55. Post antidepressant sexual dysfunction

[sean]: welcome to [roger_mcfillin]: welcome [sean]: the radically [roger_mcfillin]: to the radically [sean]: genuine [roger_mcfillin]: genuine [sean]: podcast [roger_mcfillin]: podcast [sean]: you can [roger_mcfillin]: you [sean]: find [roger_mcfillin]: can [sean]: me [roger_mcfillin]: find [sean]: dr [roger_mcfillin]: me [sean]: roger mchlnon [roger_mcfillin]: roger [sean]: twitter [roger_mcfillin]: in on twitter [sean]: at dr [roger_mcfillin]: at [sean]: mcthillan [roger_mcfillin]: mcchillan

[sean]: getting into some [roger_mcfillin]: getting [sean]: really [roger_mcfillin]: some [sean]: interesting [roger_mcfillin]: really interesting [sean]: conversations [roger_mcfillin]: conversations [sean]: on twitter [roger_mcfillin]: on twitter [sean]: and [roger_mcfillin]: and [sean]: the impact [roger_mcfillin]: the [sean]: of [roger_mcfillin]: impact [sean]: our [roger_mcfillin]: of our [sean]: podcast [roger_mcfillin]: podcast [sean]: is [roger_mcfillin]: is [sean]: somewhat far

[roger_mcfillin]: somewhat [sean]: reaching [roger_mcfillin]: far [sean]: at [roger_mcfillin]: reaching [sean]: this point [roger_mcfillin]: at this point [sean]: and one of the [roger_mcfillin]: one of the [sean]: overarching [roger_mcfillin]: overarching [sean]: goals is [roger_mcfillin]: goals [sean]: to [roger_mcfillin]: is [sean]: promote [roger_mcfillin]: to promote [sean]: awareness [roger_mcfillin]: awareness [sean]: and attention [roger_mcfillin]: and attention [sean]: support informed

[roger_mcfillin]: support [sean]: consent [roger_mcfillin]: informed consent [sean]: whenever you're [roger_mcfillin]: whenever [sean]: taking [roger_mcfillin]: you're [sean]: any [roger_mcfillin]: taking [sean]: farmasuticale [roger_mcfillin]: any farm suiticle [sean]: had a [roger_mcfillin]: had a [sean]: few [roger_mcfillin]: few [sean]: podcasts [roger_mcfillin]: podcasts [sean]: recently [roger_mcfillin]: recently [sean]: where we talked [roger_mcfillin]: where we [sean]: about

[roger_mcfillin]: talked [sean]: some [roger_mcfillin]: about [sean]: of the [roger_mcfillin]: some of the [sean]: dubious [roger_mcfillin]: dubious [sean]: and fraudulent [roger_mcfillin]: and fraudulent [sean]: marketing [roger_mcfillin]: marketing [sean]: tactics [roger_mcfillin]: tactics [sean]: of the [roger_mcfillin]: of [sean]: pharmasutical [roger_mcfillin]: the pharmasutical [sean]: industry [roger_mcfillin]: industry [sean]: and how [roger_mcfillin]: and [sean]: many

[roger_mcfillin]: how many [sean]: clients [roger_mcfillin]: clients [sean]: who have been [roger_mcfillin]: who have [sean]: taking [roger_mcfillin]: been [sean]: certain [roger_mcfillin]: taking [sean]: drugs [roger_mcfillin]: certain [sean]: are [roger_mcfillin]: drugs are [sean]: assuming [roger_mcfillin]: assuming [sean]: that [roger_mcfillin]: that [sean]: there is strong [roger_mcfillin]: there is [sean]: efficacy [roger_mcfillin]: strong efficacy [sean]: and safety [roger_mcfillin]: and

[sean]: for [roger_mcfillin]: safety [sean]: the drugs [roger_mcfillin]: for [sean]: that [roger_mcfillin]: the [sean]: they're [roger_mcfillin]: drugs that [sean]: taking [roger_mcfillin]: they're taking [sean]: without [roger_mcfillin]: without [sean]: ing [roger_mcfillin]: in [sean]: much of a background [roger_mcfillin]: much of a background [sean]: information [roger_mcfillin]: information [sean]: on how [roger_mcfillin]: on [sean]: these drugs [roger_mcfillin]: how these drugs

[sean]: came to [roger_mcfillin]: came [sean]: market [roger_mcfillin]: to market [sean]: and [roger_mcfillin]: and [sean]: some of the [roger_mcfillin]: some [sean]: adverse [roger_mcfillin]: of the adverse [sean]: consequences [roger_mcfillin]: consequences [sean]: of these drugs [roger_mcfillin]: of these drugs [sean]: so i do [roger_mcfillin]: i do [sean]: certainly [roger_mcfillin]: certainly [sean]: want [roger_mcfillin]: want [sean]: our audience [roger_mcfillin]: our audience

[sean]: to kind [roger_mcfillin]: to [sean]: of go [roger_mcfillin]: kind [sean]: back [roger_mcfillin]: of [sean]: and [roger_mcfillin]: go back [sean]: listen [roger_mcfillin]: and [sean]: to [roger_mcfillin]: listen [sean]: the [roger_mcfillin]: to the [sean]: couple of our [roger_mcfillin]: couple [sean]: previous [roger_mcfillin]: of our previous [sean]: podcasts [roger_mcfillin]: podcasts [sean]: where we [roger_mcfillin]: where we [sean]: high lighted [roger_mcfillin]: high [sean]: some

[roger_mcfillin]: lighted [sean]: of this [roger_mcfillin]: some [sean]: issue [roger_mcfillin]: of this issue [sean]: but one of the [roger_mcfillin]: but [sean]: things [roger_mcfillin]: one [sean]: has [roger_mcfillin]: of [sean]: been [roger_mcfillin]: the things has [sean]: brought [roger_mcfillin]: been [sean]: to my [roger_mcfillin]: brought [sean]: attention [roger_mcfillin]: to my attention [sean]: and i've been [roger_mcfillin]: and i've [sean]: to be [roger_mcfillin]: been

[sean]: honest [roger_mcfillin]: to [sean]: i've [roger_mcfillin]: be [sean]: been [roger_mcfillin]: honest [sean]: a [roger_mcfillin]: i've [sean]: bit [roger_mcfillin]: been a [sean]: hesitant [roger_mcfillin]: bit hesitant [sean]: to [roger_mcfillin]: to [sean]: go in this [roger_mcfillin]: go [sean]: direction [roger_mcfillin]: in this direction [sean]: on our podcast [roger_mcfillin]: on our podcast [sean]: because i just [roger_mcfillin]: because i [sean]: needed [roger_mcfillin]: just

[sean]: more [roger_mcfillin]: needed more [sean]: information [roger_mcfillin]: information [sean]: and [roger_mcfillin]: and [sean]: luckily [roger_mcfillin]: luckily [sean]: i've [roger_mcfillin]: i've [sean]: a couple people [roger_mcfillin]: a couple [sean]: have reached [roger_mcfillin]: of people have [sean]: out [roger_mcfillin]: reached [sean]: to me [roger_mcfillin]: out to [sean]: to [roger_mcfillin]: me [sean]: talk [roger_mcfillin]: to talk [sean]: more about [roger_mcfillin]: more

[sean]: a specific [roger_mcfillin]: about a specific [sean]: issue [roger_mcfillin]: issue [sean]: it's an [roger_mcfillin]: it's [sean]: adverse [roger_mcfillin]: an adverse [sean]: reaction [roger_mcfillin]: reaction [sean]: to [roger_mcfillin]: to [sean]: commonly [roger_mcfillin]: commonly [sean]: prescribed [roger_mcfillin]: prescribed [sean]: anti depressince [roger_mcfillin]: anti depressence [sean]: s s [roger_mcfillin]: s [sean]: r [roger_mcfillin]: s r [sean]: s [roger_mcfillin]: s

[sean]: s n r [roger_mcfillin]: nrizednselective [sean]: s what's an s n r selective nor apenefrin [roger_mcfillin]: nor apeneffrreuptake [sean]: re uptake inhibit [roger_mcfillin]: in [sean]: similar [roger_mcfillin]: similar [sean]: in terms of n s s s s r i in terms of what they're [roger_mcfillin]: what there [sean]: intended [roger_mcfillin]: intended [sean]: to use this [roger_mcfillin]: to [sean]: for [roger_mcfillin]: for [sean]: well the [roger_mcfillin]: well the [sean]: targeting

[roger_mcfillin]: targeting [sean]: specific [roger_mcfillin]: specific [sean]: nero chemicals [roger_mcfillin]: nero chemicals [sean]: by [roger_mcfillin]: by [sean]: preventing [yassie_pirani]: yah [sean]: the [roger_mcfillin]: preventing [sean]: re uptake [roger_mcfillin]: the re uptake [sean]: in the cell [roger_mcfillin]: in the [sean]: and then [roger_mcfillin]: cell [sean]: flooding [roger_mcfillin]: and and flooding [sean]: the the nerves [roger_mcfillin]: the nervssinaps

[sean]: an apse with that [roger_mcfillin]: with that [sean]: and so [roger_mcfillin]: and so [sean]: these two drugs [roger_mcfillin]: these two drugs [sean]: i mean those two [roger_mcfillin]: those [sean]: classes [roger_mcfillin]: two classes [sean]: of dogs [roger_mcfillin]: of [sean]: are [roger_mcfillin]: drugs [sean]: the most [roger_mcfillin]: are [sean]: commonly [roger_mcfillin]: the most commonly [sean]: prescribed [roger_mcfillin]: prescribed [sean]: to anti depressant

[roger_mcfillin]: anti depressing [sean]: and we know [roger_mcfillin]: and we [sean]: that [roger_mcfillin]: know [sean]: the conditions [roger_mcfillin]: that the conditions [sean]: in which [roger_mcfillin]: in which [sean]: these drugs [roger_mcfillin]: ese [sean]: are [roger_mcfillin]: drugs [sean]: prescribed [roger_mcfillin]: are prescribed [sean]: extend way [roger_mcfillin]: extend [sean]: beyond [roger_mcfillin]: way beyond [sean]: just somebody [roger_mcfillin]: just [sean]: in

[roger_mcfillin]: somebody [sean]: a depressive [roger_mcfillin]: in a depressive [sean]: episode [roger_mcfillin]: episode [sean]: and so there [roger_mcfillin]: and so [sean]: is [roger_mcfillin]: there [sean]: a [roger_mcfillin]: is a [sean]: common [roger_mcfillin]: common [sean]: side effect [roger_mcfillin]: side effect [sean]: unfortunately [roger_mcfillin]: unfortunately [sean]: i'm not even going [roger_mcfillin]: i'm [sean]: to [roger_mcfillin]: not [sean]: call [roger_mcfillin]: even

[sean]: it [roger_mcfillin]: going [sean]: a side [roger_mcfillin]: to call [sean]: effect [roger_mcfillin]: a side [sean]: i don't [roger_mcfillin]: effect [sean]: even think [roger_mcfillin]: i don't [sean]: that's [roger_mcfillin]: even think that's [sean]: fair to [roger_mcfillin]: fair [sean]: call it [roger_mcfillin]: to [sean]: a side [roger_mcfillin]: call [sean]: effect [roger_mcfillin]: the side [sean]: because [roger_mcfillin]: effect [sean]: it's [roger_mcfillin]: because

[sean]: almost [roger_mcfillin]: it's [sean]: like [roger_mcfillin]: almost like [sean]: under the assumption [roger_mcfillin]: under the assumption [sean]: that these drugs [roger_mcfillin]: these drugs [sean]: are highly [roger_mcfillin]: are [sean]: effective [roger_mcfillin]: highly effective [sean]: and then here's [roger_mcfillin]: and then [sean]: a side [roger_mcfillin]: here's [sean]: effect [roger_mcfillin]: a side [sean]: you [roger_mcfillin]: effect [sean]: just have

[roger_mcfillin]: you just [sean]: to [roger_mcfillin]: have [sean]: deal [roger_mcfillin]: to [sean]: with [roger_mcfillin]: deal [sean]: and [roger_mcfillin]: with and [sean]: you know [roger_mcfillin]: you know [sean]: not [roger_mcfillin]: i'm [sean]: so [roger_mcfillin]: not [sean]: certain [roger_mcfillin]: so [sean]: that [roger_mcfillin]: certain [sean]: we have [roger_mcfillin]: that [sean]: that [roger_mcfillin]: we [sean]: data [roger_mcfillin]: have that [sean]: or that

[roger_mcfillin]: data [sean]: information [roger_mcfillin]: or that information [sean]: so instead [roger_mcfillin]: so [sean]: i'm [roger_mcfillin]: instead [sean]: going to call [roger_mcfillin]: i'm going [sean]: it [roger_mcfillin]: to [sean]: an [roger_mcfillin]: call it [sean]: adverse [roger_mcfillin]: an adverse [sean]: effect [roger_mcfillin]: effect [sean]: or an adverse [roger_mcfillin]: or advert [sean]: consequence [roger_mcfillin]: consequence [sean]: to taking

[roger_mcfillin]: to [sean]: the [roger_mcfillin]: taking [sean]: drug [roger_mcfillin]: the drug [sean]: and it's [roger_mcfillin]: and [sean]: around [roger_mcfillin]: it's [sean]: sexual [roger_mcfillin]: around [sean]: disfunction [roger_mcfillin]: sexual disfunction [sean]: we're going to get [roger_mcfillin]: we're [sean]: into [roger_mcfillin]: going to get into [sean]: the weeds [roger_mcfillin]: the [sean]: on [roger_mcfillin]: weeds [sean]: sexual [roger_mcfillin]: on sexual

[sean]: disfunction [roger_mcfillin]: disfunction [sean]: it's it's disabling [roger_mcfillin]: it's disabling [sean]: it's impairing [roger_mcfillin]: it's impairing [sean]: and it's potentially [roger_mcfillin]: and it's potentially [sean]: could be something [roger_mcfillin]: be something [sean]: that [roger_mcfillin]: that [sean]: occurs [roger_mcfillin]: occurs [sean]: even after [roger_mcfillin]: even [sean]: you [roger_mcfillin]: after [sean]: stopped [roger_mcfillin]: you stop

[sean]: the use of [roger_mcfillin]: the [sean]: the [roger_mcfillin]: use [sean]: drug [roger_mcfillin]: of the drug [sean]: yes so [roger_mcfillin]: so [sean]: on today's [roger_mcfillin]: on [sean]: podcast [roger_mcfillin]: today's podcast [sean]: i want to [roger_mcfillin]: i [sean]: welcome [roger_mcfillin]: want to welcome [sean]: two [roger_mcfillin]: two [sean]: advocates [roger_mcfillin]: advocates [sean]: who are [roger_mcfillin]: who [sean]: supporting

[roger_mcfillin]: are supporting [sean]: awareness [roger_mcfillin]: awareness [sean]: in this [roger_mcfillin]: in this [sean]: research [roger_mcfillin]: research [sean]: is this [roger_mcfillin]: this [sean]: area [roger_mcfillin]: this [sean]: that [roger_mcfillin]: area that [sean]: highly [roger_mcfillin]: highly [sean]: requires [roger_mcfillin]: requires [sean]: more research [roger_mcfillin]: more research [sean]: first is [roger_mcfillin]: it [sean]: emily [roger_mcfillin]: is

[sean]: grey [roger_mcfillin]: emily [sean]: she [roger_mcfillin]: gran [sean]: is [roger_mcfillin]: she [sean]: a medical [roger_mcfillin]: is a medical [sean]: at [roger_mcfillin]: attis [sean]: this using her [roger_mcfillin]: using [sean]: on [roger_mcfillin]: her [sean]: going personal [roger_mcfillin]: going personal [sean]: experience [roger_mcfillin]: experience [sean]: of p [roger_mcfillin]: of p [sean]: s s [roger_mcfillin]: s [sean]: d [roger_mcfillin]: s t [sean]: that is post

[roger_mcfillin]: that is post [sean]: s s r [roger_mcfillin]: s [sean]: i [roger_mcfillin]: s r i [sean]: sexual dis [roger_mcfillin]: sexual [sean]: function [roger_mcfillin]: dis [sean]: so [roger_mcfillin]: function [sean]: we're going [roger_mcfillin]: so [sean]: to [roger_mcfillin]: we're [sean]: use [roger_mcfillin]: going to use [emily_]: hm [sean]: p [roger_mcfillin]: p [sean]: s s [roger_mcfillin]: s [sean]: d [roger_mcfillin]: s d [sean]: today [roger_mcfillin]: today

[sean]: her goal is [roger_mcfillin]: her [sean]: to [roger_mcfillin]: goals [sean]: raise awareness [roger_mcfillin]: to raise [sean]: of [roger_mcfillin]: awareness [sean]: the disorder [roger_mcfillin]: of the disorder [sean]: among [roger_mcfillin]: among [sean]: health care [roger_mcfillin]: health [sean]: professionals [roger_mcfillin]: care professionals [sean]: and the gray [roger_mcfillin]: and the [sean]: public [roger_mcfillin]: greater public [sean]: she is one [roger_mcfillin]: she

[sean]: of [roger_mcfillin]: is [sean]: the founders [roger_mcfillin]: one of the founders [sean]: of the registered [roger_mcfillin]: of the registered [sean]: non profit [roger_mcfillin]: non profit [sean]: canadian [roger_mcfillin]: canadian [sean]: post [roger_mcfillin]: post [sean]: s s [roger_mcfillin]: s [sean]: r [roger_mcfillin]: s [sean]: i sexual [roger_mcfillin]: r i sexual [sean]: function [roger_mcfillin]: dis function [sean]: society [roger_mcfillin]: society [sean]: she is

[roger_mcfillin]: she [sean]: net [roger_mcfillin]: is [sean]: working [roger_mcfillin]: net [sean]: with [roger_mcfillin]: working [sean]: p [roger_mcfillin]: with [sean]: s [roger_mcfillin]: p [sean]: s d [roger_mcfillin]: s s d [sean]: survivors [roger_mcfillin]: survivors [sean]: and sufferers [roger_mcfillin]: and sufferers [sean]: around the [roger_mcfillin]: around [sean]: world [roger_mcfillin]: the [sean]: and [roger_mcfillin]: world [sean]: is [roger_mcfillin]: and is

