
Tips for the depressed - bookofjoe
https://nplusonemag.com/online-only/online-only/tips-for-the-depressed/
======
PragmaticPulp
One of the biggest force multipliers in overcoming depression is accepting
that you _can_ modulate your condition by taking small, deliberate actions.

It's also one of the most difficult and delicate ideas to communicate to a
depressed person. Depression notoriously clouds peoples' judgment and makes
simple tasks seem impossible. Depression also encourages a lot of binary
thinking, where people tend to give up because they can't achieve the optimal
solution and can't imagine anything in between optimal and complete failure.
And most importantly, depressed people almost never want to hear someone else
telling them that they should _do_ something to change their own condition. If
you've ever been through a depressive episode, you'll understand how
unpalatable this idea is if it's not delivered carefully. Be careful to not
make depressed people feel even worse about their condition.

For example, I've known several depressed people who spiraled deeper into
depression when they could no longer perform their regular 60 minute gym
sessions multiple times per week. It took a while for them to accept that a
5-minute walk around the block is better than no exercise at all. From there,
they could push to 10 minute walks on good days, then 20 minutes, then 30
minutes, and eventually work their way back up to gym visits. Taking those
tiny steps is a great way to re-learn that you can accomplish things, and it's
a great to way to see gradual progress in yourself.

~~~
frausto
I've struggled with this quite a bit in my own life. I find the "No Zero"
mentality to work well for me. Treat every weekday as a "No Zero" day. What
does that mean? It means if my goal is to go to the gym, even if I literally
walk into the gym, do a pushup, and leave, that counts. It's more than Zero.
Consistent non-zero days eventually help break me out of my depression. And
when I miss a day... well forgive myself and keep going.

All easier said than done of course, and sometimes a no-zero goal is just to
get out of bed... but it has helped me.

For anyone interested I got the idea from here:
[https://www.reddit.com/r/getdisciplined/comments/1q96b5/i_ju...](https://www.reddit.com/r/getdisciplined/comments/1q96b5/i_just_dont_care_about_myself/cdah4af/)
The style and language of the post are not really my cup of tea, but the ideas
behind it have really helped me.

~~~
agumonkey
crazy how the first step is often the most important one

~~~
Jare
And every step is the first since the last one.

~~~
uoaei
That sounds inspirational but it just comes across as daunting/insurmountable
to those who haven't gotten used to the idea of taking that first step.

~~~
Jare
I meant it as factual rather than inspirational. It is daunting for sure, but
every person in this journey will find out about it as soon as they take that
first step. And most people around will not understand, and will not be able
to help and support appropriately without that understanding.

------
ditonal
I largely agree with all the advice here. I dropped out of college due to
depression, then I torched my tech career with a manic episode that led me
straight from a FAANG SWE job to an involuntary psych ward patient for a
month, which was followed by a half year brutal depression.

I’ve done a lot of research and I think psychiatry is pseudoscience and
antidepressants are largely placebo.

I’m really on the mindfulness bandwagon but don’t believe it’s “positive
thinking.” The opposite, it’s less thinking, more acknowledgment of how you
feel. If you feel depressed, maybe that’s ok, maybe that’s part of the human
experience. If it endangers your life that’s perhaps not ideal, but if it
endangers your goals, perhaps that is ok. I think modern society pathologizes
feelings and acts like anything that detracts from your ability to be
“successful “ must be cured. It’s ok to feel bad feelings it’s how we react to
them that’s more often a source of frustration. Meditation gets mislabeled as
some way to reduce stress and clear your mind when I believe it’s training for
how to learn to react to difficult thoughts and feelings.

I have many more thoughts on this topic for when the time is right but as much
as self-care advice gets responded with “thanks I’m cured” self-care is the
foundation to recovery. I have many more strategies to do this even when
thoughts/feelings are giving resistance.

~~~
PragmaticPulp
> I’ve done a lot of research and I think psychiatry is pseudoscience and
> antidepressants are largely placebo.

Please don't spread anti-psychiatry misinformation online. I'm sorry that it
didn't work for you, but please don't dissuade others from seeking proper
treatment.

Playing devil's advocate: Even if SSRIs are just placebo (they're definitely
not, and we have decades of science to explain why that's a false statement),
what would be wrong with that? Placebo is remarkably effective, and even
placebo is even getting stronger with time:
[https://www.psychologytoday.com/us/blog/straight-
talk/201803...](https://www.psychologytoday.com/us/blog/straight-
talk/201803/the-curious-case-the-growing-placebo-effect)

This is where people are mistaken when they conclude SSRIs are placebo. SSRIs
still diverge from placebo, but placebo is so incredibly powerful in short
depression studies that it's hard for SSRIs' superiority to reach a
numerically large statistical significance.

