Coping with Stress, Anxiety, and Depression | On Call with the Prairie Doc® | February 20, 2020


>>WE LIVE IN A BUSY, NOISY,
AND PRESSURE-LADEN WORLD. BEING
ABLE TO DEAL WITH THAT
ENVIRONMENT IS NOT EASY. COPING WITH STRESS, ANXIETY,
AND DEPRESSION, TONIGHT, “ON
CALL WITH THE PRAIRIE DOC.”>>GOOD EVENING, AND WELCOME TO
“ON CALL WITH THE PRAIRIE DOC.” THERE ARE TIMES WHEN IT SEEMS
THAT IF IT WEREN’T FOR BAD
LUCK, WE’D HAVE NO LUCK AT ALL. IT IS MORE THAN A CASE OF “THE
BLUES” AND CAN PUSH US INTO A
PSYCHOLOGICALLY DARK SPACE. FIRST, LET’S TAKE A LOOK AT
THIS WEEK’S “PRAIRIE DOC” QUIZ
QUESTION. THE BEST OPTION OF THERAPY FOR
SOMEONE STRUGGLING WITH
ANXIETY, PANIC DISORDER, OR
UNDERLYING DEPRESSION IS: PICK THE BEST ANSWER AMONG
THESE OPTIONS. ONE: A REGULAR
EXERCISE PROGRAM. TWO: REGULAR DOSE OF ATIVAN OR
OTHER BENZODIAZEPENE. THREE:
TOUCH AND HAND-HOLDING THERAPY. FOUR: IMPROVED SLEEP WITH A
COOLER BEDROOM AND NO TV IN THE
BEDROOM. PICK THE BEST ANSWER AMONG
THOSE OPTIONS. AND GIVE US A
CALL. VIEWERS WHO CALL IN THE CORRECT
ANSWER WILL BE ENTERED INTO A
DRAWING TO WIN A SIGNED COPY OF OUR
BOOK, “THE PICTURE OF HEALTH.” EACH OF MY ESSAYS, ORIGINALLY
WRITTEN FOR THIS SHOW, COMES WITH A WONDERFUL
ACCOMPANYING PHOTOGRAPH BY DR.
JUDITH PETERSON. WE WILL ANNOUNCE THE ANSWER AND
THE WINNER AT THE END OF THE
SHOW. REMEMBER, YOU ONLY HAVE 10
MINUTES TO GET YOUR ANSWER IN! WE ANSWER YOUR QUESTIONS ABOUT
STRESS, ANXIETY, AND DEPRESSION AS THEY ARE CALLED IN OR SENT
TO US VIA FACEBOOK OR EMAIL. CALL IN QUESTIONS TO
1-888-376-6225. OR SEND US AN
EMAIL TO THE ADDRESS ON THE
SCREEN. JOINING US TONIGHT IS DR.
ROBERT NUSS, WITH AVERA MEDICAL
GROUP UNIVERSITY PSYCHIATRY
ASSOCIATES, SIOUX FALLS. WELCOME.>>THANK YOU. GOOD TO
BE HERE.>>SO NOW YOU HAVE A M.D.
DEGREE? TELL ME ABOUT WHAT ARE
YOU TRAINED AND WHAT HAPPENED?>>I GOT MY MEDICAL DEGREE FROM
THE UNIVERSITY OF SOUTH DAKOTA. AND THEN I ACTUALLY TOOK A
RATHER MEANDERING PATH INTO
PSYCHIATRY. I DID A TRANSITIONAL YEAR IN
MEDICINE OUT IN WESTERN
PHILADELPHIA, AND ACTUALLY CAME BACK TO SIOUX
FALLS AND DID YEARS TWO THROUGH
FOUR OF MY PSYCHIATRY RESIDENCY.>>OH, WOW. AND WHAT BROUGHT
YOU HERE? DID YOU GROW UP IN
SOUTH DAKOTA?>>YOU KNOW WHAT? NO. BUT MY
DAD WAS A MILITARY GUY. SO —
>>YOU WERE EVERYWHERE?>>BUT WE WERE ALWAYS BROUGHT
BACK TO TRIPP, SOUTH DAKOTA.>>
WITH WHERE IS THE TRIPP?>>TRIPP IS SOUTH OF MITCHELL
–>>OH, I HAD FORGOTTEN. SO,
WELL WELCOME HOME. YOU’VE BEEN HERE FOR HOW LONG?>>I’VE BEEN PRACTICING WITH
AVERA FOR OVER FOUR YEARS NOW.
SO IT’S BEEN COMING UP ON A
DECADE.>>YEAH. WOW. SO LET’S TALK
ABOUT THE ISSUES OF ANXIETY AND
STRESS. LET’S START WITH STRESS. STRESS IS ONE OF THOSE THINGS
THAT MANY PEOPLE HAVE MANY
ANSWERS FOR. WHAT WOULD YOU
DEFINE STRESS AS?>>I THINK STRESSORS ARE
EVERYDAY LIFE, RIGHT? SO WE —
>>WHO DOESN’T HAVE IT?>>RIGHT, EXACTLY. WE ALL MOVE
— WE MOVE THROUGH THE DAY. AND
WE ENGAGE PEOPLE. AND THERE ARE TIMES WHEN IT’S
STRESSFUL AND THERE ARE TIMES
WHEN IT’S LESS STRESSFUL OR NOT
STRESSFUL. I THINK THE IDEA OF STRESS
ITSELF, IT’S SOMETHING THAT WE
ARE PARTICIPATING IN AND ABLE TO TOLERATE AND GET
THROUGH.>>I WAS TOLD BY A BUDDY OF
MINE WHO SAID I THINK STRESS IS
ONE OF THOSE THINGS THAT KEEPS
US MOVING FORWARD. I MEAN, IF WE DIDN’T HAVE
SOMETHING BUGGING US, WE
WOULDN’T BE ON TIME, WE
WOULDN’T GET OUR JOB DONE. WE’D JUST SIT BACK AND WE’D
PROBABLY STILL BE IN A TINY
LITTLE COLONY OF HOMO SAPIENS
IN NORTHERN AFRICA.>>SO YOU’RE SAYING I NEED TO
BE MORE STRESSED? [Laughter]>>BUT STRESS MAKES US MOVE.>>
YEAH.>>SO THE RESULT SOMETIMES IS
ANXIETY. AND I WOULD SAY THAT
CLEARLY — EVERYBODY HAS STRESS. EVERYBODY HAS ANXIETY. HOW
WOULD YOU DEFINE ANXIETY, AND
WHEN IS IT BAD?>>WELL, ANXIETY IS KIND OF THE
NEXT STEP. SO STRESS IS, YOU
KNOW, WORKING AND WALKING
THROUGH THE DAY. AND KIND OF ROLLING WITH THE
PUNCHES, SO TO SPEAK. ANXIETY
IS WHEN IT KIND OF KNOCKS YOU
DOWN. SO, YOU KNOW, BY DEFINITION,
ANXIETY IS THIS OVERWHELMING
WORRY FOR MOST OF THE TIME. THAT IS IMPACTING YOUR ABILITY
TO FUNCTION DAILY, YOUR QUALITY
OF LIFE.>>SO FUNCTION IS IT, IN ORDER
TO DECREASE –>>YEAH, THE
FUNCTIONAL PIECE IS REALLY
IMPORTANT. AND THAT’S, YOU KNOW, OUTSIDE
— IF THERE’S NO DYSFUNCTION,
THEN YOU MAY HAVE SOME STRESS,
WORRY, AND ANXIETY, BUT IT’S NOTHING TO THE POINT
WHERE WE’RE CONCERNED ABOUT
THINGS OR FEEL WE NEED TO TREAT
IT MEDICALLY.>>SO I OFTEN THINK ABOUT THAT
FAMILY IN THAT HOMESTEAD, THAT
FARM HOUSE, SITTING, AND THEIR
KIDS ARE GONE, FARM IS DETERIORATING A LITTLE
BIT. HE’S STRESSING OUT. SHE’S
STRESSING BECAUSE HE’S
STRESSING OUT. HOW MUCH OF THAT STRESS DO WE
SPREAD AROUND OUR FAMILY AND
OUR FRIENDS?>>IT’S A GREAT QUESTION. AND,
YOU KNOW, THE HONEST ANSWER IS
PROBABLY A LITTLE BIT UNKNOWN. YOU KNOW, WITH EPIGENETICS
TODAY, LIKE, THERE’S MORE AND
MORE EVIDENCE OUT THERE THAT
EVEN STRESS IN THE WOMB IS SOMETHING THAT
IS PASSED ON. SO –>>OH,
REALLY?>>STRESSFUL PREGNANCY CAN LEAD
TO STRESSFUL BABY.>>WE’RE ALL HUMAN THINGS, WHEN
THE ONE IS MISERABLE, IT’S
PRETTY HARD TO FEEL –>>HAPPY?>>YEAH.>>SO I THINK THAT THE
ANXIETY — I AGREE WITH YOU
TOTALLY ON THAT. I THINK THE ANXIETY ISSUE IS
SOMETHING THAT WE — WE ALL
DEAL WITH, BUT WE COULD DEAL WITH IT
BETTER ONE WAY OR ANOTHER. SO HOW DO WE — HOW DO PEOPLE
NORMALLY, OR USUALLY, OR
COMMONLY, OR SOMETIMES
UNCOMMONLY, RESPOND TO STRESS? I MEAN, WHAT — LET’S TALK
ABOUT THE REASON THEY COME TO
THE PSYCHIATRIC HOSPITAL. WITH
STRESS. EXPLAIN THAT STORY.>>WELL, I MEAN, YOU KNOW, WHEN
