My 20s have been pretty bad, but in the last year and a half I've lost 100+lbs and have been running and lifting.
It turns out the common sense advice to depression was really what I needed all along.
* Proper diet
If you're struggling with depression like I was - try and take baby steps to improving those 3. You don't have to be perfect and it doesn't have to be all at once, but through continued effort it has only gotten better and better for me.
I ended up going into some escapism mentality where if I'm not working I'm going to play video games/watch TV. It was a terrible rut until one morning I looked in the mirror and realized I'm letting life slip away. I'm not growing (well at least not in the productive way). Mind you most of those "explosive" problems were solved, but I wasn't. I freaked out, threw on some gym clothes, went to the gym, and ran. I don't even know what I was running toward. But I was running. I began lifting again, doing meal prep, back to studying, programming pet projects, reading, and it all came together.
It can hit you in waves, but one of the best ways to keep your head above water is to make sure those three things ElatedOwl mentioned are in check.
It is also gosh dang terrifying. I am not so much curing my depression + anxiety as much as I am running away and trying put enough stuff behind me that it can't catch me.
But when it does, it is difficult to get started again.
I'm not sure I like that way of looking at it. I choose to look at it like I'm an addict. Addicts, even once they're sober, consider themselves to be addicts their entire life. Any day they can fall off the wagon, even after years of sobriety, so they're constantly vigilant. I look at my depression the same way, only not doing the necessary things that keep me well is my version of falling off the wagon. Just like addicts do, I try to keep my streak of "sober" days going as long as possible. And when I slip up, I try not to beat myself up and just try to start an even longer new streak.
It's somewhat empowering to gain a little measure of control over it, even if it's really, really hard. But it's also important, I think, to realize I'll always be a depressive my entire life, even if I'm not feeling it at the moment.
I'm a runner with depression. I track my mileage, diet and general mood very closely and have started to brace myself for a depressive periods after major races.
I need redundancy with coping mechanisms, and the OCD nature of distance running is potentially setting people up for a fragile system should an injury occur or low-mileage phase crop up.
I'm writing this on a recumbent bike. I've averaged ninety minutes a day for four years without injury. I've also read a ton of books on my kindle.
Mere therapy isn't everything, but neither is only taking care of the non-brain parts of your body.
Sorry, not a grammar nazi, this one just always makes me grin :)
As an example, consider the following author’s self-cure for his bipolar II:
Sounds pretty easy and awesome, right?
Then, read his follow-up several years later:
In particular, notice the change in tone of his writing. Very different people speaking in each of the articles.
I want to point this out because mood cycles can sometimes last several years, and bipolar sufferers are at a higher risk of suicide. It’s not stuff that I would self-diagnose or self-treat.
But your point about bipolar II is really important. Taking anti-depressants (SSRIs) when bipolar can induce rapid cycling--a speeding up and intensifying of the depressed-elated cycle, which can be very dangerous, as I learned the hard way after being misdiagnosed. Bipolar II is often treatable (I'm deeply grateful that mine is), but with different approaches and medications than depression.
Let's fix it by being more specific, so we don't accidentally cause any more problems: "daily moderate-intensity cardiovascular exercise" (or, if you prefer, "resistance training 3x week"). Or even, "a healthy level of exercise".
I agree that therapy is a good idea, but you shouldn't need a therapist to figure this one out. A reasonable amount of exercise is good for pretty much everyone.
People with clinical depression aren't those who _can_ easily hit the gym for that dopamine rush. "Some sport is usually not a bad idea" is not the hard part, getting to the point where it can be implemented is.
And if that is the problem, and none of the pep talks on hacker news over the last few years helped, why not try the therapist?
"People with depression aren't those who can easily just hit up a therapist and continue going and get well. If that's too much of a social burden, why not try just going for a bike ride?"
I never said not to do sports (neither did the article: it merely pointed out that telling people to "_just_ do sports" may not be helpful) and I never tried to sell a silver bullet.
This is unlike the inevitable influx of comments in the style of "ignore therapy, just imitate my sports routine, and if you can't, just try harder". Those appear under _every_ depression-related submission on hacker news.
Those comments are harmful: therapy already comes with stigma, so it's not the obvious route - unlike, as you can see here, sports. Everybody proposes sports, healthy eating habits and regular sleep (btw: what about the depressed who can easily sleep 20 hours a day, should they just get one more nap?).
Reinforcing the stigma around therapy discourages folks from taking a route that might help them.
The "just try harder" angle that's all too often seen in such comments is also harmful: What do you think did those people do (often for years) before they consciously consider that something might be wrong with them? Exactly: they buckled up and tried harder - and they will continue until they crack unless something changes fundamentally.
This is not accurate, depression is just not clear cut like that. A depressed person can be fully high-functioning from the outside, even...
Quite a few people don't exercise for other reasons (time, aversion), in fact, I'd say those are all much more likely reasons than depression, but may also lead to depression.
Like any sickness, you talk to a health professional and figure out what treatments work. Going your own sucks and is a bad time regardless of how highly-functioning you are.
I can recall clearly what it would have been like (for me personally at least) were I in a strongly depressive state: I'd read the comment warning me about exercise, then I'd be afraid to exercise at all.
By framing exercise as a risky behavior based on a few exceptional anecdotes, the poster does depressed readers a disservice. It's relatively established that depressed people are more risk averse in general, and exercise also has well established benefits in treating symptoms of depression (I shouldn't have to cite sources for this one). The benefits far outweigh the risks.
"Ok, if you say so" and "of course". But the general advice to do some exercises and the advice to exercise "to counter depression" are two completely different things.
I'm trying to be as neutral as possible here: If a friend of yours needs help, please don't tell them that they "shouldn't need a therapist to figure [out a way out]". Psychology ain't an exact science even though most "science journalism" wants you make to believe that. So, whatever "wisdom" one picks up, treat it with a grain^Wbag of salt.
EDIT: parent was edited the substantially & while my principal response still holds, I would not even have responded to a response as hyperbolic as the parent is now.
Lots of people have unidentified health issues. Underlying health issues can cause low energy, which can be mistaken for depression.
Maybe you are both right!
If you have depression, and regular exercise and good diet doesn't help you, look for other solutions.
Too many people assume that getting the right balance of both will solve the problem, so they keep tweaking and tweaking the wrong solution.
It's like saying "Don't eat salad, I know someone that ate so much lettuce they got sick."
Which is dead wrong. Exercise is good for humans, depressed or not.
You also said, "Before I turned twenty I met two people my age who took your advice and exercised until ambulances had to pick them up (literally). "
...apparently as a warning that exercise is dangerous. But as you can see, it's a ridiculous statement.
Sure, people should see a therapist. They should also exercise. Go for a walk. Move around. They should also gain some sleep discipline. Those are easy to start with. There's no mutual exclusion here. Just because someone is exercising and sleeping right, does not mean they cannot talk to a therapist.
Generally, hopefully, most people will do exercise more or less "right", but this is not a safe assumption.
Quoting the UiA, "One  study indicates that 70% of therapists had seen for treatment at least one patient who had had sex with a previous therapist. Of the latter, 96% were male." 
I guess the moral of my comment is - be careful giving advice (period)
This explores the topic in a more meaningful way, and links sources.
Running is weak also, but insomuch as all you can do is fight and claw your way out of depression[^], long runs, in my experience, can aid to some degree.
[^]Which may very well be a symptom of something(s) we don't understand yet, rather than a disease.
For me, it was months jobless and isolated at a parent's house in the middle of nowhere.
For others, not battling means not getting out of bed, and for people facing other "demons" (what a bad word) not fighting might mean to continue to consume drugs or alcohol, or to keep not eating, or eating too much.
For me, it goes "I'm feeling depressed. Okay, I feel depressed. That's interesting. Now what is it that I must do right now at this moment? Get out of bed. Okay, done. I'm still depressed, but what's next?"
In other words, I don't bother fighting it or avoiding it. I just acknowledge it and then figure what needs to be done next.
To me, that is fighting.
Could be this is a cultural problem. In our culture we’re supposed to like work and everybody is expected to shut up.
There's a difference between psychologists and psychiatrists, and the article even spells it out.
"I can't get out of bed"
"You should exercise"
- Magnesium has been shown to improve „untreatable“ depression, and for me it does wonders. I use it transdermally because oral Mg gives me diarrhea. This can turn my mood around 100% in minutes.
- Near Infrared light is generally really really good for you, and I expect it to become a standard (or at least auxiliary) treatment for many diseases. Most studies have been done with LLLT (lasers), but literature suggests that standard LED diodes work almost as well, at least for cells at the surface. Buy a 850nm CCTV infrared floodlight and point it at various organs and your forehead; and buy some 250W infrared lamps, screw them into a wood board and sit in front of this for a couple of minutes naked. Add sthg like the Vitalux lamp for the extra Vit D kick. Insta mood and energy improvement that lasts up to several days—it feels like having been at the beach.
- If you are a low serotonin type, you could get your md to prescribe serotonin tablets (I haven’t), but in the meantime, dark chocolate could also do it. The crucial thing though is to keep the supply steady. I have to wean off the chocolate after a few days.
- PEMF (haven’t tried that yet) has also been reported to work: https://www.ncbi.nlm.nih.gov/m/pubmed/20385376/
There is a PEMF device called ICES that is affordable (about $400 last time I looked).
