Dr. Robert Rountree:
This is the Thorne Podcast, the show that navigates the complex world of wellness and explores the latest science behind diet, supplements and lifestyle approaches to good health. I'm Dr. Robert Rountree, chief medical advisor at Thorne and functional medicine doctor.
Dr. Frank Lipman:
And I'm Dr. Frank Lipman, New York times bestseller and functional medicine doctor. As a reminder, the recommendations made in this podcast are the recommendations of the individuals who express them and not the recommendations of Thorne. Statements in this podcast have not been evaluated by the Food and Drug Administration.
Dr. Robert Rountree:
Any products mentioned are not intended to diagnose, treat, cure, or prevent any disease.
Dr. Robert Rountree:
Hi, everyone. Welcome to the Thorne Podcast. We're glad you're here and we're really excited to talk about some very fascinating topics for you today. This week, we're starting a two episode series on anxiety and then depression. So these are obviously topics that a lot of people listening out there can relate to. We've already got a lot of questions that have come in and we're going to do our best to give you some good advice. So we're going to start with anxiety. But first, speaking of anxiety, Frank, how are you doing this week?
Dr. Frank Lipman:
I'm great, actually. Spring is here, everyone's sort of coming out of their shells. It seems like it's spring in every way, post COVID, the weather's changing, it's beautiful.
Dr. Robert Rountree:
Yep. I would say we have a similar feeling here. Things just seem to be lightening up. I know they're not in other parts of the world where there are a lot of people really suffering. But fortunately, at least here in Colorado, it's time to get out on your bike and go for little hikes and enjoy the beautiful outdoors. There's a little bit of a lightening of the mood.
Dr. Frank Lipman:
Yes.
Dr. Robert Rountree:
Which is something we can talk about.
Dr. Frank Lipman:
Exactly.
Dr. Robert Rountree:
So why don't we just dive into that? Anxiety, Frank, what's your take on anxiety? How was it a problem? When is it a problem? What do you do about it?
Dr. Frank Lipman:
Right. Well it seems to be more of a problem these days. And especially after COVID, I think anxiety is probably hit an all time high. I think people are having to deal with the fear of COVID, having to stay at home, not being able to go outside, not being able to socialize. I think all of that's made everything worse. I deal with anxiety probably similar to you. I do think with a lot of people who have anxiety, they should work through their stuff and should see a therapist and see what's going on emotionally and psychologically. But a lot of the time, I actually find there's quite a big physical component to anxiety. And by that, I mean I think the gut seems to play a big role and I often see this happening without people even realizing it, that they come in with, they don't even realize they're anxious. They're coming with gut issues and you treat their gut issues and they say, "Oh, my anxiety is much better." So I think that's a big part of anxiety.
Dr. Frank Lipman:
The second part I've noticed is sometimes when people have sort of metabolic issues where they're maybe not metabolizing certain neurochemicals properly and you assist with its methylation or detoxification functions, that seems to help a little bit. And then the standard, get people to exercise, make sure they're sleeping well. So there are a lot of little changes that people can make that will help the anxiety. So that's been my experience with anxiety. Although, as I said in the beginning, it does seem to be worse for a lot of people now just with COVID and post COVID. What's your take?
Dr. Robert Rountree:
Yeah, I totally agree. What I think I'm hearing you say is that they're really two different categories of how people present with anxiety. One category is the person who knows that they're anxious about something, they're anxious about getting COVID, and then they feel something in their body as a result of that fear that they might get an infection or something bad will happen. And it's the same thing as being anxious about having a police officer pull you over for some traffic violation, right? It causes the heart rate to go up and the palms to get sweaty, the muscles to get tense. So it's a physical sensation. And there's one group of people that have identified that sensation and said, "Well, I'm anxious about X, I'm anxious about something, I'm anxious about getting COVID, I'm anxious about getting a traffic ticket, about getting in trouble about my taxes," et cetera.
Dr. Robert Rountree:
And then there's a whole other group that has symptoms and they don't know what their symptoms are about. And from a technical perspective, we would say, there's what we call an adjustment disorder, where somebody can identify something that's triggering their anxiety. And then there's generalized anxiety, also called free floating anxiety, which is not necessarily about anything. And that's a little bit more challenging to recognize because many times a person will come in and say, "I'm having these situations where my heart speeds up and I feel a little tight in my chest and I can't breathe," and they're worried that it's their heart. And then you do all these tests and put them on a treadmill, send them to a cardiologist and you can't find anything wrong. That's a tricky situation because I never want to tell somebody this is psychosomatic because it's a real sensation, right?
