Centered on Health 2-27-25 - “It’s okay to not be okay, An open conversation about mental health with Kristine Baula, MD
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Speaker 1 (00:01):
It's now time for Centered on Health with Baptists Help
on US radio. Wait forty tel WDYJS.
Speaker 2 (00:07):
Now, here's doctor Jeff Tumbler.
Speaker 3 (00:13):
Good, good evening, everyone, and welcome to tonight's episode of
Centered on Health with Baptist Help here on news radio
eight forty whas. I'm your host, doctor Jeff Tublin. We're
joined from the studio with our producer Carl, who's waiting
to take your calls to talk to tonight's guest. Our
phone number five oh two, five seven one, eight four
eighty four if you want to call in and be
(00:35):
a part of tonight's show. I do want to mention
at the start of the show that tonight we are
going to be discussing topics of mental health, and some
topics may be difficult for some listeners, but mental health
is such an important part of our overall wellbeing. And
in twenty twenty two, about twenty three percent of us,
which is about sixty million, experienced a mental illness, with
(00:58):
six percent and about fifteen million considered serious. And here
in Kentucky alone, one hundred and ninety thousand visits annually.
So tonight, doctor Bala, Doctor Christine Bala is here to
talk to us about mental health. She's going to tell
us that it's okay to not be okay, and I
want to introduce you to her. She went to University
(01:19):
of Louisville for medical school, residency and fellowship and as
a board certified in psychiatry and neurology.
Speaker 2 (01:25):
Welcome to Centered on Health.
Speaker 1 (01:29):
Thank you so much for having me on the show.
I'm excited to be here.
Speaker 2 (01:33):
Well, we are very excited to have you.
Speaker 3 (01:35):
And you know, this is an important topic on its own,
but it has two reasons why it's particularly important. One
is I don't feel like we have enough conversation around
this topic, and I think we're sort of limited in
some of the providers that we have for this. So
I'm really excited to hear your take on sort of
all of these things. So to get us starts, tell
(01:56):
us a little bit about your decision to go into
psychiatry and to do neurology at the same time, and
how do they work together for you.
Speaker 1 (02:06):
So one thing I wanted to clarify first, I don't,
unfortunately have a neurology degree, but I am a board
certified psychiatrist and I did my fellowship in childnidolescent psychiatry
as well, And really what got me interested in psychiatry
at first is really just the uniqueness of people. Everyone
(02:28):
has a unique story to tell, even if it's maybe
not that evident from just looking at them or talking
to them once or twice. Sometimes you really have to
sit down and get to know a person and to realize,
you know, maybe maybe everyone has problems every now and then.
Speaker 3 (02:48):
And I know we're going to get into it a
deeper throughout the show, but tell us what an average
day is like for you. Are you mostly outpatient inpatient?
Is it a combination? Do you adult children? What's your dislike?
Speaker 1 (03:02):
So my my main role is as medical director for
the Baptist Health Lagrange, that behavioral health inpatient unit, and
we're an eleven bed unit that serves adults with behavioral
health issues. We uh. The day to day routine for
(03:25):
us is really get started, see if there are any
patients who had required health overnight and were admitted. I
get to meet those new patients. I spend individual time
with them, and they're also going to get to meet
our therapists and and the rest of our staff, and
then I I do do some outpatient work as well,
(03:48):
and part of that is to help address the issue
of not having enough access to mental health care providers.
I think that's especially important when you were about to
be discharged from a hospitalization and you're probably gonna be
in a pretty fragile state. Still, you're definitely better, but
(04:11):
you're going to want some extra support to make sure
you're not going to slip back. And at our unit,
we ensure that everyone gets a follow up with a
mental health provider, whether that's for medication management or for therapy,
and they get that within seven days of discharge. It
isn't super easy to get into a mental health clinic
(04:33):
in seven days, let alone. You know, if we're we're
already dealing with with the average person trying to get
help with a therapist and waiting months to bridge that gap.
I have transitional appointments to make sure that someone who's
discharging from our unit can get seen really within that
(04:55):
seven days that I.
Speaker 3 (04:57):
Mean, that just sounds so important because all the work
you're doing, you know, you don't want to lose that
ground with the gap and the follow up care. So
that sounds amazing that you're doing that. Now we're talking
about mental health. I feel like it's changing. We're not
having enough conversations, but we are having more. Do you
feel that way? Do you feel like there's still a
stigma around talking about mental health and what is mental health?
Speaker 2 (05:21):
In your opinion?
Speaker 1 (05:24):
So, mental health is health. It is part of right
everyone's health. Just like you might be taking care of
your physical health by making sure that you're getting check
ups at the doctor regularly, making sure that you're eating right,
and making sure that you're not smoking, you need to
take care of your mental health as well to make
(05:45):
sure that you're living your best life. You know, you
talk about stigma, and my goodness, yes, there is a
stigma against mental health still, and that's really that's really worldwide,
but in our country it can definitely be a regional issue.
(06:05):
There are certain cultural groups that tend to be a
lot more negative about considering mental health and considering treatment
for mental health. They are talking about it a lot
more than they used to at a younger age. They're
talking about it in the school systems. But although that
(06:27):
is hardening, sometimes I've come across a high school student
who will say, yeah, they're telling us these things. But
to be honest, I still feel that the stigma is there,
and I still feel like I'm going to get made
fun of or I'm going to be labeled as someone
who is weird or crazy if I admit that I'm
(06:49):
struggling with my mental health. I really hope that that
continues to change with social media and people sharing pretty
much everything on mine. Yeah. Yeah, that's just part of
your last story, right, if you're struggling with your mental health.
I am so proud of those people who are willing
(07:10):
to share their stories with others.
Speaker 3 (07:13):
You know, in our recent history, obviously we went through
the pandemic and there was a lot of social isolation.
I mean, you mentioned social history, but you know, people
weren't interacting. Did you find that that had an impact
on mental health during that time period?
Speaker 1 (07:28):
Absolutely? Absolutely. There are certain even certain disorders that seem
to get hit really, really hard during the pandemic, and
I think that part of that had to do with
the it's easier to fall apart and to lose your
(07:49):
support network when you're really having to stay at home
and your enforced isolation. It's going to take extra effort
to reach out out to your friends, to your family,
to your mental health providers to help in general, for example,
in eating disorders during the pandemic and during the lockdowns,
(08:14):
that's something that we saw a very very large increase
in severity and incidents. So I am glad that we've
recovered from from the pandemic to the point where, yeah,
we're able to get back to our normal socialize and
see people in person. And I'm hoping that we're making
(08:34):
progress on addressing the health issues that got worse during
ten epic.
Speaker 3 (08:42):
Yeah, and I know we're going to talk a lot
about inpatient in a little bit, But as far as
the outpatient access, what are you seeing in terms of
the what that we're doing to improve access? I mean,
I know that I've seen commercials for online therapy and things.
What are you seeing that's working to get more people
(09:02):
in the outpatient setting access to care?
