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How I Beat Depression

207 points by scottcha 14y ago

petercooper 14y ago
Cognitive behavioral therapy is also very effective in many cases (and can work on its own without medication, depending on the situation).
- rip747 14y ago
  `and can work on its own without medication, depending on the situation` nail on the head! many people don't realize when they need to go to a doctor and get the meds they need.
- richardlblair 14y ago
  I'm a huge fan of CBT. Recent studies have shown that if a person is dedicated to CBT it can actually have the same positive effects on the brain as medication, without the negative effects of medication. It is important to note, however, that the person must commit.
  - rip747 14y ago
    and its also important to note that just because it worked for your buddy doesn't mean its going to work for you. it also means that just because it worked one time doesn't mean its going to work the next time. the best thing to do is to be monitored by a doctor so you can get the medical help right away if you need it.
    - richardlblair 14y ago
      If you are working with any competent professional they should be able to identify when you will need medical help right away. There is a huge movement in north america to through drugs at everything. In Europe they take an entirely different approach on a lot of front and are seeing more success than us in those areas (ADD immediately comes to mind) I'm not against medication, but I am against rushing to medication. I'd much rather someone try various forms of therapy first. CBT is just one of them, and happens to be working at a rate equal to or greater than prescription medication. Edit: I wanted to thank you for the reply. Discussion surrounding the topic is critical to progression.
- newplagiarist 14y ago
  It can work on it's own, true, but it is more effective if used in combination with medication. [1] Though CBT doesn't seem to be more effective compared to other types of therapy for treating depression. It is still better than no therapy. [2] [1] Chan EK-H. Efficacy of cognitive-behavioral, pharmacological, and combined treatments of depression: A meta-analysis. [2]Hoffman et al. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses.
- mattchew 14y ago
  Seconded. For people who are interested in DIY approaches, I recommend reading Seligman's Learned Optimism. I am noticeably less depressed (dysthimic, really) than I used to be and Seligman's books were part of the difference.
drivebyacct2 14y ago
These can be very hard things to do when you're depressed. It helps if you have someone motivating you. I'm on my way out of a pretty serious slump and the same things have helped me as this article has described. I've been surrounded by positive family members, I've been on a generic of Lexapro, I've been running/jogging/fast-walking two miles a day and I've been reminding myself that I didn't feel this way a year ago and that in a year I might feel completely better again. Anyone who's ever been depressed knows that even on a good day, just thinking about your depression can evoke panic and sadness and a "relapse". I'm using the Seinfeld calendar system. I try to keep up a streak of good days and use that to motivate and reassure me. (Frankly, the fact that I even clicked on this topic and wrote a comment means I'm feeling better. I had to skim and mentally skip over much of HN during the weeks after Aaron's suicide. :( )
rip747 14y ago
this is the biggest misconception when it comes to clinical depression... that you can or did beat it. You can never or will never beat clinical depression, only suppress it. Beating something is finite and means that it can never happen again. The author gives great advice in the article about what steps he did to suppress this bout of depression, though if he doesn't stay the course chances are it will come back. The scary thing about clinical depression is, even if you continue to do the things that worked in the past to suppress it, it can still come back. The one piece of advice that he doesn't give (or he might have and i'm just not catching it) is realizing that you have to listen to the people around you when they tell you that you look depressed. At that point, you need to get help immediately so you don't fall further down the hole. btw... I'm not a doctor or anything. Let's just say that I have extensive experience with clinical depression and bipolar disorder.
- starpilot 14y ago
  > Beating something is finite and means that it can never happen again Since when does beating an illness mean permanent immunity? You can beat cancer and have a recurrence. There's nothing in the definition of clinical depression saying that it's a permanent illness.
- pragone 14y ago
  I came here to say something similar - you do not "get over" clinical depression caused by a biochemical imbalance in your brain. It does not get fixed without making biochemical changes to your brain. The advice the author gives is very sound advice (exercise, for example, does indeed induce biochemical changes in your brain), but without first becoming convinced of the advantages of getting treated, and taking the time to understand how those treatments effect you and how you need to actively participate in them, the rest of his suggestions are near impossible to follow through on. The stigma around psychological and psychiatric care do not help the situation; however, the numerous stories on these issues here on HN I do hope shed some light on those that are still suffering without help to know that there always is a chance to get better, and it can be as easy as calling your doctor or telling your friend you need help. Or even talking to one of us here who have been suffering from depression and suicidal ideations for many years - I certainly would be more than happy to talk with anyone who is struggling with these issues.
Xcelerate 14y ago
What if you're depressed because you're afraid of death? (I wouldn't say I'm depressed -- not in the clinical sense anyway; but I do spend what I imagine is an abnormal amount of time thinking about it because of mother's passing away when I was younger).
- rip747 14y ago
  what you describe is emotionally based, not chemically based. There is a HUGE difference.
  - dia80 14y ago
    That's a false dichotomy. Ultimately all thoughts / brain function rely on "chemicals". The idea of purely "chemical" mental distress is also severely strained - consider "there is a 0% chance your current feelings are influenced by your environment / past". It's all a bit more of a spectrum. There is serious money behind the chemical mental-distress-as-an-illness interpretation. If it's a medical problem then you need a medical solution. Anti-depressants anyone? They are being taken in such vast quantities they are starting to poison the water. [1] [1] http://www.newscientist.com/article/dn21882-antidepressants-in-water-trigger-autism-genes-in-fish.html http://www.newscientist.com/article/dn21882-antidepressants-...
    - rip747 14y ago
      no... what you've saying is false. There is a HUGE difference in feeling sad about a traumatic or past event versus the chemicals in your brain not working properly. also this conversation is about true clinical depression and the difference between it and just feeling sad; it's not about some conspiracy theory of how every doctor wants us to be on meds or the fact that flushing medication down the toilet is poising our water supply. please stay on topic if you want to continue the converation
      - dia80 14y ago
        It's a little brash to dismiss published evidence as a conspiracy theory. You may think it flawed but then please at least make an intelligent criticism. Who gets to decide what is "feeling sad" with a cause and what is idiopathic "chemical malfunction". Care to offer any references? Objective diagnostics? I included the bit about antidepressants to caution swallowing the prevailing medical model hook line and sinker with out pause for thought as to it's assumptions. Pretty sure that's on topic.
dpapathanasiou 14y ago
Exercise is incredibly important b/c of all the positive neurochemical effects it produces. But if you're exercising by yourself, it's easy to skip it, especially if you're already feeling down. It's better to take part in some kind of team or class activity where there's a little bit of social pressure to show up. There will be mornings when you think, "I don't want to go, but I don't want to let those guys down," and so you wind up doing it.
- j_baker 14y ago
  Exercise is almost never a bad idea. However, the evidence that it helps with depression has recently come under question: http://www.bbc.com/future/story/20120822-does-exercise-help-depression http://www.bbc.com/future/story/20120822-does-exercise-help-...
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- Evbn 14y ago
  Also, sell your car, and moved within range to bike to work. When exercise becomes locally optimal, it is hard to avoid it.
beersigns 14y ago
I'll agree with the working out regularly being good for your health, both mental and physical. Exercising has gotten me through some tough spots in my life and it has always been a major coping mechanism. Another thing that has always worked for me has been laughter. Whether it's watching a classic movie like Dumb & Dumber, reading reddit/r/funny, or catching The Colbert Report, laughing eases all the little things that otherwise might eat you up.
pstuart 14y ago
Matches well with this: http://www.forbes.com/sites/michaelellsberg/2011/07/18/how-i-overcame-bipolar-ii/ http://www.forbes.com/sites/michaelellsberg/2011/07/18/how-i...
richardlblair 14y ago
I'm really happy that these posts are getting onto the front page. They are very important. I want to add one thing. Working with a doctor is important, but work with a psychologist as well. Especially if you are resistant to going on meds (and I don't blame you if you are...). A good psychologist may be able to offer you treatment options that better suit your needs. Also, if you aren't getting what you need from your Dr or Psychologist then move on and find a new one. Keep doing this until you find someone who genuinely cares about you, and wants to work with you to get you feeling better.
- roflc0ptic 14y ago
  Medications obviously aren't for everyone, and certainly there's no one size fits all medication, but as someone who tried several medications that interfered with my clarity of mind, finding Wellbutrin has made a real difference for me. It works along a different pathway than other anti-depressants. It's known to increase focus. Rather than feeling like I was experiencing the world through gauze, I feel more... like me, sans the crippling depression. YMMV, but I find that every (exceedingly legitimate) objection I have towards medication simply became immaterial in the face of feeling better.
