Radically Genuine Podcast with Dr. Roger McFillin

welcome to the radically
genuine podcast dr roger mcfillin here with my

[sean]: brother shawn kelly is on vacation good
morning shawn we're aloud vacations only kelly okay

[sean]: well we kind of want to get
in the studio and address some recent events

[sean]: within the field of psychiatry psychology that
has certainly kind of taken the world by

[sean]: storm because is hit you international news
media and it's ironic because the very first

[sean]: podcast that we recorded was on this
very subject we thought it was that valuable

[sean]: in that important it was the around
the chemical and balance myth and when we

[sean]: first recorded that podcast many people would
have been surprised to hear these ideas that

[sean]: depression for example is not related to
low saratonian in the brain and therefore everything

[sean]: that we believe anti depressant to do
as far as correcting that low seratone in

[sean]: the brain is inaccurate and we've been
led to believe through very sis matic and

[sean]: targeted pharmasutical marketing campaigns to have us
believe that what we experience what we feel

[sean]: is related to an underlying brain abnormality
or an illness and in a recent review

[sean]: article in molecular psychiatry june july twentieth
came out very recent uh dr joanna moncrief

[sean]: and colleagues published this systematic review the
seratonan theory of depression a systematic umbrella review

[sean]: of the evidence anyone who wants to
get into the nitygrity details of such review

[sean]: feel free to i think for our
purposes today we just want to go over

[sean]: the highlights um very simply you know
the idea that depression is a result of

[sean]: abnormalities and brain chemicals in particular sarah
toning has been influential for decades and provides

[sean]: important justification for the use of anti
depressant what has the actual literature revealed and

[sean]: so when shan when we were recording
this podcast back in twenty twenty one june

[sean]: twenty twenty well probably fourteen months ago
fourteen months ago i just got finished with

[sean]: my own review and was surprised not
necessarily surprised but i was certainly shocked about

[sean]: how there was really no evidence at
all and we're all kind of subjected to

[sean]: media manipulation of idea yes and when
i knew very clearly that this was a

[sean]: you know a theory that was never
supported by evidence it became very important for

[sean]: us to be able to just start
communicating that that message and for me what

[sean]: was most concerning and forget about the
efficacy of anti depressence or any of the

[sean]: other effects the withdraw effects the the
side effects the long term impairment that exists

[sean]: from prolonged use i was most concerned
about was the psychological aspect of believing that

[sean]: there is something wrong with your brain
yes because of everything i know about the

[sean]: field of psychology and attempting to cope
and live well really reflect some core principles

[sean]: in how to you approach the the
experiences just being human and one of them

[sean]: is the idea that there are emotions
are there to serve us and when we

[sean]: feel something and we're experiencing something it
is something to be paid attention to because

[sean]: it is our body reacting to events
that occur in our life now those events

[sean]: could be outside of us or they
could be internal just our own thoughts our

[sean]: own our own memories and using those
emotions to our benefit is part of a

[sean]: very important adaptation process so i was
very concerned and always have been concerned about

[sean]: what happens then when you are led
to believe that what you are thinking or

[sean]: feeling is different than somebody else that
there's something you're broken in some way that

[sean]: that it's an illness and you'll never
know it was ever fixed or could be

[sean]: fixed yeah that's i would imagine that's
extremely challenging and difficult for someone to be

[sean]: in that position when you're told you're
broken and you have to do this for

[sean]: the rest of your life not only
that you have to really put trust into

[sean]: a physician who might only sit down
with you for thirty minutes forty minutes you

[sean]: know if that and just accept that
these are these are scientific advancements and you

[sean]: know there's clear validity to some of
the recommendations that are that are being made

[sean]: and so that's a lot of trust
right here take this farm a cuticle take

[sean]: this pill and you're going to feel
better over thirty plus years we've learned that

[sean]: you know most people don't feel better
and a lot get much much worse so

[sean]: where do things go from here and
what are our next steps when it's clear

[sean]: now that this has been disputed scientifically
i feel like it had been disputed scientifically

[sean]: for quite some time in a very
small niche of the psychiatry and psychological community

[sean]: of those that we're understanding the science
and it took this paper to take all

[sean]: of the research that existed compile it
into one concise statement that would finally say

