If you’re struggling with your mental health, you’re not alone.

If you are in immediate danger of harming yourself or others, call 9-1-1, or head to your nearest emergency room. You can also call or text 9-8-8 to reach the Suicide Crisis Helpline. Support is available 24 hours a day, 7 days a week.

Young people can chat anytime with Kids Help Phone by calling 1-800-668-6868. Services are available in English and French.

Wellness Together Canada provides one-on-one counselling, self-guided courses and programs, and peer support and coaching. Youth can contact this service by calling 1-888-668-6810 or texting WELLNESS to 686868. Adults can contact this service by calling 1-866-585-0445 or texting WELLNESS to 741741. You can also find credible articles and information on their website. 

The Canadian Mental Health Association can help you find resources, programs, or support for yourself or others. Find a CMHA branch in your area here. 

The Centre for Addiction and Mental Health provides Mental Health 101 tutorials and online courses on their website. 

However, when dissociation begins to disrupt or interrupt the integration of behavior, memory, identity, consciousness, and more, so much so that a person loses recollection of random times in their day-to-day life, this might be a sign of a dissociation disorder. While some skeptics argue that these disorders are related to fantasy proneness and suggestibility, research supports dissociation as a psychobiological state that functions as a protective response to traumatic or overwhelming experiences. 

While there are three main dissociative disorders, the focus of this episode of Playing with Marbles is on dissociative identity disorder, or DID for short. DID is characterized by a person having two or more distinct identities as well as difficulties with remembering personal information, learned knowledge, or important parts of their childhood. Importantly, there is neurobiological evidence supporting DID as an extreme form of post-traumatic stress disorder caused by exposure to severe and chronic trauma in childhood. One study investigating the link between different symptoms of DID and the hippocampus, a part of the brain that is important for memory, learning and emotion, found that those with DID who experience the symptom of dissociative amnesia (that is, issues with recalling information about yourself or events and people around) have reduced hippocampal volumes. This study also demonstrated an association between emotional neglect in childhood and reduced hippocampal volumes, suggesting an interplay of these factors in the severity of dissociation.

In this episode, our guest Nicole walks us through their experience with DID and introduces us to their different “parts” that they’ve named “Kay” and “Stripe”. You will hear about Kay, who acts child-like and plays with their cat, and Stripe, who, when they take over, causes Nicole to behave alarmingly and have lapses in memory. Shari Botwin, LCSW and Trauma Therapist, explains that, in many DID cases, these different parts can take on different personalities that embody the roles of a perpetrator, enabler or protector, they can have different genders, and even come from different age groups. Despite this, the switching from one part to another can still be subtle which can make DID hard to detect at times. Both Shari and Nicole present us with an uplifting perspective on DID that dissociating into different parts is the brain’s creative and protective way to survive in a situation that one might not have made it through was it not for this splitting into different parts. 

Shari Botwin's new book, Stolen Childhoods: Thriving After Abuse comes out May 7.

Fast Facts

• Dissociative identity disorder affects up to 1.5% of the global population and is often diagnosed later in life.
• Dissociative identity disorder is typically associated with severe childhood trauma and abuse. Because of the way it presents, people with DID are often misdiagnosed with other disorders, like borderline personality disorder.
• Psychotherapy is the most prominent treatment for dissociative disorders. Antidepressants or anti-anxiety medication may help treat some of the mental health-related symptoms associated with DID, but there is no medication that specifically treats this disorder.

Support

If you’re struggling with your mental health, you’re not alone.

If you are in immediate danger of harming yourself or others, call 9-1-1, or head to your nearest emergency room. You can also call or text 9-8-8 to reach the Suicide Crisis Helpline. Support is available 24 hours a day, 7 days a week.

Young people can chat anytime with Kids Help Phone by calling 1-800-668-6868. Services are available in English and French.

Wellness Together Canada provides one-on-one counselling, self-guided courses and programs, and peer support and coaching. Youth can contact this service by calling 1-888-668-6810 or texting WELLNESS to 686868. Adults can contact this service by calling 1-866-585-0445 or texting WELLNESS to 741741. You can also find credible articles and information on their website. 

The Canadian Mental Health Association can help you find resources, programs, or support for yourself or others. Find a CMHA branch in your area here. 

The Centre for Addiction and Mental Health provides Mental Health 101 tutorials and online courses on their website. 