Dr. Robert Rountree:
What's going on is really real. Your belly's hurting all the time, you've got cramping and diarrhea, you've got nausea. I'm loathed to start off by telling somebody, "Well, this could be just normal sensations in your body that you're amplifying because of your worry." I would never start there, but there is a point where you've done enough tests where you have to say, "Wait a minute, what's going on? Is there something else that's stressing you or are you somebody that's just prone to getting really stressed about minor events?" It's hard. When I think somebody is really in the grip of a whole lot of strain sensations, it's very difficult for them to say, "Well, maybe somehow my internal level of worry is contributing to this."
Dr. Frank Lipman:
Right. No, no, I agree, 100%. I think it's a very difficult issue for a lot of people. My experience has been, even if someone is anxious because of what's going on in their life and not even aware of it, when you actually, for lack of another word, optimize other functions, it helps anyway. Even if you ultimately have to deal with the way you're dealing with the stresses, often unconscious in your life, and we can talk about meditation or breathing exercises. But even then my experience has been by optimizing function, whether it's the gut, hormones, whatever it is, that alone helps, whether the stressors have been dealt with, if someone's changing or willing to change their response to stress.
Dr. Frank Lipman:
I think we need to have people understand that anxiety is multi-pronged. It's not something that fits into, it's a mind thing, you go to a psychiatrist or a psychologist only. I think anxiety is one of those symptoms that is sort of perfect for functional medicine. Yes, you've got to deal with sympathetic response and what's going on with stress, but you also need to deal with all the other parts of the body and organs that could be contributing because they usually do.
Dr. Robert Rountree:
When our ancestors lived in the trees, they had less to fear.
Dr. Frank Lipman:
Right.
Dr. Robert Rountree:
But when we dropped down onto the plains, didn't have the protection of being high up there. At any moment, a saber-toothed tiger could show up out of the woods and come out on the plains and eat us. I think that led to an increase in activity in the part of the brain called the amygdala, which is the part of us that goes into alert. It's not just that the adrenals get activated. There's a whole section of the brain that is devoted towards keeping us safe. Anxiety originally developed as a survival process, right? We've got that wiring for a reason. It kept us alive. And so I'm saying all this because if a person presents with either a complaint of anxiety or a long list of symptoms that make me wonder if anxiety is playing a role, it doesn't help from my perspective to just say, "Hey, calm down. You're wearing about nothing."
Dr. Frank Lipman:
Exactly.
Dr. Robert Rountree:
It's real, it's wired in and having anxiety keeps us from running across a busy highway.
Dr. Frank Lipman:
Exactly. So I think that's what I tend to explain to people, that that sympathetic response is a protective mechanism and it's actually good for you. But in this day and age, people stay in that sympathetic state or that response keeps getting turned on, or it doesn't get turned off. And the perfect antidote to that is stimulating your parasympathetic nervous system because the sympathetic and parasympathetic nervous systems are like your yin and yang, they sort of work together. And if you can stimulate your parasympathetic nervous system, it can modulate that or decrease the sympathetic response. And the easiest way, not the easiest way, but the perfect way to do that is with breathing exercises and or meditation, or something that stimulates a parasympathetic response.
Dr. Frank Lipman:
And what I've noticed, nevermind with myself, but with a lot of patients that just doing, 10, 15, preferably a little bit more, but even 10, 15 minutes of meditation every morning. And if you do it on a regular basis, that helps that sympathetic response or helps that sympathetic system calm down and you don't become so reactive and that sympathetic response doesn't seem to last as long. I've definitely seen that in myself and in so many of my patients, when they take up a meditation practice or a breathing practice or a yoga practice or something that stimulates the parasympathetic system, they don't seem to stay in that long-term sympathetic state.
Dr. Robert Rountree:
But it's got to be a regular practice. It's got to be something that you don't make a big deal about. It's got to be something you just put into your schedule and you do it. I have to say, I've been meditating for, I don't know, 40, 50 years now. And for me, it's like a meal, a meal for my spirit and I've got to do it. It's not like, "Oh, well that's kind of a helpful thing." It's essential for me to do that. At the same time, it's not all that I do to manage stress.
Dr. Frank Lipman:
Right, right.
