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Comment by Swizec | Hacker News Reader

Yup same here. Clinical depression in high school, meds, therapy, suicide watch the whole shebang. Fun times, can’t remember two years of my life.

So far the only thing that’s actually worked has been staying busy/productive/creative, good nutrition, exercise etc.

Everyone always tells me I’m an insensitive dick when i suggest getting off their ass and doing stuff to treat their depression. But fuck it, that shit works. Yes it’s hard to get started and your depression makes it even harder, but that is literally irrelevant, you gotta do it anyway.

And yes dear downvoters, I will never stop saying this: Changing your lifestyle to treat depression works. If enduring your downvotes helps me get the message to at least 1 person, worth it.

And to the common criticism that "Oh you just had teenage depression that doesn't count". The scars all over my body that I get to look at for the rest of my life disagree with your "just".

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Yes it’s insensitive the way you put it, but being in motion is crucial. Don’t aim to “change lifestyle”, instead focus on doing very small things. When I had chronic depression, making my bed was a big thing. If you trip over again, nevermind, do another small thing like washing the cup you’ve just drank from. Or getting out of bed. But whatever action it is, pretend that you’re a robot and focus your consciousness to the task. Nothing else, because you’re a robot.

It might take a long time to build up but the hardest part really is the first part. Hope this helps someone :)

I don't think suggesting lifestyle changes to treat depression makes you an insensitive dick, but I do think implying that it works for every depressed person does.

> Changing your lifestyle to treat depression works.

I did (and am still doing) all of those lifestyle changes and it didn't help me in the slightest. So much for that theory.

Not that people shouldn't try lifestyle changes but they are not the magic cure-all you're selling them as.

That’s awesome! Keep at it. It takes a few years.

And as other have pointed out, depression isn’t super curable, it’s more like going in remission. I liken it to addiction as well. Stop doing the things that keep it at bay? Boom there it is, comes right back.

Just like an addict makes an active decision every day to not do their thing, so too must I actively do things that keep the depression away.

No magic, just hard work,

Dude, screw you.

Seriously.

The biggest screw up we all make about mental health is the assumption that the thing that works for one person is the thing that works for another. I would have hoped that someone who has been through treatment would understand that, but here you are spouting the "get your life in order and it'll all be dandy, it worked for me!" crap that's so unhelpful in the first place to people with mental illness.

Everyone is different with this stuff. Everyone needs different treatment. You are not a mental health professional. Do not say shit like this and not expect to be called on it.

> "get your life in order and it'll all be dandy, it worked for me!"

No it won’t all be dandy. But it helps.

Or at least it’s what I’ve seen help the most people I know who are or have been depressed. At the end of the day, the main thing to do is to not give in to depression.

That thing wants you to sit on the couch and feel sorry for yourself. That’s like one of the main symptoms. Fighting that urge helps make it go away eventually.

I mean, shit, even the super-OP, Zach whose post we're commenting on, said that he had to keep taking meds and going to therapy for a few months before he saw results. Do you think doing it just once then saying "Fuck this shit, this doesn't work for me, therapy doesn't work. I tried it and it did nothing". Do you think that would've worked?

I think my other reply to you is relevant here, because your advice cannot be proven wrong. You’re replying to someone who tried what you said, saw no marginal improvements, and saying that means they have to keep trying the same thing regardless. If someone tries this for several years and it doesn’t help them, would you consider your theory thoroughly debunked?

> If someone tries this for several years and it doesn’t help them, would you consider your theory thoroughly debunked?

Yes.

Well then what do you say to the athletes in this thread who tried this for several years and felt no better? Have you been debunked? Does everyone have to spend 2 years of their life’s on your advice before they’re allowed to say “This doesn’t work for me”?

I can’t imagine you think that’s reasonable... I think it would be more helpful if people stopped throwing this sort of advice around like it’s useful to people

I’ve argued things like what you’re arguing before but really I was just afraid to think otherwise, could you be feeling the same way? I don’t think that’s a sustainable strategy though so here I am, arguing the other way. It was harder to think that way than this - less natural

> could you be feeling the same way?

Yeah you're probably right.

I guess what bothers me about the whole thing are the 2 or 3 years of my life I spent vehemently disagreeing with everyone who gave me This Advice and telling them that it doesn't work and they need to fuck right off. Then when I actually legit gave it a chance, it worked.

Maybe I just got lucky. Maybe the therapy worked more than I think and it's what enabled me to give This Advice a chance. I'll never know, it's not like I can A/B test.

I can relate, it worked for me too for a while. Still not really sure what I’m doing, but in a sense I’m back to where I was before I ever went doe that road... definitely might be totally wrong about things, I’m pretty afraid of that actually. This maybe won’t make sense to you but it basically forced me to lie about things, to pretend I didn’t understand people and I think that was cruel.