[sean]: that that hypothesis for which ant depressant
were originally marketed under is not true therefore

[sean]: we need to investigate further it's basically
for me it was an if then statement

[sean]: right that's how i interpreted it so
i don't know if we actually said what

[sean]: the results were we just kind of
were going through the history of it can

[sean]: you can you reveal what the study
um what the final statement was for this

[sean]: umbrella review sure basically the main areas
of sara tone and research provide no consistent

[sean]: evidence of there being an association between
saratonian and depression no support for the hypothesis

[sean]: that depression is caused by lower carton
an activity or concentration some evidence was consistent

[sean]: with the possibility that long term anti
depression use actually reduces sara toning concentration and

[sean]: i don't think anyone argues or we'll
support the idea that depression is related to

[sean]: one nero chemical like sarah tone but
i think we'd all be concerned about what

[sean]: would happen for long term use if
you're unable to produce sarah tone so this

[sean]: this adaptation process of the brain when
you impact its own ability to produce a

[sean]: neuro chemical so we're certainly experimenting with
such a complex organ the brain what does

[sean]: then happen for prolonged ice so we're
at a point now where even though the

[sean]: majority these studies were very short term
definitely under twenty four weeks most eight to

[sean]: sixteen weeks we now have people on
the inside a presence for ten fifteen years

[sean]: or more multiple meditations which the combination
of has never been studied never studied so

[sean]: a lot of this is going to
be shocking to many people i remember when

[sean]: we recorded the first episode in here
this was all new to me i believed

[sean]: it to be true i thought you
were crazy and my approach in this room

[sean]: was to try and balance out many
of the conversations and make sure what was

[sean]: being said was was factual at least
debate with you a little bit so i

[sean]: could continue to learn and there by
others that were listening could learn as well

[sean]: and i look back now fourteen months
ago and i realize that m right it

[sean]: was it was a marketing campaign well
there's very good reason that you would have

[sean]: believed that and thought i was the
crazy one because of directed consumer marketing it

[sean]: really started in the nineteen nineties if
we we had this we played one of

[sean]: the commercials so i pulled it up
so we can we can listen to it

[sean]: again because of the language in there
and i always like to listen to the

[sean]: words that they used specifically right because
people hear what they want to hear and

[sean]: they believe it to be true but
i worked in advertising and we chose words

[sean]: very carefully so that we would never
ever get into legal trouble you know or

[sean]: i'm going to play this let's take
a listen about a minute long you know

[sean]: when you feel the weight of sadness
you may feel exhausted hopeless and anxious whatever

[sean]: you do you feel lonely and don't
enjoy the things you once love things just

[sean]: don't feel like they used to these
are some symptoms of depression a serious medical

[sean]: commission affecting over twenty million americans while
the cause is unknown depression may be related

[sean]: to an balance of natural chemicals between
nerve cells and the brain prescription zola works

[sean]: to correct this in balance you just
shouldn't have to feel this way any more

[sean]: only your doctor can diagnose depression so
loft is not for everyone people taking m

[sean]: s where pemiside shouldn't take solo side
effects may include dry mouth insomnia sexual side

[sean]: affects diario nausea and sleepiness zolofis not
having for talk to your doctor about zola

[sean]: the number one prescribed brand of its
kind zoloft when you know more what's wrong

[sean]: you can help make it right you
know when you okay there's the reason right

[sean]: and so what i started doing over
this past i guess year and a half

[sean]: as i wanted to ask people would
you have taken an anti depressing drug if

[sean]: you were told there is no such
thing as a chemical and balance have no

[sean]: evidence depression is associated with diminished sarah
to nan we have no evidence you have

[sean]: lower sarah to nan and we have
no idea what is going to happen to

[sean]: you long term would i absolutely not
so now so i ask questions like that

[sean]: to people i know impose those questions
on twitter one hundred per cent people come

[sean]: back no i would not have taken
this drug p questions always were you communicated

[sean]: to by doctor that this drug corrects
and underlying chemical or in balance or was

[sean]: it communicated to you in some way
that you may have a chemical balance the

[sean]: question is for a large the answer
was for a large majority absolutely so even

[sean]: though we didn't have the evidence shown
yeah doctors were still communicating this to patients

