Realfoodology - An Integrative Approach to Depression and Anxiety with Dr. Peter Bongiorno

Episode Date: March 16, 2022

85: Dr. Peter Bongiorno, ND, graduated from Bastyr University, the leading accredited university for science-based natural medicine. He completed five years of training in naturopathic medicine and acupuncture, and was honored to be his class speaker.Before medical school, he researched as a pre-doctoral fellow at the National Institutes of Health in Bethesda, Maryland and at Yale University in New Haven Connecticut, and co-authored numerous medical journal articles in the field of neuro-endocrinology. He is the author of Put Anxiety Behind You; How Come They’re Happy and I’m Not?; Holistic Solutions for Anxiety & Depression. Check Out Dr. Bongiorno: http://www.drpeterbongiorno.com/ https://amzn.to/3Hw62kR https://amzn.to/35tcGet https://amzn.to/3Miuslh   Check Out Courtney: Courtney's Instagram: @realfoodology www.realfoodology.com Air Dr Air Purifier AquaTru Water Filter EWG Tap Water Database Further Listening: Toss the Toxins with Branch Basics There's What In My Makeup? Men Taking Care of Their Skin is Sexy

On today's episode of The Real Foodology Podcast. Vitamin D is a neurosteroid. So as such, it plays a lot of roles in the nervous system, number one, and low levels have been shown to be correlative with depression and anxiety. It's certainly not the only factor. Hi, everyone. Welcome back to another episode of the Real Foodology podcast. I am your host, Courtney Swan. I am the creator behind Real Foodology, which is, of course, this podcast, as well as my Instagram and the food blog that I started 10 years ago. I'm not

really active on there anymore. It more just serves as a landing page for everything else that I do. But if you are new here, I started Real Foodology as an outlet that I needed to share all the information that I was learning as I was getting my master's of science in nutrition and integrative health. And then it from there just kind of exploded into this podcast. Let's get into today's episode, which is an integrative approach to depression and anxiety with Dr. Peter Bongiorno. He's a naturopathic doctor. He graduated from Bastyr University. If you don't know about Bastyr, I actually looked into going to Bastyr. It is the leading accredited university for science-based natural medicine. He completed five years of training in naturopathic medicine,

and he was honored to be his class speaker. Before medical school, he researched as a pre-doctoral fellow at the National Institutes of Health in Maryland and at Yale University. He's also written a few books like Put Your Anxiety Behind You, How Come They're Happy and I'm Not, and Holistic Solutions for Anxiety and Depression. I've put links in the show notes to all of these books so you guys can further your studying, which I'm sure after listening to this episode, you're going to want to, I'm actually going to order all these books and read them because I am just absolutely fascinated by this whole conversation. So we dive deep into depression and anxiety as well. These are both issues that are very multifaceted. And so you have to take a very multifaceted approach.

There is not one size fits all for everyone. We talk about in his experience, why he thinks that there's rising numbers, numbers of anxiety and depression. And this is outside of the last two years of COVID. There's no doubt that COVID has raised both of those levels in our population. But we're talking more about like physiological imbalances, like nutrient deficiency, autoimmunity, endocrine disruption, chronic inflammation in the gut, which leads to an inflamed brain birth control also plays a huge

role. And we also go into air pollution, which actually I wanted to take a minute to share with you guys. So I mentioned in the episode that I use something called air doctor, which is an air purifier for your home. And I'm going to leave a link in the show notes because you get a discount if you use this link, but it is a HEPA filter. It is the best one that I found. And even if you don't live in a place where you feel like you are exposed to a lot of pollution, shockingly enough, we also have air. Our air is polluted just by the cleaning products that we use, things that are sprayed in the air, candles, also off-gassing of your furniture, your bedding, et cetera. All the materials that are used to make, for example, your couch are also off-gassing and polluting the air in your home. And so it's really important to have an air filter. Depending on the size of your apartment or home, you may want to get more than one, but anyways, I just wanted to share that with you guys. Um, cause I do have a link for the air

doctor, which is going to give you a, I think it's like, I think it saves you like almost $200. So definitely worth checking out. We also talk about, um, water as well. You definitely want to filter your tap water. I encourage everyone to go to ewg.org and go to their water database. You can actually type in your zip code and then it tells you just how contaminated your tap water is in your area. I live in LA. Mine was shockingly full of, I think it was like nine different contaminants that were well above the safe, normal range that you want in your water. Uh, that being said, I also, I use an Aqua true water filter. Berkey is another great one. I love Aqua true because they have the world's first reverse osmosis countertop system. Uh, again, you can also

use the link in my show notes for the Aqua true. It's going to save you a bunch of money. If you're not interested in doing the countertop, they also have an under the sink hookup that you can do if you have a home that you want to hook it up to. So I just wanted to share those with you guys. I love to always share options with you and hopefully that will help you kind of clear out your homes. So anyways, I'm excited to get into this episode because we talked a lot about toxins like, you know, from the air, from your water, from pesticides, from your food, et cetera, that could be actually contributing to your anxiety and depression. I want to be careful. I said this several times in the episode. We are not saying that there is one thing that causes anxiety and depression. It is a multifaceted concern that usually can be

contributed to a multitude of different things. Lifestyle and diet play a huge, huge role. We also talk about his perspective as a naturopathic MD, his perspective on SSRIs. Also, he talks a little bit about if, if, on, if you do want to come off your SSRI, he gives advice on how to do that safely with your doctor. I want to stress that very much. That's a very important thing to, um, make sure that you do. You always want to consult your doctor with anything that you want to do, especially when it comes to medication. I cannot stress that enough. Also, I like to remind you guys that this is a shame free environment. All I aim to do with this podcast is to provide information for you that you may not hear anywhere else. I just want to empower you with all the

information. I believe in informed consent. And the only way to make informed consent is when you are informed with all of the facts. And when you are armed with all the facts, you can make the best decision for you and your body. And if that means that you want to stay on your medication, there is no shame in that whatsoever. Everybody's journey is different. And I just like to provide people with resources so that they can make the best decision for their bodies and whatever works best for them. So I wanted to remind you guys, this is a shame-free zone, do whatever you feel is best for you. Um, but I did really find a lot of what we talked about really interesting. Um, he is so knowledgeable. We talk about the science and, you know, we dive into some of the studies and it's just a really in-depth conversation about things that you can do

if you are struggling with depression and anxiety. We talk all about lifestyle factors, how diet plays a role. The circadian rhythm also plays a role. And also the vagus nerve, which is a connection from the gut to the brain. We talk about light boxes and whether or not those work, vitamin D, therapy, et cetera. So anyways, before we get to the episode, if you're loving this podcast, can I ask you a favor and please leave a rating and a review? It helps this podcast so much.

