1 Psychiatrist & 20 Depressed People (ft. Dr. K) | Surrounded

Summary

Surrounded – Episode 1: Psychiatrist & 20 Depressed People (ft. Dr. K)

Jubilee Media | Air Date: May 10, 2026

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Episode Overview

In the premiere episode of Surrounded, host John Regalato and Jubilee Media challenge traditional debate formats. Instead of pitting opposing views, this episode assembles 20 people struggling with depression and invites renowned psychiatrist Dr. K (Dr. Alok Kanojia) to join their circle. The goal: explore deep, unfiltered conversations about depression, loss, trauma, and the messy journey through mental health – together.

Theme:
This episode centers on the lived realities of depression—what it feels like, why people often feel broken or hopeless, and why conventional solutions sometimes fall short. Dr. K offers clinical insight while highlighting the power and limitations of therapy, medication, and community. Participants bravely share stories ranging from childhood trauma and grief to military PTSD, perfectionism, and chronic illness, seeking understanding and new paths forward.

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Key Discussion Points & Insights

1. Are You Broken or Overwhelmed?

• Participant 1 shares intense grief after losing two close relatives, describing a sense of comfort lost forever (02:04–06:00).
• Dr. K emphasizes that feeling "broken" often comes from not being allowed to mourn or receive support. "No wonder you feel broken, cause I think you haven't had a chance to heal yet." (05:04, Dr. K)
• Family dynamics often dictate emotional expression: when mourning is discouraged or ignored, it can “trap” grief and limit healing.

2. Depression Stored in the Body / Dissociation

• Kashish, a former foster child in a dangerous environment, describes living at odds with her nervous system—mentally okay, but her body remains hypervigilant and triggered by trauma. She speaks of night terrors, dissociation, and bodily urges to cry even when mentally composed (07:47–12:08).
• Dr. K explains that trauma can disrupt communication between the brain’s emotional and logical hemispheres, leading to physical symptoms separate from conscious thought (09:32–11:20).
  Quote: “You have all of these pent up reactions that you've been carrying with you. And I can see that this is bringing up—what are you feeling?” (11:20, Dr. K)
• Dr. K highlights the crucial role other people play in emotional regulation—something Kashish had to teach herself.

3. Grief and Treatment-Resistant Depression

• Leah shares about losing her father and struggling with treatment-resistant depression, feeling the harsh disconnect between external success as a musician and profound internal emptiness (14:25–17:32).
  • Quote: “So, you know, I'm doing the thing that I love, yet I still felt... God, I feel like I've never felt more alone.” (15:40, Leah)
• Dr. K affirms that many experience “joyless success,” urging focus on attention and not battling one’s inner critic but shifting focus.

4. Hopelessness: Conclusion or Symptom?

• Dr. K Claim: Hopelessness feels like a conclusion, but it's actually a symptom (20:53–25:51).
• Joe, a former fireman, describes cycles of self-blame and feeling “dragged back” by depression despite knowing, "this is just a symptom." (21:06–24:31)
  • Quote: “There's the depression that you feel and then there's the way that you argue with yourself about the depression... that's what's keeping it alive.” (24:31, Dr. K)
• Dr. K: Changing self-loathing and how one relates to depression is as important as addressing the symptoms themselves.

5. Combat Trauma, Moral Injury & Skepticism

• Lamar, a Marine veteran, recounts transitioning to civilian life after war and feeling abandoned, failed by both the system and treatment (26:25–34:39).
  • Quote: “Every day I feel like might be my last.” (33:33, Lamar)
• Dr. K introduces "moral injury"—being forced to do or witness things that violate one's values, which standard therapy often fails to address.
• Lamar expresses profound skepticism: “After being through everything I've been through... I would have to put you in a category because I would ask you, is it medication? Is it going to be group therapy?” (29:21, Lamar)

6. Success, Perfectionism & Emptiness

• Ian and Megan reveal that outward productivity and acclaim don't equate to inner happiness. Ian describes finding no fulfillment in music—his outward “success”—and the endless cycle of striving for external validation, especially from women and peers (34:39–41:55).
  • Quote (Dr. K): “As long as you are not happy with yourself, you will be dependent on the people around you to get that sense of happiness.” (41:55)
• Megan and Kashish echo the pain of perfectionism: constantly raising the bar, never feeling “enough.”
  • Quote (Megan): "Every time I reach those goals, I set higher ones for myself. And it's just kind of a never ending, like I'll never be good enough so why try kind of mentality." (45:01, Megan)

7. Productivity with Depression / Motivation vs. Self-worth

• Participants discuss whether it's possible to be productive while deeply depressed.
  • Mylene: “Even if I'm going through what I'm going through, I’M not going to abandon my dog. I'm not going to abandon my partner. And I think that's a success.” (57:01)
• Dr. K warns against comparing our insides to others’ outsides, and the dangers of motivators rooted in self-rejection or perfectionism.
  • Quote: “We compare our insides to other people's outsides.” (48:01, Dr. K)

8. Limitations of Therapy and Psychiatry

• Many share frustration that therapy/medication often isn’t enough—especially for trauma, chronic illness, or complex issues.
  • Alex asks candidly: “What kind of protocols help people who are struggling and maybe not seen?” (61:23)
• Dr. K: There’s no “one-size-fits-all” solution. New research shows depression is affected by physiology (e.g., gut-brain connection), inflammation, and requires wider interventions (e.g., exercise, mindfulness, nutritional changes) (61:57–65:19).

9. Spirituality, Self-Healing & Meaning-making

• Taylor praises spirituality and Buddhism as key when all else failed, especially for PMDD (65:25–69:39).
  • Dr. K: Meaning-making protects against trauma/PTSD, and "adaptive misbelief" can be psychologically protective.
• Dr. K affirms self-compassion, mind-body practices, peer support, and non-traditional healing as critical tools.

10. Living with Borderline Personality Disorder (BPD)

• Lucia describes persistent emptiness, trauma, and seeking identity through others—a central theme to BPD.
• Dr. K highlights that BPD can and often does improve, but the journey is especially painful. Lasting change often comes from developing a more solid sense of self (79:10–82:49).

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Notable Quotes & Memorable Moments (With Timestamps)

• "No wonder you feel broken, cause I think you haven't had a chance to heal yet." – Dr. K (05:04)
• “It's like my nervous system and my mind are completely separate, and they're going into different things to where my body doesn't recognize that I'm safe.” – Kashish (08:35)
• “The more I let it out, the more I let it be... I'm able to like be myself again.” – Kashish (11:36)
• “God, I feel like I've never felt more alone. Sorry. I did not expect to cry.” – Leah (15:40)
• “There's the depression that you feel and then there's the way that you argue with yourself about the depression, the way that you judge yourself for having depression... that's what's keeping it alive.” – Dr. K (24:31)
• “Every day I feel like might be my last. Like, you know what I mean? Might be my last.” – Lamar (33:33)
• “As long as you are not happy with yourself, you will be dependent on the people around you to get that sense of happiness.” – Dr. K (41:55)
• “Every time I reach those goals, I set higher ones for myself. And it's just kind of a never ending, like I'll never be good enough so why try kind of mentality.” – Megan (45:01)
• “We compare our insides to other people's outsides.” – Dr. K (48:01)
• “I've been running on fumes for a long time. They can carry you way farther than you may have ever realized, which is what's insane.” – Dr. K to Lamar (88:25)

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Timestamps for Important Segments

| Timestamp | Segment/Topic | |--------------|-----------------------------------------------------------| | 00:00–02:00 | Introductions, personal stories, Dr. K’s opening claim | | 02:04–07:16 | Participant 1: Loss, grief, challenges mourning | | 07:47–13:50 | Kashish: Foster system trauma, body-mind split | | 14:25–19:48 | Leah: Treatment-resistant depression, emptiness | | 20:53–26:15 | Joe & Lamar: Hopelessness, moral injury, veteran trauma | | 34:39–41:55 | Ian & Dr. K: Success vs. happiness, validation seeking | | 45:01–53:00 | Megan & Kashish: Perfectionism’s pain, self-awareness | | 57:01–59:34 | Mylene: Suicidal ideation, routine, family rejection | | 61:23–65:19 | Alex: Limits of therapy, modern depression research | | 65:25–69:39 | Taylor: PMDD, spiritual healing, finding meaning | | 79:10–82:49 | Lucia: BPD, emptiness, trauma, validation struggles | | 83:15–94:22 | Closing circle: Dr. K and Lamar on futility & resilience |

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Tone & Takeaways

The tone is honest, raw, often heavy, but punctuated by moments of hope, dark humor, and camaraderie. Dr. K’s approach is gentle, validating, and nuanced—he acknowledges hard limits, systemic failures, and the pain of not being “fixable.” Yet he also spotlights the power of community, persistence, and even the small victories of staying in the struggle.

Essential insights:

• Depression is not a monolith: it is caused and perpetuated by grief, trauma, cultural messages, physiology, and how we are (or aren’t) allowed to process emotion.
• “Feeling broken” is often a natural response to environments that discourage grief and vulnerability.
• Success and productivity don’t immunize against depression; perfectionism is both a motivator and a trap.
• Hopelessness and self-loathing are intertwined, often keeping symptoms alive even after hard work to heal.
• Community—peer support—is just as crucial as professional therapy.
• Accepting that healing is not linear and that setbacks do not mean failure can lift the emotional burden, sometimes more than “fixing” symptoms.
• Even when the darkness feels endless, sharing stories and admitting struggle breaks isolation—and that, itself, is an act of strength.

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Summary Table: Who Spoke, Key Points, & Dr. K’s Responses

| Speaker | Key Point/Story | Dr. K’s Response/Insight | |---------------------|------------------------------------------------------------------------|-----------------------------------------------| | Participant 1 | Grief, family discouraging mourning | Need to mourn, family’s emotional norms matter| | Kashish | Foster child, trauma stored in body, body/mind disconnect | Trauma disrupts self-regulation, needs support| | Leah | Treatment-resistant depression, joyless success | Focus on attention, don't battle inner critic | | Joe | Hopelessness feels like conclusion, self-loathing | Address self-judgment, not just symptoms | | Lamar | Marine PTSD, moral injury, failed by system, skepticism | Need deep understanding, validate anger | | Ian | Productivity masks depression, needs validation, lacks joy in success | "Psychic amputation," self-worth vs. success | | Megan & Kashish | Perfectionism, goal-posts always moving, emptiness | Compare insides/outsides, root beliefs | | Mylene | Can be productive in depression, importance of small wins | Unlearn survival habits, create new ones | | Alex | Frustration with standard therapy, need for broader solutions | Depression is physiological & psychological | | Taylor | PMDD, spirituality found meaning, Buddhist coping | Meaning-making helps heal trauma, self-care | | Lucia | BPD, emptiness, trauma, validation seeking, religious conversion | BPD improvable, finding self is key |

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Final Reflections

This episode deliberately avoids easy answers, instead foregrounding empathy, evidence, and authentic struggle. Whether you’re currently in the dark, or supporting someone who is, Surrounded offers community, new language, and the radical suggestion that sometimes being “stuck” is a deeply human stage—not a failure. The power of this episode lies in its refusal to flinch from pain and its persistent, gentle faith in slow progress and shared humanity.

Transcript

[Participant 1]

My grandfather passed away and I felt like I lost a part of myself I can't get back. I can't fix it, I can't mend it because they're not here anymore.

[Leah]

So, you know, I'm doing the thing that I love. Yet I still felt. God, I feel like I've never felt more alone.

[Dr. King]

This protects you from being disappointed. It does, but it traps you.

