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One Road Out of Depression (thinkfaster.co)
252 points by wayofthesamurai on Nov 8, 2016 | hide | past | favorite | 156 comments


I experienced some depression, as a teenager, and remember eventually finding a kind of 'logical' (or perhaps 'philosophical') way out of it.

A key part of this was that, for me, depression is linked to lack of purpose. So there was this question hanging over me, 'what is the purpose of it all'. Well the answer to that question was then essentially 'why are you asking?'.

Putting it less glibly, if you are unhappy about your life, and need some purpose, then introspection about your unhappiness (exactly what are you unhappy about?) can be a way to find for yourself a kind of implied purpose.

And then, another part of it was the realisation that depression can actually make you more powerful, in some ways. To explain this a bit more, if you find yourself in a state where you are not so much able to be motivated by simple desires, then you are also not constrained by them. So, you are able to do do/achieve things that you might not normally be able to do, because you would get bored, for example, or be distracted by the need to do things that make you happy.

And I kind of liked the idea, and aesthetic, of 'just getting your head down and moving stolidly forward'. And, 'if you can't find something to do that will make you happy or interested, maybe you are then free to do something that is right'.


I just want to add a cautionary note, which is that sometimes introspection isn't the solution, but the problem itself. Especially in the case of a combination of depression and anxiety, it may be that introspection drops you further down the rabbit hole, when the way out is to do not think.


Obviously this is a complex issue, but in general I've found introspective people are the saddest. People that live in the moment are often the happiest.

http://www.smbc-comics.com/?id=3501


Fair point.

But on the other hand, not exploring the root cause of a problem can be like papering over the cracks..


Also a fair point.

But exploring the root cause can be dangerous when the tool you use to do this is the source of the problem.

This is part of the reason why outside help (professional or otherwise) can be crucial to finding a solution. If your own brain is the source of problems, it makes sense to find something outside yourself to seek a solution.


I think you're right that this sort of approach to bootstrapping purpose is the only one that could possibly work. But once every 5 or so years I remember and become fixated again on the fact that there's nothing underneath.

And the results aren't good.

If I could figure out how to skip that quinquennial crisis, then things would be a lot better.


Bootstrapping is a great way to describe this.

But once every 5 or so years I remember and become fixated again on the fact that there's nothing underneath.

And the results aren't good.

So the idea is that two sentiments you express there contradict each other, in some sense.

i.e. If there really was 'nothing underneath', then the results would be, well, irrelevant.

And, then if you start from the second bit, the fact that you have a fairly strong feeling that a certain situation is not good (by the sounds of it) and therefore (by implication) believe that there is a certain way that things should be, is what 'goes underneath'.


So, what you are saying is that true question that is/was bugging you is "what is the purpose that justifies my suffering?". And then you can get out of that existential dread either by finding a purpose, or by tackling the suffering, one way or another.

Is that about right?


Not exactly. The interesting question was really just "what is the purpose", full stop. In the sense of "what is the point of it all".

The point about the introspection bit is then that being unhappy, suffering from depression, and so on, can (philosophically) be taken to imply a purpose, even if you do not otherwise feel a desire or direct motivation that would get you out of that mental state.

(Justification is irrelevant, I think. It is only about how things are, and what you choose to do. But that is maybe just one philosophical viewpoint.)


When I got Depressed (capital D, though I was only 4 on a 10 point scale) the hardest part for me was accepting that I needed to take medication, that I couldn't WILL myself better (not for want of trying I can tell you).

Maybe some people can think themselves better, but if you are properly depressed, and your doctor is suggesting medication, it's not failing/losing/lessening to take the drugs to correct a chemical imbalance. And stay on them until you're supposed to come off (not when you begin to feel better), as the last thing you want is to ping-pong between highs & lows.

Of course, fix the underlying issue (if there is one) when you can (i.e. see a psychologist and get proper instruction), but you want to get to a stable place first.

This is just my comment, a sample size of 1, but if it helps anyone else reading through this, so much the better.


> that I couldn't WILL myself better (not for want of trying I can tell you).

Trying to will myself better didn't work for me either. But medication made things so much worse. I was emotionally numb for a decade because I bought into the thinking that the medication was helping. It allowed me to get back to work, but I lost 10 years in the prime of my life that I'll never get back. Ironically, having so many regrets for those 10 years clued me into the damaging thought patterns that were causing my depression. My mind was spending too much time thinking about the past and visualizing the future.

A conscious emphasis on being present and living in the moment has done wonders for me. And I only mention this because your comment felt like willing yourself better was the only way to think your way out of depression, which is absolutely not the case. Sometimes perspective matters more than determination.


Just for the sake of a contrasting story here: refusing to take medication for almost a decade ended up almost totally destroying my life. I came dangerously close to suicide. Thankfully I'm finally back on medication now and am slowly rebuilding. I've seen the same thing happen to several friends.

I don't mean to invalidate curun1r's experience, but I do want to make sure that people will not read a post like that and conclude, as I once wrongly did, that they are better off without medication. A bad early experience with a psychiatrist who prescribed the wrong medication for me resulted in this same experience of emotional numbness, and quitting my medication to avoid that was exactly what led me down an extremely dangerous path. It's the single decision I regret the most in my entire life.

For some people, medication really is the best chance of living something approaching a normal life. You may try medication and come to the same conclusion as curun1r, but please do not dismiss the idea out of hand, and if it isn't working well for you, try working with your psychiatrist to make things better, or maybe just getting a new psychiatrist altogether, before giving up.


Same here. I have found that my personality is far more malleable than folks expect -- habits, feelings, preferences.


What did the people who told you to take the medication tell you about the issue of feeling numb?


I used to take lithium and brought up to my doctor that it destroyed my creativity, which affected my job. His answer was, "Then the medication is doing its job."

Psychiatry has been a very unempathetic field in my experience (across 4-5 doctors), so a "deal with it" response would be unsurprising.


After I lost my dad, that's what the therapist I tried to see said: "Deal with it." At that point, I realized I was wasting my money. It took many more years, almost losing everything, and sheer fucking willpower to undo what the psychiatrists did with their meds. "Take your meds like a mindless cow," is psychiatry's attitude because they're making incredible profits off your sickness. And they get the patients to evangelize (see the top parent comment in this thread) and spread their nonsense while people are getting sick, dying, or at least wasting a whole lot of money on drugs that don't help them.

Unempathetic doesn't even begin to describe the profession. Anti-Hippocratic oath might be the place to start if you're looking for a way to describe this field. Profit driven would be even better.


I went through a period of a few years where my medication was definitely helping a lot with the depression, but at the same time I no motivation or desire to do anything (I remember a few times wishing I had the desire to sit down and watch a TV show; I couldn't even bring myself to sit on the couch and stare at the TV) and I really couldn't feel emotions other than sadness and anger. The medication wasn't at fault because if I wasn't taking it, life was just non-stop intense sadness and still no desire to do anything.

My doctors sucked ass, but at least when I told them about my lack of desire they tried a bunch of different things to try and help. Lithium actually seemed to work quite well for me the first time I was on it (the second time, it didn't seem to have an effect and I can't remember why I stopped taking it the first time). It was me that eventually suggested trying anti-psychotics and I eventually suggested the one that has worked wonders for my depression and complete apathy, but they generally were willing to try anything I thought might work better than my current treatments.

It really felt like the doctors (the clinic I was at went through so many doctors. I think I had 6 in about 4 years) were just prescription writing machines and I was the one in charge of my well-being. It was up to me to do research and find things that might help me out and it kind of makes sense because how much do you think your doctor thinks about you in a month? They probably only think about your situation for the duration of your appointment and maybe a few minutes before the appointment, so maybe 45 minutes each month (if you see the doctor monthly). On the other hand, I'm thinking about my situation almost non-stop. I'm desperate for relief so I was spending multiple hours a day, maybe hundreds of hours each month, researching how I can get better. So it's no wonder that it was me that eventually figured out what medication to try that eventually made me mostly better.


Any chance you could describe your workflow and some of the better resources for self-diagnosis?


