Depression can often be misunderstood. That’s not surprising considering how rarely people talk about it. But…that’s ironic because “depressive disorders”, as they’re formally called, are extremely common. Approximately 1 out of every 20 people worldwide experiences some sort of diagnosable depression. If you don’t personally have depression, you undoubtedly have had contact with someone who does. It could be a family member Or a friend A coworker Or your favorite actor? Everyone experiences sadness from time to time. But just because someone is sad, doesn’t mean that they have a disorder. So when does it tip the scales? When do we call something “depression”, exactly? Well, the Diagnostics and Statistics Manual, which is the tool that mental health professionals use to diagnose, defines Major Depressive Disorder as this. We’re usually referring to Major Depressive Disorder when we think about depression, but there are other diagnoses. In general, they all have features of sadness and emptiness, as well as physical and cognitive symptoms that affect the person’s capacity to function for at least a two week period.

But what causes depression? Well, Alie talked all about the genetics of depression and what depression does to your brain and I strongly suggest you check out that video right here. I’ll link to it at the end if you want to check it out. Psychologists, unlike neuroscientists, place a lot of focus on cognitive and social factors that may play a role in depression. For example, how a person thinks can say a lot. In particular, there are a couple of questions that can indicate whether someone is susceptible to depression. First, how do they view themselves or others? And second, do they cope with problems or avoid them? Let’s say you have negative expectations about your ability to cope with problems. Or maybe you think others are purposefully imposing problems on you. At any point in your life, if you have repeated failures trying to solve problem, you’re more likely to feel hopeless, helpless, or abandon your usual ways of solving problems.

These factors are all predictive of depression. Or let’s say you run into an issue. What do you do? If you’re the kind of person who wants to fix it right away or you use your active coping skills like reaching out to others for help or using meditation to calm down, congratulations! You are less likely to become depressed than someone who uses passive coping skills, such as distraction or avoidance. Life stressors can also make you susceptible to depression. In fact, most people report a severe life event or difficulty in the 6 months leading up to the onset of their depression. Now, not everyone who faces difficult problems becomes depressed, but prolonged exposure to stressors can preempt a depressive episode. This is particularly true for people who do not have strong social supports like family, friends, or a community to help them. If you don’t have that external support, then you only have your internal coping skills to rely on.

Now, if you’re feeling depressed just hearing about all this, don’t fret! There is hope. Depression can be treated! Like so many disorders, prevailing research says that the combination of medication and therapy is the most effective way to treat depression. Different studies have looked at medication and therapy independently of each other to see which one works better. And they found that they’re more or less equally effective at treating symptoms. Although therapy has longer-lasting effects after completing treatment compared to medication. Alie talked about medication for depression in the last video and I’m gonna suggest once again that you go check that out. Personally, I think that while medication does a good at treating the symptoms, therapy can do a good job at addressing the underlying cause of depression.

What led them to feel that persistent and ongoing feeling of sadness and loneliness? The two most commonly used therapies for depression are Cognitive Behavioral Therapy and Interpersonal Psychotherapy. Cognitive Behavior Therapy, or CBT, takes a two-pronged approach to address how you think and how you act. On the cognitive side, it specifically addresses negativistic thinking. This is depression’s best friend. It’s essentially a takeover of your thoughts that is overly pessimistic and critical.

A person who engages in negativistic thinking expects failure and disappointment at every turn and focuses on past failures as a way to confirm that belief. It is so common for these two things to go together, that a lot of people wonder, What comes first? Does depression cause negativistic thinking? Or does negativistic thinking cause depression? Well, research indicates that pessimistic thinkers and optimistic thinkers are both at risk of depression after exposure to stressful life events, so it seems like negativistic thinking is probably the result of depression, not the other way around. CBT tries to challenge and modify these thoughts. And by changing the thoughts, it relieves the symptoms. And on the behavioral side, clients are encouraged to engage in pleasant activities to treat the numb and anhedonic symptoms they may feel. About 1 in 3 people find that CBT alone helps them with their depression. Interpersonal Psychotherapy, or IPT, on the other hand, is a therapy that was specifically developed for Major Depressive Disorder. It theorizes that how we interact with others affects our mood. As such, by helping a depressed person improve their relationships and interactions in social situations, it relieves the distress they may feel.

Depression can often be sustained or preempted by interpersonal problems. For example, social isolation, unresolved grief or loss, life transitions, and disputes with family, friends, or coworkers can all be part of that. Unlike CBT, IPT does not examine internal conflicts or personality traits. And the therapist doesn’t even really address depressive symptoms directly. Instead, they focuses on relationship patterns and improving them to improve the person’s overall satisfaction, incidentally relieving depressive symptoms. These aren’t the only two therapies that are effective, though they are currently the two most supported by evidence. There are other therapies that have shown some effectiveness in treating depression symptoms, including Social Skill Training, Behavioral Activation, and Psychodynamic Therapy.

I’ll talk more about these theories in future videos. And finally, because my friend mentioned it the other day, there is some preliminary evidence that controlled sleep deprivation may reduce depression symptoms. Though we’re not exactly sure why yet. Thanks Brandon. None of these may be the right form of therapy for you. But there is a wide range of therapies that can help just about anyone. If you or someone you care about is struggling with depression, please don’t wait. And reach out for help and seek treatment. I’ve placed resources in the description below for more information about depression and finding treatment. Remember, you are not alone and things can get better. Thanks for watching this episode of Micah Psych on Neuro Transmissions. If you learned something new about depression, then hit the thumbs up button. And subscribe if you want to be the first to see our new videos as they come out. If you really want to help us out, then head on over to Patreon and throw a few dollars our way. It really goes a long way and we’re so grateful to all of our Patrons, particularly Carrie McKenzie, Ryan Shaver, and Raymond Chin.