[sean]: working with [roger_mcfillin]: working [sean]: researchers [roger_mcfillin]: with researchers [sean]: at qu [roger_mcfillin]: at [sean]: university [roger_mcfillin]: queen's university [sean]: and the university [roger_mcfillin]: and university [sean]: of autoa [roger_mcfillin]: of autoa [sean]: to acquire [roger_mcfillin]: to acquire [sean]: more information [roger_mcfillin]: more information [sean]: about [roger_mcfillin]: about [sean]: this [roger_mcfillin]: this [sean]: understudied

[roger_mcfillin]: under studied [sean]: condition [roger_mcfillin]: condition [sean]: emily [roger_mcfillin]: emily [sean]: welcome [roger_mcfillin]: welcome [sean]: to the [roger_mcfillin]: to [sean]: radically [roger_mcfillin]: the radically [sean]: genuine [roger_mcfillin]: genuine [sean]: podcast [roger_mcfillin]: podcast [emily_]: you very much drmchilland i'm glad to be here [sean]: before we [roger_mcfillin]: before [sean]: get to [roger_mcfillin]: we [sean]: you [roger_mcfillin]: get

[sean]: i also want [roger_mcfillin]: i also [sean]: to introduce [roger_mcfillin]: want to introduce [sean]: yaziprprani [roger_mcfillin]: yazipapprani [sean]: is a tramatherapist [roger_mcfillin]: is a tramatherapist [sean]: based in vancouver [roger_mcfillin]: based in vancouver [sean]: yasi is [roger_mcfillin]: yaziis [sean]: a register [roger_mcfillin]: a [sean]: clinical [roger_mcfillin]: register [sean]: councilor [roger_mcfillin]: clinical [sean]: with [roger_mcfillin]: councillor

[sean]: the b [roger_mcfillin]: with [sean]: c [roger_mcfillin]: the [sean]: association [roger_mcfillin]: b c association [sean]: of clinical [roger_mcfillin]: of [sean]: councillors [roger_mcfillin]: clinical councilor [sean]: and a registered [roger_mcfillin]: and a registered [sean]: social worker [roger_mcfillin]: social [sean]: with the [roger_mcfillin]: worker [sean]: b [roger_mcfillin]: with [sean]: c [roger_mcfillin]: the b [sean]: college [roger_mcfillin]: c [sean]: of

[roger_mcfillin]: college [sean]: social [roger_mcfillin]: of [sean]: workers [roger_mcfillin]: social workers [sean]: she works [roger_mcfillin]: she [sean]: with [roger_mcfillin]: works [sean]: people [roger_mcfillin]: with people [sean]: throughout the [roger_mcfillin]: throughout the [sean]: province [roger_mcfillin]: province [sean]: of [roger_mcfillin]: of [sean]: british columbia [roger_mcfillin]: british columbia [sean]: canada [emily_]: yeah [roger_mcfillin]: canada

[sean]: show an you've never been [roger_mcfillin]: an you've [sean]: to [roger_mcfillin]: never been [sean]: british [roger_mcfillin]: the [sean]: columbia [roger_mcfillin]: french columbia [sean]: multiple times [roger_mcfillin]: multiple [sean]: beautiful [roger_mcfillin]: beautiful [sean]: area [roger_mcfillin]: area [sean]: i love vancouver it is probably my favorite [roger_mcfillin]: favorite [sean]: destination [roger_mcfillin]: estin [sean]: i [roger_mcfillin]: and [sean]: was there

[roger_mcfillin]: i was there [sean]: doing multiple [roger_mcfillin]: in [sean]: advertising [roger_mcfillin]: advertising [sean]: commercial shoots [roger_mcfillin]: comical she [sean]: and i just fell in [roger_mcfillin]: just [sean]: love with [roger_mcfillin]: fell [sean]: the city so in her [roger_mcfillin]: so [sean]: range [roger_mcfillin]: in her range [sean]: of [roger_mcfillin]: of [sean]: sexual and [roger_mcfillin]: sexual [sean]: reproductive [roger_mcfillin]: and reproductive

[sean]: health concerns [roger_mcfillin]: health concerns [sean]: amongst [roger_mcfillin]: amongst [sean]: areas of her [roger_mcfillin]: areas [sean]: specialty [roger_mcfillin]: of specialty [sean]: she's worked [roger_mcfillin]: she's [sean]: many [roger_mcfillin]: worked [sean]: years [roger_mcfillin]: many years [sean]: in the areas [roger_mcfillin]: in the [sean]: of [roger_mcfillin]: areas [sean]: sexual [roger_mcfillin]: of [sean]: and [roger_mcfillin]: sexual [sean]: mental

[roger_mcfillin]: and [sean]: health [roger_mcfillin]: mental [sean]: and [roger_mcfillin]: health [sean]: works from [roger_mcfillin]: and [sean]: a [roger_mcfillin]: works [sean]: tram [roger_mcfillin]: from [sean]: and [roger_mcfillin]: the tram [sean]: formed [roger_mcfillin]: and [sean]: anti [roger_mcfillin]: formed [sean]: oppressive [roger_mcfillin]: anti oppressive [sean]: and harm reduction [roger_mcfillin]: and harm reduction [sean]: approach [roger_mcfillin]: of pro

[sean]: in her clinical [roger_mcfillin]: in her clinical [sean]: practice she [roger_mcfillin]: practice [sean]: specializes [roger_mcfillin]: she specializes [sean]: and supporting [roger_mcfillin]: and supporting [sean]: people who suffer [roger_mcfillin]: people who [sean]: from [roger_mcfillin]: suffer from [sean]: post [roger_mcfillin]: post [sean]: s s [roger_mcfillin]: s [sean]: r i [roger_mcfillin]: s [sean]: sexual [roger_mcfillin]: r i [sean]: disfunction

[roger_mcfillin]: sexual dis function [sean]: her work with [roger_mcfillin]: her [sean]: the [roger_mcfillin]: work [sean]: p [roger_mcfillin]: with the [sean]: s [roger_mcfillin]: p [sean]: s [roger_mcfillin]: s [sean]: d [roger_mcfillin]: s [sean]: community [roger_mcfillin]: t community [sean]: uniquely [emily_]: yeah [roger_mcfillin]: uniquely [sean]: position [roger_mcfillin]: position [sean]: sort of educate [roger_mcfillin]: sort of [sean]: fellow [roger_mcfillin]: educate [sean]: health

[roger_mcfillin]: fellow [sean]: care profess [roger_mcfillin]: health care [sean]: as [roger_mcfillin]: rofessionals [emily_]: yeah [sean]: in the public [roger_mcfillin]: and the public [sean]: on the real [roger_mcfillin]: on the real [sean]: impacts [roger_mcfillin]: impacts [sean]: of this disabling [roger_mcfillin]: of this disabling [sean]: condition [roger_mcfillin]: condition [sean]: i met with [roger_mcfillin]: i met [sean]: both [roger_mcfillin]: with both [sean]: yasi

[roger_mcfillin]: yasi [sean]: and emily [roger_mcfillin]: and emily [sean]: before [roger_mcfillin]: before [sean]: this podcast [roger_mcfillin]: this podcast [sean]: just for [roger_mcfillin]: just for [sean]: a bit of a [roger_mcfillin]: a [sean]: pre [roger_mcfillin]: bit [sean]: dis [roger_mcfillin]: of a [sean]: cession [roger_mcfillin]: discussion [sean]: and they are [roger_mcfillin]: they're [sean]: both extremely [roger_mcfillin]: extremely [sean]: knowledgeable

[roger_mcfillin]: knowledgeable [sean]: very [roger_mcfillin]: very [sean]: passionate [roger_mcfillin]: passionate [sean]: as welcome [roger_mcfillin]: as you [sean]: to [roger_mcfillin]: welcome [sean]: the radically [roger_mcfillin]: to the [sean]: genuine [roger_mcfillin]: radically [sean]: podcast [roger_mcfillin]: genuine podcast [yassie_pirani]: thank you so much it's great to be here [sean]: so let's just [roger_mcfillin]: so [sean]: start [roger_mcfillin]: let's [sean]: with

[roger_mcfillin]: just start [sean]: emily [roger_mcfillin]: with emily [sean]: i think [roger_mcfillin]: i think [sean]: the expected [roger_mcfillin]: expected [sean]: place to [roger_mcfillin]: place [sean]: start [roger_mcfillin]: to [sean]: emily [roger_mcfillin]: start [sean]: if you're [roger_mcfillin]: emily [sean]: willing [roger_mcfillin]: if you're willing [sean]: is just [roger_mcfillin]: is [sean]: to share [roger_mcfillin]: just to [sean]: your [roger_mcfillin]: share [sean]: story

[roger_mcfillin]: your story [sean]: and talk [roger_mcfillin]: and [sean]: about [roger_mcfillin]: talk [sean]: your [roger_mcfillin]: about your [sean]: journey [roger_mcfillin]: journey [sean]: and what you [roger_mcfillin]: what [sean]: went [roger_mcfillin]: you [sean]: through [roger_mcfillin]: went [sean]: to [roger_mcfillin]: through [sean]: get [roger_mcfillin]: to [sean]: to this [roger_mcfillin]: get [sean]: place [roger_mcfillin]: to this [sean]: in [roger_mcfillin]: place

[sean]: your career [roger_mcfillin]: in your career [emily_]: sure so when i was a teen ager as many many teenagers do i suffered [emily_]: from various what we might call mental health problems but could so just be called [emily_]: growing [roger_mcfillin]: i [emily_]: up you know [roger_mcfillin]: yeah [emily_]: i often suffered from low moods [roger_mcfillin]: ah [emily_]: i also struggled with body image i had an eating disorder which caused me some [emily_]: health issues for a little over

[roger_mcfillin]: an [emily_]: a year um and when i was seventeen years old at the recommendation of someifriends [emily_]: of the family my parents took me to talk to a psychiatrist and it was [emily_]: a very kind of come table nonchalant encounter i didn't have any negative experience with [emily_]: the psychiatrist but she recommended that i try s s [roger_mcfillin]: yeah [emily_]: r and see if that improved my my mental health you know i was just

[emily_]: about to be heading off to college she thought it would kind of help ease [emily_]: the transition um and it was treated as something very very normal and very very [emily_]: safe so i started on the s s rise and i did feel a perceived [emily_]: reduction in my symptoms the s s r i was on was sitalapram and i [emily_]: was on at thirty mile rams a day which is a very moderate normal dose [emily_]: for an s s r [sean]: let me ask you a [emily_]: yeah [sean]: question

[roger_mcfillin]: ask you [sean]: so [roger_mcfillin]: a question [sean]: you [roger_mcfillin]: so [sean]: initially [roger_mcfillin]: you initially [sean]: experienced [roger_mcfillin]: experienced [sean]: a reduction [roger_mcfillin]: a reduction [sean]: in what you [roger_mcfillin]: in what you [sean]: identified [roger_mcfillin]: identified [sean]: as symptoms [roger_mcfillin]: as symptoms [sean]: what were the [roger_mcfillin]: what [sean]: reduction [roger_mcfillin]: with the reduction

[sean]: of [roger_mcfillin]: of [sean]: symptoms that [roger_mcfillin]: symptoms [sean]: you did [roger_mcfillin]: that [sean]: experience [roger_mcfillin]: you did experience [sean]: initially [emily_]: i just [roger_mcfillin]: initially [emily_]: i felt calmer i found it easier to concentrate i felt less intense negative emotion [sean]: a [emily_]: so i would say her description of it smoothing the transition was accurate um [roger_mcfillin]: oh [emily_]: m but i [roger_mcfillin]: yeah

[emily_]: i stayed on it for several years during my college years and i kept kind [emily_]: of thinking well [roger_mcfillin]: yeah [emily_]: i should go off at some [roger_mcfillin]: ye [emily_]: point but you know i i think it's making my life easier and i hadn't [emily_]: really been warned about any negative effects so i i guess the accurate way to [emily_]: describe it is i developed a psychological dependency on them um [sean]: let me ask you [emily_]: but [roger_mcfillin]: let

[sean]: some [roger_mcfillin]: me ask [sean]: questions [roger_mcfillin]: you some questions [sean]: because i [roger_mcfillin]: because [sean]: think [roger_mcfillin]: i think [sean]: your story [roger_mcfillin]: your story [sean]: is really [roger_mcfillin]: is [sean]: interesting [roger_mcfillin]: really interesting [sean]: and it's important [roger_mcfillin]: and it's important [sean]: because [roger_mcfillin]: because [sean]: if our goal [roger_mcfillin]: if our [sean]: here

[roger_mcfillin]: goal [sean]: is to [roger_mcfillin]: here [sean]: raise [roger_mcfillin]: is [sean]: awareness [roger_mcfillin]: to raise awareness [sean]: for health [roger_mcfillin]: for [sean]: care [roger_mcfillin]: health [sean]: professionals [roger_mcfillin]: care professionals [sean]: and those [roger_mcfillin]: and [sean]: who [roger_mcfillin]: those [sean]: are [roger_mcfillin]: who are [sean]: potentially [roger_mcfillin]: potentially [sean]: prescribe [roger_mcfillin]: prescribe

[sean]: these drugs [roger_mcfillin]: these drugs [sean]: there's [roger_mcfillin]: there's [sean]: a number of [roger_mcfillin]: a [sean]: things [roger_mcfillin]: number [sean]: that [roger_mcfillin]: of things [sean]: didn't [roger_mcfillin]: that didn't [sean]: happen [roger_mcfillin]: happen [sean]: for you [roger_mcfillin]: for [sean]: that [roger_mcfillin]: you [sean]: we would [roger_mcfillin]: that [sean]: hope [roger_mcfillin]: we would [sean]: would happen [roger_mcfillin]: hope would

[sean]: in [roger_mcfillin]: happen [sean]: the future [roger_mcfillin]: in the future [sean]: so the first [roger_mcfillin]: so [emily_]: hm [roger_mcfillin]: the [sean]: thing [roger_mcfillin]: first thing [sean]: is that [roger_mcfillin]: is [sean]: you [roger_mcfillin]: that [sean]: were [roger_mcfillin]: you [sean]: not [roger_mcfillin]: were not [sean]: informed [roger_mcfillin]: informed [sean]: of [roger_mcfillin]: of [sean]: any [roger_mcfillin]: any [sean]: potential

[roger_mcfillin]: potential [sean]: adverse [roger_mcfillin]: adverse [sean]: consequences [roger_mcfillin]: consequences [emily_]: yeah [sean]: to taking [roger_mcfillin]: to [sean]: the [roger_mcfillin]: taking [sean]: drug is [roger_mcfillin]: the [sean]: that [roger_mcfillin]: drug [sean]: correct [roger_mcfillin]: is that correct [emily_]: the only side effects that were mentioned was she said that i might feel some [emily_]: nausea [roger_mcfillin]: yes

[emily_]: when coming on or off the drug [sean]: yeah [emily_]: there were there was absolutely no mention sexual dis function either long lasting or temporary [emily_]: she did not bring that up in any capacity at one later meeting with her [emily_]: because i've been experiencing some reduction in libido on the drug i asked her is [emily_]: it normal to like have less sexual desire on this medication i brought that up

[emily_]: to her as a teenage patient and she said yes that's normal but it will [emily_]: go away when you come off the medication [sean]: okay so [roger_mcfillin]: okay [sean]: the [emily_]: so [sean]: assumption [roger_mcfillin]: so the assumption [emily_]: i trusted [sean]: of the [emily_]: that [roger_mcfillin]: of [sean]: health [roger_mcfillin]: the [sean]: care [roger_mcfillin]: health [sean]: professional [roger_mcfillin]: care professional [sean]: was that [roger_mcfillin]: was

[sean]: that was [roger_mcfillin]: that that [sean]: possible [roger_mcfillin]: was possible [sean]: that it could [roger_mcfillin]: that [sean]: happen [roger_mcfillin]: it could happen [sean]: but it was [roger_mcfillin]: but [sean]: kind [roger_mcfillin]: it was [sean]: of [roger_mcfillin]: kind of [sean]: dismissed [roger_mcfillin]: dismissed [sean]: is not something [roger_mcfillin]: is not [sean]: that [roger_mcfillin]: something [sean]: could be [roger_mcfillin]: that could

[sean]: serious [roger_mcfillin]: be serious [sean]: or [roger_mcfillin]: or [sean]: lasting [roger_mcfillin]: lasting [sean]: so maybe [roger_mcfillin]: so [sean]: while [roger_mcfillin]: maybe [sean]: you're [emily_]: yeah [roger_mcfillin]: while [sean]: on [roger_mcfillin]: you're [sean]: the drug [roger_mcfillin]: on [sean]: you [roger_mcfillin]: the [sean]: can [roger_mcfillin]: drug [sean]: experience [roger_mcfillin]: you could experience [sean]: that but [roger_mcfillin]: that but

[sean]: almost [emily_]: yes [sean]: the [roger_mcfillin]: almost [sean]: assumption [roger_mcfillin]: the assumption [sean]: would be [roger_mcfillin]: would be [sean]: once you [roger_mcfillin]: once [sean]: begin [roger_mcfillin]: you [sean]: to [roger_mcfillin]: begin [sean]: taper [roger_mcfillin]: to [sean]: off [roger_mcfillin]: taper [sean]: the drug [roger_mcfillin]: off [sean]: and stop [roger_mcfillin]: the drug [sean]: the [roger_mcfillin]: and [sean]: drug

[roger_mcfillin]: stuff the drug [sean]: you [roger_mcfillin]: year [sean]: libido [roger_mcfillin]: libido [sean]: would return [roger_mcfillin]: would return [emily_]: yes and i do want to point out that seventeen years old is right in [emily_]: the middle of your sexual development it's not a trivial thing it's an important part [emily_]: of your life between ages seventeen and your early twenties like the fact that kids [emily_]: that age are being [roger_mcfillin]: m

[emily_]: prescribed drugs that have sexual side effects even even if they were guaranteed to just [emily_]: be temporary that still a big deal that still needs to be brought up in [emily_]: a clinical setting that still needs to be talked about cause it's going to impact [emily_]: their relationship it's going to impact their development yeah [sean]: good point [roger_mcfillin]: good point [emily_]: and it did i wasn't i hadn't had a serious relationship at that point in

