The Anatomy of Anxiety: Understanding and Overcoming the Body’s Fear Response

Do you ever feel like fear is controlling your life? We've all been there. But in this episode, Dr. Ellen Vora gives us insight into how to regain control with her expertise on the body's natural fear response and the tools we need to manage it effectively. Join us to learn more about understanding and overcoming anxiety so you can live a life that feels right for you!

 

Ellen Vora, MD is a board-certified psychiatrist, acupuncturist, and yoga teacher, and she is the author of the bestselling book The Anatomy of Anxiety: Understanding and Overcoming the Body's Fear Response. She takes a functional medicine approach to mental health, considering the whole person and addressing imbalance at the root. 

 

In this episode, you'll learn:

• What the body's fear response is and how to recognize it

• The importance of addressing anxiety holistically

• Tools for managing anxiety in the long-term

• Dr. Vora's personal story and journey with healing from anxiety

 

Tune in to gain greater insight into your own fear response and learn practical tips for regaining control. This episode will help you reclaim your power over fear and live a life full of joy, peace, and resilience. Let's jump right in!

 

Don't forget to share, subscribe and leave a review if you like what you heard! We look forward to hearing from you! Thanks for tuning in and we'll catch you next time!

 

(00:00): Problems that remain persistently insoluble should always be suspected as questions asked in the wrong way. Alan Watts. In this episode we talk about if you're suffering from anxiety and or on medications for anxiety, what you might be doing wrong in your approach, and how to recognize and solve the underlying problem. Stay tuned.

 

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(01:22): Hi everybody. Welcome back to another episode of the Hormone Prescription with Dr. Kyirin. Thank you so much for joining me today. Today we are talking all about the anatomy of anxiety with a true expert who's written an amazing book and has incredible insight. She has a similar journey to mine in that she was trained as a medical doctor. She went into psychiatry and really realized that we weren't helping people with giving drugs and doing surgery, and she found a better way. And now she has dedicated her life to educating others about the anatomy of anxiety and what's really going on behind the scenes. She is an incredible person. She offered this quote to me that I love from Alan Watts, who's an amazing philosopher. And this is what it says, problems that remain persistently insoluble should always be suspected as questions asked in the wrong way.

 

(02:20): So what does this mean? It means if you have a problem that hasn't been solved, you're asking the wrong question. And I once was in a coaching program with Mary Morrisey, who's amazing coach and spiritual leader, and she was talking about the importance of the right question and that if given an hour to formulate the answer to a problem, you should spend 55 minutes on formulating the right question that will give you the answer. And I have found that so much to be true. I always tell people with your health that if you, you have persistent health symptoms, diagnoses, medications, problems, whatever you wanna call it, something's not right with your health, then you haven't asked the right question. It's asking the right questions that is invaluable to fixing your health. And unfortunately, as a mainstream doctor, I didn't know the right questions to ask.

 

(03:20): Now I know the questions to ask, so I'm gonna help you ask the right question. And if you're dealing with anxiety, which millions of us do at some point in our life, many of us chronically, or we've got a loved one who's dealing with it, and it can be debilitating, prevent you from having relationships or working and all kinds of things. And if that's you or someone you know, you wanna listen up because you need to know about the anatomy of anxiety. And Dr. Vora is an expert at this. She's really taken a deep dive in her book. She's a beautiful way of looking at it. I'll tell you a little bit more about her and then we'll get started. So Ellen Vora is a medical doctor. She's a board certified psychiatrist, acupuncturist and yoga teacher, and she's the author of the bestselling book, the Anatomy of Anxiety, understanding and Overcoming the Body's Fear Response. She takes a functional medicine approach to mental health, considering the whole person and addressing imbalance at the root. Welcome, Dr. Ellen Vora to the show.

 

(04:18): Thank you so much for having me.

 

(04:20): I am so excited to dive into this topic with you. A lot of my listeners know that anxiety was a huge part of my story. I didn't really suffer from anxiety at a young age. It wasn't a problem and it really started in my forties and it got so severe that everybody knows this for that and depression. I was on five psychoactive medications at one point and the doctor told me, you will never get off of these. I couldn't even hardly function even with those five medications, I was so anxious my body would tremble, but I had nothing to be anxious about. And I know that you talk about this , so I kind of wanna dive in there. And this is for the people who have maybe been dealing with their anxiety their whole lives. Maybe they just deal with anxiety most recently. Maybe they have a loved one who has anxiety. It's so problematic and it's so debilitating. So I don't even know where to start. So I'm gonna just say, Ellen, start . Start where you think, why is this such a problem that affects so many people?

