5d ago

Recognizing High Sensitivity in Children (HSP) & Helping Them Thrive

With it being back to school season, this topic feels especially timely. In this episode, I have the pleasure of speaking with family advocate Tracy Spiaggia, founder of Slingshot Health Coaching, about recognizing high sensitivity in children and how to support sensitive children and their parents. We discuss the core traits of the Highly Sensitive Person (HSP) trait, Tracy’s great “power strip” analogy for sensory overload, and why the tripping of the power strip (the stress response) can look different in different children (fight, flight, freeze, or shutdown). We talk about challenges that may point to high sensitivity — school behavior problems, breakfast refusal, perfectionism, somatic complaints — and the practical framework Tracy uses with families to sort the “immovables” in their lives from what can actually be changed. We each share our own experience growing up as highly sensitive children, and how we each began our parenting journey largely unaware of this trait. We address the importance of awareness and self-compassion for parents. And, we close with commenting on the value of identifying and addressing pyrrole disorder- a fairly common biochemical imbalance in those with highly sensitive who are struggling with brain and physical symptoms. Timestamps: 0:00 Introduction to high sensitivity and its importance2:04 Recognizing high sensitivity in children and adults3:58 Parental support strategies for sensitive children5:52 Stress response styles and their impact7:56 The physiology of high sensitivity and overstimulation9:59 Creating modifiable environments for thriving12:06 The evolutionary purpose of high sensitivity14:04 Practical tips for supporting sensitive children in school and home15:58 The importance of self-awareness and compassion in parenting18:04 The role of nutrition and physical activity in sensitivity management20:02 Supporting adult highly sensitive persons22:11 The power of community and shared experiences24:04 Overcoming shame and embracing sensitivity as a strength25:59 Practical steps for creating supportive environments28:00 The importance of ongoing learning and adaptation29:53 Closing thoughts and resources for further support Introductions (0:00) Dr. Courtney Snyder Welcome to the Holistic Psychiatry Podcast. I’m Dr. Courtney Snyder, a physician and holistic child and adult psychiatrist. In this episode, I have the pleasure of having a conversation with Tracy Spiaggia, who is an experienced health coach who works with families. Using Elaine Aron’s term of the highly sensitive person, HSP, Tracy and I will discuss high sensitivity in children. This trait, as Tracy will mention, occurs in about 20% of the population. Tracy and I both consider ourselves to be highly sensitive, so in addition to sharing our professional experience, we’ll also share insights from our own childhoods, as well as insights from parenting highly sensitive children. Tracy is currently a candidate for a PhD in what will be Whole Health Leadership. She’s a Functional Nutrition and Lifestyle Practitioner, Certified Integrative Attachment Theory Coach, Brain Health Specialist, National Board Certified Health and Wellness Coach, and the author of the book From “Chained to Changed. Break Mental Strongholds and Transform Your Life Through Faith.” Courtney We have so many intersections in terms of what we care about and are interested in — nutrition, functional medicine, attachment, families. Tracy Why I hang on every word you put out. Courtney Thank you. Thank you. Courtney One of the things that I was thinking about is how much people do to support children that have all these different issues, but there’s not a lot of recognition of high sensitivity in children, nor what their unique needs are. They’re living in a world that’s not designed for high sensitivity. As we talk, we can help raise awareness about what that looks like — how to recognize when a child is highly sensitive, and not in a symptomatic, pathologic frame, but really, that’s who they uniquely are. And then we’ll move into how to help people make choices to support these children so that they can thrive, and also recognize the situations where they’re probably not going to thrive as easily. Tracy Correct. And then how, as a mom and dad, can I modify my expectations on the child and give them a lived experience that best aligns with their sensitive nature — so that they can become who they’re supposed to be, not vicariously living through the child, especially if you’re a non-sensitive parent. Courtney We should talk about both — when the parent is also sensitive, and then when they’re not necessarily, ‘cause there’s different dynamics that would come up. Tracy Yes, yes, yes, absolutely. Especially if the sensitive parent never knew — hello, never knew anything about HSP. And so you’re raising your children, and then when you come to find out, like, your whole brain just explodes in. And then I just kind of really became a completely different parent, almost on a dime, finding this work. And I felt the most free I’ve ever felt in my life when I came across the work. So yeah, we’ll talk about that too. Growing Up Without an Awareness of the HSP Trait(3:21) Courtney I know — I think like you, I look back and there’s things I would have done differently. Now having a daughter who’s twenty-one, certainly learning when I did has helped her, and this information helps her even make her own choices at this point. When I thought about parenting, it also made me think about being a highly sensitive person, and my own experience as a child, because there certainly wasn’t language back in the sixties and seventies. Tracy Here’s a great example. I’m going to make it personal instead of hypothetical. My parents — we came from a household where my dad was a police officer, my mom stayed home, four kids, money was super tight. And so the summer would come, and I now, as a seasoned mother, I can only imagine how she’d be like, almost dreading it — like, “oh my gosh, they’re all here.” So we would have to go to swim team ‘cause it was free from the town. We’d have to go to the town pool. We’d have a choice — we weren’t asked, “you’re going to swim team.” And if my memory serves, it started super early, maybe seven, eight o’clock in the morning. Back then I was just a bag of bones, I was so thin, and that water was freezing. I had no idea why I was so terrified to perform in front of others, but that’s part of the HSP. Like I shared earlier — when I came across this work and all of the questions that were asked to see if you fall on the spectrum of HSP, I’m like, yep, yep, yep, yep, yep. But when it was my turn to compete, I would nine out of ten times not show up on my block. I would hide in the bathroom. I’d even get good at climbing up on top of the toilet with the door closed, so if my mom came in — you know, you can’t see feet. So I would hear my name being called, like, “McMurray, block three,” and I wouldn’t show up the vast majority of the time, because I’d rather the punishment on the back end than have to endure a public display of competing in swim team. So I give that as an example — if a parent were skilled, the first time I don’t show up for my competition, there should be some really safe but powerful questions being asked, like, “hey, what’s going on for you? I noticed you weren’t there, you didn’t show up.” Obviously you’re not doing that to — the parent should be able to say, “obviously you’re not doing that just to irritate me,” but we take it all so personally as exhausted parents. But if they were skilled, they could ask questions, and I’d be able to say to them, “this is really scary for me, I don’t want to do this, I don’t like getting into the pool at seven in the morning, I’m freezing, I’d be blue, I don’t like this, I don’t want to do this.” And then they’d say, “my goodness, okay, you don’t have to do this anymore, you can come and stay home and we can figure out what you enjoy.” I didn’t grow up like that. So that’s an example of a rule I made up to the game of life — if something is bringing you to the brink of sheer terror, just don’t show up for it, go hide somewhere. That’s one example of how I started to cobble together rules of the game of life so that I could survive it. Courtney And that’s so interesting, because in my own early life, I think I cobbled the rule of “you just do it no matter what.” That has its own problems, because you don’t even become aware — you just persist through what’s quite uncomfortable. Whether that’s sporting events, public speaking, which for me was a complete nightmare — anticipating, many months in advance, a book report or something like that. And I think, even looking back, I could say, “I had anxiety as a child.” But when you think about high sensitivity, and you think about the context with which one is trying to navigate — which is highly stressful, chronic, and in some cases severe stress — that doesn’t have to even be anxiety. It could just be a severely, chronically stressful situation, trying to be in a world of extroverts. In my family I was the youngest of four, and I was the only one that was highly sensitive. It’s Not Anxiety. It’s Physiology. (7:53) Tracy As you describe that, I don’t hear an anxious child. I hear a physiology. I hear the brilliant design of the physical body, that your alert system was working perfectly well — trying to say you’re living a life that’s antithetical to who you are, but you’re kind of being forced along for the ride. If there’s a lot of children, those at the tail end just kind of get bolted on, as opposed to being seen — not all the time, but most of the time — because parents are just human beings with finite res

