1 00:00:40,040 --> 00:00:43,880 This week on She Persisted. Self reflection is A2 edged 2 00:00:43,880 --> 00:00:45,560 sword. It's good to be paying attention 3 00:00:45,560 --> 00:00:48,120 to what's going on in your life. I think where people get stuck, 4 00:00:48,120 --> 00:00:50,360 at least the folks we usually see clinically, they've gotten 5 00:00:50,360 --> 00:00:52,400 into blaming themselves for things that have gone wrong. 6 00:00:52,400 --> 00:00:55,440 I opposed to I didn't study hard enough for the test as opposed 7 00:00:55,440 --> 00:00:58,600 to, you know, most relationships are practice relationships and 8 00:00:58,600 --> 00:01:00,320 you get better with it with practice, etcetera. 9 00:01:00,480 --> 00:01:02,040 We take it to heart and we blame ourselves. 10 00:01:02,040 --> 00:01:04,360 We think we're unlovable or we think we're incompetent when 11 00:01:04,360 --> 00:01:06,840 that's not the case. Hello, hello, and welcome back 12 00:01:06,840 --> 00:01:08,480 to another episode if she persisted. 13 00:01:08,480 --> 00:01:10,320 I'm so excited you guys are here today. 14 00:01:10,800 --> 00:01:13,640 It's officially. Final season Yesterday was my 15 00:01:13,640 --> 00:01:15,360 last day of class, so things are. 16 00:01:15,360 --> 00:01:17,000 Busy. We're a little bit. 17 00:01:17,000 --> 00:01:20,880 Stressed so many things on the calendar on a day-to-day basis 18 00:01:21,120 --> 00:01:24,160 during final season. You guys know I'm really 19 00:01:24,160 --> 00:01:25,640 sensitive with my sleep schedule. 20 00:01:25,640 --> 00:01:27,920 It's like my number one non negotiable when it comes to my 21 00:01:27,920 --> 00:01:31,680 mental health and I always like to take a proactive approach and 22 00:01:31,680 --> 00:01:35,320 so I know during finals I have less flexibility with when I can 23 00:01:35,320 --> 00:01:37,720 be sleeping. Not that I'm not getting enough 24 00:01:37,720 --> 00:01:41,080 sleep, but it's definitely more limited than it is actually. 25 00:01:41,120 --> 00:01:42,600 I don't have as much flexibility. 26 00:01:43,000 --> 00:01:45,760 And that also means I have to be really cognizant about my 27 00:01:45,760 --> 00:01:47,920 caffeine intake. Like I want to be drinking more 28 00:01:47,920 --> 00:01:51,400 coffee because I feel a little bit more tired, but I also don't 29 00:01:51,400 --> 00:01:56,200 want that recurring cycle of being exhausted drinking a bunch 30 00:01:56,200 --> 00:01:58,760 of caffeine and then I'm not able to fall asleep that night. 31 00:01:58,960 --> 00:02:01,440 Which is why I am partnering with Magic Mind and I'm 32 00:02:01,440 --> 00:02:03,080 officially a Magic Mind ambassador. 33 00:02:03,080 --> 00:02:05,520 I wanted to share this with you guys because it is one of the 34 00:02:05,520 --> 00:02:08,039 best finals hacks I have come across. 35 00:02:08,039 --> 00:02:09,520 I gave a bunch to my best friend. 36 00:02:09,520 --> 00:02:11,520 She drank them all. We are obsessed. 37 00:02:11,520 --> 00:02:14,880 It is a great trick to add to your toolkit during finals or 38 00:02:14,880 --> 00:02:17,160 during any stressful periods of your life when you're a little 39 00:02:17,160 --> 00:02:19,520 bit more tired and don't want to overdo it on the caffeine, 40 00:02:20,040 --> 00:02:22,400 especially if you're anxiety prone, because caffeine can just 41 00:02:22,400 --> 00:02:24,920 make all of that worse. So Magic Mind is a mental 42 00:02:24,920 --> 00:02:27,080 performance shot. It helps with having a sharper 43 00:02:27,080 --> 00:02:29,440 mind, lower stress and calmer energy. 44 00:02:29,440 --> 00:02:34,560 And if you guys are not aware, matcha is in theory better as a 45 00:02:35,160 --> 00:02:38,720 energizing beverage then coffee is like tea. 46 00:02:39,040 --> 00:02:42,040 The general consensus is that it's better for the brain, for 47 00:02:42,040 --> 00:02:44,400 the body. I cannot do the taste of matcha. 48 00:02:44,680 --> 00:02:47,760 I've tried so many times to do like an ice vanilla matcha and 49 00:02:47,760 --> 00:02:49,720 to me it tastes like grass. I just can't do it. 50 00:02:49,720 --> 00:02:53,400 But I wanted the benefits and so this is the best hack and 51 00:02:53,400 --> 00:02:55,200 solutions. It's just a little shot and it's 52 00:02:55,200 --> 00:02:57,520 flavored with passion fruit which is one of my absolute 53 00:02:57,560 --> 00:03:00,840 favorite flavors. And also in the formula is 54 00:03:00,840 --> 00:03:04,360 Lyme's main bacopa and Cognizant for mental performance. 55 00:03:04,440 --> 00:03:07,400 Ashwagandha L theanine and turmeric for less stress, 56 00:03:07,760 --> 00:03:11,560 Rhodiola Cordyceps and matcha for calm energy and vitamins. 57 00:03:11,560 --> 00:03:17,400 B2B3B12 BC and D4 vitality. So it is the best additive to 58 00:03:17,440 --> 00:03:19,960 your routine when you don't want to overdo it on the caffeine and 59 00:03:19,960 --> 00:03:22,200 you know that your baseline is a little bit more stressed and 60 00:03:22,200 --> 00:03:24,920 overwhelmed, maybe a little bit more anxious, and you want an 61 00:03:24,920 --> 00:03:26,800 alternative to extra cups of coffee. 62 00:03:26,800 --> 00:03:30,160 So this has been the non negotiable in my morning routine 63 00:03:30,160 --> 00:03:32,760 during final season. I'm sure it will be for you guys 64 00:03:32,760 --> 00:03:35,200 as well. You can shop Magic Mind at 65 00:03:35,200 --> 00:03:38,640 magicmind.co slash. She persisted 20 and you can get 66 00:03:38,640 --> 00:03:42,640 up to 48% off your subscription with code She persisted 20. 67 00:03:42,680 --> 00:03:44,400 So all of that will be in the show notes, but 68 00:03:44,400 --> 00:03:48,520 magicmind.com/shepersisted to 20 and use code. 69 00:03:48,520 --> 00:03:53,120 She persisted 20 for 20% off a one time purchase and 48% off 70 00:03:53,120 --> 00:03:56,000 subscriptions. So in addition to finals, it has 71 00:03:56,000 --> 00:04:00,000 been very busy because I just went to ABCT, which is also 72 00:04:00,000 --> 00:04:02,640 known as the Association for Behavioral and Cognitive 73 00:04:02,640 --> 00:04:05,480 Therapies. It is a huge convention. 74 00:04:05,480 --> 00:04:06,960 This year it was in Philadelphia. 75 00:04:06,960 --> 00:04:10,040 And so a ton of clinicians and researchers all gather to talk 76 00:04:10,040 --> 00:04:12,480 about what's going on in the field, talk about new research. 77 00:04:12,840 --> 00:04:15,560 I went to a bunch of panels on social media and mental health. 78 00:04:15,560 --> 00:04:17,920 I went to a bunch of panels on depression. 79 00:04:17,920 --> 00:04:19,959 It was really incredibly interesting, and I was so 80 00:04:19,959 --> 00:04:22,640 excited because I had recorded with Doctor Holland, who's this 81 00:04:22,640 --> 00:04:27,360 week's guest before ABCT. So I got to go meet him IRL and 82 00:04:27,360 --> 00:04:30,320 hear him talk with a bunch of other really incredible 83 00:04:30,320 --> 00:04:33,720 clinicians and build on this conversation that we had. 84 00:04:34,120 --> 00:04:38,720 But if you're not familiar with ABCT or CBT or Doctor Holland's 85 00:04:38,720 --> 00:04:41,440 research, Doctor Steven Holland is a professor at Vanderbilt. 