HealthyGamerGG - Why Sh*t Life Syndrome is Holding You Back

Episode Date: June 19, 2024

In this video, we learn about "Sh*t Life Syndrome" and why understanding its impact on mental health is crucial. Check out more mental health resources here! https://bit.ly/3xsk6fE Learn more about your ad choices. Visit megaphone.fm/adchoices

So we use this term, life syndrome to basically describe this group of people whose lives are so bad as they are trying to survive in life, they run into mental health challenges. They go somewhere, they get diagnosed with a particular thing, and they just rack up these diagnoses. I remember seeing this mentioned in an HG video a while ago, but I don't remember which one it was.

I'm sure it's not an empirical medical phenomenon or anything, but whatever it resembles. I'm curious about the outcomes of the people who suffer from it. Is there such a thing in living, in living in a situation that is systemically unhealthy to the point that there isn't any viable path to good mental health, can people overcome shit life syndrome? Some time ago, I talked about this term shit life syndrome. So when I was a second year resident at the, maybe intern, at Massachusetts General Hospital, I was working with a very, very talented nurse practitioner. She would go see patients, and then I would ask her, you know, what's the diagnosis of the patient?

And then sometimes she would say that this patient has shit life syndrome. And so I was really intrigued by the term and I would ask her like, what does that mean? And she would basically say like, okay, so you have these people who come into the emergency room. And if you look at what their diagnosis is, they have like 15. They have ADHD, oppositional defined disorder. These were oftentimes like children or adolescents, major depressive disorder, bipolar disorder, and polysubstance use. So they have all of these different diagnoses. And the thing about these diagnostic constructs is that the idea that,

someone has six different independent brain pathologies or mental health pathologies that are all concurrent is exceedingly rare. And so we use this term shit life syndrome to basically describe this group of people whose lives are so bad that as they are trying to survive in life, they run into mental health challenges, they go somewhere, they get diagnosed with a particular thing and then just rack up these diagnoses. So this is where the term shit life syndrome comes from. So how to tell the difference between mental disorders and shit life syndrome? I've been trying to answer this question for a while. How do I know what's the cause and what's the effect when it comes to mental state?

Am I depressed and suicidal because of how my life turned out? Or am I perceiving life to be more shitty than it is because of underlying mental disorders? I've never been to a psychiatrist, so I've never been diagnosed, but I've been dealing with OCD since I was six. I experience a lot of MDD, anxiety, social phobia, and ADHD symptoms. I've also been suicidal for more than six years. The thing is, most of those things appear so small when put next to seven figures in the bank account. Most of my issues would immediately disappear. Only then would I be able to do the things because I can, not because I have to.

I experience what I'd call a money-induced paralysis. It's very unlikely that I'll ever be financially independent, and it's unlikely I'll ever find something interesting enough I deem worth pursuing for hours on end. Those realizations alone are enough to make me apathetic, procrastinate, all matters and basically give up on life and wait for the right opportunity to kill myself. I'd rather be dead than live a life I don't consider to be worth the effort. I've been thinking about seeing a psychiatrist for the past few months, but I have my doubts. I procrastinate on making an appointment because it feels like my problems stem from money,

and it's not like they'll make me rich over there. That is enough justification for me not to go. I also can't get myself to schedule other appointments, blood tests, physio, dentist, because if my life will remain the same, despite improving in some areas, then why bother? I'll kill myself anyway without some magical epiphany occurring in my mind. I suspect there could be something wrong with my brain because plenty of other people have lives objectively worse than me, yet they see survival as something of value and of itself. That could be the result of them being ignorant, me being ungrateful, or my brain being disabled. So some of us look at

our lives and we say that things are objectively bad. And we look at our lives and we think, okay, so like modifying my internal instrument is useless if my circumstances are bad, right? So we can say like, okay, I'm short, I'm bald. My chances of ending up with someone seem very, very, very, very low. So what's the point in trying? Like my life is objectively bad. And so then like the question is like, okay, is this mental illness? Like, is this an appropriate adaptation to negative circumstances? Or is this a mental illness that is misinterpreting what my chances are. How do I know which one it is? The short answer is that it is a false dichotomy and that even if your circumstances are bad, I believe that you can do drastic things to drastically improve your circumstances. And if you're rebelling against that,

that is part of shit life syndrome, which will kind of get to, right? So the first thing that I want you all to notice is that if I say that this is possible, your mind will automatically have a reaction. And so the problem with shit life syndrome is that you have objective problems and you have internal problems. And the problem is that your objectives of problems you may not be able to fix. But even when you're subjectively hampering yourself, it is very difficult to fix your situation. Hey, all, if you're interested in applying some of the principles that we share to actually create change in your life, check out Dr. Kay's Guide to Mental Health. It combines over two decades of my experience of both being a monk and a psychiatrist and distills all of the most important things

