Evening Exchange; Mental Health with Dr. Freda Lewis Hall

This is the cut in for free to Lewis Hall that will not air until at least August 3rd is the cut in for free to Lois hall that will not air at least August 3rd. I enjoy it Jefferson. Coming up tonight an evening exchange at 7:00 we will examine the state of black mental health with Howard University psychiatrist Dr. Frieden Lewis Hall the many racial barriers that have been broken down over the last decade seem to have no effect at all on black mental health in this country. Joining us as we journey into the madness that has rocked the social cultural and economic peace of mind of many African-Americans. It's all about black family and its mental health. Tonight at 7:00 on the exchange. Hi this is joy and this is the promo for Dr. Frita Lewis Hall for the show of August

3rd at the earliest. Rita Lewis Hall problem of Freeda Lewis Hall promo. Like. OK we're back. I am Julia Jefferson sitting in the Codonanthe join us tonight at 7:00 and even Exchange where we will explore the mental health status of African-Americans with Howard University psychiatry's. That to free the Lewis Hall. We will examine the psyche of a black America that has been tarnished by social cultural and economic barriers. Find out what you can do to jumpstart the recovery of black mental health. All of that and much more tonight at 7:00 on our two evenings tune. I am Joy ejectment and and welcome to evening exchange. Tonight we promised you an interview with Maya

Angelou. But due to circumstances beyond her control she is unable to be with us. Police say two point to formative and stimulating conversation about the state of black mental health with Howard University Hospital psychiatrist Dr. Frieden Lewis Hall all up next on EDK. I have Julia Jefferson and I'm sitting in for Codonanthe and welcome to evening exchange. Often time we hear so much about the breakdown of the black family unit and very little emphasis is put on the reasons why. Well tonight we are going to explore the status of black mental health by explaining the social and political forces that have combined many African-Americans to ghettos racially isolated schools poverty and much more. Joining us tonight is Howard University Hospital psychiatrist and the host of W H A mentor Urban Health Report.

Dr. Frieda Lewis Hall welcome back. Thank you. OK. There is a lot of talk about the breakdown of black family unit. First off could you define to us what do we mean by breakdown of it. I know that when I grew up a lot of the children I grew up with were raised either by their mother or their grand or their grandparents. How do we define breakdown at this point. Well I'm not really sure if we're being accurate in defining the family as having breakdowns at this point or being broken down at this point. We have to be careful not to define the breakdown of the family as who constitutes a family because the entire nation is seeing a change in who a core family is. This is not the mommy the daddy two children the dog surrounded by white picket fence. It's never been in the black community really. And we're really seeing the rest of the country following that trend of single parent and families extended families that include other family elders and so on and so forth.

Dr. Alvin Poussaint a few years ago made a comment to a mental health report that came out and he said that because of racism the state of black health is fragile. Is that something you would agree with. Well I think that we have to be careful not to blame all of it on racism. During the intro you mentioned social and political factors that impact on black mental health or black mental illness. And I think it's important to add another factor and that is the biological factor. Mental illness is not different from other illnesses that blacks or anybody else suffer from. So the State of Black health as it relates to heart disease stroke blindness due to glaucoma and all the other diseases cancers that we die from all have a lot to do with social political and economic issues but they don't have only to do with those issues. Now what would you say is the state of life. Asked the summing up in a paragraph or two.

How about a word poor poor in general. Not sure if he's going to get any better or any suit anytime soon unless we take a critical look at it and start doing something very quickly. Would you define the murder rate in the District of Columbia. Black on black crime as it's defined in media. Young boys killing young boys as part of that poor mental health. Yes. I think that what's critical is to look at mental health overall and mental health. We I think we get very careless in medicine as well as in other arenas and talking about mental health because we want to talk about the mind. And I as a psychiatrist I'm not sure where the mind is but I know where the brain is. And I think that one of the important things to look at is how mental illness comes about. Now if we look at health or mentality at all we're all comprised of thoughts feelings and behaviors. Essentially all of

