Founder and Chairman of the Hope for Depression Research Foundation, Audrey Gruss, on Mental Health, Awareness, & Advocacy
We are so honored and excited to have Audrey Gruss on The Seam Podcast. She is someone who has been deeply involved in the cause of mental health awareness and advocacy for decades as a philanthropist and thought leader. As the Founder and Chairman of the Hope for Depression Research Foundation (HDRF), established in 2006, Audrey is helping to pioneer international scientific research into the origins, diagnosis, treatment, and prevention of depression and its related mood and emotional disorders.
Much like the Lynne Cohen Foundation, the Hope for Depression Research Foundation is named for Audrey’s mother Hope, who battled clinical depression for decades. In this amazing interview, Audrey shares her story with us while providing crucial information about a widespread medical condition that impacts millions.
Amy: I am overwhelmed and excited, and I feel very honored to be speaking with you today, Audrey Gruss. You're the founder and chairman of the Hope for Depression Research Foundation, which you established in 2006 in memory of your late mother, Hope, who battled clinical depression for decades. The mission of the foundation is to fund pioneering international scientific research into the origins, diagnosis, treatment, and prevention of depression and its related mood and other emotional disorders with the ultimate goal of finding a cure.
The foundation distinguishes itself as the only significantly-funded research program, public or private, based on affective neuroscience, which integrates the field of neuroscience, the biology of the brain, and affect mind and emotions. It's amazing and fantastic. And if you would just tell us about why, how, and the goals of what you are doing and sort of how it came to be. I would love to hear that story from you.
“My mother had depression. years ago, in the '50s, it was called a nervous breakdown, a generic term for what we now know to be major depressive disorder.”
Audrey: Absolutely, Amy. My mother had depression. And years ago, in the '50s, it was called a nervous breakdown, a generic term for what we now know to be major depressive disorder. And it was very hard to get information from the doctors. My father and two sisters and I were devastated when she was hospitalized. And afterwards when we really didn't know very much, we were kids then. And we were just thinking, "What do we do? How did mommy break her nerves? Did we do something?" Obviously, children feel guilt. You feel that maybe you had something to do with it.
And for years, my mother did get the best available care, whatever that care was at the time. But in 2006 was the year after my mother died, when she passed away, I was bereft. I was very close to her. She was a very creative, elegant, talented woman that was a great advisor and somebody that I just related to. And she was just a wonderful person, even though she did have this illness.
And after her illness, after she had that breakdown, she was never quite the same person. And for years, even though she supposedly got the latest medication, she never had full relief of her symptoms. She had major depression with anxiety, and some paranoid overtones, it was called at the time. And she was being treated by the best psychiatrists, supposedly the best medication.
And we never quite had her back to where she was functioning as a healthy functioning woman completely. She always needed assistance or had to be in a senior residence after my father passed away, where we needed to have full-time care watching her.
So, after she passed away, I asked her psychiatrists and I spoke to many other psychiatrists, psycho-pharmacologists, the doctors that are more aware of the medications and prescribing medications and the neuroscientists that I was introduced to.
And here's what I learned - it's so simple! These are the basic simple facts about depression:
Over 20 million people, adults in the US have depression every year. That's before the pandemic. A combined CDC and census study showed us last year that 41% of Americans had some type of depression or anxiety or a combination of both during the pandemic. That is staggering. That is almost half the population of adults going through this mental health condition that most people really don't know about.
“Many uninformed people still think you pick yourself by your bootstraps. You've got a great life. Just talk yourself out of it. It is a medical condition. It is a body and mind condition. And there are many reasons why somebody can't just pull themselves out of it — because their whole body and mind are miswired.”
Many uninformed people still think you pick yourself by your bootstraps. You've got a great life. Just talk yourself out of it. It is a medical condition. It is a body and mind condition. And there are many reasons why somebody can't just pull themselves out of it — because their whole body and mind are miswired. There are many physical...and I'll get into that with you…there are many physical symptoms as well as mental symptoms of depression.
So, after I met with certain neuroscientists and some of them said, "Oh, we need so much help in this area of mental health. Let's do a building, a major neuroscience research building." I said, "Listen, I'm not so into bricks and mortar. Right now, I want to find out why my mother didn't get maximum health." I was under the impression that these new medications, she seemed to be prescribed new medications every few months. I thought they were from Europe. I thought they were being developed by major pharmaceutical companies.
