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I don’t think I was severely depressed at the time, and your note about “just do it” seems valid. I once called EAP (employee assistance program) to ask for help reading email. Their advice, which I now practice: break down the process into discrete steps, with self-care in between.

For example: 1. Acknowledge I want to open this email. 2. Turn away and breathe deeply for ten breaths. 3. Turn back and click. 4. Turn away and breathe, do push-ups, whatever your temporary escape is that Diane take you completely out of the process.

Cold showers help build the confidence to do things I will otherwise avoid for longer than is healthy. The act of stepping in and minimizing thought as I turn the handle means sometimes I’m already gasping before I have time to dither, and the suffocating blanket of fear has dissolved.

cold, and showers...both are anathema when I'm depressed

Small, cheap, habitual actions are what work. I Crawl Through It by A.S. King refined the advice from my mom to “just do something!” when I was depressed as a teenager. I could only imagine big, daunting things to do rather than the tiny steps that are more effective. Steps to build the habit of opting in to temporary cold might be one hand in a bowl of cold water every morning, then the face, then turning off the hot water before the cold water in the shower, etc. Breath-holding to increase carbon dioxide can be another helpful system shock, spurring a will to live. To get up in the morning when I’m feeling stuck I’ll start breathing quickly and deeply to increase the chances I can bypass the sinkhole of my thoughts and find myself sitting up.

[0] https://www.worldcat.org/title/i-crawl-through-it-a-novel/

[1] https://www.worldcat.org/title/breath/oclc/1249567607&refere...

As someone who has struggles with severe depression and anxiety, this is both true and false. Yes, there is never a point in my life where someone telling me to “just do it” would have helped. But simultaneously, everything said above about how doing something immediately helps lower the total amount of negative emotion is true. If I can muster the will to “just do it” from within, it does legitimately help with the anxiety in the long run. Especially as a self reinforcing loop where the more things I manage, the less I have to feel anxious about. Of course on the otber side, when I slip up and fail to manage tasks the anxiety makes it even harder to start clearing away that which is making me anxious.

There are times in my life where I have and haven’t actually managed this well. Medication is often necessary, sometimes therapy, sometimes admitting that it’s too much to people and taking a break to reset my responsibilities. But in the end it’s hard to say that anything other than “just do it” defines the way to make things happen.

The way it was explained to me was that you generally have two options: to be shackled to “maintenance” work (work can include just thinking/worrying) putting up with things as they are, or you can solve your problem once and forever.

I liked that framing, as it turned it from a vague “just do it” (which always seemed to carry the shameful connotation that you should have been smarter than to let it come to this) to a more motivating “solve it for good and be free”.

The thing that most people get wrong is the direction of causality and that when you're not depressed your mind fools you into thinking you have more free will than you really have. What allows you to say to yourself "I will solve it for good and be free" is because you're less depressed and it's allowing you to say that, believe it, and act on it. It is not the case where saying that to yourself and acting upon it is what relieved your depression. This is why the advice to "just do it" doesn't work. It's backward.

If you weren't depressed you could say, "I will solve it for good and be free" or you could do nothing and say, "this can wait for another day" or "I have better things to do right now" and they'd all be ok. There are definitely things you can do to make it worse and some things you can do to make it better but in general changing the symptoms, difficulty making decisions, anxiety, doesn't do anything because they don't effect the cause.

If you want to simulate depression a great way would be to become extremely sleep deprived. That kind of sleep deprivation where you don't actually feel tired exactly but just wiped out. Now you're sitting on your couch, exhausted, and your friend comes in and says, "snap out of it, let's go to a party." You don't really want to go. You're not going to be excited about it and just want to stay on that couch. You could force yourself to go but you're not going to have a good time. You can list all the reasons why you should have enjoyed the party but you just couldn't get into it and just wanted to go home. Forcing yourself to go to the party doesn't fix the problem even though you might have felt a little better than when you were on the couch.

> Good advice for the mildly or maybe even moderately depressed, but for severely depressed people telling them to "just do it" is much like telling them to "just get over it", like telling a person with an eating disorder just eat better, or telling an alcoholic not to drink.

At least wrt clinical depression-- there's a lecture by Robert Sapolsky where he makes the analogy to telling a diabetic to just will their body into producing more insulin.

I don't think any kind of advice will help a severely depressed person.

As a former severely depressed person myself, the top priority should be to hold onto life till you feel barely good enough to get professional help.

I think this is a slightly more nuanced response than "just do it". It goes to the core of the problem: that avoidance can easily become a habit. Avoiding building that habit (by doing tasks when you notice the slightest resistance) is good advice. But it might not necessarily be easy.

