If taking antidepressants makes you feel weak this video is for you

[@mattsmith7772]

I showed this video to my dog but he still refuses to take his meds😮‍💨

[@tidesbreath]

Have you tried putting the meds in cream cheese? I work in a shelter and that's how we give our dogs meds and very few spit out the pills or refuse to eat them 😊

[@1AlexanderCole]

😂

[@rihabhadjam]

" there's no glory in suffering through something that is preventable " hits hard

[@vikkitoria97]

I think people ("concerned" family members, etc.) forget that taking medications *doesn't* replace basic tenets of self-care such as exercise, diet, sleep, etc. It is usually intended to help you actually focus and accomplish those things more effectively.

[@fulltimeslackerii8229]

I’ve said it before and I’ll say it again: I really suspect that the stigma surrounding mental health is one of “I wouldn’t be depressed ,anxious, etc. if I had the emotional maturity/coping skills to understand/deal with my emotions”. Kinda like the hunger example: when people get to be obese, society will view that as you not having the “discipline” to ignore cravings, go to the gym, eat healthier, etc. It’s a bias that as a physician in training, I’m struggling with personally because I understand the logic, but at the same time if it was just “lol skill issue”, then it wouldn’t be so rampant

[@bigbufobufo]

Antidepressants are just another tool in the toolbox to get you back on track to feeling well. Mental health is just as important as physical health.

[@AshtonDodge-yj1le]

As a person with MDD-- I wish people would go to bat like this for our more 'acceptable' brethren in the psychiatric patient population (see any other diagnosis other than depression, anxiety, or PTSD). People are incredibly judgemental. It really hurts. Partly because of empathy for those people who are more judged than I, and partly because you become afraid of how society/loved ones/providers might act if they find out how you're just like those 'more fucked up' people, just better at 'hiding' it. And then you feel bad because that's such a self-preserving way to look at things.

[@pipp972]

What I always tell patients is that they, too, deserve to feel happy. They deserve quality of life. Why would they alone have to raw dog it through life, like they're made of steel, refusing help to get back up? It's another tool in the arsenal. If you don't like it, that's ok - it doesn't have to be the only one. It can just be the crutch you need to get back up and after you pick up the pieces you can carry on by yourself, that's ok too. But you're not weak for needing a crutch - we don't clap when we see a person with a broken foot hopping around on the other one, we tell them to stop being stubborn and use the damn crutch. So why would it be different here?

[@alisyed5865]

As someone who is going through the shitshow that is the end of M3 and the beginning of M4. I just want to say thanks man. Your videos and reels recently. GOATED. But also your skits were HYSTERICAL too. Thanks for doing you!

[@mitalishinde6890]

I love these videos as much as your skits 🤍😌

[@mattsmith7772]

Damn, with my homies you’re the odd one out if you’re not on at least lexapro 20mg

[@DrZombieDeadpool]

Love these vids. Speaking as a peer (resident) I can't say I'm a huge fan of this approach. Likening anti-depressants to Tylenol is a bit disingenuous I think. I have no qualms whatsoever with the use of psychiatric medication, I will preface with that, because there are some real wild takes below. I think a more nuanced take is appropriate, however, especially in patients with borderline symptoms of mdd/gad who are on the edge of pathology. Effect size of ssri/snri tends to be small in these patients. Same patient population where weight gain and sexual dysfunction could end up pushing them further into pathology. I think they should be educated + cautioned on this, and not just advised to "just take the Tylenol you silly goose" I think these patients represent a large fraction of any psych panel and can be more challenging than they seem. My 2c, love to hear your take

[@itspresro]

That middle population that could go either way is where a lot of (outpatient) patients live. This video was speaking directly toward someone who is already on medication that is warranted for their symptoms, but they feel like a failure because they need it. The conversation around deciding if meds are right for someone is very nuanced and I agree “just take the Tylenol silly” is not a helpful approach

[@DrZombieDeadpool]

@@itspresro sweet man yea i agree

[@honeybrew5063]

Love how Preston looks like the stereotypical young ADHD filled Emergency Med Doc, but is a calm and collected guy in an absolute opposite specialty

[@leightonolsson4846]

Interesting what you saying about feelings. It's kinda BS that there's something such as willpower or discipline in the sense that that's how the mind/brain function. We are basically slaves to the pleasure reward-anticipatiom pathways. I'm not going to call it dopamine because that grossly oversimplifies the many roles dopamine plays neurologically. Discipline and willpower are really about training your brain to get more pleasure from doing/not doing something and anticipating negative feeling or lack of pleasure from doing the thing or not doing the thing (it could be something prosaic, it could be a drug addiction). It's a slow process and involves a lot of insight on the emotions you feel about the thing and the schemas (thoughts/values) you have built up and associate with the 'thing'. I'm not making the best explanation of this phenomena, but I hope it makes sense to someone finding stuff hard to do or not do.

[@zechariahjean2942]

Do you have any advice for someone who didn't match into the specialty of their dreams and is stuck in a different one they SOAP'ed into?

[@silverbone4473]

Could you give your take on the psychology behind relatively minor inconveniences (road rage/traffic incidents, losing in a video game, sports fans watching their team lose) leading to uncontrolled rage and life-altering actions among otherwise calm, relatively mild mannered people? I.e. what causes us to fly off the deep end when we get cut off in traffic?

[@Zm4rf]

i like to think about it like other medical conditions. no one asked for rheumatoid arthritis or like polycystic kidneys, and you're not "tough" for gritting through it. now i'm not a psychiatrist so i always get confused about "essential" depression vs. "secondary" (i.e., situational) depression but the former is literally just something that happened to you so dont feel bad about needing to take medication for it.

