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Dispense Magazine Podcast2018-08-28 12:12:122019-05-21 08:48:53Dr. Metcalf at Dispense with the Nonsense The latest news, research, and reports on the therapeutic uses of cannabis from the scientific community The Case for the Entourage Effect and Conventional Breeding of Clinical Cannabis: “No Strain,” No Gain Prolific cannabis researcher Ethan Russo published a report on the entourage effect in Frontiers in Plant Science in January 2019, bringing together a […]
As of July 20, 2019, the Pennsylvania Dept. of Health now includes anxiety to the list of qualifying conditions for patients to be able to use medical cannabis. But what exactly does it mean to have anxiety? We all get anxious from time to time. And how does one go about getting a diagnosis to […]
DM:
We’re speaking today with Sara Makin from Makin Wellness of Pittsburgh, Pa. and also New Kensington. She runs a mental health clinic and has been on several podcasts with us. So, Makin, can you tell us a little about Makin Wellness and what you specialize in?
Sara:
We are premier therapy and coaching centers who specialize in holistic, mental health and addiction treatment. We’re able to do different evaluations, diagnose for different conditions and provide ongoing treatment as well.
DM:
You also do diagnoses for some of the conditions in the Pennsylvania Medical Marijuana Program. Can you tell us a little about that?
Sara:
Yes, so currently we’re able to evaluate and diagnose for all anxiety conditions, PTSD, Opioid Use Disorder, and Autism Disorder.
DM:
So when you say diagnose, how is that different from certification?
Sara:
With diagnosing, this is much different than a certification appointment. In order to get certified you must have medical records stating your diagnosis. So many times either people don’t have access to their records, misplaced their records, don’t feel comfortable asking for the records, or they’re not given the records, so they come to see us and we’re able to evaluate virtually and also in our practices.
DM:
That is truly awesome. Now, you’ve been doing this with PTSD, Opioid Use Disorder and Autism Disorder, and now they’ve just added anxiety onto the list of qualifying conditions. This is important, I think, because so many people have anxiety but they’ve never actually seen a mental health professional. Is that true?
Sara:
Oh yeah. Anxiety is actually one of the most common mental health disorders in the U.S. Approximately 40 Million adults have it. Which is approximately 18.1 percent of the population.
DM:
So, almost one out of five people walking around - if you’re in a room full of five people and everyone’s happy, then you’re the guy with anxiety then, right?
Sara:
Yes, It’s very common, and the other thing is that it’s actually a very highly treatable condition, but only about 36.9 percent receive treatment. So this is one of the conditions that you are very likely to overcome it if you seek out help but not too many people really know or understand what an anxiety disorder is. So that’s why so many people don’t.
DM:
What are the traditional treatments for anxiety?
Sara:
So some traditional treatments for anxiety are psychoanalysis, there are also different kinds of traditional talk therapies, and SSRIs, which is a specific type of medication.
DM:
What so you do there that’s a little bit different besides working with cannabis as an option?
Sara:
So, our approach is very different. First off, our approach is extremely highly individualized, so it’s really different from person to person based upon their interests and their lifestyles. So, we have cognitive behavioral therapy, which is an evidence-based form of treatment, which basically means if you start to shape your thoughts and address your thoughts, you start to change your behaviors.So, if someone has a habit, thinking some very anxious or worrisome thoughts, we help them think slightly less negative, slightly less nervous thoughts and slightly more positive thoughts, and so that builds more momentum. We have really high grade CBD Oils, we have Thoughtfield?? Treatment available as well if the patient is open to it and wants to explore that as an option. Also, many time with anxiety, we have the patient completely cut out or significantly reduce their caffeine intake. Every time you drink caffeine, your body releases cortisol, which is a hormone that’s released when you’re stressed or anxious. So, that’s another thing that many people don’t know about. They’re having coffee every single day and they think this is something giving them energy when in all actuality it’s making them anxious. We’ve had clients simply cut out caffeine and feel so much better, so that’s another major part, and also making sure that they’re eating well, and taking good care of themselves. Also including the medical cannabis is part of the treatment.
DM:
You really are a very holistic type of clinic.
Sara:
Oh yes, very. Another great thing too is you know for ongoing counseling we are networked with most major insurance companies and with most of our? Contracts, we telepsyche built in. Many times, your insurance will still pay for this, which is really great.
DM:
Telepsyche, so you can do your counseling over an internet connection?
Sara:
Yes, over a video, or over the phone.
DM:
So, let’s talk about anxiety. That’s why we have you on here today. This is really gonna expand your practice quite a bit, right?
Sara:
Ah, yes.
DM:
So, everyone has anxious moments.Everybody has anxiety about certain things. What makes it a diagnosable condition?
DM:
What makes it a diagnosable condition is when you feel like you can’t really control your thoughts, you feel like your negative thoughts spiral out of control a lot, and if it’s negatively affecting your life, whether it’s in your career, at home, or just in your overall kind of happiness level.
DM:
Let’s talk about some of the different kinds of anxiety, there are a lot of different varieties. We hear all these terms all the time: social anxiety, performance anxiety. What are some of the major ones that people have?
Sara:
Ok, so Generalized Anxiety Disorder is the most common anxiety disorder, so this affects 6.8 million adults or about 3.1 percent of the U.S. population. Women are actually twice as likely to be affected as men, and many times, GAD, will co-occur with major depression. Another very common disorder is Panic Disorder, or PD. This affects about 6 million adults or approximately 2.7 percent of the U.S. population, and again women are twice as likely to be affected as men. There is also Social Anxiety Disorder, which is another very common one. This affects 15 million adults, approximately 6.8 percent of the U.S. population. Social Anxiety Disorder or SAD, is equally common with men as well as women and this typically starts around age 13.
