What Makes Up Your Mind

This episode of What Makes Up Your Mind continues our mini-series on AI4MH, Stanford Psychiatry’s Special Initiative of the Chair, AI for Mental Health. This time, we delve into the newest frontiers of Human-Centered AI, Computer Vision Tools, Passive Sensing. Along with the meticulous training and testing of specialized Large Language Models for better and faster diagnoses of mental illnesses, our guest expert is also utilizing AI technology for catching the earliest, often undetected signs of cognitive decline with human trials already underway.Dr. Ehsan Adeli is a Stanford Assistant Professor of Psychiatry and, by courtesy, of Computer Science and of Biomedical Data Science. He co-directs the AI4MH Initiative, Directs the Stanford Translational Artificial Intelligence (STAI) in Medicine and Mental Health Lab, and shares leadership of Stanford’s AGILE Consortium which stands for Advancing Technology for Frailty and Longevity.Follow the links for more on Dr. Adeli and his work, including developing information on a public symposium focused on policies and ethics of using Artificial Intelligence in Mental Health Medicine. And, listen to our other episodes in our AI4MH mini-series.About Dr. Ehsan Adeli: https://med.stanford.edu/profiles/ehsan-adeli and https://stanford.edu/~eadeli/AI4MH: https://med.stanford.edu/content/sm/psychiatry/special-initiatives/ai4mh.html/Stanford Translational AI Lab: https://stai.stanford.edu/Stanford AGILE Consortium: https://med.stanford.edu/ortho-agile.html

This mini-series episode of What Makes Up Your Mind looks at another aspect of AI for Mental Health (AI4MH), a Special Initiative of the Chair of Stanford’s Department of Psychiatry and Behavioral Sciences. Our guest, Dr. Shannon Wiltsey Stirman, is developing ways to utilize Large Language Models (LLMs) to enhance the delivery and availability of the latest mental health treatments for PTSD. As a professor of psychiatry with many years working with the veteran community, Dr. Wiltsey Stirman knows well how the shortage of therapists, and their over-extended bandwidth, limits their access to training and administering the newest in ever-evolving, evidence-based medical care. As co-Director of CREATE – Stanford’s Center for Responsible and Effective AI Technology Enhancement of treatment for PTSD, Dr. Wiltsey Stirman’s work is utilizing this powerful technology to close the research-to-provider-to-patient treatment gap. This is AI as a human-assist for therapists, not a replacement, and our discussion includes what current commercial chatbots can and cannot offer patients. Dr. Wiltsey Stirman is also co-Lead of the Stanford Mental Health Technology and Innovation Hub.More InformationAbout Dr. Shannon Wiltsey Stirman: https://med.stanford.edu/profiles/shannon-wiltsey-stirmanCREATE website: CREATECREATE on LinkedinBy & About CREATE: Research and articles Monthly Webinar Series: CREATE Webinars | CREATEThe Mental Health Technology and Innovation Hub: https://thetechhub.stanford.edu/AI4MH Initiative : https://ai4mh.stanford.edu

If our home, planet earth, is in peril (and it is!), then so are we. As we experience more frequent and ferocious natural disasters, the irreversible loss of life-sustaining habitats, and a climate we’ve turned into an adversary of our very existence, an existential crisis is brewing. Along with concern for our physical security, our mental well-being is being battered in these storms…figuratively, but also quite literally. Among the most affected and concerned are young people who are contemplating their future in a profoundly precarious world. Understanding, documenting, and measuring the emotional cost of their fears and anxiety is the work of Dr. Britt Wray, an instructor in Stanford’s Dept of Psychiatry and Behavioral Sciences, and the Director of CIRCLE - Community-minded Interventions for Resilience, Climate Leadership, and Emotional Wellbeing.In this installment of What Makes Up Your Mind, Dr. Wray shares her research into the extent of the trauma of Climate Change on our youth, and her global work in empowering them with tools to manage their mental health in the face of these threats, which includes finding their own ways to take action toward solutions.Dr. Wray's Stanford Profile: https://med.stanford.edu/profiles/britt-wray CIRCLE website: https://circle.sites.stanford.edu/

In medical research, Artificial Intelligence is a game-changer with its power to collect and cross-analyze masses of data and lab findings to find new discoveries. And more, its ability to be trained to unlock answers to specific medical questions offers a quantum leap in refining diagnoses and treatments.In this episode of What Makes Up Your Mind, Dr. Kilian Pohl (professor in Stanford’s Department of Psychiatry and Behavioral Sciences, and by courtesy, in Electrical Engineering) explains the basics of creating and using AI tools for improving mental health research, including in adolescent substance use, HIV, and lifelong brain development and aging.Listen in on how Dr. Pohl sees this technology bringing better mental healthcare to the entire world.More InformationDr. Kilian Pohl: https://med.stanford.edu/profiles/kilian-pohlAI4MH Initiative : https://ai4mh.stanford.eduComputational Neuroscience Lab: https://cnslab.stanford.edu

