
Ask HN: How to cope with depression - lotsofthrows
I&#x27;m struggling with depression, and don&#x27;t know how to manage it.<p>Just to get my background out of the way :<p>I&#x27;m a programmer and have been severely under performing at work (to the point of almost being fired), and routinely question whether or not I deserve to be alive. As a result of my difficulties, I&#x27;ve begun seeing a therapist and psychiatrist. Both feel that I should be on anti depressants, and I am not opposed to this.<p>Short of medication, however, they haven&#x27;t really offered any strategies I can implement. Perhaps that will come later, but for now I was hoping to hear about what may have worked for others. All the logical advice (exercise, go to sleep on time, live a healthy lifestyle) are things that I struggle to find the motivation for. Perhaps the medication will help in that department. However, I&#x27;m concerned they will dull my focus (which is a bit silly, considering I can&#x27;t focus at all right now).<p>edit :<p>I am sincerely grateful for all the thoughts that have been shared. I&#x27;ve read every post in this thread. A few follow ups :<p>1. I understand the limitations of asking for advice about mental health online, and I want to reassure any&#x2F;everyone concerned that I will not make any treatment decisions without the input of the specialists I&#x27;m seeing.<p>2. Related to the above, reading about the (mostly successful &#x2F; positive) experience others have had with medication has been very reassuring. I did have some lingering skepticism about SSRI&#x27;s (which may or may not have come through in my original post), and I am very glad to hear that medication has worked well for others. Maybe it&#x27;s a bit silly to have an opinion partially validated by a peer group, but so it goes.<p>3. This is probably as emotional as I&#x27;ve been in weeks : reading through the responses here makes me feel like I&#x27;m not alone. Thank you, very, very much.
======
Tech1
I'm an Army veteran that was diagnosed with PTSD in 2010 after a particularly
shit deployment to Afghanistan. I've also battled with depression my entire
life. Name an anti-depressant or anti-anxiety pill and I've probably been on
it at one point in my life. They definitely help you. Conversely a good
therapist is also extremely helpful. They can help you find directions that
are away from the meds. I've currently been off meds for about 1.5 years and
it's been great, but it takes a lot of focus and quite literally years of
therapy to get there.

TLDR: stay on the meds; do what the therapist says to do, no matter how dumb
or inconsequential it may seem; exercise.

~~~
hiphopyo
Have you tried MDMA-assisted therapy?

[http://edition.cnn.com/2012/12/03/health/ecstasy-
ptsd-3/](http://edition.cnn.com/2012/12/03/health/ecstasy-ptsd-3/)

Incase it was never available to you, it should be soon. DEA approves study
using MDMA for anxiety in seriously ill patients (Mar 17, 2015):

[http://america.aljazeera.com/articles/2015/3/17/clinical-
tri...](http://america.aljazeera.com/articles/2015/3/17/clinical-trial-
approved-for-mdma-psychotherapy.html)

~~~
Tech1
I appreciate the info, but I currently hold (and use) a security clearance.
All these MDMA / cannabis / LSD-25 assisted therapies are doing great things
for veterans, but when it comes time to fill out that SF-86 in a few years, it
would bone me.

Still, I appreciate the info.

------
Lewisham
Take the meds; if you aren't able to feel like you can do the other things,
your depression might be too severe for those to help anyway. I didn't realize
I was depressed for a number of years, until my wife forced me to go. I am now
on medication and I feel much improved.

The wrong medicine will dull your focus (I had a very bad sedative reaction to
Lexapro) but the right ones will make you feel more normal. My work is the
same as it was before, except I am happier now.

~~~
lotsofthrows
> The wrong medicine will dull your focus (I had a very bad sedative reaction
> to Lexapro) but the right ones will make you feel more normal. My work is
> the same as it was before, except I am happier now.

I'm really glad to hear that. It's surprisingly reassuring.

Out of curiosity, how long did it take you to decide Lexapro wasn't right for
you?

~~~
brerlapn
You've gotten a lot of good advice here, and I just wanted to chime in on a
related point to this--different anti-depressants may be more effective for
you at different stages of your treatment. If you start on
Lexapro/Prozac/Paxil, and it works great, but after six months you start to
feel like it's not as effective, definitely talk to your doctor about looking
at different meds, even other SSRI's. There are subtle differences in how they
work that can make a difference (I'm not a doctor or bio guy, but they affect
different receptors differently, even when they are primarily aimed at
serotonin). Depression isn't a monolithic problem (it feels like it, but there
can be multiple factors feeding into it), so as you do the talk therapy and
the drugs your equilibrium between maladaptive cognitions, chemical
imbalances, relationship and work patterns, etc. can shift, just be aware of
how you're feeling (and if differently, how) and keep your doctor apprised.
Also, therapy can be intimidating because you're talking about problems that
feel insurmountable while you're depressed--but just spill it; they get less
insurmountable once you've expressed them. Sometimes just hearing yourself say
something out loud can make it obvious what the issue is, or how you could
look at it differently.

Good luck, it's worth the effort. Something I read that I thought was useful
to keep in mind when dealing with this stuff: you're not depressed because the
world is shit; you think the world is shit because you're depressed.

------
tunesmith
You don't have to see the medications as a permanent thing from the outset.
You may have to take the meds to give yourself the focus/ability to start
changing your other habits. After that point, you might be able to build up
enough momentum that you'll be able to work on yourself in other ways and
eventually not need the meds anymore. But depressed people often need that
initial boost to help move them out of the cycle.

Also, not to argue against "depression" or meds or anything, but... sometimes,
especially for people in the first decade of their working career, we might be
trying to convince ourselves we "should" be enjoying our career circumstances
even if we just don't. Those shoulds can certainly exacerbate depression. I'm
just saying that your underperformance might also be an indication that you
don't like your job, which is totally ok.

Finally, one of the simplest harmless things you can do to start, that you
might be able to motivate yourself for, is drink a lot more water, and take a
B vitamin every day.

But yeah, main thrust - take the meds, trusting that you may find it easier to
motivate yourself to take other healthy steps in the future.

~~~
lotsofthrows
> we might be trying to convince ourselves we "should" be enjoying our career
> circumstances even if we just don't. Those shoulds can certainly exacerbate
> depression. I'm just saying that your underperformance might also be an
> indication that you don't like your job, which is totally ok.

This is fair. My work has probably exacerbated my difficulties. In the past,
work (or programming in general) has functioned as an outlet - something to
focus on. At the moment, it's probably making things worse for various
reasons. I will need to change my job soon, but feel the need to fix myself
before I make any new commitments.

------
beat
As everyone else is saying, take the meds. But be sure to work thoroughly with
your psychiatrist to monitor the effects of the medication, and stop anything
that's going awry. Don't make the decision on your own to quit a med, either -
make an appointment.

Don't self-medicate with alcohol, "drugs" (the non-prescription kind),
promiscuity, video games, or other things that numb you. As the psych meds
take hold, you'll be able to get up, but you'll be dragged back down as well.

Be very conscious of suicidal ideas as you heal. The real danger point for
depression-driven suicide isn't when things are so black you can't even get
out of bed. It gets dangerous when you start feeling energetic again. Then you
have enough energy to hurt yourself. Have a support group or friends who
understand, and check in all the time.

Consider getting a new job now. It might help you to have a fresh thing to
care about, and getting fired from your existing job will only hurt you.

~~~
lotsofthrows
> Don't self-medicate with alcohol, "drugs" (the non-prescription kind),
> promiscuity, video games, or other things that numb you. As the psych meds
> take hold, you'll be able to get up, but you'll be dragged back down as
> well.

poignant. I either have at one point or actively self medicate with all of the
above.

> Be very conscious of suicidal ideas as you heal. The real danger point for
> depression-driven suicide isn't when things are so black you can't even get
> out of bed. It gets dangerous when you start feeling energetic again. Then
> you have enough energy to hurt yourself. Have a support group or friends who
> understand, and check in all the time.

this is valuable, thanks. I tend to be very private about anything concerning
my mental health, but this makes me consider sharing it with a friend I trust
who I can check in with.

> Consider getting a new job now. It might help you to have a fresh thing to
> care about, and getting fired from your existing job will only hurt you.

this is something I've considered very strongly. I'm a bit hesitant because I
worry I'll fail to produce in my new position (if i don't take the time to
heal), but it's definitely worth considering.

~~~
beat
Please, make sure you have someone keeping an eye on you. I've lost friends to
suicide, but never while they were really at the bottom... it was when they
were on the way back up. It takes real attention to watch for that.

------
RantyDave
Take the meds.

Expect this to be a journey - you have to try several and you may end up on a
combination (I take four). If you're dozy at work as for some ritalin to help.
I hope you have health insurance :( Also, if you go through 'high' periods
you're not depressed, you have bipolar 2.

Take the meds. This shit literally saved my life.

~~~
lotsofthrows
> I hope you have health insurance :(

That's honestly one of the only reasons I haven't quit my job. I'm performing
so poorly, and am so intensely ashamed of it, but don't want to go on COBRA
while unemployed.

> Take the meds. This shit literally saved my life.

