
The Depression Thing - darwhy
http://zachholman.com/posts/the-depression-thing
======
ElatedOwl
I was diagnosed with "major depression" when I was 14, did the medication and
therapy thing for a bit but the medication made me a zombie. Therapy helped me
learn to cope a little better, but I was never "cured" of my depression.

My 20s have been pretty bad, but in the last year and a half I've lost 100+lbs
and have been running and lifting.

It turns out the common sense advice to depression was really what I needed
all along.

* Sleep * Proper diet * Exercise

If you're struggling with depression like I was - try and take baby steps to
improving those 3. You don't have to be perfect and it doesn't have to be all
at once, but through continued effort it has only gotten better and better for
me.

~~~
SnowingXIV
It's also a viscous cycle once you stop doing these things. I had everything
going well for me, but then a bunch kinda blew up at once and I stopped eating
healthy, quit working out, and was losing sleep because I was trying to solve
all these other problems and felt those things were pointless. "Oh, I can't
get in the mindset to lift today I'm too stressed out and depressed/hopeless."
That led me from only skipping a few days to skipping months.

I ended up going into some escapism mentality where if I'm not working I'm
going to play video games/watch TV. It was a terrible rut until one morning I
looked in the mirror and realized I'm letting life slip away. I'm not growing
(well at least not in the productive way). Mind you most of those "explosive"
problems were solved, but I wasn't. I freaked out, threw on some gym clothes,
went to the gym, and ran. I don't even know what I was running toward. But I
was running. I began lifting again, doing meal prep, back to studying,
programming pet projects, reading, and it all came together.

It can hit you in waves, but one of the best ways to keep your head above
water is to make sure those three things ElatedOwl mentioned are in check.

~~~
madamelic
>It's also a viscous cycle once you stop doing these things.

It is also gosh dang terrifying. I am not so much curing my depression +
anxiety as much as I am running away and trying put enough stuff behind me
that it can't catch me.

But when it does, it is difficult to get started again.

~~~
Garph
>I am running away and trying put enough stuff behind me that it can't catch
me.

I'm a runner with depression. I track my mileage, diet and general mood very
closely and have started to brace myself for a depressive periods after major
races.

I need redundancy with coping mechanisms, and the OCD nature of distance
running is potentially setting people up for a fragile system should an injury
occur or low-mileage phase crop up.

~~~
Chattered
I spent my twenties running long distance, but gave up four years ago. The
frequent injuries were just too much. A bad injury once had me off training
for four months. Going from feeling like a machine to someone who can't manage
a jog in the space of an afternoon seriously messed with my emotional state.

I'm writing this on a recumbent bike. I've averaged ninety minutes a day for
four years without injury. I've also read a ton of books on my kindle.

------
nkurz
The article makes an opaque reference to "the oft-quoted David Foster Wallace
passage on suicide and burning buildings". Here's the actual quote from
Infinite Jest for those who have not yet had seen it quoted enough to know by
heart:

 _The so-called ‘psychotically depressed’ person who tries to kill herself
doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that
life’s assets and debits do not square. And surely not because death seems
suddenly appealing. The person in whom Its invisible agony reaches a certain
unendurable level will kill herself the same way a trapped person will
eventually jump from the window of a burning high-rise. Make no mistake about
people who leap from burning windows. Their terror of falling from a great
height is still just as great as it would be for you or me standing
speculatively at the same window just checking out the view; i.e. the fear of
falling remains a constant. The variable here is the other terror, the fire’s
flames: when the flames get close enough, falling to death becomes the
slightly less terrible of two terrors. It’s not desiring the fall; it’s terror
of the flames. And yet nobody down on the sidewalk, looking up and yelling
‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to
have personally been trapped and felt flames to really understand a terror way
beyond falling._

And here's a longer excerpt from the book that includes the quote, with some
discussion: [http://theviewfromhell.blogspot.com/2011/04/elements-of-
suic...](http://theviewfromhell.blogspot.com/2011/04/elements-of-suicide.html)

------
throwaway5650
Throwaway for reasons that will become obvious.

Imagine that you met a friend you hadn't seen in years. They seemed really
down, and you ask what's up. They say, "My job is to collect tolls in a
tollbooth in Alaska. For 9 months a year it's freezing, and the heater breaks
every day, and I'm stuck outside wrenching on the thing with one hand while
Googling "how to fix a heater" on my phone with the other while I slowly lose
my fingertips to frostbite."

Now recall a few weeks ago when someone posted an interesting article about a
board game full of ridiculous, fiddling little rules that would take years and
years to complete [0]. The reason no one has ever played this game through is
not because there is _no way_ to play it through. It's not because a
reasonably-intelligent person would be _incapable_ of coming up with a
strategy for getting through the game. It's because so far, no one has thought
it worth that time. There's no payoff.

When you talk to a depresssed person like me, you are talking to someone whose
body is that tollbooth, and whose life feels like that game. You can say
"exercise." You can say "talk to someone." But when you say those things, you
are describing a strategy for getting through a 1500-hour board game with no
payoff. You are describing to me how to fix a heater in a toll booth in Alaska
where I may be stuck for maybe the rest of my life, constantly worried that
the damn thing is going to break again.

So please, please, use that understanding when you talk to someone like me.
Empathize. You can do that. You can say "that sounds awful." You can say "If
you want someone to talk to I'm here." You can even say "Hey, let's go to the
aquarium!" But be really, really careful about saying "go exercise" or "go
talk to a therapist" and never, ever say it's going to be ok.

ok?

[0] [https://kotaku.com/the-notorious-board-game-that-
takes-1500-...](https://kotaku.com/the-notorious-board-game-that-
takes-1500-hours-to-compl-1818510912)

~~~
rmetzler
I've been in your shoes earlier this year. Or maybe I didn't come even close.
I just want to say, I felt like what you describe.

Then I read an article about the microbiome of dirt [0]. In the moment I read
this on my smartphone I sat in the grass on a hill and I thought to myself,
fuck it, what can go wrong, I'm going to stick my finger in dirt, put it in my
mouth and eat a little bit of dirt. And that's what I did.

I don't know if this was what changed my mood, but what I can say, that my
mood was changed in less than a week.

All the best to you.

[0] [https://qz.com/993258/dirt-has-a-microbiome-and-it-may-
doubl...](https://qz.com/993258/dirt-has-a-microbiome-and-it-may-double-as-an-
antidepressant/)

~~~
a_t48
Um. Please be careful, ingesting soil can lead to stuff like Botulism. As for
the GP - I've also been there, for many years. I'm not going to suggest
treatments because you have a whole thread full of it, and it wouldn't do a
damn bit of good unless you happen to be in the right state of mind for it
anyhow. I don't know you, but if you do happen to need someone to chat to, I'm
down.

~~~
hycaria
No it can't, botulism happens under anaerobical conditions. Two people doing
the same mistake, where does this misconception come from ?! Maybe you guys
are mixing it up with tetanus, which can indeed be contracted through soil on
a wound (because of _Clostridium tetani_ ).

------
pure_ambition
People: PLEASE STOP recommending depressed people to take psychedelics. There
is no such thing as "psychedelic therapy." Psychedelics can easily make people
with mental health issues MUCH WORSE. Nobody needs a full blown existential
crisis on top of major depression.

I get it if you like the idea of doing psychedelics, but they are mind-
altering in significant and poorly understood ways, and can easily cause
others harm - even if you feel they've done good for you.

~~~
dovin
Psychedelic therapy is very real. MDMA was recently deemed a "breakthrough
therapy" by the FDA, which means Phase 3 trials are being fast-tracked as they
have shown so far to treat PTSD far better than anything currently on the
market.

This is just the beginning of rigorous research into psychedelic therapy. We
don't have good non-anecdotal data on how it treats depression yet, but we'll
get there. And the data is compelling enough so far that to completely dismiss
the entire idea is closing your eyes to very valuable tools that we're just
beginning to understand.

~~~
a_t48
A big part of psychedelic therapy is the second part - "therapy". Psychedelics
by themselves may help or may hurt, it's a bit of a roll of the dice. The
thing being fast tracked by the FDA includes guidance by a therapist and isn't
just taking E in your bedroom. These treatments can _absolutely_ be helpful,
but it needs to be done the right way. The GP comment isn't saying that they
aren't helpful (and neither am I!), only that it isn't a magic bullet. Set and
setting are important.

------
Mz
Some of the best ways to deal with depression:

1) Address any known health issues you have.

2) Dietary changes. There are studies on this.

3) Problem solve. If you are depressed because of terrible personal issues,
work on resolving them. (The article mentions that a run won't pay his bill or
fix other problems. Overwhelming problems are a legitimate cause of
depression.)

4) If you are suicidal, seek company. If you know someone suicidal, spend time
with them.

You do not necessarily have to talk about their suicidal ideation or the
problems causing it. You can play games together, have lunch, be pleasant.
Suicides generally occur alone. Just physically being there goes a long way
towards preventing suicide.

If you do want to help them, help them fix problems. Feelings come from
somewhere. Just massaging emotions does not work. Do not "help" them by
preaching at them ("Just go for a run!").

~~~
Raphmedia
That's the thing with clinical depression. You can be doing all the rights
things and still be depressed. The worst moment of my live have been during
periods where I was at my fittest and healthiest.

You think to yourself :

"I am hitting the gym three time a week. I've not eaten any junk food in
months. I meditate and sleep full nights.

 _Why is everything still seen through a haze?_

What am I doing _wrong_ if everything should be fine? _Am I broken_? Who would
want to speak to me. _I am a fraud_. I look healthy but _I 'm a husk of my
former self_. Everything is so _exhausting_."

