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Experiencing a bout of COVID-19 is bad enough. But for far too many people, surviving COVID leads to lingering neurocognitive, neuropsychological, or physical symptoms called long COVID, also known as post-COVID-19 syndrome or COVID-Brain. Of the over 40% of Americans who have had COVID-19, an estimated 19% of them meet the criteria for long COVID, according to the Household Pulse Survey. This means that over 25 million people are still struggling with symptoms related to infection with SARS-CoV-2. A 2022 brain-imaging study in Nature Medicine has identified an astounding 62 symptoms related to long COVID. These symptoms include but are not limited to: But new research shows there is hope for those dealing with long COVID. Results from a 2022 study in Scientific Reports show that hyperbaric oxygen therapy (HBOT), a noninvasive treatment, can produce changes in the brain that improve long COVID symptoms. Results from a 2022 study in Scientific Reports show that hyperbaric oxygen therapy (HBOT), a noninvasive treatment, can produce changes in the brain that improve long COVID symptoms.
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WHAT IS HBOT?

Hyperbaric oxygen therapy is a well-researched treatment that involves breathing 100% pure oxygen in a pressurized chamber. HBOT allows a person to increase the amount of oxygen taken into the lungs by as much as 3 times what is inhaled with normal air pressure. The blood then carries this extra oxygen throughout the body and brain, where it can accelerate the healing process of any damaged tissues.

HBOT BENEFITS LONG COVID AND OTHER CONDITIONS

HBOT is best-known for treating decompression sickness in deep-sea divers, but it has solid research showing that it is also beneficial for a wide range of other conditions, such as carbon monoxide poisoning, burns, wound healing, and fighting infections. People have reported benefits from HBOT treatment for many other issues, such as: The new research in Nature Medicine shows that long COVID symptoms can be added to this list. This randomized, double-blind, sham-control trial analyzed the use of HBOT on people with post-COVID symptoms that had lingered for at least 3 months after testing positive for the virus. For this study, 73 people were split into 2 groups with one group receiving 40 sessions of HBOT and the other group undergoing a sham treatment. The HBOT group experienced significant improvements in attention, executive function (clearing brain fog), psychiatric symptoms, sleep, energy, and pain. Brain imaging scans revealed that the HBOT group experienced increased blood flow to multiple regions of the brain associated with cognitive function and emotions. The study authors suggest that HBOT’s benefits are due to this increase in blood flow and neuroplasticity. Many brain SPECT imaging studies show that HBOT significantly improves cerebral blood flow. SPECT measures blood flow and activity in the brain and identifies areas with healthy activity, too little activity, and too much activity. Low blood flow is associated with a range of brain health and mental health issues, including traumatic brain injuries, exposure to toxins, ADD/ADHD, some forms of autism, addictions, Alzheimer’s disease, and more. For example, research in BMC Pediatrics shows that treatment with HBOT improves functioning in people with autism. A 2017 study on military veterans who experienced concussions due to explosive blasts found that they scored higher on cognitive, psychological, and physical exams following HBOT treatment. And a fascinating case study on a 58-year-old woman with Alzheimer’s disease found that after 40 sessions of HBOT, she experienced improvements in mood, energy, and her ability to handle daily tasks. Brain imaging scans for this case study revealed an increase in brain metabolism, prompting the study authors to suggest HBOT may hold promise as a therapy for people with Alzheimer’s disease.

HOW HYPERBARIC OXYGEN THERAPY WORKS

Treatment with HBOT involves lying in a pressurized chamber for a specified amount of time. HBOT can be delivered in either hard-shell chambers or soft-sided chambers. The hard-shell chambers can reach higher air pressures and oxygen levels than soft-walled chambers. Both types of chambers can offer benefits depending on a person’s individual needs. The number of HBOT sessions recommended also depends on your needs. A trained technician monitors each session for your safety and comfort. At Amen Clinics, HBOT may be recommended as part of a comprehensive post-COVID treatment plan. Depending on your individual needs, this may also include making lifestyle changes, addressing unhealthy thinking patterns, incorporating stress-reduction techniques, and more. Post-COVID brain fog, anxiety, depression, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. When a dull ache in your head turns into a pounding pain that lasts for hours—or sometimes days—it’s possible that a migraine has taken hold, making you long for a quiet dark room to minimize the throbbing discomfort. Way beyond being merely a “bad headache,” migraines can be debilitating until they subside. In the U.S., migraines affect almost 16% of people, and women have them 3 times more often than men. There may be a genetic link for this condition since it can run in families, and although the headaches typically begin during early adult years, children can develop migraines too. Despite the prevalence, the biological cause of migraine headaches is not fully understood, although progress continues to be made. Some research has indicated that dysfunction in the brain’s vascular system (blood vessels) and electrical signaling processes lead to decreased blood flow and contribute to terrible head pain and accompanying symptoms. However, why this happens remains unclear. If you suffer from migraines, it’s a good idea to investigate all the possible causes and triggers, which can include physical, psychological, and environmental issues. Functional (also called integrative) medicine physicians can help. If you suffer from migraines, it’s a good idea to investigate all the possible causes and triggers, which can include physical, psychological, and environmental issues. Functional (also called integrative) medicine physicians can help.
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TYPES OF MIGRAINE SYMPTOMS

Some people have migraines infrequently, while others have them many times a month—or even chronically. And there is a lot of variability in how the symptoms manifest. To begin with, there are 2 primary types of these headaches:
  1. Common migraines are ones without an aura and may come on quite suddenly.
  2. Classic migraines begin with an “aura,” which largely affects vision and can cause colored or blind spots, tunnel or blurry vision, or seeing flashing lights, stars, or patterns. Auras may also cause cognitive issues, fatigue, dizziness, a sensation of “pins and needles” in extremities, and other neurological symptoms.
The accompanying headache, which may be more intense on one side of the head, in the neck, or behind the eyes, can start anywhere from a few minutes to several hours after the aura begins. In addition, many people have other symptoms concurrently, such as nausea, chills, sensitivity to sound and light, brain fog, muscle aches, and other issues that add to the discomfort. Even after a migraine subsides, some symptoms may linger in what is often referred to as a migraine “hangover.”