 

(05:30): Yeah. So the way you and I were both taught to think about anxiety, you know, we were taught in medical school to evaluate it according to the D S M, our Bible of mental health, a diagnostic statistical manual. And we're really most of all indoctrinated with the idea that our mental health issues are the results of a genetic chemical imbalance. This is our monoamine theory of depression, where we say it's your serotonin. You were born with jeans that meant that you had low serotonin, but that's okay cuz you're alive in 2023 and we have a pill that can fix that. So here, take this pill and it will fill up your empty serotonin tank and everything will be honky dory. Again. It's a nice story. I think it came primarily from well-meaning scientists using deductive reasoning when they saw that certain tuberculosis medications that manipulated serotonin seem to raise some people's moods.

 

(06:23): But it turns out it's not a true story. And it, you know, that the idea there, the implication is if you take these pills, it's gonna fix your depression. I think many people listening who have had an one or another experience with psychiatric medications, even if they're net on the whole helpful, this story's not quite so clean and simple. And so I also think what's important is that when we focus on the genetic chemical imbalance, that is our least hopeful narrative when it comes to mental health. It tells us it's a fixed trait, it's our destiny. We're broken, we're stuck. And I have observed through 10 years of practice that this is patently false. This is not true of mental health. And while genes do play a role, it is only ever a predisposition in functional medicine. As you know, we say genes loads the gun, but the environment pulls the trigger.

 

(07:18): So when we only focus on genes, that keeps us feeling like this is our destiny. I will always be depressed, I will always be anxious when we shift our focus to the environmental influences that also have an enormous impact on our mental health. Well, there's something we can do about that. Sleep and nutrition, inflammation, hormones, gut health, and then more psycho-spiritual aspects of mental health, community nature, feeling of a sense of meaning and purpose in our lives being of service. All of this also impacts our mental health, and there's a lot more we can do about that. So I prefer to shift our focus to what we can control. And I want people to know they're not stuck even if they've felt depressed or anxious. You asked, why are so many people anxious right now? I think that there's two big reasons. When I think about anxiety, I, I divide it into two categories.

 

(08:09): False anxiety and true anxiety. Where false anxiety is physical anxiety, it's based in the physical body and it's avoidable, it's related to inflammation or sleep deprivation or a blood sugar crash or a hangover. And we are these days swimming through a cesspool of causes of false anxiety. We are all inundated with environmental influences that are making us more anxious than people were even 30 years ago. But then the other piece of this is our true anxiety, which is purposeful anxiety. It's not something to pathologize, it's not something to suppress. And we don't get to fix it by simply going gluten free or switching to decaf coffee. This is our inner compass. It's nudging us, asking us to slow down and pay attention to what's not not right in the world. And these days we are also inundated with quite a lot that's not right around us.

 

(09:01): So we come by our true anxiety, honestly. And the good news is, whether it's our false anxiety or our true anxiety, there's a lot that we can do to support ourselves. And so I think that we are all so anxious these days, but we've been trained to think about mental health incorrectly, letting us feel stuck and thinking that the menu of possibilities to support our mental health is just medication and therapy. And I want people to know, first of all, there's always reason for hope, never a reason to despair. And that there's so many other strategies we can take to support our mental health.

 

(09:36): I think that is so important. And I love this, the concept you have of false anxiety and true anxiety. Is that what you called it? Yeah.

 

(09:45): Yeah. I think that's brilliant. Because , the body can cause anxiety and most people think, oh, it's a mental process, it's a mental problem. And like I said, I didn't have any reason to be anxious. There was no mental issue. Well, I was kind of on off my path and I think that , that was the problem. , I was so off my path, but also I had so much inflammation and hormone imbalance and toxicity and my body was, I didn't realize that that vibrating tremoring shaking was my body screaming that it needed help. You know, because we were both trained the same traditional medical doctor program and what would we do? Pill for every ill surgery for every symptom. So that's what I went to a doctor like that, a psychiatrist, and he just kept prescribing and kept adding. And you know, thank God, fast forward, I am off all psychoactive medications. I don't need any, once I fixed all the underlying problems and got on my path, ,

 

(10:52): That's exactly it. The false and s true dichotomy. And I think, you know, not to project, but I was in the same situation where to be a medical resident, I was in so many false moods because I was inflamed, chronically sleep deprived, absolutely malnourished, you know, overfed, but undernourished and my hormones were all whack, which is a consequence of everything else. Yeah. Out of balance. And so I had a lot of false moods. But there's also that true mood that is if you went into medicine because you actually wanted to make a difference and support people, for many of us, we wake up to the the deep crisis and disenchantment of what is the system I'm a part of? I'm not convinced that I'm helping people. I'm not convinced that I'm not harming people. And so that's true Anxiety right there for you, a textbook example, and it's beautiful that you were aware of both of these things.

