1 00:00:04,440 --> 00:00:09,280 Speaker 1: Hello everybody, and welcome back to the Psychology of Your Twenties, 2 00:00:09,920 --> 00:00:12,280 Speaker 1: the podcast where we talk through some of the big 3 00:00:12,520 --> 00:00:16,880 Speaker 1: life changes and transitions of our twenties and what they 4 00:00:16,960 --> 00:00:26,799 Speaker 1: mean for our psychology. Hello everybody, Welcome back to the show. 5 00:00:27,240 --> 00:00:31,480 Speaker 1: Welcome back to the podcast. New listeners, old listeners. Wherever 6 00:00:31,480 --> 00:00:34,080 Speaker 1: you are in the world, whatever date is, I hope 7 00:00:34,120 --> 00:00:36,560 Speaker 1: you're having a great day. Welcome back for another episode. 8 00:00:37,400 --> 00:00:40,640 Speaker 1: So you've read the title, I don't think it's any 9 00:00:40,680 --> 00:00:44,360 Speaker 1: surprise that today I'm going to talk about my experience 10 00:00:44,760 --> 00:00:49,279 Speaker 1: with depression in my twenties. I have depression. I've had 11 00:00:49,360 --> 00:00:51,880 Speaker 1: it for many years, and I really think it's time 12 00:00:52,560 --> 00:00:54,640 Speaker 1: that we talk about it. It's taken me quite a 13 00:00:54,680 --> 00:00:57,760 Speaker 1: while to really, I would say, process what I wanted 14 00:00:57,760 --> 00:00:59,840 Speaker 1: to say in this episode. I think out of fear 15 00:01:00,200 --> 00:01:04,440 Speaker 1: maybe you know, my words could be misconstrued, my experience 16 00:01:04,520 --> 00:01:08,160 Speaker 1: could be miscontrued, but also because of you know, a 17 00:01:08,240 --> 00:01:11,480 Speaker 1: level of shame. You know, it's really it's a lot 18 00:01:11,520 --> 00:01:14,759 Speaker 1: to really engage with that. There are millions of people 19 00:01:15,040 --> 00:01:18,880 Speaker 1: listening to what can be very deeply intimate and vulnerable 20 00:01:18,920 --> 00:01:21,760 Speaker 1: parts of my life, and sometimes there are things that 21 00:01:22,440 --> 00:01:25,200 Speaker 1: I don't really feel prepared to share because I think 22 00:01:25,240 --> 00:01:27,360 Speaker 1: that what you make public is kind of what you 23 00:01:27,440 --> 00:01:30,720 Speaker 1: allow people to comment on and what you allow people 24 00:01:30,720 --> 00:01:33,119 Speaker 1: to have an opinion on. But I also don't think 25 00:01:33,120 --> 00:01:35,600 Speaker 1: it's a secret. You know. I did an episode a 26 00:01:35,640 --> 00:01:38,240 Speaker 1: while back titled why am I So Unhappy? I feel 27 00:01:38,240 --> 00:01:41,320 Speaker 1: like that's a big clue. And I've also talked about, 28 00:01:41,400 --> 00:01:44,119 Speaker 1: you know, my experience with antidepressants back in the earlier 29 00:01:44,200 --> 00:01:48,400 Speaker 1: days of the show. But for a mental health podcast, 30 00:01:49,160 --> 00:01:51,640 Speaker 1: it felt like it was time to do somewhat of 31 00:01:51,680 --> 00:01:56,080 Speaker 1: a comprehensive episode on this, So today, let's talk about it. 32 00:01:56,160 --> 00:02:01,280 Speaker 1: Let's talk about depression in our twenties. This episode is 33 00:02:01,320 --> 00:02:05,080 Speaker 1: going to be, I think equal parts more scientific and 34 00:02:05,120 --> 00:02:08,880 Speaker 1: more personal than most of my episodes, because I think 35 00:02:08,919 --> 00:02:12,760 Speaker 1: when we're approaching things like mental health, you can't be 36 00:02:12,800 --> 00:02:16,160 Speaker 1: coming at it with your own theories, and there's also 37 00:02:16,280 --> 00:02:21,280 Speaker 1: no absence of really incredible research into improving the lives 38 00:02:21,280 --> 00:02:24,200 Speaker 1: of people who have this condition. It's also a sad 39 00:02:24,240 --> 00:02:27,280 Speaker 1: reality that stigma is very much alive and well. I 40 00:02:27,280 --> 00:02:30,280 Speaker 1: think as society we are getting a lot better at 41 00:02:30,320 --> 00:02:34,240 Speaker 1: accepting certain truths about depression, but a big part of 42 00:02:34,440 --> 00:02:40,480 Speaker 1: why stigma persists is because of a lack of accurate knowledge. 43 00:02:40,639 --> 00:02:44,800 Speaker 1: So kind of consider this your introductory guide, your immersion 44 00:02:44,919 --> 00:02:49,800 Speaker 1: into the psychology, but also the personal experiences of someone 45 00:02:49,840 --> 00:02:53,680 Speaker 1: who is going for this. We're going to discuss why 46 00:02:53,760 --> 00:02:57,280 Speaker 1: depression is more than just a blanket term, and how 47 00:02:57,320 --> 00:03:00,639 Speaker 1: it looks different for everyone, including people who may be 48 00:03:00,880 --> 00:03:04,720 Speaker 1: very high functioning and visibly seem very well and very okay. 49 00:03:05,360 --> 00:03:08,120 Speaker 1: It's a huge misconception that you need to look and 50 00:03:08,160 --> 00:03:11,600 Speaker 1: behave a certain way to be depressed. That's a myth 51 00:03:11,639 --> 00:03:14,760 Speaker 1: that we are definitely aiming to bust today. We're also 52 00:03:14,840 --> 00:03:18,359 Speaker 1: going to examine the different types of depression, the origins 53 00:03:18,360 --> 00:03:22,280 Speaker 1: of depression, including some of the early historical recognition of 54 00:03:22,320 --> 00:03:25,600 Speaker 1: this condition, and some of the secrets and surprises that 55 00:03:25,639 --> 00:03:29,040 Speaker 1: our biology and our DNA holds, as well as the 56 00:03:29,120 --> 00:03:32,680 Speaker 1: role of things like adrenaline, like family environment, and even 57 00:03:32,800 --> 00:03:37,240 Speaker 1: positive experiences like graduating. You know, our minds are very 58 00:03:38,000 --> 00:03:40,880 Speaker 1: very cryptic, a bit of a black box at times, 59 00:03:41,520 --> 00:03:44,840 Speaker 1: and I think depression is a lot more than being 60 00:03:44,960 --> 00:03:49,040 Speaker 1: sad or based on what we perceive as negative events 61 00:03:49,080 --> 00:03:53,960 Speaker 1: in our lives. There's also been some really fascinating research 62 00:03:54,040 --> 00:03:56,360 Speaker 1: coming out in this space that I think deserves a 63 00:03:56,480 --> 00:04:00,760 Speaker 1: very special place in this episode, particularly around the use 64 00:04:00,800 --> 00:04:06,160 Speaker 1: of things like psychedelics and certain illicit substances to treat depression. 65 00:04:06,280 --> 00:04:10,600 Speaker 1: We're going to tread lightly because the research is still ongoing, 66 00:04:11,000 --> 00:04:13,440 Speaker 1: but I think we're at this kind of new frontier 67 00:04:13,720 --> 00:04:17,360 Speaker 1: of how we approach a lot of different mental health disorders, 68 00:04:17,400 --> 00:04:22,000 Speaker 1: including depression. So although we're going to talk about typical treatments, 69 00:04:22,040 --> 00:04:25,800 Speaker 1: I really want to speak about my own experience on antidepressants, 70 00:04:26,640 --> 00:04:29,960 Speaker 1: kind of some of the myths behind why exercise is 71 00:04:30,000 --> 00:04:32,400 Speaker 1: not the secret cure we all imagine it to be. 72 00:04:33,040 --> 00:04:36,880 Speaker 1: We're also going to leave some room for new findings 73 00:04:37,000 --> 00:04:40,080 Speaker 1: and knowledge and hopefully come out of this knowing I 74 00:04:40,080 --> 00:04:43,360 Speaker 1: would say more than about ninety five the set of 75 00:04:43,400 --> 00:04:47,480 Speaker 1: the population does know about depression. There's so much information 76 00:04:47,560 --> 00:04:49,520 Speaker 1: that I want to cover. Maybe we can do a 77 00:04:49,560 --> 00:04:52,440 Speaker 1: part two, but if you're looking for an overview and 78 00:04:52,480 --> 00:04:55,360 Speaker 1: also some of the more fascinating elements that we don't 79 00:04:55,400 --> 00:04:59,200 Speaker 1: see discussed very often, hopefully this is the space where 80 00:04:59,200 --> 00:05:02,520 Speaker 1: you can learn. I want to quickly put out a 81 00:05:02,560 --> 00:05:08,839 Speaker 1: brief disclaimer. This episode is for entertainment purposes only. Maybe 82 00:05:08,880 --> 00:05:14,320 Speaker 1: not entertainment episodes informational purposes, but please do not use 83 00:05:14,360 --> 00:05:18,560 Speaker 1: this episode for diagnostic or therapeutic advice. If you find 84 00:05:18,600 --> 00:05:23,480 Speaker 1: yourself relating to this discussion or this does make you distressed, 85 00:05:23,640 --> 00:05:28,039 Speaker 1: please please reach out to someone for professional support. I 86 00:05:28,160 --> 00:05:30,320 Speaker 1: unfortunately do not know each and every one of you, 87 00:05:30,360 --> 00:05:33,719 Speaker 1: and I don't know your story or your needs, and 88 00:05:33,800 --> 00:05:36,360 Speaker 1: as we'll come to see, we all have different experiences. 89 00:05:36,400 --> 00:05:40,600 Speaker 1: But there will be links in the description for further information. 90 00:05:41,160 --> 00:05:44,320 Speaker 1: And if you're someone who's maybe listening to this to 91 00:05:44,440 --> 00:05:47,679 Speaker 1: better understand the experiences of a partner or a friend, 92 00:05:47,760 --> 00:05:52,000 Speaker 1: a sibling, parent, really anyone, Firstly, thank you for joining us. 93 00:05:52,000 --> 00:05:54,000 Speaker 1: I think it's really beautiful that you're here to learn, 94 00:05:54,560 --> 00:05:57,479 Speaker 1: and there will also be resources on how to support 95 00:05:57,520 --> 00:06:01,640 Speaker 1: people with depression as well. Like I said before, there's 96 00:06:01,680 --> 00:06:04,160 Speaker 1: a lot to cover in this episode. I'm going to 97 00:06:04,200 --> 00:06:07,320 Speaker 1: stop rambling and we're going to dive into all this 98 00:06:07,480 --> 00:06:10,680 Speaker 1: science and the psychology and a bit of my personal 99 00:06:10,760 --> 00:06:20,200 Speaker 1: experience as well. So let's get into it, alrighty. So, 100 00:06:20,520 --> 00:06:23,479 Speaker 1: I don't think I can do an episode like this 101 00:06:23,760 --> 00:06:26,880 Speaker 1: without explaining why I think it's so important we have 102 00:06:26,960 --> 00:06:31,200 Speaker 1: more discussions around depression and mental health in general, particularly 103 00:06:31,240 --> 00:06:33,440 Speaker 1: in our twenties, and as a part of that, I 104 00:06:33,480 --> 00:06:36,719 Speaker 1: want to talk really frankly and openly with you about 105 00:06:36,720 --> 00:06:41,160 Speaker 1: my own experience. So I've had I guess, clinical depression 106 00:06:41,279 --> 00:06:45,920 Speaker 1: for like five years. It comes and goes, and I 107 00:06:46,000 --> 00:06:48,599 Speaker 1: think sometimes I feel like I've spent more years of 108 00:06:48,640 --> 00:06:51,200 Speaker 1: my twenties kind of dealing with it than I have 109 00:06:51,320 --> 00:06:54,960 Speaker 1: really enjoying this time, and that you know, the best 110 00:06:55,000 --> 00:06:58,040 Speaker 1: years of my life have somehow been been claimed by 111 00:06:58,080 --> 00:07:00,440 Speaker 1: this state of mind and by this condition. And you know, 112 00:07:00,520 --> 00:07:04,480 Speaker 1: last year in particular was really hard. It was the 113 00:07:04,480 --> 00:07:07,920 Speaker 1: best year of my life. Everything I'd ever wanted kind 114 00:07:07,960 --> 00:07:10,760 Speaker 1: of came true. Everything was going right. It was these 115 00:07:10,840 --> 00:07:15,880 Speaker 1: constant milestones and celebrations. And I think despite all of that, 116 00:07:16,560 --> 00:07:21,440 Speaker 1: all of that perceived external success, I felt really deeply, 117 00:07:21,800 --> 00:07:24,400 Speaker 1: deeply unhappy. I would look at my life and I 118 00:07:24,440 --> 00:07:26,640 Speaker 1: knew I should be excited, I knew I should feel 119 00:07:26,760 --> 00:07:29,720 Speaker 1: up on cloud nine, and I just couldn't be there. 