There’s no denying that the past few years have been stressful for everyone. In my practice nearly all of my patients have needed extra support when it comes to mood, stress, focus, and sleep. There have been a lot of news articles about the mental health crisis that has come along with the pandemic and all of the climate and political chaos of the past several years. Particularly worrisome is the dramatic increase in mental health issues experienced by children and adolescents. So today, I wanted to share some thoughts and strategies to help manage stress and balance mood.  

Exercise

Exercise is probably one of the most powerful ways to quickly lower your feelings of stress, and improve mood. Exercise encourages deep breathing, helps your body “use up” stress chemicals, releases endorphins, and increases dopamine and serotonin (our feel-good brain chemicals). If you are feeling too tired, too stressed, or too achy to carve out official time for exercise, then replace that word with “MOVEMENT.” Movement is the gateway activity to exercise. Do this:

  • Go outside and take a 2-5 minute stroll or bike ride. 
  • If even that feels like too much, try going outside and take 2 minutes to do a couple of stretches or yoga poses. 
  • Do 1-2 minutes of deep focused breaths. Swing your arms. 
  • Do side bends with one or both arms overhead.  
  • Just take a few minutes, preferably a few times per day to MOVE. The weather right now is fairly nice (though the pollen… ugh), so getting outside to enjoy the sunshine and mild weather can really lift your mood and help reset your brain.  

Sleep

Make sleep a priority. In Chinese medicine, a lot of emphasis is put on maintaining a daily schedule. When I was stressed during medical and acupuncture school, my teachers from China would always tell me, “you must go to bed on time, get up on time, eat on time.” Science has now caught up with this ancient advice. Circadian rhythm deeply affects hormone levels, stress levels, adrenal function, digestion, and all of our bodily rhythms. Getting in bed and getting up at the same time every day is important. It is also important to try to follow the sun when choosing what time we get in bed and what time we get up. One of my naturopathic teachers taught me that “every hour of sleep before midnight counts for 2 hours after midnight.” So, going to bed at a reasonable time (10-11pm), and getting up at a reasonable time (6-8am) is just as important as keeping a regular pattern.  

Diet

Reset your diet. Many of us (myself included) let our diets slide during the pandemic lockdowns and the years of “crisis mode” that have followed. This spring is a great time to try to get back to basics. Make sure you are getting dark leafy greens or food from the broccoli/cabbage family at least 1x per day. Get some fresh fruit for your dose of vitamin C and flavonoids. If you eat animal protein, look for free range, wild caught, and native diet-raised animals. Stop by the farmers market to get locally grown food

Supplements and Herbs

Supplements and herbs can give you an extra layer of support for rebuilding and rebalancing your internal mood chemistry. Here are some of my favorites:

  • Omega 3 fats (EPA and DHA) are foundational for brain health. Our brains and our nerves are made primarily out of fat. The types of fats you eat in your diet are the types that are available to build your cells and maintain your brain and nerves. Having enough Omega 3’s in our diet helps our cells, brains, and nerves be flexible and healthy. Additionally, Omega 3 fats help keep our immune and inflammatory processes in balance. Inflammation is a silent but very powerful trigger for anxiety, depression, and poor focus. 
  • Probiotics: As strange as it sounds, the balance of microbes in your gut (your microbiome) is actually essential to mental health. Having too many of the “bad bugs” can lead to subtle inflammation that affects your immune system and nervous system. Many people don’t realize that most of the neurotransmitters we have in our body are made in the  gut. Anything that makes your gut unhappy, makes you unhappy. On an even deeper level, some of those “bad bugs” make and release chemicals that get absorbed by our body. Some of those “bad bug” chemicals can directly affect our ability to make and break down neurotransmitters. Taking a high quality probiotic can help push out those bad bugs. 
  • Adrenal support: Prolonged stress, poor or irregular sleep, and chronic inflammation can really take a toll on your adrenal glands. During acute stress, when we feel nervous or jittery, our adrenals can be overproducing a chemical called cortisol. Cortisol helps us be alert, helps keep our blood pressure and blood sugar high enough for us to function, and also acts (in the short term) as an anti-inflammatory agent. When we are under stress for long periods of time, that elevated cortisol can start to cause weight gain, brain fog, anxiety, insomnia and depression. When stress goes on for years and years, our adrenals can become fatigued and unable to continue producing as much cortisol as the body needs. These are all different kinds of “adrenal fatigue.” Early stages have high cortisol; later stages, low cortisol. 

