July 10, 2025 • 18 mins
Mental illness isn't always obvious. Someone suffering with anxiety or depression can still wear a smile, crack a joke and be successful. On this episode of For the Love of Health, Dr. Mustafa Mufti, Chair of the ChristianaCare Department of Psychiatry, explains how mental health should be treated the same as physical health.
Mustafa Mufti, M.D., is the chair of the ChristianaCare Department of Psychiatry. In this role, Dr. Mufti focuses on fostering and maintaining a vibrant, successful psychiatry department, including physician performance, quality, research and scholarly activity as well as the administration of all departmental educational, clinical and academic programming.
Links:
- ChristianaCare Adult Outpatient Psychiatry & Therapy
- ChristianaCare Child and Adolescent Psychiatry
- ChristianaCare Inpatient Psychiatry
- National Institute of Mental Health
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
I think one of the core things is people don't
understand that mental illnessis a medical condition.
Speaker 2 (00:10):
You're listening to For the Love of Health, a
podcast about delivering careand creating health, brought to
you by Christiana Care.
Hello everyone, I'm JasonTokarski.
Speaker 3 (00:21):
And I'm Megan McGerman.
Welcome to For the Love ofHealth brought to you by
Christiana Care.
Speaker 2 (00:25):
We've all heard the phrase it's okay to not be okay.
But what does that really mean?
Speaker 3 (00:30):
According to the National Institute of Mental
Health, it is estimated thatmore than one in five US adults
live with a mental illness.
Speaker 2 (00:38):
Joining us for a deeper look into mental health
is Mustafa Mufti, chair of theChristiana Care Department of
Psychiatry.
Speaker 3 (00:44):
Mustafa, thank you for being here today.
Speaker 1 (00:46):
Good morning.
Thank you for having me joinyou to discuss this very
important topic.
Speaker 3 (00:50):
We mentioned in the intro one in five US adults
dealing with mental illness.
In your professional opinion,how accurate is that number?
Speaker 1 (01:00):
So one in five is what the data has told us, which
equates to about 53 millionpeople annually.
I think that the true number isprobably actually much higher.
What I can tell you is that,clinically, we have seen that
this does equate to that, but wealso know that there's a fair
number of people that eitherdon't understand that they're
struggling with mental illnessor, if they do, they're afraid
(01:22):
to seek out care for a multitudeof different reasons, be that
stigma, their personal stigma,or what people may think of them
.
Speaker 2 (01:30):
What are some of the most common misconceptions that
you've seen in regards toneeding and actually seeking out
that mental health?
Speaker 1 (01:38):
I think one of the core things is people don't
understand that mental illnessis a medical condition.
You know it's very similar todiabetes, hypertension.
These are all medical illnesses.
A lot of times people feel thatmental illness is some sort of
a moral failing or a personalfailure and as such, they think
they can just work through it.
(01:58):
So they don't appreciate thatit is a medical condition that
does require experts.
It requires a diagnosis andthen perhaps different treatment
options.
Speaker 3 (02:10):
If someone is listening to this and is
personally thinking I'm fine,I'm working through, whatever
that may be, or has a loved onewho they think is kind of in
that boat, what are thosetelltale signs that say maybe
I'm not doing as okay as Ithought I was?
Speaker 1 (02:26):
There's a phrase that we often hear now and it's if
you see something, say something.
And I think for mental illnesswe need to expand that a little
further that if you seesomething or feel something, say
something, but also listen andstay.
So if you're thinking about aloved one or someone who you
think is struggling, so it'sjust not that you have to go
(02:47):
into action and do somethingabout it.
I think it's more about beingpresent in the moment and then
hearing what's wrong.
And if you think about it froma personal perspective, what
does mental illness look like?
And a lot of times I think partof the stigma, part of the media
that's created this image thatyou think of someone that is
really out of sorts, struggling,disheveled, not able to take
(03:09):
care of themselves.
But what we do know is mentalillness, what it looks like.
It can wear a smile, it canlaugh, it can crack a joke, it
can be extremely professionallysuccessful and it can be
extremely wealthy, but that'ssort of surviving, it's not
thriving.
So I think that's really whenyou have to think about things
(03:29):
If you're doing very well fromevery aspect of your life, but
you still feel that there'ssomething missing, that you're
able to do better and you're notable to thrive.
I think that would be anopportunity for either yourself
or for your loved one that juststop and listen.
