http://mentalhealth.about.com/cs/depression/a/suiciderates.h...
http://mentalhealth.about.com/cs/depression/a/suiciderates.h...
Beating depression requires mastering one's own inner life and changing the mechanics of how one thinks and interprets the world. This really does give you super powers coming out of it. And it makes you essentially depression-proof. Those 2% to 9% of people committing suicide are not people who have beat depression.
Getting 'over' depression is what happens when the depressed individual experiences a change in life circumstances or another external or temporary internal event that removes the depression for now. That depression can always come back, and among the people I know who haven't beat depression, it always seems to. They never get the 'super powers' because they never beat it.
Most of the highly successful, most gregarious people I know were deeply depressed at one point, beat it, and became expert problem solvers with superhuman capacities for perseverance. You could take their business from them, have them walk in on their spouse cheating on them, and find out their children aren't theirs and they'd be sad for a week or two then get right back on with rebuilding their lives again as soon as they finished deconstructing the problem and mapped out a new path for themselves.
Depression almost seems like a gauntlet certain high potential individuals have to pass through. Some of them make it through the gauntlet and get those super powers. Others don't make it through the gauntlet, step out for a breather, then go back in again. Then maybe they make it through that time, or maybe it's back out, then back in again. I have family members who've been sucked into the depression gauntlet repeatedly without ever beating it, and you can tell they have the potential for 'super powers', but never get them.
Would you elaborate on the "super powers" that you hint at here as being reserved for those who have made it to the Post-Depression state?
As a clinically depressed person, I am, in some ways, still very much caught up in the "gauntlet" you describe here. It would be interesting to hear what I can look forward to when I finally.. purchase your online course?
In a weird way, it's like you learn to treat yourself like any other human. If I got stood up for a date, my Asshole Brain would tell me my life was pointless, I'm ugly and unlovable, I'll be alone forever, etc. If a friend was in the same situation, my Good Guy Brain tells them the real, logical things: that it sucks but it's not your fault, the date probably had an emergency or just sucks at life, there are lots of other people to date, etc.
So it's a practice of learning to treat yourself like you'd treat that friend. Obviously it's not that simple - you can read these words and nod your head along with them, but in the middle of a depressive episode, it's like the engines cut out on your airplane and you don't know how to fly and why bother flying anyway. Pilots have to study and train for hours before they can fly a plane, but life just throws you right in the mix. It takes a BUNCH of study and training and thought experiments, plus maybe discussing with a therapist or support group or Internet strangers, but eventually you can learn to recognize these emotionally difficult situations and engage the Good Guy Brain before the Asshole Brain takes over.
Aeschylus thought so too:
>He who learns must suffer; and even in our sleep pain that cannot forget falls drop by drop upon the heart, and in our own despair, against our will, comes wisdom by the awful grace of God.
-Aeschylus, Agamemnon
But statements like these are extremely frustrating for people with actual depression.
Depression is not just a state of mind you can change through will power. Here's a fun thing to do: if everything you believe about depression is applied to a broken arm or colorblindness and sounds ludicrous, then it's wrong.
For example: "Beating a broken arm requires mastering one's own inner life and changing the mechanics of how one thinks and interprets the world..."
Or: "Getting 'over' colorblindness is what happens when the colorblind individual experiences a change in life circumstances or another external or temporary internal event that removes the colorblindness for now."
Depression changes the way you think. It removes your motivation for improving. I didn't pick these examples randomly; depression is a colorblindness of emotion. It is insidious, and nasty, and "thinking your way out of it" is something that's going to be regarded in the future the way that we regard blood-letting a fever now.
There are treatments for it, with varying side effects, and there are some tactics people prone to depressive episodes can use to try to lessen the impact of their depression, but depression itself is not something you "beat". At best, it's something you learn to live with: having a broken brain for the rest of your life.
You're applying the broken arm analogy incorrectly.
Depression is a broken mind. Yes? A broken thought pattern, or response system, or something along those lines. Right?
Therefore beating depression requires fixing that. Fixing your mind. When you put it into words, that comes out as: "requires mastering one's own inner life and changing the mechanics of how one thinks and interprets the world"
Because that's what fixing your mind is.
Applied to the broken arm analogy it becomes: "fixing a broken arm requires fixing your broken bone and learning how to use that arm again"
Doesn't sound so crazy anymore does it?
> Depression changes the way you think. It removes your motivation for improving.