those things get mediated by brain behavior. So it's electrical and chemical activity that basically makes us what we are on the mental health side we are born with genes that determine ultimately whether or not we get cancer or breast cancer or whether or not we have certain enzymes in our body to break down milk or whether we can drink milk at all. Everything about us gets determined mental health or mental illness is no different. So we come here with a biological predisposition to develop mental illness under some circumstances. Well let me get that back up. Are you saying that there are certain people who have a predisposition to end up killing people on the street. Well I'm not sure if violence falls into that category. I as an individual psychiatrist and we as medicine. I'm not sure I could safely say that at this point. However

violent behavior doesn't fall out of the sky. It's mediated by brain chemicals. So it would make sense that some people would become violent under some circumstances depending on what their genetic makeup is. Now you said thoughts feelings and behaviors what thoughts feelings and behavior lead to you having a diagnosis of poor mental health or black. Well I think that we have to divide it into several categories. First of all they're what we call psychiatric illnesses that point to having poor mental health. And that would be just like someone being diagnosed with a heart attack or with kidney disease. And that is the end product of those genetic predispositions that I talked about earlier that you came here with your body having the capacity or the predisposition to break down in a certain way depending on what happens to you in your life and those things would include such things as schizophrenia which is a

disease of the thought process depression which is a disease of the mood process manic depressive disorder which is another mood disease panic disorder which is an anxiety disorder. So all of these psychiatric illnesses are an indication of poor mental health in quotation marks or mental illnesses that come from a combination of these biological factors that give under the pressure of socioeconomic and emotional pressures that occur because of what happens to us in our lives this take it out of the room. I want to get back to the medical reasons why we have poor mental health those things that we are Prita predisposed to end up with at birth. What about social things. I mean one of the things that I think this is just personal feeling that leads to a lot of what's wrong is self-esteem. And I think that

that's a mental thing I'm not a doctor but it seems that that is up here what I think about myself. What I will and will not do is up here. Where did I get that. How come I was raised the Cherry Hill Junior High School in Baltimore and I went this way and another person is at lort. How where did I get that. Well that's really a combination of factors. A lot of people like you said mental that comes from in here. But then when you describe is not something that really comes from in here you're describing something that comes from somewhere else. All of our activities are controlled by our brain essentially. And that's the answer is that your brain may have responded to the exact same input depending on genetically what you came with your experience and how you were taught to manage those kinds of things that happened to you the kinds of resources you have around you to protect you from certain outcomes.

Well let's take a family. Family has two children. OK. Same input same parenting same style. Maybe there were only a year apart in age but they ended up at two different spectrums of mental health. One's healthy and one's not healthy. So you're saying that it's just a predisposition. So who goes which way. Well no. It it can. It decides which one may go a certain way. Two children that are born of the same parents are not genetically identical. So there are variations in families you can tell that by height hair color and all those other things. Well the other internal processes like chemicals may also be different. That's just a rule of inheritance. But then other things happen. How say the eldest child is treated or taught in their younger years may determine how they use information or how they respond to certain events later on in their

lives. And that may decide which direction they go into other things may decide how a parent responds or how a loved one responds when someone is exposed to danger for example one child when exposed to danger a parent may run and cuddle and hold them and protect them. Another child may not be protected under the same dangerous circumstances. So those two children are going to develop different ways of dealing with danger one may say well I can stay in here for a couple of minutes and mommy will run out protect me. Another one say Mommy's not coming. So I better do something for myself. And that accumulates over years. How mommy respond how a teacher responds how other things happen in that person's life. And so the roads may be parallel or they may be in opposite directions really early on. You really really don't realize that. Exactly in a situation where the family is not financially stable where there may be just one parent as one adult input.

OK. Is there anything special Those parents should look for or do. Well I think I think what families have to remember is that consistency is really key. Our bodies are meant to be were just marvelous creatures were really meant to take a lot of stress in terms of our capability of withstanding it. But the things that you just mentioned are these constant chronic insults to the system. Most people in America especially most black people do not realize the kind of stressors that they are under DAY TO DAY. Some of us feel that we've in quotation marks made it so we're not under those same stress or is. But that's not true. They're they're they're always there and they get you Licky like you just a little bit at a time. We are meant to take a tragedy perhaps and weather it but every day from daybreak to sunset and well into the night we're not meant to do that. So let's take the scenario of

a single parent who is trying to raise a family on limited on a limited income who lives in a neighborhood where danger is the rule. The parent as well as the children are under constant siege if you will. So it's almost like a hostage situation all day every day. Accumulate that over a year two years five years ten years and the result is not only poor mental health in quotation mark but poor physical health as well. We start to develop heart disease. You start to develop kidney disease you start to develop all of those things. Then what happens is that a cycle starts. Mom now has a heart disease can't work money is less and her stress level is higher. So what she can offer her children in terms of support is less. Now you have another site a little mini cycle starting on the side.

