Ep. 273 Optimizing Mental Health with Myo-Inositol: Evidence-Based Strategies

I’m delighted to have Dr. Roseann Capanna-Hodge back on the show again! She was with me before in Episode 174.

Dr. Roseann is an incredible pediatric mental health expert who utilizes traditional and non-traditional modalities for her patient population. She joins me today to discuss the role of Myo-inositol from a mood and mental health perspective. We dive into what Myo-inositol does in the body, what depletes it, and how the gut and the brain connect with the vagus nerve. We talk about the mental health benefits of Myo-inositol and how it impacts mood disorders- specifically eating disorders and binge eating, as well as obsessive-compulsive disorder, stress and anxiety, panic attacks, and depression. We also get into Dr. Roseann’s unique ways of calming the autonomic nervous system and brain inflammation, the current medical model and its limitations, and the impact of trauma.

I sincerely hope you enjoy listening to today’s interesting and informative conversation with Dr. Roseann Capanna-Hodge!

“If you are feeling really overwhelmed, just be present in the day. Start with one tiny little thing and lean into that one thing.”

– Dr. Roseann Capanna-Hodge

IN THIS EPISODE YOU WILL LEARN:

• The benefits of Myo-inositol.
• The impact of having low magnesium in the body.
• How to protect yourself from the depletion of the microbiome.
• Why it is essential to listen to your body.
• The connection between the gut and the vagus nerve.
• How the magic in mental health is in the micro-changes.
• Where to start when helping a teenager or young adult struggling with OCD, anxiety, or depression.
• Why is it important to reframe negative thoughts?
• What happens when the brain is dysregulated?
• What is going on in the brain when we’re under stress?
• The root cause of mental illness.
• What you can do to improve your brain health.
• The role of trauma in mood disorders

Connect with Cynthia Thurlow

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Check out Cynthia’s website

Connect with Dr. Roseann Capanna-Hodge

On her website

Dr. Roseann’s podcast, It’s Gonna Be OK!

Ep. 174 – Identifying and Treating Your Children’s Mental Health: How We Can Be Their Greatest Support with Dr. Roseann Capanna-Hodge

Transcript:

Cynthia Thurlow: Welcome to Everyday Wellness Podcast. I’m your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.
Today is a wonderful repeat podcast guest, Dr. Roseann Capanna-Hodge. She last joined me on Episode 174. She is an incredible pediatric mental health expert and utilizes a great deal of traditional and nontraditional modalities in her patient population. She joined me today to talk about the role of Myo-inositol from a mood and mental health perspective. We spoke at great length about what Myo-inositol does in the body, what depletes it, the contributors of the vagus nerve, mental health benefits from Myo-inositol. How it impacts mood disorders including obsessive compulsive disorder, stress and anxiety, panic attacks, depression, and specifically eating disorders and binge eating. We talked about her unique ways of calming the autonomic nervous system and brain inflammation. We spoke at great length about the current medical model and limitations there and the impact of trauma. I hope you will enjoy this conversation as much as I did recording it.

Hi, Roseann. It’s so good to have you back on Everyday Wellness.

Roseann Capanna-Hodge: I’m so excited for this conversation about mental health and how Inositol supports so many mental health conditions. I know something you and I talk about all the time and this is going to be so helpful for so many people that are struggling.

Cynthia Thurlow: Absolutely. I think for so many people, I’ve been so transparent and I’ve said, “I know a lot about Myo-inositol.” But when it comes to the mental health, the brain health, etc., this is not my area of expertise. And you were the first person I thought of to bring on as an expert, as a clinician to be able to speak to these unique qualities of Myo-inositol. For benefits of listeners, we’re going to do a brief little recap on what Myo-inositol is. It’s actually a constituent of the phospholipid layer of the cell membrane. It helps to mediate communication between cells in response to hormones, things that are recognizable and for cell growth. It’s also abundant in the brain and nerve tissue and it’s tied to some key neurotransmitters like dopamine, serotonin and how well they are utilized. It also helps to regulate specific hormones, thyroid secreting hormone or TSH, FSH, follicular stimulating hormone, which is communication between our brains and our ovaries, as well as insulin and glucose.

The other thing that’s really interesting is that our bodies can actually make some degree of Inositol. In addition to that, we can get some from our diets but most of us aren’t eating enough of the foods that incorporate these into our lifestyles. There’s really solid research on metabolic disorders, PCOS, insulin resistance, infertility, and mood disorders. So, when I did my previous podcast with Scott Emmens from MD Logic, I kept alluding to the fact I would have this conversation with Dr. Ro and so Dr. Ro is joining us today to be able to speak on behalf of a clinical perspective. Now, Dr. Ro, I would imagine with our modern-day lifestyles, there’s a lot about how we interact with our environment that can actually deplete Myo-inositol. For you, do you see low magnesium being an issue for a lot of your patients? So, you’re a clinical psychologist, you work with a variety of children and men and women. Do you find that magnesium or low magnesium can actually exacerbate our need for Myo-inositol?

Roseann Capanna-Hodge: Yeah. Please know, Myo-inositol and Inositol are used interchangeably and it’s the same thing. So, I don’t want to confuse anybody. I’m so used to always talking about Inositol, so bear with me. First, magnesium, the most used nutrient in the body is just most commonly depleted in basically every single individual I see. A lot of time, I work with families, and they bring a young adult, a teenager, a child to me, and that is the identified person who’s really struggling. It could be anxiety or depression or OCD, whatever it is. And through testing, we often find that they have low magnesium. But then when we go to mama and papa, the whole family is low in magnesium because of stress. I was just talking about this with my husband today because “I’m working on a magnesium product. He’s like, “How many magnesiums are you going to be selling to people?” I’m like, “The whole family needs it.” I was like, you take it or entire family of four takes it because we need it. And there is a connection to this very important nutrient and Inositol l for brain health, and we step out more specifically, these nutrients tend to be low individuals with Myo-inositol, in particular with anxiety, OCD, depression, bipolar, panic attacks, agoraphobia, eating disorders. And I’m putting PCOS in there because PCS tends to be a root cause of some of these other things. It’s important to make that connection between low Inositol levels, which they say are rare. But I don’t believe that because we know through research when you actually supplement with Myo-inositol and magnesium these conditions, the symptoms improve.

