“What’s Wrong with Me” What Disney’s Moana Teaches Us All About Anxiety and Identity

OK. So I know I’m a bit late to the game but I recently watched Disney’s Moana and I’m completely in love. In a wonderful departure from “waiting for the prince to save me” movies of my childhood, Moana depicts a true heroine. The movie is a great adventure journey but the true conflict in the story is one of identify. Moana struggles throughout the film with this central question “Who Am I?” This is a question many of us ask ourselves and when we are distant from the answer, it can fill us with anxiety. In fact, lack of connection to ourselves and our identity is, in my opinion, the leading spiritual cause of anxiety. In watching Moana tackle her own identity we can learn how we can better connect to our own higher selves and help our children find theirs.

So in this movie Moana has two duelling destinies. As a child, she is chosen to voyage across the ocean to restore the heart of Tafiti but as the daughter of the village chief, she is expected to take over as chief of the village. She feels drawn to the water but also a lot of shame and frustration about this desire which she expresses in “How Far I’ll Go.” Moana does what many of us do when confronted with this type of conflict, it’s so uncomfortable to hold two opposite positions at the same time, that she blames herself crying “what is wrong with me?”

This tension between others expectations and listening to our own inner voices is all to familiar. Watching Moana try and navigate this phase of self discovery can bring to light how we mange this role in our own journey and how we support the children in our lives as they discover theirs. Are we meeting this challenge with an authoritarian perspective, creating rigid rules like Moana’s father? Are we consolatory like Moana’s mother who cautions "Sometimes who we wish we were, what we wish we could do—it’s just not meant to be" Or are we meeting this conflicts with wisdom, trusting in the questioners ability to find their own answer?

In the end Moana is able to listen to herself and follow her calling. She finds her identity as a voyager and claims both her identity and her purpose. This culminates in the song “I AM MOANA” where she is able to acknowledge the voice was not something calling from outside of her but coming from inside her. In doing so is she able to loose her anxiety over her identity. She becomes the confident heroine who voyages across the ocean and in doing so is then better able to lead her village. Her anxiety is resolved because she is living in congruence with her purpose. Even though she faces challenges, she faces them confidently with a sense of purpose and identity.

This is what we all want for ourselves and our children. To feel confident in why we are here so that challenges placed in our path can be met from a place of purpose. This is what comes from creating space to listen to our higher selves and honouring the gifts we have received. Moana reminds us that we all have a calling, and that being separated from it can cause us a great sense of anxiety which can be resolved simply by reconnecting. 

Do’s and Don’ts for Feeding Your Anxious Child

Nutrition can be challenging to understand. Nutrition and kids, even more so. There are so many things to consider - it can often be overwhelming. You want your child to grow and thrive, but you only have so much time and effort to put into nutrition. Often this can be made more complicated by picky eaters and kids who loves something one week and will not touch it the next. To make it worse, nutrition advice often gets divided into camps and everyone seems to believe their camp is best for everyone. Ever met someone following a vegan diet? Gluten-Free? Paleolithic? 

The truth is nutritional science is still young, and while we know some basic truths for sure (example - vegetables are in fact good for you) scientists are still uncovering the details in terms of which diet is BEST or BEST FOR AN INDIVIDUAL. So what I’ve done for you in this guide is waded through what we know about nutrition, and what we know about anxiety and put together my best recommendations. These are meant to help you navigate the world of nutrition and make better choices for your family. What they are not meant to do is create guilt, shame, or stress. So take what you can from these guidelines but please use them as just that, guidelines, not rigid rules.

Before I get into the recommendations themselves I want to explain WHY I’m making them. If you’re the type of person that wants to know the details the next few paragraphs are for you. If you are in a hurry, or would rather skip the nutritional science, feel free to skip ahead a few paragraphs. The nutritional recommendations below are there because they support one or more of the following principles: supporting a health microbiome; creating a balanced blood sugar response; ensuring appropriate nutrients for building the nervous system; and/or avoiding common nutrient deficiencies that cause anxiety. 

