9 ms·

We Need New Ways of Treating Depression

87 points by dpflan 9y ago

elptacek 9y ago
If this is a way to treat depression, maybe dialing back the crap way we treat each other is preventative. I've been angry for a long time that I have to take medication because most of my life was full of people who seemed to get some sort of perverse pleasure out of making me feel bad for things I cannot control (like being female, nearsighted and unattractive). Somehow it's not possible to simply disagree with someone else and state your contrary opinion, but rather to escalate quickly to aggression and personal attacks. Somehow it's not possible that we can organize ourselves so that a greater number of people can have their physiological needs met, much less feel safe and heaven forbid we should feel love/belonging or have a modicum of self-esteem because how would advertisers ever sell anybody anything? And along comes the internet where anyone is entitled to say anything from a distance and not have to look into the eyes of the human being they're taking a scrap of dignity from.
- Santosh83 9y ago
  Particularly family and close friends. I really don't give a damn what one-time acquaintances and Internet handles say, but when people who should know you better don't, that can be severely damaging. Ultimately I think depression is really chronic existential crisis along with alienation, and while I don't preclude treatment with drugs (as there could be associated physiological aspects that can be corrected and normalised), ultimately one has to 'find' the meaning and joy that can get you out of the rut oneself. But its not easy.
  - agumonkey 9y ago
    Chronic existential crisis can be accidental too. I'm barely out ot a clinical critical one and it was the sum very long time factors that just exploded at the same time in ways that were near impossible for me to predict. Anyway, drug can be very helpful (coming from someone who refrained to use them) to smooth the bad peaks. It's impossible to fight that.. kinda like a bleeding. Then you can work on other aspects. Also depression has some absurd side, because as long as your brain is tilted nothing works, the day it starts to balance again, for no special reason, you'll start to have mental energy and pleasure you forgot you could have.
- aeorgnoieang 9y ago
  Your comment comes across as pretty hostile, e.g. that I personally am someone that cannot "simply disagree", that I'd rather "escalate quickly to aggression and personal attacks", etc. You're not attacking me personally; you're attacking everyone (indirectly). I hope you can surround yourself with better people!
  - inetknght 9y ago
    @elptacek's comment does not strike me as hostile. It resonates with me.
    - deleted 9y ago
      [deleted]
- shrimp_emoji 9y ago
  >And along comes the internet where anyone is entitled to say anything from a distance and not have to look into the eyes of the human being they're taking a scrap of dignity from. That's the wonderful thing about the Internet; it's not real life! Personally, I think it's a hoot, but you have to sublimate the pain with humor. :D
  - tarken 9y ago
    If you think insulting people on the internet is fun because "it's not real life" that makes you an asshole.
    - shrimp_emoji 9y ago
      Don't get me wrong, insulting people in any medium is fun, but it's less fun in real life because - you're limited to insulting only those in physical proximity, and the logistics of traveling around and repeating insults for greater insult coverage are a hassle, - your insults are easily traced to your identity, opening the possibility of social or legal consequences, - and, unlike the Internet, physical harm is an option in real life, which is a very bad consequence! That's why, for assholes or political dissidents alike, the Internet is so wonderful!
  - bhhaskin 9y ago
    But the internet is real life. It isn't some alternate reality. Your actions online effect real people offline, and they also reflect you. I think a lot of people forget that.
- FPGAhacker 9y ago
  I think this is 100% spot on correct. Life is damn hard and cruel without our help as it is. We don't need to add to it, and yet we do. Thank you for posting this. Being able to have a conversation with someone of differing opinion, and keeping it a conversation and not an assault, is immensely valuable for both parties.
- dec0dedab0de 9y ago
  ...I have to take medication because...of people who seemed to get some sort of perverse pleasure out of making me feel bad... In my head I boiled your comment down to that, and it hit pretty hard. I have had people encourage me to take anti-depressants because of my reaction to the way they're treating me.
  - agumonkey 9y ago
    I'm on your "friends" side with family members. You made me reconsider some aspects of the situation.
  - elptacek 9y ago
    There's a word for that. Gaslighting.
- bobthechef 9y ago
  Sounds to me like you have a lot of baggage. What you've written is evidently of a highly personal nature. Homo homini lupus est.
  - dang 9y ago
    That crosses into personal attack. Please don't do this, regardless of how someone's comment lands with you; it breaks the site guidelines and eventually gets you banned. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
