This is the only reasonable response in any thread on mental illness. Depression is too much of an important issue to not see a doctor, and unless we know OP's full history, any number of things could work or not work.
Primary care physicians prescribe SSRIs all the time. You probably want to see a primary care physician anyway and get a thorough checkup and blood work to rule out physical causes. Your family doc or internist should also be able to refer you to a psychiatrist (who will usually offer more complex drug therapy) or to a talk therapist or both.
Especially in more severe cases, attempting to deal with it yourself is dangerous. Think about it: depression often creates a lack of motivation and a feeling of not being in control. If you try something and it fails, then what? Then you blame yourself for failing, you feel even less motivated and even less in control, and you're possibly worse off then when you started. (Not to mention: you learn the wrong lesson about failure.)
IMHO, the very premise that you can "hack" around depression is flawed. If you tore your rotator cuff, came down with a serious fever, or broke a bone, would you try to "hack" around it? I doubt it, unless you're out in the wilderness and days from care - and at that, you'd likely seek proper care when you get back to civilization. Mental health is no different; we just have a societal problem treating it with the same seriousness and urgency.
Many people struggling with mental health issues need an external reference point along with expert advice / supervision. A good support network of friends / family provides the former. Ideally, doctors provide both; they at least provide the latter, if they're at all half-decent.
Now, it's not at all the same thing, but: I struggled with anxiety - like, full-on debilitating panic attacks - for years, trying to "hack" around it. It would get better, then I'd relapse. In the end, I finally swallowed my pride, went to a doctor, and followed their advice. If I'd done that years ago, I'd have measurably improved my quality of life for years. Now, I'm just happy I didn't wait longer. Yes, I had some measure of success in "hacking" around my mental health issues, and yes, I was probably better off than if I did nothing. That said, why would you not just use the best tools available?
It's like choosing to write your own text editor from scratch just to code - you can do it, and you'll maybe even learn something, and there's a remote chance that you'll create a better tool than was previously available. Most likely, however, you'll spend years going in circles for no particularly good reason. That's why you seek help: not because you absolutely can't do anything about it yourself, but because, quite honestly, life is too short to waste.
Now, once you regain a measure of control - possibly with the help of therapy, SSRIs, etc. - you're in a position to start talking about "how do I help myself manage this?" Here, however, you're not "hacking" around anything: you're applying well-tested methods (exercise regimens, proper sleep, relaxation / meditation techniques, etc.), possibly in conjunction with SSRIs or therapy, to slowly but surely rebuild your sense of control and agency.
Perhaps in 10 or 20 years, we'll better understand neurobiology and have much better tools to help with mental health issues. Right now, this is what we have.
I think the issue here is that to most of us, this isn't a thread on mental illness.
There's a difference between the common usage of the word "depression" and the mental illness of clinical depression/major depression/major depressive disorder.
There is a lot that can be done to fight what many people would refer to as depression, which is much more mild than clinical depression.
Can be attributed to lack of trust in the medical system. Just look at doctor's willingness to give out opoids. Doctor's first line of defense for depression is SSRIs, if those don't work they often try Serequel or worse.
A doctor won't analyze your life like a therapist would and ensure you have a good diet, sleeping schedule, friends, career, family, etc. For 99% of people these are the causes of depression and can be remidied without medication.
And don't chalk this up to a USA problem. I'm from Canada and my doctor is a pill pusher.
There are conventional things that you're going to get a lot of comments about. My conventional thing is running. The hacky part is the endorphins you get.[1] Other than the hack, you constantly set goals and achieve them, it makes you feel good about yourself. Micro goals like "I'll make it to the end of the street without stopping," and larger goals like "I'll run 5 miles today." Positive reinforcement during the run, large feeling of accomplishment after.
"At every level, from the microcellular to the psychological, exercise not only wards off the ill effects of chronic stress; it can also reverse them. Studies show that if researchers exercise rats that have been chronically stressed, that activity makes the hippocampus grow back to its preshriveled state. The mechanisms by which exercise changes how we think and feel are so much more effective than donuts, medicines, and wine. When you say you feel less stressed out after you go for a swim, or even a fast walk, you are."
-John J. Ratey, Spark: The Revolutionary New Science of Exercise and the Brain
And another
"we sometimes lose sight of the fact that the mind, brain, and body all influence one another. In addition to feeling good when you exercise, you feel good about yourself"
Reading this book opened a door out of depression for me using the prescribed medicine, which is exercise and definitely wasn't easy.
Learn to observe thoughts instead of getting lost in them.
Recognize your brain is having a mood, not that you are that mood.
A lot of stuff from meditation/mindfulness can be quite helpful. There's a book called _The Zen Path through Depression_ that's kind of interesting.
I don't view it as a "fight" rather just a "thing". Depression is normal. Not fun, but normal.
Serious depression may require professional assistance. If whatever it is you're doing isn't working, get that assistance. Reach out to people. In general they care.
Hard outdoor physical labor where you are up before dawn, work flat out all day, and fall asleep exhausted shortly after dusk. Do this 7 days a week and you won't have time to be depressed.
