Ask HN: How to cope with depression
Just to get my background out of the way :
I'm a programmer and have been severely under performing at work (to the point of almost being fired), and routinely question whether or not I deserve to be alive. As a result of my difficulties, I've begun seeing a therapist and psychiatrist. Both feel that I should be on anti depressants, and I am not opposed to this.
Short of medication, however, they haven't really offered any strategies I can implement. Perhaps that will come later, but for now I was hoping to hear about what may have worked for others. All the logical advice (exercise, go to sleep on time, live a healthy lifestyle) are things that I struggle to find the motivation for. Perhaps the medication will help in that department. However, I'm concerned they will dull my focus (which is a bit silly, considering I can't focus at all right now).
edit :
I am sincerely grateful for all the thoughts that have been shared. I've read every post in this thread. A few follow ups :
1. I understand the limitations of asking for advice about mental health online, and I want to reassure any/everyone concerned that I will not make any treatment decisions without the input of the specialists I'm seeing.
2. Related to the above, reading about the (mostly successful / positive) experience others have had with medication has been very reassuring. I did have some lingering skepticism about SSRI's (which may or may not have come through in my original post), and I am very glad to hear that medication has worked well for others. Maybe it's a bit silly to have an opinion partially validated by a peer group, but so it goes.
3. This is probably as emotional as I've been in weeks : reading through the responses here makes me feel like I'm not alone. Thank you, very, very much.
122 comments
[ 16.7 ms ] story [ 243 ms ] threadThe wrong medicine will dull your focus (I had a very bad sedative reaction to Lexapro) but the right ones will make you feel more normal. My work is the same as it was before, except I am happier now.
I'm really glad to hear that. It's surprisingly reassuring.
Out of curiosity, how long did it take you to decide Lexapro wasn't right for you?
I'm now taking Prozac which is way way better for me.
The important thing is that you have to keep trying at it; finding the right medicine and right dose will take time, but at least in my case (and it seems like others here too), there is a right formula. It's rough going for a while, but like I said before, I just feel more like the normal me, not like the angry, irritated, anxious me. And I have to believe that would have ended up a net positive productivity wise.
Good luck, it's worth the effort. Something I read that I thought was useful to keep in mind when dealing with this stuff: you're not depressed because the world is shit; you think the world is shit because you're depressed.
(I upvoted you.)
There are some very good reasons why it takes a high level of training to counsel people.
> This is something with which many of us struggle on a regular basis.
it certainly feels that way at times :(
Expect this to be a journey - you have to try several and you may end up on a combination (I take four). If you're dozy at work as for some ritalin to help. I hope you have health insurance :( Also, if you go through 'high' periods you're not depressed, you have bipolar 2.
Take the meds. This shit literally saved my life.
'Bipolar' is a condition with depressive and manic states. Low lows, and high highs.
'Bipolar Type 2' is a condition with depressive and hypomanic states. Low lows, and just feeling particularly good. People who experience hypomania without depression often don't complain about it / see it as a problem.
That's honestly one of the only reasons I haven't quit my job. I'm performing so poorly, and am so intensely ashamed of it, but don't want to go on COBRA while unemployed.
> Take the meds. This shit literally saved my life.
Thanks for sharing. It really has been reassuring to hear they've genuinely helped others.
A few months ago I went on Prozac. I still struggle with focus and getting work done and there are some other negative side effects, but crucially I am able to think more clearly about the situation. I'm now working on strategies myself to get myself to a better place long term.
I'd advise taking the medication -- it's unlikely to put you in a worse spot, and very likely to put you in a better spot. From that better spot you will see more avenues you can pursue.
I think I made two mistakes the first time I sought help:
* I stayed on the first medication I tried for far too long
* I stayed with my first therapist/psychiatrist for far too long
My new doctors are far more helpful and push me further than my old team ever did. If it's not clicking, don't give up, but maybe see if there's someone else that might be better for you.
This is meaningful to me. I'm still seeing the first therapist / psychiatrist I sought out, and the inertial barrier of seeking out an entirely new set of professionals is kind of daunting. Knowing that this could potentially have a real impact at least means I'll probably be open to consider switching if I really feel like it's necessary.
Watch some art films. Chain smoke cigarettes. Go for a walk. Play hooky from work. Go thrift shopping and buy yourself a new outfit. Plot and scheme on things that you actually want.
Don't listen to any of this advice. Do something drastic.
Sometimes you can't fix depression with pills. There are alot of mights in this situation because none of us know what OP is actually going through.
I would kindly ask that you consider my advice from personal experience and not downplay it so much. I never suggested OP not take medication or seek out a doctor, I was just giving other, more personal advice that may help them in their situation.
