Depression & Anxiety: Alternative Treatments with Dr. Ben Spielberg

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Dr. Mike Moreno: Welcome back to Wellness. I’m Dr. Mike Moreno, taking a deep dive into all thing’s wellness after over 25 years of practicing medicine. I’m fascinated with anything and everything that can help you feel better, live healthier and become the best to you possible. I’ll be interviewing the most cutting-edge experts in the field of wellness and exploring new innovative technologies to help you live your best life. At the end of each episode, I’ll give you my weekly RX. My top tips for you to use right away. Remember to subscribe for free rate and review my podcast on Apple podcasts or wherever you listen.

More and more, we’re learning about the intricacies of the brain and ways to improve our brain health. You know the days of ignoring mental health issues long-gone, folks. There is no stigma in mental health. Today we’re seeking solutions.

With almost a decade in the field of brain based behavioral health under his belt, Ben Stiller is more passionate about mental health now more than ever. A graduate of Columbia University, he went on to receive his master’s degree in neuroscience and education. During graduate school, Ben developed a specialty in clinical neuro-modulation and neuro-imaging, where he used brain scans to predict off label uses for TMS.

We’re going to talk about what TMS is, but yes, he used brain scans to predict off-label uses for TMS, neuro-feedback and ketamine. Let’s be very, very excited about this. I know I am. I have tons of questions here. Ben, welcome to Wellness Inc. How are you?

Dr. Ben Spielberg: Thank you. I’m doing great, how are you, Dr. Mike?

Dr. Mike Moreno: Excellent. When this came to my attention that we were going to get to chat, I was really excited for many reasons. I love to educate. I love to kind of spread the word, but for selfish reasons. You know, I’ve been through a lot of stuff myself. We all have, and I’m not just talking about the last year, I’m talking about in life. I was saying earlier, being an adult is kind of hard. When you talk about PTSD or depression, anxiety, I mean, I’m a primary care guy and it’s honestly been 80 percent of what I do every single day. It may not present itself that way initially. Let’s talk a little bit about TMS. Transcranial Magnetic Stimulation. Give us a little bit of insight on that.

Dr. Ben Spielberg: Sure, sure, definitely. So, we kind of think of depression as a neurotransmitter deficiency or a serotonin imbalance. That’s probably something that you’ve heard many, many times in the past, but, you know, the current neuroscience research doesn’t really support that theory of depression. It turns out that what’s really happening is these specific parts of the brain are essentially under-active. So, there is less overall blood flow, there’s less cellular metabolism. These parts of the brain are basically dormant in depressed patients.

So, what TMS does is it creates these tiny magnetic fields that are just strong enough to turn back on these parts of the brain. So as people come in, because they’re coming in five days a week for about six weeks, the symptoms of depression start to go away as these parts of the brain start to come back online. So, it really increases neuro-plasticity in these parts of the brain that are associated with depression.

Dr. Mike Moreno: So, and I know a lot of listeners are out there, they’re probably saying, hey, this sounds like ECT. Which, we’re going to talk about the difference between ECT and TMS. Listen to me with all my letters I’m throwing out there, but, you know I’m a primary care guy and I have always had a philosophy with non-traditional ways of, you treat the body, and I don’t discount anything that people do. You know, a lot of people say, oh, well, you’re an MD, you don’t agree with chiropractors. Like, where is that written? That’s ridiculous.

You know, I’ve always felt that if you’re doing something, whether it’s taking a vitamin or doing some other type of therapy or mechanical therapy, or whatever it may be, sort of the nontraditional sense of things, as long as it’s not hurting you and if it’s helping you and it’s not putting you out of house and home because of cost, why not do it? You know, so we talk about nontraditional ways and traditional ways. When I would say to you, if I was to say, hey, Ben, talk to me about what non-traditional ways of changing the brain means, what does that mean?

Dr. Ben Spielberg: So, I think the traditional ways of changing the brain are essentially antidepressant medications, right? And these are medications that we’ve used for 40 years or so and have essentially OK efficacy, [00:05:00] maybe 40 percent response rate, and for some people, they work great. Some people can get away with a very low dose of antidepressants, and that’s great.

