What's up guys, Lisa here?

Just want to let you guys know that rating review in this podcast means the absolute world to me

and to encourage you on reading out weekly reviews. This review comes from A-L-B Walker. About a year ago, my boyfriend introduced me to impact theory, stroke relationship theory. I absolutely love hearing about the journey that you and Tom have been on and gained so much inspiration from the both of you. I've just discovered women of impact and listened to the first episode and can't wait to listen to the rest.

Right now, right this second is you're watching this. Over 42 million Americans over the age of 12 have taken an anti-depressant this month. And one in six Americans take some kind of psychiatric drug. Think about that for a second. Think about how many people you know and how many people you may not even realise a suffering from depression, anxiety, bipolar and other mental disorders. My own husband was suffering from anxiety at one stage and I had no bloody clue. You see, about 15 years ago we were with my family in London and talking about something funny and I had had this great story to go along with it. So I turned to him and asked him to tell

it. Now he's such a funny guy so I knew it would sound great coming from him. And it's something weird happened. He wouldn't tell it. He was being so weird about the whole thing. I just couldn't figure it out. It wasn't until much later that he finally admitted to me that he was growing more and more anxious.

And in that moment with my family,

he felt such crushing anxiety that he couldn't speak. What? I literally had no freaking clue he was going through it. I knew him as a super confident, funny, smart, outgoing man. So this was just such a surprise, more as a surprise than Brexit. Because I didn't suffer from it, it wasn't something that I got. But now the social shame and stigma around mental disorders is still so prominent that people are still reluctant to discuss it. And if they do, still even today, most turn to medication. Now look, I have absolutely nothing against medication or antidepressants when needed. In fact, giving someone an antidepressant drug improves symptoms within six to eight weeks in 40 to 60% of cases. Amazing, right? I mean, that's officially a modern miracle. Until you realize they're giving someone a placebo pill for depression, improve symptoms within six to eight weeks in between 20 to 40% of cases. Yep, you heard me right. The placebo treatments are almost as effective as drug treatments. Now that's not to say they don't work. Going on medication for some people is absolutely the right thing to do for their mental health. But that needs to be the last resort, not the first solution. Endless to days guest. A graduate for Columbia University Medical School, now I board certified psychiatrists, acupuncturists and yoga teacher. This woman of impact takes a functional medicine approach to mental health, where she addresses the root of the problem rather than prescribe a medication and put an attempt rebanded over a gaping wound. Specializing in depression, anxiety, insomnia, women's mental health, adult ADHD, bipolar, auto-immunity and digestive issues. So please help me welcome the women whose mission is to make a dent in the 300 million people worldwide that are currently suffering from depression, making it the leading cause of disability worldwide. The woman who's given actionable and tactical advice on how to change the heartbreaking truth that about a billion people worldwide herself are from one form of mental disorder or another. The woman who is picking up a pebble and creating a tsunami in the mental health space. The mental changemaker herself, Ellen Bora. Welcome to the show, girl. Thank you, Lisa. I'm honored to be here. So honored to have you. What you talk about is so fascinating and where I want to start actually what I just said in the intro is this placebo effect. Explain to me why that is so prominent in your field where people can take one pill and it actually be a placebo and think they're getting better. Like how does that correlate to what's actually going on? Yeah, I think it speaks to a couple of things. One is just the power of our expectation, the power of our unconscious mind. It's really this motor that's going to drive so much of our reality. But also, it speaks to the fact that our medications are just non-as-effective as we'd like them to be as we've been taught that they are. And so when you combine that, what you see is that we've sort of turned mental health into a science, we've tried to make it objective. But then you see people just doing the right thing, being good citizens, going to a doctor saying, I need help that takes courage. That's a really hard thing to do. And our doctors are just trained to prescribe medication or psychiatrist. And then what happens is people go home and they take their medicine and they think, okay, I'm finally seeking help. Somebody listen to my problems. They prescribe something that's going to help me. All of that conspires to help us get a response from the medication. Feel better, we think this thing is really working. And then sometimes what you see pretty frequently is that the effect eventually wears off. And we think was that medication only temporarily working, but I think what really happened there so much at the time, it was only ever the placebo effect. And the placebo effect has with it a little bit of a bias towards this is a new exciting change I'm making. Let's see if it helps. And so then that expectation is what drives the effect. The people act differently when they then take the placebo effect because they believe it's working. And then in that action of doing something different, it actually makes them better. In a way, yes, I think that it can be used to leverage the initial push to more habit change. And so there's this idea of talking to prosack, kind of like take the medication as a bridge and then it gets you into therapy and then you start talking, you start sort of excavating the unconscious and that's where the real work begins. Or in a more holistic approach, maybe the medication as a bridge and then you start talking, you start sort of excavating the unconscious and that's where the real work begins.