>They might not have good familial relationships or friends to fall back on, or they might have issues with non-hallucinogenic drugs as it is.
I listed a bunch of different things they can do, with ors and ands all throughout. Also, hallucinogenic drugs have very strong evidence backed-trials in their favor. Of course as long as you do it in a safe situation.
I was not, in any way trying to be edgy. It's awfully offensive that you and anyone who down-voted me would think that. The guy is already a programmer, he's clearly not benefiting from the ultra-safe sterile environment that the HN crowd constantly promotes.
Sometimes you have to get dirty. Sometimes you have to make mistakes. Sometimes you have to drop shrooms and find yourself in the middle of someone else's living room dance rave party.
Maybe it's not for OP, maybe it is. Maybe none of the other advice in this thread will work for them, either. But regardless my advice is just as fucking valid as anyone elses. Coming from the perspective of a person who, as I said, went through this, still goes through this at times, and who medication has had little effect on.
But, if you want to solve his depression with condescending suggestions of medical help and medications, back that up with medical journals and statistics, that's your prerogative.
//edit Also for more clarity, when I said "don't listen to this advice" I was actually referring not only to my comment, but everyone's. I wrote that when there was like 2 comments on this thread. I'm not trying to demean anyone else's opinion. Why would I do that? I'm not an asshole.
The spirit of your post(s) is well taken. Also, I watched the shit out of the magic school bus (which is, at least, what "sometimes you have to get dirty. sometimes you have to make mistakes" reminded me of)
* Medication helps
* Logical - go for a run - blood circulation, oxygen, endorphins - cannot go wrong with that!
* Slightly related - http://www.startupsanonymo.us/
TLDR: stay on the meds; do what the therapist says to do, no matter how dumb or inconsequential it may seem; exercise.
http://edition.cnn.com/2012/12/03/health/ecstasy-ptsd-3/
Incase it was never available to you, it should be soon. DEA approves study using MDMA for anxiety in seriously ill patients (Mar 17, 2015):
http://america.aljazeera.com/articles/2015/3/17/clinical-tri...
Still, I appreciate the info.
Also, not to argue against "depression" or meds or anything, but... sometimes, especially for people in the first decade of their working career, we might be trying to convince ourselves we "should" be enjoying our career circumstances even if we just don't. Those shoulds can certainly exacerbate depression. I'm just saying that your underperformance might also be an indication that you don't like your job, which is totally ok.
Finally, one of the simplest harmless things you can do to start, that you might be able to motivate yourself for, is drink a lot more water, and take a B vitamin every day.
But yeah, main thrust - take the meds, trusting that you may find it easier to motivate yourself to take other healthy steps in the future.
This is fair. My work has probably exacerbated my difficulties. In the past, work (or programming in general) has functioned as an outlet - something to focus on. At the moment, it's probably making things worse for various reasons. I will need to change my job soon, but feel the need to fix myself before I make any new commitments.
Also, many of the harsh and weird side effects of SSRIs (the yawns, the sweats, and the weird-ass dreams in the first week) are temporary and doctors will usually prescribe anti-anxiety medication if those become an acute issue.
You need to do something about this. Medication's a good start, because it will give you the initial reboot that will make you able to exercise and regularize your sleep. After you're well, the next job is to stay well and get into an exercise routine and start eating healthier foods. Right now, though, medication is the best source for that initial "push", and it helps many people. Once you're out of the depression, establish healthy habits to maximize the probability that you stay out of it.
Also, you shouldn't question whether you "deserve to be alive" because of one job. Most people have been fired at least once. Shit happens. If your depression is interfering with your ability to perform at work, then disclose the health issue before you end up on a PIP. It won't prevent you from getting fired but it will increase the likelihood that you get a severance if you are fired.
Good luck! Depression sucks but many of us have been there and gotten out of it.
I do my exercise first thing in the morning. I wake up, hydrate, brush my teeth, put on workout clothes, and I try to be out the door by 6:30AM. I never thought I was a morning person either, but my body adapted pretty quickly.
Good luck
Do not seek any advice from anonymous people on the web about depression, ever, you're seeing a therapist, that's a good start, If you're not satisfied with your current doctor, go see another one.
How many of these people are professionals? depression IS a mental illness, and must receive professional care, not random opinions by people who did not make a proper diagnosis of that person's condition. Finally listening to someone is different from advising him about how to get better. I'm all for listening but not for people playing therapists.
It'd be a shame if OP read all the stuff about exercise and thought it was going to be a cure. We know exercise is no better than nothing at all as a treatment for depression.