Julie Holland Prescribes Human Connection

Published Feb 23, 2021, 5:00 AM

In this episode, recorded several months into the pandemic, NYC-based psychiatrist Julie Holland assures Alec it’s not just him, we’re all having a hard-time. Dr. Holland says our brains are wired for connection and isolation is causing many of us to go into “fight or flight” mode where it’s harder to feel safe and loved. But there’s hope. Put down the phone, go outside, call a friend. Connect. And, for some, drugs might help, too. Holland has been deeply curious about the brain since high school and she’s a leading researcher in using psychedelics and cannabis to treat PTSD. In controlled settings, these drugs can restore a sense of being connected with others and the larger world. Holland is the author of several books including Good Chemistry, Moody Bitches, and a memoir, Weekends at Bellevue.

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This is Alec Baldwin and you're listening to Here's the Thing from My Heart Radio. My guest today is psychiatrist Julie Holland. She has a private practice in New York City and is the author of several books, including the New York Times bestseller Moody Bitches at a Memoir Weekends at Bellevue. For decades, she's been researching the use of psychedelics to treat mental health issues, with a particular focus on using M D m A and cannabis to treat post traumatic stress disorder. Many people are struggling with their mental health in this long period of social distancing, but Holland says, even before the trauma this pandemic has caused, we were not doing that well mentally. I've been doing phone sessions from up here in Duchess County, UM, and some of my patients are still in the city, but a lot of my patients have sort of flown the coup to places where there's a lower density of people, but importantly places where there's more nature and they're getting outside. Um, they're getting more sun, more nature, and that I think for me, it's been a real bomb and one of the things that's helped me feel balanced or saying, you know, a good antidote sort of to how toxic the news is and everything that's happening is if I go out into the woods or the swamp or the lake, and I really feel much much calmer. You know, we can discuss what the snapshot is and what the health of the country is and beyond during the COVID, but to whatever extent you're willing to venture an opinion, what was the mental health of the country like prior to the Cobb Oh? Yes, well, you know, we actually had a couple of big epidemics before this pandemic, right. We had the overdose epidemic. We had more and more people, uh, not only dying of opiate overdoses or accidental overdoses, but also more people drinking themselves to death. And we also had what was called the epidemic of loneliness, where we had more and more people living alone. Everybody had gotten into their own little pod even prior to this pandemic, but we were not happier because of it. I mean, all the isolation. People felt very lonely, which makes people feel both depressed and anxious. I would love to talk more about why social isolation makes us so anxious. You point out that there are strains in our society beyond the COVID, the predate the COVID, and I want to get to later on when people are isolated COVID or no, and when people are feeling an abundance of distress, are the cures, healthcare, guaranteed income ways to address I mean, it seems that people are lonely, they can't afford healthcare, they can't afford food, and they don't have a job. The constant fear of the future. Right, So it's impossible for me to talk about depression anxiety without talking about politics and health policy and social policy. They're so intertwined. And you were asking, you know, before the pandemic, how were we doing, and I was saying, we really weren't doing very well. You know, whenever there's sort of gross inequality, a lot of people aren't going to do well. And it's not just that they have more physical problems, but they have more mental health problems. And addiction is a sign of unrest and on wellness. It's not really a thing in and of itself, it's a symptom of something bigger. So the fact that we had more and more people addicted to opiates and and overdosing. I mean, there was a glut and there, you know, there was a lot of money being made and making the drug and distributing the drug. But you know, gobormates is this great thing which is don't ask why the addiction, asked why the pain. We were in pain. People were in pain before the pandemic. You know, nine eleven was very tough on the inhabitants of New York City, and people got very anxious and started paying more attention to political issues. And then, honestly, you know, after Donald got elected, you know, everybody in the town who knew him and knew who he was and what he was made of, there was a lot of despair and and anxiety. And you know, the type of people who come to see a private psychiatrist I think tend to lean left, honestly, so I definitely have a bias sample. But my patients were really not only afraid for the country and for our democracy, but also for the planet. You know, there's this sort of background app that's always running, whether we know it or not, which is that we are in sort of mourning for what's happening to the planet, and there's a deep level of despair. And the more disconnected we are from ourselves, from our friends, from each other, from the planet, the worse we feel. The more depressed we are, the more anxious we are. So it's been going on, and I would add to that, we're moving further and further and further away from a connection between