Podcasts about celexa

Can medication truly transform the landscape of pediatric mental health, or are we oversimplifying the complexities of growing minds? In this episode of Pediatric Meltdown, Dr. Lia Gaggino welcomes Dr. Jess Pierce, a hospital-based child psychiatrist whose expertise bridges the worlds of pediatrics and mental health, especially for children in rural areas. Unraveling the fascinating history of psychopharmacology and delving into the mechanisms of action for the antidepressants, this episode offers a roadmap for pediatricians navigating the maze of SSRIs, SNRIs, risks like serotonin syndrome, and difficult conversations about side effects. The nuances matter and Dr. Pierce guides us skillfully.Discover why family history, patient buy-in, and transparent communications are pivotal to successful treatment—and why prescribing for young people demands a delicate blend of science, art, and empathy. This conversation will change the way you see—and approach—medication and the treatment of kids' mental health.[00:08:51] Exploring Pediatric Psychopharmacology's RootsTracing the unexpected origins of antidepressants, including how tuberculosis and hypertension treatments led to modern psychopharmacologyThe monoamine hypothesis: understanding the neurotransmitter focus in early depression treatmentsThe move beyond serotonin, dopamine, and norepinephrine: new research on neurobiology, neurogenesis, and stress responseProzac's arrival and its impact in reshaping the treatment landscape for pediatric mental health[08:52- 18:06 ] SSRIs in Practice: Similarities, Differences, and SelectionAll SSRIs share rapid absorption, high protein binding, and similar side effect profiles—but key differences can matterImportant reasons to avoid Paxil and to use Lexapro over Celexa, particularly due to side effect burdensNuanced considerations: matching specific SSRIs to individual patient needs, such as Prozac's activating profile for low-energy depressionPractical dosing strategies: the art of balancing “start low and go slow” with the urgency to help suffering children[18:07- 27:59] Navigating Risks, Side Effects, and Patient MonitoringThe truth behind the Black Box Warning: clarifying risks of suicidal ideation vs. the dangers of untreated depressionWhy regular, open conversations with families about medication side effects—especially sexual side effects in teens—build trust and adherenceRecognizing and managing serotonin syndrome: how to spot symptoms and when emergency intervention is neededIdentifying high-risk drug interactions, including situations with migraine or neurology medications[28:00-45:19 ] From SNRIs to the Five-Step Prescribing Approach and BeyondHow SNRIs differ from SSRIs in action, side effects, and indication—especially in pain syndromes or where activating effects are desiredThe use of Wellbutrin as an alternative with fewer sexual side effects, and cautions for seizure-prone populationsStrategic guidelines: the five-step approach to medication choice, considering patient history, family response, symptoms, buy-in, and comorbiditiesCritical cautions with genetic testing and the limitations of using these results to guide first-line medication choices[45:20-1:00:00] Dr Lia's TakeAwaysResources Mentioned:Dr. Pierce's PPT on Pediatric Psychopharmacology Hello! Here's the link to the slides: Psychopharm...

For years, antidepressants have been the default solution for dementia patients struggling with depression, anxiety, and aggression. But what if they're actually making things worse? A groundbreaking new study from the Karolinska Institute has found that dementia patients on SSRIs like Lexapro, Celexa, and Zoloft experience faster cognitive decline than those not on medication. Are we treating symptoms at the cost of accelerating the disease itself? In this episode, Dr. Bray dives into the science behind these findings. We'll explore: -How SSRIs impact the aging brain—and why they may be ineffective for many people -The hidden risks of antidepressants, including cognitive fog, emotional blunting, and increased fall risk -A smarter approach to dementia care—why non-drug interventions should be considered first The truth is, there's no one-size-fits-all answer when it comes to mental health and dementia. What works for one person may not work for another. That's why it's critical for patients, caregivers, and medical professionals to stay informed, ask questions, and do their own research before making treatment decisions. If you or a loved one is facing a decision about antidepressants and dementia, this is an episode you can't afford to miss. Listen now, and make sure you have all the facts before choosing a treatment plan because better decisions start with better knowledge. QUOTES BY DR. BRAY "Your brain health and your physical health are your responsibility. Do not abdicate them to somebody else." "Consider non-drug interventions first—therapy, lifestyle changes, and social engagement can be powerful tools." "We need to ask questions and look for signs—because sometimes, the biggest tragedies come from what we didn't see."  

This week we will discuss the use of Ketamine for treating Depression.  Our guest for this week's show is Karen DeCocker, DNP, PMHNP, CNM Karen DeCocker is the Director of Advanced Practice Providers at Stella overseeing the assessment team. She helps to identify which innovative biological medical treatments & virtual therapies can help relieve symptoms of anxiety, depression, PTSD & traumatic brain injury.  After completing a virtual assessment of each patient, Dr. DeCocker and her team analyze the medical, biological, psychological & social factors to provide personalized treatment recommendations across Stella's advanced protocols such as Dual Sympathetic Reset (advanced stellate ganglion block), Ketamine Infusion Therapy, Transcranial Magnetic Stimulation (TMS), Spravato, integration therapy, and more. Dr. DeCocker's priority is the patient's outcome. She became a nurse practitioner in 2007 after 10 years of hospital nursing experience. As rates of depression and anxiety have increased dramatically, people have sought therapies outside the standard regimen of oral antidepressants and talk therapy. Beginning in the mid-2010s, more and more doctors started offering ketamine as a treatment for depression. In 2019, the Food and Drug Administration (FDA) approved esketamine as a treatment for forms of depression that haven't improved with standard antidepressants (like citalopram/Celexa or bupropion/Wellbutrin).   (Source: Psychology Today) 

My name is Kim Newlove, and I'm an Ohio-licensed pharmacist. Welcome to the 30th episode in my drug name pronunciation series. Today, we're talking about citalopram (Celexa) and escitalopram (Lexapro).   In this episode, I divide all four drug names into syllables, tell you which syllables to emphasize, and share my sources. The written pronunciations can be helpful, so you can see them below and in the show notes on thepharmacistsvoice.com.  Thank you for listening to episode 274 of The Pharmacist's Voice ® Podcast! To read the FULL show notes, visit https://www.thepharmacistsvoice.com.  Click the Podcast tab, and select episode 274. Subscribe to or follow The Pharmacist's Voice ® Podcast to get each new episode delivered to your podcast player and YouTube every time a new one comes out!   Apple Podcasts   https://apple.co/42yqXOG  Spotify  https://spoti.fi/3qAk3uY  Amazon/Audible  https://adbl.co/43tM45P YouTube https://bit.ly/43Rnrjt   Citalopram = si-TAL-uh-pram  Emphasize TAL Source:  clinical practice and popular opinion   Celexa = se-lek-sa No emphasis is indicated by my source, but I emphasize LEX. Source:  medication guide, FDA's website   Escitalopram = ES-si-TAL-uh-pram Emphasize ES and TAL.  TAL gets the most emphasis. Source:  clinical practice and popular opinion   Lexapro = leks-a-pro No emphasis is indicated by my source, but I emphasize LEX. Source:  medication guide, FDA's website   Thank for joining me to learn how to say citalopram, Celexa, escitalopram, and Lexapro. If you know someone who needs to learn how to say citalopram, Celexa, escitalopram, and Lexapro, please share this episode with them.     Links from this episode Celexa medication guide - FDA Website Lexapro medication guide - FDA Website USP Dictionary Online (aka “USAN”)  **Subscription-based resource USP Dictionary's (USAN) pronunciation guide (Free resource on the American Medical Association's website) The Pharmacist's Voice ® Podcast Episode 272, pronunciation series episode 29 (losartan) The Pharmacist's Voice Podcast Episode 269, pronunciation series episode 28 (tirzepatide) The Pharmacist's Voice Podcast Episode 267, pronunciation series episode 27 (atorvastatin)  The Pharmacist's Voice Podcast Episode 265, pronunciation series episode 26 (omeprazole) The Pharmacist's Voice Podcast Episode 263, pronunciation series episode 25 (PDE-5 inhibitors) The Pharmacist's Voice Podcast Episode 259, pronunciation series episode 24 (ketorolac) The Pharmacist's Voice ® Podcast episode 254, pronunciation series episode 23 (Paxlovid) The Pharmacist's Voice ® Podcast episode 250, pronunciation series episode 22 (metformin/Glucophage) The Pharmacist's Voice Podcast ® episode 245, pronunciation series episode 21 (naltrexone/Vivitrol) The Pharmacist's Voice ® Podcast episode 240, pronunciation series episode 20 (levalbuterol) The Pharmacist's Voice ® Podcast episode 236, pronunciation series episode 19 (phentermine)  The Pharmacist's Voice ® Podcast episode 228, pronunciation series episode 18 (ezetimibe) The Pharmacist's Voice ® Podcast episode 219, pronunciation series episode 17 (semaglutide) The Pharmacist's Voice ® Podcast episode 215, pronunciation series episode 16 (mifepristone and misoprostol) The Pharmacist's Voice ® Podcast episode 211, pronunciation series episode 15 (Humira®) The Pharmacist's Voice ® Podcast episode 202, pronunciation series episode 14 (SMZ-TMP) The Pharmacist's Voice ® Podcast episode 198, pronunciation series episode 13 (carisoprodol) The Pharmacist's Voice ® Podcast episode 194, pronunciation series episode 12 (tianeptine) The Pharmacist's Voice ® Podcast episode 188, pronunciation series episode 11 (insulin icodec)  The Pharmacist's Voice ® Podcast episode 184, pronunciation series episode 10 (phenytoin and isotretinoin) The Pharmacist's Voice ® Podcast episode 180, pronunciation series episode 9 Apretude® (cabotegravir) The Pharmacist's Voice ® Podcast episode 177, pronunciation series episode 8 (metoprolol)  The Pharmacist's Voice ® Podcast episode 164, pronunciation series episode 7 (levetiracetam) The Pharmacist's Voice ® Podcast episode 159, pronunciation series episode 6 (talimogene laherparepvec or T-VEC)  The Pharmacist's Voice ® Podcast episode 155, pronunciation series episode 5 Trulicity® (dulaglutide)  The Pharmacist's Voice ® Podcast episode 148, pronunciation series episode 4 Besponsa® (inotuzumab ozogamicin) The Pharmacist's Voice ® Podcast episode 142, pronunciation series episode 3 Zolmitriptan and Zokinvy The Pharmacist's Voice ® Podcast episode 138, pronunciation series episode 2 Molnupiravir and Taltz The Pharmacist's Voice ® Podcast episode 134, pronunciation series episode 1 Eszopiclone and Qulipta

Brandon Daniel - Cop Killer - Full Police Interrogation Daniel, now 32, is on death row for the murder of an Austin police officer in 2012. AUSTIN – The Texas Court of Criminal Appeals has upheld the death sentence for a man convicted of fatally shooting an Austin police officer. APD Officer Jaime Padron responded to the Walmart near Interstate 35 and Parmer lane around 2:30 a.m. April 6, 2012 for a reported shoplifter. Brandon Daniel struggled with Padron before he shot and killed the officer. Daniel, now 32, was found guilty in February 2014 and sentenced to death. To whom it may concern, My name is Brandon Daniel, and I am writing this letter to you from prison. With police brutality once again in the news, and legal reform a hot topic of discussion, I'm writing to tell you about my legal case, in the hope that I might be able to spread awareness about a common but little known condition that is responsible for sending others to prison, and perhaps to leverage your platform to gain support as well. My case involves the class of anti-anxiety medication called benzodiazepines, and it is one of the clearest examples of something called Paradoxical Reaction. I am hoping that you can help me. Let me fill you in on my story. First, my background is relevant because it demonstrates that the event that led to my being here was not part of a pattern of behavior. I have no violence in my past, no felonies. I was a software engineer, I'm college educated, and I'm from a normal, middle-class home. Everything that happened that night was completely atypical and out of character. The event took place at Walmart, so it was all captured on surveillance videos. You can see me stumble around the store for twenty minutes, dropping items and running into displays. I was clearly disoriented. A police officer was called, and he confronted me, tackled me, and in the chaos of the moment I shot and killed him. The video shows how hectic the situation was, it clearly was not a thought out and intentional act. It took place in the span of 10 seconds. Subsequent blood tests revealed that I had 11 times the therapeutic dose of Xanax in my system, and these tests were taken seven hours after the event. With a half life of eleven hours, it is reasonable to assume that the amount of Xanax in my blood that night was extraordinarily high. Plus, as I later discovered, Asians metabolize Benzos faster than other populations and it stays in their systems longer. I am of Asian descent. In addition to all of this, I was interviewed by police immediately after the event, while I was still highly impaired from the medication. Again, this interview was captured on video, and one can clearly see that I am suffering from the classic symptoms of Benzodiazepines. I had amnesia, stating several times that I couldn't even remember what day or time it was. I was confabulating, giving different accounts of what happened, none of which turned out to be accurate. And I was experiencing chemical submission, complying with the detectives leading questions against my best interest. All of these are common side-effects of the Benzodiazepine class of pharmaceuticals, which includes the date rape drug “roofies.” This aspect of my case sets me apart from other similar cases, I believe. My confused statements provide a window into my state of mind at the time, while in many other incidents we can only wonder what is going on in their mind. After all of this, while awaiting trial, the jailhouse doctors put me on a cocktail of antidepressants: Zoloft, Celexa, Remeron, etc. During this time, I had several suicide attempts and I spent most of the time in observation cells, nearly catatonic. It is my belief that this common, secondary use of pharmaceuticals to medicate inmates awaiting trial, renders them complacent and fairly useless when it comes to contributing to their defense. This results in inmates who are resigned to their fate, able to be easily railroaded by the legal system, regardless of the merits of their case. Since most people who are first entering jail are, understandably, depressed, they are all too willing to accept this ‘treatment'

It's 2023 and we're back with lots of updates. Lauren checks in with her ongoing health saga. And Ashley and Lauren catch us up on a trip to Spencers and their revisit to the world of belly button piercings. Naz encourages everyone to stop saving their candles and special perfume for just the right time. Life is short. Light the damn candle. Naz talks about intention-setting and tries to narrow down the word she's going to use for 2023. This year Naz and Ashley are setting goals that are more lowkey while Lauren is aiming for something a little more take charge. Naz tells a great story about overcoming that inner voice that tells you you're just not doing enough.   Ashley reflects on the gift-giving season and the way that holidays are just so much more fun when you make it about the kids and stop worrying about trading gift cards back and forth with the adults in your life. Ashley has noticed that a lot of parents aren't telling their kids about Santa because they don't want to lie to their kids, and Lauren's got some choice words about that.   Lauren and Ashley pitch their new show Sex on Celexa and Naz discusses Jonah Hill's new documentary Stutz and the Harry & Meghan Netflix documentary.   Ashley wants to know: babies in first class? Yes or no?   Stop throwing your money away. Cancel unwanted subscriptions – and manage your expenses the easy way – by going to RocketMoney.com/getit   Right now, Kitsch is offering you 30% off your entire order at MyKitsch.com/getit More podcasts at WAVE: https://podcasts.apple.com/us/artist/wave-podcast-network/1437831426

In this episode, Dr. Zach April returns to review the SSRI's. These are some of the best treatment options for mood. We talk about what to expect in general with these medications and review some of the individual medicines including sertraline (Zoloft), fluoxetine (Prozac) and escitalopram (Lexapro) to name a few.  A disclaimer, we're providing general guidance but everyone is different and you should always discuss with your health care professional management of any disease and therapy before trying anything you discover from a source on the internet (including this podcast)

Major topics covered— Caring for your sexual body Caring for your sexual body does not require a partner! That is something that you have ownership of. You are a sexual woman whether or not you are sharing sex with a partner. It is so much easier to maintain vaginal health than it is to recover vaginal health. Maybe just start with some proactive vaginal hydration every week. This is about health in your body. Our urinary system, our vulva (outside), our vagina (inside), and the pelvic floor muscles are all impacted by the loss of estrogen in our systems. Using a full-sized vibrator with penetration at least twice a week to promote blood flow to the vagina will help maintain vaginal health, in the flexibility, in the length of its accommodation, and in the circumference of the accommodation. Listen to your body and be proactive! If you have painful intercourse, hydrate for at least two weeks, then move to dilation. Vaginal moisturizing/hydration (hydrates the tissue and promotes vaginal health) Vaginal estrogen Oral estrogen Oral estrogen combined with a non-hormonal gel Non-hormonal (hyaluronic acid products Traci recommends: Hyalo Gen Revaree Gynatrof Dilation (work) / Vibrators (fun) If sex is painful, go for a dilator Traci likes the Dr. Laura Berman Intimate Basics - Dilator Set Vibrators can be used to promote blood flow, to relax the muscles, and for pleasure Start simple until you can figure out what you like. https://www.rosetoy-official.com/ is the website mentioned, but it's certainly not the only one! Lubricants (reduces friction) - Traci recommends the following lubes Water-based lubes: Good Clean Love, Enchanted Rose, Velvet Rose Silicone-based lubes aren't recommended—they can degrade a vibrator so don't use together. Hybrid lubes: Naked Silk, Wet Gold Vaginal pH Prevention (these things will maintain a healthy environment in the vagina): Probiotics (research the biome's relationship to the vagina), vaginal estrogen, hyaluronic acid When you have recurrent bacterial infections in your vagina, Traci prescribes boric acid. Please don't use products that have fragrances! Urethral prolapse Can be caused by a combination of loss of estrogen, chronic constipation, overweight, pregnancy, childbirth, weak pelvic floor muscles, pelvic trauma. Typical treatment plan Vaginal estrogen Hydration of vaginal walls with dilation Pelvic floor therapy to strengthen muscles Use of Cialis in women FDA hasn't been approved for women. Option is to use cuddle cream / scream cream. It's easy. Put it where you want it without systemic effect. Vaginal exams Pediatric speculums are available if you are concerned about adult-sized speculums Feel free to ask if you can remain clothed to have a conversation with your gynecologist before your exam. Great idea! Advocate for yourself! Women's Healthcare Provider Worksheet Download here – https://sexafterbreastcancer.com/ Medications and sex All the meds that impact the central nervous system may impact you sexually. SSRIs have a pretty high impact on desire (diminished or inability to orgasm OR persistent genital arousal). SSRIs approved to treat depression are Celexa, Lexapro, Prozac, Paxil, Pexeva, Zoloft. Play with the timing of your meds See if you can lower the dosage Some anti-depressants that have fewer sexual side effects: Wellbutrin, Remeron, Viibryd, Trintellix     NOTE: Links shown are informational only and are not indicative of the only pricing available. Please rely on your own research.   ABOUT Sex After Breast Cancer LIVE! Our largest breast cancer support group is our Sex After Breast Cancer community on Facebook. Every month, our community of thousands from across the world grows, each woman searching for solutions to the issues they are experiencing after a breast cancer diagnosis. And we have answers! Dozens of professionals have joined our Contributing Experts team to educate the women in our community. Our current Contributing Experts have impressive credentials— Board-Certified Urologist and Sexual Medicine Specialist Medical Doctor—OB/GYN, Rosy Wellness Founder Certified Sexuality Counselor, Practice Clinician, RN Licensed Professional Counselor, Certified Clinical Trauma Specialist Pelvic Floor Physical Therapist Licensed Marriage & Family Therapist, Christian Sex Therapist Occupational Therapist, Somatic Sexologist, Clinical Sexuality and Intimacy Educator Family Nurse Practitioner, Pelvic Health Specialist Holistic Therapist, Certified Grief Facilitator Medical Doctor—OB/GYN Family Nurse Practitioner, Women's Health Specialist Life Coach/Relationship Expert Board-Certified Women's Health Nurse Practitioner Doctor of Osteopathic Medicine, Internal and Obesity Medicine Specialist Naturopathic Doctor, Homeopath E-RYT 500 Master Yoga Instructor, Yoga Teacher Trainer, Yoga Therapist, Thai Yoga Massage Practitioner, Reiki Practitioner Certified Lymphatic Therapist Clinical Thermographer Accredited Exercise Physiologist, Cancer Exercise Specialist Board Certified Integrative Nutrition Health Coach Doctor of Pharmacy, Healthcare Cost Consultant Clinical Sleep Educator Licensed Acupuncturist Certified Functional Nutrition Counselor Grief Recovery Specialist, Certified Professional Coach, RN Each week one or more of our experts joins us for Sex After Breast Cancer LIVE! inside the private Facebook group. If you can't join us live, you can always catch each episode on our podcast. Shared with love by Jan James, Hope After Breast Cancer Find out more about our private Facebook support groups (Booby Buddies, Hope After Breast Cancer, Sex After Breast Cancer, Booby Buddies en español) here. Joining our Newsletter List will give you a monthly recap of our best content, as well as information about available training and support. Subscribe to our Hope After Breast Cancer Podcast on your favorite podcast platform! Check out http://sexafterbreastcancer.com/ for quick access to our Sex After Breast Cancer community, experts, and resources. Please help me provide more content to our community by buying me a cup of coffee (or two) at Buy Me A Coffee. And please pray for my efforts to have significance in the lives of the women we serve! Thank you! Disclaimer: While professional experts and the Company address health issues and the information provided on this Website and its components relates to medical and/or health issues, the information provided is not a substitute for medical or health advice from a professional who is aware of the facts and circumstances of your individual situation.

On this episode, we hear from Denise Collins, whose husband, John, died in 2018, nine days after going on the antidepressant Citalopram, better known in the United States as Celexa. Earlier this year, her book, What Happened To John?: A memoir of enduring love, mental health, and suicide, was released and is available now in paperback and for Kindle. Denise spent three years researching, writing, and doing her best to recover following the tragic death of John and her experience of becoming a widow. The book opens on what Denise calls Day Zero, Monday, the 29th of October, 2018, a day that began "quite unremarkably," she says, but later that day, two uniformed police officers appeared at her front door. "In that moment," she writes, "I was blissfully unaware that life as I knew it had ended and that a living nightmare was about to begin." Her website, denise-collins.com, is aimed at what she terms "corporate clients." She coaches female executives on developing their authentic leadership style and building a sustainable work/life balance. Her specialties are: Guiding People In Discovering and Celebrating Their Unique Personal Power (UPP©) Supporting Those Navigating Life After Loss and Teaching Resilience And How To Embrace Change.

OK what is the common denominator in mass shootings? Guns? Yes, but that's only the tool. Heavy substance abuse No one blamed the rifle that killed JFK. Even Oswald was on early antidepressants and also heavy into drinking. When did these mass shootings begin ? Early 1960's and what else came about in this time frame? The wide spread of anti-depressants drugs. What are the side effects of these drugs? Agitation, restlessness, confusion, anxiousness, hallucinations, suicidal thoughts, self-harm, as ALL of these drugs produce subtle changes in personality traits. ( SSRI) Let's take a look at the short list: Quaaludes, Valium, Prozac, Celexa, Lexaprl, Paxil, Zoloft, Viibryd, Floutine, Paroxetire just to name a few. Yes, subjects who use these drugs have mental health issues,, but this is an issue that anti-gun folks and politicians don't want to talk about. Why?The political influence of big pharma. Their position on the issue is there is NO connection between SSRI and Violence. NONSENSE: Examples and this is a very, very short list: Zephen Xaver- Sun Bank mass shooting Lan Long - 1000 Oak nite club shooting Travis Reinking - Waffle House shooting Nikoles Cruz - Parkland school shooting Devin Kelly- Texas church shooting Seong Cho - Virgina Tech school shooting Arcan Cetin- Cascade Mall shooting Ivan Lopez - Fort Hood shooting Aaron Alexis - Washington Navy yard shooting James Holmes- Movie house shooting Robert Steward- Pine lake rehab shooting Steves Kazmierczal- No. Illinois University shooting Jeff Weise- Reo Lake Minnesota shooting ALL OF THESE SHOOTERS WERE ON SSRI DRUGS... COMMON SENSE IS NOT SO COMMON- Voltare #challengeaccepted #streets #nyc #jersey #media #spotify #apple #film #writer #motivate --- Support this podcast: https://anchor.fm/mike-k-cohen/support

This week is a pharmacopeia of inflation. The #ASFpodcast talks debilitating gastrointestinal issues and new efforts to understand and treat them (including the CANDID meeting www.candidgi.com), a new method to understand adverse events in those that cannot report them on their own, and new news on Celexa, which is used to treat anxiety. www.candidgi.com info@candidgi.com … Continue reading "What's in the medicine jar?"

