0:01 I'm psychiatrist Dr Eric Bender let's
0:03 answer your questions from the internet
0:06 this is mental health [Music]
0:09 [Music]
0:12 support at pink penguin writes someone
0:13 please educate me what does psychotic
0:15 mean psychotic means a break from
0:17 reality you are experiencing things that
0:18 other people might not be that can
0:20 include auditory hallucinations hearing
0:22 things other people might not be hearing
0:24 visual hallucinations although those are
0:26 rare you might have delusions fixed
0:28 false beliefs you believe are true
0:30 despite other people showing you that
0:32 those aren't true psychotic does not
0:34 mean someone is going to commit crimes
0:37 Andre H Perez how does depression make
0:38 you exhausted but then sometimes I'm too
0:40 sad to even sleep when you're depressed
0:43 your circadian rhythms are off in fact
0:45 one of the first things we ask patients
0:47 about is sleep people don't realize it
0:48 they have this picture that when you're
0:50 depressed you might sleep more but in
0:52 fact it's the opposite you wake up early
0:54 and people are like why am I waking up
0:55 at 5:00 in the morning not even setting
0:58 an alarm it's because your sleep cycle
1:01 has been phase shifted or phase Advanced
1:03 you go to bed earlier and you wake up
1:04 earlier we think this has to do with a
1:06 lack of neurotransmitters when you're
1:08 depressed so there's less serotonin Nur
1:10 epinephrine and there's less
1:12 acetylcholine and for some reason this
1:15 makes us wake up early at Aton Supreme
1:17 anyone else thinks dress is contagious
1:18 I'll tell you watching high school
1:19 students in the Bay Area go through the
1:21 college application process I can
1:22 absolutely tell you it is contagious
1:24 there was a study that looked at an
1:26 audience watching a speech being given
1:27 by someone who was very anxious saliva
1:29 samples were then gathered from the
1:31 audience as as well as the presenter the
1:33 saliva had increased cortisol levels
1:35 which is that stress hormone not only in
1:37 the presenter but in the audience so
1:39 stress is absolutely contagious at say
1:40 baby is asking can depression be
1:44 hypnotized out of you no hypnotherapy is
1:45 very effective for some things it can
1:47 help people with smoking sensation it
1:49 can help people decrease their temper
1:50 sometimes hypnotherapy can also be used
1:53 to treat Sleep disorders and insomnia it
1:54 cannot change a level of
1:56 neurotransmitters in your brain that are
1:57 correlated with depression some people
1:59 are more hypnotizable than others when
2:01 you you look at this eye roll chart it
2:03 gives you a sense of a gradient how
2:05 hypnotizable somebody might be you ask
2:08 them to look up into their head when
2:09 they're looking straight ahead that's a
2:12 zero then one is slightly you start to
2:14 see a little bit of white then you start
2:15 to see more white the scale goes all the
2:17 way down to four being you see mostly
2:19 white almost Exorcist style there is a
2:21 correlation between those that show a
2:22 lot of white when they roll their eyes
2:24 and being able to be hypnotized easily
2:26 DJ leapcard asks what's the difference
2:28 between a psychologist and a
2:30 psychiatrist and which one do I need to
2:31 see well psychiatrist has gone to
2:33 medical school so they can prescribe
2:35 medications if you're feeling
2:37 overwhelmed and need to talk to somebody
2:38 a therapist would be fine that could be
2:40 a psychologist or a psychiatrist if
2:42 there's suspicion that medication is
2:44 needed then a psychiatrist is the one
2:46 you'd want to see at Bel Maps wants to
2:47 know question for psychiatrist
2:50 counselors how do you not cry well at
2:52 Bell maps to be honest sometimes I do
2:54 get tearful with patients we are human
2:56 after all even though some people don't
3:01 think we are at Mets for n 33 do
3:02 personality disorders work on a spectrum
3:04 like can you have mild disorder of
3:06 narcissism absolutely there's a spectrum
3:07 here you can absolutely have
3:10 narcissistic traits when it's unhealthy
3:11 is when you start to think only of
