Ep. 13 | Joe Morgan, MD, Psychiatrist, SGMC Health

Tune in as we sit down with Joe Morgan, MD, Psychiatrist and Medical Director of Dogwood Senior Behavioral Health, to explore the landscape of mental health. Dr. Morgan delves into hot topics like therapy, anxiety, and depression, and shares his expertise on working with aging populations suffering from dementia and Alzheimer's, including key risk factors and warning signs. We also address listener-submitted questions on therapy for family members, dealing with grief, and coping with sadness. Don't miss this enlightening conversation with an expert in the field of mental health!

Transcript


- Welcome to another episode of What Brings You in Today. I'm Erika Bennett. And I'm Taylor Fisher. And today we are here with Joe Morgan, MD Psychiatry. Dr. Morgan, you've been a private physician in the Valdosta area for quite a while now. You also serve as our medical director for our Dogwood Senior Health Center. So we're excited to talk to you today. But, so what brings you in today?
 
- Well, I, I think, you know, in psychiatry you get a lot of questions from people who don't quite understand what you do. And I think it gives us a chance to talk about any area of psychiatry that people have questions about. Tends to be a murky science sometimes, you know, in, in medicine, 'cause I did medicine in neurology before psychiatry, and it's a lot more specific, you know, you can check for certain organisms in the blood when you have a, an infection for example. But psychiatry is, is one of those sciences that's as much an art as it is a science. So I think it's a good chance for people to get an idea about how we diagnose certain disorders, how we treat 'em and, and that sort of thing. And in addition to that, you know, we also, as you mentioned, we do the senior health center, Dogwood Senior Health Center. And so we get a lot of questions about dementia and Alzheimer's because that's the primary diagnosis that we treat there.
 
- Okay. Well, tell us a little bit about yourself. How you, what led you to become a physician and what led you to psychiatry?
 
- It's just a long story in a nutshell. Grew up in the military and my mother was from Nashville, Georgia. So when I, I guess when my father got outta the military, I started high school at Arian High School. And from there I went to Valdosta State. I, I was pre-med major at Valdosta State. And prior to going to medical school, I got my master's degree in veterinary physiology from the University of Georgia Vet School, then to medical school. Then I did a year of internship in medicine, a year of neurology. 'cause I was gonna be a neurologist. And to be quite honest with you, the reason I changed was I had two little kids at home. I had a 2-year-old and a 4-year-old. And we had three residents and three hospitals in neurology. And I think I got home maybe once in about six months. So it was one of those things that I said, well, you know, I like behavioral neurology, traumatic brain injury stuff and dementia. So I could do the same thing in psychiatry. But the hours were better and I actually got to see my kids grow up. So for five years after I finished my residency in Augusta, I was on the faculty there. And then after those five years were up, I moved back to Valdosta in 1994. I've had a private practice here, been on the staff of South Georgia Medical Center since that time. And I do Dogwood Senior Healthcare Center. I also work with Parkwood Development Center. The other thing I do is I teach medical students. So I'm the clerkship director for the Medical College of Georgia Southwest campus in Albany. So I've helped place students that are interested or that are doing a psychiatry rotation in psychiatry offices and in my office as well. Well
 
- That was a smart decision on your behalf to switch to that specialty because it definitely has a better work life balance.
 
- It does. I mean, I think if you're interested in going into medicine and you want to be able to balance professional and personal life, psychiatry, maybe dermatology, there are a few specialties that work out pretty well for that. But neurology is not one of them. Right,
 
- Right.
 
- Yeah, for sure. Well, we talked about what led you to pursue your career in psychiatry. So specifically mental health is something that as a society, we're hearing people talk more about lately, which I think is very good that now people are being more open to talk about it. So do you have any ideas about what's driving that awareness and what's making people wanna talk about it more now?
 
- Well, I, you know, I think, I think if you publicize a dis, well, first of all, I think it's become more okay to talk about mental health. You know, in the past it was like, you know, uncle George, it was taboo, she's schizophrenic and we don't talk about that. And now you see ads for schizophrenia, you see ads for depression, you see ads for a DD. So I think one is it's okay to talk about it now. And two is the awareness. I mean, you know, somebody asked me why, why are we seeing more and more a DD and A DHD stuff? Well, I mean, you see more ads for it, you see more programs on TV about it. And so it's, people are more aware of it and it's like, well, you know, I've got those symptoms too. So I think, you know, nobody cares too much more nowadays about talking about things like that. It's, it's okay. Yeah.
 
