Holistic Approaches for Mental Wellness

I put together this blog post of holistic approaches for mental (and physical) wellness that include everything from supplements and exercise, Mindfulness and Neurofeedback, to practitioners such as Osteopaths and Acupuncturists, because as a psychotherapist I know that the mind is part of a greater system that needs support in order to function at its best. Engaging in psychotherapy is only one part of the puzzle when addressing concerns related to our mental health. Incorporating and addressing the needs of the whole system is crucial for mental wellness.

*This list is supported by clinical research (referenced at the bottom of the page), and is not to replace medical advice from your primary care physician.

Vitamins & Supplements

Probiotics are beneficial bacteria found in traditionally fermented foods, or in the form of natural supplements. Consuming probiotics helps to build and maintain the balance of healthy bacteria in your gut.

The gut and brain have a very important relationship. There is bidirectional communication that occurs between the central nervous system and gut microbiota, which is referred to as the gut-brain-axis. Inflammation in the gut have been linked to causing several mental health concerns, including anxiety and depression. Healthy gut function has been linked to normal central nervous system (CNS) function. Hormones, neurotransmitters, and immunological factors released from the gut are known to send signals to the brain either directly or via autonomic neurons.

Hyperactivity or dysregulation of the hypothalamic – pituitary – adrenal axis (HPA axis) has a direct correlation with anxiety and depression.

Probiotics are living microorganisms, typically yeasts and bacteria, which have been utilized as supplements to other medications, or as alternative treatments for anxiety and depression. Probiotics provide a neuro-protective role by preventing stress-induced synaptic dysfunction between neurons, and normalized cortisol levels (stress hormone), regulate the HPA axis, and reduce the circulation of pro-inflammatory cytokines (Clapp et al., 2017).

Some other positive effects of probiotics on the brain:
– Normalized levels of cortisol, the “stress hormone”

– Improved production of serotonin, the “happy transmitter”

– Reduced symptoms of anxiety and stress
– Improved energy, mood and overall health
(Sinclair, F.)

Consumption of the Lactobacillus strain of bacteria has been clinically proven to have psychotropic properties that regulate emotional behaviour, ameliorate anxiety and depression, and modulate neurochemicals related to mood disorders (Bravo et al., 2011 ; Liu et al., 2016).

A list of bacteria to look for in probiotic products can be found here.

Ashwagandha
is a medicinal herb that is classified as an “adaptogen”, which means that it can help your body manage stress, as well as, providing all sorts of other benefits for your brain and body such as, lower blood sugar levels, reduce inflammation, reduce cortisol levels, boost brain function (Spritzler, F., 2018), and has clinically been shown to reduce symptoms of anxiety and depression (Cooley et al., 2008). Ashwagandha can be found at your local health foods store. 
Kava – is a beverage or extract that is made from the Piper Methysticum plant, which is native to the western Pacific Islands. Kava is taken orally for the treatment of anxiety, stress, restlessness, and insomnia. Research has shown that taking kava extracts that contain 70% kavalactones can lower anxiety and might work as well as some prescription anti-anxiety medications (WebMD). *Please note that there are serious drug interactions with psychotropic medication and Kava, so please consult with your naturopath before taking.

GABA (a, b) – is a neurotransmitter in the human brain that functions as your brains main inhibitory neurotransmitter, meaning it keeps your brain from becoming overactive and promotes calm and relaxation. It is the neurotransmitter that dissolves anxiety and improves sleep. GABA is made naturally in the body, and use it across almost all of your brain. GABA receptors always live in your gut, which helps with the communication between your gut and brain, and in turn influence your emotions. GABA can be taken in a supplement form to increase GABA, which will in turn reduce anxiety, muscle tension, improve sleep, reduce stress, and improve mood (Abdou et al., 2006; Cryan & Kaupmann, 2005; Lydiard, 2003). You can also increase GABA through meditation, yoga and exercise, which will be explained below.

*This list is not exhaustive of the supplements and vitamins that can benefit your mental and physical health. The identification of these supplements does not replace medical advice of a naturopath or physician. Please consult with your primary care provider.

