Talking To Teens: Expert Tips for Parenting Teenagers

Andy: This is a pretty revolutionary book. As far as I was concerned, I hear a lot of people talking about stress, but never in this way before. You broke down how stress affects people differently and walking through how there's these different patterns that you recognize of how people respond to stress in terms of different levels of different hormones in our body. And it's really, really interesting to me, really have me having a lot of insights about people I know and about myself. How did you discover this? What got you interested in stress? And how did you start to learn about these different types or different categories?

Dr. Doni: I've been interested in stress from a young age. I think somehow I came through my childhood. We all get some exposure to stress, of course, as humans and including in our childhood. And I went on to study naturopathic medicine, because I was very interested in how to prevent health issues, how to prevent health issues using diet and lifestyle. And that's why I chose to, well, get a bachelor's degree in nutrition and then a naturopathic degree.

Dr. Doni: And I, in that process, continued to find myself interested in stress. In fact, I also trained as a midwife. And when I was training as a doula and a midwife, I studied how stress affects women in labor. And that was one of the first studies I did was to say, hey, especially if a woman has a history of stress in her life, is that going to affect her experience of or fear of childbirth? And it was very interesting because what I learned from women in childbirth is that we need a certain amount of stress as humans actually in order for our bodies to work right, in order for the baby to come out, we need a certain amount of cortisol and adrenaline. And so that said to me, wait a minute, it's not because I think so many of us figure, which there's too much cortisol and we need to have zero cortisol.

Andy: How do we just chill out and get rid of all of that? De-stress completely.

Dr. Doni: We're thinking we need to go to zero. We're thinking, even the term of, can I be stress free? How do I get my cortisol down? These are the terminology that we hear. But in actuality, when we study humans, we see that it's not that we need to be stress free. It's that we need an optimal amount of stress and an optimal amount of stress hormones in order to function optimally. It's sort of like a whole different thing. And so when I finished my degree and my residency, I ended up moving to Manhattan right after 9/11, which was a very stressful time. So here I was again, in a very stressful environment, helping patients with stress. And I decided, let me understand this better. How do I help my patients? And how do I help myself? Because I was also suffering from severe migraines. I was having these migraines where I wouldn't be able to see patients all day if I got a migraine.

Dr. Doni: So it was like, this isn't going to work. And I had my daughter then and I needed to be able to feel good. So I just have this inquisitive mind where I'm like, okay, let me see if I can figure this out. And so I just started testing. Now, right around that time, testing became available to measure adrenaline levels in urine. So it became much easier to measure adrenaline. Before that, a lot of it, we're assuming. We're kind of assuming. We assume, oh, if I'm stressed, I must have high adrenaline or I must have high cortisol. And so I started measuring. I measured my cortisol levels and not just at one time a day. You see, cortisol is a hormone that should be higher in the morning when we wake up. It should wake us up actually, and then it should gradually decrease so it's lowest before we go to bed at night.

Dr. Doni: And so if we really want to know what's going on with our cortisol levels, which is our main stress hormone, we need to measure it at four different times a day, at least the morning when you wake up and the middle of the day and the evening and the bedtime so we can actually see what is this cortisol up to? And so when I started measuring my cortisol levels and my patient's cortisol levels, I started seeing that it's not all the same. We don't all have high cortisol. We don't all have low cortisol. There's a there's variation in what's happening for different humans at different ages. At first I thought, well, is this something that happens with age? Everybody who's 40 or something ends up with low cortisol. No, it's not an age thing.

Dr. Doni: It could be just as likely who's someone who's eight years old or 18 years old or 80 years old. They could all have the same cortisol level or it could be completely different. And so it's not an age factor. It's not based on sex. It's not based on race. It's not based on location. Or I know based on research, it's partly determined by our genetics, but not 100% genetics. Genetics plays less than 20% of the role. But there's some amount of our genetics built in about how does our body respond under stress and how much cortisol adrenaline are we going to make? And how do we metabolize it? Some people metabolize it faster than others. Two people make the same amount of adrenaline, let's say. One person, it drops faster. Another person, it hangs around longer because of the way the body metabolizes it.

Dr. Doni: But it's also determined by our history of stress exposure, history of stress in your childhood, even history of stress in your parents' life influences how you experience stress today. Even your grandparents, so research shows even from our grandparents' experience of stress affects what our body does with stress today. And so you start to realize, wow, there's a lot of variables involved here in how my human body responds to stress exposure, and it's going to be unique to me. And so I would measure and measure and analyze and find this is the stress types as I found the five most common patterns of cortisol and adrenaline based on stress exposure.

Dr. Doni: To me, it's all about, I want my patients to feel better. I had to solve my migraine. So I was very motivated to find the solution, not just, hey, what's happening here? But now what do we do about it? And I didn't learn this in naturopathic medical school or in any of the endocrinology textbooks. They don't talk about it this way. There's some understanding. I mean, there's definitely been researchers studying cortisol and stress for over 100 years. So there's a lot of research. But it's not very clinically based and it's not using this testing.

