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48. Chemical Imbalance Revisited · Radically Genuine

0:15
[sean]: brother shawn kelly is on vacation good morning shawn we're aloud vacations only kelly okay
0:25
[sean]: well we kind of want to get in the studio and address some recent events
0:29
[sean]: within the field of psychiatry psychology that has certainly kind of taken the world by
0:35
[sean]: storm because is hit you international news media and it's ironic because the very first
0:43
[sean]: podcast that we recorded was on this very subject we thought it was that valuable
0:48
[sean]: in that important it was the around the chemical and balance myth and when we
0:54
[sean]: first recorded that podcast many people would have been surprised to hear these ideas that
1:01
[sean]: depression for example is not related to low saratonian in the brain and therefore everything
1:09
[sean]: that we believe anti depressant to do as far as correcting that low seratone in
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[sean]: the brain is inaccurate and we've been led to believe through very sis matic and
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[sean]: targeted pharmasutical marketing campaigns to have us believe that what we experience what we feel
1:28
[sean]: is related to an underlying brain abnormality or an illness and in a recent review
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[sean]: article in molecular psychiatry june july twentieth came out very recent uh dr joanna moncrief
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[sean]: and colleagues published this systematic review the seratonan theory of depression a systematic umbrella review
1:57
[sean]: of the evidence anyone who wants to get into the nitygrity details of such review
2:03
[sean]: feel free to i think for our purposes today we just want to go over
2:08
[sean]: the highlights um very simply you know the idea that depression is a result of
2:14
[sean]: abnormalities and brain chemicals in particular sarah toning has been influential for decades and provides
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[sean]: important justification for the use of anti depressant what has the actual literature revealed and
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[sean]: so when shan when we were recording this podcast back in twenty twenty one june
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[sean]: twenty twenty well probably fourteen months ago fourteen months ago i just got finished with
2:44
[sean]: my own review and was surprised not necessarily surprised but i was certainly shocked about
2:55
[sean]: how there was really no evidence at all and we're all kind of subjected to
3:01
[sean]: media manipulation of idea yes and when i knew very clearly that this was a
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[sean]: you know a theory that was never supported by evidence it became very important for
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[sean]: us to be able to just start communicating that that message and for me what
3:19
[sean]: was most concerning and forget about the efficacy of anti depressence or any of the
3:24
[sean]: other effects the withdraw effects the the side effects the long term impairment that exists
3:31
[sean]: from prolonged use i was most concerned about was the psychological aspect of believing that
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[sean]: there is something wrong with your brain yes because of everything i know about the
3:44
[sean]: field of psychology and attempting to cope and live well really reflect some core principles
3:52
[sean]: in how to you approach the the experiences just being human and one of them
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[sean]: is the idea that there are emotions are there to serve us and when we
4:02
[sean]: feel something and we're experiencing something it is something to be paid attention to because
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[sean]: it is our body reacting to events that occur in our life now those events
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[sean]: could be outside of us or they could be internal just our own thoughts our
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[sean]: own our own memories and using those emotions to our benefit is part of a
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[sean]: very important adaptation process so i was very concerned and always have been concerned about
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[sean]: what happens then when you are led to believe that what you are thinking or
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[sean]: feeling is different than somebody else that there's something you're broken in some way that
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[sean]: that it's an illness and you'll never know it was ever fixed or could be
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[sean]: fixed yeah that's i would imagine that's extremely challenging and difficult for someone to be
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[sean]: in that position when you're told you're broken and you have to do this for
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[sean]: the rest of your life not only that you have to really put trust into
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[sean]: a physician who might only sit down with you for thirty minutes forty minutes you
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[sean]: know if that and just accept that these are these are scientific advancements and you
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[sean]: know there's clear validity to some of the recommendations that are that are being made
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[sean]: and so that's a lot of trust right here take this farm a cuticle take
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[sean]: this pill and you're going to feel better over thirty plus years we've learned that
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[sean]: you know most people don't feel better and a lot get much much worse so
5:35
[sean]: where do things go from here and what are our next steps when it's clear
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[sean]: now that this has been disputed scientifically i feel like it had been disputed scientifically
