Rethinking Depression

This is Hidden Brain, I'm Shankar Vedanta.

For centuries, physicians regarded fever as a dangerous disease and enemy to be crushed.

In ancient and medieval medicine, fever was thought to represent an excess of heat or

humor in the blood, a sign that the body's internal balance had gone dangerously as

Q. Treatments aimed to drive out the heat, patients

were bled, purged or doused with cold water, somewhat packed in ice, or fed diets designed

to cool the blood.

Well into the 19th century, fever was still widely feared as a destructive force that could

consume a person from within.

Doctors prescribed mercury-based compounds, quinine, or alcohol in large quantities.

Patients were subjected to fever cures, in which they were submerged in prolonged

cold baths, or were wrapped in vinegar soaked sheets, all in the hope of forcing the body's

temperature back down.

It wasn't until the late 19th and early 20th centuries that scientists began to recognize

fever not as a disease, but as a natural response of the body's immune system.

That showed that infections, not fever, were the real enemy.

Studies showed that moderate fever actually helped the body fight infection by slowing

the growth of bacteria and enhancing immune function.

This shift marked a profound change in medical thinking.

Instead of reflexively suppressing fever, physicians began to see it as evidence of the

body's vitality and capacity for self-defense.

Today, while very high fevers are still considered dangerous and treated, mild to moderate fevers

are often allowed to run their course, a quiet acknowledgement that what was once seen

as a deadly illness is, in fact, a sign of the body's strength.

Today on the show, we investigate the possibility that what is true of our physical health may

also be true of our mental health, that even a scourge like depression may have its roots

in our powerful drive to survive and flourish.

The origins of depression this week on Hidden Brain.

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A note that the story includes a discussion of suicide.

If you or someone you love is struggling with thoughts of suicide, there are people who

can help.

Call or text the suicide and crisis lifeline at 988.

If you are outside the US, we have included a link in our episode notes where you can

find mental health support in your country.

We live in a culture that prizes strength and confidence and that celebrates happiness

and high mood.

So when those things slip away, when our energy disappears, when joy goes missing, we naturally

assume that something must have gone very wrong.

We look for a problem to fix, a disease to cure.

At Cornell University, psychologists Jonathan Rottenberg has long asked if this is the

right way to think about depression.

John Rottenberg, welcome to Hiddenbrain.

Thank you.

It's wonderful to be here with you.

30 years ago, John, you were a confident, self-assured college graduate preparing to get

married and to start a career.

What was your life like at the time and what were your plans for the future?

I was studying, I was in a PhD program in history living in Baltimore at Johns Hopkins University.

I studied American history and I thought I was the smartest guy in the room and I was

then struck by a series of very bizarre experiences that I had no framework for understanding.

Tell me what happened.

In many ways, you had all of your life before you.

You had graduated from an Ivy League school.

You were about to get married.

You were doing this PhD and you thought you were the smartest person in the room.

It felt like everything was going your way.

Yes.

So when I started to feel unwell, I didn't have really much of a framework to go on.

I first noticed physical symptoms that didn't make a whole lot of sense.

I had pain on the left side of my body.

I thought there might be something wrong with my heart.

I felt physically weak.

I thought I might have a fever or some kind of flu-like illness.

I felt incredibly run down and I thought that it would just go away on its own and then

other problems started so rather than it getting better, it got worse.

What started to change was that my ability to focus, read, think, that degenerated pretty

rapidly.

This tool that I used to understand in the world, this tool that really defined who I was.

My brain, my mind, was not working right.

Here I am in a history program and I'm working on a dissertation and I can't read a book.

And I can look at a page and I see the words and my ability to concentrate is getting

to be close to zero.

So I started to get scared.

What could explain this?

So I was even more baffled and I felt like something terrible was happening to me, but

I didn't know what it was.

At what point did this clarify itself?

At what point did doctors come up with a diagnosis, John?

It took months.

I remember going home.

I was living in Baltimore driving home and that was very difficult to Connecticut and meeting

with a psychiatrist who is a colleague of my father's and I believe that colleague was

the first person to suggest that this might be depression and that rocked my world.

