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What would your protocol be to address (possible high baseline levels) Epinephrine, especially as it pertains to Service Members, Veterans, First Responders who are dealing with PTSD, as well as in comparison with what you’ve taught re: leveraging Dopamine?

You have done a beautiful job - honestly, with every podcast and every topic! At 7 years old, I was in a medically induced coma due to Rye Syndrome (1980), not expected to live and if I did pull through, they said I’d be “retarded”. Thankfully, my grandma refused to let them unplug me. I started 2nd grade in the Seattle Children’s Hospital, and while I knew I should know more than I did (and I was angry and frustrated about it), I decided to spend that energy memorizing things (even though, at the time, they made zero sense to me; I was in survival mode). I was determined to get out of there and not only stay alert – stay alive- but also THRIVE. For this and many other reasons, I consider myself to be a life-long learner. Currently, I am a clinical psychologist (working from a growth-mindset/resiliency approach/not just focused on sxs). I work with Service Members, Veterans, and their families. I am also an Air Force Veteran, married to a Ranger (now math teacher). I come from a family of Veterans, and I am HIGHLY concerned about the rates of suicide in our community, and I am very committed to optimally influencing this Nation’s approach to serving those who serve; they deserve the best integrated and effective treatment approaches available. I thank you for your commitment to science and providing practical, affordable tools that anyone can implement; truly, THANK YOU. Ask me Anything Question: What would your protocol be to address (possible high baseline levels) of Noradrenaline/Adrenaline, Epinephrine, especially as it pertains to Service Members, Veterans, First Responders who are dealing with PTSD, as well as in comparison with what you’ve taught re: leveraging Dopamine? Considering the same basic foundational behavioral things: Sleep Nutrition Fluid Intake Movement • Except with Dopamine, often, they may be experiencing “stuck in a rut” with DA below baseline • With Norepinephrine (especially as it pertains to the locus coeruleus not shutting down in REM), if those suffering with PTSD have large amounts of Norepinephrine/Adrenaline, making it difficult to not only recalibrate during the day (to thrive vs. stay hyper focused on survival), but also inhibiting their quantity and quality of their sleep, would an optimal protocol be to practice ways to recalibrate from more of a SNS to a PNS while also redirecting/practicing the ability to shift focus such as with Space Time Bridging? • And considering what you have taught re: health and resiliency/recover approaches such as but not limited to: o Leveraging Dopamine o Sleep (with Dr. Gina Poe) o NSDR Practice o Meditation – as a focus exercise o Space, Time, Bridging o Breathing o Addictions/Recovery Discussions o Alcohol - taking into account the negative impact of alcohol, which is especially important for this population who are often self-medicating o Depression o Trauma While listening to your episode on leveraging dopamine, I began thinking about the locus coeruleus, especially regarding treatment for PTSD and the fact that without quantity and quality sleep (per your episode on sleep with Dr. Gina Poe), the locus coeruleus has been shown to not shut down during REM. Both you and Dr. Poe discuss the importance of PTSD treatments integrating sleep treatment/sleep hygiene as a critical component for treatment of PTSD. I agree and have created an IOP in our clinic where sleep is addressed for a full week! On average, re: the tx of PTSD, patients are often sent for an evidence evidence-treatment, such as CPT, PE, EMDR, even nightmare, rescripting therapies, etc.. However, in re: to the tx of PTSD, overall, sleep treatment more often than not – remains separate (with one clinic not talking to the other clinic or using integrative approaches) At the same time, SSRIs are widely prescribed as a first line treatment, which, as we know, are not less invasive than bx’al interventions. In fact, 2017 VA best practice guidelines even reports that bx’al interventions should be the first thing offered (sadly, they are not, although it appears they are trying to change this; I still see Patients prescribed many things before they end up in front of me as a last hope resort). In fact, common sense and research shows that behavioral intervention should be utilized first. Further, sleep as well as nutrition and physical movement, which are key components to recovery remain in separate clinics, separate treatments, and there’s no integration or discussion re: • SSRIs can interrupt sleep • as well as the fact that without sufficient sleep, how is it even possible for them to actually recover? • how are they really supposed to experience the physiological health- neurochemically that they need to recover? • I define recovery as experiencing relief from the frequency and severity/perceived stress of external and internal triggers, while simultaneously and in increasing measure, experiencing actual and perceived qualitative and quantitative improvement in all areas of health: physical, cognitive, emotional, spiritual/if that matters, and social… I was thinking about NSDR and practicing for 10 minutes once a day every day twice would be better increases dopamine 65% in the nigral striatal pathway, which helps people to then experience more motivation to engage in the behavior they are wanting to engage in to achieve their health goals…. However, considering (I’ll just say: adrenaline) neurochemicals that tend to have an amping up effect, which does help one focus during learning (including acetylcholine) - Question: Would Space Time Bridging, as well as (all the foundational basics) facilitate recalibration of levels of norepinephrine and adrenaline in the brain and body? I recognize it would be a way of training the brain to refocus its focus along the continuum of Dissociation – Interoception – and Exteroception…. Question: And what are your thoughts (I am very concerned) about the wide and chronic use of antihistamines as a way for Service Members and Veterans to go to sleep at night?! (which have been linked to increasing the likelihood of Alzheimer’s bc it not only dries out eyes and sinuses but also the myeline in the brain!) Optimal Response Initiative (ORI) – Common Sense, Insight, and Practical Application for Stay Alert – Stay Alive – AND THRIVE! I teach my workbook and program I created the Optimal Response Initiative (ORI) during which I teach them to set long-term goals in each area of health, (aka the destination), as well as identify and take action daily on two things a day they can do to fuel their health tank. This is a requirement in my program because without action, there is no optimal result. Movement also includes physical exercise; I tell them no less than 15 minutes a day, considering of course what they can, and can’t do re fx’g mobility, etc. For the sake of having a practical tool to address their physical sensations (with the SNS) as well as a way to use emotions as intel, I also teach the difference between physical energy and emote, energy (emotion: energy in motion trying to move up and out to give one intel about what they may need to help them move towards OPTIMAL (their goals) on the ORI Continuum Response Line. To the far left is “worst” to the far right is OPTIMAL. The goal is to identify where one is upon the ORI Continuum at any given moment (dealing with eternal, internal triggers/or both) and then utilize their power to choose which direction they want to move towards (a “better” or “BETTER”) more OPTIMAL Response. Of course, long-term they want to move towards OPTIMAL, but in the short-term moment, they might want immediate relief, immediate relief options may maintain an exacerbate the cycle of PTSD (and addictions to substances and/or other bxs). I am currently working on an OPTIMAL Response Initiative EXTREMES Workbook and Program that integrates current research as well. Thank you and your amazing team for considering my questions and concerns for our Service Members, Veterans, and First Responders. Kristina Seymour, Psy.D. Columbia, SC

