Anxiety and Depression (Episode 014)

SPEAKER_01 0:02

Depression is a loss of interest, motivation, feeling, you're disconnected. It's feeling nothing. Also got the depression that comes with anxiety and the anxiety disorders. But it's not guaranteed. That's not a state that's sealed in stone by any stretch.

SPEAKER_03 0:18

People who become afraid of their own emotions, become very hypersensitive to changes in mood, will often misinterpret things like that as what if I get depressed? There's a huge difference between I've got depression, clinical depression, and a fear of depression. From a behavior point of view, a lot of people who are anxious and depressed do one thing, that's ruminate.

SPEAKER_01 0:40

Immediately they fear the what if they lose control, and also what if it's untreatable? And what if if I get depressed, then I might never recover from it. I'm Drew Linsolata, one of the co-hosts of Disordered. I'm a graduate student in clinical mental health counseling and a therapist in training here in New York.

SPEAKER_03 1:05

And I'm Joshua Fletcher, also known as Anxiety Josh, and I'm a psychotherapist based in Manchester in the UK. Hey Josh, welcome back.

SPEAKER_01 1:14

Hi, Drew. How you doing? I'm good. As if we didn't just spend 45 minutes talking about nonsense before we hit the record button.

SPEAKER_03 1:21

Yeah, you got to get all the nonsense out and then all the good content. Well, go to subjective.

SPEAKER_01 1:26

It's a per it's a nonsense purge so that we can speak intelligently.

SPEAKER_03 1:29

Yeah, exactly. Uh there's a there's there's a craft to um to to our art. Um what's the what's the title of today's episode?

SPEAKER_01 1:37

Today we're gonna talk about depression and anxiety. I think it's one of the most sadly popular topics. I hate to use the word popular, but it is. It's a thing that a lot of people are interested in.

SPEAKER_03 1:46

For the Ed Sheeran of mental health.

SPEAKER_01 1:48

100% of one of the top five, America's top 40 of anxiety is depression. It's a thing people talk about all the time. And rightly so, it needs to be talked about. Oh, what's depression? So as somebody who has lived through multiple like actual diagnosable bouts of major depressive disorder or clinical depression, whatever you want to call it, I can tell you that and what depression is. Depression is a loss of interest, motivation, feeling, context. You're disconnected. It's feeling nothing. And I think I what I always respond to, you know, question like, well, what is but I'm sad. Does that mean I'm depressed? Depression is not sadness. There's certainly uh it's a component of it for sure, but it it's a loss of interest, it's a loss of connection with everything that sort of is meaningful. You you're not interested, you're not engaged anymore, you're feeling hopeless. It's very complex and it's all pretty bleak. Yeah, in my experience.

SPEAKER_03 2:46

I I've had a bit of depression. I've had depression mostly of a natural natural depression. Um one might say healthy depression. So when I've lost loved ones, I felt depressed. You know, that that's that's very not when I've lost a job, I felt depressed, come out of a relationship. Um I wouldn't say I've ever had clinical depression, but I do work with it a lot and and and trained in it a lot. And uh so I can use that experience as and maybe in this episode we can combine personal and professional experiences together. Yeah, depression, yeah, yeah, uh often a feeling of nothingness or heaviness. Um I I often hear a lot of people who have a very nihilistic view. What's what's the point in the world, what's the point to me? Um, and then when you've got depression that kind of uh interweaves with self-esteem or lack of self-esteem, you get you get a lot of kind of well, you you're a burden, I'm a burden, people would you know it would be better without me, I'm dragging people back and stuff like that, which is obviously nonsense because that doesn't happen. Um and then you also got the depression that comes with anxiety and the anxiety disorder. So for me, I had anxiety and I had anxious anxiety so long, I would again argue it developed natural depression because when you become agrophobic, have OCD, panic disorder, stuff like that, yeah. Um that can lead to depression because you know you're not accessing your life like you'd like, you're probably not being very kind to yourself. Um what we advocate here is is is a lot of kindness. Um and yeah, so that that's why um that would occur. I think it's really important to note as well, because it's a question that we both get a lot, is that we will also address depression versus the fear of depression as well, which is something that we will do our best to distinguish.

SPEAKER_01 4:47

I think that the fear of depression is much more prevalent than the actual depression itself.

SPEAKER_02 4:53

Interesting.

SPEAKER_01 4:54

Yeah, that's my experience. That's anecdotal. Like, you know, I don't have any data to back that up. It's just dealing with a lot of people over a long period of time. But I I think part of that is because you mentioned that depression that sort of comes along with the disordered anxiety. And I think um I remember once my GP saying, well, you know, depression and anxiety, two sides of the same coin. And I've heard that again and again and again, where a lot of people hear that narrative like anxiety means you will get depressed, and they get really nervous about that. And yeah, they do coexist quite often, but it's not guaranteed. That's not a that's not a state that's sealed in stone by any stretch.