Speaker 2 (03:48):
What you just said there about people being
successful with it reminded mevery much of Robin Williams, who
was very successful, constantlycracking jokes but internally
constantly working through hisdepression and obviously not
able to get the help he needed.
So, as far as people on theoutside looking in, what do you
suggest to help them breakthrough, to make them understand
(04:12):
that they need help and thatthey're there for you or that
they can help them?
Find somebody to help them withit?
Speaker 1 (04:17):
Yeah, so you bring up Robin Williams, and that was
really.
It was heartbreaking, that wasa tragedy.
He was, for all intents andpurposes, a comedic genius,
right, he made millions ofpeople happy, laugh and just
enjoy life.
But none of us knew that thisis what, internally, he was
struggling with.
And I think that you bring up avery valid point that the pain
(04:38):
is internal.
Right, but it's not any less.
You know, if someone breaks aleg, I like using analogies to,
and I do it a lot in my clinicalpractice as well.
So if you break a leg, what wewould do is we're not going to
tell that individual to walk itoff right, we're going to say,
hey, something wrong here, let'sgo get an x-ray, go to the ER,
(05:01):
you may get a cast, you may getcrutches, you may get
medications and you may get evenphysical therapy.
But since that pain is outward,we are very empathetic about it
and we communicate about it.
The pain with mental illness isinternal, like it was for Robin
Williams.
It was not external, but itdoes not mean that it is any
less and it does not mean thatwe should provide any less form
(05:24):
of empathy or compassion forthose individuals.
Speaker 2 (05:28):
I feel like we've started to reach a point where
therapy isn't necessarily asstigmatized as it once was, that
people are a little more opento the idea of going to therapy,
but they seem to do it a lot oftimes based on a specific issue
or they're in crisis, orthey're having some specific
thing they're dealing with atthis time.
Is that necessary, or do youthink literally anybody, for any
(05:52):
reason, should or could have atherapist in their life?
Speaker 1 (05:56):
I think that anybody could or should if they feel
that that's what they need.
And, like I said, I loveanalogy, right?
So I'm going to give you theanalogy of a personal trainer.
I mean, if I go to the gym, Idon't go that much, I should,
but you know, if I were to go tothe gym, anyone would.
We see a treadmill.
But if I were to go to the gym,anyone would.
We see a treadmill.
We see a stair strapper.
We generally know what to dowith that, right, turn it on,
you walk, you run, you inclineit, et cetera.
(06:18):
But if anyone has gone to thatsame environment with a personal
trainer, an expert, what you dowith that expert in 15 minutes
is probably going to be moreimpactful than what you do an
hour by yourself.
Right?
And that's what I think aboutpsychotherapy is, these are very
highly trained, educatedindividuals in their field.
(06:40):
By and large.
I don't think they're going totell you or anybody something
you don't already know, right?
We all know generally whatwe're supposed to do for our
health Eat healthy, we'resupposed to exercise, stay well
hydrated, etc.
But it's really about when todo those things, at what times
and how to do those, and I thinkthat's where therapy really
(07:02):
comes into play, is you have anexpert that you discuss your
issues with and, based on theirknowledge, experience and
expertise, they allow you to beable to shuffle through that and
then also give you the toolsthat you can then utilize at
different times.
Life is hard and challengingfor everybody, right, and we're
(07:23):
all going to come acrossdifferent personal, social,
financial struggles.
We're all going to face thatHealth struggle, but what tools
are going to be in our toolchest to utilize is, I think,
really what a therapist is goingto face that the health
struggle, but what tools aregoing to be in our tool chest to
utilize is, I think, reallywhat a therapist is going to
help you with Stigma is reducing.
There's a lot of work to dothere.
There's a lot of things that weneed to learn more about.
(07:44):
I'm also very excited as aclinician to see where we are
and how much we've grown withthe medications, the different
treatment modalities.
I'm also very excited to seehow many employers are out now
looking at wellness and reallyspeaking about this.
I think an important step inkind of reducing stigma is
(08:05):
normalizing these conversations.
I think it's also important forfolks who are in leadership or
in positions of authority, bethat, you know, in kind of
acting or music, where peopleare now speaking about these
things, and I think that reallyhelps people normalize it.
We also are now seeing thatpeople who are getting care are
(08:26):
seeing a positive impact.
