11 ms·

On Depression & Getting Help

148 points by revorad 16y ago

mathgladiator 16y ago
Hypomania can affect mood. Hypothyroidism can also affect mood. Exercise can affect mood. You need to speak with your doctor about all three (or more since we are all different), and you need to find out if you need medication to get you out of the rut.
- berntb 16y ago
  I've found out that even allergy can affect mood. Not in a good way. (I have no idea how common it is.)
  - jackolas 16y ago
    Getting more and more common sadly. [Allergies in general]
- eavc 16y ago
  I don't understand the purpose of this comment, but it seems vaguely as though it is to suggest that "depression" is not a sufficient name for his condition and that its treatment through anti-depressants not a sufficient answer. I appreciate and support efforts to get people to continue to investigate their condition and to explore treatment options, but I bristle when it seems to stem from a kind of prejudice against psychology and psychiatry as it appears to here. (As an aside: Hypomania is on the opposite end of the emotional disorder spectrum from depression. Mentioning it here is akin to telling someone complaining of constipation that they may want to speak with their doctor about diarrhea.)
  - Alex3917 16y ago
    "I bristle when it seems to stem from a kind of prejudice against [] psychiatry as it appears to here." Why? The majority, of the research used to approve the most popular psychiatric drugs is outright fraudulent. And it's not like this is some undocumented fringe claim, there are literally dozens of books about this; the maker of the lexapro, drug the author is advocating, has racked up over 300 million dollars in fines this year alone for ethics violations related to the science of the drug in question. If you don't have a prejudice against psychiatry then you need to read more books.
    - eavc 16y ago
      Psychiatry is a branch of medicine based on the science of clinical psychology. The actions of a given pharmaceutical company hardly invalidate the discipline as a whole. Furthermore, a prejudice is never a good thing to have.
      - Alex3917 16y ago
        "The actions of a given pharmaceutical company hardly invalidate the discipline as a whole." It's not just one pharmaceutical company, it's the entire industry. The pharmaceutical industry now tops not only the defense industry, but all other industries in the total amount of fraud payments for actions against the federal government under the False Claims Act.[1] And the psychiatric drugs are, drug for drug, by far the worst offenders. And even for the drugs that haven't racked up massive fines, their scientific support is somewhere between terrible and non-existent. [1] http://www.citizen.org/hrg1924 http://www.citizen.org/hrg1924
        eavc 16y ago
        So you're telling me that psychotropic drugs have essentially zero scientific support as treatment for psychopathology?
        Alex3917 16y ago
        Yes, of course. Read Anatomy of an Epidemic, The Emperor's New Drugs, etc. Robert Whitaker's blog is also really great, although you wouldn't necessarily have all the information you'd need to read it unless you've already read the book.
        eavc 16y ago
        It's important not to throw the baby out with the bathwater. The enterprise of psychology and its application is a worthwhile and fruitful one despite errant ideas and applications in the past or in some of its member practitioners. To even dispute the efficacy of some aspect of psychology requires the practice of psychology. I grant that there are dangerous abuses and manipulations of the approvals process and public opinion, but it is also important to note that many psychotropics have a place in the treatment of dysfunction. I applaud that you are trying to spread the word about those abuses, but I encourage you to measure what you say so as not to group the nostrums and charlatans with the valid medications and practitioners of which many do exist.
samhay2u 16y ago
Beutiful article. For what its worth, i think society is coming around to mental illness. At least so in law enforcement. There are a whole brand new range of policies and proceedures for recognizing and addressing the signs,where as historacly they were much more abrasove and counter productive. However, i believe most of mankinds 21 st century mental illness issues area result of the industrial age where people are spending increasinly longer amounts of there waking hours in the abscence of sunlight. A study conducted by vanderbuilt university revealed that vitamin d3 was able to enhance the uv saturation produced synthetically by uv box lights on a populous of patients suffering from seasonal effectiveness disorder which is depression from lack of exposer to sunlight. I have stated taking vit d3 and have noticed a significant change in the dark montjs alone. You might want to ask your psyc about it to see if he would let you take it alongside rhe lexapro
blhack 16y ago
