Hey y'all. Today we're going to react to

some of the funniest mental health

advice on the internet. Let's see what

they get right, what they get wrong, and

what's actually going on underneath. I'm

Dr. Aloo Kenoja, a Harvard trade

psychiatrist. Let's get into it. May

have tried therapy in the past, but have

you considered trying drinking instead?

Therapy tries to get you to deal with

the emotional issues in the past life

traumas. But remember, you can't be

anxious, depressed, or stressed if

you're passed out in a bush somewhere.

>> Yeah. So,

>> bag of cans. And just remember, you're

not an alcoholic. You're practicing

pulness.

>> Pitefulness. love it. Okay, so the

really scary thing about this is he's

not wrong. And you know who else doesn't

think he's wrong is the pharmaceutical

companies. So we think about alcohol as

a problem for mental illness, which it

absolutely is. But alcohol works on the

GABA receptor. And what basically the

pharmaceutical companies did is develop

a pill that works basically identically

to alcohol. And you may have heard of

this pill. It's called Xanax or Valium

or Alprazilam or laorazzipam or

clonopins, kpins. So this is the really

scary thing is that alcohol and the GABA

receptor actually do shut down and or

numb parts of our brain. The problem is

that this is a very short-term effect

and over time alcohol worsens our mood

and anxiety, but it absolutely works

very well short term to numb things out.

>> He's feeling really down these days and

I don't know why. Have you exercised

today?

>> No. Did you go outside? No. Did you talk

to anyone? No. Did you eat well? No. Did

you limit your scrolling time? No. Did

you make any plans? No. Did you drink

enough water? No. Did you get enough

sleep? No. Wait.

>> Yeah. So, this is kind of hilarious. So,

we all know that we need to do these

kinds of things. But I think the job of

a therapist is not to tell you all the

stuff that you should be doing to help

you with your mental health. The job of

a therapist is to actually help you get

from any one of those nos to a yes.

>> Oh my god. People's depression gets so

bad they can't brush their teeth.

People's depression gets so bad they

kill themselves. Shannon.

>> Yeah. I don't know how I feel about

this. So, I don't like the word can't

when we talk about depression. Does

people's depression get so bad that they

can't brush their teeth? Yeah, maybe.

But I think the moment that we kind of

admit that, we have to be really careful

because we're also opening the door to

saying, "Okay, I can't brush my teeth.

That's because I'm depressed." And so, I

think the tricky thing about psychiatry

is, is your depression so bad that it

may not be possible for you to brush

your teeth? Yes. And does that mean we

should stop trying to brush our teeth

because we're depressed? Absolutely not.

>> Oh, yeah. Have you tried going for a

walk? Yeah, getting a little sun always

helps me. Exercising really helps. Yeah,

get that body moving. It's obvious that

you um don't do that. I think you need

to try doing a face mask. I have like

six in my fridge right now. I'll go get

one. Oh my god, I have this playlist.

It's called good vibes only. Hold on.

[music]

Have you tried just like not Yeah, just

like I look like you need a morning

routine. Yeah, literally changed my

life.

>> Yeah. So, what I love about this is

sometimes people who are really pushy

about things that you can do for your

mental health almost have this like

manic energy. And the really scary thing

is they need to prove it to themselves

that it works by getting you to do it.

Cuz the really scary thing is all the

gratitude journals and the walks

sometimes are just barely keeping things

at bay and they're not actually solving

their problems. And so that I don't know

if this makes sense, that existential

terror that all this crap that they're

doing may not be working. One of the

simplest ways to convince yourself that

you were wrong is by giving advice to

other people and having it be right for

them. Oh, and all that stuff does

actually help, but also isn't the actual

problem. which is what annoys me about

mental health advice is like if you're

depressed because you're broke, alone,

can't find a job, let's actually fix the

problem instead of adding a bunch of

crap that you should be doing on your

dayto-day, which is important and does

help, but like let's not forget that the

problem is the problem. Is it better to

fix your problem or use a coping

strategy? The answer is the question is

wrong. It's best to fix a problem and

then if you can't fix a problem, use a

coping strategy that then allows you to

fix the problem. If you're depressed

after a breakup, that feels bad, man.

