• Part III • Understanding Depression, Hope Through Treatment (The Mary Hanson Show)


[opening theme music] ♪ ♪ >>HELLO, AND WELCOME. THIS IS A SERIES CALLED UNDERSTANDING DEPRESSION: HOPE THROUGH TREATMENT. I’M MARY HANSON. I’M A SOCIAL WORKER AND THE
HOST OF A LONG-RUNNING PUBLIC TELEVISION AND CABLE SHOW THAT HAS FOCUSED FOR YEARS ON HEALTH AND SOCIAL ISSUS. MY COHOST IS DR. JAMES JORDAN. DR. JORDAN IS A PSYCHIATRIST. YOU ARE THE PAST PRESIDENT OF THE MINNESOTA PSYCHIATRIC SOCIETY, JIM, AND THE PAST MEDICAL DIRECTOR AT THE HAMM PSYCHIATRIC CLINIC IN ST. PAUL, MINNESOTA. AND DR. JORDAN WAS THERE FOR 25 YEARS. >>WE’RE GONNA TALK TO YOU
ABOUT A COMMON AND TREATABLE PUBLIC HEALTH PROBLEM: DEPRESSION. OUR SERIES AND THE INTERVIEWS IN THE SERIES GIVE YOU AN OPPORTUNITY TO SEE THE MANIFESTATIONS OF
DEPRESSION THROUGH THE LIFE CYCLE. WE BELIEVE THAT THERE ARE CRITICAL THINGS FOR YOU TO UNDERSTAND AND TAKE WITH
YOU IN ORDER TO BE ABLE TO TAKE
CARE OF YOURSELF, MEMBERS OF YOUR FAMILY, YOUR COWORKERS FOR
THIS VERY COMMON HEALTH PROBLEM. >>IN THIS NEXT SEGMENT, DR. JORDAN WILL INTRODUCE YOU
TO DR. PATTY LINDHOLM, WHO
HAPPENS TO BE THE PRESIDENT OF THE MINNESOTA MEDICAL ASSOCIATION. SHE’S GOING TO TALK ABOUT HER EXPERIENCE DEALING WITH MAJOR DEPRESSION, AS WELL AS HER PROFESSIONAL EXPERIENCE AND
TAKE ON DEALING WITH PATIENTS WITH DEPRESSION. PLEASE STAY WITH US. >>MY GUEST TODAY IS DR. PATRICIA LINDHOLM. DR. LINDHOLM IS A FAMILY
DOCTOR FROM FERGUS FALLS, MINNESOTA. SHE’S A COLLEAGUE OF MINE, AND SHE’S ALSO THE PRESIDENT OF THE MINNESOTA MEDICAL ASSOCIATION. WE’RE GONNA HAVE A
CONVERSATION ABOUT DEPRESSION, TREATMENT OF DEPRESSION, AND THE HOPE
THAT LIES IN THE PROPER TREATMENT OF THIS COMMON CONDITION. WELCOME, DR. LINDHOLM. >>THANK YOU. >>CAN YOU TALK TO ME, TELL US ABOUT YOUR EXPERIENCE WITH DEPRESSION AS A PHYSICIAN? >>AS A PHYSICIAN, I HAVE BEEN NOT ONLY INVOLVED IN PATIENT CARE BUT ALSO I’VE BEEN ACTIVE IN MY ORGANIZATIONS. AND I HAVE A TENDENCY TO GET OVER-INVOLVED AND TO BE VERY PRONE TO BURNING OUT BECAUSE OF MY OVER-INVOLVEMENT. AND SEVERAL YEARS AGO, I WAS IN THAT SITUATION AGAIN WHERE I FELT THAT I WAS STARTING TO GET IT WAS MORE AND MORE DIFFICULT TO GET UP IN THE MORNING, MORE AND MORE DIFFICULT TO GO TO WORK. IT IS A CYCLE THAT I HAVE BEEN THROUGH BEFORE BUT HAS BEEN WORSE DURING MY CAREER AS A PHYSICIAN. >>NOW, WHEN THIS BECAME PART OF YOUR LIFEIT EMERGED IN YOUR LIFEWHAT WERE THE STEPS YOU TOOK TO GET HELP AS A DOCTOR? >>AS A DOCTOR, EARLY IN MY CAREER, I WAS AFRAID TO TALK ABOUT IT. I WAS AFRAID TO LET ANYBODY KNOW THAT I HAD DEPRESSION AND THEREFORE STARTED
MEDICATING MYSELF, SINCE, AS A DOCTOR, I HAD A LOT OF ACCESS TO