Well if you have a situation you set all those stresses constantly bombarded you living under a state of siege. OK. Let's let's take you out of this seat and maybe put you in one of these scenarios I see on Court TV or in situation dramas on television where you the psychiatrist is called in to do a profile of this person. OK. Now this is a person who the same person you just described. Is is this not reason why there is such a high crime. Is this not is high crime and murder and self disrespect just a product of that constant bombardment. I think that it would be safe to say that now whether or not you can call that mental illness and not be sure. Certainly. Why. Well I think that as a psychiatrist I tend to be very careful on the medical doctor I want to be sure that everything stays as cleanly within

the medical realm as I can keep it as is kind of sometimes a little difficult we cross all kinds of boundaries. But I think we have to be careful. Mental illness is just very carefully described by psychiatry as certain behaviors certain moods certain feelings you know certain thoughts. And we have to be careful when we're talking about mental illness to stay in that realm. Sure. Take a person and constantly bombard them. It impairs their judgment. It changes their insight. It changes the way in which they respond to things. And you can. You don't have to use a big example like murder for example. My favorite example is the phone call in the middle of the night. Not everyone has gotten one. Not everyone will get one but there is not a person listening that has not heard the phone ring in the middle of the night that doesn't jump and that their heart doesn't beat quickly. Why. Because our experience tells us from what we've heard what we've seen that a phone call in the middle of the

night means something terrible. It could be a wrong number or anything but our response to that mentally is very different than reality necessitates. So take someone who believes that they are under siege even if they're not. Take someone who believes that they are in danger even if they're in there and put them in a situation in which they must respond. Their response is going to be different than someone who does not believe that they are under siege who never heard that they ought to jump and have their heart pounded a phone call in the middle of the night. Right. So what we understand about our experiences and about what we have to protect ourselves from changes the way that we look at things in the way that we respond to what we're going to take a short break right now but when we come back I want to talk about those categories that are really fall under mental health like depression.

OK. Those things that would make somebody suicidal those things that affect our lives every day and happen to all of us. Why don't you stay right there. We'll be right back. I enjoy a Jefferson and I'm sitting in for Codonanthe tonight. If you're just tuning in we are talking about

mental health with Howard University Hospital psychiatrist Dr. Frieda Lewis Hall. Before we go any further I want to talk about this phobia. I think African-Americans have about mental health care. I don't care how sick my friends my will be. They'll rush off to a traditional medicine doctor but if they're depressed or fordable or parents death die you cannot get a lot of people to go seek psychiatric care. Why is that. I think there are two major reasons. The first is for most people including many physicians the body stops here at your neck and above that is your mind. And so there's something that goes along with strength and faith and perseverance and all of those things that make people believe that they can weather the storm. The mental storm went actually above your neck as is your brain which is another part of your body and it has the right to get sick just like everything else. So I think the myth

that mental illness looks like sinfulness or weakness or craziness makes people not want to go in for mental health treatment. The other big thing is that the mental health system really has abused us as black folks for many many years. And I would love to say that that's over with but that's not true. Racism in mental health is alive and well. So I think that we have to be very careful consumers of mental health treatment. We have to go we must go because mental illness does not go away any more than a broken leg heals itself without appropriate mental care. But we also have to take care that a diagnosis of mental illness is not allowed to jeopardize our job or our political future or our economic future. How do we make sure of that. How do I go going to a doctor's office. How do I discern as being a valid diagnosis or a racist.

