Bipolar Awareness ~ Stop the Stigma (@stopthestigma.bsky.social)

Why Your Treatment Isn’t Working: The 3 Questions Your Brain Needs Answered This video explains why prediction is the missing link in mental health recovery and how three specific questions can transform the way we use medication and therapy. In this episode, consultant psychiatrist Dr Sanil Rege (MBBS, MRCPsych, FRANZCP) breaks down why so many people feel “stuck” despite trying multiple antidepressants, therapies, and programs — and how a simple, neuroscience-based shift can restart progress. Instead of asking only “Do you feel better?”, Dr Rege shows why the brain needs clear predictions of what “better” actually looks like in day-to-day life before it can change. You’ll learn three core questions that anchor treatment, reduce “trial and error,” and turn vague goals into measurable movement. #mentalhealth #depression #anxiety #psychiatry #psychology #neuroscience #DrRege #therapy #antidepressants #recovery #emotionalhealth #braintraining #selfunderstanding #prediction 🧠 ⏱️ Chapters 00:00 – The 3 questions that change everything 01:42 – Why so many treatments “don’t work”: the missing anchor 02:31 – The brain as a prediction machine (and why vague goals fail) 03:29 – Question 1: What does improvement look like? 04:14 – Question 2: What does feeling better look like? 05:00– Question 3: Do you know what you need in each emotion? 07:52 – Rethinking medication trials using clear predictions 10:43 – Your brain wasn’t built for happiness – it was built for movement 🔍 What this video covers •Why non-response is often misunderstood – it’s not always the wrong medication or therapist, but a missing treatment anchor •How the brain as a prediction machine uses expectations, feedback, and safety to drive change •The 3 key questions: 1.What does improvement look like? – concrete, functional predictions, not perfection 2.What does feeling better look like? – specific snapshots, not vague “better” 3.Do you know what you need when you feel each emotion? – linking sadness, anger, fear to needs and actions •Emotions as signals of unmet needs (comfort, fairness, safety, being heard) and how clearly naming needs changes behaviour and relationships •How repeated, predictable validation and safety are internalised in the brain, calming the amygdala and strengthening prefrontal regulation •A practical way to review antidepressants and other meds using defined targets (e.g. getting out of bed earlier, fewer morning ruminations) instead of yes/no “it worked” •Why routines, pacing, and structure are “nutrients of neuroadaptation,” not just lifestyle advice •The shift from “Am I happy?” to “Where am I moving?” – using cognition as the map and emotion as the engine for movement in recovery 🧠 For clinicians -A simple framework to structure reviews beyond symptom checklists -Make medication trials less random by tying them to clear functional goals -Phrases to explore needs, emotions, and predictability in-session -Use prediction + safety + neuroadaptation without overcomplicating consults 🤝 For patients, families, and carers -Turn “I want to feel better” into concrete, realistic targets -Everyday examples of what “better” looks like (sleep, work, connection) -Spot what you need when you feel sad, angry, anxious or afraid — and say it clearly -Use routines, pacing and consistent support to make treatment feel safer and more effective 👉 Resource: 3-hour masterclass at Academy.psychscene.com: https://www.academy.psychscene.com/courses/diagnostic-formulation-in-psychiatry/ Relevant Resources: PACES Model: https://youtu.be/o-B4pnQwc_s?si=KNysGTl9wG9SXIvK 👉Psychiatry Training: https://www.academy.psychscene.com 🎓RESOURCES BY PSYCH SCENE: 🌐The Academy by Psych Scene: PSYCHIATRY EDUCATION REDEFINED https://academy.psychscene.com/ Revolutionary psychiatry learning. 🌐Psych Scene Hub: PSYCHIATRY TEXTBOOK OF THE FUTURE https://psychscenehub.com/ The Hub is devoted to making you a better mental health professional. 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Follow Sanil Rege on LinkedIn: https://www.linkedin.com/in/sanilrege https://www.youtube.com/watch?v=Vi9Opuvwk4s