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Toward a Predictive Theory of Depression

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Re: Toward a Predictive Theory of Depression

#91

Post by eradicatethots »

davymac wrote: post #87
bnjms wrote: post #80

Earlier quoted context omitted.

My point is that people have to figure out what helps themselves. All of the terrible advice amounts to knowing there are people who have learned to manage themselves and therefore most people can learn to manage themselves.

Fair point. I like this view. Seeing all the anecdotal ways people have gotten themselves out of severe episodes may not work for the person seeking help, but it may give them enough hope to keep looking for the next approach before calling it quits for good.

Don’t really think there are that many. The vast majority are some form of “work out, eat healthy, ...”

Re: Toward a Predictive Theory of Depression

#92

Post by tcj_phx »

HerrFolgreich wrote: post #88
tcj_phx wrote: post #56

Earlier quoted context omitted.

> There is, it's usually pretty easy to tell the difference. Doubt anyone would mistake them, and I doubt the OP is. A few months ago a young man (early 20's) came into a shop I sometimes hang out at. "What brought you to town?" "Recovery." He'd been in town for 3 weeks, and sober for 3 weeks and 1 day. I asked him, "People usually know when their problems when substances started, when did it start for you?" When he…

Would you mind to elaborate a little bit on your suggestions? That is if it's not too specific.

The only thing that fellow could really do for himself was buy some coconut oil. The brains of alcoholics become insulin-resistant and switch to running on acetate, one of the breakdown products of ethanol. The medium-chain-triglycerides in coconut oil provide brain cells with an alternate source of fuel. (I understand that Coconut fatty acids are short enough to be burned without having to go through another step that longer saturated fats [butter, etc] require; I don't remember exactly what that step is.)

I don't think that guy was able to get the coconut oil while at the recovery center. I think giving a more helpful context for viewing his history of addiction was much more helpful than the recommendation for coconut oil.

Another heavy drinker I know does fine while on "vacation", but "stress" in his every day life leads to excess drinking. I have no influence with this one, but I'd try to get him to eat more sweets when in stressful situations - juices/etc. I've heard an old treatment for alcohol withdrawal is to feed them lots of sugar. Here's a random NY Times article that says sugar helps reduce cortisol levels: https://well.blogs.nytimes.com/2015/04/23/sugar-as-a-stress-...

IMHO, sugar in juices and other foods is basically fine; starch is 100% glucose and is a greater contributor to excess weight. Lots of caveats with regards to the sugar issue...

Re: Toward a Predictive Theory of Depression

#93

Post by fujiters »

eradicatethots wrote: post #76
trapperkeeper74 wrote: post #14

Umm, not sure this is universal but partial. Depression seems evolutionary psych for multiple, overlapping purposes: - Reducing aggression (and hence conflict) in larger groups. - Focusing on existential re/purpose by turning inward (ie find a new job/hobby/outlook/philosophy). Lots of reading, writing and ideation. Hopefully rebuild confidence/positivity with completing something. - Retreating for terminal resource…

Medication will stop working, it always does.

That's the spirit!

In all seriousness, what else is there to do? Take whatever relief you can get while you can get it.

Re: Toward a Predictive Theory of Depression

#94

Post by Avshalom »

roflc0ptic wrote: post #83
cassowary37 wrote: post #68

Earlier quoted context omitted.

Yes. This is one reason I bothered to comment. Psychiatrists who step into the public space bear a particular obligation both to advocate for our patients and to push back against misinformation.

The article is prefaced with: "Epistemic status: wild speculation." It seems like we rather do need more theorizing, because we don't currently have a theoretical description of depression that leads us to solutions. I know I've also seen him write about the possibility that depression is a set of interrelated diseases that look the same, and talked frankly about the inefficacy of treatments. It's a fairly ungenerous…

>> Do oncologists need to talk about how bad cancer is every time that they write about it in a public space? Eh.

They would if a surprisingly large portion of the public believed cancer didn't actually exist.

Re: Toward a Predictive Theory of Depression

#95

Post by eradicatethots »

fujiters wrote: post #93
eradicatethots wrote: post #76

Earlier quoted context omitted.

Medication will stop working, it always does.

That's the spirit! In all seriousness, what else is there to do? Take whatever relief you can get while you can get it.

Remove bad habits/ behaviors/people... cure the problem

Re: Toward a Predictive Theory of Depression

#96

Post by themodelplumber »

mcguire wrote: post #86
themodelplumber wrote: post #34

It's a weird coincidence to read this. I was doing basic research on depression and saw that dopamine played a role in helping people feel good. One WikiHow article [0] later, I had an idea: Start reaching goals. I started very small, like taking progressively longer walks. Since that time I have earned something like five different certificates in various areas of interest (ARRL coming up next) and as a very recent…

Do you not discover that even a minor failure to reach a goal leaves you with feelings of disappointment, anger, and rejection that make it difficult to re-start the process of working towards the goal?

