May 15, 2025 • 30 mins
May is National Mental Health Awareness Month. Manny Munoz spoke with Dr. Ken Duckworth of the National Alliance on Mental Illness about that, the stigma surrounding mental illness in our country and his book, You Are Not Alone.
AND, 1 in 3 US Adults has Hypertension……High Blood pressure…….do you know what causes it? How to treat it? More importantly, how to prevent it?
Dr. Clyde Yancy, Chief of Cardiology in the Department of Medicine at Northwestern University, answers those questions and more.
AND, 1 in 3 US Adults has Hypertension……High Blood pressure…….do you know what causes it? How to treat it? More importantly, how to prevent it?
Dr. Clyde Yancy, Chief of Cardiology in the Department of Medicine at Northwestern University, answers those questions and more.
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Transcript
Episode Transcript
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Speaker 1 (00:01):
Welcome to iHeartRadio Communities, a public affairs special focusing on
the biggest issues in facting you this week.
Speaker 2 (00:09):
Here's many Munyos and welcome to another edition of Iheartradios Communities.
As you heard, I am Manny. Munyo's May is National
Mental Health Awareness Month, and it is an issue that
has drawn increase attention, in part because of all the
stigma that still surrounds discussing mental health issues. Lucky to
(00:31):
be joined right now by doctor Ken Duckworth with the
National Alliance on Mental Health. He has also written the
book You Are Not Alone, which we will discuss here
in a moment. Doctor Duckworth, I appreciate your time, thanks
for joining us.
Speaker 1 (00:43):
Manny, I want to thank you for taking an interest
in this critical topic.
Speaker 2 (00:46):
Yeah, it really is, and it's increasingly top of mind
in our country. Let me start off with National Mental
Health Awareness Month. What is the purpose of that title
for this month?
Speaker 1 (00:58):
Congress made this designation that a month should be set
aside to attend to the critical aspect of human experience,
which is our own mental health. And anybody who's traveled
in these waters knows that there's no health without mental health.
And so maybe simply an opportunity for us to renew
our focus on this critical aspect of living.
Speaker 2 (01:23):
What exactly are we talking about when we discuss mental health?
Speaker 1 (01:28):
Uh, mental health you know, is defined in brief, you know,
as the ability to love and work and live a
full life, full of purpose and connection. A lot of
mental health conditions get in the way of that, and
a lot of circumstances get in the way of that.
So you know, about one in five Americans more if
(01:51):
you look at the numbers, but with some kind of
mental health condition, whether that's an anxiety disorder, which is
the most common set of conditions. This include anic attacks,
generalize anxiety, depression, major depression, difficulty getting out of bed,
getting going, that's the second most common area. Vulnerabilities to addiction,
(02:11):
whether that's you know, alcohol or other substances, by polar disorder, schizophrenia.
These are the things that you know, are really of
interest because these all have treatments, Services can be provided,
People can be brought in who live with these conditions
to help others. So that's why I love mental health
(02:32):
awareness Monk, and I am grateful to be on this show.
Speaker 2 (02:35):
Manny Well, I appreciate you coming on to join us
and explain these things to us. Where is the line
between somebody, for example, that is stressed and maybe feeling
down and somebody who is clinically depressed.
Speaker 1 (02:49):
Excellent question, Manny.
Speaker 3 (02:51):
I love this question.
Speaker 1 (02:53):
Really have to look at both functionality and duration. So
are you able to participate in work, work, and love?
Do the people in your relationship say, you know, Ken,
you're really off your game in a fundamental way. Now,
that could be true for two days, and that's not
typically a mental health condition. But also duration comes into play.
(03:15):
This has been going on for weeks, and those two
things together separate kind of a different human experience from
a more complex kind of biological reaction to difficult experience.
Speaker 2 (03:31):
I guess the big problem with all of these issues
is one being diagnosed, and you can't be diagnosed until
you come forward and admit you believe you might have
a problem. Is that the biggest issue we have in
our country right now with mental health?
Speaker 1 (03:45):
That's one of our issues, Manny. We also don't have
precision in our diagnostic scheme, but I work for the
National Alliance on Mental Illness. Our sister agency, mental Health America,
has screening tools that you can take online. For things
like depression, anxiety, and trauma. These screening tools are the
same ones you would get in your doctor's office. Right,
(04:08):
So while it's best to come forward and to connect
with a human being, you know, to actually work with
somebody who can interpret your results and actually talk to
you about your experience, you can do these screening tools,
and I commend them to people who are like, you know,
how far have I gotten down this road?
Speaker 2 (04:27):
Right?
Speaker 1 (04:28):
Perhaps I should take a screening evaluation and sort this
for myself. That is not a diagnosis, it's a screening fast.
But like you take your blood pressure at the pharmacy
and it doesn't look right, that doesn't mean you should
get on med. That means you should talk to somebody
who knows what they're doing and use that first screening
assessment as a way to follow up and get a
(04:51):
more precise answer to what is my blood pressure and
how do I treat it?
Speaker 2 (04:54):
Are all of these things, whether it be depression or
addiction or a schizophreny or any of the number issues,
are they all just chemical imbalances in the brain.
Speaker 1 (05:06):
Yeah, we don't use those terms because I think it's
more honest to say we don't understand the human brain
well enough to know what causes voices, what causes people
to live with severe mood swings, what causes people to
have panic attacks when they start today that we were
(05:27):
I think chemical imbalance was an old fashioned shorthand to
explain something. I think a more honest answer now is
the brain is really hard to understand, and these are
kind of pathways that you get in terms of behavior
that are seen all around the world. People have panic
attacks in Spain, people of the schizophrenia and Russia. Bipolar
(05:48):
disorder is found in Australia. So these aren't really cultural
constructs right so much. The variability may differ in different ways,
but I don't think of these as a chemical imbalance.
It's a combination of genes and environment, which is really unsatisfying,
isn't it, Because that right, well, I wish I had
(06:12):
better answers, but I think it's better to be honest
with people. And it's also important, I think, to let
people know that you can get help for these things,
even as we don't understand them at the level of
precision that we want at the brain level, you can
still get help for things, and I think that's important
for all these mental health conditions. There are very good treatments,
(06:36):
there's very good research to back up those interventions, and
you know it's not always easy to get them. I
devoted one of the chapters to Nami's first book, You
are not alone to how to find help minding the
many gaps because our system is not set up to
make things simple and easy. So, as you mentioned, Manny,
(06:58):
you have to overcome your initial resistance. Might I be
living with something you identified a brilliant point, which is
society doesn't necessarily make it easy to join a club
of people who may be struggling with their mental health.