I've learned into a choose your own adventure format. So check out the link in the bio and start your journey today. So what is the difference between a setback and a failure? So in both cases, the objective reality can be the same. I tried something and I failed. The difference between a setback and a failure is whether I decide to try again. And if I try again and then I succeed, then the failure becomes a setback. And if I decide to stop at that point, the failure becomes a failure. It is very unlikely that I'll ever be financially independent, and it's unlikely I'll ever find something interesting enough I deem worth pursuing.

Those realizations alone are enough to make me apathetic, procrastinate on all matters and basically give up on life. Right? So this is where we have to be very, very, very careful. Because now what we see is that there is a objective circumstance on the outside, which results in a realization. And then that realization creates apathy, procrastination, and people giving up. And then what is responsible for you staying stuck?

It's actually a combination of all of these things. It is a false dichotomy. So let's talk a little bit about shit life syndrome. So this is a psychodynamic article that someone kind of talks about shit life syndrome. So this is like, so this is what's really interesting. The shit life syndrome is something that clinicians came up with. So let's read this case, okay? In the letter from the doctor, we learned that she's,

had experienced a number of problems since early childhood. She had initially been raised in foster care, bad thing number one, abused by a neighbor, bad thing number two, left home at only 17, bad thing number three, subsequently engaged in a series of emotionally and sexually abusive relationships with men, bad thing number four, this is shit life syndrome. This person, it appears, does not have a chance. Bad thing after bad thing after bad thing. And there is a lot of data that supports that this is what happens, right?

So we have a lot of studies on something called adverse childhood experiences, which is that if you have a bad upbringing, what tends to happen is that this correlates with worse mental health outcomes, worse life outcomes. This is very common. So I've since become very curious about this expression, shit life syndrome. Not the least because of the implicit consensus by everyone in the meeting, including myself, as to what it meant. Everyone knows what it means, even though it's never been defined. The phrase seemed to denote a level of long-standing poverty, family breakdown, lack of stability, unemployment, and potential risk factors common to many of the predominantly young working-class patients referred to the service. For shit, of course, is something that we generally prefer not to think about, something we continually reject, get rid of, or hide.

At the same time, it is something that we cannot completely repudiate. It is part of us, something we need, something that is ineluctibly. inelectably, I don't even know what that means. Part of our status as human beings is subjects. Those suffering from shit life syndrome then would be, it would seem to be those individuals whose problems are deemed to be so terrible, so untouchable that they quite literally cannot be thought about and cannot be handled by the service.

No amount of you coming to my office one hour a week for therapy is going to fix your history of abuse, your problems with employment, your foster care background, your history of trust, trauma, the ADHD, the OCD, there's no amount of therapy that will fix this objectively bad thing. And so we call this shit life syndrome, right? Because it's like, it's too much to handle. The question is, can we do something about it? And my belief is yes. So there is this construct that we have discovered in mental health called deaths of despair. I think this was originally discovered actually in the UK. So there were these old fishing villages that used to have very

robust economies. And then once like the fishing industry left, the town became like a ghost town. There's no economy. People started drinking. People started committing suicide. And as we tunnel down into why are people killing themselves, what we discovered is that there's a lot of systemic factors that are causing this. What we find is everyone in this town is an alcoholic and is suicidal, not everyone, but the rates are way higher. And then in this neighboring town where things are socioeconomically better, like the climate is the same, the water is the same, but like the economic situation is different, we see way less suicide and alcoholic liver disease, among other things. So systemic and problems have systemic solutions. I 100% believe this. This is part of

the reason we started a healthy gamer in the first place. So I want you all to really think about this. Why did we start this? Because I saw a systemic problem that I realized no amount of like talking to people in my office is going to fix. What I saw, saw in my office was an increasing number of people who did not know how to live life. They didn't know how they work. And since you don't know how you work, you can't figure out how to live life. So this is what I want you all to understand. You are a living organism. And the whole point of a living organism is that it interacts and is shaped by its environment. We are in a homeostatic relationship with our environment. We adapt to our environment. We adapt to our environment.

we shape our environment. So it goes both ways. So if it's hot outside, I will start to sweat. If it is cold outside, that's called diaphragsus. If it's cold outside, I will have pilo erection, which means I will have goosebumps and my hair will stand on end. My physical body adapts to the circumstances around me in order to try to succeed in this scenario.

