You need to process trauma. You need to learn new ways to think, new tools to manage stress. So that's all really critical. So many women are struggling with anxiety, with depression, and they go to their doctor. And I think it's often not given the emphasis and the importance that it deserves. These changes in our mental health are affecting our relationships.
They're affecting the way that we show up in life. We're not able to be happy and to accomplish the things we want to, because our brains are getting in the way. And oftentimes the only tools we're told to try are antidepressants or therapy, both of which can be really helpful. But our guest today is a board certified psychiatrist turned functional, nutritional and metabolic psychiatrist who is going to blow our toolbox wide open.
She's going to help us fill our toolbox with different tools we can try, so we can finally feel better, so we can feel happy. So we can get rid of that anxiety so we can get rid of that depression. She's helping us look at the brain and how to decrease inflammation in the brain so that it works as well as it should.
We talk about three things that are really going to dive in and help us improve our brain health. Nutrition specific nutrients that we need to look for have been tested and be aware of. Looking at effects of outside toxins that may be causing dysfunction in the brain. We're also going to look at lifestyle measures that you can start right now to really support brain health and brain inflammation.
You will find that when you start putting these steps into place, that your brain will work better. The brain is the hardware, right? And when you're working on new ways of thinking, that's software. And both are really critical. If you don't have the hardware that's working right. It doesn't matter if you upgrade the software.
Tracy, thank you so much for being here.
It's my pleasure. Thank you so much for having me.
Tracy McCarthy is the creator of the Natural Mood Solution online program and founder and medical director of Doctor Tracy McCarthy Functional Medicine. She helps adults as they are battling depression, anxiety, brain fog, fatigue, digestive issues, hormone imbalances, the whole shebang. So we are so excited to have you here and to pick your brain and let you educate us on how to take care of our brains.
I'm excited to get started. Wonderful. Well, I want to hear first a little bit about your journey because you were trained as a conventional psychiatrist, and now consider yourself to be a functional, metabolic and nutritional psychiatrist. So tell us a little bit about maybe your journey as a conventional psychiatrist. And what was it that led you to pursue these other avenues of being able to support people in their health?
Sure. Yeah. I'm definitely in a place I would have never guessed before I went into medical school. Interesting. During medical school, I had a very conventional education in medical school, and I went to medical school to really understand what goes wrong with the body. How can we help that? You know, very excited about science and understanding. This and the first few years of medical school were pretty great for me that way.
I really enjoyed being back in school and learning that. But as my training progressed and you know this because you have the same kind of training, it becomes more and more about really labeling the pattern that we see with the diagnosis, which has its, of course, its role. But then matching that very often to a pill, a pill and this, this pharmaceutical sort of model that we've been in for the last century, I would say, became pretty frustrating to me because I felt like it wasn't I didn't get to answer the question anymore.
Why does this person have this, the symptom or this diagnosis? You know, I would ask and always be told, but we don't know. We don't know what causes schizophrenia. And then it was the end of the story, for example. And then I'm just left managing well, which medication is best for them? And of course, you know, again, there's a role for that.
And it was very helpful to acutely stabilize somebody. But you know, then patients are asking me, am I going to be on this medication forever or it's only treating part of my symptoms. And I have a lot of really bad side effects. You know, in some cases. So is this satisfying to have that sort of limited toolbox? And fortunately, around the time that I became increasingly frustrated with this, I stumbled upon the research on the role of chronic inflammation and how it can manifest in so many ways, and really went down the rabbit hole, which led me to the Institute for Functional Medicine and training with them, you know.
And along the way, I started to change how I ate and lifestyle changes, and my husband started changing how he ate. And we felt different. Better. I'm like, what? What? How come I never learned this in medical school? And, you know, as I trained, I realized if I wanted to help patients this way, I really needed to step outside of what I was doing.
At that point, I was an inpatient psychiatrist, meaning I was working with hospitalized medical, you know, mental health patients. We're going through a crisis, and I wasn't able to apply this kind of what I was learning in that environment. So I began a practice, and I started, you know, with the basics, helping people with their food and these lifestyle changes and started seeing results.
And then, you know, as I kept training, I added in gut treatment and then started working with hormones, started working with, you know, removing toxins from their body and just seeing these profound, increasing results. And that led me to where I am today, that I'm so grateful to be here, where I have had my mind opened about what you know, what causes illness, and always learning more about that and getting to partner with my patients and be a guide for them, and then watch them be empowered and take action and get better.
And it was so fun, honestly. And it's why I went into medicine. So I'm very grateful to be at this point. Well, we're grateful you're at this point because we need more of you. Yeah. We don't have enough folks doing this. That's true. And you, you mentioned metabolic and nutritional psychiatry. You know, I'm happy to see these terms coming into being more common.
Nutritional psychiatry is really this awareness. And, you know, patients, there's psychiatrists who practice knowing that, hey, nutrition matters, which should be fundamental but really isn't, it's not taught. And they're recognizing the role of B vitamins and minerals like zinc and magnesium and omega threes and really making sure they're talking to their patients about this. They're really looking at how they're helping to remove the processed inflammatory foods from their diet.
So this is a great step for you know, if practitioners are doing that they're already doing a lot more than the conventional model. Metabolic psychiatry is sort of a newer term. Very exciting because, you know, this is really focusing on the role of insulin resistance. I know you had a guest recently talking about insulin. That's a big deal for the brain, too.
And, you know, there's some very exciting research that's been coming out in recent years about, for example, a ketogenic diet in bipolar disorder and other serious mental illnesses. It's really a game changer in the role of mitochondrial function. And so metabolic psychiatry is really looking at that functional medicine. Psychiatry incorporates all of that. But then goes further really, really looking at gut health, recognizing the role of toxins like mold or heavy metals, really understanding the role of the nervous system.
And just so many pieces looking at all of that that we know matters. Thank you for explaining that. We'll take it a step further, if you will, and explain to us a little bit of your conversion, because as functionally trained or as conventionally trained physicians, I'm sure you and I have both had that same experience of like, I don't want to say toxins.
I don't want to say it like I'm not one of those doctors. And how can I tell with my own experience that I was kind of like, do I believe in mold? Do I believe in toxins? And then you start seeing people get better. What has been your experience with sort of that conversion of things that were not necessarily trained on in medical school or still aren't always completely accepted as, as the the bread and butter of conventional medicine.
