Episode 25 Transcription: Questions from the Mailbag

Mind Dive Episode 25 Transcription

00:02

Welcome to the Mind Dive podcast. Brought to you by the Menninger Clinic, a national leader in mental health care. We're your hosts, Dr. Bob Boland, and Dr. Kerry Horrell. Twice monthly, we dive into mental health topics that fascinate us as clinical professionals, and we explore those unexpected dilemmas that arise while treating patients. Join us for all of this, plus the latest research and perspectives from the minds of distinguished colleagues near and far. Let's dive in.

 

00:42

Well, here we are. Yeah, so this is our anniversary episode. This is our anniversary episode. I think I said in our very first episode, here we are redoing the podcast or something like that. All right, yeah. So here we are. Now season two Gods survived of the Mind Dive. podcast in sort of shocking, and apparently, we'd have someone listening. Some of you are listening. This is actually a really good moment. Because if you haven't noticed, today, we're doing something a little bit different. We don't have a guest on. So, we have just an extra cheeky 30 seconds to say thank you for anyone listening. Yeah, if you've been listening along with us, we so appreciate it. And it's been a really fun endeavor for us. And it's given us a lot of opportunities to talk to really cool people. That's very true. I feel like I've learned a lot over the last year. Yes, I'm amazed that people will come talk to us. It's great. It's amazing. People talk to amazing people listen to us, the whole endeavor, we could call anything I feel like before in a lot. So today, we've decided to do something different. Yeah. Are you going to describe it? I'm going to describe it. So we asked our colleagues here at the Menninger Clinic to send us in questions or conversation topics that they would want to hear about on the podcast. Now usually, I think in these kinds of podcasts, yes, your listeners, but maybe next year? Yeah. Yeah. Further, that's too much organization for that. Like, like, we need a mailbox. Exactly. So we just started with, with who we have, and asked them to submit questions. You know, one of the things that we talk about as on the podcast is that we like to think about topics and discussion points that what exactly do we say in our intro that are not unique, but are which yes, unique, but are? No, no, we have to like cutting edge and not controversial. There's a word I'm missing here. But the idea that like, listen, first, we're going to listen back, and we're going to have started without and then No, but the topics that don't receive as much attention and that are dilemmas, dilemmas that I was looking for. Yeah. And I think ultimately, a lot of the questions we ended up getting were somewhat controversial, and they're incredibly hard. I mean, so people obviously think we know everything, which. So what we thought would be fun is we selected two questions each to ask the other person, easy ones, the

 

03:05

other

 

03:06

broad, broad questions, or maybe broadly interesting,

 

03:08

personally, I chose ones that I thought I would love to hear you have to struggle to answer. Oh, is that right? Yeah. Pick the absolutely toughest ones for you, Bob. So as a

 

03:18

disclaimer, and we did pick the really easy ones for yourself. And

 

03:22

listen, listen. Okay. Let's say a little caveat here that I would say these are going to be generally in our hot takes.

 

03:29

Yeah. We didn't do a lot of preparation. No, we did look

 

03:33

through again, all the questions we got, which they've, if you're a Menninger colleague, thank

 

03:36

you for submitting questions. So we picked the ones we thought would be interesting.

 

03:39

Yeah. But since we're doing a 30 minute episode, we're just going to skim the surface of some of these topics. Yeah. And

 

03:46

we'll probably have to disclaim, but that is, you know, it's based on expertise. But these are our opinions. Yes. And not only that, but we didn't do all the preparation. So some things we say could be wrong.

 

03:57

Good disclaimer, okay. Okay. You want it? We'll do our best. Why don't you hit the first question.

 

04:01

Alright, sorry. All right. So I see we have let me we can pretend like we're pulling them out of the hat. Okay. Now, it's a little more prominent plan than that. Oh, they hit this one actually was interesting. So someone, one of our colleagues wanted to know about our thoughts about social contagions and adolescents and young adult, including the rise of self-diagnosis, or of mental health disorders.