Guess what? All of the major anti-depressants today, and even my mother through the '80s when she died in 2005, all of those medications are variations of Prozac, an SSRI, selective serotonin reuptake inhibitor, or an SNRI. Those types of medications were introduced in '85, 35 years ago, and they are still the predominant antidepressants out there.
There are two new ones that came on the market (but they're not for general use): Ketamine and another medication that's used for postpartum depression. But I don't want to get into that because they're not major. They're not for use by everybody. They're not in broad use. They're very specialized.
So, this same category is what has existed. Everything you see on television, Pristiq and Cymbalta and Effexor, and whatever names you see on television, they're all variations of SSRI and SNRI. And if you're interested, if we have time, I can explain to you how they work, what that's all about.
But basically, we need new medications. And years ago, even in 2006, seven of the top American pharmaceutical companies had stopped doing brain research. It was simply too expensive. They had some of their patents running out on their very important drugs where they were getting hundreds of millions of dollars of income from it. They just didn't have the money to go after brain research.
So, I thought what is needed here. And I have a background in science. I have a bachelor of science degree in biology, because my mother had suggested to me that I think about being a doctor. And I appreciated that. I loved the idea of medicine. I loved always kind of taking care of people and being good to people and I was fascinated by my biology classes, and I did very well on them.
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But at university, I went to Tufts University, and I graduated with a BS in Science in Biology. But I never did as well in my other science classes as I did in the humanities. And I did get a job at Revlon Research Center years ago when I had started my career, and that was medically oriented but was in the consumer product arena. And I stayed in that area, and then went into advertising and marketing in other skincare companies and textile companies, but I stayed primarily in advertising and marketing.
What I learned from that is teamwork. I learned how to direct creative people. And I learned that my scientific background was always there for me. It was a way of learning inductive, deductive reasoning, very organized, structured kind of management of the information that you had.
I brought that up because I thought at that time, I thought that there were an enormous amount of nonprofits working on depression, dealing with mental health, and there aren't and there weren't. And with my background in science, and I had been doing philanthropy, a lot of philanthropy when I married my husband, we've been married now 33 years.
But at the time, I couldn't really just work just for income. I started to do a lot of very interesting philanthropic endeavors. So, I thought, why don't I just put together the skills that I have, the skills that I used in years of, 25-year marketing career, and see what I can do in this arena.
And I was introduced to neuroscientists who worked out a strategic plan for what they would do. And our foundation initially funded the seed money. And we developed in memory of my mother, Hope, Hope for Depression Research Foundation. We started this 15 years ago. We're celebrating our 15th anniversary. We are the leading depression research organization in the states, because our depression task force of leading doctors, and they're from Canada, US and Germany, they must collaborate.
We insist that they share their information in real time to anyone who contacts them and wants to know what's going on. It's not waiting for lectures and symposiums and meetings that happen every two or three years. And then you hear about certain research, and then you have to duplicate it.
So, the idea of the foundation was to bring in private funds and money we could raise to do the most advanced research to find out the causes of depression, that they really didn't know what causes depression, we create a new category of medication that would ... because 35% to 50% of people do not respond to the existing antidepressants out there. That's why it is so critical that we find something new.
And we now, after seven years of this task force working together, we are in clinical trials at Mount Sinai and Columbia in New York, with a brand-new category of potential anti-depressant. So, that's a long answer to get you right from the beginning to where we are today. And the interim and the information that's available is very interesting.
So, to put depression into perspective, it is a mind and body illness. I'll go through the symptoms with you. But now, over 41% of Americans are struggling with it. And the pandemic was the height of it. But now, we're going to have the after effects. More people need more help to deal with it. 350 million people struggle with depression worldwide. And that is very conservative! That's a statistic before the pandemic.
And it is the number one reason in the world for disability. It absolutely is one of the most important illnesses that we should know about. I chose to focus on depression because depression and its mood disorders, like postpartum depression, bipolar depression, posttraumatic stress disorder, anxiety, those represent 95% of all mental illness, maybe even more. And they're like the common cold, the common cold of mental health.
