Medications & Well-being

This is the podcast adaptation of the ninth episode of The Break Room! This one’s all about medications and well-being. Special thanks to our host, Dr. Brian J. Dixon! Part of the Living Corporate network, The Break Room is focused on mental health, wellness and healing for Black folks at work. You can expect real talk from real experts about the real ways Black folks can protect and heal themselves from racialized trauma at work. 

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Dr. Dixon (00:09): Welcome, welcome, welcome. Welcome to The Break Room, everybody. I’m Dr. Dixon. Yay. It is super awesome to have you all on tonight. So The Break Room is a podcast. It is part of the Living Corporate empire that we’re building to share information about being Black in the workplace. And so, The Break Room is all about mental health for Black people in the workplace because we know that sometimes those environments can be really, really stressful. Normally, I’m surrounded by my awesome co-hosts, unfortunately, they couldn’t join us for tonight, but that’s okay because I’m going to be holding down the fort, talking a little bit about ‘Medications and Well-being’ – that’s going to be our topic for the evening. As always, make sure that if you have any questions that you put those in the chat, and as always, we want you to follow us on Twitter and send us any, any questions, either through email or directly through social media, because we always want to make sure to answer your questions.

(01:12): So normally, so Dr. Nikki would be here, awesome co-host, as well as Dr. LaWanda and Dr. Jide, and we are all mental health professionals that get to work with amazing people throughout the country. Today you’ll have me, so my name is Brian Dixon. I’m a child and adolescent psychiatrist based in Fortworth, Texas, and so that’s where I get to hang out, and I get to work with patients, and I do some consulting work, and the main goal is to help people live their best lives. So with the traditional podcast, what we typically do is we always start off–at the top of the hour we go through the tea, which is kind of the latest, juicy news of the week. We then move through some kind of discussion, either a teaching point or a topic of discussion that allows us to learn a little bit about ourselves and our mental health. We then transition over into any questions that the audience has, and then finally we finish up with The Last Nerve. So since I am here today, I get to do The Last Nerve and I’m super pumped, super excited, because I’m tired and irritated, and so The Last Nerve is always the epitome of our podcast. So you all will get to hear The Last Nerve tonight. So we’re going to start back at the top of the podcast. Again, our discussion tonight is ‘Medications and Well-being’ and so we’ll get to that in a second. We’re going to do kind of an offshoot of the tea, since it’s just me this evening, and I just want to give a shout-out to the Baylor Bears men’s team, men’s basketball team, for winning the NCAA tournament. Hooray! So that’s why I’m wearing my Baylor shirt today. [inaudible] Bears. I got my Baylor diploma right behind me, $80,000 worth of paper I suppose, and so I just want to give a shout out to them because they worked really, really hard. I don’t even play basketball. I don’t even know how to play basketball. I’m one of those few Black dudes in the country that has no idea of how any of that stuff works, but that’s okay because we want to make sure that we give people their credit and credit where it’s due, and they worked really hard and so I’m super, super happy about that. So that’s the tea today. I heard that the Gonzaga basketball team did something really awesome the game before the final, but I don’t remember, you all will have to fill me in on all of that stuff. So today as a psychiatrist I get to walk you all through the world of medications and well-being, and like I said, if you all have questions, by all means ask. Before we get started with a lot of the medical lingo and jargon, I always give the disclaimer that yes, I am a treating (?) psychiatrist. I like to talk about mental health. I infuse mental health into everything that I do and everything that I am and everywhere that I go, but I’m not your treating psychiatrist, and so if you are on medicines, if you think you need to be on medicines, if you have an opinion about medicines, this show is mainly for informational purposes only. It does not equal medical advice, and so if you need specific individualized medical advice, please consult your physician, because they are ready and willing and able to help you. No question is off limits. I do my best to answer anything that comes up, so let’s get started. So I’m going to break it down into kind of two different segments. So the first segment is going to be the five things that I think you just need to know about medicines, and so I’m going to walk through those and I’m going to do my best