But in addition to that, mental health coverage differs by
health insurance. Every Medicaid is different in every state. Some
(07:20):
providers take no insurance, some providers take your insurance. Some
providers change insurance what they take while while you're working
with them. So I would say it's a chaotic, fragmented
care system filled with really good people. And I want
to emphasize, you know, I don't blame the professionals or
the peers, which are people living with mental health conditions
(07:43):
who are providing these care, but the system around them
is complex and very hard to navigate them.
Speaker 2 (07:51):
A few minutes, a few more minutes here with doctor
Ken duck Duckworth with the National Alliance on Mental Health,
And I want to get to your book. You were
not alone in a moment, but you talked there about
getting health and help, and there's so much help that
people with these conditions can get. The problem is admitting
to yourself one that you might need help, and two
(08:12):
the stigma that comes along with every different kind of
mental health issue, mental illness in our country. Do you
find do you find that holds people back from actually
getting help or getting a diagnosis?
Speaker 1 (08:26):
Even I do think that's holding people back, and I
think it's true in some subcultures of our society more
than others. So I became a psychiatrist. My dad was
a wonderful man with terrible bipolar disorder. And I'm older
than you, Manny, I have gray hair.
Speaker 2 (08:42):
I have plenty of gray hair myself.
Speaker 1 (08:44):
Oh no, you look fantastic on your picture, thank you.
But the seventies, eighties, and nineties, you know, he would
have these episodes of mania and psychosis and nobody would
talk about it. And in writing AMI's book, I've been
so pressed at how much there are hundreds of people
who would be happy to use their name and share
(09:06):
what they have learned. My dad would not have been
one of those people. He was too full of shame
and concern that people would, you know, find out about it.
But in You Are Not Alone, Nami's first book, I've
run across thousands of people and I interviewed one hundred
and thirty of them who use their names and say
where they're from. How did they come to terms with
(09:27):
their diagnosis, How did they explain it to their girlfriend?
How do their family members work with them to provide
support for them? So the idea was kind of radical.
You know, real people have learned things and this is
the known as the lived experience movement. I love science.
(09:47):
I'm a doctor, right, I love all that stuff. Science
is in the book too, So it's not an either
or equation. It's a both and perspective. But if you've
lived with depression for a decade, you've probably learned. If
you loved somebody who has chilophrenia, you pick something up
over time about the best way to communicate and support
the person. That's the essence of the book. All the
(10:09):
royalties go to Nami, so I plug it with no
anxiety about self promotion because the book is our collective project.
NAMI is the largest mental health group in the country,
and there are support groups and educations all across America.
And if you go to NOMI dot org you can
find people who are living with mental health conditions or
(10:31):
love people who do, and get support and education. And
what this is is a volunteer army of people who
don't want others to feel alone. So I'm very proud
to work for this organization. It's kind of a dream
job for somebody, you know, who lived with a loving
dad and thought, God, a world should be a better
place for people. It was not his fault that he
(10:53):
hit bipolar disorder, but our society hadn't really supported him
to own it and accept it, and so he battled
with that his whole life. And now you know, No
Me is part of this movement, and I want to
thank you for having me on iHeartRadio, you know, to
help people think about the possibility, you know, that maybe
they are living with a mental health condition. And that
(11:17):
doesn't mean that there's anything wrong with you. It's information
about yourself.
Speaker 2 (11:21):
Yeah, any different than having high blood pressure or diabetes
or anything else.
Speaker 1 (11:27):
Yeah, that's right, and the National Alliance unless your local
chapter no MEI dot org will also be able to
help you find guidance on how to get the help
you deserve, just as you deserve to not you know,
have untreated diabetes and all the complexity for that. Right,
people deserve to have their mental health attended to and treated.
Speaker 2 (11:50):
N A m I. Dot org is the website dot org.
Let's let's back off a little bit from the mental
illness part of it. How about we close this out
just talking about regular everyday stress. We live in a
chaotic world. Everybody's lives can be chaotic. How do we
deal with that and make sure that just run of
(12:12):
the mill stress doesn't get the better of us and
get to something worse than that.
Speaker 1 (12:17):
But that's a great question. You know, I'm a big
fan of human connection. Somebody to talk to, having a
best friend, a poker group, a book club, human connections.
Speaker 3 (12:27):
Right.
Speaker 1 (12:27):
We think we all learned during the pandemic, manny, how
dependent we are upon human connection. Yeah, whether it's friendship,
a relationship, whe's just a person who's making your coffee
at Dunkin Donuts. I'm from Boston, ring every corner there's
a dunkin donut, but the connection with that person, it's
the same person. Hey, Ken, the regular, the usual today, Yes,
(12:50):
the usual. You know, human connection is important. Isolation is
very hard on our mental health. We have definitely learned
that the mind is connected to the body. So move
if you can, so you know, if you have access
to a park or nature, or you get a dog
who demands that you walk that dog. Movement for the
(13:12):
body is actually protective against anxiety and depression. They still
may need other treatments, but I think the idea of connections, relationships, exercise,
being in nature, if you can getting a dog, if
you have the occasion to get you know, if you
live in a place that's allowed to have a dog,
if you can afford a dog, you can share a
(13:34):
dog with a couple of neighbors and just walk the
dog three days a week. Again, companions and movement, those
are two things I like. Support groups. I had a
couple family members die and you know, I went through
some grief and I intended to support group around grief
and loss. And again it's not really a mental health condition,
(13:58):
but it could have become one. And I just thought
then this was an Anomi group I happen to love
the Nationaliance, some medal list and all the support and
education we provide. It's going to have a more traditional
grief group, and I thought I should talk to other
people because I know this is an ordinary human experience.
It was just hitting me so hard and I thought,
(14:19):
I'm just gonna, you know, break down and just be
part of a grief support group. Again. It was a
short lived thing, but I think it got helped me
to get through a little rough patch in my own life.
