Anti Depression or Pro Joy?

Nick:
Hello and welcome to the Ascend Health Show. I’m your host, Nick Angelis. I’m a nurse anesthetist and one of the owners of Ascend Health Center. And my guest today is myself. So this will be a shorter show than usual since I only can entertain myself for a few minutes at a time. But I wanted this to be one of these medical disclaimer shows because every time we do a show I might say something like “Don’t try this at home, kids.” But every so often it’s important for me to just get on camera and explain why all of the valuable medical advice that you might hear or see on this show doesn’t mean that you need to take it all in and immediately start doing all of it without talking to your health care professional. Sort of like those warning labels on toasters that say don’t throw it into the tub.

Yeah, that’s what I’m talking about. But it’s a very interesting topic because there’s health information everywhere. Every time you look at WebMD, it’s yep, I’ve got Crohn’s. So how do we educate ourselves about health? How do we know we’re getting the right message while still availing ourselves to all the education that’s out there? And obviously there’s huge examples like COVID. You want a controversy, just start researching that and let me know what you find out about boosters and shots and mRNA. But I’m already getting off topic. So the one thing I want to talk about as we’re talking about health, education and the disclaimer that you can’t believe everything that you see on even a prestigious broadcast like WCTV is what about quick fixes?

So we, obviously, at Ascend Health Center deal more with mental health. And for some patients it’s actually really simple. They are sad and then they come in and they talk to a therapist or they get an antidepressant and then they feel better. And every so often they check in and that’s the end of the story. But because we specialize in treatment resistant depression, unfortunately much more common theme is that someone comes to us after they’ve been to five specialists or they’ve tried 20 drugs and at that point there isn’t a quick fix. No matter how brilliant Doctor Molina is or our psychologist Dan Langer or a nurse practitioners or therapists or even me as a nurse anesthetist, we probably won’t have a quick fix. And sometimes we do have a quick fix where one Ketamine treatment or one round of TMS will instantly make someone’s mental health better.

But is that the end of the story? Does that mean that for the rest of their life they won’t struggle with depression? Usually it’s a hard road. It’s more of a marathon than a sprint. So as you’re looking online for different solutions for mental health or even other physical problems, how can you discern this is an actual solution for me or I’m about to waste a lot of money and it’s not going to do anything for me other than the joy of writing a one star review. So one way to think of it is and again, this is community TV and if it was anywhere else it would be censored immediately. It is think of the benefits of illicit drugs. Heroin relieves pain. So does fentanyl. Cocaine increases brain derived neurotrophic hormone in our brain. These are wonderful things. But you’ll never hear a medical professional, including me, to be clear. So be a very bad show if you clip it at the wrong time. You’ll never hear someone saying, “Try some cocaine for that.” I mean, past like 1880. No one’s recommending that you go find some narcotics on the streets of Akron.

So why is it that a lot of times we think, well, anything if I can just get this acute problem solved immediately, then everything will be fine in my life. The problem is that a lot of quick fixes, even though it’s not as preposterous of an example as trying street drugs, it still is the same conclusion where you know what? My anxiety gets better as long as I have three glasses of wine or you know, I’m not nervous about presentations as long as I get a cigaret beforehand. So again, this sounds preposterous, but what I want to think of today is instead of antidepressants, meaning instead of going depression and trying any substance, whether illicit or prescribed to alleviate those symptoms, why don’t we try more pro joy type of interventions?