This is a very, very good lecture on depression: http://www.youtube.com/watch?v=NOAgplgTxfc http://www.youtube.com/watch?v=NOAgplgTxfc Honestly, I think the disorder should be renamed. People associate being "depressed" with the same feeling that they get if they drop their iPod into a lake. They're sad. General sadness is one of many of the ways that depression as a cognitive disorder can manifest itself. I can't tell you how many times I've talked to friends with real, serious, dangerous depression and heard that there are people who tell them that they just need to get over it and cheer up. You can't cure cancer with ice cream, same goes for depression.
- haploid 16y ago
  "[I] heard that there are people who tell them that they just need to get over it and cheer up." I do this. A great many of my friends and family do this too. I'm not sure why you find it so difficult to believe that there are people who do this. It's basically impossible for people without depression to imagine what it's like to be physically incapable of eventually "cheering up" or "getting over it". This is often compounded by the fact that depression( along with asperger's )is the modern hypochondriac's condition of choice. Combine inability to empathize with widespread attention whoring by people claiming to have depression when they don't, and it's quite easy to see why many people would react cynically or casually. It's rather unfortunate for those who are genuinely stricken with mental illness, though.
  - blhack 16y ago
    >I'm not sure why you find it so difficult to believe that there are people who do this. I didn't say that it was, I said that it was very common (which should indicate that it isn't difficult for me to believe). >It's basically impossible for people without depression to imagine what it's like to be physically incapable of eventually "cheering up" or "getting over it". This. Right here, exactly what you just said is the problem with people understanding this disease. "Cheering up" has absolutely nothing to do with getting over depression. This would be like feeding somebody with mono lots of redbull so that they would have more energy and wouldn't be sick anymore. >It's rather unfortunate for those who are genuinely stricken with mental illness, though. Yes, it is, and just about everything you wrote only serves to perpetuate the general lack of understanding that most people have when it comes to cognitive disorders.
Galilyou 16y ago
Man, this is serious! My wife is on a challenging treatment, and one of its side effects is depression. That opened my eye on a whole new meaning for the word. Thank you!
daeken 16y ago
Thank you, Rob, for writing this. I figure I'll tell a short version of my story (ok, I tried to make this short, but it didn't really work out well) as well. From an early age, my parents (both in the mental health field) recognized small symptoms of bipolar disorder in me -- periods of extreme energy and no sleep followed by lulls where I wouldn't want to do anything. However, they decided that the best course wasn't to do anything about it (or even tell me they had these concerns), as they figured it was just me being a kid. For what it's worth, I think they made the right choice. I was 15 or so when I started seeing these symptoms for myself, and saw them becoming more extreme. I would spend weeks programming furiously on The Next Big Thing (TM), then fall into an equally low period, which usually lasted about twice as long as the high. Originally in these low periods I just had trouble focusing on anything, slept a lot, etc, but gradually I saw them change into something very different. I became suicidal, and the smallest thing would set me off. If I got into an argument with my parents, I would just think "is all this worth it?" and start spiraling downward. My girlfriend at the time is the only reason I made it through; she helped me realize that this wasn't normal, and that I really should do something about it. At 16, I told my mom that I wanted to see Dr. D (a friend of the family, and probably the best psychiatrist in our small town). It came as no surprise to me to be diagnosed with bipolar I with rapid cycling; it wasn't uncommon to have extreme mood swings in between the longer periods, even happening several times a day at their worst. He then started me on various drugs. I don't recall the order or combinations, but I was on -- at one point or another -- lithium, Lamictal, Abilify, carbamazepine, Depakote, and others I can't remember now. None of the standard mood stabilizers worked; I either felt completely numb or was sick as a dog. Lithium in particular made me feel worse than I ever have in my life, emotionally and physically. We tried a couple combinations to balance things out, but in the end the mood stabilizers just weren't helping; in retrospect, though, I wonder if they were and I just couldn't recognize it in myself. Regardless, the next step was anti-psychotics; I wanted to be put on anti-depressants, as the lows were what bothered me, but it was simply too risky -- if they were successful, they could well put me into mania that I couldn't control. The anti-psychotics made me feel nothing. I don't know how I can explain this to someone who hasn't been there, but it's like your emotions just