good evening, I'm psychiatrist Jay Fawver, live from the Bruce Haines studio in Fort Wayne , Indiana.

Welcome to Matters of the Mind now entering its 20th year Matters of the Mind is a live call in program where you have the chance to choose the topic for discussion.

So if you have any questions concerning mental health issues, give me a call in the Fort Wayne area by dialing two six zero (969) 27 two zero and if you're calling coast to coast you made our toll free at 866- (969) 27 two zero.

>> And if you'd like to text me on the air as we're broadcasting, you can text me at two six zero (969) 27 three zero that's 27 three zero for the techs now on a fairly regular basis we're broadcasting live every Monday night from our spectacular Fort Wayne studios which lie in the shadows of the Purdue Fort Wayne campus.

>> And if you'd like to contact me with an email question that I can answer on the air, you may write me a via the Internet at matters of the mind all one word @WFWA.org that's matters of the mind at WFWA.org and I'll start tonight's program with an email I recently received.

>> It reads during a favor I currently take fish oil magnesium and vitamin D for my mental health along with Wellbutrin and Effexor.

Are there any other proven supplements that I could safely take with the rest of my medications to improve my mental health while the supplement you want to avoid would be St.

John's Wort St.

John's Wort as a model I mean oxidase inhibitor it's a plant based antidepressant.

It will interact with Wellbutrin and Effexor so take that one off the table the ones you might want to consider you're on the right track with oarfish.

>> Well vitamin D is probably at the top of the list.

Vitamin D is something many of us should be taking two thousand units every day.

Some people can get by on five thousand units every day with vitamin D you can get a blood level to see if you're at the precise amount you want to be above about 50 on the level for vitamin D fish oil that's been controversial over the course of time.

Omega three fatty acids can be helpful for the mood based on some studies out of Japan looking at women who were pregnant and they had less post-partum depression because they had such a high fish oil intake.

>> Their diet you mentioned magnesium magnesium 200 to 400 milligrams at bedtime can actually improve sleep might help with depression.

>> So you're on the right track with those three looking at other possibilities if you have a mutation for folic acid called methylene tetra hydro folate ductus far far as an enzyme that breaks down folic acid to eliminate the folate about a third of people out there will have a mutation says that they don't break down folic acid very well and folic acid is a B vitamin.

If you don't break folic acid down adequately, you'll have difficulties manufacture serotonin, norepinephrine and dopamine.

So if you have that genetic mutation and the only way you would know is if you got genetic testing elemental folate as a supplementation could be helpful for you.

People have asked about the other B vitamins.

People have gone around and around about vitamin B6 which is Paradoks seem vitamin B 12, vitamin B 12.

If you have a deficiency in it it might be helpful for you older adults people over fifty five years of age inherently don't absorb vitamin B 12 so well so they will take us up lingual supplement or maybe get an injection every now and then if they are low on vitamin B 12.

So a lot of times it comes down to what you might be low on.

Now there are some thoughts the various other supplements might be helpful for people Saffron you might have heard about that.

It's a Middle Eastern herb saffron is something that will enhance serotonin transmission might give you a little bit more side effects with Effexor .

But if you were not taking Effexor saffron as a supplement that some people will will find beneficial for their moods.

Aceh in Acetylcysteine is a supplement that people can take at 600 milligrams twice a day and get benefit.

Oh, it does tend to have some liver detoxification effects but it might actually help with the mood because it can help you put up with stuff better.

So in AC 600 milligrams twice a day as a possibility and that's if you don't have a sulfa allergy because it does have a component of sulfa in it and if you have a sulfa allergy you cannot take in a C C in Acetylcysteine another supplement people sometimes will take especially if you're taking a statin that's a lipid lowering medication.

Statin sometimes will inhibit the benefits of coenzyme Q10 and the active byproduct of Coenzyme Q10 is Ubiquiti all Ubiquiti one hundred milligrams every day especially for older adults can be helpful especially if they're taking a statin.

>> So if you're taking a statin for Laport lowering lipids sometimes that can make you more depressed and give you difficulty mental clarity.

The reason behind that would be because statins can inhibit the benefits of coenzyme Q10 which we all naturally will will have.

But if you can't adequately metabolize coenzyme Q10 as many older adults can't, that's where Ubiquiti all can be helpful at a hundred milligrams a day.