You guys rock. Until next time, I’m Micah. Think about it..

Anxiety is a normal part of life. You might feel anxious when you have a big test or have a meeting with your boss… Or when you have enough money to pay the bills in your account. But when anxiety goes beyond just a temporary fear or worry, when it starts to impact your life, your work, your relationships… or even your health, that’s when it becomes a serious concern. If you have anxiety, you feel it. The list of physical issues sounds like the end of a Cialis ad.

If you are taking anxiety, symptoms may include chest pain, muscle tension, headaches, stomach aches, nausea, heart palpitations, restlessness, dizziness, problems sleeping, hot flashes, chills, a whole bunch of other things, and… death. Haha, I’m just kidding about that last one. Chronic anxiety can be really bad for your long-term health, too. It has been linked to things like heart attacks and a suppressed immune system. And that doesn’t even address what’s going on in your head! Anxiety Disorders often have cognitive distortions. Cognitive distortions are irrational thoughts or beliefs about ourselves or the world around us. Basically, it’s a fancy word for worries. Examples of this might include things like all-or-nothing thinking If I don’t get done everything on my to-do list today, I’m going to be a total failure! and catastrophizing.

Oh, no. I can’t believe I made that typo in that email. They must think I’m an idiot. These cognitive distortions can have serious impacts on behavior as well, affecting a persons day-to-day life, how they interact with friends, or how they manage their job. Without treatment, anxiety symptoms tend to become more severe and frequent over time. But don’t fret! Help is out there. Contrary to popular belief, an anxiety disorder isn’t something you can just snap out of or ignore.

It also isn’t a sign of personal weakness. Or someone who is unstable. Anxiety disorders can affect anyone. This stigma against anxiety disorders keeps people from seeking help. Only one third of people suffering from anxiety get treatment, and people who believe that anxiety is a choice are even less likely to get help when they actually need it. So how do anxiety disorders come about? And who’s at risk? Well, there is a popular way of thinking about anxiety called the Threshold Model. Imagine for a moment a graph with a normal distribution curve. The Y-axis is the number of people in your population.

And the X-axis is predisposition to anxiety. In the general American population, about 20 percent of people have a current anxiety disorder. That means that people whose anxiety level crosses the threshold in this upper 20 percent will likely experience an anxiety disorder. This threshold can also change based on how you change the population. For example, anxiety seems somewhat hereditary. So if the population is people who have parents with anxiety disorders, that threshold goes up to 30 percent. Or if the population is individuals who have experienced a traumatic event, such as mass violence, that threshold goes up to 67 percent. As you can see, there’s a lot of factors that can change the threshold. So, on an individual basis, depending on genetic predisposition, environment, and life experiences, the threshold will change. Okay, so lets say you think you might have anxiety and you’d like to get some help.

Now what? The first step is setting up a meeting with a psychiatrist, psychologist, or counselor. You can discuss your thoughts and symptoms with them, and they’ll determine your diagnosis. Then they’ll help you understand it, and work with you on coping with your anxiety. There are a lot of ways to treat anxiety. Typically, the combination of medication and talk therapy is considered the most effective treatment. Alie talked about different medications, but today I’m focusing on the therapy side of things.

Honestly, there’s a lot of different therapies that could be helpful for treating anxiety. But there is one that stands head and shoulders above the rest with more than 30 years of compelling empirical data. Cognitive Behavioral Therapy, or CBT. CBT focuses on what and how a person thinks or acts, more than why a person thinks or acts that way. To boil it all down, CBT has two goals. First, there’s cognitive restructuring, which involves the therapist and client working together to change thinking patterns. For example, treatment may focus on changing cognitive distortions. If the person is able to recognize irrational thoughts and change them, they will be more able to reduce their anxiety in the future. The second goal is behavioral activation, which involves clients learning to overcome obstacles to participating in enjoyable activities. For example, exposure therapy involves exposing a person to their fear without any actual danger. If a person is scared of snakes, for example, you might have a non-venomous snake in an enclosed tank across the room.

The therapist then helps the client through what they’re feeling. Eventually, when they become desensitized to the fear and feel more comfortable, the therapist moves the tank a little closer until the client’s anxiety returns. And then they repeat the process. But how effective is this? Well, for specific phobias, like fear of sharks or string beans, individuals can see an 80 percent improvement in symptoms with as little as two to nine hours of cognitive behavioral treatment. In panic disorder, patients see about 60 to 93 percent improvement in symptoms, depending on length of therapy. Patients with social anxiety disorder and most forms of PTSD also see significant, long-term improvement when using exposure and social skills training. Overall, CBT’s effectiveness is huge. At home on your own, there are a lot of coping skills that help reduce anxiety. Mostly lots of things that are good for self-care. These include building strong relationships, getting lots of sleep, exercise, eating well, doing fun activities, and meditation. If you’d like to try reducing your anxiety at home, click in the upper right corner for a guided cognitive behavioral technique that relaxes your body and, as a result, your mind.

Anxiety is no joke. If you think you or a friend or a family member is suffering from an anxiety disorder, take a look at the description for resources in your area. Help is out there and you’re not alone. So don’t wait. Thanks for watching this episode of Micah Psych! If you liked this episode, give me a thumbs up. And hit subscribe if you’d like to catch more videos about brain diseases and disorders in the future. Make sure you head over and check out Alies video about the neuroscience of anxiety! If you love us as much as we love you, consider supporting us on Patreon.

We couldn’t do all this without your support, and we really appreciate it. Tweet me if you want to talk about anxiety or treatment or therapy. And if you’d like to learn about a particular condition, let us know in the comments below. Until next time, I’m Micah. Think about it..