Interview with Dr. Aviva Romm
Part 1: Overcoming Overwhelm ~ The Adrenal Thyroid Revolution
In preparation for the annual fall Southeast Wise Women Herbal Conference, Corinna Wood interviews Aviva Romm about her work with supporting women in "overcoming overwhelm" and getting out of S.O.S. (Survival Overdrive Syndrome), as well as some of the root causes of trauma and oppression that contribute to these health issues in the first place. Aviva Romm is a midwife, herbalist, and Yale-trained MD, bridging the best of traditional medicine with good science for over three decades.
Corinna: What is SOS, and how does it impact women you see in your practice?
Aviva: SOS is a term I coined which means Survival Overdrive Syndrome, and it's based on a few things: one, it started because so many of my patients were coming in and saying things like, "Aviva, Dr. Aviva, I feel like I'm constantly in overdrive. I feel like I'm always stuck in survival mode. I feel like I'm going from one thing to the next, and I can't turn off the stress. I'm constantly overwhelmed." I started to pay attention to the words women were using and at the same time started looking at the impact of various contributors to health and imbalance on what symptoms that they were exhibiting, for example brain fog, forgetfulness, poor concentration, weight gain, high cholesterol, high blood pressure, hormonal problems, insulin resistance, anxiety, depression, fertility challenges, mood challenges.
When I started to put it all together, it was really interesting that what I discovered was that the hormone cortisol which is the m ediator, if you will, or messenger coming from our survival system for so many woman was either in overdrive, they were producing too much and feeling the downstream impact of that which is all of the conditions that I've mentioned, or they had been in overdrive for so long that now they were experiencing the flip side which is that their bodies weren't producing as much cortisol or adrenaline. What they were experiencing was extreme exhaustion, often autoimmune conditions, recurrence of latent viral infections and things that were really taking them out, making them exhausted, and often sometimes so significantly that they were unable to participate in their lives. I put two and two together and said, "Wow, these symptoms, so many of them, if not all of them actually, are coming from the results of the impact of the survival response or stress response system on their health." I started calling it Survival Overdrive Syndrome, and my patients really related. They were like, "Oh, that sounds like me," and the term was born.
Corinna: You seem to view sleep as a form of medicine. I love that. How has your perspective on that developed, and would you share some of your personal and/or professional experience regarding benefits of sleep for women's health?
Aviva: Sleep actually is medicine, and it's particularly important medicine for SOS because much as we like to think of ourselves as modern human creatures, and much as science likes to tell us that nature is unimportant and science can always win over nature, the reality is that as human beings we are hardwired to be in harmony and relationship with our planet, including the 24-hour cycle of the Earth around the sun. That's called our circadian rhythm. Cortisol is released on what's called a diurnal rhythm, which means it's got two 12-hour cycles. Those 12-hour cycles together make up that circadian rhythm. Cortisol should be high in the morning, decrease throughout the day and be much lower at night to where it reaches its lowest point about midnight or 1:00 AM or so and then it starts to go up again.
If you think about your hypothalamus as the conductor of an orchestra, think about all the cells in your body as the orchestra and think about cortisol as the sheet music. Cortisol is telling each different cell in your body when it's time to play, what tune, how loud, for how long, and at what frequency. It keeps literally every function of our health - our heart rhythm, our immune system, our brain function, our elimination, our appetite, our thinking, our hormones - in rhythm with the cycles that they're supposed to be in. When our sleep gets disrupted, we become out of harmony with that circadian rhythm, and we pay for it in all kinds of ways.
We know from studies that have been done on nurses who work night shifts that because of this disruption, they are more likely to be overweight, have insulin resistance or diabetes, high blood pressure and high cholesterol, depression and breast cancer because of the dysregulation in the immune system and the ability to control inflammation. We know that when we're missing sleep at night it also doesn't give us the best habits the next day because we're tired, so we tend to want more coffee or to have more sugar or quick-burning carbs, so that adds to the vicious cycle.