[emily_]: my life but i entered into london college and it absolutely did impact my relationship [emily_]: i just wasn't sexually bone ding and experiencing sexuality in a normal way um and [emily_]: i knew something was wrong so i decided that it was time for me to [emily_]: taper off the medication i accurately identified i think this is the s s i'm [emily_]: gonna try and come off this medication now um so under the supervision of a

[emily_]: doctor i reduced thirty milligrams to fifteen milligrams did that for a couple of months [emily_]: and then i started i tapered down to nothing over the course of two weeks [emily_]: from fifteen nelograms um but during all this tapering i was not experiencing [roger_mcfillin]: yeah [emily_]: any return of libido [roger_mcfillin]: m [emily_]: then it's just after finishing the taper fully so just a few days after coming

[emily_]: off the medication entirely i woke up one morning and i immediately knew something has [emily_]: happened something is different something very that has happened in my body there was kind [emily_]: of this feeling of overall sluggishness and lack of vitality but i immediately notice sort [emily_]: of a sensation of coldness in my my private parts in my volva so i [emily_]: like reach down was like what's going on nd i had lost all forms of

[emily_]: orogenous sensation that sexual sensation in my genitals and they were less sensitive um to [emily_]: the touch as well and you know it was very frightening it was a very [emily_]: extreme sudden night and day change i realized as i went through that day in [emily_]: the next couple of days i'm not feeling any hint of arousal i'm not feeling [emily_]: any hint of desire i'm not feeling it's like a switch has gone off my

[emily_]: entire sexuality is shut down and i'm not even feeling fully emotionally present i can't [emily_]: really feel anything towards the guy i was day and at the time you know [emily_]: i felt nothing whatsoever towards him even emotionally it's like i've been entirely deerodicized [roger_mcfillin]: m [emily_]: so i got quite frightened and anxious and i immediately made an appointment with my [emily_]: doctor and i went to my doctor and i was asking them about this and

[emily_]: all they could really say to me was well give it some time you know [emily_]: you might just be going through a withdrawal they also said it could be the [emily_]: return of your mental health problems you know because you were coming off the s [emily_]: s this could be a depressive [roger_mcfillin]: m [emily_]: symptom but i knew that it could not be a time of depression because depression [emily_]: doesn't make your clitteres feel like your knuckle depression [roger_mcfillin]: so

[emily_]: doesn't make every bit of a raging [roger_mcfillin]: a [emily_]: a sensation in your entire body switch off like a light i had experienced what [emily_]: was diagnosis depression and it did not feel anything like that [emily_]: to summarize have there's been no change in that condition for the last three years [emily_]: i have been off the medication entirely [roger_mcfillin]: m [emily_]: for three years [roger_mcfillin]: yeah

[emily_]: i am still completely deerodicized um and i've tried lifestyle changes i've tried dietary changes [emily_]: aver to exercise i've tried you know anything any natural healing [roger_mcfillin]: m [emily_]: that you expect i've tried those avenues i've even tried some other medications to try [emily_]: and correct it and they're just i experienced brief relief or moderate relief actually on [emily_]: and it seemed to sort of switch it back partially but then that faded and

[emily_]: it ceased to have any improvement um and now i'm back to square one being [emily_]: completely a sexual so about two years ago a year in having this i realized [emily_]: i can't be silent about this something has happened to me in connection with the [emily_]: s s i had discovered online communities where people were talking about exactly the same [emily_]: symptoms that i was going through and i also discovered the work of professor david

[emily_]: heale now he is a professor at master university in ontario and he has been [emily_]: working for many years to try and bring light to post esisarisexual disfunction exactly what [emily_]: i was experiencing and he'd been you know advocating hard and trying to get attention [emily_]: and research towards it and a lot of it seemed to have fallen on deaf [emily_]: ears from the medical community i saw okay what's really needed here is patients themselves

[emily_]: who have experienced tees effects and need to start coming forward and talking about it [emily_]: there's a huge amount of shame and fear around this subject um and someone's got [emily_]: to be the one to stand up and just be willing to admit this happened [emily_]: to me and it needs to stop happening to other people of course i would [emily_]: love it if we could also find research and found research and find treatment for

[emily_]: it but even if my advocacy the only result is that i stop but more [emily_]: teen agers from having their sexuality removed that would be enough for me [sean]: it's very brave [roger_mcfillin]: very brave [sean]: especially at [roger_mcfillin]: specially [sean]: a young age [roger_mcfillin]: you [sean]: emily how old are you now i'm sorry [roger_mcfillin]: or [emily_]: i'm currently twenty six i was on the medication from seventeen almost at eighteen to [emily_]: age twenty three

[sean]: well unfortunately [roger_mcfillin]: unfortunately [sean]: your [roger_mcfillin]: here [sean]: story isn't [roger_mcfillin]: story [sean]: unique [roger_mcfillin]: isn't musique [sean]: and it's really [roger_mcfillin]: and [sean]: important [roger_mcfillin]: it's really important [sean]: for us [roger_mcfillin]: for [sean]: maybe [roger_mcfillin]: us [sean]: to [roger_mcfillin]: maybe to [sean]: try to get some [roger_mcfillin]: try [sean]: understanding

[roger_mcfillin]: to get some understanding [sean]: of [roger_mcfillin]: of [sean]: what the prevalence [roger_mcfillin]: what the prevalence [sean]: rate of [roger_mcfillin]: rate [sean]: this condition [roger_mcfillin]: of this condition [sean]: is yeah [roger_mcfillin]: is [sean]: as i want [roger_mcfillin]: yea [sean]: to [roger_mcfillin]: as [sean]: bring you [roger_mcfillin]: want to [sean]: in [roger_mcfillin]: bring [sean]: here [roger_mcfillin]: you in here [sean]: are you aware

[roger_mcfillin]: are you aware [sean]: of [roger_mcfillin]: of [sean]: kind of the prevalence [roger_mcfillin]: of the prevalence [sean]: rate [roger_mcfillin]: rate [sean]: of [yassie_pirani]: ah [sean]: this kind [roger_mcfillin]: this [sean]: of disorder [roger_mcfillin]: kind of disorder [sean]: or condition [roger_mcfillin]: or condition [yassie_pirani]: ah so that's a really good question so unfortunately we don't have data we have

[yassie_pirani]: a queen ten city is putting together some qualitative research collecting patient experiences collecting stories [yassie_pirani]: about the condition so that s going to be a survey that's going to be [yassie_pirani]: open for a while on bat and then hopefully then will that will generate some [emily_]: yeah [yassie_pirani]: quantitative research but at this time it's it's really a lot of anecdotal research and

[yassie_pirani]: qualitative research in that you see avail well um and it's really really really challenging [yassie_pirani]: because so many people probably have p s s d and don't know so just [yassie_pirani]: to kind of just briefly go ju scribe sorry explain what p s is it [yassie_pirani]: is because i don't think we've we've done that exactly yet so even though it's [yassie_pirani]: estimated to be were we actually really don't know the percentage of people who will

[yassie_pirani]: take anti [emily_]: hm [yassie_pirani]: presence will develop p s s t and so it can be it's a variety [yassie_pirani]: of symptoms that can begin either during or soon after stopping an anti de present [yassie_pirani]: so up to six months after and may persist for months years are indefinitely after [yassie_pirani]: stopping the medication and so there's currently no reliable treatment and the symptoms include so

[yassie_pirani]: reduced genital sensation or what we call genital anesthesia for a lot of people explain [yassie_pirani]: it as they went to the dentist and the lido cane god put in the [yassie_pirani]: wrong place [roger_mcfillin]: m [emily_]: ye [sean]: m [yassie_pirani]: and never went away also erectile dis function or decrease vaginal lubrication later inability orgasm [yassie_pirani]: so anrgasmia pleasureless week or muted orgasms decreased or absent libido reduced response to sexual

[yassie_pirani]: stimuli decreased or lack nocturnal erections premature delayed ejaculation reduced nipple sensitivity or sensitivity an [yassie_pirani]: other orogenous zones um a loss of pnpeniland [emily_]: m [yassie_pirani]: clatoral size [emily_]: oh [yassie_pirani]: and that's the sexual side and what's which is becoming you know more i mean [yassie_pirani]: that's been recognized the by m h regulatory becoming recognized by regular tory bodies and

[yassie_pirani]: in the medical community what's not being recognized is the other symptoms that often a [yassie_pirani]: company p s s d so um that's th there's sexual symptoms so it's kind [yassie_pirani]: of [emily_]: a [yassie_pirani]: what past is called but then [emily_]: m [yassie_pirani]: there's emotional and cognitive issues on [emily_]: m [yassie_pirani]: the r really actually i mean [emily_]: okay [yassie_pirani]: all of it's very disabling but the cognate [emily_]: oh

[yassie_pirani]: emotional issues i find my patients are more disabling a sexual issues so those are [yassie_pirani]: included reduced intensity of emotions so anhidonia particularly rom antic and hidonia so feel ability [yassie_pirani]: to feel romance but a lot of people just feel generalized and hidoniaso in abel [yassie_pirani]: inability to feel any form of pleasure in life which is to not be able

[yassie_pirani]: to feel love and connection and bonding and empathy my clients say just it really [yassie_pirani]: makes them non human they really can't participate and in relationships of any kind in [yassie_pirani]: a meaningful way compromise memory for sleep quality loss of creativity a lot of people [yassie_pirani]: say you know they were once musicians artists or painters they just that architecture [emily_]: yeah

[yassie_pirani]: of their creative architecture of their brain has been disrupted and [emily_]: yeah [yassie_pirani]: they just thought that there seems to be some kind of connection with one sexual [yassie_pirani]: sexual ity and creativity we seem to find the capacity to dream at night time [yassie_pirani]: a lot of people there just there they no longer have dreams or imagination they [yassie_pirani]: can't visualize anything in their heads any more they can't talk their minds i um

[yassie_pirani]: and yeah brain fog cognitive slowing so those symptoms are what we are really wanting [yassie_pirani]: to bring attention to as well because a lot of my clients will say it [yassie_pirani]: should just be called post s s r i cyndrum because the sexual umbrella is [yassie_pirani]: just one but my experience over here has not been reckon by that label so [roger_mcfillin]: yeah [yassie_pirani]: that's [emily_]: hm

[yassie_pirani]: that's a little description of exactly what pst is and we don't know the prevalence [yassie_pirani]: at this time [sean]: what's interesting [roger_mcfillin]: what's [sean]: here [roger_mcfillin]: interesting [sean]: is [roger_mcfillin]: here is [sean]: it's the challenge [roger_mcfillin]: it's the challenge [sean]: because of [roger_mcfillin]: because [sean]: the diversity [roger_mcfillin]: of the diversity [sean]: of [roger_mcfillin]: of [sean]: human [roger_mcfillin]: human

[sean]: genetic [roger_mcfillin]: genetic [sean]: make up [roger_mcfillin]: make up [sean]: were so [roger_mcfillin]: were [sean]: different [roger_mcfillin]: so different [yassie_pirani]: yeah [sean]: so [roger_mcfillin]: so [sean]: one person [roger_mcfillin]: one person [sean]: might take [roger_mcfillin]: might [sean]: a [roger_mcfillin]: take [sean]: drug [roger_mcfillin]: a [sean]: and [roger_mcfillin]: drug [sean]: experience [roger_mcfillin]: and experience [sean]: one thing

[roger_mcfillin]: one thing [sean]: while another [roger_mcfillin]: while another [sean]: person might [roger_mcfillin]: person [sean]: take [roger_mcfillin]: might [sean]: the same [roger_mcfillin]: take the [sean]: drug [roger_mcfillin]: same drug [sean]: and not [roger_mcfillin]: and [sean]: experience [roger_mcfillin]: not experience [sean]: either that [roger_mcfillin]: either [sean]: benefit [roger_mcfillin]: that benefit [sean]: or any [roger_mcfillin]: or [sean]: of [roger_mcfillin]: any

[sean]: the negative [roger_mcfillin]: of the negative [sean]: consequences [roger_mcfillin]: consequences [sean]: with it [roger_mcfillin]: with it [yassie_pirani]: yeah [sean]: and i have [roger_mcfillin]: and [sean]: deep [roger_mcfillin]: i have [sean]: dived [roger_mcfillin]: deep dived [sean]: into [roger_mcfillin]: into [sean]: anti depressions [roger_mcfillin]: anti de presence [sean]: for the [roger_mcfillin]: for [sean]: past [roger_mcfillin]: the [sean]: couple [roger_mcfillin]: past

[sean]: of years [roger_mcfillin]: couple [sean]: i [roger_mcfillin]: of [sean]: mean [roger_mcfillin]: years i mean i've [sean]: become so [roger_mcfillin]: become [yassie_pirani]: m [sean]: obsessive [roger_mcfillin]: so obsessive [sean]: about it [roger_mcfillin]: about it [sean]: that [roger_mcfillin]: that [sean]: i want [roger_mcfillin]: i [sean]: to [roger_mcfillin]: want [sean]: find [roger_mcfillin]: to find [sean]: out [roger_mcfillin]: out [sean]: those [roger_mcfillin]: those

[sean]: who [roger_mcfillin]: who [sean]: actually [roger_mcfillin]: actually [sean]: promote [roger_mcfillin]: promote [sean]: the drug [roger_mcfillin]: the [sean]: so there [roger_mcfillin]: drug [sean]: are [roger_mcfillin]: so there [sean]: people [roger_mcfillin]: are [sean]: out [roger_mcfillin]: people [sean]: there will [roger_mcfillin]: out [sean]: say [roger_mcfillin]: there [sean]: hey [roger_mcfillin]: will [sean]: it's [roger_mcfillin]: say [sean]: really [roger_mcfillin]: hey it's

[sean]: helped [roger_mcfillin]: really [sean]: me [roger_mcfillin]: help me [sean]: and even [roger_mcfillin]: and [sean]: emily [roger_mcfillin]: even emily [sean]: here [roger_mcfillin]: here [sean]: recognize [roger_mcfillin]: recognized [sean]: as there was [roger_mcfillin]: as there [sean]: some [roger_mcfillin]: was some [emily_]: yeah [sean]: effect [roger_mcfillin]: effect [sean]: and i [emily_]: yeah [sean]: try to make [roger_mcfillin]: i try [sean]: sense [roger_mcfillin]: to make

[sean]: of that [roger_mcfillin]: sense of that [sean]: because it [roger_mcfillin]: because [sean]: really [roger_mcfillin]: it [sean]: seems [roger_mcfillin]: really [sean]: like [roger_mcfillin]: seems [sean]: it's actually [roger_mcfillin]: like it's [sean]: a [roger_mcfillin]: actually [sean]: small [roger_mcfillin]: a [sean]: percentage [roger_mcfillin]: small percentage [sean]: of people [roger_mcfillin]: of [yassie_pirani]: kay [roger_mcfillin]: people [sean]: and when

[roger_mcfillin]: and [sean]: we compare [roger_mcfillin]: when we compare [sean]: the drug [roger_mcfillin]: the [sean]: to [roger_mcfillin]: drug [sean]: placebo [roger_mcfillin]: to placebo [sean]: there real [roger_mcfillin]: there's [sean]: controversy [roger_mcfillin]: real controversy [sean]: whether it [roger_mcfillin]: whether it [sean]: out performs [roger_mcfillin]: out performs [sean]: a placebo [roger_mcfillin]: a placebo [emily_]: oh [sean]: at any [roger_mcfillin]: at anyway

[sean]: in any meaningful [roger_mcfillin]: in any meaningful [sean]: way [roger_mcfillin]: way [sean]: but [roger_mcfillin]: but [sean]: what it is [roger_mcfillin]: what it is [sean]: it is [roger_mcfillin]: it is [sean]: a [roger_mcfillin]: a [sean]: psycho active [roger_mcfillin]: psycho [sean]: substance [roger_mcfillin]: active substance [sean]: that is [roger_mcfillin]: that [sean]: going [roger_mcfillin]: is going [sean]: to [roger_mcfillin]: to [sean]: alter [roger_mcfillin]: alter

[sean]: your [roger_mcfillin]: your [sean]: cognitive [roger_mcfillin]: cognitive [sean]: and [roger_mcfillin]: and [sean]: physiological [roger_mcfillin]: physiological [emily_]: yeah [sean]: states [roger_mcfillin]: states [sean]: and so [roger_mcfillin]: and [sean]: for [roger_mcfillin]: so [sean]: somebody [roger_mcfillin]: for [sean]: who [roger_mcfillin]: somebody [sean]: might [roger_mcfillin]: who [sean]: be [roger_mcfillin]: might [sean]: experiencing [roger_mcfillin]: be experiencing

[sean]: intense [roger_mcfillin]: intense [sean]: emotional [roger_mcfillin]: emotional [sean]: pain [roger_mcfillin]: pain [sean]: or activity [roger_mcfillin]: or re activity [sean]: it's certainly [roger_mcfillin]: it's certainly [sean]: possible [roger_mcfillin]: possible [sean]: that some [roger_mcfillin]: that [sean]: people [roger_mcfillin]: some people [sean]: might [roger_mcfillin]: might [sean]: experience [roger_mcfillin]: experience [emily_]: oh [sean]: an initial

[roger_mcfillin]: an initial [sean]: positive [roger_mcfillin]: positive [sean]: response [roger_mcfillin]: response [sean]: to the dampening [roger_mcfillin]: to the dampening [sean]: of that [roger_mcfillin]: of [sean]: emotional [roger_mcfillin]: that emotional [sean]: experience [roger_mcfillin]: experience [sean]: whether we call [roger_mcfillin]: whether [sean]: it [roger_mcfillin]: we [sean]: emotional [roger_mcfillin]: call it emotional [sean]: numbing [roger_mcfillin]: numbing

[sean]: or [roger_mcfillin]: or [sean]: an emotional [roger_mcfillin]: an emotional [sean]: blond in [roger_mcfillin]: blunting [sean]: effect [roger_mcfillin]: effect [sean]: that could [roger_mcfillin]: that [sean]: be [roger_mcfillin]: could be [sean]: or a percentage [roger_mcfillin]: or a percentage [sean]: of people [roger_mcfillin]: of people [sean]: it [yassie_pirani]: yes [sean]: could be [roger_mcfillin]: could [sean]: interpreted [roger_mcfillin]: be interpreted [sean]: as something