Join Dr. Peter to go way below the surface and find the hidden meanings of obsessions, compulsions and OCD.  Through poetry and quotes, he invites you into the painful, distressing, fearful and misunderstood world of those who suffer from OCD.  He defines obsessions and compulsions, discusses the different types of each, and evaluates two conventional treatments and one alternative treatment for OCD.  Most importantly, he discusses the deepest natural causes of OCD, which are almost always disregarded in conventional treatment, which focuses primarily on the symptoms.   Lead-in OCD is not a disease that bothers; it is a disease that tortures. - Author: J.J. Keeler   “It can look like still waters on the outside while a hurricane is swirling in your mind.” — Marcie Barber Phares  Poetry or word picture (prayer of the scrupulous)  Aditi Apr 2017  Obsessive Compulsive Disorder.  OCD.  That is what we are addressing today. Here is what OCD is like for Toni Neville -- she says:  “It's like being controlled by a puppeteer. Every time you try and just walk away he pulls you back. Are you sure the stove is off and everything is unplugged? Back up we go. Are you sure your hands are as clean as they can get? Back ya go. Are you sure the doors are securely locked? Back down we go. How many people have touched this object? Wash your hands again.”  Introduction We are together in this great adventure, this podcast, Interior Integration for Catholics, we are journeying together, and I am honored to be able to spend this time with you.   I am Dr. Peter Malinoski, clinical psychologist and passionate Catholic and together, we are taking on the tough topics that matter to you.   We bring the best of psychology and human formation and harmonize it with the perennial truths of the Catholic Faith.    Interior Integration for Catholics is part of our broader outreach, Souls and Hearts bringing the best of psychology grounded in a Catholic worldview to you and the rest of the world through our website soulsandhearts.com  Today, we are getting into obsessions and compulsions -- a really deep dive into what's really going on with these experiences.  I know many of you were expecting me to discuss scrupulosity today -- And you know what?  I was expecting I would be discussing scrupulosity well, but in order to have that discussion of scrupulosity  be well-founded, we really need to get into understanding obsessions and compulsions first.  I have to bring you up to speed on obessions and compulsions before we get into scrupulosity, and there is a lot to know The questions we will be covering about obsessions and compulsions. What are Obsession and Compulsions? Getting into definitions.   Also What are the different types of obsessions and compulsions, the different forms that obsessions and compulsions can take What is the experience of OCD like?  From those who have suffered it.   Who suffers from obsessions and compulsions -- how common are they?  Who is at risk?  Why do obsessions and compulsions start and why do they keep going?  How do we overcome obsessions and compulsions?  How do we resolve them?   What does the secular literature say are the best treatments"  -- Medication and a particular kind of therapy called Exposure and Response Prevention Alternatives   Can we find not just a descriptive diagnosis, but a proscriptive conceptualization that gives a direction for healing, resolving the obsessions and compulsions  Not just symptom management. Definitions  Obsessions  DSM-5: Obsessions are defined by (1) and (2): Recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.  The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).  Not pleasurable   Involuntary My compulsive thoughts aren't even thoughts, they're absolute certainties and obeying them isn't a choice. - Author: Paul Rudnick  To resist a compulsion with willpower alone is to hold back an avalanche by melting the snow with a candle. It just keeps coming and coming and coming. - Author: David Adam   Individual works to neutralize the obsession with another thought or a compulsion.   From the International OCD Foundation:  Obsessions are thoughts, images or impulses that occur over and over again and feel outside of the person's control. Individuals with OCD do not want to have these thoughts and find them disturbing. In most cases, people with OCD realize that these thoughts don't make any sense.  Obsessions are typically accompanied by intense and uncomfortable feelings such as fear, disgust, doubt, or a feeling that things have to be done in a way that is “just right.” In the context of OCD, obsessions are time consuming and get in the way of important activities the person values.  Common Obsessions  Sources What is OCD? Article by the International OCD Foundation on their website  WebMD article How Do I Know if I Have OCD? By Danny Bonvissuto February 19. 2020  Northpointrecovery.com blog What Types of OCD Are There? Get the Breakdown Here by the Northpoint Staff from May 3, 2019  Article entitled Common Types of OCD: Subtypes, Their Symptoms and the Best Treatment by Patrick Carey dated July 6, 2021 on treatmyocd.com   Contamination Body fluids --- blood, urine, saliva, feces -   I gave my baby niece a serious illness when I held her --  I'm sure I got a disease from using the public restroom.   Germs for communicable diseases -- may be afraid to shake hands, worried about catching gonorrhea  Environmental contaminants -- radiation, asbestos  Household chemicals -- cleaners, solvents  Dirt  If you put the wrong foods in your body, you are contaminated and dirty and your stomach swells. Then the voice says, Why did you do that? Don't you know better? Ugly and wicked, you are disgusting to me. - Author: Bethany Pierce   Losing Control Giving in to an impulse to harm yourself --  I could jump in front of this bus right now.   Fear of acting on an impulse to harm others -- what if I stabbed my child with this knife?  Fear of violent or horrific images in your mind  Fear of shouting out insults or obscenities --  Fear of stealing things   Harm Fear of being responsible for some terrible event (causing a fire at an office building)  Fear of harming others because of not being careful enough (leaving a stick in your yard that fell from a tree in a wind storm that may trip and hurt an neighbor child)   Relationships Doubts about romantic partner -- is she the right one for me?  Is there a better one I am supposed to find?  What if we are not meant to be together, but we wind up marrying each other?  Is my partner faithful?   Unwanted Sexual Thoughts Forbidden or perverse sexual thoughts or images  Sexual obsessions involving children  Obsessions about aggressive sexual behavior toward others   Obsessions related to perfectionism Concern about evenness or exactness   need for things to be in their place Arranging things in a particular way before leaving home   Concern with a need to know or remember  Inability to decide whether to keep or discard things  Fear of losing things  Fear of making a mistake -- may need excessive encouragement from others  Needing to make sure that your action is just right -- I need to start this email over, something is not wright with the wording.   Obsessions about your Sexual Orientation Obsessions about being embarrassed in a public situation Getting a non-communicable disease such as cancer Superstitious ideas such as unlucky numbers or certain colors Religious Obsessions (Scrupulosity) Concern with offending God  Concerns about blasphemy  Concerns about right and wrong, morality.   Compulsions  Definitions  DSM-5 Compulsions are defined by (1) and (2): Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.  The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.  Most people with OCD have both obsessions and compulsions.   From the International OCD Foundation Compulsions are the second part of obsessive compulsive disorder. These are repetitive behaviors or thoughts that a person uses with the intention of neutralizing, counteracting, or making their obsessions go away. People with OCD realize this is only a temporary solution but without a better way to cope they rely on the compulsion as a temporary escape. Compulsions can also include avoiding situations that trigger obsessions. Compulsions are time consuming and get in the way of important activities the person values.   Common Compulsions in OCD  Sources What is OCD? Article by the International OCD Foundation on their website  WebMD article How Do I Know if I Have OCD? By Danny Bonvissuto February 19. 2020  Northpointrecovery.com blog What Types of OCD Are There? Get the Breakdown Here by the Northpoit Staff from May 3, 2019  Article entitled Common Types of OCD: Subtypes, Their Symptoms and the Best Treatment by Patrick Carey dated July 6, 2021   Washing and Cleaning Washing hands excessively or in a certain way  Excessive showering, bathing, toothbrushing, grooming  Cleaning items or objects excessively   Checking Checking that you did not or will not harm anyone  Checking that you did not or will not harm yourself  Checking that nothing terrible happened  Checking that you did not make a mistake  Checking specific parts of your body   Repeating Re-reading or re-writing   Repeating routine activities Going in and out of doors  Getting up and down from chairs   Repeating body movements Tapping  Touching  Blinking   Repeating activities in multiples Doing things three times, because three is a good, right or safe number   Mental Compulsions Mental review of events to prevent harm (to oneself others, to prevent terrible consequences)  Praying to prevent harm (to oneself others, to prevent terrible consequences)  Counting while performing a task to end on a “good,” “right,” or “safe” number  Cancelling” or “Undoing” (example: replacing a “bad” word with a “good” word to cancel it out)    Putting things in order or arranging things until it “feels right” or are in perfect symmetry Telling asking or confessing to get reassurance Avoiding situations that might trigger your obsessions  Obsessions and Compulsions go together  The vicious cycle of OCD -- Obsessive-Compulsive Disorder (OCD) at helpguide.org Obsessive thought  --  I could stab my nephew with this knife.  Anxiety -- that would be a terrible thing to happen, I can't let that happen  Compulsion -- Locking all the knives away, checking to make sure they are all accounted for when your sibling and her family are visiting  Temporary relief -- the knives are all there.  “A physical sensation crawls up my arm as I avoid compulsions. But if I complete it, the world resets itself for a moment like everything will be just fine. But only for a moment.” —  Mardy M. Berlinger Harm Obsession     Compulsion:  Keeping all knives hidden away somewhere What if I killed my nephew and I just can't remember?  Repeatedly going back to check if you ran someone over DSM-5 Obsessive-Compulsive Disorder Presence of obsessions, compulsions, or both:  The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.  The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.  The disturbance is not better explained by the symptoms of another mental disorder   Specify if: With good or fair insight: The individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true.  With poor insight:  The individual thinks obsessive-compulsive disorder beliefs are probably true.  With absent insight/delusional beliefs: The individual is completely convinced that obsessive-compulsive disorder beliefs are true. 4%  With Tic disorder up to 30%   What is the experience of OCD Poem By Forti.no   Quotes: “You lose time. You lose entire blocks of your day to obsessive thoughts or actions. I spend so much time finishing songs in my car before I can get out or redoing my entire shower routine because I lost count of how many times I scrubbed my left arm.” — Kelly Hill  “Ever seen ‘Inside Out'? With OCD, it's like Doubt has its own control console.” — Josey Eloy Franco  “Imagine all your worst thoughts as a soundtrack running through your mind 24/7, day after day.” — Adam Walker Cleveland  “Picture standing in a room filled with flies and pouring a bottle of syrup over yourself. The flies constantly swarm about you, buzzing around your head and in your face. You swat and swat, but they keep coming. The flies are like obsessional thoughts — you can't stop them, you just have to fend them off. The swatting is like compulsions — you can't resist the urge to do it, even though you know it won't really keep the flies at bay more than for a brief moment.” — Cheryl Little Sutton  “It's like you have two brains — a rational brain and an irrational brain. And they're constantly fighting.” — Emilie Ford   Who 12 month prevalence is 1.2% with international prevalence rates from 1.1 to 1.8%  NIH Women have a higher prevalence 1.8% than men 0.5%.  Males more affected in childhood.  Lifetime prevalence 2.3%   Risk Factors:  DSM-5  Temperamental Factors Greater internalizing symptoms  Higher negative emotionality  Behavioral inhibition   Environmental Factors Childhood physical abuse  Childhood sexual abuse  Other stressful or traumatic events   Genetic Monozygotic concordance rates --.57  Dizygotic concordance rates .22   Physiological  Dysfunction in the orbitofrontal cortex, anterior cingulate cortex, and striatum have been implicated.   Streptococcal infection can precede the development of OCD symptoms in children Therapy  Exposure and Response Prevention (ERP) -- Developed originally in the 1970s Stanley Rachman's work a type of behavioral therapy  that exposes the person to situations that provoke their obsessions causing distress, usually anxiety which leads to  the urge to engage in the compulsion  that gives them the temporary relief.   The goal of ERP is to break the cycle of obsessions --> anxiety --> compulsion --> temporary relief.  So you are exposed to you anxiety provoking stimulus, and have the obsession, but you prevent the compulsive response, and you don't get the temporary relief.  Basic premise: As individuals confront their fears and no longer engage in their escape response, they will eventually reduce their anxiety. The goal is to habituate, or get used to the feelings of the obsessions, without having to engage in the compulsive behavior.  This increases the capacity to handle discomfort and anxiety.  Then one is no longer reinforced by the temporary anxiety relief that the compulsion provides.   Patrick Carey writes that: Any behavior that engages with the obsession– e.g. asking for reassurance, avoidance, rumination– reinforces it. By preventing these behaviors, ERP teaches people that they can tolerate their distress without turning to compulsions. It thereby drains obsessions of their power.  Division 12 of the APA   Essence of therapy: Individuals with OCD repeatedly confront the thoughts, images, objects, and situations that make them anxious and/or start their obsessions in a systematic fashion, without performing compulsive behaviors that typically serve to reduce anxiety. Through this process, the individual learns that there is nothing to fear and the obsessions no longer cause distress. From the IOCDF :  With ERP, the difference is that when you make the choice to confront your anxiety and obsessions you must also make a commitment to not give in and engage in the compulsive behavior. When you don't do the compulsive behaviors, over time you will actually feel a drop in your anxiety level. This natural drop in anxiety that happens when you stay “exposed” and “prevent” the compulsive “response” is called habituation. Instead, a person is forced to confront their obsessive thoughts relentlessly. The goal is to make the sufferer so accustomed to their obsessions that they no longer feel tempted to engage in soothing compulsions. Types of Exposure -- GoodTherapy.org article Imaginal Exposure: In this type of exposure, a person in therapy is asked to mentally confront the fear or situation by picturing it in one's mind. For example, a person with agoraphobia, a fear of crowded places, might imagine standing in a crowded mall.  In Vivo Exposure: When using this type of exposure, a person is exposed to real-life objects and scenarios. For example, a person with a fear of flying might go to the airport and watch a plane take off.  Virtual Reality Exposure: This type of exposure combines elements of both imaginal and in vivo exposure so that a person is placed in situations that appear real but are actually fabricated. For example, someone who has a fear of heights—acrophobia—might participate in a virtual simulation of climbing down a fire escape.   Steven Pence, and colleagues in a 2010 article in the American Journal of Psychotherapy:  "When exposures go wrong: Troubleshooting guidelines for managing difficult scenarios that arise in Exposure-based treatment for Obsessive-Compulsive Disorder The present article reviews five issues that occur in therapy but have been minimally discussed in the OCD treatment literature:  1) when clients fail to habituate to their anxiety -- they don't calm down2) when clients misjudge how much anxiety an exposure will actually cause3) when incidental exposures happen in session -- other fears in the fear hierarchy intrude.  4) when mental or covert rituals interfere with treatment -- covert compulsive behaviors5) when clients demonstrate exceptionally high anxiety sensitivity.  Stacey Smith Counseling at stacysmithcounseling.com -- ERP failures Utilizing safety behaviors  Not sitting with the anxiety until it dissipates -- distracting yourself  Not working through all the irrational, unhelpful thoughts  Not practicing often enough.   ERP criticisms  Can be really unpleasant for clients -- repeated exposures to terrifying stimuli -- can there be a better way? Concerns about safety and security   Concerns about flooding with anxiety  Ben Blum: Inside the Revolutionary Treatment That Could Change Psychotherapy Forever  elemental.medium.com July 21, 2020 Robert Fox is haunted by a memory of a germophobic woman with OCD whom he met once while she was hospitalized. As part of her ERP therapy, the therapists took her into the bathroom and had her wipe her hands over the toilet and sink and then rub them through her hair. She wasn't permitted to shower until the next morning.   Concerns about dropout rates.   Dropout rate of 18.7% across 21 ERP studies with 1400 participants Clarissa Ong and colleagues in 2016 article in the Journal of Anxiety Disorders Dropout rate of 10% among youth for ERP in a 2019 meta-analysis by Carly Johnco and her colleagues in the Journal "Depression and Anxiety" 11 randomized trials I'm concerned that it doesn't go deep enough  Not getting to root causes -- staying at the symptom level -- seeing symptoms as nonsensical One thing which I can't stress enough is that OCD is completely nonsensical and will not listen to reason. This is one of the most frightening things about having it. I knew that to anyone I told, there are Salvador Dali paintings that make more sense. - Author: Joe Wells   What is the fear really about.  Let's not just ignore it.  Fear is a response to something. Tracing back layers, going back through grief and anger, all the way to shame.  Shame episodes 37-49.   Doesn't get to any spiritual issues Medication  International OCD Foundation Drugs and dosages High doses are often needed for these drugs to work in most people.   Research suggests that the following doses may be needed:  fluvoxamine (Luvox®) – up to 300 mg/day  fluoxetine (Prozac®) – 40-80 mg/day  sertraline (Zoloft®) – up to 200 mg/day   paroxetine (Paxil®) – 40-60 mg/day   citalopram (Celexa®) – up to 40 mg/day*   clomipramine (Anafranil®) – up to 250 mg/day  escitalopram (Lexapro®) – up to 40 mg/day   venlafaxine (Effexor®) – up to 375 mg/day   How Do These Medications Work?  From the International OCD Foundation.  It remains unclear as to how these particular drugs help OCD. The good news is that after decades of research, we know how to treat patients, even though we do not know exactly why our treatments work. We do know that each of these medications affect a chemical in the brain called serotonin. Serotonin is used by the brain as a messenger. If your brain does not have enough serotonin, then the nerves in your brain might not be communicating right. Adding these medications to your body can help boost your serotonin and get your brain back on track.   Discussion of conventional approaches  Medication  I am not a physician -- I'm a psychologist and I don't have prescription privileges I don't give advice on medication choices or on dosages or anything like that.  If you think your medication is helping your OCD, I'm not going to argue with you about that --  I don't want to try to dissuade anyone from taking medication for psychological issues if they think it's helping them.   Here's the thing, though.  So much of your thinking about medication depends on what you see as the cause of the problem It makes sense to take medication if you think the obsessions and compulsions pop up because of chemical imbalances.   You take the medication to restore the chemical balance and reduce the symptoms.  So many of treatments for OCD treat the obsessions and compulsions as meaningless, as irrational, as just the random epiphenomena of consciousness, or just as nonsensical expressions of miswiring in the brain or just the effects of poorly balanced neurochemical in the brain.     And so these approaches, like ERP that and medication that target the obsessions and compulsions for eradication, that seek to vanquish them result in multiple problems  I think that is a major, major mistake.   And here is what I want to emphasize.  Obsessions and Compulsions are symptoms.  They are symptoms.  Obsessions and compulsions, as painful and as debilitating as they are for many people, those obsessions and compulsions are not the primary problem.  They are the effects of the primary problem.  Obsessions and compulsions happen late in the causal chain.  I see meaning in every obsession and in every compulsion.  I see a message in every obsession and compulsion.  A cry for help, a signal of deeper distress.   There are cases in which a psychological problem can be purely or primarily organic -- due to a medical condition -- for example due to head trauma that causes brain damage.  Or a brain tumor on the pituitary gland that disrupts your whole endocrine system, resulting in mood swings. But, Most of the time, though, psychological symptoms have psychological causes.   As a Catholic psychologist, I want to move much further back in the causal chain.  I want to address and resolve the underlying issues that give rise to the obsessions in the first place.   Self Help  Obsessive-Compulsive Disorder (OCD) at helpguide.org  Identify your triggers Can help you anticipate your urges  Create a solid mental picture and then make a mental note. Tell yourself, “The window is now closed,” or “I can see that the oven is turned off.”  When the urge to check arises later, you will find it easier to re-label it as “just an obsessive thought.”   Learn to resist OCD compulsions by repeatedly exposing yourself to your OCD triggers, you can learn to resist the urge to complete your compulsive rituals --  exposure and response prevention (ERP)  Build your fear ladder -- working your way up to more and more frightening things.   Resist the urge to do your compulsive behavior The anxiety will fade You're not going to lose control or have a breakdown Practice Challenge Obsessive thoughts Thoughts are just thoughts   Write down obsessive thoughts and compulsions Writing it all down will help you see just how repetitive your obsessions are.  Writing down the same phrase or urge hundreds of times will help it lose its power.  Writing thoughts down is much harder work than simply thinking them, so your obsessive thoughts are likely to disappear sooner.   Challenge your obsessive thoughts. Use your worry period to challenge negative or intrusive thoughts by asking yourself What's the evidence that the thought is true? That it's not true? Have I confused a thought with a fact?   Is there a more positive, realistic way of looking at the situation?  What's the probability that what I'm scared of will actually happen? If the probability is low, what are some more likely outcomes?   Is the thought helpful? How will obsessing about it help me and how will it hurt me?   What would I say to a friend who had this thought?   Create an OCD worry period. Rather than trying to suppress obsessions or compulsions, develop the habit of rescheduling them. Choose one or two 10-minute “worry periods” each day, time you can devote to obsessing.  During your worry period, focus only on negative thoughts or urges. Don't try to correct them. At the end of the worry period, take a few calming breaths, let the obsessive thoughts go, and return to your normal activities. The rest of the day, however, is to be designated free of obsessions.  When thoughts come into your head during the day, write them down and “postpone” them to your worry period.   Create a tape of your OCD obsessions or intrusive thoughts. Focus on one specific thought or obsession and record it to a tape recorder or smartphone.  Recount the obsessive phrase, sentence, or story exactly as it comes into your mind.  Play the tape back to yourself, over and over for a 45-minute period each day, until listening to the obsession no longer causes you to feel highly distressed.   By continuously confronting your worry or obsession you will gradually become less anxious. You can then repeat the exercise for a different obsession.   Reach our for support Stay connected to family and friends.  Join an OCD support group.  Manage Stress Quickly self-soothe and relieve anxiety symptoms by making use of one or more of your physical senses—sight, smell, hearing, touch, taste—or movement. You might try listening to a favorite piece of music, looking at a treasured photo, savoring a cup of tea, or stroking a pet.   Practice relaxation techniques. Mindful meditation, yoga, deep breathing, and other relaxation techniques can help lower your overall stress and tension levels and help you manage your urges. For best results, try practicing a relaxation technique regularly. Lifestyle changes Exercise regularly  Get enough sleep  Avoid alcohol and nicotine   Not sure this is going to work.  Doesn't get to root causes.   IFS as an alternative From Verywellmind.com  What is Internal Family Systems?  By Theodora Blanchfield, August 22, 2021    What Is Internal Family Systems (IFS) Therapy? Internal family systems, or IFS, is a type of therapy that believes we are all made up of several parts or sub-personalities. It draws from structural, strategic, narrative, and Bowenian types of family therapy. The founder, Dr. Richard Schwartz, thought of the mind as an inner family and began applying techniques to individuals that he usually used with families.  The underlying concept of this theory is that we all have several parts living within us that fulfill both healthy and unhealthy roles. Life events or trauma, however, can force us out of those healthy roles into extreme roles. The good news is that these internal roles are not static and can change with time and work. The goal of IFS therapy is to achieve balance within the internal system and to differentiate and elevate the self so it can be an effective leader in the system.   Parts:  Separate, independently operating personalities within us, each with own unique prominent needs, roles in our lives, emotions, body sensations, guiding beliefs and assumptions, typical thoughts, intentions, desires, attitudes, impulses, interpersonal style, and world view.  Each part also has an image of God and also its own approach to sexuality.  Robert Falconer calls them insiders.  Robert Fox and Alessio Rizzo  have done the most work with IFS to work with obsessions and compulsions.    Sources IFS and Hope with OCD with Alessio Rizzo and Robert Fox -- Episode 102 of Tammy Sollenberger's podcast The One Inside -- September 17, 2021  Podcast IFS Talks:  Hosts Aníbal Henriques & Tisha Shull  A Talk with Robert Fox on OCD-types -- Robert Fox   February 20, 2021   Robert Fox, IFS therapist with OCD  Ben Blum: Inside the Revolutionary Treatment That Could Change Psychotherapy Forever  elemental.medium.com July 21, 2020 https://elemental.medium.com/inside-the-revolutionary-treatment-that-could-change-psychotherapy-forever-8be035d54770   Robert Fox, a therapist in Woburn, Massachusetts, also wishes more people knew about IFS. Diagnosed with obsessive-compulsive disorder at age 21 after a lifetime of unusual compulsions, he spent 23 years receiving the standard care: cognitive behavioral therapy (CBT) and exposure response prevention (ERP). Neither had much effect, especially ERP, which involved repeatedly exposing himself to things he was anxious about in the hopes of gradually habituating to them. “When you think about it, it's a very painful method of therapy,” he says. Fox discovered IFS in 2008. Before, he had always been encouraged to think of his compulsions as meaningless pathologies. Now, for the first time, they began making sense to him as the behavior of protectors who were trying to manage the underlying shame and fear of exiles. After two particularly powerful unburdenings, his symptoms abated by 95% and stayed that way. “[OCD] used to be almost like kryptonite around my neck when I would have serious flare-ups,” he says. “I feel a lot of freedom and peace and I really owe it to Dick [Schwartz] and the model.” Concerns about ERP  ERP doesn't bring the curiosity -- why did this happen?   Obsessions are not irrational and Compulsions are not meaningless Alessio Rizzo Conventional OCD diagnosis and treatment ERP and medication -- nothing points back to underlying causes. Alessio Rizzo:  Evidence-based approaches for OCD that work -- they work by drawing a manager part into a role of suppressing OCD symptoms  Needing to continue ERP.   Causes:  Fox Repressed anger. -- not a parent who could witness   Intense shame that is dissociated Shame from childhood -- exiled  Shame from the OCD itself.  -- sarcasm from others, especially from his older brother.   “OCD is like having a bully stuck inside your head and nobody else can see it.” — Krissy McDermott   We hide what we are ashamed of -- not easy to treat.   Fox on his treatment:  Right. I didn't see it myself until one day I was out for a walk with my dog Gizmo around my block, walking around the block with him and I had been to all these lectures about shame and I was walking one day and all of a sudden it was like, it just came to me “Holy, Holy, Holy shit. I carry that shame.” And it was like a dark cloud that was overhead and just kind of followed me wherever I went. And it was actually not an awful thing to realize. That's what had been basically walking around on my back for so long. It was this deep shame. In agreement with how central I think shame is to OCD Obsessions and compulsions develop gradually and experiment with different ways of drawing attention away from the intensity of underlying experience.  All happens in silence in the inner world.   An obsession or compulsion distracts us from the pain of an exile.  If I'm worrying about the gas in the lawnmower overflowing and blowing up the house -- takes me away from the shame of feeling inadequate at work.   Needs to be powerful enough to hijack my mind So many layers of protectors  -- takes time Alessio Rizzo Post dated March 3, 2021 entitled "IFS and OCD -- A Comparison Between CBT and IFS for OCD.  https://www.therapywithalessio.com/articles/ifs-and-ocd-how-does-the-ifs-method-work-for-ocd In IFS, we use the language of parts to describe how we function. As a consequence, the OCD is considered a part of the person. This means that, even if the OCD seems quite a strong presence in the client's life, there is much more to a person than OCD.  At this stage CBT and IFS might look similar because CBT also encourages clients to label the anxieties and the intrusive thoughts that form the OCD and not engage with them.  The main difference between CBT and IFS is in how we relate to the OCD part.  One of the foundational elements of IFS is that all parts are welcome, and, therefore, the OCD part is not dismissed or ignored, but it is respected. Respect does not mean that the client will believe the content of intrusive thoughts or that they will follow up on whatever behaviour the OCD wants. IFS gives us a way to make sure that there is enough safety and calm before offering respect to the OCD part. This might take a different amount of attempts depending on the severity of the OCD, and on the strength of the relationship between therapist and client.  Healing OCD with IFS  The main difference between CBT and IFS is in the definition of “cure” of OCD.  CBT therapy has the ultimate goal of empowering the client to overcome OCD thoughts and anxieties by never engaging with them or by using exposure therapy to demonstrate that the OCD fears and obsessions have got no evidence to exist.  IFS believes that healing is the result of the re-organisation of parts so that extreme behaviour is substituted by more functional ways of thinking and acting, and, above all, IFS aims at healing the traumatic events that have led to the development of OCD symptoms.    The result of healing the trauma that fuels OCD is a spontaneous decrease of OCD anxieties and intrusive thoughts and, in my opinion, this form of healing is preferable to the one described by CBT. Using IFS language, the CBT approach aims at creating a new part in the system that is tasked with managing the OCD, while there is no attention paid to discovery and healing of the trauma that is fueling the OCD.Choosing the method that best suits you There is no way of saying what method works best for a person.  Therapy outcomes depend on many factors and not only on the method used. Sometimes the quality of the therapeutic relationship is the biggest healing factor, and it is ultimately up to the client to find the best combination of therapist and method that can best suit them. Colleen West, LMFT LMFT  December 20 post on her website colleenwest.com  Treating OCD with Internal Family Systems Parts Work Just a word about treating OCD with IFS versus Exposure and Response Prevention (ERP). Treating obsessive and compulsive parts with IFS is diametrically opposed to treating it in the Exposure and Response Prevention, the most commonly recommended approach. IFS treats OCD parts as what they are--managers and fire fighters, they have jobs to do. If you can help the exiles underneath these protectors, there will be less need for the OCD behaviors. (This might be complicated if there are still constant stressors in the client's life, for which they need the protection.)   IFS does work, and I have successfully treated people with full blown OCD who now have about 5% of their original symptoms only during moments of high stress, and they do not consider themselves OCD anymore. These clients have been helped by taking SSRIs as well, which I will say more about below.ERP works to suppress those same protectors that IFS seeks to understand/care for. It does "work", as people get a strategy for the thoughts that are driving them nuts, but the folks I know who have gone through this treatment find they have to do their 'homework' forever or the OCD comes back, and they always feel it threatening. In short, it is stressful, and the fight is never over.For anyone doing ERP, they have to commit fully to that approach, the homework is hours a day, and one cannot be halfhearted about it or it won't work. The good thing about ERP is that it gives people some control, which they strongly desire, because they feel so powerless. Next episode Episode 87, will come out on December 6, 2022 Scrupulosity --  I have such a different take -- Scrupulosity is what happens with perfectionism and OCD get religion.   Spiritual and Psychological elements.   In the last episode we really got into understanding perfectionism.  In this episode, we worked on really getting to know about obsessions and compulsions.  Next episode, we get much more into scrupulosity.  My own battle with scrupulosity.   Remember, you as a listener can call me on my cell any Tuesday or Thursday from 4:30 PM to 5:30 PM.  I've set that time aside for you.  317.567.9594.  (repeat) or email me at crisis@soulsandhearts.com.  Resilient Catholics Community.  Talked a lot about it in episode 84, two episodes ago.  We now have 106 on the waiting list.  Reopening the community on December 1 for those on the waiting list first.  Can learn a lot more about the RCC and you can sign up at soulsandhearts.com/rcc.  We have had heavy demand.  We may have to limit how many we bring in.  I am working to clear time in my calendar to review the Initial Measures Kits and help new members through the onboarding process -- all the individual attention takes time.  I'm also hiring more staff to help.   Pray for me.  Humility.  Childlike trust   Invocations        

Citalopram is also known by the brand name Celexa. It is an antidepressant and a selective serotonin reuptake inhibitor (SSRI). The tablet come in a 10 mg, 20 mg, and 40 mg strength and is also available as a 10 mg/5 ml solution. In adults and pediatrics it can be used to treat both major depressive and obsessive compulsive disorder. There are other off-label indications in children but the only approved use is in adults for major depressive disorder. The treatment range for treating major depressive disorder in adults is 20-40 mg PO qd with a max of 40 mg/day. There is literature with a max of 60 mg/day for OCD but 40 mg/day is the most commonly accepted max dose. The onset of action and benefits for patients are typically seen within the first 1-2 weeks with continued improvements through weeks 4-6. The medication half-life is around 24-48 hours with a duration of action being the same. There is a black box warning for suicidality with the greatest concern for children, adolescents and young adults. The risk does appear to decrease in adults >24 years of age and in the elderly >65 years of age. The medication should never be stopped without approval from the prescriber even when feeling well. Go to DrugCardsDaily.com for episode show notes which consist of the drug summary, quiz, and link to the drug card for FREE! Please SUBSCRIBE, FOLLOW, and RATE on Spotify, Apple Podcasts, or wherever your favorite place to listen to podcasts are. The main goal is to go over the Top 200 Drugs with the occasional drug of interest. Also, if you'd like to say hello, suggest a drug, or leave some feedback I'd really appreciate hearing from you! Leave a voice message at anchor.fm/drugcardsdaily or find me on twitter @drugcardsdaily --- Send in a voice message: https://anchor.fm/drugcardsdaily/message

