Full Transcript Introduction to holistic mental health 0:00 Just a smile, whatever it is, the littlest act. 0:02 You have no idea what the downstream consequences are. 0:05 So you want meaning and purpose? 0:07 Go around the world and just smile at people. 0:16 Welcome back. 0:17 In this episode, I'm joined by the deeply thoughtful Dr. 0:20 Robert Hedea. 0:21 He's a pioneer in integrative psychiatry with over 40 years of clinical insight. 0:27 Together, he and I explore how true mental health extends far beyond the mind alone. 0:32 From the impact of community and connection to the importance of nutrition, faith, and daily practices, Dr Hadea offers a holistic view of healing that's 0:41 both hopeful and deeply human. 0:44 Together we talk about aging with grace, the power of belonging, and how simple acts of kindness and empathy can transform not just our relationships, 0:52 but our entire lives. 0:54 One of the biggest takeaways I had from our conversation was the POWER of conflict and when we view conflict as an opportunity, 1:03 it can offer us a pathway for deepening connection in our relationship. 1:08 This conversation is rich with all kinds of wisdom for anyone navigating the emotional, social, and spiritual aspects of growing older. 1:16 Let's dive in. 1:18 Dr. 1:18 Hedea, welcome. 1:19 Thank you for taking the time with us today. 1:21 Oh, thank you, Heather. 1:23 I've been looking forward to this for six weeks or so. 1:27 You have practiced psychiatry for over 40 years, you have deep wisdom and experience in this space. 1:33 I'm curious how your perspectives have evolved throughout your career. 1:38 Wow, wonderful question. 1:41 Well, it's evolved in various ways, right? 1:45 So the first thing I would say is, strangely, that I think that most mental health problems are not really psychological. 1:55 And because really it's think of it in a simple way as hardware and software, you know, so yes, the software can get corrupted how you think and how do you.
Community, belonging, and aging well 2:06 Think of yourself if you've had a chronic medical or mental condition, but We know that with major psychiatric disorders that there are multiple domains 2:19 in terms of physiology, in term of the body, and in the terms the social environment, the culture, community, toxins, spiritual. 2:27 All of these things have an impact. 2:29 Definitely, I would say that when you dress and you strip back all of this things, In most cases, or many, many cases the psychological problems are a consequence. 2:40 That doesn't mean we're all psychologically healthy, right? 2:44 Because we are not. 2:45 We all have our problems. 2:46 Were human beings growing up in human families with conflicts and challenges, et cetera. 2:53 But it does mean that when your brain is working well, you can usually take care of these things, maybe some therapy. 3:01 The other thing that has changed is my appreciation for community. 3:05 And this is something I want to talk about that most people will not understand, because I would not have understood it a couple of years ago, 3:12 or three years, I wouldn't have understand this. 3:14 We talk social communities, social media, the community on social medias. 3:19 These are actually asocial or anti-social media. 3:22 It's not social. 3:24 People don't even know what community means. 3:26 I moved to New Jersey area about three ago in a very tight knit community. 3:32 and I walk on the street and people I don't even know say hello, they offer me rides. 3:39 who are not in my community but are living in the community. 3:41 In other words, I'm the Jewish Sephardic community, but there's a lot of diversity here. 3:47 All so sweet and they're all so nice and all wonderful. 3:51 Now they are all human beings and far from perfect, right? 3:54 But the cordiality and the respect is there. 3:59 When you're in a community where you know you are going to see people and whatever you do, everybody knows. 4:05 We call it the Syrian News Network because it just spreads like wildfire by mouth. 4:11 You have to be very careful about what you do because there's consequences. 4:15 Online, social media, no consequences, you say whatever you want, nobody knows who you are, it doesn't matter. 4:25 So community is critical. 4:27 There are many centenarians living in this community. 4:30 It's really a blue zone. 4:32 We have lost our understanding of what that word means. 4:35 I didn't understand it. 4:36 Even though I grew up in his community, I did not understand that until three years ago. 4:41 And I was blown away and it brings a level of joy and happiness into my life that God willing will extend my life in a good quality life, 4:52 or at least the quality years, but hopefully I'll squeeze out a few extra years. 4:56 Community is a deeply profound intervention as we age. 5:02 And you're absolutely right. 5:03 The way technology has isolated us, right? 5:07 Last generation was watching TV instead of going out and socializing and playing cards. 5:11 But now it's even worse as each have our own phones. 5:15 I love this term anti-social media that you used. 5:19 It's not about being social. 5:20 It really does force us to be anti-social because we're at home alone, not really engaged in these very human interactions. 5:29 We thrive and we heal in community, and not in isolation. 5:32 And this takes work. 5:35 Right, as you mentioned over and over again, people are human and there are the ups and downs and the complexities and dynamics of those relationships. 5:44 What have you learned? 5:45 You mentioned three years ago there was a big shift. 5:47 Can you tell us a little bit more about what happened there and then also what you've learned about how to deal with these complex interpersonal human relationships? 5:57 Okay. 5:57 Well, what happened was my mother, she rest in peace, passed away about three and a half years ago. 6:03 And she had a condo overlooking the ocean in New Jersey and in this community. 6:09 I said to my wife, you know, I'm a part owner with my brother and sister. 6:13 Why don't we just go spend the summer there? 6:15 Because it was Zoom. 6:16 Everything was zoom. 6:17 What's the difference? 6:17 I might as well be looking at the ocean while I'm zooming, right? 6:21 So she said, okay, let's go. 6:23 She was a little reluctant. 6:24 she liked Maryland where we were living, but she says, Okay, Let's Go. 6:27 We got here and three weeks later, she looked at me, She said we're not going home. 6:33 I said no, we are not. 6:35 And that was it. 6:36 So this became home. 6:38 This became all I commuted for about a year and a half to transition to a practice here, open the office here in Eaton town, 6:45 New Jersey. 6:46 That's kind of what happened. 6:47 Now, how do you navigate things? 6:49 You navigate by being empathic and considerate and caring and helping people.