Anyone who has grappled with substance use, or loves a person with addictive behaviors, knows the wrenching relationship struggles and the often futile-feeling search for workable help.Well, this episode of WHAT MAKES UP YOUR MIND brings you hopeful developments thanks to the research and clinical work of our guest, Dr. Karen Chan Osilla, a licensed clinical psychologist and Associate Professor of Psychiatry in the Stanford Department of Psychiatry and Behavioral Sciences.Click LISTEN to learn about an empathy-based program called CRAFT - Community Reinforcement Approach and Family Training. A key focus of CRAFT, and Dr. Osilla’s practice, is to support the family and friends of the person with an addiction, thereby empowering them in their own wellness and as effective advocates for their loved one to consider treatment. The positive reinforcement aspect of CRAFT teaches skills that reduce the tension and confrontation that’s so often a part of personal relationships where addiction is present. It’s the opposite of Tough Love. Science shows this approach works, and Dr. Osilla’s research in opioid abuse confirms that. Read more about Dr. Karen Osilla, and find CRAFT resources here:https://med.stanford.edu/profiles/karen-osilla

Our conversation with this nationally recognized researcher and leader in Muslim Mental Health delves into her work of creating bridges between the science of medicine and the spiritual life of patients. Specifically, blending modern psychiatric and psychological treatments with the beliefs, customs, and rituals of Islam. Dr. Awaad’s research has renewed the recognition of the Islamic tradition of holistic care of mind, body, and spirit, reaching back more than a millennium. And, while her focus is on meeting the mental health needs of the Muslim community, the approach of welcoming a patient’s belief system into a treatment plan is applicable to all faiths, philosophies, and cultural experience.For more on Dr. Awaad, her work, and additional appointments at Stanford: https://med.stanford.edu/profiles/Rania_AwaadDirector of the Muslim Mental Health and Islamic Psychology Lab https://med.stanford.edu/mmhip.html , where you will find all research publications and links to Dr. Awaad’s many booksChief of centerspace Clinic, providing trauma-informed care within cross-cultural dynamics) https://med.stanford.edu/psychiatry/patient_care/centerspace.html

For neuro disorders like Autism, Attention Deficit, and Hyperactivity, causes and cures have largely remained a mystery. Yet, promising work in Stanford Psychiatry’s BRIDGE Lab is going after answers in the very nucleus of our cells, our genes, the infinitesimal carriers of information that determine the traits of all living things. Dr. Tamar Green, with help from participating families, is scanning the brains of kids with neuro conditions, mapping their genetic pathways to recognize, understand, and eventually intervene in disease-causing mutations. This intricate and microscopic research, sometimes involving more than 30-thousand genes in a single brain cell, is hoped to yield big and wide-raging benefits for treatments and, someday, cures.More InformationAbout Dr. Tamar Green: https://med.stanford.edu/profiles/tamar-greenThe Brain Imaging, Development, and Genetics (BRIDGE) Lab: https://med.stanford.edu/bridge-lab.htmlResearch Participation: https://med.stanford.edu/bridge-lab/for-families-and-participants.htmlResearch Support: https://my.supportlpch.org/give/489426/#!/donation/checkout

In this episode in our CNI-X Mini-Series on WHAT MAKES UP YOUR MIND we meet two of the Staff Mentors who add a unique dimension to Stanford Psychiatry’s Clinical Neuroscience Immersion Experience for high school students. Throughout the two week program, these college-age mentors - usually CNI-X alums themselves - share their knowledge and experience in neuroscience, facilitate discussion, and support participants as they gain confidence in exploring new subjects. Just by their presence, they offer the students an example of where they may choose to be in just a year or two in the future as college students, perhaps on their way to a career in mental healthcare. In this mini-pod, meet Nicola Manalili, who combined her love of science and the desire to make the world a better place and is now in her third year of college studying Public Health. Joining Nicola is Abhi Anand who fell in love with psychology in high school and caught the business bug watching Shark Tank with friends. He put the two together in a recent degree in Business Psychology and Marketing.Learn more about CNI-X, the role of mentors, and how to apply at https://med.stanford.edu/psychiatry/special-initiatives/CNIX.html

The subject is Circadian Rhythms, and you’re going to be surprised at the influence this intricate interaction of body clocks exerts over our lives! The high school participants in Stanford Psychiatry’s two-week Clinical Neuroscience Immersion Experience (CNI-X) always are when they meet Dr. Jamie Zeitzer, Professor of Psychiatry and Behavioral Sciences in the Division of Sleep Medicine. Dr. Zeitzer researches the mysteries of the system that drives almost every living thing on earth, and in humans impacts not just sleep, but everything from our temperature to the quality of our decision-making. As with all of the CNI-X presenters, Dr. Zeitzer’s research and discoveries make for an invaluable lesson in life and self-awareness, as well as science. For more on CNI-X, Dr. Zeitzer, and all the program presenters: https://med.stanford.edu/psychiatry/special-initiatives/CNIX

Bringing high school students into the fascinating world of Brain-Mind science is what the Stanford Psychiatry Clinical Neuroscience Immersion Experience (CNI-X) is all about. Along with the science itself, better understanding the human brain – the miraculous power of it as well as the conditions that can challenge its functioning – is information that will serve participants for a lifetime. This is the gift Stanford’s world-class researchers and clinicians offer CNI-X participants, including Dr. Odette Harris, Stanford Professor and neurosurgeon. Dr. Harris treats traumatic brain injury at all stages, from surgery through recovery. Her CNI-X presentation fosters the critical thinking needed to address the ethics of the life and death decisions that come with her work. Program participants get rare access to Dr. Harris’ unique perspective which is sure to leave a lasting impression.For more on CNI-X, Dr. Odette Harris, and all of Stanford’s expert presenters: https://med.stanford.edu/psychiatry/special-initiatives/CNIX