Oh, yeah. What converted you to that? Well, I think my original conversion and sort of what opened my mind really was about metabolic health. It was really around insulin resistance and seeing that people were having success, for example, with a low carb diet and reducing their level of insulin, you know, controlling their blood sugar by doing that and that, you know, I had just never learned that.
And it seemed so obvious once I started reading about that, like, well, why on earth, you know, like I remember learning about with diabetes, where you just count the carbs and then you adjust the insulin and story, you get better. If they could use less insulin because there's impacts from that insulin that was never discussed. And you know, this was I can't there was a few books I read that really changed my life.
One was Good Calories, Bad Calories by Gary Taubes, and that really helped debunk that. The Heart Health diet hypothesis. And, you know, Ansel Casey's 13 country study that is so flawed and realizing, like, this whole thing about being scared of fat, in fact causing everything, this is wrong. You know, that was really pretty upsetting, almost to me, because I had had this sort of blind faith in my education.
I was very naive, and I thought I was going to learn everything I needed to know in medical school to help people. I mean, I laugh now because that's a ridiculous idea that you could learn that anywhere, really. But yeah, I was you know, I was very, disillusioned. And I was kind of angry because I thought, you know, there's a lot of fundamental stuff here that I could have been taught that's in the literature about information, about nutrition.
It's, you know, the science is there. So that was, you know, the sort of the scales fell from my eyes, kind of and cracked my, my mind open. And, and I was pretty comfortable talking about those kind of things. And it was only through the functional medicine training that I really learned about the role of toxins and, you know, and the way detoxification is taught there, it's, you know, I was like, oh, yeah, I learned this in medical school.
Phase one is to liver detoxification. This is biochemistry. It's not some woo detox thing. It's a real thing that's happening in the body all the time. Yeah. So that's how I would talk about with patients. This is like every day, you know cleaning up in the body. That has to happen. Mold was an interesting one though.
I got some really great mentorship early on in my functional nursing career. And so I learned about mold really early on, and I was trying to work with people on it. And I remember thinking, this is just too hard. You know, I think I'm not going to focus on mold. I'm just going to work on people's gut. And I forget that I had I'd gone down that way and I thought this too much.
And then it was just staring me in the face. And after patient, I was like, okay, I'm getting the message. If I don't work on the mold, they're not going to get better. It is so common. It's shocking how common mold exposure is, you know, with like 48% of buildings with water damage, according to the EPA. You know, people are getting exposed a lot and some people are very vulnerable.
So, you know, so there was that part where I really tried to deny that I needed to work on that. And that's kind of been the journey, you know that. And now I'm just so far from living in the conventional, you know, model. It's it's okay for me to talk about all this because I'm talking about it with my patients.
I'm really rarely talking about it with peers. Yeah, that would be harder. Yeah. Yeah, I think that that you just described my own journey as well of sort of like. No, I'm not going to do that. I'm just going to focus on this part. And then you get more and more patients and they have more and more needs, and then you realize they need help and that we we don't have those answers in the conventional model.
And then you say, well, this is safe. And this is you know, we could try this and then you see it work and then you see it work again, and then you're like, oh, well, this is what I do now. I'm pretty grateful that you have that open. I'm so grateful that you when these people and there are so yeah, I mean, you must be like me where people come in, they are stuck and they have been banging their heads against the wall with the conventional model and they're told, oh, your labs are normal because they've gotten this like silly little lab panel and that's it.
And, you know, sometimes really gaslit like, this is in your head. You're fine. And they know they're not fine and they're not fine. Yeah. And so, you know, I feel like my number one job is to see the patient validate the present, you know. And that right there is where the healing starts. Yeah. Well, and I feel like as you start going off of the conventional path, the wonderful thing as a physician is like, I don't have to get rid of my conventional tools.
I just open my tool bag and I start shoving all the tools in every tool I can find, and then I can really talk to the patient and say, listen. Depending on where you're at, we can try conventional tools. We can try kind of middle of the road tools. We can try way off the beaten path tools if that's what you want.
And it's safe and, you know, so it's really a pleasure as a practitioner to be able to help customize that approach using whichever tool I feels right at the time. That's exactly how I like to talk about it. I'm like, I just have a much bigger toolbox and I'm happy to have that and I keep adding to it.
And yeah, we don't throw the baby out with the bathwater. There was important, useful things from my accidental training that I do still use. And, you know, there's a role for it, and it's just about having that judgment and discernment. And like you say, what is the patient, you know, want what is going to work with them? Well, so dive in a little bit and tell us about some of we'll kind of skip to the end.
And then we'll kind of fill in the gaps here. I want to hear about the successes that you're seeing, because I think for anyone who's struggled with mental health illness a little bit, or for someone who's struggled chronically of it's really affected their life, maybe they haven't been able to maintain a marriage or keep a job or, you know, some of these really severe effects on our lives.
It can be tempting to think, well, I mean, what's she going to do, make me feel like 10% better? Like, maybe I'll have a few better days. What are the successes that you're actually seeing? Can you give us an idea of what's possible? Yeah, let me give you kind of a little bit of a smattering of examples. Yeah.
You know, because it can range from it's not too many things we need to do too. There's a lot or it's a more severe complicated I should say case. But but there's so much hope. I mean, it can be as simple as a patient came to me and had had already been helped a lot with, someone who had worked with her hormones and she'd had, you know, her thyroid had been optimized, she had had insulin resistance, was on metformin and really benefiting from that medication and, you know, had done so well.
But now was having this depression. And it felt really odd to her. She hadn't struggled with depression before. And in her case, it was honestly as simple as vitamin B12 because she'd been on metformin now for a year, and nobody had told her that she needed to supplement with B12 while on metformin, and that alone made the change.
Now, I would stress that that's unusual, that it's of course I love it when it's like that. Yeah, right. I was like, I mean, it was a quick win for, you know, her to have immediate like lifting of her mood in a couple weeks. However, you know, with her working together, we did find there were other issues and went deeper that for her overall health.
Like how'd you get that insulin resistance anyways? Why wasn't thyroid not working? But for her mood, that B12 was key. Sometimes it's really about blood sugar. I had a patient who had very lifelong chronic anxiety, had been to like an anxiety day treatment program multiple times for intensive when she cut sugar out and started monitoring your blood sugar.