MIGRAINE TRIGGERS ARE WIDE-RANGING

There are many potential triggers that can start the abnormal processes in the brain which lead to migraines, including: Beyond these common triggers, migraines are also associated with certain neurological disorders. Because of the abnormal vascular function in migraines, research has found evidence that they can be a risk factor for stroke. Literature published in the medical journal, Headache, revealed numerous studies have shown some overlapping neurological processes in epilepsy and migraines, and that the headaches and auras may even trigger seizures. Other research has found that many people who suffer from migraines have a history of mild traumatic brain injury. Furthermore, Irlen Syndrome, which is a visual processing problem that causes certain colors of the light spectrum to irritate the brain, leads to several symptoms, including migraines.

HOW FUNCTIONAL MEDICINE CAN HELP MIGRAINE SUFFERERS

Many people who suffer through the often-debilitating pain of these awful headaches struggle to find solutions to manage them. While certain medications can help with pain management, a holistic approach, such as functional (integrative) medicine might yield more effective long-term results for reducing the frequency and severity of migraines. Many people who suffer through the debilitating pain of migraines struggle to find solutions to manage them, but a functional medicine approach can make a positive difference for better results.
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Functional medicine practitioners have expertise in investigating and treating the root cause of complex health problems. In the case of migraines, the doctor will want to know the details of your symptoms, the frequency with which your headaches occur, lifestyle behaviors, and any other coexisting medical or mental health disorders. For example, it is not unusual for migraine sufferers to also have one or more issues, such as: In addition, some research has found that pro-inflammatory processes and oxidative stress can contribute to the onset of migraine symptoms.

A FUNCTIONAL MEDICINE APPROACH FOR MIGRAINE ASSESSMENT AND TREATMENT

Since so many things can play a role in triggering migraines, a functional medicine physician is likely to do testing and recommend different strategies to help figure out the specific factors that are contributing to the headaches. For example, the doctor may want to: A multi-pronged investigative approach will provide the integrative healthcare professional with a wealth of information about the underlying cause(s) of these debilitating headaches. From there, an individualized and comprehensive treatment plan with specific recommendations can be created and adjusted as needed. Each person’s recommendations will be different based on their unique needs, but examples may include: By following through with the functional medicine doctor’s suggestions and guidance, the recurrence of migraine headaches can be minimized—or potentially prevented—so they do not continue to be so disruptive to your life and sense of well-being. At Amen Clinics, our Integrative/Functional Medicine physicians are here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Talk therapy can be beneficial for overcoming trauma and other mental health conditions, but it can dredge up uncomfortable emotions, and it can take a long time to see results. What if there was a therapeutic option that worked more quickly without the emotional challenges? There is, and it’s called Eye Movement Desensitization and Reprocessing (EMDR) therapy. First developed in the 1980s, and now widely embraced by mental health professionals, EMDR has been shown to treat a number of conditions, most notably trauma, adverse childhood events, post-traumatic stress disorder (PTSD), as well as related mental health issues. And experts suggest it may be more effective than traditional talk therapy. Case studies and research are indicating that EMDR therapy may be helpful in alleviating a number of mental health conditions related to trauma, such as depression, eating disorders, substance abuse, and other psychiatric conditions.
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The process involves an EMDR therapist leading a patient through a series of bilateral (side-to-side) eye movements as they recall traumatic or triggering experiences in small segments until the painful memories no longer cause distress. EMDR essentially reduces symptoms of trauma by changing how memories are stored in our brains. What’s more, preliminary case studies and research are indicating that EMDR therapy may be helpful in alleviating a number of mental health conditions related to trauma. Here’s what you need to know about this relatively new psychotherapeutic treatment and what conditions it can help.

THE ORIGINS OF EMDR

EMDR was first developed by a psychologist named Francine Shapiro in the 1980s. She conducted a study focused on 22 subjects who had suffered some form of trauma.  After undergoing an initial EMDR therapy session plus follow-ups at 1 and 3 months out, the study showed that EMDR successfully “desensitized” patients’ traumatic memories and “dramatically altered their cognitive understanding” of the situation. Additionally, they experienced behavioral changes, which included being freed of their primary complaints of intrusive thoughts, flashbacks, interrupted sleep, low self-esteem, and relationship issues. The remarkable findings were published in 1989 in the Journal of Traumatic Stress.

HOW EMDR LESSENS TRAUMA

A traumatic event or series of events triggers the body’s fight-or-flight stress response, which is designed to increase our chances of survival. However, with trauma, the brain doesn’t process the event(s) properly, and it fails to file the memory as a past event. The stress response stays engaged, and the brain stays alert to danger, even when it is safe. Sights, sounds, or smells, get attached to the trauma memory, and they can become triggers. EMDR therapy helps our brain to process the traumatic memory that has the stress response and triggers associated with it and allows for natural healing to occur. The fight-or-flight response is essentially removed from the memory, yet the memory is retained. The memory of the trauma seems to be reconsolidated in such a way that it no longer causes severe distress when later recalled. When the PTSD symptoms are resolved or lessened, other conditions are helped too.

5 MENTAL HEALTH CONDITIONS THAT CAN BENEFIT FROM EMDR

1. PTSD

There are several forms of trauma: Nonviolent (emotional) trauma, adverse childhood events, and post-traumatic stress disorder. They all affect the nervous system and storage of traumatic memories in a similar fashion. PTSD is the #1 condition EMDR was developed to help. As such, there’s a wealth of compelling research indicating its efficacy. For example, a 2018 review of EMDR used to resolve PTSD examined a total of 2 meta-analyses and 4 randomized-controlled trials. The review concluded that EMDR therapy showed an improved diagnosis of PTSD and reduced its symptoms. It also helped reduce other trauma-related symptoms. What’s more, the studies reviewed indicated EMDR therapy to be more effective than other trauma treatments. An earlier 2014 review of 24 randomized controlled studies suggested benefits from EMDR therapy for emotional trauma and adverse life events. In some of the reviewed studies, 84% to 90% of people who experienced a single trauma found relief from PTSD symptoms after just 3 EMDR sessions. A Kaiser Permanente study involving 67 individuals with trauma assigned participants to either standard care treatment or EMDR. Compared to standard care, the EMDR group showed significantly greater improvement on measures of anxiety, depression, and PTSD, and a later follow-up showed the improvements were maintained at 3 and 6 months. The American Psychiatric Association and the U.S. Department of Veterans Affairs have recognized EMDR therapy as an effective treatment for PTSD.

