“I don’t procrastinate anymore,” he added. “I’m sleeping better. I completely quit alcohol. I’m walking my dog and playing the guitar again, for nothing more than the sheer joy of it.” Most importantly, he said, “I’m remaining positive and being respectful of others. These are big changes in my life.”
Serious question: are these typical signs of depression? Now I'm wondering if I have depression.
I've had depression for 20+ years and the best way I would describe it is like this:
Think of that little "kick" you get when you think of something you want to do. Maybe you like eating ice cream, maybe you like playing tennis, whatever it is... that feeling, that subconscious little mental boost that gets you up off your ass, and moving... is completely absent in the depressed mind.
That spark that initiates and sustains action, is simply not there. Tasks, even small ones, are giant and the future is hopeless.
It took me a while to realize that most people don't consider suicide as one of a few strategies to deal with everyday problems. Thought process: I don't want to do my homework. I could (A) get up and do it, or (B) kill myself. Happily, I've learned to dissociate myself from the part of my consciousness that thinks that way.
My thinking is slightly different in this case then yours:
Ending it today will stop having to do x today, tomorrow and rest of my life.
So it's not just the homework of the day.
But due to my thinking I would also not just go without consuming my money and doing only what I want as long as possible as it also freed me from certain social boundaries.
Like suicide is bad, you need to work, lifing as long as possible is good etc.
My thinking was always comparing it to a crappy movie at a middle of nowhere theater. Sure the movie may be bad, but it still beats getting up and leaving.
How many bad movies you gonna watch until standing up and leaving becomes the better choice?
One problem might also be that in my opinion lifing as long as possible is not the right answer. I'm not life positive like independent how shitty your life is as long as you are alive is good.
Now the question arrives what is a good time to leave.having already seen and done more than any other human who lived 50 years ago already puts me ahead on a experience level
.
So determine this answer is open for me to decide.
Not having kids and not planning some right now also makes me more 'flexible'
I'm dealing with something like this too. It's come up a lot while watching shows where some protagonist's friend turns psychotic and they suddenly must fight to survive. I keep thinking to myself, "just give up and let them kill you, it will be better that way!" I can't quite pinpoint the theme that seems to permeate all of these and how much of it is my own perspective versus some specific genre. I think of it a lot while watching The Future Diary, and also Higurashi: When They Cry.
Given those two options, I'd end up choosing A. So thinking of B would actually be motivating. It wouldn't feel suicidal to think of both of those options.
The mental illness is when option B in this example seems preferable to small inconveniences and embarrassments, and when one doesn't think of things like, (C) forget about it and go hang out with some friends.
Life is full of small inconveniences and big ones time to time. It's not just one small one. So wanting to stop all that should not be considered illness, but forcing to continue the pain and trauma should be. Life is ultimately a meaningless thing, and most people suffer for it. Some people are privileged and they decide what is illness and what is not based on their own life.
One has to work 9-5 whole life that slowly kills their health and die horribly. That's normal, but if one does not want to continue that, it's illness. One must suffer. There is no other way whatever people here says, the real world does not work in any other way.
> suicide as one of a few strategies to deal with everyday problems.
That’s as much a solution to everyday problems as nuking the entire planet and the human race out of a existence is a solution to, say, Covid or hunger.
Why is wanting to stop pain and trauma is illness and wanting to continue in more of that useless suffering is normal? I am not talking about privileged here but most people who struggle whole life in world.
Because if suicide were typical, humanity wouldn't exist. Mental illness is merely abnormality, not necessarily something ethically wrong or illogical given one's a priori beliefs.
> Mental illness is merely abnormality, not necessarily something ethically wrong or illogical given one's a priori beliefs.
I agree, but what you're saying is not how the world see it. Many things that make humans exists are not necessary or makes life difficult now anyway. Like phobias, vomiting while travelling by car, allergies etc.
The thing about everyday problems is that they are every day. It isn't just looking at having to do your homework today, it's having to do your homework tomorrow, the day after that, and the day after that, out into what may as well be infinity.
Homework isn't a great example, but you can substitute anything that causes you suffering. For me, a lot of it is about my weight. I went through more suffering than most people can imagine to lose more than half of my bodyweight, and I was pretty happy with the result... until I started letting myself do the things I'd had to give up to get there: eating out with friends (or even attending any event with food), not doing intense workouts more than 3 days a week, having the occasional snack, eating something other than protein bars every meal, etc. My weight started increasing, naturally, and I realized: I never get to stop going through all that suffering if I want to maintain my weight. Ever. Ever. And without being able to maintain that weight I instead get to feel like a fat piece of shit for the rest of my life instead. Given those two options, the idea of just ending my life here and now doesn't seem so bad.