This week Harry is joined by Kevin Davies, author of the 2020 book Editing Humanity: The CRISPR Revolution and the New Era of Genome Editing. CRISPR—an acronym for Clustered Regularly Interspaced Short Palindromic Repeats—consists of DNA sequences that evolved to help bacteria recognize and defend against viral invaders, as a kind of primitive immune system. Thanks to its ability to precisely detect and cut other DNA sequences, CRISPR has spread to labs across the world in the nine years since Jennifer Doudna and Emmanuel Charpentier published a groundbreaking 2012 Science paper describing how the process works. The Nobel Prize committee recognized the two scientists for the achievement in 2020, one day after Davies' book came out. The book explains how CRISPR was discovered, how it was turned into an easily programmable tool for cutting and pasting stretches of DNA, how most of the early pioneers in the field have now formed competing biotech companies, and how the technology is being used to help patients today—and in at least one famous case, misused. Today's interview covers all of that ground and more.Davies is a PhD geneticist who has spent most of his career in life sciences publishing. After his postdoc with Harvey Lodish at the Whitehead Institute, Davies worked as an assistant editor at Nature, the founding editor of Nature Genetics (Nature's first spinoff journal), editor-in-chief at Cell Press, founding editor-in-chief of the Boston-based publication Bio-IT World, and publisher of Chemical & Engineering News. In 2018 he helped to launch The CRISPR Journal, where he is the executive editor. Davies' previous books include Breakthrough (1995) about the race to understand the BRCA1 breast cancer gene, Cracking the Genome (2001) about the Human Genome Project, The $1,000 Genome (2010) about next-generation sequencing companies, and DNA (2017), an updated version of James Watson's 2004 book, co-authored with Watson and Andrew Berry.Please rate and review MoneyBall Medicine on Apple Podcasts! Here's how to do that from an iPhone, iPad, or iPod touch:1. Open the Podcasts app on your iPhone, iPad, or Mac. 2. Navigate to the page of the MoneyBall Medicine podcast. You can find it by searching for it or selecting it from your library. Just note that you'll have to go to the series page which shows all the episodes, not just the page for a single episode.3.Scroll down to find the subhead titled "Ratings & Reviews."4.Under one of the highlighted reviews, select "Write a Review."5.Next, select a star rating at the top — you have the option of choosing between one and five stars. 6.Using the text box at the top, write a title for your review. Then, in the lower text box, write your review. Your review can be up to 300 words long.7.Once you've finished, select "Send" or "Save" in the top-right corner. 8.If you've never left a podcast review before, enter a nickname. Your nickname will be displayed next to any reviews you leave from here on out. 9.After selecting a nickname, tap OK. Your review may not be immediately visible.Full TranscriptHarry Glorikian: I'm Harry Glorikian, and this is MoneyBall Medicine, the interview podcast where we meet researchers, entrepreneurs, and physicians who are using the power of data to improve patient health and make healthcare delivery more efficient. You can think of each episode as a new chapter in the never-ending audio version of my 2017 book, “MoneyBall Medicine: Thriving in the New Data-Driven Healthcare Market.” If you like the show, please do us a favor and leave a rating and review at Apple Podcasts.Harry Glorikian: We talk a lot on the show about how computation and data are changing the way we develop new medicines and the way we deliver healthcare. Some executives in the drug discovery business speak of the computing and software side of the business as the “dry lab” —to set it apart from the “wet labs” where scientists get their hands dirty working with actual cells, tissues, and reagents.But the thing is, recent progress on the wet lab side of biotech has been just as amazing as progress in areas like machine learning. And this week, my friend Kevin Davies is here to talk about the most powerful tool to come along in the last decade, namely, precise gene editing using CRISPR.Of course, CRISPR-based gene editing has been all over the news since Jennifer Doudna and Emmanuel Charpentier published a groundbreaking Science paper in 2012 describing how the process works in the lab. That work earned them a Nobel Prize in medicine just eight years later, in 2020.But what's not as well-known is the story of how CRISPR was discovered, how it was turned into an easily programmable tool for cutting and pasting stretches of DNA, how most of the early pioneers in the field have now formed competing biotech companies, and how the technology is being used to help patients today—and in at least one famous case, misused.Kevin put that whole fascinating story together in his 2020 book Editing Humanity. And as the executive editor of The CRISPR Journal, the former editor-in-chief of Bio-IT World, the founding editor at Nature Genetics, and the author of several other important books about genomics, Kevin is one of the best-placed people in the world to tell that story. Here's our conversation.Harry Glorikian: Kevin, welcome to the show. Kevin Davies: Great to see you again, Harry. Thanks for having me on.Harry Glorikian: Yeah, no, I mean, I seem to be saying this a lot lately, it's been such a long time since, because of this whole pandemic, nobody's really seeing anybody on a regular basis. I want to give everybody a chance to hear about, you had written this book called Editing Humanity, which is, you know, beautifully placed behind you for, for product placement here. But I want to hear, can you give everybody sort of an overview of the book and why you feel that this fairly technical laboratory tool called CRISPR is so important that you needed to write a book about it?Kevin Davies: Thank you. Yes. As you may know, from some of my previous “bestsellers” or not, I've written about big stories in genetics because that's the only thing I'm remotely qualified to write about. I trained as a human geneticist in London and came over to do actually a pair of post-docs in the Boston area before realizing my talents, whatever they might be, certainly weren't as a bench researcher. So I had to find another way to stay in science but get away from the bench and hang up the lab coats.So moving into science publishing and getting a job with Nature and then launching Nature Genetics was the route for me. And over the last 30 years, I've written four or five books that have all been about, a) something big happening in genomics, b) something really big that will have both medical and societal significance, like the mapping and discovery of the BRCA1 breast cancer gene in the mid-90s, the Human Genome Project at the turn of the century, and then the birth and the dawn of consumer genetics and personalized medicine with The $1,000 Genome. And the third ingredient I really look for if I'm trying to reach a moderately, significantly large audience is for the human elements. Who are they, the heroes and the anti heroes to propel the story? Where is the human drama? Because, you know, we all love a good juicy, gossipy piece of story and rating the good guys and the bad guys. And CRISPR, when it first really took off in 2012, 2013 as a gene editing tool a lot of scientists knew about this. I mean, these papers are being published in Science in particular, not exactly a specialized journal, but I was off doing other things and really missed the initial excitement, I'm embarrassed to say. It was only a couple of years later, working on a sequel to Jim Watson's DNA, where I was tasked with trying to find and summarize the big advances in genomic technology over the previous decade or whatever, that I thought, well, this CRISPR thing seems to be taking off and the Doudnas and the Charpentiers are, you know, winning Breakthrough Prizes and being feted by celebrities. And it's going on 60 Minutes. They're going to make a film with the Rock, Dwayne Johnson. What the heck is going on. And it took very little time after that, for me to think, you know, this is such an exciting, game-changing disruptive technology that I've got to do two things. I've gotta, a) write a book and b) launch a journal, and that's what I did. And started planning at any rate in sort of 2016 and 17. We launched the CRISPR Journal at the beginning of 2018. And the book Editing Humanity came out towards the end of 2020. So 2020, literally one day before the Nobel Prize—how about that for timing?—for Doudna and Charpentier for chemistry last year. Harry Glorikian: When I think about it, I remember working with different companies that had different types of gene editing technology you know, working with some particularly in the sort of agriculture space, cause it a little bit easier to run faster than in the human space. And you could see what was happening, but CRISPR now is still very new. But from the news and different advances that are happening, especially here in the Boston area, you know, it's having some real world impacts. If you had to point to the best or the most exciting example of CRISPR technology helping an actual patient, would you say, and I've heard you say it, Victoria Gray, I think, would be the person that comes to mind. I've even, I think in one of your last interviews, you said something about her being, you know, her name will go down in history. Can you explain the technology that is helping her and what some of the similar uses of CRISPR might be?Kevin Davies: So the first half of Editing Humanity is about the heroes of CRISPR, how we, how scientists turned it from this bizarre under-appreciated bacterial antiviral defense system and leveraged it and got to grips with it, and then figured out ways to turn it into a programmable gene editing technology. And within a year or two of that happening that the classic Doudna-Charpentier paper came out in the summer of 2012. Of course the first wave of biotech companies were launched by some of the big names, indeed most of the big names in CRISPR gene editing hierarchies. So Emmanuel Charpentier, Nobel Laureate, launched CRISPR Therapeutics, Jennifer Doudna co-founded Editas Medicine with several other luminaries. That didn't go well for, for reasons of intellectual property. So she withdrew from Editas and became a co-founder of Intellia Therapeutics as well as her own company, Caribou, which just went public, and Feng Zhang and others launched Editas Medicine. So we had this sort of three-way race, if you will, by three CRISPR empowered gene editing companies who all went public within the next two or three years and all set their sights on various different genetic Mendelian disorders with a view to trying to produce clinical success for this very powerful gene editing tool. And so, yes, Victoria Gray is the first patient, the first American patient with sickle cell anemia in a trial that is being run by CRISPR Therapeutics in close association with Vertex Pharmaceuticals. And that breakthrough paper, as I think many of your listeners will know, came out right at the end of 2020 published in the New England Journal of Medicine. Doesn't get much more prestigious than that. And in the first handful of patients that CRISPR Therapeutics have edited with a view to raising the levels of fetal hemoglobin, fetal globin, to compensate for the defective beta globin that these patients have inherited, the results were truly spectacular.And if we fast forward now to about two years after the initial administration, the initial procedures for Victoria Gray and some of her other volunteer patients, the results still look as spectacular. Earlier this year CRISPR Therapeutics put out of sort of an update where they are saying that the first 20 or 24 patients that they have dosed with sickle cell and beta thallasemia are all doing well. There've been little or no adverse events. And the idea of this being a once and done therapy appears very well founded. Now it's not a trivial therapy. This is ex-vivo gene editing as obviously rounds of chemotherapy to provide the room for the gene edited stem cells to be reimplanted into the patient. So this is not an easily scalable or affordable or ideal system, but when did we, when will we ever able to say we've pretty much got a cure for sickle cell disease? This is an absolutely spectacular moment, not just for CRISPR, but for medicine, I think, overall. And Victoria Gray, who's been brilliantly profiled in a long running series on National Public Radio, led by the science broadcaster Rob Stein, she is, you know, we, we can call her Queen Victoria, we can call it many things, but I really hope that ,it's not just my idea, that she will be one of those names like Louise Brown and other heroes of modern medicine, that we look and celebrate for decades to come.So the sickle cell results have been great, and then much more recently, also in the New England Journal, we have work led by Intellia Therapeutics, one of the other three companies that I named, where they've been also using CRISPR gene editing, but they've been looking at a rare liver disease, a form of amyloidosis where a toxic protein builds up and looking to find ways to knock out the production of that abnormal gene.And so they've been doing in vivo gene editing, really using CRISPR for the first time. It's been attempted using other gene editing platforms like zinc fingers, but this is the first time that I think we can really say and the New England Journal results prove it. In the first six patients that have been reported remarkable reductions in the level of this toxic protein far, not far better, but certainly better than any approved drugs that are currently on the market. So again, this is a very, very exciting proof of principle for in vivo gene editing, which is important, not just for patients with this rare liver disorder, but it really gives I think the whole field and the whole industry enormous confidence that CRISPR is safe and can be used for a growing list of Mendelian disorders, it's 6,000 or 7,000 diseases about which we know the root genetic cause, and we're not going to tackle all of them anytime soon, but there's a list of ones that now are within reach. And more and more companies are being launched all the time to try and get at some of these diseases.So as we stand here in the summer of 2021, it's a really exciting time. The future looks very bright, but there's so much more to be done. Harry Glorikian: No, we're just at the beginning. I mean, I remember when I first saw this, my first question was off target effects, right? How are we going to manage that? How are they going to get it to that place that they need to get it to, to have it to that cell at that time, in the right way to get it to do what it needs to do. And you know, all these sorts of technical questions, but at the same time, I remember I'm going to, trying to explain this to my friends. I'm like, “You don't understand, this can change everything.” And now a high school student, I say this to people and they look at me strangely, a high school student can order it and it shows up at your house.Kevin Davies: Yeah, well, this is why I think, and this is why one reason why CRISPR has become such an exciting story and receives the Nobel Prize eight years after the sort of launch publication or the first demonstration of it as a gene editing tool. It is so relatively easy to get to work. It's truly become a democratized or democratizing technology. You don't need a million-dollar Illumina sequencer or anything. And so labs literally all around the world can do basic CRISPR experiments. Not everyone is going to be able to launch a clinical trial. But the technology is so universally used, and that means that advances in our understanding of the mechanisms, new tools for the CRISPR toolbox new pathways, new targets, new oftware, new programs, they're all coming from all corners of the globe to help not just medicine, but many other applications of CRISPR as well.Harry Glorikian: Yeah. I always joke about like, there, there are things going on in high school biology classes now that weren't, available, when I was in college and even when we were in industry and now what used to take an entire room, you can do on a corner of a lab bench.Kevin Davies: Yeah. Yeah. As far as the industry goes we mentioned three companies. But you know, today there's probably a dozen or more CRISPR based or gene editing based biotech companies. More undoubtedly are going to be launched before the end of this year. I'm sure we'll spend a bit of time talking about CRISPR 2.0, it seems too soon to be even thinking about a new and improved version of CRISPR, but I think there's a lot of excitement around also two other Boston-based companies, Beam Therapeutics in Cambridge and Verve Therapeutics both of which are launching or commercializing base editing. So base editing is a tool developed from the lab of David Lu of the Broad Institute [of MIT and Harvard]. And the early signs, again, this technology is only five or six years old, but the early signs of this are incredibly promising. David's team, academic team, had a paper in Nature earlier this year, really reporting successful base editing treatment of sickle cell disease in an animal model, not by raising the fetal globin levels, which was sort of a more indirect method that is working very well in the clinic, but by going right at the point mutation that results in sickle cell disease and using given the chemical repertoire of base editing.Base editing is able to make specific single base changes. It can't do the full repertoire of single base changes. So there are some limitations on researchers' flexibility. So they were unable to flip the sickle cell variant back to the quote unquote wild type variants, but the change they were able to make is one that they can live with, we can live with because it's a known benign variant, a very rare variant that has been observed in other, in rare people around the world. So that's completely fine. It's the next best thing. And so that looks very promising. Beam Therapeutics, which is the company that David founded or co-founded is trying a related approach, also going right at the sickle cell mutation. And there are other companies, including one that Matthew Porteus has recently founded and has gone public called Graphite Bio.So this is an exciting time for a disease sickle cell disease that has been woefully neglected, I think you would agree, both in terms of basic research, funding, medical prioritization, and medical education. Now we have many, many shots on goal and it doesn't really, it's not a matter of one's going to win and the others are going to fall by the wayside. Just like we have many COVID vaccines. We'll hopefully have many strategies for tackling sickle cell disease, but they are going to be expensive. And I think you know the economics better than I do. But I think that is the worry, that by analogy with gene therapies that have been recently approved, it's all, it's really exciting that we can now see the first quote, unquote cures in the clinic. That's amazingly exciting. But if the price tag is going to be $1 million or $2 million when these things are finally approved, if and when, that's going to be a rather deflating moment. But given the extraordinary research resources that the CRISPRs and Intellias and Beams and Graphites are pouring into this research, obviously they've got to get some return back on their investment so that they can plow it back into the company to develop the next wave of of gene editing therapies. So you know, it's a predicament Harry Glorikian: One of these days maybe I have to have a show based on the financial parts of it. Because there's a number of different ways to look at it. But just for the benefit of the listeners, right, who may not be experts, how would you explain CRISPR is different from say traditional gene therapies. And is CRISPR going to replace older methods of, of gene therapy or, or will they both have their place? Kevin Davies: No, I think they'll both have their place. CRISPR and, and these newer gene editing tools, base editing and another one called prime editing, which has a company behind it now called Prime Medicine, are able to affect specific DNA changes in the human genome.So if you can target CRISPR, which is an enzyme that cuts DNA together with a little program, the GPS signal is provided in the form of a short RNA molecule that tells the enzyme where to go, where to go in the genome. And then you have a couple of strategies. You can either cut the DNA at the appropriate target site, because you want to inactivate that gene, or you just want to scramble the sequence because you want to completely squash the expression of that gene. Or particularly using the newer forms of gene editing, like base editing, you can make a specific, a more nuanced, specific precision edit without, with one big potential advantage in the safety profile, which is, you're not completely cutting the DNA, you're just making a nick and then coaxing the cell's natural repair systems to make the change that you sort of you're able to prime.So there are many diseases where this is the way you want to go, but that does not in any way invalidate the great progress that we're making in traditional gene therapy. So for example today earlier today I was recording an interview or for one of my own programs with Laurence Reid, the CEO of Decibel Therapeutics, which is looking at therapies for hearing loss both genetic and other, other types of hearing disorders.And I pushed him on this. Aren't you actually joinomg with the gene editing wave? And he was very circumspect and said, no, we're very pleased, very happy with the results that we're getting using old fashioned gene replacement therapy. These are recessive loss of function disorders. And all we need to do is get the expression of some of the gene back. So you don't necessarily need the fancy gene editing tools. If you can just use a an AAV vector and put the healthy gene back into the key cells in the inner ear. So they're complimentary approaches which is great.Harry Glorikian: So, you know, in, in this podcast, I try to have a central theme when I'm talking to people. The relationships of big data, computation, advances in new drugs, and other ways to keep people healthy. So, you know, like question-wise, there's no question in my mind that the whole genomics revolution that started in the ‘90s, and I was happy to be at Applied Biosystems when we were doing that, would have been impossible in the absence of the advances in computing speed and storage in the last three decades. I think computing was the thing that held up the whole human genome, which gave us the book of life that CRISPR is now allowing us to really edit. But I wonder if you could bring us sort of up-to-date and talk about the way CRISPR and computation are intertwined. What happens when you combine precision of an editing tool like CRISPR with the power of machine learning and AI tools to find meaning and patterns in that huge genetic ball? Kevin Davies: Yeah. Well, yeah. I'm got to tread carefully here, but I think we are seeing papers from some really brilliant labs that are using some of the tools that you mentioned. AI and machine learning with a view to better understanding and characterizing some of the properties and selection criteria of some of these gene editing tools. So you mentioned earlier Harry, the need to look out for safety and minimize the concern of off-target effects. So I think by using some of these some algorithms and AI tools, researchers have made enormous strides in being able to design the programmable parts of the gene editing constructs in such a way that you increase the chances that they're going to go to the site that you want them to go to, and nnot get hung up latching onto a very similar sequence that's just randomly cropped up on the dark side of the genome, across the nucleus over there. You don't want that to happen. And I don't know that anybody would claim that they have a failsafe way to guarantee that that could never happen. But the you know, the clinical results that we've seen and all the preclinical results are showing in more and more diseases that we've got the tools and learned enough now to almost completely minimize these safety concerns. But I think everyone, I think while they're excited and they're moving as fast as they can, they're also doing this responsibly. I mean, they, they have to because no field, gene therapy or gene editing really wants to revisit the Jesse Gelsinger tragedy in 1999, when a teenage volunteer died in volunteering for a gene therapy trial at Penn of, with somebody with a rare liver disease. And of course that, that setback set back the, entire field of gene therapy for a decade. And it's really remarkable that you know, many of the sort of pioneers in the field refuse to throw in the towel, they realized that they had to kind of go back to the drawing board, look at the vectors again, and throw it out. Not completely but most, a lot of the work with adenoviruses has now gone by the wayside. AAV is the new virus that we hear about. It's got a much better safety profile. It's got a smaller cargo hold, so that's one drawback, but there are ways around that. And the, the explosion of gene therapy trials that we're seeing now largely on the back of AAV and now increasingly with, with non-viral delivery systems as well is, is very, very gratifying. And it's really delivery. I think that is now the pain point. Digressing from your question a little bit, but delivery, I think is now the big challenge. It's one thing to contemplate a gene therapy for the eye for rare hereditary form of blindness or the ear. Indeed those are very attractive sites and targets for some of these early trials because of the quantities that you need to produce. And the localization, the, the physical localization, those are good things. Those help you hit the target that you want to. But if you're contemplating trying something for Duchenne muscular dystrophy or spinal muscular atrophy, or some of the diseases of the brain, then you're going to need much higher quantities particularly for muscular disorders where, you run into now other challenges, including, production and manufacturing, challenges, and potentially safeguarding and making sure that there isn't an immune response as well. That's another, another issue that is always percolating in the background.But given where we were a few years ago and the clinical progress that we've talked about earlier on in the show it, I think you can safely assume that we've collectively made enormous progress in, in negating most, if not all of these potential safety issues.Harry Glorikian: No, you know, it's funny, I know that people will say like, you know, there was a problem in this and that. And I look at like, we're going into uncharted territories and it has to be expected that you just…you've got people that knew what they were doing. All of these people are new at what they are doing. And so you have to expect that along the way everything's not going to go perfectly. But I don't look at it as a negative. I look at it as, they're the new graduating class that's going to go on and understand what they did right. Or wrong, and then be able to modify it and make an improvement. And, you know, that's what we do in science. Kevin Davies: Well, and forget gene editing—in any area of drug development and, and pharmaceutical delivery, things don't always go according to plan. I'm sure many guests on Moneyball Medicine who have had to deal with clinical trial failures and withdrawing drugs that they had all kinds of high hopes for because we didn't understand the biology or there was some other reaction within, we didn't understand the dosing. You can't just extrapolate from an animal model to humans and on and on and on. And so gene editing, I don't think, necessarily, should be held to any higher standard. I think the CRISPR field has already in terms of the sort of market performance, some of the companies that we've mentioned, oh my God, it's been a real roller coaster surprisingly, because every time there's been a paper published in a prominent journal that says, oh my God, there's, there's a deletion pattern that we're seeing that we didn't anticipate, or we're seeing some immune responses or we're seeing unusual off target effects, or we're seeing P53 activation and you know, those are at least four off the top of my head. I'm sure there've been others. And all had big transient impact on the financial health of these companies. But I think that was to be expected. And the companies knew that this was just an overreaction. They've worked and demonstrated through peer review publications and preclinical and other reports that these challenges have been identified, when known about, pretty much completely have been overcome or are in the process of being overcome.So, you know, and we're still seeing in just traditional gene therapy technologies that have been around for 15, 20 years. We're still seeing reports of adverse events on some of those trials. So for gene editing to have come as far as it's common, to be able to look at these two big New England Journal success stories in sickle cell and ATTR amyloidosis, I don't think any very few, except the most ardent evangelists would have predicted we'd be where we are just a few years ago. [musical transition]Harry Glorikian: I want to pause the conversation for a minute to make a quick request. If you're a fan of MoneyBall Medicine, you know that we've published dozens of interviews with leading scientists and entrepreneurs exploring the boundaries of data-driven healthcare and research. And you can listen to all of those episodes for free at Apple Podcasts, or at my website glorikian.com, or wherever you get your podcasts.There's one small thing you can do in return, and that's to leave a rating and a review of the show on Apple Podcasts. It's one of the best ways to help other listeners find and follow the show.If you've never posted a review or a rating, it's easy. All you have to do is open the Apple Podcasts app on your smartphone, search for MoneyBall Medicine, and scroll down to the Ratings & Reviews section. Tap the stars to rate the show, and then tap the link that says Write a Review to leave your comments. It'll only take a minute, but it'll help us out immensely. Thank you! And now back to the show.[musical transition]Harry Glorikian:One of your previous books was called The $1,000 Genome. And when you published that back in 2010, it was still pretty much science fiction that it might be possible to sequence someone's entire genome for $1,000. But companies like Illumina blew past that barrier pretty quickly, and now people are talking about sequencing individual genome for just a few hundred dollars or less. My question is, how did computing contribute to the exponential trends here. And do you wish you'd called your book The $100 Genome?Kevin Davies: I've thought about putting out a sequel to the book, scratching out the 0's and hoping nobody would notice. Computing was yes, of course, a massive [deal] for the very first human genome. Remember the struggle to put that first assembly together. It's not just about the wet lab and pulling the DNA sequences off the machines, but then you know, the rapid growth of the data exposure and the ability to store and share and send across to collaborators and put the assemblies together has been critical, absolutely critical to the development of genomics.I remember people were expressing shock at the $1,000 genome. I called the book that because I heard Craig Venter use that phrase in public for the first time in 2002. And I had just recently published Cracking the Genome. And we were all still recoiling at the billions of dollars it took to put that first reference genome sequence together. And then here's Craig Venter, chairing a scientific conference in Boston saying what we need is the $1,000 genome. And I almost fell off my chair. “what are you? What are you must you're in, you're on Fantasy Island. This is, there's no way we're going to get, we're still doing automated Sanger sequencing. God bless Fred Sanger. But how on earth are you going to take that technology and go from billions of dollars to a couple of thousand dollars. This is insanity.” And that session we had in 2002 in Boston. He had a local, a little episode of America's Got Talent and he invited half a dozen scientists to come up and show what they had. And George Church was one of them. I think Applied Biosystems may have given some sort of talk during that session. And then a guy, a young British guy from a company we'd never heard of called Celexa showed up and showed a couple of pretty PowerPoint slides with colored beads, representing the budding DNA sequence on some sort of chip. I don't know that he showed any data. It was all very pretty and all very fanciful. Well guess what? They had the last laugh. Illumina bought that company in 2006. And as you said, Harry you know, I think when, when they first professed to have cracked the $1,000 dollar genome barrier, a few people felt they needed a pinch of salt to go along with that. But I think now, yeah, we're, we're, we're well past that. And there are definitely outfits like BGI, the Beijing Genomics Institute being one of them, that are touting new technologies that can get us down to a couple of hundred. And those were such fun times because for a while there Illumina had enormous competition from companies like 454 and Helicose and PacBio. And those were fun heady times with lots and lots of competition. And in a way, Illumina's had it a little easy, I think over the last few years, but with PacBio and Oxford Nanopore gaining maturity both, both in terms of the technology platforms and their business strategy and growth, I think Illumina' gonna start to feel a little bit more competition in the long read sequence space. And one is always hearing whispers of new companies that may potentially disrupt next-gen sequencing. And that would be exciting because then we'd have an excuse to write another book. Harry Glorikian: Well, Kevin, start writing because I actually think we're there. I think there are a number of things there and you're right, I think Illumina has not had to bring the price down as quickly because there hasn't been competition. And you know, when I think about the space is, if you could do a $60 genome, right, it starts to become a rounding error. Like what other business models and opportunities now come alive? And those are the things that excite me. All right. But so, but you have a unique position as editor of the journal of CRISPR and the former editor of a lot of prominent, you know, publications, Nature Genetics, Bio-IT World, Chemical & Engineering News. Do you think that there's adequate coverage of the biological versus the computing side of it? Because I, I have this feeling that the computing side still gets a little overlooked and underappreciated. Kevin Davies: I think you're right. I mean I think at my own company Genetic Engineering News, we still have such deep roots in the wet lab vision and version of biotechnology that it takes a conscious effort to look and say, you know, that's not where all the innovation is happening. Bio-IT World, which you mentioned is interesting because we launched that in 2002. It was launched by the publisher IDG, best-known from MacWorld and ComputerWorld and this, this whole family of high-tech publications.And we launched in 2002 was a very thick glossy print magazine. And ironically, you know, we just couldn't find the advertising to sustain that effort, at least in the way that we'd envisioned it. And in 2006 and 2007, your friend and mine Phillips Kuhl, the proprietor of Cambridge Healthtech Institute, kind of put us out of our misery and said, you know what I'll, take the franchise because IDG just didn't know what to do with it anymore. But what he really wanted was the trade show, the production. And even though at the magazine eventually we fell on our sword and eventually put it out of its misery, the trade show went from strength to strength and it'll be back in Boston very soon because he had the vision to realize there is a big need here as sort of supercomputing for life sciences.And it's not just about the raw high-performance computing, but it's about the software, the software tools and data sharing and management. And it's great to go back to that show and see the, you know, the Googles and Amazons and yeah, all the big household names. They're all looking at this because genome technology, as we've discussed earlier has been one of the big growth boom areas for, for their services and their products.Harry Glorikian: Right. I mean, well, if you look at companies like Tempus, right. When I talked to Joel Dudley over there on the show it's, they want to be the Amazon AWS piping for all things genomic analysis. Right. So instead of creating it on your own and building a, just use their platform, basically, so it's definitely a growth area. And at some point, if you have certain disease states, I don't see how you don't get you know, genomic sequencing done, how a physician even today in oncology, how anybody can truly prescribe with all the drugs that are being approved that have, you know, genomic biomarkers associated with them and not use that data.Kevin Davies: On a much lower, lo-fi scale, as I've been doing a lot of reading about sickle cell disease lately, it's clear that a lot of patients who are, of course, as you, as you know, as your listeners know, are mostly African-American because the disease arose in Africa and the carrier status gives carriers a huge health advantage in warding off malaria. So the gene continues to stay, stay high in in frequency. Many African-American patients would benefit from some generic drugs that are available in this country that provide some relief, but aren't aware of it and maybe their physicians aren't completely aware of it either. Which is very sad. And we've neglected the funding of this disease over many decades, whereas a disease like cystic fibrosis, which affects primarily white people of Northern European descent that receives far more funding per capita, per head, than than a disease like sickle cell does. But hopefully that will begin to change as we see the, the potential of some of these more advanced therapies.I think as far as your previous comment. I think one of the big challenges now is how we tackle common diseases. I think we're making so much progress in treating rare Mendelian diseases and we know thousands of them. But it's mental illness and asthma and diabetes you know, diseases that affect millions of people, which have a much more complicated genetic and in part environmental basis.And what can we learn, to your point about having a full genome sequence, what can we glean from that that will help the medical establishment diagnose and treat much more common diseases, not quite as simple as just treating a rare Mendelian version of those diseases? So that's, I think going to be an important frontier over the next decade.Harry Glorikian: Yeah. It's complicated. I think you're going to see as we get more real-world data that's organized and managed well, along with genomic data, I think you'll be able to make more sense of it. But some of these diseases are quite complicated. It's not going to be find one gene, and it's going to give you that answer.But I want to go back to, you can't really talk about CRISPR without talking about this specter of germline editing. And a big part of your book is about this firestorm of criticism and condemnation around, you know, the 2018 when the Chinese researcher He Jankui, I think I said it correctly.Yep.Kevin Davies: He Jankui is how I say it. Close. Harry Glorikian: He announced that he had created twin baby girls with edits to their genomes that were intended to make them immune to HIV, which sort of like—that already made me go, what? But the experiment was, it seems, unauthorized. It seems that, from what I remember, the edits were sloppy and the case spurred a huge global discussion about the ethics of using CRISPR to make edits that would be inherited by future generations. Now, where are we in that debate now? I mean, I know the National Academy of Sciences published a list of criteria, which said, don't do that. Kevin Davies: It was a little more nuanced than that. It wasn't don't do that. It was, there is a very small window through which we could move through if a whole raft of criteria are met. So they, they refuse to say hereditary genome editing should be banned or there should be a moratorium. But they said it should not proceed until we do many things. One was to make sure it is safe. We can't run before we can walk. And by that, I mean, we've got to first demonstrate—because shockingly, this hasn't been done yet—that genome editing can be done safely in human embryos. And in the last 18 months there've been at least three groups, arguably the three leading groups in terms of looking at genetic changes in early human embryos, Kathy Niakan in London, Shoukhrat Mitalipov in Oregon, and Dieter Egli in New York, who all at roughly the same time published and reports that said, or posted preprints at least that said, when we attempt to do CRISPR editing experiments in very early human embryos, we're seeing a mess. We're seeing a slew of off-target and even on-target undesirable edits.And I think that says to me, we don't completely understand the molecular biology of DNA repair in the early human embryo. It may be that there are other factors that are used in embryogenesis that are not used after we're born. That's speculation on my part. I may be wrong. But the point is we still have a lot to do to understand, even if we wanted to.And even if everybody said, “Here's a good case where we should pursue germline editing,” we've gotta be convinced that we can do it safely. And at the moment, I don't think anybody can say that. So that's a huge red flag.But let's assume, because I believe in the power of research, let's assume that we're going to figure out ways to do this safely, or maybe we say CRISPR isn't the right tool for human embryos, but other tools such as those that we've touched on earlier in the show base editing or prime editing, or maybe CRISPR 3.0 or whatever that is right now to be published somewhere. [Let's say ] those are more safe, more precise tools. Then we've got to figure out well, under what circumstances would we even want to go down this road? And the pushback was quite rightly that, well, we already have technologies that can safeguard against families having children with genetic diseases. It's called IVF and pre-implantation genetic diagnosis. So we can select from a pool of IVF embryos. The embryos that we can see by biopsy are safe and can therefore be transplanted back into the mother, taken to term and you know, a healthy baby will emerge.So why talk about gene editing when we have that proven technology? And I think that's a very strong case, but there are a small number of circumstances in which pre-implantation genetic diagnosis will simply not work. And those are those rare instances where a couple who want to have a biological child, but have both of them have a serious recessive genetic disease. Sickle cell would be an obvious case in point. So two sickle cell patients who by definition carry two copies of the sickle cell gene, once I have a healthy biological child preimplantation genetic diagnosis, it's not going to help them because there are no healthy embryos from whatever pool that they produce that they can select. So gene editing would be their only hope in that circumstance. Now the National Academy's report that you cited, Harry, did say for serious diseases, such as sickle cell and maybe a few others they could down the road potentially see and condone the use of germline gene editing in those rare cases.But they're going to be very rare, I think. It's not impossible that in an authorized approved setting that we will see the return of genome editing, but that's okay. Of course you can can issue no end of blue ribbon reports from all the world's experts, and that's not going to necessarily prevent some entrepreneur whose ethical values don't align with yours or mine to say, “You know what, there's big money to be made here. I'm going offshore and I'm going to launch a CRISPR clinic and you know, who's going to stop me because I'll be out of the clutches of the authorities.” And I think a lot of people are potentially worried that that scenario might happen. Although if anyone did try to do that, the scientific establishment would come down on them like a ton of bricks. And there'll be a lot of pressure brought to bear, I think, to make sure that they didn't cause any harm.Harry Glorikian: Yeah. It's funny. I would like to not call them entrepreneurs. I like entrepreneurs. I'd like to call them a rogue scientist. Kevin Davies: So as you say, there's the third section of four in Editing Humanity was all about the He Jankui debacle or saga. I had flown to Hong Kong. It's a funny story. I had a little bit of money left in my travel budget and there were two conferences, one in Hong Kong and one in China coming up in the last quarter of 2018. So I thought, well, okay, I'll go to one of them. And I just narrowed, almost a flip of a coin, I think. Okay, let's go to the Hong Kong meeting.It's a bioethics conference since I don't expect it to be wildly exciting, but there are some big speakers and this is an important field for the CRISPR Journal to monitor. So I flew there literally, you know, trying to get some sleep on the long flights from New York and then on landing, turn on the phone, wait for the new wireless signal provider to kick in. And then Twitter just explode on my feed as this very, very astute journalists at MIT Technology Review, Antonio Regalado, had really got the scoop of the century by identifying a registration on a Chinese clinical trial website that he and only he had the foresight and intelligence to sort of see. He had met He Jankui in an off the record meeting, as I described in the book, about a month earlier. A spider sense was tingling. He knew something was up and this was the final clue. He didn't know at that time that the Lulu and Nana, the CRISPR babies that you mentioned, had actually been born, but he knew that there was a pregnancy, at least one pregnancy, from some of the records that he'd seen attached to this registration document. So it was a brilliant piece of sleuthing. And what he didn't know is that the Asociated Press chief medical writer Marilynm Marchion had confidentially been alerted to the potential upcoming birth of these twins by an American PR professional who was working with He Jankui in Shenzhen. So she had been working on an embargoed big feature story that He Jankui and his associates hoped would be the definitive story that would tell the world, we did this quote unquote, “responsibly and accurately, and this is the story that you can believe.” So that story was posted within hours.And of course the famous YouTube videos that He Jankui had recorded announcing with some paternal pride that he had ushered into the world these two gene edited, children, screaming and crying into the world as beautiful babies I think was [the phrase]. And he thought that he was going to become famous and celebrated and lauded by not just the Chinese scientific community, but by the world community for having the ability and the bravery to go ahead and do this work after Chinese researchers spent the previous few years editing human embryos. And he was persuaded that he had to present his work in Hong Kong, because he'd set off such a such an extraordinary firestorm. And I think you've all seen now you're the clips of the videos of him nervously walking onto stage the muffled, the silence, or the only sound in the front row, the only sound in the big auditorium at Hong Kong university—[which] was absolutely packed to the rim, one side of the auditorium was packed with press photographers, hundreds of journalists and cameras clicking—and the shutters clattering was the only, that was the applause that he got as he walked on stage.And to his credit, he tried to answer the questions directly in the face of great skepticism from the audience. The first question, which was posed by David Liu, who had traveled all the way there, who just asked him simply, “What was the unmet medical need that you are trying to solve with this reckless experiment? There are medical steps that you can do, even if the couple that you're trying to help has HIV and you're trying to prevent this from being passed on. There are techniques that you can use sperm washing being one of them. That is a key element of the IVF process to ensure that the no HIV is transmitted.”But he was unable to answer the question in terms of I'm trying to help a family. He'd already moved out and was thinking far, far bigger. Right? And his naiveté was shown in the manuscript that he'd written up and by that point submitted to Nature, excerpts of which were leaked out sometime later.So he went back to Shenzhen and he was put under house arrest after he gave that talk in Hong Kong. And about a year later was sentenced to three years in jail. And so he's, to the best of my knowledge that's where he is. But I often get asked what about the children? As far as we know, there was a third child born about six months later, also gene-edited. We don't even know a name for that child, let alone anything about their health. So one hopes that somebody in the Chinese medical establishment is looking after these kids and monitoring them and doing appropriate tests. The editing, as you said, was very shoddily performed. He knocked out the gene in question, but he did not mimic the natural 32-base deletion in this gene CCR5 that exists in many members of the population that confers, essentially, HIV resistance. So Lulu and Nana on the third child are walking human experiments, sad to say. This should never have been done. Never should have been attempted. And so we hope that he hasn't condemned them to a life of, you know, cancer checkups and that there were no off-target effects. They'll be able to live, hopefully, with this inactivated CCR5 gene, but it's been inactivated in a way that I don't think any, no other humans have ever been recorded with such modifications. So we, we really hope and pray that no other damage has been done. Harry Glorikian: So before we end, I'd love to give you the chance to speculate on the future of medicine in light of CRISPR. Easy, fast, inexpensive genome sequencing, give us access to everybody's genetic code, if they so choose. Machine learning and other forms of AI are helping understand the code and trace interactions between our 20,000 genes. And now CRISPR gives us a way to modify it. So, you know, it feels like [we have] almost everything we need to create, you know, precise, targeted, custom cures for people with genetic conditions. What might be possible soon, in your view? What remaining problems need to be solved to get to this new area of medicine? Kevin Davies: If you know the sequence that has been mutated to give rise to a particular disease then in principle, we can devise a, some sort of gene edit to repair that sequence. It may be flipping the actual base or bases directly, or maybe as we saw with the first sickle cell trial, it's because we understand the bigger genetic pathway. We don't have to necessarily go after the gene mutation directly, but there may be other ways that we can compensate boost the level of a compensating gene.But I think we, we should be careful not to get too carried away. As excited as I am—and hopefully my excitement comes through in Editing Humanity—but for every company that we've just mentioned, you know, you can go on their website and look at their pipeline. And so Editas might have maybe 10 diseases in its cross hairs. And CRISPR [Therapeutics] might have 12 diseases. And Intellia might have 14 diseases and Graphite has got maybe a couple. And Beam Therapeutics has got maybe 10 or 12. And Prime Medicine will hasn't listed any yet, but we'll hopefully have a few announced soon. And so I just reeled off 50, 60, less than a hundred. And some of these are gonna work really, really well. And some are going to be either proven, ineffective or unviable economically because the patient pool is too small. And we've got, how many did we say, 6,000 known genetic diseases. So one of the companies that is particularly interesting, although they would admit they're in very early days yet, is Verve Therapeutics. I touched on them earlier because they're looking at to modify a gene called PCSK9 that is relevant to heart disease and could be a gene modification that many people might undergo because the PCSK9 gene may be perfectly fine and the sequence could be perfectly normal, but we know that if we re remove this gene, levels of the bad cholesterol plummet, and that's usually a good thing as far as heart management goes. So that's an interesting, very interesting study case study, I think, to monitor over the coming years, because there's a company looking at a much larger patient pool potentially than just some of these rare syndromes with unpronounceable names. So the future of CRISPR and gene editing is very bright. I think one of the lessons I took away from CRISPR in Editing Humanity is, looking at the full story, is how this technology, this game-changing gene-editing technology, developed because 25 years ago, a handful of European microbiologists got really interested in why certain microbes were thriving in a salt lake in Southeastern Spain. This is not exactly high-profile, NIH-must-fund-this research. There was a biological question that they wanted to answer. And the CRISPR repeats and the function of those repeats fell out of that pure curiosity, just science for science's sake. And so it's the value of basic investigator-driven, hypothesis-driven research that led to CRISPR being described and then the function of the repeats.And then the story shifted to a yogurt company in Europe that was able to experimentally show how having the right sequence within the CRISPR array could safeguard their cultures against viral infection. And then five years of work people in various groups started to see, were drawn to this like moths to a flame. Jennifer Doudna was intrigued by this from a tip-off from a coffee morning discussion with a Berkeley faculty colleagues, Jill Banfield, a brilliant microbiologist in her own. And then she met meets Emmanuelle Charpentier in Puerto Rico at a conference, and they struck up a friendship and collaboration over the course of an afternoon. And that, why should that have worked? Well, it did, because a year later they're publishing in Science. So it's serendipity and basic research. And if that can work for CRISPR, then I know that there's another technology beginning to emerge from somewhere that may, yet trump CRISPR.And I think the beauty of CRISPR is its universal appeal. And the fact is, it's drawn in so many people, it could be in Japan or China or South Korea or parts of Europe or Canada or the U.S. or South America. Somebody is taking the elements of CRISPR and thinking well, how can we improve it? How can we tweak it?And so this CRISPR toolbox is being expanded and modified and updated all the time. So there's a hugely exciting future for genome medicine. And you know, whether it's a new form of sequencing or a new form of synthetic biology, you know, hopefully your show is going to be filled for many years to come with cool, talented, young energetic entrepreneurs who've developed more cool gadgets to work with our genome and other genomes as well. We haven't even had time to talk about what this could do for rescuing the wooly mammoth from extinction. So fun things, but maybe, maybe another time. Harry Glorikian: Excellent. Well, great to have you on the show. Really appreciate the time. I hope everybody got a flavor for the enormous impact this technology can have. Like you said, we talked about human genome, but there's so many other genomic applications of CRISPR that we didn't even touch. Kevin Davies: Yup. Yup. So you have to read the book. Harry Glorikian: Yeah. I will look forward to the next book. So, great. Thank you so much. Kevin Davies: Thanks for having me on the show, Harry. All the best.Harry Glorikian: Take care.Harry Glorikian: That's it for this week's show. You can find past episodes of MoneyBall Medicine at my website, glorikian.com, under the tab “Podcast.” And you can follow me on Twitter at hglorikian.  Thanks for listening, and we'll be back soon with our next interview.

