.

GOOD EVENING.

I'M PSYCHIATRIST JAY FAUVER LIVE FROM FORT WAYNE, INDIANA.

WELCOME TO MATTERS OF THE MIND NOW IN ITS TWENTY SECOND YEAR MATTERS THE MIND IS A LIVE CALL IN PROGRAM WHERE YOU HAVE A CHANCE TO CHOOSE THE TOPIC FOR DISCUSSION.

SO IF YOU HAVE ANY QUESTIONS CONCERNING MENTAL HEALTH ISSUES, GIVE A CALL HERE AT PBS'S FORT WAYNE IN THE FORT WAYNE AREA BY DIALING NINE SIX NINE TWO SEVEN TWO ZERO OR IF YOU'RE CALLING LONG DISTANCE YOU MAY DIAL TOLL FREE AT EIGHT SIX SIX NINE SIX NINE TO SEVEN TO ZERO.

NOW ON A FAIRLY REGULAR BASIS WE ARE BROADCAST LIVE EVERY MONDAY NIGHT FROM OUR PB'S 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 CONCERNING MENTAL HEALTH ISSUES THAT I CAN ANSWER ON THE AIR, YOU MAY WRITE ME VIA THE INTERNET AT MATTERS OF THE MIND ALL ONE WORD AT WFA DAWG THAT'S MATTERS OF THE MIND AT MWF ECG AND I'LL START TONIGHT'S PROGRAM WITH A QUESTION I RECENTLY RECEIVED.

IT READS DIRDA TO FAVOR MY TREATING CLINICIAN AND I INTENTIONALLY TOOK OUT THE NAME OF YOUR TREATING CLINICIAN BY TREATING CLINICIAN HAS BEEN TREATING ME WITH EIGHT DIFFERENT MEDICATIONS FOR BIPOLAR DISORDER.

IS THAT TOO MANY?

HOW MANY MEDICATIONS ARE NEEDED TO TREAT BIPOLAR DISORDER?

IF YOU THINK ABOUT BIPOLAR DISORDER AS BEING LIKE OTHER MEDICAL CONDITIONS LIKE HEART DISEASE, ASTHMA, DIABETES, HYPERTENSION SOMETIMES WITH VARIOUS MEDICAL CONDITIONS YOU DO NEED MEDICATIONS THAT WILL HAVE DIFFERENT MECHANISMS OF ACTION AND THEY WORK TOGETHER BETTER THAN THEY WORK WOULD WORK INDIVIDUALLY AND OR IN COMBINATION.

SO THEY WORK SYNERGISE CRITICALLY AS A GROUP THEY ALL WORK BETTER.

SO WITH BIPOLAR DISORDER YOU THINK OF THREE MAIN CATEGORIES OF MEDICATIONS.

YOU THINK OF LITHIUM, YOU THINK OF THE ANTI SEIZURE MEDICATIONS WHICH ARE ALSO KNOWN AS THE ANTIEPILEPTIC MEDICATIONS.

THEN YOU THINK OF THE SECOND GENERATION ANTIPSYCHOTICS WHICH ARE MEDICATIONS THAT ARE ALSO USED FOR SCHIZOPHRENIA.

THOSE ARE THE THREE MAIN CATEGORIES.

SO WHEN I THINK ABOUT BIPOLAR DISORDER I'M OFTEN THINKING ABOUT THAT THREE THOSE THREE CATEGORIES.

SO AS A GENERAL RULE OF THUMB YOU MIGHT BE TAKING THREE DIFFERENT MEDICATIONS IF YOU'RE TAKING EIGHT DIFFERENT MEDICATIONS.

IT'S IMPORTANT TO DISCUSS WITH YOUR CLINICIAN THE PURPOSE OF EACH OF THE MEDICATIONS TO UNDERSTAND IF THEY HAVE DIFFERENT MECHANISMS OF ACTION.

WHAT THE RATIONALE MIGHT BE FOR ADDING ONE ON TOP OF ANOTHER.

DID ONE MEDICATION WORK AND IF IT DIDN'T WORK, WHY WASN'T IT TAKEN AWAY?

SOMETIMES MEDICATIONS IN COMBINATION LIKE THAT ARE LIKE GOVERNMENT GOVERNMENT REGULATIONS.

YOU KNOW, IF YOU'RE GOING TO ADD A GOVERNMENT REGULATION YOU REALLY IDEALLY OUGHT TO TAKE ONE AWAY AND THAT'S THE WAY MEDICATION SHOULD SOMETIMES BE.

IF YOU'RE GOING TO ADD A MEDICATION ON YOU MIGHT WANT TO TAKE AWAY A MEDICATION AND TRY TO KEEP THAT NUMBER DOWN.

YOU'RE TAKING A DIFFERENT MEDICATIONS FOR BIPOLAR DISORDER JUST ALONE.

THAT TELLS ME THAT YOU KNOW THAT THERE'S A LOT OF MEDICATIONS, A LOT OF A LOT OF MEDICATIONS FROM A COST STANDPOINT TO YOU IT IS A BURDEN TO TAKE EIGHT DIFFERENT MEDICATIONS.

WHEN I WAS A PHARMACIST WE ALWAYS LEARNED THAT IF SOMEBODY HAD TO TAKE MORE THAN THREE MEDICATIONS FOR A PARTICULAR CONDITION THAT WAS GOING TO BE QUITE A CHALLENGE.

AND IF WE HAD TO TAKE THEM SEVERAL TIMES A DAY THAT DECREASE THE LIKELIHOOD THAT SOMEBODY WAS ACTUALLY GOING TO TAKE THE MEDICATION.