2. Depression

Because EMDR has been proven to reduce rumination in patients with traumatic grief, researchers are now exploring it as a therapy to help those who suffer from major depressive disorder. So far, the research is promising. A 2013 review found evidence that EMDR may be a potential new approach to treating depression but suggested that more evidence-based studies are needed to be conclusive. More recently, research published in 2018 examined eight subjects with depression undergoing EMDR. Of the eight people engaged with the treatment, seven of them had shown “clinically significant and statistically reliable” improvement on the Hamilton Rating Scale for depression. The researchers concluded that EMDR is a feasible treatment for both recurrent and chronic depression. A 2021 meta-analysis of 11 studies went further claiming that “EMDR may be considered an effective treatment for improving symptoms of depression, with effects comparable to other active treatments.” However, it recommended more studies on the long-term effects of EMDR.

3. Eating Disorders

Eating disorders have proven difficult to treat through conventional methods. Mental health experts are now exploring EMDR as a way to help since eating disorders are often a maladaptive response to traumatic experiences. In one clinical case study, EMDR therapy played a critical role in the recovery of unremitting anorexia nervosa in a 17-year-old inpatient, helping her to return to a normal weight that was maintained at 12 and 24 months post-treatment. Another case report that examined EMDR and emotional eating found that the participant experienced an overall positive change in eating behavior. It also stated that EMDR might help to reduce weight over time and to improve results in maintaining weight after weight loss. A 2017 review published in Clinical Neuropsychiatry: Journal of Treatment Evaluation, concluded that EMDR holds promise for treating eating disorders, but recommended more scientific research for efficacy to be confirmed.

4. Substance Abuse

Similar to eating disorders, substance abuse issues are often associated with trauma and PTSD.  When EMDR has been used to treat both trauma and substance abuse, so far, research indicates positive results, although further investigation is needed. A case study followed 4 individuals suffering from both PTSD and substance abuse issues who underwent EMDR. The results suggested that the treatment of PTSD with the standard EMDR protocol “can have a positive effect on substance abuse disorder symptoms up to at least 12 months posttreatment.”

5. Comorbid Psychiatric Issues

In a review study titled “EMDR: Beyond PTSD” researchers claim that solid evidence shows that traumatic events can contribute to the onset of psychiatric disorders and can worsen their prognosis. The researchers sought to find if EMDR could help psychiatric comorbidities to trauma, including bipolar disorder, unipolar depression, anxiety disorders, substance use disorders, and chronic back pain. The review concluded that the available evidence shows that EMDR therapy improves trauma-associated symptoms in patients with comorbid psychiatric conditions. Additionally, it suggested that EMDR therapy could be useful in improving psychotic or affective symptoms, as well as helping with chronic pain conditions.

EMDR: A Viable Therapeutic Tool

The bottom line of the research on PTSD and other conditions shows that EMDR therapy is a viable and powerful psychotherapeutic tool on its own or in conjunction with other therapies. Post-traumatic stress disorder and other mental health disorders can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Does your life seem overwhelming at times? Personal responsibilities, taking care of family and managing a career, all at a non-stop pace that can get the best of even the strongest person. Fortunately, there is a way to prioritize yourself without diminishing the commitments you have to others. It all starts in your brain by working on your mental hygiene—a daily practice that is just as important as washing your hands. When you take the necessary measures to protect your mental health so you can function well, you support your mental hygiene, which is critical for thriving in anything you do. It is directly linked to your energy, mood, conscientiousness, motivation, and many other aspects of your life, including the ability to cope with challenges and setbacks. However, if you wake up every day wanting to pull the covers over your head, often feel stressed out, struggle with cravings, or have a mind filled with negative thoughts, chances are it’s time to make some lifestyle changes to elevate your mental hygiene—and improve your life. Mental hygiene is just as important as washing your hands.
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5 MENTAL HYGIENE PRACTICES TO PROTECT MENTAL HEALTH

Fortunately, even if you’ve never consciously paid attention to the choices and behaviors that diminish your mental health, you can change that. The practice of mental hygiene is something that can be easily incorporated into anyone’s life—and it doesn’t really cost anything. By adopting the following strategies, you can shift to new habits that improve your overall well-being.

1. Have a regular morning routine.

Starting each morning in a similar way can help you feel more grounded and focused as you prepare for the day ahead. Some people may find that sipping a cup of tea while reading or listening to the birds sing can help them feel centered. Others may spend 15 minutes in meditation, going for a walk, or doing some yoga. Whatever it is that helps you feel calmer and more mindful, rather than rattled and rushed, is good for your mental hygiene.

2. Disinfect your thoughts.

If your mind is filled with ANTs (automatic negative thoughts) that run rampant, it’s likely making you feel miserable, stressed, anxious, or depressed. Unfortunately, ANTs are very common—especially as social and political discord continue to abound, the COVID-19 pandemic still looms, and the nightly news seems to be filled with one tragedy after another. All of these can trigger the emotional centers in our brain, making those ANTs feel difficult to control. The good news is that you can get the upper hand with them by learning to challenge the ANTs that are infecting your mind. Here’s how: For each ANT you have, write it down and answer the following questions about it: Then, flip the ANT you started with to its opposite and see if this new thought isn’t actually truer—and more accurate—than the ANT is. Whenever you catch yourself ruminating on an upsetting thought, take a few minutes to challenge it. With practice, your thinking will become more realistic and improve your emotional health.

