About 2 years ago I had an epiphany while soaking in my bathtub—seemingly my favorite place for epiphanies. I was 30, had a high paying job, a beautiful house, a supportive husband, good friends, an idyllic place to live, contemplating children, and yet, alas…I was fizzling, tired, and burnt out. A classic case of perfectionism hitting the wall. My body, my mind, and soul had been aching for change, but guilt sprinkled with denial and social expectations kept me stuck. Yet that evening in the bathtub, I finally gave myself permission to feel the dichotomy, to sit with the discomfort, and to plot a plan of action.

 

 

 

 

 

Fast-forward to the present day. I got rid of my 4-bedroom house, moved into a cottage of sorts,  got rid of my job, started a business aligned with my passions, decided my parental energy was best spent on dogs, did hold on to my husband, but ultimately began a process of sorting and shedding the layers of ‘shoulds’ and put a question mark after the social expectations that seemed so important. I even parted with my bathtub for a standup shower…this was a BIG DEAL.

I realize my shift is a privilege. I was able to leave my bureaucratic workplace and carve out my own niche. I had a supportive family, I was able to ‘follow my heart’, I had resources, and I recognize my ability do so is an impossibility for many. How can we then maintain a level of sanity, contentment, and balance in the midst of work, deadlines, pressure, interpersonal stress, preserving our reputation, relationships, and oh yes, going to the gym, meditating, and drinking our green smoothie?

Maintaining a work-life balance and emotional wellness is not an accomplishment that is one day reached and completed, but a daily, intentional endeavor. The following principles are what I both strive for and teach my many clients navigating this tricky proposition and trust me, I am in no way on a pedestal…

• Prioritize non-negotiables:  What are those things that must take place of be present for you to feel grounded? Is it your morning run? Your 5-minute meditation? Scribing in your journal? Your favorite tunes? Prayer? Become familiar with your non-negotiables, share them with your family members, schedule them, make them habits. Horses, running, and nature happen to be personal faves.
  

  

  Running

  

  Nature
• Find a tribe: We are social beings and as much as you feel like you thrive as an introvert, the need for socialization is etched into your genetic code. Perhaps your tribe is small, perhaps large, but do not try to go at life’s peaks and valleys alone!
• Goodbye perfectionism: Perfectionism is the fast track to burn out. The perfectionist in me still loves to try to resurface especially in the face of uncertainty or doubt. All or nothing, black and white, I must do X, Y, and Z to be successful…all classic perfectionistic mindsets. You run a race where the finish line keeps moving. You operate in hypervigilance and competition. Contentment is fleeting if ever present. You are often exhausted. Your work may prosper, but your health, family, relationships, and contentment will almost surely suffer. Recognize that perfectionism is energy-depleting and not completing. Question your version of success.
• Become mindful: We live in a world of noise, chaos, and distraction. Many of us are more comfortable in noise than we are in silence. Many of us fear solitude without distraction as it forces us to confront our own thoughts. We do not heal by avoidance, but by awareness. Take 5 minutes of your busy day to focus on your breath, take a sensory inventory (what are you seeing, smelling, tasting, hearing?), practice gratitude, be present.
• Be open and stay flexible: In my opinion the idea of ‘finding your true self’ as if that self were a stagnant being waiting for you over the horizon is overrated. You do not have to live to work…working to live is just fine, too. There may not be a perfect job or a perfect path. Life happens and inevitably, we will go through change, transformation, epiphanies, and growth. It is okay that a once upon a time passion becomes less exciting, or your beliefs evolve, or your relationships change. Be open to this change and recognize that decisions you make today may seem silly in retrospect. Such is life. Embrace the gray when the tendency may be compartmentalize life to black and white. Be gentle with yourself.

Ultimately, emotional wellness and maintaining balance is a spectrum complicated by the unpredictability of life. Regardless of where you are on the spectrum, do not be afraid to feel, to love, and to give yourself permission to take action. I look forward to hearing about your bathtub epiphanies.

