HealthyGamerGG - The Cycle of Depression

Episode Date: August 5, 2022

Today Dr. K talks about the relationships between pessimistic thoughts and depression, identity and ego, and more! Support this podcast at — https://redcircle.com/healthygamergg/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy Learn more about your ad choices. Visit megaphone.fm/adchoices

The last thing is spend more time with yourself and spend less time with the person that you pretend to be. That's a healthy way to build your identity. Does depression cause pessimistic thoughts, or do pessimistic thoughts cause depression? This sounds a bit like the chicken or the egg. I'm trying to figure out, but I want to hear what you have to say. The answer might be obvious. Someone who knows more about it or both scenarios may exist.

I don't know. I'm thinking of someone that doesn't have any serious trauma, but still develop something that causes that person to be sad. This is a great question. I love this question because this is the kind of thing that I think we should teach everybody. It's not about clinical stuff. It's not about diagnosis or treatment or things like that. But what is the fundamental relationship between having thoughts and whether they cause depression? So does thinking pessimistically make me depressed?

Or are my pessimistic thoughts a source of the depression? Because if we're struggling with feeling sad, it's like really important to understand, right? Because like if you're feeling sad, is this something that is a distortion of my mind that is being created out of my depression? Because if that's the case, that means that I don't trust my sad thoughts. Or do my sad thoughts come first? And if they come first, do they trigger my depression? So it's not that I shouldn't trust my thought, it's that there may be something that I need to do

to prevent my pessimistic thoughts from making me depressed. Because the tricky thing is that, like, you don't know what to believe, right? Like, are the thoughts real, and then like I'm just not handling them properly, which is why I'm getting depressed? Or are the thoughts of creation of this cognitive distortion?

Because it leads to like two very different things. Like, do I need to be managing my thoughts better? Like, do I need to fix things? the way that I deal with my thoughts so that they don't make me depressed? Or are they coming from such a toxic place that I need to learn how to step away from the whole thing entirely? So it's a great question. And it's confusing for people because we don't, you know, we don't really explain the stuff. So let's understand a couple of things. Okay? There's a lot of detail about some of the stuff we're going to talk about today in Dr. Kay's guide to depression, but we're going to go over

a couple of core things. So this is what we know clinically. Sometimes we're going to be. We're we have circumstances. Circumstances make us feel sad. We have bad thoughts, pessimistic. And then what can happen is we can feel depressed. So let's just call this a depressive episode. So we're talking about clinically here, okay? So an episode of major depressive disorder. This isn't feeling depressed. Now, how do we know that this is a depressive episode? How do we know that this is a clinical thing as opposed to an appropriate response? to our circumstances. Well, there's something really interesting about depressive episodes.

If circumstances improve or even resolve, if these are the cause of the sad thoughts, what this means is that sad thoughts should go away. So what we tend to find in a depressive episode is that even if circumstances resolve, and what was making you sad in the first place does not make you sad anymore, the depressive thoughts remain. Now, this isn't for all people, but we do know that circumstances can trigger depressive episodes. So psychosocial stressors, setbacks in life, sources of stress, things like that, can trigger a depressive episode.

But the interesting thing about the depressive episode is once you get to this point, it has a life of its own. And even if the circumstances resolve, the sadness remains or the impairment and function remains. Okay? This is the case of a clinical depression. Now, once again, an oversimplification, but this is one of the hallmarks of it, right? So, like, how do you know if someone is clinically depressed? One of the key things that I look for as a clinician is seeing, are they distressed despite their circumstances or are they depressed because of their circumstances? And when I see depression despite your circumstances, i.e. you're in a good relationship,

your job is going well, et cetera, et cetera, et cetera. It's more likely to be a clinical illness. Now, let's dive in a little bit further. So let's try to understand if the circumstances are fixed, why does this continue? And this is where we can expand a little bit beyond the cope of clinical depression. We can still lean on it. We're going to take some important learnings away from it, but we're going to start to understand a little bit more in general about how the mind works. So our mind has a very, very important part, or our brain has something called the default mode network. Also a whole video about this and Dr. Kay's guide.

