We've Got Depression All Wrong. It's Trying to Save Us | Hacker News Reader

We've Got Depression All Wrong. It's Trying to Save Us

psychologytoday.com

113 pointsandrewfromx62 comments

Depression was my soul's reaction to about 16 years of systematic abuse, emotional neglect, ridicule and bullying. My intellect finally shut down and I withdrew from reality entirely, or at least that was the goal.

At the time my new abuser would ask things like what I was thinking. This was a novelty for me but she was probably trying to figure out ways to torment me more effectively. She also explained that I was trying to hide by sleeping all the time. One teacher wrote a note about my laziness, and I knew he was correct.

Depression wasn't my fault, and it wasn't within my capacity to recover from it. But my family turned it into something exclusively my responsibility. I was drugged over and over; I was permitted to leave home without any means of support or homemaking skills, and I was eventually discarded by means of restraining orders and physical assaults, so I left the state.

If a child is depressed then the worst thing to do is blame, medicate, and isolate them with individual treatment. My counselor encouraged morally reprehensible behavior and never questioned my home life.

If your child is depressed then you'd better consider their environment and social networks to be suspect. If you can't identify problems, then YOU ARE the problem and you'll need to address that with decisive action, in a practical and honest manner.

>If your child is depressed then you'd better consider their environment and social networks to be suspect. If you can't identify problems, then YOU ARE the problem

I don't know your personal story in detail, but with this, you seem to focus way too definitively on external causes for depression. There's ample clinical and other evidence that many cases of chronic depression are largely internal, chemical and won't be fixed by changes in environment, surrounding people etc.

> Sometimes the threat is so bad or goes on for so long, that the nervous system decides there is no way to fight or to flee. At that point, there is only one option left: immobilization.

Gabor Maté has expressed a similar sentiment in regards to ADHD. According to him, when you encounter stress while both fight and flight are not an option, the only option left is for your mind to distract itself.

Gabor Maté on Rogan: https://www.youtube.com/watch?v=4jQSOSi2DA8&t=133s

This video blew my mind and hit me in my soul.

> It is time that we start honoring the courage and strength of depressed people. It is time we start valuing the incredible capacity of our biology to find a way in hard times. And it is time that we stop pretending depressed people are any different than anyone else.

The article's conclusion ends in a call for society to change its ways. Such an appeal is easy to make. What's not so easy is telling a depressed person what to do right now under the circumstance that society hasn't changed and likely isn't going to change.

It's easy to tell depressed people what to do. What's hard is convincing their brain to tear down the barriers it has erected.

But do you know we're in high demand

Laura, us, people who suffer

Because we don't take to arguing

And we're quick to surrender

What’s this from?

https://genius.com/Bright-eyes-laura-laurent-lyrics

The article seems to just be a call to change how society views depression. But is there any science here? The premise that depression is not a deviation from normal functioning, but rather a biologically rooted response could be applied to any behavior. Indeed, it can be applied to the societal opprobrium towards depressed people, which exists across cultures. Maybe that’s just a biologically rooted response that protects society at large? That’s equally plausible if you posit that just because a psychological phenomenon exists it must serve some function.

It does seem pretty light on science. There's maybe a better discussion on it from a "Trying to Save Us" perspective on Wikipedia under "Evolutionary approaches to depression".

There is no science in psychology, period.

By nature of dealing with humans you can't really run thorough experiments like on rats. On top of of that, psychology is mired with quackery, big egos and partisanship (nature vs nurture, CBBT vs psychoanalysis, humanistic vs psychodynamic, approach to DSM,..)

I totally believe in good psychologists that can help you, I just don't believe there's much rigor and objectivity.

https://www.theguardian.com/science/2015/aug/27/study-delive...

You are unfairly being downvoted. The reproducibility project attempted to reproduce the results of 97 experiments in psychology that originally had "statistically significant" results and was only able to find 37 with statistically significant results during replication.

That is not to say that psychology is not helpful - it can help a great deal. But we need to stop pretending it is "science".

Stopping to consider it a science means giving up. Instead we should improve the scientific level of the field, including (but not limited to) reproducibility.

I didn't get that: I took it to be an outline of a line of research on how better to help depressed people.

I feel that this is exactly what it is. In fact, I've got a two year old journal entry detailing a theory very close to this, that I wrote in the depths of a scorching case of depression.

My depression was preceded by several months of extreme psychological stress and was, in my belief, a result of that.