[roger_mcfillin]: as [sean]: that [roger_mcfillin]: something [sean]: is [roger_mcfillin]: that [sean]: quite [roger_mcfillin]: is [sean]: relieving [roger_mcfillin]: quite relieving [sean]: so there [roger_mcfillin]: so [sean]: may [roger_mcfillin]: there [sean]: be [roger_mcfillin]: may [sean]: some [roger_mcfillin]: be [sean]: benefit [roger_mcfillin]: some benefit [sean]: the question [roger_mcfillin]: the question [sean]: is always [roger_mcfillin]: is always [sean]: at what cost

[roger_mcfillin]: at what cost [sean]: so if there [roger_mcfillin]: so if [sean]: is [roger_mcfillin]: there [sean]: a [roger_mcfillin]: is a [sean]: emotional [roger_mcfillin]: emotional [sean]: blunting [roger_mcfillin]: blunting [sean]: or physiological [roger_mcfillin]: or physiological [sean]: shifts or [roger_mcfillin]: shifts [sean]: changes [roger_mcfillin]: or changes [sean]: your reaction [roger_mcfillin]: your reaction [sean]: to emotional [roger_mcfillin]: through emotional

[sean]: stimuli [roger_mcfillin]: stimuli [sean]: it would make [roger_mcfillin]: would [sean]: sense [roger_mcfillin]: make [sean]: that there [roger_mcfillin]: sense [sean]: is [roger_mcfillin]: that there is [emily_]: yeah [sean]: blunting [roger_mcfillin]: blunting [sean]: in other [roger_mcfillin]: in [sean]: ways [roger_mcfillin]: other ways [sean]: creativity [roger_mcfillin]: creativity [sean]: sexuality [roger_mcfillin]: sexuality [yassie_pirani]: ye [sean]: vito [roger_mcfillin]: b to

[yassie_pirani]: oh [sean]: is that is [roger_mcfillin]: is [sean]: that [roger_mcfillin]: that [sean]: how [roger_mcfillin]: is that how [sean]: the two of [roger_mcfillin]: the [sean]: you [roger_mcfillin]: two [sean]: kind [roger_mcfillin]: of you [sean]: of think [roger_mcfillin]: kind [sean]: of [roger_mcfillin]: of [sean]: it [roger_mcfillin]: think of it [sean]: as i think [roger_mcfillin]: as [sean]: about [roger_mcfillin]: i think [sean]: it [roger_mcfillin]: about it

[yassie_pirani]: yeah i a hundred per cent and one thing that i [roger_mcfillin]: oh [yassie_pirani]: forgot to mention is a lot of people just feel generally less tactile sensation all [yassie_pirani]: over their body like their body is numb they don't feel connected there's de personalization [yassie_pirani]: and de realization people people experience and just just a general lack of sensation like

[yassie_pirani]: they don't feel butterflies and they're got any more that even they'll touch their skin [yassie_pirani]: and have it's just it's just it's just like somebody [emily_]: ah [yassie_pirani]: put a numbing jell all over their body and people are so confused so there's [yassie_pirani]: something deeply impacted in some people's nervous system on and the emotions you know what [yassie_pirani]: we're kind of coming to learn about the connection of our motions and our nervous

[yassie_pirani]: system and how [emily_]: m [yassie_pirani]: of course then yeah if the drug is kind of numbing some of what's going [yassie_pirani]: on for people emotionally then there's physiological numbing as well those [sean]: yeah [yassie_pirani]: things are connected because we're [sean]: here's [roger_mcfillin]: here's [sean]: here's [roger_mcfillin]: here's [sean]: i always made [roger_mcfillin]: always [sean]: the assumption [roger_mcfillin]: make [sean]: that a side effect

[roger_mcfillin]: it [sean]: while you're on a [roger_mcfillin]: you [sean]: drug is while you're [roger_mcfillin]: while you're [sean]: on the drug [roger_mcfillin]: on [sean]: and even if you [roger_mcfillin]: even [sean]: were [roger_mcfillin]: if [sean]: to read through [roger_mcfillin]: red [sean]: the list of side effects [roger_mcfillin]: side of [sean]: as you're taking [roger_mcfillin]: you're [sean]: a drug [roger_mcfillin]: taking [sean]: you [roger_mcfillin]: a

[sean]: may think i feeling any of these side effects i never really [roger_mcfillin]: never [sean]: think [roger_mcfillin]: really [sean]: about [roger_mcfillin]: think about [sean]: after [roger_mcfillin]: after [sean]: i am you know getting off [roger_mcfillin]: getting [sean]: the drug that there could be side effects [roger_mcfillin]: side [sean]: that [roger_mcfillin]: effects [sean]: continue [roger_mcfillin]: continue [sean]: or [roger_mcfillin]: or [sean]: show themselves

[roger_mcfillin]: show themselves [sean]: when i'm no [roger_mcfillin]: when [sean]: longer [roger_mcfillin]: i'm [emily_]: oh [roger_mcfillin]: no [sean]: taking [roger_mcfillin]: longer picking [sean]: the drug [roger_mcfillin]: the drug [sean]: so that makes [roger_mcfillin]: this [sean]: me think [roger_mcfillin]: makes [sean]: that [roger_mcfillin]: me [sean]: this [roger_mcfillin]: think that [sean]: is [roger_mcfillin]: this [sean]: very [roger_mcfillin]: is very [sean]: under reported

[roger_mcfillin]: under report [yassie_pirani]: yeah [sean]: and most [roger_mcfillin]: and [sean]: people [roger_mcfillin]: most [sean]: don't [roger_mcfillin]: people [sean]: even [roger_mcfillin]: don't [sean]: think [roger_mcfillin]: even [sean]: about [roger_mcfillin]: think about [sean]: the drug [roger_mcfillin]: the [sean]: as [roger_mcfillin]: drug [sean]: causing [roger_mcfillin]: as causing [sean]: this particle [roger_mcfillin]: particular [sean]: or side effect

[roger_mcfillin]: side [yassie_pirani]: yeah [roger_mcfillin]: section [yassie_pirani]: hundred [sean]: are you [yassie_pirani]: percent [sean]: experiencing [roger_mcfillin]: are you experiencing [yassie_pirani]: hundred [sean]: that [roger_mcfillin]: that [yassie_pirani]: so many people would have no idea that it's the medication and we just the [yassie_pirani]: effects to people you know my clients say like the damage to my brain and [yassie_pirani]: nervous system [emily_]: oh

[yassie_pirani]: is so much further [emily_]: yeah [yassie_pirani]: than a side effect [emily_]: yeah [yassie_pirani]: and those are the people who can really [emily_]: oh [yassie_pirani]: link the drag two [emily_]: yeah [yassie_pirani]: to their symptoms but so many [emily_]: oh [yassie_pirani]: people will have such a [emily_]: right [yassie_pirani]: range of symptoms it will be really some for some people it's really mild and [yassie_pirani]: some people it's absolutely [roger_mcfillin]: ye

[yassie_pirani]: like an on off switch like emily was describing some [sean]: oh [yassie_pirani]: people it's in between and so so many people don't know to attribute their symptoms [yassie_pirani]: to the drug so it's it's really really really under probably under recognized under reported [yassie_pirani]: um and it's like roger you're saying it's it really [emily_]: m [yassie_pirani]: oh it's a trade [emily_]: ah [yassie_pirani]: off it's a trade off because they [emily_]: m yes

[yassie_pirani]: people [emily_]: oh [yassie_pirani]: you know will say p s s d does not begin to compare to the [yassie_pirani]: distress of the depression our anxiety that they're originally seeking treatment for just goes so [yassie_pirani]: much deeper likepssdrots your spirit and breaks people and people choosing suicide over it and [yassie_pirani]: that was so much more distressing [emily_]: m [yassie_pirani]: than the you know people are ending up in the doctor's office for you know

[yassie_pirani]: losing a job or you know all break up or all the things that are [yassie_pirani]: painful [emily_]: a [yassie_pirani]: though it's life but we're medicalizing these life experiences and and applying the bio medical [yassie_pirani]: model a big way to mental health and sort of dis easifying any heartbreak any [yassie_pirani]: any any distress and not i think it's just so important to kind of normalize [yassie_pirani]: the ups and downs of life and [emily_]: oh

[yassie_pirani]: we're kind of just [emily_]: i [yassie_pirani]: in a system where people are just getting put on me so [emily_]: ye [yassie_pirani]: easily without without [roger_mcfillin]: yeah [yassie_pirani]: needful conversations about the risks involved such as this [sean]: somebody [roger_mcfillin]: somebody [sean]: tweeted [roger_mcfillin]: tweated [sean]: me recently [roger_mcfillin]: me recently [sean]: who stated [roger_mcfillin]: who stated [sean]: my depression

[roger_mcfillin]: my depression [sean]: was [roger_mcfillin]: was [sean]: a vacation [roger_mcfillin]: vacation [sean]: at a five [roger_mcfillin]: at a [sean]: star [roger_mcfillin]: five [sean]: resort [roger_mcfillin]: start [sean]: compared [roger_mcfillin]: compared [sean]: to [roger_mcfillin]: to [sean]: p s [roger_mcfillin]: p [sean]: s [roger_mcfillin]: s [sean]: d [roger_mcfillin]: d [sean]: and the symptoms [roger_mcfillin]: and the symptoms [sean]: i have to [roger_mcfillin]: i

[sean]: exhibit [roger_mcfillin]: have to exhibit [emily_]: oh [sean]: and so [roger_mcfillin]: and [sean]: i [roger_mcfillin]: so [sean]: think you [roger_mcfillin]: i [sean]: made [roger_mcfillin]: think you [sean]: an [emily_]: oh [roger_mcfillin]: made [sean]: excellent [roger_mcfillin]: an excellent [sean]: point yes [roger_mcfillin]: point [sean]: about [roger_mcfillin]: as [sean]: the [roger_mcfillin]: about [sean]: medicalization [roger_mcfillin]: the medicalization [sean]: of

[roger_mcfillin]: of [sean]: m living [roger_mcfillin]: living [sean]: and we [roger_mcfillin]: and [sean]: can get [roger_mcfillin]: we [sean]: into [roger_mcfillin]: can get [sean]: philosophy [roger_mcfillin]: into philosophy [sean]: of this [roger_mcfillin]: at [sean]: but [roger_mcfillin]: this but [sean]: obviously [roger_mcfillin]: obviously [sean]: the emotions [roger_mcfillin]: the emotions [sean]: even when [roger_mcfillin]: even [sean]: they're [roger_mcfillin]: when [sean]: negative

[roger_mcfillin]: they're negative [sean]: and they're [roger_mcfillin]: and [sean]: intense [roger_mcfillin]: they're intense [sean]: are certainly [roger_mcfillin]: are certainly [sean]: sending us [roger_mcfillin]: sending [sean]: a message [roger_mcfillin]: us a message [sean]: they're serving [roger_mcfillin]: they're [sean]: us [roger_mcfillin]: serving [sean]: in some [roger_mcfillin]: us in [sean]: way [roger_mcfillin]: some way [sean]: whether [yassie_pirani]: sir [sean]: there

[roger_mcfillin]: whether [sean]: is [roger_mcfillin]: there is [sean]: some [roger_mcfillin]: some [sean]: problem [roger_mcfillin]: problem [sean]: we need to [roger_mcfillin]: we [sean]: face [roger_mcfillin]: need to face [yassie_pirani]: m [sean]: or loss we [roger_mcfillin]: loss [sean]: need [yassie_pirani]: m [sean]: to [roger_mcfillin]: we [sean]: grieve [roger_mcfillin]: need to grieve [yassie_pirani]: m [sean]: or something [roger_mcfillin]: or [sean]: that [roger_mcfillin]: something

[sean]: we have [roger_mcfillin]: that [sean]: to do [roger_mcfillin]: we [sean]: to [roger_mcfillin]: have [sean]: change [roger_mcfillin]: to do to [sean]: our [roger_mcfillin]: change [sean]: lives [roger_mcfillin]: our lives [sean]: there's also [roger_mcfillin]: there's [sean]: potentially [roger_mcfillin]: also potentially [sean]: something [roger_mcfillin]: something [sean]: else that's [roger_mcfillin]: else [sean]: going [roger_mcfillin]: that's [sean]: on [roger_mcfillin]: going

[sean]: with us [roger_mcfillin]: on with us [sean]: medically [roger_mcfillin]: medically [sean]: that needs [roger_mcfillin]: that [sean]: to be [roger_mcfillin]: needs to [sean]: addressed [roger_mcfillin]: be addressed [sean]: so [roger_mcfillin]: so [sean]: comment [roger_mcfillin]: comment [sean]: psychiatric [roger_mcfillin]: psychiatric [sean]: symptoms [roger_mcfillin]: symptoms [sean]: can also [roger_mcfillin]: can [sean]: be [roger_mcfillin]: also [sean]: related [emily_]: m

[roger_mcfillin]: be related [sean]: to a number [roger_mcfillin]: to a number [sean]: of other potential [roger_mcfillin]: other potential [sean]: causes [roger_mcfillin]: causes [sean]: emily was [roger_mcfillin]: emily [sean]: mentioning [roger_mcfillin]: was mentioning [sean]: struggling with [roger_mcfillin]: struggling [sean]: an eating [roger_mcfillin]: with [sean]: disorder [roger_mcfillin]: an eating [sean]: which [roger_mcfillin]: disorder [sean]: is an [roger_mcfillin]: which

[sean]: area [roger_mcfillin]: is an area [sean]: of experts [roger_mcfillin]: of experts [sean]: from for me personally [roger_mcfillin]: for me personally [sean]: where i [roger_mcfillin]: where [sean]: work [roger_mcfillin]: i [sean]: with [roger_mcfillin]: worked [sean]: clients [roger_mcfillin]: with clients [sean]: and they [roger_mcfillin]: and [sean]: exhibit [roger_mcfillin]: they exhibit [sean]: symptoms [roger_mcfillin]: symptoms [sean]: that are psyche [roger_mcfillin]: are

[sean]: at [roger_mcfillin]: psychynatrican [sean]: can nature [roger_mcfillin]: nature [sean]: depressed [roger_mcfillin]: depressed [sean]: mood [roger_mcfillin]: mood [sean]: anxiety [roger_mcfillin]: anxiety [sean]: and so forth [roger_mcfillin]: and so forth [sean]: and there's [roger_mcfillin]: and [sean]: a lot [roger_mcfillin]: there's [sean]: of [roger_mcfillin]: a [sean]: nutrient [roger_mcfillin]: lot of nutrient [sean]: deficiencies [roger_mcfillin]: deficiencies [sean]: there

[roger_mcfillin]: there [sean]: their body [roger_mcfillin]: their body [sean]: is [emily_]: m [sean]: sick [roger_mcfillin]: is [sean]: it's [roger_mcfillin]: sick [sean]: ill [roger_mcfillin]: it's ill [sean]: and [roger_mcfillin]: and [emily_]: oh [sean]: and their brain [roger_mcfillin]: end their brain [sean]: is deprived [roger_mcfillin]: is deprived [sean]: of necessary [roger_mcfillin]: of cessary [sean]: fats [roger_mcfillin]: fats [sean]: and proteins [roger_mcfillin]: and proteins

[sean]: for development [roger_mcfillin]: for development [sean]: and so forth [roger_mcfillin]: and so [sean]: so they [roger_mcfillin]: forth [sean]: exhibit [roger_mcfillin]: so they exhibit [sean]: depressed [roger_mcfillin]: depressed [sean]: mood and so [roger_mcfillin]: mood [sean]: forth [roger_mcfillin]: and so [sean]: but [roger_mcfillin]: forth [sean]: what the underlying [roger_mcfillin]: the underlying [sean]: problem is [roger_mcfillin]: problem [sean]: a starvation

[roger_mcfillin]: is a starvation [sean]: and it presents [roger_mcfillin]: and it [sean]: itself [roger_mcfillin]: presents itself [sean]: as [roger_mcfillin]: as [sean]: a psychiatric [roger_mcfillin]: a psychiatric [sean]: condition [emily_]: oh [roger_mcfillin]: condition [sean]: so the idea [roger_mcfillin]: so the [sean]: to [roger_mcfillin]: idea [sean]: try [roger_mcfillin]: to [sean]: to [roger_mcfillin]: try to [sean]: treat some [roger_mcfillin]: treat [sean]: of these

[roger_mcfillin]: some [sean]: conditions [roger_mcfillin]: of these conditions [sean]: that have [roger_mcfillin]: that have [sean]: other causes [roger_mcfillin]: other causes [sean]: and their [roger_mcfillin]: and their [sean]: their purpose [roger_mcfillin]: purpose [sean]: at one [roger_mcfillin]: and [sean]: person's [roger_mcfillin]: one person's [sean]: life at [roger_mcfillin]: life at [sean]: a specific [roger_mcfillin]: a specific [sean]: time is [roger_mcfillin]: time [sean]: to try

[roger_mcfillin]: is to [sean]: to [roger_mcfillin]: try [sean]: numb [roger_mcfillin]: to numb [sean]: or to alter [roger_mcfillin]: to [sean]: or [roger_mcfillin]: alter [sean]: change [roger_mcfillin]: or [sean]: that [roger_mcfillin]: change [sean]: physiological [roger_mcfillin]: that physiological [sean]: state [roger_mcfillin]: state [sean]: to assume [roger_mcfillin]: to [sean]: that [roger_mcfillin]: assume [sean]: that has [roger_mcfillin]: that [sean]: some [roger_mcfillin]: that has

[sean]: sort [roger_mcfillin]: some [sean]: of [roger_mcfillin]: sort [sean]: benefit [roger_mcfillin]: of benefit [sean]: think [roger_mcfillin]: i think [sean]: is [roger_mcfillin]: is now [sean]: unfortunately [roger_mcfillin]: unfortunately [sean]: a direction [roger_mcfillin]: a direction [sean]: where we've gone [roger_mcfillin]: where we've got [sean]: in society [roger_mcfillin]: society [sean]: that has [roger_mcfillin]: that [sean]: worse [roger_mcfillin]: is [sean]: an