    - m3g4synC 9y ago
      it is called "guidelines" for a reason, for weenies cannot comprehend
- fit2rule 9y ago
  Bring back teaching 'manners and comportment' in schools! Seriously!
dpflan 9y ago
This article about depression is also on the front page at the moment. Seems good to link for more references and discussion: > https://news.ycombinator.com/item?id=16491986 https://news.ycombinator.com/item?id=16491986
getcrunk 9y ago
How about god and hoping for paradise. World's made to break you
sgtmas2006 9y ago
Social Prescribing has only ever had a negative outcome on me, as well as most medications. Zoloft made me extremely suicidal, Lamotrigine for mood stabilization made me lose my hair. The only medication that's ever worked for me is addictive, and prone to abuse. It helps with my severe social anxiety, and prevents rumination. Because of the addictive nature of it, I do not take it. I understand that things such as "social prescribing" may help some, but it is detrimental to me. I have no desire to be forced around a group of people that I have no known common interests, and may have none. I feel that reading the majority of discussions to treat depression fall short in my case, as a lot of them involve other people or outdoor activity. My general disregard for other people and existence as a whole tends to be an issue. I'm sure this can help some, but it seems to just be what most people understand already.
- SkyPuncher 9y ago
  > Zoloft made me extremely suicidal Were you on an upswing in your mood? There's a tough period with anti-depressants where people are on an upswing to a more positive position. They haven't yet broke free of overwhelming suicidal thoughts and low mood, but now have energy and motivation to actually do things. Unfortunately, that means suicidal thoughts that seemed too difficult now appear possible. It's a really interesting and tough situation. Being suicidal can actually indicate things are working properly, but will still need 4 to 6 weeks to get you to a more positive place.
  - DanBC 9y ago
    Yes, but also some anti depressant medication causes suicidal thoughts and actions in some people. (This isn't an argument against taking medication).
    - SkyPuncher 9y ago
      > Yes, but also some anti depressant medication causes suicidal thoughts and actions in some people. I'm not arguing that. I'm arguing why it occurs as it's a really interesting reason. When you're super down in the dumps, you simply don't have energy for anything. Even thinking about suicide is a chore so you simply don't do it. When you start on an anti-depressant, it doesn't literally cause to become more depressed or suicidal.It causes suicidal thoughts by giving you the energy to actually have difficult thoughts and actions - including suicidal thoughts.
throwaway____ 9y ago
I think that the effects of food/digestion are still hugely overlooked as an underlying cause/catalyst of mental illness in general, and not the other way around. Here's a clinical psychologist and professor of psychology who discovered the same thing for both himself and his daughter [1]. They only eat meat now, basically. [1] - https://www.youtube.com/watch?v=A6g_geYeL4U https://www.youtube.com/watch?v=A6g_geYeL4U
mhkool 9y ago
www.brokenbrain.com is what you should look at.
mkstowegnv 9y ago
Ancient wisdom and modern science support the idea that exercise and nurturing are highly effecting in fighting depression. I once spent a day in a log cabin splitting wood, dancing and baking bread and thought to myself if everyone in the world could do one of these things every day most of the world's problems wound evaporate. My specific favorite prescription for the slings and arrow of outrageous fortune is an aerobic, geometric, tribal form of dancing that is challenging but easy to learn with a subculture that welcomes and celebrates beginners - contradancing [1]. I also recommend listening to uplifting music such as Stan Roger's Mary Ellen Carter [2] 1 http://www.burningmancontradance.com/home/contraintro http://www.burningmancontradance.com/home/contraintro 2 https://www.youtube.com/watch?v=Fhop5VuLDIQ https://www.youtube.com/watch?v=Fhop5VuLDIQ
DubiousPusher 9y ago
> We offer, and are offered, drugs as the first, and often last, recourse. This is one of the many mental health memes I wish would die. I've lived my entire life with several close family members and friends who have severe mental illnesses. I have been to hundreds of appointments across dozens of providers. I have never NEVER seen a doctor give a patient a once over and then prescribe meds. I understand there are bad psychiatrists out there. Just like there are bad mechanics, bad accountants and bad everythings. But I believe the vast majority of psychiatrists understand the limits psychoactive medications. I think it would be farely rare that a psychiatrist doesn't also discuss lifestyle changes and recommend some kind of talk therapy along with medication.
- ravenstine 9y ago
  I think many psychiatrists prescribe first because people who are clinically depressed have such a high rate of suicide that it's better to first reduce the risk pf death before further treatment. I'm not saying that applying that principle so broadly is a good thing, but I can see where they're coming from.