 

04:22

I am glad that I'm getting to take this question because working on the Compass program here at the Menninger Clinic, which focuses with young adults, this is something we see all the time and also working on the adolescent unit. This is, I feel like a huge issue, at least the example that comes to my mind if you recall, the TV show “13 Reasons Why” on Netflix. I didn't watch it. So there was this TV show and a female suicide, right? Yeah. And I'm trying to write came out but it came out when I was in grad school, so probably like 2016 2017 somewhere in that ballpark. Oh, forever ago, and the show is about a young high school girl who dies by suicide. And she's left these tapes that are explaining why. And ultimately, this the show did depict a pretty graphic suicide. And in the depiction of the suicide, it was pretty ethereal, almost like it would have been a somewhat enjoyable experience.

 

05:20

No, I mean there was a lot of controversy about the show, right? Yes. And then the experience of watching it.

 

05:25

Exactly. And the experience of watching it, you as the watcher, the viewer, get all of the pleasure of watching all the people who hurt her suffer in the wake of her death. And so the experience of watching is like watching again, like what I imagine people who think about the idea of like, I wonder what it would feel like for other people to see that I'm dead, would feel like. So, what they did, there was some research done on this teen suicide increased pretty significantly. Again, I don't have the figure on hand, but in a way that was notable after this TV show was released, and

 

06:01

which is not an unusual phenomenon. Right. Right. And they often suicides become copycat, and it's not often but it does happen. And especially

 

06:08

in adolescence, yeah, it is particular in adolescents, where if a high school, for example, loses a child by suicide, again, I'm sad, I'm sorry, I don't have this statistic on hand, but there's some odd likeliness that they're going to lose another child by suicide in the next few years. And they've, they've linked that to the idea that because of the attention, care, affection, that this person has died by suicide has received, these kids without all their frontal lobe are there to kind of make the math, math felt like if you're dead, you're unfortunately not going to be feeling any of that, because

 

06:45

you will be perfectly fine. They don't care. First of all, because they're developing, they're still

 

06:49

developing it. That's correct. But they lost it, they have not lost it. It's that's a great point is haven't fully developed yet. So all this to say, I think one of the things we talked about in suicide research and some of the other self-harm research is that in adolescents, particularly social contagions, around suicide and self-harm exist, whereas we often say, you know, when we're working with people of suicide, talking about suicide deaths, and increase people's likelihood of doing it. In adolescence, there can be some of like, with a few Asterix of like, the more suicides in the media, the more we're talking about it, the more there are people who have died by suicide in the news, the more likely adolescents particularly our risk for suicide,

 

07:26

it, you know, it strikes me that it's not quite the same as the old concept of like mass hysteria. You know, we're like, a group of people get some kind of weird illness and all sudden, it seems like everyone has it. Not quite the same thing, because I'm not sure that's about social pressure that's more about suggestibility or a much fairer.

 

07:45

No, I think, I think this is different in that it is, when we think about self-harm, the more it's known by other young people that this is a way people are coping with their stress, the more likely that under stress, a young person is going to try it. And the difficulty with self-harm is that when you self-harm, especially by cutting, there is a release of opioids in the brain. And this is part of the reason why self-harm can become addictive in a way that I think many young people don't even quite realize that it's something they just feel so compelled to do. So, if you even if you learned it from like your social group, but you tried it, it can start like with other things that end up being addictive, it can then become something that spirals out of control.

 

08:26

Right. So, it sounds like you have some experience in this. What do you what do you do about it? Like, how you handled on the unit?

 

08:32

wasn't prepared for that question? Yes. How do we handle?

 

08:36

I guess I’ve set the pace for stumping each other. Okay.

 

08:40

Let me hold on. Let me hold that one in my head. I want to say the second part of this question.

 

08:45

Okay, which is the rise of diets of self-diagnosis, which, to be

 

08:50

I honestly kind of combined those two, because I thought they were related. But again, with young people, we're just seeing this mass influx of people coming in already having a sense of like, “I have autism or ADHD,” especially some of those neurodevelopmental ones, or again, I have a big one with yours. I have multiple personality disorders called not that anymore. It’s Dissociative Identity Disorder now.