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[sean]: for quite some time in a very small niche of the psychiatry and psychological community
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[sean]: of those that we're understanding the science and it took this paper to take all
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[sean]: of the research that existed compile it into one concise statement that would finally say
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[sean]: that that hypothesis for which ant depressant were originally marketed under is not true therefore
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[sean]: we need to investigate further it's basically for me it was an if then statement
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[sean]: right that's how i interpreted it so i don't know if we actually said what
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[sean]: the results were we just kind of were going through the history of it can
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[sean]: you can you reveal what the study um what the final statement was for this
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[sean]: umbrella review sure basically the main areas of sara tone and research provide no consistent
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[sean]: evidence of there being an association between saratonian and depression no support for the hypothesis
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[sean]: that depression is caused by lower carton an activity or concentration some evidence was consistent
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[sean]: with the possibility that long term anti depression use actually reduces sara toning concentration and
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[sean]: i don't think anyone argues or we'll support the idea that depression is related to
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[sean]: one nero chemical like sarah tone but i think we'd all be concerned about what
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[sean]: would happen for long term use if you're unable to produce sarah tone so this
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[sean]: this adaptation process of the brain when you impact its own ability to produce a
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[sean]: neuro chemical so we're certainly experimenting with such a complex organ the brain what does
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[sean]: then happen for prolonged ice so we're at a point now where even though the
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[sean]: majority these studies were very short term definitely under twenty four weeks most eight to
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[sean]: sixteen weeks we now have people on the inside a presence for ten fifteen years
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[sean]: or more multiple meditations which the combination of has never been studied never studied so
8:20
[sean]: a lot of this is going to be shocking to many people i remember when
8:23
[sean]: we recorded the first episode in here this was all new to me i believed
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[sean]: it to be true i thought you were crazy and my approach in this room
8:32
[sean]: was to try and balance out many of the conversations and make sure what was
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[sean]: being said was was factual at least debate with you a little bit so i
8:40
[sean]: could continue to learn and there by others that were listening could learn as well
8:45
[sean]: and i look back now fourteen months ago and i realize that m right it
8:52
[sean]: was it was a marketing campaign well there's very good reason that you would have
8:56
[sean]: believed that and thought i was the crazy one because of directed consumer marketing it
9:02
[sean]: really started in the nineteen nineties if we we had this we played one of
9:07
[sean]: the commercials so i pulled it up so we can we can listen to it
9:11
[sean]: again because of the language in there and i always like to listen to the
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[sean]: words that they used specifically right because people hear what they want to hear and
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[sean]: they believe it to be true but i worked in advertising and we chose words
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[sean]: very carefully so that we would never ever get into legal trouble you know or
9:29
[sean]: i'm going to play this let's take a listen about a minute long you know
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[sean]: when you feel the weight of sadness you may feel exhausted hopeless and anxious whatever
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[sean]: you do you feel lonely and don't enjoy the things you once love things just
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[sean]: don't feel like they used to these are some symptoms of depression a serious medical
9:51
[sean]: commission affecting over twenty million americans while the cause is unknown depression may be related
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[sean]: to an balance of natural chemicals between nerve cells and the brain prescription zola works
10:02
[sean]: to correct this in balance you just shouldn't have to feel this way any more
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[sean]: only your doctor can diagnose depression so loft is not for everyone people taking m
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[sean]: s where pemiside shouldn't take solo side effects may include dry mouth insomnia sexual side
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[sean]: affects diario nausea and sleepiness zolofis not having for talk to your doctor about zola
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[sean]: the number one prescribed brand of its kind zoloft when you know more what's wrong
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[sean]: you can help make it right you know when you okay there's the reason right
10:40
[sean]: and so what i started doing over this past i guess year and a half
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[sean]: as i wanted to ask people would you have taken an anti depressing drug if
10:52
[sean]: you were told there is no such thing as a chemical and balance have no
