Ask HN: How did you deal with depression?

90 points by welldepressedaf ↗ HN
I am starting to get a little bit hopeless on this one. Once I had passions and stuff I wanted to do, I learnt enough JS to build a small app that has proven to be incredibly useful for my family. Then came university and almost all my passions have gone, I am a good student but as of lately I have been struggling with the courses I liked in the past.

Nothing excited me anymore, and not that I am sad. I still can crack a joke I still can smile but nothing seems to make me happy anymore. I think I might have depression. I play games and procrastinate all day and it doesn't make me feel any good it is just a getaway.

Sadly I live in a 3rd world country, where mental illness is not an illness. I can get little help from people. Our healthcare system simply doesn't work at all. So HN crowd, how do you deal with these feelings?

94 comments

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Action seems to be best treatment. When I start doing things (yes I know its lot difficult) I build a stair out of black cloud hanging over my head.

Look for easiest project you can do and steps you can do to make that project work once that's done look for your next project. These small projects build your stairs / steps to rise above dark cloud and see the daylight once again :)

Think about how your talents can be used to help the needy. So many life saving nonprofits and ngo can use your help even at the volunteering capacity. You can also mentor someone who desires your skills one on one.
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Exercise. Read "The best exercises for mental illnesses": http://www.thementalrunner.org/p/the-best-exercise-for-menta...

(Via the "exercise out of depression" subreddit: https://m.reddit.com/r/EOOD/ )

I have never suffered from clinical depression but generally speaking, I would strongly endorse the idea that exercise helps the mind. It's very difficult to articulate why this is, but it is. I cannot stress this enough.
The evidence for exercise as a treatment for depression is weak at best.

You should probably not recommend exercise as a treatment for depression.

Of course, exercise is important and everyone should be exercising; and it might help with "resiliance".

http://www.cochrane.org/CD004366/DEPRESSN_exercise-for-depre...

> When only high-quality trials were included, exercise had only a small effect on mood that was not statistically significant.

> The evidence for exercise as a treatment for depression is weak at best.

That's what the link you give says...

> You should probably not recommend exercise as a treatment for depression.

But it doesn't say that.

It does say "When compared to psychological or pharmacological therapies, exercise appears to be no more effective, though this conclusion is based on a few small trials.", in which case, can anything be recommended?

The NHS still recommends exercise for treating depression, at least in some cases: http://www.nhs.uk/conditions/stress-anxiety-depression/pages... & http://www.nhs.uk/Conditions/Depression/Pages/Treatment.aspx

One time I got on to a bus and sat in front of an old gentleman who kept looking up at me occasionally. When he got off the bus and walked passed me he said: "Whatever it is, don't let it beat you kid.". I must have looked physically wrecked that day. Ever since then those words have stayed with me.

Chin up, OP.

Daily vigorous exercise might help.
This won't get a lot of votes, but it ended up as diet and exercise for me.

When I dropped caffeine and alcohol my anxiety went away. When I exercised my depression went away.

I tried a lot of things, but it ended up figuring out that I wasn't eating well or working out.

Now I do crossfit. I know, I know. It's a cult blah blah. But go try it. You need to be exercising every day to get all that endorphin goodness and plus, you meet a lot of fun people at crossfit. The community keeps me coming back. I don't get that biking (which I love) so I don't do it as much as crossfit. And I hate running. The key is to keep doing it, and that social component works magic. If you can work out at a home gym every day - good for you - but I lose interest and stop, then I get fat and lazy and depressed again.

As for food, I'm not a fan of cooking. But I found paleo then keto. And I avoid all the stuff you're told to eat. "healthy" grains, for example. I don't drink coke. Basically avoid all sugar. I'm basically paleo to paleo-keto end of the spectrum.

I really didn't think it would work but there it is.

