Why the Hesitation Around Mental Health Meds?

Whether medication is prescribed for mental or physical ailments, why do we experience hesitancy around taking medication?

For many, medication for chronic illness can feel overwhelming including finding the right medication and the long-term commitment. We invited physician assistants Cshandar Lamb and Dan Krause to discuss what starting medication looks like, the management after, and other treatment options. 

Have questions, thoughts, or stories you want to share? We would love to hear from you! Shoot us an email at brightminds@pawnee.org

Your mental health matters. While this podcast is meant to foster connection, understanding, and hope, we know that some conversations may bring up difficult or emotional moments. If you need support, help is available and you don’t have to navigate it alone.

If you or someone you know is in crisis or experiencing emotional distress, call or text 988 to reach the Suicide & Crisis Lifeline. Free, confidential support is available at any time.

To learn more about Pawnee Mental Health, visit us at https://www.pawnee.org

Transcript

SPEAKER_00 0:03

Welcome back. I'm Jonathan Saypal.

SPEAKER_04 0:05

And I'm Michelle Maliou, and this is Bright Minds and Brighter Days Podcast.

SPEAKER_00 0:09

Where every episode our goal is to bring you real conversations that meet real care.

SPEAKER_04 0:16

All right, Jonathan. Today we are going to be talking about medication management. I know in the past we've done is it mental, is it physical, and we talked a lot about medication services. I think still what's kind of confusing to the majority of people out there is a lot of people think, let me just take a pill and it's a magic pill. And guess what? I took this and 30 minutes later I'm going to be a whole different person. And if I'm not on my medication, all things are going to fall off, right?

SPEAKER_00 0:39

Right.

SPEAKER_04 0:39

And I think that's the hard part. So today we have two special guests that are going to help us talk about medication management and why it's good and lead us down the right path.

SPEAKER_00 0:48

We have with us today, we have Shandar Lamb, is a NCCPA with a degree from Midwest University with 20 years of experience working in family medicine and worked previously at a vascular surgery surgery clinic at Walter Reed in Washington, D.C. Our other guest, Dan Krause, graduated from University of Texas Medical Branch with an MPAS. Dan's worked at a variety of clinics which include a TBI clinic on Fort Riley, family practice for civilian families in active duty, and is currently the director of operations for Victory Clinic, which is a depressant treatment clinic focusing on transcranial magnetic stimulation and spravato ketamine treatments. Welcome.

SPEAKER_04 1:38

Thank you. We're excited to have you guys here. So talk about, I guess let's get to the basic. What is medication management? What does that mean?

SPEAKER_03 1:46

Um, I think, well, for me, I think it's looking at the patient, where they are, what their needs are, and how medication may or may not play into helping them reach that particular health goal. Okay.

SPEAKER_01 2:03

Yeah. That's good. I think that's a great uh great explanation. It means a lot of different things for a lot of different folks, depending on their expectations. But how can we help you meet your goals with uh medications if that's a part of it? Sometimes we're gonna you know deviate from just strict medication management and uh touch on some treatments, uh some modalities that they may not think of.

SPEAKER_04 2:30

Yeah.

SPEAKER_01 2:31

Could be lumped into that interesting umbrella.

SPEAKER_00 2:34

And so, I mean, do you ever do you ever feel like uh like is there a difference between uh medication management for mental health and medication management for uh physical ailment?

SPEAKER_01 2:45

100%. Could you elaborate? Yeah, for sure. I think when you're talking medication management, it sort of has a a slant towards uh behavioral health to begin with. Um I think if you're dealing with physical ailments, if we're talking about diabetes or high blood pressure, certainly there's medication management involved, but there's a certain weight, I think, that comes um with the behavioral health side of things. And so you know there's a stigma. We can't we can't shake the stigma of uh behavioral health and medication management. And so it can be um it can be sort of a weightier discussion, I think.

SPEAKER_04 3:29

Do you think that's why people are hesitant to take medication when it comes to mental health?

SPEAKER_01 3:33

Uh yeah, yeah, for sure.

SPEAKER_04 3:36

The stigma also is this uh something I'm gonna be on my entire life, is it never gonna get better?