Jul 22

The Hyperfocus-to-Brain Fog Roller Coaster (And How to Get Off)

Are you someone who at times has great productivity and hyperfocus, but at other times can barely focus and get things done? Do you have problems focusing and getting things done unless you’re under pressure? Do you tend to procrastinate? Do you, after periods of high-intensity work — whether that’s physical or mental — crash and burn out afterward? Do you feel that you dive deeply into an interest, but then lose interest and don’t know what just happened? Do you have serial interests, or even serial relationships? Do you feel you have great abilities — you’re a quick learner, you go deep when you’re pursuing something you’re interested in, perhaps you’re even gifted — but then feel unable to harness those abilities and gifts, and feel like you’re on a roller coaster between hyperproductivity and an inability to focus and have motivation? These are common patterns that I see in my practice, and they relate to arousal. I’m not referring to sexual arousal or emotional arousal, but arousal as far as our neurophysiology being in a place where we can ideally act — where we have focus, motivation, and energy — and not low arousal, where you can’t focus, and have low motivation, and low energy, nor hyper arousal, where we’re excessively focused in a physiologic stressed state. Many people find themselves fluctuating between both ends and having problems finding that sweet spot in the middle that allows them to sustain their interests, sustain the goals they’ve set for themselves, and harness their greatest gifts. Many of these individuals are extremely gifted — deep divers, can even be obsessive about their interests. But it can take that depth for people to function at a high level. This newsletter and podcast are for educational purposes and aren’t a substitute for professional medical advice, diagnosis, or treatment. Please talk with your own doctor about any medical or psychiatric concerns. What You’ll Learn * (0:00) Recognizing the pattern of hyperfocus and burnout * (3:43) What arousal actually means, physiologically * (4:26) The RCCX connection * (7:03) The crash, and why it happens * (10:11) Finding our sweet spot — practical tools that help Recognizing the Pattern There’s a sweet spot of arousal where we have focus, motivation, and energy. On one side of it is low arousal — brain fog, low motivation, low energy, something that can look a lot like ADD in both children and adults. On the other side is hyper-arousal — when we have excessive focus and drive, often accompanied by physiological stress. Many of the people I see fluctuate between both ends and struggle to find that middle place. They tend to have deep interests. They can dive deeply into something, even obsessive about it, and can have difficulty disengaging. When there is not enough stimulation, they tend to get bored. They often don’t enjoy small talk. What Arousal Means Physiologically When we talk about what can be happening here — when we are stressed, and again, when I’m talking about arousal, that’s a degree of stress, and we’re aiming for an optimal level of stress where we get things done and can enjoy what we’re doing. What impacts arousal? One is cortisol. If we have adequate levels of cortisol, that gives us adequate energy. Along with cortisol, catecholamines fluctuate — things like norepinephrine, which gives us motivation, and dopamine, which helps us focus. Think of these three as moving up and down together for the most part. There are other things that can impact them separately, but generally they’re increasing together, and they can be decreased or low at the same time as well. The RCCX Connection The best explanation I’ve found for why some of us find ourselves at either end of the arousal spectrum and not easily in the middle sweet spot, is RCCX theory, developed by Dr. Sharon Meglathery. This is a theory I’ve described in previous newsletters and podcasts — it makes the connection between a gene for hypermobility, a gene for 21-hydroxylase (an enzyme in the hormone pathway that produces cortisol), and another gene that relates to autoimmunity. People don’t have to have all of these genes affected, but I’d say the most important one, from a psychiatric and brain-symptom perspective, is 21-hydroxylase, needed for the production of cortisol. If we have a weakness on this gene — and it appears that likely 20% of people do — that could give us a baseline low cortisol level. It’s not as if we can pin this down to a single variant; there are likely a number of places on that gene that could be affected, and it’s not something that can currently be measured through genetic testing except in research settings. But if we have that weakness, we could still make adequate cortisol under stress — until we push it too far. Say, on one of these hyperproductive days, we push too far, and then we overwhelm that enzyme, and we don’t have enough cortisol. So why would people who struggle with this already tend to be deep divers? It appears that a vulnerability in that enzyme, 21-hydroxylase, could have affected brain development in utero and in early life — causing higher androgens and spiking cortisol that can affect particular parts of the brain, including the amygdala, which senses threat and can contribute to this high-intensity difficulty putting on the brakes once we’re under stress. So these individuals, when they’re working on something, may have difficulty stopping — and then when they’re not able to keep producing the cortisol to meet the demands they’re placing on their physiology, they hit a wall. The Crash — and Why It Happens When the enzyme can no longer keep up with the demand, cortisol and those neurotransmitters drop — that’s the crash: low energy, poor focus, no motivation. For some people, hitting that wall can also trigger mast cell activation, through another mechanism I’ve talked about in a previous episode. There’s a hormone in the brain, corticotropin-releasing hormone (CRH), that tells the adrenal glands we need more cortisol. When that happens, CRH can bind to mast cells — inflammatory cells in the body — which release histamine and inflammatory mediators that can cause physical symptoms, and worsen fatigue and brain fog. Not everyone has this happen; most people with mast cell activation have something else going on too, like a biotoxin exposure. This isn’t only about a single hard day. Zoom out, and I’ve seen people who were high-functioning — even hyper-functioning — for years, doing remarkable things across work, family, and adventure, before hitting a wall they never fully recovered from. Often there’s something else quietly using up their stress capacity underneath it all: mold or biotoxin exposure, mitochondrial dysfunction, a chronically stressful relationship, early attachment disruption, or even codependent relationship patterns that keep someone chronically stressed. Once someone hits that wall, it’s common to unconsciously reach for something to bump cortisol and those neurotransmitters back up — compulsive eating, carbs, seeking stimulation online, risk-taking, or calling the one person who reliably stirs up drama. Beyond the physical crash, there’s a bigger cost: most people aren’t recognizing this as their neurophysiology. They’re experiencing it as being inconsistent, self-defeating, self-sabotaging, or a self-esteem problem, rather than recognizing it as a very common physiologic pattern involving our stress hormone pathways and neurotransmitters — and the bigger loss is all the abilities and gifts people aren’t able to harness because they’re on this roller coaster. Finding the Sweet Spot The first thing is to notice. Notice when you feel in that hypo-arousal state, when you’re having difficulty getting things done, and then recognize what you’re reaching for — is it carbs, is it eating, is it substances, is it the internet, is it risk-taking, is it the dramatic friend who stirs up trouble? Notice Also notice when you’re in a state of hyperarousal — doing an activity, powering through without being able to stop, unable to take breaks. If you’re observant enough, you’ll notice your muscles tightening around your neck and shoulders, and simply not being able to relax. When we notice which state of arousal we’re in, we know what tools we have access to, to help modulate it. For High Arousal When you’re in a state of hyperproductivity, the last thing you want to do is take a break. But to sustain a degree of productivity, it can require putting that intensity aside and taking a break, so the wall isn’t hit. Another approach is to alternate high-intensity work with low-intensity work — step away and move if the work is on a computer. It can help to chunk activities: set goals, and after reaching them, stop and take a break, rather than letting a project sprawl deeper and deeper. It’s also important to assess your stressors — stressors aren’t all negative, but if we’re not pacing, if we’re not setting aside time to calm our nervous system, we can still hit that wall. It’s really important to set an intention before starting — how it’s going to be broken up, setting a timer for how long before a break — to really be intentional. For Low Arousal Just recognizing that low baseline arousal can already have us thinking creatively about how to increase it. Do we need to change the setting where we’re working? Do we need to find a way to make what we’re doing more interesting — what is the why? Make it more creative. When we have that low arousal, instead of reaching for food or surfing the internet, we could instead have a creative outlet that’s stimulating and raises our arousal without being harmful to us. Movement is a way to raise arousal — getting up and moving around can help. It can also help to chunk activiti

