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 28th year Matters the Mind is a live calling 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 260-969-2720, or if you're calling any place coast to coast, you may dial (866)969-2720.

Now, during this broadcast, if you'd like to text me with a question while I'm on the air, you may text me at (260)969-2730, and we'll see if I can get your text real right away when we see it on a fairly regular basis.

We are broadcasting live every Monday night from our spectacular PBS 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 mattersofthemind - all one word - @wfwa.org.

That's mattersof themind@wfwa.org.

And I'll start tonight's program with a question I recently received.

It reads due to the father I look forward to warmer weather and sunshine.

However, both usually include more loud outside noises.

How can I cope with excessive noise and get back to living a peaceful life?

I use noise canceling headphones, a white noise machine, etc.

to help reduce stress but still feel nervous.

You're doing all the right things.

What you're doing is trying to block out some of the outside noise.

Keep it in mind that you can't block it all out.

So what can you do?

Well, basically to do deep breathing exercises, try to expose yourself to the loud noise in a more relaxing type of of manner.

So if you can tolerate the loud noise with less and less anxiety over the course of time, you can kind of get used to it.

We call it a kind of, having a diminishing of the symptoms themselves.

But if you can expose yourself to that loud noise and be more relaxed as time goes on, that will often help.

But you're doing the right things.

You try to do the best you can to mitigate the loud noise.

Overall, thanks for your call.

Let's go to our next caller.

Our next caller reads due to father is from Aaron.

Aaron, you had asked why can people with ADHD focus on things like video games and not schoolwork?

Attention deficit hyperactivity disorder is a term where I don't like the name, because people can pay attention with ADHD and Add just fine if they're challenging, interesting, exciting, or new.

So when people have attention deficit disorder, it's not that they have attention problems, it's the difficulty in the direction in which they focus their attention.

And there's two very important parts of the brain that are involved with ADHD and A.D.D.

the anterior dorsal singlet gyrus, which is right here, the front part of the brain here, the anterior being in the front, dorsal being on the top side, cingulate gyrus being this little gyrus that goes around here.

That's one part of the brain.

Another part of the brain is over here.

It's called the, insula.

The anterior insula.

Those two parts of the brain very specifically will allow you to slap your face and focus on something.

It's important upon which to focus.

So, in other words, is kind of a way of jarring you out of this default mode network, which is kind of a background network where you're just thinking about different things and not focusing on anything.

You're kind of daydreaming, people who have ruminative conditions will often get stuck in the default mode network, and they just kind of go over autobiographical type of things over and over and over again.

The salience network is where that they were slapped in the face by their brain and told to focus on something to get them into the executive mode network.

So think about the salience mode network as being like a gear shift.

It's taking you out of first gear into second or third gear, so you can more efficiently drive your brain to where it needs to go.

So the problem with attention deficit Hyperactivity disorder and ADHD, attention deficit disorder will be your salience network is not working so well.

That's where the stimulant medications can be, particularly effective.

The stimulant medications for some of the A.D.D.

are not just giving them more energy.

They're actually firing up those two very specific parts of the brain that you need to be able to focus your attention in a particular manner that, warrants that attention.

Now, I mentioned, I think a week or two ago, this condition called misophonia.

Misophonia is a condition where people will be extremely annoyed by hearing people chewing, breathing.

They're annoyed by human noises and again, their network is disrupted in that case, because it's overactive.

Lee.

It's focusing their own attention on these human noises.

Now, most people, when they hear human noises, they they hear it and it just it's no big deal.

It's like a puff of smoke.

But other people will really get tuned in and actually get anxious when they hear human noises.

And it's due due to the salience network abnormality causing the hype to hyper focus on the human noises.

People with A.D.D.

can focus on things that are new, exciting, interesting, and challenging, but they can't focus on things that are more mundane or boring.

That's why a lot of people with attention Deficit disorder will do better if they have 1 to 1 tutoring versus being in a public school environment.

When they're in a classroom with 30 other kids, they have a different learning techniques.

Many people with attention deficit disorder will find that it's easier for them to learn while they're moving around.

It's called kinesthetic learning, where as they're moving around and doing things, they can learn things better.

And that's why with some people, they'll actually listen to lectures while they're on a treadmill or on an elliptical, because as they're moving around, they can comprehend information more efficiently.

Thanks for your call.

