As a doctor (non-psych) with academic and philosophical interest in psychiatry, it's one of the most compelling logical arguments I heard that I didn't quite pinpoint myself independently. A hole in the head is an EXPECTED outcome of a gunshot wound, but that does it make it normal? No, it's "normal" as in expected under these circumstances of falling under statistical likelihood of nearly 100% of happening, but it's not normal to have a hole in the head.
"A hole in the head is an EXPECTED outcome of a gunshot wound, but that does it make it normal? No, it's "normal" as in expected under these circumstances of falling under statistical likelihood of nearly 100% of happening, but it's not normal to have a hole in the head." Fallacious comparison. A hole in the head is a physical matter and has an objective and concrete point of contrast which is based on the body as a biological machine. "Depression" refers to an affective experience. "It" does not have anything to do with the body as a biological machine except in that "it" can be said to work *through* the body. Real doctors deal with *biological* normality. In this case, "normal" refers to our judgement regarding how the body ought to work as a biological machine. That is the pathological concept of disease. Modern witch doctors - such as psychiatrists and alternative medicine quacks - "treat" metaphorical "ailments" of a person's life. Here, "normal" refers to sociopolitical judgements about what kind of existential attitude a person should have toward a particular existential event. If you react with hopelessness and demoralization which continues for months, you are said to have a malfunctioning central nervous system. The evidence? Nothing at all. If you react with resilience and courage, you are said to have a 'healthy response'. The evidence? Nothing at all. The only scientifically valid conclusion? Psychiatry is pseudoscience.
@@user-rq9dm7zr3d the healthy response is whatever the patient and their family wants. There is no point in treating people's depression if they don't seek help first. Why the hell would they look for a psychatrist if they didn't want to be helped? You don't have to be a genius to understand that hopelessness and demoralization is also a symptom of depression and even if they have a real reason to feel that way they still want to soothe their pain, what should doc's do? Negate treatment? Ignore the mental suffering just because it is expected? That would be the same as denying painkillers because the pain is justified. And if people really didn't think that hopelessness and demoralization wasn't a health issue why the fuck you they go to a doctor in first place.
@@qweasd9153 1) hopelessness and demoralization are objectively not 'symptoms of' depression. They *are* what constitutes depression. 2) If there is no disease, then there is also no treatment, since there is nothing to treat. Having a rough time in life and getting something like advice for dealing with said problems in living is all fine and good, but physicians are not experts in 'correct living'. If going to a physician for some particular reason is magically treatment, then so is going to a philosopher, coach, parent, priest, or whatever else. 3) There is no 'healthy' response as long as 'health' is a category belonging to biology, in which it denotes a correctly functioning body. If you are using the term 'healthy response' in the place of the word 'approved response', then you are using the double-meaning of the word 'health' as a strategic tool to make your subjective approval seem like it has something to do with objective science. 4) What do you mean by 'health issue'? People have problems in living. If they think someone can assist them with resolving or dealing with said problems in living and want them to do so, then they will naturally go to them for said assistance. Problems in living, however, are not 'health issues' as long as we are talking about health in the context of the body as a machine. Calling them health issues is simply a rhetorical tactic, since one is then abusing the double-meaning of the word "health" to bolster one's subjective view on how we should live. It's like calling a woman a 'witch' instead of 'a woman I personally don't like' during the Catholic inquisition. The former sounds more convincing and convicting, but upon closer scrutiny says more about the name-caller than the name-called. The reason I bring this up, by the way, is because people are coerced based on them being 'unhealthy'. Take, for instance, the depressed person who wants to kill him/herself. This is why I make such a big deal out of this kind of rhetoric. I have no problem whatsoever with people going to for suggestions on how to live. You can go to a priest, a quack (Ayurveda guru, psychiatrist, quantum spiritualist, etc), a philosopher, and all the rest. As far as I'm concerned, you can even use heroin and fentanyl. You can kill yourself too, if you deem that a desirable solution. However, none of the above have anything relevant to do with disease.