Jul 6

The Mold-Brain Connection: What You Need to Know

I recently joined Annika Taylor on The Wellness Rebel Podcast to talk about mold toxicity, and how it can cause not only physical symptoms, but also brain symptoms such as anxiety, depression, OCD, brain fog, mood swings, and in more severe cases, psychosis. Watch the full conversation above. Below is a recap of our conversation, along with the resources we discussed along the way. Chapters:0:00 Introduction to Mold and Mental Health1:47 Understanding Mold Exposure and Illness5:13 Personal Journey with Mold Illness8:40 Sources of Mold Exposure12:12 Physical Symptoms of Mold Toxicity18:54 Mental Health Impacts of Mold Exposure25:32 Identifying Mold in the Environment32:28 Treatment Options for Mold Toxicity I. What Is Mold-Related Illness? Mold-related illness can be broken down into three distinct categories that often get lumped together: mold allergy, mold toxicity, and mold colonization. Mold allergy, which most people are familiar with, is a reaction to outdoor or indoor mold spores. Mold toxicity is different: it happens when mycotoxins actually accumulate in the body, something that appears to affect roughly 25% of people who can't effectively remove the toxins on their own. This explains why one family member in a home with mold can get seriously ill while another in the same house is fine. Third is the lesser-known mold colonization, where mold spores take hold directly in the sinuses or even the GI tract. That means a person can be out of a moldy environment for years and still have an internal source of toxicity. II. My Own Mold Story My interest in mold began around 10 years ago when I was diagnosed with mold toxicity. For years prior, I had been dealing with chronic fatigue, symptoms of fibromyalgia, and vague neurological symptoms that neither my doctors nor I could explain. My daughter was also having complex chronic health issues that initially looked like developmental regression. Understanding the microbiome and dietary changes were helpful to both of us, as were the Walsh Research Institute's nutrient-based interventions, but the real turning point came when the topic of mold toxicity came across my radar in 2016. Mycotoxin testing and testing of our home and my office confirmed that we had significant exposure and toxicity, which we were treated for and benefited significantly from. III. When a Partner Isn't on Board: How Mold Treatment Affects the Whole Family One thing that doesn't get talked about enough is how difficult it can be for someone to get out of or address an exposure if their spouse or partner is not on board. In my own case, I was fortunate — my then-husband was agreeable, especially when he realized how much clarity, decisiveness, and even sense of urgency I had. We'd dealt with significant health issues for a long time, and I didn't want something irreversible to emerge that would leave me in regret for not acting sooner. We acted on that instinct. We were very lucky to find that we were eligible for insurance coverage, which covered an extended-stay hotel while we had our home remediated. For a lot of families, that's not the reality. If a partner isn't on the same page, it can become one of the biggest reasons someone doesn't end up leaving a house with mold — whether that obstacle gets talked about openly or not. There are those who don't believe mold toxicity is real, and those who don't want to believe it's real (consciously or unconsciously). Education, input from those with expertise, or even seeking couples therapy can be necessary. It is important to remember that part of the treatment, namely addressing mold in the home, impacts the whole family. IV. Where Mold Hides: Common Sources of Exposure For most people who test positive for mold toxicity, the primary exposure is likely environmental, as opposed to mold in food. Leaks under sinks, problems around windows, roof leaks, chimney flashing, damp basements, and high ambient humidity are all common culprits. High humidity left unaddressed can be a big problem. Estimates of the percentage of homes that mold have crept up over the years, from 50% to 75% to, as some consultants now say, essentially every building to some degree. I've seen a couple of children with developmental issues who had mold in their mattresses from bedwetting. V. The Physical Symptoms of Mold Toxicity Mold toxicity often shows up as sinus issues (especially with colonization), asthma, and — notably in young children — recurring croup (spasmodic croup) and ear infections. Many people with mold toxicity also develop mast cell activation, which triggers an exaggerated immune response affecting the skin, respiratory tract, GI tract, and/or bladder. Racing heart, air hunger, and stomach pain can occur. Neurological complaints can include electric "jolt" sensations, numbness and tingling, headaches, light sensitivity, and temperature dysregulation. Many of these symptoms overlap with Lyme disease, EMF