Faith, mindset, and reducing anxiety 6:54 Wherever you see the opportunity to help someone, you help. 6:58 You contribute. 6:59 It's not about you. 7:04 strengthening the community and giving people the respect that you would want. 7:09 That's what it's about. 7:11 And you do it. 7:11 I have to tell you, Heather, that a part of my brain that was dormant has woken up. 7:18 But I did not have the exercise these skills. 7:21 Now I'm like, wow, I can't believe what I am doing. 7:25 12 years old and then I was essentially pulled out of the community because my parents divorced, I'm pulled that of a Yeshiva which I love, 7:40 love love. 7:41 I lost my spiritual network, my social network and my education which was really enjoyable to me. 7:48 And I went out in the world, that was in an atomized world where we are little atoms floating around. 7:53 We are atomize, we have been atomised. 7:56 There's no cohesion, very little social cohesions. 7:59 and that I didn't even know what was happening to me. 8:02 I would say a low-level sadness or depression or whatever you want to call it, loneliness, whatever we want call, it was not a happy guy. 8:11 But I don't know, just like get used to it and this is what it is and you do what you wanted to do. 8:16 It's not that you have fun and your own enjoy people in your relationship you too, but there's a network here that, I know how to convey it to you, 8:26 I'm walking down the street. 8:28 Are you okay? 8:28 I don't know this guy, but I mean, all the guy and this guys looks a little seedy or whatever, you know, so he stops and he's, 8:35 are you, okay, your cat hangs around for a minute. 8:39 Like what? 8:41 You know? 8:41 This is, this is you feel the love. 8:44 It's the place is called long branch. 8:46 I call it love branch With your experience as a brain doctor, as psychiatrist and helping support people's cognition as they age, 8:55 is there a mechanistic impact you think this is having on the brain that other people might be able to recreate outside of Love Branch? 9:04 Well, there's two things. 9:05 One, this is a kind of medical answer that when we use transcranial laser to help treat the brain. 9:11 And if you look at the right parietal area, that's actually the kind away awareness of the larger situation, the social situations. 9:20 Sometimes I will actually target that area like right now in an autistic kid and he's beginning to speak. 9:26 So, you know, can kind wake that are up. 9:30 that way, how do we create? 9:31 That's the biggest question. 9:33 And the best I could say is if you embed yourself in a constructive, I would say socially oriented, constructive community, 9:42 and I'd say religious, but maybe you're an atheist or an agnostic, you don't like that. 9:47 Fine, find an ethical society and stay in it. 9:52 Just stay at it because the relationships will deepen. 9:55 I have automatically here deep relationships. 10:00 My connections with these people go back hundreds of years, really 2,500 years. 10:10 You can recreate it by being part of this constructive group that shares your interests and goals and just be there and contribute to it and grow it, 10:19 and do whatever you can to help it thrive. 10:22 It sounds like values are part of that equation as well. 10:26 And you mentioned, you know, it's faith-based for you, but that there are other alternatives if faith isn't maybe your path. 10:33 I think of senior living communities as a potential place where this can happen, where you're walking down the hall in your neighborhood, 10:40 your wing of the community, and you see some of those same people each day. 10:45 So, you talked about just making the time for small talk. 10:49 What other examples? 10:50 Checking in on people, thinking, hey, are you okay? 10:53 Do you need something? 10:55 Recognizing people. 10:56 Acknowledging them. 10:57 You mentioned someone said, Hey, doc. 10:58 So they're acknowledging who you are in the community. 11:01 Are there other example of this or little tricks that can help people feel more connected in communities that they live in? 11:10 Really, those are the main ones. 11:11 You want to lead the community, help the communities, support the committee, be loving. 11:16 So maybe the prime thing for me is I love this community. 11:19 Do I every person in it? 11:21 No. 11:22 I don't even know them, but I loved these people. 11:25 These are my people and if you find a community that's oriented and with sharing your values and you spend time with them you got to love them. 11:34 You got to love them because they share with you. 11:36 And that's the essence. 11:38 Everything that I do and that everyone else is doing is really out of love. 11:42 Now conflicts come up and then you have to handle them appropriately. 11:46 That means keep the fire low. 11:48 Don't amplify. 11:52 Talk to people about other people. 11:54 Never talk to other about people, never, unless this is one of the rules, really. 12:00 This is from the Torah, basically. 12:03 If you were starting a business and you came to me and said, hey, I'm gonna work with Joe Blow, and I had worked with him, 12:10 then I would be obligated to listen, listen I worked him and ran into these problems. 12:15 But I never, should I ever talk to you about Joe, Blow unless there's a consequence to it. 12:20 So there are seven rules for how, when can you speak about another person? 12:26 You don't just talk about people. 12:28 It's damaging, it's considered in this community as if you're doing murder of a reputation. 12:33 So that keeps the social network flowing and functioning and safe. 12:40 And this also, it supports that mental health, right? 12:42 When you mentioned this, that there was this low-level depression when you weren't part of this community, and then coming home to it, 12:48 there is this lifting of that. 12:50 I'm curious how you've seen mental-health, whether it's depression, anxiety, you mention autism, I had a patient the other day with bipolar disorder, 13:00 schizophrenia, these kind of more extreme psychiatric conditions that people live with, how do those conditions particularly probably the common ones, 13:10 anxiety and depression, affect us as we age. 13:14 And you talk about just in general, how do they affect this? 13:17 Yeah, in ingeneral.
