Welcome to she persisted I'm your host Sadie Saxton a 19 year old from the Bay Area studying psychology at the University of Pennsylvania. She persisted is the Teen Mental Health podcast made for teenagers by a team in each episode. I'll bring you authentic accessible and relatable conversations about every aspect of mental Wellness. You can expect evidence-based, Tina, proof resources, coping skills, including lots of DBT,
insights and education. In each piece of content, you consume, she persisted Offers you a safe space to feel validated and understood in your struggle. While encouraging you to take ownership of your journey and build your life worth living. So let's Dive In. Hello, hello, and welcome back to. She persisted. I'm so excited to hear today. This is one of my favorite episodes that I've recorded in a really long time. It is with one of my professors
from Pain professor, ruscio. She taught my abnormal psychology class, and she is a practicing clinician. She works with adults, and she just brought so much interesting insight to the conversation, about mental illness and mental health. That I learned so much during this semester course, that you've probably heard bits and pieces of in the podcast, if you've been listening It consistently. But this episode is a really powerful conversation. About depression, about anxiety.
We talked about the importance of skills education. We talk about sub clinical depression. We talked about stress, we talked about common cognitive experiences, and depression, we talked about comorbidity and so. So so many things that I think most people aren't aware of when it comes to depression and anxiety. But really are very helpful to know if you are struggling or if you know someone that is struggling.
So I'm so glad that Professor ruscio joined me for this conversation and I hope you enjoy it as much as I did. Her links will be in the show notes today. If you want to learn more about her research, but yeah, I'm so excited to bring you into the classroom with me and learn more about mental health and specifically, depression and anxiety. So with that, let's dive in. Thank you so much for joining me today on. She persisted, I'm so so excited to have you on the show.
It's such a pleasure to be here with you, of course. So I'm really excited for this conversation.
We're going to kind of go A little bit all over but we're centering a lot on anxiety and depression and what lays the foundation for mental illness and really just kind of diving into those, not risk factors per se but talking about what happens in childhood with teens can do to reduce risks and then talking about how similar some of these different distress disorders can be. So to start I'd love to talk about why adolescent is such a critical period for depression.
It's something that most people are somewhat. Oh, Aware of that things, develop before 1824, but there's not a ton of understanding as to why that is. So I would love to get your perspective there. Oh yeah, such a good question and it's a question that mental health professionals have been pondering for a long time. So, you know, we for a long time.
People thought that depression really didn't start until adulthood, and it's really been the last few decades that increasingly psychologists psychiatrists have realized that. Fact, depression, often begin sooner than that. We know that there is a really, really large increase in the rate of depression that happens
during adolescence. So prior to about age, 12 or 13, there are kids who get depressed, but they're relatively few, and most of those cases, don't persist into adolescence and adulthood, but starting at around age, 12 to 13 is just a dramatic rise in the rate of depression. So you see an increase of about three percent of kids or so might become depressed at some point but then the rates go up to about 17 percent by age 18, which is much more similar to
the rates that we see in adults. So why that is is really important and interesting question. We don't have a great understanding. If there are sort of some indicators from research studies as to what might be going on in the Adolescent period, that could be contributing to the increase. There is some thinking that this could be connected in part to biological factors. Particularly those that are
linked to puberty. And it does seem for example, that kids who experienced onset of puberty earlier, are increased risk for depression, particularly girls, so there may be something going on almost certainly something going on related to hormones. In addition, there it appears that there are increasing levels of stress, particularly uncontrollable stressors that occur in adolescence compared to Childhood. And in particular, interpersonal
stressors, especially for girls. So I don't know if we'll get into this more Later. But there's a very long literature indicating that there is a sex difference in depression. Girls are about twice as likely as boys to develop depression some point in their lives and that sex difference in merges in adolescence. So, something about stress, especially interpersonal, stress may be important in helping understand why it is that adolescents, much more so than younger kids become depressed.
