
Surviving Depression - vishnumohandas
https://vishnu.tech/posts/surviving-depression/
======
cjhveal
It took me a long time after taking that leap of faith into therapy to learn
that the most valuable part of psychotherapy is not information or advice but
it is the therapist-client relationship itself. You need to internalize their
advice and techniques (as OP managed to do on their own), and therapy is about
creating a facilitative environment to alter that conception of self.

In therapy, you are unconditionally accepted with positive regard, which
facilitates viewing yourself more clearly without the need to lean on self-
defeating coping mechanisms, like self-pity or shifting blame. As social
creatures we instinctively perform a lot of mirroring of others' mental state,
so simply by being accepted we are able to try on what it is like to accept
ourselves. It's leveraging an additional set of tools baked into us at a deep
level to build self awareness and a more positive, realistic self model.

If you're struggling, I'd like to echo others and strongly recommend you reach
out to a psychiatrist and psychologist if they are within reach for you. Take
OP as an example that it is possible to change, but please explore all the
resources available to you so that you can explore what works for you.

That being said, thank you to Vishnu for sharing some of your struggles and
how you've managed to find ways to improve. It really helps to be talking
publicly about these issues.

~~~
tetha
Also, they are trained and educated to recognize if this doesn't work.
Speaking from experience there.

They'll try to gain trust, which is necessary. Actual licensed therapists have
two things going in there. You can go and meet them in private. And they are
legally forbidden from telling on you to anyone, unless you're violent or
suicidal. They will throw years and years of studies away if they give away
you secrets.

Beyond that, you'll be asked what you're struggling with. This can take a
session or three. That's normal because it takes time to gain trust and open
up. Though they'll gather data during these sessions, too. After all, you
don't end up sitting in a therapists office because you're doing great.

And they do know a number of different behaviors that end up being problematic
beyond a certain scale. But it can be refreshing to talk to someone just
knowning your bug.

I knew I was writing too much by paragraph 2. But I'm submitting this anyway.

~~~
notokay
>unless you're violent or suicidal.

Yes, and if you are suicidal, police will throw you in a jail. Or worse - in a
psychiatric hospital. And you are gonna be fired from work and will be even
more miserable than before.

There is no help for men with depression. Even if you ask for it, you have to
keep lying and downplaying your symptoms, so no one would think you are really
depressed.

~~~
arkades
We don't throw anyone in jail for being suicidal. We don't throw people into
psych hospitals unless they're at imminent risk of successfully committing
suicide - we don't do admits just for suicidal ideation. One of the first
things you learn, even as a med student, is how to distinguish between "this
person needs help" and "hide the sharp objects." That said, some patients
_are_ in the "hide the sharp objects" zone - and they get hospitalized to make
sure they don't die.

You are creating an exaggerated worst-case scenario that, luckily, means you
don't have to change or risk vulnerability or anything. Unluckily, your safe
space sounds like a pit of shit. Depression will do that to you.

Please reach out to a professional & get help. You'll be shocked how much
better you can feel in just a few months.

~~~
mewpmewp2
I don't feel like I have had much or enough help from therapy or drugs and
I've been on both of them on and off for more than 12 years now.

Whenever in therapy it seems that I always try to argue against any advice
given. Same online, so I guess any advice given to me I would try to oppose
it, but I'm still telling about this and hoping for an answer or solution,
because what else can I do. My mind only tries to find flaws in what the
therapists say. I either say it out loud and keep saying it until I frustrate
therapists or I keep it in my head and think those thoughts silently. I don't
know how to just accept the advice. Same with social situations where I just
keep silent, so I hate them too and try to avoid as much as possible in life.
I either zone out or I try to find something wrong with what they are saying,
but obviously not mentioning it. Maybe it's because I'm envious of their
knowledge so I have to somehow find errors in them so I wouldn't feel bad
about my lack of social performance/knowledge/wittiness. A lot of times maybe
I purposely misunderstand rather than give benefit of the doubt in my mind,
because possibly I really want them to be wrong. So all in all it occurs to me
that not only am I less knowledgable than most people, I also have a terrible
personality. Once again why I keep quiet, because showing it out would only
sabotage my career, life etc.

And whenever I try to follow advice I have never had it work, I'm not sure if
it's due to my own negative attitude regarding the advice, maybe I'm not
following it properly or maybe it's just brain chemistry. But in a way where
currently available anti-depressants won't affect it positively.

For instance, observing your thoughts from distance or trying to reframe them.
Observing from distance - how long do I have to do that to make it work? It
still doesn't kill the depression, frustration and anxiety. Reframing the
thoughts has never worked since I don't ever believe the reframes and this
always leads to existential crisis. If therapists suggests a reframe I will
keep arguing it until it reaches "meaning of life" point again.

Another thing is sleep. I hate falling asleep. Even if I do it seems like I
wake up too early. I feel like I have tried following all the low hanging
fruit advice such as exercising every day, use melatonin, hot baths, whatever
common tips I have found. I do running (6+ miles), go to gym every other day.
I feel like I don't progress a lot, and I'm afraid because of my shitty sleep.
If I take Ambien I will wake up in 4 hours, because that's how long it lasts,
so it can't just be some shitty sleep hygiene either if I wake too early after
falling asleep. I think I just feel disgusted about sleep and it seems that it
affects any progress I'm trying to make as well. Probably affects my gym and
running results, my cognitive performance - maybe that's a cop out since I'm
not happy with my cognitive performance and blaming it on sleep allows me to
believe that maybe I'm not cognitively as poor as I seem to perform currently
and that I actually have potential.

~~~
rjbwork
Have you tried a sleep study?

I don't have a miracle story, but I've read a number of others'. Many people's
live are nearly immediately improved after a sleep study/breathing study is
done.

~~~
mewpmewp2
I have, I snore a lot, so there's issues there, no apnoea, but this won't help
with falling asleep - why I use Ambien. Although I'll try to get off it now.

