January 28, 2025 • 33 mins
In this episode of Restoration Beyond the Couch, Dr. Lee Long welcomes back Dr. Debra Atkisson for a new conversation on depression and mental health. This episode dives deeper into psychiatry, exploring how medications and talk therapy work together and addressing common questions about treatment.
This episode offers fresh insights and practical strategies for navigating mental health challenges. Don’t miss this engaging discussion.
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Episode Transcript
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Speaker 1 (00:01):
Welcome to Restoration Beyond the Couch.
I am Dr Lee Long and I'mexcited to welcome back Dr
Deborah Ackeson, aboard-certified psychiatrist and
author of Mastering your Storm.
In her previous episode, weexplored her insights into
building resilience and mentalhealth.
Today we're shifting gears toanswer some of the most common
(00:25):
questions about psychiatry,discuss the role of medications
and talk therapy in mentalhealth treatment and provide
practical strategies forimproving overall well-being.
We also touch on new insightsfrom her book and how they apply
to real-life challenges.
This episode offers a freshperspective on mental health
(00:48):
care.
Your path to mental wellnessstarts here.
Okay, well, welcome back, dr A.
Hey, it's great to be here yeahthanks for coming again and I'm
so happy that we're here to talkabout your book, about mental
health, about all kinds of funthings.
Hey, leave it to the two of uswhen we get together.
(01:08):
God only knows what we're goingto talk about.
Speaker 2 (01:10):
Isn't that the truth?
We were chatting right at thebeginning, and I think, we have
several different topics.
We'll probably be interweavingthroughout our conversation
today.
Speaker 1 (01:18):
I think it makes sense.
So a few of our listeners hadsome questions that they wanted
to throw out to you.
So if you're cool with usstarting there, I'm glad to
answer anything I can.
Okay, well, I think you can.
One question was the safety andefficacy.
Maybe we'll start with safetyof like certain meds, like an
(01:45):
SSRI, like a Zoloft, a Lexapro,you know a Welbutrin Are those
medications from yourperspective?
Are those medications safe tobe on for extended amounts of
time?
Speaker 2 (01:53):
It's a great question .
It's a question I often havepeople ask me and I want to
start by saying in today's worldwe know that depression is a
very common issue Boy is it andthat there are, of the subsets
of people who have depression.
There's a percentage of peoplewho have chronic, recurrent
depression.
And the way we like to thinkabout that in mental health is
(02:16):
whether somebody needs to be onmedications long term.
If someone has one episode ofdepression, we will look at that
individual, we will talk withthem, we will treat them and,
just as a kind of a roughestimate of how long they're on
a medication, it's approximatelya year.
It can be a little bit longer,depending on what factors are
going on in their lives and thendepending on how well they're
(02:36):
doing, how well they have usedtherapy, how well they've
developed coping skills, then wecan look at trying them off
medication.
Developed coping skills, thenwe can look at trying them off
medication.
And I want to pause here to saythe purpose of the medicine is
to help people be able to notonly more emotionally feel
better, but it's actually tohelp a number of functional
(02:56):
areas in their lives, such assleep, appetite, motivation,
concentration, because all ofthose things get pardon my
language, they get whacked bydepression.
I mean depression is abrain-based illness and it goes
in and, with all those brainconnections, to all the areas,
almost every area of your lifegets impacted by depression.
(03:17):
And we know and this leads intosome of the work you do in
therapy, we know that whenpeople have chronic depression
that has gone untreated, itchanges their internal narrative
and it changes their help meout here intra-psychic way of
viewing themselves and theirintrapersonal way of viewing
(03:38):
themselves, which then impactstheir interpersonal
relationships with other people.
Did I get that right, dr Long?
Spot on, because you wrote athesis on that.
Right, dr Long?
Cause you wrote.
You wrote a thesis on that, Ibelieve.
Speaker 1 (03:48):
I did, I did, and there's a whole theory that is
an interpersonal.
It's a.
It's a interpersonal.
Ipt is the is the acronym forit's interpersonal therapy,
therapy and CBAS, which is whatI wrote my dissertation on in in
a theory that my mentor wrote.
(04:09):
He authored.
It is all about interpersonalunderstanding and awareness, and
so you're, you're, you're spoton that.
When, when you are in a spaceof needing medication, it's not
to pull you out of thedepression.
I've always seen it as well andLila, one of our therapists,
(04:32):
always uses the analogy thatwhen you are struggling with
depression, it's like you're ina smoke filled room and the
medication just opens the windowand allows the smoke to leave.
You still need to have theskills to go about living life
in that room.
It's just that the medicationhelps alleviate the smoke out of
(04:55):
the room 100%.
Speaker 2 (04:56):
It's a beautiful metaphor.
Speaker 1 (04:58):
And.
Speaker 2 (04:58):
I think it shows that very clearly how it works.
So I talked about if people usetherapy and they do the work,
there is a very large percentageof people who are not going to
need to be on medications longterm.
So they take them.
Of individuals who've had oneepisode of depression, if they
have a second episode ofdepression later, that is of the
(05:19):
severity that they need to goback on medications.
And, by the way, this canhappen with people who've done
great therapy, have enormousinsights.
But if they have a significantbiological basis for their
depression that has to do withhow their neurons are wired,
they're going to have recurrentdepression even if they do all
the work.
So with that second episode wego back on another course of
(05:43):
antidepressants.
Then at that point we have abranch point.
Often it depends on how severethe depression has been, it
depends on how well they'refunctioning again.
But there's an option for themto go back off meds again.
So we think of it.
When a person has a thirdepisode of significant
depression, that's when we wantto look at them being on
(06:06):
medications very long term.
And when you talk about safety,Prozac has been out since the
mid to late 80s and Zoloft aswell.
It followed right behind it, sothose are SSRIs.
We see that there are peoplewalking around who have been on
these medications 30 years andwe are not seeing long-term
(06:29):
negative effects.
As a matter of fact, the onepopulation when we think of
using medications that we reallyare concerned about safety are
women who are pregnant, andZoloft is an antidepressant that
we have a lot of pregnancy datawith and appears to be fairly
safe in pregnancy.
It's still a Category C, butit's one that OBGYNs are very
(06:52):
comfortable.
If someone needs a medicationduring pregnancy, that's one we
may consider.
Zoloft is also FDA approved forage 6 and up.
And so for it to have an FDAapproval in the child population
.
We know that physically it'sfairly safe and I would say in
the work I've done with treatingpatients I've used a lot of
(07:13):
SSRIs Zoloft, prozac and Lexaproand I can tell you that we use
these medications in people whohave very serious medical
illnesses, such as they may havecancer and be receiving
chemotherapy and need anantidepressant, and these are
deemed safe for us to use withthose patients.
So the physical safety of it,of those medications, is fairly
(07:35):
well established.
Speaker 1 (07:37):
Which is that's an encouraging thing to know, right
, Because I think that you know.