Teens have no greater ally in their life challenges than Dr. Rafael Pelayo, Stanford Psychiatry Clinical Professor and Sleep Medicine Specialist at the Stanford Sleep Medicine Center.An advocate of healthy sleep for all, Dr. Pelayo is especially passionate about how we - as a society - make it nearly impossible, through school schedules and achievement pressures, for kids to get the sleep they need. In his CNI-X presentation, Dr. Pelayo helps participants see the connection between healthy sleep and the very quality of their lives and relationships. In this mini-pod in our series on the Clinical Neuroscience Immersion Experience for high schoolers through the Stanford Department of Psychiatry and Behavioral Sciences you’ll hear why Dr. Pelayo is one of the unforgettable presenters in the two-week program.Go to https://med.stanford.edu/psychiatry/special-initiatives/CNIX for information on CNI-X, Dr. Rafael Pelayo, and all the program presenters.

It isn’t everyone who gets to interact and learn from world-class brain-mind scientists in a small, informal setting, but that’s the uniqueness of the Clinical Neuroscience Immersion Experience (CNI-X) for high schoolers from the Stanford Department of Psychiatry and Behavioral Sciences. One of the presenters in this two-week summer program uses the newest, cutting-edge tools to treat mental illnesses. Clinical Associate Professor Dr. Kristin Raj is the Chief of Stanford’s Interventional Psychiatry. She introduces students to treatments that “intervene” in the effects of resistant conditions, such as Transcranial Magnetic Stimulation (TMS) and Electroconvulsive Therapy (ECT) and delves into the thought-provoking discussion of what it means to work to “heal” but not “change” a psychiatric patient.Learn more about Dr. Kristin Raj’s work, including as Co-Chief of the Stanford Psychiatry Mood Disorder Section and as Director of Education for Interventional Psychiatry at https://med.stanford.edu/psychiatry/special-initiatives/CNIX, where you’ll also find everything you need to know about the CNI-X program.

What better way to build a mentally healthy and thriving world than to offer young people access to some of the very best researchers and care providers in mental wellbeing as they prepare to transition into adulthood?  Stanford Psychiatry’s Clinical Neuroscience Immersion Experience (CNI-X) opens the minds of highschoolers to greater self-awareness, the fascinating workings of their brains, and an opportunity to see themselves in a position to join the mission of improving mental health as career professionals.Learn more about this two-week summer immersion program, both in-person at Stanford and as a virtual experience, with CNI-X Program Manager, Dr. Laura Turner-Essel on this episode of What Makes Up Your Mind, then use the link below for application and financial assistance information for the thoughtful, curious teen in your life.https://med.stanford.edu/psychiatry/special-initiatives/CNIX

The leveling of the playing field between physical and mental health in the sports world may be underway in earnest, with an increasing number of high-profile athletes making their mental wellbeing a top priority and doing so in a very public way. In this discussion, we explore the unique pressures and expectations carried by elite competitors and the efforts of mental health providers to merge mind with body treatments for whole-person health. We also take a look in the mirror as fans to examine what drives the intensity of our adoration and criticism of our chosen athletes and teams. Our experts are from the Stanford Sports Psychiatry and Sports Psychology Program, the nation's first comprehensive mental wellbeing clinic for athletes, serving professional and Olympic athletes from around the San Francisco Bay Area, as well as Stanford's NCAA Division 1 student-athletes.From the psychiatry side of the clinic, we welcome co-founder Dr. Douglas Noordsy, Stanford Clinical Professor of Psychiatry and Behavioral Sciences, and Dr. Francesco Dandekar, Stanford Assistant Clinical Professor of Psychiatry and Behavioral Sciences, and the Associate Director of the Stanford Sports Psychiatry and Sports Psychology Program.As Dr. Noordsy explains, "The (athletic) performance enhancement work is mostly the domain of the psychology part of the program, while psychiatry is more to maintain mental health." Offering expertise in both in a centralized place makes perfect sense to Dr. Dandekar, "all of our services occupy space on the same spectrum of wellbeing." The psychology work is led by Clinic Director Dr. Lisa Post and Dr. Kelli Moran-Miller.In all, more than ten clinicians make up what Dr. Noordsy calls a "brain trust" of care. With backgrounds in athletics, they understand the unique aspects of competing at a high level while juggling other intensive activities like academics and critical life junctures.Balancing athletic performance with the rest of life's demands is among the top challenges elite athletes face, given the time and dedication needed to excel in competitive sports. While some can be motivated by and even thrive on such pressure, anxiety and depression are also not uncommon. Nor is the fear of career-ending injury or the insecurity that can set in during a long and arduous rehabilitation. Intense scrutiny of one's physical form can lend itself to body dysmorphia and eating disorders. And, just the sheer intensity of public attention – good and bad – might be an understandably disorienting experience.Through this lens, it's easy to see the importance of whole-person wellness for competitive athletes and, given the difficulty of navigating life in general, for us all.Follow this link for the Stanford Sports Psychiatry and Sports Psychology Program, its team of experts and the full array of services: med.stanford.edu/psychiatry/patie…care/sports.htmlTo learn more about Dr. Douglas Noordsy and his work: med.stanford.edu/profiles/douglas-noordsyFor more on Dr. Francesco Dandekar and the focus of his work: med.stanford.edu/profiles/francesco-dandekar