You know what studies areshowing is if you start an
antidepressant, you know it maywork up to 50% of the time.
That's a good statistic, rightStatistics in healthcare.
I will add, they're a littletough.
When I remember I was studyingfrom one of my boards, I think
one of the individuals said thatyou know, even if something is
99% effective, if you're that 1%, that it didn't help.
(08:47):
Really unfortunate for you.
But you know generally, when Igo into it, 50%.
We also know that people who doa combination of psychotherapy
and medications, there's over a70% reduction in relapse rate.
So some of the numbers are verypromising.
So I think these are allpositive things.
Speaker 3 (09:08):
You mentioned those impressive statistics about when
medication is paired with atherapy, how well people are
doing.
What about those people who arenot interested in the
medication aspect of it?
What is available to them?
Speaker 1 (09:22):
One thing about medications, before I answer
that question, is themisconceptions that some people
have that it's going to changeyour personality, it's going to
change who you are, and that isabsolutely not true.
Right, medications are justgoing to help you to be able to
deal with life and the thingsthat it throws at you.
It's going to help with yoursleep, it's going to help with
(09:43):
your energy, your concentration,et cetera.
So I think that those areimportant things to understand
To your point, like what aboutthe people who are not
interested in medications?
I guess, as a psychiatrist, thefirst thing I want to ask them
is why?
And I want to get moreinformation as to why they're
not interested, and I willrespect whatever their decision
(10:05):
If they don't want to choosethat medication or take a
medication.
I definitely want to do my jobof discussing different
alternatives.
What are the benefits?
What are the risks?
But then you said there areother treatment modalities which
are now in play.
We have therapy, which is athing.
We do have some neuromodulationopportunities that have now
come up.
There's repetitive transcranialmagnetic stimulation for the
(10:27):
treatment of depression, whichbasically entails it's sort of
like you sit, almost somethinglooks like a dental chair, and
it's a magnet that sits over acertain area of your brain and
we stimulate that area.
It's an outpatient procedure.
It is virtually not painful.
It takes about 30, 35 minutes.
There's esketamine that's nowavailable through an intranasal
(10:49):
formulation to help with more.
These are more for treatmentrefractory.
But again, I'm going to look atthis from a lens of optimism.
These are different modalitiesthat we did not have available
to us a number of years ago andI'm confident in my colleagues
who are actively involved inresearch and R&D that there's
more things on the horizon.
(11:09):
So, for those people who areafraid of medications, I would
really encourage you to speak toa professional and understand
why it is that they're, andperhaps you're right in your
concerns, but we're really notgoing to know until we have a
conversation about it.
Speaker 3 (11:30):
Do you see that age groups handle this differently
as well?
There, I know, is a kind ofstigma that millennials are
extra anxious compared to, youknow, the generations before
them.
Are you seeing that in yourpractice that different
generations present their mentalwellness differently?
Speaker 1 (11:49):
So I always I'm really bad with that whole
millennial X.
I get those things all messedup.
Speaker 3 (11:53):
The millennial.
We're in our 30s, if that'shelpful.
Yeah, I'm a little older, right.
Speaker 1 (11:57):
The good thing is, I think with the younger
generations, they are a littlebit more receptive to
understanding that this is anissue and seeking out care.
Part of what I'll talk againthe positivities that we've seen
with mental awareness is nowthat there are individuals in
schools getting diagnosed,getting checked, and what the
(12:18):
data tells us is the earlieronset of diagnosing these issues
has a better prognosis.
I look at it positively.
I think that the youngergenerations are more in tune
with understanding that theremay be a concern and kind of
seeking out help and likewise,you know, the elder generation
has done well.
(12:38):
What we did see, again apositive statistic, is access is
always an issue for mentalhealth and with the pandemic,
while national and global datahas shown us that there's about
a 25% increase in depression,anxiety and mental illness, we
also saw that there's a 400%increase in access of telehealth
right, which really allowed alot more people to be able to
(13:01):
get care.
And when I thought about this, Iwas thinking about, you know,
our individuals, the people wecare for, that are beyond the
age of 65, 70, even beyond theage of 80.
How were they going to navigatethat iPad, that email, that
link, and I was pleasantlysurprised to see how many people
had done well with that andreally utilized that access to
(13:25):
care, and I was also veryoptimistic to see people within
that age group who did come, whodid grow up during the time
when this was stigmatized a lotmore than it is now right.
