C (3:23)

Yeah. Do you. Do you think that people can tell that?

A (3:27)

Yes.

C (3:28)

Like watching you. You do?

A (3:29)

Yeah. Are you good at masking Are you good at masking when you are feeling overwhelmed and feeling exhausted?

C (3:37)

Probably. I. I think so. Because, you know, when you see patients and you don't want to bring in life to patients because it just makes their life more complicated, I think you get very used to some version of normalcy and being fine at all times, even if you're not, and then sort of dealing with it in the off hours. So I think if you were like, my friend or family member, I would be less good at masking and you'd be more able to say, like, hey, something's off, but patience work, no?

A (4:12)

I've often wondered this, and we all wonder this, those of us who are in therapy of some kind. You know, we always wonder about the people who are. Who are looking after us, like, God, this must be hard for them. I just. Boy, did I tell them a story just now, and, boy, did they listen empathetically. And that must be an awful lot to accommodate and internalize. Let's get back to you.

C (4:35)

Sure.

A (4:36)

How did you get to be you? How did you become Dr. Jesse Gold?

C (4:43)

Way too much school.

A (4:44)

Yeah. I would imagine you have an awful lot of letters behind your name, but what drew you to mental health? What drew you to psychiatry? What drew you to all this?

C (4:56)

Yeah, so a couple of things. So one, my dad's a psychiatrist.

A (4:59)

Oh, that's right.

B (5:01)

It's in the family.

A (5:02)

That's right.

C (5:03)

Yeah. And your mom, too, like. Yeah, my mom has a master's in public health. So we. We're. We're people who care about people, you know, And I think my dad's a researcher, really, and a business guy, and so grew up, like, just hearing stories about things. And that obviously gets in there even when you don't want it to. But when I went to med school, I was like, I'm not going to be a psychiatrist because I don't want to be like my dad. And then it was just every patient that I had time with, like, I was drawn to, like, the story behind them. So, you know, in. In a lot of specialties in medicine, it's like, what's your chief complaint? Like, let's ask you specific questions. Let's get to the diagnosis. Let's treat the diagnosis and psych and like, I don't know, it's just a lot more like the rest of it matters, too. Like, you get time with people, you want to know more about them. And I was trying to do that, like, in surgical rotations, you know, like, pull up a chair and talk to the Patient about their lives when, like, it's just not the culture there to really even have the time to do that. And so I think that drew me in a way I come from. I was an anthropology major. I have a master's in anthropology. So I liked people and culture in that sense, too. And then, you know, like so many people, my own personal experience outside of my family also informed that I want

A (6:26)

to talk to you about depression first, in particular, because I feel like that word gets thrown around all the time, is the word we hear the most in it. And colloquially, it becomes synonymous with mental health. Right. And I was diagnosed as having severe clinical depression at one point in my life. And I learned that that word does not mean what you think it means, Steve, you know, and it's very different than being sad. And so talk to me a little bit about that. I kind of want to hear you cook a little on what we mean medically when we talk about depression.

C (7:11)

For sure. Well, thanks for sharing. First of all, I know that you have. But I think even when you keep sharing, it is important and hard and all of the same time. So I think that it really makes a difference to people, to people talking about this openly. You know, I think mental health words are different than other words because we don't just, like, have diabetes. Like, we're not just, like, you know, using the words, like, throwing them around just for fun when we have clinical definitions for them. I think, like, mental health words like anxious or depressed are symptoms, but they're also diagnoses when they're kind of all put together. So when you're depressed, it's a mood, it's sad. Right. That's what it inherently means. But when we're talking about depression, it's much more than sadness. So, you know, I think what we look for is people who've had at least two weeks of either depressed mood or, like, what we call anhedonia, which is a fancy word for you're not interested in things you used to be interested in. So what that looks like anhedonia.

A (8:18)

Anne Hedonia. It sounds like someone I went to

C (8:19)

school with probably did.

A (8:22)

Remember Anne Hedonia? God, she was so boring. I was so uninterested in everything she said,

C (8:30)

too. Yeah, 100%. She. She. Every time I asked her to do something, she just ignored me. Yeah, I mean, I think, you know, we think about it, like, when people don't really understand what that means, like, conceptually, but really what it is, is, like, you might still be going through the motions. Like, you Might like reading and you're still reading, but it's just not like giving you the same thing. Right. Like, you watch a TV show, sure, but you used to laugh at it. You're not laughing at it anymore. It's just like background noise. And so it doesn't mean you're not doing anything. For some people it might. But, like, what it really means is that, like, you're really just not engaged and interested in the way that you were. And then, like, once you have one of those symptoms, we look for another sort of constellation of things, because depression affects a lot of other kind of areas of your physical health and. And what we're looking for. So it's change in sleep, which can kind of go either way. So some people don't sleep. Some people sleep a lot. Some people, it doesn't affect their sleep. It sort of depends on who you are and what that looks like for you. You know, sometimes you're just, like, mentally exhausted. Makes you physically exhausted. And that's just how we deal. You know, a lot of people have, like, increased symptoms of guilt. So, like, feeling guilty about a lot of things, change in energy. So, you know, just with sleep, like, you know, you can be pretty tired, like when you have. When you just feel depressed, because it does have a pretty significant physical effect. Big one, change in concentration. So I think lots of folks come up into my office and they're like, I can't concentrate. I have adhd. So I would love to tell you that every single person who can't concentrate has adhd. But, you know, lack of concentration or trouble concentrating can be caused by so much stuff. So if you think about just not sleeping can make you not concentrate, being anxious can make you not concentrate. Or if you're just sad, it's just like, why bother, right? Like, you're sort of trying to concentrate, your energy's not there, your interest is not there, your ability to have sustained, like, focus is not there. And you're just like, yeah, I tried. You know, you're just not getting as much done because you can't. And you tried. You know, I think after that is appetite. So, you know, change in appetite either way too, just like sleep. So some people eat more when they're sad, and some people eat less when they're sad. It sort of depends on what role food plays in your life. Then you mentioned sometimes you move slowly. That's another fancy word we use, which is called psychomotor retardation, which is like, you know, your, like, your movements from your, like, sort of how your psychology and your motor movements, like intersect are just making retardation just means slow are slowed. People describe that like moving through molasses, I think. But, you know, I think that's one of those things that you, you might not notice the first time someone else might notice. You might just feel like less able to kind of like get up and go, and that's all you notice. But I think that one can look pretty different in people. It might not be something you pick up on. And then the last one being suicidal thoughts, which are more common than people talk about and sort of worth a conversation on the normalcy of that in a lot of folks too. But I think, you know, are part of the constellation of what we look when we're talking about depression.

