What people FAIL TO UNDERSTAND about DEPRESSION: your life could be better

PsycHacks
1 Mar 202409:11

Summary

TLDRDr. Orion Taban argues that depression is commonly misunderstood. He critiques the belief that depression resides solely in the brain or mind of the individual, calling this the 'intraspsychic fallacy.' Instead, he contends that depression often stems from one's low position in social hierarchies, which brings discomfort and adversity. He advocates behavioral activation - actively changing one's circumstances - as the most reliable intervention. Moving up hierarchies can make life less unpleasant, which may alleviate depression more effectively than changing thoughts or brain chemistry alone.

Takeaways

  • 😟 The 'intraspychic fallacy' assumes depression resides entirely within the depressed individual's brain or mind
  • 😞 Anti-depressants have a poor track record in clinical trials and the serotonin hypothesis was disproven
  • 😐 Cognitive therapy can help reduce depressive symptoms more enduringly than medications
  • 😢 Many people are depressed due to actual difficult life circumstances
  • 😔 Symptoms of depression can perpetuate difficult life circumstances
  • 😌 Moving up status hierarchies reliably reduces depression
  • 😊 Behavioral activation and increased activity help alleviate depression
  • 🤔 Rule out whether depression is caused by loneliness, lack of fulfillment etc. before treating as disease
  • 😥 Young men often start at bottom of status hierarchies, making depression common
  • 🙂 Considering environmental factors is crucial for understanding and treating depression

Q & A

  • What is the monoamine hypothesis of depression?

    -The monoamine hypothesis is the theory that depression is caused by an imbalance in certain brain chemicals like serotonin. It suggests that antidepressants can help by recalibrating this imbalance.

  • What evidence is there against the monoamine hypothesis?

    -The largest meta-analysis on this topic found no consistent evidence linking serotonin levels to depression. Also, antidepressants have a poor track record compared to placebo in clinical trials.

  • What is the cognitive hypothesis of depression?

    -The cognitive hypothesis maintains that depression is caused by distorted beliefs and thoughts about oneself and the world. It suggests psychotherapy can help by restructuring these beliefs.

  • What evidence supports the cognitive hypothesis?

    -Psychotherapy, especially CBT, does seem to provide lasting reduction in depressive symptoms, more so than medications alone.

  • How does status relate to depression?

    -Being low status in dominance hierarchies makes life difficult and is associated with higher rates of depression. Moving up hierarchies can alleviate depression.

  • Why are young men prone to status-related depression?

    -Young men start at the bottom of most status hierarchies as soon as they enter the adult world at 18, making them vulnerable.

  • How do the symptoms of depression perpetuate it?

    -Depression promotes behavioral inertia and unrealistic pessimism about the possibility for change, making it harder for sufferers to improve their situation.

  • What is the most effective intervention for depression?

    -Behavioral activation - actually getting out and doing something different - is most consistently effective. This can improve status and life circumstances.

  • What should you rule out before treating depression medically?

    -Rule out causes like loneliness, lack of fulfillment, and poor discipline first, since those can resemble depression but don't require medical treatment.

  • What role can changing thoughts and brain chemicals play?

    -These may help treat depression arising even when life circumstances are good, but first rule out life conditions as the cause.

Outlines

00:00

😟 Monoamine hypothesis linking serotonin to depression disproven; anti-depressants ineffective

The paragraph summarizes research disproving the monoamine hypothesis that low serotonin causes depression. It states that the largest meta-analysis found no association between serotonin and depression. It also states that anti-depressants manipulating serotonin perform poorly in trials. The originator of the hypothesis recanted it decades ago due to lack of evidence.

05:00

😔 Ignoring environmental causes of depression; improving status alleviates symptoms

The paragraph argues that depression is often caused by one's status and environment rather than solely internal factors. It states that depression is associated with low status and hierarchy position, which makes life unpleasant. While therapy helps, the most effective intervention is behavioral activation - doing something to improve one's status and environmental factors. This makes life more comfortable and fulfilling, alleviating depression.

Mindmap

Keywords

💡depression

Depression is a commonly diagnosed mental health disorder characterized by persistent sadness, loss of interest in enjoyable activities, and other symptoms. The video focuses on common misunderstandings about the causes and treatments of depression.

💡monoamine hypothesis

The monoamine hypothesis is a theory that depression is caused by low levels or imbalance of brain chemicals like serotonin. The video states that this theory has been disproven but is still used to justify antidepressant medications.

💡antidepressants

Antidepressant medications are used to treat depression by altering brain chemistry. However, the video cites research showing antidepressants are often no more effective than placebos.