You are right, but I don't think that's only what this advice is saying though.

It's more suggesting the thing that makes your stomach sink, that thing you want to procrastinate most on is also the most important thing you can possibly do.

And if you pick only one thing to do each day, prioritizing your tasks in that order will be a good start. While the reverse, the piling up of these tasks can be detrimental.

I think the advice described here is distinctly different from "just do it".

What it's describing is an alternative prioritization scheme for tasks. Instead of ordinary ways to prioritize like "do what's urgent" or "do what's important", the advice is to forget all that and just do whatever is bothering you most subjectively, even if objectively there's seemingly no need to do whatever it is right now.

As an example, suppose there's some email you need to reply to within the next 2 months. From an objective standpoint, there's no need to take care of it immediately, and there are plausibly more important & urgent things to do. But now suppose that even thinking about this email gives you anxiety--then the advice is that replying to this email should be the top priority among everything in your life, because the barrier to handling it will only get worse the longer it sits there.

https://tlc.ku.edu/ "We were never designed for the sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden, frenetic pace of modern life. (Stephen Ilardi, PhD)"

From that link: "Across the industrialized modern world, clinical depression has reached epidemic proportions, despite a staggering increase in the use of antidepressant medication. In fact, depression is now the single leading cause of work-related disability for adults under 50. However, there is strong evidence that depression can be both prevented and treated through a set of straightforward changes in lifestyle. [like exercise, vitamin D, good sleep, social interaction, omega 3s and veggies, avoiding ruminant thinking, etc]"

"Deadly Psychiatry and Organised Denial" by Peter C. Gotzsche https://www.amazon.com/Deadly-Psychiatry-Organised-Denial-Go...

From that blurb: "DEADLY PSYCHIATRY AND ORGANISED DENIAL explains in evidence-based detail why the way we currently use psychiatric drugs does far more harm than good. Professor, Doctor of Medical Science, Peter C. Gøtzsche documents that psychiatric drugs kill more than half a million people every year among those aged 65 and above in the United States and Europe. This makes psychiatric drugs the third leading cause of death, after heart disease and cancer. Gøtzsche explains that we could reduce our current usage of psychotropic drugs by 98% and at the same time improve patients' mental and physical health and survival. It can be difficult, however, to come off the drugs, as many people become dependent on them. As the withdrawal symptoms can be severe, long-lasting and even dangerous, slow tapering is usually necessary. In his book, Gøtzsche debunks the many myths that leading psychiatrists - very often on drug industry payroll - have created and nurtured over decades in order to conceal the fact that biological psychiatry has generally been a failure. Biological psychiatry sees drugs as the "solution" for virtually all problems, in marked contrast to the patients' views. Most patients don't respond to the drugs they receive but, unfortunately, the psychiatrists' frustrations over the lack of progress often lead to more diagnoses, more drugs and higher doses, harming the patients further."

Other resources are in the health section here of a reading list I put together: https://github.com/pdfernhout/High-Performance-Organizations...

Good luck actually getting enough time for all this healthy living though. There is a reason a particular look is considered "hot" right now: it's a signal that the person is actually wealthy. The rest of us may be cash rich but are incredibly time poor.

Joe Cross' "Fat Sick and Nearly Dead 2" movie has some good points about how much a supportive community can make a difference in healthy eating. "Fat, Sick & Nearly Dead 2 - Official Trailer" https://www.youtube.com/watch?v=YSfQbigRlJY

Blue Zones is helping communities transform themselves into healthier places by adding sidewalks, parks, healthier menu choices, walking groups, and so on. https://www.bluezones.com/blue-zones-results-albert-lea-mn/ "When Blue Zones and Blue Zones Project began working with Albert Lea in 2009 to transform its policies, places, and people, the focus was on helping people move naturally, eat wisely, connect, and have the right outlook—all of which can lead to living longer, better. To make transformation a reality, city leaders and the Blue Zones Project identified key opportunities for impact and sought pledges from businesses and residents. ..."

Dr. Joel Fuhrman has created an online "Nutritarian" community providing some support (although it costs ~US$8 a month for the basic level). I've found it worthwhile enough to pay for over the past decade or so. https://www.drfuhrman.com/membership

So, there are at least some people out there trying to help in various ways.

Eating better does nor have to take endless time, but it does take some time. One general idea that works for some people is to cook a lot once a week and refrigerate or freeze stuff. But that is more problematical if you eat out a lot due to office work or travel.