So when we say that people with shit life syndrome, is this shit life syndrome, is this mental illness, the answer is both. Mental illness is oftentimes the consequence or the adaptation to negative circumstances. Okay? So I'll give you all a simple example. We consider PTSD a mental illness. And why is it a mental illness? Because it does not allow human beings to live their life normally. But what we also know about PTSD is that it is an adaptation. It is a mechanism of survival that the organism goes through. So as a simple example of this, if I've been traumatized in some way, my body is on high alert. My heart rate goes up, my blood pressure goes up. I start to think more catastrophically, which is not a bug. It's a feature. It's an adaptation. When the brain is

faced with danger, we need to focus on the worst case scenarios, not the middle of the road scenario. The problem is that these adaptations which allow us to survive prevent us from thriving because these two goals are fundamentally different. So the problem in shit life syndrome is that the way that you wire is not to succeed. It is to survive. Now, I want you all to think about the implications of that. Really think about that. For example, like I'll give you all just a couple of examples. So one thing that we develop is something like low self-esteem.

Or we talk about this in the trauma guide. one of the things that we see in shit life syndrome is the inability to consider the future. So if we look at this post and you read it, this person is not future oriented. They are not planning for the future. They are not doing steps one, two, three, four, five, six, seven, eight, nine, ten. They are simply existing and responding to the environment. They are apathetic. They procrastinate.

And they're not like, they're not exerting an influence to, to change their situation. Now, people can call this laziness, but it's not laziness. It's an adaptation. So let's understand this. I'll give you all just one example. So when someone grows up in a deficient environment, an environment that does not have stimulation, what happens is if we grow up in an environment where we are not allowed to plan for the future,

if we grow up in an environment where our circumstances control our future, our brain loses sight of the ability to plan for the future. Okay, so I'll give you all a simple example. Let's say I'm a kid and I want to have a birthday party because all my friends have a birthday party. So I go to my mom and my dad and I say, hey, mom and dad, can I have a birthday party this weekend with my friends? And your mom and dad say, sure. Then what happens is if you think about being a seven-year-old, you can't plan your own birthday party. You don't know how to order cake. You don't know how to invite friends. You don't know how to do any of that. So it is your parents' responsibility to do all of those things. But if your parents, if you have a single

parent household and your parent is working three jobs, if you have parents who struggle with substance use, if you have parents who don't know how to operationalize their own problems because they have a history of trauma, they don't know how to make your birthday party. And so what happens is you have, or in the worst case scenario, your parents say, yeah, we can have a birthday party. And then the day before the birthday party, one of your parents is drunk and angry, and they arbitrarily punish you for nothing that you did wrong. And they say, you don't get a birthday party because you're making too much noise. You don't understand how to be respectful, unrespectful kids, disrespectful kids don't deserve birthday parties. Now, when you grow up in an environment like this, what is the cost of thinking

about the future? Just pain. You told all your friends, hey, I'm going to have a birthday party. And what happens, your birthday party gets canceled. Now you're ashamed. Now you feel disappointed. Now you feel like your expectations have been let down. So what we see, on research from complex PTSD especially, is that the capacity for your brain to think about the future requires that when you were a child and you think about the future, that is rewarded. But if thinking about the future leads to a punishment,

leads to expectations that get dashed, lead to suffering, then your brain is like, this is a waste of time. Thinking about the future is only results in pain and nothing good ever comes of it. So we're going to stop thinking about the future. Then the problem is that these adaptations cause future problems because you don't know how to craft a life that, like, is fulfilling, right? So this person may not even know, like they say, like, pursuing a passion. I don't know how to pursue a passion.