[roger_mcfillin]: worse [sean]: the [roger_mcfillin]: than [sean]: way that [roger_mcfillin]: the way [sean]: we [roger_mcfillin]: that [sean]: deal [roger_mcfillin]: we deal [sean]: with the struggles [roger_mcfillin]: with the struggles [emily_]: m [sean]: living [roger_mcfillin]: of living [sean]: versus [roger_mcfillin]: versus [sean]: some advancement [roger_mcfillin]: some advancement [sean]: medically [roger_mcfillin]: medically [sean]: i want to bring [roger_mcfillin]: i want

[sean]: emily [roger_mcfillin]: to bring [sean]: back [roger_mcfillin]: emily [sean]: in [roger_mcfillin]: back [sean]: here [roger_mcfillin]: in [sean]: because [roger_mcfillin]: here [sean]: she [roger_mcfillin]: because [sean]: may [roger_mcfillin]: she may [sean]: have some more [roger_mcfillin]: have [sean]: information [roger_mcfillin]: some more information [sean]: on this i know [roger_mcfillin]: on this [sean]: anecdotally [roger_mcfillin]: i know anecdotally [sean]: it is quite

[roger_mcfillin]: it is [sean]: common [roger_mcfillin]: quite common [sean]: for my clients [roger_mcfillin]: for my clients [sean]: to report [roger_mcfillin]: to report [sean]: some [roger_mcfillin]: some [sean]: changes [roger_mcfillin]: changes [sean]: in their sexual [roger_mcfillin]: in their sexual [sean]: functioning [roger_mcfillin]: functioning [sean]: decrease [roger_mcfillin]: decrease [sean]: in libido [roger_mcfillin]: in libido [sean]: um [roger_mcfillin]: um [sean]: changes

[roger_mcfillin]: changes [sean]: in relationship [roger_mcfillin]: in relationship [sean]: and [roger_mcfillin]: and [sean]: i know we don't [roger_mcfillin]: i know [sean]: have [roger_mcfillin]: we don't [sean]: any [roger_mcfillin]: have [sean]: like [roger_mcfillin]: any [sean]: clue or [roger_mcfillin]: clear [sean]: data [roger_mcfillin]: data [sean]: that might [roger_mcfillin]: that [sean]: suggest [roger_mcfillin]: might suggest [sean]: that we [roger_mcfillin]: that [sean]: know

[roger_mcfillin]: we know [sean]: the percentage [roger_mcfillin]: the percentage [sean]: of people that [roger_mcfillin]: of [sean]: are [roger_mcfillin]: people [sean]: gonna experience [roger_mcfillin]: that are going experience [sean]: this adverse [roger_mcfillin]: his adverse [sean]: effect [roger_mcfillin]: effect [sean]: but in [roger_mcfillin]: and [sean]: your work [roger_mcfillin]: in your [sean]: emily [roger_mcfillin]: work [sean]: are [roger_mcfillin]: emily [sean]: you getting

[roger_mcfillin]: are you [sean]: an [roger_mcfillin]: getting [sean]: understanding [roger_mcfillin]: an understanding [sean]: of maybe how [roger_mcfillin]: of maybe [sean]: common [roger_mcfillin]: how common [sean]: something like [roger_mcfillin]: something [sean]: this is [roger_mcfillin]: like this is [emily_]: i think what we're dealing with is anyway it's a lot more common than one [emily_]: would think based on the amount of literature there is so here's an example a

[emily_]: friend of mine i made through advocacy who also suffers o p s d she [emily_]: made a tender profile in her and set it to her city and in it [emily_]: she didn't show her face but she described p s s and said i'm jus [emily_]: looking to connect with other people out there who might have it and she said [emily_]: the the area for availability to ten kilometers in either direction and within a few [emily_]: days she was getting [roger_mcfillin]: ah

[emily_]: messages from people who lived within her vicinity that had p [roger_mcfillin]: oh [emily_]: s s t that had come across her profile so this is not a rare [emily_]: thing there's someone in your town there's someone on your block who has p [yassie_pirani]: m [emily_]: s s d [yassie_pirani]: yeah [emily_]: it's probably far far more common than is ever discussed just like many other forms [emily_]: of sexual trauma [yassie_pirani]: a

[emily_]: um and i just want to add on to something that was speaking of earlier [emily_]: about [yassie_pirani]: m [emily_]: accompanying symptoms so when i [yassie_pirani]: m [emily_]: was experiencing what was diagnosed as depression in high school i could still finish high [emily_]: school when i was on the medication i was doing finding university when i developed [emily_]: psisdifyou're coming off the medication i experienced such emotional [yassie_pirani]: m

[emily_]: trauma and also accompanying physical fatigue and cognitive impacts [yassie_pirani]: oh [emily_]: like brain fag and inability to think straight or carry a work load that i [emily_]: had to ahletif university so that is both a that also makes it more difficult [emily_]: for people to address the problem of p s s t and it makes it [emily_]: more difficult for them to communicate to the people around them because it comes with

[emily_]: these accompanying symptoms of deep deep fatigue and lack of vitality so i think people [emily_]: who acquire p s st often just kind of slowly fading into the background [sean]: if if someone does suspect they may [roger_mcfillin]: they [sean]: have [roger_mcfillin]: made [sean]: p s s d how do they [roger_mcfillin]: how [sean]: go [roger_mcfillin]: did [sean]: about [roger_mcfillin]: it go [sean]: trying [roger_mcfillin]: out [sean]: to confirm because maybe people

[roger_mcfillin]: maybe [sean]: are [roger_mcfillin]: people [sean]: on the fence and not understanding [roger_mcfillin]: stand [sean]: because awareness is so low what resources [roger_mcfillin]: what is [sean]: exist if someone even [roger_mcfillin]: on [sean]: go to a doctor could a doctor properly [roger_mcfillin]: perley [sean]: confirm or [roger_mcfillin]: for [sean]: deny whether or not it's happening [roger_mcfillin]: i

[emily_]: there is there has been recently published an official diagnostic criteria and it was developed [emily_]: by a wide range of medical professionals from thirty nine different universities and i can [emily_]: link that to you afterwards the problem is that was developed in europe so this [emily_]: is starting to gain more awareness and recognition across the european union but especially in [emily_]: america were really behind on awareness so chances are when you go to a doctor

[emily_]: this is changing now but a lot of the time they haven't even heard of [emily_]: p s s so they [yassie_pirani]: m [emily_]: may just be genuinely in the dark but what you're experiencing as much as the [emily_]: patient is there's a tendency to suggs that it's the mental health issue returning there's [emily_]: also just often sort of a bold face just denial that it's possible that these [emily_]: effects can be the result of a medication and so patients may leave the doctor's

[emily_]: office just saying well i guess it can't be the medication it must be something [emily_]: else and they may spend years trying other things trying to fix other things on [emily_]: not being able to confirm that it is p s s t m generally we [emily_]: would say if you have significant sexual disfunction that was not present before taking the [emily_]: medication and that lasts three to six months after totally tapering off the medication we

[emily_]: would consider it to be p s s t we're not able yet to confirm [emily_]: bio markers there's no particular test that can be done on someone that can confirm [emily_]: that it's p s st a big clue is if there is tact nothing in [emily_]: there tall area because it's hard you know if it's lowered libido then it could [emily_]: maybe be other things tactialnumming after taking an is quite distinct that's quite a distinct [emily_]: discreet symptom [sean]: hm

[emily_]: um there are some medical professionals who are ware of past and are willing to [emily_]: diagnose it and i can make i can link you a list of them afterwards [emily_]: as well [sean]: great [yassie_pirani]: i find it's really common for people when they if they do gain the courage [yassie_pirani]: to speak to their doctor which is often a journey that i work with practice [yassie_pirani]: folks feel so much [emily_]: yeah

[yassie_pirani]: mistrust um they've gotten p s s t it's because the health care professional didn't [yassie_pirani]: have the equipment to warn them about the risk so there's a lot of mistrust [yassie_pirani]: already coming in when going into doctor's office after that experience oftentimes people have spoken [yassie_pirani]: to their families or communities and they're shamed or minimize so the strength and courage

[yassie_pirani]: it takes to even go into a doctor's office and say hey i think i [yassie_pirani]: have p s s t his it's immense and it's really common for people to [yassie_pirani]: experience miniimization and dismissal of their pscpssdsymptoms is a valid health care concern [emily_]: m [yassie_pirani]: which compound suffering [emily_]: oh [yassie_pirani]: often the greatest contributor i find to thoughts of suicide is well not actually the

[yassie_pirani]: injury itself often times it is but the experience of having their concerns to messed [yassie_pirani]: the denial of pit is a real and serious health care issue creates the conditions [yassie_pirani]: in which people too often blame themselves and self blame can further distrep relationships self [yassie_pirani]: worth and ident in sending people into a spiral of shame and self loathing and

[yassie_pirani]: read it's reached completely retrometizing for people to have to not be to not be [yassie_pirani]: validated and believed on many people with this sexual trauma from p s s t [yassie_pirani]: drop parallels [emily_]: oh [yassie_pirani]: to sexual assault made [emily_]: oh [yassie_pirani]: to drop parallels to sexual assaults to make sense of their experiences [emily_]: oh [yassie_pirani]: as they feel strongly that a violence been done to them and sexual violence framework

[yassie_pirani]: is useful for these suffers to understand their experience particularly because of the power and [yassie_pirani]: authority tiveferentials involved the dynamics around consent and the shame experienced when speaking out sufferers [yassie_pirani]: of p s just as survivors of sexual other sexual violences need to be reminded [yassie_pirani]: that their trauma is not their faults and that they have the right to feel

[yassie_pirani]: rage devastation grief confusion and their emotion related to their experience [sean]: yeah yeah [roger_mcfillin]: yeah [sean]: you [roger_mcfillin]: yeah [sean]: re you jumped [roger_mcfillin]: you [sean]: in [roger_mcfillin]: jumped [sean]: there because [roger_mcfillin]: in there [sean]: i was [roger_mcfillin]: because [sean]: going to [roger_mcfillin]: i was going [sean]: go [roger_mcfillin]: to [sean]: down [roger_mcfillin]: go [sean]: that [roger_mcfillin]: down

[sean]: lens [roger_mcfillin]: that [sean]: as [roger_mcfillin]: lends [sean]: far as [roger_mcfillin]: as [sean]: asking [roger_mcfillin]: far as [sean]: you [roger_mcfillin]: asking [sean]: some questions [roger_mcfillin]: you some questions [sean]: because i know [roger_mcfillin]: because [sean]: you do [roger_mcfillin]: i know [sean]: work [roger_mcfillin]: you [sean]: from [roger_mcfillin]: do [sean]: a [roger_mcfillin]: work [sean]: trauma [roger_mcfillin]: from a trauma [sean]: and formed

[roger_mcfillin]: and formed [sean]: perspective [roger_mcfillin]: perspective [sean]: and this [roger_mcfillin]: and [sean]: clearly [roger_mcfillin]: this clearly [sean]: to me represents [roger_mcfillin]: to me represents [sean]: medical [roger_mcfillin]: medical [sean]: trauma [roger_mcfillin]: trauma [sean]: are you [yassie_pirani]: hm [roger_mcfillin]: are you [sean]: do your [roger_mcfillin]: do [sean]: clients [roger_mcfillin]: your clients [sean]: that you're [roger_mcfillin]: that

[sean]: working [roger_mcfillin]: you're working [sean]: with also [roger_mcfillin]: with also [sean]: exhibit [roger_mcfillin]: exhibit [sean]: symptoms [roger_mcfillin]: symptoms [sean]: of [roger_mcfillin]: of [sean]: post dramatic [roger_mcfillin]: post dramatic [sean]: stress [roger_mcfillin]: stress [sean]: in a way [roger_mcfillin]: in a [sean]: that [roger_mcfillin]: way that [sean]: one would [roger_mcfillin]: one would [sean]: if they experienced [roger_mcfillin]: if they experienced

[sean]: another dramatic [roger_mcfillin]: another dramatic [sean]: event [roger_mcfillin]: event [emily_]: oh [yassie_pirani]: absolutely absolutely and people are triggered [emily_]: m [yassie_pirani]: the thing that's so hard about this is the triggers are everywhere i mean a [yassie_pirani]: love song at the mall i mean sex and relationships [emily_]: oh [yassie_pirani]: and love it's everywhere i mean you go to a friend's house and people are

[yassie_pirani]: talking about who dating and you know who's hot and who you know like it's [yassie_pirani]: just it's it's inescapable we don't realize how much or how much our culture really [yassie_pirani]: revolves around romance and sex until you until you get p s s d and [yassie_pirani]: you're triggered constantly because there's reminders of what what's happened to you and what's been [yassie_pirani]: stolen from you so it's really really hard for people it's definitely a a lot

[yassie_pirani]: i mean most people say that the p s s t has given them p [yassie_pirani]: t s d yeh [sean]: yeah i [emily_]: hm [sean]: work with [roger_mcfillin]: i work [sean]: sexual [roger_mcfillin]: with sexual [sean]: trauma [roger_mcfillin]: trauma [sean]: survivors [roger_mcfillin]: survivors [sean]: and you know as you're probably [roger_mcfillin]: as you're [sean]: well [roger_mcfillin]: probably [sean]: aware [roger_mcfillin]: well aware [sean]: that component

[roger_mcfillin]: that component [sean]: of self [roger_mcfillin]: of [sean]: blame [roger_mcfillin]: self blame [sean]: is really [roger_mcfillin]: is [sean]: problematic [roger_mcfillin]: really problematic [sean]: as [roger_mcfillin]: as [sean]: it does get [roger_mcfillin]: it does [sean]: in the [roger_mcfillin]: get [sean]: way [roger_mcfillin]: in the [sean]: of [roger_mcfillin]: way [sean]: being able [roger_mcfillin]: of being [sean]: to take [roger_mcfillin]: able to [sean]: steps

[roger_mcfillin]: take steps [sean]: forward [roger_mcfillin]: forward [sean]: and [roger_mcfillin]: and [sean]: it's really [roger_mcfillin]: it's really [sean]: even when we [roger_mcfillin]: even [sean]: look [roger_mcfillin]: when [sean]: into [roger_mcfillin]: we look [sean]: our literature [roger_mcfillin]: into our literature [sean]: it's really [roger_mcfillin]: it's [sean]: a major [roger_mcfillin]: really a [sean]: factor [roger_mcfillin]: major factor [sean]: in the development

[roger_mcfillin]: in the development [sean]: of p t [roger_mcfillin]: of [sean]: s [roger_mcfillin]: ptst [sean]: d symptoms [roger_mcfillin]: symptoms [sean]: have to [roger_mcfillin]: i [sean]: imagine [roger_mcfillin]: have to imagine [sean]: when it comes [roger_mcfillin]: when it comes [sean]: to [roger_mcfillin]: to [sean]: turning [roger_mcfillin]: turning [sean]: to [roger_mcfillin]: to [sean]: s s r eyes [roger_mcfillin]: our [sean]: and then [roger_mcfillin]: eyes [sean]: developing

[roger_mcfillin]: and then de [sean]: this [roger_mcfillin]: think [sean]: condition [roger_mcfillin]: is condition [sean]: self blame [roger_mcfillin]: self blame [sean]: is [roger_mcfillin]: is [sean]: got to be [roger_mcfillin]: got to be [sean]: one of the [roger_mcfillin]: one [sean]: challenges [roger_mcfillin]: of the challenges [sean]: that you [roger_mcfillin]: that [emily_]: hm [sean]: face [roger_mcfillin]: you [sean]: and [roger_mcfillin]: face [sean]: being able

[roger_mcfillin]: and being [sean]: to support [roger_mcfillin]: able to support [sean]: people [roger_mcfillin]: people [sean]: clinically [roger_mcfillin]: clinically [yassie_pirani]: yeah yeah it's massive because it's really really challenging for people to find people in [yassie_pirani]: their network to validate their experience yea people do not get that it's hard to [yassie_pirani]: find people to really recognize the depth of the [emily_]: ah

[yassie_pirani]: violence that has happened and to um to remind people that it's not their fault [yassie_pirani]: and that and that they have nothing to be ashamed about and that that you [yassie_pirani]: know they shouldn't be blaming themselves because it's so it's so i can think of [yassie_pirani]: a more stigmatized health care condition first you have to tell your community whoever you [yassie_pirani]: are leaning to for support first you have to say that you are on psychiatric

[yassie_pirani]: medications which carries stigma and then you have to say that you have been chemically [yassie_pirani]: castrated essentially um so the intersection of those reality it makes it extremely difficult for [yassie_pirani]: people to speak out and get the support they need from their families from their [yassie_pirani]: communities and because people haven't heard of p s s t it's just it's so

[yassie_pirani]: often minimized as an issue it's really rare for people i find to find somebody [yassie_pirani]: in their life to just say wow that you know i don't know a lot [yassie_pirani]: about that let me learn more about your experience a lot of ople really don't [yassie_pirani]: want to acknowledge that this is real because it's so confronting to the status quote [yassie_pirani]: of how we asses an treat people with mental health issues and there's a lot

[yassie_pirani]: of it's there's a lot of he a nuance that needs to be part of [yassie_pirani]: the discussion when we're bringing light to the risks of s s r is a [yassie_pirani]: lot of people who are on the medication do [yassie_pirani]: do you feel attacked when the drugs are being critigued and so people who are [yassie_pirani]: crutiguing the medicationsum [emily_]: m [yassie_pirani]: we're trying to have more robust conversations about efficacy and safety can be kind of

[yassie_pirani]: just put into a camp of conspire like oh your conspiracy theorist kind of thing [emily_]: yeah [sean]: ah [yassie_pirani]: emily say something [emily_]: yeah i was going to just completely concur that people who are currently on the [emily_]: medication [roger_mcfillin]: oh [emily_]: they have a tendency to get defensive when we're just talking about the [roger_mcfillin]: yeah [emily_]: long term effects that we've experienced i think they experience it is some kind of