SAMPLES OF MEDICATIONS, INCLUDING ANTIDEPRESSANTS. AND GOT BY FOR A LITTLE WHILE DOING THAT, AND IT WAS LIKE A WINDOW DRESSING; I WAS ABLE TO LOOK LIKE EVERYTHING WAS FINE AND ABLE TO GET THROUGH MY DAYS. OVER THE LAST SEVERAL YEARS, IT PROGRESSED, AND I REALIZED THAT IT WAS BEYOND ME TO TREAT THIS, AND I NEEDED TO HAVE SOME PROFESSIONAL HELP. I STARTED SEEING A
PSYCHIATRIST. ACTUALLY, OVER THE YEARS, I’D SEEN PSYCHIATRISTS SEVERAL TIMES BUT IN THE LAST SEVERAL YEARS HAD A VERY, VERY SERIOUS DEPRESSION AND NEEDED A LOT
MORE INTENSIVE TREATMENT. >>MAY I ASK YOU A QUESTION ABOUT THAT PARTICULAR TURNING POINT WHERE YOU WERE A DOCTOR WHO WAS DOING HER BEST TO TAKE CARE OF HERSELF, BUT THEN YOU TURNED TO PROFESSIONAL HELP? CAN YOU TELL US WHAT WAS THE THING THAT FACILITATED
THAT? >>WELL, SEVERAL THINGS. I THINK ONE IS THAT I REALIZED WHAT I WAS DOING WASN’T
WORKING. BUT ALSO, PEOPLE BECAME CONCERNED. THERE WERE ONE OR TWO PEOPLE
WHO COULD SENSE THAT SOMETHING WAS GOING ON WITH ME, AND A FRIEND WHO HAPPENS TO BE OUR HOSPITAL CHAPLAIN, HE AND I, WE WORKED TOGETHER ON A NUMBER OF PROJECTS, AND HE BECAME CONCERNED WHEN I STEPPED DOWN FROM AN IMPORTANT BOARD THAT I WAS SITTING ON AND WONDERED WHAT WAS HAPPENING. AND WE HAD A FRANK TALK. AND ACTUALLY, BY THAT TIME, I WAS ALREADY GETTING PSYCHIATRIC CARE, BUT IT
STARTED TO GET TO THE POINT WHERE I REALLY NEEDED THE BEST CARE, AND I NEEDED TO GET OVER THE EMBARRASSMENT AND THE I NEEDED TO JUST BE FRANK ABOUT MY ISSUES. AND DOCTORS CAN EASILY GET INFORMAL CARE, AS YOU KNOW, FROM OUR COLLEAGUES, AND IT
MAY NOT GO ON ANY OFFICIAL
RECORDS. WELL, I INSISTED THAT THIS GO IN MY OFFICIAL RECORDS, THAT IT GO IN MY CHART,
BECAUSE I WANTED, FOR THE FUTURE,
PEOPLE TO UNDERSTAND THE TREATMENT THAT I HAD HAD, THE PROBLEMS THAT I HAD, WHAT HAD BEEN
TRIED, AND WHAT HADN’T BEEN TRIED. BECAUSE IT’S NOT GOOD I CONCLUDED THAT IT’S NOT GOOD TO GET UNOFFICIAL, UNDOCUMENTED CARE. I WAS REFERRED BY MY PSYCHIATRIST ALSO TO A THERAPIST WHO HAPPENS TO BE A PSYCHOLOGIST, AND THOSE TWO HAVE BEEN WORKING WITH ME VERY INTENSELY FOR THREE OR FOUR YEARS NOW. >>PSYCHOTHERAPY NOW. >>PSYCHOTHERAPY. >>ALL RIGHT. SO WE HAVE THIS TURNING POINT. YOU ENTER INTO CARE AND TREATMENT. AND YOU’RE ALSO LEARNING ABOUT SOMETHING THAT HAS TO DO WITH PHYSICIANS, THEIR DAY-TO-DAY LIFE, STRESS, HOW THEY MANAGE THIS. TELL US ABOUT THE TREATMENT. HOW DID THAT UNFOLD? >>MY TREATMENT? I WAS, OF COURSE, ALREADY ON SOME MEDICATION WHEN I WENT TO MY PSYCHIATRIST AND HAD
ALREADY MAXIMIZED THE DOSING, AND WE TALKED ABOUT THINGS THAT I HAD DONE AND TAKEN IN THE PAST, AND HE CAME UP WITH A PLAN. THE TREATMENTYOU KNOW, I’M USED TO THINKING THAT IT TAKES TWO TO FOUR TO SIX WEEKS FOR