So the adaptations that we use to survive are the very things that prevent us from thriving. Now, here's the really tricky thing is it turns out that these adaptations that you make will be deterministically bad for you. in the future. Okay? So remember that the organism is in homeostasis with the environment. We're trying to survive. So we're forming certain kinds of adaptations. So if we look at some of these adaptations, what we find is that these adaptations will become problematic in the future. So what we know is that when people have a history of trauma and when they suffer from depression, which by the way can be an appropriate, like almost like an adaptation or maladaptation from your circumstances. So here's the chain of reasoning, okay? Adverse childhood experiences

increase the risk of depression. So if you've had a shit life, you are more likely to have depression. Once you add depression into the mix, that creates prospective problems. So there are multiple theories behind this, but they're basically all agree that there's some kind of bias in our mind. So we have memory biases. This is wild. So what we know is that there are memory biases in depression.

So a memory bias for negative material found that individuals diagnosed with depression were called more generic or over-general memories that then did their non-depressed counterparts. Okay? So this is kind of weird, but what this means is that people with depression do not remember like positive details. Importantly, the tendency to elaborate negative emotional information, memory bias for this information, and recall of over-general memories may be associated with other cognitive aspects of depression.

So these are the three biases. Is this mental illness or is this shit life syndrome? Illness is a consequence of two things. A genetic predisposition plus an environmental exposure. So there is something that is part of you plus some environmental shaping results in something called a mental illness. And this is really consistent with our studies of things like depression and adverse childhood experiences.

So if I have a crappy life, my mind starts to get depressed. The depression is a consequence of my past. but it very actively and negatively shapes my future. So we know that once you have some negative view of yourself, it changes the way you perceive the world. You pay attention to more negative stimuli. So if we look at this paper, what we basically find is that if you're looking at a neutral face, you will pick up negativity even within neutrality. So what we know about cognitive bias and depression is let's say that I have multiple interactions throughout

the day. 25% of my interactions are positive, 25% of my interactions are negative, and 50% of my interactions are neutral. Once I have a cognitive bias from depression, what this means is that I tend to overgeneralize the positive parts of my memory. So the positive parts of my memory become vague and fuzzy. The negative parts of my memory are negative, and then the neutral parts become negative. So now in a life that is 25% good, 25% bad, and 50% in the middle. My brain interprets that this is 75% bad and 25% neutral. And this is where I know it sounds crazy, but like the reason that I think shit life syndrome can get better is because there are three steps to this. There is circumstances which are outside of control. Create an adaptation. This adaptation creates your destiny. Now this you can't

control, but this you can fix. And when you fix, this, this changes. So that's what we're going to talk about today. So now the question is how. So I'm going to give you all just a couple of really simple examples of how you can change your thinking and what I see in people who have shit life syndrome and people who don't. So first is when people don't grow up with adverse childhood experiences are in high socioeconomic status, the first thing that's different is that people in shit life syndrome do not think that they can shape their future. If I have shit life syndrome, I grow up in an environment where my intentions do not shape my circumstances. I'm so neglected in my household that my desires become worthless.

They have no bearing on the environment. So once our brain realizes that our desire has no differential impact on the environment, it decides, let's forget about desire. Compare that to what we see in the worst cases as entitlement in people who have high socioeconomic status, where the world says, hey, you don't get to jump to the front of the line, and their cognitive bias is so robust that they say everyone else needs to move out of the way. They believe that they are allowed to shape the environment, right? So this is a huge difference, and it leads to a huge difference in outcomes. What shit life syndrome teaches you is that what you do does not matter. This is the lesson that you learn. And once you learn this lesson, then your future is determined. The beautiful thing is that you

can unlearn this lesson. And when you unlearn this lesson and you discover that you can shape your circumstances, then a lot of things will go well. So I want you to just think about two people when faced with some set of challenges. One person believes that if I'm challenged, there's nothing I can do about it. And the other person believes there is something I can do about it. I don't have to take it laying down. What impact do you think those two attitudes will have on these people's lives? So that's the first adaptation. It's simply believing that you can affect your life or you can't. Can I shape my circumstances or can I not shape my circumstances?

And I'm not saying that people are stupid for believing they can't shape their circumstances. Remember that if they believe this, they believe this for a good reason. It is because they haven't shaped their circumstances. So this is the other thing about the human organism. The human organism learns from the past and it carries that forward into the future. Now, the problem is that sometimes the learning that we do is maladaptive. So I'll give you all a great example of this. So I don't know if you all play Dark Souls 1, but in Dark Souls 1, there's this, like, cheat kind of thing that you can do. There's this dragon and you can shoot the dragon in the tail.

