Researchers treat depression by reversing brain signals traveling the wrong way
med.stanford.edu
med.stanford.edu
He's had something like 7 sessions, each lasting maybe 15 minutes. The results are nothing short of astounding for our family. He's typically been... Extremely difficult to parent. After his LENS, lasting about a week, he is a pretty happy kid who participates in family and social life. His anxiety previously prevented him from engaging with friends for more than an hour. Just the other day, he was out at a birthday party for eight hours and still cheerful afterward.
I'm very hopeful that there is a long term, lasting effect for this kind of thing.
How many sessions did your son require and how long are the results expected to last?
Results were pretty much immediate, though. After his first session (maybe only a few hours later), he self-reported improvements and we noticed a definite change in his mood and attitude.
Doing a quick search, I found the following: https://www.enrichingfamiliesnow.com/lens-neurofeedback-1
However, are there better links?
As a child raised by a depressed and emotionally unstable parent, I have to disagree. Being well-adjusted is a good predictor for being a good parent. Even if in some cases people with mental health issues have a positive transformative experience, it's at best a dice role to treat it as therapy, and early childhood trauma is the collateral.
Keyword here is “some.” One instance that does not fall in this category doesnt suggest there arent some cases that do fall in this category.
A person does not fight cancer. A person is lucky if the cancer treatments are effective and they survive. Modern day cancer treatments increase the luck of survival.
Some depression is self induced. Always and continually focusing on the negative of thee past. Seems like top post might of had this type. Time need to support the child replaced the time to keep playing back those scenarios in their head with the continue down the road of depression. Tied with changes to their environment.
All behind me now that they've mostly grown up.
From neuroscience, there's the default mode network.
https://en.wikipedia.org/wiki/Default_mode_network
> It is best known for being active when a person is not focused on the outside world and the brain is at wakeful rest, such as during daydreaming and mind-wandering.
Apparently, activation of the DMN is correlated to rumination, itself correlated to depression.
https://pubmed.ncbi.nlm.nih.gov/31655111/
Interestingly, one thing often suggested to counter depression these days – meditation – generally says right on the tin that you're supposed to get into a wakeful rest state, but specifically try to avoid daydreaming and mind-wandering.
(I should say that I'm no expert. Just passing along things that I've heard/read.)
Edit: formatting
[1] "The human brain is intrinsically organized into dynamic, anticorrelated functional networks", https://www.pnas.org/doi/abs/10.1073/pnas.0504136102
[2] "The Brain's Default Mode Network", https://www.annualreviews.org/doi/10.1146/annurev-neuro-0710... {search for 'task-positive'}
[3] "Neural antagonistic mechanism between default-mode and task-positive networks", https://www.sciencedirect.com/science/article/pii/S092523122...
[4] "Mantra Meditation Suppression of Default Mode Beyond an Active Task: a Pilot Study", https://link.springer.com/article/10.1007/s41465-017-0028-1
[5] "Modulatory interactions between the default mode network and task positive networks in resting-state", https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017816/
“Idle hands are the devils workshop”.
That also matches how treatment for depression often involves throwing spaghetti at the wall and see what method and treatment sticks. Even medication usually goes through trying different chemistries a month or two at a time and see what has any effect.
I've had friends who went out of depression by quitting their soul crushing jobs to start solo businesses. I expected they would slack a bit more and be more relaxed as self employed, but from the sidelines they looked way more busy, working way harder and longer than before. Except it seemed to work for them and they're still doing i years later.
Your story kind of resonates the same to me, and I assume the family building part can be proxied by different goals, stuff that actually matter and bring sense to what someone is doing in life and/pr a different human environment. It might not work for everyone, but I agree there must be a sizeable portion of "depressed" people who's cure are not more medication or less work, but radical changes in other aspects of their life.
There's lots of evidence that doing the opposite of rest - aerobically exercising - helps tremendously with depression (and lots of other issues).
It usually comes with medical followup and regular checkups, and the general advice I heard was to take peaceful walks, or simply going outside, and cut ties from the environment where the issue rose from for a while.
Isn't this the case with "colds" too? At least in practice.
Maybe it's my bad luck, or location-specific (Poland, EU) - but ever since I became a parent (and saw myself visiting doctors 10x as often as before), I've started to notice that, unless it's one of few very specific diseases, you just can't seem to get any diagnosis for a "cold" from a doctor. They'll prescribe you/your kid some meds or treatments, but nowhere in the conversation they say "you have ${specific illness}". No such information seems to show in medical documents either. If I ask, they always manage to deflect the question without even acknowledging it (I haven't tried to insist yet, I don't want to be rude to someone who's nice and helping me).
Is this because they genuinely don't know anything beyond "one of many pathogens that cause this group of symptoms", but it doesn't matter because they all respond to the same treatment options (or don't respond to anything, and you're just treating symptoms)? Or is there a practice of not giving such information to patients?
Negative thought loops, aka rumination, are strongly implicated in many kinds of depression. If you no longer have time to indulge in ruminating, that's one way to break such loops.
It seems to me the best way to fight depression, is to contimually distract yourself (particularly with an activity you can control), from whatever is depressing you. As if, by being busy, so much, that you end up forgetting about those depressing things. I know it's easier said than done, but to me, it seems to work if you're able, whereas focusing or dwelling on the depressing things, seems to further depression.
But other people who suffer from serious depression do so in ways that can be connected to their life circumstances and the framework of meaning they build for themselves around it.
I think one of the biggest disservices we do to people suffering from depression is lumping those two categories together.
It's like we have a single diagnosis for "bleeding" and very rarely distinguish stab wounds from hemophilia.