Which is why fixing the way you think is the only way you can fix depression. Whether that's through drugs, through sheer willpower, or by chanting prayers on top of a mountain in the himalayas. It all boils down to fixing the way you think.
There's mounting evidence that depression is a biological disease, not a woo-woo problem with your mind. You seem to be presupposing that the mind somehow exists outside of biology, and that probably isn't the case.
At best, advice like this is geared towards coping with it.
(See also: https://www.newscientist.com/article/2095769-gut-bacteria-sp...)
While advice for coping -- from people, like you, who know what they're talking about -- is good and helpful (when limited to that context), the notion that depression is a thing that can be beat through sheer willpower should be beat back with the same intensity as the argument that sleeping with virgins will cure AIDS, and for the same reason.
"mental" disorder --> mind stuff; Symptoms: "low mood, low self-esteem, loss of interest, low energy, pain". All mind stuff as well.
Yes, it often requires drugs, and yes it usually/often/maybealways has an underlying cause of biological issues. But fixing it still requires fixing your mind. Because that's what's broken - your mind.
The point is that just because something is a mental issue, doesn't mean you can fix it with will power and thought changes alone. But you definitely can't fix it without will power and thought changes.
I like to think of beating depression like beating addiction. You first need to fix the biological stuff, and then you have to mentally keep making sure you don't slip back. Maybe forever. You need willpower to not go back down that road, to avoid situations that trigger depression in you, or hell, just to keep eating right and exercising and to make your mental health a priority because it does help.
As my shrink used to say: the drugs give you the chance, but you do the work to fix your thoughts.
Does that make more sense?
There are a couple of points I feel compelled to push back on though.
First is the word "fix". This might seem like quibbling, but that really bothers me, and I think for not-trivial reasons. When a problem is fixed, it doesn't recur. Addiction and depression are never fixed. They can be coped-with, they can be treated, a person can live a (well, mostly) normal life as an addict or with depression. I think this is important because any advice or treatment offered to people with depression should be practical and it's critical not to imply, "this will fix you."
The other is that we have to be exceedingly careful when suggesting mental changes as a treatment for depression, because that can easily be misinterpreted by other people to mean that depression is caused by "bad thinking", or that a person struggling with depression can "just think their way out of it", and I submit this entire HN thread as evidence for that (and could probably dig a few more out of my comment history). That, I think, is distinctly unhelpful for people struggling with depression. They will tend to already be struggling with those thoughts as it is: "why am I broken? Come on me! Be better! Just be happy! Everyone else is happy!" and having other people show up and offer, essentially, the same advice, is really harmful.
And fwiw I too am speaking from far too much experience, both personal and family.
Fwiw I don't think mental changes treat depression. I think they're the result of treating it. At the least they go hand in hand with the process.
Mental changes aren't a sufficient step to get out of depression, but they are a required step.
It's hard to put these things into words because they're on the intuitive side of my brain, but thanks for the chance to try.
As for the downvoters, screw 'em. I got points to burn. Maybe what I'm saying can help some people make some sense of the process.
If the mind is the brain and vice versa, then it might stand to reason that in some cases the thought<->physiology<->environment feedback cycle that traps one in depression can be addressed not by willpower, but by selectively interrupting whatever part of the feedback cycle is easiest to access or most pronounced for a particular depressed person.
I've wondered about that for many years, and it's the strategy I adopted for myself a very long time ago, but I've seen scant evidence for either its effectiveness for most other people or any evidence for its basis in reality.
Like I just said elsethread, I'm more concerned here with other people misinterpreting the suggestions being offered and then sharing those with people with depression in a way which is ultimately harmful. I'm probably being a little louder than I need to be about it.
How do you know depression can't be overcome?
This kind of thinking is precisely why I stick around to argue about this subject when it pops up.
You have cause and effect reversed, and you're not up-to-date on current medical research. The science has advanced far beyond, "you're depressed because you're thinking bad things."
There is evidence linking it to intestinal bacteria: https://www.newscientist.com/article/2095769-gut-bacteria-sp... and also http://www.nature.com/news/gut-brain-link-grabs-neuroscienti...
And inflammation: http://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7...
And circadian rhythm / sleep: http://www.independent.co.uk/news/science/new-forensic-techn... and https://www.scientificamerican.com/article/fighting-depressi...
