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[Applause]
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well that was a very nice introduction
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thank you I want to say I’m very
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grateful to Anthony for arranging this
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this program this idea of his abrini
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psychology to the public to me is the
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most important thing that we as
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psychologists can do the volume of
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information is so great and the quality
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of information has improved so markedly
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over time that there’s a lot to share
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and we have a relatively short time this
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evening but I hope to give you a lot of
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good perspective about things that
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matter the most in learning to manage
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depression so let me say I will be
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speaking for roughly 45 minutes or so
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and then I will open it up to questions
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let me start with a story and get you
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thinking about this topic when I was a
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young psychologist back in 1829 my first
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job was working in a psychiatric
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facility and I was the admissions person
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it was my job to admit new patients to
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the unit now this is a locked facility
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people aren’t getting locked up because
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they’re doing well they’re not really
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doing very well at all and so my job was
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to interview them find out why they were
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there what was going on in their lives
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what the expectation was for their
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hospitalization what medications they
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were on what the treatment plan was all
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those kinds of things
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now I’m young I’m inexperienced and for
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me to have the opportunity to interview
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many hundreds of people in a relatively
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short period of time turned out to be
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pivotal and all the things I’m going to
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talk to you about tonight I would
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interview people who had been through
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the worst experiences that you can
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imagine people who had been raped
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tortured mutilated people who had fled
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their homelands literally with the
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bullets with whizzing past their
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had people who lost their entire family
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and one fell swoop
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in a plane crash or a car crash people
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who had suffered the worst adversities
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you can possibly imagine and when I
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would interview these people it was easy
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to appreciate why they were broken why
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they were so despairing why they had
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given up on life that was of course an
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interesting lesson to say the least
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the compassion the empathy was very easy
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but what fascinated me clinically that
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has every bit of relevance to what we’re
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going to talk about tonight is when I
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interviewed people who had been through
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these horrific experiences people who
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probably should have been depressed but
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they weren’t and I wanted to know why
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not what is it about the way that these
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people are coping that somehow serves to
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insulate them against depression so it
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gave rise to the for research questions
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that have guided my career now for more
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than 40 years think about your answers
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to these questions because we’re going
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to talk about them the first question
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was are there skills that people have
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that serve to insulate them very
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interesting when you ask people directly
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gee anybody who had been through your
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circumstances would be depressed you’re
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not why not and people would give me
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these very insightful answers like I
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don’t know or they would say well I
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guess it’s just luck of the draw or I
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guess it’s good genetics but they
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couldn’t really give me any insight into
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that they’re just living it they’re just
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being who they are doing what they’re
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doing so as a young researcher
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interviewing people and asking a million
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questions slight exaggeration and you
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find out that they like murder mysteries
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and they like taking walks in the park
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and they like playing with their kids
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grandkids and they like ice cream and
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they like all kinds of things and there
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I am trying to figure out so what is it
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well we’ve answered that question now
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it’s the ice cream if only it were that
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simple so starting to identify what
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patterns are present in the way this
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person thinks about things in the way
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they define problems in the way that
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they define their relationships what are
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they doing in there and what emerged
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from that with great clarity were
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certain patterns of self-organization
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keep that phrase in mind patterns of
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self-organization so then the question
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became okay if I think I have a handle
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on what’s going on with these folks what
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we can learn from them it leads to the
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second question can we say that these
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skills that these people have are in
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fact learn about are they teachable
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isn’t this what the purpose of therapy
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is is to help people acquire these
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skills that are not intuitive for them
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that are intuitive for these other
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people then the third question became
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the salient research question can we
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prove scientifically empirically that
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when people are taught these particular
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skills that it makes a difference that
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it reduces their level of depression
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reduces the frequency of depression
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reduces their vulnerability to relapses
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reduces the impact on the people around
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them this is one of the things about
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depression it doesn’t just affect the
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individual sufferer one of my recent
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books is called depression is contagious
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and not in a viral sense not in a
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bacterial sense but in a social sense
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what is it about depression that is so
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easily transmitted to kids of depressed
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parents if you’re the child of a
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depressed parent your likelihood of