The theory you're describing is "depressive realism". It's hotly contested. In some ways, depressed people can make more accurate assessments, as most people have an optimism bias, but their assessments get unrealistically over-pessimistic as time passes.
Given the general tech-dystopian living conditions and % distribution of non-free software throughout the population: depression would be near universal if this was truly the case.
So trying to figure out whether depression is reasonable is usually a trap, and will not improve the person's life. The thing to do is to manage the feelings, treat the depression, and revisit those topics once the depression lifts.
I suspect those downvotes are due to people recognizing that it implies depression is sometimes within the control of someone afflicted by it and conflating that with blaming the person afflicted by it. People seem offended by critiques of modern ideas that rationalize away an individual's control, agency, and especially culpability for their behavior or outcomes. Sometimes these rationalizations are fair, other times not.
People who are sick either continue to be sick, get well, or die. No matter what diagnosis or treatment you give to someone, they either get better, don't get better, or are removed from the conversation. We never hear from the dead again, the people who get better insist that you saved their lives, and the people who don't get better will be attacked by the people who did for not believing or trusting you enough.
But I think mental illnesses challenge our very old notions of free will, willpower and control. How much are you really in control when the mental structure for motivation in the brain is broken? Personally, it's not like I pulled myself out of depression. I just took advantage of a "break" my brain gave me.
It does? As someone who has decided not to have children, I feel very much like I’m the outcast. Particularly in the southern US. Also, here on HN where there are a shocking number of parents compared to say, Reddit.
Something like 85% of people over 40 have children - it's literally what the vast majority of people do.
That being said human connection and even animal connection are key ways to help improve and remove depression.
This is 1000% what depression feels like, once you've properly come to terms with it. Your brain seems absolutely compelled to apply the most horrific, negative interpretation to everything that happens to you.
Even when you understand it's wrong, or at least heavily negatively biased, fighting those interpretations feels like trying to swim upstream in a terrific current.
The most valuable thing I've gotten from the past several years of therapy is a better model for how humans actually process information. The simple model a lot of people have is:
1. Receive some stimulus, input, or experience.
2. Process and understand it.
3. Respond to that emotionally.
What we actually do is more like:
1. Receive some stimulus, input, or experience.
2. This data is way too ambiguous to make sense of on its own. So to turn it into coherent information, interpret it through the lens of a narrative about who we are and how we expect the world to work. This happens automatically and unconsciously.
3. React to that interpretation emotionally.
4. Watch logical rational brain then scramble around trying to come up with a coherent story that explains why we started feeling a certain way. The answer it comes up with may or may not agree with the unsconscious process that happened in step 2.
So much of therapy is "Why does X make me feel Y?" How do I fix X? The answer is almost always that X doesn't make you feel Y. X in the context of belief Z you have about yourself leads do you feeling Y. You fix Z by questioning the often toxic beliefs you hold about yourself. But it can take a lot of work and therapy to even be able to see Z, much less root it out and install a better narrative.
I think step 4 is where people really get caught in a feedback loop. You come up with a reason why you should feel bad, and then you do (step 3) and before you know it you're back at step 4.
One approach is to try and cut it off at step 2 like you mention, but I've found this to be a never-ending rabbit hole because installing a better narrative requires constant work.
While of course it's not bad to work toward a better narrative of yourself, I've also had great success with meditation and humility targeting step 4. My friends with anxiety and depression all (somewhat paradoxically) are extremely confident when it comes to the rational side of their thoughts. They think they've got it figured out and it's just their emotions or other people that are the problem. I train myself in meditation (don't rationalize at all) and humility (recognize that my rationalizations are never going to be accurate).
Yes. And because our brains are naturally recursive and meta-cognitive, it's so easy to fall into the trap of painting that work itself with the same toxic self narrative: "Ugh, I better keep working on improving my psychology because mine is so screwed up and I'm such a mess."
Short-circuiting that spiral can be really hard.
On good days, I try to just observe myself interpreting things through an unfortunate lens, acknowledge that doing that is part of who I am, and try to accept that as part of being me but that I am still a worthy person even so.
So when I'm speaking the words just come out. I've got a vague sense of where I'm going and the point I'm about to make, but it's certainly not verbal at that stage. My wife has afantasia, which is not a condition or anything as such, it just means she has no inner monologue and hears no inner voice when e.g. reading a book. Conversely one of my daughters says she is consciously aware of what she is about to say in words several seconds in advance even while speaking rapidly. My mother is an amateur artist and says she has crystal clear visual imagination and photographic memory.
There seems to be a significant variation in how our conscious and cognitive processes work between individuals, including some having varying levels of access to cognitive mechanisms that in others are completely subconscious.
That's just one example of very significant differences between individuals in one family, even in direct lines of descent, so this doesn't seem to be entirely genetic. It leads me to suspect that there may we be similarly very significant variations in how all sorts of other cognitive functions operate between individuals.
I'm sure there's an overall architecture to our brains and neurological machinery. Various brain areas are clearly specialised into particular cognitive functions, but it may well be that, within those areas, how our brains get to implement those functions might have quite a bit of variation.
This is true, but it's also a feature, and not a bug. Conscious processing is extremely slow and resource intensive. Our subsconscious processing has millions of years of evolution behind it to generate good enough solutions to many problems much faster and burning fewer calories than doing the mental processing consciously and deliberately.
It's like running an emulator versus running code natively on the CPU. The latter will always beat the former.
https://iveronicawalsh.files.wordpress.com/2012/06/cbtafg_ab...
To retrain your brain on how to appropriately react to things.
My personal belief is that SOME cases of your Z are caused by a 'learned helplessness' situational conditioning filter. The world isn't always fair and sometimes even earnest effort that in an ideal world should yield some sort of positive result has none.