💡psychotherapy

Psychotherapy refers to talk therapy techniques like cognitive behavioral therapy used to treat depression. The video acknowledges psychotherapy can help reduce depressive symptoms.

💡status

The video argues a key driver of depression is low social status and lack of life opportunities. Moving up status hierarchies can alleviate depression.

💡behavioral activation

Behavioral activation refers to increasing activity levels to counteract the inertia caused by depression. The video states behavioral activation is the most effective intervention.

💡intraspychic fallacy

The intraspychic fallacy refers to the mistaken belief that depression resides solely in the brain or mind. The video argues depression is also driven by external social status factors.

💡loneliness

The video asks whether someone is actually depressed or just lonely. Loneliness is presented as a possible alternate explanation for depression symptoms.

💡unfulfilled

The video asks if someone is depressed or just unfulfilled in life. Lack of meaning/purpose is presented as a possible driver of depression.

💡undisciplined

The video questions if someone is truly clinically depressed or just lacks discipline/direction. External factors like status are emphasized over internal factors.

Highlights

Depression is one of the most commonly diagnosed mental illnesses and affects millions of people's quality of life.

The main way depression is misunderstood is the belief that it resides entirely within the depressed individual, which I call the intrapsychic fallacy.

Antidepressants that target serotonin have a poor track record compared to placebo and the link between serotonin and depression has been disproven.

Cognitive behavioral therapy has more enduring benefits compared to medications but may not be sufficient to eliminate depression entirely.

The intrapsychic fallacy ignores external factors like relationships and status hierarchies that contribute significantly to depression.

Those at the bottom of social hierarchies are most prone to depression and least equipped to mitigate it.

Symptoms of depression can keep people stuck longer than necessary as it breeds pessimism and behavioral inertia.

Increasing social status is a reliable way to alleviate depression by making life less difficult.

It's important to rule out whether depression is caused by life being unpleasant before assuming it's purely medical.

The most effective intervention for depression is behavioral activation - doing something different.

It's worth ruling out confounds like loneliness and lack of fulfillment before treating depression medically.

Comments welcome on whether this analysis fits with personal experiences of depression.

Consider becoming a channel member for priority comment review and consultation booking.

Check out my top-rated GRE study program at StellarGRE.com if you're considering grad school.

Please share this episode if you found it valuable to help spread this different perspective on depression.

Transcripts

play00:00

I'm Dr Orion taban and this is psyx

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Better Living Through psychology and the

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topic of today's short talk is what

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people fail to understand about

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depression depression is one of the most

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commonly diagnosed mental illnesses on

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the planet Legions of Americans are

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currently taking some form of prescribed

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anti-depressant it is a problem that

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affects the quality of life of millions

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and millions of individuals every day

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and it's also an issue that is generally

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misunderstood

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by the vast majority of people including

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those suffering from it let's talk about

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this today the principal way in which

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depression is

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misunderstood is that is considered to

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reside entirely between the ears of the

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depressed individual I call this the

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intas psychic fallacy and this fallacy

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gives rise to the two most popular

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approaches to intervention neither of

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which unfortunately is associated with a

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very very high rate of success we can

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look at each one in turn the first way

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this fallacy manifests itself is in the

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belief that depression exists in the

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brain of the depressed individual you're

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probably familiar with some version of

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the monoamine hypothesis which I have

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previously discussed on this channel the

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monoamine hypothesis is the theory that

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depression is caused by an imbalance in

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certain brain chemicals like serotonin

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and if this were true true it would make

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sense to recalibrate the balance of

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these brain chemicals using

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pharmaceutical

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interventions now many people don't know

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that this hypothesis was actually

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recanted by its originator decades ago

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due to a lack of evidence to quote the

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largest metaanalysis ever conducted on

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the topic quote the main areas of

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Serotonin research provide no consistent

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evidence of there being an association

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between serotonin and depression and no

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support for the hypothesis that

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depression is caused by lower serotonin

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activity or concentrations linked to the

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full study in the pinned comment note

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that the finding was no

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association which means the metanalysis

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failed to identify even a correlation

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let alone a causation between serotonin

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levels and

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depression what's more anti presence

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that manipulate serotonin have a

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terrible track record in randomized

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controlled trials when compared against

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an active Placebo and why aren't these

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findings more widely known you know I'm

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not sure but I doubt it could have

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anything to do with the fact that there

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is an entire rationale for a

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multi-billion dollar industry that is

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predicated on the validity of that

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hypothesis but I digress the point here

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is that anti-depressants are one of the

