By Stephanie Megal, Wellness Ambassador Director | Dao Labs
Depression--with symptoms such as low-self worth, lack of concentration, fatigue, loss of appetite, insomnia and others--is a common mental disorder around the world. In fact, an estimated 300 million people suffer from mental illnesses globally.
Described as an “unseen burden” by the World Health Organization (WHO), depression can become chronic and lead to significant impairments in an individual’s ability to carry out everyday activities and can lead to suicide. The United States is one of the most depressed countries in the world after China and India. In a given year 43.8 million adults, or 1 in 5, in the U.S. experience mental illness in a given year.
Antidepressants—known by brand names such as Zoloft, Celexa, Prozac—are commonly prescribed to treat depression and are some of the most popular drugs in the United States. Nearly 13% of people 12 years of age and older said they took an antidepressant in the last month according to a 2017 report from the National Center for Health Statistics. As you can see from the graph below, women are twice as likely as men to say they took antidepressants.
Figure 1. Percentage of persons aged 12 and over who took antidepressant medication in the past month, by age and sex: United States, 2011–2014
Many antidepressants come from a class of medications known as Selective Serotonin Reuptake Inhibitors or SSRIs. Unfortunately, there are many common side effects to using SSRIs including drowsiness, fatigue, sleep difficulties, weight gain, nervousness, dry mouth, blurred vision and more. Doctors recommend a slow weaning off of SSRIs because abruptly stopping can cause Antidepressant Discontinuation Syndrome which comes with its own set of side effects including spells, extreme restlessness, dizziness, fatigue, and aches and pains.
In China, where approximately 100 million people suffer from depression, doctors have been using the Chinese herbal formula Xiao Yao San (“Free and Easy Wanderer”) as a treatment for centuries. This formula contains eight commonly used herbs: Bupleurum root, Chinese angelica root, white peony root, poria, bighead atractylodes rhizome, roasted ginger, prepared licorice root, menthol and peppermint.
In a research article entitled Chinese Herbal Formula Xiao Yao San for Treatment of Depression: A Systematic Review of Randomized Controlled Trials (Evidence-Based Complementary and Alternative Medicine, Volume 2012, Article ID 931636), researchers set out to evaluate the beneficial and harmful effects of Xiao Yao San. What they found was that using prescriptions based on Xiao Yao San in the form of pills, powder and boiling the herbs may be beneficial to patients with depression.
In Chinese Medicine theory terms, Xiao Yao San may be soothing the liver, invigorating the spleen, nourishing the blood and clearing away the liver fire due to blood deficiency. Biochemically, this formula also reversed CIS-induced decreases in brain-derived neurotrophic factoroche and increases in tyroxine hydroxylase, and neurotrophin 3 in the frontal cortex, and the hippocampal CA subregion.
In comparing Xiao Yao San prescriptions alone, antidepressants along, and the combination of Xiao Yao San prescriptions and antidepressants, the researchers found that Xiao Yao San prescriptions may have the same effectiveness as antidepressants at the end point of treatment with fewer side effects. Combining Xiao Yao San with antidepressants actually showed significant beneficial effects—shorter onset time, symptom improvement with less adverse events—as compared to the results of those taking just antidepressants or just Xiao Yao San prescriptions.
By Kylee Junghans
Research suggests that between 1-30% of the global population suffers from some form of anxiety.1 There are 13 different sub-classifications of anxiety disorders listed in the latest Diagnostic and Statistical Manual (used by medical professionals to diagnose and treat psychological conditions),2 with symptoms and physical manifestations varying considerably. From shortness of breath and variations in heart rate, to full blown and debilitating panic attacks, headaches, pain and insomnia,3 anxiety is a complex, pervasive condition that is generally treated using medication.
ACUPUNCTURE FOR ANXIETY: THE CLINICAL EVIDENCE
According to the most up to date evidence, acupuncture is an effective treatment for anxiety. In 2017, The Acupuncture Evidence Project, co-authored by Dr John McDonald, PhD and Dr Stephen Janz,4 was published, providing an up-to-date comparative review of the clinical and scientific evidence for acupuncture. This comprehensive document, updating two previous reviews, determined that acupuncture is moderately effective in treating anxiety according to high level evidence.5 Their evidence included a 2016 systematic review with over 400 randomised patients that concluded that ‘the effects from acupuncture for treating anxiety have been shown to be significant as compared to conventional treatments.’6 The largest of these studies, which included 120 randomized patients, found that acupuncture had a large effect on reducing anxiety and depression compared to conventional treatment involving pharmalogical approaches and psychotherapy, with over twice the reduction in symptoms.7
A more recent systematic review published in 2018 found that all 13 included studies “reported an anxiety decrease for their treatment group relative to the control groups.” Three of these studies used pharmaceuticals as controls.8
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BIOCHEMICAL MECHANISMS OF ACUPUNCTURE FOR ANXIETY
The autonomic nervous system (ANS), which is comprised of the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS), regulates the internal conditions necessary for existence (homeostasis).(8) Information is received from the body and external environment and a response is delivered by either the SNS, which releases excitatory signals, or the PNS which releases signals for relaxation. These signals direct the body to react in very different ways, such as increasing the heart rate and contraction force, or by reducing blood pressure and slowing the heart rate.(9) It is exciting to know that studies show acupuncture has an effect on both the SNS and the PNS, as some further examples presented below reveal.