120 00:07:29,760 --> 00:07:32,240 Speaker 1: And it was so frustrating to me to not have, 121 00:07:32,640 --> 00:07:34,840 Speaker 1: you know, I guess, access to that joy, or to 122 00:07:34,880 --> 00:07:38,400 Speaker 1: the things about myself that I valued, like my creativity 123 00:07:38,440 --> 00:07:40,840 Speaker 1: and just my kind of zest for life and I 124 00:07:40,920 --> 00:07:45,360 Speaker 1: know that that experience, having talked to listeners of the show, 125 00:07:45,480 --> 00:07:49,040 Speaker 1: having talked to friends, is not a unique one. It's 126 00:07:49,080 --> 00:07:52,600 Speaker 1: not one that I'm alone in experiencing. That's why talking 127 00:07:52,680 --> 00:07:56,600 Speaker 1: about this is so important to me on a really 128 00:07:56,680 --> 00:07:59,360 Speaker 1: vulnerable note, because I know it's hard to talk about. 129 00:07:59,480 --> 00:08:01,920 Speaker 1: I know that this side of me might not be 130 00:08:02,000 --> 00:08:04,160 Speaker 1: what people want to see or hear about. I know 131 00:08:04,200 --> 00:08:07,720 Speaker 1: that our knee jerk reaction is to feel shame or 132 00:08:07,800 --> 00:08:12,240 Speaker 1: embarrassment towards open discussions around mental health. But I'm hoping 133 00:08:12,320 --> 00:08:15,120 Speaker 1: that seeing how this has played out for me and 134 00:08:15,200 --> 00:08:18,720 Speaker 1: continues to impact me, using some of my own experiences, 135 00:08:18,720 --> 00:08:22,960 Speaker 1: but also the academic and the psychological and the scientific knowledge, 136 00:08:23,480 --> 00:08:27,080 Speaker 1: can really minimize that shame for yourself and also actors 137 00:08:27,600 --> 00:08:30,280 Speaker 1: an example that this can be your experience and you 138 00:08:30,320 --> 00:08:34,000 Speaker 1: can still have a really fulfilling and fantastic life. There's 139 00:08:34,000 --> 00:08:36,440 Speaker 1: good days, there's bad days. I guess that's part of 140 00:08:36,440 --> 00:08:39,480 Speaker 1: the game I'm still kind of adjusting to. There's no 141 00:08:39,520 --> 00:08:43,040 Speaker 1: doubt that we are seeing rising rates of not just depression, 142 00:08:43,080 --> 00:08:48,160 Speaker 1: but general unhappiness and alienation in this generation. We know 143 00:08:48,360 --> 00:08:51,480 Speaker 1: that young people have a higher rate of diagnosis for 144 00:08:51,559 --> 00:08:55,079 Speaker 1: these conditions. There's even some estimates that put it at 145 00:08:55,200 --> 00:08:59,400 Speaker 1: like thirty to thirty five percent, way more than what 146 00:08:59,440 --> 00:09:02,360 Speaker 1: we saw in in previous decades. But also in older 147 00:09:02,400 --> 00:09:06,719 Speaker 1: age groups, and it's during the ages of around sixteen 148 00:09:06,880 --> 00:09:12,000 Speaker 1: to twenty nine, early thirties that typically our first major 149 00:09:12,040 --> 00:09:15,200 Speaker 1: depressive episode, if you go on to develop a major 150 00:09:15,240 --> 00:09:18,640 Speaker 1: depressive disorder, normally occurs, So we really want to start 151 00:09:18,640 --> 00:09:21,600 Speaker 1: talking about it earlier. The factors I think that we 152 00:09:21,640 --> 00:09:25,120 Speaker 1: can point to for this upward trend are really endless. 153 00:09:25,160 --> 00:09:28,920 Speaker 1: You know. On a positive note, reduced stigma in society 154 00:09:29,120 --> 00:09:33,080 Speaker 1: is leading people to receive a diagnosis, and you know, 155 00:09:33,240 --> 00:09:38,240 Speaker 1: previous generations may not have received that despite experiencing all 156 00:09:38,280 --> 00:09:42,440 Speaker 1: the same symptoms. And also generationally, I do think there 157 00:09:42,520 --> 00:09:45,480 Speaker 1: is this kind of increasing malaise with the state of 158 00:09:45,520 --> 00:09:49,280 Speaker 1: the world, Reduced protective factors like a sense of community, 159 00:09:49,320 --> 00:09:52,400 Speaker 1: which we know has really disappeared for a lot of 160 00:09:52,440 --> 00:09:58,000 Speaker 1: people in this generation, significant pressures to perform and be exceptional, 161 00:09:58,080 --> 00:10:03,120 Speaker 1: financial uncertainty, COVID, a sense of just like general doom 162 00:10:03,360 --> 00:10:06,280 Speaker 1: about the future, and those are only really I think 163 00:10:06,280 --> 00:10:10,560 Speaker 1: a handful of explanations that psychologists and researchers are pointing 164 00:10:10,600 --> 00:10:13,600 Speaker 1: to for a lot more people coming to them saying, 165 00:10:13,679 --> 00:10:16,360 Speaker 1: I'm having this experience, I think I might be depressed. 166 00:10:17,200 --> 00:10:22,000 Speaker 1: We're never going to eliminate conditions like depression, but I 167 00:10:22,040 --> 00:10:26,079 Speaker 1: think the existence of depression in society is not the concern. 168 00:10:26,200 --> 00:10:29,040 Speaker 1: It's the rate at which so many of us are 169 00:10:29,080 --> 00:10:34,640 Speaker 1: struggling without the necessary societal and community and medical supports. 170 00:10:34,720 --> 00:10:37,400 Speaker 1: You know, this condition has always had a place within 171 00:10:37,440 --> 00:10:40,760 Speaker 1: the human experience. This is not some new illness, it's 172 00:10:40,800 --> 00:10:44,959 Speaker 1: not some bad condition. It's very very real and very 173 00:10:45,200 --> 00:10:49,520 Speaker 1: very consequential. If we look back at history, although terms 174 00:10:49,640 --> 00:10:53,280 Speaker 1: like clinical depression or major depressive disorder, and now, how 175 00:10:53,320 --> 00:10:57,520 Speaker 1: we would label this experience. Back in even like ancient Greece, 176 00:10:57,600 --> 00:11:00,600 Speaker 1: ancient Rome, they had a name for this. They had 177 00:11:00,600 --> 00:11:02,880 Speaker 1: a different name for what we're talking about, and it 178 00:11:02,920 --> 00:11:09,079 Speaker 1: was melancholia, meaning a feeling of deep, profound sadness, a 179 00:11:09,200 --> 00:11:11,520 Speaker 1: sadness that kind of sits in your bones. And there 180 00:11:11,520 --> 00:11:17,199 Speaker 1: are so many historical documents and parts of history, paintings, sculptures, folklore, 181 00:11:17,280 --> 00:11:20,439 Speaker 1: even Bible versus that show us that not only did 182 00:11:20,440 --> 00:11:23,840 Speaker 1: this condition we now know as depression exist, but there 183 00:11:23,840 --> 00:11:27,200 Speaker 1: were also efforts to treat it, it was viewed as 184 00:11:27,320 --> 00:11:31,040 Speaker 1: a medical condition, and yet we still have such a 185 00:11:31,040 --> 00:11:34,680 Speaker 1: hard time acknowledging it in our society, despite it being 186 00:11:34,800 --> 00:11:39,480 Speaker 1: what some are calling a literal epidemic and very historically significant. 187 00:11:39,559 --> 00:11:42,760 Speaker 1: You know, you'd think that we'd have used those thousands 188 00:11:42,760 --> 00:11:46,280 Speaker 1: of years to actually get better at integrating this condition 189 00:11:46,360 --> 00:11:50,440 Speaker 1: into our understanding and our compassion for others. But still 190 00:11:50,480 --> 00:11:53,160 Speaker 1: I think we endure it in silence. When we do 191 00:11:53,280 --> 00:11:55,280 Speaker 1: have the courage to ask for help, maybe you don't 192 00:11:55,280 --> 00:11:59,000 Speaker 1: receive the support that you need, or at times we're 193 00:11:59,080 --> 00:12:01,360 Speaker 1: kind of convinced that we're totally fine, it's all in 194 00:12:01,400 --> 00:12:03,640 Speaker 1: our head just to get over it, to grin and 195 00:12:03,679 --> 00:12:07,400 Speaker 1: bear it. And that fallacy that avoidance in suppression can 196 00:12:07,440 --> 00:12:11,920 Speaker 1: somehow magically cure you is so false. It's you know, it's, 197 00:12:11,920 --> 00:12:15,640 Speaker 1: without a doubt, not true. Depression is so much more 198 00:12:15,679 --> 00:12:19,480 Speaker 1: than just sadness. It's a medical condition, perhaps one of 199 00:12:19,480 --> 00:12:22,400 Speaker 1: the most common that we see. And it's not shameful. 200 00:12:22,720 --> 00:12:26,680 Speaker 1: That shame is societal. That shame is learned, and it 201 00:12:26,720 --> 00:12:29,080 Speaker 1: can be unlearned. I know this metaphor has been used 202 00:12:29,080 --> 00:12:32,280 Speaker 1: to death, but your brain is an organ, is a 203 00:12:32,320 --> 00:12:35,760 Speaker 1: part of your body, like any other, and sometimes it's 204 00:12:35,760 --> 00:12:37,800 Speaker 1: going to have a few problems. The same way that 205 00:12:37,840 --> 00:12:41,240 Speaker 1: our bones break, the same way that we get scrapes 206 00:12:41,240 --> 00:12:44,000 Speaker 1: and bruises, and our arteries clog, and our hearts beat 207 00:12:44,000 --> 00:12:47,960 Speaker 1: a little bit too fast. Sometimes our brains find themselves 208 00:12:47,960 --> 00:12:51,240 Speaker 1: in a state of chemical imbalance, or they get bumped in, 209 00:12:51,480 --> 00:12:55,960 Speaker 1: you know, symbolically metaphorically bruised by the things we experience. 210 00:12:56,600 --> 00:12:59,200 Speaker 1: I think what I found in my own experience was 211 00:12:59,240 --> 00:13:04,600 Speaker 1: that from the outside I looked really, really fine. I 212 00:13:04,600 --> 00:13:07,880 Speaker 1: think I didn't feel fine, but I was still going 213 00:13:07,880 --> 00:13:11,040 Speaker 1: to work, I was still interacting with my friends. I 214 00:13:11,120 --> 00:13:15,400 Speaker 1: was still getting good grades at university. All the feelings 215 00:13:15,400 --> 00:13:19,520 Speaker 1: and symptoms that I was experiencing were very solitary, and 216 00:13:19,840 --> 00:13:23,079 Speaker 1: because of what I thought depression looked like, I didn't 217 00:13:23,080 --> 00:13:25,600 Speaker 1: really feel like I deserved to feel this way or 218 00:13:25,640 --> 00:13:29,760 Speaker 1: to accept the diagnosis that I had to me. The 219 00:13:29,760 --> 00:13:33,839 Speaker 1: depression I saw was really dramatized in the movies, in 220 00:13:33,880 --> 00:13:37,760 Speaker 1: books and TV shows. The cases I saw that were 221 00:13:37,800 --> 00:13:41,680 Speaker 1: acknowledged by society and those around me were very visible. 