1 00:00:00,440 --> 00:00:03,960 Welcome to Sheeper Assisted. I'm your host Sadie Sutton, a 19 2 00:00:03,960 --> 00:00:06,440 year old from the Bay Area studying psychology at the 3 00:00:06,440 --> 00:00:10,000 University of Pennsylvania. Sheeper Assisted is the teen 4 00:00:10,000 --> 00:00:12,880 mental health podcast made for teenagers by a teen. 5 00:00:13,360 --> 00:00:16,120 In each episode I'll bring you authentic, accessible and 6 00:00:16,120 --> 00:00:19,440 relatable conversations about every aspect of mental Wellness 7 00:00:19,960 --> 00:00:22,000 you can expect. Evidence based teen approved 8 00:00:22,000 --> 00:00:26,040 resources, coping skills including lots of DBT insights 9 00:00:26,040 --> 00:00:28,680 and education, and each piece of content you consume. 10 00:00:29,360 --> 00:00:32,439 She Persisted offers you a safe space to feel validated and 11 00:00:32,439 --> 00:00:35,160 understood in your struggle while encouraging you to take 12 00:00:35,160 --> 00:00:37,440 ownership of your journey and build your life worth living. 13 00:00:37,840 --> 00:00:41,720 So let's dive in. This week on She Persisted. 14 00:00:42,400 --> 00:00:44,800 It's OK to talk about. I mean, I think for me, that's 15 00:00:44,800 --> 00:00:49,720 one of the main motivations for studying and talking about life 16 00:00:49,760 --> 00:00:54,960 after depression is to do my part to make it OK to talk about 17 00:00:54,960 --> 00:00:59,280 these experiences and their full measure of beauty and ugliness 18 00:00:59,320 --> 00:01:02,880 and confusing this. I think it all needs to be part 19 00:01:02,880 --> 00:01:05,440 of the picture. Hello, hello, and welcome back 20 00:01:05,440 --> 00:01:07,120 to another episode of She Persisted. 21 00:01:07,120 --> 00:01:10,560 We've done a mini hiatus because this is the busiest semester I 22 00:01:10,560 --> 00:01:13,840 have ever had. I am working on grad school apps 23 00:01:13,840 --> 00:01:17,720 and the GRE and my normal course load and a thesis and research 24 00:01:17,720 --> 00:01:20,120 and all the things. I will of course, do a grad 25 00:01:20,120 --> 00:01:23,800 school episode for you guys regardless of how things pan 26 00:01:23,800 --> 00:01:25,600 out. But I think if you want to go 27 00:01:25,600 --> 00:01:28,960 into psychology, it's really important and helpful to just be 28 00:01:28,960 --> 00:01:31,160 aware of what the field looks like. 29 00:01:31,160 --> 00:01:33,920 And a lot of the times you don't become aware until you're very 30 00:01:33,920 --> 00:01:36,960 far into the process. So if you guys have interest in 31 00:01:37,040 --> 00:01:40,640 a grad school episode and questions for that, let me know. 32 00:01:41,080 --> 00:01:44,280 But I'm so, so, so incredibly excited for today's guest. 33 00:01:44,280 --> 00:01:46,840 We have a Dr. Jonathan Rotenberg on the podcast. 34 00:01:46,840 --> 00:01:50,440 He is a professor at Cornell and he has some really, really 35 00:01:50,440 --> 00:01:53,760 fascinating research about depression and positive outcomes 36 00:01:53,760 --> 00:01:56,240 after depression. And so this conversation just 37 00:01:56,240 --> 00:01:59,960 gives a lot of nuance and insight about what it's like to 38 00:01:59,960 --> 00:02:01,840 function through the world when you're depressed. 39 00:02:01,920 --> 00:02:05,480 And then why do some people have really positive outcomes and 40 00:02:05,480 --> 00:02:08,960 high levels of well-being after experiencing depression? 41 00:02:08,960 --> 00:02:11,000 And I just absolutely loved every moment of this 42 00:02:11,080 --> 00:02:12,640 conversation. It was so fascinating. 43 00:02:12,640 --> 00:02:14,960 And I think it just adds a lot of information that we aren't 44 00:02:14,960 --> 00:02:19,040 aware of when we're struggling. And I think a lot of the fear 45 00:02:19,040 --> 00:02:23,240 and anxiety and discomfort from these things stems from not 46 00:02:23,240 --> 00:02:24,640 knowing what you're experiencing. 47 00:02:24,640 --> 00:02:27,760 You're like, I feel this way. What I used to do to try and 48 00:02:27,760 --> 00:02:29,800 cope with things like this isn't working. 49 00:02:30,120 --> 00:02:32,840 I don't know why I'm having these reactions to these things 50 00:02:32,840 --> 00:02:35,080 in my life. It's just distressing and 51 00:02:35,080 --> 00:02:36,840 overwhelming. And what I know how to do isn't 52 00:02:36,840 --> 00:02:38,960 working. And so I think conversations 53 00:02:38,960 --> 00:02:44,400 like this, at least for me, offer a lot of insight and peace 54 00:02:44,400 --> 00:02:48,200 and kind of take away some of the mystery of that internal 55 00:02:48,200 --> 00:02:51,600 experience and hopefully give you more answers rather than 56 00:02:51,600 --> 00:02:54,320 leaving you with just questions about your experience. 57 00:02:54,320 --> 00:02:58,720 So I'm so, so, so glad to have Doctor Rotenberg on the podcast. 58 00:02:58,800 --> 00:03:02,600 He is a professor of psychology at Cornell and the director of 59 00:03:02,600 --> 00:03:05,840 the Better Outcomes Laboratory. His research is on long term 60 00:03:05,840 --> 00:03:09,200 functioning and well-being after depression, and his research has 61 00:03:09,200 --> 00:03:11,560 been featured in things like the New York Times, The Washington 62 00:03:11,560 --> 00:03:14,640 Post, Wall Street Journal. He has two books you guys can 63 00:03:14,640 --> 00:03:18,720 check out in the show notes, and he also has a digital project 64 00:03:18,720 --> 00:03:21,520 called Ever After which talks about life after depression. 65 00:03:21,520 --> 00:03:23,200 So you guys should definitely check that out. 66 00:03:23,200 --> 00:03:26,200 Like I mentioned, he's doing really incredible work in the 67 00:03:26,200 --> 00:03:30,640 space and I hope you guys enjoy this conversation as much as I 68 00:03:30,640 --> 00:03:34,160 did. So with that, let's dive in and 69 00:03:34,160 --> 00:03:36,360 learn about things you didn't know about depression. 70 00:03:36,960 --> 00:03:39,560 Well, thank you so much for joining me today on G Persisted. 71 00:03:39,560 --> 00:03:43,720 I'm so excited to have this conversation about depression 72 00:03:43,720 --> 00:03:47,240 and outcomes and a lot of nuance that most people don't get if 73 00:03:47,240 --> 00:03:50,240 when they've been diagnosed or they're in their psychiatrist or 74 00:03:50,680 --> 00:03:53,560 primary care's office and hearing that this is what 75 00:03:53,560 --> 00:03:55,600 they're going through. And so I'm really excited to 76 00:03:55,600 --> 00:03:59,360 dive into your research and your story and also give people a 77 00:03:59,360 --> 00:04:02,400 greater level of understanding about what they're experiencing 78 00:04:02,400 --> 00:04:04,480 and what the path ahead might look like. 79 00:04:05,120 --> 00:04:07,640 Well, I'm excited right there with you, Sadie. 80 00:04:08,040 --> 00:04:10,040 I'm glad to be here. Amazing. 81 00:04:10,360 --> 00:04:14,360 Well, to get started, you have a really interesting area of 82 00:04:14,360 --> 00:04:17,880 research, which is depression and now more of the outcomes and 83 00:04:17,880 --> 00:04:21,040 why some people have better outcomes after experiencing 84 00:04:21,040 --> 00:04:24,080 depression. And so I'd love to hear how you 85 00:04:24,080 --> 00:04:27,200 landed in that area of psychology, why that became your 86 00:04:27,200 --> 00:04:30,160 research specialty and kind of your background there. 87 00:04:30,920 --> 00:04:35,720 Sure, I mean my like a lot of people who end up studying 88 00:04:35,720 --> 00:04:39,880 clinical topics, my Rd. went through personal experience. 89 00:04:39,880 --> 00:04:43,600 When I was a graduate student, the first time studying history, 90 00:04:43,600 --> 00:04:46,760 I had quite a significant episode of depression, lasted a 91 00:04:46,760 --> 00:04:51,480 number of years, Was profound, interesting, strange, horrible 92 00:04:51,480 --> 00:04:55,400 experience, and I was forever changed by it. 93 00:04:55,400 --> 00:04:59,520 But not least of which, deciding that I needed to understand this 94 00:04:59,520 --> 00:05:02,760 better and going into psychology in the 1st place, knowing I 95 00:05:02,760 --> 00:05:07,480 wanted to study mood disorders and to study that part of mood 96 00:05:07,480 --> 00:05:11,920 disorders that was this kind of overwhelming experience of not 97 00:05:11,920 --> 00:05:15,080 being in control of your feelings, not understanding your 98 00:05:15,080 --> 00:05:17,320 feelings, not being able to change your feelings. 99 00:05:17,800 --> 00:05:23,200 So scientists also sort of agree that mood, they call it a mood 100 00:05:23,200 --> 00:05:27,000 disorder, that mood is at the center of the mood disorder. 101 00:05:27,040 --> 00:05:32,080 That is, people feel this terrible low depressed feeling 102 00:05:32,200 --> 00:05:37,040 and they can't enjoy things and it diffuses their outlook and 103 00:05:37,040 --> 00:05:40,160 how they think, and it really alters their behavior in 104 00:05:40,320 --> 00:05:43,800 profound ways. So we did experimental studies 105 00:05:43,800 --> 00:05:48,040 where we were showing people standardized emotional stimuli 106 00:05:48,040 --> 00:05:51,920 like films and looking at how they responded, how they 107 00:05:52,440 --> 00:05:55,800 reported emotions, how they showed emotion behaviorally. 108 00:05:55,800 --> 00:05:59,400 And we also measured Physiology. And I did that for a number of 109 00:05:59,400 --> 00:06:04,640 years and I guess one of the major findings was Contra to a 110 00:06:04,640 --> 00:06:09,160 lot of the thinking of the time, which was informed by cognitive 111 00:06:09,160 --> 00:06:11,360 theories of depression. So in these cognitive theories 112 00:06:11,360 --> 00:06:15,640 of depression, the main idea is that depression alters how 113 00:06:15,640 --> 00:06:18,280 people are perceiving the world, how they're perceiving ongoing 114 00:06:18,280 --> 00:06:22,840 stimuli in a very negative way, such that you'd be prone to 115 00:06:22,960 --> 00:06:27,280 notice negative information. Remember, negative material 116 00:06:27,280 --> 00:06:30,000 better than neutral material. And from this theory, the 117 00:06:30,080 --> 00:06:34,960 expectation was if you present this standardized negative film, 118 00:06:35,200 --> 00:06:38,280 like a sad film to a depressed person, they're going to show 119 00:06:38,280 --> 00:06:41,800 this really vigorous response. This is going to match this kind 120 00:06:41,800 --> 00:06:43,440 of cognitive template in their head. 121 00:06:44,040 --> 00:06:48,160 And that's not what we found. We found a a very different 122 00:06:48,160 --> 00:06:53,120 pattern such that being in this mood disorder seemed to diminish 123 00:06:53,480 --> 00:06:57,760 or shut down people's reactivity to all manner of different 124 00:06:57,760 --> 00:07:00,280 stimuli in the environment. So it's sort of a different 125 00:07:00,280 --> 00:07:03,200 understanding of in part what this mood disorder is and what 126 00:07:03,200 --> 00:07:05,920 it does in that it turns a person inward. 127 00:07:05,920 --> 00:07:08,360 And it's not that they're not having emotions, but they're not 128 00:07:08,360 --> 00:07:13,040 necessarily having emotions to the same kinds of external 129 00:07:13,040 --> 00:07:16,880 normative stimuli that that non depressed people are. 130 00:07:17,200 --> 00:07:20,040 So in my career, I've always been open to the possibility 131 00:07:20,040 --> 00:07:22,840 that the conventional wisdom might not be right and that that 132 00:07:22,840 --> 00:07:26,760 can really open a lot of doors. So like in a related line of 133 00:07:26,760 --> 00:07:30,280 work, we looked at whether or not depressed people were more 134 00:07:30,280 --> 00:07:34,160 likely to cry in the laboratory when you expose them again to 135 00:07:34,160 --> 00:07:37,000 kind of a standardized stimulus that we know non depressed 136 00:07:37,000 --> 00:07:41,680 people are likely to cry to. And again, the hypothesis going 137 00:07:41,680 --> 00:07:44,240 in based on a lot of clinical lure, like if you read the 138 00:07:44,240 --> 00:07:46,920 Diagnostic and Statistical Manual for Mental Disorders, the 139 00:07:46,920 --> 00:07:51,200 DSM, it mentions crying as an associated sign of depression. 