(this is a transcription from the Myers Detox Podcast interview)
Wendy Myers: Hello everyone. I’m Wendy Myers of myersdetox.com. Welcome to the Myers Detox Podcast. Today, we have a fantastic show. We’re talking about anxiety, the underlying root causes of anxiety, the six heavy metals that can contribute to anxiety and how they do so. We’re going to have Dr. Nicole Cain on the show today. This is a really, really interesting show because we talk about all the different reasons that people can have anxiety. We talk about the microbiome. We talk about emotional trauma, which is a huge underlying root cause. We’ll talk about, as I’ve mentioned, the heavy metals. There’s so much more to those. There’s a lot of different underlying root causes of anxiety. You have to go through this list to figure out what your trigger is. We also talk about benzodiazepines and different medications that people take and the pros and cons of those, mostly cons.
Wendy Myers: Our guest today, Dr. Nicole Cain, wants to make sure you have the tools to send your anxiety backstage, so that you can live your best life. Dr. Nicole Cain is a naturopathic doctor with an expertise in mental health, specifically anxiety. Not only has she worked with anxiety sufferers for over a decade, she’s experienced the debilitating grips of anxiety herself. This inspired her nine-week online course for tackling anxiety at the root called The Anxiety Breakthrough Program. You can learn more about Dr. Cain and her work at drnicolecain.com. Dr. Cain, thanks so much for coming on the show.
Dr. Nicole Cain: I’m delighted to be here. Thanks for having me.
Wendy Myers: Why don’t you tell us a little bit about your background and how you got into the health field?
Dr. Nicole Cain: My background is actually Clinical Psychology. I went to graduate school, got a master’s in Clinical Psych, and found that while I loved the mental health piece, I felt really limited in my ability to really make whole person changes with my clients. After lots of researching, soul searching and doing deep dives into what kinds of things were out there, I found naturopathic medicine. In my medical training, I had the opportunity to do rotations. I did research at Baylor College of Medicine. I did oncology research. I was able to be a preceptor at different hospitals and still had that love and that passion for mental health. I found that I was able to see this really powerful, all-encompassing relationship between the mind and the brain and the brain and toxicity. I started to marry them together. I’ve been doing that for over a decade in my practice as a primary care mental health practitioner.
Wendy Myers: Oh, wow. That’s so needed right now. So many people are dealing with anxiety and fear. What are your approaches to anxiety? What are the mechanisms that promote anxiety in the body?
Dr. Nicole Cain: When I think about the mechanisms that promote anxiety, I call it the cast of characters and that helps us explain it in more lay person’s terms. When I’m talking to a client, we’ll talk about your psychological cast of characters. These are the mechanisms of the different parts of my cells: my trauma, my experiences and what it was like growing up in my household. This can bring in culture and race. Then your second cast of characters is your social cast of characters. Which really starts to look at the way that you exist amongst and within your community, your family and the way that that can impact your nervous system. Then the third cast of characters are the biological, which is really where your zone of genius comes into play, with metals and anxiety, but it can go beyond that, too. Some of the conversations that I have with people are lifestyle and diet, detoxification and nutrition, genetics and epigenetics and your vagus nerve.
Dr. Nicole Cain: When we’re looking at anxiety, we really want to do a whole person approach because one thing affects the other, and really for everybody it’s different. That being said, part of why I love your work and this podcast that you have so much is because fundamentally, everybody in some way, shape or form is dealing with toxicity. That’s a part of the conversation that I think is often missed with anxiety.
Wendy Myers: Yeah. I agree. I agree. I very rarely have heard people talk about toxins in relation to anxiety. What are the heavy metals and any chemicals that could lead to anxiety?
Dr. Nicole Cain: There are six primary heavy metals that I think about when it comes to anxiety, in particular. The six heavy metals are arsenic, cadmium, lead, mercury and uranium, which is found in batteries and the rocks in the ground, or cadmium in batteries, and platina or palladium. Those are the top six ones that I look at. What’s really interesting is the way that they work to cause anxiety. A lot of people end up finding that that is the cause, where metals are what’s actually the root. What’s underneath a diagnosis like generalized anxiety disorder is that they have been treated for years for anxiety and the treatment just isn’t working. Then the doctors slap on this label of your refractory to treatment. Treatment isn’t helping you.