Diet and exercise is extremely important if one wants to beat depression.
i have found exercise to be extremely useful when battling depression. diet also, but not nearly as much.
i'm not a big alcohol person and had been paleo for many years. one day i get a gift from a friend, some special coffee. i don't drink coffe but i gave it a try. wow! it was great, i had a cup a day for a few days and then bam!

i was in bed with a rage-depression ten times worse than a normal bout. i couldn't work for three days. i can't describe my thoughts because they are still so embarrassing. on the forth day, i figured out, well, the whole time i was depressed i thought the 'trigger' was a text from a friend. i re-read the text. it didn't even say what i thought it said.

the next day i had another coffee followed immediately by a panic attack. then i put it together and tossed the coffee. i stopped all caffeine, which for me meant no chocolate, for two weeks. i was dieing for some chocolate. so i had some with the kids on a sunday. two days later i was depressed and on a very short fuse.

now i've gone about two months with no chocolate. i sleep much better. i don't snap at people. i don't get angry. in a sense, i miss the highs very much but not enough to want to go back. i've just accepted that my brain doesn't react to caffeine like most people.

I have a similar experience with caffeine. I really enjoy the boost that I get from coffee and chocolate, but then the buzz wears off and I crash, feeling irritable, tense, and on edge. It's the withdrawal effects of the caffeine, and it can go on into the next day (unless, of course, I take in more caffeine, which just repeats the cycle). Some people like us are more sensitive to the effects of caffeine (and alcohol) and are just much better off without it. Better sleep, more even energy and moods throughout the day, etc. I, too, miss the coffee buzz and the social aspects of it, but for those of us that are more sensitive to caffeine, the negatives outweigh the positives.
I second this. I started keto and my depression went away, and although there is still anxiety, it is much lower, and it feels like I can DEAL with it, whereas before I felt helpless.

I was a neurology professor at a children's hospital in my previous job, and there is a ton of research being done studying the neurological effects of a low-carb diet, and they are, across the board, incredible. A common treatment for kids with epilepsy is the keto diet, so we had a lot of research and expertise in this area. Half of the department was on the diet, and I have been for close to two years now. I will never stop it. My wife and kids as well (though the kids are more paleo, since they have closer to 75-100 g carbs/day)

can you talk about what a typical keto diet is like? what foods does someone on a keto diet eat?
Agree. I am now doing LCHF and exercising every day. It made a HUGE difference. If you don't believe that it will work for you, try it anyway for a few weeks and see what happens.
how do you deal with being injured?

I've gotten really into running and enjoy the high, but right now I have an (unrelated) injury and can't run and I feel like I'm going stir crazy :(

It's possible that your courses are boring. After a while at university I was craving for measuring myself against the real world, not just against artificial problems set by the teachers.

Perhaps you could try doing something entirely different every once in a while?

If you know that you are depressed and can talk about it, that's a good step and you should be glad to be aware of this.

It's difficult to quit playing games and procrastinate even when someone's not depressed...

Meeting new people and finding a project seems a like good thing, at least it worked for me. You should also try and going out for like walking, biking, or whatever.

And you should avoid medicine, alcohol or drugs.

I'd argue that admitting your depression on the internet anonymously holds no additional value whatsoever. It is the same as admitting it to yourself. I know because I've been there, done that.

Rest of your advice is sound though.

Many people do not even begin to admit they are depressed, that's what I was saying: it's admitting it.
It sounds like you might be burned out by university (depression is a symptom of burnout).

Some suggestions that helped me and might work for you:

- See whether there is anything in your life that might be causing the burnout/depression. Do you have any emotional issues in your life (i.e. something in your life causing anger/resentment)? Do you have excessive stress/responsibilities? Are you doing what you really want to do with your life?

- Do more enjoyable, motivating, goal-oriented activities, both physical and mental.

- Get sufficient sleep.

- Give up alcohol and caffeine, as well as any other psychoactive substances.

I struggled with depression for YEARS. I tried everything I could find. Exercise helped a lot. Coffee helped. Meditation helped. All of these things worked but I was still in really down. Finely after years I decided what have I got to lose and went on antidepressants.

