Isolation is just not good. We are not to live in a silo. No man is an island, right? And so having a community around us, and it doesn't have to be, community doesn't have to be a big, big gig.

you know, area. It doesn't have to be a lot of people. It could just be a small social connection. Social interaction is really good, cognitively, emotionally, psychologically, physically.

We need touch. We need conversation. We need all of those things. And so the more that we're able to connect with one another, I believe that that's an opportunity for us to hear ourselves or to feel heard.

It's an opportunity for us to also find out that we're not in this by ourselves and to find out there is support and there are people who are there to help you and navigate whatever challenges you are going through.

This is Doctor Talks, real talk from real doctors on the issues that matter to you most. Welcome to the Functional Edge podcast. I'm your host, Dr. Julia Ward, medical director and founder of Balanced Body Functional Medicine.

Today, we're honored to welcome Nettie Jones to our show. In this episode, Nettie will be sharing insights on psychology and counseling and offering expert guidance to help you navigate your health journey with the latest advancements in functional medicine.

Stay tuned for an engaging conversation that promises to empower and inspire your path to wellness. So Nenny, thank you so much for being on and I'm going to turn it over to you to let you tell us a little bit more about yourself and then we'll get to some questions.

Yes. Well, thank you so much, Dr. Ward, for having me on the show. I'm so excited about chatting about those things that I'm so passionate about. I am a licensed psychotherapist.

I have been practicing for probably over 25 years. I have grown to love what I do and specialize in working with women and women's issues. Whatever it is that we women deal with is kind of what I do from anxiety to depression, the very common things or common things that we women experience in our lifetime.

So yes, I am excited to chat about those things. Awesome. Awesome. Well, let's start with some questions about chronic stress and sort of understanding this modern epidemic, if you will.

Chronic stress seems to be at an all-time high, especially with today's fast-paced lifestyle. How do you define chronic stress, and how is it different from short-term stress responses?

Yeah. You know, Julia, chronic stress, you know, now we're labeling it, we're giving it a name and we're actually, I think it's really good when people can say, oh, this is what I'm experiencing and what do I do about it?

So that's always helpful. But chronic stress is just stress that has been prolonged. for an extended period of time, as opposed to, you know, short-term stress.

But, you know, that's our body's fire flight. You know, it's more acute. It's something that happens. It's more immediate, right? And it signals us to say, hey, listen, something's not quite right here, so that you can attend to whatever it is.

But chronic stress, is long lasting and it starts to affect us physically, emotionally, and psychological wellness in those areas. Yeah, absolutely. So what are the most common physical, emotional, and behavioral symptoms of chronic stress that often go unnoticed?

Yeah, you know, I think a lot of us, especially women, we operate in this space of doing, right? And so those things that we experience, we kind of minimize them.

So it can be, you know, physical symptoms could be tension, headache, you know, abdominal problems. And as it relates to, you know, cognitively or emotionally, it's for focus, irritability, memory impairment.

So those are very subtle things that are associated with stress or chronic stress. But because we're always operating in this space, it just becomes something that we just move through.

Yeah, you just get used to it like this is my norm now. I'm just always irritated and angry or whatever the symptom might be. Yeah, I'm always an angry woman.

Right. So how does chronic stress contribute to physical health issues such as heart disease, hormonal imbalances or immune dysfunction? Yeah, you know, one of the things, and I am constantly telling clients, you know, there is something called chronic stress, and these things lead to disorders and diseases, right?

And so when we look at heart disease, you know, hypertension, you know, elevated heart rate, and so all of those things, flat buildup, these are things that contribute to our physical health that could impair that.

You know, and then so we start looking at things like, you know, our hormones. And so those things can have an impact on us as well. Yeah. Yeah. So in your experience, what are the most overlooked causes of chronic stress?

Like, are there primarily external factors or can internal patterns and beliefs also play a significant role? Well, you know, I think it's a lot of it is a combination of both I think it's it's individualized I think people experience things very differently but there are some commonalities right.

And so, you know, I think one of the. most things that most people experience is, I call it stinking thinking. It's the negative self-talk. It's the ruminating.