But you got to continue your relationships, your connections. If
you have a best friend from high school or college,
(14:40):
call them, Cherish them. They're doing something for your mental health,
even if they don't know it right. Just by knowing
you and supporting you in all these years as you
have them, it makes a difference for people.
Speaker 2 (14:51):
Yeah, and just ignoring the signs aren't going to make
anything better. We can't just put it on the back
burner and think that it's going to go away, doctor
Ke National Alliance on Mental Health. The website for NAMI,
the National Alliance of Mental Illness is NAMI dot org
and the book is titled You Are Not Alone. Doctor Duckworth.
(15:14):
I really appreciate the time.
Speaker 1 (15:15):
Be well. Thanks so much, Manny, thank you so much.
Take you care, holl bye.
Speaker 2 (15:21):
One in three adults in the United States has high
pertension high blood pressure. Do you know what causes it,
how to treat it, more importantly, how to prevent it? Well,
may happens to be National High blood Pressure Education Month.
So let's discuss all of those things as we bring
in doctor Clyde Yancey. He's chief of Cardiology in the
Department of Medicine at Northwestern University. Doctor Yancey, thanks so
(15:45):
much for the time.
Speaker 3 (15:46):
I am delighted to be here. This is such an
important conversation and I think we should expand all of
the questions he just presented.
Speaker 2 (15:54):
Yeah, well, I look forward to speaking to you about them.
What does it mean to have high blood pressure? How
about we begin there?
Speaker 3 (16:00):
So let's start at the very beginning. Part of what
the heart does so beautifully for us is to distribute
blood throughout the body. The heart is an organ, it's
actually a muscle. In addition to its other functions. That
muscle pumps blood through the body. So our lay assessment
(16:21):
of what the heart does is exactly correct. Correct That
blood that is pumped through the body comes out with force.
So that force is something that is measurable. We measure
it as pressure. There is a normal amount of force,
but there's also an elevated amount of force, and when
that force is elevated, it has consequences. Imagine the flow
(16:45):
of water through a garden hose, if there are those
who still do those kind of things. If the flow
is ginger and gentle, it just waters along without any problem.
But if it's forceful, the water is flowing, yes, but
that forceful flow of water, just like a fire hydrant,
it has consequences, can actually cause harm. Same thing in
(17:06):
our vascular system.
Speaker 2 (17:08):
How is a high blood pressure what we're talking about hypertension,
different than for example, me a middle aged guy sprinting
forty yards, and how my blood pressure will rise in
that context.
Speaker 3 (17:23):
So that's a brilliant question because it's the heart's ability
to adapt to all the different things we do in life.
Whether we're resting and lying still, whether we're digesting a meal,
or whether we're exercising, it is appropriate for your heart
function to increase. So that force that we talked about
will increase, the blood pressure will increase. But we call
(17:45):
that very carefully. We call that a physiologic meaning that's
a normal increase. But imagine what happens if your pressure,
your force increases because you're exercising, but you're not exercising,
you're just living with that increase. That's high blood pressure.
Speaker 2 (18:02):
What contributes to high blood pressure, to high pertension.
Speaker 3 (18:06):
We understand that what contributes to it, and that is
the right word, because we're still trying to understand what
causes high blood pressure. But we know that what contributes
to it is one part your family, one part perhaps
your ancestry, a big part your living circumstances, your life
and living conditions, a big part your diet. So those
(18:28):
persons that take in salt and are sensitive to salt
may have a higher blood pressure. Those people that end
up being heavier will almost surely have high blood pressure.
Those persons who live in certain neighborhoods because of their
choices their lifestyle, may also have high blood pressure. And
guess what, if you know that your parents and your
(18:50):
grandparents are high blood pressure, you should be especially attuned
to the likelihood that you'll develop high blood pressure. But
let me just tell you one other thing that's incredibly important.
There are three inevitabilities in life, death, taxes, and high
blood pressure. What I mean by that ninety percent of
all of us are alive right now, ninety percent will
(19:12):
eventually develop high blood pressure. So we can basically check
the default button and say we all need to be aware.
Speaker 2 (19:19):
And am I doctor? My primary care physician has spoken
to me about that repeatedly, says, the older we get,
just naturally, our pressure will increase. Is that right?
Speaker 3 (19:28):
And the natural part of this is that the older
we get. What's not natural, But what happens, almost without fail,
is that our blood blood vessels get more stiff. And
that stiffening of our blood vessels again comes from all
the things which we're exposed, does come from aging, does
come from being heavier. It's so important to recognize this
(19:50):
interrelatedness of being heavier, of becoming older, of maybe having
a tendency towards diabetes, these sorts of things all come together,
so it is inevitable. Your doctor is exactly right. But
what's naturalist not for your blood vescals to get more stiff.
It's how we live that makes how blood vescals get
more stiff, and thus nine out of ten of us
(20:13):
will end up having high blood pressure.
Speaker 2 (20:14):
That number that I started off with, one in three
adults in the United States has high pretension high blood pressure.
It feels like I've been hearing those numbers for decades.
Have they remained consistent? Have we made any improvement on
the number of Americans who have blood pressure?
Speaker 3 (20:33):
So where improvement has come is in the number of
Americans who know they have high blood pressure. For quite
some time, we've always known that about one third of
the population in our country at any one moment has
high blood pressure. But now a greater percentage of them
actually know that they have it. And I'll tell you
(20:54):
why that's so important. You don't need to immediately go
to drug therapy because you have high blood pressure. There
are many lifestyle changes that can actually help normalize the
blood pressure, but you don't know to make those changes
unless you are aware that your blood pursure is elevated.
So the awareness and detection programs that so many organizations
(21:15):
have promulgated are working, and people know that their blood
pressure is elevated. Now, one other number you talked about
the importance of this number. We can't overlook that one
in three number is across the board. That's correct, But
here is some more compelling number. One in four young
adults under the age of forty has high blood pressure.
(21:36):
One in four young adults, So that tells you that
beginning at age twenty five are even younger in some groups.
We need to be very conscious of our blood pressure.
Just like we know our cell phone numbers, we need
to know our blood pressure.
Speaker 2 (21:50):
A few more minutes here with doctor Clyde Yancey's chief
of cardiology in the Department of Medicine at Northwestern University,
want to unpack a little bit of that very easy
to treat these days with medication, very inexpensive medication quite often,
but I wonder if people try to if people turn
(22:10):
to that first as opposed to making changes in their lifestyle,
then might be able to control their blood pressure.
