Ep. 41 | Wendy Vandemark, MD, Psychiatry, SGMC Health

Transcript

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- Welcome to another episode of What Brings You in Today?

- I'm Erika Bennett. And I'm Taylor Fisher. And we just wanna thank all of our listeners for your support and your interest in the What Brings You in Today podcast. And if you haven't already, please like and subscribe so you can make sure you're aware of all of our latest episodes.

- And if you have any suggestions for topics or questions you'd like us to answer, you can submit those at sgmc.org/podcast.

- So today we're here with Wendy Vandemark, who's a psychiatrist with SGMC Health. So Dr. Vandemark, what brings you in today.

- Well, thanks for having me today. I'd like to talk about mental health and just general wellness and what I like to call brain health.

- Nice. Tell us a little bit about yourself and how you got into psychiatry first.

- Okay. A

- Little bit about your background.

- So I'm originally from Ohio. I went to University of Akron and did a combined Bachelor of Science medical degree program. And that's where I met my husband Sean, who's a plastic surgeon here at SGMC. We did our training in Detroit and finished that up and worked up there for, or I worked up there for a year or two. And then we have been down here in Valdosta since 2006 when South Georgia Medical Center recruited us at the time. And so what got me into, into psychiatry and mental health was, you know, I went into medical school, kind of like most medical students, I think, where I just had a vague sense of wanting to be a physician in general and, and help people. I kind of envision myself as more of like a primary care doctor or maybe a pediatrician or OB GYN. But then I hit my first year of medical school and I experienced the worst anxiety of my life. I went through a really tough time. The anxiety was pretty crippling. It affected my sleep, my appetite, my ability to function, my ability to socialize. And I didn't really reach out for help because I was embarrassed. And I, you know, saw, saw it as a personal weakness for myself. So I just kinda struggled through it and made it through somehow, but it was rough. And so, you know, when I got to my third year rotations, I, it just meant so much more to me when I did the psychiatry part because I just felt like I could really relate to the patients and understand how much their mental health was affecting everything. And, you know, I just, it felt a little more personal to me at that time. And then I did a second rotation as a fourth year, and one of the physicians there really kind of took me under his wing and kind of mentored me and felt like, you know, that it could be a good fit for me. And I, I'm so glad he did because he really encouraged me to go through with psychiatry and actually pick their residency program there at Henry Ford in Detroit. And that was just the right thing for me to do at the time. So, yeah, so looking back, I think it's the, you know, I'm so glad that it worked out the way that it did because I'm a more of a, a quiet kind of introspective kind of person. I'm more of a listener than a talker. I don't know. May not seem that way right now, but, but I am. And so it's, it is just a, a good natural fit for me because, you know, sometimes being quiet and, and quote unquote shy is, it's not helpful. But in this field I can lean into it. Yeah. And it's actually a, a great strength. So,

- Yeah. So I know we didn't have a lot of time to talk before we started recording about our like, personal passions and stuff, but you know, we are, Taylor and myself are very passionate about mental health awareness. Yes. And making sure that people are getting appropriate help when they need it. Recognizing that the pressures that are put on just individuals in general, especially women, I feel like is immense. And like, it, we shouldn't have to suffer alone or think that there's something personally wrong with anybody for struggling. Like, and then how do you like ask for help? So I guess like what is something that you tell patients or, or just individuals when they're may be hesitant about reaching out for help or to a professional about kind of what are the first signs that you might need to speak to someone? I guess,

- Yeah. I, I just like to say, you know, that we are just another medical specialty. It's like, you know, going to a rheumatologist or an endocrinologist, you know, we're just another field of, of medicine, so just come on in. And it's, it's not ever nearly as as scary as anyone thinks it is. It's just very conversational, very relaxed, you know, we're not here to judge anyone. We're just here to, you know, to help and to listen and, you know, you don't have to wait until you're really, really feeling terrible to come in. You know, like you wouldn't, if you had mild asthma, you would, you would still go seek help. Yeah. You know, you wouldn't wait until you, you know, you had to go to the er. So it's the same thing with mental health. You don't have to wait until you're, you know, incapacitated to come in. We treat all, all ranges of mental health issues. So yeah. I, I would just say, come on in, we we're not gonna slap a label on you or, you know, insist on lifelong medication or a lifetime commitment. You know, you might come in and we don't need to prescribe medication at all. There are lots of different things that, that we do, you know, in mental health it's not all about prescriptions. Right. Although we have, we do

