The One You Feed - Real Wisdom for Navigating Mental Health with Ken Duckworth

Episode Date: May 30, 2023

Dr. Ken Duckworth is not only an expert in the mental health field but he has experienced firsthand the challenges of having a loved one suffering from mental illness. This experience inspired his work with the National Alliance on Mental Illness (NAMI), advocating for awareness, research, and better access to mental health care. Ken continues to work to fight the shame and isolation surrounding mental health conditions and to promote openness and compassion in the journey toward wellness.  In this Episode, Eric and Ken Discuss Real Wisdom for Navigating Mental Health and... Understanding the significance of community support in overcoming mental health hurdles How to recognize the power of self-determination in mental health recovery journeys The importance of understanding the impact of family history on understanding mental illness Navigating the complexities of the mental healthcare system and tapping into available resources Foster open mental health conversations by hearing personal stories and experiences Grasping the value of a strong support network for mental well-being Learning to unleash your potential for self-directed growth in mental health recovery Demystify the mental healthcare landscape to find valuable resources Encouraging inclusive mental health discussions through shared personal narratives To learn more, click hereSee omnystudio.com/listener for privacy information.

I think it can benefit you to have your diagnosis because there are different treatments that may work for different things, but you are not your diagnosis. Welcome to The One You Feed. Throughout time, great thinkers have recognized the importance of the thoughts we have. Quotes like, garbage in, garbage out, or you are what you think ring true. And yet, for many of us, our thoughts don't strengthen or empower us. We tend toward negativity, self-pity, jealousy, or fear. We see what we don't have instead of what we do. We think things that hold us back and dampen our spirit. But it's not just about thinking. Our actions matter.

It takes conscious, consistent and creative effort to make a life worth living. This podcast is about how other people keep themselves moving in the right direction, how they feed their good wolf. I'm Jason Alexander. And I'm Peter Tilden. And together, our mission on the Really Know Really podcast is to get the true answers to life's baffling questions like... Why the bathroom door doesn't go all the way to the floor?

What's in the museum of failure? And does your dog truly love you? We have the answer. Go to reallynoreally.com and register to win $500, a guest spot on our podcast, or a limited edition signed Jason bobblehead. The Really No Really podcast. Follow us on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts. Thanks for joining us. Our guest on this episode is Dr. Ken Duckworth, the Chief Medical Officer of the National Alliance on Mental Illness, also known as NAMI. Ken has been the medical director since 2003, and he also serves as Assistant Professor of Psychiatry at Harvard Medical School. He's received numerous awards for his work to advance our knowledge and treatment of

mental illness. Today, Ken and Eric discuss his book, You Are Not Alone, The NAMI Guide to Navigating Mental Health, with advice from experts and wisdom from real people and families. Hi, Ken. Welcome to the show. Thank you for having me, Eric. I'm a big fan. I'm really excited to have you on and discuss your book, which is called You Are Not Alone, The NAMI Guide to Navigating Mental Health with advice from experts and wisdom from real people and families. And we'll get into all that in a minute, but let's start like we always do with the parable. In the parable, there's a grandparent who's talking with their grandchild and they say, in life, there are two

wolves inside of us that are always at battle. One is a good wolf, which represents things like kindness and bravery and love. And the other is a bad wolf, which represents things like greed and hatred and fear. And the grandchild stops, think about it for a second, and they look up at their grandparent and they say, well, which one wins? And the grandparent says, the one you feed. So I'd like to start off by asking you what that parable means to you and your life and in the work that you do. Well, Eric, it's interesting. I just became a grandparent. Congratulations. And so this is very germane to my book, which democratizes the idea of expertise. That you might be a full professor at Harvard and conducted 400 studies on bipolar disorder.

You're in my book. But if you've lived with bipolar disorder for a decade, my working assumption is that you've also learned something about self-management, communications, and relationships. And that's the joy of the book. So it's interesting. I always identified as the grandchild in my life. I was the youngest in my family system. Through a series of unfortunate losses, I'm now the oldest member of my family, and I just became a grandparent. So this idea on paper as a psychiatrist, you know, on the Harvard faculty, I look like your expert, but I actually think I learned as much from loving my dad with a severe illness, even though we couldn't communicate and talk about it.

So this idea of who is the expert, who has the wisdom is very interesting to me. I guess I would say the corollary to that on the wolf side is I think shame and isolation represent forces that I'm working against in my book. And giving people the option of seeing real people with real names from real places, just like them, is a more openness approach. And I view that as the good wolf. That's a beautiful way to sort of frame up this conversation. And actually, when you just said that, I was thinking about an experience I had a long time ago. This is probably 1992, maybe. God, it's amazing it's that long ago. Anyway, I was a heroin addict and I'd been trying different things to get sober, but

very half-heartedly and mainly moving different places and trying to detox myself. But one night I moved to this little town in Connecticut and I was in this little one room apartment I was living in and I picked up the Narcotics Anonymous book. And as I read it, I just began to sob because I had never heard anyone describe what it was like to be in my head. I didn't know why I did what I did. I didn't know what was wrong with me. I didn't know any of it. And just to hear somebody else describe it was such a powerful experience. And I think that's what in this book does a really great job is like you said, there are voices from all different kinds of people in all different parts

of mental illness, whether it be the helping side, the having it side, the parent side, right? And I just think it really frames all that up really well. I was wondering if we could start before we get into your story and the book, with a little bit about, I used it in the title of your book, The NAMI Guide. What is NAMI? The National Alliance on Mental Illness is the largest grassroots organization of people who live with mental health conditions, parens, and addiction, and those who love them. It was founded in 1979 by about 280 people who met in Madison, Wisconsin, who had been blamed by their psychiatrists for their children's mental illnesses.

And as the hospitals were closing, one woman told me, you had to get paid to be blamed, Ken. You had to go to the psychiatrist to be told this was your fault. These women got together, almost all moms, but not entirely, and formed this group, which is now 700 affiliates across America offering free services, support, education, advocacy. You may have heard of the recent 988 number, which is the National Crisis Lifeline. I had nothing to do with that. I was working on the book. But the policy team at NAMI led a coalition of people to create a mental health response instead of a police response to mental health crises. Share a little bit more about what that 988 number is and what it does, because it is still pretty new. And I would say the vast majority of people probably have never heard of it. We're still under a year. So it came out in mid-July last summer. 988 is the substitute number for a very long number for the National Suicide

Prevention Lifeline. And if you have a crisis in mental health, or you have somebody you care about who has a crisis, you call that number. Someone who's trained will respond to you. It's quite unlikely they'll have a police involvement. So the old number, calling 911, resulted in a lot of bad outcomes for a lot of people because it's not police's job to do mental health outreach. But of course, because of our fragmented, underfunded, and chaotic system, police are often left holding the bag. So 988 was an effort to create more of a thoughtful, compassionate crisis response. It's not enough.