- And I think that's great, you know, it's great direction to be going in because otherwise you have people just suffering in silence. Right.
 
- It, it is. And I think, I think that's a good thing that they basically say, you know what, instead of being worried that somebody's gonna find out, I can tell people I've got a problem, I can go get some treatment for it.
 
- What are the most common reasons that someone would come see a psychiatrist or seek professional help? So, I mean, I feel like mental health, there's a vast array of like, of issues, right. That you could have. But what are the most common that you see?
 
- I think one of the, the strange things about psychiatry is there's a, it's a vague cutoff between having a disorder and having a symptom. For example. What's the difference between, I'm depressed, broke up with somebody, I'm depressed, I lost my job and I have major depression. So I think, you know, where, where does that line split between I need to get help, I need maybe medication versus I'm okay, I'll get over it in a few weeks. And so I think that's one of the things, when people start, they're depressed, but then they start having problems with their sleep and their appetite, trouble going to work. It gets to a point where they say, okay, now I think I need to see somebody. So that's part of it is deciding where that cutoff is. And we'll take a DD for example. I think a lot of us have a DD. The question is, when does it get to a point where you might need treatment, medication or whatever. And for you, it may be different than what it is for you may be, I
 
- Actually do have a DHD. So that's funny that you mentioned that.
 
- Do you, you know, do you treat it or
 
- You I do. And it wasn't until this year, so I'm 29. It wasn't until 29 that I decided that it was interfering with my personal life at home. You know, so, so
 
- But so you make that point Exactly as like, okay, I've had it, but now it's starting to feel,
 
- I kind of had a suspicion. I wasn't sure. But then when I went and I talked to my doctor and I, you know, filled out the survey, I guess they give you the questionnaire to, you know, how many symptoms do you have? And we talked it over and then I got the official diagnosis and I was like, okay, well what can I do about it now that I feel like it's interfering with my life?
 
- See, but that's part of psychiatry is so subjective, you know, so you get to the point where you say, okay, I've had it, it's interfering with my life. I'm gonna get treatment. Somebody else may have the exact same symptoms, usually the men and say, forget it, I'm not going to see
 
- Anybody. I was gonna ask that. How do you convince someone that you think needs to see or get some help? How do you convince them to do
 
- That? Well, it's, if they're, well, it's difficult. They get defensive. Yeah. You know, if I say, I think you have a DD, you're like, why are you saying that? You know, you get defensive about it. So I think if you're gonna approach somebody about that, you need to approach it more in a positive way rather than a negative way. Instead of saying, you have this, wouldn't it be easier to do your job? You think if you had some way of maybe medication or something might help you do your job. It's sort of a positive rather than, you know, making somebody defensive.
 
- And that's kind of the route my husband took with me was he was like, I think that, you know, you could have a little bit of an easier time if you got some help for this. You know, and he kind of convinced me to, to go look into it. And it's made a positive impact on me.
 
- The other difficulty though in psychiatry is, is how you see your symptoms. And, and, and for example, you said you filled out one of those forms. You know, there's a lot of them. There's A-A-S-R-S, which is the one we use the most. There's a Connor's, there's a, oh, there's so many of 'em. There's probably 20 different things you can fill out. There's a Vanderbilt scale and then some of 'em you fill out, some of 'em your family members fill out. But the ones you fill out, like the A SRS one that we use, it's how you see yourself. I have trouble interrupting people, yes or no. And so some people they, everything is the maximum score all across the right hand side, even though maybe they don't have that. And then some people, again, men tend to be worse about, this'll have the minimum score all across the side and their wife's like, no, that's not true. But they're not lying. That's just how they see it. Yeah. And so same with depression scales. We do a thing called PHQ nine, which is required by Medicare anyway, a depression scale that we have to do the family practice docs have to do on patients that are on Medicare that come in. And I see people come in with threes, the maximum score all across the right hand side. And they're sitting there talking to me like we are. And they should be in the hospital if they're all threes. Yeah. And then I see somebody depressed and crying the whole time. They're all zeroes across. It's like, well that's how you see. Yeah. They just don't see themselves that way. So I think the point you brought up, listen to family members, listen to people you work with.
 
