Transcript 0:00 Hi, everyone. Today I'd like to welcome Brooke Bearden to the Thumb Factor podcast. 0:04 Brooke is an integrative psychiatric PAC, bridging conventional medicine and holistic evidence-informed care to offer individualized comprehensive support. 0:14 She supports collaboration, psychoeducation, and personal autonomy. Her work explores how individual lifestyle as well as broader systemic and environmental factors influence our health. Thank you so much, Brooke. 0:24 Thank you. Good morning. It's great to be here. So let's get started on your path, because you are bridging conventional medicine, holistic care. 0:34 Can you tell us what pushed you towards this bridge and how it's different than maybe how others practice? Yeah. Yeah, absolutely. 0:41 I've always been passionate about more holistic options, but my training is in conventional Western medicine, and 0:50 I've just always noticed the polarization between more of the naturopathic holistic route versus what you can call allopathic or Western medicine. 1:00 And a lot of the, the naturopaths maybe over-criticize medication or, or big pharma and critique really focusing on disease rather than investigating root causes. 1:13 While on the other side, yeah, in my training in Western medicine, you hear a lot of references to maybe naturopathic approaches as lacking evidence or pseudoscience or being too expensive. And I... 1:26 Yeah, it tends to polarize where people feel like they have to pick one or the other, or they hear these kind of vilification of the other side, and I think we absolutely can use the strengths of both. 1:37 I think there are some truths to the limitations of both approaches, but, you know, looking at what works for you and ultimately what's gonna bring your, your li- your quality of life up and, and bring you h- more health and happiness is, is ultimately my goal, and that is what I've seen work really well for people, is op- offering all these options and, and integrating both and giving you the autonomy to figure out what really feels right for me right now, which can change too, with all those external factors in our lives. 2:08 So yeah, I've seen a lot of people find a lot of relief by being told we can use both and, um, that we have all these options rather than one direction or, or the other. 2:19 What do you see as an example in your practice that maybe a psychiatrist might not see because you're able to d- to look from both points of view? 2:28 Yeah, I think that I mentioned kind of a disease focus in our training in Western medicine, and so when you come to someone and you describe your symptoms in mental health care, it's essentially kind of checking boxes, and if you f- fit a certain picture symptomatology-wise, you're told you're experiencing major depressive disorder or anxiety or insomnia, um, or PTSD, and here are the, the FDA-approved options that are, are evidence-based that we know help those symptoms for most people. 3:00 Um, and in our, in our healthcare system, a lot of people are also really limited on time with people. I think that's a, a big factor. 3:08 So while that might be the normal approach and what you'd be offered in that realm, I think what I see is looking deeper at the, the bigger picture and maybe informing people that, yes, you're experiencing symptoms of generalized anxiety disorder, um, but let's look a little deeper at all those factors to understand what might be influencing it and what your body is trying to tell you. 3:33 We can still consider all those medications that we know help stabilize those symptoms and can help you recover and heal, but if we look a little closer at are there genetic factors, are there developmental and, you know, trauma and chronic stress factors, most, which most of us have, what's going on with your gut health and your nutrition and how can you understand how that influences your brain with the gut-brain axis? 3:59 What's going on with your exercise and, you know, sleep, all those foundations, how are those contributing to how your body is responding to those conditions? 4:08 Even relationships, your work-life balance, and, and helping people understand, yeah, what are these symptoms? What's going on with my nervous system? Like I mentioned, education. 4:18 Yeah, really understanding how our nervous system functions and, and why those things are manifesting. 4:24 So I think what I would see differently is instead of a diagnosis and a, a treatment, which again can work really well, more of what are these messages and, and therefore, what can we do to help support you? 4:36 Which, again, may include a medication, but also all those other factors. How can we support on these different levels to, to treat the whole person? 