I have no answer as to how to deal with it. All I can say is that cookie
cutter answers rarely apply and can even make someone miserable.

~~~
Mz
I am not suggesting this guarantees results, and I also absolutely did not say
that physical fitness approaches alone are some magic cure all. These are the
best answers I know of that actually get results for some people, some of the
time.

I rarely suffer depression, but I have a genetic disorder and other serious
personal problems (such as: I just got off the street after 5.66 years on it
and I was molested and raped as a child). My medical condition sometimes
causes me to become suddenly suicidal. My two adult sons, ages 30 and 27, make
sure I am not left alone when I am suddenly suicidal. They know other things
to do, but a big thing is we just do not let me be alone when I am at my
worst.

Getting healthier has reduced the frequency and severity of my bouts. Figuring
out how to make money online so I can be functional in spite of my genetic
disorder empowered me to get off the street. I am still quite poor in terms of
overall income, but I have some pieces in place for my life that are usually
reserved for only the very privileged. It is having a positive effect on my
mood and mindset.

I am still stressing about money and I still have days when I get nothing
done, but my life is vastly better than it has ever been. I am 52.

So, I am speaking from firsthand experience, in some sense. I don't suffer
depression per se, but I do wrestle a lot with frequently being suicidal. It
often comes on suddenly. It always involves whackadoodle brain chemistry, a
side effect of whackadoodle body chemistry. I try to put out useful
information to the best of my ability. I do my best to couch it in
nonjudgmental, non-blamey terms.

------
cbau
Ignoring the content for a moment, I really liked how the background color
changes with the mood of the content. I don't think I've seen that before, but
it's refreshing from the wall of black text on white backgrounds which
sometimes scare me away.

Really enjoyed the post though. I think a lot articles which give advice
without personal experience don't ever really resonate. This one actually
makes me feel hopeful.

------
eswat
_health insurance problems (yay 🇺🇸, home of the brave, land of the shit health
system)_

Not sure about other countries with universal healthcare, but seeking therapy
for depression in Canada isn’t exactly that much better.

Such treatments aren’t covered by public health insurance so you’ll be
spending $100/hr CAD, likely more, out-of-pocket.

When I sought therapy, and this is probably due to unfortunate timing or being
in an underserved city (but highly doubt it being Ottawa), I had to wait 3+
months before any therapist near me had room. By that time I had largely
remedied my depression myself out of necessity.

EDIT: Realized I’m conflating psychiatry and psychotherapy with my comment.
The former is covered by our system but due to the demand you’re looking at
several months before seeing someone. My example of waiting 3+ months was just
for a psychotherapist.

~~~
stevewillows
Check with your local mental health outpatient care. They most likely have a
10 week CBT group program. You'll also most likely be assigned to a staff
psychiatrist or therapist.

I did the program through my local outpatient, and it was awesome. It wasn't a
total fix, but it did help me to become aware of some toxic patterns,
triggers, and responses.

In BC there are other groups after the 10 week course that are offered during
the day, but that's not realistic for most people.

------
icc97
This is the same Zac Holman who was fired from GitHub [0] when he was having
tough times.

It's great how open he is about it. I'm waiting until we see going to the
doctor to talk about pain in your brain the same as going to talk about pain
in say your colon. That is, perhaps not something you'd talk about to everyone
but at least you'll be able to see someone for free in Europe or with minimal
insurance costs in the US.

[0]: [https://zachholman.com/talk/firing-
people](https://zachholman.com/talk/firing-people)

------
cinnamonheart
I suffered from depression and anxiety for most of my life, and it's not
something cured by lifestyle changes alone for every person.

Despite exploring and keeping up with alternative treatments -- like therapy,
CBT, meditation, regular exercise, a proper diet -- I was still anxious and
depressed. These helped me _manage_ the anxiety and depression, but they were
still there, and, internally, quite overwhelming. It was a daily fight.

The only thing that eventually pushed it from 'I'm managing' to 'I finally
feel okay' was medication. I don't feel like a zombie, or numb; I just feel
normal for the first time in as long as I can remember. It's not something
that is manageable any other way for some, and the stigma associated with
medication is only hurting those who need it.

------
K0SM0S
It's anecdotal, but I've found my cure for depression: it's called Stoicism. I
hear it's been useful to people for a couple thousand years, and is pretty
much 'confirmed' by modern cognitive psychology.

I experienced depression on and off for about 20 years, between 12ish and 34
(2016). Then shit really hit the fan, the perfect storm so to speak, and I was
shattered to the core of my being and my values. Honestly it felt as though
dying would pretty much be a non-event (although I'm not suicidal so it wasn't
really an option, but survival instincts kicked in at some point and were all
that prompted me to feed once in a while each week for a couple months; it
took half a year before I even wanted to get better, to cope).

Then I read "The Obstacle Is The Way" by Ryan Holiday. This book pretty much
changed my life. I guess it came at just the right time.

I underwent a sort of 'quantum change' as some psychologists call it: a
profound, meaningful, lasting and massive change of my core personality and
values, even thought processes and emotional responses. I am me, I mean I do
recognize myself and so do my friends and family, but I am also a truly
different being, it's like my biology has changed and my mind with it, or the
other way around, idk. People confirm that I do look different, in the eyes,
in what they feel around me. I certainly feel like my old self was flawed
beyond salvation and has died on a psychological level. I feel like I salvaged
as little as possible and proceeded on reinventing myself. It is still an
ongoing process, although slowly stabilizing (it will be a year in December).

Overall I am now able to create from scratch all the joy and motivation I
always longed for, to accept reality easily in ways that keep surprising me,
and to remain positive (or neutral) in most circumstances. Nothing's perfect
and that's good to me. I still have habits to master (dwelling on past
circumstances that provoked this major episode last year), but it's night and
day with what I used to be.

Considering what I went through before this change, and during it, I consider
myself lucky, even blessed on some level (atheist here, with some scientific
awe for existence and the cosmos).

Feel free to ask for more details and suggestions, I'd be happy to oblige,
otherwise you know the book. Best of hope to everyone.

~~~
andrewjl
I'm curious about how you've come to realize you've changed as profoundly as
you did, was it an instantaneous observation or something that revealed itself
over time?

~~~
K0SM0S
I read the book in one shot (audio+text), and something clicked inside.
Immediately. I recognized a potential solution, so to speak. I was aware of
being exposed to something that was touching me pretty deep. But with my usual
skepticism (scientific mind), I did not know if the 'magic' explained by the
author(s) would work (I have no other word to qualify how prodigious Stoicism
appears to be when you first encounter its teachings, seen by a rather
depressed mind).

At the time I wad coping with life, trying to pass each day. I did not know if
I would ever get better, I was in survival/automatic mode. However because of
that I was blindly following advice from a few online mentors (Ralph Smart
from "Infinite Waters" on YouTube, Ali from "The perception trainers", and
John Sonmez from "Simple Programmer"). These three channels were my lifelines.

So I just added Ryan Holiday's precepts into the mix, no thinking whatsoever
beyond trying to assimilate his Stoicism. I pretty much read the book a second
time that week. Again, it clicked, it felt like a relief, soothing, I began to
see that it worked on a very basic level—like buttons to control/process
emotions using your rational thought. It wasn't the things I lived through
that were hurting me but what I thought of them, that part became very clear
very fast. Suddenly I had _some_ degree of control, it was more bearable. So
that first part was almost instantaneous (days).

Then I trained my mind further. Do note that I was as close as I've ever been
to a blank slate since my childhood at that moment, because most of my ideas
had been shattered by real life, real people (notably my illusions about
"being good" to a woman, my values that higher moral standards do yield
positive results etc; and my disease, cluster headache, was in full-blown
suffering mode and attacks were related to being emotionally upset, so
_anything_ that gave me even the slightest tad of serenity was very much
welcome).

Within days, perhaps a few weeks, I began to see a more profound change. I had
been searching for decades for a way to control my depressive tendencies, I
had admittedly real reasons to be very down at that time (grieving family
members + breakup + disease), and yet I was climbing back up. I began to
wonder if I had finally found a "cure".

This was days before 2017, and I decided to read books this year, a lot.
Entrepreneur mindset and all that. I had read Napoleon Hill's Think And Grow
Rich in November, it had moved me quite a lot as well.

The rest is history. I went to see a neurologist in February for my disease
and we found a med that worked, by May I was almost free of pain and I had
means to deal with attacks; I'm still finishing the treatment until November
but no attack in months.

I've grown exponentially since, reprogramming my mind with the best material I
could find on topics of interest to me (if you look at Tom Bilyeu's reading
list on impacttheory.com, you'll get a fairly good idea).

I'm still in process of discovering this change of mine. The best proof I have
is emotional. I've discovered a bunch of rather negative facts about my ex
(she has sociopathic tendencies, I now see that, complete with revelations
that could make more than one burst in rage or despair etc). I've cut all
contact with her (she was still playing mind games afterwards). But you know
what? I now choose not to be affected. I'd say the emotional shield is ~90%
effective, what little feelings I have thinking of all the shit she did to me
are rather empathy for her (she's a really troubled individual and I wish she
sought professional help, but personally? I shrug it off, it's not my cross to
bear). Believe me when I say that I would have been incredibly emotional and
in a victim mindset _before_. Now I don't care emotionally, and rationally I
dismiss it whenever I think of these years 'lost' with her. I simply accept
that it's my past and I can actually feel grateful because it made me who I am
today; "amor fati".

As for deaths in my family, I've accepted these too and I simply try to uphold
the moral standards of these important people in my life (father and
grandmother). I live true to what they gave me, I feel no sorrow, I just use
this as energy to move forward in my own life.

I am still evolving, actually it's become a trait. Growth, growth, growth
mindset; learn, evolve, better yourself, etc. It's a wonderful feeling. I
appreciate failure for what it teaches me, I'm actually happy regardless of
outcomes. I never feel sad or bored or upset, whatever reality throws at me
I'm happy to deal with. I actually find it weird when people get upset at
something because I hardly ever do that anymore.

Mind you I'm not perfect, not by a long shot, I still have so much to learn
and live, so I find joy every day in simply living my life. I now have a
purpose, much greater than myself, so it's all about that. I, personally, will
be OK somehow, I know it because I will it. In that sense, change is still
ongoing but I don't think it will stop any time soon. Probably when I'm dead!
And that will be just, too. :)

Does that answer your question? Sorry for the delay, busy weekend. I maintain
an Instagram account where I write long posts about this change, among other
topics, if you wish to know more.

~~~
andrewjl
I'm glad that you're better now. :)

Yes it did, thank you for the explainer. It's a good example of the fact that
changing how our minds work for the better is a multi-modal, multi-
disciplinary endeavor.

Would be interesting to see if there are doctors out there who can practice a
more integrated approach rather than just focusing on one avenue of getting
better.

------
johnny99
I love you for writing this. I spent thirty years either trying and failing to
fix myself, or being misdiagnosed (turns out treating bipolarity with
antidepressants can do more harm than good). It wasn't until I had kids that I
tried once again to get out of my hole, and got correct treatment. Luckily my
kids were still little and the only dad they'll know is someone much better
equipped to to be fully present and loving for them, in a way that was often
buried before.

To anyone needing help, if it's easier to take action for someone else, do it
for their sake. And hopefully you'll see that it's ok to have given yourself
that kindness too.

------
marojejian
Understandably, these threads are full of anecdotal cases of effective
depression treatments. But why should we assume the there is is a one-size
fits all treatment (or even 3)?

I think depression is akin to a common error code in the mind (and maybe body
too). If the mind is at least as complicated as the biggest program we can
imagine, why should we imagine one thing will likely fix this problem?

This is like suggesting the same code would always fix a given common error.

It seems more likely to me that there are many causes of depression. While
there will be many commonly effective treatments, they will vary based on
context. Sometimes the effective treatment will be very specific / personal.

