Transcript
Speaker: Do you believe that's warranted to leave somebody if the emotional toll gets too hard?
Speaker: That's a tough question because there's a lot of reasons to leave and I think the reasons are never clear.
Speaker: And it doesn't mean you're a bad partner if you can't handle it.
Speaker: But if the depression is so profound and you can't function and you can't take care of yourself and there's no relationship, there's no friendship to be had if you don't see your friend for two years because they're so depressed.
Speaker: Hi everyone, thank you for tuning in to the Pengu Spective.
Speaker: We are your hosts, Michael and Eric.
Speaker: This is part 2 of episode 12 with our special guest Nita Chen, the neurologist.
Speaker: And we want to also give a quick disclaimer and warning since we will be talking about depression, suicidal thoughts, and anxiety.
Speaker: Alright, let's get into it.
Speaker: So I have a question for Eric and also for Nita.
Speaker: So for Eric, you know, I feel like you brought up a couple of times before that you are interested in one day kind of unpacking some of your own issues and things that you've thought about.
Speaker: But I feel like you don't really have a desire.
Speaker: Like it's not pressing for you.
Speaker: So what do you think is kind of just stopping you from trying it?
Speaker: Honestly, I think I would say it's financial.
Speaker: Like it's not worth the cost for you?
Speaker: It's just not something I'm willing to spend right now.
Speaker: Yeah, I would do it right now if I was a multimillionaire, especially when it comes to psychedelic integrated therapy.
Speaker: It's also rife with like sexual assaults or like people taking advantage when you're in a vulnerable state.
Speaker: Or they're just not good.
Speaker: Like they're just not very competent.
Speaker: And I don't have a good way to filter.
Speaker: So I want to pay the premium price to get very right the first time.
Speaker: And that's going to run me easily five figures.
Speaker: So I just don't have the money for that.
Speaker: Okay.
Speaker: Well, for Anita, I guess, do you remember kind of our last pretty serious discussion when you were kind of expressing to me that I'm not there for you enough?
Speaker: Like checking up on you or when you're not feeling good?
Speaker: For me, it was a pretty serious moment because I feel I didn't realize that, right?
Speaker: Yeah.
Speaker: So I wanted to see how you feel about how I'm doing now.
Speaker: Yeah, I mean, I think it's hard, right?
Speaker: Because like, I'm the older sister, I have been my entire life, right?
Speaker: And then so there's always been like, you're my younger brother, I take care of you.
Speaker: I help you when you need me.
Speaker: And so there's always been like this self imposed pressure, I guess, to be like, I need to be fine, right?
Speaker: Because if I'm like, I don't want you to take care of me because you're younger than me.
Speaker: Obviously, that's not healthy, right?
Speaker: And we should be taking care of each other.
Speaker: And I think it's still hard.
Speaker: Like, I feel like intellectually, I understand that.
Speaker: But emotionally, it's still very like, oh, I don't want to tell him about stuff.
Speaker: Because like, whatever, he thinks I'm a bad sister because I can't take care of him and I'm not okay.
Speaker: So a lot of that is my own personal struggle.
Speaker: But I do think things have changed, right?
Speaker: Because I feel like you've kind of gone through something yourself.
Speaker: And I think like, I worry less about you now.
Speaker: And then I think we can have better conversations about it.
Speaker: And I do feel like you kind of check in more on me and kind of see where I'm at.
Speaker: I think like before your stance was kind of like, well, everything is fine unless you tell me it's not fine.
Speaker: And then I think you kind of realize that like, I don't say anything is not fine.
Speaker: And so you're better about like checking in on me to make sure like, is our things really not fine?
Speaker: Like silence doesn't mean everything is okay.
Speaker: Like no news.
Speaker: isn't always good news yeah okay uh well i wanted to uh be systematic about it so i wanted to ask you kind of like the history about if you don't mind yeah so were you clinically diagnosed yeah i was diagnosed in med school could you tell me the year if you don't mind first year of med school my colon was that 2013 yeah
Speaker: Gotcha.
Speaker: And I wanted to know like the experience and triggers or whatever, they can all be different, right?
Speaker: For every individual.
Speaker: Yeah.
Speaker: But I had some categories like diet, psychological, physical relationship.
Speaker: And I also wanted to throw in your vocation as a neurologist.
Speaker: I remember one of the cartoons that I saw, you were talking about how it's emotionally draining to deal with patients who are recovering from methamphetamine or other opioid addiction or something like that.
Speaker: Yeah.
Speaker: And I think as dentists, we can relate to it in certain degrees.
Speaker: Nobody likes going to the dentist.
Speaker: They're usually very anxious about it.
Speaker: It's not a personal attack.
Speaker: but the vibe always definitely carries on.
Speaker: Sure.
Speaker: One of my pet peeves is like, oh, it's not, I hate the dentist, but it's not you.
Speaker: And I'm like, well, but I am the dentist.
Speaker: Right, right, yeah.
Speaker: So out of those categories, I wanted to know if you had, if you think you can identify a particular aspect that kind of contributes to it or if it's all kind of like this kind of perpetual thing.
Speaker: I think,
Speaker: The easy answer is it's multifactorial, most likely.
Speaker: But I've had undiagnosed depression and anxiety for a very long time, long before I was diagnosed.