  - gnode 9y ago
    Sometimes antidepressants can increase the risk of suicide, however. This is a commonly enumerated side effect in their advice leaflets. One theory of depression is that it's evolved to take away our motivation to kill ourselves in the face of extreme adversity.
    - DubiousPusher 9y ago
      True, the link between antidepressants and suicide is a current area of study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034101/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034101/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3353604/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3353604/ In no way do I want to diminish how serious these drugs are. They can have a profound effect on a person's behavior that occurs in a very short period. Finding a medication regimen that works for a person is a serious undertaking. It often takes years. A person may have to taper on and off dozens of different regimens to find a good effect while minimizing side effects. The constant personal changes a person experiences through this process can strain relationships, ruin careers and much worse.
aaavl2821 9y ago
There's a story Andrew Solomon tells that's not unlike the Southeast Asia anecdote. Andrew traveled the world trying to understand how other cultures experience depression as a way to deal with his own depression In one African village, he asked the residents what they thought of western depression treatments. They said "why don't you bring people outside, so they can feel the sun on their skin? Why don't you dance with them, so they can feel energy of others? Why, instead, do you shut them in a dark room, alone with a stranger, to talk about things that make them sad?" It's an interesting talk, and one that illustrates just how little we know about depression
- jvogt 9y ago
  > Why, instead, do you shut them in a dark room, alone with a stranger, to talk about things that make them sad? FWIW, this isn't really how therapy goes. At least from my CBT experiences, its a few minutes of talking about what we're currently struggling with, then decoding those topics to learn how we distort our experiences and memories towards the negative / stressful. Then usually the "homework" would be small actionable steps to build up habits to become aware of these distortions, as well as habits to make other healthy choices. Not discounting Andrew's story one bit, just putting a bit more light on what modern therapy aims towards.
  - starpilot 9y ago
    The general idea is true though. For a depressed person, we aim to isolate them with a clinician instead of surrounding them with friends. We even use "therapy" as a kind insult: "You should go to therapy!" as if mental illness is something to be shamed. The overall notion is that there's something wrong with people who are depressed, and that we'd rather wash our hands of it than help them. We have similar attitudes toward the homeless and the incarcerated. It's a very puritan/Calvinist attitude, that "certain people" are innately bad, but pervasive in even progressively minded Americans.
    - d0lph 9y ago
      Friends/therapist is a false dichotomy, any good therapist encourages socializing. Depressed people are not mentally healthy, it's a condition that can lead to suicide. Being sad is not bad, but when someone is diagnosed with depression, or any mental disorder, it's because it's affecting their lives negatively. Also the rooms have do have lights in them.
deleted 9y ago
[deleted]
bobthechef 9y ago
The article should read more like "We need new ways of identifying and defining depression".
tachyoff 9y ago
We need to stop giving people reasons to be miserable then. I know too many millennials working two or three crappy service jobs for peanuts, never going to the doctor because being a server or Uber driver doesn't provide health insurance, and constantly ha-ha-only-seriously joking about becoming alcoholics for it to be just a coincidence that so many people are depressed. Oh, and I'm sure our disgusting sugar-laden diets aren't helping anything either. But maybe some basic social safety is necessary? I'd be pretty miserable too if I were afraid a single ambulance ride was going to bankrupt me (as it all too often does to Americans).
JonCox 9y ago
Here's a nifty idea.. start researching cheap, low harm, but powerful drugs again, instead of banning the research. Perhaps some new ways of treating depression using LSD or suchlike will come from the research. Perhaps not. Hard to know while the science is banned. https://www.maps.org/research/other-research https://www.maps.org/research/other-research
kungfooman 9y ago
Healthy body, (probably) healthy mind. The food industry makes us sick (meat full of anti biotics etc. killing good and bad gut bacteria) and the pharma industry makes the money (anti depressants etc.). Nobody wants you either dead or living. The industry wants you on the edge. Then you are a money machine for them. Everybody should evaluate their blood results once every month and get a copy of it. At home, graph your blood data in Excel/whatnot. Eat healthy, live healthy, look how your blood results change. Zinc deficit is also very important to treat, as it keeps the whole immune system running etc. As long everybody seems to only want to find "the right anti depressant" the pharma industry laughs its ass of for the fools not treating the root problems.