[Lamar]

Every day I feel like might be my last.

[Host John Regalato]

Are you watching this feeling hopeless or broken? Are you doing all the right things but still feel deeply depressed? I'm John Regalato and from Jubilee Media, this is Surround it, featuring 20 people who are struggling with depression. Now, if you've seen the show before, you know it's built around debate, but today we're doing something different. This won't be a debate and this time the flags won't be used to vote someone out of the circle. They'll signal your desire to speak with our Featured guest psychiatrist, Dr. King. Welcome to the show.

[Dr. King]

Thanks for having me.

[Host John Regalato]

Thank you all for being here. We're very appreciative of you guys sharing your stories. Let's get into it.

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[Dr. King]

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[Dr. King]

is you're not broken, you're overwhelmed.

[Participant 1]

I'm levels.

[Dr. King]

Okay, nice to meet you.

[Participant 1]

Levels their claim. I'll say for me personally, I feel like I was broken. I went through my uncle passing away and then the next year my grandfather passed away and I felt like a part of me broke when he went, a part of me died with him. So when I went through my throes of depression, which I, you know, I'm still in it, you know, I have my days, my good days, my bad days, I kind of went down that path of like, I. I lost a part of myself I can't get back. I can't fill that void. I can't fix it. I can't mend it because they're not here anymore.

[Dr. King]

What did you lose?

[Participant 1]

I felt like I lost my comfort.

[Dr. King]

Comfort.

[Participant 1]

I would talk to him about kind of like, you know, hey, grandpa, I'm sad. Hey, you know, grandpa, I'm having a hard time at school. Hey, what do you think? And you know, he's old. He'll go off and have his little conversation about conspiracy theorists. I'm like, oh, haha, that's cool. But it's like, it's nice to have somebody in your corner.

[Dr. King]

Yeah. I mean, I think this is one of those claims that I sort of agree with you already.

[Host John Regalato]

Yeah.

[Dr. King]

When we lose someone, that person's gone forever.

[Participant 1]

Yeah.

[Dr. King]

And we're never getting them back. And it also sounds like he was a really important part of being a safe space for you. Someone that you could talk to. Right. Can you tell me a little bit more about him?

[Participant 1]

Well, he was a veteran, so, you know, there's stuff he didn't really talk to us about. But, you know, he would take us camping and, you know, bowling. I mean, I was his first grandchild, so I kind of. All my memories were kind of tied to him, you know, going to his house, having pie, Even though pie is not the best thing to have, you know, for breakfast. But it was nice, you know, I

[Dr. King]

think it's a great breakfast.

[Participant 1]

You know, he would take me places. He would tell me, like, oh, this is my favorite food. Let's try it. Let's go do this, let's do that. You know, it was just nice, you know, I'll say my parents didn't do that. You know, it's just like having somebody outside of, you know, your parents. It was nice to have him.

[Dr. King]

So. And when you lost him, what did you lose with him?

[Participant 1]

I guess my. Everything. I didn't know how to function. I mean, I have support, but he was kind of like the main. Like the first person I would go to. And then he, He. He died of leukemia. And for me, my family was upset and I was kind of trying to be stronger for them, so I didn't realize how bad it had got. Like, I mostly wish I had more time with him. Like, I was there for him physically.

[Dr. King]

Well, it sounds like you were also present for your family when he passed.

[Participant 1]

Yeah, I didn't. I didn't let myself mourn. I didn't let myself Cry. I was more so, like, it's okay. I'll be there for you. And then when they were done mourning, it kind of got to a point where I was like, maybe I can be upset about this. And it kind of triggered everyone around me, like, hey, let's not do this right now. Like, I'm trying to relax. I'm like, hey, I'm hurting.

[Dr. King]

Oh, boy.

[Participant 1]

Yeah. But it's also like, they dealt with it.

[Dr. King]

So first of you chose not to mourn.

[Participant 1]

Yeah.

[Dr. King]

And then when you tried to mourn,

[Participant 1]

they were already done mourning.

[Dr. King]

Well, I mean, no wonder you feel broken. Cause I think you haven't had a chance to heal yet.

[Participant 1]

No, not really. But I put it off to the side. Kind of like, he's there, you know? And when I get older and my time comes, I'll get to see him again. That's kind of what kind of keeps me going, that, you know, I'm being watched over.

[Dr. King]

So I think this is also really interesting because you're kind of saying that what you will never get back. Right. Because that's what you're kind of thinking is this person who is safe, and here we are. And when you start mourning, what do the people around you do?

[Participant 1]

They're kind of off. They're like, hey, let's not talk about it right now.

[Dr. King]

And I think it sort of makes sense. Like, I know this sounds crazy, but it kind of makes sense. Right. Because if you weren't given a chance to mourn, if people didn't make you feel safe, if they didn't take good care of you and then you, like, literally, like, that's what happened. Well, no wonder you would think that this is the only person that'll do it. Because, like, he was the only one that literally did it.

[Participant with cancer]

Yeah.

[Dr. King]

And at the same time, I don't know that that's true forever. Does that kind of make sense?

[Participant 1]

Yeah, but it's like, I feel like for me, it is because I don't address it. You know, I kind of. I'm like, okay, let's put it in a little box.

[Dr. King]

Well, that's because that's what the people around you told you to do.

[Lamar]

Yeah.

[Dr. King]

If you can find that safety, maybe if you can advocate for yourself a little bit more. And I know this is tricky, Right. Because the whole problem here is that people have not been taking care of you. I think getting some degree of anger and sort of letting people know around you how not okay it is that you're hurting and you took care of them, and now it's their turn. Does that resonate with you at all, or does it send you running for the hills?

[Participant 1]

Well, it does. I mean, current issues, my grandma's health. I've been more vocal about being upset versus before, where I was like, yo, it's okay. He got to make a choice. You know, we should be happy for him. He can advocate.

[Dr. King]

And now that you're more vocal, what's happening?

[Participant 1]

I'm more aggressively vocal. And they're like, okay, like, we can't do anything about what she's doing. I'm like, why? I guess I'm being more open about this feeling because it's in the now and not in the past.

[Dr. King]

Yeah. So I'm actually, like, somewhat optimistic for you. I know it sounds crazy, but how

[Participant 1]

could you not mess with me?

[Dr. King]

Cause I think now you're doing something really scary, but very different, which is you are opening yourself up for other people to help you. And the real tragedy of life is when we open ourselves up to be helped by other people, Sometimes they meet us halfway, and sometimes they don't.

[Participant 1]

Yeah.

[Dr. King]

But I think give people a chance. Yeah. Great.

[Host John Regalato]

We're going to pause here. Thank you.

[Participant 1]

Do I shake your hand?

[Dr. King]

Sure.

[Participant 1]

Okay.

[Joe]

Sorry.

[Dr. King]

Hey, what's your name? My name's c. C?

[Mylene]

Yeah.

[Dr. King]

C. Nice to meet you, Cee.

[Kashish]

Nice to meet you. So I'm a former posture kid, and for all my life, I've lived differently from everyone else, essentially from surviving. I wasn't taught normal societal behaviors or emotions because I had to take care of myself while being in a dangerous environment. And what's interesting is that even though physically and mentally, I'm fine and I feel great and I can do my daily tasks, interact with people, it's still stuck in my body. I feel the depression. Like, right now, I don't want to cry, but for some reason, my body just wants to let it out. And before, I wouldn't let it because growing up in Hispanic culture, they'd be like, oh, po qute horror. I was like, why are you crying? Like you want to cry? Okay, I'll make you cry to where it was like, okay. Like, I can't. I can't. But the more that I would hold it in and push it down, the worse it became until eventually I just let it out. It's like my nervous system and my mind are completely separate, and they're going into different things to where my body doesn't recognize that I'm safe. Like, now I'm safe. No one is going to hurt me. No one's coming after me. No one is going to physically or emotionally hurt me, but my body is still in that hypervigilant state. It's where it's always aware. It's always like, okay. And there are times where it just becomes overwhelming. There are times where it looks like disassociation, night terrors, to where it feels like it's hard to trust or connect with people. It feels like I'm still in that physical state, whereas mentally I'm great. I just don't know how to. I've gone through the work. I go through depression. I'm taking antidepressants. I'm taking multiple classes and courses and therapies. But I just want to understand why this happens so much. Why is it that my body reacts so differently from my brain?

[Dr. King]

So the first thing we're going to talk about is dissociation. You have two parts of your brain, two hemispheres. Your right hemisphere is where we experience emotions. Your left hemisphere is where we're basically logical. I mean, that's not necessarily true, but broadly, it's true. Now, here's the really interesting thing. In the middle, there's this part of our brain called the corpus callosum. And the corpus callosum is what lets the right part of our brain talk to the left part of our brain. And when people grow up in a very traumatic environment, that thing stops communicating. You may experience that everything is fine. The left side of your brain, which is active right now, is saying, okay, we're at work. We're maybe gonna go get some ice cream after work. And you're like, living a normal life, but the other half of your brain is screaming. And the problem is the volume has been turned down so we can't hear it, or the headphones are unplugged. So even though the signal is there, this part of your brain is screaming. The left side of your brain doesn't really feel it, except there are times where it switches over. And then we feel all of these weird emotions. Like, we feel all these emotions that we had no idea, like, where this is coming from feels really inappropriate because I'm, like, sitting here having my ice cream, and my body is telling me, like, oh, my God, we're going to die, or something like that, right? So this is a really, really classic situation. I think a big part of this, and the good news is that we can heal from this. What's really hard about this is how confusing it is because you see, like, other people react appropriately to the things that happen around them. But literally, what's happened is you have all of these pent up reactions that you've been carrying with you. And I can see that this is bringing up. What are you feeling?

[Kashish]

I don't know what it is. It's just kind of just what I do is I normally just let it out. It's as if my body wants to cry, but I'm listening to you and I'm not crying, but my body is.

[Dr. King]

Yeah, see, it's happening right now. And so when you feel this way, what do you do?

[Kashish]

Before it used to be really bad where I would hit my forearm or hit myself and be like, no, you can't feel this way to where Now I've learned that I let it be, let it process. If I'm gonna cry, it's like I even close my eyes and I go, it's okay, it's okay, you're safe. No one's gonna hurt you. You can just breathe and just let it out. Because the more I let it out, the more I let it be. Then it kind of goes through this, like, stress cycle and I'm able to like be myself again. And then after that I go hang out with friends, I go outside, touch grass. It's touch, sight, smell and feel that I do to kind of be present.

[Dr. King]

You figured all this stuff out on your own?

[Kashish]

Yes.

[Dr. King]

This is amazing. Yeah. I think what's so sad about this is just how much of this should have been done for you. I think people don't realize this. The way that we manage our emotions is through other people. Even now you're sort of like a foster kid surviving on your own. Right. And this is a situation where I think like the healthiest thing is that someone else should actually handle that emotion for you. That you shouldn't have to deal with this all on your own and cope with it. And that you should be able to cry and get angry and things like that. Right. So like what a parent does when a kid is like 3 years old and they're learning how to cry, which you haven't been able to do because of what seems like some amount of Hispanic upbringing, foster care, things like that.

[Kashish]

Yeah. My parents didn't like me because I was gay. So they kept me away from society, kept me away from people. Like they had me essentially say, you were essentially a demon. So you need to stay in this area and this is how you should act and be your quiet.

[Participant with cancer]

You are.

[Kashish]

So that's what I've learned. And now I'm trying to readapt to it. And the Biggest thing is feeling my emotions like this. I can control this. It's so hard.

