The Root Causes of Anxiety – A Functional Medicine Approach | Podcast #370
Conventional medicine labels anxiety as a neurotransmitter imbalance and relies on pharmaceutical drugs to dampen the symptoms. Although, prescription medications can be a helpful and even necessary tool in periods of overwhelming anxiety. But we have so many more tools at our disposal than just medications!
Dr. J and Evan explain that they recognize that anxiety is often the proverbial “tip of the iceberg” in functional medicine. It’s the clear and present warning that something is going on below the surface that needs our attention. Our current circumstances may have been the breaking point, but the anxiety manifests in underlying issues. That’s why rectifying these issues is necessary to make anxiety more manageable or even eliminate it!
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
2:06 – Acute and Chronic Stress
4:06 – Amino Acids and Herbs
11:24 – Gut Issues
16:26 – Functional Medicine Approach
Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house with Evan Brand. Today, we’re gonna be talking about the root causes of anxiety, a functional medicine approach, and how to get to the root cause. Really excited about this topic. We see many functional medicine patients with these exact issues and we always want to get to the root cause of why that is so. Evan, how are we doing man?
Evan Brand: I’m doing good. You know the anxiety story for you and I talking about anxiety goes back literally eight years. It would have been late 2014 when I was in my luxury apartment in Austin and I was calling you and I was saying, “dude, I can’t stop this”. My heart is pounding. I’m freaking out. What the heck is going on and you said, “man, if you go to the emergency room, all they’re gonna do is they’re gonna give you some sort of anxiety medication. So why don’t you go and take about a gram of magnesium and see what happens.” And so, that’s what I did. I think I might have had some pharma GABA or some other tools on hand, maybe some passion flower and luckily, I calmed it down but little did I know back then that I had some of the big root causes of anxiety that were unresolved which included mold toxicity, Lyme, Bartonella, some of these tick-borne infections that drive up the nervous system, unfortunately. Now, knock on wood, anxiety’s been a minimal to non-existent part of my life and It’s incredibly freeing because anxiety can be so debilitating that people become housebound or they become afraid to travel, they become afraid to go on planes. They become afraid to seek the raise at their job. They just want to live in this little cocoon because they’re so afraid and anxiety is also very debilitating for children too. It affects their confidence and their self-esteem and their motivation for school and how they get bullied and so, I mean, we could do an hour on this but think just to open this thing up with a bang, I would say that infections are a big driver of anxiety so whatever that is a tick-borne infection like a Bartonella, Babesia, Lyme situation or gut infections like we’ve talked about a thousand times in the last 10 years together which is parasites, bacterial overgrowth, worms, Candida, anything that’s gonna release a toxin or aggravate the immune system.
Dr. Justin Marchegiani: Yeah. 100%. So anytime you look at anxiety, you always have to get to the root cause, right? Obviously, if it’s unresolved emotional stress, your body is designed to create anxiety for a certain situation, like if you, I don’t know, if you have lived in a forest across the street and there are bears, there should be a healthy amount of anxiety so you know, don’t leave food out and you’re just a little bit more careful with your habits so you don’t get attacked by a bear, right? There’s a healthy bit of anxiety there which is good to kind of keep you on edge so you are alert and you make good decisions. We’re talking about things that are, you know, unhealthy amounts of anxiety where you don’t have those types of emotional stressors, right? Obviously, if those emotional stressors are there, kind of take inventory of them and figure out what that corrective action is you need to kind of close the anxiety loop. I always say close the anxiety loop. What is that action? You have to take that allows you to feel confident that you are not ignoring the reason why there is anxiety there. If you did that, great, awesome. Check that off your list. The next thing is like you mentioned, obviously, any type of chronic stress or acute stress can create anxiety, right? And so, chronic and acute stressors do different things to your body. They’re going to cause B vitamins to get recycled and used up at a higher rate. They’re gonna cause magnesium to get used up at a higher rate. They’re gonna put you in a fight or flight position, where your body goes into fight