Today we’re talking about anxiety—the very prominent condition we hear about these days attached so frequently to quarantine and the massive disruption of our global lifestyle for the last couple of years, as well as a long-suffering human condition.

Today’s guest, Dr. Ellen Vora, brings a fresh, memorable, and unique take on anxiety—one that will give you some instantly helpful tips and tricks that you can implement into your own life. Through Dr. Vora’s expertise, you will learn simple strategies that allow you to tune into your anxiety in order to allow it to protect and guide you.

Author of the book The Anatomy of Anxiety, Dr. Vora works as a psychiatrist in New York City, practicing what I would call “holistic psychiatry” since she deals in the field of traditional medicine while bringing in all kinds of functional and health-promoting strategies and behaviors into her work with patients. In this episode, you’ll learn about the one thing that was the main driver behind Dr. Vora’s major health decline (this incidentally was also what led to her health awakening) and the two different kinds of anxiety—what causes them, and how to effectively treat them. You will also hear about Dr. Vora’s groundbreaking approach to understanding how anxiety manifests in the body and mind, which will give you a practical, effective perspective on how you can overcome it. Instead of thinking of the discomfort of anxiety as a pathology that must be labeled, Dr.Vora has reframed that discomfort instead as “a signal to heed.” Once you see anxiety from that viewpoint, you can truly reframe the term, and start seeing it as something that actually serves to alert us to the fact that something else is out of balance—in our bodies, our lives, our relationships, in the world. This anxiety, as you will hear Dr. Vora explain, is not harmful, but instead quite vital to our wellbeing, as it helps keep us focused on our goals and to recalibrate when we’re out of alignment with our life’s work. 

TIMESTAMPS:

Let’s talk about anxiety. There are two kinds:  false anxiety and true anxiety. [01:12]

In treating patients, Dr. Vora began to question the impact of medications. She is more interested in prevention. [4:30]

Conventional medicine is not the answer to everything. [09:12]

Ellen’s medical training has brought her to her current practice of using lifestyle adjustments and other alternative methods. [14:23]

Does she have to get off the insurance model since she practices alternative medicine? How did she transform how she is in the world? [20:12]

Anxiety can often be traced to unrelated imbalances. One can transfer the feeling into purposeful action.  [28:28]

What is the difference between true and false anxiety? {33:38]

Medical education has been bought by the pharmaceutical industry. [36:49]

There are so many things that affect mental health such as diet, lack of sleep, artificial light, inflammation, and so forth. [41:17]

How does one get motivated to adhere to the ideal lifestyle recommendations the doctor suggests? [47:00]

Do pharmaceuticals have a role in her practice? [51:12]

Are you allowed to play with the placebo effect in today’s medicine? [55:22]

LINKS:

• Brad Kearns.com
• Brad’s Shopping page
• The Anatomy of Anxiety 
• The Mood Cure
• Gretchen Rubin Podcast
• EllenVora.com
• Ellenvoramd (Instagram)

QUOTES:

• “Genes load the gun, and the environment pulls the trigger.” (Dr. Vora)
• “Mental health is physical health.” (Dr. Vora)

LISTEN: 

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B.Rad Podcast

Brad (00:01:12):
Let’s talk about anxiety. Yes, the very prominent condition these days that we hear about attached so frequently to quarantine and the massive disruption of global lifestyle in the last couple years. But of course, uh, long suffering human condition. And we have a very interesting guest named Dr. Elen Vora, and she is gonna give you a fresh, memorable, unique take on anxiety that I think is going to give you some instant, helpful tips and tricks that you can implement into your own life. In addition to buying her book, The Anatomy of Anxiety, She is a psychiatrist practicing in New York city. I would call her a holistic psychiatrist because she deals in the traditional medical career, but she also brings in all kinds of functional and health, promoting strategies and behaviors into her practice, dealing with her patients. But here’s a big one that we’re going to, uh, get into in depth on this show.

Brad (00:02:19):
There are actually two kinds of anxiety, one that she calls false anxiety and one that she calls true anxiety. Now the false anxiety is where we misunderstand some of these anxiety symptoms and they are more likely related or triggered by health conditions like low blood sugar, inadequate sleep over use of technology and chronic inflammation. She’s gonna talk about how her gluten intolerance was a major driver of her own health decline that caused her to have an awakening, uh, during the time that she was undergoing traditional medical training. Now, what about true anxiety? Well, interestingly, this is when we should be feeling a little anxious because we have major life circumstances to deal with and ruminate about in order to take action, right? So it’s sort of a survival instinct that our brain kicks into anxiety mode because we indeed need to have that conversation.

Brad (00:03:18):
And Dr. Ellen will give some examples, get rid of that lousy boyfriend change jobs, make big decisions that are anxiety producing. So just by learning to distinguish between those two, I think you’re gonna have a great time navigating this thing that we often feel out of control about. I don’t wanna put any more words into the introduction here because Dr. Ellen talks about it very gracefully, very interesting show. Here we go. Dr. Ellen Vora, The Anatomy of Anxiety, Dr. Ellen Vora with a fantastically exciting topic to talk about, maybe not the most pleasant, but something that a great many of us have been suffering from anxiety. And you have a wonderful new book with some very interesting takes on the subject. So I can’t wait to discuss your new book,The Anatomy of Anxiety,

Ellen (00:04:08):
Hmm, Brad, thank you so much for having me on today.

Brad (00:04:11):
So why don’t you tell us about your, uh, professional career, your practice, and then how you came to, uh, to, to be compelled, to, to write a book about the subject. And then of course, we’re gonna get into some of the alternative views of, you know, kind of the, the, the basic notion of what anxiety is and what the root causes are.

Ellen (00:04:30):
Sure. Yeah. I had somewhat of a, just a conventional path for the most part. I went through medical school and psychiatry residency. Although the whole time I had two parallel crises going on, one was that my own health was completely outta balance. And I thought I was doing everything seemingly right. I was after all being trained to be a physician. I thought I was eating right and exercising right. And taking all the right things. And it, you know, my body was like a machine with the springs popping out. And at the same time, I had this sinking suspicion that while I was being trained to masterfully medicate my patients, I would look at them as they’d walk out the office. And I would think, are they really better off for having met with me today? Like, were they thriving or was I just keeping them patched up? Um, but not truly participating in, in healing. And so those crises led me to wanna take a really different approach to mental health.