Speaker 3 (22:16):
I can absolutely promise you that if someone is seen
in my office, the conversation goes like this, we've identified
that you have blood pressure almost invariably is based on
home blood pressures and not the blood pressure in the office,
and I will tell them the first step is not
using drugs. The first step is lifestyle. And I will
go through all of the necessary motions, and I'll tell
(22:38):
you very quickly. For every kilogram of weight loss two pounds,
your blood pressure goes down by a point. That means
if you can get to ten kilograms of weight loss
about twenty pounds a little bit more, your blood pressure
will come down substantially. Increase your physical activity, cuts your
alcohol content in half, don't smoke. Increase your consumption not
only of fruits and vegetables, You've heard that so many times,
(23:01):
but increase your consumption of potassium, and decrease your consumption
of sodium. Those are the non drug strategies that will
effectively treat your blood pressure, but particularly weight loss.
Speaker 2 (23:13):
What is it about salt that contributes to high blood pressure?
Because let's face it, a steak ain't the same without salt.
Speaker 3 (23:22):
We can talk about eating the steak at another time.
Speaker 2 (23:25):
Yeah, I imagine that contributes to it a bit as well,
but just the salt portion of it, because I remember,
you know the Dash diet and now there's like low salt,
salt and things like that. But just not the same, is.
Speaker 3 (23:37):
It, And some people not everyone. Salt causes fluid retention,
and it's the fluid retention that expands the blood vessels
and goes back to opening conversation and keeps that force elevated.
But what makes this fascinating is that in population health,
where we've been able to replace sodium chloride with potassium chloride,
(24:01):
that step alone, without changing the palatability of food, that
is the taste of food, lowers blood pressure. And so
the idea of switching from salt as you know it
as I know it to potassium instead of sodium and
the right individual has some benefit.
Speaker 2 (24:17):
What is potassium chloride? Can I buy that at the
grocery store and put it on my steak?
Speaker 3 (24:23):
You know what? You can do one step better than that.
You can walk down the spice out and you can
look for no salt inn oh salt right, look at
the label and almost invariably that is your potassium chloride.
Speaker 2 (24:35):
That's it fascinating. We kind of referred to this a
little bit earlier. Early detection really is the key in
determining all of these things. And unless somebody is going
to get regular checkups on a yearly basis or more
often than that, chances are you're probably not going to
know that you have high blood pressure just from living
your life. So how does somebody determine they have it
(24:59):
without going to see their doctor.
Speaker 3 (25:00):
Can they So many young adults have had pre participatory
physical examinations for sports, whether it's club sports, high school sports,
college sports. There's your blood pressure. So many women of
course for pregnancy must have the blood pressure determined. So
there is another way you know this. But guess what.
You can walk into virtually any commercial drug store, look
(25:22):
along the perimeter and you'll find a free automated blood
pressure cough. Point being that there's no way you can
avoid access to getting your blood pressure measured, even if
you duck into a fire station. There is a way
to get your blood pressure know. But the key point
is the one you've already made. You have to be
aware and so yes, blood pressure is ubiquitous, so many
(25:44):
people have it, But the knowledge is what we need
to make ubiquitous to know that everybody is likely to
develop high blood pressure sometimes. So one of the things
we talk about all the time, over and over and
over again. Know your numbers, know your blood pressure, know
your know your weight. These are the things that will
help you live along in healthy life.
Speaker 2 (26:05):
Stress, sleep quality, mental health. All of those things, how
do they potentially influence our blood pressure?
Speaker 3 (26:13):
It's pretty clear that sleeping less than six hours a
night is definitely associated with an increase in blood pressure,
and an increase in the more difficult patterns of blood pressure.
That's another conversation. It's also fairly clear that stress in
the global context, whether it's worry that is, whether it's
(26:33):
mental stress, but also stress in life, anxiety about a job,
anxiety about an interpersonal relationship, all of that stress becomes
manifest as something biological. We think that the biology there
is that it's inflammation. Think of getting a mosquito bite
and look at how your skin gets rid. Stress does
that to our body. It causes our body to become inflamed,
(26:56):
and that leads to high blood pressure. So you are correct,
lack of slave being stress, those things increase our blood pressure,
just like alcohol does.
Speaker 2 (27:06):
How much of those numbers, and again will refer to
them one in three adults, you said, I think one
in four of adults under the age of just say
twenty five have high blood.
Speaker 3 (27:17):
Under the age of forty twenty five, one in four adults.
Speaker 2 (27:20):
One in four adults under the age of forty have it.
How much of that is associated with the culture in
our country, the diet compared to other countries.
Speaker 3 (27:33):
I want to be very clear about this. We think
most of it is in fact related to our lifestyle. Now,
lifestyle is a little different from diet. It's one part died, yes, sure,
but lifestyle of physical inactivity, a lifestyle that predisposes our
young adults towards being heavier, a lifestyle that very much
gratuitously enjoys alcohol, and still tobacco. When you put all
(27:56):
of that together, alcohol, tobacco, being heavier, having a very
convenient lifestyle meaning using fast food products, not being physically active,
all of that relates to this burden of high blood
pressure and young adults. And again, know your family history.
Take some time and say, mom, pop, what runs in
our family? You should be aware.
Speaker 2 (28:17):
Two final questions for you. One third, maybe we can't
control genetic if our parents, our grandparents have had it.
Two thirds of this we can control what does hypertension,
high blood pressure potentially lead to.
Speaker 3 (28:34):
So we always think about this phenomenon of what happens
to the organs that face all of that extra force
that we talked about, the three organs we really were about.
The brain. High blood pressure definitely leads the strokes the heart.
High blood pressure is associated with heart attacks. Associated with
heart fillure and the kidneys for certain high blood pressures
(28:56):
associated with having weaker kidneys, and maybe even kidney failure.
But the most important message here is that it's so
eminently treatable. We have inexpensive drugs. Lifestyle is a benefit,
and what's most exciting is that for the first time
in over a decade, we have brand new therapies and
we have procedures that can help us really finesse control
(29:19):
of blood pressure. No one needs to suffer from high
blood pressure in our future. High technology is just that good.
