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Replying to you and the wu-ikkyu's sibling comment here: please see my comment at https://news.ycombinator.com/item?id=13118079 https://news.ycombinator.com/ite

Replying to you and the wu-ikkyu's sibling comment here: please see my comment at https://news.ycombinator.com/item?id=13118079 https://news.ycombinator.com/item?id=13118079 There's mounting evidence that depression is a biological disease, not a woo-woo problem with your mind. You seem to be presupposing that the mind somehow exists outside of biology, and that probably isn't the case. At best, advice like this is geared towards coping with it. (See also: https://www.newscientist.com/article/2095769-gut-bacteria-spotted-eating-brain-chemicals-for-the-first-time/ https://www.newscientist.com/article/2095769-gut-bacteria-sp...) While advice for coping -- from people, like you, who know what they're talking about -- is good and helpful (when limited to that context), the notion that depression is a thing that can be beat through sheer willpower should be beat back with the same intensity as the argument that sleeping with virgins will cure AIDS, and for the same reason.

Swizec 10y ago
I'm not saying it's a woo-woo problem of the mind. But it is a problem of the mind in that it's literally defined as "a mental disorder characterized by at least two weeks of low mood that is present across most situations.[1] It is often accompanied by low self-esteem, loss of interest in normally enjoyable activities, low energy, and pain without a clear cause." "mental" disorder --> mind stuff; Symptoms: "low mood, low self-esteem, loss of interest, low energy, pain". All mind stuff as well. Yes, it often requires drugs, and yes it usually/often/maybealways has an underlying cause of biological issues. But fixing it still requires fixing your mind. Because that's what's broken - your mind. The point is that just because something is a mental issue, doesn't mean you can fix it with will power and thought changes alone. But you definitely can't fix it without will power and thought changes. I like to think of beating depression like beating addiction. You first need to fix the biological stuff, and then you have to mentally keep making sure you don't slip back. Maybe forever. You need willpower to not go back down that road, to avoid situations that trigger depression in you, or hell, just to keep eating right and exercising and to make your mental health a priority because it does help. As my shrink used to say: the drugs give you the chance, but you do the work to fix your thoughts. Does that make more sense?
- thaumaturgy 10y ago
  Yeah, I get where you're going with it, and believe me, I'm not looking for excuses to disagree with you. (I upvoted you above; not sure why your comment in particular, of all the responses, got downvoted.) There are a couple of points I feel compelled to push back on though. First is the word "fix". This might seem like quibbling, but that really bothers me, and I think for not-trivial reasons. When a problem is fixed, it doesn't recur. Addiction and depression are never fixed. They can be coped-with, they can be treated, a person can live a (well, mostly) normal life as an addict or with depression. I think this is important because any advice or treatment offered to people with depression should be practical and it's critical not to imply, "this will fix you." The other is that we have to be exceedingly careful when suggesting mental changes as a treatment for depression, because that can easily be misinterpreted by other people to mean that depression is caused by "bad thinking", or that a person struggling with depression can "just think their way out of it", and I submit this entire HN thread as evidence for that (and could probably dig a few more out of my comment history). That, I think, is distinctly unhelpful for people struggling with depression. They will tend to already be struggling with those thoughts as it is: "why am I broken? Come on me! Be better! Just be happy! Everyone else is happy!" and having other people show up and offer, essentially, the same advice, is really harmful. And fwiw I too am speaking from far too much experience, both personal and family.
  - Swizec 10y ago
    You're right, fixing is the wrongf terminology to use because depressed peoplr aren't broken per se. It's harmful to suggest they are especially since thinking that is one of the core tenets of depression. Fwiw I don't think mental changes treat depression. I think they're the result of treating it. At the least they go hand in hand with the process. Mental changes aren't a sufficient step to get out of depression, but they are a required step. It's hard to put these things into words because they're on the intuitive side of my brain, but thanks for the chance to try. As for the downvoters, screw 'em. I got points to burn. Maybe what I'm saying can help some people make some sense of the process.
nitrogen 10y ago
I think you and the other commenters may be closer to agreement than you think, and perhaps just mixing terminology. By my reading they are both saying that sheer will is not the answer, and are not suggesting a dualistic mind either. If the mind is the brain and vice versa, then it might stand to reason that in some cases the thought<->physiology<->environment feedback cycle that traps one in depression can be addressed not by willpower, but by selectively interrupting whatever part of the feedback cycle is easiest to access or most pronounced for a particular depressed person.
- thaumaturgy 10y ago
  > in some cases the thought<->physiology<->environment feedback cycle that traps one in depression can be addressed not by willpower, but by selectively interrupting whatever part of the feedback cycle is easiest to access or most pronounced for a particular depressed person. I've wondered about that for many years, and it's the strategy I adopted for myself a very long time ago, but I've seen scant evidence for either its effectiveness for most other people or any evidence for its basis in reality. Like I just said elsethread, I'm more concerned here with other people misinterpreting the suggestions being offered and then sharing those with people with depression in a way which is ultimately harmful. I'm probably being a little louder than I need to be about it.

