On Depression & Getting Help
robdelaney.tumblr.com
robdelaney.tumblr.com
Honestly, I think the disorder should be renamed. People associate being "depressed" with the same feeling that they get if they drop their iPod into a lake. They're sad.
General sadness is one of many of the ways that depression as a cognitive disorder can manifest itself. I can't tell you how many times I've talked to friends with real, serious, dangerous depression and heard that there are people who tell them that they just need to get over it and cheer up.
You can't cure cancer with ice cream, same goes for depression.
I do this. A great many of my friends and family do this too. I'm not sure why you find it so difficult to believe that there are people who do this.
It's basically impossible for people without depression to imagine what it's like to be physically incapable of eventually "cheering up" or "getting over it". This is often compounded by the fact that depression( along with asperger's )is the modern hypochondriac's condition of choice.
Combine inability to empathize with widespread attention whoring by people claiming to have depression when they don't, and it's quite easy to see why many people would react cynically or casually.
It's rather unfortunate for those who are genuinely stricken with mental illness, though.
I didn't say that it was, I said that it was very common (which should indicate that it isn't difficult for me to believe).
>It's basically impossible for people without depression to imagine what it's like to be physically incapable of eventually "cheering up" or "getting over it".
This. Right here, exactly what you just said is the problem with people understanding this disease. "Cheering up" has absolutely nothing to do with getting over depression. This would be like feeding somebody with mono lots of redbull so that they would have more energy and wouldn't be sick anymore.
>It's rather unfortunate for those who are genuinely stricken with mental illness, though.
Yes, it is, and just about everything you wrote only serves to perpetuate the general lack of understanding that most people have when it comes to cognitive disorders.
Some people resist medication because they're afraid it will make them not feel anything at all. While this can certainly be the case for some medications, there are enough of them that you can usually find one that doesn't dampen your emotions completely.
In my experience, antidepressants tend to put a 'floor' under your happiness; you don't fall down into the dark depths that are hard to escape from. You also don't become unhappy quite as easily; I found a big improvement in my ability to cope with external causes of stress and negativity.
Hypothyroidism can also affect mood.
Exercise can affect mood.
You need to speak with your doctor about all three (or more since we are all different), and you need to find out if you need medication to get you out of the rut.
I appreciate and support efforts to get people to continue to investigate their condition and to explore treatment options, but I bristle when it seems to stem from a kind of prejudice against psychology and psychiatry as it appears to here.
(As an aside: Hypomania is on the opposite end of the emotional disorder spectrum from depression. Mentioning it here is akin to telling someone complaining of constipation that they may want to speak with their doctor about diarrhea.)
Why? The majority, of the research used to approve the most popular psychiatric drugs is outright fraudulent. And it's not like this is some undocumented fringe claim, there are literally dozens of books about this; the maker of the lexapro, drug the author is advocating, has racked up over 300 million dollars in fines this year alone for ethics violations related to the science of the drug in question. If you don't have a prejudice against psychiatry then you need to read more books.
The actions of a given pharmaceutical company hardly invalidate the discipline as a whole.
Furthermore, a prejudice is never a good thing to have.
It's not just one pharmaceutical company, it's the entire industry. The pharmaceutical industry now tops not only the defense industry, but all other industries in the total amount of fraud payments for actions against the federal government under the False Claims Act.[1] And the psychiatric drugs are, drug for drug, by far the worst offenders. And even for the drugs that haven't racked up massive fines, their scientific support is somewhere between terrible and non-existent.
Robert Whitaker's blog is also really great, although you wouldn't necessarily have all the information you'd need to read it unless you've already read the book.
To even dispute the efficacy of some aspect of psychology requires the practice of psychology.
I grant that there are dangerous abuses and manipulations of the approvals process and public opinion, but it is also important to note that many psychotropics have a place in the treatment of dysfunction.
I applaud that you are trying to spread the word about those abuses, but I encourage you to measure what you say so as not to group the nostrums and charlatans with the valid medications and practitioners of which many do exist.
Furthermore, there is a long history of criticism of Psychology, none of which you addressed. Clinical Psychology has very little data in its favor, and while biology-based approaches have had some success in certain areas, they aren't the same field, and I'm not sure that validates Clinical Pyschology.
The canonical references for this general strand of argument are Feynman's 'Cargo Cult Science' and Paul Lutus' 'Is Psychology Science?'.
>Clinical Psychology has very little data in its favor.
This is borderline nonsense. Clinical psychology is the study of psychological pathology. It generates data, it doesn't require data in support of it.
>while biology-based approaches have had some success in certain areas, they aren't the same field, and I'm not sure that validates Clinical Pyschology.
They most certainly are in the same field. You clearly don't know what you're talking about on this point.