Unfortunately, that’s not the case for multiple people. The majority of people have side effects from these medications. Some of the side effects don’t go away after discontinuing their very, very hard medications to get off of. I think when you really look at the so-called traditional ways of treating depression, it’s important to take a step back and think, is this really the right way that we’re going about doing things?

I know in Japan recently, they basically changed their whole protocol so now when people have depression, TMS is actually a first line approach. Which makes sense, right? Why would you use a chronic treatment when an acute course of something can get the job done? And so only if TMS doesn’t work for whatever reason, then they’ll try medications. So, I think there is really a paradigm shift in the way that we’re treating mental health nowadays.

Dr. Mike Moreno: And I think, it’s I mean, it’s critical. Let’s face it, I’ve been practicing, I was in med school in the 90s. I’ve been practicing for well over 20 years and, you know, this has become year by year a bigger and bigger thing out there. I think for so many of us for so long, we just kind of swept it under the rug and this is the cause of a lot of a lot of problems. We need to give more attention to that. I think alternative ways of doing so. You know, you’ll often hear the phrase rewiring the brain. Does that resonate with you when someone says to you, rewire the brain, how would you respond or what would you say that means to you?

Dr. Ben Spielberg: Yeah, I mean, I think in many ways what we’re doing at the clinic is rewiring the brain every single day, right. Because essentially, you know, with so many mental health conditions, not just depression, but also anxiety and PTSD, people are sort of stuck, and you can see this physiologically. Their brains are really stuck in these certain modes and the only way to get them out of these states is to figure out a way to rewire the brain, whether it be with TMS or neuro-feedback or some other modality. Even talk therapy, in a way, rewires the brain.

Dr. Mike Moreno: I mean, listen, I’m a big fan of therapy. I have been, I’ve been seeing the same therapist religiously, almost weekly for honestly almost 20 years. I always joke with her because I always say, you know, you never know when the wheels are going to come off in your life. You know, you could be driving down the road and everything’s great. You’re listening your favorite song, and then you get a blow out in your tire and all hell breaks loose. Life is just like that. You can be going along through life and everything’s great. Works great, personal life’s great. You get a phone call that your family member died. I’m sharing things that have actually happened with me.

I mean, life is a series of unexpected events and the impact that it has on us, I think for so long, we’re just sort of, we’ll just deal with it. No, that’s not OK. I think it’s important, when you think about it, what are some of the things that, you know you’re on the cutting edge I would say, with the stuff that you’re doing. You’re doing stuff that I know traditionally when I was at training, we didn’t have this stuff around twenty-five years ago. What do you think you’re learning or what do you think are some of the learnings you’ve had that maybe a lot of us old guys like myself have missed about depression and anxiety and other things like that?

Dr. Ben Spielberg: I think the biggest thing is that, you know, the traditional methods really just aren’t that effective, and I think for people who were schooled a long time ago, there are some psychiatrists who were in their 80s who are still practicing, and I’ve noticed that it’s sort of a hard concept to digest, that there is just a much better way of doing things that was not around whatsoever when they were in school or residency.

Dr. Mike Moreno: How often are they even still doing ECT? I assume they’re still doing this and how often? Is it a common practice? I don’t think it is.

Dr. Ben Spielberg: It’s not that common. ECT, electroconvulsive therapy, I mean, it is really a last resort for a lot of people, but it’s really quite powerful as a treatment because the goal is really to induce a seizure in the brain, right? That’s what ECT is at the end of the day. So, and that’s not necessarily a healthy state for the brain to be in. Right? Whereas TMS, you’re kind of increasing neuro-plasticity. So, it’s sort of a brain health positive treatment. Whereas ECT is somewhat of brain health negative treatment where you induce a seizure. There’s often side effects like memory loss. So, it’s really not that commonly [00:10:00] used, but it’s still used for the very, very severe cases of depression.

