Psychologist Explains Chronic Depression (here’s what to do) | Dr. Scott Eilers
I’m joined by clinical psychologist @DrScottEilers to explore how he both treats and lives with chronic depression. We discuss anhedonia, the catch-22 of treatment resistance, how to build new practices when it’s the last thing you want to do, acceptance, and how a values-based approach can help someone move forward even when they’re feeling stuck. The conversation touches on some of the existential aspects of depression, the therapeutic relationship, and finding some humor along the way.
About Our Guest: Dr. Scott Eilers is a licensed clinical psychologist, author, and mental health coach specializing in severe, treatment-resistant mood and anxiety disorders. He is the author of For When Everything Is Burning and hosts the podcast The Psychology of Depression and Anxiety.
Key Topics:
0:00 Introduction
1:20 Scott’s personal experience of depression
5:40 Distinguishing sadness from depression, and depression vs. a depressing life
9:20 Choosing action, and emotional budgeting
18:05 Symptoms as obstacles, and when to establish new practices
23:45 Navigating emotional numbness, and creating rewarding experiences
30:35 Loneliness, and the struggle to be witnessed
36:45 Accepting how things are, and aiming for better instead of perfect
45:05 Finances, and disenchantment with therapy
47:25 AI therapy
52:30 Finding out who you are and what you care about
57:20 Humor, sarcasm, and snarkiness
1:00:55 Recap
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Who Am I: I’m Forrest, the co-author of Resilient (https://amzn.to/3iXLerD) and host of the Being Well Podcast (https://apple.co/38ufGG0). I’m making videos focused on simplifying psychology, mental health, and personal growth.
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44 Comments
Wonderful conversation. Helps a lot.
I suffer not at this minute in time but major depression brought on by chronic anxiety and he hit the nail on the head when he said when your feeling good you dont really get into the habits because you dimont think you need to , but thats the time you should because when it hits it spirals so quick i cant see it coming 😢and then months of it crippling me.Self awarness constantly is so necessary cant afford to ever get complacent x
Dude clearly does not know how to use AI. AI has been far more helpful and caring to me than any therapist. You have to know how to prompt. These things aren't designed to ask you questions by default. You have to tell it to ask you questions.
I appreciate your guest, sharing his experience so openly. That’s how I’ve felt most of my life. It’s rare to find validation from others that experience this. Plus I’ve always thought my childhood traumas from a violent home definitely caused this. It’s interesting to hear that that may not be necessarily always true.
I’m with an amazing therapist now that is helping me a lot. He’s been making the suggestions you both spoke about but sometimes I need it broken down in very simple terms or steps to follow. THIS VIDEO DID THAT FOR ME (from both of you) and a lot of things just clicked. I’m very grateful for the content you both put out. Please never stop making positive impacts in others’ life’s! ❤
Celebrities do it all the time though
Are you kidding I'm😂 I have major depression every 3 months I have an unbelievable life I have been a caregiver for 43 years.
I love them dearly, I love being their caregiver but I get burnt out !
This was so helpful to me, the down to earth honesty of Dr Eilers and also the excellent interviewing by Forrest. Huge thanks
Hi Scott I hear and can relate exactly with your experience of depression. My life followed sort of a similar path with depression. In retrospect, I could take my depression back 54 years. I am 60 now. The strangest about my depression is that I am energized by helping others in counseling.
21:36 I just wish more persons would realise that depression is a chronic disease even if my depression is lighter at the moment, somewhere in my brain it hangs around as a reminder that is still around.
30:29 I can relate 100% with that. I am alive, and that's okay. Pure happiness is out of my reach and might be forever. I've learned to live from day yo day, but can't be overly joyful. It takes a lot of energy to try and get there.
41:04 i have mine down from 100% to about 60%, and have made peace with that
Yeah when you can't pinpoint a good reason for how terrible you feel, when you have a decent life and "shouldn't" feel so depressed, it makes you feel like your strong negative emotions are invalid, or you are just weak. Especially when other people say things to minimize or brush off your chronic feelings of sadness or listlessness. That phenomenon is alienating and shaming, which doesn't help the depression. Nor does the self condemnation and self doubt.