Nuking planet is different as it will nuke all other species. Removing only humans is a solution that actually works for better of everything else things.
Life is constant struggle for most humans (not talking about privileged here). In the end we all die horribly going through all that trauma, so peaceful suicide like hypoxia may be a solution to stop the suffering.
When the target of your objectively reasonable directive is self-admittedly of the mindset "I could (A) get up and do it, or (B) kill myself", you may want to reconsider the wording.
Don't worry, I'm pretty stable these days. And seeing a therapist helped. To your point, it was someone else who booked the first appointment for me. So, if you know someone who might benefit, it'd be good to help them out with the process of finding a therapist.
"You asked me how depression felt, and this is all I could come up with.
It feels like I’m walking upstream through a current strong enough to pull me under four times over.
There are others with me but they are walking along the banks telling me to “just get out of the water.”
But instead of extending a hand in help, they just move on and leave me behind.
Every once in a while I find a rock that is strong enough for me to lean on, And I can rest for a bit.
But the rocks always get tired of holding me up, and when they let go, I’m left drowning, thrown 50 feet back again.
And nothing is harder than standing up in that current when everything in you is telling you how much easier things would be if you just let yourself get dragged under."
Does that apply to things you 'have' to do as well?
I don't really like shopping for groceries, but I'd rather do that, than order take out that's expensive and probably not very healthy.
If I'm going to cook something, I'd rather cook something with a different taste than eat pasta again.
I don't really want to do laundry, but I do want to have clean clothes that don't smell.
If I could afford to do so I wouldn't work, but until I retire that's not possible, so I might as well make the most of it and increase my earnings/time ratio.
I don't really want to go see my family, but I feel I have a duty to do so.
Does that apply to things you 'have' to do as well?
For some folks: This is the reason for a shower becoming a monumental victory in one's day: Sometimes just getting out of bed is a struggle for folks. I'm in a few cooking subreddits, and often get folks looking for "depression food": Food that takes no effort (cooking at all can be too much effort) yet is still a bit healthy. At this point, you probably aren't enjoying food anyway. I've known someone that literally bought new underwear because laundry was the more difficult option.
Not everyone has all of this, and folks are pretty good at hiding it from others and putting on a happy face.
I have seen a person so depressed they didn't even care to get out of bed to have a bowel movement. They just stayed there in it until someone else came to clean it all up.
Yes. Depending on the severity of the depression, a depressed person might have problems with even basic things as brushing teeth and showering regularly and being able to do household chores.
Yes, that's how symptoms generally work. Symptoms are signs that may or may not point toward a diagnosis. A diagnosis such as depression is something separate that is determined from the collection of symptoms on an individual by a doctor.
I'm not a doctor, but from what I've heard and seen: many depressed people manage to put up a good facade.
(Of course, that doesn't mean that putting up a facade means that you are depressed.
Also going out and doing stuff is probably better for you than sitting at home, no matter if you are depressed or not. And if that drive to make you go grocery shopping or meet people is less than healthy, that's still better than losing all motivation for everything, I guess?)
I just wanted to follow up on this as well. I also have my groceries delivered because grocery shopping is incredibly overwhelming for me and I suffer from several mental disorders. Something that I have learned is part of learning to live with mental disorder is giving yourself the grace that even if you can force yourself to do something that is very hard on you it is totally valid to find a hack to help you out(like getting your groceries delivered). This might sound like a no brainer for a neurotypical person but allowing myself access to tools to alleviate stress was seriously difficult for a long time because I felt like to be a "healthy" person I had to force myself to do things for myself that I thought "normal" people did. I forced myself to do things that were actively destructive to my mental wellness in part as punishment to myself for not being neurotypical.
Have you tried a delivery service? Walmart as an example charges $100 or so a year. And then you pay a tip to the delivery person. I think it's worth it to avoid shopping in person, and cheaper than ordering delivery from restaurants.
