Unfortunately, the capitalist system often ends up in rent-seeking. Property rights gives folks the rights to hoard resources and rent them out. This is a complicated topic with no clear yanswer. Obviously, owning, leveraging, and renting assets is a motivator and reward to those who are winning in the game.
Wow, it's almost as if the modern economic system itself is the problem... /s
Their insistence on framing depression as if it were a biological illness (and not a result of the complex and historical interplay between psyche/desire and environment) is repulsive to me. Feels like blatant propaganda to discuss depression as "merely" an economic problem, in "scientific" american no less.
> Wow, it's almost as if the modern economic system itself is the problem
What makes you so sure that it's our economic system (inb4 "let's blame capitalism for everything") and not all the other aspects of modernity that make is isolated, atomized, and nihilistic?
We don't need to invoke "capitalism" to discuss the psychic distress involved in repetitive work schedules and, more generally, the expectations surrounding labor and wages, i.e. the modern economic system. The term contains too much, although I do personally agree with many critiques of capitalism.
Because life as a hunter gatherer just a few days away from starvation at any point was less stressful? Generations upon generations of farming was less repetitive?
I'm assuming you misread me, because I'm saying something to the effect of "reducing work hours and providing flexibility might be helpful for people, but the present social equilibria prevent that from happening, and mental health provides an excuse to avoid changing aspects of the economic system that have issues", and not some primitivist whatever.
I don't think it's repetitive work or expectations surrounding labour that cause psychic distress, but worker alienation, which is one of my main gripe with capitalism.
I might be wrong here, but I feel that we can endure a repetitive work schedule and high expectations if we feel connected to the work and the fruit of our labour.
Feeling connected to work and the fruit of our labor is largely a matter of attitude. I've mopped floors for minimum wage and still took satisfaction in doing it well.
There is a matter of attitude and a matter of reality. Deluding yourself into feeling connected into meaningless work that will benefit no one but a few is just that, delusion.
Besides, worker alienation and alienation in general is way more than just taking satisfaction in doing things well, it's actually feeling connected to what you are doing and it's purpose, and feeling connected to the social relationships that enable your life instead of seeing them as impersonal exchanges of commodity on the market.
Strikes me that a lot of this is what people used to get from religion. I'm not religious myself, so definitely not trying to push it, but it does seem that there's a correlation between the rise in incidence of depression, feelings of disconnectedness, and lack of a sense if purpose that goes along with the decline in participation in organized religion.
What's the guy's point? Skimming the article, he's just saying that some people have more than others. And? So what? Is that supposed to be self evidently mentally distressing?
No, what’s distressing is that those at the bottom have nothing, and those just above the bottom are literally swimming for their lives, treading water and trying not to die.
Do you know what one of the animal models for depression is? It’s called the “behavioral despair test,” but it’s actually much crueler and more insidious than it sounds.
Put a mouse in an inescapable cylinder filled partly with water. The mouse will initially try to swim and escape, but eventually gives up. Remove the mouse after 15 minutes. Just 24 hours later, the procedure is repeated and the mouse gives up after less than 5 minutes. The mouse has become depressed.
These are the conditions that capitalism knowingly imposes on those at the bottom of the economic ladder. Living paycheck to paycheck just to keep a roof over one’s head, if one is lucky, is what it’s like for a huge swath of America.
And, this is, if not “by design,” working as intended!
Can you honestly tell me that a literal 24/7 struggle to survive isn’t “self evidently mentally distressing?” Because it sounds to me like a recipe for PTSD and depression.
Doesn't this describe nearly all of human history, for the vast majority of humans who have ever lived? For far longer than capitalism was ever the basis for any kind of human society?
I think the point was that human history predates the recent increase in depression. Having unmet needs you need to work to fill is the baseline state of all animals, and the unending grind to fill them is what we are evolved to do.
People would still have plenty of unmet needs if the basic physiological and safety needs in Maslow's hierarchy are met. What kind of straw man are you trying to argue here? If anything, having those needs met makes it easier -- nay, possible -- to "grind" toward needs at upper levels of the heirarchy (not that I accept your contention that humans were "evolved" to "grind").
Who says the increase in depression is "recent?" The article itself mentions the strong upward trend since 1990. You know 1990 is 30 years ago now, right? (Not trying to be condescending here -- I genuinely forget this myself sometime.)
Then, what are you arguing? Why does it even actually matter if the increase in depression is recent, or not? What does that have to do with the fact that mere survival does not have to be a constant 24/7 struggle for anyone, really? And, what is your evidence we were "evolved" to do much of anything besides survive and breed? More importantly, who cares?
The thing is that it just doesn't have to be this way anymore. We'd all need to work somewhere around 8h a week to produce enough food, housing and energy to survive.
Instead we make up bullshit jobs and spend hundreds of billions of dollars to convince people people they should be unhappy with what they have, while structuring the necessities for life and social function around extractive institutions.
Actually many people believe it does not. Living off the land might have caused stress occasionally due to e.g. natural hazard but on average people may have been able to get by with relatively little effort: https://en.wikipedia.org/wiki/Original_affluent_society
No. The problem is that capitalism creates wealth but in an unsustainable manner, and distributed very unevenly. This is pretty inherent in how capitalism works, because the way the free market works is that it responds to people voting with their dollars. This means that people with more dollars get more votes. So, guess who ends up with all the wealth?
This is a very simplified version of what goes on in a capitalist economy, but it can be made more rigorous using modern concepts of economics. The end result is still the same, though: a very few control an immense amount of wealth, while many have little, and some have none or nearly none.
As my meditation teacher explained to me - consumer capitalism needs to make us feel unhappy all over again in order to sell us all the stuff. People content with their life do not need to buy stuff or experience to fill their inner void, they do not make good citizens of caplitalism.
Yeah capitalism was much more ruthless in the early days of the US yet there seems to have been less depression (of course due to different societal factors surrounding diagnosis this can't be said with certainty). Even looking more recently where we have better data - suicides continue to go up through the 2000s. Is the claim seriously that the US is more capitalistic or forces more work/less engaging work now than it did in the 80s and 90s? I find that hard to believe but would be interested in data that could inform the question either way.
Certainly bad financial situations are a risk factor for depression, and we should do more to address these issues so that people working full time jobs can actually make ends meet. But I do also worry that the push on the other side to continually cut back work hours will only make things worse. HN is a total bubble, most people without a career do not know what to do with themselves. Sustaining intrinsic motivation for long periods can be very difficult. Continuing a project without regular feedback can feel impossible. These are big reasons why doing a PhD can be a really tough experience. You might not think it matters if people are productive, but in the long run it is critical to the mental health of many that they feel productive. Work also generally keeps people on a routine schedule, forces some amount of social interaction, etc. These are important for a healthy life.
As I mentioned the further back you go the harder it is to say anything definitive. But I do think it's telling that depression rates keep rising, and this isn't even just a 21st century phenomenon. There are epidemiological studies from the late 80s that read very similarly to the alarm raised now: https://jamanetwork.com/journals/jama/article-abstract/37702...
Going further back, discussion of a link between modernity/depression is largely speculation, but it is a popular hypothesis and there are some studies that focus on suicide rates for a more data-driven approach. It is harder to find information on US numbers but Scandinavian countries are notorious for access to thorough epidemiological data: https://journals.sagepub.com/doi/abs/10.2307/1389426
I think it’s worth noting that though many people would understandably view those two aspects as contradictory (biological in nature and often social and environmental in instigation) this is definitely not the dominant view of psychiatric professionals or researchers. Lead poisoning has a relatively simple cause and effect chain that few would claim is not biological, but nobody trying to combat it is blind to the environmental and social factors that determine who gets it.
You may not be the target audience of this particle piece, in the sense that they don’t have to convince you depression is worth paying attention to. When trying to signal-boost an issue, you often have to play up aspects of it that you yourself might not find to be the most acute, or even the most humane as in this case. If this is the angle that has to be taken to get it taken seriously by some people, I’d rather the argument be made than not.
Of course. The prospect of working 40 hours a week for the rest of your life on some miserable bullshit job, with no perspective and the future looking bleak, tends to make people depressed.
But instead of admitting that their life simply sucks, they are brainwashed into thinking that there must be something wrong with them.
It's part of the reason why psilocybin is so effective. It makes people actually realize that. That no amount of meds will fix it. That to be happy, you will have to change your life, get unstuck from all the things you don't really need, and prioritize happiness.
Don't recall where I read it, but it resonated with me intuitively: depression is the body's way of telling you that you need to make a change in your environment. Whether it's move to a different city, get a different job, a different girlfriend; something in your life right now isn't working for you.