It's three digits. It's not enough. It's three digits. It's a start. And what you need to do is work with your local NAMI to help advocate for mobile crisis teams and culturally consonant services for people. But it's a big improvement. It took a couple of years. And I think we all paid two cents on our Verizon bill for it. You know, our phone bill. It seems like a great investment. Yeah, I would say. What are some of the other things that NAMI offers? And if somebody is just hearing this right away and going, okay, well, yeah, I or somebody I love is dealing with mental illness and I'd like a little bit more support maybe than I'm getting. What sort of

things might we find at NAMI and how would we get to or access those things? Sure. Well, NAMI is everywhere. We're in every major community in every major state. There are groups of fabulous people. So if you say, okay, I'm dealing with a mental health thing, like borderline personality disorder. I'm hearing voices. I have a problem with severe depression

and I feel alone or I want to learn from other people. We have support groups for individuals. My son is developing an illness. I want to meet with other families so I don't feel so alone. I want to meet with other families so I don't feel so alone. I want to change the legislature to make sure that police are trained in being thoughtful and compassionate as opposed to leading with alternatives that I don't like. So this is a

group of people who will welcome you. It's from all walks of life, all across America. All the services and support are free. And so it's a pretty cool group. And it's a beautiful little piece of my life, Eric, that I became their chief medical officer based on my little experience of feeling alone. So I feel very blessed. So somebody would just look for the NAMI chapter in their area? NAMI.org. Okay. But wherever you are. So where are you, Eric? I am in Columbus, Ohio today. There's. NAMI.org. Okay. But wherever you are. So where are you, Eric? I am in Columbus, Ohio today. There's a NAMI Ohio, there's a NAMI Columbus. Onwards from there, I would love to spend a few minutes on a little bit of your background about what got you interested in a career in the mental health field.

So I want to make it clear, I had no interest in medicine or in mental health. I was actually interested in poetry, storytelling, and history. So it's no coincidence that I end up writing a mental health book that's based on people's stories, right? So it's a kind of synthesis at the end of the day. My father, who was very loving and charismatic, my cousins used to say, God, your dad's awesome. I'd say, I know. But then there's those whole months at the state hospital thing that we weren't talking about. Our family's from Philadelphia for multiple generations. I was playing in the basement, you know, making one of those forts out of books with blankets that I think every seven-year-old kid does. And I heard these booming sounds upstairs. I went upstairs and I saw my father being carted away by the police. A few months later,

we're driving in a U-Haul to the state of Michigan where we knew no one. And I thought, seven-year-old me, does this have something to do with that? But nobody would talk about it. So the rest of my life became an understanding in so many different ways. What is the thing that is so powerful that it could move a family 400 miles, but you can't speak of it? The answer is mental illness. So I'm not the kid who won the science prize. None of my volcanoes ever had game in fifth grade, Eric. I want to make it clear. I went to the career counseling center at my University of Michigan center. And don't worry, we like Columbus. We're good. My dentist is from Ohio State. We're good. I said, I can't do math, by the way. I was kind of overwhelmed by some of my dad's symptoms and I fell behind in math. And

as some of you know, when you fall behind in math, you're behind. And so he said, I've got great news for you, Ken. There's 11 medical schools that require no calculus. And I got into nine of them. And I just wanted to help my dad. I majored in political science and history. And I was honest about my reasons for wanting to become a psychiatrist, but even that had violated an unwritten rule record. I had learned that you weren't supposed to talk about your interest if it had to do with yourself or your family. I guess I was just kind of naive or perhaps way before my time, 35 years. Yeah, yeah. And so I wrote in my essay to become a psychiatrist. My dad was loving and fabulous,

and I was trying to understand both the secrecy, shame, and isolation, but also understand what helped people. And all across America, at the best psychiatry shame, and isolation, but also understand what helped people. And all across America, at the best psychiatry residency programs in America, people ignored my essay. And they talked about everything else. One world-famous facility, a man said, this was a terrible reason to become a psychiatrist. And I said, what would be a good reason? And he said, hmm, after a long pause, well, maybe if your father was a psychiatrist. So at that point, I went into that parking lot, put my head on the rental car, and I thought,

you know, I think this is actually not going to work. Cardiologists make a lot more money. They draw nicer cars. I liked cardiology. I would be good at talking to people about their hearts. And then the next day, I went to this place called the Massachusetts Mental Health Center, where a man named Ned Halliwell read my essay and said, Ken, this is fantastic. Mental Health Center where a man named Ned Halliwell read my essay and said, Ken, this is fantastic. You'll know so much more. You'll be able to help more people. I moved to Boston and I'm still on the faculty of the exact same place that one person said, your reason for doing this is okay. That's a great ending to that story. I was about to say great story, but you know,

you were talking about your father's mental illness to start. So that's not a great part. Do you know what your father had? Oh, my dad had straight up bipolar disorder. And so his first episode I later learned as I pieced it all together was at age 17. And I was in the basement. We were moving my parents to more of an assisted living. And I noticed a pattern, Eric. There would be a little teeny tiny plaque or statue, 1967. 1968, there'd be a bigger one, Salesman of the Year, the Midwest. 1969 or 68, be National Salesman of the Year. 1970, six months in a state hospital. So the pattern was unmistakable. He became more charming, more engaging, more fabulous. And he was quite a loving person. I was never mistreated.

