Timothy Culbert, MD, IFMCP

SAD has been linked to a biochemical imbalances in the brain, likely involving melatonin and serotonin prompted by shorter daylight hours and less sunlight during the fall and winter months. As seasons change, people experience a shift in their internal 24-hour “clock” or circadian rhythm and may become “out of sync” with other mind/body rhythms. SAD is more common in populations living farther from the equator.

Melatonin and SAD

Melatonin is linked to sleep. It's produced in greater quantities when it's dark or when days are shorter. Increased production of melatonin can cause sleepiness and lethargy. 

Serotonin and SAD

The production of serotonin increases with exposure to sunlight. Low levels are associated with depression, so increasing the availability of serotonin helps to combat depression. Learn how to boost serotonin here.>>>

A 2009 article analyzes SAD from proposed biological and psychological...

Timothy Culbert, MD, IFMCP

Escalating Anxiety in Kids & Teens

This year has been a season of uncertainty for most, mainly due to the coronavirus pandemic. As I transitioned to virtual visits for my patients, I witnessed firsthand the fragile psychological state so many pre-teens and teens are in as they wrestle with that chaos associated with COVID-19. They're often stuck at home, sharing with me how they are frustrated, disappointed, inconvenienced and worried.

The pandemic has increased uncertainty over school experiences, how and when kids might connect with friends, family finances, vacations, part-time employment, and medical and mental health. This lack of a clear path forward, and our powerlessness over many factors about the direction of our lives, can lead to significant stress. 

Rates of Anxiety Disorder in Kids & Teens

Even before the pandemic, studies indicated that anxiety in teens was rising as much as 20% over...

Timothy Culbert, MD, IFMCP

Symptoms of Anxiety in Kids and Teens May Not Be Obvious

Anxiety in kids and teens may not look like it does in adults. Emotional changes are more easily spotted, but social, physical, and sleep changes are also common for both anxiety and depression. 

Emotional Changes 

• Increasing anger, irritability, and/or emotional reactivity
• Feeling keyed up or restless
• Flat affect (lack of showing emotion)
• Anhedonia (not enjoying activities once enjoyed, decreased ability to feel pleasure)
• Easily bored
• Sad
• Panic, new fears, and/or persistent worries
• Increase in oppositional, non-compliant behaviors
• Restlessness
• Trouble separating from parents
• Phobias
• Obsessive/compulsive behaviors

Social Changes 

• Withdrawal
• Isolation
• Changing peer groups
• Avoiding participation in extracurricular activities

Physical Changes 

• Headaches
• Nausea
• Diarrhea
• Constipation
• Appetite change
• Stomach aches
• Low energy 
• Unexplained aches and pains
• Complaints of...

Timothy Culbert, MD, IFMCP 

Supplement Wisely

Talk with your child's primary doctor before adding a supplement and it's necessary to balance safety and efficacy concerns. I have a few favorites:

Inositol

Inositol, naturally occurs in foods such as fruits, beans, grains and nuts. Inositol is a type of sugar with several important roles to play. Inositol serves as a component of cell membranes. It affects the activity  of neurotransmitters in your brain cells. Read this article on inositol for anxiousness.>>>

It is available as a white powder that tastes somewhat sweet, so it is easy to mix into water, juice or other liquids. The typical dose is 2000-4000 MG mixed in liquid, taken up to three times daily. It is also available in capsule form

NMH Store: Found as one component contained within Unwind Powder

L-Theanine

L-theanine is an amino acid commonly extracted from tea leaves. It can be found in both green and black tea. It’s commonly available in...

by Henry Emmons, MD

[adapted from The Chemistry of Calm]

p.s., You've read Part 1 of this series and the introductory article about balancing GABA and glutamate, right? If not, head to those articles first.

NAC Benefits | NAC and Anxiety

NAC is short for n-acetylcysteine. You may have never heard of it before, but it has been used for years in emergency rooms for patients who are at risk for liver damage from something they have ingested (e.g., too much acetominophen). It protects the liver for the same reason it protects the brain: it works as a powerful antioxidant, boosting levels of the body’s own primary antioxidant—glutathione.

As researchers have realized the connection between glutamate/GABA balance and anxiety conditions, they have begun experimenting with NAC. Recently it has been used with one of the most complex anxiety illnesses—the spectrum of compulsive disorders (including OCD). Remarkably, researchers found that this...

