Anxiety & depression rear their ugly heads for many around the holidays. Dr. Jennifer Bunzenmeyer, ND discusses why this is along with tips for managing and reducing symptoms.
Episode 35: Overcoming the Holiday Blues
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Welcome to Supplementing Health, a podcast presented by Advanced Orthomolecular Research. We are all about applying evidence-based and effective dietary lifestyle and natural health product strategies for your optimal health. In each episode, we will feature very engaging clinicians and experts from the world of functional and naturopathic medicine to help achieve our mission to empower people to lead their best lives naturally.
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[1:37] Cassy Price: Hello. Welcome to Supplementing Health. Today we are joined by Dr. Jennifer Bunzenmeyer, a naturopathic doctor who will be discussing anxiety and depression over the holidays. Welcome, Jenn.
[1:48] Dr. Jennifer Bunzenmeyer: Hello, Cassy. Thanks for having me on the show.
[1:51] Cassy Price: Why don’t we kick today’s conversation off by learning a little bit about what got you interested in mental health and anxiety and depression in the first place.
[1:59] Dr. Jennifer Bunzenmeyer: Sure. I started having a focus in my practice as a naturopathic doctor on anxiety and depression in about 2010, so about ten years ago. What I was finding is there was a gap that needed filling. People knew about or know about antidepressant medications, and they know about therapy with a psychologist, but I find that there’s a whole in-between area of natural treatment that could be added that could have good physiological support.
[2:33] My goal for treatment is simple with people. I’m meeting them where they’re at. If they’re working with their conventional medical doctor, which I do suggest doing, and they’re on antidepressants, we can adjunct with those antidepressants’ natural therapies. Or if they’re wanting to try to find natural remedies and work with natural remedies first, we could do it that way but still have their MD on board as well. And I’m all of the big proponent of them working with a therapist or a psychologist to help support that mental-emotional piece as well.
[3:16] The goal of treatment, I think, is learning how to manage those thoughts of anxiousness, worry, or in depression, that low energy motivation, maybe worthlessness. Overall, that’s what we want to be managing are those thoughts. From my perspective as a naturopathic doctor, I’m giving tools to help them support them to either be calmer from an anxious perspective or maybe to help with energy levels and motivation while they’re working with a therapist, or self-help books, or different classes to help figure out how to control those thoughts, change their perceptions, and support their perceptions going forward so that they can live the best life moving forward. Does that answer your question, Cassy?
[4:17] Cassy Price: Yeah, absolutely. It makes sense. What is the difference between anxiety and depression?
[4:24] Dr. Jennifer Bunzenmeyer: There’s a huge difference between anxiety and depression. Anxiety is more that excessive, out-of-control worry that’s negatively impacting a person’s quality of life. It tends to be an excessive worry that is occurring more days than not for a long period of time, for at least a six-month period. It’s about a number of events in a person’s work life, school life, activities.
[5:01] The individual finds it difficult to control that worry, and they usually have some other symptoms with that, including things like feeling keyed up, feeling on edge, restlessness, easily fatigued, I think because they’re spending so much energy managing through that anxiety. They can have difficulty concentrating, or their mind can be going blank because of that anxiety. There can be irritability, muscle tension, and sleep disturbances – things like falling asleep is hard or staying asleep. They’re waking through the night. Those are the main things from an anxiety perspective.
[5:43] We do have to look at other things just to rule out, just to make sure that it’s not caused from another physiological condition like hyperthyroidism and looking at the different mental health disorders and making sure that it’s not schizophrenia-based and having a better understanding of the different types of anxiety, like OCD or social anxiety, which we might go into a little bit later. So, that’s more anxiety.
[6:18] Depression is more quite the opposite in the sense of we’re seeing, at least a depressed mood or a loss of interest. Those are the main areas. Then, with that depressed mood or loss of interest, we see a decrease in their interest in things that used to give them pleasure and activities that used to give them pleasure.
[6:44] They might have significant weight loss because they have a loss of appetite, or they might be gaining weight because they’re eating more. With that, they might have insomnia where it’s hard to sleep, either falling asleep or waking through the night. Or they might have hypersomnia or sleeping too much because they’re so tired.
[7:11] So there’s often a loss of energy, there’s fatigue, decreased motivation, and they can also have feelings of worthlessness, or excessive or inappropriate guilt, or diminished ability to think or concentrate, or being very indecisive. So depression is quite a different myriad than anxiety. Does that answer your question, Cassy?