As always thanks for listening.

With gratitude,

Audry Van Houweling, Owner & Founder, She Soars Psychiatry, LLC located in Sisters & Silverton, Oregon www.shesoarspsych.com

In my office I practice functional medicine. Functional medicine aims to identify root causes of health concerns and in doing so, supports treatment solutions that are long-lasting and sustainable. Given my specialty in mental health, the intersection between your hormones and emotional is a “root” that cannot be dismissed. Your hormones are intimately connected with your mood in a bidirectional, dynamic relationship and one of the major players in this relationship is your thyroid.

Your thyroid is a butterfly shaped gland that sits in the lower part of your neck. It has many important roles including growth & development, metabolism, temperature regulation, and neurotransmitter production among others.

Thyroid dysfunction is on the rise these days. This may be due to the thyroid being particularly susceptible to potentially damaging effects of synthetic, hormone disrupting chemicals that have increased exponentially the past 40-50 years finding their way into the air, water, and food supply. It is estimated that worldwide up to 25 percent of the population have some degree of thyroid dysfunction. Therefore, when I evaluate someone for depression, anxiety, poor motivation, and poor focus among other symptoms, it is imperative that thyroid function be assessed.

Thyroid imbalances can trend in two directions. Most commonly, thyroid function and hormones associated with the thyroid create a state of hypothyroidism. Symptoms associated with hypothyroidism may include fatigue, depression, brain fog, memory loss, cold intolerance, weight gain, muscle pain, and dry skin. Alternatively, hyperthyroidism can be associated with restlessness, anxiety, weight loss, insomnia, rapid heart rate, irritability, and heat intolerance.

Thyroid dysfunction may be the consequence of an autoimmune disorder. Hashimoto’s disease is the autoimmune state more commonly associated with hypothyroidism while Grave’s disease is more commonly associated with hyperthyroidism.

Women have seen the highest increases in thyroid dysfunction especially during pregnancy, postpartum, and postmenopausal states. In fact, it is estimated that up to 80 percent of postpartum depression may be associated with thyroid dysfunction.

It is important to recognize that somebody with undiagnosed thyroid dysfunction may present to a mental health clinician and meet criteria for a number of psychiatric diagnoses such as major depression, generalized anxiety, panic, or attention deficit disorder. Therefore, while your symptoms may qualify you for a psychiatric diagnosis, the foundation of these symptoms may be hormonal, which often demands treatment approaches beyond psychotropic medications.

In my opinion, truly assessing thyroid function necessitates looking at multiple pieces of the puzzle. Too often many of these pieces are neglected leaving an incomplete picture of what your thyroid is doing or not doing. At a minimum I recommend the following lab tests to assess thyroid function:

1. TSH (Thyroid Stimulating Hormone, regulates secretion of T3 & T4)
2. Free T3 (active form of thyroid hormone)
3. Free T4 (inactive thyroid hormone, requires conversion to T3)
4. Thyroid Antibody Test (this is important to rule out an autoimmune disease)
5. Liver Function Test (your liver is very important for activating thyroid hormone)
6. Ferritin (required for T3, your active thyroid hormone to work at the cellular level)

 Stress, diet, nutrient deficiency, lack of physical activity, oral contraceptives, heavy metals, pesticide exposure, chronic illness, and compromised liver or kidney function can all be contributors to thyroid dysfunction. Thus, treating thyroid dysfunction demands a personalized approach that considers these multiple factors. There is not a one-size fits all solution. The good news that with a combination of hormonal support, lifestyle changes, and close monitoring, significant improvement is possible.

Ultimately, it is important that mental health symptoms are not seen in a box and that we take a broad approach in investigating what their origins may be. Acknowledging the power of your thyroid and other possible root causes is paramount to finding sustainable solutions.

Stay healthy everyone.

