GRAND OLE PSYCHE

Your kid isn’t “broken” because they’re anxious, shut down, or fighting every boundary you set and neither are you. From the Nashville skyline, we bring on national mental health rockstar Dr. John Delony alongside Dr. Brian, a child and adolescent psychiatrist, to talk about what’s really behind rising anxiety in teens, depression in kids, school refusal, and the kind of “acting out” that leaves families exhausted and scared.

We wrestle with the hard question many parents feel but rarely say out loud: what if your child’s symptoms are a normal nervous system response to an abnormal environment? That takes us into family systems, the nature vs nurture reality, and why trauma isn’t only about what happened, but about having to carry it alone. 

We also get candid about labels, including oppositional defiant disorder and ADHD, and why the DSM can be helpful for research and insurance billing while still being a terrible tool for explaining a whole human life, especially when Google turns symptom checklists into identities.

Then we zoom out to solutions you can actually use: when to start with your pediatrician, when therapy should be the next step, why parent behavior training matters, and how exercise and real-world community can rival “quick fix” thinking for mild to moderate depression. 

We also debate AI in mental health and medicine and why technology can streamline notes and diagnostics, but can’t replace presence, trust, and bedside manner. If this conversation helps, subscribe, share it with a parent or clinician who needs it, and leave a review so more families can find it.

THANKS TO OUR GUESTS:

Dr Brian: child and adolescent psychiatric medicine

IG: @raisingadhd_org

https://raisingadhd.org/

Dr John Delony: mental health expert/counselor, comedian

IG/FB/TT/YT @johndelony

www.johndelony.com

Subscribe wherever you listen, share this with a friend and leave a review so more people can find honest conversations about healthcare and a little comedy along the way.

This episode was produced by Angie Debelak with post-production editing by Ben Hill Sound.

Thanks for listening to Dr Ben and Friends.  Laughter is the best medicine...unless you're treating bowel or bladder incontinence.  See you next time!

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Transcript

Welcome From Nashville Skyline

Dr Ben 0:09

All right, knock knock, howdy folks. Hello from the Nashville skyline and welcome to Dr. Ben and Friends, the podcast dedicating to putting the med in comedy. We're shining a big bright spotlight on everyday healthcare heroes and comedians. Southern hospitality on full blast, Nashville style, where hospitality is sweeter than sweet tea, and the comedy's twice as refreshing. Just take your insulin if you need it. All right, I'm your host, Dr. Ben, your friendly neighborhood board-certified orthopedic surgeon by day and stand-up comedian by night. I can fix your hip and break the ice in the same day. All right, listeners, we've got a very special consult in the house today. Today I'm teaming up with national mental health rock star, Dr. John Delony. Dr. John, say hi to everybody. Good to see everybody. All right, we're gonna hear more about Dr. John. His accolades read like a Encyclopedia Britannica, but we only have an hour. And then we also have a real life healthcare hero, Dr. Brian. Hey, thanks for having me. I like how you said that. We have this guy, and we have a real life guy. That's awesome. Healthcare hero. A dedicated physician specializing in child and adolescent psychiatric medicine. Can't wait to hear about what Dr. Brian does. That's right, the Dr. Ben and Friends podcast prescribes 100% comedy with zero copay. All right, today we're celebrating the real life healthcare heroes and comics who dedicate themselves to keeping you safe and laughing. Thank you both for joining us. A special thanks to our sponsor, the Needles Group, in beautiful Marco Island, Florida. As a doctor, I know

Meet The Mental Health Guests

Dr Ben 2:00

a great needle when I see one. And these realtors are the best in the business. Buying or selling, let the Needles Group inject some serious value into your property game, theneedlesgroup.com. All right. This episode of the Dr. Ben and Friends podcast is guaranteed to improve the range of motion in your smile. All right. We have a code awesome today. Code awesome in the studio today. Paging Dr. Delony. Paging Dr. Delony. Dr. Delony, uh, he's a national mental health rock star, best-selling author, radio personality. He champions handling anxiety, establishing boundaries, building a more joyful life. And uh, you may have read his uh Building a Non-Anxious Life. If you haven't, you need to. We all need to. Uh, he has questions for humans. Um, not any questions for non-humans yet. Not yet. We're working on them. Working on them. If you want to start a conversation with your golden retriever, we'll have to find someone else. But all right. Now, Dr. John. Uh, we have Dr. Brian here. Now, what do you think it is that uh Dr. Brian does? I I don't know.

Dr John Delony 3:16

I think Brian. I don't know, you're a handsome guy. Like a model? Yeah. I was gonna say, yeah. Like I think you

How Psychiatrists Train And Specialize

Dr John Delony 3:25

might be the guy that they put on the side of the bus advertising the hospital and the work that you do. It's awesome. The face of the hospital. Yeah, that's mostly my role.

Dr Brian 3:31

I'm the bus guy.