Those are some of the supplements that can be helpful but you're on the right track with that combination of fish oil, vitamin D and magnesium that's that's a really good start in terms of adding something to the effect and Wellbutrin, thank you for your email question.

>> Let's go to our first caller.

>> Hello Jeremy.

Welcome to Matters of Mind.

Jeremy, you had mentioned that you have attention deficit hyperactivity disorder and your wife and you are expecting your first child in July a boy.

>> Congratulations.

What are the odds of that?

He will have ADHD as well and what can you do to make sure he doesn't struggle?

>> Well, number one, if you have ADHD, Jeremy, chances are your IQ is higher than normal.

>> I saw a man earlier today at in my practice who had an IQ of hundred and forty and he had ADHD.

He couldn't figure out why he had such a high IQ when he had ADHD because he couldn't comprehend things so well and it took him longer to get things done.

Well, I said you know, the average IQ is one hundred one hundred and forty IQ for something that ADHD is not uncommon because many people with ADHD will have difficulty with inattentiveness so have distractibility.

They'll have trouble getting things done persevering but they typically will have an IQ 13 to 40 points higher than the average people.

So keep in mind that if your son does have ADHD chances are he can have a higher IQ.

What you want to do is consider various options including being able to tutor him if if the ADHD symptoms are problematic for him.

Many people with ADHD will have difficulty with paying attention when there's a lot people around there's a lot of distractions.

>> So with that in mind, if he can be tutored on a one to one basis, many people with ADHD will do much better in that kind of scenario.

>> And keep in mind, Jeremy, that ADHD is it goes on kind of a spectrum of severity kind of like near-sightedness.

Some people have poor vision to the point where they can't see anything of it once they get out of bed they have to get their eyeglasses on or their corrective lenses on right away.

>> Other people will they don't need corrective lenses unless they're looking at a computer and they need to look at fine print so people with vision will have different spectrum of of a difficulty with their vision.

>> The same with ADHD some people will have ADHD to such point they have a hard time getting through high school.

Other people will have ADHD where it's not highly problematic until they're academically challenged even to the point of getting to grad school.

So the key with ADHD is determined to what degree it's functionally impairing and try to address that.

We're trying not to look at ADHD as is necessarily a psychiatric illness as much as it's just a variance of how people are able to process information now.

But we want to take advantage of that high IQ and that particular unique nuance of process information.

People with ADHD will often often have people with ADHD can blurt things out.

They can have lack of social ticc.

They can be difficult to get along with sometimes because they are often think in three senses ahead of everybody else.

But on the other hand we want to make sure that we're able to address the benefits that they have because the people with ADHD will often think outside the box and there'll be creative.

There'll be entrepreneurs.

Some examples Thomas Edison, Bill Gates been very open about his ADHD over the years .

These are people who are very bright people.

They just needed assistance around them to get things done.

So with your son not a big issue.

ADHD is about 70 to 90 percent genetic.

It's as a medical condition.

It's genetic.

It's genetic propensity is only second to psoriasis.

>> So psoriasis is a skin condition.

ADHD is number two in terms of genetic conditions that are from a medical perspective ADHD is about as genetic as height.

So you know how genetic will often be.

That's kind of where genetic genetically people with ADHD will be.

So with your son yeah.

I just keep watch over him over the course of time if he's struggling in school there are treatments for ADHD of various types and it's not unlike getting treated for poor vision.

>> If you have tooth mal alignment how do you treat that you treat with braces and the braces often will be time limited with some ADHD treatments that will be as well because in school settings people sometimes will have difficulty with ADHD symptoms whereas when they're working individually or they're in a different setting that's new, challenging, exciting they won't have the difficulty with ADHD.

Thanks for your call.

Let's go to our next caller.

Hello Luanne.

Welcome to Matters of Mind Luanne.

You ought to know the similarities and differences between schizoaffective disorder and bipolar disorder.

Schizoaffective disorder lujah is where you have the symptoms of schizophrenia day by day by day.

It's a lifelong condition.

symptoms of schizophrenia could be difficulty with processing information, difficulty picking up social cues.

>> You have trouble with social anxiety.

You'll have trouble on occasion with hearing voices outside of your head inside your head.

