OYM Jodi | Healing Depression

 

It is said that if you’ve had one episode of depression, there’s a 50% chance of having another one. If you’ve had two, there’s a 75% chance. If you’ve had three, it’s 90% or higher. Conventional medicine would tell you that if you don’t take your medication, you’re going to be sick forever. However, Dr. Jodie Skillicorn is debunking this claim. She joins Timothy J. Hayes, Psy.D. on the show today to talk about healing depression through methods not involving medications. Dr. Skillicorn is a Psychiatry Specialist in Akron, OH and has over 16 years of experience in the medical field. Together with Timothy, she dives into her book called Healing Depression without Medication: A Psychiatrist’s Guide to Balancing Mind, Body, and Soul and discusses some effective and efficient methods in doing therapy other than by conventional medications.

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Healing Depression Without Medication With Dr. Jodie Skillicorn

Dr. Jodie Skillicorn is board-certified in Psychiatry and Neurology and a diplomat of the American Board of Holistic Integrative Medicine. Dr. Skillicorn is the author of the book, Healing Depression Without Medication: A Psychiatrist’s Guide To Balancing Mind, Body, and Soul.

Thank you for being here. Dr. Jodie. It is a pleasure having you agree to this interview. I found out about your book and I found out about the similarity in our trainings. I was excited to get together with you. Thank you for joining us.

I’m happy to be here. I’m excited to talk to you too.

How did you get into this from a traditional psychiatrist perspective into the perspective that you’ve shared with us in your book, Healing Depression Without Medication?

That’s where I started and then I forgot when I got into medical school. I had no interest in medicine. I had an inherent distrust of the medical system. I was in graduate school for Visual Communications, Photo Journalism. I had finished everything up, was waiting to start a job and I read Christiane Northrup’s book, Women’s Bodies, Women’s Wisdom. I immediately felt, “This is what I want to do.” The mind, body, spirit, it made much sense to me that connection. I called my parents and I was like, “This is what I want to do,” and they’re like, “You just finished grad school. Maybe you should work for a little bit.” I did that and I forgot for a little bit and then it came around. I ended up in journalism, started to feel like a vulture on the side of the road. I eventually ended up back in school. In medical school, I started to forget that this is why I started medical school because it’s dogmatic. This belief that medicines can solve every problem and this whole system is based on finding pathology and everything’s treated with a medicine or a procedure. I started to buy into it too. It’s simple, you just take a pill that solves everything.

When I decided on Psychiatry and went in and started residency, I started getting the same. All the patients I received were patients that had already been seen by the person before me and the person before them. I was thinking, “If these medicines are great as I’ve been told all through medical school and now in residency, why are people not getting better? It doesn’t make sense.” I then go back to what I had been learning before all this. Before I started medical school, I did a yoga teacher training. I already did meditating at that point for many years now. I already had all these practices that I knew worked for me and I was an inherently anxious person, still am, but not nearly as much. I knew how effective these tools were for me and I started using them with my patients and found that they were effective for them as well.

I seem to remember you mentioned in your book that there was a critical book you read by Dr. Whitaker.

Yes, Anatomy of an Epidemic. I read that book. I’d already started to question a lot of things. I read his book and his research exploded everything that I’ve been taught. It blew it to pieces. What his research suggested was that these meds were making things worse, not better. That depression and other mental illnesses specifically depression in the past had been something that was only a minority of people developed chronic depression. Most people, the vast majority, it was an acute problem related to some immediate stress or some childhood stressor, but there was an antecedent and there was a reason for it. For most people, it would pass within six months to a year, that was the norm. If you read the literature from the National Institute of Mental Health, that’s what it was stating. Once medications came in, that all started to shift. It would be an abnormality for someone to have a depression or to see a psychiatrist and for it to pass quickly. It does messages, it’s chronic and you’re going to need to be on these medications for the rest of your life.

In the story I was told was if you’ve had one episode of depression, there’s a 50% chance of having another one. If you’ve had two, there’s a 75% chance. If you’ve had three, it’s 90% or higher. What I used to tell people is you’re broken, you’re sick, and if you don’t do what I say, which is take medications, you’re going to be sick forever. That’s what happens. We tell people that and that becomes the reality. No one expects any differently. I often think of it similar in the past with stroke patients. The prevailing message in the past was that our brain could not change, that we had a certain number of neurons and as we got older, they would slowly die off.

If you had a stroke or you had something, there was nothing you could do. There was nothing you could do and people did not get better, but nowadays we know that’s simply not true. That with lots of therapy, training, and repetitions, you can retrain the brain. You can grow the brain. You can rewire the brain. Now, when people have strokes, we know that they can maybe not get fully better, but they certainly can improve. There may be some of those deficits. Why would it be any different for anything else dealing with the brain?