Brain-based therapies and patient recoveries 13:19 If it's negatively, what can we do about it? 13:21 What can you do to support healthy aging in that context of potentially being on a long-term psychiatric medication like an SSRI or an anxiolytic? 13:32 what we can do sort of mitigate the risks of both the condition and potentially the medications? 13:37 Okay. 13:37 So, well, I'm going to answer this on two levels. 13:40 Okay? 13:40 One level is I've treated depression. 13:42 I have been in psychiatry 47 years now. 13:46 And I taught cognitive behavioral therapy, which is your main accepted treatment for depression and anxiety. 13:52 Right? 13:53 And of course I am trained as a psychopharmacologist, so I know these things. 13:57 Uh, and I've lectured and taught about cognitive therapy and schemas and et cetera, et, cetera. 14:03 But I have come to the conclusion that actually it was about several, 10 years ago or something that the best thing you can have, 14:11 whether you believe it or not, is faith. 14:14 You may not believe you say, well, I don't believe it, you know. 14:17 Now, if you're an atheist, You're actually a believer because you believe that there's no God. 14:22 Well, go ahead. 14:23 Go prove it. 14:24 You can't prove that you believed there is a God go prove you can. 14:27 Right. 14:28 The only position that makes sense is being an agnostic where you said, Well maybe I'm not sure. 14:33 Okay. 14:34 That's step one. 14:34 Step two is the research is very clear. 14:38 that belong to a constructive community, like a faith-based community actually extends your lifespan by seven years. 14:45 You have less divorce, less suicide, Okay, that's step two. 14:52 Step three is we're all brainwashed. 14:55 Okay. 14:55 You think you know the truth. 14:57 I think I know that truth now. 14:58 We're brainwashing. 14:59 Every last one on the planet is brainwash by the culture and the media and their environment and then the generations that came before. 15:06 All of us are brain wash. 15:08 So I decided And I'm brainwashed, why not stick my head in the washing machine? 15:13 That will give me the best result. 15:15 I'll take seven years of extra life, better quality. 15:20 So I decided, even though my logic, my science mind said, no, this is ridiculous. 15:25 But I actually battled for many years to really assess things. 15:32 And my goal was actually to actually come to believe in a higher power that was benevolent. 15:39 That was my gold. 15:41 I didn't believe it, but that was my goal. 15:43 Since I'm brainwashed, might as well do it. 15:45 There's this idea that if we're optimistic about whatever's happening next, whether it's after we pass or even between now and when that happens, 15:54 if were optimistic because we believe that the universe is conspiring in our favor, that there is some benevolent higher power, 16:03 then it allows us to relax a little bit. 16:05 There is not so much of a tendency towards depression and anxiety. 16:09 It's easier to sleep at night, right? 16:11 100%. I'll tell you a story. 16:14 I get migraines maybe four times a year if I eat tuna fish without mayonnaise. 16:21 It's the tyramine. 16:22 You know, it's like a basal pressure or something. 16:25 But that's what happens. 16:27 So I had a stressful day and I need to innovation. 16:31 I got a little migraine and it's not painful, but it is visual symptoms. 16:35 And so I was sitting down with dinner. 16:36 It was a very stressful. 16:37 Yeah. 16:46 fell into a meditation on gratitude, like how fortunate I am for everything, everything from fingers moving to everything else, 16:54 right? 16:55 I was overcome with gratitude and this migraine was should take about 20, 30 minutes to resolve, was gone in under a minute. 17:05 So that's your mindset can change your physiology, Right? 17:08 So what I'm getting at is I believe that we are addicted to control. 17:15 We all want to have control. 17:17 It's great if you can control everything, right? 17:19 Wonderful idea. 17:20 But the truth is, you're not really controlled very much at all. 17:25 You're in control of your attitude, and that's work. 17:27 All right, so. 17:30 Perhaps the work So it is the work, right? 17:34 And I'll give you another story, true story about 15 years ago. 17:38 So when I was a kid, I had a lot of dental stuff. 17:41 My mother loved sweets. 