Holistic Psychiatry Podcast

Previously shared as a paid newsletter in May 2024. In previous newsletters, I've addressed many of the more common contributing factors to brain symptoms, including high pyrroles, copper-zinc imbalances, methylation imbalances, candida overgrowth, mast cell activation, mold and other forms of toxicity, and genetic variants, such as COMT and MAOA.Supplements can be needed to address each of these. Medication can also be necessary when treating mold and mast cell activation.But what happens when someone can't tolerate a supplement or medication because it worsens or creates new brain symptoms? Why, for example, could someone have problems tolerating B6 or SAMe or Methionine. Why might someone have problems with folate, niacinamide, glutathione, certain herbal treatments, antidepressants such as SSRIs, probiotics, antifungal medication or binders such as bentonite clay, activated charcoal, chlorella or cholestyramine?In this newsletter, I'll discuss:* Five common reasons a supplement or medication may worsen symptoms.* Specific supplements and medications that are more likely to do this.* How reactions may point to root causes.* Treatment steps that can improve tolerance.There can be a wide range of brain symptoms that can occur when someone is having an adverse reaction, such as fatigue, brain fog, depression, anxiety, agitation, and even psychosis or mania. I'll use “reactivity” to refer to this range of possibilities. While physical side effects can also occur, the focus here will be on brain symptoms.5 Common Reasons Supplements or Meds May Worsen Symptoms1. Immune ReactivityOur immune system is intertwined with our central nervous system. When our body's immune system reacts to a toxin, microbe, injury, or trauma, we can have inflammatory brain and physical symptoms.“Feel Like I'm Reacting to Everything” - Mast Cell ActivationIf someone is experiencing severe immune reactivity, such as mast cell activation, they may react to many supplements and medications, as well as triggers in their environment and stress. The number of triggers can help point to an exaggerated immune response. In my practice, this high immune reactivity is usually driven by mold toxicity.For many with this obstacle, starting very low and slow can prevent reactions. For others, interventions may be needed to lower immune reactivity and stabilize mast cells. This, however, can require certain supplements. For those who can't tolerate those treatments, limbic system retraining programs help calm the immune system so people can move forward more easily.Sensitivity & IntoleranceIt is possible to have immune sensitivity (or even allergy) to a supplement, though I find this less common. Herbal supplements, for example, which are high in salicylates, may cause symptoms in those with salicylate sensitivity. Certain probiotics have bacterial strains high in histamine. This is an issue for those with histamine intolerance.2. Too Much or Too Little Neurotransmitter ActivitySome people with brain symptoms have high neurotransmitter (NT) activity, and some have low. Common NT's include serotonin (5-HT), dopamine (DA), and norepinephrine (NE). I use the term “neurotransmitter activity” because it's not just about the amount of neurotransmitters present; it's also about the amount of receptors present that pick up NTs and remove them from the space between nerve cells.High Neurotransmitter ActivityToo much neurotransmitter activity can cause brain symptoms such as mania, psychosis, agitation, anxiety, panic, obsessions, compulsions, and hyperactivity. Reactions can occur if supplements or medications are given that further increase NT activity.Examples include:* Overmethylation* Slow COMT (involved in clearing DA and NE) and/or slow MAOA (involved in clearing 5HT, DA and NE)A variant on COMT and/or MAOA doesn't mean they are being expressed.What Increases Neurotransmitters?* SSRIs (Selective Serotonin Reuptake Inhibitor) increase serotonin activity* SNRIs (Serotonin and Norepinephrine Reuptake inhibitors) increase serotonin and norepinephrine activity.* Stimulant medications such as Ritalin and Adderall increase dopamine activity* SAMe and methionine increase serotonin and dopamine activityRemember that there can be times when there is a mixed picture, such as when someone is undermethylated and has a slow COMT.Low Neurotransmitter ActivityReactions can occur if supplements or medication decrease the neurotransmitter activity when it is already low. This could look like depression, apathy, fatigue, and brain fog.Examples include:* Undermethylation* Fast COMT (involved in clearing DA and NE) and/or fast MAOA (involved in clearing 5HT, DA and NE). The NTs are getting cleared too fast.What Decreases Neurotransmitters?* Folate, a nutrient that is good for a lot of people happens to be a big problem for many with psychiatric conditions. Most with underemethylation have low serotonin symptoms (depression and/or anxiety). While folate can help methylation, as an unfortunate aside, it can also further lower serotonin activity. Folate is in most multivitamins and B Complex vitamins. To learn more: Undermethylation, MTHFR & The Great Folate Debate.* Niacinamide can lowers DA and NE.Looking closely at someone's symptoms and traits and assessing methylation through bloodwork can help determine if NTs are too high, low, or mixed and what types of treatment to consider.3. Poor Detoxification or Toxic OverloadZincZinc is one of the most powerful tools I use in my work. Some people can easily tolerate it, while others can struggle. Here are some reasons someone may not tolerate zinc.* High copper—Zinc mobilizes copper. Moving too much copper at once can increase copper symptoms (anxiety, anger, hyperactivity, insomnia).* High toxicity—Zinc is a strong antioxidant. It is needed for the genetic expression of one of the most important antioxidants in our body, metallothionein.It took me 8 months to get my dose up to an optimal range, which is certainly not the norm. I unknowingly had significant mold toxicity at the time.When I start someone on zinc, I slowly build it up over 3-4 weeks. For some (like myself), even this is too fast.GlutathioneThis is the other major antioxidant. If someone is having difficulty tolerating it, they may have problems with detoxification and significant toxicity (metals, biotoxins like mold, and chemicals). These can start to be addressed in several other ways.BindersThese include bentonite clay, chlorella, activated charcoal, and cholestyramine. They bind toxins, especially mold toxins, in the GI tract. If they are started too quickly, the toxins they are supposed to remove get stirred up, which stirs up symptoms. When people say they can't tolerate certain binders, they usually weren't started low enough.There are others, but these are the most common in my experience.4. Underlying Microbial or Microbiome IssueB6B6 is very important for brain health. It is needed for making serotonin, dopamine, and GABA. We use it in all the Walsh nutrient protocols to varying degrees. In the last 10 years, we've seen a decrease in B6 tolerance. It's not clear why. I'm including it in this section because the reactivity is suspected to be related to the microbiome. Perhaps in recent years, we have had collective damage to our microbiomes from toxins and rising EMF exposure. We don't know.The good news is that P5P, the active form of B6, is usually well tolerated. In my practice, I rely heavily on P5P. I will occasionally use it in combination with B6 (if tolerated) for those with especially high pyrroles.Methionine and/or SAMeBoth are used, though usually not together, to help address undermethylation. I suspect candida or mold when someone is having difficulties tolerating either of these. These nutrients are usually better tolerated once candida and/or mold are addressed (or are starting to get addressed).5. Die-OffAnything that kills off microbes, such as candida or mold, can cause a “die off” of those microbes, release toxins, and worsen symptoms. Antifungal supplements, antifungal medication, and probiotics may cause this type of reactivity. Antifungal medications include nystatin, diflucan, itraconazole, and amphotericin B.Herbs and food-based supplements can have antimicrobial effects. Turmeric is one example. There are many others, so it's always worth checking. Worsening symptoms might point to an underlying fungal or other microbial overgrowth. It may also suggest that appropriate binders may be needed first.Addressing or preventing die-offs could mean supporting detoxification, starting binders if necessary, and, again, starting low and going slow.Antidepressants, interestingly, have been shown in labs to have antifungal effects. This does make me wonder if some people who can't tolerate them are having die-off.Root CausesKnowing someone's history of reactions can help point to underlying root causes.As you can see, there are typically ways to help someone tolerate and go on to benefit from a needed supplement or medication.As always, I welcome your thoughts and experience.Until next time,CourtneyP.S. To learn more about non-patient consultations, treatment, and monthly mentorship groups, please visit my website at:CourtneySnyderMD.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

We are living in a world that feels increasingly “left-brained.” Though both hemispheres are constantly working together, they have distinct values, traits, and ways of operating the world. In this podcast episode, I discuss:* The different attributes of the left and right hemisphere* How can we recognize which hemisphere is taking the lead in a given moment* The advantages of letting the right brain take the lead* How we strengthen our right hemisphere with the help of neuroplasticity (and specific (enjoyable) activities).* The added benefits of doing this in community.Related to this topic, I look forward to sharing information soon on an upcoming discussion group called “Strengthening the Right Brain in Left Brain Times.” In the meantime, as always, I welcome discussion right here. Please feel free to comment and to help me get the value of the right brain out into the world.Until next time,CourtneyP.S. To learn more about non-patient consultations, treatment, and monthly mentorship groups, please visit my website at:CourtneySnyderMD.comMedical Disclaimer:This newsletter and podcast episode is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