140 00:07:51,400 --> 00:07:54,520 So depressed people, of course, they cry more, but they didn't, 141 00:07:54,520 --> 00:07:57,440 not in the lab. And this again suggested not 142 00:07:57,440 --> 00:08:00,680 that all the clinicians were wrong about what they had been 143 00:08:00,680 --> 00:08:04,360 seeing in their patients, but that the nature of the crying 144 00:08:04,360 --> 00:08:05,720 might be different in depression. 145 00:08:05,720 --> 00:08:09,040 That is, yes, when you have someone who is sympathetic to 146 00:08:09,040 --> 00:08:11,640 you, who's ready to hear your story and you've been keeping it 147 00:08:11,640 --> 00:08:14,560 all bottled up, you might cry a lot, but it doesn't mean you're 148 00:08:14,560 --> 00:08:17,960 going to cry when Lassie dies. So it really changes kind of the 149 00:08:17,960 --> 00:08:22,320 how the behavior works in ways that were not what we expected. 150 00:08:22,320 --> 00:08:23,680 This is why you do your research. 151 00:08:24,480 --> 00:08:27,680 You do research to learn things. And that was sort of the 1st 152 00:08:27,680 --> 00:08:30,800 chapter of of having some unexpected findings. 153 00:08:31,200 --> 00:08:33,880 Yeah, it's, I think it's something most people 154 00:08:33,880 --> 00:08:37,600 subjectively have experienced and that especially if they're a 155 00:08:37,600 --> 00:08:40,600 little bit further into young adulthood or adulthood itself, 156 00:08:40,600 --> 00:08:44,200 is that they feel depressed. And then they go and try these 157 00:08:44,200 --> 00:08:47,240 things that in the past have made them feel happy or feel 158 00:08:47,240 --> 00:08:50,320 better or invoked these different emotions and it's just 159 00:08:50,320 --> 00:08:52,680 not working. It's like it doesn't have the 160 00:08:52,680 --> 00:08:55,440 same effect that it it used to. And like you're saying the 161 00:08:55,440 --> 00:08:58,240 emotional experiences are literally different and the 162 00:08:58,240 --> 00:09:00,600 depressed versus non depressed population. 163 00:09:00,600 --> 00:09:03,400 And I think that's really challenging and gives people 164 00:09:03,440 --> 00:09:06,800 that huge lack of control, which I think is, is really hard thing 165 00:09:06,800 --> 00:09:08,520 to navigate. There's a lot of unknown and 166 00:09:08,520 --> 00:09:12,200 then there's just that I I can't control what I'm feeling and 167 00:09:12,200 --> 00:09:14,560 also what I've done in the past to try and control these 168 00:09:14,560 --> 00:09:18,080 experiences or cope with them. It's just not working, which is 169 00:09:18,080 --> 00:09:20,480 really, really difficult. And so I'd love to kind of hear 170 00:09:20,480 --> 00:09:23,480 your perspective based on the research and literature and also 171 00:09:23,480 --> 00:09:26,000 subjective natively, are there any of these other shifts that 172 00:09:26,000 --> 00:09:29,120 we see in people that are depressed with the way that they 173 00:09:29,360 --> 00:09:32,920 feel and think? And behaviors also are a facet 174 00:09:32,920 --> 00:09:36,000 of that where you're literally thinking and acting differently 175 00:09:36,000 --> 00:09:38,400 when you're depressed, which when you're first diagnosed, a 176 00:09:38,400 --> 00:09:41,080 lot of people aren't told that it's, it's really a challenging 177 00:09:41,080 --> 00:09:44,000 thing to understand. Yeah, I think what you're saying 178 00:09:44,000 --> 00:09:47,440 is really quite profound, Sadie, this inability to change the way 179 00:09:47,440 --> 00:09:50,000 that you're feeling. You know, people who haven't 180 00:09:50,000 --> 00:09:52,920 gone through depression, they might be sympathetic, but not 181 00:09:52,920 --> 00:09:56,880 understanding this, they could be quite confused about why 182 00:09:56,880 --> 00:09:58,720 depressed people are doing certain things. 183 00:09:59,080 --> 00:10:03,000 So for example, depressed people might do things to themselves, 184 00:10:03,000 --> 00:10:07,880 like they might burn their arm or pick their skin and do other 185 00:10:07,880 --> 00:10:10,760 things where the person's like, well, how could that be helpful? 186 00:10:10,800 --> 00:10:13,960 And, and don't they know, don't they know that you should go for 187 00:10:13,960 --> 00:10:16,080 a walk and do yoga and drink water? 188 00:10:17,120 --> 00:10:19,280 And depressed people are not stupid. 189 00:10:19,280 --> 00:10:23,120 They have a they have this unique experience of cycling 190 00:10:23,120 --> 00:10:26,760 through all manner of emotion regulation strategies, including 191 00:10:26,760 --> 00:10:29,640 all the ones that were suggested to them on numerous occasions, 192 00:10:29,640 --> 00:10:31,520 and finding that they didn't work. 193 00:10:31,760 --> 00:10:35,640 So then depressed people might start doing things that that 194 00:10:35,640 --> 00:10:38,840 they might actually not be such great ideas, but they're trying. 195 00:10:39,000 --> 00:10:42,720 They haven't given up and they might get locked into some of 196 00:10:42,720 --> 00:10:44,760 these counterproductive strategies. 197 00:10:45,000 --> 00:10:48,520 But you can only, you can only really understand that if you 198 00:10:48,520 --> 00:10:52,080 have, you know, empathy and also knowledge that depressed people 199 00:10:52,080 --> 00:10:53,800 don't. On day one, the first day I'm 200 00:10:53,800 --> 00:10:57,840 depressed, I go immediately and start screaming into a pillow 201 00:10:57,920 --> 00:11:00,960 or, you know, banging my fist through the door. 202 00:11:01,000 --> 00:11:02,800 Like that is not what happens on day one. 203 00:11:03,320 --> 00:11:06,800 So not as much research as you would imagine tries to take 204 00:11:06,800 --> 00:11:09,720 people through time to understand how the experience 205 00:11:09,720 --> 00:11:11,680 changes. Because you're right, it's not 206 00:11:11,680 --> 00:11:15,680 the same as is everyday life when people experience all 207 00:11:15,680 --> 00:11:18,600 manner of disappointments. In real life. 208 00:11:18,680 --> 00:11:22,240 For most people, when you experience sadness or 209 00:11:22,240 --> 00:11:26,320 dejectedness, you don't get what you want, you feel disappointed. 210 00:11:26,640 --> 00:11:28,720 That's a rather transient experience. 211 00:11:28,720 --> 00:11:31,080 And one of the interesting things, and we know from basic 212 00:11:31,080 --> 00:11:34,440 research I find this fascinating, is that non 213 00:11:34,440 --> 00:11:37,280 depressed people, they tend to mispredict. 214 00:11:37,560 --> 00:11:41,920 So, for example, if you have a favorite team and someone asks 215 00:11:41,920 --> 00:11:44,480 you, so if your team doesn't win the Super Bowl, how are you 216 00:11:44,480 --> 00:11:47,280 going to feel? And the people systematically, 217 00:11:47,360 --> 00:11:49,440 they overestimate. They say, I'm going to feel 218 00:11:49,440 --> 00:11:51,760 horrible. And I can't even imagine. 219 00:11:52,080 --> 00:11:53,960 It's going to take a long time to recover from. 220 00:11:54,240 --> 00:11:57,880 But the truth is that even things that are more significant 221 00:11:57,880 --> 00:12:02,400 than your football team not winning, people tend to bounce 222 00:12:02,400 --> 00:12:04,200 back from. And so this is the normal 223 00:12:04,200 --> 00:12:07,400 experience that people have that these really strong moods don't 224 00:12:07,400 --> 00:12:09,680 last. So it's only people who are in 225 00:12:09,680 --> 00:12:12,960 the these clinical states where the the mood might last for 226 00:12:13,600 --> 00:12:18,440 three months, six months, a year, 2 years, that they really 227 00:12:18,760 --> 00:12:22,720 don't experience as much relief. And it's quite confusing because 228 00:12:22,720 --> 00:12:26,160 of their whole previous life, when they were able to either 229 00:12:26,440 --> 00:12:30,400 change what they were feeling or just spontaneously experience 230 00:12:30,400 --> 00:12:33,200 changing what they're feeling. They're no longer experiencing 231 00:12:33,200 --> 00:12:37,440 that and it's confusing. Yeah, it's really overwhelming 232 00:12:37,440 --> 00:12:39,920 and disorienting. And all you want is to feel 233 00:12:39,920 --> 00:12:42,280 differently and everything you're trying isn't working. 234 00:12:42,560 --> 00:12:44,840 And you're not hearing that narrative that like, you're 235 00:12:44,840 --> 00:12:47,360 feeling things differently and you're thinking differently and 236 00:12:47,360 --> 00:12:50,360 the skills you've worked before might not work now. 237 00:12:50,360 --> 00:12:53,000 We're just not told that until you're like very deep into the 238 00:12:53,000 --> 00:12:56,400 depression world and treatment process, which is really 239 00:12:56,800 --> 00:13:00,040 unfortunate and, and really, I think makes a lot of people feel 240 00:13:00,040 --> 00:13:02,560 really hopeless and confused and overwhelmed. 241 00:13:02,960 --> 00:13:05,280 Another thing that you've touched on in your research is 242 00:13:05,280 --> 00:13:08,440 this emotional reactivity idea, which we talked a little bit 243 00:13:08,440 --> 00:13:11,320 about with people crying and the emotions that are elicited. 244 00:13:11,320 --> 00:13:14,760 But I think this is another piece of the puzzle that is also 245 00:13:14,760 --> 00:13:17,600 very confusing and disorienting and overwhelming, which is that 246 00:13:17,720 --> 00:13:19,200 you're feeling these things differently. 247 00:13:19,200 --> 00:13:22,560 And the degree to which you're feeling them is, is also on a 248 00:13:22,560 --> 00:13:25,040 whole other level in addition to how you're coping with them. 249 00:13:25,080 --> 00:13:27,960 And just like you were saying, the way that you used to operate 250 00:13:27,960 --> 00:13:29,960 within your life and the way you used to feel about different 251 00:13:29,960 --> 00:13:31,320 things, like it's completely different. 252 00:13:31,320 --> 00:13:33,480 It's like you have a different brain and you don't know how to 253 00:13:33,480 --> 00:13:35,880 navigate with those new levels of emotional reactivity. 254 00:13:35,880 --> 00:13:39,040 So what is the the research say there with how we are reacting 255 00:13:39,040 --> 00:13:42,440 to these situations when we're depressed and versus when we're 256 00:13:42,440 --> 00:13:46,640 not feeling depressed? Yeah, I consider emotional 257 00:13:46,680 --> 00:13:48,560 reactivity, even negative emotions. 258 00:13:48,560 --> 00:13:51,120 They're not the enemy. And so I think when people start 259 00:13:51,120 --> 00:13:55,040 to come out of depression and then they start experiencing 260 00:13:55,400 --> 00:13:58,480 sadness when something sad happens and happiness when 261 00:13:58,480 --> 00:14:01,480 something happy happens, and even outrage when something in 262 00:14:01,480 --> 00:14:06,640 just happens as rather soothing and reassuring. 263 00:14:07,040 --> 00:14:11,400 Because the research with the emotion context insensitivity, 264 00:14:11,400 --> 00:14:14,120 one of the main morals is that the way that people are feeling 265 00:14:14,120 --> 00:14:19,120 has become disconnected from the usual environmental stimuli. 266 00:14:19,120 --> 00:14:22,080 So I think that again, that is what's can be terribly 267 00:14:22,080 --> 00:14:25,600 frustrating because all the things that a person normally 268 00:14:25,600 --> 00:14:29,360 could experience and expect experience a different feeling. 269 00:14:29,360 --> 00:14:33,680 So whether that's going out with friends or having a delicious 270 00:14:33,680 --> 00:14:38,560 meal, you know, going for that walk, it doesn't seem to have 271 00:14:38,560 --> 00:14:41,840 much immediate impact on the way the person is feeling. 272 00:14:42,360 --> 00:14:45,720 So, you know, again, in our in our common lore, I think there 273 00:14:45,720 --> 00:14:49,360 is sort of the idea that, oh, so it's better to always feel good. 274 00:14:49,600 --> 00:14:53,160 We don't want to feel bad. But emotions do serve us. 275 00:14:53,160 --> 00:14:57,720 They're time tested kind of responses to the world that over 276 00:14:57,720 --> 00:15:00,520 evolutionary time have proven their worth. 