[sean]: because of a very very targeted marketing
campaign to physicians themselves with farmasutical sales people

[sean]: in the offices doctors were led to
believe that this drug does correct a underlying

[sean]: chemical abnormality and many to this day
are still communicating the same message if they

[sean]: are not in this field primary care
of physicians looking at close to eighty per

[sean]: cent of these drugs being prescribed by
primary care physicians certainly not reading the literature

[sean]: in sochiatry on depression probably not listening
to the radically genuine podcast they don't have

[sean]: patients in their office every day they
are just following protocols and they also have

[sean]: a broad knowledge base so take everything
in the medical field if you're a primary

[sean]: care physician or like a pediatrician you
have to understand what's happening in so many

[sean]: areas so you rely upon the expertise
of those that are providing literature to you

[sean]: in summary form so you can clearly
read digest understand repeat so you probably got

[sean]: an email from me this week and
actually send it out to the entire staff

[sean]: twelve email today was what this weekend
was a weekend where i was obsessively for

[sean]: gest on this subject because i have
plans you know i have i have ideas

[sean]: i think we have to actually i
think i have a responsibility to contribute more

[sean]: and one of those areas that i
think i need to contribute more is providing

[sean]: people informed consent and i have to
have a very extensive then knowledge of the

[sean]: literature base if i'm going to construct
something to be able to make an impact

[sean]: in this area so i'm going to
have to say i went through fifty plus

[sean]: papers on antidepressence for both adolescence and
an adult's teams adolescence and adults for the

[sean]: most part there there in the and
the past decade but when you read a

[sean]: scientific paper you kind of you can
go down the rabbit hole because you know

[sean]: each scientific paper might have fifty citations
so then you might just check out the

[sean]: citations in there yes and boy did
i have a headache i mean it was

[sean]: it was rough because you want to
know how did we get to this point

[sean]: because prescriptions are on the rise it's
not like they're declining they're actually the rise

[sean]: each year pharmasutical industry is going to
improve their customer base for psychiatric drugs especially

[sean]: when they tell people they don't have
they can't go off of them so then

[sean]: you like got that one moving on
to the next group that's a really good

[sean]: point because i didn't want to make
sure that i i miss this because it's

[sean]: really important especially from a safety perspective
this evidence has been widely distributed and is

[sean]: part of now the main stream to
hear in the united states which will get

[sean]: to in a second but it is
critically important to know that if you are

[sean]: taking anti de presence and you are
listening to this podcast or you read this

[sean]: study or you watched it on some
news channel do not abruptly stop your medication

[sean]: it could be deadly and we now
know that there is dependent c once you

[sean]: start these drugs if you abruptly start
stop them be a withdrawal reaction and for

[sean]: some people the withdrawal reactions are very
severe including increase suicideality um agitation sleep insomnia

[sean]: a number of things it's just a
very very dangerous process so consult your prescriber

[sean]: and if you are interested in starting
taper off these drugs you're going to want

[sean]: to do it in a very safe
science based way so don't just stop it

[sean]: especially for these people who have to
have been on this drug for quite some

[sean]: time because this umbrella review did not
look into anti depressant it was only looking

[sean]: at the causality effect of sarahtonan levels
and depression it's that needs to be like

[sean]: really clearly communicated because in the media
is getting misinterpreted and of course everybody s

[sean]: run in different directions with what the
interpretation yeah i think it's simply this a

[sean]: lot of people went on anti depressant
because it's influential because of the chemical and

[sean]: balance theory that's what they were led
to believe so once people learn that there

[sean]: is no ceratonan deficiency in fact some
people have more the level can be up

[sean]: and down and it depends on when
you're etting the test exactly you know like

[sean]: my guesses may be you did some
of the things that we were talking about

[sean]: like you're in the morning and you
do you you do your walk in the

[sean]: sun maybe you exercise then you meditate
and then you get a know some form

[sean]: of test to try to measure saratonanlevels
they might pay high right so it's yeah

[sean]: it's a it's very you want to
be very skeptical of the entire idea around

[sean]: saratonan or certain brain chemicals or even
thinking about depression as a brain disorder like

[sean]: just eliminate that thinking right now we're
talking about high levels of complexity when you're