Let's go to next caller.

Hello, Jack, welcome to of Mind.

Jack, you had mentioned you take busbar ten milligrams, presumably daily for anxiety, and you'd like to know if there's a higher dosage check the usual dosage abuse in abuse bar will be about 10 to 30mg twice a day.

Twice a day.

Dosing is usually ideal.

There is no long acting or slow release.

Busbar Busbar.

As you spiral is a medication that very selectively and specifically will alter one particular of, serotonin receptors.

There's 14 different serotonin receptors.

Busbar or B spiral will go to the particular serotonin receptor called one AA.

And it will act like a dimmer switch where it can dim down serotonin one AA receptors or take the volume up, but in doing so is particularly good for ruminative anxiety.

Worry is a more common name for that.

We call it generalized anxiety.

When you think about different things that might happen and you ruminate on them and you're thinking, what if, what if, what if?

Now Blue Spiral is very good for a lot of people who specifically do have that kind of what if type of thinking, where it's out of control.

Now, a lot of college students will find the boost bar can be helpful for them because it won't dull their concentration like Xanax out of an Klonopin.

Valium will, and those medications have been used decades ago for anxiety.

Busbar will at the most give you some dizziness.

It won't cause you to feel drowsy, but dizziness double vision early in the course of treatment can be a problem with busbar.

Occasionally, some people need to start with five milligrams twice a day, but they often go up to ten milligrams twice a day.

30mg twice a day is usual maximum effective dosage for busbar, but it's fairly well tolerated.

It's very specific and very selective in what it does.

So, if it's something in which is being used for worry about the future and ruminating and, thinking about what if, what if, what if that can be something it can be helpful for that.

Thanks for your call.

Let's go to our next caller.

Hello, Bailey.

You have a message for me.

Bailey, you had asked, about quitting vaping, and you recently quit vaping and made your anxiety even worse.

Are vapes from gas stations not regulated?

How does nicotine affect your brain?

Vaping is comes in various forms.

Bailey.

Vaping does come in a form of nicotine.

And, if you, quit vaping, basically you're going to go into nicotine withdrawal.

It's a different type of delivery product compared to smoking cigarets.

But nicotine is nicotine.

Nicotine can be addictive on the brain.

And very specifically, what affect this little part of the brain called the nucleus accumbens.

The nucleus accumbens is right smack in the middle and down here in the brain.

When you use nicotine, it will fire out.

It'll push out more dopamine, and in doing so, it can make you feel more alert, more energetic, and actually give you a muscle relaxant effect.

So many people will get a positive effect, especially when they first start using nicotine cigarets or maybe nicotine vaping.

In the long run, that nicotine is something in which you grow dependent.

It used to be thought that adolescents who started smoking were more likely later on to get depressed because they were already depressed, and that's why they started smoking cigarets.

Now it's been realized that adolescents who start smoking will often create an environment in their brain where it causes them to be depressed.

So they actually the nicotine in an adolescent brain will cause them at a later date to be depressed.

It wasn't that they wanted to be depressed anyway.

So with that being said, if you stop vaping, yeah, you'll get more anxious and you're going to get some nicotine withdrawal.

Usually over the course of ten days to even 30 days.

And some people have prolonged withdrawal from nicotine depending on the dose they used and depending on how long they used it.

But nicotine withdrawal can occur with vaping as well.

There are there is the ability to vape other products.

But I think you're referring to vaping nicotine, getting it out of the gas stations.

At least here in Indiana.

Thanks for your call.

Let's go.

Next caller.

Hello, Helen.

Welcome to Marriage of Mind.

Helen, you had heard that, marijuana smoking kills brain cells before the age of 24.

Can you get those brain cells back?

What the hell?

What?

The marijuana smoking Helen does.

It doesn't necessarily kill the brain cells themselves.

What?

It does, it suppresses the growth of the insulation around the nerve cells.

Now, is that a big deal?

Yeah, it is, because imagine having your wiring in your house not insulated.

Okay.

You're gonna have more fires.

So all your wiring, your electrical wiring in your house, it needs to have insulation all around it.

And if it doesn't, then the electricity can be aberrant and cause you to have fires, and it just won't be properly directed to where you need to go.

That's what happens in your brain when the brain's not properly insulated.

It can't use the electrical energy and direct it, and that's in the place it needs to go.

