Ask The Psychiatrist: Anxiety Disorders

*The copy below was originally published in the April 20th edition of the La Jolla Light*

Anxiety is the body’s normal reaction to stress, and it has a very important purpose. It is designed to signal dangerous, uncomfortable, or unfamiliar situations so that we remain aware and alert. However, for the 40 million adults affected by anxiety disorders (which includes Obsessive-Compulsive Disorder, Panic Disorder, Post-Traumatic Stress Disorder, and Social Anxiety Disorder), the warning signal often sounds loudly and consistently, with no ‘off switch’ in sight. Below, Dr. Krista Roybal, Executive Medical Director at La Jolla’s True Life Center for Wellbeing, answers some a few common questions about this prevalent mental health issue.

Q.) I worry a lot…about my job, my kids, my weight, the growing piles of laundry on top of the washer…. do I have anxiety?

A.) We all experience stress and anxiety from time to time, and in certain     situations, like moving to a new city, taking a test, or attending a job interview, that anxiety is not only normal but beneficial. Generally, the difference between healthy anxiety and an Anxiety Disorder is the amount of time you spend in that anxious state, and the severity of the feeling. If your anxiety is preventing you from living a full and satisfying life in any way, I would encourage you to seek help. The laundry can wait.

Q.) A friend suggested that my unexplained stomach problems and migraines might be anxiety-related, but I don’t feel particularly anxious. Is it possible for anxiety to be physical?

A.) Not only is it possible, it’s very common! I often see patients who have been suffering from the physical symptoms of anxiety – which include insomnia, upset stomach or nausea, shortness of breath, headaches, fatigue, muscle tension and more – long before they receive an anxiety diagnosis. Often, individuals will visit their primary care doctor for help in addressing the symptoms, while the root cause remains unaddressed. That’s why anxiety treatment at True Life Center includes holistic services like acupuncture, yoga, and meditation. Mental health affects more than just the mind, and true healing requires attending to someone’s whole health – mind, body, and spirit.

Q.) What should I do if I suspect that I have an anxiety problem, but I’m too anxious to talk to a professional about it?

A.) You aren’t alone in being hesitant to seek help. Unfortunately, only one-third of those suffering from Anxiety Disorders receive treatment. Others delay treatment for years while numbing themselves with alcohol or prescription medication, spending excessive time on social media, or distracting themselves with work or with food. Many times I see patients who put off getting help because they fear that consciously facing the source of their anxiety will make things worse. And it might get a little worse before it gets better. But sharing and processing, thoughtful medication when necessary, and learning the tools and resources for self-care can provide immense relief. I encourage you to ask a trusted friend or loved one to support you in getting the help you need. This can mean assisting with research, helping you make phone calls, or holding you accountable for attending that first appointment.

If you have questions about anxiety disorders or want to learn more about treatment for anxiety or other mental health issues, please call True Life Center at 858-384-4535. We would be happy to provide information, resources, and support.

Finding Inspiration in Art and Science

Friends and colleagues,

Recently, I came upon a deeply inspiring article about Spanish artist and famed neuroscientist Ramon y Cajal. As a young man, Cajal gravitated toward art and photography. However, on the insistence of his physician father, he decided to study medicine and developed a fascination for the brain and nervous system. When exploring the question of how a neuron’s message travels through the body, Cajal harnessed his passion for both art and science to create gorgeous visual depictions of neuronal communication. Those striking scientific images – currently on tour as a traveling museum exhibition – became the foundation of everything we know to be true about the way cells collaborate and communicate. Today, we take for granted the technology that allows us to easily see networks of billions of cells in action, but it was the artistically gifted Cajal and his groundbreaking drawings that gave us a first glimpse into the microscopic communication that makes us who we are.

What struck me most about this story was the way Cajal’s love of art and science collided, leading him to world-changing insights. The overlap between these disciplines often lays the foundation for dynamic creativity and discovery. In my personal life, I am deeply grateful for my years as a young artist, which provided me with a framework for taking risks, honoring the body, honing non-verbal communication, and living in the present. This framework has influenced my life and my career in beautiful and unexpected ways.