One of the most sensitive measures of the body’s ability to cope with stress is something called Heart Rate Variability (HRV). Rather than beating consistently at the same rate like a metronome, the heart actually changes its rate based on its fine-tuned response to the environment. A higher HRV has been associated with better health in all domains, including mental health and low levels of anxiety. Acupuncture has been shown to improve the body’s ability to cope with stress through improving HRV.(10)
When the body is under stress, an area of the brain called the hypothalamus releases neurochemicals,9 and research shows that acupuncture can calm this response.10
Acupuncture has also been shown to increase the release of endorphins,11 the body’s own ‘feel-good’ chemicals, which play an important role in the regulation of physical and emotional stress responses such as pain, heart rate, blood pressure and digestive function.12131415 All of these acupuncture mechanisms have a direct effect on reducing anxiety.
CONVENTIONAL TREATMENT OF ANXIETY
The conventional treatment of anxiety primarily involves some combination pharmacological and psychological interventions.
There are several medications that are prescribed for anxiety, including benzodiazepines (alprazolam), selective-serotonin re-uptake inhibitors (SSRIs) such as paroxetine, and tricyclic antidepressants (imipramine), either singularly or in combination.16 According to recent research, around 50% of patients treated pharmacologically for anxiety have an ‘inadequate response,’17meaning that their symptoms are not alleviated to clinically significant levels or that the patient experiences adverse side effects. Some researchers go so far as to say that pharmacological treatments are ‘not ideal’ in terms of efficacy when employed for either short- and long-term treatment.18
Systematic reviews demonstrate that benzodiazepines can result in ‘sedation and drowsiness, mental slowing and anterograde amnesia’ (difficulty in forming new memories).19
Cognitive behavioral therapy (CBT) and mindfulness-based CBT are two other popular and effective forms of conventional treatment for anxiety and may be prescribed as standalone therapies, or in combination with medications.20 CBT is a ‘talking therapy’ that aims to overcome inaccurate or negative thought patterns,21 and has the advantage of flexibility, where therapy is tailored to each individual and their relevant anxiety disorder. A meta-analysis found that compared to a placebo therapy, CBT had a moderate to large effect on reducing anxiety from a variety of causes.22
While there are ethical and methodological challenges to designing studies that compare the effectiveness of acupuncture to the conventional treatment of anxiety,2324 the best available evidence demonstrates that acupuncture has moderate benefits in the treatment of anxiety. Studies show that acupuncture is more effective than pharmacotherapy and comparable to talking therapy, making it a helpful referral choice. Moreover, research has revealed several known biochemical and biophysical mechanisms that may offer an explanation of how this ancient modality works.
– by Tima Vlasto, as published in the San Francisco Examiner
New groundbreaking research shows that the insertion of an acupuncture needle into the skin disrupts the branching point of nerves called C fibres. These C fibres transmit low-grade sensory information over very long distances by using Merkel cells as intermediaries. Dr. Morry Silberstein of the Curtin University of Technology will publish his research in the Journal of Theoretical Biology later this year.
We have never really had a scientific explanation for how acupuncture actually works,” he said. In the absence of a scientific rationale, acupuncture has not been widely used in the mainstream medical community. If we can explain the process scientifically, we can open it to full scientific scrutiny and develop ways to use it as a part of medical treatments.”
Dr. Silberstein mentions that they have known, for some time, that the acupuncture points show lower electrical resistance than other nearby areas of the skin. His research specifically pinpoints that the C fibres actually branch exactly at acupuncture points. Scientists don’t know exactly what role C fibres play in the nervous system, but Dr. Silverstein theorizes that the bundle of nerves exists to maintain arousal or wakefulness. The insertion of the acupuncture needle disrupts this circuit and numbs our sensitivity to pain.”
Acupuncture for pain relief is actually being taught to American Air Force physicians deployed to Iraq and Afghanistan (2009) by Dr. Richard Niemtzow MD, PhD, MPH and editor of Medical Acupuncture. His technique called “Battlefield Acupuncture” relieves severe pain for several days and is a variation of acupuncture, which inserts very tiny semi-permanent needles at specific acupoints on the skin of the ear that blocks pain signals from reaching the brain.
“This is one of the fastest pain attenuators in existence,” said Dr. Niemtzow, who is the Consultant for complementary and alternative medicine for the Surgeon General of the Air Force, and is affiliated with Uniformed Services University of the Health Sciences in Bethesda. “The pain can be gone in five minutes.”
It has taken quite a long time for Western medicine to embrace acupuncture even though it was introduced in the early 1970’s after contacts with China improved.
Professor Tsuei mentions: “In 1972 the respected New York Times columnist James Reston underwent an emergency appendectomy while in China. He later wrote about acupuncture treatment for post-operative pain that was very successful. This report attracted attention and many American physicians and researchers went to China to observe and learn acupuncture techniques.”
Since then, only a few controlled studies were done in the West. Yale researchers proved its effectiveness for cocaine addiction in 2000 and published their findings in the August 14 issue of the Archives of Internal Medicine.
A North Korean researcher, Kim Bonghan, published papers in the early 1960’s and his research was confirmed by the Japanese researchers Fujiwara and Yu in 1967. Unfortunately his research took almost 40 years to be confirmed through studies done on rats, rabbit and pigs with Stereo-microscope photographs and electron microsopy.