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inevitable consequences of considering

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depression to exist in the brain of the

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depressed individual and the second way

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this fallacy manifests itself is in the

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belief that depression exists in the

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mind of the depressed individual we

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could call this the cognitive hypothesis

play03:14

which maintains that depression is

play03:16

caused by the presence of certain

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distorted beliefs about the self in the

play03:20

world if these thoughts and beliefs were

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sufficiently restructured or brought

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into alignment with reality then the

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depression should diminish significantly

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and if this were true

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it would make sense to restructure

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certain beliefs like those related to

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the self-concept or associated with

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self-efficacy using individual

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Psychotherapy and this isn't entirely

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wrong Psychotherapy especially cognitive

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behavioral therapy is associated with a

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reduction in depressive symptoms what's

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more these reductions are typically more

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enduring than any reductions associated

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with psychiatric medications that means

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that folks tend to derive a protective

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benefit from therapy even after it is

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discontinued that they don't derive from

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Pharmaceuticals after they are

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discontinued and certain therapeutic

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interventions might be necessary though

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perhaps not entirely sufficient to

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eliminating depression for instance it

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is extremely difficult if not impossible

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to recover from depression while the

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critical inner voice is still active and

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highly engaged and Psychotherapy can

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significantly help to silence this

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Insidious inject in any case the point

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here is that individual Psychotherapy is

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one of the inevitable consequences of

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considering depression to exist in the

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mind of the depressed individual now

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before I go any further if you're liking

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thank you I will also soon be starting a

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opt in you can do so on my website and

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best s the market you're going to love

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it okay so let's get back to it so

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what's wrong with the in psychic fallacy

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well in my opinion it largely ignores

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where the L's share of depression comes

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from namely people's relationships to

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their larger environments of particular

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note is the fact that depression is

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associated with being low status in a

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self-relevant dominance

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hierarchy life is hard at the bottom of

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the latter low status individuals are

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more likely to have limited if any

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optionality with respect to professional

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opportunities and little to know access

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to sexual relationships they may have

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few to know friends or close confidants

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they may be ignored or even reviled by

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those around them and while it is

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possible strictly speaking to be

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peaceful and contented and resilient at

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the bottom of the hierarchy it is

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extremely difficult to do so and those

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who reside at the lowest rungs of these

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hierarchies are typically those least

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equipped with the skills to mitigate the

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effects of their status and guest who

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always starts out at the bottom of Any

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Given status hierarchy young men as soon

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as you get out there at 18 you are at

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the bottom of the barrel that's why

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that's why this is a particularly

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Insidious disease among young men this

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kind of status oriented

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depression the fact of the matter is

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that many people are depressed because

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of the actual state of their lives

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unfortunately the symptoms of depression

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can keep people mired in this state much

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longer than is necessary this is not

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only because depression is unjustifiably

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pessimistic or even hopeless about the

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future and so inappropriately assumes

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that the way things are is the way

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they're always going to be but because

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depression is associated with behavioral

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inertia which makes constructive

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conservative effort to alter the

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unfavorable state of things less likely

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as well however I'm here to tell you

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that moving up status hierarchies is one

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of the most reliable ways of becoming

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less depressed for the simple reason

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that life doesn't suck quite so much

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when you're not at the bottom of the

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barrel this is probably why the

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intervention that is most consistently

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associated with the alleviation of

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depression in the literature is

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behavioral

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activation actually getting out there

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and doing something different when

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people change what they do over and

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above changing the thoughts inside their

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minds or the chemicals inside their

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brains they stand their best possible

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chance of influencing their positioning

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within any given status hierarchy and

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their relationship to their larger

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environment among other things this

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these increases in status can make life

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significantly more comfortable Pleasant

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and rewarding and while it is certainly

play08:11

still possible to be depressed when life

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is comfortable Pleasant and rewarding

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it's probably a good idea to first rule

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out the possibility that the depression

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is caused by life being uncomfortable

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unpleasant and

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unrewarding like are you depressed or

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are you lonely are you depressed or are

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you unfulfilled are you depressed or are

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you

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undisciplined loneliness unfulfillment

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and a lack of discipline are not

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diseases so why would you go to a

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medical doctor to fix

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them in any case it's always a good idea

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to rule out the confounds first what do

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you think does this fit with your own

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experience let me know in the comments

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below and if you've gotten this far you

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might as well like this episode And

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subscribe to this channel you may also

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consider becoming a channel member with

play09:01

perks like the priority review of

play09:02

comments or booking a paid consultation

play09:05

as always thank you for

play09:10

listening