Anxiety & Depression

Dr. Judith Joseph 00:00:00  In the real world, we think happiness is this like grand destination, and that when we get there, we should be okay. But we’re learning that that’s not it. It’s these plethora of these sensations.

Chris Forbes 00:00:17  Welcome to the one you feed. Throughout time, great thinkers have recognized the importance of the thoughts we have. Quotes like garbage in, garbage out or you are what you think ring true. And yet, for many of us, our thoughts don’t strengthen or empower us. We tend toward negativity, self-pity, jealousy, or fear. We see what we don’t have instead of what we do. We think things that hold us back and dampen our spirit. But it’s not just about thinking. Our actions matter. It takes conscious, consistent, and creative effort to make a life worth living. This podcast is about how other people keep themselves moving in the right direction. How they feed their good Wolf.

Eric Zimmer 00:01:02  You’ve got the job. The house? Maybe even the partner. You’ve checked the boxes. So why do you still feel flat? That question is at the heart of today’s conversation with psychiatrist and researcher Doctor Judith Joseph in her new book, High Functioning Overcome Your Hidden Depression and Reclaim Your Joy.

Eric Zimmer 00:01:21  She explores why many people who look fine on the outside are quietly suffering on the inside with something we rarely talk about anhedonia, the loss of joy, or the loss of ability to feel pleasure. I felt this myself many times. Moments where everything should feel good but nothing really lands. This episode resonated personally for me. As someone who’s learned that sometimes the very tools I use to succeed can become the barriers to actually feeling alive. I’m Erich Zimmer and this is the one you feed. Hi, doctor. Judith, welcome to the show.

Dr. Judith Joseph 00:01:56  Hello. Thank you for having me.

Eric Zimmer 00:01:58  I’m excited to have you on. We’re going to be discussing your book, which is called High Functioning Overcome Your Hidden Depression and Reclaim Your Joy. But before we get to that, we’ll start like we always do with the parable. And in the parable, there’s a grandparent who’s talking to their grandchild, and they say, in life there are two wolves inside of us that are always at battle. One is a good wolf, which represents things like kindness and bravery and love, and the other is a bad wolf, which represents things like greed and hatred and fear.

Eric Zimmer 00:02:28  The grandchild stops and they think about it for a second. They look up at their grandparent and they say, well, which one wins? And the grandparent says, the one you feed. So I’d like to start off by asking you what that parable means to you in your life and in the work that you do.

Dr. Judith Joseph 00:02:45  Well, you know, it’s interesting because wolves are carnivorous and you often think of them as, you know, these predators that are robbing you of something. But, you know, the interesting thing about this parable is that it allows people to realize that you can only let someone rob you of something. If you put yourself in certain situations, for that to happen. And so, you know, in many of these parables that we learn about as children, there’s almost like this, a victim mentality to it, like things are out of your control. There’s a big bad wolf who’s coming to get you. But if you look at it from a different perspective, there is a certain amount of agency involved.

Dr. Judith Joseph 00:03:33  You know, you can choose to give your joy. You can choose to give your power away. and yes, there are bad people in the world. There are situations beyond our control. But there’s always a choice, right? You always have a choice. So that’s the takeaway that I get from this parable.

Eric Zimmer 00:03:51  Beautiful. And that really is kind of to me, what it ultimately boils down to is that we. We have a choice. We are going to be faced with difficult situations. We’re going to be faced with situations where we’re not sure what the right thing to do is, but we have a choice in what we do in those choices really matter. You’ve got a term in the book. High functioning depression. Walk us through what that means.

Dr. Judith Joseph 00:04:13  Well, I’m sitting here in my research lab. I’ve had this clinical research lab, for over ten years now. And I use a diagnostic tool that I’m sure you’re familiar with as a therapist. it’s called the mini and the skid, and it’s used for just about every single behavioral health clinical research study.

Dr. Judith Joseph 00:04:34  you have to use the criteria based on the Diagnostic and Statistical Manual for Psychiatric Condition in the section on major depressive disorder, which most people think about as clinical depression. You have to have these symptoms, and they’re laid out in the, you know, Bible of psychiatry, this DSM five, that’s manual ized into these, tools that we use. And you have to have these symptoms of depression at the very end of the checklist. If you don’t meet criteria for having your symptoms impairing your functioning or causing significant distress, you don’t check the box. You know, we say, well, you don’t meet criteria come back when you break down. And throughout the pandemic, running these clinical studies and seeing all these people coming in who were actually over functioning, they didn’t they weren’t breaking down. They were coping with their pain by taking on more work, taking on more projects, creating a side hustle or to busying themselves. I say that they are humans doing instead of human beings. This was how they were coping and they kept saying, something is off, something’s off.

Dr. Judith Joseph 00:05:41  But I’m not meeting criteria. Every therapist is turning me away. And I was also experiencing this. I had this very successful research lab, you know, when every other office in the building had shut down. I was still going because I have these clinical research studies that have to continue, you know, via the FDA mandates. You can’t you can’t yank people off their meds, you know. Right, right. The research continues through crisis, at least it did back then. But, you know, I was seeing these people who were like myself functioning over functioning, showing up. They were the rocks, you know, but they had this lack of joy. They had this inner struggle, and they were coping with their pain by busying themselves. And I thought, why aren’t we focusing on these folks, too? Yes. It’s important to address people who have broken down, you know. Yes, it is important to address crises. But what if we thought about things differently? And what if we were preventative? What if we prevented the breakdown? Why aren’t we thinking like this in mental health? And I just thought, well, you know, look at all these other fields of healthcare.

Dr. Judith Joseph 00:06:45  When you look at longevity science, you don’t see doctors saying, let’s wait until stage for cancer to do something. We say, let’s educate patients about the risk of cancer and let’s prevent it. Yep. In the menopause space, where I do a lot of work in terms of mental health and menopause, we’re not saying, let’s break the let’s wait for the hip fracture. We’re saying, let’s prevent the osteoporosis by educating patients about things they can do, like, you know, using hormone therapies and weight bearing therapies and so forth. But why in mental health do we wait for people to break down? So I set out to conduct the first clinical research study in high functioning depression. And so in the study we enrolled 120 patients. We interviewed them. We didn’t do questionnaires because we found that that is not effective. You know, talking to people and getting their symptoms is more effective in terms of like collecting real data. And we found that there are these people who have these symptoms of depression, but they don’t break down.

Dr. Judith Joseph 00:07:44  So they wouldn’t meet criteria according to any diagnostic criteria that we currently have in the medical field. But in our new criteria for depression, we’re seeing them having these symptoms. But they’re not breaking down. They’re over functioning. And we’re seeing something called anhedonia, which is a scientific term meaning a lack of joy and interest and things that they want to enjoy. And many of these patients were experiencing this. They just didn’t know there was a name for it. And I wish I could take the credit for inventing the term anhedonia, but it’s been around since 1800s. Yeah, but most people have never heard of it. You know, people experience anhedonia all the time. They just don’t even know what it’s called. Many times they’ll say, well, that’s just life. That’s just being a mom. That’s just being busy. Yeah, but Anna Donia literally means a lack of joy and interest and pleasure. And I was also surprised that most people don’t know that in order to meet criteria for depression, you don’t have to be sad.

Dr. Judith Joseph 00:08:40  You don’t have to have a low mood having anhedonia, you know, according to the clinical, traditional sense of depression is enough without a low mood. And, you know, you have to have all the other symptoms. So. Yeah. When I started talking about anhedonia and high functioning depression, I thought maybe, maybe a hundred people would respond. But I was just astounded. Like, millions of people reached out saying, this is me, you know? Can I have more information about it? So, you know, it was validating because, you know, when I did the research, many of my colleagues were saying, well, oh, you know, well, we should be focusing on clinical depression. And but then the same colleagues after, you know, the work was done, said, I think my patient has that. Can I learn more about this? We need to think about this differently. You’re right. We shouldn’t be waiting for people to break down because, I mean, there are just not enough of us.

Dr. Judith Joseph 00:09:30  There are just not enough of the mental health professionals to address the growing demand. So we need to educate patients, allow them to have that access to knowledge so that they can identify when things aren’t right before they break down. And so this preventative health, you know, measure I think is crucial, Sure. Especially now.

Eric Zimmer 00:10:08  Listeners will know this, but I’m a recovering heroin addict, and after I got sober for a few years, I had clinical depression in the sense of like, not functioning very well kind of thing. The classic depression. And I went on anti depressants and I have, you know, in all the intervening years I have learned how to take care of myself physically, socially, spiritually, psychologically. And I find myself in this place where I don’t know what I don’t want to say, what I have, whether I have anything, and let me explain that. So I’m high functioning and I sometimes have Of Anatolia. But I don’t know, like I can tell it it for me, it seems clear when it comes.

Eric Zimmer 00:10:54  It’s all of a sudden there’s no books I want to read. There’s no songs I want to listen to. but that passes in in a day or two often about that time range. I have some of the other symptoms of irritability. And my question is this. And I this is something I think about a lot in regards to myself. At what point is good enough? Good enough meaning do we risk pathology using normal human experience? And when I hear questions about do you, you know, have enough joy or do you have joy? My question is like, well, how much like as a former heroin addict, I’m like, well, joy is way up here, right? You know, when I hear people say, well, low energy, I’m like, well, how much energy? So I kind of just am curious how you think about this sort of question of capable of always thinking of how things could be better, a standard of normal. It’s not even a question, but I’ll let you respond.

Dr. Judith Joseph 00:11:51  Well, in our clinical research protocol, the symptoms had to be present for at least two weeks or more. In research, you have to have clearly defined periods when you submit a protocol to the IRB, which is the review board that really oversees human research. And so what you’re describing are, you know, dips and flows in a day. Right. periods of fluctuation, which are not typically categorized in research or in the medical field. Yeah. so that’s different. usually when we look at mental health conditions, there’s a fixed period of time. It’s a persistent state. it’s not like, oh, I have a bad day today. Oh, tomorrow I’m better. That’s not what is typically used to classify. But in the folks that we did end up interviewing, we talked about a clearly defined period. And we also asked if it was persistent. We also, you know, wanted to know a bit more about their past. They had to do extensive trauma inventory. So we wanted to understand, you know, what it is that possibly could be the root of what was happening.

Dr. Judith Joseph 00:12:53  Many times during these interviews, we’d go through these really extensive questionnaires, and I would encourage people to take a look. We’ve made them available online on the website, but we go through these questionnaires, and then they’d be surprised that that was a painful experience and never acknowledged it. And you’re right, I just pushed it down. I actually just never even thought about it. And that is traumatizing. What we found was that we also do PTSD, like the traditional PTSD studies here. We found that people who fit the profile of high functioning, what they ended up doing was not avoiding people, places and situations in order to not feel triggered. What they ended up doing was they ended up diving into work, diving into projects to avoid processing their pain. So it’s a very different picture, you know, like from what we typically saw in our PTSD studies. you know, we use. We use these tools called the Capps five. It’s it’s a gold standard tool. It was developed in the VA hospitals for combat veterans.

Dr. Judith Joseph 00:13:52  But we actually used this in PTSD research. And usually using these tools, people avoid, you know, places, situations, people that trigger them but are high functioning folks. They were avoiding dealing with the pain by just busying themselves. They were afraid that if they slowed down, something catastrophic would happen. Either they’d break apart, they cried. They tapped into something that they couldn’t control. They weren’t even aware that they were doing this numbing to avoid dealing with the pain. But the problem with that is that when they were numbing, you know, these sensations, they were also possibly numbing their ability to feel that joy. Right? And it wasn’t just a blip. It was like a persistent. Yep. and hedonic a thing that they were going through. But to speak to your experience, Anna Donia, is not something that is just specific to depression. Anna Donia, as you’re well aware, is very prominent in substance conditions. Right. And with people who’ve used substances in the past, because, you know, the theory is that, you know, your brain gets somewhat, you know, changed in a way that you don’t access pleasure as much.

Dr. Judith Joseph 00:14:58  Right? Right. Antidote is also really prominent in conditions like dementia and schizophrenia. You know, schizophrenia is one of those mental health conditions where you have like the positive. And I, I really don’t like the term positive and negative, but that’s what they call it in science. Yeah. It makes sense in the science world. But in the regular world people are like, what? Is it good. But the positive symptoms of schizophrenia are like hallucinations, delusions, bizarre kind of behaviors. Right. Positive meaning? Not good, but positive meaning. You can see them. Yes. And the negative symptoms in schizophrenia not mean that they’re bad, but, you know, are the depressed depression, the anhedonia, the, the concrete thinking, the flat affect you know and so and disorganized thinking at times. So you know anecdote is something that is throughout multiple mental health conditions. So it’s not just specific to depression, but you know, as you’re aware, you know, when you have recovery from substances and so forth, you can have comorbid or co-occurring depression, co-occurring anxiety, you know, insomnia, all of these things that are part of the healing journey after, you know, you’ve made that change in your life.

