I appreciate you! Thank you so much.

Chiming in to say I’m curious to know what you did, if you have the time to give any input :)

Hi Dr Lee! Do you have an opinion on the effectiveness of DBT therapy? Are there certain types of therapies you recommend to lower stress levels, or in general?

I love that you have this wonderful insight into an unhelpful pattern and are talking about it (sometimes it can take years for people to spot this or to even acknowledge unhelpful patterns)! What you are describing sounds like rumination to me - playing the same scenario over & over in your head, perhaps sometimes thinking about the many ways that they're "wrong", and the many more ways things can still go wrong going forward - quite maddening, isn't it?

Sometimes when we are ruminating (one of my patients called it "spinning" when she caught herself doing it) - we may generate thoughts that we later realize don't make a lot of sense. Can you write down some of those thoughts and "check" them later? Over time, you may catch yourself falling into rumination again, but you may become more skillful about reminding yourself that the thoughts you have during these moments tend to be inaccurate and unproductive, and you may feel more capable of / motivated to end the rumination. Is there something that can help "yank" you out of a ruminative state? For some people, it may mean doing something very different at the moment - dunking your face in icy water, going outside for a run (or running up & down a staircase), writing a post-it note that you can look at when you fall into rumination, listening to upbeat music, or talking to a supportive person. Sending good thoughts your way!

Have you gotten any threatening emails/texts/calls from students you taught/mentored and how was it handled? I ask because a recent news report at U of A showed a disturbing amount of negligence on the part of the dean when it was brought to their attention. All the warning signs were ignored before a shooting.

Do people with pets live longer?

Thanks for the AMA, Dr Lee! I got cancer at 29, and I genuinely believe that it’s in part due to childhood trauma, chronic stress, decades of suicidal tendencies, and the straw that broke the camel’s back is the 6 months before I got sick, I was stuck in a very unsafe environment and I had never been more stressed out.

What significant or surprising facts / hypotheses do you believe in that would surprise people about the correlation between adverse childhood experiences and developing serious, potentially fatal conditions?

Hi Dr. Lee, what would you do to change the DSM and ensure better trauma/developmentally informed practices be adopted across medical, social work, educational, and first responder fields if you could get the ideal outcome?

Thank you for bringing attention to this important issue! I think it is important for people, especially those dealing with the aftermath of traumatic events, to understand the concept of self-medicating behaviors. Self-medicating behaviors often arise because people are dealing with distress so intense that they need an "out" - getting drunk, abusing drugs, over-eating, over-exercising, self-harm, and other behaviors done in an excessive manner (e.g., excessive spending) . These behaviors are often drastic means to bring relief from the severe distress we are experiencing at the moment - because being drunk, having blacked out, or being pre-occupied with something else that is intense (physical pain, the 'high' from spending money or eating food) - helps to numb or distract us from distress. The costs of self-medicating behaviors are high, as one can imagine.

Because self-medicating behaviors are often used as a means to cope with a difficult event and/or PTSD, my suggestion is to seek treatment for dealing with the difficult event and/or PTSD. There are a number of treatments with strong scientific backing (such as cognitive processing therapy, prolonged exposure, and written exposure therapy, as well as pharmacological treatment) so I strongly encourage people dealing with this (or thinking they may be self-medicating) to consult with health professionals. Thank you for bringing to light this important phenomenon.

opinion on cptsd as a diagnosis?

How do you respond to people who believe pessimism is actually seeing reality and optimism is either choosing to ignore reality or (more crudely) a symptom of stupidity?

Symptoms of mental-illness quickly become causes of increased mental-illness.

An enthusiastic hello from Belgium!

I'm a psychiatrist working with neurodiverse youths. I'm wondering if having adhd and autism, which in itself is associated with higher levels of stress, are to you knowledge also associated with a different/compromised form of aging?

Thank you for your time!

I have palmar-plantar hyperhidrosis and it is a stress response. Have you done any work with people who have a physical stress response(like sweating) and learned to minimize it with stress reduction techniques? I’ve considered trying meditation, because even though I can’t control my sweat glands, I have a few tricks for distracting myself when I feel my pores start to open that do actually stop the sweating from beginning sometimes, not always. That leads me to believe a higher degree of control could be attained with dedicated practice.