A (12:10)

First of all, I, I, I related to 90% of that list. You know, I want to. You mentioned suicidal ideation, and I'm glad you did. And because I definitely experienced a lot of that and I, it scared me so deeply. So deeply. And I was relieved to hear that that's a fairly normal thing and that, and that it is very different from what I felt that it might be. Does that make sense? I'm trying to be very responsible about how I'm talking about this. So if I'm not saying things correctly, just let me know.

C (12:59)

It's a hard thing to be. There's a lot of rules. But, you know, I think what it, I think what you're saying is like, you thought it was like something, it had to be super serious immediately, but it was sort of like more common than you thought, Is that what you mean?

A (13:15)

Yeah, what I mean is that I was having these thoughts and I thought I must be completely insane, you know, but it was a comfort to me to know that it's actually pretty common that the brain goes there, you know, and that the human brain sometimes goes there.

C (13:37)

Yeah, I mean, I think people get really worried about talking about it or asking about it, but all the evidence says, like, asking folks about it is safer than not, you know, And I think we, we worry a lot in our friends, like, oh, well, what if they say yes? Well, then you help them. Then you get them to help. Then you figure out if you have to call something like 988 and actually have them talk to someone urgently to kind of work through the crisis that they're in in the know. I think that the patients I see, I mean, I think it's a spectrum, just like anything, right? So just like, I could say you sleep. You don't sleep. And there's a spectrum of what that looks like in you. Like, the symptom of having suicidal thoughts is very similar. Like, there's a more severe version, which comes with more severe thoughts, but there's also passing thoughts. There's also thoughts that scare you, that you would never act on. But they're there, and you should know they're there, because that's scary and you should talk about it. And I. And I hope that, you know, if someone's listening and that's where they are, that they know that, like, they can talk to someone about that. You know, I think from, you know, in my role, people often worry I'm gonna, like, commit you to a hospital and you're gonna be stuck there. Cause you told me. And, you know, a lot of people just need support in other ways. And it's not like right now, today, they're at risk. That's just a warning sign like that. We need to be thinking more about it and talking more about it and helping them.

A (15:06)

Amen.

B (15:09)

So if you're here listening or even watching this podcast right now, I imagine that you are a pretty compassionate person, right? A person who cares. A person who sees what's happening all around you, a person who knows that there are kids and families going through really hard things.

A (15:32)

And.

B (15:32)

And. And if you're like me, you want to do something about it, you know? But the truth is, sometimes the problem seems so big that it is really hard to know what actually makes a difference. And that's one of the reasons I really appreciate what Children Incorporated does, because they focus on something simple and very real. You see, for many children growing up in poverty, the biggest barriers to education aren't about intelligence or motivation. They're about simple, basic needs. Write a warm coat in the winter. Shoes that actually fit. School supplies, hygiene items, enough food to focus during class. And without these simple things, staying in school becomes a lot harder than it should be. And Children Incorporated works to remove those barriers. For more than 60 years, they've partnered with trusted local volunteer coordinators, often teachers, counselors, community leaders, people who already know the children and the families that they serve. These are the people that see what's happening every day. These are the people that notice when a child is struggling. They know when a family is having a tough time, and they can make sure help reaches the kids who truly need it. So when you sponsor a child through childrenincorporated.org you're not just donating into some big system. You're helping to support one specific child. Your Sponsorship helps provide things like clothing, shoes, school supplies, hygiene items, and food. The everyday support that can help a child stay focused in school. And because Children Incorporated works with volunteers and communities, about 88% of every dollar goes directly to program support. So your help turns out into real, tangible support for real kids. But something that sponsors often say they didn't expect is the connection. Because when a child knows there's someone out there that chose to support them, that someone chose to believe in them, that builds confidence, it builds stability, and it builds hope. So if you've been looking for a

A (17:46)

way to help in a way that's

B (17:48)

real and personal, you can visit childrenincorporated.org to learn more and choose a child to sponsor today. Because sometimes changing the world doesn't start with something huge. Sometimes it starts with showing up for one child who just needs someone in their corner. Again, that's children incorporated.org.

