How Dysthymia Steals Your Happiness
Resumo
TLDRNel video si discute dell'andimia, una forma di depressione persistente caratterizzata dall'incapacità di trarre piacere dalle proprie azioni. Le persone con andimia spesso dipendono emotivamente da "altri dominanti" per il loro senso di soddisfazione, che può derivare da genitori con aspettative irrealistiche o che richiedono continuamente supporto dal figlio. Questo comportamento conduce a schemi in cui la felicità è percepita come un risultato di fattori esterni. Le soluzioni standard come la terapia e l'uso di farmaci spesso non sono efficaci. Il video suggerisce invece una serie di approcci che coinvolgono un lavoro interno per cercare la gratificazione indipendentemente dalla convalida esterna, come esplorare il senso di colpa associato a attività piacevoli e praticare l'indipendenza emotiva.
Conclusões
- 🔍 Capire l'andimia come una depressione cronica non episodica.
- ❌ Le soluzioni comuni come terapia e farmaci non sempre funzionano.
- 👶 Dipendenza dagli "altri dominanti" inizia spesso nell'infanzia.
- 📝 L'importanza di trovare gratificazione nelle proprie azioni.
- ⚖️ Equilibrio tra piacere interno e gratificazioni esterne è essenziale.
- 🚫 Evitare di cadere nel circolo vizioso della ricerca di approvazione esterna.
- 🧠 Necessità di psicoterapia focalizzata sul lavoro interiore.
- 📊 Studi mostrano che bron agisce meglio della farmacologia.
- 👥 Importanza di condividere esperienze tra persone con similia.
- 🔄 Lavoro progressivo e sequenziale è cruciale per il recupero.
Linha do tempo
- 00:00:00 - 00:05:00
Le persone affette da ditemia non riescono a trovare piacere dalle loro azioni, nonostante facciano "tutto giusto" secondo la scienza. A differenza delle persone con depressione episodica, coloro che hanno ditemia sono depressi costantemente e tradizionali soluzioni terapie e farmaci non funzionano efficacemente. L'autore ha avuto successo con alcuni pazienti, ma sottolinea la difficoltà trattare la ditemia.
- 00:05:00 - 00:10:00
C'è un concetto nella letteratura psicoanalitica chiamato 'altro dominante', che spiega come alcune persone traggano tutto il loro autostima e piacere dal riconoscimento esterno. Questo causa una dipendenza patologica e una mancanza di gratificazione interna, rendendo difficile per queste persone trarre piacere autonomamente dalle proprie attività e successi.
- 00:10:00 - 00:15:00
I bambini con genitori troppo esigenti sviluppano una dipendenza per l'accettazione esterna perché i loro sforzi non sono mai abbastanza buoni. Inoltre, in alcune situazioni, i bambini si prendono cura di un genitore malato, creando la concezione che la felicità è controllata solo da fattori esterni.
- 00:15:00 - 00:20:00
Questo tipo di persona cresce senza la capacità di essere felice da solo, poiché tutta la felicità percepita proviene dall'esterno e qualsiasi attività auto-gratificante viene vissuta con sensi di colpa. La letteratura suggerisce che questi individui evitino esperienze piacevoli percepite come inefficaci o indulgenti.
- 00:20:00 - 00:25:00
Le persone con ditemia tendono a rivolgersi a comportamenti 'dopaminergici' come l'uso di sostanze o esperienze di brivido per cercare piacere, dato che gli fornisce un breve sfogo dopaminergico. Queste attività, tuttavia, non colmano la mancanza di gratificazione interna e possono portare a sentimenti persistenti di vuoto.
- 00:25:00 - 00:30:00
Per trattare la ditemia, è importante cercare attività indipendenti e tentare di provare piacere internamente. Questo richiede notare e affrontare sensi di colpa associati alle attività piacevoli, tentando di trovare gratificazione autonoma nelle azioni quotidiane e liberarsi dalla dipendenza emotiva dagli altri.
- 00:30:00 - 00:35:59
La guarigione dalla ditemia richiede lavori interni significativi e non basta semplicemente provare a diventare più indipendenti. Anche se puoi costruire una vita che sembra esternamente "corretta", le vere fondamenta interne devono essere lavorate e sviluppate per trovare un vero senso di libertà e piacere autonomo.
Mapa mental
Perguntas frequentes
Cos'è l'andimia?
L'andimia è una forma di depressione cronica in cui una persona è sempre depressa anziché attraversare episodi depressivi periodici.
Come si può trattare l'andimia?
Le strategie includono riconoscere i modelli di dipendenza emotiva, esplorare attività indipendenti e cercare terapia che enfatizzi lo scoperta della soddisfazione interna.
Quali sono le cause principali dell'andimia?
Le persone tendono a vivere costantemente sotto depressione senza trarne piacere dagli sforzi personali, a causa di aspettative eccessive o di un ambiente che richiede costantemente la loro presenza per qualcuno, spesso un genitore.
La terapia tradizionale funziona per l'andimia?
No, la terapia convenzionale non sempre funziona per l'andimia poiché spesso si basa sull'idea che la felicità possa arrivare dall'esterno, ripetendo così il ciclo che deve essere rotto.
Qual è un segno comune di andimia?
La dipendenza emotiva da un "altro dominante" per l'autostima e la soddisfazione personale è un segno comune di andimia.