Going back to some of thethings that you you stated about
having an epigenetic you didn'tuse that term, but I know
that's what you're getting at weknow now that we have gene SNPs
the MAO-B and the MAO-A thatare connected to or they are
(08:00):
descriptive of these issues, ofof it being extra emotional I
don't want to say hyperemotional, but there's a
depressive gene and then there'sa an emotionally sensitive gene
and that's the MAOB and theMAOA.
And if somebody has those snubs, we we can say we know with
some decent confidence thatthey're going to.
(08:22):
They may struggle.
Speaker 2 (08:23):
Yes.
Speaker 1 (08:24):
The other thing that you talked about is the SSRI,
which, just for our listenerssake, it's a simple serotonin
reuptake inhibitor, that's right.
And that's serotonin.
It's just it's not enoughserotonin on the brain.
Yes, it's like a toilet thatconstantly leaks.
It never fills, and so thereserotonin manufacturer is never
(08:45):
at rest.
And something that a friend ofmine asked a neuropsych person
why is it that the SSRIs, theseserotonin reuptake inhibitors,
why is it that it takes two tofour weeks?
(09:06):
Am I giving the right window?
Speaker 2 (09:09):
You are giving the right window Two to four weeks
to be effective.
Speaker 1 (09:12):
If the serotonin is immediately on the brain, why
then does it take these two tofour weeks?
And what he said and I'm goingto see if we're accurate on this
Is that the and I call it thehousing mechanism that makes the
serotonin needs to trust thatthat serotonin is going to be
there so that it will slow down.
(09:33):
And it takes two to four weeksfor that mechanism, that
manufacturing plant, as I see itin my brain, that manufacturing
plant needs to trust that theserotonin is going to stay there
before it calms down.
And that's the window it takesstressed because of the
depression.
Speaker 2 (09:50):
So the serotonin is being moved through very rapidly
, so it's being metabolized tooquickly and moved down the pike.
(10:14):
All these medications do isthey go in and they plug some of
the places where the serotoninwould be attaching and going
down, so they can raise thelevel in the brain.
They don't make the brain makemore of it, they just regulate
it.
So you're exactly correct.
It takes a few weeks for thosemechanisms to the brain's.
An amazing machine, if you wantto think of it that way.
(10:35):
But it takes that long forthings to really shift and for
all the feedback mechanisms thathave to go into place in the
brain for it to realize okay,great, we don't know why, but
for some reason our serotoninlevel is up, so we're going to
go with it.
We can calm down a little bit.
We don't have to be sodistressed and pulling these
(10:55):
chemicals through so rapidly.
Speaker 1 (10:58):
I just think it's so fascinating how fearfully and
wonderfully we are designed andmade.
Speaker 2 (11:05):
Yes.
Speaker 1 (11:05):
That we have all these mechanisms in place as a
self-protective and self-healingmechanism and, yes, we need
outside care to heal.
Oh yes, oh yes, but that ourbrain, our body wants to
cooperate with that healingprocess.
Speaker 2 (11:23):
Well, I'm going to.
I'm going to piggyback off whatyou just said, because you
talked about fearfully andwonderfully made, and so,
depending on your view, I am aChristian, so I believe we were
designed very uniquely.
And the thing I have foundfascinating the more I have
learned in my career as a mentalhealth professional, the more I
(11:44):
realize that the things thathelp us reset and do better are
actually often connected tospiritual matters, for instance,
the whole practice ofmindfulness.
In order for us to be healthy,we need to really learn ways to
be mindful and be alive andpresent in the moment.
The reality is, the moment isall we really have, because we
(12:06):
don't know what's happening.
The past has already happened.
We don't know what will behappening.
We have to live in a way toprepare ourselves for the future
and from that we reflect andlearn from the past, but we
really only live in the moment.
And so when you think aboutmindfulness practices, all the
different things that we do withpeople and mental health to
(12:30):
help them, and then you simplyshift and think about Prayer,
prayer is an act of mindfulness,and when I'm working with
people, I'm trying to help themfind ways to look at their own
mindfulness.
I ask their faith tradition, Ifind out if prayer is something
they do and I kind of talk withthem about how that's actually a
(12:51):
moment of mindfulness and whenyou do that and you step away
from it, think of how you feel.
Everything has calmed,everything is in a better place,
and that's what mindfulnessdoes for us.
So you referenced Fearfully andWonderfully Made, which is a
great book, might I?
Speaker 1 (13:07):
add.
Speaker 2 (13:08):
So it made me think about that and I thought I just
have to comment on that.
Speaker 1 (13:11):
Well, I'm glad you did, Because I think that, in
order for us to have going backto your comment about
intrapersonal awareness, is thatthat mindfulness takes us back
to that and being aware of who Iam.
Our intrapersonal awareness, orintra psyche awareness, really
(13:32):
is just a fancy way to sayself-awareness, and I think that
there's so much there.
We often look at what arememories for right.
We think that memories.
Often we think that memoriesare to orient us to the past.
They're really not.
Memories are to orient us to thepresent, so that we don't have
(13:54):
to use so much of this big brainthat we've been given to
assimilate what is in thepresent, because our memories
help us conceptualize what we'reexperiencing in the now.
And so for us to be hamstrung oranchored to the past doesn't
(14:16):
allow us to be in the present.
And it's not that we want toavoid the thoughts of the past
doesn't allow us to be in thepresent.
And it's not that we want toavoid the thoughts of the past.
We want to assimilate thethoughts of the past.
And that's one of the reasonswhy I fell in love with the
CBASP, the cognitive behavioralanalysis systems of
psychotherapy that my, that mymentor designed or developed is
(14:37):
because it truly is a adeepening awareness of how the
present is informed by the past,but it is not dictated by the
past.
Oh yes, and that's just such aa powerful thing is when
watching people discriminate thepresent from the past.
(15:01):
That's when I see a lot ofopening up, since you're
bringing that up something wewere chatting about earlier.
Speaker 2 (15:11):
As I was reflecting about our meeting today, I was
thinking what are the thingsthat I commonly hear and
commonly see?
And one thing that I docommonly see has to do with this
notion of past decisions andpresent life and what your
future life will be.
So a lot of people that I talkwith, whether I'm seeing them as
(15:32):
a psychiatrist or I'm doing acoaching session with them, they
get trapped in these feelingsof remorse and regret about
either choices they could havemade but did not in other words,
paths they could have taken butfor whatever reason or reason,
they didn't or a path they didtake and the way that path led
(15:52):
their life to become.
And they feel stuck in that, asif I can't shift, I can't look
at things differently.
Frequently, it's because theyhave these ideas they've
developed about.
Well, this is where I would betoday, or this is how my life
would be today, if I had eithertaken that path or I didn't take
(16:13):
this path.
And I was talking about the factI was reading a fictional novel
called the Midnight Library,where this mid-30s lady finds
herself.
This won't ruin the book foranyone if they decide to read it
.
It's a fictional book that hasa good premise.
This woman finds herself inthis midnight library.
(16:33):
That has to do with all thesechoices she could have made.
She could have chosen to dosomething differently and her
life would have had thisdevelopment, and so there were
infinite possible lives shecould have lived.