The rest are out of touch with reality psychotic illness like schizophrenia. Little old me couldn't take it all on. I thought, let's focus on the common cold. If we can get answers to this, everything else will fall into place. So, that's the beginning….and that's where we are now!
And it is so exciting to work - and I'm sure you find this experience as well, Amy - to work with these brilliant minds and find that they are such fascinating, brilliant, interested and interesting people.
They are rock stars in their world. They are the top of the top. And I love the communication with them!
And one key thing, which is why I brought up my education in biology, I am not afraid to talk to them. I know enough lingo. I know enough of that scientific language and terminology and enough that I learned even in pre-med courses that I was never intimidated by sharing with them what my objectives were and understanding what their processes were of research.
Years ago, or actually, even currently now, most research institutions, their universities try to raise money for their own labs. They keep their information to themselves, until it comes out in conferences and symposiums. And I really felt that from my experience in working with committees and creative people and guiding that creative process, that I thought we had to work together.
So, that collaborative process is what makes us truly unique. And what they've learned in the last seven or eight years, because that's when I formed this depression task force, the last eight years of the foundation, the most recent eight years, we have found that this collaborative effort has really set guidelines for what's needed in research and what the whole community can look to and take advantage of as a result of this amazing research that we've done.
Depression affects everybody - every age, every religion, every sex, every economic level, every education level - everybody. It's spared, nobody. Years ago, many people thought that twice as many women as men had depression. It was thought of as a woman's health problem.
Well, as we learned more about it and as we learned more about what causes it and how people manifest it, here's what's happened. We have an annual fundraiser. And we pick a topic, the general topic of variations, some aspect of depression, and we get the best specialists to come in and talk about it. This is usually in November and early November in New York at The Plaza.
One year, we had the topic of men and depression. And one of the foremost authorities said if you take into consideration gambling, womanizing, belligerence, and kind of anger, angry behavior, so, we have most of the key points of behavior, if you take that into consideration as symptoms of depression, just as many men as women have depression, because those symptoms weren't considered actual signs of depression. And they are. So, it's very, very interesting.
The key area in our demographics of who commit suicide are white men over 60, and young adults. Young adults is more recent, that's been happening. And I think we can understand that. The isolation during the pandemic, being away from friends and our social interaction is an essential part of our being. Just connecting, even though it's on Zoom, is a wonderful way of sharing ideas and thoughts. Can you imagine if we were just in our own cocoon and didn't have that sharing with wonderful people? And young adults have really gone through a terrible, terrible time with this pandemic.
And so the reason for men, the reason that men have higher suicide rates, that is, is that they don't get help. They don't talk to their friends. I don't know what they talk about on the golf course. But it's certainly not mental health. They don't talk to their wives, when they feel that something's wrong with them, something has happened. They freeze. They just don't know what to do. And those men who have access to guns help themselves. And that's a tragedy. I don't want to get political, but I'm very much for gun control. I don't think anyone should have an automatic weapon, unless they're in the service.
Amy: Makes no sense.
Audrey: It makes no sense. But that's the tragedy of men just from their our culture and not opening up and not sharing and just feeling, oh my god, my life has gone. Something is so wrong with me. I just am not functioning, I'm not behaving, whatever.
We had a fabulous lecture by a man who was top of the top in the business world. And he said something that happened, some trauma and some reversals and all and he found himself not concentrating and not sleeping, not eating and going to work and just repeating the same sentence to himself and whatever.
Luckily, his Human Resources person was an educated person and who knew about mental health issues. So, he went to her and said, "I'm in trouble. Here's what's happening to me." And she said, "I'm making an appointment for you right now with someone we know, a psychiatrist we know." And he was helped. And he speaks to other people and is very open about it, and a wonderful man, who now has a thriving wonderful life, but he got help, not like so many who don't get help.
Women have their own other unique aspects because of our hormonal, additional hormonal system that regulates part of how we behave, and think and, and feel at times based on our cycles. And that complicates the issue. But I want to go through some of the symptoms of depression.
So, if we spot these, in our friends, our loved ones, and this is for adults because children manifest sometimes differently, but the key things are, if you see that someone's or you hear that someone is not sleeping, or sleeping too much, so not sleeping enough or sleeping too much, that whole Circadian Rhythm and cycle is very, very important that we stay on that.