Yeah, it's also interesting because, I think a lot of the times when adults experienced periods of stress, It's just a period, they've navigated that before they know they can get through it. Whereas in adolescence when you experience academic stress or relationship stress or interpersonal stress, it's really for the first time so you don't have that experience to be like, okay I've coped through this before it's going to be okay I know how to navigate this
this won't last forever. It's like the first time you're navigating it there's not a lot of guidance there and so it feels subjectively like that much overwhelming more overwhelming. Yeah I think that's a really important point when we've gone through. Something many times before we know we can weather that we have coping strategies that have worked for us before.
We have kind of the bigger perspective to put this particular situation into we know we can lean on our supports to get through it, but it's harder when you're experiencing these things for the first time especially when you're an adolescent and you're still trying to figure out who am I, how do I navigate the world, who are the people in my world who I have trusting relationships with so that definitely makes it more challenging. Yeah. Are there other factors that add to that gender?
Gap. In addition to girls having an onset of puberty more earlier on there is kind of more social tension than there is with boys. That is there anything else that adds to that risk? For sure. There are some of the factors that have been most studied our cognitive or Sinking related processes. So, girls are much more likely than boys to ruminate. This is sort of a style of coping with stress, where girls are more likely to sort of sit and dwell on all the bad things
that have happened. How how, how is it? Why do I feel this way? Why do I always get into these patterns? Why did that go wrong and the more that people sort of sit and stew? And that sort of negative past, Focus thinking about things that are abstract things, I can't do anything about any more, the less productive that can be. So generally speaking girls are more likely to ruminate boys are more likely to engage in more active problem-solving types of coping.
And it turns out that all of us when we ruminate feel worse and all of us, when we engage in more active, Focus coping tend to be sort of more successful. So, you know, I think it's important to recognize that these are thoughts down that can be changed an interesting, sort of related line of research is that girls are more likely to KO ruminate meaning there are more likely to get together with friends and dwell together on
that things that have happened. And that's also a pattern that's associated with sort of maintaining negative emotions over time. So, you know, one of the things that your listeners might think about is, if they find themselves or sitting and stewing about Out, bad things that have happened, they really can't do anything about anymore. Thinking about, okay, what can I do?
That is constructive right now. Something active, something that will get me moving instead of sitting here and dwelling on bad things. And also, if they find themselves getting into conversations with friends, where they're kind of feeling stuck there, they're helping each other in a way, stay stuck by going over and over bad things again. And again, thinking about how can we change this conversation to be more constructive, more future focused more. Tom, what can we do in this
situation or even like? Let's stop talking about this for now and go and do something active and fun as a way of breaking that negative thought cycle. I love that and it's definitely helpful because you can hold each other accountable. So it's not just you that's like okay I gotta stop ruminating but together you can back. Okay, what can we do? We're getting into this pattern again. Are there other best practices that people can Implement to counteract?
These risk factors that are so common in teenagers adolescents. I'm sure there's basic things like getting outside more being engaged in relationships, but are there other recommendations that you like to give for sure? So I should say it's important to qualify this by saying that I work clinically with adults, not without a lessons. But a lot of the same strategies I think are helpful for adolescents, as are helpful for
young adults, or older adults. So generally speaking doing activities that are active or good. So, exercise is always recommended as a way of improving mood, as well as keeping you sort of healthy and fit doing. He's that give you a sense of Mastery and accomplishment are good, so these can be pleasurable activities. They can also be things that aren't about pleasurable. That gives you a feeling of accomplishment. Like okay, did the laundry check? Right?
You know, I ran this Aaron that had to be done check where you feel like, okay I'm accomplishing things. So those are good too but especially good are activities. That give you a sense of pleasure things that you really enjoy. That can be by yourself or with other. People doesn't have to be a great. Big thing could be as simple as okay. I'm going. To go for a walk with a friend. I'm going to spend some fun time with a sibling. I really enjoy, you know,
reading this particular author. I'm going to go and to the library and get a book. I really enjoy reading your, all of those are good things. It definitely makes me think of why a lot of teenagers experience like a shift in mental health, when they go to college because all of these things whether it's building Mastery or doing activities, you enjoy being active on a team are really built into your schedule in high school and then in college.