  - cdjk 14y ago
    Feeling "more like yourself" is one of the more common descriptions of what it feels like to be on a medication that's working. I'm glad you found something that worked and you're feeling better.
    - Evbn 14y ago
      I always feel like myself, and myself is always changing. I just prefer the versions of myself that aren't bleeding profusely or have eye-burning headache or dizziness when I stand up or lower back pain or etc etc
- Evbn 14y ago
  OTOH, for someone who is working through depression, it is nice to have somewhere to go to safely talk about something else without randomly once a day (as it was during peak Swarz-steria season) getting a note shoved in your face that says "HEY! let's talk about your fucked-up mental problems again!"
borski 14y ago
This is a really important post. Something I've noticed is that more people climb in the Bay Area than anywhere I've ever been before. I wonder if its at all related to the stress and personalities contained there?
- sbhere 14y ago
  The West is also a great place for climbing (geographically speaking) - far better than many places I've lived... but I'll also vouch for climbing being a great activity. Ultimate Frisbee as well.
- Evbn 14y ago
  It is a trendy hobby. (Nothing wrong with that.) It os socially rewarding to have a popular hobby. Some people run or bike or play basketball.
zenogais 14y ago
Walking definitely helps. Last year was a particularly rough one for me in a lot of ways and just going back to the mountain town where I grew up and hiking for a few hours in the forest really helped me to change my outlook. I consider it the most important thing I did.
zindlerb 14y ago
Thank you for this post. Your post really rings true for me. I have been suffering from depression for the past year, but this week has been especially bad. I hadn't sought help until recently. I have been encountering many of the things you describe.
gubatron 14y ago
great sex.
ohwp 14y ago
Maybe this will help someone: A lot of times suicidal thoughts are not about a death wish but about a wish for silence in your head. I think realizing this can make a difference. Whatever the case: don't be ashamed, get help.
dkarl 14y ago
I would say the suggestion to work with a doctor should be struck and replaced with a suggestion to work with a psychotherapist or psychiatrist. Doctors (other than psychiatrists) are not trained to deal with mental illness beyond diagnosis and prescription. You'll need to see a doctor if you want to try drugs, but the only reason to have an ongoing relationship with a doctor is so you can try different drugs if the first one they prescribe you doesn't work. Your doctor might provide helpful counseling, but then again, so might a teacher, clergyman, friend, or any other untrained person. (I suppose these are all worth trying if you know one who might help you.) Psychotherapists, on the other hand, dedicate their professional lives to EXACTLY what you want: relief of suffering from mental illness. It isn't an exact science, and your therapist's particular background, talents, and personality make a big difference, so it isn't like there's a professional qualification that guarantees good results, but at least their professional goals, training, and experience aim at what you need instead of at something else entirely.
- DanBC 14y ago
  In the UK the family doctor (GP) acts as a gatekeeper to other services. Thus, seeing your doctor is excellent advice for people in the UK who are depressed. Your general point - don't get the treatment from a regular doctor - is a good point. In theory you should get a quick assessment, and then a referral to PCAT team (Primary Care Assessment and Treatment) - these people will either take you on for short form talking therapy (probably cognitive behaviour therapy) with possibly some medication; or they'll refer you on to a community team; or they'll send you back to the GP. The doctor may skip the PCAT referral and send you straight to a community team. They'll do an assessment and either take you on, or send you back to the GP with advice for treatment. If a community team take you on you'll get a care coordinator, a care plan, a consultant (psychiatrist), and access to different meds and different therapies. Frustratingly, you might not be allowed access to short form CBT while registered with a community team. If you need hospital you'll get hospital. In an emergency the GP will just call the crisis team for you (in theory crisis teams are available to anyone who needs them at any time, but it's usually better to go though a GP unless the crisis team already know you). The crisis team will assess you for a stay in hospital (either informally (voluntarily) or under section of the MHA (detained against your will to protect your safety)). Of course, that's the theory and often the practice differs. And, you can avoid some of that process by getting a private psychotherapist. Look for BACP registration. (There are probably other good registration, but BACP is the one I know.) About psychiatrist: I've met lots of psychiatrists. They've almost always been "odd". To become a psychiatrist in the UK you need to do the regular medical school. That turns you from a medical student into a doctor. (But not a doctor that can practice unsupervised.) You then do Foundation Year One and FY Two. (This is practice, supervised, in hospitals etc.) You then become a registrar. Eventually you become a consultant in your chosen speciality, which gives you the power to practice unsupervised. All of this means that you have great, up to date, in depth knowledge of modern treatments and medications. It also means you're a bit of a basket case to make it through that process. Your bedside manner is likely to be interesting. I'd strongly recommend people avoid psychiatrists unless the illness is severe or resistant to other forms of treatment. As always: I am not a doctor and I have no training and all of this is just my opinion and etc etc.
RockofStrength 14y ago
There are reasonably priced sunlamps that I hear good things about in the treatment of depression. Also, use common sense: pursue positive people (and avoid negative), exercise (no matter how lightly), eat healthy, pursue goals (no matter how trivial). There are multiple avenues to happiness, and pursue the ones that your body responds to.
nasir 14y ago
The points are good however usually the depressed person can't do anything by him/herself. In my own case, I was not going out of my house for very long time and I avoided seeing any people I knew. I did not admit that I am depressed so I was blaming myself so much which was draining me as well. The only thing I knew was 'Realize you can get better' and I knew if my certain problem gets solved then I will get better but I did not have any energy to do that. After a year I found a girlfriend which helped me a lot on that problem until it was finished. It was such a tough time!
djan92 14y ago
Hello, Can anyone provide any advice on how to help a friend through depression? I met this friend about a month and half ago and he recently opened up to me about his depression. He's been in and out of depression since high school (about three years I think; he is currently on medications and getting help; he's reached out to me first (we're studying abroad in Asia) and I would like to help in anyway possible. My questions are: 1) How much do I reach out and ask to hang out/eat/etc.? 2) What are the boundaries I should be aware of? Should I bring up the depression and ask him how he's doing every day? other day? week? 3) Any general advice (I went through semi-depression for about 6 months, but it was not anywhere near as drastic) (I also helped a friend through depression last year which was almost suicidal) Thank you. I appreciate any advice you can provide.
- newplagiarist 14y ago
  Having a strong social support network is a good foundation for dealing with depression. My best advice to you is just be available for when he wants to talk. Let him know that if he ever needs to talk, be it day or night, you're there for him and that he can call you. Thoughts of suicidal ideation or self-harm can come at any time and he will need someone to talk to during those times. Onto your other questions. The amount of time that he spends hanging out with any individual won't matter too much; having him be in company with people he enjoys several times a week is what is key. What this means is, it doesn't have to be you particularly but if he is hanging-out with others at least 2 or 3 times a week it would be beneficial. The only boundaries that exist are the ones he implements. Generally, you'll just need to ask him how he's doing and not 'remind' him of his depression everyday, but how often you do that should be down to him to decide. The best piece of advice I can give, is to observe him. If there is a drastic change in behavior or energy level, that is when you need to intervene and either try to get him to talk or just get him out of the house. Overall, the above article is a good basis for coping with depression. The author hinted at, but never explicitly said, two key points that I feel the need to reiterate. If your friend is taking medication or is thinking about medication it can take awhile to take effect, on the magnitude of weeks or months, and that not all depression medication is the same - if one pill isn't working move onto others. Second, if your friend is seeing a therapist, again, not all therapist are the same. If he is not connecting with the therapist personally then his treatment is going to be much less effective. I hope that helps.
The_Yayo 14y ago
I did not know this friend, but I do know depression. Anyway no one can know for sure, the problems of each, in their choose, in your life, etc.. Moreover, the help of doctors, etc, that's all very well, but many times we forget, the society in general, it is very cruel, often with other friends. This life, this world.. Comments on Ref. to Friend(s)..: http://is.gd/dMte7s http://is.gd/dMte7s http://en.wikipedia.org/wiki/Aaron_Swartz http://en.wikipedia.org/wiki/Aaron_Swartz R.I.P. D.E.P.
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bpatrianakos 14y ago