Dr. Doni: And so what I found was I needed it to be much more specific. I needed to know if a person has high cortisol, what's the best treatment, not just in terms of an herb or a nutrient. There's no medication to treat it. So that's not even an option. But if we have high cortisol, what should we change about our lifestyle, our diet, or should we do more exercise or less exercise? Should we do more yoga or less yoga? What should we do if we have high cortisol?

Dr. Doni: We have some concepts out there that get called stress management. We all should do our stress management, which some of those things there's good research behind. We can talk about that more. But I still feel like I want my stress management techniques to be specific to my cortisol and adrenaline levels because it's different. If a person has high cortisol or high adrenaline or both, their treatment strategy should be different than someone who has low cortisol, low adrenaline. And we need to be able to individualize that to truly be able to recover from stress and be resilient to stress.

Andy: Okay. So now is cortisol and adrenaline, is that kind of basically the same thing, those two?

Dr. Doni: They're both made by the adrenal glands, which the adrenal glands are above the kidneys. So they're in your back really. So the brain, I say it's like our brain has a constant radar system for stress. It's picking up on it. It's constantly like, is there a change in temperature? Is there a change in light or darkness? Is there a change in sound? Our brain is constantly, almost feels like... Yeah, exactly, exactly. It's like, where's the stress? And then as soon as it sees stress, it does two things. First, it signals what's called the sympathetic nervous system, which is what we call fight or flight. When you're sweating and your heart's racing and you're ready to just run, that's adrenaline from the sympathetic nervous system.

Dr. Doni: And that's a good thing if you're being chased by a lion. Or if something scary does happen, you need to be able to have your blood pumping and your brain able to get you out of danger. And so we have this built-in fight or flight system, and it's just that what tends to happen in our lives is it's not just on this rare occasion that we have this stress. We are getting exposed to stress day in and day out. And so we're constantly getting this fight or flight system triggered. That's the first piece of it. And that's a quick response. Sometimes you go into a fight or flight and you don't even realize that you're like, what's going on? Why is my heart racing and I'm sweating all of a sudden? Oh, my fight or flight system got triggered. Even can happen with a blood draw for some people or a finger poke. And you're like, what's going on? Oh, that's adrenaline.

Dr. Doni: Or sometimes if the alarm goes off, even just your alarm when you're waking up in the morning, let alone a fire alarm. You're like, "Oh my gosh. Adrenaline went off." But then that goes through, in a couple minutes, it's over. But then the brain signals to the adrenal glands to make more adrenaline and cortisol. And cortisol is signaling to the whole rest of the body.

Dr. Doni: So cortisol is basically sending out a mass message, I know I think of it like a text message through your whole body, saying, there's a stress going on. Everybody go into stress mode. We don't need to digest food right now. We don't need to be thinking about other hormone balance. We need to raise our blood sugar levels because blood sugar helps you deal with stress. But we're basically going to turn off everything else. So we even decrease our immune function. We decrease our neurotransmitters start shifting. Everything shifts into stress mode. And then what should happen is the stress goes away. And we go out of stress mode. We go, "Oh, that stress is done." And our body has a self-correction mechanism where now we go out of stress mode again. But again, what happens when we're like, we've got all these deadlines, this is due today or yesterday already. And this person's mad at me about this and I've got 10 more things I got to get done today. And the stress piles up.

Dr. Doni: So now the stress system is never getting a chance to reset. The adrenals are just being constantly asked to respond. And it's when we're constantly asking our adrenal glands to respond, that's when they start to get off track. They never get a full reset. It's like a computer or phone when it gets just jammed. It's like, I know this morning, I know I got to restart my computer because it hits the certain point. It's like the memory needs to clear out and it needs to reset. Our human bodies need a chance to reset too, but we are not taught that. We're mostly taught to go, go, go after the... Get this done. Be this perfect human, getting everything accomplished. But we aren't so much taught how to reset, how to allow ourselves to reset and-

Andy: And how to do it depends on how our body specifically handles stress and copes with cortisol and adrenaline.

Dr. Doni: Exactly. And I'm hoping we continue to see more research that's specific to the stress types because now even when they research something like let's say meditation, the research will show, yes, meditation is beneficial, helps to reduce cortisol that's too high. But then I'm thinking, well, what about a person who has too low cortisol? What should they do about meditation? And so when I go through the research, that's what I'm looking for is any research that helps us to clarify. And so in the book, in The Master of Stress book, that's what I do is I go through and share. Here's what we know at this point in time about how to modify what I call your self-care, your self- recovery activities, how to modify your self-care based on your stress pattern or your stress type.

Andy: Yeah. It's cool. It connects everything kind of through that lens. So you get to go through all these different areas of your life and kind of look at them and see how this connects and what you can be doing differently to sort of optimize. And it's really profound. It gets you to start thinking and realizing why certain things work and other things don't work as well for you, but that they might work for other people, they maybe don't work for you. So I love that. I think it's cool and really, really powerful.

Andy: So how do you think that you see people using this in a family setting? Is this something where you would be kind of knowing this as a parent and just kind of using this to make yourself the best that you can be? Or is this something where you're going to be trying to teach your teenager how to, you're going to see what is their stress type and be sort of teaching them how to work with that in the most effective way possible? Or how do you see that playing out or what do you recommend?