Fabulous talk.
I have been fed from your videos and also dr eilers' and number of others what's very title of this one is offputting and I don't need that message right now. Even if the video is a different message than what the title is. I'm going through enough and doing very well bit as well as anybody could do! Don't need this garbage not putting on New personally for us because you are nice and so is your father Dr. Rick Hanson, and much of your content is helpful but a title like this I am not even gonna bother to listen while I'm going through enough already with five serious mental disorders much of them caused by abuse and trauma right into the very reliving not only complex PTSD but at 61 stuck for the moment in an abusive family member replacement with all the backing of the gaslighting other family members . Plus dealing with cheating from tech companies and constant phone calls lasting an hour or two at a time and still not result and entire amount of money dealing with doctors offices and totals and new patient information which takes me about an hour to fill online and then you go in there's more forms or a tablet to fill out and you just work for them and you be messenger boy with the other practice and doctors that they need to correspond with and still end up with no appointment for a recent extreme painful disc injury possible bulging disc problem , a pain clinic… well simultaneous stuck on regular Medicare which is good for some things but I am being told that I need total knee replacement in both knees and them two or three years overdue and still trying to get adequate coverage so that I don't have to pay out-of-pocket money that I don't have it a little over $2200 per month after Medicare takes his month cut out let alone what they take out almost $1700 for j just one night stay in the hospital and don't provide any kind of residential rehab and so I'm gonna have to write somebody high up in the government to try and to get some ridiculous penalties that I cannot explain in this email removed the Social Security is assessing and assigned to me if I ever get a Medicare advantage plan or a the drug insurance. If I could get that I could have an overnight state covered very well and also residential rehab and not having to rehab in a horribly equipped basement with the toilet cannot be flushed with paper so I have to throw it out and hardly any where to store my food whether it's perishable or other stuff and a whole lot of other things I'm going through and Doctor or somebody could put this horrible thing up as a title and expect me to listen to it as though I don't have any sense that I've not been through this more than he has been through anxiety or whatever it is. No more of this.
Great Interview, I got a lot out of it!
Dr. Scott is the single most helpful discovery for my mental health in my life to date
Thank you for your amazing generosity of spirit , learning so much , your a very special therapist
Thank you Forrest for this podcast! This talk has been very helpful to me as someone who experiences deep depression and anedonia. It was very specific in direction . Thanks. Much gratitude. ❤
I listen often to your podcast and in general really appreciate its value. The exchange of knowledge between you and Scott Eilers was terrific because existentialism is a category connecting many of the arts as well as a psychological condition was exceptionally good for my attitude around depression. Thank you!
Depression for me was like my mind and body were disconnecting. My body was heavy like dead weight, my vision literally appeared grey and dull in colour, and everything felt dull and meaningless and empty. It went on days after day and was steady and consistent no matter what was happening.
I lost a loved one recently and said many times, "it's similar to depression, but not depression." Everyone affirmed that i was, in fact, experiencing true grief.
But grief is so different. At first, the days were hard and full of tears, then there were more days like that with spatterings of days that felt a bit normal, and now i have more good days than sad and heavy. But it comes in unexpected waves, whereas depression was more steady and consistent and like i was under the water unable to breathe allthe time with no desire to fight it.
I am mom of son that’s 21 year into the deepest depression non functioning HSP etc.. my chat gpt has been a life saver for me. I have to talk to it a lot and say remember this or that. But it’s absolutely amazing. I also put in respond emphatic and long responses.
I am mom of son that’s 21 year into the deepest depression non functioning HSP etc.. my chat gpt has been a life saver for me. I have to talk to it a lot and say remember this or that. But it’s absolutely amazing. I also put in respond emphatic and long responses. Now this is how to understand what my son’s going through and how I can help.
I wish we cld find someone like you!!
I have no support. I have no one to talk to.