86 00:04:41,440 --> 00:04:43,400 He's at the forefront of depression research. 87 00:04:43,400 --> 00:04:46,120 He's an extremely prominent researcher within the field and 88 00:04:46,120 --> 00:04:49,880 his research is on how behavioral interventions can 89 00:04:49,880 --> 00:04:51,520 treat depression. So how that can be an 90 00:04:51,520 --> 00:04:53,840 alternative and sometimes even more effective than 91 00:04:53,840 --> 00:04:56,640 antidepressants, which typically are like that frontline 92 00:04:56,880 --> 00:04:59,720 approach, that first line intervention for depressive 93 00:04:59,720 --> 00:05:01,320 symptoms. So to give you guys a little 94 00:05:01,320 --> 00:05:04,160 overview, because this is a more research related episode, we're 95 00:05:04,160 --> 00:05:06,880 going to talk about why Doctor Holland became interested in 96 00:05:06,880 --> 00:05:09,560 this area of research. We talked about how many people 97 00:05:09,560 --> 00:05:11,680 actually struggle with depression, like how much of the 98 00:05:11,680 --> 00:05:14,080 general population actually gets depressed. 99 00:05:14,240 --> 00:05:17,160 We talked about his perspective on how we should reviewing the 100 00:05:17,160 --> 00:05:18,720 mental health crisis that we're in. 101 00:05:19,120 --> 00:05:22,480 We talk about self reflecting on depression and what most people 102 00:05:22,480 --> 00:05:25,360 get wrong. We then dive into the 103 00:05:25,360 --> 00:05:28,360 evolutionary mechanisms behind our symptoms of depression, like 104 00:05:28,360 --> 00:05:32,120 depression serves a purpose. Obviously we live in a very 105 00:05:32,120 --> 00:05:34,960 different environment than the one that we evolved for, which 106 00:05:34,960 --> 00:05:37,400 is like caveman days. So what is depression trying to 107 00:05:37,400 --> 00:05:39,720 tell us That maybe the message isn't getting clear because we 108 00:05:39,720 --> 00:05:43,320 live in a different context now. We talk about different 109 00:05:43,320 --> 00:05:46,120 interventions other than antidepressants that are 110 00:05:46,120 --> 00:05:48,640 effective treating depression and that the research shows that 111 00:05:48,640 --> 00:05:51,400 they really work. We talked about how changing 112 00:05:51,400 --> 00:05:53,840 your thoughts and behaviors through CBT can affect 113 00:05:53,840 --> 00:05:57,360 depression. So your quick little TLDR on CBT 114 00:05:57,360 --> 00:06:00,120 is that there's this cycle of thoughts, emotions, and 115 00:06:00,120 --> 00:06:03,000 behaviors. And your emotions impact your 116 00:06:03,000 --> 00:06:04,840 thoughts and your thoughts impact your behaviors. 117 00:06:04,840 --> 00:06:07,640 And it's a continued cycle. And the idea is that when we 118 00:06:07,640 --> 00:06:09,960 experience a lot of distress, when we're depressed, when we're 119 00:06:09,960 --> 00:06:12,280 anxious, when we're not able to function in our day-to-day lives 120 00:06:12,280 --> 00:06:15,360 effectively, something with the way that we're behaving or 121 00:06:15,360 --> 00:06:17,640 thinking isn't going is actively as it could. 122 00:06:17,640 --> 00:06:19,760 So how can we intervene and adjust that cycle? 123 00:06:19,760 --> 00:06:22,640 And with CBT comes exposure therapy and behavioral 124 00:06:22,640 --> 00:06:24,200 activation. And we'll get into some of those 125 00:06:24,200 --> 00:06:26,880 in this episode, but that's your CBT is like the triangle. 126 00:06:26,880 --> 00:06:29,520 And how can we change our thoughts and behaviors to shift 127 00:06:29,520 --> 00:06:31,680 our emotions? Then Doctor Holland and I talk 128 00:06:31,680 --> 00:06:34,680 about what makes some people more likely to get depressed 129 00:06:34,680 --> 00:06:37,600 over and over again rather than just experience depression one 130 00:06:37,600 --> 00:06:39,400 time. We talk about why adolescents 131 00:06:39,400 --> 00:06:41,600 are more vulnerable to depression, which is really 132 00:06:41,600 --> 00:06:43,280 interesting. One of my favorite topics to 133 00:06:43,280 --> 00:06:45,640 touch on. We talk about two things you can 134 00:06:45,640 --> 00:06:48,520 do to stop a depression episode. And lastly, we talked about 135 00:06:48,520 --> 00:06:51,600 trusting adolescents to make positive changes for their 136 00:06:51,600 --> 00:06:53,520 mental health. This was one of my favorite 137 00:06:53,520 --> 00:06:55,120 episodes to date. Again, I'm giving you the 138 00:06:55,120 --> 00:06:57,160 warning that it's a lot of research, but you guys are going 139 00:06:57,160 --> 00:06:59,080 to enjoy it. And it's so relevant and 140 00:06:59,080 --> 00:07:01,400 impactful. And I'm so grateful to Doctor 141 00:07:01,400 --> 00:07:03,360 Holland for taking the time to sit down with me. 142 00:07:03,360 --> 00:07:05,280 And it was great to get to meet him at ABCT. 143 00:07:05,360 --> 00:07:07,680 So we hope you guys enjoyed this conversation. 144 00:07:07,840 --> 00:07:10,800 I will be getting back to studying for finals and with 145 00:07:10,800 --> 00:07:13,160 that I hope you guys have a great week. 146 00:07:13,600 --> 00:07:16,840 I will see you on Monday for a mini episode. 147 00:07:17,240 --> 00:07:20,200 As always, make sure to share with a friend or family member. 148 00:07:20,520 --> 00:07:23,320 Post on social media, tag me, I'll make sure to repost. 149 00:07:23,320 --> 00:07:25,960 I really appreciate you guys. We're almost at the end of the 150 00:07:25,960 --> 00:07:29,480 year and we just did Spotify wrapped and it was so cool to 151 00:07:29,480 --> 00:07:32,240 see how many new listeners we have here. 152 00:07:32,240 --> 00:07:34,680 How many people from different areas of the world are tuning 153 00:07:34,680 --> 00:07:36,280 in? What episodes you guys like the 154 00:07:36,280 --> 00:07:39,320 best? So loved seeing that, so 155 00:07:39,320 --> 00:07:41,800 appreciative you guys. And I'm going to stop yapping so 156 00:07:41,800 --> 00:07:43,320 we can get into this conversation. 157 00:07:43,400 --> 00:07:45,440 So let's dive in. Well, thank you. 158 00:07:45,440 --> 00:07:47,440 So much for joining me today on Cheaper Assisted. 159 00:07:47,440 --> 00:07:50,360 I'm so excited to have you on the podcast. 160 00:07:50,360 --> 00:07:53,080 We know how many young adults struggle with mental health, but 161 00:07:53,080 --> 00:07:55,920 there's this really, really big gap between the research that's 162 00:07:55,920 --> 00:07:59,960 happening and what we know about depression and anxiety and then 163 00:07:59,960 --> 00:08:02,880 what teens are aware of when they start struggling or when 164 00:08:02,880 --> 00:08:05,000 they have a friend or family member going through it. 165 00:08:05,000 --> 00:08:08,240 And so I'm hoping we can lift the curtain a little bit in an 166 00:08:08,240 --> 00:08:11,000 accessible way. And I'm just really grateful 167 00:08:11,000 --> 00:08:13,160 that you're taking the time for this conversation. 