With gratitude,

Audry Van Houweling, PMHNP-BC, Owner She Soars Psychiatry, LLC

www.shesoarspsych.com

It is estimated that one in four Americans suffers from some sort of mental illness. A good number of these individuals may lean on their faith and place of worship in times of distress. While a place of worship may provide needed refuge, in other instances our place of worship can also cause shame.

There have been noteworthy efforts among some places of worship to recognize the prevalence and impact of mental illness; however, in too many others, there continues to be a stigma and/or discomfort that perpetuates silence and isolation among its members. Even more harmful, some places of worship may continue to believe notions that mental illness is a spiritual affliction, punishment, or simply a sign of weak faith. When faced with a mental health condition, individuals may feel ashamed, spiritually inadequate, and pressured to put on a façade of strength when possible. Sunday mornings may be a joyous time of social gathering and worship, but it may also a time of social angst, fear of judgment, and high standards.

And then there are times when despite our best efforts a façade is simply not possible. Be it serious mental illness such as schizophrenia or bipolar disorder, major depression, grief, or trauma, displaying ‘spiritual resolve and strength’ can at times, be all too difficult.

A lack of support from a place of worship or the insinuation of shame to the individual may not only perpetuate an emotional crisis, but may also trigger a spiritual crisis, which together feed one another in a bi-directional struggle. Throughout my work I have witnessed this struggle not only in church members, but also among church leaders who are expected even more so to prevail and remain spiritually resolute in times of emotional distress.

As has long been the case, mental illness is often seen as separate or different than what may be considered the ‘physical body’. Places of worship may not hesitate to rally around a member battling so-called physical afflictions such as cancer through prayer, visits to the hospital, flowers, notes of encouragement, etc. Yet, when confronted with suicide or a mental health crisis, there may be reluctance or discomfort.

There may also be a hesitation to seek treatment and trust mental health professionals as they may not be adhering to the teachings of a particular faith however, the same may not be true when being treated for a ruptured appendix, diabetes, or taking pharmaceuticals.

It is important to recognize that many places of worship have good intentions, but may lack the understanding, training, and language necessary to empower and support members suffering with mental illness. Leaders of faith are often on the front lines when it comes to emotional distress, but may feel overwhelmed with knowing how to respond in a way that both promotes the faith, but also recognizes the need for professional assistance. Ultimately, there is a need for enhanced dialogue about mental illness among church leaders, congregation members, and community professionals. Places of worship need not be afraid of the reality of mental illness and ideally would feel emboldened to speak out and provide refuge and understanding.

Undoubtedly, spirituality and a person’s core beliefs are central to overall wellness and vitality. Regardless of our spiritual devotion however, we are all vulnerable to the ups and downs of life and are likely to encounter situations that transcend our spiritual understanding. Places of worship are in a unique position to provide refuge- which can begin with the simple acknowledgement that having ‘faith’ does not have to demand that we feel well, stable, or even optimistic.  And that is okay. Here’s to giving each other grace. Take care everyone.

With gratitude,

Audry Van Houweling, Owner & Founder, She Soars Psychiatry, LLC Sisters & Silverton, Oregon, www.shesoarspsych.com

Alcohol use among women is up…by a lot. According to a study conducted by JAMA Psychiatry rates of alcohol use, high risk alcohol use, and alcohol use disorder have all increased considerably among women from 2001-2002 to 2012-2013. The study also noted considerable increases in alcohol use among minorities and older adults.

While there has been a recent spotlight on opioid and prescription drug use, alcohol use has quietly been climbing and deaths attributed to alcohol continue to rival any other substance. High risk drinking, which was defined in the study as women consuming more than 4 drinks per day or men consuming more than 5 drinks per day increased by 30% between 2001-2002 to 2012-2013. Among women specifically, high risk drinking increased by nearly 60%.