The default mode network is what allows us to self-reflect. think about ourselves and essentially form an identity. So I'll tell you all why this is really important. So let's say I go fruit picking and I climb up into a tree and I fall and I hurt myself. And then let's say I go fruit picking again and I climb and I fall and I hurt myself. and then I'm walking, let's say I'm trying to get into a boat, and I fall, and I hurt myself, and I fall under the water. At some point, there are all of these individual experiences,

which my mind will then reflect on and will come to a meta-level conclusion. I'm clumsy. Once I have this sense of identity from these different experiences, this then informs the, way that I move forward. So if someone asks me, hey, Oloke, do you want to come help me replace shingles on the roof? I've never replaced shingles on the roof. I don't really know. Like, I've never had

a negative experience with that. But once the default mode network tells me that I'm clumsy, I can use that simplification of identity to inform what I should do and what I shouldn't do. So I'm going to say no, because I'm clumsy. You'll see that? So developing an identity that is a simplified version of yourself makes it easy on the mind because you don't, it's heuristic. It aids in processing information and making decisions. So this is what happens. I'm not talking about clinical depression, but now we're going to talk just about generally when people feel sad and they feel, quote, unquote, depressed, whether it's clinical or non-clin. So similar thing happens.

So I've got a particular thought that's negative. let's say sad thought, fearful thought, bad outcome. And then what happens is I form an identity. And in clinical depression, what we call this is negative self-aditude. So it's just some kind of attitude towards the self that's negative in nature. So either I'm hopeless or I think I'm incompetent or like I'm not good at something or other people are better than me or something, whatever. So we form some kind of negative identity.

Now here's what people need to understand about identity. So once we have, and now we're going to lean on yoga a little bit. So once we have an identity or ego slash ahmkar, what this actually does is creates a filter for experiences. So let's say that I think I'm clumsy. If someone I'm walking down the street, someone trips and falls, and they drop their child, and I catch their child. Right? So I have a very positive experience where clearly I'm not clumsy.

I'm like reflexive. I'm like, I caught something. I saved someone, you know, I helped this kid not fall over, caught them like, this is a good thing that runs contrary to my identity. The tricky thing about an identity is that that bounces off. So I don't start thinking, oh, like, look at me, I'm actually quite dexter. I'm still clumsy. But if I trip and fall, that sinks right in. And I let that thought into my mind. So once we have an identity, and this is why in cognitive behavioral therapy, what we'll do is we'll

deal with cognitive distortions and biases. And what we begin to see in cognitive behavioral therapy is that, like, this process is very active, where some thoughts are being bounced out, depending on what I believe and some thoughts are being let in. Does that make sense? Now, this is really, really tricky, because what our mind is actually doing is discarding a lot of stuff. So I'm going to give you all a good example of this. So there was recently a study on imposter syndrome. And one of the things that's really interesting about imposter syndrome is that when you have imposter syndrome, you reject certain kinds of feedback, which reinforces your imposter syndrome. So specifically what happens in imposter syndrome is that when you accomplish something, when you have an accomplishment, and someone says, good job, you reject it.

But anytime there's a criticism, you'll let it in. Same person. We've even done research into what is the nature of this rejection. And what we tend to find in people who have imposter syndrome is that they attribute, other people's successes to their effort. But your successes are due to things like luck. Your mind manipulates the information differently. So if like your boss says, hey, great job to you for doing such an awesome job this week

with handling that difficult client, you're like, oh, I just got lucky. Or like the client actually wasn't that bad or like it turned out that everything was okay. And like you basically knock away the praise. And if your boss says the same thing to someone else the next week, they're like, hey, great job handling that really tough client. The way that your mind handles that if you have imposter syndrome is you're like, wow, that person is like really great at handling like, you know, difficult customers. And if you get negative feedback back, that's going to, you know, you're going to let that in. And sorry, this is not right, this identity.

The negative feedback you're going to let in. And so then what that does is now we've changed what influences our identity, because we're rejecting some things, right? And so our identity will be more and more reinforced, negative identity. The other thing to keep in mind is that our identity both influences the thoughts that come into our head and also produces thoughts. it creates thoughts. These thoughts and experiences can then go back and create additional filters. So does your thoughts make you depressed, or does your depression make your thoughts?

It turns out that we're talking kind of non-clinically here for a second. The answer is a little bit of both. So what we also know is the quickest treatment for clinical depression, at least that actually maybe ECT qualifies too. So the top treatments for depression in terms of speed, not efficacy, is actually ketamine. And what people, the interesting thing about the initial studies on ketamine is that they show that if you start like antidepressant medication, it'll take a couple weeks for it to work. But people will notice like hours after ketamine, some people, there's more research that needs to be done. I suspect that it's not quite as great as some of the initial studies show. But that people sometimes experience relief of depression within hours of. a ketamine treatment.