Sorry, for the late reply. I didn't really have any workflow and I didn't self diagnose for depression, anxiety and narcolepsy (I did self-diagonose for hypothyroidism, I couldn't believe my doctor was denying it, but then I discovered online that this is a very common problem). I checked out the usual online resources. Wikipedia, Google search, crazymeds (no longer has forums), lots of Wikipedia, going over it again and again. The most useful information is what drugs are used for your condition off-label. Wikipedia might have that info, but it might not or just not be complete. Crazymeds would sometimes have more info. Sometimes you might only find out about an off-label use because some random internet stranger has tried it off-label. For their doctor it's one of those go-to backup meds if the more common ones fail, while your doctor is unaware it is even used off-label for that purpose. Another thing to look for is lists of medications of a certain type. Usually Wikipedia's list will be incomplete, crazymeds adds a few more and you discover even more through other sites via Google searches. And by checking the same sites over and over again I spotted completely new drugs that were listed hardly anywhere (one I tried was better than what I was on except for 2 months straight of watery diarrhea, the other I'm not really sure was better, but it was what I was taking prior to my current medication).

Out of all of the things I researched it ended up being atypical anti-psychotics, something I wanted to try because my mother had to be on them for a time. But we tried one drug, Abilify, (not the one that my mother was on), that I forgot why I stopped using, and then I found the other drug that I'm using now (Latuda) just from ads placed around the doctor's office. I looked the drug up online and I think looked at crazymeds to get more of a user's perspective and it sounded like the best atypical anti-psychotic with the best side-effect profile. So I suggested that and it worked out great. Then I was on an SNRI, Latuda, and Remeron (a tetracyclic anti-depressant I only used for insomnia caused by the SNRI) and I thought "this is a bit much", so with the agreement of my doctor I tried to get off of the Latuda, but after getting down to 20 mgs I felt bad for 3 or so days. So I went back to 40mgs and felt better almost immediately. This time I tried to get of the SNRI and I eventually did and still felt fine. And since I was off of the SNRI I didn't need Remeron to sleep anymore so I stopped that. Usually atypical anti-psychotics can be very powerful for depression as adjunct therapy along with an anti-depressant (Remeron + an AAP is colloquially called California Rocket Fuel). But I found it worked just great as monotherapy. So I didn't find what I'm on now through internet research, but I got the idea from my Mom's situation, the specific medication from ads that I further researched online (looking for technical information as well as anecdotal evidence and user experiences). Then I suggested cutting my medication down to where it is now.

I still don't have anything to treat anxiety, but I got a recommendation here on hacker news to maybe try Emsam and my doctor (who is way better than any of my previous doctors) had already mentioned trying an MAOI and Emsam is the only MAOI approved in the US that won't kill you if you eat cheese or other very common foods, so I was planning on trying that, but decided I didn't want to risk going down on the Latuda. Life has finally been good after a long time and I'd rather just deal with the anxiety than take a risk of feeling that bad again even for just a week or 2. Maybe I'll give it a try when work lightens up (probably never). There is one MAOI that is even better at not killing you for eating food and it's uses sound absolutely perfect for what I need, but it turns out to not be approved in the US. I have considered getting it online and self-medicating, but I don't feel that desperate right now. Maybe if I start to feel extremely panicked again I'll be motivated to self-medicate without doctor approval, but for now I'm finally okay.

Actually, I was talking to my sister-in-law and one of the drugs that their daughter takes is used for anxiety (Intuniv), but my doctor (after looking it up) said that that class of drugs helps anxiety more by helping with the secondary symptoms that are caused by anxiety rather than helping with anxiety itself (or something like that). And just last week I remembered that some anti-histamines are used for anxiety and so I'm going to mention that at my next appointment. I'm also going to see what users of Intuniv think of it, because if it worked for some people, then it's worth a try if I'm out of options and I hardly think it could make anything worse.


That the situation was better than when I was off the meds.

On the meds I was able to concentrate well enough to hold down a job. Concentration issues at work had been the primary reason I got treatment in the first place. And, like I said, I bought into that logic for a while. It was only once I realized that a full-blown meltdown would have been better than coasting through life with no enjoyment whatsoever that I felt comfortable discontinuing medication and trying to figure out another path.


I don't know what I was on the scale, but at some point the only thing keeping me aluve was the fear of inflicting a traumatic experience on my 8 years younger sister. Making an 8 year old discover her dead brother would be just a shitty thing to do.

The obly thing that finally helped, even after meds (I think) didn't do much, was a very solid "Fuck this, I don't want this anymore" and willing myself out of it by forcing myself to become a workoholic. It gave me interesting things to do and kept me distracted from the ultimate pointlessnes of it all.

Eventually the pointlessnes became my greatest asset. If nothing matters, then you can do anything right? Why give a shit about how a thing turns out, just try.

My psychiatrist at the time said that the meds gave me space to will myself out of it but who knows. I'm sure it went hand in hand.

On the other hand, it's been 13-ish years and too much leisure time still gets me sliding back towards a pit of despair. I'm probably not cured at all, just coping, and I'm likely to have to continue coping forever. Like a former drug addict or alcoholic.


In a way, I think your doctor was correct. The meds change the way you see life - supposedly - even if you didn't actually feel better. My unprofessional opinion is that LSD and other hallucinogens function about the same way - gets you out of your mindset enough so that your perspective is different when you get back in.


The meds[1] I had supposedly weren't made to change how you see life, but to numb your emotional response. You lose the ability to feel bad, but you also lose the ability to feel good. Debatable whether that's better or worse, really.

Fundamentally, I did have the meds and I did get better. Without a control, I can't say whether I got better because of the drugs, in spite of the drugs, or they had no effect. Considering they're approved meds, I can assume that statistically they work better than a placebo and do have a measurable effect. Whether they had causative effect my specific case is anyone's guess.

[1] https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_i...


In general, I'd be cautious recommending any type of medication, especially those involving serotonin, to others given how we as individuals react differently to them.

For example, the first time that I took SSRI's (a decade ago or so, recommended by my primary care physician), I had a negative reaction, and roughly a year of CBT was a much better solution (with a diagnosis of major depression). Fast forward to a few months ago, after being diagnosed yet again with major depression, this time by a psychiatrist, the SSRI's that were recommended and that I took triggered bipolar disorder--not an uncommon occurrence from what I now understand--and my current diagnosis.

All in all, it sounds like you may likely benefit from therapy (individual or group based) in addition to the meds that you're already taking (for what it's worth, it's helped me immensely).


Are there any "condensed" CBT resources you could recommend so I don't have to read this 600++ page book I've had sitting on the shelf beside me for 2 years?


I am in no way trying to be snarky here, but can I ask what is meant by the phrase, "Capital D Depressed"? I've also seen someone use "Capital A Architect". Does the meaning change by capitalizing a word that isn't usually? Is this something to do with making it into a proper noun?

Sorry that this is off-topic but it's something that's bugged me for a long time. I've never understood it and it's very hard to google for an answer.


Capital D depression implies they were diagnosed with major depressive disorder or are certain they meet the requirements and are aware of the difference between sadness and Depression.

If you see this elsewhere it is context specific. But for example there is a difference between those who draw suburban house plans and those who plan museums.


Yip, this is what I meant.


I am not a doctor, but I think if you have been clinically diagnosed as depressed, you can call yourself "Capital-D depressed" -- IMHO, obviously.


Who did you contact first about the issue? A regular doctor, a psychologist, or a psychiatrist?


I have it clinically as well. My experience went with Primary Care -> Psych Eval -> Psych Specialist. When you ask for the referral from your PC, I suggest requesting an office with a group of specialists that can bounce you to a better provider after your eval.


I used to replay the same negative thoughts as well. Here's how I broke free:

Reframe all your negative thoughts.

I used to obsess about past mistakes. Thought: "I wish I didn't do that." Reframe: "If I didn't do that, I wouldn't have learned that lesson to be the person I am today. Or in the position I am today."

Stop worrying about problems that haven't even materialized yet and very likely never will.