Much attention has rightly been given to the mental health of American children and youth since the COVID-19 pandemic upended their educational and social wellbeing. However, long before the virus hit, alarms were going off over the mental health condition of our adolescents and young adults.As you’ll hear from our guest in this episode of What Makes Up Your Mind, Stanford Psychiatry Clinical Professor Dr. Steven Adelsheim, research shows that half of all mental health conditions start by age 14, three quarters by age 24, but many go undiagnosed. Further, often when a condition is identified, Dr. Adelsheim explains there aren't enough qualified caregivers to meet the need, nor a cohesive system for early intervention and prevention.National data shows the onset of anxiety or depression can be as early as ages nine or ten. Comparing this statistic to when treatment is accessed - if it is - most kids are going seven to eight years before receiving care. Young people with obvious psychotic illnesses, meaning a loss of touch with reality, go an average of a year and a half before treatment. One in 5 under the age of 18 may be dealing with a serious mental health condition, and of those, up to 80% may be going without care altogether. It's estimated that only one-third of young kids with major depression have been able to access treatment. There is, however, a movement to address this with a proven record of success in countries like Australia, Canada, and Ireland. It's now debuting in the U.S., thanks to Dr. Adelsheim and the Stanford Center for Youth Mental Health and Wellbeing, which he Directs.After years of planning and collaboration, two newly created spaces specifically created and staffed to meet the needs of our youth have opened in Santa Clara County, California….in San Jose and Palo Alto. The name of these new centers is allcove. A cove or safe harbor for all, where every young person can find refuge and support. The name, like the services, staffing structure, and even the physical characteristics of these new brick and mortar centers, was designed not only for youth but with and by them, as well.The plan is for these centers of holistic caring for those age 12 to 25 to multiply across the country, creating a network of integrated youth health centers for mental and physical health care, educational and employment support, substance use treatment, along with peer and family support.This link will take you to the Stanford Center for Youth Mental Health and Wellbeing, working to lay the groundwork for a more inclusive and robust system of youth mental health care and prevention: med.stanford.edu/psychiatry/speci…thwellbeing.htmlClick here med.stanford.edu/profiles/steven-adelsheim to learn more about Dr. Steven Adelsheim and his work as a youth and adult psychiatrist, and his focus on supporting community and government partnerships in behavioral health, particularly systems for early detection and prevention in pediatric care and school settings. You’ll also find information on his role as the Associate Chair of Community Engagement for the Stanford Department of Psychiatry and Behavioral Sciences.

Trauma…a physically and/or emotionally threatening event… can be an individual experience, but it can also be a collective one. As we gain some distance and perspective on the crucial year of 2020, we can better understand the critical convergence of traumatic circumstances we encountered and from which we are still struggling to recover. At the same time a deadly plague was at its height, our very democracy was imperiled by destructive political divides and violent civil unrest fueled by unchecked social injustice. Add the increasing effects of climate change in the form of more frequent and intense natural disasters, and it’s no wonder we feel, and are behaving, traumatized.The good news is, we have the capacity to manage and recover from trauma and stress, to develop resiliency, and to invest in social systems that will serve us well in times of future difficulties. Our guest on this episode of What Makes Up Your Mind has even worked out a prescription for us to follow, as individuals, and as a society.Dr. Victor Carrion is the John A. Turner M.D. Professor and Vice-Chair of the Department of Psychiatry and Behavioral Sciences at Stanford University. He’s a faculty member of both Stanford University School of Medicine and Lucile Packard Children’s Hospital, as well as the Director of the Stanford Early Life Stress and Resilience Program, with three decades dedicated to researching and treating the impact of stress and trauma on young, developing minds. He’s developed a treatment called Cue-Centered Therapy, is investigating the positive and preventative impacts of a yoga and mindfulness curriculum in schools and has authored and co-authored books on both subjects. Click to listen as Dr. Carrion discusses his Prescription for Nations from the Science of Healing from Trauma.More about Dr. Carrion, his work, research and writings: profiles.stanford.edu/victor-carrionThe Early Life Stress and Resilience Program: med.stanford.edu/elspap.html

The power and connectivity of modern-day technology has never been more evident than during the COVID-19 pandemic. Information-sharing, distance learning, remote work, the safe procurement of goods and services, socially distanced personal connections, and telehealth…all critical lifelines provided by the internet and social media. There is no denying these positives. There is also no denying a darker side of these tools and their use, and overuse, in society.The medically-used term is Problematic Internet Use or PIU, if the focus is video games, Internet Gaming Disorder. Informally, it has been called internet addiction and it carries similarities to other so-called behavioral addictions such as gambling, but also has some aspects of diseases like impulse control disorders, OCD and substance abuse.Dr. Elias Aboujaoude has made the study of this new condition and the intersection of technology and psychology his specialty. An author and clinician, he is Clinical Professor of Psychiatry and Behavioral Sciences in the Stanford School of Medicine Department of Psychiatry and Behavioral Sciences, Chief of the Anxiety Disorders Section, and Director of the OCD Clinic.In this What Makes Up Your Mind conversation, Dr. Aboujaoude introduces us to the signs and impacts of PIU. He explains how interactive and visually stimulating technology entrances us, how the anonymity, invisibility and speed of social media can give rise to problematic behaviors we wouldn’t usually exhibit in person, and why putting forward a reinvented identity through social media –which imitates real life very well with its rewards and punishments - is so powerful and hard to resist. This begs us to ask ourselves the ultimate question; what is our real selves – what defines us?Click through and listen in as Dr. Aboujaoude also gives us some real-world advice on how to better monitor our technology use to create optimum life balance and well-being on this installment of What Makes Up Your Mind.For more on Dr. Aboujaoude’s work:med.stanford.edu/ocd.htmlmed.stanford.edu/psychiatry/about…ovid19/tech.html

