Gil Winkelman ND

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Meditation and Anxiety: What You Need to Know About the Benefits of Mindfulness

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For many people anxiety is a daily occurrence. Many don’t even know they are anxious. They feel stressed. Maybe they have a vague sense that something isn’t right. They can’t quite put their finger on what the problem is. Some people feel something in their body. They get a headache. Or their chest feels tight. But other people get angry or explode for no reason. Does this describe you? If so, you may be one of the 40 million Americans that experience anxiety at some point in their lives. What can you do about it? Mindfulness meditation can help relieve anxiety.  How does meditation work? What sort of meditations are helpful for anxiety? Let’s explore some of these questions.

The solution that most Americans reach for is a pill. Many people turn to medication. And for many, drugs can help relieve symptoms. But they don’t remove the underlying cause. As I’ve written elsewhere, testing can reveal the underlying physiological causes. But what if there is nothing measurably wrong with your body. Now what? Meditation may be able to help.

For many people, anxiety is a common occurrence.  They know they are anxious. They know what it feels like and it’s not comfortable. They can’t sit still. Their focus is terrible. They are antsy. They might even feel a little agitated. Focusing on anything is difficult.

Other people don’t know they are anxious. They are agitated. They may get into a fight with friends or loved ones. Or they mindlessly eat. Meditation can help break these patterns.

Meditation for Anxiety

It used to be that when meditation was brought up, one’s thoughts went to crosslegged monks on a mountain top. But meditation has become common in the US. The National Institute of Health estimates that about 18 million adults practice meditation on a regular basis.

So what exactly is meditation? It is the act of calming one’s mind and bringing attention to one thing. It could be counting breaths or watching a candle. Every time your attention drifts off you bring your attention back to that one thing. It is a state of calm alertness but more than concentration.

Concentration may be focus on one object. Reading may be concentration, but it isn’t meditation. There is a calm stillness to meditation. You just watch. You watch your breathing, you watch your thoughts. There is no attachment to anything. Writing could be a form of meditation. As I write at this moment, it is like meditation. I am concentrating and watching my mind. But I have an agenda. I want to be sure to cover certain topics. My attachment precludes me from meditating. Meditation is about letting go of outcomes. You are just still. And if you can’t be still, you notice that.

Meditation brings many health benefits. The most obvious is stress reduction. But some research has shown that meditation helps other health problems too. These include lowering blood pressure, improving IBS symptoms, and relieving depression and anxiety. It doesn’t help everyone, and I’ll get to that in a moment. But it does appear to change brain circuits involved with regulating emotions. This will help reduce inflammatory and stress hormones. In theory, meditation sounds great.

But how do you meditate if you’re anxious? We’ve already figured out that you can’t sit still! Sometimes you can’t calm your thoughts down. And sometimes, the act of meditating can make you feel worse. When I was studying counseling psychology, I had a supervisor, Gail Sher, who is a Buddhist. She was an avid meditator. She advised against prescribing meditation for people with anxiety because it often made things worse. They might become more anxious trying to meditate. So how can one benefit from meditation if one is anxious? There are several options. Let’s run through a quick list.

Breath work: Meditation is about slowing down. When we are anxious, everything tends to speed up. Slow down your breath and see if that helps. Sometimes one minute of steady breathing – an inhale for 6 seconds followed by an exhale for 6 seconds – can help.  Often, when one is anxious, it’s because the brain’s alarm response is on over-drive. Simple breath work can be enough to start sending signals from the heart to the brain to turn off the alarm response.

Take a moment to feel your body: Don’t try to push the sensations away. Just feel the anxiety. Notice how jittery you feel. Or notice the tightness in your chest. Just feel what you are feeling in your body in the moment. Don’t judge it and don’t try to change it. If you have experienced a lot of trauma in your life, this may be difficult to do on your own. Many people who have experienced trauma have difficulty feeling their bodies. If that’s the case, try another method. And get help from a qualified trauma specialist.

Listen to the sounds outside: If you can get into nature and listen to the sound of birds, waves, or running water, that can be healing. Many of my patients report feeling less anxious after walking in the woods.