And if I wake up I can't fall asleep again - unless I take more Ambien.

~~~
Ditiris
Have you tried trazodone?

------
andreyk
As someone who has survived some really bad episodes of depression, a lot of
the content of this resonates with me and seems like useful advice. I think
"My inability to find anything relatable made things worse." is very true,
there is very little out there of people sharing their recovery stories, so
props to author for writing this!

That being said, the dismissive use of 'Happy Pills' is a bit problematic IMO,
for some that is the most effective way to heal depression (not just "numbing
your senses"). Though of course, over the long term fixing external issues in
your life that lead to depression is of course sensible.

Self-plug warning, I recently wrote a post titled "Things Everyone Should Know
About Depression" which conveys some of my own experience and a lot of facts
about it: [https://www.andreykurenkov.com/writing/life/things-
everyone-...](https://www.andreykurenkov.com/writing/life/things-everyone-
should-know-about-depression/)

~~~
vishnumohandas
I’m sorry if I sounded dismissive. I guess it was because my experiences with
psychiatrists were painful and frustrating.

I completely understand and agree that medication could be a viable solution
for someone else.

~~~
cmehdy
More important than viable, for some people it actually is vital. It is a
very, very important note. For some people, psychiatric support is not a pill
to alleviate some pain, it is more like a pacemaker: it's the difference
between life and death.

It can be the difference between a completely clogged brain coupled with
suicide attempts (where no amount of tentative discussions with specialists
resonates, if the person even has the energy to get out of bed at all), and
having the energy to learn and use the therapeutic tools for well-being.

I'm glad to see that CBT has been an interesting tool for you by the way, and
there's a lot of growth around CBT, DBT, and trauma-informed care, that is
fantastic for the improvement of mental health nowadays.

~~~
exolymph
Yep, this is me with venlafaxine. I appreciate that medication is not a
panacea, but it really gets my blood up when people act like meds never work
for anyone. It's just patently false.

------
adamc
I started suffering severe depression when my (now ex-) wife asked for a
divorce, about 3.5 years ago. Therapist/psychiatrist also have told me there
is a lot of grief mixed in. The fact that my 20 year old kid won't talk to me
makes it worse.

Nonetheless, it has gradually gotten better. I don't think the medications
have been very effective, but time to internalize different ways of thinking
about my life have helped. They're slow, though. It takes a long time to
change.

Another thing I sometimes do, somewhat akin to what is described in the
article, is just close my eyes and be, for a bit. I would call it meditation
but there really isn't much thinking -- just feeling what I feel. Accepting
where I am, as best I can.

I really identify with the 'I’m better now. It’s hard to call myself “happy”
(what is happiness anyway?)'. I don't think I'm happy (I have memories of what
that felt like), but at least I'm not desperate every moment.

I've spent an insane number of hours wondering why being alive is a good
thing. Still not sure I have an answer.

~~~
rewgs
> I would call it meditation but there really isn't much thinking -- just
> feeling what I feel. Accepting where I am, as best I can.

I would very much call that meditation.

~~~
macd
Yeah, it seems to be a common misconception that meditation is forcing
yourself not to think.

FTA: > I set aside hours each day to do nothing. In some sense, this was
meditation. Except, I did not force myself to not think. I wanted to get
comfortable with the voice in my head. I would sit, lie down or walk while
paying attention to my body (the heartbeat, the breath, the funny noises my
stomach made), and the physical world outside (there were so many beautiful
things to trip on).

The author (and the top level comment) thought they weren't meditating, when
in reality they discovered mindfulness meditation :)

~~~
ridewinter
One way to understand meditation is to just give yourself the time & space to
experience & become bored with your repetitive thoughts. You don't stop
thinking - you just become bored with it and settle down. It's immensely
healing once you've experienced it.

------
weej
For those suffering from depression, anxiety, stress please consider meeting
with a psychiatrist and psychologist.

Some brains are neurologically misconfigured and prone to chemical depletion
or lack receptors for it (ex: serotonin or dopamine). All the pushing through
and search for answers, triggers, or source of problems won't solve this.

Secondly, cognitive behavioral therapy (CBT) can work well for analyzing the
'why' you feel and/or behave the way you do. It provides perspective, insight,
and tools for helping cope with problems (control/mitigate or potentially
eliminate).

Both of these are tools that can dramatically improve your life. I've been
there and still am. Seek the support you deserve. Tomorrow will bring a better
future.

~~~
slothtrop
> Some brains are neurologically misconfigured

This is almost always symptomatic. There's a fair amount of research on
dopamine depletion. Addiction, including but not limited to drug use (e.g.
high-fat-high-sugar food, pornography) can show deceases in receptors. Vitamin
D3 deficiency can pose a problem. Sedentary behavior. etc.

I'd recommend CBT principles to anyone, research shows they're as effective as
prozac. The point is many changes can be implemented before resigning to
perpetual medication.

~~~
zxexz
I'd be cautious of the claim that CBT is 'as effective as Prozac', or another
chemical solution, in general. A cursory glance at the Wikipedia Criticisms
section for CBT points out at least several concerns with the existing
research[0]. Anecdotally, a family member of mine went through a complete
round of CBT, for a mental health disorder, and they said that it seemed
mostly just like standard therapy, and perhaps increases mindfulness a bit,
but definitely felt it could not hold a candle to standard treatment. I should
point out that they followed the protocol quite rigidly, and embraced the
therapy with an open mind.

No doubt CBT has varying effectiveness between individuals. Somewhat
tangentially, I find this[1] article cited in the Wikipedia page[0] to be an
interesting read; a meta-analysis of ~70 studies, showing a seeming decrease
in effectiveness of CBT over 30 years.

[0]
[https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy#C...](https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy#Criticisms)

[1] [https://www.semanticscholar.org/paper/The-effects-of-
cogniti...](https://www.semanticscholar.org/paper/The-effects-of-cognitive-
behavioral-therapy-as-an-A-Johnsen-
Friborg/ba5fa04b5f4556cc6ccdc3e4004fe0ec28f6a188)