It's problematic when you can't make those changes, e.g. you're young and still living with/dependent upon parents, or you feel you'd have to give up too much e.g. being close to your kids, or people are telling you to just take a pill and it will be better.
IDK about psilocybin, never tried it, seems like more snake oil honestly, there are no magic answers here.
Definitely makes sense and sounds like a super healthy response to depression to realize that something should change if you're very depressed. Might not be easy of course. I think psilocybin isn't snake oil because I don't think anyone is promising it as a cure, taking some might break you out of your normal mental state enough to make you realize all sorts of things, including that you might have to change a whole bunch to get better. Not a cure, just something that make you recognize the problem or at least the existence of some problem.
> depression is the body's way of telling you that you need to make a change in your environment
That doesn't sound plausible, as one of the main parts of depression is often debilitating lack of motivation (much more than sadness or anxiety). So depressed people are usually the least likely to be able to independently make any kind of significant change in their life - they're already spending most of their "energy" on getting out of bed and following a routine.
Not to mention, establishing clear routines and minor goals is one of the main recommendations (outside medication) for dealing with depression.
To be fair, these could also be symptoms of burning out or an otherwise toxic work environment, in which case changing job may be a part of the healing process. Unfortunately, people who suffer from depression will often need outside help to actually go through such a change.
So What alternatives are people having success with? the 40 hour work week sucks, but what else can you do that's better?
I guess part of it depends on what you personally have an issue with. But I can't see trading 40 hours of meaningless work for 80 hours of running my own business, or dropping out and living some nomad life. Or the constant hustle and living near poverty to be in arts or academic research .
That's something you probably have to figure out yourself, the answer is different for everyone. Doesn't have to be that drastic. Maybe the one obvious thing I often see a lot of people are reluctant about is quitting their job. If it's not fun just quit. Try a new company, if that isn't working either, quit and try again. At least something is changing, eventually you'll either find something good or figure out something else to do.
Yeah maybe, quitting and job searching can really be a horrible experience itself. I started considering a career switch and giving up on tech during my last one until I finally found a place that would hire me. Then that job burned me out and I turned pretty cynical about work and tech.
>eventually you'll either find something good or figure out something else to do.
Or they'll die of exposure on the streets, or worse. People, in general, can't be expected to solve fundamental problems of the distribution of wealth, opportunity, education, healthcare, food, property, knowledge, power, and comfort in our society by job hopping. The median job in America is a bullshit job for a petty dictator which is a direct result of terrible policy over decades.
The "or figure out something else to do" at the end of your comment is telling of these systemic problems, even if you did not intend it to be such a profound criticism of society and culture.
>Their insistence on framing depression as if it were a biological illness (and not a result of the complex and historical interplay between psyche/desire and environment) is repulsive to me. Feels like blatant propaganda to discuss depression as "merely" an economic problem, in "scientific" american no less.
It's not one or the other. It's both, bio & environmental, like near-everything else.
I’m glad this reply is not at the bottom of the page, but I’m sad it’s not at the top. I did come here hoping to see it, though, so I’m netting pretty content right now.
The tech field is one that requires constant and ongoing self-development and learning, or you're just going to be left behind and gradually become all but unemployable (those who are able to carve out a niche by becoming an expert in an in-demand ancient technology like COBOL aside).
But how do you get the energy and motivation for constant learning and self-development when you struggle to get out of bed every day, or are burnt out on tech altogether?
Even if, against all odds, a depressed person manages to get a job, it's likely that doing it will feel meaningless and overwhelming, leading to a struggle not to quit, poor performance, and possibly firing.
If you screw up at work because of depression, of course you're not going to make a good impression on your colleagues, making getting hired or recommended by them in the future even less likely.
If one is out of work for extended periods of time, not only is that a drain on your savings, but also an economic drain on whoever helps you (whether that's family, friends, or society).
Then there are the secondary economic effects of all that lost productivity that the depressed person could have contributed to the economy but didn't because of their depression. All of the deals that could have happened, all of the innovation that was missed, the people that they might have inspired, etc, have economic consequences that are difficult to quantify but that are real nevertheless.
This doesn't even go in to the potentially drastic economic consequences of suicide, both to the family of the person who takes their life who might have been relying on them for sustenance, and because of the knock-on economic effects of depression and trauma of those affected.
That is a real problem. Here is my advice to people in tech. First, don't think you can work in tech until you retire. Maybe you will. But burn out is real and it usually happens gradually. The key is to save (and invest) as much money as you can in your early career so that when the time comes you have options. That also means being active and looking for jobs every 2-3 years in order to improve your salary. (you'll also gain more experience by working for different companies)
As for the learning part. Yes, finding motivation for self development is not easy when you're depressed or burned out. I'm not going to talk about dealing or treating depression since I'm not an expert. One thing I found helpful is developing different interests of mine since it solves the motivation problem. For example, recently I got into the world of investing and I'm learning a lot. This doesn't solve the problem of finding motivation for self development for work, but it helps in making me more productive and overall more excited about learning and doing.
This is good general career advice for non-depressed people (or maybe people with minor depression), but unfortunately the severely depressed person is unlikely to be very interested in anything (or not long enough to make a career out of it), and just doing career-oriented things like looking for jobs could be an enormous struggle.
Not that it's necessarily completely hopeless, and it varies from person to person, but people tend to underestimate how difficult ordinary, "easy" things are for people who are severely depressed.
Do you mean your learning unrelated things and its making learning tech and work related things tolerable again? Or just learning in general has been good for you?
A combination of both. For the most part just learning in general has been good for me. But it has a positive impact on my overall mood and productivity so it helps at work too. I should also mention that it can also have a negative impact on work. Often I'm more interested in doing non-work related learnings during work time. But so far it didn't get me into trouble. I can still get enough work done to be a valuable employee (although not a top performer which I'm totally OK with). I think what I'm trying to say is that my work productivity is effected by my overall well being. I think that's true for everyone.
I think only requires constant learning if you do bad choices.
If you learn angular, knockout and those framework: your not learning javascript. You're wasting your time learning framework specific stuff and at the end of the day, you don't even know js.
For example if you learned react 6 years ago, you would need to learn about hooks and very few things.
I think it's just a matter of choosing the right tools.
> The tech field is one that requires constant and ongoing self-development and learning, or you're just going to be left behind and gradually become all but unemployable
Slight tangent, but I hear this all the time and I think it's total BS. Yes, if you're working at a big tech company and are gunning to continually move up the ladder, it's true for a while (eventually soft skills become more important for most), but I know plenty of developers who make a competitive salary, even in HCOL areas, and don't look at code outside of their 9-5 jobs.
Sure, they're not making FAANG salaries, but they're making more than enough to live comfortably on. I can name three different ex-colleagues at three different companies all making well over 100k a year and they're all still writing JQuery.
If you're not striving for the top, there are plenty of development jobs where you can make an above average salary and keep work at work.
Point taken, but I'd argue that those people who manage to work 9-5 for extended periods of time are, first, probably not suffering from severe depression, and second are actually participating in on-the-job learning that really adds up over the years.
If you have severe depression, you are probably going to be missing out on years (or even decades) of work, and not learning nearly as much either on or off the job... or at most learning a bit on the rebound from your depression (as it's often cyclical, and even severely depressed people tend to have better days when they feel at least somewhat motivated or at least manage to keep it together).
Such severely depressed people are just not going to be competitive with people who manage to keep on working 9-5 for most of their career, even if the latter put in zero extra effort to learn outside of work.
> I can name three different ex-colleagues at three different companies all making well over 100k a year and they're all still writing JQuery.
And when they next apply for a job the recruiters will hang up because they don't have x years of $hotNewTech. Sure they'll probably land a job sooner or later anyway or may be able to rely on word of mouth, but it does give you less opportunities. The jobs they're being rejected for are run of the mill ones too, nothing to do with "striving for the top".
Of course this is stupid and anyone with experience should be able to pick up $hotNewtech easily, but it's how things currently work.
> The jobs they're being rejected for are run of the mill ones too, nothing to do with "striving for the top".
This is absolutely not true and you're just perpetuating the myth.
One of them was the head of another project at the company I worked at pre-covid. He liked the company we were at, but had to move across the country because of some family issues and wasn't sure if the company we were at would let him work remote full time, so he started interviewing so he could have a fall back if they said no. It took him about 6 weeks of interviewing to get 2 different offers. Both interviews were from companies you've probably heard of, but neither were companies I would classify as "tech companies".
If you've got more than a few years experience and are looking in the right places, there are tons of people who don't care that you aren't writing what ever the latest technology is.