AN ANTIDEPRESSANT TO START
WORKING, AND IN MY PAST EXPERIENCE, THAT WAS ABOUT RIGHT. THIS TIME, IT TOOK ABOUT A
YEAR TO GET BETTER. IT TOOK ABOUT A YEAR FOR THE MEDICATIONS TO BE ADJUSTED IN SUCH A WAY THAT I COULD TAKE THEM WITHOUT SIDE EFFECTS THAT WERE BOTHERSOME AND ALSO GET SOME RELF. AND BY THE TIME THE
MEDICATIONS WERE ALL ADJUSTED AND CHOSEN
AND SEEMED TO WORK TOGETHER WELL, I WAS ON THREE MEDICATIONS AND STILL AM. >>SO TAILORING AND ADJUSTING THE MEDICATION WAS AN
IMPORTANT PART OF HELPING YOU FEEL
BETTER. AND GRADUALLY, OVER A PERIOD OF MONTHSNOT DAYS OR WEEKS OR HOURS, SO NOT A QUICK,
QUICK RESPONSEBUT WE’RE STARTING TO SEE SOME IMPROVEMENT. >>ABSOLUTELY. >>AND THE THERAPY IS GOING ON IN PARALLEL TO THIS. >>IN THE MEANTIME, YES. AND I THINK THAT BOTH THE MEDICATION AND THE THERAPY
WERE ABSOLUTELY CRUCIAL THIS TIME, AND I REALLY FEEL THAT THEY SAVED MY LIFE. THEY SAVED MY LIFE. THERE’S NO DOUBT ABOUT IT, AND AS I’VE TOLD SOME OF MY COLLEAGUES, YOU KNOW, THE PSYCHIATRISTS AND OTHER MENTAL HEALTH PRACTITIONERS DON’T GET THE CREDIT THAT THE YOU KNOW, THE LIFE-SAVING
TEAMS IN THE EMERGENCY ROOM GET OR
THE PEOPLE WITH THE DEFIBRILLATORS AND SO FORTH. BUT I WAS IN MORE DANGER FROM DEPRESSION THAN ANYTHING I’D EVER EXPERIENCED. >>LET’S TALK ABOUT THAT IN TERMS OF THAT PARTICULAR SIGNAL OR SIGN OR SYMPTOM YOUR LIFE, YOUR FEELINGS ABOUT YOUR LIFE. YOU WERE FEELING LIKE LIFE WASN’T WORTH LIVING? >>EXACTLY. I WAS FEELING HOPELESS, I COULDN’T SEE THE POINT IN CONTINUING, AND I FELT LIKE THERE WAS THIS ALMOST PHYSICAL PAIN WEIGHING ON MY HEART, A PHYSICAL PAIN IN THE CHEST, ALMOST A CRUSHING SENSATION. I KNEW IT WAS FROM DEPRESSION. I WASN’T WORRIED ABOUT MY
HEART OR ANYTHING LIKE THAT, BUT IT WAS INCAPACITATING. I KNEW THAT IF I DIDN’T GET HELP, I DIDN’T HAVE MUCH TIME LEFT. I WAS IN THE WORST STATE I’D EVER BEEN, AND I’D HAD OTHER SUICIDAL FEELINGS IN THE PAST, BUT THIS TIME, IT DIDN’T
MATTER THAT I WAS A PHYSICIAN. THERE ARE OTHER PHYSICIANS. DIDN’T MATTER THAT I WAS A MOTHER. MY CHILDREN WERE GROWN-UP. I’M SURE MY HUSBAND IS
GROWN-UP ENOUGH TO GET BY WITHOUT ME. I HAD NO REASON THAT I COULD
SEE TO CONTINUE LIVING. >>YES. GRADUALLY, AS YOU WERE IN TREATMENT, THERAPY, AND TAKING MEDICATIONS THEY WERE BEING ADJUSTED AND SO FORTHYOU BEGAN TO FEEL BETTER AND BETTER. >>YES. YES. >>AND AS THAT MOVED AHEAD, IF WE LOOK AT IT TODAY, WHERE HAS THIS TAKEN YOU, THIS JOURNEY THROUGH YOUR TREATMENT AND HOW YOU’RE
FEELING TODAY AND YOUR UNDERSTANDING OF THIS? >>WELL, IT HAS BEEN AN EDUCATION FOR ME FOR SURE, NOT ONLY THAT PHYSICIANS SHOULDN’T TREAT THEMSELVES BUT ALSO A BETTER