I normally never comment, but your content is like chelation for my lead poisoning. this is so true and I hate that people are still thinking like this, especially within the medical community. Your examples are so good and eloquent. The fact that you have recognized this is part of the solution. If you were my psychiatrist I would feel so comforted. I would say that there are many ways to address this: of course systemic change from the inside out, but also media portrayals, social media like you're doing, startups/business, etc. yes it is frustrating but just you speaking out about it has made it better. You're doing great Preston!!!!!!
I rarely comment on videos. But as a psych resident myself who has been really struggling with the moral distress that comes with the field, this video really helped put some context and words to that distress - the burden we often feel compelled/forced to take on to "fix" systems out of our technical professional scope and role, while also trying to support our patients who are impacted by these systems knowing there is only so much we can do...is exhausting and overwhelming. Thank you for sharing your thoughts and content - it's really helping ❤️
i think it's a shame your curriculum is focused on patient outcomes, and that practitioner's development/success is only measured this one way. Like, if i had to pick between a 30 year old surgeon with a 100% success rate, and a 60 yo one with a 65% success rate, my insurance prefers the former, despite his lack of experience. Doctor's are measured by the outcomes, and not their principles. I suppose this is true for almost any profession, but it seems especially counterintuitive for medicine when you throw insurance into the mix.
As part of my diploma work for medschool I did a study on depression, TRD, and ketamine use. When trying to define TRD I came across a nuanced definition of Difficult-to-treat depression, or DTD. It boiled down to “you have lived, and continue to live a depression prone life”. I love the lead analogy. You need water to live, but whether your water has lead, to your knowledge or not, is likely not up to you. “You have drank, and are continuing to drink lead”. This was the first part of my discussion: As with the introduction, please allow me to write a bit more poetically. One of the greatest insights I’ve gained through my time studying depression, from DDs in general to MDD, TRD, and DTD, is that depression is nuanced. I praise all the hard-working scientists and clinicians in their attempts to classify and define depression. With definition comes understanding, with understanding comes prediction, and with prediction comes mastery. However, in writing this thesis I’ve wondered whether mastery of depression through pharmacological treatment is wise. It is not a far stretch of the imagination to believe that anti-depressants, and current psychopharmacotherapies in general as the prophesied Soma of Aldous Huxley’s A Brave New World. Physicians, and specifically psychiatrists, enable people to bare the mental slings and arrows of modern life, but as enablers, we also facilitate the stresses of that same oppressive life. As bronchodilators to a lifetime of smoking, so too SSRIs for a life-time of modern living. It’s a bit of an accelerationist thought, but I often wonder how society would be like if these psychopharmaceutical crutches were taken away. The antidepressants, the anxiolytics, the attention medications, or even commonplace stimulants like caffeine. What would happen if people en masse were to wake up to a raw life? But I digress. These are ancient questions and musings about the nature of life and the role depression plays within it, - difficult to answer. As a physician and a psychiatrist we need to accept this role in order to help our patients.
Mastery of depression through pharmacological treatment is straight up not happening. At its most functional, pharmacotherapy allows patients to leverage what agency they have, and integrating the challenges of an individual's life into a positive sense of possibility and selfhood is not achievable by identifying some NT or cytokine pathway and tweaking it just right. In a "raw" world-- let's say no seizure medications either-- people would have a reduced range of motion (often literally) and ability to enact changes that they otherwise could. Crutches exist in the real world, and I imagine people would limp along without them. The proposition to prevent the injuries inherent in the way we all live will ultimately come from outside psychiatry.
That example you gave is really spot on for a lot of the patients I’ve worked with that are unhoused or very low income. The fact that you are sharing these stories is just as important as caring for that patient. Education can always lead to other folks taking more proactive responses / action and that’s so powerful. Not an easy process but powerful nonetheless.
I can absolutely sense the disappointment and frustration you’re emoting when answering this. Thank you for advocating for a better understanding of this and sharing your patient experience. Mental health = Physical Health = overall HEALTH! On a similar vein, imagine telling someone with a fractured tibia that the pain and swelling is all in their head and they don’t need immobilization, that it’ll all get better if they “just keep running”.