- 'cause they have that subjective view. I guess
 
- There are sometimes what we call poor insight. Really, really common with people who are bipolar. They're manic, they're just causing all sorts of chaos. They're spending everything. And you ask 'em, maybe we need some treatment here. And they're like, well, there's nothing wrong with me. Yeah. And everybody in the whole room can look at 'em and say, yeah, there's something wrong. Yeah.
 
- Yeah. It's an interesting dynamic from being, so you probably have people that are super self-aware and, and feel, you know, understand all of their symptoms and stuff. And then you have the ones that are just oblivious to them.
 
- Exactly. And the same thing with, particularly people with anxiety disorders. You can't hardly give them a medication that they're not gonna have side effects from. But then you give some of those other people the same medicine, they never have any side effects. Well, I don't think either of those are true. I don't think they have every side effect you can have. And there's almost no medicine doesn't have some side effects. But I think an example was, you know, the other, that was a couple months ago. I don't take many medicines, but my wife takes Benadryl sometimes when she's, you know, helps her sleep or you know, for whatever reason. Well, I took a Benadryl and, and she says, you know, Benadryl makes me really sleepy. And I said, it doesn't do anything to me. She said, well you took that Benadryl and went to bed. I said, well, I was tired, but, you know, and that's how I, but it was probably the Benadryl.
 
- Yeah, yeah. Do are you seeing more people just get therapy in general? Like more people just doing that as like a preemptive before side effect? I mean before they're getting major
 
- Issues? Yeah, I think we always look at things when, when you're talking about both diagnosis and treatment. We got a thing called the bio-psychosocial model. Biologically medications, do they have any illnesses? Do they have an infection psychologically, you know, how did they grow up? Or they do, they have an abusive childhood and socially what's going on in their life, their job, their marriage. You have to look at all three of those areas, both in treatment and diagnosis. If you come to see me for depression and I say, here's your Prozac or Zoloft, see you later. I'm really not doing you a favor. So I think, and studies have borne this out, is that a combination of medication and therapy is probably the best thing for significant depression. For mild depression. Sometimes therapy by itself works fine. And there are tons of patients out there to get psychotherapy, but never use medications. Yeah. But I think if you get to the point where you need medicine, therapy is probably an important part of the treatment as well.
 
- So how does your brain just change over time? Like you don't have depression? I mean, explain a little bit about the chemicals in the brain. I mean, that just fascinates me. How someone can be fine. And then an event. What happens to your brain to make it like an event happen and you become depressed? What is going on?
 
- Yeah. Well I think, you know, things happen and people get depressed, but I guess the question you're asking is what for anxiety sometime? Yeah. For it to keep going. Yeah. You know, I'm upset for a week and then everything's fine versus I get worse and worse and worse over time. We used to, used to, years ago when I first started practice, it used to divide depression into what they call endogenous depression. Exogenous depression. Say there were two types. There's the kind that just happened by itself and the kind that something had to trigger it. We don't do that anymore because the symptoms are the same, the treatments are the same. And sometimes they overlap so much. You can't distinguish one from the other. Some people's brain, oh, everybody's brain works differently than everybody else's. And some people respond to medicines real well, some people don't. I think a lot of it has to do with what you had coming into it. You said something happens, you know, is, let's just say a breakup with a significant other. Why does somebody just totally get crushed by it and somebody else doesn't? A lot of times it has to do with how, what happened in your life growing up? Did you have a good childhood that was nurturing? Or did you have all kinds of chaos? And if you had chaos in your, you have this almost fear of abandonment. So when something like that happens, it is devastating versus somebody that's more healthy, you know, they have the normal response and then they're back to normal again.
 
