Episode 38: Bringing a New Vision to Life: Dr. Lindsey Van Duyn's Innovation in Mental Health

In this inspiring conversation, I sit down with my good friend and colleague, Dr. Lindsey Van Duyn, a family physician and the founder of Immersive Medical Therapy. What started as a personal mission to help teens in her rural Iowa community has grown into a pioneering program that is making a real impact in the lives of adolescents struggling with depression and anxiety.

Dr. Van Duyn shares how a single patient’s story became her “why” — and how, despite barriers and setbacks, she followed her passion and built something truly innovative using virtual reality as a powerful tool in mental health care.

You’ll hear us talk about:

• How Lindsay’s own career pivot (and life as a mom of twins!) shaped her mission
• The challenges of treating teen depression in rural settings — and why “we can’t wait 6-8 weeks”
• How virtual reality creates a safe space for teens to calm their nervous systems and learn lasting coping tools
• The power of physicians pursuing passion projects — and how this can improve fulfillment in every aspect of life
• Why peer support, community, and knowing your “why” matter when taking on big challenges

If you’ve ever felt called to do something new — even when it feels hard — this conversation will leave you inspired and hopeful about what’s possible.

Connect with Dr. Van Duyn here:

www.ImmersiveMedicalTherapy.com

Facebook as Lindsey Van Duyn

Transcript

0:08

Welcome to the Purposeful MD Podcast. As a physician, you've sacrificed so much of your life for other people, your patients, your family, your friends, and your colleagues. What would it feel like to spend time doing what you enjoy and to live without guilt? I'm your host. Dr. Laura Suttin, a family physician, certified coach, and business owner. If you're a medical professional on a journey towards your most purposeful life, a life with more time and energy, and ultimately more joy, then this is the podcast for you. For our listeners, a content warning that there is discussion of self-harm and suicide in this episode. Welcome to the Purposeful MD Podcast. I'm so happy to have on my good friend and colleague, Dr. Lindsey Van Duyn today. Dr. Van Duyn, welcome. Why, thank you. I'm excited to be here. Laura. Yeah, so Lindsay, you and I met probably, two or three years ago, virtually via Zoom, and connected there, and, you were working on something incredible, which you'll tell us all about today. And then we had a chance to meet in person, um, through Peter Kim's Mastermind, and at PIMDCON, and just, I've just really always appreciated your energy, and I'm so excited for our listeners to hear about what you're working on, so, tell us about, about you, and your background, and how you got to where you are right now. Sure, sure. So I, went to med school at VCOM, which is Edward Via College of Osteopathic Medicine, um, with Virginia, uh Tech, their D.O. School. And, um, I had all anticipation of going into orthopedic surgery. And I love sports, I love coaching, I like intense things. Um, and then I got pregnant, and that rocked my world. So, as a third year, I had twins, and I, uh, decided to step aside. So then I went into family medicine, and there's a few cases that really scared me. Um, one was when a patient said they had chest pain, cause I can't just fix that. And the other, you know, is when I have these teens in front of me that are just severely depressed. Um, that gets heavy. And I moved back home to practice, and so, you know, this is hometown Iowa. The teens that I was treating are friends or, you know, they're even my friends, si, or, uh, children. And so, um, it became a, a personal mission to help these children, I could'nt just say, I'll see you back in six to eight weeks, and it was, it was more common than I wanted it to be. And because I saw this as a problem, you know, I just tried to find a solution, and that led me to where I am, and why I am doing what I'm doing, which is immersive medical therapy. Um, you know, being trained in orthopedics, but working in family medicine, I often feel like I have to go back to the basics, and so, I did a lot of literature diving, and talking to my psych friends and, um, we kept coming across virtual reality, and, I was like, why aren't we using this? You know, like the science is already there. It's been around for over a decade. Psychologists are using it. It works. Why aren't we using this, and there's, there's some hurdles there. Um, and of course I'm, I'm happy to talk about where I've taken it today, but, that's how I got to where I'm at. I still do medicine full time. Yeah. And then I have a passion project that I've started on the side. Yeah. Thanks for sharing that. I, I know, and I've talked to you several times throughout your journey, and, you mentioned this frustration of seeing teenagers, who are suffering, and having depressive symptoms, um, suicidal ideation, and this just, you're feeling so, I haven't heard you use this word that I remember, but, helpless that you've got 15 minutes with them, and, they're probably coming in with their parents, maybe, maybe, maybe not, but just this, this really, uh, helpless feeling of