icc97 9y ago
This story is by Johann Hari who has an interesting TED talk about addiction [0]. He put addiction down to the amount of connections that people have and seems to be arguing something similar in this article too. Googling bought up this criticism of the video [1] for some perspective (with Hari, to his credit, answering the criticisms). [0]: https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong https://www.ted.com/talks/johann_hari_everything_you_think_y... [1]: https://www.thefix.com/content/4-things-hari-gets-wrong-about-addiction https://www.thefix.com/content/4-things-hari-gets-wrong-abou...
goodroot 9y ago
Not a mention of plant-based medicines and psychedelic, spirit-centric treatments of depression? There's enough data at this point that this seems willfully obtuse. We need new ways, yes, and they're out there. These new ways need champions. Ayahuasca changed my life and banished two decades of born-into depression. I have seen dozens of people transform thanks to this medicine. I've seen similar, incredible transformations from Psilocybin. Daily meditation keeps me in balance and singing tunes of contentedness. They're out there!
ltwdm 9y ago
I have doubts about the authors intentions: Look up the wikipedia article and in the past he has done things of questionable integrity to be popular. He is a good storyteller and there is strong criticism from the medical professionals about his skewed views about ineffectiveness of current treatment methods. He does not cite enough references for such a hevayweight topic. I have no problem in him presenting a new perspective, but this is more of getting into the bestseller book list by telling you what you wish to hear.
jdietrich 9y ago
Caveat lector: Johann Hari, the author of this piece, was involved in a major integrity scandal in 2011. He resigned from his job at The Independent after being accused of habitual plagiarism and admitted to vandalising the Wikipedia articles of journalists who had criticised him. https://en.wikipedia.org/wiki/Johann_Hari#2011_scandals https://en.wikipedia.org/wiki/Johann_Hari#2011_scandals His recent book Lost Connections, on which most of his recent articles about depression have been based, has faced widespread criticism for misrepresenting the evidence on depression and how it is treated. https://www.theguardian.com/science/brain-flapping/2018/jan/08/is-everything-johann-hari-knows-about-depression-wrong-lost-connections https://www.theguardian.com/science/brain-flapping/2018/jan/... http://www.independent.co.uk/voices/johann-hari-depression-anti-depressants-psychiatrists-pills-therapy-change-lifestyle-job-psychology-a8151606.html http://www.independent.co.uk/voices/johann-hari-depression-a... https://anotherangrywoman.com/2018/01/08/five-things-wrong-with-johann-haris-comeback-book-that-i-spotted-from-the-extract-alone/ https://anotherangrywoman.com/2018/01/08/five-things-wrong-w...
Im_back_4_U 9y ago
The best way would be to lower the rent. Depression is mostly caused by rent seeking, which the entire "Western" or "modern" world is founded on. Quite literally high rates of depression are caused by poverty. Money can't buy you love, but it can get everything else that prevents or diminishes depression. Oh wait, money can actually buy you love, in fact only money actually really gives love a chance. And we do know don't we that depression is, as far as it is something fixable, lack of others loving you. We have a depression problem because money, resources, are horded.
fit2rule 9y ago
I've been saying it for years - depressed? One-way plane ticket to another culture, preferably completely foreign: solved. And I've seen it work, time and again. So many times, I cannot be swayed: if you're depressed, you need to move. The deeper the depression, the more convinced you are that there is no solution: the further you need to fly, friend. No, its not easy. (Except it is). Yes, you will have to learn a new language (except that is fun and very rewarding once you do it). No, your culture is not important, you can shed it in an instant - all it takes is that boarding pass, man.
- Bakary 9y ago
  Funnily enough I became depressed from precisely this move. I don't think it is bad advice, however. But it did make me chuckle.
shellkr 9y ago
I can not talk about how things is done in other countries... but everyone who reads Psychology (and/or psychiatry) in grade school knows about Aaron Antonovsky and the "sense of coherance" theory. Everyone in health care who study assistant nurse and up knows about this theory. So this is not something new or unknown about. It is not biology or social.. it is biology and social. Both play a part. I live in a Scandinavian country and we are very aware that loneliness is an important cause for depression. The problem is.. you can't force people to be social. Family might be the problem. So drugs can be a solution until you find a more permanent solution.