- Hmm. I've seen a lot of commercials for like pre, I don't even know what the drug is, but is there anything you can take for your brain Oh, to help it? You know, you've seen things that are
 
- Like the pre the prevagen. Yeah, the prevagen comes from jellyfish, right? Is
 
- Is that actually,
 
- I don't know. I don't know about, I don't recommend it and I don't, I don't. But I'm, there are people that swear by it, really. So I don't know. So the whole theory behind dementias, which the most common type is by far Alzheimer's disease, is the theory behind it is that, you know, your brain has degenerative processes that continually over time you lose brain cells. Well, we know that the primary neurotransmitter for memory is acetylcholine. So some of the medicines, the, one of the more common ones, Aricept, Exelon, those kind of medications, what they do is they are colon esterase inhibitors. They block the breakdown of acetylcholine. They allow more acetylcholine to be in the brain. So by doing that, you kind of slow down the process, but you can't stop it. Hmm. And then there are newer medicines out there now, the IV infusions that are designed to be an antibody towards the plaques that develop in the brain that you see in Alzheimer's. And you know, they're not perfect. They help some too, but they still don't stop the continual degeneration. But they slow things down.
 
- Well, let's talk about the Dogwood Senior Health Center and what happens as you age and what is normal for, I mean, is it, it's not normal. Dementia is not, I mean, it's not a normal effect of aging, correct? I mean,
 
- It shouldn't be. Well, it shouldn't be. I mean, people say, well, I'm becoming more forgetful. A certain amount of mild memory losses may be normal. And sometimes you call 'em MCI, you know, just sort of a minimal cognitive impairment. Mild cognitive impairment. But most of the time if somebody gets diagnosed with MCI, eventually it progresses into an Alzheimer's disease, which almost doubles with every decade of life. So, you know, 60 years old, you might have a less than 5% chance, and 70 is probably pushing 10%. And then at 80, probably pushing 30 or 40% risk of having it. So that's one issue. It it is a normal, it can, it, it, it, the, the percentage of patients that have it increases significantly with age. But it shouldn't be normal for people to start becoming forgetful. The other difficulty in the diagnosis is that most people are married when they get diagnosed and their spouse over time is, is not aware of it sometimes because it's happened so slowly. Yeah. So I'll have 'em come into my office and I'll say, why are you here? And, and the spouse may say, well, that some of the family thinks she's got some memory issues. So I might turn to you and say, so what did you have for breakfast today? And the first thing they've been doing so long, they look at their, hu did you look at your husband? And he says, you know, we had bacon and eggs. Oh yeah. Bacon and eggs. I'm like, I'm trying to find out from her. And oh, I'm sorry. You know, and so you'll ask another question about the memory. You know, have you guys gone anywhere in the last few weeks on any trips? Have we gone anywhere? No. You remember we went and I said, look. Yeah. Oh, I'm sorry. They're not doing it on purpose. They've just been doing it day after day after day for years. Yeah. And so they don't see the decline that everybody else sees. So that becomes one of the issues. And the second thing is, when you're declining, you lose that insight. You don't notice it. So you might say, I'm fine. And if somebody tells me I'm losing my memory, I start thinking, are they morally depressed? Maybe it's a medication because most people with Alzheimer's, there's nothing wrong. Well, you stop driving. Well, my eyesight got bad. And I remember I asked one lady in a nursing home one time, she was like 85. I said, how old are you? And she says, young men, do not ask women their age. I said, okay, I I'm gonna get smart here. I said, okay, what year were you born? And she said, you're a smart doctor. You can look on the chart and see for yourself. So, you know, doubt it's the unintentional kind of things they do. 'cause they just don't see it
 
- If, if a patient has Alzheimer's or dementia. And do they realize that? How does that, because you said that they look to their spouse or they, they start relying on other, but do, do they realize that they have it?
 
- Most of the time? Not, I mean, particularly if it progresses, it can be real depressing in the early phases. 'cause they know what's going on in the early phases, but that, that only lasts about a year or so. And then they get to the point where they continue to decline, but they don't see it. Yeah. You know, I've had patients say, if I had to go in a nursing home, I'd kill myself. A few years later, they're in a nursing home and they're perfectly happy. Yeah. 'cause they just don't see it. They see it early, but they don't see it later on. Yeah. Which is a good thing, by the way. Right. I mean,
 
- My grandfather has dementia and he was up, or he was visiting last weekend and he would ask, you know, several times and he'd say, you know, my memory's not what it used to be. I mean, he said that multiple times, but I just was curious, like if he, and and I don't think he realizes that, but he still ha he still says, my memory is not what it used to be. You know, so Well,
 
- And I, and early going, they can probably know that. And later they probably just repeat the same phrase again. It's a defense, you know. So when I ask you for the third time, the same question Yeah. You'll understand. Hmm.
 