>> But the voices are not heard by other people and you can hear and you can have difficulty with delusions which are fixed false beliefs fixed false beliefs being fixed.

You can't talk anybody out of them and they're obviously false.

People with schizophrenia will often have processing of their thoughts such that they can go all over the place with their thought processing itself and they often will have a lot of difficulty with social interactions.

>> So that's schizophrenia.

Schizoaffective disorder is bipolar disorder on top of schizophrenia.

So affective disorder means that you have day to day symptoms of schizophrenia but on top of that you have manic highs that might last for several days where you don't need to sleep.

>> You're impulsive, you have racing thoughts, you have difficulty with doing things and saying things you ordinarily wouldn't do or say.

So those were manic highs and you may have depressive lows where you have deep dark depressions where you don't enjoy things.

You get more depressed and you ordinarily would be you feel fatigued, you can't concentrate and you might have a sense of gloom and doom that ordinarily wouldn't be there.

>> So schizoaffective disorder is schizophrenia day by day by day with periodic highs, periodic lows.

Bipolar disorder just refers to the highs and lows bipolar disorder BI refers to two polar means one extreme or the other.

So bipolar disorder means you'll have the manic highs lasting anywhere between one day and over seven days of the manic highs lasts for over seven days and they're impairing in your day to day life that's called bipolar disorder type one if the manic highs are not so impairing an only lasting four to six days that's bipolar disorder type two Sikelel Thymine will be a few days high, a few days low not highly impairing but it's there that's like lithium and then you can have major depressive disorder with mixed features.

That's where you have at least two weeks of depressive episodes but one day or two days, maybe three days here and there every two , three weeks or so of having little bitty highs.

>> So major depressive disorder is where you have predominantly depressive mood but you'll have these little spectrum of little highs that pop in there every now and then other people notice them, you notice them but they're not highly functionally impairing but they're there so there's different types of bipolar disorder itself.

I hope that helped out.

Thanks for your call.

Let's go to our next caller.

Hello, Joel.

>> Welcome to Matters of Mind.

Joel, you want to know other tests that you can take or sent away for ?

They can tell what medications might be effective at a genetic level.

Joel, I've never met any genetics that I didn't like because I can always find some benefits from some genetics and if genetic testing was free I would do it on every single person I'd see.

>> But you don't want to over promise what the benefits of genetic testing might be, Joel, because genetic testing number one, the benefits can be number one.

It can tell you if you have that methylene tetra hydro folate reduc mutation Jeffard mutation that's the mutation that tells you if you are metabolizing folic acid adequately and if you think of Shefa as an enzyme it's like the turnstile outside of a big stadium.

OK, if you think about the people outside the stadium they're like folic acid.

They're trying to get into the stadium.

Well they got to go through a turnstile that's Ja'far and once they get in there elemental folate.

So forget about twenty five.

Thirty percent of people who don't have adequate EGFR functioning.

Those are the people who need they need the supplementation elemental folate so no one genetic testing can determine who needs elemental folate and who does not.

Secondly, genetic testing you can determine right up front who's going to be at higher risk for a rash from Lamotrigine.

Lamotrigine is also known as Lamictal.

It's an anti seizure medication.

It came out in the nineteen eighties but we've been using a extensively for the purpose of mood stabilization, stress resilience and helps people put up with stuff so elemental LaMotte's gene is something that can cause a rash in about one to four thousand people.

People who are Asian descent have a higher likelihood so one of four thousand people in general have this propensity toward having a rash from limosine.

Genetic testing can see who's more likely to have a rash from llamo to gene and who's not.

So that's another benefit of genetic testing.

A third benefit of genetic testing can tell it can be that you can give you an idea if you need a high dosage or a low dosage on various medications.

>> Now the the misconception about genetic testing, especially with some genetic tests is that genetic testing will convey that if you're not a fast metabolism and if you're not a slow metabolism, you're a just right metabolize or on medication that's the medication is going to work for you.

That's not true at all.

That's just the medication will be dosed at a usual level but doesn't mean the medication is going to work.

So the misconception about genetic testing will be if you are a normal metabolism of medication those medications are going to work for you.

>> That's not true at all because if you're a fast metabolism on a medication it means that that medication can still work for you.

You just need a higher dosage because you're a fast metabolize or other medications.