the will of the people and what the government's going to do. The government operates completely independent of the will of the people, right, and they do whatever they want to do. They just ignore what mainstream thought is about. But the end result for we the people is that we get despairing and depressed because we're powerless. Right, It doesn't matter what they want, right, I mean, you know, the popular vote doesn't matter. This sense of powerlessness is a setup for depression. Right. This is your fifth book with a book like this comes along once that process, Like how did this book start to germinate with you? This book started to germinate while I was stand up paddling on a lake and there was mist. There was all this mist coming out of the lake, and I wanted to be in the midst. I'm going to be enveloped in the mist, and I was paddling out to where the mist was, but wherever I went, it seemed like the mist wasn't there anymore, and it was somewhere else. And I would paddle somewhere else where it looked like the mist was thick, and then it wasn't there. And the thing I finally realized is you're in the mist. The mist is all around you. It's just that because of the light, you can't see it, but it's there. And it was, you know, the sort of epiphany to me that you know, we're always chase sing for things, and really the things that we want were the really right in our backyard. And you know, while that ended up not being the main message of good chemistry, it is definitely a message for me now and for my patients now that you know, a lot of people were spinning their wheels and running around and now that they're sort of stuck in place, it turns out that they do have a lot of things that they need and that it's been good to sort of hunker down and go inward or be with family. You know, it's a cocooning period. One. Yeah, in the beginning, everybody was like if I just knew when this would end, I would be okay, you know, if I knew it was just for the summer or you know, I mean when it started, it was like when if I know it was just April, right, But that was a big deal. For the first few months with my patients, was just this idea that they needed to be able to encapsulate it. You know, if it could be compartmentalized, then they could deal with it. But this idea that you don't know how long it's going to go on. The thing, obviously, Michael Turn is about my children. I mean my children. I want their social skill ills to mature, and I want them and they're growing so quickly. My daughter who's seven now, I mean she's like Lillian Hellman, you know, the stuff that comes out of her mouth now, which is kind of amazing. She's so sharp and so clever and so and I want, I don't want their development, which prior to this we were kind of thrilled by. And I'm just really just chattered and I'm in a lot of pain that I'm suffering about how although there's some beautiful unintended consequences where they found each other and they only have each other. So the bonding and the relationships between them have become so profound. But my kids, like when you have a five year old boy turned to you the other and he goes, I missed New York. You know, he said, I missed New York, and I'm not thought to myself. You know, it sounds like Steve Rupel in prison. You know what I mean. I missed New York. I missed Studio fifty four. You know, my son's five, and he's like, I missed you. I'm going, Oh my god, tore me apart apart. You know. In my dealing my patients, sometimes I'm talking to a parent who's very worried about their kid and whether their kids going to go in or or go virtually. Um. I also have some patients who are teachers who are really worried about the kids. And and you know, everybody has a different opinion about what should happen. Everybody has the same fears. Everybody wants what's best for the kids. But it really is a no win situation. You know. It's just like everybody gets the misery spread sort of thing. Nobody really gets exactly what they want, you know, certainly with hybrid it's for my teachers. It's like the worst of both worlds. But the thing about our kids is, you know, we know what they're missing. You know, my son didn't get to be a c I T at camp, or uh, you know, didn't get to play drums in the in the high school musical, or somebody didn't get to go to the prom. Like, we know what those things are and we know what they're missing. But the kids themselves who haven't they don't know what they're missing, they haven't gone through it. I think it's actually easier on them. I mean, I'm not saying it's easy on the kids. I know, and more kids are being diagnosed with anxiety and being treated with the antiangs I d meads right now than ever before. So no, it's not easy on them. But sometimes I think that, you know what we wish for them, it's this extra layer of mourning or anxiety that maybe they don't even really have. I mean, they are more resilient, certainly. I've told this story before, I think on this podcast, so I'll do the distilled version of my friend who lived in Italy. He was British originally and he was there for several years. And he came back and I said, when you came back after nine years in Italy, what's the changes you noticed? He said. One thing I don't like of these applications that these people have for dating and meeting. He said. The other thing I hate is ways, because sometimes getting lost it's the greatest thing that could happen to You might get lost and go somebody to get directions, and when you go to the gas station you meet your wife of the cash register, right, And he said, we've taken all the serendipity out of out of the world. Now