SPEAKER_03 5:28

So no, yeah no, and and uh when when we say depression, like most depression is a reaction to things. Uh, if you're in a depressive state, um usually you can put a finger on that. But if you are clinically depressed, or if you maybe have a genetic predisposition to depression, or maybe you've got a depression because as a result of traumatic things, uh, maybe a difficult childhood, difficult uh times in your life. Um, whatever it is, you know, you can work with depression as well as what as well as you can when you work with anxiety. But it's important to realize that like there's a huge difference between I've got depression, clinical depression, and a fear of depression. Yeah. Um, because a lot of people are anxious and obsess about their feelings, obsess about their thoughts. A lot of these people will be very hyper-vigilant and they'll often rely on compulsions like body scanning, monitoring of feelings, stuff like that, or monitoring the lack of feelings. And people who become afraid of their own emotions become very hypersensitive to changes in mood, will often misinterpret things like that as what if I get depressed? Yeah, or does that mean depressed, right? Does this mean I'm depressed? But what they're actually fearing is that, like, rather than seeing it as something like anxiety or a feel, any other transient feeling, where their anxious response, the threat response goes to is how can I misinterpret this depressive feeling in the worst possible way? Uh and you get some what ifs with that, don't you, Drew? What's some of the what-ifs that you get with with misinterpreting depression?

SPEAKER_01 7:11

Yeah, the what-ifs, I I think there's the catastrophic in terms of listen, as somebody who's lived through depression, I understand how impactful it is, but the the what if about depression from among anxious people often revolves around a catastrophic interpretation of depression that takes you right down to the end game where you are so depressed and despondent and beyond treatment that you end your life.

unknown 7:33

Yeah.

SPEAKER_01 7:33

And I think so many people go directly to that. You know, they they skip over all the other parts. And sadly, we would have to admit that does happen to people. Certainly, depression increases your risk of doing that, but but it's not an automatic path automatically, and that's it, you're done. As soon as you get depressed, you're done. And so that's the first thing. The what if this happens? What they're really worried about is what happen, what if the worst happens? Yeah, and I wind up as that very small percentage of people that wind up going down that road.

SPEAKER_03 8:00

Yeah, and I mean it's an and it's a very small percentage. It is. Uh, and yet a very common thing because all it is is with most anxiety, uh, whether it's OCD, panic disorder, whatever. Uh with most anxiety, it's a core fear of what if I what if I lose control, or what if this gets to the point where I lose control? And it's dressed up in different ways. So I see, you know, what if I what if I'm anxious and this makes me depressed, and then I get depressed and lose control. I just shorten that. I'll particularly my clients and you'll be like, it's just what if I lose control? Yeah, you know, and that's a very common kind of dare I say, you know, yeah, very typical kind of anxious worry and thought. It just just dressed up differently, and it's not help, you know, it can often become conflated because a lot of people do get depressed, but what I find is that it's actually quite rare for someone to have kind of a clinical depression and an acute anxiety disorder because an anxieties disorder often revolves around a massive care about the self. I care about the self, I care about preserving the self. I'm worried something's wrong's gonna happen to me. Whereas I find a lot with clinical depression as a therapist is that it gets you know it's people a lack of care in the self, a lack of I don't really care. So a lot of kind of symptoms of depression are, you know, people who become unkempt, they don't wash, they don't really look after themselves, they don't eat, they don't stuff like that. Whereas anxious people often go the opposite way, where it's like, oh, I need to make sure I'm doing all these things so I don't get to a place where I feel like I'm not in control. Um, what was it like for you then to balance the boat? Did you live with both at the same time? What was that like?

SPEAKER_01 9:56

I did, and in fact, I I know that sometimes I've heard people say, Well, I follow so-and-so, and they insist that you cannot be anxious and depressed at the same time. And I'm here to tell you that is patently absurd and untrue because you can be. So for me, it was and I don't understand where that comes from. Sometimes it's used as an argument like, well, see, you're not really depressed because you're anxious, so you can't be depressed, or you're depressed, so you can't have anxiety. Who's saying that? Oh, uh, you know, I I guess we could start to name some names, but there are some folks out there, those mental health influencers, where that's one of the basic principles that they go on. My experience is yes, I was anxious and depressed at the same time. There was no doubt about that. And what you said is dead on, because I lost interest in everything, including eating and brushing my teeth and brushing my hair. But when my anxiety would kick up in the very same days, then I suddenly care a lot about myself. So it was this weird back and forth of like nothing matters, and like, oh my God, I don't want to die. Like this, what if I'm having a heart attack?

SPEAKER_03 10:53

Yeah.

SPEAKER_01 10:53

Very strange. It's exhausting. It also sounds like anxiety is kind of helpful at that point. In a way, because it would change my state a little bit, but it wouldn't change my state into anything productive. I would just go from despondent and disinterested and detached to frantic and terrified and then back again. So that was not a fun time at all. No, that's a horrible roller coaster to be on. Yeah, yeah, it was rough. But that can exist. But that was extreme. That was a hundred percent. That was not, I've been depressed multiple times. That didn't happen every time. No, but I think people also think immediately they fear the what if they lose control, and also what if it's untreatable? And what if if I get depressed, then I might never recover from this depression that I don't have yet. But I'm worried that I will get and be treatment resistant and never recover from it.

