GetzWell’s other “Dr. G,” Rachel Gilgoff, is a pediatrician specializing in integrative medicine who is passionate about helping kids find their vitality. Dr. Gilgoff takes a 10,000 foot view of each child and incorporates neurofeedback, mindfulness and other stress mitigation strategies along with nutrition, supplements and botanicals when appropriate. Families who’ve sought out her expertise rave about their results so we knew we had to share some here!
Let’s take you on 13 year old Alex’s* journey. He had been experiencing many different and seemingly unrelated symptoms including abdominal pain, anxiety, depression and insomnia. In fact, he felt so awful that he eventually refused to go to school and, as you can imagine, this led to big tensions between him and his parents. As the weeks and months wore on, understandably, Alex worried he would never get better, and as his symptoms worsened, his parents’ concerns grew. Eventually, they learned about Dr. Gilgoff’s impactful work with teens and teen anxiety, and committed to a full evaluation to determine the root causes of Alex’s symptoms. Within just a few months of working together, Alex’s symptoms–physical and mental–dramatically improved.
Read on to understand the process that led to Alex’s significant healing.
About Alex
When Alex first met with Dr. Gilgoff, he complained of daily headaches, frequent abdominal pain with constipation and lots of burping. He noticed he had been having more frequent asthma attacks and experienced anxiety, depression and difficulty sleeping, too. Alex’s teen anxiety often escalated to panic attacks with a racing heart and sweaty body. He worried he’d always feel this terrible and that this was “just how he was.” Eventually, Alex started refusing to go school, and he and his parents began arguing more and more.
Desperate to help their son, Alex’s parents sought the advice of a GI specialist for the abdominal pain and a neurologist for the headaches. In addition, Alex was seeing a therapist for cognitive behavioral therapy (CBT) as well as a psychiatrist who prescribed an antidepressant. The psychiatrist had also suggested adding ADHD and sleep medications, but Alex’s parents were skeptical, especially given Alex’s symptoms were only getting worse despite taking the antidepressant daily.
Dr. Gilgoff’s Evaluation
When a patient has a constellation of seemingly unrelated symptoms like Alex’s, rather than suppressing each symptom with a different medication, Dr. Gilgoff strives to uncover the underlying unifying biology or root cause in order to achieve meaningful improvements and restore vitality. In Alex’s case, Dr. Gilgofff used an integrative medicine lens as well as a stress-systems approach.
Using a careful and extensive interview process, Dr. Gilgoff uncovered some key stressors:
- Past: As a younger child Alex was held down multiple times for blood draws and procedures because he had numerous emergency visits and hospitalizations.
- Current: In PE at school Alex was required to participate in wrestling, which he hated. His parents insisted this was important – they wanted him to be a team player who didn’t quit. As you can imagine, this situation caused great tension and conflict in the family.
Additionally, Dr. Gilgoff used neurofeedback to look at the electrical activity in a few key areas of Alex’s brain. There was an excess of fast beta waves indicating too much arousal.
Alex’s heart rate and blood pressure were high for his age and his heart rate variability (HRV) was low, indicating a notable stress response.
All of these factors pointed to an overactive sympathetic nervous system that was keeping him awake, vigilant, and impulsive. His body was stuck in fight or flight mode!
The Root Cause of Alex’s Symptoms: Stressors + Stress Response = Nervous System Dysregulation
Overall, Alex’s symptoms and Dr. Gilgoff’s findings were consistent with nervous system dysregulation from past and current traumas. As illuminated in the book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, Alex’s emotional brain and body would viscerally remember that fear and pain even if his thinking, conscious brain couldn’t. Any slight discomfort or irritation caused an alarm bell in his brain. This hyperarousal and hypervigilance were leading to trouble sleeping and school avoidance.
The Treatment Plan
Dr. Gilgoff helped Alex and his family make the link between wrestling and past traumas in the medical setting. Once his parents saw this connection, they felt more compassion and empathy for Alex. This situation wasn’t about being a quitter, lazy or just “too tired” – it was about a biological response to the threat of being held down.
Dr. Gilgoff also explained that the stress response system was actually doing its best to try to protect Alex from a world in which people can hold you down, poke you or worse. She helped Alex understand that he was having normal reactions based on his past.
Dr. Gilgoff determined that they could reduce stressors and Alex’s stress response, both of which would help to heal his nervous system.
Reducing Stressors
For the time being, a note to get out of wrestling was important to avoid triggering Alex’s nervous system. Later, after he healed, they could revisit whether wrestling was an option. Dr. Gilgoff would also work with Alex to reset and re-regulate his nervous system through bottom-up approaches of neurofeedback and mental health therapy.
Addressing Alex’s Internal Dysregulated Stress Response System
Alex needed a “bottom-up” brain-biology-based approach to help his lower brain’s arousal and sensory systems feel safe. Nervous system dysregulation is a lower brain, instinctual, survival mechanism. Talk therapy and similar “top-down” approaches, like the cognitive behavioral therapy Alex was getting, wasn’t enough to downregulate his nervous system’s automatic response.
Neurofeedback is a “bottom-up” approach to calm an over-aroused nervous system. It helps decrease hyperarousal, hypervigilance, anxiety and sleep issues. Neurofeedback supports the brain in becoming more flexible so that it can more easily flow from an activated, energized state to a more calm and introspective one when needed. Soon, Alex felt much more relaxed, and as a result, he was able to get off screens and to sleep at night.
Dr. Gilgoff also referred Alex for EMDR (eye movement and desensitization and reprocessing), a bottom-up mental health therapy that targets the trauma symptoms.
Additionally, Dr. Gilgoff prescribed the following supplements based on lab tests revealing what he needed:
- Magnesium and vitamin B2 to calm the nervous system, prevent migraines, and treat constipation.
- High dose omega 3 to decrease inflammation, asthma, and depression symptoms.
Results
- Having an explanation for what was happening and the knowledge that there was something he could do about it almost immediately helped improve a number of Alex’s symptoms. With a school note to get out of wrestling, Alex was back at school and arguments with his parents dramatically decreased.
- Within about a month of starting neurofeedback and supplements, Alex was doing so much better. His headaches and abdominal pain resolved and his panic and anxiety symptoms improved drastically.
- Neurofeedback decreased his arousal, improved his sleep, and helped him be in a flexible, grounded, relaxed state.
- Within a few months of doing regular neurofeedback and taking supplements, Alex was weaned off his antidepressant and there was no need for additional medication.
Call us and let GetzWell Personalized Pediatrics help you find the answers to your family’s unique needs – this is our passion and expertise.
*Name changed to protect the patient’s privacy.