[7:40] Cassy Price: Yeah. It definitely does. For depression, you mentioned it can go one way or the other, and both be polar-opposites, so it is more about the extreme change that people experience that would make it depression versus a bad day?
[7:59] Dr. Jennifer Bunzenmeyer: Yes. Depression – those symptoms are occurring more often than not over a two-week time period. They’re feeling those symptoms.
[8:13] Cassy Price: You had mentioned a couple of types of anxiety disorders, being OCD and a social disorder. Can you talk about those two and maybe some of the other common types that exist?
[8:23] Dr. Jennifer Bunzenmeyer: Sure. When you asked this question, I do want to preface that I think that this is better answered by a psychologist. They know the ins and outs a little bit better than I do, but I will give you a general answer. There are five main anxiety disorders, so there’s generalized anxiety disorder, which is more of a general, exaggerated worry intention. Often, we know that it can seem irrational, but there’s a worry that is not going away that is incessant.
[8:58] Versus OCD, obsessive-compulsive disorder, which is more of a recurrent, unwanted thought or obsession that gets repeated in the mind. So things like they might be scared of germs. They might have a specific scenario happening in their head. So they then have repetitive behaviours or compulsions to try to prevent that obsessive thought like handwashing, checking and triple-checking the door to make sure that it’s locked. They’re stuck in that obsessive, repetitive behaviour cycle.
[9:42] Panic disorder is more of an intense fear that comes and goes. It’s often characterized by a person going into a place of chest pain, heart palpitations, shortness of breath, dizziness. Like, this sounds like a heart attack, and they often are terrified when they first feel that panic that it is a heart attack. So, it’s more of intense pockets of panic.
[10:13] Then there’s PTSD, which we have heard lots about, Post Traumatic Stress Disorder, which usually develops after an exposure to a terrifying event or an ordeal, which has caused them physical harm or they felt very threatened. Usually, those people have a lot of anxiety afterwards, so we all know that after a military combat, a lot of veterans can have PTSD.
[10:45] The fifth one is a social phobia. That’s where a person has a social anxiety disorder where they’re feeling overwhelmed in social situations. It might be one type of a situation like a fear of speaking, or it might be more generalized where going into social events, going into a grocery store, or going to a party and having to have those small conversations, they get that anxiety. So those are the most common five types of anxiety disorders that we see usually.
[11:22] Cassy Price: Okay. So then I would think probably with the holidays coming up, social anxiety starts to rear its head more frequently.
[11:30] Dr. Jennifer Bunzenmeyer: Yes.
[11:31] Cassy Price: With 2020 having been a stressful year, to say the least, for many people, and everything that has happened this year, I would assume there are probably many additional triggers around the holidays this year, even opposed to a normal year. Would you agree or disagree with that?
[11:50] Dr. Jennifer Bunzenmeyer: Absolutely. The holidays, in general, before a pandemic, there’s a lot of stress that is coming up. There are those family stressors, those family expectations. Everyone has their own idea of how the holidays should go. I find that it’s talking beforehand with loved ones to manage each other’s expectations and build an understanding of how we can make it a win-win for all parties to help quale that anxiety so that we can work through and we can find an even ground, basically. I think with the pandemic, we’re going to have to figure those things out even more so.
[12:38] Then there’s the internal expectations we put on ourselves around the holidays. So it’s, “Does Susie have as many gifts as David?” “My Christmas decorations don’t look at good as I want them, so I just need to add that one thing, which ends up taking till 2:00 in the morning to do, when it really doesn’t matter. So there are these different triggers that we find stress-wise around the holidays.
[13:08] Another big one that a lot of people don’t realize that I definitely look at is diet being off. We’re having more sweets; we’re not having as much protein, and that can trigger our mood to go down. So either we can be lower energy, or it can actually trigger an anxiousness as well, plus we’re dealing with all those extra family expectations, and shoulds, and things that we wish that we could be doing. Those kinds of things.
[13:42] Cassy Price: So, with stress clearly affecting anxiety, does it have a similar impact on someone who is suffering from depression?
[13:50] Dr. Jennifer Bunzenmeyer: There’s a little bit of a difference that I view. From a depression perspective, a person is already tired; they’re possibly sad; they’re low-motivated. Sometimes with depression, it’s hard to get things moving in their day-to-day lives. It’s hard to get those dishes done. It’s hard to work through the stress that’s coming upon them.