- That too. Yeah. And I think some of that is the, the stigma that we've seen for many years around mental health. But I think that luckily that is starting to change in the world where it's becoming, you know, way more common for someone to talk about their mental health publicly and seek help. I mean, like Erica said, I'm very passionate about it, so I have no problem talking about going to my therapist or you know, this or that. So I think, you know, people talking about it more is kind of helping people to feel more comfortable going that direction, don't you

- Think? Absolutely. And just normalizing it and realizing that getting help is strength. You know, that it's not a weakness that that shows a sign of strength. And it's definitely getting better, but there's still some subsets of the population that, you know, still, it, it still lingers out there. You know, one in five people suffer from mental health, but less than 50% come in for treatment. And so, you know, it's still in certain, you know, the black and Hispanic Hispanic community, it's less than 40%. And I saw a statistic that in Asian Americans, it's less than 8% will come in. So we still have some work to do there, but it's definitely getting better.

- Yeah. I know we just completed our community health needs assessment for Lowndes County, and one of the major identified issues was mental health. So it is like people, I, I don't know if it's, and that's something new to our report, you know, we do it every three years and it's not, that hasn't always been like up there as like a top five thing. So I don't know if it's, people are more aware of it too. So they're more like readily identifying that, or maybe like a younger generation completing, you know, the, the survey. So they're, they are more familiar with it. So it's more top of mind. It's just interesting that, you know, that's, that that's out there.

- I was curious when I saw that survey go out, how that would turn up and that, that doesn't surprise me that that was a huge need identified.

- Are you seeing a big difference just in trends, I guess since COVID? I mean like our, I would expect that people's mental health after that event, just because it was so traumatic for everyone, no one kind of escaped that epidemic. But are you seeing like a rise in people seeking help? Not necessarily because of COVID-19, but I'm just saying like Yeah. In general afterwards, just from the stress of that entire, like, situation across.

- Definitely, yeah. And you know, for a myriad of reasons, the mental health issues increased over 25% after the year after the pandemic. And then in the last decade, youth suicides have gone way up. They just did a survey and, and less than, or 50% of college students feel some type of issue with their, their mental health. And that's all, you know, been post COVID. So Yeah. Fortunately, you know, in some ways the telehealth during that time, you know, yeah. Was a real, was a real benefit. And it did increase the possibility for people in some rural communities to get help. But that didn't really help with the amount of providers that we have.

- Right. - Which is still, you know, a critical need. So the, the usage and utilization and the need is going up, but the amount of and providers is, is going down. Right. So that's where that mental health crisis is coming into play a little bit.

- Talking about providers. So you are at SGMC psychiatry, and can you tell us a little bit about your practice and who all works there with you and how you all work together to help patients?

- Yeah, so we're so excited. We joined SGMC our, our practice in June of this year. And so now we're SGMC psychiatry and it's myself and we have a, a child psychiatrist there, Dr. Robert Maal. So he sees all ages, you know, from two on up and does a great job. And then we have Dr. Nitin Patel. And he, he's been in practice for a long time and he has a huge following of, of his patients that he's accumulated. We have therapists there. So we've got three therapists right now working with us. And we've been able, fortunately to bring in several nurse practitioners. And that, that's been great because there is such a huge shortage of psychiatrists in general that, you know, you have to use a team approach. And so using or utilizing the help of our nurse practitioners and therapists has been great, but we just continued to grow and we're, you know, there there's more need for more therapists and and providers. So

- Do you have to have a referral to go to your

- Practice? We do not. Okay. Yeah, we do not require to,

- That's a could self refer.

