talking about mental health and mental illness 
fundamentals part one so there's obviously two   parts to this and this is based on the 
surgeon general's report on mental health in this presentation we're going to explore the 
neuroscience of mental health how mental illness   manifests itself we'll learn about the prevalence 
and epidemiology and the costs of mental illness a   little bit we're not going to go into that a lot 
because it's you know not all that interesting   we'll explore the biological psychosocial and 
individual risk factors for mental illness   and review the differences between correlation 
and causation in order to determine consequences so let's start with the neuroscience of 
mental health and one of the things that   you know it's really important to remember is that 
a lot of our feelings our emotions our ability to   think and perceive things occurs in the brain 
you know so if your brain is not healthy and   happy then it's going to be hard to feel healthy 
and happy and concentrate and do all that stuff   so you know we want to focus on this 
and i'm not going to get deep into   the details with the diagrams of the 
axons and the dendrites and all that   because you know that's really technical and 
we're just going to hit the highlights today   the working of the brain depends on the nerve 
cells being able to communicate with each other   well that makes sense now there are two different 
things that impact that structural and nutritional   is kind of how i categorized it structural means 
you know if a neuron gets damaged in some way   if it gets burned up if it gets injured in 
a traumatic brain injury something like that   it could cause a problem with the neurons 
communicating with one another nutritional   is when the neurons um don't have the nutritional 
components necessary to make the neurotransmitters   and to secrete them into the synaptic space 
each neuron makes over a thousand connections   so one neuron is really important and we have like 
billions of neurons in our brain so it's important   to recognize that each one has over a thousand 
connections one of the cool things to recognize   though is also the fact that well it has 1 000 
connections since there are billions of neurons   if one goes a little wonky then there is a 
workaround which is why a lot of people with   traumatic brain injury are able to or after 
stroke can can redevelop a lot of the skills   and things that they had if not all of them 
before that brain injury now the frontal lobe   is involved with our motor behavior it's involved 
with how we physically react to situations   the prefrontal cortex which you know you 
can kind of think of as your forehead   is responsible for planning and integrating 
cognitive and emotional streams of information   which is a really fancy way of saying it takes how 
we're thinking about something and helps us figure   out how we feel about it so if we're thinking 
about something as scary then we're going to   have an emotional reaction which is fear and it's 
going to synthesize those two things together   if we're thinking of something as exhilarating 
then it's going to synthesize that too so you   know the example i usually give is roller 
coasters i'm terrified of roller coasters   some people love them we can look 
at the same exact roller coaster   and have two very different emotional reactions 
based on our cognitions our thoughts about the   roller coasters the other thing that's important 
to remember in neuroscience is the brain continues   to develop until you're about 25 that impulse 
control area is still developing until about 25.   so we want to make sure that in this development 
process the brain has all of the abilities through   good sleep and adequate care and good nutrition 
and all that stuff to develop as fully as possible   they found that a lot of the brain 
injury that occurs as a result of   chronic stress trauma and substance 
use is actually significantly worse in   people who experience those things before the 
age of 25 because the brains still developing   so that just throws a monkey and monkey wrench 
into the works so you know we do want to look   at the timing of some of these stressors in 
addition to just the stressors themselves   so electrical signals from the neuron are 
converted into chemicals called neurotransmitters   so neuron the the ascending neuron basically 
secretes neurotransmitters into the space   between neuron number one and neuron number 
two the neurotransmitters are released from   the sending neuron into the space and they attach 
like a key into a lock called a receptor on the   receiving neuron so the receiving neuron passes on 
that that signal and it's kind of like that game   you used to play when you were a kid telephone 
you know everybody would pass along the message   well if there's a breakdown in the system 
if there's not enough neurotransmitter the   wrong neurotransmitter goes through then you know 
there's going to be a breakdown in the system and   how people feel think or react the more receptors 
that are stimulated the more intense the reaction   so if a little bit of neurotransmitter is secreted 