3. Fit in time for physical activity.

The many benefits of exercise for your mental and physical health can’t be overstated. Not only does it help with your fitness, but it also promotes the growth of new brain cells and increases the release of neurotransmitters like dopamine and serotonin, as well as endorphins, which are the body’s natural pain-relieving hormones. Physical activity can induce calmness and clarity, which elevate your mental hygiene. Exercising doesn’t have to be a chore—choose a variety of activities you enjoy. Better yet, get an exercise buddy to make it more fun. Even if you can only squeeze in 10-15 minutes at a time, it is still worth the effort.

4. Make good decisions about what you eat.

As Dr. Amen’s wife, Tana, always says, “Food is medicine, or it is poison.” Everything you drink or put on the end of your fork can help your feel energized and focused, or end up making you irritable, tired, and foggy-headed. A healthy balanced diet includes lots of fresh produce, clean protein, healthy fats, such as the ones from avocado and coconut, and foods like walnuts, salmon, and flax seeds that are high in omega-3 fatty acids. Starting your day off with a boost of protein, whether it’s a brain-healthy smoothie, eggs, or almond flour pancakes can provide you with the energy and focus needed to achieve your goals. Sugar, processed foods, and alcohol do not support your mental or physical health, so steer clear of these. To help you make better decisions about food and beverages, every time you plan to consume something, ask yourself, “Is this good for my brain, or bad for it?”

5. Prioritize your sleep.

When you don’t get adequate amounts of sleep, it affects the health of your brain and body beyond feeling cranky and tired. Sleep deprivation can increase the risk for mental health issues like depression and anxiety, make you prone to cravings, addiction, and brain fog, cause weight gain, and elevate the risk for type 2 diabetes and Alzheimer’s disease. One reason for this is that while you sleep, your brain undergoes a critical process during which it eliminates toxins and waste that are normal byproducts of cellular function. These mechanisms help to keep your brain healthy, which is a vital component of good mental hygiene. Making the necessary changes to get at least 7 hours of sleep each night supports your mental and physical health and will help you think more clearly, manage your thoughts, make better decisions, and give you the energy necessary to accomplish what you need to do. These guidelines can help you get the zzzzzz’s you need:

MENTAL HYGIENE FOR BETTER MENTAL HEALTH

Taking the steps to practice mental hygiene every day will help you feel better overall so you can enjoy the things that are important to you. Making changes might feel awkward at first, but by incorporating strategies like these into your daily life, you will quickly reap positive benefits that improve your energy and mood, support optimal mental health, and enhance the quality and success of your life. Anxiety, depression, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. When the anti-anxiety medications benzodiazepines hit the market in the mid-20th century, they earned the nickname, “mommy’s little helper.” The Rolling Stones even wrote a song entitled “Mother’s Little Helper” in 1966 that included these lyrics: Mother needs something today to calm her down And though she’s not really ill, there’s a little yellow pill She goes running for the shelter of her mother’s little helper And it helps her on her way, gets her through her busy day The song made reference to a little yellow pill, Valium, which remains one of the most commonly prescribed brands of benzodiazepines. Other widely used brands include Xanax, Ativan, and Klonopin. But research shows that “mommy’s little helper” can steal mommy’s mind. Scientists have long known that long-term use of benzodiazepines for the treatment of anxiety disorders or panic disorder can increase the risk of cognitive impairment or dementia later in life. A 2022 study in Nature Neuroscience provides new insights into how these drugs impact brain function, and it’s frightening. According to the researchers, benzodiazepines damage microglial cells, which then interfere with the synaptic connections that allow parts of the brain to communicate with other regions. When communication is disrupted, cognitive decline can occur. Research shows that “mommy’s little helper” can steal mommy’s mind. Anti-anxiety medications can increase the risk of cognitive impairment or dementia later in life.
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INCREASED USE OF ANTI-ANXIETY PILLS

This is extremely disturbing considering the increased use of such drugs. An estimated 66 million doctor appointments annually result in prescriptions for benzodiazepines, according to a report from the U.S. Department of Health and Human Services. This means that for every 100 adults who go to a doctor’s office visit, 27 will leave with a prescription for a benzodiazepine. Those numbers are getting even higher. A report released in 2020 pointed to a 34% increase in the number of anti-anxiety medication prescriptions filled during the pandemic. An even higher number, 38%, represented new prescriptions filled for benzodiazepines. This could signal a rising tsunami of dementia in the future.

CONSEQUENCES OF USING ANTI-ANXIETY MEDICATIONS

When you have anxiety or a panic attack, it can make you feel awful—nervous, fearful, jittery, breathless, and out of control. It’s no wonder people want fast relief and turn to quick fixes like benzodiazepines that can be prescribed by a primary care physician in a brief office visit. But the short-term benefits of anti-anxiety medications come with serious long-term consequences.

5 NATURAL WAYS TO SOOTHE ANXIETY WITHOUT PRESCRIPTION DRUGS

For all of these reasons, it is recommended to try alternatives to anti-anxiety pills whenever possible. Here are 5 strategies to soothe anxiety naturally. Note: If you’ve taken benzodiazepines for a long time, don’t stop taking them abruptly as this can heighten anxiety. Work with a physician to gradually taper off the drug as you try these other techniques.

1. Practice meditation, prayer, or self-hypnosis.

Research shows that all 3 of these techniques can help calm stress and anxiety. Check out 3 simple meditations to calm anxiety and discover more about how self-hypnosis can help. If you respond to prayer, recite your most comforting favorites or read Bible verses that calm your anxiety.

2. Do deep breathing.

Deep belly breathing can soothe anxiety, and it does it quickly. It can even help with panic attacks. Here’s how you do it: Take a deep breath in for 4 seconds, hold it for 1 second, then exhale for 8 seconds, and hold it again for 1 second. Repeat this 10 times, and it will induce relaxation. Watch Dr. Amen’s video on how to break a panic attack in 2 minutes where he demonstrates this breathing technique.

3. Learn to manage your mind.

Anxiety is often associated with anxious and fearful thoughts that make you feel bad. These automatic negative thoughts (ANTs) infest your mind and fuel anxiety. You can learn to gain control of your mind and eliminate the ANTs. Any time you feel sad, mad, nervous, or out of control, write down what you’re thinking. This helps get the ANT out of your mind. Then talk back to your ANTs and ask yourself if they are true. Chances are, many of your most worrisome thoughts are not true at all.