A (18:12)

So, in differentiating depression from other states of mind, some of the things I heard you say that made a lot of sense to me is it's not a mood, right? Most of the symptoms that you were outlining there were physical, right? Which tracks to my experience with depression, for sure. Um, and also you said it's a constellation of symptoms. It's many things. And you also said that there's duration is a factor, right? You know, sadness. Everyone gets sad from time to time. It's like the weather. It comes and it goes. It's neither reliable nor permanent.

B (18:55)

The same.

A (18:56)

Same is true of being happy, right? At least in my lived experience, those things come and they go. And that is part of the regular weird rhythm of being an alive person. Depression is different in my life. I always called it the gray hum, right? It was just this. It was like an air conditioner in the back of my. The back of my life, just buzzing just like that. Talk to me a little bit about how a person can be depressed and seem like they're fine and seem like they're kicking ass, because that was the case with me.

C (19:38)

So, yeah, I mean, so part of what you're saying to, like, this length of time thing, in all of our diagnoses, it's like you have to rule out that it's not caused by physical. Like a physical illness. So mental health diagnoses are diagnoses of exclusion. Meaning, like, you don't have low iron, you don't have low B12. You don't have something else physically going on with you. So, like, part of the reason I go to medical school is that part, like, so that's in there, there. Then the other things that are in there always are, like, is it getting worse? Is it interfering with your life and how long has it been going on? And those things are the big things. Like, you might say, hey, Jesse, like, I don't sleep sometimes, I'm sad sometimes. And like, okay, great. Most of us are like that. But like, is it lasting a long time? Is it happening more often? And is it interfering with your life more? Like, are you not able to do stuff you want to be doing? And are you going like, hey, I used to want to do this stuff and I can't because I'm not sleeping, I'm not functioning, all of that. So, like, those parameters, I think, like, as people kind of think about it, are important to kind of lay out. But within the context of what you're talking about, those things fit, right? Which is so much of what we learn growing up is like, show up. It's very, it can look different in different households and different cultures with different expectations, but school is a priority or work is a priority. And you learn to go. Like, you have to have a pretty high bar to not go. Like, I, my mom always had rules like, you could, you have to, you can only miss school if you have like a clear cut fever or whatever it is, right? So you, you start to have these expectations of, I show up unless, like, here's this big rule. And you also learn to be able to show up unless. So you can put on a face about it, you can go through the motions. You sort of almost like robotically learn to be successful at work and in school because you learned growing up to do it. And it kind of gets ingrained. And so, like, I have students where I'll say, how are you doing? And they say they're, they're great. And I say, why? And they say their grades are good. And then I say, well, what's the rest of your life look like? And they're like, oh, I haven't left my room. I drink all the time. I get like takeout and I have no friends, but I'm great because my grades are great, right? So it's like a measure of what we're looking at too, right? So if you look at the workplace, it's like, oftentimes we're rewarded for overwork and which is a coping mechanism or showing up no matter what, which is fair, but not always. And like, there are, there are things in the workplace, especially in the US that are prioritized as, like, key things and values. We want in people that, you know. When I was the most burnt out, my output was crazy. Like I was doing so much more because I didn't want to have to deal with how I felt. And I didn't really want to want to sit around because I'd fall asleep immediately. And so I just did more and then I kept doing more and I was fine. To everyone else because they said, look at Jesse. You can ask Jesse to do stuff and she'll do more. And I think that's what happens is like, our culture feeds into it too.

A (22:45)

Yeah, that definitely tracks. You know, when I was first, what I now know was clinically depressed, I didn't know that that's what was going on with me because it didn't feel like I thought, like what I thought depression was. I couldn't say that I went to work every day on Blue's Clues feeling sad, you know, that's not what it felt like. I felt enormously frustrated and enormously unqualified and that I shouldn't be there and that my job was hard and I had that slow motion feeling. And what I did was work harder. Right. That's what I did. That's how I dealt with that feeling, was I will just put my head down and fight, was my kind of thought. And while I was at work, I could sustain that. And then when I went home, I was empty. Just like. Like there was nothing left. When I got back to my apartment until the next day, it was almost like I wasn't there. You know, I had this like, automatic feature.

C (24:02)

Yeah. I think sometimes people who, like, act or have like a character too, it becomes almost like easier to be like, well, that character's happy, so I'm happy. Like, a lot of people who are in acting are socially anxious. And then if you. And like, you would have. You would be like, no way. They're so outgoing. Look at them on the carpet and like, look at them. But they're like, playing a role. And they like basically the way that their brain interprets that is different than being themselves. And there's like a protective layer of that, which I wonder if in some folks also happens with depression. Right? Which is like, well, that's. That's work, Jesse. That's work, Steve. Work Steve is the happiest person there is. So I'm great. You know, like, this is how I am. And like there's nothing else there. And it's almost like. I mean, it's almost like a. I mean, a mask is one thing, but it is like a whole Persona of, like, this is just the way it is, and I'm great. Until you're not. And I think what I've always felt, too, is, like, we ignore the little tiny things until the little tiny things become really big things, and then we can't ignore them anymore. But I see that all the time in my patients. Like, I see doctors a lot as patients, and they're always like, well, I haven't heard anyone yet. And I'm like, that's a terrible thing to say. Like, you haven't hurt anyone yet. So we're great. Like, you know, I steal pills or, you know, like, I'm like, this bar is terrible. And, you know, if, if, if. If our workplaces assume that we show up, like, unless we're, like, physically hemorrhaging, I don't really know how we, like, really show mental health stuff, right? Like, well, you're not pleading, so, like, even if you are, like, they'll just stitch you up back there and put you right back in. Right. And so I just don't know where mental health fits then. I don't think it can.