Edit to add: I was in a chaotic abusive household on and off from the time I was born until age 17. I’m pretty sure this happened because of things I witnessed before I was old enough to form long term memories. Onset was around age 8 or so I believe.

https://www.reddit.com/r/IAmA/comments/yd7qp6/i_am_the_coauthor_behind_acms_techbrief_on/ittyuja/

https://www.infona.pl/resource/bwmeta1.element.springer-147a2312-2fe6-3a08-9954-a904e950f9bb

> Instead of adding additional circuitry to the target design, we insert our hardware Trojans by changing the dopant polarity of existing transistors. Since the modified circuit appears legitimate on all wiring layers (including all metal and polysilicon), our family of Trojans is resistant to most detection techniques, including fine-grain optical inspection and checking against “golden chips”.

Hi Dr. Lee, thanks for AMA. Most of Action video games are putting human body into stress situation, but that is also what makes them fun. How does those games affect our health? It is good or bad? Are strategy games or other are better?

Can you learn to modify this startle response, or rather what comes after it? For example, if someone has a history of trauma related to yelling or sudden loud noises, can they learn (and is it physiologically possible?) to not become panicked and have the increased heart rate that come with the startle response, regardless of trauma?

I'm a child welfare lawyer who represents adults and children in families in crisis in Texas. Are there any good resources for finding experts who can consult, testify, or treat remotely? Texas resources are tapped out and overwhelmed.

Hi Dr Lee, could you discuss the impact of minoritized stress and the impact on folks? I’m particularly curious if there have been studies looking at the physiological impact of minoritized stress and where it overlaps between established DSM diagnoses?

[removed]

Thank you for this question. It must be challenging but also meaningful to be in veterinary medicine with PTSD. I'm impressed that you are keenly aware of the role of stress in your health and to do something about it. There are many ways in which stress -- experiencing stressors as well as our responses to them -- can affect our aging process, and it is probably not an understatement to say that stress response engages all of our bodily systems. PTSD is a precursor to age-related health conditions (e.g., cardiovascular disease, diabetes) , is associated with accelerated biological aging, and highly comorbid with other psychiatric conditions. You mentioned being triggered often in your day-to-day work and acknowledged your career as high-risk -- do these triggering situations involve experiencing flashbacks or intrusive thoughts about your trauma? what is the impact of your job on your mood, thinking, ability to have meaningful relationships, and ability to accomplish goals that are important to you? I wonder what the cost-benefit calculus is for pursuing this line of work, and whether there are ways to have the same or similar benefits without such costs?

Researchers are just beginning to understand the behavioral pathways linking PTSD to age-related diseases. Are you taking time to allow your body to rest and recuperate from stressors - good quality sleep, physical activity, and doing activities that allow your physiological systems to take a break from being triggered (e.g., progressive muscle relaxation, diaphragmatic breathing, yoga)? Are you nourishing yourself with a healthy diet, avoiding toxic exposures (e.g., cigarette smoking), and spending time in nature? Are your needs for connection and intimacy met?

Hi Dr Lee!

What is your view on dealing with the grim reality of climate change?

To elaborate, some would argue that developing emotionally positive mindsets might help finding solutions to mitigate the challenges. While others argue that we need to feel strong negative emotions to depress humanity into "doing less" - i.e. lower out activity and thus emissions.

Thanks for this and the note about causality limitations. Could you expand on how big these effects are? With a large sample a statistically significant effect may not be significant in terms of living life. Would be interesting to know!

Thank you for doing this Dr. Lee. My question revolves around how I can be more involved within the research world of PTSD. I am currently an outpatient mental health provider and about 40% of my clients have a PTSD dx. I work exclusively with veterans and mainly do CPT to treat PTSD. I eventually want to be trained in WET and CBCT but my dream is to be more involved in PTSD research. ATM I just need to take my LISW but am wondering...would I need to pursue my doctorate in order to work in research? Also, is the VA currently doing any research with MDMA assisted therapy for PTSd or work with psychedelics? Thank your for your time!

1.Top 3 nonfiction (more like factual) books related to health/nutrition/mental health you have read so far?

2. Most favourite research that was conducted?

Edit: Thanks 🤗 in advance.