17:42 And so I love sweets, it was very bad. 17:45 I have a lotta cavities, there should be fluoride and all of that stuff, And so when I go to the dentist and they're cleaning my teeth, 17:54 I get a little perspiration. 17:57 But I got nervous, right? 18:00 So the day before I was, you know, always working on the spiritual stuff and trying to understand the universe and physics and quantum physics, 18:08 and all this stuff. 18:09 So, the date before, it got this idea in my head. 18:12 about, you know, I'm actually really not in control. 18:15 Not an idea, but I actually was experiencing this. 18:18 And when I go to the dentist tomorrow, whatever's going to happen is just going happen because it's already written. 18:24 That's the Akashic record, right? 18:27 You know what I mean? 18:27 The future is kind of written. 18:29 We have a choice over attitudes and you know, the horse is going where it's going. 18:33 You could ride it with grace or not. 18:36 So I said, okay, well, it was written, and it is gonna be what it. 18:39 Is so I went and I was really relaxed and the hygienist said to me, I don't know. 18:45 What you're taking, but I want some. 18:47 So what was that? 18:50 80, 85%, 90% of my pain was suffering. 18:54 It wasn't pain. 18:55 Was suffering, suffering is different. 18:57 That is potentially under our control. 19:00 And I would say to you, and this is what I submit, that as a prevention for depression and anxiety, a person should work intensely and it takes time, 19:09 it take years and you have to be inclined also. 19:11 But to get to a position where you realize that you're in the flow of the universe. 19:16 You can't control the floor of a universe you are in. 19:19 The flow, go with the float, do the best you can, try to steer the boat. 19:23 If you, you most of time being on this podcast with you right now, if you stopped and really thought about it, how many people contributed to us being 19:34 able to talk right. 19:34 Now it's millions and millions of people and it stretches back. 19:39 As far as human civilization, whoever created the wheel was necessary to get the trucks, mine the stuff, to bet the metals, 19:47 the boats. 19:49 The lawyers, you're not in control. 19:52 We're just having to be lucky to riding this wave so we can talk to each other. 19:55 And that's the reality. 19:56 It's this sense of reverence. 20:01 Now, speaking of the technology and its reverence for the complexity of things that we have at our fingertips these days, 20:08 I know you mentioned laser, and you use a lot of pretty fancy equipment in your medical practice. 20:14 Do you have any favorites or anything that you've seen work especially well as the technologies have shifted and have been able to use these tools? 20:24 Well, what I love is a combination of a transcranial laser with neurofeedback and when appropriate hyperbaric oxygen layered on top of functional medicine, 20:38 some spiritual work. 20:39 So the way I think of it is you give the brain energy or you inhibit it over activity in certain areas and then you take that energy, 20:50 you put someone into neuro feedback where you can actually say, well, the energy should go here into this network. 20:56 for that network. 20:57 And I like that combination and it's very effective. 21:00 I'm not using eWAT, but I am thinking about using EWOT. 21:04 Then I layer that on functional medicine and I do a fair amount of talking about the spiritual. 21:09 Or if you don't want the God thing, the universe, it doesn't really matter to me. 21:13 Do you have any patients that stand out who have had either really incredible recoveries or inspired you to age in a different way personally? 21:22 Well, I have a lot of patients who have great recoveries. 21:25 Just yesterday I finished with this 24 year old guy who had Lyme, Bartonella, severe depression, really bipolar. 21:34 And for eight years he was suffering and we cleared his infections to a great, just doing wonderful. 21:40 He just got an internship in cybersecurity with the government and he's so excited and, he is, He's just done wonderfully. 21:47 and He was just so grateful. 21:48 So, you know, there are a stories like people with schizoaffective disorder who actually return to their normal lives. 21:56 It's a lot of work, but they can do it if they have the support and the willingness.
