Posts in mood
New worksheet available! Stress LESS.

Hi everybody!

I have been scribbling different versions of this worksheet for some time now, and I finally have a version that I’m excited to share. It is the first in a series of worksheets that I will be making available on the (heyyyyy) WORKSHEETS PAGE!

Me, being  not stressed  about being covered in Jell-o at my son’s 7th birthday party.  Yep, he still likes getting messy, I’ve just joined him.

Me, being not stressed about being covered in Jell-o at my son’s 7th birthday party. Yep, he still likes getting messy, I’ve just joined him.

This first worksheet is all about identifying your response to stressors. We all need LESS STRESS, and I am 100% sure you can shift your perception of your personal stressors (well, most of them anyway) to have less stress.

The basic idea is that you will identify your stressors. After you have identified your stressors, you can then have a real conversation with yourself about whether you choose to have a stress response to that or not. That’s right, you get to choose in more cases than not.

The example I always give in my clinic is when my son was about 2-3, he was obsessed with emptying all toothpaste, all dish soap, all shampoo, bubble bath, you name it..into the sink or the bath tub. We would be having a normal day, getting ready to leave the house and I’d realize that I sent him to get socks (or pants or whatever!), and he didn’t come back straight away. I would know that he was probably getting into something, and I’d feel this mild fury rise in me that he was wasting another tube of toothpaste. Even though the grownups had put it out of reach, my 5 year old probably hadn’t…..lo and behold a sink full of toothpaste AND toilet paper because he actually tried to clean it up. I was right, but I was in no place to acknowledge he was a little kid trying to learn. That moment sucked, and I wanted so much to have had a different response. It was predictable. He did it All. The. Time. He was an insatiable tiny mad scientist.

I had to learn to have a new response in that very moment. I had to decide that I would not allow myself to become stressed about wasted toothpaste. I had to decide that as I walked down the hall, rounding the corner to the bathroom, that I would take pause, assess the situation, and do my best to not allow this particular stressor become STRESS IN MY BODY. It was as simple as making a decision to respond differently. I use this example as a jumping off point. Other stressors may require more complex changes, but I’d highly recommend downloading the worksheet, and see just how many perceived stressors you can shift without embodying them anymore!

Yoga for anxiety

My very dear friend, EB Ferdig is a genius when it comes to helping people manage anxiety with yoga. Unknown

Her next series starts on 5/3, with a discount if you register by the end of today.

Series cost is $150 - but only $99, if registered by April 26! Space limited to 10 participants, register today!

The five-week series will be taught by E.B. Ferdig, E-RYT50, a yoga therapist who has been helping people with anxiety for over ten years. E.B. is highly compassionate and knows personally what it’s like to live with anxiety. She will guide you, as she has hundreds of others to a place of greater peace, clarity and personal power.

Questions? (503) 333-5484 or email: ebferdig@gmail.com

Hit this link to sign up and begin feeling relief.

Naturopathic care for Postpartum Mood Issues

Naturopathic doctors are trained to look for the root problem causing someone's symptoms, rather than just making the symptoms go away.  If we address the underlying cause, we can allow the symptoms to recede for good.  This is no different for postpartum women, and there are a number of reasons WHY women develop postpartum mood disorders.  Naturopathic doctors, especially those trained in the art of midwifery or who have had special training in pregnancy and birth, are very well-equipped to figure out how to best help each woman on an individual basis. Dr. Adriana Azacarate-Ferbel is a Portland area Naturopath who has studied Postpartum depression extensively.  I met with her last fall when I began researching this topic more myself.   She outlined the most common underlying reasons for development of Postpartum depression:

  • Fatigue and Sleep Deprivation
  • Hypothyroidism
  • Hyperthyroidsim
  • Immune system dysregulation
  • Pain
  • Low Cholesterol levels
  • Hormone imbalance
  • Neurotransmitter
  • Insulin resistance