277 00:15:00,680 --> 00:15:03,760 And so if you could choose whether to have emotions or not 278 00:15:03,760 --> 00:15:06,600 to have emotions, the better choice is to have them. 279 00:15:07,120 --> 00:15:10,160 And actually, I think depressed people, in some ways, they would 280 00:15:10,160 --> 00:15:14,200 wish that they they would have appropriate emotional reactivity 281 00:15:14,240 --> 00:15:17,520 rather than either perceiving that they feel nothing or that 282 00:15:17,520 --> 00:15:22,360 they feel overwhelming kind of negative states like anxiety or 283 00:15:22,360 --> 00:15:26,040 sadness that suffuse everything and they feel that little 284 00:15:26,040 --> 00:15:29,280 control over. So I think, you know, yes, there 285 00:15:29,280 --> 00:15:32,400 is of course some dynamism. It's not that nothing ever 286 00:15:32,400 --> 00:15:34,760 changes when people are depressed, but there does seem 287 00:15:34,760 --> 00:15:39,640 to be some disconnection between what ordinarily prompts changes 288 00:15:39,640 --> 00:15:44,000 and how the person is feeling, you know, and what the person is 289 00:15:44,000 --> 00:15:47,280 actually feeling. Yeah, it's also so tough when 290 00:15:47,280 --> 00:15:50,640 you kind of dive into that emotion education piece a little 291 00:15:50,640 --> 00:15:53,040 bit with depression. And we think like, OK, our 292 00:15:53,040 --> 00:15:55,800 emotions are serving a purpose. They get us to do these things 293 00:15:55,800 --> 00:15:59,200 that help us survive and thrive. We're scared we get away from 294 00:15:59,200 --> 00:16:01,120 that thing. If we're feeling lonely, we go 295 00:16:01,120 --> 00:16:04,160 find other people so we can connect and survive in a tribe 296 00:16:04,160 --> 00:16:06,960 and not be left in the middle of the wilderness alone with no 297 00:16:06,960 --> 00:16:09,160 resources. And when you're depressed, a lot 298 00:16:09,160 --> 00:16:11,600 of your emotions are telling you to do the opposite thing. 299 00:16:11,640 --> 00:16:13,360 It's like withdrawal from people. 300 00:16:13,560 --> 00:16:17,560 Don't engage all these negative thoughts about yourself that 301 00:16:17,560 --> 00:16:21,320 increase fear and anxiety, which may not be totally effective or 302 00:16:21,320 --> 00:16:23,480 accurate given the facts of the situation. 303 00:16:23,800 --> 00:16:26,440 And so it's just really tough thing to grapple with where it's 304 00:16:26,440 --> 00:16:28,320 like we know our emotions are good and they're telling us 305 00:16:28,320 --> 00:16:29,800 something. And when we're depressed, it's 306 00:16:29,800 --> 00:16:32,200 like they're telling us the wrong things and the messages 307 00:16:32,200 --> 00:16:34,440 are not the things that will work or be helpful. 308 00:16:35,080 --> 00:16:37,440 And like you're saying, even when you do the right things and 309 00:16:37,440 --> 00:16:40,920 go through the motions, it may not have that return on interest 310 00:16:40,920 --> 00:16:45,000 when it comes to improving your mood immediately or shifting the 311 00:16:45,000 --> 00:16:46,680 way you're thinking about your environment. 312 00:16:47,320 --> 00:16:51,960 Yeah, so I have a lot of things to say about meta meta emotion. 313 00:16:51,960 --> 00:16:54,640 I think it's really interesting. So thoughts and feelings about 314 00:16:54,920 --> 00:16:57,160 emotions, these are largely learned. 315 00:16:57,160 --> 00:16:59,680 These largely come from mark surrounding culture. 316 00:17:00,080 --> 00:17:03,840 And you know, one of the great mysteries is, is why there is so 317 00:17:03,840 --> 00:17:07,760 much depression now and in in certain demographics, like young 318 00:17:07,760 --> 00:17:10,400 people that people that are listening to your show and are 319 00:17:10,400 --> 00:17:12,839 interested in what people are talking about here. 320 00:17:13,240 --> 00:17:17,079 And So what are the meta emotional beliefs that are kind 321 00:17:17,079 --> 00:17:19,119 of in the air? And, and what are some that 322 00:17:19,119 --> 00:17:21,920 might be kind of depressigenic, but we don't have all the 323 00:17:21,920 --> 00:17:25,760 answers here, but it strikes me that we have some kind of 324 00:17:25,760 --> 00:17:28,160 unnatural views about feeling states. 325 00:17:28,160 --> 00:17:32,720 So if you watch TV, for example, and you watch commercials, they 326 00:17:32,720 --> 00:17:36,640 show people that are in these really high activation states of 327 00:17:36,640 --> 00:17:39,760 positivity, people kind of jumping around like, you know, 328 00:17:39,760 --> 00:17:42,040 jumping beans and really excited and Pepe. 329 00:17:42,040 --> 00:17:46,280 Can't believe there's a sale. Exactly. 330 00:17:46,520 --> 00:17:50,360 Yeah, It's between that and people's common social media 331 00:17:50,360 --> 00:17:54,480 persona where life is basically just a series of peaks and 332 00:17:54,560 --> 00:17:58,040 people start to represent this idea that that's normal to 333 00:17:58,040 --> 00:18:02,600 experience this really pumped up, jacked up positive 334 00:18:02,600 --> 00:18:05,800 affectivity. And so people walk around and 335 00:18:05,800 --> 00:18:08,880 they compare what they believe to be what other people are 336 00:18:08,880 --> 00:18:12,200 experiencing and what is normative in the culture to what 337 00:18:12,200 --> 00:18:14,400 they're actually experiencing. And they're noticing this 338 00:18:14,400 --> 00:18:18,040 enormous difference. The tragedy or the also the 339 00:18:18,040 --> 00:18:21,480 fascinating thing is that it's a myth that people are actually 340 00:18:21,480 --> 00:18:25,480 experiencing this peppy activated positive affect all 341 00:18:25,480 --> 00:18:26,360 the time. You know why? 342 00:18:26,360 --> 00:18:28,960 Because it's impossible. That's not how the affect system 343 00:18:28,960 --> 00:18:31,680 works. It's, it's sad, but it's true 344 00:18:31,680 --> 00:18:34,200 that you know when you get the promotion or when you get, get 345 00:18:34,200 --> 00:18:37,560 the new car and again, you expect I'm going to be excited 346 00:18:37,560 --> 00:18:40,880 for the next three weeks that in fact you're, you're excited and 347 00:18:40,880 --> 00:18:44,200 you're really happy and then it drops off it, it slows down. 348 00:18:44,440 --> 00:18:47,200 That's really how the FX system works because it's in perfect, 349 00:18:47,200 --> 00:18:50,000 because it's forward-looking and always wants you to get to the 350 00:18:50,000 --> 00:18:54,520 next, you know, the Bunny to the next carrot now the, the wage 351 00:18:54,520 --> 00:18:56,400 worker to the next payday and so forth. 352 00:18:56,400 --> 00:19:00,000 It's always about what's next. But in any case, I think it it 353 00:19:00,000 --> 00:19:04,880 does trap people in this belief that what they're feeling is not 354 00:19:04,880 --> 00:19:06,920 normal. So you have a double whammy. 355 00:19:07,080 --> 00:19:10,480 You feel bad, and feeling bad feels bad, but you also feel 356 00:19:10,480 --> 00:19:13,120 like I'm alone in these feelings. 357 00:19:13,120 --> 00:19:16,080 Other people are feeling something very different, and 358 00:19:16,080 --> 00:19:20,120 why can't I get out of it? And it sets people up to start 359 00:19:20,120 --> 00:19:23,280 monitoring their emotional experience in a way that 360 00:19:23,280 --> 00:19:27,440 probably is not well precedented in human history. 361 00:19:28,000 --> 00:19:32,240 Some of our solutions, I wonder if they're really solutions. 362 00:19:32,240 --> 00:19:35,720 So all these apps that people are wanting to make graphs of 363 00:19:35,720 --> 00:19:39,480 their mood with 15 minute intervals and so forth, again is 364 00:19:39,840 --> 00:19:44,240 making us very focused on on the ways that our feelings are 365 00:19:44,280 --> 00:19:47,520 falling short of some expectation rather than. 366 00:19:47,640 --> 00:19:52,040 And again, this may sound like someone telling someone 367 00:19:52,120 --> 00:19:56,640 unwelcome news, but some degree of acceptance of these even 368 00:19:56,640 --> 00:20:00,880 sometimes negative emotions can go a long way to helping people 369 00:20:00,880 --> 00:20:04,400 be OK with at least some of these feelings states. 370 00:20:04,400 --> 00:20:07,600 And not feeling like I'm a freak, I'm a failure. 371 00:20:07,680 --> 00:20:10,520 Why can't I control this? And so forth. 372 00:20:11,240 --> 00:20:14,400 Unfortunately I don't think research has given meta emotion 373 00:20:14,640 --> 00:20:17,760 fully its due. But we know that it's important, 374 00:20:17,760 --> 00:20:20,640 we just don't know quite how it's important in like a 375 00:20:20,640 --> 00:20:24,560 systematic way. Yeah, you mentioned that there's 376 00:20:24,560 --> 00:20:26,440 this huge increase in depression, which most people 377 00:20:26,440 --> 00:20:28,640 are aware of, especially with young adults. 378 00:20:28,640 --> 00:20:32,240 And there's been a lot of buzz recently about that topic and 379 00:20:32,240 --> 00:20:34,600 research that's come out about smartphones. 380 00:20:34,600 --> 00:20:37,200 And then there's differing opinions that this was on the 381 00:20:37,200 --> 00:20:39,840 rise prior to that. What are your thoughts there? 382 00:20:39,840 --> 00:20:42,560 Do you have a strong opinion on on why we're seeing this 383 00:20:42,560 --> 00:20:44,680 increase, especially in that demographic? 384 00:20:44,680 --> 00:20:47,280 I think what you mentioned with the the Meadow emotion piece and 385 00:20:47,280 --> 00:20:49,960 how we're seeing emotions represented is definitely a 386 00:20:49,960 --> 00:20:52,920 piece of the puzzle. But do you have an opinion or or 387 00:20:52,920 --> 00:20:55,400 theory why we're kind of in this position? 388 00:20:56,000 --> 00:21:00,120 Yeah, like anything interesting, there's almost certainly a 389 00:21:00,120 --> 00:21:03,040 multitude of factors that are going into it, rather than a 390 00:21:03,040 --> 00:21:05,080 single factor. And the world's not a controlled 391 00:21:05,080 --> 00:21:07,120 experiment where you can isolate the factors. 392 00:21:07,120 --> 00:21:09,240 So all these things are happening simultaneously. 393 00:21:09,800 --> 00:21:13,360 But I will say, as you're saying, there are some real 394 00:21:13,360 --> 00:21:17,120 cohort effects. So depression surprisingly more 395 00:21:17,120 --> 00:21:22,760 likely among those who have lived fewer years on Earth than 396 00:21:22,760 --> 00:21:25,720 people who are in their 70s, they've accumulated about the 397 00:21:25,720 --> 00:21:28,840 same amount of lifetime risk, even though the younger people 398 00:21:28,840 --> 00:21:32,200 have been alive much less long. And it does appear like that's 399 00:21:32,200 --> 00:21:36,160 real, not just a reporting bias in all of the kind of worst 400 00:21:36,160 --> 00:21:40,080 correlates of depression like hospitalization, suicide 401 00:21:40,080 --> 00:21:42,480 attempts, again, densely clustered in these younger 402 00:21:42,480 --> 00:21:43,600 folks. So there's something real 403 00:21:43,600 --> 00:21:45,840 happening. It's not just people whining or 404 00:21:45,840 --> 00:21:48,760 just a greater tendency to report depression, which is 405 00:21:49,320 --> 00:21:51,960 another possible explanation for it. 406 00:21:52,240 --> 00:21:56,880 So I do believe that Blake meta emotions that depression often 407 00:21:56,880 --> 00:22:01,160 is about expectations. So not only the expectations for 408 00:22:01,400 --> 00:22:05,880 the way that you're feeling, but also expectations about where 409 00:22:05,880 --> 00:22:10,640 you should be in life relative to where you're actually in 410 00:22:10,640 --> 00:22:12,640 life. So again, this is a hypothesis. 411 00:22:12,640 --> 00:22:15,640 I think there are some data that are, you know, consistent with 412 00:22:15,640 --> 00:22:20,000 this, that you do have a lot of people who have very, very high 413 00:22:20,000 --> 00:22:23,760 aspirations that may not be fully plugged into reality. 414 00:22:23,760 --> 00:22:27,040 So people saying, well, I'm going to be a millionaire before 415 00:22:27,040 --> 00:22:29,920 I'm 20 years old, I'm going to be Instagram famous. 416 00:22:29,960 --> 00:22:34,080 I'm going to be seen as the most beautiful or the most popular, 417 00:22:34,080 --> 00:22:37,480 and I'm going to get into Harvard or wherever those most 418 00:22:37,800 --> 00:22:42,000 desirable places are. And they may not to the extent 419 00:22:42,000 --> 00:22:44,960 that they don't have a plan for making this happen. 420 00:22:44,960 --> 00:22:48,600 That's opening the door to tremendous disappointment. 