Dr Ben 3:32

You're the bus guy. That's right. That's right. All right. Dr. Brian here is a child and adolescent psychiatrist. Now, Dr. Brian, tell us a little more about uh so you're an actual uh medical doctor that did uh your residency and training in psychiatry. Well, what's that training like to become a psychiatrist?

Dr Brian 3:50

Yeah, so psychiatry training. I mean, it's medical school just like you did. Uh, and then afterwards it's residency and fellowship, which is you know, four to five years of just on-the-job training for the most part. Wow.

Dr Ben 4:03

Is that uh inpatient psychiatry and outpatient or the rest of the year?

Dr Brian 4:07

Yeah, so so residency you end up doing inpatient, outpatient, and and also the hybrid like uh IOPs or PHPs. Now what is that? So that's uh intensive outpatient or partial hospitalization, which are are not really inpatient or outpatient, you're kind of like uh Okay. In this middle ground.

Dr Ben 4:26

And then there's uh something you called a fellowship, the training beyond the residency?

Dr Brian 4:30

Yeah, so a residency all psychiatrists would do, and then if you want to specialize like in a child, you'd do a fellowship, and so you have two extra years just focusing on adolescents and and kids. All right. That residency, is it like one flew over the cuckoo's nest with nurse ratchet? It's exactly we had we had a few nurse ratchets, but yeah, they we we passed on them. And then your fellowship is in the child and adolescent psychiatry or yeah, so child and adolescent psychiatry is what I specialize in. There's a few other ones, but that's the one that I chose.

Dr Ben 5:02

Wow. And we have two mental health experts, so I might just sit back and uh have you two juggernauts start uh talking and I'll enjoy the

Anxiety Depression And Daily Stressors

Dr Ben 5:10

show. But uh so Dr. Brian, in uh child and adolescent psychiatry, what are some common conditions you would treat uh kids and teens? Uh what do you see on a daily basis?

Dr Brian 5:21

So mostly what we see is anxiety, depression, and then uh like family psychosocial uh things like conflicts with school, conflicts with parents, siblings, boyfriends, girlfriends, uh people using marijuana. That never happens. No. Not that that ever happens, no, no, no.

Dr John Delony 5:41

Okay, can I jump and ask a question too anytime? Yes, I have so many. Yes, so many. Let's jump in. So I have what I would call like a bucket of bias. And one of my favorite things is I love being wrong. Okay. And so because it's like if I'm wrong about something, then I know how to go do it better next time, right? Right. So can I throw like a bias or two at you? Yeah, absolutely. And you say that's not real, and or you'll be like, actually, it's kind of real, or maybe it's a mix of both. Is that fair? I love it. Okay, so here is bias number one. So um I spent my career working with teenagers and young adults,

Family Systems Nature Nurture Trauma

Dr John Delony 6:20

and occasionally with high school kids and and K-5. When I look at what I would say the vast majority of pathologies, if you will. Yep. My lived experience has been almost every time I meet mom or dad or their family system, that I you just go, oh, apples and trees. Like I see it. And so I've developed a bias that is on the whole, the body's usually working pretty well, given the environment and the genetic cocktail, it was candid. And so that leaves me as somebody who's been sitting across from family saying, here's the expert you need to go see, or here's what you need to do next, stuck. Because I know that somebody can walk into your office and get some things that will shut down the anxiety alarms, shut down or lift up some of the depression alarms. But if I look at it as, what if that kid's body's working exactly as it should, given the context they're in? I always struggle with that, right? Because I know I can't solve this family system, right? It's generational, and mom and dad brought me their kid to fix their kid. And also I know I could take away this kid's discomfort today, but man, then I was I spent most of my career with them when they were 18 to 25, and they are so dysregulated in so many different areas. And I think, man, so I don't I don't know how what to do with that. Am I right? Am I wrong?

Dr Brian 7:50

No, I think you're exactly right. I think that's one of our struggles is how do we fix this family system, which we feel like is causing most of these issues. Okay. And if there was, you know, adoption or something else, and you see somebody in a completely different setting, like it's my belief that most of these kids would end up somewhat different.

Dr Ben 8:06

Yeah. And so then it's like that nature nurture argument.

Dr Brian 8:10

The nature nurture, yeah. And a lot of like our organic diseases, like schizophrenia, that we feel like has a strong genetic cause, and I mean it kind of happens. There's not a lot you can do to prevent it. But these most of the things in children we can prevent, especially anxiety, especially depression, and especially trauma, like that's a hundred percent preventable.

Dr John Delony 8:29

Right, right. And my experience with trauma, that's most of my work has been with outside the bell curve situations, is um kids can handle a lot more than we give them credit for, they just can't handle it alone. And it's when they don't have a this thing happens to them and they feel like I I live in a family system or an environment where I can't tell anybody, or if I tell somebody I'm gonna get blamed for it, nobody's gonna believe me, etc. And so they wrap it up, and then their body has all of these physiological things that it tries to do to take care of them moving forward because it like an eight-year-old can't realize I'm on my own here, even though I'm in a house where my parents feed me and whatever, I'm on my own emotionally, and that's what I've seen kids can't handle. Yeah, oh, 100%.