to copy and paste it into the chat so that you all know where I am in the flow. Then in the second part, we’re going to talk about the five medicines I’m most often asked about, and I have opinions about them, and I’m going to share those opinions. And like I said, they’re just opinions, it is not medical advice. And then the last part is we will transition over into The Last Nerve. So five things that I really, really want you all to know about medications and well-being. The first is, and I’m going to post this in chat, so the first thing I want you to know about medications and well-being is that clinicians and physicians are not magicians. We do not make the brain chemicals that we need to function. So in the world of brain chemistry, there are basically three brain chemicals that we really, really concentrate on in the field of mental health and psychiatry. The first is called serotonin, the second is called dopamine, and the last one is called norepinephrin, and each one has different functions, and I’m going to walk you all through those functions just so you get an overall idea of what they’re about, keeping in mind that lots of the gory details, again, are best discussed with your physician. So serotonin is a brain chemical that is related to mood and anxiety, and it’s a super important brain chemical and, in fact, it is so important that there are just as many serotonin receptors in your brain as there are in your gut. So your body uses lots of serotonin throughout the top to the bottom. So that’s serotonin. Dopamine is related to mood and attention and a couple other things, including movement, but the ones that we’re going to concentrate on tonight are mood and attention, and so that’s serotonin, that’s dopamine, and then dopamine using some protein, some enzymes, gets turned into something called norepinephrine. and norepinephrine is another brain chemical that is related to mood and anxiety. So those three brain chemicals are the three that we’re really going to concentrate on, and the point that I want to make to you all is that again, you make them. There’s no way for me to give you a pill that includes these things, and so that’s why I say we’re not magicians. I can’t wave a magic wand or throw a pill at you and produce these things. These are things that you actually have to produce yourself. So the medicines that I use or that any psychiatrist uses pushes around those medicines and pushes around those brain chemicals in different ways. So sometimes they will push out dopamine into the space between two brain cells. Sometimes they will block serotonin from being reabsorbed or sucked back into a brain cell, and it’s those movements that we use to help you feel better over the course of time. So I welcome questions about that, but the first thing I have that is foundational of the whole entire talk is yes, we do not, physicians do not, create those brain chemicals, because we are not magicians, and so that’s the first point. Moving to the next point, the second most important point, which is you are what you eat, literally, for real, for real. So again, let me do my due diligence. I’m working double duty to make sure that I put this in the chat as well. So you are what you eat. There are particular brain chemicals, serotonin, dopamine, norepinephrine, that are made from the food that you eat. Again, you create them from what you eat. So it’s really important that you get a really well balanced diet. I know we talk about this all the time. Like, oh my gosh, here we go again, do I need to count my points? You need to eat your vegetables and I’m here to tell you, yes, that’s exactly what you need to do. There are two in particular that I need you to pay attention to. So remember how I said that serotonin and dopamine and norepinephrine are the three we’re concentrating on? Dopamine and norepinephrine come from essentially the same place because norepinephrine comes from dopamine. So there are two things I need you to remember. So remember where serotonin comes from, remember dopamine comes from. So serotonin comes from tryptophan. So if you’ve ever heard of eating turkey, and then you get all tired after Turkey Day, after Thanksgiving, which is, like, my favorite holiday, your body converts tryptophan into serotonin, and serotonin then can help you feel better, or it can help you with sleep. So there are certain foods that have more tryptophan in them. So salmon, poultry, eggs, spinach, seeds, nuts, soy, those are all really, really rich, and the thing is, your body cannot make tryptophan. Tryptophan is something that you have to ingest. You have to eat in order to eventually turn that into serotonin so that you can feel better. Remember, you are what you eat. So yes, you need to consume foods that have tryptophan in it and that’ll take care of the serotonin side of things, and then when it comes to tyrosines. So tyrosine is what your body uses to make dopamine. I mean, it can use some other stuff, but for right now, for