhoh, am I going to be in withdrawal?
Cuz that we're suggestible. But you basically want to get to the point, not that you're still medicated, but just that you have enough medication in your system that it's mitigating the withdrawal. So your brain can slowly adapt to the removal of the medication.
>> Do you have to replace the what the medication was giving you with something else? Just first thing that popped in my head was like you have to be outside more in the sunlight >> because like that's what's going to be making up for like >> the serotonin that's in your receptors.
>> I won't even start someone on the tapering process until they've clocked about a month of supporting all those other needs. So really good nutrition, good sleep habits, exercise, getting outdoors, a healthy house plant, sunshine, water, soil, and so all of that is like the necessary precondition to even begin the process because the process is a challenge on your body and on your brain. And you want to come in really solid and I want someone to continue those habits throughout the process. The real way to give your brain the micronutrients it needs is nutrient-dense foods. Chicken liver pate is a very nutrient-dense food. red meat, different parts of the animal, not just muscle meat, eating the whole rainbow of different colors. So, all the different brightly pigmented fruits and vegetables. These are ways that we check all the boxes on the nutritional scavenger hunt.
>> Wow. Okay, that's so good to know. I feel like through ease, I really have understood how important food is and how it impacts everything. Mhm.
>> I like really appreciate and resonated with you saying that anxiety and depression is a symptom of your body telling you, you know, information, giving you feedback and input and that it's not a life sentence. I feel like a weight was lifted off of my chest just now.
>> That's right there. The whole reason for everything I do, the way I think about healing is as a mountain, the top, the summit of the mountain. This is where you feel good, where you're resilient and hopeful and mentally stable and energetic and clear and have capacity.
And that is that's where we're trying to get to. And currently my field of psychiatry, psychology, it's offering two well-worn paths up that mountain.
It's saying you can try medication and psychotherapy. And for some people, those paths get them all the way to the top of that mountain. I always count as a victory. But I just have been at this long enough to know that a lot of people hit dead ends. They try one path, they hit a dead end, they sort of keep trying other versions of those paths. You add maybe you increase the dose of a medication or add an augmentation strategy or you try a different therapist or a different therapeutic modality, but they're still not getting all the way there and they're starting to feel really stuck and even despairing. They might feel like, well, this is supposed to work. It's not working for me. So, I must be beyond repair. [clears throat] >> And that is the thought that I want to disabuse people of. That's where I want to intervene and say, "No, no, no, no.
Before you feel hopeless, before you feel any type of despair, I want people to know there are many paths up this mountain." and where people feel stuck, that's where we just need a different conversation about mental health, which helps people know that those two paths are not the only way up.
>> Thank you for saying that. We have some questions from our audience for you.
>> Um, so we want to take some questions and play one of those games.
>> Hi. So, I feel like my anxiety gets so much worse when like I'm on my period or like I haven't been sleeping well. How do I know that what I'm feeling is like something I actually need to like emotionally work on or if it's just like my hormones being crazy?
>> That's a good question.
>> It's a great question. Ludalial phase gets you. [laughter] >> Yes, phase will catch you every time.
It's um so that's right on curay because this is exactly what we're talking about and and like thank you for this question and and I'm sure you're speaking like many people are going to resonate with this. I actually disagree with that um dichotomy though of like is it something I need to emotionally work on or is it just my body being out of balance? Your body being out of balance and that's something to work on not for like any moral reason but so that you don't have to suffer so much is basically we have an exaggerated experience of PMS in modern life and that creates a lot of suffering and it shouldn't be happening.
So we want to get the body into balance.
Let's talk about the period for a moment. This is something that I think we're really undereducated on and now there's a conversation happening which thank God and not a minute too soon. So basically our menstrual cycle day one is the first day of bleeding and that's technically the beginning of the follicular phase but that's what we call the menes or the bleeding phase. It's what we call like on our period and that's a pretty tender time. We can be emotional. There can be cramping and all of this low energy. It's not the time to be doing like a hit workout. It's a time for naps and baths, reading a book with a cup of tea under a blanket.
>> And then once the bleeding starts to abate, you're really in your proper follicular phase, those first 14 days of the cycle. And that's the phase I think of it as in the yinyang. That's the yang phase of our cycle. It's when we're energetic, we're outgoing, we're social.
It's a good time to record a podcast or do a speaking.
>> I'm in my [laughter] me too.
And then we ovulate which is a time of heightened libido and sometimes even sleeplessness and that's a time when we are fertile but then as soon as you ovulate you tip into the ludal phase gets a bad rap.