222 00:13:41,760 --> 00:13:44,640 Speaker 1: It was someone laying in bed for hours, which you 223 00:13:44,679 --> 00:13:47,040 Speaker 1: know I did do, but it was also someone who 224 00:13:47,040 --> 00:13:50,280 Speaker 1: missed work, or school, whose kind of hair was always 225 00:13:50,280 --> 00:13:53,240 Speaker 1: a mess, who walked around like a zombie. I saw 226 00:13:53,280 --> 00:13:57,720 Speaker 1: depression as tearful, as very outward, and as causing dysfunction, 227 00:13:57,840 --> 00:14:01,400 Speaker 1: And for many of us, that is the experience, and 228 00:14:01,440 --> 00:14:04,840 Speaker 1: it's one that's extremely difficult. But from the outside, in 229 00:14:04,880 --> 00:14:08,040 Speaker 1: my case, I was still functioning. I wasn't crying. If anything, 230 00:14:08,520 --> 00:14:11,560 Speaker 1: I couldn't cry because I really couldn't feel anything. But 231 00:14:11,679 --> 00:14:14,680 Speaker 1: I still did all the things that people expect you 232 00:14:15,400 --> 00:14:18,600 Speaker 1: to do, and that didn't really match my perception of 233 00:14:18,600 --> 00:14:21,400 Speaker 1: what I thought depression would look like. I think our 234 00:14:21,440 --> 00:14:24,440 Speaker 1: difficulty accepting the reality of this goes deeper than just 235 00:14:24,920 --> 00:14:27,880 Speaker 1: the stigma that we've spoken about, and it's this larger 236 00:14:27,960 --> 00:14:34,720 Speaker 1: idea of a misrepresentation that our society likes to, you know, 237 00:14:34,800 --> 00:14:38,680 Speaker 1: make things look dramatic, likes to make things look a 238 00:14:38,680 --> 00:14:40,920 Speaker 1: lot more in you know, not intense than they are, 239 00:14:40,960 --> 00:14:42,640 Speaker 1: but likes to make it a little bit of a 240 00:14:42,680 --> 00:14:45,720 Speaker 1: spectacle out of the things that we go through. And 241 00:14:46,040 --> 00:14:48,040 Speaker 1: like I said before, we see that in so many 242 00:14:48,160 --> 00:14:51,320 Speaker 1: types of media that we're consuming, this idea that your 243 00:14:51,360 --> 00:14:54,440 Speaker 1: life needs to be absolutely falling apart for you to 244 00:14:54,480 --> 00:14:59,160 Speaker 1: be depressed, and that's something that needs to be needs 245 00:14:59,160 --> 00:15:03,040 Speaker 1: to be corrected. There needs to be some kind of 246 00:15:03,240 --> 00:15:07,280 Speaker 1: understanding that you can still be depressed and everything in 247 00:15:07,320 --> 00:15:10,680 Speaker 1: your life can be going really, really well. So that's 248 00:15:10,720 --> 00:15:13,920 Speaker 1: the first misconception I really want to talk about. Depression 249 00:15:14,000 --> 00:15:17,359 Speaker 1: is not just one condition. It's not a blanket diagnosis, 250 00:15:18,000 --> 00:15:21,400 Speaker 1: and it is going to look very different from person 251 00:15:21,440 --> 00:15:23,920 Speaker 1: to person. To understand this, we kind of need to 252 00:15:23,960 --> 00:15:27,080 Speaker 1: look closer at the DSM. And this is what we 253 00:15:27,120 --> 00:15:31,960 Speaker 1: call the Diagnostic and Statistical Manual of Mental Disorders. Essentially, 254 00:15:32,080 --> 00:15:35,840 Speaker 1: it's like the Bible of pretty much every mental disorder 255 00:15:35,840 --> 00:15:39,360 Speaker 1: you would experience, and it lists exactly how to diagnose 256 00:15:39,360 --> 00:15:42,560 Speaker 1: a condition and what it's going to look like. Depression 257 00:15:42,680 --> 00:15:47,120 Speaker 1: was one of the founding conditions, but previously anyone who 258 00:15:47,160 --> 00:15:50,640 Speaker 1: met the symptom cut off for depression would be diagnosed 259 00:15:50,640 --> 00:15:54,240 Speaker 1: with major depressive disorder. That is what I think our 260 00:15:54,320 --> 00:15:58,880 Speaker 1: society the typical image of what this condition is. But 261 00:15:59,040 --> 00:16:02,960 Speaker 1: on a clinical level, it requires two or more depressive episodes, 262 00:16:03,000 --> 00:16:07,040 Speaker 1: which is a discreete period of time, often a minimum 263 00:16:07,040 --> 00:16:09,800 Speaker 1: of two weeks. When we experience at least five of 264 00:16:09,800 --> 00:16:12,600 Speaker 1: the following things, we have a depressed mood for most 265 00:16:12,600 --> 00:16:16,680 Speaker 1: of the day, a diminished interest or kind of pleasure 266 00:16:17,000 --> 00:16:20,920 Speaker 1: in the activities that we used to enjoy, significant weight 267 00:16:21,000 --> 00:16:26,640 Speaker 1: gain or loss, insomnia or sleeping too much, agitation, fatigue 268 00:16:26,800 --> 00:16:31,320 Speaker 1: or loss of energy, feelings of worthlessness or excessive guilt, 269 00:16:32,000 --> 00:16:36,400 Speaker 1: a diminished ability to think or concentrate, and finally, these 270 00:16:36,800 --> 00:16:42,560 Speaker 1: recurrent thoughts of death. Like many mental health conditions, it 271 00:16:42,560 --> 00:16:46,800 Speaker 1: has little to do with what's actually happening around you. 272 00:16:46,800 --> 00:16:49,200 Speaker 1: You can have a loving family, you can have friends, 273 00:16:49,280 --> 00:16:51,480 Speaker 1: you can have a dream job, you can have the 274 00:16:51,600 --> 00:16:54,840 Speaker 1: kind of life that you've always wanted, and you can 275 00:16:54,880 --> 00:16:59,400 Speaker 1: still have depression. But for others, this typical definition of 276 00:16:59,400 --> 00:17:03,680 Speaker 1: a major disorder isn't going to be their experience, right, 277 00:17:03,760 --> 00:17:08,960 Speaker 1: And that's something that psychologists have really identified in recent decades. 278 00:17:09,600 --> 00:17:13,560 Speaker 1: They had clients coming in saying, you know, I don't 279 00:17:13,600 --> 00:17:17,040 Speaker 1: have these lows that are intense as those associated with 280 00:17:17,080 --> 00:17:20,840 Speaker 1: a major depressive disorder, but it can't shake this sadness. 281 00:17:21,119 --> 00:17:24,040 Speaker 1: And it's been years. Some days you know are better 282 00:17:24,080 --> 00:17:28,920 Speaker 1: than others, but there's this overtone of really deep unhappiness 283 00:17:28,960 --> 00:17:32,440 Speaker 1: and hopelessness in my life. This is what we now 284 00:17:32,520 --> 00:17:37,679 Speaker 1: call persistent depressive disorder. It's also known by other names 285 00:17:37,720 --> 00:17:43,120 Speaker 1: like high functioning depression or dysthymia. This is what I 286 00:17:43,160 --> 00:17:45,680 Speaker 1: now know, I think I had, and well I still 287 00:17:45,680 --> 00:17:48,399 Speaker 1: have it to this day, and the criteria are a 288 00:17:48,440 --> 00:17:52,280 Speaker 1: lot less strict, but it really points to the longevity 289 00:17:52,280 --> 00:17:54,159 Speaker 1: of this type of depression. You need to have a 290 00:17:54,200 --> 00:17:57,720 Speaker 1: depressed mood for more days than not, and he's kind 291 00:17:57,720 --> 00:18:00,480 Speaker 1: of a kicker for at least two years. But you 292 00:18:00,560 --> 00:18:04,240 Speaker 1: only need to have two of the below criteria, not five. 293 00:18:04,440 --> 00:18:07,600 Speaker 1: So the same kind of list that we talked about before. 294 00:18:07,880 --> 00:18:11,200 Speaker 1: Low mood, sense of hopelessness, a lack of energy, low 295 00:18:11,240 --> 00:18:14,800 Speaker 1: self esteem, and this condition is much more nuanced, like 296 00:18:14,840 --> 00:18:18,000 Speaker 1: we said, than just sadness. The same way that each 297 00:18:18,080 --> 00:18:21,440 Speaker 1: person is a really unique combination of so many factors 298 00:18:21,440 --> 00:18:25,480 Speaker 1: and experiences and stories, their minds and their brains are 299 00:18:25,480 --> 00:18:28,359 Speaker 1: also going to be this unique combination, so I think 300 00:18:28,400 --> 00:18:32,359 Speaker 1: it's really important that we recognize that distinction and adapt 301 00:18:32,440 --> 00:18:36,040 Speaker 1: to the diversity by which these symptoms can appear. We 302 00:18:36,119 --> 00:18:40,879 Speaker 1: also see conditions under this umbrella like seasonal effective disorder 303 00:18:40,960 --> 00:18:46,400 Speaker 1: or seasonal depression, postnatal depression, depression associated with bipolar disorder, 304 00:18:47,000 --> 00:18:52,280 Speaker 1: and then finally adjustment disorder with depressed mood that's also 305 00:18:52,440 --> 00:18:58,439 Speaker 1: known as situational depression. This looks like major depression in 306 00:18:58,520 --> 00:19:01,720 Speaker 1: many ways, but instead of being brought on by what 307 00:19:01,760 --> 00:19:05,399 Speaker 1: we might see of certain biological mechanisms or neurological roots, 308 00:19:06,040 --> 00:19:08,920 Speaker 1: it's brought on by a specific event or situation that's 309 00:19:08,960 --> 00:19:12,200 Speaker 1: been really really hard, like the death of a loved one, 310 00:19:12,600 --> 00:19:18,200 Speaker 1: or serious illness, a divorce, facing financial difficulties, even a breakup, 311 00:19:18,359 --> 00:19:21,359 Speaker 1: all of which are these events that are discreet, but 312 00:19:21,400 --> 00:19:26,040 Speaker 1: they essentially overwhelm our capacity to cope, you know, as 313 00:19:26,040 --> 00:19:29,800 Speaker 1: it's only natural and kind of expected in those situations. 314 00:19:30,400 --> 00:19:34,880 Speaker 1: Situational depression. The symptoms tend to start within three months 315 00:19:34,920 --> 00:19:39,160 Speaker 1: of the initial experience, and it follows a very similar 316 00:19:39,200 --> 00:19:43,560 Speaker 1: pattern to major depression, with the caveat being that often 317 00:19:43,720 --> 00:19:48,560 Speaker 1: it's quite comorbid with other conditions like anxiety or things 318 00:19:48,600 --> 00:19:53,199 Speaker 1: like substance use, you know, including alcohol. I think what 319 00:19:53,320 --> 00:19:57,639 Speaker 1: always complicates our perception of this condition isn't just the 320 00:19:57,760 --> 00:20:01,040 Speaker 1: variety of the ways that it can manage fest, but 321 00:20:01,160 --> 00:20:05,960 Speaker 1: also the fact that depression or feeling depressed is both 322 00:20:06,040 --> 00:20:08,919 Speaker 1: a clinical term and one that we can use to 323 00:20:08,960 --> 00:20:12,080 Speaker 1: describe a certain feeling, you know. It's both a symptom 324 00:20:12,200 --> 00:20:15,320 Speaker 1: and a condition, but one of those things is temporary. 325 00:20:15,760 --> 00:20:18,720 Speaker 1: And a question I get asked a lot is is 326 00:20:18,760 --> 00:20:21,040 Speaker 1: this kind of my life now? Will I ever be cured? 327 00:20:22,280 --> 00:20:24,800 Speaker 1: When's this going to end? I think when we are 328 00:20:24,880 --> 00:20:28,359 Speaker 1: in this state, we often need the security of a 329 00:20:28,440 --> 00:20:30,159 Speaker 1: timeline to give us a light at the end of 330 00:20:30,200 --> 00:20:32,560 Speaker 1: the tunnel. How can we kind of go on with 331 00:20:32,720 --> 00:20:35,719 Speaker 1: life if we think that this will never end? And 332 00:20:35,760 --> 00:20:38,440 Speaker 1: that's what depression convinces you that it won't, that it's 333 00:20:38,520 --> 00:20:42,280 Speaker 1: all pointless. And if you just get one thing from 334 00:20:42,280 --> 00:20:46,680 Speaker 1: this episode, one tiny, tiny piece of advice or wisdom, 335 00:20:46,960 --> 00:20:49,840 Speaker 1: it's that it's not pointless. Trust me, I know so 336 00:20:50,080 --> 00:20:54,040 Speaker 1: intimately how it feels to look at life, this thing 337 00:20:54,119 --> 00:20:57,520 Speaker 1: that we think should be precious, and feel nothing for 338 00:20:57,600 --> 00:20:59,800 Speaker 1: nothing to make us happy, to be stripped of joy. 339 00:21:00,320 --> 00:21:02,680 Speaker 1: But I also know what it feels like to kind 340 00:21:02,680 --> 00:21:05,879 Speaker 1: of slowly see that perspective change. It's like the first 341 00:21:05,880 --> 00:21:09,680 Speaker 1: flowers after spring. You know your brain is slowly defrosting 342 00:21:09,720 --> 00:21:12,359 Speaker 1: all those happy hormones, that it's that it's kept from you. 343 00:21:12,920 --> 00:21:14,920 Speaker 1: And I really do understand the desire for a quick 344 00:21:15,000 --> 00:21:19,240 Speaker 1: fix as well. You know soundly our brain is quite cryptic, 345 00:21:19,600 --> 00:21:22,800 Speaker 1: and the length of this condition is really going to 346 00:21:23,119 --> 00:21:26,480 Speaker 1: depend on a lot of factors, the primary one being 347 00:21:26,800 --> 00:21:31,200 Speaker 1: the origins and the root cause, and what about our environment, 348 00:21:31,720 --> 00:21:35,720 Speaker 1: or our context or our protective factors can be altered. 