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What was your motivation for writing Psycho-Logical?
Dr Dean Burnett
Psycho-Logical, my most recent release, is essentially the science of mental health. It comes from a lot of different strands in my general professional life.
I never really saw myself as being a mental health writer, that was never my plan. As I say in the book – and elsewhere whenever anyone asks – I've never had a clinical problem with a mental health thus far. It could happen, obviously, and it came close to happening during the pandemic – I had a lot of traumas to deal with. But I've never lost the ability to function: I'm very much in agreement with the general stance that the discussion around mental health problems should be led by those who have personal first hand experience with them. Because I just think that it's such a subjective thing. It's such a variable thing that being objective, and consistent with it is kind of impossible, so it should be those who know the emotions tell us about it. That it is my general vibe.
When I started my writing career professionally, I was working as a psychiatry tutor and lecturer. I'm a Doctor of Neuroscience and have a lot of experience of the brain. When I worked for The Guardian may general approach was, not false modesty or anything, but I described myself as the jester of the science section, because I was the guy who did comedy on the side as well. So I wrote funny things about science or satirical stuff. And it went down well. I got an audience for it. But I never saw myself as a serious writer, because that's not it's not my niche. I was just chugging along through and quite happy with it. There was some interest in me doing a book. Then in August 2014 Robin Williams passed away by suicide. I went to the office that morning, and news broke that he had died: everyone was heartbroken. It was horrible.
There was the rolling coverage of his life, his legacy. Already with the news only a few hours old you could see in via social media and the various media outlets, people saying it was selfish. "He was a selfish man for taking his life like this, upsetting those who loved him – and given everything he's got, to do that it's just selfish." You get that a lot w hen someone high profile dies by suicide. It just seems to be a kneejerk thing. For whatever reason it comes from, but that's not how it works. At the time I was lecturing in psychiatry and mental health and teaching people how to approach it – from the medical standpoint, taking the more holistic patient story into account and looking from their perspective.
I knew from first-hand vicarious experiences that that's not how depression worked. I also knew that the dangers that bad reporting and mental health can cause because I'm from Bridgend in the South Wales area, which had the Bridgend spate of suicides in the early 2000s. My family was deeply affected by that: certain members were part of my extended family and the media coverage was just shocking. It was like 'ooh, this ghoulish town with these children are taking their own lives and what's that about?' It was sensationalist, it was completely inconsiderate because 'poor white Welsh working class values town, and what do we matter' was essentially the gist of it. They just went for sensationalism. I don't know how much damage that did and how many lives were lost because of that reporting. So I've always had a bit of a knee-jerk resistance to bad report and mental health stuff. So when the Robin Williams thing happened, I was seeing this and it sort of tipped me over the edge. I thought somebody should say in the media that's not how it works. That's not how depression works.
I thought someone should correct it so much, but I don't know the actual explanation of how it works and I think no one's ever gonna do that, then it really is I had this Guardian blog. It wasn't the biggest thing but I could do something. I did a quick piece saying that's not how depression works, it works like this. It's not selfish – stop saying that, because it just does more damage. I said to them can you can put this up: I know it's not going to get much traction because it's a day of Robin Williams stories, but I feel better having said something. It went up and was the most popular piece that week of any – or any of the Robin Williams coverage – and was read two or three million times in the first seven days. And it did push my profile way, way beyond where it was currently at.
As a result, I became something of a go-to guy for mental health coverage or mental health stories or commentary. Because I approached it scientifically, it wasn't my verbal experiences. It was like, well, this is what the vaccine is the psychiatric appropriate reviews, the psychological review. But it's no, it's important to keep these things in mind. You see this thing, have this assumption that that's how it works, and ignore everything else. And I think it provided context and insight that may help to reduce stigma by saying ‘No, this is why it happens’. I wanted to do a book about that. And what I felt that book about that would be helpful at some point. The first book I did wasn't about that. But there was elements of that in it, as there was in the second and third, so it's always been something I've steered towards. When the opportunity came up with Audible, who said they wanted a dedicated audio book on regular mental health, I've always wanted to do that. Then it was published in a paperback earlier this year. In a roundabout way, that's the route which culminated in me breaking this book, which is about why mental health goes wrong, why it happens in the brain like it does, and so on. People seem to like it so far, so I'm quite happy with that.