We waste tons of mental energy worrying about problems that never happen. If you don't believe me, make a list of all you worries about near future events. Wait a week and see how many of them actually happen. You'll find 99% didn't.

This one was the hardest to put into practice: be kind to yourself.

A lot of people believe that if you stop criticizing yourself, you won't learn. You won't improve. You'll become arrogant.

When you criticize yourself, you actually make it even harder to learn from your experiences / actions. Why? Because when we feel badly, we're not very productive about forming ideas on how to change and putting them into action. Instead, we seek distractions (sometimes really unhealthy ones) to try to make ourselves feel better.

When you do something that leads to a negative outcome for you, preventing that negative outcome from happening again is enough motivation to change in of itself. You don't need to make yourself feel bad to learn and change.


This is the basis of CBT (cognitive behavioural therapy). Rewrite the negative loops of thought with constructive ones.


And, further 'down' there's zen buddhism. I've had very good experiences with CBT, but as a fan of zen buddhism, on some level I couldn't help but wonder if CBT sometimes still emphasizes/reifies 'thoughts' a bit too much.

Perhaps CBT is effective precisely because it's a kind of middle-ground. It's hard to describe, but CBT sometimes felt like bug-fixing when perhaps refactoring the whole thing was in order.

But then again in my daily life I regularly face the difficulty of choosing between fixing bugs and rewriting the whole thing, and I haven't found an easy answer. Try one, and if it doesn't work try the other?


The "chemical imbalance" theory has been losing steam for quite some time.

The British Psychological Society has issued this consensus statement: There is actually no evidence for the current view – and we agree with many senior psychiatrists in saying that – we do have an overwhelming amount of evidence that even severe psychiatric breakdown is actually the end result of a complex mix of social and psychological circumstances. People who have suffered things like bereavement, loss, discrimination, poverty, trauma, abuse, domestic violence, in other words things that have happened to you.

From my experience, and many others, we have a script running in the background of our minds. Nonstop. This script is brutal, telling us we're worthless, unable to do this, will always be alone, etc etc. It gets etched in our mind and we become it, and likely impacts all aspects of our brain chemistry. (Depressed patients are often deficient in many key areas Omega 3, Magnesium, Vitamin B, etc)

https://www.scientificamerican.com/article/is-depression-jus...


One thing, please, for anyone on this board, or anyone who intends to advise anyone about whether or not they should take medications:

Unless you are a doctor, you have no advice to give. Unless you are a doctor and have examined a patient, you have no advice to give except to that patient.

I don't care what good or bad experience you personally had with medication; people respond differently, and it does not qualify you to give advice to anyone about any drug they are considering taking.


I respectfully disagree. I would agree that someone-that-isn't-your-doctor shouldn't tell people what they should do, but hearing the personal experiences of numerous people that have taken certain medications or had certain therapies is invaluable. This is quite different than "regular" diseases and maladies. The drugs and therapies for psychological diseases aren't well understood and are very hit-and-miss. Like you said people respond differently, so hearing the experiences of multiple people can be just as, or much more valuable than your doctor's recommendation which may be based solely on a datasheet they read and maybe tried on a few patients. You may hear experiences of drugs that your doctor has never prescribed before or has never even heard of before. It's not uncommon for a psychiatrist to have certain go-to medications that they use almost exclusively. If those don't work for you, then getting advice from other patients can be a lifesaver.

The medication that helped me the most by far was not recommended to me by my doctor. I recommended it. And I found the medication through an ad in the lobby of the doctor's office plus I was considering that class of medication based on the experience of my mother. People rail on prescription medication advertising, but I might not be alive today if not for that ad. And that ad could have easily been a recommendation by a handful of random internet strangers (in fact I would trust the internet strangers more because it's less likely they have an agenda whereas the ad definitely has an agenda).


"...but hearing the personal experiences of numerous people that have taken certain medications or had certain therapies is invaluable..."

...in roughly the same way that the personal experiences of numerous people of psychic phenomena, UFOs, and the supernatural are invaluable. Or personal experiences of the safety of commercial aviation. Or that the sky is blue.

Anecdotes aren't data, data isn't always applicable, other people are frequently more concerned with themselves than helping you, and your mileage will vary.


> of numerous people of psychic phenomena, UFOs, and the supernatural are invaluable.

No, not at all. How would that be valuable? If psychic phenomena, UFOs and the supernatural were definitely real things that could help your difficult to solve problems, just not well understood and could vary in effect from person to person then they would be valuable. But they are not any of those things.

> Anecdotes aren't data

They definitely are.

> data isn't always applicable

Oh, certainly. 5 internet peoples say Drug Q helped with craziness syndrome even though that's an off-label use doesn't mean it will totally definitely work for you. But if you've tried everything else, 5 anecdotal experiences is far better than the 0 anecdotal experiences and zero studies of the zero other options you have.

> other people are frequently more concerned with themselves than helping you

How is this at all relevant? Maybe because a doctor gets kickbacks for prescribing a drug and so prescribes that drug despite it not being likely to help much? But that's just a good reason not to rely solely on your doctor. Nobody is more concerned about you than you. Doctors can have ulterior motives and can be working with out of date information especially when it comes to off-label uses of drugs. Common off-label uses became common because of anecdotes. And sometimes those anecdotes spurred the company making the drug to get it approved for that use. This isn't at all like UFOs.

> your mileage will vary

I am well aware of that. But some people are getting mileage out of it and the worst that could happen is I get no mileage just like am getting now (not right now, but before I found the right meds).


Unless you are a professional author, you have no message to communicate. Unless you are an author and have interviewed your reader, you have no idea how he or she will personally react to the words you write.

/s


The "get up and fix yourself" theory lost all its wheels long ago, though.


No, no, no, I'm not advocating for that at all.

Rather, trying to be the slightest bit aware of what the sewage of thoughts in your head consists of.


> trying to be the slightest bit aware of what the sewage of thoughts in your head consists of.

That's a pretty useful thing for a "normal" person as a preventative measure to reduce the probability of depression (although there's tons of biological causes including things about gut biome, overstressed immune system, etc., and it's not clear if this 'awareness' would help in those cases).

But to a person in the middle of depression, that's like asking them to fire up a debugger and inspect the issue, when their very problem is that their OS barely boots up and refuses to run any program whatsoever.

The first paragraph about the 'preventative' aspect might be what you had in mind, with the second para's content implicit in it, but I feel it's important to make it explicit given how widely misunderstood an illness depression is.


How do they explain the genetic factors that cause predisposition?

Just as the humans who eat too much sugar can more easily get type 2 diabetes, some humans who are exposed to 'X' can get mental diseases. (X is unknown or it varies). What if some humans are just more 'evolved' to live in the modern world than others?

10-12,000 years of living within dense populations, under despots, with periodic plagues, and in near constant war probably applies a lot of evolutionary selection pressures. Some of us whose ancestors were assimilated later probably have more genes that haven't been 'weeded out'.

I've read some research that human brain size has decreased over the last 100,000 years. The theory is that as humans began to become less independent, they had less need for certain types of brain functions. Since the brain is an extremely resource intensive organ, less brain means less energy requirements. So, humans quickly lose areas of the brain that are less necessary.

There are correlations between intelligence and depression. There are correlations between intelligence and sensory and spatial abilities. Maybe some of these things are related.


Wait, so are you saying it is or is not a chemical imbalance?


I think depression is a beast with many intersecting roads.

The chemical imbalance seems like it could be more the result of something than the root cause.


I'm just one person, but it really doesn't seem like that to me. There was no awful situation or experience that brought on my depression or continues to make me depressed. I call that situational depression. You aren't clinically depressed. You're just feeling really crappy because your situation is really crappy. Remove the crappy situation or improve it in some meaningful way and the depression goes away too. With clinical depression there is no trigger or "something" that makes you depressed. You could be in a great situation with nothing bad happening and you're still depressed.

Right now I'm in a situation that really weighs heavily on me. Yet I'm not depressed.


What you're referring to is, I believe, proximal causes and distal causes.