SO KUDOS TO YOU IF YOU'RE ACTUALLY TAKING THEM.

BUT I'D CERTAINLY TALK IT OVER WITH YOUR TREATING CLINICIAN ABOUT THE RATIONALE FOR THE NUMBER OF MEDICATIONS YOU'RE TAKING, WHAT UNFORTUNATELY SOMETIMES WILL HAPPEN AS MORE AND MORE MEDICATIONS GET ADDED, ESPECIALLY IF THEY'RE NOT WORKING THAT WELL THEN YOU START ADDING MORE MEDICATIONS FOR THE PURPOSE OF OFFSETTING THE SIDE EFFECTS OF THE NUMEROUS MEDICATIONS YOU MIGHT BE TAKING.

SO YOU'RE TAKING NOT ONLY MEDICATIONS TO TREAT THE CONDITION BUT THEN YOU START ADDING MEDICATIONS TO TREAT THE SIDE EFFECTS OF THE MEDICATIONS THAT ARE BEING PRESCRIBED.

SO IT GETS TO BE A FINE BALANCE.

IT'S VERY, VERY IMPORTANT FOR YOUR TREATING CLINICIAN TO NUMBER ONE, KEEP VERY CLOSE TRACK OF YOUR TREATMENT HISTORY AND KNOW WHAT'S WORKED AND WHAT HAS NOT WORKED.

SECONDLY, TO MAKE SURE THE DIAGNOSIS IS PROPERLY GIVEN IF YOU HAVE BIPOLAR DISORDER TYPE TWO THAT SOMETIMES WILL JUSTIFY ADDING AN ANTIDEPRESSANT MEDICATION IN SOME CASES.

BUT IF YOU HAVE BIPOLAR DISORDER TYPE ONE, THE QUESTION ALWAYS WILL BE DO YOU REALLY NEED AN ANTIDEPRESSANT BECAUSE WITH BIPOLAR DISORDER TYPE ONE WHERE PEOPLE HAVE A WEEK LONG BELLE OF MANIA PERIODICALLY THEY WILL DO WORSE MANY TIMES WITH AN ANTI DEPRESSANT IT'S KIND OF LIKE ADDING AN ACCELERATOR FOR SOMEBODY WHO HAS A POOR BRAKING SYSTEMS.

SO ADDING AN ANTIDEPRESSANT MEDICATION IF YOU'RE ALREADY FEEL MORE IRRITABLE, MORE MOODY ,MORE ANGRY, SOMETIMES THAT'LL MAKE A BIPOLAR CONDITION WORSE FOR PEOPLE.

SO THOSE ARE THE KINDS OF THINGS WE HAVE TO CONSIDER.

HAVE YOUR TREATING CLINICIAN TAKE A LOOK AT ANY OF YOUR FAMILY HISTORY OF TRAUMA RESPONSES.

IF YOU HAVE A BIPOLAR DISORDER, CHANCES ARE YOU'VE HAD FAMILY MEMBERS WITH BIPOLAR DISORDER BECAUSE IT'S HIGHLY GENETIC AND YOU WANT TO LOOK AT WHAT KIND OF THINGS YOUR FAMILY MEMBERS MIGHT HAVE DONE TO TREAT THAT AND YOU CAN USE CLUES LIKE THAT TO SOMETIMES PICK UP ON THE BEST TREATMENT PRACTICES FOR INDIVIDUAL PATIENTS.

A FINAL THING THAT WE SOMETIMES DO WILL BE TO DO GENETIC TESTING WITH GENETIC TESTING.

SOMETIMES THAT'LL HONE IN ON WHAT KIND OF DOSES OF VARIOUS MEDICATIONS YOU MIGHT NEED BECAUSE VARIOUS PEOPLE WILL BREAK DOWN OR METABOLIZE MEDICATIONS IN SOME WAY FAST AND SOME WAY SLOW AND YOU HAVE TO SORT OUT WHAT KIND OF MEDICATIONS YOU WILL BREAK DOWN MORE QUICKLY AND MORE SLOWLY.

THANKS FOR YOUR QUESTION.

LET'S GO TO OUR FIRST CALLER.

HELLO RENE.

WELCOME TO MATTERS OF MIND.

HI, THANKS FOR HAVING ME RENEE.

I HAD A QUESTION WHAT?

HI.

HI.

I HAVE AN EIGHTY THE ANXIETY AMONG OTHER THINGS AND WHAT AM I A MIND RACES?

HOW DO I KNOW WHETHER IT'S FROM ANXIETY OR ADHD?

EXCELLENT QUESTION, RENEE.

OFTEN ADHD WILL CREATE ANXIETY AND YOU VERY NICELY DESCRIBED YOUR MIND RACING.

RENEE, WILL YOUR MIND RACE MORE OFTEN THAN NOT EVERY DAY OR DOES THAT COME AND GO WHERE YOU HAVE A FEW DAYS WHERE YOUR MIND RACES THAN A FEW DAYS WHERE YOU CAN EVEN THINK DOES IT IS THAT THERE MORE OFTEN THAN NOT IT'S THERE MORE OFTEN THAN NOT?

YEAH.

YEAH.

RENEE, AS YOU KNOW, THAT'S MORE INDICATIVE OF ADHD.

IT'S A VERY IMPORTANT DIFFERENTIATION BECAUSE WE NEED TO DIFFERENTIATE ADHD VERSUS BIPOLAR DISORDER WITH BIPOLAR DISORDER PEOPLE WILL HAVE INTERMITTENT OR PERIODIC RACING OF THE MIND WHERE THEY'LL HAVE A FEW DAYS WHERE THEIR MIND WILL RACE AND THEN A FEW DAYS WHERE THEY JUST CAN'T THINK AT ALL.