Eric Zimmer 00:16:12  I totally agree, I’m a long way off from that experience. That was in my early 20s. And one other thing I think you said at one point, like, that I might know as a therapist, I want to be clear. I’m not a I’m not a therapist. I have talked to hundreds of them on this show and paid a dozen others a fair amount of money over the years to help me, but I’m not one my myself, so.

Dr. Judith Joseph 00:16:35  I’m sorry about that. Please edit that out. Yeah, no. That’s fine. Therapist.

Eric Zimmer 00:16:38  I just wanted you to know, as you as you talk to me. Yeah, exactly. So people who fall into this category of high functioning depression. Do they know something is wrong? They just can’t put their finger on it. Is that what we’re talking about? They. You know, this is not the person who just says, well, I’m kind of busy. I’m a little bit overwhelmed. Sometimes I feel this is somebody who has a sense that something is off.

Eric Zimmer 00:17:04  They don’t know what, though. Is that accurate?

Dr. Judith Joseph 00:17:06  Yeah, they they don’t necessarily come into my office saying I’m depressed. They come in and they say something’s off and usually it’s Antonia, you know, it’s different than when you’re like doing well. You’re, you’re you’re engaging in your work and you’re, you’re busy. But it’s not pathological productivity. You’re actually enjoying the work. You’re looking forward to it. You’re excited about it. That’s very different than doing these things. Busy yourself and actually not enjoying it at all, and not understanding why you can’t slow down two different experiences, you know, and it’s possible that at one point you did enjoy things. Maybe you did get excited. You you did know why you were doing things. You had purpose. And then you you find yourself no longer feeling purposeful, no longer enjoying it, feeling numb and just not knowing how to stop. You don’t even know why you’re doing it anymore. That’s typically what I see. Yeah. and, you know, I’m located in a very busy intensity in Manhattan.

Dr. Judith Joseph 00:18:05  Yeah. And so I see this a lot. And people are like, well, I, I know something’s off. I don’t know what it is. And you’re like, you’re a top psychiatrist, so you can figure it out. Please help me. And that’s usually what happens, you know. And that’s why it’s so powerful to have that term anhedonia. Because many times people will have a lot of guilt. They’ll say, I don’t know why I’m not happy and why am I here spending all this money? I have a great life. I have all these things going for me. I, I, you know, I survived all these bad things and yet I’m still feeling this way. I thought I would be happy, And I explain that, you know, for many of us, you know, we drank the Kool-Aid. We thought if I, you know, do all these things in life and I do the right things, I will be happy. But we’re learning in the science of happiness that when we have that mindset of when I finally get, you know, the partner, when I finally get the job, when I finally graduate school, I will be happy.

Dr. Judith Joseph 00:19:00  We’re learning that that delayed model of happiness actually makes us unhappy. We avoid the actual joys in life because we’re so busy chasing this idea of happiness that we don’t even realize we’re actually outrunning some past pain. And if we just slow down a bit and we tapped into our senses and we literally smell the roses, we would actually feel more joyful. Doesn’t mean that the problems are going to be solved, but by accessing these tiny points of joy along the way, you can actually become happier. And I say points of joy because in the research that I do, when we are adding up to see if someone’s actually becoming happy. We’re literally adding up points. We are asking them. You know, when you took a nap. Did you feel refreshed? We’re asking them when you were feeling lonely and you reached out to your loved one. Did you feel connected? We’re asking them when you were stressed. Were you able to self soothe all of these? Are these little points that we literally add up? To determine if someone’s becoming happier.

Dr. Judith Joseph 00:20:03  But in the real world, we think happiness is this like grand destination, and that when we get there, we should be okay. But we’re learning that that’s not it. It’s these plethora of these sensations, even in the in the suicide research that we’re doing. We’re reframing it for patients because if we if they have this idea that I will be happy one day, they may never get that. But we’re teaching them that actually, you know, it’s slowing down. It’s eating your food, savoring it. It’s going for that walk and noticing that beautiful tree and feeling that wind on your face. Right. Like all of these sensations are really what it is to experience joy, and that’s how you actually become happier in life, not this grand destination that even when you get there, the science shows us that you’re still not happy.

Eric Zimmer 00:20:48  Yeah, I love that. I mean, that accords with one of my core foundational ideas is that little by little, a little becomes a lot, right? Like, that’s how.

Eric Zimmer 00:20:56  That’s how we change. You know, and little moments accumulate over time. Little moments of goodness accumulate. And over time you start to at least my experience is over time that starts to change the overall climate inside. I have a question I want to ask though, about happiness, because happiness is one of those things that we can get fairly obsessed with. You know, I’m going to be happy. Am I happy enough? All of that? And the the science for a while, and I don’t know if it’s changed, which is kind of why I’m asking you, was that there was a certain genetic set point of happiness for people. And you could you could move it some. There’s portions of it that you could move, but that people would have sort of a set point that they would sort of settle back to something bad happens. They’re going to eventually come back to that, that point, something good happens. They’re going to feel good for a little while. They’re going to kind of come back to that point.

Eric Zimmer 00:21:56  How do you think about that in terms of the work that you do?

Dr. Judith Joseph 00:22:01  Well, there’s a field called epigenetics, and we know that things in the environment can change the way that genes are expressed. And it’s just fascinating. When I was in college I never heard of it. Right. You know, we’re learning that, you know, things in your environment can literally modify the way that your genes are expressed. And there used to be this idea that, you know, you can’t do anything about it. You’re just born this way. You know, genetics are important, but they’re not everything. Yes, In my book, I talk about a tool that most people have probably never heard of, but everyone in healthcare uses, and it’s called the biopsychosocial model. And the way that I break down the biopsychosocial system doesn’t seem too large and too like lofty is that everyone has a fingerprint. We all have our own fingerprint, but all of our fingerprints are unique. Everyone has a biopsychosocial. There are no two biopsychosocial that are identical.

Dr. Judith Joseph 00:23:05  And so when you use this model and you imagine it, imagine like this Venn diagram, these three circles that overlap. Think about yourself. You know there’s only one. You there will only ever be one you. So really take the time to understand the science of your happiness. And what I mean by that is draw this biopsychosocial. Look at your biological risk factors. Where are you losing your points of joy? Biologically, I use myself as an example, I. I have a low thyroid, so my endocrinologist has to be on top of my thyroid. If I get to high functioning and don’t go to my appointments. You know, like I’m not going to be able to have as much joy, right?

Eric Zimmer 00:23:48  Is it manifest as low energy that then translates into lack of joy? Is that kind of the mechanism or is it something different.

Dr. Judith Joseph 00:23:55  For my thyroid? Yeah. Low energy could be changes in sleep can be irritability. Yeah. You know, but other people have other medical conditions. Some people have autoimmune conditions where their bodies in this high state of inflammation.

Dr. Judith Joseph 00:24:09  Right. some people have other health issues. You know, whatever it is, where you’re losing your joy. Think about biologically what makes you different. Psychologically, that’s the other bubble in the Venn diagram. What is your past look like. What is your past trauma. What are your attachment styles. You know when I say past trauma you know people often think okay well I didn’t have anything bad happen, but maybe there were other traumas, you know? Maybe you had a divorce, or maybe you went bankrupt. Or maybe you didn’t grow up with much in life. You know, these are things that we traditionally don’t think about as being traumas. When we think trauma, we think, oh, combat near life, near-death experiences, attacks and things like. But other things can be painful, and they can shape the way that you view yourself or the way that you interact in the world. But if you don’t process it and acknowledge it, then you just don’t deal with it. And attachment styles.

Dr. Judith Joseph 00:25:03  You know, it’s another thing that we don’t often think about who is in our life, how do we interact with others? And then, you know, what are our comorbid conditions? What are our other things that we deal with every day? Some of us have ADHD. Some of us are neurodivergent. That’s all in the psychology, right? And then in the social bucket of the Venn diagram, what are the things in our day to day life? Are we getting good nutrition? You know. Are we eating foods that build up our brain? Or are we eating processed foods that are increasing inflammation in our brain? You know, all of these things interact with our genetics. What are we putting into our body? Do we have access to nature or are we in a toxic environment in terms of pollution? you know, are we around healthy individuals or are we around people that are bringing us down and increasing our stress levels? Are we getting the movement that we need so that our body is relieving stress, or are we sedentary and not, you know, living the healthiest lifestyle in terms of how much movement we’re getting? All of these things are the social things.

Dr. Judith Joseph 00:26:08  So that’s why it’s important to look at your unique biopsychosocial, because that is your fingerprint. That is your fingerprint for what you are experiencing in life and where you are losing your points of joy. And this is important because let’s say you’re someone who’s biological, you know, that part of your biopsychosocial that’s dominating where you’re really losing your points of joy. Then you’re going to focus your efforts there. You’re going to say, okay, my medical issues are getting in the way of my joy. They’re causing me all this pain and all this physical stuff. Let me prioritize there and let’s see if my life becomes a bit more easier to deal with, right? Less stressful. Yeah. But for others who are, let’s say they’re physically healthy, maybe it’s the past, maybe they’re past traumas or things that they haven’t resolved. Maybe that’s what’s blocking their joy because they’re constantly revved up in fight or flight. They can’t access joy. And for others, it’d be social. You know, it’s what’s happening in their day to day lives.

Dr. Judith Joseph 00:27:04  That’s where they’re having a loss of their points of joy. And that’s why I like this model, because it reminds people that there’s only one you, and there will only ever be one use. You got to really take the time to understand the science of your happiness, so that you can be strategic about where you want to focus your efforts to reclaim your joy.

Eric Zimmer 00:27:23  I really love that you said that, because that is a belief I’ve grown more and more into over the years that we are all different, and there are some principles that are can be helpful about being happier, about healing, and about all living a better life. All of these things. But what each of us need could be very, very different. And that’s why when we hear one size fits all mental health advice or one size fits all like life coaching advice or one size fits all diet advice like this is the right diet. I’m just I just as somebody who really sees the nuance and everything, I kind of bristle and I’m like, well, people are really different, you know, different.

Eric Zimmer 00:28:07  And I did a lot of coaching for a number of years, and I’ve started doing some again. And that’s one of the big things I learned over the years that I got better at understanding is like, oh, hang on a second. We need to understand this person more before we start thinking about what they should do. You know, you can have this bag of tools, but I think a lot of the art comes in. Like, what tool do you actually pull out to help?

Dr. Judith Joseph 00:28:29  Absolutely. I mean, in your work, you’ve seen so many different people and you would you would never just take one cookie cutter plan and apply it to one person and then use that same one. You take the time to understand what makes one person’s journey so unique. You know, what were their unique struggles because their challenges are going to be different compared to someone else, even though from like a far view, let’s say you’re like, oh, they have similar, you know, life histories. When you zoom in, you see how unique they are.

Dr. Judith Joseph 00:29:06  I think that that’s very validating. You know, like, I think when you can show someone like, this is what makes you you, right. And this is why when you read that book, when you listen to that podcast, when you when your friend sent you that meme, it didn’t work for you. It wasn’t. Yeah. That it was. You were the problem. It’s just that you didn’t understand the science of your own happiness. So you’re trying to apply someone else’s happiness to you? Yeah, it’s not going to work. And it’s very, I think, validating when I bring people into my lab and they do this tool, they just sometimes they literally break down crying and they’re like, well, I finally get it. Like, I wish I had this sooner. And it’s a tool we all use in healthcare, but most people don’t know about it. I’m really trying to change that, to make it available to everyone, so that you have the tools that you need based on the science of your happiness.

Eric Zimmer 00:30:08  Check in for a moment. Is your jaw tight, breath shallow? Are your shoulders creeping up? Those little signals are invitations to slow down and listen. Every Wednesday I send weekly bites of wisdom. A short email that turns the big ideas we explore here in each show. Things like mental health. Anxiety. Relationships. Purpose. Into bite sized practices you can use the same day. It’s free. It takes about a minute to read and thousands already swear by it. If you’d like extra fuel for the weekend, you also get a weekend podcast playlist. Join us at one you feed. That’s one you feed. Net newsletter and start receiving your next bite of wisdom. All right, back to the show. I love the biopsychosocial model also, because if we go back to me in dealing with recovery from substance abuse, which then, you know, sort of was co-morbid with depression and dealing with that, for me, it was it was all of those things were critical. You know, antidepressants were part of that for me.

Eric Zimmer 00:31:19  The food that I eat is part of that. For me. The exercise that I do, the people I, I talk to, the everything I used to say, like I just kind of thrown the kitchen sink at this, which is another way of saying biopsychosocial, right? It’s got to you’ve got to look at all aspects and, and but I love your way of prioritizing also of picking a place to start because that’s often the hard thing is to figure out where to start. And over time, little by little, we can start to layer more things on.