4. Try soothing activities.

Proven ways to decrease anxiety and stress include yoga, tai chi, and qigong. Make them part of your daily anti-anxiety practice. A 2017 EEG study that looked at brainwaves, concluded that qigong promotes a relaxed state.

5. Take calming nutritional supplements.

A number of nutraceuticals—such as GABA, l-theanine, and magnesium—have strong scientific evidence that they can be beneficial for anxiousness or stress. Anxiety disorders, panic attacks, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Struggling with a lack of concentration, muddied thinking, forgetfulness, memory problems, or other cognitive concerns? Occasional bouts of brain fog may be due to lack of sleep, overeating unhealthy foods, or the lingering aftermath of COVID-19. But, in certain cases of brain fog, there may be another underlying factor at work: anxiety. Anxiousness is characterized by a range of symptoms, both relatively minor (feelings of nervousness, tendency to predict the worst, or physical symptoms like muscle tension) and more serious (panic attacks and suicidal thoughts). Anxiety disorders are the most common mental health condition in the country, affecting more than 40 million American adults (and disproportionately prevalent among women, teens, and those with ADD/ADHD). When anxiety monopolizes the brain, other tasks suffer—including processing information, concentration, paying attention, and remembering. The result can feel like brain fog.
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THE ANXIETY-BRAIN FOG CONNECTION

The brain SPECT imaging work at Amen Clinics indicates that people with increased activity in the basal ganglia are vulnerable to anxiety. Other brain imaging research shows that ongoing stress actually causes shrinkage in the brain’s hippocampus, a region involved in the formation of memories. When anxiety takes over, the brain may not have the required capacity for other mental tasks, and a stress overload may decrease the generation of those neurons that typically form in the hippocampus. In other words, an onslaught of anxiety can cause problems with how the brain functions and how it retains information. When anxiety monopolizes the brain, other tasks suffer—including processing information, concentration, paying attention, and remembering. The result can feel like brain fog, a state that causes people to act spaced-out, distracted, or forgetful. SPECT can help determine if brain fog is anxiety-related, or if it might point to a serious long-term issue, such as dementia. SPECT is a functional brain imaging technology that measures blood flow and activity in the brain and reveals areas with healthy levels of activity, or too much or too little activity. Because brain fog can point to a bigger problem (for example, if it has persisted and/or worsened over time or is starting to seriously interfere with everyday tasks), it’s important to pinpoint the root causes and develop an appropriate treatment plan as needed.

3 TECHNIQUES TO CALM ANXIETY AND CLEAR BRAIN FOG

In some cases, it’s possible to clear brain fog and optimize cognitive function through brain healthy dietary choices, such as consuming filtered water, antioxidant-rich foods, and lean proteins, while aiming for the optimal nutrition-packed calorie counts on a daily basis. Additionally, nutritional supplements, including GABA, can help calm an overactive brain. But if anxiety, specifically, is at the root of brain fog symptoms, there are a variety of practices designed to help tackle that issue. A number of studies, for example, have shown that holistic and natural solutions—think yoga, tai chi, biofeedback, and meditation—are often helpful, and usually can be undertaken without the risk of negative side effects. Rather than reaching for anti-anxiety medications, which can carry serious side effects, try these techniques to lessen anxiety and thus free up some brainpower for healthier brain functioning:

1. Try diaphragmatic breathing.

Did you know stress negatively affects your breathing? Rapid, shallow breaths—common during bouts of anxiety—can actually impact the blood’s oxygen levels and increase anxiety further. Calm your nervous system by repeating 10 cycles of this diaphragmatic breathing cycle: Inhale through the nose for 3 seconds, hold for 1 second, exhale for 6 seconds, and hold for 1 second. A bevy of research shows that diaphragmatic breathing practices are associated with reducing the negative consequences of stress, with the added benefit of improving cognitive performance.

2. Connect with your spiritual side.

Saying a prayer or meditating can help distract a brain that’s riddled with worry, while also stimulating prefrontal cortex activity (an area of the brain associated with focus). Even reading religious or spiritual texts, writing out personal prayers or gratitude lists, chanting, or memorizing inspirational passages can work to calm stress. A review of 32 clinical studies showed that religious practices such as these were associated with reduced anxiety.

3. Decrease the stress response.

Tactics like hypnosis, guided imagery, or progressive muscle relaxation may mitigate anxiety and even offer up ancillary benefits like better sleep. Alternatively, soothing music may help calm the brain, reduce anxiety, and sharpen focus. Aim for tunes with a slower tempo (between 60 and 80 beats per minute) versus more aggressive genres (120 to 200 or more beats per minute). You can even compile your own relaxing playlist with happy-making melodies—simply press “play” in those moments when stress threatens to overwhelm. If calming anxiousness with these strategies doesn’t alleviate brain fog, it’s a good idea to consider getting a memory evaluation to determine what’s causing your symptoms. Brain fog, anxiety, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. A large 2021 study in The Lancet found that 34% of people who tested positive for COVID-19 experienced psychiatric or neurologic issues within the first 6 months of being diagnosed. Anxiety disorders ranked highest among the mental health conditions, affecting 17% of those infected. Another study published in 2021 in the Journal of Neurology, Neurosurgery & Psychiatry confirms that people who have tested positive for COVID are at a slightly higher risk for anxiety and depression compared with people who have never had the infection. The emerging research shows that you don’t have to be hospitalized or have a severe case to feel the mental health effects. Even people with mild cases of COVID-19 may develop anxiousness or panic attacks or may experience a worsening of anxiety symptoms. Experts point to several potential causes for the symptoms of long COVID, including inflammation and vagus nerve dysfunction. Experts point to several potential causes for the symptoms of long COVID, including inflammation and vagus nerve dysfunction.
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THE VAGUS NERVE, LONG COVID, AND ANXIETY