Dr Brian 9:15

Yeah, and and once you're you know 30, 40, I mean you could deal with the trauma when you're 12. There's there's no way to process what's what's going on.

Dr John Delony 9:23

And I need some regulated adults to anchor into, yeah, yeah, yeah, yeah. Man, so what's what's the how do we balance the ethics of that? Does that make sense?

Dr Brian 9:32

Yeah, I mean, the ethics is we rely on society to fix parents as much as possible. There's you know, DCS and other things that you can use somewhat, and then and like churches and other schools, some of these other things. But I mean, a lot of it goes unchecked, and there's there's no way to find these kids.

Dr John Delony 9:51

I used to really make parents uncomfortable when they would say, Hey, my kid is experiencing this or doing this. And my answer was, y'all should probably fix your marriage, or y'all need to go see somebody. And that level of introspection was tough, right? They didn't like that answer. And I I didn't know another way to be honest in that moment. Um, but man, that made people uncomfortable. Yeah, that's causing a lot of undue stress on the child.

Dr Brian 10:18

Yeah, yeah. The truth hurts sometimes,

ODD The DSM And Internet Labels

Dr Brian 10:20

but I mean, if you feel like this is in the best interest of the child, you gotta say it.

Dr John Delony 10:23

Yeah. Okay, so can I throw one more bias before we move on? Of course, yeah, one more bucket. I love the segment. Okay. So um, here's my other big one. So I remember with sitting with one of my um doctoral advisors and the guy who trained me on how to walk into crisis situations. And we I'll never forget this. We were having dinner, and I leaned across the table and I said, hey, and almost like secretive, like I don't want to let it out. And I said, ODD's not real, is it? Oppositional defiant disorder. And I said, It's not real, is it? And because I was having parent after parent who would hand their kid a tablet all day and were had no boundaries or regulations, and then they were, they would throw a fit in in a grocery store, and some some I want to be disparaging, somebody would say, Oh, your kid has oppositional defiant disorder, and it it made the parents actually feel better. Oh, my kid has a thing, right? Well, my supervisor leans forward and goes, It's a hundred percent real. And I looked at him and he and then he said this, and you've never seen it. And I said, What do you mean? And he said, Until you've been in a psych ward with five grown men trying to hold down a seven-year-old, and we can't. He said, and and and that led to a longer conversation, which is, and here's here's my bias, my bucket of bias. A document like the DSM was designed the best I can tell, for two things. One, to help researchers in Rhode Island talk to researchers in at the University of Washington to make sure we are researching apples to apples. And it was also used, I think nefariously now, but so that physicians could prove or clinicians could prove to insurance companies that they're doing a thing. And it was never designed to be released to the wild and to the internet to people who have no context for what they're looking at. And so if I have a kid who's hyper, I can Google and it will give me the symptom cluster, and I can be like, oh, my kid has that thing. And or OCD is the one I like until you've sat with a kid whose hands have no skin on them, and you're like, oh, that's what that is, versus I ruminate a lot, or it's on a spectrum, right? Is that fair or am I crazy?

Dr Brian 12:36

Yeah, I think we're sharing the exact same biases. Okay, all right. And I'm probably a little rare in the I think the ODD is also extremely rare. I I think a lot of these are like I maybe have never seen it.

Dr John Delony 12:47

Okay.

Dr Brian 12:47

That's exactly what he told. Like this is a reaction to kids' environments, and when they're fighting back against the parent, it's because this is what they've they've figured out is gets them the best chance in life, not because they lack morals. Yeah, yeah, yeah. There's no like innate morals, like we're just taught how to survive our environment. Gotcha.

Dr John Delony 13:05

And if you're what you're being taught isn't work, your body will have a it'll go through a yeah.

Dr Brian and Dr John 13:12

If it doesn't work, we're gonna try something else. Even if that means burning the the house down, even if being burned in the house, see me and body teacher, young class, whatever it takes.

Dr John Delony 13:21

Man.

Dr Ben 13:22

So educate uh myself, an orthopedic surgeon, and the listener on oppositional defiant disorder, since it is real, but we may not have seen that.

Dr Brian 13:32

It's a we've used this term to keep to identify kids that are oppositional, uh, usually to authority, like not listening in class or fighting the teacher or fighting the parents. And it's like, oh, well, what's there must be something wrong with this kid because kids aren't supposed to fight parents. And so now we call it oppositional defiant disorder.

Dr John Delony 13:50

And and I guess the the the meta thing is let's let's focus all of our energy on the one thing I can control in an office, which is this person's brain chemistry, because I can't control any of these other what school they go to, their financial resources, their trauma history, their family dynamics. I can't, their genetics, I can't control any of that. So let me see if I can control this.

Dr Brian 14:12

Yeah. Well, this one we do studies and like it occurs a lot in adopted kids. Yeah. Well, why would it occur in adopted kids? The genetics aren't different. What's different is the home environment. Right.