- Yeah. We can self-refer. So that, I think that's opened up some access to, you know, to people that maybe we're afraid to, to go to the

- Primary care doctor. Yeah. I mean, a lot of people don't go have a primary care doctor. And that's why of the things we try to encourage everyone to, you know, start there and at least make sure everything's going on normal, you know? Exactly. And then a lot of times they can help identify if they need the primary care provider and kind of give that extra push to see somebody professionally. I know that's what happened in my case. I finally bit the bullet with, is that the right phrase? But I finally got a primary care provider and started seeing her regularly and then through our conversation she's like, you know, I think it would, you would benefit from some therapy. Right. Seeing a psychiatrist and that helped give me that little push. Right. And so, because it is hard to just cold Turkey, I think call up and be like, Hey, okay, like I think you need to, I need to see you.

- Yeah.

- Yeah.

- It's very intimidating.

- It can be. Yeah. And so I, I do think the self-referral has really helped. So it's been funny 'cause now doing that, we're actually, I, I find that I'm doing it the other way, so I'll be the first one seeing some of these people and I'm like, I think you need a primary care doctor so I can refer you.

- Works both ways. Yeah. Got to make sure you are physically well and mentally well. It's a,

- Well that's, that's funny. My body spirit. Exactly. So what would the role of, you know, you have your therapist, your nurse practitioners, and then your psychiatrist. What are the different roles and how do they all kind of, do they all kind of play a part in the patient's journey or would someone just see one person? How does that work?

- So it's, you can do it a lot of different ways. You know, most of my patients will see me for diagnosis and treatment planning and kind of collaborating and coming up with, you know, what we need to do, the overall overarching plan and referrals, you know, whatever, whatever we need to do in that area. And then in addition to that, you know, and, and with the patients, we, we work hard on the medication side of things a lot of times, but not everyone needs medicine. And so they'll also have a therapist or a counselor that they meet with a little more regularly. Their visits are an hour at a time versus, you know, with us medication providers, a follow up is, is usually about 20 minutes with your therapist. It'll be an hour and you, you'll see them a little more frequently. So then the therapist and I are able to work together and share, share ideas and, you know, the therapist can alert me as to any changes or anything I need to do medically and vice versa. But some people come in and they want nothing to do with medicine, only wanna talk to a therapist. And that is fine. And some people are the other way around. They're like, I don't have time for therapy. You know, I'm not, I don't like to talk, you know, whatever. I just, I would prefer just medication treatment. And we can do that too. Where the nurse practitioners come in is they do what I do, so they focus on the, the medication side of things. But that's not to say when you don't come in to see me or a nurse practitioner that we don't speak to you because we definitely do a lot of counseling and you know, a lot of times I feel like a, a coach and a, a detective and a MD all in one, you know, so you're doing all the things. So it, it's definitely, you know, a mix of all of that, but Okay. Yeah.

- Well that's probably the most common thing that someone initially seeks, you know, help for goes to see a therapist or a psychiatrist for Yeah. Which, yeah. Which is, I mean, I feel like anxiety's probably

- Anxiety is way up there. Depression sometimes grief will bring it on. Yeah. You know, some, some event or happening in like a divorce or, you know, those kind of things. But we'll see a lot of like a DHD issues or people wondering, you know, do I have autism? My child was just diagnosed and maybe I've had it all along. You know, those kind of things. Yeah. But I would say the majority, you know, are the biggest part of what we see is, is depression and anxiety. Yeah.

- So on that note, what are, like, how do you know what's normal versus what's not? Like what are some signs or symptoms that you might wanna try to, you know, because I feel like people don't know that, so they're like, is this normal or am I, is this probably too much? What do you kind of recommend or, or how do you handle that?