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suffering depression is three to six
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times greater than if you are the child
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of a non depressed
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just having a depressed parent is a
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massive risk factor not a small one
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a big one so can we prove that by people
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acquiring and developing the skills that
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it really makes a difference and then
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the fourth question has to do with
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prevention now bear in mind I’m asking
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these questions more than 40 years ago
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when we didn’t have good antidepressant
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medications we had medications that
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weren’t particularly effective and
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people didn’t want to take them they had
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annoying little side-effects like death
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and so all in the span of 40 years all
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of those things have changed we have
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better medications we have far better
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psycho therapies a far better insight
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into what depression is who’s vulnerable
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and under what conditions but the idea
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at that time of even thinking about
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depression in terms of prevention was
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sheer fantasy we didn’t have good
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treatment much less good opportunities
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for prevention so I will summarize my
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response to all four of these questions
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yes yes yes and yes what we have learned
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is that there are certain
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vulnerabilities risk factors a risk
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factor is anything that increases the
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likelihood of somebody suffering a
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particular disease or condition and at
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the time that I started studying
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depression we knew of exactly two risk
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factors gender and family history we now
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know that there are scores of risk
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factors factors that increase
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vulnerability to depression and I’m
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going to talk about some of the key ones
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this evening now part of what came out
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of that initial study was the
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recognition that it’s not just what
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happens to you you know for the people
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who say well the reason I’m depressed is
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because here’s what happened to me when
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I was a kid or the reason that I’m
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depressed is because I lost my job or
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the reason I’m depressed is because this
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person broke up with me that’s only
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partially true at best
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it’s far less about what actually
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happens to you and it’s far more about
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how you interpret how you give the
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significance to what kind of meaning you
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attach to the events in your life and
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part of what we’ve learned is that
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there’s a phenomenon called
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attributional style a pattern of how
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people reflexively unconsciously
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interpret the significance of events and
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this is something that is imperative to
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appreciate for all of us because this is
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where some of the strongest risk factors
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reside as I’ll get into in just a little
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while but let’s backtrack to the most
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basic of questions if we ask the
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question what is depression
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well depression is technically
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considered a mood disorder but it’s far
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more than that depressions tentacles
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reach into every part of a person’s life
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it affects not just your mood it affects
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your physiology your physical health and
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how depression serves as a risk factor
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for many different conditions most
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notably cardiovascular disease in fact
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there are cardiologists around the world
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who are recommending screening for
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depression as the first screen for
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cardiovascular disease but others as
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well and it reaches into your ability to
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think and make decisions and it’s one of
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the things I’m going to talk about a
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little bit later is the quality of
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people’s decisions and how their way of
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making decisions actually
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unintentionally reinforces depression it
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affects job performance and your ability
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to function in the work that you do it
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affects concentration
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how many work-related accidents that
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damage people and damaged people’s lives
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are caused by inattention caused by
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depression it affects relationships it’s
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hard to be around people who are
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depressed it ends up damaging
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relationships and of course all that
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leads to is more
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isolation and more depression so I can
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go on and on about all the different
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tentacles of depression but you should
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get the idea that this isn’t just a bad
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mood there are a lot of things that are
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very persistent very enduring about the
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patterns that give rise to depression in
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the first place that effect a quality of
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life over the span of a lifetime so then
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if we come to the question what causes
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depression is depression caused by now
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look at this list if you were to
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research every one of these factors you
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would find that there is abundant
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evidence for all of them and more and if
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you look at this list you’ll notice that
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some of these factors are biological
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factors some of these factors are
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psychological factors some of these
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factors are social factors and the more
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that we have learned about depression
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the more that we learn how important the
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social side of the equation really is
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that so many of the risk factors for
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depression when I talk about depressed
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parenting and why kids of depressed
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parents are it’s so much higher risk it
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isn’t through genetics it’s through
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modelling as a parent you can’t teach
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kids what you don’t know and so it
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becomes an interesting field of research
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what is the relationship between family
268
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structure family coping styles family
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atmosphere and depression and leave it
270
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in general for the moment there are some
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very significant factors that operate in