87 points by dpflan 9y ago

If this is a way to treat depression, maybe dialing back the crap way we treat each other is preventative. I've been angry for a long time that I have to take medication because most of my life was full of people who seemed to get some sort of perverse pleasure out of making me feel bad for things I cannot control (like being female, nearsighted and unattractive). Somehow it's not possible to simply disagree with someone else and state your contrary opinion, but rather to escalate quickly to aggression and personal attacks. Somehow it's not possible that we can organize ourselves so that a greater number of people can have their physiological needs met, much less feel safe and heaven forbid we should feel love/belonging or have a modicum of self-esteem because how would advertisers ever sell anybody anything? And along comes the internet where anyone is entitled to say anything from a distance and not have to look into the eyes of the human being they're taking a scrap of dignity from.

Santosh83 9y ago
Particularly family and close friends. I really don't give a damn what one-time acquaintances and Internet handles say, but when people who should know you better don't, that can be severely damaging. Ultimately I think depression is really chronic existential crisis along with alienation, and while I don't preclude treatment with drugs (as there could be associated physiological aspects that can be corrected and normalised), ultimately one has to 'find' the meaning and joy that can get you out of the rut oneself. But its not easy.
- agumonkey 9y ago
  Chronic existential crisis can be accidental too. I'm barely out ot a clinical critical one and it was the sum very long time factors that just exploded at the same time in ways that were near impossible for me to predict. Anyway, drug can be very helpful (coming from someone who refrained to use them) to smooth the bad peaks. It's impossible to fight that.. kinda like a bleeding. Then you can work on other aspects. Also depression has some absurd side, because as long as your brain is tilted nothing works, the day it starts to balance again, for no special reason, you'll start to have mental energy and pleasure you forgot you could have.
aeorgnoieang 9y ago
Your comment comes across as pretty hostile, e.g. that I personally am someone that cannot "simply disagree", that I'd rather "escalate quickly to aggression and personal attacks", etc. You're not attacking me personally; you're attacking everyone (indirectly). I hope you can surround yourself with better people!
- inetknght 9y ago
  @elptacek's comment does not strike me as hostile. It resonates with me.
  - deleted 9y ago
    [deleted]
shrimp_emoji 9y ago
>And along comes the internet where anyone is entitled to say anything from a distance and not have to look into the eyes of the human being they're taking a scrap of dignity from. That's the wonderful thing about the Internet; it's not real life! Personally, I think it's a hoot, but you have to sublimate the pain with humor. :D
- tarken 9y ago
  If you think insulting people on the internet is fun because "it's not real life" that makes you an asshole.
  - shrimp_emoji 9y ago
    Don't get me wrong, insulting people in any medium is fun, but it's less fun in real life because - you're limited to insulting only those in physical proximity, and the logistics of traveling around and repeating insults for greater insult coverage are a hassle, - your insults are easily traced to your identity, opening the possibility of social or legal consequences, - and, unlike the Internet, physical harm is an option in real life, which is a very bad consequence! That's why, for assholes or political dissidents alike, the Internet is so wonderful!
- bhhaskin 9y ago
  But the internet is real life. It isn't some alternate reality. Your actions online effect real people offline, and they also reflect you. I think a lot of people forget that.
FPGAhacker 9y ago
I think this is 100% spot on correct. Life is damn hard and cruel without our help as it is. We don't need to add to it, and yet we do. Thank you for posting this. Being able to have a conversation with someone of differing opinion, and keeping it a conversation and not an assault, is immensely valuable for both parties.
dec0dedab0de 9y ago
...I have to take medication because...of people who seemed to get some sort of perverse pleasure out of making me feel bad... In my head I boiled your comment down to that, and it hit pretty hard. I have had people encourage me to take anti-depressants because of my reaction to the way they're treating me.
- agumonkey 9y ago
  I'm on your "friends" side with family members. You made me reconsider some aspects of the situation.
- elptacek 9y ago
  There's a word for that. Gaslighting.
bobthechef 9y ago
Sounds to me like you have a lot of baggage. What you've written is evidently of a highly personal nature. Homo homini lupus est.
- dang 9y ago
  That crosses into personal attack. Please don't do this, regardless of how someone's comment lands with you; it breaks the site guidelines and eventually gets you banned. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
  - m3g4synC 9y ago
    it is called "guidelines" for a reason, for weenies cannot comprehend
fit2rule 9y ago
Bring back teaching 'manners and comportment' in schools! Seriously!

