.

>> Good evening.

I'm psychiatrist Jeff Oliver live from the Bruce Haines studio in Fort Wayne , Indiana.

Welcome to Matters of the Mind now and his 27th year matters the Mind is a live call in program where you chance you have a chance to choose the topic for discussion.

So if you have any questions concerning mental health issues, give me a call here at the PBS Fort Wayne Studios by dialing (969) to seven to zero or if you're calling any place coast to coast you made a toll free at 866- (969) to seven to zero.

>> Now on a fairly regular basis we are broadcasting live every Monday night from our spectacular PBS Fort Wayne studios which lie in the shadows of the Purdue 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 via the Internet at matters of the mind all one word at WFB org that's matters of the mind org and I'll start tonight's program with a question I recently received.

>> It reads Dirda to former I've been using artificial intelligence chat websites to ask therapy like questions about issues I am facing in my day to day life .

>> Is this something that can be beneficial or should I avoid doing this?

>> I think I is going to improve with psychotherapy over the course of time but realize that's not a real person with whom you're speaking and unlike a therapist that I chat might not understand the context of your question.

>> I've heard about disastrous type of results where somebody asks where the closest bridge might be because they want to commit suicide and I will give them the location of the closest bridge and not really go into the reasons why they might want to commit suicide and follow up on that.

>> So you have to remember the Eyes program to give you certain responses for certain questions and it might be somewhat dehumanizing to do so keeping in mind that you're not talking to a real person.

>> So it's nice to have a therapist on the other end of the line.

We're big advocates of telehealth where you can talk to a real life therapist by telehealth now for convenience but there's a lot of merit to continuing to see a real life person still for talk therapy.

>> Thanks for your call.

Let's go to our next caller.

Hello Shannon.

Welcome to the Mind.

>> Shannon, you want to know about the risk factors for suicide because your brother has been expressing suicidal thoughts every now and then.

>> Shannon, if you've had previous suicidal thoughts, it does increase your risk for future suicide because the longer you're thinking about it and more importantly the more times you've attempted it, the more likely you're going to carry out suicide attempts.

So if your brother has had suicide expressions and had suicide attempts in the past, that actually puts him at a higher risk for suicide.

A family history of suicide, a mother, father, brother or sister having died by suicide will be a risk factor in itself .

>> What often will hear when somebody has a sense of hopelessness that's at the top of the list when somebody has hopelessness and mean given up all hope on their life circumstances, that's when they often will end up thinking very seriously about suicide and often that's followed by somebody having a significant loss in their life whether it be a loss of a family member, a loved one, a loss of a job, a significant loss of some type will often trigger a sense of hopelessness and having difficulty looking beyond the current day anxiety will be a big risk factor.

Some medications can actually cause people to be more restless and anxious.

We call it akathisia where they can't sit still but if you're highly anxious that puts you at risk for suicide and going along with that insomnia, having difficulty with getting to sleep and staying asleep if you sleep well it recharges your brain and helps you with the thinking part of your brain in the front.

>> The thinking part of the brain in the front helps you cope and helps you put up with stuff.

And if you can't recharge the thinking part of your brain the logical part of your brain you'll have a greater likelihood of thinking about taking your life and not looking at other alternatives in your current life circumstances.

>> So that can be a factor as well.

People who will have difficulty with impulse control and drink alcohol or use drugs of abuse will be at a higher risk for suicide especially during that time.

>> I've seen many people over the course of my career who got intoxicated.

They used some kind of narcotic or some kind of drug of abuse that they might make a suicide attempt and the following day they wonder why they did it.

They say Oh my goodness, I feel badly but I would never want to take my life .

What they did while they were under the influence of alcohol.

So if somebody is suicidal as your brother is described, I'd certainly make sure to get the alcohol out of the household, keep a close eye on him, take him seriously when he talks about suicide because he's trying to reach for help in doing so.

But if he has any weapons in the household, try to get them out of the household or at least disable them at that time.

>> Thanks for your call.

Let's go next caller.

Hello Julian.

Welcome to Matters of Mind.

>> Julian, you had mentioned that you are retired and widowed and you want to know how to maintain your mental health .

It often happens, Juliane, as people get older, they retire.

They don't have the regular job to attend day by day.

They don't have the obligations.

They don't have the socialization if they don't have the work environment then I'm put on top of that.