[Taylor]

Yeah.

[Dr. King]

So, you know, there's a modality called EFT which is called the Emotional Freedom technique. There's a lot of studies now that show that trauma is stored in the body. And I think that these reactions that you're having where you feel like your body wants to cry and your mind doesn't, like that's where like literally stuff is, is stored, is pent up. And I think it's gotta come out. And I think the most important thing. I know this sounds crazy, but I think the most important thing is trying to find someone who will deal with it for you because you've dealt with it on your own for like far too long.

[Kashish]

So what does that look like then?

[Dr. King]

It's a great question. Sometimes this can be a therapist, sometimes it can be a friend. I think it can look a lot of different ways. Tragically, you were not given that growing up. And I think this is one of the saddest things in psychiatry how, how insufficient treatment is, is a substitute for love. And I think like, love really goes a long way.

[Megan]

Yeah.

[Kashish]

That and for me it looks like actions too.

[Ian]

Yeah.

[Host John Regalato]

Thank you. C. We're going to pause here for participants.

[Dr. King]

I'm Leah, Leah Oluk. Nice to meet you.

[Leah]

Nice to meet you. Well, I just wanted to. To for one say that I've related to things that both of these people have been saying before me. First in the grief. My dad passed away six years ago. That has been a significant source of my depression and I have treatment resistant depression. But it's not for the lack of wanting to be treated. I would do anything for something that works, but like, nothing has. Like, it's like my mind is, I feel like is searching for more reasons to be depressed sometimes. And also I relate to the dissociation. Like half of me is like somewhere and the other half is like super depressed. So for example, I'm a musician and how I cope is actually writing about this really deep dark stuff like suicidality and stuff. I write about that. I was at a show and the show was going objectively really well. Sorry. Yeah, I just looked out at the. Sorry.

[Sterling]

I don't even know why I'm crying right now.

[Leah]

Objectively, everything was good. I just looked out at the crowd and just the. I felt so empty. So, you know, I'm doing the thing that I love, yet I still felt. God, I feel like I've never felt more alone. Sorry. I did not expect to cry.

[Dr. King]

Yeah.

[Leah]

Can I respond yes, please.

[Dr. King]

So thank you so much for sharing. What was your name again?

[Leah]

I'm Leah.

[Dr. King]

Leah. Here's what I'm hearing. So here you are. You make music, you use it to cope. But I imagine you like it too.

[Leah]

Yeah, of course.

[Dr. King]

And you're on stage, you're actually like kind of at the height of joy and fulfillment in your life. Like this is what you came here to do.

[Alex]

Yeah.

[Leah]

I mean, I'm not exactly where I want to be yet.

[Dr. King]

I'm sure that there's, you know, stuff that can be better. But if we think about just the moments of joy and you're denied that.

[Mylene]

Yeah.

[Leah]

It's like things are starting for me and why am I still not?

[Dr. King]

Yeah. Right. So I'm almost like thinking about how hard it must be for the things in life that are supposed to feel really good to feel so alone. Right. And I really hear that you've got treatment resistant depression. And I hear that if anything could take this feeling away. Right. If anything would just allow you to experience life the way that regular human beings do. Which is like when I'm on stage and having a good time and everyone's singing lyrics, I should be having a good time too.

[Sterling]

Yeah.

[Dr. King]

And that feels really, really terrible. Like you're being denied the chance to live an ordinary life.

[Sterling]

Yeah.

[Leah]

That's sort of like why it's so bad.

[Dr. King]

Yeah. So let me ask you this. Why do you. How do you understand that your mind is searching for reasons to be unhappy?

[Leah]

Well, I'm super judgmental of myself. So my self talk is like very negative. I'm sort of like at a constant like argument with myself. So it's like. But I'm also like, I know that I have to accept these thoughts and not argue with them to get better. Like I know the solution on paper. It's just harder to apply in practice. For example, again the stage thing, like I'm doing what I love, Right. Why is my brain, it feels like it's like looking for reasons to be upset.

[Dr. King]

So here's one of the tricky things I've learned as a psychiatrist and I've worked a fair amount with people with treatment resistant depression. Speaking of humility, I think there's three patients that I've worked with that I really have not been able to help that I can think of. And I remember them very well. And we tried really hard and I think I hate that.

[Leah]

What do you do about something like that?

[Dr. King]

I mean, tried all kinds of things. But I think the good news is that for the three patients that I've worked with who have treatment resistant depression. I've worked with 50 to 75 that things have worked. And the one thing that I would really tunnel down into just because we have a little bit of time here, is to really pay attention to that part that is searching for a reason to be unhappy. So don't argue against yourself, but try shifting your attention away from that towards other things. I definitely tried and I think that that's a skill.

[Leah]

Sometimes it works, right?

[Dr. King]

So if it works sometimes, then that's where I think learning to be better at it can offer some relief.

[Leah]

It's just the fact that it always goes back.

[Dr. King]

That's where we get to part number two, which is to understand why your mind, there's a part of your mind that is really, really unhappy with being happy. Right. The most alone that you felt is when you are actually should be the happiest. And so to really understand what is it within you that is looking for unhappiness.

[Host John Regalato]

We're going to pause here, Leah. Thank you. We're going to switch participants.

[Dr. King]

Good luck, Leah.

[Mylene]

Thank you.

[Host John Regalato]

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[Host John Regalato]

Thank you to Kickoff for sponsoring this episode. Now let's get back to the show.

[Dr. King]

My next Surrounded claim is that hopelessness feels like a conclusion, but it's actually a symptom. Hey, Joseph.

[Joe]

Hi, Dr. K. How you doing today?

[Dr. King]

Good.

[Pharmaceutical Voice]

Good.

[Joe]

To meet you.

[Dr. King]

Nice to meet you, man. Well, does hopelessness feel like a conclusion to you?

[Joe]

That's part of my issues is that when I am super depressed and I'm at the depths of everything, that's where it feels like there's no way out. And so is this a symptom of something that's bigger or is this my final state? And so that's where I get stuck because I know that it's a symptom, but the overwhelming thoughts is like, this is my conclusion, this is where I'm stuck and there's no escaping this. That's where I feel like I can't gain the traction even though I know I'm supposed to. And I have the skills and I've met doctors and worked on this. I don't know how to get past that. So I get bogged down that I'm stuck here.

[Dr. King]

Yes. So this seems really hard because it sounds like you actually know on some level that this is a symptom. Yes. You've worked with doctors, you've learned the skills in your head. You're telling yourself, oh, this is just a symptom, this is not a conclusion. You try to disbelieve yourself and then what happens?

[Joe]

Well, then that's where I've made more progress. I'm not as stuck as I was and thankfully, but I still have to work on this all the time. It never goes away. And I wax and I wane. So when I'm feeling like I can't gain traction to get out of here and I don't know what my next steps are, it gets so scary that it's almost like a self fulfilling prophecy. I can feel it dragging me backwards. And that led to ultimately to some very, very deep depressions, suicide attempt, the loss of my employment and so that didn't help, you know.

[Dr. King]

Yeah. So what I'm kind of getting the sense of is that you'll struggle for a while but then it feels like inevitably you're going to get dragged down.

[Joe]

Right. When I feel like I'm dragging myself backwards and I'm never going to get out of this and it's like, oh no, here we go again.

[Dr. King]

Can I ask you, when you say I'm dragging myself backwards.

[Joe]

Yes.

[Dr. King]

What is that? Help me understand why you think it's you who's doing the dragging.

[Joe]

Well, that's my inner struggle. Your inner voice talking with you is like, well, you know better. You know that this is going to hurt, you know, and that this is something that is bad for you. To bedrock. To doom. Scroll to just feel hopeless. I feel disappointed in myself because I feel like I know better.

[Dr. King]

Would you say that disappointed is, is almost like self loathing?

[Joe]

Oh yeah, absolutely. Absolutely.

[Dr. King]

How do you relate to that loathing feeling that you have towards yourself?

[Joe]

So I. What happens when that starts to happen is I perseverate on all the issues. I lost my job, I disappointed my family, I lost my identity being a fireman. I mean, firemen are very wrapped up in, in their profession. That becomes part of their identity. Fortunately, I tried to avoid that, but it still grabbed me. So that just really weighs heavy on my mind because I look at all the things that I destroyed or gave up.

[Dr. King]

So this is what's so tricky, right. Because what I'm noticing is that not only do you have the symptoms of depression, you actually have something else on top of that, which is a lot of blame for being depressed.

[Joe]

Yes.

[Dr. King]

After all you've put in the work, you tried everything. Right. And it's a skill and that every day is. Oh my God. It's like every day is a struggle. Every day is a struggle. Do you ever kind of tell yourself if you were different or if I did things better then like all of this stuff would be working better?

[Joe]

Oh, yeah, absolutely.

[Dr. King]

So let me ask you this, Joe. I don't know if this makes sense. There's the depression that you feel and then there's the way that you argue with yourself about the depression, the way that you judge yourself for having depression. What I think is really interesting is that's what's keeping it alive. Do you kind of get that?

[Joe]

Yes, absolutely. And I've worked on that with my doctors. You know, one of the things that my doctor and I used to talk about is I feel like what worked for me to get traction going was I was going to fake it till I make it. I'm going to act like I'm happy until I acting happy, you know, So I find myself feeling like if I don't do that, I'm just going to continue to beat myself up and it's just going to keep going and going and going and I'm never going to make any progress.

[Dr. King]

There's a lot of studies on something called behavioral activation, which we think that we have to feel better in order to do more. Right. I want to feel better so I can get out of bed. Whereas there's a lot of evidence that shows that sort of faking it till you make it actually works pretty well that when we step out of bed, when we force Ourselves out of bed, the feedback that we get can actually be helpful. So I can totally see why that has been helpful for you. I think the thing that scares me the most and feels so oppressive, Joe, sitting with you, is that just how much you have to work to have a normal day.

[Joe]

Oh, yeah, absolutely. Absolutely.

[Dr. King]

And I think that's where it's not so much about dealing with the depression and getting out of bed. It's really changing the way that you relate to your depression, that this is something that sometimes happens to me for whatever reason, I'm cursed in this way, which I know sounds crazy, but sometimes it can be useful to even think about it like that. But ultimately, changing that self loathing is going to be a huge step forward.

[Host John Regalato]

Pause here. Joe, thank you so much.

[Joe]

Absolutely. Thank you so much. Appreciate that.

[Dr. King]

Thank you for sharing your story. Hey, how are you? What's your name, bro? Lamar Olog. Thank you for coming up.

[Lamar]

No problem. I would say that for me, I can't speak as to everybody's journey or where they've been in life, but as far as for me, I feel like this is like the conclusion, a little bit of background on me. I'm a Marine, so I've been in major conflicts. I've trained people for conflicts and everything. After being in those conflicts, I only had a week on how to adjust to being a civilian again. After that week, I started sleeping in the closet for six months, had all my meals given to me in a closet because I couldn't deal with anything out there. Thinking that after serving my country for eight years that I would come back to opportunities, jobs. I came back to a park bench that I slept on. So I felt like I was kind of like left behind.

[Dr. King]

Well, you were.

[Lamar]

I was left behind. I've accepted everything that I've done as far as, like, my career over there. And it haunts me a lot of things. You know, it's taken over my life. When I got out, it feels like it's a starter package. I would talk to a mental health specialist, they would hear the problem, and then it's like they put you in a category and be like, all right, here's your Trazodone, here's your Olazepine, here's your go out the door. Here you go. If I tell you that doesn't work, then it was given to me like I was the problem. It almost seemed like I was getting penalized for the medication not working absolutely right.

