Ask HN: Best resources to support a partner with depression? | Hacker News Reader

Ask HN: Best resources to support a partner with depression?

63 pointsantihero38 comments

Not sure if this is a perfect fit for HN but seeing as a lot of people here have some good insight into mental health from time to time, and a lot of people here have struggled. I have done a bunch of googling and I am at a loss to find resources that are more than just surface level. I have my own mental health issues but the depression I've struggled with in the past has always been something I've fixed by improving my life and prospects. So am at a loss as my poor partner is suffering terribly and has been for a while, and I don't think I've been a great help by just trying to fix things in our life and situation as it feels like I'm not really doing all that I can be.

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Since you didn't mentioned: please, seek professional help before you consider anything else here.

That's expensive, though.

Professional help is basically a form of entertainment for rich people.

It's like having a personal trainer, but for your psyche.

That's an incredibly unhelpful attitude.

More importantly, though, depression and anxiety can be symptoms of other ailments as well as side effects of medications (medications targeting non-mental health issues or targeting mental health issues). It's almost always worth going to a primary care provider to get a real diagnosis as it can short-circuit the recovery process if a physical cause can be identified (like thyroid conditions, side effects from birth control medications for women, and others). If these aren't factors, at least they've been ruled out.

> That's an incredibly unhelpful attitude.

Shrug. There is no way I'd be able to afford it, if I needed it.

The unhelpfulness isn't coming from me.

If you are lucky, your PCP will check for the physical causes of depression, such as the ones you have just described. Sadly, in my experience as a person with depression, most of the time they just hand you a free sample of an SSRI and call it a day.

I found out 15 years after first being seen for depression that one of my root causes was a B-12 deficiency. Nobody had ever thought to check for it.

I have a short essay about checking for some of the other physical root causes for depression here: https://radiosof.com/category/mental-health/

and here: https://appliedgrace.wordpress.com/2012/12/08/a-simple-menta...

I suspect that there's a hidden epidemic of subtle nutritional deficiencies. Everyone just accepts the situation but widespread screening would likely pay huge societal dividends.

Hard agree. Especially since modern farming methods create food with much less nutritional value than it used to have. But nobody gets rich off of magnesium supplements, so we don't check magnesium levels for anxiety (for example).

If you have a health problem, make sure to try to have a problem that has a lucrative treatment.

Definitely, even without screening, the first step should be a prescription for basic OTC nutrients for which people are often deficient and that are associated with depression, zinc, vitamin D etc...

Similarly, most of the time people leave the doctor with a prescription for paracetamol and an advice to monitor the symptoms and come back a short while after if the symptoms don't improve.

It's simply a low cost and efficient first step of the diagnostic.

It can definitely be expensive, depending on where you live.

For those that have access to affordable therapy, it can really help and ease a lot.

For those that do not have access to that – it’s definitely unfair and yes I guess those people by necessity will need to find other more affordable solutions.

I would definitely not call it entertainment though. Just like seeing a PT isn’t entertainment.

This is particularly important because it is easy to incorrectly self-diagnose. If you are having mental health concerns that are impacting your life, ask a professional to help identify what the problems really are - root cause vs. symptoms can be tricky if you are trying to figure it out on your own.

Mhm, and what's the success rate of treating depression with a therapist?

A professional is useful even if they have to refer you to someone who has to prescribe you a solution, even if it’s ketamine recommendation.

> 62% of adults show improvement after psychotherapy (66% in CBT)

and on the flipside,

> 53% of adults with untreated depression show improvement in 12 months

More statistics where that came from here:

"Treatment outcomes for depression: challenges and opportunities" https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...

I wish OPs partner a healthy recovery :) Depression is hard.

NB: Depression can be a symptom of another root cause. E.g. ADHD. Stuff like that can also be tricky to find out.

Right, someone I know closely had no success with depression meds, but finally a doctor had her go on anti-psychotics. And it has made a world a difference. Please seek help from a professional.

What's the success rate of treating depression without one?

You can’t fix it.

You can possibly help them recover.

But clinical depression is a clinical diagnosis that warrants clinical intervention by a trained clinician. Your role is supportive over the long period of treatment.

You can’t fix it because you are so close to the person suffering. Their state will make you angry, sad, etc. because of that.

And in the end, if the person is not treating their mental illness there is not a lot you can do about it. In that sense, it’s a bit contagious…not clinically of course…but in the sense that the mental health of the people around you can stress you.

Good luck.