or flight and then that’s gonna cause increases of cortisol, increases of adrenaline and it’s gonna cause your brain to get hyperactive and obviously at the same time it’s gonna affect digestion too when you’re in fight or flight. It’s gonna decrease your body’s ability to make stomach acid and enzymes and it makes it harder for you to break down your food. And so, and then of course, the more stressed you are, now you’re gonna start craving more processed foods that increase dopamine and increase a lot of those, uh, feel-good brain chemicals to buffer that but so, I always look at like what’s the constructive vehicle to fix this, what’s the destructive vehicle. Destructive vehicle feels good at the moment but creates problems down the road. Constructive helps at the moment. May not, maybe not quite as fast but then actually gets to the root cause over time. And so, some of our constructive vehicles like you already mentioned, magnesium, right? Theanine, right? B6, B5, right? And I always look at nutrients first, like nutrients are in the hierarchy before herbs so nutrients first and then, in the hierarchy coming down would be herbs, Ashwagandha, passion flower, Valerian. Those things are nice herbs that kind of activate and stimulate GABA. So, GABA is an inhibitory neurotransmitter. So, it’s the brake pedal on the nervous system. So, think of the gas pedal as adrenaline, as cortisol. That’s the fight or flight nervous system response and the gas pedal is gonna be GABA and the things that are gonna help with GABA are gonna be Taurine, Theanine, GABA in and of itself. And then on the herbal side, things like Ashwagandha have multi-adaptogenic effects. They can increase cortisol and increase stimulation when things are too low but they can also tamp it down when it’s too high. I like my wife. She was really stressed the other day. We are getting our kids out for an easter party and she’s like, “you have something to give me? I am so stressed.” And I’m like, “here you go”. And I gave her a bunch of GABA, Taurine, and Theanine and magnesium, some B5 and vitamin C and some Ashwagandha and she looked at me like two hours later, she’s like, “what the heck did you give me. I’m on cloud 9.” I’m like, yeah, you know that, the better living through chemistry right there.
Evan Brand: That’s great. Yeah, and motherwort. I love motherwort too. It’s great for the anxiety when you’re having, like, heart palpitations, blood pressure type issues as well.
Dr. Justin Marchegiani: Hyperthyroid too. They use it on hyperthyroid, as well.
Evan Brand: Yeah. That makes sense.
Dr. Justin Marchegiani: Too high thyroid, it can also be. It can help dampen that down, as well, which is nice.
Evan Brand: It’s great for grief too so like the cool thing about certain herbs is they can be an emotionally calming tool but they can be a nervous system calming tool too. So, like, as you mentioned, there could be an emotional thing like a bad boss, a bad spouse, a bully. You know that type of emotional anxiety driver but it could be a chemical driver too, meaning like a toxin driving the nervous system to be ramped up. Also, we should talk about blood sugar. I know we’ve done podcasts on this before but you know there’s a big impact on issues with blood sugar. Thank the Lord, my blood sugar is so good now, I could eat dinner at five and not eat till 1pm the next day and I’m stable, like, I can fast for extended periods of time as needed and I don’t have any issue but however when my gut was a wreck which I want people to pay special attention to, if your digestive system is compromised, you’re not gonna be tolerating fasting that well because you’re already so likely nutrient deprived because of the malabsorption due to the infection. So, years ago when I tried doing this type of fast, I would have major anxiety and that’s low hanging fruit so do what you got to do but you got to get your gut tested and then fix the infection first.
Dr. Justin Marchegiani: 100%. So, just kind of looking at a bunch of different things. So, on the emotional side, right? If it’s unresolved emotional trauma that’s creating anxiety, you know, someone wrote about DNRS, that’s great. You know, this NLP, where you kind of visualize a stop sign or something to kind of do a pattern interrupt. That’s excellent. EFT, EMDR with eye movement or different tapping on meridian points to kind of dampen down that sympathetic nervous system response. And again, these are gonna be good, you know, uh, more chronic issues. Yeah. If it is an acute issue, you know, a lot of times, just get to the root underlying issue where that issue is acute.
Evan Brand: I was on a plane one time and the turbulence was so bad and I started tapping on the plane. That really helped. I’m like okay. Even though it feels like this plane is about to crash, I love and accept myself and I’m like okay that’s fine.