Interestingly, if you payattention to this and you read
that book, you'll find thingsaren't always the way she
(16:54):
thought they would turn out.
And that's why I'm using that asan illustration, because I
think for all of us, we have tomake choice points in the moment
in terms of using theinformation.
We have to make the bestdecision we can at the time.
Then, later, when we'redisappointed, we have to be
(17:15):
careful not to get trapped inthe quicksand of those feelings
of remorse and regret, insteadto say, okay, what did I learn
from that choice?
What came of that choice?
How do I wish things would bedifferently?
And in the moment where I'mliving now, what do I need to
put into place to develop a pathforward?
(17:36):
And that is just reallycritical.
I think and that's a lot aboutwhat my book is about it's
helping.
It's a very straightforward,simple tool to help people be
able to do just that, to pausethe moment and say how do I
develop a plan to move in thedirection I want to go?
What do I need to assess tofigure that out?
(17:56):
And that's what the book is.
What do I need to assess tofigure that?
Speaker 1 (17:59):
out, and that's what the book is.
It's a guide for that, you know.
I think that's so needed.
What we found in our depressionstudy was overwhelmingly for
the participants problem solvingis what resolved a several
decade long chronic sense ofdepression.
There you go, and I've beendoing a lot of research recently
(18:21):
looking at outcomes, and what'ssuper interesting to me is that
most of the outcome data that'spositive in mental health or in
in the treatment world has todo with skills.
Yes, it's skills.
Speaker 2 (18:38):
It do with skills.
Speaker 1 (18:39):
Yes, it's skills, it's acquiring skills, it's
learning acquisition.
That is the I don't want to saythe predictor, but it sure has
been shown in outcome data thatlearning acquisition is the most
solid uh Indicator Of positiveoutcomes.
(18:59):
And what you're talking aboutin your in your book, mastering
your Storm, is putting a pathway.
That's teaching skills, whichis again a positive predictor
for outcomes.
That's really cool.
Speaker 2 (19:14):
It is cool.
The piece of it that I reallylike a great deal is that by
teaching skills, you empowerpeople to be able to be in
charge of their life in thepresent and the direction
they're going.
Yeah, and then, whatever youencounter in that direction you
go, you have ways to cope anddeal with it through the skills
(19:36):
you've acquired.
Yeah, yeah, to cope and dealwith it through the skills
you've acquired.
Speaker 1 (19:39):
Yeah, yeah, and there's that, like you said, I
love that, that sense ofpersonal agency, yes, which goes
back to one of my favoritethings to talk about is that
whole sense of self-awareness,that intrapersonal awareness is
that when I learn what I, what'sgoing on inside of me, then I
(20:00):
know how to bring me to we yes.
And I may not be met.
I mean, I may not be met withwhat I'm wanting from someone,
but if I give what I wanted togive out of, if I did what I
wanted to do, the behaviors thatI wanted out of me, then I can
have a certain sense ofaccomplishment from that.
Yes, I can't control theenvironment, but, you're, I can
have a certain sense ofaccomplishment from that yes.
(20:21):
I can't control the environment,but you're setting people up
for a sense of agency.
And did you say that there wereseven different domains that
you touch on in your book?
Speaker 2 (20:32):
Well, let me pause here and see which ones I do
talk about.
I begin the book by talkingabout why you picked up the book
in the first place.
If you don't know anythingabout mindfulness, I have a very
straightforward each chapter isabout five to seven pages short
guide as to how you can look atmindfulness for yourself,
because we all have to begrounded in a sense of the
present to evaluate where we arein the moment, to be able to
(20:54):
move forward.
I talk about intention.
I believe all of us haveintention about things in our
life, but we don't always labelit or understand that.
So, I talk about that.
I talk about being able todevelop resilience, because I
have found all of us have thingsthat we've either done that we
(21:15):
have negative feelings about, orwe have negative feelings about
choices we didn't take.
Resilience comes sometimes fromhaving those experiences, and I
talk about ways you can developresilience without having to
have a negative experience.
So sort of talk about all ofthat.
And I talk about action,accountability, how you set that
, and then I say okay, I wantyou just to take a moment to
(21:38):
look at these different areas ofyour life.
So I ask people to look at thephysical area of their life.
It's a very high-level overviewbecause that could be a huge
book in and of itself.
Speaker 1 (21:47):
Right, each of these topics could go.
Each topic, yeah.
Speaker 2 (21:50):
And what I do at the very end is, for each chapter I
give two or three books that ifpeople want to take deeper dives
they can read about that haveto do with those specific topics
.
I talk about your emotional orpsychological self, because if
your physical self and youremotional self is not on track,
you're going to have a lot ofdifficulties and issues.
(22:11):
We have a whole career based ondealing with people with their
emotional and psychologicalareas of their lives, us and
several other people, areas oftheir lives, us and several
other people.
I talk about the spiritualdomains of your life, because
everyone does have a spiritualdomain, and I talk about how you
look at that, how you exploreit, how you get help for that.
I talk about the financialaspects of your life.
(22:34):
You must be able to have someway to manage those things.
I talk about the relationshipaspect, because we all have
relationships with other people,and then I talk about the
intellectual aspects of yourlife.
So there's about six differentareas I talk about In the
intellectual aspects.
I pull into that.
(22:55):
It's the things that we use ourbrains for that are related to
work, but it's also related tothings we have intellectual
interest and pursuits in.
I think the happiest people Iknow are the people who remain
curious and continue to learn.
I mean, lee, I look at you.
You've mastered severaldifferent areas of therapy.
Then you decided to go back andget a doctorate and master this
(23:18):
other area and you did thatafter you had a very full career
.
You could have just said youknow what I'm done with learning
, I've learned what I need toknow, but you're a lifelong
learner and I think the happiestpeople and the healthiest
people are those who arelifelong learners, so I was sure
to comment on that as well.
I ask people to look at allthese areas and then I ask them
(23:40):
to say to themselves which areado I think I need to really
focus on the most right now asthe area that is interfering
with my ability to move forwardwith the plan.
Then I help them withdeveloping a plan how to do that
.
Speaker 1 (23:55):
I think that's wonderful because you know your
statement about curiosity andlifelong learning.
Boy, first of all, thank youfor the feedback.
That means a lot, especiallycoming from you, because I feel
like you've had such an up-closeview to my world and I
appreciate that feedback andthat observation.
Speaker 2 (24:15):
Well, you know, you've mastered so many
different areas of therapy, andrelationship is a big part of
that.
You took your intellectualinterest and then you began to
realize there's the emotionaland the psychological and then
the relationship, so you reallymerged three areas there.
Speaker 1 (24:36):
Thank you, and you know the.
The thing that really standsout to me in this is the idea
that with we, we don't.
This isn't about conquering,mastering your storm is not
about conquering something andthen setting it in mothballs or
cold storage and saying I'veconquered it, I'm finished, I am
(25:00):
, I'm good in this area and Idon't need to ever evaluate it
again.
Evaluation we I, in other wordsI.
