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Ask HN: How to cope with depression

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Re: Ask HN: How to cope with depression

#71
post #17

I'm an Army veteran that was diagnosed with PTSD in 2010 after a particularly shit deployment to Afghanistan. I've also battled with depression my entire life. Name an anti-depressant or anti-anxiety pill and I've probably been on it at one point in my life. They definitely help you. Conversely a good therapist is also extremely helpful. They can help you find directions that are away from the meds. I've currently be…

Have you tried MDMA-assisted therapy?

http://edition.cnn.com/2012/12/03/health/ecstasy-ptsd-3/

Incase it was never available to you, it should be soon. DEA approves study using MDMA for anxiety in seriously ill patients (Mar 17, 2015):

http://america.aljazeera.com/articles/2015/3/17/clinical-tri...

Re: Ask HN: How to cope with depression

#72
There are a lot of different medications you can take, and they have different side effect profiles. Prozac is different from Wellbutrin is different from Lexapro, etc. Sometimes doctors don't have a good reason to choose one over another in any particular case. If you sit down and have a serious talk with your doctor about which side effects often come with each medication, and which side effects you can live with, you're more likely to get off on the right foot.

People telling you to exercise are right, but that is pretty hard advice in that format. The real answer is to find the kind of exercise that works for you, and don't give up until you do. I've never been a morning person, and I always hated running and other cardio, so for years I didn't really exercise at all outside of walking places. Turns out I really like biking and rock climbing. If you can switch to biking as part of your commute (biking to the train maybe) then you don't have a way out, and you have to exercise. Use the days when you do have energy to make plans for later days when you may not. Try to do things for other people.

The best thing for me in the end was 1. Getting out of the life situation where I had been depressed for a long time. 2. Getting into something totally new and overwhelming, and doing it totally by myself. I spent all of college and grad school dealing with some pretty severe depression, and when I finally graduated I took out extra loans to travel for a few months over the summer before my job started. I bought a one way ticket, planned almost nothing except listing a few places I wanted to see, and went alone. When you are traveling alone in a foreign country, it really hits home that you are entirely responsible for your own experience. There are beautiful sights, incredible food, life changing encounters to be had, and you have to make the choice every day between getting up and out and interacting with the world and crying on your hostel bed. You'll still spend some time crying on your hostel bed, but you might also smoke a joint with a Brazilian and some French women in a park in Prague and start a travel romance with a former professional trail runner in Barcelona.

Re: Ask HN: How to cope with depression

#73
I've dealt with a couple major depressive episodes in my life. In addition to the standard advice of 'Go see a therapist!' heres some things that help for me:

1) Committing to myself that I'm getting out of this state, and reminding myself that I'm working on fixing it. Then having the leniency on myself that depression is not a solved problem, and I will keep trying until I actually have accomplished my goal - however unclear my progress may be.

2) Consistently enforcing myself to complete small achievable goals. For me, this is stuff like: getting out of bed within 3 minutes of my alarm going off, having an ironed shirt, show up at the gym and do some sort of exercise daily.

If you have motivational trouble, start with even smaller goals eg 'I will put water in my cereal bowl after I put it in the sink so the milk doesnt dry and get gross.' Then work up to 'I will put the bowl in the dish washer after I am done with it.'

3) Creating arguments for why everything is actually all okay. Many of them don't convince me, eg 'You've got a steady income', but some of them do eg 'Well I've read several papers that forcing yourself to smile releases neurochemicals that make you happier' was pretty convincing.

4) http://examine.com/topics/Depression I'm not a medical professional, but the evidence gathered for supplements listed on this site is convincing. In addition to Fish Oil and Saffron, I've seen a lot of evidence for supplementing Vitamind D and found it to be very helpful.

5) Go see a therapist that you like and respect. It was important to me to find one who I thought was smart and practical - I didn't want a ooshy gooshy feelings therapist. I've had the most success with CBT.

6) Learn to refocus your thoughts. This is tough, but, the worst part of depression for me is often the sad thoughts that come with it. I find that days are better when I don't allow myself to indulge in thinking sad thoughts. So this means 1) catching myself when I've starting thinking something sad 2) Successfully putting my thought train on a non-negative track.

If you take the meds, just be aware of the side effects of being on the meds and also be aware of the side effects of coming off the meds. I've found no doctor that really sufficiently warns of these.

If you ever want to chat, my email address is in the link in my profile.

Re: Ask HN: How to cope with depression

#74
What I'm going to say here is going to be extremely controversial. I ask you to think carefully about what I'm about to write before raising any objections mid way through. I've helped a lot of people get through depression when meds/basic advice(exercise, meditation, etc) just wasn't working.