[sean]: talking about the human experience a biological
psychological social spiritual nutritional perspective and we are

[sean]: a mystery in so many ways the
human experience is a mystery we haven't even

[sean]: begun to evolve the stage where we
can understand the complexity of such an experience

[sean]: that being said um this did bring
about some national recognition and as you would

[sean]: expect it became politicized unfortunately you're the
one who turned me onto the initial article

[sean]: article tell me about like how you
found that i was having my morning breakfast

[sean]: coffee over that weekend and apple news
and it got served to me probably because

[sean]: of my my search in recent history
has been focused on this industory so they

[sean]: probably saw this as a relevant story
for me and they kind of get bumped

[sean]: up and promoted and i was interested
why would the rolling stone be covering this

[sean]: topic and when i was reading the
rolling stone article it made me start to

[sean]: identify some key words that i was
interpreting as an attempt to mis credit the

[sean]: authors of the paper their position on
things in the past and um and ultimately

[sean]: what they were communicating in that rolling
stone actually in the in the umbrella report

[sean]: so what was being communicated in the
report was being misinterpreted and they were looking

[sean]: for others things that these authors had
said to almost align them with a very

[sean]: here in the united states a very
conservative right wing movement and trying to tie

[sean]: it to gun violence and that i
thought was an attempt to get people to

[sean]: ignore what this was trying to communicate
in the first place yeah it was in

[sean]: very poor taste not surprising because we've
we've broached topics such as this on our

[sean]: podcast previously especially how scientific ideas have
been high jacked play sized um but this

[sean]: is really disappointing because although i don't
know dr moncrief personally she's from the u

[sean]: k i'm very familiar with her work
and she is high le respected and she

[sean]: is in no way the type of
professional who is provocative she's quite measured and

[sean]: scientific certainly presents as as very compassionate
i believe she lives by that guiding principle

[sean]: of first do no harm there is
no doubt that she is a principled individual

[sean]: the highest ethical order and

[sean]: she did we'll get into this in
a second here if you if you look

[sean]: at any of her work she's a
she's a physician she's actually a psychiatrist right

[sean]: and she speaks about this know this
drug centered model u versus like a brain

[sean]: diseased model and she talks about realistically
and scientifically what the drugs actually do and

[sean]: why some people may report a benefit
but she unfortunately had to respond to that

[sean]: rolling stone article and we'll include that
in our show summary um and i'm bringing

[sean]: up the article right now she's pretty
much associated in the article some right wing

[sean]: ideology right so i'll just read the
the title of the article who is the

[sean]: psychiatrist behind the anti depress and study
taking over right wing meet and listen i've

[sean]: been looking at the various articles around
the world and there's certainly not limited to

[sean]: any political political perspective no not at
all so it says juandanna moncrefe has spent

[sean]: two decades questioning the efiqofefficacy of s
r s recently she's gone after covid nineteen

[sean]: vaccine mandates why connect this study to
covid nineteen vaccine mandates well it's been politicized

[sean]: politicized and trying you use the words
o misinformation high jack the word science among

[sean]: other things and so like trying to
communicate a message to people that if you

[sean]: question whatever the narrative that's that's presented
then you're a science denier and ultimately that's

[sean]: they're trying to discredit people um in
some ways as if they're you no conspiracy

[sean]: theorists um the truth of the matter
is r moncrief has always been clear about

[sean]: just presenting data as it exists and
then trying to inform people of what that

[sean]: data means and concern about this article
is they misrepresented a lot of her ideas

[sean]: and in some situations they were just
flat out lies and rolling stone magazine is

[sean]: a pretty influential cultural magazine in the
united states and there's there's no doubt that

[sean]: this comes across as a farm hit
piece i'm going to try to find a

[sean]: i'm going to try to get some
quotes from psychiatrist that they tried to support

[sean]: the previous narrative um m

[sean]: this paper is not coming in a
vacuum says as tab a clinical assistant professor

[sean]: of psychiatry at case western university who
previously interviewed moncrief in twenty twenty psychiatric times

[sean]: article it's coming with two decades of
work in which moncrief has consistently challenged the

[sean]: character ization of depression as a mental
illness that's a lie r moncrief very much

[sean]: communicates that being severely depressed is a
condition that requires intervention so they're shifting the