Be mindful of what you are doing: Focus on one task and do just that task with full attention. It can be almost anything, so long as it has your full attention. But it should be something that doesn’t stress you out. For example, don’t try to balance your checkbook if that makes you stressed, and be mindful of that. Do something you like to do, but do it with your full attention.

If you know why you are anxious, you can talk over the issue with a friend. Maybe you have been ruminating or worrying about something. Getting an outside perspective can help ..

Focus on the Anxiety: For some people experiencing the anxiety can be extremely liberating. Often, it is the avoidance of the discomfort that makes it worse. Feel the anxiety. Feel what your body feels like anxious. Notice how you have difficulty breathing. Don’t try to change it. Just let it be there without judgment.

Avoiding judgment is one of the most important things for anxiety.  It’s OK to feel anxious. It’s OK to experience whatever it is underneath the anxiety. Anxiety isn’t truly an emotion. It’s a state of not feeling an emotion. It’s more rumination on something that isn’t happening in the moment. And that is why getting into the moment through meditation or other means can be so helpful.

If you have trouble with these techniques or meditation it may be that something else is out of balance. It could be something in the brain or the body. Neurofeedback and HeartMath can be extremely useful. LENS neurofeedback can help train your mind to be less reactive to situations. HeartMath is biofeedback that helps people use breath and good feelings to bring body systems into alignment. Both are powerful in gaining some of the benefits of meditation without meditating. Of course, there could be a biochemical imbalance, but I don’t recommend medication. Simple blood and urine tests may uncover the imbalance and help you find balance with a simple supplement regimen.

Anxiety is a big problem in America at the moment. I see many patients with this problem and/or other mental health issues. Fortunately, there is help available without drugs. Meditation may be a good solution for many. But if it makes your anxiety worse, stop. Try one of the techniques above. If those don’t work, get professional help. It may be that you will need it anyway. But mindfulness has helped many people all over. Don’t let anxiety stop you from being your best self.

 

The Astonishing Way that Your Mind Can Heal Your Body

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The yoga studio I go to has different teachers that teach classes for students of all levels. It is unusual, as there is a mix of advanced students and beginning ones in the same class.  Last week, one of the teachers had us do a lot of planks. This is a core building exercise that requires the yogi to hold the pose as if doing a pushup – at the top of the pushup – sometimes for several minutes. After the class, I had a discussion with another student about all of the planks. “It’s not that the pose is physically hard to hold for that long,” she said to me. “It’s that my mind has trouble holding the pose.” It was a curious comment. What is it about doing something painful that is hard? Why do we have trouble pushing through the sensation?

In this post, I want to discuss how one holds emotions in the body.  Emotional healing is an important aspect of physical healing, and an important part of my practice. But how do we release emotions? Why do they come out at times when we don’t expect them to appear? This is an aspect of my medical practice that fascinates me, and the answer isn’t clear.  The simple answer is, when the person is ready.  There are many techniques to release this storehouse of emotions, and we can explore some of them.

I think most people would agree that stress is held in the body. It’s something that one can feel and experience. Many people feel the effects of a long day at work in their neck or shoulders. But there is a deeper issue that can happen where trauma and grief are stored in the body. I have worked with many patients who have discussed this phenomenon as part of their work with me. Many report breaking down in tears while exercising as something shifted within their body. Emotions stored are released as part of the healing process.

How do we access these emotions physically? Candace Pert was a molecular biologist who studied the mind-body connection.  She discovered that the body synthesized tiny molecules in response to difficult emotions. These get deposited into various places in the body.  She and other scientists proposed that the body is a storehouse of unconscious thoughts and feelings. All of the things that have happened to us are stored in our bodies in response, regardless of whether we recall them or not.

Yoga and Emotions

Why is yoga so helpful for clearing negative emotions? Yoga, as an exercise, focuses on three things: movement, breath, and awareness. These three components play out in many of the techniques used to release emotions. When most people think of yoga, they are thinking about the exercise. Yoga is actually a series of practices that include Hatha Yoga, a series of poses. These poses are either done individually or in a sequence called a vinyasa. Each pose, or asana, has a specific breathing rhythm associated with it. The transitions between asanas also have a breathing pattern. There is a synchronization between the breath and the movement. The breath is part of the ritual and allows for a cleansing of the mind, body, and emotions.  The practice requires awareness and focus. One may become aware of the places that are stuck and painful.

