1 00:00:04,559 --> 00:00:07,960 Speaker 1: Hello everybody. I'm Jemma Spake and welcome back to the 2 00:00:07,960 --> 00:00:11,280 Speaker 1: Psychology of Your Twenties, the podcast where we talk through 3 00:00:11,320 --> 00:00:16,000 Speaker 1: the biggest changes, moments, and transitions of our twenties and 4 00:00:16,040 --> 00:00:26,040 Speaker 1: what they mean for our psychology. Hello everybody, Welcome back 5 00:00:26,079 --> 00:00:28,880 Speaker 1: to the show. Welcome back to the podcast. It is 6 00:00:28,880 --> 00:00:32,360 Speaker 1: so great to have you here back for another episode. Today, 7 00:00:32,760 --> 00:00:35,199 Speaker 1: I have a bonus episode for you guys, and if 8 00:00:35,240 --> 00:00:37,960 Speaker 1: you are new around here, let me tell you about 9 00:00:37,960 --> 00:00:43,519 Speaker 1: our bonus episode. So our bonus episodes are our little shorter, sharper, 10 00:00:44,200 --> 00:00:48,200 Speaker 1: more focused episodes that we do on a singular term, 11 00:00:48,360 --> 00:00:52,000 Speaker 1: a singular theory, a singular idea that you may have 12 00:00:52,080 --> 00:00:55,880 Speaker 1: heard thrown around to do with psychology, to do with 13 00:00:55,920 --> 00:01:00,800 Speaker 1: mental health, something that gets a lot of traction online, 14 00:01:01,000 --> 00:01:04,600 Speaker 1: but perhaps you never see properly discussed. This is like 15 00:01:04,680 --> 00:01:07,640 Speaker 1: my chance to just dive into the research for you 16 00:01:07,680 --> 00:01:11,920 Speaker 1: guys and for myself. And today we have a significant one. 17 00:01:12,360 --> 00:01:16,600 Speaker 1: We are talking about the theory that depression is just 18 00:01:16,760 --> 00:01:21,440 Speaker 1: a chemical imbalance. Is that really true or is it 19 00:01:21,560 --> 00:01:25,520 Speaker 1: a little bit too simple? A lot of how we 20 00:01:26,080 --> 00:01:33,000 Speaker 1: approach depression, think about depression is based on this biological model, 21 00:01:33,240 --> 00:01:36,000 Speaker 1: but there are definitely parts of it that are no 22 00:01:36,040 --> 00:01:38,720 Speaker 1: longer accurate and that we know are no longer accurate 23 00:01:39,160 --> 00:01:43,399 Speaker 1: as we kind of gain more medical understanding. So that 24 00:01:43,560 --> 00:01:46,360 Speaker 1: is what we are going to talk about today. A 25 00:01:46,480 --> 00:01:50,760 Speaker 1: quick disclaimer, please do not take this as medical advice. 26 00:01:51,440 --> 00:01:54,520 Speaker 1: A lot of our discussion today does have implications for 27 00:01:54,560 --> 00:01:58,840 Speaker 1: things like antidepressants. I'm on antidepressants. I literally just took 28 00:01:58,880 --> 00:02:01,920 Speaker 1: my like five minutes go. They help me. I will 29 00:02:01,960 --> 00:02:05,680 Speaker 1: continue to stay on them, and I do believe they work. 30 00:02:07,800 --> 00:02:10,120 Speaker 1: You know, some articles that we're going to cite today 31 00:02:10,600 --> 00:02:13,560 Speaker 1: are skeptical of that, but as always, you know, what 32 00:02:13,720 --> 00:02:17,000 Speaker 1: works for you might not work for everyone. If you 33 00:02:17,080 --> 00:02:20,799 Speaker 1: are on antidepressants, if you are considering it, always talk 34 00:02:20,840 --> 00:02:24,520 Speaker 1: to your doctor before starting or stopping this kind of medication. 35 00:02:25,120 --> 00:02:27,680 Speaker 1: Just want to put that in here, because yeah, you know, 36 00:02:27,720 --> 00:02:30,920 Speaker 1: this discussion does have some big implications for that, and 37 00:02:30,919 --> 00:02:34,400 Speaker 1: I don't want anybody to be making rash decisions around 38 00:02:34,639 --> 00:02:38,520 Speaker 1: thirty minutes of audio. So with that being said, let's 39 00:02:38,520 --> 00:02:41,440 Speaker 1: get into it, starting with what do we actually mean 40 00:02:41,520 --> 00:02:47,680 Speaker 1: by depression is a chemical imbalance? This is widely believed 41 00:02:47,680 --> 00:02:50,840 Speaker 1: to be to be quite an outdated description actually these 42 00:02:50,919 --> 00:02:53,880 Speaker 1: days and yet it is still used all the time. 43 00:02:53,919 --> 00:02:57,760 Speaker 1: But when people say this, what they actually mean is 44 00:02:58,400 --> 00:03:02,200 Speaker 1: the idea that depression and happens because your brain doesn't 45 00:03:02,240 --> 00:03:09,960 Speaker 1: have enough of certain neurotransmitters, especially serotonin, and therefore increasing 46 00:03:10,000 --> 00:03:15,040 Speaker 1: the balance or the level of that neurotransmitter will correct 47 00:03:15,120 --> 00:03:19,720 Speaker 1: the deficiency and will eliminate depression. Neurotransmitters just for a 48 00:03:19,960 --> 00:03:25,240 Speaker 1: very quick biological refresh. Other brains chemical messengers, your brain cells, 49 00:03:25,280 --> 00:03:28,160 Speaker 1: your neurons. They don't actually touch each other directly. They 50 00:03:28,160 --> 00:03:33,320 Speaker 1: communicate across these tiny gaps to stop electrical signals from 51 00:03:33,600 --> 00:03:37,320 Speaker 1: interrupting each other. And the things that pass through those 52 00:03:37,360 --> 00:03:41,240 Speaker 1: gaps and pass on messages are your neurotransmitters. So they 53 00:03:41,240 --> 00:03:47,960 Speaker 1: influence everything from mood to motivation, sleep, appetite, attention, stress response, 54 00:03:48,240 --> 00:03:50,840 Speaker 1: everything that is going on in your body at any 55 00:03:50,840 --> 00:03:55,160 Speaker 1: given moment. As I've mentioned, one transmitter you will hear 56 00:03:55,480 --> 00:04:00,360 Speaker 1: constantly in these conversations is serotonin. Serotonin is a chemical 57 00:04:00,400 --> 00:04:03,800 Speaker 1: messenger involved in so many processes. I think a lot 58 00:04:03,840 --> 00:04:06,240 Speaker 1: of people just think of it as the happiness drug 59 00:04:06,360 --> 00:04:10,280 Speaker 1: or the happiness chemical, but it affects everything from mood 60 00:04:10,360 --> 00:04:14,840 Speaker 1: to sleep, to appetite to emotional regulation. Those things have 61 00:04:14,960 --> 00:04:18,120 Speaker 1: a correlation with happiness, which is why yeah it or 62 00:04:18,240 --> 