Brought to you by the Depression Is Real Coalition, The Down &
Up Show is dedicated to the reality of depression. Each week our
hosts will talk with some of the world's top experts on depression, as
well as people who have been impacted by this illness. The reality of
depression is that it is a debilitating and potentially deadly medical
condition that affects more than 15 million Americans every year. The
other reality of depression is that there is hope.
Down & Up Show #58: Depression Therapies
DR. REEF KARIM:
Welcome to the Down and Up Show on Depressionisreal.org. I'm your
host, Dr. Reef Karim, psychiatrist, addiction specialist and relationship
specialist. Here to discuss is Dr. Melva Green, a psychiatrist, health
and wellness expert and popular radio personality.
Her segment, "Therapy Thursdays" is heard during the big fat morning show
on Baltimore's WERQ, 92.3 FM. Dr. Green specializes in a variety of traditional
clinical services and non-traditional services from psychiatric evaluation,
medication management and psycho-therapy.
We're happy to have her here with us today. Dr. Green, welcome.
DR. MELVA GREEN
Thank you.
DR. REEF KARIM
You have a radio show segment. So first off just tell us a little
bit about yourself and about your radio show segment, "Therapy Thursday".
DR. MELVA GREEN
Well, I graduated from Meharry Medical College which is an historically
black medical school and did my residence training and additional degrees
in public health and business at Johns Hopkins and had an opportunity
I believe to blend the best of both worlds.
I made some observations about mental health particularly in the
urban setting that led me to believe that there was a lot of misunderstanding,
a lot of (unint.) that was really attached to mental disorder, psychiatric
disorders (unint.) so that we're really fed on a lot of mis-just really
misunderstanding. People not understanding what these conditions were.
I had a conversation with one of the radio personalities several
years prior to the beginning of my segment when I was invited to just
do a segment on holiday blues. In that conversation I said to him there's
really no point in talking about HIV drug addiction, STDs and AIDS, other
social ills here in Baltimore until we have a main line, a mainstream
dialog about mental health because really the instability of mind leads
to all these other conditions and he heard that and less than a year later
we had another conversation, and he asked me what I'd like to do about
it.
I said you know how about a summit. How about we get together?
That's what I did. I started the segment called "Therapy Thursdays", and
we talk about any number of topics ranging from depression and suicide
to the impact of hip hop music on the minds of young people.
And it's incredible. It's absolutely incredible the conversations
have become some broad, so diverse, so welcome. This is stuff that people
want to talk about. They want answer, and often times the stigma has held
them back or the access, the access to a psychiatrist, the access to a
therapist.
DR. REEF KARIM
Alright, before we talk about alternative therapies because I want
to get to that, can you tell people in our audience a little more about
the importance of seeking help and getting treatment for depression.
DR. MELVA GREEN
I've been-I think it's so critical. It's interesting I've been
the consulting psychiatrist at Morgan State University for the last six
years which is the historically black college. Obviously this is a pod
cast so people can't see me. But if they go to my website, www.drmelvagreen.com they will quickly recognize that I'm African-American and you know it
was very interesting to me.
For years that I'm black, I'm on a black campus but getting young
people to come and get the help that they need was so very, very challenging.
I mean despite the incredible outreach and I have a fantastic staff it
was very, very difficult. So it let me really understand and appreciate
how powerful the stigma is and how there's so many what I call self-imposed
barriers because you know the idea is that people don't seek help because
it's financial, it's geographical, it's so many other things.
But really a lot of the inability or the unwillingness to seek
help has a lot to do with what's going on internally, and the help could
be readily available and it's so important. It's so important to seek
help because treatment works. Treatment works. Medication works, talk
therapy works, some of the things that we're gonna get into in terms of
the alternative therapies. They absolutely work.
You know why is it important to seek help? Two major reasons-suicides.
Someone takes their life every eighteen minutes in this country, every
eighteen minutes. That's huge. That's huge, and a large majority of those
people are depressed.
The second reason, disability. So people are living with depression.
But there are any number of studies that talk about the greater risk of
disability. So people with major depression have a five time greater risk
of having a disability, of not being able to live the fullness of life.