Up to you to maintain those. So if you don't build those into your schedule if you don't prioritize those, it makes sense. Why your mental health would struggle as a result? I think that's absolutely right. All of us, experience a change in routine when we go to college, right? Yeah. Your routine is completely completely unattended.
And in addition your, you're making your way with new relationships, your this structure that's built into your life in terms of when you eat and when you sleep. And so on is changed and a lot more is put on the student too. To place those structures in place, right for them. They're our parents, they're saying, okay, time to go to bed, right? Or what did you eat for breakfast? You serve have to do those
things for yourself. And so it requires establishing new routines and routines that are healthy and productive for you. Yeah. One of the questions that I've gotten most frequently recently which I hadn't had a lot of questions about before was like high functioning or sub syndrome will depression that isn't necessarily completely derail any activities or EPS but it's
definitely there. I would love to hear kind of what that clinical definition is and then why it's still important to try and either get help utilize resources or at least attempt to problem. Solve shift, your behaviors and routines even if it's not at the point where it's like, this is completely interfering with my quality of life. Yeah, that's such an important question. So we know that many many more individuals experience subclinical levels of depression and then those who, It's
clinical levels of depression. For some of those individuals, those symptoms escalated over time and can turn into a major depressive episode that might need clinical attention, you know, all of us experience ups and downs. So, it's important to recognize that having a few bad days.
Doesn't necessarily mean you have a disorder or that, this is something even Ducks concerning, but it's good to be attuned to how your mood is, and how your behavior is, and if you're finding that your day after day, you're feeling very low. Motivation to do things that are important or things that you usually enjoy or your mood is really low consistently. Then it's a really good idea to do something to attend to that. There are lots of things that can be done.
One of the things that can be done, it's to seek help from a treatment professional either, Psychotherapy. Or if you feel it's necessary in your provider recommends, it some kind of medication, and it's also possible to do other things that are less intensive. But that will be helpful.
All to your mood, some of those things can be as simple as some of the activities we talked about, but it also, there are self-help books, there are at based or internet based interventions that are less intensive than doing what's a individual psychotherapy but that can be quite helpful. So looking into those resources, can be good and of course, talking with friends and family who can be helpful to you as
well. I also loved reminding listeners that the skills that are working for people that are like severely severely. Best. If those are working to lift that level of depression, there's a very high chance that those same skills are going to work if you're having an off day. So if there's one person that like physically cannot get out of bed and the skill that will work for them is doing the opposite of what they're feeling and lowering their physical physiological, emotional intensity.
And asking for help and distracting from the emotion. Those same things will likely work if you're like, I just cannot get to school today. I'm feeling so overwhelmed and feeling unmotivated like those. Those skills transfer and you don't have to get to a certain level of distress to The Quay. Now we use the skills. Like if it's feeling uncomfortable, if it's bothering, you use the skills and it'll be easy to use them because the emotional intensity
is lower than that. Like, life interfering life-altering, super bad depression. That some people experience. I agree completely say to you're absolutely right. Those skills are useful because they're like a good life skills, right? So I cannot avoid it, things that are making you uncomfortable Or you've nervous is always a good skill. Like staying, active is a good skill examining. Thoughts that are unproductive and substituting more constructive. Helpful.
Thoughts, those are all great skills that can and should be used, even when you're let's say, more Motley distressed compared to being clinically depressed. I feel like that's one of the biggest ways that I've seen stigma show up. It's like that emotional thought, block where people are like, well, it's not that bad. We don't need those skills. That people would learn in therapy, and it's It's like, you're not even engaging in treatment, you're not even getting a diagnosis.
