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HealthyGamerGG

Why It's Getting Harder To Treat Existential Depression

04 Oct 2025

Transcription

Full Episode

0.723 - 19.76 Dr. Alok 'Dr. K' Kanojia

Hey, y'all, just a reminder that in addition to these awesome videos, we have a ton of tools and resources to help you grow and overcome the challenges that you face. We've got things like Dr. K's Guide to Mental Health, personalized coaching programs, and things like free community events and other sorts of tools to help you no matter where you are on your mental health journey.

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19.78 - 44.865 Dr. Alok 'Dr. K' Kanojia

So check out the link in the description below and back to the video. Hey chat, welcome to the Healthy Gamer GG podcast. I'm Dr. Alok Kanodja, but you can call me Dr. K. I'm a psychiatrist, gamer, and co-founder of Healthy Gamer. On this podcast, we explore mental health and life in the digital age, breaking down big ideas to help you better understand yourself and the world around you.

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45.206 - 70.048 Dr. Alok 'Dr. K' Kanojia

So let's dive right in. So this is becoming a huge problem because we're seeing an increase in the rates of diagnosis of things like mood disorders, like major depressive disorder. But we're also seeing a spike in symptom severity. So not only are more people depressed than they've ever been that we're aware of, but the severity of depression seems to be on the rise.

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70.028 - 91.572 Dr. Alok 'Dr. K' Kanojia

The bigger problem, though, is that our treatments for depression don't appear to be working. And that's what today's video is about. Understanding that not all kinds of depression are the same. And furthermore, we're going to dive into this concept of existential depression, which is really, really scary in a lot of ways because it doesn't fit the mold of what we think of as depression.

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92.132 - 110.785 Dr. Alok 'Dr. K' Kanojia

So let's start by like understanding a couple of evolutions recently that we've discovered in psychiatry. So a lot of people think that depression is caused by a chemical imbalance of serotonin. And if we improve someone's serotonin transmission by giving people antidepressants, it'll work great, right? So we'll basically be able to treat it.

111.286 - 133.761 Dr. Alok 'Dr. K' Kanojia

But there was a really interesting paper that came out in 2022 that basically found that The main areas of serotonin research provide no consistent evidence of there being an association between serotonin and depression and no support for the hypothesis that depression is caused by lower serotonin activity or concentrations. OK, so this is still somewhat up for debate.

133.881 - 147.157 Dr. Alok 'Dr. K' Kanojia

I think that a lot of treatments involving serotonin do help people with depression. But I think that this idea that there's like depression is caused by just a chemical imbalance, that if we correct the chemical imbalance, everything will be fine. That's not entirely true.

147.237 - 169.125 Dr. Alok 'Dr. K' Kanojia

So in my experience as a psychiatrist, about one third of patients who are depressed will benefit substantially from an antidepressant medication. The problem is that for those other two thirds of people, it won't help very much because the origin of their depression is a little bit different. And this is where we're going to dive into existential depression.

169.146 - 183.617 Dr. Alok 'Dr. K' Kanojia

So this is what I want you all to think about. There are two reasons that you could be depressed. One is that your life is pretty good, okay? But you have a cognitive distortion or you have something like a chemical imbalance, okay?

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