421 00:22:49,280 --> 00:22:51,840 That's not necessarily depressional by itself, but 422 00:22:52,120 --> 00:22:56,760 disappointed aspirations I think is a part of the mix and part of 423 00:22:56,760 --> 00:22:59,400 that does this disappointing aspirations, and I'm sure you've 424 00:22:59,400 --> 00:23:03,040 heard this from people who, who watch your show or listen to 425 00:23:03,040 --> 00:23:08,000 your show, is the sense that it is harder, it is harder to make 426 00:23:08,000 --> 00:23:12,160 it in a complex competitive society than than maybe it was 427 00:23:12,160 --> 00:23:15,320 for parents or grandparents. It's hard to break in 428 00:23:15,320 --> 00:23:17,040 economically. It's hard to finish your 429 00:23:17,040 --> 00:23:19,440 education. There's such rapid change. 430 00:23:20,080 --> 00:23:22,760 And yeah, I don't think it's, it's simple as there are these 431 00:23:22,760 --> 00:23:26,160 screens that people are looking at that have evil messages. 432 00:23:26,320 --> 00:23:29,200 You know, I, I think disconnection could potentially 433 00:23:29,200 --> 00:23:33,080 be part of the, the mix on the ways that screens can be 434 00:23:33,080 --> 00:23:39,320 isolating as opposed to IRL interactions and friendships and 435 00:23:39,320 --> 00:23:41,240 so forth. But those are, those are a few 436 00:23:41,240 --> 00:23:42,720 ideas. I mean, I think it's really 437 00:23:42,720 --> 00:23:45,760 quite a rich area. And, you know, there again, like 438 00:23:45,760 --> 00:23:49,080 that emotion, there's lots of room, I think, to improve our 439 00:23:49,080 --> 00:23:50,920 ability to explain what's going on. 440 00:23:51,560 --> 00:23:53,760 Yeah. Before we get into outcomes, 441 00:23:53,760 --> 00:23:57,120 which I'm so excited to dive into, you mentioned earlier the 442 00:23:57,400 --> 00:24:00,680 psychology research on our expectations about how things 443 00:24:00,680 --> 00:24:03,200 pan out and how it can be kind of helpful to understand that 444 00:24:03,200 --> 00:24:05,800 when we're depressed. Are there any other of those 445 00:24:05,880 --> 00:24:09,480 like psychology facts or insights that you really enjoy 446 00:24:09,480 --> 00:24:12,920 or find really interesting that are applicable to depression? 447 00:24:13,000 --> 00:24:16,600 One of my favorite ones is how people estimate the consistency 448 00:24:16,600 --> 00:24:19,280 and important of things going on in their life now. 449 00:24:19,280 --> 00:24:22,800 Like if how I do on this test is going to drastically impact my 450 00:24:22,800 --> 00:24:25,560 life in 10 years, I'm going to like the same bands and these 451 00:24:25,560 --> 00:24:28,200 relationships are going to have such a big impact on my life. 452 00:24:28,200 --> 00:24:30,880 And then when you ask people 10 years later, like, I don't even 453 00:24:30,880 --> 00:24:33,080 know what you're talking about with that test and I don't talk 454 00:24:33,080 --> 00:24:35,360 to that person anymore. And, and the way that we're 455 00:24:35,360 --> 00:24:38,400 thinking about those things in the moment is really ineffective 456 00:24:38,520 --> 00:24:41,360 and also inaccurate and can add to these emotions that we're 457 00:24:41,360 --> 00:24:43,880 experiencing and the pressure that we're placing on ourselves 458 00:24:43,880 --> 00:24:46,040 and the goals, like you were saying that we have for 459 00:24:46,040 --> 00:24:49,760 ourselves in the future. Kind of these like psychological 460 00:24:49,760 --> 00:24:52,680 and effective things that we're doing that we're we're not aware 461 00:24:52,680 --> 00:24:55,400 of when we're feeling and thinking these things, but also 462 00:24:55,400 --> 00:24:58,960 might not be serving us. Yeah, so something that really 463 00:24:58,960 --> 00:25:03,080 strikes me as deeply related to a lot of phenomena and 464 00:25:03,080 --> 00:25:07,200 depression that we don't always give it's due is just how mood 465 00:25:07,200 --> 00:25:11,160 dependent a variety of processes are and it's and it's amazing. 466 00:25:11,160 --> 00:25:14,520 But so like if you ask, this is even goes to diagnosis. 467 00:25:14,960 --> 00:25:18,200 If you ask someone who's in the middle of a depressive episode 468 00:25:18,200 --> 00:25:22,120 to talk about times in their life when they were experiencing 469 00:25:22,120 --> 00:25:23,520 depression, they'll have no trouble. 470 00:25:23,520 --> 00:25:27,160 They'll go into great detail in and if you ask them, so could 471 00:25:27,160 --> 00:25:30,440 you tell me about times when you were feeling well, they'll draw 472 00:25:30,440 --> 00:25:32,160 a blank. They'll really have a great 473 00:25:32,160 --> 00:25:36,400 difficulty accessing that information because the the mood 474 00:25:36,400 --> 00:25:40,640 suffuses their cognition in their attentional spotlight on 475 00:25:40,640 --> 00:25:42,280 things that are congruent with the mood. 476 00:25:42,800 --> 00:25:46,400 And the reverse is even more striking that you someone, if 477 00:25:46,400 --> 00:25:51,000 you follow someone who was depressed and interview them 20 478 00:25:51,000 --> 00:25:54,000 years later and you ask them about depression, there is 479 00:25:54,120 --> 00:25:57,680 evidence that people literally forget the depressive episodes. 480 00:25:57,680 --> 00:25:59,960 They're no longer salient. They don't, you know it's 481 00:25:59,960 --> 00:26:02,280 because you ask the screening questions about depression. 482 00:26:02,280 --> 00:26:05,480 Did you ever have a time when you felt depressed most of the 483 00:26:05,480 --> 00:26:07,480 day, nearly every day for two weeks? 484 00:26:07,720 --> 00:26:10,760 They're like nothing really bringing a bell there. 485 00:26:10,760 --> 00:26:12,320 Let's hope we all get to that point. 486 00:26:12,360 --> 00:26:15,800 That's what we hope for people. I mean, I, I don't know that I 487 00:26:15,800 --> 00:26:19,200 hope for it because I, I like the idea that they remain 488 00:26:19,400 --> 00:26:23,320 grounded in reality and are aware of all, all the ways that 489 00:26:23,320 --> 00:26:27,080 we are kind of a amalgam or summation of all the experience 490 00:26:27,080 --> 00:26:29,280 that we have. And we don't run, we don't run 491 00:26:29,280 --> 00:26:33,080 away from the fact that maybe we had depression and we can still 492 00:26:33,200 --> 00:26:36,560 appreciate that. But it it probably is, you know, 493 00:26:36,560 --> 00:26:40,280 a tribute to how powerful the mood dependent phenomena are 494 00:26:40,280 --> 00:26:42,240 that people literally forget episodes. 495 00:26:43,160 --> 00:26:46,240 That's why I believe, yeah. And especially because when 496 00:26:46,240 --> 00:26:49,520 you're in that depressive state, it's literally all you can think 497 00:26:49,520 --> 00:26:51,560 about and it's impacts everything you're doing. 498 00:26:51,560 --> 00:26:54,760 And so I remember being like, I there will never be a time where 499 00:26:54,760 --> 00:26:57,600 I'm not constantly thinking about depression or my emotions 500 00:26:57,600 --> 00:27:00,840 or how I'm feeling. And like you're saying, it's 501 00:27:00,960 --> 00:27:02,960 very mood dependent, like the fact that we're feeling 502 00:27:02,960 --> 00:27:05,800 depressed is pushing a lot of those thoughts, but also as our 503 00:27:05,800 --> 00:27:08,640 mood shifts after the fact, our memories and the intensity of 504 00:27:08,640 --> 00:27:11,920 that period also decreases. And it works the other way 505 00:27:11,920 --> 00:27:15,080 around. So you you can show someone 506 00:27:15,080 --> 00:27:17,920 information that shows conclusively that there was a 507 00:27:17,920 --> 00:27:21,720 time before this when you appeared to be quite happy. 508 00:27:22,040 --> 00:27:25,080 And the the person will look at you like you're completely 509 00:27:25,080 --> 00:27:27,440 crazy. I almost have no memory of this 510 00:27:27,440 --> 00:27:29,560 person. And again, this feeling of being 511 00:27:29,680 --> 00:27:32,920 being trapped in depression because other parts of your life 512 00:27:32,920 --> 00:27:35,720 become inaccessible if it goes on long enough. 513 00:27:36,200 --> 00:27:38,400 Yeah, yeah, I remember that. I was like, I don't remember a 514 00:27:38,400 --> 00:27:39,840 time when I didn't feel this way. 515 00:27:39,840 --> 00:27:43,040 And you can logically be like, that's probably not true, but 516 00:27:43,040 --> 00:27:46,200 you really do feel like this has been such a salient experience. 517 00:27:46,520 --> 00:27:48,960 For sure. Outcomes, I'm really excited for 518 00:27:48,960 --> 00:27:51,360 this because this is something that I think the general 519 00:27:51,360 --> 00:27:53,680 population doesn't hear a lot about. 520 00:27:53,680 --> 00:27:56,480 And your your research on why some people have positive 521 00:27:56,480 --> 00:27:58,920 outcomes from depression and why some people don't. 522 00:27:58,920 --> 00:28:01,320 I think it's really interesting. So can you give people a little 523 00:28:01,320 --> 00:28:04,360 bit of an overview of this research for those who are not 524 00:28:04,360 --> 00:28:06,440 familiar? I'd be happy to. 525 00:28:06,840 --> 00:28:11,040 I'll start by saying that I was doing depression research like 526 00:28:11,040 --> 00:28:14,000 everyone else. I was interested in outcomes, 527 00:28:14,400 --> 00:28:18,000 and I was looking at the standard things that people 528 00:28:18,000 --> 00:28:22,080 usually examine in mood disorders research, which is do 529 00:28:22,080 --> 00:28:25,240 people have more episodes of depression? 530 00:28:25,240 --> 00:28:29,000 Do they recover? Do they have symptoms of 531 00:28:29,000 --> 00:28:33,440 depression in? We know a lot about that for 532 00:28:33,440 --> 00:28:35,480 sure. But I started to get a little 533 00:28:35,480 --> 00:28:39,640 restless and I started to wonder what about the things that the 534 00:28:39,640 --> 00:28:44,960 average person would talk about as things that they want for 535 00:28:44,960 --> 00:28:48,240 their life. So, you know, yes, I think it is 536 00:28:48,240 --> 00:28:50,920 true that when people are depressed, they say I would 537 00:28:50,920 --> 00:28:55,240 rather have fewer symptoms, but symptoms is not a very rich 538 00:28:55,280 --> 00:28:58,720 mapping of of all of the domains of life and functioning. 539 00:28:58,720 --> 00:29:02,360 So people want healthy relationships, they want to live 540 00:29:02,400 --> 00:29:05,960 lives that are purposeful. They obviously want to be happy. 541 00:29:05,960 --> 00:29:08,840 They want to function well in different domains like work. 542 00:29:09,280 --> 00:29:12,640 And I realized that Wow research had really missed the boat. 543 00:29:12,640 --> 00:29:17,280 They had almost completely ignored these outcomes in for 544 00:29:17,280 --> 00:29:21,320 sure when we talked about functioning, they ignored good 545 00:29:21,320 --> 00:29:23,360 functioning. So there used to be this thing 546 00:29:23,360 --> 00:29:26,040 called the global assessment of functioning scale. 547 00:29:26,440 --> 00:29:30,000 And basically they didn't weren't very interested. 548 00:29:30,000 --> 00:29:32,640 If you were functioning fine, that was OK. 549 00:29:32,640 --> 00:29:35,280 But when someone said they were doing poorly, that would really 550 00:29:35,280 --> 00:29:37,800 affect the scale a lot. So basically the best you could 551 00:29:37,800 --> 00:29:40,480 do would be like no problems functioning. 552 00:29:40,640 --> 00:29:43,960 So that's how I got into it. And well, I was interested in 553 00:29:43,960 --> 00:29:46,880 the first question, all these different outcomes you could 554 00:29:46,880 --> 00:29:50,960 imagine that could be important to people, like how happy 555 00:29:50,960 --> 00:29:53,800 relationships, doing well on the job. 556 00:29:54,080 --> 00:29:57,760 I thought that psychological well-being shared a lot of 557 00:29:57,760 --> 00:30:01,560 promise a because that is something that people will 558 00:30:01,560 --> 00:30:04,440 identify as important. I want to feel positive 559 00:30:04,440 --> 00:30:06,280 emotions. I want to feel that my life is 560 00:30:06,280 --> 00:30:09,680 purposeful, that I have control and things like that. 561 00:30:10,240 --> 00:30:12,480 And we know how to measure this pretty well. 562 00:30:12,480 --> 00:30:16,360 There's a pretty deep literature on psychological well-being. 