Hypothetically the human social creature evolved in small tribes / large families. Possibly in those cases slight negative reactions like that would be corrected by the presence of the family. In the distraction model of recovery possibly by redirection to a more useful effort that would yield positive outcomes for the individual and group.
In modern cities, it is very easy to end up alone, or nearly alone, with very few to rely on. Even if someone has friends in a city they might be real effort to reach, and that is assuming they've got time. If there's that effort involved maybe you don't even hang out with them and drift apart until even chance meetings cost effort and thought.
However you may get downvoted because you asked how to get upvoted, which can be counterintuitive if you're Neurodivergent (like many of us). It's ok, that's not how you intended it, but that is most likely not a helpful part of the message here.
All your points may very well be true, but taken together, they paint a picture of you as sick and untrustworthy. Society puts requirements on people, stuff like
- wearing clothes in public
- <more examples>
One of those requirements is emotional resilience. Being able to absorb a setback or percieved slight, and keep moving forward in your day. It can also be seen as a game of emotional poker - sometimes you win a bit, sometimes you lose a bit, but if your bank goes down to 0, you're out!
You are holding on to these slights and injustices, and it doesn't matter whether you are right or wrong. It's a catch-22, the fact that you keep complaining instead of moving on with your day proves that you are unwell.
Trepanning is an analogy for schizophrenia. That's where part of a person's skull is removed, and the brain is directly exposed to the air. You are exposing your feelings to the world, where a normal person would have an emotional lid.
It seems very interesting. You can generally share how important it is to you within reason and that's pretty chill too.)
I like the metaphor of the spiral wishingwell. The coin/ball represents the level of depression you sink into. The gravitational draw of the void makes the spiral go faster unless you figure out a way to pull out of it and the longer you wait the harder it is to pull out cause it's moving too quickly.
So the trick becomes keeping the coin/ball off of the spiral
Just another perspective to lean on when understanding others.
Once you confront it in the most absolute sense, something akin to ego-death occurs, and you make a decision about whether it is worthwhile to continue.
Everything comes from and swings back to chaos. Embrace it and you will be free.
Woke up and thought "alright this is stupid, I need to get stuff done" and as though it were magically manifesting out of thin air I had a normal train of thought, my emotions were mostly in check, and I had motivation that I hadn't felt in years.
Almost like cracking a knuckle, but in my own brain. GP's comment resonates very hard.
Not sure I agree fully with the "time spent in the water" not seeming bad - I think I simply recognize it for what it was, while acknowledging the trauma and cascading effects that I'm unwinding 30+ years after the fact.
Perhaps you mean that you are no longer attached to the trauma and can view it "objectively"
More important to me now is unwinding the physical manifestations of trauma/anxiety that I never recognized as well as eliminating the behaviors (people pleasing, self deprecation etc...) that attract toxic attachment.
> Even when you understand it's wrong, or at least heavily negatively biased, fighting those interpretations feels like trying to swim upstream in a terrific current.
Achieving it still feels like the end of "A beautiful mind", where there are people hanging out in the room that are not there. They sound like they are they, they feel like they are, they smell familiar. But they are not real and will disappear some wonderful day, as they always do. So you just nod to them and go on with your live.
The few that remained (in my personal case, can't speak about others) was a strange sense of gamification of everything. Lift that spoon with only one finger. That allows some influx of positive will but it can get drained real fast (to the point of physiological collapse .. a bit like narcolepsia)
And yeah, long term management basically teach your brain to desensitize to its own bugs so you can at least not drown in negative emotions. But it's a double edged sword cause you're tapering down your own self in the process.
> Catastrophizing is a cognitive distortion that prompts people to jump to the worst possible conclusion, usually with very limited information or objective reason to despair. When a situation is upsetting, but not necessarily catastrophic, they still feel like they are in the midst of a crisis.
Anecdotally, many of the people I know with a tendency to "catastrophize" later suffer from clinical depression. The depression only exacerbates the problem.
Even more anecdotally, catastrophizing seems heavily correlated to the usage of certain social media platforms in the young people I've worked with. I don't know which direction the causality flows, but I do know that people who consume a lot of Reddit and Twitter seem to think the world is ending and everything is terrible. They can tell me about every political scandal, every shooting, every tragedy, and every natural disaster that happened in the past week. Eventually they come to believe their news sources are representative of the entire world, forgetting that none of these things are happening to them personally.
It's a weird doom loop spiral. Even weirder is that many of the people caught in it feel convinced that they "don't do social media" because they're not on Instagram or TikTok, yet they consume hours and hours of doom and gloom social media like Reddit all day.
Our brains evolved to deal with what was happening in our immediate vicinity. This was usually fairly neutral to pleasant, with maybe some moments of sadness, loss, alarm and danger. We just aren't mentally equipped to process an unending stream of bad news and really keep the perspective that these things are not happening to me. It's best to just avoid sources of that.
I stopped watching and reading the news a few years ago, and generally feel much less stressed about day to day living.
I quit Reddit and I remember the exact day it happened. I found myself typing and deleting a reply to a comment that was overly negative on something that I was well versed in. I knew this person was incorrect and taking a knee jerk cynical approach.
At some point I just said what the hell am I doing here I need to not be on this website anymore.
More broadly speaking though, depression is partially like being stuck in your foulest possible mood for years, with the full knowledge that it's not going away, at least in the near term.
Too many assume it's a lack of willpower, but willpower can only do so much to fight the tide (depending on the severity of the illness).
For instance if sending a strong sensory stimulation first triggers a higher activity level in one part before the other, that could be interpreted as directionality.