I would hate for someone to seelife's growth as a burden.
It is an opportunity.
It's an opportunity to enjoy, toenjoy learning more about, I
(25:22):
mean, cause.
I appreciate you bringing upthat point.
I love learning about humanbehavior and at some point you,
you know do we stake a flag inthe ground and say I know all
there is to know?
I hope not, because I hope ourfield is ever changing, because
it is.
I mean, I was just goingthrough um psychological
bulletin, which is a reviewjournal and, for those of you
(25:45):
who don't know what reviewjournals are, it's a journal
that reviews, uh, research andwrites what's called a meta
analysis, which is a whole lotof review to review of a whole
lot of different studies andpulling together the themes that
they see in all these differentstudies.
And I was going through andreviewing the themes that I see
(26:06):
in the outcome data and lookingat all of that.
And there was a, an articlepublished in this this past year
in 2023, and we call it psychbull and psychological bulletin
that was going through anddescribing almost in detail not
(26:26):
bringing up a Jim's model theCBASP, but describing in detail
one of the exercises that isused in CBASP and saying how
important differentiation is andhow important this emotional
understanding of self is.
And I'm thinking to myself.
You don't realize it, butyou're describing all of the
(26:47):
reasons why Jim, in the 1970s,developed this program.
Yes, and it was all thescientific understandings of why
he had intuitively seensomething 50 years ago.
And I just think about how ourfield is continuously moving and
(27:09):
changing, so of course we'renever going to stake that flag.
Speaker 2 (27:12):
Never.
It's going to always bechanging as we move forward, and
I hope it's not burdensome.
Oh well, you know, and you talkabout growth.
I want to comment on thatbecause I also think if every
person in their life embracesthe concept of, I will be
growing throughout my life.
You know, Eric Erickson hasstages of development that go
(27:35):
all the way through to the endof life.
I'm still working on some.
So you know, you just keepworking on those and I hope you
keep working, because I want youto live a very long life.
I'm still working on some, youknow, so you know you just keep
working on those.
Speaker 1 (27:41):
And I hope you keep working because I want you to
live a very long life.
Speaker 2 (27:46):
But you know, we just work on all these things as we
grow.
I think if people can embracethe idea that growth may feel
uncomfortable at times andthat's okay, that's a part of
life, and if they can embracethe idea of I may feel a little
unstable when I'm growing or I'mchanging or there's other areas
(28:07):
of my life that I may need toreach out and get some sort of
help.
You know, you and I weretalking about the concept of
intensive outpatient program,which is a form of outpatient
therapy.
You all do it here atRestoration right here in Fort
Worth, Texas, and do an amazingjob I'm involved with-.
Speaker 1 (28:23):
In Dallas as well.
Speaker 2 (28:24):
Yes, and in Dallas too, I'm involved with
Connections Wellness Group,which has intensive outpatient
programming more north of hereand more south of here.
We're up in the Plano McKinneyarea, then we're more south down
Arlington, mansfield, and weeven have some programs in
Tennessee.
But the intensive outpatientprogramming is a really good way
for people to go and addresssome things that are going on in
(28:48):
their life, whether it's withrelationships, their emotions,
their psychological well-being.
They're able to develop copingskills.
They're able to get somesupport, because we all need
that support at times and bydoing this they can grow, they
can make positive changes andit's a form of therapy.
And people who do intensiveoutpatient programming may not
(29:10):
even need to be on medications.
I'm coming all the way backaround to medications that you
brought at the beginning.
People on medications canbenefit from that, obviously,
but many people who just needmore intensive therapy can
really benefit from intensiveoutpatient programming.
Speaker 1 (29:26):
That's true.
Speaker 2 (29:27):
So you were talking earlier about mental health and
people asking about reallyserious mental health issues and
other types of issues.
I think we have to think ofmental health like everything
else.
It's a continuum.
That's right.
Everyone in their life willhave some mental health concerns
they're going to need toaddress.
Speaker 1 (29:45):
That's right.
Speaker 2 (29:45):
Grief is one, Loss is one.
These are important matters.
When we talk about thecontinuum, though, we talk about
the common experiences everyonehas.
Then we talk about some of thethings that are illnesses that
are not as common.
You'd mentioned bipolardisorder.
It's a small percentage of thepopulation, but it's very
genetic.
It's very biological, such asschizophrenia.
(30:06):
That is as well.
1% of the population Very smallpercentage impacted.
I think.
The thing about mental health wethink about, though, is there's
wonderful and robust data andtreatment for the common
experiences we all have, such asgrief and loss, all the way to
the more serious implications,such as people who are out of
(30:30):
touch with reality or with, asin bipolar disorder.
They are impacted in a way thatthey're not sleeping, they're
not eating, and they need tostay on routine medications just
to help them function well.
That being said, some of themost brilliant people I know
have bipolar disorder, and whenthey take their medications and
(30:50):
stay on them, they're incrediblyfunctional, and so I think
that's the good news I want tosay about mental health.
We've learned so much, but it'sa field we're going to keep
growing and learning about moreas time goes on.
It makes it exciting, for usExactly.
Speaker 1 (31:03):
I love that you use that term excited because it's
exciting, because one of thethings that I've seen in
treating people with bipolar isthat working to get the
medication right for thatindividual or the treatment
correct for that individual isthat I would hear a lot of, not
a lot.
I would hear a number ofindividuals say it way.
(31:24):
I went from living intechnicolor, dealing with that
true sense of mania, to I wentto living in the gray, and the
gray was so just depressing thatit would send me into a
depression.
And one thing that we know tobe true is that bipolar
depression is so much deeper,it's so incredibly painful, that
(31:47):
it's like they would just thecontrolling that sense of mania
would send them into a bipolardepression which is just harsh.
Speaker 2 (31:56):
There are people with bipolar 2 disorder who may not
be fully manic and they ask thequestion often is how do I know
I'm bipolar?
Here's a really good yardstick.
If you've been treated with twoor three different medications
for depression and you're doingtherapy and you can't seem to
get better, ask your doctor ifthere's a possibility you could
have a variant of bipolardisorder.
That's often a good yardstick.
Speaker 1 (32:18):
That's great, that's great.
Disorder that's often a goodyardstick.
That's great, that's great.
Well, I just want to say thankyou again for coming and talking
with us and sharing all of yourwisdom and insight with our
listeners, and your book yourbook is is available in at
Amazon and everywhere that sellsbooks.
Yes, and there's a Kindleversion coming up.
Speaker 2 (32:37):
Yes, there is a Kindle version and a paperback
version at this time Awesome.
Speaker 1 (32:42):
Well, thanks again.
Speaker 2 (32:43):
Well, thank you for having me, it's been fun talking
as always, as always.
Speaker 3 (32:48):
All right.
Thank you.
If you found value in ourdiscussion and wish to uncover
more about the fascinating worldof mental wellness, don't
forget to subscribe to thepodcast.
Stay tuned for our upcomingepisodes, where Dr Long will
continue to delve intoempowering therapies and
strategies for mental wellness.