do you find that people are leading on apps, devices, all this kind of stuff social media more than ever now? Yeah. You know when when I wrote Good Chemistry, it was before COVID, but I was already saying, you know, put down your phone. You have to go out and see people in real space. First of all, you know, anybody's profile picture, like maybe it's them, maybe it's them on their best day, or maybe it's some photoshopic not even be them. I mean you just you just don't know. And also it's not you know how tall somebody is or how they look three dimentially, it's really is also how people smell. And this is something I explained in Moody Bitches that we actually mate to some degree. You know, Pheromone detection is a real thing, and it helps us figure out not only whether we like the way someone smells, but whether they would be a good physiological match for us on a genetic level. You know, if you're immune to five things and somebody else is immune to five things, if you have a kid, it's possible that kid will be immune to all ten things. So you want somebody who's a little bit genetically dissimilar to you. And one of the ways that the body figures that out for mating is through smell, So you know, until there's like a scratch and sniff app I think that people are going to have to really you know, it's good to get together before you know, I just tell people to I mean before COVID, I was like just you know, meet for a coffee or whatever. But you can get so delusional about who you're texting or you know, if they happen to spell the way that you think, you know, if you care about spelling or uh, you know it's political, but like you know, they you really it's not just about how they spell and it is. You know, there are such things as like auras and energies and you know, souls and spiritual things like that. And you know, I know psychiatrists aren't supposed to say any of those words, but I think they're real, and I think that you know, intuition is a real thing. You know, your gut reaction to somebody, you're not gonna get. You just gonna project all of your own things onto something because you don't have enough information. Back to the book, which is that so the mist is everywhere and you're pandling yourself towards the mist that it's there. But what did you want to cover in this book? What did you want? What experience? What people have when they read the book. Well, the book is really about how important it is for us to connect and sort of the physical aspects of connection, the physiology why our bodies are designed so that if we feel connected, we are soothed, and if we feel disconnected, we get kind of agitated and anxious or depressed. So it's about these very basic ideas of connecting with the self, being in your body, being present in the moment. Right. So the way good chemistry is set up. The first chapter is about connection with the self. The second chapter is about connecting with another person and all about pheromones and sex and orgasm and all that fun stuff. The third chapters about family and how those connections work from a physiological point of view. Right, So I start talking a lot about oxytocin, which is a hormone that's involved in pregnancy, nursing, delivery, and again, and it's very high oxytose and state for orgasm. Then after self coupled Family, there's a chapter in society where I talk about how communities connect and what the physiology is of that, and how oxytocin plays a role in us versus them. Right, if you think, oh, you're on my you know you're in my tribe, you're my people. But that guy over there, you know he's them, that's an oxytocin effect. Also, then there's a chapter on connecting with nature and about sort of ecological activism versus this. You know, feeling despair, you know that action will help you feel better, Plus it's better for the planet. Then the last chapter is about connecting with the cosmos, or perhaps if you're fortunate enough to have had a psychedelic experience and you've had a peak experience. You have this sense of everything is connected. You know, it all makes sense, it's all connected, and I'm part of that, and that is a peak mystical experience. It is also a high oxytocin experience. So the book is about oxytocin as sort of the the hormone or the neuro transmitter that underlies all these feelings of connection. They make us feel safe, like we belong. And oxytocin is an antidepressant. It can be used to treat drug addiction, and it coincidentally, there's some drugs that make you feel safe and like you belong, and that's one of the reasons why we use them. Psychiatrist Julie Holland. If it's connection you're seeking, subscribe to Here's the Thing on the I Heart radio app, Apple podcasts, or wherever you get your podcasts. If Dr Holland's research into psychedelics to treat mental illness has piqued your interest, be sure to check out the Here's the Thing archives. At my conversation with author Michael Pollen, I started looking at that really interesting question is why is the species? Do we want to change our consciousness? I mean, it's not adaptive, right, It puts you at all sorts of risk. But we have this desire and in fact, many animals have it too, which is kind of a mystery, which which animals have a desire to. Elephants love to get drunk, and you can imagine how much it takes. You can hear the rest of my conversation with Michael Pollen at Here's the Thing dot Org after the Break. Psychiatrist Julie Holland explains why she's dedicated her life to understanding how our brains are wired. I'm Alec Baldwin and you're listening to Here's the Thing. Dr Julie Holland says she's hearing from