Like it's not close to what you think of stigma preventing people from doing. And yet their stats still that emotional block of like, well other people have it worse or I don't need that help yet. And it's like well why not targeted early? So like you said it doesn't get worse over time and develop into severe. Major depression. You're absolutely right. And these are skills I use all the time and it's actually look
one of the best things I think. About being trained in Psychology is if you learn these great skills that are helpful for everybody and I tell everyone I know about them including healthy people. Yes. So these are just they're just sort of good coping strategies that all of us can benefit from and you don't have to get to a certain level of severity to use them. And in fact, using those skills will help prevent you from
getting to that point. Yeah, I remember being an intensive treatment and being surrounded 24/7 by people that were like highly trained in DBT and use Seeing it in every single aspect of their life. Both at home, and in practice, there is therapist they were the community. They weren't called Community residents but they were the like psychology students that were getting their hours in in practice and they would do daily activities with us.
And then there was the Educators and then, of course, all the kids and teens themselves were using these skills. And I remember leaving being like, why is everyone being so ineffective? Like, where is the dear man? Where is the emotion regulation? Like guys, this could be so much easier and it was And just like regulating anxiety and depression. It was just basic functioning and asking for help when you need it and advocating for an
objective. Like, these are all things that if you're functioning, well, you're probably already doing. And if you're not there skills to address it, that's exactly right. I think these are often skills that people who are doing really well, high functioning and achieving the important goals they've set for themselves. Those are skills that they're doing intuitively and you're absolutely right like interpersonal, Effectiveness. That's It's always something you want to do, right?
Emotion regulation. That's always a good go. Like, use those skills. It's actually, it's a gift to have that knowledge and using it in a regular basis, can make you flourish. Even when you are sort of emotionally doing really well. It just strengthens everything.
Yeah and then when you do have those low points which everyone dies, you know, the skills, you know, how to get them they worked before and that's one less block to getting out of that low point because you are skilled and Knowledgeable and how to navigate The Challenge. Exactly. And having practiced those skills again. And again means that when you most need them, they'll be there for you. I love that this week's episode is brought to you by teen counseling.
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mental health issues. And one proven way to depression and treat anxiety is therapy and Psychotherapy. And so, a great way to get access to therapy is teen counseling. What you do is you get a teen counseling.com says, she persisted and you fill out a survey about what you're hoping to work on.
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teen counseling.com. So she persisted again, that is teen counseling.com, she persisted. So another thing that I wanted to touch on related to depression, which I think is so interesting, which is again, not something that is, commonly known as the relationship between stress and depression. So kind of stress generation in the kindling hypothesis which if you don't know what those mean, we will explain. Don't worry. But I would love to kind of hear your perspective there because
it's a really interesting. Love thought that isn't always something that comes to mind when people are struggling but it can be very helpful to be aware of if you are navigating depression. Yeah, absolutely.
So the basic principle of stress generation was introduced by Connie Hammond, an a depression researcher and what you discovered in her research is that many individuals who are depressed seem to be engaging in behaviors that almost got in their own way that were making things more difficult for them.
And so, these were Events that rather than sort of completely random acts like, you know, I got, let's say, you know, there's a hurricane, for example, you know, that's something that I have no control over. I did nothing for this hurricane to happen. I'm unfortunately, sort of stuck in the wrong place at the wrong time that would be a an independent stress. Some things independent from me. But I what you found was that many individuals depression were engaging.
Also in what she called or experiencing what she called dependent stress so dependent. An example would be like frequent arguments with a boyfriend or girlfriend. This is something that I contribute to in somewhere potentially contribute to our might have a very quarrelsome boyfriend or girlfriend, but I also may be a person who is through repeatedly doing things, that's causing arguments to happen or contributing in some way to this dress.
This has been a first at least. This was a controversial idea because we don't want to blame the victim. We don't want to say you like you know, people who Are depressed, are doing like bad things for themselves. And the other hand, I think it's really important to recognize when we are doing things that are making things harder for us so that we can take steps to try to improve the situation. And so, the basic idea behind stress generation is that to
some extent. All of us contribute or can contribute to the stress we experience and the opposite side are flip side of that is that we all have the opportunity to reduce our stress levels by You can go hard. Look at what are we potentially doing that may be increasing stress for us. So I'll give you maybe a minor example. If I'm a person who's chronically late. I just like I can't get myself on schedule. Yeah, myself to write.