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that arena it’s why I wrote the book
273
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depression is contagious because these
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factors now are being recognized across
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a variety of fields
276
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so to summarize that point how important
277
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it is to appreciate and have a
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multi-dimensional viewpoint yes biology
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matters but surprisingly not as much as
280
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you would think
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that when we look at what’s termed
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genetic variance
283
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how much do genes play a role in
284
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depression is there a depression gene no
285
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are there genes that make people
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vulnerable to depression definitely and
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so if we look at biochemistry yes it’s a
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factor if we look at disease processes
289
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there are many diseases where depression
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is a predictable consequence if we look
291
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at drugs there are many drugs that have
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depression as a predictable side effect
293
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biology matters but when we look at
294
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genetic variance that figures between
295
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point three and point four there
296
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represents a mild moderate at best
297
00:14:01,170 —> 00:14:07,189
genetic influence so when we look at the
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site power the psychological factors
299
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individual history individual
300
00:14:09,600 —> 00:14:14,850
problem-solving styles individual coping
301
00:14:12,300 —> 00:14:18,089
styles these are the kinds of things
302
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that are in the domain of individual
303
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psychology another one that I mentioned
304
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just a moment ago attributional style
305
00:14:22,470 —> 00:14:29,430
the person’s habitual or reflexive way
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of attaching meaning to life events and
307
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that the social side of the equation as
308
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we’ve learned from studies of
309
00:14:34,920 —> 00:14:41,339
depressions prevalence a field called
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epidemiology this has been particularly
311
00:14:41,339 —> 00:14:46,380
revealing I don’t know if you saw the
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the big announcement last year from the
313
00:14:46,380 —> 00:14:53,759
World Health Organization well in 2004
314
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the World Health Organization which
315
00:14:53,759 —> 00:14:58,370
monitors health issues of all types
316
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around the world including depression
317
00:14:58,370 —> 00:15:05,670
but other things as well cancer aids MS
318
00:15:02,399 —> 00:15:08,220
you name it in 2004 the World Health
319
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Organization declared depression the
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number four cause of human suffering and
321
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disability behind cancer heart disease
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and traffic accidents they predicted in
323
00:15:19,980 —> 00:15:25,630
2004 that by the year 2020 depression
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would rise to be
325
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number two in fact depression reached
326
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number two in late 2013 last year just
327
00:15:34,300 —> 00:15:40,990
around this time depression was declared
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the number one cause of human suffering
329
00:15:40,990 —> 00:15:46,660
and disability and the numbers are
330
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increasing there is no demographic group
331
00:15:46,660 —> 00:15:51,400
where the numbers are going down in
332
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every demographic group the numbers are
333
00:15:51,400 —> 00:15:58,300
going up when we look at the
334
00:15:54,090 —> 00:16:00,580
epidemiology it’s the 25 to 44 year-olds
335
00:15:58,300 —> 00:16:03,370
who represent the largest group of
336
00:16:00,580 —> 00:16:06,160
depression sufferers but the
337
00:16:03,370 —> 00:16:10,030
fastest-growing group is their children
338
00:16:06,160 —> 00:16:12,640
and this is one of the things that I am
339
00:16:10,030 —> 00:16:15,220
deeply concerned about now when you see
340
00:16:12,640 —> 00:16:17,230
a 14 year old or a 15 year old who’s
341
00:16:15,220 —> 00:16:19,240
already suffering depression shows the
342
00:16:17,230 —> 00:16:23,050
signs has the symptoms as dealing with
343
00:16:19,240 —> 00:16:25,330
it that’s a basis for concern what’s an
344
00:16:23,050 —> 00:16:27,670
even stronger basis for concern is what
345
00:16:25,330 —> 00:16:32,770
happens ten years from now when this
346
00:16:27,670 —> 00:16:35,620
depressed adolescent becomes a parent we
347
00:16:32,770 —> 00:16:38,860
now have three generation studies that
348
00:16:35,620 —> 00:16:40,450
show remarkably clearly that from one
349
00:16:38,860 —> 00:16:42,570
generation to the next
350
00:16:40,450 —> 00:16:46,240
depression increases in prevalence
351
00:16:42,570 —> 00:16:46,900
depression increases in severity I’m
352
00:16:46,240 —> 00:16:49,900
worried
353
00:16:46,900 —> 00:16:53,260
especially about the youngest among us
354
00:16:49,900 —> 00:16:56,620
who are at a very elevated risk right
355
00:16:53,260 —> 00:16:58,420
now for all kinds of reasons one of the
356
00:16:56,620 —> 00:17:01,930
points about the social side of
357
00:16:58,420 —> 00:17:04,270
depression why is depression increasing
358
00:17:01,930 —> 00:17:07,929
so dramatically think about your
359
00:17:04,270 —> 00:17:10,599
response to that well the societal
360
00:17:07,930 —> 00:17:14,470
structure has changed radically over
361
00:17:10,599 —> 00:17:18,129
time and when we look at things like the
362
00:17:14,470 —> 00:17:21,430
influence of Technology that smartphone
363
00:17:18,130 —> 00:17:23,500
that you’re carrying around represents
364
00:17:21,430 —> 00:17:27,880
one of the strongest risk factors there
365
00:17:23,500 —> 00:17:29,380
is for young people today who are no
366
00:17:27,880 —> 00:17:32,440
other way to describe it
367
00:17:29,380 —> 00:17:34,870
addicted to the technology survey after
368
00:17:32,440 —> 00:17:37,000
survey showing that if you ask somebody
369
00:17:34,870 —> 00:17:37,510
to stop checking their phone for two
370
00:17:37,000 —> 00:17:41,529
hour
371
00:17:37,510 —> 00:17:44,830
they react really badly it’s so
372
00:17:41,529 —> 00:17:47,320
engrained into their quality of life and
373
00:17:44,830 —> 00:17:49,658
as a general principle the more time you
374
00:17:47,320 —> 00:17:51,820
spend in front of a screen whether it’s
375
00:17:49,659 —> 00:17:53,639
a small one whether it’s a big one the
376
00:17:51,820 —> 00:17:56,649
more likely you are to suffer depression
377
00:17:53,639 —> 00:17:58,689
you’ve been hearing about the what
378
00:17:56,649 —> 00:18:02,049
people are calling the epidemic of
379
00:17:58,690 —> 00:18:05,860
loneliness paradoxically in this
380
00:18:02,049 —> 00:18:09,850
terribly overcrowded world people are
381
00:18:05,860 —> 00:18:12,129
dying of loneliness and the fact that
382
00:18:09,850 —> 00:18:15,250
people are as disconnected as they are
383
00:18:12,130 —> 00:18:18,399
plays a significant role so when I talk
384
00:18:15,250 —> 00:18:21,399
about what causes depression the best
385
00:18:18,399 —> 00:18:24,729
answer I can give you is many many
386
00:18:21,399 —> 00:18:27,370
things and that’s precisely why each
387
00:18:24,730 —> 00:18:30,460
person’s pathway into depression is
388
00:18:27,370 —> 00:18:32,350
different it’s why whatever pathway this
389
00:18:30,460 —> 00:18:35,200
person is gonna find out of depression
390
00:18:32,350 —> 00:18:37,469
is going to have to be unique to them is
391
00:18:35,200 —> 00:18:39,010
there a best treatment for depression
392
00:18:37,470 —> 00:18:42,250
absolutely not
393
00:18:39,010 —> 00:18:44,590
is there a best approach absolutely not
394
00:18:42,250 —> 00:18:47,139
the best approach is the one that works
395
00:18:44,590 —> 00:18:50,709
for you and that’s an important thing
396
00:18:47,139 —> 00:18:54,250
because as a consumer that as you
397
00:18:50,710 —> 00:18:56,980
approach the decision to seek help to
398
00:18:54,250 —> 00:18:58,840
take advantage of the fact that there
399
00:18:56,980 —> 00:19:01,090
are experts who have been studying these
400
00:18:58,840 —> 00:19:02,918
things for a very long time and have
401
00:19:01,090 —> 00:19:07,240
learned a lot and know how to do
402
00:19:02,919 —> 00:19:09,100
treatment quite well that your path is
403
00:19:07,240 —> 00:19:11,049
going to be different and unique
404
00:19:09,100 —> 00:19:12,939
there is no standardized treatment
405
00:19:11,049 —> 00:19:16,289
there’s no standardized way of doing
406
00:19:12,940 —> 00:19:20,440
this and so this is an important point
407
00:19:16,289 —> 00:19:23,740
I’m talking now about your risk factors
408
00:19:20,440 —> 00:19:25,990
yours you as an individual they’re not
409
00:19:23,740 —> 00:19:28,570
the same as others when I say each
410
00:19:25,990 —> 00:19:29,710
person has their own pathway in and it’s
411
00:19:28,570 —> 00:19:33,700
going to have to develop their own
412
00:19:29,710 —> 00:19:36,039
pathway out your task is learning what
413
00:19:33,700 —> 00:19:38,500
your vulnerabilities are learning what
414
00:19:36,039 —> 00:19:40,809
your risk factors are what is very
415
00:19:38,500 —> 00:19:42,669
troublesome for one person isn’t the
416
00:19:40,809 —> 00:19:45,279
least bit troublesome for someone else
417
00:19:42,669 —> 00:19:47,289
what one person avoids with every ounce
418
00:19:45,279 —> 00:19:49,620
of energy they have somebody else walks
419
00:19:47,289 —> 00:19:52,540
into openly and happily
420
00:19:49,620 —> 00:19:54,159
everybody’s different and so when we
421
00:19:52,540 —> 00:19:57,670
look at that point which is really
422
00:19:54,160 —> 00:20:00,430
nothing to sneeze at we we really have
423
00:19:57,670 —> 00:20:03,070
to appreciate that it’s that level of
424
00:20:00,430 —> 00:20:04,840
individual attention learning about
425
00:20:03,070 —> 00:20:07,600
yourself that becomes one of the most
426
00:20:04,840 —> 00:20:11,139
important things that you can do so when
427
00:20:07,600 —> 00:20:13,209
we look at the fact that currently the
428
00:20:11,140 —> 00:20:15,690
most common form of treatment the most
429
00:20:13,210 —> 00:20:18,580
popular form of treatment so had the
430
00:20:15,690 —> 00:20:21,450
antidepressant medication now
431
00:20:18,580 —> 00:20:24,820
antidepressant medications really came
432
00:20:21,450 —> 00:20:27,850
became popular in the late 1980s with
433
00:20:24,820 —> 00:20:31,030