>> Yeah. And that's the second 14 days of the cycle and that's dominated not by estrogen but by progesterone and it's a time when we're a lot more tender. We're a lot more uh emotionally raw. As we get closer to the bleeding phase, that's what we call PMS where I think what you know we have emotional, we have a lot of cultural baggage around the PMS phase.
We say someone's being irrational or [ __ ] I think that we actually have a decreased filter. I think we are more connected to the truths and the injustices and we're less willing to tolerate BS in those days right before our period. So, our world says we're being irrational. I actually think we're being irrationally chill in our follicular phase and we're being rationally like what the hell in our late ludial phase. So it's not that I think you need therapy to address all of this. I think you need functional medicine, naturopathic medicine, Chinese medicine. I think we need to get the body into balance so you don't have to suffer so much. And that's really in terms of nutrition, inflammation, digestive support, rest, all of that good diet, lifestyle practices that keep your physiology intact. That's how you can have a less pronounced PMS phase.
>> To know when you're follicular, to know when you're ovulating, to know when you're ludial, when you're about to get your period. It's so eyeopening because I used to be like, >> I am so bloated and nobody likes me and I don't like anybody. And I would just have that feeling and I'd be like, "Oh my gosh, my life must be so bad."
>> And what I know now is that like clockwork, I have those feelings exactly the day before I get my period. And when I when you have that when you're sort of grounded in understanding that there's a hormonal role in those feelings, you can be like, "Okay, it's a bit of a false mood."
There's still some kernel of truth to what really feels alive in us in those days before our period. I think there's sometimes important messages that come through, but you can take it all with a grain of salt. You can recognize that your body is having a more pronounced [clears throat] >> reaction. And so just to know that there's a hormonal component to how we're feeling is powerful.
>> So we have one more question for you.
>> I have always been an anxious person and have dealt with anxiety for a long time.
When I was in school, I dealt with agorophobia to the level where I had panic attacks in specific classrooms.
And it was especially hard when I was in this class. I saw the same people every other day. So on top of the anxiety, I also felt the pressure of their perception of me having a panic attack.
I am curious what practices or tools you have seen help your patients with agorophobia or how to deal with active panic attacks.
>> That's a great question. Okay, thank you for that question. So >> here we go. Basically the way I think about that agorophobia with panic panic disorder with agorophobia is that it can snowball where you start to associate that setting with having a panic attack.
So it's like that expression fear of fear itself like >> you start to think about oh no that classroom that's where I've had a panic attack before. It's so exquisitly uncomfortable and I feel shame and judged by the people there. So then all of those associations and all of that anticipation revs your body up and potentiates and makes it more likely that you'll panic again in that setting.
And so for a number of different reasons, the association it can snowball and make it more likely. We need a reset in two different ways. One is exposure therapy. Basically what happens with panic disorder is that your life starts to get small because you understandably want so desperately to avoid having a panic attack. So you think what if I just don't go to that class or don't go near that classroom. And you know on one level we're thinking okay this is a good way to prevent a panic attack but it just keeps making your life smaller and smaller and it actually reinforces the cycle of that that classroom means you'll have a panic attack and so we kind of make it proliferate in the avoidance of it. So what we want to do is um work with a therapist ideally who does exposure therapy and you start to slowly in a structured way develop the skill of you do it scared and you witness yourself having the experience of you went through with it and you were okay or even you you went through with it you had a panic attack and you were okay and so you want to keep making your life big again not smaller but then also physiologically I always think about like it sounds like you're already working in the functional medicine doc and and have that support. But panic attacks um you want to prevent the body from dipping into a stress response in any way.
>> Alcohol use is going to potentiate that kind of stress response. Sleep deprivation, lack of movement. Um, with nutrition, you you want not only to be really rock solid, stable blood sugar and really replete on your nutritional stores, but you also want to avoid foods that make your blood sugar swing. Cold foods. This is more of an eastern view of things, but you want grounding, warm, deeply nourishing foods. That's what's going to stabilize you in those moments.
And so there's a lot you can do to set your body up to be very stable as you head into that kind of setting, then do exposure therapy and minimize the risk of having another panic attack.
>> Back to the house plant.
>> It's always back to that.
>> And it just reminded me even when you were like minimize like alcohol, I was like well if you were given a house plant alcohol >> it would probably be kind of like wonky a little bit. [laughter] >> That's right.
>> So that makes sense in my head.
>> Not the right way to water a plant norm.