Again, an anti depressant. You are against the depression. You want to defeat the Depression and you’ll do anything to do it. But what about pro joy at Ascend Health Center? A lot of our patients have revved up nervous systems where everything is louder, everything is more intense. Sometimes we’ll have diagnoses for these borderline personality disorder, which happens through trauma, or we’ll say, Oh, you’ve got bipolar disorder and it’s immediately like, Here’s your disorder. We must fix this at any cost. And of course that’s what we try to do. I’m a health care professional. That’s kind of what I signed up for is fixing things. But there’s another side to this coin and that is, well, why don’t we concentrate on pro joy instead of anti depression? Yes. With your borderline personality disorder, you can get very depressed, almost suicidal sometimes and it’s terrible. But sometimes even with that specific disorder, there are moments of pure, unadulterated joy that most other adults are like, You’re way too happy. You need to calm down. You need to tone down. But there’s some wisdom even in the scriptures, for example, there’s a saying of Jesus where it says, Come to me like little children. Now does that mean I color between the lines or outside of the lines? And I’m not always potty trained? No, but it does mean that even as adults we miss out on things if we miss out the joy of being a child. So none of this is to tell you to take illicit drugs. None of this is to tell you to stop taking your psychiatric drugs. But sometimes we are so focused on the relief of our pain at any cost that we don’t slow down and think, Well, I’m not saying that it’s to my advantage that I have this issue, but let me at least see what I can do as far as increasing the joy in my life that instead of just hell bent, I must decrease the pain. I must solve this problem I must pour all of my resources into because that’s the thing in our country we don’t realize that sometimes it’s not worth the cost to fix something.

Sometimes it’s a very expensive procedure or a lifetime of coming every month for an appointment and it’s not worth it. So how do you make those choices? Well, for one thing, talking to a therapist is very helpful. We have some excellent health center. There’s plenty of great ones throughout the greater Akron area and we can point you to the right direction of what we think would be the better fit. But there’s also that and again, this might not be that brilliant. I thought of this like two minutes ago and here I’m talking about it on TV. But I do believe that there is something missing that a pro joy approach. A What are the moments that delight me? What are the moments when I feel most alive and how can I get there more often is a very important facet. And again, we’re not talking about getting that way chemically. We’re not talking about drugs. We’re not talking about dangerous behavior. We’re not talking about like, I feel so alive. Oops, I should have gotten better life insurance. What instead I’m saying is that if we can cherish the moments of happiness that we have, if we can focus on those not in a grasping way of, Oh, I hope this never ends, but just a realization that not everything is perfect, but this is a good moment in my life and it’s almost like I’ll put this in my pocket and at some point in the future when I have a dark, dreary day, I can take out this memory of this great thing that happened.

So and obviously this is philosophically and spiritually beyond the context of the ascent health show, but it’s just a word I wanted to share with you that a lot of times, even as we’re seeking for solutions for problems and I don’t want to minimize the agony of mental health issues or even those of neuropathic pain and many of the other issues that we treat. We’re a nervous system is so geared toward the sympathetic nervous system that, you know, you can brush against this fake foliage here and it causes pain. I’m not saying that we shouldn’t try to fix that, but I am saying that even if your nervous system is one where there are these great highs and lows, that the answer is not to quickly numb it. The answer is not okay, what drug will help me so that I’m not really living a life but I’m at least stable?

And to be clear, psychiatry has amazing drugs and many of them will numb the human experience. And that’s important for short amount of time so that you’re not suicidal so that you can function in society. But then we start talking about quality of life and that’s when you have to make decisions with obviously your doctor or health care provider of what is our goal here? What is it that I would be happy with? Is it something where I really need some of these dark days to leave, but I’m not willing to give up perhaps some joy or even some mania of okay, for this day, here’s how I’m feeling. How do I stabilize this? And many times it is a case where it’s like, okay, this is the best we can do for now and I’m fine with this and I’ll try out in a few months. At our clinic we have many patients who will do transcranial magnetic stimulation and we don’t hear from them and then two years later they’ll come back and say, okay, I’m ready for Ketamine. And in many cases that’s the right approach that I’m trying something for my health. We’ll see what it does and then I’ll give it a break and then I’ll come back. So this is just a reminder that as we’re trying to cure depression or we’re trying to be anti depression, it’s similar with cancer and. Any other diseases where if all of your focus is on let’s get this terrible thing out of my system. Sometimes you miss out on the joy that can be like, Well, let me hone in on these moments that I have of joy and how can I expand these farther.

So thanks for watching. This has been the Ascend Health Show.

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