But it was really especially just sugar. Her anxiety swings totally disappeared. And it's not always that simple either, that it's just that. But it was dramatic. We also see a lot of people's insomnia clear up when we stabilize blood sugar. So those are kind of more simple examples. One of my first mold cases, the patient had a lot of, to a very young, young woman with panic and depression as well, but a lot of anxiety, almost to the point of agoraphobia.
So kind of scared to go out. And when we cleaned up the mold and got it out of her system, you know, these symptoms went away. And now she's questioning, well, you know, I've seen so many of my patients who had things they wanted to do that they couldn't do. And then, you know, I find out she's graduated from her, you know, graduate program.
Now, she's a career of this patient, you know, is no longer homebound and is like dating. And now they're engaged. You know, these are the things I some of these for the person who just two weeks ago had a baby that could not for so long because of all the, the toxic issues and the gut issues. So, you know, these are exciting.
One of my earlier cases also that really I'll just never forget, which I think is a great kind of classic example of functional medicine. She came to me with irritable bowel syndrome. She had diarrhea all the time, and she also had anxiety. And she was on, Lexapro to help with her anxiety. And she stayed on it because it had helped some.
But she still really had a lot of anxiety and still had some panic. She used to love to travel and she could not fly anymore because the anxiety and the irritable bowel syndrome. She never knew when she was gonna need a bathroom. So her life had just shrunk, you know? And we worked together. We worked on, you know, she had a a yeast overgrowth in her gut.
She had, some hormonal imbalances. She needed some nutritional work. And, you know, we just worked on the pieces, and it didn't take very long. And several months, she was done with the irritable bowel syndrome. She'd normal gut function. Her anxiety had gone away. She told me she was taking flights with her grandson, and it was just like she was living her life, which is the goal.
And, you know, Nomad is going to do all those things you have to the root causes. So those are some examples of cases that are not unusual at all. And there's even more extreme cases like patient with psychosis, schizophrenia, where, you know, there's a big role in this case for gluten causing an issue working on the metabolic part of it.
But also these immune triggers have made a huge difference in her symptoms. Well, I love that. I it's just what's our whistles for for what's coming next. Because now we want to know like okay how do we do this. How what's what's actually involved. But it is really nice to hear when I think of mental health issues, I think of, I call it brain inflammation because I think there's so much of an expectation in society of what it means to have a mental health disorder.
It's so taboo and less so maybe in recent years. But the idea of it being a medical issue, right, that it's not something that's that you are a flawed human being. Like, this is literally the neuron and the neurotransmitters in your brain are possibly not optimized. And that when you optimize them, then you're it really does affect our thoughts and emotions.
And that's a tricky link for a lot of us. You know, we think like, no, that's just you should just think differently. You should just not be so depressed. And to actually feel like, okay, this is just like if my wrist hurts and I think I find out I have tendinitis, if you're if your mood is off, it could be that you have brain inflammation.
And really just changing that paradigm is so valuable and really gives us more tools, as you mentioned, instead of just therapy and antidepressants, both of which are great. That's right. I'm very glad both of them exist. And I think therapy especially plays a really big role because you have to retrain sometimes how your brain is actually thinking even once the inflammation is down.
But to think that it's only about therapy can feel like you're hitting your head against a wall because they keep telling you how to, you know, use different tools to think differently. And you're like, my brain's not doing it. And really, to be able to decrease the inflammation. So it's so much more receptive to that. It can be such a lifeline for people.
Yeah. You hit on so many important points there. Like, you know, the brain is the hardware, right. And when you're working on new ways of thinking, that's the software. And both are really critical. If you don't have the hardware that's working right, it doesn't matter if you upgrade the software, but you do have to upgrade the software. You know, if you've had you need to process trauma.
You need to learn new ways to to think, new tools to manage stress. So that's all really critical. But yeah, that hardware if it's not, you know, functioning well and that's just it. Inflammation is at the root of so much of this. And you're right to call it brain inflammation. I think some of this disconnect I mean it comes from this idea that the brain is somehow not part of the body.
I mean, yes, Nicholas. Right. And but that's kind of, you know, conventional medicine is very much siloed. You know, you've got your gastroenterologist, you got your neurologist, your cardiologist. And, I mean, it's funny that there's even a neurologist and a psychiatrist. Right. Exactly. I guess it's supposed to be kind of brain and mind, but it's just totally artificial.
And this separatism is really part of the big problem. And not looking at the body as a whole. And I think that's part of where we get into this issue of people just not thinking that what's going on in their brain might be part of, you know, partly due or I mean, due to what's going on in the body.
And that's, that's it's funny to me now that that's a new way of thinking. But I remember when I first was learning functional medicine and I really was asking, like, does this work for mental health too? Or is this only for autoimmune conditions and gut issues that I've been seeing? And, you know, I didn't have a lot of examples of practitioners to look at who were doing it.
But once I found 1 or 2, I was like, okay, yeah. And now, of course, I laugh because we say we realize in functional medicine that everything causes everything. So, you know, of course the brain is helped by these things. And now I've got years of examples of people getting better. Well, so let's dive into that a little more.
As a conventional psychiatrist, the convention, like you mentioned to diagnose is but it's pretty intense, right? The The Diagnostic Guide for psychiatry is constantly changing. And it's the Bible, right, of psychiatry. And we don't have that as much an ObGyn, I mean, we, we do have some diagnostic things around endometriosis and PCOS and Pmdd. You know, we have some of this.
But psychiatry is another level. You have your diagnoses and you, the conventional psychiatric world, really wants to figure out what diagnosis do you have. Is it major depression? Is it bipolar? Is it, anxiety? Is it schizoaffective? Right. Like there's all of these things and you are piecing them about and then oftentimes is giving people more than one diagnosis.
How much do you still find that in your practice now? Because it seems like in my practice it's more like well I don't care which bucket you fall in. Like, let's just make you feel better and see what symptoms go away. Has that been your experience or will you share about that? Yeah, my experience is totally like that.
I don't I do care what the diagnosis, sure, but not in the way that I used to. So I think, you know, why does that matter so much in psychiatry? Well, a large part of it is about understanding which treatments are going to work best. So when you understand this is bipolar, for example, and not schizophrenia, then it may influence, you know, your choice of medication.