> I’m really on the mindfulness bandwagon

Mindfulness is a common therapy technique within professional treatment. I
think you'd find that a lot of the mainstream self-care practices are mirrored
in professionally-guided therapy. However, some people just can't/won't trust
professional institutions, so at least we have mainstream pushes for
mindfulness and self-care to slip these techniques in the back door.

~~~
blackflame7000
It's also misinformation to assume SSRI's work the same way for everyone. For
my mother, antidepressants made her suicidal.

~~~
nikofeyn
> It's also misinformation to assume SSRI's work the same way for everyone.

the person you replied to didn't say that. the point is to defer to
professionals and not your own hunches.

~~~
ta999999171
Professionals prescribe these long-term to people, even though something like
5/7 cases never get good results.

------
retonom
I have struggled with "depression" for decades. Now I'm healed. I went to
countless psychiatrists, took drugs and everything. I didn't really help much.
I told them I feel bad, they labeled me "depressive" without trying to find
out what is really going on. In the the end I had to find it out by myself.
The depression was just a symptom. The main cause of it was a social phobia.
None of the therapists ever addressed this. Other factors: unforgiveness and
my own frustration that I wasn't aware of in many situations. So I started
peeling off all these layers. I just didn't really know myself, was so full of
inhibitions.

Often depression isn't something you should be afraid of. Neither is it
something that you just "have" like a sickness. There may be reasons for the
depression and maybe you can dig them out.

I just skimmed the article but what I've read seems to be how to cope with
depression, not how to address the underlying issues. Better try to find out
where it comes from, if possible.

~~~
bobbylarrybobby
How did you discover these facts about yourself?

~~~
retonom
good question. of course I got older which helped in bringing the inhibitions
down which made me more aware of myself and of my own feelings. then going
after those feelings and trying to figure out what they mean I slowly
discovered what was behind them.

for example, one day I was in a course and I felt miserable even before I was
there. then suddenly it dawned on me that this is my aversion to the whole
thing. it's not rational but irrational. once I knew what was going on the bad
feeling went away quite quickly when as before I'd just suffer without end.

before I was helpless, now when a negative feeling comes I try to guess what
it could mean and often I find the answer quite quickly. once the source is
identified, the bad feeling dissolves and I'm back to normal.

and another important factor was that I started trying to live by the golden
rule: "do unto others as you would have them do to you". the problem was that
not to do this often caused a lot of the confusion in my life and my feelings.
I don't think it would have been possible to figure it out while I was in this
chaos caused by not following the golden rule.

oh yeah, and the last thing that helped a lot is that I stopped going to
therapists and took on responsibility, not relying on what others say about
how I feel.

------
pmoriarty
Things that help me when I feel depressed:

\- Listening to upbeat, energetic music and avoiding depressing music, which
tends to make me feel worse

\- Walking outside on a clear, sunny day

\- Eating my favorite food

\- Playing a good game to get my mind off whatever it is that I'm obsessing
about

\- If I am able to concentrate, reading something by a favorite author,
listening to a good podcast, or watching a non-depressing movie (most of my
favorite movies are, sadly, pretty depressing, so those tend not to help)

\- Doing exercise

\- Getting enough sleep, but not too much

\- Improving my diet and supplementing to overcome nutritional deficits (this
and regular exercise are long-term fixes, and have helped my mood and energy
level tremendously)

\- Talking to a good friend, or maybe calling a crisis hotline (though the
results vary greatly depending on who you wind up talking to)

\- Journaling (I've been using a voice recorder for years, and this makes
journaling much easier, more natural and faster for me than writing... just
talking things through, even effectively just to myself, often helps a lot)

\- Talking to a good therapist. They can sometimes provide insights and offer
good advice that I otherwise would not have thought of.

\- Looking at the stars on a deeply dark night sky, and thinking about how
small and insignificant my self, my problems, and everything else on this
earth really are

\- Reading stories of people who've survived ordeals and overcome tremendous
adversity. This again helps me put my own relatively trivial problems in
perspective.

\- Then, as Nietzsche said, _" The thought of suicide is a great consolation:
by means of it one gets through many a dark night."_

\- Finally, I try to remind myself that I've been through this many times
before and I always eventually feel better. Time heals all wounds.

