Shefali says, "I'm wondering your thoughts about L-Theanine and GABA for
acute anxiety panic. The patient is followed by psych already but I'm wanting a deeper
dive into the nutrition approach. Patient is an adolescent, fairly poor eater on an SSRI already.
I don't know that much about L-Theanine, I haven't studied it.
My understanding is it does a number of things in the brain, and in part it helps promote GABA
activity. Yeah, I think anything that increases GABA activity is probably going to slow down
anxiety and panic. I think that's clear just from the drugs that are used to treat an anxiety,
or panic disorder. Xanax is used for that purpose. If you go into the Chris Masterjohn lite section
I have a bunch of videos about GABA that include getting GABA from food, that include the nutrients
that you need to make GABA, that include some of the nutrients needed for proper GABA activity.
So I do think that working on nutritional support around GABA makes sense,
but I also would look at histamine, because
histamine is an alertness signal, but I think in very excessive amounts histamine is a panic
signal. There was an allergy clinic that was treating people with a histamine-free diet
for eczema. And it didn't really work for the eczema, but they noted that, I think three of the
patients had panic attacks, and the panic attacks totally disappeared on the histamine-free diet.
I'm not suggesting a histamine- free diet is the thing to use to treat panic attacks,
but I think it supports the idea that histamine plays a role in panic attack. And I believe
histamine also plays a role in generalized anxiety, and that's supported by the use of
certain classes of antihistamines in generalized anxiety disorder, and there are studies on that.
And then I think another thing that's underappreciated is the role of mental flexibility
in anxiety and depression. And so one of the things that I've covered, and I covered this in
the greatest detail in a long form podcast called Methylate Your Way to Mental Health With Dopamine,
and you can just Google that if you want the website version,
and then search within mastering nutrition under my products if you're in the Masterpass, because
you have the transcript ready there. And the basic thrust of that framework is that dopamine
is one of the controllers of the relative balance between mental rigidity and mental flexibility.
And generally speaking, methylation of dopamine produces a more medically flexible phenotype
and less methylation of dopamine produces a more rigid mental phenotype. You want a balance
between these Because if you have too much flexibility then you can't focus on anything,
you are easily distracted, you are impulsive, and you can't focus. Whereas on the flip side,
if you have too much mental rigidity, you are endlessly ruminating and you cannot
unstick your mind from things that are causing harm to your mind.
I had a real interesting consultant client once who was an entrepreneur and he was trying
to manipulate his focus using nootropics, fasting, supplements, methylation supplements,
et cetera. And he was trying to extend the amount of hyper-focus that he had so that he
could work better at his business. And what was interesting was, by the time that he talked to me
he had already figured out for himself a protocol that involved fasting and a handful of supplements
that were basically all serving to put him in a low methylation state.
And this was dramatically extending his period of focus. The problem was that,
as part of the collateral damage, he would, a few days a month, get a panic attack.
And so, why did that happen? Well, because ruminating isn't necessarily bad
if you have enough flexibility, or just your predisposition is to constantly put you in a
place where the thing you're ruminating on is the thing that makes you money.
But if your general predispositions, because of how you think about the world,
what your emotional patterns are, what the context is. If you're surrounded by
people that cause you emotional stress or cause you to take on a negative outlook...
or if you you're suffering from financial stress or something that's increasing your anxiety level,
whatever it is. If the mix of inputs, other inputs besides mental flexibility and rigidity,
if the mix of inputs into that is biased towards things that are anxiety-provoking,
then you will ruminate on the anxiety-producing thought and the
anxiety-producing thought pattern or emotional pattern will have dramatically more power.
And there was experimental evidence consistent with this. For example, in people who have
low COMT activity, which is COMT catechol-O-methyltransferase
is the enzyme that methylates dopamine. And people who for genetic reasons have low COMT activity,
when you show them a picture with a negative emotional tone, they are far
more likely to develop an emotional response to it than someone with high COMT activity.
And within that low methylation phenotype, there are some people who have a greater prefrontal
cortex reaction to that. And they with the low methylation phenotype are the ones who don't
develop the emotional reaction as judged by their subjective reactions, as well as the amygdala
lighting up. And so what that shows is basically that the people with high methylation of dopamine,
they don't get bothered by the picture because they're like, "I don't like that picture.
I forgot it already." People with low methylation of dopamine, they see the picture and can't
stop thinking about the picture. But within that group, the people who have high executive function
are going to be like, "I can't get this out of my head, but I'm going to do something
about it. I'm going to ignore it. With their executive function, they intervene and override
the fact that this picture stuck in their mind and is trying to light up their emotional centers.
I painted that picture a little aggressive, but it could have been somebody who's very practiced from
a meditation perspective or whatever, to be able to intervene in that cycle and put it to a stop.
And so I think you have to consider methylation from the perspective of creating, low methylation
creates more rumination, less mental flexibility, which then means that if you have anxiety
producing inputs, those anxiety-producing inputs have more power. So low methylation doesn't cause
it just gives the things that cause anxiety more power. Whereas histamine is very much...
There's low levels of histamine. This is the you're knocked out zone. That's why
Benadryl makes you sleepy. These levels of histamine. This is your alert zone.
Everything's great. At these levels of histamine, this is your generalized anxiety disorder
level. And then at these levels of histamine, this is your I'm having a panic attack level. Right?
So histamine, I think is just above a certain threshold is just a pro anxiety molecule. And then
GABA, I feel like GABA is interesting because I honestly think that probably what is happening
when you take the Xanax is it's just shutting down the neural activity that's produced resulting from
that anxiety level, whether it's histamine or whatever else. However, it is also true that
GABA does play a role in helping dopamine find new things to motivate
the brain to focus on. And so I think that's a double edged sword in the sense that...
I don't know if double edged sword is the right word, but generally when you have
deficient GABA activity, I think you're going to be more distracted and less focused
because dopamine is trying to put your attention on one thing
and it relies on GABA to shut off your attention to everything else.
But it's also the case that you need a dopamine spike to a new thing, to take your mind off one
thing and put it on the other thing. And so I think GABA function might help in that particular
scenario where you're actively trying to move your focus from one thing to another and inside
basal ganglia, having access to GABA activity there may help dopamine move your attention across
those things. So to sum that up, look at Chris Masterjohn GABA videos and transcripts, there's
many of them. And then same thing, Chris Masterjohn videos and transcripts on histamine.
There's like seven of them. And then methylation and mental health on dopamine
uncovering the methylation aspects where GABA is calming. GABA might help move focus from one thing
to another. And methylating dopamine is needed to provide mental flexibility so that you don't get
stuck on anxiety producing thought patterns and emotional patterns. And histamine just
is a general stimulant of anxiety beyond a certain threshold. So I think those would be
the key areas to focus on if that helps. Thank you, Shefali, for your question.