When looking at problem drinking, which is defined as alcohol abuse that causes recurrent problems in daily life or alcohol dependence, rates among women increased by an alarming 84% within the ten-year time span. While men are still more likely to be problem drinkers than women, women are quickly catching up.

Binge drinking among women, which per The National Institute on Alcohol Abuse and Alcoholism (NIAA), is defined as 4 drinks or more in a two-hour period has also increased considerably- especially among older women. From 1997-2014 rates of binge drinking among men over 60 have stayed fairly steady, while rates for women over 60 have increased an average of 4% each year.

Women are known to be more sensitive to the damaging effects of alcohol. Aside from having generally a smaller stature than men, women also tend to have more body fat and less water (which dissolves alcohol) in their bodies compared to men, and tend to have less alcohol dehydrogenase- an important enzyme that helps our bodies break down alcohol.

The Centers for Disease Control defines heavy drinking as being more than 15 alcoholic drinks for a man per week or 8 drinks per week for a woman. Excessive alcohol use among women has been associated to cancer, heart disease, high blood pressure, stroke, gastrointestinal distress, liver damage, and brain atrophy among other health problems.

Researchers have theorized that with more women entering the work force and confronting demands of work-life balance, alcohol may be a way of coping with increased stress loads. Additionally, women can be faced with sexism, lower wages, job uncertainty, and exposure to trauma.

Throughout the media, heavy drinking among women has been normalized and in many cases associated with attractiveness, likability, and humor. There is less shame or guilt around alcohol use compared to other substances. Alcohol use is often socially acceptable and at times, even expected. A woman’s sobriety at the bachelorette party or girl’s night out may be critiqued more so than if she were to get buzzed or intoxicated.

As Oregonians and even more so, as Central Oregonians, it is hard to ignore the booze culture as trendy breweries seem to be popping up all around us. Booze tourism is serious business and the allure of what’s next on the horizon can be in all senses of the word, intoxicating. For many it is hard to contemplate fun or social outings without alcohol in the equation. It is easy to become desensitized to consequences and long-term implications.

Ultimately, while brew cycles and craft beers can be enjoyed responsibly, it is important that we maintain a realistic and frank dialogue about the very real dangers alcohol encompasses. If you or a loved on is struggling with alcohol know that there is help and certainly, know that you are not alone.

As always, thanks for listening everyone!

Wishing you health and vitality.

With gratitude,

Audry Van Houweling, PMHNP-BC, Owner & Founder She Soars Psychiatry, LLC

541-595-8337/Sisters & Silverton, Oregon/ www.shesoarspsych.com

 

 

 

Been to the doctor lately? Likely you have had the typical patient experience- sat in the waiting room past the time of your scheduled appointment, then were ushered back to the exam room, sat probably a bit longer waiting for the provider to actually be ready to see you, and when the provider finally arrives, you rush through your concerns perhaps at the insistence of the provider who might be typing away making only brief eye contact, and then you are handed a prescription 5-10 minutes later, told to rest, drink lots of fluids, and maybe just maybe, to eat healthy and exercise.

Sound familiar? Let me tell you, many of these providers have the very best intentions, but are pressured by multiple factors that may not be readily apparent as you are sitting in front of them trying to feel heard. Providers are pressured to be more and more productive as insurance reimbursements are insufficient and employers struggle to stay afloat. They are pressured to fill their schedule to the max. They feel pressured to have a solution for you, even if it is more of a band-aid. Many of them know the value of preventative medicine. Many of them wish they had more time to foster an actual relationship with you. And sadly, many providers are simply burnt out.

In part, it is why I chose to pursue functional medicine as it allowed me an opportunity to practice medicine in a way that honors the whole context in which symptoms were occurring- physiologically, psychologically, spiritually. It allows me time to develop relationships and time to discuss root causes and the foundations of wellness that are often missed in conventional medicine. Even while working in mental health where more time is allotted compared to primary care, I myself was labeled primarily as a prescriber and thus, clients came to expect a prescription at the end of the session when that may not be what is most appropriate.

