Join Valerie and Helen as they delve into the second half of their examination of depression. While Depression Part 1 presented an in-depth look at the many facets of the illness and its profound impact on the individual and society, Part 2 focuses on the expanding potential for recovery. Through treatment methods and strategies, relationships, and dazzling breakthroughs in science and medicine, recovery from this serious and often debilitating disorder is possible and sustainable. They also offer a section with ideas for the friends, families and caregivers of individuals with the illness. In addition, Helen and Valerie relate their firsthand triumphs in overcoming the relentless, fierce grip of depression. Through their lived experience, research, and reports from the field, they provide an optimistic assessment of available treatment, and a hopeful message for those fighting depression today.
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Dissecting Depression: The Background, the Battle, and the Breakthroughs -- Part Two
Episode 32
Helen Sneed: Welcome to Mental Health Hope and Recovery. I'm Helen Sneed.
Valerie Milburn: And I'm Valerie Milburn.
Helen Sneed: We both have fought and overcome severe chronic mental illnesses. Our podcast offers a unique approach to mental health conditions. We use practical skills and inspirational stories of recovery. Our knowledge is up close and personal.
Valerie Milburn: Helen and I are your peers. We're not doctors, therapists or social workers. We're not professionals, but we are experts. We are experts in our own lived experience with multiple mental health diagnoses and symptoms. Please join us on our journey.
Helen Sneed: We live in recovery.
Valerie Milburn: So can you this podcast does not provide medical advice. The information presented is not intended to be a substitute for or relied upon as medical advice, diagnosis or treatment. The podcast is for informational purposes only. Always seek the advice of your physician or other qualified health providers with any health related questions you may have.
Helen Sneed: Welcome to episode 32, dissecting depression. The Background, the Battle and the breakthroughs. Part 2 well Valerie, we managed to cover part one of this gargantuan topic and today we're going to cover Part two. We have divided and conquered.
Valerie Milburn: We have and the response to Part one has been really great. We have reached a lot of people with Part one and the feedback and has been so positive and I am so excited to launch Part two.
Helen Sneed: Well, I'm glad you brought that up because I know we both want to encourage our listeners today. Please go back and listen to Part one because Valerie and I thought we knew so much about depression and we were shocked at how much we learned. What we do in this first episode is an extensive background on depression. We look at the phenomenal impact on the individual and on society and then we look at what depression is like through the words of some great Writers who have had depression and recovered from it. So our objectives today are, and we want to focus on positive strategies and optimistic outcomes in looking at how to deal with depression. And so our objectives are, number one, treatment methods for the depressed individual, ideas for families and caregivers, cutting edge treatment breakthroughs, which is very exciting. And then Valerie and I will relate our own experiences with fighting depression and our experiences in recovering from it.
Valerie Milburn: Yes, we will. And I'm so excited about all of those objectives and can't wait to share those cutting edge treatment breakthroughs. There's some really exciting stuff going on. Yeah, the really exciting stuff in the field of treatment for depression. But let's start with the definition, this one from the American Psychiatric Association. Depression is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Depression can lead to a variety of emotional and physical problems and can decrease the ability to function at work and at home. But fortunately, depression is treatable. Research shows that with adequate treatment, 70 to 80% of those with a depressive disorder may experience a significant reduction in their symptoms.
Helen Sneed: Yes, that's what
Helen Sneed: we are going to focus on today. And we're looking at, to begin with, at treatment methods. And what we're going to try to cover are conventional treatment methods that are available today. Now, currently there are so many alternate methods and techniques and strategies and philosophies and approaches to treating depression and then also formats for treatment that we couldn't possibly list them all. And then, of course, recently it's even changed more by alternatives such as online or video sessions, videos and workbooks, computer programs, even phone apps. Now, this last stuff has evolved from the pandemic, and this is the need for continued treatment even in isolation, and the vastly increased number of people dealing with a mental health challenge today, I believe we read that it has tripled since before the pandemic.
Valerie Milburn: That is true. Unfortunately, the incredible increase in mental health challenges from the pandemic and even those that we were seeing increase before the pandemic, is astonishing. And there are indeed many treatment options available. And we're going to start, like we said, with these mainstream, traditional ones. And one of the most commonly used treatment is individual therapy. And a great number of professionals recommend a combination of individual therapy and medication. As for therapy, it's very important if you have a depressive disorder to find a therapist who is familiar with and has treated depression. This therapeutic dynamic between therapists and patients supplemented by medication can be the catalyst for recovery. Now, there are different types of psychotherapy that can also be effective for depression, such as cognitive behavioral therapy. And our favorite that we reference all the time, dialectical behavioral therapy, DBT.
Helen Sneed: Medication. Now we want to get into this a bit, but first of all want to say that the topic and use of medication is a highly personal matter between a patient and his or her psychiatrist. So we are in no way recommending a specific medication or the use of medication in general. This is a very personal decision to be made. Now let's begin with antidepressants. You know, look at the name. This is what they're for. Okay, there are selective serotonin reuptake inhibitors, SSRIs. They are often used to treat depression and anxiety and they tend to have fewer side effects. Then there are serotonin, norepinephrine reuptake inhibitors and then atypical antidepressants. They're not as easily categorized, but these all sort of fall together in having fewer side effects. Now if you look back, there are tricyclic antidepressants. These can be very effective, but they also can have more severe side effects than newer medications. These are, I guess, one of, if not the first generation of antidepressants to help fight the illness with medication. And as a result the newer ones have fewer, fewer side effects. Then there's monoamine oxidase inhibitors, MAO inhibitors. These are usually used as a last resort because they have very serious side effect and you need strict monitoring of diet and other things. Now in addition to antidepressants, there are other medications, anti anxiety and stimulant medications that may also be added for short term use. Now these can be very fast acting, but they also can be addictive.
