Weight Loss for Life

Nutrition and Integrative Mental Health with Dr Anna Glezer MD

November 08, 2022 Keri & Matthea The WLCC Season 1 Episode 87
Weight Loss for Life
Nutrition and Integrative Mental Health with Dr Anna Glezer MD
Show Notes Transcript

Today we are joined by Dr. Anna Glezer MD, a Reproductive & Integrative Psychiatrist all about mental health and the benefits of nutrition. 

On today's podcast you hear about:

  • Vitamin D and magnesium and their role in mental wellbeing
  • The importance of sleep and exercise
  • How getting out into nature and getting exposed to green and blue colours can change your mental state
  • The research around the Mediterranean diet and it's benefits to mental health
  • Plus much more!

For full show notes please go to TheWLCC.com/87

Hi everybody. Welcome. We are here for a live podcast recording. So as this is coming on, we know it takes a moment for Facebook to wake up. So we just wanna say hello to everybody. We have Dr. Anna Glazer here. She's a reproductive and integrative psychiatrist. We're gonna give it a moment cause I know it takes a second to pop on, but we're so excited to be doing this. I'm excited to be here. Yeah. So can we start out with you telling us just a little bit about yourself and specifically how did you get into reproductive and integrative psychiatry? What and what is it specifically? That's a great question and that's actually where I love to start is to, to define what those two things even mean because they're both kind of newer subspecialties in psychiatry. And so I actually began working in women's mental health as a resident in training. That became a really significant interest of mine when I became a faculty member at U C S F. I launched a women's mental health clinic that was embedded in the OB GYN department, so working with a lot of women who have challenging conceptions, pregnancy, postpartum, and now in private practice. My clinic really focuses on that same population, but really looking at reproductive psychiatry across the the lifespan. That includes women who are struggling with premenstrual symptoms, women who are struggling with difficult fertility journeys, pregnancy, postpartum, perimenopause. Really, whenever there's a potential hormonal influence to mental health symptoms. That's the field of reproductive psychiatry. And then, then there's integrative. Psychiatry and integrative psychiatry is more of an approach, really a belief in treating the whole person. And that psychiatry is more than just, you know, prescribing a medication. It really looks at all of the different factors that could be impacting mental health, whether that's nutrition, physical activity different psychological frameworks. The biology, of course, including the hormones and treatment options in the integrative space are also beyond just medications. I, I prescribe medication all the time, but I also describe. Things like botanicals and supplements and physical activity regimens and time in nature given all of the data on ecotherapy. And I work with acupuncturists and encourage light boxes and all of these kinds of other complimentary therapeutic options, and that's the space of integrative psychiatry. And I actually got into that space. Mostly at the behest of my patients, more and more women were coming to see me and they wanted treatment options that were a little bit outside of the usual Western medicine box. And so I figured out, okay, where am I gonna get more training? Where am I gonna learn about this? And brought those two fields of reproductive and integrated psychiatry together for my patients. Gosh, it's such fascinating work that you are doing and yeah, it's absolutely incredible. You have got so many great podcasts on this, well, so many different topics, but one of the big things that we saw was nutrition and mental health and integrative mental health and you know, there's just so much I think in that realm and I wondered if, if, for those of who are watching, those who are listening on this podcast who aren't aware of vitamin D, cuz I know that you did. Podcast specifically on vitamin D, and I wondered if you could just give anyone a bit of a kind of rundown of the importance of vitamin D. Why is it important, like the benefits to your physical and your mental health. Absolutely. So vitamin D is, is an essential vitamin for our internal metabolism and, and for the way that our human bodies work. And when vitamin D levels are low, which is not uncommon especially if you. Far enough north of the equator, and especially given our lifestyles, right? You know, we, we often, especially in the winter time, right, we get up, the sun hasn't even risen. We go, we go to work, we're indoors in whether it's a hospital or an office building or wherever. We're there all day. And then we come out, it's dark again. We never saw the sun. And so that that can make a big difference on mental health psychologically, but also biologically. And so when vitamin D levels are low, that is associated with increased mood symptoms and depression. And that's one of the things that I check with a number of my patients is just to make sure you know, where's your vitamin D level. It's an easy blood test. You know, you just go to lab, get your blood done, and you can get your vitamin D level. And I think that there, I mean, there's certainly different technical definitions of what is severe, moderate, and mild vitamin D deficiency. And those are usually defined as, you