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Clearly it's possible for depression to be affected by discussion with people around you. If that were not possible, then how could therapy have an effect?

johnchristopher 4y ago
> Clearly it's possible for depression to be affected by discussion with people around you. > If that were not possible, then how could therapy have an effect? Because therapy is more than discussion.
- nerdponx 4y ago
  I think it does depressed people a disservice to refuse to accept the possibility that depression might be contagious, in order to protect them from being demeaned.
  - ineedasername 4y ago
    Yes. There's a reason there are support groups for people (spouses etc) who are close to people with chronic depression and other mental illnesses. Because it has an impact of the people around a person afflicted with these illnesses.
    - wiz21c 4y ago
      If A has hard time supporting/coping with B's anxiety, the it means that A has already too much anxiety. If I go in a company and others are receptive to my anxiety, then it means anxiety is rampant in that company. In my country burn out and alikes are increasing very rapidly (like 3x in 10 years). So I believe that the articles says that when your are tired, you're more likely to catch the flu. It's not the flu that is strong, it's the other's that more fragile. And as someone who got through the burnout big time, I can assure you that this article will be misread. HR depts I have seen have a long way to go before they understand that burn out damages should be put on shoulders on the employee as well as the employer.
- jjcon 4y ago
  I mean it 100% is ultimately discussion no matter how much one wants to shroud it in academic ivory tower BS.
  - johnchristopher 4y ago
    Pretty sure the vast majority of therapists have left the academic ivory tower and build their practice on years of secular experience but okay.
  - SketchySeaBeast 4y ago
    If we reduce it to an incredibly basic form, sure, in the same way that surgery is just ultimately stabbing with medical ivory tower BS.
    - jjcon 4y ago
      If my surgeon had as much education as the average therapist does and surgery science had the replication crisis that therapy does I would call it exactly that: stabbing with medical ivory tower bs… thankfully that isn’t quite the case
      - comfypotato 4y ago
        You’ve both labeled therapy as an ivory tower and implied therapists don’t have much education; that’s somewhat of a contradiction. What’s your purpose here? I think a much better analogy than surgery would be a software bootcamp. In the same sense that a classroom-oriented bootcamp is just discussion, therapy is just discussion. There’s no replication crisis for the greater umbrella question of whether or not therapy is effective. Therapy in combination with medication is provably more effective than either alone (or nothing).
        jjcon 4y ago
        > You’ve both labeled therapy as an ivory tower and implied therapists don’t have much education; that’s somewhat of a contradiction. No contradiction - The problem isn't education obviously - its that some professions and disciplines are far more likely to produce pretentious ivory towers than others, that I have a problem with. Typically and ironically imo it is stronger in the soft sciences than the hard.
- Swizec 4y ago
  Genuine question: how is therapy more than discussion? Afaik therapists use nothing but words to effect their treatment. I am specifically referring to therapy as distinct of psychiatry (which uses meds)
  - johndunne 4y ago
    Therapy is only as good as the therapist, and it's difficult to gauge if a therapist will be any good for one particular person. Getting the right therapist is critical for therapy to 'work'. Same applies for meds. But generally, it's about helping a person help themselves.
    - klyrs 4y ago
      I'd amend that to "only as good as the client-therapist fit." A good therapist for you might be terrible for me. Which is why it's so damned hard to find a good therapist. It takes a few sessions to even figure out if this person is going to help. Several months and thousands of dollars later, you might get to start on the work.
      - johndunne 4y ago
        Agreed.
  - johnchristopher 4y ago
    Look into CBT, which would usually give the patient some tasks (jotting notes when the problem they seek help for happens and how problematic/stressful it is on a 1-5 scale, what happens when they apply some breathing techniques to cope with it, what happened before/after, etc.). Also, phobia treatment where the therapist can walk with you on a bridge to help you overcome fear of height, etc. More broadly though, the conversation you can have with a therapist has a lot more going on than a regular discussion. Without getting into the details of every school I think it's fair to say that these conversations are guided in subtle and not subtle ways to lead the patient to introspection and self-reflection much more than a drink between buddies at a bar would (which is usually what people on HN tend argue when criticizing talk therapies). Therapists have to assess where the patient stands and feel how far the patient can be pushed to change their outlook on a situation or accept it. Put in another way: a debate is also more than a discussion, same applies to therapy.
lazide 4y ago
Most types of therapy, especially talk therapy, tends to make depression worse. The only two with any evidence supporting them are CBT and IBT [https://www.apa.org/topics/depression/overcoming https://www.apa.org/topics/depression/overcoming].

