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Everyone wants a pill as a quick effortless fix, but IMO it seems a lot of our modern afflictions come down to an gross imbalance of exercise, diet, sleep, and

Everyone wants a pill as a quick effortless fix, but IMO it seems a lot of our modern afflictions come down to an gross imbalance of exercise, diet, sleep, and social connection. Most likely the way society (see disclaimer) currently functions - how we work, how we consume our limited leisure time is sort of an occupational hazard to peak health. Not to mention, exercise is "too hard" for most, the food supply is weaponized with sugar and FUD, everyone is so tired at the end of their "BS job" workday, so hit the couch and stream the streams. And now you have a vicious flywheel that quickly turns people into candidates for the latest big-pharma "cure" HN Disclaimer: I'm in the US and making generalizations based on my observations. Not saying that there aren't needs for pharma / pills / afflictions that aren't solvable by the above, etc...

kerpotgh 4y ago
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elric 4y ago
> gross imbalance of exercise, diet, sleep, and social connection Indeed. What's worse is that we, as individuals, know this. But we, as in the western society at large, seem to be utterly unwilling or incapable of addressing this. Long working hours to make ends meet. The shittiest food is the most convenient option. There's a metric fuckton of light- and sound pollution which messes with our sleep. 10% of folks suffer from sleep apnea for a variety of reasons. So many things are messing with us. At some point, we're going to have to start dealing with these things.
jasonhansel 4y ago
> Everyone wants a pill as a quick effortless fix Isn't a quick, effortless fix the ideal goal? Wouldn't that be better than a slow, difficult one? Lifestyle changes are a lot harder and more time-consuming than taking a pill; if the latter were equally effective and low-risk for all people, it would obviously be the better choice.
polished85 4y ago
I've subscribed to this line of thinking my whole life, and mostly still do, but I've had to reassess after watching/listening to the case of Andres Iniesta, a professional footballer who sought professional help in the Summer of 2009. A starter for FC Barcelona and the Spanish national team, having just won the 2009 European Champions league with FC Barcelona and the 2008 European Championship with Spain. Multimillionaire and in peak physical condition, yet fell into a deep depression during the peak of his life. Definitely caused me to reassess my assumptions on clinical depression.
danavar 4y ago
There is a book that I’ve had recommended to me that posits a similar idea to what you’re saying - it’s called “The Myth of Mental Illness” - I have not read it yet, but will pass along the recommendation to you.
- asveikau 4y ago
  > The Myth of Mental Illness Having been close to a few people with psychotic disorders (I'm not misusing that term, I mean paranoid delusions, hallucinations, ...), this rubs me the wrong way. A mild case of depression may be safe to approach this way but with serious psychiatric problems that is dangerous. The author wrote a book saying schizophrenia doesn't exist, and was made up by psychiatrists. While it's probably true that it's a blanket term for what are probably multiple causes or possibly more of a spectrum disorder, I have seen schizophrenia up close. It would be foolish to say it doesn't exist, in that there are millions of suffering people in existence who fit the symptom criteria and benefit from treatment. You also need to be careful about people who advocate this position because some of them are affiliated with cults.
asveikau 4y ago
> Not to mention, exercise is "too hard" for most, > Disclaimer: I'm in the US These are related. This is largely from car dependence. In a lot of places you can get daily exercise through walking.
gatonegro 4y ago
> it seems a lot of our modern afflictions come down to an gross imbalance of exercise, diet, sleep, and social connection If you think about it in an evolutionary timescale, the way most of us live in the West these days is horrendously incompatible with the sort of life we evolved to live. Thousands and thousands of years were spent out in nature, in small communities, eating certain types of foods, engaging in physical activities, etc. The sit-on-a-chair-all-day, look-at-screens-all-day lifestyle is a comparatively new development, and neither our minds nor our bodies are suited for such an existence. That's enough to cause us a fair amount of trouble. Add all the socioeconomic issues you mention into the mix, and it all starts to make perfect sense to me.
PragmaticPulp 4y ago
> Everyone wants a pill as a quick effortless fix, but IMO it seems a lot of our modern afflictions come down to an gross imbalance of exercise, diet, sleep, and social connection. For what it's worth, exercise, diet, sleep, social engagement, and lifestyle changes are well-known inputs to addressing depression. Therapists will explore and encourage improvements in all of these areas. Good psychiatrists will as well, given enough time and a patient who is open to listening. One of the difficult issues is that many depressed patients often don't want to hear any suggestions that depression might be due to anything other than external factors. This is why the pop-science version of the "chemical imbalance" theory became so popular in the mainstream: It gives a plausible explanation that depression is just something that happens to you due to no fault of your own, which is weirdly easier to accept for many people. There are similar treatment problems with a host of health issues, such as obesity. The trend on social media and pop culture is to explain obesity away as a chemical or societal problem, minimizing the input of personal choice and actions. It's very popular to propose theories that "counting calories doesn't work" or hear anecdotes about people who claim to only eat less than 1000 calories per day but never lose weight (which isn't possible, even 100% sedentary coma patients need more calories than that).