Valerie Milburn: It's important to note here that for someone with a substance use disorder, it's important to let his or her doctor know that substance use disorder exists because there are non addictive anti anxiety medications available to be supplemented in a treatment of a depressive disorder.
Helen Sneed: Okay, well, that's good to know. Now finally, there are something called atypical antipsychotics and these are used in conjunction with antidepressants and they can make the difference in treatment resistant depression. And by the way, from the name, this is not an indication that the patient is psychotic, but these also can create very serious side effects. So as you can see, all of these medications have side effects that should be explained and monitored by the physician. With most of these medications, it can take as long or longer than six weeks to feel the effect. It's all trial and error. It requires
Helen Sneed: great patience to experience the Full effect and easing of side effects, if that's going to happen. And the individual should always, always discuss with the psychiatrist the right way to discontinue a medication, as some cannot be safely stopped abruptly. Bear this in mind.
Valerie Milburn: Just a note on side effects. The thing I had to learn about side effects was that I had to stick them out because if I didn't, I would never know if the medication was going to work. And most of the time, the side effects went away in three, four weeks. And I then had a shot at seeing whether or not that medication was going to work again.
Helen Sneed: Enormous patience is required.
Valerie Milburn: Yep.
Helen Sneed: Now, anyone with depression should be watched closely when taking an antidepressant, starting a new medication, or changing dosage. If someone has suicidal thoughts, the person should take immediate action, such as contacting a doctor or going to the emergency room.
Valerie Milburn: And that leads into another treatment method, which is hospitalization. And we did an entire episode on psychiatric hospitalization, and that's such a powerful episode. If you haven't caught that one yet, it's. It's worth a listen. So hospitalization treatment can be extremely essential and very effective when the patient is endangered to him or herself or others. And hospitalization can be the treatment of choice for safety from suicidal behaviors or thoughts or when there is an inability to take care of oneself. And in times of medication changes, I know I have gone into the hospital to have a medication change monitored. Hospitalization provides routine and structure, provides regulation of medication, observation by staff, provides activities, and can provide a proper diet. Of great benefit with hospitalization, to me and to you, Helen, was the loss of isol isolation and the relationships?
Helen Sneed: Absolutely. You know, I've always said that I hated the hospitals, but I loved the people in them, and they really were my salvation, you know?
Valerie Milburn: Yeah, it was definitely that contact again with people that I needed sometimes when I was hospitalized. So also, outpatient day treatment programs can be very effective in providing support to get symptoms under control.
Helen Sneed: Another treatment method is group therapy. Peer support can be an incredible healing vehicle for a person who suffers from depression. Companionship, which we keep talking about, companionship with, those who have the same issues and challenges can have a very positive and lasting impact. And then there are skills and techniques. And these are things such as dialectical behavior therapy, realistic goal setting, yoga, Pilates, meditation, spirituality, mindfulness. These are methods that are very important because the individual can use them on their own.
Valerie Milburn: Those skills and techniques lead right into lifestyle habits, which isn't always considered a treatment method, but lifestyle habits is a form of treatment. Those habits are Forms of treatment. And I know my doctor asks me every time I'm in, are you exercising? What does your exercise routine look like right now? How's your sleep? So those lifestyle habits for me are what I call my wellness plan. And research shows how effective exercise is. It has been proven to help overcome depression and to prevent relapse. Healthy diet and sleep habits are also key. Other lifestyle technique, lifestyle habits that can be very effective in helping with managing depression are such things as journaling, listening to music, painting, reading can provide relief and inspiration. And then there's volunteer work that has brought incredible vitality to our recovery. Helen and I, both you and I, have found such richness in connecting with people in our community through our volunteer work.
Helen Sneed: Yes, I know. I think it's true for you too. But I couldn't have come this far without it. There's no doubt. And this leads to something that comes out of volunteer work, which is relationships. And they are of critical importance, as we
Helen Sneed: know, to treatment and recovery. That's the support and connection provided by family and friends, a sense of community, however small. You know, it can just be one person. And these connections can help an individual through a bad hour or keep them from acting on suicidal ideation. And, you know, it works to try to answer the phone, to reach out, make a call or text, or even when the individual doesn't feel like it, it's very seldom that he or she will feel worse. And in many interactions with others can experience maybe, you know, a lightening of mood. Say it's just for half an hour, an hour. It works, you know, so it's great for the individual to reach out. You know, as Forster says, connect, only connect. We've talked about this, Valerie, and I am convinced that it is loneliness that kills people with mental illness. And so these relationships can just. Nothing could be more important.