It was really considered, likeI said, either a moral failing
or a personal flaw.
They're more willing to seekout care.
(13:45):
I think these are all positivethings that we're seeing.
Speaker 2 (13:48):
Megan asked about generation and age differences
there.
What about gender?
It seems like there was a lotmore stigma about men addressing
this than women, and are youstill seeing that, or are men
starting to come to the tablemore?
Speaker 1 (14:04):
I can see where that originated from, just from that
concept of being kind of thatstrong person that you should
deal with this, that analogy Igave of just walk it off.
So it's kind of like it'sdepression, it's anxiety.
You know, just suck it up, Goon with life.
This happens to all of us.
What's the big deal?
The mental illness.
It can affect and impact anyoneand the reason being is there
(14:27):
is a biological component.
Right, it is a medical illness.
It is a difference with.
There's an imbalance inneurotransmitters.
There's been imaging studieswhich have shown us that someone
with any particular mentalillnesses versus another, there
are structural brain differencesthat are also we're now seeing.
So it's very evident that thisis a biological process.
Speaker 2 (14:53):
From what you've said , it sounds like we're already
miles ahead of where we were 10,20, 30 years ago in as far as
taking care of mental health.
What's next?
Where are we going into thefuture?
Speaker 1 (15:05):
I'm very optimistic of the future.
I think that there's a lot more.
You know I was previously thepresidency director.
I'm seeing a lot more peoplehave a lot of interest coming
into mental health as aprofession, so we're seeing a
lot more people entering it.
And there's a lot more peoplehave a lot of interest coming
into mental health as aprofession, so we're seeing a
lot more people entering it andthere's a lot more demand.
There's a lot more peopleseeking help.
We're also seeing now astechnology it's growing so
(15:28):
quickly, so expansively.
It's like you think aboutsomething and you pick up your
phone.
It's available to you throughan app, through anything.
And I think about AI.
You know AI is a veryinteresting thing and AI has a
lot of implications and also inbehavioral health, we're also
seeing that this can help withkind of even preliminary
diagnosing things.
There's different apps on therethat can help with your
(15:49):
medications, with therapies, etcetera.
So I look at all of these asvery positive, impactful tools
which can allow us to reach morepeople the way that they want
to be reached.
I think that's also veryimportant is that we really
individualize care.
I'm going to give you anexample of you know you brought
(16:09):
up how different generations areresponding and you know when
I've done telehealth visits theolder generation if they have
ambulatory difficulties, if theyhave transportation
difficulties they may have awalker wheelchair I'm able to
have a conversation with themwhen they're in the comfort of
their own living Right.
It also allows people to be alittle bit more open in
conversations.
(16:30):
I've had telehealth visits withother younger individuals who
chose to go sit on a park benchoutside in the open air and kind
of have that sort of thing.
So this has all been throughtechnology.
I think technology has a hugeimpact Pharmacologically.
There are new medicationscoming out all the time.
We're constantly looking atdifferent neurotransmitters,
(16:52):
different pathways of how tomanage, from just a basic
neurochemical standpoint, how tomanage the illness.
Speaker 3 (17:00):
Before we let you go, what is your last general
takeaway message about mentalhealth?
We've certainly all heard theit's okay to not be okay.
What is kind of your version ofthat, or your message to those
listening today?
Speaker 1 (17:14):
I think it's important to realize that mental
health is health, and yourphysical and mental health are
very codependent on each other.
They're intertwined.
I think it's very, almostimpossible to have one and not
the other, so I think that's avery important aspect.
So when I speak about mentalhealth, it's just health, it's
your health care, it's theopportunity for you to thrive.
(17:36):
At Christiana Care, we'reguided by our core values of
love and excellence.
I can tell you that that'sexactly what you're going to get
if you seek behavioral healthcare with us.
I can't guarantee a cure right,but what I can promise you is
that each and every caregiverwithin our service line will
meet you where you are.
They're going to teach you withempathy, compassion, respect
(17:57):
and offer you a lending ear tosee how it is that we can help.
Speaker 3 (18:00):
Thank you so much for your time.
We talked before this that thisepisode could have been two
hours long, so I'm sure we'llhave you back for more topics.
Speaker 1 (18:08):
Thank you so much.
It was a pleasure speaking toyou.
Speaker 2 (18:11):
Check out the show notes for this episode for more
information on behavioral healthservices at ChristianaCare.