The more ratings and reviews that I get, the more ears that this podcast falls on. And my dream and my goal is to help as many people as I possibly can. So your help is much appreciated. And I just really appreciate you taking the time to listen to this podcast today. With that, let's get into the episode. Imagine having a metabolic coach in your pocket that you could access at any point, any time in the day, whenever you want. That's what Lumen is. Lumen is the world's first handheld metabolic coach. It's a device that measures your metabolism through your breath. And on the app, it lets you know if you're burning fat or carbs and gives you tailored guidance to improve your nutrition, workout, sleep, and even stress management. I have so many podcast episodes about metabolic flexibility and why it is so incredibly important for your overall health

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fromourplace.com and enter my code realfoodology at checkout to receive 10% off sitewide. That's fromourplace.com, code realfoodology. Our place offers a 100-day trial with free shipping and returns. Well, Dr. Bongiorno, I'm so happy and excited to have you on today. I've actually been wanting to have this conversation for a long time, and I'm so happy that I came across your work. I was actually in that functional medicine doctor group that you gave a presentation back in, was that December? And it was all about anxiety and depression and how you treat it holistically. And this is a conversation, like I said, that I've been wanting to have for a long time. So I'm so excited to have you on. And I wanted to, first of all, just ask you to tell everyone a little bit about your background. So what do you

do? How did you get into treating anxiety and depression holistically? And yeah, what's your background? Sure. Well, you know, it's an interesting story. I was never, as a child and young adult, I was never involved with holistic and natural medicine. I had no interest in it. And I remember thinking, even visiting health food stores and places, you know, they seem kind of strange to me and people seem strange and the smells were weird and, you know, and so that's all I knew about natural medicine and natural health, you know, and the fruit was kind of rotten. And that was probably right in the 70s and 80s. But I was interested in medicine and decided I wanted to go to medical school. And at one point I was thinking about doing an MD-PhD.

So I was doing some research at the National Institutes of Health and applying to medical schools. And I'd gotten into one or two. And at the time, I also had a very close friend who was diagnosed with multiple sclerosis. And she had a chronic progressive type of multiple sclerosis and was very, very sick and was basically told, look, you know, go out and get a wheelchair while you can. And at that time, you know, there really weren't many natural medicine practitioners around, but she had looked for this person who I had actually taken her to a few visits and seemed like a quack to me. He was called a naturopathic doctor.

And, you know, at one point he looked at me, he said, hey, you know, you do research. He goes, why don't you look up these things? And he said, you know, look up this information about food and having a low saturated, high unsaturated fat diet. And there was a study by this guy named Swank, a 40 year study where this, what this fellow did, he put people on a low saturated, high unsaturated fat, give them some vitamins and, and saw a very low exacerbation rate in, in the MS patients who did the protocol versus those who just got conventional treatment at the time. And I thought to myself, gosh, you know, this is published in, you know, in a neurology journal

and why isn't any other neurologist talking about this? And more importantly, you know, I saw her getting better and better. And, you know, so that was my aha moment of, oh, wow, you know, this stuff actually works and it kind of makes sense. And it's even in the literature and how come more people aren't doing this? So that's when I decided I wanted to, you know, be a naturopathic doctor and try that route. So, and then as far as mental health goes, when I graduated naturopathic school, I went to Bastyr in Seattle. And when I graduated in 2003, I came back to New York. And, you know, I had, when I did research at the National Institutes of Health, it was in stress. So I was learning about how stress affects the

brain, how the brain puts out all these different inflammatory markers and changes what goes on with hormones in the body. And, you know, because they were for the first time seeing really how stress can affect the brain and how the brain then affects the body. And so that's the work I was studying. And then when I got back to New York, what I noticed is in clinical practice, everyone was very stressed out. And most people in Manhattan were on some kind of antidepressant or anti-anxiety drug. And I did notice to help them with whatever issue they had, whether it was skin problems or digestive issues or so on and so forth, I needed to work on their stress and I needed to figure out how to help their mental health to help their physical health.

So I started doing research on it and I wrote a chapter, which was in a book called The Neurobiology of Depression on complementary and alternative medicine. And then from there, I saw more patients and I started writing more and ended up writing some books on the subject. And that's just really how it happened. And it was really by need because Manhattan and New York just had a lot of people who were stressed and needed this kind of work. And really the first book I wrote on the subject was a book on natural and integrated medicine for depression. and it hadn't been written before. So it was really the first time all that information was put together. And I was, you know, really proud and excited about that because the need was there and this information hadn't really been

looked at. Thankfully now, you know, 20 years later, it's getting looked at. So it's good. I know. Thank God. Which book is that? Was that the holistic solutions for anxiety and depression? No, that's my second textbook. That's a newer publication with Norton. This was an original book called Healing Depression. It's around here somewhere. It's called Healing Depression. I'm not even sure it's in print anymore. And yeah, that's amazing. I mean, I, I love, this is what I love so much about this holistic and integrative approach to depression. Anxiety is that it feels like, um, this is kind of the missing puzzle piece because, you know, so many people are just, it's kind of, uh, you know, step in lock. Like you just, you get diagnosed with anxiety or

depression and then they just immediately throw you on a pill. And that's it. There's no discussion about lifestyle. How are you sleeping? What are you eating, etc. And what the problem I see with this is that it's we're really just masking it with, you know, a bandaid, essentially, we're not getting to the root cause of it. In your experience, what do you think is leading to this rising number of anxiety and depression in people? Sure. I mean, you know, I don't know where to start with that question in the past couple of years. I mean, you can load it all on us. Well, I mean, let's start pre-COVID. So pre-COVID, you know, there was, you know, already a strong, you know, probably, you know, 3 to 5% of people were depressed and maybe a good 10 to 15% of people had some kind of anxiety. Depending on the numbers you look at, it could have been a little higher, it could have been a little lower, but still a pretty strong number of people. And, you know, a lot of reasons for that.

One of the main reasons is financial stress. People who felt they have to keep up, who can't keep up, who can't take care of their family. You know, a time to yourself, downtime, lack of community with others, you know, those are all very minimal for a lot of us. And then, you know, certainly the foods we're eating are not the healthiest, very, very processed foods. So I think there's a lot of reasons for that. And then we see something like COVID, you know, which took over in the pandemic, you know, creating such amazing stress for people. And the numbers have just skyrocketed. The amount of people who are using drugs, you know, recreational drugs has skyrocketed and alcohol has skyrocketed and prescription medications have absolutely gone through the roof.

You know, now we're seeing numbers somewhere between 20 and 40 percent of people have some kind of anxiety or depression. I mean, just incredible, incredible numbers. Rates of suicides and increased suicides among teens have gone up exponentially. Gun suicides have just increased exponentially. I mean, I can go on and on and show you the data on that. So it's... Yeah. Well, I was going to say, I mean, first of all, hearing those numbers is heartbreaking. And then, you know, you add in COVID to already an issue that we had here. And I'm curious to know, so I come from a background of, I have my master's in nutrition and integrative health. And we learned a lot about the connection, the gut and brain connection with the vagus nerve.