00:04:21,320 Speaker 1: gets yeah, it's why it gets that simplistic definition of 63 00:04:21,360 --> 00:04:24,479 Speaker 1: like this is the happy chemical or dopamine often gets 64 00:04:24,480 --> 00:04:27,880 Speaker 1: cided as that as well for the same reasons. So 65 00:04:27,960 --> 00:04:32,359 Speaker 1: this is how the biological story of depression came to be. 66 00:04:33,240 --> 00:04:41,800 Speaker 1: Serotonin controls mood. Mood controls happiness. Depressed people aren't happy, Therefore, 67 00:04:41,960 --> 00:04:45,200 Speaker 1: working in reverse, someone who is unhappy and with the 68 00:04:45,240 --> 00:04:51,520 Speaker 1: low mood must have disturbances in serotonin. Therefore, artificially changing 69 00:04:51,600 --> 00:04:57,960 Speaker 1: or influencing serotonin availability will improve depression. Because this is, 70 00:04:58,160 --> 00:05:00,560 Speaker 1: at the end of the day, just a bio logical 71 00:05:00,680 --> 00:05:05,520 Speaker 1: shortage problem. When did this theory actually first come to be? 72 00:05:05,520 --> 00:05:08,400 Speaker 1: Because I feel like now it's just taken for granted. 73 00:05:08,440 --> 00:05:11,240 Speaker 1: I was literally like my dad says this all the time, 74 00:05:11,279 --> 00:05:14,599 Speaker 1: like it's just a chemical imbalance. We just take it 75 00:05:14,600 --> 00:05:17,919 Speaker 1: for granted, whether it is correct or not. To understand this, 76 00:05:18,000 --> 00:05:20,560 Speaker 1: you have to look back to the fifties and sixties 77 00:05:21,040 --> 00:05:25,600 Speaker 1: when there was this huge medical push to basically create 78 00:05:25,640 --> 00:05:29,599 Speaker 1: a drug for every condition, and doctors started noticing during 79 00:05:29,600 --> 00:05:33,920 Speaker 1: this process kind of by accident, that certain drugs developed 80 00:05:33,920 --> 00:05:38,200 Speaker 1: for completely different reasons were affecting mood. Drugs for like 81 00:05:38,440 --> 00:05:43,400 Speaker 1: what treatment, drugs for epilepsy, drugs for hair growth, just 82 00:05:43,400 --> 00:05:46,040 Speaker 1: like anything you can think of. They started noticing that 83 00:05:46,200 --> 00:05:49,120 Speaker 1: it was also changing how people felt. There was a 84 00:05:49,200 --> 00:05:54,760 Speaker 1: really notable review paper from this man called Shinderkraut in 85 00:05:54,839 --> 00:05:58,279 Speaker 1: nineteen sixty five, who was kind of the first one 86 00:05:58,320 --> 00:06:03,160 Speaker 1: to be like, hey, maybe this is saying something, Maybe 87 00:06:03,400 --> 00:06:08,480 Speaker 1: some depressions could be linked to a deficiency in certain chemicals. 88 00:06:08,560 --> 00:06:13,239 Speaker 1: And he concluded this based on his study of animals alone, 89 00:06:13,279 --> 00:06:16,240 Speaker 1: because back then this theory was quite an experimental one 90 00:06:16,279 --> 00:06:18,760 Speaker 1: that he was doing. And also that's normally the first 91 00:06:18,800 --> 00:06:23,680 Speaker 1: stage of any theory that wants to have like pharmaceutical implications, 92 00:06:23,720 --> 00:06:27,640 Speaker 1: like you test on animals. But at that time, like 93 00:06:27,680 --> 00:06:30,239 Speaker 1: I said, it was not controversial, it was just different. 94 00:06:30,400 --> 00:06:33,799 Speaker 1: It was just a different idea, And so it led 95 00:06:34,000 --> 00:06:39,159 Speaker 1: researchers to focus on one group of neurotransmitters in particular 96 00:06:39,640 --> 00:06:47,080 Speaker 1: called monoamines. Monoamine monoamines, I should say plural is just 97 00:06:47,200 --> 00:06:52,920 Speaker 1: a class of neurotransmitters that include things like serotonin, like neuropinephrine, 98 00:06:53,279 --> 00:06:56,400 Speaker 1: and like dopamine, And they concentrated on all those as 99 00:06:56,520 --> 00:07:02,880 Speaker 1: kind of one. In a way, this became the monamine hypothesis. 100 00:07:02,920 --> 00:07:05,280 Speaker 1: You probably you may have heard about this, but it 101 00:07:05,320 --> 00:07:09,560 Speaker 1: was basically the earliest biological theory of depression. Depression is 102 00:07:09,600 --> 00:07:14,160 Speaker 1: because of a disruption in chemical messenger systems. Fast forward 103 00:07:14,800 --> 00:07:17,760 Speaker 1: over a decade. I guess a decade, yea a decade. 104 00:07:18,280 --> 00:07:25,080 Speaker 1: In nineteen seventy five, the first big, big paper came 105 00:07:25,120 --> 00:07:29,400 Speaker 1: out about a drug called fluoxetine, which is still on 106 00:07:29,440 --> 00:07:32,840 Speaker 1: the market today and worked by it works still by 107 00:07:32,880 --> 00:07:38,600 Speaker 1: increasing serotonin in the brain of rats, of people by 108 00:07:38,880 --> 00:07:44,520 Speaker 1: preventing the reuptake of serotonin. So basically how our brain 109 00:07:45,720 --> 00:07:49,680 Speaker 1: cleans up and gets rid of serotonin that's sitting in 110 00:07:49,720 --> 00:07:52,240 Speaker 1: the signapps. That's like the simple way of putting it. 111 00:07:52,600 --> 00:08:00,920 Speaker 1: This drug became so popular, so popular almost instantly, probably 112 00:08:00,920 --> 00:08:03,480 Speaker 1: because like the other treatments for depression at that time 113 00:08:03,720 --> 00:08:09,560 Speaker 1: were not amazing. They weren't that great. Yeah, they just weren't. 114 00:08:09,600 --> 00:08:13,960 Speaker 1: They weren't great. So prozac floxatine just like hit the 115 00:08:14,000 --> 00:08:21,400 Speaker 1: market running and also started being kind of like recommended 116 00:08:21,440 --> 00:08:24,520 Speaker 1: for heaps of other things. So like, yes, major depressive disorder, 117 00:08:24,560 --> 00:08:30,440 Speaker 1: but then also OCD, panic disorder, eating disorders as well, 118 00:08:30,600 --> 00:08:35,240 Speaker 1: anything that people believed came down to mood and our 119 00:08:35,280 --> 00:08:40,280 Speaker 1: attempts to or inability to regulate our mood or regulate 120 00:08:40,320 --> 00:08:43,480 Speaker 1: things that, you know, any behaviors that we use to 121 00:08:43,520 --> 00:08:46,480 Speaker 1: try and regulate our mood that were becoming problematic or whatever. Like, 122 00:08:46,480 --> 00:08:49,640 Speaker 1: they basically just were like, this is the one you 123 00:08:49,720 --> 00:08:52,040 Speaker 1: just you grab you, you get on this, and you're 124 00:08:52,040 --> 00:08:55,800 Speaker 1: gonna be feeling so much better. So this is when 125 00:08:55,840 --> 00:09:01,600 Speaker 1: the public narrative became that simplified version of depression is 126 00:09:01,640 --> 00:09:05,000 Speaker 1: just a chemical imbalance, because now there was this drug, 127 00:09:05,440 --> 00:09:10,760 Speaker 1: like this cure that could just in their words, like 128 00:09:10,760 --> 00:09:14,120 Speaker 1: eliminate all those dark bad thoughts, like those dark bad 129 00:09:14,160 --> 00:09:17,560 Speaker 1: feelings that people felt a lot of shame towards that 130 00:09:18,160 --> 00:09:22,080 Speaker 1: I guess also yeah, really impairing people. It all came 131 00:09:22,120 --> 00:09:25,880 Speaker 1: down to this really simple equation, there isn't enough of 132 00:09:25,920 --> 00:09:27,920 Speaker 1: this one thing in your brain. We increase it, you 133 00:09:27,960 --> 00:09:31,280 Speaker 1: will feel better. And that's really reassuring to a lot 134 00:09:31,280 --> 00:09:34,680 Speaker 1: of people, and it's easy to deliver. Like in a 135 00:09:34,679 --> 00:09:37,719 Speaker 1: healthcare perspective, you know, if you're a GP, if you're 136 00:09:37,760 --> 00:09:41,440 Speaker 1: a doctor, if you're a psychologist, psychiatrist, whatever, and you've 137 00:09:41,440 --> 00:09:45,040 Speaker 1: got a short amount of time with a patient. You've 138 00:09:45,040 --> 00:09:47,839 Speaker 1: got a waiting room full of people who are really 139 00:09:47,880 --> 00:09:51,720 Speaker 1: struggling this this idea that you can give somebody this 140 00:09:51,840 --> 00:09:55,880 Speaker 1: tablet and that's going to make them feel better. It 141 00:09:55,960 --> 00:09:57,960 Speaker 1: is a great one and it's one that people really 142 00:09:57,960 --> 00:10:00,920 Speaker 1: want to hang on to. Obviously, a two thousand and 143 00:10:00,920 --> 00:10:04,880 Speaker 1: five paper from researchers in the US actually later analyzed 144 00:10:04,920 --> 00:10:09,240 Speaker 1: as well how antidepressants were marketed to the American public 145 00:10:09,800 --> 00:10:13,320 Speaker 1: when they first came out, and they argued that a 146 00:10:13,440 --> 00:10:17,880 Speaker 1: lot of these campaigns really pushed the use of antidepressants 147 00:10:17,920 --> 00:10:23,319 Speaker 1: by basically again using this chemical imbalance message, and that 148 00:10:23,440 --> 00:10:28,080 Speaker 1: marketing was really significant in how a whole generation in 149 00:10:28,120 --> 00:10:30,720 Speaker 1: the generation after that of people including you and me, 150 00:10:31,160 --> 00:10:36,480 Speaker 1: started thinking of this of this condition, started thinking of depression. 151 00:10:36,600 --> 00:10:39,679 Speaker 1: So it wasn't plucked out of thin air, as I said, 152 00:10:39,720 --> 00:10:45,839 Speaker 1: like it all came down to the first really promising 153 00:10:46,480 --> 00:10:51,040 Speaker 1: treatment pathway and why that treatment pathway seemed to work. 154 00:10:51,760 --> 00:10:56,319 Speaker 1: And the thing is, there are literally thousands of randomized 155 00:10:56,360 --> 00:11:02,120 Speaker 1: trials that show antidepressants do work. They do work, they 156 00:11:02,160 --> 00:11:08,880 Speaker 1: beat a placebo on average. But the problem is it 157 00:11:08,960 --> 00:11:11,520 Speaker 1: is not the miracle drug that people think it is 158 00:11:12,320 --> 00:11:15,000 Speaker 1: at least not for everyone, and the effects aren't as 159 00:11:15,080 --> 00:11:18,080 Speaker 1: dramatic as maybe we've been led to believe if we 160 00:11:18,280 --> 00:11:20,880 Speaker 1: kind of average out everybody's response. And this is where 161 00:11:20,880 --> 00:11:26,839 Speaker 1: the skepticism around depression is just a chemical imbalance comes in. Basically, 162 00:11:27,320 --> 00:11:30,320 Speaker 1: a drug is a great safety net, it is life changing, 163 00:11:30,760 --> 00:11:34,880 Speaker 1: but depression is a three four five headed monster and 164 00:11:35,840 --> 00:11:39,320 Speaker 1: taking medication only cuts off one of those heads. So 165 00:11:39,360 --> 00:11:42,319 Speaker 1: our healthcare system does need to be providing more than 166 00:11:42,360 --> 00:11:46,160 Speaker 1: what a biological approach would suggest. You've probably heard of this. 167 00:11:46,240 --> 00:11:50,240 Speaker 1: There has been a major push recently around this prominent 168 00:11:50,320 --> 00:11:55,160 Speaker 1: theory that the reason SSRIs work is basically because they 169 00:11:55,200 --> 00:11:58,360 Speaker 1: are a place ebo. The biological model is not correct. 170 00:11:59,080 --> 00:12:02,400 Speaker 1: It's just the idea that people are doing something for 171 00:12:02,440 --> 00:12:06,160 Speaker 1: their mental health that improves their mental health. I don't 172 00:12:06,160 --> 00:12:11,520 Speaker 1: personally believe that my thoughts about this are complicated. Let's 173 00:12:11,520 --> 00:12:14,520 Speaker 1: just get into the evidence. So this theory really took 174 00:12:14,559 --> 00:12:17,400 Speaker 1: the world by storm with the publication of this big 175 00:12:17,480 --> 00:12:21,120 Speaker 1: paper in twenty eleven that seemed to conclude that in 176 00:12:21,200 --> 00:12:23,679 Speaker 1: most cases, I think their estimate was like, in eighty 177 00:12:23,720 --> 00:12:27,840 Speaker 1: percent of cases, what people are experiencing when their symptoms 178 00:12:27,840 --> 00:12:32,160 Speaker 1: get better by taking an SSRI is purely the belief that, again, 179 00:12:32,200 --> 00:12:37,440 Speaker 1: this medication is doing something that belief influences our perception 180 00:12:37,480 --> 00:12:40,520 Speaker 1: of reality, and that perception and belief is what makes 181 00:12:40,559 --> 00:12:47,280 Speaker 1: us feel better. This study, again was massive, it did 182 00:12:47,320 --> 00:12:50,480 Speaker 1: look at so many people, but a follow up or 183 00:12:50,480 --> 00:12:55,000 Speaker 1: I guess one a prior review showed that it's probably 184 