349 00:21:35,840 --> 00:21:38,600 Speaker 1: So let me set the stage and kind of dive 350 00:21:38,720 --> 00:21:43,480 Speaker 1: into the science behind why we feel this way sometimes 351 00:21:43,560 --> 00:21:46,359 Speaker 1: where it's coming from. You know, depression is not a 352 00:21:46,400 --> 00:21:50,080 Speaker 1: personal flaw. It's not a personal weakness. It is this 353 00:21:50,200 --> 00:21:57,879 Speaker 1: hidden system and interplay of genetic and biological and environmental interactions. 354 00:21:58,000 --> 00:22:01,080 Speaker 1: If depression, you know, was true a choice or a 355 00:22:01,080 --> 00:22:04,600 Speaker 1: personal weakness, you know, we could hypothetically be able to 356 00:22:05,240 --> 00:22:08,240 Speaker 1: overcome it with sheer will power and positive thinking. And 357 00:22:08,320 --> 00:22:11,800 Speaker 1: while some people would have you believe that that is possible, 358 00:22:12,520 --> 00:22:14,440 Speaker 1: those are not the kinds of people that we want 359 00:22:14,440 --> 00:22:17,479 Speaker 1: to be listening to, especially when it comes to our 360 00:22:17,520 --> 00:22:20,720 Speaker 1: mental health. We're going to approach this from the model 361 00:22:20,760 --> 00:22:27,520 Speaker 1: of the four p's. So what that means is predisposing factors, precipitating, perpetuating, 362 00:22:28,160 --> 00:22:31,840 Speaker 1: and protective. There's kind of not just one secret formula 363 00:22:31,960 --> 00:22:34,680 Speaker 1: to what makes a depressed person, I guess, versus someone 364 00:22:34,680 --> 00:22:37,560 Speaker 1: who is not depressed. But we can use this model 365 00:22:37,600 --> 00:22:41,240 Speaker 1: to kind of break down our innate and personal vulnerabilities, 366 00:22:41,800 --> 00:22:45,000 Speaker 1: and then also what we can use to mitigate our 367 00:22:45,000 --> 00:22:48,080 Speaker 1: symptoms if we are someone who has this condition. So 368 00:22:48,240 --> 00:22:53,040 Speaker 1: predisposing factors are kind of areas of vulnerability that increase 369 00:22:53,080 --> 00:22:57,200 Speaker 1: your risk. When we talk about depression, the first one 370 00:22:57,240 --> 00:23:01,720 Speaker 1: that often comes to mind is genetics. If you're looking 371 00:23:01,760 --> 00:23:04,520 Speaker 1: for something else to blame your parents for, this one 372 00:23:04,560 --> 00:23:07,600 Speaker 1: might be for you. But our genetics are inherited from 373 00:23:07,640 --> 00:23:10,560 Speaker 1: our mother and our father, and they essentially lay out 374 00:23:10,560 --> 00:23:13,600 Speaker 1: the blueprint for how our brains and our bodies should 375 00:23:13,680 --> 00:23:17,320 Speaker 1: develop as kind of an initial template that then kind 376 00:23:17,320 --> 00:23:20,600 Speaker 1: of interacts with our environment to create our outcomes, to 377 00:23:20,680 --> 00:23:23,840 Speaker 1: create our life. Each of us has a very unique 378 00:23:23,880 --> 00:23:29,159 Speaker 1: genetic profile, with obviously the exception of biological twins, and 379 00:23:29,320 --> 00:23:32,680 Speaker 1: our genetic profile is marked by these things called mutations. 380 00:23:32,840 --> 00:23:36,280 Speaker 1: So these are caused when our cells are splitting or dividing, 381 00:23:36,800 --> 00:23:40,160 Speaker 1: and when we receive a mutation on one of our genes. 382 00:23:40,920 --> 00:23:44,480 Speaker 1: This is what is often responsible for certain disorders and illnesses, 383 00:23:44,640 --> 00:23:49,520 Speaker 1: or a certain predisposition for conditions like depressions. So when 384 00:23:49,680 --> 00:23:53,280 Speaker 1: scientists started using genetic mapping to figure out why some 385 00:23:53,320 --> 00:23:57,520 Speaker 1: people develop certain conditions for seemingly no apparent reason, and 386 00:23:57,640 --> 00:24:01,639 Speaker 1: others don't. Eventually they turn to depression to see what 387 00:24:01,680 --> 00:24:04,720 Speaker 1: they could find in our DNA, what kind of secrets 388 00:24:05,320 --> 00:24:09,640 Speaker 1: they could unlock, And here's what they found. So they 389 00:24:09,680 --> 00:24:12,720 Speaker 1: believe that as many as forty percent of those of 390 00:24:12,760 --> 00:24:16,159 Speaker 1: us who have depression can trace a link back to 391 00:24:16,720 --> 00:24:20,480 Speaker 1: something in our genetics, which is most often identified by 392 00:24:20,560 --> 00:24:24,280 Speaker 1: having a close family member or a relative who also 393 00:24:24,359 --> 00:24:28,960 Speaker 1: has depression. But it's important here to note that doesn't 394 00:24:29,040 --> 00:24:33,240 Speaker 1: necessarily mean that everyone with a mutation or family history 395 00:24:33,920 --> 00:24:38,280 Speaker 1: is going to develop depression, because often that gene needs 396 00:24:38,320 --> 00:24:41,359 Speaker 1: to be activated by our environment, and that accounts for 397 00:24:41,800 --> 00:24:45,960 Speaker 1: the other sixty percent of our kind of risk factor 398 00:24:46,080 --> 00:24:49,359 Speaker 1: or vulnerability. And this is where the interaction between family 399 00:24:49,480 --> 00:24:52,760 Speaker 1: history and genetics can become a little bit tricky, because 400 00:24:52,840 --> 00:24:55,240 Speaker 1: a child who grows up with a parent or a 401 00:24:55,280 --> 00:24:59,360 Speaker 1: person around them who has depression, maybe they are more 402 00:24:59,359 --> 00:25:02,960 Speaker 1: susceptible to the condition, not because of a genetic mutation 403 00:25:03,119 --> 00:25:06,399 Speaker 1: or because they've inherited this gene, but because they've learned 404 00:25:06,400 --> 00:25:11,399 Speaker 1: to mimic their parents' behavior, or they've experienced something perhaps 405 00:25:11,480 --> 00:25:15,639 Speaker 1: uncomfortable in childhood that is related to their parents' experience. 406 00:25:16,040 --> 00:25:19,320 Speaker 1: It's hard to separate whether the trigger, I guess, or 407 00:25:19,320 --> 00:25:22,920 Speaker 1: the predisposing factor was genetics or our environment, and that's 408 00:25:23,000 --> 00:25:25,760 Speaker 1: kind of a puzzle that we're yet to crack. But 409 00:25:25,840 --> 00:25:30,000 Speaker 1: when they dived further into what specific gene mutation was 410 00:25:30,080 --> 00:25:33,560 Speaker 1: kind of responsible for upwards of forty percent of cases, 411 00:25:34,000 --> 00:25:38,760 Speaker 1: what they really found has truly changed how we approach 412 00:25:39,080 --> 00:25:43,679 Speaker 1: this condition. Our genes are responsible for how our brain 413 00:25:44,040 --> 00:25:50,440 Speaker 1: processes and releases serotonin, and serotonin is the primary candidate 414 00:25:50,920 --> 00:25:54,960 Speaker 1: for the reason we experience depressive symptoms. It's like the 415 00:25:55,160 --> 00:25:58,520 Speaker 1: core neurotransmitter that we would hear about and that is 416 00:25:58,600 --> 00:26:01,840 Speaker 1: discussed when we're talking about this condition, and there's been 417 00:26:01,880 --> 00:26:06,199 Speaker 1: several studies that have shown this. You know, serotonin is 418 00:26:06,359 --> 00:26:10,760 Speaker 1: definitely something you've heard about before. You probably mostly know 419 00:26:10,800 --> 00:26:13,800 Speaker 1: it in terms of like the happy drug alongside famine, 420 00:26:13,880 --> 00:26:19,240 Speaker 1: the happy chemical, And that relationship between perhaps having a 421 00:26:19,600 --> 00:26:23,800 Speaker 1: less formed serotonin system or less serotonin available in our 422 00:26:23,840 --> 00:26:28,000 Speaker 1: brain and depression makes a lot of logical sense because 423 00:26:28,119 --> 00:26:31,639 Speaker 1: this neurotransmitter is responsible for our mood, for our general 424 00:26:31,720 --> 00:26:34,239 Speaker 1: levels of happiness, and also things like sleep, which we 425 00:26:34,320 --> 00:26:38,879 Speaker 1: know contribute and because this mutation disrupts the release and 426 00:26:39,160 --> 00:26:44,119 Speaker 1: how our brains process serotonin. People with depression may have 427 00:26:44,359 --> 00:26:48,520 Speaker 1: less of this neurotransmitter available to them, and that is 428 00:26:48,560 --> 00:26:52,080 Speaker 1: what results in these symptoms that we typically associate with 429 00:26:52,119 --> 00:26:54,920 Speaker 1: this condition. At the end of the day, I think 430 00:26:54,960 --> 00:27:00,120 Speaker 1: what these findings really revealed is that this may be, 431 00:27:00,440 --> 00:27:03,800 Speaker 1: you know, nothing more than just a chemical imbalance, and 432 00:27:04,160 --> 00:27:06,439 Speaker 1: it's unfortunate, but you know, we can't go into our 433 00:27:06,440 --> 00:27:09,240 Speaker 1: brain and turn on the serotonin tap whenever we'd like, 434 00:27:09,840 --> 00:27:14,320 Speaker 1: but we can take medications like selective serotonin reuptake inhibitors 435 00:27:14,920 --> 00:27:18,399 Speaker 1: or basically what we know as antidepressants, and they work 436 00:27:18,440 --> 00:27:21,720 Speaker 1: by preventing our neurons from sucking up all of that 437 00:27:21,840 --> 00:27:26,040 Speaker 1: serotonin in our brain and keeping it in action for longer, 438 00:27:26,480 --> 00:27:30,359 Speaker 1: making more of it available to us. That's obviously a really, 439 00:27:30,400 --> 00:27:35,719 Speaker 1: really simple explanation, but the apparent effectiveness they've repeatedly shown 440 00:27:35,920 --> 00:27:41,800 Speaker 1: effectiveness of this type of antidepressants really points to depression 441 00:27:41,920 --> 00:27:46,080 Speaker 1: having a biological origin in how our brain releases and 442 00:27:46,160 --> 00:27:51,000 Speaker 1: processes serotonin, in particular hormonally as well. Studies conducted in 443 00:27:51,040 --> 00:27:53,359 Speaker 1: two thousand and eleven, actually a bunch of them, not 444 00:27:53,440 --> 00:27:56,639 Speaker 1: just conducted during that year across a number of years. 