This guy keeping it real, he dont miss. People stigmatize psychiatric medication (eg. SSRIs) in a way that they dont with other types of medication. "when are you gonna get off the antidepressants? are you just gonna take them forever?" people say with an air of disgust. Okay, then why don't you see it that way with your statins, huh? You gonna take those forever?
difference is that we actually know mechanism of action of statins and we actually have empirical data why we use them , for mood disorders and other mental illness where we use SSRI , we actually dont know why or how SSRI work (or dont work ) for them .
@@Strdvd11 2 things: SSRIs have empirical evidence its just not particularly strong (same as statins). And secondly, we know very little about the complex cardiovascular system, for example narrowing of blood vessels is not correlated to increased chance of heart attacks for quite a few populations, yet we still stint. Statins may reduce LDL and LDL may be correlated with heart disease but there are not proven (key word) mechanisms for why that is. That being said we know depression is correlated to heart disease to a similar extent as LDL, and we know that ssris can cause remission of depression in many patients. I would just stay away from mechanistic bias and making judgments based on what feels intuitive as nature tends to defy intuition.
@@letsdomath1750 i agree with you on this . Another thing i would add is that ideally you should not prescribe them imediately , there is a lot of lifestyle changes that can help manage diseases that both of these medication treat.
it really is ridiculous how the young psychiatrists and trainees really seem to be ushering in a very welcome new age of mental health awareness, perspective, and philosophy. But this is not the type of thing that your average doctor thinks about or will care enough to say out loud.
I have had a depression diagnosis (Major Depressive Disorder) since 12yo and was showing signs of it starting at about 9yo. I am now 22yo and I am on at least five mental health/insomnia related medications. I didn't realize how much I was needlessly suffering until I got on them and finally felt like I could breathe. Medication has allowed me to cope with societal stressors that I have no ability to control as well as function well enough to be proactive in reducing circumstances that make my mental health worse. I never really understand the whole "it is your fault" mentality, but I also think that if you haven't experienced mental illness, it is hard to realize just how extreme the suffering can be. Idk, your videos and perspectives are just really good and I agree with you is where I was trying to go. I'm glad to see you uploading again, even with the focus being less on skits. I think you would be a wonderful provider based on what I've seen and I hope your patients are able to enjoy that.
Medication completely changed my life, for the first time in years I'm able to enjoy things and look forward to stuff and I never thought I'd say this... But PLAN things. I completely forgot what it felt like to be happy
@@fulltimeslackerii8229 I was bullied really severely when I was little. I don't think it would have showed up that early if I hadn't gone through feeling like no one but my parents loved me. The teacher made me feel like she actively hated me. I also was sexually harassed by another student and I was the one always blamed for it. I've also sadly seen kids as young as 9 attempt to take their life in my field of work. There is a reason pediatric psych facilities exist, sadly.
love the Flint, Michigan analogy. this video really helped me understand this differently. You do a great job at explaining stuff, keep it up! :) I gotta show this to my desi parents
You are a brilliant & humble voice in a sea of money hungry Psychiatrists (& world) who truly don’t care about those suffering. You alone are changing the world with your posts. Please keep posting your thoughts. They are exactly what I’ve been saying for years but I’m not an MD so no one listens lol. Brilliant sentient being who is a true hero and going into medicine for the right reasons. But you need a movement behind you to help with a huge paradigm shift in how we (society & MD’s) see and treat mental illnesses. Parkinson’s is acceptable to have but not depression, bipolar, schizophrenia or anxiety. Makes ZERO sense . Both brain based illnesses! Where’s the simple logic.
I appreciate the way you outline the challenges of broader social problems and individual problems with depression. I find lots of people struggle with understanding real data on depression which shows that medical intervention to treat MDD saves huge numbers of lives. Sure, in some magical way I wish there were scads of wilderness wellness retreats where people everywhere with trauma could come and work through the issues, but as a clinician, you are always stuck with real solutions, not magical ones.
