Hi Dr. Lee - thank you for doing this AMA! I was wondering, what are healthy versus unhealthy responses to stress?

Hi Dr.Lee -- Have you observed people who changed their stress response drastically over time? In you opinion, how could one go about it?

Thanks.

Does the idea of different stress response depending on expression of the COMT gene hold up? Does this mean that we need to approach stress in very different ways depending on the type of person we are?

Thank you for your question! One way we can evaluate a stress response is to consider whether it is helpful in dealing with the stressor on hand and what other costs or consequences it may bring about. For example, if I deal with an upcoming deadline by working overtime several days straight, that may help me meet the deadline (i.e., resolving the stressor); however, I may get sick from not eating and sleeping well, or miss out on family or social obligations (i.e., other costs and consequences).

Another consideration is what's helpful in the short-term may not be so in the long-term. For example, some stressful situations (e.g., death of a loved one) can be emotionally overwhelming. Ignoring or setting aside these emotions at the moment may help us focus mentally to deal with the challenges on hand; however, denying or suppressing strong negative feelings is not good for us mentally nor physically in the long run.

It is generally helpful to weigh the situation from different perspectives and determine what's effective for you.

Hi Dr. Lee! Hope all is well!

I'm curious to learn more about how optimism affects an individual’s physical and mental health. Can you go into more detail on this? Looking forward to reading your insights. :)

Have a family member who developed bad anxiety during Covid divorced 65 year old man. He used to be life of the party and now he is a shell. What the heck can we do? Is CBT the way to go?

Yes, most certainly, but this also depends on the type of stress response. For example, our behaviors to stressful situations (e.g., over-eating when feeling stressed) is something that can be modified over time. Other responses (e.g., a startle response when hearing an unexpected, loud sound) are more ingrained and automatic. Does that help?

Thanks for hosting Dr. Lee. Can ADHD be triggered by childhood stress? And how does it relate to adult comorbid depression/anhedonia/addictions?

There are studies showing differences in our immediate physiological response (e.g., having higher levels of the stress hormone cortisol) to stressful situations in the laboratory context. It is important to remember that genetic effects on many characteristics, including stress response, tend to be quite small; the effect is much smaller when we are just looking at 1 gene. Many other factors - genetic or otherwise - may alter our stress response and/or the effect of COMT on our stress response.

It's a great point to think about how we approach stress based on who and how we are. It is effective to understand our strengths and weaknesses, what has worked well for us and what hasn't. Dealing with stress is certainly a lifelong learning process.

Thanks for doing this, Dr. Lee! My question, which is very relevant for me specifically today, is: what is the best way to manage stress and grief so as to minimize its short-term risks to your health, especially heart health?

Does anxiety can create heart related issues ?

For more AMAs on this topic, subscribe to r/IAmA_Academic, and check out our other topic-specific AMA subreddits here.

I’m really curious about healthy aging. I, myself, have been diagnosed with PTSD and am in a field that constantly triggers me (veterinary medicine).

Over many years of therapy I have been able to develop better coping strategies that has aided in my success. However, I do worry about the stress itself and how it affects my aging.

As an already optimist, how can leveraging my optimism more help improve aging?

Secondly, how DOES stress affect aging?

I’ve always worried my adrenal glands would give out and cause a myriad of hormonal and neurological issues in the future (I see a LOT of vet med professionals kill themselves or have to retire due to their bodies giving out).

Thank you for your question. In a nutshell, higher levels of optimism have been linked to lower risks of poor physical health outcomes, such as developing heart disease and dying from chronic diseases; higher optimism levels have also been linked to more favorable physical health outcomes, such as living longer and staying healthy in old age (defined as not having memory complaints, chronic disease, major physical limitations, and living beyond age 65).

Psychologically, more optimistic people tend to have better emotional well-being (that is, higher levels of positive emotions and lower levels of negative emotions), even when faced with stressful situations like a major medical diagnosis. When dealing with stressors, more optimistic people tend to think of the situation as challenging rather than threatening, and they are less likely to feel helpless or hopeless.

One caveat is that scientists can not yet definitively say optimism *causes* good health because most of the data have come from observational studies - that is, scientists compared more versus less optimistic people on their health outcomes. A rigorous scientific approach will involve, for example, using randomized clinical trials to test the causal effect of increasing optimism levels on health in the long run.

Are there any pharmacological interventions that have been shown to reduce the effects of psychosocial stress at least in the short term?

This is so helpful. Thanks for your reply!

I am sorry to hear that. Without knowing more about what caused his anxiety, it's a bit challenging to make suggestions. Cognitive behavioral therapy does have strong empirical evidence supporting its effectiveness in addressing anxiety, so that seems like a reasonable approach. Being present, empathetic, and supportive is always helpful. He may be aware of his own change from being the life of the party to being much more withdrawn, and be sensitive to how others may be perceiving him as well - it's wonderful that you care so much for him, and reassuring him of your support (regardless of whether he is the life of the party or not) may be helpful, too. Best wishes to you and your family member.