Diet

Studies have shown that long-term effects of poor nutrition on the central nervous system affect mental health. If our bodies are not getting adequate nutrition, we will notice the impact on our immune system (frequently getting sick), energy level (feeling tired all the time), concentration and focus, our nervous system functioning, and our mood (Davidson et al., 2012).

A balanced diet which includes, plenty of vegetables and fruits, protein, healthy fats (unsaturated fatty acids, DHA, Omega 3), whole grains, anti-oxidants, and naturally fermented foods. And don’t forget WATER! Water will help your body flush out unwanted toxins and remain hydrated, which affects the body’s functioning.

https://draxe.com/healthy-fats/
https://food-guide.canada.ca/static/assets/pdf/CFG-snapshot-EN.pdf

Exercise

Studies have shown that exercise can treat mild to moderate depression as effectively as anti-depressants and can prevent relapse by maintaining a regular exercise schedule. Exercise is effective in combating depression by facilitating neural growth, reducing inflammation, releases endorphins that boost mood and energy (serotonin), and relieves tension and stress. It also normalizes sleep, which has protective effects on the brain (Harvard Health Publishing, 2011; Mayo Clinic, 2017). Weir (2011) states that, “exercise may be a way of biologically toughening up the brain so stress is less of a central impact”. To reap the mental and physical benefits of exercise, it is recommended that you engage in 30 minutes of moderate exercise, 3-5 times a week. This does not have to be a 30-minute block of exercise, it can be two 15-minute sessions, or three 10-minute sessions. The key is to get moving whenever you can.

Some tips to get your started (adapted from here):

– Start slow! Start with a 5-10 minute walk, and then increase your time gradually, over time.
– It feels counterintuitive (and downright HARD) to get moving when you are feeling tired or your mood is low, but studies have shown that exercise can dramatically reduce fatigue and increase energy levels, so all you need to do is get one-foot-in-front-of-the-other. If you are feeling this way, just commit yourself to a 5 minute walk, and chances are you will be able to do more once you get going; and if you don’t, that’s ok too!

– Schedule exercise at a time of the day where your energy is at its highest

– Do activities you enjoy: walking, swimming, kicking a soccer ball, playing basketball, yoga, running

– Reward yourself

– Make exercise a social activity; when suffering with depression, social engagement and companionship is just as important as the exercise. It can also feel more motivating when someone is doing the activity with you.

– Incorporate exercise into your life and while on the go. For example, take the stairs instead of the elevator, walk instead of drive, take walking breaks during your work day

Mindfulness

Mindful.org (2014) defines mindfulness as the “basic human ability to be fully present, aware of where we are and what we are doing, and not overly reactive or overwhelmed by what’s going on around us”. It gives us a time where we can suspend judgment and unleash out natural curiosity about the workings of the mind, approaching our experience with warmth and kindness, to ourselves, and others.

There has been extensive research indicating that mindfulness is positively associated with psychological health, and that training in mindfulness may bring about positive psychological effects. Mindfulness has shown to have positive effects as an intervention for, and treatment of, ADHD, bipolar disorder, anxiety disorder, panic disorder, depression, eating disorders, alcohol and substance abuse, post-traumatic stress disorder (PTSD), and chronic pain (Keng, 2011; van der Kolk, 2014). It also has broad effects on physical health, including improvements in immune response, blood pressure, and cortisol levels (van der Kolk, 2014). Practicing mindfulness helps calm the sympathetic nervous system.

You can start by just noticing your inner experience. What feelings are present? What sensations do you notice in your body? Can you have a gentle curiosity about your experience? Do you notice the temperature and pace of your breath? Can you feel where the breath rests in your body?