I think it's likely that within the next 50 years a treatable, biological, root cause will be found which is somehow related to all of these, and I hope that by then the lay-public will have moved away from the opinion they share with Scientology.
> Your belief in the inevitability of depression is only leading to more depression.
You have misinterpreted the purpose of my comments. I'm not here to tell people with depression how to improve their lives, because I'm not qualified to do that (words which I wish everyone on HN would hear in their head before they write anything about anything). I'm just here to clear up common misconceptions about the causes of depression and what it's like to experience it.
> You mean well, and what you're saying may be helpful to people who struggle with certain feelings from time to time. But statements like these are extremely frustrating for people with actual depression.
Discussing depression goes down-hill everytime someone pivots to what people "should" or "shouldn't" say. We're not trying to actively console someone with depression here, we're merely having a discussion on our thoughts/ideas/experiences of depression, so I think your defensive retort is quite misguided.
Regardless, I agree with your statement, but I'm at a loss to your intent. I've been depressed and yeah, it's not really helpful when others say something that translates to:
> Depression is the result of how you interpret things.
But looking back on it - at least from my perception and reality of the world; it's 100% truth. However, is stating this helpful? is it the right approach to trying to help someone who is going through depression? absolutely not.
Don't let the social politics muddy the raw discussion when appropriate, please.
> Your belief in the inevitability of depression is only leading to more depression.
This was definitely the biggest hurdle for me. The echo-chamber of "This isn't your fault! depression is a disease we'll have a cure for one day!". The vortex of negativity and the constant apathy was fed by these sorts of statements.
Mindfulness was my cure. An ultimatum of either "I end my life" or "I do what is within my control, to change the way I think." It's alot more complicated than that in reality, but the heart of what I'm trying to say is there.
As someone who spent more than a decade struggling with a diagnosed depression and the numbness that came from trying to get better with 5 different prescription drugs that addressed a few symptoms while making the whole thing a lot worse, what worked for me was, eventually, thinking my way out of it. And it's funny that you compare it to some medieval treatment because the method I used to think my way out of it has been taught for 2500 years. The key is you can't just try to think your way out of it. There is a specific technique to meditation and mindfulness that the watered down versions of mindfulness training miss. Go to the source and learn the traditional practice, not the bits and pieces that psychiatrists have tried to marry with more recent psychotherapeutic theory.
Now with daily anapana/vipassana practice, I'm able to live much more in the present moment, which allows for enjoyment and sadness free from the suffering that I now realize was manifesting in my depression. It's a form of delusion to deny or ignore the truth of what's happening right now, no matter how simple that truth might be. And when I delude myself often enough, I start to feel depressed. It's cause and effect, and I see it so clearly now. But now that I understand the cause and how to stop causing it, I can recognize when I'm feeling depressed and bring myself out of it.
Nothing used to frustrate me more than people insinuating that I could fix my depression by just trying harder. And that's what "think yourself out of it" sounded like to me. My motivation was so zapped that that kind of advice just made me more despondent. So I want to make it clear that thinking your way out of depression is not a matter of trying harder. In fact once it clicks, it becomes easier...like riding a bicycle downhill. And that's a good metaphor, because if thinking your way out of it is riding a bicycle, how effective you are at it and how hard you have to work depend entirely on which direction you point, not how hard you pedal.
Learning to live with depression _is_ the super power that the parent comment mentioned. That's the ultimate solution you say anyone can come to, and in fact, that is exactly what OP has described; you just put it more blandly.
Being depressed is when you're in a bad mood because your favourite sports team has lost a match.
Depression is when you cannot think rationally because you're ill and your brain isn't working properly.
Really, there needs to be a better name for this. Calling it 'depression' makes it sound too trivial. It's not; it's an illness. Once you've got depression, you're screwed, because your mental processes aren't working properly. Your value system gets twisted and distorted so that you can't make rational choices any more. Even if you recognise the action you need to take you get out of it, you may not be able to take it --- because you have a fricking brain malfunction. It's got nothing to do with willpower or choice. It's an illness that takes your free will away.
I'm with the parent here; these non-psychiatrists sound like they're talking dangerous nonsense.
IMHO the main question is whether you take responsibility for your situation or not. Actually great responsibility comes with great power and not vice versa. Calling depression an illness you give up your responsibility and give up also your power over it.
On the other hand depression is an illness, obesity is an illness, homelessness is caused mainly by mental illness (we had this newly on HN), there were times where under average intelligence was considered as an illness. A brave new world of lack of responsibility...