sensitivity, and other chronic conditions. The immune dysregulation caused by mold toxicity can contribute to a vulnerability to Lyme and its coinfections, Candida, SIBO, PANS, PANDAS, and more. VI. The Brain and Mental Health Symptoms of Mold Brain Fog, Fatigue, Anxiety, OCD, Psychosis, Mood Swings, Developmental Delays & Cognitive Decline I don't know what psychiatric symptom mold toxicity can't cause. Brain fog and fatigue are especially common, as is anxiety. For some, mold toxicity can contribute to psychosis and/or dramatic mood swings. In children, mold toxicity can look like ADHD, anxiety, or developmental delays. I see mold toxicity as something that aligns with — and amplifies — someone's existing genetic vulnerabilities rather than acting alone. Most of the patients I see with severe conditions like schizophrenia, bipolar disorder, or severe OCD have mold toxicity as a contributing factor, though, again, rarely the only factor. The Neurotransmitter Connection Mold toxicity can drive up pyrrole levels, which in turn depletes zinc and B6 — two nutrients essential for neurotransmitter functioning. It can also worsen copper-zinc imbalances through oxidative stress and interfere with methylation, both of which also impact neurotransmitter functioning. A Client's Story: OCD and a Hidden Leak Annika recalls when she became interested in helping those with mold toxicity. She shares the story of a friend whose severe, debilitating OCD — along with episodes of derealization and out-of-body sensations — turned out to trace back to black mold discovered behind a washing machine, the result of an old water leak. Once they addressed the mold, the connection became clear in hindsight. VII. Mold Toxins Can Create a Threat Response in the Body & Brain While we can have threats on the outside, mold toxicity is a threat we can have on the inside. When we are under threat, three systems tend to get activated: the immune system (as discussed with mast cell activation), the limbic system, and the autonomic nervous system. The limbic system puts the body into a vigilant, threat-scanning state — and for some people, that vigilance surfaces as OCD (an unconscious attempt to "make things right" when the body senses something is wrong), health anxiety, or a diffuse sense that something isn't okay. The autonomic nervous system, meanwhile, can get stuck in fight-or-flight or shutdown mode instead of rest-and-digest. Annika is careful to frame this not something to fear, but something to understand — the goal isn't panic, it's empowerment. VIII. Testing for Mold: Home and Body Testing Your Environment If there's visible water damage or visible mold, extensive testing usually isn't necessary. Generally, where there is water damage or water retained in a space, there will be mold growth. The priority becomes proper containment, and remediation. If there is no known issue and someone has mold toxicity (which could be from an old exposure), I recommend the ERMI-style dust test (I use Mycometrics), which measures water-damage-associated spore counts against outdoor spore counts from a simple cloth dust sample. I caution against relying solely on air sampling from a home inspector, which I and many of my patients have found unreliable by itself — surface or dust testing gives a clearer picture. Petri-dish testing (I use Immunolytics) can help pinpoint which room is affected, though it misses a couple of important mold species. Testing Your Body For testing mycotoxins in the body, I use RealTime Labs, an at-home urine test that screens for five toxin families. Annika discusses her experience with another company, which showed false negatives — a patient with a "no mold" result went untreated for years while ongoing exposure continued. To improve the accuracy of the test, I sometimes have patients do a sauna session or take glutathione in the days leading up to testing, to help mobilize toxins — though this isn't appropriate for everyone, particularly more sensitive patients. IX. Treatment: Binders, Antifungals, and Diet Environment: Once someone has a positive test and a known or suspected source, I recommend having a consultant (separate from the remediation company, to avoid conflicts of interest) create a remediation plan — ideally with proper containment so the remediation process itself doesn't spread spores further. After remediation, a retest should be done to confirm the space is actually clean, ideally at the remediation company's expense if it isn't. Binders: On the body side, treatment typically starts with binders — chosen based on which toxins showed up on testing — such as bentonite clay, activated charcoal, chlorella, or cholestyramine (a prescription option that binds ochratoxin particularly well). I start sensitive patients low and slow, since mobilizing toxins can temporarily worsen symptoms. Antifungals When Appropriate: Depending on the response and whether colonization is present, treatment may progress to nasal or syste