You might be a slow metabolism so you just need a higher dosage or a lower dosage on those because if you're a slow metabolism it's going to hang around for a longer period of time.

So low dose for a low metabolism or a higher dosage for a fast metabolism that's kind of how it's all going to work out so that those are called pharmacokinetic genetics.

There are some pharmacodynamic genetics that can be predictive for medications going to work for a particular condition.

There's a SLC six a four gene that's going to tell us who's going to be probably a better responder to the serotonin reuptake inhibitors such as Prozac, Lexapro, Celexa, Zoloft, Luvox, Paxil.

>> These are medications they're mainly affecting serotonin.

>> They're very commonly used but about one out of three people are going to do well with them.

Two out of three people are not.

The genetic testing can tell us predictably who's not going to do well with those medications .

>> There's a chemical methyl transferee Gene C20 gene that comes across as either Val, Val Val matter about met the people who are met met on CMT often don't do well on higher doses of dopaminergic medications like Wellbutrin and stimulants they might lower dosage because they're going to be really amped up if they take a usual or a higher dosage of Wellbutrin or the stimulant.

So that's somewhat of a predictor that something will often examined.

So you can look at some the nuances from afar pharmacodynamic standpoint but the number one reason we'd want to do genetic testing would be looking at C to see who needs L methyl folate number two would be who's likely to get a rash on Lamotrigine we choose that medication.

Number three, it's going to help us dose the medications right out the gates high or low but quite frankly, if somebody is taking a medication and they're having a whole bunch of side effects, what are we going to do?

We're going to decrease the dosage so we kind of indirectly figure out who's going to be a slow metabolism by doing that.

And finally there's some genetics that can give us a little bit of an indication on determining which type of medication we might use.

But those those genetics are often far and few between we're not going to use them so much.

>> Thanks for your call.

Let's go to our next caller.

Hello, Tom from Columbia City.

Tom, you want to know for a friend can therapy help with dementia to some degree?

>> Tom, therapy can be helpful for dementia in terms of helping mainly with the family because the family needs to be reminded when they're in the presence of their loved one with dementia.

They need to have a reminiscing interaction with them.

>> Don't get too upset with them if they can't process information.

People with dementia typically will have very good short term memory.

>> They'll remember what they might have had for lunch an hour or two ago but they'll but they'll eventually start to have trouble with things that happened a day or two ago so they'll have immediate recall that's not too bad.

But the short term memory from a few hours ago a few a few days ago might start to get worse and worse.

However, the last thing to go for people with dementia will be things that happened 20 and 30 years ago.

So reminiscing with somebody with dementia can be very, very helpful and that's why I'll often recommend that if you have a loved one with dementia you keep family photographs around to help them stimulate different memories from the past and interactions always introduce yourself when you come in the room, point out to them what it is, what day of the week it is.

Have a big clock on the wall.

Try to get them into that circadian rhythm where they realize whether it's morning, afternoon or evening.

So the therapy that's done with some of the dementia will often be for the purpose of helping them reminisce and try to stimulate those memories.

When people have dementia we try to maintain socialization and sometimes some types of purposeful meaningful activity on a day to day basis.

So purposeful meaningful activity means they need to do stuff.

>> The last thing you want to do is somebody with dementia is to change their environment from place to place often difficult to do because if somebody's dementia goes into a hospital setting it could be extremely anxiety provoking for them.

When somebody has dementia you want to keep a very consistent environment.

>> The floor plan needs to be the same.

Hopefully the housing needs to be same, the same but sometimes they do need to go into supportive housing or assisted living at the least.

But you want to try to keep some routine in their day the best you can and make it very predictable.

So they need to have very structured lifestyle, something they're going to do on a day to day basis which is not going to be unpredictable for them.

So yeah, most the therapy for somebody at dementia will be with the family members and the caregivers around them.

>> Thanks for your call.

Let's go to our next e-mail question.

Our next e-mail question regenerative offer is Misophonia a psychiatric condition?

>> Misophonia is where you will have a lot of anxiety and difficulty with humans.

Sounds chewing sniffing You go into a quiet movie theater and you hear people chomping on their popcorn or they're on their sodas that will cause a lot of anxiety with people with Misophonia.

So what's going on with Misophonia?

Will Misophonia look at the brain here?

>> The deep dark the deep parts of the brain give you what's called the default network.