My wife suffers from agoraphobia and is autistic. We (honestly: she, as she arranges it) do something similar, but we don't live in a country with tipping culture, so its a flat 100 EUR or so (you can also pay per delivery then the price fluctuates, a decent way to evaluate). Sure, it has cons. Sometimes stuff isn't fresh (report, and get your money back), or the expiration date doesn't suit our planning. Sometimes stuff isn't available or its not included. But it really does help, especially if you have difficulty leaving the house for any reason (we got little kids as well). I also find covid-19 a good reason to not go to the grocery store. However, you miss out on the fresh air and increase lack of movement. Get your little children out, for example to the local playground. A dog can help with that, too. And finally, have a buffer storage esp. with regards to non-perishables, just ensure your house or apartment can deal with the extra storage (e.g. we got an American fridge/freezer).
I used to feel the same. What I found was that thinking of chores as a "duty" made it into a something I wanted to avoid. Instead, making these into a fun "mission" turned it into a positive thing I look forward to. Something about adding a good sound track, makes all the difference.
Some examples
- Going groceries. Used to hate it. Stressful. Too many people, I'd get social anxiety. Now, I smoke some weed, put on Michael Jackson on my headphones, cruise through the store with a smile on my face and a dance in my step. They say Mediterranean cuisine is one of the healthiest diets. OK. So I bought the best Turkish cookbook (https://www.amazon.com/gp/product/0714878154/ref=ppx_yo_dt_b...), and decided this is my new food bible. "Good luck, me! You're gonna need to figure out Eggplant." I've been eating grape-leaf wrapped rice, humus, pita bread, and that kind of thing all week - have never felt healthier. The recipes are easier than you think, and are good for leftovers, meaning you can food-prep and still eat healthily.
Laundry - You might laugh, but I find that on the days where I imagine I'm going to go on a hot date (LOL one day), or meet an important client, or honestly - when I feel most badass (and comfortable!), those days - cool stuff happens. I make a cool connection, have a good conversation, experience something different... So, doing laundry has been a positive way to ensure that my favorite shirts/outfits remain ready for duty, instead of uselessly in a basket.
Work - I was in a bad work situation a couple years back. Failing in-place, in slow motion. I tried to be honest during a review with ny boss, and listed all the things I felt I needed to work on (honestly, coming clean on what I was failing at). My boss took me aside and told me, "Why not get better at what you're already good at, rather than improving on what you're not". It kinda blew my mind... I honestly took a look at one of those "find your dream career" Ven diagrams. What is the intersection of your Passion, What You're Good at, What People Pay for (https://www.authentic.com.au/wp-content/uploads/2015/08/pros...). I broke the seal, asked my friends, "Hey. I'm looking to make some career changes, and could use the perspective. You know me. What do you come to me for?" I was surprised what kind of great answers I got. I'm quite self critical, so hearing this type of feedback was very encouraging.
I find t fulfilling to identify the people in my life whom I truly admire, learn about their life goals, and help them achieve them. It's a really great feeling, and leads to getting to know your friends at such a different level.
Family - Lately, I have been calling my grandmother on the phone. She's 95. I asked her, what gets you up in the morning? Without missing a beat, she told me: "Music." She loves Singing, playing piano, dancing. I decided to learn to make music. I'm not going crazy with it, but I bought a MIDI keyboard, plugged it into Garageband, and have been learning chords to songs I like, taking lessons. I'm telling you - it's such a wonderful soul feeling. I've since found out that many of my family members - some I had "written off" - are into so music. We've truly been able to connect in ways that excite us both. One of my cousins, we've gone from a "I see you once a decade" to the the true feeling of "family"- sharing each other's cool songs we've discovered, favorite bands & albums, to even video clips of our playing music attempts, telling stories, etc. If you haven't given it a try before, piano is pretty fun & easy to pick up (Trust me, I never in a million years believed I could play any instrument). Now I can sit down at a piano and kinda play something that at least makes MY ears smile :) Check it out if you haven't. Thanks for listening to my Ted talk...
I am the same way. My depression isn’t severe enough that I CANT do the things that need to be done, but rather, they take immense effort and personal discipline.
Of course everyone (even non depressed people) sometimes struggle to do things they have to do, but don’t want to do. It’s all about how severe that struggle is, not whether or not that struggle exists at all.
Years ago I was recommended a book written by a Dutch psychiatrist who had developed depression himself. The tagline was sort of "here's a professional who suffers from it, this will be insightful."
I couldn't relate to his condition for one iota (let alone finish the book); as he had mostly feelings of guilt and shame, and dark, weird mental images.
I guess depression is a sort of blanket term by now for many things, which probably complicates diagnosis and most of all, treatment.
