Holistic Strategies to Beat Stress & Anxiety

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Holistic Strategies to Beat Stress & Anxiety

Holistic Psychiatrist, Dr. Ellen Vora, shares her diet and lifestyle tips to beat anxiety and depression, naturally. We discuss a wide range of topics including why millennials need organic food more than earlier generations and the link between gut health and mental health and even auto-immunity.

Dr. Ellen Vora

Dr. Ellen Vora

Holistic Psychiatrist

Ellen Vora, MD graduated from Columbia University Medical School, received her B.A. in English from Yale University, and she’s a board-certified psychiatrist, medical acupuncturist, and yoga teacher. Dr. Vora takes a functional medicine approach to mental health–considering the whole person and addressing imbalance at the root, rather than reflexively prescribing medication. In addition to her private practice. Dr. Vora is also a writer, speaker, blogger and a consultant for two healthcare startups.

Transcript

Maria Marlowe: [00:00:34] Welcome back to the Happier and Healthier Podcast. Today, I have the pleasure to introduce you to Dr. Ellen Vora, a psychiatrist who is taking a fresh and holistic approach to mental health while she can and does prescribe medication. She prefers to take a closer look at one’s diet and lifestyle first to see if changes in those areas could address the root cause of mental health issues. She takes the whole person into consideration, focusing on everything from physical health, sleep, nutrition, digestion, thought patterns, relationships, creativity, connection with nature and the ways we find meaning in life. Dr. Vora graduated from Columbia Medical School and is a board certified psychiatrist, medical acupuncturist and yoga teacher. In this episode, she will be sharing tips for dealing with common mental health issues like stress, anxiety and depression from a holistic standpoint.

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Maria Marlowe: [00:03:21] Dr. Vora, thanks so much for being on the show.

Dr. Ellen Vora: [00:03:24] Thank you, Maria. It is great to be here.

Maria Marlowe: [00:03:27] To start. I’d love to learn how you got interested in a more holistic approach to mental health. Is that something that you learned in medical school or that you picked up along the way?

Dr. Ellen Vora: [00:03:37] It’s nothing that anybody ever taught me. But for me, it was like pure survival. I was in med school and residency just so burned out. And in a bit of a crisis of disenchantment with what I was learning, I felt like I just did not feel in alignment with the way conventional medicine was being practiced and being taught. And I looked around at my patients, the patients in the hospital, and I just thought, this is a crazy system. I didn’t really feel like we were ever truly creating wellness or health or vitality. We were sometimes keeping people alive. But sort of in a very light, there was just so much backwards about it. Like you would be giving people powerful antibiotics and powerful medications. But then the food that was being served to people in the hospital was like, you know, almost just as equally powerful and getting people sick and who has just felt like a really broken system. And so I was in a crisis about what I was being taught and what I was being trained to do as a physician. And then I was also in a crisis in my own health and well-being and just really not feeling well. I felt like a machine where all the springs were popping out of a direction.

Dr. Ellen Vora: [00:05:16] So I was just on my own personal journey of figuring out how do I feel well in my body. How do I help my patients genuinely feel well. And that brought me to all of these different holistic approaches to healing. And that’s you know, I never really knew where this path was taking me. It wasn’t like I had some bird’s eye view of, like, if I just train and acupuncture, yoga and nutrition and functional medicine, then I’ll be focused on medicine, yoga, acupuncture, psychiatrist. I didn’t know where it was going, but, you know, I always was hopeful that maybe I could incorporate all these different tools in my practice. And then it turns out they absolutely do work together cogently and make sense as a way of approaching mental health holistically.

Maria Marlowe: [00:05:32] Yeah. And I think that’s the thing about our health. It’s not just one thing. It’s not just nutrition. It’s not just exercise. It’s not just one thing, one thing. It’s all the things. So it makes sense that they all sort of fit together like puzzle pieces now.

Dr. Ellen Vora: [00:05:47] Yeah. Usually for every single person it’s more than one thing. And then for every different individual, it’s a different assortment of different things, if that makes sense. So I find that I’m always humbled by the fact that I’ll I’ll have one patient. I’m like, okay, here’s what really did the trick for this person. And then there’s always this bias where you you approach the next patient that reminds you of that person and you’re like, OK, I know what works here. And then it always ends up being different. So you have to stay really humble and nimble and really adaptable to the new situation, because each person you’re going to use a different combination of strategies and tools and what’s really going to make this shift right.

Maria Marlowe: [00:06:26] I always say it’s so important to look at one’s bio individuality because each of us is so different and unique. So what works for your sister, What works for your best friend doesn’t necessarily work for you. And that’s why we really need to be more conscious of what’s going on in our body and listen to our body versus just blindly following the trends. So mental health, I think in recent years has become more of a topic that we talk about in public or we talk about in the media, but it’s still a very small amount of air time. And I think there’s a lot of stigma around it. Nobody really wants to talk or admits that maybe they’re struggling or feeling depressed or anxious or really overwhelmed. So I’m curious, in your practice, what are some of the most common issues that you see? And are there any trends among, say, different age groups or genders in terms of mental health issues that people face?