With ACEs and trauma in general being a significant risk factor for people who use alcohol or substances - what advice would you give for those with trauma and active self-medicating behaviours? I'm aware of safety and stabilisation techniques but is there anything else that you might consider?

Do you have any advice on dealing or recovering from work related burnout?

Why is it important for you to do an IAmA?

Thank you for your thoughtful response, Dr. Lee!

Thank you for being here and asking a question. It is great that you are taking steps to take care of your health. Stress and grief can feel like such huge burdens on our day-to-day life - often times people feel sad and unmotivated to do things that they normally do, like self-care. Some people just want to be alone even though they feel lonely. Stress can bring a host of negative emotions, like anxiety or even panic, sadness, anger. Negative emotions can affect how we see the world around us and interpret things that happen to us - for example, anxiety may cause us to feel vigilant and be on the lookout for something bad that may happen to us. Depression may make us interpret situations in a much more negative way than they really are or focus on the most negative aspects of things. Feeling stressed can also take a toll on your physiology - for example, it may keep your blood pressure higher for a longer time, which in turn takes a toll on your heart. You can see how that can trigger a downward spiral.

I appreciate that you are aware of the potential effects of stress and grief on your heart and your health - that is already a great first step. Self-care is important - it's one way to stop the downward spiral. Take time to take care of yourself - eating a healthy diet at regular intervals, not smoking, making time to exercise and being in green space, spending quality time with supportive people. If you catch yourself feeling negative emotions - if it is a reasonable response given the circumstances (e.g., grieving the recent loss of a loved one), you may choose to accept it and let it run its course without judging yourself for feeling negative, or do something to make yourself feel better. If your emotions feel too overwhelming and/or seem disproportional to the situation on hand, then it's worth seeking professional help. Sending good wishes your way.

The scientific evidence is pretty robust in suggesting anxiety has a role in the development of heart disease. In studies that follow participants over time, researchers have repeated noticed that people with higher anxiety levels at the beginning of the studies were more likely to develop heart disease over time, even after accounting for how healthy the participants were at baseline.

Hi! I spend a lot of time doing research and the AMA gives me an opportunity to talk to non-researchers about findings of studies that may help us think differently about our health and well-being. In my clinical work, patients have always been curious and appreciated conversations about scientific findings, so I welcome the opportunity to engage with a wider audience through the AMA. Thank you for this question and being here!

Drs always telling me physical issues can be caused by stress and to stress less, even though I don't feel I have anything particularly stressful going on in my life. Are there some people who are chronically stressed and don't realize it? How do you 'stress less' when you don't feel stressed?

Is there any way to become an optimist if you have pessimistic tendencies?

I have a teen on the spectrum who tends to fixate on things. Right now the fixation is past problems that caused stress, some big, some very small. But remembering causes stress and meltdowns, over and over again. How can we help them deal with the issue and move on, or at least recognize when the stress is coming and be able to control it?

Thanks so much!

What evidence exists (references please) that childhood adversity/stressors exist and carry over? Would querying for childhood adversity result in a confirmation bias of sorts due to calling attention to a potential issue? How do you establish a negative control for these types of questions? Also, who is your biggest funding source, and how's the tenure track work coming along? I ask because I'm a researcher at Forsyth but work with microbes! Hi neighbor

Is it possible that optimistic people are optimistic because they are in generally better health?

How do I get my optimism back? Me trying to navigate the shit mental health system in the UK that keeps getting worse has killed it :(

Hi Dr. Lee, thanks for your time. I tend to have an optimistic outlook, but I feel lost when trying to help somebody who has a pessimistic outlook.

Do you have any advice on how to speak with and/or guide somebody that we care about?

>Cognitive behavioral therapy does have strong empirical evidence supporting its effectiveness in addressing anxiety

That's a little outdated now, lots of new evidence that CBT is only useful for treating symptoms, not causes, and so only offers temporary relief.

Greetings,

1. Do you think burnout will ever be recognized as a medical diagnosis?

2. I have read that stress, especially when chronic, can change someone on a molecular level. Can you speak to what exactly that means and how it happens?

Thank you.

1.Top 3 nonfiction (more like factual) books related to health/nutrition/mental health you have read so far?

2. Most favourite research that was conducted?

Edit: Thanks 🤗 in advance.

Thank you for doing this Dr. Lee. My question revolves around how I can be more involved within the research world of PTSD. I am currently an outpatient mental health provider and about 40% of my clients have a PTSD dx. I work exclusively with veterans and mainly do CPT to treat PTSD. I eventually want to be trained in WET and CBCT but my dream is to be more involved in PTSD research. ATM I just need to take my LISW but am wondering...would I need to pursue my doctorate in order to work in research? Also, is the VA currently doing any research with MDMA assisted therapy for PTSd or work with psychedelics? Thank your for your time!

Thanks for this and the note about causality limitations. Could you expand on how big these effects are? With a large sample a statistically significant effect may not be significant in terms of living life. Would be interesting to know!