IT GETS BAD ENOUGH, AND AGAIN,
IT GOES BACK TO THE ABILITY TO
FUNCTION. WHEN THINGS GET SO BAD YOU’RE
NOT ABLE TO FUNCTION AT ALL,
THAT’S WHERE WE START TO SEE
FOLKS IN THE HOSPITAL. BUT WE SEE FOLKS BEFOREHAND
TOO, AND WE SEE THEM IN CLINIC
TOO, AND, YOU KNOW, THOSE
SITUATIONS, THEY’RE A LITTLE BIT DIFFERENT
IN THAT, YOU KNOW, THINGS
HAVEN’T GOTTEN AS ACUTE. I THINK ONE OF THE BIGGEST
STRUGGLES WITH ANXIETY IS THAT
IT’S A VERY ISOLATIVE DISEASE.>>MEANING?>>MEANING, YOU
WANT TO BE BY YOURSELF. SILLY
THING THAT I SHOULDN’T BE
WORRIED ABOUT. YOU KNOW, FOR A LOT OF MEN,
IT’S EMBARRASSING. FOR A LOT OF WOMEN, YOU KNOW,
PEOPLE TO START KIND OF HAVE
THEIR THOUGHTS IF SOMEONE’S
ANXIOUS ALL THE TIME. I THINK THAT IT BEING THAT TYPE
OF DISEASE MAKES IT DIFFICULT
TO TREAT BECAUSE, YOU KNOW, WE’RE ALL KIND OF
PULL OURSELVES UP BY THE
BOOTSTRAPS TYPES, RIGHT?>>WELL, THAT’S SOUTH DAKOTA,
RIGHT?>>ABSOLUTELY. AND THE RESULT SOMETIMES IS
THIS THING THAT GNAWS AND
FESTERS AND PEOPLE DON’T COME TO SEEK
HELP UNTIL THEY ABSOLUTELY HAVE
TO.>>SOME SELF-MEDICATE. EXPLAIN
THAT.>>WELL, I THINK, AGAIN, LIKE,
WE — WE ALL TRY TO FIGURE IT
OUT, RIGHT?>>RIGHT.>>SO IN ANXIOUS TIMES, SOME OF
US WILL JUST AVOID, AND SOME
WILL STEP AWAY FROM THAT. OTHER FOLKS FIND DRINK OR DRUGS
OR SOMETHING ELSE TO KIND OF
ALTER HOW THEIR MIND IS FEELING. CERTAINLY THERE ARE A LOT OF
FOLKS OUT THERE WHO WILL USE OR
MISUSE ALCOHOL BECAUSE IT DOES SEEM TO HELP A
LITTLE BIT WITH THAT ANXIETY
PIECE IN THE SHORT TERM.>>RIGHT. SO LET’S SAY THEY
COME TO YOU. YOU SEE THAT
THEY’RE — THEIR STRESS, THEIR ANXIETY IS INTERFERING
WITH THEIR LIFE. SO WHAT ARE YOU GOING TO DO AS
A PSYCHIATRIST, AS A PRIMARY
CARE DOCTOR? WHAT IS THE RIGHT THING FOR
THAT CARE PROVIDER TO DO TO
HELP SOMEBODY WITH STRESS
ISSUES?>>YOU KNOW, I THINK NUMBER ONE
IS TO TAKE A MOMENT AND LISTEN. I THINK IT TAKES A LOT OF GUTS
TO GO SEE YOUR FAMILY DOC WHO
YOU’VE KNOWN FOR YEARS OR YOUR PSYCHIATRIST OR ANY
PSYCHIATRIST THAT YOU DON’T
REALLY KNOW, AND KIND OF OPEN UP ABOUT THE
STUFF THAT’S REALLY BUGGING YOU. SO I THINK IN THOSE SITUATIONS,
IT’S IMPORTANT FOR US TO STEP
BACK, BE QUIET, AND LISTEN.>>WHAT IS THIS THING ABOUT
LISTENING?>>I KNOW, IT’S
BIZARRE.>>THAT’S YOUR BEST TOOL, ISN’T
IT?>>I THINK IT GOES A LONG
WAY. IT — YOU KNOW, WE LIVE IN A
DAY AND AGE WHERE THINGS ARE
BUSY, AND IT SEEMS THAT THERE’S NO
TIME TO LISTEN, AND I THINK
IT’S WHAT WE NEED MOST.>>I BELIEVE THAT. I THINK
ABOUT A 95-YEAR-OLD GUY WHO
WOULD COME IN EVERY THREE
MONTHS. I’D LISTEN. YOU KNOW, AND A GOT DONE WITH
THE MEAT OF, YOU KNOW, THE
VISIT WITH HIM ONE DAY, AND HE’S GETTING UP TO LEAVE,
AND HE SAYS, ALL RIGHT, YOU
KNOW, I THINK I’D LIVE FOREVER IF YOU CONTINUE TO BE MY DOCTOR
AND LISTEN LIKE YOU DO. HOW
ABOUT THAT?>>WELL, UNFORTUNATELY, IT’S A
UNIQUE ATTRIBUTE IN MEDICINE
TODAY. AND, YOU KNOW, I THINK THAT WE
NEED TO STEP BACK AND THINK
ABOUT HOW SHOULD WE DO THIS?>>HOW ARE WE PRACTICING
MEDICINE?>>YEAH.>>WE NEED TO LISTEN MORE. NO
QUESTION YOU AND I AGREE WITH
THAT 100%. THE PROBLEM IS CONVINCING THE
REST OF THE DOCTORS WHO HAVE A
TIMELINE. THEY HAVE A TIMELINE.
AND THE COMPUTER.>>OH, THE COMPUTER. YES, THE
COMPUTER EXISTS.>>OH, THE COMPUTER. SO, I
MEAN, BEYOND THE LISTENING
PIECE, WHICH I DO FEEL IS
IMPORTANT, AND I THINK THAT DOES HELP
GUIDE HOW WE TREAT SOMEONE, YOU
KNOW, WE’VE GOT MEDICINES THAT DO A
NICE JOB IN TREATING ANXIETY.>>SO WE DO HAVE GOOD MEDICINES
TO TREAT ANXIETY. WHAT ARE THE MEDICINES THAT WE
USUALLY USE THAT WE SHOULDN’T
USE TO TREAT ANXIETY?>>WELL, THAT IS A VERY GOOD
QUESTION. SO I MEAN, THERE’S THE
BENZODIAZEPENE CLASS OF
MEDICATIONS, SO ATIVAN AND
CLONOPIN AND XANAX, AND THOSE ARE, YOU KNOW, PEOPLE
TALK ABOUT HAPPY PILLS. AND THEY’RE VERY ATTRACTIVE
BECAUSE IN THE MIDST OF BEING
MISERABLE AND ANXIOUS, YOU CAN
TAKE A PILL, AND IT –>>FEEL GREAT.>>AND IT CUTS
IT. BUT IN THE END YOU’RE JUST
MASKING THE ISSUE.>>IT’S JUST A MASK.>>YEAH.
>>SO WHAT ABOUT POST-TRAUMATIC
STRESS SYNDROME? THAT’S A BIG ISSUE IN THE
VETERANS WORLD AND WE’RE GOING
TO HAVE A ROLL-IN IN A MINUTE
ABOUT IT. WHAT DO YOU THINK — HOW BIG OF
A DEAL IS THAT?>>WELL, I — YOU TALK ABOUT A
DISEASE THAT IMPACTS YOUR DAILY
LIFE. YOU KNOW, PTSD OCCURS — IT
DOESN’T OCCUR NECESSARILY
BECAUSE PEOPLE HAVE EXPERIENCED
TRAUMATIC EVENTS. THERE ARE A LOT OF FOLKS THAT
HAVE EXPERIENCED TRAUMATIC
EVENTS AND THEY DO JUST FINE.
>>RIGHT.>>IT’S THE EXPERIENCING THE
TRAUMATIC EVENTS AND NOT HAVING
ANY CONTROL OVER IT.>>WELL, IF YOU WERE THE HEAD
OF THE ARMY, AND YOU HAD YOUR
WHATEVER WISH YOU WANTED
FULFILLED, WHAT COULD YOU DO TO PREVENT
THE PTSD SCENARIO?>>YOU KNOW, I THINK THAT’S A
CHALLENGE IS HOW DO YOU PREVENT
A THING THAT WE CAN’T REALLY
PINPOINT. SO WE HAVE TWINS WHO EXPERIENCE
THE SAME ISSUE AND ONE ENDS UP
WITH PTSD. THE OTHER DOES OKAY
WITH IT.>>AND YOU DON’T KNOW REALLY
WHY?>>YEAH, IT’S DIFFICULT. WE KNOW THE REASONS WHY,
BECAUSE THERE’S TRAUMA AND
THERE’S THE LACK OF CONTROL IN
THAT EVENT. BUT AS FOR PREDICTING WHO’S
GOING TO HAVE THAT, IT’S VERY
DIFFICULT.>>VERY DIFFICULT,
YEAH.>>WHILE MILITARY SERVICE OFTEN
FOSTERS RESILIENCE IN
INDIVIDUALS AND FAMILIES, MANY SERVICE MEMBERS EXPERIENCE
MENTAL HEALTH CHALLENGES. IN FACT, 22 VETERANS DIE BY
SUICIDE EVERY DAY. BUT HELP IS
AVAILABLE.>>WHEN WE HAVE VETERANS COMING
IN HERE, IT’S USUALLY AFTER A
DEPLOYMENT, OR SOME TRAUMATIC
EVENT. IF THEY COME IN TO SEE ME ABOUT
PTSD TREATMENT, I WILL REFER
THEM USUALLY TO THE V.A.