Jun 29

High Sensitivity Through 3 Lenses: HSP, Pyrrole Disorder & RCCX Theory

As a holistic and functional psychiatrist, I see many people who are highly sensitive. Most are deep divers into information and able to connect a lot of dots. Many are gifted. Many struggle with overwhelm and low stress tolerance. Some struggled with anxiety, inner tension, or feeling “too much” for as long as they can remember. Some feel different - that they don’t fit in. As a holistic and functional psychiatrist with over twenty years in practice, I've worked with thousands of highly sensitive adults and children. Most are deep divers into information, able to connect a lot of dots — many are gifted. And yet many struggle with overwhelm, low stress tolerance, anxiety, or inner tension that has been there for as long as they can remember. Many feel different, like they don't quite fit in. What I've found is that sensitivity itself is rarely the problem — it’s the seeming vulnerability to brain-related or physical conditions. Over the years I’ve found three different models to be especially useful in explaining some of the vulnerabilities and the strengths of those of us who are highly sensitive: Dr. Elaine Aron’s work on the Highly Sensitive Person (HSP), the nutritional medicine concept of Pyrrole Disorder, and Dr. Sharon Meglathery’s RCCX Theory. Each looks at a similar group of traits through a different lens — psychological, biochemical, and genetic, respectively. Before I start, I want to emphasize that sensitivity is not a pathology or a diagnosis. It is actually a trait that has existed across human history for a reason. My goal is not to pathologize it, but to understand it — and to offer tools to those who have these traits but who are struggling with a condition more prevalent in those with these traits. As I go through these three frameworks, the overlap will be obvious and I’ll highlight what each of these has to offer that the others don’t. What You'll Learn * The HSP model provides validation and a language for sensitive individuals. * Pyrrole Disorder involves an overproduction of pyrroles, leading to nutrient depletion of nutrients critical for neurotransmitter functioning. * Pyrrole Disorder is common in brain-related conditions. * RCCX Theory connects genetic vulnerabilities to sensitivity and chronic illness. * Stress amplifies the experiences of highly sensitive individuals. * Understanding these models can lead to effective treatment options. * There are meaningful paths forward for those who are highly sensitive. Chapters * 00:00 Understanding High Sensitivity * 02:26 The Highly Sensitive Person (HSP) Model * 10:23 Exploring Pyrrole Disorder * 18:18 RCCX Theory Explained * 30:11 Intersecting Models: HSP, Pyrrole Disorder & RCCX Theory * 34:40 Conclusion and Path Forward I. THE HIGHLY SENSITIVE PERSON In the early 1990s, psychologist Dr. Elaine Aron identified a personality trait she called Sensory Processing Sensitivity (SPS) — and the people who score high in it she called Highly Sensitive Persons, or HSPs. This is not a diagnosis. It is a trait, present in roughly 15–20% of the population. It has been found across more than 100 species — from fruit flies to primates. This tells us it is evolutionarily conserved — it confers survival advantages. In any social group, having members who are wired to notice subtle cues, process information deeply, and detect threats before others do is extremely valuable. Fitting with this, many of these individuals, who also struggle with complex chronic health issues are considered the “canaries in the coal mine” since their bodies react to environmental triggers (environmental toxins, chemicals, or stressors) long before the rest of the population. Dr. Aron captured the core features of this trait in an acronym she called DOES: D — Depth of processing: HSPs think deeply, reflect before acting, and notice subtleties that others miss. O — Overstimulation: Because they process so thoroughly, HSPs reach their threshold more quickly in high-stimulation environments. E — Emotional reactivity and Empathy: HSPs feel emotions intensely and are highly attuned to the emotions of those around them. S — Sensitivity to subtle stimuli: They pick up on things — in their environment, in social dynamics, in the body — that others simply don’t register. As you can see, traits that are super powers, can become liabilities. The deep diver who loses sight of the big picture. The empath who absorbs everyone else’s energy as their own energy becomes depleted. The person who withdraws from the world because the stimulation has simply become too much. HSP Research Beyond the clinical observations, there is now a growing body of neuroscience and genetic research supporting this trait. There is evidence that the brains of sensitive people are doing more, processing more and feeling more. fMRI studies (Acevedo, Aron et al., 2014) have shown that when HSPs view emotional images — particularly photos of loved ones expressing happiness