After getting rid of the source of the stress, and 18 months of anti-depressant medication, I am now much better.

I'm glad you found a way out and if you ever decide to publish that journal I'd love to read it and see if it has any similarities to my own struggles.

I've always felt that if good times make time fly, depression stops it like a black hole.

And I hope you have or will find something to make you feel the struggle was worth it.

Reading back, there's a lot of whinging and moaning in it, with the occasional flash of insight. I don't think there's much of value to the community there.

Thanks for the kind words, and I hope you have, or will, overcome your own struggles. There are people out here who understand.

Content behind Clickbait headline:

Depression is a "freeze" reaction to stress, effectively shutting down to avoid triggering a dangerous response from the environment.

To me this seems quite a stretch, and maybe some conflation with "learned helplessness".

In my experience, depression is an irrational fear reaction. When something good happens, the brain suddenly thinks "this is not good, failed, it's worthless, a waste of effort" or "this was a mistake; this is going to end in disaster for me, I shouldn't have done this." It's not adaptive just because it's occasionally a correct prediction by chance.

A more common adaptive reaction to adversity is carefulness/stress: heightened awareness of the world and intense effort to choose safe decisions, and to fantasize ways to escape.

One way I would think of depression is, it's a condition that is triggered by a case where it seems like you fundamentally as an identity don't fit the current environment, and there doesn't seem to be a way to change the environment, or yourself to adapt to that environment. Nothing is going to make you happy, because there is something fundamentally wrong. And in many cases it won't be obvious that something is fundamentally wrong. It could be that you are genetically not wired to adapt to modern environment, which was never there. For example you are forced to go to school when it doesn't fit you, later in life forced to work at something that is not according to your talent or passion.

I wouldn't call it like a reaction to fear.

I think depression can lead to apathy, anhedonia, even nihilism but having that as an origin point for depression seems quite out of place.

The last sentence of your main paragraph is the reason for my username. It’s certainly not the origin point for that feeling, however.

It isn’t fun to realize that everything you touch within your own lifetime is temporary. Work is largely meaningless. Abusive partners, officials getting away with clear (attempted) murder because they can hide behind a piece of paper, and so on.

Sure life is “unfair”, but it is unfair for the vast majority due to it being stacked for the vanishingly tiny minority. And the majority is powerless to stop the abuses.

Why bother?

Ok then... why does depression potentially lead to suicide? Is that also adaptive? (stick with me, I'm not being facetious)

Consider the possibility that suicide is an adaptive response by the microbiome. After all, the microbes that colonize our body would survive (and subsequently participate in consuming the body, a process called autolysis). It might be their collective way of saying "this vessel is no longer viable, let's take our chances on the outside". Think of it as a self-destruct button and they're ejecting in the escape pods.

This challenges our ideas about self.

Since no individual exists standalone, we must see the individual not only as such, but also part of the larger organism/society. It is easy to see the many ways of how suicide of an individual may well be adaptive, at least historically, for the larger organism/society of which that individual is part.

It may be possible to speculatively frame it such that survival of the larger system would also benefit microbes that coexist with it (by way of colonising the bodies of its members), but I would warn against literally attributing suicide to microbes—the causal relationship is far from clear (over-simplifying, a person who feels unnecessary could incur stress manifesting as impaired immune response and over-representation of particular microbes).

So some kind of... individual apoptosis?

I think that hypothesis would need more support in terms of some kind of, er, cancerous outcome being the alternative.

What exactly are you calling “hypothesis”? The first paragraph of my comment is just an observation, the second is a view I specifically do not hold.

If you seek examples where “malfunctioning” people who harm society’s fitness survive and reproduce you can probably find those, too, but I would not take a literal comparison to apopotisis and cancer (which we do not understand nearly enough anyway) too far.

like murder-suicides and/or dictatorships?

https://en.wikipedia.org/wiki/Murder%E2%80%93suicide

Are you talking about group selection or kin selection?

In evolution what matters is that the gene(s) frequencies increases in response to selection. It would have to be a very big kin effect to offset suicide.

https://en.wikipedia.org/wiki/The_Selfish_Gene

1. As far as I know, kin selection is a subset of group selection, they are not mutually exclusive.

2. I don’t talk about either specifically. It’s a general observation. If resources are limited, it can mean that reducing the number of consumers can improve outcomes for remaining people.

3. Do you mean human genes or genes in those microorganisms from the other commenter?

It's interesting when thinking why there might be evolutionary reason for suicide, it could be for benefit of the group, however in modern life people like to tout that it's a selfish act. Things have changed in modern life of course.