Many yoga teachers say that yoga begins when one wants to move out of a pose or quit.  Bringing attention to the discomfort can help release the pain. The awareness requires non-judgement. It is what a Buddhist would call “Mindfulness.” Mindfulness is awareness without struggle. It is pure acceptance of what is.  It is about being with what is true for you in that moment. You accept the feeling, the pain, the experience.  And by doing that, the discomfort magically begins to soften. It is as if we have given our bodies permission to let go.

Emotional Healing Therapy

Yoga is such a wonderful metaphor for the process of letting go. I suspect that many people benefit from yoga because there is a visceral experience. You can feel where you are stuck and release that tension. You feel the struggle in your body. For example, let’s say you’re trying to stretch your hamstrings. There’s a quality of softening you must embrace to do so. Otherwise you are just tearing at the muscle fibers. You learn to let go.

Doing this on a psychological level, though, isn’t always as easy. This is because we have a different type of block called a “defense.” We still have the same struggle. It’s just happening in our minds. Psychologists tell us that we have defenses for a reason. We build defenses as a way to protect ourselves. They may be hiding trauma, abuse, or shame.  We create them because at the time they form, we don’t have the emotional capacity to process what is going on. The defense becomes a part of us and we begin to identify with it. It is analagous to the tight hamstrings. We don’t remember when the last time the legs were loose.

To move around defenses, psychologists have created various methods. Emotional healing techniques allow us to access these parts of ourselves. Talk therapy helps us see our defenses. We gain greater awareness and can change our typical response. Other techniques focus not so much on the spoken word, but some sort of visceral release. Eye Movement Desensitization and Reprocessing (EMDR)  is a technique that helps patients process trauma.  Emotional Freedom Technique or EFT uses a self-tapping pattern while recalling a specific event. Both of these techniques appear to allow for the body to reprocess the events on a cellular level.

While we don’t always recall the specifics, release of the event is possible. These methods suggest that there is a connection between our minds and our body. Memories are stored in the body and accessed through the brain. But the use of these techniques allows us to move around our blocks. We don’t always have to recall a specific incident. (Although both the above techniques require one to do so.) A specific event isn’t always recalled while doing yoga. It arises out of the breathing and the movement.

In my medical practice, understanding this is crucial, as so many people come to me with anxiety. Very often, anxiety strikes and is free floating. There is no easily identifiable event or experience that one can identify.  Focus on the past is less important. Focus on the present is key. It is where the defense lives. It is where the body lives.

A method that I use in my office works on a different principle of mind-body connection. HeartMath is a form of biofeedback that uses heart rate to help the user relax. It’s more than relaxation though. It helps the person see on the screen how their body reacts to different types of thoughts. Calming thoughts help bring the body in a state of coherence or where different systems in the body work together. Negative thoughts bring the body out of coherence. Watching this on the screen allows the user to learn to breathe better to gain more coherence. HeartMath works by helping the user stay in the present and notice subtle changes in their body.

Emotional healing during yoga is a great illustration of a mind-body connection. The body remembers even if we don’t. But there really isn’t a distinction. Our body knows, and it keeps track. From the mild aches and pains we feel getting up in the morning to full-blown disease, our bodies remember.

Concussion Treatment Near Me: The 3 easy things you need to know

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Tammy, not her real name, came to me 10 months after a car accident. She was having trouble with school. She couldn’t focus for longer than 15 minutes at a time. That’s difficult when you are attending a top-ranked liberal arts university. Her medical doctors had told her rest would make everything better. Her mother searched “concussion treatments near me” to find me online and made an appointment for her daughter to see me for treatment. Six weeks later she was back to her regular self. School was going well, sleep had improved, anxiety disappeared, her headaches abated. Recovery from a traumatic brain injury (TBI) is possible without pharmaceuticals. How do you treat concussion? How do you see so much change without drugs? To understand this, it is important to explore more about TBI. What is it? What symptoms arise from it? By answering these questions we begin to get a better idea of how to treat.