4:46 It's really refreshing to hear a patient being considered an individual and a sort of N of one, where it's like you're-- you are- Yes... 4:53 a unique case, and although that can maybe feel overwhelming to clinicians or larger systems, where it's like you can't put everyone specifically in a box- Yeah... 5:02 from a patient perspective, it's actually quite refreshing and relaxing. [chuckles] Um- Yeah... in the same vein, women in particular often don't fit in these pre-described boxes, or if we do, they're- Yeah... 5:14 we're really only a quarter, halfway to our solution once we get into a box. A lot of times we hear, "Your lab, labs are normal." You're like, "I don't... Something's off. I know it. It's been like this for a long time." 5:27 But you go through all of the poking, prodding, um, and you're told everything's actually fine from one, from one point of view, from the test. 5:36 Can you talk to us about the difference between optimal and being within range- Yeah... and give us an example of like what a woman should push for at visits like this? For sure. 5:46 I love this question, um, because so many people that I'm working with right now present with this exact situation. They're not feeling normal. Intuitively, they know something is off with their body. 5:58 Um, they're having these symptoms and maybe just had the, you know, basic physical lab panel done that you get with your year- yearly physical and are told everything looks good, or maybe even have truly irregular cycles and irregular symptoms hormonally, but the testing can be really tricky with, with hormonal testing and are told everything's okay, when clearly they're not having a, a healthy average cycle. 6:23 So there's a few things we can think about, but the... Yeah, with the foundations and basics, like you mentioned, a lot of the... 6:31 ranges that you're gonna get on the labs back from, um, a primary care or, yeah, your basic screening. 6:38 They're really looking at ruling out a true disease state, um, that may not still support optimal levels if you come back normal. 6:47 So it's really rare with vitamin D, for example, it's really rare that we see people come back in a really optimal level without supplementation these days, unless you're outside a lot, which is hard if you're working and busy. 7:00 Under 30 is what is gonna trigger a, a true vitamin D deficiency state that will come back abnormal on your labs. 7:09 But all the time I see people at, like, 32 or close to this low end, when we know optimal is, uh, most people quote, like, 50 to 90. 7:18 So a lot of times it can be double where you're at, even if you're just falling above the cutoff. 7:25 I think iron and, and iron deficiencies and how that affects our energy and, and mood, that's another big one that a lot of times ferritin is not being tested, 7:38 and it's a little tricky because your serum iron is capturing how much iron is circulating at the time you get your blood drawn, but the body's really adaptive and, and can keep your serum iron level stable while the storage of iron is depleting. 7:52 And that's another tricky one where only under 15 will show up as low or abnormal on the labs, but when we look at what's considered an iron deficiency is actually under 30. 8:04 So to me, that, that one's a big one that is missed a lot. And again, optimal levels for women, I like to see it at 70 to s- to show that your body really has enough iron. So those are a couple big ones. 8:16 B12, some of the other basics ones like that are, are good to look at. 8:21 And then there's also these really in-depth, what are called functional lab tests that, yeah, have a lot of their own nuances, but can look, look at deeper biomarkers and patterns for your body's needs. 8:33 So there's definitely a lot we can explore beyond what's on those typical lab panels. And I think that message is important. 8:40 There's a lot to explore beyond typical lab panels, because just getting to an appointment and having those typical panels done can be overwhelming and logistically challenging for women who are busy. Really, for anyone. 8:54 The scheduling within bigger health systems is a part-time job in and of itself, and having the results read is another part of that process. So I don't want women to feel defeated or like, "Okay, everything's normal. 9:08 I can't trust my intuition," I think is the scariest takeaway of those labs. I've certainly been there many, many times for many different reasons. 9:16 So I, I really appreciate you making the point that there are still other things to explore outside of predefined ranges as, and certainly trust yourself to, to do so if you feel like you're not getting what you want out of the typical labs. 9:31 Yeah. Yeah, like you said, there's so many barriers, and I think that is what is hard. 9:37 You know, if you're working with someone and you don't feel heard and you're not really given the time you need, it's a lot of work to go start over and look for someone new and try and find someone that's gonna be aligned. 