~~~
pdfernhout
Here is a lengthy compilation of ideas towards coping with depression that I
submitted elsewhere but it unfortunately got flagged as spam by Disqus and so
was not published in the original context:
[https://sbindependent.org/depression-and-anxiety-in-
college/](https://sbindependent.org/depression-and-anxiety-in-college/)

It very much reflects your suggestion that there are many causes of depression
and many possible coping and/or healing strategies, so I am posting it here.
[It just got a "that comment is too long" error message on hn, so I need to
split it up...]

====

Hi Jennifer (and any SB Independent readers struggling with depression for
themselves or a loved one),

Here is a collection of advice I've posted elsewhere for other people about
overcoming depression and other forms of mental illness (or at least coping
better with it). I hope this can help. I wish I had know this all when I was
an undergrad at SUNY SB a long time ago. Perhaps it might overlap the readings
you said a professor suggested to you.

First, remember, the brain is mostly fat. You need to be eating healthy fats
(like walnuts, avocado, omega 3s, etc.) for brain health. But that is just a
start on what good nutrition involves to get lots of micronutrients (more
veggies, fruits, beans, nuts, seeds, whole grains as in "you can see the
grain"). Be sure you are getting enough vitamin D3 (which is almost impossible
for most people without supplements given our indoor lifestyle and other
lifestyle factors). And get enough iodine, like from sea vegetables. And also
enough high quality B-complex vitamins.

From Dr. Joel Fuhrman: "Depression doesn't have one specific cause;
environmental and genetic factors may be at play, as well as psychosocial
stressors, however, a major factor causing depression is unhealthy dietary
factors. Fast-food and commercial baked goods are linked to depression in a
dose dependent manner, and dietary excellence can be the solution for many
suffering individuals. A feeling of a depressed mood can also be a symptom of
other medical conditions or a side effect from a medication, so to be sure of
what is causing your symptoms, you may need to discuss your depression with
your doctor."

Search also on "The UltraMind Solution: The Simple Way to Defeat Depression,
Overcome Anxiety, and Sharpen Your Mind" by Dr. Mark Hyman, again focusing on
nutrition.

Water-only fasting helps in some cases of mental illness too (especially if
brain inflammation is caused by some food allergy). The Russians did a lot of
research and practice on that.

Obviously, good mood is more complex than just nutrition. Look at Dr. Andrew
Weil for a broader perspective.

Or see an essay by Philip Hickey, Ph.D called: "Depression Is Not An Illness:
It is an Adaptive Mechanism"; quoting from that:

    
    
        "In order to feel good, the following eight factors must be present in our lives.
       * good nutrition
       * fresh air
       * sunshine (in moderation)
       * physical activity
       * purposeful activity with regular experiences of success
       * good relationships
       * adequate and regular sleep
       * ability to avoid destructive social entanglements, while remaining receptive to positive encounters"
    

[And when any one or more of those factors are missing -- it can lead to
depression, with the likelihood increasing if multiple factors are missing.]

Also, check out: "The Upward Spiral: Using Neuroscience to Reverse the Course
of Depression, One Small Change at a Time Paperback" by Alex Korb PhD.

There are lots more resources like that. There are lots of alternatives to
placebo-like mental drugs...

Search also on "Sleep deprivation can effectively treat depression" for
another option to consider.

Our society is also all too quick to label a "spiritual crisis" as mental
illness (see Wikipedia on that term).

Thanks for your series of essays on these mental health topics. I learned
something from them, especially about how depression and anxiety can cycle
together, where anxiety becomes the only force that can counter depression as
far as getting anything done. That doesn't mean that is a happy or health way
to be -- but it is informative to understand that cycle, and in that context
of depression, the "benefit" of anxiety.

As with Chester Bennington (who I learned about from the article you posted
for someone else on that, leading me to your series -- and then watched his
band's "Numb" video and a couple others), sometimes if we dwell on the
negative, it does not really get us healthier overall. As in helping create
the "Numb" video, Chester built on his strength of music and it at least
sustained him for a time and helped him help others and in other ways connect
with other people like with the rest of the Linkin Park band. And in that
"Numb" video, one might hope for the same for the protagonist as there are
certainly a lot of people out there who do appreciate art or can be moved by
it or who take joy in creating it together with others.

For my generation, Robin Williams is a bit of the same symbol as Chris
Bennington -- although he used humor instead of music to connect to people and
to manage pain (but not totally cure it). Like all helpful drugs, music and
humor can make a difference in sustaining us as we cope with pain, but we
still need to address the underlying issues as best we can. And even if both
artists lost that battle with pain in the end, they at least had much longer
and better lives from building on those strengths -- and the community around
them was much better for their long-term willingness to do what they could
with what they had. While most of us may never have that level of comedic or
musical talent, or the opportunities to refine that talent by years of
practice, "the woods would be pretty quiet if no bird sang there but the
best". Someone with even a fraction of their level of talent could make the
lives of many people around them a lot better with just a little humor or song
added to every-day interactions. You can also use a talent as a volunteer or
as a hobbyist sharing with others even if you do something else as a day-job.

[continued in a part 2 reply to this...]

~~~
pdfernhout
[part 2 to go with the above]

Look into "Positive Psychology" about building on our strengths -- like you
are doing with your writing.

See the movie "It's a Wonderful Life" \-- which, at the very least, can make
us wonder if there is any chance we could make things even just a tiny bit
better for ourselves and/or a few people around us by engaging with life?

There is an insightful comment by "Brian" on Hugh Howey's website under "Our
Silos Leak" I saw just last week where he talks about how figuring out why you
feel so badly doesn't usually help that much and may even just deepen the
traumas. It is focusing on what you want, what makes you happy (within
realistic limits) and taking steps toward that which get you to a better
place. The comedy "Cold Comfort Farm" has an interesting angle on that.

The main essay on "Silos" is also good in talking about how it is reasonable
to minimize our interactions with vexatious people (of any political
persuasion) and we can still have occasions to experience new ideas and
reflect on them in a less knee-jerk way. And those vexatious interactions can
also include (and probably do) much or all of television, "news", and social
media.

Search also on "On the Trail of the Orchid Child" for a Scientific American
Article on how whether some people's genes can either be a great benefit or a
great detriment depending on their environment.

We all have inclinations, habits, preferences, and reactions that can be
strengths or weaknesses depending on the situation. Stony Brook itself is like
a small city -- it has many different social environments that can be better
or worse for different people.

Finding the right niche(s) from all the possibilities that works for you can
be a bit of trial and error. But finding the best matches of groups to be part
of (including from family, neighbors, clubs, classes, volunteerism, jobs,
online, etc.) is essential. All of the above is much easier said than done,
and it is more feasible to be healthy when part of a group of others also
striving towards health. For example, if you try to eat well and you are
surrounded by people eating junk food who are always offering that junk to you
and denying its health cost, that just is so much harder than if you are part
of a community all trying to eat healthier and supporting each other on that
journey with all its ups and downs.

"Bluezones" is another positive touchstone to see how happy people live for a
long time -- and a lot of it is just about getting the basics right like in
the Philip Hickey quote above.

And then when things get going well (or even before), watch out for
"Supernormal Stimuli", "The Pleasure Trap", and "The Acceleration of
Addictiveness" (see two books and an essay by those names).

One nurse who was critical of one of Dr. Andrew Weil's books on Amazon pointed
out that much ill health is caused by poverty (and I might add, ignorance,
which good journalism can help dispel). Like in "A Christmas Carol", "This boy
is Ignorance. This girl is Want. Beware them both, and all of their degree,
but most of all beware this boy, for on his brow I see that written which is
Doom, unless the writing be erased." It is hard to eat well, say, when you
can't afford fresh vegetables or don't have the time or place for preparing
them -- and also if you just don't know why eating healthier is so important
or how to do it.

Long term, social and technical changes like from a basic income, improved
subsistence by personal robotics for gardening and preparing healthy food
(e.g. Farmbot or Moley Robotics), better organizational planning and
governmental accountability, and more gift giving of knowledge via the
internet, may help alleviate some of the worst causes of day-to-day pain and
worry in the modern age. So, those can be positive changes to work for -- and
working towards such things can provide some hope and bring us together with
other hopeful and caring people. And underlying all of that is a cultural
change and a "global mindshift" towards abundance thinking and favoring
cooperation over competition (see Alfie Kohn) which journalism can help with.

And, when all else fails even when we seem to be doing everything we can,
consider: "Dark Nights of the Soul: A Guide to Finding Your Way Through Life's
Ordeals" by Thomas Moore for finding meaning and even personal growth in the
darkness.

Good luck!

~~~
pdfernhout
While I did not mention this in that original contribution, here is a 200 page
essay I wrote in 2008 on re-envisioning another university I attended as a
post-scarcity institution -- hopefully one which countered depression and
other pathologies with positive psychology, healthy action, and hope: "Post-
Scarcity Princeton, or, Reading between the lines of PAW for prospective
Princeton students, or, the Health Risks of Heart Disease"
[http://pdfernhout.net/reading-between-the-
lines.html](http://pdfernhout.net/reading-between-the-lines.html)

From the introduction: "With Princeton-praising articles titled "Jumping From
the Ivory Tower", it seems like PAW [Princeton Alumni Weekly] is not helping
answer these deep questions. If anything, PAW is helping bury them under
inappropriate humor. This essay is not intended in any way to condone violence
or the abdication of personal responsibility. But it is intended to help
understand some of these issues of suicide and alienation in a university
context, and to make suggestions for improvements to the social part of these
issues. It even tries to use humor in relation to suicide and morbid themes a
bit more appropriately (satirically about PU in this case, discussing options
like its voluntary peaceful self-dissolution to help a billion poor children
get an education, or its metaphorical death and rebirth as an agent of global
economic transcendence to a post-scarcity society of abundance for all). It is
always easier to destroy than to create, so this essay includes some specific
suggestions for improving the situation at Princeton University, which is a
mythologically-troubled institution (even as it is filled with many wonderful
and caring people)."