There are also plenty of Mindfulness apps that you can download and use to guide you through a mindfulness meditation. Here are a few options for mindfulness apps (for Apple & Android):

Stop Breathe Think
Headspace
Calm: meditation and sleep stories
Present – Guided Meditation
Serenity – Mindful Meditation

Yoga

Research has supported that yoga increases body awareness, relieves stress, reduces muscle tension, strain and inflammation, sharpens attention and concentration, and calms and centres the nervous system. It has been proven to enhance social wellbeing and to improve the symptoms of depression, ADHD, and sleep disorders (Khoshaba, 2013; van der Kolk, 2014). Yoga has also been shown to increase the level of GABA, which is the neurotransmitter that helps combat anxiety. Research has shown that when yoga and meditation evokes a deep, physiological state of rest (relaxation on the nerve and cellular level) it produces immediate positive change in the expression of genes involved in immune function, energy metabolism and insulin secretion (Massachusetts General Hospital, 2013). Bessel A. van der Kolk and colleagues (2014) conducted research that showed that 10-weeks of yoga practice markedly reduced the PTSD symptoms of patients who had failed to respond to any medication or to any other treatment.

Read more here about the physiology of yoga.

Neurofeedback

Neurofeedback (also known as EEG Biofeedback) is an evidence-based treatment to help regulate electrical brainwave activity to reduce severity of symptoms that may result from an imbalance. Neurofeedback helps the client gain better control over their brainwave patterns and gives them a greater flexibility over their functioning.

Neurofeedback is based on the principles of operant conditioning. Operant conditioning is a type of learning where certain behaviours are rewarded to increase the chance of them occurring. For example, a client with ADHD symptoms will be rewarded for a calm, focused, mental state. The trainee is connected to EEG leads that will transmit information related to brainwave patters to the computer software used for training, and when the trainee enters this mental state, they are rewarded with visual and audial feedback through computer software. A participant is given instant feedback when they are no longer in the desired mental state, as the audial and visual feedback stops or is altered. Through practice, the desired mental state becomes easier to enter, maintain, and recognize. As a result, the person improves their ability to self-regulate their mental states.

Neurofeedback is based on principles of neuroplasticity, and is essentially a learning process. Information about the brain’s processing is displays to the client and the brain adapts an improves as it learns to modify its functioning.

Neurofeedback has been proven to produce long-term changes, as the brain learns to improve its function. There has been significant research published supporting the effectiveness and benefit of Neurofeedback in the treatment of Anxiety, Depression, Concussions, Traumatic Brain Injury (TBI), PTSD, trauma, and clients who want to optimize their performance (CEOs and athletes have used Neurofeedback for this purpose) (Neuropotential Clinic; van der Kolk, 2014).

To see a video about what Neurofeedback is and what it does: https://www.isnr.org/neurofeedback-introduction

https://youtu.be/qB2DI87JN5A

To find a Neurofeedback practitioner near you: https://www.isnr.org/member-list

Research article on Neurofeedback: https://www.researchgate.net/publication/263581677_Quantitative_EEG_and_Neurofeedback_in_Children_and_Adolescents_Anxiety_Disorders_Depressive_Disorders_Comorbid_Addiction_and_Attention-deficitHyperactivity_Disorder_and_Brain_Injury

Practitioners to support your Whole Body Wellness

Osteopath

Osteopathy is a manual form of therapy which emphasizes the interrelationship between structure and function of the human body. It follows a belief in the body’s ability to self-heal and self-regulate, and aims to restore function in the body by treating the causes of pain and imbalance (Canadian Academy of Osteopathy). Since our brains and our bodies are an interconnected system, any imbalances, misalignments, and blockages can have an impact on our central nervous system, and in turn, our mood. Seeing an osteopath for regular tune-ups is beneficial for everyone’s overall functioning and wellbeing. To read more about what Classical Osteopathy is, visit here and here.

Here is a video explaining what Osteopathy is: https://youtu.be/8uhO-GirLCA

To book an initial consultation with our very own 4th year Manual Osteopathic Practitioner, contact Jennifer here.

Naturopath

Naturopaths are primary care physicians with training in providing medical care with treatment interventions using nutrition, plant-based medicine, traditional Chinese medicine and acupuncture. They treat acute and chronic health concerns, as well as identify risk factors and exercise preventative measures to help optimize health in the long-term. Naturopath’s look at the whole body and how it is functioning, and provide a thorough and integrative approach to treating the underlying causes of disease/illness/discomfort. You can read more about what Naturopathic Medicine is here.