Plus, I recently discovered the term "sh*t life syndrome", which is apparently getting to be known as a well-known term in the US/UK psychiatrics system (at least it has a Wikipedia page claiming that). It describes people who are poor or lonely because of the system surrounding them (prime example: they live in an area with raging unemployment). In that case, it's argued, symptoms of depression might actually be the logical response to an outside stimulus (or lack thereof). Yet, it appears many of these people are referred to psychological treatment because, well, society doesn't come up with any better option.
But what rubicon33 describes is certainly one way of depression, and I think a common one. But I'd go one step further even: Yes, people lack that little "kick" to get them going and do something entirely. But I don't think that's the root cause.
The root cause, to me, is that this kick has been subconciously "unlearned". Because when people with this sort of depression DO force themselves to do some of these things (and man, do they need to force themselves, with rational arguments and all sorts of tricks), they are not enjoying it. To stick with the example of playing tennis: Non-depressed people come back and say: "That was fun! I powered myself out on the tennis court, maybe I even won, I feel good.". People with this particular sort of depression come back and say: "That was physically, but mostly mentally exhausting. I want to sleep or procrastinate now and reset my thoughts to the baseline of being emotionless."
Disclaimer: Yes, I think I can also kind of speak on this subject. I've been repeatedly diagnosed with childhood PTSD and depression possibly ever since that (which makes it 30+ years); which doesn't mean that I'm not questioning this all the time, because the biggest trick played by depression is to make you think that everything may be just normal sadness/exhaustion/"not trying hard enough" ...).
That's just one of many symptoms you're describing here (loss of interest). For me the main symptom is depressed mood, which essentially feels like someone you cared about a lot died recently.
Anecdotally, the lack of those things are definitely present in myself when I'm experiencing a depressive episode (I am diagnosed with clinical depression): I sleep badly, either not at all or for 12-18 hours a day, I drink far too much, I do not leave my house, and my hobbies either fall by the wayside entirely or I partake in them with no enjoyment or happiness from it.
If you're experiencing those, it might be worth talking to a psychologist or your doctor (to get a referral): you don't have to tough it out. But people who don't have clinical depression also have those issues too, which is why the diagnostic criteria is a little more involved.
For me, a short 3-4 month course of a particular SSRI lets me beat back the worst of it, and Cognitive Behavioural Therapy keeps it at bay. I haven't had an episode in years now
Noticed that both you and the OP mentioned drinking. Just the drinking can cause much of this. Drinking screws up your sleep cycle, which can also cause much of this. Drinking sessions are also time consuming, so you have less time for other things you enjoy anyway. Sure, some things you can do while drinking, but those may not be the things you would prefer to be doing while sober.
Sure! Though I drink basically not at all when I’m not in a depressive episode. It’s more of a subconscious “self medication” thing, and the symptoms don’t subside even if I’m not drinking sadly.
A Central Nervous System Depressant and Clinical Depression are two (basically) unrelated concepts. Alcohol is the former. Despite having the same word in them, they are only tangentially related to one another
Alcohol is a central nervous system depressant, which is commonly just shortened to “depressant”. This doesn’t mean it causes depression, it means it has a particular effect on us humans biologically.
That said, it does also exacerbate clinical depression, so this gets confusing quickly!
That's a massive oversimplification which came out of non-scientific 12 step literature and is simply not true in many situations.
I have on many occasions beaten back total anhedonia and a desire to die with a few drinks. It's not an optimal solution obviously, but when your options are limited it is sometimes quite preferable to not drinking.
>I have on many occasions beaten back total anhedonia and a desire to die with a few drinks. It's not an optimal solution obviously, but when your options are limited it is sometimes quite preferable to not drinking
As someone who has suffered major depression, I agree totally that recreational drug use can be helpful in managing some symptoms of mental disorder. I do however feel like moderation is a very important aspect of this which can be harder for folks when they are already feeling down
>For me, a short 3-4 month course of a particular SSRI lets me beat back the worst of it
Can you elaborate which one are you using? I was prescribed Wellbutrin/bupropion (along with some therapy sessions) about a month ago and I seem to notice no changes. I'm going to continue to be hopeful but it seems like this wasn't the one for me so just wondering what you were using.
I found medications ineffective, but my last therapist helped me tremendously. If your therapist isn't helping, find a new one. There's no shame in switching.
