Adapted from episode 81 of The Perfect Stool podcast hosted by Lindsey Parsons, EdD with guest Camila Smith, LCSW, DHSc, licensed psychotherapist, anxiety expert and Chief Clinical Officer at bekome, a mental wellness supplement company and sponsor of this episode of the podcast.
Anxiety and the Gut: Evidence-Based Interventions to Calm the Mind
Lindsey:
Why don’t you start by telling us about your own journey with mental health and how that relates to your education and dissertation topic?
Camila Smith, LCSW, DHSc:
Absolutely. So for me in 2012, I was in grad school. It was the first time that I experienced what I could then relate as anxiety, but a little bit beyond the normal anxiety that we might experience. From then on, I started having panic attacks. In 2012, my dad was having surgery. The surgery took six hours longer than expected. During that time, I got nervous and following that, I started to experience these panic attacks whenever I was in a hospital. It also didn’t help that I was interning at a hospital.
Lindsey:
So you were there all the time.
Camila Smith, LCSW, DHSc:
Yeah! Every time I went in, I would start sweating and shaking. It was a really abrupt encounter with anxiety and panic disorder. As it went on, I started finding ways to treat it, and started working as a therapist. I decided to go back to school to get my doctorate in health sciences. I have always been very passionate about anxiety disorders. It makes sense to me. I love the science. Given my own journey, and all of my research, you know, I thought it was a great way to blend my personal quest to find ways to soothe my body, along with the things that I love, which is the science part of it as well.
Lindsey:
Great. So what was your dissertation topic?
Camila Smith, LCSW, DHSc:
My dissertation topic was on the use of nutraceuticals for the treatment of anxiety as a standalone and/or an adjunctive treatment. This means that I looked at amino acids, vitamins and different herbs, then compared the research on them. I only looked at ingredients or vitamins that had been tested, that had had randomized control trials, and then I looked at the treatment efficacy. How good were they compared to traditional medication? After a side by side, I came up with a recommendation as to whether or not botanicals – nutraceuticals essentially, could be used as standalone or adjunctive.
Lindsey:
Okay, and so what’s the relationship between gut health and mental health?
Camila Smith, LCSW, DHSc:
Well, this is interesting. Let me backtrack a little to say that I was very surprised when I found out what that relationship was. After working in the field for about five years, I knew very little about the actual mind-body. We hear that term used a lot (the mind-body connection), but learning about it from the physiology part was extremely eye opening for me. Our brain is what we consider our primary hub and it’s our central nervous system as well that it attaches to. We also have a second brain – the ENS system. That connection-
Lindsey:
The enteric nervous system.
Camila Smith, LCSW, DHSc:
Yeah, exactly, yes. The enteric nervous system that has been referred to as our second brain also has the ability to process information, stimuli, response. So the gut-brain really impacts us, because we have this whole other nervous system that has the ability to feel, to sense, to respond and to react. This is especially so for anxiety, because anxiety is such an instinctual response. There is definitely a direct correlation.
Lindsey:
And they’ve done the experiments where they cut the vagus nerve, which is part of that enteric nervous system, and they change out the bacteria. The bacteria doesn’t have the influence it does on the brain when that vagus nerve is cut.
Camila Smith, LCSW, DHSc:
It’s amazing. I always refer to it as the highway, and the bacteria travels up the highway into our brain. This is where probiotics are so helpful. At the same time, though, every time that we have bacteria, that’s not good for us, it also travels. They actually did a study not too long ago and found a specific bacteria in the brain of individuals with dementia. This was one of the first times that we were able to prove, and also in the oral flora, they found bacteria that usually doesn’t exist there. Now we’re starting to be able to prove that this bacteria not only travels, but also colonizes in our brain tissue, which is why it’s so important to have this healthy balance of bacteria in our body.
Lindsey:
Yeah. So how did you become involved with bekome and what’s the company’s mission?
Camila Smith, LCSW, DHSc:
I became involved with bekome end of last year, but the way that it occurred is actually, I think, a beautiful synchronicity in everything coming together. I was on a board for a nonprofit organization with one of the co-founders, Vanessa, many years ago. From then until now, I went to school, got my dissertation. Last year, I put on a vision board that I wanted to get started on or launch a nutraceutical company. I got a call from Vanessa at the end of last year, stating that she was looking to start a nutraceutical company and thought that I would be a good addition. We reunited and it just was perfect timing. At that time, I had already done all the research and was ready to go with pretty much a formulation or at least a recommendation.