Like anything, the more you do it, the better you get at it. For example, just recently I realized I could microwave a bowl of frozen blueberries for 30 seconds to have a nice quick healthy treat that is also brain-boosting. https://www.lifeextension.com/magazine/2017/11/blueberries-e...

Still, yes, it can be difficult. The more people who do this and push back against unhealthy food, the easier it gets though, as more healthy options become easier to buy everywhere and more doctors become aware of what is possible nutritionally like reversing heart disease and diabetes and reducing cancer risks from seeing patients have successes. An an analogy, this is sort of like the more people who bicycle in an area, the easier and safer bicycling gets as there is more support for bicycle paths, bike racks, and workplace bike rooms -- and also motorists are more aware of bicycles.

Eventually maybe there will be enough political support to stop so many US Americans being killed every year via tax subsidies to various unhealthy foods: "Why a Big Mac Costs Less Than a Salad [due to government subsidies]" https://economix.blogs.nytimes.com/2010/03/09/why-a-big-mac-...

Related: "‘We’re losing more people to the sweets than to the streets’: Why two black pastors are suing Coca-Cola" https://www.washingtonpost.com/news/wonk/wp/2017/07/13/were-... "William Lamar, the senior pastor at D.C.’s historic Metropolitan African Methodist Episcopal Church, is tired of presiding over funerals for parishioners who died of heart disease, diabetes and stroke. So on Thursday, he and another prominent African American pastor filed suit against Coca-Cola and the American Beverage Association, claiming soda manufacturers knowingly deceived customers about the health risks of sugar-sweetened beverages — at enormous cost to their communities."

I've heard that Michelle Obama originally wanted to have a campaign against unhealthy food when she became First Lady -- but there was too much political pushback, and so her effort got morphed into the more innocuous "Let's Move" with a name emphasizing exercise. One remnant of her original idea was the White House organic garden which came first. Must have been one heck of a "conversation"... (Sadly...) https://letsmove.obamawhitehouse.archives.gov/achievements "In 2009, First Lady Michelle Obama planted the White House Kitchen Garden on the South Lawn to initiate a national conversation around the health and wellbeing of our nation. That conversation led to Let's Move!, an initiative launched in 2010 dedicated to helping kids and families lead healthier lives."

Related: http://www.dunkthejunk.org/blog/michelle-obamas-lets-move-ca... "However, if we judge the Lets Move campaign on its stated mission to "solve the problem of obesity within a generation" then the campaign has been a tremendous failure. This failure is no surprise to the scientists and doctors who work in the field of childhood obesity. The science based key to reversing the obesity epidemic lies in decreasing exposure to added sugars. If you tell a child to exercise more BEFORE you get them off sugary drinks then they actually gain more weight. The science is simple….A 30 minute soccer practice is NOT enough exercise to burn off the gatorade the child brings to "rehydrate" with. Every week I see children in my office who are frustrated that their efforts to exercise have failed to solve their weight problem. These children and families feel hopeless. They have followed the instructions of our national leadership and continue to gain more weight. The first thing we do is to explain the TRUTH about beating childhood obesity…. LETS NOT DRINK SUGAR. We challenge the children to battle SODATRON, the evil SODA monster, who is ravaging our communities. They must NOT drink the poison of the enemy for one month ( no sugary drinks for one month) and then they return to our office. Inevitably, upon return, their weight has plateaued or even decreased. More important then the successful weight loss is that THESE CHILDREN FEEL EMPOWERED, their sense of hopelessness has disappeared." [Emphasis in the original.]

Refined starches are also part of the issue since the body converts them quickly to sugar. Basically, people need to eat more fiber (e.g. blueberries, carrots, watermelon, lettuce, cucumbers, squash, beans, whole-as-in-visible grains, sunflower seeds, walnuts, mushrooms, etc.) and avoid overly-concentrated high-caloric foods while escaping "The Pleasure Trap": https://web.archive.org/web/20150430050047/http://drfuhrman....

But politically, the message to stop drinking sugar water etc (let alone stop subsidizing such industries with tax dollars) was something Michelle Obama could not directly say politically even if apparently she wanted to from what I hear. One can argue after-the-fact about whether she (and her husband) did the most that was possible at the time given many other priorities. Hopefully the political situation will continue to improve in any case -- perhaps including from legal actions like the one mentioned above.

An interesting search for anyone who wants to go down the rabbit hole: "sugar vs cigarettes".

And another search to link it back to the original topic: "sugar and depression".

I kind of liked the framing.

Often times there really isn't much more to be said than just do the thing, but there are better ways of saying it, this, is one of them.