April 2015

The Language and Healing Power of Flowers By Robin Miller, MD

At my house next to our front door there is a beautiful bush filled with Daphne flowers. It smells wonderful and makes me smile on my way in and out of the house. That got me thinking. Can flowers make us happy? I did a little research and found several studies that do indeed show that flowers can affect our mood in a positive way.

At Rutgers University a behavioral research study has found that flowers elicit a universal reaction that can help people feel happiness. Those who received flowers felt less depressed and anxious after receiving them, and the flowers led to more frequent contact with friends and family.

A study done at Harvard found that when people had freshly cut flowers around the house, they were less anxious. They were happier at work and also expressed more compassion and kindness towards others.

A study done at Texas A&M found that when both men and women were exposed to cut flowers at work, they both had an increase in ideas and solutions to office problems. Men generated more ideas than women, but women had more innovative and creative solutions to problems when flowers were nearby.

Flowers have certain meanings according to those who specialize in that sort of thing (Taken from The Language of Flowers by Vanessa Diffenbaugh). If you want to say something specific you might try these: Gerber daisies represent cheerfulness, baby’s breath reveal everlasting love, bird of paradise say magnificence, hyacinth communicate beauty, and jonquils represent desire.

It is spring and flowers are blooming everywhere. If you want to brighten your day or someone else’s bring in some flowers or visit your local flower shop. It will help you to be more productive, tell people how much you appreciate them and keep a smile on your face!

On Love And Loss By Robin Miller, MD MHS

As a baby boomer, I have joined the ranks of many of my brethren and can say I am part of the “sandwich” generation. I have children who are young adults and still needing support so they can eventually become independent. I had a parent that needed my help to fly and leave his nest as well.

On June 19, 2008 I lost my father. I would say that he died, but he wouldn’t let us use that term. He preferred that we say he “transitioned”. My father was an amazing man. He lived life with integrity and purpose. He was 84 years old and his mind was as sharp as ever. He had renal failure and had been on dialysis. His body was getting weaker and weaker and he finally decided to stop the dialysis. This allowed him to “transition” on his own terms. Once again his strength and dignity prevailed.

Having now gone through the experience of losing a parent and being there for the transition, it has caused me to look at how we see and experience death in our culture. I realize that each person needs to be allowed (whenever possible) to die on his or her own terms. My father had expressed his wishes to my family and me well in advance and we were able to discuss them with him and understand what he wanted. He also put these wishes into a legal document known as a living will. In his, he put me in charge.

At the time, I didn’t realize how important that was. But, when the time came, I had to act. I felt like Shirley MacLaine in the movie “Terms of Endearment” when she was fighting for pain medications for her daughter who was dying. I had to scream for morphine for my father when his lungs started to fill up with fluid. Fortunately, after quite a bit of drama, he was able to get what he needed and I honored the promise that I made to him.

His transition was peaceful and I am happy that he got what he wanted. In the wake of all this is a massive amount of grief, which is a natural part of life. It happened several years ago, but the memory is still fresh. I share this story so that it will allow you to pause and think about whether you have a living will. Have you discussed the issues of death and dying with your loved ones? Although many of us live as if we will never die, that is one of those things that is inevitable for all of us.

Although death is never easy, knowing what my dad wanted and knowing that we were able to provide it both with the living will and details of his funeral that he planned ahead of time, made things better somehow. Death is a natural part of the cycle of life. It is okay to talk about it and to address it when it is staring you in the face. But, it is also important to say all the wonderful things you want to say and understand the wants and needs of others before an emergency situation develops.

Hug your children, your parents, your brothers and sisters and your friends. Tell them you love them as often as you can. That is what my father taught me. I am glad I was able to tell him that many times before his grand transition!

Do You Need A Happy Pill? I Have One

I see a lot of depression in my practice. My experience treating it has been similar to what is discussed in medical literature. In about 70% of patients there has been some improvement with antidepressants, but a full remission has occurred in only 40 to 50%. In the interest of boosting this disappointing remission rate, I have been searching for something that will either augment antidepressants or that could be used alone.

I have found a supplement considered to be medicinal food. It is safe, and it really does work. It is a vitamin that is a form of folic acid known as L-methylfolate.

Folic acid is an essential B vitamin. It is found in green leafy vegetables, eggs, cereals and fortified foods (to name a few). When you take in folate or folic acid in your diet it is absorbed by the small intestine where it is converted by an enzyme into L-methylfolate. This metabolite is used to make serotonin, norepinephrine and dopamine, which are all important for mood regulation.

Scientists have identified 40 mutations on the gene responsible for making the enzyme that converts folic acid into L-methylfolate. The most common genotype is known as C677T. If there is one mutation on this gene your ability to convert folic acid is reduced by 34%. If you have two mutations, it is reduced by 71%. Now you probably are seeing where I am going with this.