Dr. Robert Rountree:
I think about when I get up to give lectures, sometimes in front of thousands of people, it's normal to feel a bit anxious, to have the sweaty palms and the rapid heart rate and the dry mouth. It doesn't mean that I'm terrified of being on stage. I actually like being on stage, but I still feel those sensations. And I've actually found that sometimes the best thing for me is not to go into a dark room and meditate for half an hour before I lecture, but instead to dance.
Dr. Frank Lipman:
Right.
Dr. Robert Rountree:
And I know you can relate to that because you love African dance and love moving around. And I'm just saying that movement, the moving around and really getting it out, it allows the energy to flow through me.
Dr. Frank Lipman:
Right. Well, I think that's a really good point. And Gabrielle Roth, who always used to say the quickest way to quiet the mind is to move the body.
Dr. Robert Rountree:
I love that.
Dr. Frank Lipman:
Yeah. And that's a good point, need to realize you don't have to sit on a cushion and chant a mantra to meditate. There are other ways of stimulating this parasympathetic nervous system, taking a walk in the forest or on the beach, dancing, as you said, to listening to music. There's so many other ways you can actually meditate without meditating, per se. Because so many people think, "Oh, I can't meditate. It's just not something I can do." And I got into meditation through dance and yoga, because I struggled to meditate. When I started to meditate many years ago, I struggled and it was too hard, so I gave it up. But I got into it and got there through listening to music, through yoga, through dance, just other ways of getting out of my head.
Dr. Robert Rountree:
Yeah. That's a really great point. That's a really great point. So I miss Gabrielle.
Dr. Frank Lipman:
Yeah.
Dr. Robert Rountree:
She really gave us a lot and we're still feeding off the information that she gave us, the beautiful perspective on how to be in our bodies.
Dr. Frank Lipman:
Exactly.
Dr. Robert Rountree:
I think part of the problem in our society is that we're very heady society. We don't get that opportunity to be in our bodies and we need to get re-introduced to embodiment.
Dr. Robert Rountree:
I listened the other day to a podcast with the guy that started Headspace, which I got to admit, it's a fabulous app.
Dr. Frank Lipman:
I agree.
Dr. Robert Rountree:
We use it our family. And one of the reasons I like the Headspace app is because it's very practical and there's a lot of different options that are available. So when it was first presented to me, I thought, "I don't need a meditation app, I've been doing this for decades. I know how to meditate." But the thing that I learned from the podcast is that the guy whose name I can't recall, he was a Buddhist monk for years. And he would sit in meditation for hours on end. But then he came to the realization, he had to make this practical. He wanted something where he could go to a CEO of a corporation and say, "This is a practice that you can do every day and you don't have to shave your head and wear robes and sit on the cushion, as you mentioned, it's something you can incorporate into your life." And I think they've done an excellent job of giving you a lot of different options, a lot of ways inside, which is what this is about.
Dr. Frank Lipman:
Right. I agree. I think he's done a great job and his accent is that English accent, I think people like as well.
Dr. Robert Rountree:
It makes him sound intelligent.
Dr. Frank Lipman:
Right.
Dr. Robert Rountree:
It's the same thing for you, right?
Dr. Frank Lipman:
Exactly, exactly.
Dr. Robert Rountree:
People think you're saying something intelligent.
Dr. Frank Lipman:
You Americans are suckers for English accents. Even if they're South African accents, which are bad English accents. But you know what I actually found with my meditation? So I struggled with meditation and it definitely helped with the yoga and then the music and I was doing mindfulness for many years and I rejected or didn't pursue a Vedic meditation, or mantra meditation, which is TM because I thought TM was a little bit of a ripoff and it sort of turned me off. And as I said to myself, "I'm not going to be sitting, chanting a mantra."
Dr. Frank Lipman:
But I got introduced to a meditation teacher through the author of my How to Be Well book because she studied with him. So he offered to come to my office and teach us meditation. And he came and he taught us basically TM, but at a quarter of the price, basically a mantra meditation. And I found that particularly helpful. I found for someone like me, who's got a real monkey mind and a busy mind, actually chanting a mantra was incredibly helpful for getting out of my head and it made my meditation so much easier or I seem to be able to meditate so much better with this mantra, which I thought was I never really pursued it for whatever reason. And now that I have my mantra, I chant it, I find it so much easier. As a thought comes, you just go back to the mantra, you keep going back to the mantra. So it's actually quite an effective tool.