 

09:16

Some people still call it that.

 

09:17

They come into thinking they have DID, they know the symptoms. And I think there is a bit of a rise in like popularity culture merging with mental health culture, we're seeing more like Instagram handles that are like “suicidalchick4”, or other things like that. So, there's like a sense where, in this complicated way, mental health is way less stigmatized, which is a good thing. Okay, but in a way where it's almost become a fad or a trend. Yeah. And I think that's where it can become dangerous. Because one thing that it can do is it can become sort of wrapped up in a young person's identity. Like it's part of my identity that I'm depressed. Then, when they get treatment for it, it's like, “I don't want to I don't want to not be depressed. It's part of who I am.” So, I would say in short, How do we deal with this on the unit? I think we draw attention to some of if not the many things that these patterns tend to represent in a person's life like these identity pieces.

 

10:09

I guess what they have in common to self-diagnosis and social contagion is that they're, you know, that people are very affected by the media and kind of what's out there. Yes, like, usually like self-diagnosis, when people start diagnosing stuff a lot, it's probably because either a show or book came out, like, not so much with adolescents, it's more with young adults and adults in general that after a particular book about ADHD came out, everyone started coming in and convinced that they had it.

 

10:37

And I'm sure as many people might be thinking about the rise of TikTok—the app that has the short videos on it.

 

10:44

Thanks for explaining what that is. You weren't sure I wouldn't know. Right?

 

10:49

Do you have a TikTok?

 

10:49

I do. I know it is I know it’s a security risk right now. Not on hospital device.

 

10:55

I love that for you. On TikTok, there's

 

11:00

--I don't post anything. Let's be clear.

 

11:02

I don't post anything publicly. But I do like to use it for editing videos. The point is, there's tons of videos out there about like, “Did you know that…” And then it'll be like some sort of benign or vague symptom is due to ADHD. And then you have people being like, “I have ADHD.”

 

11:21

And ultimately, I think this is for a lot of people. And this is maybe a place where we can wrap up this question. It becomes something where people feel like, “Oh, this explains why I'm struggling.” And then when people get here, I think one of the things we try to help them do is look at the complexity of it all. To use that example, when people come in, and they say, I can't pay attention. I must have ADHD, you know, one of things I say is that that's a possibility on the table. And then also, you could have had trauma, anxiety, you could be struggling pretty hard with your mood. And a lot of those also could relate to attention. And so we just help people try to kind of dig beneath the surface. So I think we handled some thoughts on that one.

 

12:05

Okay. That's, that's actually interesting. Thanks. You're turn!

 

12:09

Okay. Hey, Bob, my first question for you. Another question that again, I thought was really important. And we will not have time to dive deep enough into it. But one of our colleagues wanted us to have a discussion or think about the relationship between mental health and mass shooting, including what is psychiatry's role in combating this crisis? Oh, my Wow, that's something you know, I say an easy question.

 

12:35

Yeah. Right. Thanks for throwing me the softballs just a lobbying them out. Yeah, exactly. Yeah. Well, I mean, yeah, in your radio comes up. So every time there's like a mass shooting or something like that, you know, at least some people will start calling start blaming it on things that usually come up quickly on it is whether the shooter was psychotic, or had some other mental disorder. And then often, I mean, without getting too political, but often politicians do divert the discussion, I would say, from whether there's too many guns in the world or things like that, to the problem of mental health. In fact, was it the Uvalde shootings? Here, that was most of the discussion? I think, I guess it's not being too political to quote that our governor said that anyone would do this must have a mental disorder. I'm paraphrasing. It's not exactly what he said.

 

13:24

They and I'll even be a little more controversial and say that I think also that this is it is oftentimes a diverting away from other political issues without any actual change or saying let's fund mental health programs better.

 

13:37

Well, actually, there was some funding in one of the Omnibus Bill stuff afterward, but I'm all for that. The thing is, is it actually going to help with the shooting stuff? So, you know, I'm not going to pretend like I knew that, I looked it up. But do you want to guess at like, how many people died by gun violence last year in the United States? Oh, gosh, no, I don't know. Take a rough guess.

