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The 1000 Hours Outside Podcast
1KHO 702: Sometimes I Have Dirt on My Noodles | Dr. Christine Cain, Panic Proof
00:49:48
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- [00:00]
Jenny
Oh, it's a beautiful world Ain't nothing on screen that's ever gonna be this view oh, it's a beautiful world and I just want to share with I just want to share with you this beautiful world Such a beautiful.
- [00:35]
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- [01:54]
Eugenie Urch
Welcome to the 1000 Hours Outside podcast. My name is Eugenie Urch. I'm the founder of 1000 Hours Outside and I have a wonderful, beautiful author on today who wrote this book about panic and anxiety. It's called Panic the New Holistic Solution to End you'd Anxiety Forever. She's the founder of the holistic wellness collective, Dr. Nicole Cain.
- [02:13]
Jenny
Welcome.
- [02:14]
Dr. Nicole Cain
Thank you for having me. I'm excited.
- [02:16]
Eugenie Urch
I'm excited too, because I've heard a couple stories that are similar to yours. I interviewed this author named Justin Whitmill early and the story of not being able to sleep and then that kind of rolling into this unexpected panic. And I love the book because you talk about how there's signs along the way, but sometimes we're not used to looking for the signs and then we're suffering and we don't really know how to get our way out of it. You've got a lot of stories in the book that, that highlight this for different people, but I'd love to hear your story. You say it began with just a few bad nights of sleep due to stress and expanded into a full fledged emotional crisis. And as the panic climbed, your level of functioning plummeted. So you're in this spot, which I actually think is probably really relatable, Nicole, that you get done with college and you have a lot of debt because you know you've got all your college expenses and you're trying to start a business. I mean, this is super common, right. And then all of a sudden it's like, oh, am I going to be able to make ends meet? And it's so stressful.
- [03:18]
Dr. Nicole Cain
Yes, yes. And we can't escape ourselves. I feel like for so many things like fear, flying is. We can largely avoid getting on planes and we have alternatives like driving or taking a boat wherever. But when it comes to what's happening in our own bodies, that's really, really challenging. It's really difficult. And sleep is this paradox where the harder we try to sleep, the less sleep we get. And so for many people, and I've had lots of people coming out of the woodwork that say, oh my gosh, me too, I have such a problem with sleep. And because everything that we're told is how to make us sleep, how to make ourselves lose control in a sense, because sleeping is one of the ultimate acts of losing control. And that was the beginning of a whole new story for me, was that that journey.
- [04:13]
Eugenie Urch
So you talk about how, you know, you feel like you've got to take time off, you've got to sort of re equilibrate your body, but you can't. You said couldn't take time off. I was in repayment for over a quarter million dollars in student loans. I just opened an integrative medical mental health practice with my business partner. And you've got the cost of rent and it's double what you were budgeting. And so at night you would fall apart. And I loved this stoplight metaphor.
- [04:38]
Jenny
Yeah.
- [04:38]
Eugenie Urch
So I've had just a few times in my life where. And I don't know, like, you don't really know, like, is this a panic attack? But I felt like kind of panicky. So I'm Going to tell you one of them. This is just kind of random, and it might be a dumb one, but my brother got his super dumb. You might be like, that wasn't panic. I don't know. But my brother got his wisdom teeth out, and I was in college, and he might have been in college, or maybe he was like, at the end of high school. So my brother's getting his wisdom teeth out, and my mom was kind of freaked out about it, and so I went with my mom to help out, and he. I, you know, like, he came out and like, he's just all, you know, I think they put him under drugs and he's just whatever. And he's got this gauze in his mouth. And I was kind of freaked out about it, but then my mom kind of freaked out, too. And so they were, like, thinking she was going to faint, and they were, like, running around trying to help my mom. And they asked me, like, you're going to need to go get a wheelchair for her. And I kind. I. I was freaked out, but I thought if I show that I'm freaked out, they're not going to let us leave. We're going to be stuck here. Like, I have to be the strong one. It's just kind of like melting down. And I went into the hallway and I almost fainted. And I've never had that experience before. And I, like, sat on the floor and I'm like, feel like I'm going to black out and I'm, like, getting all sweaty, and I'm like, I got to pull it together. I'm going to have to get the wheelchair because, like, my mom's in it.
- [06:00]
Podcast Sponsor/Ad Voice
Whatever.
- [06:00]
Eugenie Urch
It was just a. It's a very light, you know, like, not a big deal situation. But I. I felt like this kind of panic. And I love this stoplight exercise that you talk about in the book, because, you know, everyone talks about box breathing and, you know, different things that you can do. And you're basically like, sometimes you might be too far gone.
- [06:21]
Dr. Nicole Cain
Absolutely. And the stoplight exercise, for those who are hearing about this for the first time, then I love that you're referring to this. It looks at anxiety on a spectrum where this. We're in the green light zone. We feel calm, we feel collected. We. You may have heard it as ventral vagal. It's when we feel connected to other people. We're relaxed, and then stress is happening around us. And if we're like a duck and it just rolls off of us, it's not stressful to us. Then we stay in the green light zone. But for almost all human beings. Right. That stress will accumulate and we'll get a little activated. And then there's that moment between green and yellow, which I called the pay attention zone. And it's like, oh, something is whispering. Something is different. And oftentimes, if we can start to become familiar with that pay attention zone or the canary in the mine, and we can start to notice that if we can provide an intervention or a solution in that moment, we can often avoid becoming anxious. But in those situations where we can't, or we didn't know about it, or. Or like your situation, you were really largely quite powerless in this situation. There's a lot of pressure on your shoulders. We get into the yellow zone. So stress is mounting, is getting bigger and bigger, and the body starts talking louder. And then we shift into the red light zone, which is more of a crisis state. And that's that I'm sitting on the floor, I feel like I'm going to faint. And you're getting this kind of vaso vagal reaction. So being able to walk through that is not only validating for the cycle of stress, but also it helps us zero in on what solutions will work when. So for you, I'm curious, do you remember that first moment when you went from like, I'm chill, I'm green, I'm okay, to like, ooh, maybe something's not quite okay?