 

(11:44): It's unfortunate that our system these days is such that if you go in and you say, I'm really not feeling okay, all we know to offer people is medication. And there's a path there that is concerning to me. And it's, it's difficult to convey this without, I don't mean this as an non-pharmacologic path. I'm a psychiatrist, I prescribe medication. I've seen them benefit people. Absolutely. But what I see so often is someone says to their primary care doctor or their psychiatrist, I'm not feeling great. And they say, you know, in the 15 minutes they have with you, well, okay, like take Lexapro. And then you start Lexapro, and then you get sexual side effects, then you add Wellbutrin, and then maybe you're not really sleeping and you add Ambien and then you can't really focus during the day. You add Adderall and then you're anxious and then they add Xanax.

 

(12:30): And before you know it, you have a cocktail of medication. And the piece of this that's most damning is that it's delicate to talk about this without, I recognize some people really need their medication. Sometimes we need more informed consent. But I think what also happens is that the medications themselves can make us more fragile. The medications beget the need for themselves. Take Xanax for example. It's very effective in the short term, in the medium and long term. It exacerbates the very problem it's set out to treat in the first place. It makes us more anxious. And we can talk about the biochemistry of that. So once somebody's on a cocktail of medication, not only are they deeply plugged into the system, but they're very neurochemically fragile at that point. And it's hard to be well on your own. And you start to think of yourself as very sick and needing a lot of medication, needing a lot of support, you're spending a lot of time standing online at the Walgreens. And it just, it leads people down a path that I, it makes me from some days sad and other days outraged to think about how many people we've plugged into this life without first asking, how are you sleeping? Do you have community in your life? What's your diet look like? Are you pooping every day? Simple diet and lifestyle strategies that we can do to address mental health At the

 

(13:47): Root, I think, oh gosh, everything you're saying is just giving me chills because ev people need to hear this. So if you're listening , maybe if you need this information, yayu, please share it. It is so vital because we have a mental health crisis and it needs to be addressed and people aren't going to get this information in their doctor's office. So please share this with all the women in your life. So I wanna dive in because you said ha, if you, that we don't ask about how are you sleeping? We don't ask, do you have community? We don't ask, are you pooping every day? And there's some people listening who are going, if I have anxiety, why would someone care if I'm pooping every day? If I'm anxious? Why do people care? Why should the doctor care if I have community? So can you start to help people understand what, what's going on? Why, why is this important? Right? We've established that the gene hypothesis is not a thing, but help them understand why, how this is, what's the manifestation of how does anxiety come about through the body?

 

(14:49): Yes. Great question. And so fundamentally, first we just have to acknowledge that we are taught to think of mental health from the neck up to say, here's where mental health happens and only here. And that's of course a very modern and very western view of the body as discrete organ systems that aren't talking to each other. There's a line in my book, which is, your brain and your gut are talking to each other, even if you're a psychiatrist or your gastroenterologist are not. And eastern modalities have always appreciated this, right? Ayurveda, Chinese medicine, they know about the richly interconnected web of communication and interrelationships between all of our organs and our organ systems. And so it's crazy to the way, I mean, at some point we're all gonna see it. We're gonna be like, wait, that is bananas. That we think that mental health is just the brain.

 

(15:35): The brain is a piece of flesh. It is impacted by everything else going on in the body. If you are inflamed, if you are micronutrient deficient, if your blood sugar is crashing, you better believe that impacts your brain health. And good mental health is in many ways a reflection of two main things. It's good physical health, it's a reflection of good, healthy brain health. And it's a reflection of us getting our fundamental human psychospiritual needs met. And so when those two things are in place, we tend to feel pretty good. Trauma is its own consideration, which we can go a bit more into. So if you take the gut, for example, when someone's thinking, well, I'm anxious, why are they asking me about my pooping? That seems crazy. , that's, that's my, that's my digestive tract. Well, three main pathways for how our gut is impacting our brain health.

 

(16:20): I'll first just open with the fact that we are now at a point where publicly we have a conversation about the fact that our brain impacts our gut. We know now that if we're anxious, if we're chronically stressed, this will impact our digestion. Someone with IBS or irritable bowel syndrome might say, I know that stress is impacting my ibs. So we appreciate top-down communication, but where we're headed is that we also have to appreciate it is a two-way street. It is a bidirectional relationship between the gut and the brain. So just as there's top down communication, there is also bottom up communication. The health of the gut is impacting the state of our brain. And it's happening along a number of different pathways. One very simple one is that there are bacteria in our gut that are involved in the synthesis of certain neurotransmitters. We talk a lot about serotonin, but my pet favorite neurotransmitter is gaba.