OCD, or Obsessive Compulsive Disorder, is a debilitating condition that involves intrusive thoughts and time-consuming, repetitive behaviors. It impacts 80 million worldwide, 2-4% of the US population or 1 in 100 people here in the US.It can be difficult to overstate the suffering caused by OCD, not only for those with this condition but also for their family members. In addition to the distress caused by the obsessional thoughts and compulsions, there can be shame and loss - loss of more meaningful, purposeful, or pleasant thoughts and behaviors. and loss of time connecting with others or engaging in purposeful or enjoyable activities.Other conditions associated with obsessive-compulsive disorder include:* Body dysmorphic disorder* Skin picking* Trichotillomania (hair pulling)* Hoarding* Hypochondria* Olfactory reference syndrome (an irrational feeling or belief that one emits a foul smell and often attempts to remove the odor).It´s not unusual for someone with OCD to have other conditions, such as:* Other forms of anxiety* Depression* ADHD* Autism spectrum disorder* Eating disorders* TourettesResearch suggests that having OCD raises one´s vulnerability to developing dementia. Many other brain conditions, however, also appear to increase this vulnerability similarly.Treatment ChallengesOCD is particularly challenging to treat. Of those with OCD, 60% do not respond to typical therapies (often medication in combination with psychotherapy involving gradual exposure to that which is being avoided). Typical medications include:* SSRI´s (Selective Serotonin Reuptake Inhibitors) -e.g., sertraline, fluoxetine, fluvoxamine, citalopram, paroxetine* Tricyclic antidepressant - clomipramine* SNRI - (Serotonin and Norepinephrine Reuptake Inhibitor) - venlafaxine* Atypical antipsychotic medications are sometimes addedMedication is combined with CBT (Cognitive Behavioral Therapy), which involves exposure and response prevention, or CBT is used alone.As you can see, most medication approaches aim to increase serotonin activity. Serotonin, however, is just one of the neurotransmitters involved. What has become increasingly clear from the research is that OCD involves abnormal activity at the NMDA receptor - a glutamate receptor.NMDA & GlutamateThe NMDA receptor is found throughout the brain. Glutamate, the primary excitatory neurotransmitter in the central nervous system, binds to the NMDA receptor. NMDA and glutamate are involved in synaptic plasticity (creating neuronal connections), learning, memory, and motor function.The synapse is the space between communicating neurons. Presynaptic neurons release glutamate, which binds to the NMDA receptor on postsynaptic neurons. This results in a cascade of signaling events that lead to “neuronal excitation.” The problem arises when this receptor has too much (or too little) activity. In the case of OCD, there is too much activity.Implications* Dysregulation at the NMDA receptor appears to play a role in OCD, depression, PTSD, schizophrenia, bipolar disorder, and substance use disorders.* Weak memory extinction can result from high activity at the NMDA receptor. While memory is a good thing, we can have problems with too much memory - or rather, problems putting our memories aside. This can look like thoughts getting stuck, for example:* Intrusive thoughts in OCD* Flashbacks in PTSD* Delusions in psychotic disorders* Cravings in addiction.* Neurodegenerative disorders, such as Alzheimer's, Parkinson's, and ALS, have also been linked to NMDA receptor malfunction.Methylation & NMDAThose who are undermethylated, especially those with OCD or addictions, have high activity at the NMDA receptor. To remind you, undermethylation is a biochemical process with many functions, including the breakdown of histamine, support of detoxification, and support of serotonin activity. When someone is undermethylated, they can tend to have allergies (from high histamine), be perfectionistic, competitive, strong-willed, have obsessive-compulsive tendencies, be ritualistic, have dietary inflexibility, and have high accomplishment or have family members with high accomplishment. Undermethylation can contribute to the low serotonin activity seen in OCD. Simply addressing undermethylation, like merely addressing serotonin, will only bring partial benefit. To address undermethylation, those of us trained by the Walsh Research Institute, use SAMe and/or methionine, B12, B6, magnesium, and antioxidants. We address this before starting methylation treatment for those with high homocysteine. But how can we also decrease activity at the NMDA receptor?Blocking NMDA & Normalizing Glutamate ActivityEsketamine or Ketamine, which has been getting much attention in recent years, can impact the brain in various ways; however, its primary mechanism is as an NMDA blocker or antagonist. For some, it can serve as a rapid-acting and highly effective antidepressant. It can also decrease OCD symptoms. Other NMDA-blocking drugs include memantine and dextromethorphan (combined with bupropion). Lamotrigine can decrease glutamate release and has been used as an adjunct medication for OCD.Nutrients, however, play an important role in the NMDA receptor. NAC or N-acetyl cysteine is a precursor to glutathione and, thus, an antioxidant. It is also anti-inflammatory and a binder for a particular toxin made by candida and mold. But, it is also a potent NMDA antagonist (decreases activity at NMDA) and has been shown to reduce obsessions and compulsions of OCD. It has also been studied in alcoholism, opiate addiction, cocaine abuse, gambling disorder, shopping disorder, cigarette addiction, and trichotillomania. It has been used by itself and as an adjunct to medication therapy. NAC has become part of the Walsh undermethylation nutrient protocols for those with OCD and/or addiction.Zinc also plays an important role in regulating functioning at the NMDA receptor. The Walsh Research Institute found that 90% of those with brain symptoms had relatively low zinc. Dosing of zinc is determined after testing plasma zinc levels using a narrow range (the Walsh/Pheiffer range differs from typical lab ranges). Zinc is checked in conjunction with copper. Zinc has been found to improve treatment response in those with OCD treated with SSRIs. Zinc can be depleted because of very high oxidative stress and/or high pyrroles, which also cause low B6. Because B6 is needed to make serotonin, pyrroles are also important to address if elevated.Inositol is a nutrient involved in the serotonin and glutamate signaling systems. It, too, is beneficial for OCD symptoms; however, it can require very high doses.The challenge of research, as you can see, is that these approaches are all looked at in isolation, as opposed to, for example, addressing undermethylation, optimizing zinc, decreasing activity at the NMDA and addressing sources of oxidative stress.Candida & MoldAside from undermethylation, low serotonin activity, and high activity at the NMDA receptor, those with OCD appear to have high oxidative stress, as is the case with most brain-related conditions. One of the more common sources of oxidative stress I see in my practice is candida overgrowth in the GI tract, which often follows antibiotic exposure and /or mold toxicity due to water damage causing seen or unseen toxic mold. Because mold and candida (yeast) thrive on sugar and a high-carb diet, symptoms can fluctuate with sugar or carb intake. How might candida and mold intersect with the NMDA receptor? Mold and yeast can contribute to high histamine states. Histamine can increase activity at the NMDA receptor. EstrogenFor women and teen girls that I see with OCD, there is often a fluctuation in their OCD symptoms with their cycle. Typically, their symptoms worsen during the times of the month when estrogen is the highest. This may be because estrogen can increase activity at the NMDA receptor.PANDAS & PANSWhen a child has an abrupt onset of OCD symptoms, PANDAS and PANS should be considered.* PANDAS = Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections* PANS = Pediatric Acute-Onset Neuropsychiatric SyndromePANDAS and PANS are autoimmune conditions, meaning the immune system is acting on the body, in this case, a part of the brain called the basal ganglia, that involves an acute onset of OCD symptoms. Other symptoms can include restricted eating, mood symptoms, regression in academic or social skills, and motor tics. While triggers are often viral, bacterial (strep in the case of PANDAS), candida,or other microbial source, what is underlying the dysregulated immune response to such microbes, in my experience, is mold toxicity. SummaryBecause OCD can be difficult to treat, my hope in sharing this information is to raise awareness that effective OCD treatments can require a multifaceted approach that includes:* addressing methylation (and high pyrroles if present) to improve serotonin activity* decreasing activity at the NMDA receptor* by optimizing zinc* using supplements or medication* addressing sources of inflammation and high histamine* address sources of oxidative stress - trauma, stress, toxins, inflammation If you find this information helpful and would like to help me get this out into the world, please consider sharing:As always, I welcome your comments, questions, and experience.Until next time,CourtneyP.S. To learn more about non-patient consultations, treatment, and monthly mentorship groups, please visit my website at:CourtneySnyderMD.comMedical Disclaimer:This newsletter and podcast episode is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

This past week, I had the pleasure of attending the Advanced Course for Walsh-Trained Practitioners. To date, 1,200 practitioners from 75 countries have been trained using the Walsh approach.For those unfamiliar, the Walsh Research Institute, founded by Dr. William Walsh, has looked at the nutrient levels of over 30,000 people with brain-related symptoms and found a surprisingly small number of nutrient imbalances (low zinc, high copper, high pyrroles, and methylation imbalances) that repeatedly show up. We address these imbalances in those with depression, anxiety, panic, obsessions, compulsions, inattention, brain fog, hyperactivity, autism, dementia, psychosis, and mood swings with significant and, at times, dramatic results. Bipolar disorder, however, because of its shifting in neurotransmitter states from mania and depression, can be particularly difficult to treat. More than nine million Americans have been diagnosed with bipolar disorder. This severe condition can lead to drug or alcohol use, financial or legal problems, discord in relationships, work and school instability, and/or suicide attempts or suicide. The course typically begins with an acute onset, followed by episodes of mania and depression, which often worsens in severity over time.In this post, after describing bipolar disorder, I will use Dr. Walsh's Comprehensive Theory of Bipolar Disorder, recently shared at the Society of Neuroscience, to explain:* the cause of bipolar disorder* the reason for the onset, persistence, and increasing severity for many over time* the reason for the increased risk of other health issues* the reason for the switch between manic and depressive states* how this information impacts treatment and preventionBipolar DisorderIt is important to note that the type of bipolar disorder I am referring to here is Bipolar I, a condition in which there are discrete episodes of mania often followed by episodes of depression. Such episodes can occur rarely or even multiple times a year.Manic episodes usually last a week up to several months and include three or more of the following:* increase in activity, energy, or agitation* distorted sense of well-being or self-confidence* needing much less sleep than usual* usually talkative or talking fast* racing thoughts or flight of ideas (jumping from one topic to another)* easily distracted* poor decision-making- e.g., excessive spending, risky sexual behavior* may become psychotic (have a break from reality)Hypomania has less severe symptoms which have less impact on functioning at work, school, social activities, and relationships. Having hypomanic episodes is not sufficient to warrant a diagnosis of Bipolar I.Depressive episodes, which often last a couple of weeks but can vary, include five or more of the below symptoms that are affecting functioning at work, school, social activities, and relationships:* depressed mood (sad, lacking feeling, hopeless, irritable, angry, or tearful)* marked loss of interest or enjoyment of activities* weight loss or weight gain (without dieting or overeating)* too much or too little sleep* behavior slowed down or restless* fatigue - loss of energy* feelings of worthlessness or inappropriate guilt* problems concentrating or making decisions* suicidal thoughts, plans, or attemptsBipolar II Disorder is a different condition. This diagnosis is given when someone has at least one major depressive episode and at least one hypomanic episode. Depressive episodes are often longer here. There is never a manic episode. Despite its name, this is not a milder form of Bipolar I. Biochemically, it is considered a different disorder.Rapid cycling is used to describe bipolar disorder when, in the past year, there have been at least four episodes of switching from mania or hypomania to depression. This can describe either type I or type II (depending on the presence or absence of mania). As with many other diagnoses, the terms came from seemingly related symptoms instead of a root cause or biochemical understanding.Dr. Walsh's comprehensive theory, which I'll describe, focuses on Bipolar I, in which there are manic episodes usually followed by depressive episodes. For those who struggle with mood swings changing within a day or a week as opposed to discrete mood episodes of mania or depression, pyrrole disorder should be considered.Genetics or Epigenetics?Having a first-degree relative (parent or sibling) with bipolar disorder raises the risk of developing bipolar disorder. After thirty years of genetic research, however, a gene for bipolar disorder has not been identified. The genetics are more complicated. It appears there are many genes involved.2021 Genome-Wide Association Study (GWAS)These studies compared the genomes of about 5,000 individuals with bipolar disorder and about 8,000 (controls/individuals without bipolar disorder). Over time, more and more “bipolar” genetic variants have been identified. By 2021, there were 64; however, there are expected to be hundreds. Of these 64 genetic variants, 49 are DNA repair genes and antioxidant genes that occur throughout the body (not just the brain). Just as it sounds, DNA repair genes make enzymes that repair DNA. Antioxidant genes make enzymes that support our protective antioxidant systems. Many of these genetic variants are also associated with cancer and other conditions impacted by DNA damage. This would suggest that those with bipolar disorder come into the world with a vulnerability in their ability to repair DNA damage (which translates to cell damage, tissue damage, and, in the case of the brain, neuronal damage. An event, however, is required to shift this vulnerability to illness.Accelerated DNA DamageWhat damages DNA? Free radicals and thus oxidative stress. To remind you, oxidative stress occurs when our body's inherent antioxidant systems are overwhelmed or depleted by free radicals (due to an insult - a toxic exposure(s), source of inflammation, or trauma). A depletion of our protection leaves our cells and DNA vulnerable to further oxidative stress and damage. If we have variants on protective genes, then we can be even more vulnerable.Numerous studies have found high levels of superoxide, hydroxyl, and ONNO (peroxynitrite)free radicals in those with bipolar disorder.This vulnerability to DNA damage also explains why many with bipolar disorder have a higher risk of other health issues, including heart disease, breast cancer, multiple sclerosis, kidney failure, immune disorders, migraines, gastrointestinal illnesses, and others. But What About the Other 15 Genes? Genetic Weakness on Ion ChannelsThe remaining identified genes are more specific to bipolar disorder and relate to ion channel genes. Ion channels exist on the neuronal membranes, allowing potassium, sodium, and calcium to move in and out of the nerve cell. This movement creates an electrical charge that travels down the cell, releasing a neurotransmitter into the space between that neuron and other neurons to communicate with the next cell(s). OnsetHere again, an epigenetic event (toxic exposure, trauma, significant illness, etc.) leading to oxidative overload impacts the production of the proteins used in these channels, which affects the movement of ions in and out of the cell (more specifically causing flooding of potassium ions (K+) outside the cell) leading to hyperactivity of that nerve. This is why Dr. Walsh's theory considers bipolar disorder a channelopathy.EuthymiaEuthymia - when the mood is neither manic nor depressed - interestingly, appears to be the first mood state after the onset of the condition. The flooding of K+ outside the cell leads to hyperactivity of neurons for serotonin. However, that doesn't appear to cause symptoms since serotonin inhibits or keeps the activity of dopamine, norepinephrine, and glutamate in check.ManiaThe onset of mania starts to occur when the serotonin neuron hyperactivity (from the K+ flooding outside the cells) starts to fizzle out. What follows is a reduction in the inhibition of the neurotransmitters (dopamine, norepinephrine, glutamate, and others) that cause widespread neuronal hyperactivity, which causes manic symptoms.Eventually, the declining serotonin activity becomes the dominating force and triggers depression, which may persist for some time. Eventually, the serotonin nerves return to hyperactivity (again keeping things at bay), resulting in a stable mood - euthymia. Progression of Illness It is well known that preventing manic episodes can prevent the severity of the condition from escalating over time. Dr. Walsh's theory also addresses why.Aside from impacting neurotransmission, the problems occurring at the ion channels are also associated with further DNA damage. This means that each episode can potentially add to the DNA damage. Add to this typical DNA damage (for all of us) that comes with aging. A typically untreated original and often persistent insult (such as a toxic exposure), events occurring at the ion channel, and aging can lead to the progression and increasing severity of illness.TreatmentAs with any theory, the inevitable question becomes, how does this impact treatment? Allopathic or mainstream psychiatry uses medication approaches that aim and usually succeed at stabilizing mood. Again, this is important because of the consequences of mania or depression but also because of the potential physiologic damage caused by ongoing episodes. What isn't typically addressed in conventional psychiatry are:* Sources of oxidative stress. Does this person have mold toxicity, Lyme, metal toxicity, candida or other microbial overgrowth, chemical exposures, high EMF exposure, trauma, and/or chronic stress that are continuing to deplete protections and contribute to DNA damage? These are the types of issues that those of us who consider ourselves functional and environmental psychiatrists address.* Support for the antioxidant system. As with any brain condition, robust antioxidant support is indicated to address free radicals, but in this case, it is also indicated to prevent further DNA damage and to protect the ion channels. * Nutrient imbalances in varying combinations are typically also involved, such as methylation imbalances (often overmethylation), pyrrole disorder, and copper-zinc imbalances. Each of these can be exacerbated by high oxidative stress, which is a further cause of oxidative stress.Research into targeted antioxidants will be needed to build upon Dr. Walsh's research. The free radicals (superoxide, hydroxyl ions, and ONNO) are more easily addressed in the body than in the brain. In the meantime, in addition to more typical antioxidants, NAC (which inhibits activity at the glutamate receptor) and MT (metallothionein) promotion therapy (a combination of glutathione, zinc, B6, and specific amino acids) are expected to be beneficial.PreventionBecause bipolar disorder appears to be an epigenetic DNA damage illness (caused by major oxidative overload), early antioxidant treatment in those who are vulnerable to bipolar disorder may prevent the onset and development of this disease. It won't be long before such vulnerabilities can be identified, as early as infancy.For more on the work of Dr. William Walsh and the Walsh Research Institute Practioner Resource Map (, visit: https://www.walshinstitute.org/As always, I welcome your comments and questions.And if you would like to help me get this information out into the world, please consider sharing.Until next time,Courtney P.S. To learn more about non-patient consultations, treatment, and monthly mentorship groups, please visit my website at:CourtneySnyderMD.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