Possible leftover maladaptive behavior. Or maybe it is still adaptive (for the group) in whatever indirect way.

Sacrifices in the old days are speculated to be healing for society by venting certain violent impulses out. Perhaps suicide could be healing by having society take a look at itself and reconsider something, but in modern days this would not work as they are not publicised.

I am intentionally adopting an extremely society-centric position, to counter-balance individual-centric position usually adopted by default. (Again, an individual literally does not exist without the society.)

I think that's fair to look at it societally, but the concept of a collective goes up and down fractally. You have self, family, neighborhood, town, etc going up... and then going down you have organs, commensurable organisms, cells, genes, etc. All replicable and self interested in their own contexts.

While we can argue against overgeneralizing, models from one scale often elegantly explain dynamics in other scales. Apoptosis, auto-immunity, depression (learned helplessness) can emerge at scales other than where they are most familiar.

Kin selection is specifically about shared genes in the kinship group. Group selection can include woolly thinking about 'benefit to the species' when it's simple not possible to increase the frequency of a gene in the population if it's only in the sub-population that dies.

> The Swedish government’s report proposed that the apathetic children were from “holistic cultures,” where it is “difficult to draw boundaries between the individual’s private sphere and the collective domain.” They were sacrificing themselves for their family by losing consciousness. “Even if no direct encouragement or directive is given,” the report said, “many children raised with holistic thinking may nonetheless act according to the group’s ‘unspoken’ rules.”

https://www.newyorker.com/magazine/2017/04/03/the-trauma-of-...

I want to stress the “historically” part. In case of humans, it is certainly that. It is not adaptive for society today, resources are not that constrained in pretty much any place one might be reading this from.

Here is a pretty comprehensive meta-analysis of literature around microbiome and depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510518/

"This literature review established a strong link of microbes in the gastrointestinal tract, affecting how individuals think and how the gut-brain axis serves as an essential pathway in considering the management of several mental issues and psychiatric illnesses. Although promising, gut microbiome studies have a long way to go."

So yes, you are right, the causal relationship is not definite. Still, it's an interesting lens which may one day prove to be clearer.

The “affecting” part is questionable unless they demonstrated that gut changes thoughts and not the opposite (e.g., stress eating resulting in different microbes) or some third factor causing both.

Immobilization, to me, sounds like learned helplessness: https://en.wikipedia.org/wiki/Learned_helplessness.

Yes. I think these are related. I’ve struggled with depression for most of my life and “learned helplessness” is something that intuitively matches my thought patterns.

2020, judging from the URL.

Some previous discussion in 2020:

https://news.ycombinator.com/item?id=25546043

Yeah, uh, ever lived with a depressed person?

You cannot get them to do anything. They only care about how sad they feel and care nothing about the effects their constant bed hiding imposes on all the people around them. It is utterly impossible to get them to treat themselves because... That involves getting out of bed .

The depressive loop in the mind has built in defenses that keep it from being treated. A depressed person often wants to be depressed because they take condition it and don't want to face all the things they could have been doing instead, a sort of procrastination on media steroids.

The best treatment for depression, exercise, involves setting all the micro behaviors that depression uses to perpetuate itself.

"A depressed person often wants to be depressed ..." I'd caution against expressing it this way. It's less a want and more a ground state.

I am one of these depressives, and I definitely do not want to spend all day in bed. It is, however, a ground state that takes an amazing amount of energy to escape, so my usual inclination is to conserve energy and not escape. It may outwardly look to non-depressives as a strong desire to spend the day in bed and away from the world except through whatever portal the Internet gives us, but it's my experience that having someone to come by to help with the parts of living that fatigue me is direly, overwhelmingly underrated.

And, like, it isn't often chores or errands that are the most helpful. (Indeed, when my depression saps me enough, I find that just going on a cleaning binge is a cheap way to recover for a while.) No, rather, it's stupid shit like having someone make decisions for me so that I can get un-stuck from whatever mental hell I've fallen into. The challenge is usually articulating which decisions I need made because merely unpacking them has a high energy cost.

It's only when I've gotten a handle on the fatigue each day that I'm truly able to get moving.

> ground state

I often find myself reaching for the term "anticipatory anhedonia": When someone doesn't feel happiness looking forward to things that are coming.