A (25:54)

Yeah. It wasn't until I didn't have the incredible pressures of work until I realized how I was really feeling. You know, once I wasn't on the show anymore and I had time to do other things, I had this other great career going, right? I had this voiceover career. Everything in my life looked awesome, right? But once I didn't have, you know, TV Steve to fight with, there was just regular Steve. And everyone was telling me that regular Steve died of a heroin overdose or something, right? So there. There was an urban legend.

C (26:32)

That was nice of them.

A (26:33)

Yeah. And so that played into it, too, where I was just like, well, work Steve's the only one anyone cares about, I guess. I guess it's to hell with regular Steve anyway, you know.

C (26:43)

Yeah.

A (26:44)

And that's when I really inherited the depression feelings, Right. Was after that is when it all really came to the fore. And, yeah, I slept all the time. I drank a lot. Like, I was just doing all of these things to not feel anything at all, right? I just wanted. I wanted stasis. I wanted to be cryogenically gone. You know, just like, freeze me in a thing and wake me up later was kind of the vibe that I had now. I also convinced myself that, that. That those dark feelings, those negative feelings, those oppressed feelings were part of who I was. And I began to identify with them and almost wear them as a badge and just say, well, you know, I'm Just a dark soul. That's just who I am. And this is me.

C (27:42)

You start writing poetry and, like, music lyrics that were just real heavy.

A (27:48)

Oh, I sure did. I made a whole album and I released a rock and roll album full of pretty dark songs and. And. But I was convincing myself that this wasn't a problem, that I didn't have to deal with it. That, you know, it's just a little harder for me because I'm sensitive and I have these feelings, man. And it was this way of identifying with unnecessary hardship and unnecessary things so that I wouldn't have to deal with them. It was the same as drinking, you know, two bottles of wine or something. Right. It was just like, assuming this wasn't a problem so I wouldn't have to deal with it. It was another way of not dealing. Does that make sense?

C (28:30)

Yeah. Sometimes people, like, don't want treatment because of that, because they think that it's going to change their personality so much, and they like their personality. Like, why would I do that? I, like, I'm cynical, I'm funny. People like the way that I am. Like, I make friends this way or whatever it is, or like, this is who I am. You can't change who I am. And like, especially with medication, which obviously, like, I. Is part of my, like, toolbox of what I use. Like, there's a whole like, well, you're going to change me completely. And, you know, I think that's not ever the goal. And like, if it's really your personality and it's not your mood and like, everything else, then it will probably still be there on the other side, you know, I think we just worry sometimes that, like, this thing that we've become known for, even if it's not a thing that we like, really like about ourselves, deep, deep down, if we think about it and do self reflection and like, went to therapy and talked about it, there's like fear of change at all. And the sort of stasis that you're talking about is also like, I'm like, I'm okay. Like, this, like, this is me. Like, I like to write emo rock music and, like, be negative. That's me. I like a bottle of wine, you know?

B (29:45)

Yeah.

A (29:45)

And also, you know, I was always a little uncomfortable with being this children's television show host that was so, like, happy and jazz handy and glitter Gl and brightly colored. I never really identified with that character. I was acting very hard to do that. You know, I mean, that's. That that's not my proclivity. Right. That's not my natural state. And I think after that show was over, there was a little bit of identity tension, at least, you know, that character was named Steve. My name is Steve. You know, everyone just thought I was that guy. And I think I kind of leaned in to my depression as a way of proving to the world that I was not him, you know, or at least proving to myself that I was different. And that just kind of became this negative feedback loop that sort of compounded on itself, you know, over and over and over again for quite a long time. So how much of it, you know, my mother struggled with depression. My uncle struggled with depression. My cousins struggle with depression. How much of this is typically biology? How much of it is circumstance? How much of it is just comes from how you live? Or how much of it is from genetics, really?

C (31:05)

Yeah, I mean, there's definitely a genetic component. We do see that. And even sometimes if, like, a medication works for your parent, it might work for you for the same reasons. But, you know, it's not exclusively genetics where it's not like, you know, if your family has no history of it, you get it. And it's not exclusively genetics where if you live in a household with a depressed person who doesn't give you validation and support in the way that you need that somehow that's not also impacting you. Right. Because, like, as much as your brain and the biology part might be coming in some percentage from genetics, the fact that you grow up in a house with somebody who is living this way or feeling like that, and then how that relates to the environment you're raised in and, like, how that person was treated and your role in the house and your role as caregiver or not or whatever, like, I think contributes just as much.

A (32:02)

Yeah.

C (32:02)

In mental health, we. We view things through a biopsychosocial lens, which is like, that depression can be caused by the bio word. So, like biology, like genetics or anything else that's coming from your brain. So lack of chemicals in your brain. Psycho. So, like, how you process stuff like what. What did you learn to, like, psychologically in the way that you're talking to someone, interacting with someone, processing the world that might interact with that and social, like your friendships, your relationships, your landscape, your household, that sort of thing, all of that combines to make, like, what you show up in an office as. And I think all of that contributes in a way, which is why medicine alone is never the answer. Or psychotherapy sometimes is better with medicine, because sometimes you need all of. Because it's coming at you from all those words. So you need to target all those words.