I do, and it works great! I normally work a desk job, alternating between the two is amazing. Working that hard every day of the year isn't sustainable, but physical labor in shorts bursts of a week or so can boost my mood for months.
I have personal experience of working this hard, but having never been depressed I have never had to use this approach. I have worked with people who have used it successfully and if I were to get depressed it is exactly what I would do.
It seems to be important that it is both hard physical labor and outdoors in the sun.
To get the best results from SSRIs it is just a bit more than showing up at the doc once and getting a prescription.
Most people will need to adjust the dose and probably try a few different meds. So your doc should prescribe you some pills and have you call back in two weeks to see how you are doing and decide if you want to change the dose or switch meds. While you are there you should also have your thyroid hormone levels checked and any other physical problems which could be associated with depression.
In terms of mainstream meds that are available as a generic and easy to get, the one that stands out as different is Venlafaxine, which binds to norephinephrine transporters as it does to serotonin transporters. It works better in more people, but it also makes some people get a blood pressure reading like 200/110. Thus you should be working with a doc, checking your vitals, etc. There are also non-SSRI antidepressants, some of them are very effective, but they tend to have more side effects, some of which can be dangerous. (For instance, tricyclic antidepressants can cause QT prolongation, a change your heartbeat that can lead to death.)
All that said, the great thing about antidepressants is that they are inexpensive and easy to try in conjunction with "everything else", of which I would rank exercise as #1 and then talk therapy at a distant #2.
Lift weights and perform intense physical activity to exhaustion.
Don’t smoke tobacco or cannabis. Don’t really drink either.
Meditation.
12-step work.
Wellbutrin (bupropion) has helped me out of holes.
Have close friends to confide in.
Say what you’re thinking. Don’t say what you’re not thinking.
Follow pointless dreams in some measure. For me, being able to buy a legendary Husaberg FE 570 motorcycle was an impossible dream, until I tried going for it. Managed to do it on a startup salary over the course of a year. It has brought me deep spiritual satisfaction.
Help others.
Be humble. Ask to be humble. Ask for your ego to be smashed.
I guess it’s hard to pin down exactly :) I guess it’s a variation of ‘To thine own self be true’. For me, I think there tends to be a background process running which attempts to find the correct and socially acceptable thing to say. This is often not related to what I find to be true and important myself. It’s kind of a simulation of a simulation: I-perceive-that-what-I-perceive-are-people’s-intentions-is-answered-by-this-pattern-I-have-observed. It’s a habit and it’s a relief when it can be tuned down a bit.
I don't know why, but I was really taken aback when I realized that there was this other side to "Do not lie." It's not just avoiding telling falsehoods, but also speaking up about important truths as you see them.
I also find it interesting, but I'm questioning its (possibly not-so-obvious) meaning: could it be that you should try to distinguish what you really think from what you merely think (in order to avoid saying spurious things maybe)? I find it often surprisingly hard to determine what I really think or feel..
It was Al-Anon. The theory was that there were maladaptive communications patterns in the generations before me, as well as alcoholism (as a coping mechanism?). The result was a more effective locus of control over life, as captured by the phrase about serenity to accept what I cannot change / courage to change what I can change / wisdom to know the difference. There are two sets delineated in this: what I can change, and what I cannot. I can change my thoughts and actions. Nothing else. I didn’t know that, or wasn’t aware. Maladaptive communication patterns in families seem to revolve around a misguided but understandable attempt to protect oneself through control of others. If that makes sense? :)
I did it without a classical God btw. The steps say to use a God such as we understand one. I used a non-deistic definition. God is in our capacity for trust and intimacy and altruism as a species, perhaps? Hard to pin it down. It worked.
Threads like these are typically filled with unverified claims, anecdotes, well-meaning tips and what others think helped them or someone they know in what they believe are similar circumstances.
Some people aren't diagnosed, but make their own assumptions. Others don't differentiate between a mood (sadness) and pathology (clinical depression).
TLDR:
There are too many variables, unknowns and right-sounding wrongs out there. A professional third party is better suited to interpret your situation than anyone else - including yourself.
You did not understand the question. OP requested a "hack", which is, by definition, an unverified claim, anecdote, well-meaning tip etc.
And anyway, your absolute faith in professionals is unwarranted.
Psychiatry and psychology remain largely unsupported by good science. There is no verified and widely-accepted predictive model of overall brain function.
Many therapists operate entirely on personal bias and superstition; at least one major university touts their M.Div. program as a preferred gateway to clinical psychology.
The evidence in support of pharmacological treatment is polluted by the fact that almost all large-scale clinical studies of psychoactive drugs are underwritten by those who intend to profit from them. Double-blinding is not an absolute guarantee against manipulation if you fund multiple studies and simply drop the results you don't like.
Truly endogenous depression, meaning that which has no legitimate external factors underlying it, may be a mythical beast. All the drugs and therapy in the world will not resolve a bad situation, particularly when that bad situation happens to be a social norm like working at a meaningless job.