Sometimes, it may be a combination of one or more of these that can cause postpartum mood disorders to develop.  Because this is true for many women, the Naturopathic approach is multifactorial as well.  The earlier we can recognize the symptoms and determine what's actually going on, the better.  In my office, a primary work-up to determine the underlying cause may include:

  • Thyroid testing, followed by nutritional supplementation and/or medicine to balance the thyroid gland (if needed)
  • Combination Hormone and Adrenal Saliva testing, followed by treatment with herbs and nutrients known to balance female hormones, DHEA, and/or cortisol (and are safe for breastfeeding).
  • Lipid panel, to look at cholesterol levels, followed by nutritional counseling to ensure adequate levels.
  • Comp. metabolic screen, Iron panel, and Complete blood count, to assess for blood sugar issues, anemia, and immune system problems
  • Musculoskeletal assessment to determine sources of pain that may be adding to increased stress and fatigue, followed by massage, acupuncture, or other forms of physiotherapy
  • In some cases, neurotransmitter testing will be done first.  This is especially true if someone has a marked history of depression, anxiety, or psychosis.

I could write pages and pages on this topic.  This is just a jumping-off point.  There is still a lot to learn about this realm of women's health, but we have a very good grasp on how to make the transition to motherhood a happy and healthy time.

Be strong.  Live healthy!images

Baby blues

imagesDid you know that about 80% of all new moms experience some form of postpartum mood flux?  There is a normal drop in mood, increase in anxiety and tearfulness that occurs in most women right after they have a baby.  In most of these women, it is hormonal.  The pregnant body is pumped full of estrogen, progesterone, relaxin, prolactin, and oxytocin.  When the baby is born, all these amounts shift---mostly dropping off like the cliffs of the Grand Canyon. Having a baby opens women up in so many ways: physically, emotionally, and spiritually.  It is a very wonderful and overwhelming time in all regards.  It is also a very vulnerable time because the body is going through so many changes AND there is a tiny little being that must be tended to 24 hours a day.  "Baby blues" affect up to 80% of new moms within the first few days postpartum.   I've seen that days 4-6 postpartum tend to be the most difficult for women mood-wise.

About 10% of new moms will go on to develop postpartum depression.  The onset of postpartum depression actually tends to be anywhere from 6 weeks to 6 months after the birth.  The symptoms are similar to depression: low mood, sleep issues, appetite changes, panic, anxiety, disinterest--plus constant concerns about ability to care for the new baby, and possible fears of actually harming the baby.  If a mom has had issues with depression prior to pregnancy, she is at a higher risk for developing postpartum depression.  Sometimes, it can be due to underlying physiological issues like hypothyroidism (which can also develop in the postpartum period).  So it's good to rule out root problems to best help with treating the symptoms.

Roughly 2% of new moms will suffer from postpartum psychosis.  This is a very serious condition that must be addressed immediately and is thought to also be due to the drop-off of hormones that occurs after the birth.  Symptoms of postpartum psychosis are seen within the first 2-3 weeks following the birth and include:

  • insomnia (other than not being able to sleep because the baby is awake)
  • mania
  • flight of ideas
  • self-harming
  • constant thoughts of harming the new baby
  • disinterest in the new baby
  • complete shift of mental status (that friends and family easily notice)

Often, these women need in-patient help with stabilizing mood, but there is a lot that can be done naturopathically to support a woman in this situation.  With the right support, these women go on to embrace being a mother.

There is a whole slew of new research coming out on postpartum and antepartum mood disorders.  More prenatal care providers are broaching the subject with their patients as well.  One of the best tools we have is to educate the patient and her family about the signs and symptoms so early intervention can occur.images-1

Next week, I'll be writing about some of ways naturopathic doctors help women who may be at greater risk for developing postpartum depression, anxiety, or pychosis.  Until then, enjoy the days as we begin to welcome Summer this year!