563 00:30:16,720 --> 00:30:20,120 Some of these other domains like how you're functioning at work 564 00:30:20,120 --> 00:30:22,400 or how's your spiritual functioning, they're a bit 565 00:30:22,400 --> 00:30:26,360 harder to measure. So we capitalized on the idea 566 00:30:26,360 --> 00:30:29,680 that we have big population samples that have completed 567 00:30:29,680 --> 00:30:32,360 measures of psychological well-being that allow us to say 568 00:30:32,760 --> 00:30:34,960 this is what it means to be doing well. 569 00:30:34,960 --> 00:30:38,320 So for example, if you're in the top quarter of people who in the 570 00:30:38,320 --> 00:30:42,160 non depressed population for well-being, that's pretty good. 571 00:30:42,440 --> 00:30:44,960 So the question then became if you have a history of 572 00:30:44,960 --> 00:30:48,440 depression, what's the likelihood that in the future 573 00:30:48,760 --> 00:30:50,680 you will have recovered from your disorder? 574 00:30:50,680 --> 00:30:53,640 So you're not reporting the symptoms of depression and 575 00:30:53,640 --> 00:30:56,040 you're reporting high levels of psychological well-being. 576 00:30:56,040 --> 00:31:00,280 So for example, being in that top quartile of a non depressed 577 00:31:00,600 --> 00:31:04,200 group based on the epidemiology. And this, I guess maybe this 578 00:31:04,200 --> 00:31:08,960 sort of speaks to whether this research should build people's 579 00:31:08,960 --> 00:31:12,720 hope or how we should feel about the research going in. 580 00:31:12,720 --> 00:31:16,720 The epidemiology of depression said pretty consistently that we 581 00:31:16,720 --> 00:31:19,040 might want to adjust our expectations. 582 00:31:19,400 --> 00:31:22,680 A lot of the epidemiology is based on clinical samples. 583 00:31:22,920 --> 00:31:26,440 So people who had depression, who were seen in therapy, in 584 00:31:26,440 --> 00:31:28,840 treatment, a lot of were inpatients and followed over 585 00:31:28,840 --> 00:31:30,840 time. And the course of depression in 586 00:31:30,840 --> 00:31:32,680 those groups doesn't look that terrific. 587 00:31:32,680 --> 00:31:35,800 I mean there tends to be a lot of recurrence of depression and 588 00:31:35,800 --> 00:31:39,800 not a lot of well periods. And so going in just like, Oh 589 00:31:39,800 --> 00:31:43,600 well, this will be like 1% that recovers from disorder and 590 00:31:43,600 --> 00:31:45,200 reporting high levels of well-being. 591 00:31:45,680 --> 00:31:49,600 And so in that context, essentially what we found in the 592 00:31:49,600 --> 00:31:53,480 first study was using U.S. National data that depression, 593 00:31:53,480 --> 00:31:57,400 it about halved the likelihood that the person would report 594 00:31:57,400 --> 00:32:00,040 well-being. And I'm a glass half full kind 595 00:32:00,040 --> 00:32:04,280 of person as I'd say like that's far from eliminating the chance. 596 00:32:04,680 --> 00:32:09,280 And so about 10% of the sample that had depression at the 597 00:32:09,280 --> 00:32:12,320 initial point was reporting very high levels of well-being 598 00:32:12,320 --> 00:32:14,280 consistent with that top quartile. 599 00:32:14,880 --> 00:32:20,200 So I thought this is amazing that these people exist in much 600 00:32:20,560 --> 00:32:23,680 larger numbers than the conventional wisdom, you know, 601 00:32:23,680 --> 00:32:28,040 would have us believe. And we replicated this pattern 602 00:32:28,240 --> 00:32:32,280 in a Canadian sample. And so I think the question of 603 00:32:32,280 --> 00:32:35,320 whether or not there is well-being after depression or 604 00:32:35,320 --> 00:32:37,800 whether there's systematic evidence, I think has been 605 00:32:37,840 --> 00:32:39,960 answered. And we're kind of in the more 606 00:32:39,960 --> 00:32:43,480 interesting phase of research, which is to begin to understand 607 00:32:44,120 --> 00:32:45,960 what explains these good outcomes. 608 00:32:46,440 --> 00:32:50,320 So in the initial studies, these were archival data analysis. 609 00:32:50,320 --> 00:32:52,640 So they were collected for other purposes. 610 00:32:53,120 --> 00:32:57,120 And they didn't really give us the tools to understand what are 611 00:32:57,120 --> 00:33:00,840 the factors that explain why some people are attaining or 612 00:33:00,840 --> 00:33:03,960 reporting well-being in the future where other people are 613 00:33:03,960 --> 00:33:05,760 not. And so we might have a lot of 614 00:33:05,760 --> 00:33:09,240 hypotheses about what would explain this, including some 615 00:33:09,240 --> 00:33:11,320 things that are awfully hard to control. 616 00:33:11,320 --> 00:33:14,560 So how severe your depression was in the 1st place, which 617 00:33:14,920 --> 00:33:18,680 could in part be a function of someone's biological 618 00:33:18,680 --> 00:33:23,400 vulnerability, or it could be a function of how much early life 619 00:33:23,400 --> 00:33:26,200 adversity they they were subjected to. 620 00:33:26,680 --> 00:33:30,040 But I also imagine that in this equation where we look at a 621 00:33:30,120 --> 00:33:33,000 number of variables that influence future well-being, 622 00:33:33,400 --> 00:33:36,520 that some of those variables are going to be within human 623 00:33:36,520 --> 00:33:39,560 control. And that's very exciting because 624 00:33:39,600 --> 00:33:42,000 those are things that you can do something about, Whether it's 625 00:33:42,000 --> 00:33:45,120 your attitudes towards depression or all the things 626 00:33:45,120 --> 00:33:48,360 that we were alluding to, ways that people try to influence 627 00:33:48,360 --> 00:33:52,160 their mood through different habits like exercise or diet or 628 00:33:52,160 --> 00:33:55,760 sleep, that may prove to be important. 629 00:33:56,080 --> 00:34:00,160 It's also likely, I think it's almost certainly the case that 630 00:34:00,160 --> 00:34:03,720 there is more than one pathway to well-being. 631 00:34:04,280 --> 00:34:09,760 So what I think we'll be saying in five or ten years is that 632 00:34:09,760 --> 00:34:11,719 there's several different pathways. 633 00:34:11,719 --> 00:34:14,880 Some involve control more than others. 634 00:34:15,120 --> 00:34:18,760 And though, you know, it's not as strong as you can just choose 635 00:34:18,760 --> 00:34:23,040 your own adventure, this does kind of suggest that people can 636 00:34:23,040 --> 00:34:26,639 experiment and find to what extent things that work for 637 00:34:26,639 --> 00:34:30,760 other people are helpful for them in building this kind of 638 00:34:30,760 --> 00:34:33,440 sustainable well-being over time. 639 00:34:33,440 --> 00:34:36,400 Because, you know, I think having well-being in a snapshot, 640 00:34:36,400 --> 00:34:39,000 that's what these research studies were showing is very 641 00:34:39,000 --> 00:34:41,679 important. And as you're suggesting is very 642 00:34:41,679 --> 00:34:45,040 helpful because I do think that there is a lot of gloom and 643 00:34:45,040 --> 00:34:48,600 misery out there about what you can expect if you have 644 00:34:48,600 --> 00:34:51,320 depression. And unfortunately, there isn't 645 00:34:51,560 --> 00:34:54,199 fantastic prognosis information out there. 646 00:34:54,480 --> 00:34:57,600 And this isn't to blame clinicians, but to say in 647 00:34:57,600 --> 00:35:00,640 reality they are going largely based on the published 648 00:35:00,640 --> 00:35:04,640 epidemiology, most of which is based on clinical samples. 649 00:35:04,880 --> 00:35:08,960 I mean, you would be amazed by how few studies look at a 650 00:35:08,960 --> 00:35:12,360 representative sample of depression as it happens in the 651 00:35:12,360 --> 00:35:15,960 community and follow those folks for decades. 652 00:35:16,000 --> 00:35:19,360 I think there's maybe 3 studies like that in the entire 653 00:35:19,360 --> 00:35:20,760 literature now. It's a lot of work. 654 00:35:21,080 --> 00:35:22,920 Population samples are a huge amount of work. 655 00:35:22,920 --> 00:35:28,240 We have enough trouble saying who's gonna vote for president 656 00:35:28,600 --> 00:35:30,920 in five days and getting a representative sample. 657 00:35:30,920 --> 00:35:33,440 So when we're talking about things that are not as common, 658 00:35:33,840 --> 00:35:39,520 like depression, that maybe only 5 or 6% of people might be 659 00:35:39,520 --> 00:35:42,640 experiencing any given time, and then we're talking about how 660 00:35:42,640 --> 00:35:45,960 people are functioning in 20 years, that that sort of work is 661 00:35:45,960 --> 00:35:48,400 really challenging. But the work in community 662 00:35:48,400 --> 00:35:52,440 samples, it definitely suggests that there are many people who 663 00:35:52,440 --> 00:35:57,400 do not have these chronic courses of depression, including 664 00:35:57,400 --> 00:36:00,840 many people who have only a single episode of depression. 665 00:36:01,040 --> 00:36:05,240 There's probably a lot to that story that remains to be teased 666 00:36:05,240 --> 00:36:08,240 out and understood. And there could be some overlap 667 00:36:08,360 --> 00:36:12,720 between in the wider world that single episodes are pretty 668 00:36:12,720 --> 00:36:16,920 common, even though the DSM still says when they just talk 669 00:36:16,920 --> 00:36:19,600 about depression and it's epidemiology that it's typically 670 00:36:19,600 --> 00:36:22,760 recurrent. I think it's like a 5050. 671 00:36:23,080 --> 00:36:26,400 It's at about half of cases it's recurrent, and in those cases 672 00:36:26,400 --> 00:36:29,680 it's often very recurrent. But the half that it's not 673 00:36:29,760 --> 00:36:32,320 recurrent is not unimportant because it's half. 674 00:36:32,320 --> 00:36:35,360 And I also think that there could be some ways in which it's 675 00:36:35,360 --> 00:36:39,440 useful for people who experience more recurrent forms of 676 00:36:39,440 --> 00:36:45,400 depression to simply know that there are other pathways and 677 00:36:45,520 --> 00:36:48,320 understanding, again, what is the explanation? 678 00:36:48,720 --> 00:36:51,680 Because anyone who has recurrent depression with would surely 679 00:36:51,680 --> 00:36:53,720 like their depression to be less recurrent. 680 00:36:53,800 --> 00:36:56,480 And so I don't think any of this is completely destiny. 681 00:36:56,960 --> 00:37:00,440 So I'm very a big believer in what I call realistic hope. 682 00:37:00,600 --> 00:37:03,840 So I don't think hope by itself is all that helpful. 683 00:37:03,840 --> 00:37:07,120 And sometimes it can be, I want to say toxic, but it can be 684 00:37:07,120 --> 00:37:10,320 almost demoralizing when people are giving you hopeful messages 685 00:37:10,320 --> 00:37:14,000 that are not really well anchored in empirical facts. 686 00:37:14,000 --> 00:37:17,280 But like this, 10 percent, 10% of people who have a history of 687 00:37:17,280 --> 00:37:19,840 depression go on to experience high levels of well-being. 688 00:37:19,840 --> 00:37:23,440 And now we're finding that in multiple samples, we found some 689 00:37:23,440 --> 00:37:28,000 things similarly striking in a sample of adolescents who had a 690 00:37:28,000 --> 00:37:31,560 history of a suicide attempt and survived, that the surprisingly 691 00:37:31,560 --> 00:37:35,240 large percentage of those youth went on to report well-being. 692 00:37:35,240 --> 00:37:38,520 And again, it's not the majority, but these are facts. 693 00:37:38,960 --> 00:37:42,960 And so I think we can, once people accept that these are 694 00:37:42,960 --> 00:37:44,800 facts, we can start to understand well, what are the 695 00:37:44,800 --> 00:37:48,240 implications of these facts. And I think some of the 696 00:37:48,240 --> 00:37:52,480 implications of these facts is that the course of depression is 697 00:37:52,480 --> 00:37:55,280 not uniformly bad. It's just not, it's just not 698 00:37:55,280 --> 00:37:57,440 uniformly bad. And I'm interested in to what 699 00:37:57,440 --> 00:38:01,880 extent this knowledge could help us improve the average. 700 00:38:01,920 --> 00:38:05,320 I mean, because ultimately, you know, epidemiology is not, it's 701 00:38:05,320 --> 00:38:07,040 not destiny. We're not talking about 702 00:38:07,040 --> 00:38:11,440 something like, I mean, there are diseases like this at least 703 00:38:11,440 --> 00:38:13,400 in our present ability to intervene. 