MEDICAL CENTER OR TO THE VET CENTER, THE VET
CENTER WAS BROUGHT ABOUT FROM
THE AGENT ORANGE SETTLEMENT. THE VET CENTER DOES NOT RELEASE
THEIR RECORDS TO ANYONE WITHOUT
THE VETERAN’S PERMISSION. THE VET CENTERS ALSO DO
COUNSELING FOR FAMILY MEMBERS. AND HERE IN BROOKINGS, WE DO
HAVE THREE COUNSELORS THAT I’M
AWARE OF THAT ALSO DEAL WITH
THE VETERANS AND PTSD. PTSD IS NOT JUST LIMITED TO,
YOU KNOW, ONE AGE GROUP OR
ANYTHING LIKE THAT. AND ONE OF MY BEST SUCCESS
STORIES ACTUALLY WAS A
GENTLEMAN THAT’S ALREADY
RETIRED. HE WAS IN KOREA. AND HE WAS A
MECHANIC THAT THEY PUT INTO THE
MORGUE DETAIL. AND THIS AFFECTED HIM FOR A
LONG TIME, AND SO AFTER HE HAD
TURNED 63 OR SO, WE FINALLY GOT
INTO SOME COUNSELING. AND IT DID NOT TAKE ALL THE
PROBLEMS AWAY, BUT HE WAS ABLE
TO ENJOY A BETTER LIFE AFTER
THAT. ALSO, WE HAVE ONES THAT ARE
DESERT STORM VETERANS. SOME OF THEM DID TAKE THE
30-DAY INPATIENT AND NOW THEY
ARE WORKING AND USEFUL MEMBERS
OF SOCIETY. BECAUSE A LOT OF OUR VETERANS
THAT HAVE PTSD WILL
SELF-MEDICATE AND THAT MEANS
THAT THEY ALSO HAVE, YOU KNOW, BASICALLY A DUAL
DIAGNOSIS. EITHER IT’S SOME
KIND OF ALCOHOL OR DRUG
DEPENDENCY. SO THESE PROGRAMS ARE REALLY
GOOD. IT GIVES THEM THAT 30
DAYS OUT, AWAY FROM ANY OF THE
INFLUENCES THAT THEY MIGHT HAVE, AND THOSE
CAN BE EXTENDED UP TO 90 DAYS
IN SOME CASES. RIGHT NOW, YOU KNOW, THEY’LL GO
THROUGH, LIKE YOU SAY, EITHER
THE — THEY’LL DO THE
COUNSELING, THEY’LL SEE A PSYCHIATRIST AT
THE V.A. THEY MAY REFER THEM
OUT TO A COUNSELOR IN THE AREA. OR HAVE THEM SEE THE VET CENTER
PART. THEN ALSO THEY DO DO SOME
MEDICATION MANAGEMENT ALSO. SO IF YOU’RE GOING THROUGH
DEPRESSION, JUST REMEMBER THAT
YOU’RE NOT ALL BY YOURSELF,
OKAY? THE OTHER PART OF IT IS,
EVERYONE WHO’S BEEN IN THE
SERVICE HAS BEEN THROUGH
CERTAIN THINGS TOGETHER, AND SO THERE’S A CERTAIN AMOUNT
OF CAMARADERIE THAT WE DO HAVE.
EVERYBODY’S DONE BASIC TRAINING. EVERYONE’S BEEN YELLED AT A
NUMBER OF TIMES, AND SO THAT’S
SOMETHING YOU CAN COME IN AND TALK WITH A VETERANS
SERVICE OFFICER ABOUT, AND WE
CAN HELP FIND A WAY TO MAKE IT
WORK BETTER FOR YOU.>>THIS IS YOUR PROGRAM, AND
YOUR QUESTIONS ARE KEY TO THE
DIRECTION OF OUR DISCUSSION. CALL IN YOUR QUESTIONS TO
1-888-376-6225. OR SEND US AN
EMAIL TO [email protected] THIS IS YOUR SHOW. YOUR
QUESTIONS REALLY MAKE THIS WORK. I HAVE TO SAY THAT MIKEY
HOLZHAUSER, I MEAN, A REAL
PROFESSIONAL AND A GOOD FRIEND,
HAD A BEER WITH ME LAST NIGHT. I MEAN, IT WAS — SO IT WAS
GOOD. HE MENTIONED THIS
HAPPENING TONIGHT. SO IT WAS — THANK YOU, MIKE.
FOR HELPING US. BUT WE GOT SOME
QUESTIONS, BOB.>>OKAY.>>LET’S JUMP RIGHT IN. I HAVE
BEEN FEELING SAD FOR A LONG
TIME. SHOULD I START WITH MY PRIMARY
DOCTOR OR SEEK OUT A
PSYCHIATRIST? GOOD QUESTION.>>THAT IS A VERY GOOD
QUESTION. I THINK A GOOD START
IS WITH YOUR PRIMARY CARE
DOCTOR. THE MEDICINES THAT WE USE ARE
SAFE MEDICINES THAT ARE
PRESCRIBED BY PRIMARY CARE DOCS
ALL THE TIME. AND THEN, YOU KNOW, THE OTHER
OPTION TO THIS TOO IS SOMETIMES
IT’S A LITTLE BIT OF THERAPY
THAT GOES A LONG WAY. AND BEGINNING TO ADDRESS THESE
ISSUES AND DIFFICULTIES. SO
THEY CAN HAVE SOME
RECOMMENDATIONS FOR THAT ALSO.>>AS A PRIMARY CARE DOC,
TALKING TO A PSYCHIATRIST, I
HAVE TO SAY THAT FOR MANY
YEARS, I WOULD START THERAPY, BUT I DID A LOT OF LISTENING,
AND WHEN THINGS GOT WORSE, THEN
YOU GOT THE BRUNT OF THE — THE
TROUBLE. AND SO IT WAS VERY IMPORTANT
FOR ME TO LISTEN CAREFULLY.
AND, YOU KNOW, THE MEDICINES DO
WORK. AND IT’S NICE TO SEE IT HAPPEN.
AND IT’S NICE TO — FOR THEM TO
BE ABLE TO DO THAT AT HOME.>>
YEAH.>>A CALLER FROM DE SMET, AND
GO BULLDOGS, SAYS MY HIGH
SCHOOL AGE DAUGHTER TELLS ME A FRIEND IS TALKING
ABOUT SUICIDE. WHAT SHOULD SHE
DO? THAT’S A SCARY QUESTION.>>THAT IS. AND THAT I THINK IT
SEEMS TO BE AN ISSUE, AND
CERTAINLY NATIONAL STATISTICS HAVE SHOWN THIS, YOU KNOW,
THERE IS MORE AND MORE SUICIDAL
THOUGHTS AND MORE ACTIVE SUICIDAL
GESTURES IN YOUNG ADULTS, YOUNG
KIDS, ADOLESCENTS THESE DAYS.>>AND I THINK IN SOUTH DAKOTA,
WE ARE RIGHT ON THE TOP OF LIST
OF STATES IN THE COUNTRY WITH
SUICIDE.>>WE ARE.>>AND RISKS ARE
VERY HIGH RIGHT NOW.>>I THINK IN THAT SITUATION,
IF SOMEONE IS TALKING ABOUT
THAT, IT’S IMPORTANT TO LET
PEOPLE KNOW. SO, YOU KNOW, IF SOMEONE IS
MAKING COMMENTS ABOUT WANTING
TO KILL THEMSELVES, AND I THINK IT’S IMPORTANT TO
CONTACT E.M.S., LET THEM KNOW.
AND THEY CAN GO CHECK THINGS
OUT. AND THEY’LL EITHER GO AND
ENSURE THAT THINGS ARE SAFE,
YOU KNOW, WE — SOMETIMES WE DON’T THINK OF OUR
FRIENDLY NEIGHBORHOOD POLICEMAN
–>>RIGHT, BUT –>>YOU KNOW, THEY DO A GREAT
JOB OF REACHING OUT TO PEOPLE
WHEN THEY’RE ABSOLUTELY IN THAT
MOMENT OF NEED. AND WE SHOULD LEAN ON THEM.>>
WHEN SOMEBODY’S TALKING
SUICIDE, IT’S TIME TO START
SOME ACTION. AND I THINK THAT SOMETIMES JUST
CALLING THE COUNSELOR, THE
SCHOOL COUNSELOR. IF THE PERSON — IF THAT CHILD
HAS A REALLY GOOD CONNECTION
WITH X, Y, OR Z, THEN YOU TALK
TO X, Y, AND Z. SO THAT SOUNDS LIKE AN
IMPORTANT THING. I AGREE WITH
HIM. LET’S CONTACT SOMEBODY.