- But
 
- It's really interesting about dementia. There, there, I mean, we were talking about how a lot of psychiatric disorders are more common now, particularly with dementia. And the obvious reason for Alzheimer's is everybody's getting older. Yeah. So it's more common. Yeah. 'cause everybody's getting older. And in the old days it was rare because people didn't live that long.
 
- Wow. Yeah. Is there anything that's been shown to, to be able to prevent any of this dementia, Alzheimer's? Is there anything you can do earlier in your life to make your brain not go that direction as you get older?
 
- Don't get a head injury. Don't smoke, don't get overweight, don't get diabetes. These are all risk factors for Alzheimer's. If you look at, and what do they mean by risk factors? If you look at somebody, if you look at 50 people that are 80 that have it and 50 people to 80 that don't, there's a higher risk of people who were overweight, who smoked, who had high blood pressure, who had a head injury. So we know those risk factors. If you avoid them earlier, stop smoking. Don't, don't drink too much alcohol, don't have any head injuries and some things you can't control. Like some of it's genetic. And we talked, we didn't talk about that, but it can go in families.
 
- Yeah. I know my, my husband's grandmother had Alzheimer's. She lived with it I think for 15 years, but towards the end she had no idea who most people were. None of her children. I don't think she knew who they were, but I don't think she had any of those risk factors. So I don't know if it was genetic or does it just happen? Even if you don't have the risk factors,
 
- The risk factors only shave off a few percentage points. So, you know, by avoiding all that stuff, that doesn't mean you're gonna avoid having Alzheimer's. It just means you have a slight reduction in the risk. Yeah. So if you're gonna get it, you're gonna get it. Yeah. And I really, they, we've experimented with vaccines with all sorts of things, but at some point, hopefully they'll come up with a, a cure for it. I think part of it has to do with how much money seems to get spent on disorders that have more social impact. And IE and the younger group of people. Yeah. When I do my talk, I talk about the difference in the money spent for Alzheimer's research versus the money spent for AIDS research, which was a tiny fraction of the number of patients, but the percentage was much, much, much higher. Well, it's younger people, people have bigger voices in, in Congress and all that. So they pour all the money towards that. And you know, some of it's justified, they're a lot younger people and they got a lot longer to live. Some of it's not because of all the money that it takes to, to treat all these patients with Alzheimer's disease
 
- Everywhere. But eventually those young people will get older and they will care then if there's money spent on it. So,
 
- Yeah. But I think eventually I'm hopeful that they'll come up with Yeah,
 
- With some, I mean, that, that would be
 
- Amazing. But, and, and again, to get off the subject a little bit, it's not just Alzheimer's that we treat at Dogwood, senior healthcare, older folks that have depression and no dementia. We see a lot of that, some psychosis not related to dementia. Sometimes organic brain syndrome, psychosis. They get an infection and they start seeing things and hearing things. We see sometimes older folks have substance abuse problems. Even 70 and 80 year olds still are drinking too much. So we do treat all of them. It is just that the primary patient is a patient with Alzheimer's that has behavioral issues. You know, because you think about it, if you're, if you don't know anybody and that person say you're still at home and that person's your caretaker and they're trying to help you take a bath or something and you don't recognize 'em, you think you're being assaulted by somebody and you start hitting them. Yeah. Well that's something we need to treat. Yeah.
 
- Let's get to, we have some patient submitted, or not patient submitted, but listener submitted questions that we wanna touch on real quick. One was, how can I identify mental health issues in my family members?
 
- Well that's a, that's a mind feel there because if you start accusing a family member of having a psychiatric issue, you may find you don't get the response you think you're gonna get.
 
- That's - True. That's true. You know, and, and just because somebody argues with you all the time or they, you know, they get angry with you. It's like if you start, well, I think you, you think you might have bipolar disorder, they're gonna, like, you're the one with bipolar disorder.
 
- Right. Well, don't di diagnose them. So, but what, would you recognize
 
- That, I assume they're talking about clear issues with a family member and Well,
 
- Or when should you be concerned? What, what would you see when should you be concerned a family member is acting in this way and that is not normal?
 