Brad (00:05:29):
So you’re treating these patients. You’re, I guess, in the mainstream model, it’s largely the, um, uh, the shuffling of the deck of the medications, the doses, and you don’t have a whole lot of time with them. I understand as well. And so I guess that’s maybe where that sinking feeling came from that you weren’t really getting to the root cause let’s say,

Ellen (00:05:54):
Yeah, that limited time is, is a subtle impact on why the whole system is so well designed for the conclusion to be a medication. As if you have eight or 15 minutes with a patient and they come in and they’re saying, well, everything is hard right now. And they start crying in your office. You sort of feel like as a physician, like, ah, how do I solve this problem with no time? I certainly can’t get to the root of the issue. I can’t hold space and participate in healing in a way that’s, you know, giving them, witnessing them and really letting them feel heard and witnessed and understood. And so the conclusion is, well, here’s a prescription and, you know, that’s, it’s a, it’s one aspect of all the ways that we’re kind of in this perfect storm where everything about conventional medicine ends up with a prescription for a medication.

Brad (00:06:48):
And how long did it, did it take for you to hit this breaking point where you’re like, there’s gotta be a better way. How many patients did you treat, or how long was your practice going through this, this narrow model?

Ellen (00:07:00):
I think of two particular moments in my training that were the aha moment for me. And one was when I was sitting in my own gynecologist’s office and I had gone there because I wasn’t getting my period. And she diagnosed me with P C O S she casually kind of in passing said that I’d be infertile, which was kind of a heavy duty thing to just drop on me with zero bedside manner. I was 23 years old at the time.

Brad (00:07:25):
Oh, Mercy,

Ellen (00:07:26):
Oh, mercy. I have a daughter now. It ended up being, not a problem at all. Um, and she, uh, I remember just scratching my head. I did not yet have the vocabulary to make sense of the way functional medicine thinks about health. That, that these diseases, their, their symptoms, their communications from the body of communicating some state of imbalance and that we can address things at the root rather than simply suppress things with medication at the time. She was like, so that’s okay, no problem. We’ll just put you on the birth control pill. And I was thinking like, how can that be the solution? Like, I can understand how that’s gonna gimme my period back, but that won’t fundamentally change anything. And if I go off the pill again, I’ll be right back where I started. And it also felt like I’m the product of 500 generations of successful reproduction.

Ellen (00:08:16):
Why did it stop with me? Like, what are the odds? And so, you know, I was, it was a head scratcher for me, but I started that’s what planted the seed of, like, maybe we’re not thinking about things correctly in conventional medicine. The other moment was when I was standing in the, or on my surgery rotation. And I remember a lot of the time in the, or you’re just shooting the shit, pardon my French. You’re just passing the time making conversation. And I was curious, and I asked the attending surgeon, what do you think causes appendicitis? We were working on someone’s appendix. And he said, we don’t ask why we just cut. And that’s where I knew I was in the wrong place because I’m a New York Jew. All I do is ask why, why, and then the deeper layer of why. And I just keep going with that and to feel like all we do is react to the problem, but we accept that there’s nothing to be done. We can’t prevent the problem in the first place. That’s uninteresting to me, I’m currently interested in prevention,

Brad (00:09:12):
Well said, wow. Yeah, I’m thinking of my own, um, emergency appendectomy that I blamed on two consecutive workouts performed in excessive, a hundred degree temperatures. I did a sprint workout and then a super hard basketball game a few days later. And then I showed up in the ER with you know, several bags, low on hydration and then, um, operating to cut an organ outta my body. And, um, you know, the doctor’s like, no, that none of that stuff has anything to do with it. It’s just random when you’re gonna lose. I appendix I’m like, come on, man. <laugh> um, it, yeah, doesn’t add up. But again, I think, especially when we’re listening in the alternative health scene and, um, it we’re very quick to criticize the mainstream model, but again, I’m standing here because the surgeon did an exceptional job taking that organ outta my body that was burnt up and saved my life, cuz it was, you know, bleeding out and the whole thing.

Brad (00:10:09):
And so I think when we need that medical intervention so that we don’t die at four or 12 or, or 38 or 47, that’s fantastic. But somehow, um, we’ve layered over, um, you know, kind of the, the end all answer to everything is pop a pill, um, buy a brace and get a surgery. And I think that’s where we’ve gone wrong. And that’s not the, the highly trained physicians’ fault because they’re focused on how to operate and get those things outta the body or, or in, in your example, um, the training is on the medications and all those things. And then, you know, it’s up to the patient to, for example, get up, get some sunlight, get some exercise, choose the right food. So that’s how we gotta come together, I guess eventually

Ellen (00:10:55):
That’s exactly right. And I’m so glad you give grace to conventional medicine. I am eternally grateful for conventional medicine when things go wrong, when you have the car accident or the heart attack or appendicitis, thank goodness for the heroic interventions that we can do in Western medicine. It’s not to poo poo that it’s, that we as individuals need to know which kind of practitioner to engage with, when depending on what we’re going through. And if you’ve had the car accident or the heart attack goes straight to the conventional medical practitioners,

Brad (00:11:27):
<laugh> maybe not even with a second opinion, just go to the hospital, they send you to. Yeah.

Ellen (00:11:31):
And then if you’re dealing with chronic fatigue or low mood or anxiety, or, you know, any number of digestive issues, autoimmune disease, all of these chronic states that we’re struggling with these days, it it’s actually just, it’s the wrong person to go to because their tools are medication and surgery and the tools we really need with these, these chronic issues, um, are diet and lifestyle. And in fact, conventional medicine does sort of disparage those tools. They think of them as soft science and not that useful. And that’s where we’ve got things so wrong because when you’re dealing with, you need to prevent the progression of a chronic inflammatory state, um, you actually really want to be dealing in these soft science, gentle diet, lifestyle tools, throwing medications and surgeries at that only makes matters worse.

Brad (00:12:20):
Mm. So what was going on with your own health? Was it a high stress experience in medical school that was, uh, maybe the, the cause of your health problems or, you know, how did you come to this awakening with, uh, learning the hard way?

Ellen (00:12:34):
Yeah, it was a perfect storm of a number of different things. Certainly the stress of medical school played a role. I was lonely. I didn’t have community. Um, I was unmoored in my life, but I, I also cannot overlook the very material physical problems. So there’s all these psycho spiritual needs that were unmet in my life. But also I turns out I don’t tolerate gluten and birth control makes me depressed. And those two things more than anything I think had my body really inflamed and out of balance. And so my journey to feeling well had a lot to do with finding community, exercise, yoga, meditation, prioritizing, sleep, sunshine, all of that. But I also had to get off gluten in the birth control pill

Brad (00:13:20):
<laugh> So now, uh, everyone in, in the audience is, uh, nodding their heads in approval because you did give a nod to the, the, the woo woo that the fluffy puffy stuff like getting enough sunshine and, uh, forming social relationships. But also the glutens are tearing up your intestinal lining and causing leaky gut and all those downstream inflammatory conditions. So, uh, fortunately you found the, the holistic approach to, um, you know, lifestyle change. And so did you, um, did you get healthy in short order, uh, as you realize that you needed a, uh, a gluten free diet and to get off that, uh, medication?