UNDERSTANDING OF MY OWN PATIENTS AND MY OWN FAMILY MEMBERS, BUT A BETTER UNDERSTANDING OF MYSELF AND THE FACT THAT I HAVE, IN MY CASE, A CHRONIC ILLNESS THAT CAN’T BE IGNORED AND NEEDS TO BE TREATED. I STARTED TO STUDY THE PROBLEM IN PHYSICIANS IN PARTICULAR AND HOW PRONE WE ARE TO
BURNOUT, TO LOSING OUR PURPOSE, TO WORKING SO HARD THAT WE
LOSE SIGHT OF THE BIG PICTURE IN OUR LIVES, AND LEARNED THAT PHYSICIANS HAVE A VERY HIGH DEATH RATE FROM SUICIDE
COMPARED TO THE GENERAL POPULATION WITH DEPRESSION AND THAT
FEMALE PHYSICIANS IN PARTICULAR ARE FOUR TIMES MORE LIKELY TO TAKE OUR LIVES THAN OTHER FEMALES IN OTHER PROFESSIONS. AND I HAVE TO CREDIT MY PSYCHOLOGIST FOR GETTING INTERESTED IN THE SUBJECT AND SHARING SOME ARTICLES WITH ME, WHICH THEN STIMULATED MY OWN RESEARCH. AND I HAD AI JUST HAD A DESIRE TO HELP MY COLLEAGUES, TO HELP OTHERS. SO AS YOU KNOW, I’M NOW THE PRESIDENT OF THE MEDICAL ASSOCIATION, WHICH I DID NOT SEEK OUT BUT I WAS INVITED TO DO, AND I SAW IT AS AN OPPORTUNITY TO WORK ON THE WELLNESS OF PHYSICIANS. >>AND THIS IS WHERE WE MET. >>THAT’S RIGHT. >>AND YOU INVITED ME TO BE A MEMBER OF YOUR TASK FORCE. EXTREMELY IMPORTANT IN THE
AREA OF, DOCTOR, TAKE CARE OF ONESELF. >>EXACTLY. >>BE A GOOD EXAMPLE FOR YOUR PATIENTS. AND THEN MORE AND MORE WOMEN
IN OUR PROFESSION WHO HAVE
CERTAIN VULNERABILITIES TO DEPRESSION IN THAT CONTEXT OF THEIR LIVES AND THEIR OTHER RESPONSIBILITIES AND SO FORTH. HOW DO YOU SEE THE FUTURE NOW AS FAR AS FAMILY PRACTICE, PSYCHIATRY, SOCIAL WORK, PSYCHOLOGY, WORKING WITH PSYCHOLOGISTS? IS THERE SOMETHING FOR US TO UNDERSTAND ABOUT WORKING TOGETHER OR LEARNING FROM EACH OTHER, LEARNING FROM
PSYCHOLOGY, PSYCHIATRY, COMMUNICATING WITH SOCIAL WORK, THIS TYPE OF
THING? >>I WOULD LOVE TO SEE US ALL WORK IN THE SAME CLINIC. IDEALLY, IT WOULD BE WONDERFUL IF DOWN THE HALL, I HAD A PSYCHIATRIST TO TALK TO, A PSYCHOLOGIST, AND A SOCIAL WORKERALL OF THESE PEOPLE WHO WOULD BE AVAILABLE AS A TEAM TO HELP ME WITH MY PATIENTS, BECAUSE EVERY ONE OF THEM ARE CRITICAL. AND RIGHT NOW, WE’RE HAVING IT’S DIFFICULT, BECAUSE PEOPLE ARE ACROSS TOWN OR THEY’RE OUT OF TOWN. THEY’RE IN SEPARATE BUILDINGS. AND I LIKE THE MODEL THAT I’VE HEARD ABOUT WHERE WE’RE TRYING TO INTEGRATE MENTAL HEALTH PROFESSIONALS INTO GENERAL MEDICAL CARE. I THINK MENTAL HEALTH CARE IS NOT SEPARATE FROM THE REST OF MEDICAL CARE. I KNOW THAT THE MIND AND THE BODY ARE ONE, AND THEY AFFECT EACH OTHER, AND THERE’S NO POINT IN PRETENDING THAT THEY ARE SEPARATE DISCIPLINES OR THAT MENTAL HEALTH ISN’T THE SAME AS HEART DISEASE, CANCER, OR ANY OTHER LIFE-THREATENING CONDITION. >>AND VERY TREATABLE. >>AND VERY TREATABLE. >>IT MIGHT TAKE SOME TIME. THERE’S SOME COMPLEXITIES. THE COMPLEXITIES NEED TO BE ADDRESSED. IF THEY’RE IN THE