- Well, we were just talking about that a few minutes ago, is when it starts to impact your family life or your social life, your job patients that if fa if employers or employees or complaining about their behavior at work, that's when something needs to be done. Women are a lot more likely to come in and get treatment than men. That's just the way it does. I've seen some women come in for treatment because the problem's so bad at home with a husband, not with them, but they're like, now they're affected and they're depressed. Yes. So a lot of times we, I I always, sometimes we get the husband's the real problem, the husband to come in. Well I call him the back door, we'll have him go to therapy and they say, have, have your husband come. Well he's not coming in. I said, well have him come in because he needs to explain her behavior at home to the therapist. Right. So when he comes in, yeah, she does this, this and this. And then we'll say something like, well, when she does that, what do you do? How do you respond to that? And for long you're engaging him in the treatment rather than her. And I've actually had a couple times where the, the guy stayed in treatment long after the wife left. Yeah. So sometimes you can ease him in the back door that way that when you know what the real problem is. Right.
 
- Yeah. That's not a bad idea. So,
 
- So anyway, it, it usually, it doesn't work. Go with me. Works a lot better than you need to go.
 
- Right. Yeah. My, so
 
- That, that would be the best advice. Go with me. Don't you need to go?
 
- Yeah. So our next one was, how can one deal with the blues when missing a loved one that's passed on, for example, you know, mother's Day, birthdays, certain holidays. I guess they're asking, you know, how they could handle that, those feelings.
 
- Well, you know, and that's, I I really try to avoid medicine in those group, in that group of people for two reasons. One is they may not need medic, they may not need an antidepressant, they need therapy. Two, you don't want to use benzodiazepines like Xanax 'cause it covers the grief up and they don't resolve it. The best thing to do by far is they have grief groups. And there are two or three now around that are available where I, a lot of my patients go to the, the grief therapy groups and feel like they get a whole lot out of it. So therapy's the number one way to deal with that if it gets to the point where they're just not getting through it. And obviously the other thing you mentioned, anniversary dates, birthdays, and, you know, those sort of things. They tend to bring up the depression again or when they get letter in the mail, that's addressed to the person that passed away.
 
- Yeah.
 
- So I would, if they're, if they're not getting over, they're having trouble with getting over, you don't really get over it, but they're not getting through it, it's a better way. Then I would recommend that they go to grief therapy and they can either do it one-on-one with a therapist, or there at least two groups in town that patients go to.
 
- The next one is, what if you, you just feel unh. I mean this may be just a sign of depression, you feel unhappy or sad, you're not even sure why you're sad.
 
- It sort of hits on that endogenous depression. Talk about don't have a Yeah. Don't to be sad, just sad. Sometimes your brain can just go haywire, you know? Yeah. And when I, when I get patients like that, first of all, I wanna make sure that it's not something that's unconscious that they saw. Like if somebody was abused, say by a parent or stepfather or something like that, sometimes they saw somebody walk by that reminded them and their brain never registered that, but they suddenly had that depression. So sometimes it's like that. Sometimes it can just be something as simple as your thyroid hormone is, is, you know, TSH is not where it should be. So the first thing we do is just do labs, make sure there's nothing physical, a mild infection, a urinary tract infection, a thyroid hypothyroidism, something like that. So do all of that. And if we can't figure that out, then I think therapy works the best. Yeah. Okay. Again, what kind of changes can you make? Why are you thinking the way you do? It's an interesting thing. All of us here could see something happen, but we all respond to it in a completely different way. You know, somebody may see something horrible and they say, well crap happens. And you say, oh my god. Yeah. Did you see that? Yeah. You know, and everybody's different. So you see the same thing. Everybody re sees the same thing, but they respond in completely different ways. When I'm talking to patients, I say, it's like the boss calls you in and say, I have to give you your yearly evaluation. You're doing a fantastic job and you're a little late, so you need to come in on time, but otherwise you're doing great. Then you come in, I say exactly the same thing. So you walk out the door and one of them over there says, what did the boss tell you? And you would say, he said, I'm doing a great job. She'd say I'm about to lose my job. I mean, I've been late all the time.
 
- That's probably what I would say, honestly, because I'd be So
 
- Same thing though. You both heard exactly the same thing.
 