WITH ADHD THE MIND WILL RACE ON A DAY TO DAY BASIS IN MANY PEOPLE WITH ADHD, RENEE WILL DESCRIBE THE PHENOMENON AS HAVING A TELEVISION REMOTE IN YOUR HEAD AND IT'S KIND OF GOING FROM ONE TOPIC TO ANOTHER TO ANOTHER.

AND AS YOU'VE NICELY DESCRIBED ,IT CREATES ANXIETY BECAUSE YOU'RE ANXIOUS ABOUT GETTING YOUR THOUGHTS TOGETHER AND PEOPLE WITH ADHD WILL OFTEN HAVE A LOT OF WORRIES ABOUT WHAT THEY DIDN'T DO, WHAT THEY FORGOT, WHAT THEY PROCRASTINATED UPON.

THEY'LL HAVE A LOT OF ANXIETY BECAUSE THEY JUST CAN'T PROCESS INFORMATION AS EFFICIENTLY AS THEY MIGHT EXPECT.

THEY'LL GO INTO A SOCIAL SETTING AND THEY'LL HEAR ALL THE DIFFERENT CONVERSATIONS GOING ON AT THE SAME TIME AND THAT CREATES A LOT OF ANXIETY.

AND UNFORTUNATELY, RENEE, YOU CAN IMAGINE WITH ANXIETY WITH ADHD, MANY PEOPLE RESORT TO DRINKING ALCOHOL OR SMOKING MARIJUANA, ESPECIALLY IN THE STATES WHERE MARIJUANA IS LEGALIZED.

SO THEY'LL SELF MEDICATE WITH THESE SUBSTANCES THAT ACTUALLY IN THE LONG RUN WILL MAKE ADHD WORSE.

SO IN MANY CASES, RENEE, I WOULD SAY IF YOU HAVE ANXIETY WITH ADHD MORE OFTEN THAN NOT IF YOU TREAT THE ADHD AND YOU CAN HELP WITH THE THOUGHT PROCESSING, SLOW THE MIND DOWN, DECREASE THE DISTRACTIBILITY THAT IN TURN OFTEN WILL RELIEVE THE ANXIETY FOR A LOT OF PEOPLE I'M OFTEN ASKED WHEN I HAVE SOMEBODY ON A ON A STIMULANT FOR ADHD AND THEY HAVE ANXIETY GOING ALONG WITH IT.

PEOPLE SOMETIMES WONDER WELL GEE YOU'VE GOT ME ON STIMULANT, WHY WOULD I BE ON A STIMULANT IF I ALREADY HAVE ANXIETY?

WHAT'S THE RATIONALE?

THE RATIONALE AS A STIMULANT WILL FIRE UP THIS LEFT FRONT PART OF THE BRAIN HERE THAT'S INVOLVED WITH FOCUSING AND PAYING ATTENTION TO THINGS THAT AREN'T THAT INTERESTING AND HELPING YOU KEEP YOUR MIND ON THINGS.

IF YOU CAN FIRE UP THAT PART OF THE BRAIN AND KEEP YOUR MIND ON THINGS BETTER, YOU MIGHT HAVE LESS ANXIETY AND THAT'S WHAT OFTEN HAPPENS WITH ADHD WHEN YOU TREAT ADHD THE ANXIETY SHOULD DECREASE.

NOW RENEE, IN SOME INSTANCES IF YOU HAVE SOMEBODY ON A STIMULANT AS A TREATING CLINICIAN AND THE ANXIETY ACTUALLY WORSENS WITH A STIMULANT, YOU NEED TO GET THEM OFF THE STIMULANT OR DECREASE THE DOSAGE BECAUSE A STIMULANT GIVEN TO SOMEBODY WITH ADHD WORSENS OR ANXIETY IS LIKE GIVING SOMEBODY EYEGLASSES THAT ARE TOO THICK.

YOU'D NEED TO BRING THAT DOWN DOSE OF THE EYEGLASS LENSES OR DECREASE THE THICKNESS OF THE LENSES.

THE SAME IS TRUE WITH ADHD.

SOMEBODY IS GETTING ANXIOUS ON ADHD TREATMENT.

WE NEED TO BACK OFF OF THOSE DOSES A BIT.

RENE, THANKS FOR YOUR CALL.

LET'S GO TO OUR NEXT CALLER.

HELLO TOM.

WELCOME TO MATTERS OF THE MIND OR I WAS WONDERING I WAS GOING TO PALM CENTER AND THEY TREAT ME FOR SPECIAL PREMIE AND BIPOLAR AND I WAS ON THE CALL.

I HAVE A MALE GROUNDS AND IT WAS A TUMOR.

THE ISSUE TO GET A BURN OFF OF IT FOR A WHILE BECAUSE I WAS IN THE HOSPITAL AND I MADE APPOINTMENT TO GO TO AND THEY WANTED TO HAVE ME COME IN AS A WALK THROUGH BECAUSE I MISSED MY APPOINTMENT.

I DON'T THINK THAT'S FAIR BECAUSE I TOLD THEM I WAS IN THE HOSPITAL.

YOU CAN CALL PAFA WELL THANKS FOR YOUR CALL.

LET ME GO THROUGH SOME OF THE SYMPTOMS YOU'RE HAVING THERE.

