Scott Webb (Host): Today, we're going to do some myth-busting about mental health and mental illness with an expert in the field, Dr. Benjamin Griffeth, psychiatrist at Prisma Health. 

Scott Webb (Host): This is Flourish, the podcast brought to you by Prisma Health. I'm Scott Webb. Doctor, it's nice to have you here today. I hope you're ready to bust some myths. I don't know if you wear a hat for that or if there's a special outfit. But we're going to try to bust some mental illness myths. And let's just start with myth number one: mental illness means someone is weak or isn't intelligent.

Dr. Benjamin Griffeth: That comes back to the idea that somehow mental illnesses are different than all the other illnesses. Mental illnesses are illnesses of the brain, just like heart disease is disease of the heart, diabetes is a disease of the endocrine system. So to say that mental illnesses are somehow uniquely aligned to your moral center or your moral strength or your confidence or your consciousness or anything like that just doesn't hold much weight. We have a lot of data that mental illnesses, because they are diseases of the brain, have the same rudimentary structure that all other illnesses do. There's a genetic component. There's a biological component. Certainly, there's a psychological component and a spiritual component and a social component, but that's also true of all the other illnesses.

For instance, you have arthritis of the knee. Well, there's a biological component. Maybe that arthritis was predisposed by genetics because your family's prone to have osteoarthritis. Maybe the arthritis is there because your active lifestyle had you competing such that you had previous injuries, and those previous injuries set up the opportunity for arthritis to develop.

And psychological impacts of the arthritis, social impacts of the arthritis. If you're having arthritis, it's difficult to go out and be as active as you previously were. And so, physical illnesses, mental illnesses, they're all the same thing. And so, they all have the same answer.

Host: Right. Yeah, like I said, we're going to bust a bunch of myths today and good to bust that one, that a mental illness is, as you say, is very similar to osteoarthritis, which I have in my knees. I was nodding my head as you were saying that. I'm like, "Yeah, right. It's a thing."

So, myth number two, there's really nothing you can do to prevent people from struggling with mental health conditions.

Dr. Benjamin Griffeth: Absolutely incorrect. The individual themself can do a lot of work towards helping their work through their mental health condition or their mental illness. We certainly have lots of data around diet being able to improve things. So for instance, the MIND diet, M-I-N-D diet, which is easily accessible on the internet, is already shown to have great linkages towards improving outcomes in patients with dementia and even preventing dementia.

So, we know diet can certainly make a difference. We know exercise can make a difference. Just the simple things like having a 15- to 20-minute walk every day can substantially change your risk of developing mental illnesses, as well as the severity of those illnesses if you do develop them. As people, when we see our fellow humans on this earth struggling with mental health, the ability to reach out and help them is substantial. That can be things like assisting them with getting to appointments, helping them with getting socially engaged with other support systems. But it can be just as simple as spending time with them, letting them have the opportunity to talk, letting them have the opportunity just to have somebody who is with them substantially changes how much of an impact their mental illness may have upon them. And so, you don't have to be specially trained. You don't have to have knowledge or abilities. For instance, in my case, you don't have to have a four-year undergraduate degree and four years of medical school and four years of psychiatric training in order to be able to talk to somebody with a mental illness. You just have to be a human and respect that they're another human and spend time with them.

Host: Yeah, I love that. You know, and there's so much AI out there, which would be a separate podcast. But you and I are humans. We're talking about humans and human stuff. And another one that I hear, Doctor, another myth I believe anyway, is that therapy's really only helpful if your mental illness is severe.

Dr. Benjamin Griffeth: Absolutely not correct. Yeah, that's a myth. Therapy helps at all levels of mental illness. In fact, you could argue, and there have been several studies to indicate that certain types of therapy work better with milder illness compared to more severe illness. But that said, therapy works for nearly all mental illnesses. Therapy works for all severity levels. Now, sometimes you have to pick and choose. Some types of therapy don't work for certain types of illness. And so, you have to pay attention to that. And like I said, there are a few illnesses where therapy is not helpful and severity does play into that.