Context, relationships, and healthy aging 22:01 So there's lot cases like that aphasia that improved Parkinson's that improves. 22:07 I was name dropping the other day when I talked to Dr. 22:10 Bredesen, I mentioned that you were on my calendar for this Friday, and he asked me to ask you about a frontotemporal dementia patient. 22:19 Do you recall one that improved pretty dramatically? 22:22 Because that is not common, right? 22:25 Well, I think with dementia across the board, but particularly FTD, frontotemporal dementia, it's quite challenging to get benefit for those patients because 22:33 there are so many psychiatric components to their presentation. 22:37 It's very hard to them on board for a functional medicine type program. 22:41 Many of them are not as aware of their decline, their cognitive decline or the changes in their personality perhaps. 22:48 So are you comfortable sharing about that particular patient? 22:51 Yes. 22:51 Well, so what I'll tell you is that there's not a patient where I said, boom, I treated FTD and they're better. 22:57 No, that's a misunderstanding and that is not true. 23:01 I do believe that, well, it's the fact that they are multiple types of FT. 23:07 If you have PTSD, you're actually at higher risk of FTD, right? 23:11 And if you just think of it as the frontal and temporal lobes, and they keep getting damaged by the trauma, et cetera, so you've got increased risk. 23:18 You can have behavioral problems, etc. 23:20 Can you treat it? 23:21 It depends on what variants are involved, there's some overlap, as you know, with ALS. 23:28 So in ALs, one of the problems is the mitochondria don't really travel all the way down the axon, so it doesn't matter if you laser somebody to find that 23:37 mitochondria produce energy, but they're not in the right place to deliver the energy. 23:40 So it does matter. 23:41 That's not going to help a certain type of FTD. 23:44 Another type FTB, it can help because it's based on that type problem. 23:50 A lot of my patients have frontotemporal problems. 23:54 Even a lot the patients who have early dementia have frontotemporal problems, but also as you know, it's not such a clear diagnosis because there are multiple 24:06 types and etiologies. 24:07 But the genetic type with progranulin haploin insufficiency, I have not treated a patient who had that and got well and I haven't had the opportunity to 24:19 treat it or try. 24:20 I'm not saying it wouldn't work because I kind of think it might actually, I think your point is all dementias, all neurodegenerative disease. 24:30 A lot of it depends on the etiology, what's causing it. 24:34 And with that functional medicine approach, it's systematically going through and asking that question. 24:40 What is triggering the immune system in the brain, that microglial activation? 24:44 What's creating an imbalance, creating this need to protect the bring that's leading to that neuro degenerative cascade? 24:52 And when we can identify those, and treat them and correct for them, create more balance in the system, then sometimes we see improvements. 25:02 Yeah, I think that's true. 25:04 I am reminded of a story of gentlemen, he's about 57 years old and he has aphasia, had a severe stroke about two and a half years ago, 25:13 roughly. 25:14 He hasn't said more than a word or two, like, ''I don't know.'' He can't really talk. 25:21 Very frustrated, who's an engineer. 25:24 One day his wife said to him that in some way that there's no more hope for you getting better. 25:30 And maybe not outright, but that's what he heard. 25:33 And he walked out of the house and he was wandering around Richmond, I don't know, for a few hours. 25:40 She called the police. 25:40 They finally found him and they took him to the emergency room. 25:44 He was in the room and starts naming things. 25:47 The guy has problems with nouns, right? 25:49 And that is the worst thing. 25:51 Eleven words. 25:54 Now, that means there's something there that he's not accessing. 25:58 And the context and the change in the contexts played some role in that as well as the physiological changes, right? 26:05 So that's very, very relevant to the whole discussion of how do you age well? 26:12 You know, how to age? 26:13 Well, you really, your context is critical. 26:17 Expand on that more. 26:18 How do age, well, and what about context? 26:21 So, okay. 26:22 So how do you age? 26:23 Well, well, you need people to help you, right? 26:26 You need your friends, your spouse, can't do it all. 26:28 You're like, this is the way I think, but you're a bacteria in a Petri dish with a culture medium. 26:34 And it's the culture of medium that determines your phenotype. 26:38 Okay. 26:38 You could want to be purple all you want, but if the culture medium is yellow, you're going to turn kind of yellow. 26:44 It doesn't matter who you hang around with, that's what influences who become. 26:49 So you wanna be around people who can help you along the way to the goals that you feel you are. 26:56 If you were married, your spouse can, help your brother, sister, uncle, friends down the street, whatever. 27:03 Get the help to go to the gym. 27:05 Let's do it together. 27:06 You know, get help because you can't. 27:08 It gets, I'll tell you Heather, it gets harder to self-motivate. 27:11 For me anyway, maybe other people you'll interview will say the other way, but for me, It's harder. 27:18 To self motivate. 27:20 The way I did when I was 40 or 50 or 55 or 60, you know, going to the gym. 27:25 I can't do what I used to do in the jam. 27:26 My was mountain biking four or five, six hours a week until three years ago. 27:31 And I kind of blew out my knees, had knee replacements and thank God I could walk now because I couldn't walk for 30 years, 27:39 but I kept bike. 27:42 I can't bike now, and it's harder. 27:45 I'm trying to get my muscles back in shape, but my wife says, hey, let's go to the gym. 27:49 Okay, I'll go. 27:50 If it is up to me, you know, maybe I will do this, do that, take a little rest, read a book, whatever. 27:59 Other people help. 28:02 That's important. 28:03 And for someone who's looking to stay mentally sharp and emotionally balanced as they age, are there daily practices that you typically recommend or lifestyle 28:13 interventions that think you get the most benefit from? 28:16 Yeah, I mean, the benefit is really the basics, right? 28:22 really good quality food, relationships, reasonable exercise, it's just the basic sleep. 28:31 Those are the basics and you work on the basis you get a lot. 28:34 You probably get 70% of the benefit coming from those. 28:38 And now if you have other factors, chronic infections, et cetera, hormonal deficiency, you address those and the whole functional medicine model, 28:45 well, your address to those, and then you do the Basics. 28:48 I mean, are you going to get like 80, 90% improvement? 28:52 And what about you personally? 28:53 You mentioned biking and you've mentioned faith. 28:56 Are there personal practices that you use like a non-negotiable every day that don't miss? 29:03 Yes, there are. 29:04 And it's taking time to develop these, believe me. 29:07 It started with meditation. 29:09 I pray every for 45 minutes. 29:13 and I do that every I probably about half hour after I wake up. 29:20 Not that I'm perfect, but I am 98%. I get to bed early enough so I can get adequate sleep. 29:26 So if I wake up in the night, I don't stress over it.