Dr. Justin Marchegiani: Yeah. Especially things like that. You don’t have control, right? There’s nothing you can do outside of just sitting there and getting through it. And so, it’s better when those things are kind of the case but you know, it’s kind of like, I’m just trying to think of you know an example, it’s kind of like, you go upstairs and don’t turn the alarm on for the house or like maybe did I leave the front door unlocked, right? And so, there’s a natural bit of anxiety. You start going down to bed and that little bit of anxiety kind of creeps in, you’re like, I’m not gonna be able to get to sleep fast if I don’t at least just check on the front door, right? So, let me make, oh good, it’s locked. Oh good, the alarm is on. Good. Now, that anxiety can go down because it’s there for a reason, right? So, if there’s a root cause, act on it, right? If there’s isn’t a root cause, right, but it’s more emotional, you can do some of the tapping and you can work with a practitioner to get to the root cause on that and then of course having better biochemistry will get will make every bit of anxiety better because you’ll be able to adapt to it and deal with it better. And so, of course, like we already talked about with cortisol, chronically high levels of cortisol and adrenaline are gonna be big so you have to get to the reason, the root cause why. And again, foods could be a reason why like gluten, too much processed sugar that can drive up that anxiety. Again, you already mentioned blood sugar fluctuations. If you’re on this reactive hypoglycemia roller coaster ride where blood sugar goes up because you ate too much processed carbohydrate, refined foods, junkie, vegetable oil, omega-6 fats. Blood sugars up and then it can crash right back down. The crashing is where you tend to get a lot of adrenaline cortisol stimulation and on the way up, you get lots of insulin so you get this insulin-cortisol-adrenaline kind of tug of war happening and that can be very stressful on the body. And then, of course, if your blood sugar is chronically high and you’re making tons of insulin that can also be a problem too. High levels of insulin can cause all kinds of problems with hormones, especially in women, it can cause issues with ovarian cysts and testosterone problems. And then, high levels of blood sugar deplete a lot of your B vitamins and magnesium. And so, if we have poor levels of B vitamin and B6 and B5 and B1 and B2 and B3 and folate and B12 and magnesium is depleted, that’s gonna cause more stress and more cortisol issues and it’ll be harder for you to deal with and adapt to that.
Evan Brand: And I would say, if you have anxiety longer than the week, I would almost consider that chronic. I mean, it’s crazy to me, how many people you have and I’ve talked to over the years who’ve had anxiety for a decade or longer and sometimes as one person commented that anxiety and OCD together is terrible. A lot of times OCD does come hand in hand with anxiety. We’ve done podcasts specifically about amino acid therapy and we use amino acid therapy in our clinics but if you have OCD, anxiety, low self-esteem, worry, negativity, depression, disturbed sleep, those are all symptoms of low serotonin. So, what you need to do is to get an organic acid test so we can measure this and look at the brain chemistry because if you’re not testing, you’re guessing. So, when you’re listening to this conversation about anxiety, I swear to you, you’re never gonna find a psychiatrist that’s gonna say, “hey, maybe we need to run an organic acids test, maybe you have low brain chemistry because you have bacterial overgrowth. So, we’re also gonna run a stool test. If they’re out there, send them our way, we’ll do a podcast with them but I doubt your psychiatrist is ever gonna consider running functional medicine testing on you to investigate this. I don’t care if you do lorazepam or the klonopin or whatever. It’s not the root cause and it’s gonna dig you.
Dr. Justin Marchegiani: Any benzo
Evan Brand: Yeah. Any benzo is gonna dig you further in the hole because now you’ve got this dependency issue and now you’ve got his issue of withdrawal and I don’t know if you’ve read some of the stories on this but my God if people try to acutely stop those benzodiazepines, there’s major major major side effects. So, it’s just not around
Dr. Justin Marchegiani: Especially, if you’re on doses, you know, above one milligram or so on a benzo, it can be harder to get off and sometimes the taper can be, you know, six months to a year coming off of it. If you’ve been on it for a while or been on a higher dose. Yeah, you need to kind of do a slower type of taper for sure.
Evan Brand: And there’s so much, I mean, just think of how many millions. I didn’t look at the numbers here but how many millions of people are on prescription anxiety medication and they never ever get to the root cause. It’s so sad to think about someone that’s been on like a Lorazepam or another benzo for 20 years and they’ve never once asked about the gut. The question came in, how does dysbiosis cause anxiety. What are the mechanisms? Well, I think, one, right out of the gates is gut inflammation. Number two would be nutrient malabsorption because as you mentioned, a lot of these B vitamins are necessary for many processes in the body including energy production so sometimes you have anxiety and chronic fatigue and that sucks too because now you’re too tired but you’re anxious so that’s not a fun recipe either. What else would you say about the gut anxiety connection?