SPEAKER_03 3:42

And I think still, even in this day and age, people feel like it's something I gotta get over, that they have to do it themselves, and that if you get medication for anxiety or depression, oh I I'm weak in some sort of way when that's really not the case at all. But that's what I I hear that a lot. Really? Surprisingly, yeah.

SPEAKER_04 4:05

It's interesting the mindset that people have when it comes to that. But medication is not the one size fits all, is it? No, it is not.

SPEAKER_01 4:14

Definitely not.

SPEAKER_03 4:15

Definitely not.

SPEAKER_01 4:16

But but I think if we're talking about uh things like depression or anxiety, these are chronic conditions. As much as people think, you know, I'm gonna be able to get through this, this is just a rough patch in my life. For the majority of folks, they're chronic conditions. And so when we get someone to, you know, normal blood pressure, we don't take them off their blood pressure med. They stay on it their whole life. If if you get to, you know, target range for your A1C, if you're diabetic, we don't take you off your medication. There are some rare instances where we can change the treatment plan and rely less on medications and more on, say, you know, you know, behavioral changes, dietary changes, things like that. But for the for the majority of folks, you're looking at a chronic disease and chronic management of it. So you've got to kind of settle into a treatment plan that that meets your needs, it's comfortable for you, and it's effective for you.

SPEAKER_04 5:22

So I feel like when I used to work the front desk a long time ago, that's something I would hear. People would constantly call and I need to be put on a medication. And we're like, eh, okay, let's back this up a little bit. Like let's kind of find what the root of the problem is, where why why are we making this decision? And then ultimately let's do some talk therapy first to figure out because I think again, everybody thinks the pill's just gonna cure them. And I think a lot of times you're gonna realize if you did talk therapy and other you know modalities that we could figure out, you know what, you may not need medication. That's true.

SPEAKER_01 5:50

Yeah, absolutely. I agree with that too. Um I think there's probably a bell curve uh for where folks uh fractionate, but there are other people who go immediately to medication, want something easy, like getting up every day, taking a pill, and not thinking about the work they might have to do. Um then there's, you know, the group of folks who just want nothing to do with medication because of uh, you know, the stigma we talked about. And so they're interested in in just about everything else. And then maybe maybe the last part of that curve would be, you know, a mashup of those two things. Um but it's not always um I find. What do you what do you think?

SPEAKER_03 6:34

I agree. Yeah, I think it just when I when I meet a patient, I just talk, just kind of see where they are, but absolutely you have some people who are just give me the pill. I mean they and I find those folks are usually disappointed when they kind of come in with that mentality because they put so much weight on the medication to solve everything. And I always tell them that, you know, meds will not change the fact that we're having relationship problems or it's not gonna change the fact, it's not gonna it's it's just not gonna do all those things. And so um there are other aspects of treatment that I think should always be explored. And whether or not they take it or not, you know, it's up to them, but you know, at least explore it. At least let's talk about it.

SPEAKER_00 7:28

And do you do you think that comes from because I I I know my my personal experience with you know being prescribed medications. Uh, you know, I s I started taking um, you know, multitude of different um psychiatric medications when I was a teenager, all the way through early adulthood. And um, of course, you know, this was late 90s, early 2000s. So, um, you know, I r I remember back then it just felt like um like they were just throwing medication at you. A lot of times it you just felt like a guinea pig, you know. And um uh so much to the point that, you know, one one time uh I went to try to fill a prescription and the f even the pharmacist said, I can't I can't prescribe this to you. And when I asked why, he's like, Well, you know, if if you're already taking this, if we prescribe you this, that can send you into cardiac arrest.

SPEAKER_01 8:15

Yeah.

SPEAKER_00 8:15

And I was I was like sixteen years old.

SPEAKER_01 8:17

Yeah.

SPEAKER_00 8:18

And so, um, but but do you think, you know, with people just coming in ex thinking, hey, I'm just gonna talk to a doctor, they have to give me the medical pill, do you think it's it it's it's because maybe in the past uh medications were just given out so you know, like I mean, just in Yeah.