3:14 yourself fantasies and obsessions over
3:17 unlimited power or beauty and then the
3:19 full-blown disorder you could go as far
3:21 as to be a malignant narcissist you have
3:22 a lack of empathy and don't really care
3:24 about other people this is where we find
3:26 Psychopaths at resilience doc how do you
3:28 think the brain gut connection Works
3:30 preclinical Data meaning data and
3:32 research from animals not people shows
3:33 that there's a relationship between the
3:36 brain the gut and the microbiota or the
3:38 bacteria that populate your gut what we
3:40 found was that in some stress induced
3:43 rodents they ended up having short chain
3:45 fatty acids and what we find is there's
3:47 actually less serotonin produced in the
3:49 stress induced rodents guts now that's
3:50 not the same serotonin that's in your
3:54 brain yes it's the same structure but
3:56 that serotonin in your gut doesn't cross
3:58 the blood brain barrier however what we
4:00 find is that the inflammation that is
4:03 caused during this stress causes the veg
4:05 nerve which is involved in depression to
4:07 not fire the way it's supposed to and so
4:09 as a result this inflammation might have
4:12 something to do with a depressive state
4:13 it suggests that with a healthy gut and
4:16 healthy microbiome we can actually have
4:18 improved mood okay next question at
4:20 dar's nobot wants to know when did
4:22 Psychiatry start well formal Psychiatry
4:24 can be traced back to the 19th century
4:26 we used to have a group of doctors
4:28 called alienists and their job was to
4:30 understand and treat and be with people
4:33 who had an alienation from the rest of
4:35 society that was due to mental health
4:39 issues in 1895 Freud wrote studies in
4:41 hysteria some consider that the birth of
4:43 psychoanalysis why does no one talk
4:44 about how depression and anxiety can
4:46 cause major memory loss depression
4:49 really can make us have memory issues
4:50 what we think that has to do with is a
4:52 lack of glutamate glutamate is the
4:54 excitatory neurotransmitter and when
4:57 there's less of that we find that people
4:58 don't lay down memory processing speed
5:00 of somebody with a depressed mind can be
5:02 40% below what it is when they're not
5:04 depressed there's something called
5:06 pseudo Dementia in fact this false
5:08 appearance of dementia but it could in
5:11 fact be a depression at megie Meg 26 you
5:12 ever had a random ass thought that just
5:14 won't leave your head I'm going through
5:16 it right now first off every human being
5:18 has a random ass thought if we don't
5:20 want them they're called intrusive and
5:21 then they can become obsessive if you
5:23 can't let go of it and that's when it
5:24 can start to go into the obsessive
5:26 compulsive disorder range so the
5:29 obsessive thought pathway starts with
5:30 the connection between the orbito
5:33 frontal cortex and goes back to these
5:35 areas here called the basil ganglia when
5:37 that pathway is activated there's a
5:40 worry but then the inhibitory pathway
5:42 goes back to the orbital frontal cortex
5:44 and actually shuts it down it inhibits
5:46 it in someone with an obsessive thought
5:48 disorder where they keep worrying about
5:50 the same thing there's overactivation of
5:52 that direct pathway back and
5:54 underactivation of the inhibitory
5:56 pathway it's like there's no breaks to
5:57 stop this worry so we have this cycle
5:59 that goes on and on and on and on
6:01 cognitive behavioral therapy or CBT is
6:03 used to help somebody with these kind of
6:04 obsessions you can also do something
6:07 called exposure and response therapy
6:08 that's where you make a hierarchy of
6:10 fears let's say somebody's fearful of
6:13 spiders first rung on that hierarchy of
6:14 fears might be all right let's talk
6:16 about spiders the next thing might be
6:18 going to the tarantula exhibit then the
6:19 last thing might be petting spiders and
6:21 letting them crawl all over you oh not
6:23 that Mimi is asking why does Tik Tok
6:24 keep telling me I have ADHD Tik Tok is
6:26 going to tell you a lot of things please
6:28 do not look at Tik Tok as your sole