Valerie Milburn: In my opinion, it is that reaching out is so important. I have a friend who knows the importance of it to the extent that she will call me sometimes and I'll say, I don't even really want to be calling you, but I know I need to call you. So. Hello, Talk to me. She's really funny, but she knows that, like you said, she's not going to feel worse after the phone call. So these are some really great treatment methods. We just went over and I want to go into support for family, friends and caregivers, because that support, you know, we just talked about treatment for the person who is living with a mental health condition. You know, the, the one we're talking about. Right now, depression. And so here are some ideas for support for those who love and care for people with a mental health condition. Because families and caregivers face incredibly difficult challenges supporting a person living with depression. Depression, of course, isn't contagious. But dealing with a depressed person's thoughts and moods can create a tremendous pressure on the caregiver's own well being. And here are some suggestions for families, friends, caregivers, as they support someone struggling with depression. First of all, educate yourself about the disorder. And Dr. Stephen Strakowski, who was one of our guests, talked about the importance of educating, learning about the disorder. So learn everything possible so that being able to react and respond appropriately is available. Take care of, of, have the importance of taking care of themselves, family members and friends and caregivers through a healthy lifestyle. Rest and exercise and finding a support system is just paramount. That is the importance is paramount. In some instances, family members or caregivers enter into therapy themselves. And when burnout strikes, a break can be necessary.
Helen Sneed: Yes, I think that it's easy to, not easy to deal with any of this. But for me, I, besides dealing with my own depression, you know, we've all dealt with it in other, other loved ones in our lives. And it, it is, it's a, it can, it takes quite a toll, you know, it really does, whether you have it or you're helping someone who's dealing with it. And so here are some productive methods for loved ones when they're dealing with the depressed individual. To begin with, it's best not to get drawn into the person's extreme reactions because just keeping sort of being more centered and more balanced and not just going to those, to those heights or depths is probably a good idea. For communications, it's important to validate the person's emotions. This for me is so important. Empathy is key and a good supporter is a good listener. It's also significant to resist the temptation to tell them what they should feel. I call this the oh, just buck up school of medicine. It can distress the depressed person to hear what a healthy person thinks would help them or how they can pull themselves out of a bad mood. And you know, we know that depression is not just a bad mood. So it's best to try not to tell them what would help or give an example of how to pull themselves out of one of these bad moods. It can make them feel anger or guilt or shame. I know for myself, I just would feel all of those emotions in huge amounts because people go, oh, well, I just, you know, I get in my car and I drive over to the mall and I get a new dress. I feel so much better. And, you know, or I play baseball with my son or whatever, and, you know,
Helen Sneed: I just want to go, darling, I cannot put my shoes on.
Valerie Milburn: Yeah.
Helen Sneed: You know, please give me a break here. You know what I mean?
Valerie Milburn: Oh, I had a friend tell me, you know, I was really suffering from depression, and I started walking and I walked every morning for three weeks, and, you know, I felt completely better. Doesn't work that way when someone has a depressive disorder and is in a, you know, this throes of a clinical depression.
Helen Sneed: Yeah, because you walking is. You. Like if you can walk to the kitchen. Now, another thing that I think is rather wonderful is that a friend or family member or caregiver shouldn't be afraid to tell the person that they care about him or her deeply or to remind them of their wonderful, unique qualities, Although they may reject it in the moment. Kind and loving words can have a real positive impact later, a real resonance. Now, I have to say, when I went into the second hospital, I was massively overmedicated. I had not slept or eaten. I was. I was just a wreck. And this is when they decided to give the psychological testing. You know, I just gotten there. And so one of the tests was an IQ test. And when this very kind and compassionate doctor was going over the results of things with me, he mentioned the IQ test. And he said, do you know how smart you are? And I said, well, you know, I sort of laughed. I said. I said, well, I have. I know. I've read a lot of. And he said, no, this is different. And he went on to explain it to me, and he told me what my IQ was. And I have to say that this was his positive words kept me going for months in that hospital. I cannot express. I just kept them clutched in my heart because it was the only positive thing about myself that I could think of. And then finally, it is imperative. We've said this before, to take any reference to suicide seriously and to not hesitate to take action to get the person to safety. Now, Valerie and I have been trained in this, and what we have been taught, and I think most people agree with this, is that talking frankly and directly will not trigger a suicidal person. I mean, Valerie, do you agree this is, generally speaking, the best approach?
Valerie Milburn: Absolutely. You know, I've been trained by national alliance on Mental Illness to present several programs to different audiences, including middle schoolers and high schoolers. And the research shows absolutely that talking frankly and directly about Suicide will not trigger someone into taking action toward suicidal behavior. It is important to take any reference to suicide seriously. And now we have the 988 number that will take you take anyone who wants to talk about someone they're worried about or themselves. 988 will take you to a person immediately.
Helen Sneed: Yes, I just read that with 988 and it's been. It's his first year anniversary and something like 50 million people have already contacted it. It is tremendously successful. So with all this in mind, here is some final advice on treatment. And it comes from Andrew Solomon, who is a man who had terrible depression and wrote one of the most brilliant books about depression that there is. And here's what he had to say. Listen to the people who love you. Believe that they are worth living for, even when you don't believe it. Seek out the memories depression takes away and project them into the future. Be brave. Be strong. Take your pills. Exercise because it's good for you, even if every step weighs a thousand pounds. Eat food when food disgusts you. Reason with yourself when you have lost your reason. The surest way out of depression is to dislike it and not to let yourself grow accustomed to it. Block out the terrible thoughts that invade your mind.
Valerie Milburn: Brilliant words, Andrew Solomon. Those different ideas in that quote just strike me every time I read them. Be brave. Be strong. You know the how he opens it. Listen to the people who love you. That has been so important for me and this quote is so powerful that we will have it in our show notes and it will be on our website so, you know, you too can access the power that we see in that quote.