So, by all means, go for a walk and then

utilize that extra energy to actually

fix the problem. It's not either or,

it's which one first. Okay, so my life

got a lot better when I viewed every

problem as a skill issue. Out of shape,

skill issue, ugly bank account, skill

issue, anxious thoughts, skill issue. I

affirmed to myself these would go away

if I got better. and magically they did

once I did. Yeah. So I really like this

because it sort of works but is a really

good example of something that is not

sustainable. So on the one hand if you

view everything as a skill issue you can

skill up and things will get better. The

bigger problem is that once you start

framing everything as a skill issue then

any problem in your life is your skill

issue. Which means that it's no longer

that your partner is abusive. It's that

you are not good enough at handling

their anger. It's not that your boss

demands too much of you. It's that you

suck too much at working. Yeah, this is

like no, not everything can be reduced

to a skill issue. The reason this works

is because if you think that you suck at

something, that's the frame, right?

That's the rules of the game is if I

suck, I am a bad person. And then if I

get better, then I am a good person. But

the problem here is that you are tying

your worth to your skill. So of course,

if you're like, "Okay, if I have sex

with 100 women, then I'm a good guy. And

then I had sex with 100 women and then I

felt like I was a good guy." Like, yeah,

that's going to work. That's not

actually fixing the problem. The problem

is your assumption that you were not a

good person unless you were good at

everything. According to a

groundbreaking study on anxiety

disorders published this week in the

[music] New England Journal of Medicine,

researchers have discovered that

feelings of anxiety can be completely

resolved as long as people think about

them real hard. After studying subjects

with mild to chronic anxiety disorders,

we found that the best way to overcome

mental stress is to isolate the root of

the anxiety, analyze it from every

possible angle, and then think about it

non-stop until it completely disappears.

The fact is whether our subjects were

spending sleepless nights panicking or

worrying so much they could done, they

all overcame their anxiety in just about

100% of the cases. Researchers worked

with numerous subjects [music] in the

middle of high stress scenarios and said

the key to overcoming anxiety is to

start by focusing on a minor problem.

List everything that can go wrong in the

worst case scenario and then repeat that

list in your head 200 times. After

anywhere between 3 to 6 hours of

perpetually torturing yourself over

things outside of your control, all

feelings of anxiety [music] will

completely disappear and you can finally

enjoy the remainder of your day.

>> So thinking about your problems doesn't

fix your anxiety as long as you're

anxious. The right thing to do is

actually calm down first and then solve

your problems. Because once the anxiety

goes away, then thinking about things

will actually like move forward in a

productive way. So it's not that you

shouldn't solve your problems. It's that

thinking about your problems while

you're anxious doesn't work in the same

way that like if I'm as a parent if I'm

pissed off at my kid and I try to

discipline them at that moment the

discipline that I come up with won't be

good right so even if I want to set

limits with my kids with my boss with my

partner I should deal with the emotion

first and solve the problem next who's

going to a therapist is he cuckoo they

don't have a therapist crazy people

you're stressed oh yeah you just need

some orange Grab it back there. It's

behind the huge tub of makebelieve

butter. Oh my god. Are you having a mild

panic attack right now? We need a

crystal. Where's the amethyst? If you're

feeling antsy, go climb a tree. You have

anxiety, too. Let's smoke trees. I'm

telling you, you're not anxious. Your

blood sugar's low. You need a Coca-Cola.

Okay. The 110 g sugar breakfast didn't

get YOU GO. COME HERE. What have I found

that helps anxiety? Uh, well, I get into

an ice bath for a few minutes every day

and I micro do ketamine. Oh, my mood

ring just turned green, which means I'm

content. I am not content. I'm going to

go dye my hair green.

>> I think I have a mental illness.

>> No, you don't.

>> I really don't think I have a mental

illness.