So, a patient, for instance, with severe dementia might not benefit from therapy because due to their illness, their ability to attain to the therapy session, their ability to remember from the therapy sessions the things that help them improve, would not be able to be something that the patient's able to retain because of their illness. But that's a very rare instance that you're talking about. Even patients with mild dementia are known to improve with cognitive therapy, with behavioral therapy. They improve with interpersonal therapy, where they are able to spend time with others, going back to the myth that we were just discussing.

And so, the idea that therapy only works if somebody's significantly impaired seems to shut the door on a lot of opportunities to help people get better sooner and get better without having to become ultimately sick. It would be the same idea that you would say that we only use insulin once you have been hospitalized for diabetes. That makes very little sense. Insulin is an appropriate treatment, then you start it from the point that it's an appropriate treatment, not waiting for bad outcomes to happen first.

Host: Yeah. Let's talk medications, Doctor. I've heard this one before, this myth, if you will. If we ask, you know, for help for a mental condition, you're just going to throw a pill at us, and that's going to be it, right?

Dr. Benjamin Griffeth: That may be part of an answer.

Host: Sure. Yeah.

Dr. Benjamin Griffeth: For many illnesses, medication is part of the answer, but that's not going to be the only answer. If you seek out help for a mental illness, especially coming to a therapist, by definition, therapists are not prescribing medicine. So, that's the first and easy way to bust this myth, to point out that most of the people who are working on mental health treatment don't even have the ability to prescribe medication.

Now, often medication is considered part of the treatment process. And again, if we go back and start thinking about mental illnesses, just like physical illnesses, having a biological component, a psychological component, and a social component, then medication may be part of the answer to the biologic arm of that.

But medication doesn't address the psychological upbringing and underpinnings of that human, nor the social factors that are going on in their life that may have impact into their mental health as well. So, medication isn't the only answer. A good prescribing physician should recognize that and should be offering the opportunity for medicine, but the opportunity for therapy at the same time.

Host: I think that I've heard this before, and I think I've even seen it on social media, Doctor, that taking medications for a mental condition is going to change our personalities.

Dr. Benjamin Griffeth: So, that is mostly not correct. So if you are an innately grouchy human, medication will not change that. If you are an innately happy person or a gregarious person or social, the medication is not going to change that. Now, if you are natively a happy person who hasn't been happy due to the presence of, say, major depressive disorder, and I give you medication that helps remove the illness or I engage you in therapy that removes the illness, then yeah, you're going to see a personality change where you actually return to your normal personality because I've removed the burden of illness.

Host: Right, like a change for the better.

Dr. Benjamin Griffeth: It should be a change for the better, that you should expect that mental health treatment is going to restore someone to their normal personality by alleviating the burden of the illness that may be coloring how they interact with the world right now.

Host: Yeah. It's also interesting and hard to, you know, solve everything today in the context of our podcast, but we're going to scratch the surface as best we can. And another myth I've heard, Doctor, is that if we've managed all this before, right, managed our mental health before, that we probably don't need help now, right? We've been fine up to this point. We're good.

Dr. Benjamin Griffeth: Right. And that makes total sense if the stresses of your world are always going to be the same, right? Let's say you travel, and you go up to the rental car agency, and you have only driven sedans your entire life, and the only car that they have available for you is a minivan, you should be able to just automatically adapt to that. You should be able to find the blind spots. You should be able to know where the corners are for parking, right? That's that same kind of logic that nothing new is going to happen in my life that is going to present me with a challenge that I don't have the answers to, that I don't have the experience to deal with. And that doesn't make a lot of sense.

One of my favorite metaphors when I'm talking to patients about the opportunities of therapy and the opportunities within treatment is this idea that when you're born, you're born with a toolbox, and as you grow up, you add tools. You add a saw, you add a hammer, you add a Phillips head screwdriver, and all that works very well. But you, at some point, are going to encounter a crescent wrench problem or an Allen wrench problem. And if you don't have that in your box, you can hit that, you know, Allen bolt with a hammer as much as you want, but it's not going to work.

Host: It's not going to turn.