Well I think the first thing that you have to do is learn a little bit about yourself and what symptoms you have. We are the way we make diagnoses now in psychiatry is with basically a cookbook called The Diagnostic and Statistical Manual. And you basically got an A list of things you have to have this and this and this and this in order to get a diagnosis. So when your doctor tells you I think you have schizophrenia then you have to ask why. What makes you think so. And then try and remember those things have them write them down what they believe makes you a phrenic or what they think you show them that makes them say that you have a major depression. If I went to a surgeon he said it was time for me to have surgery I would go get a second opinion. Should I do the same with my psychiatric diagnosis. Well I think sometimes that's important in these limited economic times though it may not be feasible for you to get a second opinion in surgery nor may it be feasible for you to do that with a mental health diagnosis. I think that the time to get a second

opinion is when you feel uncomfortable with the diagnosis that you've been given. Your doctor may be right on target but you have to be. You have to be comfortable if they tell you. I think you have a major depression. I believe that you need to take this medication if not you won't take it. And so a second opinion then is a must because you shouldn't go to a doctor get a diagnosis take a prescription and then just trash it on the way out the door and say you know I knew they were all quacks anyway and that and that's sick. I just you know I just suck it in and fix myself up by my bootstraps. Right. You really need to pursue treatment aggressively for mental illness. On the menu of available mental health diseases I guess mental diseases which one is the U.S. most prevalent in Africa. Well I think in in sheer numbers anxiety disorders are most prevalent. What's an anxiety disorder. It's actually a group of disorders about seven or eight

disorders that are characterized by anxiety or feelings of great fear. The number one our phobias most people don't go for treatment for those but they really ought to. They were afraid of dogs snakes Heights elevators driving water any number of things and they can really make a difference. People who won't take job job promotions because the new office would be on the 11th floor they can't walk it nor can they get on an elevator. People have never been to the Eastern Shore because they can't cross the Bay Bridge. So one. Phobias are very very critical parts of the mental health scenario. But most people don't go but I wouldn't think that. I mean I'm fearful of ridges of heights. I go to Ocean City by letting somebody else drive the car across the bridge. I figured that's you know why am I going to go see a doctor I just don't go to Ocean City alone. Well it works if you can work that out. But what if you lived across a bridge from where you had to go to work or worry if a promotion meant moving to the 11th floor and you

couldn't get on an elevator. I mean there are people who literally cannot do the things that they need to do just to have a day to day life because of a phobia. That's when treatment is required treatment is required when it stops you from progressing in your life. That's right when it prevents you from doing the things that you need to do when you can't go to the grocery store when you can't drive to work when you can't ride the bus or the subway when you can't ride up or down an escalator or go into a mall. And that's and it's not seeking there would be a little part of me at my age to walk into a doctor's office and say Hi Doc I can't go across a bridge. Well that's a part of what we have to make a leap from. And that is that there's something about not crossing a bridge that signals weakness but mental illness is not mental weakness. Everybody listening should say that five times because it's it really isn't. And if we could

cross that bridge alone if we could cross that bridge it were phobic of alone then then you know there's a broad horizon that we could then then reach in terms of mental illness in our community. The next one the next illness is probably panic disorders which is very common. And that's when I have a clear blue sky. You're stricken with the fear that you might die or go crazy or lose control your heart's beating you have diarrhea. Are you short of breath. You feel that you may die any minute your legs get jelly you shake and you just feel like you're dying inside. That's another illness that can be treated called panic disorder and that's triggered by we don't know. It runs in families. Many people develop it. Women may develop it at the onset of their periods or at or around their first pregnancy and it may come one at a time of great stress. The death of a loved one but what it really is is an overloading of the brain's emergency

signal mechanism. The same feeling that you would get if someone jumped at you with an Uzi and threatened to kill you is what a panic attack feels like. And that system may get turned on when you're under a lot of stress and it never gets turned off so for no real reason it turns itself on. And there you are with a panic attack. So there could be a possibility you and I'm just sitting here. I suffer from this disorder all of a sudden I slip into a panic for no apparent reason. Right. Your brain just turns that mechanism on and we don't know why that happens and some people we do know that it runs in families. So I'm a good chemical We think so in many regards in the way that the chemical gets added with the emotional is that our body has a chemical response to emotional stress that's how we handle it. And so once the stress occurs the body responds. If your body is predisposed to breaking down at that point then you will develop a panic disorder as a result of those stressors. But it's very