Dr Ben 14:21

Yeah. And Dr. Brian, what what are your thoughts on that? The DSM.

Dr Ben and Dr Brian 14:25

Is that what's it meant for? Yes, the DSM should not exist in the wild. Okay. I mean, that's I don't think that's gonna be controversial. Everybody's gonna be like, yeah, yeah, yeah, yeah, yeah.

Dr Ben and Dr John 14:38

I love it. All right. And uh for the listener, um, can you guys explain to the listener what the DSM is? It's basically the psychiatric Bible.

Dr John Delony 14:47

It it takes all of these things that a person experiences in their life and it tries to bind them up in via symptom cluster. And and all that means is do you have this many thoughts or this much activity or this little activity or whatever? And then it binds it in a time constraint for more than this, like three months or six months, and then it labels it with a code, and that code is what your clinician sends to the insurance company, and they'll say, Okay, we'll give you a hundred dollars for that hour, right? And then back and forth, right?

Dr Brian and Dr John 15:23

Um, is that is that about fair? Yeah, and it works good for research. Yeah, it doesn't work good to explain like our lives. Oh, yeah, yeah, yeah. Yeah. When a kid comes in, it's like this kid's oppositional defiant, this kid has major depression. Well, maybe this kid's school just isn't working out for him. Yeah. But that's not a billing code. Exactly. It's not the same thing.

Dr John Delony 15:42

Or maybe this kid is staring at us as a smartphone as a third grader and getting the whole world. Yeah, 12 hours of doom scrolling. Exactly.

Dr Brian 15:51

Where's that in the DSM?

Dr John Delony 15:52

Right, right, right. Uh, my question I just made a new best friend, Ben.

Dr Ben 15:56

I love it. I love it. To uh both of you would be like

Red Flags And Where To Start

Dr Ben 16:00

for the listener with the children, like what are some red flags that they would need to seek kind of professional help? Or, you know, they might, well, my kids kind of being withdrawn or irritable or oppositional or defiant. At what point do I actually need to seek professional help? And how do I go about doing that? Maybe talk to the pediatrician first or primary care provider.

Dr Brian 16:21

Yeah, I mean, you can be very quick to talk to your pediatrician. You should be talking to your pediatrician about checkups anyway. So when the checkup happens, just say, you know what, we're having difficulty in the morning getting to school. He's anxious going to school, what's going on? Uh or he seems to have trouble making friends, or uh he's he has been oppositional. What's going on? Why is why is he fighting back? And it should uh should move from the pediatrician very quickly to a therapist or or somebody else because a pediatrician's I mean their their their training's gonna be in medications and referrals, and it should be very quick to that referral. I have a strange response to that.

Dr John Delony 17:02

Can I run it by please do? When a parent asks if I should refer my kid to a specialist, my answer always begins with, and please tell me if I'm wrong, you'd be like, Don't never say that again. Is the child's behavior causing an adverse reaction in you? And as a parent, I look at um, I was with some I was actually with a speaking at a mental health event the other day, and somebody was telling kept saying, My six-year-old made me, my nine-year-old made me. And finally I was like, I have a rule against speaking out in these moments, but I gotta say, your nine-year-old can't make you do anything because they're nine, right? But if a parent feels like, and and the the behaviors I kept looking at thinking, that's developmentally appropriate. Six-year-olds are supposed to like bang their head up against boundaries and see if they'll hold. That's what six-year-olds do, right? Um, but if you feel like I am about to react in a way that I don't want to, let's and and I want uh for me, that answer always puts the emotional weight on the parent, not on the kid. And the the behavior weight on the parent, not on the kid. Let's see if we if you can't, if you're not able to stay present and whole, let's go see somebody.

Dr Brian and Dr John 18:17

Yeah, I don't know. There's very few kids that the kid should go to see a therapist and the parents shouldn't. Like almost non-existent. Yes. Yeah, yeah, yeah. I love that. And there's parent-specific training, there's like parent behavior training. Yes, which I have actually gone to.

Dr John Delony 18:33

Yeah. Yeah. I mean, like, I would like to hear about your experience. So the the thing that I didn't know how to deal with was I I I was an academic, I was