>> Yes, you do. My job is finally

implementing a companywide self-care

week. Like, it's about time.

>> What are you going to do?

>> Uh, have panic attacks.

>> Yeah. So, what I think is hilarious

about these is how hard they're trying

to convince themselves of something. So,

this is funny, right? Because people can

end up on both of these ends of the

spectrum. Either you believe that

nothing is mental illness and everything

can be solved with diet and orange

juice, or you believe that everything is

mental illness, the healing power of

crystals or whatever. The key thing

about both of these, which makes them

absurd, is that people try so hard,

they're so invested in their beliefs of

what mental illness is. And the sad

thing is the best way forward is to

actually do neither of these things or

to do a little bit of both. Not

everything is mental illness. Not

everything can be fixed with the healing

power of crystals. And actually like

going to therapy or exercising can

sometimes help when the crystals fall

short. By the way, I'm also a certified

crystal healer and raiki healer. And I'm

a Harvard trained psychiatrist. There is

a reason why I practice psychiatry every

day. And the crystal collection is

something fun that I show my kids. Hey

y'all. If y'all want to learn a little

bit more, by all means, watch another

YouTube video. If you guys are actually

interested in finding the practical

[music] tools to change on your own,

that's where memberships comes in. And

if y'all are interested in getting some

help or achieving a particular milestone

4 weeks, 8 weeks or 12 weeks from now,

[music] check out coaching. So if y'all

are interested, check out the link in

the description below.

>> Reasons why you should not kill

yourself. They will see your unshaved

PEW. THEY CAN EVEN COMB IT, COIL IT,

THEY CAN DO A LOT OF THINGS TO IT. YOU

WILL NEVER KNOW WHY BECAUSE YOU'RE DEAD.

YOUR EX WILL FIND OUT AND think you did

it because of death. YOU CAN LITERALLY

HAVE SOMEONE walking around being like,

"I'm the reason why people end their

lives." I'm a spite. Stay alive. Who

could possibly look like the baddest

bitty on the planet Earth? But you

wouldn't know cuz you wouldn't have a

future when you're gone.

>> Fake people, we act LIKE THEY KNEW YOU.

IMAGINE SOMEBODY WEARING YOUR NAME ON

THEIR SHIRT PRETENDING LIKE THEY KNEW

YOU. THIS RIGHT THERE WOULD actually

really irk me out. Boom. You have not

lived your dream life yet. You haven't

experienced life rich. You going to end

it when you broke. Damn. Damn. On a

serious note, you never know what your

life could look like. No situation is

permanent. You're not the only one going

through it. Everybody is going through

it. So, please, I beg, stay with me.

Don't go anywhere. I'll see you guys in

the next video.

>> I appreciate the sentiment, but let's go

through these. So, I think the reason

that people end up killing themselves is

because the poverty that they're in is

going to last forever. that there is

never going to be a glow up, right? Like

that's that's what happens. Like the

moment that the future becomes fixed as

bad is when people move towards suicide.

So it's fine to say like, hey, you

haven't had your glow up yet. There's

always a chance. But for the people who

believe that, they're not the ones who

are suicidal. As for the narcissism bit,

there going to be people out there that

that are going to claim credit. Yeah, I

dumped them and they couldn't handle it.

I'm the best thing on the planet. Which

is absolutely true. Like, so this is

something that's really, really scary.

People with histrionic personality

disorder and narcissistic personality

disorder use the deaths of people around

them to inflate their own ego and is

amazing opportunities for virtue

signaling and getting sympathy from

people because it's really easy to do.

Like, it's crazy how much someone's

death gets hijacked by histrionic

narcissistic people to leech sympathy

from the people around them. But I think

this is also one of these things where

it's like, okay, even if it's that's

true, is the compass that you're going

to use to live your life to deny

sympathy to narcissistic people, like

that's very motivating. Like it's a it's

a really bitter way to live life, but

that feels like it's not really like, oh

yeah, I don't want to let the narcissist

win. That's why I'm going to stay alive.