DON’T JUST — OH. AND THEY DON’T WANT TO — THEY
DON’T WANT ANYONE TO KNOW, SO
I’M NOT GOING TO — I CAN’T
TELL ANYBODY. AND THE ANSWER IS, UH-UH. YOU
NEED TO TELL SOMEBODY.>>YEAH, IT’S DIFFICULT,
BECAUSE I THINK THE YOUNGER
GENERATIONS NOW, THEY
COMMUNICATE DIFFERENTLY. SO THERE’S A LOT MORE SOCIAL
MEDIA DRIVEN CONVERSATIONS. AND
PERHAPS ONCE UPON A TIME WHEN
WE’D SIT DOWN WITH A FRIEND AND VOCALIZE
THESE CONCERNS, YOU KNOW, THAT
BECOMES KIND OF AN ONLINE EVENT
NOW. AND JUST BECAUSE IT’S ONLINE
DOESN’T MEAN IT’S NOT
IMPORTANT.>>WOW.>>AND WE HAVE THIS TENDENCY TO
WANT AND TRY AND SAY IT’S FINE.
AND WE CAN’T PREDICT IT. WE
HAVE TO BE CAREFUL.>>THE — A WOMAN FROM
BROOKINGS ASKS IF YOU CAN TOUCH
ON DEPRESSION IN THE ELDERLY. AGING, DIFFERING SOCIAL
EXPERIENCES. SO DEPRESSION IN
THE ELDERLY. IT’S A REAL DEAL.>>IT IS A VERY REAL DEAL. AND
I THINK THAT THE DIFFICULT PART
IS THAT — AND I’VE HAD LOTS OF
MY PATIENTS SAY THIS, YOU KNOW, YOU DON’T KNOW HOW
I’M FEELING BECAUSE YOU HAVEN’T
BEEN THERE. AND YOU’RE RIGHT.
LIKE, I HAVE NOT. AND IF I’M BLESSED, PERHAPS
THEY GET THERE AT SOME POINT.
>>TO BE AN OLD PERSON?>>TO BE OLD AND HAVE THOSE
STRUGGLES. BUT IT IS DIFFICULT
TO LOSE INDEPENDENCE. BOTH PHYSICALLY AND MENTALLY
SOMETIMES. AND TO SEE — TO SEE
YOUR FRIENDS MOVE ON. TO SOMETIMES SEE SIBLINGS AND
KIDS PASS AWAY. THESE ARE
MASSIVE LIFE CHANGES THAT ARE
DIFFICULT TO WORK THROUGH.>>YEAH, AND THEY HAPPEN TO
ELDERLY PEOPLE BECAUSE THEY’RE
ELDERLY LIVING ARE LIVING PAST
THE OTHER PERSON’S LIVES. I MEAN, IT’S JUST A REALITY. IF
YOU’RE GOING TO STAY ALIVE,
YOU’RE GOING TO SEE YOUR
FRIENDS DIE.>>MM-HMM.>>AND IT’S A TOUGH THING.>>
YOU KNOW, IT’S — I THINK IT’S
DIFFICULT TO DISCUSS TOO. BECAUSE, YOU KNOW, OUR OLDER
POPULATION, THEY DO HAVE THIS
STIFF UPPER LIP.>>THEY DO,
DON’T THEY?>>YOU DEAL WITH IT AND YOU
MOVE FORWARD, AND, YOU KNOW,
GRIEF AND LOSS AND DEPRESSION, YOU PUSH THROUGH IT FOR A
WHILE. AT SOME POINT, YOU JUST
RUN OUT OF GAS.>>I HEARD ONE STATISTIC. I
DON’T KNOW IF IT’S TRUE OR NOT. BUT THAT THE HIGHEST RISK FOR
SUICIDE IS THE ELDERLY MAN
WHOSE WIFE JUST DIED.>>
ABSOLUTELY.>>YOU’VE HEARD THAT THEN?>>
ABSOLUTELY, THAT IS THE CASE,
YEAH.>>DEPRESSION IS THE REAL
DEAL. LET’S JUST TALK A LITTLE BIT
ABOUT DEPRESSION.>>I MEAN,
DEPRESSION IS LOW MOOD. AND THAT’S PRETTY AMBIGUOUS,
AND, YOU KNOW, WE TALK ABOUT
IMPACTS TO SLEEP AND INTERESTS AND OVERWHELMING FEELINGS OF
GUILT OR LOW ENERGY OR POOR
CONCENTRATION. YOU CAN SEE APPETITE CHANGES.
SOME FOLKS JUST LOOK LIKE
THROUGH THEY’RE WALKING THROUGH
MOLASSES.>>THAT SOUNDS LIKE A GOOD SONG
TO WRITE.>>NOT BAD. YOU DON’T
WANT ME TO SING IT, THOUGH.
[Laughter] AND THEN THE SUICIDAL THOUGHTS
TOO. AND THAT’S A COMBINATION
OF THOSE SYMPTOMS FOR AN
EXTENDED PERIOD OF TIME, I MEAN, IT’S KIND OF WHAT WE
LABEL AS DEPRESSION.>>BUT, YOU KNOW, DON’T YOU
THINK THAT EVERYBODY HAS
DEPRESSION? THROUGH THEIR
LIVES? OFF AND ON? IT’S JUST — IF IT — IF IT
CAUSES DYSFUNCTION LIKE YOU
SAY, IT TAKES FUNCTION — IT TAKES YOU AWAY FROM BEING
ABLE TO FUNCTION, THEN –>>THEN I THINK IT’S AT THAT
POINT WHERE IT’S IMPORTANT TO
SEEK OUT SOME ASSISTANCE.>>THERE ARE PEOPLE WHO HAVE
BEEN TRAINED IN THIS, YOU KNOW.
SO CONSIDER THAT SEEKING OUT
SOME HELP. A CALLER FROM RAPID CITY ASKS
IF THERE’S GENETIC TESTING TO
HELP DISCERN WHAT KIND OF
ANTIDEPRESSANT WILL WORK BEST. THERE’S ALL THIS ABOUT WHICH
DRUG WILL WORK.>>YOU KNOW, I
THINK THAT’S A REALLY GREAT
QUESTION. AND I KNOW THAT, YOU KNOW, AS
SCIENCE PROGRESSES, WE HAVE
MORE SCIENTIFIC OPTIONS, AND CERTAINLY THERE ARE GENETIC
TESTS OUT THERE THAT WILL
MEASURE HOW WELL YOUR BODY CAN
METABOLIZE CERTAIN MEDICATIONS.
AND I THINK WE SHOULD USE THAT
AS A TOOL. YOU KNOW, IF I’M TREATING
SOMEONE AND WE’VE TRIED A
COUPLE MEDICATIONS AND THERE
HAVE BEEN POOR RESPONSE OR NO RESPONSE OR SIGNIFICANT
SIDE EFFECTS, WELL, THEN SURE,
LIKE, LET’S USE THAT TOOL AND TAKE A LOOK AT WHAT’S GOING ON.
YOU KNOW, WHERE I FEEL THAT
IT’S MISUSED IS YOU’VE GOT
SOMEONE WHO’S STABLE AND DOING FINE,
YOU CHECK THE GENETIC TESTING AND THE GENETIC TESTING SAYS
THAT MEDICINE ISN’T COMPATIBLE. SO WHEN SUDDENLY YOU’RE
CHANGING MEDICINES ON SOMEONE
WHO’S DOING FINE, AND
OFTENTIMES YOU JUST END UP PULL.>>YOU’VE SEEN THAT HAPPEN?>>
YEAH.>>WOW. WELL, THAT’S AN
IMPORTANT LESSON I THINK. WE HAVE A CALLER FROM SIOUX
FALLS WHO ASKS ABOUT THE RISK
OF HAVING GUNS IN THE HOUSE AND
THE POTENTIAL FOR SUICIDE.>>WELL, I THINK IT’S IMPORTANT
FOR ALL OF US TO RECOGNIZE THAT
SUICIDE IS OFTENTIMES AN
IMPULSIVE DECISION.>>THINK ABOUT WHEN THEY’RE
YOUNGER.>>ESPECIALLY WHEN
THEY’RE YOUNGER, IN SITUATIONS WHERE THERE’S AN
INTOXICATION OR YOUR BRAIN IS
NOT WORKING THE WAY IT NORMALLY
DOES. SO THE CHALLENGE AND THE DANGER
OF HAVING GUNS AROUND IS IF
THERE’S THAT IMPULSE, THERE’S THAT OPTION TOO, AND AS
IT TURNS OUT, GUNS ARE VERY
DEADLY.>>TAKE AWAY THAT OPTION WHEN
THE PERSON IS AT RISK, NO
QUESTION.>>AND IT’S IMPORTANT AND WE
LIVE IN SOUTH DAKOTA AND
HUNTING IS IMPORTANT TO WHAT WE
DO.>>I GOT GUNS IN MY HOUSE AND
–>>YOU GOT TO MOVE THOSE OUT
WHEN THERE’S MOMENTS OF CONCERN
AND DANGER. BUT IT DOESN’T MEAN THAT
THEY’RE OUT FOREVER. IF YOU’RE
DOING BETTER, THEN, YOU KNOW,
PART OF OUR HOBBY, IT’S PART OF WHAT WE DO IS TO
GET BACK INTO THAT.>>PART OF MY JOY IS TO HUNT
PHEASANTS, AND I CAN’T THINK OF
A HAPPIER MOMENT THAN BRINGING
UP THE MEMORY OF WALKING THROUGH A
CORN FIELD WITH MY DAD AND I
HAD A POP GUN. I MEAN, HE TOOK
ME ON HUNTS.>>YEAH.>>BUT I DIDN’T HAVE A
GUN. [Laughter] SO THOSE ARE,
YOU KNOW, I’M I HUNTER. BUT — AND I’VE HAD — I’VE —
I LOVE VENISON, AND DEER IS FUN
TO SHOOT. SO I’VE DONE ENOUGH
OF THAT TOO. BUT I HAVE TO SAY THAT WE NEED
TO BE CAREFUL ABOUT THOSE GUNS
WHEN IT’S — WHEN THE TIME IS
RIGHT IN PARTICULAR. MAYBE WE DON’T KNOW THE TIME IS
RIGHT AND WE JUST HAVE TO TAKE
THOSE GUNS AND MAKE THEM SAFE.>>I THINK BETTER SAFE THAN
SORRY.>>A WOMAN FROM SIOUX FALLS
ASKS, DOES ANXIETY OR
DEPRESSION ELEVATE BLOOD SUGAR
FOR DIABETES?>>IT CAN, YES.>>REALLY?>>
YEAH. SO IT’S A STRESS RESPONSE. SOME STUDIES OUT THERE RECENTLY
TOO THAT ARE KIND OF INDICATING
THAT EVEN DEPRESSION, ANXIETY ISSUES UNTREATED
INCREASE RISK OF BLOOD CLOT AND
STROKES. AND MAKES YOUR
PLATELETS STICKIER.>>YOU KNOW, IT REALLY GOES
DOWN TO THE WELLNESS TRIAD THAT
I ALWAYS SAY. EXERCISE IS THE BOTTOM LINE.