The most important thing in therapy is relational depth. Doesn't really matter what the method is.
"There is research to support common factors theory. One common factor is the client–therapist interaction, also known as the therapeutic alliance. A 1992 paper by Lambert showed that nearly 40 percent of the improvement in psychotherapy is from these client–therapist variables."
I am on my second therapist. The first was was a remote therapy based out of Israel. He was great and convinced me to quit my terrible job at the time and reorient my life. His therapy worked to an extent but I never could relay my deep insecurities to him. When I tried to explain deeper concepts to him it nver really registered. I just found myself wasting 120$ per session with no real payback. I continued with him on and off for 5 years before just giving up this year after my father passed away and I gained no comfort from talking to him about it.
A second remote but local(because of covid) therapist was assigned to me as part of this Wellbutrin trial. A total of 10 sessions are to be done with this trial. So far she has only told me what I already know: that I should keep trying little steps every day like increasing my exercise. She gives me little goals but I don't like the fact that since these sessions are 45 mins with no way to extend, there always seems to be a time crunch.
There are tons of therapists in my area with no way to evaluate the differences. This is an expensive proposition as it stands and so I don't know how I will find the perfect one without evaluating each and every different therapist in my area. :/
Buproprion is quite good at removing false reward loops. Made me really tone down video games. It's used also for smoking cessation. It's quite subtle. The other SSRI/SNRI meds have strong side-effects.
I will say that the effect is permanent. It's rewiring your brain when you use it.
If it's helping you to spend some time on harder but more important self-improvement, then great.
If not, you should consider switching drugs.
I currently take ADHD medicine, which is helping in many ways, but a mixed bag in others.
All the drugs are going to grease the wheels in some way, but you'll have to experiment to find the one for you.
>Buproprion is quite good at removing false reward loops. Made me really tone down video games. It's used also for smoking cessation. It's quite subtle. The other SSRI/SNRI meds have strong side-effects.
That would be a miracle if it did that. My doctor put me on this precisely because it is less strong than other drugs like Adderal. He does not want me going down an addicting road unless necessary. (my summary of what he told me)
So far I have been taking it for about a month although I have missed days here and there and while I try to take it at the same time, sometimes the window varies by +/- 1-3 hrs. I am on the 150mg XR version. What is typical time frame we are talking about before we notice changes? 1 month? 6 months? How long did it take you?
The fact that I am on HN/Reddit/youtube for a couple hrs each day instead of exercising/coding/tidying up/working on my life seem to indicate that no reward loops have been broken thus far. In fact I am slowly sinking in the other direction(but i'm not sure if buproprion is causing it). I have broken another all time record for weight gain despite increasing my exercise regime somewhat.
Was considering stopping treatment after a month if no changes are noticed and wait some time to clear it out of my system before trying something like ayahuasca or psilocybin.
I took Wellbutrin for several months. As mentioned, the effects were subtle for me. The pill isn't going to do the work for you, just grease the wheels a bit. You should probably give it 3 months before quitting.
I'm currently on Adderall. If you have ADHD, it has more benefits than drawbacks in my opinion, and the effects are not as subtle. It does give you focus for tedious tasks, though it's up to you to assure that those tedious tasks are actually important and not a rabbit hole.
Neither drug is going to make you stop browsing Reddit or HN. If you want to reduce browsing Reddit, turn off all the default subs and then subscribe to specialized subs catered to real, specific interests of yours. You will not miss the default subs. HN is only good for about 1 page usually, then it's scraping the bottom of the barrel.
If you want to do more exercise/coding/tidying up/etc. set a 5 minute timer, do at least that much work on that, then reward yourself with some HN. You'll find that starting the activity is the hardest part.
Re: weight loss, you can't outrun your own fork. All the fad diets have a kernel of truth to them, a lesson to apply or discard in your own life. Intermittent fasting is quite effective IME. Besides calorie reduction, it also resets your hunger signals. For me, it got me over this irrational fear of being hungry that I had, and also revealed just how much I was eating out of boredom rather than hunger. Also, you have to pick a problem and focus on it. Mitigate the weight situation, but don't force yourself to fight a 2 or 3 front war.
If you have ADHD, you should be on an ADHD med, unless you literally can't trust yourself to take only one pill a day.