For the record, Lutus's essay, being fraught with half-truths and strawmen, is entirely unimpressive. If you are sincerely interested in understanding the value of psychology as a science, I suggest taking a closer look at its current state rather than a highly selective sampling of the most embarrassing examples that claim the title.
From an early age, my parents (both in the mental health field) recognized small symptoms of bipolar disorder in me -- periods of extreme energy and no sleep followed by lulls where I wouldn't want to do anything. However, they decided that the best course wasn't to do anything about it (or even tell me they had these concerns), as they figured it was just me being a kid. For what it's worth, I think they made the right choice.
I was 15 or so when I started seeing these symptoms for myself, and saw them becoming more extreme. I would spend weeks programming furiously on The Next Big Thing (TM), then fall into an equally low period, which usually lasted about twice as long as the high. Originally in these low periods I just had trouble focusing on anything, slept a lot, etc, but gradually I saw them change into something very different. I became suicidal, and the smallest thing would set me off. If I got into an argument with my parents, I would just think "is all this worth it?" and start spiraling downward. My girlfriend at the time is the only reason I made it through; she helped me realize that this wasn't normal, and that I really should do something about it.
At 16, I told my mom that I wanted to see Dr. D (a friend of the family, and probably the best psychiatrist in our small town). It came as no surprise to me to be diagnosed with bipolar I with rapid cycling; it wasn't uncommon to have extreme mood swings in between the longer periods, even happening several times a day at their worst.
He then started me on various drugs. I don't recall the order or combinations, but I was on -- at one point or another -- lithium, Lamictal, Abilify, carbamazepine, Depakote, and others I can't remember now. None of the standard mood stabilizers worked; I either felt completely numb or was sick as a dog. Lithium in particular made me feel worse than I ever have in my life, emotionally and physically. We tried a couple combinations to balance things out, but in the end the mood stabilizers just weren't helping; in retrospect, though, I wonder if they were and I just couldn't recognize it in myself. Regardless, the next step was anti-psychotics; I wanted to be put on anti-depressants, as the lows were what bothered me, but it was simply too risky -- if they were successful, they could well put me into mania that I couldn't control.
The anti-psychotics made me feel nothing. I don't know how I can explain this to someone who hasn't been there, but it's like your emotions just cease to exist. In theory, they worked, but a complete lack of emotions and creativity simply wasn't worth it. I was 17 by then, and I decided to stop taking all meds. I moved to San Diego for my first job shortly thereafter.
I rode on an extreme high for the first few months I was there, working 18+ hour days. I was a 17 year old making more money than he should've been, and I took advantage of it. Sex, drugs, and rock and roll really describes it well. I went to shows, I met a girl (whom I took a cab to every weekend, an hour and a half each way, then got engaged to a month after we started dating), drank a lot, etc. In short, I did everything that someone in the throws of mania would do. It took a while for this to catch up to me, but as always with bipolar, it did. I crashed hard, and if it weren't for my fiancee at the time, there's no way I could've made it through. I frequently thought about checking into a hospital, but I thought I needed to push through. I'm not sure if I made the right decision or not, still.
It took me a long time to really get myself in balance. The first step was to recognize what state I was in -- this is remarkably difficult. The next step was to learn how to bring myself back to normal when I started getting low, and I became quite good at it. Ignoring a few small fleeting thoughts, I haven't been suicidal in about 4 years. Then I learned how to embrace the manic side of it, and put it into my work without letting it go too far; I don't know that I ever really got very good at this, as my first two months in NYC have shown me lately.
A combination of a good support network (key for everyone, IMO, not just those suffering from mental illnesses), knowing myself, and knowing when to say "no" has been crucial in me largely stabilizing myself over the past few years. It's not perfect by any means, but it's working better for me than anything else has.
To close, I want to impress upon everyone the importance of getting help with mental illness. This doesn't necessarily mean medication (it certainly didn't in my case, even thought it was tried), but just knowing yourself is insanely important. Too many people refuse to get help, and end up in far worse place. I'm happy with my life as it stands, but it could easily have not gone this way.
The next step was to learn how to bring myself back to
normal when I started getting low, and I became quite
good at it.
Thanks for sharing.
Give yourself a thirst for knowledge. Read. Read. Read!