I don't think one can actually beat depression but instead only really cope with the symptoms. I know that sounds awful and kind of defeatist (and I could be wrong) but I think the idea that you can actually conquer this disease sets you up for failure. I first noticed my own depression when I was just a 13 year old kid and first sought help just before the end of high school. I've been through the entire range of emotion from hopelessness to being suicidal and through it all I was always most upset that I couldn't actually beat it. I would try and fight so hard to make it just go away permanently and be like "normal" people but it just never happened. I eventually took to self medicating and became a polydrug abusing heroin addict for about 5 years. Five years later I realize that, for me, there is no "beating" it. There's just learning to cope with it. Before I realized this my main focus was trying to make the terrible way I felt just go away and to be happy. Now, rather than fight it, I work around it. I realize that a negative mood or feeling of worthlessness is not objectively true but instead just part of the sickness just like the author here says. In addition to most of what this post talked about I would say the most important thing is knowledge of self. To recognize and realize that what you're experiencing at any given time is really a complete distortion of reality is step one to recovering. Then to know what triggers those thoughts and knowing what works best for you in terms of mitigating them is the ultimate goal (with the understanding, of course, that you may not be able to completely defeat the experience but certainly minimize it). I learned these things and now, five years later, I still have depression but it's not debilitating. Whenever it decides to come around I'm able to push it aside completely or mitigate those symptoms and I've been able to do that because I've built the kind of lifestyle where people rely on me and I'm often running from one activity to another. Some might say it sounds like running from the disease but really my busy lifestyle is what keeps it at bay. Rather than having the time to dwell on how awful life is and how worthless of a person I am, at worst I'll have thoughts like "shit, now I have to go do this thing and I totally suck at it and everyone hates me" which isn't exactly a great thought but certainly beats being alone thinking of killing yourself and when I finally reach my destination and do whatever I need to do I've proven to myself that whatever I was thinking before was just plain wrong. Again, that's a worst case scenario. I've gotten to a point now where thoughts like that are the minority thankfully. So I'd just hope anyone else struggling with clinical depression is able to take a step back and evaluate their own thinking, understanding their own vulnerabilities and coping mechanisms in addition to seeking out lots of professional help (and yeah, exercising is amazing for this disease).
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gesman 14y ago
It's impossible to "think yourself" out of depression or "do something good" out of depression, unless it's just a temporary down mood. The way I beat depression is by doing pure mental exercises on focusing on the actual physical areas of the body where depression is felt, without trying to change/fight/eliminate the feeling itself. I came up with this technique during lowest point of my life and was almost shocked how fast I moved from suicidal to almost fully content state. This proved to be very powerful technique as it dissolved pain at it's roots. The speed of that approach for me was like taking antibiotics compare to taking vitamins. I can also second advice on exercise and better eating habits.
- westicle 14y ago
  Could you please expand on the type and method of the mental exercises? I'm interested in what worked for you... are you able to describe how someone else could undertake those exercises?
  - gesman 14y ago
    Yes sure. Hope it helps: ------------------------ To start with basics - depression in it's essence is suppressed pain (or blocked energy) within the body. This pain could start with either traumatic event, long exposure to unhealthy, unloving and unfriendly environment or as a consequence of consistently negative thought patterns. Negative thought patterns causes inner emotional unpleasant sensations within the body. More negative thoughts cause more emotional pain. This pain in turn fuels more negative thoughts and the vicious, self-fullfilling cycle starts to function on it's own: inner emotional pain fuels negative thoughts, and thoughts causes more and stronger emotional pain. Once this vicious cycle strengthens - pain becomes rooted in the body without thoughts, and person goes beyond "talkative" therapies and it becomes impossible to "talk yourself" out of depression, impossible to "do yourself" out of depression or "positively think" yourself out of depression. Changing thoughts from negative to positive no longer helps because rooted inner emotional pain burns like an underground fire that is not taken care of and easily comes back. I found the solution that worked for me better than anything. Instead of trying to "think myself" out of depression or do some "pain killing" or distracting activities, I dived into depression, or more precisely "felt myself" directly into the areas of the body where I felt painful feelings. Most people are trying to avoid, escape or suppress pain. People would use drugs, painkillers, porn, entertainment, alcohol, doing-something-noble or engage with any possible distraction away from pain. But pain inside is not taken care of and soon inevitably comes back. So here's exact technique: When you start feeling depressed or strongly emotionally down - locate inside your body exact areas where you feel these depressive or negative sensations and feelings. Usually these will be in abdomen sections, chest areas, neck, shoulders, quite often occupying large areas of your body or even covering hands or feet. Make sure you mentally "mark down" all exact areas where you feel this depression. Depression doesn't like you to look at it directly like that. Depression loves to make epic unresolvable problems of gigantic proportions out of everything, and it absolutely hates to be diminished to pure physical bodily sensations. And that's exactly what you will do. Once you pinpointed exact physical areas in the body where you feel emotional, painful sensations do these steps together: 1. Start observing these physical areas within the body where you feel something. Just observe areas without trying to change your feelings. 2. Start to consciously follow your breathing. In and out. In and out - and at the same time watch/observe your inner physical areas as above. Hint: To easily focus on body areas - imagine you breathing through theses areas. Imagine you actually inhaling and exhaling through these areas - this approach helps you to focus on exact body areas (where you feel sensations of negative emotions or depression) as well as to keep conscious breathing. When areas of pain are watched - the energy pathways opens and pain (blocked energy) starts dissolving. When you add conscious breathing - this suspends incessant thinking and increases energy flow. This accelerates the whole process. Again - you're not trying to change, kill or eliminate anything. Like Eckhart Tolle says - you just adding the light of your awareness to your body. In this case to the areas that feels negative sensations. Even if painful feelings does not dissolve during this practice, you will find that they will inevitably diminish soon after. Hope it helps!
j_baker 14y ago
One other thing worth noting: consider whether you might actually be bipolar, especially if antidepressants aren't really working for you or make you worse. A lot of Bipolar II cases (where manic states aren't as dramatic and depressive symptoms dominate) are misdiagnosed as unipolar depression.
pawnhearts 14y ago
I've been fighting depression since one year ago and I'd like to share my story with you guys and hope to get some warming advices. Quick introduction: I've always been a self-educated about computer science, but my mother always wanted to see me studying in a _regular/acknowledged_ way. When I turned 25, I started feeling very bad: my career in information technology was going really good and since I didn't passed through the academical stages (exams, graduation, etc) I felt like I didn't really deserve such professional "glory" (sorry for quick and dirt english). So I decided to join the university: I started passing exams, and finally I could go to bed with a clear conscience! One year ago I received a job offer from a big enterprise, a job that could have change my life. This job (9h/5d) would not allow me to continue my university career and they gave me one week to decide. It was really hard, and in the end I refused that job. My odyssey begins from this point. I had a panic attack on the first day of university after my choice, a huge panic attack that I thought: "I'm gonna die". After that event, my condition degenerated: I was no longer able to go out from my house, neither going downstairs to feed the dog. Everytime I went outside, I had a panic attack, it was a nightmare. Because of this hard form of agoraphobia I was neither able to go out and see a psychiatrist. I also developed tinnitus in my left ear and a painful hypochondria. It took about 4/5 months before I realized the actual cause of my depression: in this age of economical crisis, when people commits suicides for not being able to pay debts, I rejected a permanent full-time contract. After this realization, my condition started going slightly better: I had no more panic attacks and I was able to go out with my gf and my friends. At the time of this writing, one year after my first crisis, I'm still not able to go to places with many people, ot taking a train, or staying away from home for too long. I see that such a condition is common to many computer programmers, I think that alienation caused by working on computers make things worse. At some point, I also considered the option of giving up with computer science, but it's not possible, it's really the only thing I can do. I'm still fighting depression, I'm still not able to answer the questions "where would you be now to be happy?" , "what would you be doing now to be happy?". It's really sad when you can't answers these questions. Is it ever happened to you? How did you behave?
- ZenoArrow 14y ago
  I'm sorry to hear about your predicament pawnhearts. Have you managed to get to a counsellor yet?
hackquer 14y ago
Fischer Wallace Cranial Stimulator + Neurotransmitter Supplements (5HTP, etc) This is worth a try for anyone with depression. There are many different causes, but brain chemistry can be an issue caused by your lifestyle alone, as well as other stuff.