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Find the Memorizing Pharmacology book here: https://adbl.co/3wAZEmN The body system we continue to cover is gastrointestinal and omeprazole, esomeprazole, lansoprazole, pantoprazole are all proton pump inhibitors PPIs.  TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd Suffixes Omeprazole (Prilosec) with the -prazole suffix, p-r-a-z-o-l-e suffix is a true proton pump inhibitor, abbreviated PPI. We want to watch out for aripiprazole (Abilify) and brexpiprazole (Rexulti) which are antipsychotics, not PPIs but have the -piprazole ending, p-i-p-r-a-z-o-l-e. Also, some drug cards say the ending is -azole, but that is not an actual suffix, that is a chemical group, using that ending might have you confuse antifungals like fluconazole (Diflucan) for PPIs, so again, the PPI suffix is -prazole. You will notice that omeprazole (Prilosec) and esomeprazole (Nexium) are very similar and it's that omeprazole contains two molecules, a left and right mirror image and esomeprazole only contains the left-handed image. In Latin, left is sinister, so the “es, e-s” represents that only left-handed side. Why does that matter? That left-handed molecule is the active molecule. Mechanism of Action (MOA) PPIs or “prazoles” work by blocking your stomach's parietal cells which normally release hydrogen ions contributing to the stomachs' acidity. This, without the proton pump inhibitor, could lead to heartburn or possible GI ulceration. The proton pump inhibitor blocks the hydrogen/potassium ATPase pump preventing protons from going in the stomach. This raises the pH, making it more basic, and removes the excessive acid. Indications We then use proton pump inhibitors to manage heartburn, gastroesophageal reflux disease (GERD), peptic ulcer disease, and Barrett's esophagus. Barrett's esophagus is a condition where the acid reflux damages the esophagus causes it to redden. Many times patients who are on chronic NSAIDs or anticoagulants have a higher GI bleed risk and a proton pump inhibitor is for prophylaxis rather than active treatment. Dosing Traditional dosing is to give the PPI 30 to 60 minutes before breakfast. A concern comes when the medication does not seem to work, but it is not the medication, rather, the patient is taking with or even after breakfast. Make sure you know which is which. Also, H2 blockers work a bit more quickly, so the patient might expect a similar timetable with a PPI, let them know that it will take a bit longer. Clinical Considerations Acute use for a few weeks, especially with over-the-counter lengths of time, usually 2 weeks, tends to cause few side effects. Long term, however, we have concerns of B-12 deficiency, increased fracture risk, C. Diff, an opportunistic infection. Again, B-12 deficiency comes because the now less acidic stomach does not do as good a job at absorbing B-12. Before we start this section, here's a reminder contrasting enzyme inhibition and enzyme induction. A drug that inhibits and enzyme blocks the enzyme somewhat increasing drug levels making the patient toxic. A drug that induces and enzyme, makes the enzyme work better reducing drug levels and making the patient subtherapeutic. CYP2C19 inhibition can happen with citalopram (Celexa) and escitalopram (Lexapro), so in this case the antidepressant drug levels can go up leading to QTc prolongation. That's why we have dosing maximums on citalopram of 20 milligrams daily with someone on omeprazole. CYP2C19 induction with omeprazole and clopidogrel (Plavix) is one class example as clopidogrel is a pro-drug and by inducing the enzyme to break down more clopidogrel, the enzyme lowers clopidogrel levels. A pro-drug is one that is not quite the drug yet, the liver may have to metabolize it into a drug. Clopidogrel itself is an antiplatelet drug, so reducing the effectiveness of an antiplatelet drug while trying to prevent myocardial infarction (heart attacks) and strokes.   Note, prescribers can use cilostazol (Pletal) for intermittent claudication, a problem with blood flow in the legs where they might be in pain for short distances and the drug allows them to walk further is also a concern. Using lansoprazole or a similar PPI might create a favorable effect. Some drugs need an acidic environment for absorption like iron supplements and lowering the acidity runs counter to the best situation for iron. Adding ascorbic acid, vitamin C can help. Cefuroxime (Ceftin) is a second-generation cephalosporin antibiotic with good gram-positive coverage, but one might change to another antibiotic if they see omeprazole in the chart. Mesalamine (Pentasa) for ulcerative colitis and itraconazole (Sporanox) and antifungal both both benefit from an acidic stomach.    

The first body system we cover is gastrointestinal and famotidine is one of the H2 blockers we use for conditions like GERD. Find the book here: https://adbl.co/3wAZEmN and TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd GI: -tidine (not -atadine or -ine) “to dine” Famotidine, (Pepcid), Nizatidine (Axid), Cimetidine (Tagamet) are H-2 receptor antagonists. Ranitidine (Zantac) is off the market. MOA: The stomach's parietal cells secrete stomach acid to lower pH. Histamine-2 will binds the receptors and stimulate them to produce acid. By blocking histamine-2 we can reduce the secreted stomach acid. Indications: Used for GERD and peptic ulcers, conditions of acid secretion disorders such as Zollinger-Ellison syndrome. Pharmacokinetics: The onset of action is a bit faster than PPIs which include omeprazole (Prilosec) and esomeprazole (Nexium), but not near as fast as an antacid which works right away, but the antacid only works for a few hours. Side Effects: Renal (kidney) dose adjustment and can raise serum creatinine as it is a potent inhibitor of tubular creatinine secretion, normally a marker of poor kidney function, though the patient has normal kidney function. Can antagonize testosterone which can lead to sexual dysfunction and gynecomastia (breasts in men). Spironolactone (Aldactone), an aldosterone antagonist, can similarly cause gynecomastia.   B12 deficiency along with proton pump inhibitors, decreased acid leads to malabsorption. Drug Interactions: Since ranitidine (Zantac) was pulled from the market patients might see cimetidine as an OTC alternative, but it does have many drug interactions. Can inhibit the enzymes CYP1A2 (theophylline, asthma), CYP 3A4 (verapamil, CCB), CYP 2C19 (citalopram, SSRI), decrease effects of CYP2D6 (carvedilol, 3rd generation beta blocker) Inhibits enzymes that break the drug down therefore you have more drug which equals toxicity. GMRINCE Neuro/Psych Atypical antipsychotic – aripiprazole (Abilify) Traditional Antiepileptics – carbamazepine (Tegretol), phenytoin (Dilantin) Parkinson's – pramipexole (Mirapex ER) SSRIs – citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac) Cardio Anticoagulant – warfarin (Coumadin) Antihypertensives – carvedilol (Coreg), a beta blocker, verapamil, a non-dihydropyridine calcium channel blocker Antiarrhythmic - amiodarone, risk of QTc prolongation Endocrine Antidiabetics – metformin (Glucophage), a biguanide or glipizide (Glucotrol XL), a sulfonylurea    

Episode 25C-PTSD and Baby StepsAm I Feeling Better or Is It Prozac?April 29, 2021 In this episode, I am talking about feeling better on a more consistent way. This enhancement in my mood also corresponds to the window of effectiveness for Fluoxetine which is better known as Prozac. It doesn't matter to me because the experience of feeling better is motivating regardless of it's source. My role is to build on that emotional and cognitive shift taking place into a better world for myself and for the people I love and care about.I am taking Prozac, which is classified as a Selective Serotonin Reuptake Inhibiter or an SSRI. This class of anti-depressant has been shown to be just as effective in treating depression as psychotherapy. There are currently 15 different name brands of SSRIs using six fundamental compounds. For more information click on any of the links below.Lexapro (escitalopram),  Zoloft (sertraline), Prozac (fluoxetine), Paxil (paroxetine), Celexa (citalopram), Luvox (fluvoxamine), Paxil CR (paroxetine), Brisdelle (paroxetine), Sarafem (fluoxetine), Luvox CR (fluvoxamine), Prozac Weekly (fluoxetine), Pexeva (paroxetine), Selfemra (fluoxetine), and Rapiflux (fluoxetine).In the Costa Rican healthcare system, I was given the choice of Prozac, Prozac or Prozac. So, I chose Prozac.Dr. Arielle Schwarts has been writing about the journey of healing from Complex-PTSD for years. Healing Complex PTSD and Dissociation | Dr. Arielle Schwartz (drarielleschwartz.com)Here is the official government site on PTSD. I have given you the link to their information on Complex-PTSD.Complex PTSD - PTSD: National Center for PTSD (va.gov)I have given you this resource before. It's an oldie, but a goodie.Complex PTSD Healing | CPTSDfoundation.orgThrive After Abuse has a YouTube Channel and they are doing their part in helping people with Complex-PTSD. Healing from Complex PTSD: Relaxation and Affirmation Video - YouTube

Antidepressants, mood stabilizers, antipsychotics, benzodiazepines, stimulants.....READY SET GO!Med cheat sheetSSRIs (selective serotonin reuptake inhibitors)-- Prozac, Lexapro, Paxil, Celexa, Zoloft, Luvox, Trintellix, Viibryd-- They are generally NOT antidepressantsMainly helpful for OCD, body dysmorphia,  panic (if not from trauma), depression if postpartum or fueled by neuroticism or ruminative anxietySNRIs (serotonin norepinephrine reuptake inhibitors)-- Effexor/venlafaxine, Cymbalta/duloxetineMostly helpful for combined depression/anxiety, especially with insomniaWellbutrin/bupropion-- very stimulating (prison crack!), true antidepressant; can trigger/worsen anxietyMAO  (monoamine oxidase) inhibitors-- powerful antidepressants, lots of side effects and med interactionsLamictal/lamotrigine-- definitely ALL THAT and a bag of chips (see My Desert Island Meds in Season 1)Atypical antipsychotics-  Abilify/aripiprazole, Latuda/lurasidone, Seroquel/quetiapine, Saphris/asenapine, Vraylar/cariprazine, Risperdal/risperidone, Zyprexa/olanzapine, Geodon/ziprasidone, Invega/paliperidone Generally good mood stabilizers (in contrast to the putative "mood stabilizers" below); typically more helpful for severe depression and bipolar disorder than true psychosis (Zyprexa and Risperdal excepted)"Mood stabilizers"- (big misnomer, most effective for  mania/agitation, not depression)-- Depakote/valproic acid, Trileptal/oxcarbazepine, Tegretol/carbamazepineLithium- it's not clozapine, but gets the silver medal as a true mood stabilizer (see My Desert Island Meds in Season 1)Clozapine- the winner of the psychiatric med decathlon in most every event; needs weekly blood monitoring and has a few very serious potential side effectsBenzodiazepines- Xanax/alprazolam; Klonopin/clonazepam, Librium/chlordiazepoxide, Ativan/lorazepam, Valium/diazepamStimulants- Adderall/amphetamine; Vyvanse; Ritalin/Concerta/Focalin/methylphenidateAmphetamines are more euphoria-inducing, thus more abused and addictive and also tend to have more side effects; both amphetamines and methylphenidate are roughly equally effective for ADD/ADHDBFTAhttps://www.craigheacockmd.com/podcast-page/

https://astralcodexten.substack.com/p/oh-the-places-youll-go-when-trying   I. What is the right dose of Lexapro (escitalopram)? The official FDA packet insert recommends a usual dose of 10 mg, and a maximum safe dose of 20 mg. It says studies fail to show 20 mg works any better than 10, but you can use 20 if you really want to. But Jakubovski et al's Dose-Response Relationship Of Selective Serotonin Reuptake Inhibitors tries to figure out which doses of which antidepressants are equivalent to each other, and comes up with the following suggestion (ignore the graph, read the caption) 16.7 mg Lexapro equals 20 mg of paroxetine (Paxil) or fluoxetine (Prozac). But the maximum approved doses of those medications are 60 mg and 80 mg, respectively. If we convert these to mg imipramine equivalents like the study above uses, Prozac maxes out at 400, Paxil at 300, and Lexapro at 120. So Lexapro has a very low maximum dose compared to other similar antidepressants. Why? Because Lexapro (escitalopram) is a derivative of the older drug Celexa (citalopram). Sometime around 2011, the FDA freaked out that high doses of citalopram might cause a deadly heart condition called torsade de pointes, and lowered the maximum dose to prevent this. Since then it's been pretty conclusively shown that the FDA was mostly wrong about this and kind of bungled the whole process. But they forgot to ever unbungle it, so citalopram still has a lower maximum dose than every other antidepressant. When escitalopram was invented, it inherited its parent chemical's unusually-low maximum dose, and remains at that level today [edit: I got the timing messed up, see here]

An exposé of the corruption of medicine by the pharmaceutical industry at every level, from exploiting the vulnerable destitute for drug testing, through manipulation of research data, to disease mongering and promoting drugs that do more harm than good. Authors, Professor Jon Jureidini and Dr Leemon McHenry, made critical contributions to exposing the scientific misconduct in two infamous trials of antidepressants. Ghostwritten publications of these trials were highly influential in prescriptions of paroxetine (Paxil) and citalopram (Celexa) in paediatric and adolescent depression, yet both trials (Glaxo Smith Kline's paroxetine study 329 and Forest Laboratories' citalopram study CIT-MD-18) seriously misrepresented the efficacy and safety data. The Illusion of Evidence-Based Medicine: Exposing the Crisis of Credibility in Clinical Research (Wakefield Press, 2020) provides a detailed account of these studies and argues that medicine desperately needs to re-evaluate its relationship with the pharmaceutical industry. Without a basis for independent evaluation of the results of randomised, placebo-controlled clinical trials, there can be no confidence in evidence-based medicine. Science demands rigorous, critical examination and especially severe testing of hypotheses to function properly, but this is exactly what is lacking in academic medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/neuroscience

An exposé of the corruption of medicine by the pharmaceutical industry at every level, from exploiting the vulnerable destitute for drug testing, through manipulation of research data, to disease mongering and promoting drugs that do more harm than good. Authors, Professor Jon Jureidini and Dr Leemon McHenry, made critical contributions to exposing the scientific misconduct in two infamous trials of antidepressants. Ghostwritten publications of these trials were highly influential in prescriptions of paroxetine (Paxil) and citalopram (Celexa) in paediatric and adolescent depression, yet both trials (Glaxo Smith Kline's paroxetine study 329 and Forest Laboratories' citalopram study CIT-MD-18) seriously misrepresented the efficacy and safety data. The Illusion of Evidence-Based Medicine: Exposing the Crisis of Credibility in Clinical Research (Wakefield Press, 2020) provides a detailed account of these studies and argues that medicine desperately needs to re-evaluate its relationship with the pharmaceutical industry. Without a basis for independent evaluation of the results of randomised, placebo-controlled clinical trials, there can be no confidence in evidence-based medicine. Science demands rigorous, critical examination and especially severe testing of hypotheses to function properly, but this is exactly what is lacking in academic medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm

An exposé of the corruption of medicine by the pharmaceutical industry at every level, from exploiting the vulnerable destitute for drug testing, through manipulation of research data, to disease mongering and promoting drugs that do more harm than good. Authors, Professor Jon Jureidini and Dr Leemon McHenry, made critical contributions to exposing the scientific misconduct in two infamous trials of antidepressants. Ghostwritten publications of these trials were highly influential in prescriptions of paroxetine (Paxil) and citalopram (Celexa) in paediatric and adolescent depression, yet both trials (Glaxo Smith Kline's paroxetine study 329 and Forest Laboratories' citalopram study CIT-MD-18) seriously misrepresented the efficacy and safety data. The Illusion of Evidence-Based Medicine: Exposing the Crisis of Credibility in Clinical Research (Wakefield Press, 2020) provides a detailed account of these studies and argues that medicine desperately needs to re-evaluate its relationship with the pharmaceutical industry. Without a basis for independent evaluation of the results of randomised, placebo-controlled clinical trials, there can be no confidence in evidence-based medicine. Science demands rigorous, critical examination and especially severe testing of hypotheses to function properly, but this is exactly what is lacking in academic medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm

An exposé of the corruption of medicine by the pharmaceutical industry at every level, from exploiting the vulnerable destitute for drug testing, through manipulation of research data, to disease mongering and promoting drugs that do more harm than good. Authors, Professor Jon Jureidini and Dr Leemon McHenry, made critical contributions to exposing the scientific misconduct in two infamous trials of antidepressants. Ghostwritten publications of these trials were highly influential in prescriptions of paroxetine (Paxil) and citalopram (Celexa) in paediatric and adolescent depression, yet both trials (Glaxo Smith Kline's paroxetine study 329 and Forest Laboratories' citalopram study CIT-MD-18) seriously misrepresented the efficacy and safety data. The Illusion of Evidence-Based Medicine: Exposing the Crisis of Credibility in Clinical Research (Wakefield Press, 2020) provides a detailed account of these studies and argues that medicine desperately needs to re-evaluate its relationship with the pharmaceutical industry. Without a basis for independent evaluation of the results of randomised, placebo-controlled clinical trials, there can be no confidence in evidence-based medicine. Science demands rigorous, critical examination and especially severe testing of hypotheses to function properly, but this is exactly what is lacking in academic medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm

An exposé of the corruption of medicine by the pharmaceutical industry at every level, from exploiting the vulnerable destitute for drug testing, through manipulation of research data, to disease mongering and promoting drugs that do more harm than good. Authors, Professor Jon Jureidini and Dr Leemon McHenry, made critical contributions to exposing the scientific misconduct in two infamous trials of antidepressants. Ghostwritten publications of these trials were highly influential in prescriptions of paroxetine (Paxil) and citalopram (Celexa) in paediatric and adolescent depression, yet both trials (Glaxo Smith Kline's paroxetine study 329 and Forest Laboratories' citalopram study CIT-MD-18) seriously misrepresented the efficacy and safety data. The Illusion of Evidence-Based Medicine: Exposing the Crisis of Credibility in Clinical Research (Wakefield Press, 2020) provides a detailed account of these studies and argues that medicine desperately needs to re-evaluate its relationship with the pharmaceutical industry. Without a basis for independent evaluation of the results of randomised, placebo-controlled clinical trials, there can be no confidence in evidence-based medicine. Science demands rigorous, critical examination and especially severe testing of hypotheses to function properly, but this is exactly what is lacking in academic medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/medicine

An exposé of the corruption of medicine by the pharmaceutical industry at every level, from exploiting the vulnerable destitute for drug testing, through manipulation of research data, to disease mongering and promoting drugs that do more harm than good. Authors, Professor Jon Jureidini and Dr Leemon McHenry, made critical contributions to exposing the scientific misconduct in two infamous trials of antidepressants. Ghostwritten publications of these trials were highly influential in prescriptions of paroxetine (Paxil) and citalopram (Celexa) in paediatric and adolescent depression, yet both trials (Glaxo Smith Kline's paroxetine study 329 and Forest Laboratories' citalopram study CIT-MD-18) seriously misrepresented the efficacy and safety data. The Illusion of Evidence-Based Medicine: Exposing the Crisis of Credibility in Clinical Research (Wakefield Press, 2020) provides a detailed account of these studies and argues that medicine desperately needs to re-evaluate its relationship with the pharmaceutical industry. Without a basis for independent evaluation of the results of randomised, placebo-controlled clinical trials, there can be no confidence in evidence-based medicine. Science demands rigorous, critical examination and especially severe testing of hypotheses to function properly, but this is exactly what is lacking in academic medicine. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/psychology

Microdosing for regular people: is Microdosing the game-changer for anxiety, depression, and a better mental life? In this episode, we bring expert and (legendary) founder of Microdosing For Healing Kayse Gehret to the Antidōt podcast to help us demystify microdosing, what it is, who it's for and importantly who it's NOT for, how regular people who have never even considered taking what has been incorrectly stigmatized as only a "psychoactive drug" may want to rethink the topic, the legality questions, education versus sourcing, and much more. We touch on everything from the breakthrough recent research at the likes of John Hopkins University and Tim Ferriss, how regular moms with kids as well as Fortune 500 CEOs are benefitting from microdosing, debunking myths about mushrooms and microdosing, "how will I feel", what if I have anxiety and don't want to feel a loss of control, what if I'm taking an SSRI (Lexapro, Paxil, Prozac, Celexa, etc.) and contraindications, books and resources to dive deeper into the topic, and more. Our expert guest Kayse Gehret is a legend in the "healing arts", with over 20 years in the field and an impressive pedigree spanning. She's been featured in the New York Times, CNN, worked with everyone from the NBA to the Four Seasons Resorts and Fortune 500 CEOs, and has been educated by some of the top luminaries in the holistic health field -- with multiple accreditations. You can learn more about Kayse, her work and her latest Microdosing for Healing initiative at: www.microdosingforhealing.com

Sarah interviews Christy Boulware, wife, mom, speaker, writer, and “entrebeliever” founder of Fearless Women. Christy shares her story of corporate success, how fear and anxiety overtook her life, and how her faith gave her the tools to overcome. You’ll hear about the warning signs of an upcoming crash. What to look out for within yourself and your teens. How to take a pause. And so much more!Some quotes from the episode:“I’m an entrebeliever”"We were cheerleaders before we were really friends”“It was small, obedient steps - and the Lord takes care of the rest”“Your pause is your priority”“Your inability to take a pause is really rooted in pride”To parents: “Bed time - you are so exhausted… it’s when they open up. When your kids are vulnerable.”“Just because it exists and it’s there doesn’t mean you’re a failure or that you’re not still fearless in Jesus.” “God gave us fear. It’s an emotion we can feel. It’s what we do with fear in the moment that really makes a difference.”“Remember the facts. Speak the truth over it.”Mentioned in the episode:The Green Mile film. Watch on Amazon.The Anxiety Cure book. Christy’s original writing on blogspot. Proverbs 16:18(MSG): “First pride, then the crash—the bigger the ego, the harder the fall.” Questions Christy asks her kids at bedtime:Is there anything today where your feelings got hurt?Is there anything you did that made you proud today?Is there anything you did today where you stood up for someone else?Christy recommended Loreal Magic Root ConcealerFearless Women*Fearless Women is a faith-based organization whose goal is to educate and empower women to use the tools they are given to find victory over fear and anxiety. Website Stand Fearless Devotional coming out in SeptemberEmail the Fearless Team: admin@fearlesswomenstl.comFollow Fearless on Instagram: @fearlesswomenstlFollow Fearless Teens on Instagram: @fearlessteensstlFearless on FacebookPrivate Community Group on FacebookFollow Christy:Christy’s Personal Instagram: @christymboulwareChristy’s Personal FacebookTell us your story! We’re praying for you. Reach us at: podcast@sarahgood.comView this episode on YouTube: https://youtu.be/xtwQy9fU7M8Follow Now That's Something Good: Instagram | Facebook | YouTube* Will and Sarah joyfully support Fearless Women financially. Sarah recently become a board member.Need excellent royalty free music for any of your projects? All the music featured on the podcast is from Epidemic Sound. With a subscription it’s legal to use the music for almost every purpose. You’ll benefit Now That’s

Time Artist Title Duration Album Year Listeners 13:00:14 ProgPhonic Ep 16 Intro 0:47 83 13:00:56 Mangala Vallis The Centre Of Life 4:40 Voices 2020 79 13:05:36 Jonas Lindberg & The Other Side Square One 7:34 Pathfinder 2016 87 13:13:10 Rocket Scientists The Fading Light 7:20 Refuel 2014 89 13:20:30 Hats Off Gentlemen It’s Adequate Century […]

Welcome back readers, I'm back with another episode of Reading While Black Podcast and today we have Michael Arceneaux here to discuss his second book, I Don't Want To Die Poor. This is not just a perfect book for right now at this moment as student loan debt is a national conversation during the 2020 Presidential Race but it was a perfect book 10 years ago. Michael tells his story and how debt doesn't just affect you financially but becomes burdens on your mental health and your dating life. It's not too late to pick up I Don't Want To Die Poor. Remember to support your local bookstores in your community. It's also time to announce our May Book of the Month. If you did not know, May is Mental Health Awareness Month and I thought it was appropriate to select a book that focused on solutions to dealing with trauma. It gives me great pleasure to announce our book of the month for May is My Grandmother's Hands: Racialized Trauma and the Mending of Our Bodies and Hearts by Resmaa Menakem. The body is where our instincts reside and where we fight, flee, or freeze, and it endures the trauma inflicted by the ills that plague society. In this groundbreaking work, therapist Resmaa Menakem examines the damage caused by racism in America from the perspective of body-centered psychology. He argues this destruction will continue until Americans learn to heal the generational anguish of white supremacy, which is deeply embedded in all our bodies. Our collective agony doesn't just affect African Americans. White Americans suffer their own secondary trauma as well. So do blue Americans—our police. My Grandmother's Hands is a call to action for all of us to recognize that racism is not about the head, but about the body, and introduces an alternative view of what we can do to grow beyond our entrenched racialized divide. Paves the way for a new, body-centered understanding of white supremacy—how it is literally in our blood and our nervous system. Offers a step-by-step solution—a healing process—in addition to incisive social commentary. Resmaa Menakem, MSW, LICSW, is a therapist with decades of experience currently in private practice in Minneapolis, MN, specializing in trauma, body-centered psychotherapy, and violence prevention. He has appeared on the Oprah Winfrey Show and Dr. Phil as an expert on conflict and violence. Menakem has studied with bestselling authors Dr. David Schnarch (Passionate Marriage) and Dr. Bessel van der Kolk (The Body Keeps the Score). He also trained at Peter Levine's Somatic Experiencing Trauma Institute. If you live in the Montgomery, AL area, you can pick it up at your local abolition bookstore 1977 Books. In light of COVID-19, 1977 Books have gone digital so check them out on their website. www.1977Books.com Facebook: @1977Books Instagram: @1977Books Twitter: @1977Books Remember to leave us a Voice Message so you can share your reading experience and be a part of the podcast. Remember to check out Reading While Black Merch Use promo code “RWBFAM” for 35% off Remember to leave a review and five ⭐️⭐️⭐️⭐️⭐️ Follow Us Facebook: @ReadingWhileBLK Facebook Group: Reading While Black Book Club Twitter: @ReadingWhileBLK Instagram: @ReadingWhileBLK www.readingwhileblackbookclub.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/ReadingWhileBLKPOD/message

The modern biological era of psychiatry began with the 1987 release of Prozac--the first selective serotonin reuptake inhibitor, or SSRI. Other popular SSRIs have followed, including Zoloft, Paxil, Celexa, and Lexapro, and they remain the most commonly used class of antidepressants. You might think that they work by "correcting a chemical imbalance," right? Well, no such chemical imbalance has been proven to exist--and nowadays there are psychiatrists on Twitter arguing that psychiatrists never made that claim! Dr. Minot is old enough to remember when they most certainly did--and shares his own hypothesis as to how these drugs might really work....

EPISODE #327 Anti-Depressants and Mass Shootings Pt. 2 Richard welcomes an expert in serotonergic medications to talk about the possible violent side effects of anti-depressant medications. GUEST: Dr. Ann Blake Tracy is the director of the International Coalition for Drug Awareness. She has specialized for 22 years in adverse reactions to serotonergic medications (Antidepressants such as Prozac, Zoloft, Paxil, Luvox, Effexor, Celexa, Lexapro, Cymbalta, Pristiq, Serzone, Anafranil, etc. and the diet pills Fen-Phen, and Redux and the newer Atypical Anti-psychotic medications such as Zyprexa, Geodon, Abilify, Risperdal, Seroquel, etc.) and has testified before the FDA and congressional subcommittee members on Prozac. She has testified since 1992 as an expert witness in Prozac and other SSRI related court cases around the world. Her first book on the issue was published in 1991. During the last twenty years she has participated in innumerable radio, television, newspaper and magazine interviews on this subject. She is the author of Prozac: Panacea or Pandora?   PLEASE SUPPORT OUR SPONSORS!! C60EVO.COMThe Secret is out about this powerful anti-oxidant. The Purest C60 available is ESS60.  Buy Direct from the SourceUse the Code RS1SPEC for special discount. Ancient Life Oil Organic, Non GMO CBD Oil.  Big Relief in a Little Bottle! The Ferrari of CBD products. Strange Planet's Fullscript Dispensary - an online service offering hundreds of professional supplement brands, personal care items, essential oils, pet care products and much more. Nature Grade, Science Made!   Life Change and Formula 13 Teas  All Organic, No Caffeine, Non GMO!  More Energy!  Order now, use the code 'unlimited' and your first purchase ships for free.