Big cities that aren't traditionally "tech cities" have tons of these jobs. Also, like I mentioned above, big companies that aren't tech companies, but have internal tools that need to be maintained have these positions as well (regional banks, large school districts/colleges).
> It took him about 6 weeks of interviewing to get 2 different offers.
And how many rejections did they get for not having $hotNewTech on their resume? That they got a job doesn't demonstrate that they had fewer opportunities, which was the point I was making.
I think our industry is big enough to have some parts where your point applies, and other pockets with completely different dynamics.
Two caveats I would put is: we can do self-development and learning during our job hours, I'd argue it's a right that is usually understood and well supported by our workplaces.
A somewhat darker point: in 20 years there will still be devs writing jQuery, but it will only be a super small fraction of the devs that were in it 10 years ago.
The same way we have devs writing new COBOL code now, and there will still be some 50 years from now, but you can't expect 20% of our field to be leading a successful career in COBOL for the next decades. It will be a selected few that get to keep doing that job for that length of time, the rest will have to move to something else either way.
> I think our industry is big enough to have some parts where your point applies, and other pockets with completely different dynamics.
Yeah, I agree, that was kind of my point.
I see a lot of people who talk about software development as if FAANG is the only game in town, but like you said, our industry is big and only getting bigger. If you know where to look there are tons of laid back tech jobs that don't expect you to eat, sleep, and breath code.
I disagree with you though that there are only a select few who will be able to get these jobs. I think as time goes on, were only going to have more legacy systems that will require knowledge of older languages. Also as tech continues to infiltrate every other aspect of our lives, more and more companies will start to need one or two in house developers to do random tasks where no one cares whether you're using the latest and greatest technology.
Maybe it's just me, but I can't think of anything more depressing than doing the exact same thing my entire career. I think the need to stay current is an advantage of the tech industry.
Equally depressing is the thought of giving up all the ground gained and lessons learned every time a new fad takes the stage. Watching the same mistakes made over and over, only moreso... That's depressing.
I think this as much as anything contributed to my burnout. Burnout is maybe too strong a term -- disillusionment is maybe better. I see younger devs getting excited about something new, and to me it's just "yeah I've seen this movie before." The novelty factor is just gone -- work is simply not that exciting.
The thing is, though, that there are probably new technologies (or at least technologies that are new to you) that you'd probably find interesting.
The key is finding them and giving them a chance.
When I was young I hadn't heard much of Lisp, and what I did hear didn't sound that great (Lisp was old and maybe it was great back then, but technology has advanced so much, I thought, that it's probably not worth bothering about)... but when I did finally learn it I fell in love and wished I'd learned it much, much earlier.
And it wasn't just a copy of something I'd learned before, as were many other technologies that I'd learned.
That said, when you are seriously depressed or burnt out (the two go hand-in-hand), it's tough to find anything interesting, even things that you'd normally be fascinated by.
Different strokes for different folks. I would go bananas having to keep up with the totally unnecessary technology treadmill: re-skilling again and again forever, on new hotness technology fads just because they’re new.
“I can’t wait to rewrite this legacy software in Rust!” - said not me.
There are differences in the "totally unnecessary technology" treadmill. If some employer says "I want to build this product on Azure. I heard it's hot. Oh and use Mongo DB too, and use Go" when it would be sufficient to just spin up some sqlite-backed simple thing in Python on one low-end colo box, it's still unnecessary technology, but I'd definitely enjoy learning it. Those pieces of tech would also be good resume fodder for future jobs too.
When I have to learn some NIH-based technology that poorly copies something widely used (e.g. the place I currently work at has some custom language to generate "template instantiations in C" and some half-assed hideous clones of protobufs and grpc), I can't bring myself to care or really do my job.
Thank goodness this pandemic has made it easy to spend large portions of my day on leetcode / the CRLS algo book without anyone looking over my shoulder so I can get outta here!
Using old technology does not have to mean doing the same work. I write a lot of C for embedded systems, but it remains fun and exciting despite the language being 40 years old and the chips I program 15 years old. The systems I create are new.
> The number of US adults with MDD increased by 12.9%, from 15.5 to 17.5 million, between 2010 and 2018, whereas the proportion of adults with MDD aged 18–34 years increased from 34.6 to 47.5
If about half of young adults suffer from a disorder, it makes me question if it’s a disorder at all. And the noted impact of economic factors and things like Covid highlight the “nurture” aspect of the disorder instead of “nurture” (e.g. the “chemical imbalance” internet myth).
I’ve been diagnosed with MDD, GAD, ADHD, and bipolar type 1 but after I suffered a manic episode while on psych meds , I really dug into the research of psychiatrists and now have the controversial opinion it’s very weak science riding on the coattails of the rest of Western medicine and is obviously influenced by the for profit pharmaceutical companies. The DSM 5 wasn’t even created in the open.
Both as societies and as individuals, we need to introspect on how we can be so relatively wealthy yet so often so fundamentally unhappy. And the idea that half of the population has a brain disorder rather than is in a bad environment and conditioned by circumstances to feel that way seems hard to believe.
I’m very interested in the anti psychiatry movement which includes a small minority of medical professionals, and I’m more open to sane ideas that I used to consider “new age.” But more than anything, I think many aspects of mental health are like losing weight - very simple but difficult especially in the wrong environment. Close family relationships, diet, exercise, time outdoors, a sense of community, less time on social media - we mostly know that this is the key to feeling better but we desperately want an easier answer in pill from someone in a white coat and our profit driven medical system is more than happy to oblige.
I hope that before dismissing you, any critics would lend weight to the fact that you have been diagnosed with several disorders and been through the psychiatric system. You have some skin in the game here. So even though your advice is certainly not universal and many perceive great benefit from psychiatric treatment, there is some truth to be had in your argument.
The comment tone is way beyond advice and makes some bizarre claims about profit motives. Psychiatry is a hard subject and there has been some bad research, but it's pretty clear he has also done some reading on fringe sites. I understand being upset by shitty doctors and going down that rabbit hole, but it would be irresponsible to not respond to the comment when others on the fence about medication might be swayed.
The key point he is missing is that psychiatric disease can make those lifestyle changes orders of magnitude harder for someone to make than it would be for a healthy adult. As lifestyle gets worse you get a terrible loop going. Medication helps many break that loop - certainly not all, but it is something to seriously consider with your doctor.
If he was able to make those changes without medication that is great for him, but I think his message is kind of analogous to a rich entrepreneur that grew up poor telling everyone else they should just work harder and they'll move up in life. Is it probably good advice for those people to work harder? Yes, but many of them do not have the talent or luck to actually move up much, so it cheapens the message a lot.
After a certain point wealth has very little correlation with happiness. Once you get above basic needs the return on wealth to happiness really quickly diminishes.
I for one, would be much happier with a less overtly abusive workplace, and oppressive living situation. Money is not everything, but as I cannot afford a better existence, it might as well be the only thing that matters.
I'm not sure if you're asking for specific advice personally, or thinking of others but my response is generally the same. It's very hard for even a well adjusted person to create a replacement familial environment. In decades past the advice would be to go to church. Today? I've got no clue, I'm trying to figure this out.
Establishing, and garnering respect for, clear boundaries with ones abusers is an exceptionally tough task for teams of social workers working in the context of child protective services who have leverage, and the legally authorized threat of force, over the abusers.
The best alternatives are to "build relationships" with good people and find a "good psychologist" to assist you along the path as you assuredly take detours off your path and lose your way. It's hard, you'll find disappointments, may be revictimized, possibly suffer your own regressions and have to rely on yourself more than anyone should have too. I'm sorry I don't have good answers, but the task at hand is surmountable and everyone deserves a safe, loving, supportive familial-like community to uplift them and be uplifted by them.
For context, I've had almost exactly the same set of diagnoses as you, except my manic episodes were shorter so they called it type II.
I largely agree with you - diet, exercise, close friends, time in the sun and so on are fantastically useful and underrated. They solve a lot of things.
That being said, even when I had lots of close friends and was in fantastic shape, I wanted to kill myself. SSRIs stopped me from thinking about suicide every single day of my life - they literally changed my life. Lithium largely fixed the mania. If there are real, objectively bad things happening and taking a drug can stop them, I'm all for it.
I definitely think that psychiatrists don't know WHY a lot of things work and I think they way they diagnose and treat patients is basically just "try these and see if they work" but I don't think it's worth throwing everything away just because the solution needs a lot of improvement.
There are certainly issues with psychiatric disease diagnosis, but I also don't think it's surprising MDD diagnoses are high (the real number in that age bracket seems to be somewhere in the range of 10-20%). AFAIK the DSM criteria for MDD only require a single depressive episode.