The amazing photo shows the stereomicroscopic image of acupuncture meridians:
“Assemblies of tubular structures 30 to 100 micro-meters wide (red blood cells are 6-8 micro-meters in diameter). Apparently these structures have remained undiscovered for so long because they are almost transparent and so thin that they are barely visible with low-magnification surgical microscopes. They are also easily confused with fibrin, which coagulates and obscures these structures when there is bleeding in dissected tissues. Now that they have been rediscovered, researchers are investigating their composition and function. The tubular structures that make up Bonghan channels contain a flowing liquid that includes abundant hyaluronic acid, a substance that cushions and lubricates the joints, eyes, skin and even heart valves. Also visible in the photographs are small granules of DNA or microcells about 1-2 micro-meters in diameter that contain chromosomal material highly reactive to stem-cell antibody stains. When these cells were isolated and then induced to differentiate, they grew into cells of all three germ layers. These may be our body’s natural source of pluripotent adult stem cells, with the potential to develop into any cell in the body”
Russian researchers in 1991 at The Institute for Clinical and Experimental Medicine in Novosibirsk, USSR, in a research project lasting several years, discovered how the human body conducts light. They found that the light conducting ability of the human body exists only along the meridians, and can enter and exit only along the acupuncture points. Dr. Kaznachejew, a professor of physics said:
“This seems to prove that we have a light transferal system in our body somewhat like optical fiber. It appears that the light can even travel when the light canal is bent, or totally twisted. The light appears to be reflected from the inner surface, appearing to go in some sort of zigzag track. You can explain this through traditional electromagnetic light theory as it is used in optical fiber communications.”
This finding has been confirmed by a 1992 study in the Journal of Traditional Chinese Medicine and a 2005 study in the Journal of Alternative and Complementary Medicine where moxibustion and infrared thermography were used to trace meridian pathways.
Dan Gilbert, author of "Stumbling on Happiness," challenges the idea that we'll be miserable if we don't get what we want. Our "psychological immune system" lets us feel truly happy even when things don't go as planned.
Leslie Booker offers step-by-step instruction.In the four foundations of mindfulness, as laid out in the famed Satiphatthana Sutta, the Buddha offers four postures for practicing meditation:
A monk knows, when he is walking,
“I am walking”;
he knows, when he is standing,
“I am standing”;
he knows, when he is sitting,
“I am sitting”;
he knows, when he is lying down,
“I am lying down”;
or just as his body is disposed
so he knows it.
Walking meditation is often described as a meditation in motion.
In this practice, you place your full attention on the process of walking—from the shifting of the weight in your body to the mechanics of placing your foot. Walking meditation is an integral part of retreat life in many traditions and is used to offset and shift the energy of sitting practice. It is a bridge to integrate practice into daily life and can be more accessible than a sitting practice for many people.
Find an unobstructed space where you can walk in a straight line for about ten feet. This short walking distance is the instruction given in the Theravada tradition. Others prefer to walk for greater distances. Bring your attention down to your feet and slowly shift your weight from side to side and front to back. Being in bare feet can bring more awareness to what needs to happen in the body to create balance.
Coming into physical stillness, lift the crown of your head up, slide your shoulders down and away from your ears, and lift your chest with dignity and pride, as if you were a king or a queen. You can clasp your hands behind your back, hold them in front of your body, or let your arms hang loosely to the side.
Lifting your right leg, notice the weight redistribution in your body. Place your attention on what the left side of your body needs to do to hold your full weight—spreading the toes, engaging the core. Extend the right leg forward, placing the heel on the ground and rolling onto the ball of the foot. As your weight shifts forward, notice how the heel of your left foot begins to lift. Swing the left leg forward and repeat.
Adding verbal cues is a great way to establish synchronization and rhythm within the body. As the mind begins to wander, use a simple verbal cue like “lifting, moving, placing” as a reminder to bring the mind back to the body. Incorporating a gatha, a short verse to support practice, is a common technique used in Thich Nhat Hanh’s communities.
Here’s one that might be used for walking meditation:
(Breathing in) “I have arrived”; (Breathing out) “I am home.”
(Breathing in) “In the here”;
(Breathing out) “In the now.”
(Breathing in) “I am solid”;
(Breathing out) “I am free.”
(Breathing in) “In the ultimate”; (Breathing out) “I dwell.”
When you get to the end of your short walking path, come to a complete stop and take a breath. Turn a quarter of the way, maybe taking another breath, then fully turn all the way around, facing where you just came from. Start over with finding your posture and establishing your balance. Again lift, move, and place the foot.
At the beginning of this practice, you might notice that your steps are very calculated and robotic. See if you can begin to find more fluidity as you connect the breath with movement, perhaps letting go of the phrases and just allowing this to be a fully embodied practice. Start with about a ten-minute session, slowly building up to 30–45 minutes.
When you have come to the end of your practice, stand still, seeing where there is energy in the body and what is still. Notice what has risen to the top and what has been let go of.
The winter season can be welcomed as a time to enjoy cozy nights on the couch with your loved ones and your favorite Netflix shows. But after months on end cooped up inside with a dwindling queue of episodes to watch, winter can quickly become depressing. You are not alone in this feeling. About 20 to 35 percent of people suffer from mild to severe forms of seasonal affective disorder, or SAD for short.
So what's the science behind this? When we take a look at our brain, we see that one of the biggest culprits behind these winter blues is a neurotransmitter called serotonin. Serotonin is in charge of keeping you happy, and during the winter months, serotonin transporter (SERT) levels rise by up to 5 percent, which translates to less serotonin in the brain. This depletion of your feel-good neurotransmitter leaves you feeling depressed and lethargic.
Thankfully, there are many things that you can do to naturally up serotonin production and balance your hormones. So without further ado, read on for your guide to SAD!
1. Support methylation
Methylation is a process that happens one billion times every single second in your body. It is responsible for a lot of different aspects of your health, including making feel-good neurotransmitters like serotonin. B vitamins are the fuel behind methylation, so make sure to consume plenty of foods rich in B vitamins like grass-fed beef, organ meat, and folate-containing dark leafy greens.