Concussion Treatment and TBI

Six years ago, I wrote an article about concussions and Traumatic Brain Injury (TBI). The statistics were sobering; they still are. A recent study in JAMA says TBI strikes 1 in 8 elderly Americans yearly! But it occurs in all ages. TBI affects not just the brain, but physical, emotional, and cognitive problems. Many people don’t even realize that their health problems may have started with a TBI. There are many ways people get injured. Falls, sports-related injuries, motor vehicle accidents, and being struck in the head by an object are some of the leading causes of TBI. Some researchers believe the number may be as high as 55 million per year!

What these numbers don’t tell are that many people live with the consequences of a TBI long after the event. Between 3-5 million Americans live with an impairment related to a TBI. Concussions can create long term problems. Cognitive issues, including focus, concentration and memory are associated with concussion.  But most of the people who come to see me don’t even recognize that there was injury such as Jessica. Depression, anxiety, insomnia, headaches, migraines, and fatigue may all start with a TBI. Most people come to me because of one of those problems, not because of a concussion.

TBI and concussion treatment near meThere are other health risks associated with TBI.  Not long ago, the idea of TBI or concussion was such that it had to be severe to have any long term consequences.  We are learning that even a mild concussion can create long-term severe consequences.  Head trauma, even from minor incidents, can cause a wide range of  mental, emotional, and/or physical ailments. Dementia risk appears to be greater as well even if the injury is considered “mild”.  Living with the effects of a TBI can be devastating. Shocking stories abound of how former professional football players and veterans take their own or others lives. Millions of others live with the long-term effects without any of the fanfare.  I (and others) have helped people recover from TBI. And that recovery is safe, effective, inexpensive, and non-invasive.

How do you treat a concussion?

I am working on a more detailed article to describe treatment of these problems. For now let me give a brief overview. Treatment comes in two different modalities, supplementation and biofeedback. Supplementation can handle some of the symptoms and may reverse the damage. Vitamin D, magnesium, zinc, Vitamin B6, and Omega-3s are all helpful for post-concussion syndrome. Long-term supplementation may be able to reverse the damage of the TBI. I use supplementation with most of my patients with TBI. I may also use specific supplements to treat specific problems related to the TBI, including sleep issues or anxiety. This allows for symptom relief while unwinding the damage related to the injury. (Quick note: if you are elderly have your B12 levels tested. You may not be absorbing as this is a function of the aging process.)

Biofeedback though provides a more direct approach to helping TBI and treatment concussion. Neurofeedback measures the brain waves of a person and allows the brain to, in effect, see itself to recognize that there was an injury. A brain injury can result in the brain not recognizing that it has an injury. This is why I often see patients who don’t remember they had an injury but have many of the problems associated with a TBI.

Neurofeedback is Highly Effective

Neurofeedback appears to turn back on the brain’s own repair mechanisms. Studies show that neurofeedback  is effective treating TBI. And it can also be helpful for anxiety, depression, migraines, insomnia, ADHD, and other conditions. We do not completely understand the mechanisms of this, though there are some different theories.

Neurofeedback is only one treatment for TBI. New research is showing that Heart Rate Variability (HRV) Training  can treat TBI. HRV training is a form of biofeedback. HRV is the measurement in subtle changes in heart rate between beats. Our heart beats at a different rates from moment to moment when we are resting. HRV is an excellent health assessment tool. Some researchers suggest that HRV may be the single biggest predictor of health in a person. Our HRV tends to decrease as we get older with a large drop as one nears death.

Furthermore, HRV may be a way to calculate the progress of treatment of the TBI. HRV seems to change after a TBI. HeartMath helps reduce emotional symptoms related to TBI.  There is a home version of the device that allows patients to use on their own. I can review the data and assess their progress.

I’m excited to have another tool for treatment and assessment in my practice. If you or someone you know has had even a mild knock to the head, have them evaluated.  Even if you don’t remember having a concussion but have some of the symptoms, get checked. A qualified healthcare professional can help. Concussion treatment via neurofeedback and supplementation may be able to help the problem that you are having.

Once again I am offering concussion treatment near me in Honolulu. Feel free to call my office for more information.