Having a depressive episode at some point over the course of a lifetime should be seen as normal IMO. Someone can have a depressive episode and benefit from help at the time just as someone can develop a bacterial infection and require treatment. It does not need to be thought of as a chronic state, even though in a minority of cases that will occur (and is obviously much more debilitating).
Sometimes medication is extremely beneficial, other times it is not, but very few people are just being pumped with/kept on meds. You can see here that only ~6% of people with a diagnosed depressive episode in 2017 were treated with meds alone: https://www.nimh.nih.gov/health/statistics/major-depression
Of course most therapy is going to include work on lifestyle habits like what you've mentioned. While many of the people regularly receiving therapy were also on a medication, it is standard of care to do meds + CBT as they have well-documented and independent impacts on depression recovery.
It is normal to taper off use of antidepressant after a first depressive episode, and I think it's safe to say most people doing combination treatment will have proper oversight of their medication use. Maintenance medication is mainly suggested for those with a history of recurring episodes.
I'll also note I don't think this has anything to do with money grabbing. Prozac remains the most prescribed antidepressant, yet it is not under patent. Therapy on the other hand can cost an arm and a leg. Of course therapy cannot be mass-produced, but from an individual prescriber perspective therapy is more likely to be financially incentivized.
No doubt psychiatry is still operating largely in the dark ages, but that's simply because it is a hard problem (and perhaps some institutional incompetence mixed in). Drug development for psychiatric disease has actually mostly hit a wall, and numerous pharma companies have cut neuroscience research departments, because these clinical trials had a low enough success rate that the R&D costs could no longer be justified.
Further, I agree that lifestyle decisions can have a bigger impact than people think, but this sort of anti-medication attitude and thinly-veiled accusations of laziness only push patients away from good lifestyle changes. Depression can make it harder to do those things you mentioned, and it becomes a very nasty cycle. Medication can help break that cycle if used properly.
It is indeed important to make clear that the meds are a tool and not a magic cure all, and I hate the common sarcastic remarks that get posted in depression groups like "thanks exercise cured me". But I get where some of that defensiveness is coming from. Let's all try to acknowledge that a treatment plan is going to involve multiple pieces, different pieces for different people, and is not going to be easy or perfectly effective.
There's a fine line between helping and enabling, but a lot of people seem to err so far on one side that they either applaud terrible behavior or talk down to people about symptoms that they don't fully understand. Meds can be a lifesaver for some and are not desirable for others, that is something that needs to be determined by the patient and their care team(s).
Diagnoses are billing codes. They are not labels, identities, or personality traits. This reductionism is rampant, even amongst highly credentialed professionals. It is therefore my opinion that one is better served to investigate why they're using maladaptive coping strategies, learn new strategies, and demand that they be supported by the very community who allowed them to decay so far. (We can argue causation until the cows bones have fully composted, but that's a dead end.) Mind you support is like a crutch for someone with a broken leg. If you give someone with a broken leg a wheelchair and don't let them walk for two years their uninjured leg will atrophy causing another problem. Likewise, if left untreated a person's broken leg will not set correctly causing a cascade of problems until the damage is appropriately treated. Mental illnesses, barring: brain damage, disease, etc, are often times the result of a cohort of untreated wounds in a persons past that are difficult and increasingly expensive to heal with time, but it is our obligation to engage in whatever ways necessary so that when it us on the bench we can be supported. Any more specific examples I can give are likely to be far more controversial than what I've already said and I would prefer to stay on topic regarding the treatment of serious mental illnesses like MDD.
All of these "economic damage" studies have to be taken with a big grain salt due to the partial equilibrium nature of the analysis.
Take a simple example: Look at how many times waiters get sick with the flu, say a million hours per year, and then multiply by the average amount of money a waiter earns - say 20 bucks an hour -- and conclude that the flu costs the restaurant economy 20 million dollars.
Well that assumes that if the waiters didn't call in sick, that an extra 20 million dollars of tips/earnings would have been available. Yet that amount is determined by the demand for meals, not availability of waiters, and when one waiter is sick, others cover for them so all the meals get served. But then the extra labor of waiters needed to cover for each other is a cost, no? Well, again no, as collectively the pool of waiters that cover for sick waiters is the same pool that call in sick -- it is some extra volatility in hours worked, but total hours worked is unchanged. So at the end of the day, it's hard to determine how much damage to the economy is created by waiters calling in sick and covering for each other. It's certainly much, much lower than what you get by multiplying hourly wages by time spent sick.
Now come to depression. Depression may be just the mental price of brains capable of risk assessment or deep thought. Like sleep is not a dead weight cost, but just the price of having a developed brain. It's not clear that Depression is "costing" us anything anymore than sleep is costing us lost labor, and it could be that a world without depression would also be a world without genius, realism, and creativity.
I disagree. Depression appeared in humans for a reason. It is possible that one of the results of it, and the reason it sticks around is because there is value to it, even if it is exceedingly painful. Regardless, having a reason to endure, even if incorrect, has value in and of itself, even if you don't see it.
But what else could it be? You can’t just say that something has an evolutionary cause without also implying that the trait is for the purpose of survivability, which we associate with the notion of “good”.
Well strictly speaking, nothing in evolution happens for a reason - this isn't intellegent design, there is no agency or intentionality in evolution.
So if you didn't mean the usual metaphorical notion of, "was selected for by natural selection because it increased evolutionary fitness", what did you mean?
Well I can imagine a couple, though I don't have any particular reason to prefer them. If people who are unsuccessful in achieving status in their tribe or whatever (totally independent of their fitness otherwise) become depressed and as a result don't reproduce, children are more likely to be born to parents who can provide for them. All the suffering could just be side effects that are besides the evolutionary "goal". Sort of like how poisoning causes you to suffer a wide range of uncomfortable effects (nausea, vertigo), when perhaps the only real evolutionary "goal was to make you vomit the poison.
I think the prior poster may have been making a point more along the lines that depression is a downside of having benefits like neural plasticity or something, not that this disease state is necessarily beneficial in itself. More like how the downside of having high-performance tires is poor rain traction or something.
How does that constitute an evolutionary model? The genes for depression reach a dead end in the people who didn't reproduce; they aren't being passed on in the children of the people who did. Is this a kin or group selection model?
I assume you're talking about the first one? Having the gene for depression here would not always cause the individual to be depressed. Actually that would hold for both cases.
The trait is passed on because it benefits the species. You have to consider more than individuals in the evolution of social animals. In various circumstances some organisms will eat their own offspring. Obviously the "infanticide gene" if considered alone, would not make evolutionary sense, yet there it is.
There is no benefit to a gene in benefitting the species per se. A trait that increases the size of the gene pool while decreasing its own absolute prevalence will die out.
Group selection is a possible mechanism in social animals, but it requires the group to be strongly interrelated relative to the rest of the species, and it relies on the group being able to expand at the expense of the rest of the species.
Infanticide makes perfect sense; offspring are only related 50% to the parent, so if resources are less than 2x as effective in the bodies of offspring compared to once they have been digested by the parent, of course they should be consumed. The genes of the offspring won't agree, of course; for them the calculation is reversed.
I didn't say the trait would decrease its own overall prevalence. The trait wasn't simply to be depressed if get the genes, it was a predisposition to being depressed if circumstances not good for reproduction. If resources are limited, it would simply ensure that more successful members of a species are the ones to reproduce and get them. Same as in your infanticide calculation.
Resilience, endurance, learning to overcome adversity, learning to overcome yourself, learning to be self-aware, thinking "differently". I could think of dozens of other reasons. No?
I'm not sure these are good examples, but depressive realism is a pretty legit hypothesis about a potential evolutionary benefit. There's also some hypotheses about energy expenditure - doing nothing is sometimes the right move, although that would have been more important a long time ago than now.
These sort of ideas are hard to evaluate definitively, but I do think it is plausible that mild depression had/to some extent may still have benefits. Of course certain traits can be taken too far though, and when viewed through that lens it is hard to understand how they could be beneficial at all. One could say a similar thing about Autism-like traits.
Depression affects everyone differently. But it does not mean a constant unending, it can come and go and those peaks and valleys lead to what I'm talking about.
It could also be the degenerate case of something good. E.g. feeling withdrawn and unmotivated can be good sometimes - it can tell you something is wrong. Depression is like an extreme version of that. Maybe its the brain taking things too far and getting stuck in a bad state or something.
I dont know, IANAD, but it sounds mildly plausible.
There are e.g. some theories that it could be an evolutionary strategy.