Dietitian

Registered dietitians are health care professionals who are trained to provide advice and counselling about diet, food and nutrition. They help people make healthy food choices, separating fact from fiction, and distinguishing healthy eating plans from those that don’t provide optimal nourishment (Dietitians of Canada).

Since our mood is significantly impacted by what we eat, Dietitians are a great resource to consult when wanting to make changes to your diet to make healthier choices, and include more nutrients. Dietitians also help people manage health issues such as Diabetes, Celiac disease, inflammatory bowel disease, poor nutritional intake, and eating disorders.

Massage Therapist

Massage therapy has been clinically shown to reduce anxiety and depression, decrease pain, decrease cortisol and norepinephrine levels (arousal and stress hormones), reduce sleep disturbances, and reduce feelings and expression of anger (Field et al., 1996, 1997, 1992, 2007, 2008; Hou et al., 2010; Listing et al., 2010).

There are many massage schools in Toronto where you can get a low-cost massage from a Massage Therapist in training. Here is a list of low-cost massage therapy options.

Acupuncture

Recent studies have shown that acupuncture is a valuable adjunct therapy for those suffering from mental health disorders. Studies have shown that acupuncture treatment reduced symptoms of depression by 43%, and that acupuncture can block sympathetic nerve activity – the part of the nervous system responsible for anxiety and hyperarousal. Acupuncture (and massage) alleviates stress and depression symptoms by releasing endorphins, the body’s own natural painkillers, and improving the circulation of blood and lymphatic fluids which bring fresh oxygen to body tissues. The increased oxygen flow eliminates waste products from inside the body and enhances recovery from diseases. Acupuncture decreases stress hormone cortisol, lowers blood pressure, reduces heart rate and relaxes muscle tissue.

Check out more about the effectiveness of acupuncture treatment for mental health here: https://www.actcm.edu/blog/acupuncture/acupuncture-effective-in-treatment-of-mental-illness/

For low cost Acupuncture, visit: www.communityacupuncturetoronto.ca/why-do-we-use-a-sliding-scale.html



References

Abdou, A.M., Higashiguchi, S., Horie, K., Kim, M., Hatta, H., and Yokogoshi, H. (2006). Relaxation and immunity enhancement effects of gamma-aminobutyric acid (GABA) administration in humans. Biofactors, 26(3): 201 – 208. https://www.ncbi.nlm.nih.gov/pubmed/16971751

Bravo, J.A., Forsythe, P., Chew, M.V., Escaravage, E., Savignac, H.M., Dinan, T.G., Bienenstok, J., and Cryan, J.F. (2011). Ingestion of Lactobacillus strain regulates emotional behaviour and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad Sci USA, 108(38).

Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., and Wakefield, S. (2017). Gut microbiota’s effect on mental health: The gut-brain axis.
Clinics and Practice, 7(4): 987. doi: 10.4081/cp.2017.987

Cooley, K., Szcurko, O., Perri, D., Mills, EJ.,and Bernhardt, B. (2008). Naturopathic Care for Anxiety: A Randomized Controlled Trial. PLoS One, 4(8). Retrieved from: https://www.ccnm.edu/research/research-abstracts/naturopathic-care-anxiety-randomized-controlled-trial

Cryan, J.F., and Kaupmann, K. (2011). Don’t worry ‘B’ happy!: a role for GABA (B) receptors in anxiety and depression. Trends in Pharmacological Science, 26(1): 36-43.
https://www.ncbi.nlm.nih.gov/pubmed/15629203

Cryan, J.F. & O’Malony, S.M. (2011). The Microbiome-gut-brain axis: from bowel to behaviour. Neurogastroenterol Motil, 23, 187-192.

Davison KM, Ng E, Chandrasekera U, Seely C, Cairns J, Mailhot-Hall L, Sengmueller E, Jaques M, Palmer J, and Grant-Moore J. (2012) The Role of Nutrition in Mental Health Promotion and Prevention (1). Toronto: Dietitians of Canada. Retrieved from: https://www.dietitians.ca/Downloads/Public/Nutrition-and-Mental-Health-1.aspx

Field, T., Figueiredo, B., Hernandez-Reif, M., Diego, M., Deeds, O., Ascencio, A. (2008).  Massage therapy reduces pain in pregnant women, alleviates prenatal depression in both parents and improves their relationships. Journal of Bodywork and Movement Therapies, 12(2): 146-150.

