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Francis Weller

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Carl Gustav Jung

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Carl Gustav Jung

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IMMH has always been a place where forward-thinking mental health practitioners could learn about the latest evidence-based research and best clinical practice around integrative mental health and functional medicine psychiatry, and hear from the most well respected and pioneering doctors, scientists and health practitioners in their fields.

With a focus on root cause, personalized and precision medicine, combining the biochemical with the psychological, the IMMH annual conference delivers actionable, cutting edge and evidence-based scientific information so that health practitioners such as medical doctors, nurse practitioners, psychotherapists, psychologists, chiropractors, nutritionists, naturopaths and social workers, can offer more hope and better healing to their patients.

2023 IMMH Online Conference

With my experience as Founder and Editor MindHealth360 and Host of The MindHealth360 Show, I am honoured to be taking IMMH forward, guided by IMMH co-founder Dr. William Shaw and Lori Knowles-Jimenez, and in collaboration with PESI, leaders in the mental health education and conference.

Join us online November 2nd, 3rd and 4th 2023 for a fantastic line-up of world class speakers, and then in-person in November 2024. Earn CMEs and learn about the latest developments in integrative mental health and functional medicine psychiatry. Click here for the full agenda and to register: IMMH 2023.

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I was having several panic attacks a day during my postpartum depression, and was desperate to get a reprieve from the relentless insomnia, anxiety and panic. A simple breathing technique stopped my panic attacks in their tracks, and saved me from checking myself into a psychiatric hospital. 

In a last ditch attempt to avoid hospitalisation, I saw a CBT therapist Dr. Robin Hart, who taught me a very simple breathing technique that I should start as soon as I felt a wave of panic. He recorded it on my phone, and over the next few days and weeks, I clung to that recording for dear life, and in turn, it changed my life. 

It was amazingly simple: breathe in through the nose for 4 seconds; hold 4 seconds; breath out slowly through pursed lips for 8. Incredibly, it worked. Gradually, as I practiced this technique on a daily basis, I felt more and more confident that I had a reliable tool to control my panic, instead of it controlling me. 

And sure enough, in the intervening ten years since, I have rarely had another panic attack, and when I feel anxiety rise, I practice this breathing technique and instead of growing into a full blown panic attack, the anxiety gradually dissipates. 

Why is breathing so powerful? (apart from the fact that it keeps us alive!) 😉

Since then, I have learned more about the science of the breath, and why we have the capacity to calm ourselves with our breathing. I have learned that an exhale slows our heart rate down, sending the signal to our nervous system that we are safe; that increasing the amount of carbon dioxide in our blood through a longer exhale and a shorter inhale can paradoxically increase the uptake of oxygen into our cells; that deep belly breathing stimulates the vagus nerve and increases vagal tone, which helps restore balance to our nervous system. 

There are other mechanisms at work as well, but suffice it to say, that the ancient yogis and meditators were really onto something with their emphasis on breathing techniques such as pranayama, realising that it was key to a sense of peace, but also vital to feeding our life force—prana or chi—which we all depend on to survive and thrive.  

As Richie Bostock says in our interview “Exhale! The incredible power of breathwork for mental health and happiness” breathing is a tool, a Swiss army knife which can be used for many different purposes: to calm us down, rev us up, increase our feelings of happiness, help heal our trauma, and enhance sexual and spiritual experiences. The sum total of what we can do with breathing to alter our states of mind or consciousness is called “breathwork”. 

Breathwork as therapy

I had a transformative experience of breathwork when I worked with Rebecca Dennis of “the Breathing Tree”.  She used different breathing techniques to release stuck energy, stress and trauma in my body, which usually involved lying on the floor breathing in a certain way and crying uncontrollably due to some emotional release, coaxed out by Rebecca, telling me the entire time that I was safe in my body. Then, a feeling of exhaustion but also complete peace would sweep over me, and I felt somehow cleansed, happier and lighter. 

It was a form of somatic therapy that didn’t involve much talking, and taught me to stay in my body and with my breath when rocked by difficult feelings. As such, it was sort of metaphor for life—that when we are ransacked by difficult emotions and situations, we should try to stay present, aware and embodied, so that we are more able to respond appropriately, and do what is best for our wellbeing in that moment. 

 I also did a very memorable and cathartic two day workshop in May 2019 with Rebecca, Jambo Truong and Michele Barrocci called “Journey to Being: through breath, movement and sound”, which brought me several deep spiritual insights, the likes of which I had had before intellectually, but rarely experienced in such an embodied and felt way. 

The instructors took us on a journey of several hours of breathing and movement exercises, many of which involved us lying on the floor, each on a yoga mat, breathing heavily, and then descending into paroxysms of crying, screaming, pounding the floor, and generally letting out a lot of stress, anxiety, fear, trauma, and grief. Sounds like a fun weekend activity? Fun may not be the first word that springs to mind, but it was transformative.