cease to exist. In theory, they worked, but a complete lack of emotions and creativity simply wasn't worth it. I was 17 by then, and I decided to stop taking all meds. I moved to San Diego for my first job shortly thereafter. I rode on an extreme high for the first few months I was there, working 18+ hour days. I was a 17 year old making more money than he should've been, and I took advantage of it. Sex, drugs, and rock and roll really describes it well. I went to shows, I met a girl (whom I took a cab to every weekend, an hour and a half each way, then got engaged to a month after we started dating), drank a lot, etc. In short, I did everything that someone in the throws of mania would do. It took a while for this to catch up to me, but as always with bipolar, it did. I crashed hard, and if it weren't for my fiancee at the time, there's no way I could've made it through. I frequently thought about checking into a hospital, but I thought I needed to push through. I'm not sure if I made the right decision or not, still. It took me a long time to really get myself in balance. The first step was to recognize what state I was in -- this is remarkably difficult. The next step was to learn how to bring myself back to normal when I started getting low, and I became quite good at it. Ignoring a few small fleeting thoughts, I haven't been suicidal in about 4 years. Then I learned how to embrace the manic side of it, and put it into my work without letting it go too far; I don't know that I ever really got very good at this, as my first two months in NYC have shown me lately. A combination of a good support network (key for everyone, IMO, not just those suffering from mental illnesses), knowing myself, and knowing when to say "no" has been crucial in me largely stabilizing myself over the past few years. It's not perfect by any means, but it's working better for me than anything else has. To close, I want to impress upon everyone the importance of getting help with mental illness. This doesn't necessarily mean medication (it certainly didn't in my case, even thought it was tried), but just knowing yourself is insanely important. Too many people refuse to get help, and end up in far worse place. I'm happy with my life as it stands, but it could easily have not gone this way.
noname123 16y ago
Why do people keep treating depression as a medical condition? You are depressed because your life sucks. Fix it or accept it. <eom>
- zackattack 16y ago
  This guy is being unfairly downvoted. A not insignificant number of cases of depression are rooted in not cultivating proper emotional awareness, and then ignoring the body's emotional signals. But people are unwilling and, frankly, unable to take responsibility for their emotional life so this attitude is an unpopular one. Also worth pointing out is that it's unrealistic to expect that everyone can be happy, some unhappiness is essential to social stability.
  - nollidge 16y ago
    They're not being downvoted unfairly. Yours was a nuanced and considered opinion (and I upvoted); theirs was absolute and unreasonable.
  - paganel 16y ago
    > Also worth pointing out is that it's unrealistic to expect that everyone can be happy, some unhappiness is essential to social stability. Thank you for this. This was one of the most important things I learned out of my (pretty) mild depression. Since then whenever I see people pretending to always be happy or at least striving to always be happy I sense that there's something wrong. That, and the thing that I began to understand what the Stoics were saying a little bit more (http://en.wikipedia.org/wiki/Stoicism http://en.wikipedia.org/wiki/Stoicism)
    - eavc 16y ago
      Be careful not to be cynical - happiness works on a bell curve much like intelligence or height. Some people are naturally much happier than average.
  - klondikered 16y ago
    No, he's not being unfairly downvoted, and I cannot upvote you either. You are basically talking out of your ass...please cite figures to back up what you mean by "a not insignificant number". And how, pray tell, is some unhappiness essential to "social stability", whatever that may be...
Alex3917 16y ago
"[Lexapro] addressed some chemical issues in my brain" Citation needed. Sorry, just because you have depression that doesn't give you a free pass to make stuff up.
daimyoyo 16y ago
I've been battling depression for years(binge and fasting cycles, not leaving the house for days on end, sleeping 14-16hrs a day) and I'd like help but I'm afraid the medication will affect my creativity. Do any creative people have experience with what medicines to try and which if any to avoid? Thanks.
- Mz 16y ago
  Depression is far from my real issue. (I am rarely depressed and if it lasts more than 3 days, it is usually due to anemia.) But I do have a serious medical issue that is normally treated with quite a lot of medication. I found the drug side effects more crippling than my (deadly) illness. I have made a lot of dietary and lifestyle changes and gotten off about 8 or 9 different prescription drugs -- and gotten my life back. If you really want to get better and also avoid medication, it may be possible to do exactly that. Peace and good luck.