“The journey of a thousand miles begins with a single step.”― Lao TzuIn this episode, I share my journey through illness to health and how this shaped my work as a holistic psychiatrist. My wish for anyone listening is that your pursuit of health, happiness, or whatever you seek leads you to peace and a desire to help others traveling their thousand miles.Until next time,CourtneyCourtneySnyderMD.comMentoring This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

Recently, an interview by Christiane Amanpour caught my attention. It was with Coralie Fargiat, the director of “The Substance.” Though I haven't seen this 2024 body horror movie (nor do I intend to), the story brings up several teaching points about the left brain, undermethylation, neuroplasticity, and our collective obsession with beauty.The movie is about an actress, Elizabeth, who loses her job hosting a fitness television show when she turns fifty. She has “aged out.” While in the hospital after a car accident, someone directs her to a product - the substance - a neon green liquid that will allow her to bud off a younger version of herself - Sue. The rule is that Sue can only go out into the world for one week at a time, alternating each week with Elizabeth while the other lies dormant. Not surprisingly, Sue has more advantages in the world (that Elizabeth inhabits), including replacing Elizabeth on her former TV show. Increasingly, when it's time to switch, Sue breaks the one-week rule. This results in part of Elizabeth's body becoming increasingly deformed. The culmination is a grotesque battle of gore between the two, who initially were instructed to remember, “You are one.”In the interview, the director, Coralie Fargeat, discusses her personal experience:“I turned 40 and was more impacted than ever about what it's like to be a woman, the feeling that if I wasn't young and pretty and sexy, I would be totally erased from the surface of the earth. So there was this kind of emergency, this vitality to the things I speak about in my film.”Research supports this thinking that beautiful people are treated better and thus have more advantages. With the use of photoshopping, social media filters, and even plastic surgery, many teens and young adults are experiencing neuroplastic changes that are making real people, including themselves, appear increasingly off or even grotesque. Left Brain“The Substance” is a left-brain nightmare. It shows us the self-destructive path the left brain can take us on, especially in a world that tells it exactly how things should look. Elizabeth, the main character in the movie, is rigid in her thinking, addicted to an image of herself, perfectionistic, and highly competitive. In some ways, these left-brain attributes have served her, but unchecked, they destroy her. If the left brain were a person, it would have the following traits and perspective on appearance: (These traits are oversimplified and pulled from Dr. Iain McGilchrist's work) - * Detail-oriented, narrow focus of attention - “That doesn't look right.”* Prefers what it knows and prioritizes what it expects - “I should look this way.”* Has difficulties disengaging - “I can't stop thinking about this and how to fix it.”* Sees parts (as opposed to the whole) * Sees the body as a sum of parts * Doesn't have a whole image of the body (as found in those who have damage to the right hemisphere)* Is competitive - “I need to look better than they do”* Fears of uncertainty and lack of control (As you can imagine, this is a problem for anyone human and thus who will age)The left brain will set its sights on beauty, success, titles, money, objects, or anything else that feeds the “I.” Because the left brain can't see the “big picture,” it has a hard time pulling back far enough to see how its way of thinking may be getting in the way. The Right BrainOur ability to feel embodied is a job for our brain's right hemisphere. When the voice in the movie reminds Elizabeth, “You are one,” it may as well be speaking on behalf of the right hemisphere.Our right brain allows us to have compassion, including self-compassion. It honors diversity and differences. It can see the bigger picture of our lives that involve multiple developmental stages. It can sit with uncertainty. It knows that our imperfections and differences promote connection with actual humans.UndermethylationLeft brain tendencies strongly overlap with undermethylation traits. Methylation is a biochemical and cellular phenomenon that serves many important functions. If we “undermethylate,” we can have more difficulties breaking down histamine, more difficulties detoxifying, and lower serotonin activity. Methylation is impacted by a number of genes, the most well-known being MTHFR.Undermethylated traits include perfectionism, obsessive-compulsive tendencies, being highly competitive, having ruminations, and addictive tendencies. The NDMA ReceptorThose of us who are undermethylated can have high activity at the NMDA receptor, resulting in a problem with “memory extinction” or letting go of a thought. This could look like obsessive-compulsive tendencies (including those seen in body dysmorphia) and addictive tendencies. High histamine (again due to undermethylation) can increase activity at this receptor. Low zinc, high estrogen, and low magnesium can also be at play.I suspect Elizabeth is undermethylated and has high activity at the NMDA receptor. Both could be assessed for and treated (in part) using targeted nutrients. I say, in part, because the brain training / neural training that occurs through social media is difficult to override if someone is still “using.” Interestingly, EMF exposure (from phones and wireless technology) can increase histamine, further driving these issues.Neuroplasticity and Images of PerfectionThe more images of beautiful images of people we see, the more those images become the norm in our mind, and the more any deviation from that norm will stand out as problematic. This was already a problem with the photoshopping of celebrities and models. But now, with social media filters, teens and young women aren't just comparing themselves to celebrities and models; they're comparing themselves to a filtered image of themself.Filters can create larger eyes, bigger lips, more angular jawlines, whiter teeth, slimmer faces, and smooth and even skin tones. Research into the use of filters:* Millennials are predicted to take 25,000 selfies on average over their lifetimes* About 90% of women aged 18-30 report using beauty filters before posting selfies on social media. * Repeated interactions with filtered images and associated beliefs and worries are increasing the risk of mental health issues such as:* depression* social anxiety* reduced self-esteem* appearance anxiety* body dysmorphia* increase of plastic surgery* 62% of plastic surgeons report that their patients wanted cosmetic procedures because of dissatisfaction with their social media profiles* Snapchat dysmorphia” is what plastic surgeons are calling the act of taking a picture of one's self and using a filter.* Selfies are the leading cause of plastic surgery among young people* Girls who routinely shared self-images on social media had considerably higher body dissatisfaction relative to those who share selfies less frequently. * Body Dysmorphic Disorder among young women has been linked to social media use.In short, the research shows that investing in one's self-presentation on social media is often a harmful practice. The more one does it, the more damaging it tends to be. It encourages hyperattention to unrealistic beauty standards and a desire to change one's physical appearance. This problem of hyperattention to unrealistic beauty standards isn't just a phenomenon of teenage girls and younger women. I´m 57 and understand these things, and still, I´ve had to be intentional about how much attention and neuronal wiring I put into what increasingly feels like defying the very full and lovely reality of my current age. A SequelIf I could write a sequel to “The Substance,” it would be about how Elizabeth (the main character) gets off screens and finds a group of real women (her age and older) that she comes to trust, finds refuge, and who she is inspired by. Instead of looking through a lens of culturally defined beauty, she is struck by the strength, courage, and peace they never could have embodied at a younger age. These women who inspire and shape her would like Helen Mirin (79), who corrected a podcast interviewer after they said to her, “But you are young at heart.” She tells him that no, she is not….”My spirit is the age that I am. When you say 'youthful', I'm not full of youth. I'm full of the life that I've lived up to this point.As girls and women, we need these women in our lives. We can do our part to become these women - the desperately needed embodiments of the right brain. Wishing you peace and wholeness,CourtneyCourtneySnyderMD.comP.S. This Saturday begins the mentoring group for MDś, NDś, DOś, NP and PAś. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com

Recently, I was having a conversation with my daughter - who's 19 - about the mental changes in a family member with memory loss. I commented that it can feel like a long goodbye, as they seem less like themself. Even as I said that, it didn't ring true. She quickly responded, “When are we ever ourselves? It seems like we're always changing.'“Her comment, which did ring true, got me thinking a lot this week about the elusive “self.”Who Am I? Who are You?My genes and early life experiences have shaped me. The arrival of hormonal changes around puberty changed me. My friendships changed me. After puberty, hormonal cycles played a role in changing my personality throughout the month. My education changed me. Love, marriage, and motherhood changed me. My work changed the way I make sense of things. For example, I'm sure optimizing my zinc level changed me into someone more comfortable around people. Addressing mold toxicity increased my energy, so everything wasn't so hard. Addressing methylation lifted an apathy that came with toxicity. When I was in the throes of mast cell activation and inflammation, I was different. For 3 days at a time, feelings of “doom” and head and neck pain colored my world. When the flare passed, “I” was back.Sickness changed me into a more compassionate person. Despite this, I was determined to return to who I was before chronic illness. No one tells you that's not possible. We may heal, but we don't going back to a former self. Sickness forced me to let go of certainty and let go of identity so I could approach life with greater ease.Menopause lessened my intensity, possibly because less estrogen would have increased the ability of COMT and MOA-A to better clear catecholamines (which increase tension and, for some, hyperfocus). The need to go - go - go softened.I miss how much I could once do. I don't miss believing that everything mattered more than the present moment.Even on a given day, our “selves” change. “Morning Me” is calm, has plans, and sticks with a routine. The “3-4:30 pm Me” is slower and less sharp. I've come to design my schedule to take care of both. “Me on Too Many Carbs” is self-conscious and judgmental and looks for things to complain about, while “Me on Less Carbs” is more at peace with what is.The challenge, of course, is to accept whatever perceived “self” shows up at a given time of day and not banish the moment with judgments about who we think we are. When we can do this, we can extend that grace to others.Who Is This Person?If you are a parent or have a partner or spouse, you've likely noticed the changing personalities of those you love. When my daughter was three, she was struggling with episodic cognitive and mood changes, as well as some developmental regression. Though not apparent to most people, in my mind, she was “herself” only about one out of four days. This was evident in her clear thinking, playfulness, humorous comments, and ability to draw a stick figure. This was who I perceived “her” to be. I felt connected to her.But for three of the four days (for a good part of the year), she was forgetful and didn't engage in imaginative play. She was irritable and anxious. Her speech was slurred, and she couldn't draw a circle. It was as if I had repeatedly lost her to an imposter with whom I found connecting more challenging.Ideally, I would have been more present and better connected to all her “selves.” But that's not often who shows up when we're in survival mode. I am grateful to my analytical, driven, and detail-oriented left brain, which ultimately found the help and answers that allowed her to return to her developmental path. I did, however, have to let that part of me go (in our relationship), for her and my well-being.There is No Fixed SelfWith these recent thoughts of the elusive “self” came a need to rekindle my relationship with one of my favorite mystics - Leonard Cohen. Though I've heard the interview (quoted below) several times, I was surprised at how different it resonates at this stage in my life.After commenting on how he no longer struggles with chronic depression, he explains why that is.“We don't determine what we are going to see next, or hear next, or taste next, or think next, or feel next. Yet we have the sense that we're running the show. So if anything has relaxed in my mind, it's the sense of control, or the quest for meaning. My sense is there is not a fixed self. There is not one whom I can locate as the real me. And, dissolving the search for the real me is relaxation, is the content of peace….But these recognitions are temporary and fleeting, and, you know, …….we go back to thinking we know who we are.”The Right & Left BrainI love how Leonard Cohen unknowingly speaks about the differences between the right and the left brain. His right brain can't locate a real him; for this, he is glad and at peace. The sense of control he refers to is mainly from the left brain, where the ego resides with its self-focus, striving, and clinging. And though the right brain is ideally the master and where we ultimately find peace, we still reflexively return to the left brain as we “return to thinking we know who we are.”BuddhismIf Leonard Cohen sounds Buddhist, he is. Though Judaism remained integral to his spiritual life, he steeped himself in Eastern spiritual and religious practices. From the ages of 61-65, he was a Buddhist monk.I'm not Buddhist, nor do I promote specific religious beliefs or structures. But, I am beginning to understand why the doctrine of "no-self" - the idea that there is no permanent self - has helped many people worldwide. The doctrine doesn't claim that we don't exist, but it does deny ordinary claims about human identity that bring inevitable tension and, for some, anxiety.Instead, according to the doctrine, the self is considered a collection of ever-changing mental, physical, and emotional processes that interconnect with other factors. I can't help but think that among those other factors are changes in our nutrient levels, microbiome, hormones, epigenetic expression, levels of inflammation, and oxidative stress.Self-Focus & the No-SelfHave you ever noticed the difference in how you think and feel when alone with your “self?” Have you ever stopped and noticed how fleeting your thoughts and feelings are? Who were you in those minute-by-minute moments when you were excited and then when you were frustrated? Who is even doing the noticing? Now, think about how you think and feel when you are in the flow of satisfying work or taking a walk, in friendly conversation, helping someone in need, or petting a dog. In those moments, we don't need a self to orient ourselves in the world. In those moments, we are in the world.As human isolation increases, we become more self-focused. We are more in our heads and not in the world. Isolation has our left brain taking us on a tedious pursuit of who we think we are or should be. Our left brain wants an identity to hang its hat on as if that will make everything right in our world. And from this identity, we judge ourselves and others, making it more challenging to connect,….if we let it.SufferingBuddhism connects the concept of self to great human suffering.Think about how much of our attention and energy we spend to find ourselves. We strive to be authentic. Many of us have been bucking up against a self we believe we didn't have much say in creating. And many of us succeed in finding new ways of being in the world that feel more aligned with who we think we are.But many of us will reach a point where we realize the self we've been excavating or creating is fleeting. Our perpetual growth has been walking hand in hand with a falling away of self and identity. We find that all we ever had - and have - are our moments.PresenceWiring a brain to be present in such moments takes practice. It is when we practice noticing and paying more attention to the people and the world around us. It's when we notice what we see, hear, and even smell. It's when we are immersed in a conversation or our work. It is when we are creating anything or listening to music. It is when we experience compassion, which includes self-compassion. It's not all about good feelings. To be present is to sit with anger, sadness, and fear as they arise. They, too, shall pass, especially if we don't try to deny or resist them.Being present is the antidote to the self. Being present is an antidote for suffering.Wishing you moments of presence and the ability to hold everything, including your sense of identity, more lightly in the New Year.CourtneyCourtneySnyderMD.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com