EPISODE #325 Anti-Depressants and Mass Shootings Richard welcomes an expert in serotonergic medications to talk about the possible violent side effects of anti-depressant medications. GUEST: Dr. Ann Blake Tracy is the director of the International Coalition for Drug Awareness. She has specialized for 22 years in adverse reactions to serotonergic medications (Antidepressants such as Prozac, Zoloft, Paxil, Luvox, Effexor, Celexa, Lexapro, Cymbalta, Pristiq, Serzone, Anafranil, etc. and the diet pills Fen-Phen, and Redux and the newer Atypical Anti-psychotic medications such as Zyprexa, Geodon, Abilify, Risperdal, Seroquel, etc.) and has testified before the FDA and congressional subcommittee members on Prozac. She has testified since 1992 as an expert witness in Prozac and other SSRI related court cases around the world. Her first book on the issue was published in 1991. During the last twenty years she has participated in innumerable radio, television, newspaper and magazine interviews on this subject. She is the author of Prozac: Panacea or Pandora? WEBSITES:   PLEASE SUPPORT OUR SPONSORS!! Ancient Life Oil Organic, Non GMO CBD Oil.  Big Relief in a Little Bottle! The Ferrari of CBD products. C60EVO.COM The Secret is out about this powerful anti-oxidant. The Purest C60 available is ESS60.  Buy Direct from the SourceUse the Code RS1SPEC for special discount. Strange Planet's Fullscript Dispensary - an online service offering hundreds of professional supplement brands, personal care items, essential oils, pet care products and much more. Nature Grade, Science Made!   Life Change and Formula 13 Teas  All Organic, No Caffeine, Non GMO!  More Energy!  Order now, use the code 'unlimited' and your first purchase ships for free.

The Case:  Natalie is 40 but feels like she’s 80 most days She was experiencing fatigue, aches and pains, poor sleep, and depression. After several doctor visits she was diagnosed with fibromyalgia, given medication and told to expect things to get worse. An estimated 4 million Americans are diagnosed with fibromyalgia. While symptoms can be present much earlier, most diagnoses are between the age of 35 - 45. And, women are much more likely to suffer from this condition.   The Investigation This health mystery is a little different from most of my cases. Natalie already had a diagnosis and was already treating her condition. When she came to me, she hoped there was a better way. She didn’t want to accept that she would have to take medication for the rest of her life or that she should just get used to the idea of getting worse. She wanted to know if there was any hope of her feeling better despite her fibromyalgia diagnosis.  I knew we had to connect all the pieces of the puzzle to find the true underlying cause of her condition. Joining me on the show today to discuss Natalie’s case is fibromyalgia expert, Dr. Rodger Murphree. He is a board certified chiropractic physician, nutritional specialist, and author of 5 books including “Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome.”   Conventional Fibromyalgia Diagnosis Unfortunately, a lot of doctors don’t recognize Fibromyalgia. They see this long list of symptoms and they label the patient as a hypochondriac or someone who is lazy, crazy or depressed. Often, patients will have to see many doctors and go through a battery of tests to eliminate all known conditions before they actually get a diagnosis of Fibromyalgia. This can take years since so many doctors don’t recognize the syndrome.   Doctors who understand Fibromyalgia (and who are willing to give a diagnosis) often don’t really know how to help the patients because there’s no prescription, no drug-based therapy that will solve all of the issues. As a result, most doctors will tell patients to treat the symptoms and ‘learn to live with it.’   What is Fibromyalgia? Fibromyalgia is a syndrome made up of a group of symptoms. This collection of symptoms often includes achy, sometimes disabling pain, fatigue, insomnia, restless leg syndrome, irritable bowel, low moods and brain fog. When a combination of these symptoms are present and there is no other medical explanation, it’s likely to be Fibromyalgia. There is a sort of Fibromyalgia spectrum so not all Fibromyalgia patients are going to have the same experience or combination of symptoms. Dr. Murphree says that true fibromyalgia involves central sensitivity pain syndrome where the pain threshold becomes very low. Essentially, pain is magnified. Other senses may also be heightened such as sensitivity to bright lights and loud noises. Stress can also become magnified.    Stress and Fibromyalgia Up to 70% of Fibromyalgia patients say that stress was a trigger for their symptoms. It’s no surprise because stress is a trigger for most inflammatory reactions, which is the driver of most illnesses. In Fibromyalgia, we see a loss of plasticity to stress, or an inability to rebound from stress. This places the patient into a chronic state of stress that often shows up as pain and an inability to fall asleep or stay asleep. The stress causes more and more symptoms which causes the patient more stress and it becomes a vicious cycle.    Diagnosing Fibromyalgia Dr. Murphree looks at sleep when considering a Fibromyalgia diagnosis. He says that almost all patients who he suspects of having Fibromyalgia have pain and sleep issues. Many of the other symptoms that are commonly associated with Fibromyalgia, like IBS, low mood, and brain fog stem from the lack of quality sleep over time.    Treating Fibromyalgia Naturally Dr. Murphree says that he encourages his patients to shift their mindset away from the idea that drugs are the answer. He’s seen many patients who discover, after years of medicating, that drugs don’t help Fibromyalgia. All they do is poorly mask the symptoms without actually fixing the issue and they leave you vulnerable to side effects. It may seem impossible, but he says the only hope for patients is to get healthy.    Sleep is Critical for Healing Fibromyalgia Getting sufficient restorative sleep is step one in Dr. Murphree’s strategy for treating Fibromyalgia. Regular restorative sleep can decrease the amount of inflammatory chemicals your body release. A lack of deep sleep causes the metabolism to slow down which causes lethargy, weight gain and heightened pain sensitivity. It also causes brain fog and a decreased ability to deal with stress. For patients struggling with sleep, Dr. Murphree suggests temporarily taking melatonin to restore their sleep cycle.    Serotonin for Fibromyalgia Many of us know it as the happy hormone. Having healthy serotonin levels is critical in treating fibromyalgia. Serotonin increases your pain threshold, it improves digestion, and it decreases anxiety. Conventional medicine recognizes the importance of serotonin for Fibromyalgia patients. Unfortunately, the typical conventional solution is to prescribe anti-depressant medication like Celexa, Paxil or Cymbalta. The problem with this approach is that these drugs don’t increase the production of serotonin (which is what is needed) they only serve to maintain serotonin levels, or hang on to the existing serotonin in the brain. It doesn’t help to fix the problem. The natural approach to encouraging serotonin release is with a healthy diet - specifically where you are getting enough of the amino acid, tryptophan. Tryptophan, when combined with certain B vitamins, magnesium and vitamin C turns into serotonin. Additionally, patients may supplement with  5 HydroxyTryptophan (5HTP) to further support serotonin production. However, deep, restorative sleep is still a critical part of this treatment plan. Dr. Murphree outlines his recommended protocol at the 18 minute mark of this podcast.    Does 5HTP Work for Fibromyalgia Dr. Murphree has been working with patients with Fibromyalgia for decades and this is the protocol he’s seen to be most effective. Some patients have concerns because they are on antidepressant medication (which is contraindicated). He’s worked with many of these patients and has seen successes. However a very small percentage do report feeling nauseated or having headaches. It’s important to work with someone experienced with Fibromyalgia (like Dr. Murphree) if this is a concern for you.    Natural Stress Reduction One of the biggest challenges that patients with Fibromyalgia face is reducing stress - often the trigger of the Fibromyalgia in the first place. Dr. Murphree has been working hard to find natural ways to support the adrenal glands (which are responsible for the body’s stress response). He recommends adrenal glandulars. However, he cautions people to make sure that they get the cortex only type because most adrenal glandulars have both cortex and adrenaline. Too much adrenaline can cause adrenal fatigue.    Final Step in Fibromyalgia Recovery In addition to sleep, adrenal and serotonin support, the final step patients need to take is adjusting their lifestyle. A healthy diet is key as is regular exercise. Creating a mindfulness practice (like intentional breath work, meditation or journaling) is also important in resetting and managing the body’s stress response.    Cannabis for Fibromyalgia? The endocannabinoid system in an inborn system that regulates many different bodily systems. It affects body temperature regulation, sleep/wake cycle, digestion, certain hormonal systems, and pain thresholds. Taking CBD alters how the endocannabinoid system functions. Hemp oil, which contains CBD, has less than .03% THC so it provides the benefits of CBD without the ‘high’ that is associated with cannabis. CBD can repair a rundown endocannabinoid system resulting (for some) in an increased pain threshold while also correcting the circadian rhythm so that they can sleep better. However, not all hemp oil or CBD is created equal. Like many other plant crops, there is a vast difference between commercially grown and organically grown varieties.    Mystery Solved For Natalie, solving the mystery of her fibromyalgia started where most start - with her sleep. We supplemented her sleep with 5HTP and L-Theanine. She also adopted new sleep hygiene habits that put the priority on her winding down and relaxing before bed as well as protecting her natural melatonin production.  Once she was getting more restorative sleep each night, we began supporting her adrenals. Tests revealed her cortisol levels were low so she began with a supplement called Adren All from orthomolecular labs. We also introduced some stress reduction techniques to her daily routine.  To help her with her pain, Natalie was taking a CBD oil but it wasn’t as clean or as effective as it could be. She switched to an organic, higher quality CBD oil for her fibromyalgia symptoms.  The final step in helping her live comfortably with Fibromyalgia was to adjust her nutrition. She removed gluten and processed sugar from her diet and started eating clean, whole foods. She also shifted to drinking high quality water.   Happy Ending Just 4 weeks after we started working on this, Natalie was feeling so much better. She was sleeping better, she got her energy back and her pain had gone down by about 50%. The symptoms of Fibromyalgia were no longer something she would have to suffer with forever. Now, it was something she felt she could really live well with.    Eliminating Health Mysteries For Natalie’s case, we couldn’t cure her Fibromyalgia but we were able to find some of the root causes and give her the tools she needs to diminish the symptoms and feel so much better. Could these solutions help you or someone in your life with Fibromyalgia? Please share and let them know there is hope.    Resources Mentioned Thanks to my guest Dr. Rodger Murphree. You can connect with him through his website, on Facebook or Instagram. You can also find his book, Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome on Amazon.   Suggested products 5HTP Synergy   L Theanine  Colorado Hemp Oil  Adren All  Livton Complex  Aqua Tru Water Filter Thanks for Listening If you like what you heard, please rate and review this podcast. Every piece of feedback not only helps me create better shows, it helps more people find this important information. Never miss an episode - Subscribe NOW to Health Mysteries Solved with host, Inna Topiler on Apple Podcasts, Spotify, Stitcher or Google Podcasts. Find out more at http://healthmysteriessolved.com   PLEASE NOTE All information, content, and material on this podcast is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Some of the links provided are affiliate links. This means we may make a very small amount of money should you choose to buy after clicking on them. This will in no way affect the price the product but it helps us a tiny bit in covering our expenses.

EACH YEAR BRINGS ANOTHER INCREASE IN THE PREVALENCE OF ANTIDEPRESSANT USE AND THE RISE IS UNLIKELY TO SUBSIDE AT ANY TIME SOON. BETWEEN 1999 AND 2014, A 64% INCREASE IN USE. 2014 THRU 2019 ANOTHER 60^% INCREASE. OUCH AND DOUBLE OUCH. TUNE IN FOR DETAILS. Tune in every day to hear Dr. Len Brancewicz of The Nutrition Shoppe discuss today's hottest health topics and news from a complimentary perspective.  From colds to cancer and everything in between, Dr. Len can offer honest advice that makes sense. As a Registered Pharmacist (RPh), Certified Clinical Nutritionist (CCN), Doctor of Naturopathic Medicine (NMD), and a homeopath, Dr. Len has over 35 years experience in helping to keep you and your family healthy and happy. Call the show today to ask about your most pressing health concerns! Visit us on the web at www.TheNutritionShoppe.net or call  678-228-8900    to set up a personalized consultation, shop products, or ask questions! ---- Tags: health, natural health, supplements, vitamins, prescriptions, medications, pharmacist, naturopath,

Welcome to the Optimal CEO Podcast. This is Dr. Brian Brown. Join me on today's episode where we'll be discussing how I went from depressed and suicidal to naturally restored and ended a 16 year relationship with psychiatric medications. Thanks for joining me today. Last week, I explained how I discovered at age 45 that I'd been dying every single night since age 5… and how that journey gave me a profound appreciation for functional & integrative medicine. I also discussed why a blended approach is the best approach to wellness and why many wellness gurus are off-base when they tell you that their way is the only way because it's the availability of blended options that bring about wellness success in this complex system we call the human body. Today, I'm gonna to continue my story and tell you how I found a way to get off of psychiatric medications after 16 years. Let's jump right in… I've been practicing psychiatry since 1998. I've treated children as young as age 5… adolescents… young adults… middle-age adults… and senior adults. In that time, I've treated thousands of patients who were not content with life. If “happy” is defined as “feeling or showing contentment,” then I've met a lot of people who were not content (not happy) with life in their present situation. Depression and anxiety are rampant in the Western world, yet the only answer that traditional medicine seems to have is in the form of developing the next “latest and greatest” magic pill. I've actually been one of those “discontent . . . unhappy” people myself. All my life, I had longed to become a doctor. I had felt this calling since I was a young boy. It's all I'd ever dreamed of and all I ever talked about. It's what I had my sights set on. I wanted to help others and was hardwired from birth to be an empathic, caring individual. Also, in my mind, it was a way for me to find some happiness. I developed a hardworking nature right from the start: I started mowing yards when I was nine years old and started flipping burgers when I was fifteen years old. I've done everything from changing oil and pumping gas, to patching flat tires, to driving a gas truck, to unloading trucks at UPS. I'm thankful for those experiences because they have gifted me with the work ethic and people skills I have today. Because of my hardworking nature, the academic rigors of my training were second nature to me as evidenced by being a straight “A” student through my high school, undergraduate, and graduate studies. My story actually begins in the spring of 1997 when I was in my next-to-last year of professional training. One of our lectures had just dismissed for a fifteen minute break in the middle of a four-hour stretch. It was an unusually beautiful spring day, so I went outside to get some fresh air and enjoy the tulips that were in full bloom. I went to the third floor balcony that overlooked a park, the closest thing to nature near my lecture hall. I was right in the middle of my lifelong dream on that third floor balcony. . . but I wasn't happy; somehow, happiness had eluded me. I would later realize that by this point, I had been struggling with depression for about two years and that health professionals had the highest rates of suicide among all other professions. As I stood there on the balcony, propped against the balcony railing and facing the street below, I saw a dump truck speeding down the road in front of me. As the truck approached, I had a flood of emotion as all of the blood rushed from my head. I became dizzy andthe whole world around me spun out of control in a maze of vertigo. My heart was racing, and I was overwhelmed by a nauseated feeling in the pit of my stomach . . . Yet, at the same time, I had a sense of immediate relief and heard a small voice whisper, “It's over now.” It wasn't a horrific voice. It was a peaceful voice. You see as that dump truck sped by, I experienced all the sensations of being thrown over the railing into the path of the oncoming truck below—I had actually envisioned throwing myself over the rail. All of this happened in a matter of seconds. I still remember that feeling to this day. I also remember, in that split second, not knowing whether it was actually happening or all a dream. Sadly, part of me hoped that it was real. When I came to my senses and realized that it was all a vision, I was scared. It rocked me to the core. I immediately had flashes of my beautiful wife and my two beautiful daughters who were three and six at the time. Guilt and shame immediately set it. How could I have such a vision? How could I even feel hope that it was actually happening? What was wrong with me? I left the balcony that day and never stepped foot out there again. I was so ashamed. I didn't tell anyone what happened until about twenty years later. And it wasn't until a year after that incident on the balcony that I confided in a colleague that I'd been struggling with depression and anxiety. She never asked about suicidal thoughts, and I never told her… And I sure as heck didn't tell her about the dozens of other times I had avoided the impulse to swerve my car into the path of oncoming traffic while driving. She put me on Prozac, and it was at that time that I began a sixteen-year journey into the world of “chemical happiness.” I've often reflected why I went on the that first medication. The only conclusion I can draw is that I was new in my profession… in the field of psychiatry… and it just made sense. It was the way I was trained. I told myself, “Brian, why wouldn't I do this? It's what I'd do for one of my patients. Some people get their “chemical happiness” fix through drugs or alcohol, and others, like me, get their fix through antidepressants.” This is how I rationalized it. Isn't it funny how we as humans will find a rationalization for most anything that we want… or anything that we are doing… just to make sense of it all. But… I don't beat myself up too much over this journey, because my knowledge was limited when I made the decision. I guess you can say I wasn't as enlightened as I am now. And… I would even add that it was this journey that has allowed me to help so many others. So… in a strange way… it had to happen… and again, here's the rationalization of it all. Now, let's get back to the rest of the story. In the course of sixteen years, I tried nine different psychiatric medications in the pursuit of happiness… medications like Prozac, Zoloft, Celexa, Lexapro, Wellbutrin, Buspar, Lamictal, Strattera, and Provigil. None of these gave me the happiness I wanted. In fact, they made me feel numb. I couldn't feel anything. I had no emotion. And on top of that, I gained 170 pounds… At 390 pounds, I guess you can say I was “fat and chemically happy,” but I would use the word “happy” very loosely. Over time, I grew to hate the very pills that were supposed to make me feel normal. And yes, I use the word “normal” very loosely also. More than anything, I wanted off these medications. I tried a number of times to stop taking them, but I failed every time. The withdrawal side effects were not fun. Did you know that the drug companies that make these medications will tell you that they are not addictive? In the purest sense of the definition, maybe not, but in reality definitely so. When you try to stop these medication and have symptoms like rebound depression… rebound anxiety… nausea… headaches… and irritability… just to name a few… there's no doubt that these drugs are causing addictive problems. Unable to effectively get off these meds, I repeated the vicious cycle of finding the next pill that would hopefully work and not have major side effects. Oh! And speaking of side effects. They are horrible! Depending on the drug, you can be excessively sleepy and want to sleep all the time OR not be able to sleep hardly at all. You can have nausea, vomiting, diarrhea, headaches, increased appetite, loss of appetite, anger, rage, irritability, no libido, erectile dysfunction… and these are just some of the most common ones. Oh… and the yawning can be terrible… yawning all the time… and there's nothing you can do about it. During my personal sixteen-year journey into “chemical happiness,” I was treating patients with these same medications that I tried… They were dealing with the same side effects… and dealing with the same withdrawal issues. I followed the mantra of my professional training and just accepted that this was the way things were supposed to be. Again, I rationalized it with another professional mantra that we were offering the very best treatments available… after all, what other options were there. How naïve that was to say that… but it's where I was at the time. During that time, I mostly treated patients who were in their mid- to late thirties and older. They would tell me that they were feeling unhappy . . . but many of them would follow it with, “But I know it's not depression . . . it's got to be something else . . . some kind of imbalance.” Most of the time, they would follow it with a laundry list of psychiatric medications they had tried—none of which worked well. Then one day, around the age of forty, it dawned on me: maybe my patients had been right all along! Maybe my medical training had failed me. Maybe the pharmaceutical industry had lied to me. Maybe there were answers outside of traditional medical approaches. I had to find a different way of doing things. From that point forward, I made it my mission to become a student of the best alternative therapies that a person could use to physically and emotionally regain happiness from the inside out. Now, believe me, I knew that walking down this road could mean committing professional suicide. You see, I had been practicing psychiatry for years now. I was a company man. I spoke for numerous pharmaceutical companies. I talked the talk and walked the walk. I believed the lockstep answers fed to me in my medical training, and, not ironically, these same answers were fed to me by the drug reps that made sales calls on me at my office. For those of you who may not know, here's a bit of insider information… a peak behind the curtain, if you will. As a prescriber, you don't get asked to be a speaker for a pharmaceutical company unless you're a high volume prescriber… that's the first thing you need to know. And secondly, Big Pharma has pockets deep enough to be very persuasive. They provide prescribers with the most recent studies… all of which happen to prove their point and sway prescribing in their direction. They are fully aware that prescribers are busy and have little time to do in-depth clinical reading of professional journals. But the proverbial rabbit hole goes deeper. All you have to do is follow the money. Open up most any professional journal, and you will find TWO to SIX page advertising spreads for this drug or that with a cost-per-ad that will rival advertising costs in major secular publications. These same Big Pharma companies are the ones that will pay $100,000 or more for a booth at a professional conference. I give you these tidbits to let you know that the information medical professionals have at their disposal is tainted… and the professional organizations are tainted… they have been corrupted by Big Pharma. I've lived it. I've seen it first hand. And, as you may recall from podcast episode one, the numbers show it. The U.S. is almost last in health outcomes and almost first in healthcare spending. When are we going to wake up and recognize the disconnect here? But, I digress. Until this point, I had been 100 percent sold on the fact that pharmaceutical drugs were the answer, but that day I had my epiphany, something inside of me snapped. I was repulsed by all the lies propagated by Big Pharma . . . lies fed to me during my education; lies that led me down a path of unrest; and lies that certainly didn't reverse my depression. I couldn't live like this anymore, and I couldn't keep poking pills down my own throat and down the throats of my patients either. You might say I had a professional mid-life crisis. I refer to it as an awakening. I remember resolving in my mind that I couldn't do this anymore. Either I was getting out of health care altogether or I was going to reinvent myself. I set out on a journey to find answers, and it came in the strangest of ways. While away at a cardiovascular conference, the keynote speaker, who was the world's foremost authority on cholesterol, said something that lit a spark in me. Here was a guy being paid big bucks by some Big Pharma brand to speak about cholesterol. Instead, what he did surprised the audience. His entire lecture was on the natural treatment of elevated cholesterol. I have to admit, I was in awe. As a former speaker for Big Pharma brands, I knew what it meant to do what he was doing. He was committing professional suicide, but he didn't care… something that I later confirmed in a conversation with him. During that conversation, he also shared some insights that changed the course of my professional career. He pointed me in the right direction, telling me who I needed to study under to gain the knowledge and expertise that I needed. I immediately started seeking that education. After studying under the guru that he recommended for less than three months, I closed down my office practice. I had never been so sure of something in all of my life. I kept doing inpatient work to pay the bills, but I didn't darken the door of an office for nearly a year and a half. I went on to train under this guru for a total of three years. During that first year of training, I began implementing the techniques on myself… and guess what? I began to feel better. I began to lose weight and keep it off. My energy came up. My mood improved. I had stumbled onto something big. I eventually stopped my antidepressants completely in the spring of 2013. Finally, I was free. I had become an escape artist! I had escaped the confining boxes that Big Pharma and traditional medicine had me trapped in. It was a beautiful thing. But something still wasn't quite right. Sure, I was off antidepressants and happy for the first time in nearly two decades. But something was off. Then, it dawned on me. I had to share this with others and help them become escape artists too. In my second year of functional & integrative medicine training, I re-opened the doors of my office. This time, I wasn't practicing psychiatry. I was so turned off by traditional psychiatry that I didn't even want to be associated with it, and I was proud that I had escaped that box and was now beginning my journey to help others escape that box too. I laugh about it today, but it took me two years to realize that I never left psychiatry. I recall coming home one day and saying to my wife, “Guess what? I realized today that I never quit practicing psychiatry, I'm simply doing it differently. I'm doing it holistically.” Always the voice of patient wisdom, my wife said to me, “I was wondering how long it was going to take you to figure that out.” You see, it wasn't enough for me to transform myself. I had to pay it forward. I had to share other people… a way to get out of the confining boxes that traditional medicine, Big Pharma, and others try to put us into. And, that's exactly what I do today. Sure, my repertoire has far surpassed natural mood management. In my office, we manage auto-immune disorders, obesity, nutritional deficits, PCOS, menopause, andropause, gut issues, and thyroid dysfunction… just to name a few. But… since this episode is focused on the natural recovery from depression, I'll leave you with this. Throughout my years of traditional psychiatry and functional psychiatry, a few things have remained consistent… Research shows that women and men in their early thirties begin to experience a decline in hormone activity by as much as one to two1 to 2 percent per year… and this decline continues through the rest of their life. I don't think it's a coincidence that according to the National Center for Health statistics, women age 40 to 59forty to –fifty-nine have the highest rates of depression over any other age group (12.3 percent in fact%)… suicide rates among men are highest in their fifties, and, regardless of gender, those age 40 to 59forty to –fifty-nine are the least happy when compared to every other age group.? Sadly, with hormone disruptors in our diet and environment, we are seeing the ages for these statistics drop. So.. is hormone decline the cause of this depression epidemic in adults age 30 and over? I certainly think it's one of the main causes. In fact, since I've been practicing functional medicine, I've developed a very good track record at helping people avoid antidepressants and helping them come off of antidepressants… all by natural means. And… now that I have a functional medicine background, when we look at those in their late teens and twenties, I often find nutrition, diet, gut disturbances, PCOS, and/or thyroid as the cause. Many of you listening to this podcast may have been struggling silently for years… Or perhaps this is a new struggle… Either way, you need the help of a functional & integrative-medicine provider because most likely your regular medical provider doesn't have the necessary information to help you take back control of your life. Don't be forced into boxes of an antiquated system that you have no business being put into… boxes that follow old, unchallenged treatment modalities. You can easily find yourself in a cycle of being bounced around from doctor to specialist to new specialist with different results and no clear answers. Sadly, when traditional medicine can't find the answer to what ails you, it will typically use depression and anxiety as the default diagnosis box to put you in. If you don't take away anything else from this episode, I want you to leave with this… Be informed… know your options… stand up for better alternatives… and find your voice!!! Join us next time where I'll be talking about the last segment in my personal story. From 390 lbs. To A Fit Without Diet Pills

SSRIs are the most widely used class of psychiatric medications, helpful for depression, anxiety, OCD, panic, PTSD, anger, and certain personality disorders (Why should the same drug treat all these things? Great question!) They’ve been pretty thoroughly studied, but there’s still a lot we don’t understand about them. The SSC Survey is less rigorous than most existing studies, but its many questions and very high sample size provide a different tool to investigate some of these issues. I asked fifteen questions about SSRIs on the most recent survey and received answers from 2,090 people who had been on SSRIs. The sample included people on all six major SSRIs, but there were too few people on fluvoxamine (15) to have reliable results, so it was not included in most comparisons. Here’s what we found: 1. Do SSRIs work? People seem to think so: Made me feel much worse: 6% Made me feel slightly worse: 7.4% No net change in how I felt: 23.7% Made me feel slightly better: 41.4% Made me feel much better: 21.4% Of course, these statistics include the placebo effect and so cannot be taken entirely at face value. 2. Do some SSRIs work better than others? I asked people to rate their experience with the medication, on a scale from 1 to 10. Here were the results: Lexapro (356): 5.7 Zoloft (470): 5.6 Prozac (339): 5.5 Celexa (233): 5.4 Paxil (126): 4.6 Paxil differed significantly from the others; the others did not differ significantly among themselves. In a second question where participants were just asked to rate their SSRIs from -2 (“made me feel much worse”) to +2 (“made me feel much better”), the ranking was preserved, and Lexapro also separated from Celexa. This ranking correlates at r = 0.98 (!?!) with my previous study of this taken from drugs.com ratings. I don’t generally hear that Paxil is less effective than other SSRIs, but I have heard that it causes worse side effects. The survey question (probably wrongly) encouraged people to rate side effects as “negative efficacy”. My guess is that the difference here is mostly driven by side effects.

Porpoise Crispy Podcast
 Volume #8 Episode #2 Escitalopram (Lexapro, Cipralex) Curated by JohnFebruary 8, 2019            Celexa helps us remember  The Sun Smells Too Loud Mogwai The Hawk Is Howling Lawman Girl Band Lawman Doctor   Priests Bodies And Control And Money And Power Wasted Days Cloud Nothings Attack On Memory Reaching For Things HEATER HEATER - Self-Titled 7" Butler Moon Pussy Moon Pussy 2 Grab a Shovel Tørsö Build and Break   Leopard Print Jet Ski Meat Wave The Incessant Sunshine Priors New Pleasure                   Hadrianich Relique Rudimentary Peni Pope Adrian 37th Psychristiatric       Lexapro might do it better The pCrispy is only an hour of music so I know you’ve got time to enjoy to these bad asses of the Internets:  The Westerino Show Funkytown Bayerclan Squirreling Podcast Secretly Timid