know, severe. If it's less than 10, moderate, less than 20 mild, less than 30. I like to definitely push to make sure that my patients have vitamin D levels at least 30, preferably close to 40, in order to be able to really kind of make sure that's not impacting their mental health. And it's a really easy one to supplement, to rectify. There's, I mean, certainly if you can make the time to go outside, you don't need a lot of time outside to get your vitamin D dose. You need 15. Few times a week of direct sunlight between, you know, 11 and two, kind of those peak sun hours. So especially if you're living far enough north, that's not an amount of sun exposure that's also gonna predispose you. Cause you have to balance it, right? Like, you don't wanna expose yourself to too much sun and have increased risk of cancer, skin cancer. So, but that's, that's plenty. Or you, you know, if you're not someone who's able to make that work, then you can certainly take an oral. And with all oral supplements, I do just want to be cautious with making sure that it's, it's a reputable brand and a, a verified, so, so there's a few different companies that verify a few different organizations that kind of certify supplements because they're not FDA regulated, at least in, in the United. States, and so making sure that they are USP certified or NSF certified are two ways to make sure that they're reputable. Taking a look at consumer lab reports, they do some independent verifications where they took take a look at a bottle of supplements and they. You know, they, they look at what are the actual contents compared to what the label actually says. Do those match up? If it says that it's, you know, vitamin D 2000 international units, is that actually what is in this capsule? And so, so they'll make those kinds of verifications for you. So making sure that it's something that's been verified and certified. And then really, depending on how much deficiency you have in Vitamin D, you know, it comes in a whole bunch of different doses. Anywhere from a thousand international. 2000, 5,000, 10,000. There's even. For those who are severely deficient, there are prescription strength vitamin D options in the realm of 50,000 units, and it can, it's really easy to take. It comes in drops, it comes in tablets and capsules. So whatever is easiest for your body to tolerate and to process. I do also encourage if you are going to supplement with vitamin D, that you do vitamin D three, which is the active form of the vitamin. So vitamin D definitely. Make sure that our mental health, our mood is stable. It's an important con contributor to that you can easily check to make sure I don't check with everyone. Like if we, if we know that someone, because of their lifestyle is probably gonna be a little bit low, we might just empirically have someone take a vitamin D supplement. You know, it's funny that you say that. I don't know that there's anyone anymore that I'm checking. I'm so, I'm here in Indianapolis, Indiana. Everyone's low, like I, it is a rarity. The only person that's ever over 30 is cuz they're taking a supplement So, like you said, I pretty much assume if, if, if cost is prohibitive Right, Which nowadays there are lots of labs that you can even. Get a, get a prescription and do cash pain. It's cheaper, so it's more affordable. But you know, I had a question for you, and I'm not sure if you have an answer, but I've never asked a psychiatrist this. Is there any evidence or just anecdotally with working with patients once they start Vitamin D supplement, is there sort of any, Hey, within this time period we can expect your mood to improve? Does that literature or your knowledge exist? So there's not a good for a, for a lot of different supplements. There's, you know, there's, I try to be as evidence based as possible. The, the tricky thing with working with nutraceuticals supplements, things like that, is there's not a lot of great data because no one is interested in funding that research, unfortunately. And so, you know, there is some data on efficacy, on tolerability, those kinds of things, but duration for improvement is a pre, pretty rare question that's answered. And so I usually, for a lot of these things say, you know, we have to try this for at least 4, 6, 8 weeks, and then we can make a decision. I think that's already helpful though, just knowing, hey, you need to try this a month or two before you give up. I feel like in the office, I'm saying like 30 days to people with supplements, but I feel like with this, this is so good to ask you, so people could expect maybe you try it up to two months before you would know maybe if there's some changes that you're experiencing. Exactly. Yeah. It, it takes a while longer. I mean, these aren't, these aren't like antibiotics, right? You take it for three days and you begin to feel better. These things are, you know, Molecules in very complicated metabolic pathways, and it takes time for that to correct. And I, I think another thing kind of along these lines that I thought was fascinating when, you know, cuz I, I love listening to your podcast. You also talked about that there's a link between, you know, what we're eating and how we feel. And you talked on a pa a past podcast about how an anti-inflammatory diet could have some impact on that. And so I'm just wondering maybe what did that study show, or what does that even mean for something to be an anti-inflammatory diet and just any kind of pearls we can