Doesn't seem like a great reason to

live. But hatred of other people in

denying them some degree of

psychological enjoyment is actually a

very effective way to be motivated in

life.

>> Friends of local man Carl Brewster told

reporters this week that while they have

long known the cheerful 32-year-old,

they are all absolutely at a loss as to

how he is not completely depressed.

Onion reporters spoke to Brewster's

friends about the man they say should be

crippled by sadness at all times.

>> I've known Carl for years now and he

really is a great guy. I am super nice,

but honestly, I don't know how he

doesn't go home and cry himself to sleep

every night. I mean, doesn't have

healthcare. He walks dogs for a living,

and no one will ever date him. I really

don't get it.

>> Saying that they were baffled at how

their close friend managed to remain

even moderately happy day in and day out

given his life's circumstances. Sources

confirmed they were regularly confronted

with Carl's perplexingly gregarious and

affable demeanor. I mean, Carl's life

really, really sucks, but somehow he

manages to wave good morning to me every

time I see him, and he always has this

big smile on his face. Even with

everything he goes through, he's still

always asking people to hang out. I

mean, nobody ever does, but still. Maybe

he's on some kind of medication.

>> Things have always been really awful for

Carl, but he's never really been

depressed. I mean, I make three times as

much money as him, and I'm totally

miserable. Honestly, we all thought he

would have killed himself by now, but he

hasn't.

>> Yeah. So, this is hilarious. So, two

things. Number one, do circumstances

determine happiness? Right? If your

answer to that question is yes, then you

will be perplexed by why Carl is not

depressed? But I think this is where

like one of the key things that we

teach, right, when you go and you sit in

a cave in the Himalayas for a couple of

years is you learn this outlook. So

maybe the reason he's not depressed is

that he's a touch enlightened. And my

experience, this is this is going to be

really perplexing, but my experience is

that the more spiritually developed you

become, the more insane you seem to

people. And I'll leave y'all with a

quote I think by Krishna Mory that being

well adjusted to a sick society does not

make you healthy.

>> I don't understand how even after Keith

did what he did to you and even in the

midst of the shame of being here, you

can possibly still be mooning over him.

That's because you're a monkey who

doesn't understand the human condition.

>> Having met you, I understand why it's a

condition.

>> You don't stop loving a person just

because they injure you. [snorts]

>> It helps.

>> Well, love is not rational.

>> Clearly,

>> I want him to have a long life during

which he is miserable every single day

before slowly dying of regret.

>> There are 7 billion people in the world.

So, when one of them behaves badly

toward you, he's actually doing you a

great favor because he's saving you

time. He's telling you that he's not

worth your while. He's freeing you to

say, "Thank you for the information. I

will now move on to the 6

bill999,999,999

other people, some of whom may have some

value."

>> And is that what you've done, Frank?

Just sifted calmly and sensibly through

the entire population, searching for

your soulmate?

>> No, I have opted out, which makes me

uniquely qualified to observe and

comment on your situation. I'm so lucky.

>> Yeah. So, what I think is fascinating

about this is like sort of how right and

how wrong both of them are. So, I think

the most operative word here is I don't

understand. And if you don't understand

something and you choose to go on to

observe it, comment on it, be logical

about it. You don't understand. You're

applying your standard. Stepping outside

of it and judging it from the outside

like I'm like, "Oh, hey, I don't

understand why people buy bags. It's

dumb for XYZ reasons." Clearly, if you

don't understand, the solution is not to

judge from the outside. It's to actually

make an attempt to understand. The

second thing here is that there are two

ways to deal with something like

breakup. One is what the the woman is

saying, which is, you know, I'm going to

continue to be somewhat spiteful. I'm

going to continue to be somewhat

resentful. I'm going to be in love. I'm

going to stay in love. And like love,

just because someone hurts you doesn't

mean that love goes away, which is

absolutely correct. And then the other

option is I'm actually going to opt out

of all of this, which I think is equally

bad. So one is throwing in the towel and

one is staying on autopilot. I think the

right way to do it is to actually detach

from the situation, not by opting out

because like running away from it is not

detachment. Running away from it is

actually responding to your attachment

of the thing. I hate being disappointed

by love so much that I'm going to run

away or sitting in it and kind of

saying, "Hey, I love this person. They

hurt me. I wish all kinds of pain and

suffering on them." Both of those are

still being driven by the love. So, what

you want to do is have the love, but

don't be controlled by it. That's what

detachment is.