- [08:11]
Eugenie Urch
Yeah. Yes, I do, because I remember because it's when I went into the recovery room and I was kind of like, whoa. And then my mom was already starting to kind of, like, you know, freak out a little bit. And so you talk about. I thought this was so interesting. It's actually really helpful to know because it's a reminder to try and if you can, like, head it off at the past. Right. Like, if you can try not to let it get to the crisis situation. But yeah, I feel you say tightness in your chest. That's how I felt too. Like a little bit of like. Or even in my gut, like a little bit of worry. You know, you get that twinge of worry.
- [08:46]
Jenny
Yeah.
- [08:47]
Dr. Nicole Cain
So you had this.
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Jenny
Whoa.
- [08:48]
Dr. Nicole Cain
This like.
- [08:49]
Eugenie Urch
Yeah.
- [08:49]
Dr. Nicole Cain
You go into the recovery room. Oh, my gosh. Whoa. And you're intuitively, emotionally aware of not only what you're seeing occur in front of you, but also you're. You're getting feedback from your loved ones in your environment.
- [09:04]
Podcast Sponsor/Ad Voice
Yeah.
- [09:05]
Dr. Nicole Cain
And so I think that really brings up something that's important too, is we love to focus on what I can control. What, do I need to take theanine or do I need to do breath work? But I think what your story really points out is an opportunity to be cognizant of what's happening in our environment and how the people around us are affecting us. And so I wonder what it might have been like for your younger self. You were in college to see your mom dysregulating. Is that, like, when you think about that, what comes up for you? Like, that piece of the puzzle, Seeing her, because that was part of your story, is seeing her?
- [09:44]
Eugenie Urch
Yeah. I think you're just, like, worried, and it's a lot of unknowns and uncertainties and, like, what' going to happen? And. And probably in retrospect, it was not that big of a deal. Like, if I would have been woozy, too, they would have just had me lay down and get some crackers. Like, we would have all been just kind of in the recovery room. But for whatever reason, it felt like a big deal. And I felt like, you know, I have to be the strong one and go get the wheelchair and do those types of things. And I didn't necessarily have skill sets back then. Like, you know, you read these strategies in your book, and so, yeah, it's interesting, like you said, to be aware of that first. Like, the first twinge of it.
- [10:21]
Dr. Nicole Cain
Yeah, yeah. So you notice that. Whoa. You notice that first twinge of it. And in that moment, in a perfect world, you could just sit down, put your feet up, just, like, ground your body. Have somebody there who would have noticed what you're experiencing and helped you walk through it. I'm noticing maybe you're getting a little activated, getting a little stressed. Here's something we could do to head it off. And in your body's wisdom, it's like, oh, oh, there may be danger. And this is largely bypassing your prefrontal cortex. This process happens instantaneously before your logical brain can cut in. And the body is already sending out stress hormone before you even know logically what's going on. And so it's just absolutely amazing. So the reframe that I want your listeners to hear is. Is that your body is trying to protect you from something that's a little stressful. So that whoa. Moment, the body's like, we've got this. You don't even have to worry about it, Jenny. Like, we're gonna. We're gonna protect you from this metaphorical tiger that we're encountering in your logical brain when she gets back off online later. Like, now you're like, this wasn't a big deal. What was that? Well, that's your logical brain, right? That was bypassed at the time. But now what's interesting is that many of us have these kinds of stories in the past. And the body's gonna remember that even if logically we're like, looking back at it. We're like, oh, yeah, that's kind of silly. I just needed some crackers and we all needed to take a breath. The body's like. But I remember the smell of the dentist office. I remember the look of the gauze. And the body may have its own reaction outside of your logical control. So there's a lot in the book about, well, how do we help recalibrate the body so it's not keeping the score so that it's not holding on to that and creating a vasovagal response when I'm an adult.
- [12:18]
Eugenie Urch
So interesting. It's so interesting. And, you know, I think for me, it just reminded me that I need to pay attention. You gotta really pay attention because you move through these zones. And you talked about that. This was such good wording. So there's the pay attention zone. This is like the deer in the headlights, right? You look up, oh, that's really good. That's like a really good analogy. We're in Michigan. There's like deer everywhere. You know, you're always trying to make sure that you don't hit them when it's dusk. And so. And they do, they look up, they hear the noise. And so, like, you have this first, you know, re. First reaction. And then, okay, now we're in the yellow light zone where the body's starting to produce these chemical reactions. You say good stress and bad stress. Same. You're going to produce these chemical reactions.
- [12:59]
Jenny
Okay.
- [12:59]
Eugenie Urch
Then there's the wonky zone. And your body is gearing up to switch into crisis mode.
- [13:04]
Jenny
And.
