Richard: Hello, this is Richard Jacobs with the Finding Genius Podcast, now part of a Finding Genius Foundation.  I have Dr. Dr. Christina Bjorndal.  She’s a doctor of naturopathic medicine and we’re going to talk about mental wellbeing, bipolar disorder and other issues.  So Christina, thanks for coming.

Dr. Christina: Thanks for having me.  It’s great to be here.

Richard: Yes, if you would, tell me a bit about your background.  How did you become an MD and what led you on your journey to where you’re at today?

Dr. Christina: Yes.  So really for me, it was my own struggles with my mental health that ended up leading me to become a naturopathic doctor and I experienced a lot of challenges when I was in university and subsequently when I was working in the corporate world and it was after having or surviving a suicide attempt that I realized I needed to figure out another way to navigate my health other than taking medication upon medication upon medication and that led me to finding a orthomolecular or nutritionally oriented psychiatrist who started to be on supplements and dietary exchanges and then after a year of following his protocol, I had my first year where I felt free from depression and anxiety which were the primary things that I was struggling with.  So then, I decided to make a career change myself.  So that’s the journey in a nutshell for you.

Richard: Okay.  So, in your practice, I mean there’s a million things you can work on.  Are you more focused on mental problems that people have or what is the focus of your practice?

Dr. Christina: Generally, the focus of my practice is mental health.  So people who have depression, anxiety, sleeping issues and bipolar disorder, those are the main four areas and then hormone balancing fertility, those are the other areas that I have an emphasis on in my practice.

Richard: What conditions would you like to go into a little more depth today; bipolar disorder or …

Dr. Christina: Yes.  I mean …

Richard: … which ones are the most important to talk about?

Dr. Christina: Well, I think probably the most important to talk about would be in that mental realm because I think a lot of people are struggling right now with depression and anxiety.  Those are definitely more common.  One of the things for myself, I was also diagnosed with bipolar disorder and that is definitely an area that’s near and dear to my heart.  It’s just not as common for the listeners probably but I am happy to go wherever you want me to go.

Richard: Yes, let’s focus on bipolar disorder.  You said you had been diagnosed with it.  If you don’t mind, it’s up to you; if not, it’s okay but what was it like, how did you know that there was an issue with yourself and what was that journey like?

Dr. Christina: Yes.  Well, I didn’t know, so what happened to me was I – surrounding the initial diagnosis, what happened was I – had been depressed and quite suicidal and I was put on medication.  At that time, it was a class of anti-depressants that are called tricyclic anti-depressants.  So I started those and within a few months, I found myself in a place that I’ve never been before, which I wasn’t sleeping, I had racing thoughts, I was very euphoric, I really thought that I could take on the world and then I spun from there into a delusional psychotic manic episodes and it took six people to wrestle me into a straightjacket and off I went to the hospital where I was left in a rubber room after being injected with a powerful anti-psychotic.

Richard: Oh my god.

Dr. Christina: Yes.  It was quite kind of a traumatic experience because through all of that, I didn’t really understand what was happening to me and the big piece that’s important to mention is that I’m adopted.  So there’s no family history to go by and there was no forewarning if you will that this could happen and I had a hard time swallowing that diagnosis myself because I felt like “Okay, I couldn’t look to my left or my right to verify the truth of that” and would that have happened to me if I wasn’t taking medication?  So that’s always been a doubt or a question in my mind, which has prompted me to write the book that I’ve written which is called “Beyond the Label: 10 Steps to Improve Your Mental Health With Naturopathic Medicine”.  So I think that by looking at these different areas, which include stress management and sleep and ensuring you’re getting exercise, moving your body in ways that feel supportive and comfortable for you, obviously the nutrition piece.  These are all really important factors that everybody talks about because it’s important.  Dismiss the value and really the emphasis that this can have on your wellbeing.

Richard: What was your path; you were put in that room and everything that was a real low point to where you are today where not only you’re okay it sounds like but now you’re helping other people?

Dr. Christina: That’s been a long path but basically so after that diagnosis, I took the medication that was recommended and I continued finishing my schooling and then I began working in the corporate world but all the while I’m wearing this mask that I really wasn’t doing that well on the inside but I would portray on the outside that I was doing fine.  You would never know that there was nothing going on with me, I was very good at wearing this mask.  And really, it was after the suicide attempt that I realized that I just needed to figure out another way to navigate my health because the way I was doing it wasn’t leading to health for me and so that’s really been the journey.  It’s taken, gosh, I was 20 when I was diagnosed and I was 33 when I went back to high school to go back to university so that I could then go on to naturopathic school and then I graduated when I was 38 I believe or maybe I might have been 39.  I now am going to be 55, so it’s been a long journey.

