Hey, how you doing? How you feeling today? Well, you know, we change day by day. Some days we feel fantastic and some days not so much. And for some people that not so much can really, really interfere with their lives. so depression is going to be the main topic of today. We're actually going to talk about emotional disorders, and you'll see that depression is the main one. But there's also things like manic depression that actually add a little euphoria to the depression, which makes it even, in some cases, more of a problem for the person who suffers from the disorder. So lets lets get right into it. I hope I don't bring you down too much. It's hard to talk about depression in an in an uplifting way. But, so here it goes. Alright week seven lecture three, Disorder of Emotion. I'm going to start by bumming you right out. I actually think This quote says more perhaps than any definition from a DSM can say. So I'm just going to read it to you. Do you have any idea what it's like to not want to get out of bed every morning, not wanting to go and deal with all the bullshit outside of your bed? Do you even know what it feels like to feel completely alone while you know there are millions of miserable people just like you? How about what it's like to be completely repulsed by things that you used to love? To feel completely lost in the dark, and not really knowing if there's a way out? To not have the strength to feel like you can make it through the whole day, let alone the next one without breaking down? To not be able to explain how you feel at all, to have everyone constantly asking if you're okay until it gets to a point where no one asks, making you wonder if they don't notice or just don't care. To have no energy or drive to do anything, to feel completely worthless, to hate who you are and how you look, to feel like you have control over nothing, to know you don't belong, to feel trapped inside a world of ugly things but being scared of what's on the other side, to be hurting yourself constantly. To know there's noone to save you from the way you feel. To know the only one who's really hurting you is yourself. Wow. That's, that's pretty heavy. and within there are just about all of the aspects that clinicians point to, in depression. Now you know, this is, as described here, You can, you can, feel how debilitating this is and how, you know, almost this person kind of saying their suicidal you know, but they, they're also scared of what's on the other side. So trapped inside a world full of ugly things about being scared of what's on the other side. It's almost like this person Would rather kill themselves, but is scared to do that, and doesn't feel any power or control to do it anyway. So you know, a really kind of sad situation. Now we're all sad. We've, not right now, necessarily, but we all occasionally are sad and we all have points where we feel some of these things. But the major depressive disorder, is just this. When someone feels kind of all those things, they feel worthless. They feel powerless. In fact, you know, in a clinical, terms, it's a, depression is a sad and apathetic mood. So apathetic is just, I don't care; why bother? No I don't, I don't feel, I feel sad and I don't feel like anything I do will make a difference. So there's this feeling of worthlessness and helplessness. And these are two very different. You know one is me as a person. the value I think I bring to the world is nothing. I think I am worthless. And, I also think I'm powerless. I'm helpless. I can't do anything about my situation. That's a, that's a really tough combination. there's this desire to withdraw from other people, because they don't seem to understand. sleeplessness, loss of appetite, and sexual desire. Nothing matters, essentially, Not even sex. Nothing matters. and then either lethargy or agi, agitation, so some people react to this just by having absolutely no energy. Others have a lot of energy because they feel like" man, this is, I can't get out of it." So it makes them anxious, agitated. Very, very sad. it's relatively common, too, if you've remembered some of the other disorders I've shown, maybe 1 to 2% of the population suffer from it. Well look, look here, slightly different. even if we're looking at youth, the percent of youth, in the US, that suffered from depression. first of all far more common in females than males. but, you know, three to one, essentially. so females suffer more than males. And if you look at the age, it really kicks in in the post pubescent sort of period. Now this is a period of course when, when one's social world becomes very, very important friends, social connections. And if a child is having trouble finding a way to fit into the social world around them They can often feel this sense of depression and worthlessness and nobody likes me and yadda yadda, so, you know, it's serious because it's effecting our kids as well and we tend to, I think, think of depression more in adult terms, but the point I want to make here is, you know, if you are a parent watch for the signs of depression in your children, because it can hit there too. and when it hits you want to do something about it because in fact, a lot of depressed people, do attempt suicide and, and many do succeed. And so, you know in many ways it's a very deadly, deadly disease. this one I, I like to point out partly because it extends the age a little bit further. so you see That as people get older, they're not quite as prone here in general, at least once they get into older, older age, but this is all mediated importantly by income level. what you see here is that people living below the poverty level. Are far more likely to be depressed and so this points to a combination of stress and powerlessness if if you don't have a job, which is probably true of most of the people below the poverty level you know we have this,this myth sometimes of people that are living high on the hog on Social Security kind of stuff But what this suggests is, you know, no, that's not true at all. People don't feel good about just getting support from other people, not being able to earn