Have we become the Nation of Numb?

When I present to industry professionals about the growing benzodiazepine epidemic, the slide above, featuring pharmaceutical ads from the 1960’s, always elicits self-conscious laughter from the crowd. How benzos have been marketed to women and the images of antiquated gender roles are certainly jarring, but the ad copy – promising relief from anxiety and tension, and the “ability to cope with day-to-day problems” – still rings true; if not in the way the drugs are advertised, then certainly in the way they are prescribed and used.

We live in an age where worry, stress, and discomfort aren’t viewed as a normal part of the human experience, but as problems with medical solutions.

Stressed about upcoming layoffs, a sick family member, or a cross-country move? There’s a pill for that.

In “Listening to Xanax”, a New York Magazine article from 2012, the writer describes the way friends in her social circle have taken to consoling one another by sharing pills rather than hugs or advice:

“To friends worried about enduring a family holiday, she doles out a pill; to colleagues fearful of flying, she’ll commiserate before offering a cure. ‘I can’t fly without half a Xanax,” she’ll say. ‘Want some?’”

It’s an apt description of a cultural unwillingness to sit with pain – our own, and that of others – that has consequences, many of which are shouted daily from the national headlines: a worsening opioid crisis, endemic physician burnout rates, entire generations opting for a digital world rather than the uncertainties of the real one…

For me, this cultural aversion to discomfort reinforces my belief in the need to increase our tolerance of emotional pain, rather than avoid it. We have found True Life’s integrative approach to be profoundly helpful in this way. The holistic modalities that are part of mental health treatment at True Life– yoga, fitness, nutrition, acupuncture, massage, and mindfulness meditation – not only give patients real-time relief, but also lifelong tools for self-soothing and self-regulation. Our holistic providers have immense skill in helping patients to understand how implementing these self-regulating modalities can increase their tolerance for, or reduce their experience of, pain.

Because healing isn’t just about eliminating pain, it’s also about reducing suffering by learning how to better manage the pain that is an inevitable part of human life.

How do you sit with pain? How do you think we, as a society, sit with pain? I’d love to hear your thoughts on this. Thank you for letting me share some of mine.

Health and Happiness,

Dr. Krista Roybal
Founder, True Life Center

Fight Back Against ‘Food Swings’

By Kayla Rillie, Registered Dietitian

Do you find yourself susceptible to waves of anxiety or depression that manifest several times throughout the day? Do you find yourself in a bad mood or feeling angry around meal times? If so, chances are you are susceptible to food swings! You read that right, I said food swing – a mood swing that occurs simply because you are hungry…or hangry!

Hunger and hypoglycemia (low blood sugar) are primitive signals known to set off a stress response in the body, and for many, this stress response can cause anxiety and depression. Triggered by drops and fluctuations in blood sugar, these mental health issues can become chronic if food intake isn’t consistent.

Humans, like all animals, are designed to get energy from the food we eat. Without that energy, our bodies wouldn’t be able to function properly. Those feelings of anxiety, anger, and irritability we get when our blood sugar dips is actually a brilliant mechanism that ensured our great, great, great ancestors made foraging and hunting for food a priority. This helped them to avoid starvation and maintain the energy to survive in even the cruelest of conditions.

Nowadays, low blood sugar, and the negative effect it has on mood, can be a bit more challenging to navigate. Where more primitive animals would simply be spurred into food-finding mode, our more complex human brains often register the feelings of anxiety, depression, or anger, and attribute them to other root causes. We blame our bad moods on our jobs…relationships…our astrological signs…everything but the real offender – low blood sugar. Worse still, feeling depressed or stressed prompts many of us to reach for soda, candy, or chips. But junk food is no more than a Band-Aid on the problem – we feel better temporarily, but the blood sugar fluctuations only keep the cycle going.

So can we keep blood sugar levels steady and avoid any hangry outbursts? Try following the 7 rules below to stop riding those food swings once and for all.

1.) Eat regularly – every 2-3 hours

2.) Aim for balance. Meals should include:

  • Protein (wild seafood, grass-fed meats, eggs, beans, cheese)
  • Fat (avocado, nut oils, cheese, nut butters)
  • Complex Carbs (brown rice, sweet potato, whole grains bread)

3.) Include snacks

  • Try an apple with almond butter, raw nut and seed mix with dark chocolate chips, or carrots and hummus

4.) Reduce the amount of simple carbs (such as cakes, cookies, and breads) that you consume. Keep these as occasional treats. And if you are treating yourself, consider pairing the simply carb with some fat and/or protein to prevent that quick blood sugar drop later.

5.) Include fiber-rich foods. Adequate dietary fiber helps blood sugar remain stable by slowing entrance of sugar into the blood stream and prevents crashing.

6.) Try Chromium. Small doses of Chromium can prevent blood sugar dips and spikes. 200mcg of Chromium once a day in the morning can help stabilize blood sugar levels.

7.) Take B Vitamins. B-vitamins aid in carbohydrate metabolism and are critical for many other functions in the body. These vitamins are water-soluble and can easily be depleted by stress, carbohydrate consumption and environmental stressors.