>> I'm sure you're incredibly cynical about

people self- diagnosing on Chhat GPT.

>> No, you're not.

>> No, I love it.

>> Oh, I was going to actually challenge

you if you were. So, I was going to ask

you. No, no, no. I was sorry, not

challenge you. Who am I? I just mean

like you should challenge.

>> No, I guess what I mean is

>> a good podcast is all about challenge.

>> No, but I guess what I meant is like I'm

sure you're probably cynical, but don't

you think there's also some great

benefit? Sometimes I'll be totally

paranoid about something and 99 out of

100 times the internet tells me, "No,

relax. It's definitely not that." Does

that help when the internet tells you

that?

>> Of course.

>> Does it help more when the internet

tells you that or when a a human doctor

tells you that?

>> Obviously a doctor, but

>> is obviously I don't know. Some people

believe the internet more than the

doctors.

>> Absolutely. I love the way Mike

approaches this. Remember that there's a

reason why human beings do what they do.

And talking to Chachi PT, it's actually

scary how many patients I've had who

have had doctors tell them, "Hey,

there's nothing wrong with you." And

there is something wrong with you. It's

shocking how many patients I've had who

have become amateur medical

professionals by searching through the

internet over and over and over again

and do actually find answers to their

questions. That absolutely happens. The

scary thing is that there are an equal

number or probably more number of people

who go through the internet or talk to

AI and arrive at the wrong answer. And

so that's what makes like living today

on the internet so hard is that your

doctor could be right or they could be

wrong. And the the internet could lead

you to salvation or could lead you to

damnation. And I particularly like when

he was like, "Yeah, are you going to

leave a believe a group of people on the

internet more? Are you going to believe

a doctor more?" The person says, "Well,

a doctor, obviously." I actually don't

think that's obvious. I think that often

times people's experiences are that they

do believe people on the internet more.

Why? Because the people on the internet

understand you. They are your people.

They go through what you go through.

That's the whole point of algorithms and

echo chambers. These are your people, so

you're more likely to trust them instead

of a doctor. How many therapists are

saying that toxic masculinity is bad and

you should stop being that way? And yet,

is the manosphere and all the alpha

males, is that decreasing at all? Are

people believing the therapists? No,

absolutely not. And that's because we

actually do believe people on the

internet more than we believe medical

professionals. That's why people are

doing things like taking horse dewormer

for CO.

>> Are you feeling like you need a little

more self-love this week, but your

normal coping mechanisms aren't working

for you? Then this viral art therapy

activity might just be the perfect way

to pull you right out of your doom

spiral. First, think about the colors

that are bringing you the most worry. I

chose three shades of orange and a

sunburnt beige. Now, close your eyes and

let your emotions guide your arms and

sway into the artwork. Feel the artwork.

Really let go. Once you feel gratitude

in your heart, open your eyes and behold

the meaning and purpose that you just

created. Now, write down one positive

affirmation. Oh, no. And then spend the

rest of the day meditating on that

affirmation. This should help you

achieve the gratitude that you're

seeking.

>> So, I think that actually started off

really strong. So, first thing, your

coping mechanisms that keep you stuck,

try something else. Do something like

art therapy. Give it a shot. See,

there's two ways to deal with what's on

the inside. We can bury it through food,

through drugs, through technology. Or we

can let it out through therapy or art.