Multiplied By One provides a vast list of support, resources, and information for those who struggle with dissociative identity disorder, or those who are interested in learning more about the condition. 

This episode’s guest, Sophie, mentions different ways her symptoms of borderline personality disorder (or BPD) influence her relationships and ability to trust. We hear that having BPD has instilled in her a tendency towards hyper-attunement to others. This means that Sophie connects to and takes on the emotions of others, in such a way that impacts her behavior and relationships – sometimes in good ways, and sometimes in not-so-good ways. Sophie shares with us that she often identifies and latches on to a “favorite person”, which can sometimes introduce problematic coping mechanisms when things go awry. We also learn about Sophie’s difficult struggles with trust and distrust towards other people and situations. 

Often common in those afflicted with BPD, researchers have been prompted to explore the link between impairments in trust processes and the disorder. One study suggests that developmental factors, like experiences of emotional neglect or a lack of trust in parents during childhood, may influence certain behaviors in interpersonal exchanges and ultimately be a risk factor for trust issues in adults with BPD. With the involvement of trust processes being so salient in those with BPD, special attention needs to be attributed to ensuring a safe and trustworthy therapeutic alliance can be established between the therapist and person that is seeking treatment for BPD. Folks with BPD have expressed that therapy simply doesn’t work for them when they are made to feel unsafe. Because of this, care providers are encouraged to consider difficulties with trust in individual treatment plans and emphasize interpersonal trust between themselves and the person seeking treatment for BPD with the goal of developing a favorable therapeutic alliance. 

Fast Facts

• Common traits of BPD include having extreme fears of being rejected or abandoned, feeling easily rejected by others, an excessive need for reassurance from others, and more. Studies suggest that 1 to 3% of youth under 18 may have traits of borderline personality disorder.
• BPD is usually diagnosed in teens and young adults, though it may also be diagnosed later in life.
• Most youth who receive appropriate supports and services will benefit and show improvement. Youth who don’t get treatment are at higher risk for aggression, criminal behaviour, ongoing mental health problems, suicide, homelessness and problems in their relationships.

Learn More about This Episode’s Cool Researchers

As mentioned in the episode, borderline personality disorder is a much-stigmatized condition. For example, one study found that the word “difficult” can routinely be used by clinicians to label a person with BPD. Breaking through these labels and stigmas, while recognizing the need to establish safety and trust through the therapeutic alliance, many clinicians are providing compassionate care towards those with a BPD diagnosis; one such person is this episode’s expert guest, Dr. Brandon Unruh.

Dr. Unruh is disrupting the status-quo of care for BPD by examining and targeting how the next generation of clinicians are being taught about the disorder. In terms of treatment, Dr. Unruh and his colleagues focus on specialized evidence-based treatments for BPD, like dialectical behavioural therapy (DBT), mentalization-based treatment (MBT),  and transference-focused psychotherapy (TFP). Dr. Unruh is particularly interested in MBT which is based on the theory of failed mentalization for BPD and refers to impairments with identifying mental states, like attitudes or feelings, in oneself or in others along with difficulties in recognizing how these mental states are influenced by each other. To improve the process of mentalization, MBT emphasizes mental states and interpersonal interactions by encouraging individuals with BPD to focus on how their own mental states affect their own behavior, and the behavior of others. Much of Dr. Unruh’s research on BPD treatment focuses on this method, including an interesting case study on the use of MBT in treating a physician struggling with BPD.

Support

If you’re struggling with your mental health, you’re not alone.

If you are in immediate danger of harming yourself or others, call 9-1-1, or head to your nearest emergency room. You can also call or text 9-8-8 to reach the Suicide Crisis Helpline. Support is available 24 hours a day, 7 days a week.

Young people can chat anytime with Kids Help Phone by calling 1-800-668-6868. Services are available in English and French.

Wellness Together Canada provides one-on-one counselling, self-guided courses and programs, and peer support and coaching. Youth can contact this service by calling 1-888-668-6810 or texting WELLNESS to 686868. Adults can contact this service by calling 1-866-585-0445 or texting WELLNESS to 741741. You can also find credible articles and information on their website. 

The Canadian Mental Health Association can help you find resources, programs, or support for yourself or others. Find a CMHA branch in your area here. 