and only two or three receptors are stimulated   that's going to be a pretty low reaction if 50 or 
16 receptors are stimulated that's going to be a   more intense reaction so for example when somebody 
takes cocaine you know that is an excitatory   drug that we take it secretes the excitatory 
neurotransmitters like glutamate into that   synaptic cleft so then the receptors it's just 
flooded and that just floods into the receiving   neuron and it finds every single lock that's 
available so the person gets this like supercharge   of excitement the excitatory neurotransmitters 
include norepinephrine and glutamate   and this is really pretty overly simplistic 
because most neurotransmitters are involved   in a lot of things and we have other videos on 
the all ce used education channel at all   youtube about um neurotransmitters and 
neurobiology so you can get into the   depths of that a little bit more if you want 
to inhibitory or calming neurotransmitters   include gaba which is our main common 
neurotransmitter and to some extent serotonin   and we hear a lot about serotonin in terms of it 
being an antidepressant it is also an anti-anxiety   neurotransmitter serotonin also is responsible 
for a lot of other things including libido and   appetite and pain perception and heart rate it has 
14 at least different functions in the body other   neurotransmitters that we hear about a lot include 
dopamine and dopamine has at least five functions   it is our pleasure chemical so if we secrete a 
lot of dopamine that it's going to tell us do   that again it helps us concentrate and learn and 
it motivates us so dopamine is really important   acetylcholine you know that's another one of 
those neurotransmitters it's more involved in   schizophrenia um endorphins are our natural 
opiates so we have those going in there and   endorphins help us not feel pain as much and feel 
a little bit happier and substance p is one that   we're learning about now and you know we've just 
started to learn about over the past 20 years   but it is responsible in part for pain regulation 
anxiety regulation and stress management neurotransmitter availability is impacted by the 
presence of other neurotransmitters and hormones   and i'm going to show you a couple diagrams in a 
couple of minutes but neurotransmitters if there   is cortisol in the system which is a hormone that 
is our stress chemical and our stress chemical is   telling our body fightfully protect yourself so 
it is going to basically shut down or reduce the   availability of things like gaba and serotonin 
because the body is trying to fight or flee   the presence of certain hormones if you 
have um not enough estrogen or not enough   testosterone it impacts the availability of 
serotonin so everything is interconnected   we can't just say you know we want to 
increase serotonin we need to look at   what's causing serotonin to be low or 
what's causing gaba or dopamine to be low   the other thing that impacts the strength 
of the neurotransmitter is the quality and   quantity of it so if you're not eating a good 
diet and i'm not talking about being a super   nutrition freak i'm just talking about getting 
some basic proteins in there and some vitamins   if you're not eating a quality diet your body 
can't make the neurotransmitters if it can't   make the neurotransmitters it can't secrete 
the neurotransmitters so you're not going to   feel as much you're going to feel flat blah 
or you're only going to feel or really feel   intensely the neurotransmitters that your body 
does have the building blocks to make vitamins   and minerals help break down amino acids which are 
proteins to make neurotransmitters and again i'm   going to show you a diagram in a second so it's 
important to understand that you can't just have   crap you know crap in produces crap out so we 
want to make sure that you're getting something   relatively healthy but without proper nutrition 
and adequate stress management remember we want   to keep that cortisol from disrupting the whole 
system the neurons will not be able to function   effectively so we need to make sure that the 
neurons are not disrupted by too much stress and   too much cortisol and that they have the building 
blocks to make the new neurotransmitters that'll   help us feel happy and calm so here's the first 
diagram and this is how serotonin and melatonin   are made tryptophan is a protein that we eat 
and it's available in you know most any food   so it's not like it's hard to get tryptophan but 
tryptophan requires iron magnesium calcium vitamin   b6 and folic acid to be converted or broken down 
into something called 5-htp which is a precursor   of serotonin okay so we have 5-htp 
that's kind of like you know raw fuel   it still has to be distilled down to make the 
stuff that we put in our car so 5 htp has to   have vitamin c vitamin b6 zinc and magnesium 
in order to be broken down to make serotonin   okay so now we have serotonin and serotonin 
is responsible for like i said a lot of things   libido appetite sleep um pain perception as well 
as depression and anxiety and other things so if   you don't have enough serotonin you may have gut 
