EP2

Depression can be categorized into major depression and bipolar disorder. Major depression is the most common type in the American population, with around 8% affected. Signs of major depression include anhedonia, a lack of pleasure, and a vegetative stagnant state where one feels constantly tired and unmotivated. Deficiencies in neurotransmitters like serotonin, acetylcholine, and norepinephrine play a role in depression. Boosting serotonin levels can be done through diet and sleep. Getting sunlight, vitamin D, and exercise can also help improve mood. The effects of neurotransmitters vary from person to person, and consistency is key in maintaining good habits. Acetylcholine is important in voluntary muscle movement and has been linked to anxiety and depression. Norepinephrine is associated with the fight or flight response and affects alertness and attention. Hi guys, welcome to the next episode of The Hindsight Podcast with me, Ruben, and Nathan Schrader. Today's episode is going to be about depression. Okay, so Nathan, what is depression? So there are two major types of depression. We have bipolar and major depression. And so right now we're only going to focus on major depression or unipolar depression because as of right now, it's the most common type of depression that the American population suffers from. So how many American people suffer from major depression? Well, as of January 2023, we saw that about 8% of the American population has suffered from it. And so just to put that in perspective, in our average classroom of 30 people, that means at least two people suffer from it. Okay, so how do you know when someone has major depression? Are there signs that they show, or is it mostly just bobslept and not really expressed to people around them? So in a clinical sense, we can see that people with major depressive symptoms can typically exhibit anhedonia, which is kind of like the lack of pleasure. And so anhedonia, in like a definition form, is when we can't experience pleasures from activities we typically can't derive pleasure, we typically do derive pleasure from. And so that'd be like you, you know, you like wrestling, right? That'd be like you not having that dopamine effect when you go and do wrestling. Okay, that makes perfect sense. So is there any way you can see if someone is exhibiting anhedonia in like an environment like Stevenson, for example? Well, in Stevenson, we know a lot of people are involved in extracurriculars and in sports. And so typically when we see this loss of interest within like these very interesting things that people like to do, typically that's like our first sign that something may be a little off. Our second sign is kind of like this vegetative stagnant state that we see a lot of people who experience unipolar depression in, where, you know, you're constantly tired, you don't feel motivated, and yeah. Okay, so what causes this state of depression? Is it like an event that happens in a person's life? Or would you say it's something they're born with and exhibit all throughout their childhood and into adulthood? Well, you can't be born with depression, I'd say, in my own personal belief. Like, obviously, I'd say as babies, we're pretty happy and even then we don't really understand what being happy is, right? And so if we really want to look at what depression or major depression is, we can look to these deficiencies within key neurotransmitters, which are like the two that exhibit these like anhedonia and this like vegetative or stagnant state. And so the first one I kind of want to bring attention to is serotonin or 5-HT, which is both a neurotransmitter and a hormone. And so this is very important in our mood regulation, our sleep, our digestion, and our sexual desire. And so typically, serotonin is going to carry messages in between your CNS and your PNS, which is your pulmonary nervous system and your central nervous system. And so essentially, this is your feel-good chemical. And so typically, we see this deficiency of serotonin in people who have unipolar depression. And so this lack of serotonin typically affects your mood regulation and it leads to that kind of, how do I say, like this unmotivated mood. Okay, so how would I boost my serotonin levels if, say, I did have major depression and I was struggling from it? So I'd say sleep is very affected by your serotonin. Just like to increase your serotonin levels, we could also mess with your diet. And so I think a big part of your diet is just eating tryptophan-filled foods because tryptophan has a process in which it creates serotonin. And that's why I kind of like, you know, after Thanksgiving dinner, you have that like really drowsy, sleepy feeling. Just because of the tryptophan, a byproduct of that tryptophan, the serotonin process is melatonin. And so that gives you that drowsiness that you see. And so eating things like turkey, salmon, eggs, that can help boost your serotonin levels. Okay, perfect. So I've seen a lot of people, especially in Stevenson, who get very little amount of sleep, but they still seem happy and energized throughout the day. So is it, does major depression vary from person to person? Or is it like a set amount of like food and sleep you need to not be suffering from it? Well, that's the thing with depression just in general, right? It's a very, it's not a very cookie cutter. It's not a very cookie cutter mental illness, you know, everyone experiences it differently. And some