The Centre for Addiction and Mental Health provides Mental Health 101 tutorials and online courses on their website. 

Though not nation-wide, the Borderline Personality Disorder Society of British Columbia provides support and resources to those struggling with BPD.

With changing trends in diagnosis for ADHD comes a change in our understanding of how the condition affects those that have it. This episode’s guest, McKenna, discusses how having ADHD impacts her memory, explaining that she exerts quite a bit of effort to work around her forgetfulness. McKenna isn’t exaggerating when she says ADHD makes her forgetful: one study has shown that ADHD is associated with impairments in working memory, an executive function that plays a big role in how we process, use and remember information on a daily basis. This same study suggested that abilities in working memory may be related to the severity of ADHD inattentive and hyperactive/impulsive symptoms. What’s more, these impairments in memory, as well as the symptoms of hyperactivity/ impulsivity but not inattentiveness, can have direct effects on emotional regulation and dysregulation in children with ADHD.

Many options exist for treatment and maintenance of ADHD symptoms. The use of stimulant medication can improve symptoms of attention, impulsivity and hyperactivity. Stimulants have been shown to help improve symptoms in 70% of children with ADHD. Other forms of non-prescription interventions, like education and skills training, classroom management strategies, and more can be used to support children manage their symptoms. There are even less conventional forms of treatment, like neurofeedback therapy, that are being investigated! 

Fast Facts

• Globally, ADHD occurs among 3.1% of 10- to 14-year-olds and 2.4% of 15- to 19-year-olds.
• While there is no consensus on the exact cause of ADHD, there is likely a genetic link. Children born into families where there is a history of the disorder are more likely to be diagnosed with ADHD than children where there is no family history of ADHD. 
• Eighty percent of children diagnosed with ADHD continue to qualify for a diagnosis in adolescence and at least 65% continue to be effected by symptoms in adulthood.

Learn More about This Episode’s Cool Researchers

As more is uncovered about the links between ADHD, memory and emotional regulation, there is a need to have emotional dysregulation recognized as a core, diagnostic feature of ADHD alongside impulsivity, inattention, and hyperactivity. This potential fourth core symptom might be the key to why folks with ADHD tend to make use of non-adaptive emotional regulation strategies like blaming themselves, catastrophizing, and ruminating. It also presents a new and exciting avenue for treating symptoms of ADHD, including emotional dysregulation, by implementing strategies used to regulate emotions with the goal of improving one’s emotional response. At the forefront of the inquiry into better understanding the difficulties with emotion dysregulation among young adults and adults with ADHD is this episode’s expert guest, Elizabeth Bodalski – a doctoral student at the University of South Carolina. 

Among other areas of research, Elizabeth is interested in how ADHD-related emotional dysregulation may affect someone’s educational experience in college. In one study, Elizabeth and her colleagues made a case for how difficulties in emotional regulation and self-esteem partially account for the relationship between ADHD symptoms and procrastination in college students. With the links between ADHD and procrastination demystified, Elizabeth moved to research effective interventions for college students with ADHD. The time- and cost-friendly intervention suggested by Elizabeth and colleagues includes a combination of group and individual therapy that focuses on building skills directly related to the symptoms characteristic of ADHD balanced with the demands of college. The skills that are honed in on through this intervention are: organizational, time management and planning, or OTMP for short. 

Support

If you’re struggling with your mental health, you’re not alone.

If you are in immediate danger of harming yourself or others, call 9-1-1, or head to your nearest emergency room. You can also call or text 9-8-8 to reach the Suicide Crisis Helpline. Support is available 24 hours a day, 7 days a week.

Young people can chat anytime with Kids Help Phone by calling 1-800-668-6868. Services are available in English and French.

Wellness Together Canada provides one-on-one counselling, self-guided courses and programs, and peer support and coaching. Youth can contact this service by calling 1-888-668-6810 or texting WELLNESS to 686868. Adults can contact this service by calling 1-866-585-0445 or texting WELLNESS to 741741. You can also find credible articles and information on their website. 

The Canadian Mental Health Association can help you find resources, programs, or support for yourself or others. Find a CMHA branch in your area here. 

The Centre for Addiction and Mental Health provides Mental Health 101 tutorials and online courses on their website. 

The Centre for ADHD Awareness, Canada provides resources and support to those living with ADHD. 