treatable. That's the irony of it is that people often get broken with the panic disorder and they never think to go get it. So how do you treat it. Two methods really. One is by chemical methods or with medication. The other is with a very specialized type of treatment called cognitive behavioral psychotherapy which is a retraining of the way that you think and the way that you behave is behavior modification. How I mean detail how somebody how would just let you use me as an example. How would you do without the chemicals. Say I reject any chemicals. How would you convince me it's OK to drive across the bay. Well I wouldn't actually convince you I would allow you to convince yourself and we do that by breaking the task down into tiny pieces. So first of all we find out what it is about going across a bridge that makes you uncomfortable. Number one is that a tall bridge or a Lowbridge the long bridge or short bridge that it's

not attached to the ground. OK. So but some people like to go over the 14th Street Bridge which is relatively short and low but couldn't go over the Bay Bridge which is long and high. Some people can ride it but can't drive it. Other people just simply cannot go across. So we get down to the real nitty gritty of what is it about this bridge or a bridge. Then we take the one that you are most comfortable with and we do that over and over and over again until your brain retrains itself and you go over that bridge that's right over and you physically go to a site and physically go over it. Some people can't even look at a picture of a bridge they can't watch a video they can't read about it or hear about it. So in those people we would have to start at the talking stage or the picture stage and then progressed to actually getting down on the bridge. We may have to walk at first then drive it or drive it first then walk it. But we do that in very very small steps until finally the brain no longer triggers that fearful response when faced with

that with that situation. When that same thing what happened with people who are fearful of grocery stores or going outside or any other sort of anxiety. Well for those that can be treated that way some anxiety disorders we find don't respond very well at all to that or not well enough to get people to function well. And so we have to do a whole nother type of treatment with them. What do I do if I know someone who has panic anxiety who won't seek treatment but I'm simply their friend or maybe you know a relative. Well the first thing is education. Most people don't have a clue that this is an honest to goodness illness that they should see a doctor about. In fact many physicians don't know that it's an honest to goodness illness that someone should be seeing them about. So as a friend the best thing that you can do is to inform them say there is such a thing as an anxiety disorder and you should ask your doctor about that and have them be very aggressive

with your doctor about suggesting that this is a possibility. There are societies and organizations that give out information about anxiety disorders about depression about schizophrenia about you name it. And so part of being an aggressive consumer which I really think that as black people we really have to be in terms of mental health. Being an educated consumer is a critical part. So we need to be writing for information calling for information then going to our doctor and saying I think I might have this being educated about it right and insisting on education from them about it. Don't just let someone say wow I think it might be so and so take this without knowing what this is. You know really understanding what's going on with you. I did a story a few years ago where a show called America's what form it was on cardiac care and that the number one killer of black men was heart disease and that I interviewed one gentleman who had been to 14 15 doctors

over 14 15 years and no one could believe that he had a cardiac problem. He finally got here to Washington. Washington Hospital Center got a surgeons bypass surgery and he's doing just fine. Different standards are applied to black people we walk into a doctor's office certain things they don't go looking for. Is that true. Mental health to certain things are just dismissed out of hand. Yes. And one of the very difficult things there are about 1 percent of the national population has a disease called schizophrenia which is a disease that interrupts logical thinking. Essentially those are people that may hear voices or see things talk to themselves or talking to their voices or whatever they may believe things that are not true. That's a very common diagnosis in blacks. You walk in saying anything is wrong with you mentally immediately you're given a diagnosis of schizophrenia which is it is a very serious mental illness but it is not

an untreatable mental illness. So for those that have it is mis diagnosed a lot. Oh absolutely. But usually it's mis diagnosed and that it's over diagnosed. If you're black until the 70s there was actually scientific literature that said that blacks were too unsophisticated to be depressed. We were happy go lucky and so if we came in complaining that we were depressed that we were not sleeping that we were losing weight because we were not eating that we couldn't get up and go to work we were lazy instead of having major depression now we're recognizing that blacks as often suffer from major depressions. And now we're getting the correct treatment but we're still lagging behind in going in for the help. And it makes sense. I mean if you had if you weren't eating weren't sleeping were feeling sad couldn't get up were just immobilized and you went to the doctor and they said oh you're just lazy. Well it doesn't take too many of those

