Anxiety: What to Do When Labs are Normal with Dr. Ellen Vora

In this episode, Dr. Kate Kresge welcomes back psychiatrist Dr. Ellen Vora, author of The Anatomy of Anxiety, to answer a question every clinician faces: what do you do when the labs look good, the body is stable, and your patient is still anxious? Dr. Vora explains the difference between "false" anxiety, driven by physical imbalances like blood sugar swings and poor sleep, and "true" anxiety, the purposeful signal that something in our lives or world is out of alignment. She shares practical, low-risk tools for working with it, including shaking, dance, play, connection, and a good cry, plus why chasing perfect health can become its own source of anxiety.

3 Key Takeaways

• Start with the body, then listen deeper. Dr. Vora always addresses blood sugar, sleep, and nutrient status first. When anxiety remains, she shifts the question from "How do I stop feeling anxious?" to "What is my anxiety telling me?"
• Movement is medicine for mood. In a network meta-analysis of 218 trials, exercise reduced depression, with walking or jogging, yoga, strength training, and dance among the most effective options. (Noetel 2024)
• Connection is a health factor. People with stronger social relationships had about a 50% greater likelihood of survival across 148 studies. (Holt-Lunstad 2010) Dr. Vora encourages building community around places where people are "trying to do better."

Guest: Dr. Ellen Vora is a Yale- and Columbia-trained psychiatrist and author of The Anatomy of Anxiety. She takes a holistic approach to mental health, blending functional medicine, neurobiology, and spiritual insight, and emphasizes that mental health is deeply connected to physical health and daily life.

Clinical FAQ

What should be ruled out before treating anxiety as purely psychological?

Dr. Vora looks at hemoglobin A1C, folate, B12, vitamin D, RBC magnesium, inflammatory markers, and gut health, along with blood sugar stability and sleep.

What is shamanic shaking?

A short practice of shaking the body to drum music for a few minutes, then sitting quietly. She uses it to help patients complete the stress cycle and notice what comes up.

Can wellness routines make anxiety worse?

Yes. When optimization starts crowding out ease, joy, and connection, Dr. Vora encourages patients to loosen their grip, because spaciousness matters too.

Timestamps

00:00 – Introduction and exercise as a mood booster

03:32 – Recap: the physical approach to anxiety

05:30 – Lifestyle foundations: sleep and blood sugar

07:05 – When anxiety persists after physical stabilization

09:18 – True vs. false anxiety

13:10 – Social connection and community

15:34 – Letting go of control and embracing impermanence

19:42 – Shaking, movement, and emotional release

23:58 – The neuroscience of joy, singing, and play

36:17 – Reclaiming joy and levity as adults

43:04 – Connection as a remedy for loneliness

49:48 – Letting go: grief, tears, and emotional release

54:26 – Crying as a healing tool

55:49 – Where to find Dr. Vora

Ready to elevate your practice? This episode is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript helps clinicians bring supplement dispensing, lab ordering, and patient education into one centralized workflow. For more practitioner education on supplements, nutrition, and evidence-informed clinical care, visit Fullscript Academy at academy.fullscript.com.

Disclaimer: The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always check with your doctor or healthcare provider before making changes to your health routine.