Recovery-oriented. Client-centered. Respectful, evidence-based treatments. This is Stanford’s INSPIRE Clinic, carrying out the mission of meaningful recovery individuals experiencing psychosis. The severity of symptoms on the continuum of psychosis range from intrusive thoughts and bothersome voices to hallucinations and conditions like schizophrenia. But, as INSPIRE’s co-director Dr. Jacob Ballon, Clinical Associate Professor of psychiatry and behavioral sciences, tells us in this episode of What Makes Up Your Mind, misconceptions and a lack of understanding of the conditions on this spectrum of mental illness have kept stigma about it stubbornly in place. The good news is that with proper treatment attuned to the specific needs and goals of each patient, recovery and a fully functional life are very likely outcomes.Because it is also true that much is still unknown about the cause of these illnesses or exactly how they manifest in the brain, another mission of INSPIRE Clinic is continuing research. Dr. Ballon has particular interest in the connection between the brain and the rest of the body, and is looking at how exercise might positively impact treatment for psychosis and prevention of psychiatric disorders. Through collaboration with experts in other disciplines across Stanford, Dr. Ballon and INSPIRE are working to understand the whole-body impact of psychiatric illness, and are able to offer an array of different approaches to treatment, including medication, group and individual cognitive behavioral therapy, social work support, vocational and educational support, and access to clinical trials.A note for clarification: In this conversation, you’ll hear references to the Striatum, which is a critical component of the forebrain in terms of motor and reward systems, and to the NIMH, which is the National Institutes of Health.Importantly, because this podcast was recorded before the onset of COVID-19, there was much discussion of the positive impact of in-person patient interaction. While that remains the case, Dr. Ballon says of INSPIRE Clinic, “we love in-person meetings but we are actively piloting ways for people to connect online during this time.”Learn more about Dr. Ballon’s work and the INSPIRE Clinic: med.stanford.edu/psychiatry/patie…are/inspire.html profiles.stanford.edu/jacob-ballon

“Neurodiversity is a concept that regards individuals with differences in brain function and behavioral traits as part of normal variation in the human population.”Put another way, regardless of whether we consider ourselves to have “normal” brain function, whether we are challenged with Autism, ADHD, Dyslexia or Epilepsy, whether we have exceptional gifts in one or more areas of mental activity, we are all on the same broad spectrum of brain function. We are each unique; gifted in some ways and challenged in others. This is why neurodiversity should be celebrated and the potential of individuals on the spectrum should be maximized. In this segment of What Makes Up Your Mind, Dr. Lawrence Fung explains how it can be done, especially in the workplace.Dr. Fung is the Director of the Stanford Neurodiversity Project (SNP), and the Adult Neurodevelopment Clinic, as well as Assistant Professor of Psychiatry and Behavioral Sciences.In his research for best practices to broaden opportunities in quality employment for non-neurotypical workers, corporations report that neurodiverse individuals’ unique skills, talents and ways of thinking have improved bottom lines through innovation and higher productivity.“Attention to detail, out of the box thinking, and tendency to dwell deep in their topics of interest make up part of this potential,” says Dr. Fung, “but perhaps the most impactful is the general increase in employee morale when neurodiverse workers are part of a team.”Yet, the unemployment and underemployment rate for those on the spectrum remains incredibly high, with estimates in some categories topping eighty percent.Click the link to hear how SNP’s Neurodiversity at Work and Wellness Initiative offers resources for success in every component of neurodiverse employment. Utilizing the Stanford Neurodiverse Candidate Registry and the Stanford Neurodiversity Job Bank, the Neurodiversity at Work program facilitates good matches, offers interview and job prep assistance, as well as help in onboarding for neurodiverse employees, their employers and co-workers.If you have a loved one with Autism for whom a work program is not appropriate, check out the additional resources through our Autism Program at med.stanford.edu/psychiatry/patient_care/adpp.htmlFor more on Dr. Fung’s work and helpful resources:The Stanford Neurodiversity Project: med.stanford.edu/neurodiversity.htmlAdult Neurodevelopment Clinic: med.stanford.edu/psychiatry/patie…re/neurodev.htmlNeurodiversity at Work Program: med.stanford.edu/neurodiversity/NaW.htmlStanford Neurodiverse Student Support Program: med.stanford.edu/neurodiversity/s…upport--im-.html