the first release of Prozac the first of
434
00:20:27,850 —> 00:20:32,280
the newer generation antidepressants I’m
435
00:20:31,030 —> 00:20:34,420
not gonna say a lot about
436
00:20:32,280 —> 00:20:37,990
antidepressants right now you know just
437
00:20:34,420 —> 00:20:42,910
a couple of general comments what I will
438
00:20:37,990 —> 00:20:45,850
say definitively is medications are too
439
00:20:42,910 —> 00:20:48,490
heavily relied upon medications are
440
00:20:45,850 —> 00:20:51,580
viewed as somehow going to be the answer
441
00:20:48,490 —> 00:20:53,740
and I can tell you the more that we
442
00:20:51,580 —> 00:20:56,439
understand the social aspect of
443
00:20:53,740 —> 00:20:59,230
depression the more confidently I can
444
00:20:56,440 —> 00:21:01,780
say to you there will never be a drug
445
00:20:59,230 —> 00:21:03,610
that cures depression any more than
446
00:21:01,780 —> 00:21:06,639
there will be a drug that cures racism
447
00:21:03,610 —> 00:21:08,770
or poverty looking at it through the
448
00:21:06,640 —> 00:21:11,590
lens of biology is an exceptionally
449
00:21:08,770 —> 00:21:13,540
limited perspective why I made a point
450
00:21:11,590 —> 00:21:15,939
of showing you the slide that shows you
451
00:21:13,540 —> 00:21:19,659
the biological factors psychological
452
00:21:15,940 —> 00:21:22,030
factors social factors now it’s not that
453
00:21:19,660 —> 00:21:24,460
I am against antidepressants you know
454
00:21:22,030 —> 00:21:26,290
part of writing for encyclopedia
455
00:21:24,460 —> 00:21:28,420
Britannica’s I can’t just say it because
456
00:21:26,290 —> 00:21:31,379
it’s my opinion where’s the evidence for
457
00:21:28,420 —> 00:21:34,390
it antidepressants can do two things
458
00:21:31,380 —> 00:21:36,550
reasonably well they can help you manage
459
00:21:34,390 —> 00:21:39,780
the vegetative symptoms things like
460
00:21:36,550 —> 00:21:42,399
sleep disturbance appetite disturbance
461
00:21:39,780 —> 00:21:45,870
and they can raise the floor on
462
00:21:42,400 —> 00:21:48,130
depression now that will be true for
463
00:21:45,870 —> 00:21:51,520
roughly half the people who take
464
00:21:48,130 —> 00:21:55,900
medications if you take medication alone
465
00:21:51,520 —> 00:21:58,300
it’s something to reconsider medications
466
00:21:55,900 —> 00:21:59,409
have the highest rate of relapse of any
467
00:21:58,300 —> 00:22:02,539
form of tree
468
00:21:59,409 —> 00:22:04,789
so even if you happen to be a fan of
469
00:22:02,539 —> 00:22:07,190
medication and believe me there are
470
00:22:04,789 —> 00:22:10,640
people who say to me all the time that
471
00:22:07,190 —> 00:22:13,940
medication saved my life I believe them
472
00:22:10,640 —> 00:22:16,309
there’s no reason to disbelieve them but
473
00:22:13,940 —> 00:22:20,450
the larger point I’m making is it’s not
474
00:22:16,309 —> 00:22:23,960
enough it’s not enough and here’s why
475
00:22:20,450 —> 00:22:26,779
it’s not enough no amount of medication
476
00:22:23,960 —> 00:22:30,620
is going to help you develop skills and
477
00:22:26,779 —> 00:22:32,510
managing stress none no amount of
478
00:22:30,620 —> 00:22:34,850
Education is going to help you develop a
479
00:22:32,510 —> 00:22:37,399
better attributional or explanatory
480
00:22:34,850 —> 00:22:40,070
style or help you build and maintain
481
00:22:37,399 —> 00:22:42,529
positive relationships with other people
482
00:22:40,070 —> 00:22:44,450
or it’s helped you develop the kinds of
483
00:22:42,529 —> 00:22:47,210
cognitive skills that help you think
484
00:22:44,450 —> 00:22:49,840
critically about experience instead of
485
00:22:47,210 —> 00:22:51,890
just getting sucked in by your feelings
486
00:22:49,840 —> 00:22:54,080
it’s not going to help you develop
487
00:22:51,890 —> 00:22:56,360
problem-solving skills it’s not going to
488
00:22:54,080 —> 00:22:58,520
help you develop better decision-making
489
00:22:56,360 —> 00:23:00,740
strategies it’s not going to teach you
490
00:22:58,520 —> 00:23:02,899
how to build a support and network with
491
00:23:00,740 —> 00:23:05,149
people it’s not going to help you come
492
00:23:02,899 —> 00:23:07,279
to terms with whatever crummy things
493
00:23:05,149 —> 00:23:08,779
have happened in your life and it’s
494
00:23:07,279 —> 00:23:12,260
certainly not going to help you build
495
00:23:08,779 —> 00:23:14,750
one of the most important things one of
496
00:23:12,260 —> 00:23:17,929
the most important things in getting
497
00:23:14,750 —> 00:23:22,600
treatment is how to build a compelling
498
00:23:17,929 —> 00:23:24,980
future you know the past whatever
499
00:23:22,600 —> 00:23:29,029
de-stresses whatever traumas whatever
500
00:23:24,980 —> 00:23:32,929
situations you Fath you’ve faced I get
501
00:23:29,029 —> 00:23:35,929
that I listen to those experiences all
502
00:23:32,929 —> 00:23:38,299
the time and they’re tragic but if we
503
00:23:35,929 —> 00:23:41,390
ask the question who overcomes
504
00:23:38,299 —> 00:23:44,658
depression and who doesn’t the people
505
00:23:41,390 —> 00:23:47,029
who find themselves facing forward who
506
00:23:44,659 —> 00:23:51,200
start thinking in terms of how do I want
507
00:23:47,029 —> 00:23:53,960
my life to be do better than the people
508
00:23:51,200 —> 00:23:57,710
who keep focusing on the past the
509
00:23:53,960 —> 00:24:00,169
unchangeable past and that’s really the
510
00:23:57,710 —> 00:24:03,770
key and this drugs aren’t going to help
511
00:24:00,169 —> 00:24:06,049
you do that so if we look at what these
512
00:24:03,770 —> 00:24:09,139
risk factors are that I’m talking about
513
00:24:06,049 —> 00:24:09,840
when I said there are scores of risk
514
00:24:09,139 —> 00:24:12,270
factors
515
00:24:09,840 —> 00:24:14,699
literally dozens and dozens of risk
516
00:24:12,270 —> 00:24:17,158
factors things that singly and in
517
00:24:14,700 —> 00:24:21,029
combination can give rise to depression
518
00:24:17,159 —> 00:24:23,640
very easily I want to highlight for you
519
00:24:21,029 —> 00:24:26,039
some of the key ones some of the risk
520
00:24:23,640 —> 00:24:28,799
factors that have a greater impact than
521
00:24:26,039 —> 00:24:30,929
do others and I’m gonna describe these
522
00:24:28,799 —> 00:24:32,610
for you and give you an idea of what
523
00:24:30,929 —> 00:24:34,500
they look like sound like and what you
524
00:24:32,610 —> 00:24:39,000
can actually do about them how we doing
525
00:24:34,500 —> 00:24:41,760
okay so the first one let me name them
526
00:24:39,000 —> 00:24:45,750
first the internal orientation stress
527
00:24:41,760 —> 00:24:48,860
generation rumination global thinking
528
00:24:45,750 —> 00:24:51,419
and finally unrealistic expectations
529
00:24:48,860 —> 00:24:53,850
let’s look at each risk factor
530
00:24:51,419 —> 00:24:57,179
individually and how it influences your
531
00:24:53,850 —> 00:25:01,020
overall quality of experience the first
532
00:24:57,179 —> 00:25:03,029
one the internal orientation what I’m
533
00:25:01,020 —> 00:25:06,658
talking about the internal orientation
534
00:25:03,029 —> 00:25:09,750
very simply I mean what people do is
535
00:25:06,659 —> 00:25:14,070
they use themselves as the reference
536
00:25:09,750 —> 00:25:17,370
point they use their feelings to make
537
00:25:14,070 —> 00:25:19,730
decisions they use their feelings to
538
00:25:17,370 —> 00:25:22,320
interpret the things that they’re
539
00:25:19,730 —> 00:25:27,270
interpreting events that happen in their
540
00:25:22,320 —> 00:25:30,418
life the internal orientation drives you
541
00:25:27,270 —> 00:25:32,309
in wordly there are actually some
542
00:25:30,419 —> 00:25:33,960
depression writers who have framed
543
00:25:32,309 —> 00:25:37,710
depression as being the most
544
00:25:33,960 —> 00:25:41,100
narcissistic of all states now that’s
545
00:25:37,710 —> 00:25:43,590
clearly an exaggeration but it does
546
00:25:41,100 —> 00:25:46,469
speak to the quality of self-absorption
547
00:25:43,590 —> 00:25:49,470
what I mean by the internal orientation
548
00:25:46,470 —> 00:25:52,049
and when you use your feelings as the
549
00:25:49,470 —> 00:25:55,320
indicator of what to do you’re going to
550
00:25:52,049 —> 00:25:57,090
make mistakes now I know that there are
551
00:25:55,320 —> 00:25:59,418
people running around loose in the world
552
00:25:57,090 —> 00:26:02,399
who will say to you trust your feelings
553
00:25:59,419 —> 00:26:05,610
listen to your feelings listen to what
554
00:26:02,399 —> 00:26:08,580
your heart tells you I can tell you as a
555
00:26:05,610 —> 00:26:13,908
psychologist and depression expert that
556
00:26:08,580 —> 00:26:16,678
is really bad advice really bad advice
557
00:26:13,909 —> 00:26:20,309
because your feelings can too easily
558
00:26:16,679 —> 00:26:23,100
deceive you people can so easily think
559
00:26:20,309 —> 00:26:26,010
things are worse than they really are
560
00:26:23,100 —> 00:26:29,280
people can think things are better than
561
00:26:26,010 —> 00:26:32,100
they really are to be able to have the
562
00:26:29,280 —> 00:26:34,830
ability to go outside yourself and learn
563
00:26:32,100 —> 00:26:40,949
something about what’s actually going on
564
00:26:34,830 —> 00:26:42,120
out there well when I say internal
565
00:26:40,950 —> 00:26:45,630
orientation
566
00:26:42,120 —> 00:26:49,409
it’s the subjectivity here’s what I
567
00:26:45,630 —> 00:26:52,950
believe here’s how I feel this is the
568
00:26:49,410 —> 00:26:55,890
way it is and when people make bad
569
00:26:52,950 —> 00:26:58,530
decisions that unintentionally make
570
00:26:55,890 —> 00:27:00,120
their life worse that really speaks to
571
00:26:58,530 —> 00:27:02,850
what I’m going to talk about next with
572
00:27:00,120 —> 00:27:05,610
stress generation but the point I’m
573
00:27:02,850 —> 00:27:09,000
making now about what does this mean in
574
00:27:05,610 —> 00:27:12,629
terms of what to actually do I put here
575
00:27:09,000 —> 00:27:14,789
the goal is to learn to reality test one
576
00:27:12,630 —> 00:27:18,690
of the most important skills you can
577
00:27:14,789 —> 00:27:23,158
develop in life is reality testing how
578
00:27:18,690 —> 00:27:25,080
do I go outside myself in order to know
579
00:27:23,159 —> 00:27:27,570
whether this is really what’s happening
580
00:27:25,080 —> 00:27:29,520
and if you look at the times that people
581
00:27:27,570 —> 00:27:31,470
get in the most trouble it’s when they
582
00:27:29,520 —> 00:27:33,809
get wrapped up inside and whatever they
583
00:27:31,470 —> 00:27:36,150
happen to believe that may have next to
584
00:27:33,809 —> 00:27:37,668
nothing to do with what’s actually going
585
00:27:36,150 —> 00:27:40,919
on out there
586
00:27:37,669 —> 00:27:45,240
clinicians call this cognitive rigidity
587
00:27:40,919 —> 00:27:49,010
in plain language what it means is the
588
00:27:45,240 —> 00:27:53,429
key problem with depressed people is
589
00:27:49,010 —> 00:27:57,620
that they think things and then make the
590
00:27:53,429 —> 00:28:03,260
mistake of actually believing themselves
591
00:27:57,620 —> 00:28:06,299
thinking is dangerous potentially and
592
00:28:03,260 —> 00:28:09,450
without the ability to learn how to go
593
00:28:06,299 —> 00:28:11,039
outside yourself in reality test all you
594
00:28:09,450 —> 00:28:13,559
can do is be a prisoner of your own
595
00:28:11,039 —> 00:28:17,158
thoughts and if your own thoughts are
596
00:28:13,559 —> 00:28:20,010
depressing you’re in trouble and it’s
597
00:28:17,159 —> 00:28:22,039
why especially here in Australia where
598
00:28:20,010 —> 00:28:25,830
CBT is one of the most commonly applied
599
00:28:22,039 —> 00:28:28,080
approaches and appropriately so helping
600
00:28:25,830 —> 00:28:30,918
people learn the cognitive skills of how
601
00:28:28,080 —> 00:28:34,049
to gather information and how to use it
602
00:28:30,919 —> 00:28:36,179
instead of just jumping to unfounded
603
00:28:34,049 —> 00:28:36,780
conclusions and believing the things
604
00:28:36,179 —> 00:28:39,540
that
605
00:28:36,780 —> 00:28:42,899
go on and of course this also relates to
606
00:28:39,540 —> 00:28:44,850
the social isolation one of the values
607
00:28:42,900 —> 00:28:46,800