@@aydenr5467 by noting that some behaviors are drastically different from what the population does. Like, without some kind of trigger, how many people do you know suddenly develop sleeping issues, social withdrawal, can’t get out of bed to the point of almost missing work and stop eating?
Grief passes on its own with time, depression doesn’t. There’s a video from Stanford university on this platform with Robert Sapolsky (has done many years of research into neurology) who explains it pretty well I think
@@fulltimeslackerii8229 "by noting that some behaviors are drastically different from what the population does" First, "normality" only has relevance to pathology if it refers to biological normality. Courageousness can be uncommon in certain societies at certain times, and yet it is objectively biologically normal. This is the difference between "uncommon" and "abnormal." Behavior implies decision. When you are critiquing a person's behavior, you are de facto critiquing his decision to behave that way. Since decisions have nothing to do with biological capacity except in that they work through our biology, talking about "abnormal decisions" in the guise of "abnormal behavior" is moot when it comes to discussions about pathology. With that established, depression is an affective experience. When you declare depression as a disease, what you are saying is one of two things: 1) depression as an affective experience is a sign of pathology 2) reacting to something with long-lasting depression is a sign of pathology The first is easy enough to refute, and the second is easy to demonstrate as having no scientifically valid reason for suspecting it as an indicator of pathology: 1: Epidemiological evidence conclusively proves this claim as objectively wrong. It doesn't take much reading of history to find several examples of mass demoralization, hopelessness, and so on. This, of course, would be pretending that the claim that a particular affective experience in itself is a sign of disease isn't absurd. No affective experience, be it depression or contentment, is a sign of pathology. The reason for this is that we have the biological capacity for it in the first place. 2: Depression is another way of saying demoralization and hopelessness. Since a person is demoralized, hopeless, and so on, it is no surprise that the person acts the part; just as it is no surprised that a content person acts in content ways. This is not an indicator of disease in any way whatsoever. Monks isolate themselves for their personal reasons, hunger strikers stop eating for their own personal reasons, worried people have trouble sleeping, and so on.
@@cameronschyuder9034 "Grief passes on its own with time, depression doesn’t." By definition, in order for something to "pass on its own with time," it needs to have no relevance for you to pay attention to it. If it continues to have relevance to you, then you will - again, by definition - pay attention to it and therefore be weighed down by it. This does not magically turn 'depression' into an indicator of central nervous system malfunction, unless your aims are ideological and not scientific. There are no more scientifically valid reasons to suspect 'depression' of being the result of pathology than there is to suspect grief of being the result of pathology.
I'm an RT so I don't often interact with psychiatric patients, but hearing you dexcribe it so well I... can't even explain it. I feel so helpless myself in front of these people, who are so obviously distressed, and I have nothing to offer them. I wish more people would see mental illnesses the way you do.
DSM clearly separates understandable depression from MDD (major depressive disorder or clinical depression which is the older term). understandable depression orbits around a specific event, comes in waves and improves our of time. MDD has no apparent cause, does not improve over time. People dont know the difference.
Because suffering is real, and responding to suffering, pain and trauma is real. But the label of MDD is unreal, socially constructed, nonsense. It offers nothing to get the person OUT of suffering. Sadly, society seems to still believe that these diagnostic labels are valid and represent something tangible, like an illness or disease. They do not. At best they're a shorthand for clinicians to describe clusters of emotional and behavioural responses. At worst... They're a form of coercive control and life limiting. This is coming from a Psych Nurse with lived experience as a patient also.
I feel you. Treatment is better than no treatment - but Ill be honest... I was living in environments where I wasn't happy and it wasn't until I moved that my depression cleared. It only took a few weeks on my own in a new city with a good job for my thoughts to be clear, my motivation to be abundant, and my confidence to skyrocket. Therapy can't replace opportunity. Its a cast on a chronically broken leg. The way people weaponize this to say therapy is bad is pretty ridiculous though. Help is help. Therapy is the equivalent of a homeless shelter. Definitely cant beat a stable happy home but it sure beats the streets.