Dr. Nicole Cain: Also when people have hormone-type symptoms with their anxiety, I see this a lot in polycystic ovarian syndrome, PMS, or when somebody goes through childbirth and delivery and then they deal with postpartum-type symptoms. Then when they do the testing, they’re all normal. That’s when these six metals really come into play. I can explain a little bit more about that in a little bit, as we get there.
Wendy Myers: In addition to detox, how can people specifically target their symptoms of anxiety? There’s so many things that people can do, like they can detox. There’s so many different options out there for anxiety, but how do they specifically target the symptoms?
Dr. Nicole Cain: While you’re working on the root cause of what’s bringing the anxiety into your picture to begin with, and those three casts of characters, the biological, the psychological and the social cast of characters. Sometimes we need something right now to help reduce that anxiety. In fact, if we’re stuck in this vicious loop, then it can make it harder to figure out what’s what. That’s in fact, one of my stories of how I got to where I am, is that I was so focused on trying to find the root cause that my anxiety was spinning out of control. I love that you’re asking the question, how can we address it right now? What do we do? There are so many things that work and I’ll give some ideas now. The thing I want to make sure that your listeners hear is that you have to experiment because something that works for you right now, may not work in a month.
Dr. Nicole Cain: It’s a little bit of trial and error, but the best thing is to target your brainstem. The brainstem is the part of the body that is turned way up with anxiety and it responds to tangible things. If we rewind and we do a little bit of an exploration of how the brain is working when you’re anxious, we can make a figure of a fist, and this is from Dan Siegel, he makes the figure of a fist and then your fingers are curled over your thumb. In your fingers, this area represents the prefrontal cortex. This is the area behind your forehead. It’s the logical part of the brain. This is where talk therapy really emphasizes their treatment. Should you feel anxious? What are your anxious thoughts? Rationalizing your way through the anxiety process for some people, that works, but for a lot of people it isn’t enough.
Dr. Nicole Cain: The second part of the brain is your limbic system. This is right in the middle of your brain, where your thumb is. It’s the emotional seat of the brain. This is when you can feel foreboding or you can feel anxious, but it isn’t logical. It doesn’t make sense. Kind of like a phobia. I have a fear of flying, even though flying is safe, it’s coming from my midbrain. Strategies that can help with that would be more of the psychological part of the ego state, the EMDR, the trauma work, getting into those deeper emotions, getting outside of what is logical meditation and mindfulness.
Dr. Nicole Cain: The last part I want to focus on is the brainstem. The brain stem is represented in this image as your wrist. The brain stem is what gets turned way up when we’re anxious, panicking and your logical brain is turned down. You can’t think, everything’s jumbled and you’re emotional. Your amygdalas turned way up and your brain stem is producing all of those feelings of anxiety, like heart racing, numbness and tingling. You’re feeling flushed, restless, nauseated, busy and dissociated. The brain stem is running the show. The best thing you can do right now, if you’re dealing with anxiety, is to target the brain stem.
Dr. Nicole Cain: My favorite way to do that is by making a “panic pack”. I used a sequin gold fanny pack, because I like to be hands free, it’s fun and cool and you can just bring it anywhere that you are. You build your fanny pack with tools that will help stimulate your brain stem. You’re going to want to include essential oils. Essential oils will stimulate the olfactory part of the brain through inhalation. Essential oils can also, as we’ve seen in the clinical literature, absorb into the skin. They have chemical constituents that can help calm your nervous system. There’s an essential oil hack where you stimulate your vagus nerve, which is that autonomic nervous system dial that shifts you from fight and flight anxiety down into feeling calm on command. You can access that switch by putting essential oil in the bowl of your ear. The bowl of your ear is just simply on the cartilage, just above your ear lobe, over that little ledge. By placing that there, the essential oil can absorb and stimulate the vagus nerve. That’s the first thing you’re going to want in your panic pack.