YOU GOT TO HAVE EXERCISE. IT’S
SO IMPORTANT. SECOND COMPONENT IS MAYBE
EATING LESS. YOU DON’T GORGE
YOURSELF AND, YOU KNOW, JUST
EAT LESS CALORIES. BALANCED DIET AND LOTS OF
FRUITS AND VEGETABLES AND ALL
OF THAT. BUT EAT LESS. AND THE THIRD ONE IS,
CONNECTION WITH FRIENDS. AND I
MEAN, THE SPIRITUAL
RELATIONSHIPS THAT YOU HAVE WITH OTHER
PEOPLE, I THINK THOSE ARE VERY
IMPORTANT. AND IT’S INTERESTING THAT
DIABETES IS PART OF IT. MAYBE
IT’S BECAUSE YOU’RE NOT
EXERCISING BECAUSE YOU’VE STOPPED BECAUSE
YOU WERE DEPRESSED AND YOU’RE
JUST SITTING THERE.>>WELL, I MEAN, CERTAINLY IT
SEEMS THAT OUR CURRENT DIET
SETS FOLKS UP TO HAVE METABOLIC
PROBLEMS. AND, YOU KNOW, AGAIN, THERE’S A
LOT OF NEW STUDIES OUT THERE
SHOWING THAT IF YOUR MOOD IS
GOOD, YOU TAKE CARE OF YOURSELF,
WHICH SEEMS TO BE PRETTY COMMON
SENSE.>>YEAH. BUT –>>IT IS
SOMETHING THAT IS BEING TALKED
ABOUT MORE, THAT MANAGING MOOD AND CONTROLLING ANXIETY MEANS
THAT OUR BLOOD PRESSURE IS
BETTER AND WE TAKE CARE OF OUR SUGARS
THE WAY WE OUGHT TO AND WE GO
GET THE EXERCISE WE’RE SUPPOSED
TO GET.>>A CALLER FROM WAGNER STATES,
WHAT? [Laughter] THE CALLER FROM WAGNER STATES,
MY SISTER DIED FROM SUICIDE.
SHE HAD A LONG HISTORY OF
DEPRESSION. I HEARD THAT IF ONE CHILD IN A
FAMILY DIES BY SUICIDE, THERE’S
AN INCREASED RISK OF ANOTHER CHILD DYING IN THE SAME
MANNER. IS THIS ACCURATE? I
HAVE DEPRESSION TOO.>>OOH. FIRST OF ALL, I’M SORRY
TO HEAR ABOUT –>>I AM TOO.
>>THEIR SISTER. THAT’S A TOUGH SITUATION, AND
THAT IS A TRAUMATIC SITUATION.
THERE ARE SOME CERTAINLY
REPORTS OUT THERE THAT INDICATE THAT THAT THESE
TRAUMATIC ISSUES KIND OF LEAD
TO MORE POTENTIAL FOR TRAUMATIC
ISSUE. WHICH TO A CERTAIN EXTENT MAKES
SENSE, BECAUSE IT’S, YOU KNOW, IT’S THOSE SHOCKS AND THOSE
CHALLENGES THAT WE’RE NOT ABLE
TO WORK THROUGH THAT TEND TO
STICK. THERE IS CERTAINLY A GENETIC
COMPONENT TO DEPRESSION AND
ANXIETY ALSO. AND, YOU KNOW, I THINK, YOU
KNOW, WHEN WE’RE LOOKING AT
THOSE TYPES OF STATISTICS, TO RECOGNIZE THAT, YOU KNOW,
THEY’RE GOING TO LEAN MORE THAT
DIRECTION BECAUSE THERE IS THAT INCREASED
GENETIC RISK TOO.>>SO WE NEED TO HAVE —
[Inaudible] –>AND TALK ABOUT
IT.>>YEAH. WELL, WE’RE ON A
CAMPUS HERE WHERE WE HAVE A LOT
OF KIDS. KIDS, MEANING 18 TO
22-PLUS. AND THIS ISN’T A WORLD WHERE
THERE’S A LOT OF THE OTHER
DEPRESSION LIKE WE TALKED ABOUT, PROBABLY MORE IN THE ELDERLY.
WHAT ABOUT YOUNG PEOPLE WITH
DEPRESSION AND –>>WELL, YOU KNOW, I — IT’S
THERE. SO I MEAN, DEPRESSION IS
A DISEASE JUST LIKE DIABETES IS. SO –>>ARE YOU SAYING THERE’S
NO JUDGMENT AGAINST PEOPLE WHO
HAVE DEPRESSION?>>OH, YEAH, NO ONE JUDGES
THEM. [Laughter] I MEAN, THAT’S
ONE OF THE DIFFICULTIES. IT’S A VERY LONELY DISEASE.
BECAUSE IT’S HARD TO FEEL
CRUMMY AND GO DO THINGS, AND IT’S HARD TO FEEL CRUMMY
AND WANT TO TALK TO PEOPLE
ABOUT IT. IT’S HARD TO CHOOSE TO BE
VULNERABLE WHEN YOU’RE NOT SURE
HOW SOMEONE’S GOING TO REACT TO
YOU. AND THERE ARE CERTAINLY
PRECONCEIVED THOUGHTS AND
WORRIES THAT PROBABLY ARE
REASONABLE CONCERNS THAT DRIVE KIND OF THIS
NEGATIVE RESPONSE TO GETTING
TREATMENT. FOR KIDS IN COLLEGE, I MEAN,
THERE’S SO MUCH CHANGE. YOU’RE
OFF ON YOUR OWN. THERE ARE ALL SORTS OF
PRESSURES GOING ON.
RESPONSIBILITIES THAT YOU’RE
RESPONSIBLE FOR NOW. CLASSES, CHALLENGING.>>HUGE
TRANSITION TIME IN YOUR LIFE.
OH, MY GOSH. YEAH.>>I MEAN, CLASSICALLY, KIND OF
THAT’S WHERE YOU HEAR STORIES
TOO OF FIRST BIPOLAR DISORDER
KICKING IN AND SCHIZOPHRENIA,
IT’S THOSE STRESSFUL MOMENTS.>>TRYING TO GET THROUGH THE
COLLEGE YEARS. YOU KNOW, IT’S A
GREAT TIME FOR MANY. IT’S A
HARD TIME FOR MANY.>>YEAH. WELL AND I THINK THAT
IS THE PRESSURE TOO BECAUSE IT’S SUPPOSED TO BE THE BEST
TIME OF YOUR LIFE AND DOESN’T
FEEL THAT GREAT IF YOU’RE NOT FEELING LIKE IT’S
THE BEST TIME OF YOUR LIFE.>>
YEAH.>>MENTAL HEALTH ISSUES, SUCH
AS ANXIETY, ARE BECOMING MORE
PREVALENT IN THE COLLEGE
SETTING, WHICH IS WHY IT IS IMPORTANT
FOR STUDENTS AND CONCERNED
FAMILY MEMBERS TO BE FAMILIAR
WITH IT.>>WE DO HAVE A LARGE AMOUNT OF
STUDENTS THAT NEED OR WANT OR
USE OUR SERVICES. A LOT OF ANXIETY AND DEPRESSION
RELATED DIAGNOSIS. BECAUSE
MENTAL HEALTH PROBLEMS THAT ARE
MORE CHRONIC GENERALLY START PRESENTING AT
THE AGE OF THE COLLEGE STUDENT. PARTLY BECAUSE AT THAT
TRANSITION IN LIFE, THERE’S A
LOT MORE STRESS AND PRESSURES AND A LOT OF DECISIONS AND
CHANGES THAT GO ON. AND THEN THERE’S ALSO THE
DEVELOPMENT OF THE BRAIN AND
THE BODY. WE HAVE A LOT THAT’LL COME IN
AND THEY’RE MORE ACUTE, LIKE I
SAID. THEY DON’T NEED MANY
SESSIONS. MAYBE THEY NEED THREE OR FOUR
TO KIND OF ADJUST AND DEVELOP
HEALTHY COPING SKILLS AND
RESOURCES. WE CAN PROVIDE INDIVIDUAL
COUNSELING SESSIONS. OUR LEVEL
OF CARE IS USUALLY WEEKLY OR
LESS, AS FAR AS INDIVIDUAL SESSIONS
GO. WE DO OFFER THREE DIFFERENT
KINDS OF GROUPS EACH WEEK AT
THIS POINT. THIS SEMESTER WE’RE OFFERING A
GRIEF GROUP, AN ECOTHERAPY
GROUP AND WHAT WE CALL A WISE
MIND GROUP. WE ALSO HAVE URGENT CARE WHERE
IF THERE’S A CRISIS DURING THE
DAY, THEY CAN IN INTO THE CLINIC AND BE SEEN WITHIN A TIMELY
MANNER, AND WE HAVE 24/7
ON-CALL ON CAMPUS. THE TREND RIGHT NOW AS FAR AS
SUICIDAL IDEATION, THOUGHTS OF
DEATH OR EVEN SELF-HARMING BEHAVIORS
IS INCREASED A LOT. PRIMARILY THE COPING SKILLS AND
HOW I THINK SOCIAL MEDIA AND
STUFF AND INFLUENCE THAT
ELEMENT. THOUGHTS OF SUICIDE ARE A
SYMPTOM ARE SOMETHING GOING ON. THEY’RE NOT THE ONLY THING THAT
THAT PERSON HAS GOING ON. WE DO — OUR ON-CALL SERVICES
HELP WITH THE, LIKE, ACUTE
CRISIS SITUATIONS THAT MAY
HAPPEN. WE WORK WITH THE BROOKINGS E.R.