PSYCHOLOGICAL REALM OR ONE’S ENVIRONMENT, STRESS AT WORK. THERE CAN BE BIOLOGICAL
FACTORS. YOU POINTED OUT YOU HAD A VERY PROFOUND PHYSICAL SENSE OF
WHAT THIS MEANT TO BE DEPRESSED. >>YES. >>YOU KNOW, A CRUSHING
FEELING. >>MM-HMM. YES. >>AND SO THAT CAN BE A MARKER OF SOMEONE FEELING BETTER AS MEDICATION IS HELPING. THEY’RE STARTING TO FEEL
BETTER. THEN THE THERAPY CAN MOVE
AHEAD. >>EXACTLY. >>AND MAKE SOME PROGRESS IN THAT REALM. >>AND THE FACT THAT TWO PROFESSIONALS WERE SPENDING
TIME WITH ME GAVE ME HOPE, AND I THINK HOPE, EVEN BEFORE FEELING BETTER, WAS THE KEY TO STICKING WITH IT. >>DR. LINDHOLM, I WANT TO
THANK YOU SO MUCH. WHEN WE STARTED THIS PROJECT, IT WAS REALLY JUST A GIFT TO HAVE THE OPPORTUNITY TO KNOW MORE ABOUT YOU, TO HAVE YOU
HELP US WITH THIS ENDEAVOR. AND WE BELIEVE THAT IN THE CONTEXT OF TREATING A
TREATABLE CONDITION LIKE DEPRESSION, REALLY TALKING AND
UNDERSTANDING IS IN CONVERSATION, SO WE HAVE MORE OF THESE CONVERSATIONS. A CONSULTATION IS A CONVERSATION BETWEEN COLLEAGUES ALL INVOLVED IN THIS, THE TEAM EFFORT. THANK YOU SO MUCH AGAIN. WE’LL BE BACK TO TALK TO YOU MORE ABOUT DEPRESSION, MARY HANSON AND I. THANK YOU VERY MUCH. AND THANKS TO DR. LINDHOLM FOR TALKING WITH ME ABOUT THIS TOPIC TODAY. >>MANY OF YOU ARE PROBABLY SURPRISED, AND IN A WAY I AM TOO, THAT A DOCTOR WILL TALK THIS OPENLY AS DR. LINDHOLM
HAS ABOUT HER EXPERIENCE WITH MAJOR DEPRESSION. I THINK WE SOMEHOW PUT DOCTORS ON PEDESTALS YET. AND HER EXPERIENCE, THOUGH, WAS QUITE SERIOUS. SHE WAS VERY HONEST. WHAT DID YOU TAKE AWAY FROM YOUR TIME WITH HER? >>WELL, IN THE CASE OF DR. LINDHOLM AND ANY PROFESSIONAL PERSONWE’RE TALKING ABOUT A PHYSICIAN HERE FIRST OF ALL, THESE ARE HUMAN BEINGS. THEY GET UP IN THE MORNING JUST LIKE YOU AND I DO. THEY HAVE LIVES. THEY HAVE NEEDS. THEY ARE EXPOSED TO THE
STRESSES OF THEIR WORK, THE WORKPLACE. OFTEN YOU SEE IN POSITIONS OF LEADERSHIP, A PHYSICIAN IN HIS OR HER OFFICEARE TAKING CARE OF A LOT OF RESPONSIBILITY. THAT CAN BE WEIGHING ON THEM. THAT CAN BE A STRAIN OR A STRESS OR STRESSORS. AND I THINK EVERYONE’S AWARE THAT DURING THIS PERIOD OF
TIME THAT WE’RE IN NOW, THERE’S
LOTS OF STRESS ON PHYSICIANS IN
TERMS OF HOW MUCH WORK THEY HAVE TO DO, THE ELECTRONIC MEDICAL RECORD, THE DEMANDS OF
COVERAGE AT A HOSPITAL AND BACK TO THE PRACTICE. THESE ARE HUMAN BEINGS, SO TO THE EXTENT THAT THEY CAN BE HELPED AS ALL OF US WOULD LIKE TO BE HELPED IN THE WORKPLACE THIS IS THEIR WORKPLACE, THE PRACTICE OF MEDICINETHEN WE CAN MAKE SURE THAT THEY DO THE THINGS THAT THEY NEED TO DO TO PREVENT THE ONSET OF
DEPRESSION. AND IN THE CASE OF DR.
