.

>> Good evening.

I'm psychiatrist Jay Fawver live from Fort Wayne , Indiana.

Welcome to Matters of the Mind now and it's twenty seventh year Matters of Mind is a live call in program where you have the chance to choose the topic for discussion.

So if you have any questions concerning mental health issues, give me a call in the Fort Wayne area by dialing (969) 27 two zero or four calling any place else coast to coast you made our toll free at 866- (969) to seven to zero now on a fairly regular basis I am broadcasting live every Monday night from our spectacular PBS Fort Wayne studios which lie in the shadows of the Fort Wayne campus.

And if you'd like to contact me with an email question that I can answer on the air, you may write me a via the Internet at matters of the mind all one word at WFB vague That's matters of the mind at WFYI Doug and I'll start tonight's program with an email I recently received.

It reads Dear Dear Father my nephew is a heavy drug user but has indicated he's finally ready to quit when he tries to quit he gets sick and ends up finding his source.

How do I get him to take one more step and fight through this?

I think the best thing for me to do is make sure he has a clinician who's going to be able to detoxify him adequately.

>> One of the main reasons why people have so much trouble with going off of opiates for instance will be they go into withdrawal and takes between three to five days really notice it and then to go through the profound withdrawal it takes about ten days and withdraw from opiates will be manifested by diarrhea, chills ,headache, nausea.

>> You can feel terrible during that time and people are told they're going through cold turkey spells, cold turkey and they feel chilled and the turkey they're drug users so if you go off of opiates abruptly it's typically not life threatening but you feel miserable and that's why people will often crave resuming an opiate during that time if it's alcohol, alcohol withdrawal can be life threatening.

Alcohol withdrawal can be manifested by a fever.

Also tremulousness some people get very confused and you can actually have seizures during alcohol withdrawal can be highly dangerous.

So alcohol withdrawal sometimes can be completed as an outpatient with close observation but not on not commonly.

It's done over the course of three to five days at an inpatient setting just to get through the rough patch.

Other medications of abuse can include benzodiazepines like Xanax, Klonopin, Valium, Ativan those two can be slowly tapered over the course of sometimes several weeks as an outpatient if somebody is willing to do so .

So I think the reason your nephew gets back into relapsing is because he's going into withdrawal each time and that's often a detriment in terms of being able to stop for narcotic or opiate dependance.

>> There's a use of a medication called Suboxone that mimics the effect of a narcotic and gives you kind of like a mild markert a narcotic effect but yet is not as addicting as an opiate itself.

So there are ways of getting people off of various drugs of abuse but often you have to get through that withdrawal first.

Thanks for your email.

Let's go to our first caller.

>> Hello Jim.

Welcome to the Mind.

The question on post-traumatic stress one would be could you explain it and the other would be one of the effects last so long and what can you do to shorten the effects?

>> Yeah, Jim, when you encounter a stressful event it can be emotional abuse, sexual abuse, physical abuse, a very traumatic experience in combat and weather related if somebody has a motor vehicle accident when you have a very traumatic event the middle part of your brain in the brainstem give my brain a part here, middle part of the brain that's the front part of the brain over here, the brainstem here it fires out a whole bunch of adrenaline from that area and the adrenaline will embed that memory into the hippocampus in the temporal lobe and the temporal lobe is where memories are stored.

Women are more sensitive to storing memories than men because they have estrogen.

So estrogen receptors are abutted all along this temporal lobe.

So that's why you'll often hear about women having more post-traumatic stress symptoms than men.

And I've heard different arguments that women are more commonly traumatized.

But I think there's a pretty strong argument there's a neurobiological reason why women can be traumatized as well.

What'll happen in that instance, Jim, is where you have those traumatic memories that are there your brain stores those memories and you're always looking out for something bad to happen.

You know, it's like my dog Winnie when my dog Winnie encounters another dog she's always on guard.

>> That's because she's always on guard because she was likely traumatized when she was younger and we got her as a shelter dog and you know, dogs will be traumatized by past events just like people will and they'll always be sensitized to similar type of experiences.

>> So with post-traumatic stress, Jim, you can get triggered with these memories and vivid recollection of the past events just by simply smelling something that was associated with that past event, whether it be smoke, whether it be a perfume or cologne.