SSRIs may get you functional again, but is that really a positive outcome when all they are doing is revving you up to feel good about wasting your life as a corporate cog? Stimulating you to participate gamely in the destruction of the planet through mindless consumption? Convincing you to squeeze out more little consumers to propagate the system?
Evolution has not prepared animals to live in zoos; they often develop symptoms analogous to human depression. Neither has it prepared us to sit around all day in offices doing shit jobs for the primary enrichment of those at the top.
Here's my hack: if you find yourself depressed, have a look at your situation. It probably sucks. Get up, walk out, don't come back. But realize that you cannot easily escape our shitty system that constrains you to participate in economic slavery in order to afford basic shelter and minimal health care. Good luck.
My point is that there may not be an obvious hack for complicated issues like depression.
I don’t have absolute faith in professionals; Don’t know what gave you that idea. I’m saying they’re better than the alternatives, and that expertise is worth something.
I agree with some of your criticisms of the status quo, but it seems to me like you’re conflating your own views of society with an objective view that serves as a legitimate basis for a depressive reaction/sadness.
As for your claims regarding endogenous depression: I don’t know what you base them on.
I’ve seen nothing to support this position, at least.
There might be psychologically unhealthy sides to modern society, but what you and others present as alternatives is, in my opinion, glorified guesswork - as opposed to a somewhat systematic search for knowledge (flawed as it is).
I was doing that for years. I was riding my bike huge distances (400km in a day for example), I followed a solid lifting schedule and managed to reach a 370lb deadlift, and I ran far and relatively fast when I wasn't cycling. I kept that up for years and really loved it. In fact I miss it still.
But it didn't keep depression from getting to me. These days I'm in alright shape still, but getting back on that wagon is hard as hell when you feel like trash. I've done it before, I'll do it again, but I think for some of us it unfortunately takes more than exercise.
I still also highly recommend exercise as part of any effort against depression. If you're able bodied, chances are it will only be able to help.
Anecdotally:
plenty of sunlight,
a vitamin D pill,
enjoyable sex with your partner,
frequent bouts of intense exercise,
plenty of vegetables,
few processed foods,
a probiotic supplement,
and healthy bowel movements 1-2 times a day.
Look for “USP Certified”. NatureMade is a popular brand that tends to have this. Costco brand (Kirkland) also often does - note that Kirkland prices are cheap in Costco but not so much on Amazon (resold or something). If you have a Costco near you, it is a very cost effective way to get fresh food and supplements. It’s silly but it really helped me become healthier, because I stopped being hesitant about the price (I was raised in a not-well-off household... the mental barrier can be pretty strong even though it’s irrational vs wastes of money that are neutral or harm health, while nutrition is very helpful and a pretty good bang for buck)
This is really the only solution. Hacks will only give a very minor benefit. Look at your life, relationships and job and ask yourself if its what you really want.
You two are describing solutions for "feeling depressed". Clinical depression is very different.
You could bathe in diamonds every day, have the best lover, the most supporting circle of friends, be at the peak of your health and still be depressed. Depression is out of your control.
You can reduce triggers by living better but that's it. Even while living the happiest moments of your life you can still have depression lurk in the back of your head, probing you with negative thoughts.
>You two are describing solutions for "feeling depressed". Clinical depression is very different.
No, I'm talking about clinical depression. But it's interesting that this viewpoint seems to be quite prevalent on HN.
>Depression is out of your control.
Perhaps in some cases, but in many cases there are things you can change that will improve it.
You seem to be making an assumption that clinical depression can't be due to lifestyle factors. This is an incorrect assumption, based on my own experience, that of family members, and research looking into psychological stress and neuroinflammation (for example).
>Even while living the happiest moments of your life you can still have depression lurk in the back of your head, probing you with negative thoughts.
The triggers for depression aren't "moments". It builds up over a long time, and isn't due to short-term factors. So while you might have a "happy moment" during depression, that isn't likely to cure it (and that isn't what I'm saying at all).
This is an unreasonable response - not infrequently the causes are not things that can be fixed in the short term (eg years of neglect and abuse as a child), or are simple facts of life (eg an objective purpose in life does not exist). There's a whole slew of these kinds of origins and I'd venture to say that expecting to solve them for you personally in a timeframe that doesn't lead you to die from starvation (because you cannot work in the meantime) is really not practical.
That being said, it's something I think everyone should work on. Just not as a primary response mechanism to life-destroying issues happening right now.
Rigorous exercise seems to get me out of any ruts I'm in. I typically hike 5-6 miles x 3 days a week, and throw in a 11-12 mile over strenuous terrain. By the end of that, your mind will clear, your body is exhausted, and you'll rest easy that night.
Other than that, eating well, having plenty of great sex, and interacting with as many people as possible. OH most important, SLEEP, a full solid night of it. Naps are awesome too.
I can attest to this. I've struggled with anxiety/depression/insomnia/adhd for years, and over the past couple years I've learned that careful attention to exercise, diet, and sleep are the most reliable ways I can ensure a healthy baseline.