SPEAKER_03 11:39

But um what's what's really from particularly if you look at things from a CBT model is that uh what's really nice is that anxiety and depression often respond well to the same intervention.

SPEAKER_01 11:53

Yeah.

SPEAKER_03 11:54

Yeah. So from a behavior point of view, a lot of people who are anxious and depressed do one thing, that's ruminate. And if it's not ruminating about anxious what-ifs, it's ruminating about through the lens of depression about who we are, our place in the world, again, that nihilism, what's the point? Who's me, what that stuff like that, and it can fluctuate. But what you're doing as a behavior is ruminating. You're a ruminator, it's like the worst superhero name ever. Stop the rumination building's on fire, quick. Someone call the ruminator. Call the ruminator, yeah. And he'll just turn up and sit there in a chair going, What if the building keeps burning on fire? What if that happens? What if I go in and people judge me in that building? What if and be he's the worst superhero ever? Uh, very intelligent, but you wouldn't not the first superhero you'd call. Um, yeah, they're they're ruminators, and and it's often stuck in freeze, fight flight freeze. So you're just in freeze, ruminating, um, yeah, withdrawing, doing all that, and and doing the opposite of withdrawing, accessing your life, using your focus, challenging beliefs about yourself, core beliefs, conditions of worth, schemas, no matter what, wherever it is, yeah. Um, and understanding that you know, the psychoeducation behind depression and anxiety, but but a lot of it is yeah, you're in a cycle and you can pop out of it. Because a lot of my clients are like, I'm a bit worried, you know, like I've got anxiety and depression. I was like, it's okay. Yeah, feed feed that into the same behavior in your homework.

SPEAKER_01 13:27

Let's do it. Let's kill kill two birds with one stone. And that depression, too, is is all about challenging. So I know that you know, cognitively you can challenge doing some of those old old school CBT things. And like David Burns wrote the feeling book, feeling good, which is sort of the depression treatment. And it's a little bit old, but it still matters. But behaviorally challenging depression was the way out for me for sure. And it turns out that it is for most people because depression will tell you, you know, just like anxiety will tell you to not do something because it's dangerous, you know, depression will often tell you to not do things because what's the point? You know, what's the point? There's no point in this. Like nothing works anyway, nothing's gonna matter anyway. And so a lot of times it was just acting as if doing the small things like that. That led me out of that. It was challenging it 100%. So I often like to tell people, even if you do wind up, or you're dealing with depression, people will ask, like, well, do I just do I have to willfully tolerate it or surrender? No, no, no, no, we don't, it's not, it's very different. It's very different than the Claire Weeks floating through anxiety. You challenge your depression, yeah, behaviorally, cognitively, all of that.

SPEAKER_03 14:41

Yeah, you can't do this, you're not good enough. Yeah, well, we'll we'll see about that, won't won't we, Craig?

SPEAKER_02 14:49

You know, it's Craig the Critic.

SPEAKER_03 14:52

I was already that Craig the Crick is yeah, he is part of the he's part of the Depression fan club. He's he's running for for president um of it. And um with the right lobbying and funding, he's gonna win. Yeah, Craig the Craig is he is, he's he's blast in depression, he will take things for a skewed lens and try to persuade you of it, you know. What's the point? Um, where depression is similar to anxiety is that it wants you to avoid again. But like you said, Drew, it's anxiety will tell you to avoid because of the catastrophe, and depression will tell you to avoid because what's the point? There's no point. Um, I'd like to kind of address a question. We're gonna address this ethically, yeah. But like a question I get asked all the time that I can't answer really is you know, what are your views on medication for anxiety? Yeah, and and for me, I uh it depends on on the person. So, and and depress uh medication works for some and not for others. It's completely up to you. This is a conversation you've got to have with your psychiatrist or your doctor, but that said, as a concept, if you're only struggling with, I don't know, just a fear of fear itself, that's it. There's nothing underlying, there's nothing more complex, like I'm just afraid to go to the park because I don't like feeling anxious, right? Then for me, I'd be a bit like, well, what why would you take antidepressants for a problem that's a phobia or a fear? You know, that that's where I would ask. But that said, if you're with struggling with depression and anxiety, and you're struggling to do the hard stuff, you're struggling to do go onto the willful tolerance, you're struggling to do all that, uh, or you're even struggling to get to therapy to talk about things because you're not, you know, you're not being so kind to yourself, then yeah, actually, you know, if you're gonna take antidepressants to to to do that, to give yourself that boost, maybe your brain needs it. Once again, I reiterate it's a conversation you have with your doctor and your psychiatrist. But I found that people can take antidepressants and feel in a place where actually, oh, well, I've got rid of the what's the point now. Yeah, you know, I can do things. Now let's face the fear. Yeah, but if you're taking seeing medication as the magic pill to destroy and get rid of all anxiety, you'd find that the kind of you know, the the brainwiring just doesn't do that with anything because you never get the credit for things. We're gonna talk about that in another episode because I love talking about getting the credit. But yeah, it's to answer that question is just that what are your expectations from the medication?