[sean]: language and correctly interpreting the thing she
said she actually does use medications in a

[sean]: very controlled way to in crises situations
when appropriate yeah and she's going to it's

[sean]: a she believes it's a decision that
needs to be made between a doctor and

[sean]: a patient best on best best avail
but evidence in which they're provided the potential

[sean]: risks and the potential benefits and it's
carefully monitored and so she's very clear about

[sean]: the potential benefits they tend to be
too thin s one when you take an

[sean]: anti depressant there is m you're inducing
a chemical in balance so you're inducing a

[sean]: physiological reaction so your body is going
to react to it the most notable one

[sean]: is blunting of emotion numbing numbing blunting
numbing and that includes both positive emotions and

[sean]: negative emotions so for a for a
small percentage of people especially if someone's feeling

[sean]: intensity of negative emotions that might be
initially interpreted as relief so we have to

[sean]: communicate that this could numb emotions much
like other drugs for some people if you

[sean]: smoke mariana or you drink alcohol they
can have similar effects everyone is different i

[sean]: was actually watch listening to a podcast
joe rogan podcast this this particular weekend where

[sean]: a someone that we've um you know
we've listened to previously and quoted on this

[sean]: podcast um m i'm forgetting his name
it's okay what was the message the message

[sean]: was that for some people for alcohol
it impacts their dopamenreceptors to differently and so

[sean]: they become highly elated and can continue
to drink for long periods of time with

[sean]: real elevated mood while other people it's
a sedative you know so for me i

[sean]: can have a couple of drinks and
it's relaxing yeah but if i have too

[sean]: many get tired the same way i'll
have you know at most two drinks now

[sean]: that's that's what two is my you
know it's my magic my comfort so everyone

[sean]: is different and we know that right
so there might be some people who take

[sean]: it in and to press it might
be in a high agitated state in a

[sean]: lot of emotional pain some emotional blunting
initially could have some potential positive interpreted improvement

[sean]: and improvement the other thing that she's
very clear of is they provide some people

[sean]: hope so it is the the placebo
response the belief that that i've found something

[sean]: to help me it's an exhale i'm
finally doing something about this and she recognizes

[sean]: how powerful that is the thing that
makes her really separate from many of her

[sean]: colleagues in the greater field and the
medical establishment she is very clear about what

[sean]: the risks are you know she'll be
open that with this drug centered model that

[sean]: in time the brain is going to
adapt and it will have an effect on

[sean]: the body right whether it's effect on
your metabolic health or your gutmicroiato or your

[sean]: brain a mysterious organ that we're still
learning about in time it certainly does increase

[sean]: to susceptibility and potentially a greater chance
of relapsing into further depressive episodes it does

[sean]: increase suicideality as we had on previous
podcasts we're learning about evidence regarding specific um

[sean]: m you know like genetic components and
like how how drugs are metabolized differently so

[sean]: bottom line as they affect people differently
and the overall research really it doesn't distinguish

[sean]: it much from a placebo response maybe
some short term response so bottom line is

[sean]: this is that she's she is not
the person that was presented in this article

[sean]: and it brings up a lot of
concern for me because um that that tells

[sean]: me that who's ever influencing this article
who's ever driving it certainly has an agenda

[sean]: and that agenda isn't science based that
agenda isn't looking out for the well being

[sean]: the health and the well being of
the populace i agree i agree if anything

[sean]: it just it separates you know we've
talked about putting people in the two camps

[sean]: it was establishing what camp are you
a part of that's that was how i

[sean]: was responding to reading that piece and
she's responded to it also because it was

[sean]: getting so many eyeballs she felt like
she really had it to or had to

[sean]: and this particular research study right now
is like the most downloaded research study it's

[sean]: been but like two or three weeks
and there's been millions of down loads so

[sean]: of course it's getting lots of attraction
as it should and she has taken a

[sean]: very appropriate path towards how to community
what it means i don't know where you

[sean]: want to continue to go in this
discussion but i read a couple of the

[sean]: other articles and i wrote down a
couple statements and i don't know a few

[sean]: i could read through them and you
can either say true false or we can

[sean]: comment on them or what are your
thoughts on to do it okay so i've

[sean]: already said that you know i interpreted
this entire study as an if then statement