I used to run a couple miles in the morning and evenings, on streets, until I injured my leg. So I switched to hiking after my leg recovered. Short 2-3 mile hikes turned into 12 mile stretches, which turned into short trail runs, and now I'm running 5-6 miles of trails 2x a week and 12+ mile runs/hikes on weekends (I'm secretly training for an ultra). I'd always thought I'd hate running, because it was too strenuous or something, but I haven't looked back. Maybe I'm just literally running away from my problems, but, it's far more rewarding in any case.
It's 6am in Seattle right now. I woke up and I'm about to go to the gym and do my 5x5 workout. I do this 3 times a week and it changed my life ever since I started doing it two years ago.
5x5 is super useful when you start out lifting (I used it) but as you get better it might make sense to shift to other workout programs. I also definitely had times where I skipped a few increments or stayed at the same weight for a set.
If your depression is serious, and it's preventing you from living your life, or if you're feeling suicidal, see a doctor or call a hotline. Now.
If you have mild depression, or want to not get depressed in the first place, I'd recommend the following:
Do exercise, do it outside if at all possible. Even light exercise like going for a walk is better than none. Don't take your phone.
Turn off and shut away your electronic devices an hour before you go to bed. Under no circumstances have your phone by your bed. Buy an alarm clock if need be. Disrupting sleep is the best way to get depressed quickly.
Delete or neuter[1] your social media accounts. They are engineered to make you feel bad (so you click ads).
Get something to look after. A dog, or if you don't have time or space, a cat, or if you really don't have time or space a plant or two.
Put effort into your relationships with friends. Even if you don't feel it's being reciprocated. No friends where you are now? Find local meetups and go to them regularly. e.g. Parkrun, reading group, musical group, dev meetups. Keep going every week.
Put effort into yourself. Tidy up your living space, dress
and groom well every morning.
> Under no circumstances have your phone by your bed. Buy an alarm clock if need be. Disrupting sleep is the best way to get depressed quickly.
I hope a lot of people are making a correlation between their friends who have recently had young children, and why they often tend to look tired, miserable and depressed.
Which is caused by the western notion that it makes sense for a helpless infant to sleep away from its mother. We got rid of our bed frame (to prevent falling accidents) and cosleep. We all (including our daughter, who is now three with another on the way) sleep happily through the night.
No, it's caused by the fact that most very young children wake up regularly no matter where they sleep, since they usually need to eat fairly often. As they get older, they tend to start sleeping through the night - some with co-sleeping, some in their own room - but some will wake up repeatedly until they're much older no matter what you do with 'em.
I'm glad your specific approach with your specific child worked out great.
> Get something to look after. A dog, or if you don't have time or space, a cat, or if you really don't have time or space a plant or two.
As someone with two dogs and occasional bouts of mild depression, I would caution against getting a dog for this purpose.
It's a lot of responsibility, and it helps some people with depression but hurts others. A plant is a much better idea. If it doesn't work out, just throw it away. You can't (easily/responsibly) get rid of a dog, in many cases.
I do see the value - I specifically said it helps some people but doesn't help others. The reason I don't suggest it is because getting rid of the dog once you've gotten it can be difficult.
I don't know... I got a baby a year ago... the responsibility factor here trumps a dog by a factor of 10, but my baby has probably saved my life countless times this year.
My depression this year has been the worst ever - because of external factors like losing a good source of income, getting hired by an employer who then never paid, and some marital issues around faith/church (I left the church we belong to (Mormonism) because I no longer believe and am leaning Agnostic), and then celebrity(Chester Bennington)/external influences of people I know who died by suicide. Plus, I can't help feeling that death's around the corner and could happen any day. Watching 13 Reasons Why probably wasn't a great thing to do either in hindsight, though it was a pretty good series.
I've gone from one month making 7k to <500 the next and spending all our savings just to get by. I'm trying to build up my freelance docket, and hopefully through word of mouth grow out of this phase (plug: Laravel + Vue is my stack).
The point of the rant is... without my son, I think I probably would've done the unthinkable. There's also many times where I just felt crushed inside, and I didn't know what to do... but I'd go upstairs and just hold my son, and cry a bit, and it's hard to stay upset when you think of this kid and the life ahead for them, that they can do things better than you did and hopefully not make the same mistakes. Not to mention the cuteness/cuddles cheer you up a bit, I'm sure there's probably some endorphins being released even.
My dog died this year, but in the past holding/petting her helped some with depression too. Sometimes I will go a day or two without even going outside, and I find my mood also brightens if I just take out the trash or walk around the block.
A preacher once told a story when he was sitting next to the bed of a dying from anorexia girl. She had given up. He told her:
- You have two choices. First choice is to be a rotting corpse by tomorrow, making everybody's life miserable. The second choice to get up and fight, and next year you to be sitting next to a girl like you and help her live.
Depression sucks. In order to take your mind off of it, find a goal and pursue it. Helping others is one of the most universal methods. No matter how bad are you, there are people in worse condition than you. These people will see an angel in you if you show some care. "Be the person you needed when you needed someone"
- Make sure you eat sufficiently (dont skip breakfast).