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[sean]: evidence depression is associated with diminished sarah to nan we have no evidence you have
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[sean]: lower sarah to nan and we have no idea what is going to happen to
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[sean]: you long term would i absolutely not so now so i ask questions like that
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[sean]: to people i know impose those questions on twitter one hundred per cent people come
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[sean]: back no i would not have taken this drug p questions always were you communicated
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[sean]: to by doctor that this drug corrects and underlying chemical or in balance or was
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[sean]: it communicated to you in some way that you may have a chemical balance the
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[sean]: question is for a large the answer was for a large majority absolutely so even
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[sean]: though we didn't have the evidence shown yeah doctors were still communicating this to patients
12:00
[sean]: because of a very very targeted marketing campaign to physicians themselves with farmasutical sales people
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[sean]: in the offices doctors were led to believe that this drug does correct a underlying
12:15
[sean]: chemical abnormality and many to this day are still communicating the same message if they
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[sean]: are not in this field primary care of physicians looking at close to eighty per
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[sean]: cent of these drugs being prescribed by primary care physicians certainly not reading the literature
12:35
[sean]: in sochiatry on depression probably not listening to the radically genuine podcast they don't have
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[sean]: patients in their office every day they are just following protocols and they also have
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[sean]: a broad knowledge base so take everything in the medical field if you're a primary
12:51
[sean]: care physician or like a pediatrician you have to understand what's happening in so many
12:56
[sean]: areas so you rely upon the expertise of those that are providing literature to you
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[sean]: in summary form so you can clearly read digest understand repeat so you probably got
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[sean]: an email from me this week and actually send it out to the entire staff
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[sean]: twelve email today was what this weekend was a weekend where i was obsessively for
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[sean]: gest on this subject because i have plans you know i have i have ideas
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[sean]: i think we have to actually i think i have a responsibility to contribute more
13:30
[sean]: and one of those areas that i think i need to contribute more is providing
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[sean]: people informed consent and i have to have a very extensive then knowledge of the
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[sean]: literature base if i'm going to construct something to be able to make an impact
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[sean]: in this area so i'm going to have to say i went through fifty plus
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[sean]: papers on antidepressence for both adolescence and an adult's teams adolescence and adults for the
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[sean]: most part there there in the and the past decade but when you read a
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[sean]: scientific paper you kind of you can go down the rabbit hole because you know
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[sean]: each scientific paper might have fifty citations so then you might just check out the
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[sean]: citations in there yes and boy did i have a headache i mean it was
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[sean]: it was rough because you want to know how did we get to this point
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[sean]: because prescriptions are on the rise it's not like they're declining they're actually the rise
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[sean]: each year pharmasutical industry is going to improve their customer base for psychiatric drugs especially
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[sean]: when they tell people they don't have they can't go off of them so then
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[sean]: you like got that one moving on to the next group that's a really good
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[sean]: point because i didn't want to make sure that i i miss this because it's
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[sean]: really important especially from a safety perspective this evidence has been widely distributed and is
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[sean]: part of now the main stream to hear in the united states which will get
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[sean]: to in a second but it is critically important to know that if you are
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[sean]: taking anti de presence and you are listening to this podcast or you read this
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[sean]: study or you watched it on some news channel do not abruptly stop your medication
15:17
[sean]: it could be deadly and we now know that there is dependent c once you
15:23
[sean]: start these drugs if you abruptly start stop them be a withdrawal reaction and for
15:30
[sean]: some people the withdrawal reactions are very severe including increase suicideality um agitation sleep insomnia
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[sean]: a number of things it's just a very very dangerous process so consult your prescriber
15:50
[sean]: and if you are interested in starting taper off these drugs you're going to want
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[sean]: to do it in a very safe science based way so don't just stop it