~~~
allendoerfer
When you are actually depressed and not just feel a bit down, those things
seem unreachable.

~~~
afiori
my uninformed opinion on this is that there are countless way to suggest the
same thing and maybe one will resonate with you. this would become a
motivation to offer earnest advice and be prepared that likely you will not be
that magic person.

in this sense advices like "just do X" are useless, while advices like the one
above are not.

for sure serious depression is very unlikely to be treated that way, but for
every case of clinical depression there are many less critical ones.

------
jsjddbbwj
Someone here recommended David Burns' "The Feeling Good Handbook" and it was a
very, very good read. I'm not going to say it turned my life around, but it
taught me how to spot and disarm all kinds of cognitive distortions, defeat
laziness, better align my expectations of others, assess my self worth
positively...

It's also well written, fast paced, and sometimes even funny. It includes lots
of exercises that are practical and easy to do.

~~~
Trasmatta
As far as I'm concerned, this (and its predecessor, "Feeling Good") is the
best self help book ever written. It's helped me tremendously with moderate
depression and anxiety. For anyone suffering, I'd highly recommend just giving
the book and its exercises a try.

~~~
rednerrus
thework.com is along the same lines and also very good.

------
allendoerfer
I like the tip about paying someone else to clean your house.

When you are truely inside of a depressive episode, all those tips probably
won't help you. By definition, you cannot think straight.

Think of it more like a computer game: As long as everything is okay, you
should make sure to save your progress. While you are feeling good, try to
minimize the effect of an episode. This way the episode itself also becomes
less bad.

This could be: Getting a cleaning lady (edit: or __cleaning gentleman __),
setting up your bills to be paid automatically, saving money. Stuff you should
do anyway, whether you have had depressive episodes or have not. Just setting
up your life, so it can be slowed down a bit once in a while without
catastrophic outcomes.

For me the logical consequence is to adopt minimalism, so there is less stuff
potentially dragging you down with it, once things turn bad.

~~~
senectus1
yeah, written like someone on the outside looking in but never been in.

Getting a cleaning person to clean your house is often out of the question
because you're ashamed of the state your house is in and dont want anyone else
to see it until you've done something about it but you never do anything about
it because you're in a depression.

Depressions most insidious part is the fact that it re-enforces itself. You
get stuck in self defeating loops.

~~~
allendoerfer
I think I can empathize. That's why I wanted to stress the fact, that you do
those things when you have a time window of feeling good. Always be on the
lookout of how to save a little bit of progress for after things will have
inevitably turned bad again.

If you have a little bit of money, you cannot use that to feel happy, but at
least you can use it to make yourself not feel bad about a particular problem.
Alternatively, if you do not have money to solve it, consider just throwing
away the whole thing and be done with the root cause of that problem.

------
dlsso
There's some good stuff here, but it completely skips gratitude.

Focusing on what you're grateful for is one of the more powerful and best
proven methods to combat depression. I've been through clinical depression and
consider it the key to my recovery.

~~~
chrismarlow9
what if you find it difficult to have gratitude? you want to be grateful for
what you have, but you're not, and can't explain why.

if you don't care about anything, meaning you have no gratitude, how do you
jumpstart this process?

~~~
sstangl
There are two options I'm familiar with:

1\. Without wondering if you sincerely mean it, make a point to say "thank
you." Typically if you are depressed you will be alone, and so it is possible
to recognize situations where you took an action now to make something easier
for yourself later: for example, doing the dishes now instead of waiting for
them to pile up. When that happens, verbally thank yourself on behalf of your
future self. If you're capable of doing this, it jump-starts gratitude after a
while.

2\. Instead of feeling gratitude for things you perceive as positive, look for
things that you perceive as neutral. The majority of your sensory experience
is neutral. If your emotions are very negative, instead of looking for a
dichotomy between negative and positive, look for a dichotomy between negative
and neutral. You will perceive that neutral is not-negative. Because neutral
is not-negative, increased perception of neutral sensations is a positive. If
you perceive neutral sensations as positive for long enough, it jump-starts
gratitude after a while.

~~~
g3t1nmybelly
The problem with that though is I perceive nuetral as negative. Neutral is
registered same as negative because it's not positive. This is why gratitude
is hard because people like me can't find the positives nearly enough to start
recognizing and changing how I think.