~~~
slothtrop
A single study is listed as being challenged. Have others:

From 2010 - "In this 36-week study, partial and nonresponders to placebo, and
responders and partial responders to Prozac, CBT, and combination treatments
in the 12-week trial were openly treated (TADS Team, 2007). As in Phase 1,
Prozac and combination groups received additional encouragement and contact
(medication management). Despite this, all treatment conditions converged by
30 weeks and remained so by Week 36, with significantly more suicidal ideation
in the Prozac-alone group. The percentage of suicidal events for those on
Prozac, whether in combined or alone groups, was nearly 12%, double the 6% in
the CBT group. Despite the convergence of efficacy and continued risks, TADS
is often cited as evidence that combining psychotherapy and medication produce
superior results (e.g., NIMH, n.d.)." \--
[https://www.researchgate.net/profile/Dickson_Adom/post/What_...](https://www.researchgate.net/profile/Dickson_Adom/post/What_are_the_overall_benefits_of_psychotropic_drugs/attachment/5abc04c44cde26965866175a/AS%3A609264682942464%401522271428237/download/CohenPsychiatricDrugsCommonFactorsRiskandBenefits.pdf)

"Collectively, the findings detailed inA.C. Butler et al. / Clinical
Psychology Review 26 (2006) 17–3127 this review suggest that CT is highly
effective for adult unipolar depression, adolescent unipolar
depression,generalized anxiety disorder, panic disorder with or without
agoraphobia, social phobia, PTSD, and childhooddepressive and anxiety
disorders. The comparison-weighted grand mean effect size for these disorders
when compared to no-treatment, wait list, or placebo controls is 0.95
(SD=0.08). CBT is associated with large improvements in symptoms for bulimia
nervosa, and the associated effect sizes (M=1.27, SD=0.11) are significantly
larger than those that have been found for pharmacotherapy. CBT also has shown
promising results as adjunct to pharmacotherapy in the treatment of
schizophrenia." \-- [https://www.get.gg/docs/Empirical-Status-of-
CBT.pdf](https://www.get.gg/docs/Empirical-Status-of-CBT.pdf)

Prozac yields a risk of side effects, and ceasing use brings a strong risk of
relapse. Comparatively CBT offers a lasting solution.

------
whalesalad
My journey (it has been a long and arduous one, multiple therapists, multiple
psych's, more drugs than you can imagine) has recently taken me down the path
of psychoanalysis and deep exploration of my childhood. It has been eye-
opening and transformative to say the least.

I would urge anyone who may have had a traumatic childhood to dig into that
more. This book has been a fantastic resource:
[https://www.amazon.com/gp/product/B00C4BA4I6](https://www.amazon.com/gp/product/B00C4BA4I6)

~~~
M5x7wI3CmbEem10
I don’t know if I recall this correctly, but doesn’t the author write with a
religious undertone? Would this be effective for a non-religious person?

~~~
whalesalad
I haven't noticed a religious undertone. I grew up in a religious family but I
am, currently, not a very religious person. The author was raised in a
Catholic family though, so there are sometimes anecdotes or experiences that
are related to religion and clergy.

Personally I find the writing to be concise, to the point, and very
scientific. I read 30% of the book last night because I could not stop. I am
like a dried out sponge and this is the water I have been looking for.

------
throwaway_sjfgd
I'm looking for advice. I have been suffering for the last several years.

The root cause of the problem is still there and cannot realistically go away
easily [1]. I'm consulting with psychologists and was taking medicine (held
currently by the lock down). It has not helped to read literature myself [2]
as it only says sadness and depression are likely given the circumstances.

Among the good things: I have a good job [3], have several friends who are
supportive, am trying hobbies like music. I'm generally exercising also,
slowed by lock down.

[1] I've been in an abusive and sexless marriage for over a decade, living
separately now. Spouse has filed a false violence case against me, the matter
is in the courts and proceeding at its own pace. And there's more.

[2] E.g., Maslow's hierarchy of needs
([https://en.wikipedia.org/wiki/Maslow%27s_hierarchy_of_needs](https://en.wikipedia.org/wiki/Maslow%27s_hierarchy_of_needs))

[3] My performance is below my standards due to low motivation and negative
impact of stress on memory. I am barely able to do anything myself, however,
I'm doing great in guiding and mentoring others which is an important part of
my role. It has helped to let them know of my personal situation and everybody
is supportive.

~~~
whalesalad
> I've been in an abusive and sexless marriage for over a decade, living
> separately now

This is a substantial thread to pull. Do not discount the impact of this on
your life and your wellbeing.

My email is in my profile if you would like someone to talk to.

~~~
throwaway_sjfgd
Thanks a lot for the helping hand!

------
Vysero
I too suffer with depression and have been now for the better part of a
decade. I, for similar reasons, have also chosen to live instead of die. My
depression began to get worse a few years ago and I decided to do something
about it this year. So far I have tried therapy and I quit for.. yet again..
similar reasons. I have not tried medications because I have an addictive
personality and will no doubt become dependent on them.

What has helped me the most so far believe it or not is quitting smoking. Not
so much because smoking was a trigger, but because it's shown me that I am
capable of going toe to toe with myself. Exercise also seems to be helping me.
Although, I will admit I have begun to drink quite often, every night in fact,
and I am working on that.

I will give some of your suggestions a try.

~~~
throwaway_3499
antidepressants do cause physical dependency in basically everyone who takes
them -- you have to taper off slowly. but they are not addictive in a
psychological sense. they don't get you high or make you feel good in the
moment.

i took them for a while and never felt any urge or desire for them -- it was
something i had to constantly remind myself to do. indeed, i would frequently
forget to take them -- this is not something that usually happens with
addictive substances!

my point is, there are many reasons to take or not to take antidepressants,
but there is almost no risk of addictive behavior like might happen with anti-
anxiety drugs like xanax or stimulants like adderall.

~~~
slaymaker1907
If anything, I find that I am more often tempted to try and go off of them
when I shouldn't or at too quick of a pace without tapering since the side
effects of most anti-depressants are not pleasant.

~~~
helldritch
Most people need to try a few antidepressants to find one which really works
for them and which they can take with relatively few side effects.

I had Sertraline 150mg previously and found that rather than helping me it
caused a significant increase in my suicidal ideation.

I now take Mirtazapine 45mg instead and the suicidal ideation has gone away
entirely, of course I have other side effects (the Mirtazapine makes me drowsy
and has caused me start snoring!)

If you're reading this and your not getting a good response from your current
medication, talk to your GP about changing to something else. Sertraline
didn't work for me, but very well could for you, etc.

------
narak
Thanks for sharing.

Also, PSA: Get tested for any sleep disorders and hormone issues. Affects
every aspect of your health and is massively under-diagnosed (80-90%)

------
outime
I'd say psilocybin ( _magic mushrooms_ ). It doesn't cure depression by
itself, it just punches you in the face and shows your reality and then you
can decide if you want to change something, everything or nothing. It's cheap,
it's natural (not that it makes it good, but it's nice that nature provides
and it's accessible), it's been proven very safe for the majority of the
people (not to be taken with antidepressants or if suffering serious mental
issues such as schizophrenia) and it's been used for ages for many purposes
and science has been considering it as a very valid treatment for depression
for some time now and I can vouch for it.

There are places in the world where this is legal, and you can do it with
doctors if so you wish. I didn't go through the official medical route since
like many other people, I wasn't entirely convinced that taking pills covering
the problem (if anything, I don't buy the "chemical imbalance" theory - I do
believe there's one, but that's just the end of the chain and not the cause)
combined with several years of therapies was going to be a good idea in my
specific case.

Luckily HN is a quite open community and this has been discussed several times
so please use the search to read more about it. The book "How to Change Your
Mind" by Michael Pollan is a must read if you want to convince yourself and
give it a try. I can also recommend r/microdosing and r/psychonauts.

Please do a lot of research before you decide to take this route as the
process can be tough but then if you happen to be very deep into depression
it's worth looking into.

~~~
0x8BADF00D
Depression and anxiety are diseases of the ego. When you dissolve your ego,
such afflictions melt away.

~~~
onemoresoop
Are they? I thought they’d be more of a wrong interpretation of the reality,
wrong as in unecessarily negative; or a chemical imbalance or a bad situation
in life, or suppressed emotions, or lack of agency or... there could be so
many reasons. It doesn’t help that too many things are fit under the label of
depression either.

And a reason for a higher prevalence of depression in the western hemisphere
is in my opinion how we choose to live our lives.

~~~
onemoresoop
I dont doubt that there are cases of depression being caused by an unhealthy
ego, but that’s not always the case.

------
ignoramous
I feel compelled to ask this though: As a famous story goes, anyone naïve
self-diagnosing might incorrectly conclude to have been inflicted by multiple
disparate diseases.

I haven't been able to figure out what could to tell me conclusively if
someone (I or anyone else) is clinically depressed at all. I mean, is feeling
of sadness depression? Sadness depends so much on what's happening at any
given point in time, and some days are more sad than happy and vice versa.
Sometimes, there's sadness associated with a context (may be showing up at
work evokes sadness due to recent failures in professional life, say), but
coming home to your kid doesn't, or may be it's the reverse, and may be you
are suddenly, unpromptedly are reminded of an incident or a regret that
sadness comes gushing in... Is this depression, or normal emotional response
to persistent stress? I guess, what I'm trying to say is, reading up on
depression makes me feel like I may be depressed, but then how can anyone know
for sure that they aren't misinterpreting or misattributing the symptoms?

~~~
diehunde
Well think of this. When you are sad, do you feel like killing yourself is an
option to stop that feeling?

~~~
metabagel
This isn’t necessary for depression. I was severely depressed, and I never
seriously considered taking my own life. I did sometimes feel like it would be
OK if I ceased to exist.

~~~
diehunde
I didn't say seriously considered. I'm talking about what it's known as
suicidal ideation. You can be sad and down for weeks because you got rejected
from your favorite company but I would be surprised if some suicidal thought
pop into your head because of this. For people that are depressed is not rare
at all. Even people with anxiety disorders have them often.

------
kiddico
If you're ever looking for a CS partner I'm down to play. I'll race you to the
bottom of the scoreboard haha.

[https://steamcommunity.com/id/xeroxgun](https://steamcommunity.com/id/xeroxgun)

------
vesky
This is almost a full day after your post and I don't really have anything to
add, but I wanted to thank you for writing this post. It was honest and
heartfelt.

I think the worst part of modernity is the over-promise of happiness and a
good life through the constant bombardment of marketing. We grow up believing
that we're supposed to be always happy and when we're not, we're told that the
problem is us.

I have a young daughter and I will always try to keep her grounded about the
harships of life and make her see beauty in the struggle for improvement and
selflesness. Life is hard, but hard things are worth tackling. There's beauty
in the struggle if you seek it. I think it's easier if you know when to zoom
in on the day-to-day and when to pan out on the past decade and hope for the
next one. Switch between them regularly.

------
rpastuszak
Regarding the point on writing—I've been struggling with depression for some
time so I built a writing tool which helps me to refocus every day. It has
helped me immensely in the past few months, so maybe some of you will find it
useful:

[https://ulysses.sonnet.io](https://ulysses.sonnet.io)

You can install the app as a PWA and it works offline ootb, there is NO
tracking/analytics, etc... I don't even know how many people are using it.

More context:
[https://sonnet.io/posts/ulysses/](https://sonnet.io/posts/ulysses/)

------
freedomben
One of the easiest and most effective things I've ever done was start taking
DL-Phenylalanine. I'm not a doctor and you should definitely not take medical
advice from random people on the internet, but if you struggle with
depression, do yourself a big favor and look into it.

~~~
zoba
I wanted to ask you more about this but the email link in your profile is not
working. My email is also in my profile.

~~~
freedomben
Interesting, I hope scr.im is just temporarily down and not permanently
offline. My email is freedomben at proton mail dot com

------
jokoon
I really believe physical activity helps regulate your metabolism, and can
really reduce depression.

There are theories about gut bacteria being involved in regulating the brain.
There are no species on earth who experienced a sedentary lifestyle.

To be honest I don't really like exercise. But it's all about avoiding
atrophy, at all cost.

My country recommends walking for at least 30min per day.

I'm not saying jogging and pushups cured me, but it does help.

------
AlphaSquared
As someone who struggles with this on and off, probably more on than off but I
dont like to admit that, I find gratitude to be the one thing that makes a
huge difference in my life. It fits in nicely and deeply with my religion as
well so there's that.

Externally though people think I'm a very happy person. Internally I know its
just easy for me to forget or push away the dark thoughts for periods of time,
but when I let them surface, they can cause a lot of sadness.

The thing about me is that I am a very logical person. I recognize and find it
very easy to deal with the fact that depression is by and large a chemical
imbalance. So I often find it very easy to label my current sadness as
something caused by lack or excess of chemicals in my brain and that helps me
cope a lot with things as well.

I've found depressed people tend to be told a lot to excercise and dont
consider it as a solution, but again for me I find it fairly easy to co-relate
the low points in my life with a lack of excercise and fresh air. So this
tends to again help me push myself out of my low moods.

~~~
alexilliamson
As a non-religious person, all this resonates very much with me. The
gratidtude bit is something that is relatively easy, and surprisingly
effective at making you feel more connected with the world. Try writing down
the thing you're thankful for, or even actually thinking people. I bet you'll
be surprised at mood the lift you get.

~~~
AlphaSquared
Agreed. I've noticed that sometimes I get a huge boost of happiness by simply
smiling and giving a greeting to strangers passing by who seem to be having a
tough time...

Seeing the huge smile on their face when they see a random stranger greet them
brings me to the verge of tears.

The life of this world can be tough on people. Every little bit helps.

------
foolinaround
Many coping methodologies have been described here, and the role of religion
and spirituality has been scientifically studied to (in the general case) help
with depression [1]

While I can advocate for the Christian worldview, religions and spirituality
in general have advocated for 'giving up control or acknowledging the lack of
control' as one primary tool. The religions differ on who to give control to,
who is in control, etc.

However one approaches it, if one is able to find purpose in something larger
than himself ( or fake it till you get there), it keeps you moving one day at
a time.

When one is at the end of his rope, the belief that there is a more powerful
person in control and watching for you, it brings immense relief. Now, this is
the belief that one must get ( and this is where the community around him is
best positioned to help)

[1]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426191/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426191/)

~~~
dntbnmpls
> Many coping methodologies have been described here, and the role of religion
> and spirituality has been scientifically studied to (in the general case)
> help with depression [1]

That's what "therapy" ultimately is. It's a religion. Instead of going to
church once a week, you see a therapist one or more times a week.

Look at the top comment advocating for therapy. It's filled with religious
allusions - "taking that leap of faith into therapy", "and therapy is about
creating a facilitative environment to alter that conception of self", "In
therapy, you are unconditionally accepted with positive regard,", etc.

Everything in the top comment is familiar to anyone who was raised a
christian. Therapists just took the place of confidants like priests, pastors,
etc as christianity/religion decline. The way the "converted" talk about
therapy is eerily similar to those who find faith or are born again. But
whatever your "faith", there is no doubt that "faith" helps alleviate
depression. Whether there is a real neurological reason or whether it is a
placebo effect or entirely something else is TBD.

~~~
javert
Therapy isn't religion. There's an analogy there, but it only goes so far.

A good therapist is not going to ask you to buy into an ideology/doctrine that
requires faith in the religious sense.

The word "faith" in "taking a leap of faith" does not actually have the same
meaning as the word "faith" in "religious faith." It's an analogy. To say it
in programmer lingo, the word "faith" has been overloaded.

------
papito
I wonder how often people try the very basic, organic (if you will) things
before resorting to chemicals that mess with their brain. I mean - reasonable
diet, enough sleep, exercise.

A major part of it seems to be a vicious cycle.

I once went to a Sarah McLachlan concert, and you know, her music can get a
li'l "blue". Back in the day I went to a LOT of concerts, being a 20-something
guy in NYC. That crowd straight up shocked me. Most seemed morbidly
overweight, and many hauled literally _buckets_ of junk food to their seats. I
actually left early because the whole scene started bumming me out.

And I would imagine these are the people who would not even try changing their
lifestyle and just ask their doctor to make them happy. It's all very sad.

~~~
ImaCake
>reasonable diet, enough sleep, exercise

For many victims this is already too difficult to achieve. The use of pills
and therapy are the jump start they need to then use these basic steps to
improve their lives organically.

------
tarmains_nil
I do not live in a country with extreme lockdown. Neither have I been
economically affected by this. But my coping mechanism for depression was
hitting the gym. Not just the excercises themselves but the entire ritual. The
moment I feel the smell of the place, places I go to atleast 3, I get a sense
of calm and focus. I really tried my best with a rudimentary home gym and
tried some running when it was possible due to weather. It took me years to
build up the gym strategy. It took a day to break it down. After a few weeks
in lockdown without my ritual I felt the old blackness creeping back. The
complete lack of human interaction other than the synthetic zoom sessions that
do nothing for me. I dont feel any human connection over zoom. And I wonder if
all the articles of the fun zoom hen parties arent just satire. Like when
priests were trying to make jesus cool during my teen years. Lockdown has
lifted a bit and I have started to meet people in person again. Always
distanced. I imagine this is what lepers felt. Everone goes out of their way
to stay safe. Being close might make you sick. I and you are hosts for the
viral plague. Out to cause our fellow human beings with unneccesary suffering
with our pesky needs to see other human faces. See a strangers frown or smile.
2 days ago I went to the mall for some food and just get, once completely
norma, take away coffee. I met an old collegue and she broke all protocol and
just spontaniosly hugged me. I started to sob. Unctrollably. I think the last
time someone touched me was march. Or maybe late february. I have a therapist.
Losing access to her did not bother me all that much. I have no financial
issues or physical ailments. I have spent these past few months sobbing,
randomly. Pulling myself out of bed, wondering if its tuesday or saturday.
Wondering why I could not just die in my sleep so I dont have to face another
day of being an absolutely useless piece of space that no one cares about.
That hug broke something awful and my poor chocked collegue may never know
what an incredible gesture that completely normal sentiment was for me. I no
longer feel like a disgusting host for viral pestilence. The gym opens in a
week. And if it closes down again. At least this time I know what to expect
and can prepare.

~~~
masonic

      But my coping mechanism for depression was hitting the gym
    

Gyms are subject to the strictest lockdown terms here in CA. Mine in SV closed
10 weeks ago.

------
brutusborn
I read this after another sleepless night and it made me cry.

I have had "go back to therapist" on my todo list for too long. Reading it has
reminded me of my plan to get things back on track. Thank you very much for
writing this.

------
uoaei
That's really it, isn't it? No one "lives" with depression, we "survive" with
it. Depression is little more than getting used to worsening conditions and
treating yourself poorly. "Living" stops when that pattern of behavior starts,
because attempts to live are shut down by rumination and defeatism. Then
introspection starts and you can see the basic issues but can't reason your
way out of them, nor draw on the discipline that has been washed away because
of them to put in the consistent work to better oneself.

------
29athrowaway
I recommend this talk about depression and software developers:
[https://www.youtube.com/watch?v=yFIa-
Mc2KSk](https://www.youtube.com/watch?v=yFIa-Mc2KSk)

There are newer versions of this talk, but I think this one has the most
powerful storytelling.

------
flobosg
Somewhat related: "The Depression Thing" by Zach Holman
([https://zachholman.com/posts/the-depression-
thing](https://zachholman.com/posts/the-depression-thing)).

------
winrid
Setting aside time to do nothing. Man, I haven't "done nothing" in far too
long.

I have a dedicated day toward reading, which is kinda close. But just relaxing
for a bit sounds so nice.

------
spacephysics
I read others asking for possible advice on where they can go/what they can do
for help, and beyond the standard psychologist/psychiatrist, and typical
resources linked from others, I'd like to share my experience.

Had depression most of my life, going from irritable depression to standard
melancholy depression. Seen a handful of psychologists, and wished they
worked. As mentioned in the article, it takes an enormous amount of time to
get someone else 'up to speed' on you, your history, your proclivities, and
your hypothesizes. I did it a few times, but had mixed experiences. Still
think psychologists are a very good resource, its just takes time to find a
good one.

During treatment, I tried a multitude of the standard anti-depressants, which
merely masked the symptoms for myself. For others, these options work much
better.

After being frustrated from my last therapist, I decided to dive into the
research, and self-experiment. After 5 or so years, the following has helped
immensely. I still have my lows, but they feel normal, and expected:

* Exercise: My constant irritation against those that just wanted to help, made it hard to let them in. So my anger and resentment was turned to weight lifting, and focusing on muscle building. I tend to overthink, so this was a good way to still continue to analyze, but also tire me out into a meditative-like state. The key for me was not to just go through the motions of the workout (though some days that's all I did), but to feed into that primal urge for aggression, put on intense workout music (mine was heavy rock), and exert as much energy into defeating my sets as possible. I agreed to do 10 reps for this last set? F-that, I'm doing 12. Nope 14. (within reason)

* Food: If you've read my past comments, you'll know I eat carnivore. This isn't to proselytize the diet, though it has had the largest positive impact on my emotional well being compared to anything else. Rather, its to point out that diet plays a key role. If you're eating something that's inflammatory to your gut, your emotional state may be the victim. This isn't the case for all instances of depression, but the research is mounting [0][1] Though these resources contradict my attitude towards many (not all) plants, the point is find what diet is right for you, even to at least eliminate that possibility. For me, if I stray into a problematic food, I am intensely depressed for at least a day or more, reminding me of what I worked to 'cure'.

* Time to yourself: As others have pointed out, meditation is great. So is yoga (especially hot yoga, if you like a challenge). Start slow, but what I've found for myself is that as my self-discipline increases, my confidence and mood do as well. From normal yoga, to 80 degree, to 95 degree, the challenge and (enjoyable) 'pain' in the moment, leads to a euphoric bliss of calmness after.

* Sun: Vitamin D deficiency is shown to have many issues related to depression, immune health and others. Depending on where you live, and how much melanin you have, you may need more than you think. Spend time outdoors during sunny periods (without sunscreen) for a time that's appropriate (you'll have to test yourself to find your optimal amount). Ask your doctor for vitamin D tests on a regular basis, so you have data to test your hypothesis.

* Socializing: Introvert or extrovert, some communication (whether in person or over the web) is generally seen as a positive thing for many. At times I didn't want to interact with anyone, as I would just hate my own existence, and their happiness as well. So in times like those I'd join forums or play games with people online. Something to get out of your own head. Or immerse yourself in a book, 'socializing' with the characters.

Hope this helps someone, I understand all too well the deep, endless darkness
that is depression. It's always lurking around the corner, and sometimes I
forget how bad it is, until I slip up. But there is a way out, it just has to
be your way.

[0] [https://www.health.harvard.edu/blog/diet-and-
depression-2018...](https://www.health.harvard.edu/blog/diet-and-
depression-2018022213309) [1] [https://www.health.harvard.edu/mind-and-
mood/food-and-mood-i...](https://www.health.harvard.edu/mind-and-mood/food-
and-mood-is-there-a-connection)

~~~
intro-b
> For me, if I stray into a problematic food, I am intensely depressed for at
> least a day or more, reminding me of what I worked to 'cure'.

Out of curiosity, do you believe there's a possibility of this effect being
mostly (or purely) psychological? I understand that there's a robust and
growing body of research linking nutrition, inflammation, gut health, and
mental health, but they seem to be either over long timeframes or meta-
analysis of other studies. When I read people's reviews of how
keto/carnivore/low-carb/vegan impacted their mental health, I'm always wary of
statements that link a one or two-time ingestion of a certain food type with a
complete relapse of symptoms, although maybe I haven't been properly paying
attention to my own body.

~~~
spacephysics
I agree the research isn’t there to the same rigor as other fields. Thus I too
don’t like to rely too heavily on it. My experience is N=1, anecdotal, but the
subjective difference is astonishing. And although correlation != causation,
it can imply it.

It took a few months of eating consistently to see results, and taking
detailed logs daily with subjective rating system made it as close to
“scientific” for myself, to review change over time.

Alas that isn’t true science, and I’m not sure how we _can_ truly test
nutrition, ethically. Studies in other animals have similar effects as
epidemiological studies: they point to variables we should casually test.

------
ryanianian
This is such an uplifting article. It's great to see someone recognizing their
own healing and thinking about how they made it all work.

> I set aside hours each day to do nothing. In some sense, this was
> meditation. Except, I did not force myself to not think.

In fact this is exactly what many styles of meditation practice are! You're
not "not thinking," you're being self-aware of your thoughts and learning to
guide them where you want them. I say this not to be pedantic but to correct
some notions of what meditation usually tries to achieve: more self-awareness
and control, which you can use to help guide your own sense of self and
healing. (At least this is the conclusion I've come to after using one of the
well-known apps that I actually really like.)

I still suffer from light depression and moderate ADHD, but meditation has
been just as effective for me as therapy and medication for both of these
(although I'm sure medication and therapy are making the mediation easier and
more effective).

------
vietvu
It looks like words I would write. I guess there are people out there who got
the very same problem, with very same thought process. And it's fortunate that
seems it works for him. I would try.

------
fromtheabyss
I've been living with depression and anxiety for so long that it is my state
of normal. I find cover from my feelings by working 12 hours a day and
focusing as much as I can. When I lose focus is when depression resurfaces. I
finally invested in my mental health in the last year, seeing a therapist and
practicing CBT. This has been a breakthrough year for me, emotionally. I am
thinking about quitting my work and working on something entrepreneurial
related to mental health. I've found that the most important part of self-
therapy is practicing what is learned, developing new mental habits that
trigger as countermeasures to cognitive distortions.

I feel like I'm a survivor of a emotional holocaust where people see an
emaciated mind and don't understand the cause.

------
hoseja
Just make like a roach and survive to spite everyone.

~~~
foreverloop
Well said

------
mapleoin
I really enjoyed reading this. The style of it. I'd like to read more like
this. Thank you!

------
g3e0
I find it very disheartening to see antidepressants described as "happy pills"
that "numb your senses". Comments like this only serve to reinforce the stigma
around these medications. This stigma is the part of the reason why I held out
from seeking help for years.

My experience taking Mirtazapine has been the exact opposite. At the deepest
point of my depression, that is when I was "numb". Like many people I would
listen to sad music when I was depressed, but eventually sad music didn't make
me feel sad anymore, I literally just felt nothing.

Since being on Mirtazapine, my depression is gone for the first time in 13
years and it's completely changed my life. I still have the full human
emotional range - I have good/bad moods (mostly good), days where I feel
bored/meh, I cry at the sad parts in films. The antidepressants cured my
depression, they haven't given me a false sense of inflated happiness. The
question of "am I actually happy?" doesn't even really cross my mind. I'm just
content.

The only side effects I experienced were 3 days of extreme tiredness when I
first started taking them, which then subsided. And my appetite increased, so
I have gained a few pounds, but since I was already quite skinny and had
started lifting weights, this has been a net plus.

I found this lecture by Stanford professor Robert Sapolsky highly insightful -
[https://www.youtube.com/watch?v=NOAgplgTxfc](https://www.youtube.com/watch?v=NOAgplgTxfc)
\- We all get depressed, it's a normal part of life, but depression is a
disease which causes you to stay depressed for no reason, and it's as real of
a disease as diabetes (we know this because the brains of people with
depression look different, even when they're sleeping)

What's weird is that, when I was depressed, I already knew everything that he
says in that video. I doubt this will make sense, but it was as if I knew it,
without really "knowing" it. I knew I had depression. I knew how depression
affected the brain. I knew how antidepressants worked. But if you'd asked me
if I wanted them, I would have said no.

One thing that I have come to realise, is that I had to unlearn all the
negative preconceptions I had about "happy pills", and be ready to accept that
the medication had the _potential_ to work, in order for it to work.

During the 13 years that I was depressed, there were still lengthy periods of
time when I felt relatively happy. Unfortunately, this led me to the
(incorrect) conclusion that I could cure my depression myself if I just found
the right combination of lifestyle choices. I started exercising, eating
better and trying to get enough sleep. I tried to maintain good relationships
with my family and friends, and explore my hobbies. The depression always came
back.

Ironically, all this time spent trying to get better without medical help,
probably extended the years of suffering, yet it was absolutely necessary to
create the conditions that were needed for me to actually get better. The
final pieces of the puzzle were: to truly accept that I had a disease, caused
by unresolved trauma in my childhood, to seek counselling to resolve those
issues, to lose the preconceptions about antidepressants, and to start the
medication.

