4 ms·

Denial is rarely a complete thing. Most people will say they aren't 'that' depressed right up to being put in a clinic. People really overestimate the organiza

Denial is rarely a complete thing. Most people will say they aren't 'that' depressed right up to being put in a clinic. People really overestimate the organizational capacity of somebody in deep depression. Getting a doctor's appointment, showing up, then talking honestly about your problems is really hard. It's doubly hard if you think you have alternatives. Getting medical help is a really big step. Taking St-John's Wort, or eating more cumin, isn't. And that would be great if they were equivalent. But for a lot of people, they absolutely aren't. Otherwise doctors would prescribe exercise and sunlight. I'd be really happy if every advice column on depression just told people to go to a doctor. I mean, jesus, imagine if somebody put a github repo up about how to self-treat cholera! Depression is really dangerous. It kills a lot of people. If you have it, you should talk to a professional - not read random studies that are probably p-hacking anyway.

jm__87 8y ago
While I don't share your pessimism for self help, I do understand where you're coming from and I updated my post to make it very clear that I do agree that those suffering from depression should seek out professional help as well as offering some advice for doing so.
jimnotgym 8y ago
I will try and answer both of your posts together if that is OK. 1) I have suffered from and lived with sufferers of depression for my whole life. It is rare for me to say so on a public forum, but there it is. 2) I have been in a dangerous place and sought medical help. I was prescribed drugs which had catastrophic side-effects on me, and which persisted for years after I went through the horrible withdrawal process that the said drug causes. The drug was closer to killing me than the depression. I taught myself a kind of CBT (I didn't know it was called that back then) and I have been coping drug free for nearly two decades. 3) In the UK mental-health services are barely existent except for those in the most extreme circumstances, after nearly a decade of government cuts. Doctors prescribe drugs because that is all they can do. They refer you to counseling, but you face months of wait. Anecdotally it seems that most depression suffers never get the therapy that may really help them. Much of this is cultural in that somehow in 2018 people still think depression is not a real disease. 4) These stories are extremely popular on HN, and often make it to the front page, which suggests there is a demand. > probably p-hacking anyway. 5) What an absurd slur. > doctors would prescribe exercise and sunlight 6) They most certainly do exactly this. I have heard it with my own ears. A doctor told a person I know that they should try St. Johns Wort before risking anti-depressents. > jesus, imagine if somebody put a github repo up about how to self-treat cholera! 7) Is a strawman, but since you brought it up, prevention of Cholera is most definitely a self-help exercise of some worth. I believe the main treatment is 'hydration' btw. I urge all Cholera suffers who are able to to seek out medical attention, for those with no access to it, hydration would seem like a valuable self-help technique. > I'd be really happy if every advice column on depression just told people to go to a doctor 8) This list does that in the opening section. It suggests discussing the articles with a doctor too. > I went through a period of simply trying everything anybody recommended, no matter how ridiculous 9) The antithesis of researching a list of articles and being well informed when you chose to visit your medical professional to discuss it with them. If you are in the frame of mind to try snake-oil, I seriously doubt a list like this would make any difference either way. 10) Not all depression sufferers are 'cured' by their doctor. Not all react well (or at all) to drugs. Everyone I know who has learned to manage their depression has (once they have got through the denial) done it through lifestyle changes, CBT, lighting, exercise etc. If you search through the links you will find novel drug therapies which are helping people (dramatically) who have had no benefit at all from existing medicine, and have been shown to do so in a peer reviewed study (before you repeat that slur). If a close family member of mine was in that situation I have no doubt at all that I would be keen for them to find out about it and go and discuss it with their doctor. 11) I don't feel the need to protect anyone from information.
- pasabagi 8y ago
  Obviously you had a bad experience with anti-depressants - many people do. I have also had bad experiences with various drugs. The english mental health system is horrible, agreed. However, I don't think reading articles, however scientific, is a substitute for five years of training to be a psychiatrist or psychologist - and if you don't think p-hacking is endemic in this space, I have a bridge to sell you. I can't stop you doing what you are doing. But if you tell somebody who has cholera that 'drinking water' was an alternative to going to a doctor, and they died, you'd go to prison. If even one person takes your advice, against the scientific consensus that anti-depressants work, tries to 'hack' their depression with your 'alternatives', you'll be partially responsible for the outcome. Ultimately, the question is: are you confident enough of your psychiatric/psychological credentials to offer advice about a life-threatening condition? Because that is what you are doing.
  - jimnotgym 8y ago
    > However, I don't think reading articles, however scientific, is a substitute for five years of training to be a psychiatrist or psychologist Why do you keep pushing this line? The page quite clearly says on line 4 and line 6 that you should talk to a doctor. It even suggests discussing the listed things with a doctor. If a doctor prescribed me a statin to help with my cholesterol, then I went away and read up and found that reducing the amount of bacon I was eating would also help, then I went back and discussed that with my doctor, am I better or worse off? If I delete my Github account right now does the information I linked to go away? In lots of cases I have linked to the discussion rather than the article, where the extraordinarily critical HN crowd have pulled the article apart, searched for p-hacking and other frauds and discussed any merits. Is that better or worse than the tabloid stories that abound on health? I don't see how more information about your condition could be a bad thing?
  - jm__87 8y ago
    I think the point here is everything should be on the table? Is there any advice here that is harmful?