Dr. Mike Moreno: Yeah, you know, I think there’s still, and this is true with any disease entity, really, right there are still the old school way of doing things that still work and for maybe a smaller population, but, hey, you know, we’re all people. We all have our needs. We all have our different sort of focus as to why we are dealing with the problem that we’re dealing with. You know, I think the whole idea, and I’ve been on medications before, disclosure on everything, right?

I have and I can tell you there was a time when I was a resident, just went through some traumatic stuff and I wanted in my last year residency, my third year, six months, I’m done with after all the school, I was like ready to walk out, and my residency coordinator said, hold on a second, you know you’ve done all this stuff. So, I went down the pathway of, counseling is so critical, and just having that someone to just spill onto and get that that feedback, but I did take medicines for about six months and they worked. I think they served their purpose, which is what the idea is, but side effects, right? Side effects, and you mentioned this earlier, this is a chemical that was created in a lab, not knocking that because certainly there’s a lot of use for a lot of medications these days. We use them every day, but if you can get around that and find other ways of achieving what you’re trying to achieve, I mean, talk about some of the traditional antidepressants and the side effects and, you know, where are the big functionality issues you see. I mean, sexual dysfunction is probably the big thing. You know, insomnia, fatigue. I mean, tell me a little bit about that.

Dr. Ben Spielberg: Those are definitely the major issues. Insomnia, fatigue, dissociation. A lot of people have gastrointestinal side effects. Either pain or general discomfort. Sexual dysfunction is very, very common. We get a lot of phone calls of people who have tried different SSRI’s and have had that as a side effect. Anxiety. Sometimes it can help the depression but worsen anxiety. Also vice versa, can help the anxiety and worsen depression.

Sometimes people only get negative side effects. Sometimes it’ll just make them completely suicidal, right? So, antidepressants at the end of the day, they’re very much sort of a broad treatment, right. They’re telling the brain, OK, let’s increase in neurotransmitters here, which has all of these sorts of downstream effects, a different part of the brain, whereas other treatments like TMS is sort of very focused. Right. We know what we’re doing. We know what we’re targeting. We’re going to increase activity here and there’s not going to be that same side effect profile.

Dr. Mike Moreno: So, let’s get into the TMS a little bit. You know, there’s good and bad for everything. I don’t think anybody can say that a certain treatment modality, I’m not just speaking about this in particular, but anything is only good and no bad. There’s no such thing as that. I mean, we can argue that everything has some element of good and bad. So, let’s talk a little bit about TMS. Let’s kind of give a description. Let’s say I’m coming to you and I want to know more about it because I’m considering going through this. So how are you going to kind of walk me through this?

Dr. Ben Spielberg: So, first of all, we’ll tell people sort of what it is and oftentimes people have a lot of questions. One of the main questions they’ll have is what sort of side effects there may be. Right, because it’s kind of its sort of most people have never really heard of TMS before, it’s sort of a foreign concept to them and the idea of magnetic stimulation treating the brain sounds almost like froufrou science or a scam, but it’s not. It’s FDA approved.

So, we kind of get people comfortable with the idea, make sure they understand what’s really going on here, then we schedule them for an evaluation with someone from our psychiatric team because everyone’s coming for different issues. Some people, it’s just sort of a very melancholic depression. Oftentimes it’s a mix of a number of diagnoses, including depression, anxiety, insomnia, PTSD, and so the idea is we really want to personalize the treatment as much as we can, which may involve targeting different areas of the brain, using different frequencies to stimulate.

Then after that initial evaluation, if our psychiatric team deems them a good candidate, they would then start treatment.

Dr. Mike Moreno: So, I love the word team, and I think that’s so important in the management of a complex situation much like this. We’re not telling you know, I came in, I have like an eye infection or sore throat, you get antibiotics and do this and do that, you’ll be fine. When you talk about such an impactful thing in in [00:15:00] our world, talking about depression, anxiety, and I mean tens of millions of people, many of which go undiagnosed. Unfortunately, it has to be a team approach. It has to be more than like one guy. It’s really a comprehensive I guess that’s a better word.