LINDHOLM, I THINK SHE POINTED OUT HOW HER CARE NOW IS VERY WELL ESTABLISHED, AND SHE’S DOING WELL. SHE’S IN A LEADERSHIP
POSITION. >>SHE’S ALSO A GOOD ROLE
MODEL FOR HER PATIENTS, I WOULD
THINK, IF THEY SEE THIS INTERVIEW OR TALK WITH HER ABOUT HER EXPERIENCE. THAT’S AN EXAMPLE OF TAKING
CARE OF YOURSELF THAT I’M SURE
WOULD TRANSLATE IMPRESSIVELY TO HER PATIENTS. SHE TALKED, JIM, ABOUT
SOMETHING THAT WAS SO VIVID AS SHE STATED IT. SHE SAID, “I FELT LIKE I HAD A CRUSHING PAIN IN MY CHEST.” AND THIS WAS ONE OF HER
SYMPTOMS OF DEPRESSION, AND YET THIS REALLY STRUCK ME AS SOMETHING THAT COULD BE SO EASILY THOUGHTHEART PROBLEMS. WHEN YOU HEARD THAT, DID YOU FEEL THAT THAT WAS A COMMON REACTION TO MAJOR DEPRESSION? >>YOU CANIN THE CASE OF DR. LINDHOLM AND DESCRIBING IT THAT WAY HAVE A SOMATIC MANIFESTATION OF MAJOR DEPRESSION. AND AS YOU SAY, I MEAN, THAT’S IMPORTANT, TO MAKE THE DISTINCTION BETWEEN SOMETHING THAT COULD VERY WELL BE A PHYSICAL PROBLEM CORONARY ARTERY DISEASE OR PRESSURE IN THE CHEST AND SO FORTH. SO A GOOD THOROUGH PHYSICAL EXAMINATION WOULD BE
IMPORTANT, STEP ONE, IF SOMEONE PRESENTED WITH A COMPLAINT LIKE THAT. HOWEVER, THE NATURE OF IT COMBINED WITH OTHER ASPECTS OF HER LIFE EXCLUDING A
PHYSICAL CAUSE, IT CERTAINLY CAN BE. AND AS PEOPLE GET OLDER, MIDLIFE AND ON, YOU DO OFTEN SEE THESE CORRELATES WITH THE MANIFESTATIONS OF DEPRESSION WITH PHYSICAL COMPLAINTS HEADACHES, BACKACHES, CHEST PAIN, PAINS WORSE THAN IT
SHOULD BE FOR A CERTAIN CONDITION. SO THESE ARE THE KINDS OF THINGS THAT PHYSICIANS PAY ATTENTION TO, AND IN THIS
CASE, YOU HAVE A PHYSICIAN WHO IS
ABLE TO DESCRIBE IN VERY VIVID
TERMS, YOU KNOW, HOW THIS REALLY GETS INTO THE BODY AND EXPRESSES ITSELF THAT WAY. >>I THINK IF SOMEONE HASN’T EXPERIENCED SERIOUS
DEPRESSION, THEY MAYBE WOULD ASSUME IT WAS ALL AN EMOTIONAL, MENTAL KIND OF REACTIVE EXPERIENCE, AND
YET PEOPLE WHO HAVE EXPERIENCED IT DO DESCRIBE IT AS A VERY WHOLE-BODY KIND OF PAIN AND DISCOMFORT. >>YEAH. ABSOLUTELY. I MEAN, IT WILLIN THE EARLY PHASE, CAN BE AN EMOTIONAL MANIFESTATION, SADNESS AND WORRY, ANXIETY, OBSESSIVE THINKING, AND SO FORTH. BUT AS IT ADVANCES, YOU START TO SEE THE PHYSICAL
DISRUPTION, THE EFFECT ON SLEEP, APPETITE, JUST HOW YOU FEEL PHYSICALLY ENERGY, LISTLESS, NOT ABLE TO DO WHAT YOU NEED TO DO. PARENTS ARE UNABLE TO TAKE
CARE OF THEIR CHILDREN PROPERLY. YOU CAN SEE THE EFFECT THAT
THIS IS GONNA HAVE ON A FAMILY. >>THINGS START FALLING THROUGH THE CRACKS. >>THAT’S RIGHT. >>WE HAVE NOW IN OUR COUNTRY A NEW LAW CALLED THE PURITY
ACT, AND COULD YOU JUST BRFLY DEFINE IT? BECAUSE IT’S GOING TO MAKE A