"sleep, proper diet, exercise" are necessary, but may often not be sufficient. Medication, when assessed by a qualified psychiatrist may be required. Therapy (if the depression is due to an event in the past) may also be required,
Finding which drugs work for you is hit or miss; finding a therapist who can guide you is also hit or miss; they can take time. But please don't dismiss medication & therapy. They are often required for many people.
I've just noticed that sleeping, proper diet, and exercise are things that just keep me in motion. I guess one way to cope is to just build momentum.
At the very least, I can say that I feel satisfied about things that I've accomplished, even if I still don't feel great about myself. And that is at least enough to keep me getting out of bed every morning instead of moping around.
I think it depends on how deep down the hole you are, plus clearly some things work better for others.
I'd highly suggest that people look at mindfulness based cognitive therapy. That can build the tools that will make it possible to get back on track. It can also make a huge mental difference to bring people from "kinda sad but doing ok because of good sleep/diet/exercise habits" to actually being able to enjoy life.
I bike commute and also work out before work every day, but I can't say it has a particularly large effect on my mood.
My darkest days were long before I drank; then again, adolescence is a particularly hard time anyway.
I can say, though, that making these changes at any point in my life would have been a vast improvement. Sleep and nutrition help me view life in a much better lens and exercise gives me a structured, constructive outlet and scheduled time for reflection.
People mean well, and I never try to belittle people trying to do good, but in these situations people project their own feelings and motivations and then declare what needs to change in the other person's situation. But physical exercise and taking the trouble to eat right itself is a major barrier when you find it tough just getting out of bed.
It is essentially saying "stop being depressed and you won't be depressed".
I think diet and exercise can do wonders for mild and maybe even moderate depression but the odds that it can cure severe depression are very, very small. It's dangerously simplistic to say "you just need some exercise, man."
I've been writing an article in the past few days that explain why movement is so critical to fighting depression.
Still, this author's experience resonates with me in the sense that I get that taking drugs is a way to fix the depression problem.
When depression is that crippling and intense, it just doesn't seem like any one thing can help. Like you said, it's baby steps, and if drugs and therapy are on the menu along with exercise and nutrition, then all the better.
At some point, I'll be exploring the really hard causes of depression, those that come from society's own anguish.
In any case, being personally fit will add immeasurably to your mental fortitude, and events that would otherwise bowl you over won't.
Looking back on it from my thirties, I've come to the conclusion that most of my problem was disturbed sleep patterns, and the rest was unhealthy thought patterns that became self-perpetuating.
Medication didn't help me in the slightest, just made me worse. Getting some sleep and engaging with the world around me is what made all the difference. I'm skeptical of the value of anti-depressants, and some of the side-effects are deeply troubling.
The problem is that when I was in the midst of a depressive episode, I wasn't capable of fixing those things. Telling a depressed person that they just need to think happier thoughts, get some sleep, take a bath, go for a walk is utterly pointless.
I KNOW continuous exercise helps, however outside of the above forced circumstance I'm suspicious at this point that I exercise when I'm feeling better and not the other way around..
That's the problem people without depression don't necessarily understand; feeling good often precipitates exercise, and feeling bad often precipitates lethargy. Lethargy so bad you can feel it. I mean REALLY feel it. You can actually feel this lack of motivation working against your desire to do stuff. It's identifiable, experienceable, and yet so oppressive you can't work against it. I would liken it to people freezing in a life-or-death situation; it doesn't make much sense and you wouldn't think it would happen to you, but it's right there and real for no good reason.
EDIT: I would be happy to answer any questions about how depression/anxiety has affected me or my thoughts on it.
I used to say to myself "just put your running gear on. You don't have to leave the house. But you can put your running gear on".
then "OK, now go outside. You don't have to run. Just go outside"
some days I would turn around and go back in. And I've have to be OK with that, too. No point beating myself up for it. Some days were not running days.
once outside, I'd be "OK, now run to the end of the street". If I could do that, then most of the time I'd be off and could do 5 km's.
Some days I'd get to the end of the street and stop.
The temptation to beat myself up for the bad days was immense. Huge. Everything in my schooling and upbringing told me that I should just push through the reluctance and "just do it!". But for me, down that road lies worse depression. Being able to say to myself "today is not a running day, and that's OK" was a path out of the intense self-criticism that got me depressed in the first place.
It didn't help that exercise had been used as a punishment in school - "you boy, you're late, run twice around the field!". My schooling had taught me that exercise was punishment. I found it hard to run because I felt like I was punishing myself for something. But if I didn't run then I would criticise myself.
I've got a better handle on it now. Some days I run. Some days I don't. It's up to me. I enjoy running, and enjoy how it makes me feel, so I do it more often than not. But if I don't want to, I won't, and no-one has the right to criticise me for that. Not even me ;)
- Regular good sleep. Go to bed and wake up at the same time every day.
- Good exercise every day. This will help with the sleep too.
- Eat healthy food on a consistent schedule
- Avoid alcohol
- If you don't get much sun, check your Vit D levels and take supplements if needed
These things will almost always make big difference. If you're still strugging you need to see a psychologist or try some medication. Medication is hit and miss so you'll probably need to experiment with different types to find something that works for you. And of course some people just don't respond to depression medication at all. Cognitive behavioural therapy is often helpful and there are other therapy options too.
Depression is multi-faceted and you will usually need a variety of treatments to get the best results.
Some people recover and go back to normal, but many sufferers will have manage it for their whole lives.
The only thing I really do on that list is avoid alcohol. If I am in a good swing, I can sleep at regular times, but I don't exercise. I eat whatever is around really, and in severe down times I've been kicked out of college or lost jobs because I couldn't leave bed to eat or use the bathroom until it was unbearable, let alone leave my house. I also normally ate around a meal a day, at 5pm or so and might have had some apple slices, grapes, or something similar before.
The only thing that has ever helped is medication. I have bouts of severe paranoia & hallucinations, but haven't mentioned it to anyone. Lamotrigine & Methylphenidate have been the most helpful, taking me from 5-15% functioning on an average day to 80% or higher. That's worked for me for 5-6 months, but over a month I noticed that my methylphenidate became less effective, and to improve it I had to redose during the day. This was a self-medicating (horrible, i know) method, but then it came to me running out of it for the rest of the month (10 or so days.) So I was low functioning then, but I still had my lamotrigine, so I was around 30%. Then I got my refill and started my day out, and ended up feeling nothing... So I redosed, and still after an appropriate amount of time felt nothing. I kept redosing for the next 40 hours until I had taken 500+ mgs of methylphenidate. I even spent time researching and turned it into IR methylphenidate, and even boofed 81mg of it at one point. Not my greatest hour. I finally passed out at about 60 hours or so, thank god. Then I woke up and realized what happened. That was yesterday. I'm still trying to find out what to do. I've been looking for people with my combination of bipolar II and adhd for input, but I fear that with my hallucinations and paranoia that have come and gone my entire life, there may be more wrong. I don't see an issue with upping my dosage of methylphenidate, but swapping to another med is what I feel may be a better option, but I also fear that my condition will worsen, as only the combination of methylphenidate & lamotrigine helps. I've been considering dexmethylphenidate, but definitely am trying to find more answers.
Exercise itself has never produced results for me. Generally, it meant I was still stuck in the house doing something I hated. I haven't always had the luxury of going on regular walks or anything like that. I don't get a rush from being physical. Until recently, I couldn't even afford sports bras for running. Without the bras, anything too "jumpy" was physically painful. (I wear a special size, even when thin like I am now, and they generally cost between $60 and $100 when I can find them. Pre-internet, I simply couldn't find them).
All this said, having better physical health does help a bit. But eating well and feeling some pride that you've changed your diet for good? Yeah, that has benefits. The hardest part was finding the combination that worked for me (mostly vegetarian with the exception of fish). Losing weight? Yeah, that had definitely helped (I, too, have lost a great deal of weight and kept it off for years). Walking as a main form of transportation? That is my physical activity and I take some pride in being able to do it regularly. I still hate exercise for the sake of exercise, though.
It definitely wasn't a cure at all - that took actually changing my life. And it was hard. And i'm gonna guess that your exercise was a combination of things - like being able to use the coping mechanisms better. Simply growing up (I started a lot of my life changes in my late 20's, and I'm 39 now) I got out of a bad, stressful relationship with a schizophrenic man. I learned that a lot of the negative feedback I had gotten from others over the years wasn't necessarily true and the few friends I have are positive influence. Heck, I actually have a couple friends that aren't family.
Some of it was pure luck - I wound up moving overseas to a place that I fit in better than I did in small-to-medium towns in the midwest. I'm able to completely be myself at home: A weird bisexual artist that spends a lot of free time at home. I learned how to relax.
Admittedly, I'd not recommend some of what I've done to folks since I'm pretty partial to hallucinogens and visit Amsterdam every once in a while, both with my spouse and by myself. I'm gonna guess some of my crap wasn't depression, though - I completely understand why MDMA is seeming like a wonder drug to the researchers. I had a marked change in thought process after doing it once. By the time I tried it, though, I had already come a long way.
- Catholic: adoration
- Protestant: centering prayer
- Buddhism: Zazen
- Islam: contemplation
A friend who had been through something similar recommended the simple fix of sleep, diet (basically just more plants, more animal protein, way less sugar, and way less alcohol), weightlifting, and sunlight. After about a year or so I felt completely fine. I look great, feel great, and my career is back on track. It's obviously just a single person's experience but I'm inclined to believe the majority of "depression" cases can be fixed by this.