9:48 But yeah, I really would encourage people to try to advocate yourself, for yourself, and if you aren't feeling comfortable with someone that, that isn't, you know, a loud space, it, it may be worth going through that process, looking for someone new, that really is helping look at, you know, what's going on with you specifically, again, versus the kind of screening labs that you'd order for anyone. 10:11 I really like to work with people, even though I am in psychiatry and focus on mental health, but helping them advocate, even if it's outside of my scope. This could be going on hormonally. 10:21 These are, these are the kind of tests or labs I would want you to talk about with an OBGYN or with your gastroenterologist and, you know, look at the symptoms and how they're all connected and dig a little deeper. 10:34 So yeah, I, I think it's really important that you pointed out this is, this isn't an easy thing to find in our system, where clinicians are really pushed to see a lot of people and limited by insurance. 10:46 There's a, there's a lot of barriers to have the autonomy to work in this way that, that I You know, really prefer to, and it, it's taken me a while to find somewhere that I'm able to do that and kind of break out of those systems. 10:59 Yeah, we talk to a lot of women who actually realized they were burnt out because they became ill, like physically- Yeah... 11:07 ill, to the point where they actually fit within the standards of illness, which is not really a place you wanna be. 11:14 Can you talk to us about what happens in the body when chronic stress lands and more common for us right now? Yeah. 11:20 This is something that probably comes up the most [laughs] in my work with burnout and chronic stress and anxiety. 11:28 And I think I will always prioritize emphasizing at least my personal belief that, first of all, how important it is to understand that our nervous system and our biology, I think, truly was designed for [laughs] a different world than, than we're living in. 11:44 There's so many factors and influences that have changed in our modern world that did not exist when our systems were evolving. 11:53 And so that, I think, is important to acknowledge when we're having these conversations because there are these broader environmental and systemic impacts, which I think is a, yeah, important to recognize when so many of us are impacted by those symptoms. 12:09 And knowing that, yeah, I think the first thing to understand is how the nervous system works, and that we were designed to shift between these states. 12:18 Our activated, um, people know as like a fight or flight state, is called the sympathetic nervous system. And when we're activated by a stressor, a cascade of things happen in the body with our hormones. 12:30 Um, you get an immediate adrenaline response, and you can feel that if your heart starts to race, blood pressure can go up, um, blood sugar regulation changes, your digestive enzymes actually slow down, gut motility slows down. 12:46 So it's the opposite of rest and digest. And evolutionarily, that's supposed to help us respond to some kind of threat, give us that energy to get away, fight back, find shelter, um, those things. 12:58 And, and cortisol is a downstream effect that's a little longer acting in the body. And so again, in the right situation, that's a really good thing [laughs] to happen. 13:08 There's a, there's a reason we're having this response. But it was designed to be a state that we're only in a small percentage of the time. 13:16 We're s- we're supposed to be able to shift back to what's called the parasympathetic, or people know as rest and digest state, where you're feeling more grounded, present, connected, um, there's not a current threat to your, to your state or wellbeing. 13:32 Um, and again, digestion's working well. You can sleep easily. You can relax. You can focus well. You know, you don't feel that, that constant pressure. 13:42 So again, back to our modern world, you know, we have our careers, we have technology, and all this constant sensory input. 13:50 We know so much about what's happening everywhere in the world [laughs] instead of our own community. All the socioeconomic, financial pressures. 13:59 We're very separated from community, you know, really individualistic lifestyles. 14:04 There's a lot of pressure on us to take care of ourselves, our families, and we're not living in tune with [laughs] nature as naturally as we used to be. We're inside. There's artificial light. 14:14 Um, yeah, I could probably talk for an hour about how different our world is, um, but I think that is one of the most important things to understand because it's not a surprise that so many of us are at a baseline more often in this sympathetic state. 14:29 We can't slow down. There's always more deadlines. There's always more pressure. 14:34 And when our body is in that state chronically, that's when it starts to break down, we could say, or, or have these unintended effects long-term. 14:44 Yeah, your body's ability to digest food and, and regulate sleep is all gonna be impacted. And so I see a lot of GI [laughs] issues and gut health issues, like you said, a lot of sleep issues. 