When Parents Need Support Too

Dr John Delony 18:45

a nerd, and then all of a sudden I quit that job and became a podcaster, right? I didn't I didn't have any social media, this is all new. My big dirty secret, the show takes off, right? And now I'm doing interviews, I'm doing all this stuff, and people are calling in saying, How can I be better in my marriage and how can I deal with my own emotional health and how can I be a better parent? And my dirty secret was my daughter was four, five, and six at the time. She would not hug me, she wouldn't, she wouldn't in in I I couldn't. And she would go rigid and she would shove me, and she's a fireball, and she'd be like, get off me. And it broke my heart. And it was my wife, she was Dr. Delani way before me. She's way smarter than me. But she said, Has it ever have you ever thought that she wants more than anything to hug you? And these behavioral outbursts are she can't bridge that gap. And I said, What's so bad about me? And she said this. She said, Oh, you have a nuclear reactor in the middle of your chest. And I was like, Oh, this is my fault. And she she came, she was super soothing. She said, You're the best dad I've ever seen. But we all feel how hard you're trying. And I got mad, and I went down to a therapist in in Nashville, and I call her my oracle. I've and I I'm the worst to to have as a client, right, for a therapist. But um like a doctor being a patient. Yeah. But after six months with her, for the first time in more than 45 years, I said some things out loud that happened to me when I was a kid that no, I'd never spoken of. Wow. And it was a healing that I didn't know I needed to have. And now I can't keep that girl off me. I'm a human jungle gym. Wow. And what I mean, I took her to, we took her to physical therapy, we took her to all these different things, and I've got diagnostics and OCD and ADHD and all that. Like, and so I thought, oh, I've passed this along to her. The challenge at my house was me. And it was not even behavioral, it was what I was carrying. And that healed my family in a way that I never, as a tough tattooed up Texan, never would have thought, right? That the work was me sitting down and dealing with some of this stuff that my body's still trying to solve 35 years later, right? It was wild. Wow. It's amazing how the kids can just perceive that. They uh but they have to, right? They're just at six years old, she's just a walking nervous system, right? She has to for her own protection.

Dr Brian 21:19

Yeah, like in a way it's amazing, but then in a it's a it's adaptive, it's uh yeah, it's adaptive, like you'd expect this.

Dr John Delony 21:26

Yeah, yeah.

Dr Ben 21:27

Wow.

Dr John Delony 21:28

She's got to protect herself from the radiation from that guy, and I need that guy, which puts her in a really precarious position. Yeah, could you tell the difference? Oh, I mean, like for me personally, like my heart rate variability went up, my REM sleep fell off a club. I mean, it just everything in my life, the the biometrics all shifted and changed. And it I didn't increase. In fact, I worked out less. I probably ate a little bit more junk food, but uh yeah, it was just a nervous. Nervous system had been at war for 30 years, and I didn't know it. Right? I didn't know it. And so it was it was powerful. It was powerful.

Dr Ben and Dr John 22:07

Oh, through therapy. Is that uh

John Deloney On Therapy That Worked

Dr Ben 22:10

yeah, like cognitive behavioral therapy or uh I call what she does sorcery.

Dr John Delony 22:15

Okay, more thing sorcery, magic. Yeah, it wasn't just CBT. Uh she's uh she's a gangster. Yeah, it was probably more DBT and um ACT than anything else, but she's she's she's really good. Wow. That's amazing. Yeah.

Dr Ben 22:29

So all right. Um, I guess question for both of you too is that in the orthopedic surgery realm is pretty dichotomous, like a bone's broke, it needs to be fixed. I uh, you know, look at a broken bone and I see a patient and say, You have a congenital titanium deficiency. I can fix that. You weren't born with enough stainless steel in you. I can fix that. And then, but for uh mental health, how do we go about in the toolbox with therapy and medications and so many tools at your disposal? How do you approach uh treating?

Dr Brian 23:03

How do we find out who has a prozac deficiency? Right, right, yeah, yeah.

Dr John Delony 23:08

Yeah.

Dr Brian 23:09

Yeah. I mean, I think a lot of it is that that what that's what makes a good physician or a good therapist is figuring out what is actually causing this. And kind of like we talked about earlier, there's not a whole lot of organic that your genetics are set up to cause this. And no matter what you did in life, this was gonna happen. There's a few things, maybe schizophrenia, you know, a few of these. But a lot of these are getting a history and figuring out what where is the trauma or where is the social dysfunction that's causing this.

Dr Ben 23:39

And then like uh I'm curious as to uh, you know, like the screen time you mentioned and physical activity and exercise. They published that uh exercise can be just as effective as antidepressants or um therapy, especially mild to moderate depression. Yeah. So uh uh what kind of outside variables can we control and help with the kids as far as their mental health?

Dr Brian 24:06

Yeah, I mean, I think the biggest one right now is the social uh context and and people moving to TikTok and doom scrolling, and and you ask who their best friend is, and they're like, well, it's you know, Jimmy357 on TikTok, and you're like, What happened to playing in the yards? Like, what happened to going to the baseball game? These these kind of things.