[Dr. King]

So I'm getting the sense that you sort of got judged that you Were supposed to be a certain way. You were supposed to respond. You were supposed to get better, and you didn't get better.

[Lamar]

No.

[Dr. King]

And then they. They label you, they bucket you, they put you on. On this track. It almost feels like yes. Yeah. So what's. What's that like for you?

[Lamar]

Well, that's why I say it feels like a conclusion. Because after that doesn't work. My only question is, what's next? I've done the meditations, self help, believe in yourself. You know, go to groups, do this, do that. I've done all that. And still I'm left with the same conclusion, that it doesn't work.

[Dr. King]

So, Lamar, I mean, I think what's really challenging about this is clearly something is left over from your time in the Marines. Right. You're not the same person who went over. I don't know where you were, but does that kind of make sense?

[Lamar]

Yes.

[Dr. King]

And then when you came back, they said, okay. For people who aren't able to integrate, take trazodone, take loxapine. Those are heavy hitting medicines, by the way. And then if you don't get better, then do this, then do this, then do this, then do this. And you're a guy who tried it all. It sounds like you've tried meditation. I'm sure you've tried therapy.

[Lamar]

I tried everything.

[Dr. King]

And if I were to tell you, Lamar, there is something that will help you, there's something that'll help you a lot, how would you receive that?

[Lamar]

I think that at that point, after being through everything I've been through, I would have to put you in a category because I would ask you, is it medication? Is it going to be group therapy? It's going to be constantly checking in. I haven't seen anything different across the board is what I'm trying to say.

[Dr. King]

Great. So good. So now we have a different kind of problem, which is that you have learned that something won't work.

[Lamar]

I think I was taught that something won't work all this time.

[Dr. King]

Absolutely. Absolutely right, Lamar. I think the problem here is that the reason nothing is working is because I don't think anyone has really understood what you struggle with.

[Lamar]

So where do we go from here?

[Dr. King]

We understand you, man. We understand. What's it like? Why were you in the closet?

[Lamar]

Because. Just a little bit of history. Just real quick.

[Dr. King]

Yeah.

[Lamar]

I did everything in reversal. I graduated from high school in 03, going through a recession in Dallas, Texas. There was no jobs. I was working warehouses at the time. Three years later, after the contract, I go into the Marine Corps, and then I take three tours. My job description changed from heavy mechanics and helicopters to now I'm 03 infantry, heavy machine gunner. Then I switch again to intel. Now I'm doing interrogations throughout the night. And these interrogations ain't, you know.

[Dr. King]

Yeah.

[Lamar]

But I'm also telling my command I'm tired. I'm tired. They're thinking physically, I'm talking mentally.

[Dr. King]

Yeah. So let me say, say this, Lamar. What you just shared with us, I cannot stress this enough profoundly, affects every dimension of who you are. Affects your heart, affects your lungs, affects your cortisol level, affects your mind, affects the way that you cope with things, affects the way that you survive because you have to survive this. I don't think anyone can help you unless we understand the ways in which you're broken. You get me, man? There's no way people sort of labeling you and sort of saying, oh, like loxapine is going to fix this and Trazodone is going to fix this. That doesn't even begin to touch the surface. I think if you want any. Any chance, you have to have someone understand you, right. And what you struggle with on a day to day basis, I think that

[Lamar]

you can have people that have empathy. But to understand on that surface level, I don't think I've came across that.

[Dr. King]

I believe you, man.

[Lamar]

Yeah. But I'm saying, like, even though you believe me and all this, what does it do for me? What does it do for me? You know what I mean? Like, what does that do for me? After we finish all this, guess what? I'm gonna go back to that house, I'm gonna sit down, I'm gonna contemplate my life. You feel me? I'm gonna contemplate it. I contemplate it every day. And it's been going on for so long that now, at this point, like

[Dr. King]

I said, you've been alone with this, right?

[Lamar]

Yeah, most definitely. I don't try to put it. I don't try to be a burden on nobody. I don't think anybody wants to be a burden on anybody is what it is.

[Dr. King]

So, Lamar, I know this is gonna sound empty. Here's my experience I've worked with. I've done a lot of work with veterans. First thing that I learned is y' all don't come back the same. Each and every one of you comes back a little bit different. Second thing is, I don't know that there's anything that I can do or anyone else can do that will actually help you. I don't know that, man, whatever happened over there was so bad. And there's a new diagnosis, by the way, called moral injury, which is a form of ptsd. That is not when something happens to you. Moral injury is when a good person is made to do bad things or when a good person watches someone else do bad things. That breaks us in a different kind of way. I will say, though, that what I'm hearing is that people haven't really understood you and that you've been doing this alone. And I don't know that this is. I can't predict the future. I don't know you. Maybe I'm an arrogant guy who says this, but I would say that since you like analogies, if I take my car to the shop and no one understands what's wrong with it and people start fixing it, that's what people have been doing with you.

[Lamar]

Yeah.

[Dr. King]

They've been saying, hey, man, this is going to work. Hey, man, this is going to work. Hey, man, this is going to work. Now, as I say this to you, what are you feeling? Lamar, I see you shaking.

[Lamar]

I'm shaking because, like I said, after hearing the same thing, it feels repetitive. Feels like I'm in a loop. Like this feels like a loop.

[Dr. King]

What's it like to be stuck in this loop?

[Lamar]

Every day? I feel like, might be my last. Like, you know what I mean? Might be my last.

[Dr. King]

Lamar, I'm grateful to you.

[Lamar]

Yeah.

[Dr. King]

And I know it sounds kind of weird. I can see that you're really struggling. I can see that every day. On the one hand, it feels inevitable, and on the other hand, it feels like one day you're going to be off the loop and you're never going to come back.

[Ian]

Right?

[Dr. King]

It feels that way. And I think the beautiful thing about this, and I know it sounds weird to call it beautiful, is it blows my mind how many people feel the way that you do. There are a lot of people out there that have come back from war, have been cops, have been firefighters. And when they look at you, when they see you, I think what they see is someone who is like them, that they're not alone in this world. And I don't know if. If we can fix you, man, but I certainly know that if you're alone, it's going to be way harder.

[Lamar]

This is my anxiety riding. Sometimes.

[Dr. King]

It's okay.

[Host John Regalato]

All right, we're going to pause here, Lamar. Thank you. Snap some to Lamar.

[Dr. King]

My next surrounded claim is you can be productive and successful while still being deeply depressed. What's your name, bro? Ian. Ian, Olive. Nice to meet you, man.

[Ian]

All right, So I think my first problem is I see a bunch of women with red flags on my men, immediately attracted to them.

[Dr. King]

Okay.

[Ian]

The red flags.

[Dr. King]

Oh, gotcha.

[Ian]

I want to say, like, everyone in this circle is a hero. There are days where just getting to live to the end of the day without doing something yourself is the hardest thing to do. And we all did it. I would like to stay in touch with everybody because I think we can help each other better than your training because we have lived it, and we know what it's like. I would say, like, on the surface, people would consider me a successful person. I'm a musician as well. The difference is, I don't like music. I'm just good at it. I used to love it. I don't want to do it anymore. I wanted to be a therapist like you, because I want to help people. And I think, like, just from the experience is the real education. Being depressed is the education. I'm divorced. Okay. My. I woke up one day and noticed my ex wife's phone was on Snapchat and found out she was cheating on me.

[Dr. King]

Okay.

[Ian]

I laid on the floor for three days and did not eat. I wanted to die. I've kind of wanted to die ever since. That zero stars would not recommend. Okay. I appreciate, you know, anyone that's trying to help us, but I think we can help each other better than maybe a professional can.

[Dr. King]

Okay, so it seems like that's what you want to talk about, that y' all can help each other better than a professional can. Sure. I mean, I think there's plenty of evidence that there are different kinds of help. So a really good example of this is. So I do a lot of addiction psychiatry. So there are certain ways that I can help people. But what we know from tons of studies is that peer support is huge for helping people. I remember my favorite moment of medical school was attending an Alcoholics Anonymous meeting, and it was so incredibly powerful. It is a kind of help that human beings can get from each other called peer support, which is very different from psychiatry. And I think most of the studies show that both help in different ways. But if you were to say that you can help everyone here around you in a way that maybe I can't, which is an interesting conjecture because you're assuming that I haven't struggled with depression. Yeah, I mean, I would agree with you. I think that that's.

[Ian]

I don't think I said you. Yeah, because I did say that I wanted to be a therapist, too, because and maybe that's why you ended up here. But I think it's more like the experience. Is the teacher.

[Dr. King]

Sure.

[Ian]

Right.

[Dr. King]

Do you want to talk about you a little bit or not so much? Yeah. So can you tell me a little bit? So you said on the outside people would see you as successful. What's on the inside,

[Ian]

much like the last musician, a lot of self criticism, a lot of discouragement, and just in general, not thinking. I've done enough thinking. I've let everybody that believed in me down.

[Dr. King]

So I'm curious, when you were growing up, did you find that whether you were happy or not depends on the people around you?

[Ian]

It depends a lot on the women in my life. If I'm happy or not.

[Dr. King]

Yes. Can you say more about that?

[Ian]

Yeah. I mean, I know that I need external validation, especially from women, to be happy. Okay, right. So perhaps growing up, like, my parents were very supportive. Maybe.

[Dr. King]

Were they supportive or did you find that they were very conditional with their love or support?

[Lamar]

Hmm.

[Ian]

I don't know if I would know the difference.

[Dr. King]

Okay. So I think that's telling. So here's something that I've seen, and there's also research about this, which is that, you know, a lot of times people who are very successful and very unhappy on the inside, a couple of things. One is when you beat yourself up, you work harder than everybody else. I do, yeah.

[Host John Regalato]

For.

[Ian]

For sure.

[Dr. King]

So that's number one. Second thing is that oftentimes people who are like this believe that there's a choice between happiness and success. It's interesting, there's a term called psychic amputation where you, like, lop off a part of yourself in order to become successful. Like, you have to sacrifice.

[Ian]

Oh, my God. Oh, my God. This guy's good.

[Dr. King]

He's pretty good, right?

[Participant 1]

Yeah.

[Dr. King]

So I just saw your eyes light up.

[Ian]

Yeah.

[Dr. King]

Yeah. There are things that you want to do, but what do you say to yourself when you want to do something?

[Ian]

When I was trying to be good at guitar when I was coming up, I sacrificed so much socialization just to sit in my room and twiddle my fingers on the instrument. Because I was like, I'm not where I need to be. It's not time to party. It I was in a punk rock band. I didn't do any drugs. What the hell?

[Dr. King]

You deny yourself a lot of enjoyment.

[Ian]

Yeah.

[Dr. King]

Right. You make sacrifices to become successful. Now let me ask you this, okay. When you deny yourself a lot of enjoyment, does it kind of make sense that your happiness with yourself would go down? Yeah, because A lot of, like, what makes us happy is when I'm like, I want a cupcake, and then I eat a cupcake, then I feel good on the inside.

[Ian]

I don't eat any cupcakes. You see my revenge body right here?

[Dr. King]

I see it. Right. So when you don't get that happiness from yourself, where do you think it has to come from?

[Ian]

It has to come from outside sources. Oh, therapy.

[Dr. King]

Right. And in your case, which outside sources?

[Ian]

From women.

[Dr. King]

There we go. Right?

[Ian]

Yeah.

[Dr. King]

And so now you're kind of stuck because now you've sort of created this system where if I were to tell you eat a cupcake.

[Lamar]

No.