Dr. Robert Rountree:
I'm sure you're aware of the work of Herbert Benson, who I think was, wasn't he at Harvard?
Dr. Frank Lipman:
Yep.
Dr. Robert Rountree:
And studied TM and then said, "Well, wait a minute. I think he could just chant the word one and you'll get many of the same effects. And they actually did a lot of published studies showing that doing that every day, just chanting the word one, would lower people's blood pressure and their pulse, improve their digestion, have all of these benefits. I'm wondering, do you feel like he's got a valid point or do you think that having an assigned mantra is important?
Dr. Frank Lipman:
I use the mantra that I was assigned, but to be quite honest, I agree with Herbert Benson. Maybe that's my Western mind. I don't think that assigned mantras are that important. I know I've discussed it with Marco the meditator. They obviously believe strongly that it's a frequency of the sound. But to be quite honest, I don't think. I tend to agree with Herbert Benson. I think if you can find whatever resonates with you and just chanting something to get out of your head is probably what does it. But I may be wrong, but that's what I believe. Although, I still use a mantra that I was given.
Dr. Robert Rountree:
You still use it.
Dr. Frank Lipman:
Yeah.
Dr. Robert Rountree:
Yeah, and actually, so do I. I use my own mantra, but when I teach it to people, when patients come in and I'm trying to teach the relaxation response, then I think it's a good place to begin, just using the word one, which is what Benson said. Saying one or chanting one, one, one, over and over, it's very calming, very, very calming. So it's a great place to start. Now a question for you. You mentioned that you don't just use mind, body exercises or meditation with people who are either physically anxious or having symptoms that suggest anxiety, that you deal with metabolic issues. Do you also have a bag of tricks for supplements or specific nutrients that you use to calm the nervous system?
Dr. Frank Lipman:
Yeah, so I use standard nutrients like L-theanine in particular and GABA and magnesium. But what I've found is those are sort of healthier ways of using Valium or just stimulating the parasympathetic response or calming people down. But what I'm finding is if you change some of the underlying metabolic issues, whether it's detoxification problems or gut problems in particular, or some hormonal imbalance, can be incredibly effective. So I've just noticed since I've, in the last whatever 10, 15 years, since I became more aware of the connection between the gut and anxiety and depression has been huge.
Dr. Frank Lipman:
And I sort of stumbled across that many years ago, by chance, when I was doing a lot of detoxes where I was giving people anti-microbial herbs and they would come in and say, "Yeah, well, I'm not as bloated and I feel more energy. But you know what? My anxiety is better. You know what? I'm sleeping better." I have no doubt there's a connection between microbiome, or dysbiosis, microbiome imbalances and anxiety. And depression, I've had people come in and say the same thing as well, their anxiety is better, their depression is better. So I think the gut plays a big part or can play a big part in someone's anxiety or depression.
Dr. Robert Rountree:
Well, the gut microbes are making a lot of these chemicals or they're stimulating the cells lining the gut to make chemicals like GABA.
Dr. Frank Lipman:
Yep.
Dr. Robert Rountree:
Yeah. And they've done animal studies showing that you can change the microbiome in rodents and they exhibit behaviors that we would call anxious behaviors. So certainly working on the gut microbiome is a good way to go. I got to say, I love L-theanine, It's incredibly safe. You can't overdo it. It's a very subtle effect, but some people have called it Zen in a bottle, right?
Dr. Frank Lipman:
Yeah. It's fantastic, yeah.
Dr. Robert Rountree:
The L-theanine comes from green tea and that's what balances the caffeine in the green tea. I also love PharmaGABA, which is a plant based source of GABA. GABA's the same chemical that's naturally found in the brain and that's what's activated by benzodiazepine, anti-anxiety tranquilizers. So that's a natural way of getting GABA. It works. There's no doubt in my mind, I've heard docs say, "Hey, you can absorb it." Well, anyone who says that has never taken it.
Dr. Frank Lipman:
Right, I agree.
Dr. Robert Rountree:
Because if you take it, you can really tell. And then certainly magnesium is critical. So those are my favorite three, L-theanine, PharmaGABA and magnesium. Now I have to ask you, a few weeks ago, I went to see my acupuncturist, who does very traditional Chinese medicine. And I had a lot on my plate that week, so I was feeling more anxious. And I said, "Can you do some points for anxiety?" I don't know what points she was hitting, but boy, within five minutes, I was out. And there was no doubt. And I thought, okay, well that's another way of dealing with anxiety, I wouldn't have thought about, is activating some of these meridians.