168 00:08:14,160 --> 00:08:14,880 Please. Thank you. 169 00:08:15,760 --> 00:08:19,280 So to give people a little bit of a background, if they're not 170 00:08:19,280 --> 00:08:23,360 in undergrad studying psychology and really into reading all of 171 00:08:23,360 --> 00:08:28,600 the literature, what made you want to study depression and 172 00:08:28,880 --> 00:08:32,120 these different mechanisms and symptoms that are associated and 173 00:08:32,120 --> 00:08:34,360 dig deeper? What drew your interest? 174 00:08:34,919 --> 00:08:37,679 Yeah, for whatever reason, I've been interested in depression 175 00:08:37,679 --> 00:08:40,000 for as long as I can remember. You never paid much attention to 176 00:08:40,000 --> 00:08:42,400 the Bible, but the book of Job, I thought was interesting the 177 00:08:42,400 --> 00:08:44,840 most of all men could be tormented by God. 178 00:08:45,120 --> 00:08:47,760 And it just it it's kind of in the family. 179 00:08:47,760 --> 00:08:50,560 It's I've had my own episodes of depression in the in the past, 180 00:08:50,680 --> 00:08:53,160 but my father did and it was just always seemed interesting 181 00:08:53,160 --> 00:08:55,120 to me. Lincoln, Churchill, some of my 182 00:08:55,120 --> 00:08:56,720 favorite people have histories of depression. 183 00:08:56,720 --> 00:08:58,080 Yeah. Yeah, yeah. 184 00:08:58,080 --> 00:09:00,440 It's something that impacts so many people. 185 00:09:00,760 --> 00:09:03,160 And I think what's also really interesting about it is like 186 00:09:03,160 --> 00:09:05,800 when we think of those people and they come to mind, we don't 187 00:09:05,800 --> 00:09:08,080 think the first thing about them is that they're depressed. 188 00:09:08,080 --> 00:09:10,520 But when we're experiencing it ourselves, it's so different. 189 00:09:10,520 --> 00:09:13,680 It often is like, that's the biggest part of my life, or this 190 00:09:13,680 --> 00:09:15,440 is such a crucial part of my identity. 191 00:09:15,440 --> 00:09:18,560 And so in so many aspects, there's that huge shovel 192 00:09:18,560 --> 00:09:20,640 standard. Yes, very much. 193 00:09:20,760 --> 00:09:21,800 Very true. Yeah. 194 00:09:22,320 --> 00:09:26,440 So how I came across your work is I am a member of a lab at the 195 00:09:26,440 --> 00:09:31,240 University of Michigan and the Pi actually came on the podcast 196 00:09:31,240 --> 00:09:33,840 and he's doing research about how we think about depression. 197 00:09:33,840 --> 00:09:36,840 It's like if we think about the chemical imbalance theory versus 198 00:09:36,840 --> 00:09:40,880 it's a signal, how does that impact how much people engage in 199 00:09:40,880 --> 00:09:42,720 treatment and then their outcomes? 200 00:09:43,120 --> 00:09:46,240 And so we read your paper about what we got wrong about 201 00:09:46,240 --> 00:09:50,960 depression and as a field, what maybe hasn't been as effective. 202 00:09:50,960 --> 00:09:52,800 And I think, again, there's this gap. 203 00:09:52,800 --> 00:09:55,440 So a lot of the things that you mentioned, maybe people aren't 204 00:09:55,440 --> 00:09:58,440 seeing a difference yet when it comes to intervention or going 205 00:09:58,440 --> 00:10:01,240 to therapy or getting support. And so I was wondering if you 206 00:10:01,240 --> 00:10:05,160 could speak to us in your career, what you have noticed 207 00:10:05,160 --> 00:10:08,360 1st about like things maybe we haven't gotten totally right. 208 00:10:08,360 --> 00:10:10,160 And then also if there's things where you're like, I think 209 00:10:10,160 --> 00:10:12,400 that's accurate. I think that's valid from the 210 00:10:12,400 --> 00:10:14,120 research side. Yeah, sure. 211 00:10:14,120 --> 00:10:16,640 Happy to do that. There are a couple things #1 212 00:10:16,840 --> 00:10:18,960 depression, at least unipolar, non psychotic. 213 00:10:18,960 --> 00:10:21,440 Unipolar depression is a lot more common than we were aware 214 00:10:21,440 --> 00:10:23,880 of before. And if you do the retrospective 215 00:10:23,880 --> 00:10:27,320 epidemiological studies, the estimates still make it a very 216 00:10:27,320 --> 00:10:31,680 common clinical disorder. About 16% of the population, 20% 217 00:10:31,680 --> 00:10:34,400 of women, 12% of men are going to have one or more major 218 00:10:34,560 --> 00:10:36,440 episodes of major depression in their lifetime. 219 00:10:36,440 --> 00:10:40,200 Again, non psychotic, a unipolar turns out that's that's about 220 00:10:40,200 --> 00:10:42,840 three to five times lower than the actual base rates if you 221 00:10:42,840 --> 00:10:45,720 follow so a cohort from birth on or across the course of 222 00:10:45,720 --> 00:10:48,400 adolescence, which is where it usually kicks in for people. 223 00:10:48,520 --> 00:10:51,200 And what you find is the rates are well over 50%. 224 00:10:51,280 --> 00:10:53,840 For example, the Dineen cohort study, birth cohort study. 225 00:10:53,840 --> 00:10:56,360 And folks are just in their 40s now, mid 40s. 226 00:10:56,680 --> 00:10:59,520 And already more than half of the folks in the sample have had 227 00:10:59,520 --> 00:11:01,200 depressions. And the other thing that we 228 00:11:01,200 --> 00:11:03,120 weren't prepared for, we've always assumed the depression 229 00:11:03,120 --> 00:11:05,600 was quite recurrent. If you have one depression, 230 00:11:05,600 --> 00:11:08,560 you're going to have a series of of multiple episodes. 231 00:11:08,720 --> 00:11:09,880 Turns out that's not true either. 232 00:11:10,160 --> 00:11:12,120 It turns out for most folks, they're going to have one or two 233 00:11:12,120 --> 00:11:15,120 episodes in their life in response to really bad things 234 00:11:15,120 --> 00:11:17,200 that happened to them. You lose a loved 1, you lose a 235 00:11:17,640 --> 00:11:19,840 job that you really cared about. You don't get to medical school, 236 00:11:19,840 --> 00:11:22,280 whatever that may happen to be. But most folks aren't going to 237 00:11:22,280 --> 00:11:24,640 have a lot of depressions. A smaller subset of people, 238 00:11:24,640 --> 00:11:27,760 probably the 15 to 16%, are the ones that have multiple 239 00:11:27,760 --> 00:11:30,240 episodes, and those are the ones that end up coming in for 240 00:11:30,240 --> 00:11:31,560 treatment of. Those are the folks we've really 241 00:11:31,560 --> 00:11:34,200 studied. So we've gotten a biased look at 242 00:11:34,200 --> 00:11:36,880 what depression is really like. It's it's so common, you almost 243 00:11:36,880 --> 00:11:38,840 talk about it as being species typical. 244 00:11:39,000 --> 00:11:42,040 Anybody can get anxious, anybody get angry and virtually anybody 245 00:11:42,040 --> 00:11:46,040 can get depressed. What are your thoughts on we are 246 00:11:46,040 --> 00:11:48,240 like in the mental health crisis? 