Return to Transcripts main page

Dr. Drew

Discussion of Mental Illness and RedFlag Special

Aired May 05, 2015 - 22:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


(MUSIC PLAYING)

[22:00:19] DR. DREW PINSKY, HOST, DR. DREW: ON CALL: Good evening. Welcome to DR. DREW SPECIAL REPORT: MENTAL HEALTH. By some estimates, one of every

four adult will experience some form of mental illness in his or her lifetime. Some decide not to hide from the stigma, choosing instead to

post their personal battles on social media.

Now, you`ve been watching and we`ve been watching #RedFlag along with you. I have experts that will join us throughout the hour to discuss resources,

support and help. First off, I want you to watch this. Take a look.

(BEGIN VIDEO CLIP)

KELLEY, HAS MENTAL ILLNESS: I like to post my feelings. I hashtag, you know, bipolar and depression and stuff like that because I just want to

find other people that are bipolar like me.

Everything I post affects Greg because he checks my pages and, you know, sometimes I`ll say bad things about him. Sometimes I feel like my family

would be better off without me.

MATT, ANDREW`S BROTHER: Have you seen some of the things he`s been posting lately?

ANDREW, HAS MENTAL ILLNESS: Twitter has been my primary source of venting and therapy almost, in a way, these last few years.

MATT: He uses social media as a platform to vent out what he`s, you know, truly feeling inside.

(END VIDEO CLIP)

DREW: Joining us to discuss, I have Spirit, psychotherapist, Michael Catherwood, my "Loveline" co-host, and Judy Ho, clinical psychologist,

professor at Pepperdine University.

(APPLAUSE)

So, Judy, let me start with you. Posting this stuff in such a public way, in public forums, is that a good thing? Bad thing? Does it have a

downside?

JUDY HO, PH.D., CLINICAL PSYCHOLOGY: I think it`s part of how technology is leading people into this way of self expression. I think for some people

that`s a very proactive thing. It feels like they`re getting the message out, trying to help people. The cons of that is, of course, there are going

to be people who misunderstand, put a stigma towards mental illness and they`re actually going to be provoking these individuals, accusing them of

lying --

DREW: Spirit, I worry about that, too. In my experience, Twitter and even Facebook can be such a brutal environment. If somebody is tender and

fragile.

SPIRIT, HLN CONTRIBUTOR: Oh, it`s scary, some of the things I`ve seen. I`ve seen people say go ahead and kill yourself, let us send you this. They

agitate. Your family is this. And do things that exacerbate the symptoms already.

DREW: But they could also get support there, right?

SPIRIT: Absolutely. It just depend on who your friends are and exactly what the point is of what it is that you`re posting.

DREW: Yeah. Mike, what do you think?

MIKE CATHERWOOD, DR. DREW`S "LOVELINE" CO-HOST: I`m not a fan of using social networks therapeutically.

DREW: Well, not therapeutic -

CATHERWOOD: But these individuals felt like it was.

DREW: Well, they were venting. They felt like there was an environment to be heard.

CATHERWOOD: And, of course, I mean, you guys both know, as mental health professionals, to have someone who`s afflicted with any type of mental

illness, to be able to open up is a great and valuable thing. It`s indispensable. But to do it to an audience that you don`t really know at

all - Yeah, I mean, Drew, it`s not even really healthy to rely on your loved ones as therapists because they`re not professionals.

DREW: No, no, and no one is pretending -

CATHERWOOD: To open up to -

DREW: You`re so right. None of us are pretending this is therapy. I know that in that little block, he just said something about it being

therapeutic. He means therapeutic in the sense that he felt better afterwards. It`s not -

HO: Right. I got it off my chest.

DREW: It`s not treating his condition in any way.

CATHERWOOD: You`re right to point that out. But at the same time, I do get the feeling, especially with these individuals in #RedFlag, that they look

to it as a forum of their de facto therapy. That they were almost replacing actual therapy.

DREW: No, no, I don`t think so. I hope not. In fact, I`m glad you said that because let me issue a warning. This does not replace therapy. Do

not -- if you feel stigmatized and you can only act out or vent in social media, you`re making a huge mistake. You need treatment. Treatment is done

by professionals. Please, please, get real help. These are brain disorders. This thing. I could hold up a heart just as readily. These

afflictions we`re talking about just happen to affect this organ. Just happen to. There`s nothing really unusual about any organ having problems.

Things can happen.

HO: I think that`s the problem, Dr. Drew, is that sometimes people think it`s a willingness. There is something that they`re choosing when it`s a

brain disorder, versus a heart condition.

DREW: Right.

HO: And that is part of what perpetuates that stigma.

DREW: Absolutely.

SPIRIT: In addition to the family seeing the behavior, they don`t realize that it`s something that`s happening in the brain. They say snap out of

it, stop behaving this way. But they don`t understand that the behavior is a symptom of what`s going on in the brain.

DREW: Right. They can`t differentiate the person from the disorder - from the condition.

SPIRIT: Exactly.