00:12:55,040 --> 00:12:58,520 Speaker 1: a little bit different. It is not that this many 185 00:12:58,559 --> 00:13:04,680 Speaker 1: people are reacting to a placebo effect. It's that the 186 00:13:04,720 --> 00:13:08,640 Speaker 1: real benefit comes and the real benefit can be seen 187 00:13:08,720 --> 00:13:13,760 Speaker 1: based on severity first. So basically, this FDA review found 188 00:13:13,760 --> 00:13:18,480 Speaker 1: that an SSRI offers more noticeable benefits for people with 189 00:13:18,559 --> 00:13:22,320 Speaker 1: more severe depression, who are more likely to have a 190 00:13:22,400 --> 00:13:27,440 Speaker 1: larger biological component, compared to people with milder presentations who 191 00:13:27,480 --> 00:13:30,880 Speaker 1: may still have a biological component, but perhaps their depression 192 00:13:30,960 --> 00:13:34,880 Speaker 1: is coming down to other things, and for them a 193 00:13:34,920 --> 00:13:40,040 Speaker 1: placebo and an SSRI, the fake version and the real 194 00:13:40,160 --> 00:13:44,360 Speaker 1: version might impact behavior and impact how they feel in 195 00:13:44,480 --> 00:13:49,560 Speaker 1: similar ways. They also found that the reason why this 196 00:13:49,720 --> 00:13:53,920 Speaker 1: is the case is because an SSRI isn't always acting 197 00:13:53,960 --> 00:13:58,320 Speaker 1: directly on our mood. It's affecting things that are going 198 00:13:58,360 --> 00:14:03,280 Speaker 1: to impact mood down the line. So another trial from 199 00:14:03,280 --> 00:14:07,400 Speaker 1: twenty nineteen shows this really well. It looked at cetraleine 200 00:14:08,040 --> 00:14:11,880 Speaker 1: cetraline for depressive symptoms and it found that in the 201 00:14:11,920 --> 00:14:16,160 Speaker 1: first six weeks, like in under six weeks, if somebody 202 00:14:16,280 --> 00:14:20,720 Speaker 1: was like, I feel amazing, it probably wasn't because of 203 00:14:20,720 --> 00:14:24,720 Speaker 1: a biological of an immediate biological impact on serotonin levels. 204 00:14:25,480 --> 00:14:28,640 Speaker 1: It was more so because it affected how they were 205 00:14:28,680 --> 00:14:33,480 Speaker 1: able to sleep, It affected a sense of control over 206 00:14:33,960 --> 00:14:39,680 Speaker 1: the depressive symptoms, It affected energy levels, It affected, yeah, 207 00:14:39,720 --> 00:14:42,880 Speaker 1: their mindset, especially in that in that first part. What 208 00:14:43,000 --> 00:14:46,360 Speaker 1: this is really coming down to, like the placebo effect, 209 00:14:46,480 --> 00:14:49,720 Speaker 1: let's be real, is probably real for some people, like 210 00:14:49,800 --> 00:14:53,640 Speaker 1: it probably is real, but not for everyone. And it's 211 00:14:53,760 --> 00:14:58,240 Speaker 1: not just the placebo effect that's having an impact. That 212 00:14:58,400 --> 00:15:01,960 Speaker 1: is one part of perhaps some people's experience with SSRIs, 213 00:15:02,280 --> 00:15:04,880 Speaker 1: but it's also the fact that even if this drug 214 00:15:05,000 --> 00:15:10,000 Speaker 1: doesn't act directly on happiness or directly on mood, it 215 00:15:10,040 --> 00:15:13,320 Speaker 1: does act on all these other things that do make 216 00:15:13,360 --> 00:15:16,360 Speaker 1: people feel better. And that if you have and I 217 00:15:16,400 --> 00:15:19,400 Speaker 1: hate to say, like I hate to say mild depression, 218 00:15:19,640 --> 00:15:21,440 Speaker 1: but that's kind of the clinical term. If you have 219 00:15:21,560 --> 00:15:25,080 Speaker 1: mild depression, right, those things may be contributing more to 220 00:15:25,160 --> 00:15:30,320 Speaker 1: your hopelessness and your sadness and your depressed state, then 221 00:15:30,360 --> 00:15:33,240 Speaker 1: we think, and so taking those out and influencing them 222 00:15:33,720 --> 00:15:37,800 Speaker 1: is what's making us feel better. Let's discuss this a 223 00:15:37,800 --> 00:15:40,720 Speaker 1: little bit more, because I do have a problem with 224 00:15:40,760 --> 00:15:45,080 Speaker 1: this theory. I have a big problem whether a drug 225 00:15:45,200 --> 00:15:48,120 Speaker 1: is a plus ebo or not. Obviously, it is important 226 00:15:48,160 --> 00:15:50,800 Speaker 1: because you don't want to put people on medications that 227 00:15:50,840 --> 00:15:53,080 Speaker 1: are going to do that could impact them in other 228 00:15:53,120 --> 00:15:56,680 Speaker 1: ways if they literally aren't impacting the primary symptom. But 229 00:15:57,400 --> 00:15:59,960 Speaker 1: what I will say is that if it works for 230 00:16:00,160 --> 00:16:05,360 Speaker 1: people who otherwise feel hopeless, is that really a bad thing? 231 00:16:06,440 --> 00:16:10,960 Speaker 1: You know, thoughts are powerful. Taking a medication that impacts 232 00:16:11,000 --> 00:16:13,320 Speaker 1: your ability to deal with your thoughts by providing you 233 00:16:13,360 --> 00:16:17,000 Speaker 1: with a control mechanism is powerful. It's just another version 234 00:16:17,040 --> 00:16:20,080 Speaker 1: of all these thought therapies, of all the ways that 235 00:16:20,120 --> 00:16:23,120 Speaker 1: we try and change people's thoughts to change their coping 236 00:16:23,880 --> 00:16:27,240 Speaker 1: b My other issue with the placebo theory is that 237 00:16:28,400 --> 00:16:31,240 Speaker 1: you cannot take a theory as big and large as 238 00:16:31,280 --> 00:16:34,920 Speaker 1: the biological theory of depression, a theory that supports one 239 00:16:34,960 --> 00:16:37,920 Speaker 1: of the first and only lines of treatment for millions 240 00:16:38,200 --> 00:16:40,800 Speaker 1: of millions of people who are suffering. You cannot take 241 00:16:40,840 --> 00:16:44,560 Speaker 1: that theory, tear it apart and not offer another one. 242 00:16:45,080 --> 00:16:49,640 Speaker 1: I think that is deeply callous and unethical. And this 243 00:16:49,680 --> 00:16:52,960 Speaker 1: is my opinion. I think people are so quick to 244 00:16:53,000 --> 00:16:55,680 Speaker 1: want to make a headline, to want to disprove a 245 00:16:55,800 --> 00:16:59,520 Speaker 1: theory under the guise of helping people, and it actually 246 00:16:59,560 --> 00:17:03,360 Speaker 1: leaves them feeling worse. Right, there has been this whole 247 00:17:03,400 --> 00:17:06,719 Speaker 1: push recently, and it's a valid push right to be like, 248 00:17:07,080 --> 00:17:11,440 Speaker 1: is the biological theory correct? Like is medication even really 249 00:17:11,480 --> 00:17:13,600 Speaker 1: doing anything for people? Like what are we wasting our 250 00:17:13,680 --> 00:17:16,040 Speaker 1: time on? And people are really quick to be like, 251 00:17:16,080 --> 00:17:19,639 Speaker 1: it's not. This is my final conclusion. It's just a 252 00:17:19,680 --> 00:17:21,760 Speaker 1: plus ebo, rip it to shreds, and it's like, so 253 00:17:21,800 --> 00:17:26,080 Speaker 1: what else are you offering people? And don't say exercise, 254 00:17:26,760 --> 00:17:29,760 Speaker 1: don't say diet, Like what else are you offering people 255 00:17:29,800 --> 00:17:32,639 Speaker 1: with treatment resistant depression? Or what else are you offering? 