Like managing pain, right. People with chronic pain. It’s not just here’s your pills. It’s understanding the source of the pain from a psychological standpoint, from a chemical standpoint. So, I love the team approach. So, I’m imagining that in your practice, you have groups of individuals and you all kind of coalesce and say, here’s the situation and here’s what we think he needs from our end and so on. Is that how it kind of works?

Dr. Ben Spielberg: Definitely, yeah, it depends what program people want to sort of enroll themselves in. We have sort of the most comprehensive program that we offer. It’s a combination of TMS and biofeedback and individual therapy and group therapy. So, people in that program, there’s really quite a large team of staff members who all treat those patients in different ways. Then if someone is just sort of opting to do TMS ala carte for whatever reason, then they’re still sort of managed by our psychiatrists. The technicians are all in touch and we have regular treatment meetings to make sure that we’re achieving our goals.

Dr. Mike Moreno: So, let me ask you this, and I’m sure there’s, there are a lot of listeners out there that are hearing this and they’re saying, you know, this is me and I struggle with this, yet they keep it to themselves. I’m thinking about actually a very close friend, a patient of mine who I just had this discussion with yesterday, and, you know, when you get someone and it’s a little tricky because he’s a friend of mine, but when someone just spills out that this has been going on for two or three or four years. Not days or months, but years, you know, to people that are out there and with your education, your background and all of the stuff, the studies that you’ve done, how do you get people to just be more comfortable with saying, God, I need some help, I need something?

Dr. Ben Spielberg: You know, some people are not going to get there, right? Some people may get there with a lot of therapy. It really depends so much on their upbringing, but if they’ve really sort of been in a family environment where you don’t talk about your feelings at all, it’s very frowned upon. You may just not get there with that patient and that’s why we try to look at things with a few different lenses.

So, every day when people come in, we ask, how are you feeling? How’d you sleep. How’s your anxiety. How’s your mood, etc. We also give people more objective questionnaires every week. So, we’ll give them the PHD9, the best depression inventory. These are all depression, anxiety skills and, you know, it’s interesting seeing that disparity sometimes because occasionally we’ll get people who will say, I’m fine, I’m fine, every single day, but if you look at their scales, it’s in the severe depression range, right? So, I think it’s really just a matter of using all of the data that you can instead of just kind of a singular data point.

Dr. Mike Moreno: Yeah, you know, you bring up a good point, which is your environment, your upbringing. You know, my fathers from Mexico and traditionally, you know, that that machismo sort of element, right? There’s a big cultural component to that, and, you know, I can remember as a kid, and I was a kid, I was like eight or 10 or whatever, you know. I’m still a kid. I think you’re fifty-two, but I remember seeing my dad and just looking at him and just thinking, man, he looks bummed out, you know, and he would sit there with his, his forehead in his hand worrying. You know, it wasn’t till I became older and understood things, but that’s a big cultural thing, right? We just deal with it, suck it up. Whatever the term is, and if there’s anything we get out of this is letting people know that, you know, my patients say this to me all the time, and I’m very honest with my patients. I talk to them. I listen to transparency. Like I said, I’m a human just like the rest of us. I always say I’m just a doctor I know stuff that you don’t, but, you know, stuff that I don’t, but I’ve been to therapy and I go to therapy once a week. I just think that getting past that idea that when people say you do like they look at me like I’m bad or it’s weak or whatever. Yeah, I do, and if I didn’t, I don’t know that I’d be sitting in this room talking to you right now.

So, I think you bring up an important point and I think it’s important for people to recognize that you never stop trying to get there. Always trying to get to that point where reaching for help is so important. Let’s go back to the whole TMS thing a little bit. We said TMS [00:20:00] like any modality has positives and negatives. What are maybe some of the negative things people may have to think about when you’re kind of bringing in this type of treatment?

Dr. Ben Spielberg: In terms of side effects, there may be headaches in the first week or two. Not many, but they’re usually pretty mild. The other thing to keep in mind is that with some complex patients, as we try to personalize the protocols, there may be a day or two here and there where anxiety is elevated, or sleep is somewhat disturbed and that’s really important information to come back to us with because then we know how to sort of adjust the protocols from there. So, with some people, it’s not going to be a smooth ride, so to speak, but they’ll get there eventually most of the time.