a lot of people who are self medicating their way through the pandemic. I'm thirty five years sober in a twelve step program, and I'm always mindful of, you know, the substitutive nature. You know what else did I put in their food? Sex, money, power, workaholism, love, addiction, whatever. I'm wondering if you have seen that with your patients as well. We're during lockdown. I don't want to use the word abuse, but you know, medicating themselves with food pornography. Yeah, definitely, all of it. Yeah, at the same time, well, you can multitask with you know, two computers, I guess in theory, um, I mean, there's there's a lot there to unpack, you know. We there are all sorts of ways that people soothed themselves. I think one thing to keep in mind is that the way most of us were taught. The earliest ways we were soothed were orally right, somebody stuck a past fire in your mouth, or a bottle, or if you're lucky, you got a nipple and abreast and a person holding you. But still there were times when that wasn't available. You learn to suck your thumb or bite your nails. You start eating, maybe if you're a woman growing up in the United States America, whenever you eat, you feel guilty, and then you end up soothing that agitated guilty state with more food. So the COVID nineteen like people gaining nineteen pounds during the quarantine, is a real phenomenon for my patients. The quarantine e has taken on a life of its own. I definitely patients who are smoking more pot um, you know, I thought it was fascinating that cannabis went from being you know, Schedule one illegal drug to like essential during the pandemic. That was like, okay, that's pretty interesting. Moon. And you know, the other thing I want to say about the sort of embarrassment of riches or a lot of abundance besides there being a lot of options of cannabis based medicines, is there's something really exciting happening in psychiatry now. You know, we've had a lot of the same tools for a long time, and some things are hard to treat, especially post traumatic stress disorder. And what we're seeing now with m d M A assisted therapy, which is better known as ecstasy or molly or psilocybin assisted psychotherapy, as that psychiatry all of a sudden has some new tools at our disposal. Ketamine is another very sort of separate and controversial issue, but at least people are getting used to this idea that they can have some sort of inexperience where they can examine themselves more, maybe look at their childhood trauma process. Some things come out of this altered state a little bit better, a little bit less depressed, a little bit less anxious. That's a new paradigm that's a completely different way of thinking about these drugs. Uh. This idea of psychedelic psychiatry brand new, pretty exciting, but something you've been in love for a while, not new to me, right. I want to talk about that. Be your beginnings in terms of that and your beginnings in terms of psychiatry, because as a psychiatrist, you're obviously a medical doctor, correct, I am, Where did you go to medical school? I went to University of Pennsylvania. Undergrad, I went to Temple for med school, so I stayed in Philadelphia, and then I went to New York City and I did my psychiatric residency at Mount Sinai Hospital, and then I spent nine years running the psychiatric emergency room every Saturday night and Sunday night, which was kind of a rock and roll psychiatry job. It was the e R at Bellevue Hospital, the psyche r. So after those nine years, I a book call weekends at Bellevue about my time there. But because I had grown up in the seventies and a suburb full of interesting drugs to try. And then when I was an undergrad, I started learning about this m d M a assisted psychotherapy, which I was very interested in because when I was at Penn, all of a sudden, I was reading about and hearing about a new drug, and like you know, when you're studying psychopharmacology at at undergrad and there's a new drug that's a that's a big summer for you. So I got very interested in m d m A and I wrote a big paper about it because I was at a summer school class I was taking um. That turned into the Ecstasy Book, and that was my first book. I assigned chapters to every expert um on every different facet of M d m A. And then a few years later I ended up doing that with the Pop Book also, So those are actually two books that I edited. I wrote some of it, but not all of it. I knew I was going to be a psychiatrist from a pretty young I mean I knew I wanted to do something with the brain, well, knowing that psychiatry involves a far greater commitment academically because of the medical degree than of being a psychologist or a social something related. What's the impulse to psychiatry in the young woman from your background? Like, when did you know you wanted to do this? And put in all that time I wanted to be a doctor from a pretty young age. I mean, you know, I was definitely the kind of person who played doctor, you know, wrapped people up in bandages. I mean I I am. I was a smart kid, was very interested in drugs, very interested in the brain. Um pretty sure I was going to be either like a neurologist or nursergon or psychiatrist before I even went to undergrad Like, I chose pen because they had a major called the Biological Basis of Behavior. It was all about the brain and psycho farm. I had a subscription of psychology today. When I was in high school, Like, I was one of those kids who just kind of I like this, and what did your parents do? My mom was a science teacher, and my dad is a structural engineer, very analytical. I was interested in science, and I was very