And if you shoot it enough times, the tail falls off and you get this thing called the Dragon Tail Sword. Now, the Dragon Tail Sword is OP. You can one shot a lot of enemies. So when I first played Dark Souls 1, I got the Dragon's Tail Sword, because someone told me about it. And then I was one shoting all the enemies, and then I gave up on the game because it became too hard. Because at some point, the dragon tail sword stopped scaling, and you can't one shot anything. So later, a friend, I was talking to a friend of mine, and he said, you know what? The dragon tail sword is the biggest scam in the game. It is the biggest noob trap in the game.

No wonder you gave up. And I said, what do you mean? And he said, if you get the dragon tail sword, you never learn how to play the game. You don't need to roll. You don't need to parry. You don't need to like zone people out. you don't need to pay attention. It is such a crutch.

So the way that I learn to play the game based on my circumstances set me up for failure in the future. Now, if I ask you, okay, so if I play with the Dragon Tail Sword, does this mean that I can't beat Dark Souls? Of course not. But it requires you to adapt your general approach to the game. And this is exactly what shit life syndrome is like. It's very unlikely that I'll ever be financial independent,

and it's unlikely I'll ever find something interesting enough. I deem worthy worth of pursuing. These realizations make me jump to a conclusion. So the way that I would like, you know, I've had patients like this before, and there are things that you can do to change this, right? So what I'd say is, oh, that's so interesting. So unlikely Oliver find something interesting enough I deem worth pursuing. So then I would talk to this person.

This is like what I've done, right? Is I'd ask them, what is the nature of interest? What determines how interested you are? Is there anything that you can do to change your level of interest in something. Realizations are alone or enough to make me apathetic. Okay, so let's talk about being apathetic. If you are apathetic, does that mean that you cannot act? What is the relationship between feeling like acting and being able to act? So as you start to dig into a lot of these nuances, you start to see a lot of positive change, because it's this stuff that is truly deterministic.

But my point is that the adaptations to survive will oftentimes keep you from thriving. And so you need to unlearn those adaptations. And one of the most important things that I want y'all to pay attention to is how quickly your mind jumps to a conclusion. I can bet y'all money, because I've seen this before, anytime I talk about super challenging things, what inevitably happens is someone will respond. Dr. K was saying this, and they will jump to some kind of conclusion. Are they saying I'm screwed? So think about even how you were receiving what I am saying. Are you looking at it critically? or is some part of your mind jumping up and saying this is wrong? There are a thousand different things that your mind will jump to so quickly.

And look at where all of those thoughts go. All of those thoughts result in inaction. That's the problem. Look at where your mind goes. This is a paper that shows that when you have a low perceived control, when you don't believe you are in control of your life, that creates stressful situations. So our perception and results indicated that dependent interpersonal stress mediated the relationship between low perceived control and higher levels of social anxiety in girls.

Conversely, boys who exhibited low perceived control experienced a greater occurrence of dependent interpersonal stressors. So this is really important to understand. When you believe you are out of control, this creates stressors. What this paper really shows us is that it is the perception of low perceived control that creates problems in your life. And I'll give you all an example if you're skeptical of that. So let's say that I have a family emergency and I have a big paper due in one week. And I need to email my professor to let them know. There's a voice in my head that says, hey, let your professor know that you have a family emergency.

But then what happens is I procrastinate. Or I think maybe I can get the paper done. Or maybe I think I don't want, I don't feel good. It makes me feel ashamed to ask for an extension. There is a right action to take in this situation. But you procrastinate in doing the right action. And then what happens is a week goes by. You haven't worked on the paper.

Now it's the night before the papers do. And now you begin to question yourself because you're like, now if I ask, like if I tell them, oh, there was a family emergency a week ago, but now I'm asking for an extension on the paper, the professor isn't going to believe me. They're going to think I'm making it up. I really should have done it a week ago. This anxiety creates a negative situation. If you had not been anxious in the first place, you would have sent the email.

You'd have said, hey, I have a family emergency. I'm not quite sure if I'm going to be able to get to the paper, just wanted to let you know. We all know that is the right answer. And if you look at your life, you're fucking procrastinating. You know what the right answer is. The problem is you can't do it. And it is not that your life is randomly out of control. It's because you fucking neglect it.