How to Treat Depression Naturally

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In the last blog post, we discussed fevers and suggested there was a connection between fevers and mental health. Many factors exist connecting mental illness and fevers but today we will explore one of them. The connection between inflammation and depression is important to understand so that we can better understand how to treat depression naturally.

weightloss26Depression affects almost 15 million people in the United States. Symptoms can include changes in mood, behavior, sleep disturbances, changes in appetite, weight loss or weight gain. A loss of interest in activities that were once enjoyed is often seen with depression. Below is a list of problems that arise and while most people don’t have all of them, many people have some items from one or more of the categories below.

Mood: apathy, being bored or discontented, guilt, hopelessness, inability to feel pleasure, loneliness, mood swings, sadness, or emotional distress

Cognitive: lack of concentration or focus, slowness in activity and thought, or thoughts of suicide

Behavioral: agitation, excessive crying, irritability, self-harm, or social isolation

Sleep: early awakening, excess sleepiness, insomnia, or restless sleep

Psychological: depression, anxiety, or repeatedly going over thoughts

Whole body: excessive hunger, fatigue, or loss of appetite

Weight: sudden weight gain or weight loss

What Causes Depression in the Brain?

Now that we have some understanding of what depression is, let’s look at some of the causes. Why is this a big problem in the US at the moment? (As a side note, depression and anxiety are extremely prevalent in many countries including England and Australia. It is believed that Australia has a rate of depression of at least 20%. For the purposes of this article, though, I want to narrow the focus for a moment. )

Let’s ignore socio-economic factors for a moment. Clearly that plays a factor in people’s mood, and I will explore that in future articles. I’m a physician, and as such, start at the physical level. I want to share my expertise of holistic medicine to help you and your loved ones if possible. I wish to bring to light other factors that can affect someone such as a challenging boss, marital problems, and so forth.

Getting back to the body, correlations exist between obesity and depression. This connection gives us a clue as to one of the possible causes of depression. Depression may be related to a chronic inflammatory state. The result may be a low-grade fever. The process, though, could be making you feel sick and more importantly for the purposes of this article, depressed.

When we discussed fever in the last blog post, I didn’t go into the details of what a fever actually does. Fevers are a result of the inflammatory process. Fevers are generated because the immune system recognizes something that is not you. Each cell has a tag on it that lets other cells know that it belongs in the body. It’s sort of like an ID that we carry to let it be known we are citizens. We have cells called macrophages that circulate in the body trying to figure out if there is a problem. If there is one, they send out signals in the form of something called cytokines. There are many kinds of cytokines, each being a different type of signal that cells use to communicate with one another. Cytokines have different functions and one of them is to raise the body’s temperature. They also make us feel achy, tired, and slightly depressed. This is a protective mechanism so that we slow down and rest so as to not expose others. These are some of the signs of inflammation. The body uses inflammation as a way to fight disease and/or heal wounds. But the mechanism that helps the body fight disease may be responsible for all kinds of illness including depression, Parkinson’s, Alzheimer’s, insomnia, irritable bowel syndrome, heart disease, and many other conditions.

When we feel depressed, it is often because of these signals that have been turned on but haven’t been turned off. It is believed by some clinicians that depression is the first sign of many diseases because of this mechanism, and in fact that many diseases are caused by chronic inflammation.

How To Treat Depression Naturally

Understanding this one cause of depression helps us treat it. Reducing inflammation is very important as part of this treatment approach. It will also help improve other symptoms and reduce our risk of other ailments. Omega-3 fatty acids may be a very important part of reduction of low-grade inflammation causing depression. In my Naturopathic practice, I recommend 3 grams of Omega-3s to patients per day. That is to be distinguished from 3 grams of fish oil. There are other constituents in fish oil that are not omega-3s. Lower doses don’t have the same effect.

Curcumin (turmeric) is another excellent anti-inflammatory. Using turmeric in your cooking can be really helpful as well. An anti-inflammatory diet is also something that can help. Bromelain taken away from food can help reduce inflammation. It comes from papaya and helps with digestion when taken with food. Finally, I recommend testing of copper, zinc, and possibly for heavy metals if the problem persists. Often times depression arises from an imbalance in metals in the body.

There are many ways to treat depression naturally at a very low cost. I have worked with many people to help depression and get them enjoying life again. Please contact me to schedule either in-person or an online doctor consultation.

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