I was scared a fair amount of the time, but I was never mistreated. And so he had very recurrent, what we call mixed episode bipolar disorder, classic bipolar one. So he would become psychotic. So communicating with the microwave, hearing voices. And then, you know, after four months of treatment, he'd be like, hey, Ken, you want to go to the ballgame? The Tigers are in town. Let's go. So it was a lot to integrate. And a family that couldn't talk about it set me into motion. Neither of my siblings wanted anything to do with this path. But I guess as the youngest, and again, identifying with the

grandchild in your parable, not the grandparent. I just became a grandparent two weeks ago. I'm still trying to figure out that whole shift. I was like, you know, I think I got to figure this out because somebody's got to help this guy. Yeah. Because he's so fabulous. So it was a long, unusual pathway into the mental health field. And I feel very fortunate because I was able to be of some help to him. And then I've helped a few people through my work at NAMI and as a doctor. So I'd like to move into the key pieces of the book. And I think the first place that the book really starts or one of the early places is talking about getting a diagnosis or getting an assessment. And I would love to talk about that. And I would also like

to talk about the paradox of diagnosis because at least in the waters I swim in, there's a lot more criticism these days of diagnoses and of the DSM-5, which is the book that tells us what to diagnose for what conditions. But I'd love to hear you talk a little bit about the importance of diagnosis, how to feel confident or in that diagnosis and the paradox of that. Yeah. So Eric, thank you. The chapter that I wrote, the paradox of diagnosis, is I think it can benefit you to have your diagnosis because there are different treatments that may work for different things, but you are not your diagnosis. And the humility, which you have to approach diagnosis, we don't understand the underlying neurobiology of the brain. These are symptom descriptions. So when my brother died, I went through a pretty profound grief experience that at different times would

have been called major depression, would have been called grief only, would have been called super grief or extended grief reaction. That is to say the diagnostic goalposts were moving. I was the same guy who couldn't get out of bed. And my wife said to me, is this what it would be like if you had no sense of humor? I think this is what it would be like. And it was what it was like. It took months for me to pull through that experience. So you have to take diagnosis with a grain of salt.

And there are different interventions. If you have borderline personality disorder, there's a psychotherapy that teaches you coping skills that can save your life. borderline personality disorder, there's a psychotherapy that teaches you coping skills that can save your life. Bipolar disorder, like my dad, lithium could make a big difference in the course of your illness. Psychotherapy, community, giving to others, all these things are good things. But again, I'm not enamored with the diagnostic framework or am I skeptical of it. It's a tool. It's only a tool. It's the best we have. And as long as you're humble about what we don't know, which is a lot, there's probably a dozen kinds of schizophrenia. And we have one diagnosis called schizophrenia. And so there are people who have more symptoms, more motivational

problems, more relationship challenges. We lump them all together because we don't understand the underlying biology well enough. The same problem with Alzheimer's disease. Eric, I was a medical student way back in the day, in 1986. And the neurology professor announced right before my graduation that they had cracked the code of what causes Alzheimer's disease. I was like, oh my God, this is fantastic. It's so cool to be a doctor. And he said, it's amyloid. We understand the entire pathway. It gets locked up in the brain. And he said, within five to 10 years, you'll be able to treat people and prevent the scourge of humanity. And I thought, God,

it's so great that I became a doctor. And now 35 years later, we have no material treatments for Alzheimer's disease. Same problem as mental illnesses. We don't understand enough about the brain. And if you can stay humble and stay engaged and promote research, keep asking questions. Psychedelics should be researched. They shouldn't just be given. We should try to understand things. What can you do to help people? It's a big question. And I think it's important to try to answer it. Yeah. One of the criticisms of the current diagnostic models is that you often end up with many of them and you're like, well, wait a second. Do I really have all four different things?

That seems unfortunate. And then, like you said, the heterogeneity of the way they appear, right? Like you said, that your depression may cause you to sleep all the time. My depression may cause me to, you know, have trouble sleeping. Like they show up so differently, but I do agree with you as somebody who has had a number of diagnoses for different things in my life, I find them a helpful starting point, you know? And then I think to your point, we are not our diagnosis. We are more than that. And seeing the totality of who we are is always important. And also recognizing that diagnosis isn't a predictor of future reality necessarily,

because two people could have a diagnosis of depression and have completely different looking levels of functioning based on how they're treating that depression. And so, you know, sometimes the worry is that you live into your diagnosis, right? You limit yourself by, oh, I have this thing. And so thus, but I do think diagnosis is a hugely important starting point. Let's talk a little bit about where to get a diagnosis. What's the best, knowing that we're dealing with, as you said, a fractured, if not broken mental health system? I'll accept broken. It's a chaotic melange of services that are in continuous motion and different funding streams. There's private insurance and some people might decide,

hey, I'm not taking that insurance anymore as of Friday. And there's the commissioner of mental health. He says, I'm going to do this fabulous program. And then there's a budget shortfall. The program's closed. Yeah. So the system of mental health has to be in quotation marks. There's a complex melange of services. And what I encourage people to do, if you think something's going on with you, and again,

this could be your own observation or someone you love gently saying to you, I wonder if you're suffering with A, B, or C. I'm a psychiatrist. Think about that. I couldn't really appreciate that I was having a grief-depressed reaction. I have a series of buddies who happen to also be psychiatrists. People hang out with people like them. They're not my only friends, but they're my buddies that I trained with them.

They're wonderful. They took one look at me and they're like, Ken, you look like hell. You need to get an evaluation stat. And that really helped me because my wife had just told me that earlier the day. Ken, you look like hell. This isn't like you. Like this grief thing is really taking you over. So I couldn't see it. And I want to emphasize, we all tend to normalize our own experience. If somebody loves you, gives you feedback, take it seriously. And if you've had a condition before, you may have learned what the symptoms are of a recurrence of your illness. So places to go. You can go to your primary care doctor.

These are the unsung heroes of the mental health service system. They're underappreciated, but they're very comfortable. Probably half their work is anxiety, depression, and trauma and addiction. Probably half their work. Sometimes they can be helpful. Sometimes they might know of a resource or a program or a therapist. That's one idea. I would get in line. People might be critical of mental health, but the waits are months and months and months. So the demand has exploded and the supply is pretty limited. So whatever criticisms people level, I don't know a clinician who doesn't have 500 people waiting for them to be seen. So there's something happening

in terms of people's wanting to be seen. Mental Health America, MHA.org, has a lot of screening tests. These are screening tests online that you might take if you were in a primary care office. The PHQ-9 is nine questions, zero to three. 27 means you probably need to be in an inpatient hospital because you're suicidal. If you have four, you're probably having what's called Tuesday. And if you have 13, 14, you need to attend to that. You probably have a condition that needs to be evaluated. So it's a ballpark. It's kind of like your blood pressure that you would take at CVS. It's not your real blood pressure, but it's a ballpark. It would tell you, you know, if CVS

said your blood pressure was 220 over 150, you'd probably call your primary care doctor. It's not accurate, but it's probably directionally correct. So like the idea of primary care, contact your health plan. Health plans, it's their problem if you can't find somebody to help you. I emphasize this because I had a job at a health plan and I want people to know you're paying insurance. There are no cardiologists who say, I don't accept your insurance. That's not a thing, right? So if the therapist says, I don't accept your insurance, you write a letter to the health plan or make a phone call and keep your documents, your paperwork and say, I've tried A, I've tried B, I've tried C, I've tried D. You need to help me find somebody out of network. And I feel like this is an important