256 00:17:32,640 --> 00:17:38,720 Speaker 1: People who who have our own SSRIs find them to 257 00:17:38,720 --> 00:17:42,560 Speaker 1: be life saving? And now are like, so do I 258 00:17:42,640 --> 00:17:44,879 Speaker 1: not take this and go back to the way I 259 00:17:45,040 --> 00:17:48,439 Speaker 1: was before? Like I think that's I think that's a 260 00:17:48,480 --> 00:17:52,080 Speaker 1: really hard call to make. The same goes with people 261 00:17:52,080 --> 00:17:55,280 Speaker 1: online like Now that this placebo theory has really gained legs, 262 00:17:55,480 --> 00:17:57,800 Speaker 1: it's become a lot more prominent, a lot more accepted. 263 00:17:58,240 --> 00:18:00,560 Speaker 1: People are now using it as a way to kind 264 00:18:00,600 --> 00:18:04,320 Speaker 1: of shame people for health decisions. I made this post 265 00:18:04,720 --> 00:18:06,320 Speaker 1: the other day, no, not the other day, a couple 266 00:18:06,400 --> 00:18:09,520 Speaker 1: months ago, about how going on lexipo in my twenties 267 00:18:09,600 --> 00:18:12,479 Speaker 1: was life changing, and it is. And there was this 268 00:18:12,600 --> 00:18:16,320 Speaker 1: woman all up in arms in my comment section, being like, 269 00:18:17,000 --> 00:18:21,760 Speaker 1: science has completely disproved this. Science says that, like, these 270 00:18:21,840 --> 00:18:24,359 Speaker 1: drugs aren't doing anything for you, that's why I would 271 00:18:24,359 --> 00:18:27,920 Speaker 1: never take them. And when I asked her, what would 272 00:18:27,920 --> 00:18:31,880 Speaker 1: you suggest instead, she gave me some really pathetic answers, 273 00:18:32,040 --> 00:18:35,479 Speaker 1: and it annoyed me so freaking much, and actually it 274 00:18:35,680 --> 00:18:39,399 Speaker 1: made me really mad. Why come here, coming here to 275 00:18:39,480 --> 00:18:43,280 Speaker 1: my page into my life in a way, interrogate my 276 00:18:43,359 --> 00:18:48,160 Speaker 1: health choices, rip them apart, introduce a sense of hopelessness 277 00:18:48,240 --> 00:18:51,480 Speaker 1: about the thing that has helped me, and then walk 278 00:18:51,520 --> 00:18:54,080 Speaker 1: out like you've helped me without providing me with an alternative, 279 00:18:54,640 --> 00:18:58,920 Speaker 1: without understanding my situation, Like that is cruel. That is cruel. 280 00:18:58,920 --> 00:19:01,919 Speaker 1: And I think when we go to tear apout the 281 00:19:02,000 --> 00:19:04,880 Speaker 1: chemical imbalance, biological model. We do have to think about 282 00:19:04,920 --> 00:19:08,400 Speaker 1: that impact, So let's talk about that a little bit 283 00:19:08,440 --> 00:19:17,439 Speaker 1: more after this shotbreak. Once the chemical imbalanced rhetoric became 284 00:19:17,640 --> 00:19:22,760 Speaker 1: the dominant story, it not only changed like scientific research headlines, 285 00:19:23,359 --> 00:19:27,360 Speaker 1: it also changed how people understood themselves, how families responded 286 00:19:27,400 --> 00:19:31,639 Speaker 1: to diagnosis, how the healthcare system treated depression. And that 287 00:19:31,720 --> 00:19:33,919 Speaker 1: has been really, really positive for a lot of people. 288 00:19:34,359 --> 00:19:40,040 Speaker 1: The chemical imbalance framing made depression finally feel legitimate. If 289 00:19:40,080 --> 00:19:43,440 Speaker 1: you grew up with a societal narrative that mental health 290 00:19:43,560 --> 00:19:46,600 Speaker 1: was superfluous, it was an indulgent thing to pay attention to. 291 00:19:47,200 --> 00:19:50,960 Speaker 1: Then hearing that depression has links to our literal brain 292 00:19:51,240 --> 00:19:55,440 Speaker 1: chemistry can be immensely validating, and it brings a sense 293 00:19:55,440 --> 00:19:59,399 Speaker 1: of relief by knowing you are actually unwell in a 294 00:19:59,440 --> 00:20:03,920 Speaker 1: physical s sense. It also reduces this age old sense 295 00:20:03,960 --> 00:20:06,840 Speaker 1: of blame that depression is something that you can choose, 296 00:20:07,240 --> 00:20:11,000 Speaker 1: you can snap out of it. This model helped people 297 00:20:11,040 --> 00:20:13,639 Speaker 1: realize that that is not the case. You cannot go 298 00:20:13,760 --> 00:20:18,119 Speaker 1: into your brain and change chemical messaging, like that's not 299 00:20:18,200 --> 00:20:20,720 Speaker 1: something that you're able to do. You were born this way. 300 00:20:20,880 --> 00:20:24,080 Speaker 1: This is just who you are. So on a human level, 301 00:20:24,240 --> 00:20:28,119 Speaker 1: like this story this chemical and balanced story gave people 302 00:20:28,160 --> 00:20:31,920 Speaker 1: a bridge, gave people a language for suffering and for 303 00:20:31,960 --> 00:20:35,680 Speaker 1: their condition that others could understand. And it also made 304 00:20:35,720 --> 00:20:41,280 Speaker 1: medication and it made treatment feel less scary. It brought 305 00:20:41,440 --> 00:20:43,080 Speaker 1: a lot of people out of the dark, a lot 306 00:20:43,119 --> 00:20:46,640 Speaker 1: of people out of the you know, the hiding spaces 307 00:20:46,640 --> 00:20:50,360 Speaker 1: of shame, and said we can help you, We can 308 00:20:50,400 --> 00:20:53,840 Speaker 1: help you, this isn't your fault. And that has reduced 309 00:20:53,880 --> 00:20:58,400 