Dr. Nicole Cain: The second thing that you’re going to want is a straw that’s cut in half or a little bubble wand because we want to work with the breath. By slowing down the exhale, you activate your vagus nerve to switch you into a calm state.
Dr. Nicole Cain: Then you also want to include an ice pack. I don’t know about you, but I’m a girl on the go and I can’t carry freezer packs with me but they do have really cool chemical packs online, where if you break the chemical pack, it turns really cold. It’s small and it’s compact. What you want to do is put it on your eyes around where you might apply concealer or eyeshadow. This evokes something called the “dive response”. The dive response is something that we observed in deep sea divers, when they would dive down, their blood pressure would go down. Their heart rate would go down. Their anxiety would go down and that can work within 30 seconds if you’re having extreme anxiety.
Dr. Nicole Cain: I have a video I’ll share with your listeners that explains more about what you want to include in the rest of the pack, but those are some of my big heavy hitters if the stress is high.
Wendy Myers: That’s fantastic to have a tool like that when you’re on the go. I like Rescue Remedy, I’ve bought Flower Remedies too. Those are awesome as well. To activate my Vagus nerve, I use an Apollo. It’s an Apollo bracelet that you can use, but there’s other vagus nerve stimulators out there. That one that is kind of nice to wear. People love them. Everyone I know that has one absolutely loves it. Are there any other tools that you like, to stimulate the vagus nerve?
Dr. Nicole Cain: The vagus nerve can be stimulated by doing a Valsalva, which is interesting, in terms of anywhere on the go. Have you ever seen a kid when a kid’s getting really upset and anxious, they’ll kind of ball their fist and just bear down, like they’re about to pop. That’s called a Valsalva move and that actually activates the vagus nerve and it calms your nervous system down. It’s really neat. You see these kids who are naturally, impulsively doing this behavior and we’re like, “You’re having a temper tantrum. Why are you doing that?” Actually their body inherently knows how to calm their vagus nerve. I love Apollo, too.
Dr. Nicole Cain: The other thing that you can do is, there’s a heart math. They have heart rate variability monitors that you can get, where a device plugs into a smartphone. I really like that because when I was told, “Oh, work with the breath”, I was like, “Oh my gosh, everyone tells me to breathe when I’m anxious, stop telling me to breathe”. When you see what it’s doing to the body, then it’s really a lot more interesting for conversation.
Wendy Myers: We talked about heavy metals a little bit, and a handful of metals, arsenic and uranium, et cetera. Can you give us a little bit more information about those and where somebody would pick those up?
Dr. Nicole Cain: Where they would pick them up and then also how the heck are they causing issues? A lot of people will say, well, I’m not toxic. I’m fine. Why are you having all these symptoms? The really important thing to know is that we could be picking these things up as children. It’s all about the threshold. You may be in a park playing and there may be lead paint on the playground equipment. You may be using batteries or old thermometers where there’s mercury in these old thermometers. A lot of these metals are in the new carpet. A lot of these are in paint. They’re also in gasoline and car exhaust. They’re in the aluminum foil that we wrap our campfire dinner in. All of these toxins are all around us. When we think about heavy metals, there’s something really tricky about them.
Dr. Nicole Cain: It’s that your body has nutrient minerals. They have zinc, calcium and magnesium. They’re in the same family as lead, mercury and these different heavy metals. Because they’re in the same family, it can be very confusing for your body because we don’t want heavy metals in our body. We want our nutritional metals in our body. We want the minerals, but the metals can actually go in and cause disruption. Heavy metals do that in three primary ways. They disrupt enzyme systems, hormone systems and organ systems. An enzyme system is really interesting when it comes to anxiety. For example, you have neurotransmitters in your brain, like serotonin, dopamine, glutamine, GABA and epinephrine. All of these neurotransmitters have really important jobs. The job of your brain is to make them from the food that you bring in through your diet.