Helen Sneed: Yes, it's pretty wonderful and it actually, you know, you just mentioned what some of it has meant to you and I think that this is sort of a really perfect and appropriate way for me to ask you to do us all a great favor. Foreign
Helen Sneed: . This is where I think that one of the best things that we have to offer today is you're telling your story and your own, what you did to fight and to deal with depression and recovery. So Valerie, can you tell us your journey?
Valerie Milburn: I will. You know, the first thing I think about when I think about my journey and staying in recovery is that staying mentally healthy and clean and sober may take all that I have, but I have all that it takes now. Now I have all that it takes. But you know, I had a lot of treatment, Helen, and a lot of support to get me to this point where I have what it takes to stay in recovery. And this was my journey to being in recovery. My psychiatrist has led my treatment for 30 years. Alcoholics Anonymous got me sober 23 years ago and keeps me sober today. My sponsor has walked my path with me and guided me for those 23 years. My family, my family was my lifeline during those years of crisis. And my family supports my recovery daily and my higher power oversees it all. Thinking about my journey, I think it's interesting to note that the statistics on the time lapse between the onset of a mental illness and treatment for the illness is 11 years. And that's a statistic that NAMI puts out. And my delay was about 20 years, well, 21 to be exact. Diagnosed at 12, age 12 and didn't get treatment until I was 33 when I saw my psychiatrist for the first time and I crashed at 34. Age 34.
Helen Sneed: Well, that was a long wait. Now you, you've mentioned that you know that there were two treatment methods, psychotherapy and emdr, that have been critical to your recovery. And also, I should just say that both your psychiatrist and your EMDR therapist have been guests on our podcast and they are both the incredibly compassionate and brilliant individuals, unfortunately, tell about those two treatment methods in particular.
Valerie Milburn: Well, I'm fortunate to have both those people in my life because psychotherapy has been the foundation of my treatment. And emdr, which is eye movement desensitization and reprocessing therapy used mainly for trauma, that EMDR brought me into recovery from my trauma, and I didn't really get better until I got treatment for my trauma. So that's psychotherapy, the foundation, and emdr, the treatment that I needed for my trauma, biofeedback therapy was helpful for coping with anxiety and obsessive thinking. Other treatments, cognitive behavioral therapy and dialectical behavioral therapy, both helped me tremendously with the way I manage my thoughts and my behaviors. Now, we talked about hospitalization a little while ago, and when I was in psychiatric hospitals, the treatment I benefited from, that I didn't get anywhere else, was art therapy and drama therapy. And I am no artist, but I learned a lot through what I put on the paper in art therapy. So
Valerie Milburn: couples counseling was extremely important in my treatment. My husband and I went to counseling every week for two years to heal from the trauma of my illness and the crisis part of my illness. And this counseling made us stronger, made us know and love ourselves and each other much, much more. And then another really important part in my treatment was the genetic testing that my psychiatrist did about 10 years ago, because this allowed my doctor to fine tune my medications. And I had even greater stability in my mental health after we made the changes in my medication based on those genetic tests. So a bit about medication. My medication saved my life. My manic episodes had become severely destructive, and I was living in what is called a mixed state. I was depressed and having manic episodes at the same time called a mixed state. So I was so distraught over my behaviors during manic episodes that I was suicidal again. And at this point, I had been taking medication for about eight years and had had a few good stretches of recovery with my mental health. And I was even sober at this point for about three years. There was a lot going well in my life, but I could not get a handle on the mania. So we tried a new mood stabilizer, and it worked. My manic episodes just stopped. They. They stopped. And I haven't had a manic episode since I started taking that medication.
Helen Sneed: That's miraculous.
Valerie Milburn: It really is. And, you know, I know medication isn't for everyone, and I honor everybody's choice, but medication works for me, and I will gratefully take my medication for the rest of my life. Now, I do think it's very telling that one medication, the same one for all these years, has been able to control the manic side of the bipolar disorder I live with. But the depression side continues to rear its head regularly, even in recovery. And I talked about that last episode I talked about the three pretty major bouts of depression I've had in recovery. And I talk, you know, I also have these bouts of low mood about once a year. And, you know, depression's a real bear, just really is, that's the difficulty of tackling this subject. HELEN?
Helen Sneed: Well, there's something, Valerie, about hospitalization that, that I, about you, that, that is really amazing is that you were hospitalized seven separate times in 18 months. This is when you were really, really, I guess this was when the, the worst it got. I hope it was the worst it got. So you were in hospitals for a total of, of four months in 18 months, yeah. And what. Can you talk about hospitalization a little bit?