Or in a more holistic approach, maybe the medication is a bridge and then you start making the diet and lifestyle habit changes that in my opinion really make the real difference long time. Right. So someone's listening right now, they're starting from the beginning. It's always hard to know what you put first, right? What came first that she can have the egg. So in situations like this, I'm always just fascinating and so curious about what you do first,

because when you're depressed, you don't necessarily wanna seek help. You don't necessarily wanna go out. And I've heard you say that socializing actually is a really good thing to do when you're depressed. So take me back to like ground zero, number one move if someone is in this situation, do they seek help first? Do they look at diet first? Like what is that first step? Yeah, I love that. So I used to have such a protocol, such a system and say first we start with food. First you're going on a whole 30 diet or you're going gluten free or you used to say like first just focus on sleep or just focus on exercise. What I've learned now is that people are so different and so at this point I think of it more like I offer a buffet and it's like here's a buffet of options. And you know for yourself what you feel drawn to, what feels accessible, what feels plausible right now because when someone's depressed, they can barely get out of bed in the morning. They're not really necessarily even finding the motivation to take a shower, let alone do the 50 things that I'm recommending to help them treat their depression holistically. So it's a real mismatch and it I'm always kind of reading people what feels within reach to you. For some people it's I can exercise for five minutes a day and for some people it's all I can do is take a multivitamin. And then when someone is reached for something, then each change builds upon the last one. And so if you just make one shift, kind of called a keystone habit, like if you make one shift, you feel a little bit better, you've witnessed yourself successfully making a change. And I really like how Gretchen Rubin lays it out in her book Happier, where some people

are upholders. It's kind of like, tell me the 50 things to do and I go home and I'm a perfect student. It's like homework and they excel at it and they come back and they're doing everything. With those folks, I'm actually careful not to make too many recommendations because it can drive people crazy and they can get too obsessive about following my instructions. where you start to see people developing orthorexia around healthy eating or their life gets smaller and more limited because they've developed such an elaborate system of self-care that they're saying no to spontaneity and social engagements. So upholders, I kind of narrow it down, make these three to five changes, and then run off and come back and you, you have to feel better. Some people are questioners and it's like they, they're like convinced me with science. And so then I love those conversations because you know, I guess let's put my 10 years of education and debt to use and convince somebody with science. And then some people are obligers, that's tricky too. And they're gonna do something out of a sense of obligation to someone else. And I really wheeled that carefully because then people start to worry about disappointing me if they don't do something. And you never want that vibe in the therapeutic alliance. I want someone to feel safe. I want someone to feel always supported by me. And if they come back and they say,

I slipped up and I ate gluten or whatever it is. I don't want them to think that I'm wagging my finger. And then there's the rebels. And I don't have a ton of success with rebels. I love you, honestly. Rebels are someone where it's like, if I say do this, they will run into the opposite. And that's an interesting journey to be on.

If you are rebel and you know this about yourself,

but you're not feeling that well,

I think that it's, it can't. It's like if I say do this, they will run into the opposite. And that's an interesting journey to be on. If you are rebel and you know this about yourself,

but you're not feeling that well,

I think that it can be a beautiful thing. It's an internal journey then. It's between you and yourself and you have to realize why. It's not out of obligation to this doctor. It's not because I do everything to please people. It's not because I do everything people to tell me to do.

It's not because I was given some science.

It's like, this is between me and myself.

And I am suffering sufficiently that I'm motivated

to make changes. Talk to me about their bligest because that's fascinating because as you were talking, I was like, you know, there are people that really do, they like to please people. And so in those situations, how do you even start on one dot?

Yeah, I find obligers very tricky because they'll do what I ask them to do. So I feel like, oh, I'm a great doctor. They're a great patient. Everything's hungier door here. But what you really see if you look at the subtlety of it is that people are betraying themselves. They're not doing it for themselves. They're doing it out of a need to please others. And I think that I want to ultimately sort of hand that back over to the patient that this is always something that you're doing out of a sense of self love. And I think that with obligers, sometimes they get into trouble where they're just so people pleasing and putting their energy to everyone else that they really burn out. And so oblig blighter is I'm always worried that they're gonna do my recommendations almost in service to me. But how do you actually unwind it? Like if someone right now is like, oh, I'm the obliger. And the worst thing is to then try to do something to please somebody else, especially I would assume that if you're dealing with something like depression, that you're trying to get out of being depressed, someone then let's say frowns upon you says something mean or just, you know, makes you feel bad about yourself because maybe you're not doing everything perfectly. And that seems like you would always make your depression worse. Yeah. Yeah. So take for example, a patient of mine who, she's an obliger and she was really bent over

backwards taking care of everybody in her life. There were a lot of unhealthy,

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