of relationships is when you have people
608
00:28:44,850 —> 00:28:49,110
close enough to you that you can say to
609
00:28:46,800 —> 00:28:51,690
them here’s what’s going on here’s what
610
00:28:49,110 —> 00:28:53,129
I think about it and hopefully they care
611
00:28:51,690 —> 00:28:55,350
about you enough and they’re close
612
00:28:53,130 —> 00:28:58,220
enough with you to be able to say to you
613
00:28:55,350 —> 00:29:01,649
I don’t think you’re right about that
614
00:28:58,220 —> 00:29:04,080
it’s why the most important skill to
615
00:29:01,650 —> 00:29:06,630
counter cognitive rigidity is cognitive
616
00:29:04,080 —> 00:29:10,470
flexibility how can you train yourself
617
00:29:06,630 —> 00:29:14,460
to generate multiple explanations for
618
00:29:10,470 —> 00:29:17,450
things that happen simple example I call
619
00:29:14,460 —> 00:29:19,350
you up you’re not home I leave a message
620
00:29:17,450 —> 00:29:23,520
hi it’s Michael
621
00:29:19,350 —> 00:29:25,740
it’s 10:00 a.m. call me back it’s now 10
622
00:29:23,520 —> 00:29:29,940
p.m. at night and you haven’t called me
623
00:29:25,740 —> 00:29:32,220
back if I am a depressed person what is
624
00:29:29,940 —> 00:29:33,870
my predictable attribution or
625
00:29:32,220 —> 00:29:38,810
explanation for why you didn’t call me
626
00:29:33,870 —> 00:29:43,409
back you don’t care about me anymore
627
00:29:38,810 —> 00:29:44,220
that’ll cheer me up but it doesn’t stop
628
00:29:43,410 —> 00:29:46,440
there
629
00:29:44,220 —> 00:29:48,270
then it goes to the next level of how
630
00:29:46,440 —> 00:29:51,510
come people don’t care about me why
631
00:29:48,270 —> 00:29:53,700
aren’t people ever responsive to me why
632
00:29:51,510 —> 00:29:55,379
aren’t people ever staying my friends
633
00:29:53,700 —> 00:29:57,330
and the next thing you know this
634
00:29:55,380 —> 00:30:00,270
person’s built this up and built this up
635
00:29:57,330 —> 00:30:02,840
until it’s literally a suicidal crisis
636
00:30:00,270 —> 00:30:06,150
because you didn’t call them back
637
00:30:02,840 —> 00:30:09,419
that’s how it works that’s the internal
638
00:30:06,150 —> 00:30:12,150
orientation training people to generate
639
00:30:09,420 —> 00:30:14,400
multiple explanations why did this
640
00:30:12,150 —> 00:30:16,320
person call back could be this could be
641
00:30:14,400 —> 00:30:21,240
this could be this could be this could
642
00:30:16,320 —> 00:30:24,899
be this which one is it I don’t know to
643
00:30:21,240 —> 00:30:28,380
master the art of recognizing what you
644
00:30:24,900 —> 00:30:31,800
don’t know instead of making stuff up
645
00:30:28,380 —> 00:30:33,960
and then actually believing yourself the
646
00:30:31,800 —> 00:30:36,510
second risk factor is called stress
647
00:30:33,960 —> 00:30:38,700
generation this is actually one of the
648
00:30:36,510 —> 00:30:41,960
most recently developed models of
649
00:30:38,700 —> 00:30:44,820
depression and it has attained already a
650
00:30:41,960 —> 00:30:48,140
significant level of empirical support
651
00:30:44,820 —> 00:30:51,010
what stress generation speaks to is
652
00:30:48,140 —> 00:30:53,930
how people make decisions that
653
00:30:51,010 —> 00:30:55,700
complicate their depression exacerbate
654
00:30:53,930 —> 00:30:58,370
their depression they don’t do it
655
00:30:55,700 —> 00:30:59,950
intentionally but it speaks to the
656
00:30:58,370 —> 00:31:03,260
quality of their decision-making
657
00:30:59,950 —> 00:31:05,660
strategies and when people don’t have
658
00:31:03,260 —> 00:31:07,640
good decision-making strategies when
659
00:31:05,660 —> 00:31:10,010
they just follow their heart just follow
660
00:31:07,640 —> 00:31:14,930
their feelings they’re going to make
661
00:31:10,010 —> 00:31:19,250
mistakes so for example I can say to my
662
00:31:14,930 —> 00:31:21,230
depressed client I can see from all the
663
00:31:19,250 —> 00:31:22,730
cobwebs all over you that you really
664
00:31:21,230 —> 00:31:26,630
don’t move much
665
00:31:22,730 —> 00:31:29,170
and knowing that exercise has a
666
00:31:26,630 —> 00:31:31,460
treatment success rate that matches the
667
00:31:29,170 —> 00:31:34,280
antidepressants with a much much lower
668
00:31:31,460 —> 00:31:37,130
relapse rate it really would be a good
669
00:31:34,280 —> 00:31:41,870
idea for you to exercise and invariably
670
00:31:37,130 —> 00:31:47,150
my client says I know but I don’t feel
671
00:31:41,870 —> 00:31:49,879
like it bad decision your friends say to
672
00:31:47,150 —> 00:31:52,610
you wow you are really bummed out you
673
00:31:49,880 —> 00:31:58,610
are depressed you need help go to the
674
00:31:52,610 —> 00:32:01,699
doctor and you say no bad decision you
675
00:31:58,610 —> 00:32:03,830
go to the doctor the doctor says here’s
676
00:32:01,700 —> 00:32:08,110
the name of three therapists pick one
677
00:32:03,830 —> 00:32:11,050
you need help you take the names
678
00:32:08,110 —> 00:32:15,080
promptly crumple them up throw them away
679
00:32:11,050 —> 00:32:17,990
bad decision that’s what I mean by
680
00:32:15,080 —> 00:32:21,260
stress generation how many decisions do
681
00:32:17,990 —> 00:32:23,750
you make in the span of a day and this
682
00:32:21,260 —> 00:32:27,140
is what we find this comes out of the
683
00:32:23,750 —> 00:32:29,920
field of affective neuroscience which is
684
00:32:27,140 —> 00:32:33,710
just a fancy title for how do moods
685
00:32:29,920 —> 00:32:36,890
influence decision-making processes it’s
686
00:32:33,710 —> 00:32:38,960
a fascinating field and it speaks to the
687
00:32:36,890 —> 00:32:41,420
fact that these aren’t just cognitive
688
00:32:38,960 —> 00:32:44,660
processes that happen mood influences
689
00:32:41,420 —> 00:32:47,630
them your mood influences what you
690
00:32:44,660 —> 00:32:50,330
remember your mood influences how you
691
00:32:47,630 —> 00:32:53,510
remember your mood influences the
692
00:32:50,330 —> 00:32:57,110
quality of choices that you make obvious
693
00:32:53,510 —> 00:33:01,720
examples if you’re angry are you going
694
00:32:57,110 —> 00:33:07,010
to be more or less willing to take risks
695
00:33:01,720 —> 00:33:11,510
more if you’re afraid are you more or
696
00:33:07,010 —> 00:33:14,930
less likely to take risks less your mood
697
00:33:11,510 —> 00:33:17,240
state influences your perceptions your
698
00:33:14,930 —> 00:33:20,510
mood state influences the quality of
699
00:33:17,240 —> 00:33:22,730
decisions and helping people make better
700
00:33:20,510 —> 00:33:24,980
decisions filtering the mood out of the
701
00:33:22,730 —> 00:33:27,080
process is one of the most important
702
00:33:24,980 —> 00:33:31,100
things that we do clinically in the
703
00:33:27,080 —> 00:33:31,939
therapeutic work that we do so you look
704
00:33:31,100 —> 00:33:35,659
at these things
705
00:33:31,940 —> 00:33:40,730
don’t isolate socialize I don’t feel
706
00:33:35,660 —> 00:33:44,540
like it stop drinking I don’t feel like
707
00:33:40,730 —> 00:33:47,300
it why do I say stop drinking if you are
708
00:33:44,540 —> 00:33:50,899
depressed if you are vulnerable to
709
00:33:47,300 —> 00:33:56,240
depression your alcohol intake should be
710
00:33:50,900 —> 00:33:58,300
zero alcohol is a bad drug for people
711
00:33:56,240 —> 00:34:01,580
who are depressed or prone to depression
712
00:33:58,300 —> 00:34:04,639
it has been shown to aggravate the same
713
00:34:01,580 —> 00:34:06,649
neural pathways as depression if you are
714
00:34:04,640 —> 00:34:10,820
a depressed person your alcohol
715
00:34:06,650 —> 00:34:13,100
consumption should be zero and when you
716
00:34:10,820 —> 00:34:16,639
say that to somebody particularly if
717
00:34:13,100 —> 00:34:19,759
their Australian they say I don’t think
718
00:34:16,639 —> 00:34:25,340
so I’m not going to do that
719
00:34:19,760 —> 00:34:29,210
bad decision so that’s part of the task
720
00:34:25,340 —> 00:34:33,050
is learning how to take actions that are
721
00:34:29,210 —> 00:34:35,030
consistent with the goals more so than
722
00:34:33,050 —> 00:34:37,610
taking actions consistent with the
723
00:34:35,030 —> 00:34:41,389
feelings the feelings come and go the
724
00:34:37,610 —> 00:34:43,850
consequences last and to start to think
725
00:34:41,389 —> 00:34:46,040
in those terms becomes a very different
726
00:34:43,850 —> 00:34:48,529
paradigm for people who are used to
727
00:34:46,040 —> 00:34:50,889
following their feelings so closely the
728
00:34:48,530 —> 00:34:54,200
internal orientation I was talking about
729
00:34:50,889 —> 00:34:56,110
that is not one of the seven Habits of
730
00:34:54,199 —> 00:34:59,359
Highly Effective People
731
00:34:56,110 —> 00:35:02,780
when I say alcohol is a bad drug I am
732
00:34:59,360 —> 00:35:06,410
understating it when we look at the next
733
00:35:02,780 —> 00:35:09,110
risk factor rumination rumination means
734
00:35:06,410 —> 00:35:11,930
spinning around the same thoughts over
735
00:35:09,110 —> 00:35:13,620
and over and over again and analyzing
736
00:35:11,930 —> 00:35:17,450
and analyzing an animal
737
00:35:13,620 —> 00:35:20,819
at the expense of taking action
738
00:35:17,450 —> 00:35:24,660
rumination drives the symptoms of
739
00:35:20,820 —> 00:35:27,000
anxiety rumination drives the symptoms
740
00:35:24,660 —> 00:35:28,799
of depression for the people who are
741
00:35:27,000 —> 00:35:30,510
ruminate errs they have much more
742
00:35:28,800 —> 00:35:33,690
difficulty with even the most basic
743
00:35:30,510 —> 00:35:35,910
things like sleeping because their brain
744
00:35:33,690 —> 00:35:37,620
doesn’t stop they’re always thinking
745
00:35:35,910 —> 00:35:39,180
about their problems always thinking
746
00:35:37,620 —> 00:35:40,259
about the issues trying to figure out
747
00:35:39,180 —> 00:35:43,200
what to do next
748
00:35:40,260 —> 00:35:46,080
and the idea of course is thinking about
749
00:35:43,200 —> 00:35:49,230
problems is generally useful depending
750
00:35:46,080 —> 00:35:52,380
how you think about them if you keep
751
00:35:49,230 —> 00:35:55,290
analyzing but never take action you’re
752
00:35:52,380 —> 00:35:59,010
gonna feel worse if there is a cure for
753
00:35:55,290 —> 00:36:01,400
rumination its action but it has to be
754
00:35:59,010 —> 00:36:04,920
timely action it has to be effective
755
00:36:01,400 —> 00:36:09,380
action it’s not just action for the sake
756
00:36:04,920 —> 00:36:12,660
of action that doesn’t count as action
757
00:36:09,380 —> 00:36:16,350
so the ability to be able to convert
758
00:36:12,660 —> 00:36:18,950
rumination to action and when we look at
759
00:36:16,350 —> 00:36:21,600
the things that people ruminate about
760
00:36:18,950 —> 00:36:24,379
it’s almost invariably about
761
00:36:21,600 —> 00:36:27,450
relationships and probably number two is
762
00:36:24,380 —> 00:36:29,640
school and work-related issues but
763
00:36:27,450 —> 00:36:31,620
relationships are the most prominent and
764
00:36:29,640 —> 00:36:34,680
many of the relationships of course are
765
00:36:31,620 —> 00:36:37,710
relationships from the past this is one
766
00:36:34,680 —> 00:36:41,009
of the factors of depression every
767
00:36:37,710 —> 00:36:44,060
problem has a structure every problem
768
00:36:41,010 —> 00:36:47,520
every diagnostic label has components
769
00:36:44,060 —> 00:36:51,029
one of the components of depression is
770
00:36:47,520 —> 00:36:57,050
what’s called a past orientation people
771
00:36:51,030 —> 00:36:59,880
come in and they say my past controls me
772
00:36:57,050 —> 00:37:01,770
it’s because of these traumas in my past
773
00:36:59,880 —> 00:37:03,270
it’s because of these things my parents
774
00:37:01,770 —> 00:37:06,150
did it’s because of these things that
775
00:37:03,270 —> 00:37:08,100
happened to me when I was a kid and they
776
00:37:06,150 —> 00:37:10,770
don’t just ruminate about the past
777
00:37:08,100 —> 00:37:12,450
although they do that but when I say
778
00:37:10,770 —> 00:37:14,640
they’re also using the past as a
779
00:37:12,450 —> 00:37:18,779
reference point I’m saying they use the
780
00:37:14,640 —> 00:37:21,690
past to predict the future so they say
781
00:37:18,780 —> 00:37:23,880
things like I’ll never be happy
782