While still considered a public health crisis, there is a bit of hopeful news in the fight against the opioid epidemic. For the first time since the crisis hit in the 1990’s, The Centers for Disease Control and Prevention reports overdose deaths dropped in 2018, down four percent from 2017. And yet, that lower number still accounts for more than sixty seven thousand Americans who lost their lives to overdoses, close to an annual record high.Dr. Anna Lembke knows we have a long way to go before declaring the opioid crisis in hand, or addiction in general, but chooses to be optimistic that these first signs of progress are indicators we’re on the right track. As the Medical Director of Addiction Medicine at the Stanford School of Medicine, Chief of the Stanford Health Care Addiction Medicine Dual Diagnosis Clinic, and Associate Professor of Psychiatry and Behavioral Sciences, Dr. Lembke is on the front lines of addiction research, treatment, and public education. Her 2016 book, “Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, And Why It’s So Hard To Stop,” shone one of the earliest spotlights on the epidemic, including the role of the drug’s makers and distributors, duplicitous research, misinformed prescribing practices, as well as the breadth of the emergency and its terrible toll on American communities.In this episode of What Makes Up Your Mind, Dr. Lembke discusses the appropriate role of opioids as short term pain relievers, the dangerous changes that occur in our brains with prolonged use of opioids and other addictive substances, how to recognize such dependence in ourselves and our loved ones, and how to begin to address it. In addition you’ll hear her make the convincing case for bringing addiction into “the house of medicine” to create a successful continuum of care.For more on Dr. Lembke’s work, research and scholarly writings: med.stanford.edu/profiles/anna-lembkeLinks referenced in the program: Stanford Health Care Addiction Medicine Dual Diagnosis Clinic stanfordhealthcare.org/medical-clini…agnosisClinicFree online CME course “BRAVO” on how to taper patients on chronic opioid therapy med.stanford.edu/cme/courses/onli…pioid-taper.html

Making sure the children in our lives are healthy and thriving includes their mental wellbeing. While the natural resilience of kids is often referenced, the truth is that our youngest members of society are vulnerable to stress, anxiety and, sadly, traumatic experiences. It’s not always easy to tell, or to know how to help, so we’ve turned to Dr. Victor G. Carrion for guidance.Dr. Carrion is the John A. Turner M.D. Professor and Vice-Chair of the Department of Psychiatry and Behavioral Sciences at Stanford University. He’s a faculty member of both Stanford University School of Medicine and Lucile Packard Children’s Hospital, as well as the Director of the Stanford Early Life Stress and Pediatric Anxiety Program, with more than two decades dedicated to researching and treating the impact of stress and trauma on young, developing minds. He’s developed a treatment called Cue-Centered Therapy, is investigating the positive and preventative impacts of a yoga and mindfulness curriculum in schools, and has authored and co-authored books on both subjects.In this episode of What Makes Up Your Mind, Dr. Carrion explains how every day stressors can be addressed, mitigated, and how providing children with appropriate skills can actually prevent anxiety and depression, giving them lifelong tools to cope with what life may bring while also creating a healthier society. Further, he discusses serious trauma and PTSD in kids with the good news that it can be treated and cured, but greater access to treatment is needed. You’ll hear how we can all play a role in that whether we’re healthcare providers, professionals in education, religious and spiritual community members, or family and friends.More about Dr. Carrion, his work, research and writings: profiles.stanford.edu/victor-carrionThe Early Life Stress and Resilience Program: med.stanford.edu/elspap.html

The mortality rate of eating disorders is the highest of all psychological illnesses, but if you thought they were incurable our expert on this episode of What Makes Up Your Mind has heartening news. Dr. James Lock is Professor of Child and Adolescent Psychiatry and Pediatrics in the Stanford Department of Psychiatry and Behavioral Sciences.A global expert on eating disorders, Dr. Lock also directs the Stanford Eating Disorder Program for Children and Adolescents. As he explains in this episode, eating disorders gradually and sneakily take hold mostly in youth, disrupting physical and emotional development. Left unchecked serious and debilitating conditions can develop, some with fatal outcomes, including suicide. But Dr. Lock is having great success treating and curing Anorexia Nervosa and Bulimia Nervosa with Family Based Treatment (FBT) which is exactly the opposite of traditional treatment which isolated the patient and blamed parents for the condition. He is now researching whether FBT will be as effective against Avoidant Restrictive Food Intake Disorder (ARFID) that often begins in very young children, characterized by profoundly picky eating, appetite struggles, and fears of illness after eating.As efficacious as FBT has proven to be, access to eating disorder treatment is severely limited so a great focus of Dr. Lock’s work at this time is expanding access as well as training for medical providers.Click the links below for additional information and resources.Dr. James Lock Biography, Research, Publications https://med.stanford.edu/profiles/James_LockStanford Department of Child & Adolescent Psychiatry Eating Disorders Research Program https://med.stanford.edu/edresearch.htmlStanford Eating Disorder Program for Children and Adolescents https://med.stanford.edu/childpsychiatry/clinical/eating_disorders.htmlStanford Child and Adolescent Outpatient Eating Disorders Clinic https://med.stanford.edu/psychiatry/patient_care/ed.htmlStanford Children’s Health Comprehensive Eating Disorders Program (Family Based Treatment (FTB) Inpatient & Outpatient care through Packard Children’s Hospital) https://www.stanfordchildrens.org/en/service/eating-disorders-program https://www.stanfordchildrens.org/en/service/eating-disorders/outpatient-clinicStanford Adult Eating Disorders Program https://med.stanford.edu/psychiatry/patient_care/adulted.html