Hi Dr Lee!

What is your view on dealing with the grim reality of climate change?

To elaborate, some would argue that developing emotionally positive mindsets might help finding solutions to mitigate the challenges. While others argue that we need to feel strong negative emotions to depress humanity into "doing less" - i.e. lower out activity and thus emissions.

Thank you for this question. It must be challenging but also meaningful to be in veterinary medicine with PTSD. I'm impressed that you are keenly aware of the role of stress in your health and to do something about it. There are many ways in which stress -- experiencing stressors as well as our responses to them -- can affect our aging process, and it is probably not an understatement to say that stress response engages all of our bodily systems. PTSD is a precursor to age-related health conditions (e.g., cardiovascular disease, diabetes) , is associated with accelerated biological aging, and highly comorbid with other psychiatric conditions. You mentioned being triggered often in your day-to-day work and acknowledged your career as high-risk -- do these triggering situations involve experiencing flashbacks or intrusive thoughts about your trauma? what is the impact of your job on your mood, thinking, ability to have meaningful relationships, and ability to accomplish goals that are important to you? I wonder what the cost-benefit calculus is for pursuing this line of work, and whether there are ways to have the same or similar benefits without such costs?

Researchers are just beginning to understand the behavioral pathways linking PTSD to age-related diseases. Are you taking time to allow your body to rest and recuperate from stressors - good quality sleep, physical activity, and doing activities that allow your physiological systems to take a break from being triggered (e.g., progressive muscle relaxation, diaphragmatic breathing, yoga)? Are you nourishing yourself with a healthy diet, avoiding toxic exposures (e.g., cigarette smoking), and spending time in nature? Are your needs for connection and intimacy met?

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Hi Dr Lee, could you discuss the impact of minoritized stress and the impact on folks? I’m particularly curious if there have been studies looking at the physiological impact of minoritized stress and where it overlaps between established DSM diagnoses?

I'm a child welfare lawyer who represents adults and children in families in crisis in Texas. Are there any good resources for finding experts who can consult, testify, or treat remotely? Texas resources are tapped out and overwhelmed.

Can you learn to modify this startle response, or rather what comes after it? For example, if someone has a history of trauma related to yelling or sudden loud noises, can they learn (and is it physiologically possible?) to not become panicked and have the increased heart rate that come with the startle response, regardless of trauma?

Hi Dr. Lee, thanks for AMA. Most of Action video games are putting human body into stress situation, but that is also what makes them fun. How does those games affect our health? It is good or bad? Are strategy games or other are better?

I have palmar-plantar hyperhidrosis and it is a stress response. Have you done any work with people who have a physical stress response(like sweating) and learned to minimize it with stress reduction techniques? I’ve considered trying meditation, because even though I can’t control my sweat glands, I have a few tricks for distracting myself when I feel my pores start to open that do actually stop the sweating from beginning sometimes, not always. That leads me to believe a higher degree of control could be attained with dedicated practice.

Edit to add: I was in a chaotic abusive household on and off from the time I was born until age 17. I’m pretty sure this happened because of things I witnessed before I was old enough to form long term memories. Onset was around age 8 or so I believe.

An enthusiastic hello from Belgium!

I'm a psychiatrist working with neurodiverse youths. I'm wondering if having adhd and autism, which in itself is associated with higher levels of stress, are to you knowledge also associated with a different/compromised form of aging?

Thank you for your time!

Symptoms of mental-illness quickly become causes of increased mental-illness.

How do you respond to people who believe pessimism is actually seeing reality and optimism is either choosing to ignore reality or (more crudely) a symptom of stupidity?

opinion on cptsd as a diagnosis?

Thank you for bringing attention to this important issue! I think it is important for people, especially those dealing with the aftermath of traumatic events, to understand the concept of self-medicating behaviors. Self-medicating behaviors often arise because people are dealing with distress so intense that they need an "out" - getting drunk, abusing drugs, over-eating, over-exercising, self-harm, and other behaviors done in an excessive manner (e.g., excessive spending) . These behaviors are often drastic means to bring relief from the severe distress we are experiencing at the moment - because being drunk, having blacked out, or being pre-occupied with something else that is intense (physical pain, the 'high' from spending money or eating food) - helps to numb or distract us from distress. The costs of self-medicating behaviors are high, as one can imagine.

Because self-medicating behaviors are often used as a means to cope with a difficult event and/or PTSD, my suggestion is to seek treatment for dealing with the difficult event and/or PTSD. There are a number of treatments with strong scientific backing (such as cognitive processing therapy, prolonged exposure, and written exposure therapy, as well as pharmacological treatment) so I strongly encourage people dealing with this (or thinking they may be self-medicating) to consult with health professionals. Thank you for bringing to light this important phenomenon.

Hi Dr. Lee, what would you do to change the DSM and ensure better trauma/developmentally informed practices be adopted across medical, social work, educational, and first responder fields if you could get the ideal outcome?

