(Listen to the full episode here.)

What is Anxiety?

Anxiety is one of the most common mental health disorders. (R, R) It affects 30% of adults and 15-30% of children at some point in their life. Furthermore, having an anxiety disorder increases the risk for cooccurring psychiatric disorders.

There are several main types of anxiety disorders. These include generalized anxiety disorder, social anxiety disorder, panic disorder, phobias, and separation anxiety disorder. Others that are less common include health anxiety, substance or medication-induced anxiety disorder, and “false anxiety.”

The Diagnostic and Statistical Manual, Fifth edition (DSM-5) states that anxiety disorder is classified by excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). Core symptoms include restlessness or feeling keyed up, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbances.

Although chronic stress has been associated with, and is a risk for, anxiety, depression, and other psychiatric disorders, there is a distinction between them and treatments often differ. (R, R, R, R, R, R, R, R) According to the American Psychological Association:

There’s a fine line between stress and anxiety. Both are emotional responses, but stress is typically caused by an external trigger. The trigger can be short-term, such as a work deadline or a fight with a loved one or long-term, such as being unable to work, discrimination, or chronic illness. People under stress experience mental and physical symptoms, such as irritability, anger, fatigue, muscle pain, digestive troubles, and difficulty sleeping.

Anxiety, on the other hand, is defined by persistent, excessive worries that don’t go away even in the absence of a stressor. Anxiety leads to a nearly identical set of symptoms as stress: insomnia, difficulty concentrating, fatigue, muscle tension, and irritability.

A major clinical distinction is that the brains of those with anxiety “neurologically fire” on an ongoing basis. These individuals can experience dread, panic, or fear in any situation, even in circumstances that that are supposed to be “enjoyable.” On the contrary, those who do not have an anxious or depressed brain are able to get back to their set point after a stressful event is over, though some additional natural or conventional coping strategies may be required.  (R, R, R, R)

Anxiety is not a willpower issue or a core personality disorder. It is a brain health disorder. It is also not solely genetic. It is influenced by several factors that impact brain health such as environmental exposures, nutrient deficiencies, hormonal issues, blood sugar dysregulation, digestive problems, trauma, and more.

There are also brain processing patterns that are characteristic of individuals diagnosed with a mental health illness. For example, studies have demonstrated that those with psychiatric disorders have different neurotransmitter and neuroendocrine signaling, anatomical and neuroimaging findings on brain scans, and share genetic variations that differ than those without diagnoses. (R, R, R, R, R)

This means that to get to the root cause of anxiety and other mental health disorders can be complex. However, when you have a brilliant, compassionate, and passionate naturopathic and functional medicine doctor on your side, like Dr. Kate Kresge, it can also be transformative.


Hope for Anxiety with Naturopathic and Functional Medicine

On today’s episode of the Essential Oil Revolution, Dr. Kate Kresge, a leading expert in integrative mental health and naturopathic and functional medicine, shares her expertise with us.

Dr. Kresge, known as “Dr. Kate,” is the founding functional medicine director of a successful 13-location multidisciplinary integrative healthcare practice. She is a sought-after speaker, a national expert on natural and functional medicine approaches to mental health, and the head of medical education for Rupa Health. Rupa Health is a company in alignment with Dr. Kresge’s mission to find the root cause of diseases and empower functional medicine practitioners and their patients.

Dr. Kate has an amazingly insightful, grass-roots approach to applying functional and naturopathic medicine. She can effortlessly weave in her understanding of complicated biochemical and psychological imbalances with solutions that are based on the foundations of health from a wholistic perspective.

Her ability to synthesize research studies, nutritional data, and clinical experience is evident in the way that she teaches other providers and the success she has had with her patients. Dr. Kate is restoring people’s brains so they can live the life they deserve, a life where they thrive.

I can’t wait for you to listen to this episode so you can benefit from her knowledge.

Below is an overview of what we covered, but make sure you tune in to the full episode to get all the inspiring information.