Postpartum Nutrition

Good Morning!  It looks to be another beautifully sunny morning here in Portland, Oregon.  Wow, we have really been blessed with some fantastic weather the past few weeks.  Our clinic garden is looking great as well as the garden my family and I are growing at home.  I'll be taking some photos to show you all just what I mean! imagesToday I'd like to round out this series on Nutrition during pregnancy by providing some guidelines about postpartum dietary needs.  The postpartum period is defined as the time from the birth of the baby and placenta to 6 weeks afterwards.  I personally believe that this extends to 3 months after the birth at minimum, with the first 6 weeks being the time when the body makes most of it's transition back to "normal".

I put normal in quotations because it is very common for women to feel like they have a totally new body after having a baby.  images-1To a certain extent, it's true.  It's not the same body.  It looks, acts, and feels different than before pregnancy.  Therefore, it has different needs.  This is especially the case if the new baby is breastfeeding. Let's have a look at some guidelines for women in the postpartum period:

  • During pregnancy, women need 200-300 extra calories per day to grow a baby.  During breastfeeding, women may need up to 500 extra calories per day to make enough milk to feed their new baby.
  • Also needed for milk-making is WATER.  Most women will need between 2-3 LITERS of water a day to keep up with the demands of making milk.  I like to get the whole family involved in the process, stashing bottles full of water wherever mom might end up nursing the new baby.  Intense thirst universally follows feeding the new baby, and moms everywhere love having a big glass of water while they nurse.
  • Many women need extra iron after having a baby.  Moms who had a lot of bleeding with childbirth are in a higher risk category for developing postpartum anemia.  To prevent severe anemia (which can lead to excessive fatigue and lowered mood):
  1. Increase iron in the diet: red meat, eggs, enriched cereals, and blackstrap molasses are good ways to get iron.
  2. Increase Vitamin C intake: Vitamin C helps you absorb more iron from your food.  Take with meals.  Do not exceed 3000mg/day unless being supervised by a health care practitioner.
  3. No black tea: Tannins in the tea decrease iron absorption.
  4. Cook with cast-iron pots and pans.  Believe it or not, you will get good doses of iron from doing so.
  • Continue to take your prenatal vitamins through the end of breastfeeding.  You still need the nutrients.  Plus, the extra B vitamins will give you much-needed mental and physical stamina.
  • Omega-3 fatty acids with a higher DHA:EPA ratio.  Studies show that infants benefit (neurodevelopmentally) from DHA supplementation in pregnancy and breastfeeding.  Moms also need these healthy fats to help heal and replenish the reproductive and nervous system.  DHA can be found in coldwater fish and algae most readily.  Taking an encapsulated form of DHA is a sure-fire way of getting enough.

Next week I'm going to address Postpartum depression, anxiety, and mood disorders.  It's more common than you think, and there's more that can be done to help prevent it from affecting you and the ones you love.  images-2

Modern medicine as art.

I like to read the Health sections of several newspapers in the morning to see what's out there.  I generally try to discuss naturopathic medicine on this blog each week, but today I want to share with you one of the most creative, fascinating uses of modern medicine I've ever seen.  It's not even primarily about health, but about pursuing our passion in life and quenching that innate curiosity we are all born with. I have watched this curiosity bloom in my own daughter each day.  It's natural to want to know about the world around us.  It's when we stop asking questions and become complacent that we start to deteriorate mentally, physically, and emotionally.  So it is about well-being.

I challenge you this week to find what stokes that child-like inquisitiveness in you.  Pursue it a bit, and see if you don't discover something amazing.  Like this guy, Satre Stuelke, an artist turned med student.ctscan_480jpg

Vitamin D and you!

Winter in the Pacific NW generally means very little opportunity for sun exposure.  When you're talking about a nutrient that is made in the body when skin gets exposed to UV light, the lack of rays can be a problemo grande. I've been checking my patients' Vitamin D levels this winter with surprising results.  I have yet to get a normal result back.  The normal range isn't even all that high.  People still have symptoms of Vitamin D deficiency at the "normal" level.  Symptoms like: lethargy, decreased mood, body aches, soreness, headaches, decreased libido.  Any of this sound familiar?