In fact, I find it difficult to think that people are okay with neutral
because how is that any better? You arguably still failed at whatever you were
trying to do, just the results weren't as harsh. I dont know. I think I might
just be really far gone at this point.

~~~
sstangl
I'm talking about neutral perceptions, not thoughts. An example would be
something like the visual perception of a sidewalk. Presumably you don't get
an emotional reaction about the sidewalk one way or the other, it's just a
sidewalk.

The majority of your sensory experience is neutral perceptions like that. Once
you notice them, negativity seems small in terms of proportion of sensory
experience. What actually happens is that negativity occupies the majority of
_attention_ , meaning that your mind is latching onto things you perceive as
negative. Broadening the scope of awareness to include neutrality means that
definitionally the mind is not as latched-onto the negative, therefore
negative things seem smaller, therefore they are slightly more tractable to
deal with.

------
shange
I suffered from treatment-resistant depression for over ten years. In my case,
time definitely did not heal, and psych meds that were tried did not help
significantly. Felt like everyone had gotten used to my depression and did not
take it seriously. Was convinced that I had "terminal" depression. Until at a
low point, when visiting a new doctor (non-psych) for a routine check-up, the
doctor who I'd never met before told me that I seemed so low that she wasn't
comfortable sending me home alone and sent me to the emergency room. At that
point I started intensive therapy, learned DBT (Dialectical Behavioral
Therapy) skills, and was started on meds that actually did help. I'm now proud
and happy to say that I've been largely free of depression for the 5 years
since then. Sure there are low times, but coping skills and closely managing
meds have helped greatly.

Mostly here to say: If you're depressed to the point where you're seriously
thinking about killing yourself, you have a life-threatening illness. IMO, it
should be treated as such.

Some of the contents of this article basically amount to DBT skills (i.e. "Get
out of bed even if you don't want to") so I recommend looking into those if
these types of suggestions sound helpful to you. But suggesting that somebody
who is suffering should binge watch TV to wait it out seems unhelpful and
counterproductive to me. Take it seriously, and seek help if you need. Things
can get better.

------
eric234223
I have observed when i am alone for 3 or more days without talking to anyone i
get depressed. Even if i have conversation with anonymous people on the
internet over text chat, depression gets reduced a lot. Are there any
scientific research on human contact over text and depression ?

~~~
sudoit
I'm curious as well

------
ttraub
Not mentioned in the article or in the comments thus far, is that massage
therapy has an alleviative effect on clinical depression in some people.[1][2]

It's not fully understood why massage (in particular, deep massage) might
relieve depression, but it does reduce cortisol and increase general
relaxation, countering the stress caused by depression.

Another study suggested that massage therapy can be approximately as effective
as pharmaceuticals, but I'm unable to find the reference at the moment.

There's no particular harm to muscular therapy a.k.a. massage, and if you have
a good and well trained practitioner, it is very pleasant and relaxing
regardless of mental state.

1\. Meta study:
[https://www.ncbi.nlm.nih.gov/pubmed/20361919](https://www.ncbi.nlm.nih.gov/pubmed/20361919)

2\. Women's health (Mass General Hospital):
[https://womensmentalhealth.org/posts/massage-therapy-for-
dep...](https://womensmentalhealth.org/posts/massage-therapy-for-depression/)

------
invisiblerobot
I've had severe depression my whole adult life and this is what has worked for
me:

1\. Zero alcohol. 2\. ICE cold showers. 3\. Extreme cardio. 4\. Meditation.
5\. Breakfast with a friend. 6\. Play with a big young dog. 7\. Cognitive
Behavioral Therapy. 7\. Meds. 8\. Get up at 5am. 9\. Journal.

Feeling Good is one of the best books on depression from a scientific
perspective.

------
Barrin92
I've dealt with depression and anxiety on and off, and one thing that's
missing on the list that helped me a lot is purpose and service.

It may be your job, caring for another person, volunteering for something that
has impact, taking responsibility in a community or anything else really as
long as it's meaningful. It's a pain if you feel crappy to take on more
responsibility but in my opinion, it helps because at least if you feel like
crap you're still doing good for others and you can get through a lot of
suffering with that in mind.

For me personally mindfulness and talk therapy and exploring your feelings and
whatnot is fine but it's also very self-centred and you can do it all day and
still be miserable so at some point, I just thought getting out of my head and
getting on with life as best as possible is what matters.

------
htk
_AFTER FIFTY YEARS, billions of dollars of intensive marketing campaigns, and
tens of billions of dollars of profits for pharmaceutical companies, it is
still far from clear that antidepressant drugs are any more effective than
placebo. The only group of people who have demonstrably benefited from the
widespread use of antidepressants are pharmaceutical executives and
investors._

I don't think this is accurate or helpful, and I hope people who benefit from
medication don't stop taking them after reading things like this.

~~~
rjkennedy98
> I don't think this is accurate

Yes it is accurate. It is very accurate. The garbage studies routinely dumped
on us by Big Pharma have been continually debunked, reversed, and retracted
after the raw data comes out (often in lawsuits).

Nevermind the complete absence of long-term studies or any studies that
reflect the actually usage of these drugs in the real world.