Speaker 2 (29:25):
Early detection is the key, and there's a reason it's
called preventive medicine exactly. Doctor Clyde Yancey, chief of Cardiology
in the Department of Medicine at Northwestern University, truly appreciate
it for the time and the information. Thanks so much
for joining us.
Speaker 3 (29:41):
Thanks so much, and let's not forget know your numbers.
Speaker 2 (29:45):
And that'll do it for another edition of Iheartradios Communities.
I'm Manny Muno's until next time.
Welcome to iHeartRadio Communities, a public affairs special focusing on
the biggest issues in facting you this week.
Speaker 2 (00:09):
Here's many Munyos and welcome to another edition of Iheartradios Communities.
As you heard, I am Manny. Munyo's May is National
Mental Health Awareness Month, and it is an issue that
has drawn increase attention, in part because of all the
stigma that still surrounds discussing mental health issues. Lucky to
(00:31):
be joined right now by doctor Ken Duckworth with the
National Alliance on Mental Health. He has also written the
book You Are Not Alone, which we will discuss here
in a moment. Doctor Duckworth, I appreciate your time, thanks
for joining us.
Speaker 1 (00:43):
Manny, I want to thank you for taking an interest
in this critical topic.
Speaker 2 (00:46):
Yeah, it really is, and it's increasingly top of mind
in our country. Let me start off with National Mental
Health Awareness Month. What is the purpose of that title
for this month?
Speaker 1 (00:58):
Congress made this designation that a month should be set
aside to attend to the critical aspect of human experience,
which is our own mental health. And anybody who's traveled
in these waters knows that there's no health without mental health.
And so maybe simply an opportunity for us to renew
our focus on this critical aspect of living.
Speaker 2 (01:23):
What exactly are we talking about when we discuss mental health?
Speaker 1 (01:28):
Uh, mental health you know, is defined in brief, you know,
as the ability to love and work and live a
full life, full of purpose and connection. A lot of
mental health conditions get in the way of that, and
a lot of circumstances get in the way of that.
So you know, about one in five Americans more if
(01:51):
you look at the numbers, but with some kind of
mental health condition, whether that's an anxiety disorder, which is
the most common set of conditions. This include anic attacks,
generalize anxiety, depression, major depression, difficulty getting out of bed,
getting going, that's the second most common area. Vulnerabilities to addiction,
(02:11):
whether that's you know, alcohol or other substances, by polar disorder, schizophrenia.
These are the things that you know, are really of
interest because these all have treatments, Services can be provided,
People can be brought in who live with these conditions
to help others. So that's why I love mental health
(02:32):
awareness Monk, and I am grateful to be on this show.
Speaker 2 (02:35):
Manny Well, I appreciate you coming on to join us
and explain these things to us. Where is the line
between somebody, for example, that is stressed and maybe feeling
down and somebody who is clinically depressed.
Speaker 1 (02:49):
Excellent question, Manny.
Speaker 3 (02:51):
I love this question.
Speaker 1 (02:53):
Really have to look at both functionality and duration. So
are you able to participate in work, work, and love?
Do the people in your relationship say, you know, Ken,
you're really off your game in a fundamental way. Now,
that could be true for two days, and that's not
typically a mental health condition. But also duration comes into play.
(03:15):
This has been going on for weeks, and those two
things together separate kind of a different human experience from
a more complex kind of biological reaction to difficult experience.
Speaker 2 (03:31):
I guess the big problem with all of these issues
is one being diagnosed, and you can't be diagnosed until
you come forward and admit you believe you might have
a problem. Is that the biggest issue we have in
our country right now with mental health?
Speaker 1 (03:45):
That's one of our issues, Manny. We also don't have
precision in our diagnostic scheme, but I work for the
National Alliance on Mental Illness. Our sister agency, mental Health America,
has screening tools that you can take online. For things
like depression, anxiety, and trauma. These screening tools are the
same ones you would get in your doctor's office. Right,
(04:08):
So while it's best to come forward and to connect
with a human being, you know, to actually work with
somebody who can interpret your results and actually talk to
you about your experience, you can do these screening tools,
and I commend them to people who are like, you know,
how far have I gotten down this road?
Speaker 2 (04:27):
Right?
Speaker 1 (04:28):
Perhaps I should take a screening evaluation and sort this
for myself. That is not a diagnosis, it's a screening fast.
But like you take your blood pressure at the pharmacy
and it doesn't look right, that doesn't mean you should
get on med. That means you should talk to somebody
who knows what they're doing and use that first screening
assessment as a way to follow up and get a
(04:51):
more precise answer to what is my blood pressure and
how do I treat it?
Speaker 2 (04:54):
Are all of these things, whether it be depression or
addiction or a schizophreny or any of the number issues,
are they all just chemical imbalances in the brain.
Speaker 1 (05:06):
Yeah, we don't use those terms because I think it's
more honest to say we don't understand the human brain
well enough to know what causes voices, what causes people
to live with severe mood swings, what causes people to
have panic attacks when they start today that we were
(05:27):
I think chemical imbalance was an old fashioned shorthand to
explain something. I think a more honest answer now is
the brain is really hard to understand, and these are
kind of pathways that you get in terms of behavior
that are seen all around the world. People have panic
attacks in Spain, people of the schizophrenia and Russia. Bipolar
(05:48):
disorder is found in Australia. So these aren't really cultural
constructs right so much. The variability may differ in different ways,
but I don't think of these as a chemical imbalance.
It's a combination of genes and environment, which is really unsatisfying,
isn't it, Because that right, well, I wish I had
(06:12):
better answers, but I think it's better to be honest
with people. And it's also important, I think, to let
people know that you can get help for these things,
even as we don't understand them at the level of
precision that we want at the brain level, you can
still get help for things, and I think that's important
for all these mental health conditions. There are very good treatments,
(06:36):
there's very good research to back up those interventions, and
you know it's not always easy to get them. I
devoted one of the chapters to Nami's first book, You
are not alone to how to find help minding the
many gaps because our system is not set up to
make things simple and easy. So, as you mentioned, Manny,
(06:58):
you have to overcome your initial resistance. Might I be
living with something you identified a brilliant point, which is
society doesn't necessarily make it easy to join a club
of people who may be struggling with their mental health.