Ver mais resumos de vídeos
- 00:00:00if we look at these people the main
- 00:00:02problem that they have is they cannot
- 00:00:04derive a sense of pleasure from their
- 00:00:07own actions they're doing all the right
- 00:00:10stuff right they've done a lot of
- 00:00:12research and it doesn't seem to work but
- 00:00:14then there is a second component which
- 00:00:16is like patting myself on the back and
- 00:00:18this helps most human beings feel good
- 00:00:21the problem with people who have dymia
- 00:00:23is that that part is absent so normally
- 00:00:26when we think about depression we think
- 00:00:28about it like an episodic thing so human
- 00:00:30beings will get depressed for some
- 00:00:32amount of time maybe after a breakup or
- 00:00:35after they lose their job or some kind
- 00:00:36of setback and then there's this idea
- 00:00:38that human beings will kind of bounce
- 00:00:40back about 30 to 50% of people will
- 00:00:43experience depression at some point in
- 00:00:45their life but there's another group of
- 00:00:47people who seem to be depressed all the
- 00:00:50time depression isn't something that
- 00:00:52happens to them it is a characteristic
- 00:00:55of their life it is a constant and this
- 00:00:58is what we call this thyia and the
- 00:01:00problem with dymia is that it is very
- 00:01:03very hard to treat so when I work with
- 00:01:05people with dymia I'll start with a very
- 00:01:07common psychiatric question so when did
- 00:01:08your Depression start and they'll say
- 00:01:10that I've been depressed my whole life
- 00:01:12it is my constant way of being and then
- 00:01:15the other problem with people who have
- 00:01:16dymia is that Solutions tend to not work
- 00:01:20so a very common experience for these
- 00:01:21people is that other people around them
- 00:01:24will be like oh you're sad like why
- 00:01:26don't you go for a run why don't you you
- 00:01:28know just put yourself out there try to
- 00:01:30socialize more pick up a hobby and
- 00:01:33they'll even say things like man maybe
- 00:01:34you should see a psychiatrist or
- 00:01:36therapist you should start meditating
- 00:01:38all of these things that have a lot of
- 00:01:40scientific evidence but for some reason
- 00:01:43when you are dymic these things don't
- 00:01:46appear to work and there's actually
- 00:01:47literature that backs that up and that's
- 00:01:50the real challenge of being dymic you're
- 00:01:53depressed all the time and the standard
- 00:01:55solutions for some reason don't seem to
- 00:01:58work for you you may meditate you may
- 00:02:00start journaling you start going for
- 00:02:01walks and this is what happens when I
- 00:02:03work with these people like when these
- 00:02:04are my patients is that they're doing
- 00:02:06all the right stuff right they've done a
- 00:02:09lot of research they're very very like
- 00:02:10self-motivated they felt this way for a
- 00:02:12long time and they've tried a lot of
- 00:02:14stuff and it doesn't seem to work so
- 00:02:16today what we're going to dive into is
- 00:02:19understanding why this depressive almost
- 00:02:22personality or characteristic develops
- 00:02:24how it develops and thankfully what to
- 00:02:27do about it because while a lot of
- 00:02:28studies show that things like theapy and
- 00:02:30medication are not as effective for d
- 00:02:33thyia as opposed to something like major
- 00:02:35depressive disorder I've actually had a
- 00:02:37lot of success with some patients who
- 00:02:39have been dymic and they've actually
- 00:02:41learned how to sort of change their life
- 00:02:43in a pretty significant way at the same
- 00:02:45time I've also had two patients in my
- 00:02:48career that had D thyia and really
- 00:02:50didn't get better so I have to be a you
- 00:02:53know offer a little bit of a caveat here
- 00:02:54that like what we're going to lay out
- 00:02:56today I think is a very very solid
- 00:02:59solution ution for D thyia and at the
- 00:03:02same time it's something that is very
- 00:03:04very like refractory to treatment in a
- 00:03:06lot of ways and there's a reason why
- 00:03:09people who suffer from dymia will often
- 00:03:11times go to therapy and not get
- 00:03:13magically better hey y'all if you're
- 00:03:14interested in applying some of the
- 00:03:16principles that we discuss to your life
- 00:03:18to actually create change check out Dr
- 00:03:20K's guide to mental health the guide
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- 00:03:50linked below so definitely check them
- 00:03:52out so let's dive into understanding
- 00:03:54where dymia comes from how is it that
- 00:03:56someone can you know grow up and Beed
- 00:03:59pressed all the time and this is what's
- 00:04:01really cool we've sort of like figured
- 00:04:03it out right there's this concept of
- 00:04:05something called the dominant other so
- 00:04:07it's interesting because in the
- 00:04:08psychoanalytic literature they had to
- 00:04:10develop new vocabulary to describe these
- 00:04:13people's experiences because their
- 00:04:15experience of life is so different from
- 00:04:18normal people and that's what we want to
- 00:04:20share with you today so we're going to
- 00:04:21develop some new vocabulary so let's
- 00:04:23take a quick look at a paper so this was
- 00:04:25a concept that was actually discovered
- 00:04:28um in about 196 right so this is stuff
- 00:04:30that's pretty old and I think this is a
- 00:04:32really good description of it so one of
- 00:04:35the characteristics of the depressive
- 00:04:36that has been emphasized is excessive
- 00:04:39dependency on a dominant other as a
- 00:04:41source of meaning and gratification the
- 00:04:44depressive excessively derives his sense
- 00:04:46of self his self his self-esteem from
- 00:04:49being rewarded by the dominant other and
- 00:04:51appears incapable of securing
- 00:04:55satisfaction independent of this
- 00:04:57intermediary now I know that was kind of
- 00:04:59a mouthful so we'll sort of explain it
- 00:05:00okay so here's how most human beings
- 00:05:03work so I am over here I am a human and
- 00:05:06there is something outside of me like a
- 00:05:09parent or um a company you know there's
- 00:05:13something outside of me and if we look
- 00:05:15at most human beings we derive our
- 00:05:18self-esteem and even a sense of pleasure
- 00:05:21okay from our relationship with this
- 00:05:24other thing so for example when I'm
- 00:05:26growing up and I have a set of parents
- 00:05:28and if you think about like where my
- 00:05:30self-esteem comes from if my parents are