~~~
Pfhreak
> We identified 28 552 citations and of these included 522 trials comprising
> 116 477 participants. In terms of efficacy, all antidepressants were more
> effective than placebo.

[https://www.thelancet.com/journals/lancet/article/PIIS0140-6...](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(17\)32802-7/fulltext)

I dunno, studies seem to suggest otherwise. I think it's terribly
irresponsible to be telling people not to take medications that can help them.

~~~
rjkennedy98
You don't know. My brother is a doctor who writes papers on meta-analysis. The
Cipriani paper is trash. The actual effect size is LESS than in the paper
posted in this thread (Kirch et al) which was featured on 60 minutes about the
placebo effect.
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597641/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597641/)

------
ChipSkylark
2 cents: Get off / moderate your social media, news media, TV show service
intake - stop giving in to the comparison game that you can never win. When
you play this game, you are living vicariously through the lives of others
instead of realizing the incredible opportunity you have in each moment to
maximize your own potential and be the best version of yourself.

For a long time a source of my discontent in life came from comparing my small
steps towards big goals to the empires and platforms of the top performers in
the same field. It made me feel irrelevant and like my efforts were pointless.
I got out of that trap by taking extreme ownership of my actions and what I
create, and I started viewing my progress solely relative to who I was
yesterday, rather than to external benchmarks. I forget the exact quote, but
it's similar to something like: "the best way to improve something is to start
measuring it." and this really crystallized for me when I read a blog post by
James Clear: "The Domino Effect." Momentum is important in our behavior -
harnessing it to your own benefit becomes like a super power once you can
appreciate how useful it is.

------
rjkennedy98
I would love to finally see an article that has tips for a society on how to
prevent depression, instead of the constant stream of self-help BS that is
constantly directed at people who may have real reasons to be depressed.

~~~
jlangemeier
Let's pick something else that isn't as broad as "depression."

How about:

    
    
      - "I would love to finally see an article that has tips for a society on how to prevent ADHD..."
      - "I would love to finally see an article that has tips for a society on how to prevent Schizophrenia..."
      - "I would love to finally see an article that has tips for a society on how to prevent Bipolar Disorder..."
      - "I would love to finally see an article that has tips for a society on how to prevent Mania..."
    

Each and every one of these are somewhat related mental health disorders and
can cross over with depression as well. They can exacerbate it or even change
how you may respond to various types of therapy (talk, drug, STM, etc).

And "real reasons to be depressed", what would those be; or are you mixing up
sad or anxious or morose or frustrated or ... with "clinically depressed."
Clinical depression, much like the other mental health issues that I used
above, doesn't have to have a reason as proscribed socially.

Unfortunately, most "self help BS" is written from two perspectives, those
that have never had a bout of clinical depression; and those that have and
found a specific way to get __themselves__ through it. If those that used
specific things to get through it presented that information in that manner
instead of "this is what everyone should do" it may be understood better
overall, but that's a failing of being human; not of the writers.

------
rossdavidh
I have very rarely had any issues with depression, my whole life, and when I
was depressed there was always a clear reason (e.g. a breakup). Until about a
year ago, when I got my first fully remote job, and after 6-8 months I
realized I was starting to be depressed a lot, listless, feelings of despair
and anxiety, etc.

Just doing more of my work in a coffeeshop or elsewhere with people around,
seems to make a big difference. Which implies that perhaps just visiting a
depressed friend a lot, might make a difference? Just a thought.

------
majos
Related, but not exactly on topic: what do people make of the word
“depressed”? I am unsure whether people use the word to mean “a deep lack of
any enjoyment that persists for a long period of time (weeks?)” or something
stronger, which adds on “ _and whose source is not easily explained_ ”.

In my head, depression means the latter, but I’m unsure what the popular
conception is.

~~~
ThrowawayP
Clinical depression has defined symptoms:
[https://www.mayoclinic.org/diseases-
conditions/depression/ex...](https://www.mayoclinic.org/diseases-
conditions/depression/expert-answers/clinical-depression/faq-20057770)

------
econcon
I was depressed for sometime till I found I've low T, once I supplemented it
depression disappeared. I wonder why doctors don't ask you to get your T level
checked when they find you depressed instead of prescribing antidepressants.

