Transcription
It's really once you get in there, you re you see that this kind of narrative about, hey, you know, it's it's really simple. I mean, I just, you know, the the medical school education that a lot of doctors get is that there's this thing called depression. It's probably biological and we have these drugs called SSRIs and they increase serotonin and there's probably something about that that's helping people and that's pretty much it.
>> Yeah.
And so you're just like, okay, okay, you know, whatever. you know, this is what my professors are teaching me.
>> Yeah.
But that like interface where you're because what really brings it to life is when you're working with patients in the clinic and you start noticing things. You're like, well, okay. So, I put this person on, you know, a low dose of Lexapro. It's a very common SSRI.
>> Can you tell us remind us what SSRI stands for?
So, it's a selective serotonin reuptake inhibitor.
>> Okay.
And serotonin is a hormone. It's a hor Yeah, it's it's a hormone in the brain that is involved in your mood. And for a really long time, doctors have been telling people that if you're anxious or depressed, it's probably because you have low serotonin. It's just a very simplified and reductionalistic way of understanding it, which is which is wrong as well.
>> Yeah.
And we'll we'll get into that, but Lexapro is one of those.
>> And so super common drug. So you'd give them Lexapro and then you know they come and yeah it would work initially they'd say okay I feel you know I feel a little bit less anxious this is good and then they come back 6 months later and the and they're just like I only feel it 10% or I don't even feel like it's doing anything any anymore.
And so you increase the dose and then they come back a year later and the same thing happens and you're starting to notice that when I put people on these medications for quite a large group of them they just become tolerant to the effect you know we're not really correct ing any chemical imbalance. It's just like the the drug effect is wearing off. And so it's really once you get in there, you you see that this kind of narrative about, hey, you know, it's it's really simple. You just put them on this drug. You know, it's not, you know, that they're wearing off over time and we're stacking them on top of each other and patients, they just don't look good. I mean, they're hardly they're hardly doing well at all. Don't look at that as maybe one of the reasons why they're not doing well. you know, it's just their underlying condition that's morphing, which is obviously like a really easy way to just, you know, stack on more drugs, just increase doses, and really not have to look at the fact that the model is broken.
>> Yeah.
And so when I started to see that as well, like one is like the the theoretical stuff just didn't make sense what I was being taught, but like in practice, I'm just like my patients aren't getting better.
>> Yeah.