Ellen (00:14:00):
Well, That’s part of why I like to do what I do today is my process was very inefficient. I went on a lot of dead ends and stumbled across the finish line 10 years later, kind of figuring out here’s how I keep myself well. And so I’m very motivated to expedite that process for others, like read my book and then your process might take a couple of months rather than a decade. Mm,

Brad (00:14:23):
Wow. Um, okay. So you’re in your years of clinical practice realizing that you’re not making the impact that you desire. Um, and then what was some of those turning points? Uh, and tell me about your, your profession today and how, how that’s evolved.

Ellen (00:14:43):
Yeah, I mean, it was many, uh, you know, it, it doesn’t necessarily lend itself to a clean story, but there was a moment in my fourth year of residency where I had done enough training. At that point, I started to study functional medicine, Chinese medicine, acupuncture, Iveta yoga. And at that point, um, I had one particular patient who was on so many different meds. Um, she was clearly so inflamed. She would show up in my office carrying like a two liter Coke, you know, sip that throughout our appointments. And, um, she was uniquely open minded. You know, she really, I learned so much from her and she was like, I she’s like these meds aren’t helping. I don’t think we’re barking up the right tree with this. Can we try a different approach? And I was like, like, you know, like, can we try a different approach?

Ellen (00:15:33):
Like, that’s exactly what I’m hoping to create. And so it was like this opportunity to take all of these alternative trainings that I was doing and start to apply them and she was game. And so we started to change her diet started to change her sleep habits, her exercise. We changed her relationship to community at the time phones weren’t such a big deal, but even that was on our minds technology. And, um, and we, we actually slowly tapered her off of her medications, which it turns out they were not the right fit for her needs. And they were in certain ways making matters worse. So this woman, she was such living proof of the fact that diet and lifestyle not only can be effective, but in many ways safer, more effective, better tolerated. Like that’s what actually allowed this woman to thrive in her life. And I remember when we said goodbye and it was such a bittersweet moment, cuz we had such a bond and such a connection. We had really grown together and developed this functional medicine approach to psychiatry together. And she really just did not need to be working with me anymore. And so it was like,

Brad (00:16:44):
Okay, her last med is finally we’re down to one milligram for one more week and then goodbye. Oh, that’s so cute. She

Ellen (00:16:51):
Was good. She was good. Yeah. Um, and, and so it was moments like that at this point now I’m so lucky that I’m about 10 years into practice. And now I have far too many cases like her to even keep track of. Like, I’ve been able to witness so many people finding true wellbeing through some unique combination of diet and lifestyle.

Brad (00:17:15):
You’re gonna get Yelp reviews. Like there’s a lot of turnover in her practice. She doesn’t keep her patients long term. She gets a point off for that. Oh no, wait, that could be a good thing. Oh gee

Ellen (00:17:25):
Should be every practitioner’s goal. My goodness. Yeah.

Brad (00:17:27):
Really? Yeah. So what compelled you to study those alternative and, and functional, uh, sciences when you were in residency or, or medical school? Was that totally independent from, from the curriculum?

Ellen (00:17:40):
A little bit. The crisis of, I felt like what I had learned was not doing the trick, but also I would say even in those days when I was still in my self-loathing, misogyny state of suppressing, my intuition, those were intuitive hits. I, I cannot explain to you why I felt drawn to training in acupuncture. I had never gotten acupuncture. I knew nothing about it. And I had this clarion download of, I need to go pursue this. And so even then I really did not have a hotline to my intuition, but that one got through,

Brad (00:18:16):
Why do you call it misogyny it during that self-loathing misogynistic period. That’s interesting.

Ellen (00:18:23):
For me, that was the journey. I think early in my life. I read the room. I perceived that we live in a patriarchy and there are certain traits that are valued, objective reasoning, rationality, emotional evenness, and to be sensitive or woo woo or intuitive was disparaged. That was looked down on. So I learned to silence and suppress that that was not gonna be part of my persona. And I performed objectivity and emotional evenness and, oh, I’m good at math and all of these ways that I was like, you know, can I be accepted in the boys club please? I’m I’m not a crazy silly woman. And, um, and so it, it worked for a long time. <laugh> it worked and

Brad (00:19:06):
Sure you made it through medical school residency. And were you outnumbered, in terms of the fam male female ratio, especially in your, um, specialty?

Ellen (00:19:15):
No, it, by the time I’m in med school, med school is somewhat of a 50 50 endeavor. It’s certainly my specialty. It, the, the gender breakdown is very different specialty to specialty. Psychiatry happens to be more of a female dominated specialty. But it was a beautiful journey of reclaiming intuition and all of these, you know, more feminine aspects within me that I had silenced and betrayed and, and, and now I, there was a homecoming to it of like, wait, this is me. And it’s not anything to be ashamed of. And if the world doesn’t accept it, that’s the world’s problem. But I don’t need to change who I am.

Brad (00:19:51):
Yeah. Especially with, uh, Larry David Curb Your Enthusiasm, at the very top of television. And, he’s the, the questioning second guessing whiny New York Jew, just carrying the torch for, for all those who wanna live life, you know, off the, uh, off the rails a little bit.

Ellen (00:20:08):
I would’ve loved to have him in thec OR when the surgeon said we don’t ask why

Brad (00:20:12):
<laugh> <laugh> Oh my goodness. Um, so is there, I guess you’ve created an opportunity in your career, in, in the medical profession to bring in these other elements and, and how does that work? Do you have to go off of the insurance model or depart from the insurance model or what, um, what can others, um, aspire to that wanna think a little broader than boom, eight minute consult, another prescription, et cetera.

Ellen (00:20:42):
Yeah. This is such a big problem. And I think from the perspective of, of patients and practitioners, um, sometimes to deliver or get the care that you truly need, we need to be opting out of the default system that caters really only to short appointments and prescriptions. And that’s a big problem. There’s, there’s an issue of accessibility with this. I do believe that, um, that this is part of why I wrote the book, like working with me. It does not have to, how am I, what do I wanna say here? You can spend the, the $24 and get the book. And it’s just about all the information I could possibly deliver in a session. And, and people like the idea of like, you really know me, but 10 years of practice, I really know a lot of what comes up. And it, I think of it like a buffet, not everything in the book is gonna be appropriate for everyone, but you know, for yourself, what resonates, what makes sense for you, what feels accessible? And so I sort of hand you here are all my potential suggestions, and you can figure out for yourself, what’s the bespoke, prescription for you. But I don’t think that these ideas have to be gate, keep behind expensive practitioner paywalls. Like this is, um, this is accessible and it’s things that we can do safely for ourselves once we have the information.