their own way in life, and it actually really does impact depression levels significantly. If, if you actually, by the way, look at the research on happiness in general, and happiness related to income, you will see this. That when people are poor, they tend to be very unhappy. Once they get to be okay financially, then the more rich they become, it doesn't mean the more happy they become. The correlation between how much money you have and how happy you are disappears once people have enough to survive. But when they're below the poverty level, there certainly is this relationship with, with depression. alright. So depression is one thing. but sometimes as I suggested it can be combined with something we call mania. And, and that almost makes life even more difficult for the people. who suffer from it. There's sort of two levels of this. You could almost think of it, what's called Bipolar one and Bipolar two. Bipolar one is the more extreme These periods of mania It's almost hard, this is almost the best phrase for capturing it, nonstop orgasm. When people are in a manic period, they feel fantastic, they feel larger than life. They want to go out there, they want to have fun, they want to spend money. They want to eat well, they want to party hard. They want to go, go, go, go, go. and you know, I, I had a friend who went out with somebody who was manic depressive, and he said, man, when she was manic, it was a blast hanging around with her. So, you know, at some level, these people are, are really, fun. But over the top fun. and in fact, over t-, the top fun in the sense that If they have access to any funds they will typically use them. you know, be it credit cards, be it whatever, so in a manic period they may spend a ton of money. They could go to a casino and just gamble all night with no concern about how much anything is costing. and then the problem of course is this manic period only lasts so long. And when it ends, it almost always reverts to a very depressive period. So now the person is waking up the next day, they've drained their bank account, and they maybe, you know, made a fool of themselves, even the night before might feel like that. And then they wake up depressed feeling worthless, helpless, all those things. And now they have financial problems which we know from the previous figure Feeds depression even more so you know there's usually there's these swings Jimmy Hendrix has a song manic depression is bringing me down you know that same idea its not in bipolar too the depression is is much more common so in bi polar one you have these periods of mania. sometimes by themselves but more commonly mixed with depression, and bipolar too it's the depression that's most common, but you have these occasional and less intense periods of mania, so you kind of come out of it and you feel really good for awhile. Not as crazy non stop orgasm good. as in the bipolar one, but you will have this mix. Okay, so this one is clearly the more, severe. Now, in Canada we have a, a very famous, case of this and, and she's speaking out now a lot about mental illness and about helping people get support. And that's, this lady here Margaret Trudeau Margaret Trudeau was married to one of our most charismatic and most loved leaders in Canada. our Prime Minister Pierre Trudeau who was pri- Prime Minister through the, the sort of end 60s but mostly 70s period and Margaret was his wife. They had some children together, they seemed to be this sort of perfect couple in many ways except Margaret would do these weird things. She would disappear for periods of time, and when she'd disappear she would disappear to some place like Paris on a shopping trip. This was a manic episode. In one of her most famous manic episodes, she went to Montreal because the Rolling Stones were there, and she hung out backstage and partied with the Rolling Stones all night. Now the Rolling Stones at this time were like the, the rough Beatles. They were the bad boy Beatles as it were, and so it was kind of. Odd to see the wife of your Prime Minister disappearing and then ultimately found partying with the Rolling Stones backstage in Montreal. But I think it's a great example of what this manic period can do. that's you know I want to party with the rolling stones. [SOUND] Off she goes and makes it happen. kind of crazy [LAUGH] in, in this bipolar sort of way. So, you know, and, and then she would have, of course, come out and crash and hit the depressive period. what's causing all this? Well, as, as, as people try to understand the disorder, they kind of link, they, they see two things that are importantly linked. One is the so called cognitive causes, the thoughts people are having, the thoughts about themselves. The negativity that's in them and the fact that that can produce what are called self-fulfilling prophecies.Um, I'll remind you of Ekman in a second, but self-fulfilling prophecies are Ones where if you go through and you say, hey, if I try to do anything to make my life better I'm just going to make it worse. And if you go into any situation with that attitude, watch, whatever I do will just make things worse. Then chances are you're right. You know, just the attitude you bring, will almost make your predictions come true. The so called self fulfilling prohecies. And so one claim it If you want to help people with depression you really have to learn about their, the way they think about things and try to change it because the claim is, you know, we think these emotions come from ourselves and then we just feel them. But the claim is if you, if you can feel the emotion you can The way your think, and the things you do can actually shape your emotional state. You can learn to control your emotional state through your thoughts and through your actions. So, Ekman. Ekman is a guy, who spent a lot of time learning all the facial muscles correlated with emotional state: anger, surprise, happiness, every one of these things. Uses a different conglomeration of facial states, and he and his wife at one point decided to try to learn all of these in a very explicit way. Normally we do these