Speaker 1 (09:06):
Well, there are a couple of ways to consider this. First,
I want to really just give a shout out to
all the primary care physicians out there, general practitioners, because
my goodness, they are really the front line for mental
health care. Oftentimes, especially if someone is really nervous and
(09:28):
not used to seeking professional help for their mental health issues,
going to the primary care physician and saying Hey, I
have been having some difficulty breathing and running nose, and
also I've been a lot more down than normal. They're
the first ones who are really going to be able
(09:50):
to make a difference. Sometimes they'll be able to prescribe medications,
or they might be able to make their appropriate referrals
to get that patient or that person set up with
right mental health professionals. And you mentioned tal, you mentioned
the boom and internet therapy, online therapy, and we have
(10:15):
definitely expanded our visual thumbprint in outpatient care. That really
was pushed forward by the pandemic. We were very quickly
having to find a way to make sure we were
still caring for our patients when we couldn't physically be
with them. And so telehealth has continued as the countries
(10:37):
are covered from the pandemic. And I think that is
very fortunate because that allows a provider to reach a
patient who might be clear across the state without any transportation,
without support, and without any local mental health providers. They
can still see someone who can provide them with help.
(11:00):
You know, it's not always ideal, to be honest, I
very much like the in person interaction, but to be
able to expand that access of care to a wide
a wide area I think has been really really important.
Speaker 2 (11:17):
Fantastic.
Speaker 3 (11:18):
Well, we are talking tonight with doctor Christine Bala about
mental health and it's okay to not be okay a
conversation about mental health.
Speaker 2 (11:26):
We're going to take a short break.
Speaker 3 (11:27):
You are listening to Senate on Health with Baptist Health
here on News Radio eight forty whas.
Speaker 2 (11:32):
I'm your host, doctor Jeff Tublin.
Speaker 3 (11:34):
Our phone number five oh two, five seven one, eight
four eighty four. If you want to call and ask
a question of tonight's guests, we'll be right back. Welcome
back to Senate on Health with Baptist Health here on
(11:56):
news Radio eight forty whas. I'm your host, doctor Jeff Toblin,
And tonight we're talking to doctor Christine Bala about mental
health and it's okay to not be okay. Our phone
number five O two five seven one eight four eighty
four if you want to call in join the conversation.
Our producer Carl is on standby to take your calls.
(12:17):
So welcome back. And before before we went to the break,
you had talked to us a little bit about impatient
and I want to spend a little bit of time
talking about the inpatient psychiatry, because tell us give paint
us a little bit of a landscape.
Speaker 2 (12:31):
Is it like what we see.
Speaker 3 (12:32):
In the movies and the TV shows, or what is
in patient's psychl like?
Speaker 1 (12:39):
It's not really like that. There are some movies that
do a little bit better at getting it right, but
in general, movies that portray psychiatric issues are definitely going
to go forth traumatic effect. They want a good story.
They're not necessarily going for realism. I think you know,
when you think out psychiatry and mental health in the media,
(13:04):
in films, in TV shows, a lot of times it's
portrayed in a pretty negative light. You'll have these kind
of prison like conditions with this sickly greenish yellow lighting.
Everyone's always in restraints that you're always in isolation. They're
always in seclusion. To be honest, those are those can
(13:29):
be utilized, but they are utilized really as a last
resort only when we have not been able to calmbat
patient down by verbal de escalation, by redirection, by using
medications that might be able to provide some relief from
their emotional distress. It's very quite it's quite rare that
(13:52):
we actually use those things. I think media also for
some reason it wants to portray people with mental health
issues as violent, much more so than that average population.
That really is inaccurate. And and you know that's not
just in media. That also comes up whenever there is
(14:18):
an unfortunate incident in the new the shooting or some
some kind of violent occurrence where some one might have, yes,
a history of a mental health diagnosis, and suddenly the
story becomes all focused on that that that is definitely
not true. Actually, people who struggle with mental health issues
(14:40):
are more likely than the average population to be the
victims of violence and impression. Also, you know, go ahead, sorry, no, no, no,
please continue. We don't do lobotomies at least no, I
know the lobotomy is anymore just to clarify a right.
Speaker 2 (15:05):
That is definitely a Hollywood embellishment.
Speaker 3 (15:08):
So tell us what makes an inpatient stay necessary? And
if somebody's there, can they just leave when they want
to leave? Like what makes them have to go into
any patient setting? And then what's the criteria to leaving it.
Speaker 1 (15:27):
So typically the people who are going to be admitted
to behavior with a health facility, they're going to be
people who are really experiencing mental health crises. They're not
just people who had a bad day or are looking
for upbreak over the weekend. These are people who might
(15:49):
be at a high risk of hurting themselves maybe of
hurting others. They might be so psychotic and out of
touch with reality that they might not know that they're
putting themselves in danger. And those are the people who
would really benefit from going to the hospital and being
(16:10):
admitted to a behavioral health unit because we are able
to provide a safe and monitored environment where you're you're
able to really get started with treatment. And you had asked,
what how do you how do you leave a psychiatric
unit or behavioral health unit? Is that what?
Speaker 2 (16:32):
Yeah?
Speaker 1 (16:32):
Yeah, so it depends. Typically we love for patients to
stay until the treatment team feels like they've really met
the maximum benefit that they're going to from that hospitalization
and kind of graduate from hospitalization and will make sure
that they transition seamlessly into outpatient care. That typically for
(16:59):
a day is going to be about three to five days.
Of course, like I said before, you know, everyone's unique,
and so everyone might have different needs, and so that
can vary depending on that person's needs. Some people are
admitted voluntarily, they are actively seeking help. They want to
be there. They know that they are not in a
(17:20):
good place and don't know if they can keep themselves
safe if they aren't in a structured unit like ours.
And for those people, if they're able to improve to
the point where they're no longer considered an imminent risk
to themselves, if they do choose to leave the fool
we feel like they're ready to. They do retain the
(17:41):
right to legally leave against medical advice, and sometimes that
puts you at risk. Though some places will have a
default policy where if you leave, if you leave a
m A, you're not getting medications, you're not getting follow ups,
You're not getting you know, any any the discharge paperwork
or instructions at our unit. I think that's ridiculous. If
(18:07):
someone was at the point where they needed help and
they went in patients anyway, how ethical is it to
discharge them with no resources, even if they are, you know,
maybe not wanting to completely follow through their advice. There
are other patients who really need to be hospitalized for
(18:29):
their own safety or other safety. Those are patients who
when in the case that they are not willing to
be hospitalized. Any medical professional can place that patient on
a seventy two hour involuntary hold, and within that seventy
two hours they're evaluated by qualified mental health professional. Its
(18:53):
determined whether or not that person needs to continue hospitalization.
And if that seventy two hours has reached end, that
patient has either stabilized or has gotten to the point
where we can't say that there are an imminent risk
to themselves and they would benefit from further hospitalization but
don't legally need to be there, then they can leave
(19:16):
as well. In worst case scenarios, when we have really
six people who might want to leave well before before
their treatment is completed, we might file a mental inquest
warrant to make sure that they get the help that
they need.