Thanks for the AMA, Dr Lee! I got cancer at 29, and I genuinely believe that it’s in part due to childhood trauma, chronic stress, decades of suicidal tendencies, and the straw that broke the camel’s back is the 6 months before I got sick, I was stuck in a very unsafe environment and I had never been more stressed out.

What significant or surprising facts / hypotheses do you believe in that would surprise people about the correlation between adverse childhood experiences and developing serious, potentially fatal conditions?

Do people with pets live longer?

Have you gotten any threatening emails/texts/calls from students you taught/mentored and how was it handled? I ask because a recent news report at U of A showed a disturbing amount of negligence on the part of the dean when it was brought to their attention. All the warning signs were ignored before a shooting.

I love that you have this wonderful insight into an unhelpful pattern and are talking about it (sometimes it can take years for people to spot this or to even acknowledge unhelpful patterns)! What you are describing sounds like rumination to me - playing the same scenario over & over in your head, perhaps sometimes thinking about the many ways that they're "wrong", and the many more ways things can still go wrong going forward - quite maddening, isn't it?

Sometimes when we are ruminating (one of my patients called it "spinning" when she caught herself doing it) - we may generate thoughts that we later realize don't make a lot of sense. Can you write down some of those thoughts and "check" them later? Over time, you may catch yourself falling into rumination again, but you may become more skillful about reminding yourself that the thoughts you have during these moments tend to be inaccurate and unproductive, and you may feel more capable of / motivated to end the rumination. Is there something that can help "yank" you out of a ruminative state? For some people, it may mean doing something very different at the moment - dunking your face in icy water, going outside for a run (or running up & down a staircase), writing a post-it note that you can look at when you fall into rumination, listening to upbeat music, or talking to a supportive person. Sending good thoughts your way!

Hi Dr Lee! Do you have an opinion on the effectiveness of DBT therapy? Are there certain types of therapies you recommend to lower stress levels, or in general?

Thank you for this question. It is wonderful that you are trying to help others. Often times, especially when people are in distress, they may not be ready to change their way of thinking. When we offer a different way to think, the implicit message is that their way of thinking is not good (even if you don't mean it and are well-intentioned) - that may come off as judgmental and create additional distress for the recipient. Know that it is already a gift by being present, available, and expressing that you understand their difficulties.

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How does a psychiatrist use data that requires the individuals they're studying to be honest? How can a psychiatrist prove the people that their data is based on to tell the truth so that their data is as accurate as possible? If a psychiatrist can't do this, doesn't that mean that they're making educated guesses and assumptions?

Hi Dr Lee! I have hypomania, which has a wonderful side effect of keeping me positive most of the time. I also take care to try not to stress about anything as much as possible. I keep trying to tell my friends that being positive and stress free gives me both longevity and better quality of life, long term, and that they should actively try to do the same. I know that stress can cause averse health consequences, but does a lack of stress cause "slower aging", for lack of a better term?

Yes. Everything said there reads like "study finds wealthy people have more stuff"

Yes definitely. Most of your thought patterns are just habits. You can change your mental habits through repetition. One of the simplest forms of this is repeating a phrase.

Find a few triggers that will remind you to repeat a positive phrase (silently or out loud it doesn’t really matter). The triggers might be every time you brush your teeth, every time you notice yourself feeling stressed, while you’re in the shower, before and after sleep, and every time you check Reddit instead of working.

Every time these triggers happen, take a moment to repeat your phrase. It can be something like “I’m feeling really happy and optimistic” or “I’m pretty sure everything is going to work out great” or “I am so happy because of all the great things going on in in my life”. Smile really big and maybe do a big fake jolly laugh if you can.

It doesn’t matter if you actually believe these things or not. Simply thinking them trains your mind to be optimistic. It gets into the habit of thinking these positive thoughts.

This same thing works for all kinds of negative thought patterns. Whatever you wish your brain would think, just force it to think that a bunch of times on purpose and after a few weeks of training it will just be your genuine default thought pattern.

I would rather live a long happy healthy life than “see reality”. If someone I cared about was pessimistic I would try to convince them to change their outlook so that they don’t die as soon.

Thank you - Bob's Burgers also helps, but is not always available

Do you think psychedelics are worth it for some individuals?

Can we let the OP doing the AMA answer this instead? Thank you.

When do you answer these questions and queries?

😂 ok I’ll allow OP to answer

Are you the subject matter expert?

Hello Dr. Lee. I am a psychology student who is applying to schools that have an emphasis in trauma and a lab with psychedelic work. Are there any books you recommend? I’m in love with biopsychology and the effects it has on the bodily systems. It’s amazing how much reoccurring stress can cause. I know this first hand as I have c-ptsd and a myriad of chronic illnesses which have made me disabled. Also, I have experienced so many micro aggressions while trying to join research labs and see that academia is very able bodied and prefers white males. Would you say it’s hard for a woman in academia?

Relax. It’s ok for people to have a conversation. OP can still respond.