00:37:21,690 —> 00:37:26,200
prediction for the future why not
783
00:37:23,880 —> 00:37:28,960
because I never have been
784
00:37:26,200 —> 00:37:30,939
I’ll never get a good job why not
785
00:37:28,960 —> 00:37:32,529
because I’ve never had one I’ll never
786
00:37:30,940 —> 00:37:34,210
have a good relationship
787
00:37:32,529 —> 00:37:36,640
why not because I’ve never had one and
788
00:37:34,210 —> 00:37:39,490
of course the most popular one of all I
789
00:37:36,640 —> 00:37:44,710
won’t be happy until my parents treat me
790
00:37:39,490 —> 00:37:47,379
better when I was a kid and for as long
791
00:37:44,710 —> 00:37:49,500
as somebody gets caught up in that loop
792
00:37:47,380 —> 00:37:52,480
they’re not going anywhere
793
00:37:49,500 —> 00:37:56,529
why it becomes so incredibly important
794
00:37:52,480 —> 00:37:59,799
to convert to action and I’m constantly
795
00:37:56,529 —> 00:38:04,260
having to remind people whatever your
796
00:37:59,799 —> 00:38:07,930
history is you’re more than your history
797
00:38:04,260 —> 00:38:09,880
you’re more than your history you’re
798
00:38:07,930 —> 00:38:11,529
more than any one characteristic you’re
799
00:38:09,880 —> 00:38:13,720
more than your job you’re more than your
800
00:38:11,529 —> 00:38:16,660
title you’re more than your income
801
00:38:13,720 —> 00:38:18,700
you’re more than your body size you’re
802
00:38:16,660 —> 00:38:20,828
more than how many likes you get on
803
00:38:18,700 —> 00:38:23,950
Facebook or Instagram or any of these
804
00:38:20,829 —> 00:38:27,210
other social media things all of that
805
00:38:23,950 —> 00:38:31,000
stuff doesn’t ultimately matter and
806
00:38:27,210 —> 00:38:34,089
can’t be the basis for defining self and
807
00:38:31,000 —> 00:38:36,460
when people define themselves the thing
808
00:38:34,089 —> 00:38:38,349
that’s troublesome about having to tell
809
00:38:36,460 —> 00:38:42,369
people you’re more than your history is
810
00:38:38,349 —> 00:38:45,819
that when people learn a therapist says
811
00:38:42,369 —> 00:38:49,750
who them you are a trauma survivor you
812
00:38:45,819 —> 00:38:53,619
are an abuse survivor on one level that
813
00:38:49,750 —> 00:38:57,400
sounds very empowering on another level
814
00:38:53,619 —> 00:39:00,789
you’re literally adopting the label that
815
00:38:57,400 —> 00:39:04,319
says that you can globally define
816
00:39:00,789 —> 00:39:07,359
yourself by your unchangeable history
817
00:39:04,319 —> 00:39:10,049
the last thing you want to do is define
818
00:39:07,359 —> 00:39:14,049
yourself by your unchangeable history
819
00:39:10,049 —> 00:39:16,900
why that orientation of the future what
820
00:39:14,049 —> 00:39:20,650
the possibilities are if I could get
821
00:39:16,900 —> 00:39:25,150
every person to absorb that simple
822
00:39:20,650 —> 00:39:29,500
phrase create possibilities there aren’t
823
00:39:25,150 —> 00:39:32,200
any guarantees in life but we can take
824
00:39:29,500 —> 00:39:37,269
actions that create possibilities for
825
00:39:32,200 —> 00:39:38,620
the future there is a danger with
826
00:39:37,269 —> 00:39:42,700
rumination
827
00:39:38,620 —> 00:39:52,240
of thinking too much the unexamined life
828
00:39:42,700 —> 00:39:55,270
isn’t worth living said Socrates there
829
00:39:52,240 —> 00:39:58,120
is a danger in thinking too much and
830
00:39:55,270 —> 00:40:01,890
there’s a specific discrimination that
831
00:39:58,120 —> 00:40:05,400
has to be made when is it useful
832
00:40:01,890 —> 00:40:08,950
analysis and when is it useless
833
00:40:05,400 —> 00:40:12,250
rumination and I’ll answer the question
834
00:40:08,950 —> 00:40:13,839
for you if it doesn’t lead to timely and
835
00:40:12,250 —> 00:40:18,400
effective action
836
00:40:13,840 —> 00:40:21,730
it’s useless rumination the next risk
837
00:40:18,400 —> 00:40:24,250
factor one of the strongest ones is
838
00:40:21,730 —> 00:40:26,860
what’s called a global cognitive style
839
00:40:24,250 —> 00:40:29,500
if there is such a thing as a typical
840
00:40:26,860 —> 00:40:32,890
depressed person which obviously there
841
00:40:29,500 —> 00:40:35,820
isn’t but if there was such a thing one
842
00:40:32,890 —> 00:40:39,190
of the core features is global cognition
843
00:40:35,820 —> 00:40:43,960
global cognitive style means the person
844
00:40:39,190 —> 00:40:45,990
engages in over general thinking her
845
00:40:43,960 —> 00:40:49,690
boyfriend breaks up with her she says
846
00:40:45,990 —> 00:40:51,450
men his girlfriend breaks up with her
847
00:40:49,690 —> 00:40:54,400
women
848
00:40:51,450 —> 00:40:57,549
that’s over general thinking as if
849
00:40:54,400 —> 00:40:59,620
they’re all the same somebody has a bad
850
00:40:57,550 —> 00:41:04,450
day and they don’t say I had a bad day
851
00:40:59,620 —> 00:41:07,029
they say why is life so unfair now we
852
00:41:04,450 —> 00:41:09,970
just went from a bad day to life could
853
00:41:07,030 —> 00:41:12,070
we make it any bigger than that but what
854
00:41:09,970 —> 00:41:15,009
it translates into is when people walk
855
00:41:12,070 —> 00:41:18,280
and sit down and they say to me well all
856
00:41:15,010 —> 00:41:22,060
I want is to be happy is that too much
857
00:41:18,280 —> 00:41:25,090
to ask all I want is a good relationship
858
00:41:22,060 —> 00:41:27,670
is that too much to ask and then I’ll
859
00:41:25,090 —> 00:41:29,020
ask the specifics so what do you think
860
00:41:27,670 —> 00:41:31,720
it takes to build a good relationship
861
00:41:29,020 —> 00:41:34,650
and the person comes back with an
862
00:41:31,720 —> 00:41:37,649
equally global response when they say
863
00:41:34,650 —> 00:41:37,650
chemistry
864
00:41:38,489 —> 00:41:45,489
if you think in those global terms
865
00:41:43,109 —> 00:41:48,429
metaphorically you see the forest but
866
00:41:45,489 —> 00:41:52,419
you don’t see the trees then you can’t
867
00:41:48,429 —> 00:41:54,849
be an effective problem solver you can’t
868
00:41:52,419 —> 00:41:56,169
solve problems specifically by taking a
869
00:41:54,849 —> 00:41:59,409
global approach to it
870
00:41:56,169 —> 00:42:01,179
now this isn’t global about everything
871
00:41:59,409 —> 00:42:03,159
of course somebody can be very specific
872
00:42:01,179 —> 00:42:05,439
about the way they manage their bank
873
00:42:03,159 —> 00:42:08,319
account and very global in the way that
874
00:42:05,439 —> 00:42:10,868
they approach relationships and it’s the
875
00:42:08,319 —> 00:42:14,679
things that you don’t know about that
876
00:42:10,869 —> 00:42:18,189
you are inevitably global for a general
877
00:42:14,679 —> 00:42:21,219
understanding but you can’t learn skills
878
00:42:18,189 —> 00:42:26,169
that way if I want to teach you to drive
879
00:42:21,219 —> 00:42:30,219
a car I can’t say to you become one with
880
00:42:26,169 —> 00:42:32,408
the auto you’re gonna do a lot better if
881
00:42:30,219 —> 00:42:36,459
I say see this this is a steering wheel
882
00:42:32,409 —> 00:42:39,429
see that that’s a brake pedal to get the
883
00:42:36,459 —> 00:42:42,279
specifics and learn to think in specific
884
00:42:39,429 —> 00:42:46,419
terms is a real challenge when your
885
00:42:42,279 —> 00:42:49,029
cognitive style is a global one why it’s
886
00:42:46,419 —> 00:42:54,189
so important to have goals but goals
887
00:42:49,029 —> 00:42:59,439
have to be defined a goal without steps
888
00:42:54,189 —> 00:43:02,219
is merely a wish what that translates
889
00:42:59,439 —> 00:43:06,038
into one of the most important exercises
890
00:43:02,219 —> 00:43:09,369
is called a flow of steps this is how we
891
00:43:06,039 —> 00:43:11,949
train people to go from global to linear
892
00:43:09,369 —> 00:43:14,429
in their thinking I will give you the
893
00:43:11,949 —> 00:43:16,779
homework assignment as your therapist of
894
00:43:14,429 —> 00:43:19,599
picking something that you know how to
895
00:43:16,779 —> 00:43:21,249
do something simple you know how to
896
00:43:19,599 —> 00:43:23,649
dress yourself you know how to go
897
00:43:21,249 —> 00:43:28,169
grocery shopping you know how to take a
898
00:43:23,649 —> 00:43:33,038
shower well you don’t just take a shower
899
00:43:28,169 —> 00:43:35,679
that’s a global phrase taking a shower
900
00:43:33,039 —> 00:43:39,909
is a global phrase that represents how
901
00:43:35,679 —> 00:43:43,719
many steps involved so I will give the
902
00:43:39,909 —> 00:43:46,179
client the task of I want you to
903
00:43:43,719 —> 00:43:48,639
delineate every step involved in taking
904
00:43:46,179 —> 00:43:51,069
a shower I want you to pretend that
905
00:43:48,639 —> 00:43:53,799
somebody who’s never done it before
906
00:43:51,069 —> 00:43:56,410
is gonna follow your sequence and your
907
00:43:53,799 —> 00:43:59,709
job is to guarantee that they succeed at
908
00:43:56,410 —> 00:44:01,839
it bring it back to me next time they
909
00:43:59,709 —> 00:44:07,569
come back the next time they have three
910
00:44:01,839 —> 00:44:10,479
steps get wet lather up rinse off now if
911
00:44:07,569 —> 00:44:13,808
that’s what you think goes into taking a
912
00:44:10,479 —> 00:44:16,169
shower what does that say about your
913
00:44:13,809 —> 00:44:19,449
ability to be specific and problem-solve
914
00:44:16,170 —> 00:44:22,599
I’m the one who then has to say excuse
915
00:44:19,449 —> 00:44:25,329
me but how do you find where a shower is
916
00:44:22,599 —> 00:44:27,160
and when you find where a shower is how
917
00:44:25,329 —> 00:44:28,390
do you open the door and how do you walk
918
00:44:27,160 —> 00:44:30,069
through the door and how do you turn on
919
00:44:28,390 —> 00:44:31,808
a light switch and how do you close the
920
00:44:30,069 —> 00:44:33,969
door and do remember to take your
921
00:44:31,809 —> 00:44:36,039
clothes off and what about opening the
922
00:44:33,969 —> 00:44:37,809
shower door moving the shower curtain
923
00:44:36,039 —> 00:44:39,640
and reaching inside and turning on the
924
00:44:37,809 —> 00:44:41,380
hot and turning on the cold and then
925
00:44:39,640 —> 00:44:43,719
testing it out and then flicking the
926
00:44:41,380 —> 00:44:47,769
switch from tub to shower and by the
927
00:44:43,719 —> 00:44:49,150
time you sequence it out depending on
928
00:44:47,769 —> 00:44:50,890
your amount of detail there’s gonna be
929
00:44:49,150 —> 00:44:54,130
at least fifty steps involved in taking
930
00:44:50,890 —> 00:44:56,920
a shower and what if you miss one of
931
00:44:54,130 —> 00:44:59,140
them you didn’t know you had to flick
932
00:44:56,920 —> 00:45:01,089
the switch from tub to shower so there
933
00:44:59,140 —> 00:45:04,359
you are standing there naked watching
934
00:45:01,089 —> 00:45:08,109
water running down the drain I’m such a
935
00:45:04,359 —> 00:45:11,199
loser yeah everybody else can take a
936
00:45:08,109 —> 00:45:13,719
shower and I can’t what’s wrong with me
937
00:45:11,199 —> 00:45:16,539
and that’s the point
938
00:45:13,719 —> 00:45:19,509
once I have exhausted there’s taking a
939
00:45:16,539 —> 00:45:21,940
shower flow of steps then I give them
940
00:45:19,509 —> 00:45:23,890
the next one now that you’ve done the
941
00:45:21,940 —> 00:45:25,599
flowchart for how to take a shower now I
942
00:45:23,890 —> 00:45:29,199
want you to do the flowchart for how to
943
00:45:25,599 —> 00:45:32,910
be happy and that’s the first time the
944
00:45:29,199 —> 00:45:36,729
person realizes they have not a clue and
945
00:45:32,910 —> 00:45:38,069
then they discover instantly why it
946
00:45:36,729 —> 00:45:42,368
isn’t happening
947
00:45:38,069 —> 00:45:44,940
if you can’t sequence what you’re trying
948
00:45:42,369 —> 00:45:49,209
to do it isn’t going to happen
949
00:45:44,940 —> 00:45:51,699
this requires a very specific quality of
950
00:45:49,209 —> 00:45:54,930
thinking that global thinkers have a
951
00:45:51,699 —> 00:45:58,089
hard time doing it’s a training process
952
00:45:54,930 —> 00:46:00,940
training your brain to think in more
953
00:45:58,089 —> 00:46:04,239
linear terms in the specific areas where
954
00:46:00,940 —> 00:46:05,349
you need help otherwise all you can do
955
00:46:04,239 —> 00:46:11,130
is go glow
956
00:46:05,349 —> 00:46:13,990