You quote in the book, and it brings us back to it over and over again the idea that our brains do not discriminate between the real and the imagined. If you combine that with what you were talking about and the knowledge that came up in 2004 was the first time they did an experiment. It’s where they were able to track and scan the rewiring of the neural pathways and what they’re now calling Memory Reconsolidation. The brain is always learning, changing, and growing but if we keep feeding people the belief that you’re damaged, you’re broken, you’re going to have to take this pill forever. They think it, they come to believe it and then that reinforces those neural pathways, then they get stuck there. It doesn’t mean they stuck there.

OYM Jodi | Healing Depression

Healing Depression without Medication: A Psychiatrist’s Guide to Balancing Mind, Body, and Soul

It’s the nocebo effect. We’re disempowering people and making them helpless and hopeless. That’s exactly how they stay and it’s no surprise then that the outcomes are far worse.

I want to clarify what you said there, you talked about the nocebo effect. A lot of people reading may not know what that means. The placebo effect and the nocebo effect are diametrically-opposed. Can you speak to those powerful forces?

The placebo effect is when anytime a doctor gives a pill or even support and guidance, we tend to think of placebo as just a placebo, but the reality is the placebo is incredibly powerful. The pharmaceutical companies have to spend a whole lot of money and do a whole lot of manipulations in order to make their medications better than a placebo because it is effective. One of my favorite studies on placebo was not on depression, but it was irritable bowel syndrome. This was 2010 with Dr. Kaptchuk. He did a study where he took two groups of people with irritable bowel and one of them received the best medication at the time for irritable bowel. The other group received placebo. Not only did they receive placebo, but they received a bottle that said placebo on it, they were told they were giving placebo. This wasn’t hidden. It was right out in the open, but they were given a lecture on the power of placebo and how it had been shown in multiple studies to be effective for irritable bowel syndrome. What they found in fact was that the placebo did just as well as those who had received the most expensive and what was considered the most effective medication.

It’s incredibly powerful for us. It changes the brain and the body in similar ways to an actual medication. It doesn’t even require a belief in it. You cannot believe a placebo and still have a placebo effect because we’re hardwired to believe in the power of pills, our doctor, and the system. Because we believe in that, that explains a huge percent of why all medications not just psychiatric medications work. Nocebo effect is the opposite. Nocebo is to do harm and is when we plant this idea, you’re broken, you can’t get better. This is a chronic disease or cancer. You’re going to die in six months. Lots of people die basically to the day because this idea has been planted in their head that that’s the outcome, that’s what’s going to happen. It becomes the reality. My favorite nocebo study was a case study by a guy they called Mr. A. He was a 26-year-old who was depressed after a breakup. It wasn’t pathology. He was distraught over a breakup with his girlfriend, but he ended up in this study and he was given antidepressants.

In this case, he got better after he started taking the medication. A couple of weeks later, he got in a fight with his ex-girlfriend and he impulsively went and overdosed on all these pills and immediately regretted it and called for help. Meanwhile, he was getting all sweaty, his blood pressure was dropping, his heart rate was up, and he was lightheaded. The ambulance came and documented all of this and they called to figure out what medication he was on. A couple hours later, while he was still having all these symptoms, the person from the study arrived and announced that was placebo. You weren’t on anything. Immediately within fifteen minutes, he had recovered. He was back to normal, but the point is the medications can cause side effects in the same way if we believe it in the same way that a placebo can help us get better. It’s incredibly powerful. It changes our physiology in profound ways.

The power of the mind. Bruce Lipton suggested in his book, The Biology Of Belief, back in the ‘90s, why don’t we start calling it something more accurate? Something like the power of the mind or the belief effect rather than the placebo effect. People like Erik Vance, dug into it and wrote the book, Suggestible You, and talked about the power of both the placebo and the nocebo effect in a study that was done on a new treatment for Parkinson’s. It’s rather dramatic. They had to drill a hole in the skull and inject this particular medication into the brain. They did this study and you wonder, “How can you have a placebo for that?” Like the knee surgery placebo studies they’ve done, they make an incision, and then they make a little indent in the bone without going all the way through. They take all the time they would have their head the regular procedure. Some people had a part of the skull removed, the injection, and then sewn up. Other people had a little indent put in the bone and then no injection of medicine.

There’s one person who had tremendous negative effects of Parkinson’s. That put the brakes on his life and his ability to function with his kids in the study had a tremendous positive result. They were thrilled and as a double-blind study, his doctor didn’t even know whether he’d gotten the medication or not. They assumed that because his improvement was dramatic, he must have gotten the medication and they must have just found a powerful cure for the symptoms of Parkinson’s. As all of these studies work, they’re set up that after a period of time, they have to notify people whether they got the actual medication or the placebo. When the time came, the man and his doctor were both blown away by the knowledge that he got the placebo.