DREW: Now in #RedFlag, Andrew`s family struggles with his brother`s suicide. He is desperate to find his way out of his house, into treatment.

Take a look at how he approached the topic with his parents.

(BEGIN VIDEO CLIP)

ANDREW: If I`m going to get better, it has to be a positive environment, it has to be more of a home. I know that starts with me, but it also starts

with -- we`ve got to get mom healthier and I want you to be a role in that.

[22:05:05] ANDREW`S FATHER: What are your plans?

ANDREW: I can`t stay here 24/7 for the rest of my life until she gets better. We need to approach it though. Are you alright? You okay, mom?

I don`t know if I`m going to get the support that I need from my parents.

(END VIDEO CLIP)

DREW: Now, Mike, you had the infratreatment (ph) at a point in your life and your parents were actually very supportive. You`re very fortunate that

way.

CATHERWOOD: Yes, you know, so often you and I talk to young individuals on "Loveline" who are dealing with mental illnesses of some sort. I always

point out - I mean, I`m so unbelievably empathic to young people who struggle with any type of mental or psychological affliction and they don`t

have a strong support group because I know it was near impossible for me to try to battle some of the demons that I had. And I had a picturesque

support group around me.

DREW: I`m going to ask you guys, and the audience, too, don`t talk about demons. Do not talk about demons, unless you -- I`ll allow you to talk

about demons if you say that a pancreas gets sick because a demon is in the pancreas. There is no more - Demons don`t get into this organ anymore than

they get into your joints. There are issues that you had to deal with, but not because you were afflicted with demons. But how about that, Spirit? You

have a resistant family and what do kids do, what do young people do? Forget what adult children do if their family doesn`t support them or their

spouses or their children.

SPIRIT: They just do the best that they can and everybody acts like it doesn`t exist, which only exacerbates the problem. Not only for the

individual who`s actually suffering, but then you start to see the dysfunction. I always say, you know, we do family systems. That means

every last person in that family is affected. It`s not just one person dealing with mental illness. It affects everyone. Friends, family,

everyone they touch.

DREW: And, Judy, the more people involved in treatment, the more efficient the treatment.

HO: That`s right. Because there are so many different angles that the person has developed their illness around. And so the more people that can

be involved, the more people that can be supportive of the process, the better the individual is going to heal because that is the environment

they`re going to be going back to, whatever treatment they get. And that`s the environment that they have to learn to function in.

DREW: Especially adolescence. When you`re dealing with adolescent children, the family is the patient. And people have to recognize that.

You can`t just send your kid into treatment and go fix him, fix him. I know it feels like you`d like them to. But you`re always part of the

issue. Even if you don`t feel like you`re a part of it, even if you`re a minor part of it, that child getting better is dependent on you getting

better with them. Doing the process with them. It`s a tectonics, you know, relationships are funny. They`ll hold you in place so you can`t grow

the way you need to. So everyone has to grow together.

We have to take a quick break. We`ll be right back.

(APPLAUSE)

(COMMERCIAL BREAK)

[22:11:43] DREW: May is Mental Health Awareness Month and we`re talking about a broad category of conditions and disorders that can but do not have

to be debilitating. The curtain of shame is being lifted thanks to education and those who are willing to tell their stories through social

media.

Parenting can be hard enough. But if you`re trying to manage your own psychiatric conditions while caring for a spouse and children, watch here

how Kelley struggles to keep the relationship healthy and going with her son.

(BEGIN VIDEO CLIP)

KELLEY: I`m not good enough. I feel like they just don`t want me there.

Well, why won`t you talk to me?

JJ, KELLEY`S SON: Because I just want to be alone.

KELLEY: You don`t want me over here with you?

JJ: I want to be alone.

KELLEY: Knowing that I affect my kids in such a horrible way, it does push me over the edge.

Something as little as my son not wanting to have nothing to do with me is going to make me want to go into the bathroom and cut myself. Because I`m

going to feel like a horrible mother.

UNIDENTIFIED MALE: These kids need you now. They need you to give it everything you have. Give them the childhood that you didn`t have. You`re

slowly abandoning your children.

(END VIDEO CLIP)

DREW: Alright. I`m back with Spirit, Mike and Judy. Spirit, Judy and I are feeling there was so much packed into that little segment right there.

Cutting is something we`re not going to address much tonight. But know that cutting is a primitive attempt to try to regulate emotions. People

that have been traumatized, it`s a sign that people are in need of psychiatric and psychological services. So if anybody notices cutting,

please get them services immediately.

Secondly, the way, the primitive nature she`s trying to manage her feelings suggests something called a personality disorder, which is something that

we`re also not focused on in that particular piece. But she does identify with her bipolar disorder, which is, one, is her character structure, the

other is her mood disturbance. Let`s talk a little about bipolar. Also, what also was brought up, was kids, too. If you`re a child of a parent with

mental illness, children can do great, but they do great when they get treatment also. What did you say, Judy?