Dr. Kate’s Journey That Led Her to Specialize in Integrative Mental Health

Dr. Kate struggled with stomach pain, insomnia, anxiety, depression, and mental health issues from 10-21 years of age. Although she saw some of the best specialists, she was never able to get well. After doing everything recommended and not experiencing relief, Dr. Kate developed empathy for the shame and self-blame patients have when treatments fail them.

At 21 years old, Dr. Kate met with a functional medicine doctor who diagnosed her with Celiac disease. Within three days of eating a gluten-free diet, her anxiety, depression, skin problems, body image issues, and stomach pain resolved.

Experiencing this shift was life-changing for Dr. Kate. She then made it her mission to help other “medical mysteries” to find the root-cause answers that were so effective for her. Her functional medicine doctor, who was a medical doctor trained in acupuncture, steered her to become a naturopathic doctor. In this way, Dr. Kate was exposed to functional medicine during her medical education from day one.


Using Food as Medicine to Correct the Four Underlying Causes of Anxiety

When healing a brain health disorder with nutrition, broad recommendations such as “eat more plants and whole foods” don’t go far enough. Dr. Kate emphasizes a personalized nutritional approach that is strategic. It is based on the availability, absorption, and intake of specific nutrients.

Using this method, along with supplementation and lifestyle, Dr. Kate addresses the four major causes of anxiety. These include oxidative stress (R, R), nutrient deficiencies, hormone dysregulation (R), and immune imbalances.


1. Oxidative Stress

According to Medical News Today:

Oxidative stress is an imbalance of free radicals and antioxidants in the body, which can lead to cell and tissue damage. Oxidative stress occurs naturally and plays a role in the aging process.

When the body experiences stress and a lot of wear and tear, it can deplete nutrients and cause damage to our cells. (R, R) Our cells are made of fats, but when they oxidize, they become malformed and unable to effectively respond to neurotransmitters such as serotonin, dopamine, and Gamma-aminobutyric acid (GABA).

Antioxidants can protect cells by giving oxidants “something to grab” instead of our cell membranes. Many essential oil lovers are aware of how essential oils act as antioxidants that support cell membranes. Nutrients can also act in this way while fueling the body and brain.

In the past few years, science has made great strides in perfecting how to measure metabolites in the blood. These discoveries have led to the ability to correlate certain inflammatory substances and oxidative stress markers to anxiety.

Oxidative stress can be determined through Total Antioxidant Capacity (TAC) and F2-isoprostene. One can also test for specific antioxidant nutrients, such as vitamin C, in the blood. Common inflammatory mediators include hs-CRP (high sensitivity C-reactive protein), ESR (erythrocyte sedimentation rate), and various cytokines.

Another way to determine antioxidant status is through analyzing nutrient intake with myfitness pal, or, Dr. Kate’s preferred method, cronometer. These tools assess the average amount of nutrients a person consumes. Many people assume they are getting enough antioxidants from food, but it is exceedingly difficult. Dr. Kate has spent years building nutrition plans to optimize nutrients and has seen that most people are extremely deficit.

Through these assessments one can individualize their diet and supplement protocol to optimize their antioxidant intake and fuel their brain. They can also help people to move away from a restrictive mindset to what Dr. Kate calls “nutrition by addition.”


2. Nutrient Deficiencies

Along with antioxidants being deficient in those with anxiety, healthy fats (omega-3 fatty acids) can be as well. Various studies have supported the use of fish oil for psychiatric disorders.(R, R, R) Dr. Kate highlighted one of her favorite studies that demonstrated that 3g of omega-3 fatty acids caused a 60% drop in anxiety and anger in those with a substance use disorder.

Omega-3 fatty acids (n-3 fatty acids), docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), can lead to better mental health through the nutrition they provide and their ability to control inflammation. They also help to balance out pro-inflammatory omega-6 fatty acids (n-6 fatty acids). Many people have higher inflammatory n-6 fatty acids in their diets than vital essential fats.

One study states, “Cell involved in the inflammatory response are typically rich in the n-6 fatty acid arachidonic acid, but the contents of arachidonic acid and of the n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) can be altered through oral administration of EPA and DHA.”