If you have treatment-resistant depression, you can also look into ketamine, either intravenous or now intra-nasal. Pay the price to have it administered professionally, as it's not a good idea to develop a black-market hookup for something so addictive.
which ADHD medicine is good these days? do they raise blood pressure or act as a stimulant? (I guess I'm asking if there's anything better than adderall and ritalin these days)
Note that these are still stimulants tho. Vyvanse is unique in that its a slightly modified dextroamphetamine (adderall) molecule that gradually gets metabolized by the liver into dextroamphetamine, sort of a "natural" extended release and has a much smoother (side) effect curve. Concerts and XR are just cleverly designed pills that release two doses of plain methylphenidate/amphetamine spaced out, so there's two distinct peaks with a small lull between.
Escitalopram is what I found worked for me. None of the SNRIs did (Effexor and so on), and bupropion isn’t even prescribed where I am for depression for what it’s worth, but I’ve heard some people have decent luck with it, typically as an adjunct with an actual SSRI though.
It took me months to find the right one for me though. Worth talking to your doctor about it if it’s not helping much!
I tried Lexapro 6 years ago when I first attempted to work on this issue. I was prescribed some minimum dosage(I forget what). I will never forget the first day. I didn't feel happy or sad or even anxious. It was as if every emotion was stripped out of my head and instead it was replaced with perfect neutrality. Nothing mattered int he world anymore. I had no thoughts or opinions, just complete neutrality of thoughts and emotions. This also became my most productive week in years. The thought process was literally "Ok I have this task to do, let me do this task, I am done with this task, ok lets do the next task. Repeat until there are no more tasks." No breaks, no distractions were noticed while the task is being performed.
Unfortunately, the side effects were so bad I gave up after a week. Horrible nausea all the time. Such extreme fatigue that i'd sleep 16 hours and still feel exhausted. Not to mention other side effects that are not appropriate to discuss here.
I am considering trying this nightmare of a drug again because I still remember that productivity but man that first experience literally felt like poison was seeping into all areas of my body.
Yeah that absolutely apathy is what kept me alive when I was so close to the edge.
But the side effects (and primary effects!) are also why I only ever stay on it for 3 to 4 months. The sexual side effects alone are enough to impede my recovery, let alone some of the other ones.
So I use it like a bandage to get through the worst parts, rather than a “take every day for years” drug. The “take every day” bit for me is CBT exercises to rewrite my mind, and it’s worked :)
The physical sides for Lexapro at least for me disappeared. I also got the nausea initially. It’s rough, I know.
There are other more modern SSRIs that might be worth trying too, but if escitalopram seemed to work then it might be worth trying to stick it out to see if the sides get better. They usually do
I gave up after the Lexapro until this year where I am trying to tackle this issue again with the Welbutrin. I keep reading that maybe ayahuasca or psilocybin might be the miracle key that solves the underlying issues.
I think symptoms of depression are reduced to too few dimensions (these being all disorders names coming from a science which cannot reproduce most of its results).
Imagine Einstein. He can't figure it out and solve the constant problem. Somethings not right. He's not happy, not sleeping well. He's thinking hard.
But then, he takes a pill. Suddenly, no more thinking during bike rides. "I'm just looking around and dopamine rushes in, it's great".
(I'm not discouraging treatment if you have a problem !! Positive feedback loop of negativity can kill you.)
I just mean that if you have high standards you may be less easily satisfied. I do think it's good to be able to step back and really enjoy a walk or music without a care in the world, but I also don't think there's something wrong with people who don't, and instead just focus on their problem. Or even are just looking for a problem or a puzzle interesting enough to solve.
It's all in the context. Sleep is important, you should sleep well. But maybe if you are lunching a rocket tomorrow it's fine to have a problem sleeping. Respect to others is the most basic thing, but maybe if they keep distracting you from work which can improve everybody's life it's ok to say something harsh but effective. And so on.
I don't think you can truly change the world if you sincerely enjoy its current state.
Depression and other disorders are primarily described by being disproportionate responses to stimuli. The astronaut isn't clinically anxious being up at 2am before the launch, but if they were because they had to drive to the post office tomorrow that would be. That's not a world solving problem that's keeping them up at night, it's just trying to live. That's the difference.
Unless there would be something big at the office. Or they hated they job. Or they get burned out because it offers them no life-work balance and space for other activities and relationships outside of it.
In all cases above it's not the brain chemistry that you probably want to fix. But you probably can do just that..
OK, in too much simplified version: you not being content with the state of things may not necessarily be your fault - it may be the things fault.