Valerie Milburn: I can. And that four months, you know, in some ways it doesn't sound that long in the history of my mental health journey, but man, four months is a long time to be away from young kids. And at the time, my kids, it is, yeah, they were 9 and 11. And so that, that was a long time for them. So when I was in the hospital, in the hospital, it was, it was absolutely where I needed to be, as I talked about a minute ago. And one of the things I did have a lot of trouble with in the hospital was that I was on suicide watch one time for the entire five weeks. I was at the trauma hospital. And it was hard, it was really hard, but it was life saving suicide watchmen. I wasn't able to be more than 10ft away from a staff member. You know, the implications of that you can just think about. And I needed that at the time. And every time I went into the hospital, the comfort and the safety of the hospital was what I needed. The things we talked about, the structure, the people, the proper diet, the sleep. So that's all the treatment and the therapy that has worked for me and is working. And daily I work still every day, and I begin every day in prayer, in meditation. I exercise regularly. I spend time with my family because that's what sustains me. I sleep the same eight hours almost every night. I try to eat right, I do whatever it takes not to become too stressed. And I manage my calendar because I like and need order and routine in my life. I
Valerie Milburn: have to be of service to my family, my friends, my community, because my family, my friends, my community has given so much to me that I want and need to give back. And I stay in touch with my amazing friends. In fact, this weekend is a college girlfriend weekend and I can't wait. So this life of recovery, just, you know, it Requires a lot of work to maintain. And I like to say I'm always going to have a battle, but I get to choose which one. I get to choose the battle of living with a symptomatic mental illness and active addiction or the beautiful battle of recovery. And I'm going to fight to keep this beautiful life, Mental health and sobriety, productivity of family, of friends, and spiritual connection.
Helen Sneed: Oh, my. Valerie, that is. It's. It's an amazing story. And especially thinking of you, I guess I think I've said this before, but I do think of you as a fighter. And I just have known you now for some years, and I've never seen you quit, regardless of the circumstances. And that obviously, is what I think. It's what. It must have served you so well on this long journey that you had to get out of. Out of the grip of depression. So I really want to thank you and tell you again how much I admire you and respect you for. You know, it's that funny thing of. They say you pick your battles, and you clearly picked the right one.
Valerie Milburn: Thank you. You know, I was thinking this morning as I finished Angela Duckworth's book entitled Grit, I was thinking about you, Helen, because you think of me as a fighter. And, you know, I was thinking about you as someone who has a lot of grit and that you also have fought your way through a long battle with depression and now have achieved a life in recovery. And I want to hear about your journey, and I know our listeners do, too.
Helen Sneed: Well, I have. Gosh, I've been depressed my entire life, except for the past 10 years. Started. It started when I was four, even younger than that, and it was unrelenting for decades. And so I want to talk about, to, I guess, really to express and also to express my gratitude for the things that I used to recover. And so I'm trying to sort of do it in the order, like a chronology of something, of what, what worked, when. But I. I want to start off by saying that first of all, first and foremost were DBT skills. You know, again, this dialectical behavior therapy. What happened is, is that, well, I guess to begin with, my recovery from depression is still miraculous to me. I can't believe that it happened, that I did it. And I think it's also a miracle to a number of people who've known me all this time. But after my doctor told me I'd never recover, her negativity drove me to fall back on my own resources. And the thing I had was dbt. I had been trained right And I, you know, it's, it's, it teaches you dozens and dozens of skills to overcome tidal waves of horrible emotions and, and thoughts. And so I had to, I knew about the skills and I began to practice them like the lifesavers that they became. And I did it and I did it and I did it. And very slowly, white knuckle by white knuckle, I began to crawl back into the world. And it took a long time, but I never disappeared completely back into the abyss again. Now, there are other things that have helped tremendously. One of them is psychotherapy. After a really devastating, wrenching break from the doctor that said I was hopelessly sick, I then found on my own, the right therapist. And she insisted on equality in our relationship. She respected me and she believed that I could recover. She believed in me and, you know, that's really what I needed. And I began to make real progress. Medication again, something for which I am extremely grateful, although I wasn't always back then, my new psychopharmacologist found a medication that actually alleviated some of the core depression and uncontrollable thoughts and feelings that had driven me all my life. After 30 years and trying over 60 medications
Helen Sneed: that didn't work, it was like an old Testament miracle to take one that did. And because of this, I was able to again, it just reduced the suffering. It was, it was wonderful. And it allowed me to feel well enough to use my therapy and treatment to move forward. So this leads to treatment strategies. Well, let's face it, at the time, I had been in treatment for 33 years. And my new therapist focused on using my skills to deal with real life issues that would support me in the real world. And this, this was so miraculous. Treatment became a means and not an end. And so tentatively and with some reluctance, I began to successfully deal with my symptoms. I gave up cutting, which I think is the hardest thing I have ever had to do. I gradually moved away from anorexia and developed a more stable relationship with food, which is imperfect, but such an improvement. I began to exercise and sleep regularly. You know, I just made progress in all these areas. And that meant I could accept setbacks with less, less shame and self hatred. And it made it easier just to keep on fighting even in the face of the failures, inevitable failures.
Valerie Milburn: You know, what you said about setbacks is really important because I too had so many setbacks. And you said you were able to accept them with less shame and self hatred. And I think that's really important. I mean, acceptance that there are ups and downs on our journeys is key, key for me because it's just true. You also said that it was at this point when you really began to make progress because of all of the wonderful things that had happened. You know, the new psychopharma pharmacologist and new medication and using your skills. So were you able to re. Establish some of the relationships in your life at that point? I know relationships are your lifeblo blood.