Speaker 3 (18:16):
Also head to podcastchristianacareorg or
wherever you get your podcaststo check out the first two
seasons of For the Love ofHealth as we kick off season
three.
Speaker 2 (18:27):
We'll be back in two weeks with another great
conversation.
Speaker 3 (18:30):
Until then, thanks for joining us.
Speaker 2 (18:31):
For the Love of.
Speaker 3 (18:32):
Health.
I think one of the core things is people don't
understand that mental illnessis a medical condition.
Speaker 2 (00:10):
You're listening to For the Love of Health, a
podcast about delivering careand creating health, brought to
you by Christiana Care.
Hello everyone, I'm JasonTokarski.
Speaker 3 (00:21):
And I'm Megan McGerman.
Welcome to For the Love ofHealth brought to you by
Christiana Care.
Speaker 2 (00:25):
We've all heard the phrase it's okay to not be okay.
But what does that really mean?
Speaker 3 (00:30):
According to the National Institute of Mental
Health, it is estimated thatmore than one in five US adults
live with a mental illness.
Speaker 2 (00:38):
Joining us for a deeper look into mental health
is Mustafa Mufti, chair of theChristiana Care Department of
Psychiatry.
Speaker 3 (00:44):
Mustafa, thank you for being here today.
Speaker 1 (00:46):
Good morning.
Thank you for having me joinyou to discuss this very
important topic.
Speaker 3 (00:50):
We mentioned in the intro one in five US adults
dealing with mental illness.
In your professional opinion,how accurate is that number?
Speaker 1 (01:00):
So one in five is what the data has told us, which
equates to about 53 millionpeople annually.
I think that the true number isprobably actually much higher.
What I can tell you is that,clinically, we have seen that
this does equate to that, but wealso know that there's a fair
number of people that eitherdon't understand that they're
struggling with mental illnessor, if they do, they're afraid
(01:22):
to seek out care for a multitudeof different reasons, be that
stigma, their personal stigma,or what people may think of them
.
Speaker 2 (01:30):
What are some of the most common misconceptions that
you've seen in regards toneeding and actually seeking out
that mental health?
Speaker 1 (01:38):
I think one of the core things is people don't
understand that mental illnessis a medical condition.
You know it's very similar todiabetes, hypertension.
These are all medical illnesses.
A lot of times people feel thatmental illness is some sort of
a moral failing or a personalfailure and as such, they think
they can just work through it.
(01:58):
So they don't appreciate thatit is a medical condition that
does require experts.
It requires a diagnosis andthen perhaps different treatment
options.
Speaker 3 (02:10):
If someone is listening to this and is
personally thinking I'm fine,I'm working through, whatever
that may be, or has a loved onewho they think is kind of in
that boat, what are thosetelltale signs that say maybe
I'm not doing as okay as Ithought I was?
Speaker 1 (02:26):
There's a phrase that we often hear now and it's if
you see something, say something.
And I think for mental illnesswe need to expand that a little
further that if you seesomething or feel something, say
something, but also listen andstay.
So if you're thinking about aloved one or someone who you
think is struggling, so it'sjust not that you have to go
(02:47):
into action and do somethingabout it.
I think it's more about beingpresent in the moment and then
hearing what's wrong.
And if you think about it froma personal perspective, what
does mental illness look like?
And a lot of times I think partof the stigma, part of the media
that's created this image thatyou think of someone that is
really out of sorts, struggling,disheveled, not able to take
(03:09):
care of themselves.
But what we do know is mentalillness, what it looks like.
It can wear a smile, it canlaugh, it can crack a joke, it
can be extremely professionallysuccessful and it can be
extremely wealthy, but that'ssort of surviving, it's not
thriving.
So I think that's really whenyou have to think about things
(03:29):
If you're doing very well fromevery aspect of your life, but
you still feel that there'ssomething missing, that you're
able to do better and you're notable to thrive.
I think that would be anopportunity for either yourself
or for your loved one that juststop and listen.
Speaker 2 (03:48):
What you just said there about people being
successful with it reminded mevery much of Robin Williams, who
was very successful, constantlycracking jokes but internally
constantly working through hisdepression and obviously not
able to get the help he needed.
So, as far as people on theoutside looking in, what do you
suggest to help them breakthrough, to make them understand
(04:12):
that they need help and thatthey're there for you or that
they can help them?