Richard: And do you feel like because you’ve been through this journey when you have a patient that does struggle with bipolar disorder, do you feel like you’re able to use what you did to help them beyond …

Dr. Christina: Nothing.

Richard: … the naturopath methodologies, like how would you describe that like you’re in a good place to help these people and probably more than most because again, you’ve struggled with it so what is that to you, like what do you think you have that is more helpful than someone else that has never been diagnosed with or that’s never dealt with that?

Dr. Christina: I think that’s just did is that when you really have lived experience with something and you’ve really walked that same path that the person across from you has may not be exactly the same but you’ve experienced a lot of similar connections and relationships, it just brings a different level I think understanding the compassion and empathy than reading about it in a clinical way through a textbook or something that you may have studied.  So I think that that’s what draws people to me is the fact that not only do I have that educational side but I also bring that lived experience piece to the table.

Richard: Naturopathic medicine, what is there for people that are suffering from bipolar?  There’s traditional medications but naturopathic seems to be very different, so what kind of protocols have you seen that are helpful to some folks that suffer?

Dr. Christina: Well, the first area for me that’s really important is the sleep piece.  And it depends on where you are on the spectrum of bipolar disorder.  So are you coming in when you’re depressed or are you coming in because you’ve just had a psychotic event?  And those are two very different pictures.  So if we’re to take the individual that’s depressed, then regardless of whether they’re coming in with depression or have just experienced psychosis, first and foremost, it really is about understanding that person in front of you because everybody’s story is unique and there is no two use out there on the planet.  So what you’ve experienced, how you’ve processed it, what you’ve made that mean, the core beliefs you may have formed, the shadow beliefs, all of that plays a role.

So if somebody is depressed, for me, the main focus is always making sure that they’re not suicidal and supporting them in seeing the light that is within them in whichever way I can be that mirror to reflect it back to them.  So giving them some sense of purpose and understanding for why they’re here and what it is that they want to be doing.  And even if it’s just as simple as making sure that they are able to get out of the bed in the morning and get out outside and move their body, whether they’re exercising or going for a walk and a lot of this is difficult when you’re depressed and especially during this time of the pandemic because we are not as connected as we perhaps could be with people so that’s a really big piece and I think why a lot of people are struggling now is this idea and I think under-acknowledgment of the role of connection.

Richard: I know every case is different but again, what are some of the modalities or things that you help people with?  You mentioned sleep as being a huge help to people with bipolar disorder, can you spell a little bit more out like how do you help people with it and then how does it improve their circumstance once their sleep improves?

Dr. Christina: So, if you’re on the other end of the spectrum and you’re not sleeping, then we want to understand that there are two main hormones that are involved in sleep.  So cortisol and melatonin.  And if we’re wrapped up in the evening for whatever reason that there can be a variety of reasons and we’re having a difficult time falling asleep, then we want to support that person by either teaching them how to calm themselves from a cortisol management perspective, whether that’s making sure that they are winding down from TV, they’re not playing videogames, you’re offing your phones, you’re not engaging in technology, you’re not engaging in difficult conversations or having upsetting conversations before bed but you’re just doing things that are relaxing and calming for you.  And some people need to take some support so that might look like a botanical formula that’s formulated for you, could be taking melatonin.  If the issue is sustaining sleep, then it may be looking at adding things.  If there is an issue with high level of cortisol or it can be taking things like 5-HTP which gets converted over the course of the evening to more melatonin, which helps us to sustain our sleep.  So it really just depends on what the issue is.

Some people have a hard time falling asleep, sometimes people have a hard time staying asleep, sometimes people have both of those problems.  So the nutritional support and herbal recommendations are based on what’s happening with that person.

Richard: Okay.  So once you help someone with sleep, give them enough mind space to work on their own bipolar or is that just the start and there’s a lot more that needs to be done to help people?

Dr. Christina: Well, most people that come in are often taking a form of medication or mood-stabilizing medication.  So my main goal is to make sure that people are, a) not depressed and suicidal; and b) not being hospitalized in an aggressive manner that I was due to psychosis and that they’re contributing to society in a way that feels good for them.  So whatever form of employment that might — so we are wanting to understand what happened in the first place, what’s the root cause behind this label that we’re using called bipolar disorder?  So what was going on when you had your first depressive event or your first psychotic event?  And for everyone, that’s different and stress plays a big role.  So really understanding what you can do to manage that is really important.