not being able to work with them in the way that you want. Um, maybe prescribe a medication, maybe not. We all know that there are so few resources, for mental health these days, um, I imagine it's compounded in a rural area where you live, and so just really wanting to give these kids the support that they need. And, so I just, I, I love that you took this challenge, and instead of, kind of letting it, drag you down into the dumps, you decided to do something about it. Yeah. And I think thats's, so inspiring, and, you know, I think a lot of us kind of get in this feeling of like, oh, this is such a big problem, it's hopeless, and we're never gonna be able to fix it. And, we might not be able to, like, completely fix teenage mental health, um, but at the same time, I just think about the impact that you've had on your patients, and these kids, and so I just, it's so inspiring to me. I member, I remember talking to you about it, sitting here in my office talking to you about it years ago, and just like, this is incredible. This is really something amazing, and, so, yeah, let's hear all about it. I, could you imagine if all of us doctors actually put into work, a passion project, like we would change the face of medicine, right, and not be bogged down by insurance, not be bogged down by our bosses, not be bogged down, down by the amount of hours we're working, but each one of us has a solution. We all have it. We all have ideas. Right. How neat would it be, to create an environment, where we all get together, and we're just like, do it. Like, let me help you. How can I help you? You know, and I think that's where, I think Peter Kim does a great job, it's just like with, especially with me, like, Lindsay, who can I connect you with, you know? Yes. And Vikram Raya, you know, he's, he's just amazing. Like, who do you need to meet next? And I, I think, man, if we could do that for all physicians. I know. We can, right, I mean, I think that, I think you and I come from a lot of the same mentality of how do we empower each other, and, yeah. You know, we've mentioned Peter Kim a a couple times and, um, he's phenomenal as great person, good friend, good mentor, um, very good connector, and also just, incredibly motivational, mm-hmm, to, I know for you, for myself, for so many other physicians, whether or not, we, so we, you and I have had an opportunity to be in his Mastermind, and work with him closely, but I know he's, had a lot of, touchpoints, and just really had an impact on so many other physicians, and their families as well. And so, I think, yeah, we could, if we could, have that conversation too, about the power of masterminds, um, but yeah, it's, again, I think it's just this testament to, to you and your persistence, that you are like, this is, I'm, and I know you've had, you've had some barriers along the way, I remember talking you, talking to you about some of those, and, and yet here you are, and if you're watching us on YouTube, you've got the headset in the background, and I, I was a tester once, and I, didn't wanna take it off, so it was incredible. So, okay, so tell us, what is immersive medical therapy? Sure. Immersive medical therapy is combining virtual reality with medical advice, and so I essentially, help these children get into a state of mind, where they're more receptive to the advice that I'm about to give. When a child comes in, and it may be the first time that they've actually admitted to a grown adult, or a professional, that they are severely depressed, and they meet the criteria for depression, but also usually they have suicidal thoughts, or ideation, or a plan, or a previous attempt, and, you know, that's being disclosed, it's all out there now. So, so, when I was in the office, I didn't wanna just let them outta my site. You know, I'm, I'm six to eight weeks out, and I can't, it is not appropriate for me to say, I'll see you again in six to eight weeks. Um, getting em in with counseling in my area is not fast, and psychiatry takes three to six months. And so, you know, they're in my care for the time being, and, I wanted to develop a course essentially, where I could tell these kids what I wanted to tell them, without having to use my time. And so the course is designed, over eight lessons, where, I meet with them, and put them in virtual reality, and we can talk about the science behind virtual reality, cause that's actually a huge part of why it's so cool that a doctor is designing a program. I'm not gonna do something that's just woo woo, or, um, sounds good. Like, I'm actually finding literature to support the science of what we're doing. And so, you know, we talk about behavioral activation, and physiologic change, and flow state, and, uh, cortisol, adrenaline, dopamine, all of those things in the science part of it, but when I put em in the virtual reality headset, my goal, ultimately in lay terms, is to calm their brain. And that works, because a lot of the chatter in the monkey brain, is in the frontal cortex, but that's also where that visual stimuli is. And so, you know, when I get them into the headset, they're overwhelmed with visualization, that everything else calms down. And then when I get them out of the headset, I can