Thanks for sharing. It really has been reassuring to hear they've genuinely
helped others.

~~~
tunesmith
I believe you can go on cheaper individual or ACA healthcare throughout the
year if you have a change in "life circumstance". Highly likely to be much
cheaper than COBRA.

------
parkovski
I was in a kind of similar situation recently - I never went to class, ended
up dropping out of school, would sleep 10-12 hours a day at odd hours, drank
way too much, didn't really have much motivation for anything.

For me the dominant factor was anxiety, and I didn't get help until I started
having panic attacks. Like you I started seeing a psychiatrist and a
therapist, and I was very lucky to not experience any adverse effects to the
medications I was prescribed.

SSRIs are an interesting thing - because they are such a gradual change, a lot
of people write them off as not working. For a while, I wasn't even sure if it
was doing anything, but at some point I realized that I didn't get the awful
dread/despair feelings from normal everyday life anymore. I started reaching
out to old friends again, and making new ones. I sleep 8 hours now.

I didn't realize how bad things had gotten, and how much better they should
have been. I used to be very against being dependent on drugs, but I
eventually came to the realization that I'd rather live till 40 and love it
than live till 80 and hate it - even though I don't think that's the tradeoff
I'm making, it's the one I was willing to make. So I just did whatever I
could.

Don't write off drugs, meditation, exercise, diet changes, etc - try it all,
and find what works for you. I mostly wrote about drugs here, but different
people are averse to different things, or don't believe in them, when the
reality is we still don't really understand mental health very well, and your
best bet is just to throw everything you can at it and see what sticks. But
you gotta do it. It's way better when you do.

------
turoczy
I don't have any immediate answers, but I did want to quickly thank you for
having the courage to reach out, rather than just suffering silently. This is
something with which many of us struggle on a regular basis.

~~~
lotsofthrows
thank you. that's kind of you to say, and very reassuring. I honestly felt
really apprehensive and guilty / self centered / narcissistic for posting
here.

> This is something with which many of us struggle on a regular basis.

it certainly feels that way at times :(

------
goshx
Take the meds. Don't worry about focus at this point... meds are your way out
of this situation. It is hard to see light at the end of the tunnel before you
start taking them, but once you do, try to find hobbies that relax you and
make you happy. Keep working with your therapist and psychiatrist to find the
root cause... sometimes it is hard to find it when you simply can't talk about
certain subjects because of the way you feel. Don't give up. You can overcome
this and you will.

------
zoba
I've dealt with a couple major depressive episodes in my life. In addition to
the standard advice of 'Go see a therapist!' heres some things that help for
me:

1) Committing to myself that I'm getting out of this state, and reminding
myself that I'm working on fixing it. Then having the leniency on myself that
depression is not a solved problem, and I will keep trying until I actually
have accomplished my goal - however unclear my progress may be.

2) Consistently enforcing myself to complete small achievable goals. For me,
this is stuff like: getting out of bed within 3 minutes of my alarm going off,
having an ironed shirt, show up at the gym and do some sort of exercise daily.

If you have motivational trouble, start with even smaller goals eg 'I will put
water in my cereal bowl after I put it in the sink so the milk doesnt dry and
get gross.' Then work up to 'I will put the bowl in the dish washer after I am
done with it.'

3) Creating arguments for why everything is actually all okay. Many of them
don't convince me, eg 'You've got a steady income', but some of them do eg
'Well I've read several papers that forcing yourself to smile releases
neurochemicals that make you happier' was pretty convincing.

4)
[http://examine.com/topics/Depression](http://examine.com/topics/Depression)
I'm not a medical professional, but the evidence gathered for supplements
listed on this site is convincing. In addition to Fish Oil and Saffron, I've
seen a lot of evidence for supplementing Vitamind D and found it to be very
helpful.

5) Go see a therapist that you like and respect. It was important to me to
find one who I thought was smart and practical - I didn't want a ooshy gooshy
feelings therapist. I've had the most success with CBT.

6) Learn to refocus your thoughts. This is tough, but, the worst part of
depression for me is often the sad thoughts that come with it. I find that
days are better when I don't allow myself to indulge in thinking sad thoughts.
So this means 1) catching myself when I've starting thinking something sad 2)
Successfully putting my thought train on a non-negative track.

If you take the meds, just be aware of the side effects of being on the meds
and also be aware of the side effects of coming off the meds. I've found no
doctor that really sufficiently warns of these.

If you ever want to chat, my email address is in the link in my profile.

------
Kronopath
I want to start off with a bit of encouragement. You've admitted that you have
a problem and you're taking steps to solve it. That's a great thing, because
it's showing acknowledgement of the problem and a commitment to getting
better. Too many people lack that, and so you should feel proud of yourself
for that.

That said, a therapist can probably guide you better than the internet can.
The trick is finding the right one. Most of the effectiveness of a therapist
comes down to the "fit" between the two of you, so if you've gone to about
three sessions or so and you're still not feeling it, it's encouraged and
expected to try another one. Your current therapist may even refer you to
another.

Above all, just keep fighting the good fight, and never be afraid to reach out
for the things you need.

~~~
lotsofthrows
> Most of the effectiveness of a therapist comes down to the "fit" between the
> two of you, so if you've gone to about three sessions or so and you're still
> not feeling it, it's encouraged and expected to try another one. Your
> current therapist may even refer you to another.

thank you. this is _very_ helpful. you're the second person to mention this,
and it's the sort of advice about treatment I may not have come by otherwise.

as it turns out, this is something I've been curious about (how / when to
change, the etiquette of switching therapists, etc).

~~~
Kronopath
I don't have a lot of personal experience with that kind of situation of
needing to "shop around", so I'm not sure I'm the best source of information
for things like that. But if you do a bit of digging, you can find some links
and information online:

[http://drpatrickkeelan.com/psychology/the-importance-of-
clie...](http://drpatrickkeelan.com/psychology/the-importance-of-client-
therapist-fit-in-counselling/)

[https://drkathleenyoung.wordpress.com/2009/04/30/the-
therapy...](https://drkathleenyoung.wordpress.com/2009/04/30/the-therapy-
relationship-what-makes-a-good-fit/)

Ultimately it does just come down to trusting your gut, and whether you feel
comfortable with them and their approach. If you do choose to switch, your
therapist should understand that things like this can and do happen, and
shouldn't have a much of a problem with it. (If your therapist _does_ have a
problem with it, that's a huge red flag right there and you're better off
ditching them.) Some of the better therapists may even make it clear near the
beginning of your therapy that they can connect you with other resources or
refer you to other places if that's necessary. But even if they don't you do
have recourse to do that. Just keep trying, even if it means you have to go
through a whole bunch of them to find one that's right for you.

------
hipsterrific
Been suffering with depression for most of my life. Exercise does help (for
me, it's walking or hiking). I took medication for a year and I hated it. I
meditate a lot (I'm a Christian) and I spend a lot of time introspecting my
issues. Much of my depression comes from having a crappy childhood so I often
have to address them in creative ways.

There have been times work has made me depressed so I take some time off. I
also have done a good job of not associating things with my identity, so work
is work and if I lose my job, then it's my job I lost. I tend to segment
things in my mind so that when I underperform at work, I feel bad but not to
the point that I want to kill myself over it. Learning to value yourself can
be difficult but it's not impossible.

------
sameboatbro
I was in, or am in, a very similar spot. I've struggled with depression to the
point where I got almost nothing done with work. I had the same fear you did
about dulled focus, but you're right: it is silly to worry about that if you
aren't productive already.

A few months ago I went on Prozac. I still struggle with focus and getting
work done and there are some other negative side effects, but crucially I am
able to think more clearly about the situation. I'm now working on strategies
myself to get myself to a better place long term.

I'd advise taking the medication -- it's unlikely to put you in a worse spot,
and very likely to put you in a better spot. From that better spot you will
see more avenues you can pursue.

------
mbesto
Please, I urge you to speak to a professional:

[http://www.reddit.com/r/SuicideWatch/wiki/hotlines](http://www.reddit.com/r/SuicideWatch/wiki/hotlines)

------
humanrobot
1\. Try the meds. View them as a crutch on your road to recovery, not a cure
all. You have to retrain your mind to see the positives in life. The drugs may
help, they might not, but at the end of the day you are the one that
determines if you are happy. 2\. Try mindfulness meditation. TL;DR is go to
quiet spot, close your eyes, breath in and out, and focus on just breathing
deeply. Longer link at the bottom. Lots of good books out there too. 3\.
Everyone dies eventually, so there is no need to rush there. Push yourself to
enjoy life, even if it if hard.

Good luck

------
silent-h
Take the meds. That's what helped me to stabilize. Expect that you need to try
multiple anti depressants before you find one that helps you. Therapy comes
after that. For me what you call logical advice didn't work until the
medication kicked in.

------
tgb
Here's what my favorite blogger has to say about it:
[http://slatestarcodex.com/2014/06/16/things-that-
sometimes-h...](http://slatestarcodex.com/2014/06/16/things-that-sometimes-
help-if-youre-depressed/)

He's a psychiatrist but I judge him based off of his blogging not on his
medical skills. I wouldn't have seen this had he been a great doctor but a
poor blogger.

------
icc97
A psychiatrist is key - but finding the right one for you is also key. There's
a book about it (edit: changed the link):
[http://books.google.com/books/about/How_to_Choose_a_Psychoth...](http://books.google.com/books/about/How_to_Choose_a_Psychotherapist.html?id=CyhbE25IdqcC)

I used to have a 20 mile-a-day cycle commute and doing triathlons and I didn't
find that it actually helped.

I have directly witnessed my mood improve from getting a good night's sleep.
But I'll still regularly fall back into not sleeping if I'm coding - which
isn't bad as long as I'm enjoying the coding.