A (32:56)

Yeah, you say biosocial, which I think is great. Which sounds. That sounds right, you know, I mean that sounds. Yeah, yeah, that, that makes sense to me.

B (33:09)

Sleep is very important to me, especially when I'm like traveling like this all the time and I'm trying something at night. I keep hearing about Magnesium Breakthrough from bio Optimizers. I have a friend who mentioned it and a couple of listeners mentioned it and they say it's different because most magnesium supplements are like only use one or two forms. But Magnesium Breakthrough combines seven different forms plus CO factors that actually help your body absorb what's going on. And everyone talks about how they're sleeping more deeply, they're feeling calmer, there's better recovery, that's even digestion support. And I'm not super big on recommending things unless I've actually tried them. So I've actually tried this and I'm adding it to my nightly routine to see how it goes, especially here on the road. And I like this part. BIOptimizers offers a 365 day, no questions asked money back guarantee. That's a full year and there's basically no risk. And for me it's simple. I just take it at night when I'm winding down anyway. So go to buyoptimizers.com alive and use my exclusive code Alive15 to get 15% off any order. Make 2026 the year you finally start sleeping great again.

A (34:25)

This episode brought to you by Pocket Hose, the world's number one expandable hose.

B (34:29)

I've got a pretty big piece of property, and that just means that there's lots of stuff that I need to

A (34:34)

water and it's all super far away.

B (34:37)

And I have spent years with various hoses. Those old hoses that they say aren't gonna kink, but they totally kink and then you're spraying and the water's not coming. You got to go back to the spigot and do the thing. And it's incredibly frustrating. But the pocket hose Copperhead fixes that with something called the pocket pivot, which swivels a full 360 degrees of. So instead of fighting the hose while you're moving around the yard, the water just keeps flowing. And the absolute best part is that when you're done watering, the rust proof anti burst hose just shrinks back down to pocket size. It's incredibly easy to carry and store. The brand new Pocket hose Copperhead with Pocket Pivot is a total game changer. I'm never going back.

A (35:26)

I've got two. I've got a couple of them. I've got a bunch of them actually,

B (35:29)

but I have one on either corner of my porch and I use them to water everything around the house.

A (35:36)

It's awesome.

B (35:38)

So for a limited time, my listeners can get a free pocket Pivot and their 10 pattern sprayer with the purchase of any size Copperhead hose. Just text Steve to 64,000. That's Steve to 64,000 for your two free gifts with purchase. Steve to 64,000 message and data rates may apply. See Terms for details. Look, just because you happen to be on a 9 to 5 doesn't mean

A (36:04)

your health issues are. You know what I mean?

B (36:06)

With Zocdoc, having no time to book a doctor's appointment is actually no problem. So let's just say you threw your back out on the dance floor at

A (36:16)

a friend's wedding, baby. Or you've got a big bad paper

B (36:21)

cut opening a letter from your friends during mail time, for example. Or maybe you googled a symptom and you really wish you hadn't opened that door. You can go to ZocDoc anytime 24? 7 to find a doctor you love to make your health plan happen. Yep. Even if it's after hours. So ZocDoc is a free app and website that helps you find and book high quality in network doctors so you can find media, social someone you love. We're talking about booking in network appointments with more than 150,000 providers across all 50 states. Whether you're looking for dermatology, dentistry, primary care, eye care, so much is offered with Zocdoc. You can easily search by specialty or even search by symptom to find what you need. You can read patient reviews and see doctors real time availabilities and click to book instantly. Honestly, if I needed to find a new doctor really quickly, this is exactly

A (37:14)

how I would do it.

B (37:15)

So stop putting off those doctor's appointments and go to Zocdoc.com alive to find and instantly book a doctor you love today. That z o c-o c.com alive zocdoc.com alive. And thanks Octoc for sponsoring this message.

A (37:35)

Alive with Steve Burns is brought to

B (37:37)

you by Progressive Insurance. Fiscally responsible financial geniuses, Monetary magicians. These are things people say about drivers who switch their car insurance to Progressive and save hundreds because Progressive offers discounts

A (37:53)

for paying in full for owning a home and more.

B (37:56)

Plus you can count on their great

A (37:57)

customer service to help you when you need it. So your dollar goes a long way.

B (38:02)

Visit progressive.com to see if you could save on car insurance. Progressive Casualty Insurance Company and affiliates. Potential savings will vary. Not available in all states or situations.

A (38:16)

Let's talk a little bit about social media and how we, and how, how we are relating to that. My God, it seems brilliantly designed for misery and for just. I mean I try really hard to use it differently in, in ways but I mean I scroll through Instagram and I'm like, I am completely inadequate. I am so inadequate. I have no pictures of me on a yacht in Sardinia. None. I have not ever caught a giant fish. I know, right? I'm. I'm not enough. I, I'm clearly not enough because look at everyone else. And when we say social media, we basically mean TikTok and Instagram now and a little bit of Facebook, but especially Instagram is about comparing snapshots, curated snapshots of people's fake life against your real life. And I just, it'd be, I'd be hard pressed to think of a machine better designed to make us feel like shit than that.