Speaker: And I just didn't feel like it was worth dealing with because I felt like, you know, I did okay.
Speaker: I got into med school or like, you know, I made good grades in school.
Speaker: I went to college.
Speaker: Things are fine, right?
Speaker: Right.
Speaker: And I really didn't think it was that bad.
Speaker: Like I honestly had a very different perspective about it at that time.
Speaker: I felt, you know, things were okay.
Speaker: Yeah, I get depressed.
Speaker: Sometimes I cry.
Speaker: I think about dying a lot.
Speaker: But you know, whatever, doesn't everyone.
Speaker: And then I started med school and my boyfriend at that time.
Speaker: was like, you need to see somebody because you will not survive med school this way.
Speaker: And I didn't agree with him at first until he finally told me, because I think he didn't want to tell me at first because he thought I would be embarrassed or maybe feel bad about myself.
Speaker: But he said that, you know, in college, you got by okay, but you lost three hours every day.
Speaker: And I was like, what do you mean I lost three hours every day?
Speaker: And so apparently I would come home from school, from classes or whatever, and then I would lie in bed and cry for three hours.
Speaker: I would lose three hours and I would get up and, you know, do stuff and get on with my day.
Speaker: But I would just lay there and for three hours, non-responsive, like he would try to talk to me.
Speaker: I wouldn't do anything.
Speaker: The cats would climb on top of me.
Speaker: I would just cry.
Speaker: So I remember that, but I don't remember it being that long.
Speaker: Like I remember coming home and crying because I was overwhelmed.
Speaker: School was tough.
Speaker: I had a lot of things going on.
Speaker: I didn't remember losing three hours and not that frequently.
Speaker: It was like nearly every day from what he said.
Speaker: I think he felt so worried because he was like, you know, you can't lose three hours every day.
Speaker: Like a normal person is already so overwhelmed by med school.
Speaker: Like you can't afford to lose three hours.
Speaker: And I think that was finally the catalyst where I was like, okay, something is wrong.
Speaker: I guess I do need to see somebody.
Speaker: And, you know, in the beginning, it was very much like,
Speaker: Yeah, you know, my boyfriend told me to come, I think I'm okay.
Speaker: And then, you know, as we started to talk about some things and unravel some things, I realized, oh, these are very unhealthy thinking processes that I have.
Speaker: And like, these are very ingrained patterns of habit that are not healthy.
Speaker: And I kept them because I thought that they helped me succeed, but they're actually kind of hurting me as well.
Speaker: Can I jump in right there?
Speaker: Yeah, go ahead.
Speaker: So I don't know if you know Jordan Peterson, but he's a clinical psychologist.
Speaker: And one of the distinguishes that he made between clinical depression and, quote unquote, having an appalling life, that was really significant.
Speaker: So his definition of clinical depression is,
Speaker: When the situations that are going on in your life from a third person's perspective doesn't align with the emotions that you'd be feeling.
Speaker: So, you know, just think about a celebrity, right?
Speaker: When you think like they have everything from the outside perspective, why would they be depressed?
Speaker: But their brain chemistry just does not interpret that in an appropriate way.
Speaker: So like your life is actually okay, but your brain is convinced that your life is terrible.
Speaker: Versus like, you know, if you just got divorced and, you know, you're recovering from alcohol or drug addiction and your room is a mess and you have no friends, like that makes sense why you wouldn't feel so good in your life.
Speaker: And he thought that distinguishing one is important because people who are clinically depressed, the former, they would actually be more likely to respond well to antidepressant medication.
Speaker: And the second ones would not because they're, quote unquote, depressed about their life situation rather than it's not a brain chemistry issue.
Speaker: So do you feel that when you got diagnosed, you laid more in the former?
Speaker: Probably.
Speaker: I think these things are so tough, right?
Speaker: Because there's no clear line.
Speaker: Because I think in the latter group that you describe, I would still say they're clinically depressed, but it would be a situational depression, right?
Speaker: It's triggered by something else.
Speaker: And when you remove that situation, then the depression gets better, right?
Speaker: Sure.
Speaker: Yeah, I like that word.
Speaker: Situational.
Speaker: Sure.
Speaker: Yeah.
Speaker: Yeah.
Speaker: And so I think I agree.
Speaker: I was probably more in that clinical depression that you were describing where, you know, there's a mismatch, right?
Speaker: But I think like mismatch is hard to describe, right?
Speaker: Like by whose standards are we mismatching?
Speaker: So like one third party might say, oh, you know, I lost my job today.
Speaker: It's appropriate to be this, that.
Speaker: Whereas another person said, maybe like you should be devastated.
Speaker: Right.
Speaker: I feel like it's very hard to put meters on emotion.
Speaker: But the overall idea is that like, you know, your life seems overall okay, but you know, you're feeling an overwhelming amount of sadness.
Speaker: And that understanding made me feel a lot worse because I feel like I didn't earn this depression.
Speaker: Like, like, I don't have a reason to be depressed.
Speaker: Like my life is pretty good.
Speaker: You know, I have family, I have people who love me.
Speaker: I'm in a pretty good financial, very lucky in that sense.
Speaker: I get to do what I want to do.
Speaker: I got into med school, right?
Speaker: Why am I still feeling so bad about myself?
Speaker: Gotcha.