Helen Sneed: It was. Well, I guess simply put, my people returned me to the world. You know, the friends and, and, and family members and caregivers and treatment people and whatever. You know, the person at the drugstore who was like laughed at my jokes. I mean it just to be back out in the world. The only reason I got there is because of, of, of the people in my life. And so I have always said that I need people and structure really on a daily basis. And I began to put the structure in place. I had the relationships and then I got a job when I was ready to work again. And these were. But again it was all. It's, it's, it's all about. I just think it's all, it's all it comes down to people and relationships. That, that is the key to healthy living, in my opinion. So then this is sort of embarrassing, but there are, you know, something I always liked in life that I thought I would never get again was achievement and recognition. And as I got better, I wrote a play that was produced off Broadway. And to my surprise, it was a great success. And since then has been published and has had productions across the country. And back then I also began public speaking on behalf of the mentally ill and was very well received. You see, I learned that my long ugly story had value to others. And these accomplishments gave me a sense of my old self, a person I had thought was dead.
Valerie Milburn: It's so wonderful that your old self returned because you have so many talents that allow you to serve others. Your entertainment through your play, the information and hope you share through your public speaking. I mean these are amazing gifts you have to share. And they reemerged in your recovery, thank goodness.
Helen Sneed: Yes, they really did.
Valerie Milburn: Yeah. And so having all of this come back to you, what, what were some of the benefits of being able to use these talents again?
Helen Sneed: Well, I think that, you know, just sort of at the most basic level because it was through volunteer work and in, in relationships, there was a mutuality that returned, that made me feel a real sense, a genuine sense of purpose and worth. You know, it's about giving back. You know, it's, you know, it's give and take, give and take, give and take. And I just hadn't given anything or made a contribution in so long. And I think that it. To be able to use yourself to the best of your abilities is maybe the greatest blessing that a person can have in life. And I'm trying to do that. I don't always succeed, but I'm trying to do it. And it just makes for
Helen Sneed: a more fulfilling life. And that's what I seem to. The. This great reward that I seem to have gotten. And finally, one of the greatest keys to my overcoming depression has been finding the ability and strength to take action. I was paralyzed for so long, and I just. There's a DBT skill and. Valerie, is it called opposite action?
Valerie Milburn: Yes, opposite action.
Helen Sneed: I'm so glad. I'm just going to say very briefly this. If you are at home, someone calls and asks you to meet them for coffee, you don't want to go, you're not dressed. I would not want to go. I was not dressed. I felt repulsive. I didn't want to be seen. I didn't want to go out. And you know what you are taught, Take the opposite action and go. And, you know, I started being able to get myself to do that, you know, not all the time. And you know what? It works. It work. It works. Almost every time you do feel better, I felt better. So anyway, so that's, that's, that's what, what, what helped me tremendously. And so today. How to describe today? I've been living in recovery for 10 years again. First time I haven't been depressed in my whole life. It's really quite wonderful. I have the skills now to pull myself out of the abyss when I feel myself falling back into it. You know, it's this odd thing of I know what to do and, you know, I pull myself back into the moment. I say, don't look back. The past will kill you, because it will. And I. I'm able to get myself back into the present, which is where I kind of have to live. But the pandemic was a big trigger and it took me by the lapels and slammed me against a wall. I just didn't see it coming. And the depression returned and I was out of control for weeks. And this just panic because I just hadn't felt this way in so long. But I had the inner resources and the, the mechanisms inside and the support from others to fight for my life and health. And, you know, I won. Valerie, you won. People that helped Me?
Valerie Milburn: Yeah. We both had that same experience, and we helped each other through that. Helen, can you share a snapshot of what your life looks like today? I mean, you gave us the overview just now of how incredible this last 10 years in recovery has been. So what does it look like?
Helen Sneed: Well, first of all, I'm glad that you. I can't share a snapshot of what the top of my desk looks like today as I sit here, because it is pretty scary. But generally speaking, relationships, as I said I would start with that mean everything. And it's, you know, that's therapeutic and personal and social and community and whatever. People remain the most important thing in the world to me. And given the quality and endurance of my friendships old and new, my proudest achievement in my life. Now, medication I accept. I take a ton of medication, and I accept the fact that I will be on it the rest of my life. My brain needs it, and the side effects are just part of the bargain. I'm extremely grateful that it works. Then there are healthy habits which I did not have, you know, and that's, you know, exercise, sleep, diet, all these things, you know, inappropriate measure. And then the eating disorder is the most difficult symptom to manage. I have not cut one time in a day in a decade, which is, you know, just, again, miraculous.
Valerie Milburn: That's phenomenal.
Helen Sneed: Yeah. But I get the eating disorder under control sometimes for years, and then it slips back. So I'm just, you know, just have to keep fighting the good fight. I keep a journal, which I have all this time since 1981, and. And I do it now, still every day, and I recommend it to anybody. And then there's something that I had to. I had to find something that, you know, they call it self soothing. And that's where, you know, what I used to use. Cutting and acting out with food and all these horrible things. And so what I have learned is that when the world overwhelms me, which of course it does at times, I can soothe myself by the simple act of reading in bed. And I have to say here that the National Institute of Health has done a study and shows that reading has been found to reduce feelings of isolation in individuals with mental health issues by up to 40%. So y' all go get a book, I believe. Or a library card. Or a library card, yes. Now, creative work, except for the relationships in my life, this is the most important thing in. In. In my world, in me, actually. And so I am writing again. See, I had thought that recovery meant the end of
Helen Sneed: my creative life, you know, some kind of terrible trade off. You know, you don't suffer anymore, but you don't really have very good ideas anymore. Whatever. But instead I've learned that I can produce work of the same quality without being driven by mania and desperation. And I would never have believed this. And finally, this podcast, creating mental Health, Hope and recovery with you, Valerie, my great friend and collaborator, has provided an even bigger vehicle for giving back for the meaningful life. Knowing nothing about podcasting, we did take a giant risk that has paid off in ways we couldn't have foreseen because we didn't know what we were doing. And we are reaching more people than we ever dreamed of all around the world. I mean, it's fabulous. And we are able to help our peers, those who are fighting bravely for a life in recovery, just like we are now. Is this the life I dreamed of? No. It's different in so many ways. But I am heartened by the words of Rachel Marie Martin. She said, sometimes you have to let go of the picture of what you thought it would be like and learn to find joy in the story you are actually living. Well, this is the story I'm living and it is rich indeed.