But that's kind of the limit of that for me. I'm really always thinking about root causes. And, you know, the thing that's really important to understand that your listeners have probably heard you talk about is that, you know, you can have a lot of different root causes, and they're going to show up and different symptoms and different people based on their genetics and their exposures.
And you know who they are. And so it isn't so much about that. I mean, we do know certain things. And sometimes a diagnosis is a hint to me about some of what's going on. But really, like, you know, you take ten people's depression and they're not caused by the same thing. They're different clusters of causes in each of those people.
So I have to look at that level to get the results. And, you know, all of these diagnoses, these are symptoms. They're they're the result of whatever's driving it. So that is how I think I you know, I've definitely encountered some patients who are really focused on their diagnosis. Yeah, I've noticed this in particular with autoimmunity. Like what I really want to know which autoimmune disease I have.
And, you know, unfortunately for people suffering with autoimmune disease, often they go ten years before they get a diagnosis, and then they finally get the diagnosis. And, you know, I'm like, I don't care if there's a diagnosis or not. You're having an attack on your own body from your body. What's going on? What's driving that immune dysregulation. That's what we're going to work on.
So I think we're on the same page about this where it's like that's less interesting and less helpful. Yeah. So tell us how would you then approach a patient who comes to you with some sort of mental health or mood symptoms. Maybe just lay out for us some of those root causes, even if it's just categories of root causes.
You mentioned in one of your examples nutrient deficiencies. So we know nutrient deficiencies are in there. Will you continue to build that list from there. Sure. Yeah. So nutrient deficiency is just to expand first a little on that whether it's the things are missing from the diet. Or they're eating it but they're not absorbing it. So that gut health is a huge part of gut health is that assimilation, that digestion and absorption.
And I see a lot of that not going well for people. I see a lot of fat malabsorption, for example. So addressing that aspect of gut function is really important. And then the gut microbiome, that's the other huge piece right. What's happening there. And that's something I actually test for and look at you know are there overgrowth. Are there deficiencies.
Is there an infection even with a pathogen like is there a parasite. What's happening. So that's another big area mitochondrial health. You know that's a big one. The functioning of like the ability for the cells to make energy, some of that based on nutrients. And some of that's about things like insulin resistance and toxins damaging the function of the mitochondria.
Look at hormonal balance as you do. That's huge. A huge for mental health. I see lots of women, for example, with low progesterone. I had a one patient with obsessive compulsive disorder that really flared always in the second part of her cycle. And the thing that really helped her was progesterone getting that balance. It just took it away.
It was amazing. And so that's another big piece. And then we've talked about that toxic piece, which is kind of like the last step. You know, I think probably a lot of practitioners approach it that way, where you you got to work on the gut, you got to get the nutrients on board and get the building blocks there for the body to do the work.
And then you can begin to look at starting to remove toxins, because you have to have a functioning got to do that. You have to have a functioning liver to do that. So that's the last layer. But as you heal the different areas of imbalance, everything starts working better. And it's really like a feedforward cycle. And then naturally they're going to start detoxification much better.
Okay. Comment will you as well on the role of genetics here. We know that some psychiatric illness seems to have a genetic predisposition. Sometimes it's just common right. Someone says oh you know I have a family member who has depression I have depression. Is that genetic or is it just common? But then you do have some people who would like every single member of the family suffers from anxiety.
Help us understand the way that genetics plays a role there and how you use that to help people. So genetics is a really great point to bring up. I think this is one of my one of the myths I like to bust is that people think this is their destiny, or they're doomed to have this because it runs in their family.
And it's certainly it's important to know that family history because that's their, you know, vulnerability. That's how it their inflammation likely will show up. But it doesn't mean they have to have it. You know, we think of genetics for most situations is like 10% of the issue. You know, there's a phrase that it's a little violent, but the genetics loads the gun and the environment pulls the trigger.
You know, we as violent metaphor for that, you know, so it's important but it is absolutely not everything. And so I always educate patients about that and then talk about the concept of epigenetics. What's turning on and off this vulnerabilities and that those are things that are so much under our influence. You know what we eat our light exposure, our sleep, our movement, our relationship, you know, all of these things.
And so that's how I approach it, and that's how I work with it.
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Visit us at uplift for her.com or give us a call today. We have services available for those of you living in the state of Utah and some services available for those of you outside of Utah. Now let's get back to the episode. Now where how what is your construct? What how do you approach a patient then? I think a lot of functional medicine practitioners, you know, we we gain, we gather the history and then we start with maybe life style.
Right. Let's make sure that you're sleeping and you're moving and you're eating well, and then maybe some lab work tell us kind of where you start and where that goes from there and how it if it's unique in psychiatry, functional psychiatry as opposed to other functional medicine or not, I don't think the way I practice is different than general functional medicine, because I found this to be just broadly helpful and this approach.
So I we begin you know, I work with patients in a program where they are having health coaching and nutrition coaching and and brain retraining, which I'll talk about a little more as well. But so we begin to begin with those lifestyle changes. But we're doing testing immediately. And that's to get at some of the low hanging fruit.
First of all, because hey, if it is a low B12, for example, or something like that, we want to immediately start working on that, get people feeling better, and then they're even more able to implement lifestyle changes and to help them see where are the areas of imbalance that we're going to work on. Some of them are going to take time, but getting clear about that, okay, we have a lot of work to do on the gut or there's a toxin issue here.
And then and then we also do this piece of brain retraining. And I think you you alluded to that a little bit earlier about, you know, we have to change the patterns because when people have been chronically struggling with illness, they have their brain is very much sort of in the mode of having that those symptoms and trying to protect them from having, you know, anything get worse.
And it you when you heal the body and you take away those toxic threats and and make things work better, you have to update the software in the brain that the situation actually is better, because the brain's still just trying to protect you, and it can generate more symptoms in the body if you don't change that. So it's really, really important to work on that from the beginning helps people with their tolerance of treatment if they're a sensitive patient, because we've got to convince the brain that it's safe, it's going to be okay to do different, you know, supplements and make changes.
And, and it helps their brain, you know, be more neuro plastic. That's our goal, that that means that it's changeable, the brain can adapt. And often people's brains are just kind of in a stuck place. And so when we give the nutrients and lower the inflammation so that the hardware works better, we also update that software.