Dr. Benjamin Griffeth: It starts idea that you have to consistently work to increase your tools, to increase your adaptability, because new things are going to come, new stressors are going to come, and just because you've responded well to previous stressors doesn't necessarily indicate that you're going to be able to adapt to the next stressor.

Host: Right. And this metaphor, which I love, I had a typing teacher when I was in high school, and he used the card metaphor that we're all dealt a hand of cards. But it translates to this. And in this case, when we think about possibly needing help in the future despite managing things up to a certain point, you might have that wrench that we need, right?

Dr. Benjamin Griffeth: Right. Exactly. And that's often if you want to expand that toolbox metaphor, that is the point of medication. That is the point of therapy, is it's handing you a new tool, or it's teaching you how to use a tool that you've previously had in a different way. I'm doing some home renovations at the house right now, and it's amazing how much old paint you can scrape off with a screwdriver if you have to do it.

Scott Webb: Right. Well, I've loved this today. I know we're going to talk again soon about antidepressants. But let's finish up today, more human stuff of course here. This last myth that talking about mental illness just makes it worse.

Dr. Benjamin Griffeth: Talking about mental illness just makes it better. There's no way that in talking about your illness you can make things worse than they already are. The talking about process makes it better. The ability to open up to have someone else, even if all they do is listen and say, "That sounds really hard," is a reinforcing process that helps you be connected to a social system. That social system helps you feel better. The more you work on the problem that it's presented, the more likely you are to potentially have an aha moment that allows you to think about or process this challenge in a better way.

But mostly, the more you talk about it, the more people are going to say, "Hey, maybe you need to seek care. Maybe you could reach out to this person or this organization or this physician and look and find out what ways you can interact with the healthcare system to get your symptoms better so that you feel better." Because if all you do is walk around and not talk about it, everybody may perceive that something's up, but they're not going to automatically say, "Hey, Bob, you know, you seem to have been down. Can I get you a referral to a therapist?" What going to do is leave you be and let you decide when it's appropriate to talk about it. So, the talking about it helps, not hurts.

Host: Yeah, that's well said. You know, and I was just sort of thinking about me and my life and I'm like, "Well, okay, so when we talk about things, we might uncover some things that are uncomfortable or difficult or challenging," but that's the whole point, right, doctor, is to work through those things to get the tools we need in that metaphor sense to fix those things, right?

Dr. Benjamin Griffeth: That's exactly right. The lack of interaction. So, let me pick on a specific mental illness, depression. Depression I like to describe as being a jealous little animal. So, one of the things that we know about depression is people who are suffering with depression are less likely to be social, and that's because that jealous little disease in the back of their head is telling them, "Hey, don't do that." Because if you have depression and you go out and you socialize, you might feel better, and that jealous animal doesn't want you to feel better. That jealous animal's going to tell you things like, "Hey, stay up at night when no other people are around and you can't do anything but, you know, watch, TV and doom scroll on your phone. Sleep during the day when sunlight, which would help your depression, you won't see it because you're asleep. And sleep while everybody else is awake because socializing with others might help you feel better," because it's jealous. It doesn't want you to feel better. It's the same thing that it's going to tell you, that depression's going to tell you, "Eat lots of sugar and lots of carbs," because—

Host: He wants you to feel bad.

Dr. Benjamin Griffeth: Eating sugar and carbs actually contribute to your feeling down and feeling wiped out and sleepy and tired all the time. Don't eat dark leafy green vegetables. Don't eat beans and lentils and fresh fruit. Because if you do that, you might actually get the building blocks that help you feel better and alleviate your depression, because your depression doesn't want you to do it. It's jealous. It wants you to stay in the dark by yourself eating sweets and carbs because that's what keeps it alive.

Host: Yeah. Yeah, it's so interesting. As I mentioned, we're going to speak again soon about antidepressants, which will be another great conversation. But for today, thanks for your time, your expertise, your metaphors. Thank you so much.

Dr. Benjamin Griffeth: My pleasure.

Host: For more information and other podcasts just like this one, head on over to prismahealth.org/podcast. This has been Flourish, a podcast brought to you by Prisma Health. I'm Scott Webb. Stay well.