When I was in medical school, a family member called me with what sounded like a classic case of fibromyalgia.  She was having difficulty sleeping, had lots of pain in her body, and was tired all the time.  One of my mentors at the time suggested Vitamin D.  She got her levels checked and they were extremely LOW.  She started taking 1000 IU/day.  Her levels have been in the optimum range now for years AND she doesn't feel like she has fibromyalgia.

Aside from feeling good in the winter, Vitamin D is important for long-term health issues.  Check out this article in the American Journal of Clinical Nutrition.  It talks about how Vitamin D appears to delay aging and diseases of aging by slowing the turnover rate of white blood cells.

Taking a high quality Vitamin D supplement daily is a good idea if you live somewhere gray.  It's also a good idea to get your nutrients from food sources whenever possible.  The best sources of Vitamin D are:

  • Herring, 85 g (3 ounces (oz)) provides 1383 IU
  • Catfish, 85 g (3 oz) provides 425 IU
  • Salmon, cooked, 100 g (3.5 oz]) provides 360 IU
  • Mackerel, cooked, 100 g (3.5 oz]), 345 IU
  • Sardines, canned in oil, drained, 50 g (1.75 oz), 250 IU
  • Tuna, canned in oil, 85 g (3 oz), 200 IU
  • Eel, cooked, 100 g (3.5 oz), 200 IU
  • One whole egg, provides 20 IU

images*amounts provided by Wikipedia.*

Women of childbearing age and children should not eat mackerel  or more than 6oz of tuna per week due to mercury content.

There are rare cases of people overdosing on Vitamin D.  You should always consult with your doctor before adding anything new to your daily intake of nutrients.  It is advisable to have your Vitamin D levels checked to assess the proper dosage for your body.

Beat the Blues, naturally.

It's that time of year when Seasonal Affective Disorder rears its ugly head here in the Pacific NW.  Fear not, this doesn't have to mean hopping on the Prozac train, the Zoloft bus, or the Wellbutrin boat.  There are a number of natural alternatives that are effective to help with mood during these months of cloudy weather.  Check out this article by Dr. Mercola for some ideas.  Each person responds to the weather differently.  To tailor a treatment plan to specifically address your needs, think about coming in for an appointment.images

Where is happiness?

I'm going to stray just a bit from the straight up health tips today and talk about a book I just finished: The Geography of Bliss by Eric Weiner.  Mr. Weiner begins by accessing the World Database of Happiness (yes, such a thing does exist---in Denmark).  He learns which countries are the happiest in the world and sets out to discover exactly what makes us happy. One of the facts Mr. Weiner uncovers is the Swiss eat a higher than average amount of Chocolate, and Switzerland is one of the happiest countries in the world.  It turns out that according to the CHUMP study (Chocolate Happiness Undergoing More Pleasantness) you don't even have to eat 72% cacao nibs to get the happy buzz from chocolate.  People reported increased happiness from both dark and milk chocolate.  The study was considered a failure because it set out to prove that only dark chocolate would have mood-enhancing effects.  The only people who didn't get happy in the study were the ones who didn't get any chocolate!

All this being said, dark chocolate does have additional health benefits beyond happiness---so it's still your best bet when the choice is yours.

Happiness is responsible for maintaining our sense of well-being.  I feel that a good sense of well-being, no matter how sick someone is, can be one of the most important factors in determining their healing process.

This study shows the very likely correlation between increased happiness and lowered blood pressure.  In fact, if you visit PubMed, an online medical journal database, and type in "happiness" you'll find that there have been 2820 studies recently on the subject. Lower blood pressure, lower overall inflammation, better detoxification and digestion are some of the examples of the direct benefits of finding happiness.

The Geography of Bliss suggests that it may not be found where we're looking (well, maybe some of us were looking at chocolate).   The book shows the happiest places and some of the least happy places and cross- references the experiences to divulge the patterns of what makes people happy.  You don't have to travel to these places to understand the lesson, but if you do, I'd recommend Thailand...and take some chocolate.