We’ve Been Thinking About Anxiety All Wrong | ease

I don't think any of us are here wired

to be depressed or anxious. I think

again that that's those are symptoms

communicating imbalance and unmet needs.

I don't want to have to rely on medicine

for the rest of my life. No, no, no, no.

Before you feel hopeless, before you

feel

any type of despair, I want people to

know there are many paths up this

mountain. Maybe I should also gua sha

and do an infrared sauna. Maybe I should

meditate in the infrared sauna. Should I

drink electrolytes? Like

>> [music]

>> we have this overwhelm around wellness

practices. We are now fighting back

against a world that's taken us so far

from our basic needs. And I think

especially this age of AI, there's an

assault on truth, on [music] how we can

trust what we're seeing with our own

eyes. I think we need other mechanisms

for feeling what's real and feeling

what's true. And I think that happens

first in our physical bodies.

Should I lead us into a little

meditation? So, this is just my practice

now. Anytime I'm about to sit down and

write or record a podcast or give a

talk,

I want to make sure that I'm in

alignment with my intention. And so,

it's helpful to even just identify for

myself, you might want to identify for

yourselves, what is your intention in

this moment? Usually mine is some

compilation of I want to be of service

and I want to be in service of

everyone's highest and greatest good.

And then [clears throat]

I'll take Let's take us into it. So, go

ahead and find a comfortable seated

position.

You can allow your eyes to close if

that's comfortable. And if it feels more

comfortable for anyone listening to just

have a soft gaze, that's okay, too.

And just allow your breath to

feel easy, nothing forced.

And

simply observe what it feels like to be

sitting here in this moment,

supported by the chair, supported by the

floor,

feeling your body brimming beneath the

surface, and see if you can cultivate

a stance of loving awareness.

And you can even repeat to yourself, I

am loving awareness.

This is from Ram Dass, where he would

sometimes repeat continuously,

I am loving awareness.

And [snorts] finally,

just

calling in support from source,

the divine, ancestors,

whatever feels resonant, and asking all

of them to work through us, and allow us

to be in service of everyone's highest

and greatest. With reverence, with

gratitude.

And so it is.

And then, whenever you're ready, you can

allow your eyes to blink open.

And now it's nap time.

>> [laughter]

>> And now we go to sleep.

>> This is

>> That was

I love that mantra that you have.

>> Yeah, that's just the language that

makes sense to me, but this can be

completely individual.

But I think it is helpful and actually

powerful

to name that. To say, well, what are we

doing here? Right? Like, what is this

for? Is this to make money? Is this to

inflate our ego? Like, sometimes it's

helpful to make it explicit. No, no, no.

Like, yes, we need our like our physical

bodies need their needs met. We're all

on our journey of learning and growth,

but really when we show up to do our

work, make our contribution,

the point of that is to be of service.

To be in service of everyone's highest

and greatest.

>> Uh, I love that so much. And like,

usually when I meditate or pray, I like

to ask God to

like

allow me to be a vessel.

Is what I like to say. And I know that

you said that before, too.

>> let your words flow through me.

Which is similar to what you said. But

we all have like our own different

languages, which I love.

And we, you know, and each of us can mix

it up all the time.

And yeah, I think it's all powerful. I

think, in my opinion, in my experience,

it actually does

change what occurs. I almost feel it

tangibly. Like, then I start to feel

that moving through me.

And means I can show up and do my work

better.

>> Yeah, I like love even how

quick that was to just kind of like take

that breath and like reset and

reconnect. Cuz sometimes I feel like I

want to set time to just like meditate

or have a clear intention or just start

my day right by like aligning myself and

just taking a breath and being like,

I'm here. Like, I'm present. It's okay.

And I also am such a like lover of

meditation. Like, I feel so connected to

myself after. I try to do it as often as

I can, but sometimes you just get caught

up in life with literally work and then

like

my dog, my pets, my family. So, I like

that I'm able to kind of like be like, I

can even just set aside 2 minutes. Or

like 3 minutes to just like come back to

me.

>> Yeah.

>> And it doesn't have to be like a whole

like hour meditation.

>> I mean, an hour's great, but it has to

be realistic for us. And I think the

fact that I've made this practice such a

bite-size piece means that I do it

constantly. So, in the end, you know, I

think there's something holy about about

opening in that way. And And just being

receptive, putting yourself into that

frequency, I think is very powerful. So,

even though I never sit down and

meditate for 20 minutes, it's not for an

hour, but I'm in that receptive state

probably 30 times a day. And I think

that that adds up over the course of a

lifetime.

>> You know, it definitely does. If being

present is so important, if you're able

to like

close your eyes and be present, really

spending that quality time with

yourself.

>> Yeah.

>> Which is really important. And also in

like big cities like New York City,

where everything is literally moving and

everyone's in a rush. Everyone's nice,

but everyone's in a rush.

>> [laughter]

>> Um cuz it's so true, there's things

always like constantly moving. Life is

crazy for everyone. It's important to be

able to have that moment with yourself.

And sometimes an hour is not realistic.

>> I feel like nowadays in the digital age

and online, anxiety and the term anxiety

is something that I feel like I was

aware of since I was probably in middle

school or high school.