Daily practices for resilience and purpose 29:36 Bellas are really important and then really work on diet, which is a challenge because of, you know, the way our lives are structured and what's readily available. 29:45 But that's also where it works. 29:47 So I say that the biggest one I've said is the prayer, because for me that, see, I could be in any kind of stressful situation. 29:54 I won't say any time. 29:55 but really stressful situations, family, the world, whatever it is. 30:01 And I have built a mindset now where I can retreat to a place where, I see a really big picture and I trust that things are going to work out because I 30:11 could look over my life, The history of my people, et cetera. 30:15 I say, well, you know what? 30:18 Things, it looks pretty bad right now, but it's always really actually worked out and it'll work it out. 30:25 And I'm sure if I had a bad diagnosis, I'd freak out for a while. 30:29 And then I would find my balance. 30:31 That took work to get there, and I'll still work. 30:34 I will always work." You mentioned you use faith in your practice, that you discuss it with patients because it affects their psychological condition. 30:44 How exactly do you do that? 30:47 Well, first of all, I'm not pushing my faith. 30:50 That's not at all my interest. 30:52 And what I do is tell them, you know, don't care if your higher power is a big pen. 30:57 I don' really care what it is. 30:59 It's now you, that's for sure. 31:01 and it's none another person. 31:02 Okay. 31:03 So you got to work on that, but I'll tell him, if it meditation, they'll meditate or, or they have to choose what works for them. 31:10 And I will have that discussion with them about, you know, atheism and being an agnostic, because I'm not saying I am right. 31:17 I just saying it works for me. 31:20 No, that's all. 31:20 So I don't have a problem doing it. 31:22 It was actually trained that never talk about religion, never do that. 31:26 That was an editorial in the New England Journal of Medicine, I know probably 40 years ago or 50 years. 31:33 Right. 31:34 Never do. 31:34 And like, what are you kidding? 31:36 And most of the patients love it, I can imagine there are a lot of patients out there listening thinking, I've never talked to a doctor who brought that 31:46 up and it's such an important part of my life or maybe having this very eye-opening experience listening to our conversation going, 31:53 oh, maybe that's what's been missing. 31:56 Well, I have this patient with autism, severe autism. 31:59 I haven't treated another autism patient before. 32:01 He seems to be starting to talk now, which is wonderful. 32:05 But his parents, both of them loving people, they said to me, you know, You're the first doctor who has ever dealt with the spiritual aspects of this. 32:16 And we have conversations when appropriate, and if they don't want to talking about them, we'll talk about it. 32:23 That's fine by me. 32:25 I'm sorry, I'll ask people, do you want to go this route or maybe you're not interested and if they're fine. 32:33 Make sure there's an opening. 32:36 Diet is another big important component you mentioned. 32:39 Is there a particular diet that you recommend? 32:41 Are there foods to avoid, foods incorporate for our brain health as we age? 32:48 Obviously, everyone is unique, but in the big scheme of things, we know that only baby cows should be having cow milk. 32:52 Basic stuff like that and the simple carbs are really poison. 33:05 We all love them, so you can have some of them but you try and steer away from that. 33:11 I try generally to work towards what is called a zone diet. 33:16 People don't talk about that anymore, but it's basically a third of your plate is a nice, good quality protein, a 3rd of it is complex carbohydrates, 33:25 and a 1rd the calories on the plate are from healthy fats and snacks the same way. 33:30 So that's the general, but in some cases we'll shift this way or that way and use different proteins. 33:37 What's best for that patient? 33:39 I'm curious, as you are in your, going towards your 50th year in practice, what brings you the most joy these days at this stage of life? 33:51 In my practice or out of my practices? 33:53 Well, I think both, career-wise, personally, I have a lot of hobbies which I don't really get to spend that much time on. 34:02 The most joy is I love my practice. 34:10 I feel blessed and when a patient is getting better and I solve a mystery and help them get better, Wow, there's nothing like it, 34:19 really nothing. 34:20 I love it. 34:20 And I say I'm a compulsive healer. 34:22 You know, I can't give that one up. 34:25 So that's one thing. 34:26 But then of course, conversations with my wife, we have long conversations that are really deep and even conflict. 34:36 Finally, at this late stage, learn how to understand a woman. 34:44 Do tell, do tell. 34:45 Go on, Dr. 34:47 Gidea. 34:49 It's been written about, but basically, You know, I'm a guy, right? 34:54 You have a problem. 34:55 She tells me a probably, okay, well, fix it. 34:56 Here's the solution. 34:57 What do you mean you don't want to hear about the solutions? 34:59 What's wrong with you? 35:00 Right? 35:01 The guy. 35:01 Right. 35:02 But really what I came to understand is she, she's feeling bad. 35:07 He's just feeling a bit. 35:08 It doesn't matter why, if it's right, logical, not like she is feeling better. 