Speaker 1: stigma greatly. It's been an incredibly positive thing. There are 310 00:20:58,440 --> 00:21:01,639 Speaker 1: some trade offs, though. As much as I don't like 311 00:21:01,720 --> 00:21:06,840 Speaker 1: the placebo idea, I also think the prerely biological I 312 00:21:06,880 --> 00:21:10,760 Speaker 1: don't know, I don't want to say, mindset approach belief 313 00:21:11,160 --> 00:21:15,760 Speaker 1: hypothesis is also incorrect. And the reason I think it's 314 00:21:15,800 --> 00:21:19,760 Speaker 1: problematic is because it's reduced a very huge, complex condition 315 00:21:19,840 --> 00:21:25,520 Speaker 1: into a single, simplistic explanation which actually shrink and continues 316 00:21:25,560 --> 00:21:28,760 Speaker 1: to shrink down the magnitude of people's experience with it. 317 00:21:29,160 --> 00:21:33,160 Speaker 1: In a way. It confuses what the treatment changes with 318 00:21:33,200 --> 00:21:37,760 Speaker 1: what caused the problem in the first place. SSRIs change 319 00:21:37,920 --> 00:21:44,280 Speaker 1: serotonin signaling, that's true, but saying SSRIs affect serotonin, because 320 00:21:44,320 --> 00:21:49,679 Speaker 1: serotonin is the reason that you are depressed is not 321 00:21:49,960 --> 00:21:54,480 Speaker 1: entirely accurate. Just in the same way as paracetamol helps 322 00:21:54,480 --> 00:21:57,280 Speaker 1: a headache, but it's not a lack of paracetamol that 323 00:21:57,440 --> 00:22:01,280 Speaker 1: causes the headache is also true. It might be you 324 00:22:01,320 --> 00:22:04,040 Speaker 1: know you need paracetamol, you have a headache because you're ill, 325 00:22:04,160 --> 00:22:06,880 Speaker 1: because you didn't drink enough water, because you're hung over. 326 00:22:07,840 --> 00:22:12,480 Speaker 1: The paracetamol still helps. The origin of the symptom isn't 327 00:22:12,520 --> 00:22:15,080 Speaker 1: the lack of paracetamol. The same way the origin of 328 00:22:15,119 --> 00:22:18,159 Speaker 1: symptoms may not be just a lack of serotonin. A 329 00:22:18,240 --> 00:22:21,919 Speaker 1: lot of treatments work by compensating for symptoms rather than 330 00:22:21,960 --> 00:22:27,159 Speaker 1: getting down to the underlying issue. And there are a 331 00:22:27,240 --> 00:22:31,240 Speaker 1: lot of people who are depressed not because of brain 332 00:22:31,320 --> 00:22:35,480 Speaker 1: chemistry or because brain chemistry, and then a bunch of 333 00:22:35,480 --> 00:22:38,240 Speaker 1: other stuff on top of that. But it's not just 334 00:22:38,280 --> 00:22:45,280 Speaker 1: this biological thing. It's an interplay of grief, trauma, loneliness, burnout, 335 00:22:45,400 --> 00:22:52,160 Speaker 1: chronic stress, poverty, discrimination, life events. You know, a relationship 336 00:22:52,200 --> 00:22:55,600 Speaker 1: that flawed them, a life without rest, a job hunting 337 00:22:55,640 --> 00:23:00,760 Speaker 1: process that's been really terrible. The chemical imbalanced story can 338 00:23:00,840 --> 00:23:05,680 Speaker 1: sometimes make those factors feel irrelevant and say like, oh, 339 00:23:05,760 --> 00:23:09,119 Speaker 1: if we get you on this antidepressant, you will feel better. 340 00:23:09,520 --> 00:23:13,200 Speaker 1: And sometimes that's why they don't work, because they cannot 341 00:23:13,280 --> 00:23:17,840 Speaker 1: fix what lives outside the bloodstream. Medication can definitely reduce 342 00:23:17,880 --> 00:23:23,720 Speaker 1: symptoms mood, anxiety, agitation, sleep, appetite, concentration, those sort of things, 343 00:23:24,520 --> 00:23:31,240 Speaker 1: but it doesn't actually repair financial pressures, caregiving pressures, academic stress, 344 00:23:31,560 --> 00:23:39,040 Speaker 1: workplace drama, loneliness, disconnection, an unhappy, unsafe relationship, a life 345 00:23:39,080 --> 00:23:44,840 Speaker 1: that feels meaningless, people treating you badly in society. How 346 00:23:44,880 --> 00:23:47,560 Speaker 1: can we claim that a tablet can fix all of 347 00:23:47,600 --> 00:23:50,919 Speaker 1: that and call it a day. We can't. Literally, it 348 00:23:51,040 --> 00:23:53,439 Speaker 1: just can't. It can help you with coping, it doesn't 349 00:23:53,480 --> 00:23:59,440 Speaker 1: change what physically surrounds you. You know, sometimes depression is 350 00:23:59,480 --> 00:24:03,840 Speaker 1: a signal that something isn't working in your life, and 351 00:24:04,160 --> 00:24:07,879 Speaker 1: it cannot reduce those physical circumstances if those are the cause. 352 00:24:09,080 --> 00:24:12,080 Speaker 1: And I say if, because yes, the biological model is 353 00:24:12,160 --> 00:24:15,560 Speaker 1: valid on some front. But when we talk about another 354 00:24:15,640 --> 00:24:19,080 Speaker 1: theory that probably makes more sense, right that theory that 355 00:24:19,119 --> 00:24:23,560 Speaker 1: I was waiting for people to offer, I would say 356 00:24:23,960 --> 00:24:27,800 Speaker 1: a social and development theory mixed with the biological theory 357 00:24:28,320 --> 00:24:32,440 Speaker 1: is probably more accurate. You know this, like the interpersonal 358 00:24:32,480 --> 00:24:37,560 Speaker 1: model cognitive models which say that our you know, the 359 00:24:37,600 --> 00:24:40,760 Speaker 1: conditions that we have are shaped by our risk over 360 00:24:40,840 --> 00:24:44,680 Speaker 1: time and by our internal and external environment over time. 361 00:24:44,800 --> 00:24:48,840 Speaker 1: So yes, we have a biological vulnerability, but then include 362 00:24:48,840 --> 00:24:51,640 Speaker 1: the fact that you were hurt as a child, then 363 00:24:51,680 --> 00:24:56,120 Speaker 1: you had inconsistent parenting, then you had you experienced violence, 364 00:24:56,240 --> 00:24:59,080 Speaker 1: or you had cheated on Then you couldn't find a job, 365 00:24:59,640 --> 00:25:03,320 Speaker 1: then you you really struggled at uni at work, then 366 00:25:03,359 --> 00:25:06,159 Speaker 1: you felt purposeless on top of all of that, plus 367 00:25:06,200 --> 00:25:09,679 Speaker 1: you're broke again. Like, that's not just biology. You cannot 368 00:25:09,720 --> 00:25:14,399 Speaker 1: medicate your way out of structural stress. We need to 369 00:25:14,440 --> 00:25:17,560 Speaker 1: be focusing on that as well, and we also need 370 00:25:17,600 --> 00:25:21,119 Speaker 1: to be focusing on even further research that talks about 371 00:25:21,400 --> 00:25:24,080 Speaker 1: how a lot of people in modern day society lack 372 00:25:24,320 --> 00:25:26,960 Speaker 1: a sense of purpose the way that they used to 373 00:25:27,000 --> 00:25:29,560 Speaker 1: really have in what they were doing, in how they 374 00:25:29,600 --> 00:25:33,480 Speaker 1: were living in their free time. There was a twenty 375 00:25:33,520 --> 00:25:37,639 Speaker 1: twenty three meta analysis that found greater purpose in life 376 00:25:38,119 --> 00:25:42,680 Speaker 1: is significantly associated with lower depression and anxiety levels. Having 377 00:25:42,720 --> 00:25:46,199 Speaker 1: a sense that, like you mean something is incredibly influential 378 00:25:46,200 --> 00:25:48,639 Speaker 1: on how we feel, and I think in today's age, 379 00:25:48,680 --> 00:25:51,919 Speaker 1: like it's harder to feel like you actually do mean something. 380 00:25:51,960 --> 00:25:53,840 Speaker 1: You know, it's harder to feel like you're going to 381 00:25:53,880 --> 00:25:56,800 Speaker 1: find a job that you really can give back in. 382 00:25:56,880 --> 00:25:58,679 Speaker 1: It's hard to feel like you're going to make an 383 00:25:58,720 --> 00:26:02,080 Speaker 1: impact when the world feels really terrible. So we do 384 00:26:02,160 --> 00:26:05,720 Speaker 1: need to look more broadly. There's this really interesting book 385 00:26:05,720 --> 00:26:09,800 Speaker 1: I read from Johann Hari called Lost Connections, and he 386 00:26:09,880 --> 00:26:13,240 Speaker 1: looks at this idea. His central argument is because the 387 00:26:13,320 --> 00:26:16,520 Speaker 1: story of a chemical imbalance is so simple and easy 388 00:26:16,520 --> 00:26:21,760 Speaker 1: to understand, it's meant that we've underpaid attention to the 389 00:26:21,760 --> 00:26:25,440 Speaker 1: ways that modern life disconnects us from what we as 390 00:26:25,480 --> 00:26:29,359 Speaker 1: humans need, and he frames many of the drivers of 391 00:26:29,400 --> 00:26:33,920 Speaker 1: depression and anxiety as basically different forms of disconnection, not 392 00:26:33,960 --> 00:26:38,199 Speaker 1: just biological vulnerabilities. You know, we are disconnected from nature. 393 00:26:38,400 --> 00:26:42,640 Speaker 1: We are disconnected from meaningful work. We are disconnected from people, 394 00:26:43,080 --> 00:26:46,520 Speaker 1: from our communities, from a meaningful future that is having 395 00:26:46,600 --> 00:26:50,440 Speaker 1: a real life impact. With this perspective, I think depression 396 00:26:50,440 --> 00:26:54,360 Speaker 1: gets the complexity it deserves, whilst also acknowledging how medication 397 00:26:54,480 --> 00:26:56,520 Speaker 1: is a valuable part of that if we do not 398 00:26:56,680 --> 00:27:01,119 Speaker 1: also look outside of our own brains at the world 399 00:27:01,119 --> 00:27:05,600 Speaker 1: we are living in and acknowledge how that is probably 400 00:27:05,640 --> 00:27:11,800 Speaker 1: making us feel terrible. The blame does start to come back, right, 401 00:27:12,440 --> 00:27:16,960 Speaker 1: It does start to feel like as well, our depression 402 00:27:17,040 --> 00:27:21,879 Speaker 1: becomes treatment resistant, Like we are taking the medication, we 403 00:27:22,000 --> 00:27:27,120 Speaker 1: are subscribing to the biological model, and you know it's 404 00:27:27,160 --> 00:27:30,399 Speaker 1: not working. And so maybe I am to blame. Maybe 405 00:27:30,400 --> 00:27:32,280 Speaker 1: this is a permanent state of being. Maybe I'm a 406 00:27:32,400 --> 00:27:36,960 Speaker 1: much harder case than anybody has ever seen before, when 407 00:27:37,000 --> 00:27:39,720 Speaker 1: actually it's just that people are looking at your case, 408 00:27:40,240 --> 00:27:43,280 Speaker 1: or you are looking at your circumstances through a narrow lens, 409 00:27:43,560 --> 00:27:46,679 Speaker 1: and other things, other levers in your life could be pulled, 410 00:27:46,720 --> 00:27:51,360 Speaker 1: could be readjusted so that you are happier, Like I've 411 00:27:51,400 --> 00:27:55,160 Speaker 1: definitely found this since moving to London, Like my dosage 412 00:27:55,160 --> 00:27:58,120 Speaker 1: of my antidepressant has stayed the same, but it looks 413 00:27:58,160 --> 00:28:00,200 Speaker 1: like it's not working because I've become a lot sad 414 00:28:00,920 --> 00:28:05,000 Speaker 1: and meaner and shorter and agitated, just because now I'm 415 00:28:05,040 --> 00:28:08,240 Speaker 1: living in an environment that makes me feel less and 416 00:28:08,320 --> 00:28:13,760 Speaker 1: less seen and more and more like stressed out again. 417 00:28:13,800 --> 00:28:15,920 Speaker 1: I don't want this to come through as though medication 418 00:28:16,040 --> 00:28:18,320 Speaker 1: is the wrong thing to do. That's actually not what 419 00:28:18,359 --> 00:28:20,720 Speaker 1: I think. But I do think it is a medical 420 00:28:20,760 --> 00:28:24,320 Speaker 1: disservice to give someone a prescription to a drug that 421 00:28:24,440 --> 00:28:27,560 Speaker 1: is really hard to come off of that does change 422 00:28:27,600 --> 00:28:31,440 Speaker 1: things like your sex drive, like your weight, like your sleep, 423 00:28:31,600 --> 00:28:35,959 Speaker 1: like your dreams, your energy, and not maybe just maybe 424 00:28:37,080 --> 00:28:43,160 Speaker 1: look at some other factors and search for something else first. 