It's hard to do those things, of course. The essence of depression is hopelessness. For me, it's hopelessness about myself, a deep conviction of my own worthlessness and the impossibility of ever not being ashamed of myself. When you think that way, it's hard to see the point of making dinner or going for a run. Long term, the biggest factor for me was to slowly learn to disregard the reality of depression. By now I have a long enough perspective on my life and my depression that I am better at seeing it as a temporary illusion. I knew a girl who had persistent auditory hallucinations; she heard voices constantly, angels and demons mostly. She knew they weren't real. At least she said she knew, and she usually did, but when she didn't, it was a problem. Coping with depression is a bit like that -- a constant effort to disregard what your brain thinks it knows. So when I go out the door for a run, or start cooking dinner, a big and very persuasive part of my brain is convinced it's stupid and pointless, even while it's making me feel better. By the time I'm done running or cooking, I'm completely aware -- with my whole brain -- that it was worthwhile, and the fact that I've accomplished something worthwhile in itself discredits the illusion. That doesn't completely dispel the depression, not for long. Soon enough, the next activity I want to make myself do still feels stupid and pointless. But it makes it easier to cope, and it reduces the severity of the symptoms.
The older I get, the more consistently I manage to make myself do the things that make me feel better. When I was younger, depression was overwhelming and terrifying. Now it's mostly just miserable instead of scary. Especially now that I know I can hold down a job through a bout of depression, and my friends won't desert me, it's a lot less frightening.
I have been able to "self medicate" like you with exercise, diet, rigorous organizing and planning tools, and other ways of "ignoring" what my brain tells me to do. When I was younger, I was briefly on medication and did not like the side effects, and I have been lucky enough to be able to cope with the tools I have at my disposal. I do not believe this is possible for people with severe depression, and highly encourage them to seek professional help.
Personally, another thing that has helped me greatly is to preempt situations that have caused me to become depressed in the past. Because at least for me, it's incredibly hard to get past the hopelessness and despair without hitting rock bottom, and there's a lot of damage done before that happens. For me it's more economical to spend extra effort avoiding the depressive moments altogether than digging myself out of them.
So nowadays I just avoid things that trigger or resonate with those depressive emotions. So, I'll eschew watching movies that people describe as sad or depressing, no matter how good they might be. I don't fill my reading list with tragedies or existential dramas. I'm more picky in the type of music I listen to and purposely reduce the frequency with which I listen to melancholic songs.
I noticed talking about my negative emotions empowered them and gave them more substance. So now I only allow myself a limited number of instances to talk about my problems. Going to a therapist helped with this as it isolated those moments to a specific place, time and person. Thus reducing the desire to wallow in those negative thoughts with friends and acquaintances.
I've also removed people in my life who were extremely focused on their problems and misfortunes and replaced them with more active and happier people. Basically I've made an effort to befriend people that compliment my weaknesses (staying active and upbeat) instead of reinforcing them.
Being involved in periodic activities with others has also helped greatly. Like meeting with my old DnD group, despite being idle entertainment, was incredibly useful in getting me out of the house during weekends when I would be most tempted to stay in and be left alone with my thoughts.
The final thing was recognizing what situations, places and events are depressive triggers and avoid them like the plague. For example, I can't travel alone for extended periods: being isolated in a foreign country is an instant depressant. So now I always try to travel with friends or companions and that ends up being more enjoyable to boot.
Anyways, thanks to all who shared their experiences.
I had that when I first took Ritalin. It was spooky, I was completely clinical and hyper-rational. Mr. Spock, basically. And the most disturbing part? I stopped hearing music in my head. I usually have a soundtrack of some kind in my brain, and it just stopped.
Eventually this wore off, the music and emotions came back, but it's damn freaky.
If anyone thinks they may have a mental illness, do some research (e.g., learn what MOA means, what serotonin, dopamine, and norepinephrine do, etc.), pay attention to what does or doesn't work, and find a doctor who will listen to you and take your self-evaluation and observations into account.
Finding the right meds (or determining if meds are even suitable) will require some trial and error, and if you can work well with your doctor you can reduce the missteps.
This sounds wonderful to me. I'm always thinking to the beat of one song or another and sometimes it really bothers me, as if I'm wasting brain cycles.
Do you feel cycles are wasted when visualizing a problem? The music is just a different thinking language.
I'd like to mention that people should be very careful about seeking treatment with psychoactive drugs. They can often affect you in ways you don't immediately realize, and in some respects affect your personality or inhibitions. Be sure that you and your family are aware of potential side-effects before undergoing such treatments.
The thing that's always scared me away from meds is the worry that I'll have a similar experience, but knowing that withdrawal (particularly for SSRIs) can last for months and lead to symptoms that look like depression itself.
Brilliant pun, more so if it was unintended! :-)
Hmm, I suppose a sense of humour helps, too?
Just thought I'd mention it.
Now it's manageable without any various medications, doctors etc and that makes me feel pretty awesome.
P.S. The Beatles would always make me cry when I was on a low. Heh.
Peace and good luck.
I haven't found any serious consequence of taking the meds (Zoloft, Elavil and Remeron) w/r/t my creativity. I can still do the same things I used to do before, while mantaining the same level of quality. I've also found that it helps me push myself harder, which is pretty good.