Cynthia Thurlow: I think it’s so important to understand this interrelationship with our environment, the foods we’re consuming, etc. The net impact on low magnesium exacerbating this need for Inositol. It’s interesting when I was looking at the research, magnesium is actually required for biosynthesis of Inositol in the same vein, when we talk about what depletes Inositol stores in the body, it’s our hyper-processed, hyper-palatable nutrition. It’s low salt intake and when we talk about low salt intake, we know sodium is very important for a lot of physiologic processes. These low sodium diets, I mean, how many times did I tell my patients in cardiology that it was important that they consume these nearly unpalatable diets with no salt, no fat, and encouraged them to eat cardboard, essentially, and that they’re supposed to be satiated? But also, insulin resistance plays a role. We know that the aging process just even antibiotics.

Roseann Capanna-Hodge: Yes.

Cynthia Thurlow: We know that antibiotics have a huge net impact on the body. As someone who was recently on antibiotics because I picked up Salmonella during travel when I came home being very symptomatic, there’s a lot that you have to do to kind of counteract being on antibiotics. By no means am I saying that there’s not a place for antibiotics, but understanding that this in and of itself can also create these imbalances and then caffeine use. How many of us are addicted to caffeine and we consume way too much of it? That also can deplete the Inositol levels in our bodies as well.

Roseann Capanna-Hodge: Yeah. And I think we started this conversation about magnesium and you talked about this. Magnesium is the most used nutrient because over 300 processes require it as a cofactor. So, it’s the helper. When magnesium is so low for so many people because of stress and these things that you’re talking about and you can get antibiotic script for just about anything. It’s actually shocking how easily they want to hand it out when you go to the doctor. I recently had pneumonia and I was like, “Do I really have to take antibiotic and I’m going to try the herbals?” Finally, I was like, “I don’t got time for this.” I’ve had RSV. I’ve got to do it. I said, “Just give me the lowest amount, the shortest dose, and I’m going to use my herbals.” And that’s what I did. You do have to protect yourself for the depletion of the microbiome and everything is connected.

I mean I think this conversation I love to get into the weeds of thing, but ultimately, in the end, every little thing that you do can be a helper or a hurter. And there are times just like “Dr. Ro had to get on some antibiotics,” and yes, my pneumonia went away, and I caught it really early because I know myself and I know my body. I then purposely countered and making sure that I had extra nutrients and of course probiotics at the right time away from my antibiotics to repair my body. When we talk about low levels of Inositol, we may not understand some of these symptoms that we see because they’re vague and they can be attributed to a lot of things. So, like fatigue, having some mood issues, constipation, muscle weakness or numbness. Certainly, numbness is going to stand out because that’s not really a typical thing that you would see. But fatigue and mood, hello, we’re talking mostly to women here. This is like we’re in the hormone changing times and it’s really easy to struggle with those things at different points. As I always say, “If something is sticking around and it’s not a temporary,” like, “Oh, I’m tired this week.” Because I decided to do X, Y and Z or travel, you need to not ignore that.

Cynthia Thurlow: Well, I think listening to our bodies is certainly really important. In many ways for those of us that are traditionally allopathic trained, we weren’t trained to look at things like that. It was more symptomatology, not root cause. You alluded to what can transpire when we take antibiotics and how it disrupts the gut microbiome and how taking probiotics away from antibiotics can be helpful. What is it that’s unique about the gut microbiome that impacts our mood? I think this is a key kind of big concept to take away.

Roseann Capanna-Hodge: Yeah. You and I have talked about this before on our podcast, and we have a blog on this, but it is so important. There is a connection between our gut and our brain and the vagus nerve is that connection. But I don’t think people really understand. They see the Activia commercial, Cynthia, about the gut and how you need to do some probiotics. And you know what? People are doing the best they can. There’re lots of ways. But why is that important? So, number one, their neurotransmitters are created not just in the brain, but in the gut. There’s one very important neurotransmitter related to mood and attention and stress and it’s called serotonin and it’s almost exclusively created in our gut. Our gut can get disrupted by antibiotics, high stress level, hormones. I mean, there’s just a lot of things and we do always have to counter.

You’re like, “Dr. Ro, you’re telling me to do a million things.” No, we have to try to do the simplest things and live as clean of a lifestyle and moderate our stress. As my dad would say, “This is easy with the mouth Roseann.” That’s what Tony would say. But this is what we’re doing here. This is what I do. This is what Cynthia does. If you’re listening, you want to do this, too. That’s why you’re listening. And the payoff is huge. You feel better, your energy is better, your skin looks better, all these great things, and you’re role modeling for your children and I think that’s super important. The gut has to be protected and it has to be nurtured. That connection to these neurotransmitters and our vagus nerve is that bidirectional pathway to the brain. The brain influences the gut, the gut influences the brain. There’re a lot of positive things we can do to influence that by what we eat, having supplements as well as moderating our stress are the three top things that you can really do to help keep your neurotransmitters in balance.