[sean]: you know if the drugs were developed
to improve sara toni deficiency that's been proven

[sean]: not to be true then you know
what do the drugs do that was how

[sean]: she left it so number one is
that the research doesn't show that drugs aren't

[sean]: effective they only rule out one possible
way the drugs might work

[sean]: well i think we have decades of
studies shown that that show the drugs are

[sean]: not effective okay so too many physicians
are unwilling to take that leap because so

[sean]: many people are on them and the
moment you really proclaim that and you were

[sean]: somebody who wrote prescriptions and have been
part of that treatment for decades i think

[sean]: you're putting yourself in a precarious position
so i'm willing to say that because i've

[sean]: evaluated the research i don't believe the
drugs are anti depressence i don't think they

[sean]: have an effect on anti depressant something
that's really on anti depression something that's really

[sean]: interesting i got into an old article
um regarding what untreated depressive episodes look like

[sean]: okay and it's fascinating because what it
informs us is that depression has always been

[sean]: episodic so there is usually a time
limit to them and in particular it's when

[sean]: certain conditions resolve in your life right
could be loss of a job break up

[sean]: um a down period that exists you're
adapting when the conditions resolve themselves and your

[sean]: natural coping abilities allow you to overcome
them it's time limited so i think something

[sean]: like in his research eighty five percent
of all depressive episodes resolve themselves within twelve

[sean]: months most of them within three to
six so that means according to his research

[sean]: and i'll get that to you to
put in the show summer because i don't

[sean]: have the title with right now i
did post it on my twitter account this

[sean]: this weekend what that means is that
people are just inherently resilienthey're going to overcome

[sean]: those challenges on their own and if
you did not intervene they're going to improve

[sean]: i believe that to be true also
just based on this this you know people

[sean]: call we're not able to get to
everybody right away they go on the waiting

[sean]: list for people that get past ninety
days when we start calling them they say

[sean]: i no longer need your services ye
that's absolutely if they get an appointment elsewhere

[sean]: now i'm just i'm okay now good
and therefore this concept of wait fur watching

[sean]: is so important we've talked about that
before also so about there's going to be

[sean]: it just doesn't deny the fact that
depression in itself can be impairing and health

[sean]: condition to take seriously so there's about
fifteen per cent of people who are it's

[sean]: not gonna be episodic right it's going
to be prolonged there's probably various reasons for

[sean]: that and it's our responsibility in this
to identify how to intervene with them in

[sean]: a way that is most effective also
respects their autonomy and provides them the information

[sean]: because they're vulnerable right they're vulnerable for
for help so soon i don't believe that

[sean]: anti depressant work per se but i
am willing to say for a small percentage

[sean]: of people they interpret them for a
period of time as benefits that leads to

[sean]: my statement number two okay research suggests
anti depressant work only a bit better than

[sean]: placebo

[sean]: i'm gonna say that's false okay now
i want to expand upon that because in

[sean]: a in a study where it shows
a little bit better than placebo it's the

[sean]: law of averages within those that are
a little bit better than placebo there are

[sean]: some that are greater and some that
are less than you put them together the

[sean]: combined shows a little bit better than
very lowly so when you're talking about that

[sean]: in terms of it helps some people
the small percentage of those that it truly

[sean]: has helped would be into that group
that is a little that is better than

[sean]: placebo but most are at the placebo
level ye let me address that number one

[sean]: we're talking about better is a statistical
difference and interpretation it's a statistical difference on

[sean]: a a symptom check list yes the
best available evidence will say that statistical diff

[sean]: difference is not significant enough to have
any clinically relevant improvement in quality of life

[sean]: and i've taken the check list and
i know some of it is subjective based

[sean]: on how you're feeling at that moment
based on how tired you are did you

[sean]: get a good night sleep all that
stuff is factor into that so the other

[sean]: thing that's important to note is that
the this is fact that's the drug companies

[sean]: buried the studies that didn't demonstrate an
effect meaning they didn't publish them and that's

[sean]: called publication bias that you you publish
the studies that demonstrate in the fact and

[sean]: you don't in the ones that did
not support your intervention you put it all

[sean]: together my belief and this is from
my examination of the literature that they are

[sean]: a plus bo effect with side effects
got it statement number three there are many