247 00:11:48,240 --> 00:11:51,040 There's a lot of this messaging that that's a bad thing. 248 00:11:51,040 --> 00:11:54,160 If that's this is species typical and that this is a shift 249 00:11:54,400 --> 00:11:57,040 from like 50 years ago, 100 years ago. 250 00:11:57,320 --> 00:11:59,880 Do you think it's really that non judgmental approach of like 251 00:11:59,880 --> 00:12:03,240 this is something we struggle with and we can adapt 252 00:12:03,240 --> 00:12:06,200 accordingly or you're like, we're on a bad trajectory. 253 00:12:06,200 --> 00:12:07,840 This is an issue. We got a shift. 254 00:12:08,160 --> 00:12:10,800 Well, I, I think, I think it's something that we can 255 00:12:11,280 --> 00:12:12,880 understand. I think we can deal with. 256 00:12:12,880 --> 00:12:15,040 I think it's actually, it's, I think it's almost a bit of a 257 00:12:15,040 --> 00:12:18,040 growth experience. All that being said, I think the 258 00:12:18,040 --> 00:12:20,440 last thing you want to do for people coming into adolescence 259 00:12:20,440 --> 00:12:23,400 is cut them off from their friends. 1415 year olds ought to 260 00:12:23,400 --> 00:12:26,600 be with the 1415 year olds not locked away on the Internet 261 00:12:26,600 --> 00:12:28,480 because they can't go out in in public. 262 00:12:28,680 --> 00:12:32,160 So I think, I think the notion that rates are up is true, but 263 00:12:32,160 --> 00:12:33,720 that's the last thing you want to do to young teens. 264 00:12:34,160 --> 00:12:36,880 And I think that's elevated the rates of depression. 265 00:12:37,120 --> 00:12:39,400 But it's almost a sense of isolation. 266 00:12:39,680 --> 00:12:42,880 I do think that if you don't take it the wrong way, if you 267 00:12:42,880 --> 00:12:45,520 don't interpret as a sign of weakness as much as part of a 268 00:12:45,520 --> 00:12:48,200 developmental process that ideally get a chance to go 269 00:12:48,200 --> 00:12:50,360 through, then you don't take it as as quite as seriously. 270 00:12:50,880 --> 00:12:53,560 Yeah, it also gives. You a lot of empathy for like 271 00:12:53,560 --> 00:12:56,280 you mentioned, these big life experiences, whether it's grief 272 00:12:56,280 --> 00:12:59,200 or being rejected, like we all have that happen. 273 00:12:59,200 --> 00:13:02,160 And if we didn't, we wouldn't understand those intense large 274 00:13:02,160 --> 00:13:03,880 emotions. And we know, like you mentioned, 275 00:13:03,880 --> 00:13:06,080 relationships are so important for everything. 276 00:13:06,320 --> 00:13:09,440 So having that emotional experience, although incredibly 277 00:13:09,560 --> 00:13:12,240 uncomfortable, it in turn will strengthen those other 278 00:13:12,240 --> 00:13:14,920 relationships down the line. I think you're absolutely right, 279 00:13:14,920 --> 00:13:16,760 it's a miserable experience to go through. 280 00:13:16,760 --> 00:13:19,880 On the other hand, anxiety keeps you safe, pain keeps you from 281 00:13:19,880 --> 00:13:22,400 damaging already injured tissues, and depression keeps 282 00:13:22,400 --> 00:13:25,080 you thinking carefully and seriously about the things that 283 00:13:25,080 --> 00:13:26,760 are important in your life. And that's not a bad thing to 284 00:13:26,760 --> 00:13:29,360 happen. Yeah, I'm sure this will get 285 00:13:29,360 --> 00:13:32,640 into a little bit of the intervention and CBT side of 286 00:13:32,640 --> 00:13:37,240 things, but ideally you would experience a down day, a couple 287 00:13:37,240 --> 00:13:39,360 of days, maybe it's a couple of weeks and you'd be like, I have 288 00:13:39,360 --> 00:13:41,560 to think about this. Something in my life isn't going 289 00:13:41,560 --> 00:13:43,760 correctly. But I think a lot of people run 290 00:13:43,760 --> 00:13:46,040 into a wall either. There's not that awareness, like 291 00:13:46,040 --> 00:13:48,680 I'm depressed and not that you shouldn't feel that way, but 292 00:13:48,680 --> 00:13:51,760 like, how can I shift my behaviors and emotions? 293 00:13:52,320 --> 00:13:54,840 What do you do when people aren't having that self 294 00:13:54,840 --> 00:13:58,480 reflection or they're not able to make those changes around 295 00:13:58,480 --> 00:14:00,640 them? Yeah, I, I, I think, and again, 296 00:14:00,640 --> 00:14:03,560 I could be wrong here, but I think that self reflection is A2 297 00:14:03,560 --> 00:14:05,400 edged sword. It's good to be paying attention 298 00:14:05,400 --> 00:14:07,960 to what's going on in your life. I think where people get stuck, 299 00:14:07,960 --> 00:14:10,200 at least the folks we usually see clinically, they've gotten 300 00:14:10,200 --> 00:14:12,240 into blaming themselves for things that have gone wrong. 301 00:14:12,480 --> 00:14:15,320 Yeah, opposed to, I didn't study hard enough for the tester as 302 00:14:15,320 --> 00:14:18,000 opposed to, you know, most relationships or practice 303 00:14:18,000 --> 00:14:20,080 relationships and you get better with it, with practice, 304 00:14:20,080 --> 00:14:21,920 etcetera. We take it to heart and we blame 305 00:14:21,920 --> 00:14:23,360 ourselves. We think we're lovable or we 306 00:14:23,360 --> 00:14:25,440 think we're incompetent when that's not the case. 307 00:14:25,920 --> 00:14:28,200 What we try to do with somebody who's clinically depressed is 308 00:14:28,200 --> 00:14:30,920 get them testing that out. Consider what kind of behavioral 309 00:14:30,920 --> 00:14:33,240 experiments they could run. If you've had a bad experience 310 00:14:33,240 --> 00:14:36,120 in a relationship, try other kind of relationships or other 311 00:14:36,120 --> 00:14:38,480 additional relationships and see if it's really true that you're 312 00:14:38,480 --> 00:14:40,960 lovable or we just went about the last one the wrong way. 313 00:14:41,240 --> 00:14:44,040 If you're not getting what you want out of your profession or 314 00:14:44,120 --> 00:14:46,560 job, career pursuits, etcetera, try a little harder. 315 00:14:46,560 --> 00:14:49,280 Try something different. But it's usually not the case 316 00:14:49,280 --> 00:14:52,320 that people are accurate when they make a global stable 317 00:14:52,320 --> 00:14:54,880 internal attribution to some defect in the cells. 318 00:14:55,000 --> 00:14:57,320 It's usually something in their behavior and they can work that 319 00:14:57,360 --> 00:14:58,240 out. Yeah. 320 00:14:58,600 --> 00:15:02,120 Do you think that's something that we are learning from a 321 00:15:02,160 --> 00:15:05,600 societal perspective or do you think that's more internal? 322 00:15:06,080 --> 00:15:08,920 I'm sure the CBT process is reinforcing it. 323 00:15:08,920 --> 00:15:11,440 When we think about like the behaviors and the cognitions and 324 00:15:11,440 --> 00:15:13,640 the thoughts we're having, it just becomes like a self 325 00:15:13,640 --> 00:15:15,920 repeating cycle. But where do you think that 326 00:15:15,920 --> 00:15:17,040 stems from for a? Specific. 