analytical. And and I grew up in the seventies where just drugs were all around me, and I was fascinated that a little piece of paper could make you, you know, see the world in a completely different way. And how would you distinguish for people who don't have that much of an intimacy with certain kinds of pharmaceuticals? And a certain kind of drugs. Like for me when I was growing up and I was in my you know, riding the range out there in my drug and alcohol phase. Uh, you know, cocaine was the king. But for people who don't know about ecstasy and psilocybin, you feel there are benefits to either or both, Why what did they achieve in terms of therapy? So here's what I would say about m DMA and psilocybin in terms of psychiatry. I mean, first of all, the thing to keep in mind is, right now, these are still research chemicals. They're not legal. People can't prescribe them, but they are both going through an FDA approval process so that they will be prescribable in the context of their rapy. Right. So this is not you know, buying a tablet of ecstasy or some white powder that somebody tells you as molly and being on a dance floor and getting overheated or overhydrated, and those things are seriously dangerous. Also you just don't know what you're getting. This is in the context of that you're lying on a couch with a hundred and twenty milligrams or maybe even only eighty milligrams, which is pretty low dose of pure m d m A. You're not dancing for hours, you're not overhydrating, so the medical risks in that situation are pretty minimal, which is why the FDA is allowed these studies to go ahead. Right now, there are multi center trials going on with m d m A assisted psychotherapy sessions all over America and a few other countries, and psilocybin assisted psychotherapy research is happening in America and all over Europe and given to who for what, so for Some of the psilocybin studies are for treatment resistant depression and some of them are just for regular major depression. The m d m A studies are looking at pos traumatic stress disorder. There's also one m d m A study where they looked at social anxiety in adults on the autistic spectrum. For people who don't know anything about ecstasy or molly or what, you know, this is methylene dioxy meth emphetamine m d m A. So the methymphetamine part may sound familiar to you. It's sort of a cousin of speed, but it has a more of a psychedelic component to it, So what you end up with is something that increases your serotonin massively, so you're very relaxed and you feel sort of satiated, like you don't need anything. It also increases your dopamine because of the methymphetamine base, so you are awake, alert, you have very good recall for the event. You want to talk, you want to dig, you want to conn. But there's one more very important part of m d m A as it increases oxytocin, so you have that sense of safety and connection, like you belong, and so you end up with this sort of you're calm, but you're open, right, So the openness like open to bonding, open to trusting, open to looking at your ship. You know, it's almost like anesthesia with or without surgery. Like when you go to therapy. You get to a certain point where you're like, oh no, that hurts that bad stuff happened there. That's too tender. I don't want to talk about it. And the therapist says, okay, maybe next week we will. But then maybe you cancel and you don't see her. You know, it fits and starts. It takes a long time for therapy. This is one or two sessions where you feel comfortable enough and trusting enough, but awake and alert enough that you can really do some digging. So it is like a catalyst for therapy. So that's M D M A and psilocybin is different. It's something really different. Well, right, so it's you you have a mystical psychedelic experience. Maybe you're in a void which is scary. Maybe you are in that place where I said, like where you feel like everything is connected in your bathe with love. But what happens reliably and people when you give them psilocybin is you can do some mystical experience. And when you have that sense of everything is connected and love is the answer that when you have that sort of big experience, it can lead to a lot of behavioral changes. And also there's something called neuroplasticity, which is the brain rewiring itself. I'm up for that. I need that, right. So there's some psychedelics that cause neurons to grow or synapsis to grow. You get neurogenesis or synapter genesis. This means you're getting new brain cells, new connections. So not the frying pan and the egg that we are exposed to in the eighties, Like this is you know, this is drugs. This is your brain on drugs. It really for these particular drugs, it is quite the opposite where you've got new brain cells, it's not killing brain cells, and you've got new connections, a little bit of rewiring. But do you do some predictive kind of work, like for example, you say to me hallucinogenics like psilocybin, and I think to myself, I'm sitting on my couch and I take this pill and all of a sudden, I feel like I'm paddle boarding into the mist on a lake and upstatement, you are going to have left my couch, right do you do? You do you do predictive things with them before you give them the drug before because because some people might have a negative reaction to it. Not okay, so quite so. The most important thing I can tell you is it because this is just research. Now, people are screened like you and believe, very heavily screamed. Right, So if you have a history of psychosis, if you have a family history of psychosis, you're not going to be on that couch. But you