Our mission at bekome is really is to make mental health care more accessible for everyone, and to really target a full and integrative approach. We’re looking at targeting nutrition, mental health, and also just lowering inflammation. Aside from the nutrition and the supplementation part, our mission is to educate and personalize treatment. We offer consultations and one on ones. I recently ran a webinar. Our goal really is to provide a community where people can feel informed about the choices that they’re making.
So some of the things that I think are really important for us as a company and our personal mission is to also dispel some of the stigma around mental health. I think for so long, our field has separated mental health from physical health, that it’s created this stigma. We are trying to find realignment between them. In my professional experiences working at a clinic, I found that we would get referrals from primary care. There was almost this big split, where there wasn’t as much collaboration, and this is when I really started to feel that I needed to be more informed. Our field of mental health has many specialists. But if we think about primary care or just physical health, we have cardiology or gastroenterology. We have tons of different specialists, but in mental health, there are people that specialize in training. There isn’t really too much crossover between the physical aspects and the science, of anxiety and the mental health. This is where we came in. What we’re trying to do is not only make mental health care more accessible for people, but also really destigmatize it and start viewing it as it could be preventative care. It can be maintenance. It can be a lot of different things and we want to make it a part of our day to day. If we have it along with nutrition, I think that this really magnifies the outcomes that we can potentially get.
Lindsey:
That’s great. So tell me about the ingredients in bekome’s Peace of Mind Daily Packs and how you selected each ingredient.
Camila Smith, LCSW, DHSc:
Yes, so when looking to select them, I brought in some of my clinical knowledge and experience as well as personal. And in the treatment of anxiety disorders, we primarily use SSRIs, sometimes beta blockers and some people use benzodiazepines. These are more fast acting, so we almost have daily medications that help to keep the symptoms at bay and we have the as needed. When I was thinking about the ingredients, I thought it was really important to provide this sort of flexibility with our ingredients, meaning we wanted ingredients that were helpful over time, but also something that provided an immediate effect. That was one of the main parts that we considered when looking at ingredients. The ingredients that we have included are vitamins, amino acids and botanicals. The vitamins that we chose were magnesium and B6. These were specifically chosen because they are necessary for the production or the synthesis of serotonin, which is our mood, food, pain and sleep neurotransmitter. In addition to B6 and magnesium, we also chose l-theanine. L-theanine is an amino acid that’s naturally found in the highest content in green tea. L-theanine has been shown to provide relaxation and increase focus. Studies have actually found that when individuals take l-theanine there is a change in brainwaves. It activates alpha, which is a relaxed state, so we looked for somethingthat when taken in the morning would provide us with energy, calm and focus. And as we transitioned, we also added in passion flower. Passion flower is a calming botanical and it helps to relax the body. There’s flexibility with the pack. We do recommend for some people, for example, that they take the passion flower, and perhaps magnesium at night, to ease into the night in a more relaxed way. The last ingredient is our probiotic. This was because we really wanted to target the gut-brain connection, and probiotics are known to really help balance out that bacteria and decrease inflammation. We chose ingredients that help to synthesize serotonin, induce relaxation, and just promote overall mind body or brain and gut health.
Lindsey:
Great. So tell me, why did you choose not to include 5-HTP or tryptophan in the formulation?
Camila Smith, LCSW, DHSc:
When we were thinking about creating a supplement, one of the really important parts to us was to make this accessible. What I mean by that is that a majority of people would be able to take it and that it had minimal side effects or risks. We were also very intentional about selecting ingredients that could be used alongside medications, traditional SSRIs or medications for anxiety. There’s great research on 5-HTP. It’s wonderful; however, there are contraindications with SSRIs. Because a lot of individuals with anxiety disorders do take SSRIs, we wanted to keep it as open as possible and really reduce the risk of any side effects. It was primarily because of the contraindications that 5-HTP has.
Lindsey:
Just to spell it out to listeners, SSRIs or selective serotonin reuptake inhibitors, they basically increase the serotonin in the brain and 5-HTP is a precursor to serotonin, as is tryptophan. Either one of those would also increase serotonin and you can have something called serotonin syndrome where you have like a racing heart and such and it can be dangerous, so that’s why it would double operate.
Camila Smith, LCSW, DHSc:
Exactly, absolutely. This is where we added for example, the magnesium and the B6 are necessary for that breakdown from tryptophan to 5-HTP to serotonin. So we did think about adding ingredients, vitamins that would aid and make the process of creating serotonin more flow. We tried to be very mindful of serotonin syndrome.