2. Fuel your brain.
Your brain is comprised of 60 percent fat, and 25 percent of your body’s total cholesterol is located your brain as well. When dealing with the blues, it’s key to continue to fuel your brain with powerful superfoods. When you deprive your brain of what it's made of, you aren’t doing your happy neurotransmitters any favors. By upping your fat intake, you give serotonin and other feel-good chemicals an environment to thrive in. My go-to choices are coconut oil, ghee, wild-caught fish, and everyone’s favorite, avocado. Pass the guac, please!
3. Optimize your protein intake.
Tyrosine is an amino acid found in protein sources such as fish and meat. This helps your body make DOPA, which then coverts to the neurotransmitter dopamine. It is particularly high in wild-caught salmon, cage-free organic eggs, and grass-fed ground beef, so stock up on these during your next shopping trip. If you aren’t too fond of meat, you can turn to legumes, nuts, and seeds, as they contain tyrosine as well.
4. Supplement your sunshine vitamin.
Sun is the most bioavailable form of vitamin D, and it is the one nutrient that every single cell of your body needs to function properly—hormones and mood included! It's synthesized by your body when your skin is exposed to sunlight, which is way less likely to happen in the winter. And since it's impossible to get enough vitamin D from food alone, supplementation can be necessary. A normal range should be between 60 and 80 ng/mL. So depending on where your starting levels are, a good daily dose is between 2,000 and 6,000 IUs per day.
5. Try St. John's wort.
This natural herb is recommended more often than prescription medications for depression in Germany! More research needs to be done to determine just how effective it is, but long-term studies have shown its ability to help stabilize mood.
6. Heal your gut.
Medical literature often refers to your gut as your "second brain" since 95 percent of serotonin is produced and stored in your gut. By making sure your gut is healthy—by bringing in a supplement or probiotic-rich fermented foods—it will help alleviate the feelings of melancholy.
7. Take nature's chill pill.
What can’t adaptogens do? These system balancers of the plant and herb kingdom restore imbalances wherever they are needed in your body. Mucuna pruriens, in particular, is uber-powerful when dealing with the winter blues. It contains high levels of L-DOPA, which is the precursor to your neurotransmitter dopamine. Try adding some to your morning smoothie!
8. Try light therapy.
Blue-light boxes are mini sunlight machines and can improve the winter blues and symptoms of depression by mimicking the sun.
9. Wake with the sun.
Dawn simulators work as alarm clocks, but instead of a loud sound to wake you, there is a gradual increase in light that is similar to a sunrise. Look for ones with full-spectrum light that is the most similar to natural sunlight.
10. Experiment with aromatherapy.
Call your favorite essential oil company and place an order for some essential oils—STAT! Studies have shown that lavender essential oil produces a calming effect similar to the anti-anxiety medication lorazepam, which works by boosting serotonin levels.
11. Get moving.
After an intense workout, it’s not uncommon to experience an intense feeling of happiness, often referred to as "runner’s high." This is due to the increased production of endorphins your body releases after participating in some sort of exercise. In the winter, choose activities that boost your heart rate like HIIT training sessions that can be done indoors.
12. Treat yourself to the spa.
Infrared saunas are great for detoxing and reducing inflammation as well as reducing stress. I like to use my personal sauna throughout the winter to work up a sweat and Zen out. Chronic stress can do a number on your gut, which as we have seen, can affect serotonin levels.
Here's what you need to know about the flu. Remember, even if you've gotten the flu shot, you're not immune to contracting the flu. In fact, recent studies show the flu shot reduces the risk of flu by 40 to 60 percent when the vaccine virus is closely matched to the circulating virus, but this year the CDC estimates that the shot reduces risk by around 32 percent, while other reports put this number closer to 10 percent. Even in a good year, that leaves a large margin for illness.
For starters, it's important to remember that the flu is viral—meaning antibiotics aren't effective at fighting it. It also has two different strains, types A and B, and subtypes within them. There can be multiple sub-types of the flu circulating at the same time, and the virus can change over time, either slowly (which is called an antigenic drift) or rapidly (called an antigenic shift). This is why it can be hard to formulate a perfect flu vaccine year after year—and why protecting yourself in other ways is vital.
How to prevent the flu. Luckily, there are a lot of ways you can reduce your risk of getting sick from the flu this year. Most of them have everything to do with strengthening your immune system by healing your gut and reducing stress.
Here's where to start:
1. Simply wash your hands.
Hand washing is your first defense against any infection, including the flu. Use warm water and soap and wash your hands thoroughly. If you don’t have access to soap and water, hand sanitizer if your next best bet. Remember to wash your hands before meals and after commuting or being in other public spaces, like the gym, grocery store, or library. Cleaning your cellphone regularly is also a smart move.
2. Reduce stress.
Chronic stress can decrease your immune cell numbers and increase certain mechanisms that suppress your immune system. It also promotes inflammation, which makes you more susceptible to illness. Activities like meditation, journaling, exercise, and spending time outdoors are all proven ways to relieve stress.
3. Prioritize gut health.
We should focus on our gut health year-round, but it’s particularly important during flu season because a thriving microbiota leads to greater immune response. Taking a daily probiotic containing lactobacillus and bifidobacteria can improve your gut health. Eating whole foods, including lots of greens and other veggies, also helps to feed your gut bacteria beneficial prebiotics.
4. Get your vitamin D.
An estimated 42 percent of Americans have a vitamin D deficiency, and this number may be higher during the wintertime, when we get less sunlight, which is necessary to produce vitamin D. Vitamin D deficiency has been associated with an increased susceptibility to infection due to its role in immune function. Get your levels checked and ask your doctor about supplementing if you’re low. Fish like salmon, mackerel, and tuna are also good natural sources of vitamin D.