I don't know the reasons, but you're looking in a time window of four-seven days.
When I stray from my diet (meat and water) one day. I become mentally unstable after 4 days. It says for 3 day, then gets good again.
Crying for no reason, ruminating, poor sleep, strong sour smell that can't seem to be removed by washing but can be suppressed by a strong anti transpirant.
Going for sibo testing soon, if it's not hereditary, enzymes might be a solution. If it is, Pankreas is up for investigation next.
Been looking for solutions since 2018, no doctor could offer an explanation so far.
This triggered brain to make the connection between sibo and enzymes.
Basically: if crbs trigger depression AND it takes 4 days to do so, it has to do something with fermentation. Bacteria and yeast do fermentation and they can only settle in the long intestine if there is enough to eat. ergo: I might not be making enough enzymes to get rid of glucose and fructose and after 4 days the ferments get through the gut lining into the bloodstream or whatever and I'm basically hangover for the next few days.
This led me into looking into enzymes to break down sugars, (veggies are secondary concern right now)
At least what I found after 30 mind of googling was that you shouldn't just take them cuz it could be hereditary - that's when I stopped reading and decided to get tested for sibo first.
[1] https://slimemoldtimemold.com/2023/04/25/n1-latency-and-half...
Also garlic seems to be okay, but not onions, chilly powder is okay but not chilli-peppers or pepper, or tomato or seeds in general.
Allergy tests all came back negative
I'm curious about the other direction of thinking. What do SSRIs, psychedelics, CBT, and TMS all have in common? Suppose that there is one common cause, or one at least one cause that applies to 90% of cases. And it's treated by all these seemingly disparate methods.
That's what tickles my curiosity the most, as it begs a more fundamental question about the functioning of the brain.
Maybe the author's theory is correct: brain signals between certain regions are going the "wrong" way in depressed patients. That would imply that SSRIs are causing the same shift. God, I would love if the authors tested that. And then we can finally dig into why SSRIs work (we don't current know). If they're causing shifts in brain activity flow, then we can find out how. And from there maybe we can treat other mental diseases with better pharmacological or TMS solutions. Are things like schizophrenia arising from a similar bad pathing of information around the brain?
Psychedelics is also a weird one. People have proposed many theories as to their mode of operation for treating depression. But now I wonder, based on this research, if the key factor was just the disassociation from one's body and altering of senses. The other effects like connecting disparate thoughts, forming more brain connections, ego death, etc may not be related at all. That could lead the way to more targeted drugs.
Really cool stuff. If if pans out, of course. But unlike other theories of depression, at least this one is easy to test.
Maybe there is some kind of local optimum your serotonin-mediated pathways can get stuck in and need help getting out of. In fact, this (generalized outside of just serotonin) is something I do buy as a basis for depression: your brain enters some local optima or learns some poor but good-enough coping mechanisms that keep you going but prevent you from fixing underlying issues (whether it be due to maladaptive behavior, framing or interpreting things negatively, low self esteem leading to poor social performance and consequently lower self esteem). That’s also kinda what CBT is about addressing
My mental image of it is keeping a classroom under control by stopping every kid from talking to their neighbors.
Note the disclaimers, especially "TOUCHING THE DEVICE WRONG DURING ASSEMBLY CAN INSTANTLY KILL YOU. THIS DEVICE COULD KILL YOU OR MAIM YOU OR BREAK YOUR MIND."
However the other things you're posting are alternative chemical treatments. People with resistant depression have already tried the approved chemical remedies. While I broadly agree that there's evidence in favor of both psilocybin and ketamine being potent chemical anti-depressants, I also think there's a number of valid reasons for someone to reach a point where they don't want to try any other chemical remedies, and ECT / TMS become more compelling options.
This is a joke of course…
Rapamycin isn't one I've heard of before, but it looks like a does-lots-of-things drug: Wikipedia says it's an immunosuppressant. I'd recommend against DIYing that for a different reason.
The doses used recreationally are multiples of what is regimen for anti-depressive effects.
I've never seen the phrase "chemically addictive" used by someone who knew what they were talking about. It's only used by people who don't understand that neurotransmitters are chemicals too. Stop spreading this BS distinction.
The most memorable withdrawal symptom from weed for me was the sweating. Cannabinoids tend to affect the hypothalamus which is sort of like the brain's control module for the endocrine system. And one of the things it controls is temperature regulation. So if you quit cold turkey that all gets outta wack and the sweating happens. Takes at least a couple of weeks to get somewhat back to normal.
Cessation of SSRIs can have all kinds of symptoms depending on the time length of usage, but I have never heard someone claim to be addicted to SSRIs.
Most people “addicted” wait much longer than that — sometimes months to make sure they have a strong trip and offset receptor down-regulation to the point where it can hardly be called an addiction.
* TMS machine is a powerful precise device that is expensive and unlikely to be safe from doing-it-yourself
* Every brain is different, so, you’ll need to get an MRI if not an fMRI to understand the structure to target
* Once you have a target, you’ll need to align the device with your skull
* It’s not clear how you’d measure or control the regime on the brain, even if you made it to here
Please fact check my claims by visiting the US government database to find complaints against these TMS manufacturers: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/s...
Top manufacturers should be a Google search away.
You’ll find examples of seizures, etc in there.
that being said, if you take someone who is objectively "not depressed" and apply these same depression treatments, what would happen? some state of euphoria? heightened mood? happiness?
suppose that new state is now the normal state in which people are judged against. now, the before-mentioned person who was not depressed, may be considered depressed, relatively. so you now apply the same thought experiment again. clearly this can be recursively done infinitely...
such is an inflationary view. so my question really is around the cultural vs. biological construct of depression. what if it's ok to be depressed? this is not to say that we shouldn't be trying to "treat" it (and the symptoms), but I do wonder at what point do we say it's OK.