YOU DESCRIBED AS HAVING BIPOLAR DISORDER WITH SCHIZOPHRENIA THAT'S ALSO KNOWN AS SCHIZOAFFECTIVE DISORDER SCHIZOPHRENIA AS A DAY TO DAY PHENOMENON AND TOM'S SCHIZOPHRENIA IS A CONDITION WHERE EVERY DAY YOU CAN HAVE DIFFICULTY WITH PROCESSING INFORMATION EVERY DAY CAN HAVE TROUBLE SOMETIMES HEARING VOICES AND HAVING PERCEPTIONS THAT THINGS ARE HAPPENING THAT MIGHT NOT REALLY BE HAPPENING THEN BIPOLAR DISORDER IS WHERE ON TOP OF THAT YOU CAN HAVE MOOD SHIFTS WHERE YOU CAN HAVE HIGHS, WHERE YOU HAVE SOME DIFFICULTY WITH DECREASED NEED FOR SLEEP.

YOU'RE MORE IMPULSIVE, YOU'RE HAVING RACING THOUGHTS AND THEN YOU'RE HAVING LOWS THEREAFTER.

AND TOM, AFTER YOU GET DISCHARGED FROM A HOSPITAL, IT IS IMPORTANT FOR YOU TO STAY ON MEDICATION.

SEROQUEL IS A MEDICATION.

IT CAN BE USED FOR SCHIZOPHRENIA, SCHIZOAFFECTIVE DISORDER AND SOMETIMES MEDICATIONS LIKE LITHIUM WILL BE ADDED LATER TO SOMETIMES WILL BE ADDED ON TOP OF THAT.

SO TOM, I'D CERTAINLY SUGGEST THAT YOU DO THE BEST YOU CAN TO KEEP IN CONTACT WITH YOUR TREATING CLINICIANS.

I ALWAYS BELIEVE THAT IT'S A GOOD IDEA TO BE SEEN VERY QUICKLY AFTER COMING TO THE HOSPITAL SOMETHING THAT CAN BE VERY HELPFUL AND SOMETHING YOU MIGHT PURSUE WOULD BE A DISCUSSION WITH YOUR TREATING CLINICIANS, THE POSSIBILITY OF BEING ASSIGNED A CASE MANAGER OR A COUNSELOR, A CASE MANAGER IS SOMEBODY WHO KIND OF KEEPS AN EYE ON YOUR DAY TO DAY FUNCTIONING ESPECIALLY AS YOU GET OUT OF THE HOSPITAL AND THEY CAN MAKE SURE YOU'RE IN CLOSE CONTACT WITH YOUR PRESCRIBING CLINICIANS AND A COUNSELOR IS ALSO SOMEBODY WHO CAN KEEP TRACK OF YOU WITH JUST COPING ON A DAY TO DAY BASIS AND THEY TOO CAN KIND OF BE THE LIAISON OR THE GO BETWEEN YOUR TREATING CLINICIAN.

SO IT'S IMPORTANT TO TRY TO GET A HOLD OF THEM.

TOM, BUT I UNDERSTAND YOUR FRUSTRATION.

YOU WANT TO BE SEEN QUICKLY AND HE SHOULD BE FOR THE PURPOSE OF KEEPING AN EYE ON YOUR MEDICATIONS AND IT'S VERY IMPORTANT YOU STAY ON YOUR MEDICATIONS.

TOM, TOM, THANKS FOR YOUR CALL.

LET'S GO TO OUR NEXT CALLER.

HELLO, LINDA.

WELCOME TO MATTERS OF MIND.

HI, DR. FARBER.

HI, LINDA.

I RECENTLY WAS WELL WITHIN THE LAST THREE MONTHS HAVE BEEN DIAGNOSED WITH PSYCHOTIC DEPRESSION AND I'M ELDERLY AND I HAVE BEEN PUT ON SOME MEDICATIONS PLUS SUGGESTED THAT I GO SEE A COUNSELOR AND SOME OTHER GOOD SUGGESTIONS.

BUT THE THING THAT BOTHERS ME IS THE THING THAT BOTHERS ME IS THE FACT THAT EVERY DAY ON A DAILY BASIS I HAVE JUST STRANGE THINGS THAT HAPPEN TO ME LIKE WELL FOR THE LAST FOUR MONTHS I'VE BEEN HEARING VOICES THAT NIGHT AND AND HEARING CONVERSATIONS GOING ON WITH PEOPLE THAT AREN'T THERE.

AND I FINALLY GOT SO ANXIETY BY IT AND WORRIED ABOUT THAT.

I DID GO TO THE DOCTOR AND I AM BEING TREATED NOW BUT I'M ALSO SHOWING A LOT OF SIGNS TO ME IT SEEMS LIKE I'M SHOWING A LOT OF SIGNS OF LIKE EARLY DEMENTIA AND THAT CONCERNS ME.

I WONDER IF I'M REALLY HEADED FOR SOME KIND OF DEMENTIA.

WELL, I'M GLAD YOU'RE ABLE TO RECOGNIZE YOU'RE HAVING DIFFICULTY WITH CONCENTRATION AND AND MEMORY.

YOU HAD MENTIONED THE YOU RECENTLY WERE DIAGNOSED WITH PSYCHOTIC DEPRESSION.

WHAT THAT MEANS IS THIS LEFT FRONT PART YOUR BRAIN IS SIGNIFICANTLY UNDERACTIVE WHEN PEOPLE GET DEPRESSED IS LEFT FRONT FOR THE BRAIN WILL INDEED GET UNDERACTIVE.

BELINDA, WHEN YOU GET PSYCHOTICALLY DEPRESSED IT BECOMES SO UNDERACTIVE.

THIS IS THE REASONING PART OF THE BRAIN.

IT BECOMES SO UNDERACTIVE THAT YOU LOSE TOUCH WITH REALITY AND IT SOUNDS LIKE YOU STILL RECOGNIZE SOME OF THAT.