and heart problems you may have sleep problems   cravings for carbohydrates alcohol and 
other certain drugs and fibromyalgia and   other pain conditions when your serotonin 
level is low your pain tolerance is lower   the other thing with serotonin is it is broken 
down to make melatonin and melatonin is our sleep   hormone so if you don't have enough serotonin 
you're probably not going to be sleeping well   which puts you in a state of stress your body says 
you're exhausted you don't have the energy to go   you're kind of the the weak lion and the pride 
and you're going to be the one that's going to be   killed first so you need to be alert um and and 
our body operates on a very primitive survival   mechanism or thought process like that so when 
you're stressed your hpa axis your hypothalamic   pituitary adrenal axis or your threat response 
system because that's a lot easier to say   gets activated so when you're under stress because 
you're in pain you're injured you're sick or   you're just stressed out the brain tells the body 
to release cortisol which is your stress hormone   and adrenaline which is your get up and go hormone 
all right sounds like a good plan if you're under   stress you need to get stuff done so these things 
cause the release of glucose which is blood sugar   that's great gives you the energy to get the stuff 
done it suppresses sex hormones because right now   you're under stress it is not the time to be 
procreating it's the time to be protecting   your own self and it also suppresses serotonin it 
suppresses serotonin because you are under stress   right now your body perceives a threat of some 
sort so it doesn't want you relaxing it doesn't   want you chilling out it wants you activated so 
it suppresses serotonin which is can be a calming   neurochemical so what does all that do well 
that means that you have very little libido   and when your serotonin is 
suppressed your anxiety can go up   and your depression can go up your you don't have 
as much melatonin so you're not getting as much   sleep so you're going to start to feel fatigued 
and you may feel start feeling more irritable   well when you're fatigued and feeling irritable 
then that generally leads back and intensifies   the body's threat response so you get in this 
negative cycle here and you have to figure   out how to break it so all of these things play 
together that it's really important to recognize   you can't just pluck out one thing and go oh let's 
just increase this and everything will be fine   that may not be it in a lot of my other classes 
i talk about making a good marinara sauce   when you're making a good marinara sauce you have 
basil parsley oregano garlic onion um fennel you   have lots of different spices and if you taste 
it and it tastes a little bit off it doesn't   just mean let's just add some more oregano because 
oregano may enhance the flavor of a couple other   spices in there so then those spices are 
too strong and you've got to play them down   so it's a gentle balancing act between 
all of the spices in the marinara sauce   just like it's a balancing act between 
all the neurotransmitters in the brain so when people's brains are 
not functioning optimally   when they don't have adequate neurotransmitters 
they may start to feel depressed anxious angry   or they may start experiencing something 
more severe such as psychosis or   dementia so let's talk about how does mental 
illness manifest because this is really important   a lot of times people think of mental illness at 
its late stages and if we pick up on the signs   of mental illness and i really hate the term 
mental illness because it's so pathologizing   but if we pick up on the signs of depression 
and anxiety and that kind of stuff early   then we can prevent it from causing ripples of 
problems so what does it look like think about   when you're anxious you know you may have rapid 
heart rate you may have muscle tension you may   feel light-headed those are all stress reactions 
those are all cortisol and and adrenaline   reactions that result when your body perceives 
stress of some sort and it can lead to anger   it can lead to anxiety just kind of depends on 
whether you choose to fight or flee the situation   but these are signs that you know you're not happy 
fatigue is common it can be common in anxiety   when you're anxious for so long at a certain 
point your body goes i can't win this fight   so it stops devoting as much energy to that when 
you're anxious for too long remember on that   last slide when you're anxious your body is not 
letting you get good quality sleep it's kind of   like a soldier sleeping in a foxhole you may doze 
off but it's not going to be good quality sleep   because you got all that cortisol running through 
your system so eventually you're going to get   fatigued if nothing else just from lack of quality 
sleep you may have appetite changes some people   have no appetite at all you know food just makes 
them sick other people start craving carbohydrates   and things like that remember when on that last 
slide if you don't have enough serotonin you may   start having cravings for carbohydrates alcohol 
and certain drugs well when you're under stress   your body is suppressing serotonin so guess what 