I've been practicing psychiatry since 1998. I've treated children as young as age 5… adolescents… young adults… middle-age adults… and senior adults. In that time, I've treated thousands of patients who were not content with life. If “happy” is defined as “feeling or showing contentment,” then I've met a lot of people who were not content (not happy) with life in their present situation. Depression and anxiety are rampant in the Western world, yet the only answer that traditional medicine seems to have is in the form of developing the next “latest and greatest” magic pill. I've actually been one of those “discontent . . . unhappy” people myself. All my life, I had longed to become a doctor. I had felt this calling since I was a young boy. It's all I'd ever dreamed of and all I ever talked about. It's what I had my sights set on. I wanted to help others and was hardwired from birth to be an empathic, caring individual. Also, in my mind, it was a way for me to find some happiness. I developed a hardworking nature right from the start: I started mowing yards when I was nine years old and started flipping burgers when I was fifteen years old. I've done everything from changing oil and pumping gas, to patching flat tires, to driving a gas truck, to unloading trucks at UPS. I'm thankful for those experiences because they have gifted me with the work ethic and people skills I have today. Because of my hardworking nature, the academic rigors of my training were second nature to me as evidenced by being a straight “A” student through my high school, undergraduate, and graduate studies. My story actually begins in the spring of 1997 when I was in my next-to-last year of professional training. One of our lectures had just dismissed for a fifteen minute break in the middle of a four-hour stretch. It was an unusually beautiful spring day, so I went outside to get some fresh air and enjoy the tulips that were in full bloom. I went to the third floor balcony that overlooked a park, the closest thing to nature near my lecture hall. I was right in the middle of my lifelong dream on that third floor balcony. . . but I wasn't happy; somehow, happiness had eluded me. I would later realize that by this point, I had been struggling with depression for about two years and that health professionals had the highest rates of suicide among all other professions. As I stood there on the balcony, propped against the balcony railing and facing the street below, I saw a dump truck speeding down the road in front of me. As the truck approached, I had a flood of emotion as all of the blood rushed from my head. I became dizzy andthe whole world around me spun out of control in a maze of vertigo. My heart was racing, and I was overwhelmed by a nauseated feeling in the pit of my stomach . . . Yet, at the same time, I had a sense of immediate relief and heard a small voice whisper, “It's over now.” It wasn't a horrific voice. It was a peaceful voice. You see as that dump truck sped by, I experienced all the sensations of being thrown over the railing into the path of the oncoming truck below—I had actually envisioned throwing myself over the rail. All of this happened in a matter of seconds. I still remember that feeling to this day. I also remember, in that split second, not knowing whether it was actually happening or all a dream. Sadly, part of me hoped that it was real. When I came to my senses and realized that it was all a vision, I was scared. It rocked me to the core. I immediately had flashes of my beautiful wife and my two beautiful daughters who were three and six at the time. Guilt and shame immediately set it. How could I have such a vision? How could I even feel hope that it was actually happening? What was wrong with me? I left the balcony that day and never stepped foot out there again. I was so ashamed. I didn't tell anyone what happened until about twenty years later. And it wasn't until a year after that incident on the balcony that I confided in a colleague that I'd been struggling with depression and anxiety. She never asked about suicidal thoughts, and I never told her… And I sure as heck didn't tell her about the dozens of other times I had avoided the impulse to swerve my car into the path of oncoming traffic while driving. She put me on Prozac, and it was at that time that I began a sixteen-year journey into the world of “chemical happiness.” I've often reflected why I went on the that first medication. The only conclusion I can draw is that I was new in my profession… in the field of psychiatry… and it just made sense. It was the way I was trained. I told myself, “Brian, why wouldn't I do this? It's what I'd do for one of my patients. Some people get their “chemical happiness” fix through drugs or alcohol, and others, like me, get their fix through antidepressants.” This is how I rationalized it. Isn't it funny how we as humans will find a rationalization for most anything that we want… or anything that we are doing… just to make sense of it all. But… I don't beat myself up too much over this journey, because my knowledge was limited when I made the decision. I guess you can say I wasn't as enlightened as I am now. And… I would even add that it was this journey that has allowed me to help so many others. So… in a strange way… it had to happen… and again, here's the rationalization of it all. Now, let's get back to the rest of the story. In the course of sixteen years, I tried nine different psychiatric medications in the pursuit of happiness… medications like Prozac, Zoloft, Celexa, Lexapro, Wellbutrin, Buspar, Lamictal, Strattera, and Provigil. None of these gave me the happiness I wanted. In fact, they made me feel numb. I couldn't feel anything. I had no emotion. And on top of that, I gained 170 pounds… At 390 pounds, I guess you can say I was “fat and chemically happy,” but I would use the word “happy” very loosely. Over time, I grew to hate the very pills that were supposed to make me feel normal. And yes, I use the word “normal” very loosely also. More than anything, I wanted off these medications. I tried a number of times to stop taking them, but I failed every time. The withdrawal side effects were not fun. Did you know that the drug companies that make these medications will tell you that they are not addictive? In the purest sense of the definition, maybe not, but in reality definitely so. When you try to stop these medication and have symptoms like rebound depression… rebound anxiety… nausea… headaches… and irritability… just to name a few… there's no doubt that these drugs are causing addictive problems. Unable to effectively get off these meds, I repeated the vicious cycle of finding the next pill that would hopefully work and not have major side effects. Oh! And speaking of side effects. They are horrible! Depending on the drug, you can be excessively sleepy and want to sleep all the time OR not be able to sleep hardly at all. You can have nausea, vomiting, diarrhea, headaches, increased appetite, loss of appetite, anger, rage, irritability, no libido, erectile dysfunction… and these are just some of the most common ones. Oh… and the yawning can be terrible… yawning all the time… and there's nothing you can do about it. During my personal sixteen-year journey into “chemical happiness,” I was treating patients with these same medications that I tried… They were dealing with the same side effects… and dealing with the same withdrawal issues. I followed the mantra of my professional training and just accepted that this was the way things were supposed to be. Again, I rationalized it with another professional mantra that we were offering the very best treatments available… after all, what other options were there. How naïve that was to say that… but it's where I was at the time. During that time, I mostly treated patients who were in their mid- to late thirties and older. They would tell me that they were feeling unhappy . . . but many of them would follow it with, “But I know it's not depression . . . it's got to be something else . . . some kind of imbalance.” Most of the time, they would follow it with a laundry list of psychiatric medications they had tried—none of which worked well. Then one day, around the age of forty, it dawned on me: maybe my patients had been right all along! Maybe my medical training had failed me. Maybe the pharmaceutical industry had lied to me. Maybe there were answers outside of traditional medical approaches. I had to find a different way of doing things. From that point forward, I made it my mission to become a student of the best alternative therapies that a person could use to physically and emotionally regain happiness from the inside out. Now, believe me, I knew that walking down this road could mean committing professional suicide. You see, I had been practicing psychiatry for years now. I was a company man. I spoke for numerous pharmaceutical companies. I talked the talk and walked the walk. I believed the lockstep answers fed to me in my medical training, and, not ironically, these same answers were fed to me by the drug reps that made sales calls on me at my office. For those of you who may not know, here's a bit of insider information… a peak behind the curtain, if you will. As a prescriber, you don't get asked to be a speaker for a pharmaceutical company unless you're a high volume prescriber… that's the first thing you need to know. And secondly, Big Pharma has pockets deep enough to be very persuasive. They provide prescribers with the most recent studies… all of which happen to prove their point and sway prescribing in their direction. They are fully aware that prescribers are busy and have little time to do in-depth clinical reading of professional journals. But the proverbial rabbit hole goes deeper. All you have to do is follow the money. Open up most any professional journal, and you will find TWO to SIX page advertising spreads for this drug or that with a cost-per-ad that will rival advertising costs in major secular publications. These same Big Pharma companies are the ones that will pay $100,000 or more for a booth at a professional conference. I give you these tidbits to let you know that the information medical professionals have at their disposal is tainted… and the professional organizations are tainted… they have been corrupted by Big Pharma. I've lived it. I've seen it first hand. And, as you may recall from podcast episode one, the numbers show it. The U.S. is almost last in health outcomes and almost first in healthcare spending. When are we going to wake up and recognize the disconnect here? But, I digress. Until this point, I had been 100 percent sold on the fact that pharmaceutical drugs were the answer, but that day I had my epiphany, something inside of me snapped. I was repulsed by all the lies propagated by Big Pharma . . . lies fed to me during my education; lies that led me down a path of unrest; and lies that certainly didn't reverse my depression. I couldn't live like this anymore, and I couldn't keep poking pills down my own throat and down the throats of my patients either. You might say I had a professional mid-life crisis. I refer to it as an awakening. I remember resolving in my mind that I couldn't do this anymore. Either I was getting out of health care altogether or I was going to reinvent myself. I set out on a journey to find answers, and it came in the strangest of ways. While away at a cardiovascular conference, the keynote speaker, who was the world's foremost authority on cholesterol, said something that lit a spark in me. Here was a guy being paid big bucks by some Big Pharma brand to speak about cholesterol. Instead, what he did surprised the audience. His entire lecture was on the natural treatment of elevated cholesterol. I have to admit, I was in awe. As a former speaker for Big Pharma brands, I knew what it meant to do what he was doing. He was committing professional suicide, but he didn't care… something that I later confirmed in a conversation with him. During that conversation, he also shared some insights that changed the course of my professional career. He pointed me in the right direction, telling me who I needed to study under to gain the knowledge and expertise that I needed. I immediately started seeking that education. After studying under the guru that he recommended for less than three months, I closed down my office practice. I had never been so sure of something in all of my life. I kept doing inpatient work to pay the bills, but I didn't darken the door of an office for nearly a year and a half. I went on to train under this guru for a total of three years. During that first year of training, I began implementing the techniques on myself… and guess what? I began to feel better. I began to lose weight and keep it off. My energy came up. My mood improved. I had stumbled onto something big. I eventually stopped my antidepressants completely in the spring of 2013. Finally, I was free. I had become an escape artist! I had escaped the confining boxes that Big Pharma and traditional medicine had me trapped in. It was a beautiful thing. But something still wasn't quite right. Sure, I was off antidepressants and happy for the first time in nearly two decades. But something was off. Then, it dawned on me. I had to share this with others and help them become escape artists too. In my second year of functional & integrative medicine training, I re-opened the doors of my office. This time, I wasn't practicing psychiatry. I was so turned off by traditional psychiatry that I didn't even want to be associated with it, and I was proud that I had escaped that box and was now beginning my journey to help others escape that box too. I laugh about it today, but it took me two years to realize that I never left psychiatry. I recall coming home one day and saying to my wife, “Guess what? I realized today that I never quit practicing psychiatry, I'm simply doing it differently. I'm doing it holistically.” Always the voice of patient wisdom, my wife said to me, “I was wondering how long it was going to take you to figure that out.” You see, it wasn't enough for me to transform myself. I had to pay it forward. I had to share this gift to help transform other people. And, that's exactly what I do today. Sure, my repertoire has far surpassed natural mood management. In my office, we manage auto-immune disorders, obesity, nutritional deficits, PCOS, menopause, andropause, gut issues, and thyroid dysfunction. But… since this episode is focused on the natural recovery from depression, I'll leave you with this. Throughout my years of traditional psychiatry and functional psychiatry, a few things have remained consistent… Research shows that women and men in their early thirties begin to experience a decline in hormone activity by as much as one to two1 to 2 percent per year… and this decline continues through the rest of their life. I don't think it's a coincidence that according to the National Center for Health statistics, women age 40 to 59forty to –fifty-nine have the highest rates of depression over any other age group (12.3 percent in fact%)… suicide rates among men are highest in their fifties, and, regardless of gender, those age 40 to 59forty to –fifty-nine are the least happy when compared to every other age group.? Sadly, with hormone disruptors in our diet and environment, we are seeing the ages for these statistics drop. So.. is hormone decline the cause of this depression epidemic in adults age 30 and over? I certainly think it's one of the main causes. In fact, since I've been practicing functional medicine, I've developed a very good track record at helping people avoid antidepressants and helping them come off of antidepressants… all by natural means. And… now that I have a functional medicine background, when we look at those in their late teens and twenties, I often find nutrition, diet, gut disturbances, PCOS, and/or thyroid as the cause. Many of you listening to this podcast may have been struggling silently for years… Or perhaps this is a new struggle… Either way, you need the help of a functional & integrative-medicine provider because most likely your regular medical provider does not have the necessary information to help you take back control of your life. Don't be forced into boxes of an antiquated system that you have no business being put into… boxes that follow old, unchallenged treatment modalities. You can easily find yourself in a cycle of being bounced around from doctor to specialist to new specialist with different results and no clear answers. Sadly, when traditional medicine can't find the answer to what ails you, it will typically use depression and anxiety as the default diagnosis box to put you in. Be informed… know your options… stand up for better alternatives. Alright, that concludes today's episode. Next time, I'll be talking about the last segment in my personal story. From 390 lbs. To A Fitness-Work-In-Progress

Porpoise Crispy Podcast
Volume #8 Episode #1 Citalopram (Celexa, Cipramil) Curated by Megs January 29, 2019         Last of the volume sevens Sister I'm a Poet Morrissey Beethoven Was Deaf Sheets Damien Jurado Caught In The Trees Freedom Of '76 Ween Chocolate And Cheese California Girls The Magnetic Fields Distortion Tibetan Pop Stars Hop Along Get Disowned       Domestication Laura Gibson Goners My Name Is David Dust Congress October 11, 2007 at Public Trust         Forty Dollars The Twilight Singers Powder Burns          Reveal The Rats Fatal Flying Guilloteens Quantum Fucking         Day Glo Hazel Toreador of Love Let's Kill Saturday Night Silkworm You Are Dignified Colleen Joanna Newsome & The Ys Street Band EP      First of the volume eights The pCrispy is only an hour of music so I know you’ve got time to enjoy to these bad asses of the Internets:  The Westerino Show Funkytown Bayerclan Squirreling Podcast Secretly Timid    

This week the kids fill in Anthony on their non-stop week filled with highs and lows. It all begins with the sad loss of the podcast's spirit animal and Steph's baby, Nilla. The discussion moves to mini Viking pyres, busy weekends, and what dreams are made of. Tell your friends that we're back and it's time to get ridiculous! Follow, Friend, and Like Us on / / Subscribe to us on / / and now on & ! Email us at  to have your words read on the podcast! Thanks to our friends for our intro song, and Ramon Hernandez for our outro.

The Power of Speaking Your Reality into Existence Over the years, one thing that I've done before I've actually achieved a goal—whether that was a financial goal, a business goal, or maybe a fitness health goal—is I've always spoken it into existence. I would repeat affirmations. I would write down goals, and I would say them to myself before I ever achieved them. There are a couple reasons you want to do this too. Why do you want to speak something into existence? Why do you want to say things to yourself before they happen? Let's start with an example. I have one incantation right now about my health. I always say to myself, “I now weigh 165 pounds and have a thin, fit, healthy, muscular, sexy body.” I'll just repeat it over and over again. Click To Watch This Video On YouTube... Talking to Your Subconscious Mind I know it sounds crazy, but your subconscious mind cannot tell the difference between the truth and a lie. And whatever you repeat to yourself over and over and over again, you'll believe. In order to achieve, you've got to believe. When you believe you can do something, you'll actually align yourself with it and take actions toward it. You need to speak your new existence and your desired reality before it actually happens. Doing this works. This is what I've been doing over the last three years. This is how I was able to go from 220 pounds to 170 pounds. This is how I've gone from earning $30,000 at the Cracker Barrel to this year, in which my goal is to do more than $480,000 in profit. I might even hit $500,000. And all this is because I believe in myself. I don't know exactly how I'm going to achieve a lot of my goals. I just repeat it to myself over and over again, and then the opportunity always presents itself. Nonsense or Brilliance? You might be thinking to yourself, “Steve, this is BS nonsense. Brother, you're getting weird. You're odd, man. What are you doing talking about all this stuff? That doesn't work.” It does work. This isn't theory. I've been applying this to my life for years now, over the last three years especially. And it's true. Your subconscious mind really cannot tell the difference between a truth and a lie. If you tell yourself over and over again that you are now earning a certain amount of money, that you have a particular body, or that you are a certain type of person, you will believe it and will start to act in accordance with it. I can promise you that. It Works the Other Way Too But it's also true for the other side of the coin. You might be tempted to talk to yourself in a negative light: “I'm fat. I'm lazy. I am just a piece of crap. I'm always going to be broke because I'm not smart enough.” That might be your current truth, or it might notbe.  Regardless, it becomes the truth because you're saying it to yourself all the time. You've got to get control of your thoughts because your reality is in your hands. You can become anything you want. I know that sounds like self-help psycho-babble, but it's true to an extent. You really can. There's no better opportunity to design the life of your dreams than right this instant—especially with all the technology we have nowadays and the internet. We have so much information at our disposal on Google, forums Facebook groups, and YouTube. You Are Capable of Doing This I'm not saying this just to try to pump you up. It's true. It wasn't long ago that I was more than 240 pounds. I was smoking cigarettes. I was on Xanax and Adderall and Celexa, and I was living at home with my parents. I felt like crap. And, yes, it's been a while, and I've slowly been chipping away at it. It didn't happen overnight. But if I changed my life, then you can do the same thing. And one of the best things you can do is to start speaking into existence the reality that you desire so much. ...

Richard speaks with a court expert witness about the frightening connection between mass shootings and anti-depressant drugs.  In virtually all mass-shootings, the shooters were taking some type of anti-depressant or anti-psychotic medication. GUEST: Ann Blake-Tracy is the director of the International Coalition for Drug Awareness. She has specialized for 22 years in adverse reactions to serotonergic medications (Antidepressants such as Prozac, Zoloft, Paxil, Luvox, Effexor, Celexa, Lexapro, Cymbalta, Pristiq, Serzone, Anafranil, etc. and the diet pills Fen-Phen, and Redux and the newer Atypical Anti-psychotic medications such as Zyprexa, Geodon, Abilify, Risperdal, Seroquel, etc.) and has testified before the FDA and congressional subcommittee members on Prozac. Her first book on the issue, Prozac: Panacea or Pandora? was published in 1991

Santa Fe shooting: Texas governor confirms 10 people dead and 10 woundedGovernor Greg Abbott confirms the number of fatalities in a shooting at a high school about an hour south-east of Houston.https://www.theguardian.com/us-news/2018/may/18/texas-school-shooting-santa-fe-highAntidepressants Nightmareshttps://ssristories.orghttps://twitter.com/alexexumwww.alexexum.com

Santa Fe shooting: Texas governor confirms 10 people dead and 10 woundedGovernor Greg Abbott confirms the number of fatalities in a shooting at a high school about an hour south-east of Houston.https://www.theguardian.com/us-news/2018/may/18/texas-school-shooting-santa-fe-highAntidepressants Nightmareshttps://ssristories.orghttps://twitter.com/alexexumwww.alexexum.com

If you have been prescribed Zoloft (sertraline), you may be wondering about Zoloft life insurance eligibility. Getting approved for life insurance with a Zoloft prescription history is possible… if you have the right insurance agent and insurance company! There are many medications used to treat depression. Celexa, Cymbalta, Lexapro, Paxil, Wellbutrin, and Zoloft are some.. More The post Zoloft Life Insurance Eligibility appeared first on Life-Wealth-Win.

The US Government’s unique policy of deliberately obstructing positive growth which directly hurts its citizens.  

Were championing for mental health awareness or a publicity stunt Does the prescription drug, Celexa, deserve the negative press in the court case of the teenager who encouraged her boyfriend to complete suicide?     This week’s episode discusses these very questions and more on the Shrink Tank Podcast. With Katy Perry’s new album, Witness, recently launching, her mental […]