say, hey, and so lesson one is actually what is depression? I want them to know that one in five children have depression. It's very common. That they're not alone, and that, this is, a phase, and, I'm here to help em through this. And so just, you know, lesson one is just getting them familiar with the headset, but also just getting them to really understand that, hey, this is what it is. We understand it better than you think, and, it can be a phase, and I want to get them better. And usually, when I end the session, they're like, when's my next one? And I mean, what kid is excited to come to the doctor? Like, you never hear that, but because VR is fun, it's also effective, and I love that about it. So then in like, phase two, you know, we kind of go to the basics like, why did you get in this state? And we, we touch on a few things like, are you getting enough sleep? How is your nutrition? What is your social influence? Are you safe? And so, you know, we're just touching on a few things that are super important, but then also in VR, I get them exercising. So we focus on movement as medicine, and, these kids are cool. Like, they're like, ah, I never knew exercise could be so fun. Or, wow, I actually feel calm when I exercise. Or there's people that take it to a whole new level, you know, they're dancing to Pink, and they're just going to town. Um, and, you know, they leave my office feeling better, and it's, a little unusual. A lot of times, if I wasn't using VR, I didn't, they weren't excited to come back, and they certainly didn't feel better, per se. They might feel a relief, but not like, wow, you know, so this is, it's a combination of using science with modern technology, um, but then also educating them, and giving em tools that they need to get better. Right now, the biggest program I work on is Teen Depression. Um, that program's done, it's available, and, the next one I'm working on is, um, eating disorders, and then depression for adults. And so, um, you know, it can be used in so many different ways. My company is immersive medical therapy, so my goal is to make it kind of an umbrella, where we can meet different needs. But of course, my passion is working with the children. That is so cool, and I just, love what you said about, kids that are, excited to come back and, and do the next one. Yeah. Like, yeah, what, what teenager wants to come to the doctor and, and talk about their depression with, a grownup. Yeah. Right. Yeah. Yeah, yeah. And you, you said you meet, you're meeting them where they're, where they are, and, I mean, I didn't grow up with cell phones and, you know, we had video games of course, which I, I didn't, wasn't really into, but, our teens are so, so, um, accustomed to screens, and screen time, and that, that's a whole other issue, but, instead of, really looking at that and saying, well, screen time might be a contributor to, to teen depression, it's like, no, these, these kids are, this is what, this is what really stimulates them, and this is what they listen to. Like you said, this is what brings them into the safe space. And, so, really just kind of, capturing that, and capitalizing on the fact that they're, going to want to do this, and, this is something that they, are gonna find exciting, and, and, and then getting them moving too, because, a lot of teens, don't tend to move, they, they're, unless they're in sports, at least that's my experience, or something that gets them active, and, just, I just, I think that is so amazing. And I'm curious what kind of, so what are the results that you've seen in your practice, and in the building of the company? Sure, sure. Um, I, my actual numbers are on my website, and my app, but, um, I would just say a hundred percent of the kids say they got a lot out of the program. A hundred percent of the kids said they enjoyed it, and that they would recommend it, to others. Um, you know, when we look at the, PHQ 9 scores, there is a, an 80 plus percent improvement. Um, there, there was, kind of a mix, there was a, a child that, um, she was working with a counselor, while we were doing the program, and you know, her scores, didn't necessarily improve. They didn't get worse, but, when you ask her feedback on the program, she, she was like, I enjoyed the program. I could get my thoughts to change. I, um, I learned, I developed coping strategies. You know, one of the things we work with in, in, um, one of the lessons, is coping with anxiety, and using the box breathing method, method. Mm-hmm. And so, you know, that's just where you, you inhale over four, you hold over four, you exhale over four, you hold over four, and we bring in a, a military dude to teach the kids this and talk, he talks about how the Navy Seals use this in the military. And so, the kids actually get a lot out of that. And she used it. She was like, I got in a fight with my mom, and I was doing box breathing, and I didn't yell at her as much. You know, so, um, yes, the PHQ scores are improving, um, but also the techniques they're learning are applicable for the rest of their life, you know, and, um, the GAD scores. So what's very fascinating, is I wanted to hit on anxiety as well, because it, you know, it's a comorbid condition