Dr. Mike Moreno: It’s true with the medications, too. I mean, I’ve been prescribing a lot of these medications for years and I tell people they’re like, is it best to take this in the morning or the afternoon? I’m like, take it in the morning, but if it makes it tired, switch it to nighttime. You know, it’s one of those things. Everybody’s different and we’re all different inside and out. I think that that brings us to your point.

You know, I think just keeping the faith, you know, knowing that you got to keep trying, never giving up and trying to get to that place because so many people suffer with these kinds of things, and I think we, they’re around us and we don’t even know it, you know. We really don’t even know it and I think it’s frustrating, you as a provider and myself and so many people, you think, you know, we know it all, we know this person so well and then you’re like, whoa, I’ve been around this person for all these years, I never knew this was going on in their in their head.

Dr. Ben Spielberg: Right.

Dr. Mike Moreno: Let’s switch gears a little bit. Let’s talk about ketamine. First of all, let’s for our listeners, let’s talk about what ketamine is. How long has it been around? What are the traditional uses of it and is it used today?

Dr. Ben Spielberg: Yeah, so ketamine is it’s an FDA approved anesthetic. It’s been FDA approved for fifty-one years now. So, commonly in high doses, it’s used as an anesthetic and then in the 90s it sort of became this popular drug of abuse in the rape scene, and then in the year 2000, a study at Yale University revealed that these very, very small sub anesthetic doses of ketamine were really effective as a rapid antidepressant.

So, most antidepressant medications, they take six weeks to start working, right, but this study showed that ketamine worked within a day or two.

Dr. Mike Moreno: Wow.

Dr. Ben Spielberg: So, it was really sort of groundbreaking in that way and then more and more clinical trials came to light using these ketamine infusions for depression, for anxiety. One was just published the other day for PTSD, and they’ve all really revealed that these small, sub anesthetic doses of ketamine can be a really powerful antidepressant with about an 80 percent success rate.

Dr. Mike Moreno: So, are they, in a sense, pulse dosing ketamine? Is that what it is? Kind of a pulse dose. That’s a term that we use where they’re just giving small amounts continuously, or is it an infusion or how does this work?

Dr. Ben Spielberg: Yeah, so there’s a few different ways to do it, so there are infusions which are administered in a clinic and the infusions are sort of beneficial because you can really, you really know exactly how much ketamine is going into the body and also the rate that it’s going in. There’s also a ketamine nasal spray. There’s sort of one version that’s FDA approved and then there’s also a compounded nasal spray that’s pretty common and there are also oral formulations of ketamine that compound pharmacies can make as well.

Dr. Mike Moreno: And I imagine there’s variations for everything, everyone, and it’s got to be personalized and you really, your approach, as we talked about earlier, is more of a sort of a comprehensive team individualized approach, I guess is the best way to say.

Dr. Ben Spielberg: Exactly.

Dr. Mike Moreno: So, let’s talk a little bit about a new venture that you have. Bespoke treatment. Talk to our listeners a little bit about what Bespoke treatment is.

Dr. Ben Spielberg: Sure, so Bespoke Treatment is an online ketamine-based therapy program. So basically, it’s a combination of individual therapy, group therapy, mindfulness meditation and ketamine, and it’s all done at home through telemedicine. So that’s what’s kind of unique about this program, is we’re really improving access to care for individuals who can’t come to the office either right now because of Covid or because they live too far from ketamine clinic or because they want sort of an entire wraparound program, a whole [00:25:00] therapeutic program for them.

Dr. Mike Moreno: I would imagine, you bring up the word Covid, which I’ve tried to stop saying because it’s like forever in our heads, no pun intended, but the rates of depression, anxiety, PTSD have to be not only the rates sky high, but just a different kind of feel. What do you see?