- [13:04]
Eugenie Urch
And then you're in the red light zone. So the red light zone is panic and rage, dissociation, could be pain. And what you say is. This is what.
- [13:12]
Podcast Sponsor/Ad Voice
I didn't know.
- [13:13]
Eugenie Urch
This is what you say. People tell me they're trying deep breathing motion, herbs, other great integrative tools in the red light zone. And it's not working.
- [13:22]
Dr. Nicole Cain
Yeah.
- [13:23]
Eugenie Urch
And you use this analogy of like trying to put out a forest fire with the squirt gun. At this point, you need crisis resources. And those other things may not work. Whereas they may have worked in the earlier zones.
- [13:35]
Dr. Nicole Cain
Yeah, exactly. So I teach people about creating their own little crisis card. And we make panic packs Yes, I.
- [13:43]
Eugenie Urch
Saw that in the book.
- [13:44]
Jenny
Yeah.
- [13:45]
Dr. Nicole Cain
And so for those who haven't read the book yet, a panic pack is this great little, or you could call it a carrying clutch, like you could call whatever you want calm calm kit. And inside of it you're going to put strategies that you've already pre decided you're going to use in the pay attention zone. And so it's like, oh, I'm noticing this experience. What are my resources? Because again, when we're bypassing logical brain, we're not going to be able to likely think as critically or think as effectively about what do I do about it. So we have to make it accessible, we have to make it a habit. And like you said, if we're able to use those strategies early on, that's going to work really well. So put all the goodies in the panic pack and then put a little note card in there that says this is what you do. So you just pull it out and you look at it and then that creates a sense of power. And personal power is the antidote to panic and anxiety. That's the big difference is that sense of I can experience yucky things and know that I'm okay and that I. I got this.
- [14:46]
Eugenie Urch
What a tool. The panic pack.
- [14:50]
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- [18:26]
Eugenie Urch
I love this, actually. So there was a. There were some amazing ideas in here. So let's talk about some of them. Because actually, like, the situation is. You're like, it seems kind of too simple, you know, because panic feels so big. And you could have. In your pack. Okay, here's one. The cold packs, the instant cold packs. This was interesting for me to read, Nicole, because people. And I've never done it, but people talk about sticking your face in a bowl of ice water. And I'm like, oh, that's a cool idea. I think it would be good for your skin. And it also is that mammalian dive reflex thing. But often you're not in a position to have a bowl of ice water.
- [19:05]
Dr. Nicole Cain
Right. You're like at a meeting, you're driving down the interstate and you're like, hold on. You pull over, you're like, bucket of ice water.
- [19:13]
Eugenie Urch
Right, Right. So I would have never considered. You can have an instant cold pack.
- [19:17]
Dr. Nicole Cain
Isn't that brilliant? And they're small. It's the size of your cell phone. Like, I have my little cell phone here. Just you shake it up and then you can apply it. So different places that can be helpful is around the eyes, of course, you want to be really mindful if you've. You don't want to burn. Your eyes do freezer burn. So maybe like 20 seconds on a minute off, 20 seconds on the chest, the back of the head, or even underneath of the ear. So underneath the ear, the vagus nerve runs up along the neck here. I guess for those who are listening, you won't see it, but I'm gesturing at the neck behind the ear, where the earlobe is, and applying the cold back there to get it closer to where the vagus nerve is. Because that will, like you said, mammalian dive reflex. It'll help get us into parasympathetic or calm out of that fight, flight, freeze, stressed, sympathetic.
- [20:07]
Eugenie Urch
I love that you had that in there because I've thought about that a lot. Like, the cold water option is just tricky because it's not always available. And even for kids, you know, if they were able to have that maybe like, in their backpack or just as something along for them. Like, it's just so accessible. Sometimes, like, if I work later into the evening, sometimes I feel a little bit stressed, like, am I going to get my work done or. Or that type of thing. I think that's relatable. And so I'll try and have cold water and. And that actually, it helps a lot. These simple things help more than you would imagine. Another one that you talk about is. And this works well because this is the 1000 Hours Outside podcast. People could go find this right now. A rough stone and a smooth stone.
- [20:48]
Dr. Nicole Cain
That's amazing. Who needs a fidget? You could go outside and find a beautiful. A couple beautiful rocks. You don't need to fidget. Fidgets are fun. Let's be real. But a rough stone and a smooth stone. Have you ever seen those worry stones you get at the. The, like, the little. I'm thinking of, like, swag. Or if you, like, go to, like, a little shop or a boutique, they always have those little worry stones. And it's just. You can, like, even pick a color that's meaningful to you, a type of stone that's meaningful, place that's meaningful.
- [21:19]
Eugenie Urch
Yeah, yeah. My midwife had this little store for a while, and she would have, like, ones that are, like, shaped into a heart shape or, you know, and it does. It just does feel good to touch it. So you have that in your panic pack. One more I want to talk about, because it was so interesting to me. A bubble wand.
- [21:34]
Dr. Nicole Cain
Yes. Yeah. So when we panic, oftentimes we'll find that our heart rate goes up, our respiratory rate goes up. Just imagine if you're running from the tiger. You gotta breathe deeper, harder, and faster, and then that will fuel that autonomic arousal. So if we're sitting on the interstate or we're, you know, we're at home and we have our kids, and our kids are stressing us out, or we get an email that's stressing us out, is we don't want to keep breathing fast because there's no actual danger. We want to slow the breath. We want to slow the exhale. Slowing the exhale is one of the most powerful things that you can do, is anywhere you have your breath, you just slowly, slowly exhale. You notice that? Oh, this. Whoa. You slowly exhale. But sometimes we need that feedback. And I love this for kids, especially, like, adults, I have bubble wands everywhere. I love them. I have a bunch in my. My waiting room. Bubble wands, galore but this is so good for those who are like, okay, we need to slow down my exhale, purse my lips and then blow bubbles.