But in addition to that, mental health coverage differs by
health insurance. Every Medicaid is different in every state. Some
(07:20):
providers take no insurance, some providers take your insurance. Some
providers change insurance what they take while while you're working
with them. So I would say it's a chaotic, fragmented
care system filled with really good people. And I want
to emphasize, you know, I don't blame the professionals or
the peers, which are people living with mental health conditions
(07:43):
who are providing these care, but the system around them
is complex and very hard to navigate them.
Speaker 2 (07:51):
A few minutes, a few more minutes here with doctor
Ken duck Duckworth with the National Alliance on Mental Health,
And I want to get to your book. You were
not alone in a moment, but you talked there about
getting health and help, and there's so much help that
people with these conditions can get. The problem is admitting
to yourself one that you might need help, and two
(08:12):
the stigma that comes along with every different kind of
mental health issue, mental illness in our country. Do you
find do you find that holds people back from actually
getting help or getting a diagnosis?
Speaker 1 (08:26):
Even I do think that's holding people back, and I
think it's true in some subcultures of our society more
than others. So I became a psychiatrist. My dad was
a wonderful man with terrible bipolar disorder. And I'm older
than you, Manny, I have gray hair.
Speaker 2 (08:42):
I have plenty of gray hair myself.
Speaker 1 (08:44):
Oh no, you look fantastic on your picture, thank you.
But the seventies, eighties, and nineties, you know, he would
have these episodes of mania and psychosis and nobody would
talk about it. And in writing AMI's book, I've been
so pressed at how much there are hundreds of people
who would be happy to use their name and share
(09:06):
what they have learned. My dad would not have been
one of those people. He was too full of shame
and concern that people would, you know, find out about it.
But in You Are Not Alone, Nami's first book, I've
run across thousands of people and I interviewed one hundred
and thirty of them who use their names and say
where they're from. How did they come to terms with
(09:27):
their diagnosis, How did they explain it to their girlfriend?
How do their family members work with them to provide
support for them? So the idea was kind of radical.
You know, real people have learned things and this is
the known as the lived experience movement. I love science.
(09:47):
I'm a doctor, right, I love all that stuff. Science
is in the book too, So it's not an either
or equation. It's a both and perspective. But if you've
lived with depression for a decade, you've probably learned. If
you loved somebody who has chilophrenia, you pick something up
over time about the best way to communicate and support
the person. That's the essence of the book. All the
(10:09):
royalties go to Nami, so I plug it with no
anxiety about self promotion because the book is our collective project.
NAMI is the largest mental health group in the country,
and there are support groups and educations all across America.
And if you go to NOMI dot org you can
find people who are living with mental health conditions or
(10:31):
love people who do, and get support and education. And
what this is is a volunteer army of people who
don't want others to feel alone. So I'm very proud
to work for this organization. It's kind of a dream
job for somebody, you know, who lived with a loving
dad and thought, God, a world should be a better
place for people. It was not his fault that he
(10:53):
hit bipolar disorder, but our society hadn't really supported him
to own it and accept it, and so he battled
with that his whole life. And now you know, No
Me is part of this movement, and I want to
thank you for having me on iHeartRadio, you know, to
help people think about the possibility, you know, that maybe
they are living with a mental health condition. And that
(11:17):
doesn't mean that there's anything wrong with you. It's information
about yourself.
Speaker 2 (11:21):
Yeah, any different than having high blood pressure or diabetes
or anything else.
Speaker 1 (11:27):
Yeah, that's right, and the National Alliance unless your local
chapter no MEI dot org will also be able to
help you find guidance on how to get the help
you deserve, just as you deserve to not you know,
have untreated diabetes and all the complexity for that. Right,
people deserve to have their mental health attended to and treated.
Speaker 2 (11:50):
N A m I. Dot org is the website dot org.
Let's let's back off a little bit from the mental
illness part of it. How about we close this out
just talking about regular everyday stress. We live in a
chaotic world. Everybody's lives can be chaotic. How do we
deal with that and make sure that just run of
(12:12):
the mill stress doesn't get the better of us and
get to something worse than that.
Speaker 1 (12:17):
But that's a great question. You know, I'm a big
fan of human connection. Somebody to talk to, having a
best friend, a poker group, a book club, human connections.
Speaker 3 (12:27):
Right.
Speaker 1 (12:27):
We think we all learned during the pandemic, manny, how
dependent we are upon human connection. Yeah, whether it's friendship,
a relationship, whe's just a person who's making your coffee
at Dunkin Donuts. I'm from Boston, ring every corner there's
a dunkin donut, but the connection with that person, it's
the same person. Hey, Ken, the regular, the usual today, Yes,
(12:50):
the usual. You know, human connection is important. Isolation is
very hard on our mental health. We have definitely learned
that the mind is connected to the body. So move
if you can, so you know, if you have access
to a park or nature, or you get a dog
who demands that you walk that dog. Movement for the
(13:12):
body is actually protective against anxiety and depression. They still
may need other treatments, but I think the idea of connections, relationships, exercise,
being in nature, if you can getting a dog, if
you have the occasion to get you know, if you
live in a place that's allowed to have a dog,
if you can afford a dog, you can share a
(13:34):
dog with a couple of neighbors and just walk the
dog three days a week. Again, companions and movement, those
are two things I like. Support groups. I had a
couple family members die and you know, I went through
some grief and I intended to support group around grief
and loss. And again it's not really a mental health condition,
(13:58):
but it could have become one. And I just thought
then this was an Anomi group I happen to love
the Nationaliance, some medal list and all the support and
education we provide. It's going to have a more traditional
grief group, and I thought I should talk to other
people because I know this is an ordinary human experience.
It was just hitting me so hard and I thought,
(14:19):
I'm just gonna, you know, break down and just be
part of a grief support group. Again. It was a
short lived thing, but I think it got helped me
to get through a little rough patch in my own life.
But you got to continue your relationships, your connections. If
you have a best friend from high school or college,
(14:40):
call them, Cherish them. They're doing something for your mental health,
even if they don't know it right. Just by knowing
you and supporting you in all these years as you
have them, it makes a difference for people.
Speaker 2 (14:51):
Yeah, and just ignoring the signs aren't going to make
anything better. We can't just put it on the back
burner and think that it's going to go away, doctor
Ke National Alliance on Mental Health. The website for NAMI,
the National Alliance of Mental Illness is NAMI dot org
and the book is titled You Are Not Alone. Doctor Duckworth.