(17:15): We don't talk enough about gaba. It's critical to anxiety and it's manufactured by certain B species that we're supposed to have in our gut. But if we're taking multiple courses of antibiotics and we're not consuming fermented foods and we're not around soil or animal feces, which sounds gross, but this is part of how we maintain a diverse ecosystem of beneficial bacteria in our digestive tract. If we're missing critical microbes, we might be missing critical neurotransmitters like gaba. And then there's the fact that our gut is involved with inflammation, which itself directly, directly impacts brain health and anxiety levels. But the one that I find most interesting is the communication along the vagus nerve that's basically reporting on the state of affairs of our gut up to our brain all the time. And if it's saying everything is copacetic down here, go have a great day.

 

(18:05): Well that's great, but if your gut is in rough shape, if you've taken antibiotics, if you've consumed pro processed foods, if you're inflamed, then it's sending a memo constantly up to the brain saying things are rough down here, feel uneasy. It's designed to motivate us to rest, to make different choices so that we can heal. But instead, I think a lot of us go through our lives in a state of chronic low-grade anxiety just because we're in a state of chronic poor health of our digestive tract, which we come by honestly, because modern life makes a broad assault against the health of our guts, from our chlorinated tap water, antibiotics, processed food, alcohol, NSAIDs, lack of exposure to fermented foods and and microbes. And so here we are, all of us with really unhealthy guts and it's directly impacting our mental health.

 

(18:55): So important, the information that you just shared. And I was listening to, I'm listening to Peter Levine's new book about trauma and memory, and he was talking about the ratio of the ENT nerves. So the nerves in the VA that bring information from the gut, the ratio of those to the efferent that innovate the motor is five to one. Yeah,

 

(19:15):

 

(19:16): , and I had forgotten that from med school, but wow. So your body really prioritizes what is going on in the gut, which I believe in Chinese medicine they call the second brain. And so I think most people just don't get it. And you know, we're downing, and I can be guilty of this too, sometimes eating proc over highly processed foods. Oh you know, those chips are so good and , things like that. And then, and then I might wonder the next day why, and I'm not feeling great. I mean, at this point I kind of know, so I'm not willing to pay the price. But every now and then I do. But your gut is so key. So everybody listening, this is why what your poop habits matter and pooping once a week is not okay. If you're listening, I, so many people come to me and they say, well, I only poop once a week. I've been that way my whole life. That's my normal. And I'm like, yeah, but that's not okay. All right. So this false anxiety that's coming from the gut, everybody, if you're having, so some people are listening and they're thinking, oh, okay, I identify with some of these things, Dr. Ellen I'm gonna go to my doctor and ask to be referred to a gastroenterologist. So what's gonna happen is that idea,

 

(20:27): This is a big problem. Broadly, this happens with mental health too. We think like we just need better access. We need better access to mental health care. Like, oh, now you just gave me a light bulb aha moment that my gut is impacting my mental health. So let me go see a gastroenterologist. We know how this story ends. If you see that psychiatrist, if you had better access to mental health, you walk out with a prescription and it leads to more prescriptions if you go to see a gastroenterologist. All due respect, I, some of my family friends, I, I love my gastroenterologist buddies and colleagues. I think they're brilliant and wonderful healers. But the training in medicine, we always have this saying garbage in, garbage out. They are not trained to do any kind of root cause resolution or to approach the chronic degenerative, chronic low-grade inflammation issues in a supportive way.

 

(21:14): We are taught to react in, in a quite a heroic way to problems. So we have lots of great suppressive medications that can squash your immune system, that can basically say, well you're inflamed in your gut, let's just shut down the immune system. And then inflammation is gone and you feel better symptomatically temporarily. But we've done nothing to address it at the root actually we've done something, we've exacerbated the original problem. So I think that the problem is our training and if you are having an aha moment, which is that you have unhealthy gut health and then that's impacting your mental health, you're probably better served going to see a naturopath or a functional medicine doc. I think that they actually are virtuosic at understanding how the gut gets out of balance and how to support that. That will make an enormous difference in your mental health but also in your physical health more broadly. And even just improving your gut health is a direct impact on our quality of life. Going from pooping once a week to pooping every day is, it changes everything. And how we feel. I've got, I've gone on that journey myself

 

(22:15): And . Yeah.