You procrastinate. that creates your situations. We see this so much in our life. I'm not saying bad things don't happen to us. Absolutely there's bad RNG. And now we get to really the crux of shit life syndrome, which is that in this life, there are things that are outside of your control

and things that are inside of your control. And the beautiful thing about the homeostatic nature of life, this isn't just humans. This is like even amoeba. When amoeba detect the wrong chemical gradient, they will move in the opposite direction. They are responding to life. And the problem that we have in shit life syndrome is that we cannot respond appropriately to life.

I need to send my professor an email asking for an extension. That is what the situation demands. There is a right answer here. What is it that gets in the way of me engaging the right answer? This is what gets in the way. Interpretation bias. Attentional bias. Oh, my God.

My professor will think I'm pathetic. Oh, my God, he'll dislike me. Oh, my God. This hasn't worked in the past. I've asked for help in the past and it hasn't worked. There is a memory bias there, but it doesn't mean that it's all false. So another big thing that people with shit life syndrome learn, and think about how devastating this is to learn.

Asking for help doesn't help. Two kinds of people in life. Those who ask for help and those who don't. And why does someone stop asking for help? Because they learn it's useless. All of the thoughts and beliefs that you have in your mind if you have shit life syndrome are warranted. They are justified.

that does not make them right. This is a very important nuance to understand. You can have a lot of logic for believing what you believe, but the construct that you have in your brain does not dictate what happens in the future. So the first is even the belief of self-determination. The second is jumping to conclusions. The third is not asking for help. And the fourth thing that we also talked about is the loss of future orientation.

This one is very hard. So if you look at some people, like you look at some of these people and they're like living a life and part of living their life is like a dimension of future. This is so simple that it's like, I don't even know if this makes sense. You look at some people and they're doing shit in order. You guys know what I mean? They're like, today I'm going to, I'm training for a marathon in August of 2025. And I look at these people. I'm like, what the fuck, man? I'm trying to get through the week. And they're like, yeah, I have a bucket list. I'm like, bra, I'm trying to survive the day. I'm just waiting for the next Dota patch to drop? How do you have a bucket? Like, I don't have a bucket list. Someone recently asked me,

and they were like, what have you done on your bucket list? And I'm like, I don't have a bucket list. And then I was like, kind of like, is this because I'm yogically detached from my life and I'm, like, content with my life? Or is it because like when I was a fucking degenerate gamer and I was just like fucking waking up every day and playing video games for 20 hours a day, I stopped thinking about the future. I think it's a little bit of both. The concept that I can accomplish goals in my life is foreign to me, this idea, and think about the hubris of having a bucket list, this idea that if you set these random ass goals that are so far away that you will one day achieve even a portion of them. Like, what the fuck? Do you all get how that's a different? Their brain is working differently.

It is thinking about the future dimension as something that can be realized in literally half of the people that I work with. And I mean half, okay? I think there's a pretty good estimate, because I work with losers, and I work with winners. And the winners I work with have all these goals. And the losers that I work with don't have any. And it's like their mind operates in a different way. This too relates to trauma. So we know that once again, surviving in a prisoner of war camp,

thinking about the future is a waste of time. So our brain unlearns thinking about the future. So when we have shit life syndrome, is it bad? Absolutely. Is the deck stacked against you? Absolutely. But there is hope. Because what is really holding you back is not the circumstances.

That is what has held you back. That I completely agree. And this is a nuance that's important. But what holds you back, what's held you back for the last five years is different from what will hold you back from the next five years. And even remember, there's no future orientation. So even the capacity to realize that is impaired. That the future will be different from the past.

When all you are trying to do is survive, every day is the same. And we see this so much. It's so sad in our community. I'm proud of this in a weird way because this is a place where I want y'all to come and feel this. It's okay to feel this. We don't want to, we don't want you to feel ashamed of feeling this way. But people come here and they're like, I'm existing. I'm not living. So that's what we want to help you with. And the really sad thing about this is not fair. Forget about fair. We can get caught up in fair as much as you want to. I don't know about fair.

It makes me sad. I don't think life is fair. Right. I can't see, I haven't seen that. I mean, I decided on this, my first rotation is a third year medical student. I was one week in the third year and I decided fairness is fucked. All you have to do is spend one week in the pediatric ICU and you'll realize fairness is a waste of, I don't even know how this works. There's a six-year-old kid with glioblastoma multiformi. Actually, not a six-year-old. Patient with gliblastoma multiformi was a couple years later.