C (39:35)

It's fair. I mean, I think it's really interesting. Yeah, I mean social media is like. So I use social, so I always feel like I'm going to be a hypocrite if I criticize it. So I'm just going to like put it out there and say there are pluses and minuses to social. I think all things are nuanced and we tend to look at the world a little too not nuanced. And so I will say that we have had increased rates in like young women having depression. But it doesn't mean that it's all exclusively social media. You can look at data that will say that there's a trend where you can see it, but I think that what we would see is some studies will say it makes depression worse, some say it doesn't. But self esteem for sure, right? Like you're going to see it does affect their self esteem. It does affect body image for sure. Like that. You see, I think it can impact relationships. I think in this generation we're seeing a lot of loneliness and some of that is compounded by the pandemic and what that did. But pre pandemic, even with the rise of social, just like a different version of what relationships are like, do I have close friends if all I do is play video games with them remotely? Or do I have close friends if, if like what we do is just comment back and forth on Snapchat or like, what, what is. What is a close friend. And so I think that has really evolved in the context of social media. And so we do see, like increased depression rates and anxiety and things like that. And, you know, that is a component and it's one we need to be thinking about. I think we're backtracking a lot on social media. Like it happened and we didn't react in the, in real time enough and we sort of like, didn't realize it was going to become what it became. And then now we're like, oh, no, no, no. We like, need to talk about phones in schools and we need to talk about like, when, at what age someone should get it. And we need to be educating kids about what it means to be on it and actually teaching it like a skill so they can like weed out misinformation but also process it and know that it affects their mental health. Like, all these things are true, but we're backtracking on it. We have to figure out how it fits in the narrative.

A (41:45)

Yeah, I agree, I strong agree that there are positives to social media. I mean, the, the promise of all of this was community and connection, right. But it ended up alienating us and making us feel really weird. But I think that's a, I think that's user error largely. You know, I, My, my soapbox, if I have one, is this. But I agree with you that this technology is not going away and we need to humanize it is what we need to do. The next thing we need to do is show up to exactly conversations like this with enough of our human vulnerability, empathy, compassion, and skin in the game that it becomes hard to be a dick to someone. You know, Like, I really think it's that and I think that's the next step we need to take. But man, it's tough. Like, I, I kind of agree with what you're saying. It's like, kind of like the toothpaste is out of the tube and now we're going, oh, God. Ooh, we should age gate this. And I think we should age gate it. By the way, what is, what is the current science saying on that? You know, are they saying that it's hard?

C (42:56)

I think they're looking at like teen, early teen years, like 15, 16 as being, you know, like, I think some, it's not as good as we know about screen time with television. Like, again, we're sort of backtracking on like screen time because what's a script like a screen they do school on now? So how do you do screen time in the right way? So I feel like, like all these people that look at that, like the American Academy of Pediatrics are sort of going like, well, what. How do we look at this? And what's too much? And I think, you know, a lot of folks are kind of thinking like, later teen year, like, you know, later, like prior to college, but still, you know, in high school, maybe when you would get a phone to drive kind of might be worth considering. I, I think that, like, some people want you to wait till college. I worry a little about that as a person who sees college students because they binge everything. So I kind of feel like what you would get is like, is like, oh, what's this? And then they never lose, you know, like, it's like, it's like an obsession. Like, I, I sort of want to see. See it, like, built in. Like, okay, well, like, if we're gonna say that at 16 or whatever, like, let's talk to our kids about how to use it. Let's help monitor their use. Let's talk to them about time spent and how they feel about it and what they're seeing. But when they're out of your house, you can't do that. Like, you can't. You don't have as much ability to be like, so you're on social 24 7. What's that about? So I, I worry a little bit about waiting till college. That feels late to me just based on the folks that I see. For me, social media has given people, people like you who talk openly about mental health. It feels safer, it feels more normal. We can have these conversations. That's great, that's a plus. But if then you don't, like, you relate to you and you say, hey, I'm listening to these people talk, and I think I could have depression. And you do nothing except for, say, I have depression. Like, that's not actually the best next step. Like, the best next step is to go talk to someone who knows or go look at sources that know more and try to understand more and get the help you need. And so I want to see people learn to look at information, look at the source, see if that person counts as an expert, what counts as an expert. And then if you're relating to it, like, not just like, use the diagnosis willy nilly. Like, I have this because the Internet told me, but really like, to, to go take that to someone like me in an office and have good conversation about it. And, and I love conversations about how TikTok Brought you into my office. Like, I am not going to be a person who's going to go like, how dare you show me a TikTok video. You're wrong. That's just not what you're getting with me. And I think anybody who sees people now should be used to that. And we should be able to have conversations that are like, what about that resonated? And here's how I view it and here's where some things are different and here's how maybe it's not exactly that and that's okay, but we can talk through it and you know, like taking that to the next step and like learning how to do that is important just as much as it is to like not bully people and be able to understand how it's affecting your self esteem.

A (45:58)

Can you talk to me just a little bit about the brain? And some people's brains seem to make happy more than other people's brains seem to make happy. And why don't I have a happy brain? Like, what's going on in there? Like, what, what am I missing?