[sean]: different expressions of depression that come from
a wide array of causal factors and present

[sean]: themselves differently from person to person absolutely
true absolutely in fact the idea of depression

[sean]: is just some social construct and an
umbrella term right so what one person might

[sean]: communicate as depression is just a use
of language and it's our limitations of language

[sean]: and while another person may deny that
exact same experience its depression at all it's

[sean]: a label it's trying to communicate something
that we are unable to investigate through direct

[sean]: observation so that leads to my next
statement there is no single treatment approach that

[sean]: works for everyone with depression absolutely true
okay so i was encouraged because as i

[sean]: was i stumbled upon something that's happening
in the u k and it may have

[sean]: just been in the last year or
so u k doctors have been told they

[sean]: should offer therapy exercise mindful this or
meditation to people with less severe cases of

[sean]: depression before trying medication

[sean]: i mean i think for for you
who's not been involved in this field um

[sean]: that sounds encouraging but i'm it goes
back to the language again less severe depression

[sean]: and how does one even define that
would be a doctor and a client understanding

[sean]: the circumstances and working closely kind of
like what joanna mon crave thoughts we're gonna

[sean]: have a small percentage that she feels
could truly benefit in a short period of

[sean]: time it's a huge challenge because there
is probably a very very small minute percentage

[sean]: of people who've been assigned the label
of depression who are impaired in ways that

[sean]: many of our listeners do not understand
could be catatonic states um just not leaving

[sean]: their home crying all the time and
each day as a fight to get through

[sean]: without ending their life to me that
is severe right and i think those people

[sean]: who are struggling to that extent and
have not been helped by other means should

[sean]: have every right go through any treatments
that are available including anti to presents or

[sean]: innovative drug treatments or nutritional diets or
whatever it takes right like you only got

[sean]: one life to live maybe and so
therefore yeah whatever it takes and i think

[sean]: in order to ease the suffering of
people should be you know creative and work

[sean]: with them collaboratively but i also it's
really important for me to communicate that that

[sean]: is not the percentage of people most
people who are receiving anti depressance and mental

[sean]: health treatment don't even meet that criteria
i think we have a distorted idea of

[sean]: what is actually severe depression the mag
ority of therapists out there who are working

[sean]: in community based settings are dealing with
mile to moderate even some of the more

[sean]: challenging or difficult cases still don't reach
that threshold so it's just been an expansion

[sean]: of the diagnostic h severity range that
you know too many people are being identified

[sean]: as having severe depression when in fact
m that's not what others are experiencing but

[sean]: it's jane because then you don't want
to ever invalidate someone's you can be you

[sean]: can be in a lot of emotional
pain and not be severely depressed and those

[sean]: lines have been blurred um in our
society and then you'll just see a lot

[sean]: of nonsense out there that say who
are you to determine what is severe depression

[sean]: or people are hiding it and u
and they're doing a really good job of

[sean]: hiding their emotional experience well how do
we study it and how do we have

[sean]: a science base around it if professionals
aren't able to distinguish between what is most

[sean]: impairing versus what might be a range
that exist and many of us might face

[sean]: and at one point in our in
our lives i agree i would imagine there's

[sean]: a number of individuals that are severely
depressed and fail to recognize and admit it

[sean]: and go about their lives just numb
to that fact yeah that goes into coping

[sean]: right so there are wide range of
coping styles and one one coping style is

[sean]: avoidance um and another coping style is
you know reflects around a denial of the

[sean]: experience not everyone is so connected and
in touch to what they're feeling and their

[sean]: experiencing and don't even have that concept
of depression in their their view point like

[sean]: their perspective doesn't even allow them to
understand what they're experiencing in that way so

[sean]: that's that there are many different forms
of expression that is one where others are

[sean]: very expressive yeah can i read a
quote i was looking for this quote earlier

[sean]: from this i've been stalling so yes
i'm glad you and this is what's disingenuous

[sean]: and this is what's concerning i'm going
to read the paragraph within the medical community

[sean]: the papers conclusions were nothing new david
hellerstein professor of clinical psychiatry at columbia university

[sean]: medical center and director of columbia pression
evaluation service explains that the ceratoneand hypothesis the