thing that people don't really recognize. You know, your health plan, your health insurance has an obligation to help you. Like, don't just take that on yourself. Battle with them. I know it may be the last thing you want to do. Yes. Yes. I've been working with my mother on some back issues and chronic pain issues. And it just feels like it's a constant, like for crying out loud folks. For crying out loud. Well, Eric, you're a good son because an advocate makes a difference. Yes. And this is one of the beauties of NAMI is that people find how to support each other to help the people they love and themselves. Let's talk a little bit about that because

there is a, I don't know if I would say it's burgeoning now or has been burgeoning, but there's been a big change in a lot of mental health care around the idea of peer support. Tell me what peer support is, what's good about it, maybe where its limitations are, and how to go about finding it. Yeah, it's interesting, Eric. I had put together a book proposal. I'm a rookie author. I'm probably a one-hit wonder. Spotify has a one-hit wonder playlist. I'm probably going to be on it, right? I put together a book proposal, and I had a chapter called The Power of Community. Because in my work as a community psychiatrist, I had learned how much people support each other. After interviewing 130 people, I had to change the chapter to The Power of Peers and Community.

Because so many people told me that what helped them was a person like them who had been through a similar journey. And a whole other set of people said what really helped me was helping other people. That act of sharing what I had learned empowered me, gave my life meaning, gave my experience or suffering meaning. I'm Jason Alexander. And I'm Peter Tilden. And together on the Really No Really podcast, our mission is to get the true answers to life's baffling questions like why they refuse to make the bathroom door go all the way to the floor.

We got the answer. Will space junk block your cell signal? The astronaut who almost drowned during a spacewalk gives us the answer. We talk with the scientist who figured out if your dog truly loves you and the one bringing back the woolly mammoth. Plus, does Tom Cruise really do his own stunts? His stuntman reveals the answer. And you never know who's

going to drop by. Mr. Brian Cranston is with us today. How are you, too? Hello, my friend. Wayne Knight about Jurassic Park. Wayne Knight, welcome to Really No Really, sir. Bless you all. Hello, Newman. And you never know when Howie Mandel might just stop by to talk about judging. Really? That's the opening?

Really, no really. Yeah, really. No really. Go to reallynoreally.com. And register to win $500, a guest spot on our podcast, or a limited edition signed Jason bobblehead. It's called Really, No Really, and you can find it on the iHeartRadio app, on Apple Podcasts, or wherever you get your podcasts. For years, I've been like, I know what the power of 12-step programs are, right? That's the fundamental insight. I talk to you and that helps you and it helps me. And we

are equals. We are peers. But I've looked around as I've gone on my own mental health journey over the years and been like, there doesn't seem to be at the same level, this sort of thing for mental health. But I think we're seeing more of it, right? It's growing. In the same level, this sort of thing for mental health, but I think we're seeing more of it, right? It's growing. In the addiction community, it starts out as a peer movement, NA, AA, right? It's non-professional, right? The mental health community started out professional. Yes. And you could tell me whether you think the addiction community is integrating professionals well. I think the mental health community is much more welcoming to peers than ever before. I like that. I hope to think I'm part of that movement. Peers can't give you a diagnosis, and they shouldn't. Peers can't prescribe treatment.

Peers can provide support, navigation, love, and experience. And in a lot of states, that's paid for by Medicaid. Georgia pioneered that. And so I interviewed a woman from Georgia who's a peer specialist in the book and what Tara Carter's journey was about being on a mobile crisis team paid for as a peer specialist. She knows she's not the clinician, but when there's a moment the person says, I'm ready to give up on everything. Tara says, I think this is my turn to say, a few years ago, I was in your shoes. I was ready to give up on everything too. I want you to know it won't be easy and you're going to have to work. But I have a job.

I have a life. You could be just like me. And I thought to myself, I'm so happy that Georgia led the way on this. And about half the states, maybe 30, have covered peer support specialists. So it's happening. Yep. And there's not enough professionals. So while peers are not a replacement for professionals, the both end of it can be quite powerful. And while you're waiting on a professional, a NAMI group is full of peers.

Yeah. I like the way you made that observation about addiction and alcoholism started as a peer support program and how well they've brought professionalism into it. I don't think I'm going to even try and answer that. That's a whole podcast on the ambivalence about medication-assisted treatment. Yes. Yep. But an interesting point, and maybe we can transition here now, is, you know, you talk about in the book that recovery or treating mental illness, there's two sort of models, broadly speaking, that people use. One is a medical model, right, which you just described. It's going, it's getting a diagnosis.

It's perhaps getting a particular type of therapy. It may be getting medications, but it's sort of a professional medical model. But it's sort of a professional medical model. And then there's a whole other arm called the recovery model, which is support from peers and learning to live with it. Building a life. The things you do in your own life. Giving to others, faith, love, something to do on a Saturday night, all the beautiful things. But some people would say what helped me with the recovery was having my voices settle down or having my manic episodes under control. So it's not either or.

Yeah, I think you're right. I think ideally, depending on what you're dealing with, it's both. That's right. That's right. And so I really wanted to bring this idea to the fore that there is another model. And I know I'm a psychiatrist and I went to medical school. Mostly I was trained in the medical model, but I observed with my dad, even though we couldn't talk about it, the things that brought him joy was not necessarily his treatment. And certainly he hated being in the hospital, even as it helped him. So I was always interested in what could be more, what else could we think about? Yeah. I mean, I know in my case with depression, I have needed both the medical model and the recovery model. And we're going to spend more time on what the recovery model constitutes. But for me, either or wouldn't have gotten me where

I am today. Right. You know, I think like you said, going to your primary care physician is a great place to start. If you're lucky enough to have one. Yeah. Yeah. The challenge is often that your primary care physician goes, oh, you have depression. Here is this medicine. Good luck. Right. And again, I think it's good that we're getting medicine to people who need it, but it tends to leave out, I think, and again, different primary care doctors are different, tends to leave out that like, in addition to taking this little pill, if you actually want to really deal with this, there's a whole bunch of other things you can be doing that are really going to make this work better for you. You could join AA, NA, you could touch base with NAMI.

Here's a psychotherapy that might be helpful for you, right? You could exercise. All this stuff contributes. For instance, yeah. Very strong evidence for anxiety and depression prevention. But primary care people have 17 minutes per patient. So I am sympathetic to them. And they are paid the same whether they give you a prescription or not.

