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Comment by jancsika | Hacker News Reader

I mean, the person is depressed.

He'd probably do well to find a local group where he can regularly listen, sit with emotions, reflect, talk, and be challenged if he tries using his intellect to deflect from sitting with or reflecting upon said emotions.

In any case, I'm relieved to read that at least for the time being he has turned down HN's free access to a wall of zero-cost comments from pseudonymous engineers who voted up their favorite ways to problem-solve depression from first principles.

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Can we not armchair-diagnose people with mental illness, when we don't have anything more than a few blog posts to go on, and don't know much about them at all? And probably aren't qualified to make such a diagnosis anyway, even if we could sit in a room with them and talk to them for an hour about what's going on?

Nah I think we need more armchairing. In fact there should be a whole HN department around it, with salaried positions. :D

Maybe it’s just me but when I see a layperson say “this person is depressed” I don’t assume they’re armchair diagnosing clinical depression. Depressed mood is not great but it’s also not inherently disordered, it’s a normal part of the human experience and doesn’t mean someone has a mental health diagnosis.

Agree. It’s not the arm chair diagnosis that bothers me, it the “they just need too…” solutions that come after.

I completely agree that "what you need to do" sort of comments are less than helpful. Perhaps the GP was edited, but "He'd probably do well" reads as "I would suggest" which is actually meant well to me. The former presupposes what one needs and is unnecessarily authoritative (and I cannot help but assume an air of condescension from using the statement), while the second is simply the suggestion written as kindly as possible (again to me).

I'm glad they wrote it, because it has not been suggested to me that I need to "be challenged if [I] tr[y] using [my] intellect to deflect from sitting with or reflecting upon said emotions". I very much identify with this statement owing to a life of using intellect as a coping mechanism for emotions that I have been told I'm not supposed to feel. I also have work to do.

Edit: typos

To what limit are laymen required to ignore manifest reality?

If someone writes that he is sneezing, has a sore throat, runny nose etc., are we allowed to infer that he has a cold?

We are not, because he could also have had contact with particularly hot sauce, or an allergy, or an influenza infection, or covid, or early stages of worse things. There is a reason why we train medical doctors for years before they start diagnosing people.

> There is a reason why we train medical doctors for years before they start diagnosing people.

That reason is partly so that they can be recognized as doctors. Making an observational deduction has nothing to do with medicine nor imitating a doctor, per se.

Yet, people can and will use heuristics as GP does to make such inferences all the time. I don’t think we can help it. Whether that’s a problem depends on what one does with such an inference.

In the case of a suspected cold, it’s perfectly reasonable to keep one’s distance to try to avoid catching it, whether the supposition is correct or not.

Suspected depression? Harder to say, but at minimum I hope that appraisal engenders understanding and compassion. I think gently suggesting someone seek professional help is reasonable. I also think we have a tendency to overly pathologize perfectly normal mental states, however, and especially if (as the OP states) a person appraises themselves to be OK, then suggestion should not become insistence.

> There is a reason why we train medical doctors for years before they start diagnosing people.

This is not support for your previous sentence. A large portion of doctors' training consists of making sure they will treat someone with a runny nose for a cold before they'll even consider other explanations.

And when someone drops a brick, and it falls to the floor, unless you're a physicist, you shouldn't infer it fell because of gravity. It could be that the video was taken in a room in space, and it feel because the space-ship is accelerating, or due to centrifugal forces from artificial gravity, or the brick has metal components, and there's a magnet under it.

To say that you need a clinician to diagnose depression, is like saying you need an MRI machine to detect pain.

I'm not saying the person we're talking about is depressed (or that he's not), I'm just commenting on what you said.

> person is depressed

I did not get this feeling. Sometimes a bit of isolation and retrospection is enough to realize what your real priorities are. Things can be deprioritized without acknowledging a superior priority, and that's okay. As we go through life, we change, people change, our surroundings change, and sometimes all of the external things change for the worst around the same time and that's just how life goes.

Noting these deficiencies doesn't outright indicate someone is depressed and could indicate progress. Most people with any amount of deep introspection explore these possibilities, and I think that's healthy rather than living in fear of having to process uncomfortable truths. Sometimes we dig deep enough to find those truths werent as true as we thought they were, and that's progress.

Everything in his original post discussing his withdrawal, his inability to engage in society, screams clinical depression.

Or at least, it quacks an awful lot like a duck with depression.

I don't think it screams clinical depression. I live in a rural area and empathize how someone could get to feeling this way. It can be tough to have so few people to talk to face-to-face on a peer level about the things that you're passionate about most, not because they don't want to talk about it, but because they mentally can't grok the subject matter to offer any consolation. You become your own best friend, your own therapist, your own support network. It's easy to socially discard people when you are precluded from forming those connections, they're just acquaintances, like the domino crew at the barber shop. I'm not saying it's right, but it doesn't also mean they're depressed or doesn't 'scream it' as you put it.

I feel like that's not the case

Just skimming to two parts in the second to last paragraph, these two sentences, "I am often desperately looking inward to find the strength to go on", and "Accepting a constant stream of low quality things for most of my life, including interactions with other people, only contributed to the way my life has gone and the way I feel now" were really striking to the author's day-to-day. It sounds like he' struggling to doing what he needs to do and they're content with the way this is. We should want more for ourselves and for our relationships to have meaning.

It's also possible to have a problem, and then that problem makes you depressed on top. But the depression is a symptom and focusing on it can come off as "everything is fine, there's just something wrong with your brain."