get. Yeah, absolutely. So, so much of our mental health is impacted by what we put into our bodies, and the tricky thing these days is even if you are eating, you know, the organic foods that are, you know, sustainably grown, all of those kinds of things, part of the problem is that a lot of times, At least in, in the United States, a lot of our food is grown in soil that has been depleted of nutrients and there's just insufficient nutrition in some of our foods. And there's definitely a link between nutrition and various kinds of mental health. The one that's been studied probably the most is the link between nutrition, inflammation, and mood. And there is this infl inflammation hypothesis of depression. That one of the reasons, one of the causes of depression is overin inflammation in the body and the result is depression. So the anti-inflammatory diet works to correct that. And the, sometimes the word, the anti-inflammatory diet is used almost interchangeably. It's very similar to the Mediterranean diet. And so that's characterized quite a bit by things. Very low amounts of processed foods, very low amounts of processed sugar. Decreases in red meat, but increases in things like fish and healthy oils. All of oil, those kinds of things increases in vegetables. Fish, I think I already said fish. So, so those are sort of some of the, the characteristics of an anti-inflammatory and Mediterranean diet. And it's the one that's actually been studied the most in, I mean, there's a few different diets that have been studied for various kinds of conditions, but for mental health, this is the one that's been studied the most and has the best data. So repeatedly in various countries, they've done this research and it's come out that individuals who are eating. An anti-inflammatory diet, very low in processed foods, very high in some of these, you know, vegetables, fish you know, things that increase our healthy fats like olive oil, that, that does impact our, our mood. The tricky thing, right? Like the thing with depression that often happens is, depression is characterized oftentimes by low motivation, and then you have low to motivation, and then that means that you're less likely to take care of yourself, and it turns into this unfortunate negative spiral, right where you're depressed, which means you're not taking care of yourself, which means you're not eating well, which only then fuels the depression. And so it can be really hard to kind of. Turn that core, core screw, spiral into the other direction to begin to take care of yourself, which will then, you know, improve your depression, which will then increase your motivation and it'll begin to spiral in the proper direction. So you, I, you've talked about, I mean, this is a little bit, we'll come back to the food for a second, but you've talked about behavioral activation where you almost like need to do the activity in. To experience it. Can you talk a little bit more about that, kind of how to get yourself out with that? So, behavioral activation is this idea that the action has to precede the motivation. Cause oftentimes when we're. Planning anything we think that we need to be motivated to do it. One of those most common things, right, is, is like going to the gym. There's a, a lot of pe there's some people who love going to the gym and others who are like, I just do this because I need it for my cardiovascular health. And so I'm just gonna go and there's oftentimes this idea that I need to be motivated to do this activity. But what's interesting about behavioral activation is, well, can you do it even if there isn't the motivation to do it? You, you might sort of think about your underlying values and reasons for it, but you're just really not feeling it and you do it anyway. And the way that behavioral activation works is at the end of the activity. You find that motivation because you find that you feel better having done it, having, whether it's the actual activity, whether it's the sense of accomplishment, whatever it might be, that sense of mastery that then increases motivation and then that that way you can kind of. Quirk screw in the proper direction. But that's basically the concept where the action precedes the motivation. I love that concept so much, and I, I think it really relates to the dietary changes that you're talking about, because again, I think especially the time of year we're in. Hopefully this episode will go out soon. You know, it's getting darker. People, people tell us within our community that they struggle more these times of the year. They're eating more comfort foods, they're finding it hard to do those things. And so I like you talking about you're gonna take that action first, and then you're gonna look for the motivation after, because. No one has ever taken the actions and afterwards that I wish I hadn't done it. So so back to the diet though. This is, this is very much so what we recommend, right? And so it's so good to hear that it's not about weight loss at all. It's about, we often say it's like you just wanna feel better in your body. You want your mind to, to kind of calm down a little bit. And so it's nice to know that these things are also supporting this mental health aspect. Absolutely. Yeah. And it, it isn't it isn't about weight loss. It really is about providing the body with the support that it needs, nutritionally speaking to function the way that, that it functions best. So I'm curious with this you know, anti-inflammatory