Just simply having a 20 minute walk every day can be better than running or
cycling as it takes no effort and doesn't involve pressuring yourself to do
it.

I found looking for interesting projects worthwhile. Code on things that you
enjoy. If you hate some of the code you work on just try some ideas out for
yourself how you'd improve it - it shouldn't be for anyone else - just for
yourself as you enjoy it.

Yoga, meditation, Taoism, Buddhism, easy reading (about these topics),
talking, beer(s) all help too.

Accentuate the positive (in any way you can).

------
ctocoder
Take the meds. The meds get you to a level of normalcy. The underlying issues
causing depression can then be dealt with. But once you are diagnosed with
severe depression its rare for your dr to take you off of the meds. Speaking
from personal experience I have been on 20 mg of Lexapro for 10 years. When I
am off for 4 months my depression comes roaring back so I stay on it and don't
experiment with my brain anymore.

------
Kneedler
30 minutes of Exercise + 10 minutes Meditation every morning did wonders for
me. Finding the motivation to get started will be a constant struggle, but
once you establish the habit for a few weeks it gets much easier. Start small
if you have to, but do it every day -- building the habit is the key. If this
doesn't work, or you can't muster the motivation to do it, then the meds are
probably worth a try.

~~~
112864
Before going to work? what time does it make you wake up then? Well I'm not a
morning person

~~~
Kneedler
Timing is much less important than the activities themselves, but I think
mornings are most desirable because anything positive you accomplish in that
period will build positive momentum for the rest of your day. Hal Elrod's book
The Morning Miracle discusses this concept a bit more depth, if you're
interested.

I do my exercise first thing in the morning. I wake up, hydrate, brush my
teeth, put on workout clothes, and I try to be out the door by 6:30AM. I never
thought I was a morning person either, but my body adapted pretty quickly.

------
drzaiusapelord
I've posted this elsewhere before. I hope it helps.

The truth is there are no real fixes in our lives. Everything gets worn down.
This is pretty much a central concept in many philosophies and religions
through the ages. Fighting burn out, re-energizing, being unsatisfied for
while, being satisfied for a while, etc is just going to happen to you. Work
with it. But don't be short sighted to think "Oh its my career, if I was
instead $some_other_job_youll_hate, things would be perfect."

Personally, I follow a lifestyle of relatively low materialism and focus on
engaging experiences instead of chasing products or salaries. This mostly
translates into traveling instead of buying. There's no way to win this game,
you can only occasionally step off it. I also find side creative side projects
help as they take my mind off work and remove work from the "fulfillment" side
of my life. Who cares about bullshit at work when I have a robot to build at
home or when Im trying to finish the game I'm writing or the basement
remodeling I'm planning.

I also have a lot of success with meditation, being slightly more
compassionate and tolerant (even of things I know are wrong), and living a
slower paced/low drama life. I try to think about the right things, not the
default things. I try to not let the world get to me. I'm not often good at
it, but at least I'm cognizant of trying. DFW talks a bit about this here if
you're interested:

[https://www.youtube.com/watch?v=8CrOL-
ydFMI](https://www.youtube.com/watch?v=8CrOL-ydFMI)

I found bringing these attitudes into my work life helped a lot. Its hard to
explain, but I think when you get your ducks in a row in a general they
naturally get in a row at work as well.

------
TheMakeA
> they haven't really offered any strategies I can implement

I think I made two mistakes the first time I sought help:

* I stayed on the first medication I tried for far too long

* I stayed with my first therapist/psychiatrist for far too long

My new doctors are far more helpful and push me further than my old team ever
did. If it's not clicking, don't give up, but maybe see if there's someone
else that might be better for you.

~~~
lotsofthrows
> I stayed with my first therapist/psychiatrist for far too long

This is meaningful to me. I'm still seeing the first therapist / psychiatrist
I sought out, and the inertial barrier of seeking out an entirely new set of
professionals is kind of daunting. Knowing that this could potentially have a
real impact at least means I'll probably be open to consider switching if I
really feel like it's necessary.

------
ebbv
First off; you deserve to be alive. Suicide is not a solution to anything.
Life gets better, stick with it.

I've dealt with depression my whole life as well, and have also had those
feelings of anxiety and hopelessness. They are your brain playing a trick on
you. It's not reality.

What works for me is to focus on things that I enjoy, and to remember that
killing myself will only hurt the ones I care about. I think about wanting to
see my niece grow up, and one day be at her wedding, etc. Things like that.
Specific things that matter to me, not just vague ideas about loved ones.

I also try to throw myself into things I enjoy when I find myself starting to
feel down. Listening to music I like, singing along to it helps me often. I
make plans with friends. Not future plans, like immediate plans. If I find
myself starting to feel down I will reach out to friends and try to make plans
to see them ASAP. Even just to go to dinner or something. This often helps to
refocus me on my relationship with them, and importantly, I listen to what's
going on in their lives.

I was doing marathon running for a while, running 5+ days a week and that did
help as well. Unfortunately I fell out of the habit. If you can find a form of
exercise that you enjoy, it definitely will help. But obviously you're only
going to do it if you enjoy it.

Another thing that is important is to try to adopt an open minded attitude
about trying things. This has always been hard for me, but if I can do it, it
really helps. If I can open myself up to trying new things, and remember that
if they don't work out it doesn't really matter, that helps. New experiences
at least make for interesting stories.

Lastly, sometimes it can help to have a pet. My dogs' cheerful faces always
brighten up my day.

EDIT: Also keep talking to your doctors.

------
aikah
WARNING:

Do not seek any advice from anonymous people on the web about depression,
ever, you're seeing a therapist, that's a good start, If you're not satisfied
with your current doctor, go see another one.

~~~
paulornothing
I don't know why seeking a connection even with anonymous people online is
necessarily bad. There are a lot of people who have struggled with depression,
sometimes hearing from people dealing with the same struggles can help.

~~~
aikah
> I don't know why seeking a connection even with anonymous people online is
> necessarily bad.

How many of these people are professionals? depression IS a mental illness,
and must receive professional care, not random opinions by people who did not
make a proper diagnosis of that person's condition. Finally listening to
someone is different from advising him about how to get better. I'm all for
listening but not for people playing therapists.

------
err4nt
Hey man, thanks for sharing! A lot of us have battled with depression at
various points so you're in good company.

Depression used to be an annual appearance for me, like allergy season, and
even when I knew I would become depressed and could feel it happening, one
little change in attitude let me take advantage of my depression and harnass
its energy instead of feeling like a tidal wave crashed over me that I was
helpless to hold back.

When I'm not depressed, some things like getting out of bed or getting out of
the house whiles its still light out come easily. When I'm depressed making it
out of the house at all is an achievement in itself.

The thing that flipped it around for me was one time while I was depressed I
was also job hunting. Normally, I get anxious and nervous when applying, and
rejection often stings. But when I'm depressed I'm just numb to that. I don't
care, and tbe sting of rejection bounces off me.

So now I split things between "This works better when I'm not depressed" and
"Save this for when I feel depressed". When I feel myself slipping into it I'm
not afraid or disappointed anymore, I think "oh, I unexpectedly have temporary
thick-skin super powers" and think through all the things that need doing that
non-depressed me was scared of that depressed-me can get through no problem.

That shift was like a surfboard that let me ride that tidal wave and navigate
until the season of dspression was over.

Instead of giving voice to your fears, doubts, and failures - let depression
be a shield allowing you to fearlessly embark on edifying activities that will
make life for future-you better! This depression WONT last forever, capitalize
on the time you have left and pretty soon you'll find yourself not-depressdd
and it will go back to the old routine!

Surfs up! See you on the beach :)

------
bhousel
> Short of medication, however, they haven't really offered any strategies I
> can implement. Perhaps that will come later, but for now I was hoping to
> hear about what may have worked for others.

If you're looking for strategies, Cognitive Behavioral Therapy (CBT) is one
approach that I know of that can help with depression/anxiety/addiction, etc.
You generally work with a therapist to understand how your thoughts,
behaviors, and feelings can create a kind of self-reinforcing negative
feedback loop. They therapist will give you homework and tools to interrupt
the pattern and think more rationally and mindfully about your thoughts. I
guess you can also try self-directed CBT, but going with a trained therapist
is better if you can find one in your area that you're comfortable working
with.

------
andrewtbham
If you are suicidal call the National suicide prevention hotline.
1-800-273-8255

------
Thriptic
I went through a somewhat similar phase in which I didn't particularly care if
I lived or died (new city, shitty job which I wasn't doing well at, had no
friends / gf, poor health, no immediate prospects etc). I think what helped
get me out of it was focusing all of my available willpower and effort on one
or two areas which were completely in my control and where success was readily
attainable through consistent work. For me those were lifting and dieting, and
those activities reminded me that I could be successful, reminded me that I
had self worth, and boosted my morale. This created a positive feedback loop
in which that success emboldened me to address other problematic parts of my
life and create further success and happiness.

------
mattkopecki
> All the logical advice (exercise, go to sleep on time, live a healthy
> lifestyle) are things that I struggle to find the motivation for.

In my experience, that is largely the point. Take "cold showers", for example,
as this is something that is regularly suggested in cases like this. Is there
a benefit to actually being in a cold shower? Tough to say. But really, the
benefit is that it's a small-bit-slightly-unpleasant task that's easy to
avoid, and if you make yourself not avoid it, you build some small momentum
for other things in your life that you lack motivation for. If you can muster
the courage to stare into the shower head and turn it to cold, it doesn't
really matter how long you wait until you turn it to hot after that.

------
112864
Take the meds, Take the meds ........

Well that's what people (specialist or not) told me.

But that were my worse mistake

Anti depressants may not be too bad (they are said to even increase gray
matter) but a year ago, I was prescribed antipsychotics by injections (because
I had some paranoia against cigarette smoke) and those have been the worse
thing I had to live, basically it deconnects your brain. So be happy and think
there's worse, much worse elsewhere. Also sports helps, do 40 minutes of bike
everyday (like going to work by bike), this must be the best medicine

~~~
DanBC
Anti psychotic medication, especialy depot injections, is very different to
anti depressant tablets!

~~~
112864
worse? (in term of effects)

~~~
DanBC
Yes, anti-psychotic medication have worse side effects.

