Welcome to iHeartRadio Communities, a public affairs special focusing on the biggest issues in facting you this week.
Here's many Munyos and welcome to another edition of Iheartradios Communities. As you heard, I am Manny. Munyo's May is National Mental Health Awareness Month, and it is an issue that has drawn increase attention, in part because of all the stigma that still surrounds discussing mental health issues. Lucky to be joined right now by doctor Ken Duckworth with the National Alliance on Mental Health. He has also written the book You Are Not Alone, which we will discuss here
in a moment. Doctor Duckworth, I appreciate your time, thanks for joining us.
Manny, I want to thank you for taking an interest in this critical topic.
Yeah, it really is, and it's increasingly top of mind in our country. Let me start off with National Mental Health Awareness Month. What is the purpose of that title for this month?
Congress made this designation that a month should be set aside to attend to the critical aspect of human experience, which is our own mental health. And anybody who's traveled in these waters knows that there's no health without mental health. And so maybe simply an opportunity for us to renew our focus on this critical aspect of living.
What exactly are we talking about when we discuss mental health?
Uh, mental health you know, is defined in brief, you know, as the ability to love and work and live a full life, full of purpose and connection. A lot of mental health conditions get in the way of that, and a lot of circumstances get in the way of that. So you know, about one in five Americans more if you look at the numbers, but with some kind of mental health condition, whether that's an anxiety disorder, which is
the most common set of conditions. This include anic attacks, generalize anxiety, depression, major depression, difficulty getting out of bed, getting going, that's the second most common area. Vulnerabilities to addiction, whether that's you know, alcohol or other substances, by polar disorder, schizophrenia. These are the things that you know, are really of interest because these all have treatments, Services can be provided, People can be brought in who live with these conditions
to help others. So that's why I love mental health awareness Monk, and I am grateful to be on this show.
Manny Well, I appreciate you coming on to join us and explain these things to us. Where is the line between somebody, for example, that is stressed and maybe feeling down and somebody who is clinically depressed.
Excellent question, Manny.
I love this question.
Really have to look at both functionality and duration. So are you able to participate in work, work, and love? Do the people in your relationship say, you know, Ken, you're really off your game in a fundamental way. Now, that could be true for two days, and that's not typically a mental health condition. But also duration comes into play.
This has been going on for weeks, and those two things together separate kind of a different human experience from a more complex kind of biological reaction to difficult experience.
I guess the big problem with all of these issues is one being diagnosed, and you can't be diagnosed until you come forward and admit you believe you might have a problem. Is that the biggest issue we have in our country right now with mental health?
That's one of our issues, Manny. We also don't have precision in our diagnostic scheme, but I work for the National Alliance on Mental Illness. Our sister agency, mental Health America, has screening tools that you can take online. For things like depression, anxiety, and trauma. These screening tools are the
same ones you would get in your doctor's office. Right, So while it's best to come forward and to connect with a human being, you know, to actually work with somebody who can interpret your results and actually talk to you about your experience, you can do these screening tools, and I commend them to people who are like, you know, how far have I gotten down this road?
Right?
Perhaps I should take a screening evaluation and sort this for myself. That is not a diagnosis, it's a screening fast. But like you take your blood pressure at the pharmacy and it doesn't look right, that doesn't mean you should get on med. That means you should talk to somebody who knows what they're doing and use that first screening assessment as a way to follow up and get a more precise answer to what is my blood pressure and how do I treat it?
Are all of these things, whether it be depression or addiction or a schizophreny or any of the number issues, are they all just chemical imbalances in the brain.