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[sean]: especially for these people who have to have been on this drug for quite some
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[sean]: time because this umbrella review did not look into anti depressant it was only looking
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[sean]: at the causality effect of sarahtonan levels and depression it's that needs to be like
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[sean]: really clearly communicated because in the media is getting misinterpreted and of course everybody s
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[sean]: run in different directions with what the interpretation yeah i think it's simply this a
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[sean]: lot of people went on anti depressant because it's influential because of the chemical and
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[sean]: balance theory that's what they were led to believe so once people learn that there
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[sean]: is no ceratonan deficiency in fact some people have more the level can be up
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[sean]: and down and it depends on when you're etting the test exactly you know like
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[sean]: my guesses may be you did some of the things that we were talking about
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[sean]: like you're in the morning and you do you you do your walk in the
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[sean]: sun maybe you exercise then you meditate and then you get a know some form
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[sean]: of test to try to measure saratonanlevels they might pay high right so it's yeah
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[sean]: it's a it's very you want to be very skeptical of the entire idea around
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[sean]: saratonan or certain brain chemicals or even thinking about depression as a brain disorder like
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[sean]: just eliminate that thinking right now we're talking about high levels of complexity when you're
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[sean]: talking about the human experience a biological psychological social spiritual nutritional perspective and we are
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[sean]: a mystery in so many ways the human experience is a mystery we haven't even
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[sean]: begun to evolve the stage where we can understand the complexity of such an experience
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[sean]: that being said um this did bring about some national recognition and as you would
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[sean]: expect it became politicized unfortunately you're the one who turned me onto the initial article
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[sean]: article tell me about like how you found that i was having my morning breakfast
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[sean]: coffee over that weekend and apple news and it got served to me probably because
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[sean]: of my my search in recent history has been focused on this industory so they
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[sean]: probably saw this as a relevant story for me and they kind of get bumped
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[sean]: up and promoted and i was interested why would the rolling stone be covering this
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[sean]: topic and when i was reading the rolling stone article it made me start to
18:42
[sean]: identify some key words that i was interpreting as an attempt to mis credit the
18:53
[sean]: authors of the paper their position on things in the past and um and ultimately
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[sean]: what they were communicating in that rolling stone actually in the in the umbrella report
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[sean]: so what was being communicated in the report was being misinterpreted and they were looking
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[sean]: for others things that these authors had said to almost align them with a very
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[sean]: here in the united states a very conservative right wing movement and trying to tie
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[sean]: it to gun violence and that i thought was an attempt to get people to
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[sean]: ignore what this was trying to communicate in the first place yeah it was in
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[sean]: very poor taste not surprising because we've we've broached topics such as this on our
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[sean]: podcast previously especially how scientific ideas have been high jacked play sized um but this
19:51
[sean]: is really disappointing because although i don't know dr moncrief personally she's from the u
19:56
[sean]: k i'm very familiar with her work and she is high le respected and she
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[sean]: is in no way the type of professional who is provocative she's quite measured and
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[sean]: scientific certainly presents as as very compassionate i believe she lives by that guiding principle
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[sean]: of first do no harm there is no doubt that she is a principled individual
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[sean]: the highest ethical order and
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[sean]: she did we'll get into this in a second here if you if you look
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[sean]: at any of her work she's a she's a physician she's actually a psychiatrist right
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[sean]: and she speaks about this know this drug centered model u versus like a brain
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[sean]: diseased model and she talks about realistically and scientifically what the drugs actually do and