In previous podcasts, I've discussed the more common underlying factors that can drive brain-related symptoms. These factors, or “roots,” each have their constellation of symptoms and traits.Because children's brains and bodies are still developing and because they don't have the same degree of hormonal influences, some of their symptoms and associated psychiatric diagnoses will differ from adults with the same imbalances. As you'll see, inattention and hyperactivity and the diagnosis of ADHD can be the manifestation of a number of these root causes.Though I'll discuss these common imbalances separately, more than one can be present. Below are the most common imbalances I see in my work. Teenagers' symptoms tend to resemble those of adults.Each of these topics is linked to a more in-depth description if needed.* Undermethylation* High Copper* High Pyrroles* Mast Cell Activation* Candida* Mold Toxicity* Electromagnetic Hypersensitivity* OvermethylationFood sensitivities can be present and result in a range of symptoms; however, one or more imbalances are also usually present and underlying the food sensitivities.To learn more about the root causes of brain symptoms and the consultations that I offer, visit courtneysnydermd.comDisclaimer:This podcast is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com

In the last podcast, I discussed sources of toxins and how they can impact the brain and development.In this podcast, I'll focus on ways to reduce exposure. I say reduce because there is no way to completely eliminate our exposure to toxins. This reality can be liberating for those who struggle with perfectionism.If you're new at this, feel good about starting. Avoid feeling bad about what you haven't done yet. (Negative thoughts aren't great for detoxification;)For me, lowering exposures has been a stepwise process. When I began, I had to avoid overwhelm and resist trying to do everything at once.Though I've familiarized myself with the most researched toxins and their specific health impacts, I try to focus more on what I can do to avoid them so I can get on with life and not think about them.Some of the most researched toxins (last I checked) include mercury, lead, arsenic, cadmium, PBDEs, organophosphates, glycerophosphate, BPA, BHA, BHT, PCBs, sodium benzoate, butane, tartrazine dye, potassium bromate, ADA, BVO, yellow food dye number's 5 and 6, red dye number 40, bovine growth hormone, synthetic hormones, ractopamine, phthalates, parabens, phenylenediamine, oxybenzone, acrylic, DEA, triclosan, PFAS including PFOS, benzene, chlorine, chloramine, ochratoxin, trichothecenes, aflatoxin, chaetoglobosin, gliotoxin, and zearalenone.Electromagnetic fields, though not “toxins,” are considered toxicants, which have similar impacts on our bodies and brains. I've previously shared how we can start to assess and lower those.To learn more about the root causes of brain symptoms and the consultations that I offer, visit courtneysnydermd.comDisclaimer:This podcast is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com

Recently I saw a humorous reel of a man going through his day. As he does, you hear his inner dialogue. He's trying to prepare a healthy snack, but at every turn, he's stopped by his voice pointing out exposure to toxins - in the packaging, the water, the skin of the fruit. Eventually, he sits down and opens a bag of chips.Can we lower our exposure to toxins (and support detoxification) and not live in fear? I think we can. We can all hold this heavy topic lightly and do the best we can, knowing that there's no perfection here.“If we are going to live so intimately with these chemicals, eating and drinking them, taking them into the very marrow of our bones - we had better know something about their nature and their power.” - Rachel Carson in “Silent Spring” (1962)In this episode, I'd like to help you better know something about the nature and power of the chemicals and heavy metals that we're exposed to. I'll discuss* The cumulative effects of our exposures* Sources of toxins* Oxidative stress* How toxins contribute to chronic health conditions, including psychiatric conditions* Impacts on the developing brain* How oxidative stress can be measuredTo learn more about the root causes of brain symptoms and the consultations that I offer, visit courtneysnydermd.comDisclaimer:This podcast is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

Likely you've heard about the importance of muscle strengthening in the prevention of bone health. What is less known, however, is the relationship between the health of our muscles and the health of our brain. In this podcast, I'll address:* Evolution and the types of activity that our bodies were designed for* Causes of sarcopenia or muscle loss* The relationship between sarcopenia, cognitive decline and Alzheimer's* How role our muscles play in blood sugar regulation and lowering inflammation* Low grip strength as a marker of psychiatric illness and neurodegeneration* Building muscle and address oxidative stressTo learn more about the root causes of brain symptoms and the consultations that I offer, visit courtneysnydermd.comDisclaimer:This podcast is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

“If the only prayer you said in your whole life was, ‘thank you,' that would suffice. - Meister EckhartIn recent years, the benefits of practicing gratitude have become more widely known. During this time, my experience has expanded to include two more “radical” forms of gratitude that I'd like to share with you.In this podcast, I'll address:* The increasing importance of gratitude in these times* Examples of gratitude practices* The many benefits* Children and gratitude* Aspirational gratitude* Radical gratitude* Spiritual bypassingTo learn more about the root causes of brain symptoms and the consultations that I offer, visit courtneysnydermd.comDisclaimer:This podcast is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

Our gut microbiome forms a dynamic ecosystem of trillions of microbes, including bacteria, viruses, archaea, and fungi, in thousands of species—many of which have existed long before humans.While research into the microbiome has gained traction only in the past twenty years, our ancestors recognized the connection between digestion and emotions, mood, and behavior. Historical practices like fecal transplants date back to Ancient Greece and 4th century China.By the 18th century, the concept of the gut-brain axis was already recognized, and in the 19th century, physicians acknowledged the influence of the gastrointestinal (GI) tract on mental well-being. However, the 20th century saw a regression in this understanding, with scientists asserting that it was the mind affecting the gut instead.It wasn't until the 21st century that we reconciled these views, acknowledging that both can be true. The brain impacts the gut through the autonomic nervous system, while the gut influences the brain through its microbial inhabitants.So, how exactly does the gut microbiome affect the brain beyond its role in nutrient absorption? This influence is largely through three primary mechanisms.To learn more about the root causes of brain symptoms and the consultations that I offer, visit courtneysnydermd.comDisclaimer:This podcast is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

The way I think about it:We come into and leave this world accompanied by our souls. While here, one of our tasks is to maintain our connection to that inner wisdom, which guides and nourishes us in a world that otherwise can feel harsh and cold. Our soul doesn't judge us or try to fix us. It doesn't need us to be more or do more. Its unconditional love is akin to an adoring dog who only wants us to stop, be present, and see what it sees.The challenge is the neuronal wiring we develop from cultural inputs that discount this vital relationship with ourselves. We're trained to project onto others our strengths and even our shadow. We find ourselves disappointed when others can't carry that weight of our expectations.If this most vital relationship is neglected, our human connections suffer. Our relationships may feel shallow or intense and dramatic. We'll resent and blame others unconsciously for losing ourselves. Unaddressed, this comes out in the form of hurting others, or it gets repressed and fuels addiction, a range of symptoms, and chronic health conditions.Instead of rom-coms about finding the perfect person and living happily ever after, we need more stories about people falling in love with themselves. “I complete me.” The healthiest relationships are between people who honor this need in themselves and each other.Below is a blessing I print and include in birthday cards to those I love. To me, it speaks to the soul. This week, I share it with myself and with you - in honor of your arrival.Birthday Blessingby John O'Donohue (late Irish poet and, I would say, mystic)If you'd like to hear his lovely voice reading this, listen here at 8:15“Blessed be the mind that dreamed the dayThe blueprint of your lifeWould begin to glow on earth,Illuminating all the faces and voicesThat would arrive to inviteYour soul to growth.Praised be your father and mother,Who loved you before you were,And trusted to call you hereWith no idea who you would be.Blessed be those who have loved youInto becoming who you were meant to be,Blessed be those who have crossed your lifeWith dark gifts of hurt and lossThat have helped to school your mindIn the art of disappointment.When desolation surrounded you,Blessed be those who looked for youAnd found you, their kind handsUrgent to open a blue windowIn the gray wall formed around you.Blessed be the gifts you never notice,Your health, eyes to behold the world,Thoughts to countenance the unknown,Memory to harvest vanished days,Your heart to feel the world's waves,Your breath to breathe the nourishmentOf distance made intimate by earth.On this echoing-day of your birth,May you open the gift of solitudeIn order to receive your soul;Enter the generosity of silenceTo hear your hidden heart;Know the serenity of stillnessTo be enfolded anewBy the miracle of your being.”To learn more about the root causes of brain symptoms and the consultations that I offer, visit courtneysnydermd.comDisclaimer:This podcast is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

There is a wealth of information about sleep. In this podcast, I'll highlight aspects I find especially interesting and significant.  * The Pineal Gland* The Seat of the Soul* Flouride* Melatonin* Creating Melatonin* Cortisol* Brain waves* Falling Asleep & Waking Up* REM (rapid eye movement) versus non-REM sleep* Sleep cyclesIn a future episode, I will delve into tools and techniques for optimizing sleep.To learn more about the root causes of brain symptoms and the consultations that I offer, visit courtneysnydermd.comDisclaimer:This podcast is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

After sharing my favorite books for engaging the right brain last year, I thought I'd now share some for stimulating the left brain. Anyone familiar with functional medicine knows the vast landscape of information—some empowering, some daunting, some helpful, and some even alarming. Yet, feeling inundated or fearful isn't conducive to healing and well-being.Just as pairing protein with carbs helps to stabilize blood sugar levels, balancing left-brain reading with right-brain material can be beneficial. Otherwise, we risk becoming overly focused on the minutiae of healing, which can increase stress and diminish the bigger picture of our lives.The books mentioned are designed for those seeking insights for themselves or loved ones, as well as for clinicians aiming to better serve their patients. Each book has helpful information, practical tools, and well-founded hope.To learn more about the root causes of brain symptoms and the consultations that I offer, visit courtneysnydermd.comDisclaimer:This podcast is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

In previous podcasts, I've discussed many root causes of brain symptoms, none of which exist independently from our hormones.  In this podcast, I'll address the impact our sex hormones - estrogen, progesterone, and testosterone - have on our neurotransmitters.   I'll also discuss how changes in our hormones can impact our personalities and mental health over our lifetime.  While there is a great deal of diversity in our hormonal states, there are obvious similarities for those born female and similarities for those born male. Hormones are an exceedingly complex topic. I will be oversimplifying.To learn more about the root causes of brain symptoms and the consultations that I offer, visit courtneysnydermd.comDisclaimer:This podcast is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