It’s not just psychiatric medication. I think that’s what’s so shocking to people. Please know your physician, your GP, they’re doing the best they can. We’ve gotten ourselves into this place where you go in and you’re like, “I’m feeling cranky. I’m this.” They only know to write a script. They are not trained mental health people. They’re not trained functional doctors. Unless you’re going to a functional provider or a trained functional mental health provider, they’re not going to look for root causes as Cynthia said. There’s so much power in your own ability to control your mental health and your health. It’s unbelievable. I think when parents come to me and families come to me, they’re in shock. Cynthia and I were just talking. I’m working with a little guy who is losing his autism diagnosis in a matter of months, okay? It’s because they move to a clean lifestyle, they’re regulating his nervous system, and I believe he’s going to fully lose his autism diagnosis as a young child that’s under five years old. How amazing is that? Amazing. And they did it. I showed them what to do and they did it. They got the power as I always like to say, “You can hear the 90s song. [Cynthia, laughs] If I could sing, it would be going on.” How you support your systems is incredibly powerful in all of these clinical issues.

Cynthia, our biggest issues that we’re seeing with people today is anxiety and depression. I mean, those are our top issues. I’m seeing a dramatic increase in OCD, panic attacks, more extreme things that really kind of shut down lives and they don’t happen overnight, and they’re not fixed overnight. Again, people have this control outside of psychiatric medication that’s evidence based.

Cynthia Thurlow: Do you think that the increases in obsessive compulsive and anxiety and depression that you’re seeing, do you think that’s a direct relationship from the past three years, living through the pandemic, being separated from our loved ones, wearing masks and my heart really goes out to parents with younger children in particular because I have all boys. I can’t even imagine trying to have kept a mask on a young child and then they’re losing the ability to look at facial expressions and so they’re just at a time where there’s massive developmental acceleration. I would imagine as caregivers and parents, for so many people just not being able to live their lives the way that they had been could contribute to a lot of mental health issues.

Roseann Capanna-Hodge: Yeah. So, the answer is yes. Has the pandemic thrown fuel on the fire? Yes, but the fire was already burning. Before the pandemic, we’re seeing big increases in all age levels of mental health problems. There was a doubling of suicide rates that happened in 10- to 19-year-olds right before the pandemic. I mean, it’s just terrible. During the pandemic, we saw 70% of parents were reporting high levels of parenting stress, no surprise. But we also saw psychiatric medication with adults go from one in six to one in four. One quarter of people are on psych meds. Cynthia, people come to me all the time and they’re like, “I get it, I’m an Italian mother. You’re Italian mother, too.” We put our kids before ourselves. They come to me and they’re like, “We’re going to do this for our kid and we’re going to see.”

I want you to know I’m Prozac. I mean, true story happens every week. I’m like, “That’s okay, but I’m going to challenge you because you’re going to have to take care of yourself in order to create mental wellness today for all future generations.” We get stuck in ways of doing things but the level of stress for children and parents and all adults in this culture, in American culture in particular. But mental health problems across the globe are rising. Definitely, the social isolation, the mask wearing, the fear, all just really– Today still, I get somebody every week who feels that they either didn’t have a problem or they had a low-level problem that just completely spiraled out of control due to the pandemic and the isolation that they felt.

Cynthia Thurlow: Well. I feel so grateful that there are healthcare professionals like yourself that are really on the ground helping people move forward with their lives and families because that’s really what it’s all about. As a parent, I think anyone who’s listening, our children are our Achilles heel. I mean, if they’re suffering, we’re suffering. If they’re having trouble with something, we are having trouble with something. I’m so very grateful that you and other professionals that are out there are able to provide the support that so many families need and deserve. And it’s really all about education, empowerment, so that people can feel like they have some degree of control. Because there’s nothing worse than feeling like you have no control going on with [crosstalk] yourself.

Roseann Capanna-Hodge: That is actually the number one contributor to feeling hopeless is a sense of feeling out of control. I think both of our work is all about teaching people that they do have control. I think for me, a lot of times people get to me, it’s a layered complex mental health problem. We know through research that 50% of people who know they have a mental health problem don’t actually get help. 50%. I mean that’s just unacceptable. And why does that happen? I think people get caught in patterns and they also have tried a lot and maybe it didn’t work. Sometimes people try natural solutions and it didn’t work. And there’re lots of reasons why? Because it could be that it wasn’t done in the right order. I deal with a lot of people with obsessive-compulsive disorder and just to understand what OCD is, it’s intrusive thoughts that have rituals around it. And many people confuse OCD with anxiety. Anxiety is a persistent worry. There’re no rituals around it. With OCD, those rituals have to occur more than an hour a day and it can be unbelievably uncomfortable for people.

People talk about OCD like, “It’s this great thing.” Like, “I have a little OCD because I’m so organized.” No, that’s not what OCD is peeps, but you can’t separate out the clinical work, the behavioral work, and that’s why sometimes people say, “Well, I tried magnesium, I tried Inositol, I tried creatine.” These are the things that didn’t work for me. You have to use these resources as a way to calm and regulate your nervous system and brain, but then you have to actually change your behavior. They give you the wiggle room. So, when we talk about the research with Myo-inositol and Inositol, particularly with depression. So, there’s great research studies like double-blind studies, meta-analyses these are some good studies and meta-analyses for people that are– Cynthia and I are research nerds.

It’s where they take a look at several studies, and its peer reviewed, and they analyze the data. It’s considered the highest level of research. What is cool about Inositol in these studies is that there are some studies that show that the changes are lasting and there’s no relapse. In a lot of these studies, they used it with therapy. So, if you’re anxious and you take Myo-inositol and your anxiety goes down, awesome. But what little micro changes are you going to bring in your life? Are you going to hang out and talk to your sister every day who’s so negative that makes you feel panicked every time you talk to her? Or are you going to say, “I’m going to limit it and be like, hey, Catherine, I love you, but let’s start every conversation with “I’m grateful for” and let’s see if she can do it. If not, make those conversations under two minutes. [laughs]

Cynthia Thurlow: For your own mental health benefit.