The sensations I was experiencing were not what I understood to be the symptoms of depression

which were feeling sad or just losing interest in things.

I was really more experiencing this terrible fatigue, this inability to concentrate.

And so I did get a referral to see a psychiatrist in Baltimore and I was started on medication.

And unfortunately it didn't it didn't help me and I continued to struggle and become

more and more distraught over the situation and less and less functional.

So I was spending large parts of the day lying on the ground.

If someone who was so proud of his own mind and how his mind worked, I'm wondering if there

was an element of shame that you felt as you were experiencing this.

Yes, I felt humiliated and I felt completely like I didn't know who I was if I couldn't

think that I had no reason for being.

I had no purpose in life and it was it was very it was very scary and the fact that the

treatment did not initially help me made it worse and you know I had support of my then

girlfriend and she stayed with me but I became more and more difficult to be around.

I became more emotionally volatile.

I spent hours and hours crying.

I started to experience suicidal fantasies of not wanting to be alive or even believing

that I simply wouldn't have a future.

It became more and more difficult for me to imagine that I would have a future.

I didn't see myself as ever being able to emerge from this because the depression felt

like it was bigger than me.

It was stronger than me.

It was more powerful than me and that was a horrible feeling of powerlessness.

I'm wondering how you viewed your future at this time John, did the path that seemed

so bright some months earlier, did it seem that it had closed off for you?

Completely.

By this point I had gone on leave from my history program.

I told my advisor that I was probably not coming back to the program which was very very

difficult and the path forward was very unclear.

I knew that I was somehow continuing with my relationship with Laura which was incredible

that she was staying with me but I wasn't sure that I was going to make it to the other

side.

I had a lot of doubt that I was going to make it to the other side and I was at my limit.

Every day I felt I was at my absolute limit of what I could possibly bear.

I thought that no person can bear this.

I felt completely obliterated.

How long did your depression last John and how did it finally come to an end?

It lasted, I guess you could say four years and it involved my really dedicating myself

and sinking myself into the study of psychology and into the study of mood disorders.

I applied to graduate school and I thought maybe I can rehabilitate myself.

Maybe I can rehabilitate my mind and miraculously I was admitted to a PhD program actually really

a tremendous PhD program at Stanford University and that was where my wife's family was from

and so she was overjoyed.

By that point we were married and expecting a child so there were things I could imagine

that there were things to live for even if I felt like I was faking it every day.

I was still struggling to concentrate.

I did not feel confident in my ability to do this PhD program but I was going to try and

the idea that I would have the opportunity to understand depression, it felt like in

my heart my only chance.

I think it was enough to gradually move me in the direction that I needed to be and I sort

of returned to the land of the living but it was a gradual process.

When John Rottenberg first fell into a severe depression he saw it through a particular lens.

Like many of us he had absorbed the notion that depression was a flaw in character or in

brain chemistry.

It took years for him to see his experience in a different light.

That's when we come back.

You're listening to Hidden Brain, I'm Shankar Vedanta.

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This is Hidden Brain, I'm Shankar Vedanta.

For several decades now, we've been told that depression is a malfunction, a glitch

in our brain chemistry, a flaw in our cognitive wiring.

But at Cornell University, psychologist John Rottenberg says this account may be wrong

or at least incomplete.

John, how would you describe the prevailing model that we have of depression?

The prevailing model that we have of depression is that depression reflects some fundamental

defect that is inside the depressed person.

That defect might be in the person's mind, like the way that the person thinks, or that

defect might be in the person's brain, like in the chemicals that are circulating between

the neurons.

Or that defect might be in how the person is interacting with other people.

But in the final analysis, the reason that people are depressed is that they have some

fundamental defect or defects inside themselves that explain why they are subject to episode

or repeated episodes of depression.

You say that the defect model often blames depression on faulty brain chemistry and claims

that antidepressants are the solution, but that the evidence doesn't fully support this

idea.

How so, John?

People have been studying the biological contributions to depression for 50, 60, 70 years.