AND IF YOU'VE HEARD VOICES TALKING TO YOU WHEN THERE'S NOBODY AROUND THAT GOES ALONG WITH DEPRESSION AND IN SOME CASES ESPECIALLY IF YOU'VE NOT HAD IT PREVIOUSLY NOW LINDA, SOMETIMES AS WE GET OLDER AS YOU START HAVING MEMORY PROBLEMS, THE FIRST THING WE ALWAYS WANT TO DO IS MAKE SURE THE DEPRESSION IS IN GOOD CONTROL BECAUSE IF YOU HAVE DEPRESSION IT WILL SIGNIFICANTLY IMPACT THE MEMORY ALL BY ITSELF.

AND THERE'S A PHENOMENON CALLED PSEUDO DEMENTIA WHERE PEOPLE HAVE WHAT APPEARS TO BE DEMENTIA.

THEY CAN'T REMEMBER THINGS THEY'RE ABSENT MINDED BUT IT'S DUE TO DEPRESSION ITSELF.

SO IF YOU'VE HAD A SEVERE DEPRESSION AND THAT'S WHAT A PSYCHOTIC DEPRESSION WILL BE, THAT WILL CAUSE YOU TO HAVE PROFOUND MEMORY DISTURBANCES.

SO LINDA, IF YOU'VE BEEN DIAGNOSED WITH PSYCHOTIC DEPRESSION, THE FIRST THING YOU ALWAYS WANT TO DO IS GET THE DEPRESSION UNDER REALLY GOOD CONTROL.

MAKE SURE THE VOICES GO AWAY, MAKE SURE THOSE OH ODYSSEYS SESSIONS AND THOSE PERCEPTIONS YOU'RE EXPERIENCING GET TO THE POINT WHERE THEY GET IN, WALK IN GOOD CONTROL AND AFTER THAT POINT MAKE SURE THAT THE MEMORY AND CONCENTRATION ARE COMING BACK.

YOU CAN BE REASSESSED AT THAT POINT BUT IF YOU HAVE UNTREATED DEPRESSION THEN IT GOES ON DAY BY DAY, MONTH BY MONTH, YEAR BY YEAR UNTREATED DEPRESSION OVER 65 YEARS OF AGE WILL QUADRUPLE YOUR RISK OF DEVELOPING ALZHEIMER'S DEMENTIA SO IT IS A CONCERN WE WILL HAVE IF YOU HAVE ONGOING DEPRESSION AS AN OLDER ADULT THAT WILL INCREASE THE LIKELIHOOD OF YOU DEVELOPING ALZHEIMER'S DEMENTIA.

SO IT IS AN IMPORTANT CONCERN THAT WE WILL HAVE FOR PEOPLE.

BUT FOR YOU IT SOUNDS LIKE THE PSYCHOTIC DEPRESSION HAS BEEN DIAGNOSED, IT'S GETTING TREATED AND IT'S A MATTER OF TRYING TO GET REALLY GOOD CONTROL AT THIS POINT LINDA, LINDA, THANK YOU FOR YOUR CALL.

LET'S GO TO NEXT CALLER.

HELLO BRUCE.

WELCOME TO MATTERS OF BY DOCTOR.

HOW ARE YOU DOING?

I'M DOING OK BRUCE.

HOW ARE YOU?

GOOD.

I HAD THREE BRIEF COMMENTS.

GOUSSIS I CAN LISTEN TO YOUR ANALYSIS.

ALL RIGHT.

ONE OK, ONE PERSON FEELING LIKE THEY ARE HAVING AN ANXIETY ATTACK.

WHAT ARE THE SIGNS LET ME TURN THIS DOWN A LITTLE HERE, OK?

WHAT ARE THE SIGNS OF AN ANXIETY ATTACK?

ARE THEY NATURAL OR IS IT SOMETHING UNCOMMON AND WHAT WOULD BE LIKE MAYBE A NATURAL CURE OR SOMETHING A PERSON COULD DO TO OVERCOME ANXIETY IF IN FACT YOU DESCRIBE IT AS BEING AN ANXIETY ATTACK?

WHAT ARE THE SIGNS AND THAT SECONDLY HYPERACTIVITY IS THAT COMMON IN ADULTS?

AND I REMEMBER SEEING A KID AND SOME KIDS WERE ON SOMETHING CALLED THE DOCTOR FINEGOLD DIET AND THEY GOT AWAY FROM HYPERACTIVITY.

I'M WONDERING AS THEY GET OLDER IS THAT CONNECTED TO ANXIETY?

AND THEN THIRDLY, YOU'RE JUST TALKING TO A WOMAN, LINDA, ABOUT MEMORY AND THINGS.

ARE THERE ANY TECHNIQUES AN OLDER PERSON WHO FEELS THEY'RE GETTING SMALL TIME, SHORT TERM MEMORY SYMPTOMS, THINGS THEY CAN DO TO ENHANCE OR MAYBE REGAIN MEMORY?

I THINK I'VE SAID ENOUGH.

THANKS SO MUCH FOR YOUR TIME, DOCTOR.

GREAT QUESTIONS, BRUCE.

I'M GOING ANSWER THOSE NOT IN THE SAME ORDER.

I'M GOING TO ANSWER THEM MAYBE WITH A SIMPLEST ONE FIRST THE HYPERACTIVITY IN ADULTS IT CAN OCCUR WHERE YOU DO HAVE ADHD, ADULT ADHD OR ADHD IN THE ADULT YEARS WHERE YOU HAVE ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY OR IMPULSIVITY.