Roseann Capanna-Hodge: For your own mental health. I use the analogy in our BrainBehaviorReset Program of the summit. Everybody wants to just jump right to that summit, but you have to go to the base camps. And the magic in mental health is in the micro changes. Cynthia and I are always talking about mental health from our own personal journeys. It’s those little changes that really like, “Wow, create such dramatic, positive feelings of well-being.” These tools can just be such a beautiful dovetail, the Inositol lowering the stress levels, but then actually creating and cultivating change and being consistent about it. Nobody wants to be consistent. Like, when you think about intermittent fasting, people say, “Do I have to do it every day?” Yes. [chuckles]

Cynthia Thurlow: I think so much of it is human nature that it’s hard to be patient. We want to wave a magic wand and we want things to better.

Roseann Capanna-Hodge: [crosstalk]

Cynthia Thurlow: When I was writing 30, 40, 50 prescriptions every day, I had patients that would look at me and they would say, “I’m not going to change my diet, I’m not going to stop smoking, I’m not going to start exercising, I’m not going to go to bed earlier, so just write me the prescription.” So, we in many ways conditioned our patients to believe that the pill is going to be the way to get rid of whatever the symptom is, right?

Roseann Capanna-Hodge: Yeah.

Cynthia Thurlow: What both you and I are speaking from is that it’s far more nuanced and complicated than that.

Roseann Capanna-Hodge: Totally.

Cynthia Thurlow: There is a degree of lifestyle changes that are going to be important in order to be able to successfully move beyond where you are. One of the things I love about your work is also that you are research based. We kind of started the conversation initially talking about obsessive-compulsive disorder and really understanding what that manifest of. I’m just as guilty of saying over the years I was an ER nurse. This is back when we had paper charts before electronic medical records were a thing, but we’re expected to document a certain way. Same thing as a nurse practitioner, but done an electronic medical record. Very detail oriented. Being detail oriented is not the same as being OCD.

Roseann Capanna-Hodge: No. Cynthia, who hasn’t said that?

Cynthia Thurlow: Exactly.

Roseann Capanna-Hodge: Do you know what I mean? It’s just that I want people to know it is a very serious clinical condition. Until I changed my work and how I was treating people with the psychotherapy using Exposure and Response Prevention, I just wasn’t getting the same results just doing PEMF and neurofeedback and supplements. It’s behavioral and it’s scary to change your behaviors. It’s scary, as an adult, whenever I’ve changed my behaviors, which I’m always doing evolutionary work, people shake out from you. [laughs] Cynthia and I always talk about high vibrational levels. The more you move up, people are either going to come with you and join you or they’re going to leave. The leaving doesn’t have to be a bad thing. But the idea of changing what you’re doing when something feels really hard because you’re depressed, you’re anxious, of course it’s going to feel hard.

I always challenge people to say it’s about shifting. It’s about shifting your efforts. Instead of working so hard, you are working smarter. You just have to give up the idea that there is the magic wand. I always say, “You are the magic wand.” It just means you have to make the little changes. Especially when you really try to get away from the negativity bias Cynthia, I find that to be the biggest blocker of mental health whether it’s the individual for themselves and absolutely 100%, it is the number one blocker of parents. They are like, “Well, I’m coming to you, Dr. Ro.” We’ve tried the six ADD meds and we did this and we did that and I have no other choice, but I’ve got to come here and I’m like, “Okay, well, you do have another choice.” But guess what? We’re only using evidence-based approaches and we have to start with you. You have to start seeing positive, speaking positively because your brain is only going to believe what you tell it.

The moment you start being negative, which, again, I didn’t say this, but our brain is wired to see negative from evolutionary caveman processes. We see a negative in one quarter of a second and a positive in 20 seconds. So, you got to work harder. That is if you’re a glass half empty, that’s okay because you could be a glass half full. It just is of a shift and I encourage people to do it. It’s quite dramatic when you really start implementing those little things. Like no ifs, when. Whenever I say, “I’m trying,” my husband always says, “Oh, I don’t think Yoda would say that.” [Cynthia, laughs] Yoda, would say, “There’s only due.” True story. The Hodges love the Star Wars. I think those are the important things that when we really want to take hold of our mental health and if you’re feeling really overwhelmed, it’s just be, there, be present in the day and start with that one thing and lean into that one tiny thing, like just need one tiny little thing to open up the door and shift your mental health. You really do.

Cynthia Thurlow: I think that’s so important, the concept of the reframe. I think for all of us, we have moments where maybe we’re just having a bad day, we’re tired. I know when I’m tired, I’m much less likely to be in that positive mindset. But it’s important to talk about the fact that what wires together fires together. So, if you have negative intrusive thoughts and you’re struggling to kind of reframe or find kind of a positive way of looking at something, everything is a lesson as opposed to saying, “Something’s been done to me.” No, actually this has been a lesson that I’m going to then use to be able to move forward in my life. I think giving yourself grace is certainly very important.

Roseann Capanna-Hodge: So gross, yeah.

Cynthia Thurlow: I know for you in your work because it is so kind of multi-purposeful. It’s not just medications, it’s all these lifestyle pieces. You’ve kind of alluded to some of this and obviously, selfishly, I’m directing the conversation because you’re such a wealth of information. When a family comes to you and let’s say they have a young adult or a teenager that is struggling with OCD or anxiety or depression as a starting point, obviously you don’t start per se, like, right out of the gates unless someone is not stable, meaning they have to be hospitalized because there’s something very acutely going on. Someone in an outpatient environment who’s stable but kind of struggling, what are some of the things that you’re talking about? You mentioned base camp. I would imagine base camp incorporates some pretty simple things as a starting point.