Our topic on this episode of What Makes Up Your Mind takes us deep into the human brain where stimulation treatments show great promise for relieving psychiatric illnesses. Already used to treat neural conditions affecting motor skills like epilepsy and movement disorders such as Parkinson’s disease, Deep Brain Stimulation (DBS) has also been beneficial in the treatment of severe Obsessive-Compulsive Disorder (OCD) and is being tested for treatment-resistant severe depression.In our podcast, you’ll hear Dr. Bhati give an in-depth description of the DBS procedure itself, the results he’s seen, and his process for evaluating candidates for the procedure. He explains the criteria for using DBS to treat OCD is severe treatment resistance, while using DBS for severe treatment-resistant depression is currently only available through a research study. In terms of documented efficacy for depression, Dr. Bhati says past studies done as “open label” investigations in which both researchers and participants are aware of the treatment being given showed positive results from DBS. Later controlled studies did not show greater positive results than so-called “sham treatments” in which the doctor simply goes through the motions without performing the treatment, not unlike using a placebo in a blind study for a pharmaceutical. However, according to Dr. Bhati, on-going studies continue, using advanced tools like neuroimaging to better characterize patients and neural circuits, as well as investigations of longer duration, to seek better outcomes.While extremely optimistic and excited about the possibilities DBS holds for alleviating the suffering of psychiatric patients, Dr. Bhati is concerned about how accessible this and other developing treatments will be, and currently are, for those who need them. One impediment is the shortage of mental health care providers in this arena, so Dr. Bhati directs a clinical fellowship in interventional psychiatry to encourage more young psychiatrists to engage in these new treatment options. To add to our fascinating discussion, Dr. Bhati shares his interest in the role of consciousness in mental illness and healing.Click through to listen, and check the links below for more on Dr. Bhati’s work and where DBS patient trials may be available, including at the Stanford Brain Stimulation Lab.Dr. Mahendra Bhati: https://med.stanford.edu/profiles/mahendra-bhatiStanford Interventional Psychiatry Clinic: https://med.stanford.edu/psychiatry/patient_care/intvpsych.htmlStanford Brain Stimulation Lab: https://bsl.stanford.edu/

It is a very human thing to, at times, worry, ruminate, to experience self-doubt: “did I lock the door, did I give anyone this darn cold, what if ______” (fill-in the blank with any one of thousands of thoughts)? In most cases these episodes are infrequent, centered around a specific incident or situation, and our rational minds step in to interrupt the pattern and alleviate the concern. However, if we are able, for a moment, to put ourselves in the worst possible moments of those fairly typical situations - the brief panic and dread followed by an uncontrollable impulse to immediately take action - and then extend that feeling, and experience it over and over again, we’ll have an idea of the trauma that Obsessive-Compulsive Disorder, OCD, inflicts on those who suffer from it. It can be utterly debilitating for between two and three million Americans.In this episode of What Makes Up Your Mind, you’re going to learn more about OCD, how to tell if you or someone you love may be challenged by it, and where to get help if you do. But most exciting, you’re going to learn about the ground-breaking research going on to understand how and why disorders like this one manifest in the brain, and some ground-breaking work to develop fast-acting treatments which, in early trials, have offered near miraculous, temporary relief.More InformationFor more on Dr. Carolyn Rodriguez, who also serves as Associate Dean in the Office of Academic Affairs, as Consultation-Liaison at the VA Palo Alto Health Care System, and Director of the Stanford Hoarding Disorders Research Program: https://med.stanford.edu/profiles/carolyn-rodriguezAdditional educational videos by Dr. Rodriguez in both English and Spanish via the Stanford Center for Health Education: OCD: Signs and Symptoms (English) https://www.youtube.com/watch?v=-Zg6PEJHRoo (35K views) Trastorno obsesivo compulsivo (TOC) (Spanish) https://www.youtube.com/watch?v=Mf_mRF6M_Jk&t=83s OCD Treatment (English) https://www.youtube.com/watch?v=i4SGc64BwLM&t=2s (10K views)The Rodriguez Lab/ Translational Lab: https://med.stanford.edu/rodriguezlab.htmlTo learn more and volunteer for clinical trials in Dr. Rodriguez’s lab: https://med.stanford.edu/rodriguezlab/research/healthy-volunteers.html [email protected], 650-723-4095For more on Stanford Psychiatry’s Obsessive-Compulsive Disorders Program https://med.stanford.edu/ocd.htmlFor clinical care at the Obsessive-Compulsive Disorder Clinic at Stanford https://med.stanford.edu/psychiatry/patient_care/ocd.html