Speaker 3 (19:33):
And if somebody is listening or somebody is talking with
somebody and they feel that they need this sort of
level of help, where do they go, what do they do?
How do they get themselves that kind of inpatient care.
Speaker 1 (19:48):
So specifically, for our behavioral health unit, you would go
to the Baptist Health Lagrange emergency department and request the
behavioral health evaluation. They're going to make sure that you're
medically stable in the emergency department, and then once that's determined,
they'll call one of our staff members to go and
evaluate you. They're going to hear your story, they're going
(20:09):
to gather information for us. Then they'll call an on
call psychiatrist, whether that's me or one of the physicians
that assists me. They're going to present your history and
they will decide if hospitalization is actually appropriate for you.
If we think that you do need in patient help,
but our unit can't adequately serve your needs, then we
(20:31):
might send a referral to a different unit that might
be able to meet those needs. If Baptist Health the
Grained isn't the hospital that's closest to you, I would
strongly recommend just going to the closest emergency department, going
the closest hospital and letting them know that you are
having a mental health crisis, even if they don't have
(20:52):
a psychiatric provider to evaluate you there. If you can
let them know that you're interested in hospitalization and they
can send referrals, most places will allow you a name
of preference, so of course that's going to be Baptist
Health of Range Behavioral Health Unit located at ten twenty five.
You Moody Lane, Like Range, Kentucky four zero zero three one.
(21:16):
Phone number is five zero two two two five five
six three zero.
Speaker 2 (21:21):
Righterful.
Speaker 3 (21:23):
Yes, well, thank you for being the medical director. Thank
you for bringing these resources to our community. We're going
to talk a little bit more on the outpatient setting
when we come back.
Speaker 2 (21:32):
We're going to take a short break.
Speaker 3 (21:33):
You are listening to Centered on Health with Baptist Health
here on news radio eight forty whas. Our phone number
five oh two five seven one eight four eighty four.
If you'd like to call in and talk to doctor
Christine Fla who's talking to you to us tonight about
mental health, we'll be right back. Welcome back to Senate
(22:00):
on Health with Baptist Health here on news radio eight
forty whas. I'm your host, doctor Jeff Tublin, and we're
talking tonight with doctor Christine Bala about mental health.
Speaker 2 (22:10):
And if you're just joining us, we've talked a.
Speaker 3 (22:12):
Lot about the state of mental health in our communities
and the wonderful resources that she's bringing to our community
at Labrange with behavioral health clinics and inpatient work. But
I'm not surprised, doctor Bala, but we've had several people
submit questions that some prefer not to get on the
air themselves, but have asked if we could ask you
(22:33):
some questions. So the first question is about how you
see dealing with patients who have physical other illnesses, for example,
a heart attack or a stroke that might impact them
greatly either physically or their work, and feelings of depression
(22:55):
and anger that might go along with that.
Speaker 1 (23:00):
I love that you're asking this question because I'm sure
that it's a question that a lot of people can
relate to. And it's interesting that you mentioned both stroke
and heart attacks. Those two issues have a very very
high incidence of depression after the incident, and so for example,
(23:21):
with stroke, something about somewhere around twenty to forty percent
of patients who experience a stroke will go on to
develop some form of clinical depression, usually within the first
six months if their recovery, especially while they're needing to
(23:43):
relearn how to do certain things. They're working on their balance,
working on their strength. When I was training, when I
was still in medical school, I remember I was on
the stroke unit. I noticed that all of these people
(24:03):
had just newly been started on prozac, and I thought
that was so interesting, and I was wondering if there
was a you know, was there a unique neurological benefit
to starting prozac, And another answer that I got was
the incidences of depression after stroke is so high that
it can be really beneficial to go ahead and take
(24:26):
a preemptive approach. But it also can help with with
motivating someone to get out of bed and to start strengthening,
because yeah, a stroke can be a very emotionally devastating thing,
the same thing for heart attacks. You know, a lot
of times these types of medical issues are going to
(24:48):
lead to really lifelong changes, whether that's in diet and lifestyle,
and so it is vital for physicians, even if you're
not mental health positions, either a cardiologist or a neurologist,
when you are following up with those patients, you know,
(25:08):
after they were discharged from the hospital, using just a
standard depression screening tool like the PHQ nine could be
really really helpful and identifying those patients who might be
struggling emotionally and might need that additional help. Sometimes with
chronic issues, if you're going to have a chronic deficit,
(25:31):
if you are never going to regain that full functionality,
you have to learn to cope essentially with that new disability,
and there are different types of therapy that really help
kind of change your mindset around your identity in the
(25:55):
context of health issues.
Speaker 3 (25:58):
Well, I'm so glad that people are submitting these questions.
It means that they're they're listening and they're hearing, and
they're recognizing the value that you have to offer. Another
question that came in is an interesting one. This individual
wanted to know how to navigate the workplace if you
suspect that somebody that you're working with might be having
(26:23):
issues of depression or something and within the workplace and
a colleague, how would you approach that.
Speaker 1 (26:32):
So it can be a little bit challenging, how it
can be a little bit a sensitive and tricky. It's
first off, I think the approach is going to depend
on how familiar you how familiar you are with that coworker,
that colleague. But you know, it's definitely not something that
you want to ignore if you have a strong concern. Really,
(26:55):
one one of the things that you can do is
what you might do for any friend or family member
who might be struggling with whom you might suspect might
be struggling with a mental health issue. Just check in
on them and ask them how they're doing, if you
know what's going on in their life, what's going on
(27:16):
in their life outside of work, and you know if
there is something that they're willing to offer that kind
of clues you in. Maybe maybe with a loss of
a beloved pet, or maybe they were having issues at
the house and they feel like they're never getting going
to get on top of it. Just the act of
(27:40):
asking and letting them know that they have someone who
sees them can be extremely extremely important. Now, if it's
to the point where you are you have a strong
suspicion and strong concern about a coworker that they might
be at that point where they might be reaching a
(28:01):
mental health crisis, that might be an occasion where you
might want to get to uh, get higher ups involved
and make sure that they feel supportive from from all
the way up to the to down in your in
your workplace.
Speaker 2 (28:22):
Thank you, Thank you for that.
Speaker 3 (28:25):
So I want to talk about I know we're not
going to have enough time to talk about all of
the things we're going to want to talk about tonight,
but sticking with some of the broader themes. You know,
it's normal to be sad at times, right, So how
does one self reflect the difference between sadness and depression?
Speaker 1 (28:44):
Ah? Okay, so sadness does not equal depression, although sometimes
you know, just casually, you might use the terms interchangeably.