Roseann Capanna-Hodge: Yeah.

Cynthia Thurlow: What are those? What are the things that you’re starting with in [crosstalk]

Roseann Capanna-Hodge: Yeah. So, number one, I mean, the base of my work is calming the brain. If the brain is dysregulated, it’s just so much harder to think, pay attention and take action. We know this, this is evolutionary and I’m seeing so many brains on fire. For everybody who knows my work or doesn’t know my work, I should say, is I often do what’s called a QEEG brain map or if people can’t fly in or drive to me, then I do something called the BrainCheck. It’s statistically looking at brainwave activity, and you can see what’s overactive and underactive in the exact regions as well as brain communication. It’s the chisel. I love it. It’s great. Anybody’s who ever done it thinks I’m doing a tea leaf psychic reading. It’s because we know exactly what the brain does. So, brains are dysregulated. They’re on fire. I mean, you cannot live in a stress-activated state.

A lot of the depression I see, Cynthia, is from hyper high stress levels that we ignore. What are the things that we have to do is number one, we got to calm down that brain. It doesn’t matter what age you are. I’m going to look at so I love my devices. I use PMF, I use neurofeedback, I use biofeedback. Everybody’s got to move to an anti-inflammatory diet. Now, anti-inflammatory diet is the number one diet shown to reduce mental health. There’s a lot of anti-inflammatory diets. There’s keto, there’s intermittent fasting, there’s Mediterranean. I got to work with people where they’re at. Out of all the things I do, the dietary change is the hardest thing. I can convert a Catholic to Judaism easier [laughter] because they just come in and say, “I’m not changing my diet.” So, I’m soft and I get people to do buckets of change.

Like, what are you willing to do? Are you willing to do a swap out? And then we just move through it. People are so stress activated, and then it’s what is the supplements? What does the brain need? What does the clinical research say about each of these conditions? What is most helpful? So, for me, whenever I have somebody with panic attacks, very high levels of anxiety and OCD, Myo-inositol is mandatory. What I like to do is I like for them to use it twice a day. What we know from clinical research, there are some research studies. In as little as six to eight weeks, people can show some pretty significant changes. I have found that probably with OCD and I do a lot of OCD with people with PANS and PANDAS. There’s an infection or a toxin that’s causing all this brain inflammation. It causes a misdirected immune response and the body attacks itself and it creates a lot of inflammation. Many of my people with OCD have PANS and PANDAS, so I got to say that. But what I have anecdotally have found with my clinical population and please know I’ve worked with thousands of people; I’ve been around a long time. This is year 31 for me.

What I have found is about one third of people have a pretty dramatic symptom reduction within a short amount of time, even just for couple of weeks. About one-third of people show some significant symptom improvement over the first two to three months of me working with them. About one-third, either they’re not reporting it or not connecting or they’re not actually experiencing symptom change. I still believe it becomes part of the protocol and I don’t have people remove it. I know that it’s doing its work. What I’m looking for is overall symptom, but some of my people in that dramatic component are like “Wow, if I don’t take it that day, I notice something.” So, it’s easy to make the connection. A lot of times when you’re so stressed, you’re not always able to make the connection and the people around you look for those differences in intensity, frequency, and duration of symptoms. But it really is very clear that diet, lifestyle changes, nutrient replacement and really purposely trying to regulate your brain is essential for mental health. And that is really the foundation of my program.

Cynthia Thurlow: It’s really amazing and I always love connecting with you and learning from you. And for the benefit of listeners, helping people understand that we have the autonomic nervous system and so we have the parasympathetic and sympathetic and we want balance. Our body is always looking for balance. And what Dr. Ro is speaking to is that when our brain is inflamed and we’re having these mood issues, it is a direct reflection in many circumstances of our brains being stuck in this sympathetic, we’re being chased by a rabid animal, we’re fleeing from danger. One of the things that can happen and we’ve seen so much of this during the last three years, especially with the pandemic happening, that people were so frightened, their cortisol was so high that their amygdala, which is their very primitive lizard-type brain, is overriding our thinking, executive functioning part of our brain, the prefrontal cortex. This is when I will hear people saying things like I’m so stressed I can’t think straight.

Roseann Capanna-Hodge: Absolutely.

Cynthia Thurlow: [crosstalk] a physiologic thing that happens. It’s so important to understand this because you think about the pandemic or you get bad news or there’s a catastrophic accident, something happens and it’s happened to me in my lifetime. There have been specific times that I can recall exactly where I was when it happened. Just like, sometimes you’ll see animals that will just freeze. You don’t even know what to do next because you’re not able to access that part of your brain that allows you to think, like, “What’s the next thing to do?” This is when you’ll see people in many instances being very, you know they can sometimes belligerent., they can be difficult to speak to, they can have trouble making logical sense of what’s going on around them, and it’s a direct reflection of the fact that your body perceives you’re under this persistent state of very high-level stress. And cortisol is not a bad hormone. It gets a bad rap. When our brain is flooded with cortisol, there’re a lot of things that can break down in response to our bodies thinking we’re under this stress and duress. In an acute situation that’s very normal, but chronically, over time it can really deplete the body.

I know that for many of us, we really focus in on we call it somaticizing that someone has pain somewhere, someone has an infection. But equally important is what’s going on in the brain. This is why your work is so important. This is why I think on so many levels, when I kind of stumbled upon the research about the impact of Myo-inositol in the brain, I found it so interesting because it works on communication between these neurotransmitters, things like dopamine and acetylcholine and GABA, which is this calming inhibitory neurotransmitter and serotonin as you kind of talked about. It also helps with brain signaling. So, if you’re someone that is struggling to make decisions and that executive functioning the brain isn’t really optimized in conjunction with other types of modalities that Dr. Rose talked about, Myo-inositol in particular can be very helpful. Let me just back up and say for anyone that’s listening, if you are taking medications for depression, anxiety, OCD, you have an eating disorder, etc., do not stop any medications.