Dr. Judith Joseph 00:31:50  Absolutely. You know, the way you described your journey, it sounds like there are so many different avenues to gaining points of joy, right? Because when you get stuck and you’re like, well, this is the one thing you try medication, it doesn’t work, which is actually quite common in psychiatry, like so common. And but many people will start it and they’ll be like, oh my gosh, it didn’t work for me.

Dr. Judith Joseph 00:32:13  I feel hopeless versus all of these different avenues to joy. If I you maybe walked a block more a day, or if I changed my eating habits, ate Eat more leafy greens or more fish, or whatever it is that you choose to modify. You know, if I connect it with loved ones, if I tweak the medication, you know, all of these are different avenues to joy. But if we only think there’s one path, and that one path doesn’t work, we can feel so deflated, so hopeless. But learning that there are all these different paths to joy, I think provides so much more hope and opportunities for people.

Eric Zimmer 00:32:48  I love that idea and that hope idea because it can be really deflating. And that’s why I think when we think something is the answer, we’re setting ourselves up, right? Or more often we’re being set up by someone and we’re going to be disappointed, usually because life isn’t that easy. And for me, all of the different things, as they come together, they also amplify each other.

Eric Zimmer 00:33:15  It’s a cliche, right? But they come. They become more than just the sum of their parts for me in some way. And had I only done medicine, I would have had some help in the same way. Like some people only give up alcohol or drugs, which is a great step. I mean, if you if you just do that, that is a huge step really, really hard for most people to do. But my experience was I would have missed out on a whole lot that made life rich and rewarding by actually going into recovery. And I’d love to transition this conversation in that direction now, because you do have, the five V’s you talk about, which are ways of working with this high functioning depression. And so I’d love we’ve kind of talked about what the what the problem looks like. Now, I’d love to move towards some of what you think the solution is. And I’d like to start with the first V, which is validation. And you say that it’s in essence both the hardest and the most foundational of all of the other ones.

Eric Zimmer 00:34:17  So talk to me about what we mean by validation.

Dr. Judith Joseph 00:34:19  Validation is the hardest. And when I explain validation, I like to use this analogy of imagine you’re in a very dark room and you can’t see anything pitch black, and you hear a loud crash. Some of us would start screaming, some would start swinging, some would start running. But if you turn the light on and you saw, oh, it’s nothing. It’s just an inanimate object that fell. I’m safe. That is what validation is. It is turning the light on and understanding and acknowledging what you’re dealing with emotionally, what you’re experiencing. Good or bad, we’re not putting any judgment on it. Many of us, we don’t acknowledge how we feel. We invalidate ourselves all day long. We will work through lunch and ignore that hunger pain in our belly. We’ll go through a day and not use the bathroom and invalidate that, you know, sensation in our pelvis. It’s like you need to go to the bathroom. You know we will.

Dr. Judith Joseph 00:35:16  Not even the ability.

Eric Zimmer 00:35:17  To do that starts to cease when you get to be my age. It’s all of a sudden like you’re like, well, you know, I, I’m not sure I got a choice in the matter anymore.

Dr. Judith Joseph 00:35:26  That’s true. Our bodies will give eventually.

Eric Zimmer 00:35:28  Eventually.

Dr. Judith Joseph 00:35:29  We often we do. We often, you know, things happen to us and we just pass it off and say, well, this happens to everyone. But what is powerful in this exercise is that you’re actually saying this is happening. This is what I’m feeling. I’m going to acknowledge it. And it’s really useful, especially if you’ve been mis naming an experience your entire life. I have a lot of people who come in, especially men, and they’re like, I am so angry all the time. I’m so angry. And then we we actually unpack this anger and it’s actually anxiety. A lot of these, the men that I work with, they’re very, very nervous. They’re very, very anxious. They worry all the time.

Dr. Judith Joseph 00:36:09  But it was not a part of their culture to say that they worry. It just didn’t seem manly. It didn’t seem strong, but a lot of their anger would look like anger was actually rooted in anxiety. You know, they’d snap, they’d be irritable, they’d yell. But it wasn’t related to being internally angry. It was related to being internally anxious.

Eric Zimmer 00:36:31  They were afraid. And so that’s why.

Dr. Judith Joseph 00:36:33  They were afraid. Yes. Fear is not great for humans. Right. You know, it’s that. So we turn the light on and we name the emotion and we name what the worry is. And they’re no longer afraid. And so validation can sometimes be the hardest part. Many people don’t want to acknowledge how they feel. They’re afraid. They say, you know, Doctor Judith, if I name it, if I finally deal with what I. I’ve been avoiding, then maybe I’ll break down. Maybe I’ll. I’ll stop. But the opposite happens. It’s so freeing. Yeah. It is just.

Dr. Judith Joseph 00:37:02  It just releases so much tension. And you know how I said in in the happiness research, we add up those points. You know, one of the points of joy that we miss out on is that the point of stress. People used to think, oh, stress and anxiety. That’s one part of the brain. Depression’s the other side. We’re learning that. No, no, no, it’s not true. It’s really important to manage that stress and anxiety so you can access joy because you don’t know very I don’t know very many people who are stressed out and also joyful.

Eric Zimmer 00:37:29  It’s very hard to do.

Dr. Judith Joseph 00:37:30  Yeah. Being able to very, very difficult, very difficult when your body is revved up. So yeah, being able to name these emotions, identify them allows that calm, you know, what you’re dealing with in what you’re working with. And then you can choose the appropriate action.

Eric Zimmer 00:37:46  You talk about the cognitive triangle, which is a CBT concept that says, you know, an experience is really kind of thoughts, emotions and behaviors and thoughts are usually what we have at the top of the triangle.

Eric Zimmer 00:38:00  And I have spent a lot of time thinking about the relation between thoughts and emotions, and recognizing where cognitive approaches are really helpful, and then starting to learn where they’re not. And I love that you say we should pivot the triangle a little bit and put feelings at the top. I have realized for me that’s essential because one of my great strengths is a certain mental equanimity, a certain ability to see the whole picture or the certain, the ability to zoom out, the ability to have perspective. Right. Which is a great skill. And it can be a way of never letting myself feel anything because I talk myself out of it immediately. And so for me, it’s been useful to first go, oh, you’re feeling something? What are you feeling? Okay. Acknowledge that. Okay. It’s okay that you feel that way. And now I can think about, you know, okay, that’s being driven because I’m thinking about x, y and z and is x, y and Z actually true? Is it useful? But if I don’t flip it, as you say, I don’t allow myself ever to get too emotional because my cognitive is sort of a superpower that just takes over.

Eric Zimmer 00:39:16  But that’s not. That’s not good for an emotionally developed life.

Dr. Judith Joseph 00:39:20  It’s not an I used to be the same way, you know, before I became a psychiatrist, I was actually an anesthesiology resident. And I, you know, when people think about anesthesia, they think, oh, you’re putting someone asleep. But it is a highly traumatizing field. You know, 90% of the time it’s easy. You know, you’re just like, put intubated someone, you put the IVs in and you’re coasting, you’re just monitoring, and then you wake them up and then they go home. They never see you again. But 10% of the time you are literally saving someone’s life. And it could happen at any moment where things can go south. And so, you know, in healthcare you see a lot of death, you see a lot of pain, you see a lot of gory stuff, but you are conditioned to just focus on doing your job and showing up the next day and not complaining. And that’s just part of it.

Dr. Judith Joseph 00:40:13  You are in the trenches, similar to like military fields. You know, you just it’s part of the culture is just you see trauma all day long and that’s just part of it. That’s what you signed up for. And over time, many health care professionals, including myself, you just learn to just push it down. You don’t validate it. You don’t say, wow, that was tough seeing someone die. Oh, that was really hard. You know, doing a code and doing chest compressions like that was traumatizing. We don’t do that. You just show up the next day and you act like nothing happened. So that was my go to coping for a very long time when I was going through the pandemic. And, you know, this uncertainty of like, well, what’s going to happen to the world? What’s going to happen to my patients, what’s going to happen to my team? What’s going to happen to my family? I was just coping by like pushing it down. But it was when I started to realize that that wasn’t working and I was going through severe anhedonia.

Dr. Judith Joseph 00:41:04  I started to realize that I was avoiding my feelings. So now I regularly name my feelings. If I’m, like, feeling antsy, I’m like, well, why am I antsy? Oh, it’s because I didn’t sleep well. Why was I not sleeping well? Well, because I was worrying about this new study that I’m starting up and it’s not working the way that I want. You know, like, I’m able to actually verifies myself, whereas before I was pushing my feelings down. You know, that’s why it’s important to to name these feelings, not to avoid them and not to get so caught up in the thoughts. Right. And that CBT triangle, we scrutinize those thoughts way too much. And a lot of times we just need to start feeling our feelings.

Eric Zimmer 00:41:42  And it’s not that we just let the feelings run the show. One of the things I have thought a lot about is how this kind of, there’s this sort of an art, I think. And this gets back to knowing yourself.

Eric Zimmer 00:41:55  There’s an art I have found for, like, when when do I lean into the emotional? When do I lean into the cognitive? When do I lean into the behavioral. Right. Because one of my favorite sayings is sometimes you can’t think your way into right action. You have to act your way into right thinking, right? So when do I need to intervene behaviorally? And as you said, I think for most of us, the emotional is the piece. And one of the things I’ve started to do, because I can have a feeling and I can cognitively also be like, okay, that’s not really what’s happening here. I’ll give you a personal example. I like you about a year behind you on when my book comes out in April, but it’s about now that I start thinking about like, who’s going to help support me in launching this book? You know, of all the podcast guests I’ve had on who can I who can I talk to? Who could say like, oh, I help, or I’ll share it in my newsletter, which means you’re you’re reaching out and asking for something from all these people.

Eric Zimmer 00:42:49  And I have found it to be decidedly uncomfortable. And some of it is that I don’t like asking for help. But I think on a deeper level, what I identified is it feels a little bit like being in high school and going, well, will I get into the cool kids club? So I know that’s not what this is, right? I know that somebody’s choosing whether somebody does or doesn’t blurb my book or does or doesn’t share. It has an awful lot to do with a thousand factors, of which I am just a small part of. So I intellectually. But I’ll name that thing to my partner. I’ll say, this is what I’m feeling, even though I know the answer right. Cognitively, I want to name what I feel because that’s my history is to just ignore the feeling.

Dr. Judith Joseph 00:43:32  Yeah, it’s very powerful. Naming your feeling and acknowledging it and seeing it and turning light on it. You may still have that intense emotion, but it doesn’t linger as long as it used to, and it doesn’t interfere with everything else as much as it used to be.

Dr. Judith Joseph 00:43:50  Because you know what it is. Yeah, and it’s a way of not invalidating it, but living with it, living alongside it, letting it write itself out versus trying to push it down. And and that leads us into the next venting because people come into my lab. I’ll. I’ll have them take turns with this red balloon, and we’ll. They’ll try and dunk it into this tank of water. And 100% of the time, that balloon will pop right up. Right. Because you can’t out math the numbers. Can’t out math physics. But then when we take turns and we start to deflate that balloon, we can push that balloon so easily down into that tank of water. And for me, being able to say out loud, I’m anxious about this thing, it like, it just feels so much better. Like it just it’s almost it’s like that deflating that balloon and naming the feelings and acknowledging it and expressing it has been extremely powerful. And you know, when you vent and you express your emotions, you want to be intentional about who you’re venting to unless it’s your therapist.

Dr. Judith Joseph 00:45:01  Because with therapists you can vent. You’re paying them for that. That’s what they’re there for. If it is a family member, if it’s a partner, you want to be very careful. You want to vent with empathy. You want to say, is this a good time? Can I? Can I talk to you now? And you want to have an intention. You don’t want to just vent just to get it out. The intention should be either a resolution or something that you’ve thought through. And if you don’t have someone to talk to him, not everyone does. You can vent using a pen and paper. You can write in a journal. Journaling has been very effective for many of my clients. for for some of my faith based clients, prayer has been very powerful for them. You know, they talk to whoever they believe in about their emotions. They feel better. For my artist clients, singing, dancing, expressing it that way for my pediatric patients, they cry and I say, it’s okay to cry.

Dr. Judith Joseph 00:45:49  You know, a lot of the parents say, you know, my kid cry so much and I’m like, try this to tell your child when they’re crying, it’s okay to cry. You know, sometimes you feel sad and you cry. They stop crying. What do you tell a kid?

Speaker 4 00:46:03  100%.

Dr. Judith Joseph 00:46:04  They cry more.

Eric Zimmer 00:46:05  100%. That has been my experience. It was completely my experience raising my son when I was like, oh, you’re really sad. It’s okay that you’re sad. He would kind of go through it. It’d be a minute or two, and then he, you know, he’d be like, oh, look at that balloon over there and run off and start playing. But if I was trying to get him not to feel it, it just kept it was it became an episode. You know, it’s so funny the way that is. I used to have this thing written on my, you know, some of us stick things on our walls that we really need to remember.