Background Science

Although we are still uncovering the details, it has become apparent that our microbiome (the bacteria living in our intestines) have a huge impact on many aspects of our health, including our mood. These bacteria can make neurotransmitters, and can communicate with the brain via the enteric nervous system (our nervous system in the gut). While we often think of our brain sending information to our bodies, when it comes to the digestive tract 80% of the nerves between it and the brain actually go from the digestive tract TO the brain(1). Probiotic supplements (good bacteria in a pill) have been shown to be beneficial for anxiety(2). It makes sense then to support a natural healthy microbiome with our diets. We can do this by increasing foods that contain healthy bacteria (probiotics), including foods that feed the probiotics (prebiotics), and reducing food for pathogenic or harmful bacteria / yeast (sugar).  

The next principle, creating a balanced blood sugar response, is something that is important for many people, but not always considered when discussing anxiety. This is unfortunate because individuals with anxiety are more likely to experience blood sugar imbalance (3). With an impaired response to the carbohydrates in their foods, people with anxiety may experience reactive hypoglycemia. This is because the body creates too much insulin in response to sugar and an individuals blood sugar goes too low, creating symptoms like shaking, increased heart rate, and nervousness. Many people experience this as anxiety. By balancing blood sugar, individuals can feel more calm. In fact, a study examining Glycemic Index (how quickly your blood sugar goes up) of breakfast foods and mood in healthy children found that a low glycemic index breakfast was associated with feeling more alert, more happy, and less nervous (4). Imagine the difference in children with anxiety who may be even more sensitive! I want to stress than in my practice I have seen anxiety completely resolve by changing diet; in these cases the body’s response to carbohydrates was the ROOT CAUSE OF THE ANXIETY.  

The last two principles I’m going to speak about together because they both come down to getting enough nutrients (not just calories, but nutrients) from your diet. This is important for both macronutrients like proteins and fats, and micronutrients like B vitamins and Magnesium. There are things you need to get from your food because they are essential. This means your body cannot make it on its own. If you do not consume enough of these building blocks, the thing your body is trying to make just doesn’t get made. You need amino acids from protein to build neurotransmitter. You need long chain omega-3 fatty acids to act as insulators to the wires your brain. The other important thing to consider is that if you are not getting enough of a nutrient your body you may have symptoms caused by that nutrient deficiency. A lack of vitamin B12 can cause numbness and tingling, both common symptoms in anxiety. A lack of magnesium is a known cause of anxiety, this is concerning because nutritional surveys consistently demonstrate that dietary magnesium is usually below the recommended daily allowance (5).

And so, with these principles in mind, here are the Do’s and Don’t for Feeding Your Anxious Child. 

Do Include A Variety of Protein Sources 

Protein provides essential amino acids, the building blocks of neurotransmitters, compounds your brain uses to communicate. In addition to it’s essential role including protein at meals and snacks decreases the calories from carbohydrates which improves the glycemic index of the meal, helping to balance blood sugars. It’s best to include a variety of protein sources including more plant proteins (like legumes) and less red meats. 

  •  Beans (black beans, kidney beans, chick peas)
  •  Tofu, Tempeh, Soy Milk
  •  Hummus
  •  Eggs
  •  Greek Yogurt (unsweetened)
  •  Fish and Seafood
  •  Chicken and other poultry
  •  Beef, Lamb and Pork
  •  Clean protein powders (whey, soy, hemp)

Do Include Sources of Healthy Fats

Our brain is made up of a lot of fat! It’s important to make sure we are building it with the best (and least inflammatory) fats as possible.

