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The

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Hormone

WITH DR. KYRIN DUNSTON

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The Anatomy of Anxiety: Understanding and Overcoming the Body's Fear Response


Do you ever feel like fear is controlling your life? We've all been there. But in this episode, Dr. Ellen Vora gives us insight into how to regain control with her expertise on the body's natural fear response and the tools we need to manage it effectively. Join us to learn more about understanding and overcoming anxiety so you can live a life that feels right for you!

Ellen Vora, MD is a board-certified psychiatrist, acupuncturist, and yoga teacher, and she is the author of the bestselling book The Anatomy of Anxiety: Understanding and Overcoming the Body's Fear Response. She takes a functional medicine approach to mental health, considering the whole person and addressing imbalance at the root.

In this episode, you'll learn:

• What the body's fear response is and how to recognize it

• The importance of addressing anxiety holistically

• Tools for managing anxiety in the long-term

• Dr. Vora's personal story and journey with healing from anxiety

Tune in to gain greater insight into your own fear response and learn practical tips for regaining control. This episode will help you reclaim your power over fear and live a life full of joy, peace, and resilience. Let's jump right in!

Don't forget to share, subscribe and leave a review if you like what you heard! We look forward to hearing from you! Thanks for tuning in and we'll catch you next time!


(00:00): Problems that remain persistently insoluble should always be suspected as questions asked in the wrong way. Alan Watts. In this episode we talk about if you're suffering from anxiety and or on medications for anxiety, what you might be doing wrong in your approach, and how to recognize and solve the underlying problem. Stay tuned.

(00:29): So the big question is, how do women over 40 like us keep weight off, have great energy, balance our hormones and our moods, feel sexy and confident, and master midlife? If you're like most of us, you are not getting the answers you need and remain confused and pretty hopeless to ever feel like yourself Again. As an ob gyn, I had to discover for myself the truth about what creates a rock solid metabolism, lasting weight loss, and supercharged energy after 40, in order to lose a hundred pounds and fix my fatigue, now I'm on a mission. This podcast is designed to share the natural tools you need for impactful results and to give you clarity on the answers to your midlife metabolism challenges. Join me for tangible, natural strategies to crush the hormone imbalances you are facing and help you get unstuck from the sidelines of life. My name is Dr. Kyrin Dunston. Welcome to the Hormone Prescription Podcast.

(01:22): Hi everybody. Welcome back to another episode of the Hormone Prescription with Dr. Kyirin. Thank you so much for joining me today. Today we are talking all about the anatomy of anxiety with a true expert who's written an amazing book and has incredible insight. She has a similar journey to mine in that she was trained as a medical doctor. She went into psychiatry and really realized that we weren't helping people with giving drugs and doing surgery, and she found a better way. And now she has dedicated her life to educating others about the anatomy of anxiety and what's really going on behind the scenes. She is an incredible person. She offered this quote to me that I love from Alan Watts, who's an amazing philosopher. And this is what it says, problems that remain persistently insoluble should always be suspected as questions asked in the wrong way.

(02:20): So what does this mean? It means if you have a problem that hasn't been solved, you're asking the wrong question. And I once was in a coaching program with Mary Morrisey, who's amazing coach and spiritual leader, and she was talking about the importance of the right question and that if given an hour to formulate the answer to a problem, you should spend 55 minutes on formulating the right question that will give you the answer. And I have found that so much to be true. I always tell people with your health that if you, you have persistent health symptoms, diagnoses, medications, problems, whatever you wanna call it, something's not right with your health, then you haven't asked the right question. It's asking the right questions that is invaluable to fixing your health. And unfortunately, as a mainstream doctor, I didn't know the right questions to ask.