And I do believe that part of depression involves biological factors, but that's very

different from saying that there is a biological cause, a single cause in the brain.

And the search for antidepressants has led to a large number of therapies.

There's over 20 different antidepressants, but none of them could be called a cure.

And I do think it's a bit misleading this metaphor that's often used to talk about a chemical

imbalance because that imbalance has never been isolated.

It's never been fully characterized.

It can't be measured.

And so what you have are treatments which are useful for many people, but it relies on

a metaphor.

I mean, the patient comes in and wants help.

The physician or psychiatrist might tell them that they have a chemical imbalance.

But the problem is, you can't present to them their number.

And you can't show that the treatment is changing that number.

So you're really engaging in hand waving.

And I don't think that's doing a full service to our level of knowledge and being fully

candid with people who are really struggling.

So this would be in contrast to something like, you know, if a physician worries that

you have high cholesterol, you can take a blood test and actually show what your cholesterol

levels are.

And with the right medications, you can then show that your cholesterol levels are changing.

You're saying that no similar system exists when it comes to something like depression.

Correct.

So one of the main neurotransmitters that's implicated in this disease model or defect model is serotonin.

There's no way to assay serotonin and give a, you're reading where you are with respect

to serotonin right now in your brain, like you can with cholesterol or you can with insulin.

So depression involves biology, but it's not a disease in the same way that diabetes

is a disease or Huntington's disease is a disease.

I mean, in that case, we know what genes are responsible and we understand what those

genes are doing and how it relates to the symptoms of this neurological disorder.

Depression, the understanding is much more diffuse.

Like maybe it has something to do with serotonin.

Maybe it has something to do with dopamine.

That's a very different level of understanding.

Another way to think about the defect model blames depression on faulty cognition and claims

that the solution is the right kind of psychotherapy, but you say that the evidence doesn't fully

support this explanation either?

Well, I think that all of these are valid therapies.

So if you're struggling with depression, medications are an option and cognitive behavioral therapy

is an option and that's a good thing to have multiple options.

But again, that's very different from saying that the reason that people become depressed

in the first place is because there is something fundamentally deficient in their cognition

in the way that they're thinking.

It could be instead that these changes in cognition are part of what's maintaining the

depression, which is why the therapy can be useful.

So I do believe that cognitive behavioral therapies can be really helpful not only in helping

people resolve a depression episode, but the skills that are learned in cognitive behavioral

therapy can be useful in keeping people well.

So I do believe that cognition is a contributing factor to depression, but that again is different

than saying that people who were depressed all are somehow defective or deficient in how

they think about the world.

John's point is not that medications and psychotherapy are ineffective and should be discarded.

He thinks they have helped millions and could help millions more.

His point is only that depression is not necessarily evidence that there is something wrong with

the brain.

In fact, he believes the capacity for depression is wired into the brain.

There's no question that nature built us with the capacity for low mood and once you

have that capacity for low mood, you have the capacity for more serious, more severe,

more long lasting low mood.

And so that is a very important adaptation.

Mood is what is integrating all of the inputs both inside of your body and outside in your

environment.

And mood is the thing that's asking the question, what should I do next?

Is this environment that I'm in good for action or is it bad for action?

And so low moods are unpleasant, just as pain is unpleasant, anxiety is unpleasant.

But I think it's easier for people to see that pain is it evolved mechanism that allows

us to protect our body from physical damage.

And anxiety is a mechanism that allows us to avoid threats.

But what is the purpose of mood?

It's harder for people to see that mood itself could have a purpose, but it actually is

sharing a great amount of similarity with anxiety, with pain and with other mechanisms

like fever that are protecting us.

From an evolutionary perspective, John, what do you think mood is actually doing for us?

It's telling us should we proceed or should we stop?

So if you think at the most basic level of a little foraging animal where it's reached

a patch of grass where there are no leaves of grass to eat.

And everywhere it looks, there's no leaves of grass to eat.

Should the organism keep moving or should the organism stop?

At large, imagine there's a famine and there's no food available.

Mood is a stop mechanism and when we come to humans, the situations that can prompt

low mood become much more complicated than threats to your physical well-being.