- 00:05:32proud then that increases my self-esteem
- 00:05:36okay but for people who are not dymic
- 00:05:40this is really important to understand
- 00:05:42we get some amount of pleasure and
- 00:05:45self-esteem from this but we also derive
- 00:05:47some degree of pleasure and self-esteem
- 00:05:50internally right so if I take a child
- 00:05:53who's like like you know when I was a
- 00:05:54kid right I would like to play with
- 00:05:56Legos and when I'm playing with Legos
- 00:05:59like the pleasure that I derive from
- 00:06:01that and the self-esteem that I get from
- 00:06:03building something cool has nothing to
- 00:06:05do with things outside of myself the
- 00:06:08basic problem with people with dymia is
- 00:06:10that they actually get 100% of their
- 00:06:13sense of
- 00:06:14self-esteem and even a sense of pleasure
- 00:06:17and gratification from the dominant
- 00:06:19other and we see this in the literature
- 00:06:21as well this pathological dependency is
- 00:06:24exemplified in the depressive sphere of
- 00:06:26autonomous gratification meaning the
- 00:06:29ility to dve pleasure directly from
- 00:06:31one's activities or accomplishments okay
- 00:06:34if we look at these people the main
- 00:06:37problem that they have is they cannot
- 00:06:38derive a sense of pleasure from their
- 00:06:42own actions they don't derive a sense of
- 00:06:45like internal self-esteem and this
- 00:06:46explains why Solutions don't work for
- 00:06:49them so now we have to understand
- 00:06:51something about a solution so let's say
- 00:06:53I go to therapy or I do anything else
- 00:06:55let's say I I Journal so when I Journal
- 00:06:58there are two places
- 00:07:00where the value of journaling come from
- 00:07:03one place is from the journal itself
- 00:07:05right the exercise itself brings some
- 00:07:07amount of like insight into my life but
- 00:07:10then there is a second component which
- 00:07:13brings progress and self-esteem which is
- 00:07:15like patting myself on the back and
- 00:07:17saying you know what I did Journal good
- 00:07:19for me I am taking steps to improve my
- 00:07:22life and this helps most human beings
- 00:07:24feel feel good the problem with people
- 00:07:27who have dymia is that that part is
- 00:07:30absent so the most that they can ever
- 00:07:32get from an activity like journaling is
- 00:07:3550% because even though we sort of place
- 00:07:38100% emphasis on the things outside of
- 00:07:40us we cannot derive 100% pleasure from
- 00:07:44things outside of us and that may be a
- 00:07:46little bit confusing but it's sort of
- 00:07:47like fundamentally as human beings you
- 00:07:50know I can't derive 100% of my pleasure
- 00:07:54from things outside of me some of that
- 00:07:56has to come from me so if I let's take
- 00:07:58the example of like mountain clim CL in
- 00:07:59right so if I climb when I was you know
- 00:08:0122 years old I went and I climbed um a a
- 00:08:04a 14,000 ft Mountain okay so when you
- 00:08:07climb a 14,000 ft Mountain there's a
- 00:08:10certain amount of pleasure that comes
- 00:08:12from the experience you stand at the top
- 00:08:14of the mountain you look around you're
- 00:08:15like wow this is magnificent but that's
- 00:08:17not where the majority of the pleasure
- 00:08:20comes from the majority of the pleasure
- 00:08:21comes from holy crap I woke up at 4: in
- 00:08:24the morning this morning I I started
- 00:08:26climbing at 6:30 a.m. and I clim clim
- 00:08:29for 8 hours and I've now accomplished
- 00:08:32this feat there's a sense of autonomous
- 00:08:34or internal gratification and this is
- 00:08:37what is denied to people with this thyia
- 00:08:40this is also why people with dymia why
- 00:08:42Solutions don't work for them because
- 00:08:44they go on and they they're like okay so
- 00:08:45someone's saying go climb a mountain
- 00:08:47they climb a mountain but they only get
- 00:08:4950% of the pleasure people say start
- 00:08:51journaling they only get 50% of the
- 00:08:53pleasure people say start meditating
- 00:08:54they only get 50% of the pleasure they
- 00:08:57are denied this sense of internal
- 00:09:00accomplishment so then the question
- 00:09:01naturally becomes why is that how are
- 00:09:04these people different and this is where
- 00:09:05you see particular patterns in these
- 00:09:07people's upbringing so I'll illustrate
- 00:09:09what I've seen very commonly kind of as
- 00:09:12a therapist okay so the first is that
- 00:09:14there's something outside of you that
- 00:09:16determines all of your self-esteem so
- 00:09:19this can be something as simple as
- 00:09:21parents who expected way too much of you
- 00:09:23so when I work with patients these are
- 00:09:25the kinds of things where it's like okay
- 00:09:27if I get a 95 on a test and I get an A+
- 00:09:32my parents are still unhappy with me
- 00:09:34because I'm not number one in the class
- 00:09:36that kid down the street is number one
- 00:09:38in the class my you know my I'm a doctor
- 00:09:42practicing in in this particular City
- 00:09:44and there's a colleague of mine who's
- 00:09:46also a Doctor Who's practicing the in
- 00:09:48this particular City and that
- 00:09:50colleague's child is number one and
- 00:09:53you're not number one therefore I feel
- 00:09:55inferior and nothing you do is ever good
- 00:09:58enough so if you sort of grow up with
- 00:10:00this kind of pattern what that means is
- 00:10:02that like your sense of
- 00:10:04gratification comes entirely from this
- 00:10:07omnipotent being right you struggle so
- 00:10:10hard to do a good job and if this
- 00:10:13powerful figure above you that dominates
- 00:10:16your life is happy then you are happy
- 00:10:18and if they are unhappy then you are
- 00:10:20unhappy their parents don't allow their
- 00:10:23children to be happy on their own so
- 00:10:26what this results in is I'm over here
- 00:10:28right and then there's here's the
- 00:10:29dominant other here's my parent and
- 00:10:31normally 50% of my self-esteem comes
- 00:10:33from my parents 50% comes from me but in
- 00:10:36people who are dymic this 50% gets
- 00:10:39converted over here to 100% and now my
- 00:10:42whole life is about satisfying this
- 00:10:45person now this does something very very
- 00:10:48subtle and very very important which is
- 00:10:50that this person then the child learns
- 00:10:54one really important lesson about life
- 00:10:56happiness from the
- 00:10:59outside right they are
- 00:11:01denied the ability to be happy with
- 00:11:05themselves now this frames the way that