Dr John Delony 24:26

How much um how much of like the the depression study? And I've got a bunch of friends in the what I call the beefcake space, like the like what is that the snap into a slim gym space, like the oh yeah, work it out for like those guys. And I love them, they're and a lot of them are like really accomplished like nutrition researchers. And I mean, that's new talking nutrition is worse than talking religion these days, right? Um, but I've always wondered when the when the when that study was released to the wild, the things out of Australia, when it would kind of became mainstream, um you had the snap into a slim gym, the workout, the fitness community being like, We told you so. And two things happened. One is all psychiatries bunk, because it came out right when the SSRI study came out, too, which um was like essentially it's not a like it's not a serotonin deficiency. And so then that means the whole thing isn't true, despite the fact it was like 40% of people see a benefit. We don't know why. And so it was like, let's throw the baby out with a bath water, like we love to do as a culture. But the question I had inside of that was is it so if I got if I got if I got hospitalized with you with MDD, with major depressive disorder, one of the time like we we you get me to sleep and you get me some food, some nutrition, and then there'd be a treatment plan with the right medication, which I strongly support with major depressive disorder. But the the treatment plan is based on this is me saying it reductively, is little wins. I need I need you to stack some stuff on top of itself. And so I wondered with the depression and the anxiety and the exercise, how much of that is truly physiological and how much of it is you start over time to trust yourself. You start to do a thing, and that in and of itself

Tools Beyond Meds And Quick Fixes

Dr John Delony 26:20

is it it teaches your body that you have you're capable. Does that make sense? Accomplishment and maybe it's maybe I'm trying to parse it as maybe I'm being too nerdy about it. But I always wondered like, if I can just get you to start doing a thing regularly, you just start to walk taller and you begin to trust the the person you trust the least, which is yourself. Which may or may not be the thing. Right. And it doesn't I it doesn't matter, right? Right, but uh but yeah, I always wondered that.

Dr Brian 26:47

Yeah, for sure. And that's why like things like a chess club or a Dungeons and Dragons club, where there's there's not an increased heart rate, still is effective.

Dr Brian and Dr John 26:54

Yeah. Because you have you have well, you have community, you have people doing a thing like that. Community, yeah, yeah, yeah.

Dr Brian 26:59

Yeah, you have community, and now I'm learning a skill and I'm feeling better.

Dr Ben and Dr John 27:02

Yeah. Man, this guy. This guy, wealth of knowledge, and he's uh ADHD. I want to talk a little more about that expert and has a podcast on ADHD. So uh let's I don't know anything about that at all. Yeah, let's I've never had to look in the mirror on that one with this kid. Uh let's uh kind of delve into kind of diagnosis and treatment and uh um all the different uh at home. I think sometimes my wife says I'm sometimes inattentive. That she she wishes she could change two things about me, my inattentiveness, and I don't remember the other one, but uh she uh uh uh earlier this week she said uh uh I heard her say, Are you even listening to me? And

ADHD Risks Strengths And Home Strategies

Dr Ben 27:45

I thought to myself, that's a funny way to start a conversation. But uh ADHD. Like, what is it? What's what kind of um red flag should we be looking for in our kids today?

Dr Brian 27:57

I mean ADHD kind of falls in the same line. Like there is some genetics that we feel like exists, and we know that medications are effective, but even then, like in preschool kids, it's the parent behavior training is still first line. And it and I think it will always be. And I think we should start extending that beyond. If you can manage your ADHD with other things other than just medications, or together with medications, it's that much more effective. Yeah, ADHD is ADHD is an interesting one because it's a hot topic right now, and it's it's starting to become more popular in the adult world where 20 years ago it was like ah you grow out of it, and now it's maybe not.

Dr John Delony 28:33

But is is it a and again there's a bell curve to this, is it a pathology? Because it's been, I would call it my source of I would I don't know another word other than to call it my superpower. And it's only become a superpower probably in the last 10 or 15 years because my wife made peace with he's doesn't not he's not picking that up because he doesn't love me. He doesn't see it. And so I can do one of two things. I can be his friend and just pick it up and get on with my life and know I married a good guy, or um, I can be really explicit with what I want. And if I'm explicit with what I want, that guy will go to the end of the moon for me. But it it it changed my context, it changed my environment. And that's now I'm free to focus on a thing like a laser for years, and I've got a I've got a ride or die partner with me, and she gives me very clear here's how you can love me right now. And I'm all I can I can check a list off, right?

Dr Brian 29:36

Yeah, and we always use like this negative connotation to refer to anything, but maybe this is like a personality characteristic that has some benefits to it. Right, right.

Fake Ad- Common Sense Healthcare

Dr Ben 29:50

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AI Can’t Replace Human Presence

Dr Ben 30:38

All right, for both of you, uh, what role does technology did it play, does it play? Where do you think technology is going? Is AI gonna take uh uh mental health jobs or it might I don't know if they're gonna take comedy.

Dr John Delony 30:51

I have a hot take on it. Yeah.

Dr Ben 30:53

I want to hear both of your hot takes.