markhall 14y ago
Great perspective. Question for the HN community: Why/How is it that small communities like HN have removed the stigma attached with mental health while larger society has not?
- cdjk 14y ago
  I still think there's a stigma. It's good that people are talking about it, but I don't think that means the stigma is gone.
- jnorion 14y ago
  There's a lot less stigma attached when it's a (relatively) anonymous forum, when you're not face-to-face with the people responding, when you have a large support group because people who understand and care find YOU (via your headline) rather than you having to find them, and when someone who responds in a negative way is likely to get downvoted and called an asshole. There are probably still people on HN who respond negatively to an admission of depression, but they're (wisely) keeping quiet.
  - cdjk 14y ago
    I've never considered my username here to be particularly anonymous. Apparently it is, as I just discovered, but anyone who knows me would recognize my username. To be honest, the number of people who are open about mental health problems in posts like this is fairly surprising to me.
- DanBC 14y ago
  > Why/How is it that small communities like HN have removed the stigma attached with mental health They haven't - there's still stigma around MH problems. It just doesn't show itself in threads like this. See any thread about i) interviewing or ii) spree shooting and there'll be plenty of stigmatising comments. It's not so bad, because at least most people on HN are happy to talk about it.
- scottcha 14y ago
  Yes, as the author of the article I thought through the stigma associated with this before I posted. Ultimately it came down to leading with my heart and doing what I thought was right regardless of what others thought. It is great that there has been a quite open and kind discussion as that is what is needed.
michaelwww 14y ago
There are different shades of depression, some more manageable than others. I don't think medical science (or anyone) has figured out the worst of it yet. Author David Foster Wallace before his suicide: "The so-called 'psychotically depressed' person who tries to kill herself doesn't do so out of quote 'hopelessness' or any abstract conviction that life's assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire's flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It's not desiring the fall; it's terror of the flames. And yet nobody down on the sidewalk, looking up and yelling 'Don't!' and 'Hang on!', can understand the jump. Not really. You'd have to have personally been trapped and felt flames to really understand a terror way beyond falling."
umphetico 14y ago
Heroin helped me beat my bouts of depression, although the downside being extremely addictive which seems to bring you right back where you started but in all honesty, depression is caused by fixation, ironically heroin taught me how to relax and "let go" of the angst caused by fixation while at the same time my mind was completely fixated on it. To each his own, you gotta stop reading about how to cure an illness, you have to act, find meaning even though it's meaningless.
umphetico 14y ago
Also a more interesting question would be, are people working in startup, especially single software vendors more susceptible to depression? Look at Aaron Schwartz guy, all those times he was depressed, look at his increasingly erratic and tendency towards martyrdom. The pressure from idiot zealots finally tipped him.
- scottcha 14y ago
  I'm the author of the article and I asked myself this question before I wrote it. I posted some data here which came out of that research: https://news.ycombinator.com/item?id=5272763 https://news.ycombinator.com/item?id=5272763 but it didn't get much traction. When I compared across disciplines in the original dataset (using software programmer as the discipline) there wasn't a strong indication that they were more prone to suicide than other professional jobs. I don't remember exactly but doctors, lawyers, dentists were toward the top of that list. One challenge is that the dataset I reference doesn't have data post 1998. Since our discipline has grown and changed since then a more recent dataset might show something more interesting.
  - umphetico 14y ago
    I think the actual software programmer job working for a company is different than someone working alone erratic hours, building apps, marketing, selling, and breaking even. It's quite challenging in itself to produce good software product let alone selling it and breaking even so it'd be interesting to see some statistics for single founder startups or micro software vendors. I would say the stress is the biggest for SaaS type of software products, as someone posted a video here about "Constant Contact", it's described as the slow ramp of death because it takes so long and hard to reach that magic upward slope. These are all just my magical assumptions based on my own situation and experience. I'm sure there's ton of positive, empathetic, emotionally intelligent coder/hacker/entrepreneurs although there's lot of Aspies, who studies have shown to be greater risk of depression.
    - Evbn 14y ago
      Stress (and financial instability) has its own set of health problems, but that's not depression. Depression has more mundane physical and neurological causes, whereas stress disorders are caused by the pressures of difficult lifestyles like running a business on your last nickel or being ultraompetitive in your career or being a soldier at war.
the_economist 14y ago
Don't forget natural sunlight.
ko6tas 14y ago
I am wondering if anyone has tried any online intervention for anxiety or depression. Some of them have strong theoretical background (like CBT that is mentioned in another comment). Any impressions?
- mhunts 14y ago
  Online access would make it much more accessible, especially for those who are introverted and have social anxiety like me.
systematical 14y ago
Try 2+ years of it, unfortunately (for them) someone is going to 1 up me now.
Joe_Knapp 14y ago
5htp
lucian303 14y ago
I have yet to meet someone whose depression was not made worse (in the long term 6++ months) by SSRIs and SSNRIs. These medicines cause more numbness and depression. I'd be very wary of them or any doctor who rushes you on them (or any medicines). The black box warning is not just for teens. When you are in that space (SSRI / SSNRI space), it's easy to see why anyone, even the strongest minded, would want to commit suicide. Like William Styron says in "Darkness Visible: A Memoir of Madness" (one of the best written personal accounts of depression, highly recommended: http://en.wikipedia.org/wiki/Darkness_Visible_(memoir) http://en.wikipedia.org/wiki/Darkness_Visible_(memoir)), depression is an inappropriate word. The correct word, for him (and I agree), is _madness_.
pshin45 14y ago
Stay open and allow others to help. Realize you need people around you to who can be a support network. This is the hardest thing to do when you are suffering from depression. Couldn't agree more. When I was suffering from depression, I was so stubborn about wanting to face it alone and not "force" my friends and family to get involved, because I'd be becoming even more of a burden to them and to society than I already felt I was. I just felt this burning sense of shame and worthlessness at the mere thought of asking for help. Hackers are admired more than ever, but I think it comes with a price. When everyone sees you as this superman who can make and do anything and knows everything, it's gotta make it that much harder to reach out for help.
Debugreality 14y ago
Having read a lot of the comments here there seems to be two main thoughts. That depression isn't something that can be beaten and that it can be beaten. Personally I think both camps are right, in many of the cases where people have beaten depression I think there is a common element be it Cognitive Behavior Therapy or psychedelics these practices can change your brain. Meditation can also change your brain significantly and this is how I believe I have 'beaten' depression. So no you can't beat depression without changing your brain and changing your brain can be a risky business and perhaps when you do change your brain you are no longer the you that was depressed...
realsuperman 14y ago
Everything that makes you happy or sad is in your mind. So I would suggest that it is not about beating depression but achieving a balance of the two. One cannot completely eliminate depression type or extreme joy type feelings from one's life. So it is good to develop a balance that leads to the understanding that shit happens. But this too shall pass.
adfadf 14y ago
Just a couple of notes on the medication part: Yes, you will probably feel worse during the first couple of weeks of the regimen. This is common enough that your prescribing doctor should warn you about it, and s/he should set up some way of monitoring your progress - appointments twice a week for the first month or something like that. It should also be clear from the documentation that comes with the pills. Second, you should only change your medication after consulting with your doctor. In this case it looks like the course was "I took the meds for six months, and then I felt better so I stopped", which is not recommended. The relapse rate is significantly lowered if you take the meds until you have no symptoms + 6 months (or longer, if it isn't your first depression). Third, it really is very recommended to slowly taper of the medication and not go cold turkey. The side effects will be much worse if you just stop. Also, the relapse rate. Once again, discuss any planned changes in your medication with your doctor.
geldedus 14y ago
powerful tools for fighting depression: 1) learn to dance and go dancing regularly (for ex. salsa or tango) 2) take cold showers daily 3) exercise
- mhunts 14y ago
  Why cold showers?
ThinkADRIAN 14y ago
I think the key to dealing with mental conditions is to identify/diagnose/recognize it, accept it and work with professionals to learn to manage it. My own struggle was with acceptance. In my mind, my depression was due to the label placed on me via diagnosis. It took over a decade to find the right support system. My advice to those with mental conditions is to "Never give up!" May sound cliche... Yet although these conditions may not be curable, they can be manageable.
- ThinkADRIAN 14y ago
  here's an account of my own bout with a mental health condition: http://adriancunanan.com/blog/2013/3/12/heres-to-the-crazy-ones http://adriancunanan.com/blog/2013/3/12/heres-to-the-crazy-o...