you may start craving carbohydrates especially you may have dysregulation of mood and i've 
never really liked that term but it means you   have excessive anxiety or fear or excessive 
irritability or anger or depression and   what's excessive is what starts being 
problematic for you or what lasts for more than   you know a couple of days we 
all experience these emotions   when something happens we can feel anxious 
or angry or when we lose something important   we can feel depressed and those are normal 
emotions i don't want you to get the idea that   we don't want to feel those things because we do 
we want to feel the full range of emotions though   so when it becomes too much when it starts 
interfering with your relationships and   your motivation and your work and all that other 
stuff then we need to start taking a look at it   cognitive dysfunction is another thing that can 
be an example of mental illness if you start   having difficulty with memory or concentration 
now norepinephrine and dopamine are two of your   neurotransmitters that are involved with memory 
and concentration and when people get anxious   when they get depressed or when they start 
having other problems mental health problems   memory and concentration are some of the first 
things to go so you do want to pay attention   after a baby for example you know i had what i 
called mommy brain for the first year you know   i wasn't sleeping as much as i would have liked to 
um and and i would walk into a room and couldn't   remember what i walked in there for you know i 
was 28 it wasn't like i was you know 68 or 78   and but the difficulty with memory 
and concentration was more because of   my fatigue and that system not working as 
efficiently as it could other things like   deficiency of thiamine can 
cause alcohol-related dementia   which can make it difficulty for people to 
remember or concentrate or function in daily life   and finally disturbances of thought and perception 
such as hallucinations thinking you see hear   taste or feel something that's really not 
there and delusions and those are like um   delusions of grandeur you think you are you know 
god or you think you're the president or whatever   or you can have delusions of persecution where 
you think spies are chasing you so there are   a lot of disturbances of thought and perception 
but to most people that hear those they're going   yeah i'm not thinking so um but to the person 
who is experiencing those disturbances of thought   and perception they make perfect sense so you 
can't rationalize with somebody who's having   hallucinations or delusions you just need to 
accept that they're in a different space right now   these are all things we want to be on the lookout 
for in ourselves too think about when you start   getting burned out at work or you start getting 
to a point where you might be depressed that's   the time you want to intervene what symptoms do 
you have you know i know i tend to get a lot of   muscle tension my neck hurts a lot i'm fatigued i 
crave carbohydrates you know i know i'm going down   a bad road um if i continue doing what i'm doing 
and i don't step back and say what needs to change so anxiety is one of those mood disorders 
that we talk about and a lot of people have   when you experience something that triggers 
the fight or flight response you can either   feel anxiety which is the flight response it says 
get me the heck out of here or the fight response   which is saying either i can't get out 
of here so i need to protect myself   or i am going to conquer this threat 
either one is in response to a threat   obsessive compulsive disorder panic disorder 
and phobias all kind of fall under this   anxiety umbrella one thing that's interesting 
about obsessive-compulsive disorder is it has   components of anxious emotions so it has an 
emotional component obsessional thinking so it has   a cognitive component and behavioral compulsions 
when people have ocd they start getting very very   worried and very very anxious that something bad 
is going to happen if they don't do something and   in order to make those thoughts go away they have 
to do that like check the door or check the stove   and and that helps them feel a little 
bit calmer for a short period of time so let's talk a little bit about how common 
are mental illnesses or mood disorders   according to the cdc and the surgeon general about 
20 of the us struggles with a mental illness in   any given year and this is true for adults and 
children that think twenty percent doesn't sound   too bad but when you think of it in terms of 
numbers that means one in five people so look   around your office look around your church look 
around your own household if you've got more than   five people in the household there's a chance that 
one of those people may experience mental illness   in this 12-month period that's a lot and that 
doesn't mean 20 percent of the population   over here will ever experience it that means in 
one year so those 20 may experience it in 2017   and then you know five percent of them get better 
and then another five percent experience it in   2018.