Our limbic system (commonly called the lizard brain) plays an important role in our safety. If it's over-functioning, however, we can feel chronically unsafe.Previously, I discussed how the autonomic nervous system (ANS) puts us into fight, flight, or shut down when we feel threatened. The ANS operates largely outside our brain; however, it communicates with our limbic system, which is in the brain. In this newsletter:* What is the limbic system, specifically the amygdala, and how does it keep us safe?* What symptoms and conditions occur when the amygdala is over-functioning? * What does the limbic system have to do with high immune reactivity and mast cell activation, multiple chemical sensitivity, and electromagnetic hypersensitivity?* Are some of us born with an overactive amygdala?* What environmental inputs can lead to limbic system dysfunction?* How can we take advantage of neuroplasticity to address this dysfunction, feel safe in our bodies and environments, and become less reactive to food, chemicals, light, loud sounds, EMF, and other environmental inputs?What Is the Limbic System?The limbic system is a group of interconnected structures deep inside the brain (and just above the brainstem) that govern our emotions, motivation, sense of smell, and behavior.  Evolutionarily, the limbic system is considered the oldest part of the human brain.  It has been identified in fish, amphibians, reptiles, and early mammals. The structures include the thalamus, hypothalamus, basal ganglia, cingulate gyrus, hippocampus, which consolidates short-term memory into long-term memory, and last but most certainly not least, the amygdala.The Amygdala* a major processing center for emotions, especially fear, anxiety, and rage.* helps identify potential threats and trigger appropriate reactions, such as the "fight or flight" response.* stores emotional memories, especially those related to stress and fear.* helps with social interactions and interpreting information about others.* involved in learning by fear, and is necessary for acquiring both active and passive avoidance of conditioned responses.* assigns value to objects and activities; plays a role in making judgments, including social, moral, and aesthetic judgments.What is Limbic System Dysfunction?This is when neuronal pathways have been reinforced from repeated threatening inputs. What is perceived as threatening starts to become generalized. This can look like:* high anxiety and even obsessive-compulsive symptoms, such as contamination fears, disordered eating, body dysmorphia* hyper-vigilance or being excessively alert to anything perceived as a threat* excessive fear related to:* one's symptoms* one's body* food, medications, or supplements* environmental exposures, such as chemicals, mold toxins, or EMFBecause of the interconnection between the central nervous system and our immune system, once someone has developed limbic system dysfunction from toxic exposure or trauma, they can become hyper-reactive to a wide range of stimulation, including light, sound, smells, foods, supplements, medications, chemicals, and electromagnetic fields.  As you can see, this becomes self-perpetuating. As a person has more reactions, often in the form of mast cell activation with its wide range of symptoms, they become more vigilant and avoidant to try to prevent symptoms. This adaptive response, however, further reinforces a hyper-vigilant limbic system.What Does It Feel Like?I can speak to this personally, as I had limbic system dysfunction from mold toxicity (from a home that had water damage) and then later in a new Smart house with high radio frequencies and dirty electricity. Even before I knew I had mold toxicity and was being exposed to mold, my thoughts repeatedly landed on themes around safety. I knew something was causing me to have severe fatigue and headaches, but I didn't know what. “I shouldn't eat that, I shouldn't go there, I shouldn't, I can't, I better not.” I thought if I could control things, I would be fine. Everything and everyone felt “too much.” It was hard to be with people. When our body feels threatened, we are not at rest, digest, and connect. It's difficult to be present. That's a problem because the less we connect with others, the more room in our minds for rumination and reinforcing those fear pathways. My symptoms of pain, fatigue, and anxiety caused by mold toxins and EMF were helped and made worse by the limbic dysfunction that developed. If you've ever been “limbic,” you know it's all-consuming and exhausting, not just for you but for your spouse, partner, children, and close friends.Can We Be Born with Limbic System Dysfunction - “Wired For Danger?”RCCX is a gene module (cluster of genes) that appears to be at the foundation of many psychiatric conditions and complex chronic health conditions, such as mast cell activation syndrome (MCAS), chronic fatigue syndrome, chronic inflammatory response syndrome (CIRS), and postural orthostatic tachycardia syndrome (POTS)The RCCX gene module includes a gene for hypermobility (especially bendable or double-jointed), a gene for 21-hydroxylase - involved in stress hormone pathways, and a gene related to our immune response and autoimmunity.  Hypermobility is a red flag but not a requirement.A weakness in 21-hydroxylase can result in higher androgens (such as testosterone) in utero and thus impact the developing brain, specifically the amygdala. Studies have found that those with hypermobility have a larger than normal amygdala, which fits RCCX theory.   This would suggest that many of us come into the world with an amygdala that already has us on high alert. The disadvantage of the resulting global sensitivity is the greater potential for health consequences. However, there can also be advantages, including being highly intuitive, observant, creative, and empathic. Another seeming result of high androgen exposure in women during development is a finger length ratio more typical of men (the ring finger is longer than the index finger when looking with the palms up).   Perhaps the male finger length ratio in women and girls suggests a vulnerability to developing limbic system dysfunction.Neuroplasticity - Friend or Foe?Neuroplasticity is the incredible ability of our neurons to form new connections and modify the strength of existing connections. More simply put, it is the ability of our brain to rewire itself. Our experiences, thoughts, and behaviors drive these neuronal connections. As you'll see, neuroplasticity can work against us and take us into or further into limbic system dysfunction, or it can help us find our way out of limbic system dysfunction.How Do We Develop Limbic System Dysfunction?I do suspect that many of those who go on to develop limbic system dysfunction already had a vulnerability from the start; however, environmental inputs - exposures or trauma - can reinforce those neuronal pathways of fear and avoidance. Such experiences could start as early as the first three years of life.  Perhaps one's attachment experiences left them feeling unsafe and uncertain that the world was safe. There could have been trauma. Over time, toxins could have left the body feeling chronically threatened. We see this with biotoxins, especially from mold and Bartonella, but also with Lyme and other co-infections. We also see this with high EMF exposure and chemical exposures. Though we call it dysfunction, hypervigilance can lead people to their answers. Had I not been “limbic,” I probably wouldn't have discovered I had mold toxicity, but once I did, I had to teach my brain and body how to feel safe again,… perhaps even safe for the first time.Limbic System RetrainingJust as pathways of fear and vigilance can get reinforced over time, so can pathways of safety and well-being.  Limbic system retraining programs are structured programs with exercises, education, and support to help retrain the limbic system. They are incredibly helpful for most people, even those with an active “threat” like mold toxins in their body.  That doesn't mean that actual external threats don't need to be addressed. Just as I wouldn't recommend someone stay in a traumatizing relationship, I also wouldn't recommend someone stay in an environment in which they are getting significant exposure to mold toxins.Limbic system retraining programs can be done at home online. Common ingredients include raising awareness of thoughts and triggers, interrupting those thoughts (with or without movements), and a visualization or mood elevation. All of these require practice. The three programs that I have patients look into and which many of us who treat complex illness have the most experience with are:* Dynamic Neural Retraining System (DNRS)* Gupta Program* Primal Trust Though these vary somewhat (DNRS is the most structured, Gupta brings in meditation, and Primal Trust brings in more vagal nerve interventions and trauma-informed practices), they are all effective. It comes down to fit and which program the person feels the most drawn to and, thus, will be most inclined to do.  While an hour a day may be recommended by the programs and maybe most helpful, it does not have to be “all or none.” Even ten minutes a day to start can still be helpful.For patients who are so sensitive that they can not tolerate any supplements, binders (for toxins), or medications to calm down their immune and/or nervous system, limbic system retraining and vagal nerve interventions for eight weeks usually can allow them to move forward. Again, because the immune and central nervous systems are so interconnected, as the limbic system calms down, so do mast cells, inflammation, immune reactivity, and the many symptoms that they can cause.  Who Benefits From Limbic System RetrainingLimbic system retraining programs - specifically the Dynamic Neural Retraining System, not surprisingly, were first used for Multiple Chemical Sensitivity (MCS), Chronic Fatigue Syndrome (CFS), Electromagnetic Hypersensitivity Syndrome (EHS), and Fibromyalgia. They are also used for Mast Cell Activation Syndrome (MCAS), Chronic Inflammatory Response Syndrome (CIRS), mold toxicity and other biotoxin illness (Lyme and it's coinfections), Post Traumatic Stress Disorder (PTSD), Obsessive Compulsive Disorder (OCD) and more generally for: * Those who have experienced physical, psychological or emotional stress and trauma and who are now suffering from a chronic health condition* Those with chronic depression and/or anxiety* Those with chronic painHow to Help Children Limbic System DysfunctionOlder children and teens can benefit from doing limbic system training program with a parent. My daughter and I did DNRS together. Our conversations about it were reinforcing and still shape how we each think about how to support our neurophysiology.  For younger children, following the steps may be more difficult. Programs like Brain Tap and Dr. Stephen Porges' “Safe and Sound” program can be very helpful. Honoring Our Limbic SystemBefore I close, I would again point out that our amygdala - beyond keeping us safe - is the source of many of our gifts - our sensitivity, intuition about people, and inner knowing. Those of us who come into the world “wired for danger” are also wired to see things others may not see and feel things others may not feel. We can use such gifts to serve a higher good. Whether or not you struggle with limbic symptoms, I hope something here helps you appreciate your limbic system so that it can help you find peace and purpose.Until next time,Courtney To learn more about the roots brain-related symptoms and discover surprising paths to healing, consider becoming a free or paid subscriber.Medical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