And if your gut is inflamed, which a lot of people don't even realize that they're walking around with chronic inflammation due to, you know, seed oils and processed foods and pesticides, and I could go on about all that. But what is that connection? Because I want people to understand this connection between inflammation in the gut and your diet, and also your lifestyle does contribute to this as well. What is that connection to anxiety and depression? And how much of a role does that really play? Yeah, so if you take if you started from a conventional viewpoint, right, conventional psychiatry, let's say you have anxiety, it can be because your GABA levels are low. So GABA stands for gamma-immunobutyric acid, which is

the calming neurotransmitter that your brain is usually deficient in when you're really stressed out and anxious. So they'll give you a drug like a benzodiazepine, which artificially can raise it, and you do feel better, right? So the problem with the drug is that as time goes on, your body gets used to it, you need more and more, and it's never fixing the problem. In fact, it kind of burns the system out in the process. So it only compounds the problem in the long term, which is why it's not a great choice. But, you know, it tells us that, okay, you know, maybe the neurotransmitter in the case of anxiety is a reason. But my question is, well, why is that neurotransmitter off?

Why is that GABA lowered? Well, the GABA is lowered because the body has a number of probably physiologic changes going on. One of them can certainly be gut health. Because when, for one, you know, one example is when the gut bacteria are out of balance, GABA levels will naturally lower in the brain. The gut has, you know, the gut's been called the second brain. You know, there's a book that came out, I think, in the 90s called The Second Brain and talks about the importance of the gut and its role in creating serotonin, which is another neurotransmitter we need to have our brains feel good and calm and happy. So when the

gut is out of balance, there's a very strong bidirectional relationship between the gut and the brain, meaning when the gut is out of balance, the brain gets out of balance. And then when the brain gets out of balance, the gut gets out of balance. And the connection is through the vagus nerve, right? So the vagus nerve has a lot of nerves that go down into the gut and can monitor what's going on in the gut. And then there's some nerves that come back up. So those are what are called efferent and afferent nerves. And they go back up and down and they send signals back and forth. And now there's a lot of work on helping stimulate the vagus nerve and getting it to work better so that this way there's better communication between the gut and the brain. And of course, you know, if we eat better, that's going to help. If we reduce food sensitivities to reduce

inflammation, that can help. If we work on things like meditation, you know, which calms our system and brings circulation back to the gut. That's going to help too. So there's all these different ways to support the system. So can we say that our diet plays a role in GABA production, serotonin, also dopamine. Like, is there a world in which someone can argue that eating a healthier diet is going to help produce more serotonin and all of those neurotransmitters that will help with anxiety and depression? Yes. So eating a healthy diet, you know, accomplishes in a few ways. So one is it gives us the building blocks to make things like, let's say, serotonin. So serotonin, the building block to serotonin is an amino acid called tryptophan. So we need to eat

foods that have good amounts of amino acids in them and healthy proteins. So that's certainly true. So from a building block standpoint, healthy foods are important. But then also, you know, when we're eating foods that are very, very processed, that are very inflammatory, that have a lot of sugar in them, that's also going to create an imbalance in the bacteria in our digestive tract. And that's going to take us away from making the good neurotransmitters that we need. Plus, it's going to increase inflammation markers, which will go to the brain and change what's going on in the brain in a negative way as well. So there's a couple of

ways where I think a healthy diet works. You know, another way is that when we eat enough fiber, again, it feeds the good bacteria in our gut and it helps usher out toxins and things that are not good for our nervous system that would otherwise get to the brain. So there's a couple of ways where food is really brilliant and vital for good brain health. That's amazing. I mean, there's so many arguments for eating healthy. And when I started diving into this connection a little bit, I was like, whoa, wow. I'd never thought about the mental health aspect of it. I had been so focused

coming from a nutrition standpoint of, you know, we know that we need it to be healthier to feed the cells for energy, etc. But this is such a whole new world that I find absolutely fascinating. So what are some things that people may be potentially doing that could be lowering their levels of GABA, dopamine, serotonin, anything that could be causing or not? I don't want to put a blanket statement and causing because I think it's so multifaceted. But what are some things that could be causing problems for people that could be leading to depression and anxiety? Sure. Well, the first thing is, you know, and it's always the first chapter in all my books. And, and I just my last patient who just left a few minutes ago, we had this conversation too, because he has a host of health issues, including some pain, anxiety.

And we were just talking about the fact that he goes to bed 1.30, 2 o'clock, wakes up at 6.30 and feels that's okay. And four hours of sleep is not enough for your brain to fix itself. It's not enough for the body and the lymphatic system to detox what it needs to detox. It's not enough time for the mitochondria, which are the power packs of our body that creates the energy our nervous system and our heart and circulatory system needs and enough time for them to rebuild themselves. So, you know, I usually start, you know, the two things I usually start with, no matter what people come in with,

I usually start with sleep and I usually start with digestion and make sure people are having good bowel movements every day. But sleep is so critical because there's, it's hard to know what to fix if people aren't getting enough sleep, because that alone could be the reason for the problem or for the multiple problems. So it doesn't give the body a chance to

fix anything if we're not getting enough sleep. And, you know, in our lifestyle and our choices and our commitments and all of these things, oftentimes doesn't give us much time to do that. So we kind of give up on sleep so we can get all these other things done. But it's, I find that's one of the biggest problems. I mean, that's an epidemic in and of itself. Yeah, absolutely. I mean, we're all sleep deprived and nutrient depleted as well, with all the processed foods and we could go down a rabbit hole of that. And so I want to talk about this a little bit because I feel like many women are not aware of this. And I don't know if this is a topic of conversation you ever get into, but birth control. So this was never communicated to me as a young

woman. Um, when multiple doctors tried to put me on birth control, I thankfully at the time, I don't know what it was, but it had the wherewithal at 14 to be like, I don't know about that. Um, thank you. That's I'm, I don't even know where it came from. I just was like, you know, something feels a little off and, but now, you know, we, we see all these studies coming out and linking it to depression and obviously it's causing all sort of, um, all sorts of issues, chronic issues in women. Is that like, is there a big, a piece of component there that is causing depression in women? Would it be the birth control?

I mean, some of it. Well, I mean, let's think about birth control. Especially today, birth control typically is used obviously to control the menstrual cycle and to prevent fertilization. And it works for that purpose, no question about it. And it typically does that by greatly lowering the hormones as well as keeping them, you know, in a bit of a straitjacket. So now they want to lower them because they found that when they were giving higher levels of these synthetic estrogens and progestins, again, synthetic hormones, they were finding much higher levels of blood clots as well as other problems. But when we think about what is, let's say, for example, what does estrogen do in

terms of mental health? A gynecologist would say, who knows, but what does it matter? We're using this for birth control. Well, it does matter because, you know, we need proper amounts of estrogen at the right times of the cycle to support serotonin production and to support serotonin receptor production, especially in the parts of the brain like the amygdala and the hippocampus where serotonin receptors are high

and we need them to keep our mood balanced. And the same thing with progesterone. You know, progesterone helps raise GABA in the system. And estrogen and progesterone are like the yin and yang in terms of balancing and producing neurotransmitters and breaking them down as well. So that cycle, that estrogen and progesterone cycle isn't just about, you know, reproductive hormones. It's also about how well the brain can work and function and mood can function. So if you have a woman who is already susceptible to something like depression or anxiety, then certainly it's going to be much more of an issue.