 

14:03

100,000. No, it’s about 44,000.

 

14:18

It’s still a lot. Now, keep in mind that but roughly half of those are suicides. Right. But the rest are either deliberate shooting, so homicides or accidents. So, you know, the questions that always come up, I mean, the problem is, is that, you know, it's hard to look at the data in a sort of dispassionate way. Right, because you, you know, there's a lot of data out there. It's not all consistent. It's hard to do studies on these things. So, people sometimes make of it what they will. I try to avoid too many debates about this, because I understand there's a lot of opinions about this. And it's still a work in progress to understand but the way I see it really there's two questions, right? There's one question, “Are people with mental illness more likely to be violent?” And to be specific the question is “Are they more likely to shoot someone or to commit gun violence?” But that's not the same question as what I think people are getting at when they're on TV talking about this, which is, if someone does commit gun violence, are they likely to have had a mental illness?

 

15:22

Well, I really appreciate that distinction. Yeah, different

 

15:25

things. And it's important because the answers aren't the same. Not at all. Right. So the answer to the question of “Is a person with mental illness, more likely to commit gun violence?” The answer actually is yes. But very qualified, yes. Like just a little bit more. So, it's not characteristic of people with mental illness. But if you have to be honest about it, people with mental illnesses tend to have a higher rate of violence with the people, but it's very slight.

 

15:54

I appreciate that. You said it's not characteristic of people with mental illness. So, it is something where again, if we're looking at in comparison.

 

16:01

I mean, to be more specific about first of all we see mental illness we're talking about, it really is usually talking about people with very serious mental illness. Yes. So for example, there was one study that was done, where they looked at people who came out of a hospital, and they followed them, it was probably about 1000 patients who are discharged from a psych hospital, not this one, to see what see how many of them actually committed an act of gun violence within whatever the follow up time was for the study, I think it was at least a year or something like a few years, something like that. And it was about 2%, which actually sounds like a lot when you say it, if 2% of people with mental illness, committed gun violence, that would be significant. But it's not saying that it isn't. So these these are not the average mental, mentally ill person. Because these are people who wound up in a very particular hospital that served very sick people, and probably stayed in there for a bit. So that's the probably the sickest of people. And it's probably not good to use that as a statistic. When you sort of look at sort of me, it's kind of hard to do this stuff. But if you, for instance, look at a population of people with a severe mental illness, let's say schizophrenia, yes, you can look at the rate of high if you will actually create gun violence, and it is more than the average population, but it's still small. I think the rate I read, and believe me these vary, but it's something like about point 3%. Yeah, of them. Now, is that significant? Yeah. I mean, it's more than average for the general population, but it still means that like less than one in 300, people with schizophrenia is likely to commit gun violence.

 

17:33

I think and I'm really appreciating the distinction you're making here. Because I think one of the things that we get into this, this false dichotomy and this tug of war of if we're going to talk about the relationship between mental illness and mass shootings, then we're going to be stigmatizing. Yes, people who have mental illness. And that's not at all what of course, I think any of us in the mental health field want to do. Right. But then like you said, the secondary part, which is critical is our people who are committing mass shootings, right, mentally? Well,

 

18:03

that's the other half. Right, exactly. So like for the first part, you could say, okay, maybe a little bit more, but it means that, by far, by far, most people with mental illness will not commit gun violence early. Any violence. Yes, at all. And when you do talk about the ones who do, yes, schizophrenia, which already mentioned, but us in substance abuse, substance use disorders, and even that's kind of hard to know. Because, well, we'll talk about that in a sec. But because you know, there's different levels of substance abuse, there's really what I would say, the opposite question is, if a person commits gun violence, are they liable to have a mental illness? The answer actually is no. Like, almost very rarely actually, do they have a mental illness? And how can how can both be true? Well, because when you think about it, you know how many I just said less than, you know, less than 1%. So about 0.3% of patients say, with schizophrenia, alive with gun violence with Schizophrenia is a fairly rare disorder. In this country, maybe about 1% of the population. So with substance abuse is more, but still, if you start looking at the numbers, there's way more shootings and there's people who know what, then enough people with mental illness to do this. Because once again, we said there's about 44,000 different gun deaths. You can't account for that.