> Another reason depression is thought to be a pathology is that key symptoms, such as loss of interest in virtually all activities, are extremely costly to the sufferer. Biologists and economists have proposed, however, that signals with inherent costs can credibly signal information when there are conflicts of interest. In the wake of a serious negative life event, such as those that have been implicated in depression (e.g., death, divorce), "cheap" signals of need, such as crying, might not be believed when social partners have conflicts of interest.
What exactly do you disagree with? The GP claimed that depression is a terrible malady, without any comment on why it exists. How is your tangent about a "reason" for depression in disagreement with what they said?
"There is no reason to create silly rationales to justify it."
I don't agree with that and I don't agree with how it is stated. It's an absolutist statement (poster is not an expert) and it is dismissive via "silly".
I don't understand your objection. I don't understand the pedantry across this entire thread over like two or three words that aren't even wrong. Just read the extra sentence in the post.
I know this sounds rude, but how many arguments are we going to have over bikeshedding? It's like yall are looking for things to jump on and bully people about without any empathy.
I don't personally care but I don't understand why you do it.
This is what I'm talking about.
You guys can't imagine any way in which depressions might provide benefits? That's how multiple people in this thread have acted. But maybe, just maybe, people that are depressed have a different perspective on life and maybe feel differently.
> You guys can't imagine any way in which depressions might provide benefits? That's how multiple people in this thread have acted. But maybe, just maybe, people that are depressed have a different perspective on life and maybe feel differently.
Yes, my own experiences with depression in those around me (thankfully not in myself) have left me seeing no way in which depression provides benefits. It is a terrible debilitating disease (or symptom, or whatever it is) that literally saps people of their will to do anything regardless of external stimuli. I find it very hard to imagine something so maladaptive being presented as possibly useful.
I would guess that sentiments like this are the main reason behind the powerful response to your thread. It is almost like claiming that "there is a reason for cancer".
Edit: I would also note that it's possible that we're simply talking past each other, as the term "depression" actually covers some quite different disorders; it's possible that what you're thinking of when you use this word is different from what I'm thinking of - to me, it mostly refers to a disorder where people feel either deeply sad or deeply anxious, but either way they are lacking almost entirely in motivation, finding it hard to even get out of bed sometimes; and all this with little relation to external stimuli.
There might not be a reason for us existing at all, that doesn't mean we can't and shouldn't make reasons.
This is all unsettled science. I've suffered depression for a decade. In my experience you learn to live with it and you learn from it even if you never fully get used to it.
You assume we're talking about different things with different results, but I understand your description of depression. I get different results from it than you because I handle it differently.
> It's not clear that Depression is "costing" us anything anymore than sleep is costing us lost labor, and it could be that a world without depression would also be a world without genius, realism, and creativity.
This might just be a semantic quibble, but I don't think the term "costing" necessarily implies that the burden has no use. For example, I might say something like "the garbage collector is costing us 20% of the clock cycles". That doesn't mean that I think we can just shut off the garbage collector off. It just as an attempt to account for how much its spending critical resources.
I don't think it is "quibble". These articles pull out these massive values for shocking headlines about how some minor delay or incident is costing millions per second like its some debt which at the end we will have to pay back when the reality is that things are as efficient and profitable as they have ever been in history and these incidents didn't "cost" anything they just represent the failure to achieve the most optimal result which has never been achived before.
The reason for that is fairly straightforward: if something doesn't have an explicit economic cost (whether it's about ecosystems, cultural heritage, climate change, or mental health), the policy-making part of society tends to ignore it.
Historians have long puzzled over the apparent mental instability of great and terrible leaders alike: Napoleon, Lincoln, Churchill, Hitler, and others. In A First-Rate Madness, Nassir Ghaemi, director of the Mood Disorders Program at Tufts Medical Center, offers a myth-shattering exploration of the powerful connections between mental illness and leadership and sets forth a controversial, compelling thesis: The very qualities that mark those with mood disorders also make for the best leaders in times of crisis. From the importance of Lincoln's "depressive realism" to the lackluster leadership of exceedingly sane men as Neville Chamberlain, A First-Rate Madness overturns many of our most cherished perceptions about greatness and the mind.
> From the importance of Lincoln's "depressive realism" to the lackluster leadership of exceedingly sane men as Neville Chamberlain
I find these comparisons deeply suspicious. If there indeed were a strong link between leadership ability and mental illness, there cannot be a very big difference between Lincoln and Chamberlain for the reason that both men were surely at the very tails of the relevant distributions. One does not become a British Prime minister by being average. I fully expect the book to be full of cherry-picked data supporting narratives built largely on popular stereotypes about successful and unsuccessful leaders of dubious accuracy.
There are many books, but only so many hours in the day. Conveniently there are also many HN readers who have also read the book (presumably, you included) who could tell me if I'm wrong and the book is worth reading. That being said the NYT review (https://www.nytimes.com/2011/08/11/books/a-first-rate-madnes...) does not inspire confidence in me.
> Well, again no, as collectively the pool of waiters that cover for sick waiters is the same pool that call in sick -- it is some extra volatility in hours worked,
But if waiters called in sick less would there be less waiters, and some of the waiters would instead be doing something else productive?
> Depression may be just the mental price of brains capable of risk assessment or deep thought
Isn't inability to accurately asses situations objectively and difficulty focusing both symptoms of depression? That seems the opposite of risk assesment/deep thought.
Well it’s likely those ‘freed’ people would be doing things that were less productive in the short term, though it’s likely the change would have positive long-term effects.
Negativity bias is associated with depression, but healthy people display positivity bias. Someone with severe depression is probably not accurately assessing risks, but it's plausible to me that mild/moderate depression patients may make more accurate evaluations in certain situations. My understanding is there is still debate in psychology about these topics, as different types of studies have found different results.
I remember that was also the plot of the movie melancholia. It does seem potentially plausible. Plenty of other traits exist that are terrible in normal times but key to survive abnormal times.
> Depression may be just the mental price of brains capable of risk assessment or deep thought.
Well that's macabre. I really don't think that grinding to an emotional halt is a natural consequence of attentiveness. It's the opposite, if anything.
It depends how you define "the economy" if you the think of only restaurant revenues (using the example), only then would it seem there is no impact to the resturant economy. However, there are other measures of how we define the economy, eg. expenditure or income measurement derived GDP. Compare two economies one without flu (or depression) and one that has the flu. The economic output of the former would be higher than the latter, using those methods due to lost output or income.
Waiters can cover for each other, what about those working full time? Ceteris paribus, a rise in depression that leads to the inability to work which will reduce the the size of the labour force and consequently output.
Your last point on it being the "cost of genius" is pure conjecture. A rise in depression (tripling according to the article) has definite costs in terms of the economy (tangible) and human well-being (the intangible). It is in public interest to reduce the incidence of depression.
As someone who had depression for quite a while and basically wasted 5+ years of his life due to that, at least from my own experience I can definitely say that there would have been ways to prevent this depression which could've given me 5 productive years back.
During this time I wasn't working or doing anything productive.
Btw the current first line prescriptions are extremely suboptimal:
SSRIs cause sexual disfunction in 60% and even pssd
Bupropion cause tinnitus
TCAs are neurotoxic
MAOIs have a diet that is not hard to follow.
Irreversible or transdermal MAOIs are the answer for first line treatment - >
Moclobemide and Emsam
They have almost no side effects and are more effective.
I think what they meant to say is that our economic setup has an enormous impact on our mental health. We're treated like labor robots ("human resources") with the constant looming threat of unemployment, having every last bit of value squeezed out of us so that shareholders can get a few extra cents out of their Chucky Cheese tokens that entitle them to absentee ownership of some resource they've never lifted a god damned finger to produce. Not to mention there's an enormous apparatus designed solely to convince us to buy useless trash that we don't need in order to support the very system continuously bending us over a barrel.
But hey, here's some fucking happy pills, now get back to work.
> We report our latest estimates showing that the incremental economic burden of adults with MDD was $326 billion in 2018, 38 percent higher than in 2010.
This way of thinking is fundamentally responsible for our societies being so suseptible for the spiritual crises which are mainly the cause of depression.
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[ 3.3 ms ] story [ 146 ms ] threadAgreed, however our economy serves to enrich asset owners, and the health and happiness of everyone else are afterthoughts.
Their insistence on framing depression as if it were a biological illness (and not a result of the complex and historical interplay between psyche/desire and environment) is repulsive to me. Feels like blatant propaganda to discuss depression as "merely" an economic problem, in "scientific" american no less.
What makes you so sure that it's our economic system (inb4 "let's blame capitalism for everything") and not all the other aspects of modernity that make is isolated, atomized, and nihilistic?