I would look at Gabor Mate’s work on this. He is superb and is the real deal. He has a beautiful documentary “the wisdom of trauma”

No, you’re not the subject matter expert. Out here you’re might misinforming people, and giving unqualified advice like you’re an licensed therapist; which you haven’t proven you are. Is not only unethical, but also ilegal in many countries. So please, stay in your lane and let the qualified expert speak. Just because you have an opinion doesn’t mean its a valid one.

I would look into Dr. Gabor Mate’s work. He was a doctor who decided to start looking at trauma, addiction and adhd. He himself had childhood trauma which imprinted into his body and he developed adhd. The Nazi’s were occupying Hungary and his mom was afraid he’d be taken so she gave him to a stranger to take care of him. He was a child and it was traumatic for him not to have his mother. He has so many talks and books which are very enlightening.

Wait, was it ever advertised as being able to heal it? Because I always knew that it's a coping mechanism.

What heals it is understanding where it comes from, psychosocially, and addressing it if possible.

In my experience when I see younger kids medicated I see a shift in personality for the worst. I work in healthcare and I wonder what your opinion on drugging kids is? Is it something you practice?

Ok I won’t tell anyone else to think positive thoughts. I don’t want to go to jail.

That's one of the problems with phycology in general. Founders, and often even more the followers founders, believe their method is the best and the only one "good enough", while the approach should really be to use different teachings depending on the situation. For example: if it is true that cbt doesn't treat the root cause, it can still be really good. It might make you feel good enough to actually tackle the root course.

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See, you’re here spewing nonsense and by the likes you’re getting, people are buying it. And to you it’s all a joke! This is the danger of allowing people like you who aren’t qualified to misinform others; specially with a topic so sensitive like mental health. That’s why when professionals in their field try to correct garbage, they are met with resistance and dismissal. But go right ahead, keep up misinforming the masses for the likes.

Help Dr. Lee! Thank you for doing an AMA.

I have maintained a fairly optimistic outlook for most of my life. Generally speaking, this has served me well, and I could bear witness to some of the benefits you claim arise from such optimism.

My question is about the more recent concept of toxic positivity, the idea that encouraging others to "keep their chin up" in times of stress and adversity can create more stress and lacks empathy for others' hardships. While I absolutely agree that it could be insensitive to tell someone to "buck up" without actually offering a listening ear, I do wonder how much projected optimism is helpful versus harmful.

Do you have thoughts on how to strike that balance between helpful and harmful encouragement? From your studies, what are good strategies for being a positive influence, versus coming across as callous and uncaring?

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It’s funny because you are overreacting. This really isn’t dangerous advice, even if it were wrong.

But since it’s not wrong, it’s actually really helpful advice.

Here’s the Mayo Clinic on how to be more optimistic: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/positive-thinking/art-20043950

They suggest practicing positive self-thought to make it a habit.

Thank you!

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What are you, new to reddit? Relax. We don't need you to police this thread.

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Do you have any proof at all that psychiatry is based on a coherent and provable set of facts?

In my lifetime I have seen "breakthroughs" come and go and I have seem the study replication crisis stay and widen.

Is it based on truth and does it actually improve the lives of people?

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Smol pp boi acting like a little weiner

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Do people with high functioning autism (formerly known as Asperger's Syndrome) process stress psychologly different than neurotypicals? Could it be, because of the detailoriented information processing and the hypersensitivities that autistic people experience stress more severe (more intense and impressive) than their neurotypical counterparts? And if so would "need" less stress experiences to develop psychological trauma compared to neurotypicals?

Please cite your answer with research.

Everything you’ve mentioned are issues I’m currently dealing with. Can you possibly put me in touch with a psychologist?

See my point exactly.

Hi, im curious what are your thought on Dr. k and the healthgamer.gg on twitch/youtube? For those who doesnt know, Dr.K is a harvard psychologist who stream on twitch where he interviews streamers and guest and help them with there mental health, some see it as a stream therapy seasion, and the Idea is the audience whos watching the stream can feel not so alone with there problem or get healed the same time as the person whos being interviewed or at least disigmatize theraphy.

Oooh this is a really good question! I hope it gets answered!!

Hello and thank you.

Can you combat pessimism with optimism or am I lying to myself?

I can get bad news and tell myself the good side of it.. a problem is a solution waiting to be found.. etc..

I think optimism is a consequence of an already healthy, happy life. That's why it may never be proven to cause good health

I think we all would. But some of us can't hide from reality once they see it. Sometimes reality just hits deeper than others I'd say

Yes but put in the work to stop the increased mental illness and you're still left with it. This was VERY depressing as someone who set out to fix themselves with CBT and has depression. If I wanted to "manage" depression I'd have walked off a cliff already. I want that shit gone

Is depression just not one of your areas of focus?

I relate to your idea of being a “chronically stressed” person. I’ve had doctors point to stress as a aggravating factor for my chronic health condition, but I didn’t see myself as stressed at that time.