Yeah, we don't use those terms because I think it's more honest to say we don't understand the human brain well enough to know what causes voices, what causes people to live with severe mood swings, what causes people to have panic attacks when they start today that we were I think chemical imbalance was an old fashioned shorthand to explain something. I think a more honest answer now is the brain is really hard to understand, and these are kind of pathways that you get in terms of behavior
that are seen all around the world. People have panic attacks in Spain, people of the schizophrenia and Russia. Bipolar disorder is found in Australia. So these aren't really cultural constructs right so much. The variability may differ in different ways, but I don't think of these as a chemical imbalance. It's a combination of genes and environment, which is really unsatisfying, isn't it, Because that right, well, I wish I had better answers, but I think it's better to be honest
with people. And it's also important, I think, to let people know that you can get help for these things, even as we don't understand them at the level of precision that we want at the brain level, you can still get help for things, and I think that's important for all these mental health conditions. There are very good treatments, there's very good research to back up those interventions, and
you know it's not always easy to get them. I devoted one of the chapters to Nami's first book, You are not alone to how to find help minding the many gaps because our system is not set up to make things simple and easy. So, as you mentioned, Manny, you have to overcome your initial resistance. Might I be living with something you identified a brilliant point, which is society doesn't necessarily make it easy to join a club of people who may be struggling with their mental health.
But in addition to that, mental health coverage differs by health insurance. Every Medicaid is different in every state. Some providers take no insurance, some providers take your insurance. Some providers change insurance what they take while while you're working with them. So I would say it's a chaotic, fragmented
care system filled with really good people. And I want to emphasize, you know, I don't blame the professionals or the peers, which are people living with mental health conditions who are providing these care, but the system around them is complex and very hard to navigate them.
A few minutes, a few more minutes here with doctor Ken duck Duckworth with the National Alliance on Mental Health, And I want to get to your book. You were not alone in a moment, but you talked there about getting health and help, and there's so much help that people with these conditions can get. The problem is admitting to yourself one that you might need help, and two the stigma that comes along with every different kind of
mental health issue, mental illness in our country. Do you find do you find that holds people back from actually getting help or getting a diagnosis?
Even I do think that's holding people back, and I think it's true in some subcultures of our society more than others. So I became a psychiatrist. My dad was a wonderful man with terrible bipolar disorder. And I'm older than you, Manny, I have gray hair.
I have plenty of gray hair myself.
Oh no, you look fantastic on your picture, thank you. But the seventies, eighties, and nineties, you know, he would have these episodes of mania and psychosis and nobody would talk about it. And in writing AMI's book, I've been so pressed at how much there are hundreds of people who would be happy to use their name and share what they have learned. My dad would not have been one of those people. He was too full of shame and concern that people would, you know, find out about it.
But in You Are Not Alone, Nami's first book, I've run across thousands of people and I interviewed one hundred and thirty of them who use their names and say where they're from. How did they come to terms with their diagnosis, How did they explain it to their girlfriend? How do their family members work with them to provide support for them? So the idea was kind of radical. You know, real people have learned things and this is the known as the lived experience movement. I love science.
I'm a doctor, right, I love all that stuff. Science is in the book too, So it's not an either or equation. It's a both and perspective. But if you've lived with depression for a decade, you've probably learned. If you loved somebody who has chilophrenia, you pick something up over time about the best way to communicate and support the person. That's the essence of the book. All the royalties go to Nami, so I plug it with no anxiety about self promotion because the book is our collective project.
NAMI is the largest mental health group in the country, and there are support groups and educations all across America. And if you go to NOMI dot org you can find people who are living with mental health conditions or love people who do, and get support and education. And what this is is a volunteer army of people who don't want others to feel alone. So I'm very proud
to work for this organization. It's kind of a dream job for somebody, you know, who lived with a loving dad and thought, God, a world should be a better place for people. It was not his fault that he hit bipolar disorder, but our society hadn't really supported him to own it and accept it, and so he battled
with that his whole life. And now you know, No Me is part of this movement, and I want to thank you for having me on iHeartRadio, you know, to help people think about the possibility, you know, that maybe they are living with a mental health condition. And that doesn't mean that there's anything wrong with you. It's information about yourself.
Yeah, any different than having high blood pressure or diabetes or anything else.
Yeah, that's right, and the National Alliance unless your local chapter no MEI dot org will also be able to help you find guidance on how to get the help you deserve, just as you deserve to not you know, have untreated diabetes and all the complexity for that. Right, people deserve to have their mental health attended to and treated.
N A m I. Dot org is the website dot org. Let's let's back off a little bit from the mental illness part of it. How about we close this out just talking about regular everyday stress. We live in a chaotic world. Everybody's lives can be chaotic. How do we deal with that and make sure that just run of the mill stress doesn't get the better of us and get to something worse than that.