OH IT HAPPENS MORE WITH BOYS THAN MEN AND THEN PROGRESSES TO MEN COMPARED TO GIRLS.

THEY'RE BECOMING WOMEN SO BOYS CAN HAVE ADHD.

IT GOES INTO THE ADULT YEARS.

YEAH IT CAN HAPPEN AND YOU CAN HAVE MEN WHO ARE FIDGETY.

THEY CAN'T SIT STILL.

THEY'RE MORE IMPULSIVE.

THEY BLURT OUT THINGS.

IT'S THOUGHT THAT UP TO HALF OF THE PRISONERS IN THE PRISON SYSTEM, BRUCE, HAVE ADHD AND AND THE REASON THEY HAVE ADHD AND MAYBE THE REASON THEY GOT INTO TROUBLE IN SOME CASES BECAUSE THEY WERE VERY IMPULSIVE, THEY WEREN'T THINKING BEFORE THEY DID THINGS AND THEY WERE VERY HYPERACTIVE AND IMPULSIVE.

YOU HAD MENTIONED A DIFFERENT DIETARY TYPE OF MEASURES.

THEY HAD HELPED TO SOME DEGREE IF THERE ARE CERTAIN DIETS THAT SEEM TO PROVOKE THE HYPERACTIVITY MORE SURE I'VE HEARD ABOUT THE HIGH SUGAR DIETS AND A RED COLORING AND THINGS LIKE THAT.

I HAVEN'T SEEN THOSE REALLY COME ABOUT TO BE REALLY EFFECTIVE.

ONE WAY OR ANOTHER IN TERMS OF HELPING WITH ADHD.

YOU HAD MENTIONED MEMORY DISTURBANCE WITH ADULTS.

WHAT CAN WE DO AS WE GET OLDER TO DECREASE SOME OF THE MEMORY DISTURBANCES?

NUMBER ONE, STAY PHYSICALLY ACTIVE, EXERCISE AT LEAST 30 MINUTES EVERY DAY IF YOU CAN REALLY GET AROUND TO GETTING SOME KIND OF EXERCISE IN NUMBER TO STAY SOCIALLY ACTIVE, BE AROUND PEOPLE, TRY TO INTERACT ON A REGULAR BASIS.

NUMBER THREE, WATCH YOUR DIET GO EASY ON THE CARBOHYDRATES AS YOU GET OLDER AND TRY TO EAT A BIT MORE LEAN DIET.

BUT A HIGH CARBOHYDRATE DIET MIGHT GIVE YOU A HIGHER LIKELIHOOD OF HAVING DIFFICULTY WITH CONCENTRATION AND FOCUS.

I'M A BIG FAN OF INTERMITTENT FASTING FOR A LOT OF PEOPLE WHERE YOU TRY NOT TO EAT RELATIVELY ANYTHING FOR ABOUT 12 TO 14, MAYBE 16 OR 18 HOURS EVERY DAY AND JUST EAT WITHIN A LITTLE TIME WINDOW EVERY DAY.

I THINK FOR A LOT OF PEOPLE THAT ACTUALLY HELPS HER CONCENTRATION AND FOCUS AND FINALLY, IF YOU WANT TO HELP YOUR CONCENTRATION AND FOCUS, YOU WANT TO STAY INVOLVED IN IN NOVEL CHALLENGING TYPE OF ACTIVITIES, PLAY PUZZLES ON A REGULAR BASIS, CHALLENGE YOUR BRAIN, KEEP YOURSELF DOING THINGS ON A REGULAR BASIS AND STAGNATING THE BRAIN, STAGNATING THE BRAIN AS ONE OF THE WORST THINGS YOU CAN DO .

I SEE IT ALL THE TIME AND PEOPLE WHO RETIRE BUT THEY JUST DON'T USE THEIR BRAIN AS MUCH AS THEY DID PREVIOUSLY AND THAT WILL CAUSE THE CAUSE THEM TO HAVE MEMORY PROBLEMS OVER THE COURSE OF TIME.

YOUR THIRD ISSUE THERE HAD TO DO WITH ANXIETY AND PANIC ATTACKS.

BRUCE PEOPLE WITH PANIC ATTACKS WILL OFTEN HAVE A PANIC ATTACKS FIRST EMERGE WHEN THEY FEEL LIKE THEY'RE BACKED UP INTO A CORNER WITH THEIR LIFE CIRCUMSTANCES AND THEY HAVE A FIGHT OR FLIGHT PHENOMENON WHERE THEY HAVE A BLAST OF ANXIETY.

SO NO ONE YOU WANT TO IDENTIFY WHAT MIGHT BE STRESSING YOU OUT TO GIVE YOU A BLAST OF ANXIETY.

IT'S CALLED A PANIC ATTACK IF IT EMERGES QUICKLY OVER THE COURSE OF TEN MINUTES, IT PERSIST OVER THE COURSE OF MINUTES TO HOURS AND IT'S CHARACTERIZED BY FEELING DIZZY, FEELING LIKE YOU'RE GOING TO GO CRAZY OR DIE.

YOU MIGHT FEEL LIGHTHEADED, YOU MIGHT HAVE TREMORS, YOU MIGHT GET SWEATY, SWEATY SENSATION ALL OVER, YOU MIGHT GET COLD CHILLS OR YOU MIGHT EVEN GET HOT FLASHES.

SOME PEOPLE WITH PANIC ATTACKS WILL HAVE DIFFICULTY BREATHING AND HAVE A CHOKING SENSATION.

OTHER PEOPLE WILL HAVE CHEST PAIN, MAYBE A PALPITATIONS WHERE THEIR HEARTS GOING REALLY, REALLY FAST.