They tend to be more sedating or have more severe weight gain associated with
them.

------
ctb_mg
Hi. I can only offer my own anecdotal evidence. I suffered from depression for
about 9 years, and I've been past it for about 4 years now. I am not a doctor,
so YMMV.

Good that you are seeking help. That is the first step.

Meds: Take them. I always felt they dulled your emotions so that the highs are
not as high and the lows are not as low. That's not ideal, but it's worse than
the alternative: not taking the meds. The goal is to not have to take them
anymore.

Focus: In my experience, meds didn't harm my focus; maybe it even improved, as
I wasn't as often caught in the throws of depression.

Motivation: You won't get motivation from meds. The meds help you get through
each day, they help you feel less of a huge burden on your shoulders.

Strategies to implement:

Learn about yourself. Learn what makes you happy and what motivates you to do
things. Learn what types of things are more likely to get you out of bed in
the morning. Include more of those things in your life. Include less of the
things that drag you down. Pay attention to how you feel, when, and why. When
you're on your way to figuring those things out, wean yourself off of the
meds. This takes more effort than it seems; recovery isn't a quick process.

Go out and do new things. Don't feel intense pressure to go do everything. As
others have stated, this is a journey. Just make a measured effort to do a new
thing every so often. Eventually you'll latch on to something that motivates
you.

------
beeworker
I second the other comments suggesting to at least treat online advice with a
grain of salt. That said...

I burned out some years ago and have been struggling with recovery since,
depressive thoughts aren't far away but by now I've found coping mechanisms.
It's annoying I don't feel I can talk about it with my real ID because I still
don't feel like my performance and drive is even 80% what it used to be, and I
fear that would impact my future chances of switching jobs if they discovered
my inner struggles. But my performance seems to be enough for my coworkers to
value me, so I keep going another day. I too almost lost my previous job
during the early periods, but at the end of it I was valued again. (I just
observe external praise, I never feel it. Whatever.)

I'm anti-big-med for myself, but I won't discourage you from taking them as a
lot of people say they help and some even report total elimination of
depressive thoughts. I would encourage you to see if extra caffeine helps you
at all while you wait, especially as the big drugs tend to take 3-4 weeks
before kicking in at all and caffeine seems to have a more immediate effect.
How much caffeine do you take per day? If you don't take much, you may want to
get a box of 200mg pills and try for 200-600mg per day and see if it helps you
at all. Caffeine has some anti-inflammatory properties, and depression is
increasingly being recognized as an inflammatory disease, plus caffeine as a
stimulant itself can help with the focus. Anecdotally, what cripples me some
days is never-ending introspection about my value to the world and my
performance. Sometimes taking more caffeine than usual that day will allow me
to shut my mind up about itself and think about other things, and that allows
me to get things done. (Work, laundry, going to the gym.)

Last year I finally did start feeling like I was recovering a little bit, then
my mom unexpectedly died. Expect life to continuously shit on you. But
whatever. If you keep on keeping on you'll develop your own coping mechanisms
(those that don't die) so even setbacks won't necessarily send you over the
edge as you've been there before. Lastly, killing yourself in a nice way would
take effort, it's not worth it. Just look forward to sleeping instead. You
might also consider getting a pet, or a house plant -- something whose
continued existence depends on your existence.

------
jitl
Take the meds. Best money I've ever spent.

------
snikeris
Regarding exercise, just do something that's slightly more than what you're
doing now. You don't have to go running or go to the gym if you don't feel
like it.

Start small. Just get up right now and go for a walk around the neighborhood.

For something more formal, I like this guy's method:

[https://www.fourmilab.ch/hackdiet/e4/exercise.html](https://www.fourmilab.ch/hackdiet/e4/exercise.html)

------
lordnacho
It can seem strange that medication might help a psychological condition, but
definitely take the medical advice.

A friend of mine was found in his dorm room with blood on the walls; he wasn't
taking his meds. After a lot of battling (with a number of issues), he finally
got around to it. He got back to finishing his degree, and got over his
problems, getting a phd in the process.

Don't let it define you as a person that you happen to be ill.

------
Tomte
While I don't have actionable advice for you, on the subject of depression I
strongly urge everyone to read this blog post by Wil Wheaton: "Depression
Lies", [http://wilwheaton.net/2012/09/depression-
lies/](http://wilwheaton.net/2012/09/depression-lies/) It moves me to tears.

Afterwards, read his wife's account of it, "The Other Side of Depression", at
[http://www.annewheaton.com/the-other-side-of-
depression/](http://www.annewheaton.com/the-other-side-of-depression/)

For an overview of the current scientific knowledge, an introduction to brain
chemistry and the psychology of depression, and -- most importantly -- a
forceful argument that depression is a bona fide illness, a biological/medical
condition, not just some "oh, pull yourself together" thing, see this video of
Stanford professor Sapolsky:
[http://www.youtube.com/watch?v=NOAgplgTxfc](http://www.youtube.com/watch?v=NOAgplgTxfc)

------
AnthonBerg
Among other things, I recall the following to have worked for me:

* 12-step work (Al-Anon / CODA)

* Intense enough exercise. You want to get a strong endorphin high going. Anaerobic exercise can be a very powerful mood- and motivation-builder. A bodyweight/kettlebells mix taught locally as "combat conditioning" works very well for me. Kinda social enough but still good for "loners". Competitive only towards oneself. Motivation starts rearing its head strongly when body picks up on the endorphin high. I find it very hard to get motivated for straight-up weight training. Rock climbing has been very therapeutic to me as well. (The body is a subtle pillar. Living life in a strong, supple body and a trained endorphin reward system makes every single thing more enjoyable. Just walking feels _good_.

* Meditation. Any meditation is good. "Dark" / tantric meditation is invaluable as an aspect. Headspace.com works well. Meditation does really open the mind towards enlightenment, I have found. I have experienced brief glimpses of full serenity in everyday moments through meditation. Not during meditation but in the life that is lived around it.

* This unbearably beautiful Nietzche quote: "Reife des Mannes: das heisst den Ernst wiedergefunden haben, den man als Kind hatte, beim Spiel." ("Maturity: To have finally rediscovered the seriousness one had as a child at play.") Apply it to exercise, meditation, the discovery of life and living it.

* Offroad motorcycling. It cannot be adequately stated in words how transcendental, intense, and meditative the experience is.

* Edit: Giving up smoking!!! Nicotine is such a subtle poison. It's an illusion that it is hard to stop, but the illusion is tricky to break, but still it is easy. Very subtle and tricky. Allen Carr's Easyway to Stop Smoking worked for me.

------
joshrotenberg
Worry about the medication first. Don't try to overwhelm yourself with other
solutions right now.

------
mjb394
There are a lot of different medications you can take, and they have different
side effect profiles. Prozac is different from Wellbutrin is different from
Lexapro, etc. Sometimes doctors don't have a good reason to choose one over
another in any particular case. If you sit down and have a serious talk with
your doctor about which side effects often come with each medication, and
which side effects you can live with, you're more likely to get off on the
right foot.

People telling you to exercise are right, but that is pretty hard advice in
that format. The real answer is to find the kind of exercise that works for
you, and don't give up until you do. I've never been a morning person, and I
always hated running and other cardio, so for years I didn't really exercise
at all outside of walking places. Turns out I really like biking and rock
climbing. If you can switch to biking as part of your commute (biking to the
train maybe) then you don't have a way out, and you have to exercise. Use the
days when you do have energy to make plans for later days when you may not.
Try to do things for other people.

The best thing for me in the end was 1. Getting out of the life situation
where I had been depressed for a long time. 2. Getting into something totally
new and overwhelming, and doing it totally by myself. I spent all of college
and grad school dealing with some pretty severe depression, and when I finally
graduated I took out extra loans to travel for a few months over the summer
before my job started. I bought a one way ticket, planned almost nothing
except listing a few places I wanted to see, and went alone. When you are
traveling alone in a foreign country, it really hits home that you are
entirely responsible for your own experience. There are beautiful sights,
incredible food, life changing encounters to be had, and you have to make the
choice every day between getting up and out and interacting with the world and
crying on your hostel bed. You'll still spend some time crying on your hostel
bed, but you might also smoke a joint with a Brazilian and some French women
in a park in Prague and start a travel romance with a former professional
trail runner in Barcelona.

------
stefek99
* Seek specialist

* Medication helps

* Logical - go for a run - blood circulation, oxygen, endorphins - cannot go wrong with that!