Roseann Capanna-Hodge: Absolutely not. Yeah.

Cynthia Thurlow: Yeah. we’re not advocating that. I want to be the responsible clinician and make sure we put that disclaimer in there, but have a conversation because there’s really very good research. I have a family member right now that’s dealing with obsessive-compulsive disorder and this individual is in therapy. We’re in therapy talking about it to be able to support this individual. One of the things that I stumbled upon with my research was how beneficial Myo-inositol can be and how I’ve watched this individual’s behaviors improve less obsessive-intrusive thoughts, able to kind of go about their day. Of course, I’m not going to disclose who this individual is because I don’t have their permission to do so. But what was interesting is when I was getting ready for our conversation today, the Journal of Clinical Psychopharmacology talked about a significant reduction with use of Myo-inositol for six weeks in patients. There was another journal of psychiatric research that talked about the add-on treatment for OCD. So, again, this is not a solo treatment.

Roseann Capanna-Hodge: That’s right.

Cynthia Thurlow: This is to other therapies, again, improvement in symptoms. I think this is so encouraging because I think for so many of us, we’re looking to be able to improve our quality of life. We’re looking to be able to improve metrics related to quality of life. I love knowing that there are things that are safe on the market that can be used in conjunction with other modalities that can be so helpful and beneficial.

Roseann Capanna-Hodge: Well and you mentioned about the brain communication, so I love to talk about brain communication, but the research, so a lot of people who– the research has shown that with Myo-inositol when the improvement in cognitive function for people that are depressed, which I love to see because one of the biggest complaints I get when somebody is depressed is truly not just that they can’t think, they’re shut down. I think it’s so important to talk about being shut down because we talked about, as you so beautifully talked about, the autonomic nervous system. We often think of an event that creates this and you alluded to is the daily. Why does somebody go into fight, flight, or freeze? One of the biggest things I’ve actually seen in the pandemic is school refusal. So, I’ve always had school refusal cases, but it’s sort of the ultimate freeze, like, “My body is so shutdown.” This happens to adults too.

When you’re in fight, flight, or freeze and it doesn’t have to be one event. It could be multiple and when you see this in a brain, it is exactly what you said. When I do a QEEG you see an overactivated limbic system that’s where the amygdala is. And then that’s where your cortisol starts. So, you get a cortisol rush. Somebody almost ran over me, okay, I’m okay. But this cortisol rush is happening for these people that are in fight, flight, or freeze, your frontal lobes are supposed to put your brakes on. When I see a brain map, it’s worn out. There’s actually a third area, the occipital region is supposed to flood your brain when both of those systems are offline. What I’m seeing is it’s worn out. All three of these protective mechanisms in the brain that work together are not working. And guess what? Your psych meds aren’t going to help you. [chuckles] You have to rebuild and so things like Myo-inositol which is safe. You always want to check with your prescribing physician, but there’s not known interactions, so you always want to get that okay, but you can add this in along with magnesium is my favorite supplement, but in the whole world, everybody should be taking it and then iook at what other things you can do for nutrition.

For me, when anybody is this activated, protein and healthy fats become the number one priority. Most people are willing to do that part Cynthia. They may not be willing to give up certain things, but they’re willing to get in and add in clean forms of protein. Everybody likes extra yummy healthy fats and that supports neurotransmitter. You have to look at the synergy and then you can start taking actions because once we get the fire down a little bit we take you out of fight, flight or freeze, you’re actually going to be able to think and take action better and you got to do it right. What can you do to implement to make those changes? This is a great starting point for a lot of people. It’s one of my favorite supplements and it’s also a supplement that most people aren’t talking about, which is so exciting that you are recommending this because I don’t have a preferred brand. I don’t have things because it’s not common. People just aren’t using it and it doesn’t mean it’s not good, it’s just that we tend to go to the same things. So, yes, I love magnesium. A lot of people have magnesium, you might be on the wrong one or “I’m taking a B vitamin,” you might be on the wrong one taking a D or you adding K? There’re all these little pieces to help your brain health and this is like a key one for any of these clinical conditions. It’s safe to get started and really to see a difference not just in your activation, but in your thinking, which is where people need wiggle room.

Cynthia Thurlow: Absolutely. And it’s really interesting over the past four years of being your friend, I’ve learned so much about thinking outside the box about mental health and doing it in a way that honors our research backed training, but also allows us to think beyond the conventional modalities as being this is the only way to treat anxiety, depression. OCD. Now, you mentioned a little earlier, before we started recording, that there’s some potential therapeutic benefit for people with eating disorders and specific to this woman with metabolic syndrome and binge-eating disorders, which I thought was really interesting. And specifically, to this how many women in perimenopause and menopause will say to me, “I started intermittent fasting and then as soon as I broke my fast, I ate two days’ worth of food.” So, saving that propensity, that understanding what’s going on in the brain, first of all, with binge eating, but knowing that Myo-inositol can also beneficial based on research, again can be very beneficial for this and how that can impact the way that we view binge-eating disorders. I always think about eating disorders as you know there’s anorexia, there’s bulimia, and then there’s binge eating, and sometimes people have a mix of both.

Roseann Capanna-Hodge: Sure.

Cynthia Thurlow: They could have one in and of itself. But have you been using this with some of your patients that kind of fall into those buckets as well?

