Severe Depression vs. Feeling Depressed [& the Treatment that Works]

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what does somebody's life look like who

is suffering with severe depression you

know Kyle I don't think that well let's

just say this unless you have

experienced this or experienced it with

a loved one I don't think the general

population knows what true severe

depression looks like or what true

treatment-resistant depression looks

like I'm so glad you're saying you know

this what's so so important is that I

still to this day get people when I

bring up depression or when when people

read stuff like oh my god the CDC is

saying that this is it one of the

largest disabilities in the country

people like what they're depressed

they're sad get over it and when people

are profoundly depressed Kyle when

people have treatment-resistant

depression if they are non-functional

it's as if their brain and then

secondarily their body shuts down they

can't function mm-hmm I'm telling you

they I have patients with severe

treatment-resistant depression that

don't talk mmm and these are people who

are educated and held a job and have a

family they stop speaking they won't get

dressed they won't eat they won't shower

they won't bathe and they're not being

stubborn they they don't have it they

have no motivation they have no desire

to get why would you be stubborn on

living a life like that okay you don't

want that it's they completely shut down

it's as if their brain and body flat

lines in this helpless hopeless dark

place mm-hmm that is true

treatment-resistant depression it's

important that we make that distinction

this isn't just feeling blue or having a

bad day right right so for people who

get diagnosed with depression before it

reaches to the point where they're not

talking for example many psychiatrists

will recommend or use SSRIs to treat

that depression from a very high-level

standpoint what is an SSRI and how is it

used the SSRIs are probably the

first-line treatment with psychotherapy

first-line treatment for a depressive

episode so once once someone gets a

diagnosis of a major depressive episode

after an evaluation by psychologist or

psychiatrist you'll start on an SSRI

which is a very basic antidepressant

medicine the good news is is that they

work fairly well and they have minimal

side effects for the most part and

they're tolerated really well right um

but the problem with them is that only

about 50% of people respond right so if

you're really going through a hard time

in your life and you're having a severe

depressive episode and you take an

antidepressant you have a 50/50 shot of

it really working those aren't really

good odds mm-hmm you know so if those

SSRIs aren't working the depression

continues to get worse and worse

you're now at this damn at this point

where you're in a treatment resistant


why is ECT different how does it work

differently so this is we're gonna get

into the history of ECT and when you

talk about the neuroscience behind ECT

but Kyle this is something where the

treatment preceded the understanding of

it which means that in the 1930s

neuroscientists realized that when

people had a seizure whether it was from

an epilepsy or whether it was from an

induced from a fever or from a

medication if they realized that it

cleared up some mood problems that they

had after a seizure so there was this

correlation that was made that something

is going on when the brain has a seizure

that equates a relief in psychiatric

disturbance that's where it all started

got it now you know a lot more about the

brain thankfully and at this point we

realized that when the brain has a

seizure your neurons are firing what

happens it's like a domino effect your

neurons start firing and they just take

over the entire brain and they all fire

and when those neurons fire they are all

communicating and secreting

neurotransmitters so to put it very

basically it's like industrial-strength

antidepressant because the chemicals

that you're increasing with an

antidepressant an SSRI we talked about

norepinephrine serotonin dopamine all of

these you're flooding your brain with

these and now science has really looked

into what is happening when you induce a

seizure and we're seeing very similar

results that would happen with an

effective SSRI but it would take 6 8 12

weeks we're seeing in ECT can happen

within six seven eight

and those are we see changes in the

brain structure we're actually seeing

neurogenesis in certain parts of the

brain and this is similar to a lot of

psychiatric treatments that help

depression we see hypo Campbell volume

increase we see parts of the brain that

are affected by depression the

prefrontal cortex sprouting new neurons

and fibers right so you're basically

getting an industrial-strength flood of

neurotransmitters and some neurogenesis


okay two questions who is this series

for and what will people get out of this

series this series is for basically

anyone that thinks still oh my god ect

is Jack Nicholson in One Flew Over the

Cuckoo's Nest

right so we're gonna clear that up right

yeah yeah

alright and more importantly people that

have treatment-resistant depression

really want to know all of the options

people that have a loved one that has

treatment resistant depression and just

really wants to know what's out there

what are my treatment options ect is one

of them it's not the only one right

there are many others that we've talked

about and we'll mention today just so

everyone is a very well-rounded

understanding but these are the

fda-approved will ect is fda-approved

it's it's a viable treatment option that

actually does work and it's actually

really safe now so this is all about

education yeah whether it's for helping

a loved one helping yourself or just

providing yourself with a good

understanding of what is out there in

the psychiatric world thanks for

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