Dr. Ellen Vora: [00:07:20] Yeah. Yes. The stigma is really outrageous. Right. And it’s sort of like I think it is born of years and years ago, we almost thought of depression as like this mental infirmity that it was like you were somehow it was a moral failing or something along those lines or like, you know, you just have to pull up your bootstraps. And, you know, that’s what the world expected of you. And like, thank God, I think for the most part we’ve moved past that. And it’s just that looks absurd at this point. But in certain ways, we’ve moved in weirder directions around it. I think that there’s still a residual hesitation to be open about mental health. There’s still plenty of shame around it. And maybe now people are feeling more comfortable talking about their depression or their anxiety. But it’s still a little bit edgy to say, like, oh, I’m taking such and such medication. You know, that’s still really vulnerable and really exposed. Not to mention the fact that these things can be used against you in terms of insurance coverage and even employment. So all of this. There is some real reason to be hesitant to be open about it, which I think is unfortunate because I always think the more we can be open and talking about things and honest and that helps us all feel connected to each other, it helps us all learn from each other.

Dr. Ellen Vora: [00:08:35] In my practice, what I see is I know in terms of trends that major trend is just obvious and biased because I see people who come in to see a psychiatrist. But it seems so epidemic to me these days that people are feeling disconnected and despairing and depressed. People are very anxious. There’s a lot of poor motivation and poor attention and focus at work. A lot of people are struggling with sleep and just so many people are not feeling a sense of contentment or ease or fulfilment in their lives. A lot of people are feeling, whether we call it depression or if we call it anxiety, people are feeling a sort of it pit of their stomach, uneasiness kind of 24/7.

Maria Marlowe: [00:09:17] And why do you think this is? What do you think? Is it social media? Is it our phones? What is it that’s causing all of these feelings?

Dr. Ellen Vora: [00:09:25] Get comfortable. I mean, my my full answer to that question would take many, many, many hours. But basically, I’m writing a book on this right now. Why are we all anxious and what can we do about it? So I have no simple single answer to it, but I think a lot of things contribute. While there’s some things that are pretty well understood at this point, like the role that social media plays in depression and anxiety, people feeling like they’re comparing their life to other people, but also just the fact that it’s taken the place of in real life physical connection. And so it’s like an opportunity costs for actually connecting with people, making part of the brain almost feel like you got that itch scratched, but you didn’t really. And a neurochemical way I think of it almost like artificial sugar tricks your mouth into thinking you just made something sweet, but you didn’t just have real calories. You know, it’s problem. Artificial sugars are problematic in other ways as well, just like social media, which I think has a staring at screens. And, you know, even the position that our eyes are and when we’re staring at screens, I think contributes to anxiety. It’s almost like this look of terror when you’re just staring at something and that there’s always a two way street terror in your brain could make your eyes go like this. But if your eyes are like this, just staring at a screen, it’s going to feed back up to your brain as well. And so I think staring at screens, even that alone is contributing to anxiety. That’s one small piece of it.

Dr. Ellen Vora: [00:10:57] I think that there are big issues, I think, around physical health. And this is sort of under the radar. One that I like to start with the patients.It’s the low hanging fruit because it’s easier to change. You can change it pretty quickly and you can see really big results really quickly by changing physical health. So that’s things like so many of us are running around on a blood sugar rollercoaster these days because the American diet is built on a foundation of refined carbohyDr.ates and coffee Dr.inks that are actually milkshakes and rosé. Everyone is just constantly their blood sugar swinging back and forth and each blood sugar crash for some people that is experienced as anxiety. So that alone is a big factor, even just our love affair with like dark coffee. And these huge Starbucks coffee is like we’re getting in so much caffeine and we’re so addicted to the certain amount of caffeine that to not be in caffeine withDr.awal, we keep consuming more and more. But then that heightens our stress response and we’re more stressed and more anxious because of that. The gut health is an enormous factor with an ease, anxiety, depression, really. We need our gut to be in a state of diverse bacteria, not inflammation, not intestinal permeability. And modern American life is pretty systematically designed to compromise all of those aspects of gut health just being born at increasing rates by C-section, lower rates of breastfeeding, antibiotic exposure, both directly that we take it as medicine, but also the fact that it’s in our poultry, it’s in our dairy industry and it’s even residual early in our tap water. So we’re decimating our gut flora and then our food is sprayed with the pesticide bound up. The active ingredient glyphosate contributes to just dysbiosis, which is an imbalance in gut flora. And then even if we could get. So this is making us very systemically inflamed in our bodies and that’s contributing. So that was a mouthful of my flair. And you can read the book for the rest of it.

Maria Marlowe: [00:12:51] You know, it’s. It almost feels like everything in our modern life is trying to take us down in some way. And, you know, funny.

Maria Marlowe: [00:13:00] So I’m here in Dubai and my fiancé’s grandfather, who just turned 92, is here visiting. And he is the cutest man you’ll ever meet. He’s still walking. You can have a full conversation with him. He’s in great shape. He does yoga poses. So he’s Indian. So he tells me he eats everything, he drinks everything and he has normal life. He doesn’t worry about organic. He doesn’t worry about any of this stuff that I’m preoccupied with. He’s trying to tell me, like, no, look, I’m ninety two and I’ve had a great life. So, you know, you don’t have to eat organic. You don’t have to do this. And, you know, I think it’s different, though, because he personally lived in a different time, a different country. And he doesn’t realize it. But some of the main factors that colored his his life and his diet have been the healthy factor. So, for example, to him, the most important, I actually asked him, I’m like, what is the secret to living a long and healthy, happy life at 92? And he told me family. And he said, that’s the most important thing, is having your family close by. And he’s always had you know, the family’s always together, always eating meals together, always calling each other for every occasion. And he has a great, great relationships with his family and those around him. So I think that’s really important in keeping him healthy. And he’s eating a vegetarian, mostly vegetarian, Indian diet with lots of turmeric and mustard seeds and all these great spices. And he’s doing yoga. He’s doing meditation. Right. So to him, these are just normal things, which most people don’t do. But I think this is really contributed to him being relatively healthy. Ninety two.