With all the hustle and bustle, conventional medicine misses the opportunity to ask WHY when it comes to your concerns. In the business world asking WHY is important and more commonly known as a root cause analysis. A root cause analysis essentially demands asking WHY about the WHY about the WHY. The “5-WHY” model is a commonly used strategy.

Here’s an example with a car that won’t start:

Can you imagine if this were done in medicine? Let’s just use the hypothetical example of anxiety- something that is typically addressed by prescribing an anxiolytic medications in the conventional setting. 

• Anxiety (WHY)
  • WHY #1: Patient states they feel overwhelmed.
    • WHY #2: Patient states they worry about finances and their marriage.
      • WHY #3: Patient states they have been arguing a lot with their spouse and working harder than they should, but still living paycheck to paycheck.
        • WHY #4: Patient states they have a tense relationship with their boss. It is difficult to ask for a raise. A lot of their work-related stress is projected on their spouse.
          • WHY #5: Patient states their boss is intimidating. Patient states they feel taken advantage of.

While medication may mask or numb symptoms from the anxiety, given this example, might it be more sustainable to instead work on empowering the patient to confront their boss or perhaps it is time to look for a new job? Many times, patients know what might be driving their stress, but giving themselves permission to act is another ballgame.

Ready for another example? Let’s take on Type II diabetes- one of our most troubling epidemic.

Here we go:

• Type II Diabetes (WHY)
  • WHY #1: HbgA1C 7.2, fasting blood sugar 200
    • WHY #2: Patient is classified as obese.
      • WHY #3: Patient feels overwhelmed with trying to exercise and eat healthy.
        • WHY #4: Patient is on food stamps and struggles to afford healthy foods. Patient cannot afford a gym membership and lives in an unsafe neighborhood- so they are uncomfortable exercising outside. Patient is also prescribed medication that increases weight gain.
          • WHY #5: Patient has been on disability for schizophrenia since age 20. Patient has been unable to work, has little support, and has poor self-esteem.

 

There you have it. It goes back to social reforms, social justice, and addressing the pre-determinants of health & wellness (safety, shelter, food, environment, social connection). Clearly, we cannot expect providers to solve these problems in the course of a 10 minute appointment, but we must try harder to encourage upstream rather than downstream models of healthcare. Providers must also be emboldened to pause, take a step back, reevaluate, and acknowledge the WHY’s with their patients and also with themselves! And remember, providers are not saviors…so if you can do a little root analysis on yourself- you might be surprised what you come up with!

With gratitude,

Audry Van Houweling, Owner & Founder, She Soars Psychiatry, LLC

www.shesoarspsych.com

 

 

They say your gut is your second brain. We all get “gut feelings” or “butterflies in our tummy”. It is not a surprise that there is often a synchronicity between our feelings and our insides.

For a good introduction of how your gut and brain are connected, watch the below TED talk

Pretty interesting stuff, right?

At She Soars Psychiatry, your gut function is a major focus of restoring your emotional wellness. Your gut and brain are in constant communication with one another.

Depression, anxiety, poor focus, mood instability, autism, and fatigue have all been previously linked to a higher susceptibility to gastrointestinal disorders such as irritable bowel syndrome (IBS), food allergies, ulcerative colitis, and inflammatory bowel diseases.

Your gastrointestinal track houses the enteric nervous system (ENS)- made up of over 100 million nerves in your gut that release neurotransmitters, hormones, and intersect with your immune function. And by the way, your gut plays the starring role in your immune system as it is the primary site where your immune system meets invading organisms. 80% of the immune cells reside in your gut!

Supporting both your gastrointestinal health and emotional wellness is your gut’s microbiome. Your microbiome is essentially the makeup of bacteria in your gut- of which we all have trillions! Did you know your microbiome is estimated to weigh 3lbs? And, we have far more bacteria compared to the cells that our actually our own!

