Sometimes when I teach a mental health skill, like how exercise treats depression or how mindfulness
is a powerful tool to decrease anxiety, people will tell me, "Oh, that's cool, but
I have clinical depression." And what they usually mean by that is that they've been diagnosed with
depression and they assume that their diagnosis means that their depression is a biological trait,
a genetic trait, or it's something inherent, or it's a chemical imbalance - that it's part
of their being or their identity, and they assume that it's going to be a permanent characteristic
that they just cope with for their entire life. Now, this is a misunderstanding of how mental
health diagnoses work. We have this interesting problem in America where we've applied the medical
model to mental health, and it's created a lot of learned helplessness in our attempts to remove
the stigma from mental health. Many people have come to believe that all mental illnesses are
permanent genetic traits, and it's just not true. Anxiety disorders, depression, trauma and many
other mental-health conditions are really really treatable. Now, I saw this in action when I worked
in residential treatment. Clients would come in with severe depression, anxiety, trauma, and
sometimes a bunch of other co-occurring diagnoses like substance use, learning differences, learning
disorders, eating disorders, and and more. Right? Like many of my clients had six or eight
diagnoses. And one of these programs did robust testing before and after treatment and found that
at discharge, 93% of clients, they no longer met the criteria for depression or the issue that they
originally came to treatment for. We also found that many of these results lasted for years after
treatment. We saw people change in a massive way. They became so much healthier and happier. Now,
granted, in residential treatment these clients were getting literally hundreds of interventions
a week, from a daily schedule to exercise to nutrition to medical treatment. They got tons
of support from professionals. Right? But you can create these changes too, little by little,
as you apply one new skill at a time. So for many people depression, anxiety, or PTSD can
be completely resolved, and for others the symptoms can be greatly reduced. Research shows
that over 30% of people recover from depression without any treatment within six to eight weeks,
and 80% recover within a year. So in this video we're going to talk about what a mental-health
diagnosis really means and how an accurate understanding can open doors for you to change.
[Music] Okay, let's start with a story. Once upon a
time there was a huge elephant. This elephant was super strong. He could
uproot enormous trees and lift heavy logs. However, despite his extraordinary abilities,
the elephant was held captive by a small rope tied around one of his legs. Now,
one day a traveler approached the elephant's keeper and asked why this mighty creature didn't
break free from the seemingly flimsy rope that held him back. The keeper explained, "When the
elephant was very young we used a similar rope to tie him up. At that age the rope was strong
enough to hold it back. And as the elephant grew he never realized his own strength. He believed
that he could never leave because of the rope." The truth is that this elephant had the ability
inside to break free from this rope easily, but because he didn't believe that he could,
he never did. This story is an example of learned helplessness. That baby elephant couldn't break
the rope when he was tiny. And just like that, many people get overwhelmed by depression or
anxiety when they don't have the support, the resources, or the skills. But unfortunately,
many people believe that they will never be able to overcome depression or anxiety, and because
they believe they can't, they don't. Okay. Let's talk about where this huge misunderstanding came
from. Let me give you an example of a diagnosis from the medical model. So let's say you have
symptoms like vomiting or diarrhea, body aches, chills, and the doctor sees you and swabs your
throat, the lab runs the test and diagnoses you as having the flu. That medical diagnosis means
that the influenza virus is what's causing your symptoms. Now, if on the other hand you have
symptoms like sadness, low energy, frequent crying spells, and you're feeling hopeless and suicidal,
right, if you went to your doctor and you have at least five out of nine of these symptoms he would
diagnose you with depression. But what's different about mental-health diagnoses is that when they
say you have depression, they're not telling you anything about the cause of your symptoms; they're
telling you, "This cluster of symptoms, we in the scientific community, we call it depression,
but we don't know what is causing it for you." They may give you a survey or an assessment that
ranks your symptoms on a numerical scale with a clinical cutoff. So for example, if you take
the Beck Depression Inventory and your score is over 20, you have moderate depression or higher,
right? But again, all that's telling you is that you have these symptoms. It doesn't tell
you the cause. A depression diagnosis is not the cause of your symptoms; it's the outcome of your
symptoms. Now, right now we have a very limited way of understanding the individual biological
factors that lead to depression. No doctor is going to scan your brain or extract brain
fluid to diagnose depression. So the medical model doesn't perfectly fit mental health, and I think
it confuses a lot of people. Many mental-health professionals prefer the biopsychosocial model.
So to explain this I'm going to use depression as an example, but this really applies to most most
mental-health conditions. So one of my favorite conceptualizations of depression is drawn from Dr.