Dr. Frank Lipman:
Yeah. There's no question. Having been doing acupuncture for so long, acupuncture's a great tool just to calm someone down. The only thing I would say is you don't want to rely on your acupuncturist.
Dr. Robert Rountree:
Unless you can go every day.
Dr. Frank Lipman:
Yeah. But it does work really well for anxiety.
Dr. Robert Rountree:
Well with that, why don't we take a short break and then we'll take some questions when we come back.
Dr. Frank Lipman:
Now more than ever, it's important to have an optimally functioning immune system. Be ready for whatever life throws your way with Thorne's suite of immune support products. From immune supportive vitamins to time-tested the botanicals, Thorne has formulas that support immune function from every angle. Not sure what your body might be missing? Visit thorne.com to take an immune quiz and receive a recommended immune solution that's right for you. Learn more at thorne.com. That's thorne.com
Dr. Robert Rountree:
And we're back. So now it's time to answer questions that have come up from our community. Thank you, all the listeners out there. Our first question this week comes from a listener who asks, "Is anxiety genetic? Is it some kind of deficiency? Is it a response to the environment or is it all of the above?" Frank, what's your take?
Dr. Frank Lipman:
I think it can be all of the above. I do think people have a genetic predisposition and that may be, as we mentioned earlier, if they have certain metabolic genetic problems, whether it's methylation, detoxification problems. So I think that there is a genetic aspect to it because now that I'm doing more genetic testing, you do find certain pathways, aberrant or problematic, in some people who have anxiety. So absolutely, I think there's a genetic part. A deficiency, absolutely. It can be certain hormones, it can be certain nutrients and definitely a response to the environment as well. So I think, yes, all three, all of the above can be issues and they're often all work together in the same person. So it's not an either or thing. So yes. Great question, by the way, whoever asked that question.
Dr. Robert Rountree:
One thing that I would throw in there is there's this concept of epigenetics.
Dr. Frank Lipman:
Right.
Dr. Robert Rountree:
Epigenetics means that there's something that gets passed down from a parent to a child that's not directly in the gene. So it's not in the DNA. And there are actually studies that show that if the mother was in a stressful environment, that can actually change genetic expression. So it's not changing the mother's DNA, it's changing the proteins that wrap around the DNA that determine which genes are going to get turned on and turned off. The simplest way of thinking about it, it's a methylation pattern. But we don't even have to be that technical. All we have to say is that it's been proven that if a mother is under a lot of stress, then the child can have all these characteristics behaviorally that indicate that something got passed down that wasn't genetic. So the thinking is that that's, quote, epigenetics.
Dr. Frank Lipman:
Right. And I think I just saw a study recently about parents who exercised, their kids had less problems as well. So I think the epigenetic factor is important. In other words, what gets passed down in the genes is one aspect and the other aspect is this epigenetic factor. So absolutely, yes. Thank you.
Dr. Robert Rountree:
So all you pregnant women out there, eat your green leafy vegetables, eat your kale.
Dr. Frank Lipman:
Exercise.
Dr. Robert Rountree:
Every day. Exercise and eat your kale every day.
Dr. Frank Lipman:
Okay. So Bob, here's another great question. Why are so many student athletes so anxious?
Dr. Robert Rountree:
Well, I live in a college town here in Boulder. And so I do see my fair share of students. Usually their parents bring them in because they went to the local student health clinic and didn't get the answers they wanted. One thing that I find is that there's so much pressure on student athletes, especially if they're under scholarship. They got a scholarship to play lacrosse. But if they don't perform, then they may not have their tuition paid to school. That's an amazing amount of pressure for that age. So the thing that you've got to work with, with these kids, is how much their identity is tied up into performance, right? Because all the feedback they're getting says, "If you don't perform, if you don't show up, if you're not a good athlete, then you're nothing."
Dr. Robert Rountree:
And so you've got to help these kids get back in touch with their center so that they realize there's other options in life. I hate to say it, but the suicide rate is pretty high in these kids, so the pressure is that great. They're feeling like they're nobody if they have a bad season. So they really need a lot of talking to. There's nothing you can give them that's going to solve that problem. Nothing they can take, that's going to solve that problem. It's all about self-concept, and as we talked earlier, about teaching them some kind of mindfulness technique or a meditation technique or a movement meditation, just so that they don't worry because the worry itself will get in the way of their performance. So Frank, what tips do you have for someone who experiences panic attacks?