He didn’t get any medication, but his life was powerfully transformed. The role of belief in the symptoms of Parkinson’s, if somebody tells me, “You have Parkinson’s. This is a progressive disease and you’re going to have decreased functioning until the point where blah, blah, blah.” I start to believe that it starts to affect my physical functioning. On the other side of the coin, in that same study, which by the way they had to say was not a tremendous cure for Parkinson’s because the people that got the medication didn’t get that much better. Some of them didn’t get anywhere near as improved as the man in this particular example who got the placebo.

In that study, the nocebo effect was powerful that the people in the placebo group got more and stronger negative side effects than the people who had the medication injected into their brain. That’s the power of the mind. You’ve already touched on the idea that for a variety of reasons, your medical training was clearly focused on the belief that medications had to be the cause of healing. The pathology was the primary focus and then the correction or at least alleviating the symptoms from the pathology was the path. You read the Whitaker book and your eyes were open to the fact that there’s an entirely different set of interpretations and different research out there that says, “This stuff isn’t what the medical profession tells us it is.”

More importantly, that research is hard to find and often buried from the medical literature. You have to dig for it. Pharmaceutical companies make it hard to find information that disprove, that show that their medicine doesn’t work as well as.

There’s a powerful thing that’s in the first part of your book where you’re talking about all this that opens up one of the problems with peer-reviewed studies in journals. That is that if you have 5, 10, 12, 30 different studies that don’t get any positive results, where there is no statistically-significant difference between this treatment or that factor. There’s no even a correlation, much less a cause and effect relationship proof. It’s almost impossible to get those studies published in a journal. Let’s say that I had this idea that strawberries cure depression and I do a study and it comes out and there’s no real difference between people that eat strawberries and don’t, but I’m convinced that strawberries are powerful.

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They’ve got this one ingredient that I know, so I do the study four more times, and each time there is no effect. I get some money and I do it twelve times. On the twelfth study, there’s a statistically-significant difference between the people getting less depressed if they ate strawberries and not. No one knows about the first 10th, 11th studies, but I can likely get that twelfth study published in a journal. It’s not just me as an independent researcher, but you were talking about how common that is for the drug companies to do several levels, if not many trials, of their drugs in order to come up with some that are statistically different or significant and then get the FDA to approve their medication.

You only need two positive studies and you get as many tries as you want. For example, for laxity, there were eight studies and two were positive. The fact that six failed, that never shows up in the literature. It’s the same for all the other antidepressants as far as I know, there were multiple negatives. Part of what they do, it’s not just keep redoing it. It’s figuring out who’s most receptive. It’s taking advantage of the placebo and nocebo like who’s least receptive to placebo, but who’s most receptive to nocebo and you can twist and get the population you want. They may give you the result you want. There are all these other studies showing the opposite result.

The clearest example that is there was a study done in 2008 by Eric Turner and colleagues in the New England Journal of Medicine. In this one, I may not get my numbers exactly right, but it was one of the first studies where they got access to all of the studies they could, using the Freedom of Information Act. They got access to not just the studies that are published, but also the unpublished ones. They ended up with 72 studies and of those, 38 I believe were positive and 36 were negative. Here’s where it got interesting was is of the ones that were positive, all but one was published. That’s what your physician is seeing. That’s what your psychiatrist is seeing.

That’s what they’re basing their information on is based on these studies, but of the studies that were negative, only three were published. Of those, only one showed the actual effect that it was negative. The others buffered it up to make it look more positive than it was. The rest were buried. As a physician, even if my best intention is to find the best information for my patients, if I don’t have access to that information. If it’s all being buried and only every once in a while does a study negate what I’ve been taught or negate the standard belief that these medications work, then I’m going to dismiss it because 97% show it’s positive. I’m going to ignore those few that don’t. The reality is all those negative ones are being buried, I’m not getting accurate information and I’m making decisions based on only half the facts.

That data that’s published and promoted in collegial discussions is feeding the conclusion that depression is caused by this absence of a certain set of chemicals in your brain. Can you talk about that?

The predominant, what we’ve been told since medications were discovered is that there is the neurochemical imbalance. If your depression is low serotonin, low epinephrine, low dopamine, though you have lower than normal levels of these neurochemicals, these neurotransmitters. That’s what all the medications are based on is based on increasing the levels of these neurotransmitters. What the data overall shows is that a quarter of the population, whether they have depression or whether they don’t have low neurotransmitters. A quarter of the population has high neural transmitters whether they have depression or whether they don’t. The rest of us are in the middle, which indicates there is no rule and to think that it is, is delusional because it’s such a complex dance.