DM:
So is the core of it then that you’re thoughts seem to be out of control and you’re not in control of them - is that really the core of anxiety?
Sara:
It’s out of control negative, worrisome, and nervous thoughts. Many times, if someone thinks “What if?” or thinks about things going the wrong way or assuming the worst case scenario or making a mountain out of a molehill. Those types of things can all be considered anxiety.
DM:
From my experience, people tend to, like you say, make a mountain out of a molehill, they’re much more worries about what might happen rather than what actually does happen. There certainly are people who are in stressful situations who deserve to be anxious, because they’re in a very dangerous or nerve wracking situation. So, both cases are true, right? Sometimes there’s a real reason and sometimes it’s just all in their head.
Sara:
Yeah, but even the perception of it can lead it to create anxiety, even if the reality is not present. Because people, in their mind, something in their mind is real, then it is real.
DM:
Anxiety may produce other symptoms, is that true? Or there may be other symptoms of anxiety if you don’t know that you’re having anxiety, but is insomnia a symptom of anxiety?
Sara:
Oh yeah. Insomnia, feeling sweaty, hypothyroidism can also be misconstrued as anxiety and actually, for our assessments, it’s one of the questions that we ask: Do you think you anxiety is caused by another medical condition? And sometimes, that is the case.
DM:
So anxiety can be a symptom of PTSD for example?
Sara:
So, when that occurs, that term is hypervigilance, so hypervigilance is anxiety that occurs as a result of you experiencing or observing a traumatic event. That’s when you feel very on-guard or on edge or very easily startled.
DM:
Well, you’re doing a great service, helping these people, and I know you’re practice is booming both from the good work that you do and from your work with cannabis. Somehow, with a lot of people, there’s still a stigma about seeking help from a mental health professional. Is there anything you could say to people who feel weird about calling somebody for help?
Sara:
That’s a really great question. So, what I would say is that if you’re feeling upset, anxious, if you’ve gone through something traumatic, it is much more painful to hold onto that instead of reaching out for help. Reaching out for help might feel uncomfortable, or weird, but the relief that you will more than likely obtain in the long-run is gonna definitely be worth it. If you think about it, if someone is out of shape, the first time they go to the gym, it’s going to be very uncomfortable, but in the long-run, they’re gonna have a healthier, more fit body.
DM:
Since you’ve embraced cannabis as a tool to use in conjunction with some of your clients, how effective is that into helping people get into a more stable position with their situation?
Sara:
It is, from what we’ve seen with our clients, been a really effective tool. A lot of it really has to do with the dispensary pharmacist staff as well. Their input and their recommendations play a huge role in the treatment that our patients receive. So, when we coordinate care, it’s really fantastic. One of the great things about medical cannabis is that it helps to increase the neuroplasticity in your brain. So, that’s basically your brain’s ability to connect and create new neurons, which begins to naturally decrease at the age of 35 years old. So, unless you’re doing things on purpose, to maintain your own plasticity, it’s automatically going to decrease. When your brain is at a higher state of neuroplasticity, you’re able to change and think differently more quickly, so just even that in of itself, people appear to respond to the treatment more quickly when they are using medical cannabis and with the anxiety patients, so far, we’ve noticed that it really helps with reducing nervousness, it helps to mellow out, it helps with increasing quality of sleep, and another really big difference we noticed is that there’s a decreased level of agitation or irritability. Sometimes we get clients that come to see us because they heard about a friend or colleague that have come here and other times they specifically want a holistic approach, but either way, it’s really amazing, seeing all different types of people come in and really embrace a more natural approach to their mental health. It’s been really fantastic.
DM:
From what I’ve seen just in general, and I’m sure you’re seeing it in your practice, people that are open to holistic options are more open to cannabis and people who are more open to cannabis starting out are more open to holistic conditions, which is certainly a win-win for you and for them.
Sara:
Oh yeah, absolutely.
DM:
I’m encouraged as well to hear how you say that the use of cannabis with these other things make those other things work better.
Sara:
Yes, definitely. It’s all complementary and with your mental health and your happiness, it’s never good to rely on just one thing to cope. It’s good to have an arsenal of different tools and different things that you can implement to feel good so it’s been really wonderful having medical cannabis as a tool. Another thing I really want to make clear is that with these mental health and addiction conditions, it’s really important to keep in mind that medical cannabis is not supposed to be the only form of treatment. The Department of Health wants medical cannabis to be used in conjunction with effective treatment as well. So when the two are combined, it’s really fantastic.
DM:
That is so good to hear. SO, any last thoughts that you’d like to talk about related to anxiety and the state of Pennsylvania now accepting that as a qualifying condition?
Sara:
I think it’s a really fantastic thing and I’m really excited about it because I know that this is already helping so many people. We’ve seen so many clients before that just simply did not qualify because they didn’t have PTSD or Opioid Use Disorder, but they've struggled with anxiety for years, so this has been a huge relief to so many people and we are just really excited to help more people heal and become happy again.
In July, Health Secretary Dr. Rachel Levine announced that anxiety and Tourette syndrome would be added to a list of more than 20 qualifying medical marijuana conditions. Since then, a staggering 3,000 people have been certified for anxiety disorders. Even more surprising, within just the first few days, 212 people were certified for medical cannabis […]
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