So it’s a condition that I think you can manage and navigate.  Sometimes you’re going to need to take medication, sometimes you might need to take medication for a long period of time, it really just depends on the case.  Some people are able to navigate, especially bipolar type-II, that’s much easier to navigate, I think, without the medication but you have to — it’s a condition that requires a lot of self-awareness, also you need support, as I was mentioning earlier, whether that’s through a partner, a parent, sibling, cousin, someone who can help you recognize those times when you may not actually be okay when you think you are.  And then it’s understanding hormones in the body, neurotransmitters in the body and supporting the organs to detoxification in the body.  So with depression, often we’re looking at how can we support serotonin in ways that are more natural and I’ve mentioned 5-HTP that stands for 5-Hydroxytryptophan which gets converted to serotonin in the body if you have the nutritional cofactors to do so.  So nutrition is a really important piece and what you put in your body really matters because your body is using that foundational material as a building box to create the neurotransmitters and the hormones that you then need to function.

Richard: Okay.  So when you work with people, what state do they come to you and what is considered out-of-control behaviors for bipolar and then once you work with someone, what would they experience even though it may not be, again, normal mental activity or normal interactions with people but you can tell “Okay, you’re getting there, it’s better”?  I’m asking this for listeners like what happens when someone’s out of control with bipolar and what happens when someone’s starting to come back into control and not there yet?

Dr. Christina: When someone’s out-of-control, they’re not in my office.  I don’t usually see people who are at that point.  They are coming to see me after they’ve had a traumatic event, either a psychotic event and they’ve been given this diagnosis and they’re looking for other ways to navigate it or they’re depressed and they’re wanting to feel better from that perspective.  So what they can expect after they see me generally is that they feel better, that they’re not depressed, that they see the joy in life, that they have more energy, that they have more vitality, that they are able to engage with their friends and family, that’s generally the path that people take when they come to see me.  If they’re not getting better, then — and it depends.  If you’re taking medication already, then we may have to look at that piece of the puzzle.  If you aren’t taking medication and you’ve started the nutritional protocol or the herbs or the homeopathic or anything that I prescribed for you and you’re not getting better, then we may have to look at “Maybe we’re looking at the wrong microsystem in you, maybe we’re supporting your neurotransmitters but it’s actually the hormones that aren’t working”.  So maybe we have to do some more in-depth testing to figure out what’s right here or what’s wrong here with you.

Richard: But what is better?  Was that mean like the manic episodes are not as manic and the depressions are not as low, there’s less amplitude or what does it mean?

Dr. Christina: I don’t know if you — do you understand bipolar disorder?

Richard: I’ve never had it but I’ve spoken to a few people.  So it seems like the person that feels on top of the world and they have tons of energy and they don’t sleep very much and then they isolate and they go back and now the low is so low that they can’t get out of bed or they can’t do anything or function.

Dr. Christina: Right.

Richard: And again, I’ve never had it.

Dr. Christina: Right, of course, you don’t have it.  So like I said, when people are in that higher state, that’s not when they’re coming to see me because why do you think that is?  Because they feel good.  They don’t think there’s a problem, why would they come to see me?

Richard: That’s true.  That makes total sense.

Dr. Christina: So they come to see me when they’re depressed and then I do monitoring and evaluation and we’re checking in and then we use objective evaluations to determine the progress.

Richard: Do people have memory that they were manic, do they have memory that they were depressed, like do they have selective memory just one of the two or what’s that like?

Dr. Christina: No, they have memory of both ends of the spectrum.

Richard: Do they realize that they were manic, do they realize that they were really down or do they think like something else is going on with them and they were okay, was their perception of themselves accurate is what I’m saying?

Dr. Christina: Not when they’re in an episode, they don’t have always.  I mean some people have that awareness that this behavior that I’m doing or what I’m saying or what’s going on right now isn’t actually “Normal” behavior but when you’re in that state, it’s a very difficult place to — you’re just not — it’s very difficult to explain, it’s very difficult to explain.  Depressive episodes, most people recall those they’re equally not fun but they’re not clouded in the same neurotransmitter imbalance that psychotic episodes are.  So I haven’t really asked a patient if they don’t — there’s a lot of shame often and a lot of stigma and a lot of negative emotions that are associated with both ends of those extremes.