>> Mhm.

>> It was just like a term that I would

like hear older people talk about. And

as I, you know, started going to school

and like growing up and my brain started

developing, I was like, "Okay, I'm very

much aware of anxiety." But there's just

kind of like this like fine line where

like anxiety gets thrown like the word

anxiety gets thrown around a lot.

>> Yeah.

>> Could you help us start by defining what

anxiety actually is and explaining what

it means to have an anxiety disorder?

>> Mhm.

>> I can certainly talk about well, how I

was trained to think about anxiety, but

over the course of 14 years in practice,

my view of anxiety has evolved quite a

lot. And I was trained to identify these

disorders. To say here's diagnostic

criteria and there's an umbrella of

anxiety disorders and within that

there's things like generalized anxiety

disorder, a kind of pervasive 24/7 state

of worry and tension and difficulty

relaxing, difficulty falling asleep.

Some people have social anxiety, which

it's triggered in social settings and

there's a lot of fear of judgment, fear

of what it

what it feels like to be perceived by

people and how that can be activating.

There's um post-traumatic stress

disorder, PTSD. It's an anxiety disorder

um with hyperarousal, with flashbacks

and limbic activation. And then there's

things like OCD, obsessive-compulsive

disorder, panic disorder, which can have

agoraphobic features or not. So I was

really taught to think about it as there

are these disorders,

our understanding of the mechanism is

that it had a lot to do with things like

serotonin, sometimes trauma, sometimes

social factors.

And that's all well and good. That

started me off in my career and I was

categorizing patients according to their

diagnoses or according to their

symptoms and diagnostic criteria.

And I've really moved away from looking

at anxiety in that way. Let's say let's

boil it down physiologically and then

let's boil it down more

psychospiritually. I think

physiologically, your body's in a stress

response. There's cortisol, there's

adrenaline, these classic stress

hormones. And that creates a state of

activation. Some of us are experiencing

that in a really um pronounced way

that's uh a distinction from the

baseline. So a panic attack would be

almost like your baseline is calm and

then suddenly it's zero to 60, you're in

a a very peak stress response with

things like light-headedness or

dizziness and tunnel vision, tingling in

the hands and feet, shortness of breath,

you can even feel heart palpitations.

And then there's often a thought that

goes along with it, like I'm going crazy

or I'm going to have a heart attack or

I'm going to lose my mind. And people

can feel very stuck, very trapped or

suffocated in a panic attack. That's a

very pronounced version of a stress

response, but there's a lot of low-grade

stress responses, too. So, something

that we might call generalized anxiety

disorder might be a person whose body is

in a low-grade state of a stress

response much of the time. That's the

physiologic mechanism.

Psychospiritually, I think anxiety is

rich. There's a lot that goes into it,

but maybe at its essence, it's what I

like to call the inherent fragility of

walking this earth in a human body.

>> Oh,

you're right.

>> The fact that this is an impermanent

experience.

That everything is impermanent, that

there will be a point when we all die,

that we lose the people that we love,

that we might even suffer. And I think

that we can go our day-to-day lives

avoiding thinking about that, but it's

there.

>> It's there.

>> And I think a lot of us have anxiety

because we have not really made right

with our relationship to that

inevitability.

>> Holy moly. That makes sense.

>> And it's not to say we need a death

wish. Like it's more that we just need

to grapple with these bigger questions

of life. An ability to make meaning out

of what's occurring here. And I think

anxiety has a lot to do with when we

haven't lived those questions and we're

just kind of pushing it into the closet,

avoiding it.

>> Interesting.

>> If anxiety feels more intense, does that

mean that

we still just like constantly

have this thought about like death? In a

sense, it's like an existential

>> Yeah.

>> POV of life.

>> You know, in in my book, The Anatomy of

Anxiety, I break anxiety into two types,

into false anxiety and true anxiety. So,

that psycho-spiritual thing we just

talked about, the inherent fragility of

walking the earth in a human body,

that's true anxiety. And that's where

sometimes our true anxiety is not a

problem. It's not something out of

balance. It's really just our inner

compass nudging us. It's tapping on us

and saying, "Hey, like you know

something's out of alignment here.

Something requires your attention. Maybe

you need to course correct something."

So, sometimes we have a lot of strong

true anxiety, a feeling of I am not in

the right relationship or in the right

job or I need to change some things in

my personal life or my community needs

me to show up in a different way or the

world at large needs me to help course

correct in some way that seems synced up

with my personal passions and interests

cuz I don't think we need to be every

kind of activist. I think that's

actually generating quite a lot of

anxiety cuz there's a lot of problems in

the world.

>> We're at a point now where we can be on

social media aware of everything that's

wrong in every corner of the world. The

human brain did not evolve to

be able to triage that much disaster.

>> So, we need to know what syncs up with

our personal gifts and passions and what

really matters to us and that's where we

focus our energy often on a local level.

But that's where we we feel really

strong anxiety, maybe we have a strong

true anxiety that's saying, "You know

you need to show up in this way." But my

hot take is that so much of the

suffering and all the ways that we're

all so anxious these days, it's what I

would call false anxiety. That is what's

getting most of us out of balance.

>> And what is false anxiety for people who

don't know?