No, not at all. You merely change the tactics you use for dealing with it.
Plainly put, if you've never experienced depression, you have no idea what it's like...even people who have experienced depression often have no idea what it's like for other sufferers. The normal downs that you've experienced have nothing in common with what a depressed person experiences. It's like someone who only sees in black and white trying to talk about colors by talking about shades of greys. Until you experience real color, you're only qualified to make second-hand observations.
I get where people are coming from when they want to call it an illness. I believe that rather than an attempt to offload responsibility, it's an attempt to clarify a very poorly chosen label for the condition. Depression, as a word, just feels too accessible to someone who hasn't been in it.
It is your life, it is up to you what you make out of it.
Unfortunately I can not build a 500 billion $ industry on this advice.
My suggested lack of first hand experience is irrelevant.
And on a topic like this, where first-person experience is a crucial part of the subject matter and third-person science is still inconclusive, of course your own (lack of?) experience is relevant.
A short story [1]:
George Dantzig was a graduate student at UC Berkeley. Near the beginning of a class for which Dantzig was late, professor Jerzy Neyman wrote two examples of famously unsolved statistics problems on the blackboard. When Dantzig arrived, he assumed that the two problems were a homework assignment and wrote them down. According to Dantzig, the problems "seemed to be a little harder than usual", but a few days later he handed in completed solutions for the two problems, still believing that they were an assignment that was overdue.
tl;dr: You can deal with hard problems if you think that dealing with them is your job and your own responsibility. Calling negative emotions "depression" and labelling as an illness means offloading responsibility and giving up the fight. You define yourself by the fights you pick and not by the pills you take.
> Calling negative emotions "depression"...
This is the core of your misunderstanding. This is not what depression is.
Blind people cannot see, because their eyes don't work.
People with depression cannot make correct decisions, because their brain doesn't work.
It's really that simple.
Except the terrifying thing about depression is that you don't have any power over it. It takes your ability to make decisions away. You can't take responsibility over it, because you can't take responsibility over anything --- it's just not physically possible.
> A brave new world of lack of responsibility...
Be very careful; you're extremely close to saying that if people have depression then it's their own fault.
The parent comment seems to be suggesting that people with depression need to take control of their own life by recognizing what makes them unhappy in order to overcome it. There is nothing harmful about that.
> The parent comment is suggesting that people with depression need to take control of their own life by recognizing what makes them unhappy in order to overcome it.
Your comment is suggesting that depression -- clinical depression, not, "boo hoo things are tough right now and I'm unhappy" -- is the depressed person's own fault and all they need to do is change everything in their life until they're happy.
It's really wrong.
When you learn to levitate by taking control of your own life and recognizing what makes you happy, then you will have something to teach people who suffer from depression. Until then, I beg that you do more reading on the subject, and I'm happy to offer some of the material that I've found most useful.
It's somewhat unfortunate that Allie Brosh's most famous work ended up being about her depression, but: http://hyperboleandahalf.blogspot.com/2011/10/adventures-in-... -- when she published this, people struggling with depression suddenly appeared out of nowhere and said, "YES, yes, this is it exactly!" It's a great and easy primer into the depressed mindset.
She wrote a part two: http://hyperboleandahalf.blogspot.com/2013/05/depression-par...
Then watch this video: https://www.youtube.com/watch?v=tDXCvtRxZ2E&list=UUK_QgiNMxV...
Depression may well be an inflammatory disease, which means that multiple people in this thread are arguing for people to just wish away inflammation: http://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7...
The stigma of depression -- which, unfortunately, is exacerbated by well-meaning but not well-informed people on the subject -- is one factor that prevents sufferers from seeking the help they need: http://www.psychologicalscience.org/news/releases/stigma-as-...
Stephen Fry, bless his heart, was at the beginning of the more recent efforts for sufferers to come forward, in spite of their fears about stigma, and discuss the disease: http://www.stephenfry.com/2013/06/only-the-lonely/
Hope this helps someone.
But when people confuse that with advice for depression, I rush to change their minds about that, because it is a form of pop psychology which is pervasive and adds to the challenges faced by people suffering with depression.
I appreciate the experiences shared here, while completely anecdotal they are all telling me the same story and they're directly relate-able.
Your point (I think?) is: those experiences are indigestible to someone who is currently suffering depression.
