 You're welcome back, it's still the breakfast and we're talking mental health at this moment. We're being joined by a New York City area-based physician, health expert, media contributor and health writer. She's not only a practicing internist and civil surgeon designated by the United States Department of Homeland Security and the United States Citizenship and Immigration Services, but she also is a medical advisor. And it's our pleasure today to have with us Dr. Nesocci, the CEO of the Internal Medicine Private Practice and also Dr. Nesocci, rather, LLC and Health Media Consulting Company, Supermodel MDLLC. We're so glad to have you join us, Dr. Nesocci, OKK Bokui. Welcome to the program. Thank you. Wonderful to be with you both today. Okay. Right now, we're just wondering about the mental health of especially our children and we're looking at what the parents need to do, what extra do they need to do if they want to look at their children and make sure they're to the right part. What are some of the things that they need to go above and beyond to make sure that their children are in the right state of mental health? So parents undoubtedly have an integral and critical role when it comes to their child's psychological development. That is known. So it is the role of the parents to basically foster an environment of support, nurture, love, so that the child can have that environment to thrive optimally. Now, when that home environment or the environment that the child is surrounded by is compromised, then that can put the child at risk for potential issues with psychological development and problems in the future. Some of these environmental factors that can actually put a child at risk include things like having exposure to extreme violence, exposure to things such as neglect, abuse. These kinds of negative environmental risk factors can really be damaging for a child as they are in their formative years and in the important years of development. Okay, when we see some of the things that lead to depression and all that, we also wonder if there are genetic causes to these conditions that lead to depression. Are there genetic causes to this? So when we talk about depression, you really have to understand it's quite a complicated and complex condition. Just to put it in perspective and to give a framework of understanding, when we talk about depression, one of the most common forms of depression is what we call major depressive disorder. And this occurs when one can feel certain symptoms such as depressed mood, feeling basically weak and tired all the time, fatigued, having issues with suicidal ideation. The key thing that one has to realize to actually put this into a diagnosis is that you are experiencing some of these things basically more times than none on a day to day basis for at least a two week period and it's affecting your activity of daily living and pairing your day to day functioning. So to get to your question, is there a genetic cause and component to this? Well, because of the nature of depression and the nature of depressive disorder and the fact that it is so complex, we've come to understand that there is not one single cause. There are multiple factors that can contribute to having depression and one of these factors can include a genetic component. It can also include some environmental factors and it can also include changes in the brain biochemistry. So can we say that it is genes or genetics alone that can lead one to be depressed? No, we can't say that. There can be a complex interplay of many things going on to lead one to experience depression. Would you advise prospective parents to get tested for possible genetic treat of depression before having babies? So they can know beforehand what to prepare their mind for and how to handle it? Not necessarily. Many researchers believe there is not one singular gene that pokes one at risk for depression. So they can't pinpoint and say, if you have this gene, you're going to be more likely to be depressed moving forward. It's quite complex. There is that genetic component, certainly. Some researchers that have done twin studies, they found if one identical twin has depression, the likelihood of the other twin having depression during the course of their life is enhanced, increases. But with that said, is there a need for certain genetic testing for prospective parents to be? Not necessarily. You have to move forward with the framework and with the knowledge that if one were to develop depression in the future, it is a mental health condition that is quite treatable. There are various treatment modalities that are available either in the form of pharmacological treatment with antidepressant medication, also in the form of psychotherapy, what we call talk therapy. And there are also other support systems, other things that one can utilize in order to minimize some of these depressive symptoms. So for some, they have support systems, something called an emotional support animal. For some patients, these support animals can help minimize some of their symptoms. So there are options available moving forward if one were to develop this kind of mental health condition. Dr. Nesuchi, I wonder when was the last time you went back home in Nigeria? February. I'm back home at least three times a year. Oh, good. So can you tell me if Nigerians are more susceptible to depression than, say, people in the U.S., for instance? So that's a very complex question to pinpoint and give an answer. Are Nigerians more depressed than those in America or those in the western world? Because of the nature of depression and because of the complex interplay of the different factors that occur, that's what anyone is actually susceptible to depression. And you have to take a look at the individual and see what factors are at play for an individual. So someone in the U.S. versus someone in Nigeria can have different factors at play. One individual may have more of a genetic component. One individual may have more of the environmental component. One individual may have more of the brain biochemistry issues at play. So