Dr. Frank Lipman:
That's another great question, because this seems to be becoming more frequent as well. So it's the usual tips, where it's L-theanine and the GABA and the magnesium. And I'm recommending CBD more and more, and then obviously meditation, exercise. But what I've actually found is EMDR, eye movement desensitization and reprocessing. I've actually found that to be quite helpful. And I actually, I was turned on to that by my daughter, who's a therapist and she does EMDR. And she's quite a skeptic. Interestingly enough, she says, and I've seen it clinically as well, that EMDR can be quite helpful. I often send people for EMDR as well.
Dr. Robert Rountree:
So I agree. I think EMDR can be very, very helpful. I also try to give my patients with panic attacks, the largest menu or repertoire of things that they can do that you could possibly come up with. If you've got one thing that you can do well, you're having a panic attack, practice, deep breathing techniques. That's great. Right? But you start building on that. You already mentioned some of these things. Go for a walk in nature. The worst thing you can do if you have a panic attack is sit in the chair and worry about your symptoms, right? So you got to get up, you got to move and if you can move out by the beach or you can go in some woods or even just walk around your neighborhood, the walking moves it through. Dancing, put on some good music and shake it out
Dr. Frank Lipman:
And get out of your head.
Dr. Robert Rountree:
Get out of your head. The more choices you have, the better. And I actually have people write down lists of things I can do and say, okay, did you try number one, number two, number three? So it gives a person a sense of personal control, empowerment, realizing that they can do something about it, that they're not kind of stuck in that pattern.
Dr. Frank Lipman:
Okay. Bob, here's another great question. Does low progesterone play a role in anxiety?
Dr. Robert Rountree:
I understand that progesterone actually interacts with the GABA receptor. We know that GABA, gamma aminobutyric acid, is a neuro-transmitter made in the brain that calms things down. And so there's no question that progesterone is calming. It's most obvious to me, if I prescribe progesterone to a woman who say got irregular periods and I'm trying to regulate her periods or a woman in perimenopause and I give her progesterone, if you give it during the day, a lot of times women will say it makes them feel groggy or lethargic. And so the natural tendency is to give it at night. So it stands to reason to say that a progesterone deficiency could make a woman more susceptible to anxiety. There's much less data on men and progesterone, although every now and then I'll prescribe a little bit of progesterone. That was based on John Lee. Remember John Lee?
Dr. Frank Lipman:
Yes. Yes, yes, yes.
Dr. Robert Rountree:
Yeah. The doc that said progesterone for everything, it'll cure all your problems. And he had some good points about that.
Dr. Frank Lipman:
Actually, I haven't used it on men. But I do say I use it quite a lot on, especially as you said, perimenopausal woman because that's often what starts to drop in the beginning with perimenopause, your progesterone starts to drop. And I've found progesterone really, really helpful for a number of their symptoms, but for anxiety in particular.
Dr. Robert Rountree:
And what dose do you usually use?
Dr. Frank Lipman:
I start at 100 milligrams a night and then I go to 200 milligrams if it's not working. But I usually start at 100 milligrams.
Dr. Robert Rountree:
Yep. I agree. I find it very safe and it's inexpensive. You should use the oral micronized progesterone, I think you get the best effects from. Sometimes if women are very sensitive, I'll start with a little bit of cream.
Dr. Frank Lipman:
Yep.
Dr. Robert Rountree:
But I usually prefer to go with the oral micronized, I think that's the best. So Frank, are magnesium and CBD helpful?
Dr. Frank Lipman:
Yeah. Well magnesium, I use for almost everything and everybody. I think everyone probably needs magnesium. And interestingly enough, with stress, supposedly your magnesium levels drop anyway. So magnesium, absolutely. But I'm using CBD more and more. And now in New York we now have THC illegal, so it was harder to prescribe THC as well. But I use CBD a lot now for all sorts of things, but in particular for sleep and anxiety. And I find it incredibly helpful. Now, not everyone responds to the same CBD, the same dose. CBD can be tricky, but if you can find a CBD that works for you at the dose that works for you, I find CBD a great tool for anxiety.
Dr. Robert Rountree:
I agree. I use a lot of hemp oil for people which has CBD, but also has all the other complimentary chemicals that are found in hemp. And I like hemp oil combinations that don't just have hemp, but have other synergistic herbs with them. I think the thing people need to understand is it's not like taking a Valium.