6:30 source of information for mental health
6:32 a study looking at 500 videos on Tik Tok
6:34 with the hashtags mental health tips and
6:35 mental health advice showed that about
6:39 84% were misleading about 31% had
6:41 inaccurate information and 14% had
6:43 information that was damaging only 9% of
6:44 the people doing the videos even had
6:47 relevant qualifications to do the videos
6:49 as a society right now our brains are
6:51 being trained to be stimulated for only
6:53 a few seconds and to go to the next
6:54 thing and to go to the next thing and to
6:56 go to the next thing I think people find
6:58 they have a hard time focusing it's not
7:00 ADHD maybe it's being on Tik Tok too
7:03 long at Mindy I wish there was more
7:04 information available on how shrooms can
7:07 help manage PTSD anxiety and depression
7:09 the information's here and More's coming
7:11 there is a lot of promise that shrooms
7:14 or mushrooms can actually help with PTSD
7:16 or with depression what we're talking
7:17 about when we talk about shrooms is
7:20 really silos cybin a chemical that binds
7:22 to the serotonin receptor particularly
7:24 in the thalamus so that we have these
7:26 hallucinations but what's interesting is
7:29 it's not the hallucinatory experience
7:31 that necessarily is the treatment
7:33 there's a case report of a man who did
7:35 have a siloc cybin guided treatment he
7:37 didn't have the Psychedelic experience
7:38 and was actually kind of disappointed he
7:41 didn't but 40% of his depressive
7:44 symptoms went away based on his reports
7:45 and the structured evaluations that he
7:47 was given there's something about having
7:49 a guided treatment something about
7:51 having somebody there with you can be
7:52 really helpful and really powerful it
7:54 shows us that there's really a value to
7:56 being interconnected with each other at
7:58 Hex bags am I having a panic attack
8:01 heart attack heartburn weird chest pain
8:04 what is it cry Emoji cry Emoji a panic
8:07 attack is abrupt it comes out of nowhere
8:09 you can have chest tightness difficulty
8:10 breathing it can feel like your throat's
8:12 constricting you might have sweaty hands
8:15 or sweat all over and maybe some pain so
8:16 it feels like you're going to have a
8:18 heart attack that anxiety Peaks after a
8:20 certain number of minutes and then it
8:21 comes down but you're so worked up and
8:23 so worried that absolutely you feel
8:25 panicked there's also something called
8:27 an anxiety attack maybe you're giving a
8:28 presentation maybe you have to take a
8:30 test you get more and more anxious and
8:31 you feel like you can't go on that's an
8:33 anxiety attack at tune of your death
8:35 wants to know help I'm having an anxiety
8:37 attack in the middle of class sad face
8:40 what do I do help you can do a grounding
8:42 technique remind yourself where you are
8:44 and what you're doing I'm here I'm
8:46 sitting in the room there are people
8:48 around me some people go by the rule of
8:51 3 three three see three things hear
8:52 three things and move three parts of
8:55 your body a common thing people say is
8:57 just breathe that is not helpful I never
8:59 find that helpful to say just breathe a
9:00 good breathing technique is actually
9:03 inhaling through your nose and exhaling
9:05 for twice as long so you can inhale for
9:06 say a count of
9:14 six it's the exhale that's actually
9:16 relaxing at Angel disrupted I'll be
9:18 honest I don't know the difference
9:19 between serotonin or dopamine or
9:22 oxytocin or endorphins and at this point
9:24 I'm too afraid to ask endorphins are
9:26 hormones endorphin comes from the name
9:28 endogenous meaning it's made inside us
9:30 and morphine which is a painkiller and
9:33 the endorphins imitate what morphine
9:34 does that runner's high comes from
9:37 endorphins serotonin and dopamine are
9:39 neurotransmitters they transmit messages
9:41 in the brain serotonin has to do with
9:43 mood and anxiety and dopamine has to do
9:45 with joy pleasure and sometimes even
9:48 motivation or attention serotonin is
9:50 implicated in depression and anxiety
9:52 when it's low and dopamine can also be
9:56 low in depression and an ADHD oxytocin