- 00:11:08they start to live life but there are a
- 00:11:10couple of other scenarios that can
- 00:11:12result in this fundamental change so
- 00:11:15this is another one that I think often
- 00:11:16times is missed by a lot of people this
- 00:11:18is so interesting sometimes the dominant
- 00:11:21other is actually someone that you as a
- 00:11:24child take care of so this is going to
- 00:11:26be kind of hard to understand so I'm
- 00:11:28going to try to explain it but it's
- 00:11:29really important to understand okay so
- 00:11:31sometimes I've worked with patients who
- 00:11:32have parents who are like physically ill
- 00:11:35chronically ill and what happens is this
- 00:11:38parent starts to rely on the child for
- 00:11:42their health their happiness and their
- 00:11:44well-being so I have Mom or Dad who's
- 00:11:46chronically ill and whether they have a
- 00:11:48good day or they have a bad day depends
- 00:11:52entirely upon me so if I'm available to
- 00:11:55take care of them and cook them the food
- 00:11:57that they need and if I'm available able
- 00:11:59to like bring them a report card that
- 00:12:01shows them an A+ like now this person is
- 00:12:04so miserable but I can bring them Joy if
- 00:12:08I work extra hard and I bring home an A+
- 00:12:10report card my parent who's complaining
- 00:12:13all the time suffering all the time now
- 00:12:14they'll look at me and I see a slight
- 00:12:16smile and I'm like oh thank God I can
- 00:12:17make their day a little bit better the
- 00:12:19parents's happiness depends on the child
- 00:12:22now you may wonder how does this create
- 00:12:23a situation of dominant other so this is
- 00:12:26what's really interesting it's the same
- 00:12:28kind of situation because what the child
- 00:12:30learns is an adult's happiness is not in
- 00:12:35their control an adult's happiness
- 00:12:37depends on the circumstances around them
- 00:12:40right so if you are someone who has a
- 00:12:42parent who's chronically ill what you as
- 00:12:44a child will learn is a human being's
- 00:12:47happiness has nothing to do with them
- 00:12:49their parent doesn't exercise any
- 00:12:52autonomy or responsibility over their
- 00:12:55own happiness so the principle is is the
- 00:12:57same it's just kind of in the opposite
- 00:12:59direction so in this scenario right
- 00:13:01here's the child and here's the parent
- 00:13:05and the parent is sick so what does the
- 00:13:07parents happiness depend on it depends
- 00:13:09100% on the actions of the child is my
- 00:13:12child getting good grades you know are
- 00:13:14they available to rub my feet administer
- 00:13:17medicine right all kinds of stuff so
- 00:13:19what is the child learning about the
- 00:13:22script or the way that the world works
- 00:13:25this person's happiness is 100 dependent
- 00:13:28on this person person's actions and so
- 00:13:30then what happens is as this child grows
- 00:13:33up now you're in this column and now
- 00:13:36what you're thinking is my happiness
- 00:13:38depends on this external thing depends
- 00:13:40on this external thing this external
- 00:13:42thing and this external thing and here's
- 00:13:44the thing that makes me just incredibly
- 00:13:45sad which is that people who are grow up
- 00:13:49in this pattern who are dymic when
- 00:13:51they're growing up their parents can
- 00:13:53count on you right because you're like
- 00:13:55working so hard to make your parents
- 00:13:56happy the problem is when you grow up to
- 00:13:58be an adult
- 00:13:59there is no one that you can count on in
- 00:14:02the way that your parents could count on
- 00:14:04you right you s sort of started to craft
- 00:14:06your entire life around your parent but
- 00:14:10when you grow into an adult no one else
- 00:14:12is willing to make that sacrifice on
- 00:14:13your behalf and so then you run into
- 00:14:16serious trouble there are a couple of
- 00:14:18other features that I tend to see in my
- 00:14:20patients with desia so let's see if this
- 00:14:22tracks for you so one is that they like
- 00:14:25think a lot of things are frivolous so
- 00:14:27often times growing up like they parents
- 00:14:29or their conditioning or their
- 00:14:30upbringing or their thought process now
- 00:14:32is like this is frivolous like you
- 00:14:34should this is silly like we shouldn't
- 00:14:36spend our time what do you mean like
- 00:14:37waste a whole day doing nothing like
- 00:14:39that's a waste of time sometimes they
- 00:14:41think that things are frivolous
- 00:14:43sometimes they think that things are
- 00:14:44inefficient sometimes they feel it's
- 00:14:47like too indulgent to do this thing the
- 00:14:49concept of treating yourself is like
- 00:14:51completely foreign to them often times
- 00:14:54the other thing that we see in people
- 00:14:55with Damia is that their attempts at
- 00:14:58self-gratification
- 00:14:59are accompanied by intense feelings of
- 00:15:02guilt right so if we go back to the
- 00:15:04scenario of parent who's got health
- 00:15:06problems and then you one day sort of
- 00:15:09are like well I want to go to like I
- 00:15:10want to go to prom or I want to go to a
- 00:15:12party with my friends and then when you
- 00:15:14go to a party with your friends you feel
- 00:15:16an intense sense of guilt and where does
- 00:15:18that come from right because your parent
- 00:15:20is sitting there they're lying in bed
- 00:15:21and they're like oh like you know you
- 00:15:23should go and have fun I'll be okay like
- 00:15:25you know it's okay like I I I can't
- 00:15:27really make myself food but I'll be all
- 00:15:29right like you should go and live your
- 00:15:30life right don't leave me here like
- 00:15:32you're you I don't want you to ruin your
- 00:15:34life because of me like don't do that
- 00:15:36and then your parent starts crying and
- 00:15:38then they feel bad they're telling you
- 00:15:40oh go and live your life but how do you
- 00:15:42feel looking at this you're like I can't
- 00:15:44I can't [ __ ] leave right like my
- 00:15:46parent is willing to make all of the
- 00:15:47sacrifice and they suffering so much oh
- 00:15:49I won't go I I'll sort of stay here so
- 00:15:52once again the problem here is that you
- 00:15:54get conditioned you get conditioned that
- 00:15:56any kind of pleasurable activity you
- 00:15:59take automatically has a sense of guilt
- 00:16:02that comes with it and this is true of
- 00:16:04the person the the child who grows up
- 00:16:06with super high expectations as well
- 00:16:08right so I got a 95 on a test I didn't