(03:20): Now I know the questions to ask, so I'm gonna help you ask the right question. And if you're dealing with anxiety, which millions of us do at some point in our life, many of us chronically, or we've got a loved one who's dealing with it, and it can be debilitating, prevent you from having relationships or working and all kinds of things. And if that's you or someone you know, you wanna listen up because you need to know about the anatomy of anxiety. And Dr. Vora is an expert at this. She's really taken a deep dive in her book. She's a beautiful way of looking at it. I'll tell you a little bit more about her and then we'll get started. So Ellen Vora is a medical doctor. She's a board certified psychiatrist, acupuncturist and yoga teacher, and she's the author of the bestselling book, the Anatomy of Anxiety, understanding and Overcoming the Body's Fear Response. She takes a functional medicine approach to mental health, considering the whole person and addressing imbalance at the root. Welcome, Dr. Ellen Vora to the show.

(04:18): Thank you so much for having me.

(04:20): I am so excited to dive into this topic with you. A lot of my listeners know that anxiety was a huge part of my story. I didn't really suffer from anxiety at a young age. It wasn't a problem and it really started in my forties and it got so severe that everybody knows this for that and depression. I was on five psychoactive medications at one point and the doctor told me, you will never get off of these. I couldn't even hardly function even with those five medications, I was so anxious my body would tremble, but I had nothing to be anxious about. And I know that you talk about this <laugh>, so I kind of wanna dive in there. And this is for the people who have maybe been dealing with their anxiety their whole lives. Maybe they just deal with anxiety most recently. Maybe they have a loved one who has anxiety. It's so problematic and it's so debilitating. So I don't even know where to start. So I'm gonna just say, Ellen, start <laugh>. Start where you think, why is this such a problem that affects so many people?

(05:30): Yeah. So the way you and I were both taught to think about anxiety, you know, we were taught in medical school to evaluate it according to the D S M, our Bible of mental health, a diagnostic statistical manual. And we're really most of all indoctrinated with the idea that our mental health issues are the results of a genetic chemical imbalance. This is our monoamine theory of depression, where we say it's your serotonin. You were born with jeans that meant that you had low serotonin, but that's okay cuz you're alive in 2023 and we have a pill that can fix that. So here, take this pill and it will fill up your empty serotonin tank and everything will be honky dory. Again. It's a nice story. I think it came primarily from well-meaning scientists using deductive reasoning when they saw that certain tuberculosis medications that manipulated serotonin seem to raise some people's moods.

(06:23): But it turns out it's not a true story. And it, you know, that the idea there, the implication is if you take these pills, it's gonna fix your depression. I think many people listening who have had an one or another experience with psychiatric medications, even if they're net on the whole helpful, this story's not quite so clean and simple. And so I also think what's important is that when we focus on the genetic chemical imbalance, that is our least hopeful narrative when it comes to mental health. It tells us it's a fixed trait, it's our destiny. We're broken, we're stuck. And I have observed through 10 years of practice that this is patently false. This is not true of mental health. And while genes do play a role, it is only ever a predisposition in functional medicine. As you know, we say genes loads the gun, but the environment pulls the trigger.

(07:18): So when we only focus on genes, that keeps us feeling like this is our destiny. I will always be depressed, I will always be anxious when we shift our focus to the environmental influences that also have an enormous impact on our mental health. Well, there's something we can do about that. Sleep and nutrition, inflammation, hormones, gut health, and then more psycho-spiritual aspects of mental health, community nature, feeling of a sense of meaning and purpose in our lives being of service. All of this also impacts our mental health, and there's a lot more we can do about that. So I prefer to shift our focus to what we can control. And I want people to know they're not stuck even if they've felt depressed or anxious. You asked, why are so many people anxious right now? I think that there's two big reasons. When I think about anxiety, I, I divide it into two categories.

(08:09): False anxiety and true anxiety. Where false anxiety is physical anxiety, it's based in the physical body and it's avoidable, it's related to inflammation or sleep deprivation or a blood sugar crash or a hangover. And we are these days swimming through a cesspool of causes of false anxiety. We are all inundated with environmental influences that are making us more anxious than people were even 30 years ago. But then the other piece of this is our true anxiety, which is purposeful anxiety. It's not something to pathologize, it's not something to suppress. And we don't get to fix it by simply going gluten free or switching to decaf coffee. This is our inner compass. It's nudging us, asking us to slow down and pay attention to what's not not right in the world. And these days we are also inundated with quite a lot that's not right around us.