I know a lot of people love to pile on the doctors. They're making money off it. We're paid the same. I just want to emphasize that. Well, right. I don't mean any of that as a criticism of doctors. No, of course, but it is some people's experience. It's more to sort of say like, it's good that we introduced both these models. And it's part of why I wanted to talk to you so that people go, oh, okay, let me integrate it. I've often said, you know, when it comes to my depression, I have basically thrown the kitchen sink at it, right? That's right. I've put medicine on it. I have talked to people. I have had therapy. I work on exercise. I work

on diet. I work on purpose. I work, I mean, I just throw everything at it. And that works for me. That works. You know? It works for a lot of people too. Yep. So let's talk a little bit then about the recovery model. Like what sort of things go into that? You went through a list pretty quickly, but let's lay out a few other things that in addition to, if we're having a mental illness challenge, in addition to seeking professional help, what else can we be doing?

So let's take symptom reduction, the sine qua non of the medical model. And let's have, let's call having a life worth living as the sine qua non of the recovery model. Love, connection, meaning, purpose. These are things that are not easy to quantify. And they're certainly not FDA approved. The medical model would say, your blood pressure is too high. Let me give you a medicine that will lower your blood pressure. A recovery correlate to that would be,

you know, if you walked four miles a day, you would also lower your blood pressure. So there could be symptom reduction without a pure treatment. And good doctors will say, let's give you this medicine. Why don't you try exercising more? And let's see if we can get you on half a dose in six months and get you off of this in a year. And it happens all the time. So the recovery model is an

alternative to the medical model. And I have heard people put it kind of in sharp distinction. I think of it as a much more integrative process, just the way you do, Eric. Because what I've heard is so many people benefit from a both-and approach. Medicines help me reduce the intensity of my voices. But being a Meals on Wheels driver, this is a man I interviewed from Montana, I have all these people who love me and connect with me. And I'm part of my community. And I'm very happy about that. And because the medicine has reduced the intensity of my voices, it has not eliminated them. I have to accept that I will never get rid of those voices. I've had them for 30 years.

I could still have a life. And this is kind of the integration of the medical model and the recovery model. It's not either or. It's both and. There's a tool that came up as you were discussing the recovery model that I had never heard of. And after, I don't know, nearly 600 interviews of this style, I'm always sort of surprised when I'm like, whoa, never heard of that, which is always fun. But it's called the Wellness Recovery Action Plan. And I love this idea.

I cobbled one of my own together over the years. Right? But this is a – well, you tell us what it is. So this is a cool recovery self-management program that I happen to know about because of my travels in community mental health. So I went to the woman who originated it, Mary Ellen Copeland, and I interviewed her for the book. And she basically described being in a hospital and when she was leaving the hospital asking the person who ran the hospital what do you do for people that are trying to cope with stuff and

he's like yeah we don't have that we have treatment we have medical model stuff we have you know medicine shock treatment whatever we have that's not our thing i don't know what to tell you about coping in the world you should have marion coqueland on your show she's fantastic she's a friend of the family and we love her and And she basically said, I sat down with a bunch of people like, what would help us cope with depression or severe anxiety or profound loss or mood swings that seemed out of our control? And she developed this idea that it's a self management tool, that you're in charge of it. No one else can do this for you. When I talked to Mary Ellen Copeland about my panic about writing my first book on a deadline and writing Nami's first book, she said,

Oh, Ken, you should write a wellness recovery action plan for yourself. You should have all the triggers that get you really freaked out. You should have all the supports. You should put it all in place for yourself, Ken. And then she gave me her cell phone number, which was one of the kindest things anyone's ever done to me. It says, if you're having trouble with your rep, give me a call. And this is the beauty of like the recovery model. Mary Ellen Copeland exemplifies that kind of generosity of spirit. Yeah. We'll have links in the show notes where people can find her work and what actually goes into this wellness recovery action plan. I think the beauty of it, and you can follow

that approach or you can follow other approaches, but it is to a certain degree to really know what helps me. Yes. And having that accessible. And I find it really helpful to have it sort of written down because often when we're struggling mentally, it's very difficult to remember what did help us. Absolutely. I think everybody's experienced that. Under stress, we aren't the best thinkers and we don't necessarily integrate our prior lesson. Yeah. I mean, the correlate I've made to having something like this, and it is part of my, if we want to call it wellness recovery action plan, is I know music helps me. Listening to music, loud music helps me. But if I'm depressed this morning and I pick up Spotify and I start looking, I'm just like, no, no, that sucks. No, like nothing sounds good. Right? socks. No, like nothing sounds good. Right. So what I did years ago is I just made myself a playlist of music that I know. So all I have to do is go hit play, you know, and I had my own little like goal tracking thing where I had like 15 things on it that I knew helped me with my

mental health. And my goal was not to do all of them every day. My goal though, was to go in and check them off. And I could just sort of see like, oh, you got eight points today. And knowing that. Yes. You're a natural, Eric. Are you familiar with dialectical behavior therapy, DBT? I am. I became friends with Marshall Linehan who invented it. And she basically says you have coping skills that replace maladaptive, self-harming, destructive coping things. that replace maladaptive, self-harming, destructive coping things. And you rehearse them, just as you said.

And music is a great example. And you know what they are, and you rehearse them, and you go to them. And then there are people that you remember that you can go to. It sounds really simple. But when you're overwhelmed with emotion, or you're thinking of harming yourself, you may not have access to that. And so you're at work, Eric, Mary Ellen Copeland, Marshall Linehan, all these things have in common the idea it's an inventory of coping skills that are recovery-based.

It's not, oh, my God, I've got to take my medicine now. Well, you might want to call your therapist. You might want to figure out, oh, maybe I stopped taking my meds six weeks ago. I wonder if that has something to do with it. You know, again, just self-knowledge, self-awareness. But the idea of rehearsal, I love that idea, Eric. Yeah, rehearsal. And the other thing that I found helpful was that keeping track of.

Because if I was down, I could sort of look at it and go, well, yeah, the last week you've been getting, instead of doing five things on your list of 15 that are good, you've done like two. Eric, I would have given anything in my life to have pattern recognition with my own father. Yeah. My father got sick every other summer and it was like a hurricane had just arrived in June and there was no preparation in March. There was no discussion of closing the windows. There was no preparation for, hey, maybe we should think about getting that sump pump checked. I wonder if we could avoid that hurricane this one year. Every single time, because we couldn't talk about it, because there was no communication, because we hadn't rehearsed anything, it was always a surprise. And it's hard to believe that a family that was loving and well-meaning could be shocked by a recurrent

chronic illness. And we were. Well, mental illness is, A, for the person who has it, the thing that can figure this stuff out is the thing that is malfunctioning to some degree. I mean, that's a pernicious challenge. And it's well said, that's a pernicious challenge. And then, of course, all the stigma and shame around it makes it very hard for anybody else to talk about it. That's right. And so, yeah, I mean, I'm not surprised by what you're saying. You know, I think it's a pretty common know from your work in this field is that the earlier we intervene, the better chance we have for recovery or for management, right? And it just makes sense.

