Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Tips for the depressed

nplusonemag.com

Post reply on HN
Print view View original

131–140 of 224 posts

Re: Tips for the depressed

#131

Post by mcguire »

nitrogen wrote: post #72
wbronitsky wrote: post #60

Earlier quoted context omitted.

Here we go, actual data about SSRIs vs the placebo effect: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/ It would be super cool if we all took the time to cite data that back up our assertions instead of just insisting that our ideas are correct.

I'll quote the lede from the abstract so people know what they are clicking on: Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future. Nobody currently taking antidepressants should stop them without very careful planning and consideration of whether they should and how, but the same very strong consideration should be g…

On the other hand, from the end of the article, "My colleagues and I have conducted a meta-analysis of various treatments for depression, including antidepressants, psychotherapy, the combination of psychotherapy and antidepressants, and “alternative” treatments, which included acupuncture and physical exercise (Khan, Faucett, Lichtenberg, Kirsch, & Brown, 2012). We found no significant differences between these treatments or within different types of psychotherapy."

So the first thing you should know about the treatment of depression: Nothing works very well.

Re: Tips for the depressed

#132

Post by magduf »

ThrowawayP wrote: post #76
jotm wrote: post #5

I hope they work for some, but for me, SSRI's are frankly, trash. All the downsides with none of the upsides. The only thing that worked was Imipramine, and I can't get it anymore because it's "old" and "not recommended". The newer focus on psychedelics and drugs usually used for recreational purposes seems more encouraging. If you're anti-depressant resistant, I'd recommend you try Gabapentin, a seemingly overlooked…

I've got you beat; neither SSRIs nor gabapentin nor any other of a variety of on- and off-label meds worked for me. Despite that I don't think it's a good idea to recommend or disrecommend any specific drug; it is very much a biochemical roll of the dice as to whether a med will work on a given individual and the odds aren't even particularly good. My suggestion to the depressed is to try as many as you can withstand…

>Despite that I don't think it's a good idea to recommend or disrecommend any specific drug; it is very much a biochemical roll of the dice as to whether a med will work on a given individual and the odds aren't even particularly good.

Since many drugs seem to affect different people differently, it seems we really need to work on understanding how drugs affect people differently based on their genetics. This is similar to, for instance, how some people think cilantro tastes like soap, because of a gene mutation. I think there isn't nearly enough attention being paid to this, and it's making the field of psychiatry look like various drugs are no better than placebo, when it's much more likely that some drugs work great for some people, but terribly or not at all for others, so right now it's a crap-shoot when instead we should be figuring out what will actually work for certain people based on their genetics instead of shooting in the dark.

Re: Tips for the depressed

#133

Post by flycaliguy »

jsjddbbwj wrote: post #22

Someone here recommended David Burns' "The Feeling Good Handbook" and it was a very, very good read. I'm not going to say it turned my life around, but it taught me how to spot and disarm all kinds of cognitive distortions, defeat laziness, better align my expectations of others, assess my self worth positively... It's also well written, fast paced, and sometimes even funny. It includes lots of exercises that are pra…

Crazy thing about this book is I was so depressed I could only read the first chapter or so. And it still changed my life in the end and I live by that first chapter.

Re: Tips for the depressed

#134

Post by cvshepherd »

throwddd wrote: post #116

As Tianeptine wasn't mentioned: it did help me, took it for 7 months (Coaxil, 3x12mg/day), no side effects. https://en.wikipedia.org/wiki/Tianeptine

a word of caution. if you have a history of substance abuse, you're probably better off trying most other meds before this one. the abuse potential due to its recreational value is pretty high. i stopped taking it after i realized it felt just like opiates in higher dosages. reddit addiction subs are full of threads regarding this substance.

Re: Tips for the depressed

#135

Post by dorkwood »

burntoutfire wrote: post #57
cgriswald wrote: post #28

Earlier quoted context omitted.

For me, doing those small things did seem impossible and even when I managed to achieve it, I didn't feel the reward. There didn't seem any point in making the bed if I felt the same whether the bed was made or not. Eventually I reached a mental place where I could turn that around: If it doesn't make a difference in how I feel, why not make the bed? I had to more or less take it on faith that eventually the rewards…

Coincidentally, I really see no point in making the bed. I wonder if I'm depressed.

The main benefit I've found to making the bed is that it shrinks your subconscious to-do list and helps you concentrate. If you make your bed, clean up the plates on your desk, and pick up your clothes from the floor, then your brain has nowhere to hide -- the only thing left to focus on is the task at hand.