Roseann Capanna-Hodge: Yeah. Eating disorders can creep up at different times for different reasons and they do are much more prevalent in women, but they do exist in men. Sometimes we don’t think of binge eating, which is so common as a stress response. It can start out as an emotional eating and then it really becomes an eating disorder when that’s your way of coping. I also see Cynthia, with eating disorders that are binge related, a lot of hormone issues. So, women that are in our hormone age range right, they may not have had any history of this and be stuck in a cycle. So, you always want to look at what other things, what’s the root cause. So, is there a hormone relation? Is this emotional? I am actually not an emotional eater at all. Like when I get upset, I don’t eat. My mom passed away not too long ago and I actually found myself– so were very connected through food. My mother’s, like the classic, showed her love through food and I found myself cooking a lot for my family and eating and then I was like, “Oh my gosh, I’ve never done that.” You have to sit back and look and then say, “Is that really the best choice?” and then alter your behavior.

It’s always an evolutionary process and I think for some people this can really be an add on. I also see a big, for me in my clinical population, I have a lot of OCD eating disorder links. So, I have a lot of people that develop intrusive thoughts around food, and sometimes it’s contamination worries and then they develop a secondary eating disorder, which then becomes a primary problem because if you’re really losing a lot of weight and you’re not getting in nutrients, your brain is just not going to work as well as it’s a very high-risk cardiac problem when you get below a certain weight. There’re a lot of reasons why people have mental health disorders, but when we really start to get into the weeds of how can we create change? This isn’t going to have 100% recovery, but I like to say to all my peeps, “Well, this might give me 5% or 10% or 15%, then we do this and this gives me 3% and this gives me that.” The next thing you know we have 50% symptom reduction and you’ve had no symptom reduction. You have to start reframing and looking at what do I have control over, and you have control over a lot. These conversations are incredibly powerful because nobody’s talking about this stuff. I’m so grateful that mostly women but the individuals that are listening because most women are the CEOs of all family mental and physical health. This can really get very far and support not just you, but even your children as well.

Cynthia Thurlow: Yeah. And I think that kind of the traditional modalities I know when I lived in Washington, DC, almost always there were a couple of Facebook groups that I was in and women were looking for therapists, psychologists, psychiatrists for their children, for their teens, for their young adults, and how challenging it was. So, I’m wondering if– and I don’t know, this is just off hand, this just kind of occurred to me, do you think that kind of the traditional modalities– I know when I was an ER nurse, unless you were verbally expressing that you wanted to harm yourself or someone else, you couldn’t get hospitalized. I think the current medical model in many ways, until you are in an extreme, there aren’t a lot of options. People wait weeks, months, very long periods of time to get in with professionals. Do you think it’s a reflection of our current medical model? Do you think it’s that people are working with less patients? What do you think is exacerbating those circumstances?

Roseann Capanna-Hodge: Yeah. I think there’re multiple things going on as I’ve been doing this for three decades. One, it’s the medical model influencing. So, people think there really are only two options for mental health. They think it’s a pill and the pill is quick fix because that’s what’s presented to them, but they believe it as well. Two, there really is a dramatic increase, it’s unbelievable the increase and I also see every day that people don’t recognize the signs, the physical signs that either they themselves or their own child. Even with myself, I knew I was grieving, and I was like, “I did pretty well.” And then, guess what? Your body keeps the score and your body will let you know this is how you’re acting. Really, when I looked back, I was tired. Those are those kinds of things. We don’t always see the signs because people with mental health overall, I would say the vast majority of people are functional. They’re just not functioning well and they’re not happy. It creeps upon you, it’s not an overnight thing, and you sort of learn to accommodate and be functional. And then until you’re not, until your body says “Mm, you’ve been in fight, flight, or freeze way too much, I’m just going to shut you down” and it happens. These psychiatric admissions in hospitals, by the way, in the pandemic, just went on fire.

Certain states declared a state of emergency mental health. Most of my people never go to a psychiatric hospital, I mean, while they’re working with me because I have a lot of tools that are evidence based. But I knew people that went before me and there was one incident, more than one I should say, where they were in the hallway in a bed, in many places you can’t even get in. So, it’s multifaceted. We believe there’s a quick fix when there’s not. We’re not actually looking to research to what actually calms the brain. And by using these tools like Myo-inositol, PMF, magnesium, walking, gratitude journals, prayer, meditation, these things work and they’re really really powerful. Ultimately, in the end, you must pair it with actual behavioral change and a therapist can help you with that. A lot of times there are many more things that we can do on our own and it’s a culmination. There’s no quick fix is ultimately in the end. But instead of feeling overwhelmed by that, I say, I’ve already said this, “You need to be empowered by that.” You have lots of ways to make your brain, whether it’s your own or your child, be more regulated, be calmer.

Cynthia Thurlow: I think that’s so important. One thing that I think listeners have, I’ve been discovering the role of trauma and how that played a role in my life and the way that I view the world and interacting with people like Dr. Gabor Mate, which for me was one of those podcasts, I don’t know if listeners have listened to it, was probably the most personal podcast I’ve ever done. Not just on Everyday Wellness, but anywhere, just sharing things about my background. But I wonder for listeners that are listening to this, when we talk about the role of trauma and we talk about these modalities understanding that what happens to us as children, we may think trauma. I got teased, I got bullied. The boy down the street made fun of my teeth or made fun of my hair, or girl bullying or whatever is going on. You got emotional abuse, mental abuse, physical abuse. These things can crop up later and can be the impetus for a lot of these mood disorders that we are discussing today. I think it’s helpful to kind of make that connection because for many people that’s kind of a new connection to understand-

Roseann Capanna-Hodge: Yeah.