Dr. Ben Spielberg: Yeah, it’s nuts. I mean, a lot of people are really suffering right now. They’re really struggling with mental health. I saw a study last night from the CDC, 10 percent of individuals who answered this survey reported suicidal ideation in the past 12 months.

Dr. Mike Moreno: Wow.

Dr. Ben Spielberg: 10 percent of the population. So, it’s really quite intrusive in our lives, right?

Dr. Mike Moreno: Right, absolutely no, and I think, you know, telemedicine and if you look back and think as little as a year ago, right, less than a year ago, and you look at how much telemedicine was being used versus now, you would never have imagined such an increase, which is great, because we’re able to bring care to people and not have them come in, for some of us were afraid to leave the house, and not just Covid. I mean, in general, the fears that you have in your depression, anxiety may be so deep that even leaving the house is hard. So, when you could bring something like this to underserved communities, to these people who really need that care brought to them, it’s got to be a really rewarding thing.

Dr. Ben Spielberg: Yeah, definitely, definitely, it’s definitely a game changer for a lot of people. I remember before Covid happened, we used telemedicine actually for our initial psychiatric evaluations once in a while and there was some pushback from people because it just wasn’t sort of familiar for them, but now it’s really become the norm, which is pretty amazing.

Dr. Mike Moreno: Yeah, I mean, so we went through this very similar transition with our treatment, and it was exactly what we experienced. Initially people were like, well, I’d rather come in, I’d rather do this, but then when they realized how some very basic, simple things that could be handled through an email or a phone call or a simple sort of screening process, right.

We always think of the old days of going into the doctor’s office and going through the whole process and whatever. Don’t get me wrong, there’s still a role for that and there always will be, but we are looking at ways to treat the masses. We’re looking at ways to reach people who can’t get that care and so I think it’s important that we look at all of this stuff. When you look at the prevalence and sort of this evolution of Covid over the months, it must have really created a lot of thought process in you and your colleagues that said, hey, we have a tremendous opportunity here.

Dr. Ben Spielberg: Definitely, definitely, I think that it really opened the doors to starting this treatment and I really saw just how many people really yearned for sort of a non-traditional mental health treatment that they could do at home, because at the clinic we would get phone calls all day of people who really wanted to come in, but either lived too far away or were just so terrified of leaving their house because of fear of Covid, right? This was our solution.

Dr. Mike Moreno: So, let me ask you a question, I talked about some of my personal experiences and some of the things I went through, and I’m happy to because I think it’s made me who I am, and it’s allowed me to kind of give my experience to people. I mean, you, have you yourself, have you been through, we’ve all been through tough times. I mean, has there been sometimes in your life where you’ve sort of been like, God, this is not what I signed up for or, you know, how has that been for you?

Dr. Ben Spielberg: Oh, big time, yeah, so my whole life, I’ve had pretty severe ADHD. I was a C student through all of school and then at Columbia I got a 4.0 GPA into graduate school. So, I have like the perfect example of ADHD where you really sort of slack off, not slack off, but you can’t focus and then you sort of find something to hyper focus on it and really excel.

Dr. Mike Moreno: And I think you would probably it’s something you just loved, right? I think you tend to work harder and that hours just go by when you’re so engaged in something that really just strikes you, you know what I mean?

Dr. Ben Spielberg: Yeah, definitely, and part of it, too, when I was younger was, I haven’t figured out what the strategies were so that I could succeed in a setting like a school. I didn’t, we didn’t have laptops that we brought into the school at the time and that’s [00:30:00] something that helped me a lot later on. So, part of it was sort of developing those coping mechanisms, but I’ve also struggled with severe anxiety, severe depression. When I was younger. I tried a few medications. They never worked. I was on Prozac, a pretty high dosage, and I gained 60 pounds.

Dr. Mike Moreno: Wow.

Dr. Ben Spielberg: All of the doctors told me there’s no way you gained weight from Prozac. It’s impossible. The second I stopped taking Prozac, I lost all of the weight.