jm__87 8y ago

While I don't share your pessimism for self help, I do understand where you're coming from and I updated my post to make it very clear that I do agree that those suffering from depression should seek out professional help as well as offering some advice for doing so.

jimnotgym 8y ago

I will try and answer both of your posts together if that is OK. 1) I have suffered from and lived with sufferers of depression for my whole life. It is rare for me to say so on a public forum, but there it is. 2) I have been in a dangerous place and sought medical help. I was prescribed drugs which had catastrophic side-effects on me, and which persisted for years after I went through the horrible withdrawal process that the said drug causes. The drug was closer to killing me than the depression. I taught myself a kind of CBT (I didn't know it was called that back then) and I have been coping drug free for nearly two decades. 3) In the UK mental-health services are barely existent except for those in the most extreme circumstances, after nearly a decade of government cuts. Doctors prescribe drugs because that is all they can do. They refer you to counseling, but you face months of wait. Anecdotally it seems that most depression suffers never get the therapy that may really help them. Much of this is cultural in that somehow in 2018 people still think depression is not a real disease. 4) These stories are extremely popular on HN, and often make it to the front page, which suggests there is a demand. > probably p-hacking anyway. 5) What an absurd slur. > doctors would prescribe exercise and sunlight 6) They most certainly do exactly this. I have heard it with my own ears. A doctor told a person I know that they should try St. Johns Wort before risking anti-depressents. > jesus, imagine if somebody put a github repo up about how to self-treat cholera! 7) Is a strawman, but since you brought it up, prevention of Cholera is most definitely a self-help exercise of some worth. I believe the main treatment is 'hydration' btw. I urge all Cholera suffers who are able to to seek out medical attention, for those with no access to it, hydration would seem like a valuable self-help technique. > I'd be really happy if every advice column on depression just told people to go to a doctor 8) This list does that in the opening section. It suggests discussing the articles with a doctor too. > I went through a period of simply trying everything anybody recommended, no matter how ridiculous 9) The antithesis of researching a list of articles and being well informed when you chose to visit your medical professional to discuss it with them. If you are in the frame of mind to try snake-oil, I seriously doubt a list like this would make any difference either way. 10) Not all depression sufferers are 'cured' by their doctor. Not all react well (or at all) to drugs. Everyone I know who has learned to manage their depression has (once they have got through the denial) done it through lifestyle changes, CBT, lighting, exercise etc. If you search through the links you will find novel drug therapies which are helping people (dramatically) who have had no benefit at all from existing medicine, and have been shown to do so in a peer reviewed study (before you repeat that slur). If a close family member of mine was in that situation I have no doubt at all that I would be keen for them to find out about it and go and discuss it with their doctor. 11) I don't feel the need to protect anyone from information.

pasabagi 8y ago
Obviously you had a bad experience with anti-depressants - many people do. I have also had bad experiences with various drugs. The english mental health system is horrible, agreed. However, I don't think reading articles, however scientific, is a substitute for five years of training to be a psychiatrist or psychologist - and if you don't think p-hacking is endemic in this space, I have a bridge to sell you. I can't stop you doing what you are doing. But if you tell somebody who has cholera that 'drinking water' was an alternative to going to a doctor, and they died, you'd go to prison. If even one person takes your advice, against the scientific consensus that anti-depressants work, tries to 'hack' their depression with your 'alternatives', you'll be partially responsible for the outcome. Ultimately, the question is: are you confident enough of your psychiatric/psychological credentials to offer advice about a life-threatening condition? Because that is what you are doing.
- jimnotgym 8y ago
  > However, I don't think reading articles, however scientific, is a substitute for five years of training to be a psychiatrist or psychologist Why do you keep pushing this line? The page quite clearly says on line 4 and line 6 that you should talk to a doctor. It even suggests discussing the listed things with a doctor. If a doctor prescribed me a statin to help with my cholesterol, then I went away and read up and found that reducing the amount of bacon I was eating would also help, then I went back and discussed that with my doctor, am I better or worse off? If I delete my Github account right now does the information I linked to go away? In lots of cases I have linked to the discussion rather than the article, where the extraordinarily critical HN crowd have pulled the article apart, searched for p-hacking and other frauds and discussed any merits. Is that better or worse than the tabloid stories that abound on health? I don't see how more information about your condition could be a bad thing?
- jm__87 8y ago
  I think the point here is everything should be on the table? Is there any advice here that is harmful?