- 00:16:09get 100 you want to play video games
- 00:16:11that's a waste you should get a 100
- 00:16:13first so all of these pleasurable
- 00:16:15activities that you want to engage in
- 00:16:17are actually denied pleasure right so
- 00:16:20when you engage in the activity you
- 00:16:21don't experience pleasure instead what
- 00:16:24you feel is like guilt or shame or that
- 00:16:26you should be doing something else or
- 00:16:27this is a waste of time
- 00:16:29and now we begin to see how this creates
- 00:16:31D thyia because what is this what are
- 00:16:33these people's experiences of Life their
- 00:16:36experience of life is that things don't
- 00:16:39bring bring them pleasure right other
- 00:16:41people are able to socialize they're
- 00:16:42able to go to parties they're able to go
- 00:16:44on vacation but people with chronic
- 00:16:46dymia there's always this depression
- 00:16:49lurking in the background that is
- 00:16:51squeezing the joy out of your life from
- 00:16:54all of these different like activities
- 00:16:57that normies can experience Joy from
- 00:16:59therefore the future depressive has been
- 00:17:01trained to fear his own activities he
- 00:17:05requires a mediator to Grant him
- 00:17:07pleasure a dominant other who breathes
- 00:17:10meaning into their life in order for
- 00:17:12your life to have meaning it require
- 00:17:15someone else to give you meaning this
- 00:17:17dominant other and it doesn't even have
- 00:17:18to be a person by the way it can even be
- 00:17:20things like a religion or like something
- 00:17:23like the Army like where there's this
- 00:17:24other Factor outside of you that
- 00:17:27determines whether your life is is good
- 00:17:29or bad this is the Crux of people who
- 00:17:32have dnia is that they're not able to
- 00:17:34extract pleasure from Life on their own
- 00:17:37so one kind of surprising feature is
- 00:17:40that often times people with dymia are
- 00:17:42like externally incredibly capable
- 00:17:45remember earlier in our example we
- 00:17:46talked about someone getting a 95 and
- 00:17:48this is what I've seen a lot right so in
- 00:17:50my practice I work with people who are
- 00:17:51like coming to me for like learning
- 00:17:53about becoming happiness and attaining
- 00:17:55Moka and all of this kind like inner
- 00:17:57peace and stuff like that so often times
- 00:17:59people will come into my office who are
- 00:18:01very like financially successful very
- 00:18:03like externally successful but they
- 00:18:05they're constantly depressed and so
- 00:18:08early on the reason that they became so
- 00:18:09successful is because they were trying
- 00:18:11to satisfy unrealistic expectations from
- 00:18:13parents and then when they grow up and
- 00:18:15they've like sort of checked all the
- 00:18:16boxes they're like 32 33 making a ton of
- 00:18:19money like maybe even dating but they
- 00:18:21have this subsurface constant sense of
- 00:18:25depression so let's take a quick look at
- 00:18:26that paper again the problem with the
- 00:18:28helpless model is that many depressives
- 00:18:30are capable of excellent work and are
- 00:18:32convinced of their effectiveness they
- 00:18:34derive however no pleasure of meaning
- 00:18:37from their efforts it is not the
- 00:18:39realistic inability to perform but the
- 00:18:42intrapsychic inability to obtain
- 00:18:45satisfaction that seems more typical of
- 00:18:47depressives this means that a lot of
- 00:18:49y'all who are chronically dymic are not
- 00:18:52as
- 00:18:53debilitated as people who may even have
- 00:18:55something like major depressive disorder
- 00:18:57right when we think about something like
- 00:18:59MDD we think about severe depression
- 00:19:01where you can't get out of bed you can't
- 00:19:03clean your room you can't do anything so
- 00:19:05you are impaired but people with this
- 00:19:07thyia struggle constantly and are
- 00:19:11successful but no amount of success
- 00:19:14seems to bring them some sense of Joy or
- 00:19:16autonomous gratification they're not
- 00:19:18incapable they're very capable but for
- 00:19:21some reason they're eating food all the
- 00:19:23time but it has no taste the other thing
- 00:19:25that we tend to see in uh people who are
- 00:19:28dymic is that as a result of this kind
- 00:19:30of like you know upbringing and their
- 00:19:33inability to um derive like meaning from
- 00:19:37things like work or relationships they
- 00:19:39tend to gravitate towards a lot of like
- 00:19:42dopaminergic activities so now we're
- 00:19:44going to take a quick kind of side note
- 00:19:46into the Neuroscience of something
- 00:19:47called anhedonia so anhedonia is the
- 00:19:50inability to feel pleasure and if we
- 00:19:53look at sort of the the circuits for
- 00:19:55pleasure in our brain it's not just
- 00:19:57dopamine there's one kind of pleasure
- 00:20:00that's called uh consumatory pleasure so
- 00:20:03this is like when I consume something I
- 00:20:04get a spurt of dopamine so people who
- 00:20:07are just thymic can actually experience
- 00:20:09that so they can get some degree of
- 00:20:11dopamine but a lot of the pleasure that
- 00:20:13we experience in life comes from a sense
- 00:20:15of like satisfaction or contentment it's
- 00:20:18not just the dopamine it's like climbing
- 00:20:19to the top of the mountain where sure I
- 00:20:21get some amount of dopamine rush because
- 00:20:22I'm seeing something super cool but then
- 00:20:25there's also the sense of like internal
- 00:20:27contentment and that kind of is actually
- 00:20:29denied to dymic people on a
- 00:20:31neuroscientific level so we sort of know
- 00:20:34that from anhedonia and what this
- 00:20:36results in is that if you were denied
- 00:20:38sort of the sense of contentment but
- 00:20:40your consummatory pleasure is still
- 00:20:43capable right you still like your
- 00:20:44dopamine circuits are somewhat intact
- 00:20:46what that means is that people who are
- 00:20:48dymic are drawn to particular activities
- 00:20:51like alcohol substance use and this by
- 00:20:53the way has been understood for like 60
- 00:20:55years and nowadays it's things like
- 00:20:57technology and video Gam addiction other
- 00:20:59such individuals may fight a a feeling
- 00:21:01of inner deadness by Daredevil thrills
- 00:21:04or criminal excitement and then this is
- 00:21:06also hilarious they are chronically
- 00:21:08tired withd drawn people who are drawn
- 00:21:10to Melancholy aspects of Life often
- 00:21:13immersing themselves in existential