They involve also your future prospects for survival and reproduction.

We experience low mood when there is a dilemma and it is uncertain whether or not you should

proceed or whether you should stop.

And low mood forces you to think about the situation maybe longer than you would like.

But without it, we would subject ourselves to harm and we would be moving forward rationally.

Think about what happens after someone dies.

There's a funeral.

Everyone comes together.

They do not feel good, but they mark this as an important moment where I have to figure

out who am I and how will I continue without this person in my life.

And I think everyone would see that grief is a natural process.

An evital process, it's a cross-cultural process.

It's even observed in other species and it, again, like depression, is very unpleasant.

It's a very difficult state.

Nature is not optimized for our happiness.

Nature really cares more that we survive and reproduce than that we experience joy.

My depression actually fits some of these parameters in that I had invested so much in this

life plan to become a historian.

And that I think I sense that I was going to have difficulty getting a job as a historian.

And my body was kind of saying, you're not going to pursue this.

And so I was forced to stop and reconsider kind of against my will and come up with a new

life plan, which was not an easy process at all.

But did ultimately put me on a path towards a more viable future for myself.

We talked with Lisa Feldman Barrett at Northeastern University some time ago on Hidden Brain.

And one of her interesting and provocative ideas when it comes to the world of emotions

is she argues that emotions are predictions about the world rather than reactions to the

world.

They're basically guides that tell us, go forward, seek this out.

This is going to be fun, be excited, have high energy.

More on the other hand, withdraw, be careful, be afraid, something is dangerous here.

So when we think about emotions as predictors as opposed to reactions that fits very well

with the offices that moods in some ways are a guide telling us what to do next.

I completely agree with that.

What's already happened is spilled milk from the perspective of evolution.

It doesn't matter to give an example.

I remember 9-11 in watching the planes hit the towers and I felt immediate terror and

I felt immediate sadness and I felt immediate rage.

But it was about the future.

It really was.

Those feelings were about the future because there were the questions about who had done

this and what would happen next and were we safe where we were right now and whoever

did this had to pay.

I think that people thought that they were reacting against what had happened but it was

really the implications for the future that made those feelings so strong.

So I agree that our feelings are there to help us do what we need to do in the moment

and that's a future oriented system.

To bear down on this just a moment longer, you told me how debilitating your depression

was, how you felt like there was no end in sight.

You even had thoughts of ending your own life.

How could a condition that is so disabling, a condition that prompted you to consider

suicide, how can this be understood as a beneficial adaptation?

Well I think that there's many things about depression in our contemporary life that are

not serving us well.

My point only is that the original adaptation is useful.

Not that every instance of depressed mood is useful and in fact there can be mismatches

between the environment in which the adaptation emerged in our current environment.

Another thing that I really want to bring up that is unique to humans, in human depression

is the power of language and what that does to depressive episodes because I think in

an evolutionary perspective it's important to keep in mind that this adaptation is seen

across species and so we can talk about mouse depression or dog depression.

But my dog, I had a dog Cyrus and I think that there probably were times in his life when

his environment was unpropitious and maybe he was depressed but Cyrus did not get down

on himself.

He did not say that he was failing as a dog.

He didn't say that he should never have been born.

It's funny but I mean this in all seriousness that these are some of the things because

of our unique ability to use language and to have a self-view in a self-story that human

depression can be much more deep in terrifying.

We're using some of the tools that enabled us to differentiate ourselves from other species

and have in a sense mastery of the entire earth but these are some of the tools that are

also used against ourselves.

So again a perfectly good adaptation but in the hands of a highly intelligent person

using language we become our own worst enemies.

So in some ways what I hear you saying John is that as you discussed the capacity for

anxiety is a good thing which is that it's important to be on the lookout for predators

or threats and in our evolutionary history this was a very useful adaptation.

But in the modern world in which we live we are inundated with stories about things that

could be threatening.

We're reading blog posts, we're reading newspaper articles, we're watching cable television

we're on social media and we're constantly being told about all the threats that are in

our environments and this natural healthy adaptation to experience fear, to be a wary

of threats now gets put into hypodrive because we're in an environment that is constantly

pressing that button over and over again.