Timothy Culbert, MD, IFMCP

Making Sense of Scents:  Aromatherapy Blends to Support Calm

Essential oils have been a part of human history for millennia and have been used throughout all major civilizations, with uses ranging from religious rituals and cooking, to various medicinal applications and perfumery. 

Clinical Aromatherapy can be defined as the controlled use of essential oils to maintain and promote physical, psychological, and spiritual wellbeing. Aromatic oil from many plants have healing properties. Oils are extracted from flowers, bark, stems, leaves, roots or other parts of a plant one of two ways – either by steam distillation, or pressing. 

Healing Alchemy Calming Blend

Oils such as frankincense, sweet orange and lavender can be relaxing for those experiencing symptoms of anxiety and stress.

Healing Alchemy Soothing Blend

For agitation and/or GI upset associated with stress or anxiety, consider lemon, mint...

by Henry Emmons, MD

[adapted from The Chemistry of Calm]

ps: You've read Part 1 of this series and the introductory article about balancing GABA and glutamate, right? If not, head to those posts first.

pps: some of these natural therapies are not ideal for all types of anxiety. Visit our Calm Section to learn your anxiety subtype and tailor your approach.

Inositol Benefits | Inositol and Anxiety

Inositol is often classified as a B-vitamin, though technically it is not a vitamin since the body can produce it. Taken as a supplement, it has long been known to reduce general anxiety, panic and OCD symptoms. Researchers found inositol to be just as effective as a popular antidepressant for panic disorder, and participants tolerated it well even at massive doses up to 18 grams per day.¹⁷

Inositol Dosage & Use*

Inositol is often recommended at a dose of about 1-2 g daily, though in studies it has been used at much higher doses. 

Inositol Side...

Timothy Culbert, MD, IFMCP

There is a growing interest in using technology to make relaxation training more fun and engaging. Some have referred to these gadgets as electroceuticals. Below are three technologies that I suggest to my patients for anxiety management.

Heart Rate Variability Biofeedback

Heart rate variability (HRV) involves measuring the beat-to-beat variations in heart rate as it naturally speeds up and slows down throughout the day. A person can then actually see the changing HRV pattern on a computer screen or cell phone and learn to control it. Studies have found that when people are anxious, stressed or scared, their HRV pattern looks messy and disorganized. On the other hand, HRV patterns becomes more rhythmic, organized and regular  when strategies are used to shift into a calmer state. I recommend  the Inner Balance Smart Phone app and hardware for HRV practice.

Cranial Electrotherapeutic Stimulation 

Cranial...

by Henry Emmons, MD

[adapted from The Chemistry of Calm]

p.s., You've read Part 1 of this series and the introductory article about balancing GABA and glutamate, right? If not, head to those articles first.

Taurine and Anxiety | Taurine Benefits

Taurine is an amino acid that increases glycine and GABA to calm the brain (AKA ease anxiety).¹⁵ It also protects the brain by reducing the harmful effects of excess glutamate.¹⁶ I consider taurine when I see someone with mood instability along with anxiety, but it may also be helpful for anxiety alone. 

You may already be familiar with taurine, as it's often added to energy drinks (e.g., Red Bull). Manufacturers seem to consider it the drinkable solution for periods of extreme exertion, when taurine levels can become depleted. I don’t recommend replenishing it through energy drinks though. There are better ways to use taurine to calm your brain.

Taurine Dosage & Use*

Taurine is...

By Henry Emmons, MD

“Life is short. Stay awake for it.” Caribou Coffee nailed it with that promotional tagline. It’s funny, memorable and a widely shared sentiment. If we want to get the most out of life, if we don’t want to miss anything, caffeine offers a safe, legal and increasingly pleasurable way to feel more enlivened.

I have nothing against caffeine. In fact, I personally love it. I’ve given it up several times over my life, thinking it might have negative health effects on me. But each time I’ve come back to it, finally accepting that I just plain enjoy it. I like the effect it has on me, the flavor, the ritual and the communal nature of sharing a cup of coffee with someone.

I believe that the research on the health effects from caffeine come out mostly on the side of it having an overall positive impact on health. It’s a legal stimulant. It can temporarily improve energy, focus, even mood. So long as it is not used in excess, it...