- 00:21:15literature or pessimistic fiction 50 60
- 00:21:18years ago people were noticing that okay
- 00:21:21like if you're someone who feels devoid
- 00:21:23of meaning on the inside if you feel
- 00:21:25dead inside you are drawn to these
- 00:21:27external dopaminergic kinds of things
- 00:21:30and you're also like kind of a goth
- 00:21:32Doomer sort of kid right these tropes
- 00:21:34have existed for years way before we
- 00:21:37were born and thankfully we sort of have
- 00:21:39some insight into this so now the
- 00:21:41question naturally becomes if you're
- 00:21:43someone who's struggling with the simia
- 00:21:45what do you do about it so let's talk
- 00:21:47about a little bit of kind of
- 00:21:48evidence-based treatments a lot of
- 00:21:50studies show that things like
- 00:21:51pharmacology like using anti-depressant
- 00:21:53medication does have mild to moderate
- 00:21:55effects um what I was kind of taught in
- 00:21:58residen is that it doesn't really work
- 00:22:00great which is kind of fair enough
- 00:22:01that's been sort of my experience as
- 00:22:03well but I it's still not something that
- 00:22:05you should avoid by any means by all
- 00:22:06means like sort of look into things like
- 00:22:08pharmacologic you know go see a psych
- 00:22:10psychiatrist get prescribed some
- 00:22:11anti-depressant stuff it could help you
- 00:22:13second thing is there are studies on
- 00:22:15things like Psychotherapy and
- 00:22:17Psychotherapy is also like mildly to
- 00:22:19moderately effective and I think the
- 00:22:21challenge here is that a lot of these
- 00:22:23like protocolized therapies like sort of
- 00:22:26don't work because they it's not that
- 00:22:29they don't work the evidence shows that
- 00:22:30it can help but there is like a
- 00:22:32particular problem with like going to
- 00:22:34see a therapist which has to do with the
- 00:22:36way that a dymic person sees therapy so
- 00:22:39the problem is that going to see a
- 00:22:41therapist falls into the same trap that
- 00:22:45reinforces the dymic person's patterns
- 00:22:49okay now what does that mean so remember
- 00:22:51this person grew up thinking that all of
- 00:22:53my joy comes from something outside of
- 00:22:56me and the work that these people
- 00:22:57fundament need to do is to learn how to
- 00:23:01discover inner Joy independent of
- 00:23:03anything outside of me so when I go see
- 00:23:06a therapist there is a subtle thing that
- 00:23:08can happen which is I can fall into the
- 00:23:10same trap now what is the source of my
- 00:23:13joy and my pleasure it is the therapist
- 00:23:16or I will go to the therapist who has
- 00:23:17now taken the place of the dominant
- 00:23:19other it used to be that my pleasure or
- 00:23:22my happiness came from Mom or Dad but
- 00:23:24now I will go to the therapist and the
- 00:23:26therapist will bestow upon me some sense
- 00:23:29of happiness and meaning and selfworth
- 00:23:31so then you go and then you actually
- 00:23:33fall into the same trap where you go to
- 00:23:34the therapist and you're like therapize
- 00:23:36me I'm here to do the work of therapy
- 00:23:38I'm going to do everything that I'm
- 00:23:39supposed to do and I will be fixed at
- 00:23:40the end right you're going to fix me but
- 00:23:43that in and of itself is what keeps
- 00:23:45people with this thyia stuck because
- 00:23:47they're once again shunting the
- 00:23:49responsibility instead what they need to
- 00:23:51do is learn how to derive pleasure from
- 00:23:54their own activities now the question
- 00:23:56becomes how do you do that that the
- 00:23:59first is that like we noticed that all
- 00:24:01of their human relationships are not
- 00:24:03about the joy that you get by being with
- 00:24:07this person right y'all aren't just like
- 00:24:09chilling you can't just hang out your
- 00:24:11relationship with this person is once
- 00:24:13again like the dominant other like if I
- 00:24:15am in a relationship the relationship
- 00:24:17will make me happy instead of just
- 00:24:19chilling with your partner and vibing
- 00:24:22and doing nothing and just enjoying
- 00:24:24their presence you are engaging in
- 00:24:26relationships to extract pleasure and
- 00:24:29bring this happiness from something
- 00:24:31outside of you this also applies to all
- 00:24:33of the work that you do right so instead
- 00:24:35of like work being about like being
- 00:24:37satisfied with yourself you are always
- 00:24:39working for other people's approval this
- 00:24:42has to change it's starts by noticing
- 00:24:45this pattern of anything that you engage
- 00:24:47in are you thinking this is going to
- 00:24:50make me happy and I want you all to
- 00:24:52really think about that phrasing for a
- 00:24:54second right because in that who
- 00:24:57controls the baking happy this will make
- 00:24:59me happy that this is an outside thing
- 00:25:02the dominant other is acting on me and
- 00:25:04will make me happy so I'm losing all of
- 00:25:08my sense of responsibility which is the
- 00:25:11problem so the first thing is to notice
- 00:25:13that pattern the second thing to do is
- 00:25:16as you engage in particular activities
- 00:25:20what you will find is that guilty voice
- 00:25:22that voice telling you this is
- 00:25:23inefficient this is a waste of time uh
- 00:25:27it's going to be some kind of of guilt
- 00:25:28or negativity that comes with
- 00:25:30pleasurable activities now I want yall
- 00:25:33to think about like how screwed you are
- 00:25:35if that's what happens because there's
- 00:25:37some things that bring us pleasure in
- 00:25:39life and when the things that bring us
- 00:25:41pleasure and meaning in life make us
- 00:25:43feel guilty too it's like wait what it's
- 00:25:46like okay here I have a sandwich and I'm
- 00:25:48going to put some trash on top anytime I
- 00:25:50take a bite of a sandwich I'm going to
- 00:25:52put some trash on top so you're
- 00:25:54depriving yourself of the positive
- 00:25:56experiences of your life by the feeling
- 00:25:59of guilt that you layer into it so when
- 00:26:01I work with my patients usually what we
- 00:26:03do is we really try to find that guilt
- 00:26:05so when you try to do something that's
- 00:26:07pleasurable like you know what are the
- 00:26:08things that make you feel guilty and the
- 00:26:11crazy thing is you actually want to move
- 00:26:12towards those things and then really try
- 00:26:15to just experience that kind of in the-
- 00:26:17moment experience it notice the guilt
- 00:26:19set it aside but really try to engage