Furthermore, treating it as a disease rather than just a bad mood made it _way_ worse, as I was able to rationalize the fact that my life was crippled by it and that was ok because it was a disease and my hands were tied. Once I treated it as something I could fix I made vast improvements.
I don't know that I'd say I have a source of depression, I'm not sure my circumstances have an effect.
So far the only thing that’s actually worked has been staying busy/productive/creative, good nutrition, exercise etc.
Everyone always tells me I’m an insensitive dick when i suggest getting off their ass and doing stuff to treat their depression. But fuck it, that shit works. Yes it’s hard to get started and your depression makes it even harder, but that is literally irrelevant, you gotta do it anyway.
And yes dear downvoters, I will never stop saying this: Changing your lifestyle to treat depression works. If enduring your downvotes helps me get the message to at least 1 person, worth it.
And to the common criticism that "Oh you just had teenage depression that doesn't count". The scars all over my body that I get to look at for the rest of my life disagree with your "just".
It might take a long time to build up but the hardest part really is the first part. Hope this helps someone :)
I did (and am still doing) all of those lifestyle changes and it didn't help me in the slightest. So much for that theory.
Not that people shouldn't try lifestyle changes but they are not the magic cure-all you're selling them as.
And as other have pointed out, depression isn’t super curable, it’s more like going in remission. I liken it to addiction as well. Stop doing the things that keep it at bay? Boom there it is, comes right back.
Just like an addict makes an active decision every day to not do their thing, so too must I actively do things that keep the depression away.
No magic, just hard work,
The biggest screw up we all make about mental health is the assumption that the thing that works for one person is the thing that works for another. I would have hoped that someone who has been through treatment would understand that, but here you are spouting the "get your life in order and it'll all be dandy, it worked for me!" crap that's so unhelpful in the first place to people with mental illness.
Everyone is different with this stuff. Everyone needs different treatment. You are not a mental health professional. Do not say shit like this and not expect to be called on it.
No it won’t all be dandy. But it helps.
Or at least it’s what I’ve seen help the most people I know who are or have been depressed. At the end of the day, the main thing to do is to not give in to depression.
That thing wants you to sit on the couch and feel sorry for yourself. That’s like one of the main symptoms. Fighting that urge helps make it go away eventually.
I mean, shit, even the super-OP, Zach whose post we're commenting on, said that he had to keep taking meds and going to therapy for a few months before he saw results. Do you think doing it just once then saying "Fuck this shit, this doesn't work for me, therapy doesn't work. I tried it and it did nothing". Do you think that would've worked?
The day I stopped viewing myself as an ideality rather than reality, the day I realized everything I thought, felt, believed, and did was me and absolutely none of it wasn't, was the day I found an ability to change instead of deny.
Also, I'd say it is very easy to approach this with a defeatist attitude (consciously or unconsciously) if you have a belief that you are sick. Only time can fix a broken bone, so if your mind is broken, can you really change it - is it a futile effort to try?
Don't listen to a nut on the internet, though.
I can’t imagine you think that’s reasonable... I think it would be more helpful if people stopped throwing this sort of advice around like it’s useful to people
I’ve argued things like what you’re arguing before but really I was just afraid to think otherwise, could you be feeling the same way? I don’t think that’s a sustainable strategy though so here I am, arguing the other way. It was harder to think that way than this - less natural
Yeah you're probably right.
I guess what bothers me about the whole thing are the 2 or 3 years of my life I spent vehemently disagreeing with everyone who gave me This Advice and telling them that it doesn't work and they need to fuck right off. Then when I actually legit gave it a chance, it worked.
Maybe I just got lucky. Maybe the therapy worked more than I think and it's what enabled me to give This Advice a chance. I'll never know, it's not like I can A/B test.
Your tips are a little insulting to someone truly suffering. There is a difference between feeling bummed out to feeling like you shouldn't be alive any longer.
It's been a bit under three years already; no joy.
Your theory just plain doesn't hold water. Sure would be nice if it did, though.
People with major depression want to kill ourselves anyway. I don’t really see any style of tempered advice as being harmful in itself. What’s really harmful is socially pressuring anybody to stick to any approach they find to be harmful for themselves.
Going to a mental health professional requires time to see results. It also requires being with the right person. Medication won't instantly make you feel better (for longer than the short term), it requires the correct dosage, correct type, etc. The "working out, eating right, plenty of sleep" method may show results but it also takes a lot of time and persistence to see those results.
I am not saying that any of these solutions will work for everyone. I am just saying that any of these solutions takes trial and error. Some people go see a therapist once, don't make a connection, and declare that it doesn't work for them. It will take time. It is a process. Again, everyone is different and need to find what works for them, but whatever it is, they need to stick with it. I know it can be overbearing, but it comes from a place of compassion and concern. No one who cares about you wants to see you depressed. How would you prefer that they approach it?
for you -- you have no idea whether it'll work for anyone else.
Since depression is a potentially fatal illness, and you appear not to have any training in psychiatry, psychology, psychotherapy, medicine, pharmacology, you should maybe recognise your limits.
> Changing your lifestyle to treat depression works
Only for some people. you have no idea how many people it does work for, and you have no idea how many people it doesn't work for, so you might want to avoid judging people who don't take your advice.
I was sleeping, exercising, eating well, just fine. My life was in order.
Starting to take an SSRI literally just switched off my mental illness.
> Exercise is moderately more effective than no therapy for reducing symptoms of depression.
> The reviewers also note that when only high-quality studies were included, the difference between exercise and no therapy is less conclusive.
> The evidence about whether exercise for depression improves quality of life is inconclusive.
Exercise is moderately more effective than a control intervention for reducing symptoms of depression, but analysis of methodologically robust trials only shows a smaller effect in favour of exercise. When compared to psychological or pharmacological therapies, exercise appears to be no more effective, though this conclusion is based on a few small trials.
Sleep, eat well, keep active. Nothing about that advice is dangerous. But it is hard to do if you aren't in the habit of doing it. (I know what you're going to say next, "but chemicals in the brain!" What do you think sleeping, healthy dieting, and keeping active are trying to fix?)
As far as I know, outside of crappy studies it's rare for a single intervention to even work for a majority of compliant patients/clients, let alone everyone. This is probably related to the notion of "depression" actually being multiple illnesses that share a common syndrome.
except if the response to "I tried, but it doesn't work for me" is "your depression makes it even harder, but that is literally irrelevant".
Your parent post didn't leave enough room for "try something else, but don't forget these once you're fit enough".
In my experience dealing with depressed people, me included, there’s a huge spectrum in what “tried” means.
Doing it once won’t help much. Forcing yourself to consistently do it every day for 2 years? Now we’re talking.
If after 2 years of doing things that are known to up your spirits in at least some segment of the population every day you still don’t see absolutely any results, then you get to say it doesn’t work.
After all, you wouldn’t expect antidepressants to work unless you take them every day.
If you’re on meds and some days you feel like taking them and others you don’t, and you actually follow that schedule. Do you expect those meds to work?
It’s not the trying and it not working that doesn’t matter. It’s the not feeling like doing things that doesn’t matter. Gotta do it anyway. Whether it's exercise, taking meds, or going to therapy. If you don't do it, it can't help.
>if you’re on meds ...
Have you considered that the people in this thread saying it doesn’t work aren’t just saying “it’s hard”?
67% of college kids are suffering acute anxiety, is 67% of the college populations only problem a lack of excercise? Your insistence on these things is frustrating and obnoxious. The people who called you insensitive have very good cause, I hope that doesn’t make you proud.
Also, is discipline even a good thing? Do you think cave men said “well I have to hunt 5 hours a day...”? Probably not, or we wouldn’t have agriculture. Discipline seems like a substitute for ludditetism.
Also! Advice like this live and die by how hard they are to follow. If your advice is so hard to follow for te depressed that they won’t do it, it’s much harder to be proven wrong.
Sorry to rant but this advice is upsetting to me.
Yes I have.
My attitude is probably influenced by personal experience in dealing with depressed people. So far every time I’ve been observing someone long term, and they said “it doesn’t work”, they rarely kept at it for more than a month at a time here and there.
It is possible that everyone in this thread is different and kept at it for a long time consistently and it didn’t help.
And I never said “only exercise”, I said Do Things. Hang out with people, work on projects, make art, enjoy friends, go to a bar, see a movie, travel. Whatever as long as you’re not sitting on the couch giving in to your depression.
> this advice is upsetting to me
People I love sitting on the couch rotting from depression is upsetting to me.
I have a genetic disorder. It was not properly diagnosed until I was nearly 36 years old. So, I spent the first 36 years of my life hearing that I was just lazy and not trying hard enough.
You being unable to fix someone else by brilliantly suggesting what worked for you is not definitive evidence that they simply aren't trying hard enough. That underlying attitude is monstrously arrogant and insulting to other people.
The world does not revolve around you. You being upset because someone else is "sitting on the couch rotting" does not give you the right to harangue people until they prove your pet theory correct that they just need to try harder.
You can't claim that sleeping, eating, and exercising are "fixing" chemicals in the bain any more than people can claim chemical imbalance causes mental illness. There is no baseline for what normal chemical levels are.
No, the medical community calls it "evidence based medicine".
I've posted links to well run meta analysis by an organisation widely regarded as providing the gold standard for medical evidence.
other people are posting "it worked for me" - exactly what we hear from people who try crystal healing or homeopathy.
> Sleep, eat well, keep active. Nothing about that advice is dangerous.