Speaker: I wanted to dig deeper as to how you got convinced because I think that whenever I had an experience of dealing with someone who I felt was depressed, I think I know the etiquette, I guess, more so in a way, to not be preachy about it, don't dismiss their experience or feelings.
Speaker: But when it comes to actually providing help, I really struggle with that because it's very hard to convince them to get help if they're just not willing to.
Speaker: And I wanted for you to dig deeper and like, what exactly is it about what he said or what he did that actually convinced you to go there?
Speaker: Because I think that's an important transition.
Speaker: Absolutely.
Speaker: And I think that's so tough, right?
Speaker: Because what everyone needs is different and what each person needs at different stages of their life is different.
Speaker: So I think we can only speak on our own experiences.
Speaker: And for me, it's because it came from my boyfriend at the time.
Speaker: He cared incredibly about me.
Speaker: He also went through situational depression when he was in high school.
Speaker: So one of his two of his closest friends, his best friends passed away and
Speaker: when he was in high school and he experienced quite a profound situational depression and he responded very well to antidepressants.
Speaker: So knowing that for him, he was kind of like from his mind, he's seeing his girlfriend like suffering and, you know, crying every day and losing all this time.
Speaker: And, you know, she has huge ambition.
Speaker: Her big dream is to be a doctor.
Speaker: And, you know, God forbid, what if she doesn't become a doctor because she's so depressed and she can't do these things.
Speaker: Right.
Speaker: And if there's something that can help her incredibly, like he responded so well to antidepressants, he was like, I got to get her there.
Speaker: And I think because he had experienced depression, it was easier for me to believe that, okay, like, he does think something is wrong.
Speaker: And he does think it's something that I should do.
Speaker: And you know, he had been telling me these things.
Speaker: This wasn't like a one time discussion.
Speaker: He had been telling me these things in college, he tried to get me to see a therapist in college.
Speaker: And I was like, no, I'm fine.
Speaker: Because I was like, look, I'm making mostly A's.
Speaker: I'm okay.
Speaker: I'm taking five classes a quarter doing research.
Speaker: Like, can a depressed person do that?
Speaker: And he's like, yes.
Speaker: And I didn't believe him.
Speaker: And I did go one time to like the free school counseling thing.
Speaker: And I just was I was so discouraged because I was like, it just wasn't a match.
Speaker: And I was like, therapy is useless.
Speaker: Like,
Speaker: I can't do it.
Speaker: And I kind of had your opinion at the time too.
Speaker: Like therapy is so expensive.
Speaker: Like if I'm going to do it, then like I want a good therapist.
Speaker: And I think over time I've realized there's no such thing as a good therapist.
Speaker: It's a good therapist for you for that stage of your life.
Speaker: It's hard to find a therapist that fits your needs.
Speaker: And a therapist that doesn't fit your needs doesn't mean they're a bad therapist.
Speaker: They're just not the right fit for you.
Speaker: And that was a very hard lesson that I had to learn along the way.
Speaker: But really, like throughout this whole time of college for four years, I just I didn't listen to him.
Speaker: I was I was very resistant.
Speaker: But it really was a threat of failing med school and like not be able to do well and achieve my dream.
Speaker: where I was like, okay, fine, I'll give it a shot.
Speaker: And, you know, even then, like, I still went to my appointments, like with the attitude of like, this is not going to work, right, which is a really important part of therapy.
Speaker: Like, if you think it's not going to work, it's not going to work.
Speaker: And it took a long time for me to change my perspective.
Speaker: I had a really, I was very fortunate that therapists that the medical school provided was very helpful, and was a good match for me, and was able to kind of help me work through a lot of my reluctance and hesitance.
Speaker: So yeah,
Speaker: Yeah.
Speaker: I mean, I don't mean to keep pressing on it.
Speaker: It's just so when I hear about like common thing I hear about ayahuasca, for example, is to not do it until it calls upon you.
Speaker: That like it'll actually call upon you to do it.
Speaker: And it seems like something called upon you to actually try it, like to get the help.
Speaker: And I just maybe I'm looking for an imaginary bullet here.
Speaker: But yeah.
Speaker: It's just like, how can an out as an outsider encourage that within themselves is what I'm really interested to know.
Speaker: Yeah.
Speaker: Cause it's like, it feels kind of fatalistic for me to think, well, it's just, if you're ready, you're ready.
Speaker: If you're not, you're not.
Speaker: Yeah.
Speaker: Yeah.
Speaker: Yeah.
Speaker: I'm thinking back to what you said.
Speaker: So Charles having gone through situational and actually seeing him, like evidence, get improvement from antidepressants.
Speaker: I think that's one evidence that could have convinced someone.
Speaker: Yeah.
Speaker: Maybe it was just the way that he talked to you at that time.
Speaker: The sincerity would have spoke.
Speaker: Maybe that's one.
Speaker: Yeah.
Speaker: It's just like when I deal with... Well, if I want to be helpful, it's like... Right.
Speaker: what could I possibly do to kind of encourage the likelihood of them going over the hump and actually get the help on their own?
Speaker: Yeah.
Speaker: And, you know, that's super hard because like I kind of said earlier and kind of what you alluded to was like, you know, I don't think you can ever be ready, right?
Speaker: You're always going to go there unready because you're never going to feel... I think most people find that, you know, like...