Dr. Mike Moreno: We see that in a lot of people. Like you were saying, you can’t always predict it, but there are a good percentage of people who have that. You can really never, I listen to my patients and whatever they tell me, it may be the one patient in 20 years that said, hey, I did this, and I felt this. It could be a coincidence, but you got to listen to patients. You got to listen to people. You have to really give them their sort of their time because who am I to say that didn’t happen or that did happen? And then I think when you have even more higher percentages of things, listen. Yeah, I guess there’s coincidence, but I don’t know. Things happen.

So, let me ask you this. I mean, Ben, you’re a young guy and you’ve just, you’re tapping into this new thing. When we talk about TMS and all of these new way of handling things. Where do you see things going? You know, never mind Covid. You talked about the bespoke and where do you see us going as a society in our mental health?

Dr. Ben Spielberg: I see, I see a shift coming and I do see that mental health will be something that is able to be talked about more, right. You see it in sports where NBA players are now talking about mental health for the first time. I think that with the developments in telemedicine, there will be more psychiatrists and mid-levels available to treat patients.

So, I do see a shift coming, but it really is so important when you look at all of these different diagnoses, you really see how the impact of mental health affects outcomes, right? From cardiology patients to chronic pain patients, rheumatology patients, there’s, it’s so common to have these co-morbid mental health components and I think that in 10 years, these will really start to be seriously addressed.

Dr. Mike Moreno: I mean, thank God, because it’s a long time coming and we’ve got a lot of work to do, but your work that you’re doing is appreciated and it’s fascinating, really. I mean, I think it’s interesting and I hope my listeners give this a look and take a look at options. It’s all about options. You know, there’s no one thing that’s good for, you know, everybody.

Dr. Ben Spielberg: Right.

Dr. Mike Moreno: So, I think it’s about looking at your options and the whole idea in medical school, we learn this when you take the oath, is to do no harm and if something works for somebody and it does no harm, then I think you got to support those individuals. So, Ben, thank you so much. Thank you so, so much. This is fascinating new stuff. This is what I love about doing these things. I learned so much. Medicine is amazing. Human bodies, amazing and it’s just fascinating. Really appreciate the work that you’re doing. Where can we find you? How can my listeners find you?

Dr. Ben Spielberg: Yes, so the clinic website is and Bespoke Treatment is

Dr. Mike Moreno: Ben, thank you so much, really appreciate your time.

Dr. Ben Spielberg: Of course, thanks so much for having me. It was a pleasure.

Dr. Mike Moreno: Well, guys, that’s it, great stuff. There’s so many new things out there and let’s get to it.

Let’s get to the weekly RX for today. A lot of great things, but a couple of things really stood out in my mind when we talked about these things with Ben. One is I think mental health deserves its day and we need to reach out to people. We need to always be trying to get past whatever it’s our cultural beliefs or our surroundings or whatever it is that has gotten us to say I don’t need help. I think we can all use a little help and never stop reaching out and never ignore your problems. Tell somebody. I think the other point is really a comprehensive approach to managing things is the key.

You know, when we manage pain or we manage mental illness or we manage everything, the body, [00:35:00] the mind, the brain is a very complicated existence and a comprehensive approach to managing a problem is always the best approach. So, we’re going to leave you with that and feel like I’m getting serious, but thank you, Ben.

Thanks, everybody. That’s it for today. Don’t forget to subscribe for free. Download and listen to Wellness Inc with me, Dr. Mike Moreno on Apple podcast or wherever you listen. Follow me on social media at the 17-day diet. Take care.



About This Episode:

Adulting is hard, especially this past year, and things may stay difficult for a while longer. Mental health has to be front and center for all of us or things can get worse.

That’s why Dr. Mike’s guest Dr. Ben Spielberg, with a Master of Science degree in Neuroscience and Education and almost a decade in brain-based behavioral health under his belt, is an important listen.

Together they sort out the science on how brains work and shed light on alternative treatments, from antidepressants to Transcranial Magnetic Stimulation and Electroconvulsive Therapy to Ketamine and other strategies. Brain health is the key to mental health and is the key to successful adulting in difficult times. Get informed and get well!


Connect with Dr. Ben Spielberg: