
Depression lies - bane
http://wilwheaton.net/2012/09/depression-lies/
======
huggah
We have an incredible capacity for denial and self-deception. For years, I
would periodically drop into severe depression; I would stop sleeping, stop
eating, stop answering my phone or email. I wouldn't leave my room for weeks
on end; on a few occasions I was so successfully reclusive that people worried
that I disappeared or died called the police to investigate. A few times I
almost did die; I think the biggest reason I never committed suicide was that
I didn't have the willpower for even that.

 _Years_. Call it 6, with bouts every 8 months. One semester of 'A's, one
semester of 'F's.

Of course this caused me to fail classes and lost me friends, opportunities
and respect. But every time I recovered I thought to myself "Wow, that was
awful. Glad I'll never do that again!" I had to lose my fiancée and my funding
in grad school before I finally accepted to the fact that this might be a
_problem_. That there might be a cause other than being _lazy_. Because, you
know, laziness makes people curl up in an empty bathtub and cry for 24 hours.
That's normal, right?

Thanks to Wil for posting this. It's important to reach out to sufferers as
well as their friends and family. It takes a lot to recognize when you or
someone you know has a problem, even when in retrospect it's blindingly
obvious.

~~~
luriel
Knowing you "have a problem" doesn't mean you or anyone understands the
problem or what to do about it. And even if you know what to do, doesn't mean
you can do it either, the psychological, social or just practical barriers can
be impossible to climb.

Medication has a statistical significant effect, but is often marginal at
best, and most of the effect is placebo.

And this assumes an accurate diagnosis, and don't count on that, I have had
the head of psychiatric care of a major European capital say to me that the
science of psychiatric diagnosis is basically worthless, I wouldn't go that
far (the split between research and academia and practice is also a huge
problem), but is nowhere as simple as some like to make it seem.

People and lives are often much more complex than that and much more
significant factors.

Doctors can also do much more harm than good, locking people up in horribly
depressing kafkian institutions because they are suicidal is one of the most
insane things I have seen in my life.

Imagine what it feels like being locked up against your will, treated almost
like an animal, when you have done nothing to harm anyone, and being told it
is "for your own good".

~~~
SoftwareMaven
I can't read the full article (paywalls...grumble...), but this[1] would
indicate better-than-placebo performance for those with major depression.

Please don't spread unsubstantiated rumors on this topic. As many of us know
from personal experience, the results of giving people an excuse to say "that
medicine doesn't work anyway" can be devastating.

1\. <http://psycnet.apa.org/psycinfo/1991-19312-001>

~~~
philwelch
I've gathered that selective publication of results is the main problem,
actually.

~~~
SoftwareMaven
Indeed[1]. It seems to be endemic of the entire medical field[2][3] and even
further removed[4]. Combined with how difficult (if not impossible) it is to
reproduce many findings[5], I would call these the most important problems in
science today. Science cannot move forward without _all_ of the data (positive
and negative) in a reproducible fashion.

1\. <http://www.ncbi.nlm.nih.gov/pubmed/18199864> 2\.
[http://journals.lww.com/greenjournal/Citation/2003/09000/Evi...](http://journals.lww.com/greenjournal/Citation/2003/09000/Evidence_b_i_ased_medicine_selective_reporting.40.aspx)
3\. <http://jama.jamanetwork.com/article.aspx?articleid=198809> 4\.
[http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjourna...](http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0018362)
5\.
[http://online.wsj.com/article/SB1000142405297020376480457705...](http://online.wsj.com/article/SB10001424052970203764804577059841672541590.html)

------
jdietrich
I am rather disappointed by much of the discussion in these comments.

The HN community has always taken pride in being careful, analytical and data-
led. If someone were to advocate an unproven cancer therapy based on anecdote,
they would rightly be harshly criticised.

The evidence base for SSRIs is extremely poor. The most favourable metastudies
indicate only a very mild benefit, similar to that of many non-drug
interventions like exercise or conversation with friends. Other metastudies
show only a weak effect in the most severely depressed patients. There is
known to be a very serious problem of publication bias, with major statistical
irregularities indicative of the non-publication of unfavourable trials.

We feel confident in making statements about the nature of depression, but in
truth we know almost nothing with any degree of confidence. The long-held
serotonin hypothesis has proven to be completely baseless and there is no good
evidence that depression has a neurochemical etiology. fMRI data is often used
to make the case that depression has neurological rather than psychological
origin, but this is very poor reasoning; The brain is not merely a passive
vessel for the mind and environmental influences can cause substantial
structural changes to the brain, as seen in chess players, sportsmen and
myriad other groups.

It is entirely possible that the idea of depression is itself a cause of
depression, in much the same way that the western presentation anorexia
nervosa has been imported into Chinese culture and is slowly replacing the far
more common indigenous eating disorder, which presented as idiopathic
digestive problems rather than a psychological aversion to food based in body
image. It is entirely plausible that the belief that low mood is a medical
disorder which cannot be ameliorated by the patient is itself pathological.

I believe that the only statement we can make about depression with any
confidence is this: We aren't sure if "clinical depression" describes a
phenomena that can be meaningfully thought of and treated as a disease, but we
do know that if you do something that you believe will make you feel better,
you will feel better.

~~~
readymade
The politics of antidepressant medication is a political minefield, all the
more dangerous because it seems everyone has to have a strong opinion,
regardless of a professional or personal experience. While it's true that the
efficacy of SSRIs is not an open and shut case, skepticism such as yours is
not exactly the medical consensus either. Some of those meta studies with
unfavorable results don't make much of an attempt identify where ordinary low
mood ends and clinical depression begins, which further complicates the
research.

With all due respect, as I'm sure you mean well, I rather doubt you have ever
experienced anxiety or depression on the scale addressed in this post. Low
mood, if not excessively acute and prolonged, is quite normal and probably
won't see much benefit from medication. Clinical depression and anxiety can be
absolutely devastating, and while it's not the only coping strategy, SSRI
medication along with behavioral/talking therapy work wonders for a lot of
otherwise desperate people.

People for whom getting out of bed every day is remarkable achievement of
willpower, and who always seem to struggle to reach an emotional baseline.
People who are almost constantly doused in worry, panic and despair, even when
spending quality time with those they love. People who have tried everything
else to no lasting effect. And yes, people who are so desperate to make the
pain stop that they would consider killing themselves. Is this your life?
Would you tell those with Bipolar Disorder or Schizophrenia that their
suffering is simply due to a pathological awareness of the disorders
themselves?

Warning the public against overmedication is one thing, but I for one am fed
up with the stigma attached to seeking medical help for mental illness. The GP
is reaching out to those for whom these treatments could literally save lives.

But I'm sure they just need more exercise.

~~~
im3w1l
The first two paragraphs were good.

------
kevinburke
I'd also recommend reading psychologist Martin Seligman's book "What You Can
Change and What You Can't", which covers a variety of mental health issues
from sexual fetishes to fear of spiders to schizophrenia, and the treatment
options available for each.

Cognitive behavioral therapy teaches people to recognize negative thoughts ("I
failed the test because I'm stupid"), dispute the thought ("If I'm stupid, how
did I get an A in math last week"), and propose alternative explanations that
are transitory or shift the blame to an external source ("The teacher was in a
bad mood when he graded the test/I didn't study hard enough").

It's been shown in studies to be as effective as drugs, and more lasting (if
you stop taking the drugs, the sadness might come back).

It's an alternative - it might not work for everyone, the OP mentions he had
trouble with therapy and I'm glad he is finally doing better.

~~~
bad_user
Does it really work?

My guess is that's just how slim people tell fat people that laziness got them
fat and so they should do more exercise, i.e. people that never suffered from
a certain condition giving advice to people suffering from that condition.

" _I failed the test because I'm stupid_ " - that's just how I felt when I got
rejected after an onsite interview with a certain company that's renowned for
its hiring standards that yield many false negatives. Thoughts going through
my head, like "I was unlucky" or that "I came unprepared", had no effect.

You know how one partner tells the other on the verge of a breakup " _it's not
you, it's me_ "? Did that line ever work in the history of man-kind?

The mind is like an onion, having many layers. You can only control the first
layer and hope that your actions will cause a reverberation in the layers
below. And if you strongly feel a certain way, sometimes there's no stopping
it, unless enough time passes to forget about it or make it seem less
important (I guess that's why we forget things).

    
    
         The teacher was in a bad mood when he graded the test
    

I'm seeing people throw blame all the time, precisely because it's easier to
cope with failure. But it's not healthy to pass the blame, unless you have
concrete proof that the teacher's mood was in bad shape and that her mood
indeed had an effect on the grade. I'm not seeing this as being good advice.
Sooner or later you'll start thinking the whole world is against you, when
it's a lot better to recognize your own mistakes and not blow the failure out
of proportions.

It's also healthy to recognize that maybe you're not as smart as everybody
kept telling you since you were in kindergarten, and that in the real world
wit is not a substitute for experience and hard work.

~~~
kevinburke
Studies have shown the two to have the same effectiveness rate at treating
depression, around 50%.

It turns out it _is_ actually healthy to pass the blame. I'd suggest reading
one of Seligman's other books, Learned Optimism, for more, but in studies of
people in high-pressure situations (freshman year at Army, cold call insurance
salesman at MetLife, etc), the most successful people are the ones who
externalize (blame others for) negative events and internalize (credit
themselves for) positive events. It may not be an accurate view of the world,
but then again, depressed people score higher on assessing the world
accurately than non-depressed people, so it's not clear seeing the world
accurately is that helpful.

When bad things happen to me I make a concerted effort to blame other people
or one-off events ("the company I was interviewing at went through a
reorganization or promoted an internal person/it was just bad luck they asked
about the same origin policy/whatever"), and when good things happen to me I
credit myself ("I got the job because I'm smart, I work hard, and people like
being around me.") When I say it like that it sounds a little silly, but so is
not making moves in your career or your personal life that clearly make sense,
because you don't think you're good enough.

Like anything, CBT takes practice. Eventually you want to get to the point
where you do the recognition and disputation automatically, like tying your
shoes or typing the letter 'e'.

I wrote more about it here: [http://kev.inburke.com/kevin/lectures-for-
basketball-coaches...](http://kev.inburke.com/kevin/lectures-for-basketball-
coaches-how-do-you-respond-to-failure/)

~~~
nostrademons
I'm skeptical, the way you phrase it.

Rather, I've always heard that it's best to think in terms of _circumstances_
and not _blame_ , for both yourself and others. There's a subtle difference
between them. You've phrased it as "blame others, not yourself", but both of
those alternatives are equally unhealthy.

Rather, you should figure out a variety of possible explanations for your low
performance, and then ascribe meaning to the ones you can change and forget
about the ones you can't. "I failed the test because I'm stupid" is a
completely useless conclusion. So is "the teacher was in a bad mood". "I
didn't study", however, is a very useful conclusion, because it suggests what
you should do next time: study harder. So is "I don't actually like physics",
because it also suggests a course of action: switch your major.

The overall point is to get out of the habit of learned helplessness and take
responsibility for your own life. Blaming others doesn't accomplish that,
because you've still attributed outcomes to things you can't control.

~~~
neilk
I read Seligman's book about optimism as well. He studied insurance
salespeople for a time, which I think influences a lot of the advice. The best
salespeople had a modicum of self-preserving delusion. Not enough to ignore
correctable problems with their own performance, but enough to endure all the
rejections one gets as a salesperson.

This advice is clearly more applicable to sales than to, say, spacecraft
design. But maybe more things are like sales than we think.

Seligman's book is challenging to a hacker personality because he is saying
that there's some information which it's best not to ruminate about. Many
hackers are naturally inclined to perfectionism: analyze failures, perfect the
technique before daring to try again. But a lot of success in life might just
be about sheer persistence; trying again without dwelling on failures too
much.

~~~
nostrademons
So, for a lot of the social professions, success is realizing that other
people have minds of their own who may or may not agree with you, and that if
they don't, that doesn't necessarily reflect on you or mean you're doing
anything wrong. So if you blow an interview, it doesn't necessarily mean that
you're stupid, it could just be that you drew a bad question or a bad
interviewer or just weren't what the company was looking for.

I've been struggling with this for a while in the context of dating, which is
another area where you'll face _lots_ of rejection that usually isn't your
fault. I think that's a lot healthier than to phrase it as "blame others" -
you should respect others, but realize that what they want is not necessarily
what you want. Heck, put that in a dating context and you can immediately see
the problem: somebody who blames the girl when they're rejected is a creep,
not a success.

~~~
VMG
> I think that's a lot healthier than to phrase it as "blame others" - you
> should respect others, but realize that what they want is not necessarily
> what you want.

The seduction community (/r/seduction to be specific) calls this outcome
independence. A great deal of emphasis there is put on overcoming rejection.

------
jetti
I'll preface this with the fact that I know that people will see me as being
cold or just generally not agree with my opinion but I am going to share it
with you all anyways.

I have experienced this first hand. I have attempted suicide twice in my life
and have gotten help for it. Because of my experience, I think I have come out
of it with a different view which is this:

Suicide is somebody's choice and theirs only to make. Does it affect others?
Yes, of course. But I still believe that it is up to the individual to make
that choice. I remember thinking after my attempts and hearing how it is a
"selfish way out" that the my family too, was being selfish, for I was
suffering and medication and therapy just wasn't doing anything yet they
selfishly wanted me in their lives just as I wanted to end my life and stop
all of the pain.

A few other things that I just want to throw out there because I'm experience
an odd flood of emotion. The assumption that suicide is bad is solely based on
the notion that life is better than what lies beyond, which is something we
just don't know. Also, people call suicide the cowards way out or giving up. I
just don't see that. To me, it is just not delaying the inevitable. We all
die. It is a fact.

~~~
drumdance
The best description I've seen of depression-induced suicde is "a permanent
solution to a temporary problem."

~~~
jetti
The thing I always hated about hearing that phrase is that it completely
invalidates what the person is feeling and makes the person saying the phrase.
In some cases, it truly may be a temporary problem, in some cases it may not
be. How can you say something like that to somebody with Fibromyalgia? Surely
they would be apt to feel depressed and unlikely to continue wanting to live.
While that may not be a common situation, it is something that could happen
and, again speaking from my experience, from what I've encountered the people
spouting off that line are the ones who don't know 100% what the person they
are talking to are going through.

That phrase also has implications as to what happens after one dies by stating
it is a permanent solution. Sure, they won't be here any more but that doesn't
mean they won't exist anymore (though that is a discussion for another time).

~~~
drumdance
For certain situations like the one you describe, I agree. But for straight-up
depression with no other exacerbating factors (and which responds to
treatment), I think the statement still stands. It certainly helped me when I
was suicidal.

------
throwaway120912
Forgive the disposable account, I am a long-time registered user with high
karma but even I think that once in a while there is a topic that requires
anonymity (or at least further pseudonymity).

I do not feel I suffer from depression, yet I think of suicide frequently.
Frequently as in, once every couple of days to several times a day, for as
long as I remember.

Frequently these are just passing thoughts, of how I might do it, or of an
opportunity not taken. Other times these are serious considerations and the
weighing up of why not to. I don't pause on "why to" as I can answer that
instantly every time.

Ultimately I conclude every time that life isn't worth living. It never has
been, and never will be. But yet, to experience it is a gift and I should
experience as much of it as possible before the end. To experience life is the
only reason I can think of to live.

I always remember Camus, I always am mindful of the Myth of Sisyphus.

<http://www.iep.utm.edu/camus/>

    
    
      <cite>
      The Myth of Sisyphus (1943) – If there is a single non-fiction work that can be
      considered an essential or fundamental statement of Camus’ philosophy, it is
      this extended essay on the ethics of suicide (eventually translated and repackaged
      for American publication in 1955). For it is here that Camus formally introduces
      and fully articulates his most famous idea, the concept of the Absurd, and his
      equally famous image of life as a Sisyphean struggle. From its provocative
      opening sentence (“There is but one truly serious philosophical problem, and
      that is suicide”) to its stirring, paradoxical conclusion (“The struggle itself
      toward the heights is enough to fill a man’s heart. One must imagine Sisyphus
      happy”), the book has something interesting and challenging on nearly every
      page and is shot through with brilliant aphorisms and insights. In the end, Camus
      rejects suicide: the Absurd must not be evaded either by religion (“philosophical
      suicide”) or by annihilation (“physical suicide”); the task of living should not
      merely be accepted, it must be embraced.
      </cite>
    

The problem I have is that I feel I already know that one day I will be at
peace with the ridiculousness of living, and reject the "to experience"
argument. One day dying will win the argument, and it only needs to win once.

~~~
anonymous
There is one argument that wins for myself, every time. I won't do it, because
it's the same as giving up, which I'm way too stubborn and proud to do. And
yes, there are times at 4 in the morning when I'm still tossing and turning
and shaking with anxiety, that I really wish it would just end for good;
however, I quite literally can't let myself do it. It's against my inner
principles, which are so concrete and immovable, no amount of wetware
buggyness can override.

I do worry that I'm destroying my health with worrying though, the irony of
which doesn't escape me.

------
jhuckestein
_one in four adults suffer from a diagnosable mental disorder in a given year_

This is something that frightens me. What is a "diagnosable mental disorder"?
I'm willing to bet this statement was far from true 50 or a 100 years ago. Not
because I think people got more depressed or anxious, but rather because we're
looking harder to "diagnose" things.

I think there's a big danger, especially in psychological afflictions, to
always "look for" problems with yourself.

This may be a cultural thing as well. Until I came to the US (I'm from
Germany), I never asked myself "Am I depressed?", "Is this what depression
feels like?" when I was aving a down day. I also never considered that I may
have/have had ADD now/as a kid but now people tell me I should "get that
checked out" all the time.

~~~
jmitcheson
I think you are right that these things were less common 50 or a 100 years
ago, but consider this (first comment on the blog)

"It’s not a job that I want, or that I even feel really suited for, and it’s
not paying what I need, but after 11 months of unemployment, you take what you
can get. I’m not going to spill all my guts here, but life is really starting
to suck for me, mostly because I’m shoulder-deep in debt and can’t see a way
to scrabble myself back up. This is an important fact because with how little
I make, and how much I owe, I no longer can afford health insurance."

How common was this situation 50 or 100 years ago? And 100 years ago people
would have had better support systems from living in smaller communities.
Modern life causes depression; I don't think it's necessarily an over
diagnosis.

~~~
Evbn
50 or 100 years ago a person might have flat out starved in the street, or
died of an illness that no money could buy a cure for at the time.

Modern life causes more depression because basic necessities of life are too
easy (on a historcal scale) and so our brains are too idle most of the time,
so they get caught on logic bugs.

------
raintrees
One thing that helped me was additional vitamin D. I did some quick research
and found out that one must be careful, as overdosing will bring back the same
symptoms, but after adding an additional 1000 IUs a day, I am not getting as
depressed as I used to.

Please note that my depression was minor, more of the "there is too much going
on, I can't get started on anything, I don't feel like working, I think I will
just browse something new on the net" day after day, sometimes for weeks at a
time. Also, I am convinced everyone's system is different, so tread carefully
and consult professional medical advice, where appropriate.

I also had recently (4 years ago) moved to way northern California, US, along
the coast, so I get Oregon's type of weather (much more rain, overcast). Sun
was no longer so prevalent, and very much may have had a bearing on this.
YMMV.

~~~
gfunk911
It's my understanding that "overdosing" on Vitamin D is very difficult. I take
5000 IU every morning. Do you have links to the research you found?

~~~
j_s
From Steve Gibson's Vitamin D 'fan page'
<http://www.grc.com/health/vitamin-d.htm>:

John Jacob Cannell, M.D. and executive director of the Vitamin D Council has
this to say about Vitamin D Toxicity:
<http://www.vitamindcouncil.org/vitaminDToxicity.shtml>

The Merck Online Medical Manual (
<http://www.merck.com/mmpe/sec01/ch004/ch004k.html> ) has the following to
say: “Because synthesis of 1,25(OH)2D (the most active metabolite of vitamin
D) is tightly regulated, vitamin D toxicity usually occurs only if excessive
doses (prescription or megavitamin) are taken. Vitamin D 1000ug (40,000
IU)/day produces toxicity within 1 to 4 months in infants. In adults, taking
1250 ug (50,000 IU)/day for several months can produce toxicity.”

------
wsc981
Until about 2 years ago I had a long period of heavy depression. At that time,
thoughts about suicide did cross my mind often. This depression was partly
caused due to a post traumatic stress syndrome.

In his article Wil states that he wasn't very interested in using medicine and
I shared the same thought. I did went to a shrink though and eventually we
agreed that instead of medication I would go outside more, eat more healthy,
occasionally practice a bit of sports and visit friends more often. These
things might all seem very basic, but when in a depression it's really very
hard to get oneself as far as to actually make these changes. While all of
this helps, my major issue was finding a new purpose in life. But I do feel
making these changes in my habits did help me find this new purpose.

Now I live in a country with a very good social system, so I can imagine it's
easier to make those changes in life compared to countries where it's very
hard to survive when not having a job. I've had 2 jobless periods of about a
year during my depression which lasted in total for around 7 years.

~~~
seunosewa
Do that, and also get some drugs.

~~~
danielweber
If someone can take care of their depression without drugs, they should. The
same way that if someone can take care of their depression with drugs, they
should.

~~~
seunosewa
A lot of people think they are taking care of their depression without drugs.
But until they try taking drugs, they may not realise how much the depression
they think they are taking care of is actually messing up their lives.

------
ftwinnovations
I'm curious, as I see quite a few post like this regarding coping with
depression and suicide, are these very common problems among the
HN/tech/startup community? Is it in some way more prevalent in this community
vs other fields? Or are these posts for the most part shared and voted up as a
sort of public service announcement (maybe not the best way to say it but not
sure how to phrase it)?

And I don't mean it to come off as somehow insensitive because if it even
helped one person avoid suicide then it's more valuable than most any other
posts... Just very curious as I've not personally seen this from my own
relationships in this scene.

~~~
lotharbot
> _"are these very common problems among the HN/tech/startup community?"_

These are very common problems among _humanity_.

It's good that this community is willing to talk about them so openly.

------
paraschopra
What I'm not able to reconcile is if the despair and anxiety _resulting_ from
nihilism is something that should be _treated_. I'm a staunch believer in
existential nihilism (and hence believe life is inherently purposeless and
pointless), so time to time it gives a sharp tinge of sadness on the lines of
_why am I existing at all_. It's not a suicidal feeling, but very close to it.
I have (rightly, so) convinced myself of all sorts of Nihilistic conclusions
such as subjective morality, consciousness and free will as not being special
rather an illusion and byproduct of evolution, cosmos being huge and
indifferent, etc. etc. This belief definitely gives freedom in the sense that
you aren't bound by any assumptions, so you can do whatever you desire. But it
also leads to slight, nagging, constant sense of unhappiness.

Running a startup being a Nihilist is sort of a difficult task, and once I had
blogged about here: [http://paraschopra.com/blog/personal/startups-and-
nihilism-d...](http://paraschopra.com/blog/personal/startups-and-nihilism-
dont-go-together.htm) \-- I tend to agree with Camus on his Absurdist stance,
but _treating_ for having such a correct, depressing stance is something I
still haven't come to terms with.

Any thoughts on what do mental disorders really mean, or what does treatment
of those disorders really mean? My current opinion is that if happiness means
blocking or ignoring certain truths (via medication or treatment), then that
is preferable. But I'm still undecided on that.

~~~
mquander
Your despair and anxiety don't _result_ from your philosophical beliefs, which
should be trivially obvious since lots of people share your beliefs and do not
regularly suffer from despair and anxiety.

You can feel how you please, but you aren't being faced with the binary choice
of "believe X and be sad" or "disbelieve X and be happy." You also have the
choice of "change whatever weird thing in your head correlates a belief in X
with sadness." Feel free to just fix the unhappiness and leave your philosophy
alone.

~~~
paraschopra
Interesting point. That is precisely what I fear: if I fix the unhappiness
would my philosophical beliefs get diluted. Maybe that won't be the case, but
I don't know that right now.

There may be Nihilists out there who are very happy and never feel any
despair, and that's what I'm after too. Nihilism definitely doesn't mean you
should be unhappy. In fact, in light of no meaning, the sole purpose should be
to seek happiness (why would anyone want unhappiness). But it's just bit
difficult for me to feel blissful and happy _all the time_ in spite of the
full awareness that it's pointless after all. Occasional despair is inevitable
from Nihilism, won't you agree?

~~~
mediacrisis
I think its difficult for anyone to feel constantly happy and blissful. At
what point is it happiness if its your baseline? In my opinion and experience,
despair gives context to happiness.

------
jacques_chester
I've had this very experience.

Until you have the medication, you don't realise how completely you've stood
in the shadow of depression for your whole life.

------
chaostheory
I suffer from "mild" anxiety, which has lead to some depression. At times,
it's hard to go to venues where there are huge amounts of strangers or even
the office at big corporation X (it's not so great whenever you feel like
you're choking); but I power through it somehow.

I can't get rid of it, but I've found that heavy exercise (ideally both
weights and cardio) really helps to mitigate both the depression and anxiety.

[http://www.mayoclinic.com/health/depression-and-
exercise/MH0...](http://www.mayoclinic.com/health/depression-and-
exercise/MH00043)

~~~
makmanalp
Hey, sounds like you might have some (maybe mild, I'm not a pro) form of
social anxiety. Talk to someone about it, since there are very good programs
(e.g. <http://www.bostonsocialanxiety.com/> I've seen lauded on reddit) to
help you with that. I've seen people with social anxiety completely
transformed.

~~~
chaostheory
Yeah I have and that was the diagnosis. Thanks for the suggestion though.

------
chris_wot
I only recently finished having suicidal thoughts. In fact, I had them 4 days
ago. It's frightening, and disturbing. I have two small children and my wife
loves me. Still the thoughts come. Awful.

~~~
makmanalp
Hey, look. Please go and talk to your loved and trusted ones about this, and
go see a pro. Simply that is progress, and it is the kind that'll keep turning
into more progress. Just make a few phone calls and get yourself into that
office.

Don't fret about choosing the right doctor etc. It's like startups: release
your MVP as fast as you can, and then tweak it later iteratively.

~~~
chris_wot
Thanks :-) I went to see a doctor a few days ago, they gave me some medication
that literally took me out all night and all day. Won't be taking it ever
again, but it helped stop the thoughts. Only a temporary solution, I'll be
getting some help!

Thanks for your concern - it actually does mean something to read your comment
:-)

~~~
makmanalp
No problem! I don't know much about this but it appears that usually there is
a trial period where people have to go through trying several different
medications till they find the right one.

Meanwhile, try reading this: [http://www.amazon.com/Feeling-Good-The-Mood-
Therapy/dp/03808...](http://www.amazon.com/Feeling-Good-The-Mood-
Therapy/dp/0380810336/ref=sr_1_1?ie=UTF8&qid=1347542524&sr=8-1&keywords=feeling+good)
I haven't really read it but I've been exposed to the CBT methodology that
it's based on (see my other comments on this thread) and it works.

Get help soon, and good luck! :)

------
paulerdos
I wonder how depressed people in the 3rd world manage to survive.

~~~
donniezazen
They have larger life threatening problems to deal with like earning their
livelihood. There are always people around you and even if they can't help you
they keep you distracted.

~~~
ftwinnovations
I've always wondered if that is the case. And if so, doesn't that mean there
is a direct correlation between ease of living and depression? The less you
have to worry about and deal with, the more likely you are to be depressed?

~~~
lusr
I suspect the most severely depressed in 3rd world countries, to be blunt, end
up on the street and die (assuming they don't take their own lives first).
That's one reason you may not see depression as obviously prevalent in the
general population of a 3rd world country.

------
nisa
I had and have only mild depression and anxiety from time to time and I may
sound ignorant/stupid now but for me starting to read and practice stoic
philosophy really helped to keep a calmer and more rational outlook for my
life. It does a good job for me to not feel worthless and to keep a good
spirit in spite of everything falling apart.

The words of epictetus and marcus aurelius made a difference for me.

I've also saw a therapist for cognitive therapy at that time and I've found
that reading the stoics helped me with the therapy.

But: It is not an alternative for seeking profession help and I'm just a
single biased data-point.

~~~
jjmat
I'll add myself as a second data point. Understanding the stoics has helped me
as well.

The ancient stoics seem to have stumbled upon important insights into our
nature and how to be happy. A good introductory book to stoicism is William
Irvine's "A Guide to the Good Life: The Ancient Art of Stoic Joy".

Interestingly the founder of Rational Emotive Behavior Therapy, Albert Ellis,
"credited Epictetus with providing a foundation for his system of
psychotherapy".

------
rhizome
Can't let Robert Sapolsky go unmentioned:

<http://www.youtube.com/watch?v=NOAgplgTxfc>

~~~
albemuth
Came here to post this, in this lecture he makes the point that major
depression is the most devastating disease you can suffer. He also compares
major depression to diabetes in that you can't will yourself out of either
one.

------
pfedor
There are studies which suggest that people with depression have a more
accurate perception of reality than others:
<http://en.wikipedia.org/wiki/Depressive_realism>

So no, depression doesn't lie any more than a healthy brain, it just tells you
the truths and lies you don't want to hear.

Of course, I agree with the article that if you are unwell you should seek
help. But I had this thought once: the doctor who prescribes you medication
optimizes for a different thing than you may want to. Say there are two
possibilities (numbers completely made up)

(1) Not taking the medication, which results in a suicide 5% of the time and
getting over it on your own and a perfectly happy life in 95%.

(2) Going with the medication and being not suicidal but slightly unhappy for
the rest of your life with 100% chance.

Then your doctor's incentives are such that he'll certainly choose (2), but
that's not what you might choose if you were aware of the options.

------
naish
Yesterday, comedian Chris Gethard wrote a long and poignant letter to an
anonymous fan wrestling with depression and suicidal thoughts. A very
interesting read:

[http://thechrisgethardshow.tumblr.com/post/31345619495/for-g...](http://thechrisgethardshow.tumblr.com/post/31345619495/for-
gethard-anonymous-asks-gethard-i-know-youve)

------
expralitemonk
We live in a society where mental problems are considered to be a spiritual
problem, not a medical one. The brain is an organ and organs malfunction. I
think the younger people see this and are more likely to get the help and
medication they need. It seems to be the +60 year olds who will go to their
priest instead of their doctor.

------
seunosewa
TLDR: Take Your Meds. Most people will miss this part of the story.

------
benjash
I've had what would call an a depressive trait since i was a teenager until
now at 28. When i was 20 i was diagnosed with severe clinical depression and
received treatment, including counseling and medication.

My own anecdotal evidence - when i was at my worst the talk did nothing to
help me. Citalopram really help leveled and my mood, dull my anxiety and
helped me balance myself out. There probably was some sort of placebo effect,
re-enforced by the physical side effects. It helped either way...

Over the years i realized that brain does lie to me. Sometimes my brain
convinced me I'm depressed when I'm just ill, grumpy, tired, frustrated. etc.

I've know now not to trust my brain, my feelings or medication.

Talking helps keep your perception in check, i recommend it.

------
jhferris3
An article I found interesting on the potential evolutionary roots of
depression:

[http://www.scientificamerican.com/article.cfm?id=depressions...](http://www.scientificamerican.com/article.cfm?id=depressions-
evolutionary)

------
lignuist
Depression might be linked to low vitamin C levels in some cases:

[http://parrster.hubpages.com/hub/The-Vitamin-C-and-
Depressio...](http://parrster.hubpages.com/hub/The-Vitamin-C-and-Depression-
Link)

------
adeelk
> About one in four adults suffer from a diagnosable mental disorder in a
> given year. That means if you think about your 10 favorite people in the
> whole world two of them could be at risk of suicide.

No, that means _on average_ , an arbitrary set of eight adults contains two
with a mental disorder. (Presumably this refers to adults in the U.S.)

------
RockofStrength
“The mind is its own place, and in it self Can make a Heaven of Hell, a Hell
of Heaven.” ~John Milton, Paradise Lost

------
mdaniel
If you are experiencing slowness while loading the site also, perhaps this
link will help:

<http://wilwheaton.net.nyud.net/2012/09/depression-lies/>

------
jawr
Has anyone ever explored the idea that depression is a western disease?

~~~
dgabriel
It's really not, though most of the research seems to be on refugee
populations: [http://voices.yahoo.com/researchers-examine-ptsd-
depression-...](http://voices.yahoo.com/researchers-examine-ptsd-depression-
african-3780854.html?cat=70)

------
kakaroto_BR
I'm in this situation right now. I will try to pass this with some therapy and
exercises, because the medication decreases libido and I don't want to lose my
girlfriend.

~~~
danteembermage
I would hope your girlfriend would have the maturity and care for you that
this wouldn't put your relationship in danger. You know 50% of sexually active
people are in a relationship where their partner is less interested in sex
than they are on average (inevitable logic, not statistics) and if you break
it down to year by year interest that number must go up (again logic).

That said, I'm going to make the brash counter-cultural statement that if you
wait until after you commit to each other for life before having sex, then you
worry a lot less about whether you are going to lose your partner over sex. If
a necessary medication causing a libido blip is enough to derail your
relationship, maybe you should consider pushing sex further up the commitment
ladder?

~~~
philwelch
In other words: satisfying each others' sexual needs _isn't_ a valid and
important part of a relationship?

~~~
lotharbot
In a sufficiently long relationship, there will be periods during which
"satisfying each others' sexual needs" is difficult or impossible.

Couples I know have had trouble due to depression, childbirth, work-related
travel, injury, and a year-long coma. While sex is a valid and important part
of the relationship, it's also important to be able to weather periods of
difficulty.

I should also note, depression tends to make one less capable of meeting
_other_ important relationship needs. If treatment causes a temporary drop in
libido but improves those other areas, that should be a net positive. Thus, I
submit that if a relationship gets derailed by such treatment, there were
deeper issues in play.

~~~
philwelch
Sometimes it's unavoidable, but it's a concern that's worthy of consideration,
and saying shit like "just don't have sex until you're married lol" isn't
helpful.

~~~
lotharbot
The way you choose to build a relationship has a lot to do with how well you
are able to sustain it through certain types of difficulty.

The comment you were responding to said something considerably more nuanced
and interesting than "lol" in conjunction with the "don't have sex until
you're married" part. It's OK if you disagree, but please do so in a more
thoughtful way.

~~~
philwelch
What I found interesting wasn't so much what was said as the unstated
assumptions behind it. The comment was in any case almost deliberately useless
in how to handle an existing relationship that already entailed sex.

------
mfceo
before doing anything that this guy auggests, listen up :

Leave the meds behind. meds are the last resport. you have to try everything
else before doing what this guy did and let go of your supernatural
expectancies from yourself. Work less, eat better, sleep more, enjoy your life
more, stress less, change your life, live healthier, enjoy enough daylight,
and first make sure that you are not infact surrounded by assholes & idiots.
Try sports, fall in love, try dietary suplements, vitamins, make some major
life changes, stop smoking, stop drinking, stop making yourself depressed all
the time. Once you ealize that you are the admin here and that it is you that
has to take control of yourself and maintain the system. Meds are the
absolutely last resort. This guy for sure didnt try out all those above
meantioned natural techniques, but went the easy and unhealthier way. Now
there is one more pilled up dude out there that i will have to compete with.
Although i do try to live my life the healthiest way i can afford and cut all
other bs aside, i do find it sometimes difficult to compete agains all these
people on meds as they don't have to deal with as much humane feelings anymore
but can act out, in the worst case, their over the top happy personalities and
don't feel like normal humans do, dont sence when to stop smiling etc. but
yeah, if it really was the last choice for this dude, then i'm happy that this
guy is happy again. For all i know this might be just one more of those
'talks' from big pharma companies about the benefits of mood enhancers and
anti depressants. Anybody out there coping with depression, hang in there, you
dont want to cloud your judgement with a bunch of pills. instead thry ALL
natural ways to stay happy and focused. Own yourself.

~~~
GFischer
You started out with some good suggestions, and I do agree that meds shouldn't
be picked up lightly.

However, I don't understand your rant when you go on saying that "i do find it
sometimes difficult to compete agains all these people on meds as they don't
have to deal with as much humane feelings anymore"

I'd also appreciate it if you used better spacing and punctuation (uppercase I
for example), it makes your post harder to read and sound like a rant.

------
robotment
Depression lies. If you have some depression that came from the society, what
can I do? I can't get ride of that..

~~~
chmike
What do you mean by _came from the society_ ? Do you mean it' reactional to
the context ? These are the types of depressions where cognitive therapy can
be efficient. You can learn to direct your own thoughts, or avoid self bashing
thoughts, that will prevent you from falling back into depressions and take
control of your own mental wellbeing and your life.

------
vmialik
I am excited to see this on HN, anyone working on this from non-drug or even
drug standpoint?

------
rubashov
I thought I was depressed and anxious for almost two years. It turned out I
just had a chronic sinus infection.

I'm suspicious that a lot of what gets considered as psychiatric problems are
really physical health problems. Anecdotally, a lot of people switch to a
nutrient dense diet and cut out potential allergens and wind up feeling all
better.

~~~
the_economist
Not just anecdotally -- plenty of studies confirm this. Some people -- 30% of
the people by some estimates -- simply suffer from fructose malabsorption.
This means that when they eat foods with excess fructose (even fruit), they
fail to properly absorb nutrients.

In particular, individuals who suffer from fructose malabsorption fail to
absorb tryptophan: <http://en.wikipedia.org/wiki/Fructose_malabsorption>

Tryptophan deficiency is extremely common in depressed individuals:
<http://www.ncbi.nlm.nih.gov/pubmed/2148339>

Tryptophan is a serotonin precursor, so to anyone who has ever taken an SSRI,
it intuitively makes some sense that it could be related to happiness.

Sadly, no one wants to be told that their diet is a problem, or that they have
to do all the hard work of changing their diet. They just go for a pill. Which
wouldn't even be so bad, if the pills we made were truly effective and side-
effect free. But they aren't.

~~~
mej10
Any time I have mentioned that someone should change their diet to help them
deal with any number of problems (weight, mild depression, seasonal affective
disorder, overall energy levels), I am universally met with disbelief and
dismissal.

The fad diet industry has ruined people's ability to think clearly about the
topic of diet. The part that gets to me the most is that I have had profound
changes in my life due to diet and exercise changes, and they know that. They
still won't even try.

~~~
mcguire
Possibly because there are many people out there with any number of problems
(weight, depression, asthma, acne, diarrhea, rising of the lights,...) who,
when mentioning those problems, are universally met with suggestions to change
their diet. From someone who has no idea what diet the sufferer has.

But I'm with you, there, buddy. It's like these people don't even know
rutabagas exist and supply all of the particulas vitae necessary for human
existence.