>> Many people will get that trigger just by the olfactory sensation in that regard you can often have triggers occurring when people are around you that kind of remind you of the person person who might have been involved in trauma previously.

People frequently have intrusive thoughts and often comes across as nightmares.

Now back in the nineteen nineties there is something called false memory syndrome where people would have nightmares.

>> They'd go to a therapist.

The therapist would conclude Oh you must have been traumatized .

Doesn't work that way.

Simply having nightmares does not represent past trauma and that was very controversial in that thinking because it's not true you can have nightmares totally unrelated to past trauma.

Your nightmares can be reflective of something you're currently going through that aren't involving physical sexual or emotional abuse.

So if you have ongoing trauma, a symptom of that can be nightmares and difficulty with sleeping because generally speaking your brain's kind of on edge and you're always expecting similar trauma to occur.

How do you get past it?

You try to desensitize yourself and there's various treatments for about the best treatment might be eye movement desensitization and reprocessing.

It's worried a frontal lobe gets a reprograming basically it's a very simple technique but it needs to be under the influence of a done under the influence and supervision of a trained professional.

Hypnosis used to be done 20 30 years ago but that hypnosis actually makes PTSD symptoms worse.

So hypnosis is not recommended but eye movement desensitization and reprocessing is probably one of the better treatments.

>> There's talk about some of the newer hallucinogenics being possible treatments being done in an experimental phase now maybe there will be more standard treatment next two or three years but the hallucinogens mescaline being one of them have been studied for the purpose of trying to reprogram the brain to get you out of that.

>> Oh, that's sticky needle.

>> If you remember the old record players and the old records where you have the needle sometimes with post-traumatic stress, that needle keeps repeating when you're in similar situation as it reminds you of that past trauma.

>> So the key with any past traumatic event that's causing you current difficulties to keep moving forward don't avoid situations that may remind you of the past trauma for fear that you'll have another traumatic experience because if you do that you remind your brain that OK, that's a dangerous place to go.

Well, you want to expose yourself to those situations again, not put yourself in harm but basically to reprogram your brain and hopefully you won't have another traumatic experience in that situation and your brain gets reprogramed to allow you to have an awareness that doing those having those kind of experiences might not be problematic.

>> For instance, going out and socializing among people would not be necessarily traumatic for you and your brain might interpret it in that way.

>> Jim, thanks for your call.

Let's go next caller.

Hello.

Hello Sidney.

Welcome to Mariza Mind Sidney, you are asking whenever you're stressed out you have a hard time waking up and you sleep through your alarms.

>> What's happening in your brain and how can you overcome that?

I wonder, Sidney, when you're stressed out if you're having difficulty getting to sleep so when you're having difficulty was getting to sleep that's called delayed circadian rhythm disturbance and what's happening is your brain still needs the sleep.

>> It still wants to sleep and you sleep past the alarms because you're sleeping so deeply with REM and non REM sleep in the early morning hours when your alarm is going off.

Now when you're in REM sleep, which is a very deep sleep, it's a very important sleep but it means you're basically in sleep debt if you're still having non REM sleep in the early morning hours.

So I'm suspecting Sidney that if you're really stressed out you might be staying up late or at night.

>> You're thinking about things, you're worrying about things and finally you crash and you go to sleep but then you're sleeping through your alarms because you're sleeping too much into the next morning.

So I think the key for you would be if you're stressed out ,if you're worried about things, try not to take your worries to bed with you.

>> So many people will start worrying about things and they start thinking about things when the lights go off and the sensory deprivation is around them it's quiet and all of a sudden their brain just takes off and they start worrying about the different things going on in their lives.

The best thing to do to try to address that will be to keep a worry diary and it's literally a diary where you write down your worries and you can write down your worries every day three times a week, whatever it takes.

But you write down your worries and try to do so by early evening.

You don't want to write down your worries after about 7:00 p.m. because that means you're still thinking about going to bed but maybe write down your your worries at the time at five six, seven p.m. at night and then think about what you can do about them, what you can't do about them and leave the rest to God because so many things are out of our control.

But what you're going to notice, Sydney, is that if you look back at what worried you two months ago, three months ago, six months ago and you look at your diary, you're going to find out that a lot of things which were causing you so much worry are no longer problematic for you.

