I was at a dinner party in early 2019 when my friend Chris asked me, “What are you going to do with your life once your girls all leave home?” I said, without hesitation, “I want to start a podcast!” With a look of surprise, Chris said, “So do I!” We quickly determined that we had to get together and make this dream happen.
The inspiration for Back from the Abyss was my patients and their incredible stories of suffering and healing. I wanted to create something that would be like releasing balloons of hope out into the world, with the message that recovery is possible, that treatment can work, that out of the darkness can come light and wisdom and gratitude.
Most of the podcasts I listen to are interviews or talk shows. I wanted Back from the Abyss to be more intimate and to be built around very personal stories. We aim to record all the stories in person, as I think storytelling is most raw and heartfelt when it’s face to face. Often our recording sessions end with tears or high fives or hugs. Helping people tell their abyss stories has turned out to be one of the most meaningful experiences of my life.
I originally thought that the podcast would be of most interest to patients and their families, but I am finding that some of the biggest fans are therapists. This has led me to bring more of an educational focus to the podcast, rather than my initial idea of simply sticking with the stories. We make just two episodes a month, but I like to think of each one as a lovingly created meal, made from scratch, and worth the wait.
Antidepressants, mood stabilizers, antipsychotics, benzodiazepines, stimulants…..READY SET GO!
Med cheat sheet
SSRIs (selective serotonin reuptake inhibitors)– Prozac, Lexapro, Paxil, Celexa, Zoloft, Luvox, Trintellix, Viibryd– They are generally NOT antidepressants
Mainly helpful for OCD, body dysmorphia, panic (if not from trauma), depression if postpartum or fueled by neuroticism or ruminative anxiety
SNRIs (serotonin norepinephrine reuptake inhibitors)– Effexor/venlafaxine, Cymbalta/duloxetine
Mostly helpful for combined depression/anxiety, especially with insomnia
Wellbutrin/bupropion— very stimulating (prison crack!), true antidepressant; can trigger/worsen anxiety
MAO (monoamine oxidase) inhibitors– powerful antidepressants, lots of side effects and med interactions
Lamictal/lamotrigine— definitely ALL THAT and a bag of chips (see My Desert Island Meds in Season 1)
Atypical antipsychotics- Abilify/aripiprazole, Latuda/lurasidone, Seroquel/quetiapine, Saphris/asenapine, Vraylar/cariprazine, Risperdal/risperidone, Zyprexa/olanzapine, Geodon/ziprasidone, Invega/paliperidone
Generally good mood stabilizers (in contrast to the putative "mood stabilizers" below); typically more helpful for severe depression and bipolar disorder than true psychosis (Zyprexa and Risperdal excepted)
"Mood stabilizers"- (big misnomer, most effective for mania/agitation, not depression)– Depakote/valproic acid, Trileptal/oxcarbazepine, Tegretol/carbamazepine
Lithium- it's not clozapine, but gets the silver medal as a true mood stabilizer (see My Desert Island Meds in Season 1)
Clozapine- the winner of the psychiatric med decathlon in most every event; needs weekly blood monitoring and has a few very serious potential side effects
Benzodiazepines- Xanax/alprazolam; Klonopin/clonazepam, Librium/chlordiazepoxide, Ativan/lorazepam, Valium/diazepam
Stimulants- Adderall/amphetamine; Vyvanse; Ritalin/Concerta/Focalin/methylphenidate
Amphetamines are more euphoria-inducing, thus more abused and addictive and also tend to have more side effects; both amphetamines and methylphenidate are roughly equally effective for ADD/ADHD
Dr. Craig Heacock
Dr. Craig Heacock is an adolescent/adult psychiatrist and addiction specialist in Colorado. He was a co-therapist in the Phase 3 trial of MDMA-Assisted Psychotherapy for PTSD and has particular interest in the use of ketamine and other psychedelics to treat severe mood disorders and PTSD. He is a graduate of the University of New Mexico School of Medicine and did his psychiatry training at Brown University.
Chris Johnson is a distracted cartographer with a creative soul and a love for music and storytelling.
After a nightmarish sexual assault at age 15, Mitch's life felt over. Wracked by daily dread, panic, and a desperate longing to die, he eventually found his way 22 years later to the MAPS trial of MDMA-assisted psychotherapy for severe PTSD.
In this astonishing account, Mitch describes how MDMA was able to reactivate his innate healing intelligence to allow him to go directly into the hottest fires of his trauma with a powerful shield of openness, safety, self-compassion, and trust. Mitch describes the actual "how" behind MDMA-assisted therapy and why it shows such promise for the future of trauma treatment.
Chris successfully hid his increasingly severe depression throughout middle and high school, but by his first year of college he could no longer ignore the horrifying signs that his brain was losing touch with reality. Inanimate objects began to radiate into his thoughts, and suicide seemed the only way to escape. Fortunately Chris took the scariest leap of all and began to open up to a therapist about what was happening in his mind, leading to an exploration of shame, a reformulation of the self, and finally the unexpectedly powerful healing of ketamine.
This is the first of a two part very special interview with Saj Razvi, the Director of Education at Innate Path in Denver, CO. Saj weaves together his three fascinating perspectives— that of a nationally recognized trauma expert, his own personal story of early childhood neglect and how this shaped everything else to come, and finally his long journey of healing the deepest wound a person can have, eventually coming to MDMA and then psilocybin at the latter part of his therapy journey.
The episode starts with some foundational concepts in understanding trauma and its long term effects, then shifts to compare and contrast psychotherapy vs somatic therapies vs psychedelic assisted therapies (cannabis vs ketamine vs MDMA vs psilocybin). Part 1 ends with Saj's life-changing MDMA therapy session and beautifully describes how MDMA might help people break through the dissociative legacy of complex PTSD and attachment trauma.