207 points by scottcha 14y ago

Cognitive behavioral therapy is also very effective in many cases (and can work on its own without medication, depending on the situation).

rip747 14y ago
`and can work on its own without medication, depending on the situation` nail on the head! many people don't realize when they need to go to a doctor and get the meds they need.
richardlblair 14y ago
I'm a huge fan of CBT. Recent studies have shown that if a person is dedicated to CBT it can actually have the same positive effects on the brain as medication, without the negative effects of medication. It is important to note, however, that the person must commit.
- rip747 14y ago
  and its also important to note that just because it worked for your buddy doesn't mean its going to work for you. it also means that just because it worked one time doesn't mean its going to work the next time. the best thing to do is to be monitored by a doctor so you can get the medical help right away if you need it.
  - richardlblair 14y ago
    If you are working with any competent professional they should be able to identify when you will need medical help right away. There is a huge movement in north america to through drugs at everything. In Europe they take an entirely different approach on a lot of front and are seeing more success than us in those areas (ADD immediately comes to mind) I'm not against medication, but I am against rushing to medication. I'd much rather someone try various forms of therapy first. CBT is just one of them, and happens to be working at a rate equal to or greater than prescription medication. Edit: I wanted to thank you for the reply. Discussion surrounding the topic is critical to progression.
newplagiarist 14y ago
It can work on it's own, true, but it is more effective if used in combination with medication. [1] Though CBT doesn't seem to be more effective compared to other types of therapy for treating depression. It is still better than no therapy. [2] [1] Chan EK-H. Efficacy of cognitive-behavioral, pharmacological, and combined treatments of depression: A meta-analysis. [2]Hoffman et al. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses.
mattchew 14y ago
Seconded. For people who are interested in DIY approaches, I recommend reading Seligman's Learned Optimism. I am noticeably less depressed (dysthimic, really) than I used to be and Seligman's books were part of the difference.

drivebyacct2 14y ago

These can be very hard things to do when you're depressed. It helps if you have someone motivating you. I'm on my way out of a pretty serious slump and the same things have helped me as this article has described. I've been surrounded by positive family members, I've been on a generic of Lexapro, I've been running/jogging/fast-walking two miles a day and I've been reminding myself that I didn't feel this way a year ago and that in a year I might feel completely better again. Anyone who's ever been depressed knows that even on a good day, just thinking about your depression can evoke panic and sadness and a "relapse". I'm using the Seinfeld calendar system. I try to keep up a streak of good days and use that to motivate and reassure me. (Frankly, the fact that I even clicked on this topic and wrote a comment means I'm feeling better. I had to skim and mentally skip over much of HN during the weeks after Aaron's suicide. :( )

rip747 14y ago

this is the biggest misconception when it comes to clinical depression... that you can or did beat it. You can never or will never beat clinical depression, only suppress it. Beating something is finite and means that it can never happen again. The author gives great advice in the article about what steps he did to suppress this bout of depression, though if he doesn't stay the course chances are it will come back. The scary thing about clinical depression is, even if you continue to do the things that worked in the past to suppress it, it can still come back. The one piece of advice that he doesn't give (or he might have and i'm just not catching it) is realizing that you have to listen to the people around you when they tell you that you look depressed. At that point, you need to get help immediately so you don't fall further down the hole. btw... I'm not a doctor or anything. Let's just say that I have extensive experience with clinical depression and bipolar disorder.

starpilot 14y ago
> Beating something is finite and means that it can never happen again Since when does beating an illness mean permanent immunity? You can beat cancer and have a recurrence. There's nothing in the definition of clinical depression saying that it's a permanent illness.
pragone 14y ago
I came here to say something similar - you do not "get over" clinical depression caused by a biochemical imbalance in your brain. It does not get fixed without making biochemical changes to your brain. The advice the author gives is very sound advice (exercise, for example, does indeed induce biochemical changes in your brain), but without first becoming convinced of the advantages of getting treated, and taking the time to understand how those treatments effect you and how you need to actively participate in them, the rest of his suggestions are near impossible to follow through on. The stigma around psychological and psychiatric care do not help the situation; however, the numerous stories on these issues here on HN I do hope shed some light on those that are still suffering without help to know that there always is a chance to get better, and it can be as easy as calling your doctor or telling your friend you need help. Or even talking to one of us here who have been suffering from depression and suicidal ideations for many years - I certainly would be more than happy to talk with anyone who is struggling with these issues.

Xcelerate 14y ago

What if you're depressed because you're afraid of death? (I wouldn't say I'm depressed -- not in the clinical sense anyway; but I do spend what I imagine is an abnormal amount of time thinking about it because of mother's passing away when I was younger).

rip747 14y ago
what you describe is emotionally based, not chemically based. There is a HUGE difference.
- dia80 14y ago
  That's a false dichotomy. Ultimately all thoughts / brain function rely on "chemicals". The idea of purely "chemical" mental distress is also severely strained - consider "there is a 0% chance your current feelings are influenced by your environment / past". It's all a bit more of a spectrum. There is serious money behind the chemical mental-distress-as-an-illness interpretation. If it's a medical problem then you need a medical solution. Anti-depressants anyone? They are being taken in such vast quantities they are starting to poison the water. [1] [1] http://www.newscientist.com/article/dn21882-antidepressants-in-water-trigger-autism-genes-in-fish.html http://www.newscientist.com/article/dn21882-antidepressants-...
  - rip747 14y ago
    no... what you've saying is false. There is a HUGE difference in feeling sad about a traumatic or past event versus the chemicals in your brain not working properly. also this conversation is about true clinical depression and the difference between it and just feeling sad; it's not about some conspiracy theory of how every doctor wants us to be on meds or the fact that flushing medication down the toilet is poising our water supply. please stay on topic if you want to continue the converation
    - dia80 14y ago
      It's a little brash to dismiss published evidence as a conspiracy theory. You may think it flawed but then please at least make an intelligent criticism. Who gets to decide what is "feeling sad" with a cause and what is idiopathic "chemical malfunction". Care to offer any references? Objective diagnostics? I included the bit about antidepressants to caution swallowing the prevailing medical model hook line and sinker with out pause for thought as to it's assumptions. Pretty sure that's on topic.

dpapathanasiou 14y ago

Exercise is incredibly important b/c of all the positive neurochemical effects it produces. But if you're exercising by yourself, it's easy to skip it, especially if you're already feeling down. It's better to take part in some kind of team or class activity where there's a little bit of social pressure to show up. There will be mornings when you think, "I don't want to go, but I don't want to let those guys down," and so you wind up doing it.

j_baker 14y ago
Exercise is almost never a bad idea. However, the evidence that it helps with depression has recently come under question: http://www.bbc.com/future/story/20120822-does-exercise-help-depression http://www.bbc.com/future/story/20120822-does-exercise-help-...
- deleted 14y ago
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Evbn 14y ago
Also, sell your car, and moved within range to bike to work. When exercise becomes locally optimal, it is hard to avoid it.

beersigns 14y ago

I'll agree with the working out regularly being good for your health, both mental and physical. Exercising has gotten me through some tough spots in my life and it has always been a major coping mechanism. Another thing that has always worked for me has been laughter. Whether it's watching a classic movie like Dumb & Dumber, reading reddit/r/funny, or catching The Colbert Report, laughing eases all the little things that otherwise might eat you up.

pstuart 14y ago

Matches well with this: http://www.forbes.com/sites/michaelellsberg/2011/07/18/how-i-overcame-bipolar-ii/ http://www.forbes.com/sites/michaelellsberg/2011/07/18/how-i...

richardlblair 14y ago

I'm really happy that these posts are getting onto the front page. They are very important. I want to add one thing. Working with a doctor is important, but work with a psychologist as well. Especially if you are resistant to going on meds (and I don't blame you if you are...). A good psychologist may be able to offer you treatment options that better suit your needs. Also, if you aren't getting what you need from your Dr or Psychologist then move on and find a new one. Keep doing this until you find someone who genuinely cares about you, and wants to work with you to get you feeling better.