Find somebody to help them withit?
Speaker 1 (04:17):
Yeah, so you bring up Robin Williams, and that was
really.
It was heartbreaking, that wasa tragedy.
He was, for all intents andpurposes, a comedic genius,
right, he made millions ofpeople happy, laugh and just
enjoy life.
But none of us knew that thisis what, internally, he was
struggling with.
And I think that you bring up avery valid point that the pain
(04:38):
is internal.
Right, but it's not any less.
You know, if someone breaks aleg, I like using analogies to,
and I do it a lot in my clinicalpractice as well.
So if you break a leg, what wewould do is we're not going to
tell that individual to walk itoff right, we're going to say,
hey, something wrong here, let'sgo get an x-ray, go to the ER,
(05:01):
you may get a cast, you may getcrutches, you may get
medications and you may get evenphysical therapy.
But since that pain is outward,we are very empathetic about it
and we communicate about it.
The pain with mental illness isinternal, like it was for Robin
Williams.
It was not external, but itdoes not mean that it is any
less and it does not mean thatwe should provide any less form
(05:24):
of empathy or compassion forthose individuals.
Speaker 2 (05:28):
I feel like we've started to reach a point where
therapy isn't necessarily asstigmatized as it once was, that
people are a little more opento the idea of going to therapy,
but they seem to do it a lot oftimes based on a specific issue
or they're in crisis, orthey're having some specific
thing they're dealing with atthis time.
Is that necessary, or do youthink literally anybody, for any
(05:52):
reason, should or could have atherapist in their life?
Speaker 1 (05:56):
I think that anybody could or should if they feel
that that's what they need.
And, like I said, I loveanalogy, right?
So I'm going to give you theanalogy of a personal trainer.
I mean, if I go to the gym, Idon't go that much, I should,
but you know, if I were to go tothe gym, anyone would.
We see a treadmill.
But if I were to go to the gym,anyone would.
We see a treadmill.
We see a stair strapper.
We generally know what to dowith that, right, turn it on,
you walk, you run, you inclineit, et cetera.
(06:18):
But if anyone has gone to thatsame environment with a personal
trainer, an expert, what you dowith that expert in 15 minutes
is probably going to be moreimpactful than what you do an
hour by yourself.
Right?
And that's what I think aboutpsychotherapy is, these are very
highly trained, educatedindividuals in their field.
(06:40):
By and large.
I don't think they're going totell you or anybody something
you don't already know, right?
We all know generally whatwe're supposed to do for our
health Eat healthy, we'resupposed to exercise, stay well
hydrated, etc.
But it's really about when todo those things, at what times
and how to do those, and I thinkthat's where therapy really
(07:02):
comes into play, is you have anexpert that you discuss your
issues with and, based on theirknowledge, experience and
expertise, they allow you to beable to shuffle through that and
then also give you the toolsthat you can then utilize at
different times.
Life is hard and challengingfor everybody, right, and we're
(07:23):
all going to come acrossdifferent personal, social,
financial struggles.
We're all going to face thatHealth struggle, but what tools
are going to be in our toolchest to utilize is, I think,
really what a therapist is goingto face that the health
struggle, but what tools aregoing to be in our tool chest to
utilize is, I think, reallywhat a therapist is going to
help you with Stigma is reducing.
There's a lot of work to dothere.
There's a lot of things that weneed to learn more about.
(07:44):
I'm also very excited as aclinician to see where we are
and how much we've grown withthe medications, the different
treatment modalities.
I'm also very excited to seehow many employers are out now
looking at wellness and reallyspeaking about this.
I think an important step inkind of reducing stigma is
(08:05):
normalizing these conversations.
I think it's also important forfolks who are in leadership or
in positions of authority, bethat, you know, in kind of
acting or music, where peopleare now speaking about these
things, and I think that reallyhelps people normalize it.
We also are now seeing thatpeople who are getting care are
(08:26):
seeing a positive impact.
You know what studies areshowing is if you start an
antidepressant, you know it maywork up to 50% of the time.
That's a good statistic, rightStatistics in healthcare.
I will add, they're a littletough.
When I remember I was studyingfrom one of my boards, I think
one of the individuals said thatyou know, even if something is
99% effective, if you're that 1%, that it didn't help.
(08:47):
Really unfortunate for you.
But you know generally, when Igo into it, 50%.