“Addicted” - “exhibiting a compulsive, chronic, physiological or psychological need for a habit-forming substance, behavior, or activity.” Like other health conditions, addiction is multifactorial. It is the result of an alignment of root causes. In this newsletter, I'll discuss:* Substance addiction and behavioral addictions* Why addiction is not simply about dopamine and why there are multiple addictive personalities* How & why we differ in our physiologic response to substances* Our culture's shaming and punishment of addiction while fueling addiction* The role of attachment disruption, trauma, emotional dysregulation, and social isolationSubstance AddictionWhen it comes to addiction, you might expect me to talk a lot about dopamine.  Not all substance addictions are the same, however. Opioids act very differently on the body than alcohol, which acts differently than cocaine.  Some substances are more addictive than others, and even more so in certain people.  For most people, marijuana is less addictive, while alcohol, cocaine, and opioids are more addictive. Addictive Substances:* Alcohol* Caffeine* Cannabis* Hallucinogens* Sedatives and Hypnotics/Anxiolytics* Inhalants* Opioids* Stimulants* TobaccoSeemingly, 10-20 % of people who try substances will have problems with addiction. Our genetic makeup and the expression of our genes will impact how we react to substances, just as they will affect how we metabolize specific medications or environmental toxins.  We could, for example, have a weak enzyme that slows our metabolism of alcohol and results in our becoming more intoxicated more quickly.  We may have high neurotransmitter activity that we're trying to calm down with substances, or we may have low neurotransmitter activity and are taking substances or even carrying out certain behaviors that increase our neurotransmitter activity.   Behavioral AddictionWhile we can become severely addicted to substances, we can also become addicted to behaviors or the feelings brought on by the behavior or anticipation of the behavior. Examples of Behavioral Addiction:* Food addiction* Sex addiction* Love and relationship addiction* Codependence is considered a relationship addiction in that relationships are often one-sided, emotionally destructive, or even abusive.* Exercise addiction* Body dysmorphic disorder* Health addiction* Shopping addiction* Gambling addiction* Work addiction* Video game addiction* Internet addiction* Smartphone addiction* Social media addiction* Porn addiction* News addiction* Information addiction* Self-harm addiction* Extremism is also felt to overlap with addictionWe can become addicted to anything that spikes the reward chemicals in our brains.  If we're not sure if we're addicted, we can ask ourselves, “Is the compulsive behavior having negative consequences?”The severity of our addictions falls on a spectrum.  I may not have a gambling addiction where I am putting myself at financial risk; however, I could be addicted to sugar, which I know negatively impacts my health, gives me brain fog and fatigue, and causes me to check out of my relationships, including my relationship with myself. Culture: Shame & Punishment The last thing that we need if we are addicted to a substance or behavior is shame and punishment. Our culture still tends to see addiction as a moral failing or even a sin that can be removed with punishment.  This thinking leads to simplistic consequences such as rejection by family and friends and even imprisonment.  The same happens with other forms of mental illness, but in this case, there is even less understanding, less compassion, more anger, and more disdain.Culture: Fueling AddictionMeanwhile, most of us are becoming more addicted - addicted to our cell phones, social media, divisive stimulating news and information.  We have more information coming at us than we can process.  Our brains are flooded with catecholamines as we stay in highly stimulated states. One of those catecholamines is dopamine, which will drive motivation and have us in pursuit of “more.”  While there may be a type of pleasure in that pursuit, it's not a joyful or even content type of pleasure. When we are in pursuit, we are not present in our lives.   Many of us can barely process our moments, days, and lives in these modern times. For many, what was a life of memorable moments (positive and painful) has become a blur of days quickly passing by. Before we've had time to process what has happened, what we've experienced, or what we've felt, our minds are in pursuit of the next thing we need to know or have.With addictive technology comes the marketing and its messages - “more food, more sex, more youth and beauty, more health, more money, more success, and even more love - the elusive movie kind.  We are forgetting how to be satisfied and tolerate uncomfortable feelings.Attachment & TraumaWe haven't all had the same early attachment experiences. Some of us have experienced childhood trauma. We don't know what safety feels like. Two-thirds of those with opioid addiction have childhood trauma. This doesn't account for the trauma that can occur before verbal memory, which is usually not reported.Childhood trauma impacts our autonomic nervous system, our limbic system, and our hormonal stress response. Before we even experience a stressor, our baseline neurotransmitters may already be too high. Our trauma, in combination with our genetic variants, may result in high neurotransmitters that we may try to calm down with our addiction, or our trauma, in combination with our genetic variants, may have us seeking out stimulation so we can feel more alive and connected.Social IsolationPart of our understanding of addiction comes from the work of American psychologist Dr. Bruce Alexander, who did the “Rat Park” study.  Previous research had already shown that when rats were put in solitary confinement and given a choice between water and heroin or cocaine, the rats repetitively consumed the drug-laced water until they overdosed and died.Alexander realized that the problem may not be the rats but the environment.  Rats are social animals, just as we are.  So, he created “rat parks,” where the rats could roam, play, socialize, and have sex.  Despite being given the same access to the two types of drug-laced water, these rats preferred the plain water.  Even if they did drink the drug-laced water occasionally, they never did obsessively, nor did they overdose.  The social environment was protective against addiction. If we want to help those with addiction, we need to think about connection. If we want to help ourselves with an addiction, we need to think about connection.Emotional RegulationOur ability to regulate our emotions (increase calm and decrease fear and anger) comes through interactions with other humans - safe humans. Ideally, we learn to regulate our emotions during our first three years. When we were distressed as infants and toddlers, we communicated that distress through our cries and facial expressions, our caregivers responded, and our physiology returned to a sense of calm and safety. This repeated process - not necessarily perfect, but “good enough” - resulted in our internalizing that early relationship and, with that, an ability to recognize our feelings, trust others, feel worthy, respond to uncomfortable feelings with coping skills, and return to our baseline emotional state.  Without this skill we acquire through attachment, we can become overwhelmed by our feelings or detached from our feelings. Our experiences, genetics, and temperament will impact which direction we go.There is not one “addictive personality” but many addictive personalities. Some of us will be highly sensitive, and others will have a low level of sensitivity. Some of us will become overwhelmed by stress or stimulation and use addictions as a way to try to calm our emotional and high neurotransmitter states.  Others will seek sensory stimulation or risk-taking to bump those neurotransmitters and increase the feeling state. Of course, our biochemical differences impact this as well:* For those of us who are undermethylated, we may find that we are sensory seeking, have high activity at the NMDA receptor, and find ourselves craving whatever has come to have meaning or has left a mark on our neurophysiology.  * For those of us who are overmethylated, we may have the desire to calm things down, slow our racing thoughts, and lower our high neurotransmitter activity.* For those of us with high pyrroles (and or CAPs profile), we may feel socially anxious or overstimulated and desire to feel calm and comfortable, but at other times, we may feel brave and invincible.“Being bold and adventurous and being sad and cautious seem like opposite personality types. However, these two paths to addiction are actually not mutually exclusive. The third way involves having both kinds of traits, where people alternatively fear and desire novelty and behavior swings from being impulsive and rash to being compulsive, fear driven, and stuck in rigid patterns. ……My own story spirals around this paradoxical situation: I was driven enough to excel academically and fundamentally scared of change and of other people—yet I was also reckless enough to sell cocaine and shoot heroin.” - Maia Szalavitz We need to think more broadly about addiction, just as we would any other health condition.  We need to address the underlying physiological root causes, meet our human need for connection, and learn ways to experience, tolerate, and cope with our very human and necessary feeling states.  In this week's paid newsletter, I look forward to discussing cases to illustrate how various neurotransmitters can be at play with different substance addictions and how targeted nutrients can be used in the treatment of addictions - both substance and behavioral. Until next time,CourtneyIf you'd like to dive deeper into the root causes of brain symptoms, consider becoming a paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

It can be easy to forget that medical professionals are vulnerable to stress, burnout, and even physical and mental health issues. Though we expect them to be well, physicians have a relatively high rate of depression. Physician suicide is twice the rate of the general population.I'll argue that doctors have biochemical and environmental factors contributing to their strengths and vulnerabilities.Though I'll focus on physicians in this newsletter, much of what I'll discuss applies to other medical professionals and caregivers.  In this newsletter, I'll address:* The higher rates of depression and suicide in physicians* How undermethylation is likely a strong contributing factor* How early family dynamics may be at play* A medical culture that leaves physicians unsupported and reluctant to seek help* SolutionsTo learn more about the root causes of brain symptoms and the consultations that I offer, visit courtneysnydermd.com Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

“Exterior building maintenance is crucial for preventing mold from growing inside a building” - Jerry Parker, CEIC, CMRTwenty-five percent of people appear to be susceptible to mold toxicity - a surprisingly common cause of brain symptoms, including brain fog, fatigue, depression, anxiety, mood swings, OCD, panic, and psychosis. Many chronic physician health conditions can result as well. In my experience, mold toxicity is the most common cause of mast cell activation. Mold toxicity should also be considered when there are new-onset mental health issues in college students exposed to mold in their dorms or apartments.Jerry Parker is a Certified Indoor Environmental Consultant (CIEC) and Certified Microbial Remediator (CMR). Jerry has been helpful to me personally and professionally and has taught me a great deal about the environmental aspects of mold. Jerry owns Environmental Solutions Group, LLC, which has served residential and commercial clients for the last twenty years. He is about to launch an educational and consulting platform, 4 Indoor Air Quality LLC.In this newsletter and podcast, Jerry and I discuss:* why mold prevention isn't just about keeping water out; it's also about moving water away from the foundation* ways to ensure rainwater is moving away from our home and its foundation * landscaping and vegetation* gutters and downspouts* roof and siding integrity* chimneys* cantilever fireplaces and bay windows* doors and window sealing* siding and deck attachment* the importance of regular self-assessmentsAt a later date, Jerry and I will discuss mold prevention with a focus on the interior of our homes.Let us know if you have any questions or comments on mold prevention (exterior or interior).Have a good week,CourtneyTo contact Jerry Parker CIEC, CMR: email - info.4IAQ.com 4IAQ.comRelated Content:* Mold Toxicity: Depression, Anxiety, Brain Fog & Fatigue (free)* Mold Toxicity & the Brain (free)* Mold & Candida in the Brain (paid)* Environmental Mold Myths (paid) This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

Skin conditions are common in those with brain-related conditions. Most of what you'll find about this relationship is the suggestion that one is causing the other. It is believed, for example, that the stress of having a skin condition can cause depression and anxiety, which makes sense…..or that the stress of the mental health condition is causing an increase in stress hormones or inflammation that then leads to skin symptoms. This also makes good sense.In this podcast, I'll argue that skin and brain symptoms have shared common roots - one in particular. By brain symptoms, I'm referring to depression, anxiety, panic, OCD symptoms, brain fog, inattention, hyperactivity, mood swings, psychosis, and cognitive decline. I'll address:* the many ways zinc (important in brain health) impacts the skin* skin symptoms associated with specific “roots” of brain symptoms, including:* low zinc and high pyrroles* high copper* mast cell activation* candida and mold* methylation imbalances* Electromagnetic hypersensitivity (EHS)* Bartonella* how traits such as flushing, early graying, or a pale complexion can suggest vulnerabilities to the brain symptoms (Obviously, not everyone with these traits has brain symptoms, but for those who do, these traits can point to likely underlying contributing factors)* how certain acne treatments can worsen mental health conditions* the importance of understanding shared root causesIf you'd like to add to the discussion, I always appreciate your questions and comments.Have a great week,CourtneyFor information about non-patient consultations and treatment, visit: CourtneySnyderMD.comRelated Content:What Physical Symptoms Tell Us About Brain Symptoms (paid)Zinc & The Brain (free)Labs For Evaluating Brain Symptoms (paid)Medical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

Eric Windheim, BA, BBEC, EMRS, RFSO is a Certified Electromagnetic Radiation Specialist and Certified Building Biology Environmental Consultant. He is the founder of Windheim Solutions, which provides inspection, testing, and remediation of problematic EMFs. In this episode, we discuss smart meters, which are digital devices that measure electricity usage in real-time, and wirelessly send that information to the utility company. Smart meters are sometimes used for gas and water.Though there are four harmful types of electromagnetic fields—radiofrequency (wireless), electric fields, magnetic fields, and dirty electricity—smart meters use radio frequencies.Brain symptoms associated with EMF exposure include insomnia, memory problems, irritability, depression, personality changes, inattention, fatigue, confusion, headache, ringing in the ears, dizziness, numbness, and tingling.Problematic EMF can impact the brain in many ways. It causes oxidative stress and neurotoxicity. It disrupts our immune system, innate electricity, hormones, microbiome, limbic and autonomic nervous systems, and the blood-brain barrier. EMF can also contribute to elevated blood sugar.The good news is that there are many ways we can lower our exposure.In this newsletter:* Eric shares: * How he became an electromagnetic radiation specialist.* The story of smart meters * His role in a national victory with Sacramento Municipal Utility District, the first municipal electric utility to allow customers to regain the use of analog meters. * We discuss the following questions:* How do you “opt-out” and return to an analog meter?* What can you do if you have to have a smart meter?* What can you do if you're getting radio frequency exposure from your neighbor's smart meters or other wireless devices?* What meter can measure radio frequencies in and around your home?* How can you find an electromagnetic radiation specialist?If you'd like to join the conversations, consider sharing your experience or questions.Have a good week,CourtneyMentioned Resources* Windheim EMF Solutions* WIndheim EMF Solutions Youtube Channel* Building Biology Institute* EMF & the Brain* Electromagnetic Hypersensitivity - A Lesser Known Root Cause* How We Can Start to Assess & Lower Our EMF Exposure This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

I recently had the pleasure of being on the Nourished By Nature: Mind Body Wellness Podcast with Annika Taylor, a holistic health practitioner. After sharing with Annika how I became a holistic psychiatrist and how I define holistic psychiatry, we discuss:* The Walsh Research Institute's data on nutrient levels of 30,000 people with brain-related symptoms, and what were found to be the most common imbalances (One or more of these imbalances is present in about 90-95% of the patient's that I evaluate for brain-related symptoms).* The Walsh biotypes of depression. How I test for the copper-zinc imbalances, pyrrole disorder, and methylation imbalances.* High copper and its relationship to ADHD, anxiety, depression and post-partum. depression, anxiety and psychosis.* Pyrrole disorder - symptoms, traits and treatment.* How methylation impacts brain health.* Under and over-methylation symptoms and traits.* Treatment of under-methylation.* How this understanding can remove the stigma associated with mental health conditions, and provide healing and hope.In recent years, Dr. Walsh discovered that undermethylation is increasing in the population while overmethylation is decreasing.If you'd like to add to the discussion, I always appreciate your questions and comments.Have a great week,CourtneyRelated Resources:Annika Taylor - nourishedbynature.comWalsh Research InstituteFor links to specific topics address see links in the description above. Medical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for yourself or others, including but not limited to patients you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment.In this newsletter and podcast episode, I focus on the prevention and treatment of Alzheimer's. Because this condition starts prior to the onset of symptoms, and because having almost any psychiatric condition appears to raise our vulnerability, many of the tools mentioned relate to other brain symptoms and conditions as well.“What we call Alzheimer's disease is actually a protective response to a wide variety of insults to the brain: inflammation, insulin resistance, toxins, infections, and inadequate levels of nutrients, hormones, and growth factors.” - Dale Bredesen, MD  (The End of Alzheimer's Program: The First Protocol to Enhance Cognition and Reverse Decline at Any Age)In this newsletter, I'll discuss:* Medications used in mainstream medicine * Lifestyle and functional medicine approaches to preventing and treating Alzheimer's* Feeding the brain - The ketogenic diet and intermittent fasting* Exercising the body and brain* Sleep and sleep apnea* Hormonal deficiencies and dysregulation* Oral health* Toxicity, depletion of antioxidants and oxidative stress* Brain inflammation If you have any questions or comments (or topic suggestions),…If you know someone who may benefit,…Have a great week,CourtneyMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having.Resources mentioned:* Precision Medicine Approach to Alzheimer's Disease: Successful Pilot Project* Reversing Alzheimer's: The New Toolkit to Improve Cognition and Protect Brain Health by Dr. Heather Sandison * The End of Alzheimer's by Dale Bredesen, MD* Walsh Research InstitutePrevious newsletters/podcast episodes mentioned:* Alzheimer's: Factors We Have Control Over* Regulating Blood Sugar For the Brain* Intermittent Fasting & the Brain* Exercise & the Brain * Oxidative Stress & the Brain* Lowering Brain Inflammation This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