Also, stress alone isn't the issue here at all.
It was. Medieval serfs worked less than us.
http://groups.csail.mit.edu/mac/users/rauch/worktime/hours_w...
I might be wrong here, but I feel that we can endure a repetitive work schedule and high expectations if we feel connected to the work and the fruit of our labour.
Besides, worker alienation and alienation in general is way more than just taking satisfaction in doing things well, it's actually feeling connected to what you are doing and it's purpose, and feeling connected to the social relationships that enable your life instead of seeing them as impersonal exchanges of commodity on the market.
https://briarpatchmagazine.com/articles/view/gabor-mate-how-...
Edit: another good link with Gabor Maté talking about how capitalism harms our mental health.
https://patch.com/california/berkeley/ev--an-evening-with-dr...
Do you know what one of the animal models for depression is? It’s called the “behavioral despair test,” but it’s actually much crueler and more insidious than it sounds.
Put a mouse in an inescapable cylinder filled partly with water. The mouse will initially try to swim and escape, but eventually gives up. Remove the mouse after 15 minutes. Just 24 hours later, the procedure is repeated and the mouse gives up after less than 5 minutes. The mouse has become depressed.
These are the conditions that capitalism knowingly imposes on those at the bottom of the economic ladder. Living paycheck to paycheck just to keep a roof over one’s head, if one is lucky, is what it’s like for a huge swath of America.
And, this is, if not “by design,” working as intended!
Can you honestly tell me that a literal 24/7 struggle to survive isn’t “self evidently mentally distressing?” Because it sounds to me like a recipe for PTSD and depression.
https://en.wikipedia.org/wiki/Behavioural_despair_test
Doesn't this describe nearly all of human history, for the vast majority of humans who have ever lived? For far longer than capitalism was ever the basis for any kind of human society?
Today is today, not “nearly all of human history.” Who cares about “nearly all of human history?”
https://en.wikipedia.org/wiki/Maslow%27s_hierarchy_of_needs
Who says the increase in depression is "recent?" The article itself mentions the strong upward trend since 1990. You know 1990 is 30 years ago now, right? (Not trying to be condescending here -- I genuinely forget this myself sometime.)
I don't accept your non-acceptance of my contention.
I say 30 years is recent. Particularly given I was referring to evidence on a prehistoric timescale.
I hope that clears everything up for you. Totally not trying to be condescending either.
Instead we make up bullshit jobs and spend hundreds of billions of dollars to convince people people they should be unhappy with what they have, while structuring the necessities for life and social function around extractive institutions.
This is a very simplified version of what goes on in a capitalist economy, but it can be made more rigorous using modern concepts of economics. The end result is still the same, though: a very few control an immense amount of wealth, while many have little, and some have none or nearly none.
Certainly bad financial situations are a risk factor for depression, and we should do more to address these issues so that people working full time jobs can actually make ends meet. But I do also worry that the push on the other side to continually cut back work hours will only make things worse. HN is a total bubble, most people without a career do not know what to do with themselves. Sustaining intrinsic motivation for long periods can be very difficult. Continuing a project without regular feedback can feel impossible. These are big reasons why doing a PhD can be a really tough experience. You might not think it matters if people are productive, but in the long run it is critical to the mental health of many that they feel productive. Work also generally keeps people on a routine schedule, forces some amount of social interaction, etc. These are important for a healthy life.
What makes you think so? It is 100% honest question: what historical evidence makes you guess the rates of depression in early days of US?
Going further back, discussion of a link between modernity/depression is largely speculation, but it is a popular hypothesis and there are some studies that focus on suicide rates for a more data-driven approach. It is harder to find information on US numbers but Scandinavian countries are notorious for access to thorough epidemiological data: https://journals.sagepub.com/doi/abs/10.2307/1389426
You may not be the target audience of this particle piece, in the sense that they don’t have to convince you depression is worth paying attention to. When trying to signal-boost an issue, you often have to play up aspects of it that you yourself might not find to be the most acute, or even the most humane as in this case. If this is the angle that has to be taken to get it taken seriously by some people, I’d rather the argument be made than not.
But instead of admitting that their life simply sucks, they are brainwashed into thinking that there must be something wrong with them.
It's part of the reason why psilocybin is so effective. It makes people actually realize that. That no amount of meds will fix it. That to be happy, you will have to change your life, get unstuck from all the things you don't really need, and prioritize happiness.
It's problematic when you can't make those changes, e.g. you're young and still living with/dependent upon parents, or you feel you'd have to give up too much e.g. being close to your kids, or people are telling you to just take a pill and it will be better.
IDK about psilocybin, never tried it, seems like more snake oil honestly, there are no magic answers here.
That doesn't sound plausible, as one of the main parts of depression is often debilitating lack of motivation (much more than sadness or anxiety). So depressed people are usually the least likely to be able to independently make any kind of significant change in their life - they're already spending most of their "energy" on getting out of bed and following a routine.
Not to mention, establishing clear routines and minor goals is one of the main recommendations (outside medication) for dealing with depression.
I guess part of it depends on what you personally have an issue with. But I can't see trading 40 hours of meaningless work for 80 hours of running my own business, or dropping out and living some nomad life. Or the constant hustle and living near poverty to be in arts or academic research .
Or they'll die of exposure on the streets, or worse. People, in general, can't be expected to solve fundamental problems of the distribution of wealth, opportunity, education, healthcare, food, property, knowledge, power, and comfort in our society by job hopping. The median job in America is a bullshit job for a petty dictator which is a direct result of terrible policy over decades.
The "or figure out something else to do" at the end of your comment is telling of these systemic problems, even if you did not intend it to be such a profound criticism of society and culture.
It's not one or the other. It's both, bio & environmental, like near-everything else.
But how do you get the energy and motivation for constant learning and self-development when you struggle to get out of bed every day, or are burnt out on tech altogether?
Even if, against all odds, a depressed person manages to get a job, it's likely that doing it will feel meaningless and overwhelming, leading to a struggle not to quit, poor performance, and possibly firing.
If you screw up at work because of depression, of course you're not going to make a good impression on your colleagues, making getting hired or recommended by them in the future even less likely.
If one is out of work for extended periods of time, not only is that a drain on your savings, but also an economic drain on whoever helps you (whether that's family, friends, or society).
Then there are the secondary economic effects of all that lost productivity that the depressed person could have contributed to the economy but didn't because of their depression. All of the deals that could have happened, all of the innovation that was missed, the people that they might have inspired, etc, have economic consequences that are difficult to quantify but that are real nevertheless.
This doesn't even go in to the potentially drastic economic consequences of suicide, both to the family of the person who takes their life who might have been relying on them for sustenance, and because of the knock-on economic effects of depression and trauma of those affected.
As for the learning part. Yes, finding motivation for self development is not easy when you're depressed or burned out. I'm not going to talk about dealing or treating depression since I'm not an expert. One thing I found helpful is developing different interests of mine since it solves the motivation problem. For example, recently I got into the world of investing and I'm learning a lot. This doesn't solve the problem of finding motivation for self development for work, but it helps in making me more productive and overall more excited about learning and doing.
Not that it's necessarily completely hopeless, and it varies from person to person, but people tend to underestimate how difficult ordinary, "easy" things are for people who are severely depressed.
If you learn angular, knockout and those framework: your not learning javascript. You're wasting your time learning framework specific stuff and at the end of the day, you don't even know js.
For example if you learned react 6 years ago, you would need to learn about hooks and very few things.
I think it's just a matter of choosing the right tools.
Slight tangent, but I hear this all the time and I think it's total BS. Yes, if you're working at a big tech company and are gunning to continually move up the ladder, it's true for a while (eventually soft skills become more important for most), but I know plenty of developers who make a competitive salary, even in HCOL areas, and don't look at code outside of their 9-5 jobs.
Sure, they're not making FAANG salaries, but they're making more than enough to live comfortably on. I can name three different ex-colleagues at three different companies all making well over 100k a year and they're all still writing JQuery.
If you're not striving for the top, there are plenty of development jobs where you can make an above average salary and keep work at work.
If you have severe depression, you are probably going to be missing out on years (or even decades) of work, and not learning nearly as much either on or off the job... or at most learning a bit on the rebound from your depression (as it's often cyclical, and even severely depressed people tend to have better days when they feel at least somewhat motivated or at least manage to keep it together).
Such severely depressed people are just not going to be competitive with people who manage to keep on working 9-5 for most of their career, even if the latter put in zero extra effort to learn outside of work.