>> So, false anxiety, that term sometimes I

regret that term.

>> [laughter]

>> But, you know, I know how it can be it

can land as a sort of invalidating

statement like your anxiety is not real.

That's not what it means. Your anxiety

is all too real, right? This is

life-altering suffering.

But I call it false anxiety because of

the fact that

it is related to a state of imbalance

and it doesn't have to be happening. And

if we can address that state of physical

imbalance that's happening in the

physical body, then we can eliminate all

of this unnecessary suffering. So false

anxiety is just anxiety that it's not

our deep essence, it's not our inner

compass, it's not inevitable. It's a

state of imbalance in the physical body.

We do best to just address it and then

we'll walk away from all that anxiety.

>> Yeah. I I feel like the way that I'm

understanding is we all kind of have

this feeling and knowing that we are

more than just like the physical human

body. Call it a soul, call it

consciousness.

And sometimes we get so trapped up in

feelings like anxiety

that literally physically ground us in

our body and like stress us out that we

forget that we're also

this other thing. What you're kind of

saying is like if you're able to come

back to like

your

presence and your like consciousness,

then you realize that anxiety is just in

the body and that's something that can

be controlled. Like it's not all

defining. Like it's something that also

can be fixed.

>> Yeah.

>> Yeah, so where you started there, I

think are like the deeper questions of

all of this and I'm [laughter] with you

on that.

Are we a spirit, like a an eternal

transcendent

consciousness that's having a physical

experience? I believe I tend to believe

that. Um but in having that physical

experience, here we are with a meat

suit.

>> Yeah, literally. And that gives us

anxiety.

>> It gives us well, that that is prone to

anxiety in the modern environment.

>> And certain past environments, too. But

I think that's what's happening here is

that this meat suit has a lot of needs.

It has a need for fuel, it has a need

for rest, it has a need for like it's an

elaborate houseplant in many ways. It

can needs healthy soil, it needs

sunshine, it needs good water. I think

in modern life our poor little

houseplants are shriveled up in

unhealthy soil and

deprived of sunshine and often quite

dehydrated. We don't have our meat

suit's needs met and that's generating

so much of the world's anxiety.

>> Oh.

>> And so it's really about understanding

what keeps this physical body in a state

of balance. What are its needs? How do

we meet those needs? How do we not get

in the way? Cuz the design of it is

actually really good. Like with the

exception of the knee joint and

menopause, like I think the design of

the human body is very good. But um we

are often getting in the way of its

processes and we're failing to meet the

body's needs and I think that's

generating a lot of stress responses

which then subjectively show up as I

have anxiety.

>> We were talking literally yesterday or 2

days ago. We both were like I've been in

my head so much like not so feeling my

body.

And then we were like oh we're we're

getting anxious like because we were

kind of not neglecting our body but like

not paying attention to like okay, we

need water, we need food and like we're

just constantly working.

But that's interesting that you said

that because when you're too much in

your mind, you can not focus on like

what your body needs and then it creates

>> a loop.

>> Yeah, literally yesterday we were

talking about how we like I just gotten

off a flight and we were working cuz we

had a bunch of things we like needed to

turn in and

and then

I was like you have to like work and

show up and be a good daughter and also

like meditate but drink water like don't

forget to drink water and like, there's

so many things that you need to keep in

mind. Sometimes I wish that kind of like

Tomo- Tamagotchis and like little like

pets online, there's like a bar that

tells you like what they need.

>> Like Sims.

>> Yeah, like Sims. They need water, they

need food.

>> like need to be

>> Relationships are down, you need to

socialize a little bit.

>> Go to the bathroom.

>> [laughter]

>> I wish we had that.

>> three things to say in response to this.

We'll see if I can keep track of the

bullet points. And

>> Tamagotchi.

>> [laughter]

>> The second bullet point is

Oh, I remember. The wellness industrial

complex. So, keep me on track with all

that. So, with the Tamagotchi, I

remember when I had my daughter and she

was a baby, you'd be like, "Okay, this

baby's cranky. Why?" And over time, I

came to realize I needed to keep a list

on the fridge cuz there's a finite list

with a baby. It's like, "Is she tired?

Is she hungry? Does she need to be

burped? Does she have a wet diaper?"

Like, you kind of have to Is she

teething?

>> Somehow, I would never have the presence

of mind when I was just like faced with

she's upset about something, what is it?

That was a relatively simple list for an

8-month-old. We adults, we are just

oversized toddlers in so many ways, but

we also have a certain list like the

little animal. And it's like,

ultimately, we need rest, we need

nourishment. I think we do need

sunshine, we do need movement, we need

community, we need a lot of different

micronutrients.

And once we start to meet those needs,

some physical, some more

psycho-spiritual,

>> we're pretty well. And this ties in with

the wellness industrial complex because

I think anybody these days like who's

listening to these kind of podcasts,

like, we're in certain ways inundated

with wellness to-dos. We know we have to

do all the things. It's like, "Oh, maybe

I should also gua sha and do an infrared

sauna. Maybe I should meditate in

infrared sauna. Should I drink

electrolytes?" Like, we have this

overwhelm around wellness practices. And

I think that it's sometimes important to

recognize

it's become so overwhelming partly

because of capitalism and the wellness

industrial complex, but partly because

we are now fighting back against a world

that's taken us so far from our basic

needs. If you think about organic food,

used to be that's just what food was.