So the worry diary is one way to not take those worries to bed with you.

Now there are other ways people can settle themselves down but be careful about watching television or definitely looking at social media right before going to bed.

It's kind of tricky because some people can kind of tune out their day to day worries by looking at television or social media right after they go to bed.

But the problem is especially with social media, there's algorithms as you're probably aware in the social media where the social media will know what is interested.

>> Interesting you and the problem will be is the next thing you know, 30 minutes have gone by, an hour have gone by.

>> You were tired.

Now you're not tired.

You're wide awake because you've been looking at the social media going from one site to another to another to another.

So you have to be very careful about social media.

The best ways to really wind down the brain at night will be to read a book with chapters in it and the whole idea with the chapters will be at the end of the chapter then you go to sleep.

It's entirely different from the social media experience where you go from one place to another story and off you go and you can easily go down a rabbit hole with social media.

So I recommend that people don't engage in that at night if you're watching a sitcom at night time something you've watched again and again and again it's just a way of kind of winding out that's OK.

If it's something where you know it's only going to last for thirty minutes then it's going to be done.

>> Many people will wind down that way.

The only issue there can be the brightness of the television screen can sometimes keep your brain a little bit more active but it's not so bad as going through the thought processing of a social media site.

>> Sydney, thanks for your call.

Let's go to next caller.

Hello Ron.

Walk in America.

Ron, you want to know about your spouse's strange food addiction?

>> I believe is there a reason people digest odd non-food items?

>> I'd have to get more details from you on that, Ron, because no one I'd wonder if your spouse is eating things dangerously if your spouse is eating things that are putting putting your spouse in danger, that can be a problem in itself and could be a health issue and might need to be addressed by gastrointestinal experts.

People will do well ingest things like dirt.

It's called PICA.

We're people and it's usually with young kids, really young children who will just ingest dirt and they do so sometimes it's just because it's there and they have emotional immaturity in doing so.

Why would an adult do that?

Sometimes that can be all sorts of different issues, the worst of which would be a psychotic kind of condition.

When people lose touch with reality they lose touch with what's really in food and they'll eat plastic thinking it's a health food or thinking it's fruit.

So Ron, I think if your spouse is ingesting non-food items you might want to talk to your spouse's primary care clinician to see what might be happening along those lines is a lot of different things could be occurring.

>> Ron, thanks for your call this or next email question.

Our next email question reads Dear Dr. Fauver, what's the best way to increase confidence?

>> The world has conspired against me and I feel down the dumps.

Something to feel good about would really help well find something to feel good about sometimes I mentioned the worry diary.

Sometimes there's a gratitude diary that's very, very, very helpful.

Write down the different ways in which you're grateful.

It's a very simple psychotherapeutic approach but you write down day to day or week to week the five things in which you're grateful it could be something as simple as hey I am in good health today I felt pretty decent.

>> I was able to go for a two mile walk, look for those little wins and you'll hear about this with with military leaders.

They'll say that they often won't try to win the big war all in one or two battles.

They try to win the little battles and it's sometimes a progression over the course of time.

So now we have the ability to be able to find ways to give us little wins and that's what you're always looking for in life .

I think by the nature of your question you're looking at a lot of the negative things that are happening around you but you might not notice that today we had a really nice sunset and it was really beautiful this morning it's springtime so you can have those degrees of appreciation and look at things that you've been able to accomplish that well you're you weren't able to accomplish in times past and then looking for those wins.

That's how you can develop confidence.

>> Thanks for your call.

Let's go our next caller.

Hello Jennifer.

Welcome to the Mind.

Jennifer, you on know about Brexit William also known as El Ruso for for a postponement oppression.

Are there people who should not take that medication?

It is a 60 hour infusion.

Jennifer.

It's been available for several years now.

You have to be able to find a clinician who would be willing and able to prescribe it is highly regulated.

It can be highly sedating so you can't be on any other sedating medications.

But it's it's used for the treatment of postpartum depression which by definition means that you got depressed in your third trimester, your last three months of pregnancy or within one month after delivery during that time you'll have this dramatic drop in progesterone and when progesterone drops the following delivery progesterone drops.