Maria Marlowe: [00:14:37] So, yeah, you know, when you’re saying we need to think about organic and we need to think about our gut lining, like it just doesn’t common sense to most people that we have to think about these things. But it is really important. So let’s dive a little bit into the gut health aspect. And so you mentioned that, for example, your gut lining that’s really important for our mental health and really our overall health. So what are some of the food that we should be watching out for that could be damaging our gut lining?

Dr. Ellen Vora: [00:15:05] Yeah. And I want to tie this in to your kind of future grandfather in law, because I just I love that story and I love meeting a healthy, happy 92 year old. And this is, sort of my favorite anthropological way to explore the world. I’m in Portugal right now. We’re both from New York. Right. But currently abroad and in Portugal. You know, I’m so interested in observing the culture, the health of the people and their habits and sort of getting a sense for their physical health and their mental well-being. So with gut health in America in like our crazy life these days. It’s important to avoid foods like gluten, like dairy, like sugar, and one that’s a little bit less talked about as the industrially processed vegetable oils. That’s things like corn oil and canola oil and soybean oil. The reason your future grandfathered law can say, like you don’t have to worry about organic. I didn’t and I’m fine is that’s sort of exactly the faith as that sort of we have to work at it in America to eat in a way that he’s just eating us the default setting in India. And that’s changing. It’s changing in India. We really the United States has exported so many things. We’ve exported music, and that’s great. But we’ve also exported like our deranged agricultural practices and our obesity epidemic. And so that’s all now spreading across the world at a rapid rate.

Dr. Ellen Vora: [00:16:24] But ninety two years ago, things were quite different, especially in India. So one thing that your future grandfather in law has going for him is that he actually probably had less hygiene that he grew up with. So he probably has a more diverse gut flora. And we kind of think like you. But what it took to get there was less hand-washing, more flies buzzing around, landing on animal feces, landing on food, kind of spreading that flora. So basically, you know, where it’s less of a sterile hygienic environment, you get a more diverse gut flora and that’s you really good at training your immune system when you have really diverse beneficial bacteria in your gut. Your immune system understands tolerance and understands like, OK, that’s other it’s not me, but it’s cool. That bug is OK. And it learns to kind of what I call can rehearse. Yes. It’s like the calm the fuck down. It just teaches your immune system to see CFTFD, calm fuck down. And so basically now when we live in such a hygienic standard, our immune system doesn’t get quite that tolerance training. And it really starts to freak out at actually benign allergens.

Dr. Ellen Vora: [00:17:31] There’s also the issue, which is that when we have intestinal permeability also called leaky gut, then we start to leak things into our bloodstream. And that’s where I think it’s actually very justifiable that our immune system is provoked and starts to attack things. So, you know, your, grandfather in law, that he has probably a very intact gut lining. Things aren’t leaking into the bloodstream. It’s not provoking his immune system. So in the US, I think at this point, part of the reason where so many of us are kind of orthorexic and crazy about organic food and about gluten is kind of because things have gotten so deranged in the United States that it’s brought us to a tipping point where you can’t just eat and feel OK.

Maria Marlowe: [00:18:11] I want to take a quick break to share with you guys an incredible resource if you’re at all confused about organic non GMOs is what’s healthy, what’s not, what you should eat, what you should avoid. You have to check out my book, The Real Food Grocery Guide. After compiling hunDr.eds of client questions about what to eat and what to choose at the grocery store, I researched and created this extremely thorough guide that will cut through the confusion. Overwhelmed that you feel at the grocery store. It’s five star rated on Amazon and it’s also been called the most practical guide to Healthy Eating by renowned physician and researcher Dr.. Dean Ornish. The real food grocery guide has been featured in InStyle. Dr.. Oz, Well & Good and many more. So if you’re confused and overwhelmed about what to eat. Check out the real Food Grocery Guide available on Amazon and wherever books are sold.

Dr. Ellen Vora: [00:19:11] You know, I think that I love the mentality of when I come to Europe. I actually just eat. I eat everything. I’m not the same obsessive organic farmer’s market person that I am in the United States. And I just I Dr.ink the beer. I Dr.ink the cappuccino. I eat the pasta. The gluten and the dairy. And I’m fine. And I really I get it that people want to say, oh, but you’re on vacation mindset. And we can talk in a minute about the fact that I fully tested this theory for myself in places like Hawaii where I’m in vacation mindset.

Dr. Ellen Vora: [00:19:39] But on American soil eating American agricultural products, I react to American food no matter what. So the same foods, if I were to eat them in the United States, I’d have acne and constipation and bloating and brain fog. So basically, I think that that’s why you see this early wave of all of us like crazies is in the wellness world. Being so obsessive about organic food is that our food is so deranged. Roundup alone, just being sprayed on everything is making us happy and making us react to somebody foods. So like very long answer to our question. Gluten, dairy. Sugar, veggie oils.