704 00:38:13,400 --> 00:38:16,960 So, you know, Huntington's disease does not appear to be a 705 00:38:16,960 --> 00:38:20,080 disease right now that we have an intervention or even 706 00:38:20,080 --> 00:38:23,840 understand what explains its progression, but it is a highly 707 00:38:23,840 --> 00:38:27,280 progressive disease. Depression appears to be more 708 00:38:27,280 --> 00:38:31,120 reversible than a neurological disease like Huntington's 709 00:38:31,120 --> 00:38:33,040 disease. And that's not just happy talk. 710 00:38:33,200 --> 00:38:35,600 That really seems borne out in the facts. 711 00:38:36,240 --> 00:38:40,160 Yeah, it's really interesting because it is such a gap in the 712 00:38:40,160 --> 00:38:42,640 research and our understanding of depression, but it also makes 713 00:38:42,640 --> 00:38:45,080 so much sense because these people that are experiencing 714 00:38:45,400 --> 00:38:48,520 really high well-being versus still really in the struggle 715 00:38:48,960 --> 00:38:51,240 like one population, you're like, it absolutely makes sense 716 00:38:51,240 --> 00:38:52,960 that they're still in this clinical setting. 717 00:38:52,960 --> 00:38:54,520 It's easier to follow these outcomes. 718 00:38:54,520 --> 00:38:58,040 There is potentially more hospitalizations or incidents or 719 00:38:58,040 --> 00:39:00,600 prescriptions being filled, whatever data you can look at. 720 00:39:00,600 --> 00:39:02,840 And then these people that are doing really well and well-being 721 00:39:03,040 --> 00:39:05,400 kind of makes sense why we see them like drop off the map when 722 00:39:05,400 --> 00:39:07,520 it comes to these things that we check in on. 723 00:39:07,840 --> 00:39:09,360 And so I think that's really interesting. 724 00:39:09,360 --> 00:39:13,720 And I also wonder the reasons why these high levels of 725 00:39:13,720 --> 00:39:15,600 well-being occur after depression. 726 00:39:15,600 --> 00:39:19,840 I know for me anecdotally, going into college, I heard from so 727 00:39:19,840 --> 00:39:22,040 many people that it was the hardest thing they've ever gone 728 00:39:22,040 --> 00:39:25,880 through emotionally and going through that huge period of 729 00:39:25,880 --> 00:39:29,760 change and deciding their own schedule and the stress levels. 730 00:39:29,760 --> 00:39:32,520 Like a lot of people experience depression for the first time in 731 00:39:32,520 --> 00:39:34,680 college. It's such a huge shift in life 732 00:39:34,680 --> 00:39:36,760 and they've never experienced anything like it before. 733 00:39:37,160 --> 00:39:40,040 And I remember getting to college and having gone through 734 00:39:40,040 --> 00:39:44,120 DBT and had they done a lot of therapy and been through such a 735 00:39:44,120 --> 00:39:47,040 worse time emotionally being like, I have every single skill 736 00:39:47,120 --> 00:39:50,080 I could need to navigate this experience and navigate this new 737 00:39:50,320 --> 00:39:53,480 arena and build relationships. And I know that schedule is 738 00:39:53,480 --> 00:39:56,320 really important and and sleep is something that absolutely has 739 00:39:56,320 --> 00:39:58,680 to happen. And so it did feel like there is 740 00:39:58,680 --> 00:40:00,960 that skill set there that some people just didn't have. 741 00:40:00,960 --> 00:40:03,760 And I did feel like that anecdotally correlated with 742 00:40:03,760 --> 00:40:06,120 being able to maintain and improve well-being in college. 743 00:40:06,120 --> 00:40:09,600 And so I'm curious if you have in speaking to people who have. 744 00:40:09,680 --> 00:40:12,960 Kind of ended up in that camp with higher levels of well-being 745 00:40:12,960 --> 00:40:15,600 post depression. Or subjectively, if you have any 746 00:40:15,600 --> 00:40:19,440 thoughts or predictions on why some people have such positive 747 00:40:19,440 --> 00:40:22,240 outcomes after those depressive episodes. 748 00:40:22,880 --> 00:40:25,840 I mean, I love your story. I think it's, it's so telling. 749 00:40:25,840 --> 00:40:30,160 And again, not the not the default or mainstream view of 750 00:40:30,680 --> 00:40:33,960 how we think about the effects of depression mean ordinarily I 751 00:40:33,960 --> 00:40:37,760 think people think, oh, if you have depression, you're damaged, 752 00:40:37,920 --> 00:40:41,080 you got damaged. And so like the best you can do 753 00:40:41,080 --> 00:40:43,840 is you have all these scars and just kind of like repair the 754 00:40:43,840 --> 00:40:45,560 damage. But what you're describing, 755 00:40:45,920 --> 00:40:49,480 Sadie, with your experience, if I'm understanding it, is that 756 00:40:49,840 --> 00:40:52,800 depression was kind of a proving ground for you in some ways, 757 00:40:52,960 --> 00:40:58,120 that you emerged with some knowledge and some skills, both 758 00:40:58,120 --> 00:41:00,560 about yourself and about the world that you wouldn't have 759 00:41:00,560 --> 00:41:02,280 had. And it doesn't mean that it's a 760 00:41:02,280 --> 00:41:06,600 blessing for everyone or just a good thing that we just should 761 00:41:06,600 --> 00:41:09,000 be more depression so we would all have these skills. 762 00:41:09,720 --> 00:41:12,640 But I think that we ignore this at our peril because this is 763 00:41:12,640 --> 00:41:15,840 like a really profound experience that people go 764 00:41:15,840 --> 00:41:18,600 through. And it does change people. 765 00:41:19,000 --> 00:41:22,800 And I think we've ignored the ways in which those changes are 766 00:41:22,800 --> 00:41:26,720 changes that are helpful in later life, whether that's being 767 00:41:26,720 --> 00:41:30,240 more empathetic to other people who might be struggling, better 768 00:41:30,240 --> 00:41:37,160 self knowledge, a better tuning of your aspirations to projects 769 00:41:37,160 --> 00:41:40,040 that are meaningful and purposeful. 770 00:41:40,360 --> 00:41:42,960 And part of what happens in depression is people often 771 00:41:42,960 --> 00:41:46,000 experience kind of a crisis of meaning and purpose. 772 00:41:46,400 --> 00:41:50,200 And it doesn't always get solved, but sometimes it does. 773 00:41:50,320 --> 00:41:54,120 I mean, I'll just say again, anecdotally and to relate my own 774 00:41:54,120 --> 00:41:58,800 experience, I think that changing what I was doing from 775 00:41:58,800 --> 00:42:02,240 the study of history, which I loved, to the study of 776 00:42:02,240 --> 00:42:06,160 psychology, it wasn't 100%. It's hard to put on an exact 777 00:42:06,160 --> 00:42:11,480 number, but it was a significant component, I think, in how I was 778 00:42:11,480 --> 00:42:14,040 able to pull out of the depression and after the 779 00:42:14,040 --> 00:42:17,040 episode, kind of gathered something that was meaningful 780 00:42:17,040 --> 00:42:20,440 and purposeful for me. So understanding depression was 781 00:42:20,440 --> 00:42:23,720 very near and dear to my heart. And the idea that my experience 782 00:42:23,720 --> 00:42:26,920 could be something that actually leads to something good in 783 00:42:26,960 --> 00:42:29,880 scientific knowledge and helping other people, that would be a 784 00:42:29,880 --> 00:42:34,240 great example of how depression could change someone in in a in 785 00:42:34,240 --> 00:42:36,600 a positive way. And I think that's really been 786 00:42:36,600 --> 00:42:41,200 very badly neglected in psychiatry and clinical 787 00:42:41,200 --> 00:42:45,320 psychology because of this almost exclusive focus on the 788 00:42:45,320 --> 00:42:49,280 ways that depression creates different kinds of collateral 789 00:42:49,280 --> 00:42:54,800 damage, you know, in cognitions and relationships, in income and 790 00:42:54,800 --> 00:42:57,360 so forth, and you in other psychopathology. 791 00:42:57,720 --> 00:43:01,240 And look, I'm not trying to put those people out of business and 792 00:43:01,240 --> 00:43:04,600 talking about positive outcomes or positive life change. 793 00:43:04,840 --> 00:43:08,200 I just, I'm asking for a little bit more balance. 794 00:43:08,480 --> 00:43:11,480 So, you know, we could again have a discussion about what is 795 00:43:11,480 --> 00:43:14,160 the right level of balance in terms of studying negative 796 00:43:14,160 --> 00:43:16,200 outcomes versus positive outcomes. 797 00:43:16,560 --> 00:43:20,960 And I'd say about 50-50. But realistically, even if 1/4 798 00:43:20,960 --> 00:43:25,360 of the research was aimed at ways in which depression for 799 00:43:25,360 --> 00:43:29,200 some people is a kind of a bridge to a better place, I 800 00:43:29,200 --> 00:43:31,800 think it would be very useful. I think it could be very useful 801 00:43:31,800 --> 00:43:33,920 clinically. That is people who are still 802 00:43:33,920 --> 00:43:37,200 struggling because we don't have to always reinvent the wheel. 803 00:43:37,200 --> 00:43:40,400 There are a lot of common themes that are shared between people 804 00:43:40,400 --> 00:43:43,800 who have these experiences. And as you're suggesting, the 805 00:43:43,840 --> 00:43:47,400 experience of depression as it is happening now is very 806 00:43:47,400 --> 00:43:50,520 disconnecting. So you have people who are still 807 00:43:50,520 --> 00:43:54,320 quote, UN quote, still in it versus people who feel like 808 00:43:54,320 --> 00:43:56,440 they've come out the other side and they're now a different 809 00:43:56,440 --> 00:44:00,800 person and very little conversation between those those 810 00:44:00,800 --> 00:44:04,760 two groups and kind of almost like each is kind of threatened 811 00:44:04,760 --> 00:44:07,760 by the other. And I think like, wow, everyone 812 00:44:07,760 --> 00:44:09,920 has something to give here, you know? 813 00:44:09,960 --> 00:44:13,840 And so I think this dialogue about the ways that depression 814 00:44:13,840 --> 00:44:17,800 can change you and the ways that depression can change you even 815 00:44:17,800 --> 00:44:20,640 for the better, or at least it can be an opportunity for 816 00:44:20,640 --> 00:44:24,040 change, better or worse, is a kind of dialogue that I think a 817 00:44:24,080 --> 00:44:27,320 lot of people who've had these experiences would be interested 818 00:44:27,320 --> 00:44:30,680 in having, regardless of whether they're depressed right now or 819 00:44:30,680 --> 00:44:32,880 not. Yeah, it's exactly like you said 820 00:44:32,880 --> 00:44:35,360 earlier. It's literally a blind spot for 821 00:44:35,360 --> 00:44:38,120 the people that have come out of it and now don't as vividly 822 00:44:38,120 --> 00:44:40,560 remember the experience and the people that are in it that 823 00:44:40,560 --> 00:44:44,440 aren't able to contemplate what it could look like on the other 824 00:44:44,440 --> 00:44:45,960 side. And so I couldn't agree more 825 00:44:45,960 --> 00:44:48,680 that that conversation is so, so, so needed. 826 00:44:49,120 --> 00:44:53,000 But it is complicated because it sort of speaks to these issues 827 00:44:53,000 --> 00:44:55,440 of identity. So identity is a complicated 828 00:44:55,440 --> 00:44:57,880 topic, right? And say people have multiple 829 00:44:58,160 --> 00:45:02,360 things that they identify that they comprise their identity and 830 00:45:02,480 --> 00:45:05,600 and there's a question of how does mental health intersect 831 00:45:05,600 --> 00:45:09,080 with that? So, you know, typically people 832 00:45:09,160 --> 00:45:12,720 don't integrate mental health problems into their identity 833 00:45:12,720 --> 00:45:16,000 very much or very well. And part of it is that there is 834 00:45:16,000 --> 00:45:20,000 a fairly dominant model of mental health problems that's 835 00:45:20,000 --> 00:45:24,200 biomedical that conceives of these problems as fundamentally 836 00:45:24,200 --> 00:45:27,720 a disease. And so it's hard to identify 837 00:45:27,720 --> 00:45:30,000 with the disease. It's harder because it's a 838 00:45:30,000 --> 00:45:33,600 disease is something that happens to you, result of genes 839 00:45:33,600 --> 00:45:36,920 or biochemical processes. It doesn't really feel like it's 840 00:45:36,920 --> 00:45:39,480 you. But that I think is too bad in 841 00:45:39,480 --> 00:45:43,800 the sense that for everyone, it is a profound experience and 842 00:45:43,800 --> 00:45:46,680 does lead to changes in how people might think of themselves 843 00:45:46,680 --> 00:45:48,640 or their experiences or their future. 