This episode’s guest, Jess, has been diagnosed with Generalized Anxiety Disorder, or GAD. It’s the most broad and one of the most common anxiety disorders types. In this episode, Jess shares with us that she didn’t recognize her anxious episodes as symptoms of an anxiety disorder – an occurrence that is all too common. Though detection and diagnosis through self-reported measures has ameliorated over the years, anxiety disorders, like panic disorder, GAD, and social anxiety disorder, are one of a handful of disorders that often go undetected, underreported, and undiagnosed. 

Jess discusses her struggles with anxiety, alongside her past struggles with an eating disorder. She isn’t alone in her struggles with these two disorders, in fact, anxiety has been shown to be the most common psychiatric comorbidity amongst people who have eating disorders. 

Fast Facts

• Anxiety is the most common mental health problem in young people. It is estimated that, on a global scale, 3.6% of 10- to 14-year-olds and 4.6% of 15- to 19-year-olds experience an anxiety disorder.
• In addition to life-interfering fears and worries, symptoms of anxiety in children can include irritability, anger, trouble sleeping, and physical symptoms like fatigue, headaches, or stomachaches.
• According to the Canadian Paediatric Society, the optimal way to manage anxiety in children and youth is through a combination of psychoeducation, psychotherapy, and/ or pharmacotherapy.

Learn More about This Episode’s Cool Research

Eating disorders are commonly associated with other psychiatric illnesses, like anxiety (as mentioned above) and depression. One such illness is Body Dysmorphic Disorder, or BDD, a condition where a person perceives a distorted version of their own body and becomes preoccupied with it. BDD as a common comorbidity of the eating disorder anorexia nervosa, or simply “anorexia”, has been investigated since at least the early 2000s. Thanks to the research of Dr. Jamie Feusner, who we talked to for this episode, we are gaining a better understanding of the potential mechanisms that contribute to anorexia and BDD, and how they may be linked.

In a first-of-its-kind neuroimaging study, using a technology that measures brain waves called electroencephalography (EEG), Dr. Feusner found that individuals with anorexia may have abnormalities in the way they process and perceive certain types of visual information. For example, holistic, or configural, processing (e.g., seeing the face as a whole) was found to be deficient in people with anorexia while the perception of part-based, or detailed, processing (e.g., seeing the features… two eyes, a nose and a mouth… of a face) was enhanced. Taken together, these results could help explain why people with anorexia tend to fixate on particular body parts while placing less emphasis on the whole body. In people with BDD, results showed that these individuals may be experiencing abnormalities in the way they structurally encode visual information, which could contribute to the perceptual distortions that are a hallmark symptom of the disease. This research from Dr. Feusner provides an exciting avenue for the use of EEG as a biomarker of abnormal visual processing.  

Support

If you’re struggling with your mental health, you’re not alone.

If you are in immediate danger of harming yourself or others, call 9-1-1, or head to your nearest emergency room. You can also call or text 9-8-8 to reach the Suicide Crisis Helpline. Support is available 24 hours a day, 7 days a week.

Young people can chat anytime with Kids Help Phone by calling 1-800-668-6868. Services are available in English and French.

Wellness Together Canada provides one-on-one counselling, self-guided courses and programs, and peer support and coaching. Youth can contact this service by calling 1-888-668-6810 or texting WELLNESS to 686868. Adults can contact this service by calling 1-866-585-0445 or texting WELLNESS to 741741. You can also find credible articles and information on their website. 

The Canadian Mental Health Association can help you find resources, programs, or support for yourself or others. Find a CMHA branch in your area here. 

The Centre for Addiction and Mental Health provides Mental Health 101 tutorials and online courses on their website. 

The Canadian Network for Mood and Anxiety Treatment has a list of resources for those dealing with mood disorders, such as depression and bipolar disorder, and anxiety disorders. 

Anxiety Canada has resources available on their website, along with resources specifically for youth. 

The National Eating Disorders Information Centre provides resources and support to those in Canada affected by an eating disorder.

This season, we’re going a step further to understand all parts of the brain, and this one’s a little more difficult to see with a microscope. Now that we know the brain’s inner workings, we want to understand how those inner workings might affect how someone thinks, feels, and behaves. In simpler terms, we’re going to explore the intricacies of mental health, and mental illness.