HO: That`s right. The entire family has to get treatment, the children are being exposed to probably non-ideal parenting practices. As you can see in

that clip, Dr. Drew, they were talking about the fact that she basically lacked good childhood models. So how is she supposed to know now, as an

adult, how to provide good parenting to her children?

DREW: And the children, of course, react, they`re at higher risk for mental illnesses themselves, but think -- that could be mitigated if the children

get treatment early.

SPIRIT: Help is critical, Dr. Drew. The earlier the better. That is just the bottom line for everybody that`s involved. I can`t stress it enough.

DREW: So very quickly, she talks about bipolar I and bipolar II. Bipolar I is a more serious condition where people get manic, and we`ll show you some

manic episodes later. Bipolar II, and both of them are associated with, often, depressive disturbances and these swings between mania and

depression. Bipolar II is associated with a less-severe hypomania, which is people can still be connected to reality. Remember Charlie Sheen being

"winning"? That was sort of a hypomanic episode, I suspect.

Joining us right now is Dr. William Arroyo, regional medical director of Los Angeles County Department of Mental Health Child, Youth and Family

Administration. He was recommended to us by the American Psychiatric Association.

Dr. Arroyo, what is the best way to explain mental illness to a child?

[22:15:00] DR. WILLIAM ARROYO, MENTAL HEALTH EXPERT: Well, I think the most important thing to say is something that you said earlier and that is these

are not demons. These are conditions which can be effectively treated. They have an array of symptoms that are important for parents to be able to

monitor, such as this very exaggerated sense of self-esteem. They may report racing thoughts, very, very rapidly. May complain that they don`t

need any sleep. They may have one to two hours each night for a period of six, seven nights. And then many of them engage in very impulsive, self-

destructive behavior. Parents really need to monitor them closely.

DREW: Another thing that comes up, not in that particular family, but in the family, the young man whose brother had passed away, who had killed

himself, which is the issue of complicated grief, unresolved grief. I think we have a full screen on that very quickly, if you guys would show

that.

So there is a lot to be learned from these shows if you really pay attention. This is complicated grief or prolonged grief disorder,

prolonged yearning for the deceased, thoughts of guilt, shame, sense of meaninglessness, that goes on. The time frame is not on that particular

list of symptoms, but I think it has to go on for at least two months. And that`s, again, that`s something, too, that needs treatment. These things

need treatments.

Michael, in the last break, somebody came up to me during the commercial break and said what did Michael have? What happened with Mike?

CATHERWOOD: Yeah. Whatever it is, it was awesome.

DREW: You don`t appear to somebody that would have mental illness. Just like nobody looks like -- there`s no look of mental illness. I had anxiety

disorder, depression. I will talk about that later. But yours was?

CATHERWOOD: I still battle chronic depression and alcoholism, drug addiction. It`s a daily effort. It`s a prolonged, ongoing effort. And

much like, you know, diabetes, you may not see outward signs of it affecting someone, but if they keep it under control, your life becomes a

completely different issue.

My life now and my life 15 years ago are two absolutely completely separate entities. But I still deal with the same afflictions. And it`s all

because of my desire and my focus in treatment and seeking out what was best for me and what is, often times, was very difficult. But it was the

right thing to do.

DREW: And then your life is -- you have a daughter, you`re married, you`re flourishing.

CATHERWOOD: Right. Without question, I would have zero ability to have a career, to have a family, to have a daughter, to have any type of sense of

happiness or purpose in my life if it wasn`t for the fact that I sought professional, psychiatric help.

(APPLAUSE)

DREW: I`ll tell you what though. It`s not just applies for seeking help, it`s engaging it, engaging it actively. We see a lot of people that go and

then don`t do the work. You have to engage.

CATHERWOOD: Mental health is much like physical health. Plenty of people join the gym or get a personal trainer, but if you just go to show up and

go through the motions and on your way home you stop - you smoke cigarettes and get ice cream, it`s meaningless. I spent many years going to

therapists, taking certain psychiatric drugs, but I didn`t really applying myself. It made all the difference in the world once I changed my motive.

DREW: Quickly out to the audience. Do you have a question there?

AUDIENCE MEMBER: Yeah, hi. I have bipolar disorder and medication and talk therapy has been extremely helpful to me. My question is, though, do you

think in the future there will be further treatment options, things like gene therapy or cranial stimulation?

DREW: Oh, you`re singing to the choir here, I think. I mean, you know, cranial stimulation -- there are magnets already that are showing some

benefit. Isn`t that weird they can show a magnet in your brain and can change the chemistry? That`s showing some benefit in mood disorders. I

don`t know about bipolar yet. Dr. Arroyo, bipolar? No, I don`t think so.

ARROYO: Not yet.

DREW: And gene therapy -- gene therapy is the holy grail. For all illness, let`s face it. But there are some, in addiction, particularly, some really

amazing idea about the genetics and potential gene therapies. Thanks for that question.

[22:19:01] Alright, we`re going to take another quick break. We`ve got a lot more to go. We`ll be right back after this.

