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First, a lot of people are on psychiatric medications, and you generally don't hear about the success stories: people who have become fairly normal due to the medication. If you work in a high-power job, I'd wager that about 1-in-8 of your co-workers is on a psychiatric medication. For a lot of people, they're like eyeglasses: a mildly annoying, but not really painful, treatment that nonetheless allows them to function at full capacity once taken.

Compared to real mental illness, the side effects of these drugs are minor. Real depression and panic (both of which most people never experience) are more dangerous than the milder, first-line treatments for those illnesses, which are a lot less drastic than frontal lobotomy.

What is important is to separate normal emotions (which can be plenty difficult, but shouldn't be medicated away) from actual mental illness. This is a tough judgment call to make and it isn't always made right, especially with regard to teenagers. For example, if you're sad because someone close to you died, this is normal and you shouldn't be on meds for it. That's not clinical depression; it's normal sadness.

For the record, when the dosage is right, people still experience the normal emotions (sadness when something sad happens, anger when appropriate) but don't have the biological problems (the thought loops, mental fatigue, irrational fear and anger). That's the goal of treatment: not to make someone ridiculously happy, but to remove the purely biological objects in the way of happiness.




What is important is to separate normal emotions (which can be plenty difficult, but shouldn't be medicated away) from actual mental illness.

It's that 'normal' part that's hard for me. From the inside, I'd say that my negative emotional state is decidedly non-normal, frequently counter-productive, but mostly rational. I'm in my late 30's, in a fine long-term relationship, and unhappily running a promising but struggling small company. Most days I'm miserable but quite productive, the mental health equivalent of a functional alcoholic. I feel I'd easily convince a mental health professional that I'm clinically depressed, but I'm not sure where this will lead.

That's the goal of treatment: not to make someone ridiculously happy, but to remove the purely biological objects in the way of happiness.

My base problem might be that happiness is not a primary end goal for me. I want it in so far as it's absence makes effectiveness difficult, but I'm scared by being distracted by pleasure. What I want is a purpose I can believe in! I worry that what I really need is a complete lifestyle change, and ideally a different world in which to live. I'm torn as to whether settling for greater satisfaction with this one is a good thing.


My base problem might be that happiness is not a primary end goal for me. I want it in so far as it's absence makes effectiveness difficult, but I'm scared by being distracted by pleasure.

Have you ever been on a modern anti-depressant? I was on Zoloft for about six months during a bout of really bad depression. I wasn't giddy, I wasn't exuberant, and I was still myself. It didn't make me happy. It wasn't pleasure, it's not an opiate. What it did was reduce the internal, negative dialog, and it made it much, much easier for me to focus on my work. It also made me much more willing to express myself to others, which led to better relationships.

You still have to do the work to improve things which are broken in life. If you work environment is awful, for example, it will just make it more tolerable. Your neighbor will still be an asshole, it just won't bother you quite as much.

What I want is a purpose I can believe in!

I think that's what everyone thinks they want, and what few of us achieve. Also, I think that many times, out dissatisfaction with our situation is less due to the situation, and more due to our own mental state.

I bet there's a lot in your life (e.g. long term relationship) to be fulfilled by, but you probably find yourself focusing on negative feelings around your work.

By the way, I'm very much on the same page as you regarding, "whether settling for greater satisfaction with this one is a good thing," so don't take anything I've written as condescending or negative.


I'm 80% sure that 1 in 8 is correct as per recent studies, I remember it with the sentence "regularly take psychiatric medications." But I can't find the book to verify.


Among the general population, prevalence is 1 in 6:

"In the NCS-R, the lifetime prevalence of major depressive disorder among the 9,090 adult participants was 16.2%, with a 12-month prevalence of 6.6%. The NESARC, which included more than 43,000 adults found slightly lower prevalence rates than the NCS-R (13.25% lifetime and 5.28% 12-month), perhaps because the sample included previously omitted groups of individuals with lower prevalence rates (655). A number of sociodemographic factors appears to be associated with an increased prevalence of major depressive disorder, including female sex, being middle-aged, being never or previously married, having a low income, being unemployed, or being disabled (655, 976), In the NESARC, being Native American increased risk relative to being Caucasian, whereas being Asian, Hispanic, or black decreased risk."

from the American Psychiatric Association Clinical Practice Guidelines for the Treatment of Major Depressive Disorder http://www.psychiatryonline.com/pracGuide/pracGuideTopic_7.a... specifically http://www.psychiatryonline.com/content.aspx?aID=655908


(He was talking about people taking psychiatric medications, not people with depression)




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