It was the best thing I ever did. The world opened up for me. I was able to make a lot of changes that were very healthy in my life. I finely had outside interests other than work and sleep. It was like night and day.

* A daily routine is incredibly powerful -- /whatever/ the routine is and /whatever/ it is that you do. If you find yourself playing computer games for two hours every night, then that might be how you learn to concentrate again. Don't fight it before you look at yourself appreciatively.

* Do anything you need to find back your cognitive strength. You will be less intelligent while your brain chemistry is broken. That shouldn't drag you down because it's absolutely normal and natural, but it's frightening if you are a student and programmer, and used to measuring your self-worth in how well you can concentrate.

* Sleep deprivation helps supress depression for a day. Might help you get back into gear every now and then.

* St John's Wort is worth giving a try. People discuss whether it's more helpful than antidepressants, but then again it often doesn't even count as medicine. Took six weeks to kick into my own brain, and cured its chemistry back up to a point that I could sustain myself. The way back out of depression was an existential rollercoaster of emotions and attitudes with increasing frequency: Weeks at first, hours at the end while I got more stable. Some medicine might be useful for dampening, but only for that.

* Don't insist on keeping social contacts. Depressed you is somebody else than healthy you, and you can rebuild all truly good connections even after a couple of years in case they break apart. Similarly, don't insist on keeping anything else in your life if you find it doesn't work out at the moment. This is where you change careers, majors, hobbys, as well as losing your girlfriend. Keep as many things as you comfortably can a constant however, just to make it easier on yourself.

* Cognitive behavioural therapy. There's a good book on it called Feeling Good that told me /exactly/ the lessons I had missed in life, but your mileage may vary.

* Do whatever feels good to you. Your major job in life now is to make yourself feel good. After all, most people feel better than you, so it's well within your right to ignore others (and others' expectations) while focussing on yourself.

If I read this right, your still in college and hitting the wall. Its fairly normal as a lot of people turn get burnout during college.

The diet and exercise suggestions are probably the best. Taking some walks and changing your daily scenery would probably help. Do you eat in the same place everyday? Pick a random book from the library and read it. If there are campus activities that seem interesting, go do them instead of playing games.

Don't freak out if your passion is missing for a while. Its just an ebb and you need to recharge. You'll already shown inspiration, you need to let it come back.

1. Get medicated.

2. Set one small baby-step goal each day. (set an appointment today, etc.) Change the goal every time.

3. Change your environment. Move cities or schools if need be.

4. Exercise. Start with one rep on day 1, two reps on day 2, etc. Baby steps.

5. Ask for feedback on stuff. Any positive feedback helps motivate you to learn and do more projects.

6. Seek a healthy relationship.

7. Be vulnerable. Let somebody else that cares about you know of your state.

8. Be spiritually-curious. I'm christian and that inspires a lot.

9. Realize when your "objective observations" are not objective. Don't be blindsided by emotion.

10. Vent your emotion in a healthy and controlled way.

11. Write one sentence about your week every week. Again, baby steps.

12. Never do drugs. This just amplifies your problems.

13. This includes no smoking.

14. If you make lists and spreedsheets, track the frequency you leave the house.

15. Make alarms on your phone.

16. Volunteer once a week.

These are mostly based on experience and personal observations.

I will agree with Volunteerism. That was the best thing to help my mood, because, while I wasn't getting paid for it, I was among people who were genuinely happy to see you and talk to you.
My doctor (in the UK) strongly recommended 4 before 1 for several friends. I think only one used medication in the end.
I wouldn't be so fast about getting medicated. There are well known side effects. I don't think that is the solution, at least right now. I'm not sure about this obsession with getting medicated for every problem, honestly. If I got medicated for every issue I've had in my life, I would be in debt.

To answer to the original question, one of the easiest and potentially best solutions is to pick up an sport if you don't practice one and to spend more time with other things besides programming. Forget about programming for a few weeks. Do your college duties and don't spend more time than that. Go do other stuff. I've gone (and still do sometimes) through the exact same thing.