327 00:15:17,040 --> 00:15:18,880 I think we're wired up for that. OK. 328 00:15:19,280 --> 00:15:21,360 Gotten very much interested in the evolutionary perspective, 329 00:15:21,360 --> 00:15:23,720 and in particular this fellow Paul Andrews at McMaster. 330 00:15:23,720 --> 00:15:26,480 He might find interest at some point, but no evolutionary 331 00:15:26,480 --> 00:15:29,480 biologist would think about anxiety, pain, or depression as 332 00:15:29,480 --> 00:15:31,640 being aberrations. They would think of this being 333 00:15:31,640 --> 00:15:33,640 evolved adaptations that served a purpose. 334 00:15:34,040 --> 00:15:35,840 And what they would do is follow the energy. 335 00:15:35,840 --> 00:15:38,400 It's like in political scandals. You follow the money, they would 336 00:15:38,400 --> 00:15:41,280 follow the energy. And if you've got an infection, 337 00:15:41,280 --> 00:15:42,560 the energy goes to the immune system. 338 00:15:42,560 --> 00:15:44,560 You don't want to date. You want to think you're not a 339 00:15:44,600 --> 00:15:46,680 certain food. If you're starving, the energy 340 00:15:46,680 --> 00:15:49,960 goes to foraging for food and preserving the vital organs. 341 00:15:50,080 --> 00:15:52,640 If you're clinically depressed, the energy goes to the cortex 342 00:15:53,000 --> 00:15:55,760 and the energy goes to really thinking long and hard and 343 00:15:55,760 --> 00:15:57,760 carefully about whatever's going on in your life. 344 00:15:58,000 --> 00:16:00,520 And that, again, that's probably not a bad thing to do from time 345 00:16:00,520 --> 00:16:01,720 to time. You don't want to make a habit 346 00:16:01,720 --> 00:16:03,400 of it, but it's not a bad thing to do. 347 00:16:03,640 --> 00:16:06,280 What I think we do clinically in something like cognitive therapy 348 00:16:06,400 --> 00:16:09,520 is help somebody get unstuck when they focused on some defect 349 00:16:09,520 --> 00:16:12,120 in the self, which usually is not there as being the core 350 00:16:12,120 --> 00:16:15,400 problem. And so that that's where I think 351 00:16:15,400 --> 00:16:17,440 that goes. But I think we're wired up to 352 00:16:18,000 --> 00:16:20,360 think carefully about things when we get depressed. 353 00:16:20,800 --> 00:16:24,720 Yeah, We have these other really interesting mechanisms, like 354 00:16:24,720 --> 00:16:27,680 we're motivated to withdraw even though being with people would 355 00:16:27,680 --> 00:16:29,800 be more effective. You mentioned self reflection, 356 00:16:29,800 --> 00:16:32,840 even though maybe a little bit less would be more beneficial. 357 00:16:33,000 --> 00:16:34,880 There's all these other interesting you're eating more, 358 00:16:34,880 --> 00:16:37,040 you're eating less, you're sleeping a lot, you're more 359 00:16:37,040 --> 00:16:38,800 irritable and pushing people away. 360 00:16:39,160 --> 00:16:43,560 Are there any other mechanisms of depression that potentially 361 00:16:43,560 --> 00:16:47,000 have these evolutionary stems that offer a lot of validation 362 00:16:47,000 --> 00:16:50,240 and compassion and like, OK, this is not crazy to people that 363 00:16:50,240 --> 00:16:52,080 are struggling? Right, right. 364 00:16:52,080 --> 00:16:54,600 Or that we, some of the things you just mentioned, for example, 365 00:16:54,600 --> 00:16:58,200 the withdrawal, the loss of appetite, etcetera, predate 366 00:16:58,200 --> 00:17:00,360 human beings. They predate cortex. 367 00:17:00,480 --> 00:17:03,160 You get mollusks without much cortex that do those things. 368 00:17:03,320 --> 00:17:05,280 That's part of our older immune response. 369 00:17:05,560 --> 00:17:08,480 And probably what goes on to depression grew out of the way 370 00:17:08,480 --> 00:17:11,079 we dealt with infections. So things that would conserve 371 00:17:11,079 --> 00:17:14,200 energy, we're still there. What's new for human beings is 372 00:17:14,200 --> 00:17:17,280 the cortex getting involved and really trying to solve problems. 373 00:17:17,640 --> 00:17:20,720 So again, I don't, I hate to see folks get stuck. 374 00:17:20,839 --> 00:17:23,440 I can remember a couple times in my life when I got stuck, but it 375 00:17:23,440 --> 00:17:26,640 was usually when I was able to start thinking about what steps 376 00:17:26,640 --> 00:17:29,240 I would take to arrive at a change, what was going on in my 377 00:17:29,240 --> 00:17:31,280 life that I did. That's when I got unstuck. 378 00:17:31,480 --> 00:17:34,240 And I think that's basically due and at least in a cognitive 379 00:17:34,240 --> 00:17:36,040 behavioral approach to treating depression. 380 00:17:36,800 --> 00:17:39,920 If people were going to get into all the things about CBT and why 381 00:17:39,920 --> 00:17:42,360 that can be so effective, if people aren't working with the 382 00:17:42,360 --> 00:17:45,280 CBT therapist, but this is their first exposure to that and 383 00:17:45,280 --> 00:17:47,600 they're like, OK, I'm curious, I want to learn more. 384 00:17:47,760 --> 00:17:51,200 What does that specific process look like to think less, 385 00:17:51,200 --> 00:17:53,560 ruminate less, be in that cortex? 386 00:17:53,560 --> 00:17:56,160 Less intensively, yeah. Yeah, that's a good question. 387 00:17:56,160 --> 00:17:58,720 A couple things. There are self help manuals out 388 00:17:58,720 --> 00:18:00,240 there. Dennis Greenberg and Chris 389 00:18:00,240 --> 00:18:02,360 Podeski have one of the best, I think it's called Mind Over 390 00:18:02,360 --> 00:18:04,560 Mood, and it lays out what you might do with the therapist 391 00:18:04,560 --> 00:18:07,200 without the therapist. There are websites that you can 392 00:18:07,200 --> 00:18:08,480 go to. You get a little cautious there 393 00:18:08,480 --> 00:18:11,680 because it's like the Wild West. It's true. 394 00:18:12,000 --> 00:18:14,040 You can do those kinds of things. 395 00:18:14,040 --> 00:18:16,680 And it looks to be the case that there's not much you can do with 396 00:18:16,680 --> 00:18:19,160 the therapist that you can't do on your own. 397 00:18:19,160 --> 00:18:21,320 But especially if you have somebody working with a trainer 398 00:18:21,400 --> 00:18:23,720 that you're accountable to. And you can do unguided 399 00:18:23,720 --> 00:18:25,640 websites, but it works a little better if you have somebody that 400 00:18:25,640 --> 00:18:28,400 you have to report back to, even if they're not necessarily 401 00:18:28,400 --> 00:18:30,120 therapists. So there there are a lot of 402 00:18:30,120 --> 00:18:32,760 options now that we have the thing that's mentioned is 403 00:18:32,920 --> 00:18:35,480 cognitive therapy. Cognitive therapies are quite 404 00:18:35,520 --> 00:18:37,960 generally pretty useful. They have long term enduring 405 00:18:37,960 --> 00:18:39,600 effects. So they seem to reduce risk for 406 00:18:39,600 --> 00:18:41,960 subsequent episodes, but they're not the only ones that work. 407 