know, I actually don't say hallucinogen because it's it's not like you see pink elephants that aren't there. I mean, you know with with SILSA, I mean you may have visions, but you kind of know their visions. You know, you don't start interacting with things that aren't there. But their mind manifesting medicines, their consciousness medicines. And I would say, Alec that these are disruptive medicines and psychiatry. This is a disruptive paradigm making therapy go deeper and faster and getting people to turn away from instead of taking a daily dose of antidepressants or anti anxiety meds, they're having single sessions or maybe two or three sessions over half a year or a year, but they don't need the daily dose afterwards. And in the m d M A PTSD studies, they're not meeting criteria for PTSD at the end of the study. When did you ascertain that you had developed the ability to know when you were taking drugs and you were self medicating in a recreational way, and when you were taking drugs and it was part of your scientific research, Meaning when did you sidestep the Dr Checkl and Mr Hyde steven sony and a chapter of your life there? Well, I would say for many people who use drugs. It is a daily calibration and a daily question and an important question to be conscious of. What is your relationship with this drug? When are you using it, How are you using it, Why are you using it? Is it interfering with other things that need to happen? But you know, I think these are hard questions. Did you come to that point yourself when you were younger where you said there are things you were doing that that you thought you thought as if this isn't helping me, right? Sure? I mean I I smoked cigarettes for years and years and years before stopping, and that was something I'm a singer, so I knew that that was just stupid to do. Um, but it was really hard. And I quit cigarettes twice for two years and started up again twice, and I was amazed. Um, I knew I could quit, so I knew I could start up again. And the kind of rationalizations you make when you started up again. I know you grew up with brothers. I grew up with sisters, but I'm I'm the youngest of three, and you know I was I wanted to do what their friends were doing. So when I was eight, I had my first beer. When I was ten, I had my first cigarette. When I was twelve, I have my first cannabis, and when I was fourteen, I have my first psychedelic. So very young, yes, precocious, but always taking notes, learn learning, going to the library. You know, we didn't have the internet back then. You want to learn something, you had an encyclopedia, or you asked your mom to drive you the library. But I would do like any time I had to do a report, you know, I would be doing it on the brain or on the Smoking thing was the thing you did when you were very young. It wasn't like five years ago your husband catches you in the bat in the in the garage smoking out there in the country. So I mean, thank goodness. I quit smoking right before I met Jeremy. And it's a good thing I did, because I don't think you would have spoken to me if I had a cigarette in my hand. So I quit when I was twenty nine. But I smoked, you know, steady from like fifteen to twenty nine, and not so much steady from ten to fifteen. But still I would like bumb cigarettes from people. And it was like, look at this cute little kid bone a cigarette. That's so cute. Yeah, and I've got a handful of friends who are formally getting divorced now. Of course, the groundwork was laid prior to the COVID, but the COVID has certainly pushed everybody over the edge. They filed for divorce, They're getting divorced. Not a discussion anymore, They've moved on. I was gonna mention before when I said that people are falling back on and relying on different things to medicate themselves, like food and media and social media and TV watching and pornography. I thought, you win a house, and you're just as likely, maybe not more likely, but just as likely to go in the bathroom with a computer and have online sex, you know, and watch porn than you actually have sex with your partner in your house because the two of you are so sick of each other, like like normally there is there is there like a spike in the birthrate after a lockdown, And are we not going to see the spike in the birthrate from this because everyone's in the bathroom doing their own thing. Now, Yeah, well, then connecting with that person a couple of things there, I mean, you know, I actually I wrote about masturbating to porn quite a bit in moody bitches, because you know, when you have an orgasm, you have an increase in oxytocin that makes you bond or trust or be open to the person who enabled that orgasm. But if you're doing that with your laptop, are you bonding with your laptop every time? So maybe? But the other thing I will say is that I definitely have patients who have left their husbands or left their partners during these past six months. There's no question this has been like a crucible where you're like, oh my gosh, we're in the best place we've ever been in or yeah, no, that's over. So um. There's not much middle ground here. And when this ends, if it ends how it ends, there is going to be post traumatic stress disorder. I think that's pretty clear. You know, we are currently being chronically stressed, and so in theory, once the chronic stress is over, then you have the post traumatic stress disorder. You know, people who have PTSD. From nine eleven, It was a terrible day in New York City, but it was one day and then it was over. Psychiatrist Julie Holland. When we return Julie Holland talks about why the pandemic is