Certain bacteria is known to be more beneficial such as Lactobacilli and Bifidobacterium strains. Other bacteria such as C.difficile, H. Pylori, and E.coli can be more harmful. When there is an imbalance between harmful vs helpful bacteria or a lack of bacterial diversity, dysbiosis can occur. Dysbiosis can also be triggered by stress, environmental toxicity, nutrition, medications, and illness among other factors.

While mechanisms behind how exactly the microbiome supports emotional wellness are not entirely clear, it is clear that they are intimately connected be it through the vagus nerve, hormones, and/or immune responses. Your gut is also a major producer of neurotransmitters. Bifidobacterium strains for example help produce tryptophan- a precursor to serotonin. Did you know that your gut produces between 90-95% of your body’s serotonin? Certainly, if this went awry, depression and anxiety could be possible consequences.

A remarkable study demonstrated that when a fecal transplant of a depressed mouse was given to an “undepressed” mouse, the “undepressed” mouse began exhibiting depressive symptoms including lack of interest and anxiety suggesting a direct connection between your gut’s microbiome and your mood.

Your gut’s microbiome is always fluctuating and is never stagnate. You are born with a sterile gut. Babies born vaginally are exposed to their mother’s microbiota in the birth canal, which is also transferred via breast feeding. It has been shown that individuals born caesarean or who were not breast fed may be more susceptible to dysbiosis, obesity, and immune deficiencies. Much of what we do, eat, and are exposed to can either be helpful or harmful to our gut’s microbiome.

Practical ways to support your gut’s microbiome & emotional wellness:

1. Minimize refined sugars & processed foods– Sugar is quickly absorbed in the small intestine and can leave the bacteria feeling deprived so that they then start consuming the cells that line your gut, which can lead to intestinal permeability of leaky gut syndrome.
2. Eat a lot of colorful plants- especially organic vegetables and low glycemic (low sugar) fruits. Plants can supply the gut with helpful bacteria and also act as prebiotics, which are food to the healthy bacteria. Try getting most of your carbohydrates from plants.
3. Enjoy fermented foods that include an array of helpful bacteria such as kefir, sauerkraut, unprocessed yogurt, and kimchi.
4. Consider an elimination diet. At least try avoiding grains and dairy for 2-4 weeks. You might notice significant improvements! Corn, soy, eggs, and legumes can also be problematic for some folks. Taking a food first approach to restoring emotional wellness is one of the least invasive, most sustainable, and most affordable strategies!
5. Consider taking a probiotic (a good one that is). Taking a high-quality probiotic can help repopulate your gut with healthy bacteria. Probiotics can help improve your digestion, mood, immune function, and energy levels.
6. Try avoiding antibiotics when possible. Certainly, antibiotics have their place, but excess use can cause havoc for the microbiome as healthy bacteria may be compromised and diversity of bacteria lessened.
7. Support your digestion! Make sure to drink lots of water and consume fibrous foods. Antacids or proton-pump-inhibitors (PPIs) can deplete stomach acid, which is an important part of supporting your microbiome. Digestive enzymes and glutamine- the primary amino acid support your gut lining can also be helpful.
8. Practice mindfulness, gratitude, & meditation. Chronic stress can perpetuate chronic inflammation and the release of inflammatory cytokines in the gut. Getting a handle on our stress can help slow the inflammatory cascade and allow our gut to heal.

Restoring emotional wellness & gut function go hand in hand. We look forward to helping you navigate this journey at She Soars Psychiatry.

May you be well!

With gratitude,

Audry Van Houweling, Owner & Founder, She Soars Psychiatry, LLC

Oh hormones…it seems you are my worst enemy and my best friend depending on the day. Sometimes you make me happy, sometimes you make me sad, and sometimes you make my husband fear you. Ladies, I think we can all relate.