Dr. Doni: I love that question. I work with a lot of families. In some cases, it's the parent who first brings maybe the child or the teen to come see me because maybe they're experiencing anxiety or depression or hormone imbalances, or just not feeling well and their body's not sleeping well. And so I'm seeing more and more parents bring their teen to see me and say, "Hey, we're going to be graduating from high school soon and thinking about college or what's next in their life," and saying, "Hey, we want to be feeling our best." And right now in the standard medical system, when someone's experiencing anxiety or attention issues or fatigue, or even depression, there's only certain go-to medications that they can prescribe. So a lot of times a doctor might say, "Well, if you're experiencing anxiety, let's give you something to be calming the anxiety. Or if you're experiencing depression, let's give you this medication as an antidepressant. Or if you're having a hard time focusing, let's give this ADHD medication." So those are kind of their go-tos.

Dr. Doni: They might say, "Hey, it'd be good to reduce your stress," but that's about the end of the story. And you're kind of left with, what am I supposed to do with that? Because how do I reduce my stress when I'm trying to graduate from high school and do these sports or activities. And it's like it feels impossible to know what to do. And so what I do is when people work with me like that, I recommend, first of all, testing the cortisol and adrenaline and neurotransmitter levels because we can. It can be so, it's validating when you can see here's what my cortisol is doing. Here's what my adrenaline is doing. And even we can measure the neurotransmitters and we can measure serotonin, gaba, dopamine, we can measure in a urine test you can do it home. These are specialty tests and they're not integrated into the standard medical system, but they've been available and shown to be accurate in research for over 20 years. I think it's even close to 40 years now.

Dr. Doni: And so I would say, "Hey, let's get information about the body." Because it's amazing when we get information about our bodies now, because otherwise we're critical of ourself. We think there's something wrong, or we think we're not supposed to feel anxious or we're not supposed to feel low mood. And so if we get some information about our bodies and we can be accepting and say, "Oh, this makes sense that my cortisol is high or low, or that my adrenaline is high or low, because I'm a human and I'm having stress response, like all humans do." And so it becomes this acceptance and validation. And then we can say, okay, now we have so many tools to address it from a natural perspective because we know that there's herbs that can... Say cortisol is too high, and we want to help the body reset and bring the cortisol down. We can use the herbs have been researched to do that. And they don't have withdrawal symptoms or side effects. Or it's like, there's no dependency on these herbs. It's you use them to help your body reset.

Dr. Doni: Or the opposite, if the cortisol is too low, we can use herbs to help increase the cortisol or nutrients to help lower if it's too high or different nutrients that increase it if it's too low. So I just always feel like it's so much better when we can test because then we know what the levels are. And then I can guide people to rebalance. Even the neurotransmitters, we know that serotonin, for example, is a neurotransmitter our bodies make. Our bodies make all of our neurotransmitters. They didn't come from space and they definitely didn't come from a pill. They come from in our bodies.

Dr. Doni: In fact, a lot of these neurotransmitters are made in our digestion. Serotonin is mostly made in the human digestion. Then it goes to the nervous system. And serotonin is a main calming neurotransmitter. We normally, a lot of times we hear it in relation to mood. We think we're taught that if someone has low serotonin, they're more likely to have depression, but that's not even necessarily the case. Serotonin can affect mood, but it can also affect energy, sleep and focus. And it's made from amino acids. All of our neurotransmitters are made from amino acids that come from protein in our diet.

Dr. Doni: So if we go, wow. We eat protein like chicken, fish, our other sources are protein, like nuts. Our body digests the protein down to amino acids. And then our body knows how to turn these amino acids into neurotransmitters. And when we're under a lot of stress, we just use them up faster. Depending on our genetics, we burn through them. We're asking a lot of our body to say, "Hey, I'm going to be at a high level of stress, not just for a week, but for years." And the body starts to get depleted in serotonin, because I can't keep up. Same thing with dopamine.

Dr. Doni: And so when I look at these levels then, because I understand the biochemistry and the nutrition, I understand, oh, if I put in this nutrient, I know the body's going to make more of this neurotransmitter. Or if adrenaline is too high, I know if I use this nutrient, it's going to help it decrease. And so we can do so much of rebalancing neurotransmitters and hormones like cortisol just using nutrients in herbs that are, again, non-addictive no side effects that just benefiting us. So to me, it's like I do that a lot with families and teens. It's like, how do we rebalance?

Dr. Doni: Another scenario is I might see a parent, like the mom might come in to see me as a patient for her health issues. Maybe she has fatigue and I'm helping her. And then she says, "Hey, can you help my daughter or my son?" And then it becomes a family event even. Sometimes we're in appointments together with the parents and the kids and we're helping them all to rebalance and to implement these strategies, to help us be healthier while stressed. I mean, that's really my way of thinking of it is how can we support ourselves to be healthier while stressed? Because yes, there's some stresses we could choose or not choose, but ultimately we're going to have some stress around. We need to learn how to be healthy, even though we're stressed.