My perspective is that your approach here, talking about depression as an external influence that is not you - just an oppressive influence on you that must be fought off - was actively harmful for improving my mental state.

The day I stopped viewing myself as an ideality rather than reality, the day I realized everything I thought, felt, believed, and did was me and absolutely none of it wasn't, was the day I found an ability to change instead of deny.

Also, I'd say it is very easy to approach this with a defeatist attitude (consciously or unconsciously) if you have a belief that you are sick. Only time can fix a broken bone, so if your mind is broken, can you really change it - is it a futile effort to try?

Don't listen to a nut on the internet, though.

It sounds like you have really don't know deep depression can go. I can understand this attitude from someone who has never been there.

Your tips are a little insulting to someone truly suffering. There is a difference between feeling bummed out to feeling like you shouldn't be alive any longer.

> It takes a few years.

It's been a bit under three years already; no joy.

Your theory just plain doesn't hold water. Sure would be nice if it did, though.

And if you're doing all this and still depressed, there's no solution and you should kill yourself. That's how I read advice like yours when I was a college athlete. Fortunately, instead of walking in front of a bus I went to a doctor and got antidepressants, which helped tremendously.

Advice to seek professional help has exactly the same effect for people like me, for whom it makes things much worse. From my point of view it’s just the “safe” advice to give in public, because it has the argument from authority going for it.

People with major depression want to kill ourselves anyway. I don’t really see any style of tempered advice as being harmful in itself. What’s really harmful is socially pressuring anybody to stick to any approach they find to be harmful for themselves.

I 100% do not mean to point this at you in particular. I do not know your situation. But, in a general sense, a lot of the reason for the pressure is because these thing take time. There is no magic cure.

Going to a mental health professional requires time to see results. It also requires being with the right person. Medication won't instantly make you feel better (for longer than the short term), it requires the correct dosage, correct type, etc. The "working out, eating right, plenty of sleep" method may show results but it also takes a lot of time and persistence to see those results.

I am not saying that any of these solutions will work for everyone. I am just saying that any of these solutions takes trial and error. Some people go see a therapist once, don't make a connection, and declare that it doesn't work for them. It will take time. It is a process. Again, everyone is different and need to find what works for them, but whatever it is, they need to stick with it. I know it can be overbearing, but it comes from a place of compassion and concern. No one who cares about you wants to see you depressed. How would you prefer that they approach it?

In my case, time and patience could not have been the problem, except in the unprovable Russell's Teapot sense. And that is the problem. I'd prefer that people did not place unwarranted high confidence in the medical model, such that after seeing 20 therapist, and trying 20 medications that all made you sick or did nothing, people were still saying, "But maybe the next one will work."

> But fuck it, that shit works

for you -- you have no idea whether it'll work for anyone else.

Since depression is a potentially fatal illness, and you appear not to have any training in psychiatry, psychology, psychotherapy, medicine, pharmacology, you should maybe recognise your limits.

> Changing your lifestyle to treat depression works

Only for some people. you have no idea how many people it does work for, and you have no idea how many people it doesn't work for, so you might want to avoid judging people who don't take your advice.

The medical community calls what you're doing "terminal uniqueness" and I've noticed that this is very prevalent with people who suffer from depression: "Those therapies won't work on me, I am different, I need a special treatment".

Sleep, eat well, keep active. Nothing about that advice is dangerous. But it is hard to do if you aren't in the habit of doing it. (I know what you're going to say next, "but chemicals in the brain!" What do you think sleeping, healthy dieting, and keeping active are trying to fix?)

> Sleep, eat well, keep active. Nothing about that advice is dangerous

except if the response to "I tried, but it doesn't work for me" is "your depression makes it even harder, but that is literally irrelevant".

Your parent post didn't leave enough room for "try something else, but don't forget these once you're fit enough".

> except if the response to "I tried, but it doesn't work for me" is "your depression makes it even harder, but that is literally irrelevant"

In my experience dealing with depressed people, me included, there’s a huge spectrum in what “tried” means.

Doing it once won’t help much. Forcing yourself to consistently do it every day for 2 years? Now we’re talking.

If after 2 years of doing things that are known to up your spirits in at least some segment of the population every day you still don’t see absolutely any results, then you get to say it doesn’t work.

After all, you wouldn’t expect antidepressants to work unless you take them every day.

If you’re on meds and some days you feel like taking them and others you don’t, and you actually follow that schedule. Do you expect those meds to work?

It’s not the trying and it not working that doesn’t matter. It’s the not feeling like doing things that doesn’t matter. Gotta do it anyway. Whether it's exercise, taking meds, or going to therapy. If you don't do it, it can't help.

So did you try Rust for two years before deciding it didn’t help you? Your position on these things is across the board absurd

>if you’re on meds ...

Have you considered that the people in this thread saying it doesn’t work aren’t just saying “it’s hard”?