and, um, we see improvement in anxiety, almost after the first two lessons, um, in everybody, so that's really exciting. I just, like, wherever do we hear a hundred percent in any sort of research or trials, trials or anything like that. Like, that's amazing. That's amazing. And to see those improvements and, um, for our listeners aren't medical, the PHQ 9 is a measure of depression, stands for Patient Health Questionnaire, and then the GAD, um, is a measure of anxiety. So, um, so just to, for the background there. And, that example that you gave, I just, I think about, how so many of us, even if we don't have any clinical mood disorder, when we get negative thoughts, we get, well, at least for me, and I, I hear this a lot of my clients, and colleagues, that, we get stuck, and we start to ruminate, and, that's where a lot of the anxiety, and some of the cognitive behavior, cognitive behavioral therapy can come in. Yeah. And unless there's something that, that kind of breaks it, and helps us to see, okay, these are, these are my thoughts, and they're not, they're not real, and, is there a different thought that might help me? Then we get stuck in that same cycle and it's, it's very easy, to, to spiral, and, I think it can be, more magnified in adolescents, because their frontal lobes are not as developed, and there's such a sense of, I'm the only one going through this. I know, at least I have a teenager, and I know, in that generation, I, I, I'm so, just inspired by the conversations that they're having, and I feel like mental health is less of a stigma in her generation, and they're more open about it, which I think is fantastic. At the same time, the, the coping skills might not be as well developed, as in adults, and I mean, a lot of adults still don't have that great coping skills, and even those, those adults that do, can still fall back into those, patterns. And so, to have a tool that, will sit down with you, and the first thing you say is, you're not alone, this is really common, really just opens up that conversation, and then to help them to see that, there are tools that they can use to, to, to break it, like the box breathing. I, I woke up in the middle of the night last night, and I did some box breathing to help calm my nervous system, so I could go back to sleep. So, um, and it sounds like there's some humor in there too with this Navy Seal to, to give a little bit of levity and, and just some, some joy. Yeah, exercise. I try to use a variety so they're not just hearing from me. Yeah. And I think that, you know, that touches, it's like some kids love it, some kids like it, some kids are like, that wasn't my favorite. And all of that is okay. You know? Um, the other thing is I feel like, you know, they might not need something now, but these figures are, um, impressionable. And so, when they need it, they're like, oh, you remember when I learned that? You know? Yeah. So they remember it because again, and I know I'm preaching to the choir, but just what's, what I'm hearing is since you're bringing them into a state of safety in their nervous system, they're going to remember it. Yeah. And rather than a place of fear, they're feeling safe and calm, and their fight or flight is tamped down. And so I, that was one of the things you said first, is how do I put these kids in a safe space, so that they can hear me. Mm-hmm. It sounds like your, a lot of your experience was that maybe you tried some other things before this where the kids just weren't, they weren't feeling safe, and so they weren't able to really take in what you were, what you were saying, and the, the guidance and counsel that you were giving them. Yeah, yeah. And there was a study, and this was published in the American Academy of Family Medicine or Family Physicians, where they talked about the, the child's relationship with their physician is the positive predictor of an outcome. And so, um, man, when I heard that, I was like, I don't need a counselor. What I need is for them to keep coming back so I can be the influence that they need. Yeah. Um, and then when they get into counseling, I can let go a little bit, you know? So at first it was very like, oh my gosh, I need, I need air. I need air, I gotta find counselors. And they we're not available. And then it was COVID, so they weren't meeting people. And then, you know, insurance is a barrier. And for me, sometimes these kids can't drive and they gotta go 30 miles. So, um, yeah, I mean, as a physician, we know so much and we're so equipped, we don't know it all, but, I love that saying, you know, where it's like, they are just one child in our life, but at that time in their life, we are one influencer. We are maybe the one person that they truly do need, the healthy relationship, and role model that they need. Like, we are their world in that moment, because they have suicidal thoughts. They don't know if they're safe at home or you know, that relationship they just got out of is just making them feel like the world is done. And so, if we're that breath of fresh air for them, um, we need to keep em in our care. And I was going back to that statistic where just, you know, we still have significant influence over our children that are