SPEAKER_01 17:29

Yeah, and how will they be used? I mean, I can share my experience. I I will give full credit to the meditation, and you if anybody who's seen me and followed me for a while knows I don't talk about medication because I agree a hundred percent with what Josh just said, it's not my place to decide whether you should or shouldn't, or to pass judgment on it, or have an opinion on your medication status at all. It's not my place in any way. But and even in my situation where yes, I will people say, Well, did you ever take meds? Yeah, I did. I got better when I stopped taking them. That was my experience. But even I will tell you that when I was at the lowest point, that medication as an antidepressant use changed everything. I will give it credit, even though I might not be the biggest medication proponent, it did change things. And I will never forget waking up one morning after, I don't know, seven or ten days on it, and I felt different. I'm never, ever, ever gonna forget that feeling. I opened my eyes and like something's different. That literally happened to me. Well, that's broke the cycle of that I did feel that it had lifted, like all of a sudden there was color again and meaning a little bit, just opening my eyes and looking into the freaking corner of my bedroom, like had some I was connected again to my life. And I remember thinking this is the greatest thing ever. And in that moment, it was. It was you know, yeah, there were some issues down the road, but um so cool. You I didn't even know that. Thanks for sharing that in this oh 100.

SPEAKER_03 18:53

And I've color here.

SPEAKER_01 18:55

Yeah, this is a thing that you know it's taken us about 14 episodes for for us. We never mention our other podcasts, really. But if you go listen to my original podcast, The Anxious Truth, go to theanxioustruth.com and search for antidepressant and SSRI. I did three episodes that tell the whole story. Yeah, go check it out if you it was incredibly useful for me for a while.

SPEAKER_03 19:14

Whereas on my side is that I was misprescribed medication. Yep. Uh so I went with panic, you know, one day I woke up feeling hyper one day. I um developed, you know, derealization, sense of doom, dread, what if thoughts, thought I was losing my mind, and suddenly it's this cycle of hyper-vigilance, hyper-self-scanning, worry, rumination, just withdrawal. Uh, so naturally I went to the doctor and you know, gone to the doctor and said, you know, and I wasn't depressed leading up to this, naturally depressed, I think, because of things that are happening in my life, but not you know, not you know, I still felt things had a purpose. Uh and he was like, Well, you know, here's some antidepressants, I won't name which one, but you know, like here's some antidepressants. Um, and but the state of anxiety I had was um I mean, you know what I went home, I looked at the packet, I was scared to take it because I thought my brain was already broken. Did then take one and then spent three hours monitoring whether it's working yet. Has it made my brain worse? Is it made better? Is it making the panic more intense? And actually, I you know, I managed to take five or six. Um, and it it just further kind of strengthened my compulsions because my compulsion was to check in and see how I feel, and even the compulsion of do I feel better yet, do I feel worse yet? wasn't helping. And then so I went back to the doctor, and the doctor's like, Oh, yeah, you need to up your dose. And I'm like, but looking back, I feel quite sad for younger me because that wasn't helping. Yeah, you know, it's a sad story. Yeah, and if I'd have said, like, I wasn't depressed, I did become depressed, and then I developed a fear that I was gonna become more depressed and lose control and never get my brain back. But in general, like if someone would have just said, Oh, you know, you're just in a panic cycle here and it's okay, and this is compulsions, you're obsessing about how you feel, you're okay. Derealization, depersonalization is normal, feelings of doom is normal, can't catch your breath, normal, tingly hands, normal, feeling nauseous, normal, not sleeping well, normal. This is okay, you know, this isn't as bad as what your brain is suggesting it is. That would have saved me a lot of time. Yeah, but no, I I went to go through the rigmarole of taking the medication and stuff, uh, even the stuff that did help. So I was take given beta blockers, um, and yeah, that helped a bit, but not in the long run. Because one day when I went on holiday, forgot my beta blockers, I started panicking again.

SPEAKER_04 21:50

Yeah.

SPEAKER_03 21:50

Because I'm like, well, I've only survived because of my beta blockers. So I didn't actually address the problem. Um, and if this this is the first episode you've tuned into, you know. Start from the beginning, you know. We talk about like um why in the short term that isn't great. Uh for disordered anxiety, anyway. I know some musicians that take Peter Block is just for so their hands don't shake when they're playing the violin. Sure. Yeah, yeah, which is pretty important, really, isn't it? You know, like you know, I think, yeah. Yeah, yeah. Um, but in general, yeah, I mean that was that's kind of my experience. Stuff I hear a lot. So I'm sure you hear stories from across the spectrum about depression and anxiety, and all these stories becoming conflated.