Dr. Nicole Cain: Let’s talk about the enzyme system. For example, we have an enzyme and the job of the enzyme is to take a mineral, like zinc, and to bind that to a B vitamin. The enzyme has activated these two together, then they can take your amino acids from your food and turn that into a neurotransmitter. It may take tryptophan from your food and turn it into serotonin. That’s good and wonderful. If you have somebody who is really anxious. They’re experiencing a lot of anxiety, they’re having a lot of panic attacks, but they do testing and everything looks normal. They shouldn’t be having anxiety. Then they go and they see a functional medicine doctor and they’re like, “Well, your neurotransmitter levels look normal. I don’t see any imbalances there. You shouldn’t be anxious”. Then the person starts to feel like it’s all in their head.
Dr. Nicole Cain: Actually what is happening in cases like this is that it could be dysfunction of the enzyme system caused by the metal. Suddenly instead of zinc getting into that process, we have something like mercury, lead and those metals jump into those receptors, and then suddenly that enzyme doesn’t work. Your body has tryptophan, it has the nutrients from your food, but it can’t bind. It can’t make that reaction happen and so now you’re not making serotonin.
Dr. Nicole Cain: Metals can create issues with this enzyme system that are really hard to capture and test. In terms of what you do about that if you have emotional, cognitive, focus, problems with your thinking or problems with your reactions. If you’re taking medications, if you’ve tried a bunch of treatments and they’re not working, you should look at metals. If your blood pressure is going up for no apparent reason, if you’re finding that you’re needing more and more blood pressure medications, you should be looking at metals. If you have hormone issues, but your hormone levels are normal, you should be looking at metals. It’s kind of a glimpse into how those metals could actually be disrupting your brain and your mood.
Wendy Myers: I agree. I mean, metals impact every different system in the body, every organ system and different pathways. They also can damage the nervous system as well. What can people do to repair the nervous system after heavy metal damage?
Dr. Nicole Cain: There’s the category of herbs called the trophorestorative and they are absolutely amazing at helping restore the health of the nervous system. In fact, we have a ton of research literature looking at the efficacy of the trophorestorative. My two favorite trophorestorative agents, which are plants that can actually heal the brain and heal the nervous system tissue, are avena sativa and ginkgo biloba. The wonderful thing is that these are generally very safe, they’re gentle. I use them all the time in patients who are taking medications and people who are doing a detox.
Dr. Nicole Cain: As we’re working on healing, we always first want to work on building up the body, especially before asking it to detox. We want to build up the body. We always start with trophorestorative herbs, ginkgo biloba or avena sativa. Then we want to give the brain other ingredients that help those pathways to go more effectively and go more quickly.
Dr. Nicole Cain: We want to support the health of the neurons, that cell in your brain. Other ingredients I love are phosphatidylserine, acetyl-l-carnitine and phosphatidylserine which is really cool because it’s also anti-anxiety. Phopsphatidylserine has a few really cool effects. One is that it will increase the health of your brain. It increases the health of the phospholipid bilayer. These are the fatty cells that surround your brain cells, the myelin sheath, that outside part of your neuron. Phopsphatidylserine nourishes that.
Dr. Nicole Cain: Then the second thing that phosphatidylserine does is it brings down your anxiety. It brings down your cortisol so it reduces stress. When we’re anxious and when we’re stressed out, it helps to bring down that anxiety and bring down that stress. I often will put some phosphatidylserine in my panic pack. It’s a wonderful ingredient. Then the acetyl-l-carnitine, I think of it as the car that gets you from point A to point B. It helps with synaptic connection. It helps send information so that the brain cells work better.
Dr. Nicole Cain: We’re building up the brain, we’re building up the body, we’re using trophorestorative, we’re using avena, we’re using ginkgo, now we’ve got some phosphatidylserine on board. We’re bringing down the anxiety a little bit. Now we want to start replacing some of those minerals that have been displaced by the metals. We were talking about zinc earlier, and that enzyme reaction binding with the B vitamins so that you can turn tryptophan into serotonin. Then you have serotonin for helping you feel good, think and function. We want to measure your zinc and if your zinc is low, we want to replace it. We want to start replacing your minerals. That’s often neglected by major supplement companies. There’s a lot of companies that’ll give you all sorts of wonderful B vitamins and people feel better for a few months, but then after a few months have passed, they’ve burned through all their minerals. They’re not getting enough to replace it. Then they end up feeling 10 times worse, so we want to give the body and the brain minerals.