SPEAKER_01 8:37

Yeah, I think that certainly if we go back to the late eighties when Prozac first came on the market, that was the first SSRI uh selective serotonin reuptake inhibitor that was the new wave of psychiatry. Keep in mind I was, you know, in high school. I knew nothing about these things at that time. Um, not yet even th thinking about becoming a uh you know a medical provider. But I I remember just how different things kind of felt at that point in time. And because we had this new age, if you will, of medications, uh these second generation um antidepressants, first generation we still use, um, you know, there there's a lot higher side effect profile. But even taking a step back from that, depression has been um you know oversold and and oversimplified to us. And you know, we've been led to believe it was a serotonin problem all along. And as soon as you get these these drugs that are new to the market, there's a lot of direct and indirect pressure to get those out to folks. You know, the healthcare providers think, well, finally I've got a tool that can help people. And these people are showing up um at my clinic and I've got you know an obligation to help them. And so that I think drives some of that um s that that pressure that you might feel walking into um a doctor's office circa 90s or early 2000s, even. Nothing really changed except now Prozac has a bunch of other um, you know, similar drugs that it's competing with in the marketplace. Um and again, there's um I think always a gen genuine um you know earnest need for healthcare providers to help you when you walk in their office. And so um it comes from a good place, but um yeah, it might feel you know like a like a bit of a pressure. Um so I don't know. I think I answered your question. Yeah, yeah, absolutely.

SPEAKER_04 11:01

It's very detailed. I loved it. I loved it. Do you feel like social media is hard these days?

SPEAKER_01 11:07

Oh my gosh, don't get me started.

SPEAKER_04 11:09

You see somebody, oh, this person's on this medication, it's making him feel this way. That's how I want to feel. But again, just because you're taking that medication and I start taking it, we're not gonna feel the same.

SPEAKER_01 11:19

You know, there is so much that could be said. That's a whole other podcast. Okay, we'll invite you back. Um, the the curated life and what people want you to believe, and then the influencer that wants to sell something and get kickbacks, and then um, you know, everything in between there. Um certainly, you know, there there has to be a a good history and physical, um, a talk with your doc. What what do you need? How is it gonna best um fit into your lifestyle? Is it gonna be effective? All that. And so it's really important to, you know, start at the beginning so that you can get set up with the right treatment plan if if that includes um a medication for you. But yeah.

SPEAKER_03 12:09

But maybe, maybe I'm just kind of thinking, if they didn't see that influencer on that medicine, I mean, would they maybe they would have swept that under the rug? Like maybe that kind of helped. Maybe it brought it to light. Yeah, yeah.

SPEAKER_04 12:23

You know.

SPEAKER_01 12:24

That's true too. That's true.

SPEAKER_04 12:25

It's a pros and cons, just like everything else.

SPEAKER_00 12:27

Increased awareness, I like it. Yes.

SPEAKER_03 12:30

Yeah, yeah.

SPEAKER_00 12:31

So so how should someone start the conversation?

SPEAKER_03 12:36

I mean, I feel like with like with my patients, I'm I feel like I'm being open book. Like, and it doesn't have to be this very um pretty presentation that you're it can be, hey, uh, you know, I've been thinking this way or I feel this way, or what do you think? You know, and we just start asking the questions. You just un undo the layers one by one, and then you know, we can kind of figure some things out. But I think just bringing it up, just say what you feel, you know.

SPEAKER_04 13:10

Can you explain what dopamine hunting is?

SPEAKER_01 13:15

That's kind of a newer phenomenon. I I feel like um there's a lot of catchphrases today, and you know, we know dopamine is a neurotransmitter that is helpful in the reward system of our brain. And so, you know, again, back to social media, um, there's always this uh compulsion, I think, certainly with most folks, but I would say younger folks I know I might take a hit for saying that um that that want to have a constant stimulation, brain stimulation, and what's the the easiest and what is the most economical to get that hit. And so it's just not letting to me, it's not letting your brain be bored, which is a bad thing. Your brain has to be bored sometimes.

SPEAKER_04 14:11

A lot of us are trying to shut our brains off at certain points. Yeah. And then you have a generation that just wants to keep go, go, go.

SPEAKER_01 14:17

Yeah. Um so you know, if i if we think about it, um just all the input, all the stimulation we have these days uh is gonna try to activate that reward center in the brain. Um that's what it means to me. I don't know. Shandar, you have any?