  •  Fatty Fish (Salmon/Trout, Mackerel, Anchovy, Sardines, Herring)
  •  Olives and Olive Oil
  •  Raw Nuts and Seeds
  •  Coconut, Coconut Oil
  •  Avocado
  •  Organic Full Fat Dairy Products

Don’t Include Processed Sugar

As most people know, processed sugar is devoid of nutrients. It also has a high glycemic index. While it’s obvious to exclude or limit things like candy and cookies there is a lot of sugar hidden in prepared foods like pasta sauces.  It is important to read labels and look for words like sugar, cane sugar, dehydrate cane juice, glucose, fructose, glucose-fructose, sucrose, dextrose, maltodextrin, corn syrup, high-fructose corn syrup, and corn syrup solids are some of the more common words that mean “added sugar.” The labels you want to check most are:

  •  Candy, Fruit Snacks, Chocolate
  •  Cookies, Cakes, Muffins, “Breakfast Cookies”
  •  Breakfast Cereals
  •  Granola Bars
  •  Yogurt / Yogurt Products (especially kids yogurts)
  •  Pop, Fruit Drinks
  •  Pasta Sauce, Canned Soups
  •  Crackers
  •  Condiments (Ketchup, Peanut butter) and Salad Dressings

Do Include Lots of Fibre

Fibre reduces the glycemic index of our food. It also serves as a prebiotic to support a healthy microbiome.

  •  Vegetables (Fresh or Frozen)
  •  Fruits (Fresh or Frozen) 
  •  Whole Grains (brown rice, steel cut oats, polenta, spelt berries)
  •  Seeds (Hemp, Chia, Sesame, Quinoa)

Do Include Fermented Foods

Fermented foods are a natural source of probiotics that help support a healthy microbiome. 

  •  Yogurt, Kefir
  •  Cultured Vegetables (Sauerkraut, Kimchee)
  •  Miso, Tempeh
  •  Salt pickles and brine-cured olives
  •  Kombucha
  •  Apple Cider Vinegar

Don’t Include Preservatives

Preservatives are meant to kill bacteria. From a food safety / longevity standpoint it seems like a great idea. But when you consider the microbiome suddenly preservatives are not a good choice. Even if they are safe for humans, these compounds are designed to kill bacteria! And so it is important to limit these foods to support a healthy microbiome. Some major offenders include:

  •  Processed Meat (Hot Dogs, Bacon, Lunch Meats, Smoked Fish)
  •  Cereal
  •  Potato Chips
  •  Soft Drinks
  •  Dried Fruit
  •  Commercial Breads and Bread products

Do Provide High Amounts of Magnesium

It's important to prevent magnesium deficiency. In addition most of these whole foods are good for the microbiome and your blood sugar balance. When possible, choose organic vegetables, as they are generally higher in magnesium due to conservation of soil minerals compared with conventional farming practices.

  •  Organic Leafy Greens (spinach and swiss chard)
  •  Nuts and Seeds (pumpkin seeds, almonds)
  •  Cheese and Yogurt
  •  Beans and Legumes (black beans)
  •  Some Fruits (Avocado, Fig, Banana)

Don’t Restrict or Vilify Food

While you as a parent are responsible for providing healthy choices, it is also important to model healthy food relationships. Unless your child is very ill after eating something, making something a “never” food is generally a bad idea. Cultivate an enjoyment of healthy food and a respect for all foods. Making something forbidden can create an unhealthy relationship with that food. Children with anxiety are at higher risk for eating disorders in their teens and twenties. Teach them to enjoy food and to eat mindfully.

Looking for some meal inspiration that meets these guidelines? Download my “Lunches for Anxious Tummies” for 18 School, Kid, and Naturopath Approved Recipes.  