Depression is a potentially fatal illness. If people are not getting evidence based treatment because they're following advice from people who don't know what they're talking about, those people may become more ill, and they may find it harder to seek help, and they may then die by suicide. suicide is a leading cause of death in men under 49, and in all people between ages 20-35 (in UK, and probably in us if they used same definition).
> (I know what you're going to say next, "but chemicals in the brain!"
A lazy assumption, I've never said "brain chemicals". I've always said "bio-psycho-social".
Disclaimer: I'm not a doc, don't take my word on anything or listen to me.
Exercise makes you eat differently and sleep out of exhaustion earlier, you also wake up a bit sore but somehow replenished; which makes you seek slightly more active things.
I found those to be the most useful.
As far as breathwork, fitness is almost a form of meditation for me so I think there's some overlap. Running and lifting gives a lot of inner monologue and self reflection time.
If you do experiment, avoid the enthusiast's trap of trying to sample as many different cocktails as you can. Whether it's a maturity or a cultural thing, there are many temptations to 'max out' on the intensity of the experience, which I think are unhelpful.
As for the therapy aspect, it's wiser to dose with an experienced person present who can help you if you feel distressed, but if a therapist is proposing to script the whole trip then it won't really be 'your' trip any more.
Breathwork < > fitness. Breathwork, specifically Holotropic Breathwork, was developed by an Md as an alternative to LSD psychotherapy after prohibition began.
I'm happy to discuss more privately as I know these things can be very personal.
It’s also a good excuse to get out of the house, do minimum socialising and just observing the world around you. No expectations like performance measures and salaries either - your job is to just give a little.
Thankfully it's not an issue for me anymore, but those "fixes" were total crap (for me) when it was.
Are you sure you are not one of those people who confuse being moody with clinically depressed? Self pity isn't really high on the list of symptoms.
For instance my understanding of clinical depression is people often have suicidal ideation. I had that, would imagine throwing myself out a window, down the side of a mountain, etc. But I never would follow through because I noticed how my depression filtered my view of the world, and once the feeling passed things did not seem so bad. It would be horrible to make such a final decision as suicide, since it guaranteed my life would not improve, even though my depression told me it never would. Plus, believing I could go to hell for suicide helped keep me from doing it, and concern for how it would affect those I love. Finally, it seemed like such a selfish decision.
Clinically depressed people are numb for life, they are not wailing in self pity.
Depression makes it hard to do anything and can be rooted in other issues that physically make it hard to do anything.
Some people find their way out, but there is a reason why the doldrums has come to have the meaning it has.
The doldrums is a colloquial expression derived from historical maritime usage, which refers to those parts of the Atlantic Ocean and the Pacific Ocean affected by the Intertropical Convergence Zone, a low-pressure area around the equator where the prevailing winds are calm. The doldrums are also noted for calm periods when the winds disappear altogether, trapping sailing ships for periods of days or weeks.
Just like sailors once got stuck due to lack of winds, people with depression sometimes just get stuck. If they can find a means to get unstuck, awesome! But we don't know how to readily fix this. We know some things that sometimes help some people. But there is no slam dunk solution guaranteed to work.
The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.
And here's a longer excerpt from the book that includes the quote, with some discussion: http://theviewfromhell.blogspot.com/2011/04/elements-of-suic...
Imagine that you met a friend you hadn't seen in years. They seemed really down, and you ask what's up. They say, "My job is to collect tolls in a tollbooth in Alaska. For 9 months a year it's freezing, and the heater breaks every day, and I'm stuck outside wrenching on the thing with one hand while Googling "how to fix a heater" on my phone with the other while I slowly lose my fingertips to frostbite."
Now recall a few weeks ago when someone posted an interesting article about a board game full of ridiculous, fiddling little rules that would take years and years to complete . The reason no one has ever played this game through is not because there is _no way_ to play it through. It's not because a reasonably-intelligent person would be _incapable_ of coming up with a strategy for getting through the game. It's because so far, no one has thought it worth that time. There's no payoff.
When you talk to a depresssed person like me, you are talking to someone whose body is that tollbooth, and whose life feels like that game. You can say "exercise." You can say "talk to someone." But when you say those things, you are describing a strategy for getting through a 1500-hour board game with no payoff. You are describing to me how to fix a heater in a toll booth in Alaska where I may be stuck for maybe the rest of my life, constantly worried that the damn thing is going to break again.
So please, please, use that understanding when you talk to someone like me. Empathize. You can do that. You can say "that sounds awful." You can say "If you want someone to talk to I'm here." You can even say "Hey, let's go to the aquarium!" But be really, really careful about saying "go exercise" or "go talk to a therapist" and never, ever say it's going to be ok.
Will it help all depressed people? Of course not. But by saying be careful what advice we give because it might not apply to you is not a strong enough argument to stop giving this advice. There are undoubtedly people out there that think depressed people should just "get it together" and that way of thinking is not a constructive way to approach this at all. But it is also not constructive for people who are tyring to help (and whose job it is to help) be forced to parse every word they say, scared of recommending something that could help, just because it might hurt feelings. There is a fine line here, of being sensitive and being helpful, and I understand your point and how it can be tiring to listen to people who think they have all the answers to a problem you have suffered from all your life. I have also hung out on r/depression long enough to know there are people who could be helped but have convinced themselves (and others have convinced them) that they are unhelpable because they are depressed and that's that. That is not a healthy mindset, even if that is the case.
In my own experience, the people I love offer me support in many ways. Sometimes they listen to me when I'm having a bad day. Sometimes they ask if I want to go to the gym with them. Sometimes they just check in with me so I know they're there. Those are all kind things, and I appreciate them. But there are two caveats:
1. Those are people I love, not strangers on the internet. They have earned my trust and my attention and consideration. It's not impossible to do that to some extent as a stranger on the internet, but the way to start is by listening and asking questions, not by prescribing things.
2. Even when offering help, my friends are mindful of my feelings. There is a world of difference between "hey, do you want to go to the gym with me?" and "you seem depressed, you should try exercising." The former is an offer of companionship and encouragement. The latter is an alienating statement ("I can tell that there is something wrong with you") and an invitation to self-consciousness and guilt.
I guess what I am saying is: most people who are depressed have probably already considered the possibility that diet, exercise, and therapy might help. Before you recommend those things, you should consider whether the circumstances really make you the right person to offer that advice.
You, an individual commenting on Hacker News, might have already considered that diet, exercise, mindfulness and therapy might actually help, but believe me, many people out there don't consider these factors and don't know the overwhelming scientific evidence out there showing their benefit. In fact, the author of the blog post that we are commenting on himself said it took him a while to get around to therapy. Sometimes it takes uncomfortable prodding to get people to do things. Like I said, it doesn't work for everyone, but it has for enough people that I will always make sure to recommend it and make sure eating healthy and having an active lifestyle is something that is prioritized because the myriad of benefits it provides.
Do you see the value in advocating people prioritize their diet, sleep habits, exercise, and mindfulness more (while also trying to provide tangible ways they can do that)? Do you see the value in making it seem OK for people to go seek out therapy, and "normalizing" conversations about it? Because I notice there is still this ridiculous stigma many people have when it comes to seeking help for mental health, which prevents people from doing so, or even having conversations about it. And having a conversation about it is all I am trying to do here. I hope you have noticed that throughout this discussion I never gave my advice to you or anyone else on how they should deal with their depression.
Then I read an article about the microbiome of dirt . In the moment I read this on my smartphone I sat in the grass on a hill and I thought to myself, fuck it, what can go wrong, I'm going to stick my finger in dirt, put it in my mouth and eat a little bit of dirt. And that's what I did.
I don't know if this was what changed my mood, but what I can say, that my mood was changed in less than a week.
All the best to you.
I get it if you like the idea of doing psychedelics, but they are mind-altering in significant and poorly understood ways, and can easily cause others harm - even if you feel they've done good for you.
Pilot studies and clinical trials are being done and more prepared  for treating treatment-resistant depression with psychedelic therapy and there is a growing body of literature suggesting it really might be a significant help, we are not just there yet.
 A relevant quote from: Robin L Carhart-Harris and Guy M Goodwin, The Therapeutic Potential of Psychedelic Drugs: Past, Present, and Future:
"However, there is an important corollary to the continuing illegal status of psychedelics. It seems to me paradoxical, even incredible, that such drugs should not be available for medical use in conditions for which euthanasia is already available. In Belgium, neuropsychiatric disorders were first reported under euthanasia legislation in 2004/5. Of the first such 100 patients considered for euthanasia between 2007 and 2011, 58 had depression. Forty-eight of the total were accepted for euthanasia (35 completed) and 6 others had died by suicide within 12 months from the end of the study. Most patients were female, aged 40-60 years. Euthanasia for psychological suffering is similarly available in the Netherlands and Luxemburg."
This is just the beginning of rigorous research into psychedelic therapy. We don't have good non-anecdotal data on how it treats depression yet, but we'll get there. And the data is compelling enough so far that to completely dismiss the entire idea is closing your eyes to very valuable tools that we're just beginning to understand.
Furthermore, in a scenario where one ends up in a "full blown existential crisis", it's likely that one did not undergo psychedelic therapy, one merely took psychedelics.
Finally, just because you have an existential crisis doesn't mean it didn't work. Sometimes that's part of the healing process. Just like with physical therapy, our wounds can make certain movements painful, and we make them natural again through deliberate practice.
I've seen people say that a non-trivial amount of time in threads like these. It could work, but that's a huge gamble.