The problem is that when we let things

out, we don't have to end up in a

positive place. We actually want to end

up in a negative place. We want to vent

our negativity. We don't have to turn it

into something. The most damaging belief

that I've ever heard about trauma is

that it helped you in some way. It was

meant for something. No. Some things in

life actually are just bad. They just

suck. That's it. There's no benefit. You

don't have to end on a positive note.

And the more that we admit that,

acknowledge it instead of turning

everything positive, the better off

we're going to be. These positive

affirmations that you meditate on, it

doesn't work. It just it doesn't work.

Positive affirmations that you force

yourself to meditate on is how we end up

with toxic positivity, which is

essentially attempting to gaslight

yourself and turn something negative

into something positive. What actually

works way way way better is you sit with

the negativity, you vent with the

negativity, and once it's gone, you can

start the process of looking for

positive.

[music]

>> Is your partner's depression buming you

out?

>> Are your friends frequent anxiety

attacks standing in the way of you

having a good time? [music]

your friend's inescapable downward

spiral of insomnia dissociative episodes

that has obliterated their ability to

function really killing your vibe.

>> I've just been like really overwhelmed

lately and I I don't know what to do.

>> When your friend reaches out to you for

help, wouldn't it be great to be able to

just press a button and make it all go

away? Introducing Thanks, I'm Cured.

Thanks, I'm Cured comes pre-programmed

with over 1,500 automated responses

guaranteed to make you feel like you're

helping. don't know how much more of

this I can take.

>> You should probably just exercise more.

[snorts]

>> So, I just don't see any reason to keep

going.

>> My partner opened up to me about their

mental illnesses, and I didn't have the

understanding or experience to offer any

qualified advice.

>> That's okay.

>> But

that didn't stop me from weighing in

anyway.

>> Have you tried being more positive? the

new relatability expansion for when

you'd prefer to make it all about you.

>> Oh my god,

too.

>> So, first thing to understand, what is

the job of a friend or partner when it

comes to mental illness? Your job is not

to be their therapist. So, if we think

about friendship or marriage, a big part

of this is reciprocity. So, should you

help your friends when they are down?

Absolutely. Should they help you when

you are down also? Absolutely. So what I

think is like what this is really

touching on that's very interesting is

there are actually a lot of people who

have friendships where they slip into

the role of caregiver. They slip into

the role of therapist. I don't actually

think that's healthy. A friendship is

about reciprocity. Working with a

therapist is not right. There's one

person who is doing the help and one

person who is receiving the help. And

that's a really healthy model for a lot

of reasons. So there's another dynamic

that happens which is sometimes when

people are mentally ill or even not

mentally ill personality disorder they

can start to outsource their emotional

coping to other people. So instead of

managing my own emotions instead of

going to therapy what I'm going to do is

call my friend every time I'm having a a

hard time. And that I think is a really

good example of like why this is you

know this is making fun of this is

saying like oh like have you ever tried

like just listening? No, don't do that.

The problem is that sometimes you do

listen and then you're it doesn't seem

to help. It helps temporarily, but then

you're listening again the next day and

you're listening again the next day. And

this is exactly the difference between a

friend and a therapist. A therapist

doesn't listen just to listen again and

again and again and again. That

validation step, that listening step is

followed by an insight step, is followed

by an action step. So this this pattern

of mental illness with friend can end up

with a weird kind of dependence that is

absolutely unhealthy.

>> I spent years battling with severe panic

attacks. Absolutely crippling. [music]

But then I did a push-up and now I'm

cured.

>> By the way, so studies show that

exercise has the same effect size as

anti-depressants or anti-anxiety

medications for the treatment of anxiety

or depression. I had a chemical

imbalance in my brain that prevented it

from

>> By the way, there is a really

interesting paper from molecular

psychiatry that suggests that depression

is not due to a chemical imbalance and

actually lays out a convincing argument

that we have no data that it is due to a

chemical imbalance. This is kind of a

weird thing, but hear me out. The reason

we think that depression is due to a

chemical imbalance of serotonin is

because drug companies developed SSRIs,

which are selective serotonin reuptake

inhibitors, which boost serotonin

transmission in the brain. And then what

they did is they said, "Okay, here's a

random medication that helps people with

depression. This medication increases

serotonin levels. Therefore, that must

mean that serotonin levels are low in

the brain." But the thing is, in order

to measure serotonin levels in the

brain, we'd have to do like interstitial

biopsies between neurons. No one is

actually doing that. No one is injecting

needles into the brain and measuring the

serotonin concentrations between two

neurons. So, it's just that the medicine

works, but we actually don't understand

why. [sighs and gasps]

>> Okay. Um, why don't you just start by

telling me what's wrong from the

beginning?