SPEAKER_03 14:40

I mean, I definitely so I'm talking about those young folks, right? So the young I definitely hear that a lot. Um you know, this I'm bored, I need like it's this constant um need to be stimulated or that something has to be happening a hundred percent of the time, all the time. To me, that is exhausting. Yes. But um I think sometimes it's hard if I'm talking to someone who feels like they that's something they it's almost like they feel like something is wrong with them if they are not stimulated a hundred percent of the time. If they have that downtime, it's right. Like there's wrong it's like downtime is wrong almost. Yeah. And um it's not. And it's like so I think it's hard again. I just usually use the adage like, well, look, I'm an old person. You know, uh I remember times when I was in my room and I had to create things. I didn't have video games, or I didn't have, or we had video games, but you know, Atari was not. You just went outside and played this. Yeah, we just went outside. We just went outside and played. And uh so, or there was times when your friends didn't come out and it was just you, you know. So you learn how to be in the quiet and you learn how to be comfortable with it too. Absolutely. So I think that is uh I don't know, but um to me it's exhausting. I I I try to tell my patients like it's okay to be, you know, have some downtime, but I don't think they believe me.

SPEAKER_00 16:07

So so do you think do you do so do you think that um, you know, this uh you know, this feeling of I can't be bored, you know, I I I don't want to be bored, this this dopamine hunt like do you feel like this maybe leads to some like say misdiagnosis of ADHD? I mean, if a kid is constantly walk like I'm bored, I need something, I need and and so they're pacing around the house, and you know, and every time you talk to them, I'm just bored, I'm just bored. I mean, do you do you think that maybe lead parents to I think they might have ADHD, I'm gonna get them checked out. I could see that. Is that a possibility?

SPEAKER_03 16:42

I could see that.

SPEAKER_01 16:43

Yeah, I I certainly uh think that um there's enough uh concern from a parent uh mixed with some behavior. Um it wouldn't always lead to the diagnosis. But I certainly think that um there's there could be something there. Once you have a healthcare provider in front of you and some screening metrics, you can say, okay, well this doesn't necessarily meet criteria, but I could see how a parent could could think that. Um and um you know some of the same um ADHD symptoms uh are symptoms of depression too. And so um sometimes uh, you know, ADHD masquerades as uh as depression or can confound the diagnosis of depression or delay it may might be a better way of saying it.

SPEAKER_03 17:39

I agree. I think um a lot of times when, especially if a child presents as hyper, you know, and just or active. I want to say hyper, just active. Um I think that's the first thing they drag the kid in. It's my kid has ADHD. Um personally, I feel like in today's world, I feel like there's a lot of expectation on young kids. Like they have to sit with their hands folded and be quiet and focused at five years old.

SPEAKER_00 18:08

And what kid wants to do that right now? Right.

SPEAKER_03 18:10

I'm like, oh my gosh, or can do that. Yeah. So I feel like in some ways, um, and maybe it's just me. Like, you know, maybe maybe I don't have high expectations for my children. Like I'm like, well, they probably it's hard. It's it's hard for the average child to sit still and do things. And um, and like you said, sometimes kids are anxious. I've seen that a lot of times where um they presented like an ADHD. Uh and then let's say when you in the Vanderbilt questionnaire, because that's usually a common screener we use for children. It looks like it, oh yeah, yeah, this kid has ADHD. Then you put them on medication, medication's not working. Well, you know, and then as it starts to reveal itself, maybe that child really had anxiety and it was an ADHD. And so then getting them on the right meds and then voila, see, it wasn't even ADHD, it was something totally different. But they look alike, and it's hard, I think, with little people. I think it's hard with adults too, that figure out um some of those tease those things out sometimes.

SPEAKER_04 19:12

So starting a medication, it not working, trying a different medication, there's a lot of trial and error that goes into it. It's not just I come visit you, you ask me some questions, you put me on a pill, and then we're good. And then you send me on my way for a year. How often are you prescribing and then how often do you see them back?

SPEAKER_03 19:28

I mean, how often?

SPEAKER_04 19:29

So when you say how often So, like if I came to you and you prescribed me medication, and then you're gonna say, I want to see you back in is it two weeks? Is it a month? I'm gonna say three months.