diet, what types of, you know, mental health symptoms might you find are reduced with eating in this, this kind of way? So it's been looked at specifically, primarily in the research has been looked at for depression and they've looked at mild and moderate symptoms of depression, which are things like, depression. Doesn't have to just be sadness. I think that's a little bit of a misconception. Depression could just be feeling unmotivated. It could be not enjoying things as much as you used to. It could be just kind of like the word blah, right? Just feeling kind of blah. It could also be irritability for some people. So those are all kind of. The, the cardinal signs of depression. And so the anti-inflammatory diet has been shown to reduce those kinds of symptoms. It's also been looked at for managing symptoms of anxiety, whether those are related to depression or not. And I think that that is sometimes. More related to, you know, reduction in some of those process foods, particularly foods with high sugar content where you can those, not everyone, but some people are particularly sensitive to the ups and downs of, of sugar. And so that can impact anxiety just like caffeine for example. And so that's something that this can help with as. It's so interesting to me that I feel like everyone just always wants to feel better. I think that that's just like the name of the game in life and. We're thinking we go for these processed foods to feel better, but really how much it's negatively impacting us. So it's good to hear that. I have to laugh because I think you might be a little bit more, more irritable if you get rid of some of these sugars, but in the long run you might not be as depressed or as anxious. So that's just good to hear that we have much more power than we know. Right. Like you were mentioning sleep, caffeine, the food we're eating. I feel like that's always a very powerful message for me to hear. It's not that I need to go and get one medicine, it's. That maybe is what you need and always talk to your doctor. Right. But that there's all these other things that you can do too. I think that's extremely empowering. Yes, exactly. And I think that they all work synergistically. That's why, I mean that's, that's why I love integrative mental health and integrative psychiatry, integrative medicine in general is because it's never just one thing. Right. It's not like, you know, you broke your leg and you needed. It just, it doesn't quite work that way. And so you need to, to focus on the nutrition and you need to focus on time and, and space in nature. And you need to focus on relationships and support systems and, you know, time for yourself and time for self care and you know, and the biological piece is a part of it as well. This, this is also good. I feel there's so many different directions and I'm curious. I know we have several people that are here today. If you have any questions, make sure that you answer cuz we're gonna have time to get to that. I, I think another question, just kind of asking about all these different kind of bits and pieces is a little bit more about the picture where magnesium comes into this. Because I know growing up I always heard, you know, like you know the book Magnificent Magnesium and kind of how amazing all this is. And so I was just wondering if Magnesium has any benefits for, you. Did a podcast where you talked about for helping with sleep and depression, anxiety, some PMs symptoms, What what part does that have in your practice or where do you bring that in with people where they should start to look? I love magnesium. I, I fan girl on magnesium all the time. I, I think it's such a, such a helpful supplement that helps with so many things. I mean, mental health and even outside of mental health. You know, it has it plays a role in athletic performance and, and all of those kinds of things. But in the mental health world it has been shown to help with anxiety. It has been shown to promote sleep quality. It's been shown to reduce premenstrual symptoms. And you know, this isn't something where you just, you take a, a whopping dose of magnesium and you, you treat it like, you know, like a, like an antibiotic or a prescription medication. It's a supplement. So it's, it's, you know, filling some gaps. But it doesn't, you know, it's not something that is a magic wand. Although I sometimes kind of fangirl on it a little bit like it is, but I, I recommend it to probably 80% of the women that I work with because if you think about it the people that I work with struggle with anxiety, challenges with sleep premenstrual symptoms. I mean, that encompasses a whole lot of individuals. And magnesium can be really helpful for those things. I, I feel like that's like all our women by the way. Like there's, there's some, if no one like put their hand up for one of those ok. Like, does this does it have much of a role in the postmenopausal woman woman? How would it benefit her? Is that more for the sleep aspect? For Exactly, yeah, for the, for the sleep. And just kind of reducing some anxiety. And part of this kind of actually goes back to what I was saying in terms of our somewhat depleted soil, right? Because we're growing in, at this point in soil, it doesn't have as much nutrients. We're not getting as much through our food, which is why sometimes the supplementation can be really helpful and yeah, so it, it's, it's helpful even in individuals who are postmenopausal and certainly any, any men who who