in our office as patients. Um, when I read that article, that was empowering to me that I, I can do this, I should do this. You know, and, and not just VR, I'm just talking about keeping these children, um, treating these, children, even though I'm not specialized in psych, even though I'm not specialized as a pediatrician, even though I'm not a counselor, like, you know, this, this can start here, and then I can build the resources as they come. So, yeah, yeah. And I know you've, you've worked with a lot of psychiatrists and, and folks to, to help develop this too, and, and I think that's something that I hear from physicians a lot is, well, I, I, I'm only a pediatrician, so I can't do this, or I'm only a whatever. I'm just a, that little part of me dies every time I hear that. Like, you're a doctor. That's a big deal. Um, and so the fact that you didn't let that stop you, you didn't let that hold you back, and I know you've hit a few bumps in the road and yet you persisted. So yeah, share a little bit with our listeners about what helped you get past those challenges. Yeah, yeah. I think a lot of it just had to do with me not doing something like this before. You know, it feels very, um, foreign to my nervous system, so why me? You know? Um, but what gets me out of that is when I just go back to my why, you know, the child that I'm treating, and I keep her name secret for HIPAA, but um, she was a 14-year-old with suicidal ideation, that didn't share this with anybody. And her mom was one of my friends in high school. And you know, her mom looked me in the eye and said that we're a good family. Like, how did this happen to my little girl? Like, what do I do? And I need your help. And so when I developed this program, I developed it for her, and I used it with her, and like I could cry, because she would say things like, Lindsey, this is the first time that my thoughts have actually stopped. All those negative feelings stopped chasing me. And I'm like, wow, okay, what I was reading was actually real, and VR does work, and what I have to say matters. So okay, I'll just keep going. And so, you know, we would spend time usually on the weekends, um, doing these lessons together, and it was impactful. I've seen it work, and, I know in my heart it works. And so therefore, even though the funding isn't there, or um, you know, the, kind of the, there's a little bit of a resistance in the medical field, so counselors have been using VR in their clinic for over 10 years. 10 years, but yet there's resistance in the medical field. But yet the AMA has a CPT code, so you can bill for it. So why aren't we using it? So, you know, it's just like these little, these little nooks, um, that I'm punching down. And I've been invited to speak at the AOA, uh, which is pretty cool. So they have their annual conference in September. And it's gonna be the Virtual Reality of Medicine. And so my goal is, you know, just to bring awareness to people, but also we have a lot of resources out there that are already being used, and they're only getting better, and stronger. So that's exciting. Um, as far as other hurdles, you know, I still work full-time. I still mom full-time. Um, so finding the time to do this can be challenging. If anybody is a physician working on your passion project, like just keep going. Um, finding, you know, even if it's a half hour every day or an hour every day, I wake up extra early just to do this stuff. The, the passion of it overflows into the rest of my life. I am a better physician, because I also do something I really enjoy, or I am a better mom, because I'm actually not just doing the monotonous day-to-day grind, but I'm actually like giving myself fuel to the soul that allows me to be a light to the world. You know? I mean, it just like these little things that go on in my head and I don't know, maybe I'm repaving my neuro pathways, um, but, the idea of these hurdles to me, seem like they're supposed to be there, and it's my job to figure out how to conquer them. And so it's taking me longer, it's taken more money. It's taken me a stronger mindset. I don't think those are by accident, right? Like most people give up. Most businesses fail in the first year. Well, I made it my first year, so um, and the other thing is I'm still making impact and so I'm, I'm just gonna keep going. That's what I believe. So hopefully that helps somebody. Oh my gosh. So much gold in there. And I'm getting teary too, hearing you know, your story about your patient, and that she's your why, and when you've had challenges or the doubters, and I know you've had a lot of those, you just remember her and you, I say, I know this works. This works and it's saving lives. And so I'm not gonna stop. I'm not gonna let this, I'm not gonna let this, uh, veer me off track, and what you said about, those are there for a reason. Those stumbles and those roadblocks are there for a reason, and they're all to really just kind of reinforce for you that this is your path, and I think that, yeah, a lot of times we see these, these challenges as like, well, this is a sign that I shouldn't be doing this, right? Mm-hmm. Um, and to you it's like, okay, this is a sign that I need to double down. I need to make