Seconded. There are so many things that you can do to help...from helping to research / make appointments with therapists (it can be very tiring to try to find one with availability, and folks w/ depression don't have energy)...to helping them see their primary care provider...to being understanding and supportive.

That said, know that if, after many months / years of you attempting to help, if the partner does not get involved in any way in trying to get better, there can be an issue of enablement on your end. If you ever get to that point, read the archives for Captain Awkward, she has a lot to say on that subject.

Allie Brosh's book "Hyperbole and a Half" for the two chapters "Adventures in Depression" and "Depression Part Two." Excellent for both depressed people and their partners. In fact, for everyone. https://www.amazon.com/Hyperbole-Half-Unfortunate-Situations...

Also available free on her blog! (But definitely buy the book too, there’s a lot more).

http://hyperboleandahalf.blogspot.com/2011/10/adventures-in-...

This is not medical advice.

Your attitude is good, you care for your partner and are trying to help! You know you're not perfect, and honestly admit your own struggles. Therefore I feel like you'd be the best person to speak into their life, rather than some counsellor.

For me, music helps. Here's a playlist, if punk rock is their style.

https://www.youtube.com/playlist?list=PLfNF8TQij08rRJMIp0i5k...

Chocolate, words of encouragement ("you're not alone"), and opportunities to talk to total strangers (who will not gossip to friends) have all been helpful to me.

Personally I think the word "depression" is rather vague: does it mean feeling bad? feeling nothing? wanting to die? All of those are different in my opinion, but are often lumped all together as a "problem" to be solved.

Detachment from life can be freeing. I can say "I'll love you to death". The worst that the world can threaten is the death penalty, but I'm not afraid any more (V for Vendetta). This doesn't mean I feel bad! If my life is still useful for serving others (fixing computers, writing code, having the right adaptors) then it's better for us all that I stay here. But I have a greater hope for what's on the other side.

As some people said, the support of professional specialists is really foundamental. Be aware that with a psychologist you (in this case your partner, I am speaking at first person) need to empathize and this means that you should change specialist if you don't feel at ease or you don't feel suggestions good for you. Not every psychologist is for every one and also there are differents schools of psychology with different approaches, you have to found the good fit (my suggestion is cognitive behavioral school) As brudgers said you can't do the work for him/her, you can help for sure, but this can be difficult and being too protective is not a solution. At one point you should have faith in your partner being able to come out. But something has to trigger inside your partner... you can't do the job for him/her. Be aware of methods/techniques that claims to resolve it easily. Go with a psychologist, maybe you/your partner are smart enough to understand the cause of the problem, but you don't know right techniques and how to apply them properly.

In general Sport helps, there was a study by an Italian Neuropsychologist that showed how 30 minutes of aerobic sport was like a prozac (I'm simplifying, but the concept is this). Do things, action instead of thinking, this helps.

Your depression is situational, so a change in situation helps.

Your partner’s depression sounds clinical, and that's a huge construct, not so easy to grapple, so many variations.

Thus your best bet is to ask your partner what you can do to help.

I get severe depressions. Each episode is days of torture. The word sadness as a description for depression should be banished. Sadness barely charts. All I can do is wait it out. There's nothing anyone can do to help, short of ECT.

I have some advice based on experience with severe depression. Do what you can to get them out of the house, exercise and the outdoors can be wonderful shocks to a depressed system on the right day. Know that sometimes you will have to help them get through an episode by waiting. Some episodes just have to pass. Help them not feel guilty for them, treat it matter of fact. Remind them that you love them and you are there for them.

Pay attention to small signals of their mood, try to be aware of might be in the future. Sex also helps, although that one might be hard in the moment!

Some great comments here. Would highly second seeking out professional help.

Psychology Today lets you look at nearby professionals and you can filter by specialty and accepted insurance plans. https://www.psychologytoday.com/us

Talkspace is another good option is you're looking for a purely virtual experience but I personally like an independent therapist better.

Another thing you should keep in mind, when someone is suffering from chronic depression, situational changes may not be enough to help them get out of it. There are a variety of causes for depression like this but the root isn't normally something you can get at by making changes in day to day life.

While your partner likely recognizes you are trying to help, they might not want solutions and might appreciate validation of their struggles more. It sounds hard but just being there for someone in their dark moments is hugely impactful.

Make sure to take care of yourself during all of this too. Its a lot to take on but your partner will appreciate your efforts more than you know.