9:58 is that loving or bonding hormone in
10:01 women when they breastfeed that actually
10:03 helps form a loving relationship with
10:06 the child at anxiety aloner says has
10:07 anyone tried fish oil or Omega-3
10:09 supplements for mental health it's meant
10:11 to be good for anxiety and depression
10:12 did you notice any difference omega-3
10:14 fatty acids increase blood flow in the
10:16 brain now this doesn't necessarily
10:18 correlate to improvements in mood but
10:20 some people do report improvements in
10:22 mood and that Omega-3s can actually help
10:25 with depression even with ADHD there's a
10:27 population that will respond to that and
10:29 they'll be able to concentrate more you
10:31 you can take 1 G or up to 2 G but
10:33 studies show that going up to four gr
10:35 doesn't really do anything 1 G is the
10:37 equivalent of having salmon meals maybe
10:39 three times a week you could get fish
10:42 burps though just be aware of that ad
10:44 Rider Trill writes I would love to know
10:45 what trigger schizophrenia like actually
10:47 study that we do know that now
10:49 there are over 200 genes responsible for
10:51 schizophrenia and what happens is if you
10:54 have enough errors in those 200 genes
10:55 you might develop schizophrenia even in
10:57 schizophrenia and something we know has
10:59 strong genetic component to it it there
11:01 are environmental factors and we know
11:03 this from studies of twins if one twin
11:05 develops schizophrenia there's a one and
11:06 two chance the other will but it's not
11:08 100% suggesting there's something in the
11:11 environment what might unlock that could
11:13 be substance use it could be trauma
11:14 we're still trying to figure out the
11:16 connections between these what is the
11:18 Environmental Factor exactly what genes
11:20 are turned on exactly here's another one
11:22 how does stress work how do you destroy
11:24 the freeze response when we face stress
11:26 there's a section in the brain called
11:28 the amydala it's a nuclei a collection
11:31 of cells that senses a threat and sends
11:33 a message to the hypothalamus the
11:35 hypothalamus then gets our body ready to
11:37 make adrenaline or cortisol which allows
11:39 us to have that fight ORF flight
11:40 response are we going to get ready to
11:41 stand up to this threat or are we going
11:43 to take off what can also happen is
11:45 another response called the freeze
11:46 response the deer in a headlights
11:48 response your body's been flooded with
11:50 cortisol it gets you ready to fight or
11:52 flight but if your body's not responding
11:54 then you don't do anything destroying
11:56 the freeze response would probably
11:57 involve some cognitive behavioral
11:59 therapy or other types of therapy where
12:01 you you talk about what is it that is
12:03 keeping you Frozen in place at lifting
12:05 Humanity can depression be beaten or
12:07 only managed absolutely depression can
12:09 be beaten I have seen people have
12:11 depression in what's called remission
12:13 it's not coming back again what happens
12:15 in depression is that we have lower
12:17 levels of Serotonin and when I talk
12:19 about serotonin I mean between neurons
12:21 in the synapse that connection between
12:23 nerve cells there are medications called
12:25 selective serotonin reuptake Inhibitors
12:28 big fancy name ssris that Target
12:30 serotonin re ctors and block them and
12:32 then the serotonin sticks around in that
12:34 synapse with that you get increased
12:35 dendrites which are the branches of the
12:37 nerve cells and with that you get an
12:39 elevation of your mood hopefully
12:40 medications in this category might
12:42 include fluoxitine or the brand named
12:46 proac Cene which is Zoloft esalo pram
12:48 which is Lexapro what we think these
12:49 medications do is increase the number of
12:51 dendrites that's part of the reason it
12:53 might take 2 to 6 weeks for these
12:55 medications to work you're increasing
12:57 synaptic connections so medication is
12:59 one way you can beat depression in some
13:01 studies show therapy and meds together
13:03 help more than just medication or