this discussion, tyrosine gets turned into dopamine and dopamine is related to attention and to mood and to movement, and so you want to make sure you eat foods that are rich in tyrosine. So soy, chicken, turkey, fish, peanuts, almonds, avocados, bananas, milk, cheese, yogurt, a lot of the dairy stuff, lima beans, pumpkin seeds, sesame seeds, and I bring that up because you all are at work. This is a podcast about Black people at work, and we want to make sure that you are eating right. So it may be that over that lunch break, you don’t go over to the local Mexican restaurant and have a margarita. It may be that you don’t order the enchilada plate with a whole bunch of ground meat and and pico de gallo. I need you all to be very thoughtful in your food choices, because how you feel is directly related to what you eat, and so at the end of the day, if you have to be on a medication for any reason, remember that I cannot create those brain chemicals, you create them from what you eat so that then I can push those things around. So now that we’ve talked about we’re not magicians, you are what you eat–for real, for real, there is no way around that part–the next part I want you to keep in mind is that medications do not change behaviors, therapy does. So I always jokingly say this to my patients and everybody that I work with, which is if I had a pill that would tell you what to do and make you do what I wanted you to do, I would put you on it and I’d tell you how to vote. I’d tell you to go get educated on the social justice topics of the day. I would do all sorts of stuff if I had that magic pill, but that magic pill does not exist, and so there is no medication for behavior. Instead, that’s something that you have to work with, and that’s why I’m super stoked to be part of a podcast with a whole bunch of psychologists, because we talk about the importance and the power of therapy. Therapy is what helps you change your own behaviors, and so learning your triggers, super, super, super, super important. So triggers are basically anything, any stimulus, any action that happens around you that you automatically respond to most times not even thinking about what you’re doing. The best example is your phone, so anytime you hear that go off you automatically reach for your phone. That is a conditioned response. So that is a conditioned movement, that’s a conditioned behavior, and I want you all to really work hard, to be more aware of those behaviors, because then you’ll start to see them everywhere. For example, lots of people will begin to use food as a trigger, a self-medicating trigger. So in other words, you get stressed out and you tend to eat tortilla chips, or you get stressed out and you’ll eat ice cream. So, you’re at work, your boss is getting on you, you have a report due, and your tendency is to want to go and self-soothe by using some type of calorie, either going out to eat at lunch or “Oh, forget it, I brought an extra piece of candy, so I’ll go ahead and eat that,” and I’m here to tell you, you can do those in moderation, but be very, very careful because those can become self perpetuating behaviors. So food is often used for self-medication. Alcohol is definitely used to self-medicate. So in other words, self-medication is meaning you use some type of coping skills, something outside of yourself, to help you feel better. Generally, we want those things to be very healthy and positive. Sometimes they’re not, and alcohol is one that can really, really sneak up on you, especially in the business culture, because in the business culture it’s all about productivity, it’s all about being engaging and being an extrovert, and yeah, this is really interesting. Even though COVID keeps us from having happy hours, this is one of those times when a lot of people will start to drink because they are self-medicating because they’re nervous or they’re bored, or they’re tired of being at work and you just drink more, you drink more, you drink more, and so we want you all to be very, very careful and very, very thoughtful about using alcohol in that manner as a behavioral tool to self-medicate, and same thing goes with sex, and I can’t stress this enough. Dr. LaWanda is our resident expert in all things intimate relationship. Be very thoughtful of who you are when you’re getting into a relationship, because other people can’t complete you, you have to do the work yourself. So if you’re starting to feel lonely, you start to feel alone at work, be very thoughtful about what you’re doing. That’s all I have to say about that part, and we’ll have a whole podcast at some point about how to have meaningful relationships at work that are still legal and healthy and that sort of thing. So keep in mind, there are no medicines for those types of behaviors. Yes, there are some things I can use to try to keep you from overeating and try my best to limit your alcohol, but we try not to use those things. Instead we’re going to look to you to do that