Eric Zimmer 00:46:34  And mine said it helps to talk to people even when you know the answer. And what I meant by that was, I’ve done 800 of these podcasts. I’ve been in recovery for 30 plus years. I’ve I mean, I’ve read a thousand books on this stuff, right? Like, I generally know the answer, but that’s not what talking to somebody else is about. I mean, it can be about that person bringing perspective, but it’s often about talking about it. And I had to kind of remind myself that even when I was like, well, I know what I should do, I should do x, y, and Z. Okay, I’ll go do that. I had to remind myself. Talking helps even when. But I want to ask you a question about this. You’ve got a sentence that I loved, which is we should think of venting as complaining. Savvy older sister. And you talked about having an intention there. And I want to talk about how does venting become useful and not a case where I tell you how bad my life is.

Eric Zimmer 00:47:32  And you, you agree with me how bad my life is. And then I tell you, tell me how bad your life is, and I agree. You imagine two people complaining about their boss, right? And they just keep ample. It just amplifies, right? So how do we keep venting from becoming that?

Speaker 4 00:47:46  Well, what you describe.

Dr. Judith Joseph 00:47:47  That amplification was actually recently published in a study where they found that, when you vent in that manner, like it is like pouring gas onto a fire, you don’t feel better, you feel worse. Yeah. And so with with my clients, I suggest they start self eventing first. So first you start, you know, and even talking to yourself. People who talk to themselves out loud. It may look weird, but it works. It’s like they are trying to get through these emotions on their own. So what’s happening is that you’re actually de-escalating. You know, you may feel your emotions at 100%, and we don’t want to change your emotion.

Dr. Judith Joseph 00:48:27  We want you to validate it. But as you go through this process of self venting, maybe writing or talking to yourself, you actually start to get some more clarity. You start to understand what it is that you want and what’s the best way to go about doing that. And as you start to talk to yourself and your self venting and then you say, okay, now I want to talk to someone else, I’m going to check in with them. I’m going to be empathic. So that’s, you know, using that emotional consent, you know, is it okay to talk now and then that empathy. Right. Because you don’t want to just go and tromp it up on someone and they’re not ready to hear it. Maybe they have their own problems going on. Right. And you want to have a clear idea as to what you want. What is the outcome. Do you want to resolve this issue? You want to, you know, have more clarity. So when you go about venting that way, you’re going to feel better.

Dr. Judith Joseph 00:49:12  But if you go about venting in a way that you’re not even thinking about the person you’re talking to, maybe you’re talking to someone who’s in a position of power below you, like your child, who’s not going to say no. They’re going to listen because they want to feel attached to you, but they’re going to worry about you, or like to an employee who’s going to be like, well, I have to listen to the boss. And then they go home and they trauma up on their family. You know, you really want to be intentional about how you vent so that you actually have a resolution.

Eric Zimmer 00:49:38  I love the nuance in that. I’ve kind of commented on that a couple times in what I’ve seen in your work, because it’s not like venting is all good, and it’s not like you should keep everything to yourself. It’s like there’s a way to do this that’s more skillful.

Dr. Judith Joseph 00:49:53  Yes.

Eric Zimmer 00:49:54  So we’re not going to have time to go through the other three V’s, which are values, vitals and vision.

Eric Zimmer 00:50:00  But in the conclusion, you kind of walk through yourself practicing these five V’s in in a situation. I’m wondering if you could just maybe walk us through you using these in a real situation in your life.

Dr. Judith Joseph 00:50:13  Yeah. So the third V we’re landing right now was really important for me, the values. Because on the outside I got so much admiration for like being on these prestigious boards, having this research lab, everything looks so great. And again, I was experiencing anhedonia. And so I had to really go back into my past and be the archaeologist and dig up, like, where did I go wrong here? You know, I was chasing the values that the world says are important. The things with the price tags, you know, had the family, had the house, had the job, had the accolades, but feeling empty. And when I started to really look at my past and where I found meaning and purpose, you know, the things that have that don’t have price tags and things that are priceless.

Dr. Judith Joseph 00:51:04  That’s where I started to reclaim my joy. And growing up, I had very little. I came to this country from the Caribbean with very little resources, but we always, always helped out other people. You know, it wasn’t like, oh, like we don’t have much, so let’s just hoard our resources for ourselves. It was how do we help others? And that’s how my family found joy as a collective. My dad is a pastor. My mom’s very active in the church. And every weekend we would spend, giving back to the community. Either it was the YMCA or a dementia unit, you know, helping others to have some hope. And, you know, for me, getting the accolades, having the degrees, having the lab, I just I wasn’t helping others, like, I was helping people in the traditional sense of like, you’re a doctor, you help others. But there was no community outreach in the sense of, let’s just do something for the greater good. So when I started to tap back into that, you know, bringing youth into my lab to learn about Stem, creating content to educate others, just for, you know, the purpose of helping people to understand mental health.

Dr. Judith Joseph 00:52:14  I experienced this abundance of joy. And that’s for me is is what I value is connecting with people and and helping communities. But for others, it could be something else. You know, I write about in my book how clients forgot that they actually loved nature, and they were living in a big city and everything looked so successful, but they forgot that that’s what helped them to feel rooted and grounded. So we had to work together to get them back into a lifestyle where they were accessing nature. You know, so if anyone’s listening to this and they’re just like, I don’t know what I value anymore. Like, look, in your past, you know, go back to old pictures. What lit you up, you know? Was it tinkering? You know. Did you used to use your hand a lot and you don’t use your hands anymore. You’re in front of screens. Try and tap back into that, because there may be these pockets of joy that you’ve forgotten, because you’ve gotten so busy in life and things have changed around you.

Dr. Judith Joseph 00:53:10  And see if you can tap back into those aspects of your life.

Eric Zimmer 00:53:14  Before you check out, pick one insight from today and ask, how will I practice this before bedtime? Need help turning ideas into action? My free weekly Bites of Wisdom email lands every Wednesday with simple practices, reflection and links to former guests who can guide you even on the tough stuff like anxiety, purpose and habit change. Feed your good wolf at one you feed. Net newsletter again one you feed net newsletter excellent and so do you want to give me an example of applying a couple of the other V’s in your own life?

Dr. Judith Joseph 00:53:51  The fourth V is vitals. Vitals are anything that supports your body and brain. Because you only get one, you’re only going to get one body and brain in this life. And the traditional vital signs are things like, you know, getting movement, eating foods that are nutritious and fortifying for your brain and body, things like getting adequate sleep. But there are these non-traditional vital signs that I also highlight in my work.

Dr. Judith Joseph 00:54:20  One of those is our relationship with technology. You know, we we use so much technology these days. We’re on screens all the time. And I recently gave a talk about something called the auto phenomenon, where we’re looking at our faces too often and we’re instead of instead of, you know, looking at others and figuring out, is this person attaching to me? Are they, you know, are they a threat? Am I connecting with them? We’re looking at ourselves. We’re looking at our faces when we’re on these zoom calls all day long, when we’re on these, you know, face times, when we’re on our social media, we’re looking at ourselves too much. So what ends up happening is we’re not connecting with others and we’re scrutinizing ourselves. We’re judging ourselves. It’s creating a lack of confidence. It’s creating a lot of anxiety. And the autistic phenomenon is something we see in mental health, usually with people who have a psychotic illness or psychotic condition, like schizophrenia or bipolar disorder with psychosis.

Dr. Judith Joseph 00:55:17  Or it’s when they see themselves outside of their body, so they literally see themselves walking into a room, and it creates a lot of anxiety for them. Stress. We’re doing that to ourselves willingly by looking at ourselves all day long. So I really try to get my clients to develop boundaries with technology so that they are not living their lives on screens. And there was a recent study out of one of the University of Texas schools where they took adults, and they removed the smartphone capacity from their phones. And instead of being able to get online and be seamless, and, and access to, to socials all the time, they could just use their phones for communicating with text or phone calls. And what they found was that being away from that smartphone capacity for two weeks, they actually appeared to become less depressed. Right. The the amount of points that increase over two weeks. And these were not people who were depressed to begin with, but it looked as if they were being treated with an antidepressant.

Dr. Judith Joseph 00:56:13  So it’s just interesting because what they found was that these people were sleeping better. They were connecting more with others. They were in nature more. You know all those points that I said we add up in in the research, they were getting more of those points just by not being on their screen. So that relationship with technology is so crucial to examine our personal lives. And then another non-traditional vital sign that we’re learning is really important these days is our connections with others. So, you know, being in healthy relationships and not being paired and partnered and around people who literally drain us of our life force, that’s an area we need to work on. And you may not be able to just up and leave, right. But you can set boundaries so that you’re protecting your peace a bit more. And then the fifth vital, the fifth V is a vision. How do you celebrate your wins?

Speaker 5 00:57:07  I love this.

Dr. Judith Joseph 00:57:07  How do you plan joy in the future? Yes. As someone who used to, like, only celebrate the accolades.

Dr. Judith Joseph 00:57:14  Now I celebrate the small things. If I get my kid to school on time every day. I, like, give myself a pat on the back and I’m like, I’m going to sit in my living room and I’m going to enjoy my Caribbean coffee because I have this really delicious coffee from I got from Saint Martin that I love. And I’m just going to celebrate that one. And I’m going to plan joy in our lab whenever we finish a training. We celebrate it. You know, whenever there’s a birthday, we celebrate it. We acknowledge the small things. And it’s not just the big things. That is very powerful because it keeps us hopeful. It keeps us moving forward, and it keeps us from getting stuck in the past. So the wins. I think many of us don’t celebrate our wins enough, and it doesn’t have to be grand. It could be small, but it’s another point of joy that we tend to overlook.

Eric Zimmer 00:58:01  Wonderful. Well, we are out of time, but thank you so much for coming on.

Eric Zimmer 00:58:05  I enjoyed reading the book and I’ve really enjoyed this conversation, so thank you so much.

Dr. Judith Joseph 00:58:09  Thank you so much and I look forward to reading your book as well. Congratulations. Celebrate that one. It’s a big deal.

Eric Zimmer 00:58:16  Indeed indeed. Thank you so much for listening to the show. If you found this conversation helpful, inspiring, or thought provoking, I’d love for you to share it with a friend. Sharing from one person to another is the lifeblood of what we do. We don’t have a big budget, and I’m certainly not a celebrity. But we have something even better. And that’s you just hit the share button on your podcast app, or send a quick text with the episode link to someone who might enjoy it. Your support means the world, and together we can spread wisdom. One episode at a time. Thank you for being part of the one You Feed community.

Episode Transcript:

00:00:00 – Sarah Fay
There’s a part of mental health diagnoses that is really no different than horoscopes, right? They’re just introvert, extrovert, personality tests, same kind of thing. That’s how they’re being embraced today, right now. But the stakes are so high with psychiatric diagnoses.

00:00:22 – Chris Forbes
Welcome to the one you feed. Throughout time, great thinkers have recognized the importance of the thoughts. We have quotes like garbage in, garbage out, or you are what you think ring true. And yet, for many of us, our thoughts don’t strengthen or empower us. We tend toward negativity, self pity, jealousy, or fear. We see what we don’t have instead of what we do. We think things that hold us back and dampen our spirit. But it’s not just about thinking. Our actions matter. It takes conscious, consistent, and creative effort to make a life worth living. This podcast is about how other people keep themselves moving in the right direction. Direction how they feed their good. Wolf, thanks for joining us. Back on the show is Sarah Fay, an award winning author, educator, activist, and entrepreneur. Her work focuses on mental health advocacy and questioning society’s happiness formula and how to create your own. Her debut memoir was the true story of six misdiagnoses. Today, Sarah and Eric discussed the highly anticipated sequel called cured, which is a best selling featured publication on Substack.

00:01:47 – Eric Zimmer
Hi, Sarah. Welcome to the show.

00:01:48 – Sarah Fay
Thank you so much. I’m so happy to be here again. I feel very honored to be a double guest. It’s wonderful.

00:01:55 – Eric Zimmer
Yeah, I’m really happy to get to talk to you again. I think our first conversation was really about two years ago, around that timeframe, and it was around your book that was called pathological, and it was about the six diagnoses you had been given, you know, psychiatrically and where that is. And what we’re going to talk about today, mainly, is a new book you’ve written, although it’s not quite in a book form at the moment, but it’s been serialized on Substack, which is called cured. But before we get into any of that, we’ll start, like we always do, with a parable. In the parable, there’s a grandparent who’s talking with her grandchild, and they say in life there are two wolves inside of us that are always at battle. One is a good wolf, which represents things like kindness and bravery and love, and the other is a bad wolf, which represents things like greed and hatred and fear, and the grandchild stops. They think about it for a second, they look up at their grandparent and they say, well, which one wins? And the grandparent says, the one you feed. So I’d like to start off by asking you what that parable means to you in your life and in the work that you do.