1) Address any known health issues you have.
2) Dietary changes. There are studies on this.
3) Problem solve. If you are depressed because of terrible personal issues, work on resolving them. (The article mentions that a run won't pay his bill or fix other problems. Overwhelming problems are a legitimate cause of depression.)
4) If you are suicidal, seek company. If you know someone suicidal, spend time with them.
You do not necessarily have to talk about their suicidal ideation or the problems causing it. You can play games together, have lunch, be pleasant. Suicides generally occur alone. Just physically being there goes a long way towards preventing suicide.
If you do want to help them, help them fix problems. Feelings come from somewhere. Just massaging emotions does not work. Do not "help" them by preaching at them ("Just go for a run!").
You think to yourself :
"I am hitting the gym three time a week. I've not eaten any junk food in months. I meditate and sleep full nights.
Why is everything still seen through a haze?
What am I doing wrong if everything should be fine? Am I broken? Who would want to speak to me. I am a fraud. I look healthy but I'm a husk of my former self. Everything is so exhausting."
I have no answer as to how to deal with it. All I can say is that cookie cutter answers rarely apply and can even make someone miserable.
I rarely suffer depression, but I have a genetic disorder and other serious personal problems (such as: I just got off the street after 5.66 years on it and I was molested and raped as a child). My medical condition sometimes causes me to become suddenly suicidal. My two adult sons, ages 30 and 27, make sure I am not left alone when I am suddenly suicidal. They know other things to do, but a big thing is we just do not let me be alone when I am at my worst.
Getting healthier has reduced the frequency and severity of my bouts. Figuring out how to make money online so I can be functional in spite of my genetic disorder empowered me to get off the street. I am still quite poor in terms of overall income, but I have some pieces in place for my life that are usually reserved for only the very privileged. It is having a positive effect on my mood and mindset.
I am still stressing about money and I still have days when I get nothing done, but my life is vastly better than it has ever been. I am 52.
So, I am speaking from firsthand experience, in some sense. I don't suffer depression per se, but I do wrestle a lot with frequently being suicidal. It often comes on suddenly. It always involves whackadoodle brain chemistry, a side effect of whackadoodle body chemistry. I try to put out useful information to the best of my ability. I do my best to couch it in nonjudgmental, non-blamey terms.
Like most things in life there is no silver bullet. Just running / working out won't fix everything. But it's a good start so that it's not adding to the issues going on. And if you are getting good results you can make it the foundation.
Really enjoyed the post though. I think a lot articles which give advice without personal experience don't ever really resonate. This one actually makes me feel hopeful.
Not sure about other countries with universal healthcare, but seeking therapy for depression in Canada isn’t exactly that much better.
Such treatments aren’t covered by public health insurance so you’ll be spending $100/hr CAD, likely more, out-of-pocket.
When I sought therapy, and this is probably due to unfortunate timing or being in an underserved city (but highly doubt it being Ottawa), I had to wait 3+ months before any therapist near me had room. By that time I had largely remedied my depression myself out of necessity.
EDIT: Realized I’m conflating psychiatry and psychotherapy with my comment. The former is covered by our system but due to the demand you’re looking at several months before seeing someone. My example of waiting 3+ months was just for a psychotherapist.
I did the program through my local outpatient, and it was awesome. It wasn't a total fix, but it did help me to become aware of some toxic patterns, triggers, and responses.
In BC there are other groups after the 10 week course that are offered during the day, but that's not realistic for most people.
Those I knew who tried to get help on the NHS were just prescribed drugs by their doctor without being referred to a psychiatrist or a psychotherapist.
It's great how open he is about it. I'm waiting until we see going to the doctor to talk about pain in your brain the same as going to talk about pain in say your colon. That is, perhaps not something you'd talk about to everyone but at least you'll be able to see someone for free in Europe or with minimal insurance costs in the US.
Despite exploring and keeping up with alternative treatments -- like therapy, CBT, meditation, regular exercise, a proper diet -- I was still anxious and depressed. These helped me manage the anxiety and depression, but they were still there, and, internally, quite overwhelming. It was a daily fight.
The only thing that eventually pushed it from 'I'm managing' to 'I finally feel okay' was medication. I don't feel like a zombie, or numb; I just feel normal for the first time in as long as I can remember. It's not something that is manageable any other way for some, and the stigma associated with medication is only hurting those who need it.
I experienced depression on and off for about 20 years, between 12ish and 34 (2016). Then shit really hit the fan, the perfect storm so to speak, and I was shattered to the core of my being and my values. Honestly it felt as though dying would pretty much be a non-event (although I'm not suicidal so it wasn't really an option, but survival instincts kicked in at some point and were all that prompted me to feed once in a while each week for a couple months; it took half a year before I even wanted to get better, to cope).
Then I read "The Obstacle Is The Way" by Ryan Holiday. This book pretty much changed my life. I guess it came at just the right time.
I underwent a sort of 'quantum change' as some psychologists call it: a profound, meaningful, lasting and massive change of my core personality and values, even thought processes and emotional responses. I am me, I mean I do recognize myself and so do my friends and family, but I am also a truly different being, it's like my biology has changed and my mind with it, or the other way around, idk. People confirm that I do look different, in the eyes, in what they feel around me. I certainly feel like my old self was flawed beyond salvation and has died on a psychological level. I feel like I salvaged as little as possible and proceeded on reinventing myself. It is still an ongoing process, although slowly stabilizing (it will be a year in December).
Overall I am now able to create from scratch all the joy and motivation I always longed for, to accept reality easily in ways that keep surprising me, and to remain positive (or neutral) in most circumstances. Nothing's perfect and that's good to me. I still have habits to master (dwelling on past circumstances that provoked this major episode last year), but it's night and day with what I used to be.
Considering what I went through before this change, and during it, I consider myself lucky, even blessed on some level (atheist here, with some scientific awe for existence and the cosmos).
Feel free to ask for more details and suggestions, I'd be happy to oblige, otherwise you know the book. Best of hope to everyone.
At the time I wad coping with life, trying to pass each day. I did not know if I would ever get better, I was in survival/automatic mode. However because of that I was blindly following advice from a few online mentors (Ralph Smart from "Infinite Waters" on YouTube, Ali from "The perception trainers", and John Sonmez from "Simple Programmer"). These three channels were my lifelines.
So I just added Ryan Holiday's precepts into the mix, no thinking whatsoever beyond trying to assimilate his Stoicism. I pretty much read the book a second time that week. Again, it clicked, it felt like a relief, soothing, I began to see that it worked on a very basic level—like buttons to control/process emotions using your rational thought. It wasn't the things I lived through that were hurting me but what I thought of them, that part became very clear very fast. Suddenly I had some degree of control, it was more bearable. So that first part was almost instantaneous (days).
Then I trained my mind further. Do note that I was as close as I've ever been to a blank slate since my childhood at that moment, because most of my ideas had been shattered by real life, real people (notably my illusions about "being good" to a woman, my values that higher moral standards do yield positive results etc; and my disease, cluster headache, was in full-blown suffering mode and attacks were related to being emotionally upset, so anything that gave me even the slightest tad of serenity was very much welcome).
Within days, perhaps a few weeks, I began to see a more profound change. I had been searching for decades for a way to control my depressive tendencies, I had admittedly real reasons to be very down at that time (grieving family members + breakup + disease), and yet I was climbing back up. I began to wonder if I had finally found a "cure".
This was days before 2017, and I decided to read books this year, a lot. Entrepreneur mindset and all that. I had read Napoleon Hill's Think And Grow Rich in November, it had moved me quite a lot as well.
The rest is history. I went to see a neurologist in February for my disease and we found a med that worked, by May I was almost free of pain and I had means to deal with attacks; I'm still finishing the treatment until November but no attack in months.
I've grown exponentially since, reprogramming my mind with the best material I could find on topics of interest to me (if you look at Tom Bilyeu's reading list on impacttheory.com, you'll get a fairly good idea).
I'm still in process of discovering this change of mine. The best proof I have is emotional. I've discovered a bunch of rather negative facts about my ex (she has sociopathic tendencies, I now see that, complete with revelations that could make more than one burst in rage or despair etc). I've cut all contact with her (she was still playing mind games afterwards). But you know what? I now choose not to be affected. I'd say the emotional shield is ~90% effective, what little feelings I have thinking of all the shit she did to me are rather empathy for her (she's a really troubled individual and I wish she sought professional help, but personally? I shrug it off, it's not my cross to bear). Believe me when I say that I would have been incredibly emotional and in a victim mindset before. Now I don't care emotionally, and rationally I dismiss it whenever I think of these years 'lost' with her. I simply accept that it's my past and I can actually feel grateful because it made me who I am today; "amor fati".
As for deaths in my family, I've accepted these too and I simply try to uphold the moral standards of these important people in my life (father and grandmother). I live true to what they gave me, I feel no sorrow, I just use this as energy to move forward in my own life.
I am still evolving, actually it's become a trait. Growth, growth, growth mindset; learn, evolve, better yourself, etc. It's a wonderful feeling. I appreciate failure for what it teaches me, I'm actually happy regardless of outcomes. I never feel sad or bored or upset, whatever reality throws at me I'm happy to deal with. I actually find it weird when people get upset at something because I hardly ever do that anymore.