This process alone took around 2 years. I am one of the lucky ones, I
genuinely count myself as lucky that I "only" wasted 13 years. Depression is
an insidious disease.

The final thing I will say is that I often felt at the time that the therapy
sessions weren't achieving much - it is only looking back that the impact
becomes clear. (Also, you don't have to be depressed to benefit from
counselling.)

Talking to friends and family can have just as big an impact, but therapists
are trained listeners, you don't have to explain "why" something was
traumatic, they just get it.

------
sas3bot
you can add one more thing to that trello accomplishments list. vishnu.tech !
not all techie vishnus around can have a cool domain like 'vishnu.tech'. just
one. :)

------
throwaway95568
I think there are a lot of misconceptions about medications and people are
pretty down on them, but they have been a literal lifesaver for me. For the
sake of someone who may be considering medication, I'd like to share my
experience.

I went through a pretty rough period of depression several years ago, but I
realized later that I had cycled in and out of medium to mild periods of
depression in cycles throughout my life. I wouldn't have said I was depressed
at that time, because I had the common image of a person who can't get out of
bed in mind. While that is certainly the case for some people, depression
comes in many flavors. I was always irritable and had a hard time being
patient for anything. I also experienced anhedonia, which is often described
as "lack of pleasure." I feel like that is not necessarily the best
description, and it's hard to describe it unless you've experienced it. It was
more of an emotional flatness. Sometimes I felt like a robot: I sensed that it
was a sunny day, food tastes good, but didn't have any positive feelings. It
was like watching a movie that you're not invested in and don't care how it
ends. While I didn't really notice it at the time (part of therapy is learning
to pay attention to your thoughts more), I would also often ruminate on
negative thoughts: how much I was disappointing people at work, how inadequate
I was as a husband, father.

When someone talks about depression, well meaning people often suggest things
like meditation and exercise. I don't think that is necessarily bad advice,
but I do worry that this may trivialize how hard it is to climb out of the
hole when you're depressed.

The one good habit I did have before and during the time that I was depressed
was I consistently worked out 3-4 days a week, running, crossfit, lifting free
weights. I would recommend exercise to anyone and I certainly think it helped
me. But it wasn't enough to overcome my depression.

I was also meditating quite a bit at the time. I found a zendo near me and
would often duck out during lunch time to sit for a half an hour. I also found
the Headspace app really useful for short 10 minute sittings during the day. I
would recommend meditation to anyone, but it wasn't enough to overcome
depression.

At some point, I hit a point where everything seemed to be unraveling and I
started talk therapy. I would say this is one of the most important things
I've done in my life, as I realized I had a lot of maladaptive mental
patterns. Therapy isn't an easy road. My first therapist was good, but not a
fit for me. When you are in therapy for depression, often your assessment of
how well therapy is going starts to factor into how you feel, and I began to
become hopeless that I would ever feel better. After almost a year, I sent my
therapist a text out of the blue one day saying I wasn't going to come any
more, which probably wasn't the best way to handle it. Someone else who
encouraged me to go in for a last session. The therapist and I both agreed it
wasn't a fit. I found another therapist that was much more effective for me,
and made a lot of progress. I got better at catching myself having negative
thoughts or ruminating. But I still felt very flat. My therapist asked what I
would do if I never felt good again. At the time, I said "I'm not sure I'd
want to go on." But shortly after that, I accepted that this may be the way I
would feel from then on, and, while I didn't feel great, it was, in some hard-
to-describe way, better.

Finally, after several years of therapy, still feeling flat, I decided to try
medication. The first one I tried was Wellbutrin, which has relatively benign
side effects. I knew it could take a long time to find the right medication
and dosage, so, while I was hopeful, my expectations weren't too high. When I
first started taking it, I didn't notice anything, not even side effects. But
one morning, after being on it for a while, I was driving my car to work in
rush hour and suddenly realized that I felt at ease; I was enjoying the drive.
It was so amazing I wanted to cry.

People like to describe these medications as "numbing," as if they were some
sort of opiate, but that's not my experience at all (I'd add that I
subsequently also added an SSRI for anxiety). They more shifted my
perspective, gave me more space to be mindful of my thoughts and emotions.
Some people have had very bad experiences with these, and I don't to minimize
that in any way, but I'd also say medications are useful for some people.

------
preya2k
Thanks so much!

------
chrischattin
All you have to do to see that depression is a disease of the bourgeoisie (I
feel dirty using that word) is travel around the world a bit.

Some of the poorest people out there are the happiest and living hand-to-mouth
doesn't leave much time for feeling melancholy. In fact, it seems to give
satisfaction, purpose, and fulfillment.

To put things in perspective for the HN crowd, if you make over $30k/year,
you're in the the top 1% worldwide. And at that level, all your basic needs
are met by a large margin.

You are free to pursue the kinds of wildest aspirations of your heart and mind
– if you chose.

~~~
intro-b
This parroted advice is unhelpful and almost always incorrect - simple
caricatures of the "travel the world" and "you don't have it so bad" and "just
follow your dream" are just empty platitudes. Depression can not only affect
people from all socioeconomic backgrounds, but is often highly correlated with
economic distress, especially if you look in areas like the upper midwest.
Depression often negates your life's sense of purpose. Saying that the
"poorest people are the happiest" and poverty somehow alleviates depression
because they're too busy working for their next meal feels condescending and
tone-deaf.

------
sdwvit
The blog design screams 'depression' to me :|

~~~
slx26
there's a light mode switch at the bottom, though on the posts it's rather
hidden. on the main page it's more accessible.

------
jotm
If just CBT works for you, great. Everyone else, just do yourself a favour and
go get some medication. Life's too short to live it miserably stubbornly
denying the effects of drugs.

~~~
jotm
Ooor don't, you can always stay miserable or kill yourself, I guess.