Plus, we see there's a lot of research showing how using birth control is also very depleting of a number of nutrients, you know, B vitamins and a lot of nutrients and how it can affect the liver's ability to metabolize as well. So there's a few different layers of why birth control can be problematic for mood. Yeah. You know, I have to admit as a woman and having a lot of friends that have been on birth control for a long time, finally making this connection really upset me because what I found was that there's studies now showing that, uh, you know, a woman will go on birth control. They don't even think about, uh, depression being a side effect of it. And then, you know, woman goes into depression, then they put her on an SSRI and it's this whole

vicious cycle. And I'm like, right. What, you know, like we got to get to the root here. What's actually causing the issue, maybe the birth control, you know? And again, I want to be very careful with this whole conversation. I don't want to box depression and anxiety into just one little thing. Like I said earlier, it's multifaceted. There's a lot of different things going on, but I really wanted to do this episode to provide people with resources if they're struggling with how maybe they can get to the bottom of it and really, um, get out of that depression and anxiety. I mean, I, I personally have suffered from anxiety most of my life. Um, I'm happy to say that through loads of therapy, lots of different supplements like ashwagandha and holy

basil leaf and all this stuff, I've really gotten to a place where it's, it's pretty manageable for me for the most part. How do you feel, uh, as far as I know you're a doctor, but how do you feel more about treating anxiety and depression with therapy and from that kind of standpoint? Oh yeah. I mean, there's no question that psychotherapy is a key, you know, because when we have negative messages and messages, we keep telling ourselves over and over, you know, it can be very hard to break that anxiety cycle. I personally did have a lot of anxiety myself when I was younger. So I know, you know, it takes both, you know, the physiology, you know, when hormones are out of balance and nutrients are low and the gut isn't working well, that's going to make the brain more susceptible

to anxiety and depression and create more of those negative messages. And then when we keep, you know, promoting those negative messages with our thinking, that's going to change what's going on in our physiology. So it becomes like this vicious cycle, you know, between our physiology and our thoughts and our thoughts. So psychotherapy and that kind of work is critical to break that pattern, to break that side of it. At the same time, you know, what I find with my patients is while they're doing psychotherapy, we need to work on their sleep, their foods, exercise, getting them meditating, you know, checking the labs and seeing what's going on with all, you know, their gut and inflammation and all those things and getting them on the right vitamins and herbs and things like that. And I find when you do that together, that's the most powerful way to affect a change. Yeah, it's that multifaceted approach, which I am so appreciative for an integrative

and holistic approach. Cause it, it feels like you're tackling it at all angles and not just, you know, throwing a pill and I don't want to vilify, you know, SSRIs and throwing a pill at the problem. But for me, the way I see it is that often, um, you know, you'll get diagnosed and then they'll throw a pill at you. And then it's just like, okay, this is your life now. There's no conversation about things you can do in order to improve your life, maybe lifestyle strategies, maybe, you know, a timeframe where we say like, you know, we're going to put you on this medication for X amount of months and then go from there. It kind of just seems like you're, you know, they almost like shit out of luck. How do you feel?

This might be a controversial question, but how do you feel about SSRIs? I've read, I've read so many different things. I read that there, um, that there are studies that actually big pharma couldn't actually find that there was an actual connection. Um, I'm trying to think, I wrote it down in a note here. Cause I read recently that they were, they were saying they couldn't actually prove that it was, um, a deficiency in neurotransmitters that they tried desperately to because they wanted this to be like the end all answer. Yeah. Well, it's interesting. There's studies that, you know, a couple of years ago, there was a fellow named Fournier who published in the Journal of the American Medical Association showing, I should step back,

they had looked into studies that hadn't been published on SSRIs that seemed like they were purposely being kept out of the publications. And these studies were quite negative, suggesting for depression, they didn't really work all that well. So a fellow named Fournier in the Journal of the American Medical Association looked at all the studies together, and what they noticed is that for depression, mild to moderate depression, didn't seem to have, the SSRIs didn't seem to really have any more efficacy than placebo. In severe depression, there seemed to be some benefits. So it does seem that SSRIs at best, it's dubious how beneficial they are for depression. Um, not to say that they don't work at all for anyone, but, but it does seem like there's

lesser percentage than we probably originally thought. Um, and it's interesting because there's not a lot of studies, but there's a few studies on, on some medications which do the exact opposite of SSRIs. One is called Stablon, and it's a reuptake enhancer instead of a reuptake inhibitor. And those studies show similar results to SSRIs in terms of benefit. So there are some studies that suggest that lowering serotonin can help. There are studies that show it's erasing. So, I mean, in the end, it's,

you know, the neurotransmitter may be a part of it for some people, because again, there are maybe 30%, 35% of people that it helps, but then the vast majority doesn't seem to. So in those patients who it does help, that's great. But we still want to say, okay, if we raise serotonin and it helped you feel better, how can we naturally get your body to do it? And that's still why we want to go back to all the basics. And so, you know, and for anyone listening, especially if you're taking medication, you know, don't stop taking your medication. You know, just stop cold. That's an ever safe thing to do. Talk to your doctor. But you want to start looking at these other ways to help figure out the factors that are contributing to why maybe the serotonin is low.

So, so, you know, medication has their role. I mean, in, in very urgent care situations and sometimes, you know, they can be lifesaving. So it's not to say that they're completely not usable and that in every case they should be thrown away. But I think, you know, we need to think a little stronger about what's the reason when they do work, you know, why are the neurotransmitters low? And then when they don't work, you know, what else is going on here? Yeah. Yeah. I mean, this is something I'm really passionate about in general, in general is getting really getting to the root cause because the way that I view SSRIs is, you know, like I said,

um, I think it's really great if someone's in a really, really dark, bad position, like, thank God we have them. Right. But also, like you said, why, why are we not asking these questions? Like, so what's actually happening here? Why is your serotonin low? Or why is your dopamine low? What is the mechanism behind what is going on in your body? And you know, we're seeing these rising levels and people and for me, I take a step back and I'm like, there can't be that many people that are that are just being born with like, you know, off brain chemistry and quote unquote, broken transmitters, there's got to be something else going on here, especially as we see it rising. And so that's why I like to dig a little bit deeper and say like, okay, so what is going on? You know, what could be causing these

lower levels of serotonin? I'm curious to know too, do pesticides play a role in this? Because we do know that pesticides disrupt the microbiome, like glyphosate acts as an antibiotic, and we know that we need that good and bad bacteria in our gut in order to produce serotonin and all these neurotransmitters. Is that also playing a role possibly? Yeah, I mean, you know, environmental toxicity in general is, I think, is going to be one of the next frontiers for good holistic psychiatry, really understanding how do toxins play a role in our health. And there's no question that pesticides are part of that for exactly the reason you said. They're such an amazing disruptor of the microbiome. They're such an amazing disruptor of hormonal balance. They change how the liver can metabolize hormones and keep our

nutrient levels proper and all these things. So pesticides can play a role. At the same time, air pollution, I think, is also a strong issue too. We see areas where air pollution is much, much higher. We're going to see much more in terms of mental health issues. You know, it's interesting. You know, obviously, we're worried about COVID and probably about, I think worldwide now, I think it's about 5 million people have died from COVID that otherwise wouldn't have passed. But every year, at least 8.3 million people die from pollution and and there's you know there's studies to support that so um you know it's obviously important we worry about the pandemic and we protect people who are vulnerable but we're not talking about pollution, you know, and that's hurting a lot more people at this point.