[emily_]: attack on their choices and i'm not looking to take choice away from people i'm [emily_]: actually e trying to enable them ormed choice [roger_mcfillin]: oh [emily_]: and so too [sean]: yeah [emily_]: like we're not trying to make people feel ashamed for taking medication we just want [emily_]: people to go into that knowing what they are taking knowing more about what they're [emily_]: putting in their body and what the potential lunt consequences of it are they have

[emily_]: a right to know that [sean]: good [yassie_pirani]: yeah [sean]: point [emily_]: um [roger_mcfillin]: point [emily_]: m [yassie_pirani]: i think [sean]: um [yassie_pirani]: lost [roger_mcfillin]: um [yassie_pirani]: sorry [sean]: sorry [roger_mcfillin]: sorry [sean]: red yasi [roger_mcfillin]: as [yassie_pirani]: so to say a lot of people feel pressure to kind of tone down the [yassie_pirani]: impact of this on their lives because of due to the stigma against speaking frankly

[yassie_pirani]: about sexuality and the taboo of critics sing mental health medication in any way um [roger_mcfillin]: yeah [yassie_pirani]: so yeah that just really really really complicates things [emily_]: hm [sean]: agree and [roger_mcfillin]: three [sean]: i think [roger_mcfillin]: and [sean]: that [roger_mcfillin]: i [sean]: all [roger_mcfillin]: think [sean]: ties [roger_mcfillin]: that [sean]: into the under reporting [roger_mcfillin]: under [sean]: of this this effect yeah it's really

[roger_mcfillin]: yeah it's [sean]: important [roger_mcfillin]: really [sean]: because [roger_mcfillin]: important because [sean]: this isn't [roger_mcfillin]: this isn't [sean]: about pill [roger_mcfillin]: about [sean]: shaming [roger_mcfillin]: pill [sean]: this [roger_mcfillin]: steaming [sean]: is about [roger_mcfillin]: this is [sean]: providing [roger_mcfillin]: about providing [sean]: informed [roger_mcfillin]: informed [sean]: consent [roger_mcfillin]: consent [sean]: you know

[roger_mcfillin]: you [emily_]: yeah [roger_mcfillin]: know [sean]: having people [roger_mcfillin]: having people [sean]: be able [roger_mcfillin]: be [sean]: to [roger_mcfillin]: able [sean]: consent [roger_mcfillin]: to consent [sean]: to the medical [roger_mcfillin]: to the medical [sean]: treatment [roger_mcfillin]: treatment [sean]: that they choose [roger_mcfillin]: that they [sean]: by [roger_mcfillin]: choose [sean]: getting [roger_mcfillin]: by getting [sean]: all the

[roger_mcfillin]: all [sean]: available [roger_mcfillin]: the available [sean]: information [roger_mcfillin]: information [sean]: i feel like sometimes [roger_mcfillin]: i feel like [sean]: we're [roger_mcfillin]: sometimes [sean]: behind [roger_mcfillin]: we're [sean]: the [roger_mcfillin]: behind [sean]: iron [roger_mcfillin]: the [sean]: curtain [roger_mcfillin]: iron curtain [sean]: here in the [roger_mcfillin]: here [sean]: western [roger_mcfillin]: in the western [sean]: world [emily_]: oh

[roger_mcfillin]: world [sean]: when it [yassie_pirani]: m [sean]: comes [roger_mcfillin]: when it [sean]: to [roger_mcfillin]: comes to [sean]: adequate information [roger_mcfillin]: out of information [sean]: and when [emily_]: a [sean]: you [emily_]: great [roger_mcfillin]: when [sean]: talk [emily_]: way to [sean]: about [roger_mcfillin]: you [emily_]: put [sean]: eighty [roger_mcfillin]: talk [emily_]: it [roger_mcfillin]: about [sean]: per cent [roger_mcfillin]: eighty [sean]: of these

[roger_mcfillin]: per [sean]: drugs [roger_mcfillin]: cent of these [sean]: being [roger_mcfillin]: drugs [sean]: prescribed [roger_mcfillin]: being prescribed [sean]: in primary [roger_mcfillin]: in primary [sean]: care settings [roger_mcfillin]: care settings [sean]: they are getting [roger_mcfillin]: they are getting [sean]: infultrated [roger_mcfillin]: infultrated [sean]: with [roger_mcfillin]: with [sean]: parma data [roger_mcfillin]: parma data [sean]: and the [emily_]: oh

[roger_mcfillin]: and the [sean]: continuing [roger_mcfillin]: continuing [sean]: medical [roger_mcfillin]: medical [sean]: educate [roger_mcfillin]: education [sean]: and credits are [roger_mcfillin]: credits [sean]: often [roger_mcfillin]: are often [sean]: sponsored [roger_mcfillin]: sponsored [sean]: by the [roger_mcfillin]: by [sean]: parmasutical [emily_]: m [roger_mcfillin]: the parmasutical [sean]: industry [roger_mcfillin]: industry [sean]: so [roger_mcfillin]: so [sean]: what has

[roger_mcfillin]: what [sean]: to happen [roger_mcfillin]: has to [sean]: is [roger_mcfillin]: happen [sean]: it has to [roger_mcfillin]: is [sean]: be [roger_mcfillin]: it [sean]: these [roger_mcfillin]: has [sean]: grass [roger_mcfillin]: to be these [sean]: roots [roger_mcfillin]: grass [sean]: efforts [roger_mcfillin]: roots efforts [sean]: with [roger_mcfillin]: with [sean]: organizations [roger_mcfillin]: organizations [emily_]: m [sean]: like [roger_mcfillin]: like [sean]: m p

[roger_mcfillin]: m [sean]: s [roger_mcfillin]: p [sean]: s d [roger_mcfillin]: s [sean]: canada [roger_mcfillin]: s t canada [sean]: and [roger_mcfillin]: and [sean]: others [roger_mcfillin]: others [sean]: who trying [roger_mcfillin]: who are [sean]: to [roger_mcfillin]: trying [sean]: bring [roger_mcfillin]: to bring [sean]: awareness [roger_mcfillin]: awareness [sean]: and attention [roger_mcfillin]: and intention [sean]: through the [roger_mcfillin]: through [sean]: stories

[roger_mcfillin]: the stories [sean]: and [roger_mcfillin]: and [sean]: all the [roger_mcfillin]: all [sean]: information [roger_mcfillin]: the information [sean]: and try to [roger_mcfillin]: and [sean]: fund [roger_mcfillin]: try [sean]: themselves [roger_mcfillin]: to find themselves [sean]: some some way of [roger_mcfillin]: some [sean]: gathering [roger_mcfillin]: way of [sean]: the [roger_mcfillin]: gathering [sean]: data [roger_mcfillin]: the [sean]: because [roger_mcfillin]: data

[sean]: it's just [roger_mcfillin]: it's [sean]: not [roger_mcfillin]: just [sean]: going [roger_mcfillin]: not [sean]: to [roger_mcfillin]: going [sean]: be [roger_mcfillin]: to be [sean]: economically [roger_mcfillin]: economically [sean]: motivated [roger_mcfillin]: motivated [sean]: on on [roger_mcfillin]: on [sean]: from the far [roger_mcfillin]: from [sean]: masgitleinjury [roger_mcfillin]: the farm a super [sean]: industry or the [roger_mcfillin]: or the [sean]: medical authority

[roger_mcfillin]: medical authority [sean]: i feel like [roger_mcfillin]: i feel like [sean]: we are in [roger_mcfillin]: we [sean]: a [roger_mcfillin]: are [sean]: very [roger_mcfillin]: in a [sean]: challenging [roger_mcfillin]: very challenging [sean]: place [roger_mcfillin]: place [sean]: because these [roger_mcfillin]: because [sean]: drugs [roger_mcfillin]: these [sean]: are [roger_mcfillin]: drugs [sean]: so [roger_mcfillin]: are [sean]: widely [roger_mcfillin]: so widely

[sean]: prescribed [roger_mcfillin]: prescribed [sean]: it's [roger_mcfillin]: that [sean]: very [roger_mcfillin]: it's [emily_]: hm [sean]: difficult [roger_mcfillin]: very difficult [sean]: for [roger_mcfillin]: for [sean]: a [roger_mcfillin]: our [sean]: medical [roger_mcfillin]: medical [sean]: professional [roger_mcfillin]: professional [sean]: to [roger_mcfillin]: to [sean]: really face [roger_mcfillin]: really [sean]: and [roger_mcfillin]: face [sean]: accept [roger_mcfillin]: and

[sean]: this [roger_mcfillin]: accept [sean]: fully [roger_mcfillin]: this [sean]: because [roger_mcfillin]: fully [sean]: they're [roger_mcfillin]: because [sean]: so [roger_mcfillin]: they're so [sean]: complicit [roger_mcfillin]: complicit [sean]: in this [roger_mcfillin]: in this [yassie_pirani]: m [sean]: because they [roger_mcfillin]: because [sean]: are [roger_mcfillin]: they [sean]: prescribing [roger_mcfillin]: are prescribing [sean]: them [emily_]: oh [roger_mcfillin]: them

[sean]: without [roger_mcfillin]: without [sean]: full understanding [roger_mcfillin]: full understanding [sean]: of what the [roger_mcfillin]: of [sean]: effects [roger_mcfillin]: what the effects [sean]: are which [roger_mcfillin]: are [sean]: leads [roger_mcfillin]: which [sean]: to my [roger_mcfillin]: leads [sean]: next [roger_mcfillin]: to my next [sean]: question [roger_mcfillin]: question [sean]: because emily [roger_mcfillin]: because [sean]: touched [roger_mcfillin]: emily [sean]: on

[roger_mcfillin]: touched [sean]: this earlier [roger_mcfillin]: on this earlier [sean]: my concern [roger_mcfillin]: my concern [sean]: is they're [roger_mcfillin]: is [sean]: so [roger_mcfillin]: there so [sean]: frequently [roger_mcfillin]: frequently [sean]: prescribed [roger_mcfillin]: prescribed [sean]: off label [roger_mcfillin]: off label [sean]: and they're experimental [roger_mcfillin]: and they're experimental [sean]: for [roger_mcfillin]: for [sean]: young [roger_mcfillin]: young

[sean]: developing [roger_mcfillin]: developing [sean]: children [roger_mcfillin]: children [sean]: and teen agers [roger_mcfillin]: and teen agers [sean]: emily mentioned [roger_mcfillin]: emily mentioned [sean]: how [roger_mcfillin]: how [sean]: how valuable [roger_mcfillin]: how valuable [sean]: and important [roger_mcfillin]: and important [sean]: the development [roger_mcfillin]: the development [sean]: this period [roger_mcfillin]: this [sean]: in [roger_mcfillin]: period

[sean]: development [roger_mcfillin]: in development [sean]: is for [roger_mcfillin]: is [sean]: continued [roger_mcfillin]: for continued [sean]: sexuality [roger_mcfillin]: sexuality [sean]: understanding your [roger_mcfillin]: standing [sean]: sexuality [roger_mcfillin]: your sexuality [sean]: your experience [roger_mcfillin]: or experience [sean]: obviously [roger_mcfillin]: obviously [sean]: it's a it's a time [roger_mcfillin]: a time [sean]: in development [roger_mcfillin]: in development

[sean]: where we're [roger_mcfillin]: where [sean]: just [roger_mcfillin]: we're [sean]: kind [roger_mcfillin]: just [sean]: of [roger_mcfillin]: kind [sean]: bala [roger_mcfillin]: of by [sean]: jically [roger_mcfillin]: a jac [sean]: kind of [roger_mcfillin]: kind [sean]: frame [roger_mcfillin]: of frame [sean]: to reproduce [roger_mcfillin]: to reproduce [sean]: so there's [roger_mcfillin]: so there's [sean]: intense [roger_mcfillin]: intense [sean]: emotions [roger_mcfillin]: emotions

[sean]: and hormonal [roger_mcfillin]: and hormonal [sean]: reactions [roger_mcfillin]: reactions [sean]: and responses [roger_mcfillin]: and responses [sean]: that occurred [roger_mcfillin]: that [sean]: during [roger_mcfillin]: occurred [sean]: this developmental [roger_mcfillin]: during this developmental [sean]: period [roger_mcfillin]: period [sean]: and what [emily_]: oh [roger_mcfillin]: and [sean]: i'm [roger_mcfillin]: what [sean]: seeing [roger_mcfillin]: i'm seeing [sean]: and in

[roger_mcfillin]: and [sean]: contact [roger_mcfillin]: in contact [sean]: with people [roger_mcfillin]: with [sean]: around [roger_mcfillin]: people [sean]: the [roger_mcfillin]: around [sean]: world [roger_mcfillin]: the world [sean]: we [emily_]: yeah [sean]: see this [roger_mcfillin]: we [sean]: developing [roger_mcfillin]: see this developing [emily_]: oh [sean]: movement [roger_mcfillin]: movement [sean]: around [emily_]: yeah [roger_mcfillin]: around [sean]: identifying

[roger_mcfillin]: identifying [sean]: as a [roger_mcfillin]: as [sean]: sexual [roger_mcfillin]: a sexual [sean]: and [roger_mcfillin]: and [sean]: there so [roger_mcfillin]: there are [sean]: many [roger_mcfillin]: so many [sean]: young people [roger_mcfillin]: young people [sean]: that are being [roger_mcfillin]: that are [sean]: prescribed [roger_mcfillin]: being prescribed [sean]: s s [roger_mcfillin]: s [sean]: r [roger_mcfillin]: s r [sean]: is [roger_mcfillin]: is [sean]: in particular

[roger_mcfillin]: in particular [sean]: more so [roger_mcfillin]: more so [sean]: adolescent [roger_mcfillin]: lessen [sean]: females [roger_mcfillin]: males [sean]: i'm really [roger_mcfillin]: that i'm [sean]: concerned [roger_mcfillin]: really concerned [emily_]: yeah [sean]: that the drugs [roger_mcfillin]: the [sean]: themselves [roger_mcfillin]: drugs themselves [sean]: could be [roger_mcfillin]: could be [sean]: in some [roger_mcfillin]: in [sean]: way [roger_mcfillin]: some way

[sean]: um [roger_mcfillin]: um [sean]: impeding [roger_mcfillin]: impeding [sean]: normal [roger_mcfillin]: normal [sean]: sexual [roger_mcfillin]: sexual [sean]: development [roger_mcfillin]: development [sean]: and understanding [roger_mcfillin]: and understanding [sean]: you know who [roger_mcfillin]: you know [sean]: you [roger_mcfillin]: who [sean]: are [roger_mcfillin]: you [sean]: tracted [roger_mcfillin]: are attracted [sean]: to or what [roger_mcfillin]: to [sean]: you

[roger_mcfillin]: or [emily_]: m [sean]: experience [roger_mcfillin]: what you experience [sean]: or experiencing [roger_mcfillin]: or experiencing [sean]: normal [roger_mcfillin]: normal [emily_]: h [sean]: sexual [roger_mcfillin]: actual [sean]: functioning [emily_]: yeah [roger_mcfillin]: functioning [sean]: that would [roger_mcfillin]: that [sean]: be [roger_mcfillin]: would be [sean]: exhibited [roger_mcfillin]: exhibited [sean]: that age [roger_mcfillin]: that [sean]: range

[roger_mcfillin]: age range [sean]: do we have any [roger_mcfillin]: we [sean]: information [roger_mcfillin]: have any information [sean]: or even just [roger_mcfillin]: even [sean]: your [roger_mcfillin]: just [sean]: thoughts [roger_mcfillin]: to your thoughts [sean]: is this [roger_mcfillin]: is [sean]: rise [roger_mcfillin]: this [sean]: and [roger_mcfillin]: rise [sean]: identi [roger_mcfillin]: and identifying [sean]: ying as a [roger_mcfillin]: as [sean]: sexual [roger_mcfillin]: a sexual

[sean]: could it be potentially [roger_mcfillin]: could be potentially [sean]: linked [roger_mcfillin]: linked [sean]: to the [roger_mcfillin]: to [sean]: rise [roger_mcfillin]: the rise [sean]: and drugs [roger_mcfillin]: and [sean]: that [roger_mcfillin]: drugs [sean]: we're giving [roger_mcfillin]: that we're [sean]: these [roger_mcfillin]: giving these [sean]: young developing [roger_mcfillin]: young developing [sean]: teen agers [roger_mcfillin]: teenagers

[emily_]: ye i think that's a very very important question obviously i don't have any definitive [emily_]: answer on that because it hasn't been studied [roger_mcfillin]: oh [emily_]: it hasn't been properly studied why we're seeing this a sexual [roger_mcfillin]: oh [emily_]: movement i think it's it's always a possibility that some people are that way naturally [emily_]: but when you have drugs being commonly prescribed to millions of people in canada alone

[emily_]: that we know can interfere with sexual develop and m this is obviously going to [emily_]: be having some kind of systemic impact and i think that there is just such [emily_]: a taboo over examining that impact that it could be causing lots of things not [emily_]: many effects that we can't confirm so personally it would not surprise me if a [emily_]: lot of the people who identifies a sexual or or at least some of them

[emily_]: had an interrupted sexual development as a result of psychiatric medication i do personally know [emily_]: i mean i mean at this point i've talked to hundreds of people with p [emily_]: s s t i've read the posts of many more and i do have personally [emily_]: spoken to people who were prescribed rise at age eleven or age twelve and they [emily_]: just never experienced normal what they would describe as normal sexual development from that point

[emily_]: onwards so i do know i have spoken directly to people who are what society [emily_]: would deem sexual who personally attribute their sexuality to psychiatric medication particularly s s r [emily_]: is [yassie_pirani]: m [emily_]: so it definitely is something that's happening what what percentage of those people what percentage [emily_]: of people who identify as a sexual are affected by arise what percentage element has [emily_]: nothing to do with that we don't have that information

[yassie_pirani]: it's really difficult because with people who have p s s d on the onset [roger_mcfillin]: oh [yassie_pirani]: of pssdouknoas adults the [emily_]: oh [yassie_pirani]: have a base line to compare to be you were robbed of your sexuality before [yassie_pirani]: you had the capacity to develop your [emily_]: yeah [yassie_pirani]: sexuality as [emily_]: m [yassie_pirani]: as you know can happen and i have clients who know the r these medications

