I'm not sure what everybody really understands is depression. Right, because we use the term depression in our regular speech there's a colloquial way of using it I think sometimes people fail to understand that that's not what we mean. We don't mean you know boy you know you know my team lost I'm really depressed today. You know we're talking about a brain disorder. We're talking about a condition where people even you know under the under circumstances where they can recognize they have all the blessings and everything going well in their life just have no desire to live. They can barely get out of bed in the worst kinds of situations.
Their reward centers and their brains are shut down so they can't really feel pleasure from things that they may have once really enjoyed them and passionate about them, everything seems to be flat and more so maybe even dark and painful to the point where imagine somebody you know overriding the most powerful instincts of survival to actually you know have an instinct for the opposite, wanting to end their life. So that's that I hope that gives everyone watching the sense that this is really a disease, a powerful disease.
This is not you know you know somebody who just doesn't understand how to be grateful for something. Our moods change right and you mentioned if your team loses I'm depressed. There are times when we're very sad and we feel bad and that's not what we're talking about with depression. And when you go along that spectrum what's changing? I mean you know that someone you knew passed away and you're sad, or so you get some bad news and so you cry. But this is a spectrum that goes along there.
Huh, what's going on that changes someone from the typical swings that we get or even the ones that are pretty bad when something bad happens to depression? Right you know our nervous system you know it was meant for us to kind of you know the deal with the vagaries of everyday life that sometimes we were down and we're up to but you know the nervous system kind of keeps us regulated. We keep going we're generally resilient and bounce back and we lose you know people that we love very much and go through a period where we're really not functional and we're grieving but the nervous system bounces back.
With depression you know there's something dysfunctional and it doesn't bounce back, and people's nervous system would really shut down. You know the normal things that that that the nervous systems are specifically the brain I had mentioned before. You know, we have centers in our brain that allow us to feel joy and pleasure. They get activated when we're doing things that make us happy and in depression one of the things that happens, just don't get activated.
So things that you know are so powerful, things like food and sex you know are no longer of any interest to people. Those are actually two of the criteria for depression is you know a decreased appetite and a decreased interest in pleasurable things like sex. You know things were you know being with your children or grandchildren, which is a powerful biological, you know pleasure. You know people in severe depression will just, you know - it just doesn't, I'm not interested.
In fact, they try to avoid you know engaging other people because it's so it is so so challenging to be with other people and put on a mask. It's just exhausting for them. I see many people who you know aside from coming to see me and doing maybe the minimum they need to do spend all day in bed. I had one patient I always remember who was a very successful and very dynamic and beloved, a high school teacher so so so dynamic and popular that the school had to have held a lottery for kids to go into his class, Wow.
He developed depression and when he and I saw him three years into his depression where he almost was not able to take care of his own personal hygiene and stayed in bed and he said to be - the greatest accomplishment that I think I've ever done in my life to this point was just being able to stay alive the last three years because every day he deals with the thoughts of just ending this misery. So you know this is David this is how profoundly pathological this state is. You know it's not easy for the average person who doesn't have the disease or live with somebody to recognize it because it's not like a broken arm or a diseased heart that we can wrap our intellectual minds around. This is very alien for people unless they've been through it.
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