men women and mists how to distinguish
957
00:46:11,130 —> 00:46:17,790
who the good ones are from who the not
958
00:46:13,990 —> 00:46:20,500
so good ones are do a flowchart for that
959
00:46:17,790 —> 00:46:21,700
okay then the last one I’m going to
960
00:46:20,500 —> 00:46:26,369
speak to quickly
961
00:46:21,700 —> 00:46:29,109
the unrealistic expectations our
962
00:46:26,369 —> 00:46:33,160
expectations are the filter for how we
963
00:46:29,109 —> 00:46:35,740
judge everything if I’m doing what you
964
00:46:33,160 —> 00:46:37,420
think I should do as a speaker talking
965
00:46:35,740 —> 00:46:40,299
about depression tonight then you’re
966
00:46:37,420 —> 00:46:41,920
very happy with me if I’m not doing what
967
00:46:40,300 —> 00:46:45,280
you think I should do then you’re not
968
00:46:41,920 —> 00:46:47,830
happy with me our expectations are the
969
00:46:45,280 —> 00:46:50,710
filters for how we make judgments about
970
00:46:47,830 —> 00:46:52,660
anything whether it’s a movie that we
971
00:46:50,710 —> 00:46:54,940
see whether it’s a restaurant that we go
972
00:46:52,660 —> 00:47:00,040
to whether it’s a party that we go to
973
00:46:54,940 —> 00:47:03,089
and it begs the question how do you know
974
00:47:00,040 —> 00:47:06,190
whether your expectations are realistic
975
00:47:03,089 —> 00:47:08,920
what happens so commonly as a pathway
976
00:47:06,190 —> 00:47:11,080
into depression for so many is that they
977
00:47:08,920 —> 00:47:13,330
have unrealistic expectations they don’t
978
00:47:11,080 —> 00:47:15,160
know they have unrealistic expectations
979
00:47:13,330 —> 00:47:20,920
so they’re always walking around hurt
980
00:47:15,160 —> 00:47:23,379
and disappointed I swear to God every
981
00:47:20,920 —> 00:47:27,790
morning I want to call the White House
982
00:47:23,380 —> 00:47:30,240
and say let me talk to Milania and get
983
00:47:27,790 —> 00:47:33,540
her on the phone and say Milania I
984
00:47:30,240 —> 00:47:36,009
understand why you value fidelity I
985
00:47:33,540 —> 00:47:39,430
understand why faithfulness in the
986
00:47:36,010 —> 00:47:43,630
relationship matters to you but look at
987
00:47:39,430 —> 00:47:45,879
who you’re married to the closest this
988
00:47:43,630 —> 00:47:50,920
guy’s gonna come to say no to someone is
989
00:47:45,880 —> 00:47:52,030
when he says not how we’re landing what
990
00:47:50,920 —> 00:47:59,859
she wants
991
00:47:52,030 —> 00:48:03,869
makes sense but not from him if you
992
00:47:59,859 —> 00:48:07,660
really loved me you’d win the lottery
993
00:48:03,869 —> 00:48:10,570
she doesn’t look so happy and what I’m
994
00:48:07,660 —> 00:48:13,500
really curious about is his response to
995
00:48:10,570 —> 00:48:16,990
it I’d love to hear what he says next
996
00:48:13,500 —> 00:48:18,180
does he say to her your expectations are
997
00:48:16,990 —> 00:48:20,970
a little off since on
998
00:48:18,180 —> 00:48:22,710
the one in control of the lottery or is
999
00:48:20,970 —> 00:48:24,629
he gonna say I wonder if that’s true
1000
00:48:22,710 —> 00:48:26,100
maybe I don’t love you enough maybe I
1001
00:48:24,630 —> 00:48:28,890
don’t know how to love maybe I’m
1002
00:48:26,100 —> 00:48:32,640
defective emotionally maybe I don’t go
1003
00:48:28,890 —> 00:48:37,220
off into a whole thing about his ability
1004
00:48:32,640 —> 00:48:41,180
to love so when we look at how important
1005
00:48:37,220 —> 00:48:44,370
expectations are it’s a really good idea
1006
00:48:41,180 —> 00:48:47,069
before you walk into your professor’s
1007
00:48:44,370 —> 00:48:49,980
office before you ask for a friend for a
1008
00:48:47,070 —> 00:48:52,380
favor before you ask your boss for a
1009
00:48:49,980 —> 00:48:54,510
special consideration before you ask
1010
00:48:52,380 —> 00:48:56,670
your husband or wife or boyfriend or
1011
00:48:54,510 —> 00:48:59,490
girlfriend or partner for whatever it is
1012
00:48:56,670 —> 00:49:03,030
you want it would first be really nice
1013
00:48:59,490 —> 00:49:05,100
to know can this person do this is this
1014
00:49:03,030 —> 00:49:08,100
a part of this person’s makeup is it
1015
00:49:05,100 —> 00:49:10,680
realistic to expect that this person can
1016
00:49:08,100 —> 00:49:14,040
do honesty or that they can do integrity
1017
00:49:10,680 —> 00:49:15,870
or that they can do patience or anything
1018
00:49:14,040 —> 00:49:18,240
else that you would want from this
1019
00:49:15,870 —> 00:49:20,069
person how often people get into
1020
00:49:18,240 —> 00:49:22,799
relationships with other people and
1021
00:49:20,070 —> 00:49:25,050
they’re forever pulling on them you know
1022
00:49:22,800 —> 00:49:27,420
I want affection you never give me
1023
00:49:25,050 —> 00:49:30,560
affection well you know the fact that
1024
00:49:27,420 —> 00:49:33,030
you’re dating mr. Spock poses a problem
1025
00:49:30,560 —> 00:49:34,110
you’ve got to know who you’re dealing
1026
00:49:33,030 —> 00:49:37,050
with and what that whether the
1027
00:49:34,110 —> 00:49:39,620
expectations are realistic before you
1028
00:49:37,050 —> 00:49:42,300
walk into a situation that’s charged
1029
00:49:39,620 —> 00:49:46,950
before you walk into a job interview
1030
00:49:42,300 —> 00:49:48,960
before anything lay it out what are your
1031
00:49:46,950 —> 00:49:51,779
expectations how do you know whether
1032
00:49:48,960 —> 00:49:54,150
this is realistic or not if you get good
1033
00:49:51,780 —> 00:49:58,020
at doing that you will save yourself a
1034
00:49:54,150 —> 00:50:00,630
lot of disappointment well I mentioned
1035
00:49:58,020 —> 00:50:02,520
just in passing the thing that impresses
1036
00:50:00,630 —> 00:50:05,580
me the most about all the things I’m
1037
00:50:02,520 —> 00:50:07,740
talking about to you is that when we
1038
00:50:05,580 —> 00:50:10,380
have integrated these things into
1039
00:50:07,740 —> 00:50:13,169
prevention programs the very skills that
1040
00:50:10,380 —> 00:50:15,450
I’m talking to you about now when we
1041
00:50:13,170 —> 00:50:18,750
have run prevention programs with
1042
00:50:15,450 —> 00:50:21,899
high-risk populations and been able to
1043
00:50:18,750 —> 00:50:24,360
demonstrate very scientifically that
1044
00:50:21,900 —> 00:50:26,400
when people learn these skills their
1045
00:50:24,360 —> 00:50:29,430
vulnerability to depression drops
1046
00:50:26,400 —> 00:50:31,589
dramatically so for example we did a
1047
00:50:29,430 —> 00:50:34,198
program that lasted six
1048
00:50:31,589 —> 00:50:36,509
months with elementary school kids who
1049
00:50:34,199 —> 00:50:38,279
were at high risk high risk because they
1050
00:50:36,509 —> 00:50:40,890
came from very unstable family
1051
00:50:38,279 —> 00:50:44,640
environments divorce violence abuse all
1052
00:50:40,890 —> 00:50:48,209
kinds of things that were really bad in
1053
00:50:44,640 —> 00:50:50,788
these kids lives and for two hours
1054
00:50:48,209 —> 00:50:52,999
every other week for six months total of
1055
00:50:50,789 —> 00:50:56,459
24 hours these kids were trained in
1056
00:50:52,999 —> 00:50:58,709
problem-solving social skills and then
1057
00:50:56,459 —> 00:51:01,288
we followed these kids for almost ten
1058
00:50:58,709 —> 00:51:03,390
years they had less than half the rate
1059
00:51:01,289 —> 00:51:05,640
of depression less than half the rate of
1060
00:51:03,390 —> 00:51:08,219
teenage pregnancy less than half the
1061
00:51:05,640 —> 00:51:10,949
rate of drug abuse as the kids who did
1062
00:51:08,219 —> 00:51:13,739
not go through the program that’s
1063
00:51:10,949 —> 00:51:16,650
impressive and that’s 24 hours worth of
1064
00:51:13,739 —> 00:51:18,509
basic teaching of skills these skills
1065
00:51:16,650 —> 00:51:21,359
that I’m talking to you about tonight
1066
00:51:18,509 —> 00:51:24,809
not only have treatment value they have
1067
00:51:21,359 —> 00:51:28,348
prevention value well let me highlight
1068
00:51:24,809 —> 00:51:31,279
for you then some very direct advice to
1069
00:51:28,349 —> 00:51:34,259
bring let this lecture to a close
1070
00:51:31,279 —> 00:51:37,559
getting professional help is an
1071
00:51:34,259 —> 00:51:41,400
important thing to do you don’t know
1072
00:51:37,559 —> 00:51:43,499
your own blind spots you’re blind to
1073
00:51:41,400 —> 00:51:45,119
your own blind spots the stuff that you
1074
00:51:43,499 —> 00:51:47,218
struggle with and struggle with and
1075
00:51:45,119 —> 00:51:48,569
struggle with you go see somebody who
1076
00:51:47,219 —> 00:51:50,160
knows what they’re talking about and
1077
00:51:48,569 —> 00:51:51,390
they can say in five minutes here’s what
1078
00:51:50,160 —> 00:51:54,269
you’re missing here’s what we can do
1079
00:51:51,390 —> 00:51:56,038
about it problem solved it’s not always
1080
00:51:54,269 —> 00:51:56,879
that easy by any stretch of the
1081
00:51:56,039 —> 00:51:59,699
imagination
1082
00:51:56,880 —> 00:52:02,670
but the point being there’s a good value
1083
00:51:59,699 —> 00:52:03,509
and having trained eyes and ears on what
1084
00:52:02,670 —> 00:52:05,099
you’re dealing with
1085
00:52:03,509 —> 00:52:07,880
so how do you know when you need
1086
00:52:05,099 —> 00:52:09,709
professional help first and foremost
1087
00:52:07,880 —> 00:52:12,630
suicidal thoughts
1088
00:52:09,709 —> 00:52:16,140
somebody’s even remotely contemplating
1089
00:52:12,630 —> 00:52:19,009
that that is the first cue you need help
1090
00:52:16,140 —> 00:52:21,660
now before you do something impulsive
1091
00:52:19,009 —> 00:52:24,989
secondly when you’re feeling stuck and
1092
00:52:21,660 —> 00:52:27,149
hopeless when you don’t have the support
1093
00:52:24,989 —> 00:52:30,779
or people around you that you can
1094
00:52:27,150 —> 00:52:33,390
reality test with before it reaches a
1095
00:52:30,779 —> 00:52:36,150
crisis point how often people wait until
1096
00:52:33,390 —> 00:52:36,979
everything’s in flames and then they go
1097
00:52:36,150 —> 00:52:39,749
get help
1098
00:52:36,979 —> 00:52:41,879
well you don’t have to wait until it’s
1099
00:52:39,749 —> 00:52:43,669
in flames how about you take care of it
1100
00:52:41,880 —> 00:52:48,109
before things get worse
1101
00:52:43,670 —> 00:52:51,160
that requires foresight the ability to
1102
00:52:48,109 —> 00:52:54,890
make good decisions I have emphasized
1103
00:52:51,160 —> 00:52:55,970
when you have to make big decisions am I
1104
00:52:54,890 —> 00:52:57,650
going to go to this school or that
1105
00:52:55,970 —> 00:52:59,149
school am I gonna live here live there
1106
00:52:57,650 —> 00:53:01,040
am I gonna marry this person am I going
1107
00:52:59,150 —> 00:53:03,650
to move in with this person shall we put
1108
00:53:01,040 —> 00:53:05,808
have mom live with us or not live with
1109
00:53:03,650 —> 00:53:08,240
us should I take this job in another
1110
00:53:05,809 —> 00:53:10,040
city what should I do you have big
1111
00:53:08,240 —> 00:53:11,270
decisions to make you really don’t want
1112
00:53:10,040 —> 00:53:13,880
to make them through the filter of
1113
00:53:11,270 —> 00:53:16,549
depression I spoke about how depression
1114
00:53:13,880 —> 00:53:19,220
affects the quality of decision-making
1115
00:53:16,549 —> 00:53:22,819
good idea to have somebody else to
1116
00:53:19,220 —> 00:53:26,180
reality test with when you know that
1117
00:53:22,819 —> 00:53:28,880
you’re affecting other people the only
1118
00:53:26,180 —> 00:53:32,990
responsible thing to do is to get help
1119
00:53:28,880 —> 00:53:35,690
so you are not contaminating them every
1120
00:53:32,990 —> 00:53:38,569
depressed person on average affects at
1121
00:53:35,690 —> 00:53:41,359
least three other people negatively and
1122
00:53:38,569 —> 00:53:44,240
if you know that that depression makes
1123
00:53:41,359 —> 00:53:47,569
you irritable and angry and over
1124
00:53:44,240 —> 00:53:49,669
reactive and critical and harsh and all
1125
00:53:47,569 —> 00:53:52,279
the nasty things that come out of people
1126
00:53:49,670 —> 00:53:54,410
when they’re not feeling good you owe it
1127
00:53:52,280 —> 00:53:56,390
to the people that are in your sphere of
1128
00:53:54,410 —> 00:54:01,368
influence to make sure you get the help
1129
00:53:56,390 —> 00:54:04,970