people are able to bottle up what they feel. Okay. Okay. Thank you so much. Okay, so Nathan, are there any other ways that we could make up for a lack of serotonin? For example, let's say I had a really bad sleep last night, and I am prone to major depression, and I don't want to be feeling depressed all day. Is there anything else I could do to make myself feel happier? Well, I think just getting out more, like a lot of people right now, just out of winter. So you know, getting more sunlight and vitamin D, you know, that'll help you with your seasonal like depressive syndrome. And so I think just getting outside helps a lot. And I think a key part that a lot of people should start to do, whether you're depressed or not, is just getting more exercise. There's so many studies that prove it's great for your brain health, it's great for your body health, it helps with longevity, all that. Okay, so do serotonin levels from exercise from a previous day carry over through the next day, even if you had a bad night's sleep in between? Well, I'd say sleep is very important. I think a lot of us don't get a lot of sleep. And so, you know, sleep is kind of like our body's reset button. But including like, to answer your question, it is very possible that like engaging in activities like such as exercise, or eating like trip to sandfill foods, as I previously said, can like increase your serotonin levels. But it's not, it's not definite that it'd be significant or immediate for anyone. And so I would say just consistency is key, right? Like, you don't want to, you know, habits made in what is it, three weeks. So I think just making good habits for yourself is very important. Okay, so are there any other key neurotransmitters related to depression? Well, another one that I want to call a little bit of attention to, and that I kind of want to do another episode on is acetylcholine. And so acetylcholine is a neurotransmitter that carries messages from your brain to your body. And so this plays a role in your voluntary muscle movement. And it also connects, this actually is very important in Parkinson's, because we see that an imbalance of this with your dopamine levels can actually, is actually prevalent in people with Parkinson's. And also with Alzheimer's, because a lot of people who have a decreased level of acetylcholine typically do have, like a lot of people with Alzheimer's do typically have very decreased levels of acetylcholine. And so I do want to bring that up in another, but that's for another episode. I think acetylcholine is very, very important in our lives. And so there have been studies that show that acetylcholine levels are elevated in a person who's actively depressed. And so this, studies have been shown, studies have been done that indicate that acetylcholine signaling in the hippocampus promotes behaviors related to anxiety and depression. And so that's kind of like a very key part in, it's not a key part, but it's a very important part of unipolar depression. Okay. So can you go into a little more detail about what you mean by signaling in the hippocampus? Yeah. So increased cholinergic signaling can contribute to depression and the administration of ACHE. And so that's kind of, and that has been proven to induce symptoms of anxiety and depression by decreasing your breakdown of acetylcholine and increasing its levels. And so we've actually seen this in mice. There was a study conducted where they administered ACHE and we saw that the mice would demonstrate very, like a lot of symptoms of both anxiety and depression. And so chronic increases in your acetylcholine levels can kind of be correlated to mood disorders by contributing to the encoding of memories, the encoding of memories that are associated with stressful events. Okay. So I also heard that norepinephrine also plays a key part in depression. So would you mind going into more detail on that specifically? Yeah. So in people with unipolar depression, we actually see a lot of deficiencies with norepinephrine or noradrenaline, however you want to call it. And so just on the basis of what norepinephrine is, it helps transmit nerve signals across nerve endings to another nerve cell and it plays a key part in our SNS, which is linked to our fight or flight response, right? So when we have these increased levels of norepinephrine, we typically have alert, we have like high alertness, high arousal, and high attention. And so due to this association with the fight or flight response, we can kind of see this in, for example, with UFC fighters. And so during a UFC fight, we can see that there's a release of norepinephrine and so that will trigger your fight or flight response. And so it can help a UFC fighter and it can have a negative effect on the UFC fighter because for your pro, you'll have an increased focus and alertness. Your muscles will have the maximum blood flow because your norepinephrine is going to allow your heart rate to increase, your blood pressure and your blood flow all go to your muscles. And so one bad thing is that your norepinephrine will likely cause a stressed response and your fight or flight response is literally called acute stress response. And so you'll definitely see these increased levels of cortisol and so that gives you, you know, those sweaty hands before a fight, you know, it'll give you those cold feet before a fight and give you that anxiety and nervousness. But relating to depression, norepinephrine also affects your