That happens closer between 25 and 45 years old. With a kid, it was like a blood cancer, leukemia or something. Right? You look at this and you're like, there's no fairness here. This is dumb, right? And I'm thinking about this patient with glioblastoma. Well, you just do. Great, dude.

had kids, was happily married, and it's like, boom, one day you got a terminal cancer you've got three months to live. Like, that's how glioblastoma multiformi hits you. It's a rapidly progressive, very debilitating. Doesn't happen when you're old happens when you're young. When you're in the prime of your life, there's no fairness here. But there doesn't need to be fairness. That's the crazy thing, right? There's what you can control. And when you're looking for the world to fix your problems, like, I just have lost faith in the world. Like, I hate to say it. And now this is where you all have to be careful, right? Because your negative bias if you're depressed will be, Dr. Kha has

lost faith in the world, which means I should give up. No, I'm saying the exact opposite. I've lost faith in the world, but I've not lost faith in you. There's a huge difference. I don't count on the world to fix anything. That's why I'm here, because I saw a generation of people whose

lives were getting screwed. And I was like, I don't know if anyone's going to fix that. In fact, I went to people, so many smart people, so many compassionate people, so many dedicated people, who are doing nothing about technology addiction. Who are doing nothing to address rising suicide rates, rising unemployment rates in young men,

who are doing nothing to address toxicity towards women online, stalking and dickpicks. I have no faith in the world, but I have faith in you, because this is all we can control. So if you see some problem in the world, there's once again two options, right? Either I can't do something about this or I can try.

That's it. Those are your two options. And that's why I think shit life syndrome can get better because I have worked with people to address these cognitive biases, and we have moved from there is nothing I can do about this to I can try. And the really sad thing is that even when circumstances improve, it doesn't always lead to better outcomes. So if you look at women who are abused in the household,

they're more likely to be abused in romantic relationships. I think something like one in six women will be sexually raped, actually. So even sexual assault could be higher. Intimate partner violence, 30.7% of women with ADHD, are likely to have intimate partner violence. This is a staggering number. And if you look at this, like, this is bad. And the problem, why does this happen?

Why is it that if you were abused once, you are likely to be abused again? Is it because the world is rigged against you? No, this is the really crazy thing. It is because of the way that you engage in relationships. See, when you have a high self-esteem and someone mistreats you, you leave the relationship. But when you are dependent, when your goal is survival not thriving, then you are willing to tolerate abuse. It's a completely different way of looking at the world.

What's the goal? And in shit life syndrome, the goal is survival, not thriving. That creates all kinds of problems. It keeps our life in this weird limbo zone of not actually ending, right? Like we're struggling along. We're kind of chugging along, but we're never getting anywhere. We're not quitting the race because once again, I had a brilliant patient who taught me this, who tried to commit suicide seven times.

And I was like, do I need to be worried about you? like, no. I was like, help me understand. Brilliant guy. And he said, well, the seventh time I realized that, like, some part of me does not want to die. I've been trying to kill myself. And something within me is fighting for life. So I'm going to stop fighting that thing. And that's all it took for him. No more suicidality. Right. So there's something within you, even if you feel like everything is like lost and whatever, there's something within you that strives. We look at this post and here I am fucking bashing this person, right? And I'm saying, oh, look at this cognitive bias. But I want you all to point out, pay attention to something. This person posted. This person is trying to change.

This person is saying, my life is unsolvable. Nothing's ever going to end up anywhere. And they're not taking it laying down. This is a huge prognostic sign in the right direction. This is a win. The post may be full of negativity, but the fact that there is a post is a win. And this is our bias. Right. So now what I want you all to do is if you're listening to this, if you've been listening to this, did you consider that? And if the answer is, No, why not? This is bias. So shit life syndrome is not deterministic.

I do not believe that. Is the deck stacked against you? Absolutely. Can we count on the world to fix things? I don't know. Big question mark. The world isn't all bad, by the way. It's a lot of good in the world.

Right? But what I have faith in is y'all. I have faith that if you understand the way that you function, if you understand what your biases are, if you understand the way that you view the world, determine some of the way that the world is, then you can change. Your life can change.

Thank you.