dpflan 9y ago

This article about depression is also on the front page at the moment. Seems good to link for more references and discussion: > https://news.ycombinator.com/item?id=16491986 https://news.ycombinator.com/item?id=16491986

getcrunk 9y ago

How about god and hoping for paradise. World's made to break you

sgtmas2006 9y ago

Social Prescribing has only ever had a negative outcome on me, as well as most medications. Zoloft made me extremely suicidal, Lamotrigine for mood stabilization made me lose my hair. The only medication that's ever worked for me is addictive, and prone to abuse. It helps with my severe social anxiety, and prevents rumination. Because of the addictive nature of it, I do not take it. I understand that things such as "social prescribing" may help some, but it is detrimental to me. I have no desire to be forced around a group of people that I have no known common interests, and may have none. I feel that reading the majority of discussions to treat depression fall short in my case, as a lot of them involve other people or outdoor activity. My general disregard for other people and existence as a whole tends to be an issue. I'm sure this can help some, but it seems to just be what most people understand already.

SkyPuncher 9y ago
> Zoloft made me extremely suicidal Were you on an upswing in your mood? There's a tough period with anti-depressants where people are on an upswing to a more positive position. They haven't yet broke free of overwhelming suicidal thoughts and low mood, but now have energy and motivation to actually do things. Unfortunately, that means suicidal thoughts that seemed too difficult now appear possible. It's a really interesting and tough situation. Being suicidal can actually indicate things are working properly, but will still need 4 to 6 weeks to get you to a more positive place.
- DanBC 9y ago
  Yes, but also some anti depressant medication causes suicidal thoughts and actions in some people. (This isn't an argument against taking medication).
  - SkyPuncher 9y ago
    > Yes, but also some anti depressant medication causes suicidal thoughts and actions in some people. I'm not arguing that. I'm arguing why it occurs as it's a really interesting reason. When you're super down in the dumps, you simply don't have energy for anything. Even thinking about suicide is a chore so you simply don't do it. When you start on an anti-depressant, it doesn't literally cause to become more depressed or suicidal.It causes suicidal thoughts by giving you the energy to actually have difficult thoughts and actions - including suicidal thoughts.

throwaway____ 9y ago

I think that the effects of food/digestion are still hugely overlooked as an underlying cause/catalyst of mental illness in general, and not the other way around. Here's a clinical psychologist and professor of psychology who discovered the same thing for both himself and his daughter [1]. They only eat meat now, basically. [1] - https://www.youtube.com/watch?v=A6g_geYeL4U https://www.youtube.com/watch?v=A6g_geYeL4U

mhkool 9y ago

www.brokenbrain.com is what you should look at.

mkstowegnv 9y ago

Ancient wisdom and modern science support the idea that exercise and nurturing are highly effecting in fighting depression. I once spent a day in a log cabin splitting wood, dancing and baking bread and thought to myself if everyone in the world could do one of these things every day most of the world's problems wound evaporate. My specific favorite prescription for the slings and arrow of outrageous fortune is an aerobic, geometric, tribal form of dancing that is challenging but easy to learn with a subculture that welcomes and celebrates beginners - contradancing [1]. I also recommend listening to uplifting music such as Stan Roger's Mary Ellen Carter [2] 1 http://www.burningmancontradance.com/home/contraintro http://www.burningmancontradance.com/home/contraintro 2 https://www.youtube.com/watch?v=Fhop5VuLDIQ https://www.youtube.com/watch?v=Fhop5VuLDIQ

DubiousPusher 9y ago

> We offer, and are offered, drugs as the first, and often last, recourse. This is one of the many mental health memes I wish would die. I've lived my entire life with several close family members and friends who have severe mental illnesses. I have been to hundreds of appointments across dozens of providers. I have never NEVER seen a doctor give a patient a once over and then prescribe meds. I understand there are bad psychiatrists out there. Just like there are bad mechanics, bad accountants and bad everythings. But I believe the vast majority of psychiatrists understand the limits psychoactive medications. I think it would be farely rare that a psychiatrist doesn't also discuss lifestyle changes and recommend some kind of talk therapy along with medication.