00:18:42,200 --> 00:18:44,720 There's a simpler behavioral activation approach which 408 00:18:44,720 --> 00:18:47,080 doesn't pay attention to cognition at all, but seems to 409 00:18:47,080 --> 00:18:49,320 work out as well. It's not been tested as often, 410 00:18:49,560 --> 00:18:51,800 but it's well, when it has been tested, it might have an 411 00:18:51,800 --> 00:18:54,720 enduring effect in a personal psychotherapy works quite 412 00:18:54,720 --> 00:18:56,600 nicely. The variety of psychological 413 00:18:56,680 --> 00:18:59,400 logical interventions that do seem to work pretty regularly, 414 00:18:59,680 --> 00:19:01,640 pretty reasonably. And the antidepressant 415 00:19:01,640 --> 00:19:04,120 medications, they're much safer than what we had 20-30 years 416 00:19:04,120 --> 00:19:06,760 ago. I have concerns about long term 417 00:19:07,040 --> 00:19:09,200 reliance on medications because they don't have enduring 418 00:19:09,200 --> 00:19:11,120 effects. And there's some reason to 419 00:19:11,120 --> 00:19:13,080 think, and I go back to somebody like Andrew's in the 420 00:19:13,080 --> 00:19:15,440 evolutionary perspective, that they might actually suppress 421 00:19:15,440 --> 00:19:17,920 symptoms at the expense of leaving you at risk. 422 00:19:18,120 --> 00:19:20,440 At any point you try to stop, you're going to be dropped right 423 00:19:20,440 --> 00:19:21,640 back to the middle of an episode. 424 00:19:21,640 --> 00:19:24,840 So long term, I would prefer to see people have other options. 425 00:19:25,160 --> 00:19:26,600 A lot of these things work to take the edge off. 426 00:19:27,240 --> 00:19:30,520 Yeah, well, you elaborate on behavioral activation and what 427 00:19:30,520 --> 00:19:32,600 that looks like in the context of depression. 428 00:19:32,920 --> 00:19:34,760 Yeah, what we would do in something like cognitive 429 00:19:34,760 --> 00:19:36,800 therapy, which of course came out of Philadelphia, came out 430 00:19:36,800 --> 00:19:39,600 of. But what we what we do in 431 00:19:39,600 --> 00:19:42,160 cognitive therapy is to get people to use their own 432 00:19:42,160 --> 00:19:44,400 behaviors to test the accuracy of their beliefs. 433 00:19:44,840 --> 00:19:46,800 If, for example, you don't think you'd enjoy the party, go to the 434 00:19:46,800 --> 00:19:49,440 party and find out. Now it turns out that most folks 435 00:19:49,440 --> 00:19:51,480 enjoy the parties more than they thought they would. 436 00:19:51,680 --> 00:19:54,160 Depression is, to use the phrases as a disease of 437 00:19:54,400 --> 00:19:56,720 expectation and recollection. It lives in the future. 438 00:19:56,720 --> 00:19:57,920 It lives in the past at the moment. 439 00:19:58,200 --> 00:20:00,440 It's not that you can't enjoy, it's that you don't think you 440 00:20:00,440 --> 00:20:02,360 will, and you remember it differently after the fact. 441 00:20:02,640 --> 00:20:04,880 But we'll get people to run those kinds of experiments. 442 00:20:05,080 --> 00:20:07,840 If you don't think that you can get into a school that you'd 443 00:20:07,840 --> 00:20:09,760 like to go to, apply anyway and see what happens. 444 00:20:09,760 --> 00:20:11,400 Apply to a bunch of schools and see what happens. 445 00:20:11,680 --> 00:20:14,120 Sometimes you surprise yourself on somebody who's depressed 446 00:20:14,120 --> 00:20:17,360 tends to turn a low probability into a no probability. 447 00:20:18,040 --> 00:20:19,760 If I talked with an undergraduate about going on to 448 00:20:19,760 --> 00:20:21,960 medical school or gradual say what the chances are about one 449 00:20:21,960 --> 00:20:24,240 in 10, they're depressed. They think that means don't 450 00:20:24,240 --> 00:20:26,480 apply as opposed to applying to 20. 451 00:20:26,720 --> 00:20:29,560 And you get you pick. And then especially when it 452 00:20:29,560 --> 00:20:31,760 comes down to things like the notion that you have a bad 453 00:20:31,760 --> 00:20:33,680 relationship breakup and you think must be something about 454 00:20:33,680 --> 00:20:34,840 me. You know, there may be things 455 00:20:34,840 --> 00:20:37,040 you did that didn't work well, you want to pay attention to 456 00:20:37,040 --> 00:20:38,800 that because you can change those. 457 00:20:39,200 --> 00:20:41,800 But if the notion is somehow basically unlovable, try 458 00:20:41,800 --> 00:20:43,960 additional relationships and they're not all going to work. 459 00:20:43,960 --> 00:20:45,920 Some will, some won't, and it's a matter of taste. 460 00:20:46,080 --> 00:20:47,880 Same thing with jobs. Same thing with careers. 461 00:20:48,720 --> 00:20:51,520 How does that process evolve once you add in the thoughts 462 00:20:51,520 --> 00:20:53,600 element? Yeah, and, and behavioral 463 00:20:53,600 --> 00:20:56,040 activation or the behavioral activation component of CPT 464 00:20:56,320 --> 00:20:57,760 don't wait to feel like doing something. 465 00:20:57,760 --> 00:20:59,680 Do what you would do if you weren't depressed and see how it 466 00:20:59,680 --> 00:21:01,880 turns out. And the cognitive element is 467 00:21:01,880 --> 00:21:02,880 don't believe everything you think. 468 00:21:02,880 --> 00:21:05,520 And what we'll do in cognitive therapy is try to encourage 469 00:21:05,520 --> 00:21:08,840 people to check out how accurate the beliefs are. 470 00:21:08,920 --> 00:21:10,760 There's like almost kind of a mantra where you're trying to 471 00:21:10,760 --> 00:21:13,280 encourage people to lock away. And one is, what's my evidence 472 00:21:13,280 --> 00:21:15,960 for that belief? Any alternative explanation than 473 00:21:15,960 --> 00:21:18,000 the alumni I just came up with? And 3rd part of the real 474 00:21:18,000 --> 00:21:20,640 implications. And usually one or more of those 475 00:21:20,640 --> 00:21:22,680 three questions are going to help you sort out that. 476 00:21:22,680 --> 00:21:23,880 I don't know exactly what it is yet. 477 00:21:23,880 --> 00:21:25,960 Let me run an experiment and see where it's going to go. 478 00:21:27,280 --> 00:21:31,000 You mentioned in the What We Got Wrong about Depression paper, 479 00:21:31,000 --> 00:21:32,520 and you mentioned this in the beginning that there's some 480 00:21:32,520 --> 00:21:35,120 people that maybe never experienced a depression. 481 00:21:35,120 --> 00:21:38,320 There's some that maybe have an episode in response to a big 482 00:21:38,320 --> 00:21:40,480 life event, and then there's others that are. 483 00:21:40,920 --> 00:21:43,160 I don't know if more. Prone would be the right phrase, 484 00:21:43,160 --> 00:21:47,400 but they have these multi episodes what make me feel more 485 00:21:47,400 --> 00:21:50,040 likely to fit in that bucket. Well, maybe. 