There are many, it’s not as if there’s just these four neurotransmitters. There are hormones and other chemicals in the body that are acting as neurotransmitters and they all interact. It’s this dance and if this gets more than the body tries to modulate and the receptors become less receptive. It’s complex and to think that it’s just this one thing, and even the founders of this neurochemical imbalance theory thought that it was preposterously simple, but it was just a piece of the puzzle. The pharmaceutical companies have sold us on the idea that is the puzzle and it shifted over time.

At the beginning, the medications were presented to the public as what they were, which is they can help reduce symptoms temporarily but if you stop, the symptoms will come back. It gradually became that it was a cure. At that exact same time, the number, conicity of mental illness has gone up and up as we continue to use the meds. We’ve been getting a message that’s not true, but what the research is pointing towards is that it’s more an issue, test like all of the chronic diseases. The brain is part of the body and the body is part of the brain work is not as separate.

It’s not as if we’re bobbleheads walking around with these big heads and our irrelevant bodies. It’s all connected. What the research shows is that maybe like other chronic diseases and issues with inflammation, this inflammation can be caused for lots of reasons. One just chronic stress of the crazy way we live, constant dizziness, and doing. Also, the correlations are incredibly high for early childhood trauma. For example, for someone who’s hasn’t experienced the examples they use for child trauma, which would include physical, sexual and emotional abuse, losing a parent whether it’s to divorce, death, or jail, emotional neglect, these kinds of traumas.

What they found is if someone hasn’t experienced any of these, I don’t see anyone who hasn’t experienced any of them in my practice anyway, but there’s about a 12% chance of having an episode of depression in one’s lifetime. If someone’s had one early childhood trauma, that goes up to 25%. Two, it goes up to 40%. By the time you’re at four of these events, which is not all that uncommon, there’s a 400% increased risk of depression and a 1,200% increased risk of suicidality. It’s the same across the board if you look at alcoholism, for example, it’s about 800%. In drug addiction, about 500% increase. These numbers are huge as correlation between these early childhood traumas and it makes sense because when we’re small, it changes the way our brain is developing.

Our nervous system is developing. It changes the way we see ourselves or not see ourselves as safe in the world and how our body sees our self or not sees our self as safe in the world. It changes the structure and function of the brain and the nervous system. Those results have been shown in studies when they followed people twenty years, you could still see the inflammatory effects of those early childhood events. That’s where the research is pointing now, but unfortunately there’s about a seventeen-year gap between the research and what is happening in a doctor’s office. We’re perpetually behind.

OYM Jodi | Healing Depression

Healing Depression: When we plant this idea that you’re broken and you can’t get better, it becomes the reality.

 

Although the hopeful note here is that as I’ve been in the field and interviewing people, those who are working in systems that might be labeled functional, holistic or integrative medicine whether it’s in the mental health field or the physical health field. They have been working on models that accept that whole body system energy system approach. It is possible to get a clinician who will help you look at your entire energy system, which is not separated mind from body or vice-versa. There’s a woman in Australia, Allison Davies, I interviewed her a while back. She talked about how the research about the level of external stimulation in which our brains developed over the centuries and thousands of years is dramatically different from the level of stimulation that we’re living in now and this level of connection. One of the things that I love about your book is that, although the first part talks about a lot of this research, the difficulty with research, and the difficulty with adverse motivations for promoting drugs over other treatments.

The rest of your book goes into, “Here’s what you might do about it and take a look at the traumas, take a look at you’re breathing, take a look at what you’re doing with the brain.” My brain, my mind doesn’t know the difference between my belief about something happening and something actually happening to me. In sports medicine for decades and decades now they’ve known, people can improve their physical performance on the field or the court by mentally rehearsing in great detail. Doing vivid visualizations about the ski run, about the tennis game or the golf shot because now they know because they’ve got these brain scans of functional MRIs. They don’t have to wait for the autopsy to look at what’s happening in the brain. That if I sit and visualize doing one of those sports, the same areas of my brain light up is what I’m doing that sport.

Not just your brain, studies have shown you can improve muscle strength by imagining using that muscle, not to the same degree as you’re using it, but significantly.

If we look at this and we say, “There’s a big problem out there.” If we get past the idea that my depression means I don’t have enough of the right antidepressant in my brain. We get past that and we take a look at the traumas and the energies that I’ve downloaded in my body-mind system. As they get activated, later in life it can be the cause of the symptoms. Then what’s the first level of assessment you do to help somebody if they come to you? How do you begin assessing a person if they say, “I’m depressed?” Do you focus on depression? Do you do a broader assessment?