There's definitely a place for medication, but for the majority of people, it's probably not number 1.
Having spent a long time on medication for depression in the past, I can verify this. There's a lot you can do to help yourself before trying medication. Exercise and learning to manage your emotions are a great place to start and can help a lot more than most people think. It definitely has a time and place, but the side effects can be a lot more drastic (and sometimes detrimental) than a lot of people expect.
1. Get medicated. 12. Never do drugs. This just amplifies your problems.
Sure, you shouldn't rush to get medicated, but you should be open to medication as an option. I believe depression is often chemically caused, and if you've tried healthy living, meditation, etc., there are many good, relatively benign, well tested medical options out there.
Indeed. Medication are not silver bullets and usually won't solve problems alone, but a right pill may be just what's needed to enable you to deal with the problems. Personally, I'm on SSRIs and (despite getting a common side effect) I'm very happy with them - even though I still suffer from depression symptoms, they're nowhere near the level I had before getting those pills, which pretty much restored my ability to hold my head above water.
Definitely this. I fought depression (originally PPD, but didn't go away) without medication for three years. Tried exercise, sunshine, B vitamins, volunteering, etc, etc. When I finally went to the doctor the medication working was such a huge relief, because nothing else did.
Consider your state of mind. Contemplate and act on potential adjustments. This, too, shall pass. Put out feelers. Find an understanding, not "sympathetic" professional. Also, pull your pants up and get to work.
1. Get medicated.

12. Never do drugs. This just amplifies your problems.

Your points #1 and #12 are a nice big contradiction.

Anti-depression drugs in particualr tend to have rather significant side-effects, which can last for a decade after you've stopped taking the drug.

Going to drugs to help against depression should be a plan C kind of a thing. Changing your environment and activities should be well tested before that.

My guess is that GP is not native American (or a native of other English-speaking country). As a non-native, it took me some time to grok that the term "drugs" can mean both "medicines" (like aspirin) and "addictive substances" (like alcohol, tobacco or cocaine). I suspect GP is referring exclusively to the second meaning. For instance, in Polish, we always use separate words for those two concepts.
"medicines" (like aspirin) and "addictive substances"

There is a lot of overlap in these two sets.

Not disputing that, only pointing out that some languages don't use one word for those two, however overlapping, groups.
Well depends how you look at it. They are pretty much the same in many cases. There are plenty of "drugs" that aren't addictive and plenty of "medicines" that are. Is caffeine a medicine or a drug in your view? I don't see as much of a distinction as you would appear to.
Again, I'm not saying there is much difference - just that there are languages that use two separate words for those concepts and don't have a (common) one for both.

For example, in Polish you'd classify aspirin as a medicine ("lek", "lekarstwo") and caffeine as a stimulating substance ("używka"). There is another word that is used to refer to harmful addictive substances like cocaine ("narkotyk"). There is no generally used word in Polish that encompasses all three terms.

Rather than taking medication, you may want to take some supplements with 5-HTP, a precursor of serotonin. IE: Griffonia Simplicifolia.. It does have far less side-effects, no dependency.. Far less popular with the pharma industry because not patentable..
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Seems to be consensus here, but exercise really helped me to stabilize my mood and bring back my positive stoicism. Still have trouble getting motivated, but at least I have these days where I passionately follow some new thing into the rabbit-hole.
You can try cognitive behaviour therapy. Ideally this would be face to face with an experienced therapist. But if there are no therapists available you can either do computer guided CBT or self guided from a book.

Moodgym is a respected website: https://moodgym.anu.edu.au/welcome

Mind Over Mood is a respected book. http://www.amazon.co.uk/gp/aw/d/0898621283/

If you've tried CBT and it's not working you may want to see a doctor and get some meds.

Exercise. Scientifically proven to make you feel happier. Whenever you're feeling down bust out some reps. After a few months you will feel great, sleep like a baby, and look amazing too!
It was hard at times: when you hit a slump you want to stay in that slump - it was hard fighting my way out, but it can be done.