SYSTEM A LOT. IF A PERSON’S BROUGHT THERE,
U.P.D. ALSO USES US FOR WELL
CARE CHECKS IF NEEDED. I WOULD SUGGEST THE EARLIER THE
BETTER, SO THAT WAY IT’S MORE,
A FEW SESSIONS, AND MAYBE YOU
SEE PROGRESS. YOU UNDERSTAND YOURSELF A
LITTLE BIT MORE AND YOU
UNDERSTAND HOW TO MANAGE THAT A
LITTLE BIT BETTER. WHEREAS IF YOU WAIT TOO LONG,
YOU CHANCE CREATING MORE OF A
PATTERN AND DEEPER SYMPTOMS THAT TAKE
LONGER TO SEE DECREASE IN.>>THIS IS SUCH AN IMPORTANT
TOPIC. I MEAN, I — I DON’T
KNOW HOW EXCITING IT IS. BUT TO ME, THIS IS LIKE THE —
THE BOTTOM OF THE PYRAMID THAT
IS IMPORTANT IN THE QUALITY OF
LIFE FOR PEOPLE. HOW WOULD YOU RESPOND TO THAT
COMMENT?>>I, YOU KNOW, WHILE SOME
REFUSE TO BELIEVE THERE’S A
FAIR AMOUNT OF COMMON SENSE IN
PSYCHIATRY. AND IT’S PRETTY EASY TO SAY,
BOY, PEOPLE AREN’T DOING WELL,
THEY’RE ANXIOUS, DEPRESSED, THEREFORE THEY’RE NOT DOING
WELL BECAUSE THEY’RE ANXIOUS
AND DEPRESSED.>>YEAH.>>THE CHALLENGE, AGAIN, IS
THAT IT CAN BE A VERY LONELY
PATH. FIRST STEP IS IMPORTANT.>>THAT FIRST STEP. AND, YOU
KNOW, I’M JUST BLASTED OUT OF
THIS ROOM WITH THE IDEA THAT
YOU SAID, DEPRESSION IS SUCH A LONELY
CONDITION. AND IT IS. YOU’RE
RIGHT. I MEAN, I THINK ABOUT
THAT. AND I HAD NEVER PUT IT IN THAT
REALM. PEOPLE — THERE ARE A
LOT OF LONELY PEOPLE IN THIS
WORLD. AND, YOU KNOW, PART OF THE
TREATMENT MIGHT BE JUST TO BE A
FRIEND. AN EMAILER HAS COMMENTED, I
JUST WANTED TO SAY THAT
MILITARY PEOPLE ARE NOT THE
ONLY ONES WHO HAVE PTSD.>>ABSOLUTELY.>>GIVE ME OTHER
EXAMPLES YOU’VE SEEN THAT YOU
CAN SHARE WITHOUT DESTROYING
PRIVACY.>>I WAS ACTUALLY READING A
BOOK ON PTSD. AND THE AUTHOR
WAS DESCRIBING A SITUATION
WHERE HE IS PUTTING AN AIR CONDITIONER
UP IN A HIGH RISE BUILDING, AND
IT SLIPPED OUT OF HIS HANDS. AND, YOU KNOW, HE WATCHES THING
FALL, AND ALL THIS HORRIBLE
THOUGHTS OF PEOPLE GETTING
SQUASHED AND KILLED, AND HE SAID THAT HE STRUGGLED A
LOT WITH KIND OF THOSE TYPE
ISSUES FOR A WHILE THERE, BECAUSE AGAIN, IT WAS A RISKY
TRAUMATIC EVENT THAT HE HAD NO
CONTROL OVER.>>IT DIDN’T LAND ON ANYBODY?
>>IT DID NOT. EVERYBODY WAS
OKAY. OH!>>OH! BUT YOU THINK ABOUT THE
POTENTIAL OF HURTING SOMEBODY.
I HAD — I HAVE HAD THE SAME
EXACT REPERCUSSIONS, BUT IT ONLY LASTED A COUPLE,
THREE, FOUR — WELL, STILL
ALIVE IN MY BRAIN. I’M DRIVING UP FROM THE STUDIO
HERE TO GET BACK ON 6TH STREET
TO GO BACK TO THE CLINIC. AND IT’S A — I COME UP TO THE
STOP. AND I’M WAITING FOR THE
CARS ON THE LEFT, YOU KNOW, WHO
ARE — I’M READY TO GO ACROSS AND THEN
LEFT. AND HE’S STOPPED. AND
THERE’S NOBODY COMING. AND I’M
LOOKING AT THE GUY. AND I LOOK AROUND. THERE’S
NOBODY COMING. AND HE WON’T
TURN. AND I’M THINKING, I CAN
— I CAN GO RIGHT NOW. AND JUST ABOUT TO GO, AND A
BIKER DRIVES RIGHT IN FRONT OF
ME. OH, MAN, YOU THINK ABOUT THAT,
AND YOU KNOW OF ACCIDENTS THAT
WERE VERY SIMILAR TO THAT. BREAKS YOUR HEART TO THINK
ABOUT THE — WHAT YOU COULD
HAVE DONE. WHICH MAKES YOU DRIVE A LITTLE
MORE CAREFUL. I GUESS.>>THAT’S IT. YOU KNOW, I DON’T
KNOW IF I MENTIONED IT EARLIER,
BUT WHAT DOES PTSD MEAN? PTSD IS POST-TRAUMATIC STRESS
DISORDER. SO, YOU KNOW, WHEN
THE CALLER HAD KIND OF SAID
THAT, YOU KNOW, YOU DON’T HAVE TO BE
IN THE MILITARY, ABSOLUTELY
RIGHT. IT’S A POST-TRAUMA
STRESS DISORDER.>>SO THEY’D SAY RAISED IN A
MEAN FAMILY.>>OH, YEAH, I MEAN,
UNFORTUNATELY, A LOT OF THESE
ABUSES THAT OCCUR LEAVE SCARS. AND PTSD CAN BE ONE OF THE
STRUGGLES THAT PEOPLE HAVE.>>
YEAH. YEAH, WHAT ABOUT THE — I HAD
ANOTHER CASE OF A PERSON WHO
ATTEMPTED SUICIDE. WAS HOSPITALIZED AT THE
PSYCHIATRY HOSPITAL IN SIOUX
FALLS. AND THEN AFTER THE SUICIDE
EVENT, THREE DAYS LATER, WAS
RELEASED. YOU KNOW, THAT’S BEEN A DILEMMA
FOR ME TOO. HOW LONG DO YOU
KEEP THESE PEOPLE? WHAT CAN YOU DO TO HELP THEM?
AND HOW DO YOU KNOW FOR SURE
THEY’RE NOT GOING TO COMMIT
SUICIDE AFTER THIS?>>WELL, YOU DON’T KNOW FOR
SURE. AND I — YOU KNOW, THAT
STORY IS ONE THAT YOU HEAR. YOU KNOW, THERE’S THIS ISSUE
THAT HAPPENS THAT IS DANGEROUS
AND LIFE-THREATENING. AND YOU END UP IN THE PSYCH
HOSPITAL FOR IT. AND IN THREE
DAYS, YOU CAN GET SOME
TREATMENT, AND CERTAINLY WE CAN MOVE
THROUGH THE ACUITY OF THE
MOMENT, BUT I AM NOT SURE IF THREE DAYS
SOLVES THE UNDERLYING PROBLEM. AND THAT’S KIND OF WHY THESE
PLANS FOR DISCHARGE ARE
IMPORTANT. I THINK IT’S ALSO IMPORTANT TO
RECOGNIZE WHEN YOU GO TO A
PSYCHIATRY HOSPITAL, SOME PEOPLE GO THERE
INVOLUNTARILY. THEY’RE SICK AND
THEY GO THERE ON A MENTAL
HEALTH HOLD AND YOU’RE THERE AGAINST YOUR
WILL, UNFORTUNATELY. YOU KNOW,
THOSE HOLDS GET DROPPED. AND THEN IT GOES BACK TO
WHOMEVER’S IN THE HOSPITAL. DO
THEY WANT TO STAY? THEY HAVE THE OPTION TO DO SO.