through therapy. So there are no medicines for behavior. Next up, number four, there are no happy pills because, again, if I had a happy pill, don’t you think I would put everybody on it? And so I tell people this again, all the time, I don’t like prescribing medicines for folks because I have to hold at least $10,000 worth of malpractice insurance every year that I renew every year and that coverage is I think 1 million, 3 million. So I’m trying not to get sued because every time you get sued, that tends to go up and your premiums go up. So please don’t sue me. But it’s a lot of work. I have to worry about my patient’s side effects, I have to worry about is the medication working, I have to worry about the cost. So the cost of medicines is insane. We have a really dumb healthcare system–if you want my personal opinion about our healthcare finance system, just go to my individual website, I won’t belabor that here, but I don’t want to put you on medicines. I want you to be able to live your best life through therapy and through exercise and diet and that sort of thing. So if I start you on a medicine it’s because I think you’re going to benefit from it. There’s no benefit for me at all starting you on a medicine at all, and that goes for most physicians. If they can get away with helping you feel better without a medicine, we’re going to do so, and so since there are no happy pills, then how do you find happiness? Well, to me, in my opinion, happiness starts inside, living your truth, living your purpose, being your authentic self, being your Black self, being your gay self, being your straight self, being your trans self. You being you both in your own life and at work, and when those line up, when there is alignment between your personal self and your work self, I think you’re just a much happier person, and so many of us don’t do that, and as a result we tend to struggle at work, especially if our workplace is very oppressive and not inclusive. So that’s why Dr. Nikki and Dr. LaWanda and Dr. Jide and myself, that’s why we’re on this podcast, we want you all to feel more welcome at work, we want white folks to be more understanding of you. We want you to be more understanding of yourself so then there is synergy across the board. I throw out to you all, make sure that when I say an inclusive environment at work, it is very much speaking up on your physical and mental health behalf. So if you’re in an office that doesn’t have natural lighting, try to ask for it. If there are ways that you can get fresh air, make sure to ask for it. So most places will have some type of occupational health officer or some type of consultant that works in occupational health to make sure that if you’re sitting at a desk all day, that your desk is a good height, making sure that you have a chair that is conducive to the ergonomics of your back. There are a lot of workplace regulations about what the workplace is supposed to have. You’re supposed to have access to a bathroom. You’re supposed to be able to take breaks, a certain number of breaks over a certain time at work. You have the right to ask for all that stuff. That’s why our workplace, most break rooms, we don’t have it in our break room because it’s virtual, but most break rooms will have this big, long thing that talks about fair wage and laws and all that kind of stuff. Take the time to read that. It is required by law for every break room to have it, and if you have your break room doesn’t have it, by all means ask. But this is the opportunity for you to feel more empowered. Now, none of that has anything to do with the medication side of things, that’s more of the well-being. You have to advocate for your well-being at work. I own a business. I have employees, and I have to admit sometimes as the business owner, I’m so busy trying to make sure I can make payroll to pay my employees that sometimes I forget the small things. I forget the “Hey, well done. That’s awesome.” I forget the, “Hey, your son or daughter had a recital, how did it go?” I want you to speak up. Speak up in your workplace, “Hey, this is important to me. My family is important to me. My relationships are important to me. My setting, where I’m working, is important to me,” and so speak up to your boss, because I’m sure your boss wants to hear it, and if they don’t, well, again, that’s where I want you all to seriously think about the energies that are around you at your workplace, because if they’re toxic–and we have a whole podcast about toxic workplaces that you need to listen to, make sure to go to the Living Corporate page and you can flip through our old episodes–then it may be time to find a new positive workplace. The last thing I wanted to add is that many corporations, even smaller companies are buying into what we call EAPs, Employee Assistance Programs, and what they do is–this is a perk. This is a benefit of working at certain companies where they pay to have access to therapists and coaching and counselors