>> You lose you lose your loved ones not only your spouse but also many times other friends are lost and I often hear about older people looking in the obituaries because it's morbid bit because they're looking for their friends and people they might have known from the past.

>> So it's a very lonely time for many people as they get older.

>> I would first ask Julian do you have any grandchildren if you have grandchildren somehow some way whether it be within proximity or whether it be across country somehow someway maintain some kind of relationship with your grandchildren.

I remember seeing a study out of Berlin where it studied people over 70 years of age over the course of thirty years so it could study them up to 100 years old.

>> But these people were all grandparents and if they were actively involved in taking care of their grandchildren or interacting with their grandchildren actively involved living with their grandchildren, that'd be a role.

But if you were in that grandfather grandmother role and you're involved in your grandchildren's life on a regular basis, your longevity increased by thirty seven percent.

>> I always thought that was interesting because being a grandparent being an actively involved grandparent can increase your lifespan all other factors being considered so grandchildren yeah they can have a significant impact on your mental health .

Another thing you can do as you're retired, you're widowed ,try to go exercise on a regular basis and do such exercise in a social environment socializing in general not only with your grandchildren but with other people would be very, very helpful for you at this point.

Do the best you can eat a healthy diet.

I think your primary care clinician could look after that and make sure your blood pressure or blood glucose, your lipids, your overall metabolic profile is in good control.

But if you have any difficulty with hearing it's been shown that people who have a loss of hearing as often happens as you get older it will isolate you from other people because you can hear what they're saying but it will also increase your likelihood for dementia.

So it's very important that if you have a loss of hearing that you get hearing aids so you can hear what other people are saying in that way that keeps you actively involved in the world around you.

>> Thanks for your call.

Let's go next caller.

Hello Daniel.

>> Welcome to Mastermind Daniel.

>> You want to know about Fee and what is it how does it work will benefit as a combination medication of Zano.

Malene starts with X Zano Malene and trust him trust him as a medication to offset the side effects of Zano Malene Zamili has been around since the 1990s.

It was originally studied as an all as an Alzheimer's medication by Lilly in Indianapolis and it was studies as an Alzheimer's medication because it profoundly increases muscarinic activity and that means acetylcholine.

So basically it increases the effect of acetylcholine in the brain in doing so it can help with memory.

>> But the problem with the Zabbaleen when it was studied for dementia was that increased acetylcholine all over the body and it gave people horrific gastrointestinal problems because if you increase acetylcholine in the gut it can give you nausea, diarrhea and if it increases the heart it can actually slow down your heart rate.

>> So it was intolerable for people?

Well, it was rediscovered a few years later they started studying it for schizophrenia finding that if you increased acetylcholine transmission you could thereby decrease downstream in an appropriate way dopamine.

So rather directly blocking dopamine you can decrease the firing of dopamine and thereby not having all the side effects that the traditional antipsychotic medications would cause.

But what about the nausea?

What about the diarrhea?

While tropism is the second medication added, Trotskyism selectively will block acetylcholine in the rest the body but not the brain.

So Zano Malene is able to do its thing in the brain and increasing acetylcholine without being blocked by the opium trade is affecting the rest of the body and blocking acetylcholine.

The rest of the body.

>> He's been out for a year or so now so it's been around for a little while and it's getting used more extensively.

But it's an alternative to the dopamine receptor blockers, the antipsychotic medication that have been used for the past decades.

>> They worked.

It's just that they caused a lot of side effects and those side effects were predominantly from blocking dopamine which could benefit does not do.

>> Let's go to our next e-mail question.

>> Our next email question reads Dear Dr.

Farrakhan's psychiatric medications cause our change dreams or cause nightmares for people who take them specific psychiatric medications that can cause nightmares will be medications like the beta blockers metoprolol a 10 alarm propranolol.

>> These are medications that will block norepinephrine and when you block norepinephrine in the front part of the brain here you can enhance REM sleep and actually cause nightmares.

So we sometimes hear about that medications that are used for migraine slowing down the heart, decreasing blood pressure and various other reasons.

>> Beta blockers can be used in various capacities.

They can cause nightmares always going to look at the medications people are taking occasionally we'll hear about the serotonin reuptake inhibitors such as Lexapro, Prozac, Celexa, Paxil, Zoloft.

These are medications that increase serotonin it indirectly they can cause nightmares for some people and give some people difficulty with dreaming in general.