* Slightly related - [http://www.startupsanonymo.us/](http://www.startupsanonymo.us/)

------
mjallday
If you don't exercise then now would be a great time to start. Endorphins feel
great and sometimes the intensity of physical activity is a good way to hit
the reset switch on your brain.

------
nosuchthing
You need a goal and objective to keep you motivated outside of work.

What inspires you? What are your ambitions? Do you like to travel? Build?
Music? Gardening? Swimming?

------
ben_says
Life is long and hard. This rarely goes over well online, however, if you have
never read the bible, this link helps sketch a rough outline. I no information
other than what you offered, I hope this helps as you gather support.
[http://www.matthiasmedia.com.au/2wtl/2wtlonline.html](http://www.matthiasmedia.com.au/2wtl/2wtlonline.html)

------
tfb
Get a dog. They're called man's best friend for a reason. :) When I'm feeling
like you are now, I look over to my little buddy and think, "What would you do
without me?" But what I should really be thinking is, "What would I do without
you?" Words cannot express the amount of joy that my dog brings to my life. I
don't know if I would be here right now if it wasn't for him. When I don't
feel like getting out of bed, he's always there to wake me up and give me a
reason to get moving. I cherish every moment.

Here is a video I recorded the other week of one of our walks. We've walked
along this path at least a thousand times.
[https://www.youtube.com/watch?v=iH4TsjD97cU](https://www.youtube.com/watch?v=iH4TsjD97cU)

Get a dog. Give it all the love you have. You will receive the same,
unconditionally. Go do all kinds of things that your little friend enjoys. Go
for long walks as often as you can, morning and night, at least. Your friend's
excitement and joy over the smallest things will rub off on you too. And
you'll come to realize that, to your dog, you are literally everything. It
really puts things into perspective. There really isn't much more to life than
that, and I think there's a certain beauty to it.

~~~
lotsofthrows
Thank you very much for sharing. I didn't downvote you (obviously). I actually
have at many times in the last year (before things got... really bad) wished
for a dog, but I live in a very uptight apartment complex that doesn't allow
large pets.

> And you'll come to realize that, to your dog, you are literally everything.
> It really puts things into perspective. There really isn't much more to life
> than that, and I think there's a certain beauty to it.

this, and the video, made me smile. thank you.

------
emersonrsantos
Don't seek medical advice online, it's too generalized. Listen to and discuss
these problems with your doctors and family.

------
galfarragem
Every case is a case, but one of my best friends took control of his
depression and anxiety by:

1 - Take meds.

2 - Buy a piano. It seems crazy (he literally spent all his money in it) but I
can confirm that it was the best investment he ever did.

------
tblomseth
My piece of advice would be to track any intervention you might choose to
implement. Find some indicators that are personal and can tell you whether any
given intervention is working or not.

I have no personal experience with depression. However, I've used self-
tracking to improve my allergies cf.
[http://quantifiedself.com/2014/03/thomas-christiansen-
learni...](http://quantifiedself.com/2014/03/thomas-christiansen-
learning-60000-observations/).

I would also look a bit broader than just your mental state e.g. how are your
other bodily functions running. Depressive states might be a signal from your
body about something that's amiss in the layers below and/or in your
environment.

------
felipelalli
Get a sabbatical year and go to Australia with a friend. It worked for me.

------
heimatau
There is a lot of scientific research around this. I'd suggest three natural
things. A quality fish oil, exercise, and do more social activities.

Sources: [http://www.health.harvard.edu/newsweek/Exercise-and-
Depressi...](http://www.health.harvard.edu/newsweek/Exercise-and-Depression-
report-excerpt.htm) \- [http://mason.gmu.edu/~sslayden/curr-chem/fish-
oil/fishoil-wp...](http://mason.gmu.edu/~sslayden/curr-chem/fish-oil/fishoil-
wp.htm)

~~~
DanBC
Here's a meta analysis that says:

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

> When only high-quality trials were included, exercise had only a small
> effect on mood that was not statistically significant.

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

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

~~~
heimatau
"In summary, exercise appears to be an effective treatment for depression,
improving depressive symptoms to a comparable extent as pharmacotherapy and
psychotherapy. Observational studies suggest that active people are less
likely to be depressed, and interventional studies suggest that exercise is
beneficial in reducing depression. It appears that even modest levels of
exercise are associated with improvements in depression, and while most
studies to date have focused on aerobic exercise, several studies also have
found evidence that resistance training also may be effective. While the
optimal “dose” of exercise is unknown, clearly any exercise is better than no
exercise. Getting patients to initiate exercise ---and sustain it – is
critical."

Source:
[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3674785/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3674785/)

For more studies regarding this 'inconclusive' research.
[https://duckduckgo.com/?t=disconnect&x=/html&q=exercise+trea...](https://duckduckgo.com/?t=disconnect&x=/html&q=exercise+treating+depression+site%3A.edu+OR+site%3A.gov)

Also, I cited Omega 3 and social support. Are they 100% definitive? No. But
are they solid steps to healing the mind? Yes.

------
bane
See a professional and do what they say. It can take years to get sorted out,
so don't expect it to work quickly.

In the meanwhile, exercise routinely, get outside and get sunlight, force
yourself to hangout with people and do activities. Find thing you like to do
that aren't your day-to-day life and do them and enjoy them. Build positive
feedback loops in your life so you always have things to look forward to.

There's no quick solution, only retraining yourself to understand how valuable
and important you are to your world.

------
techlibertarian
Sleep, exercise, and a good diet are always a great start. I always to look to
one of those three things when anything feels off in my own life.

Everyone here is suggesting you take your meds. One alternative that is
increasingly popular, especially with depression, are psychedelics. I would
suggest Amber Lyon's Reset.me [1] if you're interested in further reading.

Now for the downvotes...

[1] [http://reset.me/](http://reset.me/)

~~~
DanBC
Suggesting hallucinogenics for someone with a known mental health problem is
irresponsible.

Therapeutic uses would be of known doses in tightly controlled situations -
neither of which are available to OP.

~~~
techlibertarian
> Therapeutic uses would be of known doses in tightly controlled situations -
> neither of which are available to OP.

I wasn't aware of this and I wasn't suggesting that he go down and buy a hit
off of the nearest corner. I was _suggesting that OP consider researching_
alternative methods that are taboo yet effective.

------
rifung
I don't have depression but I am manic depressive so I imagine there are
similar things that help.

Exercise definitely! Even just running a little bit helps. It seems like you
already have talked to a therapist. Have you considered finding people to talk
to as well? I think what usually happens with depression is that you shut
yourself away from everyone else, but you really need to open up to someone to
improve. At least, that's been my experience.

~~~
DanBC
Bipolar disorder and depression are different illnesses. The medications used
to treat are different; the therapies used to treat are different.