- [22:41]
Podcast Sponsor/Ad Voice
Wow.
- [22:42]
Eugenie Urch
Because you think about that's a thing that four year olds do and it's a long exhale.
- [22:47]
Dr. Nicole Cain
Yeah.
- [22:48]
Eugenie Urch
It's just such a good idea. And you can get those little teeny ones. You have like a pack of a hundred of them. You know, those little teeny ones. These are fantastic ideas. You use an acronym called tips. A couple P's and a lot of S's, you know, and, and just that you said making even the smallest changes to your health routine can have a big impact on your overall well being. I love to talk about a couple of those tips. One of them was going outside.
- [23:14]
Dr. Nicole Cain
Yeah, yeah. Changing the scene.
- [23:16]
Eugenie Urch
Yeah. Yeah.
- [23:17]
Dr. Nicole Cain
I wonder if that would have helped you a lot when we're thinking about your story with your brother.
- [23:22]
Eugenie Urch
Well, I was thinking about that because, you know, when I left the room and I went out in the hallway because they were sending me down to get a wheelchair, I sat on the floor. I mean, I felt like I was gonna faint. I just. And then that's when I was able to collect myself.
- [23:35]
Dr. Nicole Cain
Yeah, you were able to like remove yourself, do a pattern interrupt, and then you got on the ground. So you grounded yourself. You probably. It probably also helped your blood pressure because you, your knees were up by imagine you're sitting on the ground, your knees were more closer to the level of your heart. And so that's really important. I love that you emphasize that is if you're stressed and you have the ability, like, let's say you're at work and it gets the end of your day. And I don't know if you're like this, but I find myself like typing faster and faster and more and more and more and more. I'm like, if I could just finish it and like, really what would be better is to just be like, I'm going to set my phone for three minutes and I'm going to walk around the building or I'm going to walk outside and look at the sun and walk back inside. Look at the snow piles, Michigan walk back inside.
- [24:22]
Jenny
Yes.
- [24:23]
Eugenie Urch
Yeah.
- [24:24]
Podcast Sponsor/Ad Voice
Yes.
- [24:25]
Eugenie Urch
To change the environment. So tips tip the temperature, which you can do that a lot of times with nature. Intense exercises, paced breathing, paired muscle relaxation, relaxation seen, scent, sip stimuli. And even one other idea was to do things that challenge your brain. I loved this idea because I had a friend the other day who like sent me, she was doing a sudoku. She sent me a picture of it. And I was like, you know, you, they're for sale everywhere, like at every grocery store. You can get that on the way out or. But I'm like, gosh, we're so, I think disembodied and we don't, I don't know, like I never see anybody really that's doing a sudoku or doing a crashwood puzzle that didn't that used to be part of like kind everyday life. It was like the newspaper would come and it had a puzzle in it and it was just kind of like part of what you did.
- [25:15]
Dr. Nicole Cain
I remember I. So I, I used to have a horrible fear of flying and I would get on the plane and I would be so in my default mode network, which for those who are like, wait, what was that? Is default mode network is when we're in that anxiety state and our parts of our brain are activated that are very self referential. They're very hyper attuned to our thoughts and our feelings and our sensations. So I was like, oh, I feel a bump. Oh, my heart is beating faster. Oh, oh. And all these scary things are happening. And so when we look at the neuroscience is emotional brain is on a runaway train to trying to protect us. And logical brain is being bypassed. And so Sudoku or logical puzzles are our way of bringing our executive logical. I've got this panic proof part of your brain back on board. So now when I fly, I do sudoku so that anytime I start feeling a little goofy because the air is especially bumpy, I just like, all right, let's logical brain, let's go to an easy sudoku puzzle and start doing some mental math. And it works really well.
- [26:28]
Eugenie Urch
It's brilliant. Anything that pulls your logic in. So you talked about chess, you talked about jigsaw puzzles. Same thing. It's like, which piece would fit here? What color am I looking for? Strategy board games. That's a huge reminder of if you're, if your kids, if your family life is feeling like, you know, high pressure, high stress that like it gives a different light to family game night, doesn't it?
- [26:50]
Dr. Nicole Cain
Yes. Yeah, totally. I love that. And we could totally have fun with it. So if your kids are getting really stressed, you can teach them. There's this activity, it's called havening or amygdala de amplification. And I didn't include this in the book. So this will be like a little bonus thing that people will get from your episode is you and your kids, all ages could benefit from this is you spend maybe 10 to 30 seconds. Noticing the yuck is like, make the yuck really big. Let's really notice it. Where's the yuck in your body? Where do you feel that stress? Oh, I feel it in my heart or I feel like I'm gonna throw up or I feel like I want to scream. Ok. Will notice that. And then you do that for about 10 to 30 seconds. And then you do the mental math. So now we've activated the emotional brain. And then we're going to do mental math. So you're going to say. All right, I want you to say your ABCs out loud. Okay. Let's count backwards from 40 to zero by twos. Let's say all of your favorite avenger characters. Let's say all of the colors of the rainbow. So what is happening is we're leveraging neuroplasticity to go from emotional brain to. Now I have a road to logical. So that when that emotion pops up in the future, that you've laid down those shortcuts to the actual antidote so that your executive team, your logical brain, your coping brain, is able to solve the problem for you.