or sadness — their brains show significantly greater activation in regions associated with awareness, empathy, and sensory integration. Twin studies show that Sensory Processing Sensitivity (SPS) as defined by Dr. Aron is approximately 47% heritable. Small studies as opposed to large genome wide studies have focused on genetic variants involving dopamine and serotonin systems, such as a serotonin transport gene, a dopamine receptor gene, and COMT, which codes for the enzyme that metabolizes dopamine and norepinephrine. While this hints at a biochemical dimension, the HSP framework doesn’t address this as directly as the other two models I’ll discuss, nor does it explain the higher prevalence of physical health conditions in those who are highly sensitive. Research published in 2026 (Matsuzawa et al.) found that individuals high in SPS had substantially higher rates of depression (13.8%), anxiety disorder (10.5%), and developmental disorders, such as ADHD and ASD, compared to the general population. Despite this overlap with developmental disorders: unlike, ADHD, HSPs typically have excellent concentration in quiet environments. And unlike the social deficits described in ASD, HSPs tend to have heightened social attunement. They often feel too much of what’s happening in social situations, not too little, even if they respond awkwardly at times. Research shows that high sensory processing sensitivity is associated with more frequent physical symptoms — back pain, fatigue, digestive issues, frequent illness. What This Framework Offers The HSP model has given millions of people validation and a language for these traits that has allowed them to shift from “what is wrong with me” to “this is how I am wired.” It also offers an evolutionary reframe. High sensitivity is not a mistake and is not pathologic. It is a feature of the human population that has served us. What it doesn’t offer is a biological explanation for why some sensitive people suffer so acutely — or a path toward biochemical intervention. II. PYRROLE DISORDER Pyrrole disorder is a biochemical imbalance that has been recognized for decades, though it remains largely unknown in mainstream psychiatry. It involves an overproduction of pyrroles — metabolic byproducts that, on their own, are not a problem. When they are high, however, they can result in a depletion of zinc, B6 and a few other nutrients. First identified in the 1950s and first treated with zinc and B6 in the 1980s, pyrrole disorder is one of the most common nutrient imbalances found in brain-related conditions — and one of the most treatable. Yet most people who have it have never heard of it. I learned about pyrroles in 2014 when I first trained with the Walsh Research Institute. The Importance of Zinc, B6 & Magnesium Vitamin B6 is required to synthesize dopamine, serotonin, and GABA — three of the most critical neurotransmitters for mood regulation, anxiety, and stress response. Zinc plays a profound role in the central nervous system, the immune system, gastrointestinal tract (which we now know has its own significant influence on brain health) and connective tissue (joints and skin). Pyrrole Disorder Traits & Symptoms The most consistent feature is low stress tolerance. People with elevated pyrroles are often described as those for whom life seems harder than it should be, every transition can be destabilizing and every large group or new environment feels like too much. The overlap with the HSP profile is striking, but here, we start to see not only traits, but symptoms. - Socially anxious, shy, or fearful since childhood, with severe inner tension - Sensitive to bright light, loud noises, textures, and odors - Avoids crowds, strangers, and new situations - History of reading difficulty - Poor short-term memory - Underachievement - Irritability, mood swings, bouts of depression - Tends to stay up late; little or no dream recall; morning nausea - White spots on fingernails; very dry skin; stretch marks; poor wound healing - Joint pain - Frequent infections or autoimmune tendencies Most people with pyrrole disorder don’t have all of these symptoms — but the inner tension, the high sensitivity, and low stress intolerance are very common. What the Data Shows The Walsh Research Institute has collected data on over 30,000 patients. Elevated pyrroles were found in: * 18% of those with ADHD * 24% of those with depression * 28% of those with behavioral disorders * 35% of those with autism * 35% of those with bipolar disorder * 30% of those with schizophrenia * 12% of those with PTSD And in only 8% of healthy controls — meaning those with no psychiatric diagnosis. What Causes Pyrrole Disorder? For many, there appears to be a genetic component, but for others, pyrroles appear to have increased due to high physiologic or emotional stress. Examples include candida overgrowth or other forms of gut microbial imbalances, mold toxicity, heavy met

May 5

Why We Can't Separate Our Childhood From Our Physiology (& Biochemistry)