So if you use marijuana prior to the age of 24 years old, when the front part of the brain is still growing, you can suppress the white matter growth of the brain.

Are there ways in 2026, in which we can reverse that very quickly?

Not to my awareness.

Now ask me, in five years from now, Helen, God willing, if I'm still practicing it around, you know, I might be able to give you some ideas on some ways that you can grow back that white matter that you might have, suppressed part of the day prior to the age of 24, but prior to the age of 24 years old, your brain is still growing.

That's why I'm often vigilant in asking young adults if they're using marijuana, why they're using marijuana.

And I'm trying to help them understand that before the age of 24 especially, it's very, very dangerous on the brain.

And I wish there were more public service announcements about that.

We saw this horrible tragedy out in, Colorado occurring over the past 12, 14 years where Colorado made marijuana recreationally legal.

And now Colorado has a horrific mental health crisis with adolescents and young adults because many of them, even though it wasn't legalized until maybe the until they're 18 or I'm 21 or whatever the legalized age was, a lot of adolescents got a hold of marijuana more readily because it was recreationally legalized in Colorado, and because of that, the mental health crisis in Colorado is really problematic at this point.

And I think we're going to hear that happen with other states that have recreationally, recreationally legalized marijuana, the young adults, the adolescents need to be aware that unlike alcohol, okay, alcohol is damaging and damaging in its own way.

Alcohol is directly neurotoxic to the neurons directly in the hippocampus over here, the memory center of the brain.

But marijuana is specifically detrimental to the ability for the front part of the brain to process information.

And in doing so, it can cause you to have trouble with that decision making, attention span focus.

And it actually can drop your IQ points with an unintended consequence.

It can drop your IQ points, significantly.

Even going into the adult years, it was thought previously that only young adults and adolescents who use marijuana were the ones going to have problems with the concentration and intellect, but it was now realize that just in the past couple of years, even people who started smoking marijuana on a regular basis in their 30s were also likely to have difficulty with concentration and focus.

So can you grow it back?

Can you reverse the process?

Probably not.

From what we know in 2026.

But their day may come where we have means by which we can find ways to reverse the the damage that marijuana did.

But you don't want to rely on that for the time being.

Let's go to our next email question.

Our next email question reads, Dear Dr.

Fawver, is there any connection between gabapentin and weight gain?

Gabapentin is also known as neurons, and it came out at about 1985, something like that for us.

And now we use gabapentin extensively for pain, for sleep and for anxiety for many people, gabapentin can cause weight gain, but it's not from causing fat or adipose tissue to grow.

It's basically from water retention.

So if you have weight gain from gabapentin, you might want to be one of those few people who have water retention.

You see it in the ankles to get ankles a little bit puffy, but generally it does not cause adipose tissues and it doesn't cause weight, waist circumference, fat like we see with some other medications.

So gabapentin weight gain is related to a little bit of fluid retention.

Doesn't happen with everybody happens with some people.

And for some people we have to take them off gabapentin for that reason.

But it's typically dose related.

The higher the doses you take, the like more likelihood you're going to have the weight of the fluid retention from gabapentin.

Thank you for your call.

Let's go to next caller.

Hello, John.

Welcome to Matters of the Mind.

John, you want to know if fidget toys are helpful for kids or even adults?

Fidget toys can be helpful, especially if you're a kinesthetic learner in which I referred earlier.

You don't have to have attention deficit disorder to be a kinesthetic learner, but if you're a kinesthetic learner where you need to be moving around to be able to download information in your brain, fidget toys can be helpful for you.

So fidget toys are where you just have little toys in your hands.

Many people with ADHD will use these as a means of having some motor movement while they're thinking.

So again, that's called kind of kinesthetic learning.

We're having that motor movement.

It can be very helpful.

Back in the old days, you'd have kids clicking their pins, off and on, off and on.

And that was very annoying to people around them.

So the nice thing about the fidget toys, they're not annoying to people around them, and we don't using pins that much anymore, thank goodness.

So, the fidget toys can be helpful for a lot of kids if they're more kinesthetic learners.

Thanks for your email.

Let's go to next caller.

Our next caller.

Is from Jim.

And Jim's asking, what is cognitive dissonance and how does it affect the brain?

Cognitive dissonance.

Dissonance is basically where you have set values, set perspective as a set perspective of the world around you based on experience.