So you know, if I'm a person who's always late, then I'm going to be generating some stress for myself, right? I'm going to, let's say, pay a bill late and as a result, I'm going to have a fine. And I'm going to have to pay our let's say I'm going to arrive late. To a meeting. And as a result, I'm going to be taken less seriously. By the people. I'm supposed to be meeting with her. I'll miss some important information.
So maybe for students like maybe I because I'm over sleeping all the time I'm missing class or late for class and then I miss information, I need to know in order to do well in exams if I recognize that I am contributing to the stress that I'm experiencing by not managing my time.
Well, then by improving my time management skills, I can actually reduce stress in my life, that's an on interpersonal example but One thing to note is that kind of Hammond observed that most of the dependence, Fasteners that she observed, especially in the women in her sample, were interpersonal in nature. So the women were engaging in behaviors that were increasing the likelihood of others in their life's or arguing with them leaving them.
You know where relationships were more unstable or ending or just a more stressful more, you know in their lives. So thinking very hard about what are the Ways in which I may be contributing to difficult relationships. And, and, and that includes selecting people to have relationships with, who may not treat us the way we deserve to be treated. Yeah. Yeah. I think that's a huge thing that. I mean it's very very valid
stress to experience. And with depression, a huge thing is having a support system and a group of people that can support you and if your support system is doing the opposite of that either like you and is she getting that or them? Initiating, those conflicts that can add to how difficult it is to come out of that depression. Ask for help, utilize resources, and all of those things. In addition to kind of creating stress in different relationships.
There are some like, neurobiological emotional cognitive experiences that are pretty Universal in people that experience, depression. What are some of those that listeners can kind of listen for, and kind of observe that might be happening. I think it's a great way. It can to hear things that can be really validating, because
depression can be so isolating. And yet, like you'll highlight in these Universal things, it can be very relatable, and again, Universal in the experience, even though it is so internal and feel so subjective. Yeah, great question. So I can highlight a few of them. So, what is kind of on a neurobiological level? What is has been seen? As often happening in depression? As individuals who have a heightened sensitivity to stress, And and heightened
reactivity to stress. So, areas of the brain that are in the sort of the limbic part of the brain, particularly the olympique De le are sort of heightened an individual with depression. So, a tendency to experience negative emotion to react, very strongly distressed. And we see that prefrontal cortex areas of the brain that are involved in planning. And in self-control, self-regulation, are reduced activity in those areas are
reduced and the routine. Those aren't even fully developed, so that's exactly right. Right more susceptible, that's exactly right. And in terms of the Cross talk between the limbic system and the prefrontal systems of the brain, they're sort of less tamping down of emotion by those frontal regions of the brain. And so people with depression, kind of a universal feature is the sort of heightened, sensitivity, and hind
reactivity. When stressors occur, and all of us experienced an increase in distress and increase in sort of that cortisol response when we're stressed. That isn't normal. It's actually very adaptive. What seems to happen in depression is that people have trouble shutting that process off in a prompt way. So, you know, it's good that we react strongly want to stress or first occur so we can Marshal our resources and deal adaptively with that stressor. We don't want to ignore the
stress, right? There's it's there for a reason to warn us that something's going on environment, we need to deal with. But then once the stressor has resolved, we need to be able to bring our bodies back down and back to a regular Our stable State and often individuals with depression have trouble coming back down in a timely way and they're sort of more sensitive and more sort of hyper aroused for for a period of time beyond what healthy individuals might
experience. And maybe I'll talk about each of these Universal, and then we can talk about it. What could be done about it? So, cognitive, great. So cognitively, what we often see is people tending to respond in ways that heighten the stress, by doing things, like
blaming the stress. On themselves and unstable things that can't be changed as opposed to looking for outside reasons why this dresser might have happened or recognizing the stressors come and go that they can be temporary rather than a stable feature of me. So, if I believe that when I encounter stressors, it's because something is inherently bad, about me, it's unavoidable and it's always going to be around. I'm going to be much more likely
to stay depressed. And if I recognize that stressors also are, you know can be Things that are temporary that are outside of me and that can be controlled emotionally. We often see high levels of sadness and distress but also low levels of positive emotion. So what seems to happen is that people are feeling sore, very sad, very hopeless. But in addition, they can feel just a really difficult time.