Distal causes in depression's case maybe stuff like sleep deprivation, overstressed immune system, gut biome issues, etc. (and possibly genetic elements, who knows!) with little known about how they cause it or how they interact/overlap with one another.

The immediate proximal cause is, of course, the "chemical imbalance", which is popsci speak for neurotransmitter issues (among possibly others), a higher level proximal cause might be a life event that somehow causes some 'critical mass threshold' leading a spiraling avalanche (though again, little is known at the biological level about why this is so, assuming it is so.)


Even if that is the case, if the root cause is just some triggering event, then the chemical imbalance can still remain even if the cause is no longer present.


It exists at a different level of abstraction. There might be a correlation, but there's no simple causation (or at least, not going in that direction).


Scott Alexander ('Slate Star Codex') wrote a very good post on how to think about the "chemical imbalance theory", where it's useful and where it's not. Here it is: http://slatestarcodex.com/2015/04/05/chemical-imbalance/

I also remember reading another article by someone in the field which explained it in terms of proximal and distal causes, which is basically about "different level[s] of abstraction" as tbrownaw in this thread puts it. Will link to it if I manage to find it.


Losing steam? You mean the theory was discredited because there isn't any proof whatsoever of it being true and we don't have the means currently to prove or disprove it (measuring said chemicals while the brain is alive). I'd say that's a little more than losing steam. That's on par with the anti global warming campaign as far as science goes. But it's a nice story (think fiction) so people like to keep regurgitating it, including psychiatrists and psychologists who all should know better.

But hey, it does sell a ton of drugs, so its primary purpose has been achieved.


Author here. Thanks for all the comments, I'm surprised to see so much interest here on Hacker News. I figured this would be one of my posts that collected dust.

For the record, my way out of this happened to be psychological, but that doesn't mean I'm against medication. It just didn't happen to be my experience, so I can't comment on it. I try to avoid topics I don't know anything about.


Thanks for sharing your experience. My set of problems are different but I noticed my experience has been somewhat similar to yours. I'm working in therapy on acceptance and recognizing the internal shaming that came about because of my upbringing.

The frustrating part is that my relationship with my wife (who suffers from borderline personality disorder) makes it extremely difficult when she is fighting the new me that is emerging. She needs constant reassurance about going better places in the future and doesn't like that I'm starting to be ok with the present. The other day I tried to get something done but couldn't since she needed to talk for 6 hours on her day off work and the talk wasn't going the way she liked so it escalated and she got suicidal. She keeps arguing with me to go to a big tech company and make enough money so she never has to work and can be at home with the kids all the time but she's been a stay at home mom before and it ends up being her sitting at home stewing with anger and neglecting the kids and the house. It's hard to make real progress when it is met with so much resistance by loved ones


Thank you for publishing this. The mere notion that there's other people dealing with similar problems helps easing the pain, maybe because one feels understood for a change, to some extent at least. In fact, I found your piece so valuable that I created an offline copy to keep.

And I think all the reactions in this thread are just substitutional for a multitude of readers; you never know how many lives you have actually touched. Even writing this ridicilous comment needed to be overcome because depression feels like such a shameful thing to admit.


Reading through the suggestions here, I would suggest, if you're in a really deep hole, combine as much as you can from "all of the above".


Agreed. At this point, I use meditation, exercise, omega 3 supplementation, and therapy all in addition to the mental attitudes I discussed.


I've an odd question for you: How did you wind up sticking with meditation? What made you notice that it helped and how long did that take?

I generally quit after 2-3 months. At first it is kind of nice, but as time goes, I become a bit frustrated and bored. I don't notice a difference in myself, and I always wonder if it isn't just that I don't know what I should be looking for.

I'm mostly asking to get your personal perspective on it, in the hopes that I might identify with it.


I'm careful about suggesting meditation to my friends because I think it's different for everybody.

For me, I've always had high anxiety. OCD is essentially anxiety when you boil it down to its core. That means I carry around a great deal of stress, sometimes to the point where I can feel it in my stomach all day every day.

3-5 days of meditation makes this feeling go away. I've seen studies that show your cortisol drops after 3-5 days of doing it for 20-30 mins a day.

So to answer your question: I notice it a lot when I stop. I still fall off on the habit periodically, but I see the benefits shortly after I start again.

Some of the benefits for me: * Less Stress. * I make better eye contact with people because I'm not anxiously looking away. * I listen to my employees (and everyone) better because I'm not so tempted to interrupt them when they're speaking. * My body feels better - any pain or injuries I have get better. * My focus during the workday is dramatically improved. I don't get distracted nearly as easily.

But for someone who has less natural anxiety, I can imagine not having as many benefits. So use the classic test: if it helps you, keep doing it. If you don't see any benefit, then don't bother. Don't do it just because you think you ::should::.


Sorry to hear about your experience, but I'm glad you have found ways of managing symptoms. Like you say, people absolutely do respond differently to different medications. I'm a researcher at Yale, and we've been developing algorithms to figure out which antidepressant is most likely to help a specific patient. We've published some papers, and made our algorithm available online through our startup (www.spring.care/spring-assessment). If you find it helpful, please do send us feedback!! hello at spring dot care


I find that yoga classes that integrate meditation (such as hatha) tend to work better. It also forces you to sit and work through it for at least an hour. Here is a page to get started with the evidence: http://www.health.harvard.edu/mind-and-mood/yoga-for-anxiety...


I enjoyed your post, great and very real writing. Thank you for publishing.


My "road out" was having kids and taking on a lot of responsibility (both family and business). It's worked for 7 years now and I've never felt happier and mentally healthy, even if I am super busy and under a lot of pressure :-) I never thought I'd be the sort of person to thrive on pressure but it turns out I am.


I think many people do who don't realize it. There's a balance, certainly, and having a cause that you care about helps a great deal.

Pressure from a job that just feels like a grind can leave you feeling stressed and unessential (why do we need yet another widget?!?).

Pressure in supporting people you care about (family, friends), a country, a cause (ending hunger, eliminating a disease, etc.), and so on can leave you feeling stress, certainly, but also a sense of having a purpose.


Pressure is a fine motivator (we all know people who do their best work when under a tight deadline), but only if you are capable of being realistic about the consequences of failure (and attribution of blame).

If you raise the stakes enough for almost anyone (or they are of a mindset to ratchet those stakes up for themselves) it can be paralyzing, unless the consequences of not making a decision are somehow worse.

In some ways, SV-style celebration of failure is great, but if you're fixated on a "Unicorn or Bust" (or even an "FU money or Bust") career path, well, having a few "busts" in a row (which is a fairly likely outcome, even if you have both a good idea and execution) might just kill you.

In this sense, choosing a cause to have a sense of purpose may be a terrible option for some folks to pursue, since the consequences of not solving it completely are still dire - eg. don't choose to work on solving the World Hunger Problem if, having eliminated 90% of the problem in five years, you are going to blame yourself for the less tractable remaining 10% that still die of malnutrition and hunger.


I believe the switch from half excitement born and half imposed-but-accepted pressure from childhood regime toward the adult kind of pressure is hard to feel, understand and accept at first. The universe seems to be about pressures and waves, I wouldn't be surprised if our minds needs it too.


I've taken this path of distraction for most of my life... It's presently as bad as it's ever been...

I'm currently of the mind that the only way to cure it is to stop running and face it head on. Rip out everything that triggers it, rip out every source that adds to it. I understand that there is an element of brain chemistry that is presently considered the root cause of depression. I'm of the mind that this chemical imbalance has an underlying cause and that medicating is only treating the symptom. I've taken the medication route, and it was ineffective for me. I think the brain chemistry is a symptom of an even deeper problem. Our bodies want to be healthy and want to function properly and given the right inputs, they will.

I don't have the answers, I've struggled with this for the past 40 years. I've read about symptoms, treatments, I've read the science, the psuedo-science and the quackery. I'm still of the opinion that there is an underlying cause that isn't presently being considered - depression is on the rise. I'm aware this is just my opinion and that my opinion isn't rooted scientifically. But nobody, so far, knows me better than me - science and doctors included.