I spend a couple hours with everyone at the initial assessment because I want to know their story. I want to know how they do perceive the world around them and themselves. We start at the beginning. We start with their childhood and looking at events that shaped them, shaped the way they see the world, shaped the way they see themselves, and shaped the way they see what’s safe and what’s not safe. All the basic questions all therapists presumably are asking as well. These are important questions, but these are not just important questions in terms of our emotional wellbeing, but our physical wellbeing as well. I start there and then as we go through the story, I try to summarize it at the end by normalizing it. These symptoms you’re having, these behaviors make sense given what you’ve experienced. I try to start with normalization and understanding of how these totally makes sense and helped you survive even.

They serve some advantage at some point, they just didn’t come out of the blue. When we don’t acknowledge and when these things get buried as traumas often do. I think of it like a pot of boiling water. You can put the lid on you and bury it and that’s what often happens in childhood is you have to keep the lid on it. You’re not allowed to talk about it or the family secrets or whatever’s going. You learn to tighten up and hold all this in. At some point, it percolates out and then it doesn’t make any sense why twenty years later am I having these symptoms when my life’s fine, everything’s going great. I have no problems. There’s nothing wrong in my life. I have a great marriage. I hear these stories all the time and I’m sure you do too. When you start going back, you realize what they’ve been holding on to for so long. It’s making sense of the story and making sense of maybe what related event may have triggered these symptoms in this moment that relate back to the past.

From there, it’s a matter then of if your brain and body learn to respond this way, we can learn to respond in a different way. We can change that, change those beliefs, change that wiring. I always start with basic breathing as a way to start the body, to start to learn and see the connection between how we can, by changing our breath, start change our mood, our anxiety, our sense of how we’re feeling in the moment. Most of us whether we’ve had trauma or not, just because of a way we live our lives, we tend to breathe tight, shallow breasts into the chest.

When we do that, it’s like sending a constant yellow alert or orange alert, depending on how tight it is, to the brain that there’s some threat going on. We might be sitting on a couch watching TV and yet we’re getting a signal to the brain that the threat detector in the brain, that limbic part of the brain saying that something’s wrong. The brain tries to figure out what’s wrong, which only amps everything up and then our breath gets even more shallow. Everything gets tighter. We can be sitting there and be panicked and have no reason for it. In those moments, if we can drop down and start to breathe into the belly, just a simple place to start. We can send a different message.

We send a message to the vagal nerve, which lines up to the limbic system, that threat detector, fight-flight-freeze part of the brain. It lets it know it can put on its brake. It’s okay, there’s no immediate threat right here, right now. I’m sure things may be looming out in the future but right here, right now it’s safe. We’re sitting here on the couch and it’s okay. It’s a direct to communicate with that part of the brain and let it know we can settle. What the research shows is that by practicing, focusing on the breath twenty minutes a day ideally, it could be broken up into ten minutes in the morning and ten minutes at night, which is what I usually have my patients do. You can start to change the structure and function of the brain so it’s less reactive and less easily to get hijacked. Get into those fear-based places where we do a lot of the behaviors that feel out of control because in those moments, they are.

It’s decades and decades now, I think Herbert Benson wrote in the ‘70s about the relaxation response. The idea that if I spend that 10 or 20 minutes once or twice a day gently focusing on something that doesn’t take a lot of mental, emotional energy, stress and isn’t emotionally-loaded. Doing the breathing that sends the message to the body that there’s no physical threat. In that period of time, the other parts of the brain that jump into activity to do the refreshing, restoring, relaxing rejuvenating functions that we’re programmed to do, that we were born doing as infants and we’ve been programmed out of.

There’s a tremendous benefit in the breath work and making it a conscious daily practice. I have people do it, say 2 or 3 full deep breaths and slowly exhale. Do that 4 or 5 times a day for the standard person who comes into my office. If somebody comes in with anxiety, it’s a minimum of ten times a day do that because they are working to deprogram that heightened fight or flight response or stress response. It’s almost that fight or flight that they live in and reprogram this idea of safety, relaxation and breathing. As you talked about the vasovagal response that the vagal nerve being powerful, running from the brain, all the way down through the center of the chest and in the abdomen.

With every thought and every action, we change the brain patterns. If we start to change the input, we start to change the wiring. Click To Tweet

Sometimes I get excited thinking what research are they going to find in the near future about the levels of connection between the cranial nerves and the vagus nerve, vagal nerve is one of them, and simple things we can do to improve our life quality. We don’t just have 1 or 2 cranial nerves, we’ve got twelve. Five of them seem to be associated with senses. I had David E. Martin put out the idea that if we have five senses and there’s a cranial nerve for each one, but we’ve got twelve cranial nerves. What if we have twelve senses that we haven’t been tuned into? What if there’s potential within this energy system that we call the mind-body system to be and do much more than we’ve even tapped into yet? That’s where I like the idea, the exercises you give, and the way your book unfolds working through not just the breathing but the idea of paying attention to what your mind is saying. Can you talk a little bit about that? Do you got some exercises there for uncovering my stories?