EP086 - Dorel Juvenile Group Bob Land and Jamie Dooley   An interview with Bob Land is the VP Consumer Engagement and Jamie Dooley is the Head of E-Commerce at Dorel Juvenile Group.  Dorel Juvenile is the world’s leading juvenile product company and has over 11k employees globally. They have a portfolio of 11 brands include Cosco and Safety 1st. In this interview, we discuss Dorel's to to market strategy, including: Wholesale Direct to Consumer Marketplaces Physical/Popup DTC B2B In particular Dorel is a hybrid seller (1p and 3p) on both Walmart and Amazon's marketplaces. Jamie will be one of the speakers at "Amazon & Me" an all day workshop on Tuesday June 6th at IRCE, hosted by Scot Wingo. Don't forget to like our facebook page, and if you enjoyed this episode please write us a review on itunes. Episode 86 of the Jason & Scot show was recorded on Wednesday May 24, 2017. http://jasonandscot.com Join your hosts Jason "Retailgeek" Goldberg, SVP Commerce & Content at Razorfish, and Scot Wingo, Founder and Executive Chairman of Channel Advisor as they discuss the latest news and trends in the world of e-commerce and digital shopper marketing. New beta feature - Amazon Automated Transcription of the show: Transcript Jason: [0:25] Welcome to the Jason and Scott show this episode is being recorded live on Wednesday May 24th 2017 I'm your host Jason retailgeek Goldberg and as usual I'm here with your co-host Scot Wingo. Scot, Jamie, Bob: [0:40] Hey Jason and welcome back Jason Scott show listeners you know Jason some of the feedback we get says that some of our jokes especially yours are juvenile so we have perfect guest for the show tonight. Jason: [0:52] Internist that that feedback is mostly from my family. Scot, Jamie, Bob: [0:57] Guy cuz they get to live with them all the time so tonight we're really excited to have two members of the door old juvenile group e-commerce team dorel juvenile is the world's leading juvenile Product Company and has over 11,000 employees globally they have a portfolio of 11 Brands including Costco and safety first, we're excited to have on the show Bob land who is the VP of consumer engagement and Jamie Dooley who is the head of eCommerce welcome Bob and Jamie hello. Alright cool so what what part of the world I'm in Raleigh Jason is back home in Sunny Chicago where you guys at. [1:36] I am in the Backwoods of Southern New Hampshire and put our company is actually headquartered in the u.s. in Foxboro Massachusetts probably about 15 minutes away from the. [1:51] And I'm in the back words of Boston okay so the first Speaker there was Jamie and II was Bob for those either don't recognize their voices. Jason: [2:01] We always like to start the show by getting a rundown on your background and how you got to your current rolls and maybe a little bit about what the the scope of your role is now so Bob can we start with you. Scot, Jamie, Bob: [2:14] Sure sure I'm I'm kind of the the old man of eCommerce it seems I started off in eCommerce in 1995. Not sure how often you you hear that but I work a Polaroid and I was a product manager on it, try to call to make a print you know those machines that you going to a CVS or Walgreens and you can't hear photo, we did that 95 and we use the internet to you know send some photos to the Internet so it was. Kind of an early beginning I went to Rensselaer which is a little College in Upstate New York engineering school lunch lids.com and 1999 and if you know those guys. Happy tailor. And then cvs.com for CVS Pharmacy in around 2001 when I got into the affiliate space know if you guys are the affiliate world like I do but I started. And a Commission Junction. And then it starts from 2006 all the way to 2011 where we got bought by rapper 10 which is a pretty large e-commerce player out of Japan. That's why I stayed for a while on their leadership team and then found dorel that's our video ad from our new CEO recruiting people for a digital transformation so I've been there been here ever since. Jason: [3:44] End and how long is ever since when did you get to dorel. Scot, Jamie, Bob: [3:47] The three and a half years but then e-commerce terms is talking about sweat 7 is that the multiplier. Jason: [3:54] I think so so you're off probation then. Scot, Jamie, Bob: [3:59] Double secret probation. Jason: [4:02] Awesome in Jamie what about yourself. Scot, Jamie, Bob: [4:06] Well I'm just tangentially my probation officer I need to call him after this process will that I'm a giraffe. Jason: [4:14] That was one of the conditions of your parole if I'm not mistaken. Scot, Jamie, Bob: [4:18] And absolutely was so so I went to MIT for graduate school. Jason: [4:24] That's like a liberal arts college in the in the Northeast. Scot, Jamie, Bob: [4:29] Yes yeah it's a little small school and I actually I was one of the only people in my graduating class but actually went into retail so I would I got recruited out of. Alabama teacher to go work at the Bayern brick-and-mortar for target with snow very traditional Japanese e-commerce go go to MIT and then go into rock music. Has the buyer of rock CDs for for Target. And then what is a brick-and-mortar bar Provo Target in and Staples and then ultimately ended up back here in New England working for Wayfair where I was. The director category management for a number of categories including the baby categories that I was really my first entree into the baby space as well as toys and game rooms. And ultimately went to Dunkin brands or Dunkin Donuts headquarters where I where I live retail merchandising in eCommerce and then more recently was the, director of e-commerce merchandising strategy for Toys R us.com and babiesrus.com. Most recently I've been at the route for about a year-and-a-half now and I'm head of e-commerce where. I actually came to the company name because Bob and the leadership team and painted a really exciting vision for. Transforming what was already a very well-known company in the baby's face into more e-commerce focused and digital organization. [5:59] Very excited to a part of that change over the last year we made him take the Kool-Aid right off the bat. I was keeping track and I think between the two of you we've got 480 of the IR 500 so congratulations on that careers. Pretty robust set of companies to work for thank you. [6:23] So what's up let's kind of started a high-level and kind of work our way in peel the onion is at work so, you know you guys were at retailers before and a vendor there and now you're at Brand so tell us a little bit how do you guys think about channels and then just just, macro online offline in and how, no important that is for you guys dabs about you in so that they must be pretty important and then as we know and then within the channels within online I'll pry have a follow-up so just start there. [6:58] Sure so we saw into a number of different channels and just high-level so you guys are so of the listeners and everyone understand. We were the largest manufacturer in the US of baby products that everything from strollers car seats to infant Health Products like thermometers. Safety monitors and probably the product. People probably with his the Baby on Board sign in a lot of cars that that is so when we when we think about Channel there's obviously we went to the traditional brick-and-mortar retailers. We we silent appear quite online retailers as well. We also have a very strong and growing DTC Channel weather and I can talk a little bit more about you what comprises Rd to see Channel marketplaces. Start with kind of don't think of Market places around my marketplaces as part of Vita C. But if so that's probably another Channel we looking at and then we have we we have done physical stores and pop-up stores so Wickham orders is kind of our own channel. And then we have some B2B channels list. [8:18] Cool so Mom. What your summary of the scope of of online and is this kind of guys or Ground Zero or is there been some progress. [8:29] Yeah I think we've had some Dennis progress over the last probably the last year-and-a-half and in terms of not over not only just a digital transformation in the mentality of probably approach, e-commerce but from a sales perspective as well so the industry. Depending on the category were and we Runnin so many different categories and babies.com Rd Commerce penetration ranges anywhere from 10 to 50% off, 30% and we're certainly not work with a lot of our competitors haven't been at babiesrus.com and wait there to know that we're certainly at the high end of. About scale in terms of. Penetration relative to the rest of the industry and we're obviously a really big company were bitching about a billion dollars a year. E-commerce business is certainly one of our fastest growing parts of the business that work cited about that so we feel like. But you were going to really embraced the change and we continue to see things coming out of the hangout e-commerce. It's kind of nice I was allowed to go as broad as we have. In that you know we didn't when I you know only doing gay to see or only the e-commerce group, where in the space we're going to be call a consumer engagement but really it's we have the the brand marketing budget as well. We have call center we have to see via Parker places with several different groups under kind of One Umbrella. [10:06] So we from our perspective if we you know we feel that we should start selling, Autoflower call center upselling services or things like that we're absolutely he was in our Charter to do something like that so it's it's a nice bit of freedom, inside of a relatively large company do you guys operate at so we had Greg, poster on from VF Corp and they they're kind of like a sinner for e-commerce and then the brands kind of feed off of that in other places other, other kind of houses brands with talk to there's almost like independent groups that kind of run things how are you guys set up at a macro Essence macro level. [10:49] We're a core team so each one of the brands. So the five really that we operate out of out of Foxboro and. The week of the group the go-to-market team on once the NPD process the new product development process goes to a certain point we do all the launch planning for the company, read we really don't get into Channel management is probably what we draw the line with the sales team but it's really a core group. That that. Works to really extend the the brand marketing so the brand teams really only get to work on product development. And core brand development and then we really do the activation now part of the brand. Jason: [11:38] Got interesting you know, I'm always fascinated I have some clients that are brands that very robust direct-to-consumer business is and then I also have some some brands that are super early in their DTC journey and those guys are always terrified about the channel conflict issues, I'm sort of assuming by how robust your your channels are that that that if there were any concerns those concerns of sort of played out in the past is that the fair characterization or is that still something you have to Grapple with. Scot, Jamie, Bob: [12:15] I think we still we absolutely grapple with it everyday I wouldn't say. It's it's a huge obstacle for trying to run eCommerce but we're certainly mindful of. Are we evolve our Retail Partners as we're managing to the Sea, and I think we've approached it where we we don't we don't want to actively compete with our major Retail Partners uncertainly in my career taking Amazon honest is never a good idea. Walmart or any of the other. Major retailers video into our goal is to provide regardless of the channel to customer purchased directly. Rr1 PV terrorism cell, on the marketplace is and then our call centers in P2P our goal is ultimately to have all those channels work worth in Harmony and not trying to shoot against each other first. Jason: [13:17] Ghana and I'm assuming you're sort of Court digital team isn't just a supporting the DTC so you're probably also providing content and assets and stuff for your for your 1p partners for their own e-commerce efforts is that. Is that true. Scot, Jamie, Bob: [13:32] Yeah that's absolutely true I think that's part of how we tried to, just saw the vision to our Retail Partners and throughout the organization is that what we do from a contract perspective or everything that we're doing to enhance the customer experience online is certain Morrison. Healthy overall company attorney just to this point it's taking awhile No 3 or 4 years now. It's like a data Liberation movement had 7 or 8 products, catalogs you can spread all over the world all these different databases and recently called salsify a kind of bring it all together. And really once we took moves like that and really didn't rely on Legacy systems anymore of your completely rebuilt the marketing technology Stacks we we train the prods managers to develop, content in in you know the way that it should be developed for online so it was kind of it's getting to a point where it's a lot easier than it used to be. Wow the barriers have been really knocked down at not to say that we don't find new barriers kind of every week I'll place in front of us but I think the systems that the kind of the level of. Availity. Citizens have a really empowers everybody we would taking a lot of cost out of the business to you nobody not by giving off of these Legacy systems cell. What a nice Pivot Point here. Jason: [15:05] Yeah I find that. [15:09] Often is a cost savings for brands that you know in the old world you under nose to you or treating the same content multiple times for multiple touch points and when you're when you get those more robot systems you get better content reuse often. Scot, Jamie, Bob: [15:24] Yeah I agree absolutely we also we're spending money in the wrong places, so you don't know gone are the days we have to do $30,000 photo shoots for a single product launch as far as I'm concerned for dorel anyway. You know we do social, social photoshoot we invite you know parents who live within 30 miles of the office to bring their cute baby in for the day and we shower them with gifts and you get amazing photos out of a session like that, and you're doing consumer engagement so it's kind of my fault now. Jason: [15:56] Place very interesting we might want makes for that more but I do want to touch on something you you introduced a little earlier so Amazon is one of your Retail Partners you're selling to them 1p you're also selling on marketplaces and I'm presuming one of those marketplaces as is Amazon so you're sort of sailing, food through two methods and we often call that sort of a hybrid model is that do I have that right and if so can you can you talk our listeners through how that's work for you. Scot, Jamie, Bob: [16:31] Sure yeah and that's absolutely right yeah we are hybrid we we've sold by 1p for over a decade. 1 times and then we launched on Amazon Marketplace about a little over a year ago and it just took off and fantastic and. I think we have a really good partnership with our vendor managers on a one piece side and we're we're fortunate enough to have the Rangers for top managers on the marketplace side so I think so. Yeah meet me at some pretty wacky goals to his phone e-commerce perspective. Last year and we beat them pretty and within certainly the marketplaces were a big part of that in addition to the overall eCommerce performance. Water brands I talk to you they get really confused by this that kind of say. [17:24] Alright so I get the whole sale thing why would you have 3 piano, an answer to this. Like from from your perspective you know what was it that led you to kind of explorer that and and what are some of the levers that gives you to pull in the in the Amazon side effects. I think for us when I got hired I was hired to talidi to see and I don't think we really knew how we wanted. Focus mostly on transfer store on marketplaces physical store. [17:59] What is strong physical store on sales revenue stream in Europe. So I looked at it from a wax way and I think from from traffic perspective certainly it was it would be easiest to go after online marketplaces that was one of the. The major factors that. I thought about when we were. Trying to decide which do we focus on first focus on all them now but you only have so much resources in the beginning. I love that we have the safety net that you've done your podcast the parking lot about craft items and then we can go. A safety net for when or if Amazon decides to send to crop out items we can put them on the marketplace pretty easily and then. Our products kind of engine in six pockets and I talked about this in the session I do, and I are coming out where we will get it from A New Perspective an existing catalog perception online on one exclusives or what would call Alexander's. Accessories and then exit 17 closed. So it gives us the flexibility to. To go in and decide how we're going to approach each one of those product buckets for each one of our friends in our portfolio and gives us a lot of options for how we want to we want to drive sales for each of those. [19:31] Graco so in the early days how much skew overlap is there between 1 p and 3p a lot of the folks I've talked to they the first explorer 3p because you know they presented, 10000 skews the Amazon Amazon spot 1000, and if you would initially is a way to get the rest of their product line up there is that the case with you guys it sounds like there's a little overlap there cuz you do that safety-net kind of do listing approach. So there's absolutely no overlap on the Amazon side Amazon actually doesn't allow that so if anyone from Amazon is going to kill the lamp. Butter. What we and other and other Mark of places that does allow us and a little bit of a safety net so if the one piece side goes out of stock already. The house of a three-piece. Jason: [20:27] In just a clarifying question on the overlap. [20:33] So does that include out of stocks so if if Amazon carries ask you and they go out of stock can you sell it as 3p until they come until they make another by or or do you just stay away from those cubes entirely. Scot, Jamie, Bob: [20:48] Why I think this. If you're if you're sticking to the letter of Amazon's policy is that if Amazon carries an item or merchandise is an item on the one piece I'd you can't set that I'm up, on the three people and their algorithms actually flag, you and tell you that you don't know what to do that if it if it's a text if you have an overlapping you on the marketplace. There is any one of the other. The oversight that a lot of people have is that it's not just really one p vs 3T there's three different types of freaky and three different types of One Piece One of the types of one piece is from where. You're you're not the seller record it's not a Marketplace relationship with one. Amazon is still the seller record but it's very much like what you talked about Jason if Amazon goes out of stock it automatically defaults to a Dropship order within our warehouse. That's almost like a Marketplace you can take advantage of his laundry feeding the SI weight. Jason: [21:55] Got to and have you experimented with any vendor the field FBA stuff in your portfolio. Scot, Jamie, Bob: [22:03] Yes absolutely we actively use a PA now and we continue to work out any but the cost of shipping is one of our biggest challenges and seven e-commerce. E-commerce player and certainly you as a friend so FDA is certainly getting more expensive so we need to make sure we're watching that obviously is a very. Very powerful traffic drivers. Jason: [22:33] Yep. [22:34] And then on the one being three-peat one of the the complaints I often hear or one of the obstacles to being a hybrid seller is obviously Amazon has tools for One Piece settlers in Vendor Central and they have this Seller Central 4, for three-piece hours do you use those tools and just use them separately, play for both sides of your business or if you look at any of the sort of third-party systems that try to agregate those two tools. Scot, Jamie, Bob: [23:04] Yeah yeah so we are we both we do use both systems vendor Central and Seller Central. Anyone who is both knows that the day that you have available to you on that much more robust. Been trying to figure out how to drive more cell weather looking stop at the conversion or just all the metrics the jobs available. And was your business even on the one piece side even if you have one with the skull premium Ara. You don't have access to that kind of data so to answer your question yeah we looked at a number of third-party Data Solutions, some of them I think some of your other around previous speakers on the podcast like Lisa or Andrea, or one foot retail or friend you those are the solutions we've looked at more about the more we're about to sign a contract actually this week with one of them as you mentioned between, what size of the business in concert, cool um I know you guys are real active on Amazon advertising and we've touched on that with some pass gas but would love to hear how you guys think about it and maybe just for listeners you could recap, the I think people get kind of I know I do get confused there's all these kind of alphabet soup that gets thrown around and since your hybrid you have every, every tool available to you so maybe give a quick rundown of the tools available that's one p and 3p and then which ones you use and then would love to hear. [24:40] Any thoughts on the efficacy of those programs. [24:45] Sure so at a very high level I'm just so many different programs that Amazon has but I mean I think the paper forms from. [24:55] Formed if you were wild about nine months ago. There was just a much more defined difference between what you have available is a one piece and what you have available to speak also AMS has three different types of. Advertising on there is lots of products there's others headlines and then there is, but you only as a 3p so are you only had access to sponsor products on the MSI where is One Piece a drive axle. So from that perspective on the one beside you I talked about this even a couple of months ago and today is a one-piece so are you have just much more. Options available to you from a marketing perspective advertising perspective available. What we're hearing is that all three types of of a nice advertising are going to be available, Sellers as well so I think you're starting to see Last of Us and certainly is not about your podcast Amazon is going after the digital advertising. I wouldn't be surprised to see all options offered to post 137. On the AMG side. It's more of a branding experience if I necessarily something that's going to be easy you usually try to sell so we can use both but though. [26:32] We found that at least in the past AMG is is not have the tire off an artist is a mess with. [26:42] Contra listeners OMG is, more like banners and it kind of brand oriented advertising so CPM style advertising in AMS is more search CPC type advertising and there's there's several flavors of it with an Amazon of where things show up but that's kind of the the broad distinction there. Right and I am hearing about a lot of different beta program that there's the testing on the AMD side 30 when I getting much better be targeted. Open up advertising office again so. I think it'll be interesting to see what I am to get better I would have said, did this kind of a question and what's what's take this out of dorel just for a second cuz you guys are, you have been around that at retailers and all so do you guys think there's risk to some of the other AD companies out there you know so pretend you or at Toys R Us made as bags ample and you know I'm sure they have a huge, Google about didn't you know, seems like Amazon lose a lot more your there's the stat that always comes out that 55% of products are just started Amazon think that's a bloomreach stat but then there's also a Forester head supporting data on that up till about 2 years ago so, you know it it's kind of interesting to think you could this really be a challenge to, Google and and we're seeing broadly people really, they experimented year ago and now they're shifting budget directly out of Google Wallet over towards that side how do you guys think that's that's. [28:20] Something that could happen I do yeah I have p.m. [28:28] I'll defer to Bob with a bob has a much deeper background and digital advertising sign on them yeah I think you know. [28:39] Even just thinking about Darrell and what we've done we've really it's almost like you're shutting down our brand advertising. You know I'm pushing the money really over into Amazon just because it's almost becoming. Some of the weirdest as well. So if I say it well I'm going to do this launch a new product all that effort goes into launching that new product on Amazon with AMS. And if I'm looking sumur all the time I don't know how much they're still going, to know bloggers who have been paid to do a review on a product I think it's almost like letting the people vote so if I want a product I'm going to go to Amazon going to trust that whatever I type in, it's going to be if it's a bestseller with great reviews, how much more convincing do I need to buy that product so even some of the more considered buys I think if there's going to be a shift if it's already not know happening now. [29:44] Yeah what do you think about so I've also heard from Brands and about this common affiliate thing so what they're saying is you know, I advertise on Amazon and I thought I would get lift on Amazon and I can measure that but I'm also single lift off Amazon yeah what's your reaction to that. Oh yeah absolutely it's relatively well known about the kind of $1 for. I'll spend on Amazon equal $7 outside it varies by category so you know when baby like our products receive more like an $8 left and I was out of Amazon that's the tricky part is is. It's not that straightforward to measure you know it we're not seeing exactly those numbers so I think it takes it takes time. Jason: [30:32] Very cool so does it feel to you like that's a trend that's unique to Amazon in North America and they're just becoming a great ad platform or is it a shift to reach Arizona like we are you guys also investing in like, Walmart's equivalent which would be w/imax or or any of those sorts of things. Scot, Jamie, Bob: [30:53] That's a good question Walmart. Even even for a mess we don't use the reporting that I am s at all really we really kind of built our own reports and will do the same with W Max. And really have concentrated a lot of the other dollars right there because with guys like Triad and hooklogic can come your other choices on the on the other retailers website they've always. Kind of obscured the Bry. To some degree so it's been it's been tough I'm hoping that those systems evolve a little bit more in their little bit less opaque I think they're going to have to to stay competitive. Jason: [31:46] Dangerous a wino there's a bunch of wmx salespeople listening right now so I'm sure you'll be hearing from them from the. [31:53] What will will will be that point home that that transparency and access to data is one literally one of the impediment with folks spending money with you. [32:04] So Scot, Jamie, Bob: [32:06] I think you're pointing that out that's one of them I think she was the thing through the the challenges with. Madison mdfl now it's won the data for the day is just not easy to come by and it's not a Preposterous some of the more that was advertising Channel. Second is mobile mobile experience and desktop experience of War. I don't know that anyone including Amazon it's real practical. Mobile experience. Jason: [32:44] Yeah which is interesting because you would you would certainly think like it is hard to believe there's a technical or skills and pediment keeping someone like Amazon from building. [32:54] A great advertising platform and great report and a great mobile experiences. [33:02] Just feels like they haven't got around to it yet but hopefully I don't know if you know this but Jeff is a big listener the show so you know this could be triggering an email as we speak. Scot, Jamie, Bob: [33:12] Does a Jeff email happening right now. Jason: [33:18] Should be on the advertising are there any other considerations that you guys think about it in terms of maximizing your your results on Amazon, I noticed I and I should have mentioned this up front I've got a 20 month old in the house so I'm the big user of your products. [33:36] You've dramatically slowed down my midnight snacking because like all the the safety first products in my kitchen make it much harder to get food out in the dark. Scot, Jamie, Bob: [33:46] But thankfully that's pressure machine isn't protected. Jason: [33:52] Exactly just just a product idea for you is some LED lighting and some of that stuff might be helpful. Scot, Jamie, Bob: [33:58] Will cost us a penny more to make them glow in the dark. Jason: [34:02] Exactly. [34:04] But I have noticed you guys are well represented in all the different Amazon programs and so you know you have a lot of add-on products I also noticed you guys have some Amazon Choice status, product so you know I guess I'd be, pictures do you overly like try to achieve those things with how are you managing your portfolio of all those those sorts of things. Scot, Jamie, Bob: [34:29] Where are the where walkie to have it I wouldn't say that we we were able to. Tell you exactly how we go out I mean certainly bourbon is a profitability quotient. Turn on internet with your private label Amazon. All I got for those were going to answer your initial question as we look at managing the business there's just. What I've been talking about the last year-and-a-half if we break eCommerce and Jeff's into seven centers of excellence in, Amazon a particular kind of fall into one of those centers of excellence be we live and breathe it's almost like a religion where. One of them is marketing and another is information technology Partnerships and people. So each one of those are you looking at and we break it down from quarter-to-quarter. From year to year and suddenly we have a now next future plan for all of them. Respective definition. Which one of the bed say from Amazon perspective we talked about the marketing operations is probably just fine. [36:00] All the all the other ways and everything dipped Amazon train their customers to a second term to find shipping Apartments. Jason: [36:09] Got it in, what you don't want to do things that we haven't talked about that scares a lot of people per ticket on the one piece side of Amazon his pricing like do you hit is that been an issue for you do you have a strategy or any any pricing tips for, for folks that are going to put their products on Amazon's platform. Scot, Jamie, Bob: [36:32] Bob's Bob's advice to me in the beginning with don't lose money so I try to price my products while products not to lose money before 1. Jason: [36:45] Can you make it up in volume if you do. Scot, Jamie, Bob: [36:47] Exactly. My kids are starting to do the new math so maybe you can but I'm old school so I don't know how to turn it negative. [37:03] We know one of the things we talked about a lot and you mentioned it earlier when you talked about third-party data switch. Is the we say the date is more important and we're crossing with your friends as much data systemically to make the decision we have map policies for a number of our friends that certainly helps. I mean it's the Wild Wild West when you don't have enough policies so the constant challenge to take a look at and what's going on dynamically in the forecast. Pricing stand for in where would possibly looking at ways to differentiate. I think we're going to see a boom in brands that traditionally may have not looked at map policies. Just because of what you know Walmart continues to be priced leader you know Amazon will continue to follow but now you got Target saying they want to be a price leader to and in others. So in that kind of environment as a manufacturer brand gear you know it's like maybe I would have traditionally had a map policy on my premium products only but that's going to change use my. Roll out of my policy for my mqp in Opp lines as well just took for protection. Jason: [38:23] Wow yeah that is interesting I could totally see that there are a bunch of other 3p sellers that sell your products on Amazon I'm assuming most of those are authorized sellers is that. Scot, Jamie, Bob: [38:38] I would say it's a mix so. That's not the challenge is simply word been a lot of great partners that you sell in the marketplace and then there are some that. Yeah we're not exactly sure how they so I think we're starting to see and evolution are not just Amazon Marketplace but, I'm Walmart's and others where it's harder to be that Arbitrage type of cell are in I think we're hoping that'll help with, look at Channel management we're constantly looking at how to make sure that we have a clean Channel well only authorized stores and food in. Jason: [39:19] Yep you having to invest some significant resources in that. Scot, Jamie, Bob: [39:25] Yeah I think we are, we have already and I think we always keep trying to go for the very top. [39:36] It's much as we'd like to spend as much as we could on each of those centers of excellence and one of them is more Channel Management telephone number. Jason: [39:49] Not totally get it so another topic that comes up. Is the you know those rare occasions win you you fall out of compliance with Amazon and one way or another and the obviously the big Spector looming over everyone's head is suspensions is that. Is that coming to play for you guys at all like are there any common mistakes or tips you give to folks to avoid getting in the Amazon Penalty Box. Scot, Jamie, Bob: [40:18] Yeah I think for us we had the fear of god guitar organization did not want to. Ever end up getting suspended and no fortune. We've had just an amazing operation to approach every yes I weigh very aggressively so the shipping. 99.7%. [40:42] I need this more than just on time shipping at that way but others is a number of them that we've been fortunate to have a great class functional approach with my advice would be certainly have. A good set of. Watch all team members who are Partners in the business to understand what you're trying to do set the vision and then and check in on a very regularly. We were trying to brick-and-mortar First organization so that was a lot of the time we spent at least in the first 69 wants was just educating. A lot of people within the organization of Argo how we Commerce works and specifically how Amazon work. And I think the more communication we were able to have and then. Huge amounts of visibility to every part of the company Bob's a big believer in that class is really Champion Joe having everything. Are white dashboard in every department so they can so that we can really track you know are we are we tracking to be with shipping so how are we doing this today so I think are the Penalty Box as Bend. Great team effort and I think it starts with setting the vision for everything. That's why one of our favorite the software platforms is geckoboard. Which is Wheel of software that does one particular purpose but doesn't really really well and I want just allows you to push up. [42:16] It just allows you to creep dashboards on a monitor so I think what we did or invest heavily in the operations and consumer support. Those are two big pillars for us so even if the point where we had to sacrifice and maybe you know advertising dollars marketing dollars to really get that those two pieces of the business really humming along, and are the call center just wanted you know national award for for excellence which is really really cool in it but we had to ramp up. You know social support Amazon answers answer programs on other retailers it's really we had to, where do expand the team and be in more touch points with consumers so we think that's really going to pay off long-term. [43:08] And just one last point about suspension beyond the SOS from operational perspective there are dozens of ways you can get yourself suspended in the cellar whether it be, Aaron products at all the wild with 1p or any reviews or seller ratings or selling counterfeit products oh, I think what we had was a couple of subject matter experts. Or through all the different essays and rules and everything that Amazon foot. On on the portal to allow showers to know how to optimize a business intro we communicated that very clear with ravioli, cool so that that's been super helpful to hear, some some real world stories from you guys about how you manage Amazon and let's put a little bit and talk a little bit about Walmart so imagine you guys have a long history of selling wholesale to Walmart are you participating in the marketplace and and, I guess I would make you one of the very rare hybrid Amazon and Walmart so so curious what your doing on Walmart. [44:16] Yeah we are we are hybrid for Walmart as well we launched, probably the best possible time to launch on Walmart marketplace was in November 4th. Trey doesn't want to watch anything. But it's as if they really had fantastic resolved even before last year so really out of the cave you were very fortunate to see. Well and I think I would a little bit last year e-commerce as a team we exceeded our sales goal. But your dog and 16 by 70% and certainly Walmart marketplace was with a big part of getting us a star sailboat certainly crushing that pool. Cook any other channels marketplaces or you know anything you think that's kind of interesting that you think other brands would find kind of fascinating. [45:17] I will wear on eBay as well and we're on chat we watched on chat about a month before they got bought out so he might feel like this that had something to do. I think we're always looking at different opportunities to find what are products in front of many customers are too small. Yeah for eBay some people kind of view it as an outlet kind of a thing or other people just kind of put their main line on there and do you guys have a kind of certain part of your hot how eBay fits into the strategy. [45:53] I wouldn't say it if it will you we've completely solidified or crystallized on her arm how how how we approach eBay. I think we do have a healthy mix of a farm products as well as what we call Mike SSM ignoring clothes on eBay. Again you brought it up about Channel. Certainly there's some good extermination candy Bays doing a lot to try and improve the merchandising especially the baby category so we're we are happy to part with them and help help. Apart of that the improvement in our categories. Yeah found eBay is very good brand religion so they're there being a lot more friendly DeBrands lately and I think a lot of that has to do with how Who Came From Home Depot he can understand that Dynamic better than them folks hit that maybe didn't have that experience. [46:53] Yeah I'm a big fan of how a lot and having watched him what he did at Home Depot was when she was really impressive so I'm hoping they can do the same. What we don't want to do is just go on to any Marketplace for the sake of being there so I say that we have a crystallized our strategy but we do think very closely about know what Ridge Marketplace. What is Protonix Place Mall. It's easy to launch a new Marketplace you know as we see fit. Know if we want to try something else we can easily be up and you know I matter with no days or weeks so that it's not really a huge investment if we want to play with something which interesting is watching at Walmart marketplace evolve. Just month after Mom very interesting focused as a company and we're going to benefit from it and other reports and dashboards going to get better, it's it's an interesting year to be on Walmart marketplace that's for sure. Yes seems to be a big big area and Lori's in there swinging the bat like crazy so we'll see what kind of comes up, requires and he's an amazing guy I mean we were we were riveted. So while he certainly has a captive audience so we're definitely big fans. [48:24] So yeah funny funny story between Mark and me I interviewed with Mark at Quincy. Where do a month before they close the deal with Amazon and then we visited with Market Chad about a month before Walmart plaza Sol. I feel like I got to start taking more meetings your guy you should get out of stock options I don't know if that's, that may violate some ethics thing but that's not my problem that's your problem, what questions do you guys are in a lot of places in earlier you mentioned you have kind of six categories of products is there I know some some, brands have kind of a good they look at these channels and there's some mapping that happens where they'll say alright, Channel B I'm going to put this type of product there but not this type of product and you guys have any how do you think about that, but everything everywhere that's another valid strategy as well no I think we definitely. Where were careful when in will have a specific kind of game plan for. Access Imaging Closeouts versus completely different strategy for how we're going to approach this. Anything for my Walmart exclusive so yeah it's none of that spray and pray kind of approaches to the TV. Jason: [49:54] Got it you guys are. [49:57] I'm going to characterize you as very digitally mature for a branded manufacturer in the in the digital Spectrum in interesting Lee a lot of clients that are, very large wholesale businesses that are really just getting started on the digital side of the fence and you don't. [50:17] One of the big challenges you always run into is. [50:21] Getting an organization to change its all this institutional inertia and all these antibodies that are in the organization that fight all of these kind of new initiatives, it sounds like you got to go through that in your you're beginning and Darrell like do you have any advice for for folks that are just getting started on their Journey. Scot, Jamie, Bob: [50:45] Go ahead because I've never heard that before. I'll say that one of the reasons I came to dorel was because. And our CEO told me on a vision where they already started down that kind of mentality show. And made the investments in just a lot of the out-of-the-box thinking in terms of Technology Investments. And resources were a lot different than most of the other cpg companies and other vendor partners that I work with another retailers. Even being your 2016 at the bottom bathing how many still just trying to figure out e-commerce oh. I arrived having seen a vision that was already somewhat said I was just sort of evangelizing that Vision but I think that's the big that was the really important part of our successes. Evangelizing that Vision in getting people excited and I think in many cases this kind of Captain Obvious with a lot of people. It's almost a threat to their job so number one you have people who will get and say am I going to be out of a job in six months because of his e-commerce. Or this is 20% extra work for what it was already a very hard job so I think. I've been walkie I think we had a cross-functional team for 100 people that really jumped on board but I think we also had a really strong Vision that was able to get people energized with from the top down. [52:24] Bob Probert already established. It was a very difficult have a full head of hair too but now not so much but I think you know what we're trying to do is digital transformation from the inside, which, what is the most difficult in my opinion and in my experience and I don't recommend it it's it's just it's the long path but because you do have to you know evangelize quite a bit and you know I understand it's going to slow you down a little bit, what are the things that I'm trying to do is build a startup type of culture we're just the sense of time is is very different. So you know instead of people communicating in the email they're there now communicating and giora. Is it just a complete shift and in first I would say just get the the early adopters like you need a ring of people that get it, are we have a dining kaybern on our team that is a web Technologies guy that we just we know that we can throw anything at this guy and he's just amazing. And he can quickly integrated system or develop a database or so I think having kind of a crappy team to start with. Yeah the Band of Brothers kind of thing helps a lot but then you have to just keep converting the people who want to be converted and then kind of work your way down the curve to the people who you know they're going to be really resistant. Where I'd say we're Midway down that Journey right now. Jason: [53:54] Then cool it sounds like I don't to put words in your mouth it sounds like you had a blend of evangelizing some of the Legacy employees that were most susceptible to become part of the digital solution and then you brought in some some outside digital disruptors, is well I eat Jamie does that do I have that right and does that seem like the right approach to. Scot, Jamie, Bob: [54:21] Yeah I do I really think that one of the big mistakes is to go kind of Whole Hog you know out of the gate what one is to do almost nothing and just talk about transformation and that that's just seen companies I've been at companies that are done that. Jason: [54:36] But just to be clear that's fine as long as you're paying a consultant like sapientrazorfish while you're doing that. Scot, Jamie, Bob: [54:41] Exactly that's exactly what I say but no you know what's funny is it's almost like if I took a step back for a second the the the key. To to Our Success so far has been lots of quick wins and constant wins, so not just sitting this massive gold in a way out there but really understanding let's let's just a few small goal let's let's get all of our product data in one place so we can actually use it okay, let's go with salsify salsify not very expensive so I can put it on a credit card so it kind of scrap a system together, and then build kind of agile process ease around that and then people gravitate toward the money, now you can just follow the money if we're making the you know massive Headway and there's dollars and the dollars keep adding up people tend to say, you know I want that maybe I haven't had that in my team and I want to go on that team I want to be on the successful team so you just kind of read this internal inertia and guys like Jamie it's easy carries that flag, and people just want to follow him. Jason: [55:56] Very very cool by the way this is going to sound super cheesy I call that stair step approach The Stairway to awesomeness. Scot, Jamie, Bob: [56:04] That's exactly what it is. Jason: [56:06] Yeah they like you know you you paint that aspirational picture of where you want to get and you just can't do it in one giant big bang project so the stairway to awesomeness is the way to go. Scot, Jamie, Bob: [56:16] And if you give Jason six beers I think is the number somewhere in there 4 to 6 he will sing Stairway to Heaven but it's Stairway to awesomeness and it's it it's a thing to behold another time, yeah yeah yeah no no beer is here on the podcast this is definitely a dry podcast. Jason: [56:35] Either did I. Scot, Jamie, Bob: [56:39] So we have about five minutes for one last question and I wanted to get super high level you guys have both had great careers and in retail and Brands and digital, where do you see the future of e-commerce is it going to be no Celexa after smartphones or you feel free to kind of go, two years outer are 10 years out so just would love to hear your thoughts seven haven't seen kind of the the play out so far. [57:10] Bronco versus Bob's is probably better than mine so I don't so I think your two two things I see one or. I would have to it a little bit earlier is that I think so. [57:24] What what's available for a one piece and what's available for three people I think it's going to start to quote the gas going to start. Obviously the growth Amazon enjoying a large part of that is I think he's going to start more more. More of that consumer experience I've become more consistent on orthopedic in one piece. In particular I think about advertising and one of the gaps that I see that I think expect is probably going to happen and I hit just. You say it with artificial intelligence but I think ribbon Predictive Analytics to help. To help cpg brands in to help anyone who wants to use digital advertising or to use it for, projector for casting I think that needs to happen and I think I just it still seems really Nathan I think I see a lot of solutions out there. Don't take into account all the dozens of of sales drivers and forecast in the theaters that are need to be followers and I think they're supposed to Lucien to still feels on in the brick-and-mortar world. You're not taking into account estimated ship windows or find a drink or the dozens of things that can help to drive, sales on e-commerce side that's just don't doubt it don't get back turd in then I don't think this is any human being to make those decisions. [58:58] As they're using them to the forecast there the sales or Churchill Drive their advertising can I think it has to be any item, that's a prediction I'd see Captain someone diacetyl. [59:16] Yeah Predictive Analytics it's definitely going to be pervasive in all everything that we that we do. I worked at a company where we built our own real-time bidding engine and it's it's very complex but as computing power power gets better and this more people working on projects like that, a lot of the manual activity 72 will just gravitate toward that kind of naturally taking over I see a lot of near-term stuff. Nothing that's important where I really think that retailers will start understanding that no Prime is not a shipping program. You don't like I really do think that once other big retailers develop Prime like programs and it you know the full breath and power of a program like that fell under the sun understanding the the game. And I really I don't like I haven't seen. Seems kind of small attempts at a prime like program but nothing nothing even close to it if if it's not a shipping program what is it. [1:00:24] It's I mean it's like it's a massive loyalty program it's it's the stickiness that the. That you just can't get out of it it has unbelievable unmistakable value. I think they've gone well past the you know the yearly the annual fee for the program in terms of value at this point. I really do think that that is a massive way to build loyalty. [1:00:54] Go to know you guys are both. Deep in the world of Amazon do you think it's game over or do you think that you know just like we saw in. Bob you're old enough to remember this used to be that you know no one could be the IBM there you would just like it, people just call him up to get mainframes installed and then suddenly Microsoft took over and then it was Google and now it's Amazon you know what do you any votes on like the next Dark Horse you know is it going to be a company we've already heard of it is it some company that's like, two dudes in the garage right now that's a good one Jamie want to go first for that one. So I yeah I mean history tells us no one no company remains thought when I first Are we more than more than 50 years even if it's still around and I think she's somewhere. They're fucking a trance of Walmart's probably one where they're starting to come around they made been made my friend information. [1:01:55] I think one of the things I think about is on demand that you fart a lot of them. Disruptor obviously Amazon going after 2 but. Medium different different category next Amazon. Jason: [1:02:20] Oh that's crushing I've spent like 85 episodes trying to to get Scott's ego down and you just told him that he's the future of e-commerce crate. Scot, Jamie, Bob: [1:02:28] You're going to pay me in cash my check, what's what's amazing to me it almost seems like Amazon is is Bucking that the you know the old trend of you know IBM companies like that just kind of, really having to Pivot hard and and swallow hard to and now it major inflection points is the scale that's the thing that gets me, it's no looking at you no announcements from Target sing over going to spend a billion dollars and, supply chain up when Amazon spending well 18 billion, yeah it's just the scale is is something to really think about it how do you how does a disruptor in a two guys in that garage. Really really break into that no no I'm not saying Amazon perfect I've noticed a lotta, a lot of Kinks on a on a daily basis in the armor or chinks in the armor where they're even like my guaranteed shipping package didn't arrive in 2 days. Several times now so you know there's definitely some Growing Pains there. But I got to think it's only another giant it's got to be like a Walmart that really really can can keep up with those guys. I also since I worked at racquet and I would not discount all these guys that are overseas currently that have just been watching the market patiently. Rakuten Alibaba out there they're just massive groups that certainly have the power to and they're not known to be first movers remember. [1:04:08] They they watch and they're perfectly fine to be the second or third yeah they're the only guys that have kind of beat, Amazon Kenosha Amazon didn't do well in China and continues to be kind of like number three or four there and I don't know about Japan Amazon's done pretty well in Japan but yeah they're they're definitely rocked Anna's is still a major factor there, oh yeah oh absolutely I think probably going to the guarantee for me is the. You can check back thirty years from now I think when Bezos decides to retire a walk away that's definitely rest I mean you work at Target and, dominant really when Bob all that stuff down on that was I was really when started, start to struggle Walmart Walton and I can see the same thing no one ever gave us has to step down no disrespect to the rest of the leadership team but it's a pretty big dr. Phil. Jason: [1:05:07] I think your point that no no Empire was forever Jeff is made that point and said but what you really want to do is just make sure that your Empire outlives you. [1:05:19] Repeat the same strategy there because it has happen again we've wasted a perfectly good outside I really want to thank you guys for spending an hour with us and sharing the knowledge. Scot, Jamie, Bob: [1:05:38] Thank you thank you. Yep Bob and Jamie thanks for joining us and low plug here for Jamie and I Jamie is going to be one of my speakers at the internet retailer Conference & exhibition also known as IRC on June 6th I do a day there that's called Amazon and me where, we go pretty darn deep about these kinds of topics in a, 12 hour Extravaganza so if you're interested in that topic join us then and Jamie will be there, what's the just went through 18 decks on this whole thing so you're talking about hybrid is that right Jamie is that the topic. Yeah I'm talking about how to manage your Amazon strategy whether you're one p3p or Hut. Yep so overall strategy yes and your presentation is awesome so people are going to love it thanks guys and hope to see Jamie I'll see you there and I hope to see some listeners there. Thanks looking for toys. Jason: [1:06:36] Until next time happy commercing.