The depression that mental health professionals manage, that they treat
is a pathological condition. Essentially, most common is going to
(29:05):
be major depressive disorder, where really it's gone beyond sadness,
it has gone to the point where it is affecting
it's affecting multiple, multiple aspects of your life. You might
have a sustained depression that lasts for months, but really
(29:28):
to be diagnosed with depression, the symptoms have to be
present for at least two weeks and they do cause
distress or impairment in your daily life. Some of the
symptoms that might come along with depression could be an
irritable mood. Sometimes people lashed out as almost a more
(29:50):
socially accepted way of showing your emotions when they don't
quite know how to put words to their emotions. They
might have lack of interes in doing things that they
know they used to like to do, and they might
have lack of motivation to do those things that they
used to like to do. You might have changes an appetite.
(30:10):
Sometimes we'll see a weight an increase in appetite. More
often we'll see a decrease in appetite. Sleep is usually disturbed.
Oftentimes with early morning awakenings, you might feel really fatigued,
even though you might be sleeping adequately ish. A lot
of people who struggle with depression will also struggle with concentration,
(30:33):
will struggle with feelings of hopelessness and worthlessness, and they'll
also feel like it's them, the problem is them, and
they deal with excessive guilt. They might apologize for things
that really aren't their fault. And when things get really
really bad, depression can present with suicidal thoughts or thoughts
(30:56):
of self harm. Depression does eventually ron it's course, even
without treatment for most people. But you know, when I
see someone who's really struggling with oppression, I'd rather them
get better sooner rather than later and get back to
normal functioning.
Speaker 3 (31:16):
Of course, So if you have questions, we are we
are here. We are centered on health. You are listening
to Senate on Health with Baptist Health here on News
Radio eight forty whas. I'm your host, doctor Jeff Tublin.
We're talking with doctor Christine Bala. We're tackling a big
issue tonight with mental health. We will see you after
these words and we'll be right back. Welcome back to
(31:48):
Cenate on Health with Baptist Health here on news radio
eight forty whas. I'm your host, doctor Jeff Tublin. We're
talking tonight with doctor Christine Bala about mental health issues
and getting evaluation and treatment. I want to remind everybody
to download the iHeartRadio app to re listen to this
or any of our previous segments. It's easy to use
(32:09):
and it gives you all the features that the app
has to offer. So you told us a little bit
about how to tell the difference between kind of sadness
and depression, and kind of along those saying lines for
our listeners, it's also normal to be nervous sometimes or
a little bit anxious so or worried. When when does
(32:31):
worry become anxiety? And how do you define anxiety when
it becomes something that needs to be treated.
Speaker 1 (32:39):
So you are kind of starting along my motto, which
is essentially it's okay to be a little a little
sad and depressed. It's okay to be a little anxious.
It's okay to even be a little psychotic sometimes. So
you know, there are definitely times where nervousness and anxiety
are natural and normal reactions. If you are, for example,
(33:05):
in a dangerous situation, a little bit of anxiety because
that's going to be protective, that's going to tell you
probably shouldn't be hanging out in that area. Probably get
to get out of there. But the point at which
anxiety becomes something that might need to be addressed by
a professional is when that anxiety becomes excessive, when it
(33:28):
becomes persistent or near constant, and when the anxiety is
unrealistic or really out of portion to the stress that
you might be dealing with. Sometimes, for example, you know,
if you are facing a difficult time financially, you might
(33:51):
you might want to consider, you know, taking a little
bit more more carry er finances. Might might worry a
little bit if you have some bigger expenses coming up,
but say times later on are are better for you financially,
but you retain that anxiety of not having enough, and
so you never spend the money that you have available
(34:14):
to you. You just kind of save it up for
a rainy day, save it up for a rainy day,
but that rainy day is never going to come. That's
what That's what I would consider excessive anxiety. It is
anxiety that kind of takes you out of a reasonable
a reasonable response. The hallmark of anxiety that that I
(34:39):
typically treat is the type of anxiety that just gets
stuck in your head. Then it just circles around, circles around,
and you feel like it's outside of you, but you
have no power to stop it. And that's not that's
not true. That's not true. But if you don't get
(34:59):
treatment for it, or if you're not very very proactive about,
you know, doing some of your own research and managing
your anxiety, it can really take over your life. Anxiety
when it starts to when it directly affects your physical health,
(35:20):
there's definitely something you're going to want to address. Sometimes
anxiety can come with severe nausea and vomiting. You know,
little kids who you think they want to stay home
from school because they're always complaining at a tummy ache,
No it Oftentimes they might be actually feeling their anxiety
and their gut and and you might want to take
(35:43):
them seriously if they do it too much. It's not
a it's probably not going to be that. But if
if you're anxious about something for an extended period of time,
long after it's past or long before it's coming, chances
(36:03):
are you would benefit from seeking some professional.
Speaker 3 (36:07):
Health and sort of sticking in that depression and anxiety lane.
You know, it's kind of a little bit of time
that we have left. I know, we all know there's
medications and things like that, which would be a whole
nother show to talk about that. But are there some
easy coping mechanisms or strategies that you use in your
(36:28):
office when yes, they need to be seeing a professional,
but maybe they don't really need to be on medications
and there's like a kind of an in between behavioral approach.
Speaker 2 (36:37):
How does that look like for you?
Speaker 1 (36:40):
So for that, you know, I'm never going to not
not recommend therapy because oftentimes, you know, even though one
of my main roles is to find the right medication
to prescribe, there are sometimes legitimate mental health issues that
can very much benefit from therapy alone. Actually, anxiety is
(37:01):
one of those. Anxiety is something that you know, using
certain approaches, might be able to resolve or at least
become much more manageable, even ONLA than in the course
of a couple of months. You could go from having
daily or multiple time of day pemic attacks, feeling what
you're having a heart attack with at any point, to
(37:25):
recognizing your triggers and recognizing that you have control over
that anxiety. A type of therapy called cognitive behavioral therapy
can be a very very effective means of addressing that
without medication, and you know medication can sometimes you might
(37:50):
sometimes start with medication, but if you start with therapy,
there's always the option of adding medication later on if
you find that things just kind of not't going exactly
as well as you wanted them to.
Speaker 3 (38:04):
Well, I really appreciate that you are coming on and
sharing so much of this information with us tonight. I
know that you know there's multiple multiple things we could
talk about, and we are just going to have to
have you back, but we are going to wrap up
tonight's segment. I want to thank our guest doctor Bala
for joining us tonight. She is at Lagrange and is
(38:27):
the medical director for our outpatient clinics. And please do
not hesitate to seek help if you need it. That
is going to do it for tonight's segment of Centered
on Health. I'm your host, doctor Jeff Tublin. I want
to thank our guests, I want to thank our callers
for sending in these very very important questions, and I
want to thank our producer Carl. Join us every Thursday
(38:47):
night for another segment and we will see you next week.
Have a great weekend and enjoy the rest of the week.
Speaker 1 (39:13):
These programs for informational purposes only and should not be
relied upon this medical advice. The content of this program
is not intended to be a substitute for professional medical advice, diagnosis,
or treatment. This show is not designed to replace the
physician's medical assessment and medical judgment. Always seek the advice
of your physician with any questions or concerns you may
(39:34):
have related to your personal health or regarding specific medical conditions.