BIG DIFFERENCE, HOPEFULLY, IN THE WAY PEOPLE ACCESS CARE, TO
THEIR PHYSICIAN TO GET DIAGNOSED, TO MENTAL HEALTH
PROFESSIONALS. >>WE’RE VERY PROUD OF THIS
HERE IN MINNESOTA. PAUL WELLSTONE AND OTHERS JIM RAMSTAD AND MANY OTHERS HAVE HELPED MOVE THIS CONCEPT, THIS IDEA THAT MENTAL HEALTH CARE HAS TO BE EQUIVALENT TO THE TREATMENT OF ANY OTHER HEALTH CONDITION. AND WITHOUT GETTING INTO THE TECHNICAL ASPECTS OF THE LAW, THE LAW NOW IS A FEDERAL LAW THAT A MENTAL HEALTH CONDITION LIKE MAJOR DEPRESSION HAS TO
BE TREATED ON A PAR BASIS WITH DIABETES, HEART DISEASE. IN OTHER WORDS, ALL OF THE EXPECTATIONS THAT WE WOULD
HAVE FOR APPROPRIATE EVALUATION AND TREATMENT ARE THE SAME FOR THE TREATMENT OF MENTAL HEALTH CONDITIONS, AND SERIOUS ONES LIKE MAJOR DEPRESSION, JUST
LIKE ANY OTHER HEALTH PROBLEM. >>THAT IS SUCH A FORWARD AND, FINALLY, WONDERFUL LAW, ISN’T IT? I WANT TO GO BACK TO SOMETHING DR. LINDHOLM SAID. SHE REALLY SAID THAT SHE CONSIDERS HERSELF HAVING A CHRONIC ILLNESS. DO YOU FEEL THAT MOST SERIOUS DEPRESSIONMOST DEPRESSION IS GOING TO KIND OF EBB AND FLOW? ARE PEOPLE GOING TO HAVE REOCCURRENCES USUALLY OR OCCASIONALLY? >>WELL, IT’S AN IMPORTANT DISTINCTION TO MAKE IN TERMS OF CHRONIC OR RECURRENT, YES. THERE IS A PERCENTAGE OF
PEOPLE THAT WILL HAVE A RECURRENCE OF A MAJOR DEPRESSIVE EPISODE. ONE OF THE THINGS THAT’S MOST IMPORTANT IN TERMS OF THAT POSSIBILITY IS TO GET EARLY TREATMENT AND TO HAVE
SUSTAINED AND GOOD TREATMENT JUST LIKE DR. LINDHOLM DESCRIBES, A COMBINATION OF MEDICATION
AND EFFECTIVE PSYCHOTHERAPY SO
THAT SHE MANAGES HER CONDITION AS WELL AS POSSIBLE. YES, IT CAN BE RECURRENT, BUT ALSO, THERE CAN BE A
SINGLE EPISODE, AND THAT CAN BE IT, SO YOU WANT TO TREAT SOMEONE EFFECTIVELY. THE TREATMENT USUALLY
TRANSPIRES OVER A PERIOD OF MONTHS. CLOSE MONITORING. AND THEN JUDICIOUS USE OF MEDICATION COMBINED WITH PSYCHOTHERAPY. REASSESS THE PATIENT. SO EVALUATION AT THE FRONT
END. REEVALUATION AS YOU GO ALONG. THESE ARE THE COMPONENTS OF
GOOD PRACTICES, AND THIS IS THE
KIND OF THING THAT CAN HELP, IN
THIS CASE, A PHYSICIAN GET THE CARE THAT SHE NEEDS. AND AS YOU SAID, ALSO BY
HAVING THE EXPERIENCE WITH THIS CONDITION, HOW SENSITIVE, HOW THOUGHTFUL, HOW EMPATHIC SHE
CAN BE WITH HER OWN PATIENTS AS A LEADER, NOW, IN
UNDERSTANDING THIS AND THE STRESS OF PHYSICIANS IN MINNESOTA. THIS IS HER INITIATIVE WITH
THE MINNESOTA MEDICAL ASSOCIATION. >>REALLY, HER STORY REALLY SPEAKS TO THE NECESSITY TO
TAKE CARE OF OURSELVES, WHETHER
WE’RE IN THE HEALTH SYSTEM OR NOT, DOESN’T IT? SHE REALLY STRUGGLED, SHE