particularly challenging for already anxious kids. I'm Alec Baldwin, and this is here's the thing. I wanted to understand why someone starts seeing a psychiatrist. So usually if somebody comes to me, it's because they're already in therapy and their therapist is saying, I think you need to talk about medicines. I think medicines would help you. So they've already sort of gone past the threshold. It's not just like people are coming to me and saying, you know, I feel lousy and I don't know why, although I mean back in the nineties that was the case. The people were just I don't know what's the matter with me, and I would have to sort of hold their hand and convince them that, you know, maybe they ainty medicine. I don't have to do any kind of destigmatizing with medicine. Now everybody knows somebody who's taking antidepressants, anti anxiety meds, sleeping pills, they're everywhere, right, they're advertised. We you know, we're all sort of soaking in it. So I do think ever since nine eleven, I think a lot of people got permission to medicate themselves, so when they come to you, it's beyond talk. So yeah, they're coming because they're wondering if they need medicines. They hit a wall, they need the medicine to get through that wall. They've definitely hit a wall. Or I have people coming to me who've been on medicines for years who want to get off, and that's something that I help people do. And it's really complicated to get off antidepressants when you been on them for decades, which unfortunately happens a lot. You know, these meds were really only studied to be used for six months or maybe twelve months, and in some people you have to take them long term. But almost everybody, they get on them and they stay on them because they do make it easier. You know, what I talk about in good chemistry is they don't necessarily give you more connections in your life. They just make you not mine that you're disconnected. That's my friend. My friend said that once. He said, I took drugs because I wanted to care less about my problems, he said, And I stopped dating taking drugs because I wanted to care again. I wanted to care again. And he said, and that that was the mechanism in which I can then move forward and start to care about what's happening to me, my loved once, my children, right and then and if you care, you can make changes. And you know, I definitely want to say for the twelve step programs that there is a lot of love in those rooms, and there's a lot of connection in those rooms. And you walk in fit's your home meeting, and you're going again and again. There is that sense of belonging and safety and all of those things feeling connected, feeling safe, feeling like you belong to something bigger than you. Those are high oxytocin states that get you out of fight or flight and into this whole other paradigm for your body, which is called the parasympathetic nervous system. Right, So it's the opposite of the sympathetic nervous system. And good chemistry talks a lot about how to get yourself out of fight or flight and over into what you could call rest and digest or connect and protect, or tend and befriend. But it's it's the things that aren't fighting and running away. It's things like staying and negotiating and cooperating and collaborating. You know, all those things can't happen when we're in fight or flight. And if we're being traumatized, and if we're afraid of contagion, and if we have a sense of powerlessness, we're all going to be in fight or flight way too much of the time. Are you concerned? I mean, our research such as it is, you know my show, are producers that anti anxiety prescriptions for kids have on up significantly during the COVID. Does that concern you? Oh? Absolutely? Yeah. First of all, you know, over pathologizing women and children is really a reflection of the sort of patriarchal structure in medicine. But we you know, some people get sort of narcissistic about their kids, and their kids are like extensions of themselves, you know. And there is a little bit of a sort of a niche population in New York City where it's almost like you take pride if your kid is going to a psychiatrist, or your kids in therapy, or your kid has like special classes or something. So here's the thing. Are culture is pretty toxic right now and very anxiety producing right now, and it is normal to be anxious fear of contagion is a real thing, and it is normal to be afraid that you're gonna get sick, or that your parents are gonna get sick, or that your grandparents are gonna die. That's all normal anxiety. And then it's normal to be anxious if you don't know what's going to happen next month or next year, or whether you're going to be in class or at home, you know, or whether you're gonna be allowed to touch your friends or hug your friends or play sports. I mean, there's so many reasons we have right now for kids being anxious. All the rules have changed, right that everything they used to be able to do, they can't do anymore. And also wearing masks. And I'm not saying that we shouldn't wear masks. We should all wear masks, but you know, it would be great as if we had clear masks because interpreting social cues, if we could interpret social shoes. You know, now with a mask, you can't tell if someone's smirking at you or smiling or yawning, right, and so and our brains because back when we were cave people, if you got kicked out of the group, you were gonna get picked off the herd. You were gonna die, or no one was going to share their food with you, or no one's going to help you build a structure. You know, if you weren't in the club and in the tribe and you got separated