And, yeah, what were you going to say? I was going to say I'm so glad that you brought this up because I actually didn't even think about that connection to anxiety and depression. People don't think about this. So cleaning products that they use in their, you know, kitchens, bathrooms, houses, et cetera, that have fragrance, fragrances that you're spraying on your body, all the chemicals that are in lotions, all the makeup that women wear. I mean, we're just being inundated candles. This is why I'm such a proponent for one, tossing all of those toxins out. And for people listening, I have an entire podcast episode on this. It sounds way more daunting than it actually is. There are a lot of companies that are creating non-toxic cleaning products and beauty and makeup and skincare

products, et cetera, that are clean. Also, I'm a huge proponent for getting a air filter in your house. So I have one from Air Doctor, right? Like getting a HEPA filter, because on top of that, I don't think people even think about this outside of candles, but also your furniture is off gassing all of the materials that they use to manufacture all of that. You're betting. I mean, it's, it's a lot. And for people listening, this is a newer conversation for it sounds a little bit overwhelming, but once you educate yourself and you put the things in place, you will, you'll be fine. And it won't be so overwhelming. Like I said, I bought an air doctor for my apartment. It cleans my apartment. I also, as you can see, the listeners can't, I have like a jungle in my apartment plants really helped to clean the air, clean that air. Absolutely. And that plays a huge role, but I didn't even think about the anxiety depression

component of it. That's fascinating. Yeah, no, there's a lot of literature that's showing the connections between, uh, polluted air and, um, you know, worsening of anxiety and depression. Yeah. So it's, yeah, I mean, there's no question about it. I mean, think about, you know, when you think about pollutants, you know, when we eat foods that are unhealthy or have poisons in them, that's one thing, but the lungs have basically one, it's one cell thick lining because the lungs have to, have to, have to bring the air to our bloodstream so our bloodstream can get oxygen diffused into it, right? So it's, there's almost no filter there.

And so, so any air pollutants, the easiest way to get into our body is through our lungs. And so think about the chlorine we have in our water. We take a shower, it vaporizes, we breathe it in, and now we have all this chlorine in our bloodstream that's oxidizing all the lipids, all the fats in there. And, you know, and think about what that does for inflammation. So if you have someone who's predisposed to depression, now they have much higher levels of lipid peroxidation, lower levels of things like glutathione, which is such an important antioxidant that we need for our brain for good mood. And, you know, that's just one example of how, you know, introducing these pollutants will trigger these kinds of mental health issues. Yeah, that's a great point.

Also, I'm a huge proponent of getting a shower filter and then as as well as obviously a water filter. For that exact reason. Yeah, absolutely. Exactly. That's really important. Do you want to hear the biggest discovery of our time for promoting healthy aging? Of course you do, because all of us are concerned about aging. There is a class of ingredients called senolytics that were discovered less than 10 years ago, and they are being called the biggest discovery of our time for promoting healthy aging and enhancing your physical prime. Now, when I'm talking about aging here, I'm not just talking about on a superficial level, wrinkles and saggy skin. I'm talking about energy, joint pain, your ability to show up for your life, cognitive function. I'm talking about

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go to organifi.com slash realfoodology and use code realfoodology for 20% off. Again, that's Organifi. It's O-R-G-A-N-I-F-I.com slash realfoodology. So what I'm going to go a little bit off topic, but I'm curious to hear your thoughts on the circadian rhythm and mood. So as far as like waking up at the sun, people that maybe that live in places like New York or Washington where it's dark a lot of the year? Do you believe in doing the sun boxes? What's the vitamin D sun connection?

I trained in Seattle. So I remember the first year I was there as a first year medical student, we had over a hundred days without actual sun coming out. It was just dark. That's depressing. So again, if you're predisposed to low serotonin levels, you're predisposed, it's going to affect you. You know, I think that's why we all drink a lot of coffee over there. So you're depressed and wired. Right, wired and depressed, what's going to happen? So yeah, so circadian rhythm is clearly important. And oftentimes when our body gets stressed out, we get out of circadian rhythm. You know, circadian rhythm is clearly important. And oftentimes when our body gets stressed out, we get out of circadian rhythm. You know, circadian rhythm really refers to the idea that our body knows when morning is and feels awake in the morning.

And then as the day goes on, we get calmer and more quiet. And our body knows when evening is and we want to go to sleep at night. And then we fall asleep well and we have a great sleep. And then we wake up in the morning and our stress hormones go up the way have a great sleep. And then we wake up in the morning and our stress hormones go up the way they're supposed to and then we wake up and we do it again. That's a normal healthy circadian rhythm. But a lot of times when the system is perturbed and we have anxiety and depression, the circadian rhythm gets all out of balance and you start seeing people who can't fall asleep at night, who wake up in the middle of the night, can't go back to sleep. They're exhausted during the day.

And that's, you know, that's a sure sign that the circadian rhythm is off. And sometimes they'll do testing, you know, there's urine testing that I'll do that'll look at people's cortisol levels, for example. I'll take a little sample of cortisol by urine a couple of times a day, and then we can kind of graph what's going on. And oftentimes I'll see it very low in the morning, shoots up at night, so completely off the normal rhythm.

And there's a lot of ways to help heal that. You had mentioned using a light box in the morning can help getting up, taking a walk in the morning when it's sunny, which I know is hard when you're really tired. You don't want to get up. You just want to keep sleeping. Yeah. Using the light box, as I said, can be useful.

Also, meal timing is a very important way to help keep your circadian rhythm. You know, I know I see the dog sitting on the bed back there. He looks adorable, you know, on the couch. And, you know, animals, you know, I know when we got our dog a couple of years ago, you know, the vet said, you know, it's really important that the dog eats at the same time. You try to take him out at the same time and, you know, shut out the light so he goes to sleep at the same because that creates a healthy, calm animal, especially if the dog is prone to anxiety, which some breeds are. And, and I was thinking to myself, as she was saying these things,

I'm thinking, yeah, that's exactly what I tell my patients exact same thing. We know we want to get up at the same time, eat at the same time, poop at the same time, maybe exercise, you know, go to bed at the same time. Because that is a calming to our body. Our bodies need ritual, you know. And when we have ritual and our bodies know what to expect, it's going to create a calmer system, a healthier digestive system. And we'll, you know, and we'll keep our circadian rhythm intact. And our circadian rhythm is really, you know, in the middle of the brain there, where it's called the suprachiasmatic nucleus, you know, it's where it knows the timing for the day is.

That part of the brain really communicates with our nervous system, our immune system, our hormonal system, and helps it all organize. So when we have all those going on properly through good circadian rhythm, then we're going to have a much better chance to have a great mood. Yeah, that makes sense. And, you know, it's an argument too for getting those blue blocker glasses that people wear at night, especially if you're on your phone or on your computer or watching TV, because that will help your body wind down and not block the melatonin that's supposed to release at night that helps you relax, get ready for bed.