Your journey to understandingand embracing mental health is
(33:08):
just beginning and we're excitedto have you with us every step
of the way.
Until next time, keep exploring, keep growing and remember to
celebrate restored freedom asyou uncover it.
Welcome to Restoration Beyond the Couch.
I am Dr Lee Long and I'mexcited to welcome back Dr
Deborah Ackeson, aboard-certified psychiatrist and
author of Mastering your Storm.
In her previous episode, weexplored her insights into
building resilience and mentalhealth.
Today we're shifting gears toanswer some of the most common
(00:25):
questions about psychiatry,discuss the role of medications
and talk therapy in mentalhealth treatment and provide
practical strategies forimproving overall well-being.
We also touch on new insightsfrom her book and how they apply
to real-life challenges.
This episode offers a freshperspective on mental health
(00:48):
care.
Your path to mental wellnessstarts here.
Okay, well, welcome back, dr A.
Hey, it's great to be here yeahthanks for coming again and I'm
so happy that we're here to talkabout your book, about mental
health, about all kinds of funthings.
Hey, leave it to the two of uswhen we get together.
(01:08):
God only knows what we're goingto talk about.
Speaker 2 (01:10):
Isn't that the truth?
We were chatting right at thebeginning, and I think, we have
several different topics.
We'll probably be interweavingthroughout our conversation
today.
Speaker 1 (01:18):
I think it makes sense.
So a few of our listeners hadsome questions that they wanted
to throw out to you.
So if you're cool with usstarting there, I'm glad to
answer anything I can.
Okay, well, I think you can.
One question was the safety andefficacy.
Maybe we'll start with safetyof like certain meds, like an
(01:45):
SSRI, like a Zoloft, a Lexapro,you know a Welbutrin Are those
medications from yourperspective?
Are those medications safe tobe on for extended amounts of
time?
Speaker 2 (01:53):
It's a great question .
It's a question I often havepeople ask me and I want to
start by saying in today's worldwe know that depression is a
very common issue Boy is it andthat there are, of the subsets
of people who have depression.
There's a percentage of peoplewho have chronic, recurrent
depression.
And the way we like to thinkabout that in mental health is
(02:16):
whether somebody needs to be onmedications long term.
If someone has one episode ofdepression, we will look at that
individual, we will talk withthem, we will treat them and,
just as a kind of a roughestimate of how long they're on
a medication, it's approximatelya year.
It can be a little bit longer,depending on what factors are
going on in their lives and thendepending on how well they're
(02:36):
doing, how well they have usedtherapy, how well they've
developed coping skills, then wecan look at trying them off
medication.
Developed coping skills, thenwe can look at trying them off
medication.
And I want to pause here to saythe purpose of the medicine is
to help people be able to notonly more emotionally feel
better, but it's actually tohelp a number of functional
(02:56):
areas in their lives, such assleep, appetite, motivation,
concentration, because all ofthose things get pardon my
language, they get whacked bydepression.
I mean depression is abrain-based illness and it goes
in and, with all those brainconnections, to all the areas,
almost every area of your lifegets impacted by depression.
(03:17):
And we know and this leads intosome of the work you do in
therapy, we know that whenpeople have chronic depression
that has gone untreated, itchanges their internal narrative
and it changes their help meout here intra-psychic way of
viewing themselves and theirintrapersonal way of viewing
(03:38):
themselves, which then impactstheir interpersonal
relationships with other people.
Did I get that right, dr Long?
Spot on, because you wrote athesis on that.
Right, dr Long?
Cause you wrote.
You wrote a thesis on that, Ibelieve.
Speaker 1 (03:48):
I did, I did, and there's a whole theory that is
an interpersonal.
It's a.
It's a interpersonal.
Ipt is the is the acronym forit's interpersonal therapy,
therapy and CBAS, which is whatI wrote my dissertation on in in
a theory that my mentor wrote.
(04:09):
He authored.
It is all about interpersonalunderstanding and awareness, and
so you're, you're, you're spoton that.
When, when you are in a spaceof needing medication, it's not
to pull you out of thedepression.
I've always seen it as well andLila, one of our therapists,
(04:32):
always uses the analogy thatwhen you are struggling with
depression, it's like you're ina smoke filled room and the
medication just opens the windowand allows the smoke to leave.
You still need to have theskills to go about living life
in that room.
It's just that the medicationhelps alleviate the smoke out of
(04:55):
the room 100%.
Speaker 2 (04:56):
It's a beautiful metaphor.
Speaker 1 (04:58):
And.
Speaker 2 (04:58):
I think it shows that very clearly how it works.
So I talked about if people usetherapy and they do the work,
there is a very large percentageof people who are not going to
need to be on medications longterm.
So they take them.
Of individuals who've had oneepisode of depression, if they
have a second episode ofdepression later, that is of the
(05:19):
severity that they need to goback on medications.
And, by the way, this canhappen with people who've done
great therapy, have enormousinsights.
But if they have a significantbiological basis for their
depression that has to do withhow their neurons are wired,
they're going to have recurrentdepression even if they do all
the work.
So with that second episode wego back on another course of
(05:43):
antidepressants.
Then at that point we have abranch point.
Often it depends on how severethe depression has been, it
depends on how well they'refunctioning again.
But there's an option for themto go back off meds again.
So we think of it.
When a person has a thirdepisode of significant
depression, that's when we wantto look at them being on
(06:06):
medications very long term.
And when you talk about safety,Prozac has been out since the
mid to late 80s and Zoloft aswell.
It followed right behind it, sothose are SSRIs.
We see that there are peoplewalking around who have been on
these medications 30 years andwe are not seeing long-term
(06:29):
negative effects.
As a matter of fact, the onepopulation when we think of
using medications that we reallyare concerned about safety are
women who are pregnant, andZoloft is an antidepressant that
we have a lot of pregnancy datawith and appears to be fairly
safe in pregnancy.
It's still a Category C, butit's one that OBGYNs are very
(06:52):
comfortable.
If someone needs a medicationduring pregnancy, that's one we
may consider.
Zoloft is also FDA approved forage 6 and up.
And so for it to have an FDAapproval in the child population
.
We know that physically it'sfairly safe and I would say in
the work I've done with treatingpatients I've used a lot of
(07:13):
SSRIs Zoloft, prozac and Lexaproand I can tell you that we use
these medications in people whohave very serious medical
illnesses, such as they may havecancer and be receiving
chemotherapy and need anantidepressant, and these are
deemed safe for us to use withthose patients.
So the physical safety of it,of those medications, is fairly
(07:35):
well established.
Speaker 1 (07:37):
Which is that's an encouraging thing to know, right
, Because I think that you know.
Going back to some of thethings that you you stated about
having an epigenetic you didn'tuse that term, but I know
that's what you're getting at weknow now that we have gene SNPs
the MAO-B and the MAO-A thatare connected to or they are
(08:00):
descriptive of these issues, ofof it being extra emotional I
don't want to say hyperemotional, but there's a
depressive gene and then there'sa an emotionally sensitive gene
and that's the MAOB and theMAOA.