Maria Marlowe: [00:20:15] Yeah. No. And I love that answer. And it makes a ton of sense. And, you know, I think that’s something people don’t realize is that American food standards are very different than standards in other parts of the world. So our meat standards, for example, what is our conventional is not allowed to be sold in Europe. Right. Because the standards are too low. Right. They have more restrictions on what chemicals and things can be used on. For example, their agricultural products. What can be fed to the animals, to the livestock. So they have a lot more stringent standards even further, quote unquote, conventional foods. So whereas, OK, maybe when you’re in Europe, it’s not as important when you’re back in the US. It’s definitely something that you want to be aware and cognizant of.

Dr. Ellen Vora: [00:20:59] Yeah. Even Roundup. Right. So that’s just barely I think being allowed to be fed to livestock is produce sprayed with Roundup, whereas in the U.S. it’s fed directly to the people in spades. So we’re exposed to this compound that the World Health Organization has acknowledged as a probable carcinogen. And at this point, Bear, who purchased Monsanto, is paid out, I think, in the billions of dollars and lawsuits for people who have. The court has agreed. Like this product caused the cancer. So this is something that we’re just directly eating. Babies are eating. It’s shows up in umbilical cord blood. Like we’re all exposed to it. Such a heavy amount in the United States. Sometimes I wonder if that alone really makes a difference in terms of our health outcomes in the US.

Maria Marlowe: [00:21:42] Yeah, for sure. And the point that you brought up is that we’re reads differently like now. Doctors are scheduling C-sections and you know, if you have a vaginal birth, that’s probably less common in certain cities for sure. You know where we. So for the grandfathers 92nd birthday, he took the whole family like this. I think 16 of us on a cruise and on the cruise ship, it was my first cruise. But every time you walk into a dining hall or whatever it is, they have these Purell hand sanitizers everywhere and everyone’s using them. And I’m like, no. Like, I wash my hands, you know, in the bathroom with regular soap. But I was steering clear of those things because we’re just so used to being so sterile that it makes sense that we’re kind of these delicate flowers in terms of when we’re exposed to whatever these agricultural chemicals and certain foods that it’s really hurting us and causing the acne and digestive issues and autoimmune and all this other stuff.

Dr. Ellen Vora: [00:22:38] Not to mention the fact that the Purell also contains BPA. So you’re getting this exposure to enter can disrupt and chemicals. And when you really think about the scheduled C-section, your future grandfather in law probably born at home.

Maria Marlowe: [00:22:54] They didn’t have electricity. You know, he studied under like street lamps. And, you know, things were definitely way different in those days. And he has a stomach of skill, really, like he could quite literally eat anything and be OK. But then it’s like the, you know, two generations later and it’s like any little thing is a huge problem.

Dr. Ellen Vora: [00:23:12] So, yeah, it’s something that, you know, he was doing yoga and eating organic and doing home-birth long before it was cool.

Maria Marlowe: [00:23:20] Yeah. Very sure. He’s the original. We had a shirt made for him that like made in 1927 or something like that. All right. So let’s talk about then. Well, first, let’s start with food. So we know we need to avoid the dairy. The gluten, the sugar, refined vegetable oils. What should we be focusing on and making sure that we’re getting every day?

Dr. Ellen Vora: [00:23:40] Yeah. And I would say like to caveat that not everyone always. It’s more like these are the likely culprits. And if people wanted to a little bit of self experimentation, if you’re not feeling well, if you’re always bloated, always constipated, alternating between constipation and diarrhea, if you’re having stomach cramps, all of these reasons to suspect something’s not agreeing with your stomach. Those are places to look first. And there’s a lot of different philosophies on where you start in a conventional world. People would say, like that’s IBS and you should start by getting off of side maps, which. I think I can translate that it’s Fructo oligosaccharides disaccharides, monossaccharides and polyols I think. But so basically, you know, these are foods that are kind of difficult to digest by a compromised digestive system.

Dr. Ellen Vora: [00:24:24] So if you are in a state of poor gut health, then getting off of those foods does helps. Symptomatically, at least because you’re kind of not challenging your digestive tract quite as much. I don’t think of it as a definitive solution. And I think it’s sometimes it’s too restrictive. It can be too difficult for some people to follow. And it gets you off of a lot of otherwise healthy foods like artichoke or broccoli. These are challenging to digest. So I think better it’s actually more fundamentally heal the gut. And then your digestive system works enough that you can handle artichokes and broccoli. And then some people are fine with dairy. Some people are fine with gluten. I think nobody should really be having industrially veg processed boils and we should all be eating way, way, way less sugar. So I think it’s generally OK to eat fruit. So that’s a place to start. But then what you want to include, this is where I think some of us in the health space get it really wrong because we get really fixated on what to eliminate and what to take out.

Dr. Ellen Vora: [00:25:21] People get very focused on clean eating and not getting exposed to the bad foods, the toxins. And what we miss is how to eat a nutrient dense diet, how to eat like your great, great great grandmother, a man. This is partly because especially in the states, we just don’t have any traditional food culture. We’ve been totally you know, we sold that to the highest bidder. So our traditional food culture is like, you know, start the day with cereal and Goran’s juice and a glass of skim milk.

Maria Marlowe: [00:25:49] Basically, anything out of a box.

Dr. Ellen Vora: [00:25:52] Anything that someone can make a really good profit on because it’s shelf stable and sugary and addictive and not nutrient dense and therefore not shoot satiating. And so we kind of have to get back to the traditional food culture that makes the most sense for your genes. And if you’re kind of a pure bred, you know, if you know your ancestors, you can be like, okay, well, what were my great great great grandparents eating? If you’re like me in sort of a month, you have to be a little bit more creative. But just sort of. Then you just tune into your body and listen and figure out what does it create with your body.