Feeling pleasure and enjoy and connection to other people that really contributes to the difficulties of this disorder and an Personally, oftentimes people withdraw from others, they isolate themselves rather than reaching out and connecting
with other people. And that can make it very difficult for the depression to stop in part because when we're alone, were more likely to ruminate and we're less likely to talk to people who can help distract us from what's going on, can help give us A New Perspective that might be helpful and help us lift our mood. So all these universals I think in terms of thinking about how to address them M. An important. First step is to recognize that, you know, one stressors occur.
All of us are going to react. What we have some control over is, how are we going to respond? And so, if we know that we're a person, who, when we experience a stress or tends to be, you know, could react really strongly, which is actually very common. Not just among people with depression and thinking about hey, what can I do now to deal productively with this. So talked earlier about active
problem-solving types. Copying what I brought about the situation is sort of out of my control and it's like, I need to let go of that. And what part of this can I do something about? Let me actually make a plan for how we're going to address this taking, kind of concrete steps, and having a plan in place to address the things that can be
addressed cognitively. Emotionally interpersonally, rather than kind of withdrawing and isolating myself and thinking about all the ways in which things are going wrong. Can I, can I instead approach? So instead of To avoid. I'm going to go approach, I'm going to reach out to people who I trust and who I love who I know will help me get through the situation. Give me something else to do, encourage me to try something different.
Can I sir think about activities that I can engage in that are going to lift my positive emotion and will help me curtail that negative emotional experience. It's so interesting. I remember one of the biggest skills that I utilized initially and DBT was opposite action.
It sounds so counterintuitive because it's like, you're going to do exactly the opposite of what your emotions are telling you to do and it's almost it is on Instinct that we listen to our emotions that we lean into those urges because they're there to Keep Us Alive. Its evolutionarily something that's very beneficial. And yet when you have struggled with depression for a while and that's kind of skewing these emotional cues and it's not serving you to listen to them.
You have to reteach yourself to not, listen to them. And then at some point, What you kind of go back to listening to your emotional cues as they get more balanced, but it can be very counterintuitive, especially initially, that's exactly right. And I think, you know, it's very natural that we want to avoid situations that give us pain, emotional pain, or physical pain.
It's, you're absolutely right. That, when you've been depressed for a long time, sometimes those emotions, don't serve us very well. And we tend to want to avoid everything including things that are potential sources of pleasure. And I meant for us and so doing the opposite sort of encourages us to approach, rather than avoid in ways that can be very helpful. Yeah, but you did touch on this little bit of avoidance as something that can show up a lot with anxiety with OCD.
With other mental illnesses. There is a pretty high level of comorbidity of depression with other mental disorders. What are your thoughts there? Is it something that like the is it like depression is the first thing that causes these other things to pop up or Do these other stressors and overwhelming emotions and lead to this feeling of depression. I think it's probably both, you're absolutely right. That rates of comorbidity or co-occurrence of depression.
With other mental disorders is very high in teens very often. The co-occurring conditions are other anxiety disorders they can be eating disorders substance use disorders. Sometimes depression is a response or reaction to having those other conditions. So for example, if I'm really anxious the depression May almost be like a demoralization reaction it. So I'm so tired of struggling. So much life is really really hard.