Dr John Delony 30:55

My hot take on it is if you are and I notice this, my PhD is in counseling, right? So the the application of this. Let me say so. Psychiatry, for those of you who don't know, psychiatry is the overlord, right? Y'all are the ones that went to med school, and then there's psychologists, and then there is, depending on what state you're in, a fight for who who's who's next on the pecking order, which is like LSW, like social workers or marriage family therapists or counselors. And um, and depending on what state you're in, is kind of the hierarchy there. Um I'm in a state of confusion. Yes, exactly. My my colleagues became obsessed with getting really good at diagnostics. And it felt like we want to we want to be taken as seriously as, and the way we do this is we memorize all the symptom clusters too, and we can we can diagnose too. And I think AI is gonna take that for diagnosing. What I don't think it can take is we are still bioregulated human beings. And so if you are, I have a buddy who works at the med school down the street and he as a professor and he teaches first-year students, and I tell him, I would double and triple and quadruple down on bedside banner. Can you sit with somebody? Because a robot can take this and this and this and this. That's a good point, but they can't hold your hand as this is happening, or you just woke up, or you're having to tell somebody something, and they can't walk with you biologically through that. And so for me, I think this will reduce the number of clinicians who uh big especially those who tried to really focus on being hardcore, and it will really raise up those who can sit with hurting people and say, I see you and I know you, and let's figure this out together.

Dr Brian 32:43

Yep. Yeah, I 100% concur. Uh I think it's gonna take like billing and like notes and like all the like backyard stuff. This is good. Right. Please do. Yeah. So I'm excited for it. And sitting with patients will never be replaced by a computer. If that's replaced by a computer in therapy, like you're not even doing therapy, you're just doing questions, answers.

Dr John Delony 33:02

There you go. Yeah, yeah. And and and gosh, I don't make this all about me. Can I tell you one of the things that my sorcerer did, the oracle therapist I saw? Here's what she did. Um, she didn't golf clap me, but in my head, I remember her golf clapping me during a session once. And I looked at her and she said, I've been wondering if you're smarter than me. You are. You're smarter than me. And I was like, okay. And she goes, No, no, no, you've read more than me. You have an answer for all the like, she's like, it's impressive. And she said, So next time you come to therapy, we aren't gonna say any words for the whole hour. We're going to sit with each other and I'm we're gonna do these breathing exercises and we're gonna make eye contact. And I started laughing and I was like, no chance I'm doing that. And I said, Since I'm so smart, I know that therapy is when we talk. And she said, Oh, John, you have an answer for everything, but you can't sit in my presence and be okay with you. And we're gonna work on that. And I won't tell you the things I said back, but it was not for a clean show. And we were laughing, but it but that was the healing thing. Wow. It was her hearing me and me realizing she didn't run and it didn't sc I don't scare her. And in fact, she still loved me and cared about me in despite what had happened to me this many this many years ago. And that was the healing, right?

Dr Brian 34:19

Yeah, and there's no way that Chat GPT could take that or AI. Yeah, right, right.

Dr Ben and Dr John 34:24

And that was the session where you did breathing, breathing exercises. It was and it and it was I don't I sound silly. It was transcendent. But it had nothing to do with the breathing exercise. It had it had to do with can you be okay with you? And I didn't realize that most of my pathologies were playing defense in a world because I didn't wanted them to know this guy that I don't like, right? And making peace from with from the inside out. That's just been it's been freeing.

Dr Brian 34:52

AI's not very good at recognizing that in the first place. Like it's looking for a diagnostic list and it's saying this, this, this, and getting you an answer. Yeah. So not only can it not sit with you at Disney and recognize that's what's needed in the first place. Uh gotcha.

Dr Ben 35:05

And I like that you uh emphasize the bedside manner. I don't think in medical school that they put enough emphasis, at least back when we were there was no formal training on it or is that really emphasized.

Dr John Delony 35:15

Do you feel like that's like when I look at the robotics and I look at the the especially the diagnostic stuff, it seems that that's where it's headed in your world too. That really folks who can sit with other people are gonna be the ones who do really well.

Dr Ben 35:31

Right. And that's in in surgery, that uh um is just a tremendous help when you can kind of alleviate someone's uh this very stressful situation when you're about to undergo surgery, whether it's first time or not. And if you can kind of sit down, get to their level, touch them, reassure them, tell a joke, it really breaks the ice.

Dr John Delony 35:53

So or telling a joke, come I've had multiple surgeries. I've had a great surgeon tell jokes when I'm coming out, and that always just breaks the whole thing, you know, it just takes the attention away.

Dr Ben 36:04

Yes, that uh bets uh there's a saying that uh patients don't uh care how much you know until they know how much you care. Like that's good. With like AI, you could have every sign and symptom and treatment memorized, but unless you can convey that you care about their outcome and their well-being, they don't really care how much you know. So they can go to AI for for all that other.

Dr John Delony 36:28

I've had this conversation with pastors even about like if you spent all of your time deconstructing the Hebrew of this particular scripture and this particular thing, that gigs up because the smartest theologian that has ever existed on the planet has just been built. Can you go to somebody's house whose husband's about to pass away? Can you sit with that couple who just found out somebody's been cheating on the other person? Like, can you go in that house when they have to refer their child to a psychiatric inpatient stay? Can you be a pastor in those moments, right? And it's it I think it's all the helping professions have gotten punch

ECT And What Catatonia Looks Like

Dr John Delony 37:05

drunk on the science of it all, and that's so important. But if you lead science first, I think AI is gonna take that from you. If you lead humanity first and you have a toolkit full of science stuff, it's gonna be magic. Yep. Yep.