If you do get the flu:
Here are your go-to natural flu remedies and treatments. If you find yourself feeling ill this flu season (which runs through March), symptoms may include fever, chills, runny or stuffy nose, cough, sore throat, body aches, headache, fatigue, and sometimes vomiting and diarrhea. Not everyone will have all of the symptoms, and the severity of symptoms can range from mild to severe.
If some or all of these symptoms sound all too real, try these natural remedies to combat flu symptoms, and contact your doctor if symptoms worsen:
1. Stay home.
Once you have the flu, you’re contagious for one day prior to experiencing symptoms and up to seven days after you start feeling sick. The virus can spread to others up to 6 feet away through droplets in the air just by breathing and also through coughing or sneezing. Touching a contaminated object can also spread the flu. Staying home is the best way to prevent spreading the flu to other people.
2. Get extra rest.
Don’t feel bad about sleeping in or napping while you’re home sick: It can actually help you recover faster from the flu. A recent animal study discovered there is a specific protein found in mammal brains that interacts with the sleep-regulating protein interleukin 1 to signal the body to sleep more when infected with the influenza virus. The extra sleep may help the body to bounce back more efficiently by facilitating an immune response, according to research in Sleep.
3. Get upright.
Yes, you want to sleep more, but you also need to spend some time with your lungs in a vertical position, even if you are just watching Netflix. Influenza is a respiratory virus, so allowing your lungs to open up by being upright can make coughing more productive. You can also lie on your back propped up on yoga blocks under your upper spine and back of the head, breathing deeply, which can help the lungs open. This is important for preventing complications from the flu, like pneumonia. A vertical posture will also aid with lymphatic drainage, which helps to remove toxins.
4. Stay hydrated.
When you’re sleeping more, feeling lousy, and outside your normal routine, it’s easy to forget to drink water throughout the day. But hydration will ensure that your kidneys have enough water to do their job of eliminating waste and fluids and also keep the rest of the processes in your body running normally, allowing your natural defenses to take over. If you have a fever, it can also worsen dehydration and vice versa, so fluids are key. Hot liquids, like broth or herbal (noncaffeinated) tea, will help to loosen mucus and are easier for the body to absorb.
5. Try immune-boosting foods.
There’s no cure-all food for the flu, but it won’t hurt to try foods known to assist the immune system or ease symptoms. Fresh gingerhas been shown to have antiviral properties, while turmeric (with a pinch of black pepper to aid absorption) is a powerful anti-inflammatory. Berries are another good source of inflammation-fighting compounds. In general, try to stick to whole foods with lots of fruits and veggies to get a dose of vitamins and minerals that will strengthen your defenses.
6. Take these supplements.
At Parsley Health we recommend professional-grade supplements including vitamin D3/K2, which we recommend increasing to 10,000 units daily when you are sick (and then reducing this back to 5,000 units for day-to-day). We also recommend high-dose buffered vitamin C, at 2,000 mg twice daily, which has antiviral properties, especially against the flu during early stages, and an herbal immune-booster.
And always, if you have a fever above 102 degrees F, are unable to keep down liquids, or are in respiratory distress, visit your doctor or the emergency room. The above does not replace your personal doctor’s medical advice.
When tragedy strikes, surrendering to your sadness and staying in bed all day sometimes seem like the only option.But it's possible to have an entirely different reaction to a serious setback: You can actually come back from something hurtful or tragic stronger and with a better perspective on life. This theory, a trending topic of discussion in the world of psychology, is called transformative resilience. And transformative resilience isn't something you have or don't have in your DNA—experts agree that it's something you can learn.
"Transformative resilience is the art of realizing you can really only succeed from failure and tragedy," explains Ilene Ruhoy, M.D., Ph.D. "We learn to navigate our lives through the downturns since it helps us to understand who we are, what we want, what we need, and how best to serve our purpose."
Understanding how transformative resilience works. When we get knocked down, it's hard to imagine whatever difficult time we're going through ever being something we grow from. But Alison Stone, LCSW, says healing from emotionally difficult experiences is a lot like healing from a physical injury. "Perhaps your physical injury healed on its own through rest, or maybe you needed medical intervention like a cast or physical therapy. Regardless, most of us have witnessed our bodies recover," she explains. "Transformative resilience works because our brains, like our bodies, are hard-wired to heal and adapt. Our brains are very capable of taking in new information and using that to guide our behavior moving forward."
Of course, sometimes that adaptation doesn't happen naturally. In that case, Stone explains, most people seek therapy to help move the process along. Sometimes that adaptation or healing doesn’t occur so seamlessly, which is often why people seek therapy."
Who displays transformative resilience? If you're thinking, That sounds great, but it doesn't sound like me, think again. If you've ever stepped foot in a therapist's office—or even thought about it—you're likely to experience transformative resilience at some point. "I’d say most people who come into my office are displaying transformative resilience," says Stone. "If you're willing to be open and vulnerable in order to heal, I think that’s something that should be celebrated."
A more concrete example Stone sees often is people who come to her because they've been hurt by someone close to them. "Often the instinct is to want to change the other person. Well, we aren’t going to have much luck changing other people. But, we can heal the wounds inflicted and decide if or how we want to participate in these relationships going forward," she explains. "I’ve also seen how crucial a shift in perspective is. Many people blame themselves for traumas they have suffered, and releasing this burden can ignite their inner resiliency."
How to set yourself up for transformative resilience.With the right training, anyone can develop transformative resiliency," explains Elizabeth Lombardo, Ph.D., author of Better Than Perfect: 7 Strategies to Crush Your Inner Critic and Create a Life You Love. "It is a skill that can be learned and practiced."