Those are the parts that are important for neuroplasticity. Let me just emphasize that because I think that's so key in all aspects of functional medicine, but especially when it comes to mental health in the brain, is the brain does get stuck in this fight or flight, right? So I call it saber tooth tigers. But it's not just that our brain is stuck in fight or flight.
This is a mistake I think a lot of people make when they're dealing with mental health is they say, oh, I need to retrain my brain not to overreact. And yes, that's what you're going to talk about with the brain retraining, but also it goes down deeper to the actual cells. The brain is the input. That's right. That's the programing.
We don't have a lot of different programing. I mean, maybe if you you have sensory on your skin or your fingers, but like most of the input we have telling our body what to do is based on our thoughts and our perception of the world. And so if our brain perceives the world as dangerous, that programed the cells to perceive the world as dangerous, it actually shifts them from like healing mode and from maintenance mode into, military mode, into like soldier mode.
And those cells staying, locked on in soldier mode can make it really difficult to get better, because the cells are actually rejecting any sort of supplement you try to give them, as you mentioned. So it really is a two fold approach, is you have to get those cells to calm down, and then you have to retrain the brain, and then you have to get the cells calmed down a little more, and then you have to retrain the brain.
Did I restate that okay. Yeah, I think I mean, it really is iterative. And they feed each other. So yeah. You to calm that nervous system enough that the brain thinks things are safe enough that you can begin to get cells out of that state. Because it's true. Like we don't detoxify when we are in fight or flight, like the biochemistry shifts.
Yeah. And we have to send the signal of safety for things to happen. But we increasingly send the signal of safety back up to the brain from the body when things are going better. So they interact with each other, and you do have to iterate on it like that. Tell us then more about brain retraining. How is that different than therapy or, you know, thought work or is it different?
What what actually are you doing in that component of the treatment? Well, you know, therapy super important can mean a lot of different things. Yes. And sometimes therapy ends up being great. Unfortunately, sometimes it really ends up being kind of re walking the same path, the same neural circuits, like telling the same story about the trauma that happened and not actually processing it with the right kind of approach.
It really is processed and that's very, very important. But if you're just sort of repeating the same patterns, then nothing's changing. And so with brain retraining, there's several steps, but it's about and there's different programs out there that do that. And they're they're all really great. But they have sort of shared components. There's things that are going to calm the nervous system.
And then there's the part about visualizing and picturing things being different than they are. And it's almost like an exposure therapy. You're doing it stepwise to it has to be something you can believe, because otherwise you're just going to reject it and it won't work. But you're using your imagination to picture doing things that maybe right now you can't do.
So let's take an example. Someone who's extremely fatigued and you know, they normally can't walk down the street to the mailbox. So maybe that's the thing they're first imagining in their mind doing, and that the brain is so interesting, it doesn't really know the difference between what's real and what's imaginary. So if you practice, you know, that's been shown with athletes, right?
They can imagine doing the lift, for example, of the mass of the weight, and they will actually gain muscle. Like this is so cool what the brain can do. And the brain is running the physiology. So, you know, you're using that brain practice to get the body to be able to come along and do more, and to help your brain realize, like it's help you realize I, you know, expand what's doable for you, what's safe for you.
You know, maybe it's like certain foods you haven't been able to eat, and then you sort of imagine that you can start to incorporate them and not have the same gut pain, for example. And so, and it's about changing your idea about what's possible. So there's different ways people approach this. But I think it's a really, really important part of healing.
If you've had any kind of long standing. And when I say that chronic, I mean like six months or more of a chronic symptoms, it's a game changer. It can help you feel better, especially with your mood actually pretty quickly, and then helps your treatments go faster and then helps them stick helps you. You're not regress. So cool.
So what does this look like in your clinic? Is it one on one? Is it a digital program? Is it a meditation library? What does that look like for you? Oh, we have a brain returning coach that does meet with patients. And, it's part of our program that she teaches the foundations. And then there's a follow up, you know, session where she's going deeper.
Sometimes we do recommend people do a program like Primal Trust Gupta Program. Those are great. And then we also have, an educational webinar, library of resources on, you know, our brain retraining coach and myself and our health coach and nutritionist talking about different subjects. Educate people and refer them to these, like, please watch that one. And, you know, there's our resources.
We have. Awesome. So where does a patient start when they are struggling with mental health. Number one is there something are there some generalization general rules that they could apply to get started before they ever see a doctor? Or is it best to not? I mean, I don't think necessarily experimenting with something like keto is necessarily the way to go, but perhaps whole foods are what are the types of things that you would say?
Yes. If you're struggling with anxiety, depression, postpartum depression, you know, what are some things that they could do? Pretty generalizable. Yeah, I, I love this question because I think there's actually a lot people can do before they ever have to see someone like me. And I think your point about keto is also very important because it's complex. It's really effective.
It it's a therapeutic tool and should be done with supervision. But eating paleo, for example, or, you know, just clean whole foods diet, lower carb that you can do very safely and have a lot of impact. And that's one of those things. So patients can start with these foundational lifestyle changes. So that would be anti-inflammatory diet. You know just start with removing processed foods.
You know. And wherever you are on that spectrum, you know maybe that's just stopping drinking soda. You know, maybe it's not going to fast food restaurants anymore, you know? And it's like always baby stepping your way forward. So the anti-inflammatory diet really important getting in the nutrients. Making sure you're getting some basic, potentially basic supplementation unless you're eating a very nutrient dense diet.
So B vitamins are critical for mental health. That includes folate from dark leafy greens and includes B12 from animal products and and the other B vitamins. Those are all really important. Zinc, magnesium. These are things we see very low in mental health conditions that people often benefit from adding. You can get these from foods. Some people need to supplement as well.
Omega three fats? I almost didn't say that one. That's so critical. Anti-inflammatory. The brain needs these desperately, and most people have just hardly any. And they have a high level of omega six fats, the inflammatory fats from all our processed oils. And that's a real problem. So even just doing those kinds of things makes a huge difference.
And, you know, that's where I would begin. And then things like light exposure, seeing, getting light in the morning and making sure that you aren't exposed to a lot of light right before bed, like not looking at screens that are going to tell your brain it's morning when it's nighttime, you know, these things are basic sounding, but they make a huge difference.