[sean]: idea that depression is caused by lowsrtoneand
levels a quaint and over simplified shorthand that

[sean]: has been superseded by other explanations and
clinical practice for decades now he said to

[sean]: the review was largely met with yawns
from the psychiatric community and reading it i

[sean]: was kind of thinking wow next she'll
tackle the discrediting of the black bile theory

[sean]: of depression he tells rolling stones you
smug i read you smug clown i right

[sean]: now and i want you to come
on to this podcast david hallerston i will

[sean]: reach out to you because that is
such an offensive comment because still on major

[sean]: websites around your profession they'll still talk
about it in the possibility of a chemical

[sean]: de balance chemical and balance most people
who have depression and are seeking out psychiatric

[sean]: medications still believe that to be true
our physicians in community based settings are talking

[sean]: to ants about sarah toning and depression
and that's how it's being treated in the

[sean]: in the psychiatric community you're still treating
it with s s r is selective sarah

[sean]: to nan up take inhibitors you are
talking about and associating the chemical and balance

[sean]: theory with the screading of the black
bile theory of depression how can you put

[sean]: yourself out there in a major news
outlet like rolling stone with such a stupid

[sean]: statement that's embarrassing and that is why
i have such a challenge working in this

[sean]: field when you make a statement like
that r a professor of clinical psychiatry a

[sean]: renowned university at columbia

[sean]: um hm so here's the one thing
that i like about joanna moncreave is the

[sean]: published paper came out on the twentieth
and she wrote a piece that she was

[sean]: directing everybody to where she takes it
basically step by step and she says basically

[sean]: was a title of her article actually
did a social media and it's how to

[sean]: take the news that depression has not
been shown to be caused by a chemical

[sean]: balance uh that to me is a
very responsible way of handling this and not

[sean]: attacking anyone but purely just to help
those who may misinterpret um so i think

[sean]: this is a good way to end
it not reading her thing but we've already

[sean]: touched on the important of informed consent
people reading the literature for themselves understanding what

[sean]: is communicated and then recognizing that the
next steps are not to independently make any

[sean]: decisions but to consult with physicians in
a responsible way to determine what their next

[sean]: steps may be because everybody's pressive situation
is unique and everyone is an individual their

[sean]: situations very drastically so how how can
we responsibly communicate what the next steps are

[sean]: for anyone who may be listening to
this tell you what it's you're using the

[sean]: right word being responsible and that's the
difference between someone of dr joanna moncrete's stature

[sean]: and character versus the gentleman from olumbia
is that she is going to continue this

[sean]: process on how to communicate it responsibly
to clients she also understand and i think

[sean]: through empathy that a lot of people
are going to hurt and feel a lot

[sean]: of resentment and distrust towards the greater
mental health field which i'm a part of

[sean]: and so she recognize is it with
compassion and she helps people to better understand

[sean]: the complexity of what might be happening
to them and gives them a more thorough

[sean]: clear directive on what these drugs actually
do and what are the potential risks ultimately

[sean]: that's what we're asking for we're just
asking for honesty we're asking to be able

[sean]: to communicate to people hey if you're
going to put something into your body you're

[sean]: going to start any form of treatment
or medical intervention that you're aware of what

[sean]: the potential negative outcomes exist might choose
to do it with those risks just based

[sean]: on how you're feeling right now but
it is your choice i'm here with you

[sean]: and that's just that's not the way
it's been in psychiatry psychiatry has has made

[sean]: statements that are you know really what
are ridiculous come at this point there you

[sean]: know they're going to be flected on
is absolutely ridiculous such as like considering what

[sean]: you're experiencing or feeling to be similar
to insolent for diabetes associating these drugs as

[sean]: as if they're life saving there's so
many messages that we've been exposed to over

[sean]: the last thirty years that are just
inaccurate they're harmful and they're certainly not standing

[sean]: the test of scientific scrutiny so we
have that responsibility and i like that word

[sean]: this cast has to be responsible i'm
certainly aware that people are listening and they've

[sean]: been on these sores for potentially decades
they might even prescribe them to their own

[sean]: children yeah the goal of this is
to get you to become more educated and

[sean]: to wear and then to make do
your own research and then to take the

[sean]: appropriate steps that are the best interest
of yourself or your loved ones it's important