Richard: And do people think that they’re more okay than they are?  Like when they get feedback from friends, relatives, associates, are they surprised about the feedback?

Dr. Christina: I’d have to ask, I haven’t asked that question because I think that it’s a very sensitive condition, it can be humiliating, some of the behaviors that can come out of both depression and psychosis.  And I think that it requires a very kind, considerate, compassionate person to help somebody navigate through these experiences that they’ve had.

Richard: No, I agree.  I haven’t heard from various mental health practitioners and people that had been effected but sometimes when they are in a depressed state or maybe a manic state, they literally don’t have memory of some of the things they’ve said.  It’s kind of a fog in a way and they don’t remember some of it.  Have you experienced that or hurt that?

Dr. Christina: Not from a depression, no, but I have heard that and I would say I would relate to that from a psychotic perspective, there’s aspects of it that I may not recall.

Richard: Okay.  I’m just wondering.  Another thing that …

Dr. Christina: Yes, I’m curious why you’re wondering about that.

Richard: Well, again, because some of the interviews I’ve done, certain people have told me that they didn’t have memory of some of the things they said and they were surprised a loved one or someone said “You’re really this way last night” and they literally may not remember.  And I’ve heard this from a few different people so I just wonder if it’s a common phenomena or maybe I just somehow happen to stumble on a few people that said that.  So that’s why I want to have your experience is, you know, you’ve spoken to far, far more people on this issue than I have.

Dr. Christina: Yes.  And the people that I have experienced with are — they’re not — there are people that experienced what’s called rapid cycling, which is where they can go up and down within the period of a day.  That’s not what I work with nor have any experience with.  So for me, it’s for the most time a person’s doing fine and normal and then they stumble or have these short blips into — like it’s not like psychosis lasts for years in somebody.  It’s basically a very short-lived experience like less than 3 days.

Richard: Has anyone figured out what the triggers are that put someone into a manic or depressed state, what makes them psycho?

Dr. Christina: Well, the depression side is, the current model is that this is the medical western model is that you have a chemical imbalance in your brain and that you just need to support commonly serotonin from the depressive perspective and from the mania side, there’s different suggestions that then it’s sort of the opposite side because there’s inhibitory and excitatory neurotransmitters.  So instead of the — so in depression, you have a low amount of inhibitory so we need to raise those and the opposite in psychosis, there’s too much of the excitatory neurotransmitters.

Richard: What’s your thought, do you think that makes sense or only for a certain people or what do you think?

Dr. Christina: Yes.  I think that there are things that can — so connecting back to stress, I think that the more stress a person’s under and again, everyone has a different tolerance and threshold for what they can handle.  Perhaps they are moving into or producing too much cortisol and then not then in tern effects sleep as I was mentioning earlier, which if you’re not sleeping, even if you don’t have bipolar disorder, if you don’t sleep well for a few days, most people don’t feel good if they don’t sleep well.  And so in bipolar disorder, I think that piece gets switch in the wrong direction if you will and that plays a big role.  So it’s a little bit of a vicious cycle that feeds upon each other because the more stress you have the less likely you could be to sleep, which then causes you to produce more excitatory neurotransmitters, which then feeds into the lack of sleep and so then off you go.

Richard: I got you.  So the people that you work with that you’ve been able to help and reduce their bipolar issues like how does the person describe how they feel better, do they just come less often and that’s what gets them better or do they say things to you that pull you in that they’re doing better?

Dr. Christina: Again, normally I see people when they’re in a depressive state so it’s helping them navigate through that.  And then once they’re feeling better from that perspective, then I will check in with them.  It really just depends on that frequency, whether it’s — initially, I’ll see people, again, it might be weekly if you’re suicidal, it might be every second day, it might be every month, it just depends on the degree and severity of the depression.  But once you’re better, then I would see you for usually once a quarter, I would say, for the first year and then thereafter, we would touch base once every six months and I mean my goal isn’t really to have you seeing me all the time.  That’s not my goal.  My goal is to have you feeling better and to teach you tools and how to navigate this condition but I’m always there to help you if you need me but ultimately my goal isn’t to have you coming to see me every week.  That’s not the objective.

Richard: Right, that’s good.  I hope you’ve seen that I guess regular depression or anxiety is different from bipolar disorder.

Dr. Christina: I don’t think it is different, I think there’s no difference.  The only difference is the tendency to have a manic episode if you have bipolar disorder, it’s the only difference.  People with unipolar depression do not have bipolar episodes.