We want you to feel at ease a little bit. We've been yapping. So, if you can paint us something that brings you at ease, >> we'll bring in the paint set right now >> and then um we'll ask you a question once you start painting. As we've talked through everything today, a kind of theme that I'm getting or a lesson is throughout social media or media in general, everything that we're we're in this era of influence. You've mentioned like listen to your body and how that's more important sometimes than being told what medicine to take. How can we think better for ourselves? M >> I really appreciate that question because while I paint um [laughter] and soothingly don't make eye contact me out sometime just to be in parallel play communicating. So um this is the topic of my second book. The book that I'm writing now comes out in October.
It's called Season of the Witch, >> a psychiatrist case for magic >> and it's told through the arc of grief.
It's really a memoir about losing my parents and and everything that I grappled with in the wake of that. But that's really where I learned to have a very insourced like as opposed to outsourced like an insourced sense of discernment, sovereignty, >> um connection to awe and and trust and surrender. And so I think a big part of that journey for many of us is grappling with the bigger questions of life and recognizing there's a lot of forces right now that will want us to outsource to them. It's sort of part of my feeling about the MRIs, right? Like that is an outsourcing and it can be really useful and it can be life-saving, but we just always want to note when we're saying that the this the power is is outside of us and not within us. I think that we really just want to bring a lot of that back home and to have a lot of sovereignty over I'm good here.
I'm very home in my body. The lights are on. I'm wide awake here, present and connected to myself so that I can go through the world in discernment. And I think especially in this age of AI, there's an assault on truth, on how we can trust what we're seeing with our own eyes. I think we need other mechanisms for feeling what's real and feeling what's true. And I think that happens first in our physical bodies. And so we just want to keep strengthening our ability to tune in and listen because our bodies have wisdom vastly beyond what we realize.
>> That's true.
>> And if we're checking in, it's hard for us to be led astray.
>> I love that. That's so good. I like the idea of strengthening your discernment like a muscle and just keep tuning in and like making it stronger and stronger.
>> Can you show us your painting?
>> Oh yes. Okay. So, we've shifted now fully from book one, the anatomy of anxiety, to book two, season of the witch.
>> Now, we didn't end up putting a yinyang on the cover design, though that was my original vision was a yinyang with like the hemispheres of the brain overlaid, left hemisphere, right hemisphere, but >> Oh, cool.
>> for book three. But I think that um the idea here is that this was something I always doodled in childhood and um and I didn't even really know why. I didn't have any exposure to Chinese medicine or Dowoism, but I um ultimately and went on to study Chinese medicine. And for me now, the yin-yang is a very important operative framework for how I view everything in the world and everything with health. And um and I think that this symbol captures so much about where we're out of balance as a culture where we um disavow parts of ourselves as women. And so that's what I've really been exploring. That's the cultural commentary of this book is that we're in a world that celebrates the yang, that masculine sun aspect of life. That's action, doing productivity. what's evidence-based. We love this. And then there's this pesky y the inside that's the feminine moon, mysterious, receptive, surrendered, non-doing. And that's the part we systemically devalue.
But that's got us out of balance.
>> Got chills.
>> Me too. I'm going to cry. That's so true.
>> And so I really come back to this symbol all the time because we're not living in this beautiful balance. But this is inevitable. We're existing in dynamic equilibrium between these two states.
And we have to, I think, reclaim our yin. We have a final question that we say at the end of our episodes and we like to tie it back into ease. Our last question for you is how do we find ease when we aren't in ease?
>> I'm asking my guides for what what needs to come through on that.
[sighs] >> We're being kind of pinalled around by shoulds at all times. We, you know, we should meditate and we should eat this.
And even a lot of what I've said today is very should. It's like we should do these diet lifestyle practices to support our mental health and I stand by it but within reason and gently with a light grip. And I think often we actually need to push back on all of those shoulds and allow and be with our just our being exactly as we are realizing embodying that we are whole that we already have what we need that it's internally resourced and I think sometimes the should baked within this is like if we can get out of our heads and drop into our heart centers that's where we can remember that we are whole into ourselves inner resourced and divine exactly as we are.
>> I love when someone says like actually there's no pressure there's no rush this like timeline that you have it actually doesn't exist and you're okay and I love this like loosening of like this is what we should be doing and it's like no actually you you don't need to be doing anything.
>> Yeah.
>> So >> it's this part [laughter] it's the balance. Thank you so much for having this conversation with us today Dr. Bora. We had such a great time. We were so excited to talk to you and you did not disappoint.
>> You did not disappoint. You brought us clarity.
>> You brought us clarity.
>> This has been a sheer delight and this is clearly in service and I'm honored to be a part of it.
>> Thank you so much. are so honored, too.
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