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I would argue it's understood poorly and discussed in an unhelpful way.

My own struggles have taught me that at least in some cases it seems to be more like a "mental obesity" than a "mental disease". It's not necessarily that there's something wrong with the person's brain, but that their depression/anxiety is a perfectly normal reaction to a lifestyle that's toxic.

If you never take the time to do the activities you really, truly enjoy (by this I mean the type of thing where afterwards you feel better and think to yourself "that was great; I'm so glad I took the time out of my day to do that" - not necessarily things that are hyper-engaging), don't eat vegetables and fruit every day, sleep poorly, live alone, don't make the time to socialise with others and are constantly surrounded by a hostile environment (cluttered, tripping over things, disgustingly/unpleasantly unclean sights and smells), then the depression is just a "healthy" response.

This is a bit of a chicken-or-egg problem. If you’re depressed, you don’t have the energy to do the beneficial things you’re recommending above. So I come back to the idea that you need to look inward, into the core causes of your depression, and make some sort of peace with them — freeing you to move forward. Therapy helps.

>If you’re depressed, you don’t have the energy to do the beneficial things you’re recommending above.

That's just not true. You can't do all of them, of course, but you can take one step at a time over the course of months/years. It's a positive feedback loop that really does help.

>If you’re depressed, you don’t have the energy to do the beneficial things you’re recommending above.

Again, I'm not sure this is true either (at least in the general case). For many people, there's no obvious cause for their depression, but they "just are". There's no peace that needs to be made or trauma that needs integrating, just learning to live life in a way that isn't toxic to your mind.

For me, therapy and mindfulness meditation were both beyond useless.

Learning to stop over-intellectualising everything and implementing strategies to make mundane, day-to-day life more pleasant and wholesome has done wonders.

This comment highlights just how different each person’s journey is.

> For many people, there's no obvious cause for their depression, but they "just are"

And for many people, their depression can be traced back to specific events or situations.

Mine: C-PTSD from a pretty screwed up childhood. Most people I know would never know, but I’m working to build an entirely new way to frame the world and my responses to it.

I appreciate that not everyone has the same background, but what I’ve learned through my journey is that there are more people with similar challenges than I ever realized. And in a way that’s the theme of this thread.

> You can't do all of them, of course, but you can take one step at a time over the course of months/years

The key here is the word years. At least for a period of time, one step at a time is mostly indistinguishable from “don’t have the energy to do the beneficial things”.

Yes, one can be making progress, but it often takes some time to see the results.

> Learning to stop over-intellectualising everything

And this characterization of the problem is exactly the kind of undercurrent that continues to stigmatize mental health issues, IMO. “Just stop over intellectualizing everything” is not going to help someone who’s currently “in it”. Certainly not going to help if someone is at the point of being suicidal.

> For me, therapy and mindfulness meditation were both beyond useless.”

And for me, therapy probably saved my life.

> and implementing strategies to make mundane, day-to-day life more pleasant

No offense, but this is “rest of the fucking owl” stuff. I’m pretty sure most people focused on improving their depression want this.

The answer is not just “implement strategies” any more than a novice painter’s journey to master is to “paint better”.

The process is often long, slow, and pretty difficult.

>And for many people, their depression can be traced back to specific events or situations.

It isn't an either-or situation. As you said, everyone has a different experience.

When I spoke to professionals or listened to others having the "mental health conversation" the focus was entirely on dealing with trauma or, if there was no trauma, taking antidepressants because clearly my brain was broken.

Being told to "draw the rest of the fucking owl" was one of the most eye-opening and empowering things I heard, precisely because the conversation focuses on people with experiences similar to yours.

I was told by society and doctors that I was a victim of my neurochemistry and that could never change. Turns out I was just bad at looking after myself as an adult. I am now less bad at it, and one day hope to even be good.

Fair - people definitely have different paths, and I don’t mean to suggest that therapy is a panacea. I will say however that not all therapy is focused on trauma; it can also address patterns of thought and behavior which are not conducive to your happiness. In short, I think good therapy is often about learning how to have deeper relationships with yourself and with others through being able to practice vulnerability in a safe, controlled environment. That’s helpful to people whether or not they’ve suffered deep trauma, as feeling connected to others is often the first step out of depression.