Brad (00:22:02):
Yeah. I know. That’s why the book business, the economics are sometimes disturbing to me having written so many books and worked so hard. And I’m, I’m thinking like when I finish a book, I go, you know, the, the retail sticker price on this book should be $2,000, <laugh> because I am giving you my, my heart and soul here, my blood, sweat, and tears that I’ve learned the hard way of 20 years of training at the highest level and scrutinizing my diet and listening to the world’s greatest experts and going on this quest and here it all is in a book for, for $24 or whatever it is. It’s like, oh, it’s, you know, it’s unweighted, but, um, still, it’s a great opportunity. And then I guess if a million people buy your book, you’re, um, you’re happy and you’re getting the information out, but it is kind of funny how, um, if we’re inclined, we can, you know, grab it’s it’s right there for the taking a complete life’s transformation and not having to go the hard way.

Ellen (00:22:55):
It’s definitely true. I think books, it’s the best deal in town. You can even get them for free at the library.

Brad (00:23:00):
Oh, that’s right. I forgot about that. Or the, the audible membership for $14.95 a month. Uh, I know we gotta get deep into this concept of anxiety, but, um, one thing I’m, I’m curious. So you had this, um, sort of transformation where you rediscovered your voice from, uh, the, the self-loathing, misogynistic self, and now you’re, you’re able to kind of be your authentic self. And if that might mean asking follow up questions and asking why. That’s great. And how does that, uh, play out in daily life? Like did, did you have to kind of go overboard to assert that you were finding a new voice? Did people have to adjust that are in your world because previously you were, um, whatever, a pushover and now they’re getting annoyed, cuz you are asking follow up questions. I mean, was that a difficult transformation or would, was everyone highly supportive in giving you a hand because you finally spoke up at the group meeting or what have you?

Ellen (00:23:54):
That’s interesting. I mean, I think that it’s, um, if anything, it’s, it’s more that there are probably people who knew me in a earlier phase of life that might see how I’m showing up in the world and, and think it’s pretty cringy. You know, <laugh> think like, you know, she’s lost the plot. Like what is she talking about with intuition? And, um, cuz I, I think that I really used to do so much performing of I’m objective I’m evidence based like it was such an airtight well defended way to be who can call you out. And now it’s so vulnerable and exposed to be like, well here’s a hunch and here’s how I work with people, even if it isn’t solidly evidence based. And so, um, I’m sure there are people that judge it. It’s a nice thing about this homecoming is that just as you get more judge, you care less, but I think that, um,

Brad (00:24:48):
It’s like two curves. Uh, you let’s graph that and put it on a, uh, yeah. The intersecting lines where yeah. You could care less and you get more judged departing lines of the graph. Yeah.

Ellen (00:24:59):
But really it’s a beautiful thing in daily life. It’s this additional compass that I have access to. I still value objective reasoning and data. I’m still, you know, squarely analyzing that aspect of a problem, but I have this additional source of information that I can counterbalance and, and, or just add to the data and so that I have a, a different way of navigating the choices in my life.

Brad (00:25:25):
And so are you in practice now in New York City for individual, uh, patients?

Ellen (00:25:30):
I am.

Brad (00:25:31):
And is this necessarily outside of the insurance model or how does that work?

Ellen (00:25:39):
I’m sure there are people who can manage to do it within the insurance model. The difficult thing about being a psychiatrist in private practice is that working with the modern American insurance system is its own person’s job. Um, mm-hmm <affirmative> so you’d kind of need to be in a bigger practice that, um, sort of justifies having an employee navigating insurance reimbursement. I’m a solo practitioner and I’m balancing practice with writing and speaking. And so it doesn’t make sense for me to have an employee that’s doing all of that leg work. And so I do this lighting scale model where, um, you know, I wanna make this treatment, um, accessible and um, sort of pay my bills, keep the lights on and not bankrupt my patients. And I try to strike that balance.

Brad (00:26:29):
Yeah, that’s funny. I remember going to my fantastic PT Revolution, physical therapy in Lake Tahoe and them helping me fix these really problematic injuries with hands on physical therapy and exercises and really progressive, you know, know athletic minded practice and they billed my insurance and it was such a hassle. And I remember making a couple follow up phone calls and then they’re following up again and again, and it, it finally turned out that they, my insurance pays 19 bucks for an out of network visit. And she said, here’s the thing. It, it takes us more than $19 to go get the $19. So why don’t we just cut a deal and you can give us a, you know, give us a cash pay and we’ll all go on with our lives. And it’s just so ridiculous. But, um, I, I, I see this coming more and more cuz people are, um, you know, working hard, they have the resources and they want the best care. And you know, choosing outta that model, I think it’s only gonna build momentum to where we have more options and things get simpler.

Ellen (00:27:29):
That’s right. Yeah. My physical therapist is by far and away, the most virtuosic practitioner I’ve ever worked with. His skills, his knowledge of the body, like whatever insurance values it at, I’m sure it’s just woefully underappreciated. And that’s, that’s often the case. What, what we value in our insurance system is, is an interesting its own sort of patriarchal weird system. <laugh> so, um, and so I do think

Brad (00:27:51):
There goes that word again. All right, Ellen, drop it in there. They deserve it. Come on. Now, people, you know it.

Ellen (00:27:56):
As much as I wish we did have socialized medicine, I think that would be the solution for a lot of problems. Um, I, I also think I enjoy the freedom to opt out because I think sometimes you have to, um, have a really nimble system to say, here’s what I value this at.

Brad (00:28:11):
Well, socialized medicine is so rare and unrealistic because there’s only 214 countries in the world that have it. And what is it? One, one remaining country that doesn’t is that, is that accurate? Something like that, right?

Ellen (00:28:23):
That’s about right. A country that makes some other dubious choices in terms of how take care of its population. Yeah.

Brad (00:28:28):
So interestingly about anxiety, the discomfort of anxiety can often be traced to seemingly unrelated imbalances says Dr. Ellen in the premise of her book, The Anatomy of Anxiety, which is super interesting, cuz I think the conventional notion of anxiety is you are experiencing an anxiety producing, um, thought or event. So start us off set us straight with this, uh, with this whole concept here.

Ellen (00:28:57):
Yeah. So the consensus currently, how we have all been indoctrinated to think about mental health is that it’s a genetic chemical imbalance. It’s basically this destiny that says, well, genetically you have low serotonin, and therefore you’re destined to have mental health issues for your whole life, but you can take this medication and it will correct your chemical imbalance and you’ll be fine. And nothing about that story is accurate. And um, and it’s also our least empowered or hopeful way of understanding mental health. I don’t deny that we have genetic predisposition for mental health issues, but as we say in functional medicine, genes load the gun and environment pulls the trigger,

Brad (00:29:34):
Right? I’m I may have a genetic predisposition for alcoholism because, uh, there’s a presence in my extended family, but if I don’t drink, I think that’s a pretty simple example for everyone to embrace. Um, I’m, I’m not gonna become an alcoholic without drinking.