implicitly. And so he would be able to put on the face for happiness and put on the face for anger or disappointment or whatever. He learned all these. But one of the things he noticed is that when he literally put on a certain face, let's say happiness. He actually started to feel happier. And if he was putting on anger, he actually started to feel angry. So the claim is the way you think and the actions you do will actually control your emotional states as well. and so if you can learn kind of like Ekman did to have some control over these things then perhaps you can learn to control your emotional state a little bit. These are the things these people, depressive people tend to do, they take the small negatives in life and they see them as catastrophic and the good ones they seem to ignore. So they're really you know focusing on the negatives. They also blame any negative that happens on their inadequacies. Okay so they have this what's called an attribution style of, of taking personal responsibility for everything that goes wrong, and assuming the environment was responsible for anything that might go right. So they internalized the bad stuff and externalize the good stuff. And that leaves them feeling helpless, hopeless, et cetera. Of course if negative things happen, then, then that feeds all of these things, right? They over blow it and think its due to themselves. So these cognitive causes are important, and when we get to the treatments, you'll see some of these treatments focus on trying to change these cognitive causes. There are also biological causes. There are genetic factors, so you will see mood disorders run in families, for example. And you will also see in, in twin studies, that if you have a pair of identical twins who have the same genetic. code, essentially. Versus a pair of fraternal twins who were still born at the same time, but they're different sperm and egg combinations, they have a different genetic code. With genetic twins, if one of them has depression, the other one is quite likely to have depression. Far more likely than is the case for the fraternals. Okay, if they're fraternals, if one has depression, the other one isn't that much more likely to get it. A little bit more than just anybody else would, but for the identical twins, there seems to be a strong co-occurence, and so that seems to suggest that genetics do play a role. Some people may be more prone to depression genetically we know that the, if you actually look at the neurotransmitters that one has, In their brain, associated with their brain, that there are associations in the sense that norepinephrine and serotonin, two of our strong neurotransmitters generally for people who are depressed, have less of those and if you give them drugs that somehow can increase the amount of those, they tend to feel better. So there is some link to neurochemistry in a sense. There's also a link to sleep and to the way you hook your sleep into the so-called zeitgebers. for example, let me give you this. If you travel a lot, and so you're, you're constantly messing with your internal clock, and when you wake up, and when you go to sleep, A you usually feel tired but B you usually start to feel depressed. But if you can get locked in and if you can literally sort of wake up with the sun and synchronize your clock then people tend to feel happier and better when they do that. So there's some notion that depression is linked to improper sleep patterns, And you know especially for example you've heard of seasonal affective disorder prob, probably. In the winter when we get less sunlight, we get more depression in the general population. So it's like sun and synchrony with the sun makes us feel good but when we lose that we can get depressed as well. [COUGH] Excuse me. Alright and the last thing I want to talk about here is the strong link between depression and pregnancy. in fact emotional disorders and pregnancy. If you look at depression here but also the bipolar disorders. What you see is that people when they're pregnant. Can have these and at a relatively high rate by the way. These blue bars are not low. So pregnant mothers can suffer from these disorders, but their likelihood of suffering increases significantly post childbirth. Which having seen this first hand Is not that surprising because if you think of a mother being sort of hopeless and powerless. I mean the mother really suddenly is at the mercy of the child. Her life has suddenly become about the child. And many mothers almost feel imprisoned during that first period. That they're literally at home with the child taking care of it. All day they have trouble eating right, they have trouble sleeping right, and you see a lot of these problems with depression really spike up. So there's a strong link there as well which those of you who are mothers probably know that very well. Alright so, some things for you to check out. Here is Margaret Trudeau talking about bipolar disorder. and trying to encourage other people to, to seek help, that it is a treatable disorder. so check that out. this is a guy named Robert Sapolsky, he's, he's a fascinating lecturer. and this is a, a full talk he gave on depression. So if you want a little more detail you can get it there. Flight from darkness, is, is, again a video, a sort of documentary related to, bipolar disorder, actually, so you can get a sense of that in a lot of detail. These couple of pages are more, I threw these in for people, if there's any of you out there who are fighting depression, This first one tries to give some tips about what a person can do, even if they have like minor depression like a lot of us might have minor depression. We're still functional, we're not laying in our bed all day. But we still don't feel good, don't feel happy. So this could kind of help a little bit. And if any of you are pregnant or have just gone through pregnancy, here's a little bit more about that relation between depression and pregnancy. All right, so I will leave you there. When we come back next lecture it will be all about schizophrenia. So I will see you in that one. Have a great day.
