#966 - Dr Scott Eilers - Why Does Life Sometimes Feel Emotionally Numb?

Overview

This episode dives deep into the complexities of depression, exploring its emotional, neurological, and social dimensions. Dr. Scott Eilers shares his professional expertise and personal experiences to unpack what depression truly feels like, why it can be so difficult to treat, and practical strategies for managing it. The conversation also touches on the relationship between intelligence and depression, the risks of excessive self-awareness, and the importance of building a life that supports mental health.

Notable Quotes

- Depression feels like working for no paycheck. You’re told to keep going, but there’s no reward waiting for you. – Dr. Scott Eilers, on the emotional numbness of depression.

- If you want to live like nobody else, you have to live like nobody else. – Dr. Scott Eilers, on the need for tailored mental health strategies.

- You can either try to do things that feel good, or you can try to do things that make it feel good to be you. – Dr. Scott Eilers, on the difference between fleeting pleasure and sustainable well-being.

🌀 Understanding Depression

- Depression often manifests as numbness or emptiness rather than sadness. A key symptom is anhedonia, the inability to feel joy or reward.

- Dr. Eilers compares depression to losing leverage in life: the effort you put in no longer yields emotional returns.

- Persistent depressive disorder (PDD) differs from episodic depression by being a constant, low-grade state of depression, akin to a personality trait.

🧠 The Science and Challenges of Mental Health Treatment

- Despite advances, mental health treatments like therapy and medication only help about 50-60% of people, often providing partial relief.

- Dr. Eilers criticizes the term treatment-resistant, arguing it unfairly shifts blame to patients rather than addressing systemic gaps in care.

- There’s a lack of reliable biomarkers for depression, making it harder to diagnose and treat compared to physical illnesses.

💡 Practical Strategies for Coping with Depression

Dr. Eilers outlines five actionable strategies for managing anhedonia and emotional numbness:

- Investments: Engage in activities even if they don’t feel rewarding in the moment; they may bring joy later.

- Checking the Lock: Do one small thing daily that could theoretically spark joy to test if the emotional lock has lifted.

- Stacking: Combine achievement-based activities with pleasurable ones to surpass the raised threshold for joy.

- Loopholes: Identify specific activities or stimuli that still bring some joy, even if most don’t.

- Apathy-ception: Accept that you can act without feeling motivated, reframing reward as optional.

🧩 Intelligence, Self-Awareness, and Depression

- High IQ and emotional intelligence (EQ) are paradoxically risk factors for depression. Greater awareness of life’s complexities and quicker pattern recognition can lead to overthinking and rumination.

- Excessive self-awareness can become counterproductive, leading to paralysis by analysis. Dr. Eilers likens this to the Yerkes-Dodson law, where too much stress or focus diminishes performance.

🌞 Building a Foundation for Mental Health

- Dr. Eilers emphasizes the importance of addressing biological needs (sleep, nutrition, exercise) before tackling psychological and social factors.

- He advocates for a proactive approach to mental health, treating it as a primary focus rather than a secondary concern.

- Inversion thinking can help: identify behaviors that would worsen your mental health and do the opposite.