One issue I explore is that the virtues of elitism, competition, and
excellence that Princeton University celebrates all have shadow sides like
alienation, destructiveness, and perfectionism which can lead to depression,
anxiety, and a host of other illnesses from extremism (including heart disease
possibly from an extreme fat-free diet which killed a classmate at an early
age), such as when I wrote: "I can also hope that many of these issues at PU
continue to slowly change. There is some hopeful news now and then in PAW
(like more profiles of alternative alumni careers), even as the deep issues
about "elitism" (alienation?), "competition" (destructiveness?), and
"excellence" (dissatisfaction? perfectionism? excessive self-criticism?)
usually remain unspoken."

~~~
pdfernhout
Here is also some more recent (as-yet-mostly-unrealized) ideas (put together
for a 2013 Knight News Challenge) towards helping people make sense of their
own health issues (depression or whatever they may be) when confronted with a
mass of often conflicting information often dispensed by people with
undisclosed conflicts of interest:

[https://web.archive.org/web/20161104203536/https://www.newsc...](https://web.archive.org/web/20161104203536/https://www.newschallenge.org/challenge/healthdata/entries/health-
sensemaking-software-tools) "We want to improve public health through free and
open source public intelligence tools for individual and collective
sensemaking about health topics -- especially related to nutrition and
lifestyle... When confronted with a health issue, many people turn to their
doctor, the internet, or friends for advice. But then what do you and your
family do with all the advice you receive? What do even health professionals
do with all the often conflicting information out there when they research a
patient's health issues? We want to create software that helps with that
challenge by making it easier for individuals and communites to collect health
information (from whatever public sources including the internet), organize
it, prioritize it, reason about it, act on it, and feed back the results of
action into a next iteration as a learning experience."

Here is a motivational example about salt intake from that proposal, but it
could just as well be about understanding depression and various options as
they apply in your own life:

====

For example, consider the question of how much salt of what type is good for a
specific person (you) to eat every day? How easy is it to begin to research
that for yourself? How long would it take, even with a web browser and search
engine at your finger tips? How would you know which study to trust and how
much -- including based on who funded them or how carefully the work was done?
How could the online community help organize all that information for you? If
it was organized, how would any general advice you found about salt
consumption apply to your own specific situation and lifestyle and family
history? Would the amount of salt you needed matter based on how much you
exercised, or where you lived, or whether you went outdoors a lot, or whether
you ate a lot of fruits and vegetables? How would you answer the question of
whether there other health factors in play that may make some people sensitive
to salt, and perhaps if you improve those, maybe salt intake won't matter
much? How have opinions about that changed over time? If you try changing how
much salt you eat, how should you interpret any changes in how you feel?

There may well be "experts" out there who know good answers for these
questions specifically about salt, but they probably are not you personally.
Statistically there might be a small number of experts out of billions of
people, so most people thinking about how much salt to eat are not going to be
experts. So, almost everyone is left wondering which experts to trust? Even if
all the experts agree, they could still be wrong, or their general advice
might be easy to misinterpret for your particular situation. And if you
specifically by chance are an expert on salt intake, then you probably are not
an expert on phytonutrient intake or cancer treatments, and so you would be
faced with this same issue in some other area of personal health. So, there
can be a gap between what an expert (or community of experts) know, and what
an individual or local community knows and then acts on. Part of the value of
better software tools, including educational aspects, may be to help bridge
that gap between expert knowledge and individual practice.

This recently temporarily "withdrawn" article on "Reduced dietary salt for the
prevention of cardiovascular disease" due to "doubts raised about the
integrity of research" is an a example of how dynamic the medical publication
landscape can be. Withdrawal of one article does not mean other similar
articles are not valid though, or that a general concept is not valid. The
research landscape can seem very dynamic and conflicted, even if there may
often eventually emerge broad agreement on some truths. Could better tools
help even subject matter experts track all these changes? So, whether you are
an expert in a field or just an individual with a health issue, there is a
challenge to make sense of this all for yourself at any point in time (even if
the challenges may differ somewhat for expert and patient). It is also hard to
draw conclusions from small numbers of studies in a mass of large numbers of
publications on complex topics (something somewhat analogous to "weak signal
detection" in the intelligence community). Yet, ultimately, each of us still
personally needs to decide how much salt to eat each day (or broccoli or sugar
or barley), so we can't avoid the issue (even if we can ignore the issue or
any new information and just keep on eating as we have in the past).

Ideally, one might imagine authoritative sources on every aspect of health
(including salt consumption) which supply the best health advice for every
locality specific to every person. For example, imagine the archetypal old-
fashioned-but-up-to-date grizzled "country doctor" who knows entire families
in a community from birth for multiple generations in a personal way and
provides the best specific health advice for the area and the individual. That
might range perhaps from "Salt killed your grandpap!" to "Ain't too much to
worry about salt since you exercise so much working outside in the Arizona
sunshine." But such a health practitioner and community is mostly just a
fantasy. There may be such health practitioners and stable communities out
there, but they would seem at best few and far between these days in today's
highly mobile society.

Compared to the ideal mentioned above, in practice a typical real-life health
interaction for all too many people is more likely to be ten minutes spent
with a new physician (perhaps due to insurance plan coverage changes) who
recently moved to the area, has big worries about repaying US$200K in newly-
minted student loans, and has limited experience with a specific health
complaint and the individual's life history (including what is not said). In
regards to an issue like advice on salt consumption, even if the physician
knows that in theory someone who exercises outdoors a lot probably needs to
take in more salt, is there going to be time to get around to discussing that
level of detail about lifestyle with the patient or how it might relate to
some health issue? Would there be time to explore and address a digestive
complaint perhaps unknowingly from weak stomach acid from low salt levels? It
may well be that many people eat too much salt, but perhaps this specific
person perhaps eats too little for his or her situation?

In practice, there are a variety of sources of health information we encounter
each with various conflicts of interest and with limitations in focus,
experience, time, and continuity. A person with a health issue is confronted
by all that complexity, even if they may choose to delegate the authority for
all their health decisions to some chosen medical practitioner. Ultimately, we
can delegate "authority", but not "responsibility"; in that sense a competent
adult remains responsible for his or her health regardless of who has been
asked for advice or who we let perform procedures on us.

====

There is the vaguest beginning of that in a GitHub project linked here and in
some other projects called Twirlip (but they've been eclipsed by a need to do
other things for income): [https://github.com/pdfernhout/health-decision-
support-tools](https://github.com/pdfernhout/health-decision-support-tools)

Although, as in the example there using IBIS to explore choices for dental
health issue, it is possible that the IBIS methodology may be good enough to
get a lot of people fairly far. Likely we can do better than IBIS, but I can
acknowledge it is hard to do better than IBIS for several reasons (including
simplicity, learnability, speed, and collaborativeness). For more on IBIS,
Dialog Mapping, and Wicked Problems, see the references I've collected here
(among others on a larger topic): [https://github.com/pdfernhout/High-
Performance-Organizations...](https://github.com/pdfernhout/High-Performance-
Organizations-Reading-List)

------
hndl
The solution is that every one of you listen to a friend who is in need and
empathize and say, yeah -- i'm here.

Kudos to Zach for opening up about this. I'm going through a similar shit show
and I'm hoping that folks who grok it stick close and the others just sway
with.

~~~
hndl
REMINDER: we're talking about something sensitive here.

------
projektir
Some conundrums I have with this article and other folk here saying that you
should get a therapist, that everyone should see a therapist, and you should
listen to your therapist:

1\. How do you find a good therapist, and given the disparity in their
quality, why would you trust yours all that much?

2\. Therapists can get very very expensive. Yes, including insurance. Very
very expensive.

3\. Therapists often can't meet you outside of business hours when you're
often working.

~~~
AlphaWeaver
These are very real questions that we as a society really need to think about
solutions for. Very good to point them out...

------
devdad
With respect, and as pure anecdote based on myself, "run a mile" is really
good advice. I've dealt with depression since puberty and the main thing that
helps me is excercise.

Lifting, getting punched with gloves or preparing for a marathon works wonders
for me (not said as an opposite opinion than the author, but as a datapoint).

And please, if you're dealing with depression, you need to find out what works
for you. Friends and family can help you find your way back, but they can't
make the decision. When you decide - you - to take steps for coping with it
nothing is impossible.

The author has sound advice on where to start. I'd just like to add that it
can take quite some time, and that's ok, because life is long and you'll look
back at this period and thank yourself for acting on it.

------
slr555
Saying my family history is significant for depression is an extreme
understatement. My parents and grandparents shared the sunny disposition of
Henrik Ibsen. It was no surprise that I too suffered from major depressive
episodes and dysthymia (persistent depressed mood over a long period of time).

It has been a long strange journey but by taking advantage of what the medical
community has to offer I now am happier than I ever thought possible. One
really important moment for me was the realization that everything is biology.
There is no difference between physical and mental health. Migraine pain and
the pain of depression both hurt. A heart attack and suicide make you the very
same dead. Everything you think feel and do is modulated by the soup between
your ears. If the soup is short of some ingredient or another it manifests as
emotion or behavior.

The book Behave by Robert M. Sapolosky is a fantastic journey into the
chemical basis for behavior. While the book is admittedly dense, Sapolosky
clearly explains how neuroanatomy and neurochemistry form the basis of
experience and consciousness. The writings of the late Oliver Sacks also
illuminate how when the physical seat of perception and cognition, the brain,
is disrupted in some way, our ability to perceive or what we perceive is
fundamentally altered. A patient with a visual field disruption was only able
to perceive half the food on their plate. Turn the plate around and the other
half was experienced by the patient.

The human organism is insanely complex and nuanced. Human life is in cosmic
terms is a trace of a blink. For anyone suffering from depression I would urge
you to put aside any misgivings you have about labels and stigma, find the
best doctor you can and start to address your depression. It's pretty great
not to be miserable. I've tried both.

------
imd23
Zen and buddhism. (Zen is not really buddhism).

Among many others things (therapy, running, playing high level piano, amazing
remote job), Zen rewired and helps me to deal with this every day.

I'd recommend this authors with all my heart to anyone:

\- Thich Nhat Hanh ("You are here")

\- Alan Watts

\- Eckhart Tolle ("Stillness Speaks")

\- Shunryū Suzuki ("Zen mind beginner's mind")

\- Ryan Holiday ("Ego is the enemy")

Piano helped me quite a lot. First my teacher, I could even say my piano
teacher played a more important role in helping me, more than my family ever
could. Musically I felt in love with Chopin and I really hope someday to be
able to play Ballade 4 op. 52. It puts me at least decade long goal (yup, it
is really really hard to play that).

Running, eating healthy, etc sure. But I think it works better to have the
brain thinking better first. Otherwise we'll stick in the same trap over and
over, with the same bad thoughts and habits we want to break.

We need to get beyond thinking and feeling. Training ourselves to see them,
observer them and letting them go. It takes a lot of time. But you can do it.

Hope something of this help someone.

------
swendoog
One thing for certain can be gleaned from reading all the responses in this
thread: We have no idea neither what the cause of depression is, nor what the
solution is.

Everyone here has posted something different. Exercise, diet, sleep,
medication x, medication y, prayer, water, gluten, meditation, losing weight,
socializing... the list goes on, and on.

If this weren't heavily susceptible to placebo, you'd expect that list to be
much shorter. My guess is that just doing SOMETHING makes people feel better.

------
gblain23
Cutting gluten out of my life basically "cured" my depression, which sounds
crazy, since it is just something I'm eating...

I'm not allergic, but probably intolerant. I ate wheat for most of my life.
I'm pretty sure it is related to inflammation, and how eating wheat products
probably screwed my digestion up. I also rarely get sick anymore.

Not trying to suggest that medicine, therapy, etc. does or does not work, just
that there may be some other things that people can consider and experiment
with.