I'm skeptical of this page and encourage others to be as well.
This data visualization suggests that saying that St. John's Wort isn't really snake oil.
I was expecting to find a folksy anecdote or some "hack," and I was pleasantly surprised.
Citation needed. Sorry, just because you have depression that doesn't give you a free pass to make stuff up.
Surely that's why several millionaires go up, go to excess, lose it all etc.
Thank you for this. This was one of the most important things I learned out of my (pretty) mild depression. Since then whenever I see people pretending to always be happy or at least striving to always be happy I sense that there's something wrong. That, and the thing that I began to understand what the Stoics were saying a little bit more (http://en.wikipedia.org/wiki/Stoicism)
Case in point, Love in the Time of Cholera. You want to get the girl but you are a victim of socioeconomic scarcity. You become a life-long melancholic but are motivated to climb the social/professional ladder to get what it is that you couldn't get in the first place. All great literature, music, scientific discoveries were of products of unrequited love, jealousy, or the urge to overcome a self-inferiority complex.
Beyond a basic level, this fails to be true.
>which in term induces human productivity/creativity.
Show me that depression leads to greater productivity. I expect that you cannot.
>climb the social/professional ladder to get what it is that you couldn't get in the first place.
This has nothing to do with depression and little to do with happiness.
>All great literature, music, scientific discoveries were of products of unrequited love, jealousy, or the urge to overcome a self-inferiority complex.
This is trite, wildly hyperbolic, and almost certainly baseless.
"Stars" are more likely to be hypomanic. Or just people who like writing or composing music too much :) People like to blame success on mental disease or drugs because it helps them justify their laziness. Also, attempt to claim that Jimi Hendrix or Kurt Kobain wrote their music because they had a self-inferiority complex might be caused by the self-inferiority complex and envy :P
I'd say that it's pretty funny that so many people took it upon themselves to explain how their life is so perfect and that any possible explaination for their depression could not lie in that their life sucks.
The reality is that most people's lives suck (including mine and yours) and that most people spend their lives covering up how their lives suck by buying more crap, settling & self-medication. As you said, if it didn't suck, human civilization would not progress.
People make a simple problem into a much more complicated one. If your life sucks, then fix it or accept it. The caveat is that you have to either man up to fix it or swallow your pride to accept it.
Edit: on second thought, don't. It probably won't help me overcome any of my personal rationalizations or bring me any closer to my goals. But I have a recommendation. Read Nassim Taleb's Bed of Procrustes.
You are speaking in vague generalities, with authority, on matters about which you are apparently ignorant. Moreover, your propagating this misinformation is detrimental to attitudes about depression, both for those who might be afflicted and the public as a whole.
Depression is a serious problem which should be addressed through science, credible education, and consultation with professionals.
The comment you are defending is utterly asinine. Persistent depression is far more likely to be the result of cognitive-behavioral factors and/or physiological factors rooted in genetics than it is to be the result of bad life circumstances aside from some negative extremes.
Furthermore, you grant that people are "unable to take responsibility for their emotional life" and yet somehow also support the patent contradiction to that idea in suggesting that "fix it or accept it" is acceptable advice.
Your final line (in addition to conflating freedom from depression with "being happy") belies a kind of moralistic thinking about mental health. Would you say that broken legs are essential to social stability? Or ulcers?
Warm regards.
One of the symptoms of depression is ahedonia, the inability to experience pleasure. It is a very strange experience.
One day I went outside and it was a beautiful sunny day, and I couldn't enjoy it. Not that I was so sad the sunny day didn't matter. It did nothing. It was like I was looking at it through a store window, but my world was overcast and gray.
One day I went to play at a pool with my newborn son. It was a beautiful day, he was laughing, kids were frolicking and playing. I felt nothing. Not the slightest reaction. As if they weren't there.
I have a beautiful life. No financial stress. My family is awesome. My job is awesome. I don't do anything reckless or self-destructive. I have lots of hopes for the near future. But many days, I didn't care if I lived or died, didn't care if I missed so much work I got fired, didn't care if I alienated my family, didn't care that I was cold even though there was a blanket within arm's reach.
Medication resulted in a nearly immediate improvement, and a slow return to normalcy. And it is definitely the medication. One day I missed my meds, and I went into a three day long tailspin during which I couldn't care enough about anything to make even small decisions like whether to have lunch or how to put my socks on.
It tells the story of John Kirwin, a legendary Rugby player here in New Zealand. He was supposed to be living the dream as one of the best and toughest Rugby players in the world, yet depression still got the better of him.
From the outside it's easy to tell someone to "harden up" but that does no good when the person is going through a personal hell.