Dr. Justin Marchegiani: Well, so anytime you have chronic gut inflammation whether it’s from food, whether it’s antibiotics. Antibiotics are creating rebound yeast or bacterial overgrowth. We could put H. pylori in that category, and other infections, as well. That’s a one you and I already mentioned, creates malabsorption just from indigestion, right? Not enough enzymes, not enough acids, not absorbing things well. Two, you’re gonna have exogenous production of lipopolysaccharides which in and of itself are a toxin, right? They’re produced, they’re part of the gram-negative bacteria in the gut and they’re stressful on the liver and there’s also can go to the blood-brain barrier. And when they’re in the brain, they can create mood and anxiety issues as well. So yeah, lipopolysaccharides, you could have acetaldehyde and mycotoxins from fungus. You could have issues with the parasites producing their own type of internal toxins for sure. Of course, your body also produces through healthy gut bacteria, a fermentation process to make its own B vitamins, vitamin K. Those kinds of things. So, if we have dysbiosis, we typically are gonna have low levels of beneficial bacteria so we don’t have that good endogenous production behind it. And then, of course, that’s gonna over activate our immune system. So now, we have all these toxins kind of slipping through our bloodstream. We have undigested food particles, getting through our bloodstream. Now, our immune system starts becoming hyperactive and that can suck up energy. That can suck up resources. So, there’s studies on for instance H. pylori creating mental health issues, mental, emotional issues, depression and anxiety partly because of the lipopolysaccharides and endotoxins are the same thing by the way. LPS or endotoxins and obviously nutrient absorption problems too.
Evan Brand: Man, when I had H. pylori, I was super anxious. I don’t know if I was depressed as much but I was definitely anxious and you remember how skinny I got, I mean, I lost so much weight too. So, a lot of people, you know, they look at anxiety on the surface right. And everyone looks anxiety is just like this mental thing and you just need to watch some hoorah motivational video and just get over your fears and that I was like no anxiety goes way deeper than that. You just eloquently illustrated this, the aldehydes from the yeast and the fungus toxins and the bacterial toxins and the parasitic toxins and the mycotoxins. You guys, this anxiety is not in your freaking head. It’s not. It may manifest in your head but the root cause is not in your head unless you’re describing like, this toxin getting across the blood-brain-barrier but beyond that, the gut I would say is the biggest driver of anxiety. I’d say, if I had to pick one place to look, it would be the gut.
Dr. Justin Marchegiani: Yeah. So, when we look at this, what’s kind of the hierarchy of addressing this? So, of course, you fix the foods, right? Because the foods are one. You’re gonna decrease inflammation from the foods. And the inflammation in the foods is gonna cause gut permeability so you cut out the gluten, the dairy, the processed refined sugars and flours, the junky omega-6. You focus on good high-quality animal-based fats, good healthy proteins, you know, more carbohydrate from fruit and starch, especially if there’s blood sugar issues and then from there, then you work on digesting it. So, make sure enzymes and acids and good digestion are there. Get your gut looked at especially if there’s any type of chronic bloating or motility issues or indigestion, unadjusted food in your stool, diarrhea, then you get your gut looked at and of course if this issue is more chronic, you want to look at your stress handling system so the interplay sympathetic and parasympathetic nervous system in your body and your nervous system is your adrenals and so you can get your adrenals looked at cortisol rhythm wise, you can do a cortisol panel. Look at your cortisol in the morning and throughout the day. Make sure it’s not too high or it’s reversed. On a good organic acid test, we can look at neurotransmitters like Vanilmandelate which looks at adrenaline. We can get Homovanillate which looks at dopamine, right? We can get the DOPA which looks at dopamine. We could also get 5-hydroxyindoleacytate to look at serotonin and then of course we can look at B6 like a kind of urenate or xanthurenate, right? We can look at brain inflammation markers like picolinate and quinolinate so there’s inflammation in the brain that gives us more indications. We can look at oxidative stress markers like 8-hydroxy-2-deoxyguanosine. There are good markers out there to look at these different things to give us a window of what’s happening so you know, we work on the food, work on the lifestyle, sleep. Make sure we’re digesting and breaking things down. Look at the nutrient deficiencies, look at the gut, look at the infection, look at the digestion and then of course, you know, we can always branch out and look at mold or mycotoxins or heavy metals or more toxic burdens down the road. That’s the foundation first and then I would say on top of that, if there’s any type of chronic pattern where there’s an emotional trauma involved that’s more unresolved definitely bring in a good practitioner, you know with some tools in their tool bag of NLP or EFT or EMDR or hypnosis. Anything that you want techniques to get into the subconscious but again the healthier you are the better the emotional stuff is to resolve so if you’re doing EMDR and EFT and NLP and you’re eating processed food and crap, it can still work, but it’s gonna be better when your brain chemistry is healthier.