Richard: Okay.  So a regular depressed person will be depressed and then kind of normal, and then depressed and normal but bipolar, they’re going down and up way high and way down or way up.

Dr. Christina: Yes.

Richard: Okay.  Yes, that’s interesting.

Dr. Christina: Yes.

Richard: Is there any benefit at all to being bipolar versus just straight up depressed?  I know it’s a weird question but is there any?

Dr. Christina: Well, I think if we want to look at this from a spiritual perspective, then we want to ask ourselves what is the reason why depression comes in the first place.  So for some people, it could be to help your ego, might be moving in a certain direction, and your spirit or your soul wants to move in a different direction and therefore you get stuck between these two masters and you don’t know who to listen to and we call that depression.

Richard: Is it like a form of cognitive dissonance in a way?

Dr. Christina: I think I look at it more like a spiritual crisis in people’s lives.  So it really depends on what the root is and some people, the root is related to perhaps some sort of trauma or abuse that’s happened in the past.  For some people, it’s just simply that on that physical level that oh gosh, what I’m not ingesting tryptophan forming foods but tryptophan is the essential amino acid that we all need to eat because that gets converted to serotonin, otherwise we can’t make serotonin.  Maybe it could be just as simple as that for some people.  Other people, maybe they’re going through a really difficult divorce or others, it could be — we use depression for a lot of — in a lot of different situations.  I mean it could actually be connected to grief.  So it really just depends on the individual.

Richard: Are there people that you can’t help and if so, is there any commonality for them?

Dr. Christina: Well, I like to say that we are able to help everyone but the challenge is that you have to be willing to help yourself.  So sometimes other people want you to do something that you might not be ready to do.  For example, a parent who has a child who might be 20 years old who is now an adult but does not want to — doesn’t believe in naturopathic medicine for example, so I’m not going to be able to help that individual.  They’re not open-minded.

Richard: Right.  So if someone wants help, you’ve been able to help them.

Dr. Christina: I would say, yes.

Richard: That’s excellent.  Are there any new treatments that are coming up that you’re evaluating?

Dr. Christina: They’re not in my scope of practice but I think it’s interesting to look at the psychedelics.  There’s a book by Michael Pollan that came out a couple of years ago now called “How to Change Your Mind”, I believe.  So I think that field is interesting but that’s not in my scope of practice.

Richard: And since you said you only see people when they’re depressed, have you had any patients that have tried these and given the feedback?

Dr. Christina: I’m in Canada and since it’s not in my scope of practice, I think the last time I looked into it, it wasn’t available here.

Richard: Okay, I was just wondering.  What do you think is the future of the treatment for these conditions?

Dr. Christina: I think the future is really in understanding the individual’s journey and bringing more empathy and compassion to the table and not necessarily seeing that we have to give a pill for every problem but really trying to get at the root of what’s going on with somebody.  And I think that there hasn’t been much additional research, money going towards mental health and yet it’s a group of conditions that continues to rise.  So it’s kind of bit troubling in that regard, the suicide rates, they haven’t gone down, rates of depression they haven’t gone down.  These things are just continuing to increase.  So we’re not really, as a society, I think missing something here and I think we need to get back to one of the things that I mentioned, again, at the beginning is that sense of connection and community.  And I know in England, they recently, maybe in the last five years, appointed a minister of loneliness.  So they’re recognizing that people that are lonely get depressed and what can be done to help in that regard.

Richard: What have you seen in the past two years with the whole virus situation, has it exacerbated, has it made it difficult for your patients more than before or what it’s been like?

Dr. Christina: It’s definitely exacerbated things and made things worse for people for sure.

Richard: So you say you’re in Canada, so for listeners, if they can’t get help from you directly, what’s in the analog, let’s say in the US, do they look up for naturopathic doctors or what would you be called if someone is to look for you online?

Dr. Christina: Yes.  If you want to look in the United States, it would be the American Association of Naturopathic Physicians is what they use the term “Physicians” or the website is naturopathic.org and that’s the American Association of Naturopathic Physicians and in Canada, it’s the Canadian Association of Naturopathic Doctors so cand.ca and then you can click on the “Find a doctor” and then type in your area and somebody will pop up hopefully.

Richard: Okay, very good.  Where can people find out more about you and your practice?

Dr. Christina: For me, it’s just on my website, which is drchristinabjorndal.com.

Richard: Okay.  Well, Christine, thank you so much for coming on the podcast.  I really appreciate it.

Dr. Christina: Great, thank you so much.