486 00:21:50,040 --> 00:21:53,320 So the folks that we typically see in clinical settings have 487 00:21:53,320 --> 00:21:55,840 multiple recurrences and most folks who get depressed don't 488 00:21:55,840 --> 00:21:58,200 have multiple recurrences. That's one of the we're just 489 00:21:58,200 --> 00:21:59,960 finding out. Then the question is what makes 490 00:21:59,960 --> 00:22:01,920 the folks that have multiple recurrences different from the 491 00:22:01,920 --> 00:22:03,960 folks that don't? And there are a host of things 492 00:22:03,960 --> 00:22:05,920 that may be going on with the baby, some bit of genetics 493 00:22:05,920 --> 00:22:07,880 involved. Although a unipolar depression 494 00:22:07,880 --> 00:22:10,200 is not particularly heritable, it's less heritable than 495 00:22:10,200 --> 00:22:12,480 political preference. Does mean that particularly 496 00:22:12,480 --> 00:22:14,560 people have early onsets may have a little bit more of a 497 00:22:14,600 --> 00:22:18,320 genetic loading that may be the people that have histories of 498 00:22:18,320 --> 00:22:21,320 childhood trauma are a little more likely to get depressed. 499 00:22:21,600 --> 00:22:25,040 There's a curious aspect here. In our evolutionary past, 500 00:22:25,480 --> 00:22:29,840 depression seems to not show up much in pre adolescence, but it 501 00:22:29,840 --> 00:22:32,760 kicks in in adolescence. So if somebody's going to have a 502 00:22:33,160 --> 00:22:36,520 lifetime course of depression or even multiple recurrences, about 503 00:22:36,520 --> 00:22:39,040 half or more of this folks going to have the first episode when 504 00:22:39,040 --> 00:22:41,720 they're adolescents may not get treated, but it may be the kind 505 00:22:41,720 --> 00:22:42,880 of thing that that they remember. 506 00:22:43,400 --> 00:22:46,680 And in our evolutionary past, that's when our species became 507 00:22:46,680 --> 00:22:50,160 reproductively capable, that's we had to worry about sex, the 508 00:22:50,160 --> 00:22:52,040 other gender and, and getting pregnant. 509 00:22:52,200 --> 00:22:55,400 And unipolar depression is twice as common in women as in men. 510 00:22:55,680 --> 00:22:58,400 And when you start thinking about maybe what we're doing 511 00:22:58,400 --> 00:23:01,120 here is having more cortical involvement to solve problems. 512 00:23:01,360 --> 00:23:03,560 Nothing's more problematic to a young adolescent than 513 00:23:03,600 --> 00:23:05,760 relationships. So it's exactly the time you 514 00:23:05,760 --> 00:23:08,760 want to be able to think carefully about stuff that may 515 00:23:08,760 --> 00:23:13,000 not be a bad thing. So that interesting period, not 516 00:23:13,000 --> 00:23:17,160 necessarily pre adolescence, but adolescence potentially launches 517 00:23:17,160 --> 00:23:20,040 really follows this pattern. Is there anything else about 518 00:23:20,040 --> 00:23:22,760 that time frame or that time period that you think either 519 00:23:22,760 --> 00:23:26,040 environmentally is that additional stressor or the way 520 00:23:26,040 --> 00:23:28,480 we're thinking about things? Rejection is definitely 521 00:23:28,480 --> 00:23:30,080 heightened. Any thoughts there? 522 00:23:30,360 --> 00:23:31,640 That's when we outgrow our families. 523 00:23:31,920 --> 00:23:33,960 My wife's, a developmental psychopathologist, works with 524 00:23:33,960 --> 00:23:36,800 particular with adolescents. And that's about the time that 525 00:23:36,800 --> 00:23:38,800 the reality becomes what your friends think it is. 526 00:23:39,520 --> 00:23:42,400 And 11/12/13, nothing's more important to us than how we 527 00:23:42,720 --> 00:23:44,800 think we fit in with our other friends, with our peers. 528 00:23:45,200 --> 00:23:47,560 And you can sometimes get a little stuck, a little over 529 00:23:47,560 --> 00:23:49,720 concerned about that. But this, there's a lot of drama 530 00:23:49,720 --> 00:23:51,640 and, and understandably, but that's where, that's where 531 00:23:51,640 --> 00:23:53,560 you're sorting out who you are, how you get along with other 532 00:23:53,560 --> 00:23:54,960 people. And it's going to be, it's going 533 00:23:54,960 --> 00:23:57,080 to be a time of testing your own independence. 534 00:23:57,080 --> 00:23:59,160 Yeah. Yeah, I'd love your thoughts 535 00:23:59,160 --> 00:24:01,080 right now. A big theory floating around 536 00:24:01,080 --> 00:24:04,560 about why that period is tough is social media and phones have 537 00:24:05,200 --> 00:24:08,720 exacerbated issues with regard to mental health, especially in 538 00:24:08,760 --> 00:24:11,200 girls. Do you buy into that? 539 00:24:11,200 --> 00:24:15,200 Do you have other thoughts? I, I don't know for sure rates 540 00:24:15,200 --> 00:24:17,800 have gone up, and it's hard to say exactly why rates have gone 541 00:24:17,800 --> 00:24:19,840 up, but they started going up even before the pandemic. 542 00:24:20,160 --> 00:24:22,440 So the isolation of the pandemic made it even worse. 543 00:24:22,520 --> 00:24:25,920 My understanding is that junior high school is a cruel time for 544 00:24:25,920 --> 00:24:28,280 anybody. But if you can get unliked and 545 00:24:28,280 --> 00:24:29,840 lie, I don't know all the things that happens on the Internet, 546 00:24:29,840 --> 00:24:31,440 but a lot of stuff happens on the Internet. 547 00:24:31,800 --> 00:24:33,400 And I've got two young granddaughters. 548 00:24:33,400 --> 00:24:35,000 I kind of hope they get protected from that. 549 00:24:35,000 --> 00:24:37,640 Right now they're just Disney Princess films, but God, things 550 00:24:37,640 --> 00:24:38,960 are going to get worse in a couple of years. 551 00:24:39,000 --> 00:24:41,040 Yeah, yeah, yeah. We were talking about thinking 552 00:24:41,040 --> 00:24:43,240 about things too much. It's like the Internet feeds 553 00:24:43,240 --> 00:24:45,320 into that because it's not like you see your friends at school 554 00:24:45,320 --> 00:24:47,600 and you maybe you see them across the the lunchroom and 555 00:24:47,600 --> 00:24:49,440 you're like, they're talking to that person or they're not 556 00:24:49,440 --> 00:24:51,520 engaging with me. It's like they're not responding 557 00:24:51,520 --> 00:24:53,840 to my Snapchat, but I know they're online and I see them on 558 00:24:53,840 --> 00:24:55,640 Instagram. Dude, there's so much more 559 00:24:55,640 --> 00:24:57,960 information. So much more information and 560 00:24:57,960 --> 00:25:00,880 it's readily accessible, and I think it's easier to be cruel on 561 00:25:00,880 --> 00:25:02,120 the Internet than it is in person. 562 00:25:03,200 --> 00:25:06,440 I could be wrong. For people that have experienced 563 00:25:06,440 --> 00:25:09,000 depression in adolescence and they're like, OK, maybe 564 00:25:09,000 --> 00:25:11,760 potentially this might pop up again later in life, is there 565 00:25:11,760 --> 00:25:14,920 anything that you would recommend they do at this point 566 00:25:14,920 --> 00:25:17,920 in young adulthood to build that skill set? 567 00:25:17,920 --> 00:25:21,080 Think about this differently. Again, the the the two major 568 00:25:21,080 --> 00:25:23,840 things and once that the straight behavioral activation 569 00:25:23,840 --> 00:25:26,520 component was just wait to feel like doing something. 