Dr. Ellen Vora: [00:26:25] But generally, what I think that looks like is that your plate should be about a quarter well-sourced protein about a quarter say starch. So it starts from a starchy vegetable like sweet potato or squash or plantain or Tara or Jukka. And then about half of your plate is some kind of vegetables, preferably prepared with liberal amounts of healthy fats. So maybe green sautéed in ghee or if you’re having a salad, there’s really good olive oil on top of it. And I think overall we just need to be re-educated into embracing all of the different kinds of meat, all of the different cuts of meat. That fattier cuts of meat are OK. Eating the skin is OK. I think of it that like as long as something is real food and this is a healthy animal, this is not a factory farmed animal, pasture raised animal, that there is no wrong meat to eat or no wrong part of the animal. It’s more just that you want to eat a variety and you want to listen to your body because it will tell you what you’re needing in that moment.

Dr. Ellen Vora: [00:27:24] If we can kind of lose all of the programming and conditioning that told us, like white meat is better or, you know, pork is bad or red meat, we’ll give you a heart attack if we can strip away all of that programming and conditioning and just listen to our body. It’ll tell us today I want fish for today. I want lamb. And it will show you with cravings what micronutrients you need.

Maria Marlowe: [00:27:44] Yeah. And I love that philosophy to focus more on what you can have than focusing on what you can’t have, because I think that’s what trips people up when they realized, oh, my God, I can’t have anything. You know, my all my favorite foods are out. I have nothing to eat. That’s when they don’t stick to a healthier way of eating because that’s what they’re focusing on. When you focus on all the delicious and nutritious things you can have. It becomes a lot easier.

Dr. Ellen Vora: [00:28:09] So it’s really easy when you’re cooking for yourself at home to eat this delicious, abundant, indulgent way of eating real foods. And then I’m no stranger. I’m sure you’re either to the fact that when you’re out in the world and try to find a convenient way, it’s really tough. The world is not like I was saying this on a recent podcast. It’s not whole 30 islands out there. Like you’re not everywhere you turn. Just real foods on offer. It’s basically combinations of gluten, dairy and sugar. That’s what you can buy conveniently out in the world. So that’s really difficult.

Maria Marlowe: [00:28:38] But you know what? I think that we’re so lucky to live in the age of Internet. So at least in major cities anyway, you can use like I use an app called Happy Cow that will show you restaurants that are more vegetarian friendly. So those are usually good and it will usually include places that are organic or paleo or things like that where you can get better options or just whenever I’m traveling somewhere, that’s the first thing I Google is organic restaurants and or healthy restaurants and paleo restaurants. And inevitably, wherever you go, there’s at least that one. that has something. So, you know. Yeah.

Maria Marlowe: [00:29:14] It just becomes a matter of also knowing how to order things or asking for substitutions. Asking for things. Asking for them to maybe use olive oil instead of canola oil on whatever they’re cooking or whatever the case says. But yeah, I definitely hear you that it’s it’s a lot easier when you’re home and you have control over what you’re cooking because you don’t even realize a lot of these restaurants are using MSG. Right. It’s out of Chinese restaurants because people know that it was used in Chinese food. So you’ll see that all the Chinese restaurants say no MSG, but your fancy, you know, five star restaurant may still be using it.

Dr. Ellen Vora: [00:29:48] So you taste something in there like this is so good. It’s almost too good.There’s MSG in that.

Maria Marlowe: [00:29:55] I had a friend that went through chef school and she was interning at different top restaurants in New York City. She’s like, you would be amazed how many of these places are using MSG and you’d have no idea. So, yes, definitely cooking at home is really helpful to know what you’re actually consuming.

Dr. Ellen Vora: [00:30:11] And my consciousness on meat, I think it’s really helpful to know with restaurants, because I had a lot of patients, a lot of friends who are like, well, are you vegetarian at home? And I’ll just have meat when I’m out in the world. And I think, if anything, you almost want to flip that, because at home you can control the quality of how your sourcing meat. And that’s important both for your physical health, but also on a more ethical level. What kind of farming practices you are supporting with your money? You don’t want to support the factory farms that are really, truly inhumane experience for the cows. You want to be supporting pasture as meat. That’s easier to do when you’re buying it for a butcher and cooking for yourself at home in restaurants. If you’re not certain that this is a place that’s like we source our meat. You know, happy hollow pick a boo farm, you know, and they’re saying that in bold and italics on the menu. Then when is out? This is factory farm meat. Of course it is, because they need to cut costs. They need me to make it more delicious. Cornfed meat is going to be more delicious than grass-fed meat. And so when you’re at a restaurant, if you can’t be certain it’s good meat. I actually recommend just eating vegetarian when you’re out in the world, which is delightful as well as vegetables for you. And it’s a treat.

Maria Marlowe: [00:31:13] Yeah, that’s exactly what I advise that. Well, I say be a vegetarian when you eat out and at home, that’s where you can be more paleo and eat your meat. And you know, you brought up this point before that people sometimes don’t even realize all of the variety of options we have when it comes to animal products like we think there’s beef, chicken and shrimp or fish. And that’s it. You know, we don’t think about bison or I was just in Norway. They had moose burgers everywhere. So I tried a moose burger, something I never thought I’d do, but it was actually delicious. So, you know, there’s all these other types of meat and in many cases, they taste even better than what you’re used to. So it’s okay to be a little adventurous. And I think now at farmers markets, for example, they’ll have sometimes availability of these different types of meat or even online. There’s so many online resources now where you can buy direct from the farm for a bison or whatever else. You know, it’s available.