- Make sure you have people to talk to on a regular basis. Isolation makes things worse.
If you are so deep in depression you can hardly function, you probably need to see a specialist ASAP and get professional counsel first before trying to hack anything.
Go and see a doctor. Seriously. Even without this, figure out how to do things you want in life even if you don't feel like it.
I don't know about some of the other advice. Eating habits don't seem to work for me, and following a strict diet makes things worse because I spend a lot of time worrying about food if I do that. Exercise? I've never found any exercise I enjoy when I'm content, let alone trying to get the energy up to actually follow through with it. The only way I can work that in is if I walk as my primary transportation.
Having a structured day helps me a little bit, but this is simply because it doesn't give my brain time to ruminate as much. Meditation seems unbearable if I'm depressed. The sessions themselves aren't so bad, but I obsess with it off and on through the day. Mindfulness just makes me feel anxious because I'm constantly worried that I'm not normal and I can't tell if that is true or not.
Now, the things that have helped keep depression away have been different. I couldn't do this stuff in the depths of depression, but making the changes changed my life outlook. I do get mild depression now, but it doesn't last as long nor feel as bad. I made life changes. I got in a stable, loving relationship after ending a bad one. I moved, which gave me a little more control over myself and how I acted because expectations changed. I did MDMA. Not that this is something for everyone nor actually legal, but it let me parse out some of the things in my head. The weeks after taking were an eye-opener.
It was like someone massaged my thoughts or rinsed off my brain. Maybe it is more like a reboot. In any case, my brain felt good. So many thoughts that were negative just didn't have the same sort of affect on everything else. My worries had a different sort of framing on them. I could look at some of these things and make a reasonable decision about them. Some things, sure, I need to work on - but I was a bit more motivated to actually do so. Other things, I was able to make a decision not to be bothered by them. Since I had some time without so much mental stress, it wasn't so difficult to teach myself that those things were a bit ridiculous. I had a better sense of personal well-being and self-love that has stuck around.
I imagine doing this with an actual therapist would be even more helpful. I completely understand why it seems like a miracle for mental health in drug trials.
I've done other sorts of drugs in my life - lsd, for example. While they shaped some of my perception and thoughts about the world and life, nothing was quite like this. I couldn't describe myself as unhappy before, but now I'm really content with life.
I should now mention that I would urge folks to have caution. I can understand how folks would get addicted to it. And there is a risk of simply doing it too often and actually having the opposite effect. This is something to do occasionally, not every weekend or even once a month. The most profound change was the first time: I've done it since then, and it while (for me) it reinforces the things I learned the first time and still feel mentally refreshed the next day, it simply isn't as large of a change.
Another small sidenote: I've done it with my spouse. It also strengthened our relationship as well simply because we basically sat and talked positively for hours.
One time when I was younger, I babysat for a family. They said it was fine to watch TV while their kids slept. The reception was fuzzy and static-y but I still watched it. After a few hours, I got used to the fuzz and bad reception.
Then they came home, saw me watching and said, "oh you've got to turn off the VCR." They did that and the picture became impossibly crystal clear. I was floored by what I had been missing and how I had convinced myself that things before were "fine."
Had pretty much the same experience the first few weeks after taking MDMA. Felt like someone had improved the reception on the world and turned off the static and noise.
150 comments
[ 2.0 ms ] story [ 222 ms ] threadFor one thing, "which doctor?"
Primary care physicians prescribe SSRIs all the time. You probably want to see a primary care physician anyway and get a thorough checkup and blood work to rule out physical causes. Your family doc or internist should also be able to refer you to a psychiatrist (who will usually offer more complex drug therapy) or to a talk therapist or both.
Especially in more severe cases, attempting to deal with it yourself is dangerous. Think about it: depression often creates a lack of motivation and a feeling of not being in control. If you try something and it fails, then what? Then you blame yourself for failing, you feel even less motivated and even less in control, and you're possibly worse off then when you started. (Not to mention: you learn the wrong lesson about failure.)
IMHO, the very premise that you can "hack" around depression is flawed. If you tore your rotator cuff, came down with a serious fever, or broke a bone, would you try to "hack" around it? I doubt it, unless you're out in the wilderness and days from care - and at that, you'd likely seek proper care when you get back to civilization. Mental health is no different; we just have a societal problem treating it with the same seriousness and urgency. Many people struggling with mental health issues need an external reference point along with expert advice / supervision. A good support network of friends / family provides the former. Ideally, doctors provide both; they at least provide the latter, if they're at all half-decent.
Now, it's not at all the same thing, but: I struggled with anxiety - like, full-on debilitating panic attacks - for years, trying to "hack" around it. It would get better, then I'd relapse. In the end, I finally swallowed my pride, went to a doctor, and followed their advice. If I'd done that years ago, I'd have measurably improved my quality of life for years. Now, I'm just happy I didn't wait longer. Yes, I had some measure of success in "hacking" around my mental health issues, and yes, I was probably better off than if I did nothing. That said, why would you not just use the best tools available?