But that's a great question. You know, I'm a big fan of human connection. Somebody to talk to, having a best friend, a poker group, a book club, human connections.
Right.
We think we all learned during the pandemic, manny, how dependent we are upon human connection. Yeah, whether it's friendship, a relationship, whe's just a person who's making your coffee at Dunkin Donuts. I'm from Boston, ring every corner there's a dunkin donut, but the connection with that person, it's the same person. Hey, Ken, the regular, the usual today, Yes, the usual. You know, human connection is important. Isolation is very hard on our mental health. We have definitely learned
that the mind is connected to the body. So move if you can, so you know, if you have access to a park or nature, or you get a dog who demands that you walk that dog. Movement for the
body is actually protective against anxiety and depression. They still may need other treatments, but I think the idea of connections, relationships, exercise, being in nature, if you can getting a dog, if you have the occasion to get you know, if you live in a place that's allowed to have a dog, if you can afford a dog, you can share a dog with a couple of neighbors and just walk the dog three days a week. Again, companions and movement, those
are two things I like. Support groups. I had a couple family members die and you know, I went through some grief and I intended to support group around grief and loss. And again it's not really a mental health condition, but it could have become one. And I just thought then this was an Anomi group I happen to love the Nationaliance, some medal list and all the support and
education we provide. It's going to have a more traditional grief group, and I thought I should talk to other people because I know this is an ordinary human experience. It was just hitting me so hard and I thought, I'm just gonna, you know, break down and just be part of a grief support group. Again. It was a short lived thing, but I think it got helped me to get through a little rough patch in my own life.
But you got to continue your relationships, your connections. If you have a best friend from high school or college, call them, Cherish them. They're doing something for your mental health, even if they don't know it right. Just by knowing you and supporting you in all these years as you have them, it makes a difference for people.
Yeah, and just ignoring the signs aren't going to make anything better. We can't just put it on the back burner and think that it's going to go away, doctor Ke National Alliance on Mental Health. The website for NAMI, the National Alliance of Mental Illness is NAMI dot org and the book is titled You Are Not Alone. Doctor Duckworth. I really appreciate the time.
Be well. Thanks so much, Manny, thank you so much. Take you care, holl bye.
One in three adults in the United States has high pertension high blood pressure. Do you know what causes it, how to treat it, more importantly, how to prevent it? Well, may happens to be National High blood Pressure Education Month. So let's discuss all of those things as we bring in doctor Clyde Yancey. He's chief of Cardiology in the Department of Medicine at Northwestern University. Doctor Yancey, thanks so much for the time.
I am delighted to be here. This is such an important conversation and I think we should expand all of the questions he just presented.
Yeah, well, I look forward to speaking to you about them. What does it mean to have high blood pressure? How about we begin there?
So let's start at the very beginning. Part of what the heart does so beautifully for us is to distribute blood throughout the body. The heart is an organ, it's actually a muscle. In addition to its other functions. That muscle pumps blood through the body. So our lay assessment of what the heart does is exactly correct. Correct That blood that is pumped through the body comes out with force. So that force is something that is measurable. We measure
it as pressure. There is a normal amount of force, but there's also an elevated amount of force, and when that force is elevated, it has consequences. Imagine the flow of water through a garden hose, if there are those who still do those kind of things. If the flow is ginger and gentle, it just waters along without any problem. But if it's forceful, the water is flowing, yes, but that forceful flow of water, just like a fire hydrant,
it has consequences, can actually cause harm. Same thing in our vascular system.
How is a high blood pressure what we're talking about hypertension, different than for example, me a middle aged guy sprinting forty yards, and how my blood pressure will rise in that context.
So that's a brilliant question because it's the heart's ability to adapt to all the different things we do in life. Whether we're resting and lying still, whether we're digesting a meal, or whether we're exercising, it is appropriate for your heart function to increase. So that force that we talked about will increase, the blood pressure will increase. But we call that very carefully. We call that a physiologic meaning that's
a normal increase. But imagine what happens if your pressure, your force increases because you're exercising, but you're not exercising, you're just living with that increase. That's high blood pressure.
What contributes to high blood pressure, to high pertension.