I was actually suggested this book by someone on Hackernews and it was awesome for me- did more than meds and is pretty easy to follow: The Depression Cure by dr. Stephen Ilardi https://www.amazon.com/Depression-Cure-6-Step-Program-withou...

I still go back and reread certain sections when I feel like I'm struggling.

Find nutritional support information at doctoryourself.com -- lots of good info here and it can make a big difference. One example: http://www.doctoryourself.com/depression.html

Also, Linus Pauling (the two time Nobel prize winner) has a book "How to Live Longer and Feel Better". Best of luck to you and your partner.

Not medical advice: Sometimes a powerful spiritual experience can help depression.

I’d say go to like some super old religious worship (I.e not evangelical American one), like an Orthodox Church one with the smells and bells or something. Maybe like a Muslim service, with lots of chants and what not.

Doing stuff like that after fasting would also make your mind be in a different place where it could have a big effect.

Though if that isn’t someone’s thing it might still be a spiritual experience, but it might be a fearful one?

Psilocybin maybe? Could also have a bad spiritual experience on that but I’ve heard many people say they have a good one. I wouldn’t consider doing that unless you were able to be safe and secure doing it.

I know there are material causes of depression, but it doesn’t change that it is a dark spiritual place. (Like if someone drew a painting of their soul while in that dark place, well it would probably be dark).

I don’t know what material changes happen when people go to a brighter spiritual place, nor always how to get there, but when people do get there; sure enough the material things will have changed (new neural pathways???)

Essentially when people are in that dark place, everything they see is dark. Their friend is getting married, and they wonder why am I not. A friend gets a raise, why didn’t I get a raise.

A good book to read I’d say is “Learned Optimism”

Meditation isn't a meme and has helped me a lot. There's different techniques that have different effects. When I do breath of fire followed by 3 root locks it feels like I'm resetting my mood and that has got me thru a lot of shit days. Hope this helps.

Meditation works. There's different techniques for different effects. When I do breath of fire followed by 2 root locks it feels like I've reset my mood. Have a look into the different approaches and experiment. It has seriously helped me. All the best.

I would start with your partner’s PCP. If they’d like a service in the US, Brightside has a good program and providers that can help guide your partner: https://www.brightside.com/

Often you will need the person to bottom out if they are stubborn. Your job is to control what that bottom is (not death, not financial ruin). Does he/she know that you can possibly leave? They are not valuing things properly anymore, so you have to jump start that.

I will speak out against professional help since I know many cases (anecdotal) where such help doesn’t work or reinforces the problem.

My own depression came out of entitlement. I didn’t know I could actually get sadder (which inevitably happened), and it bumped everything back into perspective. It’s a perception issue imho. You think this is as sad as you can get, well let me show you. Guide him/her through the shadow of the valley of death, and let them see the bottom.

Scared straight works.

A friend of mine had a partner who was depressed. He went to every professional under the sun and it only got worse. In the end she was sitting all day watching TV with him taking care of the entire household.

You know what worked? When he finally gave up.

He stopped catering to her, bringing her food. He started going out with friends and basically ignored her depression. She didn't eat for a day and implied suicide the next. He told her to deal with it, because he wasn't going to any more. Within a day she was up and about.

Sometimes depressed people need a serious reality check to bring them back. Enabling their depression doesn't seem to help long term.

Since seeing this I am also really wary of Professional therapists, after all, it's in their interest for the person to remain depressed.

Also have a look into amino acids. They're a far better alternative to SSRI's etc. Id recommend 5 htp and ashwaganda

Don't take SSRI's. They're the worst medicine, with horrific side effects. Worse than antipsychotics. I lost my ability to sit still because of SSRI's, now I must always pace due to this strange inner restlessness. Learn from my mistakes.

My wife is a psychiatrist.

There are several class of related drugs - SSRIs, SNRIs, and a few other classes.

Different people react differently to each category. If one type doesn't work for you, you may have significantly better results with a different type.

So agrees every psychiatrist (and seemingly ever psychiatrist‘s spouse). Finding patients who agree could be somewhat more challenging.

Are you a pharmaceutical sales rep? Wouldn't that be sweet. One spouse a shrink, another a shrink's drug dealer, both in collusion to grow “the business”. I see a Netflix series in the near future.

Your symptoms are / were your own but this advice is biased, unhelpful at best and harmful at worst.

For many people SSRIs, SNRIs and other mental health medications are a life changing and at times life saving tool. Advising people not to take prescribed medication is potentially very dangerous.

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