Mind you I'm not perfect, not by a long shot, I still have so much to learn and live, so I find joy every day in simply living my life. I now have a purpose, much greater than myself, so it's all about that. I, personally, will be OK somehow, I know it because I will it. In that sense, change is still ongoing but I don't think it will stop any time soon. Probably when I'm dead! And that will be just, too. :)
Does that answer your question? Sorry for the delay, busy weekend. I maintain an Instagram account where I write long posts about this change, among other topics, if you wish to know more.
Yes it did, thank you for the explainer. It's a good example of the fact that changing how our minds work for the better is a multi-modal, multi-disciplinary endeavor.
Would be interesting to see if there are doctors out there who can practice a more integrated approach rather than just focusing on one avenue of getting better.
To anyone needing help, if it's easier to take action for someone else, do it for their sake. And hopefully you'll see that it's ok to have given yourself that kindness too.
I think depression is akin to a common error code in the mind (and maybe body too). If the mind is at least as complicated as the biggest program we can imagine, why should we imagine one thing will likely fix this problem?
This is like suggesting the same code would always fix a given common error.
It seems more likely to me that there are many causes of depression. While there will be many commonly effective treatments, they will vary based on context. Sometimes the effective treatment will be very specific / personal.
It very much reflects your suggestion that there are many causes of depression and many possible coping and/or healing strategies, so I am posting it here. [It just got a "that comment is too long" error message on hn, so I need to split it up...]
Hi Jennifer (and any SB Independent readers struggling with depression for themselves or a loved one),
Here is a collection of advice I've posted elsewhere for other people about overcoming depression and other forms of mental illness (or at least coping better with it). I hope this can help. I wish I had know this all when I was an undergrad at SUNY SB a long time ago. Perhaps it might overlap the readings you said a professor suggested to you.
First, remember, the brain is mostly fat. You need to be eating healthy fats (like walnuts, avocado, omega 3s, etc.) for brain health. But that is just a start on what good nutrition involves to get lots of micronutrients (more veggies, fruits, beans, nuts, seeds, whole grains as in "you can see the grain"). Be sure you are getting enough vitamin D3 (which is almost impossible for most people without supplements given our indoor lifestyle and other lifestyle factors). And get enough iodine, like from sea vegetables. And also enough high quality B-complex vitamins.
From Dr. Joel Fuhrman: "Depression doesn't have one specific cause; environmental and genetic factors may be at play, as well as psychosocial stressors, however, a major factor causing depression is unhealthy dietary factors. Fast-food and commercial baked goods are linked to depression in a dose dependent manner, and dietary excellence can be the solution for many suffering individuals. A feeling of a depressed mood can also be a symptom of other medical conditions or a side effect from a medication, so to be sure of what is causing your symptoms, you may need to discuss your depression with your doctor."
Search also on "The UltraMind Solution: The Simple Way to Defeat Depression, Overcome Anxiety, and Sharpen Your Mind" by Dr. Mark Hyman, again focusing on nutrition.
Water-only fasting helps in some cases of mental illness too (especially if brain inflammation is caused by some food allergy). The Russians did a lot of research and practice on that.
Obviously, good mood is more complex than just nutrition. Look at Dr. Andrew Weil for a broader perspective.
Or see an essay by Philip Hickey, Ph.D called: "Depression Is Not An Illness: It is an Adaptive Mechanism"; quoting from that:
"In order to feel good, the following eight factors must be present in our lives.
* good nutrition
* fresh air
* sunshine (in moderation)
* physical activity
* purposeful activity with regular experiences of success
* good relationships
* adequate and regular sleep
* ability to avoid destructive social entanglements, while remaining receptive to positive encounters"
Also, check out: "The Upward Spiral: Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time Paperback" by Alex Korb PhD.
There are lots more resources like that. There are lots of alternatives to placebo-like mental drugs...
Search also on "Sleep deprivation can effectively treat depression" for another option to consider.
Our society is also all too quick to label a "spiritual crisis" as mental illness (see Wikipedia on that term).
Thanks for your series of essays on these mental health topics. I learned something from them, especially about how depression and anxiety can cycle together, where anxiety becomes the only force that can counter depression as far as getting anything done. That doesn't mean that is a happy or health way to be -- but it is informative to understand that cycle, and in that context of depression, the "benefit" of anxiety.
As with Chester Bennington (who I learned about from the article you posted for someone else on that, leading me to your series -- and then watched his band's "Numb" video and a couple others), sometimes if we dwell on the negative, it does not really get us healthier overall. As in helping create the "Numb" video, Chester built on his strength of music and it at least sustained him for a time and helped him help others and in other ways connect with other people like with the rest of the Linkin Park band. And in that "Numb" video, one might hope for the same for the protagonist as there are certainly a lot of people out there who do appreciate art or can be moved by it or who take joy in creating it together with others.
For my generation, Robin Williams is a bit of the same symbol as Chris Bennington -- although he used humor instead of music to connect to people and to manage pain (but not totally cure it). Like all helpful drugs, music and humor can make a difference in sustaining us as we cope with pain, but we still need to address the underlying issues as best we can. And even if both artists lost that battle with pain in the end, they at least had much longer and better lives from building on those strengths -- and the community around them was much better for their long-term willingness to do what they could with what they had. While most of us may never have that level of comedic or musical talent, or the opportunities to refine that talent by years of practice, "the woods would be pretty quiet if no bird sang there but the best". Someone with even a fraction of their level of talent could make the lives of many people around them a lot better with just a little humor or song added to every-day interactions. You can also use a talent as a volunteer or as a hobbyist sharing with others even if you do something else as a day-job.
[continued in a part 2 reply to this...]
Look into "Positive Psychology" about building on our strengths -- like you are doing with your writing.
See the movie "It's a Wonderful Life" -- which, at the very least, can make us wonder if there is any chance we could make things even just a tiny bit better for ourselves and/or a few people around us by engaging with life?
There is an insightful comment by "Brian" on Hugh Howey's website under "Our Silos Leak" I saw just last week where he talks about how figuring out why you feel so badly doesn't usually help that much and may even just deepen the traumas. It is focusing on what you want, what makes you happy (within realistic limits) and taking steps toward that which get you to a better place. The comedy "Cold Comfort Farm" has an interesting angle on that.
The main essay on "Silos" is also good in talking about how it is reasonable to minimize our interactions with vexatious people (of any political persuasion) and we can still have occasions to experience new ideas and reflect on them in a less knee-jerk way. And those vexatious interactions can also include (and probably do) much or all of television, "news", and social media.
Search also on "On the Trail of the Orchid Child" for a Scientific American Article on how whether some people's genes can either be a great benefit or a great detriment depending on their environment.
We all have inclinations, habits, preferences, and reactions that can be strengths or weaknesses depending on the situation. Stony Brook itself is like a small city -- it has many different social environments that can be better or worse for different people.
Finding the right niche(s) from all the possibilities that works for you can be a bit of trial and error. But finding the best matches of groups to be part of (including from family, neighbors, clubs, classes, volunteerism, jobs, online, etc.) is essential. All of the above is much easier said than done, and it is more feasible to be healthy when part of a group of others also striving towards health. For example, if you try to eat well and you are surrounded by people eating junk food who are always offering that junk to you and denying its health cost, that just is so much harder than if you are part of a community all trying to eat healthier and supporting each other on that journey with all its ups and downs.
"Bluezones" is another positive touchstone to see how happy people live for a long time -- and a lot of it is just about getting the basics right like in the Philip Hickey quote above.
And then when things get going well (or even before), watch out for "Supernormal Stimuli", "The Pleasure Trap", and "The Acceleration of Addictiveness" (see two books and an essay by those names).
One nurse who was critical of one of Dr. Andrew Weil's books on Amazon pointed out that much ill health is caused by poverty (and I might add, ignorance, which good journalism can help dispel). Like in "A Christmas Carol", "This boy is Ignorance. This girl is Want. Beware them both, and all of their degree, but most of all beware this boy, for on his brow I see that written which is Doom, unless the writing be erased." It is hard to eat well, say, when you can't afford fresh vegetables or don't have the time or place for preparing them -- and also if you just don't know why eating healthier is so important or how to do it.
Long term, social and technical changes like from a basic income, improved subsistence by personal robotics for gardening and preparing healthy food (e.g. Farmbot or Moley Robotics), better organizational planning and governmental accountability, and more gift giving of knowledge via the internet, may help alleviate some of the worst causes of day-to-day pain and worry in the modern age. So, those can be positive changes to work for -- and working towards such things can provide some hope and bring us together with other hopeful and caring people. And underlying all of that is a cultural change and a "global mindshift" towards abundance thinking and favoring cooperation over competition (see Alfie Kohn) which journalism can help with.
And, when all else fails even when we seem to be doing everything we can, consider: "Dark Nights of the Soul: A Guide to Finding Your Way Through Life's Ordeals" by Thomas Moore for finding meaning and even personal growth in the darkness.
From the introduction: "With Princeton-praising articles titled "Jumping From the Ivory Tower", it seems like PAW [Princeton Alumni Weekly] is not helping answer these deep questions. If anything, PAW is helping bury them under inappropriate humor. This essay is not intended in any way to condone violence or the abdication of personal responsibility. But it is intended to help understand some of these issues of suicide and alienation in a university context, and to make suggestions for improvements to the social part of these issues. It even tries to use humor in relation to suicide and morbid themes a bit more appropriately (satirically about PU in this case, discussing options like its voluntary peaceful self-dissolution to help a billion poor children get an education, or its metaphorical death and rebirth as an agent of global economic transcendence to a post-scarcity society of abundance for all). It is always easier to destroy than to create, so this essay includes some specific suggestions for improving the situation at Princeton University, which is a mythologically-troubled institution (even as it is filled with many wonderful and caring people)."