C (46:19)

Yeah, yeah, it's a good question. You know, a lot of what you're talking about too is like in the moment, coping skills. And I think that that's also important for folks is like when we're thinking about like, I'm really depressed right now, I have diagnostic depression, what do I do? It might look like a combination of therapy meds and all that stuff, but as you kind of go, instead of waiting until you're that bad again to prevent you from getting that bad again, figuring out what you do along the way, how you don't do certain things, how you keep other things, how you learn what you like and what you don't like is part of that. And I think we've been unnecessarily prescriptive with what a coping skill is. And people think that it's like, oh, I can only do mindfulness or I can only do yoga. Well, like if you like it, you'll do it. So that's what you should do. So like when you think about that as part of a toolkit, that's important too, but in terms of the brain. So like there's this paper that came out that people got all in a tizzy about because it implied that the only chemical that makes you sad is not just, just not having serotonin. And we've known that for a very long time. So yes, our medications that we use like try to replenish this neurochemical in the brain. Called serotonin. But it's not the only thing. Serotonin also, like, can be, like, kind of built after vitamin D, which is why sometimes you feel better in the sun. I'm just thinking about that, looking behind me. But there's another chemical called norepinephrine and another chemical called dopamine. And they all kind of create a balance of what it looks like for some people to be happy, not happy. You know, I think it's a state that fluctuates, which is what you see in yourself and what you see. And whether it's constant or not, Sometimes you need help replenishing some of that because either your brain doesn't have enough of something, isn't making enough, or something is blocking the stuff that it's making from actually getting in. Like, there are lots of ways that you could have less. Right. It doesn't just mean that you just don't have any. It could just mean that for some reason, the thing that should be making it isn't working as well or isn't registering it as much. Right. And so I think when we think about the brain, it's still a definite work in progress in terms of what we see in, like, scans and what we. What we do to treat it. And that's one of the cool things about working in psychiatry or neurology versus some other fields is it's still pretty, like, unknown and growing. Like, the first antidepressant was like, the 80s. Like, people don't realize that.

B (48:50)

Really? Really?

C (48:51)

Yeah, yeah. Prozac was like the 80s. Yeah. And so, like, you know, there were like, a couple other things before that that were good. Ish. But we don't use them anymore, really. And so I think electroshock therapy, we use that still. You know, we call that electroconvulsive therapy. It gets a bad reputation. It does not look like you see on one flu over the cuckoo's nest. And for severe depression for people who are pregnant, there's a lot of things that. That actually is better in. But that's a whole different conversation. But I think, you know, a lot has changed quickly in that, like, you'll see that we've had some evolution of treatments, and some treatments people are really hopeful about, like, with. With some psychoactive substances that you might be able to kind of, like, hear about, like psilocybin and all those kind of things. Like, there's a lot of, like, conversations about that, right? And they're like, what that looks like in folks and how we'll get there. And Some of that is like, you know, people still trying to play with, like, what makes us happy and what doesn't and, and what the proper balance is because we also don't want to make people manic or too happy. Right. And so I think the brain isn't cool. Uncharted territory where we know some version of what some people's brains look like when they're sad and some of them have less of one thing or another. But it's not perfect. Like, I wish we could say, like, I'm going to scan your brain and based on that we can give you a certain medicine. There's a person who does that, and that's not evidence based, so I'll just say that. But I, but I think, like, we just don't know enough to do that. If we did know enough to do that, all of us would do that because we'd be able to help you better.

A (50:31)

Exactly. Yeah, yeah, yeah, yeah. So why do so many of these terms sound like girls you might have gone to high school with? Like.

C (50:39)

Serotonin.

A (50:40)

Yeah, serotonin. She was great. She was great.

C (50:44)

She.

A (50:44)

It's just like, I just felt so awesome whenever she showed up. You know, it's like, oh, serotonin's here. And then there was Nora.

C (50:50)

That's funny. Nora. Epinephrine.

A (50:54)

Yeah.

C (50:55)

I don't know, maybe. Maybe I never really thought about that. Probably they were named by men, so that's all I've got to tell you.

A (51:07)

Yeah, she lived on that cul de sac right down on Schaefer Road. Norepinephrine. I remember her. She's great. I don't know why all that is so.

C (51:18)

Yep, me neither.

A (51:21)

How do you feel about the current conversation around mental health? Because there's so much conversation around mental health and I, you know, I think it's awesome that people are talking about it and there are people out there de. Stigmatizing it. That's what I try to do. I try to say, you know, even the happiest man in North America feels this way, you know, sometimes, you know, and I always say, you know, I, I've come to believe that the struggle is not optional, you know, doesn't matter who you are, you're gonna, you're feel some of it in, in some way. So what's, what's your take on the current temperature of, of that conversation?

C (52:04)

Yeah, I mean, I think that like, awareness is a step, right. But there's always more to it. And I think that that realization has been coming more. I think, like talking about it should be boring. Like, it shouldn't be novel. That, like, you and I have our experiences that we've had. Like, we. It shouldn't be headline news and yet it, like, still is. Like, as a psychiatrist who. Or as the happiest person on tv, who is that? Right. Like, it's still so interesting to people, and yet I would like to get to a place when like, the. That's boring. And then what? Like, we all have these struggles and now what? Like, let's fix them, let's help with them. Like, let's invest in them. Let's help our communities, like, reconnect and get off the Internet, whatever it is. Right. And so, like, that part still has some work to be done to get to that point, point to. Then we all say that. But I, I'm hopeful it's getting there with like some sort of, I don't know, like, number of people having talked about it, that it becomes enough.

A (53:06)

If someone decides that they do want and need help, what can that look like?