How many times have people accused you of being “hormonal”? Feels a bit sexist, right? Was it your significant other as is often typical? I think it’s about time as women that we take this term back- reclaim it. My response is, “Well yes, I am hormonal and in fact, my hormones probably made you attracted to me in the first place. Thank you very much”.

As women we experience dynamic hormone transitions throughout our lives. Whether it is our monthly cycle that may be predictable or highly unpredictable, pregnancy, lactation, and/or menopause, we have all experienced the force of our body’s messengers. Sometimes these changes and transitions are rejuvenating, sometimes just tolerable, sometimes comical, but sometimes they can cause serious disruptions in our mood and overall vitality.

In conventional psychiatry, there is an acknowledgment that hormones may play a role in emotional wellness, yet it remains rare that hormone levels and function are actually tested for and considered with making treatment decisions. Unfortunately, too often psychotropic medications such as antidepressants or mood stabilizers are prescribed without a second thought to addressing hormone balance. Clients may meet every criterion for clinical major depressive disorder and per recommendations, would be a “good candidate” for an antidepressant, and yet lab tests may reveal significant hormone imbalances such as thyroid dysfunction, which when corrected remedies the depressive symptoms. Go figure!

At She Soars Psychiatry, we focus on hormones that we feel are most implicated in influencing your emotional wellness.

For the sake of maintaining your focus, I will not get too wordy with the science, but if there is a take home message, please consider getting your hormones checked before jumping to the conclusion that you have a “mood disorder”. Here are some noteworthy hormones worth consideration.

Noteworthy hormones for women:

Thyroid: Thyroid function is critical to maintaining emotional wellness. Dysfunction may be caused by multiple mechanisms including autoimmune disease. Hyperthyroidism (producing too much thyroid hormone) can cause insomnia, panic attacks, irritability, heat intolerance, and more. Hypothyroidism (producing too little thyroid hormone) can cause fatigue, depression, cold intolerance, weight gain, and foggy thinking. Women can be particularly susceptible to thyroid dysfunction following childbirth, which needs to be considered if postpartum mood symptoms are experienced.

 

Sex hormones: An imbalance between estrogen and progesterone can lead to multiple mood symptoms. Estrogen dominance or excess can cause symptoms of both depression and anxiety along with progesterone deficiency (the two often go hand in hand). Testosterone is also important for women and plays a role in facilitating motivation, sex drive, and energy levels. Our environment is full of xenoestrogens (estrogen mimicking compounds), which can cause further hormone disruption. Sex hormone balance should be particularly considered in women on oral contraceptives, women experiencing pre-menstrual mood changes, women with endometriosis, polycystic ovarian syndrome, uterine fibroids, and women in the peri-menopause and menopause stages.

 

Adrenals & HPA axis function: This is a big topic and one we will explore further in detail. Essentially, your adrenals and HPA (hypothalamic-pituitary-adrenal axis) are an intimate part of your stress response. It all starts in your brain with the hypothalamus, which assesses internal and external information and then communicates with another very important part of your brain, the pituitary gland. When stressed, the adrenal glands (which sit on top of your kidneys) release both norepinephrine/epinephrine and glucocorticoids (cortisol). Many of you may have heard of cortisol and how chronically elevated levels of cortisol may be associated with inflammation, blood sugar instability, weight gain, and depression. In cases where stress is not alleviated such as post-traumatic stress disorder, cortisol levels may actually be depleted and cause symptoms of burn out, chronic fatigue, a lack of motivation, and even autoimmune conditions.

 

 

The good news is that many of these hormones can be tested and there are practical and non-invasive steps you can take to restore hormone balance and vitality!

In the end, our hormones are amazing, yet delicate messengers that deserve the utmost respect for how they keep us feeling motivated, passionate, desirable, confident, and strong. They allow us to birth children, feed our children, run from danger, sleep well at night, and get up the next day ready to go at it again. So, no matter many times they have been your scapegoat or nemesis, they do deserve our praise.

 

 

 

Wishing you balance and dynamism!