Top sources of omega 3’s include salmon, chia seeds, flax seeds, and walnuts.


3. Hormonal Dysregulation

Besides the sex hormones, the thyroid is one of the most common imbalances found in those with anxiety disorders. High or low thyroid function and autoimmune thyroid disorders, like Hashimoto’s, all have been linked to anxiety.

One review study states this correlation is related to neurotransmitter regulation, “Thyroid disorders and mental illness are often interrelated. T3 has been intimately associated with depression and anxiety due to its regulatory effects on serotonin and nor-adrenaline.”

Dr. Kate will often run a full thyroid panel including TSH, thyroid hormones (T3 and T4), free thyroid hormones (fT3 and fT4), and thyroid antibodies to asses if an imbalance in this organ is contributing to brain health issues.

Testosterone has also been linked to mood imbalances. Along with the other sex hormones, it should also be considered.

Importantly, Dr. Kate has often found that low DHEA and other androgens are often missed as contributors to anxiety in favor of the sex hormones. This may be based on how androgens get depleted with high cortisol output from stress leading to “adrenal fatigue,” which impacts emotional health. This “cortisol steal” of DHEA can be represented by the hormone cascade which depicts how DHEA can bypass this “cortisol steal” and help to fuel estrogen and testosterone.

Low DHEA could also impact mood related to how neurosteroids regulate the brain. In a review article on the impact of DHEA on the brain, the authors stated that dehydroepiandrosterone (DHEA) likely leads to emotional modulation via influencing neural connectivity and pathways in the brain. Specifically, brain imaging revealed that DHEA seems to reduce activity in the amygdala and hippocampus while enhancing their connectivity as it boosts the anterior cingulate gyrus. These brain-based changes were associated with less negative affect in study participants.

Due to the fact that the adrenal glands help with estrogen production by making DHEA and androgens during menopause, it is imperative to support them with any hormonal shifts.

Dr. Kate will often check all these hormones through various lab panels. These include DHEA, cortisol, estrogen, progesterone, and the hypothalamic-adrenal-pituitary (HPA) axis signaling molecules, FSH and LH.

Dr. Kate can usually get DHEA and hormones boosted with lifestyle, supplements, and nutritional support. However, supplemental DHEA may be needed when one is truly depleted.


Essential Oils for Hormonal Health

Naturopathically, essential oils and adaptogenic herbs, can help with stress resiliency. They can both assist with cortisol balance and adrenal health as a result.

According to the American Botanical Council:

Essential oils (EOs) of angelica (Angelica archangelica, Apiaceae), fennel (Foeniculum vulgare, Apiaceae), sage (Salvia officinalis, Lamiaceae), lavender (Lavandula spp., Lamiaceae), geranium (Pelargonium spp., Geraniaceae), and neroli (orange blossom; Citrus × aurantium, Rutaceae) contain phytoestrogens that stimulate release of neurotransmitters like endorphins, norepinephrine, and serotonin, affecting emotions. Neroli’s constituents linalyl acetate, linalool, myrcene, and limonene are credited with anxiolytic and relaxing effects. Neroli also has antidepressant, antioxidant, antispasmodic, and aphrodisiac properties and no known AEs.

Dr. Kate also likes to use lavender oil due to how it has been shown to be as effective as benzodiazepines for anxiety. It has a dual action of soothing the brain through neurosteroid signaling and lowering cortisol.


4. Immune System Imbalances

When the brain is inflamed by an immune trigger, various psychological, cognitive, mood, and muscular issues can occur. For example, an autoimmune flare can cause autoimmune encephalitis (AIE), an immune-mediated condition that induces brain inflammation.

An example of how the immune system interacts with the brain is PANDAS, short for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. In this instance, strep antibodies attack the brain which results in extreme psychiatric symptoms, including obsessive compulsive behaviors. One must fix the root cause (infectious) to address and heal the mental health manifestations, not just treat the anxiety symptoms.