If somebody is eating too much or eating too little, that can be a sign. If someone is not enjoying the basic pleasures that they loved going to the movies, and now there's, "I don't want to do that."
If they if they're not doing the basic things that gave them pleasure in life, and that keeps going on for at least two weeks, if somebody is ruminating and telling you, "I feel so guilty. I'm the one that causes this or that. Something wrong with me I'm not a good person, just ruminating about unrealistic negative things." That's a sign of depression.
If someone has body pain, and the body pain can't be exactly identified with a physical reason for it - we had a speaker on body pain and depression - and he's one of the foremost orthopedic surgeons in New York! Anyway, he said that 60% of the people with back pain in his practice also have depression, 60%. So, body pain, that kind of feeling is also one of the signs of depression.
And then we have symptoms 8, 9 and 10. And I can send those to you, by the way, if you want to post them on your website, that would be wonderful if we could do that. That would be so great.
So, if somebody has five of these or more for two weeks or more, you've got to get them to their doctor – just internal medicine – a G.P. And what we always say is, if someone opens up to you and shares with you that they're not feeling right, they're off, and they can't quite even articulate it, say to them that you'll take them, you go with them to their internist. And the internist is a good place to start because they can recommend an appropriate psychiatrist or mental health person, whether it's a psychologist, social worker, whatever.
But I think we always should be so kind to those around us, the ones we love and the associates we have in business, because everybody somehow is one step away from this. It affects everybody, directly or indirectly. It is our brain. It is the last frontier of medicine. And everybody's touched by it one way or another.
So, that's part of the story of what we've done with Hope for Depression Research Foundation and how much it's needed. So much of the research has gone overseas. A lot of our top scientists have been simply wooed away to Singapore, to other places where they're offering great big, huge salaries to scientists and wanting to be ahead in this area.
So, with the pharmaceutical companies closing down their brain research departments with scientists going overseas, with the epidemic. I think there's an epidemic within the pandemic of mental health. That's what I think has been happening. With that happening, we need more foundations like ours. We need more money being put into this by the government.
When cancer was really at its height, and this was when Nixon was president, and cancer was coming on so strong people were finally admitting they had it, and people could talk about it and whatever, Nixon put hundreds of millions of dollars in the NIMH, National Institute of Mental Health budget, to try to get that pumped and primed and doing more research. And then corporations followed in doing fundraisers and donating.
And I'm hoping that we can follow the same pattern, whether we can get the monies from government. That's something that is very hard for us laypeople to control. But you never know. I mean, as long as we can lobby and have this ability with foundations such as ours.
But I think through the corporate area, through individuals who make a difference, I hope that there will be a lot of Audrey Grusses, people who may want to start their own foundations locally, work with their own research centers and universities there, because it can be done. I started from scratch. And to me, the creative was very important. So, just designing the logo and getting the right attorney to have our agreements done and all of that, it's also important, whatever you do at the beginning, and I really wanted the best. I wanted what I felt very comfortable with that would last and take us into many, many years.
So, whatever you do at the beginning, if you're thinking about doing anything in a nonprofit, get your best people that you can, consultants, set it up the way you want to set it up very well and restructured very well so you don't have to go back and say, "Whoops, we didn't do that or this." Get the best people, set it up properly, and then you're set for whatever you want to do in the actual mission of the foundation.
Amy: Oh my god, you said so many things. I don't know where I have to pick and choose to dig in. It's incredible. I mean, there's a doctor at NYU who said lots of people start things and lots of people start foundations in particular, often out of tragedy, when they lose someone they love.
Audrey: Yes!
Amy: But very few people carry it on and see it through knowing that there might not be an end, that you do this, and do this, and do this until maybe you pass the torch or something gets bigger, and you're able to move it to that next state.
Audrey: Yes.
Amy: She said that to me often. And I always take it as a compliment. And also, that this is my heart. What I do is my heart and my soul, women's health and wellness preventive care, and clearly, it's yours, too. And it's just incredible to listen to you and see how, like you said, you started from ground zero and were very particular with the details from the beginning, which clearly laid an incredible foundation to continue to do what you've been doing since 2006. And in the last seven years with your task forces, inspiring and incredible.