Women who are not sleeping well at night tend to have more hormonal problems. We know that even a little bit of sleep loss on an infrequent basis can increase depression and so many more of the parameters that I've talked about. The vicious cycle about it all is that if you're under other kinds of stress other than just sleep disruption and that affects your HPA axis, your stress response itself can change the cortisol rhythm enough that that then leads to sleep problems.
Further, when your cortisol is elevated at night, it suppresses melatonin. If melatonin can't rise to the level that it needs to rise to help you get into sleep, then that’s going to have an impact on your sleep. Something a lot of people don't know about melatonin is that it’s not only a sleep aid; it's also a detoxifier for our body. One of the most important things it helps to detoxify is excess estrogen that we're producing in our bodies or that we're getting exposed to from the environment or more commonly both, which may be one of the key reasons that women who work night shifts as nurses have higher rates of breast cancer. They're not getting that healthy melatonin.
I came to understand this probably through two primary reasons. One is my study of adaptogens and HPA axis dysregulation and neuroscience, but also because so many of my patients who were experiencing all the symptoms that I was talking about earlier had sleep problems. I barely ever have a woman who comes in and says she's sleeping well.
We know that hormones have an impact on our sleep. I know the night before my period starts, for example. Beginning around when I was turned 48, I noticed the night before my moon time I never fell asleep as easily, and I commonly had a disrupted sleep sometimes with weird dreams, and then I'd wake up and there's my moon time starting. We go through life cycles like pregnancy where sleep is disturbed, new babies and nursing where our sleep is disturbed, and then perimenopause and menopause where we often have disturbed sleep. Then as we get older and melatonin production declines sometimes people who are more elderly also start to have sleep disruption.
I was seeing it left and right and trying to understand it. We can use chamomile, we can use lavender, we can use passiflora and all our beautiful sleep herbs, and that can really help someone to start to reset their sleep pattern, but sometimes what's going on is even deeper. It's cortisol disruption. The culmination of my research and what I was seeing in my clients really made a difference for me.
Corinna: You encourage women to be health rebels. How does your book give women the tools to get out of chronic overwhelm and take back their health?
Aviva: Okay, so there's a few things here. The 24/7 world we're living in is based on a very western model of achievement, productivity and capitalism. If you look at other countries, let's say some of the Scandinavian countries, they have a different value system that they're operating under. They value health, happiness, time off, social time, and family. They work shorter days, and some of these countries have four-day work weeks, and up to 18 months of maternity leave for women. You just put that right on the overlay of everything, and you're going to see lower stress. We live in a culture that is demanding more of us than we are evolutionarily capable of delivering, and it is killing us.
One of the ways that we can be a health rebel is by saying, "No, you can't have my health. You can't have my life. You can't have my mind, my mood, my body, my hormones," to the dominant culture. We do that by staking a claim for reevaluating what our priorities are, what our needs are, how we define success and within that how we create lives that keep us supported, replenished, nourished and healthy. We're redefining success as health, satisfaction, time to breathe, time to be well, and we're defining how we get to health as feeling replenished, nourished and having reserves. That means eating well, sleeping well, making time for being with the people we love, being creative. It does means making some decisions about what's important you. That's one thing.
Another thing is that as women, we have been taught to be nice, be good, play it small, be seen and not heard, be good girls. This can literally kill us. In fact, if you will, please link over to one of my blogs called, "How Being a Good Girl can be Hazardous to Your Health." Being a good girl can literally kill you. How do I mean? Well, let's say you go to the doctor's office and your doctor is saying, "No, I don't think you have a medical problem. You're just actually stressed, or you're a new mom," and it turns out that you actually do have a medical problem. You have an autoimmune disease or you have Lyme disease or you have something else going on, and you don't get that taken care of. What's the outcome?
What's the outcome if you are at a job and you're never getting the promotion that you deserve? Every guy around you is getting promoted, or you're being treated differently, or you're experiencing sexual harassment at work and you don't speak up. This can kill you short term or long term. We have to learn to smartly, wisely and safely of course - because we don't want to get assaulted or hurt - use our voices and speak up. We have to be rebellious.