However, with time and the help of a therapist, I begin to realize that I actually had a lot of unacknowledged stress. It’s not that I wasn’t stressed before; it’s that I was out of touch with my body, my feelings, and what signals they were trying to give me.

Since that time, I’ve learned so much about myself and my anxiety. I have a clearer perspective on what things trigger stress in me and why; I have better awareness and a process to recognize it when it happens and move through it.

I’m no doctor, but just sharing my anecdotal experience in the hope it’s helpful. Wishing you less stress!

This might sounds like a terribly silly question, but considering a lot of psychological research is done on college students, how does that effect your particular field of study especially when it comes to finding participants?

The pessimist: "Wow! Things are so bad, they can't get much worse".

The optimist: "Nah, don't you worry. They can get much worse!"

Lmao man what is your deal???

In general, how positive are psychiatrists in their own lives? Do they hear a lot of depressing stories from patients? How does it affect them?

Hi Dr. Lee! Why is it that our childhood traumas can be SO impactful on life, to the point of preventing us from reaching our potential? Shouldn't we be able to learn our way out of it through just growing up?

What would you recommend to someone who was physically abused by their mom while growing up, and now has a hard time dealing with strong women in the workplace? And how to deal with having a relationship with their mom, who is now loving, but would never admit to her drunken rages of the past?

Any specific types of therapy that person should seek?

Other than exercise, to help the hippocampus, and intentionally practicing reframing things, what are some things one can do to help someone rewire their minds after trauma? I'm interested in neurology, and I've been trying to help a friend, as well as help myself

Your brain is like a forest. If you walk the same paths over and over, they become trodden, and easier to walk. Your neurons will fire down those paths more easily. Pick new paths and walk those instead, and let the old ones become overgrown and disappear over time. It takes active practice, active benefit-finding. If you want a free podcast regarding methods for this, and how the brain works, I recommend

https://www.udemy.com/share/101DxI3@GJGN4AkzRXPwfCcyrHjyxSe0wkxcYcXS-DHuBOPMukTo4ih__hpcvGeqFpGSIwqRjQ==/

She hasn't answered you yet. I'm no expert, but I will, since I have an interest in and some knowledge of neuroscience.

Yes, it's possible, because of neuron plasticity - the fact that your mind is built to be able to change and adjust.

What is also helpful is the fact that memories are not "stored" as-is. What I mean by that, is that they are re-created from scratch each time, based on what neurons fire. And each time you remember something, a bit of your environment/current situation is unconsciously added to it each time. You might not remember it differently, but the impact/levels of things can be changed over time.

Medications that lower the heartbeat, also have an impact. As do things that cause priming effects, such as warmth, and things pleasant to the senses.

My suggestion? Recreate the situations that cause the startle response. Do it while having blanket around you, preferably a weighted one, and holding something warm. Recreate it in a safe environment. Maybe have some soothing music or water/nature sounds on. Have a friend do yelling, or use a YouTube video where there's yelling. Over time, that startle response should ease up,or even go away.

If you can't recreate it, then just practicing remembering it, while in a safe, pleasant environment, and remembering that you're safe, will also help.

I used to have a startle response to hearing anyone outside my apartment door, because I used to live with an abuser and startle to hearing her coming to my bedroom. That's all but gone now.

This might help. It's a free podcast https://www.udemy.com/share/101DxI3@GJGN4AkzRXPwfCcyrHjyxSe0wkxcYcXS-DHuBOPMukTo4ih__hpcvGeqFpGSIwqRjQ==/

What do You think of Jordan Peterson?

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How can childhood trauma affect the brain? Is there any treatment to reverse the damage done to the neural pathways?

>So please, stay in your lane and let the qualified expert speak. Just because you have an opinion doesn’t mean its a valid one.

Personally I find it is (somewhat) about surrendering control. Can I fix the huge problems in the world? Absolutley not. But I can work with what I have, and I can strengthen my community.

Can you speak at all about how CBT does not seem to work for a lot of neurodivergent people? This is something I have anecdotally experienced and I think it could be significant.

Hi Dr. Lee Thanks for taking the time to do this AMA. In the recent years, I constantly find myself being extremely negative, stressed out and anxious. I have started to worry about the smallest things and pessimism is becoming my default mode of operation. In fact, when I am optimistic my brain often gets scared that I’ll jinx the positive outcome I’m hoping for. I’m getting really really stressed about what I am subjecting my body to with all the stress and that in turn causes me more stress and it’s a vicious cycle.

1. How do I counter this thought of jinxing my happiness if I am optimistic and hopeful?
2. Techniques that can help me be more optimistic in life(making the switch from pessimism) and also reduce the levels of stress and anxiety I’m feeling. I understand it’s quite a broad question but any actionable information is appreciated. Thank you for your time.

not adhd or autism per se, but the comorbidity

>even when faced with stressful situations like a major medical diagnosis.

is that not somewhat at odds with this statement?

There’s some evidence for EMDR and other such therapies for startle response. It’s worth consulting a doctor if you have that symptom and it causes you distress.