SPEAKER_01 22:33

Yeah. I think even the medication stuff, not and we'll get off the topic because I I agree, I it is uncomfortable to talk about, and it's a little with borders on unethical, but even the stories, even a guy who says I got better when I stopped taking it, will tell you that like the horror stories about the medication are also often conflated because there's reporting bias. Nobody talks about their antidepressant because they loved it, they only talk about it when it caused a problem. So, you know, and an anxious mind will you know, will hang on to that and like, well, you know, I my doctor really thinks, or my psychiatrist really thinks that my depression would benefit from use of a medication, but I heard that then I'll be on it forever and I'll have withdrawal and it'll take me years to get off. Well, maybe, but your brain will say automatically, as soon as I take this, I'm failing, I failed, I'm broken, I need meds, I'm I'm ill, and I might never get off these. It's gonna be none, which isn't isn't automatically true. Yeah, it would be disingenuous for me to say, yeah, that's it. No, it's not true. That might not be true.

SPEAKER_03 23:28

So yeah, I hear from some of my uh OCD and panic clients, like they're they have that fear like, what if I rely on this, have to have this medication? What if this benzodiazepine becomes addictive and and and things like that? Uh, but again, we reiterate uh talk talk with your psychiatrist, talk with your doctor. The psychiatrist is the expert, they that's where they study is. We're we can only speak from the perspective of working with people in the niche of anxiety disorders um and depression and our own experience, but we don't know the ins and outs of that stuff. So if you've got questions about kind of medication half-life, withdrawal, stuff like that, chat to your chat to your psychiatrist, whether it, you know, and um also on the flip side, if you're not happy with it, say I'm not really happy with it. Chat to the psychiatrist. Yeah, you're you're you get to choose.

SPEAKER_01 24:16

Yeah, like yeah, yeah. The last thing I'll say about meds is just ask the doctors. And if you don't like the one doctor, ask another one. Don't ask the internet. That's a terrible place to get your information.

SPEAKER_02 24:28

Yeah, it it really is, isn't it?

SPEAKER_01 24:30

That's my belief, anyway. So take it for what it's worth. So, but depression-wise, you know, even if you do wind up depressed, uh, you know, again, I think it's important for me to, in my own experience and and and the experience that I've seen other people go through and the training that I'm getting now that I'm fortunate to be getting, and I know you've been through it, you're doing it professionally and qualified to do it. There is a way out of it. It is not a life sentence. So there are really well-known, well-validated, very effective ways to treat depression. So it's not the nightmare that you think it is. And so many people in their life will have at least one depressive episode naturally for whatever reason, and they come out the other side. It is not a death sentence, even if you do wind up depressed. It's okay.

SPEAKER_03 25:11

Yeah, it's absolutely fine. I find a lot with depression as well when in the practice when you work with self-esteem-based depression. So, you know, I think we spoke years ago, didn't we? About I love the the humanistic model of introjections, or in uh, I think Aram Beck called them schemas in CBT. And it's these just basically these beliefs about ourselves and the world around us. Uh, and an introjection is is a belief that we kind of infer, the kind of that the we that we learn from a lived experience. So, for example, you know, if I'm a if I'm a kid and I come home from school and you know I've done a finger painting, and my parents are like, hey, that's a really good finger painting, you know. Tell us about your day. I might introject a lesson that you know I'm an interesting person who's got talent and skill. On the flip side, an introjection might be, um, I you know, come home from school and my mom and dad ignore me. And when I tell them about my finger painting, they'll they say, Well, what did you get in mathematics today? And I got a C. Why didn't you get an A? I start to introject the lesson that I only have value when I'm perfect. And I'm not interesting if I'm not achieving. Um, and that's stuff I hear quite a lot, you know. Um, in complex relationships and things like that, in abusive relationships, you might interject that you know I only have value when the people around me ha are happy. Well, that's not true, you know, and all these can contribute, these negative interjections can contribute to a very kind of conditional view of the self. And every depressed person I speak to, most of them anyway, some people just have unfortunate clinical depression, usually genetic and stuff. But most depression I work with, it's usually about how how do you see yourself and why and where you learn that from. You know, and I've I've had some beautiful sessions in here where people are like, you know, I know I've got anxiety, you know, City and all that stuff, but can we just talk about you know why how I speak to myself, why I speak to myself, where does that come from? And that's I'm like, yeah, we'll park all that anxiety stuff in our let's have a look, you know what what happened, you know? And yeah, people are like actually my household was um you know quite full of conflict, it was really aggressive, it was unpredictable, I was on eggshells all the time. And as I say it out loud, now I know why I'm in my 40s and I'm still on eggshells because I've still reenact the same behaviors, you know. I placate, I people please. I feel I only have value when the out the end product of something is perfect, because that's all I was praised for. You know, and you start to unpick the layers of your own identity which can contribute to depression, and particularly people are at risk of depression when they've been abused, when they've been neglected, when a parent goes missing, when you've got an annoying sibling who gets all the praise because they're good at something that the parents approve of, and no one likes your photography. You know, yeah, yeah, he's part of he's in the football team, you know, and you're your your photography sucks. You know, go on, Brandon. I don't know where I'm going with this.

SPEAKER_01 28:36

Um sorry for any Brandon's listening.