In this episode, Dr. Courtney Snyder, a Holistic Child and Adult Psychiatrist discusses: - The research into Adverse Childhood Events (ACEs) and health outcomes (at a population level) - How early adversity can impact our physiology, biochemistry and thus neurotransmitter functioning - Why ACEs scores are less meaningful at an individual level - The role of Positive Childhood Experiences (PCEs) on mitigating the effects of adversity in childhood - The gift of neuroplasticity and resources to help teach/train/rewire our nervous system to feel safe. Chapters 00:00 Introduction to Holistic Psychiatry 01:25 Understanding Adverse Childhood Experiences (ACEs) 07:07 Impact of Early Stress on Physiology and Biochemistry 16:27 The Role of Positive Childhood Experiences 21:01 Vulnerability to Trauma and Genetic Factors 22:05 The Power of Positive Experiences in Healing Positive Adaptive Childhood Experiences Study 2019 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6747474/ To learn more visit: CourtneySnyderMD.com Medical Disclaimer: This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

Apr 19

How Nutrients Impact Neurotransmitters & Walsh Data

It is increasingly understood that our brain health is dependent on our having healthy nutrient levels. But how do nutrients actually impact our neurotransmitters. We might assume that certain nutrient levels would cause certain symptoms or conditions. Instead, what we find are biotypes - one condition is often associated with a small handful of imbalances. For example, the biotypes of depression from the Walsh Research Institute, included undermethylation, overmethylation, pyrrole disorder, copper overload and metal toxicity. And reversely, one nutrient imbalance can contribute to a range of brain symptoms. Copper overload, for example, can be a factor in ADHD for one person, but for another contribute to panic or insomnia and still another rage or tantrums. There are some conditions, however, that have a very strong associations with specific nutrient imbalances. In this newsletter, I will address: * 5 Ways Nutrients Impact Neurotransmitter Functioning * Psychiatric Conditions That Can Almost Predict a Specific Nutrient Imbalance The data comes from the Walsh Research Institute. Nutrient Imbalances Can Be Due to Too Much or Too Little I use the term nutrient imbalances, because it’s not just about deficiencies of certain nutrients. Specific nutrient overloads can impact brain health as well. This biochemical diversity means we don’t all have the same needs when it comes to diet and supplementation. Some of us, for example, can benefit from folate, but for others with excess folate, supplementation could worsen depression and anxiety. Those with copper overload can similarly have worsening of symptoms with copper supplementation, while others will have a need for copper. What Causes Nutrient Imbalances While it might seem that this is all about our intake of nutrients, we can come by these imbalances genetically. We can also acquire deficiencies and even overloads through high oxidative stress. This is when our body (including our brain) is dealing with too many insults, resulting in a depletion of our inherent antioxidants leaving us vulnerable to DNA and thus cell damage, inflammation and their consequences). Copper zinc imbalances and elevated pyrroles, which results in relatively low zinc and B6, are signs of oxidative stress. Often an imbalance appears to have multiple causes. For example a woman with high copper causing high anxiety, could have a family history of high copper conditions (post partum depression, ADHD, angry outbursts) and thus have a likely genetic vulnerability. She may also, be taking a multivitamin with copper, eating a lot of chocolate (high in copper) dealing with high oxidative stress and not the least, be on an oral contraceptive (added estrogen can make copper go up). 5 Ways Nutrients Can Impact Neurotransmitter Functioning Nutrients often function as co-factors, helping certain enzymes do their job. Specific nutrients are needed: * For production of neurotransmitters. Vitamin B6, for example is needed to make serotonin, dopamine and GABA. B6 can be low in pyrrole disorder and thus contribute to a range of symptoms. * To convert one neurotransmitter to another. Copper is needed to turn dopamine into norepinephrine (think adrenaline). If we are high in copper, we could have relatively low dopamine and high adrenaline states, which is what is seen in ADHD. * To support enzymes involved in the breakdown of neurotransmitters. For example MAOA is an enzyme that needs Vitamin B2 to do its job breaking down serotonin, dopamine and norepinephrine. If these aren’t broken down, there could be problems with activation and anxiety. * To help receptors do their job. Receptors are what neurotransmitters bind to, resulting in a impulse being sent down the nerve cell. Zinc and magnesium help regulate the NMDA receptor. If not well regulated, there can be high activity, which can look like thoughts getting stuck - ruminations, obsessions in OCD, cravings in addiction, and even delusions in psychosis. * Regulate the expression of genes for serotonin reuptake receptors. Folate causes an increase in the expression of these genes (and thus production of these receptors). This results in more serotonin being picked up and less available between nerve cells. This could be a problem for someone who already has low serotonin symptoms. SAMe, on the other hand, does the opposite and it can function like an SSRI. Why One Diagnosis Isn’t Always Associated With One Imbalance * Psychiatric conditions appear to have various causes. If someone comes to me with a diagnosis of depression, for example, that only tells me what type of symptoms they likely have. It doesn’t tell me if those symptoms are related to high copper, a methylation imbalance, elevated pyrroles, candida, a misaligned upper cervical spine , mast cell activation, mold toxicity, metal toxicity, hormone imbalances or a combination of any of these…….or something else. * More often multiple factors appear to be aligning. It is not uncommon, for example, to have candida or mold causing high pyrroles causing low zinc, leading to high copper, and as an aside also be undermethylated. * One “root cause” can contribute to a range of conditions and symptoms. Some people with high copper are diagnosed with depression or anxiety and others with ADHD. Some people who are undermethylated have OCD, others depression and still other schizophrenia. Very often, people will be have multiple diagnoses fitting with an imbalance. “Comorbidities” in psychiatry are the norm, rather than the exception. Despite all of this, there are certain nutrient imbalances that occur so commonly in certain psychiatric conditions that they can almost be predicted . Data From Walsh Research Institute Simply knowing someone has a mental health condition makes it more likely that they will have a methylation imbalance - more often undermethylation. The Walsh Research Institute has looked at the methylation status of 30,000 over 40 year and found that 70% of those with mental illness exhibit a methylation imbalance (undermethylation and overmethylation). This is relative to the general population, in which 30% had a methylation imbalance. Other Data From the Walsh Research Institute: * History of Postpartum Depression - 95% have copper overload * ADHD - 68% have a copper zinc imbalance * Autism Spectrum Disorder - 98% undermethylation, 98% low zinc * Antisocial Personality Disorder - 95% undermethylation, 95% pyrrole disorder, 95% low zinc * Oppositional Defiant Disorder - 85% undermethylation * Schizoaffective Disorder - 90% undermethylation * Anorexia - 82% undermethylation * Schizophrenia - 70% undermethylation * Violent behavior - 78% high copper Evaluation & Labs Are Still Important None of these are 100%. And, again, there is rarely one contributing factor, so a comprehensive evaluation and lab testing are still important. Even if I am fairly confident that someone is low in zinc, I don’t recommend starting zinc without checking zinc and copper levels. Starting zinc too rapidly can mobilize high copper and worsen symptoms. If copper is low, zinc can cause a further decrease. Also, there are occasions when it can be difficult to address an imbalance, without addressing another contributing issue first. For example, I see some patients who are unable to tolerate treatment of undermethylation until they begin treatment for candida or mold. There is always so much more data to share, when it comes to the Walsh Research Institute. I look forward to discussing biotypes of depression, ADHD and schizophrenia in a future episode. As always, I welcome your comments and questions. Until next time, Courtney To learn more about my discovery calls, non-patient consultations, and treatment practice, visit: CourtneySnyderMD.com Medical Disclaimer: This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