Other times. Depression can actually contribute to these other disorders. So for example if I'm feeling really down and depressed, I might use substances to try to make me feel better and that can lead to a substance use problem and then very often, there's some third Factor that's Rebooting to both the depression and the other disorders. So if I have a lot of stress, for example, that might increase depression, as well as anxiety
or substance use disorders. If I tend to engage in kind of problematic coping strategies that are causing problems for me. I may I may give rise to multiple disorders. Yeah, today's episode is brought to you by to Karis the car. Is a nutrition company that focuses on overall, Wellness, starting with what you eat. They offer a meal delivery services with plant-based gluten-free non-GMO, organic Anak meals that are delivered straight to your door ready to go.
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The last thing I want to touch on which I thought was So interesting, one of my favorite things we learned this semester was about the idea of distress disorders and how similar generalized, anxiety disorder and depression can be because if I were to think about it, going in blind at be like, well, they're completely opposite like one is completely dampening. Your emotional expression in your mood and the other one it's like heightened arousal and yeah, as you explained, they can
be so similar. And it's almost like how you're interacting with your environment and causal factors that can kind of create. Create the difference of how you're presenting. So, I'd love to hear your thoughts there about the similarities and the differences of generalized, anxiety and depression. Yeah. So this is an area that I study
and I find this so fascinating. So, one of the things we talked about in class is that actually the genetic research suggests that genetically generalized anxiety disorder and major depression are the same disorder. It's so interesting and we look at the clinical features of these disorders. They do have a lot of features
in common, right. So both Writers, for example, have involved difficulties with sleep involve difficulties with concentration and decision-making, involve difficulties with mood, especially high levels of negative, mood negative emotion, but there are some important differences to in GA day. Of course, we see heightened levels of worry and anxiety and depression.
These are not Central features although we know that depression is very heterogeneous and there are many divisions with depression who actually are quite anxious. And very Very, very restless have difficulty falling asleep and so on it has a very kind of anxious depressed mixed presentation, although worry has traditionally been thought of, as a feature of anxiety, not depression. We now know that rumination and depression and worry and gadd
are close cousins. They're not the same exact thing but they are very, very similar both involve this process of thinking in an abstract, uncontrollable fashion about things that Bad about me. And that I for the most part cannot change. And worry is for future-focused elimination is or cast focused. But other than that, there's not too many things that distinguish worry from elimination.
So one of the possibilities, my students and I have been actually studying is perhaps that tendency to get stuck and - repetitive patterns of thinking actually is a shared vulnerability factor for gadd and major depression and there are active Treatments for depression and anxiety. Have a lot of shared features, many of the same. Strategies are helpful in Psychotherapy, for JT and major depression. And many of the same pharmacological treatments are effective or GED and major
depression. So they're definitely seem to be a lot of commonalities there for us to think about there are some differences between D and m d d. If they're hard to find anxiety disorders have been described in the literature as disorders. People are primarily concerned about threat, very sensitive to detecting potential threats in the environment. And I don't mean just threats like a spider, you know, a snake, those Arts of threats, but that's where I perceive.
There's some potential for negative outcome. For me, in GA D, this tends to take the form of thinking about all the bad things that could happen to me in the future. And why I think I'm not going to be able to cope with those bad things, if they happen to me, right? And we'd have found some evidence that threat sensitivity is higher in GA D than in major depression, however, major depression tends to show higher threat, sensitivity than people who have no Psychopathology at all.
So it might more of a matter of degree than really a complete difference. Exactly. And sort of conversely for major depression, we've been pursuing the possibility that in depression with distinguishes it from JD and from other anxiety disorders, is that low positive emotionality Difficulty finding pleasure and joy in life and enjoying rewarding experiences when they happen. And we have found some evidence that yes, reward sensitivity word responding is lower in depression than in gadd.