[yassie_pirani]: obviously the symptom really ranges but i mean i have some clients who they do [yassie_pirani]: have their romantic attraction and arouse but their genitals are numb and they have norgasmea [yassie_pirani]: and they have they've been diagnosed p c there's no other reason why they would [yassie_pirani]: have those symptoms [emily_]: yeah [yassie_pirani]: so there are there are very clearly impacts develop mentally too somebody's body sexually by

[yassie_pirani]: these medications and so any range of those symptoms can impact samedis sexual response [emily_]: right [yassie_pirani]: system and identity development that correlates with what has or hasn't been able to develop [yassie_pirani]: sexually so i mean it only makes sense we we we don't know obviously we [yassie_pirani]: don't have numbers we don't have data we desperately need more data of all kinds [yassie_pirani]: of about p s s d but yeah for when i see my clinical practice

[yassie_pirani]: it for or would makes sense that that is a part of the movement that [yassie_pirani]: we're seeing [emily_]: and while there has been not the early enough study on this and there's much [emily_]: much more required there has been one very [roger_mcfillin]: yeah [emily_]: interesting paper that was published in twenty twenty in the journal of sexual medicine it [emily_]: is by tyranny laurens ph d and it's titled antidepressent use during development may impair

[emily_]: women's sexual desire and adulthood [sean]: m [emily_]: and this is one of the this is this is i think should be a [emily_]: jumping off point for more studies [yassie_pirani]: m [emily_]: um the i'll read you the introduction here is that okay [sean]: please [roger_mcfillin]: please [emily_]: it says although antidepressents are well known because sexual side effects and adults the long

[emily_]: term effects of anti depressant use during development on adult sexual adult sexual function is [emily_]: unknown the aim of the stuf is to explore differences in sexual desire and sexual [emily_]: behavior between adults who did versus did not use antidepressince during childhood methods an online [emily_]: survey of six hundred and ten young adults who were sixty six percent women assessed

[emily_]: childhood and current mental health and use of anti depressence and other psychiatric medications before [emily_]: the age of sixteen and currently partnered and solitary sexual desire and frequency of masturbation [emily_]: and partner sexual activity and presents were coded into either selective sara tone and reupticeinhibitors [emily_]: or other non s s antidepressente and here are the results for women childhood s

[emily_]: s r use was associated with significantly lower sexual desire desire for an attractive other [emily_]: and frequency of masturbation this was true even when controlling for childhood mental health concerns [emily_]: current mental health and current anti depressant use and i will happily link you that [emily_]: study because i think it's really intrig in place to start and we should be [roger_mcfillin]: ah [emily_]: umreplicating that on a much much wider level

[yassie_pirani]: and rodent studies show that the sexual development sorry sexual basically mirror all of that [yassie_pirani]: in what you shared emily and there's a lot of rodents more rodent studies so [yassie_pirani]: i mean we just we need more research [sean]: i'll include a link [roger_mcfillin]: includally [sean]: to that study in the show summary yeah an [roger_mcfillin]: yeah [sean]: emily [roger_mcfillin]: mile [sean]: i am [roger_mcfillin]: i am [sean]: interested

[roger_mcfillin]: interested [sean]: in [roger_mcfillin]: in [sean]: hoping [roger_mcfillin]: coping [sean]: the clinical [roger_mcfillin]: the [sean]: work [roger_mcfillin]: clinical [sean]: that's [roger_mcfillin]: work [sean]: done [roger_mcfillin]: that's done [sean]: how you approach [roger_mcfillin]: how you approach [sean]: your life [roger_mcfillin]: your life [sean]: and [roger_mcfillin]: and [sean]: the clients [roger_mcfillin]: the clients [sean]: who [roger_mcfillin]: who

[sean]: are suffering [roger_mcfillin]: are suffering [sean]: from this [roger_mcfillin]: from [sean]: how they [roger_mcfillin]: how they [sean]: come to [roger_mcfillin]: come [sean]: some acceptance [roger_mcfillin]: to some acceptance [sean]: and how they [roger_mcfillin]: and [sean]: cope [roger_mcfillin]: how they [sean]: and [roger_mcfillin]: cope [sean]: create [roger_mcfillin]: and [sean]: a life [roger_mcfillin]: create a life [sean]: value [roger_mcfillin]: value

[sean]: purpose one that's [roger_mcfillin]: one that's [sean]: worth living [roger_mcfillin]: worth living [sean]: i'm interested [roger_mcfillin]: i'm interested [sean]: to know [roger_mcfillin]: to know [sean]: in [roger_mcfillin]: in [sean]: intimate relationships [roger_mcfillin]: intimate relationships [sean]: and [roger_mcfillin]: and [sean]: with their partners [roger_mcfillin]: with their partners [sean]: how they [roger_mcfillin]: how [sean]: are [roger_mcfillin]: they're

[sean]: able to [roger_mcfillin]: able [sean]: kind of [roger_mcfillin]: to [sean]: adapt [roger_mcfillin]: kind of adapt [sean]: so any [roger_mcfillin]: so [sean]: information [roger_mcfillin]: any information [sean]: that you can [roger_mcfillin]: that you can [sean]: provide about [roger_mcfillin]: provide about [sean]: we know clinically [roger_mcfillin]: we know clinically [sean]: to be able [roger_mcfillin]: to [sean]: to support [roger_mcfillin]: be able to support [sean]: people who

[roger_mcfillin]: people [sean]: are going [roger_mcfillin]: who [sean]: through [roger_mcfillin]: are going [sean]: this [roger_mcfillin]: through [yassie_pirani]: so in my work of understanding more about the lived experience with people with p [yassie_pirani]: s d i've just come to learn how immense the ripple effects are this condition [yassie_pirani]: can beyond people's lives as relationships self esteem quality of life motivation identity and many

[yassie_pirani]: other aspects the loss of sexual identity and expression can have devastating consequences on mental [yassie_pirani]: health of course and really shatter one's identity and self worth [emily_]: m [yassie_pirani]: and be a really big reading process so a lot of the work is [emily_]: okay [yassie_pirani]: moving to grief and to a place of [emily_]: yeah [yassie_pirani]: of acceptance [emily_]: oh

[yassie_pirani]: m p p s s t it's only when somebody's sexuality is removed when people [yassie_pirani]: realize how intrinsic it is to their self expression and sense of empowerment um so [yassie_pirani]: people feel this experience is profoundly s empowering injury and [roger_mcfillin]: a [yassie_pirani]: really can shape have such an impact on somebody's identity [emily_]: ah [yassie_pirani]: especially you know in terms of figuring out somebody's sexual orientation or membership in the

[yassie_pirani]: queer community is it [roger_mcfillin]: i [yassie_pirani]: really really is so so life altering and and again depending on the symptom profile [yassie_pirani]: for some people it's absolutely catastrophic and some people are impacted less profoundly depending on [yassie_pirani]: what symptoms they get and so it really i find it's a spectrum and for [yassie_pirani]: some people on one end they're entirely sexually and emotionally non functional and some people

[yassie_pirani]: it's just kind of my mild to moderate libido reduction that doesn't strongly impact their [yassie_pirani]: life in a big way so it's really up to you know i find um [yassie_pirani]: following the following the lead on on the pap on the patient experience [roger_mcfillin]: okay [yassie_pirani]: and really using their language and their frame of reference to understand how it's impacted [yassie_pirani]: them is so important in terms of hoping i mean it just it so depends

[yassie_pirani]: on the symptom profile um you know for most people it really is grief it's [yassie_pirani]: shock process and developing the capacity to build community with other people who have p [yassie_pirani]: s s t is really important because it's just so hard for people so alienating [yassie_pirani]: such an alienating experience people can't seem to get the support or understanding that they

[yassie_pirani]: need from people who haven't had this condition so there's there's something that is real [yassie_pirani]: quite profound about being able to connect and talk to other people who've had this [yassie_pirani]: happened to them as well and really i find [yassie_pirani]: people it's so healing for people to be believed by their health care providers to [yassie_pirani]: be believed by people in positions and authority who are supposed to be safe guarding

[yassie_pirani]: their well being how healing is for people to actually just have somebody say recognize [yassie_pirani]: this and say this is real and here's the diagnosis un this is something wrong [yassie_pirani]: that you know happened to you and it's not your fault like that and it's [yassie_pirani]: self is immense and it's really hard for people to come by it's a lot [yassie_pirani]: easier to have your doctor believe [emily_]: yeah

[yassie_pirani]: you if you were a victim of other kinds of sexual violence this this type [yassie_pirani]: of sexual violence it's really hard to be believed and to be validated and believed [yassie_pirani]: is a corner stone of the healing process so it's it's so important that we [yassie_pirani]: build more awareness about this so people can at least have their [emily_]: oh [yassie_pirani]: pain recognized and validated as something real

[emily_]: yeah yeah i agree with all of that i tell you that i mean having [emily_]: your sexuality chemically removed and the attendant symptoms of cognitive dis function it isn't really [emily_]: something your god to get over it's going to be something that hurts you for [emily_]: the rest of your life and it's goin o come in waves like any grieving [emily_]: process and i think describing as grieving processes you're very accurate you know i went

[emily_]: through all of the stages of grief coming to terms with the fact that this [emily_]: was going to be most likely was going to be something i would have to [emily_]: live with for the rest of my life the things i found that were conducive [emily_]: to learning how to cope were removing self blame from the equation reaching out to [emily_]: other people who had p s s t you know like she described there is

[emily_]: an incredible feeling of isolation but being able to build a community of people around [emily_]: me who have gone through the same thing and can kind of come in write [emily_]: about it that did make me feel more supported unless alone and also [roger_mcfillin]: m [emily_]: i did eventually start getting through both people in my life and some of the [emily_]: people in the medical community here in b c you know and i have done

[emily_]: presentations to the b c union of social workers a colleague of ours did a [emily_]: presentation to the b c psychiatric college so the feeling of actually making some progress [emily_]: has enabled me to create some meaning out of it and gain a sense of [emily_]: calm and it gives me some of my control back you know it's not just [emily_]: something that is being done to me it is something that i do have i

[emily_]: do have a measure of control within this ation um in my personal life it [emily_]: has simply had to be learning how not to think about it all the time [emily_]: just truly having to develop the capacity to compartmentalize and of the people i have [emily_]: known who have experienced i'm not going to say healing but increase in their ability [emily_]: to cope compartmentalization is often a big part of it just being [roger_mcfillin]: m

[emily_]: able to set it aside okay okay i will focus on [yassie_pirani]: oh [emily_]: other aspects of my life because this ass fact is just destroyed but of course [emily_]: the ripple effects throughout your life are incredible you know you don't really have access [emily_]: to the normal social environment that young people inhabit the primary [roger_mcfillin]: yeah [emily_]: person in most people's life is their partner you know you may move to different

[emily_]: cities you may or may not be close to your family most people [yassie_pirani]: oh [emily_]: the number one person in their life is suppose um [yassie_pirani]: oh [emily_]: and then after that they're children but if [yassie_pirani]: oh [emily_]: you don't have the ability really to have supposed to have a relationship how are [emily_]: you going to build a family so the people who manage to deal with p [emily_]: s s t in a less desperate way are the people who are able to

[emily_]: build relationships outside of sort of that tum [roger_mcfillin]: yeah [emily_]: who are able to build platonic relationships that don't rely on a romantic connection but [emily_]: for some people that's very very difficult [sean]: hm [roger_mcfillin]: hm [yassie_pirani]: yet your everything you're saying emily [roger_mcfillin]: yeah [yassie_pirani]: is so important i mean of course to have your ability to experience an intimate

[yassie_pirani]: relationship and feel at home in your own body and to have functioning emotions completely [yassie_pirani]: removed by medicatio that was meant [roger_mcfillin]: yeah [yassie_pirani]: to alleviate your emotional distress is such a catastrophic thing to happen to someone and [yassie_pirani]: so for most people it's not just a traumatic event but a trauma that is [yassie_pirani]: ongoing and nature remains unresolved it's sort of hard to [roger_mcfillin]: m

[yassie_pirani]: heal from a trauma when it's kind of and continuing to happen to other [roger_mcfillin]: so [yassie_pirani]: people around you as well and just to know that there every day there's [emily_]: oh [yassie_pirani]: somebody who's at risk of having this happen makes it really hard to feel like [yassie_pirani]: you can have your own trauma resolve because of this nobody's we don't have informed

[yassie_pirani]: consent practices that are that are stopping this harm so many people yet really need [yassie_pirani]: on going emotional and psychological support i found sharing your story [roger_mcfillin]: ah [yassie_pirani]: and raising awareness can reduce that helplessness and hopelessness and finding community so yeah like [yassie_pirani]: finding ways to not to to reduce sense of aliens the sense of alienation and [yassie_pirani]: despair like like emily was mentioning yeah year

[emily_]: yeah [sean]: well said [roger_mcfillin]: well [sean]: thank [roger_mcfillin]: said [sean]: you [roger_mcfillin]: thank you [sean]: many clinicians [roger_mcfillin]: many clinic [sean]: out there [roger_mcfillin]: out [sean]: and [roger_mcfillin]: there [sean]: medical [roger_mcfillin]: and [sean]: professionals [roger_mcfillin]: medical professionals [sean]: have been [roger_mcfillin]: have been [sean]: kind of conditioned [roger_mcfillin]: kind of [emily_]: m

[roger_mcfillin]: condition [sean]: and taught [roger_mcfillin]: caught [sean]: through [roger_mcfillin]: through [sean]: guide lines [roger_mcfillin]: guide [sean]: that [roger_mcfillin]: lines [sean]: are supposed [roger_mcfillin]: are [sean]: to [roger_mcfillin]: supposed [sean]: be evidence [roger_mcfillin]: to be [sean]: based [roger_mcfillin]: evidence [sean]: in [roger_mcfillin]: be [sean]: research [roger_mcfillin]: research [sean]: supported [roger_mcfillin]: supported

[sean]: that when someone [roger_mcfillin]: that when someone [sean]: is suffering [roger_mcfillin]: is suffering [sean]: emotionally [roger_mcfillin]: emotionally [sean]: a front line [roger_mcfillin]: front [sean]: treatment [roger_mcfillin]: line treatment [sean]: would be [roger_mcfillin]: would be [sean]: n s [roger_mcfillin]: and [sean]: s [roger_mcfillin]: s [sean]: r [roger_mcfillin]: s [sean]: i [roger_mcfillin]: r [emily_]: yes [roger_mcfillin]: i [sean]: it's almost

[roger_mcfillin]: it's almost [sean]: so widely [roger_mcfillin]: so widely [sean]: accepted [roger_mcfillin]: accepted [sean]: now [roger_mcfillin]: now [sean]: that it's not [roger_mcfillin]: it's not [sean]: even thought [roger_mcfillin]: even [sean]: about [roger_mcfillin]: thought [sean]: as [roger_mcfillin]: about as [sean]: potentially [roger_mcfillin]: potentially [sean]: a risky [roger_mcfillin]: a risky [sean]: medical intervention [roger_mcfillin]: medical intervention

[sean]: what advice [roger_mcfillin]: what advice [sean]: can you give [roger_mcfillin]: can you give [sean]: to [roger_mcfillin]: to [sean]: both medical [roger_mcfillin]: both [sean]: profs [roger_mcfillin]: medical [sean]: ationals [roger_mcfillin]: professionals [sean]: and those [roger_mcfillin]: and those [sean]: who [roger_mcfillin]: who [sean]: are [roger_mcfillin]: are [sean]: in [roger_mcfillin]: in [sean]: doing [roger_mcfillin]: doing [sean]: conducting [roger_mcfillin]: conducting

[sean]: clinical [roger_mcfillin]: clinical [sean]: work and [roger_mcfillin]: work [sean]: recommending [roger_mcfillin]: and recommending [sean]: their patients [roger_mcfillin]: their patients [sean]: go seek out [roger_mcfillin]: seek [sean]: a consult [roger_mcfillin]: out to consult [sean]: for [roger_mcfillin]: for [sean]: medication [roger_mcfillin]: medication [sean]: evaluation [roger_mcfillin]: valuation [sean]: what [roger_mcfillin]: what [sean]: advice [roger_mcfillin]: advice

[sean]: would you [roger_mcfillin]: would [sean]: give [roger_mcfillin]: you [sean]: them [roger_mcfillin]: give them [emily_]: ah he do you want to go first [yassie_pirani]: i think i think there's so many ways to look at human distress and mental [yassie_pirani]: illness and suffering and i think one of the disease model the bio cal model [yassie_pirani]: that we have predominantly for mental illness right now in the medical community on is

[yassie_pirani]: if if you have a mental illness in our culture or to have any periods [yassie_pirani]: of darkness or suffering it's wrong and it means you're off track and it needs [yassie_pirani]: to need to be fixed and i think a lot we can learn from spiritual [yassie_pirani]: paradoms that see someone who is truly trying to be in the [roger_mcfillin]: m [yassie_pirani]: awake in their life will go through suffering because life is sad and difficult and

[yassie_pirani]: hard and as you get closer to knowing your heart you're going to find pain [yassie_pirani]: there and it doesn't mean you're messing up means you're really committed to learning and [yassie_pirani]: being awake and growing sometimes a we we go through pain and it brings us [yassie_pirani]: brings us to a place that we wouldn't [emily_]: ye [yassie_pirani]: have gotten to otherwise and there is value there is value in being with our

[yassie_pirani]: suffering and being with our pain and i think that value needs to be acknowledged [yassie_pirani]: and recognized of course um you know we we also need to be looking at [yassie_pirani]: bigger social context around what it is is causing distress do we need um political [yassie_pirani]: interventions to what's happening with the economy like all these kinds of environmental [roger_mcfillin]: yeah

[yassie_pirani]: factors like are suicide rates going up because teen agers brains or they're on their [yassie_pirani]: phones too much and their ten their brains are tan no it's it's we're living [yassie_pirani]: in a terrifying world the scientists are saying we're in ecological [roger_mcfillin]: ah [yassie_pirani]: armegetan i mean that's terrifying for young people and the prospects for finding stability [roger_mcfillin]: right