SPEAKER_03 28:39

Yeah, it is your fault, Brandon. If you're listening, um, but yeah, that kind of thing, and and suddenly, but I you know, it's your job to be like just because that's what you saw at one point in your life, and people around you behave like that, doesn't mean that is actually definitive of who you are. And a lot of overcoming depression is realizing, you know, you're not a piece of crap.

SPEAKER_01 29:02

You grow and that's that's what we talked about too, because those things end up in the the end game of that is it's what's the point? I'm a piece of crap, I'm worthless, I'm incapable, I'm weak, I'm stupid, I'm not, I'm not lovable, I'm not absolutely not. And so you begin to challenge that through your some cognitive restructuring work and some behavioral work, and just like we talk about with disordered anxiety, you begin to, well, I'm gonna have to take the chance to do this, even if I think I'm a piece of crap, and I'll have to find out if I really am. Oh, look, I'm maybe I'm not. Yeah, so and you're faking it in the beginning, in many ways, you're faking it, but that's okay because that's how you start.

SPEAKER_03 29:39

Yeah, I saw a post the other day on by a popular social media person who who I follow actually. So they're not a horrible clue. Yeah, but they said like that was it. Yeah, it was from a very uh anti-censor and censorship influencer who writes a lot of cool stuff. Um, and it was I've probably read it in the wrong context, but um they put, you know, why faking it till you make it doesn't work. I'm like, well, depends, really, you know.

SPEAKER_02 30:06

Yeah, it depends on the context.

SPEAKER_03 30:07

You get if you've got agrophobia, social anxiety, all that stuff, you're like, it does, it actually works. It actually works, it works. Teaching the brain, look, this is safe, and okay, I'm not enjoying it now, but you know, yeah, anyway. I thought I'd uh that popped it, popped in my brain.

SPEAKER_01 30:21

But there's a lot of that, and you know, again, personal experience, not all my personal experience is that indicated indicative of everybody's, but like, yeah, I was totally faking it. I was going through the motions of things that I had no interest in. I didn't want to do these things, didn't had no interest. What's the point? But it mattered because those those experiences did add up, and ultimately it started like the color started to come back in again. And and I've been through that multiple times with with medication and without. And that is always the way out for me. Challenge, challenge, challenge. So yeah.

SPEAKER_03 30:53

I remember with when I was depressed and anxious as a result of the anxiety disorder, uh, and having the oh, what if this depression gets worse, whatever? And and that with my behavior, my focus, my endeavor, my where I'm channeling all my effort, I started to notice a bit, a bit similar to you, but like going to like events, you know, just going to a cafe with a friend or doing that or going around a party, I noticed larger and larger windows where I'm just not where I'm just eng engrossed and engaged with what I'm doing, and that was lovely. Yeah, and even if it was like 60 seconds, I was like after 60 seconds there, I was just I just forgot I felt normal, you know. Um for me, what normal means. I'm autistic, or I'll always feel neurodivergent, but that's fine. I I love feeling a bit um other. Um, but like uh it's in general just what was normal for me, like kind of, oh yeah, that's I I just completely forgot about this thing I've been absolutely obsessed with for years. Um, and if I can do it for 60 seconds, let's see how and I did that kind of by just putting myself in that situation. Even though my brain was telling me to avoid the depression, I was like, what's the point? You know, like, yeah, and I think I was really yeah, I'm glad you brought that up. Fake it till you make it is not is not that bad. Or the Susan Jeffrey things, you know, the feel feel the fear and do it anyways. There's methods that matter. This is why we love the did it anyways. We've kind of just Yeah, there is, yeah, yeah.

SPEAKER_01 32:26

There's validity there to a certain extent. I mean, I would almost there is validity there for sure. And I think I would almost go so far to say that in periods where wonderful would not enter into my vocabulary at all, those were actually wonderful moments for me in the middle of murk and darkness and shit. Because when I discovered that, like, oh, I actually not you're gonna have to beep that out, Drew, because we the we're we're a clean podcast. We are we are a family-friendly podcast. I will beep that out.

SPEAKER_03 32:58

Yeah. But uh you'll also have to beep out Yeah, I know now that I will sue us, you know, and I don't want to have to go to his lawn and start uh digging it all up and let letting my dog do things to it anyway. But no one knows who I'm talking about because it's gonna be beeped out.

SPEAKER_01 33:17

Oh, it's gonna be really good too. Yeah, I'm gonna do a good job with that, but uh no one will know. But you're in the UK, so he'll reach you. He won't get he won't get makes him here, but uh you coward.

SPEAKER_03 33:29

Now I've got to deal with him.

SPEAKER_01 33:30

Yeah, just here I am throwing my partner under the bus. But anyway, those were wonderful moments in the midst of darkness because they were glimpses of like, oh, look, I can actually not be so concerned with how I feel for two minutes or three minutes.

SPEAKER_03 33:48

Yes, I 100% resonate with that.

SPEAKER_01 33:51

I could feel the relief now that I felt back then, just in in telling that. It was like a weight would lift for a few minutes at a time, and then more and more and more. There's a way out, yeah.