35:12 And I love her and I don' want her feeling that that's it, that the end of the story. 35:16 So what can I do to help you feel better? 35:20 Cause I, love you and you're part of me. 35:22 And we get through conflicts so, so beautifully. 35:27 It's not that we have a lot of conflicts, but we're, we were able to talk to each other more and more freely and really give each of that love real, 35:34 you know, and so forth. 35:35 So that's really a big deal. 35:38 It sounds like you see the conflict as an opportunity for potentially more connection and a problem solving, right? 35:45 Just like with your patients, there's this ability to solve the problem and to feel that resolution. 35:51 And if the conflicts weren't there, they might not be that same opportunity. 35:55 It's very true, it's just so gratifying to both of us. 36:00 I'm so glad that I heard her and that could be just hearing her, and understanding, empathizing. 36:07 It feels wonderful to be able to help her. 36:09 She feels it is the same, going both ways. 36:12 That's a beautiful thing. 36:21 That's just me, my limitations, you know. 36:23 Any advice for those who are in their forties or fifties, or sixties? 36:28 Is there a way to get there faster or does it really just take time? 36:33 Well, I think you can get that faster. 36:35 I don't, uh, You have to have imagination. 36:39 You can't empathize without imagination, so for example, My wife will say something and I'll say, and she says, okay. 36:49 What if such and such happened to you and this happened? 36:52 And they said, how would you feel? 36:54 I'd be like, oh my gosh, yeah, no, I want to like leave right away. 36:58 She says, that's right. 36:59 I'm like oh wow, so she has the imagination to create that scenario that I could relate to. 37:05 And I have the imaginations to be able to step into her shoes. 37:09 So it takes some imagination, right? 37:12 It's not factual. 37:14 What about some patience, some creativity, Some empathy, and some willingness to show up and be present in the conversation as well? 37:22 That's right. 37:22 And you know what? 37:23 People, a lot of people, myself included, don't like conflict. 37:26 So you avoid it. 37:27 I won't talk about this. 37:28 Just bury it, but you bury and the pile grows and it comes out somewhere and you're like, well, what was that about? 37:38 So the avoidance of conflict is actually You have to kind of take a deep breath and just in a nice way, say how you feel. 37:48 Not always, I feel this. 37:52 You're not saying what the facts are. 37:53 Nobody has a video camera to prove what happened, right? 37:57 It's I, feel, this, and I'll say, no, not say I'm right, you're right.
Conflict, empathy, and meaning in later life 38:03 It was just what I felt. 38:04 This is my experience. 38:05 That's all. 38:07 And of course, well, she doesn't want me to have that experience, so she wants to understand, you know, vice versa. 38:12 I love it, the benefits of conflict, right? 38:15 This deepening of relationship. 38:18 And that relationship, this is kind of where we started the conversation, is those relationships, whether it's community or these deep relationships with 38:24 a spouse, maybe with children, adult children with siblings, with these people we have long experiences sharing life with. 38:34 It leads me to my question, you emphasize the importance of purpose and meaning in mental health. 38:41 And how do you help patients connect with those values as they age? 38:47 Everyone has their own path, right? 38:48 So you look at what I do is I sometimes I'll ask a simple question and say, you can do anything. 38:54 Imagine you could do. 38:56 Anything at all. 38:56 You press a button and boom, it's reality. 38:59 It's just reality What would you wish for? 39:03 Kind of get the juices going, get things flowing, et cetera. 39:06 I will also ask them to think about what they enjoyed when they were very young. 39:10 That'll give you clues, right? 39:12 When were you happiest in your life? 39:15 What were the elements of that happiness, you know? 39:17 Things like that. 39:18 And sometimes I'll send people for testing, aptitude testing to see what their aptitudes are. 39:24 You know, they're good at this, good that, So those are the things that I do. 39:29 But I will say kind of back to one of my original points. 39:31 Once you get the brain working again, they'll find it. 39:35 Usually they will find. 39:37 And the aptitude testing, I imagine a lot of people are curious about that. 39:41 Can you talk more about it or are there tests online? 39:44 How do we know what our aptitudes is to help? 39:47 I've always sent people to this place in Northern Virginia called Ability Potentials. 39:53 Haven't sent them there in a while now, but that's where I send them. 39:57 I'm sure there are many ways of doing this, and the other thing, let's put it this way. 40:03 If you're in a community and your aunt or your uncle is living around you, you say, hey, Uncle Joe, I don't know what to do. 40:10 What do you think? 40:11 Oh, since you were a kid, do always like marketing. 40:15 No, no, You don' know. 40:17 You love marketing, that's Uncle Jo, right? 40:23 that could be worth all the testing in the world, right? 40:26 Right. 