From the Green Velvet Couch | A Conversation with Dr. Laurie Ballew
When someone walks into a psychiatrist’s office, they often arrive hoping for a prescription to support their mental health during the hardest parts of life. Dr. Laurie Ballew has spent decades gently explaining why that isn’t quite how it works, and why the answer is actually so much better than a single pill.
On an episode of From the Green Velvet Couch, Shelly sat down with Dr. Ballew, a psychiatrist, addictionologist, and one of the most respected mental health voices in western Kentucky. Their conversation covered everything from holistic psychiatry and the difference between mental illness and everyday behavior, to family addiction dynamics and the science behind one of the most promising treatments in modern mental health care: TMS.
Here are the moments worth holding onto.
A Career Built on Following the Patient
Dr. Ballew’s path to psychiatry was anything but linear. She started as a music major, pivoted to English and psychology, then became a speech pathologist for sixteen years, helping launch the speech therapy and swallowing study programs at Mercy Lourdes Hospital. After working with countless patients recovering from strokes and brain injuries, she wanted to be more medically involved and went to medical school. During her family practice internship, she noticed something interesting. Her clinic kept filling up with patients who had mental health concerns, and her colleagues kept sending more her way.
That was the moment she found her niche. She completed her psychiatry residency at the University of Louisville, served as Chief of Service for Psychiatry at UofL Hospital, and went on to build a practice grounded in something deceptively simple: treating the whole person.
What “Holistic” Actually Means
The word “holistic” gets thrown around so often that it can start to feel meaningless. Dr. Ballew offered one of the clearest definitions you’ll hear.
Holistic psychiatry treats the person who lives an entire life across an entire day. That includes nutrition, movement, sleep, relationships, spirituality, time spent in nature, and yes, medication when it is needed. It is the recognition that you cannot separate your mental health from your physical health, because your brain is running the show for both.
She also drew a useful distinction between holistic and alternative medicine, since people often confuse the two. Holistic care addresses mind, body, and spirit as one integrated system. Alternative medicine refers to specific practices outside of conventional Western medicine, things like acupuncture, herbal remedies, and therapeutic massage. You can practice holistic care that includes alternative approaches, but the two terms are not interchangeable.
This whole-person philosophy is also at the heart of how Shelly approaches her own work. You can learn more about her holistic wellness consulting services and how she supports clients across the emotional, physical, financial, and spiritual parts of their lives.
Mental Illness vs. Everyday Behavior
One of the most clarifying parts of the conversation was Dr. Ballew’s explanation of where ordinary quirks end and a mental health diagnosis begins. The line, she explained, comes down to functioning.
An annoying habit is something you can live around. A mental illness impairs daily functioning. She used the example of a child with severe obsessive compulsive disorder who needs to count to thirteen before completing any task. That child cannot finish their schoolwork, cannot keep up with their classmates, and cannot move through their day with ease. The behavior is no longer a quirk. It is interfering with the life they are trying to live.
Diagnosis itself is systematic and criteria-based, not a casual label. Understanding that distinction can take some of the fear out of seeking help.
Why the Stigma Still Hurts Us
Shelly and Dr. Ballew spent a meaningful part of the conversation on why people resist the language of mental health even though they have no problem saying they have high blood pressure or diabetes. Dr. Ballew’s take was elegant: our mental wellbeing and our physical wellbeing are completely intertwined, because the brain is in charge of the rest of us.
When someone has a cardiac event, the recovery is not only physical. There is fear, anxiety, and often a reluctance to be alone. When someone learns to use mindfulness or tai chi to calm their nervous system, the benefit is not only mental. Their blood pressure responds. Their sleep responds. Their immune system responds.
You cannot, as Dr. Ballew put it, set your head down on the table and walk around without it. We are one person.
Addiction, Genetics, and the Weight Families Carry
As a board-certified addictionologist, Dr. Ballew treats patients struggling with opiate, alcohol, and methamphetamine dependence, among others. One of the first things she does with new patients and their families is sit down and build a genetic tree, going back to grandparents and great-grandparents.
Why? Because addiction has a strong genetic component, and families carry an enormous amount of shame and self-blame that often is not warranted. She also walked through the biology, including the role of aldehyde dehydrogenase, an enzyme some people simply do not produce in sufficient quantities to process alcohol normally.
Shelly added a powerful observation from her own clinical work. She has seen families essentially put their entire lives on hold while waiting for an addicted loved one to get sober. Good people, healthy people, parents who looked like they were doing everything right. They had stopped traveling, stopped enjoying their grandchildren, stopped living, all out of guilt and a belief that they could not be okay until their child was okay.
That kind of enabling looks like love from the outside. On the inside, it sends a quiet message to everyone in the family that no one gets to thrive until the person in active addiction is well. As both Shelly and Dr. Ballew know from experience, that is not how recovery actually works.
Dr. Ballew’s recommendation for families in this situation is consistent and clear. She refers loved ones to Al-Anon, the support group designed specifically for the families and friends of people struggling with addiction.
TMS: One of the Most Exciting Tools in Modern Psychiatry
The final stretch of the conversation turned to Transcranial Magnetic Stimulation, or TMS. Dr. Ballew has been involved with TMS since 2010, when she helped bring it into the Depression Center at the University of Louisville. Today she offers it in her own practice in Paducah.
A magnetic coil is placed on the patient’s head. The brain is mapped to find the precise location of the prefrontal cortex, the region tied to mood regulation. Magnetic pulses are then delivered to that area, which generates electrical energy and prompts the release of neurotransmitters that help lift depression. Treatment runs five days a week for about thirty days, then tapers down over the following weeks.
The results have been remarkable. Dr. Ballew’s office has seen an 85 percent success rate. Nationally, the data show 83 percent of patients improve on TMS while remaining on medication, and 62 percent improve enough to come off medication entirely. TMS is now FDA approved for major depression, obsessive compulsive disorder, and anxious depression, with ongoing studies exploring its use for Parkinson’s disease and dementia-related memory issues.
Designed to Do Hard Things
Toward the end of the episode, Shelly asked Dr. Ballew how she stays resilient after a career spent walking alongside people through some of the hardest moments of their lives. Her answer was beautifully ordinary. She loves what she does. She loves the people she works with. She goes home to a family that cares about her, two little dogs she adores, and a baby grand piano in her music room.
Every day, she said, is a good day. Some are better than others, but when she opens her eyes and puts her feet on the floor, that is already a win.
Shelly closed the episode by reminding listeners that healthy people are not people with fewer problems. They are people who have learned to navigate problems with more skill and more gratitude. That, more than anything, is what good mental health looks like in practice.
🎧 Join the Conversation
If this post sparked something in you, the full episode is waiting with even more warmth and thoughtful insight.
✨ Listen to the full conversation on the From the Green Velvet Couch podcast. Visit the Podcast page discover more episodes focused on resilience, leadership wellbeing, and holistic wellness.
Let this be your invitation to slow down, breathe deeply, and step into a well-grounded life full of growth and intention.