- And is there is, can you know, I don't even know how to say this. Can you talk yourself out of depression? Can you mentally be like, I'm gonna overcome this and I'm gonna change the way I think. Can positive thinking, can your thinking change reality?
 
- Absolutely. And I think, again, that gets back to therapy. That's therapists don't, they're not your friend. They're trying to teach you how to do what you just said. Yeah. There's a thing, I don't know if there's a philosophy called stoic philosophy comes from the ancient Greeks and the Romans. And a lot of that was don't try to change, change things. You can't, because if you think about depression, what all things that happen to you that cause depression boils down to one thing and that's the loss of control. Somebody dies, you can't bring them back, you get fired from your job, you can't get it back. Your husband or wife leaves you, you can't do anything about it. It's a loss of control. So some people beat their head against the wall trying to figure out how to regain control of something they can't. And other people say, okay, I need to focus on the things I can control then. And that takes therapy. Yeah. And that allows you to do what you're talking about self help
 
- Kind of. Yeah. That mental, I say like mental toughness, right? Like just being discipline perspective. Yeah. Being disciplined in your
 
- Mind. Yeah. That, that's what a therapist would do. And you know, that's what therapy's all about is, is is helping you learn how to help yourself. If you go to a therapist to answer your questions, I mean, that's not a therapist. Right. And a good therapist would usually say, well how do you think you should have handled that situation? Rather than, let me tell you what you should have done.
 
- Yeah. Well, and it's just not something we're taught, we're not taught how to navigate life like this. I mean, you're not taught therapy in school. Right.
 
- So, man, that wouldn't be a bad course,
 
- Right? I mean, maybe we should, maybe we need to, you know, add that to the, to the curriculum. But yeah, it's just interest. It's very interesting. So, but we do have to wrap it up 'cause we have limited time. We could talk forever. Well, we're having so
 
- Much.
 
- I know. I know. We'll have to bring you on again. We'll have to bring you on again. But we certainly Thank you. Anything else you wanna share just last minute before we
 
- No, I think, I think we covered a lot of things, but I, you know, I think just don't forget that if you need some help, whether it's with somebody with dementia, you can always call Dogwood senior Health. And if it's for something else, they're, and, and, and one of the good things about Valdosta, I'll say we have more good qualified psychiatrists. I, I think than an entire city of Albany, the entire city of Macon. When I, when I talk to the pharmaceutical reps to cover all those areas, they said, I can't believe how many psychiatrists are here in Veloce compared to, say Albany, for example. And the psychiatrists here in town are pretty good. So if you can't get in with one, call another one. But somebody should be. We also have an abundance of good therapists and there are therapists that work in psych psychiatric offices, there are therapists that are independent and or in groups and there's just tons of good ones. So don't let that go. If you need help, call somebody.
 
- And thank you for what you do too in the medical school realm and helping train other physicians because certainly we need to keep that pipeline going so that we can continue to have access
 
- To, that's sort of mental health care. Yeah, that's sort of selfish. I do that because it puts, keeps me on my toes. That's right. Medical students, I ask you the simplest question that you never really thought of. You know, I mean, somebody asked me, and why would you give a dopamine blocker? Which is like say Abilify or something that somebody who's depressed when we try to increase dopamine when they're not. I'm like, let me think about that. Yeah. Yeah. So they ask you questions that you have to, to think about and they, they expand my knowledge 'cause I go and do the research then. Right? Yep. So teaching students really helps. Yeah,
 
- We are, we just became a clinical site for Mercer University School of Medicine. So we'll have third and fourth year students here starting this summer. And then of course we have our residency training program in internal medicine and transitional year. But yeah, I mean that's kind of one of the benefits that it, it up levels our whole physician, our whole medical staff because it then requires them to make sure they're at their top of their game.
 
- See, in my opinion, a good physician would never balk at teaching students because by teaching you learn. Yeah. So I think, I think that helps us as much as it helps the students.
 
- Keeps your brain sharp.
 
- Yep. It does.
 
- Keeps you from getting to me dementia.
 
- There you go. All right, well thank you Dr. Morgan. We appreciate you coming on and we appreciate you serving our community in the way that you do.
 
- So Yes, and thank you for everybody listening and subscribing and leaving us good reviews. And if you have any questions you wanna submit, you can do that at sgmc.org/podcast.