By Courtney Snyder, MD
Half of my work day is spent honing in on details. For each person I evaluate and treat, I’m considering multiple symptoms, lab data, contributing factors, and treatment interventions. Left unchecked, this amount of detail hurts my brain - figuratively and literally. This type of work might be considered “left brain“ and appealing to someone who is “undermethylated,” which I am.
The other half of my work day is involved with addressing how, from a spiritual perspective, we:
By spiritual, I mean our inner life. My writing and teaching about the intersection between neuroplasticity and spirituality is essentially about how we exercise those parts of the brain that relate to that inner work. Instead of honing in on details, this is about pulling back and looking at the bigger picture of our lives and our humanity. This right brain work feels good.
Psychological Risks of Functional Medicine Approaches
While identifying root causes can be important in a healing process, there are risks. The amount of details involved can be overwhelming. It can put some people at odds with their body; giving them a sense that the goal is to exert control over their biochemistry and microbiome, as opposed to bringing them back in balance as much as is possible. The details can lead to the notion that there is a “right way” - that if we do everything right, everything will be fine. Those who are “undermethylated” are especially vulnerable to this type of black and white thinking. Such thinking can get in the way of healing and the experience of wellbeing. Most people I treat are undermethylated.
Methylation relates to a biochemical process (involving methyl and folate). It is pivotal in the functioning of detoxification pathways, the repair of DNA, the breakdown of histamine, epigenetic expression (“the turning on and off of genes), and neurotransmitter activity. Families with methylation imbalances have a higher incidence of psychiatric conditions, neurodegenerative diseases, cancer and cardiovascular diseases such as strokes and heart attacks. The understanding of the relationship between methylation and brain related symptoms comes out of the work of Dr. William Walsh, PhD and the Walsh Research Institute.
Undermethylation can result in low neurotransmitter activity (relative to overmethylation in which there is too much). This low neurotransmitter activity can be a contributing factor in brain related diagnoses such as depression and ADHD, but also bipolar disorder, schizophrenia and various forms of addiction.
We all fall on a spectrum of how “methylated” we are. About 70% of people with brain related symptoms have a methylation imbalance (most of which are undermethylated), compared to 22% of the general population. Most physicians, CEOs, attorneys, accountants, engineers, and competitive athletes are likely undermethylated. If you’re interested in functional medicine blogs and reading this, you too may be undermethylated.
Multiple genes determine our methylation status (MTHFR being just one). An overgrowth of Candida in the gastrointestinal tract can also contribute as well. Candida makes a toxin that inhibits methylation. Antibiotics, because of their potential to kill off beneficial bacteria that can keep candida in check, could thus exacerbate undermethylation. There is also evidence that early caregiving plays a role. One study found that mice who weren’t “licked and groomed” by their mother were more likely to be undermethylated and anxious, versus those that had appropriate caregiving and had normal methylation and were calm. Heavy antibiotic use, a Western diet high in sugar and carbs (which feeds candida) and the low value placed on early caregiving in our culture is a recipe for an undermethylated collective.
Symptoms of Undermethylation (Rarely does someone have all of these)
Diagnoses Associated With Undermethylation
The Incidences of Undermethylation (from the Walsh Research Institute)
Assessing for undermethylation is done through a medical evaluation - a careful review of symptoms and traits and a whole blood histamine lab test (which is usually elevated in those with undermethylation). If necessary, a methylation profile - also a blood test - can be completed. Often, however, those with undermethylation can be recognized before doing labs and in some cases even before taking a history. Questionnaires completed with great detail, an exceedingly neat appearance, and beautiful penmanship can be clues to undermethylation. I’m pointing this out, not as criticism, but to make the point that our biochemistry shapes us is surprising ways.
As I mentioned I'm undermethylated, fitting with my being a physician. My art also points to undermethylation in that my collages have repetition, precision and a calculated balance of light, dark and medium colors. Whether you like or dislike my art may depend in part on your own methylation status.
Treatment of Undermethylation
From a biochemical and nutrient standpoint, the way we address undermethylation is often to provide nutrients that compensate for deficiencies in the methylation cycle - Methionine, S-adenosylmethionine, Magnesium, Calcium, and Vitamin B6 to name a few. For some individuals with high homocysteine levels, this level has to brought into the optimal range before undemethylation can be addressed.