445 00:27:57,080 --> 00:28:01,080 Speaker 1: They also suggest that major depression may involve an overactive 446 00:28:01,160 --> 00:28:06,440 Speaker 1: hypothalamic pituitary adrenal axis. Very long word, very long term, 447 00:28:06,440 --> 00:28:10,159 Speaker 1: but essentially it's responsible for a lot of our hormones, 448 00:28:10,200 --> 00:28:13,879 Speaker 1: including estrogen, which, as you may have guessed, it also 449 00:28:13,960 --> 00:28:17,760 Speaker 1: impacts serotonin levels. All of it comes back to this 450 00:28:18,119 --> 00:28:21,679 Speaker 1: one little neurotransmitter. But we're going to talk on this 451 00:28:21,720 --> 00:28:25,720 Speaker 1: a little bit more later, specifically the hormonal influences. I 452 00:28:25,760 --> 00:28:28,920 Speaker 1: want to quickly return to that question, how long does 453 00:28:28,960 --> 00:28:31,080 Speaker 1: this last? How long is your depression going to last? 454 00:28:31,600 --> 00:28:33,879 Speaker 1: You know, I can't answer that for you, but I 455 00:28:33,920 --> 00:28:36,640 Speaker 1: think if it's the case that a lot of your 456 00:28:36,640 --> 00:28:41,160 Speaker 1: condition is coming from hereditary factors like genetics, which consequently 457 00:28:41,200 --> 00:28:44,920 Speaker 1: impact your innate biology, I think the unfortunate news is 458 00:28:44,960 --> 00:28:48,760 Speaker 1: that you know, sadly you cannot rewire your brain, so 459 00:28:49,040 --> 00:28:51,920 Speaker 1: not accounting for the protective factors we're going to discuss 460 00:28:52,000 --> 00:28:54,880 Speaker 1: later on, it's really hard to say. It may be chronic, 461 00:28:54,920 --> 00:28:59,360 Speaker 1: but it's not untreatable. SSRIs are highly reliable. They've been 462 00:28:59,400 --> 00:29:04,239 Speaker 1: systematic tested for their effectiveness in these situations, particularly in 463 00:29:04,320 --> 00:29:09,360 Speaker 1: response to this chemical imbalanced explanation but the fact that 464 00:29:09,400 --> 00:29:13,720 Speaker 1: they don't work for everyone points to this kind of 465 00:29:13,840 --> 00:29:18,240 Speaker 1: deeper truth that not everyone's depressive symptoms have a genetic 466 00:29:18,400 --> 00:29:21,120 Speaker 1: or even a neural origin to do with some kind 467 00:29:21,160 --> 00:29:28,120 Speaker 1: of serotonin dysfunction or hormonal dysfunction. Certain personality types and 468 00:29:28,240 --> 00:29:32,120 Speaker 1: people of certain temperaments may also be more susceptible, and 469 00:29:32,240 --> 00:29:36,400 Speaker 1: there's a few that we typically look at, particularly those 470 00:29:36,400 --> 00:29:42,760 Speaker 1: who are rejection sensitive, self critical, anxious, worrying, or personally reserved. 471 00:29:43,280 --> 00:29:45,800 Speaker 1: And then of course we have things like extraneous events 472 00:29:45,840 --> 00:29:50,400 Speaker 1: and circumstances. It's not all about temperament and personality. The 473 00:29:50,440 --> 00:29:54,640 Speaker 1: things that happen to us create the thought patterns and 474 00:29:54,680 --> 00:29:57,960 Speaker 1: the response that our brain is going to have. So trauma, 475 00:29:58,040 --> 00:30:00,680 Speaker 1: as we know, is a massive country out There is 476 00:30:00,720 --> 00:30:06,360 Speaker 1: a large consensus that indicates that childhood trauma is significantly 477 00:30:06,400 --> 00:30:09,719 Speaker 1: involved in the development of depression. In one study they 478 00:30:09,760 --> 00:30:14,360 Speaker 1: conducted in twenty fifteen that I found so comprehensive and 479 00:30:14,440 --> 00:30:21,360 Speaker 1: incredibly well done, researchers ask people to retrospectively recall childhood trauma, 480 00:30:21,880 --> 00:30:25,360 Speaker 1: and they also measured their rates of chronic depression, and 481 00:30:25,440 --> 00:30:30,000 Speaker 1: the relationship between these two things was really really significant. 482 00:30:30,560 --> 00:30:36,280 Speaker 1: Our environment particularly our early childhood environment is so powerful, 483 00:30:36,720 --> 00:30:40,600 Speaker 1: and things like neglect and abuse have the capacity to 484 00:30:41,240 --> 00:30:45,959 Speaker 1: literally change how our neural and global structure is developing 485 00:30:46,480 --> 00:30:51,960 Speaker 1: in some instances, even shrinking or delaying development. Our brains 486 00:30:52,000 --> 00:30:55,200 Speaker 1: are also not great at forgetting trauma. We have an 487 00:30:55,280 --> 00:30:59,320 Speaker 1: evolutionary and a survival instinct to remember the bad things 488 00:30:59,360 --> 00:31:01,720 Speaker 1: that happened to us. Yes, and even when you know 489 00:31:01,720 --> 00:31:05,320 Speaker 1: they do come through as suppressed memories, the body does 490 00:31:05,320 --> 00:31:09,880 Speaker 1: not forget, and that stress and that experience does unfortunately 491 00:31:10,520 --> 00:31:14,720 Speaker 1: stay with us. These factors, though, they all have something 492 00:31:14,720 --> 00:31:17,080 Speaker 1: in common the ones that we've talked about, and I 493 00:31:17,160 --> 00:31:22,680 Speaker 1: want to emphasize that commonality. Really clearly, none of these factors, 494 00:31:22,800 --> 00:31:28,360 Speaker 1: none of these predisposing determinants are within our control. None 495 00:31:28,400 --> 00:31:30,800 Speaker 1: of them. None of them could be our fault. There 496 00:31:30,880 --> 00:31:33,440 Speaker 1: is nothing in that list that we have agency over. 497 00:31:33,840 --> 00:31:37,320 Speaker 1: You know, our genetics absolutely, not our personality. Some would 498 00:31:37,400 --> 00:31:40,040 Speaker 1: argue maybe, but I would say not the trauma and 499 00:31:40,080 --> 00:31:44,080 Speaker 1: the things that we experience, our hormone levels. If we could, 500 00:31:44,160 --> 00:31:46,800 Speaker 1: we would definitely make it so that we did not 501 00:31:46,920 --> 00:31:50,440 Speaker 1: have this predisposition, that we did not have this experience. 502 00:31:50,520 --> 00:31:54,760 Speaker 1: Once again, that's misconception. Number two, and something that we 503 00:31:54,800 --> 00:31:58,000 Speaker 1: have to say is that you do not get to 504 00:31:58,520 --> 00:32:03,800 Speaker 1: control how this condition manifests. And I think that really 505 00:32:03,920 --> 00:32:06,920 Speaker 1: takes a lot of the shame away from it because 506 00:32:06,960 --> 00:32:11,040 Speaker 1: it's not something that you have decided to opt into. 507 00:32:11,760 --> 00:32:16,080 Speaker 1: It's not something that you want to be dealing with. 508 00:32:16,320 --> 00:32:19,320 Speaker 1: You know, depending on your experience, I would say most 509 00:32:19,320 --> 00:32:22,640 Speaker 1: of us would prefer not to be depressed the majority 510 00:32:22,680 --> 00:32:25,320 Speaker 1: of the time. Okay, I think it's time for a 511 00:32:25,400 --> 00:32:28,920 Speaker 1: quick break to gather our thoughts, grab a cup of tea, 512 00:32:29,000 --> 00:32:32,880 Speaker 1: tell your friends that you love them, and when we return, 513 00:32:33,360 --> 00:32:37,880 Speaker 1: I really want to discuss precipitating factors, protective factors, and 514 00:32:38,040 --> 00:32:41,120 Speaker 1: also some of the new treatments that we are seeing 515 00:32:41,240 --> 00:32:45,480 Speaker 1: for depression, including the use of psychedelics not as fun 516 00:32:45,480 --> 00:32:50,200 Speaker 1: as it sounds, actually but really interesting, and also why 517 00:32:50,240 --> 00:32:54,480 Speaker 1: some people think that things like ketamine or even nature 518 00:32:54,720 --> 00:33:03,680 Speaker 1: may be particularly healing for people with these symptoms. We've 519 00:33:03,720 --> 00:33:07,400 Speaker 1: done a bit of an overview of what people typically 520 00:33:07,400 --> 00:33:10,400 Speaker 1: see as the causes of depression, but what kind of 521 00:33:10,440 --> 00:33:16,000 Speaker 1: triggers a depressive episode or something like persistent depressive disorder. 522 00:33:16,800 --> 00:33:20,040 Speaker 1: This is where we turn our focus to precipitating factors. 523 00:33:20,520 --> 00:33:24,360 Speaker 1: These are things that initiate or promote the onset of 524 00:33:24,400 --> 00:33:29,080 Speaker 1: a condition. The main fender, I would say is stressful 525 00:33:29,120 --> 00:33:33,560 Speaker 1: or adverse life experiences. These two psychologists actually created a 526 00:33:33,640 --> 00:33:37,360 Speaker 1: scale for what these might be and which ones may 527 00:33:37,400 --> 00:33:41,600 Speaker 1: be more predictive of depression. So it's called the stress scale, 528 00:33:42,120 --> 00:33:46,320 Speaker 1: and number one is the death obviously of a spouse 529 00:33:46,480 --> 00:33:50,840 Speaker 1: or of your child, things like divorce and separation, imprisonment, 530 00:33:51,320 --> 00:33:54,520 Speaker 1: the death of a close family member, injury. But then 531 00:33:54,840 --> 00:33:59,080 Speaker 1: surprisingly we actually see some things that are more positive, 532 00:34:00,240 --> 00:34:03,960 Speaker 1: like marriage and retirement and the birth of a child, 533 00:34:04,480 --> 00:34:07,800 Speaker 1: can be so stressful even though we see them as 534 00:34:07,840 --> 00:34:12,920 Speaker 1: beautiful that they trigger this kind of emotional and deeper reaction. 535 00:34:13,800 --> 00:34:16,439 Speaker 1: Let's focus in on some of the events that particularly 536 00:34:16,480 --> 00:34:21,480 Speaker 1: pertain to our twenties, in particular significant life changes things 537 00:34:21,520 --> 00:34:24,520 Speaker 1: like grief, but also moving out of home, our first 538 00:34:24,560 --> 00:34:29,279 Speaker 1: significant breakup, and deep feelings of things like isolation and alienation. 539 00:34:29,920 --> 00:34:33,000 Speaker 1: There are so many other unique things, and when multiple 540 00:34:33,600 --> 00:34:36,800 Speaker 1: of these events occur in a short period of time, 541 00:34:37,400 --> 00:34:40,680 Speaker 1: this has what we would call a cumulative effect. So 542 00:34:41,280 --> 00:34:46,480 Speaker 1: the prolonged accumulation of momentary stress leads to an increase 543 00:34:46,600 --> 00:34:50,600 Speaker 1: in long term cumulative stress and just general impacts on 544 00:34:50,640 --> 00:34:54,160 Speaker 1: our overall health, perhaps because of the release of things 545 00:34:54,239 --> 00:34:59,600 Speaker 1: like cortiso and adrenaline. It's a biological interaction that has 546 00:34:59,640 --> 00:35:03,520 Speaker 1: the name post adrenaline blues. When we go through something 547 00:35:03,640 --> 00:35:08,440 Speaker 1: intensely shocking and life altering, our bodies respond to this 548 00:35:08,600 --> 00:35:11,839 Speaker 1: as they would respond to danger or a threat, and 549 00:35:11,880 --> 00:35:15,560 Speaker 1: they pump us with a nice cocktail of neuropinephrine. It's 550 00:35:15,600 --> 00:35:18,520 Speaker 1: also known as adrenaline and cort result, which is the 551 00:35:18,560 --> 00:35:22,160 Speaker 1: main stress hormone that's released from our thyroid when that 552 00:35:22,280 --> 00:35:27,200 Speaker 1: danger passes, when that event kind of fades, when the 553 00:35:27,200 --> 00:35:29,719 Speaker 1: wedding is over, when you've unpacked all your boxes in 554 00:35:29,760 --> 00:35:33,360 Speaker 1: the new city, you crash and your body is trying 555 00:35:33,400 --> 00:35:37,040 Speaker 1: to restore things to normal, And what that can induce 556 00:35:37,200 --> 00:35:40,040 Speaker 1: is a depressive period or a depressive episode. So yes, 557 00:35:40,760 --> 00:35:44,040 Speaker 1: one event may be enough to really trigger something like 558 00:35:44,120 --> 00:35:48,560 Speaker 1: situational depression or an adjustment disorder with depressive symptoms, but 559 00:35:49,120 --> 00:35:52,680 Speaker 1: it can also interact with some of our earlier predispositions 560 00:35:53,160 --> 00:35:57,080 Speaker 1: and create other elements or symptoms or even a depressive 561 00:35:57,160 --> 00:36:00,760 Speaker 1: episode because it is so shocking, because it has really 562 00:36:01,560 --> 00:36:06,080 Speaker 1: caused us to perhaps rethink life. It's made or limited 563 00:36:06,640 --> 00:36:11,759 Speaker 1: the availability of our coping mechanisms. It's really transformed how 564 00:36:11,800 --> 00:36:15,960 Speaker 1: we see the world and is naturally incredibly stressful. But 565 00:36:16,080 --> 00:36:19,160 Speaker 1: something that's kind of missing from this discussion, I think, 566 00:36:19,360 --> 00:36:23,560 Speaker 1: and is often missing and rarely spoken about, is protective factors. 