~~~
rednerrus
How are you taking it?

~~~
snagglegaggle
I can't answer for him, but typically it is 100mg/wk for testosterone
replacement. This can be taken once a week. For body building administration
is usually done twice weekly. There is a newer cream that is applied to the
scrotum, otherwise it is usually injection.

If you are doing TRT testicular atrophy usually isn't a concern although it
could be a cosmetic concern. Taking human chorionic gonadotropin will preserve
testicular function but may not return the look of your saggy nads.

------
newestThrowaway
This came at a good time, thank you OP. I just lost my job -- excuse me,
'parted ways from my employer' or 'joined the gig economy', whatever euphemism
is in fashion -- and without a clear place to go in the morning, it's been
hard to do simple ADL (Activities of Daily Living)
[https://www.care.com/c/stories/15077/activities-of-daily-
liv...](https://www.care.com/c/stories/15077/activities-of-daily-liv..). -- I
think I will try the alarm clock thing, firts of all.

------
failrate
Do _not_ use the snooze function.

First, once you're out of bed at an appropriate time, you want to stay out of
bed. Second, the minimum interval of sleep you need to actually rest is 15
minutes. Snooze alarms, even on mobile devices, are currently 9 minutes.
Third, tangentially related, do not use an obnoxious-sounding alarm, because
you will make a negative association with your necessary tool. Use pleasant or
inspiring music.

Source: I am a person with chronic depression who managed to solve this issue
for myself.

~~~
rdlw
For me, even not depressed, "[d]o _not_ use the snooze function" means "turn
the alarm off and sleep in another three hours."

Obviously if it works for you it works for you, but if you don't have the
willpower to stay out of bed, as I generally don't, at least the snooze button
gives you another chance to wake up at a reasonable time, which puts the day
on the right track.

~~~
failrate
I'm not sure why you wouldn't adjust your standard waking time, if you feel
the urge to snooze.

Sleeping for me means the same time to bed and to rise as I can make it to
avoid disruption.

------
benevol
A close friend of mine suffered from clinical depression for approximately 8
years and after all conventional medical approaches it was 1 dose of
approximately 125 micrograms of LSD that solved that depression within minutes
for several months completely. Obviously, he had to continue to work on the
underlying issues as well so as not to fall into a negative cycle again.

~~~
ncmncm
Just don't ever give LSD to somebody borderline schizo, if you don't want them
to spiral down the drain. Little life lesson there.

------
Erwin
I liked this bit personally:

> Depressed people want to open their hearts, to confess their fears and
> forbidden urges, to be comforted, reassured, persuaded that life is worth
> living despite this intolerable, indescribable pain. They want the other
> person to open his or her heart, not recite from a script. The communion of
> hearts is healing.

------
at_a_remove
One thing on which I have never gotten clarification, only evasion, is ...
what if you are faced with something permanent that is a bummer, major, and
that affects your mood. A progressive disease, an unfixable disability, and so
forth. Are you "depressed" then, or just legitimately sad?

------
PeterStuer
How do you report things on HN? This may be the wildest inaccurate information
I have ever seen pass here.

I have suffered depression, and nearly all of the points mentioned in the
article except for some trivialities are completely of the mark.

~~~
steveklabnik
> How do you report things on HN?

Users with enough karma can click "flag," or you can email hn@ycombinator.com

------
AlexTWithBeard
The #1 tip for the depressed learnt the hard way: talk to the doctor.

Please. Don't delay. Your brain is playing tricks to you. But it has bad sense
of humor. One of the tricks may become the last trick in your life.

Please.

------
godDLL
This will make a neat self-checkup downward spiral detection checklist. I have
one, but it's three items, and I'm not happy with it, I'm still struggling to
be aware of how I am on any given day or any given moment.

My current three points are "Feeling sexy?", "Endlessly arguing invisible
opponent?", and "Light is fucking annoying?"

------
throwddd
As Tianeptine wasn't mentioned: it did help me, took it for 7 months (Coaxil,
3x12mg/day), no side effects.

[https://en.wikipedia.org/wiki/Tianeptine](https://en.wikipedia.org/wiki/Tianeptine)

~~~
starpilot
There's a dead comment mentioning it's addictive potential. This is no joke,
there's /r/QuittingTianeptine. There used to be a subreddit for sourcing
tianeptine (closed down I think) and the desperation in some of the posts was
scary.

~~~
rdlw
Do you, or does anyone reading this, have experience with taking it,
improving, and quitting it? How does the risk compare to its effects?

~~~
starpilot
Yes, I took it for a while. It really helped me get out of bed, like a light
stimulant. It wasn't habit forming for me, but I could definitely tell how
others might get hooked. It was more effective than the 6 or so other
conventional antidepressants I took.

------
fersho311
I have a hard time understanding depression, I’m curious about the topic, but
I’m afraid to ask the questions I want to ask because I don’t want to offend
anybody. Is there a safe place somewhere. Does anyone know a depression ama
out there?