Dr. Ellen Vora: [00:32:10] US Wellness is one of my favorites, which I think is like grassland beef dot com and that I’ll point a lot of my patients to, especially when I have patients who are not living in New York City or major cities where they have a fancy grass-fed butcher than anybody can order from us wellness. And that’s really well sourced, really good quality meat. And you can really eat such a variety of different animals, different parts of the animal. It’s not just sort of like overplayed beef, chicken, muscle meat that we’re all constantly eating.

Maria Marlowe: [00:32:39] Yeah, for sure. That’s a great tip. I actually haven’t used that, so I’ll have to check that one out.

Dr. Ellen Vora: [00:32:44] So less meat, overall, it’s worth pointing out as well. Sorry, just less meat is a wonderful thing too, because basically, you know, when we look at your future grandfather law, he’s probably eating either a vegetarian diet or a semi vegetarian diet. I mean, we look at the blue zones, these places in the world where people tend to live the longest. Those are almost universally semi vegetarian diets. So it’s not that you would good, Sharon. It’s not the total absence of animal foods, but it’s also not the sort of more like American or like the wrong take away the paleo diet, which is that your plate is just a huge chunk of meat or a stack of bacon. You know, it’s sort of like meat as a condiment, meat as something to include that. It’s not necessarily the main event. Your main event is still vegetables for sure.

Maria Marlowe: [00:33:26] Yeah. I like that whole that idea that your meat as the side dish and not the main dish because it’s very often reversed in the U.S.. Yeah. Speaking of that though, I’m curious because I know on your website you talk about also helping people with autoimmune disease. Right. And as it relates to mental health. So. Well, first off, I’m curious, what should we know in terms of autoimmune disease and mental health? How do they influence each other? Well, let’s start there and then I’ll ask you my follow up question.

Dr. Ellen Vora: [00:33:54] Yeah. So it’s actually a pretty complicated question. So I think that in a way, the most cut and Dr.y physical level, when someone has auto immune activity in their body, that’s heightened inflammation, its immune dis-regulation like the immune system sort of gone awry. And then there’s systemic inflammation, so whenever there’s information throughout the body, whether it’s attacking the skin or the joints or the gut, it is also attacking the brain. So often you see with someone with autoimmune disease, they’re also going to have some mental health manifestations. And that looks a little different in everybody. I think of it almost like these are different covers of the same song. So some people it looks like depression. For some people, brain inflammation looks like anxiety. For some people, it’s bipolar. For some people, they just can’t focus. And so, you know, you’ll see it track a lot. But then I think there’s also this other important, more subtle aspect of autoimmunity, which is that when someone has early childhood adverse events, when someone has trauma, there’s higher rates of autoimmunity. So I think it behooves us to start to talk about the fact that not in every case, but in a lot of cases, a lot of immunity there is a sort of psycho spiritual issue, whether it’s shame or guilt or feeling like things are hopeless or I don’t deserve to be well or I don’t belong or, you know, whatever it is that early childhood adversity created whatever schema in the mind that it creates. I do believe that contributes to the body attacking itself.

Dr. Ellen Vora: [00:35:22] So when I’m treating someone with autoimmunity, yes, I want to heal that. But I don’t want to change their diet and I want to detox in all of these things to approach things on a physical level. But I think of it as like a mountain that we’re summiting in a few different paths and there’s the physical path. But I think there is also the psycho spiritual or even energetic or vibrational path. So I want someone to be stepping into a place of self-love. I want someone to do really deep healing of old wounds so that they’re no longer feeling that shame and that guilt from early childhood experiences. I think it’s all a part of the puzzle when it comes to autoimmune disease.

Maria Marlowe: [00:35:58] Yeah, that’s so interesting that you I mean, obviously it makes sense, right. But you’re taking a very multi-pronged approach to dealing with auto immune, because I know one of the really popular ways that’s talked about a lot now, especially in the wellness community, is the paleo auto immune protocol diet, which is pretty it’s not more meat heavy than vegetables. Still, vegetables make up the larger share of the plate. But there is a very large emphasis on the animal products. So I’m just curious, in your opinion, in terms of diet then when you’re helping people with autoimmune. Do you prescribe to that autoimmune paleo protocol or what? What are your thoughts on that? In general.

Dr. Ellen Vora: [00:36:40] So I’m usually I’m such a realist and I want to make things realistic and accessible for my patients. So like in a perfect world, if we did live on Holiday Island, like I would have most of my patients about immune disease on autoimmune paleo or a A.I.P. Diet, but it’s so damn hard that sometimes that becomes counter therapeutic because then what you’re doing is you’re isolating someone, you’re making it harder for them to socialize and go to restaurants as friends. You’re making them have to do this a part time job of sourcing and preparing your own food. And so I tend to think that like that gets to be like one step forward, two steps back as we’re getting somebody healthier. So what I’ll do instead is, you know, if someone’s like, oh, I cook for myself and my family all the time, I love cooking already. I own an instant pot. No problem. Then I’ll say, great, let’s do the autoimmune paleo diet. But if I’m treating a 20 something who is still out there trying to, you know, meet a partner, at least establish friendships like it’s just too much, sometimes it’s too isolating. So in those cases like baby features of the autoimmune paleo diet, but with some balance, a little bit more of an 80/20 approach, I don’t think AIP has to be so meat focused. It’s I think bone broth can end up being really helpful. It’s very helpful for healing up the gut lining. I think in the early phases of anybody who has had a period of time of being a vegetarian or vision, in a way they got their body out of balance, which isn’t true for everybody, even if it’s turned into a diet.