that you need it’s important to shop for
1130
00:54:01,369 —> 00:54:06,380
a therapist like any field would matter
1131
00:54:04,970 —> 00:54:08,808
if we’re talking about plumbers or
1132
00:54:06,380 —> 00:54:10,940
electricians in any field there are
1133
00:54:08,809 —> 00:54:13,760
people who are more well trained people
1134
00:54:10,940 —> 00:54:16,609
who are better skilled people who have
1135
00:54:13,760 —> 00:54:19,700
more experience and it means that your
1136
00:54:16,609 —> 00:54:23,990
job is going to be to shop and to have
1137
00:54:19,700 —> 00:54:26,359
the kinds of questions handy that you
1138
00:54:23,990 —> 00:54:28,129
need to have answered is this person
1139
00:54:26,359 —> 00:54:29,720
experienced with depression what is
1140
00:54:28,130 —> 00:54:32,569
their general approach to it what’s
1141
00:54:29,720 —> 00:54:34,520
their style how active are they in the
1142
00:54:32,569 —> 00:54:37,369
treatment process will they assign
1143
00:54:34,520 —> 00:54:40,579
homework to you will they involve other
1144
00:54:37,369 —> 00:54:42,680
people couples work family work other
1145
00:54:40,579 —> 00:54:45,170
people who are involved in this problem
1146
00:54:42,680 —> 00:54:47,000
for you are they available for
1147
00:54:45,170 —> 00:54:49,819
appointments how do what do they charge
1148
00:54:47,000 —> 00:54:52,220
how long are their sessions that’s what
1149
00:54:49,819 —> 00:54:54,980
I mean by shopping to have plenty of
1150
00:54:52,220 —> 00:54:57,169
questions ready for as you interview
1151
00:54:54,980 —> 00:54:57,530
different therapists for who you click
1152
00:54:57,170 —> 00:55:00,110
with
1153
00:54:57,530 —> 00:55:03,470
who you discover just by talking with
1154
00:55:00,110 —> 00:55:05,390
them you can tell that there’s some some
1155
00:55:03,470 —> 00:55:09,080
juice there that that you want to be
1156
00:55:05,390 —> 00:55:11,060
with this person so I gave you all these
1157
00:55:09,080 —> 00:55:13,520
things about choosing a therapist let me
1158
00:55:11,060 —> 00:55:16,970
just give you the last couple of slides
1159
00:55:13,520 —> 00:55:20,050
of very specific bullet point pieces of
1160
00:55:16,970 —> 00:55:25,129
advice if you’re dealing with depression
1161
00:55:20,050 —> 00:55:28,070
first get a thorough physical exam when
1162
00:55:25,130 —> 00:55:30,200
I say that biology matters this is the
1163
00:55:28,070 —> 00:55:32,150
starting place to make sure that there
1164
00:55:30,200 —> 00:55:34,129
isn’t anything going on medically that
1165
00:55:32,150 —> 00:55:39,290
would give rise to depression as a
1166
00:55:34,130 —> 00:55:42,410
consequence avoid alcohol completely yes
1167
00:55:39,290 —> 00:55:44,779
you strive to learn about your
1168
00:55:42,410 —> 00:55:47,450
vulnerabilities and develop ways to
1169
00:55:44,780 —> 00:55:49,100
manage them what are your specific risk
1170
00:55:47,450 —> 00:55:51,589
factors what are the things that you’re
1171
00:55:49,100 —> 00:55:54,770
reactive to that other people are not
1172
00:55:51,590 —> 00:55:58,550
particularly reactive to learn to
1173
00:55:54,770 —> 00:56:02,960
distinguish facts from feelings beliefs
1174
00:55:58,550 —> 00:56:05,270
from facts sleep is such a critically
1175
00:56:02,960 —> 00:56:06,740
important issue it’s the number one
1176
00:56:05,270 —> 00:56:09,680
complaint of people who suffer
1177
00:56:06,740 —> 00:56:13,100
depression how it affects their quality
1178
00:56:09,680 —> 00:56:15,290
of sleep creates insomnia no surprise
1179
00:56:13,100 —> 00:56:18,500
then that fatigue is the second most
1180
00:56:15,290 —> 00:56:20,630
common complaint a very important thing
1181
00:56:18,500 —> 00:56:23,750
to be able to take sleep seriously
1182
00:56:20,630 —> 00:56:26,570
sleeping with your smartphone not a good
1183
00:56:23,750 —> 00:56:29,390
idea having your computer on not a good
1184
00:56:26,570 —> 00:56:31,430
idea having roommates that are blasting
1185
00:56:29,390 —> 00:56:33,920
Jimmy Hendrix at 3:00 in the morning not
1186
00:56:31,430 —> 00:56:36,520
a good idea being very very careful
1187
00:56:33,920 —> 00:56:40,580
about the environment you create
1188
00:56:36,520 —> 00:56:43,640
challenge yourself 50 times a day here’s
1189
00:56:40,580 —> 00:56:45,380
what I think how do I know reality
1190
00:56:43,640 —> 00:56:50,210
testing such a critically important
1191
00:56:45,380 —> 00:56:52,640
skill exercise easy available it works
1192
00:56:50,210 —> 00:56:54,380
and part of the reason it works is not
1193
00:56:52,640 —> 00:56:57,230
just because of the neurochemical that
1194
00:56:54,380 —> 00:56:59,120
hypothesis is a reasonable one but the
1195
00:56:57,230 —> 00:57:01,490
other thing about exercise is the gains
1196
00:56:59,120 —> 00:57:03,529
are to be made very quickly you start
1197
00:57:01,490 —> 00:57:06,770
exercising today you can barely walk
1198
00:57:03,530 —> 00:57:09,360
half a block and you stay with it in two
1199
00:57:06,770 —> 00:57:11,700
weeks from now you’re walking a mile
1200
00:57:09,360 —> 00:57:13,620
games happen very quickly and for people
1201
00:57:11,700 —> 00:57:16,200
who typically have low frustration
1202
00:57:13,620 —> 00:57:19,440
tolerance this is a good way to get
1203
00:57:16,200 —> 00:57:22,020
ahead relatively quickly do fun things
1204
00:57:19,440 —> 00:57:24,180
and do them often one of the first
1205
00:57:22,020 —> 00:57:26,940
things to go when somebody’s depressed
1206
00:57:24,180 —> 00:57:28,770
is their sense of humor there’s nothing
1207
00:57:26,940 —> 00:57:33,840
worse than when you crack a joke to
1208
00:57:28,770 —> 00:57:38,550
somebody in their response to it is and
1209
00:57:33,840 —> 00:57:41,330
it ends there to do fun things to follow
1210
00:57:38,550 —> 00:57:48,210
the motto that at least some of the time
1211
00:57:41,330 —> 00:57:52,100
dare to be superficial get and stay
1212
00:57:48,210 —> 00:57:54,930
connected to other people learn to relax
1213
00:57:52,100 —> 00:57:57,569
relaxation processes meditation
1214
00:57:54,930 —> 00:58:00,870
visualization guided imagery hypnosis
1215
00:57:57,570 —> 00:58:05,160
any kind of relaxation process is going
1216
00:58:00,870 —> 00:58:07,890
to be beneficial being goal-oriented in
1217
00:58:05,160 —> 00:58:10,259
the important areas of your life but
1218
00:58:07,890 —> 00:58:12,660
again they have to be realistic goals if
1219
00:58:10,260 —> 00:58:14,370
you can’t do the flow of steps if you
1220
00:58:12,660 —> 00:58:17,220
don’t know what the steps are
1221
00:58:14,370 —> 00:58:20,089
then you’re caught up in that you wish
1222
00:58:17,220 —> 00:58:23,370
but you don’t really have a plan
1223
00:58:20,090 —> 00:58:26,550
prioritize and problem-solve get support
1224
00:58:23,370 —> 00:58:29,520
get help don’t wait if I’m going to talk
1225
00:58:26,550 —> 00:58:33,570
about the things to do I might as well
1226
00:58:29,520 —> 00:58:37,470
talk about the things not to do don’t
1227
00:58:33,570 —> 00:58:41,520
dwell on the past it’s gone but tomorrow
1228
00:58:37,470 —> 00:58:43,379
hasn’t happened yet really focus on what
1229
00:58:41,520 —> 00:58:45,570
can I do that’ll be different in the
1230
00:58:43,380 —> 00:58:48,780
future that’ll change how I feel about
1231
00:58:45,570 —> 00:58:50,520
the past don’t compare yourself to
1232
00:58:48,780 —> 00:58:53,550
others this is one of the worst things
1233
00:58:50,520 —> 00:58:55,980
about social media if you watch social
1234
00:58:53,550 —> 00:58:58,650
media if you participate in social media
1235
00:58:55,980 —> 00:59:01,530
how easy it is to conclude everyone else
1236
00:58:58,650 —> 00:59:04,020
is having fun everyone else is lovable
1237
00:59:01,530 —> 00:59:06,270
everyone else is popular everyone else
1238
00:59:04,020 —> 00:59:10,200
is going places that are cool everyone
1239
00:59:06,270 —> 00:59:12,960
else is and I’m not guaranteed pathway
1240
00:59:10,200 —> 00:59:15,299
into feeling lousy comparing yourself to
1241
00:59:12,960 —> 00:59:18,570
other people particularly when you don’t
1242
00:59:15,300 —> 00:59:19,980
have any information you know you can’t
1243
00:59:18,570 —> 00:59:22,290
look at a picture and say that that’s
1244
00:59:19,980 —> 00:59:23,740
this person’s life that’s global
1245
00:59:22,290 —> 00:59:26,630
thinking
1246
00:59:23,740 —> 00:59:31,700
don’t catastrophize it helps to
1247
00:59:26,630 —> 00:59:34,400
understand the probabilities don’t leave
1248
00:59:31,700 —> 00:59:37,330
important things unsaid or unresolved
1249
00:59:34,400 —> 00:59:42,500
closure counts for a lot
1250
00:59:37,330 —> 00:59:47,390
don’t analyze too deeply move on don’t
1251
00:59:42,500 —> 00:59:50,330
ignore reality get the facts don’t
1252
00:59:47,390 —> 00:59:53,509
ignore your own needs self-care is not
1253
00:59:50,330 —> 00:59:55,700
the same as being selfish you’re the
1254
00:59:53,510 —> 01:00:01,100
only one who can manage yourself and
1255
00:59:55,700 —> 01:00:03,740
here’s a key point no mood expert that I
1256
01:00:01,100 —> 01:00:07,220
know of would ever talk about curing
1257
01:00:03,740 —> 01:00:10,040
depression keep this point from this
1258
01:00:07,220 —> 01:00:13,250
lecture the goal is not to cure
1259
01:00:10,040 —> 01:00:18,230
depression the goal is to learn how to
1260
01:00:13,250 —> 01:00:22,190
manage your moods death phrase manage
1261
01:00:18,230 —> 01:00:23,930
your moods you don’t exercise once and
1262
01:00:22,190 —> 01:00:26,180
now you’re done with the exercise thing
1263
01:00:23,930 —> 01:00:27,500
you don’t discipline your kid once and
1264
01:00:26,180 —> 01:00:30,259
now you’re done with the parenting thing
1265
01:00:27,500 —> 01:00:32,020
you don’t make a bank deposit once and
1266
01:00:30,260 —> 01:00:34,850
now you’re done with the banking thing
1267
01:00:32,020 —> 01:00:38,450
these are things you have to manage
1268
01:00:34,850 —> 01:00:42,140
every day of your life and managing your
1269
01:00:38,450 —> 01:00:45,649
mood requires the skills psychologists
1270
01:00:42,140 —> 01:00:49,220
call it self-regulation but the simple
1271
01:00:45,650 —> 01:00:52,070
phrase managing your mood counts it’s
1272
01:00:49,220 —> 01:00:55,220
what I’m really speaking about it helps
1273
01:00:52,070 —> 01:00:59,120
to have a realistic expectation who gets
1274
01:00:55,220 —> 01:01:01,930
depressed everybody everybody’s
1275
01:00:59,120 —> 01:01:06,520
vulnerable if you are capable of moods
1276
01:01:01,930 —> 01:01:09,379
you’re capable of mood disorders
1277
01:01:06,520 —> 01:01:12,400
learning how to manage that aspect of
1278
01:01:09,380 —> 01:01:16,490
yourself is so critically important
1279
01:01:12,400 —> 01:01:19,220
don’t give up or be passive try again
1280
01:01:16,490 —> 01:01:22,339
but do something different don’t isolate
1281
01:01:19,220 —> 01:01:26,509
find good people to be with and don’t
1282
01:01:22,340 —> 01:01:30,530
leave time unstructured there is so so
1283
01:01:26,510 —> 01:01:33,650
much more I could say I feel like I have
1284
01:01:30,530 —> 01:01:34,540
hit many of the key things to get across
1285
01:01:33,650 —> 01:01:38,170
to you
1286
01:01:34,540 —> 01:01:40,900
I hope you feel the same way well
1287
01:01:38,170 —> 01:01:43,300
Michael it’s difficult to believe that
1288
01:01:40,900 —> 01:01:46,600
our time has already come to an end it’s
1289
01:01:43,300 —> 01:01:48,340
really been an experience of time
1290
01:01:46,600 —> 01:01:51,670
distortion in this room it’s been a
1291
01:01:48,340 —> 01:01:55,650
fascinating overview of depression join
1292
01:01:51,670 —> 01:01:55,650
me in thanking Michael we have a
1293
01:01:57,260 —> 01:02:01,780
[Music]
1294
01:01:58,310 —> 01:02:01,779
[Applause]
1295
01:02:07,080 —> 01:02:12,610
Australia that you can take that ah
1296
01:02:10,050 —> 01:02:21,610
thanks so much Anthony it has been a
1297
01:02:12,610 —> 01:02:24,130
pleasure thank you it’s a Porsche thank
1298
01:02:21,610 —> 01:02:25,540
you so much I appreciate it a lot thanks
1299
01:02:24,130 —> 01:02:27,290
for coming out tonight everybody I hope
1300
01:02:25,540 —> 01:02:33,900
it was useful for thank you for coming
1301
01:02:27,290 —> 01:02:33,900
[Applause]