You could say to someone if you've been touched by cancer and everyone can say yes, and we're just talking about women, people always know someone who's had breast cancer or ovarian cancer, lung cancer, whatever it is. And I absolutely think today is the same when you talk about mental health.
And you can ask anybody, do you know someone struggling with their mental health in whatever capacity that it shows itself. And I can't think of anyone that would say no. Everyone I know is perfectly healthy. And I also believe our physical well-being and our mental health are, they're like this. They're in twined.
Audrey: Intertwined.
Amy: Intertwined. It's our whole body. And I think what you were saying about men and then internalizing their pain and dealing with it as they're taught to do, and for women, we spend the majority of our lives taking care of everyone else.
Audrey: Absolutely.
Amy: There are many times put ourselves on the back burner when it comes to not just our physical but also our mental health. So, your advocacy is incredible. And this last year, I mean, I know one of my nieces who struggled with her mental health and anxiety and depression, that it probably was bubbling before the pandemic, but the pandemic definitely kicked it.
Audrey: Yes.
Amy: And my sister has done an incredible job of taking care of her and getting her to all the right experts. And we've taught a lot about it because I've also seen it where you can see some signs of people in their younger years, young adults, teenagers. And when you don't address it, a family member or a friend, they don't have them tools to deal with it and understand it as they get older.
Audrey: Exactly.
Amy: Right? And that's a huge pandemic amongst itself. So, in this last year, we're unable to help the millions of people who are feeling from a level 1 to 10 depression, anxiety, change in mood, their health and wellness habits of eating and exercising, of nutrition intake. It won't get better. It doesn't go away.
Audrey: You have to deal with it.
Amy: It gets worse. Yeah.
Audrey: Amy, I'd love to tell you what we say are the four “pillars” of mental health. This is for everybody, whether you think you might have some symptoms, whether you just want to feel better or your best. The four pillars for everyone are nutrition, proper nutrition for whatever that means for you; sleep, everybody needs their best amount of sleep, whether it's seven, eight or nine hours, or whatever works for you, you've got to get enough sleep. So, work your life around the fact that sleep is that regenerative, nurturing kind of time; exercise.
Nutrition, sleep, exercise. We definitely know that exercise is very beneficial to the brain; and mindfulness or meditation. This is the fourth pillar. And I have to be honest, I myself tried to do it. But I kind of hit the ground running every morning. And I always think, oh, I've got to get this, that, that, that. But I know it works. I've done it a few times. When I've made that time and effort to calm myself down and just focus on nothing and whatever the process is of doing meditation, it really works.
So, those are the four things anybody can do if they want to prevent depression from coming into their lives or other mental health issues. But when I say depression, it really is a big umbrella. It's almost everything in terms of emotional, mood disorders, and then the anxiety, the postpartum depressions, posttraumatic stress disorder, and bipolar. That is really a major, major part. I mean, we have social phobias and other things. And then they're classified somewhere in that area of nonpsychotic in touch with reality illnesses.
But the one other thing that bothers me so much is even though there are podcasts such as yours, there are intelligent, educated people, et cetera, there's still such stigma, there's less and less, but in the areas that aren't maybe metropolitan where people don't get as much recent information. I don't know why and where it happens. But stigma still prevails. It's been going on for thousands of years. So, it's something you can't see. That's what it is. It's something you can't see. And it's very scary to some people. They're very afraid of somebody with mental issues, especially if they're really very, very seriously ill like schizophrenic. That can be frightening to anybody when somebody is out of touch.
But I think the more awareness, the more education, the more people get help, I think the more that stigma will fade into the background because it really is our brain is it controls us, it runs us, it does everything for us. And I think the more we take care of it and do some of the preventive things that I've just outlined, the preventive and then to get help, 50% of those who have depression don't seek help. They never see a doctor. It's a tragedy.
And I find that today on the news, I am so gratified to hear the newscasters, the journalists do many more articles on mental health because it's so prevalent. They can't avoid it anymore. And I think that it's now become commonplace, more and more. And that's how the media will probably reach greater numbers and get kind of an awareness about giving stigma, which we certainly don't need. We need no stigma so that everybody can get help.
Amy: Yeah, and access to help.