To find a Baptist health provider, please visit Baptist Heealth
dot com.
It's now time for Centered on Health with Baptists Help
on US radio. Wait forty tel WDYJS.
Speaker 2 (00:07):
Now, here's doctor Jeff Tumbler.
Speaker 3 (00:13):
Good, good evening, everyone, and welcome to tonight's episode of
Centered on Health with Baptist Help here on news radio
eight forty whas. I'm your host, doctor Jeff Tublin. We're
joined from the studio with our producer Carl, who's waiting
to take your calls to talk to tonight's guest. Our
phone number five oh two, five seven one, eight four
eighty four if you want to call in and be
(00:35):
a part of tonight's show. I do want to mention
at the start of the show that tonight we are
going to be discussing topics of mental health, and some
topics may be difficult for some listeners, but mental health
is such an important part of our overall wellbeing. And
in twenty twenty two, about twenty three percent of us,
which is about sixty million, experienced a mental illness, with
(00:58):
six percent and about fifteen million considered serious. And here
in Kentucky alone, one hundred and ninety thousand visits annually.
So tonight, doctor Bala, Doctor Christine Bala is here to
talk to us about mental health. She's going to tell
us that it's okay to not be okay, and I
want to introduce you to her. She went to University
(01:19):
of Louisville for medical school, residency and fellowship and as
a board certified in psychiatry and neurology.
Speaker 2 (01:25):
Welcome to Centered on Health.
Speaker 1 (01:29):
Thank you so much for having me on the show.
I'm excited to be here.
Speaker 2 (01:33):
Well, we are very excited to have you.
Speaker 3 (01:35):
And you know, this is an important topic on its own,
but it has two reasons why it's particularly important. One
is I don't feel like we have enough conversation around
this topic, and I think we're sort of limited in
some of the providers that we have for this. So
I'm really excited to hear your take on sort of
all of these things. So to get us starts, tell
(01:56):
us a little bit about your decision to go into
psychiatry and to do neurology at the same time, and
how do they work together for you.
Speaker 1 (02:06):
So one thing I wanted to clarify first, I don't,
unfortunately have a neurology degree, but I am a board
certified psychiatrist and I did my fellowship in childnidolescent psychiatry
as well, And really what got me interested in psychiatry
at first is really just the uniqueness of people. Everyone
(02:28):
has a unique story to tell, even if it's maybe
not that evident from just looking at them or talking
to them once or twice. Sometimes you really have to
sit down and get to know a person and to realize,
you know, maybe maybe everyone has problems every now and then.
Speaker 3 (02:48):
And I know we're going to get into it a
deeper throughout the show, but tell us what an average
day is like for you. Are you mostly outpatient inpatient?
Is it a combination? Do you adult children? What's your dislike?
Speaker 1 (03:02):
So my my main role is as medical director for
the Baptist Health Lagrange, that behavioral health inpatient unit, and
we're an eleven bed unit that serves adults with behavioral
health issues. We uh. The day to day routine for
(03:25):
us is really get started, see if there are any
patients who had required health overnight and were admitted. I
get to meet those new patients. I spend individual time
with them, and they're also going to get to meet
our therapists and and the rest of our staff, and
then I I do do some outpatient work as well,
(03:48):
and part of that is to help address the issue
of not having enough access to mental health care providers.
I think that's especially important when you were about to
be discharged from a hospitalization and you're probably gonna be
in a pretty fragile state. Still, you're definitely better, but
(04:11):
you're going to want some extra support to make sure
you're not going to slip back. And at our unit,
we ensure that everyone gets a follow up with a
mental health provider, whether that's for medication management or for therapy,
and they get that within seven days of discharge. It
isn't super easy to get into a mental health clinic
(04:33):
in seven days, let alone. You know, if we're we're
already dealing with with the average person trying to get
help with a therapist and waiting months to bridge that gap.
I have transitional appointments to make sure that someone who's
discharging from our unit can get seen really within that
(04:55):
seven days that I.
Speaker 3 (04:57):
Mean, that just sounds so important because all the work
you're doing, you know, you don't want to lose that
ground with the gap and the follow up care. So
that sounds amazing that you're doing that. Now we're talking
about mental health. I feel like it's changing. We're not
having enough conversations, but we are having more. Do you
feel that way? Do you feel like there's still a
stigma around talking about mental health and what is mental health?
Speaker 2 (05:21):
In your opinion?
Speaker 1 (05:24):
So, mental health is health. It is part of right
everyone's health. Just like you might be taking care of
your physical health by making sure that you're getting check
ups at the doctor regularly, making sure that you're eating right,
and making sure that you're not smoking, you need to
take care of your mental health as well to make
(05:45):
sure that you're living your best life. You know, you
talk about stigma, and my goodness, yes, there is a
stigma against mental health still, and that's really that's really worldwide,
but in our country it can definitely be a regional issue.
(06:05):
There are certain cultural groups that tend to be a
lot more negative about considering mental health and considering treatment
for mental health. They are talking about it a lot
more than they used to at a younger age. They're
talking about it in the school systems. But although that
(06:27):
is hardening, sometimes I've come across a high school student
who will say, yeah, they're telling us these things. But
to be honest, I still feel that the stigma is there,
and I still feel like I'm going to get made
fun of or I'm going to be labeled as someone
who is weird or crazy if I admit that I'm
(06:49):
struggling with my mental health. I really hope that that
continues to change with social media and people sharing pretty
much everything on mine. Yeah. Yeah, that's just part of
your last story, right, if you're struggling with your mental health.
I am so proud of those people who are willing
(07:10):
to share their stories with others.
Speaker 3 (07:13):
You know, in our recent history, obviously we went through
the pandemic and there was a lot of social isolation.
I mean, you mentioned social history, but you know, people
weren't interacting. Did you find that that had an impact
on mental health during that time period?
Speaker 1 (07:28):
Absolutely? Absolutely. There are certain even certain disorders that seem
to get hit really, really hard during the pandemic, and
I think that part of that had to do with
the it's easier to fall apart and to lose your
(07:49):
support network when you're really having to stay at home
and your enforced isolation. It's going to take extra effort
to reach out out to your friends, to your family,
to your mental health providers to help in general, for example,
in eating disorders during the pandemic and during the lockdowns,
(08:14):
that's something that we saw a very very large increase
in severity and incidents. So I am glad that we've
recovered from from the pandemic to the point where, yeah,
we're able to get back to our normal socialize and
see people in person. And I'm hoping that we're making
(08:34):
progress on addressing the health issues that got worse during
ten epic.
Speaker 3 (08:42):
Yeah, and I know we're going to talk a lot
about inpatient in a little bit, But as far as
the outpatient access, what are you seeing in terms of
the what that we're doing to improve access? I mean,
I know that I've seen commercials for online therapy and things.
What are you seeing that's working to get more people
(09:02):
in the outpatient setting access to care?