And if somebody has those snubs, we we can say we know with
some decent confidence thatthey're going to.
(08:22):
They may struggle.
Speaker 2 (08:23):
Yes.
Speaker 1 (08:24):
The other thing that you talked about is the SSRI,
which, just for our listenerssake, it's a simple serotonin
reuptake inhibitor, that's right.
And that's serotonin.
It's just it's not enoughserotonin on the brain.
Yes, it's like a toilet thatconstantly leaks.
It never fills, and so thereserotonin manufacturer is never
(08:45):
at rest.
And something that a friend ofmine asked a neuropsych person
why is it that the SSRIs, theseserotonin reuptake inhibitors,
why is it that it takes two tofour weeks?
(09:06):
Am I giving the right window?
Speaker 2 (09:09):
You are giving the right window Two to four weeks
to be effective.
Speaker 1 (09:12):
If the serotonin is immediately on the brain, why
then does it take these two tofour weeks?
And what he said and I'm goingto see if we're accurate on this
Is that the and I call it thehousing mechanism that makes the
serotonin needs to trust thatthat serotonin is going to be
there so that it will slow down.
(09:33):
And it takes two to four weeksfor that mechanism, that
manufacturing plant, as I see itin my brain, that manufacturing
plant needs to trust that theserotonin is going to stay there
before it calms down.
And that's the window it takesstressed because of the
depression.
Speaker 2 (09:50):
So the serotonin is being moved through very rapidly
, so it's being metabolized tooquickly and moved down the pike.
(10:14):
All these medications do isthey go in and they plug some of
the places where the serotoninwould be attaching and going
down, so they can raise thelevel in the brain.
They don't make the brain makemore of it, they just regulate
it.
So you're exactly correct.
It takes a few weeks for thosemechanisms to the brain's.
An amazing machine, if you wantto think of it that way.
(10:35):
But it takes that long forthings to really shift and for
all the feedback mechanisms thathave to go into place in the
brain for it to realize okay,great, we don't know why, but
for some reason our serotoninlevel is up, so we're going to
go with it.
We can calm down a little bit.
We don't have to be sodistressed and pulling these
(10:55):
chemicals through so rapidly.
Speaker 1 (10:58):
I just think it's so fascinating how fearfully and
wonderfully we are designed andmade.
Speaker 2 (11:05):
Yes.
Speaker 1 (11:05):
That we have all these mechanisms in place as a
self-protective and self-healingmechanism and, yes, we need
outside care to heal.
Oh yes, oh yes, but that ourbrain, our body wants to
cooperate with that healingprocess.
Speaker 2 (11:23):
Well, I'm going to.
I'm going to piggyback off whatyou just said, because you
talked about fearfully andwonderfully made, and so,
depending on your view, I am aChristian, so I believe we were
designed very uniquely.
And the thing I have foundfascinating the more I have
learned in my career as a mentalhealth professional, the more I
(11:44):
realize that the things thathelp us reset and do better are
actually often connected tospiritual matters, for instance,
the whole practice ofmindfulness.
In order for us to be healthy,we need to really learn ways to
be mindful and be alive andpresent in the moment.
The reality is, the moment isall we really have, because we
(12:06):
don't know what's happening.
The past has already happened.
We don't know what will behappening.
We have to live in a way toprepare ourselves for the future
and from that we reflect andlearn from the past, but we
really only live in the moment.
And so when you think aboutmindfulness practices, all the
different things that we do withpeople and mental health to
(12:30):
help them, and then you simplyshift and think about Prayer,
prayer is an act of mindfulness,and when I'm working with
people, I'm trying to help themfind ways to look at their own
mindfulness.
I ask their faith tradition, Ifind out if prayer is something
they do and I kind of talk withthem about how that's actually a
(12:51):
moment of mindfulness and whenyou do that and you step away
from it, think of how you feel.
Everything has calmed,everything is in a better place,
and that's what mindfulnessdoes for us.
So you referenced Fearfully andWonderfully Made, which is a
great book, might I?
Speaker 1 (13:07):
add.
Speaker 2 (13:08):
So it made me think about that and I thought I just
have to comment on that.
Speaker 1 (13:11):
Well, I'm glad you did, Because I think that, in
order for us to have going backto your comment about
intrapersonal awareness, is thatthat mindfulness takes us back
to that and being aware of who Iam.
Our intrapersonal awareness, orintra psyche awareness, really
(13:32):
is just a fancy way to sayself-awareness, and I think that
there's so much there.
We often look at what arememories for right.
We think that memories.
Often we think that memoriesare to orient us to the past.
They're really not.
Memories are to orient us to thepresent, so that we don't have
(13:54):
to use so much of this big brainthat we've been given to
assimilate what is in thepresent, because our memories
help us conceptualize what we'reexperiencing in the now.
And so for us to be hamstrung oranchored to the past doesn't
(14:16):
allow us to be in the present.
And it's not that we want toavoid the thoughts of the past
doesn't allow us to be in thepresent.
And it's not that we want toavoid the thoughts of the past.
We want to assimilate thethoughts of the past.
And that's one of the reasonswhy I fell in love with the
CBASP, the cognitive behavioralanalysis systems of
psychotherapy that my, that mymentor designed or developed is
(14:37):
because it truly is a adeepening awareness of how the
present is informed by the past,but it is not dictated by the
past.
Oh yes, and that's just such aa powerful thing is when
watching people discriminate thepresent from the past.
(15:01):
That's when I see a lot ofopening up, since you're
bringing that up something wewere chatting about earlier.
Speaker 2 (15:11):
As I was reflecting about our meeting today, I was
thinking what are the thingsthat I commonly hear and
commonly see?
And one thing that I docommonly see has to do with this
notion of past decisions andpresent life and what your
future life will be.
So a lot of people that I talkwith, whether I'm seeing them as
(15:32):
a psychiatrist or I'm doing acoaching session with them, they
get trapped in these feelingsof remorse and regret about
either choices they could havemade but did not in other words,
paths they could have taken butfor whatever reason or reason,
they didn't or a path they didtake and the way that path led
(15:52):
their life to become.
And they feel stuck in that, asif I can't shift, I can't look
at things differently.
Frequently, it's because theyhave these ideas they've
developed about.
Well, this is where I would betoday, or this is how my life
would be today, if I had eithertaken that path or I didn't take
(16:13):
this path.
And I was talking about the factI was reading a fictional novel
called the Midnight Library,where this mid-30s lady finds
herself.
This won't ruin the book foranyone if they decide to read it
.
It's a fictional book that hasa good premise.
This woman finds herself inthis midnight library.
(16:33):
That has to do with all thesechoices she could have made.
She could have chosen to dosomething differently and her
life would have had thisdevelopment, and so there were
infinite possible lives shecould have lived.
Interestingly, if you payattention to this and you read
that book, you'll find thingsaren't always the way she
(16:54):
thought they would turn out.
And that's why I'm using that asan illustration, because I
think for all of us, we have tomake choice points in the moment
in terms of using theinformation.