14:56 You're exhausted, um, you're depleted, but the adrenaline's still telling your brain there could be a threat. We have to be ready. We have to be on edge. 15:05 And also downstream, especially after years, the statistics are, are pretty telling in terms of chronic health conditions, especially autoimmune conditions, especially in women, which is a whole nother interesting conversation too with the stressors that are specific to women and cultural roles and social impacts. 15:26 There's a lot there, too, on how we kind of hold and suppress stress. And like you said, we can really keep functioning and keep it together for a long time until the body starts to, to shut down or it can't keep up. 15:39 And, and so yeah, as resilient as we are, the system just was not designed to be this chronic baseline state. So it really does have those impacts on our mind and body long-term. 15:52 In addition to rest and digest as a practice, are there any other practices you'd tell someone who's in that chronic baseline- State of stress to start. Yeah. 16:05 There's so many things, and of course, if it were easier, [laughs] we, we wouldn't be in this situation. But yeah, I try and think about, you know, what, what are those easiest points of entry for you in your life? 16:17 It's gonna look different for everyone. 16:19 As much as, you know, our relationship to work if you're working and career is often a big point of stress, as much as we can try and work with that, I know a lot of times that can be outside of our control how much influence we have, but it's still always a very important conversation to be honest about how it's impacting you and, and your quality of life. 16:40 But on a more day-to-day basis, yeah, sleep has gotta be one of the most important things. 16:45 Um, and I know we all hear it with sleep hygiene, but truly, having boundaries with getting off the screens at least an hour before bed, even lowering lights in your home to, to let your body start to wind down. 16:57 Um, there's just so much input on the screens that is intentionally designed to elicit emotions through media. 17:05 You know, their goal is to keep [laughs] us engaged, and whether that is fear or anger or something exciting, that is still adding that kind of stress response right before bed often. 17:17 So that would be a big one, is to really give your system time to wind down, because if you're tired enough to fall asleep, but you're still having insomnia, that's, that's a huge signal. 17:29 Yeah, even mindful moments before eating, when we mention rest and digest, grounding, breathing, allowing your body to settle. You might notice a difference in sym- symptoms like bloating or indigestion. 17:42 And then I really like, you know, of course with mindfulness, yoga and meditation, but I personally really like breathwork as just a very accessible tool because we know meditation over time really does help the brain regulate stress, come back to that parasympathetic state. 17:59 But breathwork I feel like is, is cool because you can feel the immediate benefit, in my opinion, a little quicker, a little easier, um, and you can use that daily to... 18:10 I think of it as like a workout for the nervous system to help train it to come back to this, this restful state. 18:17 But even in specific moments of overwhelm, the way that we're breathing both influences our heart rate, but also the oxygen and CO2 balance. It's really interesting, affects how our body is responding. 18:31 So you can do down-regulating breathwork, usually lower or slower exhales, longer exhales. 18:38 There's so many good tools on apps or YouTube that you can follow along with, and that, in the moment really, our, our body has to respond, slowing down the heart rate, grounding, feeling some relief. 18:50 So there's, there's so many things we can do to try and lower stress and regulate. But yeah, I try to look with people specifically, what's your day looking like? 18:59 Where are these little inputs one at a time that we can work on to build in breaks and help your, your system come back to this parasympathetic state? I, I do the box breathing if I can't- Yeah... 19:11 fall asleep when it's so useful. It surprises me how useful it is, honestly. Yeah. [laughs] I tell people, keep trying. 19:18 If like the first one i- doesn't feel right for you, there's so many, there's so many styles, box breathing. 19:24 One that they studied in recent years over at Stanford is just the cyclic sigh, where you do a deep breath in through the nose and then another, [sniffs] 19:34 another tiny inhale to really fill, and then a slow [exhales] exhale through the mouth, and you just cycle through that. And someone I heard once mention, you know, we kind of do this naturally. 