might be listening to this podcast could be helpful for you as. definitely. And we got a great question. I know this is asked often cuz there's many types of magnesium. If anyone's ever gone to the supplement store, you're gonna be a little bit overwhelmed. So I guess now that we have you here as an expert we got a question here. Is there any one type of magnesium that's better than another for this purpose? Yes. So I really like magnesium glyconate, and the reason I like that one is that one tends to have the best research specifically for the sleep quality piece. If you are someone, there's other situations where you might choose a different type of magnesium. For example, I work with a lot of pregnant patients. Pregnancy is associated with constipation. So there are types of magnesium, like magnesium citrate, which can actually help with cons with constipation. There's, you know, there's other types of magnesium. Probably one of the most common ones that you see on the shelves is magnesium oxide. Sometimes that one is a little bit. Easily absorbed in the GI system, but for those who have, you know, no concerning GI symptoms that, that would be perfectly appropriate. But my, my recommendation tends to be magnesium glyconate. Well, I'm curious to know if, if we've got people who have been talking about this transition going into, you know, the darker time of year, the holiday period, all of that and how, you know, anxiety and, and mental health has just been really a concern for them. So I'm just wondering, without giving any medical advice, would you say, are there any general tips that you would say for people who are in that situation to help them, you know, feel a little bit better over this time of. Yeah, so this is the time of year that I recommend that all of my patients who have. Take your light box outta storage, put it on your desk, and I, I'm a big, there's actually some really good data on the role of light boxes in certainly seasonal affective symptoms, but also just more general depression. And I really love light boxes that they have so few side effects. There can be some. There can be eye, eye irritation in individuals who are maybe predisposed to bipolar illness. It can be a concern, but otherwise it's a really well tolerated treatment option that, you know, you basically. You start with 10 minutes every morning, you're not looking directly at it. You could be eating your breakfast or, you know, putting on your makeup or writing in your journal whatever, whatever you're doing in the morning, and you have it on for 10 minutes and work your way up to 30 minutes. And it can really, really help with some of those seasonal affective symptoms. So I'm a, I'm a really big fan of light boxes. if you are able to, you know, spending more time in the daylight outdoors. I'm a big fan of ecotherapy. There's some really good data on that as well. Time in green spaces, time in blue spaces can make a really big difference on our mental health as well. And then I think really thinking about, cuz one of the things, one of the reasons that people. Oh, I just saw a question. Someone asked, What is a light box? That's a great place. That's a great question. Let me answer that one. I'm talking all about light boxes and I haven't explained what these are. So it's actually a device. You can, you know, you can purchase it on Amazon, you can purchase it in many places that. And I have one. I have one right here. Let me, let me show you guys what one looks like. I was gonna say, show us, because I have to laugh here. You're gonna show us. But when I was in medical school, or sorry, residency, we were all depressed. We had our work rooms in the inside of the hospital. No, no windows. And a medical student brought in a light box. And you know what? We were all happier that month. Yes. It worked really great. Absolutely. So this is, this is the, this is the one I have. Let me see. So it's basically, I mean it's, it's just like a giant I don't know, it's maybe not coming out super well, but it's basically a giant lamp. It's just a, it's a giant lamp. It can be in various shapes. I chose one that is a trapezoid just cuz I like the shape, but it's basically a giant lamp and. It it is important that when you look for one, that it's specified that it's 10,000 bucks. So that's the brightness of it. And that, and the box itself, depending on the size of the lamp, will tell you how far from it you should situate yourself. So sometimes it's two feet, sometimes it's, you know, four feet, whatever it might be. Depends on the size of the lamp at. So basically a light box is a very fancy treatment. To, to treat seasonal mood symptoms. That is, I love that you bring that up. I know one of our members talked about this and Okay. The other thing you brought up that I just love and I guess I had not heard these terms before, when you say Ecotherapy, you know, being outside, you talked about getting in green and blue spaces. That just, that just hit me. It's like, oh my gosh, I'm assuming we mean, see the sky, look at some try to find some type of nature. Yeah, exactly. So, so green spaces and you know, there, there is more and more data on green spaces, which is, you know, parks or really any, and. Any time in nature. The Japanese call it nature bathing. I, I can't pronounce the actual Japanese word for it. And it really is, there's good data on how it decreases our sympathetic nervous system, and the sympathetic nervous system is the fight or flight system. We