Speaker 1 (09:06):
Well, there are a couple of ways to consider this. First,
I want to really just give a shout out to
all the primary care physicians out there, general practitioners, because
my goodness, they are really the front line for mental
health care. Oftentimes, especially if someone is really nervous and
(09:28):
not used to seeking professional help for their mental health issues,
going to the primary care physician and saying Hey, I
have been having some difficulty breathing and running nose, and
also I've been a lot more down than normal. They're
the first ones who are really going to be able
(09:50):
to make a difference. Sometimes they'll be able to prescribe medications,
or they might be able to make their appropriate referrals
to get that patient or that person set up with
right mental health professionals. And you mentioned tal, you mentioned
the boom and internet therapy, online therapy, and we have
(10:15):
definitely expanded our visual thumbprint in outpatient care. That really
was pushed forward by the pandemic. We were very quickly
having to find a way to make sure we were
still caring for our patients when we couldn't physically be
with them. And so telehealth has continued as the countries
(10:37):
are covered from the pandemic. And I think that is
very fortunate because that allows a provider to reach a
patient who might be clear across the state without any transportation,
without support, and without any local mental health providers. They
can still see someone who can provide them with help.
(11:00):
You know, it's not always ideal, to be honest, I
very much like the in person interaction, but to be
able to expand that access of care to a wide
a wide area I think has been really really important.
Speaker 2 (11:17):
Fantastic.
Speaker 3 (11:18):
Well, we are talking tonight with doctor Christine Bala about
mental health and it's okay to not be okay a
conversation about mental health.
Speaker 2 (11:26):
We're going to take a short break.
Speaker 3 (11:27):
You are listening to Senate on Health with Baptist Health
here on News Radio eight forty whas.
Speaker 2 (11:32):
I'm your host, doctor Jeff Tublin.
Speaker 3 (11:34):
Our phone number five oh two, five seven one, eight
four eighty four. If you want to call and ask
a question of tonight's guests, we'll be right back. Welcome
back to Senate on Health with Baptist Health here on
(11:56):
news Radio eight forty whas. I'm your host, doctor Jeff Toblin,
And tonight we're talking to doctor Christine Bala about mental
health and it's okay to not be okay. Our phone
number five O two five seven one eight four eighty
four if you want to call in join the conversation.
Our producer Carl is on standby to take your calls.
(12:17):
So welcome back. And before before we went to the break,
you had talked to us a little bit about impatient
and I want to spend a little bit of time
talking about the inpatient psychiatry, because tell us give paint
us a little bit of a landscape.
Speaker 2 (12:31):
Is it like what we see.
Speaker 3 (12:32):
In the movies and the TV shows, or what is
in patient's psychl like?
Speaker 1 (12:39):
It's not really like that. There are some movies that
do a little bit better at getting it right, but
in general, movies that portray psychiatric issues are definitely going
to go forth traumatic effect. They want a good story.
They're not necessarily going for realism. I think you know,
when you think out psychiatry and mental health in the media,
(13:04):
in films, in TV shows, a lot of times it's
portrayed in a pretty negative light. You'll have these kind
of prison like conditions with this sickly greenish yellow lighting.
Everyone's always in restraints that you're always in isolation. They're
always in seclusion. To be honest, those are those can
(13:29):
be utilized, but they are utilized really as a last
resort only when we have not been able to calmbat
patient down by verbal de escalation, by redirection, by using
medications that might be able to provide some relief from
their emotional distress. It's very quite it's quite rare that
(13:52):
we actually use those things. I think media also for
some reason it wants to portray people with mental health
issues as violent, much more so than that average population.
That really is inaccurate. And and you know that's not
just in media. That also comes up whenever there is
(14:18):
an unfortunate incident in the new the shooting or some
some kind of violent occurrence where some one might have, yes,
a history of a mental health diagnosis, and suddenly the
story becomes all focused on that that that is definitely
not true. Actually, people who struggle with mental health issues
(14:40):
are more likely than the average population to be the
victims of violence and impression. Also, you know, go ahead, sorry, no, no, no,
please continue. We don't do lobotomies at least no, I
know the lobotomy is anymore just to clarify a right.
Speaker 2 (15:05):
That is definitely a Hollywood embellishment.
Speaker 3 (15:08):
So tell us what makes an inpatient stay necessary? And
if somebody's there, can they just leave when they want
to leave? Like what makes them have to go into
any patient setting? And then what's the criteria to leaving it.
Speaker 1 (15:27):
So typically the people who are going to be admitted
to behavior with a health facility, they're going to be
people who are really experiencing mental health crises. They're not
just people who had a bad day or are looking
for upbreak over the weekend. These are people who might
(15:49):
be at a high risk of hurting themselves maybe of
hurting others. They might be so psychotic and out of
touch with reality that they might not know that they're
putting themselves in danger. And those are the people who
would really benefit from going to the hospital and being
(16:10):
admitted to a behavioral health unit because we are able
to provide a safe and monitored environment where you're you're
able to really get started with treatment. And you had asked,
what how do you how do you leave a psychiatric
unit or behavioral health unit? Is that what?
Speaker 2 (16:32):
Yeah?
Speaker 1 (16:32):
Yeah, so it depends. Typically we love for patients to
stay until the treatment team feels like they've really met
the maximum benefit that they're going to from that hospitalization
and kind of graduate from hospitalization and will make sure
that they transition seamlessly into outpatient care. That typically for
(16:59):
a day is going to be about three to five days.
Of course, like I said before, you know, everyone's unique,
and so everyone might have different needs, and so that
can vary depending on that person's needs. Some people are
admitted voluntarily, they are actively seeking help. They want to
be there. They know that they are not in a
(17:20):
good place and don't know if they can keep themselves
safe if they aren't in a structured unit like ours.
And for those people, if they're able to improve to
the point where they're no longer considered an imminent risk
to themselves, if they do choose to leave the fool
we feel like they're ready to. They do retain the
(17:41):
right to legally leave against medical advice, and sometimes that
puts you at risk. Though some places will have a
default policy where if you leave, if you leave a
m A, you're not getting medications, you're not getting follow ups,
You're not getting you know, any any the discharge paperwork
or instructions at our unit. I think that's ridiculous. If
(18:07):
someone was at the point where they needed help and
they went in patients anyway, how ethical is it to
discharge them with no resources, even if they are, you know,
maybe not wanting to completely follow through their advice. There
are other patients who really need to be hospitalized for
(18:29):
their own safety or other safety. Those are patients who
when in the case that they are not willing to
be hospitalized. Any medical professional can place that patient on
a seventy two hour involuntary hold, and within that seventy
two hours they're evaluated by qualified mental health professional. Its
(18:53):
determined whether or not that person needs to continue hospitalization.
And if that seventy two hours has reached end, that
patient has either stabilized or has gotten to the point
where we can't say that there are an imminent risk
to themselves and they would benefit from further hospitalization but
don't legally need to be there, then they can leave
(19:16):
as well. In worst case scenarios, when we have really
six people who might want to leave well before before
their treatment is completed, we might file a mental inquest
warrant to make sure that they get the help that
they need.