Prior to learning to analyze, yes, I did feel that way. In fact I was swallowed up by those feelings quite often, for years.

After learning more about analysis, not so much. Analytical thinking is more tactical and adaptive. It says, "forget about the big picture of who you are and what this says about you, and just focus on what this situation seems to demand. Which changes would seem to give you the most leverage on your next try?" So I'd try different things the next time and kind of keep a log, asking how it was all working. "Star date..." I was Jean-luc Picard and today was another episode. An internal monologue helped.

Tactical / analytical thinkers are good negotiators. I began to admire those who were in it to _win_ it, not just to give it a shot and see what happened. I followed study blogs and watched presentations by negotiators. For all they knew, if they failed at reaching a goal, it was the goal's fault! This was a real reset to my thinking.

I also have a son who is a very gifted tactical thinker. He's constantly analyzing and negotiating. Analyzing his behavior, I've learned that he will ask again and again until you get sick of him asking for things. The asking comes at little cost to him and there's a good chance that the asked will give in.

So: I'm more of an asker now. And I find that I accomplish more as a result.

I don't mean to communicate that I'm perfect, some kind of ubermensch, btw. Just sharing what I've learned. Also, I don't think this advice will work for everybody, but I hope it can help you somehow.

Re: Toward a Predictive Theory of Depression

#97

Post by asddddd »

tsomctl wrote: post #13
tcj_phx wrote: post #9

> Depressed people move more slowly, in a characteristic pattern called “psychomotor retardation”. They display perceptual abnormalities. They’re more likely to get sick. There are lots of results like this. > Depression has to be about something more than just beliefs; it has to be something fundamental to the nervous system. Depression is frequently related to metabolic problems: people are exhausted because their…

I find that creatine helps, which weight lifters take to make it easier for your muscles to use ATP.

Note that creatine should be avoided if you're bipolar, according to a study or two and a lot of anecdotes.

Kidneys: https://examine.com/nutrition/does-creatine-cause-kidney-pro...

Overall, it's a very safe and moderately effective supplement, particularly if you don't eat a lot of red meat. Just make sure to drink enough water.

I wouldn't say I've been depressed (a psychiatrist might disagree, I've been dx'ed with it in the past), but daily 5mg creatine and 2k IU vitamin D have made a remarkable difference in mood/energy for me this year.

Re: Toward a Predictive Theory of Depression

#98

Post by jdale27 »

Asooka wrote: post #84
cassowary37 wrote: post #65

Professor of psychiatry here - I've spent the past 20 years trying to help folks with depression, and related illnesses, and trying to study these diseases at a genetic level. I suspect this will get me down-voted as I know the medical/biological perspective is often unwelcome on hn. However: a key error people make here and elsewhere in speculating about depression (and suicide, and ADHD, and...) is either extrapola…

Could they be several different illnesses with different underlying causes, but similar symptoms that mistakenly get classified under the same name?

Yes, that certainly could be the case. Unfortunately there doesn't seem to be much (if any) understanding of what is different about those illnesses, and in particular no practical test that can distinguish between them to help identify the proper treatment.

By contrast, it is now very well recognized that there is no single disease called "cancer". There are many subtypes, not just based on tissue (e.g., breast cancer vs. lung cancer) but also on the molecular etiology (i.e., which mutations are present in the tumor and therefore which pathways of oncogenesis are involved). Because of this, it is in some cases possible to determine based on DNA sequencing which is the appropriate drug to use to treat a particular cancer. Depression is not anywhere near as well understood.

Re: Toward a Predictive Theory of Depression

#99

Post by [deleted] »

cassowary37 wrote: post #65

Professor of psychiatry here - I've spent the past 20 years trying to help folks with depression, and related illnesses, and trying to study these diseases at a genetic level. I suspect this will get me down-voted as I know the medical/biological perspective is often unwelcome on hn. However: a key error people make here and elsewhere in speculating about depression (and suicide, and ADHD, and...) is either extrapola…

[deleted]

Re: Toward a Predictive Theory of Depression

#100

Post by empath75 »

cassowary37 wrote: post #65

Professor of psychiatry here - I've spent the past 20 years trying to help folks with depression, and related illnesses, and trying to study these diseases at a genetic level. I suspect this will get me down-voted as I know the medical/biological perspective is often unwelcome on hn. However: a key error people make here and elsewhere in speculating about depression (and suicide, and ADHD, and...) is either extrapola…

I’ve never been sure why it’s treated as a disease rather than a symptom. It’s like saying someone with a high temperature is suffering from fever. Which is nice and descriptive and treatable with the right medications, but does nothing to describe the underlying cause.
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