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Comment by marquis | Hacker News Reader

The many many people in our lives suffering from a chemical/medical issue can not solve their problems with therapy alone. Depression is multi-factored and definitely partly chemical - maybe for some it's solved by spending more time in the sun but for many of our friends it is a serious clinical issue not to be mistaken as having a purely talk-it-out solution. Stephen is an excellent example here: he has the sheer intellect and forwardness of self-examination to know it can't be beat without looking at all factors and wouldn't presume to say that it's solved with drugs, or therapy, alone.

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And in these cases the situation can be exasperated by well meaning friends, relatives and practitioners searching for a root cause that, if addressed, will make it all go away.

Jesus christ, yes. This is why many people suffering from mental illness don't talk about their problems: they end up feeling worse because their friends either try to "fix" them, or they end up comforting the friend, or both. It's always with the best of intentions, but I recently had an experience where I truly understood how terminal cancer patients feel; a friend wanted so badly to help, and kept feeling worse and worse about what was going on with me, and I just tried my best to comfort them at my own expense.

When the only reason you haven't killed yourself is that you don't have the strength to do so, the last thing you want to do is have the people you love going down with you.

(Note, before people get worried: I'm on the way up again now, and getting the help I need to ensure I don't get bad again.)

I always cringe when I hear or read a non-depressed person's advice to a depressed person. It often involves getting more exercise and going out in the sun. Getting more exercise and sunlight might help this person, but it probably won't be enough. The person will probably need cognitive-behavioral therapy and maybe even medication. Even then, a depression-free life is not guaranteed. Mental illness is complicated.

If I was one of your friends, would you have liked me to have just treated you as I normally do? If I had someone close who was dying, when I'm seeing them I think I'd just interact with them as I normally do (though accepting and recognising they are, in fact, dying), and not let the fact that they were dying to get in the way of our relationship. I rationalize this by thinking people don't want to feel being pitied upon. They want to feel important; and seeing them just because I want to see them would help in that regard.

Am I doing the right thing?

Yes. Absolutely, absolutely, yes. What I want more than anything else: to feel normal. Even if it's just for 10 minutes while we're bitching about how bad some new album is, or playing a game. I won't say that's universal, but in my case I can't imagine anything better.

For me this depends very much on who it is that's trying to help.

If they've not experienced something similar to the mental health problems I'm suffering from it's usually best if they treat me as normal. The effort required to try and explain aspects of what I'm going through, usually with little success, is often far more detrimental than any benefit they could hope to provide. Being distracted from the problems, even if only for a short while, can be blissful and hugely appreciated.

On the other hand, I'm usually happy to be treated differently by people that have had similar experiences to me. I can often communicate to them in a sentence things which would take hours of conversation with somebody who'd not been there before.

It's a difficult situation for both the supporter and the supported, particularly in the early days.

> The effort required to try and explain aspects of what I'm going through, usually with little success, is often far more detrimental than any benefit they could hope to provide. Being distracted from the problems, even if only for a short while, can be blissful and hugely appreciated.

> On the other hand, I'm usually happy to be treated differently by people that have had similar experiences to me. I can often communicate to them in a sentence things which would take hours of conversation with somebody who'd not been there before.

I very much agree with both parts of what you've said here. I'm curious if & how you tend to balance between the two?

Generally when I'm having a bad time just having some casual distraction works fine, especially from someone who doesn't know what's wrong.

When I'm stuck in a rut, just having a few friends who can stop me bullshitting and keep me talking works wonders.

Most people I regularly spend time with are aware that I'm bipolar even if they aren't in the "been there" category. This is quite deliberate. When I'm well, I do my best to explain the difficulties I have during an episode to try and avoid people feeling alienated. This is not something I can do effectively whilst ill.

The result of this seems to be that when I become unwell people in this group provide me with the best kind of support that they're equipped to give while others help me talk it out.

Unfortunately this hasn't been so easy to achieve with family members as it has with friends since they're so desperate to see me well, although things are improving. Fortunately (or unfortunately) my wife is also bipolar so I don't have that problem with her.

As to balancing talking it out vs. distraction? I rapid cycle so distraction can be very effective for dealing with short-term mood swings. If I notice that I'm distracting myself a lot then that's a sign that bigger trouble is just around the corner and is when I start to seek help. My wife and I discuss the state of our mental health very frequently so there's always a certain amount of discussion going on as well.

In case you hadn't seen it, the author of Hyperbole and a Half recently posted about her depression, and she hit on similar things in a poignant way: http://hyperboleandahalf.blogspot.com/

Extensive HN thread: https://news.ycombinator.com/item?id=5684773

>maybe for some it's solved by spending more time in the sun but for many of our friends it is a serious clinical issue

Or so a 21st century corrupt medical establishment, that abuses and neglects science in favour of greed (from inventing mental issues out of thin air to over-prescribing medication, to even advocating unnecessary operations) likes to tell people.

Depression sure is a true medical condition for some (relatively few) people -- but in the quantities and degrees it affects the general population though, it's anything but.

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