But as we've taken on larger industrial

practices and chemical fertilizers, now

you need to kind of make it fancy and

bougie to get back to food that just

growing. We are building back the

village in so many ways.

>> The other day I saw something on Tik Tok

that was like basically a full body MRI

scan. It just made me think about the

fact that like there's so much going on

in our bodies and it's kind of hard to

keep track on your own. As much as like

you can be so in tune with your body,

nowadays there's so many factors.

So even kind of going back to like

anxiety and how that's something that

our body is essentially telling us like

there's a need that isn't met.

>> Yeah.

>> This needs a little more like attention.

>> Yeah.

>> How can we like figure out how to like

understand our bodies and like be aware

of

what we need?

>> The full body MRIs, to me it's not a

no-brainer. That's that's actually not

such a simple question because there is

such a thing as incidentalomas. There's

things that you'll pick up that are

incidental findings on a full body MRI.

You didn't know you had that won't

necessarily be consequential, but once

you know you have it then there's stress

that comes with that. There's sometimes

invasive procedures and decision trees

around should we intervene or not. And I

think that

it also for me it's a practice that

reinforces this idea that we don't know

our bodies, external instruments know

our bodies. And of course there's a time

and a place for scans and preventive

like I get it. But there's also I think

a hotline to our own internal state that

we need to dust dust off and strengthen

that we've gotten very atrophied with

tuning in. We need to be full body MRI

scanning ourselves all the time, but

from a perspective of

tuning in.

>> The idea of like relying on something

external is complicated and like not the

best thing to do because even in doing

like when I stumbled across this video,

this Tik Tok, I was like, oh, I need an

MRI scan. And it was almost like this

sense of panic a little bit. Like I was

like, oh, I want to see what's going on

in my body.

And

that is me like

already kind of getting ahead of myself

and having like this anxiety over

something that I'm not even like sure

of. And I think that like that just

shifts the focus to like fear based

rather than like let me like just like

tune in with myself and see how do I

feel right now?

>> Yeah, exactly. And even that fear of

like I should get that MRI or once you

get it you're waiting for your results.

Like all of that chemical stew of fear

that we bathe our bodies in, it's

material that has an impact on our

health. And so we just don't want to

approach it lightly. It's not to say

none of us should ever get an MRI. It's

more that

um we need to weigh all of those costs

and benefits.

And fear matters a lot and our own

relationship to our bodies matters a

lot. I like to bolster our ongoing

dialogue with ourselves and our trust of

our bodies. I think our bodies are

actually very good at communicating to

us states of imbalance. That's a big

part of how I look at mental health

differently than how I was trained. I

was trained to say, you know, this

constellation of symptoms is what we

call depression, is what we call anxiety

as though that's a thing. As if that's

really an entity like you have

depression, you have anxiety. I think

depression and anxiety are themselves

symptoms. Those are not the final

verdict. Those are the beginning of the

inquiry. It's It's not telling us what

you have, which would sort of imply, now

that we know what you have, we know what

to do to heal you or cure you. Those

Those terms don't tell us how we cure

you. Those are symptoms. They're not

telling us what you have, they're

telling us, here's how your body is

communicating to us about imbalance. And

it's at that point we roll up our

sleeves and start doing the

reconnaissance and the digging and say,

okay, so why are you exhibiting this

symptom of anxiety?

>> Or this symptom of depression. What is

the body communicating?

>> Growing up, I was always like a very

like fidgety child. Like I was always

like talking in class or like grabbing

things and like there was a time where I

had like even counselors tell my mom and

like pull my mom in and be like, we

think she might have like ADHD cuz she's

always like talking and touching things.

Um she's great, but like she's like a

little distracted.

And my mom was very much like the type

of mom that was like, I don't want to

put my child on medication. She's also

very Mexican, so she's like, I come to

the United States and they're like

saying that she has like ADHD and now

she has to get on medication. Like

that's just like a lot.

So she was just kind of like, okay,

let's like see where this goes.

I will offer her like support. So

growing up, that kind of started getting

complicated because I kind of was going

undiagnosed. It like escalates the

problem a little bit. Like things start

You know, you're not diagnosed, so like

you start noticing other things kind of

like trickle into your life. So I

started experiencing like anxiety and

depression. And when I first had that

like side effect of like or like was

experiencing anxiety and depression, I

remember just being so not healthy with

my body.

I was not getting enough sleep at all. I

was like not eating my three meals a

day. I was not going outside and getting

exercise and walking. Um and these were

all like things that a human being needs

to be happy.

>> Mhm.

>> And it kind of like reminds me of what

you're saying with like anxiety and

depression being side effects of the

fact that like it's something is kind of

lacking. Anyways, I ended up going to a

really great doctor and he basically

gave me anxiety medication. And he also

told me, he was like, "This is just as

important as the medication. You need to

be eating three meals a day. You need to

walk. You need to go Yeah, you have to

go exercise for an hour every single

day. Like it's just as important as

taking the medicine."