But to me, that in itself is an entirely different discussion...
I can't at this moment think of anything more polite to say to you.
Do you believe I can think my way into and out of a sprained calf, for instance? How about rheumatoid arthritis? IBD? Alzheimer's?
What medical training do you have to make claims like the ones made above? If none, what do you think you are contributing to the conversation?
I dunno, to me it reads as a (possibly) clumsily articulated suggestion to manage depression. Suggesting that one recognize and address the problem doesn't preclude the idea the problem is depression and addressing it to take control of one's life means seeking treatment. Maybe they're just speaking the generic advice and assuming the reader can put the pieces together.
Part of my own journey with depression was realizing that when I got agitated over posts that imply or even explicitly portray a "just cheer up and get over it" attitude towards depression, I was just doing it for the temporary rush of indignation. I wasn't helping anyone. Not the person I responded to, and certainly not passerby readers. Eventually I realized, the smart response wasn't to disagree, it was to make a friendly expansion on that post for any passerby readers who might not know. There's no reason to assume malice unless someone is openly asserting clinical depression is a lie and depressed people are just bummed out. And even in that case the best possibly outcome is still achieved with a friendly retort that still focuses the message on utility to the passerby readers.
What if the thing that makes them unhappy is their own brain?
There is absolutely no reason for me to be unhappy and generally I'm not, I just don't feel anything except for some anxiety. I have an amazing job, an extremely supportive family, a nice apartment, several close friends. Yet, there are some mornings I struggle to get out of bed. There's no external source in my life currently (or past really) that is causing this. I have been diagnosed with ADHD, Depression, and Anxiety, several of my other family members (brothers, mother, grandmother, etc.) have some or all those things too. It's a very real, biological, sometimes genetic thing. It's a very complicated beast. There's no just recognizing it and overcoming it. Yes, I recognize a lot of my symptoms are caused by my brain, but that doesn't do a lot for me to be able to just overcome it when I can't even find the motivation to brush my teeth. It takes help, and a long time retraining your mind to not just immediately assume you're a worthless piece of shit not worthy of anything.
It's beatable, but when you're in the state of mind of a depressed person, you're not going to see that immediately.
/rant
I've had depression my entire adult life, and have been in a very similar circumstance to you.
I've been trying to 'think my way out of it' for many years, but it was never achievable. Finally a few months ago I bit the bullet and went to see a Clinical Psychologist, who quickly recommended me to a Psychiatrist and have started medication. I've always been extremely skeptical of anti-depressants given the nature of them and all the talk surrounding them. However, The effects of this medication have literally changed my life in the span of about 4-6 weeks. It was definitely the missing link in what I needed to do 'fix' my brain (chemically) to get everything onto the right path.
Want to get out of bed in the morning? Sure thing, but good luck concentrating on anything when combining SSRIs with ADHD brain. Don't want to break out in a cold sweat at the prospect of being called on in a work meeting? No problemo, I hope you enjoy discovering the hidden depression sub-basement, and you thought you were already at the bottom of the pit.
Then there's all the crazy drug-drug interactions with CPY2D6 inhibiting anti-depressants and whatever else you might be on. I gets better if it's something like prozac or paroxetine, as both are simultaneously substrates and inhibitors of that enzyme (i.e. they inhibit their own metabolism so have non-linear DRCs... ah wacky fun).
But don't worry, you don't actually need drugs! All you need are positive thoughts filled with hopes and dreams, you filthy junkie.
/rant
On a more serious note, the only sustainable pharmacological treatments I can think of are:
- Dexamphetamine & beta-blockers (better chances if your anxiety is closer to a 'panic' disorder). This worked pretty well for me, until my local government health authority decided I couldn't be trusted with 'dangerous' drugs like dex. Far better to cast me back into the pit than to fuel our local ice epidemic, since clearly smoking meth is 'pretty much the same thing' as taking dex under medical supervision.
- Monotherapy with a non-reverse-able MAOI (e.g. Parnate, Nardil). Although good luck finding a psych willing to prescribe one, even if you can demonstrate you understand the interaction risks and know how to mitigate them.
Well, OK, then work on the brain. Take control by seeking treatment! Or doubling down on commitment to existing therapy.
"Have hope," you cry to the hopeless. You may as well tell the poor, "have money". Where do you expect them to find it?
How does one seek treatment if they cannot even get out of bed?