- Yeah, so, you know, everybody has mood swings. Everybody has an anxiety and, and sadness at times that's perfectly normal. But when it gets to the point where it's interfering with your functioning, when it's interfering with your ability to go to, to school or to work or interact with your family or you know, to, to be a person, you know, to eat or sleep or you know, do all the things that you need to do to be a, a human, that's when it's starting to become a little, an issue. Yeah. And something that, that we can probably start to help you with, you know, so, and if you're on the fence and you know, let us, let us help you decide that. And sometimes it's reassuring to hear, you know, nope, this is just, you know, that's, you're doing great, just keep on going. So, you know, those are the kind of things.

- And sometimes it's hard to tell and it takes, I think someone close to you to point it out because it's hard for us to, you know, introspectively notice because I know I've dealt with anxiety my entire life. But, you know, I didn't know that that's what it was 'cause I didn't have a word for it. Right. Until I got a little older and someone told me, I think that you have anxiety. I think that's, you know, what's going on with you? And I was like, really? Because in my family we didn't, you know, talk about that kind of stuff. So then once you have a word for it and you start looking into it, you're like, oh wow, that kind of just changes everything. So just kind of, not necessarily diagnosing your friends and family, but you know, it is kind of helpful if you see someone you love struggling to kind of, Hey, maybe you should talk to someone. Do you ever see that your patients, a family member is the one that encouraged them to come in?

- Yeah. And that's a really good point too. You know, it's important to be introspective and notice things about yourself, but also, you know, in your family, if you are seeing things that you, you're noticing or picking up on, you know, it is a good thing to kind of point that out to them and, and maybe encourage family members to get help or get treatment to try to destigmatize that. But Absolutely. Sometimes we'll have people come in and, and they'll be just kind of rolling their eyes like, my wife wants me to be here, but I'm fine. You know, and then, then I'll look over at the spouse and you know, and she'll, they'll have some very valid concerns and, and so then when you really dig deeper, you know, the patient's able to admit that, okay, yes. You know, things aren't great. Yeah. You know, so it, it's really helpful if someone is fortunate enough to have support that cares enough to point things out like that and to even, you know, come into the sessions and give us some perspective on things. And it works the other way too. Sometimes the patient will come in and say, you know, you put me on this medicine and I'm no better at all. And their family will come in and be like, yeah, but you have been going to, you know, the baseball games again and you are coming outta your room more. And you know, so sometimes they see the, the positive changes sooner as well.

- Yeah, yeah. I've noticed that whenever I, I got diagnosed with A DHD and I felt like the medicine wasn't healthy, but my husband was like, but I think it is actually because I didn't feel like it was, you know, but, and my doctor even told me, ask your husband, ask people around you if they notice a change in you because they might notice it before you do. Exactly. Yeah. That happens a lot. Yeah.

- So this is random, but have you seen that movie Inside Out? Yes. With the, yeah. Inside. Yes. Having two small children. I've watched that mo that one Inside Out and Inside Out too. And I just thought that was fascinating how they talked about all the emotions and gave them names. Starting, you know, at a young audience to start thinking about this and making it more, you know, not such a bad thing. And like, yes, I just thought that was so cool. And then talking about like core memories and things, that was really interesting to me how they,

- I know

- That all together in a movie.

- I, I think that was, I think that was great. And I think, you know, the more we talk about those kind of things, the easier it gets to talk about it. And you know, when you make your emotions or experiences more of a narrative, you know, and can put words into it, then it kinda, you know, takes some of the sting out of how you're feeling. Yeah. And you're able to, you know, articulate it and get help. Yeah. So

- I haven't seen the movie. You have to,

- It's really good for even I saw the second one first and I was like, wow, okay, I need to go see the fir. And then I went back and watched the first one. But I was fascinated from just the medical perspective, looking at it from an adult and how they visualized all the things, but they make it relative to children. I was like, that is so cool.

- I love that. I know. I hope they come out with a third

- One. Yeah, they probably will. I'm sure they'll, because you know, mental health's not going, so there's all kinds of problems as that character evolves, but,

- Well maybe I need to check it out.