I usually start with the breath, so focusing on the breath. It’s a form of mindfulness and meditation, which is all to say paying attention to what’s happening right here, right now in this present moment. The more senses you can bring in to what you were saying, the better. The more you can notice the sounds around you and the sensations. Now, I’m feeling sun on the side of my face and on this side of my face, I can feel myself sitting in this chair. I’m noticing my arms are moving a lot because I tend to move when I talk. Noticing what’s going on right here, right now.

The emotions, the thoughts and the sensations, what that does is it brings us back here because anxiety is all about being out in the future. Worrying about what’s going to happen next, worrying about my to-do list for tomorrow or worrying about what I have to do to get ready for the dinner tonight or whatever it is. Worrying about what’s going on in the world and all the things that are wrong and all the things I can’t do in this moment to fix it. All those things rev up anxiety. It’s not to say we don’t need to plan for the future and we don’t need to think about it at times, but we don’t need to spin out over all the time.

We need to come back especially if we’re getting all anxious. We need to come back right here, right now. Depression is often the opposite. It’s going back in time. Replaying something someone said to you that upset you whether it was yesterday, this morning, or whether it was twenty years ago. Replaying those scenes or the regrets or the things you wish had gone differently. Training the brain to stay here and it is training, no different than preparing for a marathon. You don’t just go out and run it. You have to practice on a daily basis to keep your body strong, supple and flexible. It’s training your brain to stay here so that it’s reducing the stress of all those things we can’t control out in the future and all those things we can’t change in the past.

Ironically, that leaves us better equipped to deal with what’s happening in this moment.

Our brain is onboard and we’re able to focus and have a much bigger, clearer picture of what’s going on in this moment so we can make much better decisions.

You move into and it may not be the next segment, but one of the things that’s powerful for me is helping people uncover their habitual negative stories. Michael Singer in his book, Untethered Soul, talks a lot about how powerful and how negative the internal dialogue is for most of us. He says, “If you could get a transcript of your internal dialogue for a day and hand that transcript to a friend and had them read it to you throughout the day, you’d kick them out of your life before noon.” You can’t tolerate anybody talking to you the way you talk to yourself.

One way, as you’re in the moment, as you start to notice thoughts, you start to notice how repetitive they are and why they’re boring, but also how often we keep retelling these particularly negative stories. We don’t usually retell the positive ones. For example, for depression, the stories are often, “I’m broken. I’m unfixable. I can’t function like other people. I can’t do things like other people. I’m not normal. There’s something wrong with me. I’m not enough. I’m not good enough. I don’t deserve.” These stories not only do they amp up our nervous system again, they create a cage that doesn’t exist. Throughout the book, I keep on coming back to the metaphor, there’s a story. It was a real story of Mohini the tiger and that tiger was given to the president. It was presented to the national zoo and the national zoo at the time only had those 12×12 foot cages to put this tiger in.

The tiger is growing up in this little cage and pacing back and forth. The zoo raised money so that they could build this tiger a much bigger enclosure with waterfalls, rocks, gardens, and mountains and whatever. By the time they did, the tiger had been in an enclosure for a long time. The grand opening day, they bring the tiger into this grand, new enclosure and the tiger paced back and forth in the back corner by the 12×12 foot space and never left it. The tiger lived his whole life right in that tiny 12×12 foot space but we all do this to a certain extent. We all have stories. They keep us smaller and contained and we don’t recognize them. As we start to investigate, we can start to see some of these stories for what they are and start to expand our possibilities.

Hopefully, rewrite the stories. Fortunately for most humans, we have a far more what they’re now calling neuroplasticity, the ability for our brains to change and grow throughout the lifetime. I’ve been honored as a therapist to have people in their 70s come to me for therapy and make substantial changes in thought patterns, belief systems, interactions, and relationships. It is a little bit more difficult when you’re that old and you have that history of decades of practicing a certain negative thought pattern and it’s possible to change it.

With every thought and every action, we change the brain patterns. It appears static to us because most of us continue to do the same things and send the same thoughts. It appears as if it’s a static, unchanging brain, but it’s not the reality. If we start to change the input, we start to change the wiring.

OYM Jodi | Healing Depression

Healing Depression: Studies have shown that you can improve muscle strength by imagining using that muscle, not to the same degree, but significantly. It’s the same with the brain.

 

If I’ve been conditioned to believe that my brain is the way it is and because I don’t have the right chemicals in it and I need to take this pill, then I don’t change any of the thought patterns. I do reinforce the belief that I need that pill to maintain and that’s all I do is maintain. I don’t grow. I don’t find joy usually in things. As you pointed out in one section of the book, the medications that are given for various psychiatric diagnoses are not prone to make people live a joyful, expansive life.