Alzheimer's is a neurodegenerative disease. It involves the death of brain cells and the eventual loos of brain tissue. The brain changes begin twenty years prior to the onset of symptoms. This is important, because we do have control over what appear to be most of the contributing factors. In this newsletter and podcast episode, I'll address:* The incidence of Alzheimer's* What happens in the brain* The course of the illness* Biomarkers used for diagnosis, even prior to the onset of symptoms* Mild Cognitive Impairment (MCI) due to Alzheimer's* Risks* The role of the APOe4 gene* The role of Insulin resistance in the brain* The role of oxidative stress* The role of inflammation* Evidence of a fungal presence * How these factors may be working togetherIn the next episode, I'll discuss mainstream treatment, as well as functional/integrative/holistic approaches to target blood sugar regulation, oxidative stress, inflammation and even the presence of mold and candida.Feel free to add to the discussion with your questions or comments.If you know someone who may benefit from this information, please consider sharing.Have a good week,Courtney Mentioned Resources:* Alzheimer's Association Facts & Figures* Meet the Switching Mice: They Flip Their Glia APOE4 to APOE2* Mold & Candida in the Brain (free)Other Related Newsletters:* High Copper, Metallothionein, Cancer & Mental Health (paid)* Lowering Brain Inflammation (free)* Regulating Blood Sugar For the Brain (paid)Medical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

In this newsletter and podcast episode, I share the simple yet powerful tool of intermittent fasting. Here, I discuss:* The types of intermittent fasting with a focus on “time restricted eating,” in which fasting is extended to 12-16hours a day (from the more typical 8-10 hours).* Why it makes good sense from an evolutionary standpoint.* What it has to teach us about our metabolism and our brain's use of energy.* The health conditions it is has been shown to be beneficial for.* The many mechanism by which is impacts the brain.* My experience with intermittent fasting.* When fasting can become problematic.If you have experience with intermittent fasting (or questions), please consider adding to the discussion. Have a great week,CourtneyP.S. For paid subscribers watch out for a midweek post on other ways we can work with our body's metabolism and rhythms to improve blood glucose regulation, which is particularly important when it comes to brain health. Additional Resources:* The Effects of Intermittent Fasting on Brain and Cognitive Function* Intermittent Fasting as a Potential Therapeutic Instrument for Major Depression Disorder: A Systematic Review of Clinical and Preclinical StudiesRelated Content* Exercise & the Brain - 10 Ways Exercise Improves Our Mood, Lowers Anxiety & Protects Our Brain.Medical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

My purpose in this video is to remind us to protect our mental health, our physical health and our relationships this election season. We have a natural impulse to pay attention to danger. News networks and social media take advantage and profit from this instinct.Here in the US, we are facing five months of what can be highly stressful. Some will have an increase in anxiety, depression, anger and addictive behaviors including news addiction and internet addiction. If we care about lowering toxic exposures, lowering our stress response and thus inflammation, then these next five months offer a great opportunity. If we care about setting healthy boundaries between ourselves and the negative or self-serving energy of others, these next five months are a great time to strengthen our boundaries. In this video, I discuss:* What is happening in our body and brain when we engage with fear-inducing content.* Media literacy to remind us what we easily forget when we're under the influence of media that aims to get and keep our attention.* How the echo chamber of news and social media is rewiring our brains, and reinforcing left brain tendencies.* What we can do to lower our exposure and it's impacts, and..* How we can call in the right hemisphere while doing our part to better the world we're actually living in.If you'd like to add to the discussion, please….Have a good week, CourtneyTo learn more about this and other factors contributing to brain symptoms or to receive these newsletters in your mailbox each week, visit www.CourtneySnyderMD.comRelated Content:Left and Right Brain: Knowing When to Call in the Other HalfUndermethylation & Strengthening the Right Brain in a Left Brain WorldMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

In this video and podcast episode, I discuss pyrrole disorder - one of the most common nutrient imbalances in brain-related conditions affecting adults and children. Elevated Hydroxyhemopyrrolin-2-one (HPL) in the urine, often referred to as “pyrroles,” has been associated with depression, anxiety, schizophrenia, bipolar disorder, autism, ADHD, learning disorders, substance use disorders, and violent behavior. Here, I address:* How pyrrole disorder relates to other “root causes.”* What we know, what we don't know, and why this topic is controversial.* Causes.* Zinc and B6 depletion and how these impact brain health.* Brain and physical symptoms and traits.* Treatment. * How low-stress tolerance can impact one's ability to pursue meaningful education, work, and relationships.As always, I welcome your questions and comments.Have a good week,CourtneyTo learn more about this and other factors contributing to brain symptoms or to receive these newsletters in your mailbox each week, visit www.CourtneySnyderMD.comRelated Resources* Pyrrole Disorder Symptoms List* Zinc & the Brain https://courtneysnydermd.substack.com/p/zinc-and-the-brain* RCCX Theory, Hypermobility, Mental Health & Complex Chronic Illnesshttps://courtneysnydermd.substack.com/p/hypermobility-rccx-theory-mentalMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

In this video newsletter, I discuss why zinc is so important for the brain. I'll address:* Psychiatric conditions linked to low zinc.* Three ways that zinc impacts neurotransmitter functioning.* Zinc's role as an antioxidant and its relationship to metallothioneins.* The importance of zinc for immune regulation.* The many ways zinc impacts the digestive tract.* How we measure zinc (along with copper) and the limitations of typical lab ranges.* Why optimizing zinc requires testing and monitoring.Until next time,Courtney SnyderAdditional resources for those who'd like to take a deeper dive:* Meet the NMDA Receptor (paid)https://courtneysnydermd.substack.com/p/meet-the-nmda-receptor* High Copper, Metallothionein, Mental Health & Cancer (paid)https://courtneysnydermd.substack.com/p/high-copper-metallothioneins-mental* Mast Cell Activation & Inflammation in Brain Conditions: How to Calm Things Down (free)https://www.courtneysnydermd.com/blog/mast-cell-activation-inflammation-in-brain-disorders-how-to-calm-things-down* Walsh Research Institutehttps://www.walshinstitute.org/Medical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

In the last episode, I discussed narcissistic personality disorder - traits, seeming causes, prognosis, and course.  In this episode, I'll discuss:* the more nuanced understanding of narcissism in our culture* the experience of those hurt in narcissistic relationships, and* tools for self-preservation and healing This topic is particularly important for those of us who are highly sensitive and more permeable to the energies of others. But anyone can be vulnerable to another's masterful self-serving behaviors. This could be in workplace settings, communities, friendships, and romantic relationships.Unless we think like narcissists (which most of us don't), it is difficult to imagine such self-serving motivations. That lack of imagination, however, can get us into trouble.To receive the weekly Holistic Psychiatry Newsletter (text and audio) in your mailbox each week, visit:https://www.courtneysnydermd.comor on Substack at:https://www.courtneysnydermd.substack.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

-In this newsletter, I'll discuss:--The Impact of Narcissistic Personality Disorder --Terminology & Diagnostic Criteria--Seeming Contributing Factors--Brain Differences--Prognosis & CourseTo receive the weekly Holistic Psychiatry Newsletter (text and audio) in your mailbox each week, visit:https://www.courtneysnydermd.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

Candida is the most common fungi in the microbiome. Several factors, including antibiotic exposure, can lead to its overgrowth and colonization in the gastrointestinal tract. Brain fog, fatigue, anxiety, depression, mood swings, insomnia, carbohydrate cravings, and gastrointestinal symptoms (especially constipation) are common symptoms. Children with candida overgrowth are often diagnosed with ADD.In this episode, I will discuss 10 factors that can make it difficult to move beyond candida overgrowth, including:* Low zinc* Mold toxicity and metal toxicity* High blood sugar* Lack of movement and exercise* High stress & catecholamines* High cortisol* High estrogen* Poor gut motility* Low digestive enzymes, stomach acid and bile acids* Low beneficial bacteriaFor the referenced previous podcast episode on candida:Candida, Carb Craving & Brain Symptomshttps://courtneysnydermd.substack.com/p/candida-carb-craving-and-brain-related-fdeTo receive the weekly Holistic Psychiatry Newsletter (text and audio) in your mailbox each week, visit:https://www.courtneysnydermd.comor on Substack at:https://www.courtneysnydermd.substack.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

Hypermobility - having one or more joints that bend further than normal -is a surprisingly common trait in those with brain symptoms.  Using RCCX theory, I'll attempt to explain why this may be. RCCX is a gene module (cluster of genes) that appears to be at the foundation of many psychiatric conditions and complex chronic health conditions, such as mast cell activation syndrome (MCAS), chronic fatigue syndrome, chronic inflammatory response syndrome (CIRS), and postural orthostatic tachycardia syndrome (POTS). Hypermobility - a red flag for an RCCX vulnerability - does not have to be present for someone to be impacted by brain symptoms.For a more detailed explanation of Dr. Meglathery's work, as well as a list of associated conditions, visit RCCX Theory at: http://www.rccxandillness.com/To receive the weekly Holistic Psychiatry Newsletter (text and audio) in your mailbox each week, visit:https://www.courtneysnydermd.comor on Substack at:https://www.courtneysnydermd.substack.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

Exercise has been found to be as effective as SSRIs and as effective as psychotherapy for depression.*In this episode, I'll discuss:* The mood-enhancing chemicals we receive from our body and brain when we move and exercise. * The ways exercise improves our cognition and protects our brain as we age.* The types of movement and exercise.* Exercise Intolerance* How we can mentally move beyond all-or-none thinking, avoid overdoing it and learn to meet our body where it's at.* "The Effects and Mechanisms of Exercise on the Treatment of Depression” https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.705559/fullTo receive the weekly Holistic Psychiatry Newsletter (text and audio) in your mailbox each week, visit:https://www.courtneysnydermd.comor on Substack at:https://www.courtneysnydermd.substack.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

According to the National Institutes of Mental Health, 75% of people rank fear of public speaking as their number one fear.In this episode, I discuss:* The impacts of this common fear* Surprising tools that can help decrease anxiety before and during a speaking event* Ways to avoid and manage freeze if it happens * Medication and nutrient-based interventions that can be helpful if neededTo receive the weekly Holistic Psychiatry Newsletter (text and audio) in your mailbox each week, visit:https://www.courtneysnydermd.comor on Substack at:https://www.courtneysnydermd.substack.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

What is Functional Medicine?“An integrative, biology-based approach that promotes healing and wellness by focusing on the bio-chemically unique aspects of each patient, and then using individually tailored interventions to restore balance. This approach focuses on understanding the fundamental physiological processes, the environmental inputs and the genetic predispositions that influence health and disease. The interventions aim to address the root causes.”In the case of Functional Medicine Psychiatry, such interventions are aimed at promoting healing and wellness for those with brain symptoms such as depression, anxiety, mood swings, fatigue, brain fog, hyperactivity, cognitive impairment, social communication deficits and/or psychosis.In this episode I'll discuss:* The advantages and disadvantages of mainstream medicine* Characteristics of many who seek out functional medicine* Benefits of functional medicine* Risks of functional medicine* How these risks can be mitigated by functional medicine physicians and those seeking this type of treatmentTo receive the weekly Holistic Psychiatry Newsletter (text and audio) in your mailbox each week, visit:https://www.courtneysnydermd.comor on Substack at:https://www.courtneysnydermd.substack.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

Psychiatric symptoms normally are not caused by a specific gene. Instead, certain genes, or rather genetic variants, raise our vulnerability to developing depression, anxiety, mood swings, brain fog, hyperactivity, angry outbursts and psychosisIn this newsletter, I hope to demystify the various ways this can happen.I'll discuss:* The relationship between genes and the proteins they code for* The role of methylation and oxidative stress in gene expression* The types of proteins that are especially important in brain health* Examples of variants that can impact neurotransmitter functioning and thus symptomsTo receive the weekly Holistic Psychiatry Newsletter (text and audio) in your mailbox each week, visit:https://www.courtneysnydermd.comor on Substack at:https://www.courtneysnydermd.substack.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