 

(22:17): To actually have that working every day is victorious. I never, I still don't take it for granted at this point, probably like 20 years into that. So I think that you'd wanna get your care in a more holistic setting so that you're not just suppressing functions in the body. Symptoms suppressing it turns out is it's a beautiful thing that western medicine can do when the problem is really big. If you have already had a car accident or a heart attack or you already have cancer, I think our ability to do heroics and suppress symptoms and really fundamentally change the body is a beautiful thing about Western medicine. But so much of what ails us are these subtler, chronic degenerative diseases, chronic inflammatory conditions that are as resulting from modern life. And when we go in with heroics, we actually make the original problem worse. So you wanna go into a holistic treatment where they're thinking, oh, here are the inputs that are irritating the system. Here are the inputs that you're missing. Let's give the body what it needs and then trust that the body knows what to do with that. And it can heal itself.

 

(23:17): Does body super intelligent like , we couldn't create a human body and it knows what to do. So sometimes you just get out of the way, get the things out of the way, blocking it, give it the things it needs and then watch it heal. And you know, I had this vision when you were talking about the pooping, cuz I went through that phase two now it's like when you make a beautiful poop in the toilet every time you eat, cuz that's how nature created you. You literally should jump up. Like you gotta field goal and be like, yay , yay me. Right? Not just for little kids anymore that yay you pooped in the potty, but yay pooped in the pot.

 

(23:58): A hundred percent .

 

(24:00): I do wanna talk about trauma. You mentioned it earlier. It ended up being a huge part of my story, which I actually didn't know. I didn't, I knew I had a crappy childhood. My mom used to have this tote bag that was of this, this cartoon woman and and it said let's put the fun back in dysfunctional. We had dysfunction in my family for sure, but I didn't know that I had trauma. And then that was part of this, the latter part of my journey. After I healed my gut and got off all the medications, well then my body was like, well now we gotta deal with this residual trauma. And so that was another part of my journey. So I'm wondering if you can talk a little bit about that and how it relates to anxiety and what do you do about that?

 

(24:45): Yeah, I mean trauma is such a big and heavy topic and I think that the tricky thing about it is that the brain learns that's what brains do. And when you are in an unsafe environment, a chaotic environment, a dysfunctional environment, when there is a real risk to your bodily safety or to somebody near to you, very understandably, the brain adapts and it learns to be hyper-vigilant, to be on high alert. And that's an adaptation in an unsafe setting. If you're living in a war zone, if you're in a traumatic childhood, you want to be hypervigilant in a state of hyper arousal. This keeps you safe, it helps your survival. So I think it's really important to first just give grace and compassion to the fact that this was how your brain and your body responded. The tricky thing is that if you're lucky enough to then no longer be in as unsafe of an environment, this adaptation becomes a mal adaptation because now you are stuck with the foot almost stuck on the accelerator pedal, your limbic system, your amygdala, your brain is stuck and locked into a position of hyper arousal and hypervigilance.

 

(25:50): And not only is that a really unpleasant and anxiety provoking state to go through life and it, you're basically perceiving threat even when there is none. It distorts your view of reality. But then also it's very hard to heal or be well in other ways because a lot of our healing hinges on a particular fulcrum in the nervous system. Whether our nervous system is in a tone of sympathetic or parasympathetic. And now with polyvagal theory it's more complex. But I think that, you know, the most simple understanding is are you in a state of stress or are you in a state of relaxation? And when you're in a state of relaxation, your gut can heal, you can sleep deeply and well and then everything else can heal while you're asleep. You can feel a sense of calm and awe and gratitude. And when you're in a state of stress, everything is, there's a triage mechanism that happens in the body.

 

(26:38): The body basically says, this is not the time for housekeeping, this is not the time for healing or repair work. This is the time for dealing with the threat. And so we can go our entire lives triaging out of housekeeping, triaging out of repair work in our bodies because our body is still stuck in that state of we have something to be stressed about. And so the trouble with trauma is when we get stuck. And that's where I think trauma focused therapies that work at the level of the limbic system, whether that's E M D R or somatic experiencing therapy or something like DN r s or primal trust, something that's going in and with precision really reprogramming the limbic system and where it hangs out so that it can start to understand that was then this is now. And we don't, we no longer need that now maladaptive state of hyper arousal. And I think that that can help people who have a history of trauma move forward from a place of a calmer limbic system, the ability to be in a state of relaxation.

 

(27:37): So some people listening, because this was me before I realized I had trauma, are thinking, oh, I don't have any, I didn't have any trauma . I'm just wondering how would somebody know that you might be talking to them that they might be a candidate for having trauma. So if you could talk a little bit about what trauma is. I mean I used to think, you know, nobody beat me when I was a kid. I didn't have trauma, right? I didn't have this extreme thing so I didn't have trauma. And then come to find out I had a lot of things I didn't remember that happened and that I did qualify. So I just want to wondering what you might say to those people who are wondering, could this apply to me? I

 

(28:24): Think it's a really good question and I'm not sure I have a great answer. I think that one thing I'm always on the lookout for is like a heightened startled response. Like , you know, somebody closes a door behind you and you jump at a proportion to what it is like, is your body basically perceiving threat disproportionate to, to what's happening around you? Any state of hyper arousal. But I think that I'd be so curious. I think in a way I am, I have a handicap, which is that people come to me already saying I need help. And so I think I'm less good at the phase that happens in the lead up, which is going from, I'm not sure I have a problem to realizing that we do. So I'd be so curious to hear what shifted for you and how did you start to pick up on the fact that you were holding trauma?