And I think starting there is important. I think that, you know, there's a lot of things available. There's great books out there, there's courses, there's things you can do on your own, and then you see how far you get. And then if you get to where you feel like you've done a lot of these things, you've definitely had improvements.
But there's some things that are stuck. That's when I would start thinking about seeing a practitioner that's really helpful. One thing that I do see come up for patients is, you know, I tried that. Nope, I tried that. Nope, I tried that. And I think it's really important to recognize that most of these things in the brain, really, and in what we do in functional medicine, it's very multifactorial.
And so if you try a B vitamin on its own, sometimes you don't feel anything. And then you try zinc on its own and you're like, well, that didn't do anything. And sometimes it is kind of looking at that whole lifestyle piece and saying, okay, we really want to. It's a tricky balance between when I take care of my patients, I want to help them with baby steps.
I don't want to overwhelm them. I don't want to do too much. And at the same time, sometimes we have to, do more than one thing before we really see the results. So just to note on that, because I think that comes up for people of like, I tried that it didn't work for me. Yeah, I tell people a lot this term, which is where my education in the past, which is something is necessary but not sufficient.
Yes. And everybody has multiple things that they need to do. And you don't do them all overnight. So you're building a foundation and hopefully some of those are things are going to feel difference from. But you might need to do a bunch of things before you really feel a difference. But I think when people can be, you know, when they start to learn what are these imbalances and what are what's going on, then they start to grasp that, okay, it's going to take multiple things and they're okay with that.
And yeah, it's a dance, isn't it, with the patient where it's like, we have to do enough things that they feel a difference, but if it's too many things and they're overwhelmed, then they're not going to do anything and they're going to feel terrible about themselves. And we don't want that at all. So it is about, you know, this is why it's so important, I think, you know, to get the support of somebody as you work on this, whether it's your coach or therapist or your partner or it's their functional medicine practitioner, you know that you are someone showing you, helping you look back and go, remember where you were before.
Remember when you were eating all those food like you've come really far and what's the next step now that you those things are easy for you? You know what? What's the next step to incorporate? Yes, I want to emphasize that that idea of having some way to measure your progress is so important, because it's really easy to lose motivation if you're not 100% better, because the whole thing is that as our mental health is troubled, it's really difficult to get a perfectly accurate perspective on what's going on.
And I say that, as you know, I've had my own mental health struggles in the past. And so I call it lenses where you like, you can't even see the world. You can't tell what lenses are on. That's just what the world looks like. And it's only when the lenses come off that you really get an accurate view of like, oh, I was really depressed.
Like I was not seeing that accurately. And so having some way to track your progress along those lines where you, you can have that motivation to say, I have made quite a bit of improvement. I'm not there yet, but I've made quite a bit of improvement. And I agree with you. That's one of the things that I find most beneficial of meeting with my patients is me saying, how are you doing?
And they have to really stop and think of like, oh, I notice this is better. I also will sometimes read the notes that I wrote their last visit and say, you said that this was going on or you said that you could hardly get out of bed. Is that better? And that sometimes will trigger them to say like, oh yeah, I forgot that was going on.
I didn't I haven't even didn't even remember that. That's how bad I was. So the negativity bias is a big issue that we're all fighting against is there to help us keep us alive, but it also can make us very unhappy and make us think we're not making any progress. So some of the things that I think help a lot, help me personally with this and help my patients is writing our wins each night or each morning like three things that I got, you know, that happened that are successes and really taking a little bit of time to savor that because it helps us remember, like, oh, I am getting stuff done.
I am making progress. Another one is like with my patients, I do the same thing. I always following up on the last note. Well, how are these things? But sometimes it's helpful to show them, you know, their symptom score that they had at the beginning. It's like, well, you were 120 on our medical symptom score. That's a lot.
And now you're at 60. So that's still like 60 is lots of issues, right. And of course you want to keep working on those. They want to keep working on it. But hey you've got cut in half right, right. And that shows you what's possible. Yeah. You know, I have a patient right now who really does struggle with this.
And she's like, I'm never going to get better. I just think, you know, I it's not possible for me. And I'm like, well, do you remember when we started working together a year ago and you had all these problems and a whole bunch of those are actually gone, and that shows you that change is possible. And as soon as we talk, she's always like, oh that's right.
Oh yes. Okay. I always feel better after we talk. Yeah. But if your brain or brain is always just kind of a little bit fighting, you know, like change now and it's, it means so. Well. Right. It's possible. But negativity thing really can make us unhappy. Yeah. Yeah. Such, important aspects of this. So maybe tell us next.
Are there some of the what are the major tests that you do when someone comes in, maybe with more advanced mental health concerns? I mean, if someone has a couple months of anxiety, then we may think more like your patient of like the insulin resistance or the B12 deficiency or something like that. But when someone comes in with longstanding mental health issues, what are your go to lab tests that are you find most critical in really helping them uncover what's going on?
I know there's a wide array. So just as I come to mind, three batteries to test always, as a foundation. And I would say that all my mental health patients also have other issues like this is, you know, it's not their only symptom. Yeah, exactly. They've got issues or pain issues or something. So, I start with a very comprehensive blood test that looks at all kinds of hormones, you know, sex hormones, thyroid, insulin, cortisol, you know, nutritional factors, inflammatory factors.
So that's that's very important. And then I also do a comprehensive stool test, that is looking at digestion, inflammation in the gut, microbiome infection. That's very important. And then I do an urinary organic acid test as well, which is another window into the gut and catches things that the stool test does not. I find that organic is pretty helpful to look for fungal issues and hints about mold issues and, also more nutritional status in that test.
And also, some information about, detox pathways and neurotransmitters and mitochondria. So I find that a really great place to start. And then I might go down some other paths after that. Like maybe I want to do a, I don't want to just have serum hormones. Maybe I want to do a urine test to look at the metabolites, the hormones, how they're, you know, how they're processing that.
Is that unhealthy pathways with their estrogen or not? I will consider doing urine and testing for mold toxins in some cases. You know, those are probably the next two most common tests I will do. I'm adding some genetics testing, actually, now that there's been a leap forward with the genetics testing, that makes me interested in it again, because it used to feel like a rabbit hole that didn't really help anybody actually feel better.