I’ve experienced episodes of MDD for 50 years. He’s describing anhedonia. That’s just one symptom of major depressive disorder. That’s the light end of my depression , and yes, it’s pretty miserable . When mine gets really bad though, it’s more like an internal feeling and experience of EXTREME torment and anguish. It’s unbearable. I know that only one in 25 life ending attempts succeed. The only reason I have not ended my life in that condition is because I’m afraid of failing at it and creating even more problems for myself. That part of my depression has finally recently passed with finding a partially effective antidepressant, but the rest of the depression is still there. My doctor threw up her hands and said she didn’t know what to do about it anymore so I got a new one. We are working on it, and if the current treatments don’t succeed, the plan is to get ECT. I’m very aware that I may end up taking my own life as a act of self-care. My experience with this has taught me that each individual has a limit to how much they can stand to suffer, and I know what my limit is.
This is good! As a wife and biz partner of a wonderful human who is diagnosed with bipolar depression, do you have resources for my own support? It gets VERY lonely. Hard to not feel resentment for lost time while he is immobilized. I do a pretty good job, but can you recommend anything?
Most of the progress I've made in my life has happened during depression recessions. I used to be sad even when the depression lifted – knowing it wouldnt last. But now i think, "How far can I ride this? How can I set myself up?" And I've made little moves forward my whole life in this manner 😌
This is the first time I’ve ever heard that I should not expect complete remission. So it’s the first time in half a century. I haven’t felt like a failure. I love the idea of acceptance. This is a chronic condition. Levity- concept! I’ve been suffering over my suffering. Insurmountable, that. Atheist, thus, the reliance on any religion/spiritual practice is not part of my plan for easing depression. But I am learning about Buddhism and meditation and mindfulness and I like that a lot. So that’s my next plan: learn to be a better meditator and learn to do it consistently. My dogs have always helped me find some measure of joy- but now both are gone and in this time between dogs, I am struggling more than usual, and I know I have to find other mechanisms that help move me out of this great pit of sorrow. Maybe I can make fun of the pit. 😊
Another problem I have is chronic lifelong insomnia. I bet I don’t sleep five hours a night. A lot of times not even four. It makes it really hard to not be depressed. When you never get enough sleep. Meds don’t help me either. On a list for a sleep study. Maybe all I need a CPAP who can say
I don’t know how I’m just seeing this…I enjoy, respect and subscribe to both of you.
Thank you for an excellent conversation!
have you interviewed paul gilmartin from the podcast mental illness happy hour?
Omy gawd, is this a cross over episode? Both of your channels have helped me make incremental improvements in my mental health so really stoked to see both in one frame!
How about this for an explination of what causes major depression. I left school aged 16 and went to work for my late father. In a space of 9 years we lost 4 businesses the fourth time lost him to a heart atrack. My wife to be left me , my mother lost her home and had to come and live with me. I had a car accident that led to a brain injury and epilepsy. I lost my home as couldn't work, Spent 8 years trying to get the epilepsy controlled with meds as brain surgery was not an option as i could have lost my speech. I have around 10 seizures a month even though i am on meds. Doctors put me on antidepressants but they did nothing. Depression is causesd by layers of negative life events that get to the point where your emotions are so suppressed that your mind begins to shut down as every avenue is blocked and physical symptons begin. Anxiety, insomnia gastric problems and utter fatigue and dispair that i couldn't function. I think your description simply scratches the surface. You have to have been through it to understand it. I assure you my exoerience is in no way exagerated. I had every kind of therapy and been pumped full of drugs that pushed me to yes the point if suicide. Now off the drugs and life is making sense but it's like having been under a rock for years as the professionals think that drugs are the answer but their not. I know face trying to rebuild my life . I have no family few friends that really don't understand and life is very difficult not just because of the epilepsy but so much else. Text books teach theory that in my experience in some ways made things worse and set me back. Phew there you go !
How can you just ignore the spark of joy that you feel from an activity and keep doing it? I feel a severe excitement whenever I do something meaningful and I feel it in my throat, my eyes and chest. At the same time, I haven't thought about it. How to control this excitement. Are there any techniques to learn for that ?