What is the vagus nerve? The body’s lengthiest cranial nerve, the vagus nerve stretches all the way from the brain to the large intestine. The word “vagus” means “to wander” in Latin, and this nerve essentially wanders throughout the body, connecting the brain, heart, lungs, gut, and intestines. It plays a role in a variety of involuntary bodily functions, including heart rate, perspiration, and getting food from the mouth into the stomach. The vagus nerve is involved in both the sympathetic (fight or flight) nervous system and the parasympathetic (rest and digest) nervous system. It activates the sympathetic nervous system when you’re in a dangerous or stressful situation and then switches back to the parasympathetic nervous system when the threat is gone. When vagal tone—how well your vagus nerve communicates with all these various organs—is healthy, your body is able to downshift back into relaxation mode more quickly. In some people, this important nerve can get stuck in fight-or-flight mode, ramping up feelings of nervousness and anxiousness Emerging research points to a link between long COVID symptoms—such as tachycardia (fast heart rate), dysphonia (difficulty speaking), and dysphagia (difficulty swallowing)—and vagus nerve dysfunction. One study used ultrasound to examine the vagus nerve in patients with long COVID and found changes, such as nerve thickening as well as signs associated with inflammation. Additional research suggests vagus nerve stimulation may have therapeutic benefits for those suffering from long COVID.

NATURAL WAYS TO STIMULATE THE VAGUS NERVE AND CALM ANXIETY

Here are 12 natural ways to stimulate the vagus nerve and elicit a relaxation response.

1. Get vocal.

The vocal cords located at the back of the throat are connected to the vagus nerve. Gargling, singing loudly, humming, or chanting activates the nerve and improves vagal tone. A 2019 study in BMJ Open found that singing significantly reduced anxiety over a 6-month period.

2. Go for a foot massage.

Reflexology is a method of massage that when used on the feet activates the vagus nerve, decreases sympathetic response, and lowers blood pressure, according to findings in a study in Alternative Therapies in Health and Medicine.

3. Try cold exposure.

Research shows that cold water immersion triggers vagus nerve activity that is associated with a decrease in heart rate. Take a cold shower, go outdoors on a frosty day, or simply immerse the top half of your face—down to your cheeks—in cold water to elicit the response. As an added bonus, research shows that cold water also reduces inflammation.

4. Use your mind to warm your hands.

Using metal imagery to warm your hands counteracts the stress response and increases parasympathetic tone and relaxation. A number of studies report lowered blood pressure with hand-warming, including one study from Korea, in which a significant decline in the systolic and diastolic blood pressure was observed in the treatment group.

5. Watch what you eat.

High-fat and high-carbohydrate diets have been found to impair vagus nerve signaling, according to a 2021 study in Scientific Reports. Conversely, consuming fiber-rich foods—such as oatmeal, broccoli, or chia seeds—improves vagal tone for better signaling.

6. Enjoy a belly laugh.

Letting out a good chuckle can stimulate the vagus nerve and promote relaxation in response to stress. One 2018 study in BioPsychoSocial Medicine suggests that simply hearing laughter can increase a parasympathetic response.

7. Meditate.

Decades of research show that this ancient practice stimulates the vagus nerve, decreases the sympathetic fight-or-flight response, promotes relaxation, and calms anxiety.

8. Get active.

Physical exercise promotes vagus nerve stimulation while lowering the stress responses associated with the sympathetic nervous system.

9. Blow on your thumb.

This may sound weird, but it works. Put your thumb in your mouth and blow on it, but don’t let the air escape. This odd trick activates the vagus nerve.

10. Breathe deeply.

Scientific findings indicate that slow diaphragmatic breathing activates the vagus nerve and reduces the stress response. It can also help break a panic attack quickly. To do it, lie on your back and place a small book on your belly. When you breathe in, make the book go up, and when you breathe out, make the book go down. Shifting the center of breathing lower in your body will help you feel more relaxed and in better control of yourself.

11. Listen to calming music.

Music creates vibrations that can impact the vagus nerve, according to scientific studies. Listening to relaxing music can trigger a parasympathetic response that reduces anxiousness.

12. Smell the lavender.

Aromatherapy activates the parasympathetic nervous system, according to research. Specifically, the scent of lavender was found to soothe anxiety in a 2017 study.

OTHER NATURAL WAYS TO SOOTHE COVID-RELATED ANXIETY

Natural supplements that can help promote relaxation and calm an anxious mind include: Anxiety, long COVID, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Have you (or a loved one) experienced a sudden change in personality? Have you noticed inappropriate social behavior, impulsivity, or emotional outbursts that are out of character? These could be signs of a disorder that most people have never heard of: frontal lobe syndrome.

WHAT ARE THE FRONTAL LOBES?

The human brain is a very delicate but vastly complex organ that is involved in everything we think, say, do, believe, and create. It is comprised of 200 billion neurons (a type of brain cell) and many distinct, but interconnected structures each of which provides a vital and necessary role in our human experience. The outermost portion of the brain is called the cerebral cortex—often referred to as grey matter. It is divided into four major sections: the frontal, temporal, parietal, and occipital lobes. Of these, the frontal lobe is the largest and is comprised of the prefrontal cortex and the motor cortices (plural for cortex). The frontal lobes are responsible for a wide range of higher-level functions, including: A healthy frontal lobe is paramount for personal autonomy, appropriate social behavior, good interpersonal relationships, information processing, and success in life. However, the brain’s fragile texture makes it vulnerable to damage. When this happens in the frontal lobes, a person may start acting and thinking differently and get diagnosed with what is called frontal lobe syndrome. When the brain’s frontal lobes are damaged, a person may start acting and thinking differently and get diagnosed with what is called 'frontal lobe syndrome.'
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COMMON CAUSES OF FRONTAL LOBE SYNDROME 

There are numerous ways the function of the frontal lobes can be disrupted. Some of the more common causes of this are:

Traumatic Brain Injury:

The frontal lobes are one of the two brain areas most often damaged in head injuries. The more severe the injury, the greater the number of symptoms and problems a person will likely develop. The famous case of Phineas Gage, although a dramatic example, is a good illustration of what can happen to this part of the brain after a serious injury. In the mid-1800s, Mr. Gage was a popular and affable man who worked installing new railroad tracks. One day while using a long tamping iron to pack down explosive powder, the powder ignited and caused the tamping iron to shoot through his cheek, brain, and the top of his skull, exiting completely and landing on the ground. Although he lost one eye from the incident, he survived physically. His personality, however, was a different story. The accident transformed him from being a well-liked citizen into a rude, inconsiderate, irritable, profane, and poorly behaved man. The tamping rod had significantly damaged his frontal lobes.