That's exactly right. Yeah. And I'm curious, too, if this would help some people, because I'm trying to think of ways to help. I get a lot of questions in my DMs from people that are, you know, living in Seattle or New York in the winter. And, you know, I, I feel very fortunate that I live in LA and we have sun, you know, like 11 months out of the 12 months. So I don't always know how to answer this for people. Cause I speak a lot about the importance of getting in the sun, getting vitamin D. So I'm wondering, yeah, that's why I wanted to ask about light boxes. Also, I've seen these alarms that people can get where it wakes you up with a light gradually. And I'm wondering if that would help people, too, that live in darker areas.

Yes. Yeah. So, yeah. So the gradual light, I remember in Seattle, we would also recommend these motorized appliances that you could put on your shades to help your shade open slowly. So this way you start getting light little by little, you know, as if the sun's coming up. So, so that can be useful. Like I said, light boxes have been proven to be very helpful to help raise serotonin. What was the other thing you mentioned? Oh, I just said those little alarm clocks that I've seen that like will gradually,

the light will get brighter and it kind of naturally wakes you up. Yeah. I mean, I guess you would need them at a certain brightness. So they're probably pretty bright. But yeah, I would imagine that would work too. And vitamin D supplementation. I feel like that's a really good one, especially if you're living in a place where you're not getting a lot of sunlight. Yeah, absolutely.

I mean, most of us are low in vitamin D. If it's possible, it's best to get checked your vitamin D levels and then you can supplement accordingly. But yeah, I mean, most people could probably safely take 1,000 IUs without knowing their vitamin D levels, although I still recommend checking just in case you are high. You don't want to take more and have too much because that can be toxic too. Especially if you don't have calcium enough. Yeah, exactly.

And I usually recommend – I might even recommend 5,000 a day depending on how deficient a person is. And generally, in a normal range between 30 and 100 nanograms per mil, I usually recommend at least 55, 60 would be a reasonable level to get to as a goal. Well, and for people listening, I just realized that we didn't really talk about this. Is there a link between vitamin D levels and depression? Yes, there certainly is. Vitamin D is a neurosteroid. So as such, it plays a lot of roles in the nervous system, number one, and low levels have been shown to be correlative with depression and anxiety. It's certainly not the only factor, but it's an important one. Some people call it the happy vitamin, right?

I think John Denver did a study on that saying, you know, sunshine on my shoulders makes me happy. And that's because of vitamin D level. I stole that joke from Alan Gaby, who's a medical doctor and nutrient guru. Anyway, but it's very, very true, you know, that sunshine, vitamin D will help make us happier. So it's very important to have that. And the literature certainly shows that, you know, vitamin D is also really important for how the immune system controls inflammation. So when we have low levels of vitamin D, we're going to have much more inflammation in our body. And inflammation is going to be a certain factor for depression and anxiety as well. Yeah, that makes a lot of sense. So is there kind of a common thread? I know this might be a complicated question, but I'm just curious if there is a common thread that you see in people

who struggle with anxiety, depression, anxiety and depression, is there, you know, low levels of vitamin D, lower levels of, I think iron might be contributing to that as well. Is there kind of a common thread that you see in a lot of your patients? Well, I mean, you know, unfortunately with anxiety and depression, like I said, it's the tip of the iceberg and it's just telling us things are out of balance. And what is out of balance is going to be very, very different for everyone. And some people, it could be high stress hormones like cortisol. Some people, it could be low. It could be low vitamin D. I can't say that there's one thing that I'll recognize among everybody. I would say maybe one thing could be stress. That would be, and lack of sleep would probably be my first two. My third might be poor food choices and lack of essential fatty acids would probably be maybe my top three.

And then after that, it's going to vary, I think, for everybody, what's going to be at play in terms of why they're experiencing what we're calling anxiety and depression. Yeah, unfortunately, there's no one size fits all with it. Life is tough. Yeah, and it's not tough, but it takes time because there's a number of factors. And once we start looking at all of them, then we can, you know, this is what I do for my patients. We look at all of them, figure out which ones seem most appropriate for the patient

to start working on, and then we prioritize them and start working on them. And usually that's where I see benefit and I see people start getting better. It's, you know, it takes time, but it's certainly worth it, right? Because I think, you know, when people's mood isn't well, then it's really. It affects everything and bleeds into every area of your life. Absolutely. So when you see a patient, um, are there, are there specific labs that you suggest? So maybe for people listening, if they aren't able to physically see you, maybe they can go to their doctor and say, Hey, can you test me for X, Y, and Z? Are there certain things that

you would suggest? Yeah. In my books, I do have a sheet that people can actually rip out and bring to their doctor. I'm not sure the doctor wants to see it, but which book is that? So I'm sure they're thrilled. So I have two books that's written for the public. One's called Put Anxiety Behind You. Okay. And the other book is called How Come They're Happy and I'm Not. And then for those of you who are professionals out there or want to do even more reading because you're interested, there's a textbook by Norton called Holistic Solutions for Anxiety and Depression, which is a little more of a heavy read, but has a lot of good information in it as well. And all of those books talk about all the tests that I like to use. I mean, I basically, in general, I like to do a good adrenal test. I like to check a really thorough blood work that looks at, you know, all the basics a regular doctor would look at, plus a lot more vitamins and a lot more hormones and a much more in-depth thyroid panel. Like you

mentioned, looking at iron, iron storage, B12, magnesium, zinc, zinc to copper ratio, inflammatory markers. And then, you know, possibly depending on the patient and what the case and story sounds like, maybe looking further into digestive function, looking at stool testing might be very important. So it could be small intestinal bowel overgrowth or looking at stools testing might be useful. There are some people, their history suggests maybe mold toxicity and doing urine tests to look at mold. That could be, I've seen a number of cases where that was the critical piece. Some patients, I look at histamine and what's going on with histamine levels. There's so many tests that are possible to use. We can't use them all. I'd love to have

every patient do every test because that would be, you know, from a clinician standpoint, that'd be ideal. But from a cost standpoint and even from a blood standpoint, you'd be ideal. But from a cost standpoint, and even from a blood standpoint, you know, there's so many reasons why it's just not physically possible. So it's my job to sit with each patient and really listen to the story as closely as I can get to know them and start to figure out, you know, okay, which ones seem most likely for this person. And we'll start with these tests. And, you know, and we'll look at that. But those are some of the mitochondrial testing could be very, very important. Genetic testing could be useful, you know, especially if the personal history of the mood disorder starts at a very young age or there's a lot of family history of it, then that could be more useful. You know, all of these tests are great, but they all can be useless in the wrong person.

So it's important to kind of be judicious and say, okay, well, what's going to be most valuable for this particular person? Yeah. Food allergy testing. That's a good one, too. I go on and on. And you could even do like heavy metal toxicity testing because that could be something. I do a little bit of that with blood work, but yeah. Yeah.