 

(29:09): Oh, , that's a long story. Let me see what the short version is. But basically, you know, there's this compulsion when you've had traumatic interpersonal relationships, particularly with your primary caregivers when you're young to have that repetition compulsion. And so it was a repetition compulsion relationship issue that sent me into having acute P T S D symptoms. And then it was, oh my gosh, what is happening then? Then that's when I discovered, oh yeah, I was traumatized. And through some of the modalities you mentioned then uncovered memories ca you did go through an alphabet soup there, kind of, which I know some people Yes. Are going what, so for those people who, you know, even have an inkling that it might, this might be who you do want and I would love it if you could talk about what is a trauma informed therapist, what credentials they might have, but also some of the modalities you mentioned.

 

(30:09): Yeah, so let's see if I can define those. The alphabet soup, I think the first one I said was E M D R, which I believe stands for I movement desensitization and reprocessing. Reprogramming, I mean one of those. And so this is a wonderful non-invasive modality. That's it really. It's, it uses a smart way of kind of distracting the mind as it helps you work through trauma. I think that's a big part of all of the trauma focused therapies is that in a way we need to access the amygdala, the limbic system where the brain is holding onto these memories and work through them without tripping a wire that sets off an all out stress response because then we're just a, an animal against a wall in a very defensive stress response and not a lot of fruitful work can happen in that state.

 

(30:55): So a lot of these therapies really figure out a way of, of kind of working around and not tripping that wire in the first place. I mentioned Somatic Experiencing Therapy, a very body-based therapy. I also mentioned D N R S, which stands for Dynamic Neural Retraining System. Hmm. And that, you know, people do rounds and there's a lot of difference in terms of how you talk to yourself and how much you focus on symptoms. And so all different ways for reprogramming. And then Primal Trust is kind of this newer version of of DN r s that I actually really like the evolution there, which is recognizing that there is a body, there's a, this is just like the true anxiety, false anxiety dichotomy that some things are related to our trauma and some things are related to inflammation and caffeine and gluten. And sometimes we need to discern which one to, where do we need to make changes and where do we need to accept and recognize that it's our nervous system creating our symptoms.

 

(31:52): Okay, thank you for explaining that. And if, if someone also suspects that this, they might be a candidate, how do they find someone who's actually skilled at working with trauma?

 

(32:04): Yeah, so if you're wanting to do therapy around trauma, it's really important to make sure that someone has, I think, self-described as a trauma-focused therapy. Because any kind of therapist, whether it's a psychiatrist, a psychologist, a licensed mental health counselor, family mari, marital therapist, basically if we're not trained and I'm not right, if you're not trained in, in trauma focused therapy, then what you do is you do talk therapy. And talk therapy is not only often ineffective for trauma but can be actively unhelpful, can be retraumatizing. And so I think it's critical to work with one of these less verbal, more limbic based modalities. And so look for those words on someone's website. And if you wanna start by doing something on your own, if you kind of have the safety and the leeway to do that, something like Primal Trust is a good place to start. This is something you can do for yourself and there are support groups you can join, there are coaches you can work with and that's a really nice system. And if you're not finding the perfect word of mouth trauma-focused therapist in your area that's affordable and taking new patients and working with your insurance, starting with something like Primal Trust is a great, is a great place to start.

 

(33:13): Awesome. Thank you so much for sharing those resources. We have to talk about this topic before we wrap up, so hopefully everybody listening will give us a little few more minute leeway. This idea of being off your path and what is your path and how does that create anxiety? That was a huge part of my story and exactly what you described, Ellen, where I had gone into medicine because I knew I wanted to work with women and help them with their health. And I said, well how, what will gimme the biggest toolbox in order to do that? So of course I went and got my medical doctorate and then was disillusioned when I was in practice that exactly what you said, I started saying, are we really helping anyone? We're harming people. And that was off my path, but I didn't know what to do about it and of course had my own health challenges so that discordance created this anxiety. So I'm wondering if you can talking, talk about that a little bit.