844 00:45:48,960 --> 00:45:53,240 And so it does intersect with with identity and people have 845 00:45:53,240 --> 00:45:56,720 difficulty figuring out how do I relate to this thing? 846 00:45:56,720 --> 00:45:59,720 Does this mean that I'm a bad person or what does it mean? 847 00:46:00,040 --> 00:46:03,000 And so I think part of this dialogue, what it could do is to 848 00:46:03,000 --> 00:46:06,440 help reconnect these profound experiences to people's 849 00:46:06,440 --> 00:46:08,720 identities. And not only in ways where 850 00:46:08,720 --> 00:46:11,160 people feel diminished because they had a mental health 851 00:46:11,160 --> 00:46:16,000 problem, but also in ways that they feel a sense that this is a 852 00:46:16,040 --> 00:46:20,120 important part of them that they maybe even want to hold close 853 00:46:20,120 --> 00:46:22,880 that they appreciate. I guess that's a more radical 854 00:46:22,880 --> 00:46:24,800 view, but I think there's something to it. 855 00:46:24,800 --> 00:46:27,600 And, and maybe you experience something similarly in your 856 00:46:27,600 --> 00:46:31,160 experience that it's become a part of you, you and you could 857 00:46:31,160 --> 00:46:33,360 talk about it. It's not the whole of you but 858 00:46:33,360 --> 00:46:36,400 but it would be a shame if you have to always put this in a 859 00:46:36,400 --> 00:46:38,760 closet and never be able to talk about it. 860 00:46:39,120 --> 00:46:42,600 Yeah, it's so interesting you say that, that people have that 861 00:46:42,600 --> 00:46:45,640 resistance to identifying with a disease, because I remember for 862 00:46:45,640 --> 00:46:47,520 some reason feeling the exact opposite. 863 00:46:47,560 --> 00:46:52,280 I did an IOP program twice and we would do occupational therapy 864 00:46:52,280 --> 00:46:54,920 and they'd have us do art and maybe it would positively impact 865 00:46:54,920 --> 00:46:57,320 our mood. But one of the activities we did 866 00:46:57,320 --> 00:47:01,760 was drawing or painting or your sense of identity. 867 00:47:01,760 --> 00:47:05,520 And I remember my identity drawing and a lot of other 868 00:47:05,520 --> 00:47:09,400 people's really prominently included depression and anxiety. 869 00:47:09,760 --> 00:47:14,480 And it was like, I go to school, these are my interests and I'm 870 00:47:14,520 --> 00:47:16,880 depressed. Like that was the the sense of 871 00:47:16,880 --> 00:47:18,640 identity. And I think it was not only that 872 00:47:18,640 --> 00:47:21,960 so much of my life was consumed by depression and I was in and 873 00:47:21,960 --> 00:47:24,360 out of the hospital and doing intensive outpatient all the 874 00:47:24,360 --> 00:47:25,840 time. And everything I was feeling and 875 00:47:25,840 --> 00:47:28,160 thinking kind of had that negative tilt to it. 876 00:47:28,440 --> 00:47:30,880 But it also was the selfless steam side of things. 877 00:47:30,880 --> 00:47:34,200 It felt like depression was something that was maybe broken 878 00:47:34,200 --> 00:47:36,720 or wrong or not normal or not how normal people are 879 00:47:36,720 --> 00:47:39,320 functioning. And that was absolutely me. 880 00:47:39,320 --> 00:47:41,080 Like something was wrong and I was depressed. 881 00:47:41,080 --> 00:47:44,280 And that was, it wasn't like I have depression, it was I am 882 00:47:44,280 --> 00:47:46,160 depressed. And so I, I think it's really 883 00:47:46,160 --> 00:47:49,000 interesting, like you're saying that the positive and negatives 884 00:47:49,000 --> 00:47:51,760 about how we talk about this thing, whether it's the chemical 885 00:47:51,760 --> 00:47:54,240 imbalance theory or depression is more a signal and we need to 886 00:47:54,240 --> 00:47:57,320 change something in our life. Or it's a disease that we're 887 00:47:57,320 --> 00:48:00,640 experiencing and that happens to us, or we are the, the disorder 888 00:48:00,640 --> 00:48:02,920 and it's something that follows us for the rest of our lives. 889 00:48:03,240 --> 00:48:05,720 It's really interesting. It is really interesting. 890 00:48:06,200 --> 00:48:10,080 Let me give you an example, sort of explain what I mean by 891 00:48:10,080 --> 00:48:14,000 talking about it as a positive, because I don't want this to 892 00:48:14,000 --> 00:48:18,320 come off as like, oh, John is saying that depression is good 893 00:48:18,320 --> 00:48:20,560 and you know, we should all experience depression so we can 894 00:48:20,560 --> 00:48:23,080 become better. People have a very specific 895 00:48:23,080 --> 00:48:25,800 kinds of insights and experiences, you know, that I 896 00:48:25,800 --> 00:48:29,960 think are pretty commonly experienced, even if they're not 897 00:48:30,240 --> 00:48:32,960 discussed much. And some of them come from some 898 00:48:32,960 --> 00:48:35,680 of the most awful parts of depression. 899 00:48:35,680 --> 00:48:39,680 So for example, a lot of people, when they experience depression, 900 00:48:39,680 --> 00:48:44,040 I experienced this as well, are obsessed with different aspects 901 00:48:44,040 --> 00:48:49,000 of death, that things die, that the planet is dying, that your 902 00:48:49,000 --> 00:48:52,840 life is finite. And people become even fixated 903 00:48:52,840 --> 00:48:55,920 on the idea that maybe this wouldn't be a bad thing. 904 00:48:55,920 --> 00:48:58,120 And they have passive death wishes and they think about 905 00:48:58,120 --> 00:49:00,240 suicide. And this is really quite 906 00:49:00,240 --> 00:49:03,240 alarming and horrifying. And it's horrifying not only the 907 00:49:03,240 --> 00:49:06,000 person experiencing, but it's horrifying to the other people 908 00:49:06,000 --> 00:49:08,440 around them. And what are the things that I 909 00:49:08,440 --> 00:49:11,240 find really remarkable on the other side of depression, 910 00:49:11,240 --> 00:49:15,600 reflecting on these experiences and on in some ways feeling like 911 00:49:15,760 --> 00:49:19,680 I was immersed, I was saturated in in death and death 912 00:49:19,680 --> 00:49:22,960 experiences for probably about 18 months of my depression. 913 00:49:22,960 --> 00:49:24,320 I was thinking a lot about death. 914 00:49:24,720 --> 00:49:30,000 On the other side, I realized, hey, I'm alive, BI don't want to 915 00:49:30,000 --> 00:49:32,640 die. C, I'm really grateful that I'm 916 00:49:32,640 --> 00:49:39,040 alive and D things actually seem more alive than they did before. 917 00:49:39,520 --> 00:49:43,120 And it's kind of just like my head explodes sometimes. 918 00:49:43,720 --> 00:49:47,280 And again, it's I don't think if I had had this experience that I 919 00:49:47,280 --> 00:49:50,440 would be in this place. So it's it is a horrible 920 00:49:50,440 --> 00:49:53,360 experience. It is a difficult experience if 921 00:49:53,360 --> 00:49:56,240 there are some potential benefits if you if you look for 922 00:49:56,240 --> 00:49:59,760 them and in talking about them, I don't think diminishes the 923 00:49:59,760 --> 00:50:02,520 horror of the pain or make it all go away. 924 00:50:02,800 --> 00:50:06,160 But I think there are a lot of people who experienced this and, 925 00:50:06,160 --> 00:50:09,560 you know, we, we don't have much time we get in this world and 926 00:50:09,560 --> 00:50:13,080 there are a lot of people who don't experience depression, who 927 00:50:13,120 --> 00:50:16,800 are, you could say, maybe sleepwalking through all their 928 00:50:16,800 --> 00:50:20,160 part of their life and not seizing on the opportunities 929 00:50:20,160 --> 00:50:22,560 that they have and enjoying what they can. 930 00:50:23,080 --> 00:50:26,480 And one thing that can happen, and I hope happens to a lot of 931 00:50:26,480 --> 00:50:29,840 people who go through really painful experiencing and do get 932 00:50:29,840 --> 00:50:33,920 some breathing space from it on the other side is realizing, 933 00:50:34,000 --> 00:50:37,400 maybe not always in that order, but that ABC and D, but you 934 00:50:37,560 --> 00:50:40,760 know, ending with like, it's kind of a miracle that I made it 935 00:50:40,800 --> 00:50:42,480 and that I'm able to enjoy things. 936 00:50:42,480 --> 00:50:45,200 And there's a lot of amazing things, you know, in this in 937 00:50:45,200 --> 00:50:47,800 this world. Yeah, there's this thing on 938 00:50:47,800 --> 00:50:50,680 TikTok called the butterfly effect, and it's like one thing 939 00:50:50,680 --> 00:50:53,000 happened and there was all these positive repercussions. 940 00:50:53,000 --> 00:50:56,280 And I think, like when I look at all the things that I love and 941 00:50:56,280 --> 00:50:59,960 are my favorite parts of life and that I enjoy it, it really 942 00:50:59,960 --> 00:51:02,280 all goes back to depression. Like my relationship with my 943 00:51:02,280 --> 00:51:05,120 family that was built, there was nothing when I was depressed. 944 00:51:05,120 --> 00:51:07,480 It was completely destroyed. There was no communication or 945 00:51:07,480 --> 00:51:10,760 closeness or vulnerability. All those skills were learned 946 00:51:10,760 --> 00:51:13,080 because I got depressed. And now we have an incredible 947 00:51:13,080 --> 00:51:15,520 relationship. The podcast, it started because 948 00:51:15,520 --> 00:51:17,560 I got depressed and have reached so many people. 949 00:51:18,000 --> 00:51:20,760 What I'm doing for school and studying psychology and wanting 950 00:51:20,760 --> 00:51:23,160 to go to grad school, All of that is because of what I went 951 00:51:23,160 --> 00:51:25,960 through and all these other little things that I look and 952 00:51:25,960 --> 00:51:27,560 I'm like, these are my favorite parts of life. 953 00:51:27,560 --> 00:51:29,800 None of that would have been there if I hadn't gone through 954 00:51:30,040 --> 00:51:33,040 that depression. And so I, I really agree with 955 00:51:33,040 --> 00:51:35,800 what you're saying and I think it hopefully will give people a 956 00:51:35,800 --> 00:51:40,120 lot of hope and that other side of the picture that it doesn't 957 00:51:40,120 --> 00:51:42,880 just have to be downhill. It's OK to talk about. 958 00:51:42,880 --> 00:51:45,480 I mean, I think, I think for me, that's one of the main 959 00:51:45,480 --> 00:51:49,960 motivations for studying and talking about life after 960 00:51:49,960 --> 00:51:54,880 depression is to to do my part to make it OK to talk about 961 00:51:54,880 --> 00:51:58,960 these experiences in in their full measure of beauty and 962 00:51:58,960 --> 00:52:03,440 ugliness and confusingness. I think it all needs to be part 963 00:52:03,440 --> 00:52:07,640 of the picture because it's not like even the words that we use. 964 00:52:07,680 --> 00:52:10,640 So language is very powerful. The word that we use that that 965 00:52:10,640 --> 00:52:13,960 often it is people's goal recovery. 966 00:52:14,240 --> 00:52:17,520 You know, we used recovery like you were working on a Word 967 00:52:17,520 --> 00:52:21,880 document and then you got a message that the the file was 968 00:52:21,880 --> 00:52:23,920 corrupted. And then you call IT and you're 969 00:52:23,920 --> 00:52:27,200 hoping, can I recover my file? Your file was recovered. 970 00:52:27,200 --> 00:52:29,280 You open it up and it's the same words, right? 971 00:52:29,760 --> 00:52:32,680 So it's sort of like this idea of like, well, you went back to 972 00:52:32,680 --> 00:52:36,960 the way things were before and this bad experience, this 973 00:52:36,960 --> 00:52:39,440 corruption, you know, has now been purged. 974 00:52:39,440 --> 00:52:43,400 And that's your life and the a I think that's not true because 975 00:52:43,480 --> 00:52:46,400 you're going to change even if you didn't have depression and 976 00:52:46,400 --> 00:52:49,840 BI don't really think the goal. I don't think most people's goal 977 00:52:49,840 --> 00:52:52,880 when they really think about it, when they really think about it, 978 00:52:52,880 --> 00:52:57,240 is just to go back and recover the words from the file. 979 00:52:57,240 --> 00:53:00,640 People have rather more complex aspirations for the rest of 980 00:53:00,640 --> 00:53:02,920 their life. So, you know, talking about ways 981 00:53:02,920 --> 00:53:06,520 maybe that depression is transformative and changes 982 00:53:06,640 --> 00:53:10,240 people as opposed to in ways that are good or bad is more 983 00:53:10,240 --> 00:53:14,080 interesting to me than simply saying, oh, we're, we're all 984 00:53:14,080 --> 00:53:17,080 aiming for this recovery state and it's all kind of, we all 985 00:53:17,080 --> 00:53:20,360 know what that is just going back to the way that it was 986 00:53:20,360 --> 00:53:23,080 before, whatever that is. Yeah. 987 00:53:23,080 --> 00:53:25,080 No, I've never thought about that, but it's very true. 988 00:53:25,080 --> 00:53:27,200 Our goal is not to revert to original. 