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[sean]: why some people may report a benefit but she unfortunately had to respond to that
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[sean]: rolling stone article and we'll include that in our show summary um and i'm bringing
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[sean]: up the article right now she's pretty much associated in the article some right wing
21:24
[sean]: ideology right so i'll just read the the title of the article who is the
21:30
[sean]: psychiatrist behind the anti depress and study taking over right wing meet and listen i've
21:35
[sean]: been looking at the various articles around the world and there's certainly not limited to
21:42
[sean]: any political political perspective no not at all so it says juandanna moncrefe has spent
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[sean]: two decades questioning the efiqofefficacy of s r s recently she's gone after covid nineteen
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[sean]: vaccine mandates why connect this study to covid nineteen vaccine mandates well it's been politicized
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[sean]: politicized and trying you use the words o misinformation high jack the word science among
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[sean]: other things and so like trying to communicate a message to people that if you
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[sean]: question whatever the narrative that's that's presented then you're a science denier and ultimately that's
22:23
[sean]: they're trying to discredit people um in some ways as if they're you no conspiracy
22:28
[sean]: theorists um the truth of the matter is r moncrief has always been clear about
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[sean]: just presenting data as it exists and then trying to inform people of what that
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[sean]: data means and concern about this article is they misrepresented a lot of her ideas
22:53
[sean]: and in some situations they were just flat out lies and rolling stone magazine is
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[sean]: a pretty influential cultural magazine in the united states and there's there's no doubt that
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[sean]: this comes across as a farm hit piece i'm going to try to find a
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[sean]: i'm going to try to get some quotes from psychiatrist that they tried to support
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[sean]: the previous narrative um m
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[sean]: this paper is not coming in a vacuum says as tab a clinical assistant professor
23:38
[sean]: of psychiatry at case western university who previously interviewed moncrief in twenty twenty psychiatric times
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[sean]: article it's coming with two decades of work in which moncrief has consistently challenged the
23:50
[sean]: character ization of depression as a mental illness that's a lie r moncrief very much
23:58
[sean]: communicates that being severely depressed is a condition that requires intervention so they're shifting the
24:06
[sean]: language and correctly interpreting the thing she said she actually does use medications in a
24:15
[sean]: very controlled way to in crises situations when appropriate yeah and she's going to it's
24:20
[sean]: a she believes it's a decision that needs to be made between a doctor and
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[sean]: a patient best on best best avail but evidence in which they're provided the potential
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[sean]: risks and the potential benefits and it's carefully monitored and so she's very clear about
24:35
[sean]: the potential benefits they tend to be too thin s one when you take an
24:41
[sean]: anti depressant there is m you're inducing a chemical in balance so you're inducing a
24:50
[sean]: physiological reaction so your body is going to react to it the most notable one
24:55
[sean]: is blunting of emotion numbing numbing blunting numbing and that includes both positive emotions and
25:04
[sean]: negative emotions so for a for a small percentage of people especially if someone's feeling
25:10
[sean]: intensity of negative emotions that might be initially interpreted as relief so we have to
25:18
[sean]: communicate that this could numb emotions much like other drugs for some people if you
25:24
[sean]: smoke mariana or you drink alcohol they can have similar effects everyone is different i
25:30
[sean]: was actually watch listening to a podcast joe rogan podcast this this particular weekend where
25:38
[sean]: a someone that we've um you know we've listened to previously and quoted on this
25:45
[sean]: podcast um m i'm forgetting his name it's okay what was the message the message
25:50
[sean]: was that for some people for alcohol it impacts their dopamenreceptors to differently and so
25:58
[sean]: they become highly elated and can continue to drink for long periods of time with
26:04
[sean]: real elevated mood while other people it's a sedative you know so for me i
26:09
[sean]: can have a couple of drinks and it's relaxing yeah but if i have too
26:14
[sean]: many get tired the same way i'll have you know at most two drinks now
26:21
[sean]: that's that's what two is my you know it's my magic my comfort so everyone
26:25
[sean]: is different and we know that right so there might be some people who take
26:30
[sean]: it in and to press it might be in a high agitated state in a
26:33
[sean]: lot of emotional pain some emotional blunting initially could have some potential positive interpreted improvement
26:42
[sean]: and improvement the other thing that she's very clear of is they provide some people
26:48
[sean]: hope so it is the the placebo response the belief that that i've found something
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[sean]: to help me it's an exhale i'm finally doing something about this and she recognizes
27:03
[sean]: how powerful that is the thing that makes her really separate from many of her
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[sean]: colleagues in the greater field and the medical establishment she is very clear about what
27:17
[sean]: the risks are you know she'll be open that with this drug centered model that