In this episode, I'll address:* Common obstacles to starting a meditation practice* The uniting thread of all forms of meditation* The types of meditation and how to pick one for you* The gifts of meditation including and beyond the mental and physical health benefits* How to begin “We don't sit in meditation to become good mediators. We sit in meditation so that we'll be more awake in our lives.” Pema ChödrönTo receive the weekly Holistic Psychiatry Newsletter (text and audio) in your mailbox each week, visit: https://www.courtneysnydermd.comor on Substack at:https://www.courtneysnydermd.substack.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

I look forward to the day when lowering exposure to Electromagnetic Fields (EMF) will be right up there with other basic health recommendations, such as getting adequate sleep and exercise, managing stress and limiting or avoiding sugar. In the meantime, I'll try, in this episode, to convince you of why lowering exposure is a good idea. I'll discuss:* Symptoms associated with EMF exposure.* How EMF appears to impact the brain.* Factors that increase our vulnerability to the effects of EMF.* Ways to lower that vulnerability.When I use “EMF,” I'm referring to the more concerning types - radio-frequencies, magnetic and electric fields and dirty electricity.  For simplicity, I'll be talking about these collectively, though much of the emerging research is on radio-frequencies (cell phones, WiFi, SMART or wireless technology).  This newsletter can found at:https://courtneysnydermd.substack.com/p/emf-and-the-brainTo receive the weekly Holistic Psychiatry Newsletter (text and audio) in your mailbox each week, subscribe at: https://www.courtneysnydermd.com or on Substack at:https://www.courtneysnydermd.substack.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

As with toxins, EMF (a “toxicant”) can impact the brain in a number of ways. It contributes to inflammation, oxidative stress, disruption of the micro-biome, and interferes with our innate electricity. Anything we do to decrease it will benefit our health.EMF exists on a spectrum, which includes UV light, the visible spectrum, and infrared among other types. Most of the interventions discussed will relate to radio frequencies (RF), which are rabidly increasing around us.Completely eliminating exposure to EMF is not possible. In this episode, I'll walk through a checklist to help you assess and already start to lower your own exposure. This is not an all or none endeavor. Some will find a couple of ways that have the biggest impact for them and others will want or need to go deeper into the list. You might find it helpful to print this off the checklist and mark the situations that apply to your circumstances and even rank your priorities.This newsletter can found at:https://courtneysnydermd.substack.com/p/how-we-can-assess-and-lower-our-emfTo receive the weekly Holistic Psychiatry Newsletter (text and audio) in your mailbox each week, subscribe at: https://www.courtneysnydermd.com oron Substack at:https://www.courtneysnydermd.substack.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

In this episode, I won't focus on any specific health choices. We all know what they generally are for us at this time in our life or in our healing process. Instead, I'll be introducing mental shifts that can help us get off the roller coaster and step onto a path of sustainable self-care. Self pampering can be a part of self-care, but the type of self-care I'm referring to is much bigger than that.Three people who've influenced my thinking on this topic and who are referenced in this episode are:* Jason Seib - Self care and mindfulness coach, author of Body Beliefs and creator of the (dis)Comfort Zone Workshop* James Clear - Author of Atomic Habits, An Easy & Proven Way to Build Good Habits & Break Bad Ones* Dr. Robert Biswas-Diener - Positive psychologist, author and speakerIn this episodes I discuss the following mental shifts and give examples:* Shifting Our Why - Extrinsic vs Intrinsic Motivation* Shifting Our Identify* Shifting Our Values* Shifting Our Relationship to Our Feelings* “Widening Our Comfort Zone” - (To borrow the phrase from Jason Seib)* Removing Obstacles* Increasing Obstacles* Shifting From Goal to Process* Shifting From Radical to Incremental Changes* AccountabilityTo receive the weekly Holistic Psychiatry Newsletter (text and audio) in your mailbox each week, subscribe at: https://www.courtneysnydermd.com oron Substack at:https://www.courtneysnydermd.substack.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

The last newsletter, I addressed how our hormonal stress response can trigger mast cells and microglial cells, thereby interfering with neuronal communication in the brain and causing symptoms. Such symptoms can include brain fog, fatigue, depression, anxiety, mood swings and, for some, hallucinations. We live in a world that is increasingly inflammatory - more toxins, more insults to our microbiome, and more insults to our sense of self from marketing and media. Add to this the reality that many things that lower our stress response and thus inflammation, are being diminished - less human connection, less silence, solitude, stillness and time in the natural world. But, we have choices. Supporting our brain and well-being is really about getting back to the basics of our humanity and getting back to the things most of us long to do anyway. We can approach the below list with an openness to ideas (of which one or two may resonate) ...or we can approach it like a to-do list - one that reinforces the notion that we need to fix ourselves to be worthy. My hope is the former. We're already worthy and deserving of feeling healthy. This list will generally move in the direction of what I think most of us can benefit from (1-3), additional considerations that may be helpful for those with brain symptoms (4-7) and, lastly, I've included tools for those who are dealing with very high immune reactivity and/or mast cell activation syndrome (8-10). This list will not be complete. Perhaps you'll share what is helpful for you. To receive the newsletter (text and audio) in your mailbox each week, subscribe at: https://www.courtneysnydermd.com or on Substack at: https://www.courtneysnydermd.substack.com Medical Disclaimer: This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

In this episode, I'll break down the key players in brain inflammation, how these players work together, and how they can ultimately disrupt neuronal communication.  I'll discuss:* The beneficial role of inflammation.* The bridge between the brain and immune system - mast cells & microglial cells.* The bridge between the immune system and our hormonal stress response - Corticotropin Releasing Hormone (CRH).* How head injury, toxicity, problematic microbes, and emotional and psychological stress contribute to brain inflammation.With this groundwork laid, in an upcoming newsletter, I'll discuss the many ways we can lower inflammation in the brain.To receive the newsletter (text and audio) in your mailbox each week,subscribe at: https://www.courtneysnydermd.com oron Substack:Medical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

Whether it's an older child with frequent tantrums, or an adult who easily loses their temper, I think of angry outbursts as a symptom with underlying root causes.   While there may be triggers, someone's inability to regulate their emotions, in my experience, suggests a biochemical and/or inflammatory driver.  In this episode, I'll discuss:* An important difference between angry outbursts and other symptoms.* The impact on the neuro-physiology of others.* Reasons this behavior may be enabled by others.* Associated diagnoses.* The four most common underlying physiologic factors that I see in my practice that appear to drive angry outburst.* What the presence or absence of remorse after a tantrum can tell us about underlying physiologic drivers.To receive the newsletter (text and audio) in your mailbox each week,subscribe at: https://www.courtneysnydermd.com oron Substack:Medical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

Though we are wired for connection, we're also separate human beings.  How we navigate these two realities can make all the difference in the quality of our relationships and our lives.  Our relationships can be with the family we grew up in, our friendships, romantic relationships, partnerships, marriage and the families we create. In this newsletter, using Murray Bowen, MD's Family Systems Theory, I'll discuss:* The tension that exists in couples and families because of the need to be together, but also to be separate.* What being out of balance can look like in a “system.”* What this can look like for us individually.* How we can move towards more balance in our relationships.We don't need to be in a relationship to be impacted by these forces.  We all carry within us expectations of togetherness and separateness from the families we grew up in.  Our parents carried their own norms based on their families of origin. Through our repeated experiences, our neuronal pathways are reinforced. They can impact how comforting or threatening togetherness feels and how comforting or threatening separateness feels.To receive the newsletter (text and audio) in your mailbox each week,subscribe at: https://www.courtneysnydermd.com or on Substack:Medical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

Schizophrenia affects 1 in 300 people or 24 million people worldwide (2.6 million in the U.S.) It remains the most treatment resistant psychiatric condition. In this newsletter, using the story of John Nash (Beautiful Mind) as a reference point, I'll discuss:* Theories attempting to explain schizophrenia.* How the belief that all people with schizophrenia have the same biochemical disorder has resulted in lack of effective treatment and problematic side effects for many.* Research from the Walsh Research Institute, which has identified three distinct biotypes for schizophrenia (undermethylation, overmethylation and pyrroluria), each with different predominant symptoms and biochemical needs.* How those of us trained by the Walsh Research Institute assess and treat schizophrenia. * The real story of John Nash's life not shared in the movie.To receive the weekly newsletter (text and audio) in your mailbox, subscribe at: https://www.courtneysnydermd.com or on Substack:https://CourtneySnyderMD.substack.comMedical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

If you don't identify with one of the labels in the title, you likely know someone who does. As with all labels, however, they don't completely define us. Those of us who have these patterns are not the same, nor struggle to the same extent.  Still, this psychological construct has been repeatedly recognized in the mental health field. Perhaps because it is so common, you won't find it included as a condition or personality disorder in the DSM (Diagnostic and Statistical Manual of Mental Health Disorders).  Nonetheless, this way of being in the world can be painful and stressful. At the very least, these tendencies can keep us from enjoying the full potential of our lives. In this episode, I discuss:* Overlapping definitions from attachment theory, family systems theory and 12-step programs* Common early experiences * Cultural messages* Suspected genetic variants* Difficulties with boundaries* Communication style* Common behaviors* Common emotions* Education and resources* Parenting our inner childTo receive the newsletter (text and audio) in your mailbox each week, subscribe at: https://www.courtneysnydermd.com or on Substack: https://courtneysnydermd.substack.com/ Medical Disclaimer:This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

Misalignment of the upper part of the spine is an often overlooked problem for those with brain symptoms, chronic complex illness and/or mysterious health issues.  In these modern times with cell phones and laptops, we look down A LOT.  This raises our likelihood of having problems that originate in our neck.  A previous neck injury and/or a tendency to be flexible can make us even more vulnerable.  Flexibility is especially common in those with brain related or psychiatric conditions. In this episode, I'll discuss:* The very important role of the atlas, our first vertebrae, and why is can easily become misaligned. * The many neck structures, including the vagus, which can be impacted when we misalignment.* The importance of ligaments holding the atlas in place and how hypermobility can contribute laxity of this joint.* The activities beyond injury that contribute to the atlas becoming misaligned. * Forward Head Posture, which results from having our head down too much and for too long, such as when we use a cell phone, laptop, poorly positioned computer or even read a book or write for extended periods. * The role emotions can play in shifting the atlas out of place.* The many symptoms associated with misalignment or upper cervical instability. * A simple was to evaluate if vagus might be impacted and the types of imaging that is used to diagnose this problem. * Types of treatment and specialists.* The role of posture in keeping our head on straight.Links mentioned:The Healing Power of the Vagus Nerve in Brain Disorders (Part 1 of 2)https://courtneysnydermd.substack.com/p/the-healing-power-of-the-vagus-nerve-33dThe Healing Power of the Vagus Nerve in Brain Disorders (Part 2 of 2)https://courtneysnydermd.substack.com/p/accessing-the-power-of-the-vagus-bdeTo receive the newsletter (text and audio) in your mailbox each week, subscribe at:https://www.courtneysnydermd.comor on Substack:Medical Disclaimer: This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical and psychiatric issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

In anticipation of the new year, I'm previewing some of the topics I look forward to sharing in the coming months.  * Topics that I briefly comment on in this episode:* How Having Our Head On Straight Impacts Our Mental Health* The Relationship Between Hypermobility (Flexibility, Being Double Jointed, Etc) and Brain Health* The Many Root Cause Intersections Of Mast Cell Activation* Common Root Causes for Specific Brain Disorders* Recognizing and Managing High Dopamine States Such as Hyper-focus and Addictive Tendencies* Managing Our Energy and Our Focus Throughout the Day* Codependency - An Invisible Chronic Stress That Can Prevent Healing & Thriving* Neuroplasticity of Spiritual Growth* Getting Okay With Uncertainty * Learning to Listen to Ourselves I'm also sharing a poem I wrote for my daughter when she was four, called “Follow the Energy”. For those interested in checking out a couple of samples of the midweek paid newsletter, I've un-paywalled a couple of my favorites.A Different Kind of Goal Setting for the New YearEssentialism in Health & HealingTo receive the newsletter (text and audio) in your mailbox each week, subscribe at:https://www.courtneysnydermd.comor on Substack:Medical Disclaimer: This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical and psychiatric issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe

In this episode, I discuss winter solstice, themes of darkness and light, winter, the Dark Night of the Soul, radical gratitude, and the rhythms of the natural world and of our lives.To receive the newsletter (text and audio) in your mailbox each week, subscribe at:https://www.courtneysnydermd.comor on Substack Medical Disclaimer: This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your own physician for any medical and psychiatric issues that you may be having. Get full access to Holistic Psychiatry at courtneysnydermd.substack.com/subscribe