But I am doing some, some advanced, genetics work now that I think can help certain cases. So, you know, I was looking at new things. Yeah. What was going to help? One question that comes up a lot with, with some of my patients is like a hair mineral analysis test. Do you use that much to look for metals or minerals?
I don't much, it is an option for sure. It can be a way to assess, you know, certain toxin, like metal exposures, like you mentioned. I don't tend to find that that necessary. I guess I would say. Yeah. Yeah, that's good to know. Okay. So you're kind of taking a patient comes in. You're definitely looking at their lifestyle.
You're definitely looking at this this wide array of tests. And I think this is important for people to understand because I think as patients we are used to the conventional medical model of you're going to get 20 minutes with your doctor, they're going to give you a diagnosis, they're going to give you a pill. And honestly, there are times when I miss that style of medicine where it's like, that was so easy.
I just met with them. I knew exactly what they needed. I gave them their stuff and they, they, they went on their way whether they felt better or not, but they went on their way. But, I mean, I joke because it it was simpler. No, you're right, but we have to it's very complex. And we have to understand that as practitioners, as physicians.
But but as patients, we also need to understand that because I think the idea of hope is 100% there. There are so many things that we can do to feel better and to improve our lives. And to improve our life expectancy, and to manage chronic disease and go on and on. But what we do in functional medicine is involved, and it really involves looking not at everything, you know, every tiny little, like it's not millions of things, but it's like 5 to 10 big categories of things.
And I think as patients we want to come in with that expectation of like, okay, this is I am going to have to really dive into a few different categories of things, but I am going to get better. And just having that expectation can be helpful. Do you give any sort of expectation of timeframe of what people can expect?
Yeah, I mean it does of course vary, but I, I think we really work hard to set expectations even before people are patients. Is education kind of in the process of becoming a patient to help people understand what you were talking about right there, which is, you know, there's a lot of pieces that are going to be done.
But often people are pretty excited about that because they want someone to look at the whole view because nobody has been. Yeah. But also that, you know, there's a time commitment and, you have to step up in your own commitment to yourself to do this work. And so, you know, we have an initial program that's six months, and people get lots and lots of gains in that time.
But, you know, a more toxicity issue is not going to be resolved in six months. But that doesn't mean they're not going to be well on their way and feeling a lot better. Yeah. So it depending on what the issue is, I'm going to adjust those expectations with people about, you know, what it might take. And it's of course their level of engagement really dictates that rate of progress as well.
Yeah, I just want there to be accurate expectations because it's I, it's so valuable. It's such a valuable set of tools that we have. And I wish it was simpler. Like I wish it was just super, super easy. And it's not it's not. But man, it can change a whole lives. I mean, absolutely, it can change lives. We both see that all the time.
Yeah. But I do think I hear what you're saying because I think before I worked with people in a program. Yeah. You know, that that's part of the problem, I think, is people have to be ready to make that kind of commitment. Yeah, that's when they see the results. And I would joke, sometimes people want me to wave my magic green wand, you know, to fix things.
That's not a pill. It's like, well, this is actually work, you know? Yeah, it's going to take a lot of work on your part and a lot of steps, but it's also going to feel really good to accomplish that and to be empowered and to see that you made yourself better. And I think you learn so much. That's the other part of I think this big paradigm shift is when the human world was simpler, you know, that that we we were cave people.
You didn't need to know that much because everything was reflexive and there wasn't much sort of quote unquote, poisoning our health. Right? I mean, you got up, you went and hunted for something, and hopefully you didn't fall off a cliff or get eaten by a tiger, and you did okay because your body was was interacting with its environment the way that it was meant to.
And ours is not that way anymore. And so fortunately or unforced, I think it's a way for us to have the best health is to to become our own best expert, you know, to become empowered to say, I understand my got better now. I understand why I need to get sleep. I understand you know why I need to eat this way for my health.
This is what my body needs. And honestly, that is a hard earned set of information. But the patients that get that, I think, I hope, feel empowered and feel like they're on this wonderful trajectory for the rest of their lives, that they understand their health and they understand what goes into it. They're going to have better outcomes. They're going to have better outcomes.
Then take a pill and stay on that pill for the rest of your life. Yeah, I have pieces I've worked with for several years that that, you know, you really see that what you're talking about, that they do feel that way. They feel like they they have a whole new way of living. And, you know, it's it's natural to them and you see them have this huge impact on their community.
Yeah. I think they've changed things for their husband and their kids and their you know, their friends. And and partly I see this because some the friends and the husband stuff start seeing me. But it's that patient and their influence on like the decisions in the family. What they're buying, what the you know, the what's the food or are they drinking out of plastic water bottles, all these kinds of things that, they have this wonderful ripple effect.
And it's because this is now they understand why. And I find that when people need to do a, you know, when they're working a program that takes a lot of supplements for a while to fix the different imbalances. You know, I had patients start with me and sometimes say, like, I've never been good at taking supplements. And I, I say, you know, I was like that actually.
Also, when I didn't know why I was really taking these things or, you know, if it worked for me, I heard that was good, you know? So that's not enough. You need to see the labs understand from the clinical history, you know, with my guidance why that's important for you. And, you know, they never have trouble with it at that point.
I mean, in general. And it's really great because I think that that's the key is understanding why they need it. And it's such a good point. And I think like, I think some people don't understand this, and I'm sure that in other places it's false. But I think as physicians we want you off supplements as much as you do.
And we don't want you taking stuff that you don't need to take. I sometimes look at lists of supplements and I'm like, oh man, I wish I could cut that down. But this is where your health is at. This is where your body is at. But I really think the the bulk of us don't really want you taking stuff that you don't need to be taking.
We we really want to stick to your goal and your improvement. And we see these successes. So we do use a lot of different tools for that. But we want to personalize it as much as anyone else know. And I always explain to folks like, well, first of all, you can't supplement your way out of like a bad diet or lifestyle.
So that's still the key. We use the supplements to get the, you know, the change as quickly as we can. You know, we need targeted supplements that are, for example, an anti-microbial herb. Like we have to kill that overgrowth. We have to use a tool to do that. But these I tell people this is like a project we're doing.