C (53:16)

Yeah, I mean, so I always say to people, like, if you know, you have a friend or family member or someone that you can trust, that's a good place to start. But if you know that's just not a safe place or you don't know who that person would be, Professional help exists for a reason. You know, finding professional help is complex and insurance can be an issue. Cost can be an issue. All of those things are true. Accessibility in your area, Telehealth has helped with that a lot. You know, a place to start can be like looking at your insurance company and seeing who's covered and comparing that to like a therapist directory, like Psychology Today, and saying like, hey, who's in my area and what are they talking about and do I like them? If you read someone's paragraph just like a dating app, and you're like, this person would be terrible. Do not spend time with them. If you go to one visit and you're like, this person is terrible. It depends on why they're terrible. If you try one more time. Because sometimes it's just they asked you a lot of questions because it was the first visit, but you know, it's a fit thing. So give yourself time to find a fit. Don't just like, jump right on the first thing you have. You know, there are lots of apps that can connect you quickly to people. Be mindful that maybe their skill set isn't as good because they're underpaid. So if you want to get connected quickly, you can and you could always do that in the interim while you find someone else. But just know, like, that can be a challenge. With some of those apps that connect you quickly if you need to talk to someone in a moment. We have all sorts of hotlines, warm lines, crisis lines, identity group based in some aspects, but also just like 988 is always there. Easy number to remember. You can call about a friend, too. It doesn't mean you have to be suicidal. Could just need to talk. They're trained to help you with that. So if you are sort of like, I don't know where to go, like, that's always a place you can go. They're. They're trained to help you in whatever you define a crisis by. You know, organizations like the national alliance of Mental Illness. If you're sort of looking at like, someone diagnosed me with something and I don't really know, or my son is struggling and I don't know how to talk to them, they have, like, parental support groups also, like, can pair you with a parent going through something similar. That's all great, too, because sometimes it just. You just need someone to talk to who gets it, and that can be really helpful. But, yeah, I mean, I. I want to say that, like, I wish it was easier to go, like, I need help, I get help. It's just not. And I know that that results in a lot of people, you know, not seeking care quickly or not getting in quickly and then having to go to emergency rooms and stuff like that. And I wish it didn't, but, you know, those folks are there if that's what you kind of are left with and what you can do, too.

A (56:06)

Yeah, I mean, I always. It seems to me that many of them may be imperfect and. But there. But there is help. You know, that there are resources out there. And for me, it was. The most important thing was taking a first step was, you know, just taking the step and then reevaluating and then taking another step and reevaluating. Taking another step and reevaluating. I think a lot of people forget. Forget that what you were talking about, like, your therapist has to be the right therapist for you. You know, like, it has to work. I was with this when I first started therapy. I was. It was going really well, but I was like, I think I need to see someone else. And she said, why? And I'm embarrassed to say this, but I was like, because you're really attractive and I'm trying to impress you. You know what I mean? She was like, yeah, right on, man. That's what you're doing. Yeah. Correct. You know, and I was like, I wish that wasn't true, but I see myself trying to impress you and trying to be like, oh, you know, I would. I don't want to say that, you know, Or. Or what? If I said that and sounded funny, you know, that was ridiculous. You know?

C (57:16)

Yeah. If you don't feel safe, if you feel like you're putting on a show, if you feel like, you know, it reminds you of your mother in a way that's un. Helpful, whatever it is. Like, all of the data on therapy says fit is everything, and I feel like I didn't understand that until I had a really good therapist. And then I was like, yeah. Oh, remember how we were talking about lying? I feel like I. I. The first visit I had with this therapist, I go, I didn't lie about anything. And I was, like, shocked. And I was like, I guess she can stick with me then.

A (57:49)

Yeah. I bet you're an awesome. I bet you're awesome to talk to. You have been awesome to talk to.

C (57:55)

Oh, thank you.

A (57:56)

You have been awesome to talk to. And I'm really glad that you got back to us because I was really looking forward to having this conversation. Thank you so much for coming by.

C (58:05)

Oh, thanks for having me. Yeah. I'm honored, truly.

A (58:09)

This was wonderful. Have a great day.

C (58:12)

You, too.

A (58:14)

Bye.

C (58:17)

Wow.

A (58:18)

She's amazing, right? Isn't she great? I love that conversation. I thought it was super fascinating, and I learned a bunch. How about you? What did you learn? Yeah. Yeah, right. I particularly loved when she said the bright spot of the pandemic was that everyone got sad, because that feels a little counterintuitive and a little weird, but it's actually true. We were all sharing the same sad and the same weird and the same struggle in that moment. And that, I think, can be a really good thing. What do you think? If you knew that someone else shared the same pain that you feel, how might that make it easier to be kind? Yeah. Well, listen, thanks for coming by, and it's great to see you. And you look great. You do. Admit it. You look great. Just say it.

B (60:20)

Say I look great.

A (60:20)

Say it. Go ahead, say it. Alive with Steve Burns is a Lemonada Media original. If you haven't subscribed to Lemonada Premium yet, now's the perfect time. You can listen to the show completely ad free, plus you'll unlock exclusive bonus content from me as I reflect on this episode. Just press subscribe on Apple podcasts. Head to lemonadapremium.com to subscribe on any other app or listen ad free on Amazon Music with your prime membership. That's lemonadapremium.com Are you team Batman or Spider Man?

D (60:49)

Is the ultimate dish pizza or tacos? SmashBoom Best will help settle those diffic debates. And so many more. Every episode we take two cool things, smash them together, and we see which one is best. Debaters use facts, jokes, stories, and more to argue for their side, and it's all judged by a teenager, because who is better at judging than a teen? It's fun. It's weirdly informative. It's smashboom Best. Get it Wherever you get your podcasts.