Well, this is why it's so important that we approach this from a very bio-individual approach. And this is what I love, again, so much about integrative and functional medicine is that when you see your doctor, instead of getting 10 to 15 minutes with them, you get like an hour, you know, and you get to really like dive in, talk about your lifestyle, you know, your history, your diet, etc. Because then it really gives the doctor an insight into what's happening. I mean, I love this. I've heard this so many times now is that oftentimes, if a doctor has long enough with you, you tell them the problem without you realizing, you know what I mean? Because you're just like divulging all this stuff about your life. And eventually they're like, Oh, yeah, that's probably it. Ding, ding, ding. Right. Yep, exactly. Yeah, it takes time, you have to get to know someone and, and really have that time. And sometimes,

you know, I think trust is really important, too, because at first, you know, naturally, as humans, we have our guard up a little bit and we're not going to divulge everything or feel we can. And sometimes we'll just leave things out. But then as you get to know someone, you get to realize, oh, you know, this person cares for me. And I could see I feel that sense of compassion and that they want to help me, then naturally our brain will open up to say more that could be very useful. And I find with patients, sometimes things they don't think are helpful, I find very useful, you know, as a key piece to figuring out, you know, what's happening with them. Exactly. So sometimes it's the things that you don't even really think anything of that you just happen to mention that could be like the missing link, which is fascinating. Dr. You know, it's funny.

I was working with a patient yesterday. It was our second visit, a young boy who has a lot of aggressiveness, aggressive behavior issues. And we ran some blood work and I noticed copper was, as an example, which isn't very common. And so, and at the second, and this was the second visit, so it's another hour after the first hour and a half with them. And so, you know, as we were talking, I meant, we were talking about, we got to, you know, what's going on with sinuses. And it turned out there were a lot of sinus issues, a lot of histaminic type of things, which the mom didn't tell me about the first visit, because we were talking about so many other things, you know, it's hard to get to everything.

And I saw the low copper. And it turns out that low copper is very, when copper is low, it's very hard for your body to break down histamines. So if you have a lot of histamine and you have low copper, and histamine itself is a neurotransmitter that creates a lot of arousal. And so it keeps the brain awake and this child's not sleeping at night, and it'll make them much more anxious and a bit more aggressive too. So it's things like that. If we didn't spend time together, it would have been hard to really make those connections. Yeah, exactly. That's so interesting. I love hearing stories like that. So are there supplements that you believe really help people in work? I know, I know of a couple personally, like the integrative therapeutics has something called Lovella, which the research behind lavender. Yeah. It's like lavender oil, which looks pretty promising.

There's also, I know, 5-HTP, or I really like Macuna prurines, which is called Dopamine. It's like the precursor to dopamine. Yeah, I mean, they're all good. They all have good research. You know, 5-HTP was well studied up until the point where Prozac came along. And there are a few studies using Prozac or 5-HTP or some kind of tryptophan and seeing some benefits there,

but not a lot, you know, despite the fact that it's so well used. And I find a lot of benefits with it in my clinical practice. The studies are still pretty scant because, you know, unfortunately when you study a natural supplement, you know, you spend all this money on the study and then no one can make money off that because it's natural and it's not patentable. So that's one of the problems

with natural supplement, you know, using them as remedies because they're not going to get well studied unless someone altruistically wants to do it because the government isn't doing it and no one else will do it because the government isn't doing it and no one else will do it. And that's why you see most of the studies come from places where people are really interested in it. Like let's say in Iran, you'll see a lot of studies on saffron

because they love saffron and they just believe in it, you know, so they're studying it to see what it can do. And the government supports that as an example. So, but unfortunately... Oh, sorry. Oh, but unfortunately, what's that? Oh, I was just going to say in the irony too of a lot of pharmaceutical drugs is that if you look at them, the majority of pharmaceutical drugs started out from a plant that already exists in nature that then they decided to, you know, study and turn into a full-blown pharmaceutical drug. Yeah. So to answer your question, you question, let's say for depression, just really briefly, there are meta-analyses of meta-analyses, meaning there are large studies

of large studies that show SAMe, which is SAM-adenosylmethionine, also saffron, also curcumin, also rhodiola, would work as well as SSRIs. So there are studies that show this with less side effects. St. John's Wort, of course, is another one. So those alone have really good literature behind them that suggests the benefits for depression. And I'm not saying they're appropriate for every person who has depression. I still think, you know, if you're depressed, you want to work with somebody and be monitored properly. But those are, in many cases, very,

very good choices. And I see work well over and over. So, and the literature supports it. And, you know, and the less side effect profile. Me as a clinician, if I could choose something that's more natural, has less side effects and works as well as an SSRI in studies, why wouldn't I use that? Now, remember what I said before about SSRIs. SSRIs have some benefit, but probably not much better than placebo. Yeah, I've read the studies. So now that I've criticized the SSRIs, I also have to say with the natural remedies, yes, we can get at least as good effect as the medications with some of them. But that doesn't mean you take them and get cured. People still have to work on sleep, work on exercise, the right diet, meditation, go to, you know, go get the right therapy, and then take the supplement that might be appropriate for you as well. And that's really where you get the best results. But yeah, I do think the supplements can play a strong role. Lovella for anxiety. Yeah, there's studies that support it can be as beneficial as some of the drugs for generalized anxiety disorder.

There's also a theanine, which I find is very helpful. I use lithium orotate, which is not the drug lithium. It's a nutritional lithium. It can be very useful. Magnesium has some wonderful benefits as well for anxiety. CBD, cannabidiol can also be very beneficial. So there's, you know, they all work a little different. So I might recommend one versus another depending on my patient, but certainly very valuable in my practice. Yeah, I love that. Well, and there's a comparison that was once made by a doctor on my podcast that I love to bring up often because you touched on a great point is that, you know, we need to be approaching it from all angles. You can't just take a supplement or, or even a medication and think that that's going to

fix everything. Cause it's kind of like, so in your kitchen, if you have some crumbs in the corner and you keep catching cockroaches and instead of getting rid of the crumbs, you're just spraying the cockroaches. Well, you're going to continue to have more cockroaches come after those crumbs until you clean up the crumbs and cleaning up the crumbs means you need to address your lifestyle, your diet, your stress, your sleep, et cetera. You can't just be, you know, throwing raid at it or throwing pills, supplements, medications, whatever it is. You got to get to the root cause in order to really figure out the issue. Yeah. And, and, and if he keeps throwing raid at it, at some point it's going to poison you anyway. And honestly with the,

with the medications, like you kind of see that, you know, they, or the bug is going to stop. There's going to figure out how to live through it because it's going to get used to it. And, and that's what happens with the medications. They don't work as well after time, and it changes our body in typically an unhealthy way. And so really, even when, you know, for anyone who's listening who's on medications, like I said, don't change your medication. Stay on it. But start working with a practitioner who's going to look into these things

to help you get to the place where you won't need them anymore, hopefully, or at least lower the doses. Yeah, and I really want to stress for anyone listening to not do that alone. Cause I actually heard a psychiatrist talking about this on a podcast. She said that when she first started helping some of her patients get off SSRI, she felt like she was running a drug clinic. She felt like she was running a, sorry, a drug rehab clinic. She was like, it's worse than coming off of heroin for some people. And I don't want to frighten people, but I say that, um, to let you know that it, it is tough and you definitely want to have professional help. If you decide it's your decision and it's a decision that you have with your doctor,

but you don't want to do it alone. Absolutely. And, you know, I talk about that in my books too about, you know, and the last chapters is usually about weaning off medication. And the first step is feeling better on the medication, you know, using all the natural and lifestyle and diet changes and things like that. And then the second step is starting the process of supporting whatever system the medication works on. So maybe if it's an SSRI, which raises serotonin, maybe using things that help support serotonin in your body as the person is slowly getting off the medication.