- Yeah, you should watch it. You should watch it this

- Weekend. Are there any certain types of, you know, new therapies or new modalities or anything that you're seeing kind of emerge that are making a difference for any of your patients other than just we've talked about medication and talk therapy. What else is out there?

- Well, yeah, there, there definitely is. And it's so exciting. It is one of the things I love about this field is it it's ever-changing and new, new, new ideas and treatments come out all the time. There are a lot of new medications out, I will say that, you know, which is so wonderful. You know, even since I completed my training 20 years ago, our repertoire of, of options for medicines has just expanded and they're so much safer now and they're not addictive and they don't, you know, cause any long-term issues with your body. And so, so that's wonderful. Definitely have new, you know, therapeutic techniques that have come out in terms of the way therapists can do therapy. You know, there's EMDR therapy and different therapy that we do specifically to process trauma. There's also a whole field of psychedelic medication and treatment and assisted therapy that's coming out and emerging. And it's just fascinating. And it's like using things such as psilocybin and MDMA and some older, you know, substances that we have had around and applying them in different ways. And, and ketamine treatment has, has gotten amazing, very rapid results for people. And then we have things like transcranial magnetic stimulation, which, you know, all in the past that we had was electroconvulsive therapy, which sounds terrifying, but really isn't. But you know, it, it is a process and, and transcranial magnetic stimulation is just an easier, more accessible type of treatment that we have for patients. So yeah. And then biomarkers are coming out, you know, and different scans that we can do. I think the big challenge is getting payers or insurance companies to reimburse for some of these things. But I, you know, I think the more evidence that comes out, you know, the more that will be available too. So

- Yeah, I've heard of some of those. I've done EMDR myself and I found it extremely, extremely helpful.

- Yes.

- Like you said, for processing things and you don't even realize that you're doing anything. It's not painful, it's not, you know, anything scary, just literally sitting and, and talking while the therapist does certain things. Yes. And then it, it totally makes a huge difference for you.

- It does. And it works more quickly than some of the, the previous types of therapy that we had, like analysis where, you know, it would go on for years. EMDR is is much more rapid and I would say efficient and convenient. Yeah. So it's exciting.

- Yeah. If you had one thing that you had to recommend or that's like the easiest step someone can take to have, be a little bit more healthy on their brain, what would that be? Would it be, what would you recommend? I kind of feel like exercise is on there on one, but I'm curious just to what you're

- Yeah, absolutely. So I'm, I'm big about brain health 'cause you know, the brain is basically the command center of the body and you can't have health without brain health. And so the big things that go into that are absolutely exercise and things like yoga and meditation and just protecting your brain, not doing the, the, the other things that can be harmful, like using substances or cigarettes or, you know, so just really protecting the brain, you know, eating healthy, getting exercise, getting sleep. And also that social connectivity is really important, you know, and that, that could be with pets or people or, but just that feeling of being connected, all of those things together. So you wanna do those things before there's a crisis, right. So we wanna do those things before

- That's probably not gonna help you in the middle of a crisis, right? Yes. But you can start before that happens.

- Exactly. It's a

- Proactive measure.

- Definitely. And, you know, and it's not, everything works for everybody. Like, yes, I love yoga, it's, it's one of my coping mechanisms and whatever, but that's not for everybody, you know, so you really have to find what works for you. And sometimes it's just a, a mix of different things. But yeah, I really try to emphasize that with my patients.

- I totally agree. I mean, even just going for a walk.

- Yes. - You know, not in the 90 whatever degree. Right. But going for a walk and just clearing your head. I also like yoga as well. And you know, spending time with my pets. I have two dogs. Pets are the best. So I mean, those different small things do make a huge difference just to kind of decompress from your day because we're so busy all the time. Yeah.

- Now. And life doesn't stop being like stressors. I mean they just come, they are constantly coming. Things are happening, events are happening. Things that unexpected tragedy happens. I mean, it's out there and I feel like now more than ever, we're probably seeing a lot more of it constantly because we're on the access we have through social media and just like seeing so many things. It could be easy to like kind of have overwhelmed from that. So disconnecting from, I don't know if that's part of your, no. Disconnecting from social media and things like that can be driving a lot of issues.