ravenstine 9y ago
I think many psychiatrists prescribe first because people who are clinically depressed have such a high rate of suicide that it's better to first reduce the risk pf death before further treatment. I'm not saying that applying that principle so broadly is a good thing, but I can see where they're coming from.
- gnode 9y ago
  Sometimes antidepressants can increase the risk of suicide, however. This is a commonly enumerated side effect in their advice leaflets. One theory of depression is that it's evolved to take away our motivation to kill ourselves in the face of extreme adversity.
  - DubiousPusher 9y ago
    True, the link between antidepressants and suicide is a current area of study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034101/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034101/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3353604/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3353604/ In no way do I want to diminish how serious these drugs are. They can have a profound effect on a person's behavior that occurs in a very short period. Finding a medication regimen that works for a person is a serious undertaking. It often takes years. A person may have to taper on and off dozens of different regimens to find a good effect while minimizing side effects. The constant personal changes a person experiences through this process can strain relationships, ruin careers and much worse.

aaavl2821 9y ago

There's a story Andrew Solomon tells that's not unlike the Southeast Asia anecdote. Andrew traveled the world trying to understand how other cultures experience depression as a way to deal with his own depression In one African village, he asked the residents what they thought of western depression treatments. They said "why don't you bring people outside, so they can feel the sun on their skin? Why don't you dance with them, so they can feel energy of others? Why, instead, do you shut them in a dark room, alone with a stranger, to talk about things that make them sad?" It's an interesting talk, and one that illustrates just how little we know about depression

jvogt 9y ago
> Why, instead, do you shut them in a dark room, alone with a stranger, to talk about things that make them sad? FWIW, this isn't really how therapy goes. At least from my CBT experiences, its a few minutes of talking about what we're currently struggling with, then decoding those topics to learn how we distort our experiences and memories towards the negative / stressful. Then usually the "homework" would be small actionable steps to build up habits to become aware of these distortions, as well as habits to make other healthy choices. Not discounting Andrew's story one bit, just putting a bit more light on what modern therapy aims towards.
- starpilot 9y ago
  The general idea is true though. For a depressed person, we aim to isolate them with a clinician instead of surrounding them with friends. We even use "therapy" as a kind insult: "You should go to therapy!" as if mental illness is something to be shamed. The overall notion is that there's something wrong with people who are depressed, and that we'd rather wash our hands of it than help them. We have similar attitudes toward the homeless and the incarcerated. It's a very puritan/Calvinist attitude, that "certain people" are innately bad, but pervasive in even progressively minded Americans.
  - d0lph 9y ago
    Friends/therapist is a false dichotomy, any good therapist encourages socializing. Depressed people are not mentally healthy, it's a condition that can lead to suicide. Being sad is not bad, but when someone is diagnosed with depression, or any mental disorder, it's because it's affecting their lives negatively. Also the rooms have do have lights in them.

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bobthechef 9y ago

The article should read more like "We need new ways of identifying and defining depression".

tachyoff 9y ago

We need to stop giving people reasons to be miserable then. I know too many millennials working two or three crappy service jobs for peanuts, never going to the doctor because being a server or Uber driver doesn't provide health insurance, and constantly ha-ha-only-seriously joking about becoming alcoholics for it to be just a coincidence that so many people are depressed. Oh, and I'm sure our disgusting sugar-laden diets aren't helping anything either. But maybe some basic social safety is necessary? I'd be pretty miserable too if I were afraid a single ambulance ride was going to bankrupt me (as it all too often does to Americans).

JonCox 9y ago

Here's a nifty idea.. start researching cheap, low harm, but powerful drugs again, instead of banning the research. Perhaps some new ways of treating depression using LSD or suchlike will come from the research. Perhaps not. Hard to know while the science is banned. https://www.maps.org/research/other-research https://www.maps.org/research/other-research

kungfooman 9y ago

Healthy body, (probably) healthy mind. The food industry makes us sick (meat full of anti biotics etc. killing good and bad gut bacteria) and the pharma industry makes the money (anti depressants etc.). Nobody wants you either dead or living. The industry wants you on the edge. Then you are a money machine for them. Everybody should evaluate their blood results once every month and get a copy of it. At home, graph your blood data in Excel/whatnot. Eat healthy, live healthy, look how your blood results change. Zinc deficit is also very important to treat, as it keeps the whole immune system running etc. As long everybody seems to only want to find "the right anti depressant" the pharma industry laughs its ass of for the fools not treating the root problems.