[14:22] So, if we add extra stress on like holiday stress and getting things organized, then for that person that’s depressed, extra energy that they’re having to spend, I like to look at it as their gas tank is already empty or close to being empty. So that stress is there; they’re tensing their muscles more; they’re often already tense muscles. They’re expending energy in dealing with the stress, and that can drain them more where that can enhance their tiredness, enhance their muscle tension, decrease in interest and motivation to do things that they need to do or they need to get ready for. That decrease in fuel is going to perpetuate or has the potential of perpetuating that depression.
[15:18] Versus anxiety – that stress is basically triggering that fight-or-flight response. We’ve all heard of how stress triggers the fight-or-flight in our body. Adrenaline is released, and that usually helps us work through the stress. But for a person who is already anxious, they already have a lot of adrenaline pumping through their system that that extra stress is just perpetuating that adrenaline release, and it can increase that anxiety perspective that they’re already feeling.
[16:01] They’re dealing with the stress. It’s part of the worry that they’re experiencing, so what I like to do is work on calming down that nervous system so that when that stress comes, they’re able to manage through it easier. There’s a little bit of a difference between anxiety and depression and how it impacts, how stress impacts both conditions.
[16:27] Cassy Price: Yeah. That makes sense, for sure. Is it just adults who can feel this during the holiday season, or can kids also be suffering from holiday anxiety?
[16:37] Dr. Jennifer Bunzenmeyer: Kids pick up on stress extremely easily, so they feel it from their parents, they feel the stress is happening, so I think kids can really pick up on it easily, as well, and they can have that holiday anxiety too.
[16:55] Cassy Price: In your opinion, are we likely to see an uptick in people suffering from these conditions this year due to the extra strain?
[17:03] Dr. Jennifer Bunzenmeyer: With the pandemic?
[17:05] Cassy Price: Yeah.
[17:05] Dr. Jennifer Bunzenmeyer: Yeah. I would definitely think that with the social isolation piece that we’re all feeling, the inhibition of our lifestyles and how we’re feeling inhibited in many different ways in what our normal is, I would definitely think there would be an uptick in anxiety or depression because we don’t have as many of our outlets accessible, and we’re having to find creative and innovative ways to stay safe in a pandemic, but have some social connection over Zoom or phone calls or socially distancing, and things like that. So, in my opinion, yes. I do think that anxiety and depression would be more common in this pandemic.
[17:57] Cassy Price: For those that are having to travel, I know that’s being cut down significantly this year, but I’m sure there are probably some people who still are having to face travel during the holiday season. Do you have any tips to help manage or reduce the anxiety and stress of going through that process?
[18:17] Dr. Jennifer Bunzenmeyer: I’m a firm believer of trying to keep routine as normal as possible through that travel and if we’re having to wake up earlier than we’re used to and to drive to family and that kind of thing, try to have as much routine and mealtime at the same time, bed and wake times the same time routines really helps keep the gas in our gas tanks. That would be number one.
[18:51] Number two, I would say trying to keep a relatively healthy diet. I’m not a proponent of strict diet. I’m like an 80/20 person: 80 good, 20 maybe not so good, but trying to keep blood sugar balanced as much as possible with diet, trying to not have too many sweets, have protein with each meal.
[19:15] Having that diet thing can really help support. And I always, when I’m travelling, to have extra snacks with me – some seeds or a protein bar just in case I get stuck where there are no meals we can grab and things like that. I think that’s important. Then, making sure we’re getting outside on a regular basis, having that movement, having that sunshine hit our face to help with our mood, support from that perspective as well.
[19:54] Lastly, I would say self-care as much as possible. If we’re staying at our family’s house, we’re out of routine. We don’t have our normal self-care routine in place, so trying to have some of those things like take some time off, go for a walk by yourself or with you and your spouse and your kids, so you have some alone time. Things like that can be really helpful.
[20:24] Cassy Price: Awesome. You had mentioned that going outside and getting the sun on your face can help. Research has shown that vitamin D deficiency is linked to an increased incidence of depression. Here, in Canada, due to the limited sun exposure during the months of November to April, our winter months, a lot of people do suffer from lower vitamin D levels. Do you believe that’s a contributing factor to the increase that we see during the holiday season?