Of course you can change yourself, all problems are within you, they are created by your optimization function. Apocalypse is not a problem unless you don't want it to happen. Without people who don't make themself content with the state of things right now it's not a nice place to be. But without people who are not content and are trying to fix it it's not getting better.
Just to be too verbose because of sensitive topic: it may be you, it may be chemical imbalance, I'm not saying it's a happy pill and long story short if you haven't experienced happiness in a long time go see a doctor yada yada.
You can be happy during apocalypse when you are making progress towards ending it, you can not like things and accept it. I'm just making a case for unhappiness being the sane reaction in specific contexts.
It's really hard to have a meaningful discussion about this topic without being seen as a murderer while providing a decent information density. Even on HN.
I don't think it's ever the thing's fault. If you're actually depressed about not solving a really challenging problem, this results from a process that works differently in people who aren't susceptible to depression. For instance, maybe you get depressed because you thought you could solve it much more quickly, and you're realizing your self-assessment is entirely wrong, and this starts negative thought spirals that maybe your abilities to do anything are over inflated, and that you'll just experience frustration and negative emotions in tackling anything, and this sucks the drive and enjoyment you used to experience from any of your hobbies.
If you weren't susceptible to depression these spirals wouldn't take hold, you might just say, "huh, now that I've learned more, I realize this is a harder problem than I first thought" and you just carry on.
It is never the thing fault. But it may be the thing fault given your optimization function.
Imagine a kid drowning in front of you (that somewhat happens but on the other side of the world so you can't see directly). You can be unhappy about it, but that's within you. If you don't care about the kid you have no reason to be upset.
Most probably would agree that maybe doing something to yourself to make you less upset about the kid drowning is not optimal. Reality is somewhere between this and somebody living a perfect life and wanting to kill himself.
This doesn't control for the fact that the world sucks now, does it? I read a few months ago that ~25% of young adults had thoughts of suicide in the past year, so I think it's safe to say that the causes are more external than internal at this point.
Disentangling pandemic effects from "normal" life is complex but overall in the US suicide rates are actually down for 2020, though slightly increased for younger Americans. The trend in the US was upwards into 2019 so these are positive developments.
It is very difficult to properly assess 2020-2021 survey data both because the "you should be depressed" messaging is very strong in the media and the bias in who responds to surveys is complicated by the pandemic.
I am a Canadian and we saw an enormous drop in suicides, 30+%, in 2020 despite survey data (and wacky conspiracies) to the contrary.
I don't think it is "safe to say" much of anything about suicide rates or individual motivations, it is a complex issue.
> the bias in who responds to surveys is complicated by the pandemic.
Many people have lost family members and been pushed into poverty. It is incredibly callous to think mental health can be discretely measured without accounting for the environment.
Suicide is not a quantitative measure of mental health.
If the claim that "Suicide is not a quantitative measure of mental health" means that such large fluctuations in the suicide numbers across many jurisdictions with differing underlying rates can't be used to inform any opinions about the impacts of the pandemic on mental health then I emphatically disagree.
I don't know who said you can measure mental health without accounting for the environment, I never made that claim! I literally said "I don't think it is "safe to say" much of anything about suicide rates or individual motivations, it is a complex issue."
It's probably more likely that the internet is amplifying every problem in the world and since young adults grew up with it, it's more integral to their lives.
Additionally, there seems to be a stigma attached to not caring about a particular event, especially if doesn't affect you, all because of the slippery slope argument which is a fallacy.
> This doesn't control for the fact that the world sucks now, does it? I read a few months ago that ~25% of young adults had thoughts of suicide in the past year, so I think it's safe to say that the causes are more external than internal at this point.
How did you come to think depressions' cause must be internal ?
I am increasingly confident I suffer from depression, rather than just being generically miserable.
How do you deal with the trust issues posed by that questionnaire? I have suicidal thoughts most days, but I'm concerned that revealing this to an NHS doctor would quickly result in my freedom of choice on what happens next being taken from me. Seems like one of the few cases where US healthcare (where you are explicitly a customer as well as a patient) has some advantages.
Not a doctor but have experienced something like what you're describing. It is important to be open with your doctor about this stuff because it allows them to accelerate getting you help. Differentiating between suicidal thoughts and intentions (the former of which I had, the latter I did not) made me comfortable enough to have the conversation.
Really though, seek help. It is unlikely you'd lose choices (eg be sectioned) if you're asking for help and engaging with that help.