Besides autoimmunity, immune system deregulation can occur with allergic responses. These can also impact the brain. In fact, histamine is an excitatory neurotransmitter. This means treating allergies may help with anxiety. Antioxidants help calm down high histamine and inflammation, serving a dual role for mediating the immune response and oxidative stress.

Another link to immune health is the gut-brain-immune association. This means when the gut is “off,” the immune system can become pro-inflammatory and set the brain on fire.


Essential Oils for Gut-Immune Health

Dr. Kate’s favorite essential oil DIY is one that she recommends for patients with SIBO, small bacterial intestinal overgrowth. SIBO is a form of dysbiosis, or bacterial imbalance, in the small intestine. The formulation she uses is a blend of thyme and oregano oils with sage and lemon balm extracts, CandiBactin- AR. This product, along with another herbal formulation, was found in one study to be as effective as the conventional treatment, rifaximin, with less side effects.

Essential oils also offer the additional benefit of supporting the microbiome, rather than wiping out good bugs. They can also quench oxidative stress, offer digestive support, relieve stress, balance the nervous system, and mediate various pathways involved in inflammation.


Learn More

Dr. Kate and I close with our traditional closing questions. Interestingly, what she does daily for self-care relates to anxiety! You’ll have to listen to find out what it is!

Click here to hear the interview and access the show notes.

Please support the show by subscribing and providing a rating and feedback on your favorite podcast player. This is a no-cost way to spread the word and to keep attracting amazing guests like Dr. Kate!


Links to Learn More About Dr. Kresge and Her Offerings


Articles by Dr. Kresge on Mental Health

Podcast Interview: Nutrition’s Role in Anxiety Disorders: Evaluating Mental Wellness


Dr. Kresge’s Bio:

Dr. Kate Kresge is a passionate, compassionate, and brilliant naturopathic physician who is the current Head of Medical Education at RUPA Health, a company dedicated to bringing root cause medicine to the world. Before joining RUPA, Dr. Kresge was the founding Director of Functional Medicine at Sanare Today, an impressive 13-location practice on the east coast of the U.S. This integrative clinic combines therapy, coaching, and natural medicine and has succeeded in helping over 8,000 people to thrive.

Dr. Kresge is a sought-after speaker and national expert in the utilization of natural therapies and nutrition for psychiatric conditions such as anxiety, depression, and ADHD. She offers CEU courses for naturopathic doctors and pharmacists on mental health. Dr. Kresge also shares her knowledge as the host of the Root Cause Medicine Podcast, where her training in naturopathic medicine, biofeedback, and nutrition allows her to highlight the power of implementing root-cause treatments.

Dr. Kresge is a strong advocate for correcting the misconception that mental health is solely based on psychology or willpower. She empowers both patients and practitioners with her integrative and team-based approach. She also strives to help keep functional medicine accessible to all with an emphasis on low-cost and effective protocols.

Dr. Kresge’s science-based approach to nutritional support, lifestyle medicine, and personalized supplementation is erasing the shame of mental health and legitimizing that biological imbalances in the brain do not need to be stigmatized. Perhaps this is one of her most admiral qualities, besides her genius. She provides a fierce yet heart-based message that when the brain gets the nutrition and support it needs, it can optimally function, and people can once again thrive. You can learn more about Dr. Kresge at https://www.doctorkatehenry.com/ and on Rupa Health at https://www.rupahealth.com/author/dr-kate-Kresge.

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Disclaimer: This material is for information purposes only and is not intended to diagnose, treat, or prescribe for any illness. You should check with your doctor regarding implementing any new strategies into your wellness regime. These statements have not been evaluated by the FDA. (Affiliation link.)

This information is applicable ONLY for therapeutic quality essential oils. This information DOES NOT apply to essential oils that have not been tested for purity and standardized constituents. There is no quality control in the United States, and oils labeled as “100% pure” need only to contain 5% of the actual oil. The rest of the bottle can be filled with fillers and sometimes toxic ingredients that can irritate the skin. The studies are not based solely on a specific brand of an essential oil, unless stated. Please read the full study for more information.

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