sure more people know about this and I need to shout it from more rooftops. And I just, that is just so inspiring for me and so inspiring for our audience and, and what you said about rewiring your nervous system. Yeah. You really are. Because every time that you, see a challenge and push past it and go back to your why, that you're bringing your own nervous system back into safety. You're doing for yourself, what you're doing for your patients, and showing them that, yeah, it's okay and this is my path and, what you said about being a better mom, and a better physician, as a result of this passion project. I, I hear that a lot of times too, from other physicians and my clients that, well, I, you know, I can't do this because it's gonna take time away from my kids. And you've brought your girls into this. I know you've, you've shared with me some of the conversations that you've had with them and you've showed it to them, and, and so, they use the VR headset almost better than I do. That's so fun. Yeah. So you're not, it's not like the separation of my passion project, oh, and then spend time with my kids. Like, you've brought them into the mix, and so they get to see what mom does, and get to be excited right there along with you. Yeah. Yeah. And, you know, and it, when it gets difficult, I go into my team, right? So like, um, in March I always go to Cedar Sinai's Virtual Reality and Medicine Conference, and I had a list, and I was fully ready to say, do I keep going or not? Like these are real barriers. Um, and my team pulled together and pretty much said, don't stop. You need to talk to this person. You need to meet up with this person. You need to change your headset, headset from Meta Quest to Pico. Um, you need to, you know, meet with this lawyer. You need to, um, you know, consider this FDA path instead of that FDA path. I've met with the FDA, um, I'm working with IRB Research, you know, I, I have a lot of, uh, people around me that are cheering me on in ways that I never thought I would need or look for, but because I just keep going, it's like the opportunities, you know, they just kind of lock into place and I think it makes the project stronger. Um, it's, I feel like I'm doing it on my own, but really I'm not, because I couldn't do this alone. Mm-hmm. You know, so it's, it's, yeah, I hope, I hope that resonates with somebody that's trying to do something, because don't give up. Like it's, it's about who you know, and if you have your passion, and you know it makes a difference, just keep going. Yeah. I hear that too. It's like, well, I don't know how to do X, Y, or Z. Like, well, you didn't know how to do a central line 20 years ago, but you, you've learned, yeah, you figured it out, and somebody showed you the path, so somebody can show you this path. Yeah. Yeah. I, it's so exciting, and I am just so happy for you and, um, you've inspired me over the years in so many ways. So thank you for that and for um, yeah, for being that for me. Tell us, so you mentioned the App, so I wanna hear more about the App, and then where people can find you. Congrats on the speaking at AOA, uh, that's incredible. I just, I can't wait to hear how that goes, so you'll definitely have to have to let me know. But yeah, tell us about the App. Tell us where people can find you, and some advice for our listeners. Sure, sure. So if you have an Android or an Apple, um, you can download my App on immersive medical therapy. Um, the logo, I don't know, can you guys see that? That's a logo. Yeah. On YouTube we can, we can see it a little bit. We might wanna, have to, drop it in there for our podcast listeners. So, there you go, there's the logo. So when you search for immersive medical therapy, you just pull that up. Uh, it's my website too, is immersivemedicaltherapy.com. Um, you can email me at immersivemedicaltherapy@gmail.com. Um, as far as, you know, contacting me, of course I have my business cell phone number available. Um, somebody can reach me that way. So I, I'm happy to talk to, you know, whoever has questions or needs inspiration. Um, uh, if you want to look at using the product, um, for your patients or for kids, um, yeah, yeah. Thank you so much. So wonderful to talk to you. Thanks for having me. Yeah, I appreciate, yes, like I said, it's just been incredible to, to watch your journey, and just see everything that you've pushed through and, um, like I said, really inspiring for me, and so thank you. You've always been an inspiration, and a rock for me too. Someday I'm gonna write a book just like you. Thanks so much for being here, Lindsey. Thanks, Laura, bye-bye.​While I am a physician, the information presented in this podcast is for educational purposes only and should not be considered medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Please consult with your own healthcare provider before making any significant changes to your lifestyle or routine. By listening to this podcast, you are not creating a physician patient relationship. Thank you for listening to the Purposeful MD Podcast. If you like what you hear, please rate and review the show. Please also visit my website, www.thepurposefulmd.com for free downloads or to discuss working with me as your coach.