I can tell you this without any shred of doubt - if you continue to ignore it, continue to run from it, eventually you will have a weak moment and it will get you. Hopefully it doesn't threaten to rip your life apart as it has threatened to do to me at various points in my life.


I'm currently of the mind that the only way to cure it is to stop running and face it head on. Rip out everything that triggers it, rip out every source that adds to it.

I agree. But I think that's a lot easier to do when you're happy and in a good mental state than when you're not.

I didn't mean to imply that busyness is a mere distraction strategy - it's more a way to bootstrap a life-long process.


Try starting with something simple, like 15 pushups a day.


On days when it literally takes everything you can muster to drag yourself out of bed and into the shower, 15 pushups just aren't happening.

On other days it seems like a walk in the park to blast through 100... so I hear what you're saying. It's just that it's not always just as easy as getting through 15 pushups a day.


I've been in that same boat, being blessed with both bipolar and depression, and although just saying "hey some push-ups will do the trick" is perhaps a bit trivial I will add that even a tiny bit of exercise will help as it releases endorphins that are rather pleasant. Even on really fucking shitty days, I've tried to do a little work out. It's not a work out that will get me buff or anything but that's not the point. It honestly started as a healthy form of masochism for me...I loved the pain and it took my mind off everything else for a minute so I could focus on breathing and form. Even one or two push-ups, a long run...anything really...can help. It isn't a solution, but it's a relief and in the world of depression sometimes that's the difference between waking up tomorrow or punctuating a very short life.


I cycle for the same reason - forget the endorphins, they never really did anything for me. When it's just you and the road and the pain, you're free of all of it for as long as you can make your legs keep going. I imagine drugs do the same for some people, make them feel invincible or whatever, I don't know, I've never tried them and I have no wish for that kind of destruction in my life. The depression is threat enough to my way of life without compounding the issue.

But the bike, the wind in your face and the physical pain of the endurance is an escape from it all for as long as you can keep going.


If you keep ignoring it for another 7 years by just burying yourself in work it'll certainly continue to be OK.

No way one day it's going come back with a vengeance


If you're obese and go on an exercise regime, you might think you'll just get fat again when you stop the exercise regime.

In the short term, that's probably true. But if you do it long enough, you'd expect someone who has exercised for many years to eventually develop better eating habits :-) And so it goes.


To a first approximation, nobody recovers from obesity. Less than 1% of obese people regain a normal weight through any kind of lifestyle change. What works, kind of, is bariatric surgery.

https://www.eurekalert.org/pub_releases/2015-07/kcl-lco07141...


This might be correct for now but it doesn't need to be so.

A good number of people do regain normal weight only by eating healthier and wait.

I think more people could if we stopped scaring them away from trying really hard by talking about how hard is it etc.


Putting the well-being of others first also helped me. In your case, look at all the people who have benefited. Everyone who has listened to your shows and consumed your content is somehow better in some way. Good job! :)


I am going to suggest something that is not usually suggested. But I have seen it work wonders. Find a place where it is legal, and grow marijuana. If it suits you, smoke it, but ultimately start a garden and grow the plant.

People refer to the medicinal values of marijuana, but the one fact that is scientifically proven that is often left out is that having a garden and working in a garden is good for your mental health. That is not speculation.

This part is speculation. I believe a marijuana is the perfect plant to grow if you are fighting depression. First off, potentially you can harvest every 60-70 days. That means every single day you have to take care of the plants, but every day they grow significantly. Problems one day are disasters the next and if you can just stick to it every day, there's a harvest which can be rewarding monetarily or just intrinsically. If you are really good at it, you will find out that you are actually helping a bunch of people with all sorts of medical conditions. So the reward is comes fast, and then you can start again! Also, one more point, the grow lights can be another form of light therapy.

I have journaled about this stuff in the past, this is just a brief overview of my feelings of the hidden benefits of cannabis. Like the title states, this is just One Road and often the one less traveled...


Apparently people failed to read in my initial comment, "Find a place where it is legal".

Also, not sure why there is opposition. But for the banking, places are figuring that out, and its totally legal to recoop costs from YOUR patients in plenty of states, just can't sell to everybody.

One more note: Obama< "If another state passes legalization, prohibition won't be an option."


FYI: It is still illegal at the federal level. This is causing all kinds of headaches for people growing it legally as part of a medical marijuana business (such as difficulty getting a bank account). So, this advice is not good advice anywhere in the US.


I tried marijuana legally (Colorado) twice (each time was a couple of months) in a desperate bid to help out my anxiety. I had read good things about it treating PTSD and people in general use marijuana to relax right? So, I thought it had a chance of helping.

For me I found it didn't really help with anxiety and I didn't like the feeling of a slight loss of control. I gave it a good go and then even tried it a second time thinking maybe I just hadn't used the right strains, but it just isn't for me.


I think your issue is this

> I didn't like the feeling of a slight loss of control

Cannabis can help you relax, but you have to be willing and able to relax in the first place. that means being ok with feeling a slight loss of control.


If I was able to relax in the first place I wouldn't need to treat my anxiety.


Just want to say, this is terrible advice. If only because marijuana is illegal in most states. I can buy the gardening advice, but I would suggest something legal.


Not true. 25 States and DC currently have medical marijuana laws AND more to come after today.

http://medicalmarijuana.procon.org/view.resource.php?resourc...


This law is only to serve interest of politicians, corporations and cartels.


this is good advice. and if cannabis isn't legal to grow where you live, then plant tomatoes, or tulips, or some basil and oregano and mint.


Cliff notes: guy raised in a family of over-achievers, worked himself to the bone while never taking the time to grow up emotionally, hoping achievement would fill the gap.

It didn't, he had to face that fact and now that he's let go of the false hopes of success fixing his life - he's slowly but surely getting his shit together and is very glad to be doing so.

Perhaps the one thing missing from this article is how common this is - I see it all the time, in all walks of life. You have to address whatever is really bothering you, sooner or later. The more you put it off and try to band-aid it, the harder it will be later on.

A quote that I really liked related to this is - a year from now, you'll wish you had started today.

That resonated with me.


I too got stuck into a restricted life path because that was a very plausible and effective life drive (the neverending good student). Until it stopped. Gotta realign your priorities (emotional, familial and social balance) and it's surprisingly difficult for a while.

It's hard to avoid over specification in life, it's a natural reflex to aim at what seems and feels the best, thinking the rest, scary and annoying has no value whatsoever.

I write this very very often nowadays. I'm sad that our cultures completely ignores such things, and itself too, optimizes for other indicators (economy, foo) while so many people spend years in life confusion because simple things aren't said earlier.


These are just the pains of growing up.

It's like wishing there was no bullying in school - human nature isn't going to change anytime soon and by learning to deal with dickheads, you learn a valuable lesson or two.

As for culture - you have to wrap your head around the average IQ of an American being 100. 100 is really, really dumb.

You probably don't talk to anyone twice as smart as the average person on a regular basis - he/she won't be able to relate to you and vice versa.

But even so, it just doesn't matter - because culture or society, doesn't owe you anything. Wishing it was different is a fool's game - there are pockets in every city that you'll feel very at home with. Once you find them, you'll look back on wishing to change society as madness - you're the highly intelligent weird-o that needs a rare environment to thrive, most people are fine, they bicker until their dying breath just fine :)


I wouldn't mention it if I didn't hear it in others voices. Be it sexuality, love, education, society, work, celebrity... so many ideas get into our heads, so many of us get sidetracked.

And I don't want problems to go away, just to get them outside of our heads, instead of self alienation by lack of understanding of what is happening and if or not you're alone in this case (my belief: you're often not).

I also believe that older social groups had a more balanced structure where people would share more and listen more rather than western cultures where it's dealt with by outsourcing growing into institutions.


Do you or somebody else have an idea on where I could explore this idea further, in terms of books, websites etc…? Having semi-recently graduated University and moved out on my own, I am having quite a few personal issues related to an achievement-obsession that I have been socialized into but which is holding me back from much day-to-day happiness.