567 00:36:23,640 --> 00:36:26,600 Speaker 1: We like to focus on the negatives. Maybe that in 568 00:36:26,640 --> 00:36:30,200 Speaker 1: itself is symptomatic, but also our society is rather pessimistic. 569 00:36:30,640 --> 00:36:34,120 Speaker 1: I think our obsession with predisposition kind of also links 570 00:36:34,120 --> 00:36:37,360 Speaker 1: to that innate stigma. If we know how depression is 571 00:36:37,920 --> 00:36:41,719 Speaker 1: created or developed, maybe we can eliminate it from society, 572 00:36:42,320 --> 00:36:46,960 Speaker 1: which I personally don't think is quite valuable. Maybe that's 573 00:36:46,960 --> 00:36:50,200 Speaker 1: a controversial thing to say, but for me, you know, yeah, 574 00:36:50,239 --> 00:36:52,799 Speaker 1: you have your bad days. But if someone kind of 575 00:36:52,800 --> 00:36:55,920 Speaker 1: gave me a magical button, I think I'd have some doubts. 576 00:36:56,080 --> 00:36:57,960 Speaker 1: I don't want to say there's been benefits, but there's 577 00:36:58,000 --> 00:37:02,520 Speaker 1: been definite perspectives shift and various outlooks that my depression 578 00:37:02,520 --> 00:37:05,399 Speaker 1: has kind of given me. You know, who could say 579 00:37:05,440 --> 00:37:07,440 Speaker 1: I would be even making this podcast now if I 580 00:37:07,480 --> 00:37:11,200 Speaker 1: didn't have this experience and didn't relate to some of 581 00:37:11,200 --> 00:37:16,560 Speaker 1: the deeper discussions happening around mental health and psychology. But 582 00:37:16,640 --> 00:37:20,040 Speaker 1: I also understand that part of that comes from the 583 00:37:20,080 --> 00:37:24,799 Speaker 1: attitude I have towards what I'm experiencing, and attitude, as 584 00:37:24,840 --> 00:37:28,280 Speaker 1: silly as it sounds, it's not going to cure your depression, 585 00:37:28,840 --> 00:37:31,120 Speaker 1: but there has been evidence that it does minimize your 586 00:37:31,120 --> 00:37:34,840 Speaker 1: distress and perhaps the severity of your symptom profile because 587 00:37:34,840 --> 00:37:38,320 Speaker 1: of its role as a protective factor. Things like you know, 588 00:37:38,360 --> 00:37:41,439 Speaker 1: if you're innately pessimistic versus optimistic, which we'll talk about 589 00:37:41,440 --> 00:37:44,760 Speaker 1: in a second, that is going to influence your thinking 590 00:37:44,800 --> 00:37:48,799 Speaker 1: style and also your coping mechanisms. But let's discuss a 591 00:37:48,840 --> 00:37:54,279 Speaker 1: few other of these protective factors that are really impactful 592 00:37:54,320 --> 00:37:57,520 Speaker 1: when we talk about depression. Like I mentioned personal attributes, 593 00:37:58,040 --> 00:38:01,480 Speaker 1: but then things like social support, networks, sense of community. 594 00:38:01,840 --> 00:38:05,320 Speaker 1: Really nobody can overstate the beauty and the importance of belonging. 595 00:38:05,760 --> 00:38:07,319 Speaker 1: It kind of quats us in a bit of a 596 00:38:07,360 --> 00:38:11,160 Speaker 1: protective shield. Also, a strong sense of identity, a sense 597 00:38:11,200 --> 00:38:15,480 Speaker 1: of self, even things like spirituality or your connection with 598 00:38:15,520 --> 00:38:20,200 Speaker 1: a particular religion that really encompasses a reason for being. 599 00:38:20,880 --> 00:38:25,040 Speaker 1: And then also things like depression, physical health and fitness. 600 00:38:25,520 --> 00:38:27,920 Speaker 1: I think it's valuable that we focus on that last 601 00:38:27,960 --> 00:38:31,759 Speaker 1: one because I know the opinions around it are very 602 00:38:31,840 --> 00:38:36,480 Speaker 1: nuanced and at times contradictory. From an evidence based perspective, 603 00:38:37,080 --> 00:38:41,000 Speaker 1: there is there are a lot of findings that exercise 604 00:38:41,120 --> 00:38:45,040 Speaker 1: as a behavioral intervention does alleviate some of the symptoms 605 00:38:45,040 --> 00:38:49,160 Speaker 1: of depression. In a few large scale studies, one in particular, 606 00:38:49,200 --> 00:38:52,719 Speaker 1: which was conducted here in Australia actually published this year 607 00:38:52,760 --> 00:38:55,920 Speaker 1: twenty twenty three. They found that active men and women 608 00:38:56,280 --> 00:39:00,600 Speaker 1: became depressed at much lower rates than set A two people, 609 00:39:00,760 --> 00:39:03,920 Speaker 1: even if they exercise for only a few minutes a 610 00:39:04,000 --> 00:39:06,600 Speaker 1: day or a few days a week. But the kind 611 00:39:06,640 --> 00:39:12,120 Speaker 1: of precise mechanisms by which bodily movements alter brain functions 612 00:39:12,160 --> 00:39:16,000 Speaker 1: to improve our mood really remains unclear, as do the 613 00:39:16,040 --> 00:39:20,120 Speaker 1: differences in people's responses. So in every study the researchers 614 00:39:20,440 --> 00:39:26,480 Speaker 1: looked at, some people's depression was alleviated while others remained unchanged. 615 00:39:26,960 --> 00:39:29,680 Speaker 1: I also think we need to be skeptical when we're 616 00:39:29,719 --> 00:39:33,880 Speaker 1: promoting things like exercise because a like we showed, it 617 00:39:33,920 --> 00:39:37,359 Speaker 1: doesn't work for everyone. B. I think when we read 618 00:39:37,400 --> 00:39:41,520 Speaker 1: these findings without considering the broader context and interactions between 619 00:39:41,960 --> 00:39:46,239 Speaker 1: exercise and other factors, we can sometimes reduce these conclusions 620 00:39:46,280 --> 00:39:48,120 Speaker 1: to suggest that, you know, just buying a pair of 621 00:39:48,200 --> 00:39:51,600 Speaker 1: running shoes and going for a job is the magical answer. 622 00:39:51,680 --> 00:39:54,919 Speaker 1: And see, I think it shouldn't be considered the first 623 00:39:54,960 --> 00:39:56,960 Speaker 1: line of treatment for some people. I think in many 624 00:39:56,960 --> 00:39:59,759 Speaker 1: ways that would be unethical. Also, when we think about 625 00:39:59,840 --> 00:40:03,120 Speaker 1: the impact depression has on our motivation, it's really hard 626 00:40:03,160 --> 00:40:04,920 Speaker 1: for your therapists to be like, oh, just go for 627 00:40:04,960 --> 00:40:06,680 Speaker 1: a run when you can't even get out of bed. 628 00:40:07,320 --> 00:40:12,040 Speaker 1: Or it also excludes people with certain disabilities. It's a 629 00:40:12,080 --> 00:40:15,000 Speaker 1: protective factor. I will say, it's not a cure, and 630 00:40:15,120 --> 00:40:17,080 Speaker 1: to sell it as anything more than that, I think 631 00:40:17,120 --> 00:40:20,880 Speaker 1: would be very misleading. You know, look at elite athletes 632 00:40:20,920 --> 00:40:24,400 Speaker 1: as an example. We've seen so many people like Simone 633 00:40:24,440 --> 00:40:28,680 Speaker 1: Bios and Naomi Osaka come out and talk really openly 634 00:40:28,920 --> 00:40:31,839 Speaker 1: about their mental health problems. And I'm going to bet 635 00:40:31,880 --> 00:40:34,279 Speaker 1: some pretty good money that these people are exercising for 636 00:40:34,320 --> 00:40:38,000 Speaker 1: more than forty five minutes a day. So the relationship 637 00:40:38,080 --> 00:40:42,200 Speaker 1: that has been promised between physical activity and an alleviation 638 00:40:42,280 --> 00:40:46,520 Speaker 1: of mental distress isn't quite there. What it seems to 639 00:40:46,520 --> 00:40:49,680 Speaker 1: be is a combination. If we have a strong support network, 640 00:40:50,000 --> 00:40:53,799 Speaker 1: particularly if people we can speak openly with that really 641 00:40:53,920 --> 00:40:56,719 Speaker 1: lessens the load, as does, like we said, a sense 642 00:40:56,760 --> 00:41:01,560 Speaker 1: of being a purpose and personality or temperament, the main 643 00:41:01,600 --> 00:41:04,000 Speaker 1: one being, like we said, the distinction between being an 644 00:41:04,080 --> 00:41:06,640 Speaker 1: optimist or a pessimist. You know, do you see the 645 00:41:06,680 --> 00:41:10,120 Speaker 1: world and your future is genuinely positive or are you 646 00:41:10,239 --> 00:41:13,680 Speaker 1: expecting the worst case scenario. Also, I think depression can 647 00:41:13,719 --> 00:41:16,520 Speaker 1: make us feel like we're all pessimists, the outlook carried 648 00:41:16,600 --> 00:41:22,279 Speaker 1: through though by our prior predisposition for optimism, even just 649 00:41:22,719 --> 00:41:25,640 Speaker 1: even just this slight sense, even if just that like 650 00:41:25,880 --> 00:41:28,160 Speaker 1: very hidden voice in our head that says, all right, 651 00:41:28,239 --> 00:41:30,399 Speaker 1: let's keep focusing. Things are going to turn out or right, 652 00:41:31,000 --> 00:41:33,719 Speaker 1: That can maybe counteract that negative thought pattern that we 653 00:41:33,760 --> 00:41:38,719 Speaker 1: associate with these symptoms. Something I've also found really effective 654 00:41:38,880 --> 00:41:43,440 Speaker 1: is active coping skills, forcing myself to journal what I 655 00:41:43,480 --> 00:41:46,799 Speaker 1: was feeling, especially as a way to look back and 656 00:41:46,840 --> 00:41:50,040 Speaker 1: see how far I've progressed, but also as a reminder 657 00:41:50,120 --> 00:41:53,359 Speaker 1: to myself during future hard times that this is not 658 00:41:53,400 --> 00:41:55,680 Speaker 1: the first time I've been through this. I've survived, I've 659 00:41:55,680 --> 00:41:58,759 Speaker 1: pulled through. There are beautiful things waiting for me. That 660 00:41:59,080 --> 00:42:04,440 Speaker 1: is a really important and valuable part of my approach 661 00:42:04,480 --> 00:42:08,920 Speaker 1: to managing what I'm going through having a perspective. Okay, 662 00:42:08,960 --> 00:42:10,759 Speaker 1: so the final thing that we've been missing from this 663 00:42:10,840 --> 00:42:14,960 Speaker 1: conversation has been discussions of treatment. If we're taking a 664 00:42:15,000 --> 00:42:20,719 Speaker 1: biomedical approach to depression, that perspective tells us that, like 665 00:42:20,840 --> 00:42:24,040 Speaker 1: any other form of illness, depression should be managed through 666 00:42:24,080 --> 00:42:27,600 Speaker 1: a series of treatments or interventions. I also want to 667 00:42:27,600 --> 00:42:29,960 Speaker 1: state that this should not be taken as advice. Like 668 00:42:30,000 --> 