Ask HN: Beating depression with or without anti-depressants?

>So HN, what has your experience been with depression?

I am sharing my own experience, the topic being a taboo does not help people who suffer.

I was also shit scared of medication, and too apprehensive to go to a medical professional... until it was too late and it all collapsed.

I visited 4 different emergency psychiatrists. Only one of them managed to identify the condition and treat me accordingly. His goal: keeping me alive for 18 months. It worked. I did need strong medication, and it had to be carefully adjusted several times. This kicked me out of depression in about six to eight months, but did not solve underlying issues. Once the emergency psychiatrist rated that I was in a stable route for recovery, I switched to a regular psychiatrist that basically checks my medication once every two months.

In parallel, I started weekly therapy with a psychologist. Also I tried two doctors and ended up with the second one. This one is needed to solve underlying issues. It took long time to get it really working, but it ended up great. It's been a year and I am still attending weekly therapy.

Its been 18 months since I started treatment. I am better now than I've been the last 10 years, but change did not come overnight, and I am still working on it with full energy. I wouldn't have made it so well without any off:

a) sport & good food & sleep. b) amazing doctors. c) medication.

> Have you tried the drugs?

Yes, quite a few actually.

> What worked or didn't?

What worked: medication + full trust in the doctor + lots of patience.

What it did not work: expecting to be back to "normal" fast.

> Have you been able to triumph without chemical assistance and what did that look like?

I really doubt I would have triumphed without chemical assistance.

> Is my utter terror of these drugs warranted or should I just bite the bullet and try them?

Terror is due to depression being taboo, and fear of the unknown. Medication is not to be underestimated. It has side effects, for me it was mostly feeling even less energy than normal. So I would not take them unless you have under close surveillance and you trust fully your doctor. On the other hand, they are very very effective. I am weaning-off medication slowly and I am experiencing no side effects.

What worked for me was cutting all drugs and alcohol then waiting around 6-9 months for my mind to heal. Exercise if you want to wake up deliriously happy but the important part was no substances.

Try replacing 'depression' with 'high blood pressure' and see if you feel the same way about the pills?

Except high blood pressure is a lot easier to measure and there's a lot less subjectivity involved in the decision. Whether or not someone is depressed is nowhere near as easy to measure

I went through mild (and not professionally diagnosed) depression a few years back. No suicidal thoughts, no pit in the stomach, just a complete lack of desire to do anything at all. Crystallized apathy. Before seeing my doctor, I figured I would anticipate his questions: he would ask, "Do you get any exercise?" And I would say, "No, I walk up two flights of stairs and back down those flights of stairs each day and that's about it." And my doctor would say to me, "Get some exercise, and see what happens."

So I got some exercise. I bought a bike and put it on a trainer. I rode a few times. I loved riding my bike when I was young. That helped, a little. I think it helped me take my next step.

I'd been coaching my 9yo son at soccer for a year or so, but I never played soccer myself. So I decided I'd try playing a local soccer pickup game.

That was the trick for me. I don't know why. But suddenly I found motivation. Just enough to play soccer. Once a week, and then twice a week, and then three times, and now as many times a week as I can fit into my schedule. I lost 10#, 20#, 30#, even made it to 40# before the pandemic and found more motivation in other areas of life as well.

Soccer hurts. A lot of games I can barely shuffle through my garage after driving home. I was 39 when I started playing and I'm 41 now. I'm no spring chicken. But the mental and physical engagement of playing soccer, even just pickup soccer, has thoroughly enriched my life.

I have a friend who's a psychiatrist. I talked to him about this. He told me that I correctly anticipated my doctor's response. Exercise is the first line of defense and the first treatment suggested for depression. And it doesn't take much to try it and see if it helps. Your depression sounds worse than mine. Maybe you can walk before you run.

You shouldn't be afraid of the drugs: let the doctors handle that. But if you prefer to try something before drugs, exercise is the clear choice.