Ellen (00:29:50):
We have so much power to impact how our genes manifest our genetic predispositions, whether or not they manifest by how we live our lives by our diet and lifestyle choices. And so with anxiety, I think of it as two types of anxiety, what I call false anxiety and true anxiety. And this is really based on the work of a woman named Julia Ross who wrote a book called The Mood Cure. And she first identified this idea that we have true moods, something happened and we’re in a mood as a result. And then we have what she called emotional imposters, or false moods, times when there’s actually some state of physical imbalance in the body that triggers a stress response. And that we experience as a change in our mood, whether it’s anxiety or panic or low mood where we can’t focus or we can’t sleep. And so with anxiety, I think false anxiety are all these times that there’s some state of physical imbalance creating a stress response and we experience it as anxiety it’s avoidable.

Ellen (00:30:46):
It’s not serving us. It’s really just time for us to look through all of these seemingly benign habits in modern life, recognize how they’re tripping us into unnecessary stress responses and creating all of this unnecessary suffering and chip away at that. But at the same time, we also have what I would call true anxiety, which is not something to pathologize. It’s not something that we can gluten free or decaf coffee, our way out of it’s our inner compass nudging us and saying, Hey, something’s really not right here. And we need to slow down and pay attention and address it course correct. And I think that, you know, in the United States, right now we have untold amounts of false anxieties. We’re inflamed, we’re chronically sleep deprived. Mm-hmm, <affirmative>, we’re malnourished. We have digestive issues. We’re over caffeinated and over dooms scrolled. And we have all of these things contributing to unnecessary stress responses. And we have the deep existential angst around the fact that we don’t have health insurance or, you know, state sponsored childcare or education. And um, all of these ways that it is, um, that we get a signal of we’re not safe and we’re not held and we don’t have community these days. So I think we have a lot of both.

Brad (00:32:01):
So the true anxiety could possibly be, um, serving a, a, a positive, personal growth purpose, because it’s getting you to reflect on how, um, we don’t have equal rights in the country. So we need to go attend the march, uh, whatever, you know, like you’re gonna take action to try to improve your life because you are experiencing an anxiety producing event. I have to call my debtors once again, cuz I’ve missed the monthly payment and I gotta make a deal. You know, something that’s gonna going to, um, address the situation because if there were no anxiety coming, then you might be just laying on your lounge chair, um, with a smile and a Snoop dog beverage. and that, that might, that might not turn out well. Is that, is that, is that what we’re talking about with true anxiety is like you have a reason to be anxious. So let’s give a, give you a break and go deal with it.

Ellen (00:32:57):
That’s exactly right. I, I think of it as purposeful anxiety and it’s not something to ignore. It’s not something we want to be suppressing. It it’s really something here with a call to action baked into it. And that sometimes is personal development. It sometimes pertains to the fact that we, you know, for really honest with ourselves, we need to get out of a relationship or get out of a job. And sometimes it speaks to something much more global. Like we belong showing up as an activist in a particular cause that matters to us or we need to call our grandma. You know, it can be so many different things, but it’s something nudging us and saying we feel uneasy, but for a reason, and we can translate that feeling into purposeful action.

Brad (00:33:38):
Okay. And so back to the false anxiety that could be driven by these are, this is your list, low blood sugar, inadequate sleep overuse of technology inflammation. You’re talking about chronic inflammation caused by for, in your example, the gluten or, or whatever. Um, so this is now being disguised as anxiety, I guess. And, um, what’s that person’s maybe gonna go and get prescription medication to deal with anxiety, potentially making the underlying causes worse. So how do we like become aware of the difference between the two and take some action that will kind of get us away from false anxiety?

Ellen (00:34:23):
Yeah. In the book I put early on in the book, a list that I call the false anxiety inventory and I think it’s actually useful. I intend for people to just cut it out of the book and put it on the refrigerator. Cuz when you’re in that moment where some state of imbalances tripped you into a stress response and you’re anxious, it’s very hard to have the presence of mind to be like, oh my blood, sugar’s crashing and I didn’t sleep last night and I’m hungover. And I had an extra double espresso this morning. Maybe that’s why I’m having a panic attack. It’s just hard to have that clarity in the moment. So to have a list like that, that can cue you and take some of the charge outta the feeling. It’s not that the sky is falling. It’s that you have all of these different physiologic states of imbalance contributing to how you’re feeling.

Ellen (00:35:06):
And in the short term, some of those you can address, you know, some of them, you can have a snack, you can, um, go outside and move around in the fresh air and sunshine. You can shake it off a bit. There’s a lot of different things we can do in the short term, in the long term, in a way I just present this buffet up here are all of the common causes of false anxiety. I see and think about which ones might be true for you. And you know, if you have 10 years of digestive issues, it’s fairly reasonable to think that there’s some degree of dysbiosis and intestinal permeability and that’s contributing to your anxiety. So we’re not gonna get you feeling well, unless we address that.

Brad (00:35:46):
Now, if you have a patient where you suspect some of these things, um, can you dig into those in those directions as well, distinguishing you from 99.9% of the psychiatry care available?

Ellen (00:36:00):
Yeah. It’s, it’s crazy that we’re not there yet, but it’s coming. I see it with the trainees. People pursuing psychiatry. Now they want that functional medicine education. It’s wild to me that psychiatrists continue to focus on the neck up and they’re like, this is our purview. Nothing else don’t they don’t get involved. Don’t wanna overstep their bounds. Mental health is physical health. Physical health is mental health. We need to understand that our brain is a physical organ. It’s a piece of flesh like any other organ in the body. Anything going on in the physical body is impacting the brain and an inflamed brain and malnourished brain, a blood sugar grassing brain, a sleep deprived brain. All of this can show up as what we call mental health issues. So yes, I roll up my sleeves and take a very functional medicine approach to mental health. And it’s absurd to me that that’s not just the standard of care at this point.

Brad (00:36:49):
Yeah. Why, why do you think, I mean, we, we only, we already have four years of medical school and, and many years of residency. So is it just that there’s so much required learning and high level of expertise to, to function as a physician today that it’s not really practical or possible to layer on even more training? Or do you feel like if you could go back to medical school and residency and reposition some of those hours, we could do better job.