Can the effects of early life adversity be overcome? What are said effects ?

This is exactly what a pessimist would say and that's why you won't live past 65.

Hello.

How does an episode of depression in a prepubescent child affect its development and personality later as an adult?

I’m a public defender. If your agency has resources to pay (or can get court vouchers to pay) message me, and I can try to get you some names.

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I don't see it as hiding from reality. I see it as accepting reality. I don't see optimism and realism as mutually exclusive concepts.

Easy for me to say having not endured a fraction of the percentage of hardship that some have, but so far I think I've done pretty well in this regard.

I'm assuming from time to time you do whatever the equivalent of "ACEs training"

Have you guys ever considered leading with resiliency and whatnot, and then supporting it's importance with ACEs stuff instead of spending 90% of the class talking about how people with ACEs are turbo fucked?

They should do a study on how ACEs training further fucks up people with a bunch of ACEs when they learn about it.

I wish I could ask you a million questions! My life has been defined largely by an inability to handle/manage stress and I truly feel like it's taking years of my life. If you revisit this discussion later I do have one thing in particular to ask:

How do high-stress childhood experiences train our bodies to physically react to stress?

Hmmm I'd be interested to know how one could retrain the brain to see situations as challenging instead of threatening, even if they have experienced a number of genuinely life-threatening situations. I used to be addicted to drugs, so quite often one "mistake" i.e relapse, truly meant the loss of absolutely everything. It's hard to not feel like everything you do is all or nothing when that's what your rock bottom is.

Pessimist response: "well, I've probably already done the damage" lol

Yeah, reality unfortunately is very harsh, "life isn't fair" and all that. I find the silver lining in things when I can so I wouldn't say I'm super pessimistic, but when you've seen people you love die, watched people harm themselves and been harmed yourself, it's hard to say "everything will be okay". Because "okay" depends on what it is you desire

Hi Dr Lee, interesting & very important research you’re doing!

I know two young children (4&8) who have had quite a difficult and stressful life so far, with a fairly poor/absent father figure. The older child is already a very anxious child and sometimes acts out, although it has gotten better recently. We suspect adhd and dyslexia. We only see them every few weeks or few months but will see them more often soon.

What are some things we can do to help them develop more healthily? We already try to compliment where possible and pay active attention to them when we see them.

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What do you think about Risperidone and Olanzapine being prescribed to people and especially children?

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Dr Lee,

Something that I'm wondering about: if someone is in bad circumstances, like they're living a fairly isolated life due to deafness and tinnitus, and they've lost their husband but they're getting regular visits from family, healthcare professionals, social workers etc, and they seem to be coping pretty well, keeping it together, do you think it might be possible for over-eager social workers who are not doctors or psychiatrists by insisting that the patient *is* depressed, that they must be depressed, to tip them into depression? I believe this may have happened with my mother - she was widowed fairly recently, back in May of last year, and once that happened I think maybe they wanted her to move into a home when she was in fact coping pretty well. My father's death was not a sudden thing. He died of vascular dementia as a complication of type 2 diabetes. It took about a year after he was institutionalised - due to lockdown we couldn't visit him. So yes, she was in grief, which is natural, but they insisted, over and over, that she must be depressed, and eventually she broke down crying and said I guess so, I must be depressed. It was not long after this that real frailty set in, she had a fall, suffered a lisfranc injury to her foot, went into hospital, contracted COVID-19 and died.

I'm not aiming to sue anyone. I just want the social workers to, if appropriate, get some guidelines to stop them basically bullying people into depression, because that's what it looked like.

He's a pessimist

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Hi, I’m late to the party so u might not get to me, but thank you for this!

My kids were molested and raped by their father/my ex husband when they were aged 0?-10. (They are safe, doing pretty well, don’t see him, regular counselling, and police involved).

My question is, I often am fearful that this will ‘ruin’ their lives forever. While they are doing ok, it’s all relative of course. Is there an age where things will be easier for them due to their brain/mind finishing to grow? They are currently 19, 18, & 16.

We are not going hurt about any of their past despite being told by many authorities that we shouldn’t talk about it. Proud isn’t the right word but we have worked hard to be not ashamed and the way we did that was to not hide it from ourselves or anyone else. So far so good but better would be amazing.

Any advice you can give us appreciated.

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Does anyone know what the podcast recommendation is? The link doesn’t direct me to one

The neuroscience of reframing and how to do it

By anette prehn, on Udemy

For chronic numbness (15 years now) what would thrrapies would recommend except SE , emdr, trauma sensitive yoga, TRE, myo fascial massage , psychadelic therapy, ?

I'm doing a paper on pandemic induced isolation creating cognitive decline in adolescents, is there are specific resources you recommend I look into?

Thanks!

Hi Dr. Lee! I'm a teenager and unsurprisingly, my friends and I carry a fair amount a stress, especially as we're applying to college. Sometimes I feel numb or avoidant towards stress while other times I consciously experience it. Could this contribute to irregular menstrual cycles? I know people who get gray hairs and we really just don't get enough sleep. Thanks in advance!!