27:24
[sean]: in time the brain is going to adapt and it will have an effect on
27:29
[sean]: the body right whether it's effect on your metabolic health or your gutmicroiato or your
27:36
[sean]: brain a mysterious organ that we're still learning about in time it certainly does increase
27:42
[sean]: to susceptibility and potentially a greater chance of relapsing into further depressive episodes it does
27:50
[sean]: increase suicideality as we had on previous podcasts we're learning about evidence regarding specific um
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[sean]: m you know like genetic components and like how how drugs are metabolized differently so
28:06
[sean]: bottom line as they affect people differently and the overall research really it doesn't distinguish
28:14
[sean]: it much from a placebo response maybe some short term response so bottom line is
28:19
[sean]: this is that she's she is not the person that was presented in this article
28:28
[sean]: and it brings up a lot of concern for me because um that that tells
28:33
[sean]: me that who's ever influencing this article who's ever driving it certainly has an agenda
28:42
[sean]: and that agenda isn't science based that agenda isn't looking out for the well being
28:49
[sean]: the health and the well being of the populace i agree i agree if anything
28:57
[sean]: it just it separates you know we've talked about putting people in the two camps
29:01
[sean]: it was establishing what camp are you a part of that's that was how i
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[sean]: was responding to reading that piece and she's responded to it also because it was
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[sean]: getting so many eyeballs she felt like she really had it to or had to
29:16
[sean]: and this particular research study right now is like the most downloaded research study it's
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[sean]: been but like two or three weeks and there's been millions of down loads so
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[sean]: of course it's getting lots of attraction as it should and she has taken a
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[sean]: very appropriate path towards how to community what it means i don't know where you
29:37
[sean]: want to continue to go in this discussion but i read a couple of the
29:41
[sean]: other articles and i wrote down a couple statements and i don't know a few
29:46
[sean]: i could read through them and you can either say true false or we can
29:50
[sean]: comment on them or what are your thoughts on to do it okay so i've
29:54
[sean]: already said that you know i interpreted this entire study as an if then statement
29:59
[sean]: you know if the drugs were developed to improve sara toni deficiency that's been proven
30:08
[sean]: not to be true then you know what do the drugs do that was how
30:14
[sean]: she left it so number one is that the research doesn't show that drugs aren't
30:21
[sean]: effective they only rule out one possible way the drugs might work
30:30
[sean]: well i think we have decades of studies shown that that show the drugs are
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[sean]: not effective okay so too many physicians are unwilling to take that leap because so
30:44
[sean]: many people are on them and the moment you really proclaim that and you were
30:50
[sean]: somebody who wrote prescriptions and have been part of that treatment for decades i think
30:57
[sean]: you're putting yourself in a precarious position so i'm willing to say that because i've
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[sean]: evaluated the research i don't believe the drugs are anti depressence i don't think they
31:13
[sean]: have an effect on anti depressant something that's really on anti depression something that's really
31:19
[sean]: interesting i got into an old article um regarding what untreated depressive episodes look like
31:28
[sean]: okay and it's fascinating because what it informs us is that depression has always been
31:39
[sean]: episodic so there is usually a time limit to them and in particular it's when
31:47
[sean]: certain conditions resolve in your life right could be loss of a job break up
31:54
[sean]: um a down period that exists you're adapting when the conditions resolve themselves and your
32:02
[sean]: natural coping abilities allow you to overcome them it's time limited so i think something
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[sean]: like in his research eighty five percent of all depressive episodes resolve themselves within twelve
32:17
[sean]: months most of them within three to six so that means according to his research
32:26
[sean]: and i'll get that to you to put in the show summer because i don't
32:29
[sean]: have the title with right now i did post it on my twitter account this
32:33
[sean]: this weekend what that means is that people are just inherently resilienthey're going to overcome
32:40
[sean]: those challenges on their own and if you did not intervene they're going to improve
32:46
[sean]: i believe that to be true also just based on this this you know people
32:50
[sean]: call we're not able to get to everybody right away they go on the waiting
32:53
[sean]: list for people that get past ninety days when we start calling them they say
33:00
[sean]: i no longer need your services ye that's absolutely if they get an appointment elsewhere
33:03
[sean]: now i'm just i'm okay now good and therefore this concept of wait fur watching
33:11
[sean]: is so important we've talked about that before also so about there's going to be
33:15
[sean]: it just doesn't deny the fact that depression in itself can be impairing and health
33:22
[sean]: condition to take seriously so there's about fifteen per cent of people who are it's
33:27
[sean]: not gonna be episodic right it's going to be prolonged there's probably various reasons for
33:31
[sean]: that and it's our responsibility in this to identify how to intervene with them in
33:36
[sean]: a way that is most effective also respects their autonomy and provides them the information
33:46
[sean]: because they're vulnerable right they're vulnerable for for help so soon i don't believe that
33:53
[sean]: anti depressant work per se but i am willing to say for a small percentage
34:00
[sean]: of people they interpret them for a period of time as benefits that leads to
34:05
[sean]: my statement number two okay research suggests anti depressant work only a bit better than