------
quotz
Had minor depression that lasted 2 years, visited a few psychiatrists who
wanted to prescribe meds, which I refused. Despite nothing bad happening in my
life, I felt depressed, therefore logically I assumed it must be my health. I
tested for everything in my blood tests, and I went to every specific
parameter and researched very well about it. Turns out, labs have very bad
standardized measures about testosterone, which puts 20year olds and 70 year
olds in the same bracket. I had the testosterone of a 60 year old. I got on
testosterone replacement therapy and literally it helped in a week!

Conclusion: Sometimes its not your environment, or bad stuff happening in your
life. Sometimes its just bad doctors and terrible public healthcare that
doesnt have a stake in your wellness. Check your testosterone people!

------
cosmotic
The article says acupuncture has no side effects. That is not true.

[http://whatstheharm.net/acupuncture.html](http://whatstheharm.net/acupuncture.html)

------
deft
This is the first article on depression that didn't make me angry. Thank you.
For some reason telling people time heals offends them. I only do it because I
know from experience.

------
oarabbus_
This will be exceedingly unpopular here but a good tip for the depressed is to
go to a rural or downtrodden part of Mexico, or a country in Africa, or India,
etc.

------
prawn
Any recommendations for someone trying to help a depressed friend get their
work and health on track? I make a lot of attempts to help but many seem
futile.

------
utxaa
has anyone found that doing math, geometric puzzles or problems helps a lot? i
found this out by accident, and it works most of the time. as soon as i
realize i'm spiraling down i start doing problems. usually i try to do one or
two a day so that i don't have to ramp up during the next "episode".

------
naraga
Acupuncture? Closed the tab right away.

------
aantix
Biggest game changers for my depression:

* Magnesium glycinate 1200mg/day

* More sunlight

* Expressing Really difficult feelings

* cutting out all caffeine

------
yters
My question is why are people so depressed nowadays?

------
zackmorris
I had some health issues starting from age 40: untreated sleep apnea that I
didn't know about for at least 10 years -> led to (combined with?) low thyroid
-> led to IBS and something like a food allergy to legumes and nightshades
(leaky gut). Which resulted in the worst burnout I've ever had in my life and
a falling out with my favorite job I've ever had.

I finally started climbing out of the hole I was in around October or November
of last year, and got "back to normal" around February of this year after
taking an online survey and realizing that I had most of the symptoms of ADHD.
My steps:

* Started eating bacon again and more meat in general, because tryptophan is converted to serotonin in the gut. There are also vegetarian options for this which I've listed below (this was the single biggest factor that led to my recovery).

* Started taking iodine, I immediately had energy again and my eyebrows grew back (for thyroid).

* Started taking syllium husk powder (Metamucil) 1-3 times per day and drinking kefir to feed good bacteria (for gut health).

* Starting keeping todo lists so I could separate the planning and doing of tasks (for ADHD primarily, to overcome task anxiety and executive dysfunction).

* Started saying no and slowing down in general, to provide time for meditation, daydreaming and seeing myself from the outside/being grateful like the visualization exercises of astral projection (for ADHD, depression and anxiety).

I could write at length about this because the journey has been difficult,
frustrating, but enjoyable and rewarding as well. I think that western culture
discounts mental health to such a degree that we sacrifice our lives for
inanimate things like money and responsibility. I also think that a
substantial part of mental health issues are physiological and environmental.
Carrying a chronically high load of cortisol our entire lives is just not
natural.

Here are some products that should help with depression if you don't want to
be on medication. I'm not a doctor obviously, nor affiliated with NOW (they
just make affordable supplements):

[https://www.amazon.com/NOW-L-Tryptophan-500-Veg-
Capsules/dp/...](https://www.amazon.com/NOW-L-Tryptophan-500-Veg-
Capsules/dp/B000X24T4S)

[https://www.amazon.com/Now-Foods-L-tryptophan-Veg-
Capsules-2...](https://www.amazon.com/Now-Foods-L-tryptophan-Veg-
Capsules-240-Count/dp/B00L83G7BE)

[https://www.amazon.com/NOW-L-
Tryptophan-1000-60-Tablets/dp/B...](https://www.amazon.com/NOW-L-
Tryptophan-1000-60-Tablets/dp/B002JNIAQW)

Iodine and supporting minerals, take 1-2 weeks to start, then as needed:

[https://www.amazon.com/NOW-Supplements-Tyrosine-Selenium-
Cap...](https://www.amazon.com/NOW-Supplements-Tyrosine-Selenium-
Capsules/dp/B002JNEK5M)

I've tried tons of other things like zinc for weightlifting and omega 3, B
vitamins, iron, etc to boost mood and the immune system. Everyone should try
seeing a few nutritionists and holistic medicine healers to find what works
for them. Hope this helps someone.