Lombardo emphasizes that the belief that you have the power to respond to a specific situation the way you want to is key to transformative resilience. "You can 'train' yourself by looking for positives, even in less-than-positive events," she says. "For example, looking back in your life, when were some times when you were upset about what was going on, only to realize in the long run it was a blessing? Maybe your relationship ended, or you did not get a job you wanted at the time. And yet, with time, you found a better partner or work."
It may not be easy, but remembering the power of transformative resilience when you're going through a hard time is crucial to coming out stronger than ever on the other end.
Fascinated by the concept of transformative resilience? Here are five things resilient people do differently.
Every year the month of October sees several national campaigns designated to bringing awareness to the widespread problem of depression: National Depression Screening Day (October 8th), World Mental Health Day (October 10th), Mental Illness Awareness Week (October 4-10th), and Depression and Mental Health Awareness Month (October).
Depression is costly to society. According to the National Institute of Mental Health, an estimated 1 in 4 adults suffer from a mental health disorder in a given year. In 2004, this figure translated to 57.7 million people. Approximately 19 million adults suffer from depression alone, and major depressive disorder is the leading cause of disability in the U.S. Up to one-half of all visits to primary care physicians are due to conditions that are caused or exacerbated by mental or emotional problems. Studies indicate that the cost of clinical depression exceeds $47.3 billion annually. Of which $24 billion is comprised of lost productivity and worker absenteeism on the job.
With so many Americans suffering from mental health disorders, the FDA estimates that sales of antidepressant drugs, such as Prozac and Zoloft reached over $10 billion in 2005. About half the people who seek treatment for depression are not helped by psychotherapy and medication or withdraw from treatment too early. Of those who recover, more than one third relapse within eighteen months. In a study of 2,318 patients conducted by the University of Colorado, only 20 percent of the patients taking medication were found to improve as a result. This suggests that alternative treatment may be very helpful for people who suffer from depression.
To help alleviate depression, more and more Americans are turning to age-old holistic modalities such as Chinese medicine. “Chinese medicine,which includes acupuncture, massage and herbal medicine, is a very popular way to help individuals relax and re-energize. It can help with conditions such as anxiousness, depression, insomnia, tense muscles, headaches and pain; all things many of us experience”, said licensed acupuncturist and American College of Traditional Chinese Medicine clinic dean, John Kolenda. The College’s low-cost Community Clinics have treated patients with mental illness since the 1980’s, and see upwards of 17,000 patient treatments each year.
According to Kolenda, many patients report an enhanced sense of well-being and a deep feeling of relaxation after an acupuncture or massage treatment. These modalities alleviate stress and depression symptoms by releasing endorphins, the body’s own natural painkillers, and improving the circulation of blood and lymphatic fluids which bring fresh oxygen to body tissues. This increased oxygen flow eliminates waste products from inside the body and enhances recovery from diseases. Acupuncture and massage also decrease the stress hormone cortisol, lower blood pressure, reduce the heart rate, and relax muscle tissue. “One of the reasons acupuncture and massage are so popular is because they provide health benefits that are also free of side effects when performed by a licensed professional”, Kolenda said.
This 3,000-year-old gentle modality provides a safe, effective alternative to controversial antidepressants and treats the symptoms of depression and anxiety as well as the root or underlying cause of imbalances of the body. Depression is most commonly caused by a blockage of Qi (or, vital energy) in the body. It is Qi that regulates spiritual, emotional, mental and physical balance. Blockages of Qi can be caused by many factors such as physical trauma, emotional trauma, inherited weakness of Qi, poor diet, or chemical, physical and emotional stress. Acupuncture keeps the flow of this energy unblocked, and because Chinese medical practitioners treat patients as individuals, they consequently treat the true source of the depression instead of just prescribing pills.
According to recent studies, acupuncture is a valuable adjunct therapy for those suffering from mental health disorders. A study conducted at the
University of Arizona examined the responses of 34 depressed women to acupuncture, generalized acupuncture that didn’t use specific points, and no treatment at all. Of the women who received acupuncture specifically for depression, 43 percent experienced a reduction in their symptoms, compared with 22 percent who received general acupuncture and 14 percent who received no treatment. After eight weeks, over half of the women who received specific acupuncture were no longer depressed.
Other studies verify these findings. Holly Middlekauff, an associate professor of medicine at UCLA, and a team of investigators presented their research at the American Heart Association’s 2001 Scientific Sessions conference, which showed that acupuncture can block sympathetic nerve activity. Twenty-two advanced heart failure patients (both men and women, average age 43) were used in the study. Blood pressure, heart rate and
sympathetic nerve activity – which regulate a person’s heartbeat and is also responsible for the "fight-or-flight" response – were measured in each patient immediately after subjecting them to four minutes of anxiety-producing situations. Results showed that sympathetic nervous system activity increased approximately 25 percent as a result of the mental stress.
After the test, the researchers divided the patients into three groups. The patients received either authentic acupuncture delivered for 20 minutes at established acupuncture points; sham acupuncture delivered at non-acupuncture points; or no-needle acupuncture, in which the patients were told they’d receive acupuncture, but were in fact only tapped by a needle holder on the back of the neck. The mental stress test was repeated after the acupuncture treatments, with the same measurements taken at the conclusion of the second test. While patients in the sham and no-needle group experienced the same increases in heart rate, blood pressure and sympathetic nervous system activity after taking the second test as they had after taking the test the first time, patients in the authentic acupuncture group showed no increase in sympathetic nervous system activity.
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Being a woman in Zen was problematic from the start. My first teacher found me physically attractive and seemed unable to keep himself from letting me know this.