We understand that what contributes to it, and that is the right word, because we're still trying to understand what causes high blood pressure. But we know that what contributes to it is one part your family, one part perhaps your ancestry, a big part your living circumstances, your life and living conditions, a big part your diet. So those persons that take in salt and are sensitive to salt
may have a higher blood pressure. Those people that end up being heavier will almost surely have high blood pressure. Those persons who live in certain neighborhoods because of their choices their lifestyle, may also have high blood pressure. And guess what, if you know that your parents and your grandparents are high blood pressure, you should be especially attuned to the likelihood that you'll develop high blood pressure. But let me just tell you one other thing that's incredibly important.
There are three inevitabilities in life, death, taxes, and high blood pressure. What I mean by that ninety percent of all of us are alive right now, ninety percent will eventually develop high blood pressure. So we can basically check the default button and say we all need to be aware.
And am I doctor? My primary care physician has spoken to me about that repeatedly, says, the older we get, just naturally, our pressure will increase. Is that right?
And the natural part of this is that the older we get. What's not natural, But what happens, almost without fail, is that our blood blood vessels get more stiff. And that stiffening of our blood vessels again comes from all the things which we're exposed, does come from aging, does come from being heavier. It's so important to recognize this interrelatedness of being heavier, of becoming older, of maybe having a tendency towards diabetes, these sorts of things all come together,
so it is inevitable. Your doctor is exactly right. But what's naturalist not for your blood vescals to get more stiff. It's how we live that makes how blood vescals get more stiff, and thus nine out of ten of us will end up having high blood pressure.
That number that I started off with, one in three adults in the United States has high pretension high blood pressure. It feels like I've been hearing those numbers for decades. Have they remained consistent? Have we made any improvement on the number of Americans who have blood pressure?
So where improvement has come is in the number of Americans who know they have high blood pressure. For quite some time, we've always known that about one third of the population in our country at any one moment has high blood pressure. But now a greater percentage of them actually know that they have it. And I'll tell you why that's so important. You don't need to immediately go
to drug therapy because you have high blood pressure. There are many lifestyle changes that can actually help normalize the blood pressure, but you don't know to make those changes unless you are aware that your blood pursure is elevated. So the awareness and detection programs that so many organizations have promulgated are working, and people know that their blood pressure is elevated. Now, one other number you talked about the importance of this number. We can't overlook that one
in three number is across the board. That's correct, But here is some more compelling number. One in four young adults under the age of forty has high blood pressure. One in four young adults, So that tells you that beginning at age twenty five are even younger in some groups. We need to be very conscious of our blood pressure. Just like we know our cell phone numbers, we need to know our blood pressure.
A few more minutes here with doctor Clyde Yancey's chief of cardiology in the Department of Medicine at Northwestern University, want to unpack a little bit of that very easy to treat these days with medication, very inexpensive medication quite often, but I wonder if people try to if people turn to that first as opposed to making changes in their lifestyle, then might be able to control their blood pressure.
I can absolutely promise you that if someone is seen in my office, the conversation goes like this, we've identified that you have blood pressure almost invariably is based on home blood pressures and not the blood pressure in the office, and I will tell them the first step is not using drugs. The first step is lifestyle. And I will go through all of the necessary motions, and I'll tell you very quickly. For every kilogram of weight loss two pounds,
your blood pressure goes down by a point. That means if you can get to ten kilograms of weight loss about twenty pounds a little bit more, your blood pressure will come down substantially. Increase your physical activity, cuts your alcohol content in half, don't smoke. Increase your consumption not only of fruits and vegetables, You've heard that so many times, but increase your consumption of potassium, and decrease your consumption
of sodium. Those are the non drug strategies that will effectively treat your blood pressure, but particularly weight loss.
What is it about salt that contributes to high blood pressure? Because let's face it, a steak ain't the same without salt.
We can talk about eating the steak at another time.
Yeah, I imagine that contributes to it a bit as well, but just the salt portion of it, because I remember, you know the Dash diet and now there's like low salt, salt and things like that. But just not the same, is.
It, And some people not everyone. Salt causes fluid retention, and it's the fluid retention that expands the blood vessels and goes back to opening conversation and keeps that force elevated. But what makes this fascinating is that in population health, where we've been able to replace sodium chloride with potassium chloride, that step alone, without changing the palatability of food, that
is the taste of food, lowers blood pressure. And so the idea of switching from salt as you know it as I know it to potassium instead of sodium and the right individual has some benefit.