- kar5pt 4y ago
  I could flip this around and say that focusing on internal causes of depression is a way for those in power to avoid the social responsibility of having to change it. We can kick the responsibility ball back and forth all day. Why is it so hard for people to get adequate sleep, exercise, a good diet and social interaction? Even most non-depressed people I know don't do these things well (except maybe the last one), so this isn't something unique to depression.
  - ryanwaggoner 4y ago
    Exactly this. We throw people into a sick society and then blame them for their lack of personal responsibility when they get sick themselves. As an individual, yes, do what you can (which might mean changing to a less “sick” culture or subculture so you’re not fighting a sisyphean battle). And also, we should do better as a society.
com2kid 4y ago
I know the serotonin theory of depression is pretty much dead, but it is a fact that being around people raises serotonin levels. For introverts it is tiring, but it is better than not being around people. Being around people reduces cognitive decline in old age. Being around people reduces depression levels. Being in a supportive community reduces the severity of symptoms from schizophrenia. The 2+2 nuclear family concept is an abomination, we are supposed to live in a multigenerational community, surrounded by friends and family. The modern American lifestyle destroys psychological health. Without large social circles, finding romantic partners is hard, which leads to all sorts of negative life outcomes. Raising kids is hard, friends of mine who have nearby extended family have a much easier time raising kids (and are more likely to have more kids!) Heck my sister had kids 20 years before I did (bit of an age difference), 2 sets of grand parents, lots of free baby sitting, and aunts and uncles to help out with homework. It was also useful for me, I got to learn a lot about babies early on. > gross imbalance of exercise, diet, sleep, and social connection Yeah lots of these are solved with a large social group. I have some good friends (who sadly now live a bit aways from me) who host dinner parties 3 or 4 nights a week. People come over and help cook and clean up, so everyone eats healthy meals all the time. Friends who have lots of family nearby, just rotate whose house they go to on different nights, all the kids and adults after school/work get together to do child care and cooking. Healthy food for everyone, less work. Lots of modern life scales up really well. 2 parents will get exhausted taking care of 1 baby, between cooking, cleaning, and watching the child. 4 parents, 3 kids? Much easier. Seriously, piece of cake. 3 grand parents, 4 parents, a young auntie, 5 kids? No problem at all. Society has seriously screwed the pooch. If I had some insane amount of capitol I'd try to start some sort of shared housing for families, do intense interviews to match people up (see: My last failed startup) people cook together, raise kids together, support each other. Put 3-5 new/young families in a mid size housing complex with a shared yard. Put a support network in place, house chaperone (cough RA cough) to help out now and then. Extended Family as a Service. Dystopian, maybe, but possibly it'd do a lot of good in the world. (If any investors want to get in touch, please do, :-D )
- AnIdiotOnTheNet 4y ago
  > Society has seriously screwed the pooch. Pretty much all available data says as much, but we refuse to do anything about it. Hell, most refuse to recognize there's even a problem.
2OEH8eoCRo0 4y ago
I think so too. 9 times out of 10 a person has horrible eating, sleeping, or drug habits and a sedentary lifestyle.
robocat 4y ago
I’ll add situational-depression to your list: an ongoing sadness due to being stuck in a bad circumstance (bad relationship, terrible job, etcetera). The defining factor is that once the bad circumstance is “fixed”, the long-term sadness is quickly gone (replaced with ongoing contentment) and symptoms don’t reappear. This is not an academic definition, just a personal observation, although perhaps you have seen the effect happen to others in your life. I’ve had situational-depression badly enough that I would easily have been diagnosed as clinically depressed (more than one person said so, and if I had gone to a doctor I am sure I would have been given a label and some pills). When the cause was resolved, I immediately switched out of the funk and all symptoms of “depression” were gone. I don’t believe it was correlation, that is I don’t believe depression lifting caused me to fix my bad circumstance: I don’t think I had any influence over the actual date the underlying cause was “fixed”. Chronic clinical depression is not usually fixed in a day.
stronglikedan 4y ago
I'd lump those pill into that list of the cause of modern afflictions. I got off them, because they made things worse, just in different ways than the depression itself. I cured myself with diet and exercise.
- curioussavage 4y ago
  Seems rather heavy handed conclusion. And are you just referring to ssri drugs or all depression drugs. Do you think you would have been able to make the lifestyle changes without medication first? If so then why? It may be easy after the fact when the depression is lower and you have side effects to look back and judge the value that way. But it may be hard to imagine what did not happen or how life may have trended if not for it. Obviously I have my own bias. I don’t think I would have been able to start and stick to exercise if not for the kickstart from medication
chasil 4y ago
Serotonin syndrome is also a real risk. SSRIs are extremely dangerous if tryptophan intake is also increased (with supplements, for example), even moreso if niacin is also consumed to encourage the tryptophan -> serotonin pathway. https://selfhacked.com/blog/serotonin-syndrome/ https://selfhacked.com/blog/serotonin-syndrome/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6184959/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6184959/