And when they next apply for a job the recruiters will hang up because they don't have x years of $hotNewTech. Sure they'll probably land a job sooner or later anyway or may be able to rely on word of mouth, but it does give you less opportunities. The jobs they're being rejected for are run of the mill ones too, nothing to do with "striving for the top".
Of course this is stupid and anyone with experience should be able to pick up $hotNewtech easily, but it's how things currently work.
This is absolutely not true and you're just perpetuating the myth.
One of them was the head of another project at the company I worked at pre-covid. He liked the company we were at, but had to move across the country because of some family issues and wasn't sure if the company we were at would let him work remote full time, so he started interviewing so he could have a fall back if they said no. It took him about 6 weeks of interviewing to get 2 different offers. Both interviews were from companies you've probably heard of, but neither were companies I would classify as "tech companies".
If you've got more than a few years experience and are looking in the right places, there are tons of people who don't care that you aren't writing what ever the latest technology is.
Big cities that aren't traditionally "tech cities" have tons of these jobs. Also, like I mentioned above, big companies that aren't tech companies, but have internal tools that need to be maintained have these positions as well (regional banks, large school districts/colleges).
And how many rejections did they get for not having $hotNewTech on their resume? That they got a job doesn't demonstrate that they had fewer opportunities, which was the point I was making.
Two caveats I would put is: we can do self-development and learning during our job hours, I'd argue it's a right that is usually understood and well supported by our workplaces.
A somewhat darker point: in 20 years there will still be devs writing jQuery, but it will only be a super small fraction of the devs that were in it 10 years ago.
The same way we have devs writing new COBOL code now, and there will still be some 50 years from now, but you can't expect 20% of our field to be leading a successful career in COBOL for the next decades. It will be a selected few that get to keep doing that job for that length of time, the rest will have to move to something else either way.
Yeah, I agree, that was kind of my point.
I see a lot of people who talk about software development as if FAANG is the only game in town, but like you said, our industry is big and only getting bigger. If you know where to look there are tons of laid back tech jobs that don't expect you to eat, sleep, and breath code.
I disagree with you though that there are only a select few who will be able to get these jobs. I think as time goes on, were only going to have more legacy systems that will require knowledge of older languages. Also as tech continues to infiltrate every other aspect of our lives, more and more companies will start to need one or two in house developers to do random tasks where no one cares whether you're using the latest and greatest technology.
The key is finding them and giving them a chance.
When I was young I hadn't heard much of Lisp, and what I did hear didn't sound that great (Lisp was old and maybe it was great back then, but technology has advanced so much, I thought, that it's probably not worth bothering about)... but when I did finally learn it I fell in love and wished I'd learned it much, much earlier.
And it wasn't just a copy of something I'd learned before, as were many other technologies that I'd learned.
That said, when you are seriously depressed or burnt out (the two go hand-in-hand), it's tough to find anything interesting, even things that you'd normally be fascinated by.
“I can’t wait to rewrite this legacy software in Rust!” - said not me.
When I have to learn some NIH-based technology that poorly copies something widely used (e.g. the place I currently work at has some custom language to generate "template instantiations in C" and some half-assed hideous clones of protobufs and grpc), I can't bring myself to care or really do my job.
Thank goodness this pandemic has made it easy to spend large portions of my day on leetcode / the CRLS algo book without anyone looking over my shoulder so I can get outta here!
That's not to say i want to do the same thing forever. I want to do different things. Superficial trends dont count.
If about half of young adults suffer from a disorder, it makes me question if it’s a disorder at all. And the noted impact of economic factors and things like Covid highlight the “nurture” aspect of the disorder instead of “nurture” (e.g. the “chemical imbalance” internet myth).
I’ve been diagnosed with MDD, GAD, ADHD, and bipolar type 1 but after I suffered a manic episode while on psych meds , I really dug into the research of psychiatrists and now have the controversial opinion it’s very weak science riding on the coattails of the rest of Western medicine and is obviously influenced by the for profit pharmaceutical companies. The DSM 5 wasn’t even created in the open.
Both as societies and as individuals, we need to introspect on how we can be so relatively wealthy yet so often so fundamentally unhappy. And the idea that half of the population has a brain disorder rather than is in a bad environment and conditioned by circumstances to feel that way seems hard to believe.
I’m very interested in the anti psychiatry movement which includes a small minority of medical professionals, and I’m more open to sane ideas that I used to consider “new age.” But more than anything, I think many aspects of mental health are like losing weight - very simple but difficult especially in the wrong environment. Close family relationships, diet, exercise, time outdoors, a sense of community, less time on social media - we mostly know that this is the key to feeling better but we desperately want an easier answer in pill from someone in a white coat and our profit driven medical system is more than happy to oblige.
The key point he is missing is that psychiatric disease can make those lifestyle changes orders of magnitude harder for someone to make than it would be for a healthy adult. As lifestyle gets worse you get a terrible loop going. Medication helps many break that loop - certainly not all, but it is something to seriously consider with your doctor.
If he was able to make those changes without medication that is great for him, but I think his message is kind of analogous to a rich entrepreneur that grew up poor telling everyone else they should just work harder and they'll move up in life. Is it probably good advice for those people to work harder? Yes, but many of them do not have the talent or luck to actually move up much, so it cheapens the message a lot.
This is a misreading of the (admittedly confusing) statistic
> the proportion of adults with MDD aged 18–34 years increased from 34.6 to 47.5
This is not saying that 47.5% of 18-34 year-olds have MDD, but rather that of adults with MDD, 47.5% are in the 18-34 age range.
https://www.forbes.com/sites/alexledsom/2021/02/07/new-study...
I for one, would be much happier with a less overtly abusive workplace, and oppressive living situation. Money is not everything, but as I cannot afford a better existence, it might as well be the only thing that matters.
Establishing, and garnering respect for, clear boundaries with ones abusers is an exceptionally tough task for teams of social workers working in the context of child protective services who have leverage, and the legally authorized threat of force, over the abusers.
The best alternatives are to "build relationships" with good people and find a "good psychologist" to assist you along the path as you assuredly take detours off your path and lose your way. It's hard, you'll find disappointments, may be revictimized, possibly suffer your own regressions and have to rely on yourself more than anyone should have too. I'm sorry I don't have good answers, but the task at hand is surmountable and everyone deserves a safe, loving, supportive familial-like community to uplift them and be uplifted by them.
I largely agree with you - diet, exercise, close friends, time in the sun and so on are fantastically useful and underrated. They solve a lot of things.
That being said, even when I had lots of close friends and was in fantastic shape, I wanted to kill myself. SSRIs stopped me from thinking about suicide every single day of my life - they literally changed my life. Lithium largely fixed the mania. If there are real, objectively bad things happening and taking a drug can stop them, I'm all for it.
I definitely think that psychiatrists don't know WHY a lot of things work and I think they way they diagnose and treat patients is basically just "try these and see if they work" but I don't think it's worth throwing everything away just because the solution needs a lot of improvement.
Having a depressive episode at some point over the course of a lifetime should be seen as normal IMO. Someone can have a depressive episode and benefit from help at the time just as someone can develop a bacterial infection and require treatment. It does not need to be thought of as a chronic state, even though in a minority of cases that will occur (and is obviously much more debilitating).
Sometimes medication is extremely beneficial, other times it is not, but very few people are just being pumped with/kept on meds. You can see here that only ~6% of people with a diagnosed depressive episode in 2017 were treated with meds alone: https://www.nimh.nih.gov/health/statistics/major-depression
Of course most therapy is going to include work on lifestyle habits like what you've mentioned. While many of the people regularly receiving therapy were also on a medication, it is standard of care to do meds + CBT as they have well-documented and independent impacts on depression recovery.
It is normal to taper off use of antidepressant after a first depressive episode, and I think it's safe to say most people doing combination treatment will have proper oversight of their medication use. Maintenance medication is mainly suggested for those with a history of recurring episodes.
I'll also note I don't think this has anything to do with money grabbing. Prozac remains the most prescribed antidepressant, yet it is not under patent. Therapy on the other hand can cost an arm and a leg. Of course therapy cannot be mass-produced, but from an individual prescriber perspective therapy is more likely to be financially incentivized.
No doubt psychiatry is still operating largely in the dark ages, but that's simply because it is a hard problem (and perhaps some institutional incompetence mixed in). Drug development for psychiatric disease has actually mostly hit a wall, and numerous pharma companies have cut neuroscience research departments, because these clinical trials had a low enough success rate that the R&D costs could no longer be justified.
Further, I agree that lifestyle decisions can have a bigger impact than people think, but this sort of anti-medication attitude and thinly-veiled accusations of laziness only push patients away from good lifestyle changes. Depression can make it harder to do those things you mentioned, and it becomes a very nasty cycle. Medication can help break that cycle if used properly.