IF THEY HAVE NO INTEREST, THEY
CAN SAY NO THANK YOU.>>YOU CAN’T HOSPITALIZE THEM
ALL. THERE WAS A QUESTION ABOUT
BAD BOSSES. I KNOW FULL WELL WHEN I HAVE A
GOOD BOSS AND I’M WORKING FOR
THAT GOOD BOSS, I’LL FOLLOW A — FALL ON A SWORD TO SATISFY
THAT GUY OR GAL. THAT IS
DIRECTING ME. AND I HAVE
LOYALTY TO THEM. BUT THERE ARE TIMES WHEN I SEE
THE BAD BOSSES CAN DESTROY A
PERSON. THEY CAN PICK OUT SOMEBODY THEY
DON’T LIKE, AND THEN THEY CAN
JUST DRIVE THEM RIGHT INTO THE
GROUND.>>YEAH.>>WHAT DO YOU SAY
ABOUT THAT?>>I THINK IT GOES
WITH ALL RELATIONS THAT WE HAVE. YOU KNOW, OUR ENGAGEMENT WITH
OTHER PEOPLE DRIVES, DICTATES
HOW WE FEEL, HOW WE FEEL ABOUT
OURSELVES, HOW WE FEEL ABOUT THEM. IT’S
TOUGH TO GO TO WORK EVERY DAY
FOR SOMEONE THAT YOU DON’T LIKE, THAT YOU DON’T HAVE RESPECT
FOR, BECAUSE THEY DON’T HAVE
RESPECT FOR YOU. I THINK — THOSE BOSSES WHO
CHOOSE TO BE VULNERABLE, WHO
CHOOSE TO STOP AND LISTEN, YOU’RE ABSOLUTELY RIGHT — OH,
YEAH, YOU GET SOMEONE WORKING
FOR YOU BECAUSE THEY WANT TO WORK FOR
YOU, BECAUSE IT’S A GOOD PLACE
TO WORK.>>THAT’S SO IMPORTANT. HOW
COULD WE TEACH THAT TO EVERY
BOSS OUT THERE? AN EMAILER STATES, AND WE’RE
RUNNING OUT OF TIME, SO WE GOT
TO HAVE SHORT ANSWERS.>>OKAY. STATES, I’VE BEEN
SUFFERING FROM SEVERE ANXIETY,
PTSD AND M.D.D. WHICH IS?>>MAJOR DEPRESSIVE DISORDER.
>>FOR ALMOST THREE YEARS NOW. HAVE TRIED MULTIPLE MEDICINES
WITH HORRIBLE SIDE EFFECTS,
BEEN HOSPITALIZED NUMEROUS
TIMES, FEEL LIKE ALL MY PSYCHIATRIST
DOES IS PUSH DIFFERENT
MEDICATIONS ON ME CONSTANTLY, DOESN’T FULLY LISTEN TO MY
CONCERNS. CAN I GET THROUGH
THIS WITH JUST THERAPY AND NO
MEDICATION? SHOULD I TRY TO FIND A NEW
PSYCHIATRIST?>>I THINK THOSE
ARE ALL VERY GOOD QUESTIONS. I WOULD SAY THAT IF THE
DEPRESSION HAS BEEN THAT DEEP,
THAT THERE PROBABLY IS A ROLE
FOR MEDICINES. THE CHALLENGE, AND MY APPROACH
ON DOING MEDICINES IS MY GOAL
IS TO GET YOU FEELING BACK TO
YOURSELF.>>FIND THAT RIGHT MEDICINE.>>
RIGHT. SO IT’S IMPORTANT IF THE
RELATIONSHIP YOU HAVE WITH YOUR PSYCHIATRIST IS NOT
WORKING –>>FIND ANOTHER –>>I THINK IT MAKES SENSE TO GO
FIND AN ANSWER SOMEWHERE.>>ME
TOO. IF YOU CAN LOVE AND TRUST YOUR
PRIMARY CARE GUY OR GAL, THAT
PERSON WILL HELP YOU THROUGH SO
MUCH.>>I THINK THAT’S WHERE THE
ROLE OF GETTING THERAPY IS
IMPORTANT TOO. BECAUSE THERE’S THAT LISTENING
COMPONENT INVOLVED.>>TWO
MINUTES. FOUR QUESTIONS. A MAN FROM SIOUX FALLS STATES,
WITH DEPRESSION, YOU OFTEN FIND
A PROBLEM WITH SLEEP
DISTURBANCES. WE COULD GO ALL NIGHT LONG WITH
THAT ONE. SO DO YOU FIND A
SIMILAR PROBLEM WITH DEPRESSION. DOES SLEEP DEPRIVATION AND
DEPRESSION CORRELATE? SLEEP
DISORDERS CERTAINLY DO.>>YEAH, THE ANSWER IS YES. BUT
IT’S A CHICKEN OR — CHICKEN OR
EGG QUESTION. ARE YOU SLEEPING CRUMMY BECAUSE
YOU’RE DEPRESSED OR WORRIED OR
VICE VERSA?>>THE WORST TREATMENT WOULD BE
WHAT?>>DRINKING A BUNCH OF
COFFEE AND KEEPING THE TV ON.
[Laughter]>>LIKE A.M. BEEN. AMBIEN. BAD
CHOICE.>>YOU’RE PUTTING SOMEONE DOWN
OR TRYING TO MASK THE ISSUE AS
OPPOSED TO FINDING THE SOLUTION.>>WE’VE GOT ONE MINUTE. A MAN
FROM — SHOULD WE CONSIDER THE
LOVE ANIMALS, GIVE TO PEOPLE TO, AS A MEANS
OF TREATMENT? DO YOU LIKE —
YES OR NO, DO YOU LIKE ANIMALS?>>I LIKE ANIMALS, YEAH. I
THINK IT’S IMPORTANT AND IT’S
ACCOUNTABILITY AND INVESTMENT. SOMETIMES HAVING A DOG YOU HAVE
TO TAKE CARE OF GETS YOU UP AND
OUT OF THE HOUSE.>>I AGREE. CALLER FROM
ABERDEEN SAYS HER TEENAGE
DAUGHTER IS SHOWING SOME
REPETITIVE BEHAVIOR, SEEMS TO BE GETTING MORE
FREQUENT, STARTING TO DISRUPT
HER LIFE. O.C.D.?>>COULD BE THE POTENTIAL FOR
IT.>>LAST QUESTION, A CALLER FROM
ABERDEEN SAYS HER TEENAGE
DAUGHTER — OH, 22 YEAR OLD PERSON CAN’T
FUNCTION, SLEEPS 12 TO 14 HOURS, NO AMBITION TO GET A JOB, DO
WELL IN SCHOOL. HOSPITAL WON’T
ACCEPT HER.>>I THINK IN THAT SITUATION, I
THINK IT’S ESTABLISHING A GOOD
RELATIONSHIP WITH A PSYCHIATRIST AND A GOOD RELATIONSHIP WITH A
PSYCHOLOGIST. GETTING THAT
THERAPY GOING.>>OKAY.>>AND NOW FOR THE WINNER OF
TONIGHT’S “PRAIRIE DOC” QUIZ
QUESTION. THE BEST OPTION OF THERAPY FOR
SOMEONE STRUGGLING WITH
ANXIETY, PANIC DISORDER, UNDERLYING DEPRESSION IS: PICK
THE BEST ANSWER AMONG THESE
OPTIONS. ONE: A REGULAR EXERCISE
PROGRAM. TWO: REGULAR DOSE OF
ATIVAN OR OTHER BENZODIAZEPINE. THREE: TOUCH AND HAND-HOLDING
THERAPY. FOUR: IMPROVED SLEEP
WITH A COOLER BEDROOM AND NO TV
IN THE BEDROOM. WHAT’S YOUR ANSWER?>>NUMBER
ONE.>>NUMBER ONE, EXERCISE. AND THE ANSWER IS: NUMBER ONE,
OUR OLD FRIEND EXERCISE. IT
IMPROVES ALMOST EVERY CONDITION
WE CAN EXPERIENCE. IT WAS: AMY CHEMANEK FROM
TRENTON, SOUTH DAKOTA WHO
ANSWERED THE QUESTION CORRECTLY. THANK YOU, AMY, FOR
PARTICIPATING. AND A BOOK WILL
BE IN THE MAIL TO YOU SOON! OUR “PRAIRIE DOC” PRODUCTION
TEAM HAS BEEN PLANNING FOR THE
FUTURE FOR SOME TIME NOW, AND NO MATTER HOW MY PRESENT
HEALTH CONCERNS RESOLVE, WE
KNOW THAT LAYING THE GROUNDWORK FOR THE YEARS TO COME IS
IMPORTANT. AND WE’RE DOING THAT. WE’VE FELT PRIVILEGED TO HAVE
HAD THE HONOR TO GREET A LEGACY
AND SERVICE TO THE PRAIRIE DOC
ORGANIZATION.>>IT HAS BEEN OUR DESIRE AND
GOAL TO SHARE HEALTH
INFORMATION THAT IS NOT
INFLUENCED BY MARKETING OR SALES BUT
RATHER IS BASED ON SCIENCE.>>WE STARTED IN THE ’80s WITH
A NEWSPAPER ARTICLE, AND
EXPANDED IN THE ’90s WITH A
RADIO SHOW, IN 2003, WE STARTED A TV
PROGRAM. AND IN 2010, WE ADDED
OUR SOCIAL MEDIA PLATFORMS.>>THIS IS BEEN A TEAM EFFORT
TO MAKE POSSIBLE BY MANY
VOLUNTEER PHYSICIANS AND EXPERTS SERVING AS HOSTS
AND GUESTS. ALL OF THEM ARE
PRAIRIE DOCS.>>THANKS TO THEM WE’VE BEEN
GIVEN THE ABILITY TO PASS THE
TORCH SO THAT THIS LEGACY MAY CONTINUE BEYOND MY TIME ON
THIS EARTH.>>PLEASE JOIN ME IN EMBRACING
OUR TEAM OF PRAIRIE DOC
PHYSICIANS, EACH COMMITTED TO
THIS MISSION. FAMILY PHYSICIAN ANDREW
ELLSWORTH, DEB JOHNSTON AND
JILL KRUZE ALONG WITH INTERNISTS KELLY
EVANS, ALL FROM BROOKINGS,
SOUTH DAKOTA.>>THESE VOLUNTEER PHYSICIANS
AND MANY OTHERS HAVE IN THE
PAST AND WILL IN THE FUTURE SERVE AS AUTHORS OF PRAIRIE DOC
NEWSPAPER COLUMNS, HOST OF OUR
TV AND RADIO PROGRAMS.>>BOTH: THANK YOU.>>STANDING IN FRONT OF A GROUP
OF DE SMET PARENT TEACHER
ASSOCIATION, OR P.T.A., MEMBERS, I WAS TO PLAY A TRUMPET SOLO.