>> I mean, I guess the short story is I'm

depressed.

>> Uh, how long has it been going on?

>> It's it's been going on for a while now.

The thing is, I just I just never feel

happy. I wake up in the morning and I'm

depressed and that just carries through

the rest of the day. And then anytime

anyone says anything to me, it just

sends me into a negative thought spiral

that I can't get out of.

>> Yeah. Right. A negative thought spiral.

>> Yeah. [music]

>> Um have you tried uh when you wake up in

the morning just

not being depressed?

>> What?

>> Because it starts in the morning. Um

have you tried starting the day not

being depressed?

>> Not being depressed.

>> Wake up and not be depressed.

>> Well, that's the thing I'm finding

difficult. I I I can't do that. Have you

tried uh having an apple?

>> Just just an apple.

>> Yeah, just have a munch on a nice red

apple. You'll feel better in no time.

>> And that works.

>> Absolutely it does.

>> I just don't think a diet change is

going to help me.

>> So, actually diet change does help. So,

I I saw another study about stool

transplants and apparently inserting

stool from non-depressed people into

people who are depressed can lead to

dramatic reductions. I think the highest

effect side size I've seen is 70%. And

the crazy thing about is that you don't

have to do anything. You just get a

stool transplant and it changes your

mental health. Probably the reason for

that is that serotonin is actually

produced by our gut bacteria. So if you

have low productions gut bacteria in

your gut, which can be due to diet, then

your body is not producing enough

indogenous serotonin. And then if you

transplant high serotonin producing

bacteria, that can actually be quite

sufficient at improving symptoms. The

other really scary thing about this is

when people say, "Oh, have you tried not

being depressed?" And the thought of

that is absurd, right? The only thing

that's absurd is trying harder. But if

we literally think about what is my job

as a psychiatrist, it is teaching people

the skill of not being depressed. It is

teaching people the skill of acting in

spite of how you think. So there's a

great study on something called or great

methodology called behavioral activation

which shows that depressed people think

that the reason that they can't act is

because they're depressed. But studies

on behavioral activation show us it's

the other way around that it is the

inaction that leads to depression. And

if we induce action, depression actually

gets better. So as crazy as that sounds,

like this is an evidence-based modality

called behavioral activation. Another

example of the right skill to not be

depressed, this is a skill issue, not an

effort issue, is something called a

cognitive reframe. So when something

happens in my life, my brain is trained

to interpret it in a particular way. If

I'm prone to depression, that means

something called a negative cognitive

bias. So I tend to view things in the

worst light. This is the crazy thing.

There is actually a skill to retrain

your brain to not view things in the

worst possible light. And this is

something that you have to practice day

in and day out and ideally is taught to

you, modeled for you by a therapist. But

the really scary thing is that like a

lot of what we do in psychotherapy is

actually teaching people how to not be

depressed by sort of thinking their way

out of it and kind of trying to not be

depressed. The only problem is nobody

knows what the actual trying looks like.

>> What is it?

>> It's an apple.

>> It's [clears throat] an apple. So have a

munch.

You really get those juices around the

mouth. That sugar. You'll feel the sugar

kind of like revitalizing you.

>> Yeah. How's it feeling?

>> No. No. No.

>> The scary thing is that there's actually

some validity to this, too. I know it's

absurd, but literally what the guy just

said, which is feel the sugars in your

mouth is actually helpful for

depression. So, in depression, one of

the things that happens is we have

thought spirals. We're stuck up up here.