No problem

I’m not the one giving opinions on the subject matter with out any qualifications. But please, keep the strawman argument coming.

Not how it works in my experience.

I'm bipolar and while I will need to take medication, I'm getting the most benefit right now with DBT a form of CBT. I know regular CBT didn't help me much but that's not too say it ain't help others, and other firms of CBT can help you too.

I'm generally optimistic about most things, but I become pessimistic when it comes to my health. Well--more than that, really. I'm quite paranoid about it. How would that work then?

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Yes, accepting certain realities is not easy. Why should we have to accept realities that are wrong or evil in this world. Those realities simply carry more weight for some than others, whether they accept them or not

That's right. Something shifts inside once we have to endure or experience those types of realities. The shifts will be different for everyone, how we respond will be different.

Hey I'm happy any time something works for someone. CBT was really useful to me too but it couldn't make a dent in my depression so. I've come to realize this isn't a psychological issue at all it's chemical/biological.

I think I was someone who never really spiraled from mental illness and was naturally good at not making it worse. I guess that has always been a blessing. But it doesn't mean the curse has gone away

Why is this being downvoted to hell? Are people downvoting because there's something wrong with your "evidence" or do they just not agree that it treats symptoms not causes.

Exposure therapy, then.

Indoctrination. As mental health falls under the profit directives of capitalism, despite the goodwill of individuals (and most are well intentioned in the healthcare industry), the priority is always to get the person "back to work" as the main metric of success. CBT was considered a quick fix solution that satisfied the immediate financial interests of the state and the insurance companies. In the NHS in the UK, this problem has come to light recently, whether or not it stays in the light is another matter.

Is there a comedy that teen likes? Images from crabby burger (sponge Bob), etc. while food is not preferred, even use of food with humor. It’s not Bob’s…or food with intent. Tell me how it’s not Bob’s. And engage in a process of recreating Bob’s or making their own better Bob’s.

Suggest making sure this is not a health problem.

Hi, I work with CBT and folks who are neurodivergent. Lots of folks need more than ‘just CBT’. Even within CBT, a focus beyond thought changing can be helpful. It is Cognitive behavioral therapy. Some folks do better with an approach from behavior— doing over thinking.

Thoughts on ECT vs KETAMINE vs psylocybin?

Edit: in regards to depression, anxiety and PTSD treatment modalities.

I mean, CBT wasn't developed as a quick fix solution though right? Could you elaborate more on that, with state and insurance?

Absolutely, it was well-intentioned from the start, but what 95% of mental health unconsciously does is to place the problem "within" the individual, as a 'psychological' failure, as opposed to a social problem (although we all recognise the need for support). Death is part of life, but the elderly man whose wife dies suffers to the point of being unable to cope nine times out of ten because he struggles to find a sufficient network of relations around him that help him through it, and substituting warm, caring personal relationships with professional support doesn't really cut it. We are increasingly socially isolated thanks to the needs of capital (we have to move to where the work/education is, and isolation in retirement is very common).

The main concern of State is profit in late stage capitalism (to keep the corporate sponsors of political parties happy), hence, get the patient back to work a.s.a.p. This does not have to descend into some kind of bleak Marxist diatribe against capitalism, it is merely an accurate critique of how it works and that financial profit is its most determining factor. To place the problem "within" the individual is to obfuscate the underlying socio-economic factors. If we were to confront those properly, it would threaten the interests of capital.

Yes.

Wow. Ive absolutely experienced therapy wherein it places the problem within me. Like I've been doing something wrong, or the reverse I haven't been doing enough of something or the right way. The fault always seems to be placed on me.

The problem is, even if you could prove beyond a shadow of a doubt that the socio-economic factors were an underlying cause of certain mental illness, there's no help for that. And trying to tackle capitalism in any form just isn't going to happen anytime soon.

I've never heard of corporate interest in mental health, but it wouldn't surprise me. I'm not really sold on this yet. But like I said, if the problem is societal then wth are we supposed to do? Medicine doesn't always work either

Well, there's a whole philosophical rabbit hole you are invited to jump into, but you may not come back out: the meeting of Hegel, Marx and psychoanalysis. Try r/zizek.

Thank you. This is very helpful.

This is great and all but it just furthers my point, there's no real help readily available and accessible for people who the system that fails them.

Couldn't agree more. But the problem is never going to be solved by such help when the system itself is the problem, because the 'help' is determined by the system that sustains it.

Have done that all endocrine panels and chemistries are normal

And probably is why the Buddha said life is suffering. Until there's a perfect system designed by a near flawless being, I guess we're all just at the mercy of life.

Well at any rate, I don't think I'll be letting therapy and medicine attempt to fix this problem anymore, except where applicable/appropriate. It's just head games on top of more head games, what a trip

Well, that's a salient point. People who are involved with real and tangible political struggles (i.e. not just voicing opinions on reddit and shouting at others), are statistically lees prone to 'mental health' problems.