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JuQgJxYriYI.txt
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JuQgJxYriYI.txt
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Speaker 1: 00:00 So the question is, how do you differentiate the utility of behavioral slash psychotherapeutic treatments for conditions like depression versus medical treatments? Okay, so the first thing I would say is don't underestimate the utility of medical interventions. Depression is a catastrophe. It carries with it a very high suicide rate and it also levels people out and it's really hard on their families and so and it and it's physiologically extraordinarily damaging. And so if you're in a depressive state and it's severe, you can try an antidepressant. You'll know in a month if it works, if it works well, maybe it'll help you get your life together. Like we could say, well maybe you're depressed because your life isn't very well together. Could be. Sometimes people are depressed, their life is just, it isn't fine because no one's life is fine. Everyone's life is a tragedy. But sometimes people have their lives in order, as much as you could expect anyone to have.
Speaker 1: 00:57 They have friends, they have an intimate relationship, they have a career that they like, you know, they're, they're qualified industrious people working hard on what they're doing. And, and, and really playing a minimum number of games with themselves and they're terribly depressed, antidepressant man that sometimes that will just fix it. And so hooray, you were biological entity. If, if there's something out there that can help you strengthen yourself so that you can prevail. Great. And you know, people, you hear, everyone takes antidepressants, you know, everyone's taking them. It's like no one takes those bloody things without serious consideration. Half the time I spend with my clients who are depressed is often the two years long attempt to get them to tentatively try an antidepressant because there are so guilty that they're relying on an external crutch to sort out their lives that they can't even tolerate it.
Speaker 1: 01:47 But you know, I say, well look man, what if you had diabetes, you know are going to take your insulin. It's like you got stressed, you blew out at your weakest point. That's what happens when you get stressed. If there's something out there that might help you, it's like try it for God's sake. You'll know in a month and you'd just stop if it doesn't work. Now, having said that, you want to do a multidimensional analysis, it's like, well, do you have any friends? Do you have an intimate relationship? Are you pursuing one? Do you have a reasonable career? Are you as educated as you are? Intelligent? You have something useful to do with your time outside of work? Do you have a drug or alcohol problem? Are there other behavioral issues like sleep dysregulation and lack of eating that are contributing to the pathology? You want to differentiate all of that and wherever you can make a behavioral intervention so much the better, but sometimes too, you're dealing with people whose lives are so that they don't even know where to start.
Speaker 1: 02:40 They're different than the ones who have everything in order. See, and you say, well, try this man. Maybe you won't cut your throat in the next month because if your dad, it's going to be hard to work with you, and so, so medical interventions, anything. If you're sick, you do what's necessary to get better and you your pride behind. If you. If you have to, and that says nothing about the utility of the behavioral interventions, you want to hit the problem with everything you have at your disposal, but some antidepressants especially, especially for people whose lives are together and who are depressed, antidepressants can be absolutely miraculous. So you know when you hear about the clinical evidence in their favor being iffy, and that's partly because the diagnosis of depression isn't very well formulated, that it's very different to have a terrible life than to be depressed and antidepressants can only help you so much if you have a terrible life. So yeah.