Evan Brand: Oh, yeah. Amen. Well, think about all the people that are in talk therapy and then they go and they go eat a subway sandwich for lunch, thinking that they’re doing themselves a good favor by eating turkey on wheat bread with processed cheese and then they get mayonnaise or sweet and sour sauce on it or whatever the heck they’re doing and then they feel like crap, I mean.
Dr. Justin Marchegiani: Yeah. I’m not a big fan of talk therapy in the long term. I think, talk therapy is good did you kind of just consciously process something like how did this happen maybe you’re learning some tools to enter into your life from a habit standpoint to fix whatever that issue was but then most of that trauma sits in the subconscious area of the brain which is where 90% of all your thoughts are subconscious and so that’s where you want some of these techniques like we talked about but I think talk therapy is good to acutely process what you’ve observed whatever your experiences are and then talk about, hey what can you do, you know, as a person today as an adult today, um, you know, from a habit standpoint to address it but then after that then you gotta, you know, if you’re in talk therapy months and months later and you’re still just ruminating over the same thing then it’s a subconscious thing you got to work on next.
Evan Brand: Yeah, and look, don’t let me talk people out of doing it. I’m not trying to do that but what I’m saying is I’ve had people that said, “oh yeah, I’ve been with this therapist for 3 years and I meet with them every week or every other week”. And I’m like, “okay and what do you do with this therapist?” “We talked.”, “Okay and what else do you do?” That’s it. It’s talk therapy and I go, okay, you’ve been doing talk therapy every week or every two weeks for 3 years and you still have anxiety that’s this bad. We got to dig deeper. So, like I said, there’s a role for that but it’s not gonna get you out of the woods. The person who commented about the dysbiosis and anxiety question, they also commented in here said they did have a stool test that showed H. pylori. They have extremely high Morganella which is one of those bacteria we’ve talked about and calprotectin which is gut inflammation over a thousand. Fatigue and anxiety were the main symptoms. We see this everyday all day.
Dr. Justin Marchegiani: Yep. Exactly. I’m familiar with that case for sure. And inflammation in the gut can definitely create those types of issues and get to the root cause of it too. And then, someone writes in, about Accutane too, I mean, this is super common if you get into the dermatology world. I mean, dermatologists, they either cut something. They burn it off with a laser. They freeze it off or they use some type of antibiotic, topical or internal or they use some kind of like, synthetic vitamin A. That’s it. That’s the dermatology world you know in a nutshell and they tend to not get to the root, you know, we’re talking like more chronic acne, chronic skin stuff. They tend to not ever get to the root cause of how or why that’s even there. Diet, sugars, junky, omega-6, poor digestion, poor fats, poor proteins. They don’t really get to the root cause of what that is and so, they recommend synthetic vitamin A, which is Accutane, which again, will decrease the amount of oil produced by your sebaceous glands which can be helpful in the short run if they’re producing too much oil but they can create chronic skin and eye dryness in the long term and they’re not even getting to the reason why your skin’s producing too much oil to begin with. Usually, it’s too much insulin. Insulin is a huge driving factor of excess oil and then of course, you have different food allergens, gluten, dairy, too much sugar. That can also cause a lot of problems with the skin cells.
Evan Brand: And not to mention, the connection between people that have anxiety and acne. Guess what, they’re both linked to the gut. So, if you have acne and anxiety, you gotta investigate your gut. Please. Please. Please.
Dr. Justin Marchegiani: Yep. 100%. And again, you know, outside of that, you know, we look at different toxins down the road. If we look at heavy metals, there’s different tests. We can look at, to do a challenge test on your metals with a DMPS or some kind of a challenge agent. We can definitely look at mold if there’s mold in the environment that’s important to look at. And again, if you’re in an environment where you feel better leaving that environment then there could be some mold in there, especially, if a history of water damage that was unresolved, definitely want to get your mold looked at or just your home looked at too, especially if it’s something that the whole family is dealing with just get the home looked at to start. It’s usually cheaper and more effective out of the gates.