Ellen (00:37:17):
I think that there’s room to reposition. I mean, I think if I’m feeling a little salty today, I think that our medical education has in certain ways been bought by the pharmaceutical industry. And so I

Brad (00:37:31):
Didn’t know that, Ellen

Ellen (00:37:32):
Systemically biased, um, but basically, you know, we, as, as good physicians want to practice the standard of care, but what’s the standard of care it’s based on guidelines, which are formed by experts in our field that themselves often have financial ties to pharmaceutical industries. And they’re basing the guidelines on the studies that are published in our medical journals. But what gets studied in the first place, what gets approved, what gets published, all of that is, is influenced by pharmaceutical dollars. Um, cause they’re funding much of the research. They’re deciding what to study in the first place. They’re deciding what studies go through. And so, um, we’re, it’s, there’s this idea of garbage in garbage out. And we have all of these really smart high level physicians saying here’s the standard of care, but it’s based on a mountain of evidence that is itself systemically biased. So I think we could reposition some of those hours. I learned a lot about Zyprexa in my psychiatry training. I could have learned a little bit less about Zyprexa and a lot more about gut healing or the role that inflammation plays in mental health or even just how to support people to get better sleep.

Brad (00:38:44):
How does, uh, big pharma dollars infiltrate the wonderful Ivy-covered institutions of psychiatry medical school?

Ellen (00:38:55):
Yeah. So in a way, what, what we’re doing as well-meaning physicians is saying, I I’m gonna practice the standard of care and it’s built on the evidence basis, but the evidence basis is, is derived from somebody decides, okay, we have this new medication we’re gonna conduct a study. We’re gonna see if it’s better than placebo. We’re gonna see if it’s better than the current treatment. And, um, it’s a, it’s a nice idea. Evidence-based medicine, right? It’s a beautiful idea. It’s the pursuit of truth. And really, it seems aimed at helping people and, and innovating and advancing are, are offerings, but the trouble is that these studies are expensive and take years to do. And the people in a position to run trials like that are people with a financial interest in whether or not that trial shows that that medication works. So it’s just, it’s just not, um, if this were run by the NIH, we, this would be a different conversation, but the vast majority of the research funding is coming from the pharmaceutical industry.

Brad (00:40:01):
And so the research funding impacts the curriculum, you’re saying.

Ellen (00:40:05):
yes.

Brad (00:40:05):
Whew. Okay. Um, I’m not quite getting that. Why Harvard or San Jose State or Utah would have any, um, reason to associate with pharmaceutical companies when preparing their, their medical school curriculum.

Ellen (00:40:28):
Yeah, so it, it basically comes down to the fact that what would be in my textbook is gonna be, is gonna say, um, well, these medications are the standard of care and here’s how you prescribe them. And here are considerations and here are contraindications. But the fact that that made it to that point of being the standard of care is based on the fact of like, this is what got published in the journals. This is what got passed through. This is where the positive studies, this is what got studied in the first place. Mm-hmm <affirmative>. And so it’s not that Harvard is, you know, BFF with a pharmaceutical company, although <laugh>, you can make

Brad (00:41:03):
Possible. Yeah.

Ellen (00:41:04):
Um, but it it’s more that, you know, well-meaning experts are basically saying, well, here’s what our evidence tells us. Is that this is, this is the latest, most effective medication, but that itself is systemically bias. I

Brad (00:41:17):
See. Wow. So if someone is, uh, trafficking in these adverse lifestyle practices, insufficient sleep, overuse of technology, dietary processed foods, um, could this manifest in other ways, besides anxiety, if one’s not prone to anxiety, could it be a depression, uh, track or you name it? You said O C D I think also.

Ellen (00:41:41):
Yeah, absolutely. The writer, uh, Johan ha puts this so well. He describes depression and anxiety as covers of the same song. I think that different people’s brains have a tendency to take the same imbalance and it manifests slightly differently. So one person, their inflammation might show up as anxiety for someone else. It could show up as depression, still another person O C, D, or bipolar and so on and so forth. So I think that these different diagnoses, there are themes to them with anxiety. I’m always gonna think about what’s causing a stress response. Is it a blood sugar crash? Is it excessive caffeine with depression? I’m thinking more about a lack of vitality. So I’m thinking about, micronutrient deficiency, chronic sleep deprivation, sleep apnea, this person not getting enough oxygenation, are they not getting proper mitochondrial function? Is there some lack of energy and vitality thyroid issues?

Ellen (00:42:33):
And then with bipolar, I’m often thinking about what is stretching this rubber band such that it’s snapping and with bipolar, I think a lot about circadian rhythm and light sensitivity. There are a lot of different things that can stretch and snap a bipolar brain, you know, for one person it could be cocaine or alcohol, or it can be gluten. It can be a gluten’s impact on the thyroids impact on the brain. Um, but I, I see a lot of bipolar people who are, or people with bipolar disorder who seem to be uniquely sensitive to light. And then this artificial light exposure of modern life sends their circadian rhythm, more outta balance in someone else. And so they’re more likely to, um, have wakefulness inappropriately on into the night and then that itself can be a toxic effect on the brain. Um, so the lack of sleep is actually what induces the state of mania and then creates bipolar disorder. With O C D actually think of that as an inflammatory condition until proven otherwise. And when someone has OCD symptoms, especially if they came on precipitously, I always wanna know what was happening right around then. And for some people it can be a strep infection or a course of antibiotics, some kind of medical intervention, something that really changed and dysregulated the immune system in that moment, that then leaves the brain in this chronic state of inflammation. And that can show up as OCD symptoms.

Brad (00:43:59):
So in contrast to Dr. Ellen’s opinion, just expressed where, when we talk about bipolar, the prevailing notion is that this is a genetic driven condition with no, uh, no cure or something, something like that.

Ellen (00:44:17):
Yeah. I mean, definitely genetic predisposition is absolutely a part of it. And as we were saying earlier, um, that to me, that’s the least empowering or hopeful way of thinking about bipolar disorder. I like to look at the patterns of not just the genetic predisposition, but what seemed to be the ways that a bipolar brain gets outta balance. What’s contributing to that? Um, and so that’s where I think we have the ability to actually fundamentally heal the issue for some people.

Brad (00:44:46):
Yeah. I’m fascinated with Amber O Hearn, she’s the leading advocate of the carnivore diet. She’s been on podcasts and claims to, well, I mean, her claim is pretty substantiated. She hasn’t take any medication anymore. So she, um, pretty much cured a apparently a pretty severe bipolar condition through this, uh, crazy diet that, um, probably hasn’t made it into the medical journals yet. But when someone’s walking around talking about it, you’re compelled to listen. And I’m sure you have countless, as you said, count countless patient success stories who are no longer coming to you. That’s, you know, that’s gotta be a good thing.

Ellen (00:45:25):
I have a number of patients who have gone from being pretty brittle bipolars, like needing medication in and out of hospitalizations who are now not only not on medication, but are no longer symptomatic or not having depressive or manic episodes. That said, and for each of them, it was a slightly different journey for some people it had to do with light sensitivity and being very careful about their circadian rhythms for one of my patients, it meant getting off of alcohol and keeping his blood sugar stable. For still another, it was about gluten and thyroid issues for still another. It was about the birth control pill. Um, that said I’ve had a lot of failures with bipolar patients. Um, so it’s incredible when, you know, a bipolar patient truly fundamentally remedies their bipolar disorder, but it requires discipline that is sometimes hard to access once you’re already symptomatically bipolar, because there is something about bipolar disorder that can make it.