We also use dietary interventions including a relatively high protein diet (methyl is from protein) and avoidance of folic acid, and high folate foods (for those with evidence of low serotonin activity, e.g. depression, anxiety). This isn’t with an intention of changing someone’s personality, but rather to alleviate symptoms that are impacting their quality of life. (If someone is undermethylated without evidence of low serotonin activity, then folate would be encouraged in their diet and/or supplementing.)
Undermethylation and the Left Brain
Though both brain hemispheres are continuously working together in complex ways, there are attributes which are more strongly associated with each side. In the most primitive sense, we’re using our left brain when we reach out to grasp a berry. We’re using our right brain when we scan our environment, notice the berries over here, the nuts over there, and the lion in the distance that could be ready to ruin our day.
Though undermethylation is a biochemical difference, it has many traits consistent with those of the left hemisphere. Similarly, the diagnoses associated with undermethylation generally are the diagnoses associated with right hemisphere dysfunction (and thus a relatively overfunctioning left hemisphere).
A brilliant book about the right and left hemispheres is “The Master and His Emissary - The Divided Brain and the Making of the Western World” by Ian McGilChrist, MD, a Scottish Psychiatrist.
The Left Brain Personified
To oversimplify Dr. McGilChrist's work, if we were to personify the left brain, it would be like a person who -
Relationship to Others:
Relationship to Objects:
Relationship to Body:
Emotions & Outlook
Relationship to the Future
The Left Brain Perspective
As you can see, the left brain sees the world quite differently than the right. The left brain would have it's sights set on success, titles, money, objects or anything else that feeds the “I.” It will also have us obsessing over our health, excessively surfing the internet for answers, and micromanaging every everything we put into our body. It doesn’t have the ability to see the “big picture,” which the right hemisphere does. Therefore, it has a hard time pulling back far enough to see how it’s way of thinking may be getting in the way.
As Dr. McGilChrist's book points out, while our western culture would have us believe the left brain is the master. It is not. The left brain ideally is working for the right brain. As Einstein said, “The intuitive mind is a sacred gift and the rational mind is a faithful servant. We have created a society that honors the servant and has forgotten the gift.”
The Right Brain Perspective
When we are viewing the world more from the right brain, we are in the moment, experiencing ourselves as part of something larger than ourselves, feeling connected to humanity, seeing the bigger picture or our lives, and feeling in tune with our bodies (not hyper-focused on parts of our body or on our biochemistry). It is predominantly from the right brain that we create, laugh, cry and experience wonder, curiosity and awe.
A totally right brain existence can be problematic as well. We do need a degree of structure to our lives and to our emotional states to avoid becoming overwhelmed and lost. Still, for most of us, bringing more of a right brain perspective can bring an ease to life that the left brain never will. Too it can lower stress hormones and inflammation.
If you are someone grasping for “success” as our culture sees it, keep in mind that the most successful (in all senses of the word) are going to be those who make decisions from the intuitive right brain and then use the left brain to essentially get the details of the job done. If you are just honing in and never pulling back to see the big picture, you’ll miss a lot, not the least - your life - your fleeting moment here on earth.
It’s arguable if the soul resides anywhere within us, it would be in the right hemisphere; while the ego would be in the left. Just as the left brain isn’t bad, neither is the ego. It’s just not an effective place from which to make decisions. It’s a different experience, and even outcome, to do something to serve oneself (a project, a career, a relationship) than to do it with the purpose of serving others or a higher good. It’s one thing to choose a path because it’s impressive and another to choose a path because it’s aligned with who we uniquely are. If you’re unsure if you operating from the soul or the ego, pay attention to how you feel - uptight, stressed, or open and trusting.
So how might we find peace “in the right hemisphere,” especially in a world and culture that would have us grasping, pushing, doing, fixing, getting, worrying, and clinging to outcomes from our left brains? I’ve listed some ideas. You may have your own that resonate specifically for you.
“Exercising the Right Brain”
1. Simplify - Practice letting things go and growing clarity about what matters and what doesn’t - especially if our left brain has collected a lot of things, a lot of titles, a lot of ego supporting, though unsatisfying relationships
2. Gratitude Lists - Move our brains beyond ruminating, getting and planning to a place of gratitude for what is.
3. Letting Go - We can recognize when we are clinging to outcome and clinging to certainty. We can recognize this for what it is - an illusion of control. Let go of worries as if they are balloons or write them on a piece of paper and dropping them in a box - call it what you want - a “God Box” or a “I Control Nothing Box.”.