SPEAKER_03 19:39

Two to four weeks on average, especially when it's a new medication, because I just want to see how they're doing because you have to me you have the whole gamut. You have people who rock and roll, they're doing great, and then you have others who feel every single side effect. And it's scary if you've never felt that, I get that. Um so I'd rather have a closer follow-up so we can adjust. Yeah. As needed.

SPEAKER_04 20:03

And then you continually monitor them, don't you? Absolutely. We don't just send somebody with a script and say, check back in in however long, right? Absolutely not. Hence the reason it's called management. Absolutely. Yeah.

SPEAKER_01 20:13

It used to be that that, you know, when you're talking about SSRIs, um, you know, depression, antidepressant meds, um we didn't have something called a pharmac pharmacogenetic test. That eliminates a lot of the trial and error that we used to have to go through. So we'd start folks on, say, Prozac or Zoloft or Selexa, and we'd have to see them back six weeks. We have to give that drug a six-week trial before we would see you back. Super frustrating. Okay? That's an eternity for someone who's struggling with depression. And if they're not getting better during that time, you know, what's what's the incentive for them to keep taking it, especially if they have some side effects? And so the advent of gene sequencing and pharmacogenetics, we can take a cheek swab now and send it off and get a pretty detailed report back that has dosing considerations for all those drugs. Okay, there's several different classes. This does not tell you if the drug is going to make you feel better. Okay, that's an important thing to note. It's not going to say, hey, well, but my depression. But it certainly eliminates about 50% of the trials that we had to do previously. If there's any dosing considerations, we would just cast those drugs aside and work through the ones where there were no issues with dosing. So we could start you on, say, 10 milligrams, uh, increase you to 20 after two weeks if you felt like there was some benefit, but maybe not enough. Um And so on and so forth. So you know, that has been a really um game changer. Absolutely. I think in in behavioral health management, medication management.

SPEAKER_04 22:10

Is that something standard that every provider is doing? Or if somebody's listening and their provider is not, should they be asking?

SPEAKER_01 22:17

They should be. Yeah. GeneSight and Tempest are two tests that are available. I think there's a new one I just heard about Clarity. I haven't used that in the past. But, you know, all of them are harnessing the same kind of science to get you a better result. So, you know, they all take a little sample of your DNA and sequence it and look for changes that might be in your everybody's natural uh drug breakdown system. We all have that system in our liver. And so this is looking for changes. Uh they're called genetic polymorphisms, changes in how those enzymes work. Some work faster, some work slower. And we don't know this unless we do that test. So um ask your provider about gene site, um, tempests, and I think clarity. And how long has that been going on? Uh so I first heard about gene site probably about nine, eight, eight or nine years ago. Yeah. Something like that. Does that sound right? That sounds about right. Yeah. Um I was working in pain management at the time and and um I saw a report um one of the docs I was working with, and um he's like, Yeah, pharmacogenetics. It's the wave of the future. So I was like, cool.

SPEAKER_00 23:43

Yeah. So are there any questions that someone should be asking their provider but but typically don't? Yes.

SPEAKER_01 23:51

Um, just being honest, I think, and and realizing that this is a problem for you and possibly your family. Um, if you're not getting the help you need and you're not able to achieve uh the things you want to, um, it's impacting, you know, all those people around you as well. And just being honest with yourself and I think um confronting the problem. Your provider might do some screening and say, hey, you know, you seem really like you're not yourself lately, why don't you answer these questionnaires for me? But they're not always gonna have a a lot of time to address all your complaints, and if you're not good about seeing your doc, you might come in, you know, less than annually, um, you know, which may or may not be a good thing depending on your age. And so I think just um being honest with yourself and and considering those around you, ask the questions. There's no dumb questions. I know it's a cliche to say, but uh that's true, yeah.

unknown 25:03

That's true.

SPEAKER_04 25:04

Do you guys have a story on how somebody taking the right medication has helped and or saved a relationship with family, friends, a coworker?