It's replaying very stressful situations, relationships, finances, and job-related. 95% of my practice is working with women, and I find that a bit part of their stress comes with their occupation.

So occupationally, financially, and these create a lot of stressors. And so you find that this is ongoing, ongoing, ongoing, ongoing. And so I think those are the subtle things, but yet very, very prominent.

I think it's interesting how our brains just automatically keep kind of focusing on the negative. And I guess it's our brain trying to keep us safe, but it can be really debilitating if you're just constantly focused on that negativity.

Yeah, it does. It keeps us stuck. Yeah. So what role does lifestyle medicine play in mitigating the effects of chronic stress? Oh my gosh. Oh, wow. Huge.

Huge, you know? And this is the deal. These are things that you don't have to go out and purchase, right? So they're, I mean, you know, they're probably like, there's like sleep, you know.

I'm learning our bodies and exercise, hydration, and of course, fueling our bodies with the right things. And so, you know, I share with clients, if we can do those things, you know, we can just get that under control.

You will see some of these symptoms that you experience that are associated with stress or other, you know, disorders, you see that they will decrease significantly.

Maybe I'll say that, but it's a good start. Right, right. Just get some of those basics out of the way. And then making sure you're managing your stress, you know, having good coping mechanisms, having a good social support system, you know, people you can speak with and talk to, and then making sure you're in a healthy environment.

Yes. Yeah. So many people struggle to recognize the early signs of depression and anxiety in themselves or loved ones. What are some of the subtle warning signs that people should be aware of?

You know, that's a huge question. And I say that because the word subtle is a word that's often used. But then in retrospect, if we're talking about looking at someone, we recognize these were the signs, right?

So you know what I mean? Addictive effect, while it's going on, we minimize, oh, they're just tired, they're fatigued, they're irritated, they're not feeling well, those kind of things, right?

As opposed to just kind of digging a little bit deeper and seeing what's going on there. So they are subtle at… but they are very common, you know, they're like textbook.

And so for, you know, with depression, the sadness, you know, feeling of being worthless or not feeling that you have purpose, those things that you enjoy doing, you no longer do, you know, you isolate yourself, sleep disturbance.

you know, those are just kind of hallmark to depression. And then you look at decreased appetite, an increase in substances, something like, you know, drinking more alcohol or using drugs, not just recreationally, but also to kind of self-medicate.

And again, this is a change in behavior. This is the change in how a person is, if you're observing a loved one and or if you find yourself doing some of those things.

And when I speak with my clients who have had recurring or have recurring episodes or bouts or experiences with depression, I often say, okay, so what are those things that indicate that you may be going down that little pathway again, you know, and okay, are you isolating?

Are you not going and doing the things that you normally would do? Are you having problems sleeping? And of course, physical, you know, there's headaches and abdominal problems and, you know, those kind of issues as well.

Yeah. And again, I find it interesting that it's so much easier for us to see signs of depression, anxiety in our friends or other people that we care about, but not so much in ourselves.

Absolutely. Absolutely. You know, and for a lot of us, we've been in this space for such a long time, it feels like it's just what we do. And it's almost as if when you're around people, it's like, you know, lights, camera, action, how's it going?

Oh, everything's fine when it's raining, right? And then it gets to the point for some that they can no longer, you know, play the part. Right. What they do is they avoid.

They avoid, they start isolating. Right, and so they self-isolate, absolutely. Yeah. So depression and anxiety can manifest physically, not just mentally.

What are some of the physical symptoms that might indicate someone struggling with one of these conditions? Yeah, you know, that's the deal with anxiety.

I tell you, it feels like it could be something physiological and it does. It actually, you can measure it, right? You can measure it. As a physician, I can come in and my, you know, heart rate may be elevated, my blood pressure may be high, my pupils may be dilated, you know, all of those things.

I may even experience, you know, some chest pain, difficulty breathing, you know, numbness, all of these things that can feel Like, you know a heart attack or something like that But actually after it's ruled out clearly you start to see that these could be symptoms associated with anxiety So for a lot of us and I you know, I share with with clients all the time I suffer from panic attack, right and so Recognizing what that is and how I can manage it gives me an edge on managing that for myself But yes for sure anxiety can be physiological in nature And as it relates to depression, if it's, you know, where you're to the point, excuse me, where you're just not moved, you know, want to get up and move and take care of yourself.