~~~
Omnius
1 hour hold account 1 hour old comment. I am not trying to be negative but i
have seen no science to state that cutting gluten is going to do anything at
all for anyone unless they have Celiac disease.

You want to back that up with study or something? Its just WOO if i am wrong i
will be happy to eat some crow.

Further more the comment near this one about some imaginary threshold of MEME
count gives something legitimacy. REALLY?

WHERE AM I!!

~~~
scythe
It's also impossible to know that you _don 't_ have celiac disease unless
you've had an immunoassay that comes up negative. Not all celiac cases show
severe GI symptoms. As such assuming that someone does not have celiac disease
who has not been tested has a 1-2% false negative rate.

Secondly, gluten can aggravate FODMAPs sensitivity:

[http://www.gastrojournal.org/article/S0016-5085(13)00702-6/f...](http://www.gastrojournal.org/article/S0016-5085\(13\)00702-6/fulltext)

This study is often cited to "prove" that non-celiac gluten sensitivity does
not exist, but what it actually shows is that most "NCGS" cases are caused by
FODMAPs and that gluten can aggravate the symptoms in a person who has not cut
out FODMAPs:

>In all participants, gastrointestinal symptoms consistently and significantly
improved during reduced FODMAP intake, but significantly worsened to a similar
degree when their diets included gluten or whey protein.

Gluten increases GI residence time in everybody, which is not an unhealthy
effect on its own, but which can increase the duration of exposure to any
dietary irritant:

[http://www.gastrojournal.org/article/0016-5085(83)90374-8/pd...](http://www.gastrojournal.org/article/0016-5085\(83\)90374-8/pdf)

>Hydrolyzed gluten prolonged intestinal transit time, and this effect was
reversed by concomitant administration of naloxone

It's seriously that easy to just look up "gluten sensitivity" on Google
Scholar or SciFinder or (insert academic search site here) to find these sort
of studies. And frankly it's kind of annoying to see people who won't even go
to that level of effort degrading the actual personal experiences of someone
who is simply trying to improve their own life.

~~~
Omnius
Thank you for the links. As to laziness on searching for gluten sensitivity" i
wasn't the one making the claim that it cures depression.

Have an upvote anyways for your efforts.

------
tabeth
One thing I want to mention in addition to what everyone else says is that
community is essential. Even if you sleep well, eat right and exercise,
without community it's likely depression will find you eventually.

------
baus
As someone who has suffered from, at times, significant symptoms of bipolar
disorder, I glad to see prominent members of the community coming forward to
discuss mental health. I think the best way to break the stigma around mental
illness is open discussion.

I wonder if there is a higher rate of mental illness in the software
development industry compared with the population as a whole

------
abalone
Not a sufferer myself but I really enjoyed the book _Rob Delaney: Mother.
Wife. Sister. Human. Warrior. Falcon. Yardstick. Turban. Cabbage._ [1] Very
funny but also touches on his severe, near-fatal depression and alcoholism in
an enlightened manner. Talks about medication, how he talked himself into
getting help, the unfathomable experience of clinical depression itself, lots
of the things Holman mentions. Now he's the "funniest guy on Twitter" and has
a brilliant show on the BBC / Amazon ( _Catastrophe_ ).

[1] [https://www.amazon.com/Rob-Delaney-Warrior-Yardstick-
Cabbage...](https://www.amazon.com/Rob-Delaney-Warrior-Yardstick-
Cabbage/dp/0812983181)

------
lohankin
Following generic ideas as to how to improve your life is what makes people
depressed in the first place. You MUST do this, you MUST do that, become rich,
retire early, make the world a better place, do something for humanity,
healthy diet, exercise, you name it... Sure this all makes you depressed -
it's surprising there's still someone not depressed out there. And now what?
More diet, more exercise? Come up with a list of things you enjoy. Be
contrarian. Stop listening to anyone, and especially - to your "inner voice"
\- he is lying to you.

------
AElsinore77
In my experience, exercise was helpful, but mostly only after I realized what
I could learn about myself from it. Primarily, it allowed me to better
understand and manage 2 types of “automatic” thought processes that I have
constantly: (1) Intrusive Thoughts - unpleasant thoughts that pop into my head
(2) Motivated Reasoning - mind trying to draw logical but untrue conclusions
in line with my current feelings at the time

As an example of how the 2 may combine in normal life, an internal dialogue
might look like this: (1) Intrusive thought: “I can’t accomplish this goal”
(2) Motivated reasoning: “Because I’m a failure and I’m worthless” The most
insidious thing is that these motivated conclusions feel so right, feel so
self evident.

With exercise, similar thought processes will arise. The difference is,
because you are dealing with a simple physical task, there is the possibility
of immediate physical evidence to demonstrate to yourself your intrusive
thought, and the reasoning for it, are simply wrong.

The analogous thought processes during exercise might look like this: (1)
Intrusive thought: “I can’t finish this workout” (2) Motivated reasoning:
“Because I’m not in good enough shape and it hurts too much, I can’t take it,
I need to stop” There is a point where I feel like I want to stop, and at
first it seems so reasonable to stop, to not overwork myself and hurt myself.
But if I push on past that point, there is a realization “Huh - I’m still
here, I’m still doing this, I thought I didn’t have it in me, but irrefutably
I did because I am here still doing this after I thought I was done.”

I always thought I was naturally unathletic; I was never good at sports and
hated exercise until I became an adult. Looking back now, I realized the only
reason I was unathletic was because I believed I was, and my power of belief
made it a reality.

As I’ve grown older, the intrusive thoughts and motivated reasoning are still
here, but where in the past they stopped me dead in my tracks, now I have
learned to see them for what they are and not let them define me.

Everyone has different experiences, and I mean no disrespect to anyone who
hasn’t found value in exercise; I believe there are many ways to learn these
types of lessons; for me, it just happened to be exercise, but it could have
been anything.

------
chasd00
It's just about impossible to fix your brain on your own. The only tool you
have is the one that's broken. How do you fix a hammer with a broken hammer?
Seek external help first.

------
phantarch
A question for the author or anyone who has been through a similar experience:
Can you better describe what life is like without the "haze"?

One thing that I see consistently in these kinds of writeups is the author
describing living life "through a haze". Then later, after the therapy/drugs
helps them out of the depressive pit, they say how much clearer things are.
This worries me because I have plenty of days where I feel "hazy", but have
always though it to be normal.

------
theyregreat
I have nearly life-long chronic major depression that can’t be cured with
socialization, sex, money, sleep, diet, exercise or various forms of therapy.
I’ll take a random stab that it is mostly genetic and partly by having had a
tyrannical, histrionic, screaming father whom caused frequent stress: this
then setup poor vagal tone and “walking-on-egg-shells” hyper-vigilance which
then neuroplasticized towards reinforcing pain-depression complex of the
military-industrial kind.

I now have depression again after mirtazapine tachyphylaxis. It’s a widely-
hitting NaSSA and powerful antihistamine (which also means hypnotic). It’s
also the most effective antidepressant (I was on a heavy dose, 60 mg) but it
causes weight gain (+25% body mass) and G.I. slow-down. That’s great when it
works, but now I’m letting the old black dog have another ride as buproprion
XL 300 mg isn’t doing anything useful so far. Maybe, still really foggy,
confused and increased pain perception.

Not being depressed is awesome: like the clouds parted, quieted inward
observation, less reading, less writing, less sleeping-in, pain set aside,
more energy, enjoyment and orderly thinking; almost manic but, presumably, not
bet-kid’s-education-fund-on-18 far.