Speaker: you don't seek therapy because you either think things are not that bad or you think you're not worth it or you think that there's no point in living anyway or all of the above or combination of any of those.
Speaker: So it's like a barrier to get therapy.
Speaker: And then there's so many therapy barriers from healthcare too, right?
Speaker: Hard to schedule an appointment.
Speaker: Wait time is super long.
Speaker: Insurance is difficult.
Speaker: You might not find a good match on the first time.
Speaker: Often is you have to go through a lot of it and that's very discouraging, right?
Speaker: Like you have to tell your life story to...
Speaker: a stranger like three or four times before you find a good fit like geez and then it takes even longer for therapy you're not going to get a magic bullet on the first time it's going to take like hours and hours and therapy is not fun
Speaker: Like I left a lot of my therapy sessions discouraged and crying because you're working through trauma and do like very negative things.
Speaker: So it's not a fun time.
Speaker: You go there and get encouraged.
Speaker: So it's tough.
Speaker: Like there's a lot of barriers to get you go and to continue.
Speaker: And I think that was an important thing.
Speaker: So my ex was really like, you know, you have to give it a shot.
Speaker: And for him,
Speaker: he actually called and made the appointment for me because I told him I couldn't do it.
Speaker: I couldn't deal with the discouragement of them saying, I'm sorry, I don't have a spot because I was in such a bad place at that time.
Speaker: Like calling them and them saying that we don't have any availability.
Speaker: I would be so crushed by that.
Speaker: Be like, that's it.
Speaker: Nobody wants to help me.
Speaker: Like I'm pointless.
Speaker: Right.
Speaker: And so he actually called and he got, he, I gave him permission first.
Speaker: They won't let you do that.
Speaker: If you,
Speaker: if you don't get permission.
Speaker: So he scheduled the appointment for me.
Speaker: And so he was in Connecticut at that time when I was in Albany, New York.
Speaker: So we were doing a long distance.
Speaker: And so it was one of the first priorities that he did for medicals because he kept harping on it.
Speaker: And he was like, this is the one thing I want you to do.
Speaker: And he like, this sincerity was like very convincing.
Speaker: Right, yeah, because he's scheduling it for you, you know?
Speaker: Yeah, so he scheduled it.
Speaker: He gave me the directions.
Speaker: And I didn't have a car in med school, so I had to take the shuttle.
Speaker: But he, like, made sure the shuttle was there.
Speaker: Like, he gave me the timetable of the schedule.
Speaker: He called me on my first appointment and said, you're going.
Speaker: Call me when you get on the shuttle.
Speaker: And I got on the shuttle when I got off.
Speaker: And t hen he called me after the appointment to debrief and be like, how was it?
Speaker: How are you doing?
Speaker: All that stuff.
Speaker: And the next, honestly, the next couple of appointments, he had to do that.
Speaker: Like I scheduled the follow up myself, but he had to call me every time to make sure I went and then called me afterwards to make sure I was okay.
Speaker: And then the first couple of times he actually drove from Canada to my place, like over the weekend to be like, look, you did a good job.
Speaker: Like you may not feel like it, but you did something for yourself.
Speaker: to like continue to encourage me to do it.
Speaker: And there were times when I was feeling incredibly low where he would just book the appointment for me because he's like, you have to go.
Speaker: And those were the times like I knew like during the winter times, my depression got added on with the seasonal affective disorder of being very depressed.
Speaker: And I would just,
Speaker: skip and I wouldn't go to my appointments.
Speaker: I would no show them, which is terrible.
Speaker: And you should not do that.
Speaker: And those times he would actually kind of come up over the weekend and book an appointment on like a Monday or Friday.
Speaker: And then he would drive me to the appointment myself.
Speaker: And then he would make sure that like I did those things.
Speaker: And on top of that, I think it's also that the other aspects help too.
Speaker: Like everyone experiences depression very differently.
Speaker: For me, it was kind of just a feeling of like not being able to do anything for myself because I felt like those things were pointless.
Speaker: And eating well, sleeping well, you know, hydration, hygiene, food, exercise, all of those things are like paramount to your mental well-being, right?
Speaker: It's easy for us to say it, but like it really takes a toll.
Speaker: Like when I'm depressed and I think life is pointless, am I going to cook a meal for myself?
Speaker: No.
Speaker: Why?
Speaker: What's the point?
Speaker: Am I going to go change my sheets?
Speaker: No.
Speaker: What's the point?
Speaker: Right.
Speaker: And so he made sure that he could help from as much as he could.
Speaker: So he made, he would deliver, he would order delivery for food for me.
Speaker: So it would be there.
Speaker: And those things help because having a real meal every day is good for your mental health.
Speaker: As dumb as that sounds, it's very hard to do that when you're
Speaker: really depressed.
Speaker: And so it was very helpful that he kind of made sure.
Speaker: And then he also had my friend, my two medical school classmates who were really close to me.
Speaker: He had their phone numbers, so he would call them.
Speaker: And just when I wasn't doing well to make sure that they came in, checked on me, make sure I was alive, and then helped me do groceries or things like that.
Speaker: And yeah, those things were very helpful.
Speaker: And I think the persistence of it is what matters most.
Speaker: Because I think when you start it, you're like, this is not going to help.
Speaker: And you're just waiting.
Speaker: You're like, okay, this is helping a little bit, but it's going to get worse.