Dr. Ellen Vora: [00:38:02] But for a lot of my patients, a lot of people with sort of like depression, anxiety and autoimmune disease, I’ll see. And, you know, there’s no judgment here. This was me, too. I’ll see a period of like 10 years of vegetarianism. But it was sort of like crap-eteriasm. It’s like it’s technically literate, but it’s pizza and so French fries. Yeah. Luna bars.

Dr. Ellen Vora: [00:38:24] And so basically, you know, then you’ll see somebody who I think actually has a little bit of like a red meat debt to pay back. And so for those folks, I actually want them to eat a pretty decent amount of red meat, fatty cuts of meat initially just to sort of repeat whatever that saying gorgeous, that blood building essence of that is once they’ve depleted it. Then we sort of resume meat should just be a condiment. This is how you get back to a point where your body’s intuition is telling you how much. But early on, I think we need to over rule because there’s just so much conditioning. Red meat ss bad. So like I’ll have somebody eat more initially and then get down to a place where they’re not eating quite as much. But ideally where you want to get with everyone is that they’re their own body’s intuition and craving is guiding them. How much or how little to eat, but a lot of us are so many layers removed from that intuition that it sometimes requires a little proxy guidance.

Maria Marlowe: [00:39:18] Well, I think also we’re sometimes taught to rely on outside people, primarily doctors, right, to tell us what to do with our body. And we feel like we don’t know what to do with our cravings. We think of cravings as bad. Right, because the cravings are typically for we think we want junk food or we want candy or whatever it is. So people are very removed from their body and they don’t even know, you know, like what’s going on. And, you know, anything below their neck, they have no idea what’s going on. So I think it does take a little time and effort to actually get to that place where you can listen to your body and you can hear the cravings and you can start to understand that. But it’s definitely possible.

Dr. Ellen Vora: [00:39:59] I’m so glad you brought that up. I think there’s two kinds of cravings, really. There is Dr.ug cravings and there’s actual nutritional cravings. And so when you’re having a craving, you just want to ask yourself the question, like, am I craving a real food or a Dr.ug? So if you’re craving pizza or ice cream or something sugary, that’s a Dr.ug craving, you know, no harm, no shame. It’s just like know it for what it is. We’ve all been at this point, like if you made it through your life, not addicted to all this foods, you know, good for you. But basically, you know, if it’s gluten, if it’s dairy, if it’s sugar, if it’s a processed food, which seem to always have flavor crystals or sometimes MSG, that’s a drug craving. And then if you’re like, I really want a juicy red steak or I really want a salad or a salmon, that’s probably a nutritional craving.

Maria Marlowe: [00:40:42] Yeah. So I think that some of the most common issues, especially that I see amongst my peers clients, is that a lot of people are dealing with stress, feelings of depression and anxiety. So in terms of lifestyle, what are some things we can do lifestyle wise that’s gonna help ease some of these feelings?

Dr. Ellen Vora: [00:41:02] So lifestyle wise for easing anxiety, let’s say, I think my favorites are going to bed early, getting the phone out of the beDr.oom, building small amounts of exercise and then just airing on the side of eating real food. And so basically, you know, sleep is probably our best medicine. It’s free. It feels good. It really heals whatever ails us, including anxiety. But in our modern life, we have so many barriers to getting good sleep. And a big part of that is actually electricity and artificial light. And certainly all the screens and electronics that go with that. So that’s making us artificially awake late into the evening. So if she wanted to dial down on electronics, have a little bit of a stopping point where you shut down your computer, don’t look at Instragram any longer, and then that way your brain can start to get tired and then you want it aimed to have an earlier bedtime. Something in the range of 10, 10:30, 11:00 is really fantastic if you can manage it.

Dr. Ellen Vora: [00:42:02] Getting the phone out of the bedroom is a profoundly impactful intervention because basically then you’re not looking at that blue spectrum light screen right before bed. You’re not going to bed right next to that thing that’s full of all these stimulating associations, stressful associations like work, e-mail and geopolitical news crises and all of this like right next to us, online dating social media. So you want that out of sight, out of mind when you’re sleeping. And then it also changes how the morning goes. You sort of set your own intention for the day rather than just being led passively by whatever notification pushed to the top of your phone. And then, you know, everyone freaks out or like, it’s my alarm clock. And like, it turns out you can get an alarm clock. They sell them.

Maria Marlowe: [00:42:44] We forgot we forgot that there was actually a thing called an alarm clock before cell phones.

Dr. Ellen Vora: [00:42:50] So it’s a $10 on Amazon and I highly recommend it as a great life improvement and then exercise. I mean, some people are just in a good group of exercise. That’s fantastic. But for so many of my patients, they’re not. I’m myself like a working mom. And I find it so difficult at this point to build exercise. And so I like for people to lower their standards about exercise. And basically, just rather than the two hour door to door full yoga class experience or the SoulCycle or whatever, instead of that, just about five or ten, maybe fifteen minutes in your own living room where you do some calisthenics, you hold plank pose, you do a little bit of yoga, a little bit of palates or just some pushups. And that alone won’t get you a lot of the benefits. But it’s so realistic and sustainable.