sleep-wake cycle, mood, and memory. And so that's why we see this constant drowsiness in unipolar depression. And so reduced norepinephrine neurotransmission can be associated with decreased alertness, low energy, trouble concentrating, and your decreased cognitive ability. And so therapeutic agents which specifically increase your norepinephrine are actually effective antidepressants. And so they actually did a study on this with mice, again, with a genetically enhanced version of your norepinephrine system. And so this helps protect the rats from a stress-induced depression. Okay, so what exactly in the brain is affected by this? So your norepinephrine neurons are projected to your limbic system. So like just in general for the limbic system, the norepinephrine neurons are going to project your amygdala, your hippocampus, and your hypothalamus, all of which are involved in emotion, cognition, appetite, response to pain, levels of pleasure, and behavior. And so imaging has shown that major depressive disorder is typically associated with abnormalities in your limbic and your paralimbic, but we won't get into that structure. So why do you think that there's so much depression and anxiety in recent times, like knowing like all these biological facts now? So I think that social media has created a dopamine-addicted generation. And without social media, many people, especially high schoolers, can't really live without it and then they fall into like this depressive state. So I think America perpetuates this with like its reliance on motivators like wealth, fame, and image. And a recent study at Harvard actually showed that people who attend like religious services such as church drastically have significantly less deaths related to suicide, drug overdoses, and alcohol poisoning. So I think that there's like a significant relation between mental illnesses such as depression and doing stuff that will really help your body, such as attending like a religious service. So Ruben, do you know any technological things that can help with depression? Yeah, so many people have actually decided to code mental health apps and release them on platforms such as like the App Store. So since between 2016 and 2018, mental health apps have actually grown threefold in number. So offering help for many people who actually suffer with things such as depression. So there are like over 10,000 mental health apps that people can use. So in a survey of 320 health seekers from four clinics in the United States, 70% of those people, those 320 people, showed interest in using apps to get help and manage their mental health to make sure it doesn't spiral out of control. It's really interesting because interpersonal relationships and community ties are typically pretty weak in someone that exhibits unipolar depression because they'll have a diminished sense of belonging, support, and purpose. And so I would actually like to draw a lot of attention to purpose because I think purpose plays a really big part in our lives. And personally, I feel like a lot of people are unsure of what their true purpose is. And so one philosopher, Gabriel Marcel, actually said that we realize that we are an existing thing, but we desire to prove we are more. And so this is kind of our struggle with everyday life. And we can kind of connect that to Maslow's hierarchy of needs, which is not accepted by all, but it's a pretty good blueprint. And so our foundational need is our physiological needs, or just our basic things we need for living like water, food, all that. And then the second thing is safety and security. So having that security of a safe home, not that fear of getting eaten or shot by someone. And then thirdly, we have love and belonging. And so having those stable relationships, healthy relationships with your friends, your parents, and significant others, that's really important. And then the second most important thing is your self-esteem. Just respecting ourselves is very important, and having that time to work on ourselves. Being a little selfish sometimes is good for us. And the most important thing for Maslow and his hierarchy of needs was self-actualization, which is kind of just like finding out what your purpose in life was. So Ruben, how can AI kind of help with individuals who feel kind of purposeless and are in this depressive state? So with AI specifically, going back to the apps that help with mental illnesses, I think many of our listeners know of this app. It's called Calm. It's on the App Store. And it uses AI fields such as computer vision and natural language processing to help its users kind of battle depression. And it offers things such as bedtime stories, meditation, and more. And AI is actually a big process in its functionality. Yeah, I've seen a lot of stuff with how AI is being incorporated into the health field. I do have a little bit off-topic, but I do feel like AI can start to help us with online patient records, diagnosing certain patients. I think that AI will start to have a very prevalent role in the medical field. Yeah, exactly. I do feel like if someone with a mental illness does have very noticeable symptoms, and they tell the AI in these mental health apps how they're feeling, they can catch on to this disease that they have before they take it too far and end up doing something such as taking their own life. Yeah, so do you think that AI could actually be used to identify, like what I said, the deficiencies in key