roflc0ptic 14y ago
Medications obviously aren't for everyone, and certainly there's no one size fits all medication, but as someone who tried several medications that interfered with my clarity of mind, finding Wellbutrin has made a real difference for me. It works along a different pathway than other anti-depressants. It's known to increase focus. Rather than feeling like I was experiencing the world through gauze, I feel more... like me, sans the crippling depression. YMMV, but I find that every (exceedingly legitimate) objection I have towards medication simply became immaterial in the face of feeling better.
- cdjk 14y ago
  Feeling "more like yourself" is one of the more common descriptions of what it feels like to be on a medication that's working. I'm glad you found something that worked and you're feeling better.
  - Evbn 14y ago
    I always feel like myself, and myself is always changing. I just prefer the versions of myself that aren't bleeding profusely or have eye-burning headache or dizziness when I stand up or lower back pain or etc etc
Evbn 14y ago
OTOH, for someone who is working through depression, it is nice to have somewhere to go to safely talk about something else without randomly once a day (as it was during peak Swarz-steria season) getting a note shoved in your face that says "HEY! let's talk about your fucked-up mental problems again!"

borski 14y ago

This is a really important post. Something I've noticed is that more people climb in the Bay Area than anywhere I've ever been before. I wonder if its at all related to the stress and personalities contained there?

sbhere 14y ago
The West is also a great place for climbing (geographically speaking) - far better than many places I've lived... but I'll also vouch for climbing being a great activity. Ultimate Frisbee as well.
Evbn 14y ago
It is a trendy hobby. (Nothing wrong with that.) It os socially rewarding to have a popular hobby. Some people run or bike or play basketball.

zenogais 14y ago

Walking definitely helps. Last year was a particularly rough one for me in a lot of ways and just going back to the mountain town where I grew up and hiking for a few hours in the forest really helped me to change my outlook. I consider it the most important thing I did.

zindlerb 14y ago

Thank you for this post. Your post really rings true for me. I have been suffering from depression for the past year, but this week has been especially bad. I hadn't sought help until recently. I have been encountering many of the things you describe.

gubatron 14y ago

great sex.

ohwp 14y ago

Maybe this will help someone: A lot of times suicidal thoughts are not about a death wish but about a wish for silence in your head. I think realizing this can make a difference. Whatever the case: don't be ashamed, get help.

dkarl 14y ago

I would say the suggestion to work with a doctor should be struck and replaced with a suggestion to work with a psychotherapist or psychiatrist. Doctors (other than psychiatrists) are not trained to deal with mental illness beyond diagnosis and prescription. You'll need to see a doctor if you want to try drugs, but the only reason to have an ongoing relationship with a doctor is so you can try different drugs if the first one they prescribe you doesn't work. Your doctor might provide helpful counseling, but then again, so might a teacher, clergyman, friend, or any other untrained person. (I suppose these are all worth trying if you know one who might help you.) Psychotherapists, on the other hand, dedicate their professional lives to EXACTLY what you want: relief of suffering from mental illness. It isn't an exact science, and your therapist's particular background, talents, and personality make a big difference, so it isn't like there's a professional qualification that guarantees good results, but at least their professional goals, training, and experience aim at what you need instead of at something else entirely.

DanBC 14y ago
In the UK the family doctor (GP) acts as a gatekeeper to other services. Thus, seeing your doctor is excellent advice for people in the UK who are depressed. Your general point - don't get the treatment from a regular doctor - is a good point. In theory you should get a quick assessment, and then a referral to PCAT team (Primary Care Assessment and Treatment) - these people will either take you on for short form talking therapy (probably cognitive behaviour therapy) with possibly some medication; or they'll refer you on to a community team; or they'll send you back to the GP. The doctor may skip the PCAT referral and send you straight to a community team. They'll do an assessment and either take you on, or send you back to the GP with advice for treatment. If a community team take you on you'll get a care coordinator, a care plan, a consultant (psychiatrist), and access to different meds and different therapies. Frustratingly, you might not be allowed access to short form CBT while registered with a community team. If you need hospital you'll get hospital. In an emergency the GP will just call the crisis team for you (in theory crisis teams are available to anyone who needs them at any time, but it's usually better to go though a GP unless the crisis team already know you). The crisis team will assess you for a stay in hospital (either informally (voluntarily) or under section of the MHA (detained against your will to protect your safety)). Of course, that's the theory and often the practice differs. And, you can avoid some of that process by getting a private psychotherapist. Look for BACP registration. (There are probably other good registration, but BACP is the one I know.) About psychiatrist: I've met lots of psychiatrists. They've almost always been "odd". To become a psychiatrist in the UK you need to do the regular medical school. That turns you from a medical student into a doctor. (But not a doctor that can practice unsupervised.) You then do Foundation Year One and FY Two. (This is practice, supervised, in hospitals etc.) You then become a registrar. Eventually you become a consultant in your chosen speciality, which gives you the power to practice unsupervised. All of this means that you have great, up to date, in depth knowledge of modern treatments and medications. It also means you're a bit of a basket case to make it through that process. Your bedside manner is likely to be interesting. I'd strongly recommend people avoid psychiatrists unless the illness is severe or resistant to other forms of treatment. As always: I am not a doctor and I have no training and all of this is just my opinion and etc etc.

RockofStrength 14y ago

There are reasonably priced sunlamps that I hear good things about in the treatment of depression. Also, use common sense: pursue positive people (and avoid negative), exercise (no matter how lightly), eat healthy, pursue goals (no matter how trivial). There are multiple avenues to happiness, and pursue the ones that your body responds to.

nasir 14y ago

The points are good however usually the depressed person can't do anything by him/herself. In my own case, I was not going out of my house for very long time and I avoided seeing any people I knew. I did not admit that I am depressed so I was blaming myself so much which was draining me as well. The only thing I knew was 'Realize you can get better' and I knew if my certain problem gets solved then I will get better but I did not have any energy to do that. After a year I found a girlfriend which helped me a lot on that problem until it was finished. It was such a tough time!

djan92 14y ago

Hello, Can anyone provide any advice on how to help a friend through depression? I met this friend about a month and half ago and he recently opened up to me about his depression. He's been in and out of depression since high school (about three years I think; he is currently on medications and getting help; he's reached out to me first (we're studying abroad in Asia) and I would like to help in anyway possible. My questions are: 1) How much do I reach out and ask to hang out/eat/etc.? 2) What are the boundaries I should be aware of? Should I bring up the depression and ask him how he's doing every day? other day? week? 3) Any general advice (I went through semi-depression for about 6 months, but it was not anywhere near as drastic) (I also helped a friend through depression last year which was almost suicidal) Thank you. I appreciate any advice you can provide.

newplagiarist 14y ago
Having a strong social support network is a good foundation for dealing with depression. My best advice to you is just be available for when he wants to talk. Let him know that if he ever needs to talk, be it day or night, you're there for him and that he can call you. Thoughts of suicidal ideation or self-harm can come at any time and he will need someone to talk to during those times. Onto your other questions. The amount of time that he spends hanging out with any individual won't matter too much; having him be in company with people he enjoys several times a week is what is key. What this means is, it doesn't have to be you particularly but if he is hanging-out with others at least 2 or 3 times a week it would be beneficial. The only boundaries that exist are the ones he implements. Generally, you'll just need to ask him how he's doing and not 'remind' him of his depression everyday, but how often you do that should be down to him to decide. The best piece of advice I can give, is to observe him. If there is a drastic change in behavior or energy level, that is when you need to intervene and either try to get him to talk or just get him out of the house. Overall, the above article is a good basis for coping with depression. The author hinted at, but never explicitly said, two key points that I feel the need to reiterate. If your friend is taking medication or is thinking about medication it can take awhile to take effect, on the magnitude of weeks or months, and that not all depression medication is the same - if one pill isn't working move onto others. Second, if your friend is seeing a therapist, again, not all therapist are the same. If he is not connecting with the therapist personally then his treatment is going to be much less effective. I hope that helps.

The_Yayo 14y ago

I did not know this friend, but I do know depression. Anyway no one can know for sure, the problems of each, in their choose, in your life, etc.. Moreover, the help of doctors, etc, that's all very well, but many times we forget, the society in general, it is very cruel, often with other friends. This life, this world.. Comments on Ref. to Friend(s)..: http://is.gd/dMte7s http://is.gd/dMte7s http://en.wikipedia.org/wiki/Aaron_Swartz http://en.wikipedia.org/wiki/Aaron_Swartz R.I.P. D.E.P.