Just as we focused on women’s brain health last season, we want to make sure we’re zeroing in on those who have been forgotten or who need the most support. As heard in this episode, mental illness is the leading cause of disability for people in Canada between the ages of 15 and 29 - that’s why we’re centering this season on youth mental health! There’s tons of information out there for young people about mental health, but much of it falls into the category of pop science at best, and misinformation at worst. To combat the junk science out there, we’re talking to real scientists about what goes on in the brain when someone is experiencing mental illness.

To make sure we’re getting all sides of this complicated topic, we’re doing something we’ve never done before on Playing With Marbles. This season, we talk to real young people who struggle with their mental health. Our guests range in age, gender, and diagnosis. You’ll get to hear what it’s like living with obsessive-compulsive disorder, the day-to-day struggles of ADHD, and what it’s like to seek treatment for an eating disorder. We hope pairing the real, lived experiences with the science behind these disorders will provide a nuanced look at the long-maligned topic of mental health and mental illness.

This episode serves as a primer for all to come on this season of Playing With Marbles. Hop on in and listen to what’s in store.

Fast Facts

• Globally, one in seven 10- to 19-year-olds experiences a mental health disorder.
• By the time people in Canada reach 40 years of age, 1 in 2 have, or will have had, mental illness. Importantly, young people aged 15 to 24 are more likely to experience mental illness than any other age group.
• Up to 70 percent of mental health challenges begin during childhood or teenage years.
• The COVID-19 pandemic greatly affected the mental health of young people in Canada. Only 42 percent of youth in Canada aged 15 to 24 years old reported having excellent or very good mental health in late March and early April of 2020, compared to 62 percent in 2018—the largest drop of any age group.
• Less than 20 percent of youth struggling with their mental health receive appropriate treatment.

Learn More about This Episode’s Cool Research

The focus of this season of Playing With Marbles is all about youth mental health. As heard in this episode, one in every four young people are in need of mental health services every year. That’s why Brain Canada has partnered with RBC Future Launch and Power Corporation to support the Canadian Youth Mental Health Insight Platform, led by Dr. Sean Hill from the Centre for Addition and Mental Health (CAMH). The platform seeks to provide a state-of-the-art informatics platform that can serve as a foundation to optimize mental health for youth across Canada. It will support knowledge and data integration, open data, machine learning and improved communication between key networks, research databases and stakeholders in the youth mental health community. Read more about the platform through Brain Canada’s website here. 

Support

If you’re struggling with your mental health, you’re not alone.

If you are in immediate danger of harming yourself or others, call 9-1-1, or head to your nearest emergency room. You can also call or text 9-8-8 to reach the Suicide Crisis Helpline. Support is available 24 hours a day, 7 days a week.

Young people can chat anytime with Kids Help Phone by calling 1-800-668-6868. Services are available in English and French.

Wellness Together Canada provides one-on-one counselling, self-guided courses and programs, and peer support and coaching. Youth can contact this service by calling 1-888-668-6810 or texting WELLNESS to 686868. Adults can contact this service by calling 1-866-585-0445 or texting WELLNESS to 741741. You can also find credible articles and information on their website. 

The Canadian Mental Health Association can help you find resources, programs, or support for yourself or others. Find a CMHA branch in your area here. 

The Centre for Addiction and Mental Health provides Mental Health 101 tutorials and online courses on their website. 

This episode’s guest, Tammy, shares with us that she began experiencing symptoms of MDD when she was in grade school. While depressive disorders tend to begin later in life and global data suggests that the median age for the onset of symptoms is 26 years old, a study from the United States showed that depression can be diagnosed as young as three years of age. Interestingly, a study from Korea showed that the age at which a person experiences their first major depressive episode may be correlated to a variety of different clinical indicators, like the frequency in which MDD episodes recur, that play a key role in one’s clinical prognosis of MDD and its outcomes. 

In this episode, we learn about a few of Tammy’s family members, one of whom also struggles with their mental health. Given the hereditary, or genetic, predisposition to mental disorders, it is common for some mental illnesses, like bipolar disorder, schizophrenia and depression, to run in the family. But when discussing the “nature” side of things, we mustn’t forget about the “nurture”. We’ve also seen that the environmental factors like one’s family structure, exposure to traumatic events, and much more can increase rates of mental health problems. 