- 00:26:20with it if you're you know so I I had a
- 00:26:22patient who was like 36 years old and
- 00:26:25they really loved Legos and then like
- 00:26:26something happened and they got punished
- 00:26:28when they were the at the age of eight
- 00:26:30they did something as an 8-year-old and
- 00:26:31their parents were like no more Legos
- 00:26:33for you they took all their Legos and
- 00:26:34they never got them Legos again and they
- 00:26:37you know anytime they would ask for
- 00:26:38Legos like the parents would be like no
- 00:26:40you shouldn't be doing Legos you should
- 00:26:41be doing this instead like you should be
- 00:26:43focused focusing on your studies Al
- 00:26:45focus on your studies this isn't me by
- 00:26:47the way my parents let me play with
- 00:26:48Legos so now what we really want to do
- 00:26:50is practice engaging in those things
- 00:26:52that actually make us feel guilty and we
- 00:26:55want to kind of acknowledge the guilt
- 00:26:56and we want to sort of like see if we
- 00:26:58can find some way to derive pleasure
- 00:27:00without the guilt It's actually an
- 00:27:02internal work not an external work and
- 00:27:05that's the problem that these people
- 00:27:06slip into is they they're assuming that
- 00:27:08if I go through the motions the good
- 00:27:10stuff will happen then I will be happy
- 00:27:12but they don't do the internal work the
- 00:27:14next step that we usually have to take
- 00:27:16is we have to acknowledge all of the
- 00:27:18repressed thoughts so usually what
- 00:27:20happens if we look at people who are
- 00:27:21dymic is as a result of this
- 00:27:24conditioning there are a lot of natural
- 00:27:27reaction that arise within us right so
- 00:27:30like when I'm when I get a 95 on a test
- 00:27:33and my parents say why couldn't you be
- 00:27:34number one there's a natural reaction of
- 00:27:37like hey can't you be proud of me like I
- 00:27:40was proud like I come home and I'm so
- 00:27:43excited because I got an a right and all
- 00:27:45you've ever wanted for me is get a 4.0
- 00:27:47GPA so I have this like natural reaction
- 00:27:50to my circumstances and what happens
- 00:27:53when you're raised with the dominant
- 00:27:54other is that your natural reactions
- 00:27:57have to be depressed because you come in
- 00:27:59excited and your parents are
- 00:28:01disappointed and that's like Whiplash
- 00:28:02for you so in the stage of healing what
- 00:28:05we have to do is start
- 00:28:07uncovering these reactions a great way
- 00:28:10to do this and I this is kind of like
- 00:28:12practical advice that I give to my
- 00:28:13patients is do things that are a little
- 00:28:15bit impractical do things that are a
- 00:28:17little bit indulgent and when they
- 00:28:19engage in these activities we already
- 00:28:21talked about the guilt but then there's
- 00:28:22another thing that happens so you start
- 00:28:24to feel the guilt right and the guilt is
- 00:28:26what represses it's not just about
- 00:28:28noticing the guilt it's about noticing
- 00:28:30what the guilt is covering up remember
- 00:28:32there's the sandwich and there's the
- 00:28:33trash on top so one part is removing the
- 00:28:36trash the second part is actually
- 00:28:38focusing on the sandwich so what is it
- 00:28:40that I enjoy about this kind of thing
- 00:28:43and this is basically what I find is
- 00:28:45that like the reason that these people
- 00:28:46aren't enable to derive that internal
- 00:28:49satisfaction is because they repress
- 00:28:51these very actively and there's guilt
- 00:28:53layered on top the next thing to do is
- 00:28:56to really try to become independ
- 00:28:58dependent and what do I mean by that so
- 00:29:00what I mean by and a lot of times like
- 00:29:02people who are dymic remember they can
- 00:29:03be very capable and very successful so
- 00:29:05they may be like financially independent
- 00:29:07they have their own place sometimes they
- 00:29:09struggle in those Dimensions too but
- 00:29:11what I mean by independent is if I when
- 00:29:13I talk to my patients who are dymic
- 00:29:15they're always thinking about someone
- 00:29:17else like okay do I want to go to like
- 00:29:19the gym today well I have a buddy who
- 00:29:21works out and he likes to go to the gym
- 00:29:23and I don't want to disappoint him so
- 00:29:24I'm going to go to the gym and they'll
- 00:29:25go to the gym and they'll work out but
- 00:29:26they're afraid of disappointing people
- 00:29:28they're afraid of disappointing bosses
- 00:29:29they're afraid of disappointing you know
- 00:29:31their spouses they're afraid of
- 00:29:32disappointing other people so their
- 00:29:34whole life is kind of constructed in
- 00:29:37relation to something else that's the
- 00:29:39whole problem with the dominant other so
- 00:29:41what we really strive for is
- 00:29:43Independence go and do something by
- 00:29:46yourself right go and do something
- 00:29:48irrespective of what someone else thinks
- 00:29:50go and do something that you can enjoy
- 00:29:53now this is once again the Trap that
- 00:29:54they fall into so when they hear that
- 00:29:56advice there is a very easy way for this
- 00:30:00to end up not helping you at all which
- 00:30:03it's kind of so subtle so hard to
- 00:30:05understand and this is why it's so damn
- 00:30:06hard to treat so if you think to
- 00:30:08yourself oh if I do independent
- 00:30:10activities the independent activities
- 00:30:13will bring me happiness same [ __ ]
- 00:30:15trap do you all get what I'm saying like
- 00:30:16I don't even know how to put this into
- 00:30:18words but oh like the independent
- 00:30:19activity that will be my salvation if
- 00:30:22you fall into the Trap of thinking a
- 00:30:24therapist will fix you an independent
- 00:30:26activity will fix you meditation will
- 00:30:28fix you it will not work the independent
- 00:30:31activity will not fix you from the
- 00:30:33outside when you engage with the
- 00:30:36independ activity don't look at it
- 00:30:38outside of yourself pay attention to it
- 00:30:41within you what do I enjoy about this
- 00:30:43experience am I feeling guilty how do I
- 00:30:45derive pleasure and to practice being by
- 00:30:48yourself and really digging around
- 00:30:52inside of yourself for some kind of
- 00:30:53pleasure now the last step which is
- 00:30:56absolutely necessary which which is
- 00:30:58often times the the reason that people
- 00:31:00also get sabotaged is as you start to
- 00:31:03walk down this road the people around
- 00:31:06you will punish you for it so this is