We have to make the bestdecision we can at the time.
Then, later, when we'redisappointed, we have to be
(17:15):
careful not to get trapped inthe quicksand of those feelings
of remorse and regret, insteadto say, okay, what did I learn
from that choice?
What came of that choice?
How do I wish things would bedifferently?
And in the moment where I'mliving now, what do I need to
put into place to develop a pathforward?
(17:36):
And that is just reallycritical.
I think and that's a lot aboutwhat my book is about it's
helping.
It's a very straightforward,simple tool to help people be
able to do just that, to pausethe moment and say how do I
develop a plan to move in thedirection I want to go?
What do I need to assess tofigure that out?
(17:56):
And that's what the book is.
What do I need to assess tofigure that?
Speaker 1 (17:59):
out, and that's what the book is.
It's a guide for that, you know.
I think that's so needed.
What we found in our depressionstudy was overwhelmingly for
the participants problem solvingis what resolved a several
decade long chronic sense ofdepression.
There you go, and I've beendoing a lot of research recently
(18:21):
looking at outcomes, and what'ssuper interesting to me is that
most of the outcome data that'spositive in mental health or in
in the treatment world has todo with skills.
Yes, it's skills.
Speaker 2 (18:38):
It do with skills.
Speaker 1 (18:39):
Yes, it's skills, it's acquiring skills, it's
learning acquisition.
That is the I don't want to saythe predictor, but it sure has
been shown in outcome data thatlearning acquisition is the most
solid uh Indicator Of positiveoutcomes.
(18:59):
And what you're talking aboutin your in your book, mastering
your Storm, is putting a pathway.
That's teaching skills, whichis again a positive predictor
for outcomes.
That's really cool.
Speaker 2 (19:14):
It is cool.
The piece of it that I reallylike a great deal is that by
teaching skills, you empowerpeople to be able to be in
charge of their life in thepresent and the direction
they're going.
Yeah, and then, whatever youencounter in that direction you
go, you have ways to cope anddeal with it through the skills
(19:36):
you've acquired.
Yeah, yeah, to cope and dealwith it through the skills
you've acquired.
Speaker 1 (19:39):
Yeah, yeah, and there's that, like you said, I
love that, that sense ofpersonal agency, yes, which goes
back to one of my favoritethings to talk about is that
whole sense of self-awareness,that intrapersonal awareness is
that when I learn what I, what'sgoing on inside of me, then I
(20:00):
know how to bring me to we yes.
And I may not be met.
I mean, I may not be met withwhat I'm wanting from someone,
but if I give what I wanted togive out of, if I did what I
wanted to do, the behaviors thatI wanted out of me, then I can
have a certain sense ofaccomplishment from that.
Yes, I can't control theenvironment, but, you're, I can
have a certain sense ofaccomplishment from that yes.
(20:21):
I can't control the environment,but you're setting people up
for a sense of agency.
And did you say that there wereseven different domains that
you touch on in your book?
Speaker 2 (20:32):
Well, let me pause here and see which ones I do
talk about.
I begin the book by talkingabout why you picked up the book
in the first place.
If you don't know anythingabout mindfulness, I have a very
straightforward each chapter isabout five to seven pages short
guide as to how you can look atmindfulness for yourself,
because we all have to begrounded in a sense of the
present to evaluate where we arein the moment, to be able to
(20:54):
move forward.
I talk about intention.
I believe all of us haveintention about things in our
life, but we don't always labelit or understand that.
So, I talk about that.
I talk about being able todevelop resilience, because I
have found all of us have thingsthat we've either done that we
(21:15):
have negative feelings about, orwe have negative feelings about
choices we didn't take.
Resilience comes sometimes fromhaving those experiences, and I
talk about ways you can developresilience without having to
have a negative experience.
So sort of talk about all ofthat.
And I talk about action,accountability, how you set that
, and then I say okay, I wantyou just to take a moment to
(21:38):
look at these different areas ofyour life.
So I ask people to look at thephysical area of their life.
It's a very high-level overviewbecause that could be a huge
book in and of itself.
Speaker 1 (21:47):
Right, each of these topics could go.
Each topic, yeah.
Speaker 2 (21:50):
And what I do at the very end is, for each chapter I
give two or three books that ifpeople want to take deeper dives
they can read about that haveto do with those specific topics
.
I talk about your emotional orpsychological self, because if
your physical self and youremotional self is not on track,
you're going to have a lot ofdifficulties and issues.
(22:11):
We have a whole career based ondealing with people with their
emotional and psychologicalareas of their lives, us and
several other people, areas oftheir lives, us and several
other people.
I talk about the spiritualdomains of your life, because
everyone does have a spiritualdomain, and I talk about how you
look at that, how you exploreit, how you get help for that.
I talk about the financialaspects of your life.
(22:34):
You must be able to have someway to manage those things.
I talk about the relationshipaspect, because we all have
relationships with other people,and then I talk about the
intellectual aspects of yourlife.
So there's about six differentareas I talk about In the
intellectual aspects.
I pull into that.
(22:55):
It's the things that we use ourbrains for that are related to
work, but it's also related tothings we have intellectual
interest and pursuits in.
I think the happiest people Iknow are the people who remain
curious and continue to learn.
I mean, lee, I look at you.
You've mastered severaldifferent areas of therapy.
Then you decided to go back andget a doctorate and master this
(23:18):
other area and you did thatafter you had a very full career
.
You could have just said youknow what I'm done with learning
, I've learned what I need toknow, but you're a lifelong
learner and I think the happiestpeople and the healthiest
people are those who arelifelong learners, so I was sure
to comment on that as well.
I ask people to look at allthese areas and then I ask them
(23:40):
to say to themselves which areado I think I need to really
focus on the most right now asthe area that is interfering
with my ability to move forwardwith the plan.
Then I help them withdeveloping a plan how to do that
.
Speaker 1 (23:55):
I think that's wonderful because you know your
statement about curiosity andlifelong learning.
Boy, first of all, thank youfor the feedback.
That means a lot, especiallycoming from you, because I feel
like you've had such an up-closeview to my world and I
appreciate that feedback andthat observation.
Speaker 2 (24:15):
Well, you know, you've mastered so many
different areas of therapy, andrelationship is a big part of
that.
You took your intellectualinterest and then you began to
realize there's the emotionaland the psychological and then
the relationship, so you reallymerged three areas there.
Speaker 1 (24:36):
Thank you, and you know the.
The thing that really standsout to me in this is the idea
that with we, we don't.
This isn't about conquering,mastering your storm is not
about conquering something andthen setting it in mothballs or
cold storage and saying I'veconquered it, I'm finished, I am
(25:00):
, I'm good in this area and Idon't need to ever evaluate it
again.
Evaluation we I, in other wordsI.
I would hate for someone to seelife's growth as a burden.
It is an opportunity.
It's an opportunity to enjoy, toenjoy learning more about, I
(25:22):
mean, cause.
I appreciate you bringing upthat point.