00:03:02 – Sarah Fay
I love this parable, and I’ve been thinking so much about it for the last couple of days because it was a spoiler. I already knew you were going to ask me, and so. But really, I never could have predicted when we talked the last time, because we talked right before pathological came out, I never could have predicted what was going to happen with psychiatric diagnoses in the last two years. And so what I mean by that is, to me, the good wolf is when diagnoses are used by trained professionals to get people in emotional and mental distress help. And the bad wolf is when diagnoses are used by the public who don’t have that training, often by teenagers and even children diagnosing themselves on social media like they’re doing right now. And social media influencers with no training spreading misinformation. So you’ve got, you know, the good wolf is kind of diagnoses being used in the right way, even though they’re flawed. And then the bad wolf is diagnoses being used by the public who really don’t know enough about them. And I wrote pathological to prevent that. But now what we’ve seen is that we’ve been feeding the bad wolf, and that has really created a new kind of crisis. Instead of feeding the good wolf, which it was meant to do, right, mental health awareness was meant to do that. And instead, basically, you’ve got people who really don’t understand the diagnoses, which is why I wrote pathological about the DSM, to educate people, especially parents. And just over the last two years, I’ve seen how young people on TikTok and Instagram are really diagnosing themselves. There’s this idea that you can be undiagnosed, autistic or borderline personality disorder or whatever it is, and then the statistics of how damaging that can be. And it really has saddened me in some ways. But I wrote cured, hopefully, as a remedy to that or an alternative to that.

00:05:00 – Eric Zimmer
It is sort of fascinating. I’m not really on social media, so I’m talking secondhand here, broadly. But you quote a study that found that 83% of the mental health advice on TikTok is misleading. And we’re not talking about, like, a few people are seeing this. It is huge on TikTok. I can’t remember the impression numbers I was seeing, but they were huge numbers.

00:05:22 – Sarah Fay
24 million people.

00:05:24 – Eric Zimmer
Yeah, yeah, yeah. I mean, that’s a lot of people. And so diagnosing ourselves is a risky sort of thing. And I think the other thing that’s just fascinating to me is that people seem to almost want these diagnoses. And I understand that on some level, because if you’re suffering for me at least, and I think I’ve heard enough people report this initially, some sort of diagnosis feels good. Like, if I’ve got some unknown pain and I don’t know what’s going on, and I go to the doctor and they’re like, oh, you’ve got a strained right quadricep. I’m like, oh, great, okay, we know what this is, and ideally we’re going to be able to do something about it. So these diagnoses, I get why they can be helpful, but it’s so strange for them to be almost a status symbol in some ways. And I agree with you that I think our desire to make mental health awareness go up is backfiring in some ways.

00:06:19 – Sarah Fay
It really has, and in the scariest, scariest way. And this was true of me in pathological. I really show my trajectory from being someone who. I got six different diagnoses. I took each one on as a label and they became self fulfilling prophecies. And I should say mental illness is very real. I had a severe mental illness for 25 years. I know what it’s like. There was something wrong. So I’m not doubting that these young people or whoever aren’t in mental and emotional pain and some of them may have serious mental illness. So I’m not at all saying that. It’s just that when you don’t understand, and this was true for me, that DSM diagnoses, they’re subjective, they have racial and gender biases, they’re scientifically invalid. There’s no test we can use to prove them they’re unreliable. So two mental health professionals can see the same person at the same time and give them two different diagnoses, and then there’s all this influence with big pharma in their creation. So what the DSM is, it’d be very different if the public was educated on that and parents knew and everyone knew and was very aware and we had all the information. Christina. Karen at the New York Times did a wonderful piece about how people are now going into therapist’s office and psychiatrist’s office and demanding diagnoses, like saying, I know I have this. And so really almost putting the professional out of the equation in many ways. So there’s nothing wrong with even identifying and labeling yourself if it brings you some relief. But in some ways, there’s a part of mental health diagnoses that is really no different than horoscopes. Right. They’re just introvert, extrovert, personality tests, same kind of thing. That’s how they’re being embraced today right now. But the stakes are so high with psychiatric diagnoses.

00:08:03 – Eric Zimmer
Right.

00:08:04 – Sarah Fay
You know, they can be, you know, in terms of looking at it as a medical disease, as something that I need a medication for, or I’m gonna limit my life by. And medications can be so helpful and so not helpful. So. And I’m not laughing at that, but in many ways, they were a godsend for me, and they have been very, very unhelpful, both for me and others. So that’s not to discount medication. But again, that study was unbelievable. So 83% of people on social media giving advice, particularly TikTok, in this study, 91% had no mental health training. 14% of the videos were potentially damaging content. And then what was so fascinating to me, because it feels like everyone is saying they have ADHD, is 100% of the videos in their study on ADHD were misleading. I mean, that’s just what. What are we doing? And then the algorithm puts you in a silo of misinformation, and so it just gets reinforced. But going back to what you were saying about some of them are cool. There are cool diagnoses, and then there are uncool diagnoses. And there was a study on stigma and mental health awareness, and what they found was the stigma for certain diagnoses, anxiety, depression, ADHD, and in some ways, very high functioning autism. If you are one of these exceptional people, the stigma for those went down. If you’re calling yourself neurodivergent. So these are not like the people with autism and the young people that I worked with in the New York City public schools who are non verbal, who are extremely low functioning. That is in the uncool category. So also anything with psychosis, the stigma against those has gone way up, which is really fascinating. So we’re just in a very weird, scary position. I interviewed Martin Rafferty, who’s with youth era, which is an exceptional organization in Oregon where they really help youth. And he said something really, really scary to me, which is I asked him about recovery, because if you are over identifying with these diagnoses in a mental health system that does not mention recovery, you are just given the diagnosis and sent on your way. Like, there is no such thing as recovery. In 25 years, I never heard the word recovery. But he said that young people who he works with and he’s very tapped into, they have disavowed recovery. They don’t even want to recover. So they really do embrace their diagnoses. They refuse it, and they want the negative symptoms, they want the positive symptoms. And some of that can be good because being a human means that, you know, there’s mental and emotional suffering. We don’t get to escape that, but they’re pathologizing it, and that can be very damaging.

00:10:47 – Eric Zimmer
You and I talked about, and I’ve talked about with lots of people on this show, this idea of diagnoses and labels and all of that, and I think they are useful until they’re not. And that’s my framework for so many things, is like, is this useful? And I think that’s the lens to look through these things because to your point, the DSM is the diagnostic statistical manual. It’s the way that psychiatrists and psychologists look at and say, oh, you know, you have these symptoms. That means you have this thing, or you have these symptoms for three months, then you have this thing, right? That’s for people who are wondering what DSM. That’s what it is. It’s the guidebook. And the point that you made, which is good, is that it’s a highly unreliable guide. Meaning, like you said, there’s no scientific validity to it. There’s no, like, I can give you a test and find out that you’re bipolar, too. And so I could describe my symptoms and you said this to one psychologist, and they could be like, you have bipolar, and I could describe it to another psychologist who could be like, you have depression, and another one who might say, you have ADHD. Right? And according to the DSM, they would all sort of be correct in their own way because these symptoms, they just cross over in so many different ways. And so taking on these labels or diagnoses, getting back to where I started, can be helpful, like I said, until they’re not, because you’re taking on an identity that in some ways doesn’t even really exist. We don’t know what mental illness is at this point. I mean, it’s sort of frightening to say, but we just don’t. We don’t understand the cluster of symptoms that seem to show up. The models that make the most sense to me are sort of the biopsychosocial models, which are saying, like, this is some combination of biology, psychology and culture. And the people you’re around. I think that’s the best model for addiction, too, which is the thing I’m most familiar with. And so we don’t know what it is. And what you’re doing so well, you did in Pathological, and you’re doing here is trying, I think, to get us to loosen our grip on believing things about ourselves that may or may not be true and being open to the fact that this is more fluid than we think it is. And the important thing that you’re talking about is this idea of recovery.

00:13:15 – Sarah Fay
Yeah.

00:13:15 – Eric Zimmer
Say more about recovery from mental illness.

00:13:19 – Sarah Fay
I just wanted to stop. I realized I just launched into the DSM. So maybe I’ll define the DSM. Okay. So that we can put that back in. So I don’t just launch into this. But the DSM is the Diagnostic and Statistical Manual of Mental Disorders. It started in 1952, and it was started by a small group of psychiatrists who at the time, unsurprisingly, were white, heterosexual men. And they came up with about. Close to about 90 diagnoses. And it was a way to try to order and categorize and take mental and emotional pain and give, essentially, a language for doctors to talk to other doctors about patients. It was never meant to be in the hands of patients, ever. So until the 1980s, patients never knew their diagnoses. You just got therapy. You never needed to know it. And then in 1980, they did a revision of the DSM that was really monumental, and it created a checklist of symptoms for diagnoses. And so basically, you could go through and say, yes, insomnia, yes, anhedonia, which is a loss of interest in things. Yes, eating too much. But note, these are symptoms of depression in the DSM. But note that it’s also sleeping too much, sleeping too little. It’s eating too much, eating too little. And you’re like, well, I’m gonna fit one of those.

00:14:41 – Eric Zimmer
Yeah, exactly.

00:14:42 – Sarah Fay
Yeah. They turned it into a checklist, and they, you know, kind of the criticism was it’s this restaurant menu of diagnoses, and that it was very reductive and it wasn’t helpful. This was from mental health professionals. Now, the twists that happened in this sort of plot of how diagnoses have come into the culture is that the DSM became a bestseller. It went on the bestseller list, and it became the American Psychiatric Association’s primary income stream. I mean, that’s just phenomenal. Besides big pharma. So suddenly it was in the hands of all kinds of people. So it got into the public, and then more and more and more. And they expanded the diagnostic criteria and added diagnoses so that we now have over 300 different psychiatric diagnoses. So it’s very hard not to find yourself in the DSM. I mean, we all have been there, and especially when we’re not well. And again, it’s very different when you’re dysfunctional. I was to the point that I could no longer live independently. They were basically telling me that I would most likely die by suicide and I would never hold a full time job, etcetera. So I was really given this very, very dismal prognosis. So that’s the DSM.  

In terms of recovery, recovery is another well kept secret, for some reason, in the mental health field. Part of that is because there is no recovery in the DSM. There’s no page on recovery. I think it’s mentioned once. And so, really, we have mental health professionals right now who have no training in recovery. That’s phenomenal. Can you imagine if all of our doctors knew nothing of recovery from broken bones and Afib and stroke or whatever? I mean, that’s what we’re living in right now. And so if you went into a doctor’s office and he told you you have Afib, see you. Like, have a good day, you know, here’s some medication. You will never recover. And, you know, Afib is hard. You know, there are certainly physical diagnoses that we don’t recover from, and not everyone will recover from mental illness. But my feeling was that I was not given the chance, and everyone should be given the chance. I had a psychiatrist who also really alerted me to the DSM and the realities of the diagnoses that we receive. And he’s wonderful. He’s a serious biopsychiatrist. I mean, he believes in psychiatry wholeheartedly. He’s not even a critic of it. But he was very honest with me, and he said, you know, these are flawed. These are just really flawed diagnoses. And that really opened my mind, and that’s why I wrote pathological, to bring that information to other people. And then he also told me a story, and we were talking about something. It was apropos of nothing. And he told me about a patient of his who had schizoaffective disorder. So that is a combination of schizophrenia with bipolar features. And so it’s a very, very grave prognosis. And really, I mean, the idea that you could recover is just not there. He never mentioned the word recovery, but he said she came from a wealthy family, and he treated her so they had everything at their disposal. That’s important because recovery, we don’t have a mental health system that supports it either. They had everything at their disposal and he said that he treated her and he wasn’t boasting in this way, but they worked together off all medications and became an executive at Google. And I was like, what? First of all, you don’t recover from mental illness. And two, you do not become an executive at Google. Now, I do not want to be an executive at Google, but it seemed to, like, embody health and productivity and wellness and all this kind of for better or worse, like, it seemed like, oh, that’s it. And I couldn’t believe someone had healed.

00:18:24 – Eric Zimmer
Yeah, I think it’s interesting, this idea of recovery, because, I mean, I was in recovery from addiction. I mean, that’s what we call it when you go to a meeting. I was in twelve steps, we call it recovery. And the idea is there is recovery. So it’s interesting, when I got my first sort of psychiatric diagnosis of depression, I think that I didn’t take it on in the way that you did because everything in my mind was in the context of recovery. I also had hepatitis C from my needle use and was treated for that. And I was one of the lucky few back then. It’s a lot more common now where it kind of just went away. So it was this weird sort of thing because the doctors didn’t know what to call it, because if you test me, you’ll detect that there is some degree of viral load of that. But it is so low that it hasn’t done anything and infected my liver in all these years. And so I’ve never known what to call it. Do I call myself cured? I’m not. I mean, kind of. It’s interesting to me that my view into mental illness was always one of that. There’s some ability to get better. I don’t know how much better. But it’s interesting to me that you took them on and the way they were presented to you as basically life sentences and very predictive of your future capability and capacity.