(15:14):
I really appreciate the time.
Speaker 1 (15:15):
Be well. Thanks so much, Manny, thank you so much.
Take you care, holl bye.
Speaker 2 (15:21):
One in three adults in the United States has high
pertension high blood pressure. Do you know what causes it,
how to treat it, more importantly, how to prevent it? Well,
may happens to be National High blood Pressure Education Month.
So let's discuss all of those things as we bring
in doctor Clyde Yancey. He's chief of Cardiology in the
Department of Medicine at Northwestern University. Doctor Yancey, thanks so
(15:45):
much for the time.
Speaker 3 (15:46):
I am delighted to be here. This is such an
important conversation and I think we should expand all of
the questions he just presented.
Speaker 2 (15:54):
Yeah, well, I look forward to speaking to you about them.
What does it mean to have high blood pressure? How
about we begin there?
Speaker 3 (16:00):
So let's start at the very beginning. Part of what
the heart does so beautifully for us is to distribute
blood throughout the body. The heart is an organ, it's
actually a muscle. In addition to its other functions. That
muscle pumps blood through the body. So our lay assessment
(16:21):
of what the heart does is exactly correct. Correct That
blood that is pumped through the body comes out with force.
So that force is something that is measurable. We measure
it as pressure. There is a normal amount of force,
but there's also an elevated amount of force, and when
that force is elevated, it has consequences. Imagine the flow
(16:45):
of water through a garden hose, if there are those
who still do those kind of things. If the flow
is ginger and gentle, it just waters along without any problem.
But if it's forceful, the water is flowing, yes, but
that forceful flow of water, just like a fire hydrant,
it has consequences, can actually cause harm. Same thing in
(17:06):
our vascular system.
Speaker 2 (17:08):
How is a high blood pressure what we're talking about hypertension,
different than for example, me a middle aged guy sprinting
forty yards, and how my blood pressure will rise in
that context.
Speaker 3 (17:23):
So that's a brilliant question because it's the heart's ability
to adapt to all the different things we do in life.
Whether we're resting and lying still, whether we're digesting a meal,
or whether we're exercising, it is appropriate for your heart
function to increase. So that force that we talked about
will increase, the blood pressure will increase. But we call
(17:45):
that very carefully. We call that a physiologic meaning that's
a normal increase. But imagine what happens if your pressure,
your force increases because you're exercising, but you're not exercising,
you're just living with that increase. That's high blood pressure.
Speaker 2 (18:02):
What contributes to high blood pressure, to high pertension.
Speaker 3 (18:06):
We understand that what contributes to it, and that is
the right word, because we're still trying to understand what
causes high blood pressure. But we know that what contributes
to it is one part your family, one part perhaps
your ancestry, a big part your living circumstances, your life
and living conditions, a big part your diet. So those
(18:28):
persons that take in salt and are sensitive to salt
may have a higher blood pressure. Those people that end
up being heavier will almost surely have high blood pressure.
Those persons who live in certain neighborhoods because of their
choices their lifestyle, may also have high blood pressure. And
guess what, if you know that your parents and your
(18:50):
grandparents are high blood pressure, you should be especially attuned
to the likelihood that you'll develop high blood pressure. But
let me just tell you one other thing that's incredibly important.
There are three inevitabilities in life, death, taxes, and high
blood pressure. What I mean by that ninety percent of
all of us are alive right now, ninety percent will
(19:12):
eventually develop high blood pressure. So we can basically check
the default button and say we all need to be aware.
Speaker 2 (19:19):
And am I doctor? My primary care physician has spoken
to me about that repeatedly, says, the older we get,
just naturally, our pressure will increase. Is that right?
Speaker 3 (19:28):
And the natural part of this is that the older
we get. What's not natural, But what happens, almost without fail,
is that our blood blood vessels get more stiff. And
that stiffening of our blood vessels again comes from all
the things which we're exposed, does come from aging, does
come from being heavier. It's so important to recognize this
(19:50):
interrelatedness of being heavier, of becoming older, of maybe having
a tendency towards diabetes, these sorts of things all come together,
so it is inevitable. Your doctor is exactly right. But
what's naturalist not for your blood vescals to get more stiff.
It's how we live that makes how blood vescals get
more stiff, and thus nine out of ten of us
(20:13):
will end up having high blood pressure.
Speaker 2 (20:14):
That number that I started off with, one in three
adults in the United States has high pretension high blood pressure.
It feels like I've been hearing those numbers for decades.
Have they remained consistent? Have we made any improvement on
the number of Americans who have blood pressure?
Speaker 3 (20:33):
So where improvement has come is in the number of
Americans who know they have high blood pressure. For quite
some time, we've always known that about one third of
the population in our country at any one moment has
high blood pressure. But now a greater percentage of them
actually know that they have it. And I'll tell you
(20:54):
why that's so important. You don't need to immediately go
to drug therapy because you have high blood pressure. There
are many lifestyle changes that can actually help normalize the
blood pressure, but you don't know to make those changes
unless you are aware that your blood pursure is elevated.
So the awareness and detection programs that so many organizations
(21:15):
have promulgated are working, and people know that their blood
pressure is elevated. Now, one other number you talked about
the importance of this number. We can't overlook that one
in three number is across the board. That's correct, But
here is some more compelling number. One in four young
adults under the age of forty has high blood pressure.
(21:36):
One in four young adults, So that tells you that
beginning at age twenty five are even younger in some groups.
We need to be very conscious of our blood pressure.
Just like we know our cell phone numbers, we need
to know our blood pressure.
Speaker 2 (21:50):
A few more minutes here with doctor Clyde Yancey's chief
of cardiology in the Department of Medicine at Northwestern University,
want to unpack a little bit of that very easy
to treat these days with medication, very inexpensive medication quite often,
but I wonder if people try to if people turn
(22:10):
to that first as opposed to making changes in their lifestyle,
then might be able to control their blood pressure.