One issue I explore is that the virtues of elitism, competition, and excellence that Princeton University celebrates all have shadow sides like alienation, destructiveness, and perfectionism which can lead to depression, anxiety, and a host of other illnesses from extremism (including heart disease possibly from an extreme fat-free diet which killed a classmate at an early age), such as when I wrote: "I can also hope that many of these issues at PU continue to slowly change. There is some hopeful news now and then in PAW (like more profiles of alternative alumni careers), even as the deep issues about "elitism" (alienation?), "competition" (destructiveness?), and "excellence" (dissatisfaction? perfectionism? excessive self-criticism?) usually remain unspoken."
"We want to improve public health through free and open source public intelligence tools for individual and collective sensemaking about health topics -- especially related to nutrition and lifestyle... When confronted with a health issue, many people turn to their doctor, the internet, or friends for advice. But then what do you and your family do with all the advice you receive? What do even health professionals do with all the often conflicting information out there when they research a patient's health issues? We want to create software that helps with that challenge by making it easier for individuals and communites to collect health information (from whatever public sources including the internet), organize it, prioritize it, reason about it, act on it, and feed back the results of action into a next iteration as a learning experience."
Here is a motivational example about salt intake from that proposal, but it could just as well be about understanding depression and various options as they apply in your own life:
For example, consider the question of how much salt of what type is good for a specific person (you) to eat every day? How easy is it to begin to research that for yourself? How long would it take, even with a web browser and search engine at your finger tips? How would you know which study to trust and how much -- including based on who funded them or how carefully the work was done? How could the online community help organize all that information for you? If it was organized, how would any general advice you found about salt consumption apply to your own specific situation and lifestyle and family history? Would the amount of salt you needed matter based on how much you exercised, or where you lived, or whether you went outdoors a lot, or whether you ate a lot of fruits and vegetables? How would you answer the question of whether there other health factors in play that may make some people sensitive to salt, and perhaps if you improve those, maybe salt intake won't matter much? How have opinions about that changed over time? If you try changing how much salt you eat, how should you interpret any changes in how you feel?
There may well be "experts" out there who know good answers for these questions specifically about salt, but they probably are not you personally. Statistically there might be a small number of experts out of billions of people, so most people thinking about how much salt to eat are not going to be experts. So, almost everyone is left wondering which experts to trust? Even if all the experts agree, they could still be wrong, or their general advice might be easy to misinterpret for your particular situation. And if you specifically by chance are an expert on salt intake, then you probably are not an expert on phytonutrient intake or cancer treatments, and so you would be faced with this same issue in some other area of personal health. So, there can be a gap between what an expert (or community of experts) know, and what an individual or local community knows and then acts on. Part of the value of better software tools, including educational aspects, may be to help bridge that gap between expert knowledge and individual practice.
This recently temporarily "withdrawn" article on "Reduced dietary salt for the prevention of cardiovascular disease" due to "doubts raised about the integrity of research" is an a example of how dynamic the medical publication landscape can be. Withdrawal of one article does not mean other similar articles are not valid though, or that a general concept is not valid. The research landscape can seem very dynamic and conflicted, even if there may often eventually emerge broad agreement on some truths. Could better tools help even subject matter experts track all these changes? So, whether you are an expert in a field or just an individual with a health issue, there is a challenge to make sense of this all for yourself at any point in time (even if the challenges may differ somewhat for expert and patient). It is also hard to draw conclusions from small numbers of studies in a mass of large numbers of publications on complex topics (something somewhat analogous to "weak signal detection" in the intelligence community). Yet, ultimately, each of us still personally needs to decide how much salt to eat each day (or broccoli or sugar or barley), so we can't avoid the issue (even if we can ignore the issue or any new information and just keep on eating as we have in the past).
Ideally, one might imagine authoritative sources on every aspect of health (including salt consumption) which supply the best health advice for every locality specific to every person. For example, imagine the archetypal old-fashioned-but-up-to-date grizzled "country doctor" who knows entire families in a community from birth for multiple generations in a personal way and provides the best specific health advice for the area and the individual. That might range perhaps from "Salt killed your grandpap!" to "Ain't too much to worry about salt since you exercise so much working outside in the Arizona sunshine." But such a health practitioner and community is mostly just a fantasy. There may be such health practitioners and stable communities out there, but they would seem at best few and far between these days in today's highly mobile society.
Compared to the ideal mentioned above, in practice a typical real-life health interaction for all too many people is more likely to be ten minutes spent with a new physician (perhaps due to insurance plan coverage changes) who recently moved to the area, has big worries about repaying US$200K in newly-minted student loans, and has limited experience with a specific health complaint and the individual's life history (including what is not said). In regards to an issue like advice on salt consumption, even if the physician knows that in theory someone who exercises outdoors a lot probably needs to take in more salt, is there going to be time to get around to discussing that level of detail about lifestyle with the patient or how it might relate to some health issue? Would there be time to explore and address a digestive complaint perhaps unknowingly from weak stomach acid from low salt levels? It may well be that many people eat too much salt, but perhaps this specific person perhaps eats too little for his or her situation?
In practice, there are a variety of sources of health information we encounter each with various conflicts of interest and with limitations in focus, experience, time, and continuity. A person with a health issue is confronted by all that complexity, even if they may choose to delegate the authority for all their health decisions to some chosen medical practitioner. Ultimately, we can delegate "authority", but not "responsibility"; in that sense a competent adult remains responsible for his or her health regardless of who has been asked for advice or who we let perform procedures on us.
There is the vaguest beginning of that in a GitHub project linked here and in some other projects called Twirlip (but they've been eclipsed by a need to do other things for income):
Although, as in the example there using IBIS to explore choices for dental health issue, it is possible that the IBIS methodology may be good enough to get a lot of people fairly far. Likely we can do better than IBIS, but I can acknowledge it is hard to do better than IBIS for several reasons (including simplicity, learnability, speed, and collaborativeness). For more on IBIS, Dialog Mapping, and Wicked Problems, see the references I've collected here (among others on a larger topic):
Kudos to Zach for opening up about this. I'm going through a similar shit show and I'm hoping that folks who grok it stick close and the others just sway with.
1. How do you find a good therapist, and given the disparity in their quality, why would you trust yours all that much?
2. Therapists can get very very expensive. Yes, including insurance. Very very expensive.
3. Therapists often can't meet you outside of business hours when you're often working.
Lifting, getting punched with gloves or preparing for a marathon works wonders for me (not said as an opposite opinion than the author, but as a datapoint).
And please, if you're dealing with depression, you need to find out what works for you. Friends and family can help you find your way back, but they can't make the decision. When you decide - you - to take steps for coping with it nothing is impossible.
The author has sound advice on where to start. I'd just like to add that it can take quite some time, and that's ok, because life is long and you'll look back at this period and thank yourself for acting on it.
I've never been depressed, but I've lost friends to depression.
Edit: to the down voters, I'm not implying it's any easier than, say, beating cancer.
Things do seem to be improving however. For example, second generation antipsychotics like aripiprazole seem to be a significant leap.
Meanwhile my cancer screenings for a large lump that required 4 visits were done in 2 weeks and super straightforward.
Respectfully, please don't give up. Continuing to go to your therapist would be exposure therapy for your social anxiety, which _is_ a form of CBT. Maybe just switching therapists will work for you.
Now that I write that out I guess it's like every other health disorder. We're pretty good at a subset of them, so-so at another set, and have no flipping clue what to do about the last set.
I'm broadly generalizing here, but depression caused by a physical condition (e.g. an autoimmune deficiency) can typically be cured by attacking the underlying cause, but depression caused by a psychiatric condition is much harder to "cure" in the traditional sense and instead can be managed via modern pharmaceuticals. Now, those drugs come with some strings attached, but if they help a patient get out of the bed and function in the morning (as they do with my wife) then that's a net positive, but we're realistic about the fact this is likely a life-long battle that will require constant work to stay on top of.
As far as depression goes, the list of potential causal factors is long and our ability to measure brain states is extremely limited. For many people it's a condition to be managed rather than a disease that can be cured. Compare the case of a bereaved person; the intensity of their grief may fade and be replaced by acceptance, but there's no going back to the state of mind prior to the bereavement.
The idea that depression is "anger directed inward" was a useful tool for me.
The view that we can release these old traumas and form new pathways and responses helped me heal after a diagnosis of schizophrenia and bipolar (which included suicidal depression and panic attacks, anxiety).
I mean, it's within your rights...
My entire life up until that point had been based around avoiding emotions. From chasing fame, money, success,drugs, sex, criticizing, creating drama, etc.
At the time I was consulting for a Peter Thiel backed startup focusing on finding alternative cures for western diagnosis.
I took what the doctors there were showing me and began to look at alternative perspectives.
What I found was shocking. That antidepressants didn't really work and outcomes for most people were pretty terrible in general.
The view of depression that is it is unfelt anger allowed me to begin to make more space to feel anger vs. stuffing it down or projecting it onto others. There has been a little research into this that doesn't contradict it.
I followed the experience of anger back inside and it opened up an entirely new part of my mind. I was able to see past events in my life where I was hurt and scared and shut down. And how I learned to supress my emotions.
Through a combination of psychedelics, breathwork and NARM therapy, I learned how to stay with my emotions and how to make space to heal older traumas when I was feeling triggered or overwhelmed.