Is that the point that you're making?

It is the point that I'm making and I make it a little bit different for depression because

some of the environmental factors involve our culture.

So for example we don't simply experience our mood, we also experience our mood relative

to what we believe we should be experiencing or what we believe other people are experiencing.

So this phenomenon of social media has really changed how people experience their mood

because what people often project on social media are lives where I am leading an ecstatic

existence of a series of amazing experiences and if you witness other people's social media

feeds you become to believe that other people are experiencing off the charts positive

affect which leads you to ask the question why am I not experiencing this.

So you're experiencing a big discrepancy between what you believe you ought to be feeling

and what you are feeling and what you believe other people are feeling so your mood becomes

a big problem in this environment and then you start to ask the question what is wrong

with me that I feel this way and I believe that more people are asking that question right

now than have ever asked that question in human history.

Certainly if I think about my Russian and Eastern European peasants ancestors in the 19th century

who were living in villages I do not think that they were all the time thinking what is wrong

with the way that I am feeling.

I think there was a greater acceptance that negative emotions perhaps were the part for

the course to be expected so there's a number of things that are going on in our contemporary

environment that are probably exacerbating low mood.

So here again the problem might not be social comparison per se because again as you

point out in our ancestral environments perhaps some social comparison was useful if somebody

figured out how to build a better hut than your hut then you learned to build a better

hut yourself but now we're confronted with social comparison with millions of other

people, people who are better athletes, people who are eating nicer dinners, people who

are in happier relationships and Rick constantly asking ourselves the question why is it that

I have fallen short completely and you know as opposed to the example of the hut well

you see what the hut looks like but the truth is we don't know what anyone is experiencing

so we're really in the dark fundamentally when we make this comparisons all we have are

other people what other people say or what other people look like and unfortunately in

our culture there isn't a lot of transparency about low mood people don't want to post

on their Facebook profile I'm having a low mood day and people often don't know how

to react when they do post such a thing.

You also observe John that our modern culture leads people to pursue happiness in ways that

may set themselves up for unhappiness what do you mean by this?

Well I believe in our contemporary environment a lot of people have developed very unrealistic

goals for themselves for example and young people saying I'm going to be a billionaire

or I'm going to amass 10 million followers on social media or I'm going to be the most

beautiful so that I will be a fashion model and people will follow me all around the world

that unfortunately very few people will succeed at these very unrealistic goals and consequently

if your happiness is contingent on reaching these goals you will tend to feel depressed.

Can you talk a moment John about how in the United States we've actually written the pursuit

of happiness into one of our foundational documents what do you think that does to our mental

states?

Well the idea of pursuing happiness obviously is very old and you're right Thomas Jefferson

included that in the declaration of independence as a fundamental human aspiration I think the

question is how to pursue happiness right so is it that happiness is something that you experience

along the way as you pursue other things that are meaningful in your life so for example starting

a family or meaningful work or helping others or it's happiness and end in itself meaning I want

happiness now and I need to figure out what I will do today to feel happy right now. Those

are very different and I think many people have started to train themselves on thinking about

happiness as a short term phenomenon and I'm not sure that Thomas Jefferson was thinking that

the pursuit of happiness meant that the 18th century farmers needed to find a way to experience

euphoria today.

Our culture has embraced the idea that depression is a sign of something broken within us

but John's research in affective science suggests that depression might emerge from the same

mood system that helps us to adapt and survive. When we come back writing a new story about depression

one that offers greater understanding and hope.

You're listening to Hidden Brain. I'm Shankar Vedanta.

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This is Hidden Brain. I'm Shankar Vedanta. Psychologist John Rottenberg studies depression

and where it comes from. If you have a personal story about your own battles with your moods

or follow up questions or comments that you would be willing to share with the Hidden Brain audience

please find a very quiet room and record a voice memo on your phone. Email it to us at feedback

at hiddenbrain.org. Use the subject line depression. That email address again is feedback at hiddenbrain.org.