SOME PEOPLE WILL HAVE NAUSEA, THE PEOPLE WILL HAVE DIARRHEA.

THESE ARE ALL SYMPTOMS OF PANIC ATTACKS IF THEY COME ON AS A GROUP WITHIN ABOUT TEN MINUTES AND IT HITS YOU LIKE A TON OF BRICKS IF THEY'RE UNPROVOKED IT'S TRULY A PANIC ATTACK IF PROVOKED IT'S USUALLY DUE TO A SITUATIONAL STRESS AND WE WILL TREAT THOSE CONDITIONS DIFFERENTLY.

THE BEST THING YOU CAN DO FOR A SITUATIONAL STRESS IS TRY TO ADDRESS THE STRESS THE BEST WAY POSSIBLE IF YOU HAVE A PANIC ATTACK THAT'S UNPROVOKED, THIS COMES ON THE BLUE AS A PERSON I SAW TODAY DESCRIBED SOMETIMES WE'LL USE ADDITIONAL MEASURES TO HELP HIM WITH THAT YOU CAN USE DEEP BREATHING TECHNIQUES TO TRY TO HELP YOU WITH PANIC ATTACKS.

IN OTHER WORDS, IF YOU BREATHE IN THEN SLOWLY BREATHE OUT THAT CAN SOMETIMES DECREASE THE HEART RATE AND ENHANCE THE SO-CALLED PARASYMPATHETIC SYSTEM WHICH IS THE RELAXING AUTONOMIC SYSTEM THAT WE ALL HAVE.

AND AS YOU'RE BREATHING OUT SLOWLY THAT CAN ACTIVATE THAT MORE COMPARED TO WHEN YOU BREATHE IN.

SO THERE'S DIFFERENT TECHNIQUES WE WILL USE.

BRUCE, THANKS FOR YOUR CALL.

LET'S GO TO OUR NEXT CALLER.

HELLO JEFF.

WELCOME TO MATTERS OF THE MIND .

GOOD EVENING, DOCTOR.

GOOD EVENING, JEFF.

YEAH, I HAVE A NEPHEW WHO JUST GOT DIAGNOSED WITH A THOUGHT DISORDER AND PRIOR TO THAT HE HAS BEEN HAVING PROBLEMS ANXIETY, DEPRESSION AND SUICIDAL THOUGHTS FOR THE LAST SEVERAL MONTHS, MAYBE OVER A YEAR.

BUT WE HAVE I HAVE NEVER HEARD OF A THOUGHT DISORDER.

CAN YOU EXPLAIN THAT?

A SYMPTOM, JEFF BASICALLY THOUGHT DISORDER IS QUITE FRANKLY WHERE SOMEBODY IS HAVING DISTURBANCES IN THEIR FLOW OF THEIR THINKING.

THEY WILL JUMP FROM TOPIC TO TOPIC OR THEY MIGHT HAVE DIFFICULTY PROCESSING INFORMATION WHERE THEY'LL START ON ONE TOPIC AND THEY'LL GO OFF ON A TANGENT TO SOMETHING ELSE OR THEY MIGHT HAVE CIRCUMSTANTIAL THOUGHT PROCESSING DISTURBANCES WHERE THEY GO ROUND AND ROUND AND EVENTUALLY GET BACK TO THEIR ORIGINAL THOUGHT.

SOME PEOPLE WILL HAVE A FLIGHT OF IDEAS WHERE THEY GO FROM ONE THOUGHT TO ANOTHER TO ANOTHER.

THESE ARE ALL SYMPTOMS OF A THOUGHT DISORDER NOW THOUGHT DISORDER IS NOT A DIAGNOSIS.

IT'S A SYMPTOM OF A BIGGER CLUSTER OF SYMPTOMS WHICH CAN BE DEPRESSIONS WHEN PEOPLE HAVE DEPRESSION NOT UNCOMMONLY JEFF, THEY HAVE DIFFICULTY WITH PROCESSING SPEED OF THEIR THOUGHTS AND THEY'LL HAVE MORE DISTRACTIBILITY AND HAVE DIFFICULTY WITH CONCENTRATION AND SOMETIMES IT'S CALLED A THOUGHT DISORDER ITSELF.

SO THINK OF A THOUGHT DISORDER IS BASICALLY BEING A MANIFESTATION IN THIS CASE OF DEPRESSION WHERE SOMEBODY IS HAVING DIFFICULTY WITH THEIR FLOW OF THOUGHTS WITH THEIR ABATED PROCESS INFORMATION IN AN ORGANIZED MANNER.

JEFF, THANKS FOR CALL.

LET'S GO TO OUR NEXT CALLER.

HELLO BRIDGETTE.

WELCOME TO MARAZUL BRAIN OR MATTERS OF MIND.

HI.

HI BRIDGETTE.

YES.

YES I HAVE INSIDE MY BRAIN AND I HAVE TO HAVE AN MRI ON IT AND I HAVE SUCH HEADACHES IT'S I CAN THEN IT GOES AWAY AFTER A WHILE AND IT COMES BACK AND I AM BIPOLAR AND THEY GIVE ME DIFFERENT THAT HAS BEEN HER FIRST BAR AND DIFFERENT HIGH BLOOD PRESSURE HAD A MILD HEART ATTACK, WAS IN THE HOSPITAL FOR A LITTLE WHILE FOR A WEEK SO TOOK A REALLY ACTUALLY I TOOK ONE OTHER PILL I SHOULD KNOW AND I DON'T REMEMBER ANYTHING SO I WAS REALLY SCARED.

WELL BRIDGET IT'S IMPORTANT TO TRY TO GET THE CYST ADDRESSED IN THE BRAIN ONE WAY OR ANOTHER.