- fbuilesv 16y ago
  Speaking from personal experience, worrying about creativity is the least of your problems when talking about depression. In my own case, I'd spend 4-6 months without doing anything at all besides sleeping. No side-projects, no programming, no guitar, nada; sleep, watch TV and sleep some more. Once I started taking medications I started programming again, going out, exercising a bit. Once you get to the point where depression is stopping you from doing anything, creativity is worthless (since you're not creating anything). I haven't found any serious consequence of taking the meds (Zoloft, Elavil and Remeron) w/r/t my creativity. I can still do the same things I used to do before, while mantaining the same level of quality. I've also found that it helps me push myself harder, which is pretty good.
ja27 16y ago
We're heading into the time of year that I've always struggled the most with my chronic depression. I really have to force myself to get outside and get sunlight, exercise, and eat better than usual. Those three things go a long way. The short days and cold weather really make it hard.
- iandanforth 16y ago
  Do you have a light box? Seasonal Affective Disorder has high co-morbidity with depression and getting the right amount of the right wavelengths of light at the right time has a surprisingly helpful effect. If you're into hacking in physical space (aka making stuff) set up your bedroom so that you get very bright light in the morning at a set time. Sunrise alarm clocks are crap so ignore them and build the system yourself.
- thewordpainter 16y ago
  force yourself into a routine, and it'll make it a whole lot easier. i also believe proper sleep cycles are especially important for those who are/have battled depression.
pella 16y ago
http://www.curetogether.com/depression/treatments/pmi/ http://www.curetogether.com/depression/treatments/pmi/ http://www.curetogether.com/depression/ig/treatment-effectiveness-vs-popularity http://www.curetogether.com/depression/ig/treatment-effectiv...
- pella 16y ago
  "What works for depression (and what doesn't)." http://bluepages.anu.edu.au/treatments/what_works/ http://bluepages.anu.edu.au/treatments/what_works/
  - eavc 16y ago
    St. John's Wort is as effective as anti-depressants? I'm skeptical of this page and encourage others to be as well.
    - JoshCole 16y ago
      http://www.informationisbeautiful.net/play/snake-oil-supplements/ http://www.informationisbeautiful.net/play/snake-oil-supplem... This data visualization suggests that saying that St. John's Wort isn't really snake oil.
veb 16y ago
I've had some unfortunate things happen to me, in turn which gave me extreme depression and PTSD. What I did was pretty simple... I did everything I could do to have a good nights sleep. If that meant exercise, better food etc, I did it. Now it's manageable without any various medications, doctors etc and that makes me feel pretty awesome. P.S. The Beatles would always make me cry when I was on a low. Heh.
eavc 16y ago
I am so pleased to find that this is a simple personal testimony about the value of professional treatment and support. I was expecting to find a folksy anecdote or some "hack," and I was pleasantly surprised.
rpeden 16y ago
I can't emphasize enough how important it is to seek treatment if you feel this way. For years, I just lived with it. I look back on those now as lost years when I could have accomplished a lot, but instead sat around accomplishing very little. Some people resist medication because they're afraid it will make them not feel anything at all. While this can certainly be the case for some medications, there are enough of them that you can usually find one that doesn't dampen your emotions completely. In my experience, antidepressants tend to put a 'floor' under your happiness; you don't fall down into the dark depths that are hard to escape from. You also don't become unhappy quite as easily; I found a big improvement in my ability to cope with external causes of stress and negativity.
gentrysherrill 16y ago
Really appreciate this article, as someone who has struggled with depression extensively and (more or less) come out the better for it. People who are experiencing the worst depression can mete out feel empty, desperate and alone in a way that is almost indescribable to anyone who has not felt that way. It's important for them to know that people care, are happy to speak with them, and that those who have had similar experiences have, eventually, found a happier and better existence.
phren0logy 16y ago
I'm a psychiatrist, an it is my great pleasure to treat people and see them get better. I'm glad this was posted to increase awareness of the seriousness of a Major Depression. It's a very misunderstood condition. Hope you continue to feel better.
RiderOfGiraffes 16y ago
This being Hacker News, my first thought was "Holy crap on a cracker - Andrew Koenig is dead!?!". Then I discovered there is another Andrew Koenig of whom I'd never heard, and it wasn't the author of Traps and Pitfalls who'd died. Just thought I'd mention it.