As a woman studying Zen, I had heard Buddhist teachings that females were less able than males to practice the dharma and recognize their awakened nature. This belief was not surprising. Having grown up in the U.S. in the 1950s, the assumed inferiority of women was the air I breathed. And though the feminism that emerged in the 1960s helped me see through these assumptions, I continued to struggle with them. It was hard for me to challenge the patriarchal culture that surrounded me; in some part of my deep unconscious mind, I carried the idea that I was less than a man. Still, I was determined to practice feminism and live a life of equality between men and women.
At one point early in my Zen studies, I witnessed a public conversation between a female student and her male Asian teacher that startled and challenged many of the assumptions I had been carrying. The student asked, “Can a woman attain awakening?” The teacher said, “No.” After the gasps subsided, he said, “And a man can’t either. No man, no woman, no attaining.” As I continued my journey into the heart of Zen practice, I held this story close. Wanting to be a good Zen student, I did my best to ignore the differences in gender that were so obvious and strong in my life. I worked hard to view gender as empty, but as time went on, I had to admit this view was limited and not really useful in helping me solve the koan of being a woman in the world of Zen.
How do I understand my gender within the context of Zen teachings? Am I a woman? Am I not a woman? Could there be some way to embrace my gender without it getting in the way of my Zen practice? I’ve found myself circumambulating these questions for the last thirty-five years of my Zen training and teaching.
Being a woman in Zen was problematic from the start. My first teacher found me physically attractive and seemed unable to keep himself from letting me know this—a betrayal of trust that came on gradually and eventually ended with my leaving him. I was a slow learner in this area, confused by his insistence on our potential sexual connection. Not only were both of us married but my husband was also one of his students! I found myself flattered by his attention, but I knew deep in my bones that the sort of relationship he wanted was not about the dharma. My sangha brothers and gay sisters were free to be themselves with this teacher, but I felt trapped in my woman’s body, limited to being an object of desire rather than a whole person.
Often, when I acted strongly and clearly, I was criticized for not being feminine enough. I was told to be softer. This advice was never directed toward my male sangha brothers
Of course, this particular issue is not unique to Zen. And it’s not new. We see this old story of the objectification of women by the male patriarchy everywhere in history and in modern Western culture. I was enacting a stereotype: the vulnerable young female student of a powerful older male teacher. I felt betrayed, confused, angry, and sad for many years.
For me, retreating into the emptiness of gender was strongly appealing. In my life, this view became a lifeline I could use to help free me from the attention of my teacher’s sexual predation. Sadly, other women in our sangha were not so lucky. And, as I came to understand later, seeing into the emptiness of everything is only half of the path of awakening.
While trying to work out these issues, I continued my life as a straight woman in modern America. I married and had a child. I worked as a therapist and as a mindfulness teacher and trainer, helping people live fully in the midst of grief and despair. While striving in my Zen life to be simply a neutral person of the way, in my everyday life, I was definitely a woman.
As I became a senior student, I struggled to own my power. Often, when I acted strongly and clearly, I was criticized for not being feminine enough. I was told to be softer, to not be so sure of things. This advice was never directed toward my male sangha brothers. I encountered the same dilemma in my professional life.
This struggle began to resolve when I met my second Zen teacher, James Ford. He combined dharma clarity with tenderness and kindness and also demonstrated a scrupulous respect for boundaries, managing to keep his desires from inappropriately overshadowing his teaching. And even though, by the time I met him, I had made a habit of hiding my own strength, he quickly recognized similar leadership qualities in me. His no-nonsense unwillingness to buy into my lack of self-confidence helped me develop my capacity to become a teacher, eventually enabling me to receive transmission from him. Even then, it has taken years for me to integrate my gender, my personality, and my dharma understanding.
I have been inspired by the examples of other women Zen teachers, and I have learned a great deal from many of them about how to be a woman of the way. But the help I received from these wise and compassionate women was always tempered by the fact that many of them were dealing with similar issues, such as being disrespected for their strength and power or recovering from (or denying) their own histories of abuse by their male teachers. Other women sangha members have also been helpful. Through candid conversations with sangha sisters and female teachers, experiences that once seemed personal have been revealed as all too common.
And so I looked to the koan stories that have inspired my heart since I first began practicing Zen. When I first engaged in koan practice as a young student, there were very few examples of women teachers in the traditional collections. More recently, some helpful guides in this area have been published, including Grace Schireson’s Zen Women, which offers stories about the scattering of women whose stories were recorded in Zen histories. Many of these women are merely unnamed background characters, “old grannies,” as one male teacher describes them, or women who sell tea by the side of the road. Often, they seem to exist solely in relationship to men, valued for their capacity to challenge male teachers. The Hidden Lamp, a collection of stories edited by Florence Caplow and Susan Moon, gathers many more examples of women teachers from the last two and half millennia, with commentaries by contemporary women teachers.
Wanting to be a good Zen student, I worked hard to view gender as empty, but as time went on, I had to admit this view was limited.
Iron Grindstone Liu was the first named Zen woman I came across in my studies, decades before these two books were published. I found her fascinating right from the start. Born in 871, her full name was Liu Tiemo, and she was a student of Guishan, the other character in this koan. It appears she had her own temple and was considered an equal to the male teachers she met. In one encounter, Zen master Zihu asks, “I have heard of Iron Grindstone Liu. They say you’re not easy to contend with. Is that so?” And she replies, “Where do you hear that?” He continues, “It’s conveyed from the left and right.” She replies, “Don’t fall down, Master.” The dialogue ends with Zihu driving her out of the room, beating her with a stick.
Here is a little hint of Liu’s capacity to blend the relative world (not easy to contend with, and heard about from left and right) with the absolute, as she tells Zihu not to fall down among these sorts of unhelpful comparisons and judgments.