And for some people, they experience a lot of fatigue, lack of motivation and extreme, you know, I guess that fatigue or feeling tired. And so yes, these things can be physiological.

And like I say to most clients is that anxiety and depression is like old married couple, they kind of go together. They do. They go hand in hand. Where depression is lurking, where depression is lurking, anxiety, and they just kind of connect.

Yeah, yeah, absolutely. They overlap quite a bit. Yeah, and I can tell you from personal experience, just looking at some biomarkers on myself after going through a particularly stressful time, it really does have an effect on blood sugar regulation, even on my cholesterol.

There's all kinds of physical manifestations. How does chronic stress contribute to the development of depression and anxiety? Is it always a causal relationship or are other factors playing a role?

Well, you know, both anxiety and depression are multifactorial in nature. You know, I don't necessarily know that there is just one determining factor.

And so, you know, we all deal with things very differently. So some people have really healthy coping mechanisms and, you know, let me just say this. Healthy coping mechanisms for me today and this space in my life may not be the same healthy coping mechanisms I need five years from now.

So I have to make sure that my mechanisms kind of match where I am and that they are appropriate and that they are They work and they're healthy, right?

And so some people lack that. And then you can be predisposed for depression and anxiety. Those are things that definitely, you know, can happen. And then we look at, you know, depression, is it situational?

You know, if you've just lost someone close to you in your family, if you've lost a job, if there is, you know, a life crisis or if you've got some health challenges, these are all things that can warrant and you present with those symptoms that are consistent with depression.

And so it is one of those things where there are oftentimes multiple things that can contribute to one having an onset of depressive episodes and or anxiety.

Yeah, yeah. Well, let's kind of move on to like what to do about this now. So some solutions. So what are some daily practices or lifestyle changes people can implement to build resilience against stress, anxiety and depression?

That is, you know, that's a million dollar question. I wish I had the answer. I would be probably one of the richest women in the world, right? Well, you know, I think managing that requires a person to be aware of themselves.

That's number one. And to recognize that I'm experiencing stress, I am experiencing symptoms associated with anxiety and depression or whatever that might be so that I can now manage those things.

So I think the first thing is the awareness. So now that I know, acknowledge, right? And so now what are my options to doing? As you know, talk therapy is awesome.

And what I love about talk therapy is I told people all the time, I'm not the expert. You are. You are the expert on you. I just asked you good questions.

And being able to process what you're experiencing and to kind of contextualize it, take ownership, and then also help individuals develop good coping mechanisms.

And, you know, Dr. Ward, what you do is an amazing thing. You know, it's like people present with symptoms. And so I guess traditional medicine basically gives you something to mask the symptoms, right?

They can go to a functional medicine doctor and get down to the nitty gritty. Okay, on the surface, this is what's going on, but what's creating this?

Why isn't the serotonin being produced in the necessary range, right? Okay, so what do you find that? And so you can explore a little bit more and then come up with treatments that will be more beneficial to a lot of patients, right?

And educating people on choices, So lifestyle changes, exercise, doing things that they find pleasure in, you know, meditating, quietening the mind. These are all things that I think will help as it relates to, you know, interventions or treatments.

Of course, their medication, those who might, that is warranted. So ideally, you know, a combination of having a safe space to talk, process, and then having some specific things to do to manage one's lifestyle.

Yeah. Well, that's great. That sort of leads into the next question about how important mindfulness, meditation, and breath work are in managing mental health and if there's any specific techniques that you recommend to your patients.

Yeah, you know, everybody's different. You know, I can talk to a client about meditation and the first thing they go is, I don't do that. I can't sit still long enough.

If I mention yoga, oh no, that's too slow. Oh, I can't, you know, and so you kind of have to go where people are. And so being mindful, I find, is one of the things that most people, like the glove that kind of fits most people, they're open to the process.

It's just explaining what mindfulness is and how simple it can be to just pay attention to what's going on right now in the time. And, you know, the breath work is vast.