As everyone was screaming and pounding the floor, I was overcome with the profound sense that we were all connected in our humanity, in our common pain and wounding. And yet I was also acutely aware that each of us had our own drama that we needed to process alone. That the screaming person next to me, in front of me, behind me, were in their own drama, as I was in mine, and that was OK. 

I was very conscious that our bodies were our boundaries, and it became really important not to get sucked into the other person’s drama, but to stay in our own bodies. Just as it was important to stay in our own bodies while we experienced our own wounding; our bodies being the container for all this humanity with its inherent pain. 

It drove home the importance of boundaries, figuratively and literally. The importance of processing our own stuff without getting distracted, blindsided or sidetrack by other peoples’ stuff, without needing the other to look at our own drama, judging or validating it. 

Some insights from breathwork

No wonder we have a hard time with boundaries. We crave that feeling of fusion and connection which is our birth right, and yet ideally we come to it from a place of being fully grounded in our own reality, fully boundaried within and connected to ourselves first and foremost, before we can connect with others. 

How do we navigate this dichotomy between the desire for fusional connection with others, and the need for firm boundaries and a developed and autonomous Self? The helpers who supported us throughout the weekend seemed to symbolise this by coming and going, holding us in our pain, because they themselves were resourced enough to be able to hold us, but then moved on and left us to it. 

And maybe that is what it’s about – we need to be taught from the outside first, how to be held in our pain—as a good mother teaches a child how to manage difficult emotions. Once we integrate that, we can do it for ourselves. And then from the strength of being integrated and embodied within ourselves, we can hold and connect with others. We will realise more fully that we are always, and have always been connected with them; and that as resilient adults, if we can, we owe it to our fellow human to hold each other in our common humanity and pain.

We are all just walking each other home – Ram Das

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Not one of the three psychiatrists or two GPs I saw ever mentioned my hormones. It is rare that psychiatrists, or even GPs, make the link and measure our hormones when we present with mental health problems. 

And yet, whether you are a man or a woman, your hormones — chemical messengers that travel from organ to organ throughout the day and night — not only regulate most of your bodily functions such as digestion, sex drive, appetite, body temperature, but they are also essential to regulating your moods, anxiety levels, memory, sleep and concentration.

Their importance to our mental health cannot be overstated 

My crazy French hormone story

One of my most memorable experiences with a doctor was a French endocrinologist in Strasbourg, my home town.

Back in 2011, I went to see her because I wanted to test my hormones as I was in the throes of post-partum depression — anxiety, panic attacks, insomnia and mood swings, and having seen various doctors in London to no avail, I thought that maybe in France they would be more up to speed on the importance of hormones for mental health, which I had started to learn about through my own research from the US. 

When I explained why I wanted to see her she practically scoffed at me and said: 

“Why are you here? You should be seeing your psychiatrist.” 

I replied that I wanted to see her because my hormones were clearly out of balance post-partum and it was affecting my mental health. 

“Your hormones have nothing to do with your mental health.” 

I argued with her that surely they did — what about women who got depressed and anxious during menopause? 

“They are that way because they are usually of the age when their kids leave home.”

Outraged by what I perceived to be either gross ignorance or patronising refusal to engage, I challenged her. 

Finally, she admitted: “The truth is, you are like black boxes to us, we don’t understand the causes, so we can only treat the symptoms.” 

While her honesty was a relief, it also felt outdated and ill-informed to me, especially based on what I was learning about integrative health from US doctors and scientists. 

And she was not alone. Not one of my UK conventional doctors ever suggested testing my hormones.

• Not my obgyn who supervised my pregnancy 
• Not my GP
• Not my cardiologist who diagnosed me with benign ectopic beats and suggested I go on a beta blocker but never suggested testing my thyroid
• Not my UK endocrinologist who tested me for reactive hypoglycaemia and diagnosed that as the cause of my panic attacks but never thought to test my stress hormones, adrenals or HPA axis
• Not my psychiatrist, who put me on anti-depressants and sleeping pills (and other psychiatrists offered me anti-psychotics and various other forms of anti-depressants when I complained that I was not getting any better), and told me that I would have to be on them “indefinitely”, even though they were having intolerable side effects and I felt were exacerbating my depression

Post-partum depression

As someone who had suffered from some anxiety but never a full-blown depression, I didn’t have a track record of depression, and so clearly this episode of massive anxiety, panic attacks, low mood and insomnia was due to something new and different in my life — something related to pregnancy and childbirth, and therefore surely must have had something to do with my hormones… 

The hormonal upheaval around pregnancy, childbirth, breastfeeding, and interrupted nights is significant, and massively impacts our hormones. Combined with the stress of becoming a new mother (which in itself is enough to dysregulate our hormones and our nervous system) and the psycho-spiritual issues which can arise from becoming a mother (which can prompt a resurgence of all one’s unresolved childhood issues), and you can see why post-partum depression affects 10% of women (and clearly it’s a higher number if you take into account the undiagnosed). 