It's like if I've got a little fire over here, I can probably dump my water on it and put it out. A brush fire, you can handle that. My son is now a wildland firefighter, and I think he's going to head to Canada in a few days where they've got, you know, God knows how many acres already on fire. That's pretty hard to put out at that point, right? Yeah, I'll say. So this earlier intervention, say a little bit more about that. So one of the reasons I wanted to have real people use their names and share their stories,

and everybody reviewed their quotes and approved them. So I want to make it clear. This couldn't have been a more collaborative or respectful conversation. I think it's helpful. Like my family, had we found you were not alone, we might have said, wait a minute, there's all these other people with bipolar disorder. They talk about it. They problem solve it.

The families deal with this. Like, what are you kidding me? Right? They don't go to the police station. Like that's not the first or second or third thing that other people do. So one of the things I was trying to do to promote early intervention was see that there's real people just like you. So I interviewed people from all across the country, from different ages, races, ethnicities, religions, professions,

because what I wanted to do is make it clear that you are not alone, which is, of course, the title of the book. There's someone like you. And so if you are cutting yourself in high school, instead of hiding that behavior, consider reading the book and you'll find someone like you, right? If you are hearing voices, that's a terrifying experience. There are other people who are going through that. And there's actually now 300 programs across the country that will treat you with love and strength approach, not medicine and a clinic, not a medical model. You'll get a recovery model. That's in the book because I want people to recognize earlier is better than later. And I think my effort to reduce the shame and isolation that travels with these conditions was to do a book that didn't have the tone of every other book written by a psychiatrist. My patients are

my greatest teachers. There's no resemblance to anyone in any aspect of this book. Privacy is everything. I like privacy. I want to make it clear. I don't encourage people to go on Channel 5 and tell their mental health journey. But if you're ready, you can find a lot of meaning in helping other people. As you have done, Eric, I've listened to a bunch of your podcasts. It's beautiful how you've metabolized your experience to be in service to this purpose. It's beautiful to watch. Thank you. So so We've given our Instagram account a new look and we're sharing content there that we don't share anywhere else. Encouraging positive posts with wisdom that support you in feeding your good wolf. As well as some behind the scenes video of the show and some of Ginny and I's day to day life.

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So if we know that intervening earlier is helpful, what that leads to is that for a lot of people who are parents, they may need to play a key role in seeking help. I mean, and we know that the symptoms show up far earlier than we used to think about. I mean, you talked about, you found out from your dad. I mean, I read an essay with a interviewed a guy recently. I don't know if you know Andrew Solomon. Of course, he endorsed the back of the book. He's one of the giants. He's on the Mount Rushmore of American mental health. Incredible guy. I don't know if you know Andrew Solomon. Of course, he endorsed the back of the book. He's one of the giants. He's on the Mount Rushmore of American mental health. Incredible guy. I interviewed him again recently. But in preparing for that, I read a very long essay that he wrote, a very devastating essay that he wrote about childhood suicide. So my point is that as parents, we aren't quite sure what to do. Is this normal teenage stuff?

Do we have a problem here? My kid doesn't seem to really want to talk about it. Can you provide a little guidance for parents out there on how to start getting some help earlier if there is a problem? Sure. I just want to say there's a second book coming and I'm delighted to report I'm not writing it, which is very good for my relationships in life. Your own mental health is going way up.

Can we talk about anything besides the people in your book tonight, Ken? I actually don't think so, but we could watch Netflix and be quiet. So the next book is going to be a parent guide. And my colleague, Christine Crawford, who's a child psychiatrist like me, is writing a book interviewing parents and kids and teenagers for what they noticed and when they noticed it. And that book will be coming out in a year. Its tentative title is You Are Not Alone, A Parent's Guide. Okay, so that's just one piece. And like my book, all the royalties will go to NAMI. NAMI owns the copyright. That's kind of the model that I wanted to create for this kind of beautiful mission.

So parents, you know your kids pretty well. In fact, you know them better than anyone. And so there's some basic developmental milestones that a pediatrician will help you with. Can they walk? Can they talk? How are they at basic socialization? But that's so early in life, you can pick up autistic spectrum disorder risk very early on. And the earlier you intervene, back to your earlier point, Eric, the better. So waiting till they're five is much more

uphill than getting intervention at 18 or 20 months. So that's one good example. And we don't understand why there's a rise in the rate of autistic spectrum disorder. The Center for Disease Control doesn't know why. So I want to emphasize, it's not just me who doesn't know. Nobody knows. That's a great thing for parents to be on the lookout for. Childhood anxiety, okay, all kids get anxious. But if the anxiety is in the way of their functioning, that's something that can be treated.

Obsessive compulsive disorder happens in kids. Clinical depression happens in kids. So I was taught, Eric, back in the day, that kids could never become depressed because they didn't have their super ego developed, which was the critical part of your brain that would say, Ken, you're a bad boy. You should feel bad about yourself. And instead, what happened was researchers interviewed hundreds of kids and said, you know, these kids aren't sleeping well. They're thinking of self-harm. They're incredibly sad. They're brokenhearted about the death in their family. These kids meet all the criteria for depression. So the answer is always to talk to people and to listen to them. But parents just need to be mindful also of your own family history.

I interviewed many people who found out about their family history along their journey, and it helped them make decisions. So for example, I have a bipolar disorder in my family, and I'm mindful of that. One of my delightful daughters has ADHD and couldn't be more fantastic, creative, innovative. Remember, ADHD is not all deficits. None of these things are all deficits. And I was very cautious on considering a stimulant given the risk of bipolar disorder in my little genetic loading. Just as an example. So I knew my history. I thought I'd share that with them because these things are relevant. Nothing is a straight line.