SAID, ALMOST A YEAR, I BELIEVE, TO COME UP WITH HER DOCTORS THE CORRECT AND PROPER KIND OF MED REGIME. AND I KNOW OUR FIRST GUEST ALSO SAID THAT SHE STRUGGLED WITH MEDS IN THAT WAY AND
DIDN’T REALLY EVER FIND THEM
EFFECTIVE. BUT DR. LINDHOLM IS NOW ON, SHE SAID, THREE MEDS. IS THAT COMMON, TO BE ON SEVERAL MEDS? >>YES. IT CAN BE FOR RECURRENT DEPRESSION, AND THE
COMBINATION OF MEDICATION IS SOMETHING YOU GET TO. I THINK AT THE OUTSET, OFTEN, IN GOOD PRACTICES, YOU START WITH ONE MEDICATION. STABILIZE THE PATIENT IN TERMS OF THE MAJOR DEPRESSIVE SIGNS AND SYMPTOMS. BUT OFTEN, THAT MEDICATION MAY NOT BE WORKING EFFECTIVELY, AND YOU NEED TO ADD SOMETHING ELSE TO IT. AND SO THERE ARE COMBINATIONS OF MEDICATION, BUT ONCE AGAIN, THIS SHOULD BE DONE VERY, VERY THOUGHTFULLY, CLOSELY SUPERVISED. AND I REALLY THINK THIS IS WHERE PSYCHIATRIC CONSULTATION AND VERY CLOSE MANAGEMENT OF THE MIX OF MEDICATIONS BECAUSE YOU GET MULTIPLE SIDE EFFECTS. THESE DRUGS POTENTIATE THE EFFECT OF EACH OTHER. AND SO IT BECOMES A TECHNICAL MANAGEMENT QUESTION, AND I
THINK THIS IS REALLY THE ROLE OF PSYCHIATRY AND PSYCHIATRIC CONSULTATION, WHEN SOMEONE IS NOT RESPONDING TO THAT FIRST TRIAL OF MEDICATION AND THEY’RE NEEDING MULTIPLE MEDICATIONS TO
MAINTAIN THEIR STABILITY IN REMISSION. >>DR. LINDHOLM TALKED ABOUT
HER ROLE AS A PRIMARY PHYSICIAN. AND IN OUR HEALTH CARE SYSTEM NOW, THE PRIMARY DOC IS OFTEN, AS I THINK YOU SAID ONCE, JIM, THE ENTRYWAY TO BEING TREATED FOR DEPRESSION. AND PEOPLE PROBABLY MOST
OFTEN, AM I RIGHT, GO TO THE PRIMARY DOCTOR FOR DIAGNOSIS? AND DO YOU FEEL THAT IN JUST A FEW SECONDS HERE IS THE BEST PLACE TO GO FIRST? >>IT PROBABLY IS, IF WE’RE TALKING ABOUT MAJOR
DEPRESSION, BECAUSE YOU’RE GONNA GET A
GOOD AND THOROUGH PHYSICAL EXAMINATION TO EXCLUDE ANY PHYSICAL BASIS FOR THE WAY
THAT YOU’RE FEELING. AND THENAND WE’RE PARTICULARLY INTERESTED IN THIS IN
MINNESOTA. WE HAVE SCREENING GOING ON NOW ACROSS THE STATE LOOKING FOR DEPRESSION EARLY. EARLY TREATMENT. SO YES, THAT’S THE FIRST
PORTAL OF ENTRY. WE RECOMMEND IT BECAUSE OF THE THOROUGHNESS OF IT. AND THEN IT’S A GOOD PLATFORM
TO STAND ON FOR FURTHER TREATMENT AND REFERRAL. >>WELL, WE ARE COVERING
THINGS QUICKLY HERE, BUT NEXT WEEK,
WE WILL TALK MORE ABOUT
TREATMENT. JIM WILL ALSO INTRODUCE YOU TO ANOTHER PERSON WHO IS
DEALING WITH MAJOR DEPRESSION. THANK YOU FOR BEING WITH US. WE WANT TO THANK EVERYONE WHO HAS BEEN A PART OF THE PREPARATION FOR THIS SHOW, KSTP AND OUR UNDERWRITERS. WE’LL SEE YOU, HOPEFULLY, NEXT WEEK. Captioning by CaptionMax www.captionmax.com

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