It's like choosing to write your own text editor from scratch just to code - you can do it, and you'll maybe even learn something, and there's a remote chance that you'll create a better tool than was previously available. Most likely, however, you'll spend years going in circles for no particularly good reason. That's why you seek help: not because you absolutely can't do anything about it yourself, but because, quite honestly, life is too short to waste.
Now, once you regain a measure of control - possibly with the help of therapy, SSRIs, etc. - you're in a position to start talking about "how do I help myself manage this?" Here, however, you're not "hacking" around anything: you're applying well-tested methods (exercise regimens, proper sleep, relaxation / meditation techniques, etc.), possibly in conjunction with SSRIs or therapy, to slowly but surely rebuild your sense of control and agency.
Perhaps in 10 or 20 years, we'll better understand neurobiology and have much better tools to help with mental health issues. Right now, this is what we have.
</rant>
There's a difference between the common usage of the word "depression" and the mental illness of clinical depression/major depression/major depressive disorder.
There is a lot that can be done to fight what many people would refer to as depression, which is much more mild than clinical depression.
A doctor won't analyze your life like a therapist would and ensure you have a good diet, sleeping schedule, friends, career, family, etc. For 99% of people these are the causes of depression and can be remidied without medication.
And don't chalk this up to a USA problem. I'm from Canada and my doctor is a pill pusher.
[1]https://www.webmd.com/depression/guide/exercise-depression#1
And another
"we sometimes lose sight of the fact that the mind, brain, and body all influence one another. In addition to feeling good when you exercise, you feel good about yourself"
Reading this book opened a door out of depression for me using the prescribed medicine, which is exercise and definitely wasn't easy.
Learn to observe thoughts instead of getting lost in them.
Recognize your brain is having a mood, not that you are that mood.
A lot of stuff from meditation/mindfulness can be quite helpful. There's a book called _The Zen Path through Depression_ that's kind of interesting.
I don't view it as a "fight" rather just a "thing". Depression is normal. Not fun, but normal.
Serious depression may require professional assistance. If whatever it is you're doing isn't working, get that assistance. Reach out to people. In general they care.
It seems to be important that it is both hard physical labor and outdoors in the sun.
One guy who got that advice from his brother went on to be the Forrest Gump of eggs in Indonesia and became a billionaire.
Raising animals has all that and you also have the emotional relationship of the animals to boot.
Most people will need to adjust the dose and probably try a few different meds. So your doc should prescribe you some pills and have you call back in two weeks to see how you are doing and decide if you want to change the dose or switch meds. While you are there you should also have your thyroid hormone levels checked and any other physical problems which could be associated with depression.
In terms of mainstream meds that are available as a generic and easy to get, the one that stands out as different is Venlafaxine, which binds to norephinephrine transporters as it does to serotonin transporters. It works better in more people, but it also makes some people get a blood pressure reading like 200/110. Thus you should be working with a doc, checking your vitals, etc. There are also non-SSRI antidepressants, some of them are very effective, but they tend to have more side effects, some of which can be dangerous. (For instance, tricyclic antidepressants can cause QT prolongation, a change your heartbeat that can lead to death.)
All that said, the great thing about antidepressants is that they are inexpensive and easy to try in conjunction with "everything else", of which I would rank exercise as #1 and then talk therapy at a distant #2.
Lift weights and perform intense physical activity to exhaustion.
Don’t smoke tobacco or cannabis. Don’t really drink either.
Meditation.
12-step work.
Wellbutrin (bupropion) has helped me out of holes.
Have close friends to confide in.
Say what you’re thinking. Don’t say what you’re not thinking.
Follow pointless dreams in some measure. For me, being able to buy a legendary Husaberg FE 570 motorcycle was an impossible dream, until I tried going for it. Managed to do it on a startup salary over the course of a year. It has brought me deep spiritual satisfaction.
Help others.
Be humble. Ask to be humble. Ask for your ego to be smashed.
Read books. Listen to music. Make music.
> Say what you’re thinking. Don’t say what you’re not thinking.
But I Love this one. :)
I did it without a classical God btw. The steps say to use a God such as we understand one. I used a non-deistic definition. God is in our capacity for trust and intimacy and altruism as a species, perhaps? Hard to pin it down. It worked.
Even reading about other people's trips on ADVrider lightens my mood, and my own trips have brought me priceless memories.
Threads like these are typically filled with unverified claims, anecdotes, well-meaning tips and what others think helped them or someone they know in what they believe are similar circumstances.
Some people aren't diagnosed, but make their own assumptions. Others don't differentiate between a mood (sadness) and pathology (clinical depression).
TLDR: There are too many variables, unknowns and right-sounding wrongs out there. A professional third party is better suited to interpret your situation than anyone else - including yourself.
And anyway, your absolute faith in professionals is unwarranted.
Psychiatry and psychology remain largely unsupported by good science. There is no verified and widely-accepted predictive model of overall brain function.