Speaker: Or he's going to get tired.
Speaker: They're going to give up.
Speaker: They're going to realize that it's not worth it.
Speaker: So you're just waiting with that bated breath of like, things are going to get bad again.
Speaker: And so he continued to prove that like, I'm still here.
Speaker: I'm still willing to do these things for you.
Speaker: I'm still willing to help you through it.
Speaker: Like you getting better doesn't mean I'm abandoning you.
Speaker: And even if you get worse, it doesn't mean I'm abandoning you either.
Speaker: And so like that kind of persistence and consistency was very helpful for me.
Speaker: Yeah, thanks for sharing that.
Speaker: Yeah, absolutely.
Speaker: What I found valuable was like just on a systematic level, like minimizing all the things that could go wrong because you already know the therapy process itself is going to go wrong from time to time.
Speaker: So things like booking the bus, making sure like maybe the traffic's not too bad.
Speaker: Yeah, they're all small things.
Speaker: But when to a person who is very depressed, they seem like unbearable things.
Speaker: Yeah, you know, Michael, we took the personality test, so I'm not sure if you remember this, but neuroticism is one of the aspects.
Speaker: And I believe this is kind of like what it is.
Speaker: It's like neuroticism is like, how bad do you take a bad news?
Speaker: Right.
Speaker: It's basically what it is.
Speaker: So like to a really depressed person burning, you know, your husband's dinner.
Speaker: I feel suicidal.
Speaker: Not really.
Speaker: That's what depression is, though.
Speaker: You take the badness to the top level, like existential level.
Speaker: And the best way, I guess, in that case is to minimize all the bad things that can happen around them so that in the process of getting help, you're not worsened.
Speaker: Yeah, or discouraged.
Speaker: You want to keep trying.
Speaker: And that was something like, so when I moved from Albany back to California for residency, I had to start over and find my own therapist and all that.
Speaker: I didn't do that stuff all again.
Speaker: I broke up with my boyfriend at that time, so I didn't have him anymore, which is fine.
Speaker: But it was a lot of work and it was very hard to find a therapist who first find a therapist, period.
Speaker: And then find a therapist that fit my residency schedule, which was super unpredictable.
Speaker: And so my friend who I was very close with, my wealthy friend, the wealthy friend who also has gone through a lot of stuff, was very understanding and she kind of understood the struggle.
Speaker: And so she had offered if I wanted her to call and I was like, no, I want to do this for myself.
Speaker: I need to do this for myself.
Speaker: And
Speaker: She was kind of like, okay, that's fine.
Speaker: But then she would text me.
Speaker: He's like, text me when you're going to call them.
Speaker: And then I'll be there if you need anything.
Speaker: Because I remember in the low points, I had called.
Speaker: And I still remember they told me that there was no opening right now.
Speaker: And I just started crying because I was like, what's the point of doing this?
Speaker: I could barely finish that phone call.
Speaker: And I couldn't do another call.
Speaker: And so she was there to text me to be like, you called one.
Speaker: Good job.
Speaker: Let's go get food.
Speaker: Right.
Speaker: Let's go feed yourself, you know, and then try again, you know, in a week or something like that.
Speaker: Right.
Speaker: And even like just being there to offer the options.
Speaker: So not stop offering the options.
Speaker: Because I think there is, at least for me, I always have this fear of like, if I say no, are they going to stop offering?
Speaker: Right.
Speaker: If I say I don't want to hang out.
Speaker: because I'm really depressed right now are they going to be like okay we're just not going to hang out with her ever again and so the fact that every time she would be like I'm still offering I'm always going to continue to keep offering even if you say no was incredibly helpful gotcha very nice very nice I hear you Eric I hear you you want me to schedule an appointment for you I can call are you going to drive him and then like make sure you bring him some good food some tteokki or something
Speaker: yeah did you order your flight ticket why do you think that's what he eats he eats other things all right all right this is sibling right now um so here's the thing like obviously i can't be empathetic to that situation but i'm i'm trying to understand a lot more about like when you when you say these things and
Speaker: For a second, if you could like hold our, you know, audience and myself and Michael to a high standard about our understanding about depression.
Speaker: Okay.
Speaker: So like things like, oh, they're faking it.
Speaker: It's imaginary.
Speaker: Don't fix it for them.
Speaker: I think we all understand like those are kind of false beliefs about it.
Speaker: Right.
Speaker: But with that said, so getting rid of all those.
Speaker: Is there anything that you still feel like people don't quite understand about depression conceptually from outside?
Speaker: I think that's so hard because depression is so pervasive and common, yet it's so isolating at the same time.
Speaker: Of course, to generalize, I think most depressed people think that nobody understands how they feel.
Speaker: When in fact, a lot of people go through depression.
Speaker: You may experience depression very differently because there's so many different types and your life is so different.
Speaker: This was an interesting conversation I had with my ex at that time because he kind of went through a second wave of depression close to when we were breaking up because he decided to have a complete career change.
Speaker: So he shifted from a PhD to consulting.
Speaker: That was very stressful for him.
Speaker: He kind of had like an identity crisis in...
Speaker: he like re-experienced depression.
Speaker: And it was very interesting, the conversations we had because when he experienced situational depression, he felt very differently.
Speaker: And you know, after he stopped being depressed, it almost is like childbirth where you forget how bad it was.