or ostracized, you were gonna die. And so we still, on a very deep level, have that kind of reaction. Am I safe? Am I in the group? Am I okay? So when you're on a zoom meeting and there's like eight people, your brain is scanning, scanning all the time to make sure everybody's okay with you. And if it's a herky jerky connection or you can't see their face or their cameras off, that's missing data that your brain is trying to, you know, fill in. So that will make us anxious. So these kids that are on zoom calls or the kids that can play with their friends but they can't really play the way they used to play. And don't don't go run to Johnny. You know, Johnny's dad works in the emergency room. Don't stand back like the rules keep changing, the social rules are changing, and they and they can't be held and comforted by so many people Now it's just maybe your parents and that's it. I have always viewed myself that I've typically been for most of my life. A person that functions under my trust is yours to lose. When I met people, I was very open, regardless of what I did for a living. And now with this what's going on in the world, as much as anything in combination with the COVID, it's made me think, you know, my trust is yours to gain. I'm going to go out in the world now filled with suspicions. I'm wondering, do you find that this suspicion, this neurosis about going back out into the world. Are we going to go back into the world and everyone's going to be different. Well, so there's a few things that are making us suspicious. We're worried about somebody getting us sick, and we're worried about our democracy crumbling and that people around us don't get it or they're so misinformed that they're never going to get it. Yeah, it's all completely terrifying. So look, you know, the the idea with oxytocin is if somebody makes you trust them, then you are more open. You have more oxytocin you become more trusting. They feel that you're becoming more trusting, they start to have more oxytocin and its cycles upward from that, you know, more eye contact if you could hold them or like a really great but but is everybody get to turn the oxytocin spick it off when they go out? It has been turned off? First of all, you only have oxytocin if you're in that parasympathetic state. We're calm, right, so it has been turned if you know, here's the analogy I give of. You know, when you're in fight or flight, which we all are now, right, if your kitchens on fire, you don't pick up the phone if it's ringing, or make a call, or you know you're that a fire and like where's the fire extinguisher? Or have to run out of the house. You don't have any social skills. You're not. There's no niceness there. So the more we're in fight or flight and the more we're in the sympathetic mode, the lousier are social skills are, the less we trust, the less oxytocin we have. You know, you don't really have oxytocin when you're in fight or flight. You have adrenaline and cortisol. And this is why we can't sleep. You know, we're biting our nails, we're trying to soothe ourselves orally, you've got this fat around your stomach. It's because we're in fight or flight. It deranges your metabolism. It makes it very hard to sleep, you don't digest your food. Well, all the things that happen in parasympathetic where you can rest and digest and you can have sex and you can be social, none of those things happen when we're in fight or flight. Like for me, my fear this is so antathetical to my nature. But my fear is I'm gonna go out into the world with with this idea of like the less people in my life now the better people are the problem. And I need people in my life on an as needed basis. Everyone who's in my life, why are you in my life? And if I don't have a really good reason, it's it's literally like we're all gonna on an emotional level, we're gonna go in and we're all going to clean out the closet now right, Well, it's like does this person spark joy or not? No, they have to go. So yeah, but that's good. I want to say one thing about your on WE at five o'clock in the evening, and that is, if you ever have a morning that you can get out and go see a sunrise. It is the antidote to that on WE that if you happen to be around for dawn and sunrise, you will have a little more hope. Um, and you know, don't bring your phone, don't don't like no news, have like an hour of nature, you know. No, I turned my phone off a lot. I've been doing much better with my phone. Well, listen, I think, I think if you read me correctly, I'm not quite sure, but you are a professional listener. What I want is I want to take some pharmaceuticals with you, and we're going to paddle out into the mist together. We're gonna just open ourselves up to whatever the universe is telling us. I mean, I'm being silly, but it's like, well, it's soothing though. It's like hydrotherapy, you know, just listening. You know, first of all, even just the salt air, even just smelling the salt there is good for your brain. Thank you so much for doing this with us. Thank you so much, absolutely my pleasure. Anytime you know you need to talk to a shrink, you come call me. I'm gonna get in touch with you, okay it' Psychiatrist Julie Holland has a private practice in New York City. I'm out like Baldwin. Here's the thing is brought to you by my Heart Radio. We're produced by Kathleen Russo, Carrie donohue, and Zach McNeice. Our engineer is Frank Imperial. Thanks for listening all

Here's The Thing with Alec Baldwin

Award-winning actor Alec Baldwin takes listeners into the lives of artists, policy makers and perfor 
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