We also know that people who doa combination of psychotherapy
and medications, there's over a70% reduction in relapse rate.
So some of the numbers are verypromising.
So I think these are allpositive things.
Speaker 3 (09:08):
You mentioned those impressive statistics about when
medication is paired with atherapy, how well people are
doing.
What about those people who arenot interested in the
medication aspect of it?
What is available to them?
Speaker 1 (09:22):
One thing about medications, before I answer
that question, is themisconceptions that some people
have that it's going to changeyour personality, it's going to
change who you are, and that isabsolutely not true.
Right, medications are justgoing to help you to be able to
deal with life and the thingsthat it throws at you.
It's going to help with yoursleep, it's going to help with
(09:43):
your energy, your concentration,et cetera.
So I think that those areimportant things to understand
To your point, like what aboutthe people who are not
interested in medications?
I guess, as a psychiatrist, thefirst thing I want to ask them
is why?
And I want to get moreinformation as to why they're
not interested, and I willrespect whatever their decision
(10:05):
If they don't want to choosethat medication or take a
medication.
I definitely want to do my jobof discussing different
alternatives.
What are the benefits?
What are the risks?
But then you said there areother treatment modalities which
are now in play.
We have therapy, which is athing.
We do have some neuromodulationopportunities that have now
come up.
There's repetitive transcranialmagnetic stimulation for the
(10:27):
treatment of depression, whichbasically entails it's sort of
like you sit, almost somethinglooks like a dental chair, and
it's a magnet that sits over acertain area of your brain and
we stimulate that area.
It's an outpatient procedure.
It is virtually not painful.
It takes about 30, 35 minutes.
There's esketamine that's nowavailable through an intranasal
(10:49):
formulation to help with more.
These are more for treatmentrefractory.
But again, I'm going to look atthis from a lens of optimism.
These are different modalitiesthat we did not have available
to us a number of years ago andI'm confident in my colleagues
who are actively involved inresearch and R&D that there's
more things on the horizon.
(11:09):
So, for those people who areafraid of medications, I would
really encourage you to speak toa professional and understand
why it is that they're, andperhaps you're right in your
concerns, but we're really notgoing to know until we have a
conversation about it.
Speaker 3 (11:30):
Do you see that age groups handle this differently
as well?
There, I know, is a kind ofstigma that millennials are
extra anxious compared to, youknow, the generations before
them.
Are you seeing that in yourpractice that different
generations present their mentalwellness differently?
Speaker 1 (11:49):
So I always I'm really bad with that whole
millennial X.
I get those things all messedup.
Speaker 3 (11:53):
The millennial.
We're in our 30s, if that'shelpful.
Yeah, I'm a little older, right.
Speaker 1 (11:57):
The good thing is, I think with the younger
generations, they are a littlebit more receptive to
understanding that this is anissue and seeking out care.
Part of what I'll talk againthe positivities that we've seen
with mental awareness is nowthat there are individuals in
schools getting diagnosed,getting checked, and what the
(12:18):
data tells us is the earlieronset of diagnosing these issues
has a better prognosis.
I look at it positively.
I think that the youngergenerations are more in tune
with understanding that theremay be a concern and kind of
seeking out help and likewise,you know, the elder generation
has done well.
(12:38):
What we did see, again apositive statistic, is access is
always an issue for mentalhealth and with the pandemic,
while national and global datahas shown us that there's about
a 25% increase in depression,anxiety and mental illness, we
also saw that there's a 400%increase in access of telehealth
right, which really allowed alot more people to be able to
(13:01):
get care.
And when I thought about this, Iwas thinking about, you know,
our individuals, the people wecare for, that are beyond the
age of 65, 70, even beyond theage of 80.
How were they going to navigatethat iPad, that email, that
link, and I was pleasantlysurprised to see how many people
had done well with that andreally utilized that access to
(13:25):
care, and I was also veryoptimistic to see people within
that age group who did come, whodid grow up during the time
when this was stigmatized a lotmore than it is now right.
It was really considered, likeI said, either a moral failing
or a personal flaw.
They're more willing to seekout care.
(13:45):
I think these are all positivethings that we're seeing.
Speaker 2 (13:48):
Megan asked about generation and age differences
there.
What about gender?
It seems like there was a lotmore stigma about men addressing
this than women, and are youstill seeing that, or are men
starting to come to the tablemore?