34:12
[sean]: placebo
34:18
[sean]: i'm gonna say that's false okay now i want to expand upon that because in
34:21
[sean]: a in a study where it shows a little bit better than placebo it's the
34:25
[sean]: law of averages within those that are a little bit better than placebo there are
34:30
[sean]: some that are greater and some that are less than you put them together the
34:34
[sean]: combined shows a little bit better than very lowly so when you're talking about that
34:39
[sean]: in terms of it helps some people the small percentage of those that it truly
34:43
[sean]: has helped would be into that group that is a little that is better than
34:49
[sean]: placebo but most are at the placebo level ye let me address that number one
34:56
[sean]: we're talking about better is a statistical difference and interpretation it's a statistical difference on
35:04
[sean]: a a symptom check list yes the best available evidence will say that statistical diff
35:13
[sean]: difference is not significant enough to have any clinically relevant improvement in quality of life
35:21
[sean]: and i've taken the check list and i know some of it is subjective based
35:24
[sean]: on how you're feeling at that moment based on how tired you are did you
35:27
[sean]: get a good night sleep all that stuff is factor into that so the other
35:31
[sean]: thing that's important to note is that the this is fact that's the drug companies
35:39
[sean]: buried the studies that didn't demonstrate an effect meaning they didn't publish them and that's
35:46
[sean]: called publication bias that you you publish the studies that demonstrate in the fact and
35:54
[sean]: you don't in the ones that did not support your intervention you put it all
35:59
[sean]: together my belief and this is from my examination of the literature that they are
36:05
[sean]: a plus bo effect with side effects got it statement number three there are many
36:13
[sean]: different expressions of depression that come from a wide array of causal factors and present
36:19
[sean]: themselves differently from person to person absolutely true absolutely in fact the idea of depression
36:27
[sean]: is just some social construct and an umbrella term right so what one person might
36:34
[sean]: communicate as depression is just a use of language and it's our limitations of language
36:39
[sean]: and while another person may deny that exact same experience its depression at all it's
36:45
[sean]: a label it's trying to communicate something that we are unable to investigate through direct
36:51
[sean]: observation so that leads to my next statement there is no single treatment approach that
36:57
[sean]: works for everyone with depression absolutely true okay so i was encouraged because as i
37:06
[sean]: was i stumbled upon something that's happening in the u k and it may have
37:10
[sean]: just been in the last year or so u k doctors have been told they
37:13
[sean]: should offer therapy exercise mindful this or meditation to people with less severe cases of
37:20
[sean]: depression before trying medication
37:25
[sean]: i mean i think for for you who's not been involved in this field um
37:30
[sean]: that sounds encouraging but i'm it goes back to the language again less severe depression
37:36
[sean]: and how does one even define that would be a doctor and a client understanding
37:42
[sean]: the circumstances and working closely kind of like what joanna mon crave thoughts we're gonna
37:46
[sean]: have a small percentage that she feels could truly benefit in a short period of
37:50
[sean]: time it's a huge challenge because there is probably a very very small minute percentage
37:59
[sean]: of people who've been assigned the label of depression who are impaired in ways that
38:04
[sean]: many of our listeners do not understand could be catatonic states um just not leaving
38:14
[sean]: their home crying all the time and each day as a fight to get through
38:21
[sean]: without ending their life to me that is severe right and i think those people
38:31
[sean]: who are struggling to that extent and have not been helped by other means should
38:37
[sean]: have every right go through any treatments that are available including anti to presents or
38:46
[sean]: innovative drug treatments or nutritional diets or whatever it takes right like you only got
38:55
[sean]: one life to live maybe and so therefore yeah whatever it takes and i think
39:00
[sean]: in order to ease the suffering of people should be you know creative and work
39:05
[sean]: with them collaboratively but i also it's really important for me to communicate that that
39:10
[sean]: is not the percentage of people most people who are receiving anti depressance and mental
39:17
[sean]: health treatment don't even meet that criteria i think we have a distorted idea of
39:22
[sean]: what is actually severe depression the mag ority of therapists out there who are working
39:28
[sean]: in community based settings are dealing with mile to moderate even some of the more
39:33
[sean]: challenging or difficult cases still don't reach that threshold so it's just been an expansion
39:40
[sean]: of the diagnostic h severity range that you know too many people are being identified
39:49
[sean]: as having severe depression when in fact m that's not what others are experiencing but
39:56
[sean]: it's jane because then you don't want to ever invalidate someone's you can be you
40:00
[sean]: can be in a lot of emotional pain and not be severely depressed and those
40:06
[sean]: lines have been blurred um in our society and then you'll just see a lot
40:11
[sean]: of nonsense out there that say who are you to determine what is severe depression
40:18
[sean]: or people are hiding it and u and they're doing a really good job of
40:24
[sean]: hiding their emotional experience well how do we study it and how do we have
40:31
[sean]: a science base around it if professionals aren't able to distinguish between what is most
40:38
[sean]: impairing versus what might be a range that exist and many of us might face
40:43
[sean]: and at one point in our in our lives i agree i would imagine there's
40:48
[sean]: a number of individuals that are severely depressed and fail to recognize and admit it
40:54
[sean]: and go about their lives just numb to that fact yeah that goes into coping
41:02
[sean]: right so there are wide range of coping styles and one one coping style is
41:09
[sean]: avoidance um and another coping style is you know reflects around a denial of the