(APPLAUSE)

(COMMERCIAL BREAK)

DREW: We are talking about mental health, mental illness. Of course, this is not a choice. There`s no need for shame. But there`s a great deal of

misunderstanding about psychiatric conditions. Sheila Shay (ph) stabbed her six-year-old son to death. She was tried and found not guilty by

reason of insanity. She received treatment in a mental health facility for an extended period of time. Now, to what you think of what she did, I

think this will still have an impact on you. I spoke to her right after she had been released. Here is her story. Take a look.

(BEGIN VIDEO CLIP)

SHEILA SHAY (ph), STABBED SIX-YEAR-OLD SON TO DEATH: I was in an abusive relationship. I knew that people were there and were trying to harm me. My

abuser tried to set me on fire. It just triggered all of this paranoia. I had a mental breakdown. I thought people were after me. I got very

paranoid. They had me diagnosed as paranoid schizophrenic. I started taking medication, took it for six months, quit taking the medication. I

started getting paranoid again.

DREW: So tell me what happened.

SHAY: My kids were -- two of my kids were asleep in the bedroom. My daughter was asleep on the couch because she just had surgery and my other

son was watching TV in the living room. I stayed up all night long and --

DREW: Paranoia?

SHAY: Yes.

DREW: You were worried somebody was coming in.

SHAY: I ran in the kitchen, I got a knife and was going to go kill myself because my abuser had told me that I was safe as long as I stayed with

them. And I thought at first, I was like, if I kill myself, then they won`t have no reason to come. And I was going down the hallway towards the

bathroom and I was, like, my kids, you know, they`re going to rape my kids, they`re going to torture my kids, they`re going to mutilate my kids. And I

thought that if I killed my kids and then killed myself, that there wouldn`t be anybody to hurt them. And I thought that at least I would be

merciful, that I wouldn`t torture them or torment them or anything like that.

(END VIDEO CLIP)

[22:25:32] DREW: Back with Spirit, Mike and Judy. Mike, have you ever seen anything like this before? Where someone gets so delusional that they

believe they`re saving their children by killing them? Is this crazy thinking?

CATHERWOOD: I`ve seen it a lot with stimulant addicts. It`s exactly like tweakers and coke heads. When it gets into the, you know, the advanced

stages of addiction of certain stimulants, it sounds exactly like it.

DREW: Right. So what`s called paranoid psychosis, where people -- really, the system they`re in, they`re delusional, they believe people are out to

get them, their thinking is very disturbed, very disconnected. And what makes sense to them is actually not sensible at all.

HO: Right. And delusions are all about a misperception of your reality. They may be walking around and if you`re not asking them specifically about

their delusions, they can seem like a normal person. But when you actually start talking to them about it, there are all of these believes in their

head about people coming after them. In fact, that is the most common type of delusion, Dr. Drew, of paranoid delusion, that people are out to harm

you.

DREW: And as Mike mentioned with meth, the delusions are usually focused on family, friends, co-workers and neighbors. They can be very elaborate

where they are trying to put gases into their house and there are little men to torment. They get very elaborate. Cocaine psychosis, which comes on

much more quickly, is a universally, a focus on uniformed officers. Police, Navy, SWAT Team. The uniformed officers are outside and coming to get

them. They usually put foil on the windows, the tweakers --

CATHERWOOD: That keeps cops out. A lot of people don`t know that.

(CROSSTALK)

HO: No, no, no -

CATHERWOOD: It would block all law enforcement.

DREW: They can`t beam the -

SPIRIT: Exactly. They can`t beam (ph) the thoughts in. It acts as a blocker. But you know, Dr. Drew, one of the things that she said that I

think is very important for people to understand, she said I took my medicine for about six months and then I got off. This is something that

we need to stress to individuals with chronic mental illness. What happens is they`ll start their medications and then once they start to do better,

they feel that they don`t need it anymore because they don`t recognize that it is the medication that is stabilizing them.

DREW: And nobody likes to take medicine. But if you have a chronic condition, you have to take medicine.

SPIRIT: We take medicine for everything else.

DREW: I take high blood pressure medicine. Yeah. What`s the big deal?

SPIRIT: For high blood pressure, high cholesterol. We take vitamins every day. So we have to stress the importance of medication compliance.

DREW: Can I play a little more with Sheila Shay here? Because we`re going to talk a little later about cognitive behavioral therapy and how that

impacts - how they evaluate their delusions and their need for medication. Here`s a little more from Sheila`s interview.

(BEGIN VIDEO CLIP)

SHAY: It hurts me to know that he`s never going to go to high school, he`s never going to have his first kiss, he`s never going to have --

DREW: Because of his mom. His mom`s mental illness.

SHAY: Yes. And it`s like -- I say it all the time, you know, I would sell my soul if I could take it back. But when I lay down at night, every night,

you know, I`m right there in that moment.

(END VIDEO CLIP)

DREW: You`ve got some questions from Facebook. Here`s someone who says, "She needs to be locked up. Can anyone say for certain she won`t do it

again? I think not. Crazy is as crazy does." "How can you be sure she will continue to take her medication?" This is just what Spirit was saying.