Speaker 1 (14:04):
I can see where that originated from, just from that
concept of being kind of thatstrong person that you should
deal with this, that analogy Igave of just walk it off.
So it's kind of like it'sdepression, it's anxiety.
You know, just suck it up, Goon with life.
This happens to all of us.
What's the big deal?
The mental illness.
It can affect and impact anyoneand the reason being is there
(14:27):
is a biological component.
Right, it is a medical illness.
It is a difference with.
There's an imbalance inneurotransmitters.
There's been imaging studieswhich have shown us that someone
with any particular mentalillnesses versus another, there
are structural brain differencesthat are also we're now seeing.
So it's very evident that thisis a biological process.
Speaker 2 (14:53):
From what you've said , it sounds like we're already
miles ahead of where we were 10,20, 30 years ago in as far as
taking care of mental health.
What's next?
Where are we going into thefuture?
Speaker 1 (15:05):
I'm very optimistic of the future.
I think that there's a lot more.
You know I was previously thepresidency director.
I'm seeing a lot more peoplehave a lot of interest coming
into mental health as aprofession, so we're seeing a
lot more people entering it.
And there's a lot more peoplehave a lot of interest coming
into mental health as aprofession, so we're seeing a
lot more people entering it andthere's a lot more demand.
There's a lot more peopleseeking help.
We're also seeing now astechnology it's growing so
(15:28):
quickly, so expansively.
It's like you think aboutsomething and you pick up your
phone.
It's available to you throughan app, through anything.
And I think about AI.
You know AI is a veryinteresting thing and AI has a
lot of implications and also inbehavioral health, we're also
seeing that this can help withkind of even preliminary
diagnosing things.
There's different apps on therethat can help with your
(15:49):
medications, with therapies, etcetera.
So I look at all of these asvery positive, impactful tools
which can allow us to reach morepeople the way that they want
to be reached.
I think that's also veryimportant is that we really
individualize care.
I'm going to give you anexample of you know you brought
(16:09):
up how different generations areresponding and you know when
I've done telehealth visits theolder generation if they have
ambulatory difficulties, if theyhave transportation
difficulties they may have awalker wheelchair I'm able to
have a conversation with themwhen they're in the comfort of
their own living Right.
It also allows people to be alittle bit more open in
conversations.
(16:30):
I've had telehealth visits withother younger individuals who
chose to go sit on a park benchoutside in the open air and kind
of have that sort of thing.
So this has all been throughtechnology.
I think technology has a hugeimpact Pharmacologically.
There are new medicationscoming out all the time.
We're constantly looking atdifferent neurotransmitters,
(16:52):
different pathways of how tomanage, from just a basic
neurochemical standpoint, how tomanage the illness.
Speaker 3 (17:00):
Before we let you go, what is your last general
takeaway message about mentalhealth?
We've certainly all heard theit's okay to not be okay.
What is kind of your version ofthat, or your message to those
listening today?
Speaker 1 (17:14):
I think it's important to realize that mental
health is health, and yourphysical and mental health are
very codependent on each other.
They're intertwined.
I think it's very, almostimpossible to have one and not
the other, so I think that's avery important aspect.
So when I speak about mentalhealth, it's just health, it's
your health care, it's theopportunity for you to thrive.
(17:36):
At Christiana Care, we'reguided by our core values of
love and excellence.
I can tell you that that'sexactly what you're going to get
if you seek behavioral healthcare with us.
I can't guarantee a cure right,but what I can promise you is
that each and every caregiverwithin our service line will
meet you where you are.
They're going to teach you withempathy, compassion, respect
(17:57):
and offer you a lending ear tosee how it is that we can help.
Speaker 3 (18:00):
Thank you so much for your time.
We talked before this that thisepisode could have been two
hours long, so I'm sure we'llhave you back for more topics.
Speaker 1 (18:08):
Thank you so much.
It was a pleasure speaking toyou.
Speaker 2 (18:11):
Check out the show notes for this episode for more
information on behavioral healthservices at ChristianaCare.
Speaker 3 (18:16):
Also head to podcastchristianacareorg or
wherever you get your podcaststo check out the first two
seasons of For the Love ofHealth as we kick off season
three.
Speaker 2 (18:27):
We'll be back in two weeks with another great
conversation.
Speaker 3 (18:30):
Until then, thanks for joining us.
Speaker 2 (18:31):
For the Love of.
Speaker 3 (18:32):
Health.
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