 

19:17

I'm surprised by some of what you're saying just now. Because I feel like so you're saying that a lot of people who can make gun violence, some majority of them, it sounds like do not have documented, just the majority of the great majority do not have a psychiatric illness,

 

19:29

right? So keep in mind that this, this is harder to do, right? Because it's none of this is easy, but it's easier to say I'm going to take a group of schizophrenic patients, people with schizophrenia, and follow them see, do they ever commit gun violence and you follow them as long as you possibly can? Yeah, that's not easy, but it seems possible the other way around. I'm going to take someone who commits gun violence and find out did they ever have a mental disorder? That's not so easy. Yeah. Because how do you know what if they're not alive anymore?

 

19:56

This is an anecdotal and really not that useful, but this is something that's on my mind a lot is like mentally healthy people mentally well, people don't commit gun violence.

 

20:08

You think that you're saying that's true? Or you think it's true?

 

20:12

I think that mentally healthy people do not commit gun violence,

 

20:16

I guess the case is--What do you mean by mentally healthy people who are well?

 

20:19

And if you are not well, then you are ill. And again, that is not a particularly useful thing. But I mean, like when I think, of course, like in research, we try to we try to boil it down to particular past diagnosed psychiatric illnesses. And I think, especially this question is about mass violence, like school shootings.

 

20:42

so we have to differentiate because most gun violence is not as not, right, the great majority of gun owners love to it is, you know, shooting someone you know, yep. Just single single act, accidental gun violence. Yes. At the same time, which you know, which of course, you know, acts of jealousy, things like that gang violence, and of course, suicide and things like that. So for on average for gun violence, so someone who actually does shoot someone else, about 10%, probably had a mental illness, as best as studies can tell,

 

21:12

that makes again, I think that makes more sense for so 90% did gun violence in general? Because think of why do people shoot other people? Heat of the moment

 

21:21

acts of anger, like is anger a mental illness? No. Is jealousy a mental illness? No. Is hatred a mental illness? No.

 

21:27

But I think when we think about mass shootings. You premeditatedly go into a public space and just shoot people, often strangers, yes. These are children, right? Like, these are people, right? I can't possibly fathom.

 

21:44

So once again, you know, these people don't survive the shooting. So it's hard to know. But at least the figures I've seen say, about 20% of them had a mental illness. We know some of the high-profile ones. Yes. You know, the people like Jared Lee Loughner, or people like that, where they showed us plenty of pictures of him looking psychotic, whatever that means. But you know, looking like our sort of classic view of what a psychotic killer might look like. But that's kind of the minority. A lot of these people who do it when you read about it had no such history, which is scary. But you know, I mean, this is what happens when you give lots people who potentially impulsive guns. They tend to be young, they tend to be male. Now, do you

 

22:28

think psychiatry plays a role?

 

22:29

Do you think psychiatry plays a role in

 

22:31

combating the gun violence epidemic? Well,

 

22:35

sure, of course, right. I mean, you know, on a national level, the problems, I mean, we need to sort of set the record straight the best we can, because, once again, I'm all for using any reason to get more, you know, support for mental health and strengthening people, we need more treatment, we need more facilities, we need more intervention. So I'm all for that. But we need to make it clear that, you know, it's not really in the interest of decreasing gun violence, because it's not going to work. You know, we have to be honest about that, and hopefully use whatever influence we have, though, I realize it's so politicized now, to point our fingers to the things that do matter. For instance, just the amount of guns out there and how easy it is to get a gun. It's probably the best predictor of whether someone's going to use a gun.

 

23:18

What a great answer. Yeah, I think you nailed that one. Okay. Thanks.

 

23:22

So thought, but it's tough. But you know, we don't want to sort of you mentioned the important that you know, what, forget about suicide, that is an example, where the use of guns is dramatically increased in all sorts of mentally ill patients. And that is a real problem. Yes. Which we're really not doing enough about.