It's its active metabolite pregnant and will also drop without Olalla pregnant alone.

It's like your brain gets on fire and 80 percent of women will notice it within five days of delivery but it goes away within a couple of weeks.

They're not compared to a great degree that's called baby blues.

Baby blues will not be impairing it's not functioning impairing.

It goes away within a couple of weeks.

Postpartum depression will hammer a woman and cause a lot of functional impairment for at least two weeks and it can go on for up to a year after delivery.

>> So Rexon alone is an IV infusion that's infused over the course of sixty hours in an inpatient setting which is typically a three day hospitalization.

Where should you not use it yet?

Be careful if you had severe liver disturbances you'd probably want to get a lower dosage but I think right now with Brexit alone the biggest challenge would be finding a clinician who would be willing to to use that medication not because it's so dangerous, it's just that it's outside of the treatment scope of a lot of clinicians.

We now have the zoove which is Derrinallum Zoove is an oral medication where you take two capsules are 25 milligrams apiece for a fifty milligram dosage to capsule every evening with food with a fatty meal and you do that for fourteen days.

So women are treating postpartum depression with Brexit alone which is an IV medication over the course of sixty hours in the hospital and they now are using Zarein alone or Zoove as an oral medication for fourteen days and that's it.

>> Fourteen treatment basically for the purpose of trying to normalize the brain chemistry in which try to get it back to where it should be because they are pregnant and need alone levels are so low what both Brexit alone ends around alone will do as they kind of mimic the effect of our pregnant alone so in doing so they kind of rebalance the brain's chemistry following delivery so a woman does not have those classic symptoms of postpartum depression which can be characterized by overwhelming sadness, lack of motivation, not enjoying anything.

>> Many women will feel highly anxious during postpartum depression and they have difficulty with sleeping.

Both Brexit alone and Zaranj alone will be very, very effective in helping with anxiety and insomnia.

>> Thanks for your call.

Let's go our next caller.

Hello Mark.

Welcome to Mastermind Mark.

>> You mentioned that you consistently think about when you will die but you're not suicidal.

Is that normal, Mark?

You know you're talking about the whole concept of thinking about your own mortality, thinking about when when you're going to die and it's a psychiatrist.

Yeah, we have to sort that out, Mark, because some people decide to take their own take their lives earlier than earlier than they really should and they will die by suicide.

>> So we're doing what we can to try to prevent that.

So when people get depressed they kind of have this fatalistic viewpoint on the world around them and they kind of give up.

So part of your thinking about death will be the whole concept of life being over and being done with your current hopefully not suffering but many people will endure the perception of suffering now so they start thinking about when they would die and they kind of want their current life suffering to be over.

But you have to remember, Mark, the the suffering you have now might not be even apparent three months from now and I'm often reminding people who are thinking about death and dying and even thinking about suicide the what you're going through right now might not be present three and six months from now.

And I hear from that from a lot of people who had thoughts of death as they recover from depression as they got through their current life circumstances and their current journey, they typically will look back and think I don't know why I was thinking about suicide.

I'm always thinking about death back then, you know, I got through things and yeah, life is tough but I'm willing to live out the rest of my life and enjoy what I can.

>> You have to think about the people around you.

You might say well I don't have anybody around me.

Well, keep in mind that there can be people in your in your life family, friends, people in your life with whom you can form an attachment so socialization is something that's very, very important to keep yourself going.

>> But when people have kind of a fatalistic attitude concerning dying, you know, they have a lot of different reasons for that is that they're afraid of dying or are they wondering what the afterlife will be like?

Are they having thoughts about dying because of their current suffering?

A lot of different factors can be associated with that.

But Mark, make sure to talk to your clinician about it to see if you have a depression.

It's a factor now and keep talking to a counselor or some kind of spiritual counselor that might help you through your life journey as as you're going through right now.

>> Thanks for your call, this guy our next caller.

Hello, Brook.

Welcome to America.

Mind break.

>> You ought to know how can you support your friends mental health journey without overstepping your own boundaries?

>> How do you how what I what I suggest to protect your own mental health .

>> Brooke, I wonder when you say friend a friend a friendship is a two way relationship.

OK, so if this person with whom you're trying to help with their mental health training which is very noble of you, are they truly a friend?