4. Practice Mindfulness - Being only in the moment: savor every bite of a meal, sit and listen to music while doing nothing else. When you go reflexively for that phone, that food, that purchase - ask yourself who's driving: your left brain or your right brain?
5. Notice Others - Not as separate, but as part of the same humanity. Consider their experience, their struggle and how they might feel. Look into their eyes. Be with them and resist interrupting or imposing your agenda, opinion or need to fix them.
6. Be Embodied - Notice your breathing. Notice when you have a strong emotion what you experience in your body. Acknowledge any anger you may have towards your body. Be grateful for you body, consider it as a home for your mind, your heart and your spirit. Sing. Dance. Stretch. Move.
7. Exercise - Not to look good, not to be better than, but to simply be in your body. Experience your wholeness and the wonder that you even exist.
8. Be in Nature - Savor the beauty. Be humbled by your small place in the natural order of things.
9. Do Something Spontaneous: Just follow your gut and see where it takes you. Take a walk without a destination. Write in a journal whatever pops into your head. Do anything that you normally think of as frivolous.
10. Shift Your Intention - Instead of doing something to get what you want or accomplish what you want, shift your thoughts to how what you are about to do can serve a higher good. Perhaps even invite the universe to use you for a higher good. This is a great way to take the pressure off because it will move you from performing to feeling supported by unseen forces within and outside of you.
Likely anything you think of that feels good is going to be relatively right brain [I don’t mean any addictive type behavior that leads us to checking out from our feelings - which would be left brain.].
Inner Work and the Right Brain
For many of us, these types of “exercises” or what I would call inner work is done in isolation. It was for me, until I read the following quote by Parker Palmer:
“First, we could lift up the value of “inner work.” That phrase should become commonplace in families, schools, and religious institutions, at least, helping us understand that inner work is as real as outer work and involves skills one can develop, skills like journaling, reflective reading, spiritual friendship, meditation and prayer. We can teach our children, something that their parents did not always know: if people skimp on their inner work, their outer work will suffer as well.
Second, we could spread the word that inner work, though it is a deeply personal matter, is not necessarily a private matter: inner work can be helped along in community. Indeed doing inner work together is a vital counterpoint to doing it alone.”
Exercising The Right Brain But With Others
Upon reading this, I felt “called” (a concept my left brain would find amusing) to start a discussion group, called Pragmatic Spirituality. My husband and I have facilitated these discussions for the past 2 years. Marty works with organizational and leadership development. He too is undermethylated and thus has a tendency toward his left brain, at least by history. Facilitating and being part of this group has shifted us both gladly in the direction of the right brain.
Given the repeated messages we get from our left brain culture, we all have deficits when it comes to our brain hemispheres. Because of neuroplasticity, however, we essentially can rewire neurological pathways by getting those neglected neurons firing. This is the neurobiology of spiritual growth.
All that being said, I also take supplements to help address undermethylation. I eat a diet high in protein (to increase methyl) and minimize inflammation and toxicity which undermethylated people tend to be more susceptible to. None of these strategies, however, feel as good as those that heavily rely on the right brain. Like many people with undermethylation, I've had times when I've found myself engaged in repetitive and potentially addictive activities, specifically internet surfing and overeating. This was much more frequent when I was in the throws of inflammation.
By addressing inflammation and shifting to a more right brain perspective these tendencies have subsided. Now, I more easily recognize when I need to see the bigger picture. To do so has allowed me to be more effective, has improved my health and made everything more meaningful, including writing these blogs. What at times was a relatively perfectionistic and self conscious pursuit, is now an enjoyable process. The start of this blog was an open attention to what interests me and what seems to be a need of those I see and who read this blog. The middle involves a narrowing of my attention to the nuts and bolts of the topic. The end is a pulling back, letting go and having a sense of peace that I've given what I have to offer, however small, to something larger than myself.
To learn more about methylation, visit - "Epigenetics, Methylation, MTHFR & the Brain, Made Easy...er"
I'm a conventionally trained child, adolescent and adult psychiatrist. My current approach to health is both holistic (pertaining to the whole person) and functional (addressing the root causes of illness). I write this blog to share what I've learned.