 

(34:09): Yeah, I mean and it's, it's interesting I think even how both of us, I've never thought about it this way before but in a meta way getting off our path was a very critical part of our path . And so go figure, you know, it's just giving people permission to slow down, get still and just tune in like how are we doing? Like not like are your parents approving of what you're doing? Do your friends, are they impressed by it? How's your bank account? But like how are you really doing? What are your values? What kind of life do you wanna live? What makes you feel fulfilled? And is that happening or are you on track towards building a life where that is happening? And if you feel like you might be way off course, we have a world that gives us a lot of junky values where it tells us like here's what you should be striving for, have this kind of skin and this kind of car and this kind of money and this kind of impressive job and this kind of attractive partner and have these perfect kids.

 

(35:05): And you know, it tells us, here's what Instagram is telling you what we like, you know, literally what we like, what get gathers likes and who is to say any of that is what fulfills you or what feels right or familiar for you. And so I think it's just so important to step out of the framework and the conditioning that we've all inherited and just know for yourself what is right for you. And then make sure that you're actually on the path towards building toward that if you don't already have it. And it's certainly not moving actively in the wrong, wrong direction. And so this sometimes has a lot of inconvenient truths, it can blow up our lives, right? You can feel like, you can feel like you just gave 10 years a lot of student debt, blood, sweat and tears to medical trading and you're like, holy, I'm harming people.

 

(35:52): What the hell did I just do . And so I think that I love my friend Brit Frank, brilliant therapist and she says, choose your hard. And there are these moments when you realize you're off your path and you're like, it would be really hard to get back on a path and it would be so much harder to live the rest of your life this far off your path. And so sometimes we really do have to choose that short-term, really hard blow up our life change to get on our path. And I will be the first to admit it is scary and difficult to do this. But it has to be a, a dance where you're constantly checking in with yourself and from a place of radical self-love and self-worth and also self-love and self-worth that helps guide us back. But also, and this one's big and sometimes harder for us to realize this is my worldview.

 

(36:38): It doesn't have to be everyone's but a recognition that we have a unique set of gifts and perspectives and insights and talents that we have to offer this world. It's a contribution that we only us can uniquely make. And I think I have a lot of friends right now, they're coming to me and being like, how do I change my career and do something more meaningful? And they feel like, how would I have the audacity to think I could be an artist or I could be a healer or I could be a writer, whatever it is. And I think the question is really like how could you have the audacity to think that you should suppress these gifts? Like this world assigns you a mission, we desperately need you doing that work. Who are you to block that from being manifest in this world?

 

(37:22): Oh my God so beautifully said. It reminds me of Maryanne Williamson's. I think it's in Return to Love where she says like, you know, it's not our darkness that scares us, it's our light. And who are we not to express our light? And that's really one of the reasons that I do what I do is because I think some people are only gonna hear it from me. Some people are only gonna hear it from you Ellen, right? So if your unique voice is missing from the choir that's singing the song of true health and healing, then there are women and men who aren't gonna hear it and they're not gonna get the memo. But you listening, you're so lucky cuz you are here and you heard it from Dr. Ellen yourself. So for me, a key part was being off the path and I didn't know, I knew I was on the wrong path, but I didn't know what the right path was.

 

(38:15): And through a series of synchronous events, the universe conspiring to get me on the right path, you know, I got there. Unfortunately, I did have to blow up a lot of things in my life and I'm all the better for it. So yeah, choose your heart. I love that This has been so rich and so wonderful. I am so happy to have you here. I'm so, if you're listening, you just got a huge big gift to hear this woman share her brilliance and her journey and I so encourage you to get her book. She has a free gift free, we're gonna tell you about that. The link will be in the show notes. So tell them about your free gift, your book, where to find you online.

 

(38:56): Sure, yeah. At one point you were asking like, you know, if you go in, if your doctor's asking you like, well, you know, you're feeling like what does white gut have to do with my mental health? I was just thinking like , the only way I can summarize that is the two 50 pages of my book that are like, here's what your gut has to do with your mental health and here's what your thyroid and your nutrition and your hormones and your caffeine consumption and alcohol and so on and so forth that a lot of that's not fun. Like the chapters on alcohol and caffeine, everybody's least favorite chapters but impactful, right? Nonetheless. So my book is called The Anatomy of Anxiety and it really details this concept of true anxiety and false anxiety and, and how we can work with both and experience less anxiety, but also to fuel, let that purposeful anxiety, fuel purposeful action. My free gift is, I think it's called Dr. Vos Four Keys to Health. And it's like, it's the one page version of my book . I said my best to make it concise if people wanna interact. I'm pretty active on Instagram. I'm at Ellen Vora, md.

 

(39:55): Awesome, thank you so much Ellen. Any last words you want to offer? Everybody listening before we go?