425 00:28:44,200 --> 00:28:46,640 Speaker 1: So what do we do with all this information? One 426 00:28:46,640 --> 00:28:48,360 Speaker 1: of the main takeaways I want to leave you with 427 00:28:48,920 --> 00:28:52,360 Speaker 1: is that depression is as unique as we are. It 428 00:28:52,400 --> 00:28:55,240 Speaker 1: is a label for a cluster of symptoms, and people 429 00:28:55,320 --> 00:28:58,520 Speaker 1: can end up in a depressed state through totally different pathways, 430 00:28:59,040 --> 00:29:04,680 Speaker 1: through grief, loneliness, illness, rumination, loss of meaning, chronic stress, 431 00:29:05,320 --> 00:29:08,400 Speaker 1: often a mix of several and then maybe also a 432 00:29:08,400 --> 00:29:12,000 Speaker 1: biological component. That's why a one size fits all explanation 433 00:29:12,120 --> 00:29:16,720 Speaker 1: never really works. There is an infinite number of combinations 434 00:29:16,760 --> 00:29:21,240 Speaker 1: of biological and environmental and psychological factors that all come 435 00:29:21,320 --> 00:29:24,920 Speaker 1: together to create this experience. That's why two people can 436 00:29:24,960 --> 00:29:27,920 Speaker 1: go through the same thing, beyond the same medications, even 437 00:29:28,280 --> 00:29:33,440 Speaker 1: have totally different outcomes, and why they're like a neat explanation. 438 00:29:33,920 --> 00:29:37,040 Speaker 1: Any narrative that wants a simple phrase to explain this 439 00:29:37,120 --> 00:29:40,960 Speaker 1: probably won't work. I think instead of hunting for these 440 00:29:41,000 --> 00:29:44,760 Speaker 1: single cause that makes people depressed these single cause that 441 00:29:44,880 --> 00:29:49,120 Speaker 1: is easy to digest. We recognize how complex this is. 442 00:29:49,720 --> 00:29:54,440 Speaker 1: We focus on reducing stress where possible, rebuilding protective connections 443 00:29:54,800 --> 00:29:58,520 Speaker 1: to people, to purpose, to safety, to community, finding emotional 444 00:29:58,600 --> 00:30:02,360 Speaker 1: outlets that work for us, increasing coping skills in children, 445 00:30:02,480 --> 00:30:05,360 Speaker 1: finding play and joy, strengthening the parts of you that 446 00:30:05,360 --> 00:30:09,960 Speaker 1: are vulnerable through therapy, through skills, through routine, and then 447 00:30:10,000 --> 00:30:13,760 Speaker 1: allowing medication to remain as the sidekick, not the star 448 00:30:13,840 --> 00:30:16,280 Speaker 1: of the show. And I think that that would allow 449 00:30:16,320 --> 00:30:19,600 Speaker 1: people to just feel more seen think would also allow 450 00:30:19,680 --> 00:30:23,040 Speaker 1: people to just get better in a way that is 451 00:30:23,080 --> 00:30:29,520 Speaker 1: more sustainable and holistic and meaningful. So there we go. 452 00:30:30,080 --> 00:30:32,040 Speaker 1: That's how I'm going to wrap up the episode. I 453 00:30:32,080 --> 00:30:33,520 Speaker 1: know I said at the start, like this is going 454 00:30:33,600 --> 00:30:35,600 Speaker 1: to be a short, bonus episode. Obviously that is not 455 00:30:35,640 --> 00:30:38,720 Speaker 1: the case. I have a lot to say about this topic, 456 00:30:38,800 --> 00:30:41,000 Speaker 1: and honestly, even as I'm wrapping up, I'm like, oh, 457 00:30:41,040 --> 00:30:43,640 Speaker 1: I didn't even mention this. I didn't mention that. But yeah, 458 00:30:43,640 --> 00:30:45,280 Speaker 1: I want to keep it short and sweet for you guys. 459 00:30:45,320 --> 00:30:48,000 Speaker 1: I hope that this episode, even if you didn't agree 460 00:30:48,000 --> 00:30:50,040 Speaker 1: with everything I said, I'm sure there's going to be 461 00:30:50,080 --> 00:30:55,400 Speaker 1: some of you like it just spurred conversation. Honestly, people 462 00:30:55,560 --> 00:31:00,040 Speaker 1: in either camp stick to their guns very strongly. This 463 00:31:00,320 --> 00:31:03,240 Speaker 1: interesting thing where like the answer you go looking for 464 00:31:03,360 --> 00:31:05,120 Speaker 1: is the one that you will probably find because there 465 00:31:05,160 --> 00:31:10,040 Speaker 1: is actually a lot of evidence for both. But you 466 00:31:10,120 --> 00:31:12,120 Speaker 1: are still free to form your own opinion based on 467 00:31:12,360 --> 00:31:15,200 Speaker 1: what works for you. Honestly, at the end of the day, 468 00:31:15,840 --> 00:31:18,440 Speaker 1: whatever works for you, if a biological model really works 469 00:31:18,440 --> 00:31:23,520 Speaker 1: for you, and that's like just just something to tell yourself. Honestly, 470 00:31:23,560 --> 00:31:26,920 Speaker 1: who cares what the evidence is, keep it up, keep 471 00:31:27,000 --> 00:31:30,400 Speaker 1: that explanation going in your mind. You know, really, if 472 00:31:30,400 --> 00:31:32,120 Speaker 1: that is the thing that's making you feel better, I 473 00:31:32,160 --> 00:31:35,120 Speaker 1: really don't see a problem with that. So yeah, I 474 00:31:35,160 --> 00:31:36,920 Speaker 1: hope you enjoyed the episode. Thank you, as always to 475 00:31:36,960 --> 00:31:40,680 Speaker 1: our researcher Lebby Colbert for her assistance with this episode. 476 00:31:41,360 --> 00:31:43,080 Speaker 1: If you do not know, you can actually go on 477 00:31:43,200 --> 00:31:45,959 Speaker 1: watch full episodes of the podcast, not this episode though, 478 00:31:46,000 --> 00:31:49,280 Speaker 1: because this was a special bonus episode, but other episodes 479 00:31:49,280 --> 00:31:53,840 Speaker 1: of the podcast in video format on Netflix. That's right, 480 00:31:53,920 --> 00:31:57,400 Speaker 1: you can watch this show on Netflix. You can go 481 00:31:57,440 --> 00:32:01,720 Speaker 1: there right now and check it out. You can prove 482 00:32:01,720 --> 00:32:05,520 Speaker 1: me right, prove me wrong. Also, you can follow us 483 00:32:05,520 --> 00:32:07,800 Speaker 1: on substack. You can follow us on Instagram if you 484 00:32:07,800 --> 00:32:11,320 Speaker 1: want to connect in other ways. Instagram is a really 485 00:32:11,360 --> 00:32:14,600 Speaker 1: great place to contribute to future episodes like this one, 486 00:32:14,600 --> 00:32:16,680 Speaker 1: if that's something that you would like to do, and 487 00:32:16,720 --> 00:32:20,880 Speaker 1: also to give feedback to keep the conversation going, and yeah, 488 00:32:20,960 --> 00:32:22,840 Speaker 1: to share your own lived experience if this is something 489 00:32:22,880 --> 00:32:25,840 Speaker 1: that you've been through. I always love hearing from you, guys, 490 00:32:25,840 --> 00:32:29,480 Speaker 1: I love hearing from the listeners. So I will hopefully 491 00:32:29,560 --> 00:32:32,480 Speaker 1: see you over there, But until next time, be safe, 492 00:32:33,000 --> 00:32:36,360 Speaker 1: be kind, be gentle to yourself, and we will talk 493 00:32:36,800 --> 00:32:37,440 Speaker 1: very very soon.