If you reduce sadness, you also reduce joy. It narrows everything and unfortunately, when we don’t have joy, that is depressing. That’s what we live for. No one ever lives in a joyful state all the time, but to have those moments, it’s what makes life meaningful. To cut people off from that is limiting. That is why people do come to me is they start to recognize that I’ve had people come to me because they were at their daughter’s wedding and they didn’t even feel joy or they were at their mother’s funeral and couldn’t cry. It wasn’t that they were protecting their emotions. It’s that they weren’t the there. They had been cut off on them. They wanted to feel like them and unfortunately when we cut ourselves off from pain, we cut ourselves off from gratitude, joy, compassion and all the other positive emotions.

That is one of the toughest cells that I have to make in therapy is that I used to take people into the room where we had the fax machine and there’s this alignment device. If you’re going to send an envelope, you’d move the two in this one. If we’re going to send an 8.5×11 and 11×14, as you move one, the other moves. You can’t move one side of that because it’s going to try and keep it lined up in the center. I would go in there and say, “If you want more joy in your life out here on the joy side, you’re going to open yourself up to more pain and sadness when the joy ends.” If you say, “I can’t stand the pain. I want no more pain.” You bring in the capacity for joy down to almost nothing. It’s the way it works.

Michael Singer’s work at a higher end will say, “You can get past the point where you interpret things as painful, bad or negative now. You can get past the point where you’re interpreting them that way and then they don’t have that impact on you and you live in that more blissful state,” but there’s a journey to get there from here. In the current state for most of us, we have to expand our capacity and our tools for coping with, dealing with the not so happy things in life, if we want to be able to experience more of that joy, gratitude, appreciation, pick your favorite word for that. That’s another set of training and teachings that I think are far more potentially powerful and beneficial than numbing out with a pill.

That is the work for all of us.

That’s one of the things that I was drawn to in your book is the idea that you’re presenting a way to teach people how to live a more active and fulfilling life. It’s taking an active role of participation in the development of your own skills for experiencing and managing life.

Learning those skills is empowering and empowerment is they had to adapt to depression anyway because at the heart of depression is hopelessness and helplessness. If I’m learning, not becoming dependent on someone else to fix it for me or some pill to fix it for me or some external force or my life has to change before I can be happy. It’s learning these skills that you can maybe you’re not always happy, but you can be accepting and okay wherever you are and whatever’s happening. I love your analogy of that effect. That’s great. The centering device, it’s a clear image I’ve been learning to expand that out. For some people who are terrified of feeling anything, you can only expand it a tiny little bit at a time but you slowly start to move it out and start to step out of the cage a little bit and be able to live more fully and thrive.

Part of it is all of the skill building and you quote Thich Nhat Hanh in your work about how peace can only exist in the present moment. If I can build the skill of staying awake and aware, not only is it this great benefit because I don’t have to turn around the car on halfway to work and go back and get the stuff that I didn’t put in the car. I’m more aware and awake in the moment as I’m doing my morning preparations, but it also starts to expand the potential for an entirely different experience of my life events.

If you’re like me with two kids and two cats, I still forget things I need on my way to work, but I don’t have to stress about it as much. I can recognize that it is what it is and then move forward.

For most of us, it isn’t, “It’s dementia.” It’s, “I was distracted. I was thinking about other things. I wasn’t in the moment.” I say, “Let me be more awake in the moment now and decide if I want to turn her on and go get those things or just drive on to work and do without,” and I don’t have to add all of that volume and intensity to the negative self-talk, the fear about dementia or whatever. It’s many of us are trained to do.

It’s huge.

As we shift and become more centered and grounded ourselves, we influence those around us. Click To Tweet

In the book, Buddha’s Brain, it talks about how our brain developed and it makes good sense that we evolved to overpredict for the negatives.

The negative bias.

If I dive into the bush every time I hear a noise, I might be diving away from a rabbit or a deer that couldn’t hurt me. If I dive in the bush every time there’s a noise, I also dive in a bush when there’s a tiger or a bear. I end up surviving more than the people that every time there’s a noise I go, “It’s a curious noise. Let me go explore and decide what it is,” and then they get eaten and then they don’t pass on their genetics. There’s a level of heightened awareness. We see it in the police training these days, they have dramatically reduced the number of police fatalities as they’ve trained police people to have this ultra-high sense of awareness whenever they have the uniform on. You might be killed at any moment. They’re living their lives at this agitated almost right at the fight or flight state and the vigilance for it and they survive more. The impact on their physiology is increased blood pressure problems, diabetes and stress. All of the chronic stress diseases in the police is elevated.