Mar 27

Children, Teens & Technology: Research & Resources for Parents

In light of the recent lawsuit against Meta and YouTube/Google, I want to share an overview of some of the research into the impacts of screen media on the development and mental health of children and teens. But more, I want to provide support and resources for parents. In this episode, I discuss: * The recent and expected deluge of lawsuits against social media platforms * Research into: * Infants and toddlers and screen time * Online learning in schools * Amount of time online in teens pre and post COVID * Chatbots and generative AI * Children’s exposure to pornography * EMF, which has a greater impact on children than adults * Support and resources for parents (see below) * The importance of aligning with children and teens around shared goals Referenced Resources * Boston Children’s Digital Wellness Lab * The 5 M’s of Digital Wellness * Family Digital Wellness Guide Assessing and Lowering EMF Exposure EMF and the Brain As always, I welcome your thoughts and questions. I learn a lot from your comments. Until next time, Courtney To learn more about my discovery calls, non-patient consultations, treatment or to inquire about mentoring, please visit my website at: CourtneySnyderMD.com Medical Disclaimer: This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

Mar 7

Stop Chasing "Anti-Aging." Lower Oxidative Stress Instead

In this short episode, I discuss the relationship between accelerated aging “oxidative stress.” Oxidative stress is what accelerates aging, promotes chronic illness, including brain related conditions, and depletes our energy, focus and quality of life. Our left brain would like to control our bodies and the natural order of things, while our right brain would have us paying more attention to our embodied short existence on this planet. Instead of focusing on “anti-aging,” we could consider ways to lower oxidative stress (in a relaxed way). Here, I comment on: * The double bind of aging in these times * What oxidative stress is * Signs and health conditions associated with oxidative stress * Causes of oxidative stress * General ways to address oxidative stress (more on this in future episodes) * The importance of lowering oxidative stress in a relaxed way (so as to not have undo stress increasing oxidative stress!) I look forward to sharing more details on limiting exposures, and supporting our antioxidant and detoxifications systems in future episodes. As always, I welcome your thoughts and questions. I learn a lot from you. Until next time, Courtney To learn more about my discovery calls, non-patient consultations, treatment or to inquire about mentoring, please visit my website at: CourtneySnyderMD.com Referenced Resources: Understanding the Impact of Toxins on the Brain and Brain Development Medical Disclaimer: This newsletter is for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment for either yourself or others, including but not limited to patients that you are treating (if you are a practitioner). Consult your physician for any medical issues that you may be having. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit courtneysnydermd.substack.com/subscribe

Holistic Psychiatry Podcast

Recognizing High Sensitivity in Children (HSP) & Helping Them Thrive

The Hyperfocus-to-Brain Fog Roller Coaster (And How to Get Off)

The Mold-Brain Connection: What You Need to Know

High Sensitivity Through 3 Lenses: HSP, Pyrrole Disorder & RCCX Theory

Why We Can't Separate Our Childhood From Our Physiology (& Biochemistry)

How Nutrients Impact Neurotransmitters & Walsh Data

Children, Teens & Technology: Research & Resources for Parents

Stop Chasing "Anti-Aging." Lower Oxidative Stress Instead

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Holistic Psychiatry Podcast

Episodes

Recognizing High Sensitivity in Children (HSP) & Helping Them Thrive

The Hyperfocus-to-Brain Fog Roller Coaster (And How to Get Off)

The Mold-Brain Connection: What You Need to Know

High Sensitivity Through 3 Lenses: HSP, Pyrrole Disorder & RCCX Theory

Why We Can't Separate Our Childhood From Our Physiology (& Biochemistry)

How Nutrients Impact Neurotransmitters & Walsh Data

Children, Teens & Technology: Research & Resources for Parents

Stop Chasing "Anti-Aging." Lower Oxidative Stress Instead

About

Information

You Might Also Like