Oh, they might be happy during the activity, and they might abstractly know that they'll enjoy it a lot, the gut-reaction during the planning phase is that it's a to-do item that might be a big hassle.

Sort of. Extreme self-centeredness, inability to concentrate or prioritize, and low energy.

There is no "best," one-size-fits-all treatment for depression. There are many possible holistic, overlapping habits and treatment options.

Yes, when you’re depressed you should make yourself exercise. Every time.

> you’re depressed you should make yourself exercise. Every time.

works for me. plus a daily spoonful of cod liver oil. the best defense against depression is discipline to do what you have to do even when there's no dopamine coming.

Since we're chiming in, exercise doesn't usually improve my condition when I'm depressed and occasionally instead exacerbates it.

Rather try physical movement then and build up to exercise.

If you are consistent for long enough the body begins to crave it and you feel better afterwards.

Maybe walk then run. Or pushups then pull ups then dulbells then weights. Swimming can be a great cardio and total musculature system workout.

Find what you can do and try and remain consistent through the loss of motivation, as that will happen.

I know everyone is different but it's been infinitely more effective and a positive in my life than any medications I'd tried.

If you need someone to help cheer you on I updated my bio to include my email.

Same. I exercised through my worst bout of depression and still ended up in the hospital.

me either, doesn't help me at all generally. i do find that going out for (non strenous) walks in parks and nice places helps though, so i wonder if it's more to do with the environment than the exercise. working out at home or going to a dark, dingy gym is hardly going to make anyone feel better imo. i wonder if the people who find success with exercising are jogging outside and don't live in a shithole?

Hug a tree. It might be the only thing that loves you back.

There's always someone saying a treatment or diet or so on had no effect on them. The fact of the matter is that exercising is a thing that most people can do with their own bodies, and it has a positive effect versus depression for most people as well. It would be much better for a person to realize the exercise doesn't help their depression than to never try it and never have any path to solution.

What I did not see from any of the responses is what did you do instead? Exercising did not work. What did you do? At least the people positing exercise as an answer gave an actionable response. And it does work. Nothing works for everyone.

Oh how I wish this was true.

I've a high propensity for depression because basically my life has been very difficult. Was late to many many milestones in my life - I know it's individual but I've missed out on a ton of things.

Last time it hit me was the worst. Despite having a great toolset for dealing with it because it wasn't the first time, it was by the worst that I have ever seen.

I went to the gym and became fit and muscular. Added a ton of muscle even had visible abs but it barely did anything. If it did anything it was so small that it was barely noticable. Meditation didn't help. Nothing did. Just flashbacks persistent anxiety to the point where I couldn't even relax to have a chill conversation with anyone I was in robotic mode. It was triggered by heartbreak & the covid.

The worst was the inability to focus no matter the coffee my brain was just barely working. Attention span was at most 15 minutes. Everything seemed boring. The default state was so utterly bleak that a video on YT where people were chill and laughing was like absurd. The fatigue and lack of focus were the worst my mind just didn't grab onto things like it did before. It was terrifying.

I'm out of it now and happy as a clam. I'm not wiser at all through the process. What I've found is that this world is out of our control and if life wants us tomorrow to dismantle us. There are no guides, no tips, no tricks, no plans, no escaping to reason, no escaping to the gym nor anything like that.

Depression hits the control unit of the mind.

> You cannot get them to do anything. They only care about how sad they feel and care nothing about the effects their constant bed hiding imposes on all the people around them. It is utterly impossible to get them to treat themselves because... That involves getting out of bed .

Please don't use your anecdata to lump all depressed people into this bucket. I've been depressed for over a decade (diagnosed MDD) and this does not reflect me or my actions at all. In fact I've felt insanely guilty that my mood affects the others around me. This just causes me mask the depression, making me less likely to reach out to anyone when things get bad.

I guess I'd be what you'd call high-functioning depression. I've lived with it for so long its all I know. I moped my way to school, I did my work poorly, barely passed. Now I mope my way to work and I work and when I'm not burnt out I do a good enough job and then I go home and cry and go to sleep.

I would love to spend all day in bed, mostly because I'm constantly tired, and mostly because it's far more comfortable than doing anything else. But I have enough will and discipline to get up and do normal shit even if I'm cripplingly sad, bored, tired, and sometimes even teary eyed all day.

As for exercise, it helps me immensely! But I have in no way been cured by exercise alone.

yeah it's trying to save us like an allergic reaction is trying to save us

Maybe in the context of hunter-gathering societies, but not today.

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