DR. REEF KARIM
Yeah. The bottom line is that it does work. Treatment works. I
agree with you that's really the bottom line. You're life will be better
if you get treatment. Your life won't be better if you don't get treatment.
You know it's....
DR. MELVA GREEN
Many-it's always so incredible at graduation time I always get
so many cards and invitations to graduations and people are saying things
like you know I wouldn't be graduating, I wouldn't be alive if I hadn't
come to see you.
DR. REEF KARIM
So let's talk about these alternative therapies. What are alternative
therapies and what sparked your interest in the area?
DR. MELVA GREEN
Well, let me start with what sparked my interest. Again as I mentioned
I'm African-American. In the African-American community there is-there's
a tremendous amount of stigma at baseline about mental illness. But I
believe there's a double stigma, what I call a double discrimination.
It is the discrimination that people believe they may have-may
endure based on having some sort of psychiatric disorder. But there's
a double discrimination that they have a psychiatric disorder. They may
have-and they have the audacity to be "crazy". So there are multiple layers.
There are multiple barriers, and I don't-that's not just true for African-American
communities.
That's true in the Latino community, that's true in the Asian community,
that's true in the Native-American population. But it's true. One of the
things that I've found is that if I can start the conversation not based
on what's wrong but what's based on what's right meaning what's right
in your life.
So not just focusing on the body but focusing on the mind and the
spirit. Focusing on the whole being. So oftentimes we won't even talk
about-I won't open the evaluation with tell me about your symptoms. I
start with what do you eat? What'd you eat today? What did you eat yesterday?
What do you like? What tastes good? It's amazing what you can find out
about people's relationship with food which gives you so much information
based on what they're putting in their bodies.
So we begin to go from there. So by the end of the evaluation and
while I may have made a diagnosis of clinical depression, major depression,
what I've also done is really done a very thorough evaluation of what
does their life look like on a day-to-day basis and what are they using
to cope?
What are they using to self-medicate? In ethnic populations that's
clinically important because more often times they've self-medicated their
depression with food, drugs, alcohol, sex, shopping, all those other things.
So it's incredibly important to not only understand what have been
their alternative methods for self-medication but what may be some potential
alternative methods that I could use as an adjunct to the medication that
I may offer, to the talk therapy that I may offer in the language that
they understand because if I start off the conversation with you've got
depression and here's an ant9-depressant they're not gonna take it by
in large.
DR. REEF KARIM
You mentioned like negative coping skills. So when someone has
depression besides giving them medication what are specific alternative
therapies you would do with them?
DR. MELVA GREEN
The number one alternative therapy, and it's not really alternative,
it should be a part of it, is lifestyle management, lifestyle management.
Sleep. It's amazing-while depression often times causes sleep disruption
many people just don't really understand the value of sleep and the lack
thereof.
So if you're not sleeping they're more agitated, they're up at
night, they're eating. They're doing other negative behaviors as a result
of not sleeping and they're brain doesn't have an opportunity to restore
itself. So sleep management.
Stress, the other issue. While I tell my patients repeatedly stress
may not be-we may not be able to eradicate it, but we can certainly manage
it. Some people really just often times need to have permission to say
no. Not to take on so many responsibilities.
That is particularly true for women. It's particularly true for
women. Women almost inevitably, almost 100% of the time, you know I have
to have a conversation about why do you need to do all of that? They've
assigned themselves certain gender roles and responsibilities that are
really over the top that really make the depression worse because if you're
not sleeping you're stressed, your body is stressed, your physical body
is stressed, your heart rate is up, your respiratory rate is up.
Everything is-your muscles are tense. You're having aches and pains
and you're not restoring-you're not doing good self-care management. It
only drives the depression. It only makes the situation more and more
difficult.
You know I do in my practice have two acupuncturists as well as
a massage therapy who is a Master of raki work as well which is energy
work as well as a psychologists. Now I wouldn't bear to think that I could
know any and everything about all that they do.
But I certainly know when one of my patients could benefit from
any one of those things. They're-the best I can tell you is it works.
It absolutely works, and I think what each of these modalities works I
their own respective-there are volumes of literature about traditional
Chinese medicine and different-all these different types of psycho-therapies
that my psychologist offers as well.