Part of what you talked about there is the fact that there has been stigma, and that I can remember from five, 10, 20 years ago, there seems to have been progress. But it seems that the lockdown has really accelerated an understanding of the fact that we all have this concept of mental health that we are looking to try and maintain. We've been thrust into a completely abnormal situation that none of us have experienced before. And I think that's part of what's really interesting, listening to the audio book. Can you tell me a bit about depression, anxiety, and addiction, and what some of the causes for those are?
Dr Dean Burnett
One of the main factors in the prevalence of mental health problems in the modern world is stress. Stress is a subjective thing. If you are born into massive, massive wealth, and you have never to worry about money ever, ever, ever, ever, you have a high standard of living. But that becomes your baseline. That's what you're used to. So say if your mansion burns down, you could afford loads more you can afford another one the next day. But that is you've lost something you cared about. And it's not always something that's going to cause you a lot of stress that could cause you to develop a mental health problem as a result. So you know, it's a subjective thing. So even though our lives are objectively more comfortable in the past, now, there's been something more to be stressed about, you know, the more you have, the more you can lose, I suppose you could argue that way. Stress is easy to come by. And our brains are very good at stress. They are inherently disposed to look for dangers and risks and hazards. Because that's kept us alive for millions upon millions of years back when before we were humans. So it's a deeply embedded circuit in the brain. And when we come to something, which is a threat or could potentially harm us, we experienced the fear response. So as people often call it, the fight or flight reaction, but it's not all or nothing. It's not like anything potentially dangerous suddenly for fight or flight because that's, that's impractical, that the being powerful and draining response and you have the full adrenalin shock, you know, you just go into panic mode. Can't do that with everything which may possibly present some sort of risk at some point, because you're never getting done. So the precursors are like the build up to the stress response, fight or flight response. Stress is essentially it's your body coming prep to deal with a danger. It's like the, I think the book I use the analogy that it's like, it's the fight or flight response is the big boss in a video game. Stress is all the minions you have to wade through to get to it. And the accurately want to, but it doesn't have to serve. So they're not as big as powerful as the main thing, but there's a lot more of them, and they can easily damage you and kill you if you need to, they need to. And this is a sort of problem. Because the human brain sort of evolved in a way which has become a victim of his own success. It can now encapsulate and appreciate and just be aware of possibilities and hypothetical scenarios, or it can predict things that you anticipate, which is a great boom, willing to do stuff with that. But because the fundamental parts of our brain which handles stress and, and the various emotions, they don't really discern between things that are really happening to us and things that could potentially happen to us at some point that the higher brain sort of creates.
Normally a creature in the wild would be stressed by the presence of a predator or lack of food or wandering through new territory with like, no loss of shadows. So these are all things like these could be threatening to us right now, these could present a danger, a mortal danger to us any minute. So you become stressed, and I'm just going through stuff like that. But when the human you know, human Britain, you can think like, well, the economy is not going great because of the pandemic, I could lose my job, I could just be on it, I could lose my income, I could not pay my mortgage, I can lose the house. And these things stress you out, they haven't happened, it may never happen. But the possibility of these hypothetical things happening, causes stress, even though they don't actually physically harm us. And as you come to them not be able to buy food, or shelter and stuff is harmful. Or if you're in a relationship, you know, you see the partner, your partner, or someone else and you don't know who that is, you think, oh, maybe she or he is flirting with them. Maybe she was planning to leave being you, you bring up all these wild scenarios in your head about what could happen if your partner dumped you and like broke up and you've become suspicious and stuff and you have emotional reactions to things which he haven't happened and being may never happen. We even become stressed about things which definitely did not and cannot happen. When you cross a road out and mindedly in a car and he misses you. You'd be panicked about that for hours, just doing another fear reaction, you dwell on it, you'll think about it constantly, because it's your brains way of learning, sort of saying like, Well, that was bad, don't do that, again, gonna reinforce this over and over again, until it sinks in that I don't want to be in that situation where that could be killed like that again. There are loads of things the human brain is able to conjure up, which causes a stress, but the stress mechanism is still the same fundamental when we've had millions of years. And the brain didn't really evolve to deal with stress long term, it's always been an acute stress, like the short, sharp burst of it, because dangerous here, either get you or you escape it, in which case danger is gone. And you live to fight another day. So stress. So the fear response is meant to be temporary, but because we can keep these possibilities in our head that there's no real getting rid of them. So let's see, if you see if your power that your partner is gonna leave you until they actually do leave you, you're gonna come to be paranoid about that, because there's the you can't prove a negative. And so like, there's no end point to that. And so you can be constantly stressed about that. Or if your job is hard, and you're constantly demanding things of you, and there's no end in sight that'll conflict rescue out, there's no end point to it. But stress has a tangible physical effect on us. If it causes us to become immunosuppressed to do it suppresses the immune reaction, because when you're in fighting via light, if you don't want to have the sort of the swelling and inflammation of an immune response, so that's sort of maybe a short term stopgap to keep us going, but it's not helpful in long term at all. And of course, it's to gain weight because we comfort eat or build up our reserves to ensure that we survive long term because we're stressed and stuff and we drink water to take the edge off. And that's self medicating and stuff.