A default network is kind of the network that's in the background of your head when you're not really thinking about a whole lot.

You're driving down the interstate.

Yeah, you're paying attention to the traffic but you're kind of off in your own world.

Some people call that highway hypnosis.

It's simply your default network kicking your default network is always kind of ruminate is kind of always in the past it's generating in the it's always generating in the background where it's important for biographical information and just kind of remembering things from the past.

So it's kind of always lingering in the background.

The default network kicks in to the executive functioning network which is the south side part of the brain that's called the the Executive Mode Network.

The Executive Mode Network is the network of your brain that you use when you're thinking very, very intently on something you're not distracted.

You're trying to figure out something you're calculating something you're strategizing that's where you're really trying to pay attention.

The problem with Misophonia will be a couple different things number one, your default mode network kicks in to paying attention overly so by basically shifting the gear into your Salyut network.

>> You're saying network is basically your gear shift that takes you from the default network up to the executive functioning network.

So when you have Misophonia you're actually thinking about these other people who are choosing and making these sounds.

You're focusing too much on the on the sounds of these other people and most of us don't notice it if we do.

It's not bothersome for us because it's kind of in the background overall.

>> So part of the problem is you might have an overactive salian network that's kind of kicking in in an exaggerated manner.

A second part of Misophonia is this little part of the brain called the insula.

The insula is in the it's the thumb part of the brain over here, the temporal lobe that's the front part of the brain insula is right back here.

The thumb part of the brain, the insula is thought to be overly overly active as well and that's the part of the brain that's basically making you aware of what's going on with yourself and other people.

So it's thought to be a little bit overactive itself.

So is it a psychiatric condition?

I don't think so.

It will cause anxiety.

Misophonia will cause anxiety.

But I think it's more of a neurological condition where your brain is a bit overactive than it would ordinarily be.

We used to think it was an ear, nose and throat condition.

I don't think so.

I don't think it has anything to do structurally with the ear.

>> I think it's more of a neurological condition where certain parts of your brain networks are overactive when they shouldn't and the treatments right now we don't know we don't know about any specific treatments but it's getting more and more discussed.

>> Misophonia is something you're going to be hearing about more and more as time goes on.

>> Thanks for your call.

Let's go our next caller.

Hello Bob.

Welcome to Matters of Mind, Bob.

Whatever you want to know, if I were put people on a metha later I take that's I take it that's a menthol inhaler.

No, I don't use that as treatment.

Some people will find that aroma therapy such as lavender ,they'll have all sorts of different aromas they might try that can give people a relaxing effect from a psychiatric standpoint.

There's not a lot of research on that.

I treat people myself with depression, anxiety, ADHD, various conditions that are causing me to have a lot of functional impairment.

>> I probably wouldn't use a mentholatum or its aroma therapy for those people because we have medications that can be very effective for them cause different types of psychotherapy can be effective for specific indicator as well.

Somebody asked me just this last week if I would use detoxification techniques such as laxatives to help people with mental health issues and I didn't get a thorough ability to respond to that question.

But no, usually detoxification is something that might be done from a gastrointestinal standpoint.

But with detoxification you can get yourself into trouble with interfering with the natural flora of the bacteria of the gut.

So if you simply use a lot of toxic ducks' faders and lose detoxification that can cause you to have diarrhea and that can cause she to have disturbances of the flora, the gut and that can cause you to have a lot of other problems itself.

So you have to be careful about the cause and effect about different things.

I was also asked recently about the use of heavy metal extractors will keep in mind that magnesium calcium, zinc these are heavy metals as well so you don't want to extract those from the body so you have to be careful about using format full body extractors and it sounds like Eric, you have a question about body detoxification for anxiety.

I would not recommend that because with body full body detoxification you have to be careful about the potential side effects with that again, if you use means of of having a laxative effect and trying to get rid of theoretical toxins from the body, you can get rid of a lot of good bacteria from the gut as well and they can get you into trouble.

So Eric, I hope that helped out on force.

I'm out of time for this evening.

If you have any questions that I can answer on the air, you may write me via the Internet at matters of the mind all one word @WFWA.org.

I'm psychiatrist Jay Fawver and you've been watching matters of mine on PBS Fort Wayne and God willing and PBS willing I'll be back again next week.

>> Thanks for watching.

Goodnight