No, I never researched this, mostly because I had to cope with too many little problems to really deal with things calmly and I don't even know if there's a term or idiom about this. I mentioned it a few times on the web and you're the first to actually discuss it. At least you seem to be aware of it and ready to reflect.


Eckhart Tolle has some legit ideas about what he calls inherited mind patterns, the collective madness of society and dealing with the ego.


I was able to drop anti-depressants with 1 super-well-prepared LSD experience in nature. Since then, I do meditation daily, up to 1.5 hours at most (Jon Kabat-Zinn's mindful meditation method). Plus, I redo LSD once every 6 months. This worked extremely well.

The pharma industry hates me for saying that. Not sorry.


> with 1 super-well-prepared LSD experience in nature

Please tell me you didn't run naked into a jungle


I finally realized I was depressed when I couldn't remember a time I wasn't angry. I didn't know that constant irritation and low-level anger are also depression symptoms. I remembered trouble sleeping and no energy and sadness, but "anger" was new to me. When I started getting pissed at other drivers and couldn't be patient with my son, my wife said, "Are you okay?"

I wasn't. I was depressed. I started taking medication and I slowly got better. I still had a lot of the mental habits of depression ("How long has it been since I've showered?" and "Why aren't I telling my friends what I'm going through?") but I worked on those. And I asked for help, from everyone who loved me. And they helped a lot. Who knew! ( =


How old was your son and what were the things that he did that made you impatient with him? He didn't want to do homework or chores?


He was three, and was mostly just being a toddler: he would get grumpy, get frustrated and yell when he couldn't do things, was making us tell him stuff dozens of times, over and over.

My responses felt reasonable at the time. Why wouldn't I get angry at him when he yelled at me? Oh, right, he's a toddler and I'm an adult. I've been in the saddle with respect to my emotions for decades. This could, no fooling, only be the 200th time he's ever been truly angry. I'm the responsible one here. Realizing I lost sight of that perspective was what took me by surprise and scared me a little.


Trying to work on a startup when your emotional gas tank is on empty is basically a cruel paradox. Doing anything productive is virtually impossible when you're consumed with self-hatred.

By the same token, starting a startup because you have nothing to lose is generally a terrible idea, because the aforementioned tank is already empty before you even begin. Road trips seldom succeed when you have to push the entire way.

While the author didn't make the latter mistake per se, his situation sounds more akin to having embarked upon a road trip with a single tank of gas, and no gas stations along the route.


There's lots of good advice here already - let me add one, for the supplement lovers: Find a good probiotic and run with it for a few months. You might feel some benefits for mood after only a couple days. I've tried a lot of supplements in the last few years (any kind of vitamin, and some broadest-band multivitamins, even methylation stuff like Methyl-B12, Folate, active B6) - but the only ones that really made an impact were probiotics. My favorite probiotics are Mutaflor and Prescript Assist, both costing ~€1 per day - but they are so worth it. Call me a lunatic, but they affect my mood in different ways. Mutaflor makes me grateful for things, and P.A. gives me focus and a sense of purpose in life.


It looks like Mutaflor isn't available outside Canada.


Or Europe, in my case (mainly in Germany.. it was actually prescribed to Hitler, so long has it been around). The FDA banned it, I'm reading right now. That sucks.



My "road out" was pretty severe.

I had to move on from my social group who were not healthy (some of my closet friends at the time), I stopped drinking and partying entirely, I started working out, and started to plan out my goals for the next two years.

I completely closed ranks on my life - which was a major decision and started from scratch again. Probably the hardest decision I've ever made. Two years of being clinically depressed and I felt like I needed to jump start my life again.

It wasn't easy, but in the long run it's been well worth it.


> I had to move on from my social group who were not healthy (some of my closet friends at the time), I stopped drinking and partying entirely, I started working out, and started to plan out my goals for the next two years.

I suppose you mean closest. Even though closet could explain depression too.

It's far from easy to express yourself [1] in your traditional circles when the inner self distance is very large. I spent lots of years following the average persons because I couldn't really accept my own desires.

[1] This comment has a lot of homosexual subtext, but it's only half pun, I believe they're a good extrapolation for having to deal with lives they didn't want but are force fed on them. Anybody who doesn't listen and accept himself ends up in the same situation.


yeap one "s" can change the whole meaning right?

Thanks for the good laugh this afternoon.


It could be OCD, or it could be the downfall of most young men (many of whom I'm friends with) when they leave tech companies in bay area to strike out on their own: "for fame and fortune". Thats your problem.

You need to do it because you are passionate about the problem you are trying to solve and genuinely interested in the work you do.

You were frustrated with the rest of your life because you were looking for it to supplement your job, because you werent excited about it for the right reasons.

It's not just a problem with you, so many high level VCs are sick and tired of seeing really smart engineers come up with ideas that clutter the system with another food delivery service or the "next facebook".

When you are aiming for fame and fortune, youre aiming to emulate people who have already come up with original ideas, instead of focusing on your own originality.

That's why the bay area is filled with so many "me too" ideas while the rest of the world has multi billion dollar low hanging fruit begging to be worked on. Because they exist in neighborhoods that arent cool or hip, that do not resonate fame or fortune, when it is precisely when you leave the things you are trying to emulate that you find what you are looking for.


> the rest of the world has multi billion dollar low hanging fruit begging to be worked on

go on...


My road out, even though its still rocky as my treatments are not perfect, is getting checked for sleep apnea and getting treated for it. I wonder how many depressed people have an undiagnosed sleep disorder. Its incredible what just one or two nights of poor sleep quality can do to a person, let alone years.


A resource for tech workers struggling with depression:

https://forums.osmihelp.org/ (the former DevPressed.com ) "We are a non-profit org (just applied for 501c3) that works to improve mental wellness in the tech industry."


Great article.

Currently fighting to claw out of my own depression.


From personal experience: I recommend considering both a psychiatrist (medication) and a therapist (works on your thinking patterns. Both help a lot. Depending on the depth of your depression, you might be able to get by with just the therapist, but in my case, both help.


This article: (https://www.psychologytoday.com/blog/the-squeaky-wheel/20151...) seems relevant to the posted article, as well as some of the comments here.


Nutrition for me has been a big one. I've only very gradually realised the enormous impact my diet has had on my mood and cognition in general.

Sure, I've heard a million times before that a good diet, sleep[1], and exercise[2] have a great impact on one's mood and brain function. And if I was ever challenged on it, I would have said that I believed it. But I never acted like I believed in it, until I actually started to change and improve each of these areas and felt the impact for myself.

So for anyone suffering depression (or other mental/cognitive issues), I strongly recommend you take a very thorough and serious look at what you're eating, and consider the possibility that you might be deficient in some nutrients that are good for you or maybe getting too many that are bad for you.

Nutritional advice is unfortunately all over the place, and it's very difficult to find any kind of consensus on what's actually good and what's bad. Fortunately, you can simply experiment on yourself, and try various things that are widely regarded as "healthy" and see how they affect you (just thoroughly do your research first and be safe!).

Doing this does take motivation, something very depressed people don't tend to have much of. So in whatever way works for you, you have to first get motivated enough to seriously want to make a change and do the hard work it takes to get there. Perhaps that way is medication[3] or therapy[4]. Once you have the real motivation to change, the really hard work begins.

In my case, all my life I had verious allergies which kept me from eating certain foods which I later found out were really critical for brain function. In addition, I was a really picky eater, and didn't like to eat a lot of food which was good for me. That made it worse. Even worse yet, I didn't take my diet seriously, and ate lots of things which I knew were bad for me and on top of that didn't have a very varied diet.

All of that eventually caught up to me, and I suffered from a variety of medical conditions which I'm discovering are diet-related. I'm slowly making positive changes and am seeing impressive results. I'm still nowhere near where I want to be with my mental and physical health. But both are improving and I've finally gotten interested in diet and nutrition, investigating them, and am taking them seriously.