SPEAKER_03 25:13

I do. Would you mind sharing it? Okay. Uh okay, so this was a young adult, so early 20s uh male uh had ADHD severe anxiety, like crippling anxiety with panic attacks, um, was treated only, so I'm trying to remember his whole story, but uh was treated for the ADHD early on, but that was it. And um just felt like just he couldn't get a control of his emotions, so very socially, um, had a lot of social anxiety, so didn't attend, um prom, didn't too scared to go and get a job, too scared to leave the couch, you know, to to leave his home basically. Um and then I think when he got on the right medications, that also addressed the anxiety as well. Um it was amazing, it was amazing, like a complete 180. He just was at got a job where he worked with elderly folks and um was able to have his own money, was able to move out from his parents' home. I'm sure they were real happy about that. Uh but yeah, just really blossomed just with the right medication. It took a while to get there, what I understand, but a totally different person.

SPEAKER_04 26:41

So that story just kind of helps people that are kind of stuck on the fence there. Should I keep pushing forward? Is it gonna make a difference? Like, give it time. Yeah, yeah. Good. Thank you for sharing.

SPEAKER_01 26:53

Did you have a story? I might be a little more cynical about uh what's here? Uh SSRIs, antidepressants in general. Um, you know, it's it's not a good fit for everybody. Um I think, like we touched on earlier, that there is this hope. Um, you know, this medication, I haven't tried it before. It can change my life, it can help me achieve my goals, get rid of some of that um, you know, hopelessness I'm feeling. Um there's a really important study that came out a decade ago. This year it was published called the STARDE trial. And it sought to answer the question: how good are antidepressants in helping folks? And um I think there were 4,000 uh participants in this study, $35 million study, biggest NIH has ever done, I think the biggest in psychiatry. And the results, you know, obviously you can interpret studies a lot of different ways, but the take-home for me was, again, that we've really sort of oversimplified depression and and have been oversold this story about, you know, what brings most people down. And, you know, it talked about how when you start on your first medication, the chances of that working, you know, are less than 40%. Okay, so you're already starting, you know, less than heads or tails, uh, which is not great, but still there's some hope there. And if you have to try another drug if you couldn't tolerate side effects or it just didn't work for you, the you know, the percentage goes down. And if we're you know starting on maybe a third drug and we routinely see people on five plus trials, if not ten plus trials, you're looking at less than five percent effectiveness at that point. So, you know, I'm not saying that antidepressants don't have a very important place in the overall treatment plan for folks. But, you know, it's not a serotonin problem. It's not even a serotonin and norepinephrine problem. These are neurotransmitters we might or might not have heard about, certainly the dopamine, like we talked about. It's something more complex than that. And I think some of the treatment modalities we're seeing now, um, ketamine, sketamine, TMS, transcranial magnetic stimulation, are really important because they don't exploit the same pathways uh that we've been relying on modulating for the past almost 50 years. Um they operate in a different way and help to induce neuroplasticity, um, something we haven't touched on yet. So when we're depressed, our brain circuitry disconnects for some reason. We really don't understand how or why that happens, but you know, we can do functional MRIs uh on people's brains. These are living breathing MRIs, not the static type you would do for a torn ACL. And you can see when someone complains of depression, it maps out to a center in the brain. Uh, and we can then treat that area of the brain with TMS, and people will improve, their symptoms will go away. And this really has no direct modulation in serotonin. So here we've got something that's completely outside the treatment paradigm that's helping people move forward. And we're seeing a lot greater effects with treatments like TMS and ketamine the same way. Uh ketamine's been around now. It was uh ketamine first was um synthesized in a lab in 62, 1962, and then it was used in uh Vietnam, uh Army medics would carry it around. Dissociative anesthetic, but you know, the importance of that was we started to see all this um anecdotal evidence of treatment of depression. That wasn't our primary use of it, you know, in jungle medicine, but um it was a very important one. Fast forward to 2019. I realize that's a long time, but um, you know, we're using sprivato, which is the branded form of ketamine, S- ketamine, it's a purified uh enantimer, and we're seeing just completely different uh things than we've ever seen with with SSRIs or other antidepressants, folks having breakthroughs and and really um it's been a huge game changer. So, you know, there are places for SSRIs, um, absolutely, but I think it should be probably a smaller part of the treatment plan for most folks.

SPEAKER_00 32:12

So what's what what's your opinion on um you know on new on other things like uh like Ibogaine treatments? Absolutely.