Lindsey:
Yeah, I have a lot of clients who show up, I mean, pretty much everybody – I wonder if it’s an artifact of the test – on an organic acids test, they show up with low B6, and it often comes alongside these mental health issues like anxiety and depression.
Camila Smith, LCSW, DHSc:
Yeah, B12 has been found to mimic depression and sometimes manic episodes; they’re pretty similar. If you put them side by side, B12 deficiency looks exactly like major depressive disorder. The only real difference that we find is that a B12 deficiency does not tend to cause harmful thoughts, but there are some mirroring side effects or symptoms between them.
Lindsey:
Hmm, interesting. So I know that you offer consults, in addition to the supplements, to potential customers. Are those free and tell me what’s involved in those consults?
Camila Smith, LCSW, DHSc:
Yes, there’s two consults. One is a 15-minute consultation, and other one is a 30-minute consultation. The 15-minute consultation is available to anyone that wants to. Maybe they’re on the fence about the supplements. Perhaps they have questions. That 15 minutes gives us an opportunity to connect one on one. Again, one of our primary goals is to provide personalized care and also to educate. The 15-minute can be booked at any time with no purchase necessary whatsoever. The 30 minute consultation is included with the 28-day or the subscription. Ideally, we would have the 15-minute either at the start of or prior to starting. And then the 30-minute really allows us to do a little bit more of a deep dive. During this consultation, we check in in regards to progress, any barriers that somebody might be having and also offer guidance for individuals. Some individuals might have questions regarding their nutrition or sleep, which I have also worked around. It provides an open format where we can really get down to breaking down the barriers and what we can do as collaboratively to help people feel better.
Lindsey:
And so those are free as part of the service?
Camila Smith, LCSW, DHSc:
Yes, they come included.
Lindsey:
Okay.
Camila Smith, LCSW, DHSc:
The 15-minute is free, and so is the 30-minute but that is with the 28 – a month’s supply, there is that additional 30-minute one that’s included.
Lindsey:
Right. Okay. So tell me about how you selected the strains for the probiotic that’s included in your daily packs.
Camila Smith, LCSW, DHSc:
Again there’s so many probiotics, there’s tons of different bacteria and they all have their own benefits. One of the things that I did similar to the other ingredients was research specifically. It’d be information, the data on the benefits of it with mental health. We particularly focused on anxiety disorders, and really looked at the best ones. I created a list of the top ones that we wanted to include, and ended up selecting a blend that has a multitude of different strains.
Lindsey:
And so what future plans does the company have with regard to the products?
Camila Smith, LCSW, DHSc:
We have a lot of exciting things in store right now. We’re in the early phases of starting to think about adding different packs. For example, when we’re looking at anxiety and sleep: these can be add-ons for somebody that is having trouble with sleep. We would, in addition to the primary pack, there would be additional ingredients to help with sleep. So we’re looking at sleep, mood, focus and a pregnancy pack. That’s one area we’re looking to continue to expand. We’re also considering adding, what we will have to think about as the SOS pack, right. Those are the fast acting things that we can take in the moment if we are feeling really stressed. Hopefully, in the future, we’d like to personalize even more. There’s a lot of different ideas that we have. One is creating an app for every customer to go in and share their symptoms. That gives us a better picture and we would personalize a blend of different ingredients specifically for that person. We’re hoping to in the future even get more and more personalized, even considering adding in different testing so that we can see where people’s levels are, whether it’s organic acid or enzymes. Really just looking at all the different facets that impact mental health.
Lindsey:
So digging a little more into the details, what type of magnesium is in them, and how many milligrams?
Camila Smith, LCSW, DHSc:
We have magnesium glycinate and it’s at 225 right now. The research shows that it really can go anywhere, and even up to 400 milligrams. We wanted to start at a dose that is well tolerated for the majority of people. We chose magnesium glycinate, particularly because of the bio absorption of it. We wanted to be mindful of selecting a kind of magnesium that didn’t leave the body as quickly.
Lindsey:
Right. Because of course the magnesium oxide and the magnesium citrate both will promote bowel movements. And you don’t want to overdo that for people for whom that’s not an issue. What about the B6?
Camila Smith, LCSW, DHSc:
There’s research that shows that a 10:1 ratio, Ten magnesium to one B6, has had really great results. They synergize really well together and when taken at that ratio, it’s known to improve the efficacy of it. So when selecting the dosage, we tried to keep it at that 10:1 to really optimize both ingredients.
Lindsey:
And in your studies, did you look at all at nutritional interventions for mental health issues?