"People just use the insanity defense to get out of jail."

Now, what you didn`t see in that interview, is she described what happened to her after this all happened. She tore her hair out, she threw herself

into things to try to kill herself, once she sort of realized what had happened. I mean, she`s severely ill. Maybe she should have stayed forever

in a mental hospital, I understand that.

SPIRIT: I don`t think so. That`s not the answer to lock up everyone who suffers from mental illness. We have to have a better understanding of

what it is, especially with schizophrenia. You`re talking about an altered sense of reality because chemical differences and changes can happen in the

brain.

DREW: Listen. So many of these conditions have potential to harm more the patient than them hurting somebody else. And my constant refrain is get

help before you hurt yourself or someone else. Help can be a benefit. The earlier, the better, first of all. And secondly, long before it ever has

to come to something like this. Treatment works. This doesn`t have to happen. We`re back after this.

(APPLAUSE)

[22:30:00]

(COMMERICAL BREAK)

(BEGIN AUDIO CLIP)

SHEILA SHEA, MENTAL PATIENT: If somebody had told me, you know, Sheila, you`re going to go insane and you`re going to kill one of your kids, I`d

have told them they didn`t know what they were talking about. Because it is an unbearable, for me at times.

(END AUDIO CLIP)

DR. DREW PINSKY, ON CALL: We do in this show talk a lot about the human experience. Sometimes about mental health, physical health, and tonight

we`re taking a few minutes to really talk specifically about mental health to try to reduce stigma, increase awareness, breaking down some of these

issues. And sometimes we don`t have the time to really talk about. Sheila Shea stabbed her 6-year-old son to death during a severe psychiatric

decompensation. She spent years in a psychiatric facility, was released last July. I`m back with Spirit, Mike and Judy. As I said, it is mental

health awareness month. And we are trying to raise awareness, reduce stigma. Also joining me via Skype, Nando Palusi, Clinical Psychologist.

Now, Dr. Palusi, one of the things we had talked about in the last break was cognitive behavioral therapy was something that has found to be very,

very useful and even something that is largely biological, schizophrenia Tell us about CBT and how it has sort revolutionized schizophrenic

treatment?

DR. NANDO PALUSI, PSYCHOLOGIST: Well, what we`ve looked at often is not just how people think, but the circumstances they find themselves in, the

premises that they bring to those circumstances. Very often, they`re not even aware of the premises they have about these circumstances. So by

questioning, we highlight what they bring to these circumstances.

[22:34:56]

PINSKY: And I also noticed, Dr. Palusi, some of my schizophrenic patients learn how to sort of go through kind of a procedural process of looking at

their delusions, evaluating whether they`re having a delusion or whether it`s a rational thought. And they kind of do the same thing. Sometimes

they`re thinking about their medication, if they don`t want to take it, for instance.

PALUSI: That`s right. So sometimes there`s an interaction. A primary effect might be anxiety. But then, the secondary effect is getting anxious

about your anxiety, or depressed about your depression. So, when people tune into that process and get better at understanding that they are able

to intervene.

PINSKY: Judy, do you want to say something?

JUDY HO, PH.D: CLINICAL PSYCHOLOGIST: Yes, you know, I was actually just going to give an example of something great in CBT for schizophrenics,

which is behavioral experimentation. That`s where you actually challenge some of their delusions. And when I worked with a schizophrenic patient,

he had a particular delusion that he was missing out on all the mail because the U.S. postal office was intercepting all the communication. -

PINSKY: Of, course. Only his mail.

HO: Right. Exactly. So, we could really check that out. And it was actually a really fun experiment. We wrote all of these letters to him and mailed

them out and saw how many he got. And luckily for us, the U.S. post office delivered all of them. Ad that`s actually where - its a starting point

for us to talk about that delusion to really look at it.

PINSKY: Yes, the past (INADUBLE) need to spend time doing it, (INAUDIBLE) they`re medication. That`s it. Let`s go to our audience. Thank you Dr.

Palusi. Audience question. Yes, ma`am?

UNIDENTIFIED FEMALE: Yes, I want to know when dealing with someone suffering from mental illness, how much slack do you give them when they`re

having an episode or an out burst. Because, we don`t want to enable them.

PINSKY: Depends, yes, depends on what which illness we`re talking about, to some extent. I mean, --

UNIDENTIFIED FEMALE: Bipolar Disorder in particular. Also, people dealing with anger management issues.

SPIRIT, PSYCHOLOGIST: You know, these are tough. And I get this even more so with children, because especially parents. They go well, how do I know

when they`re just behaving badly or it`s really their disorder. And so, you know, I always try to find reference for individuals. With bipolar

disorder, it`s an oldie, but a goodie. If hate you, please don`t leave me. And so, if you can understand that it`s the constant I`m pushing you away,

but the minute I push you away, it`s the come back. But, you have to remember in there, it`s about education. You know, it`s too much to do

now, but it`s the getting help. It goes back to let a therapist or a qualified individual teach you the lessons for how to respond

appropriately.