In the face of record opioid overdose deaths and cases of addiction, this episode of What Makes Up Your Mind offers hope. Our guest is Dr. Keith Humphreys, the Esther Ting Memorial Professor in the Department of Psychiatry and Behavioral Sciences at Stanford University, an internationally recognized expert on addiction, treatment, and public policy. He was part of the Obama administration's team when the Affordable Care Act was crafted and passed and was the architect of policy to allow naloxone, a life-saving antidote to opioid overdose, to be used outside health care facilities so that first responders, and even family members and other caretakers could have it at hand. This strategy has saved untold lives.Currently, and in the years during the worst of the COVID crisis, opioid addictions and overdose deaths have been overwhelmingly driven by illegal fentanyl, a synthetic drug manufactured with raw chemicals from China, illegally processed and smuggled into the United States by criminal organizations, primarily Mexican drug cartels, according to the Federal Drug Enforcement Administration. Besides its addictive properties, fentanyl's extreme potency means vast numbers of deadly doses can be trafficked without detection. Fentanyl pills can be disguised to look like other recreationally used prescription drugs and, in powder form, can be laced with other narcotics. A dire situation, to be sure, but experts are working to unlock the brain's susceptibility to these addictions, develop new treatment methods, and expand the efficacy of those we already have.As Dr. Humphreys points out, in medical uses, they are effective in relieving acute pain; "We don't just have an opioid crisis, we have a crisis of pain with a lot of people not getting the care they need." You'll learn how patients can work with their doctors to use these pain relievers safely, what loved ones can do to help mitigate risk and assist people who are addicted, the challenges of developing an addiction vaccine, and the latest treatment about which Dr. Humphreys is most optimistic. What you'll hear most in this installment of What Makes Up Your Mind, is caring and compassion.To learn more about Dr. Humphreys https://med.stanford.edu/profiles/keith-humphreysThe Stanford-Lancet Commission on the North American Opioid Crisis https://opioids.stanford.edu/The Stanford Network on Addiction Policy – Bridging Science and Public Policy https://addictionpolicy.stanford.edu/

To sleep, perchance to….rejuvenate, heal, affect mental, emotional, behavioral, and physical wellbeing…and yes, dream? Unlocking the mystery of why we sleep and what we suffer when we do not is the mission of Dr. Luis de Lecea and his lab in the Stanford University Psychiatry and Behavioral Sciences. In this segment of What Makes Up Your Mind, you’ll hear about Dr. de Lecea’s discovery of a pair of neuropeptides in the hypothalamus which influence on sleep, wakefulness, stress, and reward. Called The Hypocretins, their discovery opened a new path of research into how these messengers signal sleep-related activities to the brain. Dr. de Lecea and his team are following this path with vigor, aiming to uncover not only the connection between quality of sleep and wellness, but how manipulation of these specific neuropeptides might result in the treatment of mental and brain related illness. Imagine the implications! Researchers already know that insomnia is a symptom of some conditions, and that poor sleep quality can make the symptoms of some illnesses worse. But, by understanding the exact mechanisms at work when the brain is at rest, or deprived of it, those mechanisms could be utilized to mitigate the impacts of everything from depression and anxiety to addiction, to autism, as well as illnesses like Parkinson’s. Some of the questions Dr. de Lecea is working to answer more completely are likely some of the same questions you have about sleep: Why do we sleep and why, at times, is it so difficult to get quality sleep? Do all animals sleep? Do our sleep patterns and what we need from sleep change as we age? What do we risk, health-wise, when we don’t get the rest we need? How can we optimize the sleep we do get? Dr. de Lecea addresses all of these topics, and more, in this podcast, and shares his excitement about new developments on the horizon, including next generation sleep monitoring and therapeutics. You’ll also learn why our small mice companions are so critical to Dr. de Lecea’s work and in what way we are very much like them! We owe them our gratitude for helping us understand ourselves better. Read more on the work of Dr. de Lecea and his lab at: https://med.stanford.edu/delecea/home.html For help with sleeping issues: https://stanfordhealthcare.org/medical-clinics/sleep-medicine-center.html

“Let food be thy medicine and medicine be thy food.” So said Hippocrates, the ancient Greek physician known as the father of modern medicine. (Interestingly, he came to fame by saving Athens from a plague!) His view of food as a source of health continues to be validated by ever-evolving research, and not just good health of the body but of the mind, as well.This is the focus of this episode of What Makes Up Your Mind, with Dr. Maryam S. Makowski, clinical assistant professor in the Stanford University Department of Psychiatry and Behavioral Sciences. Her expertise is in nutrition and wellbeing, serving as a nutrition professional and physician wellbeing coach in the Department of Psychiatry’s WellConnect program, Stanford University BeWell Lifestyle Coaching Program, and the Associate Director of Scholarship and Health Promotion of the Stanford Medicine WellMD & WellPhD Center. Along with explaining how what we eat feeds our brain (or doesn’t), Dr. Makowski helps us follow the process of how our bodily fuel also impacts our emotions and moods. She also discusses foods for mental alertness and performance, extra motivation when facing a daunting task, and ways food can ease anxiety and depression.Learn more about Dr. Maryam Makowski and her work here: Academic Profile: https://med.stanford.edu/profiles/maryam-makowskiWellConnect: https://med.stanford.edu/psychiatry/special-initiatives/wellconnect.htmlStanford Healthy Living Coaches: https://healthyliving.stanford.edu/coaching/bios.php?sc=6364d3f0f495b6ab9dcf8d3b5c6e0b01&ci=NjA4MTYxNCwgNjA4MTYxNywgNjA4MTYyNywgNjA4MTYxOSwgNjA4MTYyNiwgNjAzOTk5NSwgNjA4MTYzMA==Stanford Faculty and Staff can sign up for nutrition coaching through BeWell Program: https://healthyliving.stanford.edu/classes/register/hipClasses.php?t=1cce34dfd3cbss383d348a508b1be48cc821&ct=17