Dr. Ellen Vora: [00:43:38] And then the real food thing, I think for anybody who is like have committed to making changes, like they’re feeling a little depressed, they’re feeling a little anxious. They’re like, what the hell were these women talking about with autoimmune paleo diet? You know, you’re not there yet, but you just want to feel a little bit better. I think just airing on the side of real food. And that’s a compass that we can all carry around in our pocket all the time. It’s like you’re at the restaurant, you’re at your friend’s house or you’re at home. It’s like they each season the real, real food that grew in the ground or it was a healthy animal. And if it doesn’t fit either of those descriptions, like. Not really real food when you want to minimize the fake food in your life.

Maria Marlowe: [00:44:14] And just going back to what you were saying about exercise. I love that you said exercise, but not too much. I think sometimes we get this idea in our head that we need to do a super intense one hour plus workout. And the truth is, you don’t really like even just walking. So one habit that I got into that I really love is that whenever I have a phone call with a client or, you know, a company that I’m working with, that’s fifteen or 30 minutes, I’ll take it. I’ll just go outside and put my headset on and take it while I’m walking around the block. Even that is good enough. Or there are so many YouTube videos now. You’re like, oh well if I’m at home, I don’t really know what to do. I can do a plank and crunches, but I don’t know what else. There are millions, literally millions of YouTube for free that you can check out. There’s one that I love, Lily Sabri, Lean with Lily. Her channel’s amazing and I’m sure there’s tons more. But don’t make excuses. Even if you have that 10, 15, 30 minutes. That’s totally sufficient.

Dr. Ellen Vora: [00:45:09] Yeah, it can be free and it can be quick.

Maria Marlowe: [00:45:11] So you mentioned a little bit about the food. Any supplements for anyone who is dealing with a lot of stress, anxiety, anything, just sort of generally that, you know, we should be looking to replenish?

Dr. Ellen Vora: [00:45:24] I mean, yes and no. I’m always hesitant to go down the whole separate path because what I’ve learned through many years and practice people are just like, okay, get to the part. You just tell me what supplements to take. All right.

Maria Marlowe: [00:45:33] And they bypass the rest.

Dr. Ellen Vora: [00:45:38] Yeah, just like I was. So I was just like wasting everyone’s time talking about food. Nobody wanted these interventions. No one wants to do the effortful. I’ll get the pill. So, you know. Yeah. There are things that help. I think someone I feel most comfortable recommending on a broad level, as my news implies to me, which is very safe and very necessary and helpful. Most of us are depleted in magnesium and it helps with so many of the problems of modern life, like depleting your magnesium level, helps with insomnia and anxiety, ulcers, migraines and headaches and menstrual cramps and muscle tension, constipation and even with like cardiovascular health. So it’s a wonderful thing. Sleep. I could go on and on and we could talk about the valerian roots and the L-theanine and all of these different supplements. But for the most part, I actually don’t like my patients to take that many supplements. I think that it’s a distraction from the fact that your nutrition comes from food and your wellbeing comes from sleep and community and exercise and sunshine and fresh air. And I like to think it comes from a plastic bottle is bananas.

Maria Marlowe: [00:46:41] I love that you said that. I really do. I know that people always ask me that question. So I wanted to ask you, but. Yeah. And what’s the great source of magnesium? Dark leafy greens, which most people are not eating nearly enough. So I always try to recommend people are getting them in. At least your lunch and dinner meals if you can. Getting a good hefty serving because that is going to make sure that you don’t need to rely on those plastic bottles.

Dr. Ellen Vora: [00:47:06] And also chocolate contains lots of magnesium OK.

Maria Marlowe: [00:47:10] But don’t rely on it.

Dr. Ellen Vora: [00:47:14] Sometimes I’m hesitant to be like you can have some chocolate, but also greens.

Maria Marlowe: [00:47:18] Yes. So one question that I like to ask all of my guests on this show is if you can leave our listeners with just one tip or piece of advice for how they can live a happier and healthier life. What would that be?

Dr. Ellen Vora: [00:47:33] Ok, so I actually the fact that in Portugal right now and so deep and observing this culture, I’m gonna say something different than I would ordinarily say, which is that at every juncture of your life, choose people like choose people over everything. You cannot go wrong if you are spending your time, your money, your resources, your effort, investing in your relationships, being generous. Attune to people, being a better listener. Spending time physically with the people in your life. So, you know, basically you have the Saturday choose people. Thursday evening and you want to take a walk, make a phone call instead of listening to your podcasts just at every juncture, choose people.

Maria Marlowe: [00:48:17] It’s really well said. Well, thank you so much for all of your wisdom and advice. And if people want to learn more, can you tell us where they can find you and remind us the name of the book and where they’ll be able to find that?

Dr. Ellen Vora: [00:48:29] Sure. Yeah. So the best way is to find me or either on Instagram and at Ellen Vora MD or you can go to my website which is elenvora.com and the book is like not really due out until twenty thirty five. So stay tuned and jump throwing back a lot of golden milks and try to do my best to write quickly, but it’ll take awhile. And then another way if you want to access my approach, I’m in September starting an online group, so that would be like a small gathering of us over Zoom conference for we’re just going to talk about my my holistic approach to mental health. So that you can find out more about on my website.



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