How does the book help? I would say three ways. One, it gives women the background on how we are being mistreated and either under or over-diagnosed inappropriately depending on the situation. It gives women the reminder that we do have to speak up for ourselves and some tools to do that. Third, it gives women the tools to take back our health because the reality is we're not going to get most of that information that we need in the doctor's office even if we speak up and even if we have a doctor who's listening to us because western medicine doesn't really have the solutions for preventing and reversing most of the chronic health problems that we're experiencing as a result of SOS.
It has the treatments for reducing your cholesterol and reducing your blood sugar and giving you some neurotransmitters that might help your depression and pills that can help you lower your weight or sleep better, but most of those have unintended consequences that can cause as many symptoms as they're curing, and none of them are getting to the root cause that's leading to the problem in the first place.
I'd say the other thing and the final thing the book does that I think is so important is that it's not just a book. It's a community and a tribe. This is something I learned from women and the women who follow me as my tribe and hang out with me is that we do better when we do it together. There are times we all need alone. Many of us have solitary pursuits. I need to write alone, I need to think alone, I need to do my art alone, I need to do my prayers alone sometimes. When it comes to supporting each other and when it comes to staying motivated, it takes a village. It really does.
I saw this firsthand in a program that I ran online. We had 6,000 women in the group. The support and passion and energy and tips and ideas and love that these women were giving each other day to day, using Facebook as a technology to connect and communicate, blew me away. I was brought to tears every single day that I went onto the Facebook page.
One day I posted something about a replenishing bath, and it was just some Epsom salts and lavender in a bath. I posted it in the morning, and I came back to my Facebook page to follow up because I was committing to staying dialed into the group while we were running this 28-day program, which was totally free by the way.
By the time I got back to my Facebook that afternoon or evening, one of the women had written that "I really want to do this, but I'm so embarrassed, but I feel safe saying this. I can't stand looking at my body, and I can barely fit into my bathtub." I tell you what, Corinna, by the time I got to Facebook, 20 women had written responses. They were like, "Oh, we love you." Some of them said, "I've been there, I understand." Some of them said, "You're beautiful however you are, but we understand. We're just here to support you." They were writing things like, "Take the lavender and put it on a washcloth and throw it into a shower," or "Put the lavender and Epsom salts into a foot bath and do a foot bath." The woman was so supported. It was so beautiful.
One of the things I did with the book was to create a page on Facebook where women can connect and where I hang out also. I've also created an adjunct course, two courses actually. One is called the Ten-Day Adrenal Reset. It's a mini kind of stress detox if you will about healing women to get back onto a healthy circadian rhythm and self-care. The other is called Fear to Freedom, Perfectionism to Peace because as I said earlier, fear and perfectionism are just a couple of the patterns we develop as a result of that stress response to keep us safe. Mine might have been considered a perfectionism pattern. Always doing more, always achieving more, always making it perfect, always pleasing people, and fear of being stuck in that negativity bias.
Fear to Freedom is a program that women can access through my website. It was a free bonus with the book, but going forward it’s going to be a paid course women can join and do to help to rewire unhealthy neuro pathways and create new ones that maybe re-frames some of our special gifts. Maybe a perfectionist is really a high achiever, and that's a beautiful thing. Maybe somebody who always is a people pleaser really does love and want to serve people. It's learning how to honor and use and work with the gifts without the shadow side.
Continue reading Part 2: Health Impacts of Trauma & Oppression
Aviva Romm, MD
A midwife, herbalist, and Yale-trained MD, Board Certified in Family Medicine with Obstetrics, Dr. Romm has bridged the best of traditional medicine with good science for over three decades.
Founder and director of Southeast Wise Women and co-founder of Red Moon Herbs, Corinna has been practicing and sharing the Wise Woman Tradition of herbal medicine for over 25 years.