[20:51] Dr. Jennifer Bunzenmeyer: I think that vitamin D is – yes. Research has shown that there is a link between vitamin D and depression – low levels of vitamin D and depression, especially with Seasonal Effective Disorder, as well. It is definitely something on my radar to screen my clients and do lab work through to see where their levels are at.
[21:20] So, it’s part of the treatment, but I don’t find that it’s the only thing that I’m looking at. There are many other areas that I would be looking at from a depression standpoint. But, yes. Research has shown that vitamin D can be lower in that it can help with depression.
[21:39] Cassy Price: How does staying active or getting in regular exercise affect these issues?
[21:45] Dr. Jennifer Bunzenmeyer: We know for certain that movement – I like to call it movement instead of exercise. I feel like it has a less negative connotation. We do know that movement and exercise is a really important stress-reliever, and it has been shown in many studies to help both anxiety and depression, so it is something that I think is really important to be getting.
[22:12] From an anxiety perspective, it’s distracting, so it gets the person out of that hamster wheel thinking of the worry that they’re fixated on, so it can help from that perspective. From a depression standpoint, oftentimes, they have a low motivation. They have low energy, and I often will tell my clients, if you’re sad, get up and move around. Do the dishes, do some laundry, go for a five-minute walk or a ten-minute walk outside just getting some fresh air.
[22:49] Sometimes, those baby steps of just having a little bit of movement can actually help a person that’s depressed because it gets their adrenaline moving a little bit, and it can actually help in that energy and low motivation to do things. Then they can slowly work up to longer periods of movement or exercise, going to a gym or working out at home as well. So, it definitely makes a difference for both anxiety and depression – exercise does.
[23:27] Cassy Price: That’s great to know. You’ve mentioned diet a few times, and in particular, sugar intake. We all know that the holidays have far more treats hanging around than the regular day-to-day.
[23:41] Dr. Jennifer Bunzenmeyer: Totally.
[23:41] Cassy Price: Can you speak a little bit to how sugar intake plays a role in anxiety and/or depression?
[23:47] Dr. Jennifer Bunzenmeyer: Yes. Totally. Diet is one of the first things that I look at with clients. In the sense of educating them to have them understand why it’s so important. If we’re having too many starchy foods or sugar in our diet, and we’re not having enough protein or those non-starchy veggies like salads or just raw veggies of cucumber, peppers, and things like that.
[24:19] Those starchy foods or the sugar, particularly over the Christmas holidays, can increase our blood sugar. Our body can only have that glucose in the system for a certain amount of time before it will release insulin, and then that blood sugar gets shoved into the cells. Then your blood sugar drops. It’s that drop in the sugar that can often make us feel anxious or depressed.
[24:52] Often, when I’m working with clients, once we start working on diet, they start putting it together where they start noticing that they’re balancing their blood sugar, their diet is balanced, and they will indulge and have some candy. For a depressed person, I find that it can trigger them for a couple of days after where it really affects their mood.
[25:18] So that balancing blood sugar as much as possible is important through diet. Things like trying to make sure you’re having protein with each meal. That’s my first step. I always say half your plate, those non-starchy veg, a quarter of your plate protein, a quarter of your plate starch. That’s my go-to.
[25:46] Then it’s about monitoring their reactions 30 to 90 minutes after their meal. Are they having what we call hypoglycemic reactions where they feel shaky, they feel weak, fatigued, sweating? They can often get brain fog. I’m sure we’ve all felt that. You know, when you have a big pasta meal, and an hour later you feel really tired, it’s too much starch and not enough protein, not enough non-starchy veg. So it’s about trying to balance our blood sugar as much as possible.
[26:28] Another thing I wanted to say is with depression, specifically, we go over the diet aspect, but sometimes people are so tired that they just feel overwhelmed trying to even put together a good diet or a balanced diet. So we might start with baby steps and maybe, let’s put protein with breakfast, lunch, and dinner. Let’s just see if we can do that and baby steps along the way, so while we’re working on energy levels and motivation, I’m at least educating them about that, and then they can start to understand once their energy gets better. Then they can be doing more from a diet perspective. So, it’s just baby steps.
[27:21] Then the other piece I would say is from the holiday perspective. This is where my 80/20 comes in of “Yes. I like to enjoy my mom’s jam-jams or a piece of chocolate. But it’s making sure that you’re getting protein in breakfast, lunch, dinner so that you’re able to balance sugars as much as possible, knowing that you’ve had that sugar. Does that make sense?