Ellen (00:46:23):
Um, you’re, you’re just a little less motivated to do that really disciplined approach to diet and lifestyle that will fundamentally heal the disorder. Um, partly the problem is mania is fun and <laugh>, it’s, it’s hard to motivate someone to fully move away from it that said, you know, I, I don’t wanna overlook the fact that someone’s struggling with bipolar disorder. Um, the depression is really not fun. And so they, they know that they don’t want that, but it’s just somehow that disorder I find doesn’t always lend itself to the discipline approach to diet lifestyle that’s required to fundamentally heal it.

Brad (00:47:00):
Well, it seems also, depression or anxiety sufferer might not have a great success formula to adhere to the wonderful lifestyle recommendations of cut out these foods, get more exercise, get more sleep. And so, um, when you run into that in your practice, how, what are some of your strategies and, um, secret formulas to get people to adhere to a comprehensive approach rather than I think most people can swallow a pill more easily than getting their screen use and their, their circadian rhythms optimized.

Ellen (00:47:35):
It’s a great point. And, you know, depression in particular where it can be hard to get out of bed. It can be hard to take a shower. It can be really hard to do a comprehensive diet and lifestyle approach to your mental health. Um, I am a big believer in it’s a little different for everyone, but for a lot of folks, it’s baby step. It’s incremental progress and you get some quick upfront winds, um, something like blood sugar stabilization for someone with anxiety. It’s not that much skin off your back. You take a spoon full of almond butter every few hours to keep your blood sugar stable. And if that can prevent panic attacks, then you’re already kind of cooking with gas right out of the gates. And so then you’re suffering less, you’re debilitated less you’re, you’re starting to feel hopeful and then you can make the next incremental change.

Ellen (00:48:17):
Um, and so, you know, certainly my approach is not boil the whole ocean at once. It’s what feels accessible to you right now. And doesn’t overwhelm you and, and resonates start with that, make a little progress. Then you’re standing on slightly more solid ground. You can make the next step. And I work a lot with the Gretchen Rubin types, sort of understanding different people. And I, I feel like I’m driving a manual transmission with patients. If somebody is an upholder, I almost have to hold back on how many suggestions I give them. Cause they can go run too far with that and become obsessive become orthorexic can sort of, it takes over their life. Their healing becomes a part-time job. Um, whereas someone who’s a rebel, uh, anything I say they will run the other way. So I have to kind of do this, you know, mind games of like, I know gluten free, so annoying, right? <laugh> that to kinda approach it indirectly. Questioners are my favorite, but anybody who needs to be convinced with science that’s my favorite thing to do is to sit with a patient and nerd out on here’s why this works. And here’s why this makes sense as a treatment for the way you’re suffering.

Brad (00:49:21):
Oh my gosh. I had Gretchen on the show, I’m a big fan of those four tendencies. So you would be a questioner. You already revealed that, I guess, right.

Ellen (00:49:30):
I’m a mixture of a questioner and an upholder. Yeah.

Brad (00:49:33):
Right, right. Um, and uh, you start to get good at identifying the tendency of the, the person you’re interacting with the patient in your case or anyone in your life. And then you kind of play to, uh, their strengths and so forth.

Ellen (00:49:49):
Yeah. Obligers are tricky because they want to people please me and be a good student and do the right thing that I’m asking them to do. But it’s dangerous when someone’s doing it for me. We need to be making these kinds of changes for ourselves as a radical act of self love. And it needs to feel like it’s a personal choice, not in a dynamic with trying to please someone else. So that gets tricky. I haven’t mastered that one.

Brad (00:50:14):
Um, yeah. Listeners obligers are those who answer to outside expectations primarily. So they’re really good at getting to work on time. And then when they get home, their home office is a disaster because they just haven’t had time to get to it. But, uh, the, the answer to the outside world really nicely, they get to the gym on time for the eight o’clock class, but they can’t seem to, um, you know, you hear a lot of people during quarantine, like, yeah, I’m, I’m outta shape because my gym’s closed. I’m like, what are you talking about? You know, I’m a rebel, I’ll work out anywhere. I don’t care what anybody thinks. I’ll, you know, I’ll take my shirt off in the hotel lobby if I’m running up the stairs and down. Fun stuff. Yeah. Go listen to that, show people. But that’s so cool that you integrate that into your practice. Really interesting.

Ellen (00:50:55):
Yeah. I’m indebted to her work. I think she’s brilliant.

Brad (00:50:59):
So with all these tools, uh, at your disposal, what is the role of pharmaceuticals, uh, in, in the, uh, overall picture, in your practice?

Ellen (00:51:12):
Yeah, I mean, I’m always reconsidering it and I’ll say as a, I I’m a psychiatrist and I prescribe medication and sometimes people hear my approach and assume that I’m dogmatically against pharmaceuticals and I’m not, I, I put people on meds. Um, I, it’s just not my default setting, knee-jerk reflex. Like I’m doing everything else first, not just as a, as a kind of philosophical reputation of meds, but really because it, for me, it’s a compulsive need to find the more elegant solution to a problem. If someone comes into me and they’re depressed, I’m not thinking that that’s Alexapro deficiency disorder, I’m thinking let’s do some sleuthing. What is this? Is this micronutrient deficiency? Is it a thyroid issue masquerading as depression? Is it inflammation? Is it dysbiosis? Is it, um, that they don’t have community or purpose in their life? It’s, it’s, you know, I always want to find the true root cause and address it there.

Ellen (00:52:09):
And then once in a while it feels like, well, in this case, the king, the keys to the kingdom are a medication. I don’t have a great explanation in my mind for why it works when it does. I think it’s a combination of different things. For some people, it truly is a placebo and I prefer to deal in fully benign placebos. But sometimes it, we need to pull out the big guns cuz that’s the only thing that will placebo them. And um, sometimes it seems to be, I have a patient with O C D and for her, Luvox, which is a particular SSRI that’s helpful in O C D is absolutely what works for her. That is truly the it’s a pharmaceutical solution to her problem. And I, I don’t deny it. And um, and then I think that one slightly controversial view on this is that I’ll see a lot of patients that, um, you know, they’ve been chewed up and spit out by the mental health world. I’m not their first psychiatrist. So they have a history of psych meds in the past. And I sometimes worry that the most effective a medication can be is as the antidote to its own subacute withdrawal. And so I have patients

Brad (00:53:21):
Say that again,

Ellen (00:53:22):
Sometimes the most effective a medication can be is as the antidote to its own subacute withdrawal. So I have some patients who went on a med originally, you know, like, let’s say someone was anxious and depressed and they met with a psychiatrist or a primary care doctor who didn’t do the sleuthing. Maybe it turns out that their depression or their anxiety was micro deficiencies, lack of healthy fats in their diet, chronic Lyme disease, lack of vitamin D, no sunshine, a bad job, a bad boyfriend. Um, and the birth control pill, right? So someone like that got put on Lexapro and their doc was like, is it helping? And the person’s kinda like, I don’t know, I, I might be crying less. And so then, you know, they stay on it for a while and then eventually they get off of it and, uh, cuz they feel better and they’re like, ah, I guess I’m fine.