So a lot of people are going to be touched 
by mental illness at some point in their life in   1996 over a hundred billion dollars was spent 
as a direct cost of mental illness in the u.s   now direct cost relates to hospitalizations uh 
medical treatment those sorts of things indirect   costs are costs such as you know employers who 
lost productivity from employees it's estimated   that greater than 45 percent of people will 
experience an addiction in their lifetime now   i'm not necessarily talking to drugs or alcohol 
you know it can be sex addiction it can be   smoking it can be food issues or it can be alcohol 
or drugs there are a lot of different addiction or   addictive behaviors out there but it's estimated 
that nearly half of people will experience one   in their lifetime so we need to be aware of 
that because it doesn't matter what kind it is   it negatively impacts the person's life that 
by definition for it to be an addiction it   has to negatively impact the person 
in two or more areas of their life   so well that sounds kind of all depressing what 
do we know well we know that there are risk and   protective factors and those factors can be in 
the individual they can be in the person's biology   or they can be in the psychosocial realm 
which kind of encompasses their environment   their friends and all that other stuff well that's 
great so there's all these risk and protective   factors so why don't we know what causes it well 
because we've never been able to find a one-to-one   causation where we can say if this happens 
then this person is definitely going to   develop an addiction or become depressed 
we have a lot of information out there   and we're going to talk about these risk 
and protective factors in a few minutes   but it's important to recognize that correlation 
means you know it's more likely if the person has   you know certain genetic characteristics like a 
family history of depression and they're exposed   to trauma when they're a child then they have a 
stronger chance of developing depression or ptsd   it doesn't mean it can it will happen 
there is you know a lot of variation there   so causation we don't know 
correlation we're quite sure of causes of health and disease are 
generally viewed as a product   of the interplay or interaction between biological 
psychological and socio-cultural factors   according to the biopsychosocial model one factor 
by itself may not weigh in very heavily but the   combination of factors are exponentially additive 
which means you may have a genetic predisposition   but if you've got a great environment when you're 
growing up and you've got good self-esteem and you   take care of yourself that genetic predisposition 
may not ever show itself but if you have a genetic   predisposition an unhealthy environment and 
you know you have low self-esteem for example   all of those things together may add up to 
finally cause that problem to express itself mental disorders arise in part from defects 
not in single genes but multiple genes so   they found a lot of physical problems that have 
occurred as a result in defects in a single gene   so they can look on the on the dna and they 
can go that one you know that's a problem   mental disorders we haven't found a causation 
we haven't found a gene that we can say   if the person has this gene they're going to get 
develop depression we've also haven't found a   correlation a strong correlation where we can 
say if they have that one gene then there's a   strong chance they'll develop depression there 
are multiple genes that have to be interacting mental illness appears to result from the 
interaction of those multiple genes that   confer risk so a person may have genes to have a 
more irritable or fussy temperament as a child in   addition to a genetic predisposition or a genetic 
inheritance of certain genes related to depression   so there's a lot of stuff that goes in there 
one thing that's good to know is that no gene   is equivalent to fate for mental illness so 
we're not going to look at the dna and go   you're definitely going to develop schizophrenia 
or you're definitely going to develop depression   we can't say that there are modifiable 
environmental risk factors which can become   targets for prevention efforts and we're 
going to talk about those in a couple slides   even with a high level of heritability such as 
schizophrenia it's essential to point out that   environmental factors such as environment 
nutrition and health care access play a   significant role in the severity and course of 
the disorder again not everybody who inherits a   gene for a mental health disorder like 
schizophrenia that does tend to have   high heritability will necessarily develop 
it if they have a really good environment   infectious agents can penetrate into the brain 
where they can cause mental disorders so this   is one of those risk factors that is generally 
modifiable we do want to protect ourselves from   as many viruses and infection infectious agents 
as possible some examples include hiv-associated   dementia which happens because the immune cells 
in hiv get you know messed up and they're called   macrophages and they indirectly call cause the 
death of nearby neurons because they release   toxins as they're trying to destroy you know 
the virus and other things so you know it's   kind of the the byproduct kind of like the gas 
or not the gas but the um what am i thinking of   the exhaust that comes out of our car the 