148 points by revorad 16y ago

Hypomania can affect mood. Hypothyroidism can also affect mood. Exercise can affect mood. You need to speak with your doctor about all three (or more since we are all different), and you need to find out if you need medication to get you out of the rut.

berntb 16y ago
I've found out that even allergy can affect mood. Not in a good way. (I have no idea how common it is.)
- jackolas 16y ago
  Getting more and more common sadly. [Allergies in general]
eavc 16y ago
I don't understand the purpose of this comment, but it seems vaguely as though it is to suggest that "depression" is not a sufficient name for his condition and that its treatment through anti-depressants not a sufficient answer. I appreciate and support efforts to get people to continue to investigate their condition and to explore treatment options, but I bristle when it seems to stem from a kind of prejudice against psychology and psychiatry as it appears to here. (As an aside: Hypomania is on the opposite end of the emotional disorder spectrum from depression. Mentioning it here is akin to telling someone complaining of constipation that they may want to speak with their doctor about diarrhea.)
- Alex3917 16y ago
  "I bristle when it seems to stem from a kind of prejudice against [] psychiatry as it appears to here." Why? The majority, of the research used to approve the most popular psychiatric drugs is outright fraudulent. And it's not like this is some undocumented fringe claim, there are literally dozens of books about this; the maker of the lexapro, drug the author is advocating, has racked up over 300 million dollars in fines this year alone for ethics violations related to the science of the drug in question. If you don't have a prejudice against psychiatry then you need to read more books.
  - eavc 16y ago
    Psychiatry is a branch of medicine based on the science of clinical psychology. The actions of a given pharmaceutical company hardly invalidate the discipline as a whole. Furthermore, a prejudice is never a good thing to have.
    - Alex3917 16y ago
      "The actions of a given pharmaceutical company hardly invalidate the discipline as a whole." It's not just one pharmaceutical company, it's the entire industry. The pharmaceutical industry now tops not only the defense industry, but all other industries in the total amount of fraud payments for actions against the federal government under the False Claims Act.[1] And the psychiatric drugs are, drug for drug, by far the worst offenders. And even for the drugs that haven't racked up massive fines, their scientific support is somewhere between terrible and non-existent. [1] http://www.citizen.org/hrg1924 http://www.citizen.org/hrg1924
      - eavc 16y ago
        So you're telling me that psychotropic drugs have essentially zero scientific support as treatment for psychopathology?
        Alex3917 16y ago
        Yes, of course. Read Anatomy of an Epidemic, The Emperor's New Drugs, etc. Robert Whitaker's blog is also really great, although you wouldn't necessarily have all the information you'd need to read it unless you've already read the book.
        eavc 16y ago
        It's important not to throw the baby out with the bathwater. The enterprise of psychology and its application is a worthwhile and fruitful one despite errant ideas and applications in the past or in some of its member practitioners. To even dispute the efficacy of some aspect of psychology requires the practice of psychology. I grant that there are dangerous abuses and manipulations of the approvals process and public opinion, but it is also important to note that many psychotropics have a place in the treatment of dysfunction. I applaud that you are trying to spread the word about those abuses, but I encourage you to measure what you say so as not to group the nostrums and charlatans with the valid medications and practitioners of which many do exist.

samhay2u 16y ago

Beutiful article. For what its worth, i think society is coming around to mental illness. At least so in law enforcement. There are a whole brand new range of policies and proceedures for recognizing and addressing the signs,where as historacly they were much more abrasove and counter productive. However, i believe most of mankinds 21 st century mental illness issues area result of the industrial age where people are spending increasinly longer amounts of there waking hours in the abscence of sunlight. A study conducted by vanderbuilt university revealed that vitamin d3 was able to enhance the uv saturation produced synthetically by uv box lights on a populous of patients suffering from seasonal effectiveness disorder which is depression from lack of exposer to sunlight. I have stated taking vit d3 and have noticed a significant change in the dark montjs alone. You might want to ask your psyc about it to see if he would let you take it alongside rhe lexapro

blhack 16y ago

This is a very, very good lecture on depression: http://www.youtube.com/watch?v=NOAgplgTxfc http://www.youtube.com/watch?v=NOAgplgTxfc Honestly, I think the disorder should be renamed. People associate being "depressed" with the same feeling that they get if they drop their iPod into a lake. They're sad. General sadness is one of many of the ways that depression as a cognitive disorder can manifest itself. I can't tell you how many times I've talked to friends with real, serious, dangerous depression and heard that there are people who tell them that they just need to get over it and cheer up. You can't cure cancer with ice cream, same goes for depression.