And I mean slowly. I mean doing it as slow as much, much slower than typically conventional psychiatrists would recommend because it does take time for the for the receptors to change you know to get used to new levels for your body's own production to increase and and that usually requires going very very slow much slower than than i think most doctors would recommend because doctors will recommend a certain schedule to hand everyone the same schedule say here you know do two pills here and one pill next week and then half a pill and then stop. And that usually doesn't work for people.

You usually got to go really, really slow. Yeah. And then when you see symptoms arise, you know, stop or even go back up a little and say, okay, well, what are the symptoms? What is the body now telling us that we need to learn here? And then how do we fix work on that? Um, and that's usually the next step to the healing, you know, cause now we're learning things we didn't see because the medication was masking it before. And, um, so take that time, you know, let's not get in a rush to get off the medication. Yeah. I think that's great advice. And, um, I hope that people find that really helpful. So is there

anything that we haven't talked about in this episode that you think is really important for people to know regarding depression, anxiety? Well, you know, many people who are suffering with depression, anxiety, I just want you to know that and you could be suffering for decades. And I just want you to know that there's always a way to work on it that hasn't been tried. And even though maybe you've tried a number of different things, keep looking for that practitioner who you feel comfortable with, who you feel compassion and you feel you get along with

and have them work with you on all of these factors and just know that there's, that hope is still out there and that it's not, it doesn't mean, you know, because many of us, and I know I had anxiety myself and you, sometimes you think to yourself, oh, there's no way I can fix it. Like, it's just, this is just me. And it's, there's always, there's always a way to work on things and just don't give up and keep working on it. And until you find the person and usually the team, it's usually a couple of people who's going to help you, you know, synergize what you need to put together to create that healing you're looking

for. So don't, don't give up. I love that. You know, and actually, as you were saying this, I realized that we didn't address something that at least for me personally, was a huge key to my overall ability to kind of get over my anxiety. Because as you were saying, you know, I always thought that just this was me, and I'm just an anxious person. So that was very much me. I lived most of my childhood and early adult life in fight or flight. And I just came to, I got to this point where I just identified as I'm just an anxious person. And for me, a huge component of this was addressing some trauma that I went through as a kid. And, and I feel like trauma is, is thrown around very lightly these days. I'm not talking about, um, you know, you, you encounter some, like some road

rage on, you know, on the road or something like that. Like I'm talking about, like I went through, my little sister passed away very tragically when I was eight and I had never addressed, thank you. Well, I had never addressed that trauma and that grief that I was carrying around. And I, for years tried to, you know, I was trying to change my diet and taking, you know, L-theanine and all this stuff for the anxiety. And while of course, everything that we just talked about, I think is so important, but I was completely missing this one component that was a very, very important part of my healing journey. And so I want to encourage anyone that maybe, um, has gone through any sort of trauma or

anything of the like to address it and get help, whether that be therapy or another thing that really helped me was mushrooms actually. And I have a whole podcast episode about that. There's a lot of studies on psilocybin. Anyways, I just want to encourage people that that could be another missing component as well. Yeah, no, that's brilliant. Thank you for sharing that. And yeah, no question, especially, you know, what they call adverse childhood events, you know, things that happen when we're young, it can really reset our stress system, what they call the hypothalamic pituitary adrenal axis, right, our stress system. And it resets it for decades if we don't actively work on setting it back. And it sounds like that's exactly what you, you know, you had that awful, uh, experience and, um, and loss and it reset your brain, um, to be more fearful and, um, and, and, and, and, and, but you had, you know, you create, you know, you found tools to help set it back to more of a balanced way.

And that's brilliant. So, you know, it's not easy. It's not easy work. No, it's not. And it's,

you know, what we've been saying throughout this entire episode is that it's a very, it's a multifaceted issue that needs to be treated from all different angles, you know, and you need to find a practitioner that is willing to really dive into all those different areas and help you get to the bottom of it. That's right. Yeah.

That's right. Well, this has been such an amazing conversation. Before we go, I want to ask you a question that I ask all of my guests. Hold on. My dog is really going right now. Aw, he's a cutie. Thank you. I'm like, he never barks during my episodes.

He's such a good puppy head. For some reason, he's really on one today. He's excited about this topic. It's good. He's like, finally, mom. We've been needing to have this conversation for a long time. Okay, so my question for you is, what are some of your health non-negotiables? So these are things that no matter how busy your day is, that you prioritize in order to better your health. Right. Well, the first thing I think about is, you know, all of them, you know, it's sort of like a stool, right? Like health is like being seated comfortably on a stool and feeling centered. And we have all of these poles on the stool,

right? So there's sleep and exercise and diet and supplementation and meditation, all of these things. So they're all super important. The good thing is if you're generally healthy, any one of them you can kind of pull out for a little bit and you're not going to topple over. So they all can be negotiated a little bit from time to time. For me, again, number one would be sleep. I know when I don't sleep, you know, maybe I get away with it for a day every once in a while, but not regularly. So making sure I'm getting at least eight hours of sleep is very, very critical. Drinking enough

water is going to be very, very important. You know, making sure I'm eating clean foods is very important, too. So starting with the basic of basics, moving my body and exercising, is just something that's important to me. Being involved in music, doing something I love, that I'm passionate about, outside of my work, which, of course, I'm very passionate about, I think is critical, too. So those are mine, you know. Those are all very helpful. Yeah. Amazing. Well, let everyone know where they can find you, find your work, find your books if they want to learn more.

Thank you. Yeah, so you can go to drpeterbongiorno.com, D-R-P-E-T-E-R. And then my last name, B-O-N-G-I-O-R-N-O.com, DrPeterBongiorno.com. And yeah, and I'm also on Facebook and Instagram and Twitter. So feel free to join me there as well. And I have a newsletter. So if you want to send a newsletter to info at drpeterbongiorno.com, I'd be happy to put you on that. And it's just good information. As I get excited about research, I send it out to my newsletter list as well. Awesome. I'm going to have to join that. Yeah, please do. Happy to have you. And thank you for the great work that you do and putting out the wonderful information that you've been putting out all this time too so it's I know it helps a lot of people and so thank you for doing that thank you I really appreciate that well we will add all the links to that in the show notes so people can

find you easily and I just want to thank you so much for all the work that you're doing and for coming on today. It was my pleasure. Thank you, Courtney. Thank you. Thanks for listening to today's episode of The Real Foodology Podcast. If you liked this episode, please leave a review in your podcast app to let me know. This is a resident media production produced by Drake Peterson and edited by Chris McCone. The theme song is called Heaven by the amazing singer Georgie, spelled with a J. Love you guys so much. See you next week. The content of this show is for educational and informational purposes only. It is not a substitute for individual medical and mental health advice

and doesn't constitute a provider patient relationship. I am a nutritionist, but I am not your nutritionist. As always, talk to your doctor or your health team first.