These things make us unhealthier and we become more stressed as a result. But then these stress chemicals also have effects on the brain. Like they amp up the focus and the memory system when we stressed and that it's an emotional response. And the brain adapts it becomes a changes response to what's asked of it. And that means that the part is used more often become bigger and stronger like a muscle. So the amygdala, the part which controls stress and fear becomes more active when we're constantly stressed because it's been used more to the point where it's the noodle system to keep it in check and rein it in and powerful enough to stop it and you experience constant fear and stress which is anxiety, you know, you have a constant and attach anxiety response if you're afraid you don't know why there's no real reason for it. Or if there is a reason your fear response is completely disproportionate to the actual outcome could be and all it can happen into short bursts because in the middle of it suddenly kicks off and you have panic attacks. So it's Like that, or there could be a certain one traumatic event which is PTSD. So there's lingers in memory and causes constant anxiety because you can't face it, you can't process it, it's just too traumatic. So that's sort of anxiety and how stress works there.
Not every part of the brain adapts in the same way. One modern theory is that constant stress causes the parts of the brain which control mood, regulate mood and how to change. They become overtaxed by stress, like the constant reaction to it. They get worn out: the neurons are exhausted by the constant demands placed on them by the stress chemicals. So they just stop working. They don't die, but they're on standby, and therefore our mood becomes fixed. And we can't change it because we were stressed before. That's all like the key hallmark of depression. It's not being sad – because as people point out everyone has low moods now and again – it's that you can't change them. They stay in place for two weeks at a time, which is really weird for any mood, let alone a really bad one. It's because the theory is now that these neurons, which allow us to change our mood, have been worn out by stress. Antidepressants, slowly but gradually coax them back into life – which is why antidepressants take two to three weeks to kick, or at least the most common everyday antidepressants.
Stress seems to be the key aspect of a lot of modern day mental health problems, which is, when it comes to addiction, not too much stress. But the response to stress, you sort of self medicate. And if you're prone to addiction or your reward pathway is too sensitive, then you might be someone who's got a weakness is becoming addicted to these pleasurable novel compounds and your brain adapts to them in really unhelpful and harmful ways. So you know, you can point to stress as a big factor in a lot of bonding mental health stuff. And obviously, as you alluded to just now, the pandemic has caused a lot of people to be a lot more stressed for longer periods, combined with the fact that the usual avenue for reducing stress in healthier ways, like going out, or just travelling nor experiencing new things, or just getting out and about or seeing friends and family, these are all known to be stress reduces, all of those have been blocked, we can't do any of those things. So not only we have a lot more to worry about the pandemic itself, and all the restrictions we have to obey and the danger of it and the uncertainty of it all. And it's added to the stress and usual options for dispelling the stress of being taken away, too. There's like a double whammy of increased stress for all people, which is why you'd expect to see sharp spikes in the general mental health problems of the overall population and gone by the data available. Now we are actually seeing that so yeah, so it's all some sort of constant theme of stress and anxiety in dealing with the issues of modern life, which takes its toll on mental health.
There's been that combination that people have experienced a variety of anxiety, depression, lapses into addiction. There's been people talk about languishing as well. Has there been anything that surprises you in terms of how we as a public have dealt with such a unique situation over the past 16 months?