Ask the Psychiatrist: Alcohol Fact vs. Fiction

In the movies, the character with a drinking problem is easy to spot: sullen, unemployed, and estranged, typically found drinking alone or picking fights. Outside of Hollywood fiction, however, problem drinkers often look like our neighbors, co-workers, loved ones, and friends. They may be highly respected in their careers, beloved by their families, and appear to drink only when socially appropriate. The outward signs and symptoms of a drinking problem aren’t always obvious, especially when our view of alcohol-use disorders is colored by stereotypes. Below, Dr. Krista Roybal, Executive Medical Director at True Life Center for Wellbeing addresses several common misconceptions about alcohol use.

Myth: “I enjoy a few glasses of wine each night to unwind from work. My wife seems to have a problem with my drinking habits, and lately she’s been throwing around the word ‘alcoholic.’ I’m a very successful businessman and a good father, there is no way I’m an alcoholic.”

A problematic drinking habit often begins innocently: as a way to relax or transition from work to home, as the most common drug people use to fall asleep, to have sex, to reduce social anxiety, and to enjoy themselves. So before we ask loved ones to stop drinking altogether, we must first understand what role alcohol is playing in their lives. Drinking problems are defined not only by how much and how often someone drinks, but also by the effect drinking has on a person’s health, home, social, legal, or work life. It’s helpful to avoid shame-inducing terms like “alcoholic,” but if your drinking is having a real and negative impact on one or more of your primary relationships, a wise next step would be to talk with your doctor or therapist in a supportive environment about the role alcohol is playing in your life.

Myth: “My college-aged daughter confided to me that she has, on occasion, blacked out after drinking too much at a party. But that’s just part of the college experience these days, not an indication of a larger problem.”  

I want to first commend your courage for even exploring the idea that your child could have a problem with alcohol. For many parents, underlying fear keeps them in denial. Binge-drinking (defined as 4 or more alcoholic drinks within a few hours for women, 5 or more for men) is a part of the college experience for more than 40% of students, according to some estimates. My concern for those students, and for your daughter, is safety. The dangers of binge-drinking include alcohol poisoning, unsafe sex, sexual assault, drunk driving, legal or academic consequences, and serious or fatal injury. Binge-drinking could certainly be an indication of an alcohol use disorder. It could also be a symptom of an underlying mental health issue like anxiety or depression. It would be in your family’s best interest to continue this conversation with a professional who can help you make informed decisions about wisely and compassionately supporting your daughter.

Myth: “Alcoholics just lack willpower. With discipline, someone could easily get their drinking under control on their own.”

This is the kind of myth that breaks my heart, because it might prevent someone from seeking or receiving much-needed help. Alcohol Use Disorder is a biological, brain-based disease. It is my job as a physician, and our society’s job as a whole, to treat addiction with the compassion and medical attention it deserves. Consider a disease like cancer or diabetes; you would never suggest that someone battling those illnesses should simply will him or herself to overcome the illness overnight. Additionally, sudden and severe withdrawal could cause painful physical symptoms leading to hospitalization or death. In my experience, so many people suffering from addiction want to change, but they don’t know how. Safe, supportive, and effective treatment is the bridge between the desire to change and the ability to change.

True Life Center for Wellbeing is an integrative mental health and addiction treatment center located in La Jolla’s UTC area. We offer an Intensive Outpatient Program as well as outpatient psychiatry and therapy appointments. If you or a loved one feels ready to prioritize wellness, please give us a call at 858-384-4535 or visit truelifewellbeing.com.

 

 

 

Embracing the Space Between

Dear Friends and Colleagues,

Lately, I’ve been thinking about “before-and-afters”: the “jaw-dropping weight loss” magazine covers in the supermarket checkout, the home improvement show that remodels ‘shack to chic’ over the course of a commercial break, my kids’ classmates who will invariably come back from summer break looking like entirely different kids. There is something undeniably compelling about those types of dramatic transformations. But as someone who has always been fascinated by the full narrative, the root cause of illness, the journey…I find myself less interested in the before and after than in the space between.

That “space between” was on my mind today, while selecting which of the hundreds of wonderful photographs from last month’s Open House I wanted to share with you.  Please take a look at them here. You might consider these images to be the “after photos.” They were captured after the completion of our beautiful new facility, after the recent expansion of our programming (including the addition of a cost-conscious Group IOP for addiction; the launch of DBT-Skills and Self-Image & Resilience support groups in-house; and a variety of recovery groups open to the community), and after more than three-years’ (!) worth of healing, discovery and progress.

But because I believe that growth is essential; because I’m consistently blown away by the True Life team’s willingness to ask hard questions, reflect, and adapt; and because we’ve set big goals for ourselves as a center, I know that someday these photos will serve as the “before pictures” for the fulfillment of a larger mission. And as I scrolled through image after image of our beautiful new suite, incredible team of practitioners, and supportive community (thank you, from the bottom of my heart, for all of the encouragement and kind words!), I couldn’t help but acknowledge that this, right now, is the space between. What a privilege it is to be here.

I am so proud of how far we’ve come, so optimistic about where we’re going, and so grateful for all of you who have supported, and will continue to support us along the way.

Health and Happiness,

Dr. Krista Roybal
Executive Medical Director
True Life Center for Wellbeing

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 nutritionaltherapy.com. 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.