In professional and executive circles, we often focus our efforts on wealth management and asset protection. But to fully safeguard your family’s future, you need to protect your most important asset: the “human capital,” or the mental health and cognitive endurance of each individual family member.
Recently, the founder of the Lieberman Center for Psychotherapeutics, Brad Lieberman, JD, PMHNP, was invited to speak at the City National Bank fireside chat regarding the psychiatric complexities within affluent family systems.
This important dialogue brought to light the unique mental health challenges that affect wealthy families. These challenges not only affect individual family members’ mental well-being, but can also have an enormous impact on long-term financial stability and generational wealth.
We at the Lieberman Center strongly believe we need to do away with stigma and address these topics head-on. This is the only way families like yours will be able to preserve both financial success and overall well-being across generations.
Here, we’ve presented the highlights of the event and our founder’s insights on topics like substance use in high net-worth individuals, the gut-brain axis, and “hype” in the mental health world.
The Lieberman Center for Psychotherapeutics provides integrative psychiatry and stress management in NYC for high-achieving professionals who are looking for clinically sophisticated care. Our New York mental health clinics are located in Manhattan, Garden City (Long Island), and Scarsdale (Westchester County). Schedule a free consultation now.
Q: What are some subtle warning signs that someone in your family needs mental health treatment?
There is no one sign that presents in every individual, so it’s important to know each person’s baseline and how they behave when they’re feeling “well.”
One common sign that you may need to intervene is when your family member is becoming more erratic or engaging in riskier behaviors.
For example, making unusually impulsive financial decisions, increasing substance use at networking or social events, pulling away from responsibilities they can typically manage with ease, or taking on high-risk ventures that are out of character. They may be more irritable and lash out, which can be a sign of anxiety, especially in men.
You may notice that the individual is acting covertly or becoming more and more suspicious. You might feel that they’re hiding something or not telling you the full truth. This can be a hidden sign of substance use disorder, but it can also indicate something like psychosis.
Q: What is your perspective on the mind-body connection?
It’s a scientific fact that the mind and body are inexorably connected. What we think of as “the mind” — our thoughts and emotions — resides in the brain, and the brain is located in the body. The connection between them is indisputable.
The gut-brain axis (GBA) has become an area of increasingly focused research. The studies conducted have shown us the power of what we eat. Our gut bacteria has a significant impact on our mental health — it can literally change our minds through neuroendocrinal pathways. Up to 95% of the body’s serotonin (the neurotransmitter responsible for regulating mood and sleep) is produced in the gastrointestinal tract.
This is why integrative psychiatric care is so critical. It means that it’s not enough to simply “treat” surface-level mental health symptoms in isolation. We need to address underlying biological, psychological, and lifestyle factors that influence how the brain and body function as a whole.
Q: There’s a lot of “hype” around new and innovative mental health treatments. What is truly effective, and what is “just hype”?
It’s natural for people to look for more and more innovative mental health solutions, which leads to a lot of “hype.” It’s critical to be able to distinguish what is just the most recent trending topic, and what is an actually effective solution — especially when it comes to allocating valuable resources to these treatments.
One area gaining a lot of attention is psychedelics in mental health. Recent research has shown that psychedelics have equal efficacy to traditional anti-depressants. IV ketamine is one of the most effective interventions available for treatment-resistant depression (depression that hasn’t responded to more traditional treatments).
But it’s not a panacea for every mental health problem, and it does come with risks. It’s a highly-targeted intervention that can only be delivered safely with close medical supervision. So far, research only definitively shows it’s effective for treatment-resistant depression, not other mental health conditions. So it should only be used in clinical scenarios where evidence actually supports it.
As a side note, intranasal ketamine (Spravato), is not nearly as effective as IV ketamine based on the evidence that we have available — even though it’s approved by the FDA. It’s essential to be able to decipher clinical studies and equip yourself with accurate information.
Q: What does substance use look like in high net-worth individuals in New York?
Substance use when you’re a high earner looks different than it does in lower-income individuals. Functional substance use is common, where you may continue to be functional at work or school despite an unhealthy reliance on substances.
The consequence of this is that substance use can remain hidden for a longer time, which delays needed intervention and treatment. The resources you have access to may allow you to prevent hitting “rock bottom” as we tend to think of it.
For example, having a driver means you’re less likely to get a DUI. Domestic staff often prevent crises from happening that may have been the touchstone for seeking sobriety. Many executives and entrepreneurs have constantly fluctuating work schedules, which can enable substance use to remain hidden.
On top of this, there continues to be a lot of stigma surrounding mental health in higher-income families. Research shows that higher net-worth individuals are more likely to see mental illness as a result of internal, controllable factors (rather than a valid health condition that can affect anyone, which is what it really is). This also plays a huge role in delayed treatment.
Q: How is the landscape changing in adolescent substance use, especially with regards to synthetic drugs?
Studies have shown that adolescents with high-earning parents are more likely to engage in higher rates of binge drinking, cannabis use, and cocaine use. This is not about parenting skill, but about access and resources.
The “good” news is that the total number of teens using traditional substances, like cigarettes and alcohol, is at a historic low. Unfortunately, the intensity and risk of the substances they do use have escalated significantly in recent years.
The most dramatic shift involves the transition from natural substances (like cannabis) to high-potency and synthetic THC products. Vaping is a particularly troubling trend — the percentage of adolescents, including pre-teens aged 11 to 13, who vape synthetic cannabinoids has significantly increased. These synthetics can contain up to 90% THC, compared with natural cannabis which contains around 25% THC.
The most current research highlights that the adolescent brain (which develops until roughly age 25) is uniquely vulnerable to these high-potency synthetics. Use during these years is linked to permanent changes in the brain’s reward system, which may to a higher incidence of bipolar and psychotic disorders.
Q: What resources are available for families who are struggling and need support?
There are so many resources out there. The bigger challenge is finding providers who understand your unique situation and can work within the realities of your lifestyle and standards. Mental health treatment is not one-size-fits-all. What works for your family isn’t going to be the same thing that works for families with a different level of access and resources.
At the Lieberman Center for Psychotherapeutics, we work directly with individuals, including parents, and adolescents, to provide integrative care. We can also coordinate referrals to boutique treatment programs and parenting coaches that prioritize privacy and clinical excellence.
If your family member is in crisis, contact your physician immediately to access emergency services. You can also call the 988 Suicide & Crisis Lifeline or dial 911.
Integrative psychiatry in NYC, Long Island, and Westchester County for driven individuals
At the Lieberman Center for Psychotherapeutics, we take a highly individualized and discreet approach to mental health care. Brad Lieberman’s background as both an attorney and psychiatric provider gives him a deep understanding of the demands that come with high-performance careers.
We also collaborate with trusted professionals for services like parent coaching and specialized care, so you can access the right level of treatment without unnecessary exposure or disruption to your family’s life.
Invest in your family’s future, and book a free consultation today.