>> Yeah.

>> I've seen such a change and shift over

the last like 2 years that I've been on

it. Um and you know, like listening to

the doctor's orders.

But [laughter]

But um it did kind of like bring me back

to what my mom was initially saying and

I don't want to have to rely on medicine

for the rest of my life. And I think

that that's what my mom was kind of like

afraid of and feared a little. It was

like, "Okay, she starts a medicine, but

then

this is something that she'll have to

take for a while and the side effects of

that." I think right now I'm at a place

where I'm like, "This has helped me so

much and I'm so happy that I was able to

get this diagnosis and get something

that was able to like change my life and

help me."

>> Mhm.

>> Um but I don't want to have to rely on

it for the rest of my life and have to

like take a pill every single night. I

know you talk in your book a little bit

about like holistic healing and how

you've had some of your patients who

you've been able to get them off of the

medications that they were on naturally

and transition naturally.

>> I mean, I've never framed ADHD this way

before actually, but in hearing you

describe it, sometimes I do think

there's a little true and false within

ADHD as well. And to me, there's no

question that there is such a thing as

like true blue ADHD. Now, do I think

it's actually a disorder something

pathological? I don't. I think it's a

normal and meant to be aspect of the

neuro divergence of human brains. Like I

think we need all types of humans and we

need the person who's like I'm focused

and then we need the person who's like

I'm taking in a lot of data right now.

>> [laughter]

>> Sometimes I'm hyper focused on one

particular very rewarding thing. So

there is true blue ADHD no question.

Is it pathological inherently? I don't

think so. Is it a mismatch for our

modern school and work environments?

Often in different ways for boys and

girls, but I think that there is also

sometimes some false ADHD that's

happening and it will often happen with

someone who has that intrinsic ADHD-ness

underneath, but they're more symptomatic

than they need to be and that can relate

to things like inflammation, like zinc

and magnesium levels, but the thing I

see overwhelmingly most common is that

it's related to breathing and in

particular how someone's breathing

overnight while they're asleep. So more

times that I could possibly count,

there's someone who is breathing through

their mouth rather than their nose

during the day, but also while they

sleep at night. They're not getting

adequate oxygenation or sufficiently

restful sleep and then their brain is

basically so exhausted that it kind of

stems itself into hyperactivity during

the day and it struggles with executive

function because it's not a rested brain

during the day. So you see all the

symptoms of ADHD exaggerated by this

chronic sleep deprivation that's the

result of

disordered breathing. So

when someone is ADHD like a child, I

always want them to be evaluated for

airway, for how they're breathing and

just to make sure we're setting them up

for success to breathe through their

nose especially while they sleep and not

to say we're curing ADHD with that.

Sometimes someone still requires

medication, but often they're less

symptomatic and I think that's it has a

profound impact on their overall

well-being, mental, physical health on

into the rest of their life.

>> Yeah.

>> So, in terms of medication and that

whole journey, I think, you know, I I

don't know exactly what went through

your mom's mind in that moment, but part

of where I have a just a different

relationship to psychiatric medications

than my colleagues is that it's the

implication

that mental health is a fixed trait.

That we're basically saying, you are

someone who is wired to have anxiety or

depression. You are someone who has a

genetic chemical imbalance, but don't

worry, we can fix it with a pill. I just

don't buy that that's the makeup of the

human genome. I don't think any of us

are here wired to be depressed or

anxious. I think, again, that that's

those are symptoms communicating

imbalance and unmet needs. And so, I

have much more of a growth mindset

around depression and anxiety. I think

that it's not a fixed trait, it's not a

genetic chemical destiny. It is

something communicating imbalance.

Sometimes it's necessary to add a

medication as a bridge to pull somebody

out, to get them doing okay in their

life while we do that work of

understanding what's the physical

imbalance, what's the psycho-spiritual

unmet need. But, I don't approach that

decision lightly about whether or not to

start someone on a medication. My only

hesitation around starting someone on a

medication is what can happen when if

and when they want to get off of that

medication.

So, that's what gives me pause because

for some people they can get off of a

psychiatric medication, no big deal, and

that's beautiful and wonderful, but for

a lot of folks, and I think it's

under-appreciated and under-diagnosed,

there's um a lot of

post-SSRI sexual dysfunction. There's a

lot of um people having subacute

withdrawal for many months after getting

off of a medication. The discontinuation

process is generally harder than we

appreciate, and it needs to be

approached in a really careful way. You

want to go so much more slowly than

people typically know to do, including

the prescribers. So, sometimes I'll I'll

still hear in the community that a

prescriber is saying, "Okay, you want to

get off of a medication." Usually

they'll discourage it, but then if you

you know, reluctantly they'll agree to

support it, and they'll say, "Why don't

you cut the dose in half, take that for

two to four weeks,

and maybe cut it in half again, and then

go off of it." And that's woefully

too rapid. That's not a safe way to

approach it, and I would like to work

with a compounding pharmacy. That's a

pharmacist that's going to actually use

the sort of ground down powder of the

medication, so that they're siphoning

out the exact amount of medication,

and reducing it about 10% of the

original dose per month.

So, it's typically taking a minimum of a

year.

And that's just for one medication. So,

if you're on multiple medications, then

you wouldn't really want to approach

them all at the same time. You would do

a year to get off of one, a year to get

it off another. And I know that people

can feel discouraged by that

information,

but the whole idea of this is that it's

not even a process you have to think

about that much. You just get your

prescription every month from the

compounding pharmacy, take it in the

background, don't even overthink like,

"Uh-oh, am I going to be in withdrawal?"

cuz that we're suggestible. But you

basically want to get to the point not

that you're still medicated, but just

that you have enough medication in your

system that it's

mitigating the withdrawal. So, your

brain can slowly adapt to the removal of

the medication.

>> Do you have to replace

the what the medication was giving you

with something else? Just first thing

that popped in my head was like, you

have to be outside more in the sunlight.

Cuz like that's what's going to be

making up for like

>> Yeah.

>> the serotonin that's in your receptors.

>> I won't even start someone on the

tapering process until they've clocked

about a month of supporting all those

other needs. So, really good nutrition,

good sleep habits, exercise, getting

outdoors, a healthy house plant,

sunshine, water, soil. And so, all of

that is like the necessary precondition

to even begin the process cuz the

process is a challenge on your body and

on your brain. And you want to come in

really solid and I want someone to

continue those habits throughout the

process. The real way to give your brain

the micronutrients it needs is

nutrient-dense foods. Chicken liver pate

is a very nutrient-dense food. Red meat,

different parts of the animal, not just

muscle meat, eating the whole rainbow of

different colors. So, all the different

brightly pigmented fruits and

vegetables. These are ways that we check

all the boxes on the nutritional

scavenger hunt.

>> Wow, okay. That's so good to know. I

feel like through Ease, I really have

understood how important food is and how

it impacts everything.

>> Mhm.

>> I like really

appreciate and resonated with you saying

that anxiety and depression is a symptom

of your body telling you, you know,

information, giving you feedback and

input and that it's not a life sentence.

I feel like a weight was lifted off of

my chest just now.

>> That's right there

the whole reason for everything I do.

>> The way I think about healing is as a

mountain. The top, the summit of the

mountain, this is where you feel good,

where you're resilient and hopeful and

mentally stable and energetic and clear

and have capacity. And that is that's

where we're trying to get to. And

currently, my field of psychiatry,

psychology, it's offering two well-worn

paths up that mountain. It's saying you

can try medication and psychotherapy.

And for some people, those paths get

them all the way to the top of the

mountain. I always count as a victory.

But I just have been at this long enough

to know that a lot of people hit dead

ends. They try one path, they hit a dead

end, they sort of keep trying other

versions of those paths. You add maybe

you increase the dose of a medication or

add an augmentation strategy or you try

a different therapist or a different

therapeutic modality, but they're still

not getting all the way there and

they're starting to feel really stuck

and even despairing. They might feel

like, well, this is supposed to work,

it's not working for me, so I must be

beyond repair.

And [clears throat] that is the thought

that I want to disabuse people of.

That's where I want to intervene and

say, no, no, no, no, before you feel

hopeless, before you feel

any type of despair, I want people to

know there are many paths up this

mountain. And where people feel stuck,

that's where we just need a different

conversation about mental health, which

helps people know that those two paths

are not the only way up.

>> Thank you for saying that. We have some

questions from our audience for you. Um

so we want to take some questions and

play one of those.

>> Great.

>> Hi. So I feel like my anxiety gets

so much worse when like I'm on my period

or like I haven't been sleeping well.

How do I know that what I'm feeling is

like something I actually need to like

emotionally work on or if it's just like

my hormones being crazy?

>> That's a good question.

>> It's a great question. The luteal phase

gets you.

>> Yes, [laughter]

the luteal phase will get you every

time.

>> It's um so that's right on cue, right?

This is exactly what we're talking

about. And and like thank you for this

question and and I'm sure you're

speaking like many people are going to

resonate with this. I actually disagree

with that um dichotomy though of like is

it something I need to emotionally work

on or is it just my body being out of

balance? Your body being out of balance

and that's something to work on not for

like any moral reason, but so that you

don't have to suffer so much. It's

basically we have an exaggerated

experience of PMS in modern life, and

that creates a lot of suffering, and it

shouldn't be happening. So, we want to

get the body into balance. Let's talk

about the period for a moment. This is

something that I think we're really

under-educated on, and now there's a

conversation happening, which thank god

and not a minute too soon. So, basically

our menstrual cycle, day one is the

first day of bleeding, and that's

technically the beginning of the

follicular phase, but that's what we

call the menses or the bleeding phase.

That's what we call like on our period.

And that's a pretty tender time. We can

be emotional, there can be cramping and

all of this, low energy. It's not the

time to be doing like a hit workout.

It's a time for naps and baths, reading

a book with a cup of tea under a

blanket.

And then, once the bleeding starts to

abate, you're really in your proper

follicular phase, those first 14 days of

the cycle. And that's the phase, I think

of it as in the yin yang, that's the

yang phase of our cycle. That's when

we're energetic, we're outgoing, we're

social. It's a good time to record a

podcast or do a speaking event.

>> I'm in my follicular phase.

>> [laughter]

>> Yeah, you should have me, too.

And then we ovulate, which is a time of

heightened libido, and sometimes even

sleeplessness, and that's a time when we

are fertile. But then, as soon as you

ovulate, you tip into the luteal phase.

It gets a bad rap.

>> Yeah, and it does.

>> That's the second 14 days of the cycle,

and that's dominated not by estrogen,

but by progesterone. And it's a time

when we're a lot more tender, we're a

lot more emotionally raw. As we get

closer to the bleeding phase, that's

what we call PMS, where

I think what, you know, we have

emotional, we have a lot of cultural

baggage around the PMS phase. We say

someone's being irrational or [ __ ] I

think that we actually have a decreased

filter. I think we are more connected to

the truths and the injustices, and we're

less willing to tolerate BS in those

days right before our period. So, our

world says we're being irrational. I

actually think we're being irrationally

chill in our follicular phase and we're

being rationally like what the hell in

our late luteal phase. So, it's not that

I think you need therapy to address all

of this. I think you need functional

medicine, naturopathic medicine, Chinese

medicine. Think we need to get the body

into balance so you don't have to suffer

so much. And that's really in terms of

nutrition, inflammation, and digestive

support, rest, all of that good diet

lifestyle practices that keep your

physiology intact. That's how you can

have a less pronounced PMS phase.

To know when you're follicular, to know

when you're ovulating, to know when

you're luteal, when you're about to get

your period, it's so eye-opening because

I used to be like

I am so bloated and nobody likes me and

I don't like anybody and I would just

have that feeling and I'd be like, "Oh

my gosh, my life must be so bad." And

what I know now is that like clockwork,

I have those feelings exactly the day

before I get my period. And when I when

you have that

when you're sort of grounded in

understanding that there's an a hormonal

role in those feelings, you're going to

be like, "Okay, it's a bit of a false

mood." There's still some kernel of

truth to what really feels alive in us

in those days before our period. I think

there's sometimes important messages

that come through.

But you can take it all with a grain of

salt. You can recognize that your body

is having a more pronounced

reaction. [clears throat]

And so, just to know that there's a

hormonal component to how we're feeling

is powerful.

>> So, we have one more question for you.

>> I have always been an anxious person

and have dealt with anxiety for a long

time. When I was in school, I dealt with

agoraphobia to the level where I had

panic attacks in specific classrooms.

And it was especially hard when I was in

this class, I saw the same people every

other day. So, on top of the anxiety, I

also felt the pressure of their

perception of me having a panic attack.

I am curious what practices or tools you

have seen help your patients with

agoraphobia or how to deal with active

panic attacks?

>> That's a great question. Okay, thank you

for that question. So,

here we go.

Basically, the way I think about that

agoraphobia with panic panic disorder

with agoraphobia is that it can snowball

where you start to associate that

setting with having a panic attack. So,

it's like that expression fear of fear

itself. Like, you start to think about,

"Oh, no, that classroom, that's where I

had a panic attack before. It's so

exquisitely uncomfortable and I feel

shame and judged by the people there."

So, then all of those associations and

all of that anticipation revs your body

up and potentiates and makes it more

likely that you'll panic again in that

setting. And so, for a number of

different reasons, the association it

can snowball and make it more likely.

We need a reset in two different ways.

One is exposure therapy. Basically, what

happens with panic disorder is that your

life starts to get small cuz you

understandably want so desperately to

avoid having a panic attack. So, you

think, "What if I just don't go to that

class or don't go near that classroom?"

And you know, on one level we're

thinking, "Okay, this is a good way to

prevent a panic attack." But it just

keeps making your life smaller and

smaller. It actually reinforces the

cycle of that that classroom means

you'll have a panic attack. And so, we

kind of make it proliferate in the

avoidance of it. So, what we want to do

is work with a therapist ideally who

does exposure therapy and you start to

slowly in a structured way develop the

skill of you do it scared. And you

witness yourself

having the experience of you went

through with it and you were okay. Or

even you you went through with it, you

had a panic attack and you were okay.

And so you want to keep making your life

big again, not smaller. But then also

physiologically, I always think about

like it sounds like you're already

working with a functional medicine doc

and and have that support. But panic

attacks,

um you want to prevent the body from

dipping into a stress response in any

way. Alcohol use is going to potentiate

that kind of stress response. Sleep

deprivation, lack of movement, um with

nutrition, you you want not only to be

really

rock solid stable blood sugar and

really replete on your nutritional

stores, but you also want to avoid foods

that make your blood sugar swing, cold

foods. This is more of a Eastern view of

things, but you want grounding warm

deeply nourishing foods. That's what's

going to stabilize you in those moments.

And so there's a lot you can do to set

your body up to be very stable as you

head into that kind of setting, then do

exposure therapy, and minimize the risk

of having another panic attack.

>> Back to the house plant.

>> Yeah.

>> Back to the house. It's always back to

that.

>> And it just reminded me even you when

you were like minimize like alcohol, I

was like, well if you were given a house

plant alcohol,

>> Mhm.

>> it would probably be kind of like wonky

a little bit.

>> [laughter]

>> That's right.

>> So that makes sense in my head.

>> That's right. Not the right way to water

a plant.