John you say that part of your effort to push back against the defect model of depression is to

investigate what you call silver linings in depression and other psychological disorders.

What do you mean by silver linings? Well historically the idea has been that

as people experience depression they experience further damage. Each episode of depression damages

your relationships damages your body damages your mind and that leaves out the active ways that

people adapt and learn from their depressive episodes and the ways that these episodes can actually

be engines of meaning engines of change engines for a better future and the person is actually

I hate to say it because I think many people find this difficult to accept the better for it.

In the course of your own depression you learn some important things yourself.

One of them is that people were really there for you.

That's deeply true. I started out I think as a 24 year old,

lotably as an independent person but I learned through my depression how much it's okay

to lean on other people and that everyone gets a turn.

I'm wondering whether you felt greater empathy for others who've been through the same thing as a

result of going through so much suffering yourself. I did and I don't think it's only me.

I think another you could say silver lining of depression is that you do develop compassion

for other people's suffering and because you have it could be that other people are suffering

for a different reason or it may be a different variety of suffering but you are a little bit more

attuned to that pain and that is in some ways it's a good thing because it's a way that you're in

touch with a part of your fundamental humanity in a deeper way but that's not the only

kind of irony of suffering. I think that also from suffering deeply you can come to appreciate

not suffering in a more profound way meaning that I wake up today and I'm not in pain

and that is beautiful in a way that I don't think I could appreciate before I struggled with

depression and not to say that everyone who's going through life who has an experience

depression or some other mental health crisis is sleepwalking through life I wouldn't say that

but I do think that the experience of being depressed, of being suicidal is something that can

make you appreciate normality if that's a phrase in a more robust way than if you hadn't had this

experience in the first place. You told me when you were describing your depression that at times

it felt like it was bigger than you that it was stronger than you that you were dealing with the

force that in some ways was much more powerful than you are but at the same time John you are here

today your depression isn't. I know this is one thing that keeps me going the the knowledge that

I was able to persevere and none of us I hate to say is immune from depression or even suffering

if suffering is inevitable it's really how we are able to tolerate it and work with it and hopefully

integrate it into our lives that really enables us to move forward. There have been a number of

studies that I've also found that people who are experiencing depression in some ways can have a

more accurate view of reality than people who are not depressed that when we are in a low

mood in a bad mood sometimes we might actually be able to see ourselves to see the situation

more clearly and in some ways this aligns with your thesis that if a low mood is designed to make

us stop and think in ponder perhaps we're able to stop and think in ponder better than when we are

in euphoric mood. It's probably true I'm not arguing that we should all encourage ourselves to

be depressed so we'll process the world in a more accurate way but I think we should also be

attuned to the ways that being in a good mood is consistent with having some you could say positive

illusions so we temporarily suspend or put to the side big things like that we are mortal that we

are all going to die and that all the people that we care about are going to die too that we temporarily

don't focus on the suffering and the bad news that's happening on every continent and that's

totally understandable and that when you're depressed you become much more attuned to these hard

truths is very much a mix blessing but it is something that is a part of this low mood syndrome

that we think about things we think about things deeply and that we don't don't look away from

the pain or the painful things in fact we we immerse ourselves in the pain and the difficult

things you've also indicated that in some ways your own depression was the origin story of your

research career as a psychologist in some ways it seems odd to say this but depression helped

you find your purpose in life oh it definitely helped me find my purpose in life there's no question

about that in strange thing to say but I think truthful thing to say is that I feel grateful

that I was able to make this big change in my life even though it was extraordinarily painful

and it put me at risk I think I was at at grave risk for not making it to the other side

but I have now been on the other side for some decades and I don't think any of this would have

happened if I had continued in history I want to take a moment and underline something really

important you've studied some of the silver linings that come with depression you've

challenged the idea that depression is a brain disorder or merely about errors in cognition

some people might listen to this and say okay John Rottenberg thinks that the the enterprise

of treating depression with psychotherapy or medications is flawed they should be discarded

that is not what you are saying right John absolutely I I would love for there to be less

depression in the world and I am very interested in trying to understand how people can experience

well-being despite a history of depression how people can avoid having future episodes of depression

depression is demoralizing and it often leads people to be profoundly hopeless so I am delighted

to be able to say that there are treatments and people should absolutely try psychotherapy they

should absolutely try medications if they've found that they're not able to resolve the episode

on their own and they should also rely they should also try to get help from the people around them

because it often is all of the above approach that really enables people to make the kinds of changes

that are needed in order to fully recover from depression so I believe that treatment is often

a critical first step towards recovering and ultimately thriving after depression