References

  1. Browning and Travagli. Central Nervous System Control of Gastrointestinal Motility and Secretion and Modulation of Gastrointestinal Functions. Compr Physiol. 2014 Oct; 4(4): 1339-1368 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858318/
  2. Pirbaglou et al. Probiotic supplementation can positively impact anxiety and depression symptoms: a systematic review of randomized controlled trials. Nutrition Research.  https://www.researchgate.net/profile/Joel_Katz/publication/304402610_Probiotic_supplementation_can_positively_affect_anxiety_and_depressive_symptoms_a_systematic_review_of_randomized_controlled_trials/links/578f74a908ae81b44671c97d.pdf 
  3. Zhou et al. The Prevalence of impaired glucose regulation in anxiety disorder patients and the relationship with hypothalamic-pituitary-adrenal axis and hypothalamic-pituitary-thyroid axis activity. J Evid Based Med. 2016 Aug 29. [Abstract] https://www.ncbi.nlm.nih.gov/pubmed/27792263
  4. Micha, Rogers and Nelson. Glyceamic index and glyceamic load of breakfast predict cognitive function and mood in school children: a randomized controlled trial. Br J Nutr. 2011 Nov;106(10):1552-61. [Abstract] https://www.ncbi.nlm.nih.gov/pubmed/21736777
  5. Gaby. Nutritional Medicine. 2011. Concord NH. Magnesium. Ch 27. Pg 136. 

Don't forget to grab your copy of my "Lunches for Anxious Tummies" for easy meal ideas and recipes that put these principles into practice. 

What to Consider When Choosing an Anxiety Supplement

"Dr. Katie, does magnesium work for anxiety?" This questions, and variations of it, is one of the most common off the cuff questions I get asked, both in my practice and when I'm out in the community. In some ways the answer is straightforward, the evidence of efficacy (or if something works) for a particular ingredient (say magnesium) is easy enough for me to assess. However, the full answer is more complicated. Many factors contribute to whether or not a particular supplement is effective for anxiety. This is complicated by the fact that when someone asks "does something work for anxiety?" they are almost always asking "will this work for me?" 

These are related but different questions. "Will this work for me?" is a more complicated question involving not only the efficacy of the supplement but an individualized assessment of each person's experience, and a deeper understanding of how each supplement effects an individuals mind body and spirit. This process doesn't lend it's self well to lists, but I've done my best, and so here it is, the seven things I always consider when answering "does this work for anxiety" for my patients.   

Evidence.

This is the first thing I consider when someone asks "does something work." Evidence comes in a variety of forms, which are graded in Evidence Based Medicine. Evidence ranges from historical use of a product, to our understanding of how something would support normal body functions, to case reports, clinical trials and meta-analysis (where the results of several clinical trials are amalgamated.) Some remedies have been studied in clinical trials, when that has been done it is important to include that information in assessing whether a supplement will work for an individual. Regardless of whether or not a meta analysis is available, the highest level of evidence available is used to determine the supplements efficacy.

Form. 

The form of a supplement is something that can greatly impact efficacy, even between two of the "same" supplements. When it comes to herbal medicine there are a variety of ways to take different herbs. Some herbs may be available in a tea, some in a capsule, and others in an alcohol extract called a tincture. Different herbs are more effective when extracted in water vs alcohol or vice versa. Knowing what form is going to be effective is an important part of know which anxiety supplement is going to work. In nutrition supplementation, different forms of vitamins and minerals are more readily absorbed by the body. Some individuals may require or respond better to forms of vitamins that are in their most active form, especially if they are unable to activate them themselves. These factors are important, because the right dose of an effective ingredient is not helpful if it is not effectively absorbed. Form can greatly impact the efficacy of a supplement and is an important consideration when asking "does this supplement work?"

Dose.

Dosing is another important factor when considering the effectiveness of a supplement. If an ingredient is effective, but a supplement does not have sufficient amounts of the at ingredient, the supplement may not work. This is not a fault of the ingredient it's self but a reflection of the amount of the ingredient in the product. Also dosing may be different for the same supplement for different conditions and for different individuals. For example, the dosing of NAC is not the same in OCD as it is for influenza, even though NAC is effective for both conditions. 

Quality.