- I I, I totally agree. I think, you know, that that has definitely played a part, especially for the, you know, our, our younger folks in high school and well even younger, you know, middle school, grade school, all those kind of things. So yeah, it's wild out there. I know, that's, it's wild.

- It's tough. Yeah. It's just the constant access to everything on the internet. Yeah. And even as an adult, it's hard to have that all the time. You know, the comparison, I talk a lot about that comparing, you know, your bodies, your lifestyle, what you have to other people and that just leads to so much misery, I think just the constant comparison.

- Yeah. And now with ai, you know, things are, we talked about that's generated. Yeah. You really don't even know. You don't even know what to trust. Yeah, exactly. Yeah. So yeah, that's why we all need to just protect our brains

- Disconnect, maybe say no to some things. Yes. I found that that has been something that's become more important as I've gotten older is saying no and not always saying yes to every single thing that's asked of your time, because you only have so much time and you have to protect it. So it's okay to say no sometimes I'm, I can't do that right now because you need to rest or you need to prioritize, you know, your me time.

- Absolutely. Yeah. I think that, you know, that helps prevent burnout too. You know, we've been talking a lot about physician burnout and, and burnout in general, but you have to, you have to have those, those boundaries to ha to have any kind, meaningful career of any type of longevity. You, you have to, you have to take the time off. You have to put your phone away for a minute, you know, and really disconnect sometimes. So you're,

- Yeah.

- You can get that rest.

- Yes. Protect your energy. Yes. It's hard though. It is, but it's important. Yeah. And I do think people are, that's another thing that's kind of just becoming more common. Like people are aware of it. Like, okay, I only have so much I can give. Like you cannot, and you just can't get from an empty well, so you have to re Yeah. You gotta refill yourself so that you can,

- You can't be reached twenty four seven. The phone's gonna have to go and do not disturb at some point. Exactly, yes. Okay. And don't feel guilty about it. Yeah. Yeah. Yeah. Well I think we're coming to the end of our time. So do you have any final thoughts of encouragement or anything that you would like to say to anyone who's listening to this who is maybe a little wary about getting help or talking to someone?

- Yeah, I would say, you know, just, just come in. Just come in and, and try it out. And like I said, you know, it's, it's a strength to get help, not a, a weakness. And you know, there's just so many great options out there that we can help people with. So make yourself a priority and take the time and, you know, just, just take care of yourself and your,

- Your brain. It's kind of similar. That sounds similar to me from what I hear from when someone's like, well how do I know if I'm having a heart attack or if I should go into the er? Like I don't wanna embarrass myself and go in there and it be, you know, gas or something. Well you don't know, so you really should go get it fixed. Fixed or looked at just to be on the safe side. And that's kind of what I'm hearing with the mental health too. Yeah. If you kind of have an inkling that you might need to see someone, it wouldn't hurt Right. To check it out.

- Yeah.

- So it's not gonna hurt anything. Give a go and then most likely it would probably help. I bet.

- Yes. And our last question that we always end with, since our providers spend so much time here, is, what is your favorite meal to eat here in our cafeteria or in our All spice?

- So my husband spends even more time here than I do as a surgeon. So he has created the Denmark Wrap. Oh, nice. So it's a, it's his own concoction of a grilled chicken and a cheese, I can't even tell you, but that's what I usually order. It's, it's, it's

- Pretty good. So you don't even know what it's on it, you just tell 'em. They just know.

- They just know they've, he just walks up and just nods and they, yeah. And they're like, do,

- I don't know, I'm not to that level, but, okay. Well if you want one of those, you can go ask for it. Maybe you'll find out what's on it. Alright, well thank you so much for being here today and I think this has been really good episode. Yeah. We appreciate you taking time to My pleasure. Share with us and thank you to all of our listeners for tuning in today. And if you have any questions or topics you'd like to submit, you can do that sgmc.org/podcast.