There are some difficult life transitions (real-world problems that are never going to go away) that can cause long-term feelings of grief that overlap clinically with depression. Maybe you need to take the time to process those feelings. Or maybe you don't have that luxury, you have bills to pay, so you're going to medicate those feelings away.

(Or maybe everything is fine, and there's just something wrong with your brain. But that's not for Internet randos to decide.)

There are more mental illnesses / patterns etc. beyond clinical depression, but it's just the most prominent in people's minds. Here's an example: https://www.mayoclinic.org/diseases-conditions/schizoid-pers... (note: I am not even speculating this is at all a diagnosis, merely pointing out that the symptoms you list are not exclusive to clinical depression). Of course, you can also have any combination.

I wish people would stop pathologizing a proper response to a fcked up situation.

Sceptics would say the DSM is excellent at doing that, so it's perhaps not a surprise when people jump to pathologies.

As someone without any diagnostic training, I would also think that someone that is in a depression (A) could write a blogpost like that (B). That is, I can imagine that A ==> B is true. However, even if that were actually so in the real world, that does not mean its converse (B ==> A) is true as well.

So even in the optimistic case where, lack of diagnostic training notwithstanding, A ==> B, even then observing B does not necessarily imply A.

Which probably is part of the reason you shouldn't diagnose people over the Internet based on their posts, but via a diagnostic process actively involving them.

> As someone without any diagnostic training, I would also think that someone that is in a depression (A) could write a blogpost like that (B). That is, I can imagine that A ==> B is true.

What you have stated in words is rather more like, in the modal+temporal logic sense, "it is possible that A and then B" (temporal 'then'), not "if A, then B" (logical 'then'), which is how I read A ==> B--unless you meant, as I think you didn't, everyone experiencing A will do B.

You have a point, though I would see it as an exists operator (\exists_A A\implies B) than a modal operator. But that might be because it's been a while since I used modal logic :)

You are making the assumption that something is wrong with him. What if there is something wrong with society and he is just early to see it and be affected?

This is what capitalism odes, it always puts the burden on the individual. No, there is nothing every wrong with how we structure our society, never.

I am sure you could name some groups you would not find it pleasing to engage with...

Wait what? Like half of the ish we talk about on HN is what’s wrong with society, and we often look for the structural reasons behind society’s ills.. Including direct shots at capitalism.. And this is just one of a zillion online communities for folks of different stripes..

For sure I can imagine someone getting to a place where they feel gaslit by dysfunctional society, many must be in this boat all the time, the world is a challenging place. Should we not offer them a friendly hand, if they’re open to it?

Yes it is more than depression alone. Although depression may be one component. It is also disenchantment and disconnect. Even a mild existential crisis maybe. And advice from people online is rarely helpful. He could try personal therapy or perhaps simply just live with it. We're all built in different ways, and we don't have to always react the same way to the world. In fact we can't... it is a pity that the world , like a complex program, is optimised for the happy path, and if you deviate, it starts to complain.

> the person is depressed

I often wonder if modern society is truly happier than past societies, but then wonder if I’m only thinking that because I’m depressed, and most people probably don’t wonder such things?

Life is certainly more complex than it has been in the past, and I don’t know if we’ve adapted to really handle it yet. It seems unlikely.

Of course there are many objective metrics that suggest we should be happier (life expectancy, infant mortality, etc) but maybe we’ve just moved the goal posts?

Are these kinds of thoughts limited to depressed people?

Those thoughts do not sound like depressed thoughts to me.

People in richer nations report to be happier and a higher life satisfaction than people from poorer nations. Most countries now have higher self reported life satisfaction and happiness than in the past.

Rates of mental health disorders haven't changed much during the last 30 years.

https://ourworldindata.org/grapher/gdp-vs-happiness

https://ourworldindata.org/happiness-and-life-satisfaction

https://ourworldindata.org/global-mental-health

As one of those who commented on the first article [1], I would still like to figure out how his problem could be solved from first principles if it isn't interpreted as depression.

>My ideas, my attitude, my life story, the difficulties I currently have in functioning- all of these things make me too different to fit in anywhere for more than a singular moment.

How could a social network be built to find the few people who think alike when that group doesn't have well-established labels?

[1] https://news.ycombinator.com/item?id=31859072

> As one of those who commented on the first article [1], I would still like to figure out how his problem could be solved from first principles if it isn't interpreted as depression.

I think your parent's point wasn't "these are the wrong first principles to bring to the attempt to solve their problem", but rather "no-one who's only read this post is in a position meaningfully to try to solve their problem" (setting aside whether that's even the right goal).

I agree with my parent that it's difficult to solve depression from first principles. However, I think that there is the possibility that OP is not depressed and just seeks like-minded company that is difficult to find. In that case, HN should have the knowledge to discuss a technical solution.

I am someone who feels a lot like him, and what you describe would be depressing beyond belief. I'm also not all that depressed. Some of us are able to be relatively content while always holding rational beliefs about how horrible many things are. I often think that the depressed are the rational ones, while those of us who function are broken in a useful way.

> In any case, I'm relieved to read that at least for the time being he has turned down HN's free access to a wall of zero-cost comments from pseudonymous engineers who voted up their favorite ways to problem-solve depression from first principles.

Such as offering the "clinical" diagnosis that he is depressed?

What's your problem? Are you some kind of oracle that knows down to the minutae of everything about everyone's life that you know what you said to be true?

How are you this confident? Who convinced you that you're right in any sense of the word?

Seems like you're projecting extremely hard. He is not you.

Maybe there's a hint of self-reflection here.

the blog post meets some of the diagnostic criteria for depression, and while I would never jump to the conclusion and say it definitively, it’s something the writer should seriously consider and rule out

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