Speaker 3 (19:33):
And if somebody is listening or somebody is talking with
somebody and they feel that they need this sort of
level of help, where do they go, what do they do?
How do they get themselves that kind of inpatient care.
Speaker 1 (19:48):
So specifically, for our behavioral health unit, you would go
to the Baptist Health Lagrange emergency department and request the
behavioral health evaluation. They're going to make sure that you're
medically stable in the emergency department, and then once that's determined,
they'll call one of our staff members to go and
evaluate you. They're going to hear your story, they're going
(20:09):
to gather information for us. Then they'll call an on
call psychiatrist, whether that's me or one of the physicians
that assists me. They're going to present your history and
they will decide if hospitalization is actually appropriate for you.
If we think that you do need in patient help,
but our unit can't adequately serve your needs, then we
(20:31):
might send a referral to a different unit that might
be able to meet those needs. If Baptist Health the
Grained isn't the hospital that's closest to you, I would
strongly recommend just going to the closest emergency department, going
the closest hospital and letting them know that you are
having a mental health crisis, even if they don't have
(20:52):
a psychiatric provider to evaluate you there. If you can
let them know that you're interested in hospitalization and they
can send referrals, most places will allow you a name
of preference, so of course that's going to be Baptist
Health of Range Behavioral Health Unit located at ten twenty five.
You Moody Lane, Like Range, Kentucky four zero zero three one.
(21:16):
Phone number is five zero two two two five five
six three zero.
Speaker 2 (21:21):
Righterful.
Speaker 3 (21:23):
Yes, well, thank you for being the medical director. Thank
you for bringing these resources to our community. We're going
to talk a little bit more on the outpatient setting
when we come back.
Speaker 2 (21:32):
We're going to take a short break.
Speaker 3 (21:33):
You are listening to Centered on Health with Baptist Health
here on news radio eight forty whas. Our phone number
five oh two five seven one eight four eighty four.
If you'd like to call in and talk to doctor
Christine Fla who's talking to you to us tonight about
mental health, we'll be right back. Welcome back to Senate
(22:00):
on Health with Baptist Health here on news radio eight
forty whas. I'm your host, doctor Jeff Tublin, and we're
talking tonight with doctor Christine Bala about mental health.
Speaker 2 (22:10):
And if you're just joining us, we've talked a.
Speaker 3 (22:12):
Lot about the state of mental health in our communities
and the wonderful resources that she's bringing to our community
at Labrange with behavioral health clinics and inpatient work. But
I'm not surprised, doctor Bala, but we've had several people
submit questions that some prefer not to get on the
air themselves, but have asked if we could ask you
(22:33):
some questions. So the first question is about how you
see dealing with patients who have physical other illnesses, for example,
a heart attack or a stroke that might impact them
greatly either physically or their work, and feelings of depression
(22:55):
and anger that might go along with that.
Speaker 1 (23:00):
I love that you're asking this question because I'm sure
that it's a question that a lot of people can
relate to. And it's interesting that you mentioned both stroke
and heart attacks. Those two issues have a very very
high incidence of depression after the incident, and so for example,
(23:21):
with stroke, something about somewhere around twenty to forty percent
of patients who experience a stroke will go on to
develop some form of clinical depression, usually within the first
six months if their recovery, especially while they're needing to
(23:43):
relearn how to do certain things. They're working on their balance,
working on their strength. When I was training, when I
was still in medical school, I remember I was on
the stroke unit. I noticed that all of these people
(24:03):
had just newly been started on prozac, and I thought
that was so interesting, and I was wondering if there
was a you know, was there a unique neurological benefit
to starting prozac, And another answer that I got was
the incidences of depression after stroke is so high that
it can be really beneficial to go ahead and take
(24:26):
a preemptive approach. But it also can help with with
motivating someone to get out of bed and to start strengthening,
because yeah, a stroke can be a very emotionally devastating thing,
the same thing for heart attacks. You know, a lot
of times these types of medical issues are going to
(24:48):
lead to really lifelong changes, whether that's in diet and lifestyle,
and so it is vital for physicians, even if you're
not mental health positions, either a cardiologist or a neurologist,
when you are following up with those patients, you know,
(25:08):
after they were discharged from the hospital, using just a
standard depression screening tool like the PHQ nine could be
really really helpful and identifying those patients who might be
struggling emotionally and might need that additional help. Sometimes with
chronic issues, if you're going to have a chronic deficit,
(25:31):
if you are never going to regain that full functionality,
you have to learn to cope essentially with that new disability,
and there are different types of therapy that really help
kind of change your mindset around your identity in the
(25:55):
context of health issues.
Speaker 3 (25:58):
Well, I'm so glad that people are submitting these questions.
It means that they're they're listening and they're hearing, and
they're recognizing the value that you have to offer. Another
question that came in is an interesting one. This individual
wanted to know how to navigate the workplace if you
suspect that somebody that you're working with might be having
(26:23):
issues of depression or something and within the workplace and
a colleague, how would you approach that.
Speaker 1 (26:32):
So it can be a little bit challenging, how it
can be a little bit a sensitive and tricky. It's
first off, I think the approach is going to depend
on how familiar you how familiar you are with that coworker,
that colleague. But you know, it's definitely not something that
you want to ignore if you have a strong concern. Really,
(26:55):
one one of the things that you can do is
what you might do for any friend or family member
who might be struggling with whom you might suspect might
be struggling with a mental health issue. Just check in
on them and ask them how they're doing, if you
know what's going on in their life, what's going on
(27:16):
in their life outside of work, and you know if
there is something that they're willing to offer that kind
of clues you in. Maybe maybe with a loss of
a beloved pet, or maybe they were having issues at
the house and they feel like they're never getting going
to get on top of it. Just the act of
(27:40):
asking and letting them know that they have someone who
sees them can be extremely extremely important. Now, if it's
to the point where you are you have a strong
suspicion and strong concern about a coworker that they might
be at that point where they might be reaching a
(28:01):
mental health crisis, that might be an occasion where you
might want to get to uh, get higher ups involved
and make sure that they feel supportive from from all
the way up to the to down in your in
your workplace.
Speaker 2 (28:22):
Thank you, Thank you for that.
Speaker 3 (28:25):
So I want to talk about I know we're not
going to have enough time to talk about all of
the things we're going to want to talk about tonight,
but sticking with some of the broader themes. You know,
it's normal to be sad at times, right, So how
does one self reflect the difference between sadness and depression?
Speaker 1 (28:44):
Ah? Okay, so sadness does not equal depression, although sometimes
you know, just casually, you might use the terms interchangeably.
The depression that mental health professionals manage, that they treat
is a pathological condition. Essentially, most common is going to
(29:05):
be major depressive disorder, where really it's gone beyond sadness,
it has gone to the point where it is affecting
it's affecting multiple, multiple aspects of your life. You might
have a sustained depression that lasts for months, but really
(29:28):
to be diagnosed with depression, the symptoms have to be
present for at least two weeks and they do cause
distress or impairment in your daily life. Some of the
symptoms that might come along with depression could be an
irritable mood. Sometimes people lashed out as almost a more
(29:50):
socially accepted way of showing your emotions when they don't
quite know how to put words to their emotions. They
might have lack of interes in doing things that they
know they used to like to do, and they might
have lack of motivation to do those things that they
used to like to do. You might have changes an appetite.