"Stop and smell the roses." Take the time to notice the beauty in things around you: both nature and concrete. I'm talking about the most sublime things. I first noticed it one night when I was driving home - the lights were reflecting off this dirty little dam of no significance, but for some reason I noticed it and for some reason it was beautiful. For a very long time after that I would make a point of noticing that little spot every day on the way home. Out of that habit I then started noticing more and more things. When you become depressed use that happy place as an anchor and hold onto it.

I realized that I used to think the same way as a kid: everything in the world was wondrous and happy - I think everyone forgets how to see the world that way. Re-learn that mindset.

Be very respectful toward alcohol, cannabis and caffeine. Too much of any will set you back.

Finally, something like 80% of the human race has a 5-MTHF deficiency (for genetic reasons, Google it). It presents as vitamin B deficiency and is therefore often misdiagnosed as depression and some learning disabilities (including trouble concentrating). If you can't get it from a chemist (I can't, 3rd world too) check herbal/homeopathy stores (which is how I get it). Speak to your doctor before taking it and ask for advice, you'll need to take it for quite a while before you start noticing a difference - 2 to 4 weeks at least.

Believe in yourself because I believe in you, I know you can do it. If at all possible get meds.

What a bunch of hooey. Just 'deciding to be happy' is nonsense for someone with major depressive disorder (the medically accepted name of the disorder, as opposed to the term 'clinical depression', which people without experience tend to use...) I'm glad things worked out for you but this is not helpful advice for someone who is actually depressed. It's like telling someone who's short to just decide to be taller.
the mind is the most powerful thing known to man. even with a disorder strong minded people have worked their way through and came back to being productive and happy members of society. alcoholism is considered a disease but people get through it with will power alone.
I guess you're right. I'll just remove that one paragraph. If you are at a doctor you are more than welcome to weigh in on the 2 opinions I had at 10 after being bullied for 3 years. I might not be able to remember all the terminology, but I do remember not being able to get out of it. I do remember not being able to have more than 1 friend up until I was 20. I do remember drinking myself into a pit at 22 (2 six packs a night, alone for a year, sound healthy?). I do remember digging myself out of it, alone, without help. Because for some reason I can't explain I started believing that I could. I am now happy. The only thing I have left is excruciating existential anxiety, can I beat that too? Fuck yeah.

Bunch of hooey, though.

I can tell you one thing: OP isn't going to win by believing it's impossible because even the best meds only provide symptomatic relief. They don't fix the underlying problem. It's like giving a short person a mirror that makes them look taller. Meds can help you win, meds are good. I would never recommend someone to avoid them. All irrelevant: OP indicated depression is not an illness in his country. He/she supposedly can't see a doctor. No meds. All that's left is will power.

Knowing someone else did it makes all the difference.

Finally, as an expert on the matter, where is your advice? Or are you here tear OP down? I know OP can do it, all you know is what a major depressive disorder is.

I'm certainly not an expert (although I too have been diagnosed twice), and I'm not here to denigrate your experience. Like I said, I'm glad you made it through it, by whatever means. I'm just saying, your advice is usually considered unhelpful by people with depression (just decide to be happy!)

I think other people in the thread have good advice on practical steps to take - big ones being meditation/mindfulness training, changing circumstances/surroundings, and diet/exercise. All of these things can do much more to alter brain chemistry and enact a positive feedback cycle than just "deciding" something.

I don't think you really should have removed that paragraph :). Yes, it jumped on me too, but after thinking about it for a second, I actually appreciated it. I've never been able to think myself out of something like you did, but I found it reassuring. I actually envy you that skill; myself I was also drinking myself every night for almost a year; at some point I run out of money for cheap beers, stopped drinking, realized that I like being sober and never returned to the habit. So in my case this seems more like random walk around the potential gradient, with hope that at some point I'll accidentally escape the local minimum.