I really think that with mental health injury, there should almost always be some form of therapy that goes along with treatment. I really agree with everything you are saying here as well
I've termed it - for myself in my unique situation, and how I have felt both mentally AND physically - as 'psychological concussion, or psychological brain damage'.
I like to explain this to patients using the biopsychosocial model of disease. I explain that all 3 parts can contribute to disease, and realistically usually all 3 do, but in their case the main culprit is the "social" part. So I tell them that I think the best treatment for their case is having them no longer work 3 jobs and stop having a stressful life, but y'know, easier said than done, and we laugh about it a little. They know that's the problem, but until they can get better living conditions, their life still sucks. What am I gonna do? I can't get them a better life. But I can get them meds that will honestly help a great deal as well as point them towards therapy that will help them better deal with these stressors. That's the bio and psycho parts.
How sad it is that we've gotten to a place in human society where we are medicating people so that they can be productive members of a greedy economic model. The whole concept is utterly depressing, and that's not a diagnosis or a problem for me. It's a problem for society.
@@aydenr5467 I'm not medicating anyone so they can be productive. We medicate people because they feel like shit. The distinction is made very clear in the video. I cannot fix society, but I can help you feel less awful.
@itspresor I absolutely agree with all of what you're saying - I think it's just an interesting distinction as your last post surrounding how psychiatry and neurology might (or are beginning to) merge. I didn't mean to imply that depression or anxiety that is due to environmental factors isn't "real pathological depression" - and definitely not that it's a personal failing that they can't tolerate lead water (to mix around more analogies). I'm just wondering how the idea of "genetically predisposed" depression would be functionally different to "environmentally caused" depression in the hypothetical merge of psych/neuro. I don't think it would be based off what you're saying - and I don't think that's a bad thing. People who are drinking lead water vs people who have a genetic predisposition to accumulate lead - they both need to get lead out of their body. I think it's just part of me accepting (as a relatively new med student) the role doctors play in the dystopian idea of a society being so horrible that the only way to help patients cope is pharmaceutical treatment (the Bad part of that being the society part - not that they need zoloft)
Not Preston, but I think doing what Preston is doing (speaking out on social media) is very important towards changing culture and attitudes. Other options include research/academia, brainstorming and working with leaders at your practice/health system, looking at mental health acceptance and startups in this area (consider being an advisor/founder), creating creative content (comics/webtoons, books, podcasts, screenplays), getting together a group of your colleagues/friends and thinking of ways your professional academic society can make a difference, talking with patients/providers in support groups and considering tackling the problem through any of the above, etc. Change can be done at a local institutional level or on a wider scale, just through acknowledging the problem and healing from personal feelings or by grouping together with others to put an initiative into action, through research or entrepreneurship or quality improvement, etc. So many options!
I spent a long time gaslighting myself for years that i wasnt depressed, and i started antidepressants 5 mo ths ago and when i tell u they saved my life. THEY SAVED MY LIFE. I think its so important to remove the stigma of taking medication because even though u cant see it, its still there, and its very real
I think it’s an important distinction to emphasize the fact that it’s the environment because our culture is hyper individualized and that has promoted a false narrative about mental health being an individual “chemical imbalance” or a moral and character failing. I think acknowledging it’s the system can be a relief for some who have been gaslit their whole life, told they just don’t have the right “mindset”. Or even in therapy I think it needs to be acknowledged for the strategies a therapist implements to be more authentic and effective. Anything we can do to acknowledge the systems roll, is absolutely crucial. AND we can help people with medication and therapy in light of that. I don’t think people saying it’s a normal reaction are advocating that we shouldn’t provide support to people with that reaction. It’s meant to be empathetic, and provide context to people’s emotions. You wouldn’t believe the amount of people I talk to who think they just have a defective brain and that’s why they feel bad. It’s super important that people don’t believe they have a faulty brain when the system and world IS so messed up, and it can lead to different approaches like community action, rather than a self help book
I appreciate your comment, one thing to note is people absolutely are saying that because it’s a normal reaction it should not be treated. They perceive it as medicalizing the normal range of human emotion and use that to vilify psychiatry. It’s important to distinguish between normal, pathologic and rational vs irrational. Depression is a pathologic, rational response to a shitty situation. Whereas sadness is a normal, rational response to a terrible environment. The former requires treatment
@@itspresro I appreciate you engaging with my comment! I see what you are saying. To truly unpack this, I think it would require a very lengthy conversation about the historical roots of various prominent diagnoses, and the institutional nature of psychiatry itself. How the people historically in power categorize human behavior and what is or isn’t pathological and understanding and what effect this has on people’s lives. Thanks again
Is it possible to determine whether someone's depression is a normal response to their environment/circumstances without projecting our own biases? Related to that, can we ever truly adjudicate between "chemical imbalance" and "situational" etiologies? Non med here, so perhaps that's not even a dichotomy that is taken seriously, just something I hear often.