1 - Person A has the flu
2 - Person B does not have the flu
3 - Person A treats the flu with rest, fluids and antiviral medications
If person B also rested, drank fluids and took antiviral medications, they would not become an unusually healthy person. Person B would not become the new normal.
What you're proposing is that it's OK to be sick. We treat every other form of illness with aggressive treatments. Depression is often ignored, poorly treated or treatment is inaccessible to many people due to cost.
That puts a pretty reasonable lower bound on what is or isn't depressed. It is absolutely an altered state of mind, and an information processing disorder.
For anyone who might feel like "it's ok to be depressed", this is not a normal thought, and there is no normal amount of suicidal ideation. Seek professional help or strong social support; just ask for help anywhere it might exist (go to an emergency room and just have a seat if you must). If you aren't depressed, these thoughts literally don't happen, as strange as that may sound if you are in the thick of it.
being depressed doesn't mean you have suicidal ideation, though.
Depression isn't on the happiness-sadness scale. It's quite tangential to that. In fact, perhaps quizzically, you can be happy and depressed. It's fairly common for people who learn about the loss of a loved one to recall how happy them seemed the day before.
Depression treatment, therefore, doesn't make one "less sad". And consequently it wouldn't make a healthy patient "more happy".
(1) I don't mean this in a negative way towards the comment I'm replying to. Nor am I implying that the commenter believes this. I just noticed a pattern and I'm responding in the spirit of education.
(2) It's okay to not understand depression; not everyone has to be an expert on everything. It only becomes dangerous when providing ill formed advice. Which is unfortunately common when it comes to depression.
Antidepressants don't typically cause mania in healthy people, but they could paradoxically cause depression.
Legitimately what dialogue are you attempting to start?
This isn't an "ooo society is wrong" type of situation. Sure there are some societal pressures to appear happy which can make depression _worse_, but depression is still awful regardless of those and we treat it because it's awful.
> what if it's ok to be depressed?
I dunno, what if it was _ok_ to be hungry? I don't think this question makes much sense.
If you're very stable and happy emotionally, then that dulling might be unpleasant.
Beyond that, while SSRIs tend to have fewer side effects and be more safe than many other classes of anti-depressants, even SSRIs have very noticeable side effects. They are very easy to stomach if they make a dramatic difference in your mood and quality of life, but if you were already mentally well the side effects will be more impactful than whatever benefits you might get.
I know that my medication dulls my most intense emotions, but that is the point. It is slightly sad knowing that I don't experience the highest highs that I used to, but it is completely worth it to stop experiencing the lowest lows that were completely debilitating. I would stop taking them immediately if I could be assured that I wouldn't fall back into physically debilitating anxiety.
No, usually nothing happens which is why people don't bother abusing antidepressants. These aren't like cocaine or alcohol.
I'm pretty desperate to get onto a trial. Here's hoping that this gets FDA approval ASAP.
Maybe it’s just me, but I have to work hard to avoid:
- Bad posture, hunching towards the monitor
- Scrunching the face
- Feeling impatient because my fingers and the computer can’t keep up with where I am in my mind
- “Damn you, computer!” frustration in small doses throughout
- Frequent interruptions via email, Slack, texts, coworkers, etc
- In some cultures, it’s very hard to have a plan for what to get done in the day and then execute on it due to getting sucked into meetings and stuff.
1. Depression can be treated and even overcome in some circumstances
2. There are very justifiable reasons many people might be depressed
Really think on it deeply for a bit and you'll realize this belief can't possibly be justified rationally. Who are you to say that resources and power shouldn't be concentrated in the 1%? You say they overstep morality? That's your morality and you can't defend it rationally (no one can). Plus you can't change these things anyway, so you have no moral responsibility to do so (my morality).
Media, politicians, advertisers, etc. all instill FUD to make you feel this way so the default option is pessimism. Try optimism. It may be wrong, but pessimism may be wrong as well and no one will ever find out so why even care who is right?
Who are you? Everybody has the right to say this, or the opposite. If you think that people need some sort of permission to critique the morality of murderers, or that there are no rational arguments for any sort of morality, I'm here to inform you that neither you or they need permission, and maybe read or think a little more about secular morality. Feel free, however, to continue giving your opinion without my permission.
> Plus you can't change these things anyway
This isn't rationality, it's just learned helplessness. To say the least, people have changed things before, and will change them again. You have changed things, even if they were very small.
> Try optimism.
This comment is 100% doomer. Maybe try some optimism yourself.
I am not sure where I fall on the above two threads, seemingly strongly felt opinions on both sides. But if I can share what my takeaway from the parent of this reply, infuse it with my own experience, just in case it helps somebody or somebody finds it interesting:
It's that in the deepest moments of anxiety and depression, it can feel incredibly exhilarating to think about all the reasons that one is brought to this place of darkness. And to _know_ them to be correct, especially enticing are the global explanations. I notice this most strikingly in my mother, for whom all explanations need to be terrible, omnipresent, and incurable. "The reason that X treatment will never be available freely is because corporations have existed for all time as gatekeepers and sit in delight that they will never ever help an innocent soul who couldn't pay for it, so unless we have a revolution we should probably all just wait around until we die". These are our "conversations" weekly and have been for years. But I notice this in myself. She's not saying it because she's going to start petitioning against the corporations, she's saying it because it feels satisfactory (I have confirmed this by many a time digging into her rationale). And I do the same thing. In my darkest moments, I can talk endlessly about all the reasons. Quite convincingly, at least to myself, which is all that matters in that internal dialogue.