Speaker: afterwards like you feel like oh it feels like a distant memory right and so when he approached and talked to me like he still kind of remembered the feeling but it wasn't quite the same so when he experienced depression again during his life change he was like I understand now like I actually understand now what you're saying like when you said that you couldn't get out of bed
Speaker: I understood before, but I thought it was just like you felt bad and you didn't want to move.
Speaker: But I understand now.
Speaker: So knowing that someone who has never experienced depression, how can you expect them to understand what you say when you say, I feel depressed?
Speaker: Unless they become clinically depressed themselves, they will never.
Speaker: And I would never want that of people I care about.
Speaker: And so I think...
Speaker: When people are trying to be helpful, it's helpful to not say that you understand and not to align your life experiences with their life experiences, because what you're experiencing is not the same as what they're experiencing.
Speaker: Yeah, I think I saw that echo somewhere else.
Speaker: What makes me sad about it is especially the clinical depression as I define it.
Speaker: It seems very fatalistic.
Speaker: Like it's like once the Grim Reaper picks you, you're kind of done.
Speaker: Yeah, that's it.
Speaker: At its worst point.
Speaker: Yeah.
Speaker: Like there's nothing the world can show you to change it.
Speaker: Right.
Speaker: Yeah, it feels very fatalistic.
Speaker: Yeah, yeah.
Speaker: But it's also very dynamic, right?
Speaker: Like a lot of people who experience depression don't experience that all of the time, right?
Speaker: Because if you would, then you'd be dead.
Speaker: You commit suicide because you're like, what is the point?
Speaker: Most people don't experience it like that continuously all the time.
Speaker: There are periods where you feel less depressed.
Speaker: You feel a little better, a little, like maybe you don't feel happy, but you feel less like that and it fluctuates throughout the day or throughout the years or whatever.
Speaker: But when you're in that pit,
Speaker: it feels like it has always been like that.
Speaker: Like you truly believe that it has always been like that and it will never get better.
Speaker: And then when you come out of it, then you can see, oh, it was not always like that.
Speaker: But in that moment, it really felt like that.
Speaker: So your perspective really warps during that time.
Speaker: And I think when other people see that, when you say you're depressed, a lot of people are like, well, you're not depressed right now.
Speaker: Or like, you seem okay, right?
Speaker: And you can seem okay,
Speaker: but still have terrible periods like that.
Speaker: And I think that's hard for people to reconcile, right?
Speaker: Kind of like Michael was saying before, like you have to kind of show that you're suffering and like feeling bad for people to believe you.
Speaker: Because most people are saying that, hey, you're functional, you're doing okay, you're holding down a job.
Speaker: Like, how are you depressed?
Speaker: Like, I don't understand.
Speaker: It must not be that bad.
Speaker: But it can be.
Speaker: It's hard to express that.
Speaker: On one hand, you want people to understand and see that you're suffering.
Speaker: On the other hand, you also don't want them to see that because you don't want them to judge you and push you away because people lose friendships and relationships because of depression.
Speaker: That's not well controlled.
Speaker: Do you believe that's warranted to leave somebody if the emotional toll gets too hard?
Speaker: That's a tough question because there's a lot of reasons to leave.
Speaker: And I think the reasons are never clear.
Speaker: It's very hard when two people are together in the romantic relationship for you to separate that.
Speaker: Or even friendships.
Speaker: Yeah.
Speaker: And friendships too.
Speaker: It's, you know, you are my friend and you're not my therapist.
Speaker: Yes, I can share things when, you know, things are not going well and tell you I'm sad about stuff.
Speaker: But the line where this is something you should talk to your therapist is very gray.
Speaker: And it can be very hard to know that line for one person because it will change for every person.
Speaker: And what you're comfortable with as a friend or a partner will be different too.
Speaker: And you may not have the capacity.
Speaker: And I think it doesn't mean you're a bad partner if you can't handle it, right?
Speaker: Because it's a lot.
Speaker: But I think it should be a discussion and not like, your depression is too much.
Speaker: I'm leaving you.
Speaker: It should be more of a discussion over time of like, this is what I can do to help.
Speaker: How can we help you get there?
Speaker: But if the depression is so profound and you can't function and you can't take care of yourself and
Speaker: You can't take care of your partner.
Speaker: There's no relationship.
Speaker: There's no friendship to be had if you don't see your friend for two years because they're so depressed.
Speaker: So it's hard.
Speaker: I mean, as someone who's, you know, gone through it or going through it, though, would you be able to find understanding if a close friend of yours decided to part ways?
Speaker: Yeah, yeah.
Speaker: I don't know.
Speaker: Everyone's in a different headspace, right?
Speaker: And like, there's no right answer.
Speaker: I think when you're in the midst of it, it's very hard, right?
Speaker: Because you'd be like, see, there goes another person.
Speaker: They left, right?
Speaker: And it's hard not to take that the wrong way.
Speaker: And like knowing that, right, it's hard for a partner or friend to leave because you're like, oh my God, what if I leave and they like get super depressed and kill themselves or something, right?
Speaker: Like there's always that fear.
Speaker: It's a reasonable fear, right?
Speaker: Because that's the point that tips you over the edge or whatever.