People are at pains to blame someone for their mental health issues, because that makes them feel like they have control over their lives, things just don't randomly happen to people and the world makes sense again.
Both can be true to a point. People can have addiction but that does not mean they are not responsible for it, they may have caused it by relying on drugs instead mental healthcare. Diabetics have to care for their diet, and if they take too much sugar it is bad for them. Same For depression to a point that is also true... Wemay need medication to treat it but also we need inner work and responsibility.
The problem is when docs think that there is lead poisoning and in reality , there is no lead poisoning and this extra and unwanted medication that you pump in causes poisoning and then withdrawal and just an endless loop
The problem i have is people blaming and thinking depression is caused by vitamins deficiency and evade also avoid mental health clinic because of this believe
Also, a deformed bone secondary to a motorbike accident is a "normal/natural/obvious response" to that phyisical injury, but if you don't get surgical intervention asap you may die. Also, feeling pain in that situation (or in migraine) is a normal and evolutive response, but analgesics are universally preferred, instead of freely feeling pain for no reason, and no anti-psychiatry gang call that "medicalization of the normal", they just take the painkillers. Thrombosis is also a normal and expected coagulation response to endothelial injury in athersclerosis-plaque rupture, but stopping it with aspirine makes you live 25% more than not taking it. "Normal" and "abnormal" are not the point in therapeutics in medicine, but rather if it's "treatable" or "improved" by a medical intervention. Most depressions are improved by psychotherapy, pharmacoterarapy and so on, that should be the point, not whether you are treating a "normal response". Thanks for the video.
So amazing. Thanks ☺️ Your brilliance and compassion and humour and truth telling are an awesome combination. At some point, i look forward to your research into and speaking about FND which is hugely stigmatised ( and still wrongly seen as making stuff up by many in healthcare, even if they might be less inclined to say it outright these days , which i suppose is a sort of initial good step . ) I think you would appreciate the work of Dr Jon Stone who has done so much to advance more understanding in the area... ( yeah anyone can google him in relation to FND. A very kind neurologist. But isnt it RATHER TELLING AND FASCINATING, Preston , when being kind as a doctor becomes a suprise ??? Something wrong there?). And why dont the medical profession seem to want to look at and talk about Medically induced trauma ? Both that patients can experience for many reasons but it seems doctors experience it too in the way that medicine is taught, trained and practiced !? Sorry for my very long comment but basically thank you ! And yes, what you say about depression here- spot on. I also think Gabor Mate would applaud you.
This was very helpful thank you! Could you rebuttal some other anti-psych arguments, like: 1) “our kids should not be given drugs, it’s bad for their brains, etc” 2) “antidepressants and antipsychotics ruined X in my life and Y in my friends life, they are better off without that poison.”