When I am most depressed, I very painfully make myself begin to exercise, daily or twice daily, and it's never cured me, but it sure helps. I sometimes wish that I could convince my mom that if she used 10% of the energy she does crafting the perfect mental narrative for why the world is unfixable- so why bother, and directed it towards proven things for long-term health, physically and mentally (restarting therapy, considering experimental therapies, exercising, diet, sleep!) that maybe _her_ world wouldn't seem so unfixable. Maybe even _the_ world.
I haven't succeeded yet, but if anyone has any ideas I am all ears.
As someone who is interested in a rational solution. I call this bullshit. There are thermodynamic reasons why it makes no sense. Even neoclassical models don't model capitalism i.e. they predict its absence.
>Plus you can't change these things anyway, so you have no moral responsibility to do so (my morality).
Wrong, it is possible to change these things in fact, it is even possible to earn money in the process. There are small and big steps that can be taken in this direction. There is no need to act helpless in the face of these things. I don't give a damn about the learned helplessness called "anti reformism" of Marxists and capitalists.
I have found that people treat depression and anxiety like a medical condition -- diabetes, or high cholesterol.
Yet I can measure those numbers, compare them with other people similar to me, determine what ranges are outside the norm, and observe changes as I try different strategies to manage them.
Depression, like physical pain, can neither be measured nor compared. And if this analogy holds, then there are those who would rather dull their pain with medication and claim victimhood, rather than find the source of it.
Stopped sugar suddenly? Inflammation from food you’re eating? IBS in general? Traumatic upbringing leading to entrenched “thought loops”? Undiagnosed disease?
These all and more can have depression as a symptom.
My armchair psychologist opinion is the DSM 5 category process isn’t fitting correctly to how humans operate. I believe there’s a completely different modality that has yet to be discovered (or known in mainstream science) that gives us a better way to diagnose people.
I find it nuts that you subjectively, in most cases, ask the patient if they fit in usually 3 of 5 categories, or what not, and that determines the diagnoses. Countless times it’s like “okay, what does hyper mean?” “What does intense rumination mean?”
We need a more objective way to measure these criteria.
I was diagnosed with depression for a while, tried a bunch of drugs, none really worked. Then for shits I do a neurological adhd battery and lo and behold, seems like that’s it.
Now using the correct behavioral changes leads to the depression going away, and far higher quality of life.
I know the system, DSM 5, is best we have now, but we need more innovation in this space
Make a mistake? No big deal it’ll be better next time. Learn from it rather than beat myself up for it.
Hit that red traffic light? Time for self contemplation and putting the heated seats on rather than being pissed off I’m delayed 30 seconds.
Get an email that triggers my threat response? Take a breath and think about who I have around me who can help rather than take it all on myself.
Have a read of learned optimism. Great book.
Get therapy. Hit the gym. Go for walks. Brush your teeth for 2 mins. Moisturise. Show yourself as much self care as you can.
Also, on the ADHD side, implementing schedules and routines to make sure I get things done appropriately and not get as easily distracted by things like video games or social media.
At first it felt like I was in grade school again, with an agenda book and blocking out time, but lo and behold it works out well. Not fully able to follow schedule to a T, but a vast improvement over before.
We don't understand all of the mechanisms of long-term illnesses like depression, diabetes, heart disease, Alzheimer's, etc. but we do know how to fight them: exercise and good diet. *
Some processes in the human body obviously get disrupted under modern conditions, so it's important to give your body something it's a little more used to: more movement, more traditional foods.
* (Obviously, it's not going to automatically fix depression in all cases, but it's absolutely worth fighting the good fight if you can. Other treatments are definitely worth trying too.)
- Jim Carrey
Sometimes though, any one of those or all of them can end up seeming impossible because of the depression one is fighting.
Slowly build up incrementally better habits over years. It might start with a 10 minute walk.
The ADHD makes it impossible for me to stick to exercise routines as well as other routines. The depressive symptoms make me feel like I am carrying a ball and chain and every little thing requires so much energy.
The worst part is that I am treated for ADHD, and even that has basically any negligible difference anymore.
I feel like I am trapped in a negative feedback loop that I cannot escape.
It's part of the reason why office work is so difficult and working from home is not. Sitting in a office is quite tiring since I have to use a lot of energy to restrain myself. I'm the type of person who paces when thinking/talking on the phone, talks with their hands, bounces my leg when sitting, fiddling with something in my hands when talking, etc..
The best description I can give is it feels almost like a bad itch. I cannot control when something itches, but once the urge to scratch presents itself, it's almost impossible to resist. Trying to force myself to not move doesn't make the "itch" go away. It just gets worse.
In fact, my body now demands that I go to the gym every day of the week, either for weights, cardio, or both. On my one rest day, I feel riddled by anxiety at 6 pm because I'm not doing any real physical activity. (Now that I write this, maybe I should walk on my rest day, but oh well.)
It's hard work to form the habit, but it's the best treatment for this sort of thing that I've found. Once you start associating exercise = relief, it becomes welcome.
Much as we don't think of "fever" as an illness any more, I suspect "depression" will become descriptive rather than predictive - which, to an extent, it already is, at least according to the DSM as I understand.
It's also possible that we'll see it as something that is multifactorial - some genetic susceptibility combined with environmental and/or infectious triggers.
It did, however, completely change how I see myself, to the point where I feel disconnected and separate from the person in my memory. Likewise, my sense of empathy and how I few the world is completely different, for the better.
I plan to do another round this summer.
The historical record has many descriptions of depression dating all the way to B.C. times. Depression has been a thing that has affected humanity for at least as long as organized civilization has existed.