00:19:49 – Sarah Fay
Yes. And I did what a lot of young people are doing. I made it my identity then you are locked into it. You can’t recover. You don’t want to recover. It’s your identity. And if someone had told me what I’m talking about right now, and I’ve spoken to so many young people who are very resistant to this, I tell them I would have been too. It was my identity I didn’t want to lose that? Who wants to do that? But your analogy with hepatitis C, that is it. Because we’re never going to be without depression. We’re never going to be without anxiety. Psychosis is probably the most extreme example of a symptom that not everyone experiences. But distraction, irritability, insomnia, sleeping too much, eating too much, all of these symptoms are part of the human experience. So I think what you said is sometimes there’s a viral load there. It will always be present, but do we have it anymore? And people say to me, do you still have a diagnosis? And my psychiatrist did give me one. He had never told me. When I first went to see him, he said to me, I don’t know what you have. And that’s what kind of changed my whole view of diagnoses. And then after, when we were on the road to recovery, he’s since declared me cured. But here’s the confusing part. I am still on medication. I’ve been on it for ten years. It’s going to take me about ten years to go off of it safely. And so he and I are really working toward that, and it’s very hard to go off these medications. So anyone listening to this, please do not do it without medical supervision. I tell you, I’m on the ten year plan, and that’s okay with me. But so, wait, I’m taking a medication. Doesn’t that mean I’m still sick? And so, on his records, I still have a diagnosis, because that’s how you get medication. So it is very confusing. But I know for myself, well, first of all, I’m thriving in my life, and that is part of it. But I have terrible anxiety. I mean, just crippling my neck right now. So terrible because of things going on in my life. And that’s okay. It’s very different than it being a pathological condition. And I see the difference. I know the difference.

00:21:56 – Eric Zimmer
Yeah. I have not known for several years now how to talk about depression in myself. I don’t know what to say. I don’t know whether to say I still have it. I don’t have it. I’m prone to low moods. I’m prone to anhedonia, but not to the degree I used to be. And what’s a normal amount and what’s in the amount? That’s just my temperament, my personality, my makeup. And so I don’t know what to say about it. Like, I literally get sort of like, uh. I don’t know. I battled with, I struggled with. I had. I have. I don’t know what to say about that, because exactly to your point, with alcohol and drugs, I don’t really use the word recovered. We’ll get into that in a second. But it’s pretty easy for me to say I’m in recovery very heavily because it’s just gone. I just don’t do those things. And I haven’t for 15 years this time. These other things, as you said, are a lot harder because we all have anxiety at times, we all have low moods at times. We all have a feeling of disconnection at times. And so what degree of it becomes a diagnosis of something you have? And obviously there’s no right answer. And I think we’ve learned the same thing with alcoholism and addiction. They give you some strange twelve question test, and if you answered seven of them, you were an alcoholic. And now we know, like, it’s a lot more nuanced than that, right. All this stuff is on a spectrum. And so we talk about alcohol use disorder, and they’ll plot you somewhere on this line right between no problem to serious alcohol. I don’t know the exact terms, but we don’t talk about psychiatric diagnoses in that way, that you’re on some sort of spectrum. Right. It’s this idea that you cross this line and now you have this thing. Ellen Langer, who’s a professor at, I believe, Harvard, and she wrote a lot about mindfulness, but she also has written very compellingly about something she calls, I think she called them border conditions. And what she was talking about was there’s been a number of studies done. Let’s take somebody who is right on the line of diabetes or non diabetes. If you’re at a blood sugar of x, you are non diabetic, and a blood sugar of x plus one, you are diabetic. And this is a test where they’re actually measuring something, unlike psychiatric diagnosis, which are even farther off. But statistically, there’s no big difference in one point of blood sugar. But what she has found and others have found is that it makes a tremendous difference in the outcomes of those people. And you might think that getting the diabetes diagnosis is positive because now you get treated for it, but they find almost exactly the opposite. They find that the minute you are now in that category, you are treated differently and you do things differently. And they’ve seen the same thing in like children with, like IQ. Like if you’re like one point above, you’re in normal classes, and if you’re one point below, you’re in special ed classes and your outcomes are dramatically different. And it’s not because you had a one point difference. It’s because of what happened after that and what you internalized about yourself. And so even in these things, where we’re measuring something a little bit more than we are in psychiatric diagnoses, this labeling has profound implications.

00:25:25 – Sarah Fay
What you just said is so resonant and so important, and that’s what I found in my life, is that even if I hadn’t thought it was, you know, a death sentence, it still limited me so much, and it definitely dictated my path, no question. Now that I’ve recovered, there is a lot of regret. You know, I feel like I lost 25 years of my life to the DSM in some ways. And, you know, that’s not fair to put on a book, but it really does. It does feel that way sometimes. I think, what would I have done? Where would I be right now if I hadn’t been pigeonholed or said, you know, sort of slap with this label and thought that I was limited in any way. But it’s interesting. What you’re talking about, too, is, what is the measurement, and how do we do that? And I write about this in Cured. I didn’t want to tell anyone. And actually, the first time I was on with you, I thought, wait, I think I’m better. I thought, I think I’m really better. And I didn’t want to say anything. In our first interview, I didn’t feel like I could tell anyone. It was like a big secret, because I thought someone would say, one, no, you haven’t, and you can’t. And two, I just thought it wasn’t possible. I had not heard of the recovery movement. I had no idea that people had been recovering from mental illness since the 16th century and that this was a thing and that there were all these people out there advocating for it. I just had never come across it. And so I’d not told my psychiatrist at that time. But I went to lunch with my father, and I decided, okay, I’m gonna take a chance. And I said, dad, you know, I think I’m better. I think I’m well. And he looked at me and he said, I know you are. I know you are. And it was like, I get chills. Cause it was the best day of my life, and especially cause I’d had such a fraught relationship with my father. And now we are very close and just feeling like, oh, wait, he sees it. And we’ve talked about, and he said, I’ve never seen anything so complete. I’ve never seen such a complete, massive change. And so much of it came from believing I could. I mean, that’s it. So much of it was that. I mean, there were a lot of other things, and I really detailed them and cured. Learning how to manage my mind, learning my emotions. I had a panic attack last night. I knew now, okay, there isn’t something pathologically wrong with me. You’re having a panic attack. And sometimes we can’t do that for ourselves. But I really have learned to talk to myself. And then, of course, diet. I have a very extreme diet, and I don’t eat any sugar. I don’t eat any white flour. There are things I had to do, and these are things that we have seen really help. I drink no caffeine. I don’t drink alcohol. I obviously take no drugs besides psychiatric drugs. And, you know, I have two cats that I give my life to, so we know that’s very healthy. I go to bed at the same time, I wake up at the same time. There’s just a lot there that goes into recovery, that a lot of people are in a place where that would be very, very difficult. And then just going to. The term recovery is so interesting. So for cured, because I serialized it on a platform called Substack. So Substack is essentially, we could call it. It’s my own personal media magazine. So it is a newsletter. If you sign up for it, you will receive emails from me. But it’s also a blog. So basically, it is on the Internet, and you can go on there, and it would be like visiting a website. And so what I did was part of my dissertation. So I do have a PhD in literature, and part of my dissertation was on serialization in the 19th century. And I love it. It’s just so amazing. So all of Dickens’s novels came to people chapter by chapter. It was portioned out. We didn’t have single volume novels at that time, so in the 19th century. And so that was how storytelling really came to be. It was not.  here’s a book. So you can imagine television pre netflix versus television. Now, you couldn’t binge on a novel. And I’ve always loved that form. And so, I mean, Agatha Christie serialized, and F. Scott Fitzgerald. So it did move into the 20th century. And so I decided we went to my publisher with Cured, which was the sequel to Pathological. They had optioned my second book, and they passed. And part of the reason that they passed was that it’s not the book. And they said that it’s just that pathological came out at a time when, again, people just wanted their diagnoses. They didn’t want to be questioned, they didn’t want to be educated. And that has shifted so much. And there’s so much publicity now happening about the need for not getting rid of diagnoses. I, in no way, I don’t have a system to replace it, so I can’t do that. But it is about knowing the truth and empowering patients and empowering parents to know, okay, this is what this diagnosis is. It’s useful here. It’s not useful to this degree. And maybe I can help my child understand that and myself. So we went to them, but I spoke with my editor and my agent and they said, why don’t you serialize it on Substack and why don’t you bring it to people? Partly because I really wanted to enact social change. And my agent said the most phenomenal thing to me. She said, Sarah, books don’t incite change. They reflect on change, they reflect on social movement. And that may or may not be true across the board, but I think generally she’s right.

00:30:42 – Eric Zimmer
That’s an interesting idea. Yeah.

00:30:43 – Sarah Fay
Yeah. By bringing it to people and then I was able to record it. So there’s an audiobook. But what I was able to do as part of that, it’s this living thing on Substack. So I was able to interview other people who’ve recovered, so it isn’t just me to kind of give evidence of that. And their stories and their trajectory is so different from mine.

00:31:03 – Eric Zimmer
Right.

00:31:03 – Sarah Fay
Some of them still embrace a diagnosis, some of them don’t. Some of them, you know, are transgender and had addiction issues. And so there’s so many different dimensions to this. And then I was also able to interview so many people in the mental health field, those who do agree that recovery is possible and those who don’t. And that was also really phenomenal. So it became this other thing. I was able to interview Larry Davidson, who runs SAmHSA’s office of recovery. We do have an office, my friends. So there is an office in the us government that we have for recovery. So the US government has acknowledged it. It was early two thousands that they first acknowledged that mental health recovery was possible. And so the government has been trying to bring it to people for two decades, but because of big pharma, because of other things, it just has not gone. And because of people wanting their diagnoses, not listening to this idea of recovery, it’s just not gotten into the media mainstream. So it hasn’t reached people. Larry Davidson, who also is at Yale, which has an amazing center for recovery, mental health recovery, and they’re doing really the preeminent research on it. But what he said to me was recovery. The name of it is problematic because it is so associated with addiction and so it just was used and they haven’t come up with another one. And I use the term cured ironically, right. There isn’t a cure, right single, there’s no magic bullet. But can we cure? The verb? Can it be an ongoing process in our lives of living more well, whatever that means to that person?

00:32:56 – Eric Zimmer
Let’s talk about this idea. Recovery is the word that’s being used, so let’s stick with it for now. What is recovery from mental illness?

00:33:05 – Sarah Fay
So I asked my psychiatrist this when he declared me well, and for him he said it was that you have not had an episode in a year, so you have not had some sort of crisis in one year. Now that was him. So there is no overall definition of it, but there are two models. So there’s clinical recovery and then there’s personal recovery. And so clinical recovery is what we went by for a very long time. And that means that your psychiatrist declares you cured, well recovered, and it is purely their decision and they decide your trajectory. Now, the problem is with this, they call it the clinician’s illusion. And when you are in the mental health system, psychiatrists, mental health professionals, they see people who are not well. So their view is no one can recover, not all of them. But it’s understandable why they think that, because they’re only seeing us. But the minute we’re, well, we’re out of their office, we’re not seeing them anymore.

00:34:05 – Eric Zimmer
Twelve step programs have the same thing, right? What they see is the people who go out and come back. The idea then is if you go back out there and drink, you come back, because that’s all that we see. We don’t see the people who just disappear and either decide they don’t need twelve step help anymore or go back to some form of drinking that doesn’t get them to the same point. Right. And it is an illusion because you’re only seeing part of what’s happening and there are more scenarios out there occurring than what they’re seeing. So I understand why clinicians would have be the same way. Right. They see the people who are still suffering, right.

00:34:44 – Sarah Fay
And so it makes total sense. But because that’s not even in the conversation, it’s unlikely that a clinician’s going to say, you know, I think you’re well, and I think we can go for this. So there’s something called personal recovery, and that is when you and the clinician decide together that you are well. And that is why I think right now, as long as medical schools are not teaching recovery and as long as recovery is not a part of the DSM, the way it should be, what we need to do is really empower people to be saying, can we have this conversation about recovery? Can we talk about what is my path to recovery? What would that look like? And decide together when I’ve gotten there. Now, that doesn’t mean you stop seeing a therapist. I still see my psychiatrist because, as I said, it’s going to take me a very long time to get off medications. And I could have chosen to stay on medications. I mean, in some ways my body is fully dependent on them. If it turns out that I cannot get off them because the withdrawal symptoms are so bad, that’s fine with me. There are long term side effects I’d like to avoid, but if I can get it as low as possible, that’s great, I’m good, you know, so again, I don’t want people to feel this pressure of. Okay, then I have to be this normal person.