Dr Dean Burnett
Yeah, it's been a lot of surprises, both good and bad, obviously mean, it's been quite surprising how many people have just not accepted it, just refuse to believe that it's even a thing. And do this, I'm sort of surprised but not really surprised. When I think about it, with the level of conspiracy theories which pop up about it and think they always sort of must be a hoax, it must be a scam, or it's a lie or to cover up all these things. It does actually make sense when you think that it's a big scary event that's happened in the wider world as a fact that all of us in some way, shape or form some more than others. Definitely. But everyone's been, you know, tangibly affected by this thing that's happened, and conspiracy theories arise. When do you think that the human brain in thinking does not like uncertainty, because uncertainty means you know what's gonna happen, you know, what's gonna happen, you can't prepare for it or can't anticipate it. So it could hurt you. And that's not a good way to be. And so like the human brain does every can to reduce uncertainty. And in stuff like this or like major world events, which are banned. The idea that they can happen just randomly by just pure bad luck is funny in a fundamental way scarier than the idea that they were organised by a shadowy cabal or like Illuminati or whatever it happens to be, because that means we can't do anything about it. If it's chance or bad luck. That's just the way they fall sometimes. But if it's, it's all the work of the mysterious powers, then Well, somebody is in charge here at least and we can appeal to that nature we can find them out and you know, also gives you a sense of superiority of simple sense of strength and reassurance that I know the secret nobody else does. I know that I'm better than you. Because I know it's a sense of control, which we all sort of strive for an everyday situation. So there's been that I have been sort of pleased by the degree to which most people have been quite willing to go along with the restrictions and staffing as much as they don't like it. That was one thing for the government behavioural scientists underestimated the, I've always been, by and large. I'm an optimist about people. I think the average person is a good person. Maybe this maybe they define good, different to I do, but they mean, well, we'll do the right thing. In most situations, some don't. That's they stand open, they tend to be elected. And that's the whole other issue. But it's, you know, I guess I'm an appraiser. So that was reassuring for me to see that lots of people will do what's required. And honestly, it's lots of news about people who don't, don't give us a break. curfew, okay. Okay, if you breach lockdown rules and stormed the beaches and stuff, but when you think of only people that are in this country, it's a surprisingly small percentage of us all, but because they're the ones doing stuff, then they get the news coverage. So you know, there's no news to be had in 99.9% of people just behave normally. And that's, that's not a news story. It's 10,000 people are bad versus 57 million people are fine. But it's the former, which actually gets headlines. So I mean, like, that wasn't surprised, but it's looking like that way. I think it can be quite reassuring. So, yeah, it's been it's been a mixed bag of experiences during the pandemic.
I was going to ask in terms of your own brain, because as somebody who studies, I wonder if there's anything about your own reaction and your own experience, which has surprised you, since the pandemic?
Dr Dean Burnett
I'm literally writing a book about that exact thing right now. It'll probably be published next year, if I can hit the deadline by the end of this month. I've had a particularly tough pandemic, as people who know me will know that in April last year, I my father passed away from Covid-19. He contracted it in March and lasted a month and succumb to it. He was 58 years old, no pre health conditions. So it was a very painful, tragic loss for me, in the midst of the strongest possible lockdown where I couldn't see anyone I couldn't be with anyone I couldn't have anyone help me or share my grief. When people experience you help out: you look out for their kids to them, you cook for them, or you just do what you can do. I couldn't have any of that. I had to still be the father to my children they needed, because they were scared and alone and isolated in this particularly traumatic time. I guess I was sort of surprised by how I managed to get through it. I mean, my mental health took a huge knock and my wellbeing really suffered, but it never declined to the point where I couldn't cope or couldn't function. But who knows? Maybe it will. Because like, I think one thing I do know is that we're only just now coming out of lockdown ish. And I haven't been back in the normal world since my father died. So should I end up sort of seeing family more regularly again, and doing things which I would be doing, which he would normally be at, finally, maybe his absence will then suddenly strike me as Oh, my God, he's gone. He's never coming back. Because I haven't seen him for a year and a half now nearly. But I I haven't seen nearly anyone. And that's sort of, if not, maybe it's not different enough for me to appreciate it in a tangible sense. But it's been sort of, it's been helpful. Being a neuroscience guy at this time I can, knowing why my reactions are what they are.