13: Happiness: "The True Driver Of Success?" Wait What?  I Thought It was Anger!   In this show our hosts Dave Frees and Somnath Sikdar (Alex is away) examine why happiness matters and has to be balanced with Anger and a true driver of success.  There are over 20 happiness hacks and strategies that have some level of science to back them up.   https://www.facebook.com/intopform/videos/340175963046804/   Key Words:  Happiness, happiness hacks, strategies of happiness,   Want to attend the Business Black Ops Live event? http://www.3DaysToSuccess.com or call Lisa at 610-933-8069   What You’ll Learn In This Show:   The placebo effect and happiness Dave’s experience with the Dali Lama and happiness, shakti, and telling his holiness a joke. Understanding: Happiness, gratitude, resilience, love, compassion...and desired/interrelated states, how they are created and how to have more of these states. Resources: Psychology Today blog:  The Neurochemistry of Happiness, The Hormones of Happiness, The Greater Good From Berkley University. The science of happiness. https://www.psychologytoday.com/blog/the-athletes-way/201211/the-neurochemicals-happiness  Chris Bergland, http://www.indiatimes.com/health/healthyliving/the-hormones-of-happiness-and-how-to-increase-them-242282.html, http://greatergood.berkeley.edu/article/item/how_to_trick_your_brain_for_happiness There are four major chemicals in the brain that influence our happiness, create better states by designing your experiences to improve your mental chemistry and states. (DOSE): Dopamine Ways to increase your dopamine levels: • Set daily or monthly goals, since they give you something to strive towards. • Set exercise goals, since dopamine increases in tandem with serotonin and endorphins when you exercise. Setting goals will increase the production of dopamine even more.• Eat foods that are rich in protein.• Set exercise goals, since dopamine increases in tandem with serotonin and endorphins when you exercise. Setting goals will increase the production of dopamine even more.• Eat foods that are rich in protein. Oxytocin Ways to increase your oxytocin levels: • Get a massage, since it relaxes your muscles and the prolonged physical contact triggers the release of oxytocin. Show your friends and family that you love them by touching them affectionately. You can hug your parents, throw an arm around a friend or cuddle up with your partner.   Serotonin Ways to increase your serotonin levels: Spend time in the sun, since sunlight causes your body to produce Vitamin D, which triggers the release of serotonin. • Think happy thoughts, since your brain produces serotonin when you remember happy memories or think about things that make you happy. Consume foods like milk and corn, since they contain tryptophan, a substance that your body converts to serotonin. Other carbohydrates also contain tryptophan. Do a low-intensity workout, since your body produces serotonin when it is performing aerobic exercise, as opposed to the endorphins it produces during anaerobic exercise.     Endorphins. - Ways to increase your endorphin levels: • Exercise to cope with chronic pain.• Eat spicy food, since your tongue has receptors that react to spice by sending messages to your brain that are similar to pain signals, causing your brain to trigger the release of endorphins.   Endocannabinoids: “The Bliss Molecule” Endocannabinoids are self-produced cannabis that work on the CB-1 and CB-2 receptors of the cannabinoid system. Anandamide (from the Sanskrit “Ananda” meaning Bliss) is the most well known endocannabinoid. Interestingly, at least 85 different cannabinoids have been isolated from the Cannabis plant. The assumption is that each of these acts like a key that slips into a different lock of the cannabinoid system and alters perceptions and states of consciousness in various ways. It is likely that we self-produce just as many variations of endocannabinoids, but it will take neuroscientists decades to isolate them. Dopamine: “The Reward Molecule” Dopamine is responsible for reward-driven behavior and pleasure seeking. Every type of reward seeking behavior that has been studied increases the level of dopamine transmission in the brain. If you want to get a hit of dopamine, set a goal and achieve it.   Oxytocin: “The Bonding Molecule” Oxytocin is a hormone directly linked to human bonding and increasing trust and loyalty.  In some studies, high levels of oxytocin have been correlated with romantic attachment. Some studies show if a couple is separated for a long period of time, the lack of physical contact reduces oxytocin and drives the feeling of longing to bond with that person again. But there is some debate as to whether oxytocin has the same effect on men as it does on women. In men, vasopressin (a close cousin to oxytocin) may actually be the “bonding molecule.” But again, the bottom line is that skin-to-skin contact, affection, love making and intimacy are key to feeling happy.   In a cyber world, where we are often ‘alone together’ on our digital devices, it is more important than ever to maintain face-to-face intimate human bonds and ‘tribal’ connections within your community. Working out at a gym, in a group environment or having a jogging buddy is a great way to sustain these human bonds and release oxytocin.   In a 2003 study, oxytocin levels rose in both the dog and the owner after time spent ‘cuddling’. The strong emotional bonding between humans and dogs may have a biological basis in oxytocin. If you don’t have another human being to offer you affection and increase oxytocin your favorite pet can also do the trick.   Endorphin: “The Pain-Killing Molecule” The name Endorphin translates into “self-produced morphine."  Endorphins resemble opiates in their chemical structure and have analgesic properties. Endorphins are produced by the pituitary gland and the hypothalamus during strenuous physical exertion, sexual intercourse and orgasm. Make these pursuits a part of your regular life to keep the endorphins pumping.   Endorphins are linked less to ‘Runner’s High’ now than endocannabinoids, but are connected to the ‘feeling no pain’ aspect of aerobic exercise and are produced in larger quantities during high intensity ‘anaerobic’ cardio and strength training.   In 1999, clinical researchers reported that inserting acupuncture needles into specific body points triggers the production of endorphins. In another study, higher levels of endorphins were found in cerebrospinal fluid after patients underwent acupuncture.  Acupuncture is a terrific way to stimulate the release of endorphins.   GABA: “The Anti-Anxiety Molecule” GABA is an inhibitory molecule that slows down the firing of neurons and creates a sense of calmness. You can increase GABA naturally by practicing yoga, meditation or “The Relaxation Response.”  Benzodiazepines (Such as Valium and Xanax) are sedatives that work as anti-anxiety medication by increasing GABA. These drugs have many side effects and risks of dependency but are still widely prescribed. A study from the "Journal of Alternative and Complementary Medicine" found a 27% increase in GABA levels among yoga practitioners after a 60-minute yoga session when compared against participants who read a book for 60 minutes. The study suggests yoga might increase GABA levels naturally.   Serotonin: “The Confidence Molecule” Serotonin plays so many different roles in our bodies that it is really tough to tag it. For the sake of practical application I call it “The Confidence Molecule.” Ultimately the link between higher serotonin and a lack of rejection sensitivity allows people to put themselves in situations that will bolster self-esteem, increase feelings of worthiness and create a sense of belonging. To increase serotonin, challenge yourself regularly and pursue things that reinforce a sense of purpose, meaning and accomplishment.  Being able to say "I did it!" will produce a feedback loop that will reinforce behaviors that build self esteem and make you less insecure and create an upward spiral of more and more serotonin.   A variety of popular anti-depressants are called Serotonin-Specific Reuptake Inhibitors (SSRIs) — these are well known drugs like Prozac, Celexa, Lexapro, Zoloft, etc. The main indication for SSRIs is clinical depression, but SSRIs are frequently prescribed for anxiety, panic disorders, obsessive compulsive disorder (OCD), eating disorders, chronic pain, and post-traumatic stress disorder (PTSD).   Adrenaline: “The Energy Molecule” Adrenaline, technically known as epinephrine, plays a large role in the fight or flight mechanism. The release of epinephrine is exhilarating and creates a surge in energy. Adrenaline causes an increase in heart rate, blood pressure, and works by causing less important blood vessels to constrict and increasing blood flow to larger muscles. An “Epi-Pen” is a shot of epinephrine used in the treatment of acute allergic reactions.   An ‘adrenaline rush’ comes in times of distress or facing fearful situations. It can be triggered on demand by doing things that terrify you or being thrust into a situation that feels dangerous. You can also create an adrenaline rush by taking short rapid breathes and contracting muscles. This jolt can be healthy in small doses, especially when you need a pick me up.   25 Happiness Hacks:   http://www.cnn.com/2016/01/22/health/happiness-hacks/   Turn on a light box DMF: Verilux Light therapy is an effective treatment for seasonal affective disorder (SAD), but experts agree that it works to treat symptoms of major depressive disorder as well. Feeling blue? You can turn on a light box for 30 minutes to an hour   Open the shades and close them (SLEEPMASK) DMF If you don't have access to a light box, the simple act of letting in some sunlight can brighten your mood. When your workspace or living area is brighter, you tend to feel happier too. Go outside Starting to feel down? Head outside to soak up some sunshine. The human body produces vitamin D when exposed to the sun's rays, and research suggests that people who are deficient in the vitamin are more likely to be depressed, anxious, and tired. Step into the sunshine for 20 to 25 minutes of sunlight to lighten your mood naturally. Try meditation DMF: Guided meditation, mantra meditation Mindfulness breathing Headspace and calm Good news: Meditation is a proven stress-buster with no harmful side effects. Studies have shown that its benefits range from pain reduction and lower blood pressure to a boost in libido. Best part? It releases "happy" chemicals in the brain—serotonin, dopamine, and endorphins—all of which work together to put you in a better mood. If you don't know where to start, try a guided meditation to de-stress or start your morning.   Smell the oranges DMF essential oils Citrus scents, such as orange, lemon, and grapefruit bring out positive chemical reactions in your brain as well as work to ease stress. If you want to feel uplifted, use a few drops of citrus essential oil on your pressure points. You can also mix the scent with a floral aroma such as jasmine to increase the positive effects.   Eat carbs as an afternoon snack You know that afternoon mood slump that hits at just the worst time? Well, it turns out that you can eat your way to a happier, more energized afternoon—carbs. For years we've been hearing that we should avoid carbs, but in reality, a low-carb diet can make us feel sad and stressed. Carbohydrates actually boost mood-boosting chemicals in the brain. But let's get something straight here—we want to focus on healthy, whole-grain sources instead of refined carbohydrates to reap the benefits. When you begin to feel down, go for an afternoon snack of 25 to 30 grams of carbs, such as a three-quarter-cup serving of Cheerios.   Play with your pet Having a dog or cat can seriously improve your quality of life—their excitement in seeing you come home and their unyielding loyalty make them great companions. There are a host of reasons why pets improve your health, but they can turn around a bad mood and make you happier in no time. A study found that petting a dog for only 15 minutes releases serotonin, prolactin, and oxytocin—all of which are mood-enhancing hormones, while lowering the stress hormone cortisol.   Take microbreaks Research shows that people who take quick breaks during their workday to watch funny videos online get a high emotional payoff and report feeling more energetic and happy with fewer negative emotions. Not only will this improve your mental health overall; this is an easy way to turn around a bad mood in less than a minute—plus, you can get a metabolism boost, too!   Add turmeric to your meal The active compound in turmeric, curcumin, has natural antidepressant qualities. You may already be adding turmeric to your meals because of its vast whole-body health benefits, such as lessening the effects of rheumatoid arthritis, osteoarthritis, and other inflammatory conditions, as well as fighting Alzheimer's disease and diabetes. Animal studies have also linked curcumin to an increase in serotonin and dopamine, so it's a powerful way to boost your mood.   Listen to music... Have you ever heard a song over the radio that just felt good? Or have you turned on an old CD only to find a flood of happy memories come streaming back? Well, that's due to the fact that music is a mood-booster. It releases the feel-good chemical dopamine into your system and brings on nostalgia.   ...And sing along You can also get happy by making your own music—by singing. University of Manchester researchers discovered that a tiny organ in the inner ear (called the sacculus) is connected to a part of your brain that registers pleasure. The sacculus registers frequency notes that are associated with singing almost instantly, giving you a warm and fuzzy feeling. So go ahead and sing in the shower, belt it out in your car, or get up on that karaoke stage.   Eat chocolate (yes!) While you might not need another excuse to eat more chocolate, here's another: It makes us happier. Chocolate contains tryptophan, which boosts the production of serotonin in the brain, leading to better moods. This trick also works with other foods containing tryptophan, such as poultry and eggs.   Drink coffee This morning energy boost doubles as a mood pick-me-up. A Harvard University study found that women who drank at least two cups of coffee regularly were at a 15% lower risk of depression than women who did not. Just keep in mind that those fancy coffee drinks can have tons of hidden sugar and calories, so it's best to stick with black coffee (and some skim milk).   Sip on some green tea Green tea already boasts an impressive résumé of health benefits. Thanks to the polyphenols it contains, green tea helps with weight loss by boosting metabolism, as well as providing a reduced risk of heart disease, high blood pressure, certain cancers, and osteoporosis. But for your mood? Green tea has been shown to reduce stress levels. A study found that people who drank five or more cups of green tea per day had a 20% lower level of stress than those who drank less than one.   Make a human connection Put down your smartphone and take a step back from your computer screen. If you want to feel better—and fast—go to a friend or family member for some relief. A study from the University of North Carolina at Chapel Hill found that human touch releases those feel-good chemicals like serotonin, as well as reduces blood pressure and heart rate making you feel more relaxed.   Consume healthy fats You know how avocados are some of the most pleasurable foods to eat, with their rich taste and smooth, decadent texture? That's a mood-booster on its own, but research also suggests that their fat content is also the reason why they better our mood. Because fat slows digestion, it evens our blood sugar levels leaving us to feel calm and satisfied. So go ahead and treat yourself to some avocado or nuts next time you're feeling anxious.   Eat more salmon Fatty fish like salmon is high in omega-3 fatty acids, which can help stave off depression (omega-3s are also present in avocados and nuts, as well as grass-fed beef and chicken). This is because they help to maintain brain function in the areas that regulate mood and emotion—a study found that women who hate fish two times per week had a 25% lower risk of depression than women who ate it less often. If you don't like to eat fish, try taking omega-3 fish oil supplements instead.   Try St. John's wort WARNING! This herbal supplement is one of the most-studied herbal supplements for depression, and research shows that it may be as beneficial as antidepressants when treating mild depression. While it may seem like a no-brainer, St. John's wort has known serious drug interactions, including reducing the effectiveness of birth control. Additionally, when taken in conjunction with antidepressants, the supplement can create too-high levels of serotonin, which can lead to heart problems. So before you try this one, be sure to check in with your doctor.      

Today in FirstWord:

Interview of theoretical scientist and Chief Data Scientist for GILD in San Francisco on how to use big data techniques to design more democratic and merit based hiring practices.TRANSCRIPTSpeaker 1:Method to the madness is next. You're listening to method to the madness, a biweekly program celebrating Bay area innovators. I'm Lisa Kiefer and today I'm interviewing Dr Vivienne Ming, chief scientist at Guild, a talent acquisition tech company in San Francisco. I read about you in New York Times, so tell me what you do at guild is a company whose goal is to bring meritocracy back to tech hiring. We have customers that [00:00:30] are looking for programmers. All the biggest tech companies you can like Google and like Google, Facebook, Microsoft Tho branching now, people that you wouldn't think of like Nike, some banks and others. It just, it's so pervasive. So much of what we do is based on some kind of programming. Every company has somebody that they need to hire in this space. The founders short sigh and Luke Obama soar, decided they wanted to create a company that could go [00:01:00] beyond qualities in a resume that they know. Speaker 1:We could just look at. The easiest way to get a job at Google is be good, but go to Stanford and know people that are already working. If you don't fit those two qualities, it's not a knock on Google. They get so many resumes that in some sense, what else are they going to do? So as chief scientist, what I do is come up with algorithms to go beyond that. How many variables are you looking at and could you talk about what some of those might be? Currently we're looking at 50,000 [00:01:30] different features as we call them about a person that boils down to something on that order of a hundred independent dimensions. Each of those dimensions is saying something unique about the people that we're looking at or each of them weighed differently. Each of them are weighed differently and one of the cool things we do is that they're weighed slightly differently for slightly different companies and where we're in the process of developing and advancing these algorithms all the time. Speaker 1:So the number of features increases. The weighting on these factors increases. [00:02:00] We can go to these companies. They say to us, I'm looking for a Java developer in Boston and we return a list ordered by how good we predict people to be of the Best Java developers in Boston. Okay. Now talk about some of these variables on the higher east side. Some of these variables have to do with how people express themselves, not generically, but specifically related to the profession that we're recommending them for. Some of these are very simple things. We just look at [00:02:30] what social sites they spend their times on. That would give us a little nudge in one direction or another in our estimate of how good you are. The way you describe yourself on your resume on linkedin. Actually don't look that much at Facebook because Facebook really strongly represents what you want other people to think about you rather than who you actually are to strange quality. Speaker 1:There's a lot of information there. I was going to ask you about that. I think all of these sites are pretty easily gamed. Say a company's looking for someone to be a c, so c [00:03:00] is a fairly low level programming language. It's used by people to build really fundamental pieces, a very fast processing. There's also a language called C plus. Plus. It's very similar to c in its application, but it has a different and a pretty fundamental one and how it's structured. You will very commonly see on resumes that someone is proficient in c slash c plus. Plus if they say that our algorithm predicts that they are not a good c or c [00:03:30] plus plus programmer. Why? Because these are different languages so you are professional programmers. C was your space for doing things. Even if you happen to know c plus plus, that's not how you describe yourself. Speaker 1:At least as we look across the 4 million profiles in our database, that is not how the best c programmers or c plus plus programmers described themselves. So your algorithms sounds like they're going to be constantly changing, but the more information you get into this, and in fact we built it with what we call temporal discounting. So over time [00:04:00] it tends to ignore things that happened a long time ago and really focuses on right now. So that allows us to have a bit of a memory in a sense. I can say something like what I just said because I know our algorithm will adapt if people search to start to try to game it. But at the same time the tech world is so fast moving, it has to adapt. You know, if we recommend someone as a highly qualified programmer because they use a technology that was popular 10 years ago, then we're probably not doing a service to our customers. Speaker 1:Are you only servicing [00:04:30] tech companies in the bay area? Certainly, but we certainly service ecommerce companies like Walmart, they have an incredible presence in, in technology. A long before, in fact, a lot of other companies were doing big data. They had huge servers full of everyone's behavior at Walmart, uh, that they were analyzing. Look at our co founder and chief technology officer came up with the original idea of let's look at open source code. So this is code that developers write freely to share [00:05:00] amongst themselves. And this isn't trivial work. Some of the absolute backbone of our technology infrastructure is based on open source code. And this ranges from Linux, which runs a vast amount of computing and web serving and everything around the world to machine learning languages like [inaudible]. It's all just freely given out. Luca came up with the idea, why don't we go there and actually look at the free public code that they put out and evaluate it. Speaker 1:He wrote this just fantastic system that goes [00:05:30] through and reads their code, reads their contribution cause many of these projects have many people on and we can split that out and evaluate how good they are as a programmer. And so our original system was based on that. Some companies like Google and Facebook actually do open source as part of their internal development for any techies listening. Things like Hadoop and Cassandra have been turned out by Yahoo and by Facebook just freely for the use of the rest of us. But they built it for themselves [00:06:00] internally. That's awesome. But many, many tech companies, particularly a lot of these big server-based companies like IBM, they don't do that. And so there's a whole army of people working there that we traditionally don't have insight into. We have hundreds of thousands of people that we can look at and evaluate. Speaker 1:There are millions of developers out there. We very roughly estimate about 8 million professional working developers in the world. Yeah, we have a database in the u s Europe, China and large parts of Asian India [00:06:30] of roughly 4 million. I've been amazed and been told by some of our customers that some of their best results have come by looking outside the United States within our database. So we want to take those hundreds of thousands of people that have gone out and done something wonderful and very accurately convey to our customers how good they are. This is k a l x Berkeley 90.7 on your FM dial and streaming on the web@kalxdotberkeley.edu I've been talking a lot about almost surface level [00:07:00] information that we pull out of these sites like you know, did people really like the answers? You Post it on stack overflow and how often was your code on get hub? How often was the code on get hub polled forked as they call it and used by others or followed by others. Speaker 1:But we can actually get more sophisticated than that. We can literally go in and evaluate the content of what people are saying. I can tell how what kind of person they are in essence and, and I think many of our customers would be interested in us putting out a product that [00:07:30] can actually say this person is a good personality match for you or a good, you know, match in terms of housing and all of these search firms and we're not trying to build something to replace the existing systems per se. Some of them need replacing, they need disruption. Yeah. As they say, disruption. But even starting more simply. A lot of recruiters with titles like technical recruiter are not technical people themselves, but many of them, they get a resume [00:08:00] and it says, we need someone with flask experience. Well, what does flask does? Recruiter doesn't know. Speaker 1:And it's not because they don't know their job, it's because that's a pretty specific technology. It's a subset of python, which is a subset of interpretive languages and it isn't necessarily their job to know this, although wouldn't it be nice if they did and then they get a resume and that resume says the person works in Django. Well, [00:08:30] little do they know those are highly compatible technologies. That person may be a great candidate, but if they don't see those matching words. Part of our research right now and some exciting potential products to come is based around being able to turn people into instant experts, essentially designing systems that will understand the ontology, the taxonomy of the technology, maybe other worlds as well. Wouldn't it be nice if we could just say, [00:09:00] tell us who you love at your company right now, who is incredible and you say, oh well and Brad and I love Jill and Brad and we just said, Oh care 20 more Jill and brats. Speaker 1:And you say, oh well these five, not quite what I meant. And we say, oh, thanks here. Another five that fit even better and you can turn that experience into the recruiting experience. It's like you did one interview and we behind the scenes populate the results of your interview [00:09:30] with the ideal candidate or their ideal set of candidates. Your job is to simply go out and do the recruiting. All we care about is whether they fit the job, what you just said you need it. I saw Ray Kurzweil speak here recently and one of the things he was talking about was the ability to know before you even know what you need. Well that's the beauty of what I'm just describing myself. For example, I just recently found out my team for guild. I started the process by trying to scratch down ideas of who would be the right candidate and then we start [00:10:00] the process and we realize, oh, that's not quite right. Speaker 1:And then we go back and we kind of iterate a little bit and you know, my recruiters looking to match the specific terms on my job description I've written up and it's an ugly and inefficient process and it's inevitably going to miss great candidates, great candidates that don't fit the obvious mold of a great candidate. Like the guy that in the New York Times article, jade jade, okay, he didn't go to college. Jade has this amazing story, no obvious [00:10:30] exceptionalism in high school, no work history that speaks to the corporate world or even the startup world. You wouldn't just not bring them in for an interview. His resume probably wouldn't even get in the door. Why would you ever consider someone like this? Well, you'd consider him because he's an amazing front end developer and he's done amazing work for the US and Luca discovered him using the algorithm look a developed by saying who is the best front end developer in Los Angeles? Speaker 1:Essentially that was his question. [00:11:00] There was jade with a perfect score right up there, like a guide no one would ever look at, you know, we call them up and of course [inaudible] us while at this tech company in San Francisco has startup. What do, they brought him up for an interview and it clicked and he does great work. You know, as the article says, this is kind of an experiment. I think an experiment, which I can personally say jade is gonna do great things and I love him. It's fun having him in the office. There was a huge discovery for [00:11:30] us. People that would otherwise get ignored, have a legitimate shot at jobs. They're qualified for it. In fact, my research, as for every one of those standouts, there are hundred times as many people that are just as qualified. The tragedy isn't that the credential people are getting the jobs, they deserve it. Speaker 1:The tragedy is all of those other people being left behind. And we have the opportunity now to look at this here at 10 people were saying they're all equally qualified. You've got the money and the opportunity and you want certainty. [00:12:00] Okay, hire the Stanford candidate, the MIT candidate, the cal tech candidate, but if you want somebody good and you don't have that money or maybe you've lost out to Facebook and Google, not everybody can throw $1 million just to get someone to come work for them. There's a real market distortion. A small number of people are being highly overvalued and it is scorched earth and silicon valley trying to find those proven developers. There are a lot of people out there. The question is how do you find them? How do you validate them? Facebook and Google are testing [00:12:30] our system, not because they need us to find candidates because they want to find the candidates. Speaker 1:They can't find other ones to use their language. They want to find diversity, fully qualified, equally qualified candidates. Our system does not over promote anybody. You have to make it there on your merit. Open source is a wonderful thing to do for the world, but it's also a demonstration of who you are and what you can do. Even small projects, we use those and believe me, recruiters look there. Also, if you're just tuning in, you're listening to method to the madness on [00:13:00] k a l x Berkeley, and today I'm interviewing Dr Vivienne Ming, chief scientist at Gild it talent acquisition tech company in San Francisco. I have a thread that runs through all of my work, so I'm a visiting scholar here at Berkeley at the Redwood Center for theoretical neuroscience. I have a company that I co founded with my wife and a former student of mine called socos where we do cognitive modeling of students for educational technology and I even dabble around with things like Google glass that I'm wearing [00:13:30] right now and working in modeling diabetes, which applies to my son who has diabetes. Speaker 1:Across all of that. What's important to me is maximizing human potential at the Redwood Center. I'm interested in neuroprosthetics particularly what we call cognitive neuroprosthetics. People that have Alzheimer's, that have hearing loss, that have decreased working memory spans that have autism. Imagine what we can do with the technology that's coming up to compensate for these [00:14:00] Google glass. For those of you who don't know is that sort of experimental development of project that Google's actually put out in the wild now. So I'm wearing a pair right now and they don't look too bad either. People know and they're going to look pretty cool. I like them. It's voice activated and so I can turn it down with the head nod and say, okay glass, take a picture and there we go. I just took a picture so I can essentially see Google search results. I can see videos, get directions. Speaker 1:Imagine I'd put this on an autistic child. [00:14:30] I've done previous research in automatic facial expression recognition. Imagine the video camera is watching the expressions of the person I'm talking to, processing it back on a server and then in the little pop up I'm telling the child what, what emotion that person is feeling so they have a chance to get a real time feedback on their interactions. Imagine people in Boston had been wearing glass, the explosions go off and there's 20 people say, okay glass virtual EMT and they are alive, connected [00:15:00] with an emergency room doctor working at desk. And the doctor can see what they see through the camera. I can hear the doctor in a Mike that goes into my ear and in a heads up, I can see them talking to me. I can read your heart rate right off the camera just from subtle changes in your skin color and body temperature and things like that, and suddenly those 20 people went from being shoppers and runners to being first responders. Speaker 1:The idea of what you can do with people through neuroprosthetics as I call them and now [00:15:30] it's the augmenting cognition is is just amazing. Retinal implants, motor prosthetics, people learning to move quadriplegics and stroke victims and strikes with people that haven't moved parts of their body in years and years. This really laid the groundwork. It was what had got me into graduate school. It's what drives my academic research still. When I was given a chance to think about, for example, cognitive modeling of students, I wanted [00:16:00] the opportunity to go out and bring that onto the world instead of being an academic project, which is incredibly valuable. My wife and I founded a company so that we could access it soco. So that's so close. I was working at the time as a research scientist at UC Berkeley. Uh, my wife was a lecturer. She studies the learning sciences, which is sort of cognitive psychology for education. Speaker 1:And I had a student at the time, the most amazing guy, he's at the Ed school at Stanford now. His name is [inaudible]. We [00:16:30] decided we wanted to start a company where we could do something amazing, which was figure out whether students understood what they were talking about in their own free form discussions, talking to other students, interacting with instructors, sending emails, doing homework. So helping teachers know where they're not reaching students. Exactly, but to do it without imposing anything on them. There's a lot of buzz around Ed Tech Con Academy and you know a lot of [00:17:00] work by the gates foundation. Companies like dreambox and Carnegie learning and others putting out really amazing technology. But one aspect of most of that technology is this is the learning experience. We have decided a curriculum for you, if you want to adopt this for your classroom, this is what the experience will be and we'll need to retrain your teachers and we'll bring the computers into the classroom and the kids will solve math games. Speaker 1:That took you know, years to really optimize [00:17:30] and get just right and there are proven effective, at least in the lab. They have some challenges in the wild though teachers don't buy in. The curriculum isn't quite adopted correctly. Hard to track exactly what students are doing. Wouldn't it be better and sort of more responsible for us as technologists to say, teachers, curriculum developers, you're the experts. Go explore and educate the way you want to. Just share with us everything that that experience producers and it will be our heart job [00:18:00] to make meaning out of it. We looked at an introduction to biology class and an MBA class in economics and we simply looked at their online discussions. What we found was one, we could learn biology and economics just by listening to the students. We didn't need to model a textbook ahead of time or bring an expert in to build our system instead of an expert system about biology. Speaker 1:We had an expert system about how students thought about [00:18:30] biology or what they knew or what they knew, so it included the right and the wrong and it included it with nuance and then when we took in a new group of students with new instructors, we found in week one we could predict what grade they get in the class. Again, just from their freeform discussions, not looking at homeworks or essays or final exams. By the end of the class we had an extremely tight understanding of what they knew and how they would perform in the class. The final grade they would get and the vision is wouldn't it be great? [00:19:00] Then back in week one, if we could say to the student, the learner, to the instructor, we predict these students share misconcept and historically looking at other students, we found that these interventions like a reading or lecture or homework experience were effective in moving students from this misconcept to this more normative concept. Speaker 1:The teacher teaches the class the way they want and the way they should because they know what their kids aren't getting. They are the expert. And we simply [00:19:30] essentially in real time, give them feedback on which students are getting it and which aren't and effective ways they might go back to the students that aren't. And this is in practice right now somewhere. Um, we've published papers on it. We're in touch with a couple of prominent educational technologies, companies that want to use our system as the intelligence behind their amazing products. So we're gonna make people a lot smarter. That's our goal. And then there's going to be a lot more competition for all those great jobs you're finding [00:20:00] too. Well, again, so we're looking at maximizing human potential and the ability of our system is to identify the unique understanding of a given student and really try and move them in the most positive direction we can. Speaker 1:We are incredibly passionate about the ability to understand student cognition and really create ais that are just personal tutors that will go with students with the rest of their lives. Here's our big thing for soft costs and all standardized [00:20:30] testing. I, I get the sense that your life is definitely informing your work. Everyone always thought I would be really good at school. My Mom, my dad being the sort of crazy geemer that he was just was convinced you are again, you're gonna get a Nobel prize someday. I know he was incredibly successful. Had he got a bronze medal in Vietnam, right? Did He, I mean, he was like an amazing helicopter surgeon I would with him. So he grew up on a farm, five kids and his graduating class, I think he [00:21:00] got full scholarships. He was an amazing man. As a, as a doctor in the community, specifically at gastroenterologists, you know, treating all the patients that come into his door. Speaker 1:He instilled in me the belief that you should leave a life of substance. And it's why I choose to do the work that I do. But my mother's a teacher out of Kansas as well, worked for decades and a, and a great teachers, Sixth Grade Public School, Salinas, California. She is an amazing woman. They expected [00:21:30] things of me despite the fact I typically was failing all of my classes through high school. Through my first years of college, I was very unhappy growing up. The only way my father agreed to send me to this private high school, Robert Louis Stevenson, is if I played football. But he had these fears. This is back, you know, early eighties you know, some froofy private school might turn my son gay. Little did he know that it was that very experience [00:22:00] that totally clarified the world for me and the world being, I never understood the other pies. Speaker 1:Their behavior, casual sexual jokes made no sense to me. I'll be honest, I thought everyone was an idiot but me, and then I understood I was the one that was different. When did you come to that realization? This was when I was 12 the understanding didn't change anything and in some ways it sort of made it worse because okay, I was a boy and I didn't want it. B, what good does that do? That just makes life harder. So I got through high [00:22:30] school is the best way of describing it. I loved academia. I was planning on being a doctor, like 85% of the undergrads at UC San Diego. It was just basically a big biotech school, and I showed up there and now no one was even looking over my shoulder and I wasn't doing the homework and then I wasn't going to class. And then I wasn't even bothering sharp with the final gone. Speaker 1:So you had not confronted either your mother father at this point with how you felt. So you know, now we're into my twenties by that point I considered the idea of gender transition, [00:23:00] but I was so isolated and so alone and no support. So I'm starting to learn a little bit, but I'm not part of any community and I'm thinking, how am I going to keep going? Being unhappy. I completely stumbled into a job without looking for it. Running an abalone farm in Santa Cruz, California, the economy in Japan crops. So there our main customer base, and now they're not buying our Sushi anymore when the end came, because it was inevitable. I had saved up a little bit of money and I thought, why don't I just go back to school and try [00:23:30] and do something substantial. So you had not finished your undergraduate? Not finished. Speaker 1:My Undergrad, I'd been, I think I'd been there three years. What degree could I finish in a single year? I literally flipped a coin between economics and cognitive science, cognitive science one I thought, okay, I'm going to be a neuroscientist. I went there and started taking classes and they were just like ridiculously easy. I was getting A's and a pluses and everything compared to having worked at this abalone farm where you know, the world was falling apart every single day [00:24:00] and my, my love of research and academia finally had fertile ground where I actually got successful feedback in one class. The professor came back and said, I've got a research project, which I like to work on it and that eventually led me into this field of theoretical neuroscience. I applied to Grad schools and I was still presenting male at that time. I had a very deep voice and a presence and I was getting a lot of the benefit of the doubt. Speaker 1:You [00:24:30] know, I'd come into psychology departments and talk sophisticated mathematical ideas about cognition with that presence and people would start nodding their heads and saying, you know, would you want to come join our lab? Of course I cherish those opportunities, but I always kind of felt like a fraud, do really know exactly. And I gained it all the way to Carnegie Mellon, which is an amazing place. And I worked there with several people. Jay McClelland, who's Jay is now at Stanford, Mike Wiki now at case western and [00:25:00] Laurie halt, who is still at CMU. I just loved working with all of them, but I was still fundamentally unhappy. I was having all of the success fighting, you know, our, my work with Mike was published in nature and I had chances to get up in front of hundreds of people at major conferences and talk about our research and feel good for five minutes and then it was gone. Speaker 1:And then I'm out. Norma. Um, we were together in the psychology department at Carnegie Mellon early on in our weird courtship. [00:25:30] She taught me deep, dark secrets about herself. And all I said was, I've got a pretty big secret to maybe I'll tell you to you someday. Four years later, our final year at Carnegie Mellon finish finishing our dissertations. It was my birthday. We were together. We were actually engaged at that point. I'm just going to be the best husband that I can and I'm successful at work. I have someone that makes me happy. So many people don't have either of those things, much less, both of them. I don't know how it came about, but I was invited to be in an experiment to [00:26:00] look at the effects of NZ Alytics. So anxiety reducing medicines on heart health. And it was a blind double-blind. No one knew what medicine they were getting. Speaker 1:So I was taking something turned out the medicine they were testing is called Celexa. But I didn't know if I was taking any. And in retrospect it was so obvious that like the change in behavior and so forth. But turned out I was, I learned after the fact I was in the treatment group. Why was that so fascinating? Because there was in the midst of this and looking back, I realized, wow, I wasn't shouting at any people. I'm, I'm, I [00:26:30] was like a notorious angry driver. And I said, wow, I haven't like shouted at anyone in the car in like months in the midst of this for whatever reason. I taught in a moment total freedom to just share that with Norma. My big, deep, dark secret is I wish I were a woman. You weren't married yet, right? We weren't married though. We weren't engaged. Speaker 1:Um, we stayed up that night talking and, and we talked for about a week. That was the start of my transition. Completely unplanned, completely unexpected, but with her full support. But we loved each other. Her parents still [00:27:00] really struggled. How about yours? What makes me most happy is that before my father passed away, he was back to bragging about me again. He had some struggles and he had troubles with pronouns. I mean our parents, I will single out my mother, she had like three days of tears and then a light switch and she was like, all right, we've got to go get you a new wardrobe yet you need professional outfits. I mean, she just has been amazing from that moment on. My siblings have been incredibly supportive. Enormous siblings have been incredibly supportive. My friends, [00:27:30] friends that I most feared coming out to it, their response was amazing. Speaker 1:Normally this decision is a decision to start a new life, not because you want to because your family leaves you and your friends won't talk to you and your career is offering. Most importantly to me, Norma is still enormous source of happiness. Our children aren't enormous sources. Do you have a boy and a girl? Right? I have a boy and a girl. Um, I'm their mommy. I'm also their donor. Did you have the foresight to a banked uh, ahead of time? Very [00:28:00] good. That tells me a lot about how this idea of merit and bias, like you say, how people treated you as a man and you were gaming that. So that has informed a lot of your algorithmic work at gala. I feel like a secret spy having seen all of this, they're a man's eyes and that's such a good thing to do to try to eliminate bias in the hiring practices of the workforce, whatever they might be. Speaker 1:At Guild, I had the opportunity to work in a company [00:28:30] whose motto is meritocracy. We want to give everyone a legitimate shot at what they're qualified so I could take my expertise there and apply it. Again, back to my life's goal of empowerment and maximizing human potential, and so guilt really has become an amazing platform for that. I bet a lot of our listeners are to want to get ahold of you or talk to you or maybe ask you a question. Do you have a website that you would recommend they look at both for guild questions, but also LGBT [00:29:00] questions are an absent that. If you look us up@giltdotcomgild.com you can see the kind of work that we do and you can learn a little bit about me and the founders there and our work in meritocracy. Our education work@sovosisatsovos.me, s o c o s. Speaker 1:Dot. Emmy at the Redwood Center for theoretical neuroscience here at UC Berkeley. It's at redwood.berkeley.edu [00:29:30] you can see all of the amazing research we do. Very Geeky. You'll love it. Finally, there's my own website. If you just want to reach out to me personally and maybe on LGBT issues or anything like that, you can find me@vivianming.com I am not much of a social networker, but I love to sit down and talk with people. I told a group of students here from Stanford and cow yesterday, learn to do something of value so that you'll have some tools [00:30:00] for the rest of your life. Learn engineering or learn the practical skills of putting words on a page, whatever it is, but learn something tangible that other people will value. Commit fully to that amazing thing you're doing right now. You've got a whole life ahead of you to do more amazing things. That's kind of how I personally have embraced the very weird and and incredibly fortuitous life. I've had the chance to have an amazing life of Dr Vivian [00:30:30] Maine. Thank you for being on this program. I've really enjoyed it. It was a real pleasure. If you have any questions or comments, go to our website method to the madness.org that's all one word. So you in two weeks at the same time. See acast.com/privacy for privacy and opt-out information.

With tracks from Alex Flatner & Lopazz, Greenville Massive, Greg Paulus, John Roberts, Space Ranger, The Chemical Brothers, Simon Garcia, White Lions, Filipsson & Ulysses, Petar Dundov, Jay Shepheard, Pascal Kleiman, Mesak, The Soft Pink Truth, James Curd, Storm Queen, Michael J Collins, David August, James Teej, James Johnston and Lullabies In The Dark. Contact: dj@ribeaud.ch.