neurotransmitters, hormones, all that, like deficiencies in norepinephrine, ACH, serotonin, dopamine, thyroid, all of the things that can indicate major depressive disorder? Yeah, 100%. So the way AI works, it's been trained on a lot of user data. So it takes what data that is given, and it can basically tell whether or not they fall into a certain category or not. So this can be used for anything. It doesn't have to just be mental illnesses. But if many people who do exhibit some form of depression or any form of mental illness, and they all share very noticeable features, such as, say, loneliness or isolation, AI can pick up on that. And it can ask a user of these apps whether or not they feel something similar. And if many things match up, if many of these feelings they have match up, it could kind of self-diagnose the person and tell them whether or not, you know, if they have a mental disorder, what they're struggling with and how to help them. Does that kind of make sense? Yeah, so I guess you could kind of, correct me if I'm wrong, you could kind of sum up AI to being like an autofill generator on crack. Yeah, exactly. But as everyone knows, it's not perfect. So you might still have to see a doctor. But I do feel like with the advancements that we're seeing in AI today, like the major advancements we're seeing, it could really help a lot of people who are unsure whether or not they really need the help, right? If AI does diagnose them with something that they feel they are struggling with, maybe then the next step is to see a doctor and to really know if you really have that mental illness and how you can move forward with it going on. Yeah, I think AI will definitely be a key component in how we diagnose and assess patients. And another thing I wanted to ask you actually, not regarding like any medical or like technical things, what do you think a person should do if they're battling depression? So I really feel like they should not be kept bottled up inside the person. They should find others who have overcome it and ask them how to overcome it. Just like if I were to learn something new, I would not try all by my own. I would try to figure out how I can get better at what I'm learning. I'd say if you are suffering with something such as depression, the best way to go about it is to find out how others have defeated it or how they have learned to live with it. And from there on, try to incorporate what those people have done in their lives into their own and see if it really does make a difference. If everyone's different, so it really might not, but you know, I do feel like there's a really good chance that they could in fact get better and start to feel a bit happier. Yeah, but I have one kind of argument with your reasoning and it was kind of just going off of, you know, I see a lot of people who try to support that you shouldn't live with depression and I know that I think I've seen like psychologists say this, but I feel personally that like, don't you think that not living with depression and learning to fight against it to lead yourself to a better life by exercising, going outside, getting that vitamin D, eating good food, eating healthy, meeting new people, establishing those support systems, don't you think that would be like a little bit better than just learning to live with it? Yeah, 100%. So I really do feel like everyone that has depression should learn to do all those things like that you said, like going outside, making new friends. But I feel like on top of that, learning how to manage your depression just so that it doesn't get to a point where you can't manage it anymore is something that could be really beneficial because if those things like going outside and making new friends do not work, like if someone is just still battling it and they have just given up at that point, then it could lead to situations such as taking their own life. Yeah, and it's really unfortunate how we're seeing the suicide rate, especially with men, like drastically increasing. I think I remember seeing like every five minutes, maybe a minute or something, a man takes his life or something, and it's really unfortunate what we're seeing in today's generation. Yeah, exactly. I do feel like, like you said, most men, they are really scared to get the help they need because they're afraid of being laughed at in society and deemed as weak. So I do feel like many men, especially younger men in today's generation, try to break that stigma and start to get the help they need and admit that they need help. It could really help many young men not live with something and then eventually take their own life with it. Yeah, I think just for people suffering out there, I think the first step to getting better is wanting to get better, you know what I mean? Because I feel like a lot of people, I think the biggest problem is getting your butt off the couch, you know what I mean? Instead of just stagnating there, I think sometimes you do need to kind of force yourself to take new dives into new things, maybe try new foods, try new experiences, go out, see the world, or start focusing more on what's important to you. Exactly. I feel like when people do realize that they are depressed, they kind of just accept it and they act like they're depressed, it kind of reinforces that idea into them, so it leaves them stuck in this cycle of depression. And unless they really try to realize that this can be dealt with, they're just going