And it can be simple, but then it can be complex, you know, for the person who'd be like, well, what's bad knee? What's breath work? I breathe every day.

And sometimes it's just a simple thing of taking five, you know, breathing in and out, you know, inhaling and exhaling and just kind of sitting down for the moment to breathe.

And so I definitely think that these all benefit. It slows people down. It allows people, it forces you to pay attention to yourself. I think one of the most challenging things to do is to quieten our minds.

Yes, absolutely. What role does community and social support play in preventing or managing depression and anxiety? Oh, isolation is just not good. You know, we are not to live in a silo.

No man is an island, right? And so having a community around us, and it doesn't have to be, community doesn't have to be a big, big gig. you know, area.

It doesn't have to be a lot of people. It could just be a small social connection. Social interaction is really good, cognitively, emotionally, psychologically, physically.

And then just sometimes some people just to say, hey, I miss you. It's good seeing you. And that just feels good. So yes, definitely community and connecting and having a support.

And you know, this is really interesting, I find, but it happens more than I would like to hear is that there are a lot of people who are very isolated.

You know, they locate for jobs. And you know, being an adult, it tried to find friends. It's like, you know, when you're a kid, you walk up and go, Hey, would you like to be my friend?

But, you know, as an adult, that makes it a little bit more challenging. So people relocate for whatever reason for their jobs or life, right? So connecting with people may sometimes be very difficult.

Then, you know, after COVID, a lot of people had to start to work from home, which meant they were a little bit more isolated. So we definitely saw significant increase in anxiety and depression because people were not socializing the way that they have been for.

So it is very important to have a support group and community. Absolutely. So how can individuals become more self-aware of their mental health state before reaching a point of crisis?

Recognize that having these conversations like what you're doing on your podcast is so important. The more we talk about mental wellness, and I always try to say wellness because it's something when you say mental, you say health, it will shut people down.

Now, but when you start talking about stress, People don't like to hear the word depression, but they will use the word anxiety, right? But the more conversations we have, the more we talk about this, and the more we talk about these, as you said, subtle symptoms or subtle things that we can identify, then it allows us to identify those things in ourselves, maybe have us pause and say, I have not wanted to connect with people lately.

I've been really irritated, you know, a lot of headaches, a lot of, you know, Donald saying, I'm not sleeping well. Yeah, well, what's wrong with me, right?

And if nothing else, it may get them to go to the doctor's office. And so, you know, going and talking to your physician and then ruling out that there is nothing else going on and then being able to say, you know, it might be really good if you find somebody just to kind of talk to, to kind of navigate through where you're going.

And the more we talk about talk therapy, a fancy name is psychotherapist. But when I say talk therapy, it's more palatable for people. They're more inclined to want to, you know, talk.

And so that is what I believe. We have to, you know, shout it to the mountaintops and we have to talk about mental wellness and we have to include it in wellness.

And that's just not the physical. It needs to be the whole, the whole wellness. Yeah, absolutely. What's the best way to help without being overbearing or dismissive?

Yes, that is such a fragile, fragile one. And I think the first approach is to approach it with love and concern. And just say things like, I noticed that lately you've not been yourself.

How can I support you? What can I help you with? I think a gentle soft touch. And instead of saying things like, I think you're depressed. I think something's wrong with you.

asking them you know what's going on and sometimes people will share what's going on and then you're able to say oh my god well that makes sense that you've been you know behaving this way or you've kind of pulled back yeah and so what are some of the things that i can do to kind of help support you where you are Who can I help?

Who can I contact for you? Those are the kind of things, I think, coming from a place of loving concern and being compassionate, patient. And I think that's the hard part.

Sometimes we get a little frustrated. And if you ever suspect that someone is suicidal, I think it is very important to ask very specifically, are you going to harm yourself?

Are you suicidal? That's something that you don't need you know, kind of softly coddle them and, you know, that kind of thing. I think you need to go straight to it.

And then, of course, if you do feel that that's the case, then, you know, get them some support immediately. Right. Right. That's not something you want to just sweep under the rug.