Or the parents that say “I don’t want him being dependent on a medication to not be depressed” not realizing that untreated depression is a risk factor for illicit drug use ie self medication
There is no real rebuttal, antidepressants are in a shitty state, they have low effectiveness (15 minute walk every other day is on par with most ssris) and they come with serious side affects. That's a part of the drug. Anti-psychs are better, they're still bad for you, the positive is that for a small % of the population they're treating something far worse. I still think anti-depressants are a useful tool for a small minority of depression cases it's just that the vast majority isn't going to see a significant benefit that outweighs their severe downsides.
I’ve been thinking a lot about this a lot, specifically with the flint analogy and have a question. Let’s say someone has a mild cough and sore throat and they just want to make sure it’s not strep or something. Obviously this very uncomfortable. But nobody’s gonna get mad at the doctor for saying “this will probably go away on its own in a few days. In the meantime just power through” But when it comes to psych, you’ll get lambasted online for saying something like “breakups are difficult but cope”. In your optho resident video the other day, you said that by saying things to the effect of “lol skill issue just cope” is saying that “mental health isn’t real health”. Another classic example is the idea of “man flu” but nobody takes that to mean “this isn’t real health”. In the man flu scenario, you’re acknowledging that there is something wrong but that you’re dealing with it appropriately. So I guess my question is, why does psych seemingly get special treatment in this aspect. Isn’t the point of therapy to literally teach people how to cope? Why is “learn to cope” such a taboo thing to say but only with psych?
It depends who you're speaking to, right? People who seek psych treatment have generally already tried to walk it off, because getting effective treatment is often costly and time-consuming, and "learning to cope" is arguably what therapy is for. If someone is experiencing psychological stress that outstrips what they seem to be dealing with in life, that's a pathological response which is more in line with an injury than a difficult period alone. If you know a lot about someone's medical history and personality there's nothing wrong with saying something like "you'll be fine" after something scary like a job loss or breakup. If you don't know them well, saying "cope" assumes a lot about what's going on both neurologically and elsewhere in their life.
Doctors focused on depression since my teenager years when they should have been focusing on my anxiety. Signs were extremely obvious but anxiety can be complex. Depression they can just chucked tablets at you. F lses of course shes depressed😒🙄. Wasted years of my life.
Depression can be a normal response to a traumatic environment. However, this explanation should not justify delayed or absent treatment. I once heard someone say that “therapy can make you sick.” Really? Talking to someone once a week or twice a month will make you sick? Sure, there are some terrible mental health professionals out there. But if talking to them can make you “sick” then you were probably already sick to begin with.
Yes, sometimes people have maladaptive coping mechanisms that they limp along with. When they start therapy things may get worse before they get better as they unpack the stuff they haven’t been addressing. Like reducing a dislocated shoulder. Putting traction on it will be painful but that’s not what caused it
I could have said this part better. The argument is conflating the terms normal and reasonable. Abnormal environments causes abnormal changes to the mind. Which is reasonable, but now the mind is not “normal” it’s experiencing pathology. So when you treat it you are treating mental illness, an abnormal state of mind, that is perfectly reasonable for someone to have
@@itspresroI was with you up until the term Mental Illness, and pathology. If we take pathology to mean the study of injury, specifically, that I could agree with. However then to frame the person's response to (social) injury as mental illness seems like a jump. When someone dies, we cry. When someone yells, we jump. When someone abuses us, we freeze, we panic. When someone neglects us, we yearn. When someone manipulates us, we fear. Where does the response to the injury itself becomes a pathology/injury? Do we call the inflammation at the site of an infection pathology? (Maybe you do, I am not a doctor personally, just a humble mental health nurse). I love your content, your passion and compassion. But I am struggling to grabble your conceptualisation of human suffering and ontological security.
@@aydenr5467 The example of inflammation in the context of infection is actually a great analogy. Inflammation is the normal response to an infection - it's a part of the process of healing. Sepsis, however, is when that response becomes as harmful (or more harmful) than the causative agent, resulting in a host overreaction that leads to significant morbidity and mortality. It was caused by a pathogenic bacteria, but the exaggerated inflammatory response is what's killing the patient. There's a clear parallel between that and the pathological exaggerated adaptations in affective disorders caused by social and environmental factors, though it might not be quite as neatly packaged as sepsis.