MY TEACHER THOUGHT I WAS
PREPARED, BUT, UNFORTUNATELY, I
WAS NOT. MY FEARS BROUGHT MY HEART UP
INTO MY THROAT. I BECAME SHORT
OF BREATH. MY HEART POUNDED. AND, INDEED, I STUMBLED AND HAD
TO START OVER AGAIN. ALTHOUGH
MY FAILINGS WERE LIKELY AMUSING TO SOME IN THE
AUDIENCE, THEY WERE CERTAINLY
NOT INDICATING ANY MUSICAL
SKILLS. IT WAS A DEVASTATING EXPERIENCE
FOR ME. DURING OUR LIFETIMES, ALL OF US
EXPERIENCE PHYSICAL AND
PSYCHOLOGICAL AILMENTS. PEOPLE WILL ADMIT TO PHYSICAL
TROUBLE, BUT THEY DON’T LIKE TO
ADMIT TO PSYCHOLOGICAL PROBLEMS, AND MOST OF US ARE RELUCTANT TO
ASK FOR HELP. MANY OF THESE
FEELINGS INCREASE ADRENALINE
LEVELS WHICH, IN TURN, CAUSE FAST
HEART RATE, SHAKING, SHORTNESS
OF BREATH, DIZZINESS, DIARRHEA, URINARY FREQUENCY,
SLEEPLESSNESS, HEADACHE,
SWEATING, AND GENERALIZED
DISCOMFORT. SOMETIMES THESE FEELINGS OF
ANXIETY ARE NORMAL, AND
SOMETIMES NOT. A REASONABLE LEVEL OF ANXIETY
CAN KEEP US DRIVEN TO HUNT FOR
FOOD, FIX SOMETHING, DISCOVER ANOTHER FRONTIER, AND
IMPROVE WHAT WE CAN IMPROVE. WITHOUT STRESSORS, AND THE
ANXIETY THAT FOLLOWS, SOME
EXPERTS BELIEVE WE WOULD BECOME
LAZY, STOP DEALING WITH TROUBLES, AND
CIVILIZATION WOULD END. ON THE OTHER HAND, WHEN
FEELINGS OF ANXIETY EXPAND OUT
OF PROPORTION TO THE TROUBLE
THAT WE ARE FACING, OR COME ON EASILY AND
FREQUENTLY, ANXIETY CAN
SOMETIMES INTERFERE WITH A
NORMAL FUNCTIONING LIFE. TOO MUCH ANXIETY CAN BE HARMFUL
TO THE INDIVIDUAL. WE ARE ALL THROWN OFF BALANCE
BY ONE KIND OF PSYCHOLOGICAL
CHALLENGE OR ANOTHER AS WE
STRUGGLE THROUGH THE NORMAL ENCOUNTERS
OF DAILY LIVING. WHO HASN’T EXPERIENCED PERIODS
OF ANXIOUS MOODINESS THAT
FOLLOW THE REDUCED SUNLIGHT OF
WINTER, OR ANXIETY FOLLOWING THE LOSS
OF A JOB OR FACING THE DEMANDS
OF A NEW JOB? HOW DOES ANYONE HANDLE A SEVERE
ILLNESS IN A CHILD OR A SPOUSE? WHO CAN DEAL WITH DIVORCE
WITHOUT ANGER, DISAPPOINTMENT,
AND, YOU GUESSED IT, ANXIETY? LIFE IS OFTEN VERY DIFFICULT;
EVERY INDIVIDUAL WILL CONFRONT
STRESSORS IN DIFFERENT WAYS, AND SOMETIMES WE JUST NEED HELP. BOTTOM LINE: EACH OF US MUST
DEAL WITH OUR OWN PHYSICAL AND
MENTAL ILLNESSES THROUGHOUT OUR LIFETIME:
SOMETIMES MINOR, LIKE
FORGETTING A TRUMPET SOLO; SOMETIMES MAJOR, LIKE A
PROLONGED SENSE OF ANGUISH
AFTER A DEATH IN THE FAMILY. WHEN OUR ABILITY TO LIVE A
NORMAL LIFE IS BEING
INTERRUPTED BY ANXIETY, IT’S
TIME TO SEE THE DOCTOR.>>A BIG THANK YOU TO DR.
ROBERT NUSS FOR VOLUNTEERING TO
COME TO OUR STUDIO IN YEAGER HALL ON THE CAMPUS OF
SOUTH DAKOTA STATE UNIVERSITY AND ADD HIS EXPERIENCE AND
KNOWLEDGE TO OUR DISCUSSION
TONIGHT. IF YOU WOULD LIKE MORE
INFORMATION ABOUT THIS PROGRAM
OR TO SEE MORE EPISODES, PLEASE LIKE AND FOLLOW US ON
FACEBOOK OR VISIT US AT
PRAIRIEDOC.ORG. THE NUMBER OF CONFIRMED CASES
OF THE FLU HAS REALLY TAKEN OFF. THERE ARE MORE PEOPLE WITH THE
FLU THAN AT ANY TIME IN THE
LAST FIVE YEARS. SO FAR THIS FLU SEASON, OVER
280 PEOPLE HAVE BEEN
HOSPITALIZED, AND THERE HAVE BEEN AT LEAST
SEVEN DEATHS FROM
COMPLICATIONS, INCLUDING, LAST WEEK, A SOUTH DAKOTA
FOURTH GRADER. IT IS NOT TOO
LATE TO GET YOUR FLU SHOT. IT IS IMPORTANT NOT JUST FOR
YOU BUT TO HELP PROTECT THOSE
AROUND YOU. THAT DOES IT FOR TONIGHT. FROM
ALL OF US HERE AT “ON CALL WITH
THE PRAIRIE DOC,” UNTIL NEXT TIME, STAY HEALTHY
OUT THERE, PEOPLE.>>THE VERY FIRST DOCTORS IN
THE AMERICAS USED THE TOOLS AT
HAND: PLANTS, ANIMALS, AND
THEIR INSIGHTFUL SKILLS. WITH THE COMING OF THE
EUROPEANS, THIS NATURAL AND
EFFECTIVE APPROACH WAS
REPRESSED. CHANGES IN NATIVE AMERICAN
HEALTH CARE, NEXT TIME, “ON
CALL WITH THE PRAIRIE DOC.”>>FOR MORE THAN A DECADE, HAVE
EMERGED AS A LEADER OF HEALTH
CARE EDUCATION IN SOUTH DAKOTA AND ACROSS THE
COUNTRY. EVERY WEEK DR. HOLM AND OTHER
MEDICAL PROFESSIONALS VOLUNTEER
MANY HOURS TO SHARE SCIENCE BASED TRUTHS
ABOUT HEALTH CARE ON PUBLIC
TELEVISION, ON THE RADIO, AND IN OUR
NEWSPAPERS AND ONLINE. AND BEST OF ALL, EVERYONE HAS
FREE, EASY ACCESS TO THE ENTIRE
PRAIRIE DOC LIBRARY.>>I ASK YOU TO CONSIDER MAKING
A DONATION. PLEASE HELP US
CONTINUE THIS IMPORTANT WORK. GO TO PRAIRIEDOC.ORG AND MAKE A
DONATION TODAY. THANK YOU.>>MAJOR FUNDING FOR “ON CALL
WITH THE PRAIRIE DOC” HAS BEEN
PROVIDED BY:>>AVERA IS A PROUD SPONSOR OF
“ON CALL WITH THE PRAIRIE DOC”
ON SOUTH DAKOTA PUBLIC
BROADCASTING.>>LARSON MANUFACTURING IS
PROUD TO SUPPORT “ON CALL WITH
THE PRAIRIE DOC” AS IT CONTINUES TO OPEN DOORS
FOR IMPORTANT MEDICAL
INFORMATION.>>AND WITH THE ONGOING SUPPORT
OF THESE INDIVIDUALS AND
INSTITUTIONS…

Leave a Reply

Your email address will not be published. Required fields are marked *