Many therapists operate entirely on personal bias and superstition; at least one major university touts their M.Div. program as a preferred gateway to clinical psychology.
The evidence in support of pharmacological treatment is polluted by the fact that almost all large-scale clinical studies of psychoactive drugs are underwritten by those who intend to profit from them. Double-blinding is not an absolute guarantee against manipulation if you fund multiple studies and simply drop the results you don't like.
Truly endogenous depression, meaning that which has no legitimate external factors underlying it, may be a mythical beast. All the drugs and therapy in the world will not resolve a bad situation, particularly when that bad situation happens to be a social norm like working at a meaningless job.
SSRIs may get you functional again, but is that really a positive outcome when all they are doing is revving you up to feel good about wasting your life as a corporate cog? Stimulating you to participate gamely in the destruction of the planet through mindless consumption? Convincing you to squeeze out more little consumers to propagate the system?
Evolution has not prepared animals to live in zoos; they often develop symptoms analogous to human depression. Neither has it prepared us to sit around all day in offices doing shit jobs for the primary enrichment of those at the top.
Here's my hack: if you find yourself depressed, have a look at your situation. It probably sucks. Get up, walk out, don't come back. But realize that you cannot easily escape our shitty system that constrains you to participate in economic slavery in order to afford basic shelter and minimal health care. Good luck.
I don’t have absolute faith in professionals; Don’t know what gave you that idea. I’m saying they’re better than the alternatives, and that expertise is worth something.
I agree with some of your criticisms of the status quo, but it seems to me like you’re conflating your own views of society with an objective view that serves as a legitimate basis for a depressive reaction/sadness.
As for your claims regarding endogenous depression: I don’t know what you base them on. I’ve seen nothing to support this position, at least.
There might be psychologically unhealthy sides to modern society, but what you and others present as alternatives is, in my opinion, glorified guesswork - as opposed to a somewhat systematic search for knowledge (flawed as it is).
But it didn't keep depression from getting to me. These days I'm in alright shape still, but getting back on that wagon is hard as hell when you feel like trash. I've done it before, I'll do it again, but I think for some of us it unfortunately takes more than exercise.
I still also highly recommend exercise as part of any effort against depression. If you're able bodied, chances are it will only be able to help.
Anecdotally: plenty of sunlight, a vitamin D pill, enjoyable sex with your partner, frequent bouts of intense exercise, plenty of vegetables, few processed foods, a probiotic supplement, and healthy bowel movements 1-2 times a day.
Now taking less of each, cycling my dosage up and down as required. Sometimes taking neither for up to about a week.
You could bathe in diamonds every day, have the best lover, the most supporting circle of friends, be at the peak of your health and still be depressed. Depression is out of your control.
You can reduce triggers by living better but that's it. Even while living the happiest moments of your life you can still have depression lurk in the back of your head, probing you with negative thoughts.
No, I'm talking about clinical depression. But it's interesting that this viewpoint seems to be quite prevalent on HN.
>Depression is out of your control.
Perhaps in some cases, but in many cases there are things you can change that will improve it.
You seem to be making an assumption that clinical depression can't be due to lifestyle factors. This is an incorrect assumption, based on my own experience, that of family members, and research looking into psychological stress and neuroinflammation (for example).
>Even while living the happiest moments of your life you can still have depression lurk in the back of your head, probing you with negative thoughts.
The triggers for depression aren't "moments". It builds up over a long time, and isn't due to short-term factors. So while you might have a "happy moment" during depression, that isn't likely to cure it (and that isn't what I'm saying at all).
That being said, it's something I think everyone should work on. Just not as a primary response mechanism to life-destroying issues happening right now.
Other than that, eating well, having plenty of great sex, and interacting with as many people as possible. OH most important, SLEEP, a full solid night of it. Naps are awesome too.
I used to run a couple miles in the morning and evenings, on streets, until I injured my leg. So I switched to hiking after my leg recovered. Short 2-3 mile hikes turned into 12 mile stretches, which turned into short trail runs, and now I'm running 5-6 miles of trails 2x a week and 12+ mile runs/hikes on weekends (I'm secretly training for an ultra). I'd always thought I'd hate running, because it was too strenuous or something, but I haven't looked back. Maybe I'm just literally running away from my problems, but, it's far more rewarding in any case.
It's 6am in Seattle right now. I woke up and I'm about to go to the gym and do my 5x5 workout. I do this 3 times a week and it changed my life ever since I started doing it two years ago.
If you have mild depression, or want to not get depressed in the first place, I'd recommend the following:
Do exercise, do it outside if at all possible. Even light exercise like going for a walk is better than none. Don't take your phone.
Turn off and shut away your electronic devices an hour before you go to bed. Under no circumstances have your phone by your bed. Buy an alarm clock if need be. Disrupting sleep is the best way to get depressed quickly.
Delete or neuter[1] your social media accounts. They are engineered to make you feel bad (so you click ads).
Get something to look after. A dog, or if you don't have time or space, a cat, or if you really don't have time or space a plant or two.