Cynthia Thurlow: –what’s really at the basis for the anxiety, depression, potentially the OCD, the eating disorder, could really be these unresolved traumas that we grew up in. So, I’d love to kind of end the conversation talking about that a little bit from a perspective that gives people options and really a reframe to understand that there’s no one out there that doesn’t have some degree of trauma. Right?

Roseann Capanna-Hodge: Absolutely.

Cynthia Thurlow: Trauma is just a wound. That’s how Gabor Mate describes it. Each one of us have experienced these things. It just is important or the distinction should be made but that can contribute to why people ultimately go on to develop some of these mood-related issues.

Roseann Capanna-Hodge: Yeah. For sure. And you said it, right, “Who hasn’t had a traumatic event?” It’s just understanding its impact to the nervous system. So, we can’t ignore something that happened and a lot of people have big traumas. I mean, I always talk about my dad’s trauma. My dad and I are like, a lot of like and he’s really fun. I always say, when I go out locally, nobody knows me as Dr. Roseann. I’m only Tony’s daughter. They’re like, “Oh, I love your dad.” It’s usually some Italian. It doesn’t matter where I am, the bank, anybody. I’m only Tony’s daughter. And he’s very beloved, but he had a horrible, horrible, traumatic childhood, and I should make a lifetime movie out of it, I love to write, and it’s really an unbelievable story. Ultimately, his father was prisoner of war for the first eight years of his life and his mother beat the crap out of him in his sleep when he did normal stuff. He is the most happy man and he has, like, unconditional acceptance and love for his mother. When stuff comes up, we can have a conversation about it, but that’s a clear-cut case of trauma. One of my most traumatic events was my son getting his tonsils and adenoids out. It was a horrible, horrible experience and really, we knew something was wrong with him, and it turned out it was Lyme disease, and it just opened up into this world of PANS, and it was a nightmare, and it was bad. It was bad on a lot of levels, but nobody might not think that.

They’re like, “Well, you weren’t being– you were clothed and fed,” and all that, doesn’t matter. If something is an unresolved issue in your nervous system, it’s going to show up. What’s interesting that I noticed, Cynthia, about menopausal and perimenopausal women, is that especially when you’re high level and you’ve been functioning and the hormones go down, some of these traumas, some of these injuries, actual physical injuries to the brain, you aren’t able to keep it together in the same way. Things flood your nervous system and you may have an activation as well as some of the developmental milestones of your children may be bringing up some of these traumatic experiences. So, we can’t ignore it. Sometimes people will say to me, “Well, I have to just let it run in the back of my head.” No, you don’t. You don’t have to let it run in your back of your head. I help people all the time. I was one of nine approved providers at Sandy Hook. I’ve done a lot of work with 9/11 survivors and had the privilege of supporting a lot of other people with big T’s too and little t’s over the years. I think that acknowledging it is the first step but if you start to really see how this plays into your day to day, is this where your negativity bias comes from. Is this how you speak to your child. Does this create fears that hold you back?

Well, these are all things that can be explored, certainly in psychotherapy. You’ve got to regulate the nervous system and then find a way to healthily put away your trauma in its closet, whether that’s EFT tapping, somatic work, EMDR. There are lots of types of very trauma-specific therapy that really can help you to process it without reliving it. Many people with trauma get stuck in a reliving kind of state and it doesn’t have to be that way. I hope that’s helpful because I think trauma is so much more prevalent, big and little t’s than we realize and what a disruptor it is to your nervous system. If you’re working with somebody and you’re not getting somewhere, that trauma may have more of an impact, and you might have to do a deeper level of work. I recently worked with oh, God, she’s the coolest lady, but she had such a horrible trauma, abuse background, massive physical abuse. She’s very successful in her industry. She’s one of top four people in the world in her job. Okay, I can’t say what it is because it’s an obscure job. She’s been seeing her psychotherapist since 1998. Okay, 1998 people, so she comes here and we do neurofeedback, and she’s like, “I didn’t even know it was possible to not have trauma activation.”

Now we realize she has executive functioning challenges, so we’re supporting her in her executive functioning, but she just doesn’t have the activation anymore. The activation was really disrupting on so many levels, moodiness, anxiety, as high level as she was at work, they accepted her abrasiveness with others because she was gifted at what she did, but she had constant conflict with people. She chose not to have children and for her and her path, she made a lot of a choices because of a trauma that she couldn’t get under control. Once she’s been able to get that under control, her life is so dramatically different. So, no matter what has happened, there’s always a path. I don’t believe that somebody can’t get better as long as you want to believe in it and you make those changes, actionable small steps is really what creates these massive waves in our nervous system.

Cynthia Thurlow: Well, and it’s interesting, our mutual friend Dr. Joan Rosenberg always says, “If you have the capacity to think, you have the capacity to change.” Thank you for the amazing work that you do, my friend. Thank you for carving time out of your busy schedule to come on the podcast to be able to speak to all of these tools and strategies that people can use to support better mental health.

Roseann Capanna-Hodge: Well, thank you for being here. I could talk to you all day. Wherever people are in their journey, you just have to take one small step. That’s my biggest takeaway in all of this. If that is starting with Myo-inositol, then do it. It’s safe and it’s worth a try and you just have to be consistent with it. That is one of my biggest takeaways. Those small actions of consistency is really where you create mental wellness.

Cynthia Thurlow: Absolutely. Please let my listeners know how to connect with you, how to find your book, how to find your work, and your new podcast.

Roseann Capanna-Hodge: Yeah. So, you can go to www.drroseann.com and you can go to /podcasts. If you’re a parent looking for more tools and support and all of my work, it’s there, my podcast is, It’s Gonna Be Ok! We talk about all this stuff all the time and it’s been a pleasure and a privilege to be able to share that information because, man, people need a lifeline.

Cynthia Thurlow: They absolutely do. Thanks again.

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