(I didn't downvote you)

~~~
rifung
I appreciate that you took the time to explain why I was downvoted.

Also, I'm pretty sure the things I described are good for both.. I was
misdiagnosed with depression at first so I did a lot of research into it, but
maybe my memory is failing me.

------
anigbrowl
Well, there's no magic bullet. You could ask you professionals about getting
cognitive therapy or look up a psychoanalyst in your area.

'Talk thereapy' like psychoanalysis has been severely out of fashion in recent
years because it's intuitive rather than rigorous, so your existing
professionals might not want to recommend anyone. Where it does well is in
helping the patient to get fully familiar with the course of his or her
depression - not so much to identify a single cause, which there may not be,
as to help identify the differences between the malady and the ordinary ups
and downs of life. If you're a very verbal, analytical person, this might be
helpful for you. I sometimes feel a bit frustrated when I see a psychiatrist
that he just catalogs a few details about my mood, sleep patterns etc. and we
don't talk much about the experience of things - a bit like a doctor that
writes you a prescription for a painkiller but doesn't seem to have any
interest in the diagnostic aspects of the pain, eg 'it hurts much more when I
do this, what does it mean?' 'Oh that's normal, take two of these and call em
in the morning.' 'Grrrr.'

Exercise is very useful, But of course you feel demotivated. You could try to
put in some effort finding what kind of exercise options are available. I find
the idea of going to a regular gym insufferably dull, for example, but I enjoy
climbing and martial arts, and you should be able to find options for both in
any large city. Martial arts has a lot going for it because it gives you a
simple problem to focus on - how to prevent your opponent from beating you up-
but with the benefit that the opponent isn't trying to make you feel bad, so
you don't need to take his or her assaults personally. If you investigate this
don't go for a place that is heavy into competitions and belts and other
stuff, look up the sort of people who do small tai chi classes in parks and so
on. As a general rule, the less rent someone has to pay the more personal
attention you'll get. Of course you don't have to go with an Asian martial
art, if you've always wanted to learn fencing or something try that. The basic
point is that it's really helpful to have something or someone external to
grapple with, it takes you out of yourself. Also,as you learn more skill you
can exercise mentally by running through sequences of different moves in your
mind, like a chess game. This is very good for managing feelings of negativity
and worthlessness, after a while you recognize patterns of unhealthy thought
and learn to short-circuit them.

You could also consider getting a pet, particularly a dog. Now matter how
shitty you feel, being responsible for another creature kind of forces you to
get out of bed int he morning. Of course it comes with annoyances an
irritations too, from cleaning up occasional toilet accidents to their refusal
to take no for an answer when you don't want to get out of bed. But they're
manageable problems. On the flip side, they give you an excuse for managing
your life more rigorously; if you can function more consistently at work, then
you can also say you need to go at the end of the day because you have to feed
your animal. Some workplaces will allow you to bring in a service animal, and
if animal companionship is helpful to you than you have very strong rights
under the Americans with Disabilities Act (I'm assuming you're in the US). Use
them. If you're already had an animal in your childhood then you know what you
like, if not then get some advice. Dogs are generally more emotionally
responsive than cats, plus they're more familiar as service animals, so unless
you're already a 'cat person' a mid-size dog is a better choice. They're more
work than a cat, but that is a Good Thing because it will get you out of the
house.

Work-wise, maybe programming isn't for you. I got quite alienated in my 20s by
the virtuality of programming; you're pushing stuff around in memory or in the
cloud somewhere, shoveling bits to make $ and after a while it all seems
rather meaningless and pointless if you're not solving a problem that you
actively care about. Also, the never-ending stream of New! Stuff! coming fown
the pipe (frameworks, protocols etc.) means that your knowledge base is being
constantly degraded, which just gets a bit tiring after a while because unless
you're writing for mainframes you may well feel that you're building on sand,
an this becomes an Unpleasant Metaphor for Life, of the sort you can easily
obsess over when depressed. Start asking yourself what else are you interested
in besides code? If you weren't a programmer, what sort of things would you
engage programmers to do? Let your imagination roam - run a winning formula 1
team? reduce world hunger? Solve humanity's most ancient mysteries? Bear in
mind that outside of pure computer science, a lot of programming is service
work - skilled service work, but still service work. It's like being an
accountant - you have to be smart and on your game, but ultimately you're a
functionary rather than a decision maker in many programming jobs. Just
because you're good at it doesn't mean you have to do it for the rest of your
life. The mental skills of programming are highly transferable to many other
contexts, and you may very well find it profitable to move into a different
domain and build up a pile of expert knowledge there, where you will also find
new and interesting problems that could be easily solved by technology,
allowing you to progress very quickly by being The Smart Person.

So as an exercise, imagine that you were fired and further imagine that you
were put on some sort of programming blacklist and forbidden from working in
the tech sector, forced to work in some other context as an underground
programmer. What other fields are you interested in? Protip: while some highly
specialized subfields like medicine obviously require significant
qualifications to enter and would require you to go back to school for many
years and at great expense, many interesting and exciting areas require no
qualifications at all, just a capacity for obsession. You already have one of
those, it's what makes your depression so intense. When you find something,
start learning about it intensively outside of your day job; use the latter to
finance your actual interest. You shouldn't feel the least bit guilty about
this.

Of course, you don't have to leave programming. but you do have to know why
you're in it, and that means it's important to be programming to some end that
you are interested in. Who is it that decides what sort of programming
problems you work on, and if that is not you, then why not? I have the
impression that you derive a good deal of your self-worth from your job, and
are disproportionately sensitive to how you do there, not least by the
proximity of how you discuss your job situation with questioning whether you
deserve to be alive (by the way, the answer to that question is that you
don't, but neither does anyone else - you just are, and you don't owe anyone
an apology for your existence unless you deliberately dedicate yourself to
making other people feel awful). Shift your perspective to thinking about how
you perform a service so they give you money, and focus on what other things
you would like to do with money besides pay rent and put food in your mouth.
This will help you get through individual bad days - it is perfectly OK to
have an ulterior motive for work. Obviously don't say out loud that you're
only there for the money, but start thinking of your line of work as a ladder
to get to somewhere else you want to go.

~~~
anigbrowl
2/2

If you're still having a problem imagining other places you want to go, work
with your therapist to identify what sort of things you feel unambiguously
positive about even though you may get intense anxiety that you don't deserve
to enjoy such things. I have a theory (which I'm going to completely handwave
here) that when we're depressed we often avoid thinking about the good things
in life too hard because our brain is churning out hormonal painkillers of
offset the mental and muscular pain of anxiety, and those painkillers are
actually rather addictive, so you get used to feeling bad because once you
feel sufficiently awful at least you get to wallow in your own hormones a bit
and that yields relief. Thinking about good things initially makes you feel
_worse_ because you know they're good but you don't feel any chemical payoff,
so when you try to model yourself enjoying this good thing you are only
conscious of the burden of pain you're carrying and the temptation is to shift
the focus back to that burden to get another shot of compensatory hormones. So
say your happiest memory involves, I dunno, hot air balloons. You think about
hot air balloons but you don't get any particular charge off it so you begin
thinking that once hot air balloons made you very happy but now you only feel
pain, and so you have lost your capacity to enjoy hot air balloons (or
anything else) forever. But did your earlier self who derived great enjoyment
from hot air balloons deserve to suffer for the sake of that enjoyment? Of
course not. Can you imagine someone talking to that younger and happier
version of yourself standing there saying 'oh, you're a horrible person, your
naive joy in hot air balloons is an illusion will be crushed by a lifetime of
misery, ha ha.'

I'm pretty sure you can because that's basically what you're telling yourself
as a despressed person here in the present. Now focus once more on the
imaginary person saying this to your younger and happier self, and actively
trying to make that self feel awful in the same way that you feel awful right
now. What an asshole, right? IF you saw someone else doing that you'd tell
them to shut up and shove off, and stop trying to ruin other people's
enjoyment of life. Well, that's what your depression is - an imaginary
miserable person that you carry around in your head who is constantly running
you down and telling you that you're No Good. It's your own critical faculty
on steroids a useful faculty but one that has gotten out of control and turned
into the mental equivalent of a scab that you keep picking at day after day
and never allowing to heal. It's not evil, or inevitable, or or inaccessible.
It's just a part of your psyche that's stuck in a self-reinforcing loop, a
race condition if you like.

So all the coping strategies I've outlined above are ways of establishing
different perspectives to stop seeing that psychic irritation as The Only
Thing That Matters and instead acknowledge it as a Painful Thing but not the
Only Thing. Drugs may assist with that process (or not; don't be surprise if
it takes several attempts to find something that works, or that things work
for a while and then stop etc.). I say 'process' because it's not a threshold
thing where you have some big realization or turn a corner, come out of the
darkness into the light, and you're not depressed any more. Instead it's this
thing that just comes up more or less intensively and you need to develop a
process of recognizing it as a symptom of your depression, remembering that
its a painful internal injury rather than some objective moral flaw in the
world or yourself, and then try to sidestep the pain the same way you would
with the pain from a broken arm or whatever.

This process won't make much difference at first, the same way that taking a
deep breath doesn't help much with the pain from a broken arm when you need to
do something like buttoning a shirt or turn on a light switch, never mind
things like pulling on your pants or lifting heavy weights. On bad days you
have to remind yourself 100 times a day that it's only a symptom and that
sooner or later it will heal if given the opportunity, and then do it again 5
minutes later. but after a while you find you're only dealing with it 80 times
a day instead of 100, or 50 times a day instead of 80, and so on.