Are you getting something out of the relationship otherwise you're a therapist.

So if you're a therapist for somebody and you're in the position where your job is to try to get them through this mental health journey, that's a whole different perspective than a friend.

A friend.

Yeah.

You're often not going to be that good of a mental health therapist for your friend because same reason weak clinicians shouldn't be treating our family members.

We're not going to be objective.

So if your friend if it's a give and take relationship where you're getting something out of that relationship as well if you start applying what you know about therapy toward that friend and start giving them concrete advice, you might jeopardize that friendship and you might not give them the advice they need to hear.

So a therapist on their hand should not have that emotional attachment.

>> A therapist should have more objectivity in making those in trying to address the issues your friend might be experiencing.

>> So when you're talking about boundaries, you're often talking about a boundary between the role of being a friend versus the role being a therapist and the boundaries are entirely different.

And if you're feeling kind of uncomfortable about boundaries right now because you're trying to give your friend mental health advice, it might be because you're trying to work in role as a therapist while you're also a friend.

So it gets complicated in that regard.

So I would is just that you get your friend lined up with a therapist or a clinican who can oversee your friend's care and you maintain your friendship with your friend so that you don't have to be in that role of a therapist because you're right because boundaries can be can be stepped upon in that case and that's where your friend probably needs a therapist.

>> Thanks for your call.

That's your next caller.

Hello Greg.

Welcome to Matters of Mind.

>> Greg, you mentioned you're on Zoloft but you still have a lot of anxiety.

Are there over-the-counter supplements that you can take to support your medications?

I'll give you a definite maybe on that, Greg.

Zoloft is a medication.

It primarily will increase serotonin and it has probably better effects on anxiety than it does depression.

>> You know, it's also been around since 1992 so it's been around for a long time and gets to the brain a little bit of a calming effect.

So if you increase serotonin you can have a bit of a calming effect.

So are there over-the-counter supplements that are possibilities?

The two that I often will recommend the most to patients will be healthy and healthy and will give you the the potency of green tea?

>> It has a chemical that's in green tea and it can sometimes help with anxiety.

So Athena is fairly safe, does not interact with other medication so to speak.

>> But that's often a recommendation I'll give to people if they can take a 200 milligrams two or three times a day as an a common dosage.

There's another one called Ashwell Gonda.

Atul Gawande is a plant based or supplement and it's something that can help with stress tolerance.

It'll help many people put up with stuff better and it's something that you in which you have to be careful if you have thyroid issues because Atul Gawande can increase thyroid levels.

So if you're kind of high thyroid already yet be careful because it can increase thyroid functioning and increase thyroid levels and that's the main issue there with Ashwell gone to but work on this typically given 600 milligrams twice a day as a common dosage of it.

But it's something that often people will take for stress tolerance.

Talk it over with your primary care clinician to make sure either of those supplements will be something that can be helpful for you.

I would not recommend KBD if you're taking Zoloft so often CBD sometimes will have drug interactions.

I would say.

>> But a lot of people do take CBD as a means of helping with anxiety and what I frequently advise with CBD will be if you use CBD just make sure you don't take it with any other medications because it's going to probably interact with a lot of your other medications and increase blood levels.

>> So if you want to take CBD, make sure to talk to your your clinician who might be prescribing any medication because those on the medication will likely have interactions.

>> Let's go to our no let's go to our next caller.

Hello Nicki.

Welcome to Mastermind Neck You assault lamp's beneficial mental health couldn't tell you Nicky it's I'll give you a definite maybe on that one because I don't think there's enough we know about salt lamps themselves to say definitively better for mental health .

I know of some people that use them and they get benefit from them.

Other people don't.

It's one of those anecdotal things you can try it out for a couple of weeks and really see if it really gives you any benefit.

Nikki, thanks for your call.

Unfortunately I'm out of time for this evening.

If you have any questions concerning mental health issues you may write me via the Internet at matters of MIDA did you have a dog?

I'll see if I get your question on the air.

I'm psychiatrist Fauver and you've been watching Matters of Mind on PBS Fort Wayne now available on YouTube God willing and PBS willing.

I'll be back again next week.

Thanks for watching.

Goodnight