41:14
[sean]: experience not everyone is so connected and in touch to what they're feeling and their
41:18
[sean]: experiencing and don't even have that concept of depression in their their view point like
41:24
[sean]: their perspective doesn't even allow them to understand what they're experiencing in that way so
41:29
[sean]: that's that there are many different forms of expression that is one where others are
41:34
[sean]: very expressive yeah can i read a quote i was looking for this quote earlier
41:39
[sean]: from this i've been stalling so yes i'm glad you and this is what's disingenuous
41:44
[sean]: and this is what's concerning i'm going to read the paragraph within the medical community
41:50
[sean]: the papers conclusions were nothing new david hellerstein professor of clinical psychiatry at columbia university
41:57
[sean]: medical center and director of columbia pression evaluation service explains that the ceratoneand hypothesis the
42:03
[sean]: idea that depression is caused by lowsrtoneand levels a quaint and over simplified shorthand that
42:10
[sean]: has been superseded by other explanations and clinical practice for decades now he said to
42:16
[sean]: the review was largely met with yawns from the psychiatric community and reading it i
42:21
[sean]: was kind of thinking wow next she'll tackle the discrediting of the black bile theory
42:27
[sean]: of depression he tells rolling stones you smug i read you smug clown i right
42:38
[sean]: now and i want you to come on to this podcast david hallerston i will
42:43
[sean]: reach out to you because that is such an offensive comment because still on major
42:51
[sean]: websites around your profession they'll still talk about it in the possibility of a chemical
42:55
[sean]: de balance chemical and balance most people who have depression and are seeking out psychiatric
43:01
[sean]: medications still believe that to be true our physicians in community based settings are talking
43:09
[sean]: to ants about sarah toning and depression and that's how it's being treated in the
43:18
[sean]: in the psychiatric community you're still treating it with s s r is selective sarah
43:27
[sean]: to nan up take inhibitors you are talking about and associating the chemical and balance
43:35
[sean]: theory with the screading of the black bile theory of depression how can you put
43:41
[sean]: yourself out there in a major news outlet like rolling stone with such a stupid
43:48
[sean]: statement that's embarrassing and that is why i have such a challenge working in this
43:55
[sean]: field when you make a statement like that r a professor of clinical psychiatry a
44:03
[sean]: renowned university at columbia
44:10
[sean]: um hm so here's the one thing that i like about joanna moncreave is the
44:17
[sean]: published paper came out on the twentieth and she wrote a piece that she was
44:23
[sean]: directing everybody to where she takes it basically step by step and she says basically
44:29
[sean]: was a title of her article actually did a social media and it's how to
44:33
[sean]: take the news that depression has not been shown to be caused by a chemical
44:38
[sean]: balance uh that to me is a very responsible way of handling this and not
44:44
[sean]: attacking anyone but purely just to help those who may misinterpret um so i think
44:52
[sean]: this is a good way to end it not reading her thing but we've already
44:55
[sean]: touched on the important of informed consent people reading the literature for themselves understanding what
45:03
[sean]: is communicated and then recognizing that the next steps are not to independently make any
45:08
[sean]: decisions but to consult with physicians in a responsible way to determine what their next
45:13
[sean]: steps may be because everybody's pressive situation is unique and everyone is an individual their
45:20
[sean]: situations very drastically so how how can we responsibly communicate what the next steps are
45:26
[sean]: for anyone who may be listening to this tell you what it's you're using the
45:30
[sean]: right word being responsible and that's the difference between someone of dr joanna moncrete's stature
45:39
[sean]: and character versus the gentleman from olumbia is that she is going to continue this
45:47
[sean]: process on how to communicate it responsibly to clients she also understand and i think
45:52
[sean]: through empathy that a lot of people are going to hurt and feel a lot
45:58
[sean]: of resentment and distrust towards the greater mental health field which i'm a part of
46:06
[sean]: and so she recognize is it with compassion and she helps people to better understand
46:12
[sean]: the complexity of what might be happening to them and gives them a more thorough
46:19
[sean]: clear directive on what these drugs actually do and what are the potential risks ultimately
46:27
[sean]: that's what we're asking for we're just asking for honesty we're asking to be able
46:34
[sean]: to communicate to people hey if you're going to put something into your body you're
46:39
[sean]: going to start any form of treatment or medical intervention that you're aware of what
46:45
[sean]: the potential negative outcomes exist might choose to do it with those risks just based
46:51
[sean]: on how you're feeling right now but it is your choice i'm here with you
46:56
[sean]: and that's just that's not the way it's been in psychiatry psychiatry has has made
47:02
[sean]: statements that are you know really what are ridiculous come at this point there you
47:07
[sean]: know they're going to be flected on is absolutely ridiculous such as like considering what
47:13
[sean]: you're experiencing or feeling to be similar to insolent for diabetes associating these drugs as
47:20
[sean]: as if they're life saving there's so many messages that we've been exposed to over
47:24
[sean]: the last thirty years that are just inaccurate they're harmful and they're certainly not standing
47:33
[sean]: the test of scientific scrutiny so we have that responsibility and i like that word
47:39
[sean]: this cast has to be responsible i'm certainly aware that people are listening and they've
47:44
[sean]: been on these sores for potentially decades they might even prescribe them to their own
47:48
[sean]: children yeah the goal of this is to get you to become more educated and
47:56
[sean]: to wear and then to make do your own research and then to take the
48:01
[sean]: appropriate steps that are the best interest of yourself or your loved ones it's important