Cause of Hyper/Hypo tension

I could not find a single good post in the net that explains the real cause of Hyper/Hypo tension going through the mechanistic process of blood pressure. Is blood pressure pathway being only through nervous system activating norepinephrine, adrenaline etc.? And how physiological, metabolic condition impact that course of action? Can you please have a dedicated podcast on this subject?

Sleep apnea

Dr. Huberman, thank you for everything that you have done with this podcast. You have undoubtedly enhanced everyone's lives with what you have brought to the public. Thank you. Wondering if you could do an episode on sleep apnea or discuss how to abate episodes? I have read that ~20% of Americans have some form, including my mom. I have heard mouth taping at night works but if there are other protocols? Thank you very much for reading. Also, any chance that you will host an event in Dallas TX soon? Griffin Wolfe

Plasma Donating

Dr. Huberman, Wondering if you can discuss the impact of donating plasma on the body (especially long-term health effects). I have donated 2x per week (max limit) for a year and a half. I have read a few studies but was unclear on the overall findings. Approximately 20 million Americans donate each year and we likely share the same curiosity. Thank you for everything you do. Griffin Wolfe

Night Terrors in Adults

Is there a herbal substitute for clonazepam to eradicate night terror episodes? Currently take magnesium bisglycinate and ashwagandha before going to sleep which don't seem to help.