Take a few steps to strengthen your immunity. Get your vitamin D from sunshine or supplement, get your vitamin C from fruits & veggies or a lemon squeeze in water, and get your zinc from meat, legumes, shellfish or supplementation. I love elderberry thyme syrup by Tru Botanica (not an ad, just a fan). And our immune system relies on darkness at night, sufficient quantity and quality of sleep, and a state of relaxation to function optimally. Just by leaving your phone outside the bedroom at night, you achieve more darkness, less doom scrolling and stress, and better sleep.

I know I don’t make any friends with this one… but my goal is to offer helpful information.

Caffeine is an anxiogenic drug–i.e., it causes anxiety. Some of us are slow metabolizers, meaning it can have an even stronger impact. If you suspect caffeine impacts your anxiety (if you’re anxious and you consume caffeine, it probably does), I recommend gradually decreasing your caffeine consumption to see if your anxiety improves.

For anybody drinking coffee and taking meds for anxiety or insomnia, recognize that you’re taking an anxiogenic drug in the morning to wake up, and then another drug to treat the anxiety caused by the anxiogenic drug, and perhaps still another drug to treat the insomnia exacerbated by caffeine. Ideally you would avoid the drug that’s causing anxiety and insomnia in the first place.

I know caffeine is our favorite ritual and sometimes feels like our one true friend in the world. Just remember that caffeine feels so good because it’s the antidote to its own withdrawal.

Remember to make any and all changes GRADUALLY. Caffeine is a real drug with a real withdrawal.

What’s the root cause of your bipolar? In my practice, I’ve noticed that the root cause of bipolar varies from person to person. For some it’s an undiagnosed or poorly-managed thyroid condition, for others it’s a reaction to eating gluten. I frequently see people with bipolar who are very sensitive to light. The same blue-spectrum light in the evening that might cause mild insomnia for one person might cause a manic episode in someone with this predisposition. Also, there is an underappreciated risk of SSRI medications, which is that they can induce what’s called “iatrogenic” (aka doctor-caused) bipolar disorder. And don’t overlook the role that substances, such as cocaine and alcohol, can play in inducing mania in vulnerable individuals.

ADD and ADHD are many things. I don’t deny the existence of these conditions, but I think we benefit from opening our eyes to the various potential root causes, and understanding these symptoms in the context of a person’s life/job/sleep/diet/sensitivities/trauma. This granular understanding also shows us the path forward to symptom management. That last one is something Dr. Gabor Maté opened my eyes to in his book Scattered Minds.

NYC, if you’re listening, this is what we need to do to stay vital. Turn the unused space into green space. The current abundance of boarded up businesses and abandoned spaces could be our downfall or our salvation. If we could convert some of this concrete into green space & pedestrian-only plazas, this could help improve the quality of life and mental health of those living here, and it could make NYC more desirable, increasing the demand for people and businesses to stay. Caveat: I know little to nothing about urban planning or the realities of this issue. Consider this a lighthearted if uninformed plea to slightly shift the balance from cars to pedestrians, and from concrete to green. ⁠

We’re being taught to slather on sunblock, and that “15 minutes” a day of sun exposure is enough. But nearly every patient I’ve ever tested has been severely Vitamin D deficient. So these 15 minutes a day aren’t cutting it.

We should think of having healthy vitamin D levels as a non-negotiable. Get it. We all have a different balance of risks and benefits when it comes to sun exposure based on how melanated our skin is and family history of skin cancer. Whether you can get your vitamin D safely from sunshine, or if you prefer to do supplementation, get your Vitamin D levels checked and fill up your empty tank. This will impact how you feel today, and it will impact your future health and longevity.

When someone has an issue going on in their body, from thyroid conditions and digestive issues to c-section scar pain or knee pain, the question often comes up: is this a purely physical phenomenon, or does it have a psychospiritual basis (trauma, the meaning of the illness or injury, chakra blockage). In my experience, it’s almost always BOTH. Of course injuries can be purely physical events, but the ones that create lasting blockage in the flow of energy (and lasting symptoms) often have some traumatic or meaningful associations. If you’re struggling with something, realize you can take one or both approaches to heal the problem. Never overlook the very real material realities of bodily issues–gut dysbiosis, food intolerances, inflammation, exposures, structural misalignment, etc. But if you really want to accelerate your healing process, it’s time to get still & quiet and ask your body: what is the meaning of this injury or illness? What is it here to teach me? What was I going through when this began? In what ways does having this issue keep me struggling but also safe in some subtle way?

I thought this picture made sense because kids are a blend between their parents in the way illness and injury is a blend between the material and the meaning.

Photo: Molly Menschel

While this combination is common, that does not mean it’s normal. I consider all of these to be forms of atopy (heightened immune response to common allergens), and they can all be an indication that the immune system is dysregulated. Start by reducing allergens (experiment with eliminating gluten/dairy/eggs, set up dust mite covers & air filters, transition to natural personal care & cleaning products), then focus on gut healing, and get the body juicey with nutrient-dense anti-inflammatory foods like bone broth, cod liver oil, turmeric, ghee, and plenty of veggies. Re-calibrate the immune system by getting some exposure to beneficial bacteria and (roundup-free) dirt. There is a path forward.

I see this cluster occur together frequently. My theory is that consuming gluten generates anti-gluten antibodies that attack the thyroid gland. This occurs because of molecular mimicry–there are components of thyroid tissue that resemble the molecular sequence of gluten. I believe these antibodies initially stimulate the thyroid gland, causing a state of relative hyperthyroidism, which can look like mania, yet these antibodies ultimately destroy the thyroid gland over time, causing a state of relative hypothyroidism, which can look like depression. The path to healing involves eliminating gluten, healing the gut, detox, and cultivating the relaxation response to allow for deep tissue repair.

Have you noticed this cluster in your friends, family or yourself?