So I think seeing the general theme throughout is that here's someone
who understands me number one and number two that there's hope that I
can get better. You know that there is all-there's this pot pourri of
options that I have to get better.
DR. REEF KARIM
What-tell us more about food and mood and some of the work you've
done in that area.
DR. MELVA GREEN
Well, one of the things that I do in any evaluation is to review
a diet log. What are you eating every day? Often times peoples' diets
are more than inundated with caffeine, with obviously decrease of sleep,
increase of blood pressure, increase of heart rate, increase of respiratory
rate. A little-a half a cup of coffee is not a bad thing.
That's probably good for you. But four cups of coffee is not good
for you. So alleviating caffeine-and people often don't realize what other
things have caffeine in them. So getting rid of all of the excess caffeine.
Also getting rid of the excessive concentrated foods. You know excessive
carbohydrates, those things that life your mood but then crash almost
instantly after your mood has been lifted.
Not only taking away the bad stuff but also putting in the good
stuff. So there's been a lot of really great work on omega III fatty acids
which as you know are found in fish oils that has been shows to be very,
very effective and helpful. Specifically the work has been in done in
bi-polar disorder.
That has been incredibly useful not only in mood stabilization
but also in increasing cognition, increasing the clarity of thinking.
It's just amazing with just adding a small supplement of Omega
III fatty acids in fish oil to their regimen every day it's like night
and day. It's completely night and day. Of course if anyone's had a history
of alcohol-even if it's in the past or a history of drug addiction even
in the past making sure that they're Thiamine, making sure that their
Folate, making sure that the basic nutrients, the basic supplements, are
being supplemented and are in place because there are very few people
that I know that sort of eat their six squares every day and have all
of the major food groups represented and have all of their daily minerals
and nutrients in place.
So really taking out the bad stuff, simply put, taking out the
bad stuff and putting in as much good stuff or stuff that may be missing
in their daily diet shows incredible results in terms of mood as well
as clarity of mind.
DR. REEF KARIM
Now what are some daily practices people with depression can do
to help improve their recovery? What can they do to help?
DR. MELVA GREEN
Exercise, exercise. You know exercise is an incredible, incredibly
important. Twenty minutes of good, vigorous exercise, increasing those
endorphins, increasing the oxygenation of the brain is incredibly useful
for depression.
Also meditation and yoga. People with depression often times, even
people who are recovering from depression or are in remission have not
only just depression but also have anxiety associated with it. So they
sort of formed a new baseline if you will of being in an anxious state.
So they don't look-they've almost forgotten how to not be anxious
or it's either not being anxious or not being depressed. But are unable
to sort of find this even keel. So yoga and medication is certainly something,
and it doesn't have to be done in a studio. It's literally something that
can be done at home for fifteen minutes.
Also good deep breathing. You know it's amazing to me when I'll
ask my patients do you know how to breathe and they say yeah, yeah, yeah,
and I say no, not breathing to live but living to breathe. So literally
taking the time to take in good, deep breaths and being conscious of the
whole body.
All of those things are incredibly important in terms of managing
the bio-chemistry and the neuron-transmitters or in the traditional Chinese
medicine world what they call the chi (ph.) or the meridians or the energy.
We're talking-we're all talking about the same things, we're just using
different terminology.
DR. REEF KARIM
This is great. Is there anything else you want to add?
DR. MELVA GREEN
Well, you know again I would just add that I think that this works.
That Depression Is Real campaign is an absolutely incredible asset, and
I think what the core goal of it is a sense of empowerment and hope that
things can get better because I do think sort of pervasive to all of
depression is hopelessness.
And things like this, really capturing the media, capturing alternatives,
capturing opportunities that are really global, that are really, really
broad, is really the only way that people are going to be able to find
the place of healing. So I think it's incredible.
DR. REEF KARIM
Works great. Thank you so much for speaking with us today, Dr.
Green.
DR. MELVA GREEN
Thank you.
DR. REEF KARIM
Join us next week for another segment of the Down and Up Show on
depressionisreal.org. I'm Dr. Reef Karim.
