The Big Sleep

Darcy—a tall, sleepy-looking blonde 20-something in sweats—walked in the front door of naturopathic physician Ginger Nash’s New Haven office, trailing behind her mom. Darcy’s mom, Janet, a rather jolly woman with a shock of dark hair and dark-framed glasses, made herself at home on the couch in the waiting area as Darcy plopped down beside her. “Hasn’t slept in days,” Janet said, extending her thumb toward her daughter, a college student in New York City. “We don’t know what to do.” Darcy had the look that is all-to-familiar to naturopathic doctors: the bleary eyes and drawn complexion of sleep deprivation. In an age when 60 million Americans have insomnia, it’s a difficult not to encounter this diagnosis on a regular basis. As a medical student, it’s something with which I’ve had far more first-hand experience than I care to dwell on. When Dr. Nash brought Darcy back to her office for her intake, it appeared that Darcy’s insomnia had its origins in anxiety and depression over a significant trauma she’d experienced in the last year, as well as over her sister’s hospitalization due to mental health problems. As homeopathic scholars describe it, psychological illness can be passed down as miasms—a sort-of transfer of energy—from generation to generation within families; Darcy and her sister were suffering from the same subset of a disease pattern, though Darcy’s were of a less severe nature.

Darcy sat up attentively in her chair and described her symptoms quietly but articulately. She couldn’t fall asleep due to hyper ideation and when she did, she’d awake every two hours, having had disruptive, disturbing dreams. After almost every meal, she’d have cramping and bloating and had taken to eating as a way of coping with the stresses of schoolwork. Occasionally, she’d be doubled over in pain after a meal due to a “spasm-like” feeling on her sides. Despite the insomnia, she described her energy levels as “pretty good” and said that her exercise was walking around the city all day. Her menses are normal and she experiences bad cramping during the first day and a half of her period. She has migraines not infrequently and is quite worried about the acne that seems to be stress-induced. She stores stress in her upper back and neck where painful knots accumulate. A psychiatrist that Darcy had seen a month prior had put her on Ativan for the anxiety, but she wanted to discontinue it, fearing a dependence on the medication and because she was experiencing the annoying side effect of dry mouth; more significantly, it had stopped working for her, particularly at night.

Dr. Nash took all of this in, nodding her head and murmuring sympathetic, understanding comments as she wrote an occasional note on her clipboard. Naturopathic doctors are trained the same as their conventional medicine counterparts when it comes to basic and clinical sciences, but they also get extensive training in counseling. Often, patients will come to naturopathic doctors not only for medical prescriptions but also for a well-trained, sympathetic ear. Dr. Nash is no exception and she provided Darcy with some excellent feedback in that regard. To calm down Darcy’s sympathetic nervous system, Dr. Nash prescribed two NAP products: Cortiguard and Tranquility Base, both of which address concerns related to nervous system upset.

Cortiguard is an excellent product for anyone with mental and physical burnout. When we are chronically stressed out, the adrenal glands, which are located above the kidneys, continually pump out cortisol (the stress hormone) and at much higher levels than is normal. High levels of cortisol have been linked to insomnia, weight gain, type 2 diabetes, bone loss, infertility, and lowered immune function, among other things. Cortiguard is effective because it contains adaptogenic herbs that provide support directly to the adrenals to fend off exhaustion and return them to as much of a baseline as possible in terms of cortisol production. The herbs contained in Cortiguard are: bacopa leaf, boerhavia root extract, panax ginseng root, and eleuthero root. Cortiguard also contains Vitamins C, B1, B5 and B6, and alpha-lipoic acid, which are essential for a healthy stress response.

Read more about Cortiguard at: http://www.scribd.com/doc/34243296/Cortiguard-SpecSheet

Tranquility Base aims to relax the body at both the physical and mental level. It contains GABA, the main inhibitory neurotransmitter in the brain, which means it has a sedative effect. L-theanine is the ingredient in green tea that keeps you from getting jittery after consuming that caffeinated beverage; it is a major amino acid that augments alpha waves in the brain, facilitating a calming effect minus drowsiness. Tranquility Base also contains two heavy hitters of calming herbs: lemon balm and chamomile.

For more information on Tranquility Base, click on:

http://www.scribd.com/doc/34534005 /Tranquility-Base-SpecSheet

As for Darcy’s gastrointestinal issues, Dr. Nash associated them with her anxiety; the gut has the same number of neurotransmitters as the brain and originates from the same fetal material. So, resolving her anxiety and sleep issues would significantly reduce her bloating and cramping. Dr. Nash also gave Darcy some guidelines for eating according to her AB blood type that might help resolve some food reactivity: consume smaller amounts of meat, avoiding pork, chicken and beef; focus on lamb, turkey and seafood with some eggs, dairy and grains such as spelt, but not wheat. Dr. Nash also put her on some homeopathic remedies to further support Darcy’s nervous system.

How is Darcy doing now? By all reports she’s sleeping better and has had a significant decline in anxiety and hyper ideation, which weekly therapy has also helped. She will continue on the both the Cortiguard and Tranquility Base until her symptoms resolve more completely. Adrenal repair is not a quick fix and continuing to support adrenal function, especially in students and the otherwise chronically stressed, is an ongoing process. It is important to note that a patient who suffers from this particular symptomatology will always have some an occasional bout of insomnia and anxiety; it is never completely eradicated. The worst part about this is the feeling of powerlessness patients feel. Therefore, the goal is to provide the patient with a set of tools for dealing with the occasional flare-up—whether adding Cortiguard for a month or practicing meditation— as means for coping. The key is keeping anxiety its accompanying set of terrors to occasional visit, not a permanent stay.