>> Yeah.

>> We want you to feel at ease a little

bit. We've been yapping. So,

if you can paint us something that

brings you at ease, we'll bring in the

paints that right now.

And then um we'll ask you a question

once you start painting.

>> Yeah.

>> As we've talked through everything

today,

a kind of theme that I'm getting or

lesson is throughout social media or

media in general, everything that we're

we're in this era of influence. You've

mentioned like listen to your body and

how that's more important sometimes than

being told what medicine to take. How

can we think better for ourselves?

>> Mhm.

>> I really appreciate that question

because while I paint um

>> [laughter]

>> and soothingly don't make eye contact.

>> Which is a whole need we have sometimes.

>> Just to be in parallel play

communicating. So, um this is the topic

of my second book, the book that I'm

writing now. It comes out in October.

It's called Season of the Witch, a

psychiatrist's case for magic.

And it's told through the arc of grief.

It's really a memoir about losing my

parents and and everything that I

grappled with in the wake of that. But

that's really where I learned to have a

very insourced, like as opposed to

outsourced, like an insourced

sense of discernment, sovereignty,

um connection to awe, and and trust, and

surrender. And so, I think a big part of

that journey for many of us is

grappling with the bigger questions of

life and recognizing there's a lot of

forces right now that want us to

outsource to them. And so, that's part

of my feeling about the MRIs, right?

Like that is an outsourcing and it can

be really useful and it can be

life-saving, but we just always want to

note when we're saying that the the the

power is is outside of us and not within

us. I think that we really just want to

bring a lot of that back home and have a

lot of sovereignty over I'm good here.

I'm very home in my body. The lights are

on. I'm wide awake here, present and

connected to myself so that I can go

through the world in discernment. And I

think especially in this age of AI,

there's an assault on truth, on how we

can trust what we're seeing with our own

eyes. I think we need other mechanisms

for feeling what's real and feeling

what's true. And I think that happens

first in our physical bodies. And so, we

just want to keep strengthening our

ability to tune in and listen because

our bodies have wisdom vastly beyond

what we realize. And if we're checking

in, it's hard for us to be led astray.

>> I love that. That's so good. I like the

idea of strengthening your discernment

like a muscle and just keep tuning in

and like making it stronger and

stronger.

>> Can you show us your painting?

>> Oh, yes.

>> Okay, so we've shifted now fully from

book one The Anatomy of Anxiety to book

two Season of the Witch. Now, we didn't

end up putting a yin yang on the cover

design. Though that was my original

vision was a yin yang with like the

hemispheres of the brain overlaid left

hemisphere right hemisphere, but

>> Oh, cool.

>> for book three. But I think that the

idea here is that this was something I

always doodled in childhood and

and I didn't even really know why. I

didn't have any exposure to Chinese

medicine or Taoism, but I

ultimately and went on to study Chinese

medicine.

And for me now the yin yang is a very

important operative framework for how I

view everything in the world and

everything with health. And

and I think that this symbol captures so

much about where we're out of balance as

a culture, where we

disavow parts of ourselves as women. And

so that's what I've really been

exploring. That's the cultural

commentary of this book is that we're in

a world that celebrates the yang, that

masculine sun aspect of life that's

action, doing, productivity, what's

evidence-based. We love this. And then

there's this pesky yin the inside that's

the feminine moon mysterious receptive

surrendered non-doing. And that's the

part we systemically devalue, but that's

got us out of balance.

>> I just got chills.

>> Me, too. I'm going to cry.

>> And so I really come back to this symbol

all the time cuz we're not living in

this beautiful balance, but this is

inevitable. We're existing in dynamic

equilibrium between these two states and

we have to I think reclaim our yin.

>> We have a final question that we say at

the end of our episodes and we like to

tie it back into ease. Our last question

for you is, how do we find ease when we

aren't in ease?

>> I'm asking my guides for what what needs

to come through on that.

>> [sighs]

>> We're being kind of pinballed around by

shoulds at all times. We should you

know, we should meditate and we should

eat this and and even a lot of what I've

said today is very should. It's like we

should do these diet lifestyle practices

to support our mental health and I stand

by it. But within reason and gently with

a light grip. And I think often we

actually need to push back on all of

those shoulds

and allow and be with our just our being

exactly as we are realizing embodying

that we are whole that we already have

what we need that it's internally

resourced and I think sometimes the

should baked within this is like if we

can get out of our heads and drop into

our heart centers

that's where we can remember that we are

whole unto ourselves inner resourced and

divine exactly as we are.

>> I love when someone says like actually

there's no pressure there's no rush this

like timeline that you have it actually

doesn't exist and you're okay and I love

this like loosening of like this is what

we should be doing and it's like no

actually you you don't need to be doing

anything.

>> Yeah.

>> It's so

>> It's this part.

>> [laughter]

>> Or it's the balance. Thank you so much

for having this conversation with us

today

>> Thank you both so much.

>> We had such a great time. We were so

excited to talk to you and you did not

disappoint.

>> You did not disappoint. You brought us

clarity.

>> You brought us clarity.

>> This has been a sheer delight and this

is clearly in service and I'm honored to

be a part of it.

>> Thank you so much.

>> honored too.