[27:51] Cassy Price: Yeah, absolutely. Another substance that I wanted to ask you about when we’re talking about fatigue and anxious feelings is caffeine. A lot of us drink coffee in the morning, or if we’re at a friend’s house, we go for a coffee with them, something like that. How would that [crosstalk 28:09]?
[28:10] Dr. Jennifer Bunzenmeyer: [Inaudible] Yes. From an anxiety perspective, particularly, caffeine is very stimulating. I often will suggest to avoid it or take it out as much as possible because it can stimulate an anxiety reaction in the system. To get off the caffeine, I will often suggest to do half caffeinated, half decaf. Do that for a while, and then slowly cut down. But you’re right. It can definitely affect.
[28:44] Cassy Price: We all experience ups and downs like we’ve mentioned earlier, but how does someone know when it’s time to seek help?
[28:51] Dr. Jennifer Bunzenmeyer: Very good question. I love how you’re pointing out the fact that these are normal feelings. Anxiety is a normal feeling. Depression is a normal feeling. We all have ups and downs so that in itself is really good to recognize and have awareness around. But I would say that from a depression standpoint if you’re seeing consistent symptoms for more than a two-week period, I would definitely look at seeking some help from a therapist or your doctor or your naturopathic doctor. Look from that perspective.
[29:32] Anxiety is a little bit longer, so the definition they say is more like a six-month period or more of anxiousness; we should be looking for help. I’m a proponent of preventative as much as possible, so if you’re managing through some stress that’s come your way, or a crisis, or high amounts of stress at work, it’s really great to work with a therapist to have an understanding of how to manage through that stress and the anxiety that you’re feeling.
[30:09] Cassy Price: Okay. So what are some of the resources that are available to people to get them started on that prevention or treatment plan?
[30:19] Dr. Jennifer Bunzenmeyer: As a naturopathic doctor, I’m definitely happy to work with people in the sense of looking at their diet. There are different natural remedies that we use to help support anxiousness, help calm the nervous system. Or from a depression standpoint, there are things that we can look at to help with energy and motivation or imbalances of serotonin or things like that. So definitely, as a naturopathic doctor, we can work from that perspective.
[30:56] I do have a network of psychologists that I work with around the city. They and I work together with people to work from that. They’re working on the mental/emotional piece. I’m working on that physical aspect. Definitely, work from that perspective and then definitely people should be seeking help and telling their medical doctor about this as well so that their MD is on board. And there are traditional treatment options as well. I would look from that perspective.
[31:38] Then other resources are things like getting exercise on a regular basis, signing up for – there’s lots of Yoga’s and Palates on-demand now even with the pandemic. Or some other good things are – there’s the Calm app, which is a meditation app. There are lots of good meditations that you can do on that app.
[32:10] One of my favourite books in terms of trying to decrease our perfectionistic tendencies is The Gifts of Imperfection by Brené Brown. An excellent book. With anxiety, we’re often trying to be perfect, and her book is excellent on trying to embrace being good enough. So, I love that book.
[32:40] Then, one thing that I really look at is, are we getting our values met? What I mean by that is looking at what are your core values that drive you, that you would walk over broken glass for? If we can figure out what those are and then match our lifestyle so that we have those in our lifestyle, I find that is huge at helping mood.
[33:12] So, for example, connection is one of my core values. For me, connecting in my jobs, this is why I love working with clients, connecting with family and friends. Those are really important things for me. I’m having to be very innovative during the pandemic. Another core value of mine is health. I, fortunately, listened years ago to getting into naturopathic medicine, and I can support people in their health, and it’s one of my core values, so I practice what I preach. I walk the talk as much as I can.
[34:00] It’s those kinds of things – you’re figuring out what your core values are. It might be you love learning, or you need a secure lifestyle, or you need freedom, or you need to feel accomplished. So, then, how can you match those things and have them in your lifestyle. I find that can really help our moods as well. So I actually have on my website a blog on how to find your core values that I find works really well at helping with mood.
[34:41] Cassy Price: Fantastic. I’ll have to add that book to my to-read list that you mentioned. It sounds great. We’ll share your blog in the description for the podcast as well so that any of our listeners can find it because I think that will be a great resource for them. We have, unfortunately, reached the end of our time for today, but if any of our listeners want to work with you or get ahold of you to further
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