Dr Ben 37:21

This is kind of a non-sequitur for Dr. Brian here, but uh when I was a medical student um doing my psychiatric rotation, which I love because they let me start the IVs and everything, but we did electroconvulsive therapy. And are are we still doing that? That was a long time ago when I did the rotation.

Dr Brian 37:38

It's still being done. I mean, it's uh it's very specific circumstances. It's it's definitely not like a first line in anything, but yeah, it's it can definitely be a miracle treatment if it's not the Wild West like it used to be. No, very controlled, precise. It's very it's precise, it's scientific, the machines are like high-tech, it's yeah.

Dr Ben and Dr Brian 37:58

And it treats like major depressive disorder or yeah, it does treat major depressive disorder.

Dr Brian 38:03

Uh catatonia is actually the one that there's there's very few other treatments. You you kinda have one like set of medications that and if they don't work, it's ECT is the next line. And a lot of there's a lot of treatment-resistant catatonia that requires ECT.

Dr John and Dr Brian 38:19

Is catatonia like the way outside the bell curve? Is it on the same trend line as depression? It can be. Uh a body just says I'm shutting you.

Dr Brian 38:28

Okay. Yeah. So catatonia is another one that we really don't understand. Like we have this set of symptoms. Uh it occurs a lot with depression, occurs with other things.

Dr Ben 38:39

So for the listener and for the orthopedic surgeon, what is catatonia? What are those symptoms?

Dr Brian 38:43

So, well, catatonia, if you've ever seen like any of the old psychiatric movies, uh, is it's kind of like a set of symptoms like rigidity or non-responsiveness. You ever see somebody who's stuck in one position and almost like comatose but not really in a coma, not asleep? I mean, that's what ketatonia looks like.

Dr John and Dr Ben 39:01

It's like when you tell a joke on stage and you have a long setup and the punchline, you drop it, and the audience there's nothing. And that that immediate feeling you get. That's it. Just an extended state, right? We should have Dr. Brian in our next show for those uh for the audience that's he'll get a topic. Diagnose us, just give him a microphone to be like he's experiencing or a couple of electrodes to all the you will laugh or be he is slipping into major depressive

Closing Thoughts And How To Connect

Dr John Delony 39:30

disorder right now.

Dr Ben 39:33

All right, folks. Thank you for tuning in to the Dr. Ben and Friends podcast. This Grand Old Psyche episode is discharged. All right, with Dr. Ben and Friends from the heart of Nashville, we love celebrating healthcare heroes and professional comedians. Remember, we can be serious in surgery, but some of us can be seriously funny. If you love today's episode celebrating comics and healthcare heroes, join the Dr. Ben and Friends team and hit that subscribe button. Your word of mouth is our best support. So tell a friend, your healthcare hero, your psychiatrist, your mental health expert. Uh, we'd love to hear from you and your friends. Drop your favorite joke or general questions at drben and friends.com. We can't wait to hear from you. All right. Today we had the very hilarious Dr. John Delony, mental health expert. Dropping wisdom smoother than a perfect central line. Dr. John Delony, where can our listeners find and follow you?

Dr John Delony 40:31

You'll have to know that he's like this all the time. All the time. It's not even an act. It's so good. It comes from your soul. It's so good. Thank you, Dr. Um, you can I'm on the internet. Look for him on the internet. Yeah, at John Delony. You can find me there. Is that this worldwide web they talk about? After you listen to the Dr. Ben podcast, and after you listen to the ADHD podcast, then you can come over and listen to the Dr. John Delony show.

Dr Ben 40:58

I love it. I love it. I we love that show. It reminds me a little of remember the Dr. Laura Schlesinger show where people would call in and uh sometimes they just need that voice of reason. Yeah, I know the right answer, but I gotta hear Dr. John tell me. Well, I I would bet give me some affirmation. 85% of people who call the show know what I'm going to say.

Dr John Delony 41:19

But we need to hear it. But it's less about what I'm saying and saying it with yeah, with somebody, yeah.

Dr Ben 41:24

Right.

Dr John Delony 41:24

Yeah.

Dr Ben 41:25

Like, is vaping really bad for me, Dr. John? I need you to tell me. Dr. John said vaping's bad for me, so I better quit. All right, we had Dr. Brian, child and adolescent psychiatrist here. Thanks for being on the show. Anything uh you want to share with our listeners and uh maybe where we can find you or any advice?

Dr Brian 41:45

Yeah, I mean, just stay healthy. Uh, you can find me online on the RaisingADHD podcast. It's on any any podcasts or Instagram.

Dr Ben 41:55

All right, listener, thank you. See you next week when I, Dr. Ben and my Friends, help you put the med in comedy, Dr.

Speaker 2 42:14

Ben.