This is not a lifelong thing. This this thing. Right now is a project. We're going to treat this maintenance. Supplementation when you're healthy is a tiny short list. You know. Exactly. Tell us what is the likelihood of someone coming off an antidepressant? I realize that's a giant question, but tell us how you approach coming off of the, antidepressant or anti-anxiety medications.
Yeah, I think this is actually really important to talk about because it's not handled well. I think in the conventional model. And part of that is the education. So in my training, I was taught, you know, when somebody who's been well from depression, after a certain number of months, you can taper off the medication. If they have another episode, then now they have to stay on the medication for the rest of her life.
Yeah. And also another problem is that when they are, tapering the medication, then they often have a relapse of symptoms. And that's seen as indication that they can't get it out, that they need it because they're still depressed when actually often that is actually a withdrawal symptom, a discontinuation syndrome symptom that is horribly under-recognized with just basic like SSRI medications like Prozac or Lexapro, that this does exist.
So this gets back to that topic of neuroplasticity. I was talking about earlier, which is that ability of the brain to change and adapt. And what's happened with medications is that the brain is adapted to that medication. It's used to it. And when you take it away, it's got to adjust to coming off of that. If the brain is not flexible, that's going to be really uncomfortable and produce symptoms.
But there's so much we can do to prepare our brain for that change. And this is about making sure that hardware's working. Well, you know what's the omega threes and the magnesium. You know the B vitamins. What's the level of information. So if we prepare people and that's clean then we can talk about tapering. And then we also do it slowly.
And one of the things that I think is very important is I work with my patients on how do they feel about this decrease in the dose, because this gets back to that safety in the brain. If they think cutting it in half is too big a leap and is scary, and we're not going to do it, because if that's what their belief is when they take it, the brain is feeling threatened and that's going to trigger symptoms.
So it's very important to say what feels comfortable is a rate of decrease. Do we need to get it, you know, compounded into some other level of dose. That's going to be just a gentle decrease. And of course there's all kinds of nuances. It depends on what type of medication we're talking about, how we might do that. But I really like to try to get patients to tune in to their own feelings around that decrease and, you know, their intuition, because that helps a lot.
But first, it's about preparing the brain and really solving the root cause of the of the depression. And then then working with coming off the medication. Thank you for sharing that. I know it's something a lot of people want to do and have concerns about and feel stuck. And so just to know it's a possibility for a lot of people, it's so nice to understand.
It is possible for many many people. Yeah. Yeah. Which is wonderful. Okay. As our last question, you know, being a gynecologist, an ob gyn, I just can't talk about mental health without bringing it back to postpartum depression because I think it's so underserved. You know, I think that that that diagnosis is one that we don't understand very well and we don't always treat very well.
Will you comment on your experience on it and any thoughts that that women should keep in mind if they have a history of postpartum depression or are getting ready to have a baby and watching out for that. Yeah, I'm so glad you're asking about this. I know when I had my first son, I was very worried about this because my sister had struggled with postpartum depression and I was very fortunate not to deal with it, but I think it was to do with some steps I had taken.
And, you know, just a basic one that comes to mind that I wish everybody would do is making sure their vitamin D level is good. That's going to help your nursing baby a lot. That's going to it's going to help your mood and your whole immune system. But some of the things that happen a lot with postpartum depression, you know, that are just not recognized in conventional medicine.
And this will be two key areas. One is the zinc and copper ratio in the body. That's very, very important. And getting that optimized usually it's people are low in zinc and high in copper. Working with someone who is experienced with fixing that can be a real game changer. And that's not hard to do. And then the other thing is progesterone, I think is a really big one here too, because even now, you know, an approved treatment that is used conventionally, that is based on progesterone for this body, we actually have progesterone, you know, bioidentical, which we can be using.
So, you know, there's a huge drop in progesterone after you, you know, when you deliver. And for some people that is just too much for their brain function, you know, to not be impacted and to have that mood and it's safe and easy to use. And so those are the two biggies that I feel like, hey, if we address these, we're going to help a lot of people with their, with their postpartum depression.
Yeah. Well, thank you for bringing that up. I think, even if nothing else, to have hope. I think sometimes when we have postpartum depression, it's too often dismissed as like, well, postpartum is rough. Like, what are you going to do? And like if you believe that your brain is not working the way that it should be, trust that you're right and even if you don't think that you're like, even if that's not the case for you, if people around you feel like your brain is not working the way like get help because there is so much we can do, and it shouldn't just be this like, you're a mom now, suck it up and deal
with it like there's there's so much more we can do. I thank you for everything that's so important. Well, as we wrap up, is there any last sort of overview or summary statement or any last message that you'd like to give to our, our women listening? Just that I really think it's important to recognize that there's a reason that you're having your symptoms.
There are root causes at play and those can be uncovered and those can be addressed. And sometimes you can improve them without ever really knowing what they are when you make these lifestyle changes. We talked about these nutrition changes because when the body can just work better and fix that problem. Yeah. So have hope, understand that little baby steps add up.
And that's how you make any kind of change. One little baby step at a time. Keep on going. You can feel so much better. You know there's just so much hope. Well thank you for that. Thank you for explaining all of this to us and helping us understand, you know what? What we should be looking for. And also then that helps us understand what should be in our toolbox to help people, feel better, to help ourselves feel better.
So thank you so much for being on it. It was such a pleasure to have you here and it's just such an important topic. I'm so glad we can shed light on it and not feel so hopeless when it comes to mental health disease, with with anxiety and depression, that it's more of a brain inflammation than than really something we should feel bogged down by too much.
That's right. Thank you so much for having me. Will you tell our listeners where they can find you and where they can, how they can work with you? So my practice can be found at Doctor Tracy mccarthy.com. And that's for people in California. That's my license California license. One of the things I've created for listeners is a guide.
That's just a great place to start. It's top ten overlooked causes of anxiety and depression. And you can find that at Doctor Tracy mccarthy.com/top ten. That's top one zero. And I really encourage people just to get that because that's a great place to start. And you know if they are interested in more than that, then I have an online program called the Natural Mood Solution, which people can participate in from anywhere.
That's an educational program that goes deeper about the things we were talking about today. Wonderful. What great resources. I'm so happy to to share that with our listeners. So thank you again for being here. My pleasure. Thank you so much for tuning in to today's episode. A huge thank you to our guests for sharing their insights and time with us.
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