johnchristopher 4y ago

> Clearly it's possible for depression to be affected by discussion with people around you. > If that were not possible, then how could therapy have an effect? Because therapy is more than discussion.

nerdponx 4y ago
I think it does depressed people a disservice to refuse to accept the possibility that depression might be contagious, in order to protect them from being demeaned.
- ineedasername 4y ago
  Yes. There's a reason there are support groups for people (spouses etc) who are close to people with chronic depression and other mental illnesses. Because it has an impact of the people around a person afflicted with these illnesses.
  - wiz21c 4y ago
    If A has hard time supporting/coping with B's anxiety, the it means that A has already too much anxiety. If I go in a company and others are receptive to my anxiety, then it means anxiety is rampant in that company. In my country burn out and alikes are increasing very rapidly (like 3x in 10 years). So I believe that the articles says that when your are tired, you're more likely to catch the flu. It's not the flu that is strong, it's the other's that more fragile. And as someone who got through the burnout big time, I can assure you that this article will be misread. HR depts I have seen have a long way to go before they understand that burn out damages should be put on shoulders on the employee as well as the employer.
jjcon 4y ago
I mean it 100% is ultimately discussion no matter how much one wants to shroud it in academic ivory tower BS.
- johnchristopher 4y ago
  Pretty sure the vast majority of therapists have left the academic ivory tower and build their practice on years of secular experience but okay.
- SketchySeaBeast 4y ago
  If we reduce it to an incredibly basic form, sure, in the same way that surgery is just ultimately stabbing with medical ivory tower BS.
  - jjcon 4y ago
    If my surgeon had as much education as the average therapist does and surgery science had the replication crisis that therapy does I would call it exactly that: stabbing with medical ivory tower bs… thankfully that isn’t quite the case
    - comfypotato 4y ago
      You’ve both labeled therapy as an ivory tower and implied therapists don’t have much education; that’s somewhat of a contradiction. What’s your purpose here? I think a much better analogy than surgery would be a software bootcamp. In the same sense that a classroom-oriented bootcamp is just discussion, therapy is just discussion. There’s no replication crisis for the greater umbrella question of whether or not therapy is effective. Therapy in combination with medication is provably more effective than either alone (or nothing).
      - jjcon 4y ago
        > You’ve both labeled therapy as an ivory tower and implied therapists don’t have much education; that’s somewhat of a contradiction. No contradiction - The problem isn't education obviously - its that some professions and disciplines are far more likely to produce pretentious ivory towers than others, that I have a problem with. Typically and ironically imo it is stronger in the soft sciences than the hard.
Swizec 4y ago
Genuine question: how is therapy more than discussion? Afaik therapists use nothing but words to effect their treatment. I am specifically referring to therapy as distinct of psychiatry (which uses meds)
- johndunne 4y ago
  Therapy is only as good as the therapist, and it's difficult to gauge if a therapist will be any good for one particular person. Getting the right therapist is critical for therapy to 'work'. Same applies for meds. But generally, it's about helping a person help themselves.
  - klyrs 4y ago
    I'd amend that to "only as good as the client-therapist fit." A good therapist for you might be terrible for me. Which is why it's so damned hard to find a good therapist. It takes a few sessions to even figure out if this person is going to help. Several months and thousands of dollars later, you might get to start on the work.
    - johndunne 4y ago
      Agreed.
- johnchristopher 4y ago
  Look into CBT, which would usually give the patient some tasks (jotting notes when the problem they seek help for happens and how problematic/stressful it is on a 1-5 scale, what happens when they apply some breathing techniques to cope with it, what happened before/after, etc.). Also, phobia treatment where the therapist can walk with you on a bridge to help you overcome fear of height, etc. More broadly though, the conversation you can have with a therapist has a lot more going on than a regular discussion. Without getting into the details of every school I think it's fair to say that these conversations are guided in subtle and not subtle ways to lead the patient to introspection and self-reflection much more than a drink between buddies at a bar would (which is usually what people on HN tend argue when criticizing talk therapies). Therapists have to assess where the patient stands and feel how far the patient can be pushed to change their outlook on a situation or accept it. Put in another way: a debate is also more than a discussion, same applies to therapy.

lazide 4y ago

Most types of therapy, especially talk therapy, tends to make depression worse. The only two with any evidence supporting them are CBT and IBT [https://www.apa.org/topics/depression/overcoming https://www.apa.org/topics/depression/overcoming].