At True Life, we explore the marriage of the rational and the creative every day, from our commitment to scientific and holistic modalities, to crafting treatment plans that are clinically informed and artfully customized to each individual, to the way we treat each patient not as an illness or a series of symptoms, but as a whole individual who deserves physical, mental, and spiritual wellness. This collaborative, creative, multi-disciplinary approach to healing has guided our patients to incredible results in sustainable health and authentic living.

How about you? How do you make space in your life, or in your approach to treatment, for both art and science?

Health and Happiness,

Dr. Krista Roybal

Healthy Habits for the Whole Family

By Kristy Malone, Nutritional Therapist

Food: it’s a part of our everyday lives, and the focus of much of our time and energy. It’s how we stay fueled, how we nurture those we love, how we comfort ourselves, and how we connect with one another. Yet the simple question, “what’s for dinner?” can feel daunting for many parents.

The food children consume plays a crucial role in their development. Every cell, tissue, and organ requires specific nutrients for growth and repair. Unfortunately, the Standard American Diet (or “SAD”) – with its abundance of refined sugar, highly processed oils, chemicals and additives – often falls short of meeting children’s nutritional needs. As a result, chronic illness, allergies, food sensitivities, and behavioral issues are occurring at alarming rates.

Although most of us know that it’s important for kids to eat healthy, modern society would have us believe that processed, nutrient-deficient foods are the cheap and convenient choice, while properly prepared whole foods are the more expensive and time-consuming option. Even for conscientious parents who strive to put healthier meals on the table, it’s easy to make well-intentioned mistakes due to misinformation and conflicting nutritional messages.

The good news is that it is possible to feed your family in a way that’s healthy, enjoyable, and sanity preserving. The great news is that a nutrient-dense, whole-food diet tastes delicious and satiates the appetite. But when I speak to my clients about the importance of healthy eating for the whole family, I talk to them about more than just what to put on the dinner table and into their mouths. A holistic view of healthy eating includes our relationships to food. For children, learning the importance of nutrition, developing good habits, and forming positive associations can promote self-worth and lifelong wellness.

Here are a few tips to point you and your loved ones in the right direction:


  1. Get educated. A nutritional therapist or other holistic practitioner can provide you with the tools and knowledge to make health-promoting choices for you and your family. They can also provide you with resources for meal planning and preparation, locally sourced produce and meats, and practical strategies for eating healthfully based on your family’s budget and schedule. You can search for a practitioner in your area using this tool from Many nutritional therapists, myself included, are happy to work with both local and long-distance clients.


  1. Tell a positive narrative about food. If you serve your family a dish they don’t particularly like, you might hear complaints like “It’s yucky” or “I don’t like this.” First, try not to be too deeply offended, and pat yourself on the back for introducing something new. Then, respond with positive dialogue like “I’m glad you are finding out what you like and don’t like by trying a little bit of everything.” Or, “It’s ok to try something and decide it isn’t your favorite.” Their feelings can be acknowledged and validated while they are asked to eat what’s on their plate.


  1. Make mealtimes about connection. As often as possible, try to make meals a whole-family activity that involves sitting at the table with no TV, phones, or other outside distractions. Dinnertime traditions can cultivate connection and positive interactions. Avoid confrontation or focusing on negative behavior at the table. Research shows that kids who have regular shared family meals have better grades, healthier relationships, reduced risk of obesity, and are less likely to engage in risky behaviors like drinking and drugs.


  1. Encourage exploration. Have children be involved with meal preparation in ways that are appropriate to their developmental level. For example, you might consider taking your child to the farmer’s market and allowing them to select an item to incorporate into a weekly meal. This encourages greater connection to their food, to their community, and broadens their nutritional horizons.


  1. Eating healthy is a process and a practice. Throughout the stages of the family lifecycle you will encounter new challenges. Some days, the only way to get everyone fed is to order pizza. Some days, path of least resistance is to let the kids eat cereal in front of the TV. That’s okay. It’s the regular habits and the nutritional education you give your family that will determine their long-term health and relationship with food.