PINSKY: And whether the therapist may have to learn what`s going on with that particular couple or family to set those boundaries for you. I mean,

Mike, sometimes we think with addicts, it`s zero tolerance. You reject the disease, you embrace the recovery. Period. End. But, if somebody`s bipolar

maniac, you job may be to get out of there and maybe bring in enforcement, like even police sometime.

And often time, you know, it`s whatever substance it may be can help manifest that disorder or at least strengthen it you know, some of the

symptoms. You know you see people acting more and more erratic depending on what other substances they want to add to it.

PINSKY: Absolutely. Let`s go back to our audience. What do you have there? Yes, ma`am?

UNIDENTIFIED FEMALE: Hi, I want to know approximately what percentage of those with schizophrenia actually are violent toward others?

PINSKY: I would think that would be a small number. But-

HO: Very small number. Yes. It`s definitely lower than five percent. I think what we hear media is all the ones that are violent. And so that

perpetuates this idea that that schizophrenics are violent. It`s really not true. It`s a very small percentage of them and usually their disease has

gone on for quite a long time before they get to that space.

PINSKY: Yes, that`s the really the tragedy when it does come to that. And again, people with mental illness are more likely to be the object of

violence, and the perpetrator of violence. But the fact is, it doesn`t have to go there. I mean, when I look at that theater killing with the

"Batman" killer, that kid was severely psychotic. Severely schizophrenic for a long time. And for some reason, no one could -- at a certain time,

when you forcing treatments for the good of the patient, the good of the patient, make them better. Your not being mean to them. Your making them

better. And that`s another thing for families to be aware of. Is sometimes we have to be very, very firm to get them help. Better.

HO: Some of what you really can do as a family member of a loved one is to provide compassion by providing that structure. And we`re talking about

them trying to help themselves when they`re ill with the part of their body, the brain, that sick --

PINSKY: Well, I`m holding up the brain. Not one of the really features of having disorders is this organ is you sometimes or many times, in certain

conditions, lose insight. You lose the ability to be subjective when you`re in an objective state. You can no longer do that. All right,

everybody, take a quick break. We`ll be right back after this.

(APPLAUSE)

[22:39:30] (COMMERCIAL BREAK)

PINSKY: As we`ve been discussing social media playing, of course, is playing a role in mental illness and mental illness awareness. Samantha is

a Youtuber who`s living with bipolar disorder. She documented some of her symptoms on her Youtube channel. It`s devoted to mental health issues. It`s

called "Rawsammi". Here, now, she developed -- this is bipolar one, so remember earlier in the show, I mentioned what mania is? This what mania

looks like. This is a manic episode she posted. Have a look.

(BEGIN AUDIO CLIP)

UNIDENTIFIED FEMALE: (INAUDIBLE) (EXPLETIVE) (INAUDIBLE) (EXPLETIVE)

(END AUDIO CLIP)

PINSKY: Dr. Spirit, Mike and Judy, and Judy was saying on her -- I guess her Facebook post or the Youtube page, they were saying what about her

there?

[ 22:45:00] HO: Well, there were a lot of comments about her being an actress and how bad of an actress she was and that she was doing this for

fame and she was faking it.

PINSKY: And back in the day, they would take people in this condition and throw them in a well.

HO: Oh, yes,

PINSKY: Alright, that would be -

SPIRIT: They thought they were a witch or --

PINSKY: Or possessed.

SPIRIT: --possessed or yes.

PINSKY: Well, joining us on by Skype is Samantha. Samantha, three days later, you were actually hospitalized. Did you recall even making that

video?

SAMANTHA, YOUTUBER: I do recall making it. But I don`t recall what I was actually thinking about.

PINSKY: My understanding is you had paranoia delusions that your parents were trying to poison you. So, these are customary delusions really for a

manic state, right?

SAMANTHA: Right.

PINSKY: What other thinking disturbances - again we`re trying to help people understand that they see somebody in this condition, they need help.

They`re not to be made fun of. They`re not to be, you know, stigmatized. What other thoughts? Help people understand what other things your

thinking or saying in a condition like that?

SAMANTHA: I also thought that the government was after me. And I thought that my parents were going to burn down the house and I`m trying to think

what else. I thought my organs were going to be harvested and sold on the black market. And, you know, I had delusions of grandeur. I thought I was

the Dahli Lama and like Jesus was talking to me. And yes, hearing like voices, hearing, like, radio sounds.

PINSKY: And you post these things on Youtube. First of all, hats off to you having the courage to do all of that. I hope it helps de-stigmatize

these conditions. What else are you able to accomplish through sharing through social media?

SAMANTHA: Well, I think it`s helpful for me, as well. It`s kind of an outlet. And I also feel like I`m doing out reach for people. At first, it

was really just for me to kind of vent how I felt and then also, I started noticing that it was really helping people. So, now I gear my videos, you

know, mostly towards helping people. But also, I just really enjoy it.