- [28:16]
Eugenie Urch
Wow. I'm so glad that you explained that because it reminds me of when our kids were younger and our kids are older now, but they, you know, like, all kids have meltdowns.
- [28:24]
Podcast Sponsor/Ad Voice
Right.
- [28:24]
Eugenie Urch
They're emotionally overstimulated. And if. If we would be like, let's race to the car. Or, you know, who can just like, it's a. It's a change in their brain that's happening where all of a sudden there's like a. Oh.
- [28:36]
Podcast Sponsor/Ad Voice
Or I'm gonna do. Or who can.
- [28:37]
Eugenie Urch
Who can clean up the fat or who can get this. Or can someone. But. And it would help. Huh. I just thought it was, like, distracting, but there's an actual thing going on.
- [28:46]
Dr. Nicole Cain
Yeah, because. Because especially the way you just said doing it is then you're incorporating, moving the body into it. And so then that moves the excess adrenaline and it gives it somewhere to go so that it's just not recycling. It's brilliant.
- [29:01]
Eugenie Urch
So can you explain. You have this statement in the book, and the book is called Panic Proof, the new holistic solution to end your anxiety forever. You say panic is protective. So for someone who will be confused by that, can you explain why?
- [29:19]
Dr. Nicole Cain
Yeah. The purpose of panic is to protect you from danger. And you're alive today because your ancestors were able to have a panic response into danger. And our healthcare system, I think, has an opportunity to catch up with the research. And the research shows that the body is giving us symptoms to tell us what needs healing and how. Just like a baby cries because a baby has something that they need, they're cold or they're hungry or they're sad or their tummy hurts. The baby doesn't cry just to make you miserable. Your body doesn't produce panic just to be mean. It doesn't care about your well being, it cares about your survival. And so when you're experiencing panic is what I would love to help people start moving towards is thank you, I'm listening. Thank you body for talking to me. I hear you and what is it you need me to know? And sometimes when we are able to do that kind of work after a panic attack, when we're feeling more calm and allow that to support us. So with the, the doctors is it, is that you were able, after your brother's thing, you were able to as an adult look back on it now you're like, oh, that's a little bit, a little bit silly. It's not a big deal. But in the moment it felt like a big deal. So when we have these big experiences, if we could go back into that experience, talk to that experience and allow us to be informed about what was going on, then we can make changes in our lives so that it's no longer a problem. And that sort of circles back to my story is my symptoms were telling me that I had created a life that was not sustainable for my well being and I'd bitten off more than I could chew and I had a lot of debt and I had a lot of responsibility and a lot of commitments and I didn't have, have the income and the support team to survive in that. So my body was screaming no, no, no. And my brain was like push, push, push. Until all of the treatments stopped working because my body was really persistent and saying, no, I'm not going to listen to your holistic treatments. We're, we got to remove the obstacle to cure. And it wasn't until I removed that obstacle and sold my business, did a pattern interrupt, moved to Michigan, that I actually started the healing process. And so I think that that's a real gift that our panic can give us.
- [31:51]
Eugenie Urch
I loved this sentence. For many people, chronic panic attacks are caused by coping mechanisms that were originally intended to protect them, but have now become the very things that are keeping them in a state of anxiety. And you say there's always a reason for panic. It typically starts small. Back to the stoplight exercise and trying to notice that there's something about the.
- [32:13]
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- [34:25]
Eugenie Urch
Can you talk about the effect of aging and hormonal changes on anxiety and panic?
- [34:32]
Dr. Nicole Cain
Oh, that's actually I was just talking to a patient today about that. Is that this woman will say that she's like 60 years old, we'll say, and she has a history of thyroid autoimmunity. And so they took her thyroid out and so now she's on synthetic thyroid. And she also ended up having ovarian cancer. So then they did an oophorectomy, they took her ovaries out, but they didn't want to give her any hormone replacement because it was ovarian cancer. So she's now in early menopause and she's now in her 60s. And so she's been in menopause since all that happened. And she has a ton of insomnia. She's anxiety and insomnia. And so we did her hormone testing and the body has no estrogen and no progesterone. Her levels are very, very low. So what happens as a result of that? So estrogen is a panic protecting hormone. So there's this really interesting study that was done is estrogen gets such a bad rap, I feel like, but they had a bunch of like sort of a sad story. They had a bunch of women who were victims of DV and so the one of the groups of women, when they analyze the results, one of the groups of women, they experienced the DV and then they were able to get estrogen emergency contraceptive treatment right afterwards. And the other group of women didn't. And then they did a meta analysis and they looked at symptoms of post traumatic stress disorder, panic and depression in the two groups of women. And they found that the women that received the estrogen treatment had statistically less post traumatic stress disorder, way less anxiety, way less depression than the women who didn't receive the estrogen. So then we start exploring, well, why is that? What's going on with the estrogen. And so we know that estrogen can help modify and modulate our neurotransmitters, like your serotonin and your GABA and your dopamine. Estrogen talks to your immune system. It talks to mast cells, histamine. Right. Estrogen talks to your gut microbiome. And so like you were just introducing is that our hormones really matter. And this woman's hormones just were taken away.