13:05 therapy alone at goldes 27 writes I was
13:07 telling my therapist about Encanto that
13:09 was all about generational trauma and
13:11 she was like uh you sure about that a
13:13 Disney movie yes I'm sure about that in
13:15 Kanto was absolutely about what's called
13:17 transgenerational trauma Abella the
13:19 grandmother lost her husband Pedro he
13:21 was killed right in front of her what
13:23 ends up happening is that that trauma
13:25 was so disruptive she wants to keep her
13:27 children close she wants them to not do
13:29 anything that will cause her any any
13:31 kind of worry or pain everyone is trying
13:33 to protect Abella from experiencing any
13:35 kind of loss or sadness again and in the
13:38 case of Bruno who recognizes wait this
13:40 doesn't feel right he is the one who's
13:42 Outcast because he's not part of this
13:43 group of people who are protecting
13:45 Abella she wants nothing to do with him
13:47 we don't talk about Bruno well you know
13:48 you should talk about Bruno because
13:49 Bruno is actually realizing something's
13:52 wrong at latrae asks are mental health
13:54 issues genetic there's a gene on my
13:55 mom's side of the family that has me
13:57 questioning my reactions all the time
13:58 some mental health conditions do have a
14:00 very strong genetic components things
14:03 like bipolar disorder schizophrenia
14:07 autism even ADHD in fact in ADHD cases
14:10 sometimes 25 to 50% of the time a parent
14:13 has ADHD but genetics are not the only
14:15 part of the picture your environment
14:17 plays a huge role in whether your genes
14:20 are expressed so you could have a gene
14:22 or several genes that contribute to you
14:24 showing a mental health issue and if
14:26 they're not turned on then you're not
14:28 going to express that that's called
14:30 epigenetic it means there's something
14:32 else that turns on this genetic code
14:35 that unlocks it at metal Guru girl is
14:37 asking how many of us take a form of
14:39 anti-depressant medication well the CDC
14:41 data is actually from 2015 to 2018 they
14:43 said that during that time frame about
14:46 13.2% of the population took an
14:48 anti-depressant however that was before
14:50 the pandemic the American Academy of
14:51 Pediatrics said in their Journal that
14:55 from 2020 on there was a 64% increase in
14:56 prescriptions to children and teens
14:59 alone in terms of anti-depressants so
15:01 it's certainly more than 13.2% of the
15:04 population now at sour kitas asks does
15:06 ketamine therapy work asking for a
15:08 friend yes there's a lot of data on
15:11 ketamine working for depression however
15:13 it's really important then to know that
15:15 ketamine therapy is not recreational
15:18 ketamine there's an amount that you take
15:20 either by an intravenous infusion
15:23 there's also a spray esketamine what
15:25 ketamine does is it blocks the place
15:27 where glutamate the excitatory
15:29 neurotransmitter binds by block blocking
15:31 that the glutamate can increase it
15:33 allows us to actually feel better but it
15:36 only lasts for 2 or 3 days the drug
15:38 rapamycin is being looked at it's being
15:40 given with ketamine and what that does
15:42 is it's actually preventing GLE cells in
15:44 the brain which chew up neurons from
15:46 chewing up neurons and the length of
15:48 ketamine is lasting longer so there's
15:49 promise here that's being investigated
15:51 at Yale and we need to still see more
15:54 results and more data at Ruby Bonia 3 is
15:56 curious is there a test for psychopathy
15:59 yes Robert hair a Canadian psychologist
16:00 came up with a scale called the
16:02 psychopathy checklist he wrote out a
16:05 number of traits that you look at to see
16:07 how someone fits on a scale of
16:08 psychopathy those include personality
16:10 traits and those include criminal
16:11 behaviors some of the personality traits
16:13 might be pathologically lying
16:15 particularly about your own history or
16:16 you might be glib you might not share
16:18 much that's real with other people
16:20 someone goes through each of these 20
16:22 items and scores it 0 one or two zero is
16:24 not present two is very much present