And guess what ketamine does? Shuts off the default mode network. It's a dissociative agent. So ketamine was originally used as anesthesia so that people could tolerate procedures because it unplugs you from yourself. We also have some theories that things like meditation and psychedelics and some of these novel treatments for depression will also work on our sense of identity. so they'll like, you know, help us feel connected to the rest of the world.

So, like, my small identity doesn't feel, you know, I'm me and I don't feel connected to anyone else. And, like, some of these psychedelic agents appear to affect through that mechanism. I'm not recommending the use of psychedelics for the record. Right? This is just the research that's being done. We need to learn more about it. But it comes down to this identity. Meditation also appears to work by reducing the activity.

of the default mode network. So do your thoughts create your depression or do your depression create your thoughts? It turns out that the answer is a little bit of both. I think the key thing is that they're mediated through the sense of identity, at least in depression, at least with the way we're simplifying it right now. There's more to it, right? We're not talking about serotonin or other networks or other aspects of depression, physiologic aspects of depression, inflammatory aspects of depression, et cetera.

So a couple of things to keep in mind, if this feels like, like it applies to you. I don't know that this is really, this person was asking for what do I do about it, but I'm just going to share with y'all some thoughts about how to make this applicable. So the first thing is, if you're in this situation, to think a little bit about your identity and where it comes from. So what we tend to find when we do this is that our identity oftentimes is piece together from traumatic experiences that have unprocessed emotions and lead to erroneous conclusions about ourselves. So I'll give you all just an example from my own life.

So when I was young, when I started school, I was about one year younger than most of my classmates. And so what I found was that I sucked at basketball, I sucked at baseball, I sucked at football. So I concluded, I'm not athletic. Now, it turns out that the reason that, probably the biggest reason that I sucked at all three of these things is because I was a five-year-old competing against six-year-olds. Or I was a four-year-old competing against five-year-olds. The thing is, this sense of identity stuck with me. And these experiences aren't wrong. It's just these experiences, every time I got picked last for the basketball team, it emotionally hurt.

I hated P.E. I knew I was going to get picked last all the time. Since I was nervous and getting picked last, I, like, would screw up sometimes, right? Because I don't know how to play, and the kids would make fun of me. That would hurt, too. Sometimes that even resulted in bullying. I was, like, four or five at the time, so I had no idea how to process emotions. So it just developed into an identity.

So as I wanted to develop confidence of myself, and I'm sure you all can understand that even today, I sort of still experience this from time to time, where this will create thoughts in my head. So people will ask me, hey, I'll look, do you want to go do this? And I'll say no, because I'm not athletic. So how do you deal with that? You start by sort of working on this by understanding where does it come from. Where did I start to believe this about myself? The second thing to do, and then as you ask that, hopefully you can reinterpret it, right,

and develop like a better understanding that resolves this emotional hurt and starts to change your identity. Second thing is really important. Take a look at your filter. What do you reject? Subtle. Sometimes it's like, I'd almost say it's almost impossible to figure out on your own. That's not true. But it's just so much more effective.

It's hard to see your own cognitive biases. This is another reason why it's good to work with someone. Right? So when I work with my clients, I'm able to spot their cognitive biases way faster than they are. And if you all have watched like Collins, streams or interviews that you do, you will notice the cognitive bias. You don't have to have to be trained. You will notice the cognitive bias in someone way before they do. So it's hard to do. But really pay attention to your filter. And what do you reject and what do you accept?

And then ask yourself, if I filter these, what impact does this filter? Oh my God, this is so terrible, have on my identity. Because here's the thing, if you have imposter syndrome and you're rejecting your own successes and appreciating other peoples and letting the criticism in, holy crap, no wonder you feel like an imposter. Because all the evidence that you're not an imposter, that you're actually a decent person, has been ruled inadmissible. So you're not going to let it in.

Once you have awareness of that, so this is actually, there's research on this, that if you have someone who's got imposter syndrome, what you can actually do is have them reframe from this to this. And have them notice, hey, any time you get praise, pay attention. And notice, does your mind say,

oh, this is just because I got lucky? Notice you rejecting it. And then ask yourself, why do I think that I got lucky, but I'm willing to attribute? No, actually, like, and there's even, like, an exercise that you can do as an imposter where you can, like, sit down and, like, ask yourself, when you get a good achievement at work, ask yourself, like, really think through, okay, what are the things that I did do to deserve this? I'm not saying at the end of the day that I deserved it or didn't get lucky, but what was my contribution? Right.