haploid 16y ago
"[I] heard that there are people who tell them that they just need to get over it and cheer up." I do this. A great many of my friends and family do this too. I'm not sure why you find it so difficult to believe that there are people who do this. It's basically impossible for people without depression to imagine what it's like to be physically incapable of eventually "cheering up" or "getting over it". This is often compounded by the fact that depression( along with asperger's )is the modern hypochondriac's condition of choice. Combine inability to empathize with widespread attention whoring by people claiming to have depression when they don't, and it's quite easy to see why many people would react cynically or casually. It's rather unfortunate for those who are genuinely stricken with mental illness, though.
- blhack 16y ago
  >I'm not sure why you find it so difficult to believe that there are people who do this. I didn't say that it was, I said that it was very common (which should indicate that it isn't difficult for me to believe). >It's basically impossible for people without depression to imagine what it's like to be physically incapable of eventually "cheering up" or "getting over it". This. Right here, exactly what you just said is the problem with people understanding this disease. "Cheering up" has absolutely nothing to do with getting over depression. This would be like feeding somebody with mono lots of redbull so that they would have more energy and wouldn't be sick anymore. >It's rather unfortunate for those who are genuinely stricken with mental illness, though. Yes, it is, and just about everything you wrote only serves to perpetuate the general lack of understanding that most people have when it comes to cognitive disorders.

Galilyou 16y ago

Man, this is serious! My wife is on a challenging treatment, and one of its side effects is depression. That opened my eye on a whole new meaning for the word. Thank you!

daeken 16y ago

Thank you, Rob, for writing this. I figure I'll tell a short version of my story (ok, I tried to make this short, but it didn't really work out well) as well. From an early age, my parents (both in the mental health field) recognized small symptoms of bipolar disorder in me -- periods of extreme energy and no sleep followed by lulls where I wouldn't want to do anything. However, they decided that the best course wasn't to do anything about it (or even tell me they had these concerns), as they figured it was just me being a kid. For what it's worth, I think they made the right choice. I was 15 or so when I started seeing these symptoms for myself, and saw them becoming more extreme. I would spend weeks programming furiously on The Next Big Thing (TM), then fall into an equally low period, which usually lasted about twice as long as the high. Originally in these low periods I just had trouble focusing on anything, slept a lot, etc, but gradually I saw them change into something very different. I became suicidal, and the smallest thing would set me off. If I got into an argument with my parents, I would just think "is all this worth it?" and start spiraling downward. My girlfriend at the time is the only reason I made it through; she helped me realize that this wasn't normal, and that I really should do something about it. At 16, I told my mom that I wanted to see Dr. D (a friend of the family, and probably the best psychiatrist in our small town). It came as no surprise to me to be diagnosed with bipolar I with rapid cycling; it wasn't uncommon to have extreme mood swings in between the longer periods, even happening several times a day at their worst. He then started me on various drugs. I don't recall the order or combinations, but I was on -- at one point or another -- lithium, Lamictal, Abilify, carbamazepine, Depakote, and others I can't remember now. None of the standard mood stabilizers worked; I either felt completely numb or was sick as a dog. Lithium in particular made me feel worse than I ever have in my life, emotionally and physically. We tried a couple combinations to balance things out, but in the end the mood stabilizers just weren't helping; in retrospect, though, I wonder if they were and I just couldn't recognize it in myself. Regardless, the next step was anti-psychotics; I wanted to be put on anti-depressants, as the lows were what bothered me, but it was simply too risky -- if they were successful, they could well put me into mania that I couldn't control. The anti-psychotics made me feel nothing. I don't know how I can explain this to someone who hasn't been there, but it's like your emotions just cease to exist. In theory, they worked, but a complete lack of emotions and creativity simply wasn't worth it. I was 17 by then, and I decided to stop taking all meds. I moved to San Diego for my first job shortly thereafter. I rode on an extreme high for the first few months I was there, working 18+ hour days. I was a 17 year old making more money than he should've been, and I took advantage of it. Sex, drugs, and rock and roll really describes it well. I went to shows, I met a girl (whom I took a cab to every weekend, an hour and a half each way, then got engaged to a month after we started dating), drank a lot, etc. In short, I did everything that someone in the throws of mania would do. It took a while for this to catch up to me, but as always with bipolar, it did. I crashed hard, and if it weren't for my fiancee at the time, there's no way I could've made it through. I frequently thought about checking into a hospital, but I thought I needed to push through. I'm not sure if I made the right decision or not, still. It took me a long time to really get myself in balance. The first step was to recognize what state I was in -- this is remarkably difficult. The next step was to learn how to bring myself back to normal when I started getting low, and I became quite good at it. Ignoring a few small fleeting thoughts, I haven't been suicidal in about 4 years. Then I learned how to embrace the manic side of it, and put it into my work without letting it go too far; I don't know that I ever really got very good at this, as my first two months in NYC have shown me lately. A combination of a good support network (key for everyone, IMO, not just those suffering from mental illnesses), knowing myself, and knowing when to say "no" has been crucial in me largely stabilizing myself over the past few years. It's not perfect by any means, but it's working better for me than anything else has. To close, I want to impress upon everyone the importance of getting help with mental illness. This doesn't necessarily mean medication (it certainly didn't in my case, even thought it was tried), but just knowing yourself is insanely important. Too many people refuse to get help, and end up in far worse place. I'm happy with my life as it stands, but it could easily have not gone this way.