Numerous studies on things like

grounding techniques and the mechanism

of mindfulness, which has been shown to

be effective in depression, is when you

ground your attention in something else.

And if you think about a thought spiral,

what's going on is you're spinning in

your head. You're thinking about it.

Your attention is on your thoughts. If

we deviate our attention away from our

thoughts, the thought energy will

actually deplete. Like that's like the

literally the mechanism of mindfulness.

And when I'm working with patients who

are struggling to do mindfulness, the

main thing that I tell them to do is to

engage in a sensory experience that is

very strong. When I was working on the

inpatient unit for borderline

personality disorder and trauma

disorders, we'd sometimes have patients

who would engage in self-injurious

behavior, would be acutely suicidal, and

we'd tell them to take their face and

dunk it in a bucket of ice water. And

this strong sensory experience literally

snaps them out of their thinking.

There's also something called the

mamalian diving reflex, which is

triggered when you go into cold water,

which actually like physiologically

shuts off your thought spirals. So, I

know this is absurd and there's an

element to this is absurd, but there's

an element of this actually works which

is even crazier.

>> Oh, look, an apple's not going to help.

>> And I love this reaction because this is

the other problem when it comes to a lot

of these solutions for depression. My

biggest challenge as a psychiatrist is

not the intervention itself. It is

getting patients to give it a fair try.

So, we're all familiar with something

called the placebo effect, which is if I

believe something's going to work, it's

going to work. And the placebo effect

works for things like cancer. Like, you

can literally give someone with cancer a

sugar pill, tell them it'll help, and it

you can actually see an improvement in

cancer. There's another effect called

the noibo effect, which is if you

believe something isn't going to work,

it reduces its therapeutic value. So if

you've given up mentally checked out of

the treatment before it even starts,

that is the reason that it's not

working, not because the treatment is

ineffective.

>> I need your help. I need actual tips to

change my mindset because I don't know

what I'm going to do if I can't.

>> I can see that this is [music] a really

serious issue for you.

Depression is a beast that can drag you

down for years. But what I need you to

know is that you just need

to snap out of it. You feel the sadness

and you just go shake it off. You do

that or just let go and shake it off.

Shake [snorts] the sadness off. Another

thing you can try just smile and you can

laugh as well. [laughter]

>> Scary.

>> But four things. Let's talk about them

each in turn. Number one, he did a good

job of empathizing. So, how do we

convince a patient that a treatment may

work? We actually listen and absorb some

of the energy of their negative

experience. You have to actually

validate that yeah, it is hopeless. You

have to get that negative energy out so

that things can work. Second thing that

he talked about is shake it out, which

actually once again in numerous studies

show that physical exercise, even things

like holotropic breath work, yoga,

physically, even things I imagine like

dance may be effective at reducing your

depression. in terms of exercise and

other kinds of physical mobility like

that's absolutely true. I haven't seen

studies on dance but I imagine if you

can get a depressed person to actually

dance it's got to elevate their mood.

The last thing once again is smiling. So

it's not a fake smile but cultivating

positive emotion is one of the skills to

combat depression and a smile has a

reciprocal effect. When I'm happy I

smile and if I smile I will feel happy.

That is the nature of an empathic smile.

So I'll give you guys an example. So

notice that if you smiled, I mean that

was kind of a fake smile, but if you're

smiling right now, notice that the smile

comes first in a burst of contentment,

happiness, or pleasure comes next.

>> I choose to be happy.

>> Happiness is not a choice, it's a skill.

The crazy thing is that some of the

stuff we covered today does actually

work even though people are memeing on

it. So, we have a Chiong master who did

an awesome lecture for us that when

people shake in the way that he teaches,

it actually improves mood and anxiety.

You guys can find it in the link in the

description below. It'll take you to our

website in our membership where you can

sign up for your free trial and actually

take the class and see if you feel

better. I got into it. I did it for 5

minutes and like I felt better. It's

insane how quickly it works.