Swizec 10y ago

I'm not saying it's a woo-woo problem of the mind. But it is a problem of the mind in that it's literally defined as "a mental disorder characterized by at least two weeks of low mood that is present across most situations.[1] It is often accompanied by low self-esteem, loss of interest in normally enjoyable activities, low energy, and pain without a clear cause." "mental" disorder --> mind stuff; Symptoms: "low mood, low self-esteem, loss of interest, low energy, pain". All mind stuff as well. Yes, it often requires drugs, and yes it usually/often/maybealways has an underlying cause of biological issues. But fixing it still requires fixing your mind. Because that's what's broken - your mind. The point is that just because something is a mental issue, doesn't mean you can fix it with will power and thought changes alone. But you definitely can't fix it without will power and thought changes. I like to think of beating depression like beating addiction. You first need to fix the biological stuff, and then you have to mentally keep making sure you don't slip back. Maybe forever. You need willpower to not go back down that road, to avoid situations that trigger depression in you, or hell, just to keep eating right and exercising and to make your mental health a priority because it does help. As my shrink used to say: the drugs give you the chance, but you do the work to fix your thoughts. Does that make more sense?

thaumaturgy 10y ago
Yeah, I get where you're going with it, and believe me, I'm not looking for excuses to disagree with you. (I upvoted you above; not sure why your comment in particular, of all the responses, got downvoted.) There are a couple of points I feel compelled to push back on though. First is the word "fix". This might seem like quibbling, but that really bothers me, and I think for not-trivial reasons. When a problem is fixed, it doesn't recur. Addiction and depression are never fixed. They can be coped-with, they can be treated, a person can live a (well, mostly) normal life as an addict or with depression. I think this is important because any advice or treatment offered to people with depression should be practical and it's critical not to imply, "this will fix you." The other is that we have to be exceedingly careful when suggesting mental changes as a treatment for depression, because that can easily be misinterpreted by other people to mean that depression is caused by "bad thinking", or that a person struggling with depression can "just think their way out of it", and I submit this entire HN thread as evidence for that (and could probably dig a few more out of my comment history). That, I think, is distinctly unhelpful for people struggling with depression. They will tend to already be struggling with those thoughts as it is: "why am I broken? Come on me! Be better! Just be happy! Everyone else is happy!" and having other people show up and offer, essentially, the same advice, is really harmful. And fwiw I too am speaking from far too much experience, both personal and family.
- Swizec 10y ago
  You're right, fixing is the wrongf terminology to use because depressed peoplr aren't broken per se. It's harmful to suggest they are especially since thinking that is one of the core tenets of depression. Fwiw I don't think mental changes treat depression. I think they're the result of treating it. At the least they go hand in hand with the process. Mental changes aren't a sufficient step to get out of depression, but they are a required step. It's hard to put these things into words because they're on the intuitive side of my brain, but thanks for the chance to try. As for the downvoters, screw 'em. I got points to burn. Maybe what I'm saying can help some people make some sense of the process.

nitrogen 10y ago

I think you and the other commenters may be closer to agreement than you think, and perhaps just mixing terminology. By my reading they are both saying that sheer will is not the answer, and are not suggesting a dualistic mind either. If the mind is the brain and vice versa, then it might stand to reason that in some cases the thought<->physiology<->environment feedback cycle that traps one in depression can be addressed not by willpower, but by selectively interrupting whatever part of the feedback cycle is easiest to access or most pronounced for a particular depressed person.

thaumaturgy 10y ago
> in some cases the thought<->physiology<->environment feedback cycle that traps one in depression can be addressed not by willpower, but by selectively interrupting whatever part of the feedback cycle is easiest to access or most pronounced for a particular depressed person. I've wondered about that for many years, and it's the strategy I adopted for myself a very long time ago, but I've seen scant evidence for either its effectiveness for most other people or any evidence for its basis in reality. Like I just said elsethread, I'm more concerned here with other people misinterpreting the suggestions being offered and then sharing those with people with depression in a way which is ultimately harmful. I'm probably being a little louder than I need to be about it.