If you have a defective enzyme then you cannot convert folic acid to L-methylfolate properly and you will have lower serotonin, norepinephrine and dopamine levels. These gene mutations are extremely common. The treatment is simple. It is a prescription of L-methylfolate, a vitamin. If given in the proper amounts (7.5 to 15 mgs) it can improve mild depression relatively quickly. In a study of elderly depressed patients, the response rate at 6 weeks was 81%. Results are often seen in just two weeks.

A recent study of those with major depression found that adding L-methylfolate improved depression from 7% for those on an antidepressant alone to 18.5% with the addition of L-methylfolate over a period of 60 days.

It is well tolerated with no more side effects than placebo. It does not interact with other medications. In my experience, if an antidepressant has produced a positive response but the patient is still somewhat depressed L-methylfolate can help.

The results I have seen are impressive. When I treat those with MTHFR mutations (with or without mild depression) with L-methylfolate their mood improves and often they sleep better. Related problems such as irritable bowel will often get better as well.

If you are depressed and/or on medication for depression, I recommend you ask your doctor to see if you have the genetic abnormality that I mentioned. The blood test is called MTHFR. It just makes sense. If serotonin levels are genetically low then why not find a healthy way to boost them?

Heartbreak: What Is It and How To Get Over It? Robin Miller, MD

Heartbreak: What is it and How To Get Over It?

A dear friend of mine recently went through a breakup that has left him heartbroken.  The end of the relationship was amicable but has been painful nonetheless.  His experience has caused me to wonder a couple of things.

What is heartbreak and is it purely an emotional issue or is there more to it than that?


What is the best way to help someone get over it?

In Webster’s dictionary heartbreak is defined as crushing grief, anguish, or distress. It has been present since the dawn of humankind. We know because poets and writers have described it through the ages. It is something that the majority of us have experienced and some have been left scarred and scared as a result.  What exactly is going on when the heart is broken?

There is new research that has answered this question. Scientists have found that it can actually cause physical pain.  In their study they took 40 people in New York City who had felt intensely rejected.  Their brains were being scanned as they were instructed to look at a set of photos of friends and think positive thoughts.  Then they were given pictures of their exes and told to think about their breakups.  Lastly, they were given brain scans when they received an actual pain stimulus. The same part of the brain lit up when they were thinking of their exes and when they experienced physical pain.

There is an extreme version of this called Broken Heart Syndrome.  I have seen this a couple of times in my practice and it is dramatic.  It usually happens when there is either a traumatic loss or a breakup that comes out of the blue.  This type of pain actually looks and presents just like a heart attack.  The heart will not function normally when this occurs but there is no evidence of heart damage.

The shock of the event causes a huge outpouring of adrenaline, which acts like a stun gun to the heart.  This causes it to malfunction for a short period of time (usually no more than a week). These patients need to be observed and cared for in the hospital until things return to normal.

How can you help a friend to get over heartbreak?  To be honest, in the throws of a breakup it is really hard to tell anyone how to get over it.  However, there are a couple of things that might help.  The most important thing to point out is that if someone is heartbroken they actually have a heart.  They were able to become vulnerable and connect with someone on a deep level. They were able to love and allow themselves to be loved. Love is what makes life livable.  If they can do it once, they can do it again.

It is also important to note that they now have the knowledge of what works in a relationship and what doesn’t. This offers an excellent chance for introspection that can help them to find the person who can be a more compatible partner.  With this insight they will know what to look for in their next relationship.

Once someone is over the initial loss they may be more receptive to the rest of this advice.

  • It is important to eat healthy and exercise. That will help you to feel better regardless of how sad you still might be.
  • Keep busy.  See friends and do all the things you like to do. It could be going to a movie, dancing, or just having dinner out with friends.
  • Give yourself time to recover.
  • Be kind to yourself. It is over. Don’t look back. We all tend to obsess in the land of “would haves should haves could haves”. Don’t go there. Be present in the moment and then you will be able to move forward.
  • Finally, laughing helps. Go to a funny movie, hang out with people that are positive and help you to see the humor in the world.


Time often does heal all wounds and sometimes we are left with scars.  But, hopefully it leads us to where we ultimately are meant to be.  As one who has had my heart broken many times, hang in there, you will get over it. It may not seem like it in the thick of it, but you will. In the meantime, take care of your health so that you can enjoy yourself when you get to that point!

I leave you with these words of wisdom.

“Perhaps that is what the stories meant when they called somebody heartsick. Your heart and your stomach and your whole insides felt empty and hollow and aching.”

Gabriel Garcia Marquez

AND Just one more thing…..

This is a quote from Elizabeth Gilbert’s book, Eat, Pray, Love from Richard who is telling her why she should not feel  so horrible about the end of her relationship with a man she identified as her soul-mate:  “A true soul mate is probably the most important person you’ll ever meet, because they tear down your walls and smack you awake. But to live with a soul mate forever? Nah. Too painful. Soul mates, they come into your life just to reveal another layer of yourself to you, and then leave.”








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