Re: Tips for the depressed

#136

Post by __s »

dorkwood wrote: post #135
burntoutfire wrote: post #57

Earlier quoted context omitted.

Coincidentally, I really see no point in making the bed. I wonder if I'm depressed.

The main benefit I've found to making the bed is that it shrinks your subconscious to-do list and helps you concentrate. If you make your bed, clean up the plates on your desk, and pick up your clothes from the floor, then your brain has nowhere to hide -- the only thing left to focus on is the task at hand.

But making my bed & cleaning were never on my todo list to begin with, so it isn't shrinking my subconscious todo list

Re: Tips for the depressed

#137

Post by fogetti »

rjkennedy98 wrote: post #24

I would love to finally see an article that has tips for a society on how to prevent depression, instead of the constant stream of self-help BS that is constantly directed at people who may have real reasons to be depressed.

That's a good point. Everything, even the coronavirus has this narrative attached that prevention should be the utmost priority. At the same time the same narrative is completely missing in case of depression.

I guess the difference is that depression has been learned to capitalize on for a long time now.

Re: Tips for the depressed

#138

Post by jlangemeier »

MegaButts wrote: post #129
notRobot wrote: post #103

Earlier quoted context omitted.

> I’ve done a lot of research and I think psychiatry is pseudoscience and antidepressants are largely placebo. Even if they didn't work for you, making claims like this on a public forum is very irresponsible for you, and can be very dangerous for those who really need the help. Please refrain from making such statements unless you're a medical professional.

I think people should be allowed to share their opinions, even if they're controversial. Just because you disagree doesn't mean he's wrong (nor am I saying he's right). I have no dog in this fight, but you don't have to Google much to find studies that cast doubt on the efficacy of anti-depressants. https://www.medicalnewstoday.com/articles/325767

Ehhhhhhh...

And google swings... and it misses...

There are two somewhat competing studies involved in what you linked.

The original meta-analysis is stating that "[a]ll antidepressants were more efficacious than placebo in adults with major depressive disorder." And if you dig into that study, the level of effectiveness varies, but is consistently above a placebo.

The other, states that the original meta-analysis missed some points within their study; specifically that under the standardized criterion, there is an unknown level of bias in the results (73% showing unknown bias, and 26% showing high risk of bias - essentially confirming that most studies couldn't be done in a full blind or double-blind manner); and that while the sample size was high, the effect size was less known due to drop-out rates of the studies.

This isn't necessarily contrary to the initial meta-analysis, but brings to light that they may need to be taken with a level of caution; it doesn't make the claim that anti-depressants are no better than placebos, but that when doing the meta-analysis Cipriani et. al. needed to make more apparent exigencies with their results.

All this being said, the puff piece draws a more black and white tone with the meta-analysis and the meta-meta-analysis results; which tends to be the problem with these types of pieces. Sure, do your own research, but you'll need to dig into what's actually behind the journalistic fluff to get at the real meat and potatoes of the subject, if you don't you may come away with the idea that anti-depressants have 0 efficacy instead of "some efficacy, with the caveat that studies are somewhat mixed on individual results due to the nature of how the studies are conducted."

Re: Tips for the depressed

#139

Post by blackflame7000 »

ditonal wrote: post #19

I largely agree with all the advice here. I dropped out of college due to depression, then I torched my tech career with a manic episode that led me straight from a FAANG SWE job to an involuntary psych ward patient for a month, which was followed by a half year brutal depression. I’ve done a lot of research and I think psychiatry is pseudoscience and antidepressants are largely placebo. I’m really on the mindfulness…

I think in many ways antidepressants can actually make things worse because of the emotional blunting side effect that can make it hard to connect with others.

Re: Tips for the depressed

#140

Post by blackflame7000 »

PragmaticPulp wrote: post #70
ditonal wrote: post #19

I largely agree with all the advice here. I dropped out of college due to depression, then I torched my tech career with a manic episode that led me straight from a FAANG SWE job to an involuntary psych ward patient for a month, which was followed by a half year brutal depression. I’ve done a lot of research and I think psychiatry is pseudoscience and antidepressants are largely placebo. I’m really on the mindfulness…

> I’ve done a lot of research and I think psychiatry is pseudoscience and antidepressants are largely placebo. Please don't spread anti-psychiatry misinformation online. I'm sorry that it didn't work for you, but please don't dissuade others from seeking proper treatment. Playing devil's advocate: Even if SSRIs are just placebo (they're definitely not, and we have decades of science to explain why that's a false stat…

It's also misinformation to assume SSRI's work the same way for everyone. For my mother, antidepressants made her suicidal.
Post reply on HN