67% of college kids are suffering acute anxiety, is 67% of the college populations only problem a lack of excercise? Your insistence on these things is frustrating and obnoxious. The people who called you insensitive have very good cause, I hope that doesn’t make you proud.

Also, is discipline even a good thing? Do you think cave men said “well I have to hunt 5 hours a day...”? Probably not, or we wouldn’t have agriculture. Discipline seems like a substitute for ludditetism.

Also! Advice like this live and die by how hard they are to follow. If your advice is so hard to follow for te depressed that they won’t do it, it’s much harder to be proven wrong.

Sorry to rant but this advice is upsetting to me.

> Have you considered that the people in this thread saying it doesn’t work aren’t just saying “it’s hard”?

Yes I have.

My attitude is probably influenced by personal experience in dealing with depressed people. So far every time I’ve been observing someone long term, and they said “it doesn’t work”, they rarely kept at it for more than a month at a time here and there.

It is possible that everyone in this thread is different and kept at it for a long time consistently and it didn’t help.

And I never said “only exercise”, I said Do Things. Hang out with people, work on projects, make art, enjoy friends, go to a bar, see a movie, travel. Whatever as long as you’re not sitting on the couch giving in to your depression.

> this advice is upsetting to me

People I love sitting on the couch rotting from depression is upsetting to me.

Please stop this.

I have a genetic disorder. It was not properly diagnosed until I was nearly 36 years old. So, I spent the first 36 years of my life hearing that I was just lazy and not trying hard enough.

You being unable to fix someone else by brilliantly suggesting what worked for you is not definitive evidence that they simply aren't trying hard enough. That underlying attitude is monstrously arrogant and insulting to other people.

The world does not revolve around you. You being upset because someone else is "sitting on the couch rotting" does not give you the right to harangue people until they prove your pet theory correct that they just need to try harder.

Is there actual research that shows that the sleep/eat/exercise approach works by itself for everyone that is compliant? Most of the psychiatric community would absolutely agree that it helps, or couldn't hurt, but (anecdotally) I know athletes that control all of that stuff like a science because they have to in order to compete, but still suffer from depression, so I have trouble believing that's all there is to it.

> Is there actual research that shows that the sleep/eat/exercise approach works by itself for everyone that is compliant?

As far as I know, outside of crappy studies it's rare for a single intervention to even work for a majority of compliant patients/clients, let alone everyone. This is probably related to the notion of "depression" actually being multiple illnesses that share a common syndrome.

I wouldn't bring up chemicals in the brain, because that is a nonsense marketing term.

https://chriskresser.com/the-chemical-imbalance-myth/ http://www.brown.uk.com/diagnosis/france.pdf

You can't claim that sleeping, eating, and exercising are "fixing" chemicals in the bain any more than people can claim chemical imbalance causes mental illness. There is no baseline for what normal chemical levels are.

> The medical community calls what you're doing "terminal uniqueness"

No, the medical community calls it "evidence based medicine".

I've posted links to well run meta analysis by an organisation widely regarded as providing the gold standard for medical evidence.

other people are posting "it worked for me" - exactly what we hear from people who try crystal healing or homeopathy.

> Sleep, eat well, keep active. Nothing about that advice is dangerous.

Depression is a potentially fatal illness. If people are not getting evidence based treatment because they're following advice from people who don't know what they're talking about, those people may become more ill, and they may find it harder to seek help, and they may then die by suicide. suicide is a leading cause of death in men under 49, and in all people between ages 20-35 (in UK, and probably in us if they used same definition).

> (I know what you're going to say next, "but chemicals in the brain!"

A lazy assumption, I've never said "brain chemicals". I've always said "bio-psycho-social".

Thank you for writing that.

I was sleeping, exercising, eating well, just fine. My life was in order.

Starting to take an SSRI literally just switched off my mental illness.

A quick search on pubmed shows plenty of positive results.

https://www.ncbi.nlm.nih.gov/pubmed/21495519/

And a quick search of Cochrane shows that when you look at good quality research the benefits of exercise are hard to find.

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

> Exercise is moderately more effective than no therapy for reducing symptoms of depression.

[...]

> The reviewers also note that when only high-quality studies were included, the difference between exercise and no therapy is less conclusive.

[...]

> The evidence about whether exercise for depression improves quality of life is inconclusive.

Authors' conclusions:

Exercise is moderately more effective than a control intervention for reducing symptoms of depression, but analysis of methodologically robust trials only shows a smaller effect in favour of exercise. When compared to psychological or pharmacological therapies, exercise appears to be no more effective, though this conclusion is based on a few small trials.

And what do you say to people who have actually tried it and feel no better? Just try it more? And if that’s what you say, it seems you don’t hold this belief based on the fact that it works, but something unrelated entirely, and so I’d say it’s not useful to share it with me or anyone else.

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