------
uhoh-itsmaciek
>It has been said that we are as far advanced in the understanding of
depression at this moment as was the European conquest of the Americas when
Columbus first set foot in the Bahamas in 1492.

Comparing the fight against mental illness to the genocide of native Americans
is unfortunate.

------
jotm
I hope they work for some, but for me, SSRI's are frankly, trash. All the
downsides with none of the upsides.

The only thing that worked was Imipramine, and I can't get it anymore because
it's "old" and "not recommended".

The newer focus on psychedelics and drugs usually used for recreational
purposes seems more encouraging.

If you're anti-depressant resistant, I'd recommend you try Gabapentin, a
seemingly overlooked drug that works wonders for anxiety and depression. Quick
tolerance buildup, do not give in and try to go over ~2g/day.

The somewhat similar Phenibut also works, but it's a direct GABA agonist with
terrible withdrawal symptoms and an extremely fast tolerance buildup.

~~~
PragmaticPulp
> I hope they work for some, but for me, SSRI's are frankly, trash. All the
> downsides with none of the upsides.

They absolutely work for many people. Unfortunately, many people deprive
themselves of SSRI trials because they read too many negative anecdotes
online. If you're seriously depressed for an extended period of time, it's
worth a trial of an SSRI medication. If it doesn't work, just taper off and be
done with it. At least you'll know.

> The only thing that worked was Imipramine, and I can't get it anymore
> because it's "old" and "not recommended".

That's bizarre. Imipramine is still widely prescribed with over a million
prescriptions per year in the United States alone. If it works for you and
your doctor is withholding it for some reason, please see a different doctor
ASAP.

Given your strange and definitely not-normal experience with the medical
system, can I suggest that you refrain from giving advice to others? I'm sorry
you've had a negative experience with SSRIs and doctors, but it's extremely
important that you not dissuade others from seeking proper medical treatment.

> If you're anti-depressant resistant, I'd recommend you try Gabapentin, a
> seemingly overlooked drug that works wonders for anxiety and depression.
> Quick tolerance buildup, do not give in and try to go over ~2g/day.

I recommend against Gabapentin as a first-line or even a second-line
treatment. "Quick tolerance buildup" is not compatible with long term
treatment stability. Gabapentin can be prescribed in limited circumstances for
anxiety, but it's not a good first choice solution.

> The somewhat similar Phenibut also works, but it's a direct GABA agonist
> with terrible withdrawal symptoms and an extremely fast tolerance buildup.

Please don't recommend Phenibut. It's not an antidepressant. It's highly
addictive and has severe rebound and withdrawal symptoms. Drugs that make you
temporarily feel good should not be confused with antidepressant drugs.

~~~
magduf
>Please don't recommend Phenibut. It's not an antidepressant. It's highly
addictive and has severe rebound and withdrawal symptoms. Drugs that make you
temporarily feel good should not be confused with antidepressant drugs.

This kinda sounds like drugs like clonazepam or lorazepam. They're also very
addictive, and are not antidepressants at all, however they are anti-anxiety
drugs and they work very quickly. And anxiety and depression seem to go hand-
in-hand for many sufferers, so they do seem to really help some people, at
least initially.

I think a big problem is the medical establishment really doesn't have a good
handle on what depression really is (biologically) or how to treat it.

~~~
PragmaticPulp
> This kinda sounds like drugs like clonazepam or lorazepam. They're also very
> addictive, and are not antidepressants at all, however they are anti-anxiety
> drugs and they work very quickly. And anxiety and depression seem to go
> hand-in-hand for many sufferers, so they do seem to really help some people,
> at least initially.

Phenibut works through similar pathways as those drugs. A lot of people
overestimate their understanding of Phenibut by reducing it to a simple GABA-B
agonist, but at the high doses that people take for euphoric effects it's
actually doing a lot more.

> I think a big problem is the medical establishment really doesn't have a
> good handle on what depression really is (biologically) or how to treat it.

We can always improve, yes, but the standard treatment protocols (therapy,
lifestyle changes, therapy + medication) are actually quite decent if you find
a provider who cares enough to work with you. Many people find a lot of relief
through standard practices. Unfortunately, many people don't have the
resources or patience for therapy, and they won't tolerate any side effects
from medication (which tend to diminish over time). A lot of those cases are
the most vocally negative about depression treatment and "big pharma", skewing
the overall perception. Many of the SSRI and therapy success stories don't go
broadcasting their depression stories to the world. They just quietly go back
to their lives.