PINSKY: And Samantha, it seems --you see completely reconstituted. You`re doing well now?

SAMANTHA: Yes, very well.

PINSKY: Was that episode about not taking medication or not complying with treatment?

SAMANTHA: That was before I was diagnosed. That video.

PINSKY: Oh, wow. Mike, is this new for you, Mike, to see somebody in this condition?

MIKE CATHARWOOD, LOVELINE: Uh, I mean, it certainly is -- to see with my own eyes -

PINSKY: (INAUDIBLE)

CATHERWOOD: Yes, who`s not on drugs exactly. I mean, it`s just to see someone behave that way --

PINSKY: Well, you bring up a really important point which is that psychiatric conditions are diagnosed only when there are not medication-

related, substance-related, substance-withdrawal or other medical conditions, which by the way, can also present like this, but if you don`t

have those things, then you have the psychiatric disorder.

SIPIRT: Yes, there it is. And, you know, another thing that I think is important for us to talk about Dr. Drew is individuals who actually don`t

want treatment because they like certain also aspects of the disorder.

PINSKY: Mania. People like being manic.

SPIRIT: People love mania. You know, I have clients tell me all of the time. Well, I don`t want the meds because when I`m manic, I`m highly

creative, I can clean my house, I am super-mom.

PINKSY: I get stuff done.

SPIRIT: Yes, and so, but when they talk about the crash and the depression and those dark spaces.

PINSKY: Then you can treat.

SPIRIT: There you go.

PINSKY: Samantha.

CATHERWOOD: I`m impressed with her delusions of grandeur though. Because I mean, like to think that Jesus is talking to you and your the Dalai Lama -

I used to think Conan O`Brien was talking to me. That`s not at all is cool, but I was convinced. I used to take a part my VCR`s because I though

Conan O`Brien was telling me to do that.

PINSKY: That was your (INAUDIBLE).

HO: Well, the tricky thing about bipolar disorder too is that there is an aspect of it where the person can have very prolonged depression.

Sometimes for a year or two years. Then they have a very brief manic episode -

PINSKY: You miss that.

HO: You missed that and then, so that person gets diagnosed with depression. They`re treated with depression. They`re two completely

different illness.

PINSKY: Well, then does anti-depressant medicines can precipitate severe mania. And that`s one thing concerns me about primary care doctors handing

out anti-depressants. They`re not trained to evaluate exactly what your talking about. Mike?

CATHERWOOD: I want to know --

(APPLAUSE)

PINSKY: Yes, I know.

CATHERWOOD: -- from Samantha`s standpoint, I mean, how unbelievably terrifying must it have been to just all of the sudden behave in a fashion

where your out of control of your own kind of decision making, knowing that you didn`t take any kind of mood-altering drugs. To just rifle into that

kind of behavior.

PINSKY: She may not of had insight.

SPIRIT: It`s not curable at all. Yes.

PINSKY: Sometimes they like it. What do you say, Samantha?

SAMANTHA: Yes, I didn`t really have insight into it as far as it being scary that I lost control of myself. Now that I`ve been diagnosed, I would

know what want was going on and I would be scared. But when that happened, I really, you know, I had never heard of bipolar disorder. Or I might have

heard of it, but I didn`t know what it was. So, what was scary to me you know were the actual delusions that I was having and the actual

hallucinations. That`s what was scaring me.

[22:49:44] PINSKY: Thank you, Samantha. Keep doing well and we`ll be right back after this.

(COMMERICAL BREAK)

PINSKY: Time for Dr. Drew`s cues and tonight Spirit, Mike and Judy will join me. We`re going to help -they`ll help me answer questions that you may

have about mental health, social media. We`re going to go out to our audience. Yes, ma`am? What do you have there?

UNIDENTIFIED FEMALE: Hi there. I was wondering, is there any special diet or any specific food items that could possibly aggravate mental health and

even possibly cause mental illness?

CATHERWOOD: Certain mushrooms.

(LAUGHTER)

[ 22:54:28] PINSKY: Poison, No, he`s right. Poisonous foods. Poisonous foods. I have a psychiatric friend, Dan Siegel, who told me a story once

that he ate a rotten banana and it triggered severe suicidal thoughts. And he said, boy, how strange. And, so he ate it again and they came back.

And so yes, there is obviously poisons. I mean literally if there`s an excess of a chemical in a food because of decay or because it`s there in

the plant to protect it from being eaten, like a mushroom, things can happen. They it an precipitate mental illness. But not in the course of a

normal diet. So, now structure, you know, not having wide fluctuations in your diet and activity and that can help stabilize your mood and anxiety.

It`s just good general mental and psychical health.

So, Angela on Twitter, is it better to get therapy by yourself or with your family and spouse? And we talked earlier about, it`s good to go by

yourself, but often times to have, you know, really grow a lot, the people around you would have to grow alongside you. Judy your smiling.