 

23:39

I think my very quick hot take before we go to the next question is just the idea that I don't like the idea that psychiatry in the mental health field in general, would wipe their hands of the mental experience of people who especially commit mass violence by saying things like, it's evil, and therefore, it's not related to mental illness. Yeah. Because I think that that's conflating kind of spiritual, moral terms with what we do in our scientific medical practice.

 

24:10

Well, I mean, two things about that. One is that I imagine you did you ask patients like whether they have a gun have access to it? I think we all do. We try to do some preventive work. And we feel that they're at risk. And often the patients we see, you know, anyone's that depression is at risk of using a gun, for example. I mean, we do try to intervene to them, this is not a good time to have access to it. And we often, you know, go as far to talk with your family and other people to say that this is a risk right now.

 

24:37

And I think things like more programs to intervene at especially like the adolescent age, against bullying against neglect in the home, like just more programs to help young people who might be struggling from for it escalated to this point, I think we could have a role to play.

 

24:55

Yeah, I agree. Fair enough. All right. Well, I think I've gone on it

 

24:59

again. I Think you absolutely nailed it. Okay, hit me with the next one. Oh gosh, oh boy or two? Well, how about this? Yeah, we take the we'll take a third question and we'll just use that. And we'll we'll do it together. Yeah. Okay, we've apparently yammered on already for quite a bit. So here's our third question, again, one we'll handle together?

 

Can and should psychiatry have a larger role in preventative care for illness? And what are some of our thoughts about the relationship between mental wellness and general health, including it's therapy should be something that most everyone considers doing? As in? Here's how I'm hearing this. Most people should go to the gym or do exercise? Should most people be involved in some sort of psychiatric therapy, wellness, because of its relationship to general health? And I'm going to be honest, I picked this question for you. Because some of your background is in the relationship between depression and illness.

 

25:57

I’m in consultation-liaison psychiatry, which means I'm very interested in that. But really, every psychiatrist should be and every psychologist and pretty much anyone in mental health. And why is that? Because we have a relationship with the patients? Yes. So I'll tell you a quick thing. Okay. Like I took over a, I helped a doctor was retiring, this older psychiatrist was retiring. I got a bunch of his patients. And they came in to see me—this is many, many years ago, and when I was doing some outpatient work, and a lot of them would come and say, “I need you to take care of my diabetes as well.” And I’d be like, “Well, I don't really do diabetes. I'm a psychiatrist.” “But the other doctor, he always did my diabetes, and I don't really have another doctor. So why can't you do that?” That kind of made me come to terms of “Well, why don't why am I not?” and I'd be helpful in these things. So there is a history of psychiatrists actually taking more of an interest in people's overall mental health and stuff and see themselves more as like primary care physicians. But I would argue that like, the reason we should care is a couple of reasons. One is because patients with mental illnesses tend to die earlier than other people. And why do they die early, I'm taking on serious mental illnesses, like things like, you know, schizophrenia, again, or bipolar disorder. And the thing, the surprising thing is the reason they die has less to do with their I've done this, they're not dying by suicide, though that is a problem. And they're not dying by sort of other behaviors. They're dying from medical illness, cardiovascular disease, the same things that kill all of us, yes. But they get more, you know, cardiovascular disease, strokes, diabetes, all those sorts of things.

 

27:34

And there's a relationship between again, this is more your area of expertise in mind. Like there's they’re inextricably bound up, right? Like, when you're really struggling, and stress is high, it messes with other things like cortisol and your body, and then you're more likely to get

 

27:51

all right. So right, so you have the direct effects that you know, probably all the mental illnesses we have are somehow wrapped up in sort of stress and inflammation and things like that, right, that actually negatively affect your body, I suppose. And you're absolutely right, it probably accounts for a fair, probably more of it than we know, because we're still trying to understand those relationships. Yes. But it's, I think we know enough now to say that we have got to stop dividing the body in the mind.