Speaker: But, you know, I think the main thing for that is to make sure they get a good psychiatric or psychological care and then like really work through that because, you know,
Speaker: You know, in that moment, you may feel like it's your friend's fault or your partner's fault for leaving.
Speaker: But like, give it time and therapy and healing.
Speaker: And you'll realize that it really wasn't them.
Speaker: Like maybe they were the straw that broke the camel's back, but there was a huge lump of stuff in between.
Speaker: beforehand so that's hard i mean i so one of the reasons my ex and i broke up there were many reasons but one of my ex one of the reasons was that he said is that michael laughing are you smirking at me i don't know you want to bring up so much details about your break i don't
Speaker: care he's not gonna listen to this he's also married so whatever when we broke up one of the reasons that he told me that you know our relationship didn't work was he felt like my depression really burned him out like he didn't feel like he could take care of me and be in a relationship anymore and this was a point of contention that was like you know he was so instrumental in getting me into therapy and getting help there's no sugarcoating he was my therapist for a very long time
Speaker: But as I was getting better, there was a lot of points in my relationship where I said, you need to tell me when it's too much.
Speaker: You have to tell me when you're being my therapist because I don't want you to be.
Speaker: I want you to be my partner.
Speaker: And if you're doing more than that, you have to tell me.
Speaker: If you can't handle it, you have to tell me.
Speaker: And I think, I don't know if it's pride.
Speaker: I don't know if maybe he just overestimated himself or maybe he thought it was okay, but he just told me it was fine.
Speaker: And it was fine until it wasn't.
Speaker: That's hard because not everyone has that self-reflection.
Speaker: Yeah, to be like, this is too much for me.
Speaker: Like, I want to help, but this is not healthy for me.
Speaker: And to separate that, like, I need to take care of myself first.
Speaker: And, you know, I think that was one of the mistakes that he made, that he was so wound up in making sure I was okay.
Speaker: that it was he couldn't separate himself and be like, this is not healthy for me either, and have that discussion.
Speaker: And that was very disappointing and traumatizing for me, because from my perspective, it's like, I told you, I told you to tell me.
Speaker: And you know, sometimes you just can't tell.
Speaker: And I think I held a lot of anger towards him for that for a very long time.
Speaker: But it's better now, you know, like, it's, it's hard.
Speaker: We're all growing as people.
Speaker: Right.
Speaker: Thank you for sharing that.
Speaker: Yeah.
Speaker: I have two kind of epilogue questions.
Speaker: Okay.
Speaker: One is, you know, I saw a YouTube video, Drew Gooden, but he did a video about how there's this rampant marketing mindfulness products because that's kind of like in vogue right now, just like mental health and so forth.
Speaker: It's kind of an adjunct, right?
Speaker: Yeah.
Speaker: And there's all these products about, you know, Alpha Wave or like healing stones or things like that.
Speaker: And he was giving...
Speaker: critiques about, you know, it's not really scientifically researched.
Speaker: There's no genuine desire to help.
Speaker: It seems most of the products did seem more like ineffective is one, but more like it also comes from a place of taking advantage of this new, what they consider a fad rather than like a condition that people may need help on.
Speaker: And I don't know if you know this, but BetterHelp, the online kind of therapist, it's a way to scale therapy, right?
Speaker: Yep.
Speaker: using tech, but they also got in trouble.
Speaker: And some people dropped them because they got into a scandal about how they were letting unlicensed or like very incompetent therapists participate in the program and so forth.
Speaker: And I guess what I wanted to ask you is, you know, from a more, you know, since you have a more medical background, like, did you see any innovations otherwise, like in the tech aspect or in other ways that you think like genuinely help people deal with depression?
Speaker: Yeah, yeah.
Speaker: I think a lot of the new agey stuff, you're right, like there's no evidence-based data to say like something like objectively worked.
Speaker: But I will say, knowing that the mind is very powerful and placebo is very powerful, it's very significant.
Speaker: And a lot of mental health has to do with your perspective.
Speaker: If you believe something will work, it will help you feel better, most likely.
Speaker: It's not going to get you all the way, but it will help.
Speaker: So, you know, I often...
Speaker: Say to my patients, you know, if they ask me, you know, healing stones and all that stuff, and I'm kind of like, well, if it helps you feel better, you know, that's good.
Speaker: But it's, there's no data to support and scientifically makes it better.
Speaker: And justify the means for you in this.
Speaker: Right.
Speaker: Yeah.
Speaker: Yeah.
Speaker: As long as there's no harm to you, right?
Speaker: And there's a fine line between like, I'm doing this because I think this has a holistic thing.
Speaker: It lines my chakras, makes me feel better.
Speaker: And like, this is magic and like, it will cure my disease, right?
Speaker: Those are very different things.
Speaker: And so as long as we're not in the latter, I think the former is okay.
Speaker: You know, just because the mind is very powerful, right?
Speaker: Like keeping a positive attitude and like believing something is really helpful.
Speaker: And encourages you to do things.
Speaker: In terms of technology, I have not seen any technology lately that has been positive in terms of strong evidence base.
Speaker: But there are more and more apps out there that are helpful to encourage mindfulness, like the cognitive behavioral therapy app or something.
Speaker: I can't remember the name of it.
Speaker: But it basically kind of serves as a way to keep a memoir or a diary.
Speaker: It poses questions to you to encourage mindfulness.
