Comment by H8crilA | Hacker News Reader

Comment by H8crilA | Hacker News Reader

The more I learn about my depression the more I realize just how underdeveloped medicine is in this area. Everything that the author writes is true, some psychiatrists will even admit as much - i.e. that standard treatments such as psychotherapy or SSRIs or exercise work, but each of them just barely. We may be decades or even centuries away from reliably treating depression.

Most depressions indeed go away on their own, and perhaps are even helpful - they can force a person to reconsider and rearrange their life. The heavier ones probably have to be treated with everything that the patient and their environment can muster, all at the same time. And since the patient usually can't do much, it's up to the environment (friends, family, health care, mental hospitals). Please keep that in mind and force your depressed friends to go for walks, or do anything else at all, repeatedly. All the +5% basics like physical activity or smalltalk really do add up. Though the depressed person will not be able to see it for a while.

I had a pretty bad bout of depression about a decade ago. My girlfriend left me, followed shortly by one of my closest friends dying. I saw a therapist and went on antidepressants. I didn’t find either particularly effective or helpful.

I don’t know if it’s even possible for other people but what I ended up doing out of desperation was just logic-ing my way out of it. I would sense it coming and start directly countering thoughts and waves of emotions with reasons what I was feeling was not true and things I was grateful for. It was literally like arguing with my own thoughts and telling them to shut up. It shortened the bouts by a ton, stopped me from spiraling and eventually they stopped all together.

Maybe that will help someone else super analytical like myself? I genuinely don’t know. In more recent years, did not help my wife with her struggles at all.

That sounds a bit like you invented your own version of cognitive behaviour therapy

I do the same. Once in a while I remind myself of the five stages of grief/loss and I go explicitly through all of them to see where I stand now. Although I sometimes feel stuck, doing this exercise explicitly helps me to see I make progress. Progress as in 'two steps forward, one step back', but progress nonetheless.

Logic-ing or grounding is also something I recognize myself doing. And it can all be such simple accessible things to make it happen. For example, looking at a picture or video of my young nephews playing works wonders. Probably more than any talking session, although one has to also get the dirt work out of the way. The hard work of fixing stuff, and then relaxing by grounding work.

Have you tried ketamine therapy?

Ketamine is a valid therapy in Switzerland, but it's close to the end of what the medical system can offer. Along with electroconvulsive therapy and transcranial magnetic stimulation. Doctors do not recommend it for me yet (due to the cost of the therapy, i.e. the potential side effects), but they made it clear that I can try those options later.

But guess what - those methods also have a limited effect. Perhaps a bit stronger than the more common methods, but not by a lot.

K works until you run out of money. It was really helpful, and almost exactly counterbalanced by the amount of shit I had to wade through to get insurance to cover what they said they'd cover.

You (rarely) can force a cure onto people, and in the case of mental problem it's basically impossible.

If the science was clear in that depression would be heavily contained if the sufferer engaged in physical activity, good sleep, good diet, good general routine and zero stuff like social media or mindless entertainment, then how man people would actually follow through?

We criticize psychs for their love of giving pills, but we are the first who are lazy and stupid and would never actually do what's best for us

We might not be able to force a cure, but I can think of a multi trillion dollar industry (or two) that’s undoubtedly pushing the opposite. Maybe we should start there.

Reply on news.ycombinator.com