so that then you can anonymously contact them and use those resources to help you feel better, to find local mental health resources that are local to you, to find ways to deal with that co-worker that gets on your nerves or to deal with that boss that gets on your nerves. Keeping in mind that a lot of times, those are also your avenues for if you need to file any official complaints about harassment and that sort of thing at work, because again, most workplaces want to have a safe and inclusive workplace, and if they don’t, they need to learn, and they don’t learn unless you speak up. So as they say, the squeaky wheel gets the grease, so speak up and that generally helps. Interesting tidbit, somebody told me this–take it with a grain of salt, but it’s a pearl that I found to be true. If you go to a new job, make sure you ask for whatever you want within the first six months of you being there, because if you start asking for stuff after that, sometimes it doesn’t go well. So if you’re going to speak up, speak up early. So we talked about how clinicians and physicians aren’t magicians. So we don’t make the brain chemicals that help you feel good. You are what you eat, so you make sure to eat the good stuff, so that then if I need to push those things around with medications I can, keeping in mind there are no happy pills because it just doesn’t work that way and that medicines do not change behaviors and so if you want some change in your life, you have to go to therapy and that’s why we are doing what we do. The last big point of medications and well-being of this portion of the podcast is that pooping is important, and I know, I couldn’t think of another time to put it on the podcast, so I’m going to do it now while nobody else is here. So I’m sure Dr. Nikki, Dr. Jide and Dr. LaWanda are like, “What is this?” So one of my my doctor friends who works as a gastroenterologist, which is a fancy term for doctor who works with everything from your mouth to your anus, said that most people don’t think about their butthole until it stops working, and you all, I don’t want yours to stop working. I want it to work the way it’s supposed to, and the way you do that is you eat fiber. We do not eat enough fiber in this country because we can do ridiculous things sometimes, and so you need to eat a certain amount of fiber, of soluble fiber, and make sure you drink lots of water and essentially it kind of acts as a sponge or Roto-Rooter to make sure to clean out your large intestine. Now with all that said, and it really is that straightforward, if you are straining, like going in the bathroom and straining, that’s a bad thing you all, and make sure that if that happens, you want to make sure that you are checking with your doctor because there may be other things going on that’s making that worse, and we don’t want that to happen because straining can cause all sorts of stuff. You can pass out. You can have hemorrhoids. It’s just no good, no bueno for anybody. One thing I did want to throw out to you is that a lot of people do these colon cleansing things, and be careful with those things. If you do what you’re supposed to do with your diet–remember how I said make sure that you’re eating certain things so that you feel better, and remember that I said that there are just as many serotonin receptors in your gut as there are in your brain–if you’re eating the right diet, you’re going to feel so much better, you’re going to poop a lot better, because constipation–it’s a big problem, and you’re going to feel worse. There is no such thing as a liver detox, so I don’t know who keeps bringing that up. So I want to make sure to put that on the record in the digital space to last forever. Your liver detoxes. It doesn’t detox, it is the detox. It cleans everything. That’s the whole point of the liver, and so when you’re using those detox pills or doing those detox things, be very, very careful because again, your liver will do it as long as you give your body water, as long as you’re eating right and you’re exercising. Your liver will take care of all the filtering that it needs to take care of. So you don’t have to do anything special in that regard. Then as soon as we are talking about the workplace, we want to make sure that you find the good bathrooms. So everybody has the good bathroom at work. You already know, so just make sure that you take your time, don’t strain, wash your hands when you’re done, because lots of things get transmitted. Lots of viruses and things and bacteria obviously can get transmitted if that’s not the case. So make sure that your setting and is clean, and for those folks who can’t poop at work–and I don’t blame you because you know how that goes, then again, plan your meals accordingly, because there’s something called the gastrocolic reflex, which is a reflex in your body that when you eat, a certain amount of time after that, most times, about 10, 15, 20 minutes you’ll feel the need to poop, and so be mindful of that if