SPEAKER_01 32:19

Um I'm all for it. Uh with the recent uh signing, uh the fast tracking that uh Trump signed uh with Joe Rogan over his shoulder. Goo goofy cast of characters. I know this isn't a political podcast, but you know, the the uh use of some of these uh herbal remedies that have been around in um you know, shamanistic uh ritualistic uh ceremonies for eons, um, they have a really, really exciting future, I think. Um whether it's DMT or psilocybin, um you know, these drugs act on primarily 2A, HC2A serotonin receptor. And um, you know, it's it's just tremendous to think about what they can uh do for folks with depression. Um there's a really good um I'm not gonna remember the name of it, it's on Netflix, How to Change Your Mind, um, with Michael Pollan. Um he takes five different drugs and kind of places them in uh throughout history um and talks about their import in in some of the you know uh ritualistic um uses in the past. Um I think the important thing is that people recognized early on in history that they had a place and they had a healing benefit. And if we can get these drugs scheduled so that we can conduct research on them, placebo controlled, double-blinded, gold standard type research, um, we're gonna find that there's uh tremendous benefit. Um Michael Pollan really touches on the fact that LSD back in the 50s um and into the Nixon administration, there were just um, you know, there's tremendous promise for that drug, um, helping people with anxiety and depression, and I think we're coming back around. There's um MM120, I think it's called, which is a um a drug in trial for anxiety. Um a single dose can um give you remission from your anxiety up to three months, a single dose. Um that's phase three right now. A Canadian company is is producing it. So yeah, um I bagain. Certainly a pretty intense um trip from what I've heard uh requires a lot of medical attention. Um you know, there's certainly um that that wouldn't be possible to do uh for most folks. Um, you know, too expensive, too risky. Um but can we reduce the dose? Can we um you know use uh modeling to shape that molecule so it's more potent and less stressful? Um I think there's an answer probably out there for sure.

SPEAKER_00 35:37

Sounds like a exciting road forward.

SPEAKER_01 35:39

Yeah, yeah, I think so. To me anyway. I look forward to uh that stuff.

SPEAKER_00 35:45

Alright, well I like to end my uh I like to end the podcast with uh one question. Uh this question's for both of y'all. What gives you hope for the future? Me first.

SPEAKER_03 35:56

Yeah, you go in question.

unknown 36:01

Oh my god.

SPEAKER_01 36:02

That's a that's a weighty one. That is. Um I am I'm a pretty positive person, and I think uh things can be pretty difficult for folks right now. We certainly see it in our clinic, Victory Clinic, um, people coming in um feeling pretty hopeless, the state of the world. Um but I really feel like um not to make light of it, but everything comes out in the wash. Everything starts to equilibrate over time and things will ultimately get better. Um, you know, we may not be at the worst yet, um, but I I feel like um, you know, for every action there's an equal uh reaction that occurs and and the world will write itself. I don't know, that's kind of vague, but that's me. You're on.

SPEAKER_03 37:01

Okay. I like that. Okay, so I'm gonna piggyback on that. Like it. So that kind of reminds me of what my grandmother would say, you know, like this too shall pass, or you know, what goes up will come will come down. So yeah, yeah, even though times might be kind of bleak looking, you know. And but you know what, there's still beauty, those moments, right? Like if you look for them, right? There's still that right, you know, that that that great interaction you have with someone, or just it's a beautiful day. Yep. Living the moment. That's right. So gotta keep your eyes open. Hunt the good stuff.

SPEAKER_04 37:40

That's right. That's right. Thank you both. I appreciate it. All right, thanks for some days feel lighter than others, and some days just feel heavy. Mental health isn't a straight path. It's messy, it's human, and it looks different for everyone. But even in the middle of all that, hope grows with each new day. May is mental health month, and we're having honest conversations about what to take care of when it comes to your mental health. The hard parts, the progress, and everything in between. Because more good days are possible together.

SPEAKER_00 38:14

Michelle and I would like you to know pain is temporary, but giving up is permanent, and you don't have to face it alone.

SPEAKER_04 38:21

If you or someone you know is in need of care, hope is available. For local listeners, you can call Pawnee's Crisis Hotline at 1-800-609-2002.

SPEAKER_00 38:33

For our national listeners, you can call or text the National Suicide and Crisis Lifeline at 988.

SPEAKER_04 38:39

Other mental health resources can also be located on our website, Pawnee.org.

SPEAKER_00 38:44

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