16:28 maximum score is 40 if someone is 25 in
16:30 some places particularly for research
16:32 they meet criteria for psychopath based
16:34 on this checklist the closest diagnosis
16:36 from DSM is antisocial personality
16:38 disorder that's where you break rules a
16:40 lot but not everyone with anti-al
16:42 personality disorder is a psychopath
16:44 however typically those with psychopathy
16:46 are in fact having criteria for
16:49 antisocial personality disorder at Malik
16:50 Mars wants to know can you develop a
16:52 personality disorder I think I caught
16:54 one from somebody you can catch lots of
16:55 things from people but typically a
16:58 personality disorder isn't one now that
17:00 said there are a couple cases where
17:02 people might show personality traits
17:04 when that is already in their family for
17:06 instance histrionic personality traits
17:08 being very dramatic about things if
17:11 someone in a family acts that way you
17:12 might start to do that too there's
17:14 something called Folly Ado which is
17:16 folly for two and that's when a mental
17:18 health experience is transmitted to
17:19 somebody else and they have the same
17:21 experience that often happens when
17:22 you're living with someone who's
17:23 psychotic and maybe they have a break
17:25 from reality in fact the next Joker
17:28 movie is called fully Adu referring to
17:30 Harley Quinn and the Joker in their
17:32 relationship at real jawbreaker wants to
17:34 know what does the dsm5 say about me
17:35 thinking everyone is constantly talking
17:38 about me behind my back well the
17:40 dsm5 might actually say you are a
17:42 paranoid person there is something
17:44 called paranoid personality disorder
17:47 where the DSM lists out criteria saying
17:48 that you might have delusional beliefs
17:51 the DSM 5 is the diagnostic and
17:53 statistical Manual of mental illness
17:55 it's essentially the guidelines with all
17:56 the criteria that psychiatrists and
17:59 psychologists use to diagnose people
18:00 with a mental illness sometimes it's
18:03 controversial in early DSM volumes being
18:06 gay was a disorder clearly that has
18:07 changed over time a new version of the
18:10 DSM can come out once every 11 or 12
18:12 years or so so I guess I'll have a new
18:14 one to look forward to in another 5
18:17 years or so at X Tadashi wants to know
18:19 what does the ink blot test even prove
18:21 the ink blot test also called the roar
18:22 shock test was developed by Herman
18:24 rorock he was a psychologist and a
18:26 psychoanalyst and what happens when you
18:28 given a roar shock test someone might
18:30 hold up the card and say tell me what
18:33 you see Batman some kind of animal
18:34 something sexual and then there's a
18:36 scoring system you would look at what
18:38 part of the picture did someone focus on
18:40 and the idea is that it reveals
18:41 something about their unconscious
18:43 initially wor shock thought this could
18:45 be a way to diagnose schizophrenia we
18:47 know that that's not the case the
18:50 warshock test is still used in some ways
18:53 in Psychotherapy particularly with kids
18:54 you get a sense into how they're
18:56 thinking what their life is like so
18:58 there's a way to glean something about
19:00 something from this test it's just not
19:01 going to be a way to diagnose
19:04 schizophrenia at Soul money says what do
19:05 you think about integrative Psychiatry
19:07 which merges traditional medicine with
19:08 alternative therapies can these things
19:10 work together I have actually had
19:13 patients given terminal diagnoses of
19:15 illnesses they took on conventional
19:18 treatment and then brought in spiritual
19:21 healers or guided meditation and what
19:23 was a terminal diagnosis has turned into
19:25 this person's tumor shrinking there was
19:28 a study that looked at around 30,000
19:31 outcomes and the outcomes with anxiety
19:33 were that therapy and medication
19:34 together did better to me that's an
19:36 example of how you can combine
19:38 treatments and do a lot of good so those
19:40 are all the questions for today thanks
19:42 for watching mental health support [Music]