40:26 Someone who really knows you, who's seen you grow up. 40:30 And the other thing is, if you do it well, you'll probably end up liking it. 40:35 I've heard this from the concept of Ikigai in Japan, is what do you enjoy? 40:41 What do do well? 40:42 what can make you money? 40:43 right. 40:44 What provides value for the planet, for world and the community? 40:48 And if can think through something that fits into all of those categories, then you might be going in the direction of your purpose and meaning. 40:56 Now, as we age, once we approach that retirement, we don't have to worry so much about does this provide money, right? 41:03 We're not in that phase anymore. 41:05 It's like that learn, earn, return. 41:07 We are in return phase of life. 41:10 And we can start thinking, and I think sometimes people I see in my practice that people miss that opportunity to kind of rethink. 41:16 In this phase What is driving purpose and meaning for me? 41:22 How can I return some of the gifts I've been given, give back to the community, and do it in a way where I'm kind of free from the need to make money, 41:31 make ends meet? 41:33 And that's worth kind sitting down and really reflecting, maybe going through some sort of aptitude testing, talking to people you've known for a long 41:44 time who know you well, and figuring out what is it going to be? 41:49 I mean, there's a litany. 41:50 There's long, long list of things. 41:53 I'll tell you a personal story because it has to do with meaning and purpose and your impact in the world. 41:59 My mother, again, probably 20, 25 years ago was in an emergency room and she was there for maybe 10, 12 hours and very hungry. 42:07 A guy walks by, he says, ma'am, can I get you sandwich? 42:10 Oh, that'd be great. 42:11 Gets her a sandwich. 42:12 She's like, oh, thank you. 42:13 Thank you, Thank You. 42:14 He leaves. 42:15 she says, wow, I'm going to volunteer here. 42:29 drive and you let someone go ahead of you with smile and wave, just a smile, whatever it is, the littlest act, you have no idea what the downstream consequences are. 42:38 So you want meaning and purpose? 42:40 Go around the world and just smile at people. 42:43 You have not idea the effect you can have. 42:46 Be kind, right? 42:47 And now that is simple. 42:50 Anybody could do it. 42:51 Yeah, these simple acts of kindness. 42:54 You have had countless patients, I can imagine thousands of patients over the years. 42:59 Have any in particular stood out as inspiring, particularly older patients that you might have learned from? 43:06 Good question. 43:09 Is there anything that have you learned about growing older with grace and resilience from your patients? 43:14 The woman who comes back to me actually, this goes way back, so this is when I started my practice, her name is Dora Lipowitz. 43:24 Okay, now she's passed, long gone. 43:26 Her husband's past, but Dara was a woman with children who had coronary artery bypass and no depression before, after that she had depression. 43:37 unrelenting, and she was one of my very first patients. 43:40 And her husband would come in with her and they would just, they approached everything in such a kind, calm way. 43:48 I was able to help her get better, but I able see the peace and the calmness of this elderly couple moving into the later years and facing challenging 44:01 health situations. 44:03 So she really stands out to me. 44:06 There are a lot of elderly patients who have done well. 44:08 I have another woman who is 80 something now with chronic depression. 44:14 She's still traveling, single. 44:16 she just came back from Vietnam. 44:18 You know, she's amazing. 44:19 And I tell her she is like a rock. 44:22 So I said, you're my rock! 44:25 The courage that it takes to go to a foreign country with different language to travel, especially across continents is stressful on anyone, 44:35 let alone someone in their 80s struggling with depression. 44:38 And so it's just the courage and the perseverance and like the chutzpah to take it on. 44:47 There's my aunt who lives above me in my building. 44:51 She's 95. And she's, my wife had surgery on her knee, you know, several months ago, and she comes down, slips into our apartment and puts some rice pudding 45:02 in the fridge. 45:03 You know what I mean? 45:04 So there's a community, right? 45:06 And, she is 95, She's taking care of us. 45:08 She calls, how's it going? 45:10 How's. 45:11 So really, I honestly could age well by giving and loving, that's the big, big thing, really. 45:19 Dr. 45:19 Hedaya, I cannot thank you enough for taking time out of your busy practice and your full life to share with us your wisdom and experience today. 45:27 It is such a pleasure to connect with you. 45:30 Thank you really so much for the opportunity. 45:32 These things that you're talking about are not usually spoken about and they're very essential. 45:37 They're foundational. 45:39 it's really the juice of life, right? 45:42 It's the most important thing. 45:43 Well, thank You. 45:44 I hope that our conversation inspires others to age well and enjoy it. 45:49 I feel the same way. 45:51 Thank you. 46:11 To stay connected, get bonus resources and never miss an episode, head over to drheathersanderson.com and join my email list. 46:22 Until next time, keep thinking well and aging on purpose.
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