And that's how you learn to manage it. The more work you invest in managing
it, the more it is to recognize as a symptom rather than The Awful Truth, so
that when it waxes and wanes you can learn which strategies work best to deal
with it, like when it's more effective to work or to take a rest. You know how
kids are horrified by physical injuries because the pain if such a novel
sensation and now they think this is how it's going to be for ever? Exact same
thing. Just as it still hurts to hit your hear or cut your finger or break a
bone, but you have learned that physical pain is transitory and treatable, you
need to learn the same thing about mental pain, and keep patiently trying out
different things until you identify the characteristics of of your particular
mental injury and what you have to do to handle it. It is absolutely a
manageable problem that becomes easier with practice - much easier, and that
practice can significantly improve your competence to deal with other external
problems and support creative and professional accomplishment.

~~~
lotsofthrows
thank you very much. I found your post quite helpful. I definitely have
experienced at points an existential crisis wrt programming. I do enjoy it,
but it's been a while since I worked on something I truly cared about.

my therapist described me as having an "idealistic streak" and mentioned I
might be happier if I were working on something that motivated me more than a
paycheck. This is something I'll have to take into account as I look for a new
position.

------
pawnhearts
I suffered from a major depression some years ago, and with "major" I mean a
condition where I used to have panic attacks everytime I left my house. It was
painful and took me a very long time (2 years in the middle of my twenties),
but in the end I made it.

Some random advices based on my own experience that helped me feel better and
bow out of depression (please consider that I am not a doctor):

0) You are not alone, so you don't have to feel alone; talk to people that you
won't feel judged by (the internet is great for this, and so are the
therapists) and spit out everything

1) As you pointed out, medications can alter somehow your ability to focus,
particularly on the first days. I lived my depression as a condition where I
hadn't really too much control over myself, so I decided not to take any med
because I didn't want them to take control over myself: you probably want to
do the same

2) Day by day, write down simple todo lists, and try to complete all items.
These lists will help you distinguishing days by their completed items and
reacquire the awareness of time. Additionally, there is always a little bit of
satisfaction in completing things you were supposed to complete, and we all
need that!

3) Your job pays your bills, work hard but don't forget that you're only in it
for the money, your life is something else, somewhere else

4) When you feel you're at the lowest mood, don't question if you deserve to
be alive or not, rather smile and think that one day you will be fine again.
If you didn't deserve to be alive, you would be probably already dead so let
that bad bad thought go away

5) Don't be ashamed of your current condition but at the same time try not to
get into the collective imaginary as 'that depressed guy'; there's nothing
wrong about being depressed, but the last thing you want to deal with now is
people's pity. I occasionally run into people that knew about my condition and
I can still clearly see that 'oh, poor guy :-(' look on their faces: a bit
frustrating to be honest!

6) From time to time during the day, for several days, give your mood a
rating, write it down, then look for patterns and ask yourself why, at some
point, your mood was increasing or decreasing. You have no idea how this
helped me

7) Read this two parts post [1, 2]

8) As you sense you're starting feeling a little bit better, that is the time
you should ride the wave and get yourself out of it, no fear, no look back:
you made it

[1] [http://hyperboleandahalf.blogspot.it/2011/10/adventures-
in-d...](http://hyperboleandahalf.blogspot.it/2011/10/adventures-in-
depression.html)

[2] [http://hyperboleandahalf.blogspot.it/2013/05/depression-
part...](http://hyperboleandahalf.blogspot.it/2013/05/depression-part-
two.html)

------
bigcatns16
I've dealt with depression several times in my life (I'm 24).

First, when I was around 16-17 and then off and on throughout college with the
worst of it being the year and a half that spanned by grandma being diagnosed
with and passing away from cancer.

I can give you a little background on both. I don't know and won't guess on
what exactly you're going through, but I can share my experience in hope that
it helps.

Growing up I was a pretty high achiever, with that continuing into high
school. Around my sophomore year, class rank came out, I was first (hooray).
No one thought I deserved to be first and made sure to tell me that. If they
didn't tell me I didn't deserve it, they would tell other people. I realize
this seems like a non-problem, but it really messed with my head. All of a
sudden, my peers and friends were basically calling me a fraud and I was
struggling not to believe them. I put an enormous amount of pressure on myself
to out perform them and, when they scored a few points higher than me on the
ACT, I started to crack. Around the end of the second semester, I couldn't
eat, I couldn't sleep, and I was essentially having a constant panic attack. I
finally told my parents, who took me to see a therapist. I was embarrassed by
this, normal people weren't supposed to see therapists. I wanted to avoid
medication, most of it doesn't have much of an effect on me, so we just ended
up talking. 'If you don't get straight A's, what then?'; 'If you aren't number
one in the class, what happens?'; a lot of these huge pressures I felt were
artificial. What I took away from all of it was that instead of taking
satisfaction from the progress I was making by comparing myself today to
myself yesterday, I was now looking outward for validation, which is never
really a good thing. It's certainly helpful to use others that are better as
bar, but it is terrible to continually point out the ways you are not as good
as them. By adjusting my perspective a little bit, I was able to rid myself of
all of the external pressures I felt and was instead able to focus on how
exactly I could be better tomorrow.

After dealing with the high school stuff, I had a pretty successful last two
years of high school and ended up going to our state school to run cross
country and track and to get my software engineering degree. My college career
played out like this: Freshman year: broken foot, death of family friend;
Sophomore year: friend accidentally shot himself; Junior year: broken foot;
Senior year: grandmother diagnosed with terminal illness and passed away 7
months later, broken rib. It was not great. Honestly some of the worst and
darkest years of my life. Particularly my senior year. I skipped classes for
about 3 weeks both fall and spring semesters, because of what I was dealing
with, just doing enough to pass my classes. It was hard. I didn't sleep. A lot
of nights I wouldn't fall asleep until close to 4. I ended up taking a
combination of melatonin, sleeping pills, and extra sleepy time tea just to
give me a chance at sleep. Ater I broke my rib, I drank a lot more because I
didn't have to worry about running. I never thought about suicide, I had seen
what it could do to families and felt that whatever pain I was going through
was worth it for my family and friends. I did, however, think that it might be
better to just not be here anymore. I knew it wasn't realistic, but it did
seem better. I was determined to deal with it on my own. I read 'The River of
Doubt' (a book about one of the darkest periods of Teddy Roosevelt's life) and
it helped. His methods for dealing with shit really resonated with me
(basically throwing yourself into the pursuit of some grand goal) and I
started feeling better.

I still have moments. Depending on the situation, different things help. One
is that nothing really matters, not in like a cynical mad at the world way,
more in a there is no point in not trying, because the outcome, whether
success or failure, doesn't really matter. If people want to look at you
differently who cares. Most of the time, you can learn and grow from your
failures. Another is that emotions like 'worry' and 'embarrassment' are often
pointless emotions, it's just you making yourself feel bad about something
that hasn't happened yet or about what you think people are thinking about
you. The stuff with my grandma still isn't easy to deal with, but I have hope
that I'm still making her proud. If you're not a religious person, you can
still hope that what you're doing would make them proud. The ones we love
never truly leave us, it's still valid to strive for them.

Life is too awesome to give up on. And you are never as bad as you may seem.
Keep your head down and your chin up. Failure is something you should be proud
of, most people give up before they have the chance to fail. I know a lot of
this may seem like feel good mumbo jumbo, but fuck cynicism, feel good mumbo
jumbo is usually pretty spot on.

Here's a quote by a person a lot more eloquent than me:

“It is not the critic who counts; not the man who points out how the strong
man stumbles, or where the doer of deeds could have done them better. The
credit belongs to the man who is actually in the arena, whose face is marred
by dust and sweat and blood; who strives valiantly; who errs, who comes short
again and again, because there is no effort without error and shortcoming; but
who does actually strive to do the deeds; who knows great enthusiasms, the
great devotions; who spends himself in a worthy cause; who at the best knows
in the end the triumph of high achievement, and who at the worst, if he fails,
at least fails while daring greatly, so that his place shall never be with
those cold and timid souls who neither know victory nor defeat.” - Teddy
Roosevelt

A song I listened to a lot: Walt Grace's Submarine Test, January 1967 - John
Mayer

If you just need someone to talk to, I would be more than happy. Just let me
know your preferred method of communication, I'll reach out to you.

------
Theodores
Change the variables: you can be unhappy in a town doing a job because you
haven't got any friends in that town (e.g. colleagues could be a lot older or
at a different stage of life to you and therefore not able to be the friend
material you need, e.g. to go out on the town with, no time after work to do
anything else).

If you move town for a new job then you can find yourself with some initial
difficulties to make friends, but, after a brief settling in period you can
have a life outside work with a scene etc. This has a lot to do with where you
end up living. Just one or two new friends that welcome you in to whatever
they are doing can make all the difference.

It is not necessary to take on a career advancing job for such a move. You can
move sideways from programming to helpdesk. There are rewards of job
satisfaction if you can help people, you can go home with nothing hanging over
you, your shift is done. Plus actual shifts, e.g. an afternoon to evening
shift, that might help.

On the helpdesk you are learning and there is promotion if you are good to
team lead and that might be enough for you. You can go back to programming
with a few more strings to your bow. Compared to your peers you will be much
more customer focused due to the helpdesk experience, which would become a
retrospectively made positive career choice.

Obviously there are other sideways moves you could make, that depends on you
and what you can do. Maybe you have an 'angle', e.g. science, or an industry,
to make that easier. If you start over in some new town you will meet some new
people to live and work with. There is luck in the draw, but how else are
things going to change? You could meet someone in the workplace that mentors
you, you could get a housemate that shares a few of your interests and
welcomes you into his/her social circle. You might find yourself participating
in awesome banter, you might find people appreciate your work, who knows,
could happen, and that sort of stuff is probably the best cure for depression.

The above could go wrong, or need to be kept on track. Sometimes a secondary
house move might be needed in the new job so look for somewhere temporary that
is adequate for initial purposes (e.g. saving money, meeting people,
proximity) with a view to moving somewhere else, 'more you', when settled in.
You will also have to be very committed to making the new job work, there is
no time for depression if you have to do that.

It is actually quite hard logistically to start in a new job in a new town but
there is satisfaction in surviving that. You will need to interact with people
courteously because you don't have all the things you need when you first get
there. If it all goes well then it will be fun and you will wonder how you
ever were on that pill taking abyss, desperately seeking advice.
Accomplishment + achievement = happiness.

------
DanBC
This is not medical advice.

In England front line treatment for depression is a talking therapy. This
would normally be cognitive behaviour therapy, butthere are others. This works
best one to one, face to face, with an experienced practitioner. But some
people like and get benefit from group therapy, or from telephone provided
sessions, or even self-guided by book or website.

Meds should help. The side effects can be unpleasant and you need to be able
to be honest with your clinicians about what the side effects are and if
you're taking the meds.

It's really important to hold onto the idea of hope. Things feel overwhelming
at the moment, but recovery is possible.

Once recovery has started you might want to look at "resiliance" \- ways to
protect yourself in future. This might be taking part in team sports or
gardening or meditation or putting in place some stuff around work. People
talk a lot about the curative powers of exercise for depression, but we don't
have enough evidence to show that exercise is a cure.
[http://www.cochrane.org/CD004366/DEPRESSN_exercise-for-
depre...](http://www.cochrane.org/CD004366/DEPRESSN_exercise-for-depression)

> When only high-quality trials were included, exercise had only a small
> effect on mood that was not statistically significant.

Exercise probably won't hurt, but don't beat yourself up about it if you're
not exercising.

Here's a nice UK website discussing "talking therapies".
[http://www.mentalhealth.org.uk/content/assets/PDF/publicatio...](http://www.mentalhealth.org.uk/content/assets/PDF/publications/talking_therapies_explained.pdf?view=Standard)

Here's the recommendations for treatment of depression in adults in England.
[http://www.nice.org.uk/guidance/cg90](http://www.nice.org.uk/guidance/cg90)

If you want a book for cbt I've heard "Mind over Mood" is a useful workbook,
although it's probably for the milder end or in conjunction with a therapist.
I've heard "mood Gym", and Australian website, is also good.
[https://moodgym.anu.edu.au/welcome](https://moodgym.anu.edu.au/welcome)

There are other computer guided therapies. It's a good idea to check the
research because some of them are not very good. The Cochrane Collaboration
has checked some computer cbt programmes for anxiety or depression.

It's great that you are doing something to tackle this health problem! Good
Luck!