Camila Smith, LCSW, DHSc:
Yeah, when I was, with my dissertation, there were several kind of dietary interventions, nutritional, that we looked at and that I formulated. We have it actually on our website if anybody’s interested on the blog. There is a whole document that’s included on the blog that has all of the recommendations for different foods that are high in magnesium or high in tryptophan. We talked about tryptophan earlier. There’s certain foods that we can eat that are natural mood boosters. We offer that again on the website and it is something that through our consultations, we also check in and see how everyone’s doing in terms of their diet and offer recommendations as needed. We definitely did include that in our approach.
Lindsey:
I know that depression in particular is thought of to be in large part a result of inflammation and obviously, a very pro-inflammatory diet with lots of sugar, processed food, omega 6 fatty acids and white carbs is probably pretty detrimental to mental health.
Camila Smith, LCSW, DHSc:
Absolutely. There’s actually 12 different subsets of anxiety. We tend to group it together, but we have generalized anxiety, panic, and social. Another form of anxiety is what we call anxiety secondary to medical conditions. What this means is that somebody might have, let’s say, a cardiac condition, and these changes that the body experiences will then offset a stress response because the body is experiencing these fluctuations. When we’re thinking about the importance of balancing out the body through nutrition and supplementation, it’s really important because anxiety can be triggered by mental stressors and physical stressors; both. Our stress response can also be activated by, for example, changes in our histamine levels, right? If we’re having a reaction to our environment, it can be anxiety. It can be offset by changes in temperature. Pretty much anything that throws our body off, can trigger anxiety.
Lindsey:
Yeah I know. Years ago, I started to have some panic attacks and it always started where I got a little bit short of breath. All of a sudden, I was questioning whether or not I was having a heart attack. And it just started snowballing! One time I actually went to the hospital and got them to test my heart, and then I realized it was panic attacks. I was having health issues and had just moved to a new place. I didn’t have a doctor and I’m a little bit of a hypochondriac, so I thought I had cancer as I have on numerous occasions in my life. Once I got all that sorted out and went through the cycle of the different anti-anxiety medications one could take, ultimately, once I resolved the health issue it was not an issue, but I know what it feels like to be in that panic attack cycle.
Camila Smith, LCSW, DHSc:
Yeah, definitely our body reacts right when there’s any changes or when anything catches us by surprise – even something like a stomachache, or a headache. If we have something for a sustained period of time, our body reacts to that and humans have this incredible ability for metacognition. This means that we have the ability to think about our thoughts. That sounds tricky, but let’s say that I have a stomach ache. I have the ability to think about having a stomachache. I can then come up with a narrative. This is where fear and random anxiety kicks in. There is a huge connection with our body or physical state and anxiety. Anxiety is, after all, an evolutionary response. It’s what’s kept us alive as a species and we will all experience anxiety at some point. Anxiety is natural, and almost like building a relationship with our anxiety, understanding its purpose, and finding ways to soothe and calm our body and establish safety is really important.
Lindsey:
Yeah. So have you yourself taken this this daily pack?
Camila Smith, LCSW, DHSc:
Yes, I do. Actually, I’m currently taking it. So I had recent pretty significant life stressors, life changes, car accident, and it really changed my life. It changed a lot of my day to day in a few months. Around May, I started taking an SSRI, and initially it was helpful, but I started having really, really difficult side effects. I started having nightmares, and the nightmares were scary to the point where I was dreading going to sleep or I would wake up, fall asleep and go back into these nightmares. I would also experience the withdrawal symptoms rather fast off it, so if I was late with a dose or even missed a day, I wouldstart to get really dizzy and nauseous. The side effects were a bit much, so I started to working with my provider to titrate down and add it in the pack. I have to say that it really made a difference. I don’t have the side effects and I feel good. There were about three weeks where I was coming down, I was titrating down before I started the pack, there was a period in time where I wasn’t taking the supplements. Two weeks into taking them, I felt different. There were also notable changes from an outside perspective. I had someone in my life say, “You seem to be doing really well! You’re in good spirits and you’re focused!” It was really awesome. Sometimes it’s hard to gauge our own progress. It might take a little bit of time to see, but yeah, definitely I take it every day and it has really been a blessing for me.
Lindsey:
Yeah, and I know you’ve got a Facebook community group. Have you got a good conversation going in there with people who’ve been trying it?