19:45 If you're ever really overwhelmed and crying and releasing energy, and you [sniffs] do that like double inhale, it, it slows the body back down. 19:53 Um, and so sometimes even like a few rounds of that, you'll feel in your body something changing. So yeah, I'd encourage people to try different things. I really love Breathe With Sandy on YouTube. 20:04 He, he makes his own music to go along with these different pretty short videos, or there's a whole range, but they're really nice to just throw on with some tea at the end of the night and listen along and not have to think about it and be guided through that and really feel the difference as you're getting ready for bed. 20:24 Super helpful. I'm thinking about myself. I'm also thinking about my kids. Small little behaviors that, that could help, especially in a moment of meltdown. For sure. Yeah. 20:33 It's so exciting to hear people talk more about how do we talk to our kids about emotional regulation and these tools and helping them understand too, what am, what am I feeling? 20:44 It's overwhelming, and, and what can I do to take care of myself? I think that little things like that can change the world and our future. Yeah, I couldn't agree more. Yeah. 20:55 I could go down a whole nother rabbit hole just with emotional regulation and, and yeah, when we are taking care of ourselves first and loving ourselves in these ways, um, I mean, that absolutely is gonna impact how you interact with everyone, how you work, your family, your friends. 21:13 Yeah, we, we, if we can regulate and take care of ourselves first, it, it changes everything with how we interact with the world around us and the ripple effect that that has. So yeah, it's huge. 21:24 I wonder if you have any, uh, thoughts on that, you know, in addition to, to all the other approaches. Yeah. 21:32 Yeah, it's a great question, and it is what is s- what makes, I think, mental health unique to, I guess, unique compared to the rest of the sym- systems, and especially because the way mental health manifests, yeah, it's how we experience our life and ourselves and relate to the world, that that is gonna be different than, you know, when you're diabetic and needing to support that organ system differently. 21:57 So spirituality is huge. 21:59 It is one of my lists of questions I touch on when I'm getting to know people on y- where that's at for them and how important, and I think that, yeah, again comes back to some changes in our modern world that whether-... 22:13 not religious or not spiritual. We are disconnected from a lot that even culturally or I think in the past was more integrated into our lifestyles, and that looks different for different cultures and different timelines. 22:26 But it is very important to, to consider, and there's a lot of deeper layers there. 22:32 And whether it's something I'm addressing very directly with people through their own practices or preferences or bringing in psychologists, I always recommend therapy as one of the most important components, again, with all these factors we're working on. 22:49 It's, yeah, very important to, to address. And like you said, we could, could go deeper, but that is one unique component that, that feels different compared to the rest of medicine, the, the psycho-spiritual impacts. 23:03 And again, thinking about our modern world and a lot of stressors and, yeah, a lot of... I'm trying to think of another word other than stressors, but a lot of... 23:13 With the technology evolution and, and changes in that way, how, how separated we're becoming from that connection. 23:21 Yeah, through a lot of different late stage capitalists and technology evolution ways, we're, we're being more and more separated, I think. 23:30 Your perspective is so needed, particularly for women, not just in the workspace, 'cause often we're connecting the current structures and systems to the future structures and systems- Mm-hmm... 23:42 and trying to figure out a way to get there. It's also very much in healthcare- Yeah... 23:48 and, and psychology where we're trying to get sort of to a next level of, of systems and, and often that entails combining what we currently have into something new. 23:58 I appreciate you and your practice and sharing that with us. Thank you so much. Can you let us know where people can find you? Yeah. 24:08 I would say, like, professionally connecting, LinkedIn, I'm on just my name, Brooke Bearden, B-E-A-R-D-E-N. Yeah, I don't have Instagram or social media on my, like, clinical business side at this time. 24:23 We stay pretty, pretty busy in mental health, and I think the best way clinically to connect or for those kinds of services is just through the practice that I'm independently contracted with, working with, is called Helyx Health, and that's spelled H-E-L-Y-X, helyxhealth.org. 24:41 We're, we're a Bay Area small group practice focused on mental health and, and sleep, and we have a lot of wonderful psychologists and a couple of us on the, the psychiatry side as well. Amazing. 24:53 Thank you again for your time