[@WaqasAhmed-sh4cr]

Brilliant

[@aminoglycoside]

Could you please explain what you meant by not being able to "will yourself to feel anything"? Seems like many things like gratitude journaling, CBT, meditation are based on that? Thanks

[@zacharytavallaee5916]

Not OP but I would argue that meditation and CBT are more about accepting that you can’t control how you feel, and avoiding a secondary response of making yourself feel worse because you already feel bad. It’s one thing to be sad. It’s another to be upset because you’re sad and you want to be happy. Meditation and mindfulness practices are about letting emotions come to you and pass over you, instead of latching on and spiraling out of control. Gratitude journaling is basically a branch of CBT in how doing certain actions can induce certain feelings. Writing down what you’re grateful for can lead to feelings of appreciation. But a little thought experiment: have you ever written down what you’re grateful for and instead felt something different? Perhaps fear of losing what you are grateful for? Thus, you can’t force feelings or specific emotions, at least not consistently.

[@1AlexanderCole]

Unfortunately chronic pain patients are being forced off effective opioid treatments and being told it’s all in their head. “Just meditate the pain away”

[@brucewayne8704]

Do antidepressants actually work tho? Vast majority of studies shows it has the same effect as placebo…and not to mention all the side effects of taking them…i dont know if I would call taking them “treating” the illness.

[@itspresro]

“Vast majority of studies showing it has the same effect as placebo” is an objectively incorrect statement. Large high powered trials consistently show it is superior to placebo but these results are called into question by some because of the potential for unblinding. If you are concerned as to where they work or not a good place to look is animals. Birds for example, will self mutilate less when placed on an SSRI and show better distress tolerance.

[@brucewayne8704]

@@itspresro right, and i believe to correct for the unblinding, some studies would give placebo pills with side effects, and in those studies the placebo would be equivocal and in some cases more effective than the ssri treatment. My point is that if there is still such gap in proving that these pills have a definitive effect in “treating” depression, why prescribe them so loosely to the general population. Why not push for solutions that try to give a person tools to deal with their depression, e.g; CBT, as a 1st line rather than putting a vast majority of the population on drugs that have problematic side effects and even withdrawal problems. Not to mention by giving them these pills, without fully explaining to the patient that we dont fully understand what the exact cause of their depression is, we give the implication that a magic pill will treat their “neurochemical imbalance”.

[@brucewayne8704]

@@itspresro its not “objectively incorrect” . Even the most recent meta analysis calls into question the utility of SSRIs when compared to placebo. Also i had a longer response previously but got deleted.

[@bobjoe5937]

Damn. Hit me in the feels. It's bull spit because I know the benefits and the rates of suicide are higher as a vet but I still can't bring myself to go in. Mind you I also work in healthcare. I know I'm not infallible. Yet I can't take that first step.

[@EmTheAdventurousPea85]

It's hard, totally been there with how hard it is to take that first step. Love and support your way 🙏🏻🪷

[@fulltimeslackerii8229]

You had me nodding until “preventable” what did you mean by that?

[@itspresro]

Treatable would be a better word

[@catBoi_Finnbjorn]

idk if this needs saying but for liability purposes this does not begin a doctor patient relationship etc.

[@Dragonmoon8526]

Needing medication isn't a weakness. Yes, there are alternative options to deal with depression or other mental health conditions. But, sometimes, medication is still needed despite utilizing those other options, i.e., healthy diet, sleep, and exercise. To often do we see others' success and self compare, believing we are weak or a failure. But, our life journey, be it career, love, mental health, is relative only to us. Comparison to others or allowing the judgment of others to determine our self-worth only diminishes our desire to seek help and make the choices that enhance our overall well-being. Paraphrasing Taylor Tomlinson, "People who judge you for taking medication. Don't care about you. So maybe F#%k those people."

[@dan2dos2zwei]

The stigma attached to pharmacological treatments of mental illness is pretty stubborn. We can't solve all depression with wellness retreats and happy social gathering. People who take their meds are potentially saving their own lives, and for that they should feel the tremendous courage of their choices to seek and comply with treatment.

[@Snuffymcgee]

But do antidepressants really work? There’s been a lot of suggestion that the biomedical model of serotonin imbalance is incorrect. Aren’t you psychiatrists mainly dispensing placebos? Perhaps these patients should be referred to psychologists and therapists where they need to do the hard work of cognitive therapy to get over their issues. Psychiatric medicine is mostly false.

[@mattsmith7772]

Yeah bro, let’s just discontinue my schizoaffective patients’ mood stabilizers and antipsychotics because ‘psychiatric medicine is false’ and see how many voices they hear by the end of the day 😒

[@Snuffymcgee]

@@mattsmith7772 I said mostly false. Some mood stabilizers for bipolars and anti-psychotics for paranoid schizophrenics might make sense. SSRI anti-depressants have been shown to be false though.

[@JohanWXC]

@@Snuffymcgee There is an almost overwhelming preponderance of data to support the notion that SSRIs are effective in the treatment of many mood disorders. Moreover, virtually all of these studies assign placebos to the control group and arrive at their conclusions by way of statistical analysis - not conjecture. It should be noted that the vast majority of these studies were performed by independent physicians, not pharmaceutical companies.

[@pipp972]

Completely untrue. The mechanistic explanations of the serotonin model were never the justification for why we use SSRIs, they were an attempt to explain why SSRIs work so damn well. You got it the wrong way around. Look to clinical trials, not conjecture based on supposed mechanisms.

[@A---ti3zz]

Need to do the hard work?!? Taking medications isn’t an easy way out. The people on those meds are suffering and crap like what you said is why people feel like a failure for being on a medication.