 

28:17

And that's why I say, I mean, this is why I appreciated this question, because I think if we were to tie together three questions, one of the things that we're addressing is stigma. And I think that there still is surprisingly, quite a bit of stigma against going to therapy, I think, especially for a particular age, like more kind of adult age people. And the oftentimes the question of like, oh, have you thought about going to therapy? I know in my life, people have responded with things like why you think I need to therapy my like, Jake, I'm like, really not doing well. And it's like, word be a great place to just go. Yeah, well, I'm sure that space to reflect I've seen

 

28:51

the meme like, you know, “Men will do X rather than go to therapy.”

 

29:00

And I think ultimately like seeing and of course, I should say I think it's a very privileged thing to say like everyone's going to therapy, because therapy is quite expensive. It's not always very accessible. But I think having time and space, whether that be meditation, taking up journaling, doing things that are set aside for self-care, relaxation, slowing down, touching base insight, one thing I'm thinking of I'm thinking of the things that I'm Dr. gesti way back when talk to us about wisdom, and like how part of it’s self-reflection and insight and taking that time to turn inward. I think it's something that people should be prioritizing as much as they're prioritizing their physical health

 

29:40

trying I wonder other reason why we should care about people's physical health, because we actually do sometimes cause health problems, particularly when I say we, I guess psychiatrists, maybe have a fair amount of the brunt of that because the medications again, I thought that a lot of them, they can cause weight gain, not all of them And sometimes they do. Sometimes they don't, but they could. They can cause metabolic syndrome, which, you know, is like hypertension and weight gain and other problems that you get is with sort of glucose tolerance, sexual dysfunction, sexual dysfunction, sleep problems, sleep. Yeah. So we cause a lot of sorts of health problems in a way of things that are all rather important. So we should probably take some responsibility to do something about it.

 

30:25

Jesus interesting. You heard this question differently than I did. You heard, why should psychiatrists care on physical health? I heard, why should everybody care about mental health?

 

30:34

I see. That's much more self-serving.

 

30:36

I know. I don't even know. I can't even know what the real question was. But that's where I think it was. I think everybody should think about, well, I guess, like, because I honestly think that many people are more willing to be like, Yeah, I don't want to get diabetes, then I don't want to get depression. It was a good

 

30:54

introduce. I

 

30:55

don't know if people would say

 

30:56

that. But yeah, it was a very good internist. Early on, you know, when you still I was probably still getting into mind-body split. And I was a medical student at the time, who after I came back and gave a very good history of the patients, cardiac problems and stuff. He said, well tell me a bit about their lives, like where they live, what they do, what are their stresses? What's their biggest concerns? I'm like, I have no idea. And he's like, Well, then irrelevant. Yeah, exactly. I got there. I know what their pulse is. I know what their blood pressure is. I I listened to their you know, I listen to their heartbeat. So yeah, and he's trying to sit within how can you help to her help this person?

 

31:32

Oh, my God. Life changing? Exactly. Now?

 

31:36

Yeah. And you know, and good for him that like it's good came from a non non mental health person to understand if you don't understand the whole person

 

31:44

was when you were a medical student. It was as good as a few. I was like, we were already a psychiatrist.

 

31:48

Yeah, that'd be kind of embarrassing.

 

31:51

Well, we did a little bit. Okay, we

 

31:53

touched this.

 

31:54

Last, we handled

 

31:56

three questions. Yeah. So now we know better next time. We're planning this.

 

32:00

I really enjoyed this, though. I think clearly, you and I are itching to talk.

 

32:04

Yeah. Apparently, we've been so good. Trying to not but in too much.

 

32:09

I again would maybe want to close by just thanking folks for listening and for being interested in mental health and these unique topics and diving kind of further into things.

32:30

Let's say it. Alright.

 

32:34

You've been listening to the Mind Dive podcast. We've been your hosts. I'm Dr. Kerry Horrell. And I'm Dr. Bob Boland. Thanks for diving in!

 

32:45

The Mind Dive podcast is presented by the Menninger Clinic. If you're curious about the professional experiences of mental health clinicians, make sure to subscribe wherever you listen. For more episodes like this, visit www dot Menninger clinic.org. To submit a topic for discussion, send us an email

 

33:03

at podcast@menninger.edu