kerpotgh 4y ago

[dead]

elric 4y ago

> gross imbalance of exercise, diet, sleep, and social connection Indeed. What's worse is that we, as individuals, know this. But we, as in the western society at large, seem to be utterly unwilling or incapable of addressing this. Long working hours to make ends meet. The shittiest food is the most convenient option. There's a metric fuckton of light- and sound pollution which messes with our sleep. 10% of folks suffer from sleep apnea for a variety of reasons. So many things are messing with us. At some point, we're going to have to start dealing with these things.

jasonhansel 4y ago

> Everyone wants a pill as a quick effortless fix Isn't a quick, effortless fix the ideal goal? Wouldn't that be better than a slow, difficult one? Lifestyle changes are a lot harder and more time-consuming than taking a pill; if the latter were equally effective and low-risk for all people, it would obviously be the better choice.

polished85 4y ago

I've subscribed to this line of thinking my whole life, and mostly still do, but I've had to reassess after watching/listening to the case of Andres Iniesta, a professional footballer who sought professional help in the Summer of 2009. A starter for FC Barcelona and the Spanish national team, having just won the 2009 European Champions league with FC Barcelona and the 2008 European Championship with Spain. Multimillionaire and in peak physical condition, yet fell into a deep depression during the peak of his life. Definitely caused me to reassess my assumptions on clinical depression.

danavar 4y ago

There is a book that I’ve had recommended to me that posits a similar idea to what you’re saying - it’s called “The Myth of Mental Illness” - I have not read it yet, but will pass along the recommendation to you.

asveikau 4y ago
> The Myth of Mental Illness Having been close to a few people with psychotic disorders (I'm not misusing that term, I mean paranoid delusions, hallucinations, ...), this rubs me the wrong way. A mild case of depression may be safe to approach this way but with serious psychiatric problems that is dangerous. The author wrote a book saying schizophrenia doesn't exist, and was made up by psychiatrists. While it's probably true that it's a blanket term for what are probably multiple causes or possibly more of a spectrum disorder, I have seen schizophrenia up close. It would be foolish to say it doesn't exist, in that there are millions of suffering people in existence who fit the symptom criteria and benefit from treatment. You also need to be careful about people who advocate this position because some of them are affiliated with cults.

asveikau 4y ago

> Not to mention, exercise is "too hard" for most, > Disclaimer: I'm in the US These are related. This is largely from car dependence. In a lot of places you can get daily exercise through walking.

gatonegro 4y ago

> it seems a lot of our modern afflictions come down to an gross imbalance of exercise, diet, sleep, and social connection If you think about it in an evolutionary timescale, the way most of us live in the West these days is horrendously incompatible with the sort of life we evolved to live. Thousands and thousands of years were spent out in nature, in small communities, eating certain types of foods, engaging in physical activities, etc. The sit-on-a-chair-all-day, look-at-screens-all-day lifestyle is a comparatively new development, and neither our minds nor our bodies are suited for such an existence. That's enough to cause us a fair amount of trouble. Add all the socioeconomic issues you mention into the mix, and it all starts to make perfect sense to me.

PragmaticPulp 4y ago

> Everyone wants a pill as a quick effortless fix, but IMO it seems a lot of our modern afflictions come down to an gross imbalance of exercise, diet, sleep, and social connection. For what it's worth, exercise, diet, sleep, social engagement, and lifestyle changes are well-known inputs to addressing depression. Therapists will explore and encourage improvements in all of these areas. Good psychiatrists will as well, given enough time and a patient who is open to listening. One of the difficult issues is that many depressed patients often don't want to hear any suggestions that depression might be due to anything other than external factors. This is why the pop-science version of the "chemical imbalance" theory became so popular in the mainstream: It gives a plausible explanation that depression is just something that happens to you due to no fault of your own, which is weirdly easier to accept for many people. There are similar treatment problems with a host of health issues, such as obesity. The trend on social media and pop culture is to explain obesity away as a chemical or societal problem, minimizing the input of personal choice and actions. It's very popular to propose theories that "counting calories doesn't work" or hear anecdotes about people who claim to only eat less than 1000 calories per day but never lose weight (which isn't possible, even 100% sedentary coma patients need more calories than that).