want to decrease the activation of that system and increase the parasympathetic nervous system, which is the rest and digest system. Time in nature decreases our sympathetic nervous system drive and just allows us to relax a little bit better. And it's, it doesn't have to be a lot of time and really kind of just being mindful in that place, right? If you're, you're walking through the park, you know, taking the, the mindfulness approach where you're, you're looking at the trees, you're listening to the sounds of the. You're smelling, you know, the, the, the smells of fall. All of those kinds of things, you know, engaging all of your senses as you're going through it and engaging in nature that way can make a big difference in reducing things like blood pressure and anxiety and depression. I've heard of something called forest bathing over here, and I think in Europe. So this is basically exactly the same thing. I, That's that's what it's exactly, yeah. Yeah. Amazing. Just the power of nature, isn't it? It is. As we move into this dark season, then you know, the light box is there, you know, getting out in nature if you can. I see one of our members here is talking about, she lives in a place where it gets to minus 35, so she doesn't necessarily get that chance, which is fair enough. Sure. What else can people do? Are there things that they can eat? Are there things that they can drink? Are there any other kind of integrative things as general tips that people can. Yeah. I mean, I think continuing to maintain you know, if you're already focusing on maintaining a, an anti-inflammatory diet, like we've talked about, continuing that through the winter months, and that can be harder, right? Especially if you live in a climate where it's hard to get fresh fruit and vegetables in the winter time, right? So it definitely can take a little bit more effort. That's where sometimes the supplementation can come in handy, right? If you're not able to get it through the food. Can you get it through, you know, purchasing high quality supplements that can also help maintain, you know, your levels of vitamin D and magnesium and some of the other things that we've talked about. And then I also think that there's, there's a component, there's an important role for that behavioral activation piece. So continuing to, because sometimes, you know, in the winter, You know, you just wanna like, curl up and not, and hibernate, right? Like we're, we're like little bears. But really making time to connect socially because humans are social creatures and having, you know, that social connection can be really valuable. Getting support and connecting with friends and family and that sort of thing can be really important. Sometimes, you know, just really focusing on those types of self care and setting boundaries and making sure that you're taking time for you. Yeah. These are all, everything that you're saying. I'm just like, Yes, yes, yes. I need to do all of this And I think probably, I mean, when you're working with women, they're not doing everything at once, right? I mean, like, this is like broad strokes overview. Oh, yeah, yeah, yeah. Cause I mean, what doesn't work is you set like 10 goals and you decide to do all of them at once. Right? Like that just, that doesn't work. And I think, I mean there's that book. That came out I think was called like Atomic Habits or, or something. Well, we are in love with the book ATO Our whole program is Atomic Habits. We love the book Yeah. So, so I mean, that really speaks to this idea that it's small changes over time that become habits over time. And I, you know, so you choose one of these things. You decide you're gonna start with 10 minutes of a light box every single morning. You do that for a month and then, you know, maybe you add. 10 minutes of a walk around your block, you do that for a month. You know, you kind of layer these things on because trying to do 10 things at once and completely overhaul and, and change everything is sort of are setting you up for. Not succeeding. Yeah, that's good to hear. I mean, I, I feel like I, I need everyone to always hear that a million times. Like we don't do it all at once. No, you are not failing. This is you doing it the way it needs to get done, Exactly. But this is. So good to hear. And also the other thing too is I think probably there's no right way to do this. Like you maybe light box helps, maybe ecotherapy, maybe self care, but I mean, ideally we could do some version of all of it, but wherever you can maybe start with that and or whatever feels most joyful for you because it might sound really fun to get the light box to start out with and it might sound really hard if it's minus whatever to get out in the weather. Right. Depending on when people are listening to this. Exactly. You have to tailor it to your lifestyle, to your environment. To your schedule, all of these things because you want to, as much as possible, decrease the activation energy to do these things. And speaking of activation, when you've got patients or clients who come to you and say, You know, I find it really hard though. I'm really, really, really struggling with motivation. How do you help them to get this behavioral activation piece going? Do you give them any tips to kind of get started with that? Yeah, we really focus on breaking it down to the smallest possible quantity. So for example If I have someone who, who wants to figure out a way to do a half hour walk, but that's really