your gastrocolic reflex is really strong, because otherwise you’ll get really anxious if you can’t use the bathroom. So all those things come together. I know it’s a lot of information, but I’m just super glad that I got to share it on the podcast at the Break Room. So those are the five things that I want you to remember about medications and well-being. For some of you all that are on other medications, so medications for diabetes, medications for high blood pressure, some of them can make constipation worse. Some of them can do other things, and so that’s why it’s even more important that if you have a pre-existing condition—so if you have a pre-existing condition like heart disease, congestive heart failure, diabetes that you do these five things, because not only will it be good for your mental health, it’s going to be good for your medical health as well. So moving on to the next part, we’ll make sure that; yes, good. So if you all have questions, like I said, make sure to put those in the chat, and I see Dr. LaWanda out there, and we will get those questions taken care of. So we’re going to switch over to talking about the five medicines that I am asked about the most. Keep in mind, again, this is not medical advice, this is Dr. Brian Dixon doing a podcast for your informational entertainment. So I’m going to start with the one that I hear the most, about that I’m asked about the most, which is Prozac. So Prozac is the brand name, fluoxetine is the generic name, and what it does, it works through the serotonin system. So it blocks serotonin for these brain cells over here so that these brain cells over here can pick it up a lot easier, and over the course of time, most times three to four to six weeks, your sense of anxiety will come down. Your sense of depression will come down. But remember, it does not make you happy, because I don’t have a happy pill, and it doesn’t calm you down, especially in the moment, it’s not designed to do that. So it’s a very safe medicine. It has been around for a really long time, and luckily it’s very inexpensive, and we use it for quite a few different things. So anxiety, depression, panic attack–again, it doesn’t treat the panic attack in the moment. It’s more to prevent the panic attacks from happening in the future. PTSD, it can be used with bipolar disorder if you are being treated correctly. So again, check with your doctor. So those are the big uses; oh, OCD is another one, and so it’s really, really common, and if I had to say love it or hate it, I would say I love it because it can be super, super helpful. My rule of thumb is that if I start someone on a medicine I’m going to do my damnedest to get them off of that medicine at some point, and this is probably one of the medicines that I use the most. So that is Prozac, fluoxetine, so that’s number one. Lots of people ask me about number two, and I’m going to do my best not to cuss and act a fool because it drives me nuts. So Xanax. Xanax is the brand name, the generic name is alprazolam, and what Xanax does–Xanax works on a different receptor that we did not talk about, the receptor affects GABA, the GABA receptor. You can look all that stuff up on Wikipedia. But the reason why I hate Xanax so much with the heat of a thousand suns and I wish they would take it off the market is because it works too well. So what happens when you hit the GABA receptor is that you get calm, and the problem with Xanax is that it hits the GABA receptor so fast and so well that you get calm. The problem is it doesn’t last very long and boom–Dr. LaWanda, you’re a hundred percent correct–that means that you can build an addictive cycle. So in our circles, we call it psychological and physiological dependence. Psychological dependence, meaning every time you get upset or you start to get anxiou you feel like you need it, and that is very, very worrisome. Then physiological dependence means that if I take it away, you actually go through withdrawals, you get really nervous, you get shaky, you get really irritable, and those two types of dependence mean that I do my damnedest to stay away from Xanax. I do, and the reason why is because there are lots of other options that you can use that don’t work so fast and don’t wear off so quickly. When I say there are a lot, I mean, there are a lot of other options. And so if you’re on Xanax, I’m not saying to stop it. In fact, don’t stop it. That’d be a bad idea, you need to talk to your doctor first. What I am saying is know that there are other options out there that are not as addictive and just as helpful, and so I wish they would take it off the market, but what do I know? I’m just a doctor that spent $225,000 on a degree, but whatever. So that’s Xanax, love it or hate it. I hate it. I hate it with the heat of a thousand suns. Number three, Adderall and Ritalin. So Adderall and Ritalin are stimulants. We use those in ADHD, a couple other things. So anytime you need to pay attention is essentially when you can use