- [36:51]
Eugenie Urch
Out of whack.
- [36:52]
Dr. Nicole Cain
Yeah, so out of whack. And so it wasn't until we got those back on track that she started sleeping again and her anxiety got better.
- [37:00]
Eugenie Urch
Wow, there's a lot there.
- [37:03]
Dr. Nicole Cain
Yeah.
- [37:03]
Eugenie Urch
You talk about because, you know, I've heard both sides of this, that when we use medications it's confusing because you say, well, sometimes they help and sometimes they don't help. You have these questions, why do antidepressants help some people but not others? Why is it that within 35 minutes of taking an SSRI like Prozac, the levels of serotonin in neuro in neural synapses rapidly increases, but it takes upwards of two weeks for someone to feel better. So, you know, we're always talking about serotonin and you're like, well, that's only one part. And actually for some people there can be this serotonin syndrome where increasing it can actually make matters worse. So for those who are confused.
- [37:46]
Jenny
By.
- [37:46]
Eugenie Urch
The information that is out there, what are your thoughts?
- [37:50]
Dr. Nicole Cain
We should be confused because we decided in the 1960s that a hypothesis was therefore thereby factual. And so this started. The first neurotransmitter that we discovered was enteramine, which is the serotonin. And they discovered this in the gut. And then they started to research it and then they found that, oh, interestingly in this study, when we gave more serotonin to this study participant, there was less depression. So what if that means that more serotonin is more happy and less serotonin is less happy? And then the pharmaceutical companies did more than 20 clinical trials and they came up with Proac. And after more than 20 clinical trials of it not being any better than placebo, they finally showed that it was helpful for people. And so then we're off to the races where there's this really compelling marketing, all this advertising. I remember when I was in my master's degree, we were getting taken out to lunch by Zoloft supplement recommend or medication farm reps. And so everybody was like, we found the magic pill for depression and anxiety and it's a SSRI. And in 2022, all of this was completely free thrown out because there's a meta analysis done where they looked at all of the research and the conclusion of the scientists that did this analysis was there's no correlation between serotonin levels and depression and anxiety. So now we're like, all in the healthcare situation is we're all either putting on horse blinders and we're like, well, I'm just going to keep doing what I'm doing because this is what we've done since the 60s and the rest of us, as you said, we're all confused. But I think this is a great place to be so. Because now we get to ask better questions. Well, what is the serotonin drug doing? And there's theories. One is that it may decrease inflammation in the brain, which I would argue we have better ways to decrease inflammation in the brain with less side effects. Another study shows that it can increase brain derived neurotrophic factor, which is one of the things our brain uses to heal itself for neuroplasticity. We have better ways to do that. Another is that it talks to the gut. And so then I'm wondering, well, what's going on in the gut and can we treat the gut with something? Gut healing. Instead of a pharmaceutical that is just targeting serotonin, let's actually heal the gut. So now this whole world of root cause and why is open to us in the healthcare system. So there's a lot more to it than just serotonin. And the answers I think are really exciting.
- [40:31]
Eugenie Urch
So people can know, they can obviously read more about this in your book, which is called Panic Proof, but you have your own podcast, so tell us about that.
- [40:38]
Dr. Nicole Cain
Yeah, come hang out. It's the holistic inner balance and we talk about all things holistic healing in a way that's kind of fun, approachable, research backed. We have a lot of really fascinating and great guests on. And Hadley is my co host and we often sing songs because who doesn't want a podcast where the hosts sing songs very badly off key?
- [40:59]
Eugenie Urch
Do you both sing?
- [41:01]
Dr. Nicole Cain
She's actually a good singer. I sing, but it's more for my benefit and nobody else's.
- [41:07]
Eugenie Urch
I went on a tour earlier this year with my friend Emily and neither of us can sing and we sang at it and it was really great.
- [41:13]
Dr. Nicole Cain
That's the best part. Yeah.
- [41:15]
Eugenie Urch
Even harmonized, it was. It was fantastic. I love that people can check that out, the holistic inner balance, because these are pretty extensive and deep topics. So talking about hormone balance and talking about SSRIs and talking about benzodiazepines, which I was kind of excited to say that word because I just. It's a cool sounding word and I've never said it.
- [41:37]
Dr. Nicole Cain
You nailed it. That was like perfect.
- [41:40]
Eugenie Urch
But you're talking about just panic stopping habits and different things that you can do. And the eye, the eye movement thing, which I don't know anything about, but I always Hear about it. And expressive Arts therapy, which. I love this. I love this. It's just more about being in our bodies. If we could just be in our bodies more, it would just help. I liked how you said there's other ways that we can do these things. So expressive art therapies art, singing, music, dance, movement, and writing to help people express their emotions, process difficult experiences, and develop a sense of personal control and mastery. I like, have it starred and hearted. And you have a website people can go to. International Expressive Arts Arts Therapy Association. Yeah, they're taking the arts out of childhood.
- [42:24]
Dr. Nicole Cain
I know. It hurts my heart. I had a. I had a young girl I was working with. She was 12, and she'd been to so much therapy, and it's like a whole story. I feel like you and I could do a whole podcast about this case, this beautiful human. And she ended up in the work that we did together, doing her own therapy through creative writing. And what was so beautiful about it is that if I had had presented to her as many of her other therapists had of, we're gonna do emdr, we're gonna do parts work, we're gonna analyze the problem that felt too big and too close, and she just threw up walls. But she loved creative writing, and we ended up doing the therapy on the characters in her story. Well, what is. What is Ursula in your book? Like, what is. What's her story with her mom? Well, what is. What is coming up for her? And so the creative arts are so powerful for all of us. So bring creativity, bring art, bring dance, bring music back into our lives.