That's a good point - thanks. "Thoughts" rather than "intentions" is definitely more aligned with where I am. Part of the trouble for me and presumably a lot of people is untangling those things - for example, would my thoughts be intentions if not for having a spouse, who I could never imagine hurting in that way by leaving? Moreover, does the mere presence of that kind of "blocker" represent a positive sign?
I pick at this stuff in my own head all the time, and just don't have enough confidence in doctors to believe they could tell me anything new. Being able to skip straight to pharmaceutical or other non-talking solutions via a disclaimer would probably mean a lot more people like me would seek help.
> Being able to skip straight to pharmaceutical or other non-talking solutions via a disclaimer would probably mean a lot more people like me would seek help.
Antidepressants are strong stuff. Some years ago I hit a bit of a snag and went to a doctor and got just this, a prescription after five minutes of talking with helpful advice like "get a girlfriend" or "study something else". Stuff really worked... except in the wrong direction. Not an exception either, common enough they put "suicide" as a side effect in the fine print. I think if you're gonna take something like that you need some kind of feedback/monitoring and test different drugs until you might find something that works right. A hands off fire and forget prescription like I got likely won't work for most people.
Yes, the presence of a blocker like that is a good thing. What ifs aren't the most useful thing though.
GPs have been enormously helpful to me with this stuff. Most are very understanding. If you can do an online appointment booking that might help too - so the immediacy isn't an issue so you can write the appointment reason very clearly and revise it as much as you want before hitting the button. Otherwise, tell the receptionist you'd like a phone appointment (for the distance that gives psychologically) and that it is for a mental health issue. The diagnostic criteria for depression are fairly easy to satisfy - it is mostly about low mood for 4+ weeks. Keep details to a minimum you need to get a prescription but be cooperative if they probe.
Whatever you do though, don't just suffer. Tell your spouse how you feel too. Get some help.
Involuntary admission works the same way in the US.
I have kinda the same problem. I've had depression for a very long time - stable, but consistently declining. I get the "... or I could just kill myself" xapata mentioned a couple times per week and the reasons I don't are basically "that sounds like work" and "that would make my mother sad". Which aren't exactly good reasons, I know, but so far I've done very little actual self-harm and I very much don't want to get involuntarily admitted. I really would like to get help to deal with depression. I've battled it out alone with it for 15+ years and I'm not exactly winning that fight. But- anyone that's qualified to offer that help is pretty much legally required to admit me if I answer their screening questions somewhat truthfully.
Yes - those things are closely related to some of the diagnostic criteria used by some of the tests for depression. The remission of those symptoms is a quite a good signal all by itself.
Yes, they can be. Self-diagnosing isn't a great idea; lots of non-depressed people have some symptoms of depression. It would probably be a good idea to find someone to talk with though.
Where "someone" is a therapist or counsellor. They can refer you on to someone who works with pharmaceuticals if necessary, but there's a lot to try before going that route.
Heads up, ‘There is a lot to try before going that route’ is a medical opinion that is hard to notice. Exactly what the treatment plan would be and in what order is entirely up to the doctor and sometimes (often) the best thing that works is the actual drugs.
I’m just conscious of this because I’ve seen this argument used to justify delaying actual treatment in favour of ‘alternative medicine’.
True, yes, but nothing you hear in a CBT session should be super surprising. It may help you see things in a new way or understand the motivations of the other people involved in your life situations, but they're not going to tell you sleep with crystals or wear a magnetic bracelet or something.
Basically the counselling/therapy part of the process would be identifying if there's a "real world" root cause to address ahead of going the pharma route and facing potential side effects, and/or the reality of having to go off it later and immediately regressing because the root cause hasn't been fixed.
In any case, I'm obviously not a doctor; neither this post nor the GP should be construed as medical advice.
I wouldn't rely on answers from HN. I don't have depression, but I do have anxiety, and professional help changed my life. It would not hurt to get an evaluation if you feel like something is off.
Yes. When you have depression you get basically nothing done. Even things that used to be fun aren’t fun anymore. You are miserable if you do something or nothing.
Lately I've been reflecting on the source of my low feelings and I have determined that in my case that alcohol is playing a key role. It is a de-motivator and its effects are pernicious in that it causes the user to become unaware that it is responsible for exacerbating depressed moods even after feeling intoxicated has worn off. I drink responsibly but think its time to cut it out to see if I feel better.
Serious question: are these typical signs of depression? Now I'm wondering if I have depression.