Ellen (00:54:06):
They get off a bit. And then all hell breaks loose. They feel irritable. They can’t sleep, they feel terrible. So they go back on Lexapro and then they feel better and they say Lexapro saved my life. And I think in that instance, Lexapro was initially a little bit of a placebo that did much emotions, you know? So you are crying less, you’re a little bit blunted in both directions. A little, your lows are less low, your highs are less high, then you go off of it and you’re in Lexapro withdrawal and Lexapro is a fantastic treatment for Lexapro withdrawal.

Brad (00:54:36):
<laugh> um, it’s kinda like having a drink in the morning when you’re hungover, it’s

Ellen (00:54:40):
The hair of the dog. And so, um, and so basically those folks really credit Lexapro with saving them. Um, but I think we, we have not appreciated yet how much these medications can create a withdrawal state. And so sometimes I have patients in my practice that have been miserable ever since they got off a psyched, even if that’s years ago and sometimes every holistic approach in the world doesn’t scratch the itch and it’s actually to go back on that medication and I wish that weren’t so, but I have found that to be true once in a while.

Brad (00:55:13):
Well, I guess there’s possible placebo in there along with the actual pharmacological.

Ellen (00:55:22):
It, it could be that. Usually these are patients who don’t want to be back on the medication. Oh, Uhhuh <affirmative>. That’s why they’re seeing me. Mm-hmm <affirmative> um, so I think it’s, that’s a complex, that’s a complicated placebo effect.

Brad (00:55:33):
What’s a benign placebo that you prefer to deal in. What’s an example. Well,

Ellen (00:55:37):
It’s interesting. Cause I say that, but all the benign placebos I deal in it’s really just that the world would call them placebos. I think they have biologic plausibility for why they work. The world would say acupuncture is a placebo. It’s not, it’s real. They would say turmeric is a placebo. It’s not, it’s real. Um, so, you know, I, I say that I’m really glad you called me out on it. I’m not sure I even mean it. Um, because there’s nothing I use in my practice. Um, other than perhaps encouraging words that I truly think are a placebo.

Brad (00:56:08):
Uh, yeah, cuz I’m I’m, I might be wrong. I’m I’m thinking decades ago. My father was a surgeon and I, I, I think this is way long time ago that he used to prescribe glucose pills. Um, and you know, tell the patient something. I don’t know if they were allowed to do that a long time ago and say, take these whenever you get a headache and the person doesn’t know what, um, the term means on the, uh, maltodextrin capsule, 40 milligram. Um, do you know anything about that? Or are, are they, are you allowed to play with the, um, the placebo effect a bit even today?

Ellen (00:56:39):
That’s interesting. I don’t think so. I think we have really serious ethical standards around informed consent, but I also think that, you know, sugar does make people feel better.

Brad (00:56:49):
<laugh> yeah. Here’s some glucose. Yeah.

Ellen (00:56:50):
There’s, that’s actually not just a pure placebo effect, even in that case.

Brad (00:56:53):
Yeah. Here’s a chocolate bar. I’m gonna give you some Fen Ethel alanine, and it’s gonna become in this square thing and you break off one square, as it says on the label. That would be fun. Mm-hmm <laugh> yeah. Well we, um, I think we’re sufficiently excited to go grab the book and save hours and hours of, of therapy and, and travel back and forth from New York city. Uh, but those of us listening in New York City go, go check her out. Where else should we connect with you? Dr. Ellen, besides purchasing The Anatomy of Anxiety? We will leave a link for that in the show notes.

Ellen (00:57:25):
Uh, I’m pretty active on Instagram. I’m at Ellen Vora MD and, um, you’re welcome to come by my website, which is Ellen vora.com and sign up for my newsletter, which I promise one of these days I’m gonna start sending out actively

Brad (00:57:38):
Great show. Thank you so much. That really is empowering, uh, people close to me suffering from anxiety. And to think that you could categorize it and separate, is this true anxiety or is this, uh, false anxiety? I think that alone that single insight alone will help people navigate it so much more effectively. I know that, um, if I’m, you know, missing sleep or I’m up past my bedtime, I can reference many times in my life where I will feel, you know, a change in mood. And I’m, I’m thinking that it’s my, uh, reflections on my career and getting frustrated or, or depressed or anxious about something, but it also happens to be 11:30 at night when I should have been in bed at 10 21, like usual. So that’s super interesting to think how you can snap and then go into, um, mental illness when we’re, um, you know, let’s say chowing down bagels every day, unknowingly with the gluten intolerance causing inflammation, messing with energy production, mitochondrial function

Ellen (00:58:43):
As one last little mini pearl, just cuz you brought that up. This is such a transformative understanding of that. We get overtired when we stay up past the point when our body wants to go to sleep and our body thinks well, oh, we must have some good reason for staying awake. Maybe we’re on the night shift. Oh, there’s the war going on? So in trying to be a zealous employee, our body secretes cortisol our stress hormone, it’s trying to help us. And then we get that second wind. We’re tired, but wired and cortisol is our stress hormone. And then our mind starts to race with Remini thoughts and, and we start to think, well, everything is doom and gloom. Um, so it’s, it’s, it’s all about, um, getting over tired when we push past the point when we are perfectly tired and our body wants to go to bed.

Brad (00:59:21):
Right? It’s all part of magnificent, elegant design that we’re putting ourselves on high alert, uh, for, for a life or death reason, uh, to our primitive brain. Yeah. Interesting. I never heard, never heard a position that way. That’s great. I love that. Dr. Ellen Vora, people, The Anatomy of Anxiety, it’s now on your reading list. Go connect with her on her great Instagram and thank you for listening. Thank you for listening to the show. I love sharing the experience with you and greatly appreciate your support please. Email podcast@bradventures.com with feedback, suggestions and questions for the Q and A shows. Subscribe to our email list at bradkearns.com for a weekly blast about the published episodes and a wonderful bimonthly newsletter edition with informative articles and practical tips for all aspects of healthy living. You can also download several awesome free eBooks when you subscribe to the email list.

Brad (01:00:23):
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