>> Historically the medication we've used for depression have actually decreased dreaming such that they will have a decreased REM sleep and thereby have a lessening of the nightmare effect the old tricyclic unsuppressed medications nor tryptophan imipramine amitriptyline these are medications we use a low dose is to actually prevent nightmares for a lot of people so they can block REM sleep so depending on what medication you're taking some of them can worsen nightmares.

They can actually enhance your dreams or actually block your dreams.

But there are different reasons why we'll use different medications and they will affect dreams in different ways.

>> Thanks for your email.

Let's go next caller.

Hello Kathy .

Welcome to Mars Mind Kathy .

You want to know how does a sense of smell affect your mind with stress and emotion?

>> Smell has a very profound effect on the memory center, Kathy because the sense of smell gets embedded in the hippocampus.

>> Here are the temporal lobe part of the brain, the yellow part of the brain and a sense of smell is one of the most powerful evocative of memory that you'll find of any of the senses you have.

So that's why it can be very subtle if somebody had a traumatic experience and they smell something associated with that traumatic experience, it can profoundly cause them to have a lot of anxiety.

>> They don't know why but it's a sense of smell.

>> It can be very, very pronounced now people will use aroma therapy as they call it as a means of getting themselves a calming effect.

>> Some people are calmed by certain aromas and that's perfectly legit and it can be safe as long as the aroma itself is not an oily type of aroma that's going to coat your lungs.

You got to make sure that the aroma therapy that you're using is not going to be hazardous to your lungs themselves.

>> But some people can be very calmed by certain aromas were getting into the holiday season now in the holiday season people will often have good memories of certain smells and it's always nice to have those smells around.

So the sense of smell has a very profound effect on the memory center of the brain and can bring back good memories or bad memories in some cases.

>> Thanks for your call.

Let's go our next caller.

Hello Markus.

Welcome to Matters of Mind.

>> Marcus, you want to know is it OK if your mental health team is only your psychiatrist you feel like you get more out of those appointments than therapy?

I think it's up to you Marcus with your psychiatrist typically psychiatrists in the twenty first century are going to be primarily in the role of psychopharmacologist.

In other words, we're going to be prescribing medications but we're also going to be diagnostically assessing people.

So we want to make sure we get the right diagnosis and based on that direct the therapy therapists will often be social workers.

Psychologists sometimes nurse practitioners can be and the role of therapists as well.

So you'll have a therapy team not uncommonly but if you feel like you're doing well with your psychiatrist at this point and you're feeling like you're able to achieve your goals what you want to do in life and keep moving forward and you're only seeing your psychiatrist at this point that's fine.

>> It all depends on your personalized goals and what kind of treatment you'd like to see at this point.

>> Thanks for your call.

Let's go our next caller.

Hello Zach.

Welcome to mastermind Zach.

You want to nor are we currently facing a mental health crisis with a rise in anxiety and depression.

>> It's an interesting phenomenon that we're seeing in the past 20, 30 years because I think people right now are struggling with identity and when I say that they're struggling with who they want to be, what they want to do and they're often comparing themselves to others based on what they see on social media, that's very, very important that you have that baseline on identifying who you want to be and what you expect out of yourself.

>> So unlike 30, 40 years ago, I think people now are more struggling with what they want to be in life , who they should be and there's a lot of questions I'm seeing a lot of people have a dissociation with their families.

It used to be that people would have a very strong bonding with their brothers and sisters, with their parents, with their grandparents.

You have this multigenerational effect and as I was mentioning earlier with grand parenting that's very, very important in terms of developing the personalities of young people and you don't see that so much anymore because families are moving away from each other and grandparents are as involved as they used to be.

>> I was reading about grandparents not too long ago and I found that in the animal kingdom there are four species of whales and the Asian elephant who are actively involved in rearing their grandchildren they're grand animals in those cases.

So for species of whales and an Asian elephant and then we have grandparents as humans so grandparents as human has a very important role not for the purpose of reproducing more children.

>> It's just more for the bonding and the social guidance of the grandchild themselves.

So I think all that put together is something is very, very important as we go into the 21st century.

I don't want to see our children in the future reared by the public schools or the governmental type than Dr.

Nation that they could get.

I'd rather see the families have a greater means of bonding and connectivity and I think we're losing that as time goes on.

So is that creating a more anxiety and depression?

I hear about it because people get more anxious when they start to lose that sense of identity and having to understand what direction they're going to go in life .