[Dr. King]

No. Right. Do you want a cupcake?

[Ian]

Yeah, I'll take. I would, like. Got to worry about abs, though. Like this.

[Dr. King]

Right, so. And you need abs why?

[Ian]

So that women will like me.

[Dr. King]

Right. And then if women like you, then how do you feel?

[Ian]

Great.

[Dr. King]

Great. So you've got to make a decision, Ian. I mean, this is only for you to do is do you want to continue living life the way that you have, or do you want to allow yourself to be happy with things that you want, giving yourself those things?

[Ian]

So I've been instilled with this mentality that if I work hard, like, we're all told this as a kid, you're gonna get what you want.

[Dr. King]

How's it working out?

[Ian]

Not well.

[Dr. King]

So you wanna change it?

[Ian]

So stop working hard and get what I want.

[Dr. King]

That's not what I asked. Do you wanna change that?

[Ian]

Oh, yes. Yes.

[Dr. King]

Okay.

[Ian]

Of course. Just a hard society. You know, I got divorced and found out I was 5 7, and nobody likes that. So, yeah, it's a hard one for you to fix.

[Host John Regalato]

And Dr. Kick, can we also. I think there's, like, a specific thing that you're alluding to here, the need for validation from women. You know, I think there's going to be a lot of guys who might be watching this video who feel that specific need. Could you kind of put that on more specifically?

[Dr. King]

I think so. We live in a society where validation from women, and this is what's really interesting, is amongst dudes, is the way that we get respect. It's not even about the women. It's actually amongst dudes. So, you know, if you're someone who really struggles with being very, very susceptible to needing validation, I think a lot of this is because you've been programmed to let parts of yourself go. As long as you are not happy with yourself, you will be dependent on the people around you to get that sense of happiness. And just to give you just a tiny little example. So I struggled to date. I was just terrible at it for many years. And then I decided to become a monk and I decided to be celibate. And then I was like, I'm done with women. I'm done. I'm going to just be celibate for the rest of my life. And it turns out that once I found peace with that, that's when I met my wife. It's really bizarre.

[Ian]

I'm not gonna do that, but thank you.

[Host John Regalato]

We gotta pause here. Thank you, Ian. Thanks, doctor.

[Dr. King]

Thank you so much, man.

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[Dr. King]

Hey Alok. Nice to meet you.

[Megan]

I think for me, my depression kind of started stems from this sort of perfectionist mindset that I have for myself. And I feel like I can't get to a sense of success or self acceptance because I feel like nothing I do is ever good enough for myself. And every time I reach those goals, I set higher ones for myself. And it's just kind of a never ending, like I'll never be good enough so why try kind of mentality.

[Dr. King]

And do you find that being perfectionistic helps you?

[Megan]

It kind of keeps me going in, in a sense that like I feel like, you know, kind of what Ian said, I feel like if I just work hard and keep going, that'll kind of get what I want. But it almost feels like that gets farther and farther away the harder that I try.

[Dr. King]

Yeah, but it does keep you moving, right?

[Megan]

It does, yeah.

[Dr. King]

And so if you didn't have that to keep you moving, what would happen?

[Megan]

Yeah, we just kind of stopped trying.

[Dr. King]

I think you'd stop trying.

[Megan]

Yeah.

[Dr. King]

And so what are you trying for? What are you trying to achieve?

[Megan]

I think just happiness, self acceptance, success.

[Dr. King]

And what would you have to be in order to be comfortable to accept yourself?

[Participant with cancer]

Right.

[Dr. King]

You want to accept a certain version of yourself. Right?

[Megan]

Right. The version I have in my head that I feel like is just like the perfect. Like I don't make any mistakes, I'm good at everything. I have everything that I need or desire and I don't have any flaws, I suppose.

[Dr. King]

How did that become the standard? Why did you need to be so good?

[Megan]

Comparing myself to others is a big one.

[Dr. King]

Okay.

[Megan]

So I'll see others and what they're doing and think that I need to match that or be better than that.

[Dr. King]

Okay. And if you aren't perfect, how do you feel about yourself?

[Megan]

I don't like myself.

[Dr. King]

Do you remember a time that you did like yourself?

[Megan]

When I was a kid, just as I got older, into high school and everything, I just kind of stopped feeling good about myself.

[Dr. King]

So I think it's a really, really, really common problem. I think sometimes we forget that human beings didn't evolve to be happy. We evolved to function. And so you may wonder, like, you know, why is depression a part of how we experience things? And I think sometimes people who are very perfectionistic, you know, there are a couple things. The first is that it helps you. Actually, it's a huge motivational component. Right. Because if I want to be better, then I motivate myself and I keep pushing myself. I beat myself up until I achieve this thing, and then once I achieve that thing, then I will be happy. So I think the first thing is that this doesn't get better. Because if I were to tell you, okay, Megan, you should learn to love and accept yourself, would you actually do that?

[Megan]

It's easier said than done.

[Dr. King]

Easier said than done. What would stop you from doing it?

[Megan]

The negative thoughts in my head of just not feeling good enough.

[Dr. King]

Not feeling good enough. Right, right. And so I think there's a element there that you can look for, which is that if you were to accept yourself, what would happen in your life? Let me ask you that. What would your life look like if you had self acceptance?

[Megan]

I think I'd be happier. I'd be less hard on myself.

[Dr. King]

Would you do stuff?

[Megan]

Yeah, I would.

[Dr. King]

So that's actually really good. So sometimes people get stuck in this perfectionism and they get dependent on it for motivation. It doesn't sound like that's the case with you. So I'm going to share another concept which is is I think comparison is a huge part of perfectionism. One really interesting thing about perfectionism is that it's not like a diagnosis, but it is actually a way that our brain thinks predisposes you to things like depression and anxiety. And so the other thing that I would strongly, strongly encourage you to do is to focus less on comparisons. But notice how much your mind compares. This is where this gets a little bit more easier. But basically we have this sense of ego or identity, and this is who I am, and I want to be this thing. But that's like an idea in your head. It's not really who you are. And another really common thing that happens when we're perfectionistic is we compare our insides to other people's outsides. So let me ask you this. This is going to be really kind of focused. When you do a good job, what are the reasons, reasons that your mind comes up with, like, why did you do a good job? What does it say?

[Megan]

Like, if I worked hard at something, it'll say, like, you worked hard at that you deserve that.

[Dr. King]

Really?

[Megan]

It'll say that sometimes.

[Dr. King]

What else does it say? Does it say you got lucky? Sometimes when somebody else does a good job, what does your mind say about why they did good job?

[Megan]

That they're just good at it or they talented? They're talented. They're lucky for them. They just got it.

[Dr. King]

They just got it.

[Megan]

Yeah.

[Dr. King]

And when you do a good job, are you talented or lucky?

[Megan]

I don't often consider myself that now.

[Dr. King]

Yeah. So this is really important where it's so interesting, because there's research that shows that when people attribute other people's successes to talent or hard work, but their own successes to things like luck or circumstances or stuff like that, literally you're judging yourself on a different standard from the way that you're judging other people. And as long as you do that, then this will continue. And what some people find is helpful is when somebody else does a good job, to ask yourself, how did that other person get lucky? And when you did a good job, what did you do to deserve it? And it sounds like you're actually sort of halfway there because you do that sometimes.

[Megan]

Yeah, I do catch myself, you know, thinking those things. But then it just goes right back to like, the thoughts of, like, well, if you were good enough, you would. You would be able to be as successful as them, but you're not. So.

[Dr. King]

Yeah. So I would really tunnel down into how you learned that you're fundamentally not good. Right. Because a lot of that is like, you are striving, so you're down here and you want to be perfect because you're up here. The question is what? Where did you get the idea that you're down here to begin with?

[Megan]

Yeah, that makes sense.

[Host John Regalato]

We're going to pause here. Thanks, Megan.

[Dr. King]

Thank you, Megan.

[Megan]

Thank you.

[Kashish]

Hi, I'm Kashish.

[Dr. King]

Kashish Alok. Nice to meet you.

[Megan]

Nice to meet you.

[Kashish]

So I'm someone who also feels like no matter how much I accomplish the bar is always raising as if, like, if I get into the law school I want, the next thing is I have to pass the bar, get a job, and it just keeps going and snowballing. So it's hard for me to feel satisfied with my success. And I think I've correlated my happiness with it from, like the beginning. But I'm also very self aware of it. So I'm not sure what should be done.

[Dr. King]

She seems super self aware.

[Participant with cancer]

Yeah.

[Kashish]

So I'm not sure what should be done for people like me who know the problem but are just unsure how to Go about it.

[Dr. King]

Yeah. So is your happiness correlated with your success?

[Kashish]

It has been from when I was a kid and I still struggle with that sometimes.

[Dr. King]

What were you taught as a kid?

[Kashish]

The better you are, the more people like you in the sense of like, I was always in the honors programs, getting first place in sports and everything, and it just kept getting reinforced because I think society rewards productivity and success more than just mental well being or soft skills.

[Dr. King]

Yeah. What would your parents say about mental well being versus getting an A?

[Kashish]

I mean, they would ideally want me to score well, but my parents have never had as high expectations of me as I do of myself. So usually it's me where I would be like upset in second grade because I got a 9.5 out of 10 and they'd be like, oh, that's a great score. You're doing amazing. I just like, couldn't believe. Believe that because it wasn't perfect.

[Dr. King]

Do you want that to change?

[Kashish]

Yes.

[Dr. King]

Are you sure?

[Kashish]

Yes.

[Dr. King]

Why?

[Kashish]

Because it's honestly miserable. Always wanting to meet the next goal, and the goal is always going to keep raising. I don't think there's like a solution out of it. I see it as kind of like a circular problem where once I meet the goal, I just go to the next one and just keeps going and going and going. And it seems like the only way out of it is getting rid of that attachment from success and happiness.

[Dr. King]

So this is going to be a bit hard. So I'm going to ask you a question. Do you want this to change?

[Kashish]

I'm not sure, actually.

[Dr. King]

There we go. Right. So I asked you, do you want it to change? And then you said yes. And now I asked it again and you're saying, I'm not sure. So walk us through. Where's the conflict?

[Kashish]

The conflict is the reinforcement you get from being successful and gaining all of it. It just makes me feel more loved and desired or seen as well. And since I've attached my worth to my happiness, to my achievements, it just feels like that's the only way for me to be happy. But I'm also very well aware that that's not true.

[Dr. King]

Very good. Okay, so now we come to a really interesting problem, which is that, you know, intellectually this is not good.

[Kashish]

Yes.

[Dr. King]

Right. But there is a part of you that still wants it.

[Megan]

Yes.

[Dr. King]

Right. And as someone who had aspirations to go to Harvard myself, this is something that I struggled with a lot as well. But it comes down to the nature of happiness. So this is going to be a little bit different. But what Is happiness.

[Kashish]

I feel like my answer would be like, happiness is success. Success. But not anymore. I'm trying to change that.

[Dr. King]

No, no, don't change it.

[Kashish]

Okay.

[Dr. King]

Yeah. So when you. You feel happy when you're successful.

[Kashish]

Yes.

[Dr. King]

Okay, so. So, right. So then. But what does success do in you that makes you happy?

[Kashish]

It makes me feel as if I'm valuable, as if my skills are being put to good use, as if I'm useful, maybe. Otherwise, if I'm just, like, in bed or not doing anything, I just feel, like, awful, like I should be doing something or like I should be maximizing my time.

[Dr. King]

Okay, when you say you should be maximizing your time, you feel tortured, right?

[Kashish]

Yes.