You can, well, I showed up every day. I did actually work really hard. It was very challenging. Like, I asked for advice. These are the things that I did do. And when you do that kind of cognitive reframe, it starts to melt away at the imposter syndrome. Another thing to consider, since we are talking about a depression, is getting a clinical evaluation. Right? So, like, you can do all this kind of stuff, but, like, remember, we sort of started talking about this.

So we're kind of like, some of this stuff could be like a clinical illness, and some of this is just the way that our mind works. How do you know, which is what the natural question is? And that's where, like, you don't know, right? So they're trained professionals who know how to tell the difference, and you should go see one. The last thing to consider is unplugging from your identity. So we know that, for example, ketamine. I'm not suggesting use ketamine. That should be used in a licensed, prescribed way. But essentially, what we know is that if you're stuck in this thought loop where you have a particular identity that's creating thoughts,

what we know is from various kinds of research, you can do things like meditate or even some pharmacologic agents that are prescribed that can help you unplug from your identity. Last thing that we already touched on a little bit today is that another way from unplugging your identity is actually spending time with yourself, with nature, and away from other people. Because remember, a lot of your identity is what you project, right, especially for something like imposter syndrome. Because who you are and who other people think you are is like two different things. And so to spend time with yourself, sometimes literally what you have to do is spend time away from other people. And like, I don't know how to say this, but like, I don't know that if you're a castaway on a desert island and you're living by yourself for 20 years, I don't think it's possible to have imposter syndrome. There's no other people to judge you. So you can't be an imposter. Right? Maybe I'm wrong. Maybe there's some castaway that tells me, oh, yeah, I actually had the worst imposter syndrome of my life.

What we tend to find is that spending time with nature, like literally just going for a walk or hiking or camping, like helps with unplugging from this identity that we construct. And keep in mind that this identity we construct is getting worse through things like social media. Because now, like, does a lot of Reddit karma make me a good person? Do a lot of likes on my tweet make me a good person? We're starting to equate social media approval with intrinsic value of a human being. And so unplugging from that is really, really important.

So spend time with yourself, like, you know, caution with socials. So it's a good question. What comes first? The sad thoughts or the depression? A really fundamental question, right? Is it my negative thoughts that are making me depressed? Or is my depression making the negative thoughts? It may seem like a little bit of a chicken or the egg, but it's actually really important

because how we deal with it is very important. very different. So it's important. Because if my negative thoughts are making me depressed, I need to be a little bit more careful about not letting them get out of control or I need to address them. But if my thoughts are from a state of mind that is distorted cognitively, then like I don't need to treat them that seriously, right, because it's all cognitive distortion anyway. So in order to understand that, chances are there's a little bit of both, right? But as we got into the nuance of it and as we get into detail, we start to see that, actually, we do have some answers. So in the case of a clinical depression, originally it can be triggered by a thought that's appropriate to your circumstances,

but once it gets triggered, it has a life of its own and can persist even when the circumstance that originally made you depressed is completely gone. In a more general sense, if we understand how the mind works, we've got to be super careful. Because when we have sad thoughts, sometimes they can form into an, or we have negative experiences and sad thoughts, they can form into an identity. I will be alone forever. I will never find love. I'm not athletic.

And the tricky thing is once we develop that identity, the identity comes with a filter. The problem with the filter is that as we start filtering thoughts that are contrary to our identity, that's when we really get into trouble. Because it turns out that you are lovable. You just reject that thought. And you let the thoughts that reinforce

the idea that you're unlovable. Did I say lovable or unlovable? You reject the thoughts that, you reject the evidence that you are lovable in favor of the evidence that you are not lovable. And once that happens, it just reinforces the identity, strengthens the filter, et cetera, et cetera. It's a good question. And hopefully today we've dived into a little bit about how that works and to give you all some tools to play with. The end of the day, you want to be a little bit careful about how your identity formed in the first place and be a little bit critical of that. Second thing that you need to do is understand how your filter works. What's the information that you reject and what's the information that you let in? You can start to do some kind of cognitive

reframes, things like that. If we're really talking about issues of depression, another thing that you should really do is get a clinical evaluation, right? Because is this like more of the yogic, like this is how my mind works or do I actually have depression? Like, that's something for a clinician to determine. The last thing is spend more time with your and spend less time with the way, with the person that you pretend to be. That's a healthy way to build your identity.