~~~
lotsofthrows
Thank you for responding. I found this to be a very helpful comment.

------
diminoten
This is probably not a good place to discuss this particular issue.

~~~
DanBC
There is a frustrating mix of terrible advice and good advice. Is that why
you'd recommend not getting advice here, or is there some other reason?

(I upvoted you.)

~~~
diminoten
Oh, absolutely -- I always worry when someone who's having emotional trouble
seeks out the greater Internet for advice.

There are some very good reasons why it takes a high level of training to
counsel people.

~~~
lotsofthrows
I mentioned this elsewhere, but I'm not taking direct action based on any
comments here. Yours is an understandable concern, though.

------
vegetajs
What I'm going to say here is going to be extremely controversial. I ask you
to think carefully about what I'm about to write before raising any objections
mid way through. I've helped a lot of people get through depression when
meds/basic advice(exercise, meditation, etc) just wasn't working.

1\. First, figure out if it's your situation. Chronic stress that comes from a
source outside your control is number one cause of depression. Most people are
depressed because they lie to themselves saying they are working at a
job/going to school for something they love but they really don't. The little
voice in the back of your head that tells you maybe you should actually pursue
EXACTLY what you want out of life, instead of telling yourself doing it the
'safe way' is better, safer or it's just what supposed to be. Because at that
point even though you raise the stress level, you allow the stress to come
from a source that you CAN control (you are finally in charge and are doing
EXACTLY what you want in life) instead of from an uncontrolled source (shitty
manager, company stock falling, you don't get along with your peers and can't
change teams).

2\. Stop running away from negative feelings. Learn to have a perverted
attraction for mishaps. You don't actively seek trouble or purposely put
yourself in situations, but you simply learn to love the fact how life just
won't give you what you demand 99% of the time, and it will let you cherish
the time that it does. Learn that it is okay when things go bad, it is not the
end of the world, it is not unfair, you are not damned. It is merely
unpleasant and annoying, but life is full of that.

3\. Poor omega 3 - 6 ratio. Not enough DHA. Among other nutrition advice, this
is probably the most prevalent. Start eating omega-3 organic eggs and wild
caught salmon every day for breakfast. Both those foods are extremely high in
omega 3, and unlike plant omega 3's, the animal sources contain DHA which is
essential for neurogenesis on prefrontal cortex neurons. Those neurons are
essential for willpower, motivation, and decision making.

4\. Take uridine supplements (sublingually) and make sure you get adequate
choline intake. Uridine + Choline + DHA increases the rate of neurogenisis
than simply DHA alone. Most people with depression have under developed pre
frontal cortex neurons, which exacerbate the symptoms of depression. Before
people freak out about drugs/nootropics, choline is found in highest ammounts
in eggs, beef livers, chicken hearts. Chicken breast/wings/thighs also contain
a fair amount of it. Choline is essential for proper memory funciton as well.
Uridine occurs naturally in spirulina. I recommend you buy bulk powder of
Uridine online since if you take it sublingually, it is about 9 times more
effective. Oral capsules for uridine are pretty expensive. I use
powdercity.com.

------
michaelochurch
Side effects of anti-depressants exist, but not everyone gets them, and
they're mild compared to actually being depressed. Depression is more
distracting, debilitating, and hazardous than the treatments for it. If you
have depression, starting medication is a positive-expected-value move. If
your first medication doesn't work or has unacceptable side effects, then your
doctor will gladly change it. Generally, treatment starts with the drugs with
the fewest side effects (e.g. Lexapro) and higher doses or or more blunt drugs
are used if needed. You're not going to end up on a high dose of Prozac
against your will.

Also, many of the harsh and weird side effects of SSRIs (the yawns, the
sweats, and the weird-ass dreams in the first week) are temporary and doctors
will usually prescribe anti-anxiety medication if those become an acute issue.

You need to do something about this. Medication's a good start, because it
will give you the initial reboot that will make you able to exercise and
regularize your sleep. After you're well, the next job is to stay well and get
into an exercise routine and start eating healthier foods. Right now, though,
medication is the best source for that initial "push", and it helps many
people. Once you're out of the depression, establish healthy habits to
maximize the probability that you stay out of it.

Also, you shouldn't question whether you "deserve to be alive" because of one
job. Most people have been fired at least once. Shit happens. If your
depression is interfering with your ability to perform at work, then disclose
the health issue before you end up on a PIP. It won't prevent you from getting
fired but it will increase the likelihood that you get a severance if you are
fired.

Good luck! Depression sucks but many of us have been there and gotten out of
it.

------
anon3_
First, sorry you're in pain!

Depression is psychologically being trapped in a prediction we feel we can't
turn around. Financial, romantic, lifestyle and other elements play a role in
the lack of powerlessness you feel. Either of these things may be significant
enough to make every breath harder.

The way to fight depression is to empower yourself and give you more options
to flourish.

If you're determined antidepressants are what you need - SSRI's are something
we really don't know about. When you mixin meds into the equation, you're
ceding your emotions to someone else, mixing in complicated medicine into your
own personal growth narrative could sidetrack you for years from finding what
your core problems are.

------
112864
dfbfgbfg

------
teen
Switching cities / jobs helped me a lot.

------
jklinger410
Take some hallucinogenic drugs (look them up on erowid first). Write some
poetry. Make some art. Stay up late. Get drunk. Purge your demons. Call your
parents, call your best friend, vent. If you like to be alone be alone. If you
like people go find some people.

Watch some art films. Chain smoke cigarettes. Go for a walk. Play hooky from
work. Go thrift shopping and buy yourself a new outfit. Plot and scheme on
things that you actually want.

Don't listen to any of this advice. Do something drastic.

~~~
rmxt
I get that you're trying to be edgy, but none of those are full-on substitutes
for the the results of evidence-backed medical trials. They are great in
conjunction with standard pharmacological and therapeutic approaches, but
might end up pushing someone already on the brink further into the abyss of
depression. They might not have good familial relationships or friends to fall
back on, or they might have issues with non-hallucinogenic drugs as it is.

~~~
jklinger410
I'm not trying to be edgy at all. I have anxiety disorder and personally
suffered through depression. I spent years on medications that didn't work.

Sometimes you can't fix depression with pills. There are alot of mights in
this situation because none of us know what OP is actually going through.

I would kindly ask that you consider my advice from personal experience and
not downplay it so much. I never suggested OP not take medication or seek out
a doctor, I was just giving other, more personal advice that may help them in
their situation.

>They might not have good familial relationships or friends to fall back on,
or they might have issues with non-hallucinogenic drugs as it is.

I listed a bunch of different things they can do, with ors and ands all
throughout. Also, hallucinogenic drugs have very strong evidence backed-trials
in their favor. Of course as long as you do it in a safe situation.

I was not, in any way trying to be edgy. It's awfully offensive that you and
anyone who down-voted me would think that. The guy is already a programmer,
he's clearly not benefiting from the ultra-safe sterile environment that the
HN crowd constantly promotes.

Sometimes you have to get dirty. Sometimes you have to make mistakes.
Sometimes you have to drop shrooms and find yourself in the middle of someone
else's living room dance rave party.

Maybe it's not for OP, maybe it is. Maybe none of the other advice in this
thread will work for them, either. But regardless my advice is just as fucking
valid as anyone elses. Coming from the perspective of a person who, as I said,
went through this, still goes through this at times, and who medication has
had little effect on.

But, if you want to solve his depression with condescending suggestions of
medical help and medications, back that up with medical journals and
statistics, that's your prerogative.

//edit Also for more clarity, when I said "don't listen to this advice" I was
actually referring not only to my comment, but everyone's. I wrote that when
there was like 2 comments on this thread. I'm not trying to demean anyone
else's opinion. Why would I do that? I'm not an asshole.

~~~
rmxt
My apologies for the dismissive tone in my first post. I can't and didn't
downvote any of your posts. I misinterpreted your "don't listen to this
advice" to be the strict opposite of what your explanation was: "don't listen
to everyone else, but DO listen to me." I too (as many of us have) have been
in similar shoes re: depression and anxiety. Finding what works for each of us
as individuals is the most important thing. I agree with the potential
therapeutic benefits of hallucinogens, but I also am a firm believer in the
trial-backed science of medicine and therapy as the first and best line of
defense. "Ultra-safe sterile" or not, it's the best answer for the broadest
range of people. Call me a Vulcan, but that's what I'd suggest for people that
are on "the edge", instead of "getting dirty" or "make mistakes", both of
which might help, but also might let people slide further into the abyss. At
least with medicine and their "black-box" labels, you are under the monitoring
of a trained professional that can catch and negative side-effects of the
medication. Best of luck on your quest to get and stay better.

~~~
jklinger410
Thank you for the response. No hard feelings. :)