Fast Facts

• Globally, depression is estimated to occur among 1.1% of adolescents aged 10 to14 years, and 2.8% of 15- to 19-year-olds. 
• More than a quarter of a million Canadian youth, representing 6.5% of people between the ages of 15 and 24, experience major depression each year.
• Depression can go unnoticed in children. Some may not talk about their helpless and hopeless thoughts and may not appear sad. Depression might also cause a child to make trouble or act unmotivated causing others to incorrectly label the child as a troublemaker or lazy.
• In Canada, once depression is recognized, intervention and treatment can make a difference for 80% of people who are affected, which allows them to get back to their regular activities.

Learn More about This Episode’s Cool Research

In this episode, we spoke to Dr. Valerie Taylor, Head of Psychiatry at the University of Calgary, and the namesake for the Taylor Lab. Their main area of research is how the gut influences brain health, known in the literature as the gut-brain barrier. Scientists have already shown a potential for the influence of gut microbiota in diseases like asthma and type I and type II diabetes, to name a few. When it comes to the bidirectional relationship between the brain, gut and microbiome there is a growing amount of evidence that this is a valuable area of research that may have implications on new therapeutic avenues. For example, studies aiming to elucidate the relationship between depression and the microbiome have shown a link between MDD and an imbalance of the gut microbiota’s bacterial composition. Some of these studies even reported seeing modest improvements in depressive symptoms following interventions targeting the gut microbiome. 

Dr. Taylor and her team are interested in whether or not microbiomes from the gut of healthy people can be used as a treatment for those suffering with ailments, and in their case specifically, people struggling with treatment-resistant MDD. In order to get those healthy microbiomes transferred, the Taylor Lab is experimenting with Fecal Matter Transplant, or FMT for short. For their research, the process involves retrieving fecal samples from healthy screened donors, converting those samples into capsules (also known as “poop pills”),and orally administering the capsules to patients. There is a fair amount of evidence to back up the efficacy of FMT in treating disease, in fact, the practice has been reported in literature dating 2,000 years ago. The efficacy of FMT for patients with treatment-resistant MDD, however, continues to be a question the Taylor Lab is working hard to answer. 

Through this work, Dr. Taylor remains hopeful. In an interview with Mike Fisher for the University of Calgary, Dr. Taylor discusses her team’s research. 

“...[T]he jury is still out on whether we can actually leverage what seems to be a gut-brain connection into the next generation of therapies. There is reason to be excited and to pursue this work and that's what fuels us — the possibility. [...] There has been research that shows if you take bacteria from depressed mice and put it into non-depressed mice, they become depressed. Microbiota are not benign, and we want to ensure people are aware of that. [...] Patients are desperate for new treatments, sometimes the current treatments don’t work for everyone or have side effects that are not tolerable. So, people are looking for anything that will help them.”

Support

If you’re struggling with your mental health, you’re not alone.

If you are in immediate danger of harming yourself or others, call 9-1-1, or head to your nearest emergency room. You can also call or text 9-8-8 to reach the Suicide Crisis Helpline. Support is available 24 hours a day, 7 days a week.

Young people can chat anytime with Kids Help Phone by calling 1-800-668-6868. Services are available in English and French.

Wellness Together Canada provides one-on-one counselling, self-guided courses and programs, and peer support and coaching. Youth can contact this service by calling 1-888-668-6810 or texting WELLNESS to 686868. Adults can contact this service by calling 1-866-585-0445 or texting WELLNESS to 741741. You can also find credible articles and information on their website. 

The Canadian Mental Health Association can help you find resources, programs, or support for yourself or others. Find a CMHA branch in your area here. 

The Centre for Addiction and Mental Health provides Mental Health 101 tutorials and online courses on their website. 

The Canadian Network for Mood and Anxiety Treatment has a list of resources for those dealing with mood disorders, such as depression and bipolar disorder, and anxiety disorders. 

Depression Hurts is a website developed by the Mood Disorders Society of Canada that includes a symptom checklist and doctor discussion guide for patients.

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Follow the show:

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Follow the show:

• Twitter: @marblespod
• Instagram:  @marblespod

Follow the show:

• Twitter: @marblespod
• Instagram:  @marblespod

Follow the show:

• Twitter: @marblespod
• Instagram:  @marblespod

Follow the show:

• Twitter: @marblespod
• Instagram:  @marblespod