Audrey: And access, access to help. Absolutely.
Amy: This is really important. One of the things that you said I found so fascinating was pertaining to the history of Prozac, and how there have been no real new drugs incentive. A good friend of mine is almost done. She's creating a new baby formula from scratch to get FDA approved. Because she realized that there had been no new FDA approvals for infant formula, since infant formula was created, so, 1960s, '70s, and-
Audrey: Oh, my heavens.
Amy: Right? Which means all those different brands and all those different, what it says on them they do differently on the shelves in the United States, are all based on the same FDA-approved formula.
Audrey: Variations on the category.
Amy: Exactly, which means they're basically the same.
Audrey: Yes.
Amy: Maybe one has an organic base. Essentially, the ingredients have to be so similar, otherwise, they wouldn't be able to get approved. And then you mentioned that, I thought that same thing, and what's the root cause of that? Is it the laziness on the pharmaceutical end? And it's too much work, it's too hard?
Audrey: Yes, and cost.
Amy: It's so costly, of course.
Audrey: It's costly.
Amy: Clearly, people need different kinds of drugs.
Audrey: Yes.
Amy: And from the different levels of mental health issues they have from the different kinds, you're saying ranging from one thing to another, it's incredible that in this day and age, when you say something like that, I think it's jarring for many people to hear that and understand that all those drugs are based on the same FDA-approved drug. It blows me away. It literally renders me speechless!
Audrey: Amy, it blew me away 15 years ago. And that's why I started this. I could not believe. I mean, mother was taking variations. But there may have been a reason for trying the different ones. That's all they had. They're metabolized in different parts of the body. One may be metabolized in the stomach. Another may be metabolized in the intestines or in the liver.
So, each one has certain differences. But as you said, the basic ingredient, the SSRI has to be the same because the FDA approval is for that ingredient. So, I can understand what each pharmaceutical company wanted a piece of the action. It's a multitrillion-dollar market and they wanted their own version of it. So, they worked out their own version. And it's okay. There are side effects to these medications.
And what we're working on is something that has to be taken once a day with no side effects. It would be amazing if our new potential category proved positive. It's on the right track. It's in the midst of the research that we're very, very excited about it. We really are.
Amy: What a breakthrough!
Audrey: Oh, I was going to tell you! Amy, I was going to tell you how serotonin works.
Amy: Oh please.
Audrey: Because a lot of people also are afraid to take drugs. They say, "I don't want to take this drug. I'll beat it. What can I do just to beat it?" Research has shown that the best treatment for depression is a combination of medication and CBT, cognitive behavioral therapy or talk therapy. So, the combination is the best. And either/or is okay as long as people get help.
Audrey: Our body makes our own serotonin. And when we're mis-wired for whatever reasons we get mis-wired, the endings of our nerves suck up. They, selective serotonin reuptake, the uptake they suck up the serotonin.
So, picture this river flowing in somewhere and the endings are sucking up our own serotonin and then the messages from one nerve to the other don't pass through this medium. It needs to pass through something just to get the message there. So, that's what serotonin, these SSRIs are, selective meaning not all the endings, serotonin reuptake inhibitors. The medication inhibits the uptake of our own serotonin or our own norepinephrine in an SS- sorry – an SNRI, selective norepinephrine reuptake inhibitor.
There's some medications that deal with the dopamine and related kind of neurotransmitters. But basically, people should think of this as I'm taking a medication that will assist my own body in functioning properly rather than off. It's a little off. It's just not functioning the way it should be. No one should be afraid of taking and trying antidepressants, if it can help them, live better, and function better and are very taxing society today.
I mean, we have the stresses, especially if someone, like we're talking to women, I mean, someone's a mother and a wife, and a daughter, and all these things that we as women take care of, we know what we have to do. And it is very important that our mental health is something that we take care of, as much as if we have anything that we can physically see on the bodies.
Amy: I completely agree. I mean, there's-
Audrey: What you're doing! That's what you're doing.
Amy: I'm trying, I'm trying.
Audrey: Oh, that's fantastic though. I admire you.
Amy: Thank you, and you know, we try in our personal relationships and then try to use a bigger platform to make change, which is just what we do! And I'm so appreciative of everything you do, also!