>> GOOD EVENING.

I'M PSYCHIATRIST J FALL FOR LIFE FROM FORT WAYNE INDIANA.

WELCOME TO MATTERS OF THE MIND NOW IT'S A 22ND YEAR MATTERS.

THE MINE IS A LIVE CALL IN PROGRAM WHERE YOU HAVE THE CHANCE TO CHOOSE THE TOPIC FOR DISCUSSION.

SO IF YOU REALLY QUESTIONS CONCERNING MENTAL HEALTH TOPICS.

GIVE ME A CALL HERE PBS FORT WAYNE BY DIALING IN THE FORT WAYNE AREA NIGHT.

6, 9, 2, 7, 2, 0, OR IF YOU'RE CALLING LONG-DISTANCE COAST TO COAST.

YOU MAY DIAL 8, 6, 6, 9, 6, 9, 2, 7, TO 0 NOW ON A FAIRLY REGULAR BASIS WHERE BROADCASTING LIVE EVERY MONDAY NIGHT FROM OUR SPECTACULAR PBS FORT WAYNE STUDIOS WHICH LAND THE SHADOWS OF THE PURDUE UNIVERSITY FORT WAYNE CAMPUS.

AND IF YOU THOUGHT TO CONTACT ME WITH AN E-MAIL QUESTION THAT A CANCER ON THE AIR.

YOU MAY WRITE ME VIA THE INTERNET AT MATTERS OF THE MIND.

ALL ONE WORD AT WFTV DOT ORG.

THAT'S MATTERS OF THE MIND AT THE VFW.

A DOT ORG WILL START TONIGHT'S PROGRAM WITH A QUESTION I RECENTLY RECEIVED IT READS DEAR DOCTOR FARBER.

MY SPOUSE HAS JUST RECENTLY BEEN ADMITTED.

TO THE HOSPITAL WITH PNEUMONIA.

HE IS ALSO SUFFERING FROM ALCOHOL WITHDRAWAL.

HE SEEMS TO PRESTON HASN'T US.

IS THIS NORMAL.

HOW LONG WILL THIS LAST?

WELL, THERE'S 2 FACTORS GOING ON THERE.

IF YOU HAVE PNEUMONIA, YOU CAN HAVE A CONDITION CALLED DELIRIUM BASICALLY DELIRIUM IS WHERE YOU HAVE DIFFICULTY GETTING ENOUGH OXYGEN IN AND LONG ENOUGH CARBON DIOXIDE OFF.

AND IN THE HOSPITAL, YOU'RE IN A VERY SUPERVISED SETTING WHERE THEY ARE MONITORING YOUR AUCTION LEVEL.

SO THEY'RE TRYING TO KEEP THAT ADEQUATE.

BUT ON TOP OF THAT YOU HAVE THE INFLAMMATORY ELEMENT OF THE INFECTION ITSELF WITH PNEUMONIA INFECTION ITSELF WILL CAUSE THE RELEASE OF THESE INSIDER, TROY PROTEINS THAT CAN MAKE YOU FEEL DEPRESSED AND BLAH.

SO YOU'VE GOT THE INFLAMMATION INFECTION.

YOU'VE GOT THE AUCTION SOMETIMES WILL OCCUR WITH PNEUMONIA AND YOU PUT THAT TOGETHER AND THAT CAN MAKE YOU FEEL KIND OF LOUSY ITSELF.

BUT ON TOP OF THAT PNEUMONIA ON TOP OF PNEUMONIA PUT ON TOP OF ALCOHOL WITHDRAWAL.

ALCOHOL WITHDRAWAL FOR 5 TO 7 DAYS WILL CAUSE YOU TO HAVE SOME THINGS SUCH AS SHAKINESS.

YOU CAN HAVE A HEADACHE NAUSEA.

YOU CAN HAVE DIFFICULTY WITH INSOMNIA, EDUCATION, TREMENDOUS ANXIETY.

YOU CAN HAVE TROUBLE EVEN YOUR TONGUE CAN TRAVEL.

AND THAT'S WHAT SOMETHING IS SOMETHING THAT WE OFTEN ASSESS WITH PEOPLE WHO ARE WITHDRAWING FROM ALCOHOL, PEOPLE WHO ARE WITHDRAWING FROM ALCOHOL WILL OFTEN FEEL MORE ANXIOUS AND THEY WILL DEPRESSED, THEY WILL HAVE.

DISTURBANCES FROM THAT AS WELL FOR ALCOHOL WITHDRAWAL, YOU'LL OFTEN GET MEDICATIONS KNOWN AS BENZODIAZEPINES SUCH AS OUT OF THE AT LIBERUM CAUGHT UP IN AND THOSE MEDICATIONS CAN EASE THE IMPACT OF WITHDRAWAL ITSELF.

SO NOT UNCOMMONLY WHEN SOMEONE COMES IN THE HOSPITAL, THEY HAVE TO STOP THE ALCOHOL ABRUPTLY.

WE'LL HAVE THE SYMPTOMS WITHDRAWL AND SOMETIMES THEY CAN HAVE WHAT'S CALLED DELIRIUM TREATMENTS WHERE THEY DON'T KNOW WHERE THEY ARE.

THEY DON'T KNOW WHAT THEY'RE DOING AND THAT'S WHERE THEY CAN SEE VISUAL COLORFUL.

HALLUCINATIONS AROUND THEM AND THEY'RE VERY CONFUSED IN THAT OFTEN THE FAMILY MEMBERS VERY CONCERNED WHEN THEY SEE THAT AND PEOPLE TYPICALLY COME OUT OF TYPE OF PHENOMENON OVER THE COURSE OF 2 TO 3 DAYS, ESPECIALLY IF THEY GET TREATMENT, MOST SERIOUSLY PEOPLE CAN HAVE SEIZURES RELATED ALCOHOL WITHDRAWAL.

AND AS PARTICULARLY PROBLEMATIC WHEN THEY ALREADY HAVE AND INFECTION BECAUSE YOU PUT THE INFECTION ON TOP OF ALCOHOL WITHDRAWAL.

PEOPLE CAN BE VERY PRONE TO HAVING A LOT OF COMPLICATIONS.

SO IN THE HOSPITAL THEY TEND TO WELL MANAGE THOSE KIND OF SYMPTOMS WITH THE PNEUMONIA.

THIS MANAGE WITH THE ANTIBODY EXCEPT IT'S BACK TO OLD AMMONIA.

THEY CAN USE ANTI VIRAL AGENTS.

IS THAT SOMETHING LIKE COVID RELATED PNEUMONIA.

THEY ALSO WILL MONITOR THE AUCTION LEVELS CARBON DIOXIDE LEVELS.

AND THEN WITH THE ALCOHOL THAT WELL, THEY'LL MEDICATIONS ACCORDINGLY.

SO HOW LONG WILL IT LAST.

TYPICALLY ABOUT A WEEK OR SO.

THEY COME OUT OF THE DEVONIA.

THEY COME OUT OF DELIRIUM RELATED PNEUMONIA ITSELF DURING THAT TIME THERE OFF THE ALCOHOL.

SHE PUT THAT TOGETHER TYPICAL WITHIN ABOUT A WEEK.

PEOPLE START TO FEEL BETTER.

THEY LESS DEPRESSED AND THEY'RE MORE ENERGETIC AND HAVE A LITTLE BIT LESS ANXIETY AND THEY'RE MORE CLEAR-HEADED AT THAT POINT.

THANKS TO YOUR QUESTION, LET'S GO TO THE NEXT.

QUESTION.

LET'S GO NEXT IT READS DUE TO THE FALL OVER.

MY DOCTOR TOLD ME THAT I'M HAVING HEADACHES AND STOMACH PROBLEMS DUE TO MY WORK.

IF I'M HAVING PHYSICAL AND EMOTIONAL PROBLEMS DUE TO MY WORK.

SHOULD I QUIT.

WELL, THAT'S A GOOD QUESTION.

IT'S A CHICKEN OR THE EGG PHENOMENON.

IT'S AN EASY ANSWER TO GIVE SOMEBODY THAT, YOU KNOW, YOUR WORK.

STRESSING YOU OUT.

JUST QUIT.

WELL, KEEP IN MIND THAT IF YOU QUIT YOUR WORK, YOU MIGHT EVEN BE MORE STRESSED OUT WITH UNEMPLOYMENT AND YOU CAN ALWAYS ASSUME THAT YOU'RE GOING TO GET DISABILITY PAYMENTS FOR MEDICAL REASONS OR FOR UNEMPLOYMENT AND THAT THAT MIGHT NOT BE ENOUGH TO SUSTAIN YOU.

MOST IMPORTANTLY, FROM MY PERSPECTIVE OF SOMEBODY DOES NOT HAVE DAILY PRODUCTIVE ACTIVITY OF SOMEBODY DOES NOT HAVE A REASON TO GET UP EVERY DAY.

THAT IN ITSELF IS A BIG RISK FACTOR FOR DEPRESSION, ANXIETY.

SO FROM MY PERSPECTIVE, I'D RECOMMEND YOU STAY ON THE JOB THE BEST YOU CAN TALK TO YOUR PRIMARY CARE CLINICIAN WHO MIGHT REFER YOU TO A MENTAL HEALTH CLINICIAN FOR THE PURPOSE OF TRYING TO HELP YOU DEAL WITH THE KIND OF THINGS THAT ARE STRESSING OUT OF A JOB BECAUSE IT'S A CHICKEN OR THE EGG TO NOMINATE.

IF YOU HAVE THE DEVELOPMENT OF DEPRESSION OR ANXIETY.

IT WILL CAUSE YOU TO REACT TO SITUATIONS IN EXAGGERATED MANNER.

SO IF YOU HAVE DEPRESSION OR ANXIETY, YOU HAVE TROUBLE WITH WHAT WE CALL STRESS TOLERANCE, STRESS TOLERANCE HAS TO DO WITH THE ABILITY TO PUT UP WITH STUFF.

SO IF YOU'RE STRESSED OUT, IF YOU HAVE A LOT OF ANXIETY.

IT WILL CAUSE YOU MORE DIFFICULTY PUTTING UP WITH STUFF NOW, HOW DOES THAT ALL COME ABOUT.

WELL, THE ABILITY TO PUT UP WITH STUFF STARTS IN WITH SO WE'RE ALL HARD WIRED IN A CERTAIN WAY.

BUT THEN FROM A GENETIC STANDPOINT.

YOU GO THROUGH LIFE AND YOU HAVE CERTAIN STRESSES THAT OCCUR AND THEN YOU ADAPT TO THOSE CERTAIN STRESSES.

WE CALL THAT COPING MECHANISMS.

SO WE ALL HAVE DIFFERENT TYPE OF THINGS THAT HAVE HAPPENED IN HER CHILDHOOD THE KIND OF STRESS TO SOUTH.

WELL LEARNED IN DIFFERENT WAYS GOOD OR BAD, HOW TO COPE WITH THOSE DIFFERENT STRESSES AND WITH EACH SUBSTANCE TRIP SUBSEQUENT STRESS LATER IN OUR LIVES, WE'LL BE ABLE TO ADAPT OR COPE IN VARIOUS WAYS IN IF IT BECOMES OVERWHELMING FOR YOU.

THAT'S WHERE YOU HAVE MORE DIFFICULTY IN ONE SITUATION OR ANOTHER.

BUT I'VE HAD PATIENTS COME TO ME OVER THE COURSE OF TIME SAVE MY JOB STRESS ME OUT.

FRIEND OR MY FAMILY MEMBER TOLD ME I JUST NEED TO QUIT THE JOB.

YOU HAVE TO THINK ABOUT THE CONSEQUENCES OF DOING THAT.

I ALWAYS TELL PEOPLE BEFORE QUITTING A JOB AND GRANTED THERE ARE LOW JOBS OUT THERE THAT ARE NOT GOOD FITS FOR CERTAIN PEOPLE BEFORE YOU QUIT A JOB HAVE SOMETHING ELSE LINED UP AND BE AWARE THAT IF YOU GET INTO THIS PATTERN WHERE YOU'RE JUMPING FROM ONE JOB TO ANOTHER JOB TO ANOTHER JOB THAT MIGHT NOT BE THE JOB.

THAT MIGHT BE AN ISSUE WITH YOUR ABILITY TO COPE WITH DIFFERENT STRESSING ABOUT WERE EXAMINED.

WHY YOU'RE QUITTING ONE JOB AND GOING TO ANOTHER WITH THAT BEING SAID, YOU JUST NEED TO BE AWARE THAT STRESS TOLERANCE MIGHT BE A FACTOR THERE.

AND I OFTEN WILL RECOMMEND PEOPLE TO NOT QUIT A JOB WHEN THEY'RE DEPRESSED WHEN THEY'RE ANXIOUS, WHEN THE NOT SLEEPING, TRY TO BE A VERY CLEAR.

THEY HAVE FED VERY CLEAR SENSE IS WHEN YOU'RE MAKING A BIG DECISION LIKE THAT.

MAKE SURE TO TALK IT OVER WITH OTHER PEOPLE.

INTERESTED FRIENDS AND FAMILY TO BE ABLE TO SORT OUT.

IS THIS REALLY THE RIGHT THING FOR YOU TO DO AND MAYBE GIVE IT A DAY OR 2 BEFORE YOU DECIDE TO QUIT.

TALKING WITH PEOPLE THAT THINK IT THROUGH A LITTLE BIT MORE MAKE SURE YOU'RE SLEEPING.

WELL, A LOT OF PEOPLE WILL HAVE DIFFICULTY WITH SLEEPING BECAUSE THEY'RE WORRYING ABOUT DIFFERENT THINGS ARE UP ALL NIGHT.

AND BECAUSE OF THAT, THAT AFFECTS YOUR ABILITY TO MAKE GOOD DECISIONS.

WHEN YOU SLEEP AT NIGHT, THIS FRONT PART OF YOUR BRAIN UP HERE WILL TEND TO KIND OF REBOOT.

THAT'S YOUR RECHARGING CENTER.

YOUR BRAIN AT SLEEP.

THAT'S THAT DURING SLEEP.

AND THAT'S YOUR JUDGMENT SENT A PART OF THE BRAIN.

THAT'S THE PART OF THE BRAIN THAT ALLOWS YOU TO FOCUS CONCENTRATE ON THINGS.

WE'LL KEEP YOUR MIND ON THINGS BUT ALSO HELPS YOU MAINTAIN PROPER JUDGMENT.

THIS PART OF THE BRAIN IS WAS RESTING WITH A GOOD NIGHT'S SLEEP AND IF YOU DON'T ALLOW THAT PART OF THE BRAIN TO REST JUST LIKE NOT HAVING A CELL PHONE CHARGED UP ADEQUATELY DIS.

IT JUST WON'T FUNCTION SO WELL AND THAT CAN CAUSE YOU TO MAKE BAD DECISIONS OVER THE COURSE OF TIME.

THANKS YOUR QUESTION.

LET'S GO TO OUR FIRST CALLER.

HELLO, THOMAS.

WELCOME I'D.

WELL THOMAS SHOULD MENTION THAT YOU HAVE A FRIEND.

WHO HAS SOME VERY BIZARRE BEHAVIOR PATTERNS AND YOU WONDER IF HE HAS A PERSONALITY DISORDER.

SO YOU WONDER THIS.

I COULD DESCRIBE THE CONDITION.

THE CONDITION WITH A BIZARRE BEHAVIOR PATTERNS.

SO YOU CAN UNDERSTAND BETTER WEALTH.

BIZARRE BEHAVIOR PATTERNS CAN COME IN DIFFERENT SIZES AND SHAPES.

THOMAS BIZARRE BEHAVIOR TAP AS CAN BE RELATED TO A MOOD DISORDER BEFORE IN SAYS WORK WHEN SOMEBODY HAS BIPOLAR DISORDER, THEY CAN HAVE THESE MANIC HIGHS WHERE THEY DON'T NEED TO SLEEP.

THEY'RE TALKING A MILE A MINUTE.

THEY HAVE A DRASTIC SHIFT IN THEIR PERSONALITY DURING THAT TIME, THEIR IMPULSE EVE, THEY WILL BUT IN ON CONVERSATIONS AND IT'S VERY AND KISS CHARACTERISTIC FOR THEM BECAUSE ON THE OTHER HAND, THE SAME PEOPLE CAN DROPPING TO A LOW WHERE THE PRESS THEY WANT TO SLEEP ALL THE TIME.

THEY ARE VERY SLOW MOVING.

THEY DON'T WANT TO TALK TO PEOPLE THERE.

THERE DON'T ENJOY ANYTHING.

SO THEY HAVE THE SHIFTS IN THEIR MOVES UP AND DOWN.

IT'S A VERY TREATABLE CONDITION.

THOMAS WERE WE GIVE THESE PEOPLE CRUISE CONTROLS FOR THE MOOD OF THE WEEK.

ALL MOOD STABILIZERS AND WE LEVEL THEM BIPOLAR DISORDER IS ABOUT 60%.

GENETICS WHO HAS A STRONG GENETIC COMPONENT TO IT.

BUT IT'S VERY IMPORTANT PEOPLE.

BE ABLE STABILIZER MOVES TO HAVE A NORMAL QUALITY OF LIFE.

YOU CAN ALWAYS THINK OF BIPOLAR DISORDER IS KIND OF BEING A SEIZURE DISORDER OF THE MOOD WITH EPILEPSY WITH SEIZURES.

THEY COME ON OUT THE BLUE.

THEY ARE VERY IMPAIRING.

BUT YOU TREAT THEM WITH ANTI SEIZURE MEDICATIONS AND STABILIZES.

THEIR BRAIN CHEMISTRY SAID I HAVE SENIORS ANYMORE.

IT'S IRONIC THAT WE DO USE ANTI SEIZURE MEDICATIONS FOR BIPOLAR DISORDER BECAUSE WHAT WE'RE TRYING TO DO IS STABILIZE THE MOOD.

SO QUITE COMMON THAT PEOPLE WILL HAVE MOOD STABILIZERS THAT ARE ANTI SEIZURE MEDICATIONS TO BE ABLE TO LEVEL THEM OUT.

YOUR FRIEND MIGHT HAVE BIZARRE AS YOU MENTIONED, POSSIBLY DUE TO A PERSONALITY DISORDER.

THERE IS A PERSONALITY DISORDER CALLED BORDERLINE PERSONALITY DISORDER, WHICH IS KIND OF TYPE OF BIPOLAR DISORDER WITH BORDERLINE SO THIS SORT OF PEOPLE HAVE ABRUPT SHIFTS IN THEIR MOOD BASED ON PEOPLE AND SITUATIONS.

SO THEY OFTEN HAVE SOMEONE OF THE COMMUNITY AND PERSONALITY WHERE THEY TAKE ON THE PERSONALITIES OF OTHER PEOPLE AROUND THEM AND AGAIN, BABY VERY QUICK TO REACT TO STRESS IS AN TO INTERPERSONAL RELATIONSHIPS WHERE THEY COULD HAVE RAGE.

THEY COULD HAVE ANGER THEY LOOK LIKE THEY HAVE BIPOLAR CONDITIONS, BUT IT'S VERY BRIEF AND IT'S VERY ABRUPT AS OFTEN AND TYPICALLY PROVOKED BY SITUATION OVERALL PEOPLE WITH BORDERLINE PERSONALITY DISORDER WILL OFTEN HAVE SUICIDAL THINKING THEY'LL THREATEN SUICIDE.

THEY OFTEN WILL CUT THEMSELVES AS A MEANS OF GETTING SOME RELIEF.

THEY FEEL DEVASTATED IF PERCEIVE THAT THERE ARE ABANDONED OR THEY'RE LEFT ALONE.

SO THEY ALWAYS NEED TO ATTACH TO SOMEBODY.

SO THEY DON'T HAVE THAT SENSE OF OF BEING ALONE.

AND THAT'S CAN SOMETIMES COME ACROSS AS BEING SOME KIND SOMEWHAT LIKE THIS ARE BEHAVIOR FOR A LOT OF PEOPLE.

THOMAS, THANKS.

YOUR CALL IS GOING NEXT.

CALLER.

HELLO, BRENDA WALKING MATTERS OF LIFE.

OF RANDY, YOU WANT TO KNOW IF I COULD EXPLAIN NARCISSISM IN RELATIONSHIP TO EGO FOR THAT REASON TO TREATMENTS TO LESSEN THE EFFECTS OF THAT CONDITION NARCISSISM.

BRENDA QUITE SIMPLY IS REAL SIMPLE.

IT SITS WHERE SOMEBODY WILL HAVE THE ENTIRE FOCUS ON THEMSELVES AND THEY WILL NOT CONSIDER THE NEEDS OR THE WISHES OF 4 OTHER PEOPLE.

THEY DO LACK A SENSE OF EMPATHY.

SO THEY HAVE A DIFFICULT TIME RELATING TO OTHER PEOPLE THAT WAY THAT WHERE THEY COME ACROSS IN BECOMES VERY FUNCTIONALLY IMPAIRING.

THEY HAVE DIFFICULTY REALLY RELATING TO OTHERS BECAUSE THEY PUT THEIR NEEDS FIRST AND ABOUT EVERYBODY ELSE IS VERY DIFFICULT TO TREAT BECAUSE PEOPLE DO NOT TYPICALLY HAVE GOOD INSIGHT INTO THE BEHAVIOR UNTIL THEY HAVE ONE RELATIONSHIP AFTER ANOTHER FAIL UNTIL THEY LOSE ONE JOB AFTER ANOTHER BECAUSE THERE ARE SO DIFFICULT TO MANAGE IN THE WORKPLACE.

SO UNLESS THEY GET INSIGHT INTO HOW IT'S ACTUALLY AFFECTING THEM ON A DAY-TO-DAY BASIS AT THAT WORKERS ON THE JOB WITH RELATIONSHIPS.

THEY OFTEN HAVE DIFFICULTY RECOGNIZING IT'S EVEN BEING A PROBLEM THERE ARE NO MEDICATIONS FOR IT.

IT'S A CONDITION WHERE YOU CAN HAVE A A THERAPIST.

TRY TO INTERACT WITH THEM AND HELP THEM.

BUT THE PROBLEM IS THEY OFTEN PERCEIVE THAT THEY KNOW MORE THAN THE THERAPIST.

AND THAT'S AN ONGOING ISSUE.

AND WITH NARCISSISM THESE PEOPLE PERCEIVE THAT THEY HAVE ALL THE ANSWERS THERE.

THEY PERCEIVE THAT THEY'RE AN ELITIST WHERE THEY HAVE THE ANSWERS FOR EVERYTHING THEY ARE VERY DIFFICULT TO TO INTERACT WITH AND OFTEN THEIR RELATIONSHIPS ARE NOT SUSTAINED DUE TO THAT.

BRENDA, THANKS FOR COFFEE.

LET'S GO TO OUR NEXT E-MAIL QUESTION.

I THINK I WE HAVE ANOTHER E-MAIL QUESTION THERE.

YES, WE DO IT SAYS DUE TO THE FALL OF OR IS IT BEST TO TREAT DEPRESSION WITH MEDICATION OR PSYCHOTHERAPY OR BOTH IDEAL.

I WOULD BASED ON ALL THE RESEARCH WE HAVE OUT THERE WHEN YOU'RE TREATING DEPRESSION, BOTH MEDICATION AND COUNSELING AND PSYCHOTHERAPY CAN CAN BE IDEAL.

SOME PEOPLE 6 OR 8 OR 12 PSYCHOTHERAPY AS SESSIONS THAT BRIEF DYNAMIC PSYCHOTHERAPY IS SOMETHING THAT CAN HELP A LOT OF PEOPLE OUT THERE JUST WANT TO TRY TO HAVE AN OUTSIDE OBJECTIVE OBSERVER.

GIVE THEM SOME IDEAS ABOUT DIFFERENT THINGS.

OTHER PEOPLE WILL FIND PSYCHOTHERAPY TO BE HELPFUL IF THEY CONTINUE AT LEAST EVERY NOW AND THEN.

SOMETIMES FOR MONTHS AND THAT'S SOMETHING THAT YOU NEGOTIATE WITH YOUR THERAPIST, WITH ONGOING COUNSELING.

THERE'S A LOT OF DIFFERENT TYPES OF OF COUNSELING OR THERAPY.

THERE'S DIALECT A BEHAVIORAL THERAPY.

THERE'S WHAT WE CALL EYE MOVEMENT DESENSITIZATION AND REPROCESSING OR EMDR.

THAT'S THOSE ARE BOTH VERY GOOD FOR POST TRAUMATIC STRESS.

THERE'S RAPID RESOLUTION THERAPY.

IT'S SOMETHING THAT'S VERY MUCH IN ITS INFANCY.

IT NEEDS LONG-TERM STUDY.

BUT I'M HEARING ANECDOTALLY A LOT OF PEOPLE GETTING SOME NICE BENEFIT FROM THAT FOR POST-TRAUMATIC STRESS DISORDER.

AND THEN FOR DEPRESSION, THERE'S THE COGNITIVE BEHAVIORAL THERAPY.

IT'S BEEN AROUND FOR A LONG TIME.

INTERPERSONAL THERAPY WHERE YOU'RE HAVING SPECIFIC DIFFICULTIES RELATING TO OTHER PEOPLE.

THAT'S AVAILABLE FOR QUITE SOME TIME.

INTERPERSONAL A DYNAMIC DIAMOND DYNAMIC UP PSYCHOTHERAPY IS SOMETHING WE'RE YOU TRY TO LOOK INTO YOUR CHILDHOOD HISTORY.

AND YOU'RE BACK IN YOUR PAST EXPERIENCES AND YOU TRY TO RELATE HOW YOUR CURRENT EXPERIENCES AND YOUR DECISIONS YOU'RE MAKING RELATE TO WHAT HAPPENED TO YOU IN THE PAST.

AND THAT'S CALLED THERAPY.

AND FINALLY PSYCHOANALYTIC THERAPY A TREATMENT THAT'S NOT VERY COMMON ANYMORE.

PSYCHOANALYTIC THERAPY IS WHERE YOUR LOOKING FOR UNDERLYING MEANINGS OF DREAMS UNCONSCIOUS BE UNCONSCIOUS.

KIND MOTIVATIONS THAT YOU MIGHT EXPERIENCE.

IT'S INTERESTING.

BUT WE ARE WE OFTEN FIND THAT THE OTHER TYPES OF THERAPY OR BETTER RESEARCH AND OFTEN MORE EFFECTIVE AND A SHORTER IN CYCLED THERAPY CAN HE WANTS A WEEK.

IT CAN BE TWICE A WEEK.

IT CAN GO ON FOR WEEKS OR EVEN OR 4 YEARS.

BOTTOM LINE IS YOU WANT SOMETHING IS GOING TO BE EFFECTIVE IN SOMETHING WHERE YOU CAN SEE MEANINGFUL OUTCOMES.

HOPEFULLY WITHIN ABOUT 6 OR 8 SESSIONS.

AND I ALWAYS TELL PEOPLE TRY TO HANG IN THERE FOR 6 OR 8 SESSIONS BEFORE YOU REALLY GIVE UP ON.

AND THEN AT THAT POINT TRY TO DETERMINE GIVING YOU SOME KIND OF MEANINGFUL OUTCOMES NOW MEDICATION, OTHER HAND, WHAT THAT'S TRY TO DO IS HELP THE BRAIN WORK SO MEDICATIONS TRYING TO STABILIZE THE BRAIN CHEMISTRY ITSELF.

YOU'RE TRYING TO HELP THE BRAIN WORK.

YOU'RE TRYING TO HELP THE FRONT PART OF THE BRAIN FUNCTION SO THAT YOU CAN HAVE GOOD JUDGMENT COULD INSIDE THE BEHAVIOR.

YOU CAN BE LESS IMPULSIVE, PERHAPS.

BUT THE PROBLEM WITH YOU'LL SEE YOU'LL SEE WITH DEPRESSION.

FRANCES IS LEFT FRONT PART OF RAIN UP HERE.

THIS INVOLVED IN REASONING AND THINKING THROUGH THINGS.

IT'S UNDER ACTIVE.

AND THEN THE FRONT PART OF THE BRAIN IN THE IN THE VERY FRONT PART ABOVE THE EYEBALL.

THAT PART OF THE BRAIN CAN BE UNDER ACTIVE CAUSING YOU TO HAVE DIFFICULTY IMPULSIVITY AND NOT THINKING THROUGH DECISIONS BEFORE MAKING THEM.

BUT IT CAN BE OVERACTIVE WHEN YOU HAVE SEVERE DEPRESSION AND WHEN THIS PART OF THE BRAIN IS OVERACTIVE.

THAT'S THE DECISION-MAKING PART OF THE BRAIN.

YOU CAN START TO BROOD ON THINGS AND YOU GET STUCK SO YOU THINK THROUGH THINGS YOU THINK THROUGH THINGS AND YOU GET STUCK IN YOUR WORRY.

SO WHAT MEDICATIONS ARE TRYING TO DO IS JUST A MECHANICAL STANDPOINT, TRY TO MAKE ALL THIS PART OF THE BRAIN WORK BETTER.

SO YOU DON'T RUMINATE ON THINGS AND YOU'RE NOT SO OBSESSIVE AND THAT WILL THEREBY HELP YOU.

IN FACT, THEIR A P BACK IN THE 1980'S WHEN I WAS FINISHING UP MY TRAINING IN PSYCHIATRY.

WE ALWAYS, ALWAYS, ALWAYS THAT THERAPY FIRST FOR PEOPLE WE ALWAYS HAD BEEN COUNSELING.

WE HAD INVOLVED IN THERAPY FIRST.

AND MOST OF MY TRAINING BACK IN THE 1980'S WAS PSYCHOTHERAPY.

DESPITE MY BEING A PEOPLE ARE TELLING ME I WAS WASTING MY CAREER IN PSYCHIATRY BECAUSE I'D BEEN A PHARMACIST AND PEER TELL ME I WAS WASTING MY CAREER IN PSYCHIATRY BECAUSE IN THE 1980'S THERE WEREN'T THAT MANY MEDICATIONS BEING USED AND PSYCHIATRY IN PLUM BEHOLD.

NOW WE HAVE ABOUT 90 MEDICATIONS.

WE USE AND SOMETIMES WE USE THEM IN COMBINATIONS AND SOMETIMES WHEN WE USE THEM.

TO DIFFERENT TO TRY TO GET PEOPLE ON THE RIGHT COMBINATION WHERE THEY HAVE HELP WITH DEPRESSION, SLEEP CONCENTRATION AS WELL AS ANXIETY.

SO WE OFTEN USE THE COMBINATION OF MEDICATION AND CAL SING ESPECIALLY EARLY ON THE TREATMENT.

THANKS YOUR E-MAIL.

LET'S GO NEXT.

CALLER.

HELLO, KATHY.

WALK IN AMERICA MIGHT.

OK, THANK YOU.

>> AND I THINK YOU ARE.

YES.

>> I'M TO SEE IF YOU KNOW ANYTHING ABOUT.

FUNCTIONAL NEUROLOGICAL DISORDER USED TO BE CALLED CONVERSION THERAPY.

AIR.

>> CONVERSION DISORDER.

YOU'RE EXACTLY RIGHT.

FUNCTIONAL NEUROLOGICAL DISORDER IS WHERE BASICALLY YOUR BRAIN SHORT CIRCUITS WHEN YOU'RE UNDER STRESS, GETTING NEW PHYSICAL SYMPTOMS AND AN EXAMPLE WILL BE WHERE YOU HAVE A PHYSICAL SYMPTOM OF A SEIZURE WHEN YOU'RE REALLY STRESSED OUT OR MAYBE YOUR BRAIN IS TRYING TO GET YOU TO AVOID A CERTAIN SITUATIONS.

SO WHAT WE'RE ALWAYS TRYING TO DETERMINE.

KATHY.

WHEN YOU'RE REALLY STRESSED OUT AT TIMES OR SOMETHING.

AND CAUTIOUSLY TRIGGERS THE BRAIN TO KIND SHORT CIRCUIT.

THE BRAIN WILL CAUSE YOU TO HAVE PHYSICAL SYMPTOMS SUCH AS A SEIZURE SOMEPLACE.

PEOPLE HAVE PARALYSIS IN THEIR LEGS WHERE THEY CAN'T WALK THE BOTTOM LINE IS FUNCTIONAL NEUROLOGICAL DISORDER MEANS THERE'S NOT ANY ELECTRICAL TYPE OF REASONING FOR IT.

SO IF YOU DO ANY EASY ON THE BRAIN.

FRANCE'S THEY CAN'T.

THERE'S NOT ANY OVERT EVIDENCE.

IF YOU LOOK AT SOME OF THESE.

REFLEXES, FOR INSTANCE, IN THEIR LEGS.

THERE'S NO EVIDENCE OF ANY FISCAL.

NO LAW SCHOOL, A DISTURBANCE THAT WOULD LEAD TO SOMEBODY HAVING PROWESS IS SO THERE'S NOT THE PHYSICAL TYPE OF SYMPTOMS WILL SEE WITH THESE KIND OF NEUROLOGICAL SYMPTOMS.

BUT WHAT YOU NOTICE IS THAT THEY'RE THERE AND THEY'RE VERY DEBILITATING FOR A LOT OF PEOPLE, BUT IT'S BASICALLY THE BRAIN SHORT-CIRCUITING.

IT'S REALLY HAPPENING.

BUT THE BRAIN SHORT-CIRCUITING IN SUCH A WAY THAT IT'S NOT A REAL NEUROLOGICAL CONDITION, BUT IT APPEARS THAT WAY.

WHEN YOU EXPERIENCE IT AND OFTEN FROM A PSYCHOLOGICAL STANDPOINT, KATHY, PEOPLE HAVE THESE KIND OF SYMPTOMS WHEN THEY'RE IN A SITUATION WHERE THEY FEEL OVERWHELMED.

SO WITH SOME PEOPLE THEY FEEL OVERWHELMED.

THEY JUST WALK AWAY FROM THAT SITUATION.

OTHER PEOPLE IN THE GET OVERWHELMED BREAK DOWN CRYING AND THEY JUST FEEL OVERLY DISTRESS.

BUT IF YOU HAVE FUNCTIONAL NEUROLOGICAL DISORDER, IT'S VERY SUBTLE.

YOU CAN FEEL OVERWHELMED AND YOU CAN HAVE THOSE PARTICULAR SYMPTOMS.

SO YOU GO TO THE NEUROLOGIST AND ARE ALL JUST SAYS.

WE CAN'T FIND ANY PHYSICAL REASON FOR YOU HAVING THESE SYMPTOMS AND THAT'S WHERE YOU CAN SEE A THERAPIST FOR THE PURPOSE OF TRYING TO IDENTIFY OKAY.

WHAT ARE THE TRIGGERS FOR HAVING THOSE KIND OF SYMPTOMS WHERE YOU HAVE DIFFICULTY WITH MOVEMENT IN YOUR LEGS.

WE HAVE A SEIZURE WHEN YOU'RE HAVING THOSE KIND OF SYMPTOMS.

WHAT KIND OF TRIGGERS MIGHT HAVE BROUGHT THOSE ON AND THEN YOU GO BACK AND YOU TRY TO SORT OUT WHAT INFLUENCE THE TRIGGER NOT DONE IN THE FUTURE.

THE IDEA WILL BE IF YOU ENCOUNTER SIMILAR TRIGGERS, WHAT CAN YOU DO DIFFERENTLY?

HOW COULD YOU ADDRESS THEM IF IT'S IN THE WORKPLACE, FOR INSTANCE.

AND YOU HAVE PERHAPS A BOSS IT'S KIND OF LOUD AND EMOTIONAL AND THAT BOSS KIND OF MAKE SURE REMINDED OF A OF AN ABUSIVE FATHER FIGURE PERHAPS.

WELL, IN THOSE CASES YOU HAVE TO RECOGNIZE THAT.

OKAY.

THAT PARTICULAR BOSS IS NOT YOUR FATHER YELLING AT YOU, BUT YOUR BRAIN MIGHT BE UNCONSCIOUSLY TELLING YOU THAT AND THEREBY YOU COULD HAVE DIFFICULTY NEUROLOGICALLY WHEN THAT HAPPENS.

SO YOUR BRAIN IS MAKING A CONNECTION OFTEN IN APPROPRIATELY TO A PAST EXPERIENCE AND THEN YOU HAVE THESE NEUROLOGICAL SYMPTOMS.

KATHY, THANK YOUR CALL.

LET'S GO TO THE NEXT CALLER.

HELLO, DEBORAH WALK IN A MATTER OF THE MIND.

>> YES, HI, I WAS JUST IF YOU COULD EXPLAIN SOMETHING MORE ABOUT THE UNCONSCIOUS MIND.

YEAH.

AND HOW THAT AFFECTS OUR DAILY LIVES.

>> CONSCIOUS MIND IS ON THE OUTSIDE DENVER.

SO THE CONSCIOUS MIND AND MY TALKING TO YOU RIGHT NOW.

I'M VERY CONSCIOUS OF IT.

I'M USING THE OUTSIDE PART OF MY BRAIN BASICALLY UNCONSCIOUS IS DEEP INSIDE AND UNCONSCIOUS.

PART OF THE BRAIN.

WE CALLED SUBCONSCIOUS AND THAT'S THE PART OF THE BRAIN THAT'S DEEP INSIDE THE BRAIN.

AND THAT'S THE PART OF THE BRAIN THAT IS WORKING BEHIND THE SCENES AND THAT'S THE PART OF THE BRAIN.

FRANCE'S THAT HELPS YOU SLEEP SO DOWN HERE IS YOUR SLEEP CENTER AND YOU'VE GOT ALL THESE WAYS OF THE BRAIN WORKING DEEP DEEP INSIDE AND DEEPER DOWN THE BRAIN.

SHE'S GOT WHITE MATTER AND THERE WHICH LINE WITH THESE MILE IN SHEETS AND THEN THE OUTSIDE IS THE MORE THE GRAY MATTER.

SO WHEN YOU'RE ABOUT GRAY MATTER, THAT'S MORE OF YOUR CONSCIOUS THINKING PART OF THE BRAIN AND CAUTIOUSLY.

YEAH, YOU CAN BE DRIVEN BY DIFFERENT THINGS AND.

IT'S SOMETHING THAT IS IS GOT A STEADY TO A DEGREE BECAUSE YOU HAVE THIS REMARKABLE MEMORY CENTER OUT HERE ON THE TEMPORAL LOBE ON THE OUTSIDE THAT YOUR LIBRARY OF THE BRAIN RIGHT THERE.

DEBERAN, YOU'VE GOT THIS LIBRARY THAT REMEMBERS A LOT OF STUFF AND I THINK IT COULD BE SPECULATED THAT SOMEWHERE IN THIS LIBRARY WE HAVE MEMORIES OF EVERY SINGLE THING WE'VE EVER ENCOUNTERED.

NOW.

HOW DOES IT GET HOW DO WE BRING IT UP TO CONSCIOUS MEMORY.

A LOT OF THINGS WE'RE SUPPOSED TO REMEMBER IF YOU'VE HAD TRAUMATIC EXPERIENCES, YOU'LL OFTEN HAVE DIFFICULTY REMEMBERING DETAILS OF THOSE TRAUMATIC EXPERIENCES SUCH THAT THEY GET KIND OF TUCKED AWAY AND THEY MIGHT COME BACK IN VERY SUBTLE WAYS IN THE FUTURE AND WHETHER IT'S SETTLED TRIGGERS FOR BRINGING BACK A TRAUMATIC MEMORY CAN BE A SMELL.

AND I'VE HEARD PEOPLE SAY WHEN THEY WHEN THEY ARE ABLE TO SMELL A CERTAIN COLOGNE OR PERFUME OR THEY SMELL SMOKE.

THAT BRINGS BACK THESE TRAUMATIC MEMORIES THAT HAD BEEN BURIED FOR A LONG TIME.

BUT YOUR SENSE OF SMELL IS A TREMENDOUS TRIGGER FOR BRINGING BACK MEMORIES.

YOU MIGHT.

BE WALKING DOWN A HALLWAY SOMEPLACE AND YOU SMELL A PERFUME AND ALL OF A SUDDEN YOU THINK OF YOUR 4TH GRADE TEACHER BECAUSE YOU'RE 4TH GRADE TEACHER BY TO HAVE THAT SAME PERFUME, THESE DEEP MEMORIES ARE THERE.

AND LIKE I SAID, THEY'RE THEY'RE EMBEDDED IN YOUR MEMORY CENTER.

IT'S JUST THAT MANY OF THEM ARE STORED AWAY AND THE MATCH AND EVER.

IF YOU REMEMBERED IF YOU COULD CONSCIOUSLY REMEMBER EVERY SINGLE THING THAT EVER HAPPENED TO YOU.

YOUR BRAIN WOULD BE SO OVERWHELMED.

YOU'RE THINKING PRETTY BRINGING PEACE OVERWHELM YOU UNTIL TO THINK ABOUT WHAT YOU'RE DOING NOW.

SO I THINK THERE'S A REASON CRY.

A LOT OF THINGS ARE TUCKED AWAY IN OUR SUBCONSCIOUS.

AND DEBORAH, A LOT OF THIS COMES OUT OF THEIR SLEEP WHEN WE SLEEP, WE WILL NORMALLY AND IF YOU DREAM YOUR BREATH, YOU'LL HAVE THESE.

SYMBOLIC TYPE OF MEMORIES THAT COME OUT THE SYMBOLIC TYPE OF EVENTS.

THEY DON'T MAKE ANY SENSE TO YOU AT ALL UNLESS YOU THINK ABOUT IT IMMEDIATELY THAT FOLLOWING MORNING AND THINK, OK, HOW DID THIS.

HOW DID THIS DREAM SEQUENCE SYMBOLICALLY.

REPRESENT WHAT I'M GOING THROUGH OVER THE PAST DAY.

IF YOU THINK ABOUT THAT IMMEDIATELY UPON AWAKENING.

YOU CAN SOMETIMES THINK THROUGH, OK, THAT REPRESENTED THAT THAT REPRESENTIVE THAT THE DREAMS ARE VERY SYMBOLIC.

YOU CAN THINK THROUGH YOUR YOUR THE CONTEXT OF YOUR DREAMS.

IF YOU FIRST WAKE UP, IF YOU WAIT A COUPLE HOURS, THEN TRY TO THINK ABOUT WHAT YOU ARE CORRECT ABOUT WILL OFTEN FORGET YOUR DREAMS GET A RACE TO FERRY.

VERY QUICKLY.

IF YOU DON'T WRITE THEM DOWN OR THINK AMAELI UPON AWAKENING.

AND IF YOU DON'T TALK EMILIA PART WAKING SO I REMEMBER WHEN I WAS IN FOR 2 AND A HALF YEARS.

I HAD PSYCHOANALYSIS AT 6.30 IN THE MORNING ON TUESDAYS AND FRIDAYS FOR 2 AND A HALF YEARS.

SO MY DREAMS ARE FRESH IN MY HEAD.

SO I WAS ABLE TO TALK ABOUT MY DREAMS TO MY ON A VERY REGULAR BASIS THAT WAY.

IT WAS REALLY HELPFUL TO HAVE TO CHIVAS OR THE SESSIONS THAT EARLY THE MORNING.

DEBORAH, THANKS, YOUR CALL.

LET'S GO TO THE LAST CALLER.

HELLO, JOE WALKING AMERICAN MIGHT.

JOE, YOU BIPOLAR PEOPLE MORE INCLINED OF NARCISSISTIC CHARACTERISTICS AND ONE OF THE DOLLAR AND THE CHARACTERISTICS OF NARCISSISM BASICALLY, JOE A BIPOLAR.

PEOPLE MIGHT COME ACROSS AS BEING MORE SELF-CENTERED WHEN THEY'RE MANIC BECAUSE THEY HAVE POOR JUDGMENT.

THAT DOESN'T MEAN THEY'RE NARCISSISTIC ITS THE CELLS ARE IS WHERE AGAIN, YOU'RE SELF-CENTERED.

YOUR YOUR FOCUS IS ONLY ON YOURSELF.

YOU GET IN TROUBLE WITH OTHER PEOPLE BECAUSE YOU DON'T THINK ABOUT THEIR NEEDS.

YOU TEND TO SEE YOURSELF AS BEING SUPERIOR AND ALL-KNOWING.

WHEN YOU NARCISSISTIC NOW YOU CAN BE GRANDIOSE WHEN YOU HAVE BIPOLAR MANIA AND THAT COMES ACROSS AS BUT WHEN YOU'RE GRANDIOSE AND YOUR HIGHER THAN A KITE USE PERCEIVE THAT YOU CAN DO ANYTHING.

YOU'RE MORE CREATIVE.

YOU HAVE ALL THESE IDEAS THAT MIGHT BE IT'S INAPPROPRIATE AND THAT YOU COME ACROSS AS BEING MORE SELF-CENTERED WHEN YOU'RE GRANDIOSE.

THERE IS A DIFFERENCE THERE JAIL AND WE WOULD INDEED TREAT THAT DIFFERENTLY.

THANKS.

YEAR.

CALL WE'LL TELL YOU I THINK WE'VE RUN OUT TIME FOR FOR THE NIGHT.

>> IF YOU HAVE ANY QUESTIONS THAT I CAN ANSWER ON THE AIR.

YOU MAY WRITE ME VIA THE INTERNET AT MATTERS OF THE MIND.

ALL ONE WORD AT W F W A DOT ORG.

I'M PSYCHIATRIST.

JAY FARBER, YOU'VE BEEN WATCHING MATTERS.

THE MINE ON PBS FORT WAYNE GOD WILLING IN PPS WILLINGLY BACK AGAIN NEXT WEEK.

AND GOOD EVENING TONIGHT.