How to recover from depression

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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
00:12:37,760 —> 00:12:43,819
structure family coping styles family

269
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atmosphere and depression and leave it

270
00:12:43,820 —> 00:12:47,900
in general for the moment there are some

271
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very significant factors that operate in

272
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that arena it’s why I wrote the book

273
00:12:50,420 —> 00:12:56,030
depression is contagious because these

274
00:12:53,300 —> 00:12:57,589
factors now are being recognized across

275
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a variety of fields

276
00:12:57,590 —> 00:13:03,470
so to summarize that point how important

277
00:13:01,670 —> 00:13:07,430
it is to appreciate and have a

278
00:13:03,470 —> 00:13:11,300
multi-dimensional viewpoint yes biology

279
00:13:07,430 —> 00:13:12,599
matters but surprisingly not as much as

280
00:13:11,300 —> 00:13:15,209
you would think

281
00:13:12,600 —> 00:13:16,769
that when we look at what’s termed

282
00:13:15,209 —> 00:13:19,920
genetic variance

283
00:13:16,769 —> 00:13:23,839
how much do genes play a role in

284
00:13:19,920 —> 00:13:26,759
depression is there a depression gene no

285
00:13:23,839 —> 00:13:30,480
are there genes that make people

286
00:13:26,759 —> 00:13:34,529
vulnerable to depression definitely and

287
00:13:30,480 —> 00:13:38,310
so if we look at biochemistry yes it’s a

288
00:13:34,529 —> 00:13:40,740
factor if we look at disease processes

289
00:13:38,310 —> 00:13:43,589
there are many diseases where depression

290
00:13:40,740 —> 00:13:47,220
is a predictable consequence if we look

291
00:13:43,589 —> 00:13:50,449
at drugs there are many drugs that have

292
00:13:47,220 —> 00:13:53,430
depression as a predictable side effect

293
00:13:50,449 —> 00:13:55,649
biology matters but when we look at

294
00:13:53,430 —> 00:13:58,079
genetic variance that figures between

295
00:13:55,649 —> 00:14:01,170
point three and point four there

296
00:13:58,079 —> 00:14:04,739
represents a mild moderate at best

297
00:14:01,170 —> 00:14:07,189
genetic influence so when we look at the

298
00:14:04,740 —> 00:14:09,600
site power the psychological factors

299
00:14:07,190 —> 00:14:12,300
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
00:14:14,850 —> 00:14:20,610
that are in the domain of individual

303
00:14:18,089 —> 00:14:22,470
psychology another one that I mentioned

304
00:14:20,610 —> 00:14:26,009
just a moment ago attributional style

305
00:14:22,470 —> 00:14:29,430
the person’s habitual or reflexive way

306
00:14:26,009 —> 00:14:33,269
of attaching meaning to life events and

307
00:14:29,430 —> 00:14:34,920
that the social side of the equation as

308
00:14:33,269 —> 00:14:38,149
we’ve learned from studies of

309
00:14:34,920 —> 00:14:41,339
depressions prevalence a field called

310
00:14:38,149 —> 00:14:43,500
epidemiology this has been particularly

311
00:14:41,339 —> 00:14:46,380
revealing I don’t know if you saw the

312
00:14:43,500 —> 00:14:51,300
the big announcement last year from the

313
00:14:46,380 —> 00:14:53,759
World Health Organization well in 2004

314
00:14:51,300 —> 00:14:56,459
the World Health Organization which

315
00:14:53,759 —> 00:14:58,370
monitors health issues of all types

316
00:14:56,459 —> 00:15:02,399
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
00:15:05,670 —> 00:15:11,550
Organization declared depression the

320
00:15:08,220 —> 00:15:16,529
number four cause of human suffering and

321
00:15:11,550 —> 00:15:19,979
disability behind cancer heart disease

322
00:15:16,529 —> 00:15:24,029
and traffic accidents they predicted in

323
00:15:19,980 —> 00:15:25,630
2004 that by the year 2020 depression

324
00:15:24,029 —> 00:15:29,380
would rise to be

325
00:15:25,630 —> 00:15:34,300
number two in fact depression reached

326
00:15:29,380 —> 00:15:37,960
number two in late 2013 last year just

327
00:15:34,300 —> 00:15:40,990
around this time depression was declared

328
00:15:37,960 —> 00:15:43,990
the number one cause of human suffering

329
00:15:40,990 —> 00:15:46,660
and disability and the numbers are

330
00:15:43,990 —> 00:15:49,180
increasing there is no demographic group

331
00:15:46,660 —> 00:15:51,400
where the numbers are going down in

332
00:15:49,180 —> 00:15:54,089
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]