Wendy Myers: I agree. I’ve been talking about minerals for 10 years and I think people want to think about certain issues as very complex. You have to go back to basics. If you don’t have enough minerals, you’re going to feel stressed. Your nervous system won’t be able to relax, minerals relax your nervous system, reduce stress and calm your nerves. It’s one of the easiest and least expensive types of supplements that you can take.
Dr. Nicole Cain: Magnesium is one of the best for anti-anxiety. If someone’s listening to this and you’re wondering, oh my goodness, where do I start? A lot of people feel so much better just getting magnesium in their bodies. I have no affiliation, but there’s this product called Calm Mag, which you can find at most grocery stores that is a pretty yummy and tolerable magnesium. Often just getting it in people, can make a pretty big impact.
Wendy Myers: When I first started taking minerals, I started taking magnesium and calcium and I could not believe how much less stressed I felt and I slept better. It made such a huge, huge impact in a very short period of time. That’s back to basics. It doesn’t have to be super complex, but you want to do the basics and work up from there. Is there anything we’ve left out of this conversation? Any things that you recommend for people with anxiety?
Dr. Nicole Cain: I think that the most important thing about anxiety is the way that we relate to our anxiety. I feel like oftentimes we approach anxiety as an adversary. How can I beat anxiety? How can I silence anxiety? How can I suppress anxiety? Anxiety is an opportunity to see that there may be something out of balance. For example, Mad Hatter syndrome. We know the story of the Mad Hatter from Alice in Wonderland. He had mercury poisoning and his body had been telling him with all of these systems that were getting messed up and they were becoming dysfunctional. Had he not had symptoms, then we would not have had the data to know that he needed healing. By having symptoms, you are able to begin the process of exploring your cast of characters, getting to the root cause of why you feel the way that you feel, so that not only does your anxiety get better, but the rest of your body gets better too. This will help you in your long-term life, be as healthy as possible.
Dr. Nicole Cain: Changing the relationship to anxiety, when anxiety comes up, a message that I teach my clients is that when your anxiety presents itself, just stop for a moment and say, “I hear you and I’m listening. What do you need me to know?” Oftentimes that can give us so much data as to what needs healing. I stop, I acknowledge you, I hear you, what do you need me to know? Then we can start the process of diving into healing.
Wendy Myers: What I hear from friends or clients that have anxiety, if they start feeling a little bit of anxiety, it just spirals out of control. It’s kind of their perception of it. They can have a full-blown anxiety attack simply because they’re scared of having an anxiety attack. It’s kind of like this catch 22. You do have to get some perspective on that.
Dr. Nicole Cain: It’s like fear of fear, right?
Wendy Myers: I’m getting depressed about being depressed. That’s what I use to put that in perspective. I just didn’t allow this feeling to wash over me and not get depressed or anxious about it.
Dr. Nicole Cain: I was going to say, “I am the sky and the storm is here, but I am not the storm”.
Wendy Myers: It will pass. It will pass, inevitably. What are you currently working on and how can people work with you to curb their anxiety?
Dr. Nicole Cain: I have a ton of free things for people online. I’m really active on Instagram. If you pop onto Instagram, I’m @DrNicoleCain. Then there’s a link in the bio where I have a ton of free stuff. I have an anxiety springboard. I have a one-week challenge there and I have a course, The Anxiety Breakthrough Program. I walk you through all of the naturopathic functional ways to send anxiety into its rightful place as a warning system, but not your center stage. If somebody is just wanting some support right now, pop on Instagram and download our free information. I think that’s a really awesome place to start. I do see some people, direct patient care, but I’m really limited. If someone wants to work with me directly, they could click on the link in the bio and it can take them to an application page at my website.