No. Yeah. Not at all. So in your opinion, what are some of the biggest misconceptions society still holds about mental health, particularly regarding depression and anxiety?

Well, you know, in the word mental health, people automatically say, well, I'm not crazy, you know, and, you know, anxiety can present in many ways and many forms of, you know, and so anxiety can look like many things, right, untreated.

And so a lot of people have symptoms that that look like other disorders. And untreated, it can really, it could really become problematic for individuals.

And so the support, the help and letting them know it's treatable, you know? And I often say things like, if you knew that you had high cholesterol and your physician recommended that you alter your diet, do some exercise, and then if that didn't work, then maybe these are some medications or supplements that you could do to improve that.

Would you do it, right? If you had hypertension and your doctor told you to do all these things, what is something about when you start talking about depression and, you know, if you talk about anxiety or if you talk about any of the other disorders, bipolar disorder, schizophrenia, if you talk about any of those things, people don't want to discuss it.

because they automatically don't want to be labeled and labeling it's the crazy label. The art is a lot of times people don't feel that there's hope for them because For some, they've operated in this space for a while and been able to kind of manage it themselves or to the point where it's not starting to affect them occupationally or socially or relationally, right?

And so now that it is, it's something they're embarrassed or they think this is the way I'll always be. And so they sometimes don't have the hope. So again, it's treatable.

A lot of mental disorders are very much treatable and manageable like anything else. It's just the acknowledging it and diagnosing and then looking at the ideal treatment model module for that individual.

Yeah, right. Which leads us to our next question of how can health care providers better integrate mental health awareness and prevention into their practices?

You know, I think most family practice doctors, internal medicine doctors, I think are pretty good with that. I know there are some who will just refer out to psychiatry simply because they are not as comfortable with diagnoses and treatments.

But generally, for anxiety and depression, most primary care doctors are pretty comfortable with that. And once they find that they are not able to kind of manage that pharmacologically, oftentimes they will refer out to an area of specialty, but typically psychiatry or neurology just depend on our new like, you know, one of the things have a specialization in perinatal mood disorder and one of the challenges early on was you know doctors beyond the you know this little edinburgh test that they would give right just to kind of see where women were there was no really follow-up after that woman would go and do her follow-ups post-pregnancy and so so often women would deal with, you know, post-pregnancy or postpartum disorder and go untreated.

And so I think for a lot of obstetrician gynecologists, it's kind of like, what do we do with this, right? What do I do with this? And so it was just something that I believe the awareness and not just the awareness, because I know that they are aware, but where do I send my patient?

Where do I send my patient so that the best services, right? That's a whole nother conversation. A lot of women who are breastfeeding may not want to, you know, take traditional medicine.

And so there are just a lot of different, I think, you know, the more that, I don't know, you could probably speak more to this about your training, you know, how much of your training You may have done a psychiatry rotation, but, you know, how much of your training is in mental health, right?

And so what do you do with it? So maybe the awareness or doctors having an interest in being aware and how they can better, you know, serve their patients as far as, you know, sending them out, following up with them outside of…

Writing a prescription. Yeah, exactly. There's so many other ways to address it. Yeah. Are there any emerging treatments or research findings in the field of mental health that you're particularly excited about?

You and I have talked a lot about, you know, some of the psychedelics. And so I'm really keeping my ear to the ground on that to see how that's going.

Um, research does have some very good outcomes, you know, question is finding the ideal candidates for that, you know, for treatment and especially for you know, those patients who are very resistant to certain, you know, medications and or have been kind of in this rut, you know, for so long.

Yeah, absolutely. I know on, from my end, I'm particularly excited about some new kind of DNA testing that's looking at genomics and how that affects, yeah.

So definitely, you know, there's a company that will, you know, and it's a nice easy task because it's just a cheek swab. But you get so much detailed information about so many different, you know, these SNPs or single nucleotide polymorphisms and how it affects, you know, your production of neurotransmitters, your absorption of vitamins.

your propensity for, you know, different things. And it's never just a one gene kind of a thing. There's no one gene for depression or anxiety. It's a conglomeration of multiple different things.

And so having that information, you can kind of more tailor specifically what nutrients, what lifestyle interventions are going to be the most beneficial for you.