byproduct is what's killing these nearby neurons   herpes simplex encephalitis sometimes when 
people get herpes it can migrate to their   brain and cause their brain to swell measles and 
encephalitis can cause the brain to swell rabies   encephalitis you know all of these obviously 
are penetrating into the brain and causing   physic physiological disruption 
in the neurons in the brain   and there's also a new classification of obsessive 
compulsive disorder called pandas or pediatric   autoimmune neuropsychiatric disorders associated 
with streptococcal infection which basically means   the kid got strep and the strep went to the brain 
the strep infection somehow manages to attack   a part of the brain called the basal ganglia which 
results in ocd or obsessive-compulsive disorder   symptoms so what can we do and i said we're going 
to talk about risk factors but i changed my mind   and we're going to talk about protective factors 
adequate prenatal care let's make sure when the   fetus is in there it's getting everything 
it needs and it's not exposed to things like   alcohol drugs or viruses including 
toxoplasmosis that can potentially cause   brain injury adequate medical medical care once 
the child is out of the womb we need to make sure   that they are not exposed to those viruses and 
if they have a head injury they get treatment etc   and this is true for adults too you know any of a 
lot of these things can happen when you're adults   herpes simplex encephalitis or hiv-associated 
dementia you know we can get herpes we can   get hiv or if you're not vaccinated even measles 
when you are older and it can cause brain damage   and poor hygiene and health practices you know 
wash your hands so you're not getting those   potential harmful agents in your body get enough 
sleep and eat enough good good nutritious foods   so your brain can do its job we 
need to keep the brain healthy   and those are the ways to protect 
yourself biologically psychosocial   protective factors now i'm going to start out 
with young children because they're unique young children need attachments to responsive 
caregivers so it's really important that they   have a caregiver or several caregivers that are 
responsive and comforting and all that kind of   stuff that goes a long way to the development 
of trust and self-esteem and self-efficacy   you can learn more about that in 
our videos on child development   and they need to have consistency in rules and 
parental supervision so they need to understand   the environment and under feel like they've got 
some control in what's going on now for all people   from infants through elderly we need a safe 
nurturing somewhat stimulating environment   safe from physical harm say from emotional harm 
it needs to be nurturing so we have friends we   have family we have people that care about us 
and stimulating enough to kind of keep our brain   working because if you don't use it you lose 
it and they've done a lot of studies that have   found in the elderly population those people who 
stay more cognitively engaged and more physically   engaged tend to have fewer signs of dementia and 
cognitive decline we want to protect everybody   from abuse and neglect not only does that hurt 
self-esteem and mood and produce a lot of anxiety   and stress but it can cause physical damage to the 
brain we want to protect people from abandonment   and life stress now life stress happens but we do 
want to try to mitigate that as much as possible   and and protect them from feelings of abandonment 
so they always have hopefully somebody they can   rely on we want to protect people from being 
in a household with a member that has a mental   illness or substance use disorder when you're 
in a household with somebody with depression   it can be exhausting it can be depressing 
it can be frustrating it can be a lot of   unhappy type emotions so we do want to make sure 
that if you're living with somebody with mental   illness or substance use disorder you have support 
outside of the home and household conflict and   family dysfunction increases everybody's stress so 
we do want to make sure that we're addressing that   we want to make sure people have consistent 
support positive peer relationships   school and work success and some sort of 
a sense of control over their environment for individuals we want to look at you know 
what things may contribute well you can't really   contribute control whether you were a full term 
or a premature birth that that just happened but   that is one of those individual characteristics 
if a child is born premature you know all of the   stuff didn't finish linking up before they were 
born and the more premature they are the more   likely they are to have difficulties which can 
lead to developmental delays so it's important   that this person receives early intervention 
for developmental delays which may be genetic   um because of down syndrome or something else 
or illness related children who have lots   of ear infections often have developmental 
delays which can cause them to struggle in   school and in peer relationships and it's been 
linked to increases in depression and anxiety   and prematurity is also in there it's not really 
an illness or genetic but we do want to make sure   that early intervention is available physical 
disabilities people need early intervention and   you know children can be born with them but 
they can also be acquired at any stage in   your life and when people lose the ability 
to function in some way if they lose their   sight or lose the use of an arm or whatever 