00:42:32,680 Speaker 1: I said before, I'm not in the position to give 669 00:42:32,719 --> 00:42:37,839 Speaker 1: you actual medical recommendation prescriptions because I guess I don't 670 00:42:37,880 --> 00:42:40,120 Speaker 1: know you personally. But knowledge is power, and I think 671 00:42:40,160 --> 00:42:44,560 Speaker 1: psycho education is power. So consider this just an introductory 672 00:42:44,640 --> 00:42:48,560 Speaker 1: overview or glance at what is actually out there. So 673 00:42:49,360 --> 00:42:52,839 Speaker 1: there are two main forms of treatment that we typically see, 674 00:42:52,840 --> 00:42:57,640 Speaker 1: that's medication and therapy. We already know the basics behind 675 00:42:57,880 --> 00:43:04,040 Speaker 1: why antidepressants were Depression involves changes in brain chemistry and 676 00:43:04,400 --> 00:43:07,960 Speaker 1: that can change how people respond to the world, and 677 00:43:08,040 --> 00:43:11,600 Speaker 1: so these kinds of medication can correct the imbalance of 678 00:43:11,680 --> 00:43:15,840 Speaker 1: chemicals in the brain, such as that a natural balance 679 00:43:16,000 --> 00:43:19,480 Speaker 1: is restored. I have an old episode on this's called 680 00:43:19,520 --> 00:43:24,399 Speaker 1: antidepressants literally just antidepressants, and it basically explains my own 681 00:43:24,440 --> 00:43:28,239 Speaker 1: experience on Lexipro, which I've been on since I was 682 00:43:28,520 --> 00:43:30,799 Speaker 1: around twenty, and it felt like the right option for me. 683 00:43:30,960 --> 00:43:32,880 Speaker 1: I would, you know, had been going to therapy for 684 00:43:32,920 --> 00:43:36,120 Speaker 1: a while, I'd made the lifestyle changes, and I think 685 00:43:36,160 --> 00:43:39,400 Speaker 1: I got to the realization that what I was dealing 686 00:43:39,480 --> 00:43:42,759 Speaker 1: with wasn't going to be fixed through my behavior, and 687 00:43:42,800 --> 00:43:46,120 Speaker 1: it really personally did change my life. And four years on, it's, 688 00:43:46,440 --> 00:43:49,520 Speaker 1: you know, its second nature to be taking this medication. 689 00:43:50,120 --> 00:43:52,360 Speaker 1: The times I have tried to go off it have 690 00:43:52,440 --> 00:43:56,960 Speaker 1: been fucking horrendous, like dizziness, irritation, nausea, and you know, 691 00:43:57,000 --> 00:44:00,200 Speaker 1: sometimes I do worry that I will be dep it 692 00:44:00,239 --> 00:44:02,200 Speaker 1: my whole life, but I think I'm honestly a little 693 00:44:02,200 --> 00:44:05,160 Speaker 1: bit scared of who I'll be without it. And you know, 694 00:44:05,200 --> 00:44:07,120 Speaker 1: when the time is right, I'll try it again and 695 00:44:07,160 --> 00:44:10,759 Speaker 1: I'll see what happens. But it's definitely something to be 696 00:44:10,840 --> 00:44:13,360 Speaker 1: discussed before you go on it. It's not something that 697 00:44:13,400 --> 00:44:19,120 Speaker 1: you go on to temporarily relieve your hopelessness or your sadness. 698 00:44:19,680 --> 00:44:23,359 Speaker 1: It's like a two year thing kind of minimum. And 699 00:44:23,400 --> 00:44:27,520 Speaker 1: it's widely believed that these medical interventions they work best 700 00:44:27,640 --> 00:44:33,000 Speaker 1: when combined with some kind of talking therapy, one that 701 00:44:33,160 --> 00:44:36,319 Speaker 1: really gets to the core of how you're processing your 702 00:44:36,360 --> 00:44:39,040 Speaker 1: reality and the nature of your thoughts. Like we always 703 00:44:39,040 --> 00:44:42,799 Speaker 1: say on the show, a problem spoken out loud is 704 00:44:42,920 --> 00:44:46,680 Speaker 1: half the problem. So the two types that are most prominent, 705 00:44:46,719 --> 00:44:50,440 Speaker 1: I would say are cognitive behavioral therapy CBT if you've 706 00:44:50,440 --> 00:44:54,319 Speaker 1: heard of that before, and interpersonal therapy. So we're going 707 00:44:54,400 --> 00:44:58,400 Speaker 1: to start with cognitive behavioral therapy. It is perhaps the 708 00:44:58,440 --> 00:45:03,080 Speaker 1: most widely practiced and effective form of psychotherapy, and it 709 00:45:03,160 --> 00:45:07,440 Speaker 1: operates on the principle that our thoughts, our beliefs, our feelings, 710 00:45:07,920 --> 00:45:12,239 Speaker 1: and therefore our behaviors are interconnected, and by identifying and 711 00:45:12,400 --> 00:45:17,880 Speaker 1: challenging negative or distorted thought patterns, we bring about positive 712 00:45:17,960 --> 00:45:22,440 Speaker 1: changes and our emotions and our actions. Interpersonal therapy is 713 00:45:22,480 --> 00:45:26,080 Speaker 1: a bit different, and it's a time limited form of psychotherapy. 714 00:45:26,400 --> 00:45:30,960 Speaker 1: Once again. Psychotherapy is also known as kind of talking therapy, 715 00:45:31,000 --> 00:45:36,280 Speaker 1: and it centers on improving our personal relationships and addressing 716 00:45:36,760 --> 00:45:40,719 Speaker 1: the emotional issues within that context that may be contributing 717 00:45:41,040 --> 00:45:44,240 Speaker 1: to how we're feeling. I think by exploring our past 718 00:45:44,400 --> 00:45:49,440 Speaker 1: or current relationships, even by exploring our attachment style, our communication, 719 00:45:50,160 --> 00:45:54,759 Speaker 1: life transitions as well, we can really gain these insights 720 00:45:54,840 --> 00:45:59,520 Speaker 1: into how these discrete aspects of our lives are actually 721 00:45:59,560 --> 00:46:04,680 Speaker 1: influenced seeing our deeper emotional wellbeing. But I want to 722 00:46:04,719 --> 00:46:09,040 Speaker 1: talk about some of the more experimental incoming treatments as well, 723 00:46:09,120 --> 00:46:15,040 Speaker 1: because treatment for depression, specifically major depressive disorder, has stayed 724 00:46:15,080 --> 00:46:18,839 Speaker 1: relatively the same for the last two decades, but we 725 00:46:18,880 --> 00:46:22,280 Speaker 1: are seeing a lot of new presentations and rising rates 726 00:46:22,680 --> 00:46:25,319 Speaker 1: and that's made a lot of scientists and researchers really 727 00:46:25,400 --> 00:46:28,799 Speaker 1: question whether we could be doing better. You know, back 728 00:46:28,800 --> 00:46:32,799 Speaker 1: in the day, Freud used to treat his patients with cocaine, 729 00:46:33,200 --> 00:46:35,560 Speaker 1: and it seems like we're coming back full circle with 730 00:46:35,880 --> 00:46:38,840 Speaker 1: the introduction of what we would typically see as illicit 731 00:46:39,040 --> 00:46:43,319 Speaker 1: substances like ketamine or LSD now being used in a 732 00:46:43,360 --> 00:46:47,759 Speaker 1: clinical medical setting. So you've probably heard about this, but 733 00:46:47,800 --> 00:46:50,720 Speaker 1: I want to clear it up. No doctor is going 734 00:46:50,760 --> 00:46:54,680 Speaker 1: to hand you over a bag of whatever drug and 735 00:46:54,760 --> 00:46:56,799 Speaker 1: sago nuts. They're not going to ask you to go 736 00:46:56,840 --> 00:47:00,520 Speaker 1: and source it for yourself. It is highly regulated, highly detected. 737 00:47:01,040 --> 00:47:06,480 Speaker 1: In twenty nineteen, the US actually approved ketamine based nasal 738 00:47:06,520 --> 00:47:10,560 Speaker 1: spray for the first time, but it's very much used 739 00:47:10,600 --> 00:47:13,560 Speaker 1: for specific cases. You know, when We're dealing with addictive 740 00:47:13,640 --> 00:47:16,759 Speaker 1: drugs that have been proven to be very destructive, and 741 00:47:16,760 --> 00:47:19,279 Speaker 1: now we're trying to leverage them for something productive. You've 742 00:47:19,280 --> 00:47:22,680 Speaker 1: really got to be cautious, you know, especially around there, 743 00:47:23,280 --> 00:47:27,840 Speaker 1: you know the propensity or the risk for substance abuse. 744 00:47:28,400 --> 00:47:31,080 Speaker 1: I want to explain why it may work though. With 745 00:47:31,280 --> 00:47:37,880 Speaker 1: most medications, like valium or even lexopo or an SSRI, 746 00:47:38,760 --> 00:47:42,640 Speaker 1: the antidepressive or anti anxiety effect is only going to 747 00:47:43,000 --> 00:47:47,200 Speaker 1: last when that drug is in your system. When the 748 00:47:47,280 --> 00:47:51,200 Speaker 1: valium goes away, when the SSRI goes away, you're going 749 00:47:51,239 --> 00:47:54,840 Speaker 1: to get rebound anxiety or some kind of withdrawal. But 750 00:47:54,960 --> 00:47:58,520 Speaker 1: when you take ketamine, it actually triggers reactions in your 751 00:47:58,560 --> 00:48:04,280 Speaker 1: cortex that enable brain connections to regrow. It's the reaction 752 00:48:04,440 --> 00:48:07,240 Speaker 1: to ketemine, not the presence of ketamine in the body, 753 00:48:07,280 --> 00:48:11,160 Speaker 1: that constitutes its effect. Most of the research has been 754 00:48:11,160 --> 00:48:15,080 Speaker 1: coming out of Yale, and the responses and the findings 755 00:48:15,719 --> 00:48:19,440 Speaker 1: have been genuinely mind blowing, especially when we think about 756 00:48:19,440 --> 00:48:22,239 Speaker 1: how stagnant some of the research on depression has been 757 00:48:22,280 --> 00:48:25,240 Speaker 1: for quite some time. They've done a number of studies, 758 00:48:25,239 --> 00:48:29,279 Speaker 1: as has John Hopkins as well, and in one in particular, 759 00:48:29,440 --> 00:48:33,359 Speaker 1: more than half of the participants who were administered this 760 00:48:33,480 --> 00:48:39,040 Speaker 1: nasal ketamine spray showed a significant decrease in depressive symptoms 761 00:48:39,080 --> 00:48:44,120 Speaker 1: after just twenty four hours. These are patients who felt 762 00:48:44,280 --> 00:48:49,560 Speaker 1: no meaningful improvement on other antidepressant medications or through other 763 00:48:49,680 --> 00:48:53,520 Speaker 1: forms of therapy. And I think that's just so life changing. 764 00:48:53,560 --> 00:48:57,719 Speaker 1: I can't even imagine how profound that would be. Then, 765 00:48:57,760 --> 00:49:02,600 Speaker 1: we also have psychedelics, particularly psilocybin, so that's more commonly 766 00:49:02,880 --> 00:49:06,160 Speaker 1: known as you know, well magic mushrooms essentially, and it's 767 00:49:06,360 --> 00:49:11,600 Speaker 1: Psilocybin is the active ingredient in this recreational drug, and 768 00:49:11,640 --> 00:49:16,000 Speaker 1: it's a hallucinogen. It changes the brain's response to a 769 00:49:16,080 --> 00:49:19,080 Speaker 1: chemical in our brain which you may have already guessed 770 00:49:19,080 --> 00:49:23,239 Speaker 1: it it's serotonin. And when broken down, when psilocybin is 771 00:49:23,280 --> 00:49:28,000 Speaker 1: broken down, it causes an altered state of consciousness and perception. 772 00:49:28,600 --> 00:49:32,120 Speaker 1: And what this does is cause our brains to use 773 00:49:32,280 --> 00:49:38,160 Speaker 1: different neural pathways as it processes this substance, essentially opening 774 00:49:38,239 --> 00:49:41,880 Speaker 1: us up to experiences, connecting us to our surroundings and 775 00:49:41,920 --> 00:49:47,440 Speaker 1: triggering an alerted or mild, you know, mild to severe 776 00:49:48,120 --> 00:49:54,000 Speaker 1: hallucinogenic state when we experience chronic depression. This can often 777 00:49:54,640 --> 00:49:58,000 Speaker 1: reduce neuroplasticity, and it causes us to feel very stuck. 