There are a group of herbs called “adaptogens” that help our body handle this stress and moderate the production and breakdown of cortisol. 

Herbs that help when you have too much cortisol:

Ashwagandha is a well-known adaptogenic herb. It is originally from Ayurveda (the ancient medical tradition of India), and is famed for its restorative and tonifying actions. It was recommended for people who were exhausted from prolonged stress or illness. We now know that Ashwagandha helps lower the levels of cortisol in the body when they are too high. This herb is best used when both stress and cortisol levels are elevated.  

There are several herbal combinations that are known to help lower cortisol levels. These herbs are often recommended to help with sleep when sleep is delayed by stress and worry. The most popular combination is ashwagandha plus magnolia and ziziphus. Another popular addition for high cortisol is holy basil. Holy basil is a delightful plant in the mint family. It grows easily here in Austin and has a heavenly aroma.  

Calming herbs. Herbs are one of my favorite ways of calming the nervous system. Some well known herbs that have a direct calming effect are: passionflower, California poppy, lemon balm, chamomile, skullcap and hops. These herbs are soothing to the nervous system without directly affecting cortisol levels. Most are quite gentle. Chamomile, lemon balm, passionflower and hops are all appropriate for both adults and children.  

CBD and hemp extracts are the new kids on the block. CBD extracts of industrial hemp have extremely low levels of the psychoactive substance THC, so are legal to use and very safe. The cannabinoid molecules (CBD is the best known, but there are CBA, CBN and many others) have anti-inflammatory and anti-anxiety properties that work on a specific set of receptors in the body that are separate from neurotransmitters and cortisol. Genetics play the largest role in determining if these products will work for you. Some people have very high levels of the enzyme that breaks down cannabinoids. These people will not get much benefit from CBD or hemp products. Other people have low levels of these enzymes. For this group of people, CBD and hemp products can be transformational for both stress and pain.

Functional mushrooms are another group of naturally occurring adaptogens.  They not only help the immune system adapt, but some mushrooms like Cordychi also help balance our stress response.

Herbs that help when you need more cortisol:

Licorice root is a great place to start. Licorice (Glycerrhiza glabra) contains molecules that are similar to cortisol. These can help your body by filling in the gaps so that your adrenals do not have to work so hard to keep up with your stress levels. These cortisol-like molecules also have mild anti-inflammatory activity. Licorice has a wonderful, earthy, sweet flavor and is often used in formulas to enhance energy and soothe an irritated digestive tract. It is also somewhat antiviral. It is used in nearly every classical Chinese herbal medicine formula and is known as “the great harmonizer.” 

Other adaptogen herbs that can help us manage stress and adrenal fatigue are:  Eleutherococcus (Siberian ginseng), Panax ginseng (Chinese ginseng), rhodiola, and brahmi.

Mental Health Resources

Last but not least: If you need professional help, please get it! There are lots of private counselors and counseling clinics and many of them take health insurance. Many, if not most counselors are offering remote sessions. If you are not sure where to turn, or if you or someone you love are in crisis, you may find some help here:  
City of Austin Mental Health Resources 
Free Online Therapy Chats 


BECKY ANDREWS, ND*, L.AC.

Becky Andrews, ND*, LAc received her Doctorate of Naturopathic Medicine and Masters in Acupuncture at Bastyr University. She specializes in complex, chronic and “difficult” cases, especially relating to digestive health, fatigue, mood and detoxification. She works extensively with MTHFr and genetic challenges. In addition to seeing patients in Austin, she is faculty at AOMA School of Integrative Medicine.

*Naturopathic Doctors are not currently licensed in the state of Texas. To support licensure efforts please visit www.txand.org.

If you have comments and/or questions about this blog, email us at blog@peoplesrx.com.