Thanks to improvements in nutrition, my mood has improved a lot, I am more motivated, and have a lot more energy than I used to. My physical health is improving also. As I eat more nutritiously, I hope to see even more benefits in the long run.

Some other tips which, I think, have saved my life over the years:

The most important one is the ability to gain perspective. A lot of depressed people tend to get stuck in a sort of tunnel vision and magnify their problems all out of proportion, thinking that theirs are the most important, only, and worst problems in the world. I believe my study of philosophy, psychology, religion, history, my experience in living abroad, and interest in the fate, outlook and suffering of others has repeatedly helped me to realize that my problems really aren't so bad when compared to those of a lot of other people throughout the world and through history. Over and over again I've seen that it can always be worse, and in many ways even in my worst and darkest days, I'm very, very fortunate. At the same time I recognize that my pain is real, and can be very severe. But it will end. This leads to the next point.

Over the decades of my life, I've had many run-ins with depression. When I was young, it often felt like there was no light at the end of the tunnel, that the depression would never end, and that there was no way out. But eventually it did get better. This cycle has repeated many times for me now, but now I have evidence from my own experience that it always gets better. Time does heal all wounds. So now when I get depressed, I try to remind myself of that and try to keep perspective. I try to just make it to the next day.

I've found that meditation helps. It can help with mental and physical pain, and sometimes helps me to break out of of a cycle of feeling sorry for myself and dwelling on the past. But at the same time, I don't believe it nor any of the other techniques here are a complete answer, as they can be a way of avoiding dealing with important issues, which should be dealt with in therapy.

Journaling helps. I've often felt a lot of relief by writing down what I've been feeling or thinking -- things that I had a hard time admitting to others. More recently, I've started using a portable voice recorder to just talk in to about the things that are on my mind, and do so much faster and more freely than I can write. That's helped a lot.

There was a time when I was in therapy that I kept a dream journal, and analysed my dreams with the help of the therapist. I can definitely recommend that as a way of gaining insight in to one's own mind.[5]

Talking with someone on a crisis hotline can help, but shouldn't be used as a substitute for therapy.. more as an emergency measure. On the other hand, if you're not in therapy and have no one to talk to, it can definitely be a lot better than nothing.

Also, I try not to dwell on the past, and rather look to the future. I try to learn the lessons that are there to learn from the past, and then move on. Looking to the past with the aid of a therapist, however, can be very constructive, and I consider that to be quite different and a lot better than simply going in an endless loop over the same events in the past on your own, without making progress and without learning anything. It's that latter, unconstructive type of dwelling on the past that I try to avoid.

I try to be happy with myself, enjoy my own company, spend a lot of time pursuing my own interests, and seeking out new ones. This helps to deal with boredom, low self esteem, and loneliness, which have at times been major contributing factors to my depression.

Helping others can be a great way to get out of your own problems, to recognize how bad others have it, to feel solidarity with them, and to feel positive about making a difference and being needed. I can definitely recommend volunteering as a way to help oneself feel better in all sorts of ways.

Finally, what's helped me a lot is to keep busy with something (like work and/or hobbies). I don't think this is ultimately super constructive, especially if you keep busy at the cost of introspection and really facing your demons and dealing with aspects of your life you really have to deal with. But it can very effectively keep depression at bay -- at least it has done so repeatedly for me.. until I burn out and am forced to take a reassessment of my life and deal with the issues I've been putting off. So I only reluctantly mention it here. The best, I think, is to keep busy with something that's really fulfilling and is really in line with your highest ethics, goals, and motivations. I haven't found my way to that yet.

[1] - Sleep is super important, and I try to get as much as possible because I instantly see the effect on my mood and my mind when I get little or bad quality sleep for a long time. Getting enough sleep (ideally about 10 hours for me) is very difficult when working in tech, at most jobs, and I see sleep deprivation as one of the major downsides of working in this profession.

[2] - I've experienced great improvement in my mood when regularly doing intensive exercise, like strength training and aerobic exercise. Unfortunately, I've not able to make a long-term habit of it. It's worked for me in the past, though, and I intend to get back in to it soon.

[3] - I generally see antidepressants as emotional bandaids -- they can temporarily stop the bleeding, but won't treat the underlying illness. They can also have some very serious side effects. One person I knew had their emotions dulled permanently by antidepressants. Another underwent serious negative personality changes while taking them. There have been many reports of even more serious side effects, including worsening depression and suicide.

[4] - I'm a great believer in therapy. But there's no guarantee that any particular therapy or therapist will work. It may be necessary to try a lot of different ones until you find the one that works for you. Effective therapy can also take a lot of motivation and commitment to do the hard work on your part for the therapy to work. A lot of people think that therapy is like having a tooth pulled -- you sit there and the doctor does all the hard work. But that's not how it works. You are the one that has to do the hard work. The therapist just facilitates, guides, and helps you along the way.

[5] - Whether dreams have significance and what that significance is is controversial. Some people think they are just random or meaningless, just reflect what's happened in the day, or are just a way your mind has of processing experience and reinforcing memories, but I think they have a deeper meaning and are a way for the subconscious part of your mind to communicate with the conscious part (a Jungian view). I could write another very long post just on dreams, but I'll spare you. If you're interested, read up on the Jungian view of dreams, and that's close to my view. Jungian therapy in general is the type I prefer, though I have some problems with it -- in particular, I'm not very big on all the myth stuff. But apart from that, I find it to be the most insightful and beneficial type of therapy for me.


Some other things that I've found helpful:

I try not to put too much stock on external measures of "success". I try to find my own way and do things that are meaningful and fulfilling to me, rather than chase things that others say that I should have.

Perhaps because of that I haven't achieved many things that are considered by others to be desirable. On the other hand, I'm much more at peace for not having achieved them, and more satisfied at having achieved other things that are important to me, whether or not others consider them valuable.

For example, I'd generally rather have health and peace of mind than money. I recognize that many people with a lot of money are miserable, and I try to be content when my modest needs are satisfied.

In general, I try to be satisfied with what I have rather than lust after things that are far out of my reach. I try to detach, and am attracted to paths that lead towards detachment.


cool to see a fellow ambiguous believer of dreams, here is my take on them https://medium.com/@duopixel/an-exploration-into-dreams-5b8e...


That's a very interesting read, deserving of an HN thread all its own.

Some comments:

You might want to consider keeping track of the images and themes that come up in your dreams, and cross-reference them. When I did so, it helped me to recognize that my dreams have a sort of language that is spoken in symbols, and understanding the meaning of those symbols can help reveal what a dream is trying to communicate.

I believe that each person's dream symbols have meaning that is specific to that individual, though sometimes there are commonalities between people and even cultures. This is why I really hesitate to interpret anyone else's dream. Just because one symbol might mean something to me, or even to a lot of people doesn't mean it'll mean the same thing to the dreamer.

There are also ways of digging deeper in to the subconscious and fruitfully looking deeper in to the dream than what might appear on the surface. One well known technique is doing free association with anything and everything in the dream.

For example, if someone in a dream was wearing a black hat, what does that make you think of? Perhaps the first thing you think of is that the person in question is a bad guy. What else does it make you think of? Perhaps you recently saw someone wearing a black hat in waking life, or you know someone who usually wears a black hat. Or maybe you associate it with the Black Hat security conference, or with hackers, or with all of the above.

As you can imagine, every dream image or symbol has potentially infinite meanings, and often very personal ones. Investigating them like this can yield a lot of insight, and this can be done for every symbol in the dream. Even better results can come if you index and cross-reference all of these symbols and interpretations. Such record keeping can help you to remember that, for instance, a black-hat wearing person that you dreamt of last night also appeared in another dream a year ago, and studying those dreams together could help you make further connections that you might not have immediately thought of if you had not done this.

Another technique is having imaginal dialogues with or asking questions of the people or even objects in your dreams. That can help to, in a way, pick up dreaming where you left off, and to get more insight as to the role of something in the dream. Some people might object that since the dialogue is imagined it's not valuable. But, as Jung pointed out to a patient of his who after a long time revealed that all the dreams she told him she never had and simply made them up, they still come from the imagination and therefore are just as valuable as "real" dreams in understanding one's subconscious. Anyway, it's just another thing to try. Your mileage may vary.