experiences to convince you that there's no help there. So the idea is to now go in understanding a little bit about depression before you get there and saying this is what I think I have. Doc what do you think. And then the doctor kind of lead in the direction for looking for depression in blacks where 10 years ago it wasn't fashionable. And I guess it's kind of like if you walk into an automobile can you just say it's making a noise fix it walk away you're liable to get anything but if you can in just a little aware around car and what you think is problem you'll find more respect the practitioner and as a friend or family member the other thing is a lot of people go and say I just don't feel good. And that's like going to a mechanic saying there's a noise in my car. You need to be able to tell them it's in the right front. So you need to go into the doctor saying I have problems sleeping. I don't get to sleep. I wake up I get up early in the morning can't go back to sleep. I've lost weight. I just don't feel like trying to do the diagnostic run yourself. So you should

go into the doctor with the help of a friend or family member with a whole list of things that have been happening to you for the past several months that led you to go to the doctor in the first place. And I've had patients who have said to me on the first visit Well I just don't feel good. And we have problems sleeping. Not really no problems. No not really. Then the next visit they say well I've had a problem sleeping for three months or so I'm you know Ms Johnson Why didn't you tell me before. And they say well I don't want to sound like I was complaining. Right now you have to go in with this man. That's right. Illness being seen at some level. Right. But you have to go in with your whole laundry list because we make our diagnosis by having the whole picture. And you know many people have an anxiety disorder and that's why they are short with their family. That's why they can't sleep. That's why they can't work. That's why they fly off the handle. Not

everybody but many people. That's why they use drugs or drink or smoke or do other things that are going to lead down the road to a whole nother set of illnesses. So early diagnosis is the key. And understanding that this has nothing to do with weakness. And don't let anybody tell you that you know don't let your doctor or mental health work or patch on the back and say Get a grip. Don't let them to convince you that it's only your circumstances or it's only in your mind. Right. It's only in your mind if they say that say where's my mind. And when you find it and show me that that's where this problem is then I believe that. But until then you have to be very aggressive about getting the kind of help. And actually that's a backdoor approach to what we started talking about. Why are young kids killing each other. Could it be that they have post-traumatic stress disorder which is the result of a chemical illness that

results from years and years of being under siege that living in northwest Washington looks a lot like living in the jungles of Vietnam. To someone who's out there on the street and do they end up with the same kind of illness. The answer is yes. Do they drink to calm their nerves so that they can handle it. In many yes do they do drugs. Absolutely. Do they fight for their survival. You better believe it. So you know major problems like drug abuse alcohol abuse and violence may be directly the result of one young person being under siege for many months or their entire lives. And so we end up on the far end with a new mental health illness or a new mental health problem. What do we do about that though. I mean a few months ago we had noted African-Americans on and we asked them to define racism and to say

what does the African-American community do about it now you have defined mental health or mental health. What do we do about that. Well I think we do three things. The first thing is we treat it where we find it and that is many people who have mental illness simply need to be treated for what their illness is if they have a panic disorder or a phobia if they have post-traumatic stress disorder they need a diagnosis and they need medical treatment. So the first thing is to correctly diagnose as many people as we can identify and correctly treat them. But should we first get them to go seek their help. Absolutely. OK. And that may that may mean going to where they are. That may mean finding young and young children who may have an anxiety disorder in the third grade correctly diagnosing them and treating them in the third grade. Not in the 10th grade when they get ready to drop out of school because of school problems. But the first thing is to find them wherever they

are in doctor's offices in church at school walking down the street if need be at shelters wherever people are. They have mental illness. We find them and we treat them. The second thing is to treat some of the emotional and physiological or physical stressors that may lead to emotional illness. That may mean doing intervention projects feeding folks correctly so that their bodies are chemically in balance so that it doesn't lead to a mental illness. It may mean providing shelter in other things as social programs are designed to do. And we need to be aggressive about that but we also need to do Provenge plain and simple helping folks when they're 60 is admirable but you could have done a lot more in terms of prevention when they're five to six months. So I really think that we have to deal with prevention at

the childhood level because that's when the stressors start making their impact. It may be too late to do much when they're 20. So we start when they're 20 months. But the other kind of prevention is I always use the analogy for racism that if we went into a room and our feet were dog tired and we were dog tired we would not look around the room at upturned chairs and try and figure out whose fault it was we would hopefully write one chair and sit down in it. Right. And the next person who came in would do the same thing. So I think that in terms of racism one of the responsibilities that as a black community we have is to put a wedge between racism which we will strive to fix over the long haul and its impact which we may be able to change over the short haul with what we are able to do to protect ourselves. And that means things that