Looking at next alternatives:

* Bupropion XL 450mg

* AXS-05 (60 mg DM with bupropion)

* Venlafaxine ER

* Venlafaxine ER + Lamotrigine

* Venlafaxine ER + Mirtazapine

PS: Paxil gave me serotonin syndrome and Zoloft did jack shit.

~~~
nylonstrung
I'm on Buproprion as well. I'd recommend ketamine, tianeptine, possibly MAOis.
The latter are remarkably effective but underprescribed for a number of
reasons, including an overblown fear of hypertensive crisis.

------
nils-m-holm
There is a lot of advice regarding depression and a lot of things people say
may be helpful to many others.

There is, however, also the chance that someone's life really is FUBAR and no
amount of exercise, therapy, drugs, and whatnot will change anything. And then
everybody says that the one who is suffering "does not want any help", "is not
suffering enough to accept help", "is happy with his suffering", etc.

Well, pardon my language, but that's such a giant pile of bullshit! All that's
happening there is that the one giving advice is helpless and not willing to
admit it. And that's _especially_ true of psychologists and other
"professionals".

Source: have lost three people who committed suicide and in two cases I would
say that there really was no other way. We, as a species, totally suck at
helping.

And, yes, there probably would have been ways to help above people, but it
would have taken _time_ and _dedication_ and who is willing to invest that?
It's so much easier to try a quick fix and when it does not work, blame it on
the sufferer. Unfortunately I was young back then and did not understand
that...

------
fiachamp
Thanks for posting this, right around Worldwide Mental Health Awareness Day
too.

To anyone reading this who is struggling but hasn't had the time to talk to a
human therapist, I'm working on an accessible AI therapist to provide at least
some experimentally verified help. I've got a prototype up at
facebook.com/mindfulmarsha and would love feedback from yall. I work on this
bot at night after work and am a ways out from doing anything to monetize it,
so if you're interested in helping with dev time, message Marsha on FB or
contribute to our patreon: www.patreon.com/mindfulmarsha

I was diagnosed with Generalized Anxiety Disorder after a panic attack in
2014, ironically during a time that it looked like the startup I was at was
going to be unable to raise a round and my girlfriend at the time was
suffering from severe depression. It has taken me years to be functional
despite my appearances, and I literally, while working on adding the PHQ-9
Depression screener to the bot, realized that I had also been suffering from
depression. Trying to turn this pain into a platform though. Looking forward
to feedback!

------
openfuture
I spent several years paralyzed with depression, it got to the point that all
I could do was stare at the ceiling - wasn't even worth the effort to commit
suicide I might as well just wait until I die.

Self destruction is a natural thing, a part of the growing process, you just
have to channel it somewhere. Some do tattoos or something, I like yoga, but
whatever works I guess.

What I've started to realize is that we hold on to our ego with all our might
until nothing else is left. However, embracing new perspectives is a
prerequisite to growth and whether you do that through religion, drugs,
therapy or meditation the fact is when you're suicidal you desperately need a
new perspective.

Letting go of your past self to become the next version is a metaphorical
death and sometimes it can be confused with the desire for actual death. This
is what I mean by channeling the self destruction, maybe you do it in a way
that leaves a scar so you can be reminded of your older self. That may be
necessary if you've been completely conquered by your ego.. but for most
'normal' people it's enough to "take action" so to speak and start behaving
differently (exercise, food, socializing, etc.)

Just never ever ever let yourself feel self pity. Self pity is a feedback loop
and the worst thing you can do to yourself, if you can just stop that one
thing you will eventually fix things on your own.

Edit: That first step getting out of depression is difficult, you may need a
nudge but be sure not to let yourself go back there!! You need to keep "self
destructing" constructively or you will sink again, there is no cure-all that
lasts forever. You need to keep living cause the living never give up - that
choice isn't going anywhere, it's called death.

------
andrewjl
Our society puts a strong onus on people suffering from depression to seek out
treatment. Which, don't get me wrong, oftentimes works and can genuinely
improve people's lives.

But what if depression is a sign of a deeper societal / cultural /
teleological incompatibilities with what naturally makes us happy or
fulfilled? What if the real solution isn't to (just) treat individuals but to
build the kind of world where depression is less prevalent. I'll repeat myself
to avoid misunderstanding, every person should seek out and has the right to
be provided with best possible treatment if that's what they need, my point is
that it's a start but not enough to address the root cause. There are
statistical relationships between rates of depression and modern "developed
world" lifestyles.

------
yters
In the same way pain can indicate something is wrong with our body, depression
indicates something is wrong with our psyche. Lifestyle changes have helped
me, but reasoning about the pain, trying to release it to God, and getting my
life right have also helped. An older Catholic told me mental illness
increased dramatically when people stopped going to confession regularly.
Looking back, a lot of my depression came from guilt, and still does. Ignoring
and rationalizing the guilt by believing free will did not exist did not help,
it just made me unable to accept responsibility and fix the problems in my
life.

------
joeblau
Zach was one of the developers I idolized when I moved to San Francisco in
2011. From what I saw, he had everything going for him. Sub 10th employee at
one of the hottest startups, amazing blog posts, amazing talks, great
developer, ability to travel the world. He was the man. After the whole GitHub
shakeup, I started hearing less and less from him and since I didn't know him
personally, I never reached out. After reading this, I'm happy to see that
he's in a really good place.

I hope your best days are a head of you and I wish you the best Zach!

------
B1narySunset
I've been on a ketogenic diet for the past two months, and I've noticed less
"down days", negative thoughts, and a more positive outlook on life in
general.

------
wolfspider
In my teenage years what really helped with my depression was going out and
getting involved in the local music scene. Becoming a "personality" of sorts
did wonders. Especially the punk scene- those are some upbeat people they will
literally kick the depression out of you simply because its not widely
tolerated at their shows. Live a little, create your own strange fiction, give
yourself something to remember.

------
acscott
In general, if one has a serious decision to make, it's probably wise to seek
out expert counsel (not that you should blindly follow that counsel either).
Same goes with your health.

[Avoiding getting into some kind of discussion about anecdotes, scientific
evidence, etiology, qualifications, etc. I am glad for remissions and worried
about those still suffering.]

------
maxlamb
while on the subject, highly recommend this video on depression from
Stanford's Sapolsky to understanding the underlying biological aspect of it:
[https://www.youtube.com/watch?v=NOAgplgTxfc&t=1216s](https://www.youtube.com/watch?v=NOAgplgTxfc&t=1216s)

------
miguelmota
Anti-depressants have done wonders for me (sertraline) and also for people I
know with depression. On the flip side, I've read stories that they make
people more suicidal. You won't know till you try different treatments. Some
things work better than others for different people.

------
Simulacra
Depression is a killer, and that's even without stress. My husband works in
politics and he goes through this depression and happiness cycle. The less
stress he has (read: The more stress I can take off his plate) the better he
performs and is able to manage his depression.

------
ThinkBeat
Here is a great lecture by Stanford's Sapolsky On Depression, that explains
clinical depression fairly well.

[https://www.youtube.com/watch?v=NOAgplgTxfc](https://www.youtube.com/watch?v=NOAgplgTxfc)

------
NiklasMort
If you are not religious I find it hard to find a reason to try to continue or
to get out of the hole. The biggest problem is the lack of goals, or feeling
like you have done everything already. Then you ask: Why bother?

------
codecamper
I was pretty depressed for a while. Swimming & surfing fixed that. Started
surfing age 34, so it's never too late. There really is something about it
that hits all the right neurotransmitters.

------
ada1981
MDMA assisted therapy helped heal this in me entirely. I found depression was
resistance to feeling and accepting my emotions fully and that I could instead
make space to engage with and be with emotions.

~~~
kweinber
Is there a legal, accepted MDMA assisted treatment path or something you
fashioned yourself? Any references you could share?

~~~
ada1981
Maps.org is the best place to get the latest resources and to learn of current
clinical trials (mostly for PTSD).

I did my work on my own with a trusted guide. Though I have been asked to
write up my experience to serve as a starting point for more research.

Basic format was 100mg + 50mg booster at 2 hour mark. Eye mask, couch,
blanket, music.

My interface with western psychiatry was a diagnosis of schizophrenia (at 18)
and later bipolar (at 33). And I've experienced everything from anxiety,
paranoia, depersonalization, depression, suicidailty, panic attacks, etc.

I'm med free, feeling very healthy inside, in love with a wonderful woman. My
relationships are nourishing and my internal compass is much more trustable.
I'm 36 now, so it took a couple years once I decided to "fix" the problem. I
also feel like I let go of a lot of the defenses I was hiding behind and quite
enjoy life from a vulnerable and honest place.

My biggest challenge now is just cleaning up the debts and general mess left
by my healing process expenses and getting a bit more consistent income. But
both of those seem possible and manageable. And I also have been able to help
/ coach a lot of other people along the way.

------
GeertVL
"I want transparent discussion of mental problems in society."

Me too. I am still in the same league Zach was.

------
Domenic_S
Meta (sorry mods, feel free to delete):

Is anyone else getting insta-downvoted on every comment?