(30:10):
Sometimes we'll see a weight an increase in appetite. More
often we'll see a decrease in appetite. Sleep is usually disturbed.
Oftentimes with early morning awakenings, you might feel really fatigued,
even though you might be sleeping adequately ish. A lot
of people who struggle with depression will also struggle with concentration,
(30:33):
will struggle with feelings of hopelessness and worthlessness, and they'll
also feel like it's them, the problem is them, and
they deal with excessive guilt. They might apologize for things
that really aren't their fault. And when things get really
really bad, depression can present with suicidal thoughts or thoughts
(30:56):
of self harm. Depression does eventually ron it's course, even
without treatment for most people. But you know, when I
see someone who's really struggling with oppression, I'd rather them
get better sooner rather than later and get back to
normal functioning.
Speaker 3 (31:16):
Of course, So if you have questions, we are we
are here. We are centered on health. You are listening
to Senate on Health with Baptist Health here on News
Radio eight forty whas. I'm your host, doctor Jeff Tublin.
We're talking with doctor Christine Bala. We're tackling a big
issue tonight with mental health. We will see you after
these words and we'll be right back. Welcome back to
(31:48):
Cenate on Health with Baptist Health here on news radio
eight forty whas. I'm your host, doctor Jeff Tublin. We're
talking tonight with doctor Christine Bala about mental health issues
and getting evaluation and treatment. I want to remind everybody
to download the iHeartRadio app to re listen to this
or any of our previous segments. It's easy to use
(32:09):
and it gives you all the features that the app
has to offer. So you told us a little bit
about how to tell the difference between kind of sadness
and depression, and kind of along those saying lines for
our listeners, it's also normal to be nervous sometimes or
a little bit anxious so or worried. When when does
(32:31):
worry become anxiety? And how do you define anxiety when
it becomes something that needs to be treated.
Speaker 1 (32:39):
So you are kind of starting along my motto, which
is essentially it's okay to be a little a little
sad and depressed. It's okay to be a little anxious.
It's okay to even be a little psychotic sometimes. So
you know, there are definitely times where nervousness and anxiety
are natural and normal reactions. If you are, for example,
(33:05):
in a dangerous situation, a little bit of anxiety because
that's going to be protective, that's going to tell you
probably shouldn't be hanging out in that area. Probably get
to get out of there. But the point at which
anxiety becomes something that might need to be addressed by
a professional is when that anxiety becomes excessive, when it
(33:28):
becomes persistent or near constant, and when the anxiety is
unrealistic or really out of portion to the stress that
you might be dealing with. Sometimes, for example, you know,
if you are facing a difficult time financially, you might
(33:51):
you might want to consider, you know, taking a little
bit more more carry er finances. Might might worry a
little bit if you have some bigger expenses coming up,
but say times later on are are better for you financially,
but you retain that anxiety of not having enough, and
so you never spend the money that you have available
(34:14):
to you. You just kind of save it up for
a rainy day, save it up for a rainy day,
but that rainy day is never going to come. That's
what That's what I would consider excessive anxiety. It is
anxiety that kind of takes you out of a reasonable
a reasonable response. The hallmark of anxiety that that I
(34:39):
typically treat is the type of anxiety that just gets
stuck in your head. Then it just circles around, circles around,
and you feel like it's outside of you, but you
have no power to stop it. And that's not that's
not true. That's not true. But if you don't get
(34:59):
treatment for it, or if you're not very very proactive about,
you know, doing some of your own research and managing
your anxiety, it can really take over your life. Anxiety
when it starts to when it directly affects your physical health,
(35:20):
there's definitely something you're going to want to address. Sometimes
anxiety can come with severe nausea and vomiting. You know,
little kids who you think they want to stay home
from school because they're always complaining at a tummy ache,
No it Oftentimes they might be actually feeling their anxiety
and their gut and and you might want to take
(35:43):
them seriously if they do it too much. It's not
a it's probably not going to be that. But if
if you're anxious about something for an extended period of time,
long after it's past or long before it's coming, chances
(36:03):
are you would benefit from seeking some professional.
Speaker 3 (36:07):
Health and sort of sticking in that depression and anxiety lane.
You know, it's kind of a little bit of time
that we have left. I know, we all know there's
medications and things like that, which would be a whole
nother show to talk about that. But are there some
easy coping mechanisms or strategies that you use in your
(36:28):
office when yes, they need to be seeing a professional,
but maybe they don't really need to be on medications
and there's like a kind of an in between behavioral approach.
Speaker 2 (36:37):
How does that look like for you?
Speaker 1 (36:40):
So for that, you know, I'm never going to not
not recommend therapy because oftentimes, you know, even though one
of my main roles is to find the right medication
to prescribe, there are sometimes legitimate mental health issues that
can very much benefit from therapy alone. Actually, anxiety is
(37:01):
one of those. Anxiety is something that you know, using
certain approaches, might be able to resolve or at least
become much more manageable, even ONLA than in the course
of a couple of months. You could go from having
daily or multiple time of day pemic attacks, feeling what
you're having a heart attack with at any point, to
(37:25):
recognizing your triggers and recognizing that you have control over
that anxiety. A type of therapy called cognitive behavioral therapy
can be a very very effective means of addressing that
without medication, and you know medication can sometimes you might
(37:50):
sometimes start with medication, but if you start with therapy,
there's always the option of adding medication later on if
you find that things just kind of not't going exactly
as well as you wanted them to.
Speaker 3 (38:04):
Well, I really appreciate that you are coming on and
sharing so much of this information with us tonight. I
know that you know there's multiple multiple things we could
talk about, and we are just going to have to
have you back, but we are going to wrap up
tonight's segment. I want to thank our guest doctor Bala
for joining us tonight. She is at Lagrange and is
(38:27):
the medical director for our outpatient clinics. And please do
not hesitate to seek help if you need it. That
is going to do it for tonight's segment of Centered
on Health. I'm your host, doctor Jeff Tublin. I want
to thank our guests, I want to thank our callers
for sending in these very very important questions, and I
want to thank our producer Carl. Join us every Thursday
(38:47):
night for another segment and we will see you next week.
Have a great weekend and enjoy the rest of the week.
Speaker 1 (39:13):
These programs for informational purposes only and should not be
relied upon this medical advice. The content of this program
is not intended to be a substitute for professional medical advice, diagnosis,
or treatment. This show is not designed to replace the
physician's medical assessment and medical judgment. Always seek the advice
of your physician with any questions or concerns you may
(39:34):
have related to your personal health or regarding specific medical conditions.
To find a Baptist health provider, please visit Baptist Heealth
dot com.
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