I understand John that a few years ago you reached out to one of the psychiatrist who treated you

when you were depressed why did you reach out and how did the conversation unfold I did it was

something that I thought about a lot this was actually the psychiatrist who admitted me to the

hospital at Johns Hopkins for a month and he had been working with me for over a year we had tried

I wouldn't say everything but we had tried many medications together and in combination

and I felt that he had done his absolute best but also that he hadn't been able to make me better

and I felt a certain amount of guilt that I wasn't a good patient at the time and I also felt like

he didn't know me despite the fact that we had the most intimate conversations for like 18 months

and so when I finally did recover I thought about Dr. McGinnis and he had become a pretty

eminent research psychologist at the University of Michigan and I just wondered what would it

what would it be like if I reached out to him like would he remember me would he would he be

surprised that not had not only gotten out of the depression but that I was now in the field

and not only I was in the field I was studying depression and I was a faculty member

like he was and so I wrote him with really very little expectation just I really wanted to say

that I knew that he had done his best he was a very kind is a very kind man in that that it was

just a really difficult depression that really I don't know if anyone could have done better than

he did and just see just see what he said and he not only did he write me back he wanted to talk

with me and we continue to be in contact and I've seen him in person and to me this was very

gratifying because he is someone who knew me as the depressed John but also as the the person

who's on the other side of depression and he's one of the few people who who really knows all

of those parts intimately and he also someone who really understands depression so I think in

addition to it being very gratifying for me I think it was also gratifying for him to see that his

patient finally was able to get out of it and turn his life into something that is an asset to the

world in our companion story to this episode available exclusively to subscribers to hidden

brain plus we explore John's ideas about how it's possible to live a good life even to flourish

if you or someone you know has depression if you're a subscriber that episode is available right

now it's titled flourishing after depression if you're not yet a subscriber please visit support

dot hidden brain dot org if you're using an apple device go to apple dot co slash hidden brain

you can get a free seven day trial in both places you'll instantly have access to all our

subscriber only content including past episodes again that support dot hidden brain dot org or

apple dot co slash hidden brain John rottenberg is a psychologist at Cornell University he's the

author of the depths the evolutionary origins of the depression epidemic John thank you so much

for joining me today on hidden brain thank you for having me with such a pleasure

if you have a personal story about your own battles with your modes or follow up questions or

comments that you would be willing to share with the hidden brain audience please find a very quiet

room and record a voice memo on your phone two or three minutes is plenty email the file to us

at feedback at hidden brain dot org use the subject line depression that email address again

is feedback at hidden brain dot org also if you are someone you love is struggling with suicidal

thoughts there are people who can help if you're in the US you can call or text the suicide and crisis

lifeline at nine eight eight that number again is nine eight eight if you're outside the US check

the episode notes for today's conversation to find information about support in your location

hidden brain is produced by hidden brain media our audio production team includes Annie Murphy

Paul Kristen Wong Laura Quarelle Ryan Katz Autumn Barnes Andrew Chadwick and Nick Woodbury Tara

Boyle is our executive producer I'm hidden brain executive editor thank you to loom by Atlassian

for sponsoring the hidden brain perceptions tour with loom teams move work forward faster replacing

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Molly Sands head of the teamwork lab at Atlassian about how loom is transforming the way teams work

I am Dr. Molly Sands and I lead the teamwork lab at Atlassian which is our future of work

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I wish teams would embrace a synchronous communication so sharing updates or feedback in ways

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loom is a video messaging platform that lets you quickly record and share updates walkthroughs

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I'm Shankar Vedantam see you soon

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