THE THIS MIGHT BE IRRITATING THE BRAIN IN SUCH A WAY YOU CAN WELL NOT ONLY HAVE BIPOLAR SYMPTOMS FROM THE SYSTEM ITSELF, IT CAN AGGRAVATE BIPOLAR SYMPTOMS BUT THE CYSTS CAN SOMETIMES CAUSE INCREASED PRESSURE ON THE BRAIN.

YOU'RE DOING THE RIGHT THING.

YOU'RE GETTING IT EVALUATED.

YOU'RE GETTING WORKED UP AND I WOULD SUGGEST THAT YOU PUT YOUR TRUST IN THE CLINICIANS WHO ARE SEEING YOU IF YOU NEED A NEUROSURGICAL INTERVENTION WITH IT, TRY TO DO SOMETHING ABOUT IT.

BUT IT'S SOMETHING THAT DOES NEED AN INTERVENTION IS NOT UNCOMMON WHEN PEOPLE HAVE SOME TYPE OF TRAUMA TO THE BRAIN LIKE THAT SUCH AS A CYST, IT CAN MAKE THEM MORE MOODY, MORE IRRITABLE AND BRING OUT THE SYMPTOMS OF BIPOLAR DISORDER THAT YOU'RE DESCRIBING.

BRIDGET, THANKS FOR YOUR CALL.

LET'S GO TO OUR NEXT CALLER.

HELLO, RON.

WELCOME TO MATTERS.

MIND YOU, WHAT CAUSES OF SCAR TISSUE ON YOUR BRAIN IS FROM A NERVOUS CAUSE.

WE HAVE DIZZINESS AND MIGRAINE HEADACHES SIX YEARS STRAIGHT NOW.

YEAH, RANNA SCARRING ON THE BRAIN CAN OCCUR FROM BRAIN TRAUMA ITSELF.

YOU CAN HAVE A LITTLE STROKE SOMETIMES BUT WHEN YOU HAVE SCARRING ON THE BRAIN IS NOT UNCOMMON TO HAVE HEADACHES FROM THAT AND MIGRAINE HEADACHES CAN BE TRIGGERED FROM SCARRING ON THE BRAIN.

SO THAT'S NOT UNCOMMON.

THE KEY TREATMENT WILL NOT UNCOMMONLY BE ANTIEPILEPTIC OR ANTI SEIZURE MEDICATIONS NOT BECAUSE YOU'RE NECESSARILY HAVING A SEIZURE BUT BECAUSE YOU'RE HAVING BRAIN TRAUMA THAT'S CAUSING DIFFICULTY WITH THE HEADACHES AND SOMETIMES IRRITABILITY GOING ON TOP OF THAT.

RON, THANKS FOR YOUR CALL.

LET'S GO OUR NEXT CALLER.

HELLO, LIZ.

WELCOME MASTERMIND.

HI.

YES, DR. BOB.

I'M 62 YEARS OLD AND ABOUT ELEVEN ROSCOE I WAS DIAGNOSED WITH BOTH TYPES OF SLEEP APNEA AND DURING THE RECENT UPDATED SLEEP STUDY I WAS DIAGNOSED WITH PERIODIC LIMB MOVEMENT DISORDER.

I'M I WAS WONDERING WHAT CAUSES THAT AND WHAT THE TREATMENT IS FOR THAT PERIODIC LIMB MOVEMENT DISORDER IS A CONDITION, LYZ, WHERE PEOPLE HAVE JUMPY LEGS AND THEY'LL HAVE MOVEMENT MOVEMENTS THEIR LEGS IN THE EVENING NOT UNCOMMONLY PEOPLE WILL USE THE SO-CALLED DOPAMINE AGONIST MEDICATIONS LIKE MIRROR PEX.

THEY'LL UNDOUBTEDLY BE CHECKING YOU FOR IRON LEVELS BECAUSE LOW IONS SOMETIMES I'LL GIVE YOU RESTLESS LEGS IN PERIODIC LIMB MOVEMENTS.

YOU'D WANT TO MAKE SURE YOU DON'T NECESSARILY ARE NOT ON A SEROTONIN ANTIDEPRESSANT MEDICATION BECAUSE SEROTONIN ENHANCEMENTS SOMETIMES WILL INDIRECTLY DECREASE DOPAMINE AND THAT'LL GIVE YOU SOME DIFFICULTY WITH RESTLESS LEGS AS WELL.

SO THERE ARE VARIOUS TREATMENTS FOR THAT AND IT WILL GIVE YOU A BETTER QUALITY OF SLEEP.

LIZ, THANKS FOR YOUR CALL.

UNFORTUNATELY, RONNIE, I'M OUT OF TIME HERE.

YOU HAD A QUESTION ABOUT HYDROXY ZENIN KLONOPIN CAUSING AND RELATED TO ACHINESS AND STRESS.

YEAH, HYDROXYL ZINA'S AN ANTIHISTAMINE CAN HELP WITH ACHINESS.

KLONOPIN IS AN ANTI ANXIETY MEDICATION CAN HELP WITH STRESS AND SOMETIMES THEY DO GO HAND IN HAND.

RONNEY, THANKS FOR YOUR CALL.

UNFORTUNATELY I'M OUT OF TIME FOR THIS EVENING.

I'M PSYCHIATRIST JEFF AUBREY.

YOU'VE BEEN WATCHING MATTERS OF THE MIND, GOD WILLING AND PB'S WILLING.

I'LL BE BACK AGAIN NEXT WEEK.

THANKS FOR WATCHING.

HAVE A GOOD EVENING.

GOOD NIGHT.