(09:01): So we come by our true anxiety, honestly. And the good news is, whether it's our false anxiety or our true anxiety, there's a lot that we can do to support ourselves. And so I think that we are all so anxious these days, but we've been trained to think about mental health incorrectly, letting us feel stuck and thinking that the menu of possibilities to support our mental health is just medication and therapy. And I want people to know, first of all, there's always reason for hope, never a reason to despair. And that there's so many other strategies we can take to support our mental health.

(09:36): I think that is so important. And I love this, the concept you have of false anxiety and true anxiety. Is that what you called it? Yeah.

(09:45): Yeah. I think that's brilliant. Because <laugh>, the body can cause anxiety and most people think, oh, it's a mental process, it's a mental problem. And like I said, I didn't have any reason to be anxious. There was no mental issue. Well, I was kind of on off my path and I think that <laugh>, that was the problem. <Laugh>, I was so off my path, but also I had so much inflammation and hormone imbalance and toxicity and my body was, I didn't realize that that vibrating tremoring shaking was my body screaming that it needed help. You know, because we were both trained the same traditional medical doctor program and what would we do? Pill for every ill surgery for every symptom. So that's what I went to a doctor like that, a psychiatrist, and he just kept prescribing and kept adding. And you know, thank God, fast forward, I am off all psychoactive medications. I don't need any, once I fixed all the underlying problems and got on my path, <laugh>,

(10:52): That's exactly it. The false and s true dichotomy. And I think, you know, not to project, but I was in the same situation where to be a medical resident, I was in so many false moods because I was inflamed, chronically sleep deprived, absolutely malnourished, you know, overfed, but undernourished and my hormones were all whack, which is a consequence of everything else. Yeah. Out of balance. And so I had a lot of false moods. But there's also that true mood that is if you went into medicine because you actually wanted to make a difference and support people, for many of us, we wake up to the the deep crisis and disenchantment of what is the system I'm a part of? I'm not convinced that I'm helping people. I'm not convinced that I'm not harming people. And so that's true Anxiety right there for you, a textbook example, and it's beautiful that you were aware of both of these things.

(11:44): It's unfortunate that our system these days is such that if you go in and you say, I'm really not feeling okay, all we know to offer people is medication. And there's a path there that is concerning to me. And it's, it's difficult to convey this without, I don't mean this as an non-pharmacologic path. I'm a psychiatrist, I prescribe medication. I've seen them benefit people. Absolutely. But what I see so often is someone says to their primary care doctor or their psychiatrist, I'm not feeling great. And they say, you know, in the 15 minutes they have with you, well, okay, like take Lexapro. And then you start Lexapro, and then you get sexual side effects, then you add Wellbutrin, and then maybe you're not really sleeping and you add Ambien and then you can't really focus during the day. You add Adderall and then you're anxious and then they add Xanax.

(12:30): And before you know it, you have a cocktail of medication. And the piece of this that's most damning is that it's delicate to talk about this without, I recognize some people really need their medication. Sometimes we need more informed consent. But I think what also happens is that the medications themselves can make us more fragile. The medications beget the need for themselves. Take Xanax for example. It's very effective in the short term, in the medium and long term. It exacerbates the very problem it's set out to treat in the first place. It makes us more anxious. And we can talk about the biochemistry of that. So once somebody's on a cocktail of medication, not only are they deeply plugged into the system, but they're very neurochemically fragile at that point. And it's hard to be well on your own. And you start to think of yourself as very sick and needing a lot of medication, needing a lot of support, you're spending a lot of time standing online at the Walgreens. And it just, it leads people down a path that I, it makes me from some days sad and other days outraged to think about how many people we've plugged into this life without first asking, how are you sleeping? Do you have community in your life? What's your diet look like? Are you pooping every day? Simple diet and lifestyle strategies that we can do to address mental health At the

(13:47): Root, I think, oh gosh, everything you're saying is just giving me chills because ev people need to hear this. So if you're listening <laugh>, maybe if you need this information, yayu, please share it. It is so vital because we have a mental health crisis and it needs to be addressed and people aren't going to get this information in their doctor's office. So please share this with a