Valerie Milburn: It is. It is rich indeed. And thank you for sharing that story. Your journey. Like I said, you're a fighter and I love to hear about the types of treatment and the strategies you use because it's such practical information to share with our listeners. Because it took a lot and you used a lot and you searched and you tried and you conquered. And it's a story of inspiration to, you know, like you said, a lot of patients, trial and error that we don't give up. It takes, takes grit. And that was what I started with that grit. So we've talked about treatment, we've shared our stories and I think it's a great time to talk about where we're headed in the future. And a lot of these cutting edge treatments aren't in the future, they're now. What is happening is so exciting because what we're going to. What I really want to talk about, just kick this off, is the gigantic achievements we have. What we have achieved in treatment. I can sum up by saying that we have gone from treating depression with a frontal lobotomy, which was literally putting an ice pick in a person's brain as recently as the 1950s, to being able now through a non invasive, painless procedure, to achieve remission from treatment resistant major depressive disorder. So from the 50s to now, we have gone from a Frontal lobotomy to, as you're going to hear, non invasive painless procedures achieving remission from treatment resistant major depressive disorder. So I want to start with the fact that there are psychedelics currently being used for treatment in depression. And that's new and cutting edge and different. Though only one is, only one of these is approved right now for use by the fda. The other two are in clinical trials. The one that is approved by the FDA was approved in 2019 and it is ketamine. Ketamine is derived from PCP or angel dust. And ketamine has been used in hospitals and veterinary clinics for years as an anesthetic and it was also cited as a drug of misuse under the term Special K. Now people may be familiar with it once I put it in those terms. So ketamine recently, as I said, since 2019, has been used widely for treatment resistant depression that I just mentioned. So relief from this treatment resistant depression with ketamine happens rapidly instead of waiting for a traditional antidepressant to hopefully provide relief. People with treatment from, with ketamine can get benefits in about 40 minutes and can also stay stable in stable remission for up to 16 weeks.
Helen Sneed: This doesn't seem possible.
Valerie Milburn: It's pretty amazing.
Helen Sneed: I believe you, but it doesn't seem possible. It's so, it's so wonderful.
Valerie Milburn: It is, and it's being used very widely and very effectively. And another interesting thing that's very exciting is that in recent trials with ketamine,
Valerie Milburn: recent clinical trials, in fact, this was just released last month, ketamine has been found to be equally, just about as equally effective as electroconvulsive therapy, ECT for treatment of major depressive disorder. And that is pretty amazing because ketamine has the advantages over ECT of not needing anesthesia and has no chance of the loss of short term memory that's often associated with ect. So that's pretty, pretty cool finding. So that's ketamine. Now the other psychedelics such as psilocybin, which is found in a species of mushrooms and mdma, commonly known as ecstasy, have also gained attention in recent years for their potential in treating depression and other mental health conditions. So these, these two are in clinical research studies and they have shown promising results. Now here is some hot off the press research. The FDA released just a couple of weeks ago their first ever draft guidance for researchers looking into these psychedelic treatments and they've included one that has not been included before and that's lysergic acid dithylamilide. And yes, that's lsd. So these guidelines include LSD psilocybin, which again is found in mushrooms, and mdma, which is also known as ecstasy. That's pretty cool. The FDA has given draft guidance for these three psychedelics. So on to other new treatments. And this one, the last one I want to talk about, is called transcranial Magnetic stimulation, also known as, referred to as TMS. The TMS has been in use since 2008, approved by the FDA in 2008. And it is a procedure that uses magnetic fields to stimulate nerve cells in the brain. And it's very simple. It's a electromagnetic coil, is placed against the scalp of patient's head and it delivers a magnetic pulse. It has been shown to be extremely effective for treatment resistant depression. So last thing is so exciting, there's a new type of magnetic brain stimulation, a new type of tms, and it is referred to as saint. It's from the Stanford University School of Medicine and the acronym for it is saint. It has brought about rapid remission to almost 80% of participants in the clinical trial who have severe depression. That's pretty amazing. And in the study, the remission typically occurred within days and lasted months. The only side effects were temporary fatigue and headaches. Now this is what the senior author of the study said. Here's his quote, it could be a game changer. Now here's what I think is extremely, what I think is extraordinary about the study. Okay. In three quarters of the research participants, the T, the SAINT procedure, the new tms, advanced transmitted trans. The advanced tms, they were able to reverse neural activity that was flowing in the opposite direction in participants who were severely depressed. Flowing in the opposite direction than it was with a, quote, normal brain. So it was 80% of these participants who had rapid remission from severe depression. Okay, so they were actually able to reverse neural activity. And it was those patients whose neural activity was reversed who had the rapid remission and only with mild temporary side effects. I mean, I'd say this is incredible progression in the treatment. We've gone from sticking an ice pick in people's brains to reversing neural activity to achieve remission from depression. Anyway, I think that's pretty cool.