SPEAKER_03 34:02

Yeah, in a good way, in a positive way. Yes, the best way out. Yeah, there is a positive way out, like it's still here, life's still here, it's waiting for you. Yep, you know. Um, your brain and body have just been reacting to stuff out of sync, out of order. Yeah, um, but we'll bring it back to balance. We'll do more on depression and stuff and get, I think in the future we should get some kind of depression experts in, particularly around self-esteem, depress uh or and even psychiatrists and stuff as well, maybe actually have a chat through through stuff. I think that'd be really helpful for people.

SPEAKER_01 34:38

I am aware of one psychiatrist here in the States. I'm aware of this person. We know each other, who I think is doing tremendous work because I know a few people who see this person, and this guy is very well informed and looks at the use of the medication as a as a tool and a temporary thing and is a big advocate of therapy and like so refreshing. So we'd love to get that person on. I'll see what I can do. Yeah, sounds good.

SPEAKER_03 34:59

Um, I like usual, Drew. We um we usually take a question or and celebrate some dinner anyways. Do we have any questions drop in today?

SPEAKER_01 35:09

We do have a question. This one is a voicemail, so I'm gonna play not the whole thing because it's a bit long, but I'm going to play the voicemail and we will talk about it. This has to do with like when your anxiety is sort of glued to chronic health conditions. Ready? So let's do it.

SPEAKER_00 35:24

I realize only a small percentage of your audience probably has hyperthyroidism, but unfortunately I'm one of them. And I struggle with my physical symptoms, and that leads to my anxious thoughts.

SPEAKER_01 35:39

Yeah, there's more. And thank you so much for the question. We're not going to say the name, but thank you for the question because I know you know many people deal with this. Not just hyperthyroidism, but chronic medical conditions in general.

SPEAKER_03 35:49

Yeah, I think we should uh answer that um as in with the chronic medical condition. Jim, I think the answer is very um it's very similar. Uh, first of all, you're already, you know, you've already got a big job on your hands because you we talk about this kind of hyper uh vigilance of the self, the the kind of constant body scanning, checking, stuff like that, which can be compulsive. The difference for people with chronic conditions like yourself, and again, thanks for sharing that. And I know in the longer voice note you said, you know, part of a very small minority. I actually don't think you are, and I think this applies to to many people is that it you got the tricky task of trying to distinguish what is kind of rational, um, sensible checking in for your symptoms, um, and what is a post-compulsive kind of obsession over what is an anxious symptom. And that is tricky, and I don't envy that task, but I do know from working with lots of chronic people is that you can get good at distinguishing it. Yeah. Uh so you can look at a symptom and go, what is that? What if that is something to do? What if that is something to do with my chronic condition, my hypothyroidism? Well, that is a question that you have to ask. Um, but if it's the eighth time you've you've asked it that day and you've noticed a pattern in a behavior, what you need to do to be able to do is to distinguish okay, maybe this is just an anxious um symptom now, and maybe it's okay to leave this alone. But it's something that is tricky, you're not gonna get it a spot on. Uh my partner has two chronic conditions, and she has to do the same thing. Like, is this a symptom of this or that or whatever? It's okay. But remember when the threat response is on, it wants your attention, and so it will try and persuade you that each little nick ache, you know, any any th anything that differs from what is a neutral normal state, and I use normal loosely, but normal for you, um, is the first sign of disaster. And often what I'm hearing from um from there is that I'm struggling not to compulsively check, scan, and all my attention is internal. So, yeah, just set yourself a compassionate challenge, right? Okay, I need to be start to distinguish between and get good at identifying what is this hypothyroidism and what is anxiety.

SPEAKER_01 38:28

Yeah, I think it's the what where am I when am I feeling an impairment, which is a real thing, legitimate thing, clearly for these people. And when am I worried about feeling this impairment, which is a hard thing to tease apart for sure, because you're gonna worry about it. It it is impacting your life, that's normal. But when am I becoming, I like how you use the word compulsive, when I when am I going too far down the road of this because now it's no longer productive. So I think for me, one of the ways to start to learn that balance is understanding, like, yes, nothing is for sure, and you might make a mistake here and there, and you do the best you can to be prepared, but also understanding when it feels like it's always urgent and always important and always dangerous, that is a good clue that says, Oh, this isn't necessarily my hyperthyroidism or my whatever your chronic condition is. This is my worry about it. Now calling all the shots on me all the time.

SPEAKER_03 39:22

That's a great distinction. Uh, also, what's highly recommended, obviously keep in uh conversation with your doctor and psychiatrist, but also recommend some intensive CBT work, cognitive behavioral therapy, because where you can literally formulate your life, your what ifs, your symptoms, and together with a therapist, you can start to distinguish and notice and work on your specific case. Uh, it's something I've done, it's really because you know, anxiety has an abundance of symptoms, as you know, if you've listened to that episode we've done, but also they can overlap and have similar symptoms to kind of hypothyroidism. So, what would be nice is to sit with a therapist and just kind of map out which are the ones that are are most common. Is there a pattern here? And you start to kind of see it more from a metacognitive view, and and that that can help you. And that's certainly what I do here, yeah. But um, great question. And yeah, uh, I know you sounded uh almost apologetic leaving that voice now, but don't never. There's no such thing as a bad question.