I think a good question to ask is: Do uncontacted ("lost tribe" cultures if you will) peoples have differing prevalence of depression compared to the connected world?
I don't know the answer to that question, but I wouldn't be surprised if the rates of depression in those cultures is lower.
Why would you think that it is?
There have been few days in my adult life that I wouldn't have preferred to not be here. Depression sucks. Yet, I don't think people are right when they tell me I'm wrong to be depressed.
I hear that some people feel their depression shouldn't be there and that they should feel happy, and in those cases I think this sounds like it could be an excellent solution, but in my case (and I think others too) I could give you very well reasoned arguments for why I would prefer to not to be here and why I feel a sense of sadness as my default state. At least in my case I believe arguments for optimism are more wrong than my depression.
Interestingly, my girlfriend is the total opposite to me. She's the happiest person ever met and I often wonder why she isn't also considered to be suffering from some kind of mental defect – I guess in her case the signals must be moving the "right" way because obviously the "right" way to feel is happy 24/7 and prolonged sadness is "wrong".
I guess I always kinda liked the idea that any advanced intelligence would end up as some iteration of Marvin the Paranoid Android, since the logical conclusion should perhaps be that life is pointless and hard, so therefore why bother? Perhaps the "right" way for signals to travel is in the direction of depression and hopelessness.
Sorry I know this isn't really on topic and I sound like a complete downer. I'm certainly not trying to diminish this research. I've guess I've just always found it interesting how some people feel they can categorise mental states as "right" or "wrong".
It is "wrong" in the sense that it has all of these objectively negative consequences whereas being blissfully happy does not, so it can be claimed to be "right" in relative terms.
I think you are attributing to the word "right" a sense of an obligation to feel happy, with "wrong" therefore being a deviation from that True Path, but I don't think that is the intended meaning when people use those words to describe depression.
I would argue that "right" in this context means something closer to "nominal", as in "working as intended". Nobody is faulting you (or me or others) for constantly feeling down.
I hope that helps.
> It is "wrong" in the sense that it has all of these objectively negative consequences whereas being blissfully happy does not, so it can be claimed to be "right" in relative terms.
Obviously I can only speak for myself but depression has manifested both as hyper-productivity and hyper-defeatism for me. I've never felt content so a lot of my life has been an endless struggle to just feel okay which made me unbelievably productive when I was younger and naive enough to think I could fix things.
It can be negative at times though, but my perspective on this that optimising for my own happiness is not an achievable goal. All I can do is optimise so that my suffering can be a net-positive for humanity and those I love. So although I might feel like I don't want to go on and I don't want to be productive I do because if I'm not productive or kill myself then I'm letting everyone down and my existence then truly was a net-negative both subjectively and objectively. I have to at least make this objectively positive.
So the reason optimising for other people's happiness is everything to me, is because my own means nothing. But that does get destructive when I'm letting people down because then I suddenly start trying to calculate if my life is a net positive to the world and things can go "bad" quick when convince myself I'm doing more harm than good.
I think I'm atypical to be fair, but I would argue my depression isn't objectively negative at all which is exactly why I put up with it.
I don’t really feel like my emotions are representation if my mental state since they are a part of it as well as an influence on the more rational side. They also don’t correspond perfectly to the outside world, I can be cheerful even when things are objectively bad which lets me celebrate the small good things I can find in those situations. I can also feel terrible when things are going great sometimes but maybe that’s because I really should be doing something different.
Even if one concludes that life is pointless, depression is not the logical direction to head. Depression makes it harder, and full of pointless suffering. The logical direction to head would be maximizing pleasure despite the pointlessness. Of course that opens a whole can of worms about hedonism, but the point is that depression isn't logical unless you conclude that life should be as miserable as possible, which I wouldn't say is a logical thing to conclude.
Once I finally realized that depression was something happening to me, literally an illness, and that it wasn't an intrinsic part of my personality, I sought medication. That medication had a near-immediate effect of making me feel ok. I wasn't depressed, I was able to just get through a day without thinknig too much about it. But it didn't work perfectly, and I found I could still slip into depression a couple times a year.
More recently I got on a new medication that seems to actually work. It's not giving me a fake happiness and it's not taking away any of my very real concerns about how "good" life is. I am not optimistic about my state, my country, the future of humanity, or very much in general. But I am not depressed. I find it easy to enjoy things that I love in life. I can take real pleasure in disconnecting from work and foraging blackberries in the woods. It is pointless to do so (I have plenty of food), but it doesn't feel pointless. It feels fun and interesting.
To me that's the biggest difference with depression. I can be extremely sad, and I often am. I can even believe that the world would be better off without me (I go back and forth), but I still feel satisfied to be alive. Even on my bad days, I can take small pleasures.
I do think that staying depressed is "wrong" insofar as I would say it is "right" to seek comfort, pleasure, and health. I also think that it's fair to say these signals are moving in the "wrong" direction with respect to the direction that they move in non-depressed people. If the goal is not to be depressed, and something is causing depression, it's a "wrong" action.
But I don't want this to sound like I'm chastising you. I get it. I am still a pretty pessimistic person and everything you're saying is logical. The difference is, I can think about and believe those things without it changing how I feel on a fundamental level. It is extremely hard to see that without getting treatment. And I also understand that it sucks to be told you're "wrong" or there's something "wrong" with you for being depressed, because it's happened to me plenty. So I understand your qualms with the language. Again, though - you don't have to feel bad. You can think the world sucks (my state government wants me and my community eradicated) and still feel good.
From what you said I think we probably have slightly different manifestations of depression. Mine doesn't seem to be as absolute as it sounds like yours was. I was happy when I was a kid, it was only when I reached adulthood and started to disliked the way my life was playing out that I became depressed. This compounded with knowledge that life is just a pointless struggle basically makes me depressed constantly as I see no hope in it ever getting meaningfully better.