it's really not an answer that you can say one individual from the U.S. or one individual from Nigeria is more at risk, but you look at it from an individual perspective and individual standpoint. And I think the key is whether you are in the western world, whether you are in Nigeria, when you have some of these symptoms of depression, when you have any kind of issue or concern with mental health disorder, mental health disorders, I think the key is actually reaching out to get the appropriate health, appropriate help that is necessary. I think one key thing that I've noticed in my visits to Nigeria versus being based in the U.S., there is certainly a greater stigma that I have noticed in Nigeria when it comes to mental health conditions and mental health disorders. Those in Nigeria that battle with mental health disorders and mental health conditions, I've noticed they are extremely stigmatized. There are a lot of Nigerians that I've noticed that are suffering in silence and they are deemed a pariah in society because they feel like they cannot speak up and get the help and the treatment that they require. With that said, I think the key takeaway is if you are somebody grappling or dealing with depression in Nigeria, seek out that help. And I think another important thing that I've also noticed is we have to continue to debunk some of the myths that surround depression in Nigeria. Okay, well I've heard people say that because in the UK, for instance, you have more mental health institutions, more help, so to speak, available to people dealing with stuff like this more than we do have here in Nigeria. And some Nigerians will tell you that the treasure, Nigerians' pain threshold is stronger than that of people in the West, people in the U.S. Do you agree to that? Nigerians are tougher when it comes to dealing with pains. And so Nigerians do not really come down easily with depression. Is that just been unreasonable? Or is that the fact? So I think, to an extent, that is somewhat of a myth. Every individual, whether you are in Nigeria or anywhere else in the world, you experience pain. You experience the world around you. And of course, there are factors that can make you experience different things in a different kind of way. So let's just put it this way. One that is in the Western world, they might not experience some of the things that typical Nigerians may experience in their day-to-day environment, in their day-to-day world. Does that mean that Nigerians, by virtue of how they have a thicker skin, that would make them less susceptible to issues like depression? Certainly not. And I think that is part of what causes some of that stigma, because we're supposed to be deemed as those who are always so strong in Nigeria that we can take on everything that, oh, it's not my portion to have depression. It's a spiritual attack. We can pray this away. So guess what? Depression, it's a mental health condition. So all Nigerians are susceptible to it. All Americans are susceptible to it. Anyone is susceptible to depression. And I think that is an important takeaway. OK, not my portion syndrome, is there really? I'm glad you mentioned that. But just finally, and as quickly as possible, would you have any advice on how to get us, and by us, I mean Nigerians and even Africans in general, to embrace the fact that we need mental health checkups from time to time, because it's something we do not embrace? I understand the fact that there's stigma. But if there is stigma, it comes mostly from the lack of education and all that. So if you were to advise, what kind of things that we need to do, we need to do, either as a people or as a government with deliberate policies that will make sure that people have access to mental health services and also get the people to embrace it and go for help when they need it? So I think as a country, as a nation, the framework of medical care, preventive health in Nigeria has to be changed. We have to basically tweak a lot of things, but there are a lot of problems with the medical infrastructure in Nigeria. One thing I have to say is when I, as a physician in the US, am doing an annual checkup for our patients, part of that annual checkup is a depression screening. Now, if this is being done in Nigeria, your annual checkup, are doctors in Nigeria actually screening patients for depression? This has to be something that is part of the routine evaluation of any patient. I think we kind of miss the mark sometimes in Nigeria when it comes to overall comprehensive care of a patient, when it comes to mental health and physical health as well. I think when it becomes so commonplace that when you go to see your doctor or your annual for your physical and they are asking you these questions about your mental health, it doesn't become stigmatized anymore. It becomes part of the actual evaluation of a patient and it kind of removes and attaches some of that stigma that continues to exist about mental health. I think that having that initial discussion with your general practitioner, that's a good starting point. Okay, thank you so much, Dr. Nesochie, Okke Ke Igwokwe for coming on the show and giving us insight. And I hope that the people who make the laws are listening and will implement what you have just said, especially at the end of this. Thank you so much for being a part of our show today. Thank you for having me. Okay, we've been talking with Dr. Nesochie, the CEO of the Internal Medicine Private Practice, Dr. Nesochie, LLC and Health Media Consulting Company, Supermodel MD, LLC. So she's been talking about depression and what we need to do and the need to remove stigma and know that there is nobody who's posture it is. So we cannot keep saying it is not my posture, not my J, it's not like that. If it's happening, it's happening and you need help and that is the only way to go about it. Yes, that's the way to go. Forget the stigmatization and seek the help that you may really need. Okay, we'll just take a short break and we'll be joined by Mukhel Attinobu, who will be taking us around the world of sports. Stay with us. Stay with us.