989 00:53:27,200 --> 00:53:30,720 There's so much beyond that. I mean, this is, this may also 990 00:53:30,720 --> 00:53:34,480 interact with your experiences, the idea that, you know, the 991 00:53:34,480 --> 00:53:38,680 goal is 0 depression, 0 depressive symptoms, you know, 992 00:53:38,720 --> 00:53:42,040 sort of the recovery model, like, oh, I don't, I don't, not 993 00:53:42,040 --> 00:53:43,920 even in the same zip code as depression. 994 00:53:44,200 --> 00:53:46,880 That may not be super realistic for a lot of people. 995 00:53:46,880 --> 00:53:50,880 And it, it may not be entirely healthy too, because you're 996 00:53:51,000 --> 00:53:52,680 likely going to have to be coping. 997 00:53:52,680 --> 00:53:55,880 If you're the kind of person who had a significant depressive 998 00:53:55,880 --> 00:53:59,520 episode, you have that propensity towards a kind of 999 00:53:59,520 --> 00:54:02,040 melancholic state. It's going to happen at some 1000 00:54:02,040 --> 00:54:05,360 point on some level. In being able to accept it and 1001 00:54:05,360 --> 00:54:09,160 cope with it and dial it back seems really vital, and I don't 1002 00:54:09,160 --> 00:54:12,120 know that the terminology of recovery really gives people 1003 00:54:12,120 --> 00:54:15,120 those kinds of tools. Yeah, when the fact that you 1004 00:54:15,120 --> 00:54:18,800 have those skills that like, you know, something's not where it 1005 00:54:18,800 --> 00:54:22,480 should be and you can then kind of shift your life and shift 1006 00:54:22,480 --> 00:54:25,600 these things to put yourself on the path you want to be on. 1007 00:54:25,920 --> 00:54:28,480 That's really something to celebrate and something you gain 1008 00:54:28,480 --> 00:54:31,040 from that experience. Even though it there, there 1009 00:54:31,040 --> 00:54:33,600 might not have been positive things there, those skills are 1010 00:54:33,600 --> 00:54:36,520 really incredible and a lot of people don't have that. 1011 00:54:37,040 --> 00:54:41,440 Yeah, I really love that idea that we should give people a lot 1012 00:54:41,440 --> 00:54:45,160 of positive reinforcement for going through the experiences of 1013 00:54:45,160 --> 00:54:47,200 depression. Again, recovery is like, you 1014 00:54:47,320 --> 00:54:50,920 know, the file was recovered. We have the words, you know, 1015 00:54:50,960 --> 00:54:54,320 yeah, you're relieved, but it doesn't really communicate the 1016 00:54:54,400 --> 00:54:58,400 the gravity of how much work was required to, you know, endure 1017 00:54:58,400 --> 00:55:01,680 this state because depression, anxiety, all these mental health 1018 00:55:01,680 --> 00:55:05,480 problems can be just so draining and so hard. 1019 00:55:05,520 --> 00:55:08,160 And getting to the end and outlasting them. 1020 00:55:08,160 --> 00:55:12,440 We're finding some clever way to get to their end really is 1021 00:55:12,440 --> 00:55:15,720 something that I think we just don't spend as much time in 1022 00:55:15,720 --> 00:55:20,560 really luxuriating and giving people the full measure. 1023 00:55:20,640 --> 00:55:24,560 It may be in part because it's not really widely appreciated or 1024 00:55:24,560 --> 00:55:28,760 understood what it is like to go through a full episode. 1025 00:55:28,760 --> 00:55:30,920 And it is hard. It is hard. 1026 00:55:30,920 --> 00:55:34,720 And language is not that well suited to conveying these 1027 00:55:34,720 --> 00:55:36,200 experiences. I mean, there are some good 1028 00:55:36,200 --> 00:55:39,600 books people can that I think gives some of the experience. 1029 00:55:39,920 --> 00:55:43,040 I think part of The thing is you may have encountered this in 1030 00:55:43,040 --> 00:55:45,600 classes you've taken and so forth, this whole idea of 1031 00:55:45,880 --> 00:55:48,680 phenomenology, So what it's like to experience. 1032 00:55:49,040 --> 00:55:52,040 And there is something, if you really think about it 1033 00:55:52,400 --> 00:55:56,240 incommensurate, that is hard to communicate between my 1034 00:55:56,240 --> 00:55:58,400 experience and your experience. We can use words. 1035 00:55:58,400 --> 00:56:00,880 You can tell me what you're feeling and you can say that's a 1036 00:56:00,880 --> 00:56:02,760 beautiful sunset. And I have an idea. 1037 00:56:02,960 --> 00:56:06,240 There's a famous essay by this man Thomas Nagel called What's 1038 00:56:06,240 --> 00:56:09,160 It Like to Be a Bat? Which really puts a fine point 1039 00:56:09,160 --> 00:56:11,680 on it because bats do echolocation. 1040 00:56:11,680 --> 00:56:14,600 And we really have no idea, right, really what it's like to 1041 00:56:14,600 --> 00:56:17,320 be a bat. But, you know, I don't really 1042 00:56:17,320 --> 00:56:19,800 know what it's like to be Sadie. You don't really know what it's 1043 00:56:19,800 --> 00:56:22,320 like to be John. We try with, with words and so, 1044 00:56:22,400 --> 00:56:23,840 so forth. And then we talked about these 1045 00:56:23,840 --> 00:56:27,840 really profound experiences, like depression, where even I 1046 00:56:27,840 --> 00:56:30,720 don't have trouble putting into words something that happened to 1047 00:56:30,720 --> 00:56:32,920 me. You really see that we have a 1048 00:56:32,920 --> 00:56:35,160 challenge here. And maybe that's part of why, 1049 00:56:35,520 --> 00:56:37,400 you know, at the end of these depressions, people are just 1050 00:56:37,400 --> 00:56:40,440 like, oh, I'm glad you're back. Yeah. 1051 00:56:40,440 --> 00:56:43,200 But not really understanding what the person went through. 1052 00:56:43,680 --> 00:56:45,720 Totally. I remember my sister was working 1053 00:56:45,720 --> 00:56:48,680 on her college applications and the first process was just like 1054 00:56:48,680 --> 00:56:50,840 writing down everything impactful that had happened 1055 00:56:50,840 --> 00:56:52,440 before. She narrowed down on what she 1056 00:56:52,440 --> 00:56:54,000 wanted to write a personal statement about. 1057 00:56:54,000 --> 00:56:57,160 And she was like, my sister was really depressed and she put up 1058 00:56:57,160 --> 00:56:58,880 a good fight. And I was like, you're making it 1059 00:56:58,880 --> 00:57:01,840 sound like I died, Like I'm still here, I'm on the other 1060 00:57:01,840 --> 00:57:03,080 side. I'm doing great. 1061 00:57:03,320 --> 00:57:06,360 And you're right, there's not a good way to distill that and 1062 00:57:06,360 --> 00:57:10,160 explain that and give space for all the painful experiences, but 1063 00:57:10,160 --> 00:57:13,240 also all the potentially positive things that have come 1064 00:57:13,240 --> 00:57:15,320 with that experience as well. Yeah. 1065 00:57:15,400 --> 00:57:18,320 But I honestly, I think you're doing, you're doing Yeoman 1066 00:57:18,320 --> 00:57:22,160 service is I think what I understand you're very 1067 00:57:22,160 --> 00:57:25,920 interested in what the experience is, is like in, in 1068 00:57:25,920 --> 00:57:28,960 good ways and bad. And I think the more people 1069 00:57:28,960 --> 00:57:33,080 become familiar with it, the more it gets detoxified and it 1070 00:57:33,080 --> 00:57:35,200 becomes a little bit less radioactive. 1071 00:57:35,200 --> 00:57:37,640 It's still not easy. There still is a tremendous 1072 00:57:37,640 --> 00:57:41,600 amount of discrimination that happens, for lack of a better 1073 00:57:41,600 --> 00:57:45,960 word, and often in high stakes, you know, situations like when 1074 00:57:45,960 --> 00:57:49,640 people are applying for jobs or people are forming 1075 00:57:49,640 --> 00:57:53,320 relationships, there's a lot of fear, a lot of fear of mental 1076 00:57:53,320 --> 00:57:55,640 health problems. And they can be seen as 1077 00:57:55,640 --> 00:57:58,840 absolutely disqualifying. And we're wasting of just a huge 1078 00:57:58,840 --> 00:58:02,360 amount of some of our most talented people because of the 1079 00:58:02,360 --> 00:58:06,360 difficulty of understanding what can be a wide gulf between 1080 00:58:06,480 --> 00:58:09,080 people's experiences. So I think we really do need 1081 00:58:09,080 --> 00:58:12,240 more of this and not just kind of speaking in some of the 1082 00:58:12,240 --> 00:58:16,640 cliches that do, but just not that helpful to give people of 1083 00:58:16,640 --> 00:58:20,000 the the 3D picture of these sorts of experiences and 1084 00:58:20,000 --> 00:58:24,520 bringing them back into the things that are discussable in 1085 00:58:24,520 --> 00:58:28,000 polite conversation. And it doesn't make you weird or 1086 00:58:28,000 --> 00:58:31,600 a bad person or needing to talk about this all the time, but it 1087 00:58:31,640 --> 00:58:34,520 it is a real shame and maybe it's generational. 1088 00:58:34,520 --> 00:58:36,960 I think that the younger generation is going to be the 1089 00:58:36,960 --> 00:58:40,960 one I think to to finally breakthrough here. 1090 00:58:41,040 --> 00:58:46,000 As bad as things are with mental health for younger people, that 1091 00:58:46,000 --> 00:58:49,480 will be a really good thing that comes of it, I believe and you 1092 00:58:49,480 --> 00:58:50,720 guys are going to get through it. 1093 00:58:50,720 --> 00:58:57,160 And I don't think that the situation is necessarily a one 1094 00:58:57,160 --> 00:58:59,920 way, a one way train. I mean, again, the picture that 1095 00:58:59,920 --> 00:59:02,000 we have of mental health problems is that they're 1096 00:59:02,000 --> 00:59:04,800 escalating, that if you had these problems, you're going to 1097 00:59:04,800 --> 00:59:07,200 accumulate other problems. So if you had depression, you're 1098 00:59:07,200 --> 00:59:11,280 more likely to get substance problems and anxiety and you're 1099 00:59:11,360 --> 00:59:13,120 you're going to be kind of trapped forever. 1100 00:59:13,480 --> 00:59:16,280 Again, understanding the the heterogeneity. 1101 00:59:16,280 --> 00:59:19,040 So knowing that there are a variety of outcomes and that 1102 00:59:19,040 --> 00:59:24,000 things are not set in stone, stone by any means to me is back 1103 00:59:24,000 --> 00:59:27,560 to this realistic hope that the people need, they need to know. 1104 00:59:27,560 --> 00:59:30,360 And, and, and I think, I think it's, I think it's really quite 1105 00:59:30,360 --> 00:59:35,520 important to, I could say morale, morale of morale of 1106 00:59:35,520 --> 00:59:39,400 younger people and, and people who are caring for them. 1107 00:59:40,000 --> 00:59:43,520 Yeah, well, people want to follow along with your research 1108 00:59:43,520 --> 00:59:46,320 or read your books or connect. Where can they do that? 1109 00:59:47,280 --> 00:59:50,800 Well, probably the best one stop shopping is to visit our website 1110 00:59:50,800 --> 00:59:52,600 at the Better Outcomes Laboratory. 1111 00:59:52,960 --> 00:59:56,240 So this is at my laboratory at Cornell University. 1112 00:59:56,360 --> 00:59:59,480 And if you go there, you'll see you'll see some of this 1113 00:59:59,480 --> 01:00:02,200 programming that I was talking about on life after depression, 1114 01:00:02,200 --> 01:00:05,800 which is happening both in research and on social media. 1115 01:00:06,200 --> 01:00:11,200 So we have a new set of channels that we're calling ever After. 1116 01:00:11,920 --> 01:00:16,160 And it talks about these some of these profound experiences in 1117 01:00:16,160 --> 01:00:20,400 ways that depression can change people, both for for the worse, 1118 01:00:20,400 --> 01:00:23,720 as as as many people have discussed, but also for the 1119 01:00:23,720 --> 01:00:26,080 better. And that potential for for 1120 01:00:26,080 --> 01:00:30,560 mental health problems to lead to a life that's more beautiful, 1121 01:00:31,120 --> 01:00:35,280 more meaningful, and more happy. Yeah, Well, thank you so much. 1122 01:00:35,280 --> 01:00:38,800 This was absolutely incredible. It was a real privilege. 1123 01:00:39,120 --> 01:00:40,200 Thank you for having me on.