hard. So we start with, can we. Just go outside and walk to the mailbox and then come back. Can we do something like that? Or, I have people who have somewhat grandiose plans to start meditating for 45 minutes, you know, every other day. It's like, okay, well, can we just have a mindfulness moment for one minute every time we brush our teeth? You know, just small things like that. I also do like to pair things with what your regular schedule is, which is why I often think about, okay, can you take your supplements at the same time as you're brushing your teeth or can you you know, do a mindfulness moment at the same time as you're having your morning cup of coffee because you already have a habit developed and so you're just kind of tying to it and expanding something that you already have. I feel like, So next month we're talking about joyful movement and like everything you're talking about has made its way into those modules. I talk about behavioral activation. I, I need to like link your reel. You have one on TikTok about it. I'm like, I just need to link it all in there. But but it's so good what you're saying. So basically, what's the smallest part you can break it down to? And I think we often discredit that. Like, Oh, that's not gonna matter, that's not gonna count. But often. That is the equivalent of putting the shoes on that has little spikes where you can walk on the ice and safely make it over. Right. So it's like, I love that. And then number two, you said pair it with regular activities, which is this habit stacking of you're doing that anyway. You like doing it or you're used to, so let's just pair it together. So it all, in my mind when you're saying it like sounds more manageable, like, Yeah, I can get out and do that exactly the way you're Exactly, and that's the goal is. That decreases that activation energy and allows you to do the thing, and then you'll be able to have the motivation to do the thing. Yep. It sounds really, really doable. Really, really easy for people when you say it like that, so, yeah. Excellent. So, Matea, do you have any other questions before we we wrap up? Cause I feel like we've done such a, a great discussion on this whole topic. I say I've, I always, I've learned so much here and I know there were so many other areas that we wanted to dig into, but we wanted. Just ask these questions. Say, I guess the, one of the biggest questions I have is, this has been amazing to hear what you've, what you've been talking about today. How can people find you what's the best way to work with you and is there any things that you have going on right now that you wanna make sure that everybody knows about? Absolutely. Yeah. So one of the things that I've just developed is this online course, a fellowship course at the interface between the reproductive and the integrative psychiatry. So for. Who is a clinician, whether you are a a psychiatrist, an obstetrician, a pediatrician, a nurse practitioner, a midwife, a psychotherapist, whatever kind of clinician you are who works in this space. The, the reason I developed it is because there's not a lot of courses that talk about magnesium, vitamin D, anti-inflammatory diets and all of these kinds of things. So I put all of that together in one kind of educational space, and so that's, That's the fellowship in reproductive and integrative psychiatry that's currently open for early early admission for the January cohort. And you can go to psychiatry fellowship.com to learn more about that. So that's more f. Something I'm very passionate about educating other clinicians and, and that's one place that if you are a clinician, you wanna learn more, you can go my, if you are interested more in like the clinical practice. My what? My clinic is women's Wellness Psychiatry. It serves California. So at this point we're just licensed in the state of California. But we also have just links to various resources that you can access. Postpartum body image program that's free, Other kinds of resources. So you're welcome to take a look at my general clinical website to learn more as well, which is just my name on a glazer nd.com. And then I also have a, a podcast which you, you referenced which does talk about a lot of these things in a little bit more, more. which is just Women's Wellness Psychiatry podcast and a blog that answers some of these questions, which is mind body pregnancy.com. So, lots of ways to find me. I'm in many different places. Feel free to connect. This is so exciting. I was sitting here and I'm thinking, I definitely need to take this, this course, this fellowship that you have because you are so right. These, the, the this, this training is not out there and the fact that you're actively practicing it and willing to teach others is just amazing. So I'm really excited about that and. I wanna put a plug in for your podcast because I feel like the episodes are just so practical and amazing and you, you feel really empowered. Like, I can go do something now. Like, Okay, that was amazing, now let's go implement it. So I feel like it's would be really good for people to check all of this out. Thank you so much. I appreciate it. I, I love doing this. I love creating this content. Okay. Thank you so much for being here today, and we're gonna put links to everything that you've mentioned, all in the show notes. So if you're listening to the podcast, go to the show notes, check it out, and thank you so much. It's been such a great conversation. Thank you.