It is indeed important to make clear that the meds are a tool and not a magic cure all, and I hate the common sarcastic remarks that get posted in depression groups like "thanks exercise cured me". But I get where some of that defensiveness is coming from. Let's all try to acknowledge that a treatment plan is going to involve multiple pieces, different pieces for different people, and is not going to be easy or perfectly effective.
There's a fine line between helping and enabling, but a lot of people seem to err so far on one side that they either applaud terrible behavior or talk down to people about symptoms that they don't fully understand. Meds can be a lifesaver for some and are not desirable for others, that is something that needs to be determined by the patient and their care team(s).
Take a simple example: Look at how many times waiters get sick with the flu, say a million hours per year, and then multiply by the average amount of money a waiter earns - say 20 bucks an hour -- and conclude that the flu costs the restaurant economy 20 million dollars.
Well that assumes that if the waiters didn't call in sick, that an extra 20 million dollars of tips/earnings would have been available. Yet that amount is determined by the demand for meals, not availability of waiters, and when one waiter is sick, others cover for them so all the meals get served. But then the extra labor of waiters needed to cover for each other is a cost, no? Well, again no, as collectively the pool of waiters that cover for sick waiters is the same pool that call in sick -- it is some extra volatility in hours worked, but total hours worked is unchanged. So at the end of the day, it's hard to determine how much damage to the economy is created by waiters calling in sick and covering for each other. It's certainly much, much lower than what you get by multiplying hourly wages by time spent sick.
Now come to depression. Depression may be just the mental price of brains capable of risk assessment or deep thought. Like sleep is not a dead weight cost, but just the price of having a developed brain. It's not clear that Depression is "costing" us anything anymore than sleep is costing us lost labor, and it could be that a world without depression would also be a world without genius, realism, and creativity.
There are plenty of very smart people who aren't depressed, but I don't know of any smart people who don't sleep.
Depression is at worst a lethal malady that creates suffering not only in the depressed but for their families as well.
Plenty of things appeared in humans for no positive reason. Its not like smallpox was valuable it some point.
Its possible that depression has some positive function, but its just as possible it does not.
So if you didn't mean the usual metaphorical notion of, "was selected for by natural selection because it increased evolutionary fitness", what did you mean?
I think the prior poster may have been making a point more along the lines that depression is a downside of having benefits like neural plasticity or something, not that this disease state is necessarily beneficial in itself. More like how the downside of having high-performance tires is poor rain traction or something.
The trait is passed on because it benefits the species. You have to consider more than individuals in the evolution of social animals. In various circumstances some organisms will eat their own offspring. Obviously the "infanticide gene" if considered alone, would not make evolutionary sense, yet there it is.
Group selection is a possible mechanism in social animals, but it requires the group to be strongly interrelated relative to the rest of the species, and it relies on the group being able to expand at the expense of the rest of the species.
Infanticide makes perfect sense; offspring are only related 50% to the parent, so if resources are less than 2x as effective in the bodies of offspring compared to once they have been digested by the parent, of course they should be consumed. The genes of the offspring won't agree, of course; for them the calculation is reversed.
Literal survivor's bias. If you are depressed but not resilient, you kill yourself.
> learning to overcome adversity, learning to overcome yourself
Overcoming adversity requires doing something. Depression prevents that.
> learning to be self-aware
I wish.
> thinking "differently".
In what way?
https://www.medscape.com/answers/286759-14675/what-is-the-su...
These sort of ideas are hard to evaluate definitively, but I do think it is plausible that mild depression had/to some extent may still have benefits. Of course certain traits can be taken too far though, and when viewed through that lens it is hard to understand how they could be beneficial at all. One could say a similar thing about Autism-like traits.
I dont know, IANAD, but it sounds mildly plausible.
> Another reason depression is thought to be a pathology is that key symptoms, such as loss of interest in virtually all activities, are extremely costly to the sufferer. Biologists and economists have proposed, however, that signals with inherent costs can credibly signal information when there are conflicts of interest. In the wake of a serious negative life event, such as those that have been implicated in depression (e.g., death, divorce), "cheap" signals of need, such as crying, might not be believed when social partners have conflicts of interest.
https://en.wikipedia.org/wiki/Evolutionary_approaches_to_dep...
Where did you get that absurd idea from?
I don't agree with that and I don't agree with how it is stated. It's an absolutist statement (poster is not an expert) and it is dismissive via "silly".
I don't understand your objection. I don't understand the pedantry across this entire thread over like two or three words that aren't even wrong. Just read the extra sentence in the post.
I know this sounds rude, but how many arguments are we going to have over bikeshedding? It's like yall are looking for things to jump on and bully people about without any empathy.
I don't personally care but I don't understand why you do it.
This is what I'm talking about.
You guys can't imagine any way in which depressions might provide benefits? That's how multiple people in this thread have acted. But maybe, just maybe, people that are depressed have a different perspective on life and maybe feel differently.
What is the issue?
Yes, my own experiences with depression in those around me (thankfully not in myself) have left me seeing no way in which depression provides benefits. It is a terrible debilitating disease (or symptom, or whatever it is) that literally saps people of their will to do anything regardless of external stimuli. I find it very hard to imagine something so maladaptive being presented as possibly useful.
I would guess that sentiments like this are the main reason behind the powerful response to your thread. It is almost like claiming that "there is a reason for cancer".
Edit: I would also note that it's possible that we're simply talking past each other, as the term "depression" actually covers some quite different disorders; it's possible that what you're thinking of when you use this word is different from what I'm thinking of - to me, it mostly refers to a disorder where people feel either deeply sad or deeply anxious, but either way they are lacking almost entirely in motivation, finding it hard to even get out of bed sometimes; and all this with little relation to external stimuli.
This is all unsettled science. I've suffered depression for a decade. In my experience you learn to live with it and you learn from it even if you never fully get used to it.
This might just be a semantic quibble, but I don't think the term "costing" necessarily implies that the burden has no use. For example, I might say something like "the garbage collector is costing us 20% of the clock cycles". That doesn't mean that I think we can just shut off the garbage collector off. It just as an attempt to account for how much its spending critical resources.
Historians have long puzzled over the apparent mental instability of great and terrible leaders alike: Napoleon, Lincoln, Churchill, Hitler, and others. In A First-Rate Madness, Nassir Ghaemi, director of the Mood Disorders Program at Tufts Medical Center, offers a myth-shattering exploration of the powerful connections between mental illness and leadership and sets forth a controversial, compelling thesis: The very qualities that mark those with mood disorders also make for the best leaders in times of crisis. From the importance of Lincoln's "depressive realism" to the lackluster leadership of exceedingly sane men as Neville Chamberlain, A First-Rate Madness overturns many of our most cherished perceptions about greatness and the mind.
I find these comparisons deeply suspicious. If there indeed were a strong link between leadership ability and mental illness, there cannot be a very big difference between Lincoln and Chamberlain for the reason that both men were surely at the very tails of the relevant distributions. One does not become a British Prime minister by being average. I fully expect the book to be full of cherry-picked data supporting narratives built largely on popular stereotypes about successful and unsuccessful leaders of dubious accuracy.
But if waiters called in sick less would there be less waiters, and some of the waiters would instead be doing something else productive?
> Depression may be just the mental price of brains capable of risk assessment or deep thought
Isn't inability to accurately asses situations objectively and difficulty focusing both symptoms of depression? That seems the opposite of risk assesment/deep thought.
This review is kinda old, but written by the psychiatrist behind CBT, so it's probably worth a read if anyone is interested in an intro to the topic: https://www.sciencedirect.com/science/article/abs/pii/000579...!
That is because people who make accurate risk analysis and talk about it get punished. So you learn to shut up about negatives.
Or unemployed.
Well that's macabre. I really don't think that grinding to an emotional halt is a natural consequence of attentiveness. It's the opposite, if anything.
Waiters can cover for each other, what about those working full time? Ceteris paribus, a rise in depression that leads to the inability to work which will reduce the the size of the labour force and consequently output.
Your last point on it being the "cost of genius" is pure conjecture. A rise in depression (tripling according to the article) has definite costs in terms of the economy (tangible) and human well-being (the intangible). It is in public interest to reduce the incidence of depression.
Irreversible or transdermal MAOIs are the answer for first line treatment - > Moclobemide and Emsam They have almost no side effects and are more effective.
But hey, here's some fucking happy pills, now get back to work.
This way of thinking is fundamentally responsible for our societies being so suseptible for the spiritual crises which are mainly the cause of depression.