I love learning about humanbehavior and at some point you,
you know do we stake a flag inthe ground and say I know all
there is to know?
I hope not, because I hope ourfield is ever changing, because
it is.
I mean, I was just goingthrough um psychological
bulletin, which is a reviewjournal and, for those of you
(25:45):
who don't know what reviewjournals are, it's a journal
that reviews, uh, research andwrites what's called a meta
analysis, which is a whole lotof review to review of a whole
lot of different studies andpulling together the themes that
they see in all these differentstudies.
And I was going through andreviewing the themes that I see
(26:06):
in the outcome data and lookingat all of that.
And there was a, an articlepublished in this this past year
in 2023, and we call it psychbull and psychological bulletin
that was going through anddescribing almost in detail not
(26:26):
bringing up a Jim's model theCBASP, but describing in detail
one of the exercises that isused in CBASP and saying how
important differentiation is andhow important this emotional
understanding of self is.
And I'm thinking to myself.
You don't realize it, butyou're describing all of the
(26:47):
reasons why Jim, in the 1970s,developed this program.
Yes, and it was all thescientific understandings of why
he had intuitively seensomething 50 years ago.
And I just think about how ourfield is continuously moving and
(27:09):
changing, so of course we'renever going to stake that flag.
Speaker 2 (27:12):
Never.
It's going to always bechanging as we move forward, and
I hope it's not burdensome.
Oh well, you know, and you talkabout growth.
I want to comment on thatbecause I also think if every
person in their life embracesthe concept of, I will be
growing throughout my life.
You know, Eric Erickson hasstages of development that go
(27:35):
all the way through to the endof life.
I'm still working on some.
So you know, you just keepworking on those and I hope you
keep working, because I want youto live a very long life.
I'm still working on some, youknow, so you know you just keep
working on those.
Speaker 1 (27:41):
And I hope you keep working because I want you to
live a very long life.
Speaker 2 (27:46):
But you know, we just work on all these things as we
grow.
I think if people can embracethe idea that growth may feel
uncomfortable at times andthat's okay, that's a part of
life, and if they can embracethe idea of I may feel a little
unstable when I'm growing or I'mchanging or there's other areas
(28:07):
of my life that I may need toreach out and get some sort of
help.
You know, you and I weretalking about the concept of
intensive outpatient program,which is a form of outpatient
therapy.
You all do it here atRestoration right here in Fort
Worth, Texas, and do an amazingjob I'm involved with-.
Speaker 1 (28:23):
In Dallas as well.
Speaker 2 (28:24):
Yes, and in Dallas too, I'm involved with
Connections Wellness Group,which has intensive outpatient
programming more north of hereand more south of here.
We're up in the Plano McKinneyarea, then we're more south down
Arlington, mansfield, and weeven have some programs in
Tennessee.
But the intensive outpatientprogramming is a really good way
for people to go and addresssome things that are going on in
(28:48):
their life, whether it's withrelationships, their emotions,
their psychological well-being.
They're able to develop copingskills.
They're able to get somesupport, because we all need
that support at times and bydoing this they can grow, they
can make positive changes andit's a form of therapy.
And people who do intensiveoutpatient programming may not
(29:10):
even need to be on medications.
I'm coming all the way backaround to medications that you
brought at the beginning.
People on medications canbenefit from that, obviously,
but many people who just needmore intensive therapy can
really benefit from intensiveoutpatient programming.
Speaker 1 (29:26):
That's true.
Speaker 2 (29:27):
So you were talking earlier about mental health and
people asking about reallyserious mental health issues and
other types of issues.
I think we have to think ofmental health like everything
else.
It's a continuum.
That's right.
Everyone in their life willhave some mental health concerns
they're going to need toaddress.
Speaker 1 (29:45):
That's right.
Speaker 2 (29:45):
Grief is one, Loss is one.
These are important matters.
When we talk about thecontinuum, though, we talk about
the common experiences everyonehas.
Then we talk about some of thethings that are illnesses that
are not as common.
You'd mentioned bipolardisorder.
It's a small percentage of thepopulation, but it's very
genetic.
It's very biological, such asschizophrenia.
(30:06):
That is as well.
1% of the population Very smallpercentage impacted.
I think.
The thing about mental health wethink about, though, is there's
wonderful and robust data andtreatment for the common
experiences we all have, such asgrief and loss, all the way to
the more serious implications,such as people who are out of
(30:30):
touch with reality or with, asin bipolar disorder.
They are impacted in a way thatthey're not sleeping, they're
not eating, and they need tostay on routine medications just
to help them function well.
That being said, some of themost brilliant people I know
have bipolar disorder, and whenthey take their medications and
(30:50):
stay on them, they're incrediblyfunctional, and so I think
that's the good news I want tosay about mental health.
We've learned so much, but it'sa field we're going to keep
growing and learning about moreas time goes on.
It makes it exciting, for usExactly.
Speaker 1 (31:03):
I love that you use that term excited because it's
exciting, because one of thethings that I've seen in
treating people with bipolar isthat working to get the
medication right for thatindividual or the treatment
correct for that individual isthat I would hear a lot of, not
a lot.
I would hear a number ofindividuals say it way.
(31:24):
I went from living intechnicolor, dealing with that
true sense of mania, to I wentto living in the gray, and the
gray was so just depressing thatit would send me into a
depression.
And one thing that we know tobe true is that bipolar
depression is so much deeper,it's so incredibly painful, that
(31:47):
it's like they would just thecontrolling that sense of mania
would send them into a bipolardepression which is just harsh.
Speaker 2 (31:56):
There are people with bipolar 2 disorder who may not
be fully manic and they ask thequestion often is how do I know
I'm bipolar?
Here's a really good yardstick.
If you've been treated with twoor three different medications
for depression and you're doingtherapy and you can't seem to
get better, ask your doctor ifthere's a possibility you could
have a variant of bipolardisorder.
That's often a good yardstick.
Speaker 1 (32:18):
That's great, that's great.
Disorder that's often a goodyardstick.
That's great, that's great.
Well, I just want to say thankyou again for coming and talking
with us and sharing all of yourwisdom and insight with our
listeners, and your book yourbook is is available in at
Amazon and everywhere that sellsbooks.
Yes, and there's a Kindleversion coming up.
Speaker 2 (32:37):
Yes, there is a Kindle version and a paperback
version at this time Awesome.
Speaker 1 (32:42):
Well, thanks again.
Speaker 2 (32:43):
Well, thank you for having me, it's been fun talking
as always, as always.
Speaker 3 (32:48):
All right.
Thank you.
If you found value in ourdiscussion and wish to uncover
more about the fascinating worldof mental wellness, don't
forget to subscribe to thepodcast.
Stay tuned for our upcomingepisodes, where Dr Long will
continue to delve intoempowering therapies and
strategies for mental wellness.
Your journey to understandingand embracing mental health is
(33:08):
just beginning and we're excitedto have you with us every step
of the way.
Until next time, keep exploring, keep growing and remember to
celebrate restored freedom asyou uncover it.
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