It's not all genetics. It's not all anything. I've heard you say that on this podcast. It's not all one thing. And so know your own history. So you might have an indication. So if your family history had multiple people die of addiction, you might want to be mindful of that and think about that with your child, particularly as they enter the independence that comes with the middle school and teen years. Yeah. My son, Jordan, his mother and I met at a heroin dealer's house, which tells you that we were off to a fast start together. So we both addicts and we were open with Jordan from very, I mean, not like when he was four, but I mean, I would say by the time he was 11, maybe, I don't know exactly about, hey, FYI, you may respond differently than other people do. Not

even if you experiment, almost when you experiment, right? Like when it happens, you know, just know that you have a higher risk. That's right. Let's talk about what that looks like and what that means. And thankfully, at least so talk about what that looks like and what that means. And thankfully, at least so far, he doesn't seem to have that tendency. It's great. Integrating the family history, just as you would if you had cancer or heart disease. It's just part of the conversation. It's just integrated into, here's what we got biologically. Here's what we're working with. It's not deterministic, but it's things to note. Yep. There's a lot of depression in my family that I don't think until I was in my 30s, probably, was I able to sort of name it and see it in them. And then my mom went on at one point

to try and commit suicide. So it was there. It just was not known. It wasn't talked about. It wasn't out in the open until I started really dealing with it and started looking around and going, well, hang on a second. It's been helpful to me in a way just to kind of know like, well, you know, I came by some of this honestly. Yeah, that's right. That's right. It's just a way of understanding it without all the shame and isolation. It's just another data point in life. This part of the portfolio that I have. And how do I act on that? How do I understand that? Yep. I want to find a line here that you wrote. This is similar to what we were just saying. And you said a central theme is that no one medication, therapy, lifestyle

change, or relationship is likely to be a magic wand. And I think this is such an important idea, which is we've kind of hit it multiple times in this conversation about putting together sort of a package of these different things. And also being willing to keep trying if something isn't working. So many of the people that I interviewed, Eric, struggled badly in their teens and 20s and built beautiful lives in their 30s and 40s. and 20s and built beautiful lives in their 30s and 40s. Many of them. It was so interesting to me that the things looked hopeless or they had had suicide attempts or overdoses and they had learned things. They had tried and learned things. They hadn't just given up. They kept engaging. So some people found NAMI. Some people found NA. Some people found a medication that finally got their symptoms under control. Then they found a love, and love made all the difference for them. Some people

found faith. It's very interesting. To me, it's a pretty wide library of things that you might pick up that could make a difference for you. And that's very hopeful to me. There is no one script. that could make a difference for you. And that's very hopeful to me. Yeah. There is no one script. In listening to all these people, I was so impressed that so many of them felt that if you could look farther ahead

than what they were experiencing. So I'm hoping some people in their 20s and teens who are struggling read this book and say, my gosh, there's all these guys in their 30s that have kind of figured some of this out. Yeah. What did they do? How did they do? And I try to break that down a of figured some of this out. Yeah. What did they do? How did

they do? And I try to break that down a little bit. It's funny in retrospect, I can see an old writing I would do when I was like 18 or 20. And I just thought like, the game is over now being 52 and looking back, I'm like, well, I clearly had zero perspective. You know, it's funny in retrospect to be like my favorite song at like 19 is called God Damn the Sun, right? I mean, it's just not a sign of you being on your way to the best place in the world. Well, we're back to the parable, because when you're young, you don't know everything. You know, Mark Twain said, my father was really an idiot when I was 16. Then I went away for a few years, and he had become so much more mature in that period of time. Right. So we're all in a learning process.

There were a number of different things that we might say would go into this recovery portfolio. And you listed a few of them. And I thought we could talk through what a few of these are. I'm just going to read what they all are. Sure. So people have that whole picture and then maybe we can hit one or two of them. Acceptance, looking outward for community and purpose, looking inward to be present, belief in something bigger, developing belief in oneself, self-determination, and a journey orientation. So pick up any of those that you would like to start with. So Eric, these didn't come from me. These came from listening to about 80 people who said, this is my primary experience is mental health slash addiction. About 80 people said, you know, I really consider myself a family member. So that means about 40 people said, you know,

I have an illness and I love somebody with an illness, right? So they're both an individual and a family member. So, you know, I like that list a lot. One of the things that I found compelling was the idea of becoming a peer in service to others. Many people picked up on that. And of course, you know, if you've ever seen a sponsor in AA or NA, it's a way to help your own recovery. Yes, you're helping other people, becoming a peer support. And what I learned in this book is so many people at the end of the interview, I checked in on them. What was this like to talk about for a book? You're going to use your name.

Remember that when there's a hundred thousand of these out there, I can't take them back. What they said was my experience caused me so much heartache, if I could help another person by helping them get to where I am quicker, the meaning, the purpose, finding that again, this idea of something bigger than yourself, looking outward and saying, okay, I can't believe I get the opportunity to share what I've learned with other people. So it's pretty cool. Yeah. I mean, I think that thing right there is a really pivotal piece of recovery from whatever, where you sort of realize like, oh, everything I've gone through here, I can transmute into something that is helpful, that is a gift to the world. And that's when you get people saying crazy things like, I'm grateful I was

a heroin addict. You're like, well, hang on, like slow down with that for a second. But my experience was that's when I started to feel that sort of feeling was when I was like, holy mackerel, like I have something to give that like I didn't have before. And I mean, AA sort of started the 12-step movement. I think at the end of the day, that's its foundational insight is one alcoholic talking to another and that both people are helped equally in that. It is a truly reciprocal thing. I think that's so, so important. And if we can find that with whatever we're dealing with, I think it is a huge pivot point for me in seeing all these things differently. Well, not everybody has been down that road. And you have. And you've learned something. And that's why it's so valuable to learn from you.

And to me, even though I didn't necessarily want to have a dad with a recurrent psychosis, I'd probably be a high school history teacher now. And I think of how rich and lovely my professional life has been. The people that I have met that have just broken my heart with beauty on the service orientation, the giving to others, the work and the problem, going to the legislature, the testifying for more research, more service. And I think, okay, this is not at all what I had in mind, at all. I want to emphasize this. And I think I came out with a really nice life and I'm very grateful. I think the next life, I'd like to be a high school history teacher. I'd like to run that play and see how it compares, but you know, next life. Sure. Yeah. I mean, I think sometimes this

idea gets trivialized and we sort of make it sound like, well, it's a worthwhile trade, you know, like you had this incredible, awful thing happen to you and then you were able to help people with it. And what a good thing it turned out to be. And I think that can be overstating the case. There's a lot of situations where I think if people had a choice, you'd be like, no, thank you. No, thank you. No, thank you. No way. Don't want it. And I have it. I have this thing, whatever it is. That's right. What am I going to do with it? And, you know, one of the reliable ways of making that better, I think, is to share what you've learned with others. Yeah. To go at it instead of away from it. And that's an instinct that both you and I have, Eric. Yeah. Let's talk about a journey orientation. What does that mean?

So you say you're 18 and you've decided it's never going to get better. I remember feeling that way with my dad. And I thought, this is absolutely hopeless. He said, Northville State Hospital again. I am the most alone person on the planet. And I remember thinking that. And of course, it seems trite to say it's a pathway. It's a long road.