778 00:49:58,360 --> 00:50:01,920 Speaker 1: That's where that hopelessness and that's sadness comes from. But 779 00:50:02,000 --> 00:50:05,840 Speaker 1: psychedelics do the opposite. They really encourage the growth of 780 00:50:05,840 --> 00:50:10,439 Speaker 1: new connections through this hallucinogenic effect of expanding the way 781 00:50:10,440 --> 00:50:16,520 Speaker 1: our neurons fire. Now, once again a very clear disclaimer here, 782 00:50:17,160 --> 00:50:20,120 Speaker 1: this is not stuff that you would buy on I 783 00:50:20,120 --> 00:50:22,960 Speaker 1: don't know, the dark web. This is medication that is 784 00:50:23,000 --> 00:50:28,680 Speaker 1: being severely and cautiously vetted and administered in a clinical setting. 785 00:50:29,239 --> 00:50:32,520 Speaker 1: And in one study, a single dose of a synthetic 786 00:50:32,600 --> 00:50:37,040 Speaker 1: version of this component of magic mushrooms it improved depression 787 00:50:37,120 --> 00:50:40,680 Speaker 1: in people with what we would call a treatment resistant 788 00:50:40,840 --> 00:50:45,359 Speaker 1: form of the condition. And importantly, what's really valuable when 789 00:50:45,400 --> 00:50:50,680 Speaker 1: we are studying new treatments, particularly new medical interventions, is 790 00:50:50,840 --> 00:50:54,000 Speaker 1: whether the study was double blind, so meaning neither the 791 00:50:54,040 --> 00:50:57,880 Speaker 1: participants or the researchers knew which one of the trial 792 00:50:58,000 --> 00:51:02,600 Speaker 1: patients was actually received the drug. So this helps eliminate 793 00:51:02,680 --> 00:51:07,040 Speaker 1: things like placebo effect, which we know can be quite common. 794 00:51:07,080 --> 00:51:09,839 Speaker 1: And I think the other interest in psychedelics is that 795 00:51:10,440 --> 00:51:15,680 Speaker 1: psilocybin or even LSD. According to some statements some opinions, 796 00:51:16,280 --> 00:51:19,959 Speaker 1: it doesn't really have the abuse potential in the same 797 00:51:20,040 --> 00:51:25,840 Speaker 1: fashion as things like cocaine or opioids, or alcohol or nicotine. However, 798 00:51:25,880 --> 00:51:28,600 Speaker 1: there is still so much that we don't know, so 799 00:51:29,400 --> 00:51:32,200 Speaker 1: I think for now it's best to stick to the 800 00:51:32,239 --> 00:51:37,120 Speaker 1: approved therapies that are recommended by a licensed professional talking 801 00:51:37,160 --> 00:51:43,759 Speaker 1: therapy an antidepressant. I think that it's such fascinating research. 802 00:51:43,840 --> 00:51:47,760 Speaker 1: I think that people who use these drugs recreationally before 803 00:51:47,800 --> 00:51:53,279 Speaker 1: they started undergoing scientific testing have regularly said that this 804 00:51:53,360 --> 00:51:56,800 Speaker 1: is an impact and an influence that they personally experience 805 00:51:56,880 --> 00:52:00,120 Speaker 1: outside of a medical setting. So I'm very excited to 806 00:52:00,160 --> 00:52:01,840 Speaker 1: see where that goes. You know, I can't speak to 807 00:52:01,880 --> 00:52:04,320 Speaker 1: this personally, but what I do kind of want to 808 00:52:04,360 --> 00:52:07,160 Speaker 1: finish on is kind of where I'm at now. Given 809 00:52:07,239 --> 00:52:09,920 Speaker 1: we've had this broader overview, I think I want to 810 00:52:09,920 --> 00:52:12,759 Speaker 1: take some time to reflect on, you know, where that 811 00:52:12,800 --> 00:52:15,000 Speaker 1: knowledge kind of leaves us. If you're someone who is 812 00:52:15,080 --> 00:52:18,319 Speaker 1: experiencing depression, what can you really take from that? But 813 00:52:18,360 --> 00:52:21,799 Speaker 1: what can you really take from my experience? I think 814 00:52:21,840 --> 00:52:24,720 Speaker 1: I'm at this point, I've said this before, where I'm 815 00:52:24,760 --> 00:52:27,759 Speaker 1: really seeking to manage and not to cure. It's kind 816 00:52:27,800 --> 00:52:30,839 Speaker 1: of this really stoic perspective where I'm like, you know what, 817 00:52:31,040 --> 00:52:34,880 Speaker 1: this is my reality, and you know, sadly, there is 818 00:52:34,920 --> 00:52:37,560 Speaker 1: not some switch that's going to change how my brain operates. 819 00:52:38,000 --> 00:52:40,799 Speaker 1: I've just got to accept it. Also, you know, a 820 00:52:40,840 --> 00:52:44,239 Speaker 1: final misconception that I really wanted to bunk is that 821 00:52:44,440 --> 00:52:47,680 Speaker 1: it's not as if my life is devoid of happiness. 822 00:52:47,760 --> 00:52:50,120 Speaker 1: You know, I have really happy moments. I have an 823 00:52:50,160 --> 00:52:53,880 Speaker 1: amazing family, incredible friends. I'm super grateful, and I do 824 00:52:53,960 --> 00:52:57,120 Speaker 1: get to experience a lot of joy very readily, very rapidly. 825 00:52:57,960 --> 00:53:02,400 Speaker 1: Depression is not just the absence of any feeling but sadness. 826 00:53:02,400 --> 00:53:05,640 Speaker 1: It's not just sadness. It's more complicated than that. And 827 00:53:05,680 --> 00:53:08,399 Speaker 1: I don't want people to think that that's all there 828 00:53:08,440 --> 00:53:11,040 Speaker 1: is to a person, and then it will come to 829 00:53:11,080 --> 00:53:13,000 Speaker 1: define them. You know, I'm a good friend, I have 830 00:53:13,080 --> 00:53:16,480 Speaker 1: hobbies and passions, I love, I'm productive and I do 831 00:53:16,560 --> 00:53:21,360 Speaker 1: things with a lot of love. I still feel incredibly deeply, 832 00:53:21,400 --> 00:53:24,040 Speaker 1: and I have dreams and goals. It's just that sometimes 833 00:53:24,480 --> 00:53:28,200 Speaker 1: those things seem less clear to me. It doesn't mean 834 00:53:28,320 --> 00:53:30,880 Speaker 1: that they're not there. I still think we face a 835 00:53:30,880 --> 00:53:33,600 Speaker 1: lot of stigma. But it's so surprising that when you 836 00:53:33,640 --> 00:53:36,560 Speaker 1: start having these conversations, you'll realize that every single one 837 00:53:36,600 --> 00:53:41,440 Speaker 1: of us knows someone in some capacity who is experiencing 838 00:53:41,680 --> 00:53:46,520 Speaker 1: something very very similar. And that sense of not community, 839 00:53:46,560 --> 00:53:50,240 Speaker 1: but that sense of not going at it alone, really 840 00:53:51,000 --> 00:53:54,520 Speaker 1: is quite powerful for me. Depression can make you feel 841 00:53:55,000 --> 00:53:57,680 Speaker 1: quite selfishly like you're the only person in the world, 842 00:53:58,080 --> 00:54:02,200 Speaker 1: like you're the only person who is this sad and 843 00:54:02,200 --> 00:54:05,239 Speaker 1: this miserable, And although you don't want other people in 844 00:54:05,280 --> 00:54:07,239 Speaker 1: the boat with you, you don't want to acknowledge that 845 00:54:07,280 --> 00:54:09,600 Speaker 1: maybe they're going through the same thing. You know you 846 00:54:09,640 --> 00:54:13,040 Speaker 1: can't change that, And sometimes having an open line of 847 00:54:13,080 --> 00:54:17,840 Speaker 1: communication and open discussions about this are so valuable. So 848 00:54:17,920 --> 00:54:21,280 Speaker 1: I really want to thank you for listening to today's episode. 849 00:54:21,320 --> 00:54:23,480 Speaker 1: It was definitely a vulnerable one, I know. So if 850 00:54:23,480 --> 00:54:26,680 Speaker 1: you're still with us, I hope that you're feeling very 851 00:54:26,760 --> 00:54:30,359 Speaker 1: knowledgeable and you're feeling very optimistic, and if you're here 852 00:54:30,440 --> 00:54:33,680 Speaker 1: for someone you know and someone you love, I promise 853 00:54:34,120 --> 00:54:35,799 Speaker 1: it's not as hard as you think to take care 854 00:54:35,840 --> 00:54:38,680 Speaker 1: of those who you care about. I know it can 855 00:54:38,760 --> 00:54:41,040 Speaker 1: feel like you might say the wrong thing or do 856 00:54:41,160 --> 00:54:43,719 Speaker 1: the wrong thing, but as long as you're showing up 857 00:54:43,800 --> 00:54:46,440 Speaker 1: and you're asking how you can help, you're sending the 858 00:54:46,480 --> 00:54:49,399 Speaker 1: occasional message just seeing how they're doing, if they need 859 00:54:49,440 --> 00:54:52,560 Speaker 1: to talk. You're really doing a lot more than most. 860 00:54:52,600 --> 00:54:55,560 Speaker 1: You're doing the right thing. I promise that even listening 861 00:54:55,640 --> 00:54:57,640 Speaker 1: to this is one step in the right direction. It's 862 00:54:57,680 --> 00:55:01,440 Speaker 1: still such an unknown I don't want to say disease, 863 00:55:01,640 --> 00:55:06,560 Speaker 1: such an unknown condition. Despite all of that historical knowledge 864 00:55:06,600 --> 00:55:10,280 Speaker 1: that we realistically should have, there is so much about 865 00:55:10,280 --> 00:55:13,960 Speaker 1: it that is not understood, not just from a scientific perspective, 866 00:55:14,040 --> 00:55:18,000 Speaker 1: but from a general societal perspective. But I hope that 867 00:55:18,040 --> 00:55:21,600 Speaker 1: we're taking steps in the right direction. And I'm going 868 00:55:21,680 --> 00:55:24,800 Speaker 1: to list some really fascinating studies that we talked about 869 00:55:24,840 --> 00:55:27,960 Speaker 1: in this episode in the description, as well as some 870 00:55:28,080 --> 00:55:31,840 Speaker 1: resources for when you can get further help, further information. 871 00:55:32,600 --> 00:55:34,239 Speaker 1: You know, it's a tough time in our twenties, and 872 00:55:34,280 --> 00:55:36,719 Speaker 1: it's a bit tougher when you've got this kind of 873 00:55:36,960 --> 00:55:39,279 Speaker 1: like we say, black cloud over our heads. But I 874 00:55:39,360 --> 00:55:42,200 Speaker 1: promise it's someone who's gone through it as well. There 875 00:55:42,280 --> 00:55:46,399 Speaker 1: is so many good things coming and hard times as well, 876 00:55:46,440 --> 00:55:50,040 Speaker 1: but you'll be able to approach them a lot better. 877 00:55:50,239 --> 00:55:52,440 Speaker 1: A lot better, So I want to thank you for listening. 878 00:55:52,920 --> 00:55:55,399 Speaker 1: If you enjoyed this episode, please feel free to leave 879 00:55:55,440 --> 00:55:58,560 Speaker 1: a five star review on Apple Podcasts, Spotify, wherever you're 880 00:55:58,560 --> 00:56:01,799 Speaker 1: listening right now, and maybe your friend needs to hear this, 881 00:56:02,080 --> 00:56:04,279 Speaker 1: feel free to share it with them. I would really 882 00:56:04,280 --> 00:56:07,680 Speaker 1: appreciate that as well. If you have an episode suggestion, 883 00:56:07,800 --> 00:56:09,200 Speaker 1: or you want to get in touch. If you like 884 00:56:09,280 --> 00:56:13,040 Speaker 1: this episode or have some feedback, please follow me at 885 00:56:13,120 --> 00:56:16,759 Speaker 1: that Psychology podcast on Instagram. I love receiving messages from 886 00:56:16,840 --> 00:56:19,480 Speaker 1: you and seeing the community grow. So I want to 887 00:56:19,520 --> 00:56:21,800 Speaker 1: thank you for listening to this episode. I hope you 888 00:56:21,920 --> 00:56:24,719 Speaker 1: learned something. I'm glad you're here, and we will be 889 00:56:24,800 --> 00:56:28,680 Speaker 1: back next week for another episode.