If I could live my ideal life – one where I wouldn't have to socialise with people and wouldn't have to work for a living (I'm autistic) – I'm fairly sure I'd be fine with my pointless existence (although maybe incorrectly). I probably wouldn't be irrationally happy or anything, but I'm sure I'd feel mostly neutral between situational moments of happiness and sadness.
But as it stands it's just all struggle for me because I dislike my life and cannot fix the problems I have. So while I could medicate myself to make my life more bearable I know I find it hard to find a balance when I take that path. Whenever I've decided to "fix" feeling depressed I've always ended up in a hedonistic spiral seeking my own selfish near-term happiness at the expense of everyone I love.
The best answer I've ever settled on is to simply embrace the sadness. So while I may not be able to be happy myself, I can still make others happy. And I think in this way my depression may even serve a noble goal because I've given up on my own happiness so entirely that maximising other people's happiness is the only thing that matters to me anymore.
But getting back on topic, I think in my case you could probably argue my personality is "wrong" – an optimal me probably wouldn't be autistic, and I probably wouldn't dislike socialising or being forced to work as much as I do. But my depression in my opinion is "right" since it's just accurately describing how I intellectually view the struggles of my day to day life.
I wouldn't deny that I could medicate the pain away, but I'm not sure that makes it "right" either – even if it doesn't feel fake.
But if you're just saying I should give medication a go because it might make me feel better, then I appreciate you sharing your experience. I definitely found it interesting that you described your medication as not giving you a fake sense of happiness. For what it's worth I used to abuse alcohol and while I was drunk that's exactly how I remember feeling and why I drank. Perhaps the right medication would be sustainable though... It's a place I'm a bit scared to even explore again to be honest. Prioritising happiness has never served me well.
I'm actually very, very similar to you in that way. In fact, a lot of what you just wrote resonates with me strongly. I am not doing what I ever thought I would be when I was younger. Honestly, I don't fault you for feeling the way you do. It really just depends on what you want your life to be like moving forward from where you are now.
I'll say that for me, I find it much easier to make others happy when I feel good as when I'm depressed. But I tend not to fall too deeply into hedonistic spirals, so that may be a key difference. Also, I originally started taking bupropion for depression, but it's supposed to help with cravings and addictive behavior as well.
> an optimal me probably wouldn't be autistic
Maybe... it can manifest differently in everyone. I can't imagine myself not being autistic. It's a horrible thought to me. However, I would give my foot to be free of ADHD - it feels like such a burden. (I haven't been able to try medication for that yet.)
> For what it's worth I used to abuse alcohol and while I was drunk that's exactly how I remember feeling and why I drank
Totally, and the same with, well, other substances. One, specifically, which induces pure euphoria for a few hours and made me wish I could feel that constantly. However, the big difference is that being in that state is clearly not sustainable. You can't feel on top of the world at all times; it wouldn't make sense, it would be exhausting, and it would be unsafe.
The medication I'm on allows me to feel sad, tired, bored, anxious, scared, irritated, and everything else. It's just that those emotions don't overtake my whole being anymore. They're things I feel in response to events in my life, just like happiness isn't something I feel all the time.
I guess a better way to explain it would be that it's giving all my emotions an even playing field. I can still get really down when shitty things happen - this week has been really rough for me, and I'm not having a lot of fun. But I can still get chores done, enjoy little pleasures here and there, make tiny progress on some hobby projects, and basically avoid the devastation from coloring all of my experiences. I don't feel hopeless even though I've had a big setback.
So, I guess that's off topic. I don't know if I'm trying to convince you to try medication again or not. (Definitely wouldn't recommend doing any experimentation with a psychiatrist's supervision and a lot of honesty with yourself.) In terms of what's "right" or "wrong", it's really about what you want for yourself. Happiness, pleasure, and joy aren't the same things. To me happiness is about equal parts joy and satisfaction. There of days where I have a lot of fun and don't feel "happiness" because maybe it was a little empty. There are plenty of days where I don't have very much fun and I feel happiness because I'm with my loved ones.
Ah, I get the point you're making, but that's not what the article said/meant, is it?
“When they analyzed fMRI data across the whole brain, one connection stood out. In the normal brain, the anterior insula, a region that integrates bodily sensations, sends signals to a region that governs emotions, the anterior cingulate cortex.
“You could think of it as the anterior cingulate cortex receiving this information about the body — like heart rate or temperature — and then deciding how to feel on the basis of all these signals,” Mitra said.
In three-quarters of the participants with depression, however, the typical flow of activity was reversed: The anterior cingulate cortex sent signals to the anterior insula. The more severe the depression, the higher the proportion of signals that traveled the wrong way.”
Wrong here means reversed from the norm. As in, it's not logical to argue that the mood should precede the telemetry, is it? The flow of information going the other way makes little sense from a bio-mechanistic viewpoint. That's why it's "wrong". The article makes no other judgement about (major) depression. And arguably, as we all know, it is correct to have reactive depression if some awful thing befalls us.
I think the metric that mental health professionals use is roughly "interfering with your life." So if she were frustrating her colleagues and friends with her upbeat attitude -- if they saw it as insincere, e.g. and they decided to limit interaction with her -- that might be considered "wrong" or "treatable." If she herself saw the negative impact of her happiness, she could likely be treated by a professional.
> I hate this idea that signals can move the "wrong" way.
IMO that metric helps make things much more objective such that "wrong" can be considered instead "problematic."
Don't stop at nihilism, take the next step towards absurdism!