[Dr. King]

So there's a lot going on in your head, and when you are maximizing your time, what's going on in your head?

[Kashish]

The busier I am, the less I have to think about my feelings and my thoughts and existence.

[Dr. King]

Oh, great. Great, great, great, great, great.

[Ian]

Okay, okay.

[Dr. King]

Good, good, good. So the busier you are, the less you think.

[Kashish]

Yes.

[Dr. King]

The more tortured you are, the more you think.

[Kashish]

Yes.

[Dr. King]

Right. When we become content, I want everybody to think about this. I want something. Oh, my God. I want this person to say yes when I ask them out on a date. I want to go to Harvard. I want to do this. I want to do this. Wanting, wanting. Wanting, wanting, wanting. A lot of mental activity. Sitting at the beach, looking at the sun can still be torture. If I'm thinking about all the stuff that I should be doing. If you look at the nature of contentment. I want a cookie. There is activity in the mind. Once I get my cookie, there's nothing in the mind. There is a certain kind of thing that brings your mind to a calm state. And if you can duplicate that calm state without being dependent on success, then you will be happy.

[Host John Regalato]

Sorry, we gotta pause and move on to the next participant.

[Dr. King]

No worries.

[Host John Regalato]

But thank you, Kashisha.

[Megan]

Thank you.

[Mylene]

Thank you, Mylene.

[Dr. King]

Nice to meet you.

[Mylene]

Nice to meet you. Yes, I do believe that you can be productive and successful. And the reason that I say that is because I've dealt with suicidal ideation for the majority of my life. For as long as I could remember, last year, I had a pretty bad episode. I could not get up out of my bed. I refused to do anything for myself. I lost a ton of muscle. I lost the ability to be confident myself. But the one thing that I was able to do was take my dog out for a walk. Even if I'm going through what I'm going through, I'M not going to abandon my dog. I'm not going to abandon my partner. And I think that's a success. You know, And I would like to bring this up because today, ironically, is my dad's birthday, and he did pass. And I wanted to share my story because I want to be productive. And by being here and talking about it, sharing and listening to people's stories, that's a goal that I have succeeded in. By sitting here.

[Dr. King]

Absolutely. Yeah. I mean, I think it sounds quite exhausting, actually, because I can see how hard you try. I get the sense that you're always trying to move forward and that you're not letting the people or animals down around you. Right. That there are lots of things that your depression may win on, but you're going to take your dog for a walk every single day because it deserves that.

[Mylene]

Yeah.

[Dr. King]

I'm so curious. What's it like? I mean, you said you've been suicidal since it sounds like you were quite young.

[Mylene]

Yeah. Growing up, I was never really encouraged to express my emotions. I grew up in a religious household where they believed that depression wasn't a thing. They tell me to pray, and, you know, I have nothing against religion, but I also wanted to feel seen. The lack of that took a toll on me, and I bottled it all in. And since it's never been addressed, it's so heavy on your heart, and you mentioned it earlier, that, you know, it's. It reflects on your body, and I feel it so much in. In, like, my chest and my heart, and it weighs heavy, and you have to put on this mask and just continue on as if you're okay.

[Dr. King]

Yeah. So, listening to your story, Mylene, I'm struck by something, you know, I've seen which is just so unfortunate as a psychiatrist, which is there's the burden of depression, and then there is the burden of not dealing with depression in the right way. So you actually carry two burdens. Right. There's all of the negativity that maybe was there at baseline, and then there is the rejection from your family. There's the forcing yourself to put on a mask. There's pushing all those emotions down. Half of what I really struggle with as a psychiatrist is helping people unlearn the things that helped them survive, like

[Mylene]

unlearning the habits or unlearning the experiences.

[Dr. King]

Both, but I was talking about more about the habits. So when you grow up with depression, you have to adapt to survive, and then those adaptations sometimes become mal. Adaptive later on. But then the problem is you can't Just take those away. Right. Because if you take that away, you're left with nothing or too much emotion or you're in bed all day or all these kinds of things. And that's why it's so tricky that you have to unlearn something while learning something else. And it. It's really hard.

[Alex]

Yeah.

[Mylene]

And that's why I focus on alignment. You have to align your habits with your goals. Even if I'm unhappy at that moment, if I change that habit, it'll change the outcome and the result of how I feel about what. What comes out of it all.

[Dr. King]

Does that work?

[Participant with cancer]

It's worked so far.

[Host John Regalato]

We have to pause here because we're out of time.

[Dr. King]

Thank you.

[Host John Regalato]

Thank you, Mylene.

[Participant with cancer]

Thank you.

[Dr. King]

My final surrounded claim is that if therapy didn't work for you before, it doesn't mean that nothing will. Nice to meet you, Alex.

[Alex]

So I'm curious to know what made you choose this particular claim to bring to this.

[Dr. King]

So I think that somewhere along the way, we started saying that there's a right way to deal with depression. We said, go to a psychiatrist, take a medication, go see a therapist. And there are a lot of people who are struggling. And we said, this is the answer. This will help. This will fix you. And my experience has been that that isn't always the case. And there's a ton of new research, the wildest of which weirdest trial I've seen to date is for a stool transplant, which is what it sounds like. We take stool from one human being and then we transplant that stool into another human being. And it turns out, yeah, it turns out that this has been shown to improve depression because the bacteria in your gut produce tryptophan. And tryptophan is a serotonin precursor. And when we boost serotonin transmission in the brain, it sometimes helps people with depression. For far too long, I think we've assumed that depression is a mental illness, whereas I think there's a lot of physiology to it. And so I think there's still a lot of options out there.

[Alex]

Yeah, I mean, I know there's the only so much that psychiatrists or psychologists can do. When you're in therapy, they only have an hour to diagnose, quickly, treat or figure out something, a quick solution for them in and out. Especially like in America for health care and stuff like that. But what kind of protocols do you think would help other people who are struggling that maybe aren't seen or like, instead of just, oh, here's a medication, try this and see what happens. And what are the traits that you would say, oh, this person would need something else.

[Dr. King]

So one thing that's really interesting is there's evidence of inflammation in the brain with depression. So as your inflammation level goes down, there is a good chance that depression improves. There are studies that. One study from 2003 found that exercise was just as effective as therapy in treating depression. It certainly helped some. I think there's a new wave of evidence based psychotherapies, what we call the third wave. These are basically like the Eastern things. So mindfulness, a big thing that I think people can learn how to do, this is a skill, is to be cognitively flexible. So oftentimes in depression, our mind thinks one way and then we think to ourselves, that's the way that it thinks. Learning to think. CBT therapy. Not necessarily cbt, but CBT is a portion of this literally holding contrary views at the same time. So even though if I break up with someone, I may think to myself, I'll be alone for the rest of my life, and this was a terrible waste of my time. At the same time, it can also be true that one relationship gives you more experience to be successful at the other one. So holding contrary claims is another really big thing. Dietary changes. We know that certain kinds of gut bacteria will actually improve depression. I think there's a lot out there that can be really helpful.

[Alex]

I understand that because a lot of the therapies that people go through are the talk therapy and the medication therapy. I've been on SSRIs for a very long time. I recently stopped taking them for the

[Dr. King]

past maybe five years.

[Alex]

And I found that it really didn't help. But the other forms of therapy I've tried, they help, but it's. I always get back into the loop of where like, then I go through two weeks of, oh man, I don't enjoy this anymore. I don't enjoy. I get the anhedonia or the lack of motivation to do the things that I used to like, or I'm not getting the same umph from what I was doing. What are the treatments after that?

[Lamar]

What.

[Alex]

What am I supposed to do?

[Dr. King]

Yeah, so I, I think, you know, what I'm hearing is, and this is unfortunate, sometimes you can do everything right and you can still feel like shit. And there somewhere along the way we got this idea that if I do more right stuff, it'll fix it. It'll fix it. And I think this, the thing that scares me the most as a psychiatrist is that it doesn't always work. It hurts. That People have to try so hard to just not drown, you know? And I wish I had an answer that there was some way to make everything better. I think that's the real struggle. There's something really weird that I've seen happen and I wish I knew how to make it happen, which is sort of accepting that, you know what, this is something I'm going to have to deal with for the rest of my life. That once you sort of accept that there's sort of a burden that can be eased up on. And then once there's a little bit of that easing of the burden, things feel a little bit easier. The weight becomes easier to carry. And I don't think it fixes everything, but I've seen some people really do get way better and then everything else starts to work a little bit more. But I think there is that fundamental, like grappling with the unfairness of. Of being born with the curse of depression.

[Host John Regalato]

Okay, we gotta pause there. Thank you.

[Dr. King]

Yeah, thank you so much. Alex. Hey, Taylor, how are you? Yeah, absolutely.

[Taylor]

People coughing up in here.

[Dr. King]

I'm one of them.

[Participant with cancer]

So.

[Participant 1]

Okay.

[Taylor]

I have reached a place I'm not a big fan of. Psychiatry, no shade. And have been in therapy for a number of years. I've done group, I've done individual, I've done cognitive behavioral therapy. That was my favorite.

[Dr. King]

Okay.

[Taylor]

Hence the. You know, and then I do a lot of grounding exercises. As far as my depression goes, it's changed over time. The one that I suffer from now, unfortunately, is pmdd.

[Dr. King]

Okay.

[Taylor]

Which is the pre menstrual depression. And it is horrific in a sense that I'm very confident. I'm funny, I'm cute, my body is t. I get money. But every two weeks my world is about to get rocked and there's no nothing I can do about it. I just strap in, buckle up, and just wait for the freight train to come. And it is so unfortunate as far as that goes. It's just like, where are you left with that? You know? And then I'm also in a place where I have been on the front lines politically and I also benefit from certain privileges in my life. Like we're not in a war torn country and that is kind of where I find joy.

[Dr. King]

Which is actually awful.

[Taylor]

To say nonetheless is like, I don't take those smaller things for granted. Right. What happens when you can't do anything about it at all? It's just like, what does one do at that point? I heard you talk about Buddhism and that was really exciting to me. Because that's what saved me.

[Dr. King]

Okay.

[Taylor]

I was raised Catholic, which is rough. And then when I got sober, I was introduced to spirituality.

[Dr. King]

Okay.

[Taylor]

Would you say that the spiritual realm and the spiritual practice and even a metaphysic practice can be a solution in this sense where there's nothing else working?

[Dr. King]

Absolutely.

[Taylor]

Okay. Yeah.

[Dr. King]

Would you like to hear more? Yes. Okay, so let's start with some data.

[Taylor]

Okay.

[Dr. King]

So what's, you know, something really interesting you were talking about how, you know, there's a lot of terrible stuff going on in the world today. One of the things that I found really confusing is why all survivors of genocidal conflicts don't have ptsd. Wow. You know, it's kind of weird, right? When we think about it, there's like terrible stuff happening and like the bad stuff is happening to everybody. Like that's the whole point of a genocidal conflict. But actually the majority of people don't end up psychologically traumatized in a way that impairs their function or debilitates them. One of the key things that we discovered when we tried to figure out why everyone who survived a genocidal conflict doesn't have PTSD is something called meaning making. So it turns out that our human brain has something called adaptive misbelief. So human brains are designed to believe in all kinds of things that may not be true. And the reason is because it's like the height of psychological copium, we have to make sense of the world around us. And this is what's really interesting. I've worked with a lot of people with chronic pain, and I think this is a really hard situation because we can't really figure out what's wrong with you physically. There isn't a diagnosable thing that's going on. It's probably something in the brain, but there's nothing we can intervene on. So if you've got a stomach ache, but there's nothing wrong with your stomach, then you just have to deal with the ache. So I think this is where making meaning, making sense of your suffering is a huge part to finding relief.