What is potassium chloride? Can I buy that at the grocery store and put it on my steak?
You know what? You can do one step better than that. You can walk down the spice out and you can look for no salt inn oh salt right, look at the label and almost invariably that is your potassium chloride.
That's it fascinating. We kind of referred to this a little bit earlier. Early detection really is the key in determining all of these things. And unless somebody is going to get regular checkups on a yearly basis or more often than that, chances are you're probably not going to know that you have high blood pressure just from living your life. So how does somebody determine they have it without going to see their doctor.
Can they So many young adults have had pre participatory physical examinations for sports, whether it's club sports, high school sports, college sports. There's your blood pressure. So many women of course for pregnancy must have the blood pressure determined. So there is another way you know this. But guess what. You can walk into virtually any commercial drug store, look along the perimeter and you'll find a free automated blood
pressure cough. Point being that there's no way you can avoid access to getting your blood pressure measured, even if you duck into a fire station. There is a way to get your blood pressure know. But the key point is the one you've already made. You have to be aware and so yes, blood pressure is ubiquitous, so many people have it, But the knowledge is what we need to make ubiquitous to know that everybody is likely to
develop high blood pressure sometimes. So one of the things we talk about all the time, over and over and over again. Know your numbers, know your blood pressure, know your know your weight. These are the things that will help you live along in healthy life.
Stress, sleep quality, mental health. All of those things, how do they potentially influence our blood pressure?
It's pretty clear that sleeping less than six hours a night is definitely associated with an increase in blood pressure, and an increase in the more difficult patterns of blood pressure. That's another conversation. It's also fairly clear that stress in the global context, whether it's worry that is, whether it's mental stress, but also stress in life, anxiety about a job, anxiety about an interpersonal relationship, all of that stress becomes
manifest as something biological. We think that the biology there is that it's inflammation. Think of getting a mosquito bite and look at how your skin gets rid. Stress does that to our body. It causes our body to become inflamed, and that leads to high blood pressure. So you are correct, lack of slave being stress, those things increase our blood pressure, just like alcohol does.
How much of those numbers, and again will refer to them one in three adults, you said, I think one in four of adults under the age of just say twenty five have high blood.
Under the age of forty twenty five, one in four adults.
One in four adults under the age of forty have it. How much of that is associated with the culture in our country, the diet compared to other countries.
I want to be very clear about this. We think most of it is in fact related to our lifestyle. Now, lifestyle is a little different from diet. It's one part died, yes, sure, but lifestyle of physical inactivity, a lifestyle that predisposes our young adults towards being heavier, a lifestyle that very much
gratuitously enjoys alcohol, and still tobacco. When you put all of that together, alcohol, tobacco, being heavier, having a very convenient lifestyle meaning using fast food products, not being physically active, all of that relates to this burden of high blood pressure and young adults. And again, know your family history. Take some time and say, mom, pop, what runs in our family? You should be aware.
Two final questions for you. One third, maybe we can't control genetic if our parents, our grandparents have had it. Two thirds of this we can control what does hypertension, high blood pressure potentially lead to.
So we always think about this phenomenon of what happens to the organs that face all of that extra force that we talked about, the three organs we really were about. The brain. High blood pressure definitely leads the strokes the heart. High blood pressure is associated with heart attacks. Associated with heart fillure and the kidneys for certain high blood pressures associated with having weaker kidneys, and maybe even kidney failure. But the most important message here is that it's so
eminently treatable. We have inexpensive drugs. Lifestyle is a benefit, and what's most exciting is that for the first time in over a decade, we have brand new therapies and we have procedures that can help us really finesse control of blood pressure. No one needs to suffer from high blood pressure in our future. High technology is just that good.
Early detection is the key, and there's a reason it's called preventive medicine exactly. Doctor Clyde Yancey, chief of Cardiology in the Department of Medicine at Northwestern University, truly appreciate it for the time and the information. Thanks so much for joining us.
Thanks so much, and let's not forget know your numbers.
And that'll do it for another edition of Iheartradios Communities. I'm Manny Muno's until next time.