And based on life experiences especially.

And it's where you have a set of values that have that have been ingrained in your brain for a long, long time.

And it's specifically in this area of the brain called the ventral cingulate gyrus.

The vent is the ventral singular gyrus is right in here.

It's the lower part of the singular cingulate gyrus.

On the front side.

There.

But the ventral singular gyrus is the part of the brain where you've established values and meaning in your whole identity.

This is where you've determined who you are based on your life experiences.

You have an identity.

That way, when you hear information that confirms your underlying beliefs, that part of the brain gets activated.

And that kind of validates why you believe what you do.

If you hear information objectively, even though it might be entirely true.

But it is not jive with your underlying beliefs based on your values and your identity.

You can get very anxious because it doesn't match up with what you've come to believe over the course of time.

So cognitive dissonance is where you have values, identity.

You have, a particular way of looking at the world around you from a perspective that might be very individualistic to you.

When that gets challenged with objective information that doesn't match up with your values, you can get very anxious and very angry, even though it might objectively be true.

So cognitive dissonance exists, and this is where you get kind of set into those values.

Well, that's on the ventral anterior cingulate gyrus.

There's a dorsal anterior cingulate gyrus just above that.

The dorsal aspect of the single gyrus is where you're assessing your values with the values of people around you.

So you can be influenced by your peers, your colleagues and people.

That too, with whom you want to have respect.

So if you have a social network that perceives the world in a certain way, you're more likely to have your values aligned with theirs.

And, that's also, a means of socially networking.

And it's a really a means of coping, even from a, over the course of several generations, people have learned to kind of to integrate with the values of the people around them for social acceptance.

So one of the ways you can gain social acceptance is by aligning with the values of people in your social network.

If you disagree too much with those values, sometimes that can cause not only anxiety for you, but you might even be isolated and shunned by your social network.

So those two parts, those two gyri of the brain, they are layer right on top of each other.

The bottom layer is where you have these ingrained values of who you are, what you want to be, your perspective on the world around you.

Right above that is the social network values that you have to kind of balance out, and how much you can align with all of those.

So cognitive dissonance is where you're aligned with your values as you see the world around you.

And you can get anxious when you're challenged by those values, especially if the challenges appear to be very objective and, and appear to be the truth.

Thank you for your email.

Let's go to our next text message.

It's from Kandi and Huntington concerning Lyrica 100mg of Lyrica, also known as pregabalin, dangerous to take twice a day.

And so what organs?

If you take it for nerve pain down your leg, left leg, sciatica nerve pain, can be affected.

Lyrica and gabapentin are metabolized by the kidneys, but they don't get, they don't cause kidney damage.

So Lyrica pregabalin does not cause damage to any organs.

100mg twice a day is kind of a medium dosage.

People on Lyrica go up to 285mg twice a day.

Not uncommonly so.

You're at about half the usual dosage.

Many people will take Lyrica twice a day dosing.

Gabapentin is often three times a day dosing their chemical cousins.

Gabapentin is also known as Naughton Pregabalin is also known as Lyrica.

They work in different ways on the calcium channel, the calcium channel.

The nerves are basically the trigger finger.

So the nerves have a trigger finger.

And it's thought that when you have sciatica, we've got that disc pushing against the sciatic nerve.

It causes the nerve to fire off so much that it's causing you so much pain.

Well, Lyrica and pregabalin can decrease the firing of that nerve by suppressing the frequency of the trigger finger itself, the trigger finger being the calcium channel.

So lyric and pregabalin are very useful in doing that.

But, they are metabolized by the kidneys, not so much by the liver.

So if you have moderate to severe renal problems, kidney problems, that's where you're going to have trouble with something like Lyrica or Gabapentin.

But by themselves, they don't seem to cause kidney damage or any other damage.

Overall.

Where are you going to have trouble with Lyrica would be if you have to take an opiate or narcotic with it.

So let's say the pain in your nerves get to the point where it becomes unbearable and you have to take a narcotic.

You probably want don't want to take a narcotic with Lyrica because Lyrica will amplify the effect of the narcotic.

Not in a good way.

So you can get a higher potency of the narcotic by taking Lyrica or gabapentin.

Kind of like what we have heard in the past with benzodiazepines.

If you take Xanax out of an Klonopin Valium, those can also amplify detrimentally the effect of a narcotic.