I was able to be with even more extreme states like paranoia or psychosis and every time I'd go to the heart of the emotional experience, in the moment I'd find some unprocessed event from my life that needed attention.
So, yeah. That way of thinking was very useful for me and was supported by a variety of resources that helped me along the way. Including some psychiatrists, doctors, and therapists.
I take no medication and now have access to a very deep, soft, warm and loving center in myself that I had never experienced before.
If something happens (like my grandmother dying last month), and I noticed I'm feeling depresssed, I use those same tools and get closer to the hurt or pain vs my old default of numbing, avoidance, depression or mania.
I'm an N of 1, of course but I've been able to help other people do the same and this approach feels healthier and more useful than purely symptom management.
We are all unique, and I certainly have access to some exotic states of consciousness, but as I said I feel connected, loving, content, solid and welcoming of all emotions including love and happiness.
Happy to discuss more privately if you prefer:
Learning to love yourself and to let go of things gives you a new perspective. A new perspective leads to new thinking and new experiences, and we all know our brains are plastic and are constantly changing.
You are the fool, not he.
1) notice I'm depressed
2) create space to feel emotions more and use something like Breathwork to loosen up my ego enough to get out of my default mode of shutting down / numbing out.
3) having a deeply personal / visionary like experience of seeing old events in my life or relationships or choosing to forgive someone.
4) am actually emotional release, like crying and feeling like I was able to be back in my body vs being stuck in a painful loop in my head.
I know that this is sometimes the case because I've struggled with depression on-and-off and it tracks 1:1 with my physical health and ability to live a normal, enjoyable life.
(that's not what I think. But these psychologists are reasonably common.)
All the "mad in america" stuff: https://www.madinamerica.com/about-us/
> one that emphasizes psychosocial care, and de-emphasizes the use of psychiatric medications, particularly over the long-term.
> It's not about 'illness.' It's about being human. http://peerlyhuman.blogspot.co.uk/2017/10/why-i-oppose-world... … #WorldMentalHealthDay #WMHD17
> on World Mental Health Day, Let's remember structural inequalities and oppressions are behind many/most mental health problems
I don't know if you've been through the system or not, but in the US MUCH of the time you tell your GP you've got the blues, and they say oh hey well take this zoloft/xanax and see how you feel. On the first visit. It happened to me, it happened to my wife, it's happened to more friends than I can count, all of us on great, private insurance. Anyway, that's the kind of thing mad in america is talking about, not ANY HINT of biology.
I currently work in the bureaucratic end of the English system. I meet very many people who have been through, or are going through, treatment for mental ill health. This includes all settings, from secure (forensic) units, through regular MH hospitals, or community treatment, to primary care. It includes common "mild to moderate" illnesses and severe and enduring mental illness, and also personality disorder.
I talk to a wide range of mental health professionals: health care assistants, registered nurses, AMHPs, doctors (consultants, T3 and other junior doctors), speech and language therapists, occupational therapists, art therapists, psychological staff. I talk to people from band 4 (NHS England agenda for change pay banding) through to band 8d, and also directors.
I'm a member of the South of England Collaborative for Mental Health Quality and Patient Safety Improvement. https://iqmentalhealth.co.uk/
I'm a member of the Q community. https://q.health.org.uk/
Being polite: I know more about this than you do.
The reason I linked to specific twitter accounts is so that you can ask them what their opinion is. You don't have to take my word for it - maybe I would distort their views.
> you tell your GP
I was very clearly only talking about psychologists. I wasn't talking about GPs. If you had asked me about GPs I would have spoken about the frustration I have that they rely too much on medication, and not enough on talking therapy. Even though in England talking therapy is free and easily available.
It has been a long strange journey but by taking advantage of what the medical community has to offer I now am happier than I ever thought possible. One really important moment for me was the realization that everything is biology. There is no difference between physical and mental health. Migraine pain and the pain of depression both hurt. A heart attack and suicide make you the very same dead. Everything you think feel and do is modulated by the soup between your ears. If the soup is short of some ingredient or another it manifests as emotion or behavior.
The book Behave by Robert M. Sapolosky is a fantastic journey into the chemical basis for behavior. While the book is admittedly dense, Sapolosky clearly explains how neuroanatomy and neurochemistry form the basis of experience and consciousness. The writings of the late Oliver Sacks also illuminate how when the physical seat of perception and cognition, the brain, is disrupted in some way, our ability to perceive or what we perceive is fundamentally altered. A patient with a visual field disruption was only able to perceive half the food on their plate. Turn the plate around and the other half was experienced by the patient.
The human organism is insanely complex and nuanced. Human life is in cosmic terms is a trace of a blink. For anyone suffering from depression I would urge you to put aside any misgivings you have about labels and stigma, find the best doctor you can and start to address your depression. It's pretty great not to be miserable. I've tried both.
Among many others things (therapy, running, playing high level piano, amazing remote job), Zen rewired and helps me to deal with this every day.
I'd recommend this authors with all my heart to anyone:
- Thich Nhat Hanh ("You are here")
- Alan Watts
- Eckhart Tolle ("Stillness Speaks")
- Shunryū Suzuki ("Zen mind beginner's mind")
- Ryan Holiday ("Ego is the enemy")
Piano helped me quite a lot. First my teacher, I could even say my piano teacher played a more important role in helping me, more than my family ever could. Musically I felt in love with Chopin and I really hope someday to be able to play Ballade 4 op. 52. It puts me at least decade long goal (yup, it is really really hard to play that).
Running, eating healthy, etc sure. But I think it works better to have the brain thinking better first. Otherwise we'll stick in the same trap over and over, with the same bad thoughts and habits we want to break.
We need to get beyond thinking and feeling. Training ourselves to see them, observer them and letting them go. It takes a lot of time. But you can do it.
Hope something of this help someone.
Everyone here has posted something different. Exercise, diet, sleep, medication x, medication y, prayer, water, gluten, meditation, losing weight, socializing... the list goes on, and on.
If this weren't heavily susceptible to placebo, you'd expect that list to be much shorter. My guess is that just doing SOMETHING makes people feel better.
I'm not allergic, but probably intolerant. I ate wheat for most of my life. I'm pretty sure it is related to inflammation, and how eating wheat products probably screwed my digestion up. I also rarely get sick anymore.
Not trying to suggest that medicine, therapy, etc. does or does not work, just that there may be some other things that people can consider and experiment with.
The mind maybe, but the bloating and sluggishness has come back, along with the apathy, lethargy and a touch of depression. Gluten (I've tried introducing it back this last week) or no gluten, the bloating's the same and sometimes worse when avoiding gluten.
Back to the drawing board, but for those reading, YMMV.
You want to back that up with study or something? Its just WOO if i am wrong i will be happy to eat some crow.
Further more the comment near this one about some imaginary threshold of MEME count gives something legitimacy. REALLY?
WHERE AM I!!
Secondly, gluten can aggravate FODMAPs sensitivity:
This study is often cited to "prove" that non-celiac gluten sensitivity does not exist, but what it actually shows is that most "NCGS" cases are caused by FODMAPs and that gluten can aggravate the symptoms in a person who has not cut out FODMAPs:
>In all participants, gastrointestinal symptoms consistently and significantly improved during reduced FODMAP intake, but significantly worsened to a similar degree when their diets included gluten or whey protein.
Gluten increases GI residence time in everybody, which is not an unhealthy effect on its own, but which can increase the duration of exposure to any dietary irritant:
>Hydrolyzed gluten prolonged intestinal transit time, and this effect was reversed by concomitant administration of naloxone
It's seriously that easy to just look up "gluten sensitivity" on Google Scholar or SciFinder or (insert academic search site here) to find these sort of studies. And frankly it's kind of annoying to see people who won't even go to that level of effort degrading the actual personal experiences of someone who is simply trying to improve their own life.
Have an upvote anyways for your efforts.
Regarding science and evidence, this is anecdotal, and just my personal experience. It has 100% changed my life, so I thought I would share.
I'm also fairly lactose intolerant, and cut out dairy years before the gluten thing, and that also had a huge impact on my health.
Scientifically speaking, administration of my supplement is inconclusive. Don't take natural medicines for chronic conditions unless a qualified professional is looking out for you.
However, I'm not sure if it's just gluten or glyphosate toxicity  (being concentrated in GMO wheat as that includes "roundup ready wheat" which, clearly gets more roundup on it).
Why not suggest this? It is so funny to see people been so skeptical about religion and always so believer in anything called science.
I've self diagnosed myself to a combination of depression/cyclothymia/bipolar disorder. Basically, I've been working at 50% potential, on a good day, for the past 10 years.
Interested in the science behind ketogenic diets, I've tried to cut all grains and processed food for many month-long stretches, and I've always noticed my brain being sharper, and moving farther and farther away from the "black dog". But eventually I get back in the trap and it's extremely hard to pull myself up again — impossibly hard cutting grains with Italian friends and family.
Keto probably isn't the solution, but I'm more and more convinced the key lies in our gut, not in our brain chemistry.
EDIT: depression is a common modern "disease", and in my ignorant opinion, I'm convinced there's two types of depression:
You might be depressed if your life is in the shitter, and there's no sane way of getting out of it. Think bad marriage or crippling loneliness.
You might also be depressed because your chemistry isn't optimal, because of what you eat or bad health.
I believe most modern depression is of the latter type, and in both cases medication treats the symptoms, not the actual cause. We need to do more work on this.
Again, this is my personal opinion, and I might be talking out of my arse.