those medicines, and they are very short acting. So Adderall and Ritalin only work the day you take them. They do not work the next day unless you take them, right? So if you skip a day, forget a day, forget your medicine at home, you’re not going to pay attention. And so ADHD is actually very common. I didn’t believe in it when I first started medical school. I was like, “No, these are just bad kids, and somebody just needs to give them a butt-whooping because this is ridiculous,” until I did my pediatric rotation and I was in the room with a eight-year-old that had it and I was like, “Holy shit, this is not only real, it’s debilitating,” because kids literally cannot sit down sometimes depending on the type of ADHD they have. Since this is an adult podcast for work I want to tell you all that there are lots of people in the workforce who have ADHD and they actually don’t know it, and as a result they are struggling at work. As over producing adults, we tend internalize everything. So if I can’t concentrate, if I can’t get my reports done, if I’m procrastinating too much, I turn it inward and go, “Oh, my God, I’m a terrible person. Maybe I don’t like this job. Maybe this job isn’t for me. Maybe this career is wrong.” Well, sometimes it’s actually untreated ADHD, and so if you think you have ADHD talk to your doctor, that’s what they’re there for. Talk to your psychologist, that’s what they’re there for. So Adderall and Ritalin, they work by increasing dopamine, making dopamine more available so that you can pay attention, and I like it, I like it a lot. The main side effect is appetite suppression for most folks, or you don’t–you really don’t even think about eating while you’re on it, but that does not mean that we use these for weight loss and that sort of thing. Nope, nope, nope. Don’t do that. Again, that’s a whole other discussion for a whole other day. This medicine is to help you focus and to concentrate, and so when people ask about the addiction potential–so they actually designed these things to not be addictive. They don’t give you the sense of euphoria that some of its distant cousins like cocaine would give you. So technically they are very, very safe when you use them correctly, and that’s the key. So make sure you talk to your doctor, and so I would say love them or hate them, I love them. I write for them all the time and they’re super, super safe. Again, make sure that you do all of the other things I talked about earlier, especially with your diet, and make sure you moderate your caffeine. Number four medicine that I’m often asked about in the context of bipolar is lithium. So lithium is very interesting, and I don’t know if y’all can tell, but I love my job. I think it’s great, and I think everybody should become a psychiatrist. So when it comes to lithium–so lithium is a salt, and we actually don’t really know how it works, your guesses are as good as ours. But we do know that it’s very helpful for people with bipolar who have a manic episode. So manic is very defined. There’s a defined criteria for mania. Most times it’s not what you think it is, and so I hear people say all the time, “Oh, my God, I’m so bipolar,” and I’m like, if you’re saying that, you’re probably not. So be careful with that stuff because it is very well-defined, and if you have questions about that by all means talk to your doctor, talk to your therapist. Lithium is a very safe medicine if you use it correctly. So one of the hiccups with lithium is that you have to get a lot of lab draws and to make sure your blood level is correct and quite a few people hate getting their blood drawn. So some doctors will kind of be hesitant sometimes to write for that particular medicine, but if you are having trouble with mania or mood stabilization, it can be very, very helpful, and so the key is to make sure that your kidneys are healthy, and this is where all the other stuff comes in. So if you have diabetes and you’re having kidney damage and you’re on lithium, the issue is that lithium is only excreted through your kidney. So in other words if you don’t have the filter, if your kidney filters aren’t very good or you’re causing damage due to your diabetes, you can actually get a buildup of lithium where you start seeing halos around light, you get really jittery and your hair can start to fall out and stuff, and so you need to be very, very careful. So talk to your doctor as always, but used in safe quantities, lithium is awesome, yay. I love it. Again, just talk to your doctor, and then the last medicine, last but not least that I get asked about all the time is Ambien. So, again there are certain medicines that I just hate, and Ambien is one of the ones, again, that I hate. So Ambien is actually a distant cousin–it’s not distant, it’s a cousin to Xanax because of the way that it works. I can’t even remember the generic name of it because I just try to avoid it like the plague, and so Ambien, I think a few years ago people were like, “Oh, well, I