Speaker: meditation stuff too.
Speaker: Yeah, yeah.
Speaker: I mean like meditative space or something.
Speaker: And some of these are really helpful.
Speaker: But again, because mental health is so heterogeneous and complex, what works for one person will not work for the other person.
Speaker: The advantage of technology is diversity.
Speaker: You have a huge diverse range of options that you could choose from, from things that may work for you or may not work for you.
Speaker: Right.
Speaker: I mean, I'll make a small correction.
Speaker: I think one that I am feeling very optimistic is psychedelics.
Speaker: Psychedelics, let's just therapy.
Speaker: I remember back in, this is back in high school or maybe early in college.
Speaker: I remember like you were very anxious to try marijuana.
Speaker: because you are very sensitive about the changes it could make to your brain chemistry yes do you still hold that same opinion when it comes to other psychedelics like psilocybin or mdma wait wait hold on when does this conversation take place i don't even remember this uh yeah it was a conversation i had with you actually i think it was like one of those random things that eric asks
Speaker: Yeah, and then you're like, Nita's really, no, I think you said something like Nita's really paranoid about trying marijuana because of the changes they could have her brain chemistry.
Speaker: And like, she got very existential about it.
Speaker: It's like, this could literally change who I am.
Speaker: I mean, you are right to some extent it does.
Speaker: But, you know, in 2023, I did want to get an update.
Speaker: How do you feel about other psychedelics though?
Speaker: Like suicide and MDMA and stuff like that.
Speaker: And are you more open to trying these out in the future or you're still...
Speaker: like i'm still very conservative but the reason i'm conservative is that there is no evidence-based studies right like strong evidence-based studies right now it's like whoever guy finds it and like i mean they are working on it i mind you know the you know johns hopkins i mean they are yeah they're working on it oh absolutely and i believe that like
Speaker: At the minute there is evidence-based stuff, like there's, there were some trials for like ketamine infusions for adolescents who like cured their depression or like feed it back into remission for a very long period of time.
Speaker: Like that I believe is just the recreational stuff.
Speaker: I don't trust another person to create a pure product that I'm going to open my brain with.
Speaker: Again, this is why you, this is why you would need to pay premium because you're doing, you're not just doing Molly at a rave, right?
Speaker: You're doing MDMA.
Speaker: in the presence of a therapist in a professional setting with the right product.
Speaker: FDA regulated, blah, blah, blah.
Speaker: And then, you know, enough evidence-based things to come out for me to be like, okay, that seems like it's worth it.
Speaker: Gotcha.
Speaker: But yeah.
Speaker: I mean, I've heard a lot of stories, especially in Florida.
Speaker: There's a lot of shroomies here.
Speaker: Yeah.
Speaker: Also, this is a PSA.
Speaker: Apparently, psilocybin is lethal to anyone who's taking on lithium.
Speaker: Yes, there's interest.
Speaker: So, I mean, you definitely got to do your due diligence.
Speaker: But again, that's why I want to pay premium because I want those things taken care of.
Speaker: Yeah, you don't want some street K, right?
Speaker: Yeah.
Speaker: Last question.
Speaker: Any media or TV shows or movies that, in your opinion, represented what it feels like to be depressed or dealing with depression to you very well?
Speaker: Just on your personal aspect.
Speaker: That is a great question and I have an answer for you.
Speaker: There is an episode on Amazon Prime.
Speaker: It's a show called Modern Love.
Speaker: I don't know how you've heard of Modern Romance.
Speaker: And it's one episode.
Speaker: It stars Anne Hathaway.
Speaker: And the person that Anne Hathaway is representing is a woman with bipolar disorder.
Speaker: And the illustration of how an acute depressive episode comes on is eerily accurate.
Speaker: I actually sent my parents, like I texted them, oh, I watched this episode.
Speaker: Like this is how it feels or like very close to how it feels.
Speaker: Interesting.
Speaker: Yeah.
Speaker: Thank you.
Speaker: I'll probably check that out.
Speaker: If I could add my two cents in, it's a movie called On the Count of Three starring Gerard Carmichael.
Speaker: And it spoke to me just, again, like this, the feeling that there's nothing that the world can do to change his mind.
Speaker: I won't spoil the ending, but like it described that feeling very well in the movie.
Speaker: So, all right.
Speaker: Thanks for sharing.
Speaker: This is a heavy one.
Speaker: So you got into it.
Speaker: Thank you for joining us today, Anita.
Speaker: We'll link her profile and Etsy shop, you know, on our Instagram.
Speaker: But anything else you want to promote or talk about?
Speaker: Yeah, no, thanks for having me.
Speaker: I had a really good time.
Speaker: I hope you both had a good time chatting.
Speaker: Yeah, it's been like since high school since we've had an in-depth chat, Eric.
Speaker: Yeah, for real.
Speaker: Yeah, yeah.
Speaker: But yeah, you can find me at Neurological Panda on my Instagram and there's links to everything else from there.
Speaker: All right.
Speaker: That about wraps it up.
Speaker: Thank you for tuning in to the Pengu Spective.
Speaker: Check out our Instagram at pengupective, P-E-N-G-U, spective for behind the scenes podcast clips, post pod clarity, and other exclusive content.
Speaker: Thank you for joining us, Nita.
Speaker: Until next time, peace.
Speaker: Peace.