it is it has a significant impact on their sense of of self it also results in a period of 
grieving and some anger and and some other stuff   that we need to help people work through or people 
need to work through it but it's important that   people recognize if i develop a disability or if 
my child is born with a disability you know we're   gonna have to figure out how that person can 
learn to accept and embrace that disability as   you know being differently abled comorbid mental 
health issues we want to look for them sometimes   a child may be born with you know mental health 
issues and start showing signs of depression or   anxiety or ocd or adhd at a very young age it's 
not super common but the earlier we catch it the   earlier we can provide intervention and prevent it 
from having a ripple effect on their development temperament you know everybody has different 
preferences for the types of environment they   like to be in if people are aware of their 
temperament then they can put themselves   in environments that are in line with what they 
prefer for example you know extroverts tend to be   like like to be around a lot of people they draw 
energy from other people whereas introverts don't   and my daughter is an introvert and we'll go to 
martial arts or she'll go to a picnic or something   and she'll come home and she's like okay two hours 
of extroverting was plenty for me today and she   will just want to go to a room and draw or you 
know sit on the couch and veg for a little while   because it's draining for her but she recognizes 
that so if she has to go into a situation that   adds a little bit of stress she recognizes it 
and then takes care of herself before and after   so knowing your temperament doesn't mean you 
can always be in your preferred environment   but it means you know what's going to be stressful 
so you can save up energy leading into it and   you can take care of yourself afterwards which 
helps prevent exhaustion frustration depression   anxiety a high self-esteem is great because it 
means you feel good you're not relying on somebody   else to tell you you're okay so developing a 
high self-esteem in children is awesome but if it   didn't happen when you were a kid no harm no fat 
well a little bit of harm but it's not irreparable   people can develop their self-esteem as adults 
and getting adequate nutrition and sleep again so   the body can do what it needs to do those are all 
things the individual can do to protect themselves so mental health is largely impacted 
by the functioning of the brain   and the learning experiences of the person 
so remember i referred to the roller coaster   you know i look at a roller coaster and i'm 
terrified somebody else looks at a roller coaster   they think wow that's really awesome i'd love to 
do that i look at a dog running towards me barking   and i'm like oh sweet puppy somebody else may 
look at a dog running towards them barking and   carrying on and be like that dog's going to eat me 
so it's all based on our learning experiences that   we process and then our brain figures out 
how we're supposed to respond either with   a calm response or a stress response damage to 
the brain itself or problems in neurotransmitter   functioning can lead to mental illness 
if certain parts of the brain get damaged   irreparably especially large 
parts not just a single neuron   people can experience more apathy 
depression anxiety or impulse control issues   biological protection includes proper prenatal 
care and avoidance of viruses and substances   which can harm the fetus or your own brain 
harm your brain such as hiv or hepatitis or um   herpes psychosocial protection includes ensuring a 
safe supportive environment and the development of   healthy coping skills this can happen at any 
age we all need a safe supportive environment   and you know most of us could use a little 
help with our coping skills once in a while   because life will sometimes throw us more than 
we can handle and that's when we grow individual   protection includes good health behaviors 
development of self-esteem and this is an   ongoing process we should even as adults 
we should be working on ensuring that we're   developing our self-esteem and we feel good 
about ourselves understanding one's temperament   and needs and receiving early intervention for 
any traumas developmental delays or disabilities   so again early intervention doesn't necessarily 
just mean childhood it can be you know if there   was a trauma you were in a car accident 
and you know it was a traumatic experience   getting early intervention for that can be 
vital to preventing the development of ptsd   does it mean that everybody who experiences 
a trauma has to go to counseling no   it's important for that person to check in and say 
what resources do i have what do i need and can i   manage this on my on my own but they provide early 
intervention for themselves and if they realize   they need more help than they've got available 
personally then they can reach out for counseling other videos that relate to this are on 
youtube remember i said you go to all   youtube and i have three different 
playlists one's on self-esteem development   one's on child development and 
one's on infant toddler development   and all of those can be useful we also have 
videos on depression and ptsd and other things   if you're interested all right well thank you for 
joining me today and i will see you on thursday



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