[Megan]

Right.

[Dr. King]

And if you look at some of these Eastern spiritual perspectives, you know, they'll say that you can't control pain in life, but you do have some degree of control over whether you suffer or not. Yes. And this is where there are certain evidence based techniques. I practice a lot of stuff that is not evidence based because I spent years studying in India. But I think that unfortunately, as a doctor, I mean, you're talking about PMDD and how there's nothing you can do about it. Yeah, you may not be able to fix that, but the way that you handle it, you can handle it in ways that seem to be better in the sense that you can achieve some degree of peace or you can handle it in ways that can enhance your suffering. There seems to be a lot of data to support that as well. I happen to think that that's true.

[Host John Regalato]

And we gotta pause there because we're out of time. Thank you, Taylor.

[Taylor]

Thank you. Thank you. Appreciate it.

[Dr. King]

Oh, yeah, sorry.

[Kashish]

Thanks, player.

[Dr. King]

Yeah.

[Commercial Voice]

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[Dr. King]

Edu Sci Marvel Television's Wonder Man. An eight episode series now streaming on Disney plus.

[Pharmaceutical Voice]

A superhero remake. Not exactly what we'd expect from an Oscar winning director.

[Host John Regalato]

Action.

[Lamar]

Simon Williams audition for Wonder Man.

[Dr. King]

I'm gonna need you to sign this. Assuming you don't have superpowers.

[Lamar]

I never work again. If anyone found out, My lips are sealed.

[Dr. King]

Marvel Television's Wonder man all eight episodes now streaming only on Disney plus. Nice to meet you, Daniela.

[Participant with cancer]

My depression was. It started in 2024 when I was diagnosed with stage four Hodgkin's lymphoma.

[Dr. King]

Okay.

[Participant with cancer]

Which is blood cancer. And honestly, I can say that in those situations, there's really nothing that could have helped me other than being healthy.

[Dr. King]

Yeah. I mean, what. Thank you for sharing that. I'm curious, what are you thinking? How am I going to respond to that? Do you have an idea?

[Participant with cancer]

I feel like there's nothing you can possibly do in that situation because you can't solve the root of the problem, which is the cancer.

[Dr. King]

Yeah. So if we can't, and I agree with you, there's tons of research that shows that people who are diagnosed with cancer experience depression. Interesting thing is that's not just a psychological thing, it's also a physiologic thing, is in stage four cancer, your immune system is going whack. There's inflammation in the brain. And I think that this is like, you're right. That if you are diagnosed with something that could be a terminal illness, that the most natural reaction is to be depressed. I think that we also have a subspecialty of psychiatry of trying to help patients with cancer. You know, sometimes we help people cope with the prospect of death. We help them grieve the life that they could have lived, which they no longer get to because of cancer. And I'd like to think that we're able to alleviate their suffering in some way, but I would not. I mean, when you're someone who's been diagnosed with stage four cancer at quite a young age, I can't imagine that anything is going to fix that, except for exactly what you said.

[Participant with cancer]

So would you say in those situations therapy and psychiatry is kind of pointless?

[Dr. King]

Well, so that I would say no. And I think there are plenty of patients I've worked with who would agree. I think it depends on define pointless.

[Participant with cancer]

So my thing with psychiatry is they kind of just help the person cope, but they don't solve the root of the problem. Even not just in like cancer, but in other situations.

[Dr. King]

Yeah. So I think when psychiatry, in some cases where it's practiced poorly, that's what we do. I think psychiatry is a field. I think we made kind of a. I don't know if this is a mistake. It feels like a mistake to me that we stopped accepting responsibility for patients happiness. We started saying that we can teach you coping skills, that that's the best that we can do. We can't actually improve your life. We can just improve the way that you cope with your life. I don't think that we do that all the time, but I think it happens way too much. I think psychiatry as a field, we'll throw in the towel very easily. And that too is not necessarily our fault because I think there's a lot of stuff that we can't control. Like we can't cure people's cancer necessarily. But I do think that psychiatry, when it's practiced in the best way, is not about coping. Coping is just what we do to help people put the fires out. Then you get to the real work. I think coping is not the last step. It's the first step.

[Host John Regalato]

I'm sorry, we have to pause there and switch participants, but thank you.

[Participant 1]

Thank you.

[Sterling]

Hi, my name is Sterling. I use they. Them pronouns.

[Dr. King]

Okay. Nice to meet you, Sterling. Thank you for sharing your pronouns.

[Sterling]

Yeah, happily. So something for me is I think therapy is like a good avenue and psychiatry is a good, good door to open it up. But I feel like there's outside components that need to be done, at least in my personal experience, to like, continue like growing positive mental health.

[Joe]

Can.

[Dr. King]

Can you share more about that?

[Sterling]

Yeah. Like, I do think, like, mental health and physical health is tied. So like, sometimes it is internal as well as, like, out internal. Like your mental health versus your body trying to heal, like, old scars or old traumas and just finding the balance between, like, what can really make you happy and bring you the peace and joy that you're, like, looking for long term.

[Dr. King]

Yeah, I mean, I completely agree. So I think that, you know, when you say psychiatry is a start, I think there is a portion of things that we can do. And I think what we're discovering is that a lot of your mental functioning. My mental functioning. Our brain exists within a body.

[Megan]

Yeah.

[Dr. King]

And the nature of the body can profoundly affect the mind. I learned this when I went to India and I started studying yoga. I was in a really bad mental space. And there's a lot of evidence that shows that when we do some of these mind body practices, like yoga or Tai chi, it rewires our nervous system, which will then affect our mind. So I completely agree with you. And yeah.

[Sterling]

Having moments or classes where I was able to put myself into my body, realize, oh, I carry shame here, like, physically, I was, like, embarrassed to dance or to try something new. And it's working the muscles to, like, be open to, like, healing and like, loving yourself, which is something like, I know I've struggled is just allowing myself to be okay or sit in my emotions.

[Dr. King]

Yeah. And what has been your experience of working with your body?

[Sterling]

Something I found that I really enjoy is staged combat. So it's just something that it forces me to think how I react, how to keep my partner safe and just being beyond myself.

[Dr. King]

So there are two kind of. I agree with you. But there are two things that I'd love to share. One is, so there are some interesting studies that show that when people are depressed, their physiology is constricted, so their heart rate stays in a very narrow range. And when we're healthy, our heart rate will kind of go upper down because we get excited and then we get sad, we get tired, we get happy. And so there's literally evidence that shows that if you change your physiologic level of activity, that it'll improve your depression. And there's a really interesting version of this, which is sometimes when I would have patients who are having a panic attack, we tried one thing, which is we would step outside of my office and then we would run as fast as we can for 60 seconds in a park. And something really cool happens when you have a panic attack is, you know, your heart rate is elevating. But if you actually push your body even more and you run really fast, then you feel exhausted at the end of that. And when you feel physically exhausted, it actually slows down your heart rate, brings your respiratory rate under control, and in some cases can really help with the panic attack. And I completely agree that. I think the body is the most underutilized tool in the treatment of depression today.

[Host John Regalato]

All right, we're going to pause there. Thank you, Sterling.

[Sterling]

Thank you.

[Host John Regalato]

We've got one more.

[Kashish]

Lucia.

[Dr. King]

Lucia, nice to meet you all.

[Participant with cancer]

Nice to meet you.

[Dr. King]

Thank you for coming today.

[Participant with cancer]

Thank you. I did want to, like, mention, like, earlier, she was your name again.

[Mylene]

Yeah.

[Participant with cancer]

Alex was talking about how, like, some people do, like, workouts or, like, anything to like, take their mind off of it. And I feel like I'm the poster child for that, like, working out and, like, reading and all these other hobbies, but it still doesn't feel like enough for me. And same with therapy. And it's different for me because, like, I did group therapy, and then I also did, like, DBT therapy, group therapy. Like, I still feel this, like, emptiness and this, like, shadow, like, following me. Because also my depression is different because I don't know if anybody else has, like, another mental health like, that they deal with that kind of, like, coincides with their depression. Because for me, I have. I just got diagnosed last year with bpd. So my depression is like a whole. I also have a problem with seeking validation, not necessarily from women, but, like, other people. And I like, sort of kind of immerse myself in other people's to find, like, me in a way. And I just. I don't know. Yeah.

[Dr. King]

Lucia, thank you so much for sharing that, because I'm glad that you shared the sense of emptiness that comes with bpd. So I think sometimes when we talk about depression, we talk about it, like, one thing, but depression is a way that you feel, and there are lots of different contributions to that. So I personally have learned so much from my patients with bpd. It's been some of the most rewarding and difficult clinical work I've ever had to do. So I'd like to just talk about BPD for a second, if that's okay.

[Megan]

Yeah.

[Dr. King]

So for people who don't know, there's a certain kind of depression where, see, we go through the world, and I have a sense of who I am, and I carry that with me wherever I go. Right. So if someone calls me an idiot, I have some sense that I'm not an idiot. When someone has bpd, that can be absent or very, very quiet. And so the way that they feel is literally determined, like a vacuum. It's a void that gets filled up by the way that people treat them. So if someone treats you really well, you feel great, and if someone treats you really poorly, you internalize that. And so, couple of things about BPD is that it's actually one of the things that improves. So I think, like, at 16 years out from diagnosis, 95 plus percent of people actually won't qualify for the diagnosis anymore. So it is something that can get healed, but I think that it's really, really hard before it happens. And I think that a lot of the stuff, a lot of the work that I do around BPD is about really getting in touch with who you are. It feels empty. It feels like a void. And then the reason that people get diagnosed with this is because they're missing. Oftentimes there's trauma early in life.

[Participant with cancer]

So I wanted to touch on that, is that, like, I am, like, also religious, I'm Jewish, I converted after I graduated in 2024 from high school. And like, once again, like, I've. I've done all of these things. And I think also what makes it hard for me with my BPD is also, like, the amount of trauma that I've been through because I also went through a loss. Like, I lost my father from COVID six years ago, and he was never in my life, like, never knew him. And I also do seek my validation from relationships because I've never had that father figure, of course. And it's like the abandonment of everything. And that's why also, like, I sought conversion also to, like, help me move through it. But, like, yet again, like, it still feels like there. There isn't that, like, light for me because of how much, like, other trauma that I've experienced too.

[Dr. King]

And I think that that's what's really hard. So. So the thing is, since. Since you're. There's that kind of void inside, I don't know if this makes sense. The hopelessness can fill up that void and then you will feel full of hopelessness. And that's what I've seen with people with bpd, is that when you're feeling down, it fills up every cell of your body. And then it just. It's so big. The good news, there is a way to find that stability within yourself, to find a sense of self that kind of, like, is a life raft. And once it's kind of there, then people can really start to stabilize around it and Like I said, the outcomes from BPD are actually quite good just because it is one of the most painful things. That has nothing to do with how long it will last. That has nothing to do with its permanence.

[Participant with cancer]

Yeah.

[Host John Regalato]

All right, we have to pause. We're out of time. Thank you, Lucia.

[Dr. King]

Thank you so much.

[Participant with cancer]

Thank you so much.

[Host John Regalato]

All right, we've come to the last part of the show, Doctor. Okay, great job so far. We want you to look around the circle, and you can select somebody you haven't spoken to yet or somebody who you want to keep exploring what they're going through. So you can choose anyone in the circle, but just take a moment, select them, and then let us know why.