are immediately within our individual control that means proper diet. And you can eat correctly no matter how poor you are. It means proper hygiene. Because we can do that no matter what our political and economic situation is. So I really think that as individuals we can do this thing we can do despite our circumstances right. We're going to take a short break. When we come back I want to talk about depression and some work within it. We'll be right back. Welcome back to the exchange. I'm Joy Jefferson and I'm sitting in for Kojo Nnamdi and our guest today

is that free to Louis heart Howard University Hospital. We're here talking about mental health. I want to slide the discussion into something that I find pretty common with one African-American women who have like you said earlier made it and then our sisters and brothers who have not made it we all seem to suffer from depression. But depression seems to have many different phases when I think of somebody who's depressed they tend to be somebody who is you know moroseness and around in their mopy And you know they're in a bad mood they're crying. But I have run into people who have been diagnosed with depression who have none of those. Well depression is a spectrum. Like most of the things that humans deal with and we define depression is a mood. How do you feel today. I feel sad or blue or depressed or I feel wonderful disorders of depression run the whole spectrum. You can either be mood disorder or have a kind of depression if your mood is too low consistently

and that usually includes things like not sleeping not eating feeling depressed feeling guilty about things that you really weren't in control of having low self-esteem feeling suicidal thinking about death a lot and not enjoying anything even things that you used to enjoy and at the other end of the spectrum is what we call a mania which is to happy essentially. These people don't easily. They're not sleeping at all they're up all night working doing projects. They feel energetic elated. They feel wonderful on top of the world and sometimes that goes too far to the other end so that they take on multiple projects. They end up feeling so excited that they think they can take on the world. So that doesn't sound like a mental disorder. Well it can't be because these are people who may go out on buying sprees. They buy cars and boats and planes they may gamble away all their money.

They may be sexually promiscuous at that end of the spectrum because they have this feeling on top of the world they take on projects that they really can't handle. And then the crash comes. So there's the those two ends. Most of us hang around the middle. We are neither so elated and energetic as to take on the world. Nor are we so depressed as to not be able to wash our faces in the morning. The diseases can either be depression at one end or manic depression which is now called bipolar disorder. At the other end whether or not you have a disease of depression depends on how long it is and how tense how intense it is. If my mother died tonight chances are I would feel exactly at that end of the spectrum where I'm not sleeping I'm not eating I feel awful I'm crying all the time I feel guilty all those things that would tell me I had a huge depression would

make sense if a tragedy such as the death of my mother occurred. So the Depression can be appropriate makes sense. In that event. Well what if it's a year after my mother died and I'm still feeling exactly as I did the day after. I still can't get up and go to work. I've lost 30 pounds. I can't I just can't manage my life. I still feel guilty. Now it's a disorder. It's too deep and it's lasted too long. A year too long I mean how do you judge what were you personally when you're doing your diagnostic. What do you say is too long. Well I think that you have to think in terms of a steady improvement with circumstances divorce death serious illness loss of a job any major happening ought to make you depressed if it doesn't I'm worried about you. OK. So which you should see is an improvement that you are getting better and better. So if you were depressed and down crying feeling sad

feeling that you wanted to hurt yourself that's the first signal that you have to go to go for some help if you're not feeling like you want to hurt yourself but you are feeling down and you understand the reason for it and it happens seven days a week all day every day in the next week. You feel a little better for a few hours a day although you're generally depressed the next week a little better the next week a little better then you're on the road to recovery. Three to six months you should be doing better if you're heading down. Seek help right away. I mean that's that's important. If it lasts longer than a couple of months even if you see a good reason go for help if ever you entertain hurting yourself. Don't delay it all go for help that minute. So if I if you were if you said to me right now. Well actually I was feeling like I might. I felt like I wanted to die or to hurt myself I'd say let's pull these mikes and go for help right this minute.