Quality of supplements is also a factor when determining if something is going to work. In herbal medicine, where and how the plant was grown, how it was harvested, stored and prepared can all impact the medicinal effects of the supplement. I am quite partial to herbs that have been wild harvested or grown organically. The struggle of the herbs to grow in their natural environment encourages the creation of the medicinal compounds in the plant. 

Experience

Anxiety doesn't look the same in everyone. Some people have difficulty breathing, Others experience more tension in their bodies, some may be unable to concentrate due to repetitive thoughts and worries. Some experience digestive discomfort. Each of these presentations can be labeled "anxiety", but different supplements are more indicated for certain presentations of anxiety. How severe someone's anxiety is informs the dosing and choice of a supplement. While some individuals may respond best to gentler treatment, others may need a more aggressive approach. Something that works well for someone may not be the best dose to work for someone else. Anxiety is something that encompasses a variety of different diagnosis. Some individuals experience anxiety all the time, such as in Generalized Anxiety Disorder, others may experience anxiety in only certain social situations. The supplement and dosing used in each of these situations is different, and should be different.

Safety

I almost didn't include this one because it is so obvious but it is the most important. If a supplement is going to be effective, it has to be safe for the patient to take. Safety in supplements is not something I take lightly. Just because you can pick something up off the shelf at a health food store does not mean it is without risk. We are lucky in Canada as all of our supplements are quite highly regulated and are unlikely to be contaminated however, just because a supplement is what it says on the bottle does not necessarily make it a good choice, or a good choice for you. A supplement may be safe for some people and not others. It's always a good idea to consult a health care provider when taking a new supplement especially if you have a disease or disorder, you are taking pharmaceutical or over the counter medication, or you are pregnant or breastfeeding. 

Intuition

Lastly, I think it's very important to take into account your own intuition about what is happening in your body and what you think will help you. In my practice I value what my patients think about their bodies and acknowledge that they have access to their own bodies wisdom. I also consider my own intuition, not above issues of safety and evidence of efficacy, but alongside the patients experience. In this way I strive to find the supplement that matches the patient not only in their body, but is an energetic or spiritual match as well.

Massage for Tension Headaches

One of the side effects of stress is that a lot of people carry it in their bodies. One of the common places is in the neck and shoulders. I sat down with Leslie Brown RMT to discuss how massage can help with managing one of the most common physical side effects I see of stress in my practice - tension headaches.

What are tension headaches?

Tension headaches are trigger points that refer pain into your head. Trigger points are a tight hyper irritable spot that most people call knots. Each muscle has a different location and referral pattern. For example some one might experience pain behind their eyes and someone else might have pain in the back of the head. A massage therapist will know what muscles to treat based on where your tension headache is. Active trigger points will constantly refer pain into your head, while latent trigger points only create pain when you press on the trigger point. 

This picture shows some common referral patterns of the neck muscles.  The X's are trigger point locations in the muscles and the red areas show where the referral pain (tension headaches) are felt.

This picture shows some common referral patterns of the neck muscles.  The X's are trigger point locations in the muscles and the red areas show where the referral pain (tension headaches) are felt.

Why do people get them?

Neck problems are so prevalent. So many people have poor posture and are so stressed! Also repetitive computer and cell phone use affects posture and causes neck pain and headaches. These headaches are very prevalent and exhausting. They take away from your focus and energy and impact sleep because when you have pain you don't have restorative sleep, which impacts your overall healing. 

How do you treat tension headaches?

I have a lot of experience with treating headaches and neck pain because of my work with people who have been in motor vehicle accidents.  Many people do not only come in when they have a headache, they come in for prevention and maintenance. Typical treatment would be 1/month to counteract lifestyle factors such as ongoing postural and stress tension. It is also beneficial as time for self care and to help with relaxation. If you are getting more than 3 headaches a year, treatment can help reduce frequency and intensity of your headaches.

Leslie Brown is a Registered Massage Therapist at Norfolk Chiropractic Wellness Centre. To book a massage with Leslie, or chat with Dr. Katie about multidisciplinary headache care call 519 827-0040.