[Dr. King]

Okay, so I have someone in mind. Lamar.

[Host John Regalato]

Okay, Lamar, let's go with you.

[Lamar]

I would have a claim, I guess, in my opinion, that most therapists or psychiatrists don't truly believe in the ways in which to help. It's almost like you go to school long enough for something that you feel like you can't turn around now, like you've been in it. So let me just go forward and let me just play the game almost. You know, I hate to put stuff the way I think it, but it's like a game. It's just how I feel. But I've heard what you've told others, and it's some things that I find to be quite out there.

[Dr. King]

Like what?

[Lamar]

Like the swapping of the shite.

[Dr. King]

Oh, yeah. Yes.

[Lamar]

I think, like, this is the point that we've got to now, like, if someone gets my shit, they gonna be messed up for a little bit because.

[Dr. King]

Right.

[Lamar]

Like. But you see what I'm saying? Like, now we're just throwing spaghetti against the wall, hoping that it sticks. I don't know.

[Dr. King]

Yeah, so. So, I mean, so we can. We can talk about that specifically, if you want. I agree. I mean, the reason I brought her up is because I thought it was, like, absolutely. Absolutely insane. Right. And then the even crazier thing. The even crazier thing. These people were insane to begin with, is that it worked.

[Lamar]

Well, I guess my question would be for you then. Out of every. Out of everyone that you've spoken to today, do you truly feel as if you've helped anybody at all?

[Dr. King]

Do I feel as if I've helped? I don't know. So one of the key things I've learned in my life, Lamar, is to not trust what I feel, to act independently of what I feel.

[Lamar]

What do you do with those who just seem like they can't Find a way out. Can't get any better.

[Dr. King]

I mean, in my case, I keep trying. And I love this question, by the way, Lamar. So one of the challenges that I have is I don't know when to give up on a patient. Because let's say I work with. Let's say that we start working together, and I work with you for two years, and you don't get better at all. Do I give up at that point, or is three years. Maybe. Three years could do it. There's a conversation we'll have which is like, okay, therapy does not work. Psychiatry does not help you. What now? What are we going to do? Are you willing to not give up with me?

[Lamar]

I guess up to a certain point. But like I said, we just keep on hitting our head against the wall. Then it's like, at what point is it. Is it. Like I said, I don't know what words used, but at what point is it stupid?

[Dr. King]

Yeah. So like I said, I've had three patients in my career, okay. And I've seen somewhere between probably 500 and 1,000 people that I really don't believe I've been able to help. Those are the three that I tried everything that I knew and learned a bunch of other stuff.

[Lamar]

Yeah.

[Dr. King]

The other thing that I've learned, which is really, really hard, I know that this is going to have a lot of skepticism. See, the nature of depression is that even if you're getting better, you won't notice it.

[Lamar]

How does that help? If you don't notice that you're not getting better, how does that help?

[Dr. King]

Because you are getting better. So I'll give you a really. This is weird, right? I know.

[Joe]

This is weird.

[Lamar]

Twilight Zone.

[Dr. King]

I had a patient who came into my office once, a couple years in, and he said, Dr. K, I'm just as bad as when I showed up. I've been coming here for two years. I'm no better. And then I asked him, I said, well, how's your work going? Because they had trouble with work, and they said, work's fine now. I'm not getting in trouble anymore. I said, how's your relationship going? And he's like, relationship is going okay. Like, they had troubles with the relationship, but they were doing better. They started taking their cholesterol medication. There are many things in their life that had improved, but they didn't feel like it had improved. And then I told them that day, I said, you know, I think you're not depressed. I think you're unhappy. And there's a big difference between Those

[Lamar]

two things doesn't want to lead to the other.

[Dr. King]

I mean, we would hope so, right? And I think the two are connected. And one of the interesting things is that if you weren't in therapy, would you potentially be worse?

[Lamar]

It's hard to say because I've taken therapy and shows, like, you know what I mean?

[Dr. King]

Like, Lamar, like, it's like a hydra.

[Lamar]

Almost like one head chop one off and two more grow back, like.

[Dr. King]

And so that I think. I think you're dealing with a. A profound sense of skepticism. I wouldn't even call it hopeless. But I think you've learned that nothing seems to help. Like I said before, I think the biggest problem that people have had dealing with you is that they label you really fast and they think they know what will help.

[Lamar]

I think so, too.

[Dr. King]

But I've seen too many people in your situation who have gotten better. And so I. Stupidly, foolishly. I know it's dumb. I choose to keep trying because when I'm hopeless, I could be wrong. And when I'm hopeful, I could be wrong, too. So then. Then we're left with one basic question, which is when we don't know what's going to work, we don't know, is it going to work? Is it not going to work? How are you going to respond to that uncertainty?

[Lamar]

I don't think there's no direct answer to any of that. Like, I think at this point, I just roll with punches. Like, I just rock with punches. At this point, I'm really running off of fumes in this last little bit of my life. Like, I truly believe that.

[Dr. King]

So, yeah, I mean, you've been running on fumes for a long time. They've carried. They can carry you way farther than you may have ever realized, which is what's insane, dude, I think.

[Lamar]

But see, that's the point. It used to be I persevered through it. Like, no matter what happens, as long as I'm breathing, I keep on going. But at this point now, I done hype myself up, hype myself up, hype myself up. It doesn't work, doesn't work no more. It ain't always rainbows and gumdrops. Like, I mean, the world is really shitty.

[Dr. King]

Like, when was the last time it was rainbows? Can you even remember?

[Lamar]

No, actually, like, I've been in survival mode so, so long that when I see something that may potentially be a happy moment, I. I shun away from that because I feel like it's a fleeting moment. Like, it's not for me.

[Dr. King]

Oh, wow.

[Host John Regalato]

Yeah.

[Lamar]

I'm not gonna leave it.

[Dr. King]

Even if there's a fleeting moment of happiness, you turn away from it.

[Lamar]

I turn away from it because I've been dealt shitty hands. You know what I mean? Like, when the sky starts to open up, the sun comes out, I'm looking at like, nah, where's the rain cloud at? Like, damn, all this. Cause why everybody's like this.

[Dr. King]

When someone turns away from the sun, how dark do you think their life is gonna be?

[Lamar]

Pretty sure it gets darker. But if. When the sun is out and it's still dark, though. You know what I mean?

[Dr. King]

You're the one who's turning away.

[Lamar]

Yeah, because I've already been. I've already been, I guess, conditioned.

[Dr. King]

I want you to think about that for a second. Lamar, I don't doubt that you believe this for a good reason. Because you've learned, right, that even though there's sun, it ends up being rain clouds anyway.

[Lamar]

Yeah.

[Dr. King]

This protects you.

[Lamar]

It does.

[Dr. King]

From being disappointed. It is, but it traps you. Yeah.

[Lamar]

There's pros and cons in it. Most definitely. There's pros and cons. So, because I don't know how to really cope with this, the only thing I can do is just to lock it away and lock myself away, you know, no matter how it sounds, no matter how crazy it may look like to anybody else, I know the reason why I do it. You know what I mean?

[Dr. King]

Let me ask you this, Lamar. When people try to help you, like a therapist, do you still keep it locked away? Yes, you do.

[Lamar]

Yes, I do.

[Dr. King]

Yes, you do. Now we have another problem, which is that there are people around who want to carry it with you. But you won't give us a chance.

[Lamar]

No, because I've tried that before.

[Dr. King]

You have?

[Lamar]

I've tried, but I always got rejected. I always caught the bad hand of it all. So after a while of getting your hand hit too many times, you don't want to put your hand out there no more.

[Dr. King]

What was it like for you to come here today?

[Lamar]

Hard.

[Dr. King]

Hard.

[Lamar]

Like, real hard. Like crowds and groups and shit. Like, I don't do that.

[Dr. King]

What do you think that some of these people who are sitting around us, what do you think they think about you?

[Lamar]

I guess some would say it's brave. I guess some would say whatever, but I honestly don't know. I don't.

[Dr. King]

And if they did, if they did think that you were brave, I guess

[Lamar]

at this point it wouldn't matter because I've been called brave for other things.

[Dr. King]

Do you run away from it?

[Lamar]

Do I run away from it?

[Dr. King]

Respect from other people? Appreciation?

[Lamar]

Yes, I do, actually, because, like I say, it's not turned out. Yes, it's. It's not an everyday occurrence on. To me, it's a fluke. It feels like a fluke. You know what I mean? I don't know how to put it, but I just don't feel like it's real, like it's based in reality for me.

[Dr. King]

Yeah, I get it.

[Lamar]

Let me tell. I felt better at being in the war zone than when I left the war zone, only because it's not fake. If you don't like me, you don't like me. If I don't like you, I don't like you. But there's no fakeness in between it. I get more scared being out of war because of all the masks that being worn by people. You see what I'm saying? So that's another reason why I just.

[Dr. King]

It's simpler over there.

[Lamar]

It's. It's way simpler over there. And I think it's not so much the war that has people messed up. I think it's just being in that situation so much that it becomes like home to. To you. It becomes like something that you need. I had a sense of worth, but when I got out, I don't know what changed. I try to. I try to be that Marine that comes back. It's just shitty, man. It's just shitty. It's not what was told to me. Like, you do this, get the honorable discharges, and America take care of you, like all this type of stuff. So I've been fed all this. I. I believed it wholeheartedly. There we go. Like, I'm. I held onto that hope. Just to be shattered, man. Just to be shattered in a way that touched with my. My Achilles heel. Like, I've never been touched like that before. Like hurt, all that type of stuff. After serving and doing all this just to be tossed away. Ain't nothing you can really tell me at this point because now I'm in piss mode. Really. I'm pissed. You feel me? I'm beyond pissed. So when you try to come in with the niceness, okay, that's cool. But in my mind, that shit temporary. We ain't got no connection like that. You're a good person. You're a good dude. I'm sure everybody's good in here, but at the end of the day, just me personally. Just the way my life has gone. Nah, man, this just ain't for me right now.

[Dr. King]

I'm glad you're sharing your anger with me. You've been told a thousand times, do this and it'll work. And it's never worked.

[Lamar]

Just never worked.

[Dr. King]

Never worked. And then there's this whole business about turning away from the sun. I think what's going to be really interesting is I don't know how to help you. I believe you can be helped. And I think there's something that I'm going to kind of leave you with, which is this is going to be a video that's going to be watched by millions of people, and all those people are going to watch you, and they're going to think something about you and they're going to say something about you. I think what they say about you and what they think about you is going to be profound. I wish there was a way that I could flip a switch in your head and have you receive that the way that normal human beings get to.

[Lamar]

Yeah.

[Host John Regalato]

Lamar, thank you for coming all the

[Lamar]

way out here, man.

[Dr. King]

Thanks a lot, man.

[Host John Regalato]

And sharing. We're out of time.

[Dr. King]

I think I see a lot of strength and resilience, which really gives me hope. It reminded me why I fell in love with psychiatry.

[Ian]

Oh. I think it was really healthy. Very respectful. He had a lot of interesting points. Kind of opened my eyes a couple times to some stuff, which a good therapist should do.

[Taylor]

Generally speaking, it was very interesting to see where everybody was at emotionally and mentally with their part of their journey.

[Mylene]

It took me a while to even open up about being depressed, and for years I was ignoring it. And I thought if I just pretend I don't have it, it's fine. It's so important to me that people talk more about it.

[Host John Regalato]

Don't forget to subscribe to Surrounded wherever you get your podcasts so that you don't miss an episode. And if you want to watch the video version of Surrounded, subscribe to Jubilee on YouTube.