Charles Raison. He's a psychiatrist, a professor of psychiatry, and the co-author of the book The
New Mind-Body Science of Depression. And I'm going to summarize what he says. He says depression
doesn't exist as a single thing or cause. Its causes are incredibly complex. It may be
1,000 different disease states. It does exist. It is a real experience, and it's common to
all the societies across the world, including hunter-gatherers. He says depression is the most
common way humans break down under adversity. Now, I would I would change that just a little bit,
and I would say the depression response is actually a chance for our body to rest and
heal and recover and try something new when what we've been trying seems hopeless. So I take a
little bit different approach to it, but this is how he describes it. And I believe that humans
are actually inherently very resilient. We can handle a lot of adversity. But when your mind and
body get overwhelmed, it's like your body shifts into this shutdown state for self-protection. And
depression has many contributing factors. And in mine Change Your Brain course you learn that for
some people their depression is contributed to by a nutrient deficiency or by a lack of sleep, and
for other people their thoughts and actions lead to feeling hopeless or overwhelmed. Things like
childhood trauma abuse and faulty thinking can also contribute to depression, but so can things
like inflammation and allergies and loneliness. Then we also know that genetics are involved.
So twin studies have shown us that depression is around 35% heritable, meaning that there's around
a 35% chance that your genes are contributing to your depression. The estimates for anxiety
are similar; they're somewhere between 27% and 40%. Now, for some other mental health disorders,
genes play a much bigger role. Research indicates that a genetic predisposition for depression might
get turned on by life circumstances like abuse or trauma, but if 35% of depression is genetic,
that also means that about 65% of the rest of contributing factors has to do with other causes.
Now, this is actually really helpful because when we can decrease just a few of these hits we can
actually often overcome depression. Now, we know that medication helps around 65% of people reduce
the symptoms of depression, and research shows us that there are a ton of other
effective treatments for depression too. So when we improve social connection or physical health,
when we change thinking patterns or process trauma or improve nutrition, all of these factors can tip
the scale toward no longer meeting the criteria for a diagnosis. Anxiety disorders are similar.
They're caused by a combination of factors. And we can treat various aspects of anxiety,
from the biological side of things to the psychological and behavioral side of things.
So please don't automatically assume if you get a mental-health diagnosis that
this is permanent. Don't assume that you're stuck feeling this way forever. It's just not the case,
and it's not what a mental-health diagnosis really means. What I'd like for people to
know is that a mental-health diagnosis does not mean you have this or you are this. It means you
are experiencing this. Because a diagnosis doesn't tell you the cause. It doesn't say, "You have this
gene, and here's the cause." When we reduce or eliminate the symptoms of depression or anxiety,
you no longer qualify for the diagnosis. So what I'm saying is that mental illness isn't always
permanent. When we fuse our identity with our diagnosis, when we label ourselves as
a depressed person or an anxious person, we limit our options. We create learned helplessness. Just
like that elephant we tie ourselves down, we limit our potential, simply because we don't
believe our life could be different than it is. And you'll see this when people who have over
over-identified with their diagnosis, they might have a bad day and they might say, "Oh,
why is life so unfair? Why do I have to feel this way? Why do I feel so depressed? Why does it make
me feel so awful?" instead of a more flexible approach where they maybe look at what caused
a bad day and exploring what options you have to make your life better. So when people use their
diagnosis as an explanation for why they feel the way they do, it simply limits their options.
Please don't resign yourself to just giving up, to feeling miserable for the rest of your
life. Tiny changes can add up over time to huge results. So I would just say, like, let's keep
chipping away at it. You don't know what you don't know. There's so many options for treatment. Like,
let's learn what some of them are and try them out. I do want to say depression is real. It's not
a weakness. It does have biological contributing factors. And by me saying, like, we're gonna shift
away from this medical model, it doesn't mean that mental illness isn't real. It is is real. And most
of the people I work with are doing everything they know to make things better, but the things
they've tried in the past just aren't working. I want to clarify: mental illness is not laziness.
It's not a moral failure. But it's also not your identity. Now, some mental illnesses are chronic,
but that's just not the first assumption I would make about a case of depression, anxiety, or PTSD.
It's also not inherent to who you are. I see it more as being about a lack of resources; you just
don't know what skills can help you to overcome your challenges. I would say it's certainly not
helpful to blame yourself or beat yourself up for the way that you're feeling. You say, "Let's take
a step back," and just ask, is there something that you can do that's going to improve your life?
If your gut reaction to that question is like, "I'm offended," then it's possible
you've over-identified with your diagnosis. Instead, hold labels and diagnoses flexibly.
Use a diagnosis when it's helpful for you, but don't cling to it so tightly that it limits your
options. Explore multiple treatment options before deciding that your situation is chronic. Again,
if you do have a mental-health diagnosis, please don't resign yourself to just coping with it or
feeling miserable for the rest of your life. There is so much that can be done to resolve
the symptoms and sometimes the cause of mental illness. You really can learn the
skills to get better at feeling and change your life. Um this video is day seven of my Break
the Anxiety Cycle in 30 days course. If you'd like to watch the entire course without ads,
with all the bonus exercises, with the workbook and the live Q&A's, please check
out the link in the description. And again, thank you so much for watching, and take care.
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