Dr. Frank Lipman:
Right.
Dr. Robert Rountree:
If you take THC, you can usually feel it in an hour. If you take hemp oil, it's more for general calming of the system and it can take days and sometimes weeks before the full effect comes out. So it requires a little bit of patience. It's not like you have a panic attack, you take some hemp oil and boom, your panic goes away immediately. This is more for generally calming the system down to prevent the panic attacks.
Dr. Frank Lipman:
Right. Okay. Here's a interesting question. How should I know if I should be on antidepressants or anxiety medicine?
Dr. Robert Rountree:
Well, we'll talk about the antidepressants in our next session. So I'd say that to tune in. My rule of thumb for anxiety medicine, and I'll say up front, I do sometimes prescribe a tranquilizer for a person or sometimes a serotonin re-uptake inhibitor, citalopram or something like that. My rule of thumb for when I've got to do that is that the person can function. They come to see me, I'm crying all the time, I'm so anxious that I just can't function, I can't sleep, I can't get my work done. And I talk about all the things we've discussed, meditation, mindfulness, movement, cleaning up the gut. But they say, "I just need something to get me over the hump." Then I say, "I will prescribe this with the intention of taking you off it. I'll give it to you with the plan to stop giving it to you." Right?
Dr. Robert Rountree:
There's a very small percentage of people that maybe just have the genetics where it's really hard for them to not take something that's a prescription agent, but a of people can get by just fine if they do something temporarily and then have a plan to taper off. So again, my rule of thumb is if it's at the point where your life really isn't working and you just can't deal with it, it's not an occasional problem or something that's an annoyance, but it's really interfering with your quality of life. Then I think medication might be necessary. But I do like to try the L-theanine, the magnesium, the PharmaGABA first.
Dr. Frank Lipman:
Yep.
Dr. Robert Rountree:
So I feel really anxious leaving the house because of COVID. This is a question that came in. My friends feel the same way. Is the world going to be full of shut-ins?
Dr. Frank Lipman:
Well, I think we're going to all have to adjust, same way we had to adjust to lock downs and living with COVID. I think we now need to readjust to a relatively normal life. And I think it's normal to be a little bit anxious to go back out. It may be easier that most people are vaccinated. But I think it's normal to be a little bit anxious now that you have to go back to your old normal or whatever, relatively normal life. So I think that's normal. And I think that you'll adjust as you go out more and you see more and more people out and you start socializing more. I think that's normal and I don't think it should be a long-term issue.
Dr. Robert Rountree:
I agree. I think the world is not going to be full of shut-ins. I think eventually, this whole thing is going to die down. I have no idea when this is going to peter out or go away, but it is going to fade and what's going to happen is that there's going to be an incremental expansion. We started this podcast by saying things feel like they're lightening up, at least where you are, where I am. I think that's going to take hold in other places.
Dr. Robert Rountree:
So the key to me, and the answer is to do it incrementally. Pay attention. Anxiety is a signal to pay attention. Anxiety is not a signal to stop and pull back, it's a signal to pay attention. So if you're worried, be careful. But it doesn't mean you should be paralyzed.
Dr. Frank Lipman:
Yeah, yeah. Exactly.
Dr. Robert Rountree:
All right folks, that's all the time we have this week. We did want to say one thing, which is that if you are feeling like you just can't take it and you need somebody to talk to, there is a free hotline that you can call, the National Suicide Prevention Lifeline. It's +1 800-273-8255, +1 800-273-8255. Don't hesitate to call if you need to talk to somebody. So remember to subscribe to our podcast and if you feel like leaving a comment, we appreciate any feedback you have. Thanks again for listening and thank you Frank, for being on this podcast with me. It's a great pleasure.
Dr. Frank Lipman:
Thank you, Bob, and thank you, all you listeners.
Dr. Frank Lipman:
Thanks for listening to the Thorne Podcast. Make sure to never miss an episode by subscribing to the show on your podcast app of choice.
Dr. Robert Rountree:
If you've got a health or wellness question you'd like answered, simply follow our Instagram and shoot a message to @ThorneHealth. You can also learn more about the topics we discussed by visiting thorne.com, and checking out the latest news videos and stories on Thorne's Take 5 daily blog.
Dr. Frank Lipman:
Once again, thanks for tuning in and don't forget to join us next time for another episode of the Thorne Podcast.