>> Thanks for your call.

Let's go next email.

Our next email reads Deirdre Evolver is a caffeine supplement OK to use I'm a college student and sometimes I have to put in a late night of studying.

>> I get that as a college student you often have to do that and as a college student I could advise you to be careful to still get your sleep.

>> It's been actually shown that if you have a late night of studying and you're going into 2:00 and 3:00 in the morning and 4:00 in the morning and you have an early morning examination, you're not going to retain any more information probably after about 10:00 or 11:00 p.m.

at night even with caffeine.

>> What caffeine does is it will basically allow you to recharge the brain and give the brain a little bit more wakefulness.

Caffeine also indirectly will increase dopamine transmission but caffeine is simply an adenosine receptor blocker.

>> So when you think about adenosine and adenosine, when you hear about ATP adenosine triphosphate thanas ADP, it does seem Dief phosphate adenosine is basically the fumes in the brain.

>> The brain's working all day long and it's setting off fumes just like our car releases fumes from the engine adenosine gets released as fumes in the brain and it makes you tired as the day goes long.

So what do you do?

You can use some caffeine as a means of blocking the adenosine receptors.

They don't feel as tired or more awake that way but you're also indirectly increasing dopamine as well helping with concentration where my stance is on caffeine is uses sparingly.

>> If you overuse it your brain gets used to it.

You need more and more.

Did you get headaches and you feel lousy if you don't have the caffeine at a certain time if you use caffeine I don't recommend using it in the form of tablets tablets of about 100 to 200 milligrams of caffeine in them taking that as one gulp as one shot I think I can give you a surge of caffeine but that would wear off very quickly.

Caffeine doesn't last very long in the body so I would often recommend having a caffeinated beverage.

>> The favorite caffeinated beverage I could recommend if it works for you is simply t t is a combination of caffeine and thickening in it and it's a beautiful combination because the caffeine gives you awake full effect.

The theunissen gives you a calming effect.

It tends to balance out the blood pressure that way and it's a smoother effect overall.

>> So if it works for you hot tea, iced tea, some kind of tea would be very, very helpful.

Eloise's caffeinated but coffee can be helpful if you sip it slowly over the course of maybe an hour or two .

If you gulp down coffee , it's going to get in your system very quickly just like that caffeine tablet but it's not going to last very long.

So sipping it slowly would be very helpful.

But caffeine has a very useful role.

It can be what we call precognitive in terms of helping with concentration, helping with alertness and find it to use as the day goes on.

>> But as I often recommend to medical students who I teach, I tell them to take that late afternoon nap or early evening nap for no more than thirty minutes if you get by with that a brief nap set an alarm if you need to but don't go more than thirty minutes because a brief nap will recharge the brain you typically with a brief nap at the end of a long day will it'll give you enhanced non rem sleep it'll give you a little bit of dream sleep basically allows your brain to recharge when you go into non REM sleep that's going to be a very deep sleep and it's where your front part of your brain is at total rest.

So in that front part of the brain is that total rest.

It allows you to recharge you're able to download memories the hippocampus better and thirty minutes is often all you need.

>> It's called a power nap.

Einstein talked about power naps for about twenty minutes later in the afternoon.

It's very effective for helping a concentration focus much more so than even caffeine.

>> So using a power nap with caffeine is a particularly effective there is something called a coffee nap.

I just heard about that phenomenon a few years ago.

A coffee nap is where you have a cup of coffee that immediately go take a nap for twenty or thirty minutes.

You're very energized and awake at the end of that twenty or thirty minute nap because the coffee's just starting to kick in and about that time and you've had your nap so it's giving you a really nice synergistic dual effect that way.

>> Thanks for your call.

Let's go next caller.

Hello Yolanda.

Welcome Merza mind Yolanda you want to know is it possible to train your brain to think only positive thoughts?

It's not only possible, Yolanda.

It's very likely that you can in terms of focusing more on the positive because if you do think about negative ruminations, it's like driving down the road and always looking in your rearview mirror.

Now sometimes it's nice to look in rearview mirror but if you're going through life like that it's important to understand, OK, what's happened to and how you can learn from the past.

But if you focus on the negative recollections it'll cause you to be more depressed.

So is it positive?

Is it possible to have positive thoughts?

You bet.

>> Try to block out the negativity.

Always look forward to something and we also have things that we can look forward to doing whether it be tomorrow or it can be next week or even next year but always have a forward focused mindset because that will help you more with positivity itself.