- 00:31:09something that is so sad but I work with
- 00:31:11so many people who have all kinds of
- 00:31:13diagnoses and what tends to happen when
- 00:31:15they start to make progress in their
- 00:31:17life is the people around them punish
- 00:31:19them so if you are some someone who has
- 00:31:21been disomic your whole life and you've
- 00:31:23been like thinking about the dominant
- 00:31:25other right you've lived your life to
- 00:31:26make your boss happy your spouse house
- 00:31:28happy your parents happy and then once
- 00:31:30you start living for yourself they are
- 00:31:33not going to like it right because
- 00:31:35they've expected oh like this is the
- 00:31:37person that I can call at the drop of a
- 00:31:39hat you may even derive some positive
- 00:31:41sense of ego people call you a great
- 00:31:43friend they're like oh yeah this person
- 00:31:44is always available no matter what I
- 00:31:46appreciate you so much they'll say this
- 00:31:48kind of crap to you right and it you may
- 00:31:50derive some degree of pleasure from it
- 00:31:52that's the problem from the dominant
- 00:31:53other is the only time you feel good
- 00:31:55about yourself is when they tell you oh
- 00:31:57you're such a good person but then in
- 00:31:59order for you to feel good about
- 00:32:01yourself you have to continually
- 00:32:03sacrifice for the sake of the other
- 00:32:05person and when you are continually
- 00:32:07sacrificing for someone else who does
- 00:32:09not sacrifice for you you cannot be
- 00:32:11happy this is the Trap of the dymic
- 00:32:14something outside of me makes me happy
- 00:32:17so I constantly have to chase it Chase
- 00:32:19it Chase it Chase it Chase it and no
- 00:32:21matter how much I chase it dude you can
- 00:32:23never be at peace if you are constantly
- 00:32:25chasing something and so as my start to
- 00:32:28make progress the people around them are
- 00:32:31not happy with it and then they start
- 00:32:32punishing them and if you have not done
- 00:32:35enough internal work then that
- 00:32:38punishment will be too hard for you to
- 00:32:40handle and you'll end up cracking and
- 00:32:42you will sort of go back to your old
- 00:32:43patterns and so this is the tricky thing
- 00:32:45about sort of overcoming this dymia is
- 00:32:48that there are a lot of steps to it but
- 00:32:50the challenge is that you know people
- 00:32:51will sort of say like okay if you're
- 00:32:53dymic and you're too dependent on other
- 00:32:54people start by being independent ju
- 00:32:57just be more more independent just go do
- 00:32:59these kinds of things but that doesn't
- 00:33:00work in my experience as a psychiatrist
- 00:33:03there is a sequencing to this stuff that
- 00:33:05is very important you can't just strive
- 00:33:07for Independence piss off all the people
- 00:33:10who have come to expect of you being a
- 00:33:13doormat and the punishment that they
- 00:33:14give you is going to be too much for you
- 00:33:16to handle until you've done the work of
- 00:33:20understanding the guilt that you feel
- 00:33:21right because when they when they impose
- 00:33:23guilt upon you that's going to pile on
- 00:33:25to the guilt that you feel and it's
- 00:33:27going to make things like overwhelming
- 00:33:28so the key thing about this process is
- 00:33:31that people will look at some of these
- 00:33:32Solutions and they'll say like okay I
- 00:33:33have to do this solution then I'll be
- 00:33:34fixed it doesn't work like that
- 00:33:36recovering from dymia the best analogy I
- 00:33:38can give youall is it's a little bit
- 00:33:40like assembling Furniture there's a
- 00:33:42bunch of pieces and you can look at a
- 00:33:43picture of let's say like you know a
- 00:33:45cabinet that's been put together but you
- 00:33:47can't just put together the walls of the
- 00:33:48cabinet you have to do a lot of internal
- 00:33:50work you have to put together the
- 00:33:51drawers put together the shelves and
- 00:33:53then you slot them all into place then
- 00:33:55you create the outside of the cabinet
- 00:33:57and that's what you need to do if you're
- 00:33:59struggling with d thyia you can't just
- 00:34:01jump straight to the end and become
- 00:34:02independent and find Joy if you it
- 00:34:04doesn't work like that if you try to do
- 00:34:06that what you'll end up with is
- 00:34:07something that looks like a cabinet but
- 00:34:08has nothing on the inside instead think
- 00:34:11a little bit about the steps that we've
- 00:34:13laid out now this is like once again
- 00:34:15just one clinician's take on what this
- 00:34:18has looked like when I work with them
- 00:34:20your Road May Vary your mileage may vary
- 00:34:22but the good news is that when I've
- 00:34:24worked with a lot of these people like
- 00:34:25it's pretty cool like how transformed
- 00:34:27their lives are at the end of this like
- 00:34:30many people are like H holy crap like
- 00:34:32now I'm enjoying life like I'm deriving
- 00:34:34pleasure from my life without being
- 00:34:37dependent on other people leads to a
- 00:34:39huge sense of Freedom leads to a huge
- 00:34:42sense of like putting down a burden
- 00:34:44leads to like I'm not chasing anything
- 00:34:46anymore so I can just sit down and chill
- 00:34:48so this timey is something that you know
- 00:34:50is actually way more common than we
- 00:34:52realize like so we said that you know 30
- 00:34:54to 50% of people will experience
- 00:34:55depression of some form at some point in
- 00:34:57their life
- 00:34:58the crazy thing is like a third of those
- 00:35:00people will be dymic so we're talking
- 00:35:02about somewhere between like 10 and 20%
- 00:35:05of the population struggles with this
- 00:35:08constant sense of like emptiness lack of
- 00:35:11meaning and our hope today is that we
- 00:35:13can sort of illustrate a little bit of
- 00:35:15this problem for you so that you can
- 00:35:17take a couple of steps and hopefully
- 00:35:19move in the right direction but
- 00:35:22remember that just because you watch
- 00:35:24this video and you follow the steps
- 00:35:26doesn't mean that the Happ will come
- 00:35:28right you have to do the internal work
- 00:35:31which I know is hard because you're like
- 00:35:32I don't know how to do that because your
- 00:35:33parents conditioned you to never do that
- 00:35:35internal work and just focus on making
- 00:35:37them happy so it's like it's a real
- 00:35:39tough nut to crack but good luck with
- 00:35:41that
- 00:35:47[Music]
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