00:35:58 – Eric Zimmer
Yep.

00:35:58 – Sarah Fay
I’m so not normal. My life is so not normal. I cannot tell you, but it’s works for me.

00:36:04 – Eric Zimmer
Yeah. It’s interesting because you’re saying that you’re borrowing from the recovery movement, but there’s a couple different definitions. And one here is from the Depression and bipolar support alliance, where they say recovery is the process of gaining control over one’s life and the direction one wants that life to go on the other side of a psychiatric diagnosis and all the losses usually associated with that diagnosis. And I think the other thing you’re saying here, and you had misconceptions about what recovering might be, right. You thought it would mean you’re off all medicines, you thought it would mean you’re not in therapy. And I think, again, if we go back to the recovery from alcoholism, that’s primarily out there, which is twelve step recovery, that we see people are in recovery or recovered doesn’t mean that they don’t go to meetings anymore. Right. So it’s the same sort of idea. But you are having panic attacks. Right. Or had a panic attack. So talk to me about how that fits into the concept of being cured or recovered.

00:37:08 – Sarah Fay
We’re not going to be able to escape depression, anxiety, all these distractibility, irritability. Those things are still part of me. The difference in why it’s just a whole different world. And why my mind is so different is because I don’t think there’s anything wrong when those things happen. I don’t think it’s a sign that something’s gone horribly wrong. And before I did, it was an episode. Now, there are points where I was at in total dysfunction. And what I want to also emphasize is that, you know, I suffered from suicidality for five years. Chronic suicidality, that’s a very different situation. You know, again, those are extremes. That is not something that should be dismissed or, you know, or said, oh, this is just part of the experience, although some people argue that is part of the human experience and that we shame people for it in a way that we shouldn’t. And I believe that, too. I don’t think it’s, you know, definitely get help, but I think that also we tend to shame people. It’s got a lot of stigma suicidality does in a way that I wish it didn’t. So I don’t think that anything has gone wrong. I don’t rush to my psychiatrist. I do not change medication dosages in any way. And again, that doesn’t mean that someone who isn’t in crisis wouldn’t do that. But that’s the difference. I don’t need to do that. And it does change with time. But I’m also going through a lot right now. I run a business on Substack. I am a full time. I’m a writer. I teach at Northwestern. I mean, I have a very full life. So it’s not surprising to me that I have anxiety, and it’s not surprising to me that I have these lows because my life is so up. You know, it’s like so many things going on that when actually the weekend comes or I have a day off, I’ll find that I get kind of depressed. I get a little low because I’m going at this rate, you know, and.

00:38:59 – Eric Zimmer
That’S just very different.

00:39:00 – Sarah Fay
But the emotions are so uncomfortable and they’re so awful that I want to run from them, too. I want to say there’s something terribly wrong with me when I feel these. Lisa Feldman Barrett, she’s at MIT, I think, but she has a wonderful book on emotions. And when I read her book, that really helped me realize I didn’t even know what an emotion was. I didn’t know that an emotion was a sensation in my body. I had no emotion education. I was emotionally illiterate, you know, illiterate about emotions. And what I did was I really studied what they are. And I could say I didn’t know what anxiety felt like in my body. It just was terrible.

00:39:39 – Eric Zimmer
Right

00:39:39 – Sarah Fay
And now I’m thinking, oh, okay, wow, my chest feels like it’s about to collapse, and it’s just awful. And I feel like I’m jumping out of my skin, and all I want to do is stop this. Oh, I’m having anxiety. This is normal. This is a part of the human experience. One thing that’s really helped me is evolutionary psychiatry and psychology has been very helpful. So understanding that we are programmed for these emotions. Anxiety is a very helpful emotion when you are living on the savannah and you have to go hunt for your food and you’re being chased by lions. But when I open my email, I am not being chased by lions. And yet my body is designed to react that way. And so that makes me really understand, okay, this is just how I’m programmed now. I can understand it on an intellectual level. I can stop. I can just sit for a second, feel the terrible, allow the terrible emotion, not enjoy it, but accept it. And sometimes it goes away and sometimes it doesn’t. And then I live with it and I work, I go through my day, and, you know, that’s just how I’ve learned to really adjust.

00:40:46 – Eric Zimmer
Yeah. And that’s a really helpful way of explaining it. They also talk about recovery centering on three basic principles, improving health, living a self directed life, and striving to reach our potential. And again, I think the point you’re making is that personal recovery does not mean you’re free of symptoms. And that’s what clinical recovery would say. Clinical recovery is. You’re free of symptoms. And as we’ve said, some of these things, like depression is part of the human condition, or at least low moods. Right, right. So you’re not going to be completely asymptomatic. And so I think the question is, when is it bad enough that you feel like you want or need more help than you’re getting?

00:41:28 – Sarah Fay
I was just going to say that is why it is so important for patients and people to be empowered with, with all of this information. Right now, we’re just blind in this mental health system, and I don’t think the mental health system is bad. When pathological came out, I thought my editor and I and HarperCollins thought, we’re gonna get so much pushback on this from psychiatry. I was on NPR with the head of the steering committee, Paul Applebaum for the DSM with Thomas Insull, who was former head of the National Institute for Mental Health, both biopsychiatrists and both said, you’re right. The public deserves to know.  Psychiatry, the mental health system is not resistant to these things. It’s the public that is, and that is phenomenal. And they’re the ones who need that empowerment. And I think that we could all work together beautifully, beautifully, if people understood the information that I have in pathological and what’s in cured, and then again, talked to other people and spoke to others. And Thomas insull has a wonderful book on recovery as well. So really going toward that. But you’re so right that where it comes down to is it will be in the individual. Like, when is this a problem for me in my life? When am I not seeing it being a problem? But we also have to get to a place where mental and emotional pain isn’t necessarily a problem.

00:42:51 – Eric Zimmer
Right?

00:42:51 – Sarah Fay
That is what we think we have this happiness addiction, you know, in some ways, I don’t mean to use the word addiction flippantly, but, like, this happiness obsession, let’s put it that way. This kind of cult of happiness where we think we’re all supposed to be these happy, instagram y individuals, and it’s just not what life is. That’s not what it’s actually supposed to be like, and that’s not the full human experience.

00:43:12 – Eric Zimmer
It’s really tricky to know what is acceptable level of suffering. And acceptable is maybe the wrong word, but it’s the one that’s coming to mind. And I think about this a lot, right? I still have low mood. I have anhedonia, right? And these things will happen. And the nature of it when I’m in it, is to believe that it’s always this way, that always has been this way, and it always will be this way, and that is not true. And yet the question for me is, is it worth increasing my medication dose when I’m in the middle of one of those? And I don’t know. And the answer for me for years now has been, no, I don’t. I’m on a very low dose, and I’ve stayed on a very low dose largely for the reasons that you have described, which is our brains become dependent on them. It’s fascinating to me that you’re on a ten year plan. I thought I was doing really good to be on a one year plan in the past, which still seemed like an incredibly long time anyway, maybe we’ll talk more about that in the post show conversation, but it’s just difficult to know but what I like about this idea of personal recovery so much is that we become responsible for our mental health, and a doctor or a clinician is part of that, but it’s not all of it. And there’s all these other elements that you talked about. You’ve talked about diet, you’ve talked about sleep patterns. Right. And I’ve said for years, like, I throw the kitchen sink at my depression. Right.

00:44:47 – Sarah Fay
Yeah.

00:44:47 – Eric Zimmer
Like, it has been a lifestyle overhaul that has allowed me to be, I would say, very high functioning, but it’s been diet, it’s been exercise, it’s been sleep, it’s been talking to other people. It’s been doing things that I like. It’s been playing music, it’s reading books. It’s all of it. And I don’t want to position that as an ongoing struggle because the things that tend to make me better in that regard are also many of the wonderful things in life. And so I love this idea of recovery. I’m curious about recovery versus recovered, and this is a debate that has happened in twelve step programs forever. There is a phrase in the aa big book, we are people who have recovered. And so there are people who use that phrase, and there are other people that say that’s not accurate. Like, we’re in recovery. And I’ve always sort of, I think of myself as in recovery, not recovered. But again, we’ve sort of ascertained that my working with labels is fairly fluid, so I haven’t gotten too hung up in the debate. But is there a similar debate in the recovery movement in mental illness?

00:46:02 – Sarah Fay
We’re not even at that point yet.

00:46:04 – Eric Zimmer
Okay.

00:46:05 – Sarah Fay
I wish we were. That’s where we have to get. And I think that’s so, so smart and such a wonderful way to look at it, which is that maybe there isn’t an answer. Maybe it doesn’t have to be one or the other, that maybe what that indicates is a level of care that you need at that point or a level of support. Right. So if I feel like, because I’ve interviewed so many people who consider themselves either in recovery or recovered from serious mental illness often. So we’re not talking about what SAmHSA defines as any mental illness, which is high functioning. We’re talking about people who really went into a low functioning period of their lives, and some of them felt, no, I still have this diagnosis. I still very much identify with it. This is who I am and this is where I am. But I’m in recovery. I’m not sick anymore, whereas I have absolutely no interest in that, because I know how powerful my brain is. And that self fulfilling prophecy. I did it for so long that I don’t even want to know what’s on my medical records because I will adopt it. I don’t go by horoscopes. I don’t go by, I’m an introvert. I’m an extrovert. I don’t like because it just makes me into something, and I don’t want to be something.

00:47:14 – Eric Zimmer
I tend to agree. I take all those things, Myers Briggs or enneagram tests or all of that stuff with a huge grain of salt, you know, because I always find even answering the questions hard, because I’m like, well, you know, would you rather go to a party or stay home and read a book? And I’m like, well, what’s the party? What’s the book? You know, how much did I sleep last night? You know, like, what else? I mean, like, I can’t answer that. I’m going to need a. A whole lot more information to answer this question. And so, again, I find them sort of mildly interesting. But like you said, I will not go see a psychic. Even if I’m walking by, like, a free psychic. I’m like, no, I don’t want whatever you say, even the little bit that will get caught in my mind. I don’t want it there, good or bad, because I worry, like you, that, like, it will linger there in some way and in many ways. And you talk about this near the end, cured. Is that what we’re talking about here, to a large degree, is, what is the story we’re telling ourselves about our mental illness or whatever. And stories are extraordinarily powerful. The story we tell ourselves about it is really important. And you’ve chosen to tell yourself a story of, I am recovering. I am recovered. And that. That has been really important for you in getting to a place where you’re much better than you used to be, if that’s a phrase you’re comfortable using.

00:48:42 – Sarah Fay
Yes, 100%. I mean, I consider myself well, and I don’t have a diagnosis, all of that. And yet, if someone else wanted to say, no, I have a diagnosis. I’m in recovery, and I am living. What you just said, which is the definition of it is striving to reach my full potential. That is so important. And some people might condemn that and say, it’s so capitalist, and, you know, all of this probably, but striving to reach your full potential could be being a great mother to my cats.

00:49:15 – Eric Zimmer
I have absolutely right.

00:49:16 – Sarah Fay
I mean, it means that I am gardening. Yeah. I’m gardening every day, and I am making sure I carve out that time for myself. I am sleeping well. Right? Striving to reach my full potential does not mean I’m an executive at Google. I don’t want anyone to go work at Google. You’re fine. 

00:49:54 – Eric Zimmer
Part of your book that made me laugh cured, which is not a book yet. It’s a serialized Substack. And your Substack is wonderful. We’ll have links in the show notes to it. But you talk for a little bit about Jaco Wilnick, who, for people who don’t know, he is like, an ex military podcaster, but he is all about, like, you know, you go get it, you kill it, you crush it. Like, discipline, mental fortitude, toughness. Right. And you compare him, maybe even in the same sub stack, with people like Brene Brown and Kristen Neff.

00:50:28 – Sarah Fay
Yep.

00:50:28 – Eric Zimmer
That cracked me up. I just thought of, like, the jocko Willnick Kristen Neff cage match, and that just made me. Made me happy and made me laugh. I’ve interviewed Kristen a couple times, and she’s wonderful. But I think about this also, and I think about it in this way, that there is a place for a jocko will nick type approach. I think with my thoughts, where I sort of say, like, enough. No more. I’m not thinking this anymore. And I may have to do that 500 times, and at the same exact time, there is a place for. Okay, I can’t seem to fight you. Like, I’m just gonna let you be here.

00:51:07 – Sarah Fay
Yeah, right.

00:51:08 – Eric Zimmer
Knowing when to do which of those things I’m painting with very broad strokes, but when to sort of fight and adjust and when to allow and accept when it comes to the contents of our own brain is so nuanced. And so I just loved putting those two in the same sort of sentence group because it defines for me very well that struggle or what that challenge is. And it’s one that I talk about on this show all the time, trying to figure that out, that nuance.