Yet another technique is to imagine yourself in a situation from a dream you've had, and imagining what you would do in that situation, and 'dreaming it forward' as it were. Jung called this technique 'active imagination', and stressed that he thought it was critical that the person doing this should try to act in the imagination just as if he really were in the situation he imagined. This technique can make you even more in touch with your subconscious, especially if afterwards you analyze the imagined events just as if they'd been a dream.

On another note, I don't think it's really clear where dream contents come from. Some may say that it's obvious they come from one's self, and nothing else. But even if they do, what is the self? Many people have very different conceptions of the self. Some believe there is just the conscious self and nothing else -- the ego, as it were. Some believe one's self is nothing but the brain. Others believe there is a conscious and subconscious self. Some believe in a 'higher self', or even in many selves, etc. Jung thought archetypes were the sources of some dream contents, but he did not commit to saying what the source of the archetypes were, even leaving open the possibility that their sources were extra-personal (ie. outside the boundary of what is normally considered to be a particular human body and mind) such as gods or spirits -- one of the things that earned him the reputation for being a mystic. I don't believe in anything in particular myself, but do find it interesting to consider the possibilities, and generally find the simple reductionist view that everything's just a matter of physics in the brain to be unpalatable.


Just wanted to say thanks for this. Was feeling a little down, and this was just the ray of light I needed.


That sense of entitlement really makes it worse - the feeling that things should be better for you but they aren't and it wasn't even your fault.

Rosebush Inside by Sean Hayes helped put things into perspective for me when I was probably very lost.


Great piece. Be happy on your own terms, not ycombinators and startup marketing siren songs. The smartest among us are often the most vulnerable.


I don't see any way out :(


But the way is still there. Email in profile, if you want to talk.


Please delete my comments.


When I was unhappy I was always unhappy (eventually). Whether it was by myself or with other people. Smallco or Bigco.

IMHO, 5 things are essential. Everything else is secondary:

- Sleep / resting the body-mind

- Exercise / moving the body

- Meditation / moving the mind

- Nutrition / feeding the body-mind

- Access to high quality internet on a high quality computer with a good electricity network


I realize this is subjective to you, but one of these is not like the others, as they say. Care to explain?


I honestly couldn't finish reading it because the article was so long-winded.


For others:

It took me less than ten minutes to read, and is worth it if you want a well-written, insightful article on both OCD and depression.


Really. I have suffered in my life, this didn't resonate with me at all. Quoting Mr. Robot and Blink 182....


It's an article more or less about his personal experience with Depression and OCD, on his personal blog, where he mentions several times angsty/sad songs were his escape, especially in his teens. It seems silly to pick apart who he quotes to me.


Meh, I didn't really read the quotes. The biographical elements certainly fit with my own experience of depression and (minor, not as severe as his) OCD.


I agree they didn't add anything to the article, but if you ignore them I think it's a worthwhile read.


Looks like we melted it -- or the server got depressed.



My Psychiatrist has been telling me, for over two decades, "All my patients are different."

It's one of his better stock answers to questions.

I have never been truely suicidial, but I had, I guess, a panic attack in my twenties, and from the next day on I was a nervous emotional mess for years. I tried to go back to a professional school I was in, but just crossing the Richmond bridge was a feat in itself.

I knew my life would never be the same. Looking back--I'm not sure that was a terrible thing?

I spent my savings(financial aid, and dirty money) on Therapy. I got introduced to the right Psychiatrist--I think? (Yes--try to avoid drugs if you can.)

It's ironic he brought up M. Scott Peck's Book. The Road Less Traveled. It was required reading in a college speech class. Yea, I think the professor decided to become a Healer? The book has a great first paragraph. Maybe the best I have ever heard.

'Life is difficult--why not work hard in school, or work, and become someone with a great life', or something along those lines. Then he goes into the second half of the book, 'If you can't disprove the existence of a god, why not embrace religion.'

I read the book, but I was trying my best in life. I was doing the hard work. I was doing what they(society) told me to do. I was young, idealistic, and wired pretty tight. I believed I could do anything, and up to my breakdown, I could. I was one of the more capable persons everwhere I went.

Then I busted a gasket. And I was a trembling mess. I needed two 375 ml bottles of wine, just to get through the door of a chitty/easy job. I was a dizzy mess all day.

I've been in about a year of therapy, been on >10 drugs. Looked into four Psychiatrists faces.

What worked? The more addictive drugs helped a bit. Exercise helped. I didn't have a problem with a higher power, but that higher power didn't help me, even on a Placebo level.

The biggest factor in my healing was time.

And yes--we don't have much time, but it's the only thing I can look back on with confidence. I hear about people committing suicide, and I always think they didn't give it enough time. And yes, sometimes it's years, but Everyone is Different. It might be a few months until you don't feel like your in that cloud of misery? It's usually just a few weeks though. Mine was unusual according to a professional.

I have a theory, and it's just geared towards Americans, because I've never been anywhere else.

It's this:

We are so conditioned to be great; we push ourselves too hard. We take on too much stress in our twenties/thirties, and the brain which is basically geared(evolutionary) to procreate, and eat--sometimes just breaks down, and we get OCD, depression, anxiety, etc.

Most of you will be able to work towards having everything, but some of us will break down.

I really don't have any advice, other than don't beat yourself up. Work, or to school, but don't work youself sick. Don't try to have everything right out of high school, or college.

It's just so hard to have everything in life. By the way, most people don't have everything. Everyone I know is missing something. There's the person with the great job, and can buy anything, but is all alone. And the reverse. We're all kinda misserable.

My heart goes out to anyone in agony. Just please give it time.


My experience parallels yours. I was wound pretty tight, tried to do way too much, and burned myself out. For 2 years I was seeing a psych, and trying to push myself to exercise, but the medications didn't work though I was still on them; ultimately what happened was I slowly recovered my ability to function with 2 years of doing nothing.


Thanks for sharing your experiences. I'm glad you made it through. I'm a researcher at Yale, and we've been developing algorithms to figure out which antidepressant is most likely to help a specific patient. We want to help patients get back on track sooner, to help minimize suffering. We've published our research, and made our algorithm available online through our startup (www.spring.care/spring-assessment). If you know of any other friends or family that are struggling with depression, please do let them know about our work, and I hope that they find it helpful


Well, I mean, it's too late for many. A lot of folks are only a few years away from a heart attack and have nothing to live for.

You've let down everyone and your dreams haven't come true.


Are you my mind?



That's accidentally pretty bleak.


Might trigger a long walk in nature, which is one with the highest ROI to alleviate depressive states.


For me, it's less a problem with the database and more a problem with the connection.

Not to mention the fact that I am no longer able to seek professional help for suicidal thoughts. Those, they come unbidden, and I will never be able to be honest or open about it again.


[flagged]


That's not accurate at all, and if you're intending a joke based on the article misrepresents its contents.


[flagged]


It is clear you - or anyone close to you - have never suffered from depression, because these types of comments are actually very pervasive, and extremely unhelpful.


I can tell, you are not a fan of dark humour. Understanding depression has nothing to do with it.


Dark humor, especially when it flirts with Poe's law, can't succeed without competent execution. Perhaps you are good at it in other contexts. In this one, you're catastrophically failing. You should stop.


That's depressing...


Stop being a troll. It isn't funny.



That's what I keep telling my amputee friend too - just walk it off.


You see, this is actually funny because there's a pun there. Parent is either a troll or has no sense of humor, or both.


It's funny, but it is still the sort of joke that best comes from someone in the same predicament (or from a really close friend), and isn't particularly suitable for most public fora.


I'm disgusted with myself that I laughed at this...


This server error is making me a little emotional.


Made an archive in case it fails again: https://archive.fo/Vyz09 (https://archive.fo/20161108171830/https://thinkfaster.co/201...)

P.S. Someone took a snapshot of that error 2 hours ago.




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