- [43:32]
Eugenie Urch
One of my favorite authors is named Shawn Diedrich. He goes by Shaun of the South. And do you know him? He's just like.
- [43:38]
Dr. Nicole Cain
I've heard of him. Yes. Yes.
- [43:40]
Eugenie Urch
He's just a wonderful. He writes every day. He's got like a 600ish word thing that goes up every day. And he's got a really sad story where his dad took his life when Sean was in the seventh grade, and then he dropped out of school, he didn't go back, and, you know, just had this rocky road and ended up becoming this writer. And he's written all kinds of books. Like, he's written memoirs and. And then he also writes fiction. So I had an opportunity to interview him about one of his fiction books. And I. You know, I didn't realize in. In preparing for it. What I didn't realize was that this fiction book is like a window into his soul. You know, the things that the characters say or the. The Views that they have on the world. I was like, is that your view too? Or do you.
- [44:21]
Podcast Sponsor/Ad Voice
Or that.
- [44:21]
Eugenie Urch
I've interviewed this author, Jack Carr. He's also a fiction writer. And like, his character doesn't like mayonnaise. I was like, do you not like me? You know, so you get this little bit of window into their soul. So what an amazing tool to use for children to use creative writing. And as they sort of write about the characters, it helps them to process what they think and feel. And it would help someone who's working with them, whether that's a parent or a therapist or a teacher, to get a better understanding into their inner life.
- [44:49]
Dr. Nicole Cain
Oh, that's so brilliant. And vision boards, I feel like, are really an awesome opportunity is Carl Jung was his famous psychotherapist and he talks about the quadrants. So you have somebody draw a picture and you draw different things all over the piece of paper. Or you do a vision board and you get images and you stick them all over the board and then you draw that into four quadrants. And I don't want to tell people what the quadrants mean. We can, like, do a sneak peek behind the scenes about that later because I don't want to influence what you put there. But Carl Jung teaches about. Okay, well, let's look at this upper left corner from a lens of this, what comes up for you. And then what is this quadrant? When we say through the lens of that, what comes up for you? And it's this kind of creative, even location dependent, which brings in brain spotting and oh, my goodness. This location dependent way of accessing what might be underneath the unconscious through creativity and spatial. And so art. It's so fun.
- [45:51]
Eugenie Urch
Yes, yes. Expressive arts therapy. Okay, I'm gonna ask you a question about something that, like, really stuck out to me. And I'm not sure if I'm gonna interpret it right or not. You'll have to tell me.
- [46:00]
Dr. Nicole Cain
Yeah.
- [46:01]
Eugenie Urch
You have this sentence. It's two sentences actually.
- [46:04]
Podcast Sponsor/Ad Voice
Just picked it out.
- [46:04]
Eugenie Urch
It's like in the kind of toward the middle of the book. And you wrote this. When you don't move your head for more than a few minutes at a time, your brains. I have written saline network. I don't know if that's a typo or not.
- [46:16]
Dr. Nicole Cain
Salience. Yes, salience.
- [46:18]
Eugenie Urch
It is a typo. I'm missing the c. I'm like saline. That's like water, isn't it?
- [46:22]
Podcast Sponsor/Ad Voice
Is.
- [46:22]
Eugenie Urch
Or salt water.
- [46:23]
Dr. Nicole Cain
Yeah.
- [46:24]
Eugenie Urch
I don't think the brain has a saline network. A salience network.
- [46:28]
Podcast Sponsor/Ad Voice
Okay.
- [46:28]
Eugenie Urch
I was missing the seat. When you don't move your head for more than a few minutes at a time, your brain salience network shifts into high alert. This can make you start to feel anxious. And that made me think about screens and in particular gaming.
- [46:41]
Podcast Sponsor/Ad Voice
Are they related?
- [46:43]
Dr. Nicole Cain
100%. Absolutely. Earlier you mentioned a deer and headlights. Right. So our salience network, for those who this is, this is great neuroscience 101 is I want you to imagine like a colander that you're straining noodles in. Right. And so you run the water and then all of the dirt, all of the whatevers on your noodles, hopefully not dirt. It all runs through.
- [47:07]
Eugenie Urch
Sometimes I have dirt on my noodles.
- [47:10]
Dr. Nicole Cain
Who doesn't have dirt on your noodles? That's going to be the title of this pie. Who doesn't have dirt on their noodles? And so what happens is all of this information, your interoceptive, our body's internal sensations goes to the filter, all of the stimuli and the input from the environment around us goes into this filter. And what can happen is it can get very easily overwhelmed because our brains haven't evolved much beyond what our brains and nervous systems were like when we were cave people. And the level of stimuli is just astronomically higher.
- [47:48]
Eugenie Urch
Yeah.
