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