Luckily, I eventually found doctors and nutritionists in London who were practicing in an integrative way, and through a combination of diet, lifestyle interventions, stress relief, and bioidentical hormones, I was able to stay off my anti-depressants and gradually heal. But it took me a lot longer than it should have, and I had to go on a time consuming and expensive journey to get there.

How hormones are essential for mental health

Hormones don’t only affect mental health around childbirth, but on a daily basis, our moods, anxiety levels, sleep, memory and concentration are all affected by hormones — both for women and men. This is why puberty, menopause and andropause can be precarious times for our mental health. 

But equally, every time we feel stressed, we are releasing stress hormones such as cortisol and adrenaline, which will then have an effect on our sex, thyroid and metabolic hormones, but also on our levels of inflammation and the integrity of our vital protective barriers such as the gut barrier, and the blood brain barrier. 

We now know that “depression” and “anxiety” are often symptoms of a dysregulated nervous system, and a dysregulated nervous system can be both a cause and a consequence of a stress hormone imbalance. We know that “stress”, especially when it is chronic, can not only throw all our other hormones out of balance, but is also one of the most substantial causes of mental health symptoms. 

Ten years later, while it is now more accepted in the mainstream that hormones are hugely impactful to mental health, unless you are lucky enough to work with an integrative psychiatrist or GP, you’re still unlikely to have your hormones checked when you present with mental health symptoms such as depression, anxiety, insomnia, poor memory or poor attention.  

Read more on how hormones can impact your mental health. 

Read more on how sex hormones can impact your mental health. 

Read more on how stress hormones can impact your mental health. 

Read more on how thyroid hormones can impact your mental health. 

Read more on how metabolic hormones can impact your mental health. 

Dr. Felice Gersh on how to optimise hormones for better mental health

In my interview this month with Dr. Felice Gersh, obgyn, we discuss the crucial link between hormones and mental health. Her interview is rich with information and advice on the impact of hormones on our mental health, and what we can do to restore hormonal balance. 

She tells us which hormones are linked with which neurotransmitters, and which hormones are neuroprotective and neuroregenerative. She tells us how hormone imbalances can cause neuroinflammation and impact the integrity of brain cells, the blood brain barrier, the gut microbiome and the gut barrier.

She tells us that light and time of day, movement, foods, toxicants, and sleep can all contribute to balancing or disrupting our hormones, and therefore our mental health. 

A few key ideas she covers in the interview: 

Hormones, neurotransmitters and the brain

• The link between estrogen and serotonin (the happy neurotransmitter) as well as the effects of estrogen on neuroplasticity, immunomodulation and the brain in both men and women
• The link between progesterone and GABA (the calming neurotransmitter)
• Progesterone as neuroprotective
• The link between testosterone, estrogen and dopamine (the reward and motivation neurotransmitter)
• The importance of estrogen in preserving the integrity of the blood-brain barrier

Hormones and mental health

• Why there is a 400% increase in depression and anxiety in women who are menopausal and 3x greater incidence of Alzheimer’s in women than in men
• The vital importance of testosterone to estrogen balance and mental health, in both men and women
• The importance of T3 Thyroid hormone for mental health and how it can be hard to get enough of it 
• Insulin, inflammation, the autonomic nervous system and mental health
• Why dementia is sometimes called Type 3 Diabetes
• The nervous system, vagus nerve and our hormones

Causes of hormone imbalance

• How inflammation and endocrine disruptors such as plastics can cause hormone imbalances and mental health issues
• The dangers of the contraceptive pill for hormone balance and mental health
• The effects of chronically high cortisol on the brain and mental health via neuroinflammation, and the breaking down of the blood brain barrier and the gut barrier
• Why stress makes you make bad decisions and impairs cognitive function and brain health
• The link between inflammation and sleep apnea, and why breathing well at night is essential to hormone balance
• Which toxins are endocrine disruptors and how to minimise our toxic load to improve our hormone balance and mental health

Optimising hormonal balance for better mental health

• The importance of circadian rhythms in balancing our hormones
• Why fun and pleasure are essential to hormone balance
• How oxytocin is key to mental health, appetite and great orgasms
• The importance of omega 3s and 6s and the right amounts of saturated fats for hormonal balance and brain function
• The key nutrients for maintaining hormone balance
• Why just replacing hormones (with bioidentical, or worse synthetic) hormones is not enough — you have to ensure optimum nutrition with the right antioxidants and polyphenols, the right exercise, the right sleep and circadian rhythms, and reduce toxic load
• Why eating breakfast and not snacking are key to hormone balance
• The right type of exercise for optimal hormone balance and longevity

Read more on how to optimise your hormones for better mental health. 

Read more on how to optimise your nutrition and supplement for greater hormone balance. 

Watch or listen to my interview with Dr. Felice Gersh.

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