- [47:48]
Dr. Nicole Cain
And we haven't evolved to process that. So we have somebody who's sitting really still like a deer in headlights, in what the body would associate with a danger position. I'm really stiff, I'm not rotating my head, I'm in a freeze. So that's interoceptively danger. And then you have all this stimuli from the environment coming in. And you mentioned gaming in particular. So there's lights and stuff, sounds and flashes and reflexes and all these things. So we're frozen and all the stimuli is coming in. And so now the salience network is like, I don't know what's going on. When in doubt, send it forward. So it sends it to the amygdala, the big emotional processing, the big feeling part of the brain. Amygdala is flooded. The amygdala is like, I don't know how to deal with all this. When in doubt, send it on. So amygdala starts a fight, flight, freeze, flop, fawn, fracture, cascade. And so now we're stressed, now we can't sleep, now we're agitated and we have ADHD and nobody can focus anymore because when you're in danger, you don't want to focus. When you're in danger, you want to multi everything all around you and go. And so what we could do is a salience hack. And so a quick thing for all of those who have been sitting on their computers all day today. Maybe your kid's been gaming, maybe you've been gaming, maybe you've been playing Candy Crush for the past hour and a half while listening to this podcast. And the body's in a danger zone state is you just simply are going to do it this. So you're going to exhale and then you're going to take a nice breath in and you're going to rotate your eyes and your head over your left shoulder. And then you're going to exhale again as you come to the front. And then you're going to go over the right side, rotate your eyes and your head over your right shoulder. And then on the exhale, you're going to come back to center and now you're going to focus your eyes over the device. You're going to look far away and then you're going to focus your vision close up. And that's a, that's a reset. So that takes the body out of that circuit loop, that snowball that's rolling down the hill to stress. And so for those who have computer jobs, desk jobs is try to do that periodically. Shoulder, shoulder, far and close.
- [50:06]
Eugenie Urch
Okay, Nicole, that's so interesting. When you don't move your head for more than a few minutes at a time, your brain salience network shifts into high alert. This is why, because when you're gaming in particular, like I think if you're watching tv, kids are laying down. You know, they're, you know, kids will lay on top of each other. They move around. You might be like upside down on the couch.
- [50:26]
Podcast Sponsor/Ad Voice
Couch.
- [50:26]
Eugenie Urch
Or you might be on the floor. You might be snuggling with the dog. This Angela Hanscom talks about how kids need to move in vigorous ways. She's a pediatric occupational therapist. Like, the head's got to be moving and rotating. So like if you're, if you're watching tv, it's, you know, you're probably going to be moving around some. If you're playing Candy Crush on your phone, you might be looking up or looking around here or there. But when you play video games, that is a different animal. That really is. You are sitting up. No one's ever really laying down or upside down on the couch. You are sitting up. And that's when people say, like, they try and take it away from their kids and the kids become violent.
- [51:00]
Dr. Nicole Cain
Yeah, yeah, absolutely. Because they've been in that fight flight freeze. It's like building, building, building, building. Yeah.
- [51:07]
Jenny
Wow.
- [51:07]
Dr. Nicole Cain
And then you break that circuit and then their dopamine crashes. Right? Because we think about, like gaming and that dopamine. And so now we have a dopamine withdrawal. Combine that with Fight, Flight, freeze, and it's a recipe for tons of shame in that kid and anger and frustration in that parent. Very, very difficult.
- [51:28]
Eugenie Urch
Something to watch out for when you don't move your head for more than a few minutes at a time. So interesting. I learned so much. The book is called Panic Proof, the new holistic solution to end your anxiety forever at your website, dr, nicole kane.com which I'll put a link in the show notes.
- [51:41]
Podcast Sponsor/Ad Voice
You've got courses, you've got a shop.
- [51:42]
Eugenie Urch
You'Ve got your own podcast. People can go there to find so much information. And there is a lot of information. You know, you talk about how you were born in 1982 to two very young and isolated parents who recycled how they had been parented. And I thought, oh, that's really good wording, Nicole. Like, how often do all of us do that? We just recycle. And so this is the time to learn new things and to get books like yours and to really understand what's going on in our bodies so that we can help ourselves, we can help our kids. We always end our show with the same question. What's a favorite memory from your childhood?
- [52:12]
Podcast Sponsor/Ad Voice
That was outside.
- [52:15]
Dr. Nicole Cain
My favorite was before I made a panic pack as an adult.
- [52:18]
Jenny
Adult.
- [52:18]
Dr. Nicole Cain
I made a fanny pack with band aids and gauze as a third grader and I put that little fanny pack on and we would climb in the woods, someone would get a little scrape and I was, I have a band.
- [52:29]
Jenny
Aid.
- [52:32]
Dr. Nicole Cain
Prepared where I went prepared. Little Nicole came with her little fanny pack and band aids.
- [52:39]
Eugenie Urch
I love that because really, in so many ways, you're still doing the same thing, which is you're helping people with their healing. You talk about this as a bottom up approach, focusing on regulating the body to heal the mind. So you've been a body healer since the third grade. I love that. What an answer. What an answer. What an honor. Thank you so much for your time and for writing this wonderful book.
- [53:02]
Dr. Nicole Cain
Thank you for having me. This has been awesome.
- [53:06]
Jenny
Get outside open your eyes Feel that smile Sunshine kissing your skin Throw your worries out to the wind.
- [53:17]
Podcast Sponsor/Ad Voice
Climb some.
- [53:18]
Jenny
Trees Skin your knees Feel that grass on your feet again get out there and take it in oh, it's a beautiful world Ain't nothing on scream it's ever gonna be this view oh, it's.
- [53:42]
Dr. Nicole Cain
A beautiful world.
- [53:46]
Jenny
And I just wanna share with I just wanna share with you this beautiful world Such a beautiful world.
- [53:57]
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