Put effort into your relationships with friends. Even if you don't feel it's being reciprocated. No friends where you are now? Find local meetups and go to them regularly. e.g. Parkrun, reading group, musical group, dev meetups. Keep going every week.
Put effort into yourself. Tidy up your living space, dress and groom well every morning.
1: https://blog.mamota.net/posts/solving-facebook/
I hope a lot of people are making a correlation between their friends who have recently had young children, and why they often tend to look tired, miserable and depressed.
I'm glad your specific approach with your specific child worked out great.
As someone with two dogs and occasional bouts of mild depression, I would caution against getting a dog for this purpose.
It's a lot of responsibility, and it helps some people with depression but hurts others. A plant is a much better idea. If it doesn't work out, just throw it away. You can't (easily/responsibly) get rid of a dog, in many cases.
Being responsible for someone or something is difficult, it's supposed to be.
My depression this year has been the worst ever - because of external factors like losing a good source of income, getting hired by an employer who then never paid, and some marital issues around faith/church (I left the church we belong to (Mormonism) because I no longer believe and am leaning Agnostic), and then celebrity(Chester Bennington)/external influences of people I know who died by suicide. Plus, I can't help feeling that death's around the corner and could happen any day. Watching 13 Reasons Why probably wasn't a great thing to do either in hindsight, though it was a pretty good series.
I've gone from one month making 7k to <500 the next and spending all our savings just to get by. I'm trying to build up my freelance docket, and hopefully through word of mouth grow out of this phase (plug: Laravel + Vue is my stack).
The point of the rant is... without my son, I think I probably would've done the unthinkable. There's also many times where I just felt crushed inside, and I didn't know what to do... but I'd go upstairs and just hold my son, and cry a bit, and it's hard to stay upset when you think of this kid and the life ahead for them, that they can do things better than you did and hopefully not make the same mistakes. Not to mention the cuteness/cuddles cheer you up a bit, I'm sure there's probably some endorphins being released even.
My dog died this year, but in the past holding/petting her helped some with depression too. Sometimes I will go a day or two without even going outside, and I find my mood also brightens if I just take out the trash or walk around the block.
Depression sucks. In order to take your mind off of it, find a goal and pursue it. Helping others is one of the most universal methods. No matter how bad are you, there are people in worse condition than you. These people will see an angel in you if you show some care. "Be the person you needed when you needed someone"
- Go to sleep and wake up at regular times.
- Make sure you eat sufficiently (dont skip breakfast).
- Make sure you have people to talk to on a regular basis. Isolation makes things worse.
If you are so deep in depression you can hardly function, you probably need to see a specialist ASAP and get professional counsel first before trying to hack anything.
It contains a lot of advice on how to choose a therapist and how to behave with them and what you can otherwise do if you won't go to a therapist.
I don't know about some of the other advice. Eating habits don't seem to work for me, and following a strict diet makes things worse because I spend a lot of time worrying about food if I do that. Exercise? I've never found any exercise I enjoy when I'm content, let alone trying to get the energy up to actually follow through with it. The only way I can work that in is if I walk as my primary transportation.
Having a structured day helps me a little bit, but this is simply because it doesn't give my brain time to ruminate as much. Meditation seems unbearable if I'm depressed. The sessions themselves aren't so bad, but I obsess with it off and on through the day. Mindfulness just makes me feel anxious because I'm constantly worried that I'm not normal and I can't tell if that is true or not.
Now, the things that have helped keep depression away have been different. I couldn't do this stuff in the depths of depression, but making the changes changed my life outlook. I do get mild depression now, but it doesn't last as long nor feel as bad. I made life changes. I got in a stable, loving relationship after ending a bad one. I moved, which gave me a little more control over myself and how I acted because expectations changed. I did MDMA. Not that this is something for everyone nor actually legal, but it let me parse out some of the things in my head. The weeks after taking were an eye-opener.
I imagine doing this with an actual therapist would be even more helpful. I completely understand why it seems like a miracle for mental health in drug trials.
I've done other sorts of drugs in my life - lsd, for example. While they shaped some of my perception and thoughts about the world and life, nothing was quite like this. I couldn't describe myself as unhappy before, but now I'm really content with life.
I should now mention that I would urge folks to have caution. I can understand how folks would get addicted to it. And there is a risk of simply doing it too often and actually having the opposite effect. This is something to do occasionally, not every weekend or even once a month. The most profound change was the first time: I've done it since then, and it while (for me) it reinforces the things I learned the first time and still feel mentally refreshed the next day, it simply isn't as large of a change.
Another small sidenote: I've done it with my spouse. It also strengthened our relationship as well simply because we basically sat and talked positively for hours.
Then they came home, saw me watching and said, "oh you've got to turn off the VCR." They did that and the picture became impossibly crystal clear. I was floored by what I had been missing and how I had convinced myself that things before were "fine."
Had pretty much the same experience the first few weeks after taking MDMA. Felt like someone had improved the reception on the world and turned off the static and noise.