Cerebrovascular Disease and Stroke:

We have blood vessels—capillaries, veins, and arteries—throughout our body and brain. A disease called atherosclerosis (hardening of the arteries) is caused by the buildup of plaque and other substances in the arterial walls. This is often the result of high cholesterol, hypertension, insulin resistance, inflammation, or tobacco use, among other health problems. Over time, the arteries become stiff, brittle, and vulnerable to rupture, and plaques can obstruct the flow of blood in the brain. Both processes can cause a stroke, which can occur in many areas of the brain, including the frontal lobes. The resulting damage will depend on the severity and location of the stroke.

Brain Tumors:

A cancerous or benign tumor growing inside the brain or under the skull can destroy or damage cells, put pressure on brain tissues, or cause a buildup of fluid inside the skull and/or brain. Frontal lobe tumors can interfere with the way this part of the brain works.

Neurodegenerative Diseases and Other Conditions:

Although they are usually classified under their own disease category, many neurodegenerative processes can alter frontal lobe function. For instance, vascular dementia, which results from the aforementioned damage to blood vessels in the brain, is thought to be one of the more common causes of frontal lobe symptoms. Other forms of dementia as well as degenerative neurological conditions such as Huntington’s disease and Parkinson’s disease can deteriorate the frontal lobes. And, while not necessarily degenerative, brain infections and frontal lobe epilepsy can also affect behavior, movement, and thinking processes associated with this part of the brain.

SYMPTOMS OF FRONTAL LOBE SYNDROME

Because of their diverse functions and critical connectivity to other parts of the brain, injury to the frontal lobes can cause significant changes in the way a person behaves, thinks, and is able to function. In any individual, the symptoms that emerge will reflect the damage to the specific frontal lobe structures that have been impacted by injury or disease, and can include any of these: While many of these symptoms are seen in other mental health or medical disorders, when someone develops frontal lobe syndrome, these symptoms will be new for them. In other words, prior to the injury or disease, they were not noticeable concerns or were related to a previously diagnosed problem for which the symptoms have worsened since the damage occurred.

TREATMENT FOR FRONTAL LOBE SYNDROME

In addition to any medications or surgical procedures necessary for addressing the underlying cause of symptoms, treatment strategies for frontal lobe syndrome vary depending on the type and degree of damage to the brain. For example, when the motor areas are affected, physical rehabilitation can help someone build strength and function to the extent possible or learn alternative ways of moving. Other types of treatment may include: In addition, many people can benefit from making healthy dietary changes. Switching from a high-sugar, high-fat, processed-food diet to one that has clean and lean protein sources, plenty of fresh produce and foods that are high in omega-3s (such as salmon, walnuts, and chia and flax seeds) can help to support brain function and the recovery process. Brain injuries, concussions, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Modern medicine is full of many miracles. But are antidepressants one of them? A growing body of evidence suggests the meds taken by millions of Americans may not be the solution depressed people want. During the past century, we witnessed the eradication of some serious diseases, the development of cures for previously incurable illnesses, and medications to help manage the symptoms of what could otherwise be life-threatening conditions. Yet, despite the progress that has been made in numerous realms of the medical field, there has not been an equal degree of advancement in the treatments for mental health disorders, including depression. Despite the progress that has been made in numerous realms of the medical field, there has not been an equal degree of advancement in the treatments for mental health disorders.
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In the late 1980s, the now well-known antidepressant medication Prozac was introduced into our consumer consciousness because of its lower side effect profile and its reported ability to reduce symptoms. Following this, many other similar medications for depression cleared the FDA hurdles too, and launched the mind-drug revolution in the field of psychiatry. Since that time, prescriptions for antidepressants have been on the rise. Even before the COVID-19 pandemic exacerbated mental health issues for so many people, it’s estimated that more than 40 million people in the U.S. were taking an antidepressant.

HOW EFFECTIVE ARE ANTIDEPRESSANTS?

The theory behind the way these medications work is that they increase the availability of certain neurotransmitters in the brain—serotonin, norepinephrine, or dopamine—which are chemicals associated with our sense of well-being. Therefore, it would seem to make sense that antidepressants could potentially be the solution for anyone struggling with depression. Unfortunately, that is far from the reality of the response rate to them. Although people struggling with severe depression often benefit more from antidepressants, scientific research has repeatedly found that the average rate of symptom remission from taking these medications hovers somewhere between 30% and 50%. Ironically, in many studies on depression, placebos (fake pills) have a 50% response rate as does psychotherapy. An important reason why more people don’t get relief from antidepressants is that depression does not have a singular cause. There are numerous underlying factors that can lead to depressive symptoms, including: In addition, symptoms of depression are linked to unhealthy lifestyle habits, such as a poor diet, overeating, smoking, addictions, and being physically inactive. Furthermore, depression frequently accompanies medical problems. A research study published in General Hospital Psychiatry looked at the data from 30,801 adults with chronic medical conditions, including high blood pressure, diabetes, and stroke, among others, and found that their risk for depression was 3 times higher than that of healthy control subjects.

ANTIDEPRESSANTS AREN’T THE ANSWER TO A BETTER QUALITY OF LIFE

A 2022 study in the journal PLoS One analyzed the data on more than 17 million people who had depression along with at least one medical condition. The researchers specifically looked at the differences in the mental and physical components of the health-related quality of life (HRQoL) between those who took antidepressants for their depression and those who did not. In this study, the mental components of the HRQoL assessment measured each person’s social functioning, psychological distress, any role limitations from mental health problems, and a sense of well-being. The physical components they evaluated were energy level and fatigue, pain, overall health, and role limitations due to medical conditions. The researchers were surprised by what they found. Compared to the people not taking an antidepressant, those taking them had some mild improvements in some of their mental scores but had no significant improvement in their physical scores. In other words, antidepressants were not helping them have a better quality of life.