HO: That`s right. Well, yes. I was just thinking about all the studies show us, in collectivistic cultures, people with schizophrenia do so much

better, even adults because they have that family structure around them no matter what age they are.

PINSKY: You need others.

SPIRIT: We do. So, you have the individual therapy. But then, for the family, it teaches what to do in certain situations. What to do when

they`re manic. That`s, you know, you`re freezing credit cards, your making sure that they stay in the house and that they have somebody with them.

The more people that can join in that treatment, the more successful it`s going to be.

PINSKY: Audience question, yes, sir?

UNIDENTIFIED MALE: I survived from depression and I`ve been in treatment for many years.

PINSKY: Doing good now?

UNIDENTIFIED MALE: Yes, no. I`m good now. I`m happy. I have a good life. I`m in a committed relationship now and I haven`t told her that I do suffer

from depression.

PINSKY: Are you on medication presently?

UNIDENTIFIED MALE: Yes.

PINSKY: Are you on medication?

UNIDENTIFIED MALE: Yes.

PINSKY: So what is your obligation -- How long have you been with her?

UNIDENTIFIED MALE: Four months.

PINSKY: It`s important, right? It`s a piece of who you are.

CATHERWOOD: I know of my treatment and my depression, my boner would tell a big story.

PINSKY: Yes, the anti-depressant did really affect -

CATHERWOOD: I`m surprised you haven`t crossed that bridge yet because of how profoundly it`s affected my libeto and things. I don`t know - I mean,

not going to --

UNIDENTIFIED MALE: I`m younger than you.

CATHERWOOD: Yes, you are.

SIPIRT: Oh, so your compensating.

PINSKY: In fact, there`s a next question. Stay up there. The next question correlates to this. Says Dr. Drew, have you ever suffered with a

mental health issue and if so, how did you address it? Same thing. I had depression when I was in college. But I had more than depression. So in

retrospect, I could see the mood disorder. At the time, what I was complaining about panic attacks. Severe panic attacks, which was part of a

depressive symptom that frankly got mismanaged poorly. And I think what maybe sort of interest in helping young people with - and you said you had

--

SPIRIT: Yes, situational depression. Years ago in my twenty`s. coming out of a horrible relationship. And it was the panic disorder. It was the

anxiety. And, you know, I thought I was actually having heart attacks.

PINSKY: Oh, that`s the panic.

SPIRIT: Yes, you know. Come to find out, it the panic attacks.

PINSKY: I thought I was going crazy. Turns out I was. Judy`s perfect though. Judy never had any mental illness.

CATHERWOOD: But, I feel like with a relationship, a romantic relationship, it`s kind of like with the young lady in the red flag special, in dealing

with your children. You can`t -- there`s really no right or wrong answer with how you deal with each child or each relationship. I think you got to

kind of play it by ear.

PINSKY: It`s an important part of your life story. I would think you would want to share that with an intimate partner. If you feel uncomfortable,

it`s because you feel stigmatized and you shouldn`t.

HO: There`s a lot of self-stigma and what that person is going to think of you. And I hope that most people can take from this special that if you

educate people that this is a physical illness just anything else, like heart disease, like diabetes. That might be an entryway to talking about it

in a way that`s less stigmatizing.

SPIRIT: And before it happens, don`t wait until you`re in a depressive state or after and leave them going, well, what the hell was that? I don`t

know if I want any parts of that. You let them know up front. Hey this is something that I suffer from and sometimes, this is what it might look

like. They can be a support system and stop you from going as far in as you might go.

PINSKY: Great point. Last audience question, please.

UNIDENTIFIED FEMALE: Hi, so I`ve suffered from PTSD for about seven years now. And --

PINSKY: From a childhood event or --

UNIDENTIFIED FEMALE: I was 18. And it was sexual abuse by a family member. So, no closure really.

PINSKY: Did you have anything earlier or this, because the reason I`m asking is sometimes true chronic PTSD, which you`re kind of describing, is

usually kind of a second hit. Did something earlier happen or did something later happen?

UNIDENTIFED FEMALE: Yes, I was molested when I was like five by --

PINSKY: Okay so, yes. There you go.

UNIDENTIFIED FEMALE: So, I never really got closure. But I ruined a lot of relationships the first couple of years. But, the past three years, I`ve

actually really gained control. But really actually, really, really, recently, anxiety and stress, of course, you know

PINSKY: Well, I`m going to stop you and just say that trauma is a exceedingly common phenomenon today. And by trauma, I mean in childhood

particularly, physical abuse, sexual abuse, neglect, and then, of course, trauma .In adulthood, we have people coming back from Afghanistan and Iraq

and things. So, trauma is a feature of mental health issues in our time. So, thank you for bringing it up.

I will simply say there are people that specialize in treating trauma. And you should avail yourself of those specialists because trauma it has

(INAUDIBLE) manifestation from mental standpoint. But is sort of a core phenomenon there of trauma that can be address. Things like EMDR. There are

all kinds of neuro-bio feedback. There`s all kinds of new treatments out there.

[23:00:00]

END