 

(40:04): I think in addition to everything else we've covered, if there's two things that Trump all like everything, how we support our mental health, I think on a physical level at sleep, if you could focus on only one thing, it's prioritizing better sleep, which in the postmenopausal or perimenopausal body is always its own special tricky journey. But there are things we can do That's chapter five of my book. Even though perimenopausal sleep is is tough, there's still things we can do to support it. And then I think community on the psychospiritual end of things, if you could choose only one thing that trumps everything else, it's just prioritizing, making sure we're actually connecting with the people that fill us up. And it's hard in modern life, but it's really worth fighting for.

 

(40:47): So important I call sleep the nectar of life. , I preach it all the time, but now I realize I forgot to ask you such an important question. So if you'll allow me one more. You know, this time of life, midlife and beyond, I think, you know, I think it's so the Dai Lamas quoted as saying that the western woman will save the world and I think it's the western menopausal woman. Mm. And I'm wondering apropo, our que our conversation about life path and blowing up your life and switching your path , and I see so many women who are stuck in these lives that they've realized they're not really in alignment with, whether it's a marriage or a job or a career and they wanna make changes. I'm just wondering if you have any insight or or words of wisdom for them about, you know, I can't remember and maybe it's in the book of Thomas, in the Bible it says, if you bring forth what is within you, it will save you. If you don't bring forth what is within you, it will kill you basically. That's my paraphrasing. Yeah. Can you speak to that?

 

(41:50): Oh, I love this question. I mean, I think about menopause. Let me see if I can do this in like less than an hour. . So I think about, I don't know if you were taught this, I think I was actually taught this undergraduate and not medical school, which is that menopause is this oddity evolutionarily because it's by definition post reproductive. So it's very hard for us to select four genes that make for a better menopause. It doesn't work for survival of the fittest because even if somebody did have a mutation that gave them a better menopause, then you know, it dies with them and there's no way for them to have had a more successful reproductive life for having that gene. So in a way the body reacts in a way that would be adaptive to something that happens in the reproductive life. And so in many ways that crash in hormones, if it resembles any crash in hormones in our reproductive years, it's actually the postpartum period.

 

(42:39): So in some sense, the way our body reacts in the menopausal years is what would be adaptive in the postpartum period. You should mobilize calcium from your bones to make breast milk. You should radiate heat to keep the baby warm. You should have very superficial sleep so that you'll wake up if you hear the baby cry. And it's like, well that's all well and good if you have a newborn. And man, is it a bummer if you're in your forties and fifties and you're just trying to live. But I think that it comes with it, this concept of it's a bit of a rebirth, but there isn't a baby. This is a rebirth of a a different and in certain ways truer version of ourselves. And I think that estrogen is the hormone that helps us keep the peace. Because in primate populations, the more interpersonally effective you are, the more reproductive successful you are.

 

(43:25): Estrogen makes us say yes and nod and smile and suppress our own needs in favor of other people's. And that's fun, but it's not necessarily our deeper truth. And so we have a cultural attitude, which is that menopause is unfortunate because we don't value wisdom and age and we only value youth. And this is a whole other problem. But can we reframe the whole dang thing to realize this is a rebirth when we have waning levels of estrogen and we no longer are hormonally programmed to keep the peace and suppress our own needs in favor of other people's needs. This is a rebirth where we are the baby, where we get to say, it's my turn and here's my truth and here's what I know I want and it's gonna ruffle some feathers and not everyone is gonna like this. And that no longer really matters to me.

 

(44:16): , I love that. Oh my gosh, that is spam. Okay, it's gonna take me like a week to unpack what you just said. That was amazing. I hope you all heard that. If you need to listen to that again, because that's just so insightful and revolutionary and I love it. Thank you again so much for being here. Thank you for sharing just your brilliance and beauty with everyone. I hope you will take action listeners from what you have heard today. You know, always I, I know I beat the drum of the sleeping, the nectar of light, but it really is. So go do that and get yourself pooping every day and give yourself a high five when you make a nice Nike Swoosh in the toilet . So this and more information on how to get your hormone today. We'll have another great rest for you next week. Thanks so much for joining me and until next week, peace,

 

(45:15): Love, and the

 

(45:16): Hormones y'all.

 

(45:17): Thank you so much for listening. I know that incredible vitality occurs for women over 40 when we learn to speak hormone and balance these vital regulators to create the health and the life that we deserve. If you're enjoying this podcast, I'd love it if you'd give me a review and subscribe. It really does help this podcast out so much. You can visit the hormone prescription.com where we have some free gifts for you and you can sign up to have a hormone evaluation with me on the podcast to gain clarity into your personal situation. Until next time, remember, take small steps each day to balance your hormones and watch the wonderful changes in your health that begin to unfold for you. Talk to you soon.

 

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