noname123 16y ago

Why do people keep treating depression as a medical condition? You are depressed because your life sucks. Fix it or accept it. <eom>

zackattack 16y ago
This guy is being unfairly downvoted. A not insignificant number of cases of depression are rooted in not cultivating proper emotional awareness, and then ignoring the body's emotional signals. But people are unwilling and, frankly, unable to take responsibility for their emotional life so this attitude is an unpopular one. Also worth pointing out is that it's unrealistic to expect that everyone can be happy, some unhappiness is essential to social stability.
- nollidge 16y ago
  They're not being downvoted unfairly. Yours was a nuanced and considered opinion (and I upvoted); theirs was absolute and unreasonable.
- paganel 16y ago
  > Also worth pointing out is that it's unrealistic to expect that everyone can be happy, some unhappiness is essential to social stability. Thank you for this. This was one of the most important things I learned out of my (pretty) mild depression. Since then whenever I see people pretending to always be happy or at least striving to always be happy I sense that there's something wrong. That, and the thing that I began to understand what the Stoics were saying a little bit more (http://en.wikipedia.org/wiki/Stoicism http://en.wikipedia.org/wiki/Stoicism)
  - eavc 16y ago
    Be careful not to be cynical - happiness works on a bell curve much like intelligence or height. Some people are naturally much happier than average.
- klondikered 16y ago
  No, he's not being unfairly downvoted, and I cannot upvote you either. You are basically talking out of your ass...please cite figures to back up what you mean by "a not insignificant number". And how, pray tell, is some unhappiness essential to "social stability", whatever that may be...

Alex3917 16y ago

"[Lexapro] addressed some chemical issues in my brain" Citation needed. Sorry, just because you have depression that doesn't give you a free pass to make stuff up.

daimyoyo 16y ago

I've been battling depression for years(binge and fasting cycles, not leaving the house for days on end, sleeping 14-16hrs a day) and I'd like help but I'm afraid the medication will affect my creativity. Do any creative people have experience with what medicines to try and which if any to avoid? Thanks.