I so much wanted to be like her—an Iron Woman, as Grace Schireson describes her, tough and more like a man than a woman. She was so far from who I—a young, small, and timid woman—could ever dream of being. In studying koans, though, it’s important to look beneath appearances. Perhaps Liu had found a way to solve the koan of being a woman in Zen.
Liu’s teacher was Guishan, who was a student of Baizhang. In one of my favorite Zen stories, which takes place when Guishan was still a student, his teacher asked him to see if there was any fire left in the stove. Guishan searched the ashes and was unable to find anything, at which point Baizhang himself poked in the ashes and found an ember. Showing it to Guishan, he said, “You said you didn’t see anything—but what about this?” As students, we lose faith in the teachings on a regular basis. A true teacher helps the student find the glowing ember of the awakened heart, alive in the ashes of whatever is presently acting as an obstruction.
After this, Guishan became the cook at Baizhang’s monastery. In another famous koan, Baizhang was looking for someone to be the teacher at a new monastery on Mount Gui. He put a water bottle on the floor and asked his gathered students, “You can’t call this a water bottle—what do you call it?” The head monk answered, “You can’t call it a wooden sandal!” Guishan, however, simply kicked the bottle over and walked away. Baizhang named Guishan head of the new monastery. On Mount Gui, Guishan built himself a hut and continued his practice. After about eight years, students began to gather around him. Their number eventually reached fifteen hundred. Guishan, notable for his calmness, patience, and skill at teaching, produced forty-one successors, including Liu Tiemo.
Looking at the famous dialogue between Guishan and Liu—“Old cow, you’ve come!”—the two of them appear to have had quite an unusual relationship for the times they lived in. Even for the present time, it’s refreshing to see two people as playful as they are in this case, both embracing and disregarding gender. Pat Enkyo O’Hara, in her commentary on this koan in The Hidden Lamp, calls the exchange “a perfect pas de deux…satisfyingly complete and heartbreakingly intimate.”
Yuanwu comments: “Might as well gather together, touching the difficult. Playing her part, this experienced old woman does not play by the rules.” Here is the first clue to Liu’s freedom, a woman who is not trapped by gender but is most certainly a woman. Guishan calls her “Old cow!” In English, calling a woman a cow is an insult, but in this relationship, it functions as a recognition of sameness and differentiation. Guishan himself identified with being a water buffalo, saying that was the form in which he would be reborn. Here, the male buffalo and the female cow meet, ready to engage.
Yuanwu compares the encounter to searching for something in the shadows of the grass with a pole. It can’t yet be seen, but it can be touched, remotely at first. It’s an invitation. Guishan is asking, “What will you do, my old friend, with this moment?”
Liu invites him to a feast—a simple and direct response from the world of consensus reality. There is nothing complicated. Yuanwu comments on this directness, comparing Liu’s words to an arrow that doesn’t miss its target: “In Tang Dynasty, beat a drum; in Korea, dance.” Be appropriate to the place and the situation you’re in. She is like the arrow, suddenly releasing itself into the air with no hesitation.
And now the story takes a turn. Guishan doesn’t answer from the binary, dualistic world. He simply lies down. Yuanwu approves. As he comments, Guishan has made an accurate hit himself. Two arrows have met in midair. The mist is dissipated—any confusion is set aside.
Liu responds by leaving. There’s nothing more to say. Yuanwu approves of this, too, and calls it a celebration. The line “meeting the pivot and acting” refers to the capacity to quickly transform from oneness to differentiation at the moment the situation pivots. Everything balances on a fine point, ready to change in a heartbeat. If we have learned to live in both the worlds of oneness and form, we can perform this dance together.
The last two lines of this new translation—“Iron Grindstone Liu! / Nun—yes!” are not usually found in modern koan collections; Dosho Port told me he discovered them in the Chinese characters. He and I were mutually delighted with them. For me, they are the affirmation of a strong woman who can play in the fields of emptiness and form, as required.
There is a practice in Zen of saying yes to everything we encounter. When something happens that is hurtful, when something is joyful, we just say yes. After all, saying no is a form of objecting to reality. We can certainly spend our lives doing this, but ultimately we have to bow to what is real. (And sometimes this includes saying yes to the mind that rejects.)
Here, Xuedou and Yuanwu say yes to Iron Grindstone Liu. As I reflect on what I have learned in my life as a woman in Zen, I can remember so many times when I said no to who I am, letting myself be defined by what others thought I should be. Now I see my work in the world as being fully myself. I am a woman. And I am not a woman. Ultimately, I am both a woman and not a woman. When I get up in the morning at a sesshin, I put on my women’s underwear, comb my hair, and don my priest’s robes. On other days, I put on my women’s underwear, comb my hair, and don jewelry. All of these clothes and markers of form are made of emptiness.
In the current political climate, it’s harder to ignore the misogyny behind blatant criticisms of strong women and the denial of our value as full human beings. We encounter sexism every day—sometimes like a shadow and sometimes unavoidably in the news, in relationships, in our families. Is it possible, without falling into overreaction or ignoring, to meet each instance directly? There is an emotional cost to being present in this way. Sometimes we feel the pain and injustice of objectification more strongly, sometimes less. But either way, through the practice of widening our view of reality, of bringing together the worlds of sameness and differentiation, we can learn to feel them fully. Our duty, as practitioners of any gender, is to say yes to whatever arises and then to act from the balanced place of response rather than reactivity.
My intention is to be like Iron Grindstone Liu—to find a way to be direct and playful in my encounters with what has so often been confusing and frustrating. Woman! No woman! Woman Zen teacher—yes!
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M.Om., Dipl. Acu (NCCAOM) L.Ac.
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