So I'm excited about that. Yeah. And of course, you know, we've been offering ketamine therapy here, and that's ideal for people who do have treatment-resistant depression, anxiety.

It's been great for those with PTSD. Of course, it's always better when it's done in conjunction with a therapist. I think you get more out of it. Yes.

So what advice would you give to someone who feels stuck in a cycle of stress, anxiety, or depression, but doesn't know where to begin seeking help? You know, ironically enough, I think they should start at their primary care office.

And I say that simply because you want to rule out anything else, you know? You want to rule out anything medical. And so a lot of times people often will pick up the phone and call or look up a therapist, a psychotherapist, More based on emotional issues, relational issues, right?

And then you find out that there are these other, you know, they're experiencing some physiological issues. And of course, at that point, I will, you know, recommend that they see their doctor to rule out anything.

And so, you know, feeling stuck and in this rut and feel like you just can't move. And, you know, depending on what those things are, I would, I would go and just say, hey, listen, this is what I'm experiencing.

This is what I'm feeling. And at least have somebody kind of screen it. Right. And so, but if it's more situational, if it's lifestyle, if it's those kinds of things, for sure, you know, find a therapist, a psychotherapist or a psychologist that you can speak with to kind of process and move through whatever life challenges you might have.

There are, you know, Psychology Today is a great source. It's a national platform and you can go and it will allow you to find a mental health professional, a psychiatrist, a psychologist, psychotherapist, and you can identify gender, age group, areas of specialty, how long they've been in practice.

All of the clinicians have been verified. Give you a lot of good information if they accept insurances. Oh, that's good to know, yeah. see who these individuals are and see if it's a good fit.

Yes. And I think too, Julia is calling and speaking with that clinician to see if it's a good fit for you. Yeah. Yeah. All important. Yeah. All right.

That's huge. I often will talk to patients who say, well, I've done therapy before and it was it was worthless. It was useless. I said, well, you just didn't find the right therapist.

It's like there's you have to click with the therapist in order for it to really be effective. Absolutely, absolutely. One of the questions, or in the intake, I ask, have you ever seen a therapist or a mental health professional before?

And if a client clicks yes, then I will ask them, what was your experience? And there are different answers, right? And so there are people who want you to tell them what to do.

Well, I'm not a directive. I mean, that's just not my style and several, you know, that person may feel like, well, I need you to give me things to do.

You know, some people want homework. Some people want things to walk away. Some people don't. I mean, you know, and so you've got to see. if that's a good fit for you.

Yes, that's important. Well, finally, can you share just one message with listeners about mental health and self-care? What would that be? So, you know, the most important person, I believe, is you.

And, you know, getting to know who you are emotionally, physically, psychologically, spiritually is so, so important. You know, I use the analogy, you know, you come to therapy, and you have all the answers you go to your doctor and guess what you have all the answers so you run tests right and so who finds out the answers you know the position does but it's all in your test, in your lab work, in your x-rays, in your scans, right?

And so when you go to talk therapy, you have the answers within. And so you are the most important person. So it's important for you to get to know who you are mentally, emotionally, psychologically, and physically, and also find ways to enjoy your life.

Blow down, take good care of yourself, and enjoy. Life is meant to be good. And so in this life, you want to live, and you want to live to enjoy it. Yeah.

So prioritize yourself. Yeah, you're the most important person. Awesome. That is great advice. Yeah, so. Thank you so much for being on. It was really so, it was so great having you on, and really appreciate your time, and help with all of this.

Well, thank you. I appreciate it. Be well. Thanks. Thank you for tuning into Doctor Talks. We hope today's episode has enlightened and inspired you on your path to optimal health.

Each day is a new opportunity to make choices, but empower your well-being. For more insights and strategies, subscribe to our podcast and visit our website, www.doctortalks.com.

Stay connected, stay healthy, and join us next time on Doctor Talks. Real Talks from Real Doctors, on the issues that matter to you most.

Struggling with Chronic Stress & Anxiety? Your Roadmap to Relief & Resilience!

Julia Ward, MD

Dr. Nettie Jones

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