Evan Brand: Yeah. well said. And, heavy metals too. I’m glad you brought that up. You know, mercury and other heavy metals that can stimulate the nervous system and cause issues. So, if you have a bunch of silver fillings in your mouth, you’ve got to consider that. May not be your number one smoking gun, sometimes it is but heavy metals are a big problem and even detox too can make people feel too sick. I mean, you and I have seen this many times. Other practitioners that have handled people before they come to us or they’ve done something too aggressively with chelation or other detox methods and then they’ve ended up worse. So, there’s like a tight rope and that’s where the art of medicine comes in. Everything is not just like cookie cutters. So, too much is a problem. Too little is a problem and that depends on gut and detox and beta glucuronidase and liver and all of it. So, like if your friend got better and you tried what your friend did and you didn’t do well, that might not be your right protocol.
Dr. Justin Marchegiani: Yeah. Exactly. And then, just to kind of highlight the nutrients in, compared to talk therapy, Julia Ross is out there. She’s like a family therapist person but she’s done a lot of books on amino acids and diet and she had different clients that she used to use talk therapy for years and years and years and said, “hey, let me just try adding in some amino acid therapy to their protocol and let’s see how they do with their talk therapy when we add in the amino acids”. She started to do that and then these patients would come the next week and they’d be like, “Yeah, just, I’m just good. I just don’t even feel the need to talk about it. I’m over it”. And it’s like wow so it’s like it gives people the equipment to kind of, like, process these issues and again I think talk therapy acutely may be fine. It’s just when you’re talking about the same thing for years and years and years, you’re probably not getting to the root cause, right? This is probably just covering up something else, you know. Now, I think it’s better than being on a drug, right? So, if it’s helpful and you don’t need a drug that’s great but, in the end, you know, if you can do some of these nutritional things along with it, you may find that you can just deal with the issues better you know I, the analogy I get patients is, try dealing with difficult problems around the home and not having slept for a couple nights. You’re gonna lose your patience with your wife with your kids. You’re not gonna be able to think right, you’ll be foggy, get some good night sleep and then wake up and deal with the problem. It’s like you’re gonna be way more equipped to deal with it. I think that’s kind of how brain chemistry works when you’re dealing with these stressors.
Evan Brand: Yeah. Absolutely. Well, I remember in that book too, talking about how, like, amino acids were administered, right? At the beginning of a session and then the people would just immediately like, smile or loosen up or relax and so it’s amazing no matter how much you talk. Long story short, I know we’ve beat the drum on this for a minute but last thing, no matter how much you talk. It’s never gonna change your levels of serotonin just by talking it out. If you have a gut problem that’s affecting your nutrient absorption which is affecting the tryptophan and the conversion with the B6 over to 5HTP and then over to serotonin and then to melatonin so sleep issues too. So skin, sleep, anxiety, they’re all connected depression. We’ve already talked about that. This person here’s putting a bunch of question marks like they’re mad at us. What is the connection between Accutane and depression?
Dr. Justin Marchegiani: It’s just a side effect. It’s a side effect of the drug.
Evan Brand: It could be a side effect. Yeah.
Dr. Justin Marchegiani: Yeah. Just the side effects of the drug. That’s all it is. Yeah. So certain drugs, you know, are gonna have side effects. Ibuprofen can cause ulcers and liver issues, right? Just a drug side effect.
Evan Brand: Yeah. Well, we got to wrap this thing up. But if you need help clinically, you can feel free to reach out. We work with people around the world. We send these functional medicine labs to your door. We have an incredible logistical team on both sides where it’s incredible. We can help people in literally every part of the globe where people like us don’t exist or maybe they do but we’re better. So, if you need help, you can reach out directly to Dr. J, that’s Dr. Justin Marchegiani at justinhealth.com for consults or me, Evan Brand at evanbrand.com. We’re happy to help. You guys, don’t give up. We’ve been through it. We are warriors ourselves and we’ve worked on our health for years and we love what we do and we love helping people and there’s so much possibility when you can beat an issue like anxiety. So, like I said in the beginning, whether it’s seeking that raise, that new promotion, that new job, that new spouse, you know, that partner, that relationship that you want to grow but you can’t because you’re held back by anxiety. This is a huge huge problem and you can overcome this. So please don’t give up.
Dr. Justin Marchegiani: Yeah. If you guys enjoyed it too, look down below, you’ll see a little link where you can write us a review. We appreciate the review and if, also, it’s benefiting you, feel free to share with family and friends and there’ll be links where you can reach out to us directly to get that extra bit of help. All right guys, have a phenomenal day. Take care. Bye everyone.
Evan Brand: Bye-bye.
Dr. Justin Marchegiani: Bye.