SPEAKER_01 40:26

No, especially like maybe it's not necessarily hyperfibro, but in general, this is a thing that on many people in this community hyperthyroidism and other medical conditions. So it was a great question, I think. I would add to that for just one second would be there's a lot of really good work being done in mindfulness-based, you know, treatments or chronic pain and chronic conditions that help you get recognize when you're in that rumination loop of like I'm trying to play out the entire course of my condition in my head over the next 10 years right now. Oh, wait, I don't have to do that. I can come back to the here and now and be a little bit more productive in in my life.

SPEAKER_03 41:00

So yeah, mindfulness. I've heard some mindfulness, mindfulness based CBT stuff, some good stuff. Yeah. Um, just aware of the time, we always end with some celebrations. Um, do you have any celebratory news?

SPEAKER_01 41:13

Or do we have any in the disordered.fm inbox? We do, as a matter of fact. I'm looking at one right now. Um, this is a good did it anyway for sure. Hashtag did it anyway. Uh so this person says, in 2021, I developed panic disorder and agoraphobia and struggled being outside of my apartment. I white knuckled every day at the office for almost a year and would time uh at the time would describe every day as being an 18-hour panic attack, really textbook stuff. That being said, I just got back from a two-week solo trip to Japan. Whoa. Yeah, through a lot of work and facing my fears and doing exposures, I was able to do something that two years ago would have seemed unimaginable. Did I go and do it perfect and feel no anxiety whatsoever? Of course not. In fact, I but in fact, it didn't feel as scary as going to the grocery store two years ago. Why is it always the grocery store?

SPEAKER_02 42:03

Always the grocery store.

SPEAKER_01 42:05

This is tremendous. So from like agoraphobic, terrified to leave the house to going alone to Japan in in a two-year time.

SPEAKER_03 42:12

That's incredible. I hope you had a great time as well. I'm really jealous. Yeah. I hope you had a great time, but not the best time.

SPEAKER_01 42:19

Yeah, because I had I didn't have that good time.

SPEAKER_03 42:21

Because I want that good time for me.

SPEAKER_01 42:23

I had the privilege of actually speaking to this person, and the story was really good. He did have a great time and learned so much from it.

SPEAKER_03 42:28

So I'm I'm really happy, honestly. That that's great. Um, I mean we we were chatting beforehand that there's no there's no better the win, there's no big wins, and they're all big wins. Uh that's why I've got a good and ear. I love I love this because I can resonate with it. I'm sure you can. Um, hey, Drew and Josh. This was a submission on the uh disordered.fm webpage. Um, I just wanted to share uh a small dinner anyway. It's not small, it's massive. Um today I ate something I've been avoiding to eat for five years because I was afraid um it would make me throw up or I'd have some kind of reaction to it because once I ate it and then I got a panic attack. Um I I think I'm it's of someone who struggles with emetophobia, maybe a bit of OCD, but it was basically I was afraid to eat something for their own reasons and I managed to eat it, uh, which I think is wonderful. Um, I think it's absolutely brilliant, brilliant. Um, and it was food, by the way, that they shared. It's not just no, I'm not eating gravel. I was afraid to eat gravel for five years. Uh no, they're um, yeah, they they're just eat to still eat something. And I can I can res I remember doing that. I remember going, I was afraid to eat chocolate because I was afraid the caffeine and the tyramine would send me into oblivion. Yeah, uh, and so I can relate to that. So well done. Well done to you both. Both massive, massive, massive wins.

SPEAKER_01 43:58

Both equal, even though that they look different, both equally is important. So yeah, well done. Well, I think we're good, man. 43 minutes, a little bit of a marathon, but hopefully you guys hung in there with us. Yeah, I can't wait to catch up with you guys next time.

SPEAKER_03 44:11

Yep. Um, but for now, if you oh, if you ever want to if you want to get in contact, go to disordered.fm. If you want to find us on social media, uh The Anxious Truth and Anxiety Josh. Um, we'll catch you soon. Stay safe.

SPEAKER_01 44:25

Yeah, sounds good. See you next week. Hey, it's Drew. Thanks for joining us for this episode of Disordered. Josh and I both hope that you're finding it helpful in some way. For more information about Josh or me or the Disordered Podcast, find us on the web at disordered.fm. That's disordered.fm. Hop on over and find links to our social media platforms, join our mailing list so we can let you know when new podcast episodes are available, and we'll send you easy ways to ask us questions and share your wins so we can answer questions on the air and share your successes with the community. And if you're listening to the podcast on Apple Podcasts or Spotify or any platform that lets you rate a review, do us a favor and leave us a five-star rating and maybe write a review if you're digging disordered. It really helps us out and we appreciate that. Thanks again for coming by, and we'll see you in the next episode.