Wendy Myers: Ok, fantastic. Thank you so much for coming on the show. That was so enlightening about all the different causes of anxiety, and different very simple solutions. It’s absolutely something you can get under control, fairly easily. Like you said, there are so many different underlying root causes, you need to work with someone that’s an expert. I’m a fan of band-aids temporarily, I’ve taken Xanax myself when I had a period where I wasn’t sleeping, but it’s so addictive. It was hell getting off Xanax and there’s other medications in that family of diazepam medications. They are absolutely some of the worst medications to come off of. You really want to think twice before your doctor casually prescribes that to you, without really giving you this informed consent about how addictive they are. Can you give us some perspective on that?
Dr. Nicole Cain: That’s a big part of my story. I’ll share that with you. So I never stopped. I went through undergraduate, got my graduate degree, went to medical school, I was selected for a residency and then I was running a private practice. Then I opened a clinic and I was redesigning the psych curriculum at the medical school I was working at. Your nervous system loves to be in homeostasis.
Wendy Myers: And Xanax.
Dr. Nicole Cain: Xanax, yes. Oh, Xanax was a friend. So I was more and more and more stressed. I was constantly thinking about having to do this and having to do that. I stopped sleeping and because I wasn’t sleeping, I felt like garbage. I was having a ton of anxiety. It would be like, “Oh my God, tonight, I’m going to get really anxious. I’m going to have a panic attack. I’m not going to sleep. And I have to work tomorrow”. I tried all sorts of naturopathic herbs. I tried kava kava and theanine and Rescue Remedy. I did acupuncture and chiropractic medicine and homeopathy. I did all of the things and I ended up taking Xanax. Then my dose of Xanax got higher and higher so they switched me to the longer-acting diazepam, and that got higher and higher. My anxiety just got louder and louder and louder.
Dr. Nicole Cain: I found myself in this vicious loop of panic, insomnia, more panic, medication after medication after medication, and my life was crumbling. It wasn’t until I was willing and able to look at the big pink elephant in the room, which were the choices that I was making in my life, that I was able to be free from that vicious cycle. I had to say “no” to things that I desperately wanted to say “yes” to. Then I began the journey of recovery, which involved coming down off benzos. That is one of the hardest things I’ve ever done.
Dr. Nicole Cain: It is incredibly difficult and thanks to naturopathic medicine, I was able to do it. I’m really grateful for that. As you’re listening to this podcast, make sure that if you are on benzodiazepines, you’re hearing this and you’re like, “Oh my gosh, I want to get off of them”. Do it with a doctor as slow and steady wins the race. It’s really important that you don’t send your nervous system into a slingshot where it causes long term benzo withdrawal. You want to be really gentle and slow with it.
Wendy Myers: I was only taking 0.5 milligrams of Xanax, it was such a small amount seemingly. I just stopped taking it one day and I didn’t sleep or eat for three days. I thought maybe I should take the Xanax again, started taking it again and then slowly and immediately felt relief of all my symptoms. Then I started just slowly tapering off, a half of the 0.5 for a few weeks, then a quarter for a few weeks, then an eighth and there’s a little nibble off the pill. Then I finally was able to get off it, but it was absolute hell. You want to look for natural alternative ways to address your anxiety before you are going to that crutch because it’s really a tough road to get off that.
Dr. Nicole Cain: The supplements too. A lot of people will just take hundreds and hundreds of dollars of supplements and now they’re hooked on supplements but they haven’t gotten to the root cause. If I had exposure to arsenic when I was a kid and then my barrel got full throughout life, now I have these breakthrough symptoms happening and I’m taking every herb and my symptoms are getting more and more chronic. I’m doing myself a disservice. I think it’s really important too, to emphasize that just because it’s natural or herbal doesn’t necessarily mean that it’s good, safe and the answer. I think a lot of people think, “Well, it’s kava kava, it’s fine. It’s not Xanax at least”. This anxiety is trying to tell you something. The kava kava is effectively increasing your GABA to make you feel more calm, but is it answering the question as to why the anxiety’s speaking?
Wendy Myers: Absolutely. I’m all for bandaids. I’m all for something to address the symptoms, so you’re comfortable until you can get to the underlying root cause because that’s going to be a lot of trial and error, trying to fix that and it can take time once you even pinpoint what the issue is. There’s no little warning label with all these things. Why don’t you tell us your website again and how clients can work with you.
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