icc97 9y ago

This story is by Johann Hari who has an interesting TED talk about addiction [0]. He put addiction down to the amount of connections that people have and seems to be arguing something similar in this article too. Googling bought up this criticism of the video [1] for some perspective (with Hari, to his credit, answering the criticisms). [0]: https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong https://www.ted.com/talks/johann_hari_everything_you_think_y... [1]: https://www.thefix.com/content/4-things-hari-gets-wrong-about-addiction https://www.thefix.com/content/4-things-hari-gets-wrong-abou...

goodroot 9y ago

Not a mention of plant-based medicines and psychedelic, spirit-centric treatments of depression? There's enough data at this point that this seems willfully obtuse. We need new ways, yes, and they're out there. These new ways need champions. Ayahuasca changed my life and banished two decades of born-into depression. I have seen dozens of people transform thanks to this medicine. I've seen similar, incredible transformations from Psilocybin. Daily meditation keeps me in balance and singing tunes of contentedness. They're out there!

ltwdm 9y ago

I have doubts about the authors intentions: Look up the wikipedia article and in the past he has done things of questionable integrity to be popular. He is a good storyteller and there is strong criticism from the medical professionals about his skewed views about ineffectiveness of current treatment methods. He does not cite enough references for such a hevayweight topic. I have no problem in him presenting a new perspective, but this is more of getting into the bestseller book list by telling you what you wish to hear.

jdietrich 9y ago

Caveat lector: Johann Hari, the author of this piece, was involved in a major integrity scandal in 2011. He resigned from his job at The Independent after being accused of habitual plagiarism and admitted to vandalising the Wikipedia articles of journalists who had criticised him. https://en.wikipedia.org/wiki/Johann_Hari#2011_scandals https://en.wikipedia.org/wiki/Johann_Hari#2011_scandals His recent book Lost Connections, on which most of his recent articles about depression have been based, has faced widespread criticism for misrepresenting the evidence on depression and how it is treated. https://www.theguardian.com/science/brain-flapping/2018/jan/08/is-everything-johann-hari-knows-about-depression-wrong-lost-connections https://www.theguardian.com/science/brain-flapping/2018/jan/... http://www.independent.co.uk/voices/johann-hari-depression-anti-depressants-psychiatrists-pills-therapy-change-lifestyle-job-psychology-a8151606.html http://www.independent.co.uk/voices/johann-hari-depression-a... https://anotherangrywoman.com/2018/01/08/five-things-wrong-with-johann-haris-comeback-book-that-i-spotted-from-the-extract-alone/ https://anotherangrywoman.com/2018/01/08/five-things-wrong-w...

Im_back_4_U 9y ago

The best way would be to lower the rent. Depression is mostly caused by rent seeking, which the entire "Western" or "modern" world is founded on. Quite literally high rates of depression are caused by poverty. Money can't buy you love, but it can get everything else that prevents or diminishes depression. Oh wait, money can actually buy you love, in fact only money actually really gives love a chance. And we do know don't we that depression is, as far as it is something fixable, lack of others loving you. We have a depression problem because money, resources, are horded.

fit2rule 9y ago

I've been saying it for years - depressed? One-way plane ticket to another culture, preferably completely foreign: solved. And I've seen it work, time and again. So many times, I cannot be swayed: if you're depressed, you need to move. The deeper the depression, the more convinced you are that there is no solution: the further you need to fly, friend. No, its not easy. (Except it is). Yes, you will have to learn a new language (except that is fun and very rewarding once you do it). No, your culture is not important, you can shed it in an instant - all it takes is that boarding pass, man.

Bakary 9y ago
Funnily enough I became depressed from precisely this move. I don't think it is bad advice, however. But it did make me chuckle.

shellkr 9y ago

I can not talk about how things is done in other countries... but everyone who reads Psychology (and/or psychiatry) in grade school knows about Aaron Antonovsky and the "sense of coherance" theory. Everyone in health care who study assistant nurse and up knows about this theory. So this is not something new or unknown about. It is not biology or social.. it is biology and social. Both play a part. I live in a Scandinavian country and we are very aware that loneliness is an important cause for depression. The problem is.. you can't force people to be social. Family might be the problem. So drugs can be a solution until you find a more permanent solution.