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bpatrianakos 14y ago

I don't think one can actually beat depression but instead only really cope with the symptoms. I know that sounds awful and kind of defeatist (and I could be wrong) but I think the idea that you can actually conquer this disease sets you up for failure. I first noticed my own depression when I was just a 13 year old kid and first sought help just before the end of high school. I've been through the entire range of emotion from hopelessness to being suicidal and through it all I was always most upset that I couldn't actually beat it. I would try and fight so hard to make it just go away permanently and be like "normal" people but it just never happened. I eventually took to self medicating and became a polydrug abusing heroin addict for about 5 years. Five years later I realize that, for me, there is no "beating" it. There's just learning to cope with it. Before I realized this my main focus was trying to make the terrible way I felt just go away and to be happy. Now, rather than fight it, I work around it. I realize that a negative mood or feeling of worthlessness is not objectively true but instead just part of the sickness just like the author here says. In addition to most of what this post talked about I would say the most important thing is knowledge of self. To recognize and realize that what you're experiencing at any given time is really a complete distortion of reality is step one to recovering. Then to know what triggers those thoughts and knowing what works best for you in terms of mitigating them is the ultimate goal (with the understanding, of course, that you may not be able to completely defeat the experience but certainly minimize it). I learned these things and now, five years later, I still have depression but it's not debilitating. Whenever it decides to come around I'm able to push it aside completely or mitigate those symptoms and I've been able to do that because I've built the kind of lifestyle where people rely on me and I'm often running from one activity to another. Some might say it sounds like running from the disease but really my busy lifestyle is what keeps it at bay. Rather than having the time to dwell on how awful life is and how worthless of a person I am, at worst I'll have thoughts like "shit, now I have to go do this thing and I totally suck at it and everyone hates me" which isn't exactly a great thought but certainly beats being alone thinking of killing yourself and when I finally reach my destination and do whatever I need to do I've proven to myself that whatever I was thinking before was just plain wrong. Again, that's a worst case scenario. I've gotten to a point now where thoughts like that are the minority thankfully. So I'd just hope anyone else struggling with clinical depression is able to take a step back and evaluate their own thinking, understanding their own vulnerabilities and coping mechanisms in addition to seeking out lots of professional help (and yeah, exercising is amazing for this disease).

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gesman 14y ago

It's impossible to "think yourself" out of depression or "do something good" out of depression, unless it's just a temporary down mood. The way I beat depression is by doing pure mental exercises on focusing on the actual physical areas of the body where depression is felt, without trying to change/fight/eliminate the feeling itself. I came up with this technique during lowest point of my life and was almost shocked how fast I moved from suicidal to almost fully content state. This proved to be very powerful technique as it dissolved pain at it's roots. The speed of that approach for me was like taking antibiotics compare to taking vitamins. I can also second advice on exercise and better eating habits.

westicle 14y ago
Could you please expand on the type and method of the mental exercises? I'm interested in what worked for you... are you able to describe how someone else could undertake those exercises?
- gesman 14y ago
  Yes sure. Hope it helps: ------------------------ To start with basics - depression in it's essence is suppressed pain (or blocked energy) within the body. This pain could start with either traumatic event, long exposure to unhealthy, unloving and unfriendly environment or as a consequence of consistently negative thought patterns. Negative thought patterns causes inner emotional unpleasant sensations within the body. More negative thoughts cause more emotional pain. This pain in turn fuels more negative thoughts and the vicious, self-fullfilling cycle starts to function on it's own: inner emotional pain fuels negative thoughts, and thoughts causes more and stronger emotional pain. Once this vicious cycle strengthens - pain becomes rooted in the body without thoughts, and person goes beyond "talkative" therapies and it becomes impossible to "talk yourself" out of depression, impossible to "do yourself" out of depression or "positively think" yourself out of depression. Changing thoughts from negative to positive no longer helps because rooted inner emotional pain burns like an underground fire that is not taken care of and easily comes back. I found the solution that worked for me better than anything. Instead of trying to "think myself" out of depression or do some "pain killing" or distracting activities, I dived into depression, or more precisely "felt myself" directly into the areas of the body where I felt painful feelings. Most people are trying to avoid, escape or suppress pain. People would use drugs, painkillers, porn, entertainment, alcohol, doing-something-noble or engage with any possible distraction away from pain. But pain inside is not taken care of and soon inevitably comes back. So here's exact technique: When you start feeling depressed or strongly emotionally down - locate inside your body exact areas where you feel these depressive or negative sensations and feelings. Usually these will be in abdomen sections, chest areas, neck, shoulders, quite often occupying large areas of your body or even covering hands or feet. Make sure you mentally "mark down" all exact areas where you feel this depression. Depression doesn't like you to look at it directly like that. Depression loves to make epic unresolvable problems of gigantic proportions out of everything, and it absolutely hates to be diminished to pure physical bodily sensations. And that's exactly what you will do. Once you pinpointed exact physical areas in the body where you feel emotional, painful sensations do these steps together: 1. Start observing these physical areas within the body where you feel something. Just observe areas without trying to change your feelings. 2. Start to consciously follow your breathing. In and out. In and out - and at the same time watch/observe your inner physical areas as above. Hint: To easily focus on body areas - imagine you breathing through theses areas. Imagine you actually inhaling and exhaling through these areas - this approach helps you to focus on exact body areas (where you feel sensations of negative emotions or depression) as well as to keep conscious breathing. When areas of pain are watched - the energy pathways opens and pain (blocked energy) starts dissolving. When you add conscious breathing - this suspends incessant thinking and increases energy flow. This accelerates the whole process. Again - you're not trying to change, kill or eliminate anything. Like Eckhart Tolle says - you just adding the light of your awareness to your body. In this case to the areas that feels negative sensations. Even if painful feelings does not dissolve during this practice, you will find that they will inevitably diminish soon after. Hope it helps!

j_baker 14y ago

One other thing worth noting: consider whether you might actually be bipolar, especially if antidepressants aren't really working for you or make you worse. A lot of Bipolar II cases (where manic states aren't as dramatic and depressive symptoms dominate) are misdiagnosed as unipolar depression.

pawnhearts 14y ago

I've been fighting depression since one year ago and I'd like to share my story with you guys and hope to get some warming advices. Quick introduction: I've always been a self-educated about computer science, but my mother always wanted to see me studying in a _regular/acknowledged_ way. When I turned 25, I started feeling very bad: my career in information technology was going really good and since I didn't passed through the academical stages (exams, graduation, etc) I felt like I didn't really deserve such professional "glory" (sorry for quick and dirt english). So I decided to join the university: I started passing exams, and finally I could go to bed with a clear conscience! One year ago I received a job offer from a big enterprise, a job that could have change my life. This job (9h/5d) would not allow me to continue my university career and they gave me one week to decide. It was really hard, and in the end I refused that job. My odyssey begins from this point. I had a panic attack on the first day of university after my choice, a huge panic attack that I thought: "I'm gonna die". After that event, my condition degenerated: I was no longer able to go out from my house, neither going downstairs to feed the dog. Everytime I went outside, I had a panic attack, it was a nightmare. Because of this hard form of agoraphobia I was neither able to go out and see a psychiatrist. I also developed tinnitus in my left ear and a painful hypochondria. It took about 4/5 months before I realized the actual cause of my depression: in this age of economical crisis, when people commits suicides for not being able to pay debts, I rejected a permanent full-time contract. After this realization, my condition started going slightly better: I had no more panic attacks and I was able to go out with my gf and my friends. At the time of this writing, one year after my first crisis, I'm still not able to go to places with many people, ot taking a train, or staying away from home for too long. I see that such a condition is common to many computer programmers, I think that alienation caused by working on computers make things worse. At some point, I also considered the option of giving up with computer science, but it's not possible, it's really the only thing I can do. I'm still fighting depression, I'm still not able to answer the questions "where would you be now to be happy?" , "what would you be doing now to be happy?". It's really sad when you can't answers these questions. Is it ever happened to you? How did you behave?