We don’t have to look far to see how that results in behaviors. Reacting before it’s necessary because you’re at such a place of hypervigilance. A toy gun or a facial expression becomes a threat.

They survive more so it works. It’s like how our brains got passed on to be this high level. We currently don’t live in an environment where there’s a life-threatening danger around every corner, but that tendency for our brains to overpredict the negative is now counterproductive. If we can be aware of that, catch it, call a timeout, question it and say, “Take a breath,” if my body will let me take that nice, long, slow, deep breath, it’s an irrefutable signal to my body that this isn’t a life-threatening situation. The whole system starts to calm down. I then get a bigger picture to look at and I make better decisions about where to move next in this next moment. If I stay in that heightened vigilance, my picture gets small and I’m looking for the outside validation of the inside experience and it becomes this perpetual loop.

Not only that, but when we’re stuck in that loop, it influences those around us so those around us are more likely to be stuck in that loop especially if you’re a parent. Without question, you’re passing that same loop onto your kids and they’re experiencing that same level of threat even if they aren’t, even if they don’t see a threat around, they’re feeling it. As we shift our own and become more centered and grounded ourselves, we influence those around us. That’s a trickle effect, which so much of what’s going on now. Everyone’s reacting in fear and in a cultural way our entire society. Each one of us is becoming more and more pertinent that we all have to step back and ground ourselves first so that we can see clearly and figure out what the next best step is for ourselves and collectively.

I wanted to ask is there a preferred way you want people to contact you, where you’d prefer them to buy your book, Healing Depression Without Medication or another topic that we haven’t even touched on yet that you’d like to put out there in this first of our hopefully series of interviews with you?

I can’t think of a topic I want to go to right this second. The book is available anywhere, although I’m a huge proponent of indie bookstores, if at all possible. I can be found at JodieSkillicorn.com is my website and on Facebook, @MindfulPsychiatry and @DrJSkillicorn.

The book title is Healing Depression Without Medication: A Psychiatrist’s Guide To Balancing Mind, Body, and Soul. I hope you will come back for a series of these talks, so we can talk a little bit more detail about some of the corrective skills that you teach people. I’m thrilled to have this book as a resource, to refer my patients to. I look forward to our next conversation.

That sounds fun and thanks for having me. I enjoyed talking with you.

It’s a pleasure. We will talk again soon. Thank you.

OYM Jodi | Healing Depression

Healing Depression: We keep retelling these particularly negative stories, and these stories not only amp up our nervous system but create a cage that doesn’t exist.

 

Take care.

Dr. Jodie Skillicorn is board-certified in Psychiatry and Neurology and a diplomat of the American Board of Holistic Integrative Medicine. After graduating Phi Beta Kappa from Skidmore College with a BA in English and working for nearly a decade as a photo journalist. She attended Ohio University Heritage College of Osteopathic Medicine. She completed her Psychiatry residency at Northeast Ohio Medical University. Dr. Skillicorn is the author of the book, Healing Depression Without Medication: A Psychiatrist’s Guide To Balancing Mind, Body, and Soul.

At her private practice in Stow, Iowa, Dr. Jodie Skillicorn integrates conventional medical training with evidence-based holistic methods that include breathwork, meditation, yoga, mindfulness-based cognitive therapy, Eye Movement Desensitization and Reprocessing known as EMDR, emotional freedom techniques, mind-body medicine, nutrition, exercise, and oracular acupuncture. Dr. Skillicorn believes strongly in the body’s ability to heal itself if given the resources and support and the importance of empowering patients to take back their own health through simple but effective lifestyle changes.

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About Jodi Skillicorn, DO

OYM Jodi | Healing DepressionDr. Jodie Skillicorn is board certified in Psychiatry and Neurology, and a Diplomate of American Board of Holistic Integrative Medicine. After graduating Phi Beta Kappa from Skidmore College with a BA in English, and working for nearly a decade as a photojournalist, she attended Ohio University Heritage College of Osteopathic Medicine.

She completed her Psychiatry Residency at Northeast Ohio Medical University.

Dr. Jodie Skillicorn is the author of the book, Healing Depression Without Medications: A Psychiatrist’s Guide to Balancing Mind, Body, and Soul. At her private practice in Stow, Ohio, Dr. Jodie Skillicorn integrates conventional medical training with evidence-based holistic methods that include breathwork, meditation, yoga, Mindfulness Based Cognitive Therapy (MBCT), Eye Movement Desensitization and Reprocessing (EMDR), Emotional Freedom Techniques (EFT), Mind-Body Medicine, nutrition, exercise, and auricular acupuncture. She believes strongly in the body’s ability to heal itself if given resources and support, and in the importance of empowering patients to take back their health through simple, but effective lifestyle changes.

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