4 BASIC STRATEGIES TO GET HEALTHIER AND BOOST YOUR MOOD

Most people will agree that having a good quality of life is important on so many levels because of its direct impact on our mental health and physical well-being. It can help to provide us with a sense of purpose and meaning and feel connected to others—without which our lives can feel empty or insignificant. Because of this, it is vitally important to take preventative steps to protect your health as much as you can. And, even if you’ve been bad to your body and brain, you can choose to make positive changes now that will serve you well. Some basic strategies to prioritize your overall health should include:
  1. Getting an annual check-up and following your doctor’s recommendations for the treatment of any health problems. Ask your doctor to help you create a plan to overcome or best manage any medical concerns.
  2. Switch from a high-fat, high-sugar diet to one that includes clean protein, low-glycemic carbs, healthy fats (like avocados), and plenty of fresh produce—research has found that the more daily servings (up to 8) of fruits and vegetables a person consumes, the better their mood is.
  3. Get regular exercise. Physical activity is so important! If you’ve been a couch potato, start with a walk around the block and increase the minutes you walk each day. Gardening and housework count as physical activity too. Not only does exercise improve your fitness and help with weight management, it also boosts brain chemicals that improve your mood.
  4. Manage your stress. Whether it’s with supportive counseling, meditation, yoga, tai chi, or learning to extinguish the automatic negative thoughts (ANTs) swirling around your mind, it’s critical to find a way to minimize your stress because it can be a big driver of health problems and depressive symptoms.
Getting control of your physical health is fundamental to not only having a better quality of life but also helping to keep psychiatric issues from holding you back. Change can be hard and giving up those bad habits can be a challenge, but you can do it. Start with one healthy thing at a time and notice that when you experience success with it you will be naturally motivated to keep going in the right direction. As the saying goes, “Every journey begins with a single step.” Depression and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Sensationalized in films and TV, such as Sybil, Split, and The Three Faces of Eve, dissociative identity disorder—once called multiple personality disorder—remains one of the most misunderstood mental health issues. The condition is characterized by a disconnect between memories and a person’s sense of self and involves the presence of at least two distinct identities within a single individual. These identities—known as splits or alters—have a profoundly negative impact on a person’s quality of life. Yet, many people refuse to believe the condition is real.

WHAT IS DISSOCIATIVE IDENTITY DISORDER?

Dissociative identity disorder (DID) is one of 3 types of dissociative disorders—the other 2 types are dissociative amnesia and depersonalization/derealization disorder. Approximately 2% of the general population are affected by dissociative disorders. DID is more commonly diagnosed in women and is estimated to affect up to 1% of people. In DID, which involves multiple distinct identities, these splits or alters can have different names, mannerisms, genders, ethnicities, memories, interests, tones of voice, and speaking patterns. Many people with DID are unaware of their alternate personalities.

DISSOCIATIVE IDENTITY DISORDER SYMPTOMS

In general, the criteria for a diagnosis of dissociative identity disorder include: For a DID diagnosis, these out-of-character behaviors, thinking patterns, and interests cannot be the direct result of mind-altering substances, a religious practice, or a medical condition. Other signs and symptoms of dissociative identity disorder include headaches, out-of-body experiences, self-harm, and suicide attempts. One study in the journal Psychiatry that analyzed 236 people with DID found that 72% of them had attempted suicide. Violent behavior may also be present and is more commonly seen in men. These symptoms can make it extremely challenging to navigate everyday life, careers, academics, and relationships. People with DID may also have co-occurring mental health problems, such as:

WHAT CAUSES DISSOCIATIVE IDENTITY DISORDER?

What makes someone vulnerable to such a complex disorder? Experts say experiencing physical, sexual, or emotional abuse during childhood is the biggest risk factor for developing DID. Dissociation is believed to be a way for children to cope with, or compartmentalize, the ordeal of ongoing adverse childhood experiences. In a study in the Canadian Journal of Psychiatry, researchers interviewed over 100 people with DID and found that during childhood 90% of them had suffered sexual abuse and 84% had suffered physical abuse. More than half of these individuals reports that the sexual or physical trauma commenced before they reached their fifth birthday. On average, the abuse lasted a decade. Experiencing physical, sexual, or emotional abuse during childhood is the biggest risk factor for developing dissociative identity disorder (formerly called multiple personality disorder).
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Other risk factors for DID include childhood exposure to war, violence, or natural disasters.

WHAT BRAIN IMAGING SHOWS ABOUT DISSOCIATIVE IDENTITY DISORDER

Brain imaging offers clues about the development of dissociative identity disorder. A study in The American Journal of Psychiatry found that key structures in the brain involved in memory and fear have decreased volume in people with DID. The volume of the hippocampus was over 19% smaller and the amygdala was 31% smaller in those with DID compared with healthy individuals. A 2020 systematic review of the neuroimaging findings related to DID also showed smaller volume in parts of the frontal lobes involved in fear learning and the parietal lobes involved in personal awareness. People with DID had heightened levels of white matter, which plays a role in communication in areas involved in feelings, memory retrieval, and perception. The study authors concluded, “The neuroanatomical evidence for the existence of DID as a genuine disorder is growing and the structural differences seen in DID patients’ brains, as reviewed in this report, contribute to that growth.”

TREATING DISSOCIATIVE IDENTITY DISORDER

Treatment for DID often includes psychotherapy to work through any past childhood trauma, learn to manage symptoms related to the condition, and blend alternate personalities into a single one. One technique that has shown benefits for trauma survivors is EMDR (eye movement desensitization and reprocessing). Some people with DID have shown improvement with hypnosis. In fact, research shows that hypnosis played a pivotal part in successfully treating the first-known case of the disorder in the 1830s. In treating DID it is also critical to address any co-occurring disorders, which may involve medication and natural therapies. Dissociative identity disorder and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.