ZenoArrow 14y ago
I'm sorry to hear about your predicament pawnhearts. Have you managed to get to a counsellor yet?

hackquer 14y ago

Fischer Wallace Cranial Stimulator + Neurotransmitter Supplements (5HTP, etc) This is worth a try for anyone with depression. There are many different causes, but brain chemistry can be an issue caused by your lifestyle alone, as well as other stuff.

markhall 14y ago

Great perspective. Question for the HN community: Why/How is it that small communities like HN have removed the stigma attached with mental health while larger society has not?

cdjk 14y ago
I still think there's a stigma. It's good that people are talking about it, but I don't think that means the stigma is gone.
jnorion 14y ago
There's a lot less stigma attached when it's a (relatively) anonymous forum, when you're not face-to-face with the people responding, when you have a large support group because people who understand and care find YOU (via your headline) rather than you having to find them, and when someone who responds in a negative way is likely to get downvoted and called an asshole. There are probably still people on HN who respond negatively to an admission of depression, but they're (wisely) keeping quiet.
- cdjk 14y ago
  I've never considered my username here to be particularly anonymous. Apparently it is, as I just discovered, but anyone who knows me would recognize my username. To be honest, the number of people who are open about mental health problems in posts like this is fairly surprising to me.
DanBC 14y ago
> Why/How is it that small communities like HN have removed the stigma attached with mental health They haven't - there's still stigma around MH problems. It just doesn't show itself in threads like this. See any thread about i) interviewing or ii) spree shooting and there'll be plenty of stigmatising comments. It's not so bad, because at least most people on HN are happy to talk about it.
scottcha 14y ago
Yes, as the author of the article I thought through the stigma associated with this before I posted. Ultimately it came down to leading with my heart and doing what I thought was right regardless of what others thought. It is great that there has been a quite open and kind discussion as that is what is needed.

michaelwww 14y ago

There are different shades of depression, some more manageable than others. I don't think medical science (or anyone) has figured out the worst of it yet. Author David Foster Wallace before his suicide: "The so-called 'psychotically depressed' person who tries to kill herself doesn't do so out of quote 'hopelessness' or any abstract conviction that life's assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire's flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It's not desiring the fall; it's terror of the flames. And yet nobody down on the sidewalk, looking up and yelling 'Don't!' and 'Hang on!', can understand the jump. Not really. You'd have to have personally been trapped and felt flames to really understand a terror way beyond falling."

umphetico 14y ago

Heroin helped me beat my bouts of depression, although the downside being extremely addictive which seems to bring you right back where you started but in all honesty, depression is caused by fixation, ironically heroin taught me how to relax and "let go" of the angst caused by fixation while at the same time my mind was completely fixated on it. To each his own, you gotta stop reading about how to cure an illness, you have to act, find meaning even though it's meaningless.

umphetico 14y ago

Also a more interesting question would be, are people working in startup, especially single software vendors more susceptible to depression? Look at Aaron Schwartz guy, all those times he was depressed, look at his increasingly erratic and tendency towards martyrdom. The pressure from idiot zealots finally tipped him.

scottcha 14y ago
I'm the author of the article and I asked myself this question before I wrote it. I posted some data here which came out of that research: https://news.ycombinator.com/item?id=5272763 https://news.ycombinator.com/item?id=5272763 but it didn't get much traction. When I compared across disciplines in the original dataset (using software programmer as the discipline) there wasn't a strong indication that they were more prone to suicide than other professional jobs. I don't remember exactly but doctors, lawyers, dentists were toward the top of that list. One challenge is that the dataset I reference doesn't have data post 1998. Since our discipline has grown and changed since then a more recent dataset might show something more interesting.
- umphetico 14y ago
  I think the actual software programmer job working for a company is different than someone working alone erratic hours, building apps, marketing, selling, and breaking even. It's quite challenging in itself to produce good software product let alone selling it and breaking even so it'd be interesting to see some statistics for single founder startups or micro software vendors. I would say the stress is the biggest for SaaS type of software products, as someone posted a video here about "Constant Contact", it's described as the slow ramp of death because it takes so long and hard to reach that magic upward slope. These are all just my magical assumptions based on my own situation and experience. I'm sure there's ton of positive, empathetic, emotionally intelligent coder/hacker/entrepreneurs although there's lot of Aspies, who studies have shown to be greater risk of depression.
  - Evbn 14y ago
    Stress (and financial instability) has its own set of health problems, but that's not depression. Depression has more mundane physical and neurological causes, whereas stress disorders are caused by the pressures of difficult lifestyles like running a business on your last nickel or being ultraompetitive in your career or being a soldier at war.

the_economist 14y ago

Don't forget natural sunlight.

ko6tas 14y ago

I am wondering if anyone has tried any online intervention for anxiety or depression. Some of them have strong theoretical background (like CBT that is mentioned in another comment). Any impressions?

mhunts 14y ago
Online access would make it much more accessible, especially for those who are introverted and have social anxiety like me.

systematical 14y ago

Try 2+ years of it, unfortunately (for them) someone is going to 1 up me now.

Joe_Knapp 14y ago

5htp

lucian303 14y ago

I have yet to meet someone whose depression was not made worse (in the long term 6++ months) by SSRIs and SSNRIs. These medicines cause more numbness and depression. I'd be very wary of them or any doctor who rushes you on them (or any medicines). The black box warning is not just for teens. When you are in that space (SSRI / SSNRI space), it's easy to see why anyone, even the strongest minded, would want to commit suicide. Like William Styron says in "Darkness Visible: A Memoir of Madness" (one of the best written personal accounts of depression, highly recommended: http://en.wikipedia.org/wiki/Darkness_Visible_(memoir) http://en.wikipedia.org/wiki/Darkness_Visible_(memoir)), depression is an inappropriate word. The correct word, for him (and I agree), is _madness_.

pshin45 14y ago

Stay open and allow others to help. Realize you need people around you to who can be a support network. This is the hardest thing to do when you are suffering from depression. Couldn't agree more. When I was suffering from depression, I was so stubborn about wanting to face it alone and not "force" my friends and family to get involved, because I'd be becoming even more of a burden to them and to society than I already felt I was. I just felt this burning sense of shame and worthlessness at the mere thought of asking for help. Hackers are admired more than ever, but I think it comes with a price. When everyone sees you as this superman who can make and do anything and knows everything, it's gotta make it that much harder to reach out for help.

Debugreality 14y ago

Having read a lot of the comments here there seems to be two main thoughts. That depression isn't something that can be beaten and that it can be beaten. Personally I think both camps are right, in many of the cases where people have beaten depression I think there is a common element be it Cognitive Behavior Therapy or psychedelics these practices can change your brain. Meditation can also change your brain significantly and this is how I believe I have 'beaten' depression. So no you can't beat depression without changing your brain and changing your brain can be a risky business and perhaps when you do change your brain you are no longer the you that was depressed...

realsuperman 14y ago

Everything that makes you happy or sad is in your mind. So I would suggest that it is not about beating depression but achieving a balance of the two. One cannot completely eliminate depression type or extreme joy type feelings from one's life. So it is good to develop a balance that leads to the understanding that shit happens. But this too shall pass.

adfadf 14y ago

Just a couple of notes on the medication part: Yes, you will probably feel worse during the first couple of weeks of the regimen. This is common enough that your prescribing doctor should warn you about it, and s/he should set up some way of monitoring your progress - appointments twice a week for the first month or something like that. It should also be clear from the documentation that comes with the pills. Second, you should only change your medication after consulting with your doctor. In this case it looks like the course was "I took the meds for six months, and then I felt better so I stopped", which is not recommended. The relapse rate is significantly lowered if you take the meds until you have no symptoms + 6 months (or longer, if it isn't your first depression). Third, it really is very recommended to slowly taper of the medication and not go cold turkey. The side effects will be much worse if you just stop. Also, the relapse rate. Once again, discuss any planned changes in your medication with your doctor.

geldedus 14y ago

powerful tools for fighting depression: 1) learn to dance and go dancing regularly (for ex. salsa or tango) 2) take cold showers daily 3) exercise

mhunts 14y ago
Why cold showers?

ThinkADRIAN 14y ago

I think the key to dealing with mental conditions is to identify/diagnose/recognize it, accept it and work with professionals to learn to manage it. My own struggle was with acceptance. In my mind, my depression was due to the label placed on me via diagnosis. It took over a decade to find the right support system. My advice to those with mental conditions is to "Never give up!" May sound cliche... Yet although these conditions may not be curable, they can be manageable.

ThinkADRIAN 14y ago
here's an account of my own bout with a mental health condition: http://adriancunanan.com/blog/2013/3/12/heres-to-the-crazy-ones http://adriancunanan.com/blog/2013/3/12/heres-to-the-crazy-o...