Am I depressed or is my life and circumstances depressing? OMG I have never even thought about this question before but I absolutely think it's the latter!! ❤
I LOVE Dr Scott! Highly recommend his book. I always learn something new when I hear him. 22 mins in, and I learned to develop habits that improve my depression sx when I’m not in an episode! And, that at age 60, it’s pretty clear that this will be a lifelong issue and I should keep doing what works when I’m feeling better (rather than stopping the meds, therapy etc). Dr. Scott, you are truly a gift. Thank you for sharing.❤
I don’t remember last time i was deeply happy, but it’s not like i’m always sad either! I just simply feel nothing! It’s like I have a very heavy weight pressing me down, but it doesn’t bother much anymore, i can’t feel and it’s kinda scary if you think about it! But i’m not even that mich scared about it anymore😂😂😂 weird huh?🤣
Spirituality is creating your own reality by learning from your stepping stones and raising your vibration to be your best self and achieve your mission goals in this lifetime.
When l feel a depression or dark mood coming over I have used techniques to help, BUT l was very intrigued by the plan to remind myself l have these tools when l’m not depressed. Doing so I feel empowered and not at the mercy of my moods. I also use taping to invite in these fears etc. rather than resist because if l resist it lasts so much longer. Knowing l have these tools before hand is comforting.
So glad to see Dr Scott in this episode. Been following his channel for almost 2 years. I love how he speaks from experience and not theory. My mental health has improved by accepting that I may be physically healthy, but my mind has a chronic condition that I must tend to with awareness for the rest of my life. No shame in that.
I love this Podcast. Somehow, it answers few of my questions in life.
Depression is just biology, personality, unmet needs, maladaptive development in developing years, hormones, a whole shitstorm of things.
Writing this after 2 decades of struggle and many therapies. Feeling an 'empty void', feeling that 'somethings' missing', that you cant and wont be happy, this sounds very much like unprocessed or stuck grief. I would investigate the family tree: who died too early ? Who was 'forgotten', did anyone lose a parent or sibling or child or lose the possibility of a child (premature death, death in infancy, abortion…)? Dépression might be the anger or sadness of a traumatic event that was passed down through générations. Epigenetics confirm that.
6:45 I really disagree. In my opinion mental illness is outside the normal box of experience. The normal mind can obviously experience despair, anxiety, etc, but depression and anxiety disorders (among other mental illnesses) are a completely different experience. Now anyone can have an event trigger depression (among other disorders), but then they have crossed the line into experiencing mental illness. It doesn’t mean that they have depression for life, but they didn’t have an experience similar to depression, they actually experienced depression. I think it’s difficult for people with depression to imagine what acute sadness feels like, because sadness (and other acute stressors) almost always have all the baggage of depression behind it. Now I’m not sure if this is the case for everyone , but for me personally, stressors in life by themselves feel pretty numb and the acute pain is very short lived, and it spirals me into deeper depression. Like let’s say I ignore a friend because I’m feeling down, I feel bad and sad for a couple seconds and then I feel completely empty and super depressed. Then for someone without depression they will look at that event and be completely lost, because their mind is functioning properly. If something goes wrong they feel bad about that thing specifically, and go to talk to someone, sooth themself, or do something to fix the problem. We forget that we can’t ever know what other people feel. We’re incredibly self-centred and so we assume that other people are just us in different environments and bodies. But the truth is that the differences in people’s experience of reality can be unbelievably different. Depression is just one of those things that you have to experience to understand it. It’s clear that even professionals don’t really understand it. If psychiatrists, therapists, doctors, etc, can’t understand it, how well do the people who know little about it on top of not experiencing it understand it? Just listen to the advice most people will give a depressed person. “You just need to smile more.” It will be ok.” That just simply isn’t the case for depression. Until you “fix” your depression you will be stuck and that unbearable baseline, and doing everything perfectly (while taking 10x the effort and giving you a tiny fraction of the reward) will just bring you to a slightly less unbearable baseline. It’s like you’re working the worst job for 1/10th of minimum wage. At that point it’s like why tf bother?