Field, T., Grizzle, N., Scafidi, F., & Schanberg, S. (1996). Massage and relaxation therapies’ effects on depressed adolescent mothers. Adolescence, 31(124): 903-11.

Field, T., Hernandes-Reif, M., Diego, M., Fraser, M. (2007).  Lower back pain and sleep disturbance are reduced following massage therapy.  Journal of Bodywork and Movement Therapies, 11(2): 141-145.

Field, T., Morrow, C., Valdeon, C., Larson, S., Kuhn, C., Schanberg, S. (1992). Massage reduces anxiety in child and adolescent psychiatric patients.  Journal of the American Academy of Child and Adolescent Psychiatry, 31(1): 125-31.

Field, T.M., Sunshine, W., Hernandez-Reif, M., Quintino, O., Schanberg, S., Kuhn, C., & Burman, I. (1997). Massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome. Journal of Chronic Fatigue Syndrome. 3, 43-51.

Harvard Medical School Publishing (2011). Exercising to relax. Harvard Medical School. Retrieved from: https://www.health.harvard.edu/staying-healthy/exercising-to-relax

Hou, W.H., Chiang, P.T., Hsu, T.Y., Chiu, S.Y., Yen, Y.C. (2010). Treatment effects of massage therapy in depressed people: a meta-analysis. Journal of Clinical Psychiatry. 71(7): 894-901.

Keng, S.L., Smoski, M.J., & Robins, C.J. (2011). Effects of mindfulness on psychological health: A review of empirical studies. Clinical Psychology Review, Article in Press. Retrieved from: https://greatergood.berkeley.edu/images/uploads/Keng-Mindfulness_Review_and_Conceptions.pdf. Doi: 10.1016/j.cpr.2011.04.006

Khoshaba, D. (2013). Take a Stand for Yoga Today: Yoga’s positive benefits for mental health and well being. Psychology Today. Retrieved on March 19, 2019 from: https://www.psychologytoday.com/ca/blog/get-hardy/201305/take-stand-yoga-today

Listing, M., Krohn, M., Liezmann, C., Kim, I., Reisshauer, A., Peters, E., Klapp, B.F., Rauchfuss, M. (2010). The efficacy of classical massage on stress perception and cortisol following primary treatment of breast cancer. Archives of Womens Mental Health. 13(2): 165-73.

Liu, Y.W., Liu, W.H., Wu, C.C., Juan, Y.C., Tsai, H.P., Wang, S., and Tsai, Y.C. (2016). Psychotropic effects of Lactobacillus plantarum PS128 in early life-stressed and naïve adult mice. Brain Res., 1631: 1-12.

Lydiard, R.B. (2003). The role of GABA in anxiety disorders. Journal of Clinical Psychiatry, 64(3): 21 – 27. https://www.ncbi.nlm.nih.gov/pubmed/12662130

Massachusetts General Hospital. (2013, May 1). Study identifies genes, pathways altered during relaxation response practice. ScienceDaily. Retrieved March 19, 2019 from http://www.sciencedaily.com/releases/2013/05/130501193204.htm

Mayo Clinic Staff (2017). Depression and anxiety: Exercise eases symptoms. Retrieved from: https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495

Sinclair, F. (2019). Microbiome & Mood: The Link Between Your Gut Bacteria and Mental Health. Retrieved on March 15, 2019 from: https://roottohealth.ca/gut-bacteria-and-mental-health/

Spritzler, F. (2018). 12 Proven Health Benefits of Ashwagandha. Retrieved from: https://www.healthline.com/nutrition/12-proven-ashwagandha-benefits#section5

van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York, NY, USA: Viking.
Weir, K. (2011). The exercise effect. American Psychological Association, 42(11). Retrieved from: https://www.apa.org/monitor/2011/12/exercise

Websites:

https://www.mindful.org/what-is-mindfulness/

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