was hearing about people taking Ambien and having all these weird dreams and getting up in the middle of the night and driving around and all that,” and yes, it is possible. So Ambien and Xanax hit the exact same receptor as alcohol, and so for people who drink alcohol plus use Xanax or Ambien, you run the risk of some really major interactions because it can keep you from breathing, literally kill you. It can do all sorts of stuff, and so if you’re listening to this podcast, be very, very, very careful. Are they safe in small quantities if you’re using them correctly? Yes. They are FDA approved. They are very, very safe. If you’re on them, don’t stop them unless you talk to your doctor. Like I said, I’m not trying to fearmonger, I’m just trying to educate. But if you can do everything else to help yourself sleep, exercise, lose weight, if you snore and you have sleep apnea, go get that treated or checked and get your CPAP, avoid alcohol, don’t use the bedroom for anything other than sleep or sex. So if you can do all of those things to make sure that you can fall asleep without Ambien, then please do. So if you use Ambien, just use it carefully. If you find yourself using escalating doses of Ambien or escalating doses of Xanax, you need to go talk to somebody. You need to talk to your physician, your psychiatrist, whoever’s prescribing your medicines. So do I love it or do I hate it? I hate it. I just hate Ambien. So those are the top five medications that I’m asked about. For you in the workplace, I want you to just be mindful that the best medicine is diet, sleep and exercise. So start with those things first. If you need to be on a medicine, just make sure you take it the way that it’s written, make sure that you take it at your doctor’s instructions, and then if you’re self-medicating again, call yourself on your triggers and be very alert to what you’re doing. So I hope that those two sections were helpful. All the medications and well-being, and then my top five love them or hate them list. Before we jump into The Last Nerve, I want to make sure I give a shout out to Living Corporate once again, because they are our hosting platform and we’re really, really lucky to be on The Break Room. So do I love or hate lithium? I love lithium. I think it works great for who it works for. So especially if you have a history of bipolar with mania, it’s generally very safe and very effective if you use it correctly. So let me find my phone because our rule is our last nerve, we always shoot for a 90 second last nerve, so I’m going to pull up my stopwatch and we’re going to go for one minute and 30 seconds. So my last nerve for today you all is wilful ignorance. So I’m in Fort Worth, Texas. I love this city. Yes, we have a long way to go when it comes to racial justice and equality, but I just got a notice that there’s going to be a white lives matter rally in Fort Worth, and I think it’s the dumbest shit I’ve ever heard, and the reason why I say that is because number one, we all know that white lives matter because we see it every single day, and just because we say Black lives matter does not negate the idea that we believe the white lives matter too. So let’s get that correct. Number two, especially as treating psychologists and psychiatrists, we love working with people. Sometimes we work with people who don’t even agree with us. Sometimes we work with people who don’t know their blind spots, but we work with them anyway, regardless of their color, but what we cannot stand, myself included, is willful ignorance. When you know better and you choose not to do better, that’s a problem. That’s a big old problem. So when we see things like this, especially in an age right now where diversity, equity and inclusion is being talked about, it’s online, it’s in every corporate manual, everybody’s putting out a notice, when you do that stuff, it’s just so hurtful. It is so hurtful, and so what we want is we want our white allies to stand up and say, “This is bullshit. Stop doing that. That’s not helpful.” I want every person, regardless of color, but especially our white allies to use that phrase, “That’s not helpful.” Willful ignorance is not helpful, and there’s no way we’re going to excuse you of your behavior when you know better. Like my mama said, “If you know better, you have to do better.” Let me just be clear about that. Ooh, got my blood pressure up, and it’s all hot in my home studio. Lord have mercy. So I hope that you enjoyed the podcast on medications and well-being. I’m Dr. Brian Dixon, Like I said, super, super glad to have you all on tonight. If you have any other questions, make sure to let us know on Twitter. We are @thebreakroomlc. If you want to send us any messages, make sure to send it to On behalf of Dr. LaWanda and Dr. Jide and Dr. Nikki, who are the hosts of your Black folks at work podcast known as The Break Room, we are out. Thank you all so much. See you later.

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