With gratitude,

Audry Van Houweling, PMHNP-BC, HNFM certified, DONA trained postpartum doula

Owner & Founder She Soars Psychiatry, LLC. Holistic Psychiatry & Wellness for Women & Girls. 

www.shesoarspsych.com

 

Throughout my years working in psychiatry, the magic word that indicated “success” either in inpatient or outpatient settings was “stability” or “stable”. During my time working as a registered nurse in a hospital-based psychiatric unit, the discharge note would inevitably note something along the lines as, “the patient has achieved stability…the patient is now stable…the patient notes they feel stable…and they are now fit to be discharged. During my years as a nurse practitioner, I would catch myself ending my note stating, “the patient reports stability…no further changes need to be made”.

Can we ponder what being stable actually means for a moment? How have we defined it over the years in conventional psychiatry? Does it mean the patient is no longer suicidal? No longer psychotic? No longer having panic attacks? When they can follow a conversation without being distracted? How much does our personal bias as providers influence what we feel is actually “stable”? What is the actual rubric by which we define this?

Does it matter that a patient may be returning to the same environment that may have led to instability in the first place? Can we really claim a patient is “stable” when they have a myriad of chronic health problems? What about poor diet or a lack of physical activity?

The mechanism by which conventional psychiatry seeks “stability” is primary via pharmaceuticals. I want to state again that in some cases when there is imminent need, medications can be powerful tools to regain a client’s sense of control and awareness. That said, they are tools and in my opinion fall short of being solutions. It is important that we recognize that while medications may allay symptoms, they certainly do not guarantee “stability”.

Perhaps you have been on psychiatric medications and have been through the trial and error process. Perhaps you have had the experience when you started with one medication and then needed to add another or yet another to counter possible side effects or because there was a sense that symptoms were not yet adequately controlled. It can be a frustrating and confusing process sometimes made much worse by side effects.

I have prescribed a lot of medications over the years. If it all goes well, patients often come back feeling pleased with the results, but it is rare that this feeling sustains itself. Perhaps months later they may say, “I don’t think this medication is working anymore…” or “I am concerned about side effects.” I have learned that it is unrealistic to assume that “stability” can continue in the midst of chronic disease, chronic stress, contentious relationships, social isolation, and/or socioeconomic limitations.

Now it is time for a bit of imagery.

Picture yourself sailing in a boat in the water. There are multiple small holes in the boat. You have a bucket and are able to throw water overboard allowing the boat to stay afloat for a while longer. Yet, the holes still remain and at some point you are going to become exhausted from trying to stay afloat. A medication may be a bucket for a while, but often does not address the foundational problem.

I have not come across a medication that seals all the holes in your boat.

This is why I have become passionate about functional medicine. Functional medicine is looking for the holes in your boat. We might give you a bucket from time to time, but the goal is to seal the holes and even better, just give you a new, stronger boat that withstands the rough waters. This is the basis of vitality- when you can function with resilience and “sail” or per our namesake, “SOAR” to your full potential.

At She Soars Psychiatry, LLC we take a close look at all factors including cellular health, immune function, inflammation, organ health, gastrointestinal health, nutrition, physical activity, psychosocial, and psycho-spiritual. When these factors go awry they can cause “holes in your boat” leading to emotional imbalances. We aim to restore not just stability, but vitality.

Everyone feels like they are sinking from time to time. Life happens. Resilience can be strengthened however. We look forward to helping you stay strong and afloat as there are certainly rough waters to navigate out there. Happy sailing!

To learn more about functional medicine, please visit The Institute for Functional Medicine.

To schedule an appointment with us call 541-595-8337 or visit www.shesoarpsych.com

Like us on Facebook @ She Soars Psychiatry, LLC

With gratitude,

Audry Van Houweling, PMHNP-BC, HNFM certified, DONA trained postpartum doula, Owner & Founder, She Soars Psychiatry, LLC