That's our critical Vendeans segue off a little bit to go for help immediately. A lot of people may not go for help because we get the impression that psychiatric care is very expensive. You know I saw Prince of Tides. She told her mom her hourly rate was like $50 an hour. I have $150 to get me to sit talk with you for now. Well that's about right. But chances are you are not going to sit and talk with me. Probably your first line of getting help should be your your medical doctor. Especially depression but as well. Any other psychiatric problem. Any problems with mood feeling down or blue may have a medical problem that goes along with it. People with thyroid problems heart problems all of them may have as their first symptom or depression. So always start with your medical doctor say Doc this is what's happened to me. That list we talked about earlier all your symptoms then your doctor can decide whether or not to send you one to a mental health professional mental mental health treatment costs just like all other health treatment costs.

There are places where it is isn't it is not as expensive as we might think. There are public clinics. There are hospital clinics. So the Prince of Tides psychiatrist is at the far high end of what mental health treatment costs Many insurances pay for psychiatric treatment as well as a part of the medical benefits. And people who work often have the additional place to go for help such as their employee assistance program. Someone in that vicinity. So there are all of these first points of treatment children that you think may be depressed you can start with the school system. So it doesn't have to be expensive although it does cost just like everything else cause. The other thing is that the analogy you would not lay at your house with a broken leg just because they were going to charge you $400 to walk into an emergency room you would be grateful to have some place to

go and he'd go as quickly as an ambulance or one of your friends could get you there. People have to treat their mental illness the same way. It is equally debilitating when you see depression in children. Now that struck me because I don't think I've ever run into a depressed child even though I know that the diagnosis exists. How would you as a parent or an aunt or a neighbor start to recognize depression in a child. Well first of all please don't be fooled. Children get depressed by most people's acts. What are they depressed about. Unless there's some obvious reason why you think a child should be depressed they suffer from the chemical type of depression as well. And they commit suicide successfully. So the first thing to always say children are talking on the 12. Yeah that's exactly what we're talking about. Children who kill themselves by drowning by taking pills that belong to parents which look like accidental overdoses they drink Clorox. They step in front of cars accident prone.

Children should be very carefully looked at for whether or not they are trying to hurt themselves. So all of those things you see every time I turn around he's gotten into something. So you have to recognize that children yes under 12 get depressed and they attempt and sometimes complete suicide. How do you know a child is depressed. They may not be able to say that know by the way that they behave any really strange changes in school behavior be students who are now DS to children who have no behavior problems that are all of a sudden behavior problems. Children I get along with other children and adults who all of a sudden don't want to be bothered with anyone stay in their rooms or away from people. Those are all signs of depression kids who let's say a two or five year old who are sleeping through the night who now all of a sudden is getting up at night or who is having problems at bedtime or who is up in the morning when you get up. OK. Those are changes in

eating habits. Kids that were eating everything and are now picking and not eating and not sleeping. Our kids through all of this. That's right. OK. Those are. It's interesting. Our bodies are programmed to do if nothing else breathe eat and sleep OK. OK. So as soon as you're not doing to those three as soon as you're not doing two of those three things then something is wrong either physical or physiologically in terms of mental illness. So always look for those things not sleeping and not eating are not normal. And if they last for a period of time you must go and see what it's about. It may be nothing but it may be a lot. It's worth looking. Absolutely. We'll be right back. We'll be right back. OK we're back and before we leave I want to free the Lewis Hall to just give us a brief

little list of the mental the things we can do to keep our mental health healthy. OK well the first thing that you can do is to keep your body healthy because remember your brains and your body. So you always want to eat as is properly as you can well-balanced meals. The second thing is get rest you know eight hours sleep long hours for all them farmer's hours sleep as long as you possibly can exercise regularly because that protects your brain as well. The other thing is you want to as often as possible during the course of a day. Take a break do deep breathing exercises during the course of a day just stop two minutes and relax yourself tense your body and release it do deep breathing and then start. Don't overload yourself. If you can help it. I tell people do not watch the news. If a lot of bad news is happening do not talk to your neighbors if you know that your neighbors are going through a lot of problems. Don't do things that are going to add unnecessary stress and then take all of the problems that you

are grappling with and take them one by one the little baby pieces as opposed to the hold. As I try to solve the whole worlds problem at one time just one little tiny thing at one time already. That's our show for tonight. All right. Thank you Doctor for being here. I would like to thank you for being here. Cojo We're back tomorrow. Hope you will be too. And right. Now. Even. The exchange depends on your contributions. Please send your donation to W H M MTV 22:22 Fourth Street Northwest Washington DC 0 0 5 9