If you have any tips about "excruciating existential anxiety" (of which I've been suffering for half the decade already, recently successfully moderated by SSRIs) I'd be more than glad to hear them. Right now the only coping strategy I have is to ignore it, but it interferes with my ability to concentrate and plan for the future - I'm literally unable to plan for more than a week-two in advance without getting serious emotional pains.

FWIW, when I was very young (and surrounded by adults with various behavioral issues) I concluded that if my brain could influence my thoughts, then my thoughts could influence my brain. i.e., if I worked through something mentally, I could improve my mood or deal with adversity or grief or melancholy or the occasional bout of really bad depression.

That's worked out well for me as a sort of first line of defense, but it has side effects too. I've been seeing a therapist for most of a year now to try to unwind some of it, because unfortunately the same mechanisms that repress something like anxiety also repress love or joy.

And I'd never recommend it to anyone else. For one thing, I haven't even been able to decide for myself if it's just a bunch of self-delusion or not; I'd have no idea how to go about suggesting someone else try it.

> If you have any tips about "excruciating existential anxiety"

I've found that the more I think about it the worse it gets - which makes sense: it's habit-forming. Try this:

1. Stay on the SSRIs - they can help you learn how to break the habit.

2. Pick a "safe topic." It doesn't have to be interesting (although that probably helps), but should just have a good chance of not leading to existential issues.

3. Next time you start thinking about existential issues, start thinking about your topic instead.

I have no idea if it works in the long-run but it's what I am doing right now. I'm not sure if the underlying cause for the anxiety will ever go away, but if I can habitually stop thinking about it then it might as well no longer be there.

Also, it's usually worst when I am trying to go to sleep. I put on YouTube with brain-numbing content face-down next to my pillow: nothing stimulating (interesting or humorous).

>Because for some reason I can't explain I started believing that I could. I am now happy. The only thing I have left is excruciating existential anxiety, can I beat that too? Fuck yeah.

This appeals to me, and perhaps to a lot other people. I know, it may not help all situations and all people. But sometimes unleashing/encouraging the fighter in you, may be the best thing. For me literature (novels etc.) and movies are helpful to generate that kind of fighting instinct.

Atleast some of them have that skill. I remember a friend at school, who used to be very depressed because one of her parents passed away. This was early in her childhood, but the effect was still there in college. She often had mood swings and except those who were very close to her, no one understood her. Then she was reading a few self-help books. I dunno if it was the books, or something within her but by the fourth year, she was out of her depression without any outside help and had a lot of friends and enjoyed life in general. She also volunteered for a few responsibilities in college. But do note that this was very gradual and happened over a two years. I can only imagine the kind of journey she would have had.
Get enough sleep and physical activity.

In my experience the brain follows the body. An active mind is generated by an active body. Likewise a sleepy and listless mind can be created easily.

A1. First, if you are from Russia — run ASAP. It will never get better. I did 4 years ago, never had anything resembling depression since that.

A2. If your country is OK (e.g. suicide rate there is less than 15 per 100000 people per year), I think you need to search for the intersection between things you have passion for, and things that are paid well. After you will find that intersection, I think you will get better. You see, when you was a kid, just following your passion was enough for happiness. In the adult world, however, you also need some financial independence for that.

A3. There are other things, like alcoholism or herbal medicine, but I generally do not recommend those to young people.

Before medication try Cognitive Behavioral Therapy, Read: Feeling Good: The New Mood Therapy by David B. Burns
Seconded--actually I highly recommend The Feeling Good Handbook by the same author (David Burns). I've found it very helpful for dealing with procrastination as well.
Meditation has helped me more than anything else, maybe even therapy. For years I did it "wrong." You can meditate to train focus, and you can meditate to dive through the layers of the mind. What helped me is the latter. The former helps you get work done, but it actually either makes the depression worse, or cuts you off from the world.

I don't know what the quality and breadth of instruction is, where you are in the world, so YMMV.