570 00:25:26,520 --> 00:25:28,720 If you would have done it, they can depress and do that anyway. 571 00:25:28,720 --> 00:25:31,000 Make yourself do that and see where it goes. 572 00:25:31,040 --> 00:25:33,640 You can get things moving more rapidly and then cognitively. 573 00:25:33,640 --> 00:25:34,840 Don't believe everything you think. 574 00:25:34,840 --> 00:25:37,080 Just because you think it's true, particularly if you're in 575 00:25:37,080 --> 00:25:38,960 a bad mood, doesn't mean it is true. 576 00:25:39,160 --> 00:25:43,280 Check those two things out. Interpersonal psychotherapy has 577 00:25:43,280 --> 00:25:46,400 some really good strategies for building relationship, etcetera, 578 00:25:46,400 --> 00:25:48,440 and I don't want, I don't want to short shrift them. 579 00:25:48,440 --> 00:25:52,320 That's another very effective clinical intervention and all 580 00:25:52,320 --> 00:25:56,000 good stuff, yeah. I'm curious to to get towards 581 00:25:56,000 --> 00:25:59,840 the end of our conversation what you hope to see in the field of 582 00:25:59,840 --> 00:26:02,520 depression research. What different areas you're 583 00:26:02,520 --> 00:26:04,960 curious? About in the next 10. 20-30 584 00:26:04,960 --> 00:26:07,920 years where you think we should be directing our energy or what 585 00:26:07,920 --> 00:26:09,880 you think we need to. Understand more about. 586 00:26:10,400 --> 00:26:13,200 Great question. I think focusing on just pre and 587 00:26:13,200 --> 00:26:15,560 post adolescence is particularly part, again, my wife's 588 00:26:15,560 --> 00:26:19,080 developmental psychopathologist and in her trials she can take 589 00:26:19,080 --> 00:26:22,200 kids at elevated risk because they have parents with a history 590 00:26:22,200 --> 00:26:24,920 of depression and cut the risk of initial onset in half. 591 00:26:25,360 --> 00:26:28,600 And same kind of strategy we do for adults, but kids pick that 592 00:26:28,600 --> 00:26:30,240 stuff up. Yeah, yeah. 593 00:26:30,280 --> 00:26:33,200 What does that look like when she's working to decrease the 594 00:26:33,200 --> 00:26:35,200 risk? Is it behavioral activation and 595 00:26:35,520 --> 00:26:37,240 not trusting what you're thinking or any other 596 00:26:37,240 --> 00:26:39,720 interventions? Exactly or where the two catch 597 00:26:39,720 --> 00:26:42,160 phrases come from her. Oh, I love that. 598 00:26:42,480 --> 00:26:44,520 Yeah. And she also trained at Penn 599 00:26:44,520 --> 00:26:47,080 there with Marty Seligman that come from her basically, yeah, 600 00:26:47,520 --> 00:26:49,400 adolescents can can do all of that stuff. 601 00:26:49,800 --> 00:26:52,280 Yeah, no, I love that. I I took his class last 602 00:26:52,280 --> 00:26:53,760 semester. It was incredible. 603 00:26:54,080 --> 00:26:56,640 I got lucky because he hasn't taught undergrads in like 7 604 00:26:56,640 --> 00:26:58,880 years and I happened to be here when he was teaching undergrads. 605 00:26:58,880 --> 00:27:01,360 I was like, yeah, yeah, no, I think she's absolutely right. 606 00:27:01,360 --> 00:27:04,440 And I think a lot of people underestimate how well 607 00:27:04,440 --> 00:27:06,200 adolescents can internalize skills. 608 00:27:06,200 --> 00:27:07,400 From a mental health perspective. 609 00:27:07,400 --> 00:27:09,120 Like if you can learn how to think about those things 610 00:27:09,120 --> 00:27:11,880 differently and how to manage your behaviors at that young 611 00:27:11,880 --> 00:27:14,960 age, you really are setting yourself up for success in so 612 00:27:14,960 --> 00:27:16,760 many ways. Because prior to that, it's like 613 00:27:17,000 --> 00:27:19,160 you're environment and your schedule, which is largely 614 00:27:19,160 --> 00:27:22,040 determined for you is doing a lot of the legwork. 615 00:27:22,040 --> 00:27:24,520 You're not really building those mental health skills and so. 616 00:27:25,080 --> 00:27:28,320 You have a lot of. Agency and capacity and I, I. 617 00:27:28,320 --> 00:27:30,800 Don't know if we're trusting. Adolescents enough to be able to 618 00:27:30,800 --> 00:27:33,280 like, remember, and internalize and implement these things. 619 00:27:33,880 --> 00:27:36,520 I think you're exactly right. Our experience has been that 620 00:27:36,560 --> 00:27:38,840 there's nothing an adult can do that an adolescent can't do. 621 00:27:38,840 --> 00:27:41,080 The real change comes pre adolescents opposed to into 622 00:27:41,080 --> 00:27:43,600 adolescents. From 11:12 on, that's just 623 00:27:43,760 --> 00:27:46,720 miniature adults. Yeah, yeah, I love it. 624 00:27:46,720 --> 00:27:49,800 Well, if people want to continue to keep up with your research, 625 00:27:50,040 --> 00:27:53,080 where can they do that? I have a website at Vanderbilt 626 00:27:53,360 --> 00:27:56,120 and we published periodically. When you took the class, was 627 00:27:56,120 --> 00:27:59,640 that with the rupus or Seligman? We took it with Doctor Seligman. 628 00:27:59,640 --> 00:28:03,240 He did the lectures for every single class and he had brought 629 00:28:03,240 --> 00:28:06,400 in a bunch of MAP graduates at T as TA, so it was really 630 00:28:06,400 --> 00:28:08,640 incredible. He was one of my, I think it was 631 00:28:08,640 --> 00:28:11,720 one of my three mentors, along with Tim Beck and my wife's 632 00:28:11,760 --> 00:28:14,400 primary mentor. Oh my gosh, that's incredible. 633 00:28:15,200 --> 00:28:16,520 So he's that absolutely marvelous. 634 00:28:16,720 --> 00:28:20,480 And he and Steve Mayer did a paper came out in 2016 where 635 00:28:20,480 --> 00:28:22,040 essentially they said we got helplessness. 636 00:28:22,040 --> 00:28:25,520 We're helplessness all wrong. Yeah, that marvelous thing. 637 00:28:25,520 --> 00:28:29,120 And most scientists make their theories more complex when 638 00:28:29,120 --> 00:28:31,400 they're conflicting data. This guy said no, we looked at 639 00:28:31,400 --> 00:28:35,000 it and we had it. We turned upside down and and 640 00:28:35,040 --> 00:28:37,520 you don't find many instances of that kind of courage in in the 641 00:28:37,520 --> 00:28:39,760 sciences, but bless his heart for doing that. 642 00:28:39,920 --> 00:28:42,880 You always used to say that in science, the goal isn't to start 643 00:28:42,880 --> 00:28:44,960 right, it's to get right. What a great role model for 644 00:28:44,960 --> 00:28:47,960 that. Yeah, no, we did the last couple 645 00:28:47,960 --> 00:28:50,960 classes on AI and where he wanted to see the field going 646 00:28:50,960 --> 00:28:54,680 and international conflict, like he's very much early adopter 647 00:28:54,680 --> 00:28:57,280 thinking ahead. It's really, really incredible. 648 00:28:57,560 --> 00:28:58,840 Yep, Yep, Yep. Marvelous. 649 00:28:59,080 --> 00:29:01,200 It's amazing. Well, thank you so, so much. 650 00:29:01,200 --> 00:29:02,320 For taking the time.