Something I often recommend for people to do is simply have a notebook where they write down the kind of things in which they're grateful.

>> So it's a gratitude journal and many people forget to remind themselves of all the gratitude they have.

>> They think about all the bad stuff happening in their lives and all the all the mean things people did to them but they forget the kind of things in which they should be grateful.

So having a gratitude journal where you simply write down five things in which you're grateful, write them down once a week and just always remember the kind of things you're grateful for , whether it be something as simple as still being able to walk around and have your physical health that you have whether it be your friends, family, whether you be that you have a job for the time but focus on the things in which you're grateful.

>> That's the sense of positivity that is really good for your mental health .

Thanks for your call.

Let's go next e-mail question our next e-mail question reads Dirda to favor I haven't seen these commercials on television concerning tardive dyskinesia also known as TD.

Why are these medications used and who is at risk for developing tardive dyskinesia?

>> Tardive dyskinesia is a condition where your middle part of your brain, the movement part of your brain is getting too much dopamine.

>> It's called the substantial nigra substantial means body nigra means blacks with are kind of black body in the middle part of your brain and if you have decreased volume of your substantial nigra you get Parkinson's disease.

Many people have seen Parkinson's disease was the famous actor Michael Fox Michael J. Fox but he has Parkinson's.

These two little dopamine tardive dyskinesia is where you have too much dopamine transmission especially in that substantial Negreanu that makes you twitchy so you have trouble with hard blinking.

>> You mouth movements, you move your shoulders abnormally and your overall have tics and twitches.

So it's too much dopamine.

>> How do you get too much dopamine?

Well if you block dopamine excessively with some antipsychotic medications it can give you on down the line tardive dyskinesia who's a risk for tardive dyskinesia?

No one.

>> If you use an antipsychotic medication that strongly blocks dopamine for a mood condition like bipolar disorder or depression, unfortunately that can put you at a higher risk for tardive dyskinesia.

Now here's the good news not all of these so-called antipsychotic medications will block dopamine to the same amount.

So ideally you want a medication is going to block block dopamine less but still work for depression.

Why do we use these antipsychotics for depression while antipsychotic medications added to an antidepressant can improve the likelihood of you getting a response the antidepressive by 70 percent so they're effective.

>> It's just that if you block dopamine tightly you can have the twitchy movements consistent with tardive dyskinesia.

>> Women are more likely to have older people are more likely to have Apted if you're if you also have type two diabetes that can put you at a higher risk for tardive dyskinesia and if you have early extra pyramidal symptoms where you're shaky from antipsychotic medication and you have shuffling gait and maybe you have tightness of the limbs, it's called extra pyramidal symptoms if you have extra pyramidal symptoms, you're two and a half times more likely to have TRD later on.

So you're referring to the medications Austereo and Ingres these are medications that are on the advertisements and they're the treatments for tardive dyskinesia and I'm very grateful we have those treatments because you know, some people get tardive dyskinesia.

These are a means of alleviating those treatments.

I am always a big fan of trying to avoid the TRD to begin with but if you have TRD you need something and those are very effective medications for relieving the TRD themselves.

They typically can have a little bit of sedation associated with them but what they are doing is basically increasing the breakdown of dopamine specifically and selectively in that movement center of your brain itself.

>> Thanks for your call.

I think I have another call available where I can answer in this last minute.

Hello Carlos.

Welcome to Matters of Mind.

Carlos, you want to know what's a good age to start thinking about the quality of your memory?

I think at any age, Carlos, if you're having trouble with your memory earlier on, it can be something as subtle as thyroid disturbances, diabetes, some kind of medical condition if you're in your middle age period, maybe it's sleep apnea.

There could be something else causing memory problems and as you get over sixty five years of age depression early dementia can be a factor at any age alcohol consumption or the use of marijuana can affect the memory.

So I think it is based on the age you're in.

But if you have any trouble with your memory at all by all means talk to your primary care clinician to see what can be addressed.

Thanks for your call.

Unfortunate I'm out of time for this evening.

If you have any questions concerning mental health issues that I can answer on the air you may write me a via the Internet at matters of mind all one word at WFYI Dog.

I'm psychiatrist Jeff all right.

You've been watching matters of mind on PBS for Wayne God willing a PBS willing.

>> I'll be back again next week.

Thanks for watching.

Goodnight