I agree “just doing stuff” can help to. But for many people, as others have pointed out, such advice is not immediately actionable. People can be made to do stuff, but if they hate doing those things then they’ll still be depressed.

> Mental health issues are hard for some people to understand if they haven’t experienced their own challenges.

Bingo. This is the root of the problem IMHO. We're really good at recognizing and empathizing with a gaping physical wound, but if we can't see it/touch it/feel it/etc it's hard to grok.

I think the biggest issue comes from thinking that since it's in the mind and not in the body, you can just cure it by yourself: be happy, not depressed! Which is obviously wrong and comes from ignorance.

As someone who has experienced a lot depression myself and with family, I think the chemical/body mechanism is grossly overstated.

It is a mind problem, but that makes it harder, not easier to address. The only real solution IS "happy, not depressed", but it is terribly difficult to do if you have poor tools and learned patterns.

Medicine can help break up patterns.

Right. The phrase "it's all in your head" takes on new connotations because hey, guess what, I live in my head 24/7. Yes it is in my head. It's inescapable. Medicine is tools and technology, and it's a wheelchair for the mind's broken legs.

Reminds me of this other comment I made on an old thread discussing this point in a way which hopefully others can relate to at-least a bit.

https://news.ycombinator.com/item?id=27909275

> Even though awareness has grown, those old stigmas and default behaviors remain just under the surface.

This is exactly right. Even in the last few years I feel more understanding about mental health struggles, and I strive to be supportive as well, but even I judge people who take time off for mental health reasons, and I hesitate to tell people about my own struggles.

Taboo/misunderstanding/hangups beget that hesitation, round it goes, sadly.

> it’s easy to downplay it or believe that the person struggling can change just by thinking hard enough.

The reason some of us downplay mental health issues is because we hear stats like "97% kids are ADHD" or "74% of university students are on Ritalin" or "108% of Americans are on anti-depressants and visiting psychiatrists"

"Mental health" (without further qualifications) is closer to herpes than to cancer.

> The reason some of us downplay mental health issues is because we hear stats like "97% kids are ADHD"

Quite frankly, this is a poor excuse. I don't draw sweeping conclusions about "physical health" issues because of cherry picked stats about extremely prevalent physical health issues.

"73% of adult Americans are overweight" doesn't make me downplay physical health across an entire spectrum of issues.

Another conclusion one might draw is "holy shit, this is a crisis!". And there is growing evidence to support this. Humans haven't evolved to deal with the realities of the current century. We're only just starting to understand the impact of modern technology and many other developments of the last decade.

If someone sees a crisis and concludes that this must be something to dismiss, that says more about that person than it does about the crisis.

> "Mental health" (without further qualifications) is closer to herpes than to cancer.

And yet, people still take herpes seriously. People don't just dismiss ailments that aren't cancer.

But there's a more fundamental issue with the entire line of thinking raised by this comment. A key point that many people miss is that mental health and physical health aren’t really two distinct categories at all. The two are deeply intertwined, and usually inseparable.

Who you go to see, or what actions you take when you start to have issues will change, but you also see a dermatologist for skin problems, a cardiologist for heart problems, etc.

I agree, “mental health issues” are much more similar to obesity than to cancer.

Societal reactions reflect that, both dismissive (“just exercise more”, “don’t be lazy”) and constructive (“we should find the cause - is it endocrine disruptors / social media?”)

> I agree, “mental health issues” are much more similar to obesity than to cancer.

Will you explain how/why you agree with that sentence?

To be clear, nothing in my comments concluded anything close to this. Your agreement is certainly not with me.

If I said “poverty is more similar to overspending than homelessness”, I’d expect someone to tell me this is a meaningless (and ridiculous) comparison, and rightly so.

Such conclusions are not useful, and don’t help anyone involved: not the person struggling, not the person trying to understand the struggle, not the people trying to fix it.

Will you help me understand the point you’re trying to make here? Because it’s unclear.

Depression and suicidal thoughts have a lot of public awareness and sympathy, at least in my country which has had public health campaigns about it. There are still many mental health problems that are stigmatized because they come with behaviors and feelings that are rightly stigamitized in normal people who have the power to not do them. Things like anxiety, anger, violence, inappropriate sexual feelings, and self-pity.