kar5pt 4y ago
I could flip this around and say that focusing on internal causes of depression is a way for those in power to avoid the social responsibility of having to change it. We can kick the responsibility ball back and forth all day. Why is it so hard for people to get adequate sleep, exercise, a good diet and social interaction? Even most non-depressed people I know don't do these things well (except maybe the last one), so this isn't something unique to depression.
- ryanwaggoner 4y ago
  Exactly this. We throw people into a sick society and then blame them for their lack of personal responsibility when they get sick themselves. As an individual, yes, do what you can (which might mean changing to a less “sick” culture or subculture so you’re not fighting a sisyphean battle). And also, we should do better as a society.

com2kid 4y ago

I know the serotonin theory of depression is pretty much dead, but it is a fact that being around people raises serotonin levels. For introverts it is tiring, but it is better than not being around people. Being around people reduces cognitive decline in old age. Being around people reduces depression levels. Being in a supportive community reduces the severity of symptoms from schizophrenia. The 2+2 nuclear family concept is an abomination, we are supposed to live in a multigenerational community, surrounded by friends and family. The modern American lifestyle destroys psychological health. Without large social circles, finding romantic partners is hard, which leads to all sorts of negative life outcomes. Raising kids is hard, friends of mine who have nearby extended family have a much easier time raising kids (and are more likely to have more kids!) Heck my sister had kids 20 years before I did (bit of an age difference), 2 sets of grand parents, lots of free baby sitting, and aunts and uncles to help out with homework. It was also useful for me, I got to learn a lot about babies early on. > gross imbalance of exercise, diet, sleep, and social connection Yeah lots of these are solved with a large social group. I have some good friends (who sadly now live a bit aways from me) who host dinner parties 3 or 4 nights a week. People come over and help cook and clean up, so everyone eats healthy meals all the time. Friends who have lots of family nearby, just rotate whose house they go to on different nights, all the kids and adults after school/work get together to do child care and cooking. Healthy food for everyone, less work. Lots of modern life scales up really well. 2 parents will get exhausted taking care of 1 baby, between cooking, cleaning, and watching the child. 4 parents, 3 kids? Much easier. Seriously, piece of cake. 3 grand parents, 4 parents, a young auntie, 5 kids? No problem at all. Society has seriously screwed the pooch. If I had some insane amount of capitol I'd try to start some sort of shared housing for families, do intense interviews to match people up (see: My last failed startup) people cook together, raise kids together, support each other. Put 3-5 new/young families in a mid size housing complex with a shared yard. Put a support network in place, house chaperone (cough RA cough) to help out now and then. Extended Family as a Service. Dystopian, maybe, but possibly it'd do a lot of good in the world. (If any investors want to get in touch, please do, :-D )

AnIdiotOnTheNet 4y ago
> Society has seriously screwed the pooch. Pretty much all available data says as much, but we refuse to do anything about it. Hell, most refuse to recognize there's even a problem.

2OEH8eoCRo0 4y ago

I think so too. 9 times out of 10 a person has horrible eating, sleeping, or drug habits and a sedentary lifestyle.

robocat 4y ago

I’ll add situational-depression to your list: an ongoing sadness due to being stuck in a bad circumstance (bad relationship, terrible job, etcetera). The defining factor is that once the bad circumstance is “fixed”, the long-term sadness is quickly gone (replaced with ongoing contentment) and symptoms don’t reappear. This is not an academic definition, just a personal observation, although perhaps you have seen the effect happen to others in your life. I’ve had situational-depression badly enough that I would easily have been diagnosed as clinically depressed (more than one person said so, and if I had gone to a doctor I am sure I would have been given a label and some pills). When the cause was resolved, I immediately switched out of the funk and all symptoms of “depression” were gone. I don’t believe it was correlation, that is I don’t believe depression lifting caused me to fix my bad circumstance: I don’t think I had any influence over the actual date the underlying cause was “fixed”. Chronic clinical depression is not usually fixed in a day.

stronglikedan 4y ago

I'd lump those pill into that list of the cause of modern afflictions. I got off them, because they made things worse, just in different ways than the depression itself. I cured myself with diet and exercise.

curioussavage 4y ago
Seems rather heavy handed conclusion. And are you just referring to ssri drugs or all depression drugs. Do you think you would have been able to make the lifestyle changes without medication first? If so then why? It may be easy after the fact when the depression is lower and you have side effects to look back and judge the value that way. But it may be hard to imagine what did not happen or how life may have trended if not for it. Obviously I have my own bias. I don’t think I would have been able to start and stick to exercise if not for the kickstart from medication

chasil 4y ago

Serotonin syndrome is also a real risk. SSRIs are extremely dangerous if tryptophan intake is also increased (with supplements, for example), even moreso if niacin is also consumed to encourage the tryptophan -> serotonin pathway. https://selfhacked.com/blog/serotonin-syndrome/ https://selfhacked.com/blog/serotonin-syndrome/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6184959/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6184959/