But if you can take a long view, it does look different. Many people do well with even serious mental health conditions over time. The research has demonstrated this over and over. But I find a lot of professionals don't necessarily have that exposure. They see people in the hospital. They're really sick. The person goes home. They don't necessarily have that exposure. They see people in the hospital, they're really sick. The person goes home, they don't follow them up for the next decade or two. So this is both for professionals and for people and families and individuals. You can take the long view. And I know that's not the most natural thing to do, right? It has value.

It is a journey. You've got to learn along the way. You've got to put tools in your bag as you travel down the path. And everybody's journey is different, but you can learn from each other. And I think that's part of the beauty of the work that I've been involved in is a lot we can learn from each other. Yeah. Yeah. I think that is a really useful thing is to be able to at least have some part of you looking down the road and seeing a bigger perspective. It's not to minimize the pain that we're in by saying like, oh, it's going to be fine. Don't worry about it. I mean, the pain is real. And when you're in it, part of it is dealing with that and accepting that and working with it. But for me, it's always sort of like, can I have like part of one eye at least, you know, down the road a little ways going,

you know what? I don't know how this turns out. Even if I can't get to hopeful, right? Like, well, I can at least get to my mind doesn't know the future. Stick around for a while and see what happens. And this is the challenge for adolescents, particularly in today's world. You know, they get humiliated on social media, for example, and they haven't had the experience of getting through something difficult. And this is why being 15 is so hard now. Because you're humiliated and you don't have the experience and it's very difficult to have a longitudinal perspective. Then in fact, in 10 years, you're not even going to remember who was giving you a hard time on that social media platform. If you could sustain that somehow.

So it's very challenging. You're right. I mean, it is hard to have that perspective when you're younger. It's just more challenging to have. I mean, one of the things that is most helpful to me in my life is my ability to reflect back on and go, you've been through lots of hard things. That's right. Here we are. Here we are. You feel overwhelmed, but you've been overwhelmed somewhere around, I don't know, 12,000 times. Right. And you've gotten through it 12,000 times. And that's really helpful. But you're right. At 15, you don't have that experience. You just

haven't done it enough yet. Right. And that's, you know, the rise of adolescent suicide is one of the public health crises we have. And part of that is it's very difficult to have a journey orientation when you're at the beginning of the journey. Yeah. Right. You're taking the first few steps and you think that's the future. Yeah. I think it's a real challenge. And this is part of why I think, you know, the adolescent mental health crisis is such an important thing for us to be working on as a community, as a society. Yeah. And I think

it's difficult at any age, right? Yes. My depression has a few things that it is always certain to bring up every time it comes around. It's got a few key talking points on its platform. And one of them is you're always like this and you're always going to be like this. Right. And I'm like, the automatic critical thoughts, the automatic negative this. Right. And I'm like, well. The automatic critical thoughts, the automatic negative thoughts. That's just a signature one, you know? Yes. You're always like this, which I have to go like, well, hang on.

Like, was I like this last week? No, I wasn't. And what about now? I guess, you know, I guess I'm not always like this and you'll always be like this. It feels very, very real. Yes. And I know from experience, it's not. But that journey orientation is really helpful. Let's talk a little bit about what self-determination in this list means.

Why was that one of the things that was a theme you pulled from all these people? Well, Mary Ellen Copeland and I had a beautiful interview. And she says self-determination is the idea that you're going to develop your plan and your life, that no one else can do it for you, that other people can support you, but you're actually the agent of your recovery, which actually is very close to the addiction model in AA. You're the agent, right? It's up to you. Nobody's going to cover for you or call in if you miss work.

You're accountable. But the flip side of that is you Nobody's going to cover for you or call in if you miss work. You're accountable. But the flip side of that is you have the authority to design what you want. And a lot of people in mental health have told me that they felt they lost agency. When in the hospital, when their symptoms were out of control, when a relationship broke down because they couldn't articulate what was struggling with them, they felt that they had lost their self-determination in some way. And of course, involuntary hospitalization is a great example of that. People feel like, hey, they take my shoes, my shoelaces. What are you kidding me?

Right? Like it's the ultimate injury in that regard. Hopefully in the service of a short-term emergency, right? And hopefully you get some help and you get back into determining your life. But several people told me how harmful that was to them and how much that impacted them, that kind of experience. And the idea that you can lose your agency because your moods can get so severe

that you can't control them. It doesn't feel like you. So self-determination seems like such a simple concept. Run your own life. But it turns out in the mental health and also in the addiction space, it actually becomes pretty central to what people say they need and what helps them. Now, other people can help you though. That's critical. You don't have to do it alone. Yep. Yep. So we're kind of at the end of our time here, but if you wanted to sort of leave listeners who either have mental health challenges in their own life or in the

lives of people around them, you know, what would you leave us with as kind of a parting few words? I want to say, you know, it's the first book I ever wrote. Five publishers bid on it. People actually wanted to learn from real people. And I got a very cool publisher named Molly Stern, who edited Michelle Obama's Becoming, the best-selling biography in American history. So there's no typos in the book, because society has gotten to the place. It doesn't look like I printed it in my basement. Society has gotten to the place where we are ready to learn from each other and consider your experience as a valid source of expertise. So the shame and isolation you might naturally be inclined towards is not the only choice that you

have. And I feel like groups like NAMI, The Trevor Project, Mental Health America, DBSA, AA, NA, these are all communities of people that will welcome you. This journey is hard to do alone. And I think you will find there's a more welcoming set of communities than ever before, even as the service system is a mess. Those are both true, and they're both true at the same time. You are not alone. You are not alone. Thank you so much, Ken.

This has been a real pleasure. Your book is a gift, and I think for people who are early in a mental health journey of any sort, it is an outstanding resource. So thank you so much for the book and for spending some time with us today. Eric, I think you're really doing beautiful work. And I want to thank you for having me. If what you just heard was helpful to you, please consider making a monthly donation to support the One You Feed podcast. When you join our membership community with this monthly pledge,

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The One You Feed podcast would like to sincerely thank our sponsors for supporting the show. I'm Jason Alexander. And I'm Peter Tilden. And together, our mission on the Really Know Really podcast is to get the true answers to life's baffling questions like why the bathroom door doesn't go all the way to the floor what's in the museum of failure and does your dog truly love you we have the answer go to really know really.com and register to win 500 a guest spot on our podcast or a limited edition signed jason bobblehead the really know really podcast follow us on the iheart radio app apple podcasts or wherever you get your podcasts