Speaker 3 (22:16):
I can absolutely promise you that if someone is seen
in my office, the conversation goes like this, we've identified
that you have blood pressure almost invariably is based on
home blood pressures and not the blood pressure in the office,
and I will tell them the first step is not
using drugs. The first step is lifestyle. And I will
go through all of the necessary motions, and I'll tell
(22:38):
you very quickly. For every kilogram of weight loss two pounds,
your blood pressure goes down by a point. That means
if you can get to ten kilograms of weight loss
about twenty pounds a little bit more, your blood pressure
will come down substantially. Increase your physical activity, cuts your
alcohol content in half, don't smoke. Increase your consumption not
only of fruits and vegetables, You've heard that so many times,
(23:01):
but increase your consumption of potassium, and decrease your consumption
of sodium. Those are the non drug strategies that will
effectively treat your blood pressure, but particularly weight loss.
Speaker 2 (23:13):
What is it about salt that contributes to high blood pressure?
Because let's face it, a steak ain't the same without salt.
Speaker 3 (23:22):
We can talk about eating the steak at another time.
Speaker 2 (23:25):
Yeah, I imagine that contributes to it a bit as well,
but just the salt portion of it, because I remember,
you know the Dash diet and now there's like low salt,
salt and things like that. But just not the same, is.
Speaker 3 (23:37):
It, And some people not everyone. Salt causes fluid retention,
and it's the fluid retention that expands the blood vessels
and goes back to opening conversation and keeps that force elevated.
But what makes this fascinating is that in population health,
where we've been able to replace sodium chloride with potassium chloride,
(24:01):
that step alone, without changing the palatability of food, that
is the taste of food, lowers blood pressure. And so
the idea of switching from salt as you know it
as I know it to potassium instead of sodium and
the right individual has some benefit.
Speaker 2 (24:17):
What is potassium chloride? Can I buy that at the
grocery store and put it on my steak?
Speaker 3 (24:23):
You know what? You can do one step better than that.
You can walk down the spice out and you can
look for no salt inn oh salt right, look at
the label and almost invariably that is your potassium chloride.
Speaker 2 (24:35):
That's it fascinating. We kind of referred to this a
little bit earlier. Early detection really is the key in
determining all of these things. And unless somebody is going
to get regular checkups on a yearly basis or more
often than that, chances are you're probably not going to
know that you have high blood pressure just from living
your life. So how does somebody determine they have it
(24:59):
without going to see their doctor.
Speaker 3 (25:00):
Can they So many young adults have had pre participatory
physical examinations for sports, whether it's club sports, high school sports,
college sports. There's your blood pressure. So many women of
course for pregnancy must have the blood pressure determined. So
there is another way you know this. But guess what.
You can walk into virtually any commercial drug store, look
(25:22):
along the perimeter and you'll find a free automated blood
pressure cough. Point being that there's no way you can
avoid access to getting your blood pressure measured, even if
you duck into a fire station. There is a way
to get your blood pressure know. But the key point
is the one you've already made. You have to be
aware and so yes, blood pressure is ubiquitous, so many
(25:44):
people have it, But the knowledge is what we need
to make ubiquitous to know that everybody is likely to
develop high blood pressure sometimes. So one of the things
we talk about all the time, over and over and
over again. Know your numbers, know your blood pressure, know
your know your weight. These are the things that will
help you live along in healthy life.
Speaker 2 (26:05):
Stress, sleep quality, mental health. All of those things, how
do they potentially influence our blood pressure?
Speaker 3 (26:13):
It's pretty clear that sleeping less than six hours a
night is definitely associated with an increase in blood pressure,
and an increase in the more difficult patterns of blood pressure.
That's another conversation. It's also fairly clear that stress in
the global context, whether it's worry that is, whether it's
(26:33):
mental stress, but also stress in life, anxiety about a job,
anxiety about an interpersonal relationship, all of that stress becomes
manifest as something biological. We think that the biology there
is that it's inflammation. Think of getting a mosquito bite
and look at how your skin gets rid. Stress does
that to our body. It causes our body to become inflamed,
(26:56):
and that leads to high blood pressure. So you are correct,
lack of slave being stress, those things increase our blood pressure,
just like alcohol does.
Speaker 2 (27:06):
How much of those numbers, and again will refer to
them one in three adults, you said, I think one
in four of adults under the age of just say
twenty five have high blood.
Speaker 3 (27:17):
Under the age of forty twenty five, one in four adults.
Speaker 2 (27:20):
One in four adults under the age of forty have it.
How much of that is associated with the culture in
our country, the diet compared to other countries.
Speaker 3 (27:33):
I want to be very clear about this. We think
most of it is in fact related to our lifestyle. Now,
lifestyle is a little different from diet. It's one part died, yes, sure,
but lifestyle of physical inactivity, a lifestyle that predisposes our
young adults towards being heavier, a lifestyle that very much
gratuitously enjoys alcohol, and still tobacco. When you put all
(27:56):
of that together, alcohol, tobacco, being heavier, having a very
convenient lifestyle meaning using fast food products, not being physically active,
all of that relates to this burden of high blood
pressure and young adults. And again, know your family history.
Take some time and say, mom, pop, what runs in
our family? You should be aware.
Speaker 2 (28:17):
Two final questions for you. One third, maybe we can't
control genetic if our parents, our grandparents have had it.
Two thirds of this we can control what does hypertension,
high blood pressure potentially lead to.
Speaker 3 (28:34):
So we always think about this phenomenon of what happens
to the organs that face all of that extra force
that we talked about, the three organs we really were about.
The brain. High blood pressure definitely leads the strokes the heart.
High blood pressure is associated with heart attacks. Associated with
heart fillure and the kidneys for certain high blood pressures
(28:56):
associated with having weaker kidneys, and maybe even kidney failure.
But the most important message here is that it's so
eminently treatable. We have inexpensive drugs. Lifestyle is a benefit,
and what's most exciting is that for the first time
in over a decade, we have brand new therapies and
we have procedures that can help us really finesse control
(29:19):
of blood pressure. No one needs to suffer from high
blood pressure in our future. High technology is just that good.
Speaker 2 (29:25):
Early detection is the key, and there's a reason it's
called preventive medicine exactly. Doctor Clyde Yancey, chief of Cardiology
in the Department of Medicine at Northwestern University, truly appreciate
it for the time and the information. Thanks so much
for joining us.
Speaker 3 (29:41):
Thanks so much, and let's not forget know your numbers.
Speaker 2 (29:45):
And that'll do it for another edition of Iheartradios Communities.
I'm Manny Muno's until next time.
Host
Manny Munoz
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Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.