to be stuck in this cycle and eventually it's going to lead to something that is not good for them or their peers or anyone else around them. Yeah, I actually saw this one thing on the Huberman podcast with one episode with David Goggins and it was actually, you know David Goggins, he was a 300 pound morbidly obese man and he became a Navy SEAL, right? And I think it's very interesting how much our own willpower plays a role in helping us get better, right? And in that podcast, Huberman actually mentioned a thing called your anterior mid-cingulate cortex and I don't want to get too into it because it's a very interesting topic and I'd like to save it for another episode, but essentially it's like our tenacity center for our brain and I think it's very interesting that a lot of the things we do, we don't do it with enough tenacity, we prefer to stay comfortable and I think just learning to be comfortable being uncomfortable is very important in today because I feel like that already accelerates you to the top 1% of people, you know what I mean? It helps you guarantee success, but more than that, I think it guarantees yourself. Yeah, exactly. I don't know if this has been done already, but I would love to see a study be performed comparing people that all have a mental disorder such as depression, but with half of the participants actually believing that, you know, they can get better and they will get better if they keep a good attitude because I do feel like that attitude plays a big role in if you stay depressed or if you battle it and eventually overcome it. Not that I've had any experiences with depression, but we've all had experiences where we do have that, you know, that very sad state and I have to say I think the times when I feel the most energetic, the most happy would be when I'm able to exercise, establish, have those like strong support systems that I do have and I think something I really want to draw on that I've kind of been drawing on this whole episode is exercise. I think a lot of people don't exercise properly, you know what I mean? I feel like some people, you know, you go for a week and then you never go back or, you know, you get lazy, things pile up, but I think just making time for things you don't want to do is very important. I think I remember this one quote from someone, I'm not sure who it was, but, you know, it's not that you don't make time, it's that you don't want to. Yeah, I do feel like exercise plays a big role in mental illnesses. I do feel like in COVID specifically, people who were stuck at home because they couldn't leave their house, that's when depression really started to spike. They were just stuck at home and they had no way of seeing new people, meeting their friends. So they were kind of stuck at home alone and they couldn't go outside for a walk and exercise really without being at fear of catching the virus. So I do feel like exercise and just the fact of like meeting new people has a big role and in people's mental health. Yeah, I feel like it's a very big problem. I feel like a lot of people have social anxiety, anxiety these days, right? You know, they struggle to meet new people. And obviously, you know, all of us have trouble talking to new people. It's not just a one person thing, but I think just learning how to overcome some of those fears is pretty key in your battle, like with becoming like the best person that you can be. And I think that like I've been stressing exercise because exercise, you know, it can boost your serotonin, boost your dopamine, it can help your ACH levels, it can help your neuro or your norepinephrine level. All of that, I think, connects to exercise. And more than that, just not even exercise, I think just being more active, having a good diet and just living a better life is very important. Exactly. Including being in touch with society and making sure you're surrounded by people who can really help you fight that mental health battle. Yeah. You know, if you surround yourself with good people, you'll never have to have those. You'll never have to have those bad times alone. You know what I mean? Exactly. And I feel like people who have been in your shoes before and have had to work through it and have finally broken that depressive state can really be someone that you look up to and can help you in your battle against it. So, yeah. So just to conclude, I feel like some key parts were just like, you know, I think helping like I hope like you guys are more aware of like what these obviously the biological things that cause these disorders, but also just being more aware of how it affects you and your peers is pretty important. And I think, you know, just realizing the signs and just becoming a better person overall will prevent all of this. I think we should all aim to be better than what we are. Yeah, exactly. And if you if you do see someone who who is you do feel that they are suffering from a mental illness such as depression. I do feel like it is important to really just step up and try to give them the help they need or try to offer them a way that you could help them. Yeah, just putting yourself in other people's shoes is very important to just how our society works as a whole. You know what I mean? Just communicating with people and. You know, having that sympathy for others. Exactly. OK, guys, I think it's going to wrap up this episode. So, yeah, it's been Ruben and Nathan. I guess we'll see you guys on the next episode.