00:51:41 – Sarah Fay
Yeah.

00:51:42 – Eric Zimmer
Where have you landed with it?

00:51:43 – Sarah Fay
Well, it’s funny because that was a period of time I was in the cult of Jaco. As I say, there’s just this cult around him. He loves jiu jitsu, and he’s like, do 100 burpees and tell me if you feel bad. You know, that’s kind of like what he said. And so I was like, okay, I’ll do 100 burpees and see if I feel bad.

00:52:00 – Eric Zimmer
The answer is yes, I do feel bad.

00:52:02 – Sarah Fay
I feel worse. Yeah.

00:52:03 – Eric Zimmer
At least for 75 to 85 of those burpees. I’m feeling worse. 

00:52:08 – Sarah Fay
But when I was in partial hospitalization programs, it was the cult of Brene Brown. It was the cult of Kristin Neff, who. Brene Brown. I feel like with vulnerability and the sort of cult of vulnerability that can be very hard people from marginalized communities, it can be very difficult from people who’ve had suffered from mental illness. We are already vulnerable, like a white woman with a great job and, you know, upper middle class. And, you know, to make yourself vulnerable is very different than someone who is in a psychiatric hospital. You know, doing that, it’s, you know, it’s just so, so different. So, you know, I understood that. But at some point, what I had to do for my recovery was to be hard on myself. I just did. And I just had to say no. And I did end up having a life coach, being in a life coach’s program. And one thing she said that stayed with me is that your brain is like a toddler running around with a knife. Your brain is just wild. I think of it as, and this is, again, evolutionary psychiatry and psychology. Our brains are evolutionarily designed to keep us alive. That is it. They are not designed to make us happy. They are not designed to give us what we want to make us. They are designed for us to stay alive, seek pleasure, and avoid pain, and that is it. And so when I’m negative, that’s what my brain is designed to do. So I just say, I get it, Brain. You’re looking for danger. You’re looking for everything to be terrible so that you keep me alive. And I always say, thank you. Thank you, Brain. You’re doing a great job, and you’re awful. So I’ve learned to really talk to myself in a very sweet way and get to know my brain and have a really good relationship with it and just get that it is just very, very mistaken most of the time. Now, sometimes there are dangers, and that’s real. So I also don’t want to discount it. So sometimes I sit down, and I’ll just write down my thoughts and look at which of these are facts. Okay? So, basically, and this is, again, something a life coach taught me, which is so if I write them all down, you know, she’s horrible. My cats hate me. Whatever it is, none of those are facts right now, right? So if it’s not a fact, it’s not necessarily a danger. And so then I can kind of piece it out and say, okay. Until it’s a fact that can be proven in a court of law. Law. And we could get into whether or not they’re really facts and all of that. But then I say, if it is a fact, though, you know, like, my business is failing, right. I get more specific. I’m losing subscribers or something. I’m not. But, like, if that were happening, that’s real. And as a business owner, I should look at that and say, okay, but that’s a business problem. That’s a math problem. That isn’t something, you know, terribly wrong with me. So being able to distinguish between what, what is fact and what is just my brain trying to take care of me and a thought of, we’re in danger, you know, it’s always on high alert.

00:54:59 – Eric Zimmer
I think that you sort of hit on where I land generally with this, which is, I am extremely kind to myself and I don’t let my brain just run wild. And I think Kristin Neff actually does a decent job of describing this when she talks about what self compassion is. Right. Because she says, like, think about a good parent, right. A good parent is not going to let the child eat all the ice cream. Yeah, but they’re also not going to be like, you pig, why would you want to eat all that ice cream? Right. They’re simply going to say, like, sweetheart, hey, look, you can’t have that ice cream. I know you really want it. But, and they maybe if the context is there, explain, you know, here’s why. You’ll get a stomach ache and blah, blah, blah. So I think that that seems to be the answer. But people, I think, often think that being, being kind to ourselves means we’re not accountable to ourselves. And so I’m often sort of trying to strike that balance now in my mind of Jocko and Kristin Neff. I wanted to ask you about writing down your thoughts because you talk about this a fair amount in cured, and I’m curious your process for it and when you do it, because thoughts are, they’re just constant. Right. If I was to write down every thought I had, I would just simply sit here and just be writing all day long. Thought, and this thought, that thought, this thought. So when are you doing it and what are you doing?

00:56:27 – Sarah Fay
Yeah.

00:56:29 – Eric Zimmer
What’s working for you? Yeah.

00:56:30 – Sarah Fay
Writing down all my thoughts would be frightening.

00:56:32 – Eric Zimmer
It’d be like a Jack Kerouac novel. You’d be like, all right, this is not, you know, so when I first.

00:56:36 – Sarah Fay
Started doing it, I would do what the life coach I worked with called a thought download. And I did it every morning.

00:56:42 – Eric Zimmer
Okay.

00:56:43 – Sarah Fay
Some people might think, oh, morning pages or something like that. No, it’s not quite morning pages, but it’s a similar idea, which is. So I would just write them in a line. So it’s not a journal. It’s just one line thought. One line thought, one line thought. And I would just do it.

00:56:57 – Sarah Fay
At first, I didn’t want to do this because I’m a writer. I feel like writing things down are very powerful, and if I wrote down my garbage thoughts and my negative thoughts, it would kind of make them more real or a little bit like, imprint on me. But so far, I’ve found that does not happen. And then what I would do would. Was pick out just one thought that was troubling. And then I would look at it, as we said, from this more educated point of view, which was another person that I’ve learned a lot from, calls it the four ends. How can I normalize this? Why would it be normal that I’m thinking this extreme thought, like, she hates me? Well, that’s because we got into an argument. Of course I think that. But is it true? So I used to do a process of looking at what’s the circumstance? And this is, again, from a life coach named Brooke Castillo. So I want to give credit where it’s due. She didn’t make it up, but she just does it in a way that people will probably recognize this. But you kind of look at the circumstance, and then you put your thought in, and then how does that make you feel and what actions do you take and what’s the result, and then how would you want it to be different? So I did that every single morning and night while I was recovering. I mean, every single morning and night. And I would do it during the day, too. So when I would have very crippling anxiety, I would do it, things like that. But then after a while, since I’ve now, you know, I don’t need to do it as much. I can kind of coach myself. I can basically talk myself out of things in some ways, but I’ll still do it. As you were asking, I probably should have done it last night when I was having my panic attack. It did go away. But whenever it’s interrupting my life, basically, when my mind has stopped me from going about my day. So what does that mean? Well, I do write down what I’m going to do every day. I don’t give myself this empty space. I know some people love that, and it’s considered freedom. I find a lot of freedom in. I know what I’m doing each day, because then it allows me to say, okay, wait, no, I’m not really doing what I want to do. So, again, going to these measurements, is this problematic? I just have ways of kind of measuring it, and that’s just been really helpful for me.

00:59:13 – Eric Zimmer
Yeah. I don’t know who said it, but the phrase structure liberates for some of us is really true. I think for some of us, structure is actually very freeing. It’s not that way for everybody, but for some of us, the key being, of course, that we get to decide the structure. Structure imposed upon us is not liberating, but structure that we decide that we’re going to put in place tends to be.

00:59:34 – Sarah Fay
I was just going to say, the other thing that was really helpful for me was Ethan Cross, who you interviewed, has a book called Chatter, where he talks about self talk and just how we speak to ourselves. And I spoke to myself horribly. I always said it was like a mean fifth grade girl on the playground. Just so mean and so really learning how to monitor that and just say, like you were saying. Say to myself, like, no, we don’t talk to ourselves like that anymore.

01:00:01 – Eric Zimmer
Yeah, there’s another great book out there. We interviewed him. His name’s john Acuff, and it’s called Soundtracks, and it’s about a similar idea. We are at the end of our time. You and I are going to continue in the post show conversation, talking all things about this, but we might be talking about medication. We’ll see. I don’t know exactly, but listeners, if you’d like access to this poorly defined post show conversation or all ad free episodes, and to be part of our wonderful community, we’d love to have you. Oneyoufeed.net join. Sarah, thanks so much. Such a pleasure to get to see you again and talk with you again.

01:00:40 – Sarah Fay
So great to be here. Thank you. Eric

01:00:57 – Chris Forbes
If what you just heard was helpful to you, please consider making a monthly donation to support the One U Feed podcast when you join our membership community with this monthly pledge, you get lots of exclusive members only benefits. It’s our way of saying thank you for your support. Now, we are so grateful for the members of our community, we wouldn’t be able to do what we do without their support, and we don’t take a single dollar for granted. To learn more, make a donation at any level and become a member of the One U feed community, go to oneyoufeed.net Join the One U Feed podcast would like to sincerely thank our sponsors for supporting the show.

• Understand the impact of anxiety on mental health and well-being
• Learn about the benefits and limitations of medication and therapy in managing mental health challenges
• Engage in a nuanced conversation about mental health, exploring its complexities and varied experiences
• Take responsibility for anxiety by exploring practical strategies such as slowing down
• Create space in anxiety management by discovering techniques for finding peace and balance in everyday life

Connect with Sarah Wilson: Website | Instagram | Facebook | Twitter

If you enjoyed this conversation with Sarah Wilson, check out these other episodes:

Paul Gilmartin is a stand-up comedian, podcast host, and television personality best known as the long time host of TBS’ Dinner and a Movie.  Since 2011, Paul has been the host and executive producer of the podcast, Mental Illness Happy Hour.

In this episode, Eric and Paul discuss his strategies and practical approaches to deal with fear and depression.

But wait, there’s more! The episode is not quite over!! We continue the conversation and you can access this exclusive content right in your podcast player feed. Head over to our Patreon page and pledge to donate just $10 a month. It’s that simple and we’ll give you good stuff as a thank you!

Paul Gilmartin and I Discuss What How to Work Through Fear and Depression and …

• His podcast, Mental Illness Happy Hour
• How we all have something that we worship that orients our actions
• Learning to be truly and deeply vulnerable
• How there is no instant gratification in spirituality
• Living a fear based life and addictive behaviors
• Reconnecting with the body’s instincts
• Getting curious about the thoughts that come up during meditation
• The difference between self reflection and self obsession
• Strategies for moving away from self obsessing
• Finding himself stuck in the paralysis of perfection
• The importance of taking a break from the world when you need it
• The opposing forces of fear and hope
• Moving through his fears and depression
• How acting according to his values keeps him connected to his higher power
• His spiritual growth includes facing his everyday fears
• Learning to see past our mental barriers and realize what we’re capable of

Paul Gilmartin Links

Paul’s Website

Twitter

Instagram

Facebook

By purchasing products and/or services from our sponsors, you are helping to support The One You Feed and we greatly appreciate it. Thank you!

If you enjoyed this conversation with Paul Gilmartin, check out these other episodes:

Paul Gilmartin (2014 Interview)

Discovering Spiritual Truths with Pete Holmes

Alex Riley is an award-winning science writer. In 2019 he received a Best Feature award from the Association of British Science Writers for his reporting on the Friendship Bench, a project that began in Zimbabwe in 2006. Alex’s articles have been published by New Scientist, Mosaic, Nautilus Magazine, the BBC, and others.

In this episode, Alex and Eric talk about his new book, A Cure for Darkness: The Story of Depression and How We Treat It.

But wait – there’s more! The episode is not quite over!! We continue the conversation and you can access this exclusive content right in your podcast player feed. Head over to our Patreon page and pledge to donate just $10 a month. It’s that simple and we’ll give you good stuff as a thank you!

Alex Riley and I Discuss Emerging Perspectives on Depression and…

• A Cure for Darkness: The Story of Depression and How We Treat It
• Eric’s telltale sign he’s in a depressive episode
• The cause of Alex’s most recent depressive episode
• Eric and Alex’s experiences taking SSRIs for depression
• How he makes the decision to come on and off antidepressants
• His experience of psilocybin treatment for depression
• The role of nutrition in supporting his mental health and wellness
• A working definition of depression
• The connection between depression and “thinking too much”
• The “P” factor – an idea that all mental illnesses are fundamentally connected at their root
• The winners curse
• Eric’s experience with LSD earlier in life

Alex Riley links:

Alex’s Website

Twitter

When you purchase products and/or services from the sponsors of this episode, you help support The One You Feed.  Your support is greatly appreciated, thank you!

If you enjoyed this conversation with Alex Riley, you might also enjoy these other episodes:

Strategies for Depression with Therese Borchard

Recovering from Depression with Brent Williams

Don’t Miss Out

Subscribe to instantly download my free ebook, “The Top 5 Reasons You Can’t Seem To Stick With A Meditation Practice —And How To Actually Build One That Lasts” — plus the latest podcast delivered straight to your inbox each week!