~~~
NumberCruncher
Some people don't share your views. So what? Why do you care?

~~~
Domenic_S
I've got the karma to burn that I don't really care about the points. But
aside from the "downvote is not a disagree button," twice in a row I clicked
submit on a comment and by the time the page loaded I was at 0. I mean it was
so quick that I wondered if 0 was the new default!

I noticed a few other people with perfectly reasonable comments that were
grey, too. It seemed unusual. I've been around long enough to have a sense of
what's usual.

------
jackschultz
There are a lot of comments here about their depression, so I thought I'd
throw my experience in here since it's slightly different.

Last year, after having these episodes that I didn't recognize for a while
that were seizures, I went to the doctor, had an MRI, and was started on the
anti-seizure drug Keppra. The seizures went away, and I thought it was half
funny this whole experience. Time ticked on for a month or so and things
started going downhill. I have a programming and a golf blog, and I didn't
have the energy to keep writing. I loved going to the gym and I just stopped
being able to go. I love watching the Brewers every night on tv, but I half
stopped being able to do that. It got to the point where for a few days in a
row, I'd get back at around 5 and just sit in my living room chair in the dark
until 9 and then I'd feel legit going to sleep.

I knew I was having issues, issues that I thought were "natural", so I'd force
myself to get out of the house. The biggest point was when I told myself to go
out and buy some tea or something. So I took the train down there, made myself
be friendly to the person working, and then decided to walk back. About
halfway to the house I lived in I couldn't move, didn't have any of the
energy, so I sat on a stoop for over an hour just unable to get up.

There are so many side effects of anti-seizure pills which list everything you
can think of mentally. And at some point I figured the pills could be the
cause. I contacted the doctor who said stop taking the pills and made an
appointment for a few days after to get a new drug.

The morning after I didn't take the nighttime dose, I woke up and I could feel
the depression going away. It's impossible to describe the feeling of knowing
the issues were evaporating. I was out in the sun and felt happier. I could
move. I could stand. The desire to do things was coming back. Three days later
the depression was completely gone.

It's tough for me to know if my feelings exactly match other people's
depressions. I've never been the person to give advice to people with
depression; It's obviously impossible to relate if you haven't experienced it
yourself. There still isn't any advice I'd be able to give because it's just
sitting there, being in control of you, and even when your head knows that you
need to be active, knows that sitting there isn't the right thing to do,
depression will still win that battle. I was so lucky that my issues were
caused by a drug that I could stop taking, and that the issues vanished so
quickly. I think back and can't imagine how difficult a life is when your
actions aren't causing the depression, but be stuck with the depression thing
caused by nature.

------
baruchvelez
Wow this shit is a bigger downer than I thought...

------
matchagaucho
Thoughtful and brilliant... on many levels.

------
zoom6628
Good read and gutsy publish.

------
b0rsuk
What worked for me was a combination of things:

Physical exercise. 2 years ago I got scared because my bad back condition got
worse. When I went to a therapy, I noticed exercises (with swiss ball) seemed
to help me the most. I'm supposed to do them daily (they take 40 minutes each
time), but by trial and error I figured out 4 is the sweet spot. Anything more
and I get overtraining.

To answer the article: how do you even start ? You simply start small.
Performing the required number of repetitions is not important at all, and
sometimes even counterproductive because you're tempted to use bad form to
achieve your goal. Keeping your schedule is SUPER important. Exercise yields
best results when it's regular, and this in turn _tadaa!!_ builds character.
No, really. I would argue working out even a little is more about willpower
than anything else. Then I started adding other exercises to feed my vanity
and make up for my insecurities. I always looked like a nerd. I added push-
ups. Then squats (both 3 times per week). Quick tip: wall facing squats make
it impossible to cheat. If you can't do them, do some stretching exercises and
look up some progression exercices. I don't recommend running to beginners
because everyone can do running half-assedly, but you need good technique to
avoid permanent injury. I got permanent injury and squats compensate for this.
I have an exoskeleton of muscles around my spine and knee now. I recommend
cycling to beginners. Much harder to get an injury unless you like pedalling
downhill (all the cases where I had an accident where while pedalling
downhill).

But this post already looks depth-first while my escape from the black hole
was breadth-first.

Music. I always liked music very much. Finding new music you like provides a
short mood boost. I found funk. The trouble with music is searching for
something you like requires time, and I need novelty constanty. But every
little bit helps.

Friends. If you don't have friends, and it's safe to say I didn't 2 years ago,
go somewhere where people with similar interests gather. I found a place where
people play board games. A small monthly fee and you can play one of nearly
hundred board games with other male nerds. Board games are similar to computer
games, but thrive on innovation in game mechanic department. Very good if you
like strategy games. Board games are the most refined kind of multiplayer
game, they are designed to be finished in one seating and the better ones are
built about interesting decisions. Unlike with modern multiplayer where you
are shoveled around with complete strangers by a matchmaking system, you get
to play with the same group. It's like dedicated servers are back ! Even
better, only one person needs to own a board game. It's like StarCraft 1
multiplayer "Spawn" feature is back!! Also, you get to see and meet people,
and disconnects are very rare because it's more awkward to disconnect from
people you're seeing face to face. No one would like to play with that jerk
again. Automatic self-moderation system ! No need to appoint moderators,
referees or implement a voting system that 2 pals can abuse to kick you
because you killed them, or that never gets through because it needs 50%+
people and they're happy you're stuck with a bad teammate because it will make
them win. I still don't have many friends, and I only really meet them every
Wednesday - but every little bit helps.

Get out of your flat. Simply go for a walk and see a changing view instead of
the same 4 walls. No need to talk to anyone. This always helped me for a short
while. Every little bit helps.

Hypericum pills. Herbal meds that according to some clinical tests are as
effective as synthetic meds, with much fewer side effects. Notably, they don't
cloud your thoughts, which is important for a programmer. The one notable
downside is phototoxicity. You want to stay away from sunlight, or you'll get
permanent dark spots on skin. I accomplish this by covering my skin. I
understand this is not an option in Australia, but every little bit helps.
Note: for hypericum you want either pills, or oil/alcohol based extracts,
because the key component doesn't dissolve in water. Don't waste money on
"tea".

Reading books, watching a movie. There are times when my anxiety overpowers me
and I can't even focus on that, but a good movie puts me in a good mood and I
don't necessarily mean a movie with a good ending.

Meditation. Supposedly improves concentration, memory and stress resistance by
30-40%ish. Just what I need. I only recently started so it's hard to estimate
if it's helping me, but it's free and harmless and easy. 2 times a day, 15
minutes. You simply go into standby mode, close your eyes, try to throw out
all thoughts from your mind. In particular, don't think about the past and
don't make plans. If you must focus on something, focus on the present, like
your breath or sounds (but human speech is very distracting). Every little bit
helps.

Merely reading about your condition can be helpful. I started to feel better
and gradually solve my problems once I read a bit about my behavior and
motivation. It's like some barriers fade away and you slowly start exploring
areas of your life you've never tried, things you were too shy to try, etc. It
takes time.

Tips on sleep: I have an alarm set to 23:00 every day. When it rings, I go to
bed. Actually recently I started going to bed even earlier. Turn off TV if you
have one, stay away from computer monitor, smartphones, tablets. There's
something about the blue light they emit that makes people not realize how
tired they are. When I go to bed, I read a book or a newspaper. This doesn't
interfere with my natural exhaustion sensor and the extra mental fatigue helps
me fall asleep faster. If I have insomnia and really can't fall asleep, I turn
on the light and read. Then I try going to sleep 1 hour later or so. If you
still can't sleep, just lie with eyes closed and try to relax. Lying with eyes
closed will still make you much more fresh in the morning than going out of
bed or watching something and pretending you had no rest.

Also, I don't remember the source, but a recent study I read about found that
sugar intake makes you feel better in the short run but causes anxiety and
depression the long run. Foul stuff!

To do all these things (acting is the hardest part of depression) I used
observation and logic. Observation to identify activities that make me feel
marginally better. Logic, to tell myself it will be worse if I never do them.
See, it's like the female zombie in Return of the Living Dead says. You don't
eat brains to feel good. You do that to make the pain go away. Do tell
yourself it will make the pain go away, just a little. Keep repeating that.

------
ravenstine
Humanity has a long way to go before it can actually treat depression
properly. Granted, some things have improved drastically, but there's a lot
left to be desired.

Awareness around clinical depression is a lot better than it was just decades
ago, and that's great for the millions who are clinically depressed. Yet I've
been seeing us going down this destructive path of seeing all depression as a
physiological condition, which is often not the case and delegitimizes actual
issues that are causing a person to be depressed. I can tell because too often
the answer is either "just eat/sleep/exercise better" or "see a therapist and
get medicated". What wonderfully simple solutions to a complex problem.

In LA, my sort of city, the culture has an emphasis on being happy or "good"
all the time. If someone asks you how you're doing and you reply "I'm doing
okay", there's a good chance that person will cock an eyebrow and assume that
something's wrong because you didn't say you were good or great. I suspect
this is a phenomenon in a lot of places in America, but I think it's
especially prevalent in SoCal where superficiality is through the roof. Sure,
asking people about their day is mostly a form of social lubricant, but such
language subtly tells the unconscious mind that something is socially wrong
with broadcasting unhappiness of any kind.

In actually, I'd say the unconscious mind is correct in its interpretation;
people generally don't want to help you, let alone hear what you have to say,
if something is genuinely wrong with your life or even if it's merely hum-
drum. This can even be true with your closest friends and family, and even if
they are receptive, you may be motivated to be stoic in order to maintain your
role in your circle. Nobody wants to be the one who has problems or is "crazy"
because everyone knows deep down that opening up could mean you'll be treated
as lesser than you were when you held it all in.

Social media is an amplification of this phenomenon. The vast majority of what
you see on social media is people posting the very best of that they've got,
creating a misleading image that they and everyone else are having splendid
lives. Why aren't you one of those beautiful chiclet-teethed young people
constantly traveling and partying? Something must be wrong if your life isn't
like that. /sarcasm

Therapy is great, and medication can be great for those who really need it. It
just sucks that we've not created a world for ourselves where we can talk to
each other about our problems. It's not about providing solutions, but about
being heard and understood by someone. Maybe sometimes people are depressed
for real reasons, and telling them that their feelings are akin to a disease
can serve to harm them rather than help. I believe I'm open to hearing out my
friend's problems, but I know that they think they'll be a burden unto others
and be outcast. This I assume from hearing my friends mention going to
therapy, but they rarely if ever have anything particularly troubling or deep
to say to me. It may not even be conscious, but instinctual, to want not to
seem like a burden – for the consequences can be hard to bear.

It's about time we allow each other to be a burden every once and a while.

------
dogruck
My view is that depression is a treatable medical illness.

I've never been depressed, but I've lost friends to depression.

Edit: to the down voters, I'm not implying it's any easier than, say, beating
cancer.

~~~
kyberias
Are there legitimate other views of depression?

~~~
ada1981
I believe depression often involves some developmental or shock traumas that
prevent or inhibit the full feeling of emotions.

The idea that depression is "anger directed inward" was a useful tool for me.

The view that we can release these old traumas and form new pathways and
responses helped me heal after a diagnosis of schizophrenia and bipolar (which
included suicidal depression and panic attacks, anxiety).

~~~
thanatropism
Do you believe in Austrian economics or Young Earth Creationism too?

I mean, it's within your rights...

~~~
betenoire
This is too dismissive, I think you are reading too much into words like
"release".

Learning to love yourself and to let go of things gives you a new perspective.
A new perspective leads to new thinking and new experiences, and we all know
our brains are plastic and are constantly changing.

You are the fool, not he.

~~~
ada1981
For me the experience often went like:

1) notice I'm depressed 2) create space to feel emotions more and use
something like Breathwork to loosen up my ego enough to get out of my default
mode of shutting down / numbing out.

3) having a deeply personal / visionary like experience of seeing old events
in my life or relationships or choosing to forgive someone.

4) am actually emotional release, like crying and feeling like I was able to
be back in my body vs being stuck in a painful loop in my head.

------
gt_
Psychologists are much better trained than therapists. If at all possible, see
a psychologist.