Helen Sneed: Well, this is, again, you said this at the, at the beginning that not only are these breakthroughs thrilling, but they are here. And I mean, it's, I don't know how much more time it will be with more clinical trials will be necessary and stuff, but it's, it's, it's, it's just, it's it's thrilling to think of, of what it might do.
Valerie Milburn: It is. I know, I know it's just in clinical trials and I can kind of geek out on it, but there's so much I
Valerie Milburn: didn't include. I mean, Helen was like, valerie, you are geeking out on this. You got to stop, stop researching. I just really got caught up in this in that last one. I mean, it's just so amazing what we've done in the last, really, just the last 10 years. The brain research has exploded.
Helen Sneed: Well, I'm reversing, reversing the, you know, some whatever neural activity in the brain to go in the opposite direction. Don't, I don't understand how they did that. That's why they're called saints, I guess.
Valerie Milburn: Yep.
Helen Sneed: But anyway, I think that this is a sort of like a really positive way to close our two part investigation of depression. I mean, Valerie, what you've uncovered, the, the progress and promise in treating depression are staggering. And it, it makes me very hopeful for those who are fighting today. And we always like to focus on hope. And this is because, Valerie, you and I have found it in abundance through our own lived experience with the disorder. And believe me, I lived for many, many years with no hope of any kind. And so when you get it, you know, it's just makes all the difference in the world. You and I are living proof that depression can be overcome. But let's turn to the eloquent wisdom of writers who suffered and recovered from depression. Now here are some positive words about depression from writers who know. So this first one is from Kay Redfield Jamison, the brilliant woman. She says, love has at its best made the inherent sadness of life bearable and its beauty manifest. If love is not the cure, it certainly can act as a very strong medicine. Okay, so out of depression, this is love. Jenny Lawson said, I've often thought that people with severe depression have developed such a well for experiencing extreme emotion that they must be able to experience extreme joy in a way that normal people also might never understand. That's joy. And finally, from Andrew Solomon, the opposite of depression is not happiness, but vitality. And my life as I write this is vital even when sad. So these people say, coming out of depression, they speak of love, joy and vitality. And now, Valerie, I hope you are going to take us through a mindfulness exercise.
Valerie Milburn: I feel the need, of course, I always do. We will indeed close with our traditional mindfulness exercise. What is mindfulness? I always give a definition. Mindfulness is a mental state achieved by Focusing one's awareness on the present moment while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations without judgment. Helen, you know, when you mentioned a week or so ago the quote about joy that you just read, it got me thinking about a concept I was introduced to recently in Mindful magazine, and that is the concept of non problematic joy. Now, what's meant by non problematic joy is that sometimes finding joy is as simple as noticing what's not wrong. You know, I mean, in the wild swings between pleasant and unpleasant, we often neglect the contentment of the neutral middle. And while these experiences of things, experiences of things that are not problematic might not thrill us, paying attention to them encourages an appreciation and gratitude for all that's still right in the world. So let's try it. Let's get mindful. We will begin, as always, with our diaphragmatic breathing. If you're driving or walking, please adapt this mindfulness exercise in such a way that it works in your current surroundings. If you can find a comfortable seated position, try closing your eyes. If it's safe to do so, we will take two diaphragmatic breaths. I usually take about 10 to start my mindfulness and meditation practice. Let's breathe. Inhale through your nose, expanding an imaginary balloon in your stomach. Exhale through your mouth, pulling your stomach in as you do, all the way in.
Valerie Milburn: Take another inhale through your nose. Expand that imaginary balloon. Exhale through your mouth. Drop your shoulders. Pull your stomach all the way in. Continue with this deep, regular breathing. Now, imagine you are just waking up in the morning. If the sun has already risen, acknowledge that this is the first thing that has gone right for you today. If the sun has not yet risen, acknowledge that you have a sunrise to look forward to. Now, acknowledge one of your senses. Sight, smell, hearing, touch. Another thing is going right. Non problematic joy. Recall getting into your car yesterday. Did the engine start? If you rode your bike yesterday, did your legs perform as expected? More things are going right. Non problematic joy. Did you have the benefit of electricity today? Did you have water? Food? Air? Acknowledge these many things in the neutral middle, going right as shade. Min Kong wrote, knowing you are not entirely at the mercy of agitation can bring some joy. If your eyes are closed, please open them and gently bring yourself back to your surroundings. Thank you for doing this mindfulness exercise with me.
Helen Sneed: Excuse me. Thank you, Valerie. That. That really helped me get in touch with my own joy, literally. And to you, our listeners, we hope you're feeling joyful. We are so happy and grateful that you have been with us today and please pass on the word about our podcast. One of the most effective ways for us to reach more people is when our listeners share our podcast with their friends on their social media sites. It would also be great if you could post a review wherever you access your podcast. And don't forget to visit our new website, mental healthhopeandrecovery.com it's the place to find all our episodes and to send us a message. Now come on you guys, we would love to hear from you. Now for our next episode, we are bringing you something that we just get the most feedback on, positive feedback on. We are bringing you more fascinating and inspiring real life stories of the fight against mental illnesses. Our guests will share their remarkable stories of struggle, hope and recovery. Please join us and meet these extraordinary individuals and hear their amazing triumphs over mental health challenges. Until then, we leave you with our favorite word. Onward.