I've also learned a great deal about just how entrenched our emotions like it's quite typical in science, to ignore emotions, but sort of like no button to one side, or just like, oh, that's fine. They're just there. And that that's what the thrust of the book is like, my emotional reactions. evox gonna be called emotional ignorance. There's going to be called emotional intelligence. They're really they don't have any psychological emotional ignorance. And hopefully, that'll resonate. Because, you know, but it's just just by being the go to brain expert for many years now. The depths of my own ignorance about how my own brain dealt with emotions was quite startling to me and I, the range of things I felt, you know, the whole thing about five stages of grief, it's nowhere near that simple. Even the person who originally did that says it's not that simple. It's just been warped by the mainstream. But yeah, so it's been helpful to grasp this is happening, like sort of gateway is happening, but being able to do anything about it is perhaps the most the most profound thing. On the day of my father's funeral. I didn't cry until later that evening. I was certainly sad enough, it was horrible. But I didn't. Because other people were around and I've been conditioned my entire life, not by anyone on purpose, but I'm a man, I don't cry, I'm strong. I am stoic. And I know how harmful that stereotype is, because emotional suppression is never more than just a short term, helpful thing. If you're trying to get through something, in the long term, it's really damaging, it stops you processing emotions and at some build up, it affects your memory affects your well being and may be a big factor in why male suicide is so much higher than female suicide, because we don't have the ability to cope with our emotions, because we're never allowed on encouraged to express them, which is a big part of how we deal with and protest our emotions. And I've learned that since. But knowing that I'm unable to do it was a whole another thing.
That was weird for me to find out. As much as I know, this is just a cultural stereotype that men aren't emotional, and don't show emotions as much as I wanted to break it, you're still really hard to do so because that stuff goes in very, very deep. To sum up my general view of how me being a neuroscientist helped me through my pandemic, it's sort of like being a trained mechanic trapped in a car with no brakes on the motorway: you know what the problem is, but you're still inside, you can't do any about it until this comes to a stop. You just have to grab the wheel and hope you can get through this, and hope nothing sideswipes or totals you until you can get to a safe place. Knowing what the problem is, is one thing, but being able to address it – I couldn't because it's all happening in the brain I was using to think about this was a brain that was thrown out all these disrupt disruptive feelings and emotion. So it was it was an interesting experience. But then when everyone can read about it, so enough, I guess.
Finally, in terms of advice, for people listening to this, I think one of the things you speak about in the book, is that through understanding how the brain works now from the help in terms of being able to cope with it, would that be correct?
Dr Dean Burnett
One thing, which seems to be a common theme in a lot of modern therapies is that it's involves a process of taking the aspects of the mental health problem and making them more tangible – give them a presence in the real world which they are those otherwise lack, because that is something mental health problems often don't have, compared to physical problems, because the physical health problem like a broken leg, you can point them and say, that's my leg. That's what's wrong with it. And it's not really me. But when it's like, you know, low moods or constant anxiety, or hallucinations, or paranoia, it's happening within your own mind, no one else can see it. And your experience of it is really intimate. And it's kind of hard to express it or to get any sort of grasp on it, because there's no boundaries to it. It's only your mind is intangible, it's subjective, it's, there's no limit or definition to it. That makes anything go wrong with it a lot more scary or anything. This also fuels the stigma and suspicion around it. So a lot of modern technology is being introduced to give mental problems, more presence, the things like biofeedback and neurofeedback, where, if someone with anxiety is hooked up to a monitor showing the sort of brainwaves or heart rate, when experiencing anxiety spike, those activity levels, jump. You say try and reduce those rather than stop being anxious because you can't really do that. It gives us something to focus on. Because I'm an external, tangible thing to do to grasp, the brain has something to grasp. And although therapy is doing that, with hallucinations in schizophrenia, with the avatar therapy, and PTSD is being treated in this way. Now, you'll be exposed to scenes from the memory, and so on and so on. So, that's something I've told, you know, in a roundabout way, I'm gonna do that. With the book I'm saying, yes, you may have these issues and problems, but here's what's happened in your brain when this occurs. It's not necessarily your fault, it's not your responsibility: this is what's happening, and here's the physical basis for it. This is what we think is going on, and here’s why you're not flawed – you're just dealing with this thing right now. I believe giving it a more tangible basis is something which, fingers crossed, can be reassuring, be comforting, and help people understand it better. We can understand why certain therapies and medications work. That is the goal, I guess.
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