Mz 16y ago
Depression is far from my real issue. (I am rarely depressed and if it lasts more than 3 days, it is usually due to anemia.) But I do have a serious medical issue that is normally treated with quite a lot of medication. I found the drug side effects more crippling than my (deadly) illness. I have made a lot of dietary and lifestyle changes and gotten off about 8 or 9 different prescription drugs -- and gotten my life back. If you really want to get better and also avoid medication, it may be possible to do exactly that. Peace and good luck.
fbuilesv 16y ago
Speaking from personal experience, worrying about creativity is the least of your problems when talking about depression. In my own case, I'd spend 4-6 months without doing anything at all besides sleeping. No side-projects, no programming, no guitar, nada; sleep, watch TV and sleep some more. Once I started taking medications I started programming again, going out, exercising a bit. Once you get to the point where depression is stopping you from doing anything, creativity is worthless (since you're not creating anything). I haven't found any serious consequence of taking the meds (Zoloft, Elavil and Remeron) w/r/t my creativity. I can still do the same things I used to do before, while mantaining the same level of quality. I've also found that it helps me push myself harder, which is pretty good.

ja27 16y ago

We're heading into the time of year that I've always struggled the most with my chronic depression. I really have to force myself to get outside and get sunlight, exercise, and eat better than usual. Those three things go a long way. The short days and cold weather really make it hard.

iandanforth 16y ago
Do you have a light box? Seasonal Affective Disorder has high co-morbidity with depression and getting the right amount of the right wavelengths of light at the right time has a surprisingly helpful effect. If you're into hacking in physical space (aka making stuff) set up your bedroom so that you get very bright light in the morning at a set time. Sunrise alarm clocks are crap so ignore them and build the system yourself.
thewordpainter 16y ago
force yourself into a routine, and it'll make it a whole lot easier. i also believe proper sleep cycles are especially important for those who are/have battled depression.

pella 16y ago

http://www.curetogether.com/depression/treatments/pmi/ http://www.curetogether.com/depression/treatments/pmi/ http://www.curetogether.com/depression/ig/treatment-effectiveness-vs-popularity http://www.curetogether.com/depression/ig/treatment-effectiv...

pella 16y ago
"What works for depression (and what doesn't)." http://bluepages.anu.edu.au/treatments/what_works/ http://bluepages.anu.edu.au/treatments/what_works/
- eavc 16y ago
  St. John's Wort is as effective as anti-depressants? I'm skeptical of this page and encourage others to be as well.
  - JoshCole 16y ago
    http://www.informationisbeautiful.net/play/snake-oil-supplements/ http://www.informationisbeautiful.net/play/snake-oil-supplem... This data visualization suggests that saying that St. John's Wort isn't really snake oil.

veb 16y ago

I've had some unfortunate things happen to me, in turn which gave me extreme depression and PTSD. What I did was pretty simple... I did everything I could do to have a good nights sleep. If that meant exercise, better food etc, I did it. Now it's manageable without any various medications, doctors etc and that makes me feel pretty awesome. P.S. The Beatles would always make me cry when I was on a low. Heh.

eavc 16y ago

I am so pleased to find that this is a simple personal testimony about the value of professional treatment and support. I was expecting to find a folksy anecdote or some "hack," and I was pleasantly surprised.

rpeden 16y ago

I can't emphasize enough how important it is to seek treatment if you feel this way. For years, I just lived with it. I look back on those now as lost years when I could have accomplished a lot, but instead sat around accomplishing very little. Some people resist medication because they're afraid it will make them not feel anything at all. While this can certainly be the case for some medications, there are enough of them that you can usually find one that doesn't dampen your emotions completely. In my experience, antidepressants tend to put a 'floor' under your happiness; you don't fall down into the dark depths that are hard to escape from. You also don't become unhappy quite as easily; I found a big improvement in my ability to cope with external causes of stress and negativity.

gentrysherrill 16y ago

Really appreciate this article, as someone who has struggled with depression extensively and (more or less) come out the better for it. People who are experiencing the worst depression can mete out feel empty, desperate and alone in a way that is almost indescribable to anyone who has not felt that way. It's important for them to know that people care, are happy to speak with them, and that those who have had similar experiences have, eventually, found a happier and better existence.

phren0logy 16y ago

I'm a psychiatrist, an it is my great pleasure to treat people and see them get better. I'm glad this was posted to increase awareness of the seriousness of a Major Depression. It's a very misunderstood condition. Hope you continue to feel better.

RiderOfGiraffes 16y ago

This being Hacker News, my first thought was "Holy crap on a cracker - Andrew Koenig is dead!?!". Then I discovered there is another Andrew Koenig of whom I'd never heard, and it wasn't the author of Traps and Pitfalls who'd died. Just thought I'd mention it.