Therapists are minimally trained, and do not understand neurological
conditions on nearly the same level. If your issues are beyond basic
depression, a therapist will not be able to tell.

~~~
blakes
I'm probably biased (my wife is a therapist), but I disagree with you.

Therapists require a lot of training (depends on state/specialization).
Thousands of hours of supervision and a Masters degree in the field. I would
not say that is minimally trained. Less so than a psychologist however.

Therapists are trained in understanding systems and the why/how something is.
You are very much right about psychologists understanding neurological
conditions far better than a therapist. Therapists with a bachelor degree in
psychology (like my wife) mostly agree that it is useless for a lot of
therapy.

Depression is a tough one. I'd just see both a therapist and a psychologist.
Probably go for a therapist first and try to get some understanding of what is
going on. It may help a lot! Or maybe not at all, with the nature of
depression. Then see a psychologist and get some medication.

------
gt_
Just some mellow _" Brain Shock"_ side effects and he was on his way.

Terrifying.

~~~
taco_emoji
Yeah it's not as bad as it sounds. Hard to describe, but it's sorta like if
somebody flashed a light in your face, you'd probably wince and kinda lose
your train of thought. It's like that but without any obvious stimulus (and
obviously without the retinal damage). And (at least for me) only happened
when I was sort of sitting "idle" \- not while I was standing or walking or
actively programming, more just when I was half-heartedly reading some boring
news article or whatever.

------
mpg515
An important subject ruined by incredibly bad writing. Do not write in this
style. It is not funny, nor smart, but it is very bad.

------
lqdc13
Please be advised that taking SSRIs can have negative side effects that you
might not be aware of.

When people I'm close with start taking them, they are less interested in
being intimate and stop "loving"/being affectionate.

In my experience, having a schedule, exercising and making sure you are around
other people help a lot more while preserving your personality.

~~~
pure_ambition
In my experience, people who start taking SSRIs have improved dramatically.
Stop using anecdotal evidence to discourage people from seeking valuable help.

~~~
kbhn
He's not discouraging people from seeking help; he's encouraging people to be
educated about the help they're seeking. For people who are in affectionate
relationships, this _is_ an important factor and is worth mentioning.

------
chrishacken
\- "What is with it with people expecting that a quick run will sort out your
life? Like cool, activity releases endorphins and shit, but are endorphins
going to pay this credit card bill? They going to patch things over with my
friend? They going to find me a job? They going to fix my life?"

\- "How the hell am I supposed to get out of the house to go running a few
miles when I practically can’t get out off my couch?"

No, running and exercise won't immediately solve your problems, but neither is
sitting on on your couch.

What exercise will do is make you feel good and make you a productive human
being so that your brain is functioning optimally and so that you can solve
those problems.

------
marlokk
Why is depression thought to be an illness with the individual? I guess
otherwise would mean facing our slavers.

------
earlybike
Nice thread and here my top 10 list of antidepressants (in that order):

1\. Most of the times, there's a clear reason for a depression, something
which is not that easy to change and worse not that easy to identify as the
real cause (e.g. wrong boss, wrong cofounder, wrong investor, wrong friends,
toxic workplace, big nose, etc.); before looking at the other antidepressants,
try to get rid of the main issue; often it is even too late, even if you get
rid of the main depression cause, the depression just stays (PTSD). Either
because the cause was too strong or too long. Some think that there is no
direct cause-effect-relationship but this could be also another sign of a
severe depression and that they just resigned (‘I can’t do anything about my
depression, it’s genetic, this is me...’). It ‘s easier to resign and to give
up, especially if you are depressed

2\. Have social encounters every day, best: have a SO or friends (ok) or some
good coworkers (better than nothing); this can be quite hard, having social
interactions is not that easy when lacking a SO or friends

3\. No addictive/depressing online stuff (FB leading the way, then your
smartphone)

4\. Sleep

5\. Cut gluten, should be on #1, gluten and too many wrong carbs boost anxiety

6\. Keep carbs under control, no need for keto but low carb might not be the
worst idea

7\. Exercise

8\. Working/be productive, consume less

9\. Create urgency, set yourself goals with deadlines, get busy and you won't
have time to get depressed; just imagine you catch a plane the last minute (do
you think you are depressed when catching the plane? No of course not)

10\. Meditation

Again: Advice 2-9 won’t help if 1 is not solved.

Edit: Why the downvotes?

Edit2: After I got downvoted, my final advice...

11: Stay away from depressed people on HN because "negativity is infectious"
(Robert Greene)

~~~
kbhn
> Most of the times, there's a clear reason for a depression

I'm gonna have to disagree pretty strongly with that assertion without any
supporting evidence. In fact, I would argue that _rarely_ is depression caused
by a clear reason which has a direct path to resolution. This is the exact
perspective that makes those going through depression feel like others are
trivializing what they're going through.

That's probably why you're getting downvoted, since it's #1 on your list.

~~~
earlybike
> In fact, I would argue that rarely is depression caused by a clear reason
> which has a direct path to resolution.

I'm gonna have to disagree pretty strongly with that assertion without any
supporting evidence.

~~~
kbhn
Sure, let me quote Harvard[1]:

"It's often said that depression results from a chemical imbalance, but that
figure of speech doesn't capture how complex the disease is. Research suggests
that depression doesn't spring from simply having too much or too little of
certain brain chemicals. Rather, there are many possible causes of depression,
including faulty mood regulation by the brain, genetic vulnerability,
stressful life events, medications, and medical problems. It's believed that
several of these forces interact to bring on depression."

Enjoy your continued confusion as to why your 'advice' is being downvoted.

[1] - [https://www.health.harvard.edu/mind-and-mood/what-causes-
dep...](https://www.health.harvard.edu/mind-and-mood/what-causes-depression)

~~~
earlybike
‘It's believed’ != evidence

~~~
kbhn
Someone's throwing stones in a glass house.

Still waiting on ~any~ article to back up your assertion from a respected
institution.

~~~
earlybike
I never claimed to have any evidence— _you did but didn’t deliver._

If you read my initial post again you can read that this is _my_ personal top
10 list. So I won’t provide any evidence. And my one reply was just imitating
your discussion style.

~~~
pdfernhout
See my posts above for references to books and articles by Fuhrman, Hyman,
Weil, Korb, Hickey, Moore, Bluezones, Howey, and others that support your
suggestions as things that can help people in various ways -- quite a few
providing evidence linked to scientific studies and thus moving beyond
personal anecdotes.

Your point #11 is insightful too, judging by the moderation of several
comments in this thread. :-)

That said, often the ongoing "cause" of depression is an interwoven set of
issues which may feed on each other in a downward spiral, and getting out of
those overlapping feedback loops can be difficult -- even if in hindsight
specific causes might be identifiable. So, I can see why someone might object
to the phrasing that "there's a clear reason for a depression" even as I tend
to agree with the premise overall that causes (e.g. lack of sunlight, lack of
sleep, relationship issues, poor nutrition, etc.) can usually be identified
and (hopefully) addressed. But when the causes interact, granted, it can be
very difficult to try to untangle that knot -- like when money issues prevent
eating healthier or when (as an extreme interwoven example) relationship
issues undermine sleeping well, which leads to financial issues, which
stresses relationships further, leading to binge eating of junk food and sugar
spikes and inflammation and headaches, leading to avoiding exercise, causing
lowered self-esteem from worse appearance contributing back to relationship
issues, and so on for strange knotty loops... The good news is, like Alex Korb
(in "The Upward Spiral: Using Neuroscience to Reverse the Course of
Depression, One Small Change at a Time") and others point out elsewhere, a
positive upward spiral is possible too, as one issue after another gets
addressed which frees more energy for dealing with the next issue...

------
iamleppert
If we're supposed to be happy all the time, why are there so many sad songs?

Seriously though it irritates me how people have been brainwashed to think
depression is somehow abnormal.

Here's something I've learned in life: Depression exists for a reason.

There have been times in my life that I've been very depressed. Sometimes it
was due to some event that happened but more often it was pretty random.

During these periods, I've often been very creative or it has done something
else that I didn't immediately recognize as a benefit at the time. Yes, it was
painful. But life isn't supposed to be all roses.

What I do think is wrong is taking (and getting hooked on) anti-depressants. A
lot of my friends take them -- usually in response to a depression and now
they've been taking them ever since. Unless you suffer from a very severe form
of depression, I think anti-depressants do more harm over the long term than
good, and many doctors of course want to keep their patients on them so it
gives them an excuse to have an office visit. There's a lot of abuse, because
there's a lot of money to be made trying to make people happy.

In my experience, anti-depressants do not make you happy. They make you numb,
and (at least for me) they destroy your sex life. What kind of life is that?

I've come to the realization of acceptance. There's only so much I can control
in my life, and that includes all the complicated chemicals swirling around in
my head that are controlling my emotions. You start to realize that control
and free-will is mostly illusionary, how you feel and what that does to you is
more like a partnership with you and your body. There are of course things you
can do but if your brain wants to make you depressed, you're going to be
depressed and go through that experience. I don't think it wouldn't be as
prevelant if it didn't serve some higher purpose, and I try to keep that in
mind whenever I find myself depressed.

~~~
SonicSoul
It's pretty sad when my friend tells me his doctor diagnosed him with a lack
of something in his brain where only way to go is anti depressants for the
rest of his life. He didn't even suggest aerobic exercise or diet, nope
straight to prescription drugs. I'm not a doctor but based on my experience
with depression and health, lifeStyle is so much more important than drugs no
matter which disease you have or don't have

~~~
DanBC
What your friend deserves is evidence based treatment. For depression that's a
talking therapy (CBT), maybe combined with meds.

The evidence for exercise as a treatment for depression is poor.

[http://www.cochrane.org/CD004366/DEPRESSN_exercise-for-
depre...](http://www.cochrane.org/CD004366/DEPRESSN_exercise-for-depression)

> Exercise is moderately more effective than no therapy for reducing symptoms
> of depression.

> Exercise is no more effective than antidepressants for reducing symptoms of
> depression, although this conclusion is based on a small number of studies.

> Exercise is no more effective than psychological therapies for reducing
> symptoms of depression, although this conclusion is based on small number of
> studies.

> The reviewers also note that when only high-quality studies were included,
> the difference between exercise and no therapy is less conclusive.

> Attendance rates for exercise treatments ranged from 50% to 100%.

> The evidence about whether exercise for depression improves quality of life
> is inconclusive.

this line, and the last line, are important:

> The reviewers also note that when only high-quality studies were included,
> the difference between exercise and no therapy is less conclusive.

> The evidence about whether exercise for depression improves quality of life
> is inconclusive.