But once again, people with deity show lower, reward responding than healthy individuals who have no Psychopathology. So again, a matter of degree, so interesting. And again, going in blind, you would not pick up on those things like. I think, the way that we're aware of them as a society, they seem so different. And yet, when you really do, look at the presentations and when you look at the the presentation in compared to a normal presenting person,
they're very similar. And there's a lot of things that overlap and again, like even from the treatment perspective, things that are effective on both fronts, which is great if you are struggling with comorbid depression, Shouldn't and anxiety. I think, that's right. And what we know about generalized, anxiety, and major depression, is that they usually go together. It's very hard, especially in clinical settings. It's very hard to find people who have one and not the other.
They often go together and individuals who have both generally have sort of the most emotional distress. The most reactive to stress and sometimes over time, their the individuals who are going to be sort of more have a more chronic course of illness. So those Are the individual we see, as where it's, especially important, that they seek help and learn and use the strategies regularly to manage their emotions and to cope successfully with stress.
Yeah, if there is one piece of research or literature, or a statistic that you wish, the general population was more aware of relating to depression, anxiety, and mental health. What would it be? I know that's hard one. So I think that I don't know if this is a statistic for say, maybe I'll give you two things if it's okay.
Yeah, so one thing that we talked about in class a semester and for me, is sort of the most blunt mind-blowing statistic about mental illness is a. Most of us will develop a mental disorder at some time in our lives. So general population, surveys in the US have shown that approximately half of the adult population, the us will have a mental disorder at some time in their life.
That's probably an under estimate because that number it comes from studies of people who are living out in the community. And we know that people who are let's say in institutions for example in prisons or an inpatient hospitals or people who've died prematurely due to Suicide or accidents have an elevated rate of Psychopathology relative to others in the population and it's also the case that when we ask people, have you Your life experience, dot dot dot, sometimes people
forget. And they are, they any proper stigma in our society, right? Under that, people would under report and that's the other thing that people may be reluctant to report. Especially since these surveys are usually done with lay interviewers, who are strangers. And these are sensitive things to talk about, especially with some stranger, who's come to your right?
And so when people are followed forward, in time, we actually see rates as high as 70 or even 80 percent of people, will eventually develop A mental disorder. Now, that's really important and hopeful in a way because it tells us that it need not be stigmatized to have a mental disorder. In fact, the more rare and unusual situation is the person who reaches, you know, the age of 80 or 90 having never had a mental disorder. I think we have a lot to learn from those individuals.
Like, are you okay? I know exactly how did you do that? That normalizes at some point in our lives, for going to go through rough patch. The might be really rough for some individuals, there will be recurrent problems or chronic problems. And for others, the problem will be resolved and not recur. So I think it's just important to recognize that mental illness is all around us and one form or another and that having experienced this, we're not alone, we're actually in the
majority. So that's that's really important to note. And then I'll pair that with the second observation I want to share, which is that. Effective treatments exist. We have some really effective treatments out there and the real heartbreak for me, is that so many people who struggle and suffer don't know about these treatments or don't have access to be treatments.
So I think if you're a person who is struggling with depression with anxiety because I know that's the focus of today's conversation, we have effective treatments, you know, it's so important to get help because those treatments can be extremely helpful and given that these are problems that can persist To become chronic or recurrent over time the earlier, you seek help the better because learning those skills will help
you. Not only deal with the current episode of depression but prevent future episodes from happening in your life. I love that. I think that's the perfect note to end on and it's relevant to anyone and everyone whether you yourself have struggled in the past currently struggling, May struggle in the future are trying to support, someone who is struggling.
It really. Is something that is universally important to know and be aware of Of and it just, it really just makes me wonder again how we have so much stigma. When again, the majority of us do struggle or will struggle at some point. Yeah, I think that so often we don't talk about these things because we feel like we're alone, we feel ashamed. And I think if we open up the dialogue and are open with one another about this, both discover that, in fact, many other people are dealing with
very similar things. Yeah, yeah. Well, thank you so much for joining me today. I'm so glad we got to do this me. Me to thank you so much for inviting me. It's been such a pleasure Sadie, of course. Thank you so much for listening to this week's episode of she persisted. If you enjoyed make sure to share with a friend or family member.
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