Lyrica and gabapentin can do so only to a lesser degree.

Say be very careful and take in a medication like Lyrica, with a medication like a narcotic or an opiate.

Thank you for your call.

Let's go.

Our next email question.

Our next email question reads data.

Dear Dr.

Fawver, I do not like to fly and haven't flown in many years.

I've read that Xanax can help, so my doctor prescribed me for of the point five milligram tablets for a two hour, a round trip flight several days apart.

Can can you offer any insight into if this can help me and how I will feel when taking it.

I, too, will prescribe Xanax alprazolam specifically for people to get on the airplane fuselage.

And that's the key.

When you get on an airplane, you're helpless.

I mean, you're inside this big metal tube.

It's called a fuselage.

And you, you have to get on that plane now all but definitely prescribe a lot of people.

Xanax point five milligrams.

So that's a good dosage.

Take it in the boarding area.

When they hear their flight called, that's when they pop it.

If when you get on the plane, you'll start to notice a kick in, typically in about 20 minutes.

And then you get out on the runway.

The most anxiety provoking part of of flight usually will be takeoff and landing, because you're going through the clouds and you're getting more turbulence.

And with turbulence, it's it's most dangerous when you're taking off and landing, and that's when you people are going to notice you're not going to have that much anxiety once you're in the air at, several thousand feet.

So the key will be to calm you down some get on a plane, don't drink any alcohol, obviously, but just get on a plane and chill out.

If you take a little nap, like on the plane, that's okay.

Point five milligrams of Xanax should not knock you out.

So it shouldn't be that you're going to be wiped out when you are, on the plane itself.

And if you take a Xanax before you get on a flight, yeah, it's going to last you about 4 to 5 hours.

So a two hour flight would be fine.

You could take that before you go out, to your destination.

And upon returning, there would be two tablets right there.

We'll use Xanax exactly for that purpose.

And the more you fly, the easier is going to get.

The best way to overcome any phobia is to keep exposing yourself to that phobia again and again and again.

And flying is no different.

I mean, not uncommon when people first fly.

You can always talk to the airline attendant if the airline attendant has the time to talk to you about things.

But people sometimes get, anxious about the turbulence.

They get anxious when they hear the wheels.

Roll up and they think the plane's falling apart.

Flying is very, very safe in 2026.

So it's something that, it's something you have to kind of adapt to, being able to fly and to be able to use that type of transportation.

But it's very efficient and it's very safe overall.

But the key is you need to start doing it.

And the best way to start doing it is to get on the plane again and again and again.

Thanks for your call.

Let's go to that last email question.

Our last email question is due to the father I have recently been prescribed appropriate for depression, and what's the best way for me to monitor my progress?

What are the signs that the medications are working or not working?

The best way to monitor, if appropriate appropriate is working for you.

Would be to try to gauge your main goals.

Why are you using it?

What symptoms of depression are most problematic for you?

Many people will use the appropriate to help them concentrate.

Help them with energy.

Help them with get up and go.

Help them with enjoyment, helping with, pleasurable activities and so forth.

So identify what kind of goals you want to achieve in two weeks after taking the program, you should get a little bit of an improvement.

20% or more improvement at two weeks predicts long term that you're going to have a good outcome with something ibuprofen or antidepressants.

So at the two week mark, it's very early.

We should have about a 20% or more improvement.

Ideally, you want to wait 6 to 8 weeks to get the full effect of before we dose it between generally between 300 to 450mg a day.

Some people get by with 150mg a day because genetically they're very sensitive to the use of, and so some people can get by a lower dosage, but be appropriate is something that can be very helpful for depression, especially for the activating energizing effects of it.

And it can help with focus and concentration, because indirectly it's enhancing norepinephrine and dopamine about half the potency of a stimulant.

It's not addictive, but it can give you about half the potency of a stimulant and give you a little bit more energy and get up and go.

If you have the need for such, those symptoms can be resolved.

Thanks for your call.

Unfortunately, I'm out of time for this evening.

If you have any questions that I can answer on the air, you can write me via the email at mattersofthemind - all one word - @wfwa.org.

I'm psychiatrist Jay Fawver, and you've been watching Matters of Mind on PBS Fort Wayne, now available on YouTube.

God willing of PBS willing.

I'll be back again next week.

Thanks for watching.

Good night.