[yassie_pirani]: and security and such a such a tumultue it's changing [roger_mcfillin]: yes [yassie_pirani]: ecosystem [roger_mcfillin]: yeah [yassie_pirani]: that we're finding ourselves in in the world these [emily_]: oh [yassie_pirani]: days know those things are need to be recognized and we need we need social [yassie_pirani]: change i think and to put all the blame on somebody brain or or you

[yassie_pirani]: know just okay this there's a disease process and you need medication that's one lens [yassie_pirani]: but there's all these other lenses that we need to be looking at in terms [yassie_pirani]: of what makes somebody have good mental have good mental health do they have access [yassie_pirani]: to do they have access to the kind of what kind of quality of life [yassie_pirani]: are they living based on their associate com mike status et cetera et cetera [sean]: so the idea

[roger_mcfillin]: so the [sean]: that [roger_mcfillin]: idea [sean]: somebody [roger_mcfillin]: that somebody [sean]: experiences [roger_mcfillin]: experiences [sean]: what would [roger_mcfillin]: what [sean]: be [roger_mcfillin]: would [sean]: considered [roger_mcfillin]: be considered [sean]: normal and [roger_mcfillin]: normal [sean]: expected [roger_mcfillin]: and expected [sean]: emotions [roger_mcfillin]: emotions [sean]: given the [roger_mcfillin]: given [sean]: events

[roger_mcfillin]: the [sean]: of [roger_mcfillin]: events [sean]: their life [roger_mcfillin]: of [sean]: that [roger_mcfillin]: their [sean]: they're [roger_mcfillin]: life [sean]: facing [roger_mcfillin]: that they're [sean]: with [roger_mcfillin]: facing [sean]: the idea [roger_mcfillin]: with the idea [sean]: of identifying [roger_mcfillin]: identifying [sean]: it as [roger_mcfillin]: it [sean]: an [roger_mcfillin]: as [sean]: illness [roger_mcfillin]: an illness [sean]: is extremely

[roger_mcfillin]: is extremely [sean]: harmful [roger_mcfillin]: harmful [sean]: and it's [roger_mcfillin]: and [sean]: a [roger_mcfillin]: it's [sean]: it's a world [roger_mcfillin]: it's a [sean]: view [roger_mcfillin]: world view [sean]: that [roger_mcfillin]: that [emily_]: oh [sean]: creates [roger_mcfillin]: creates [sean]: tremendous [roger_mcfillin]: tremendous [sean]: amounts [emily_]: yeah [roger_mcfillin]: amount [sean]: of dependency [roger_mcfillin]: of dependency

[sean]: vulnerability [roger_mcfillin]: vulnerability [sean]: and it's a [roger_mcfillin]: and [sean]: harmful [roger_mcfillin]: it's a harmful [sean]: idea [roger_mcfillin]: idea [sean]: and we have [roger_mcfillin]: and [sean]: to be [roger_mcfillin]: we have [sean]: open [roger_mcfillin]: to be [sean]: about [roger_mcfillin]: open [sean]: that [roger_mcfillin]: about [sean]: we [roger_mcfillin]: that [sean]: have to [roger_mcfillin]: we [sean]: be [roger_mcfillin]: have to [sean]: very

[roger_mcfillin]: be [sean]: very [roger_mcfillin]: very [sean]: clear [roger_mcfillin]: very clear [sean]: that our [roger_mcfillin]: that [sean]: emotional [roger_mcfillin]: our emotional [sean]: experien [roger_mcfillin]: experin [sean]: it is related [roger_mcfillin]: does it relate [sean]: to stressful [roger_mcfillin]: to stressful [sean]: and adverse [roger_mcfillin]: and adverse [sean]: conditions [roger_mcfillin]: conditions [sean]: are normal [roger_mcfillin]: are [sean]: and

[roger_mcfillin]: normal [sean]: expected [roger_mcfillin]: and expected [sean]: and there's a purpose [roger_mcfillin]: an there's a purpose [sean]: for them [roger_mcfillin]: for them [sean]: and so to [roger_mcfillin]: and [sean]: quickly [roger_mcfillin]: so to quickly [sean]: label that [roger_mcfillin]: label [sean]: in some [roger_mcfillin]: that [sean]: disease [roger_mcfillin]: is some disease [sean]: state [roger_mcfillin]: state [sean]: is a [roger_mcfillin]: is [sean]: harmful

[roger_mcfillin]: a harmful [sean]: idea [roger_mcfillin]: idea [sean]: could lead [roger_mcfillin]: could [sean]: to a [roger_mcfillin]: lead [sean]: harmful [roger_mcfillin]: to a harmful [sean]: medical [roger_mcfillin]: medical [sean]: intervention [roger_mcfillin]: intervention [sean]: emily you [roger_mcfillin]: emily [sean]: are [roger_mcfillin]: you are [sean]: you know somebody [roger_mcfillin]: you know somebody [sean]: who was [roger_mcfillin]: who was [sean]: at seventeen

[roger_mcfillin]: at seventeen was [sean]: was placed in that [roger_mcfillin]: placed [sean]: position [roger_mcfillin]: in that position [sean]: i'm sure if [roger_mcfillin]: i'm [sean]: you [roger_mcfillin]: sure [sean]: would [roger_mcfillin]: if [sean]: you [roger_mcfillin]: you [sean]: would [roger_mcfillin]: would you [sean]: look back [roger_mcfillin]: look back [sean]: you you prefer [roger_mcfillin]: you prefer [sean]: to able to [roger_mcfillin]: to [sean]: deal

[roger_mcfillin]: be able [sean]: with [roger_mcfillin]: to [sean]: what [roger_mcfillin]: deal [sean]: you [roger_mcfillin]: with [sean]: are [roger_mcfillin]: what [sean]: feeling [roger_mcfillin]: you are feeling [sean]: in different [roger_mcfillin]: in different [sean]: ways [roger_mcfillin]: ways [sean]: but you [roger_mcfillin]: but [sean]: are [roger_mcfillin]: you were [sean]: provided [roger_mcfillin]: provided [sean]: what [roger_mcfillin]: at [sean]: it amounted

[roger_mcfillin]: what amounted [sean]: to to believe somewhat [roger_mcfillin]: to believe [sean]: of [roger_mcfillin]: somewhat [sean]: a kind [roger_mcfillin]: of a [sean]: of a [roger_mcfillin]: kind [sean]: a [roger_mcfillin]: of [sean]: quick fix [roger_mcfillin]: quick [sean]: to [roger_mcfillin]: fix [sean]: kind of [roger_mcfillin]: to kind [sean]: help [roger_mcfillin]: of [emily_]: oh [sean]: you [roger_mcfillin]: help you [sean]: in dealing [roger_mcfillin]: in [sean]: with

[roger_mcfillin]: dealing [sean]: what [roger_mcfillin]: with [sean]: you were [roger_mcfillin]: like you were [sean]: dealing with [roger_mcfillin]: dealing [sean]: what advice [roger_mcfillin]: with what [sean]: would [roger_mcfillin]: advice [sean]: you give [roger_mcfillin]: would [sean]: to [roger_mcfillin]: you [sean]: that [roger_mcfillin]: give [sean]: medical [roger_mcfillin]: to that [sean]: professional [roger_mcfillin]: medical professional [sean]: who you [roger_mcfillin]: who

[sean]: initially consulted [roger_mcfillin]: initially consulted [sean]: with [roger_mcfillin]: with [emily_]: yuh simply that [emily_]: when you don't know the long term effects of medication you know it can interfere [emily_]: with sexual development and you know that it is common for ten ages to go [emily_]: through not just temporary periods sometimes even years of emotional tribulanceis there eveloping is it

[emily_]: really the less dangerous option to prescribe that medication i recognize that all medical professionals [emily_]: have to make tough calls sometimes they have to sometimes choose the less dangerous or [emily_]: perceived less harmful approach but why was that the less dangerous approach to put a [emily_]: certain drug a certain chemical who that they don't know the long term effects of [emily_]: into a teenage body a very critical developmental period i just don't understand so i

[emily_]: think i would just tell her to maybe [roger_mcfillin]: i [emily_]: i think that much better ways of coping for me at the time would have [emily_]: been more psychologically focused or frankly even just letting me grow up just leaving well [emily_]: enough alone it probably would have worked itself out in time [sean]: yeah there's that [roger_mcfillin]: yeah there's [sean]: that [roger_mcfillin]: that at [sean]: that concept [roger_mcfillin]: that concept [sean]: of [roger_mcfillin]: of

[sean]: watchful [roger_mcfillin]: watch [sean]: waiting [roger_mcfillin]: for [sean]: which [roger_mcfillin]: which [sean]: we don't use [roger_mcfillin]: we [emily_]: hm [roger_mcfillin]: don't [sean]: enough [roger_mcfillin]: use enough [sean]: it's just [roger_mcfillin]: it's just [sean]: being able [roger_mcfillin]: being [sean]: to [roger_mcfillin]: able [sean]: not [roger_mcfillin]: to [sean]: intervene [roger_mcfillin]: not in [sean]: and let [roger_mcfillin]: and [sean]: the natural

[roger_mcfillin]: let the natural [sean]: progression [roger_mcfillin]: progression [sean]: of [roger_mcfillin]: of [sean]: a what we call [roger_mcfillin]: what we [sean]: episodes [roger_mcfillin]: call episodes [sean]: to be able [roger_mcfillin]: to [sean]: to [roger_mcfillin]: be [sean]: play [roger_mcfillin]: able [sean]: itself [roger_mcfillin]: to play itself [sean]: out in somewhat [roger_mcfillin]: out in somewhat [sean]: a different [roger_mcfillin]: a [sean]: kind

[roger_mcfillin]: different [sean]: of [roger_mcfillin]: kind [sean]: approach [roger_mcfillin]: approach [sean]: the watchful [roger_mcfillin]: the watchful [sean]: part meaning [roger_mcfillin]: part [sean]: we [roger_mcfillin]: meaning [sean]: take it [roger_mcfillin]: we [sean]: seriously [roger_mcfillin]: take it seriously [sean]: and maybe [roger_mcfillin]: and [sean]: that's [roger_mcfillin]: maybe [sean]: the need [roger_mcfillin]: that's [sean]: for [roger_mcfillin]: the [sean]: some

[roger_mcfillin]: need for [sean]: emotional [roger_mcfillin]: some emotional [sean]: support [roger_mcfillin]: support [sean]: or family [roger_mcfillin]: or [sean]: or [roger_mcfillin]: family [sean]: community [roger_mcfillin]: or community [sean]: to be able [roger_mcfillin]: to be [sean]: to [roger_mcfillin]: able [sean]: assist [roger_mcfillin]: to [sean]: that [roger_mcfillin]: assist [sean]: person [roger_mcfillin]: that [sean]: who [roger_mcfillin]: person [sean]: is struggling

[roger_mcfillin]: who is struggling [sean]: maybe [roger_mcfillin]: maybe [sean]: even a [roger_mcfillin]: even a [sean]: know less restrictive [roger_mcfillin]: a less restrictive [sean]: intervention [roger_mcfillin]: intervention [sean]: like a [roger_mcfillin]: like [sean]: like [roger_mcfillin]: a [sean]: a therapy [roger_mcfillin]: like a therapy [sean]: might be [roger_mcfillin]: might be [sean]: you know necessary [roger_mcfillin]: necessary [sean]: or recommended

[roger_mcfillin]: or recommended [sean]: but the idea [roger_mcfillin]: but the [sean]: that everything [roger_mcfillin]: idea that [sean]: has [roger_mcfillin]: everything [sean]: to be [roger_mcfillin]: has [sean]: quickly [roger_mcfillin]: to be quickly [sean]: intervened [roger_mcfillin]: devine [sean]: with with [roger_mcfillin]: with [sean]: a pill [roger_mcfillin]: with a pill [sean]: obviously [roger_mcfillin]: obviously [sean]: has [roger_mcfillin]: has [sean]: great consequences

[roger_mcfillin]: great consequences [yassie_pirani]: there's a variety of treatment options that that are known to be effective for people [yassie_pirani]: with anxiety and depression and under other mental health issues that have significantly less risk [yassie_pirani]: of harm associated for example therapy attention exercise do does your doctor teach you about [yassie_pirani]: these things typically now when you go to the hospital for an episode do they [yassie_pirani]: teach you

[roger_mcfillin]: yeah [yassie_pirani]: grounding and breathing and all its kinds of tools do you learn them in school [roger_mcfillin]: ah [yassie_pirani]: most people don't i mean maybe that's changing now hopefully but i didn't and you [yassie_pirani]: know there's the research just on xerciseumis quite profound and i think [roger_mcfillin]: ye [yassie_pirani]: the we just going going physicians don't know what's at stake right you know who

[yassie_pirani]: aren't aware of these patients are going in they don't know what's at stake and [yassie_pirani]: the true risks of these drugs and so until we we just need wider awareness [yassie_pirani]: who need more of these conversations happening because it's just so important for people to [yassie_pirani]: be able to access all the information and then way the true risks and benefits [yassie_pirani]: of all options so they can decide what themselves what risks they're willing to take

[yassie_pirani]: and i think it also engages questions around okay is there accessible for people pills [yassie_pirani]: are accessible medications accept accessible is living in in [roger_mcfillin]: i [yassie_pirani]: a community where you have support and [roger_mcfillin]: m [yassie_pirani]: access to clean water and nutritious food and nature are those things accessible for everybody [yassie_pirani]: or people you know they're working three jobs like they don't you know they don't

[yassie_pirani]: have they [emily_]: o [yassie_pirani]: can't they can't afford private therapy and the weight less for their ping the public [yassie_pirani]: health system so so long so those are all things we need to be also [yassie_pirani]: addressing as well we're looking at informed consent [emily_]: oh [yassie_pirani]: is somebody exercising informed consent when all of those other options aren't actually financially accessible

[yassie_pirani]: for them and the pills are really the only thing that's being told to but [yassie_pirani]: offered by their doctors [roger_mcfillin]: yeah [yassie_pirani]: it's not true for in content [roger_mcfillin]: a [sean]: good point [roger_mcfillin]: good point [sean]: you guys are amazing [roger_mcfillin]: you guys are amazing [sean]: i couldn't [roger_mcfillin]: i [sean]: imagine [roger_mcfillin]: couldn't imagine [sean]: two better [roger_mcfillin]: to [sean]: voices

[roger_mcfillin]: better voices [sean]: for this [roger_mcfillin]: for this [sean]: serious [roger_mcfillin]: serious [sean]: complex [roger_mcfillin]: complex [sean]: and challenging [roger_mcfillin]: and challenging [sean]: issue [roger_mcfillin]: issue [sean]: where can [roger_mcfillin]: where [sean]: people [roger_mcfillin]: can people [sean]: find you [roger_mcfillin]: find [sean]: or [roger_mcfillin]: you [sean]: how can [roger_mcfillin]: or [sean]: we [roger_mcfillin]: how [sean]: bring

[roger_mcfillin]: can [sean]: attention [roger_mcfillin]: we bring attention [sean]: to some of [roger_mcfillin]: to [sean]: the work [roger_mcfillin]: some of [sean]: that [roger_mcfillin]: the [sean]: you're [roger_mcfillin]: work that [sean]: doing [roger_mcfillin]: you're doing [sean]: for we close [roger_mcfillin]: for we [sean]: today [roger_mcfillin]: close today [emily_]: we have a website for the canadian p s s t society it's a w

[emily_]: w dot p s s t canada dot c a i'd also like to draw [emily_]: some attention to new p s s d focused organization that recently started up based [emily_]: in australia called the p s s d network and it can be found at [emily_]: p s s t network dot or they've hit the ground running and have already [emily_]: done a photo [roger_mcfillin]: uh [emily_]: campaign to try and raise awareness about [roger_mcfillin]: h

[emily_]: p s s t we've also seen a lot of organization starting up around the [emily_]: world in the past few years there's a very active one in germany called pssdhillfa [emily_]: hill face belt h i l f e m and you can access their site [emily_]: and you can so they have a english translation button on the side if you [emily_]: want to keep track of their activities the work of professor david healy is a [emily_]: great place to get an over view of p s s t he has a

[emily_]: large of the available literature linked on his websiteum [yassie_pirani]: risk dot [emily_]: yeah [yassie_pirani]: or [emily_]: and risk [yassie_pirani]: i [emily_]: dot or yeah yeah and also if you visit the p s st canada website [emily_]: we have a page under resources of many different other organizations and we also have [emily_]: a compilation of a mike sources that you can access [sean]: great [roger_mcfillin]: great [sean]: thank you [roger_mcfillin]: thank you

[sean]: i want to thank [roger_mcfillin]: i [sean]: you [roger_mcfillin]: want to [sean]: both [roger_mcfillin]: thank you both [sean]: for having [roger_mcfillin]: for [sean]: a radically [roger_mcfillin]: having [sean]: genuine [roger_mcfillin]: radically [sean]: conversation [roger_mcfillin]: genuine conversation [sean]: with us [roger_mcfillin]: with us [sean]: obviously [yassie_pirani]: yeah [roger_mcfillin]: obviously [sean]: there is some [roger_mcfillin]: there [sean]: momentum

[roger_mcfillin]: is momentum [sean]: that is moving [roger_mcfillin]: that is [sean]: in the [roger_mcfillin]: moving [sean]: right [roger_mcfillin]: in [sean]: direction [roger_mcfillin]: the right direction [sean]: to greater [roger_mcfillin]: to [sean]: inform [roger_mcfillin]: greater [emily_]: hm [sean]: the [roger_mcfillin]: nor [sean]: public [roger_mcfillin]: public [sean]: and medical [roger_mcfillin]: and medical [sean]: and mental health [roger_mcfillin]: and [emily_]: oh

[roger_mcfillin]: mental [sean]: professionals [roger_mcfillin]: professionals [sean]: about this really [roger_mcfillin]: about this [sean]: important [roger_mcfillin]: really [sean]: issue [roger_mcfillin]: important issue [sean]: thank you so [roger_mcfillin]: thank [sean]: much [roger_mcfillin]: you [sean]: for [roger_mcfillin]: so [sean]: coming [roger_mcfillin]: much for [sean]: on [roger_mcfillin]: coming on [emily_]: thank you very much mchillan [yassie_pirani]: thank you

[sean]: thank you both [yassie_pirani]: yes [roger_mcfillin]: thank you both