Camila Smith, LCSW, DHSc:
We just started with the Facebook group about two-three weeks ago. This was right after I ran a webinar, which is actually available on YouTube. It’s a 30 minute webinar on the overlap between nutrition and mental health. Following the webinar, we created the Facebook community to start having a central place. We also put out content on Instagram, and Tik Tok is, as of right now, some of our primary sources, but we are looking to build our community. We’re in the earlier stages, but it’s also a very exciting time because we’re building.
Lindsey:
Awesome, and where can people find your website and try out the peace of mind daily packs?
Camila Smith, LCSW, DHSc:
Yeah, so one way would be to go on either any of the sources on Instagram or handle is “join bekome” and bekome is with a “k.” It’s the same handle for Facebook if you go on Facebook and type in joinbekome. Our website is also joinbekome.co. Currently we are offering, which is really exciting, so we have the 7-day pack. Initially we only had the 28-day, but we’ve started offering a 7-day trial. We have a 14-day, we have a 28-day and we have a subscription. It’s been really great to see how many people are willing to try it and are returning after the 7-day pack. Again, with the 7-day pack, there is a complimentary 15 minute consultation. Whether somebody decides to take the consultation before they start, or maybe halfway through it, there is wiggle room there. Every customer can choose when they sign up for it.
Lindsey:
I understand that there is a discount for my listeners for 20% off.
Camila Smith, LCSW, DHSc:
Yeah, actually, we’re going to go ahead and update to 30%.
Lindsey:
Wow.
Camila Smith, LCSW, DHSc:
For the 30% off, we will call it Lindsey30.
Lindsey:
Okay, beautiful. So that’s just for my people.
Camila Smith, LCSW, DHSc:
Yes, just for your people.
Lindsey:
How long will that last?
Camila Smith, LCSW, DHSc:
You know, we don’t necessarily have an end. Seeing that people will listen to podcasts at different times. we want to be able to offer it.
Lindsey:
Awesome. Well, I appreciate you doing that for them.
Camila Smith, LCSW, DHSc:
You’re very welcome. We’re very excited to have different people try it. When we put the product out there, we’re also passionate about the bigger picture of this, that it wasn’t our intention was not by any means to just put out a pack. We really want to build connections, to educate and support. However we can get people to feel comfortable, we’re definitely here to do that.
Lindsey:
That’s awesome. I appreciate that mission.
Camila Smith, LCSW, DHSc:
Yeah.
Lindsey:
Any final thoughts before we go?
Camila Smith, LCSW, DHSc:
No, just again, reiterating what an exciting time this is in science, in mental health. At the same time, it can be really overwhelming because we have so many resources available. Sometimes it is hard to know where to go when presented with an overabundance of options and resources. I think this is where having trusted sources [is important]. This might be working with a clinician, taking supplements or working with a doctor. Finding that support can be really, really helpful. I encourage anyone that is on a journey to mental health, to utilize and access whatever resources are available. The more resources we have alongside education means we will be more competent and comfortable in our ability to manage whatever it is that we’re experiencing.
Lindsey:
Well, I did appreciate the fact that you had this topic of your dissertation and that you looked at the scientific evidence and the weight of it for each of these ingredients. I like everything that I recommend to be evidence-based, which is why I was happy to have you sponsor the podcast and come talk about this. I’m glad to share this with my listeners.
Camila Smith, LCSW, DHSc:
Thank you so much. That was so key for me. I think even as a consumer, there’s been many times where I might go on Amazon and there’s so many different supplements. It’s hard to do all of that, that work ourselves right to go in and understand – and even if we do all the research, we may not fully get it. There’s a little bit of a deeper layer when it comes to the dosages or how ingredients work synergistically together. Which ingredients work with which ones? Which ones do not? Contraindications. There’s a lot of little or big nuances that also go into formulation. We wanted to take that pressure away and offer something that is evidence-based that works, our results also show. We ran a trial prior to launching and we found that within the first week, there was a 91% improvement, which was really amazing to see. Overall there was a 41% reduction in symptoms. This was measured by a scale. We used current scales and we did a baseline prior to starting the supplements. We did weekly and at the end. We compared the data using the scores and looked across the board to see how individuals were progressing. We measured a variety of different symptoms, including the physical, maybe palpitations, muscle tightness, but we also looked at mood, feelings of hopefulness, sleep and gastrointestinal. We really tried to look at all of the different buckets of anxiety so that we could see firsthand how it was impacting individuals. And you know, we were really happy to see that it was very positive.
If you’re struggling with your mental health, gut health or all over body problems, you’re welcome to set up a free, 30-minute breakthrough session with me (Lindsey). We’ll talk about what you’ve been going through and I’ll tell you about my 5- appointment health coaching program in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.
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