Just because a response is "normal" doesn't mean that it doesn't impair your functioning. And in our "normal" world we don't really give any slack to people whose ability to function is even slightly impaired (for any reason). This should be obvious, but after 25 years in mental health, I know that it is not. Don't get me started on the misuse of the word normal. I appreciate this video because it's good to see someone politely explain something I am becoming increasingly impatient about. On a slightly more optimistic note, explaining that antidepressants aren't just happy drugs and giving specific information about why not tends to be very helpful for clients. Cocaine, for example, is a happy drug, whereas Prozac doesn't change much for someone without depression and anxiety. Then point out that cocaine has a lot of serious side effects, including destroying your whole life, which are not associated with antidepressants. There are definitely problems with medical models of psychopathology, but let's be honest here: telling people to get their lives and relationships in good working order presupposes that people have a degree of control over the machinery of their lives that many of us just don't have. I feel like a clown at work every day too. But I still wouldn't trade it.
You do have power to change it. We can invest in building a better society, in looking after people, rather than just researching different receptor sites in the brain and new drug candidates. We have to put the focus elsewhere, in making our society less stressful, more connected, more compassionate, more humane. And we also need to reflect as to whether why we feel so defensive on this issue is that we need validation that we are “proper doctors” treating real diseases. I personally have a secure enough ego that I don’t care whether people think I am treating real conditions or not. And I also won’t gaslight people into telling them they have a chemical imbalance in the brain when they’re actually facing social injustice.
The main problem is that there are so many social Darwinists out there. The reality is that most of people are evil. Vast majority will leave their own to die of they are in need instead of pooling their money together to help.
I have a running theory: "People who care the most, hurt the most." What is this ancient view of "strength" where men are stoic? Is detachment and productivity really the way we are supposed to live? The people who are brave enough to feel and care about others outside of themselves are the ones with depression. Those who repress, detach, are apathetic, pursue the inability to have an "unbroken mind / will", that is the true pathology. Is it needed? Yes. But let's understand that their "strength" is a necessary pathology, not the ideal standard.
The lead poisoning analogy is a very poor one, and I'm surprised to see someone who should know better making such a comparison. The point at the end is a stronger one though, and bravo for making it.
Not only is depression the medicalization of normal human emotion, ADHD is similarly a medicalization of normal childhood behavior, especially for boys. Parents and teachers want to drug the children into submission, dulling them and reducing their energy. They do this because they find their overly energetic kids annoying and unmanageable, not because the kid has an actual "disease".
@@DannyD-lr5yg True or false: The pharmaceutical industry wants to maximize its profits. This means they want everyone on drugs, even if they don't really need the drugs.
I used to think opinions like these were just misinformed garbage and unempathetic bs, until I actually started rotating in peds clinics. Then I realized it really is almost always just bad and neglectful parenting. Many kids were just thrown on stimulants because the parents thought they were annoying at home, even if they had good grades and no complaints at school. A lot of the kids whose teachers did endorse "disruptive" behavior at school would say they were being bullied by other kids in class but the teachers wouldn't help, so they couldn't focus. The pediatrician and their parent would just talk over them, up their ritalin dose, and switch back to small talk.
@@BennyOcean That would be really insightful if it weren't for all of the peer-reviewed high-quality clinical trials run by people with absolutely no vested interests in the profits of pharmaceutical companies demonstrating psychostimulants to be incredibly important for improving long-term outcomes in ADHD.
@@BennyOcean Idk because I don’t get treatment from “the pharmaceutical industry,” I get it from my doctor. And he has explicitly told me it would be his wish that no one had to be on any meds at all. He has prescribed me ADHD meds, helped me try different ones, and fully supported me in getting off of them. (But newsflash: it’s still real, and still a neurodevelopmental delay, and I will always need certain tools to function on par with adults without ADHD. Sometimes that includes meds, sometimes it doesn’t.)