1. First, figure out if it's your situation. Chronic stress that comes from a source outside your control is number one cause of depression. Most people are depressed because they lie to themselves saying they are working at a job/going to school for something they love but they really don't. The little voice in the back of your head that tells you maybe you should actually pursue EXACTLY what you want out of life, instead of telling yourself doing it the 'safe way' is better, safer or it's just what supposed to be. Because at that point even though you raise the stress level, you allow the stress to come from a source that you CAN control (you are finally in charge and are doing EXACTLY what you want in life) instead of from an uncontrolled source (shitty manager, company stock falling, you don't get along with your peers and can't change teams).

2. Stop running away from negative feelings. Learn to have a perverted attraction for mishaps. You don't actively seek trouble or purposely put yourself in situations, but you simply learn to love the fact how life just won't give you what you demand 99% of the time, and it will let you cherish the time that it does. Learn that it is okay when things go bad, it is not the end of the world, it is not unfair, you are not damned. It is merely unpleasant and annoying, but life is full of that.

3. Poor omega 3 - 6 ratio. Not enough DHA. Among other nutrition advice, this is probably the most prevalent. Start eating omega-3 organic eggs and wild caught salmon every day for breakfast. Both those foods are extremely high in omega 3, and unlike plant omega 3's, the animal sources contain DHA which is essential for neurogenesis on prefrontal cortex neurons. Those neurons are essential for willpower, motivation, and decision making.

4. Take uridine supplements (sublingually) and make sure you get adequate choline intake. Uridine + Choline + DHA increases the rate of neurogenisis than simply DHA alone. Most people with depression have under developed pre frontal cortex neurons, which exacerbate the symptoms of depression. Before people freak out about drugs/nootropics, choline is found in highest ammounts in eggs, beef livers, chicken hearts. Chicken breast/wings/thighs also contain a fair amount of it. Choline is essential for proper memory funciton as well. Uridine occurs naturally in spirulina. I recommend you buy bulk powder of Uridine online since if you take it sublingually, it is about 9 times more effective. Oral capsules for uridine are pretty expensive. I use powdercity.com.

Re: Ask HN: How to cope with depression

#75
post #53

Take the meds, Take the meds ........ Well that's what people (specialist or not) told me. But that were my worse mistake Anti depressants may not be too bad (they are said to even increase gray matter) but a year ago, I was prescribed antipsychotics by injections (because I had some paranoia against cigarette smoke) and those have been the worse thing I had to live, basically it deconnects your brain. So be happy an…

Anti psychotic medication, especialy depot injections, is very different to anti depressant tablets!

Re: Ask HN: How to cope with depression

#76
I second the other comments suggesting to at least treat online advice with a grain of salt. That said...

I burned out some years ago and have been struggling with recovery since, depressive thoughts aren't far away but by now I've found coping mechanisms. It's annoying I don't feel I can talk about it with my real ID because I still don't feel like my performance and drive is even 80% what it used to be, and I fear that would impact my future chances of switching jobs if they discovered my inner struggles. But my performance seems to be enough for my coworkers to value me, so I keep going another day. I too almost lost my previous job during the early periods, but at the end of it I was valued again. (I just observe external praise, I never feel it. Whatever.)

I'm anti-big-med for myself, but I won't discourage you from taking them as a lot of people say they help and some even report total elimination of depressive thoughts. I would encourage you to see if extra caffeine helps you at all while you wait, especially as the big drugs tend to take 3-4 weeks before kicking in at all and caffeine seems to have a more immediate effect. How much caffeine do you take per day? If you don't take much, you may want to get a box of 200mg pills and try for 200-600mg per day and see if it helps you at all. Caffeine has some anti-inflammatory properties, and depression is increasingly being recognized as an inflammatory disease, plus caffeine as a stimulant itself can help with the focus. Anecdotally, what cripples me some days is never-ending introspection about my value to the world and my performance. Sometimes taking more caffeine than usual that day will allow me to shut my mind up about itself and think about other things, and that allows me to get things done. (Work, laundry, going to the gym.)

Last year I finally did start feeling like I was recovering a little bit, then my mom unexpectedly died. Expect life to continuously shit on you. But whatever. If you keep on keeping on you'll develop your own coping mechanisms (those that don't die) so even setbacks won't necessarily send you over the edge as you've been there before. Lastly, killing yourself in a nice way would take effort, it's not worth it. Just look forward to sleeping instead. You might also consider getting a pet, or a house plant -- something whose continued existence depends on your existence.

Re: Ask HN: How to cope with depression

#77
Change the variables: you can be unhappy in a town doing a job because you haven't got any friends in that town (e.g. colleagues could be a lot older or at a different stage of life to you and therefore not able to be the friend material you need, e.g. to go out on the town with, no time after work to do anything else).

If you move town for a new job then you can find yourself with some initial difficulties to make friends, but, after a brief settling in period you can have a life outside work with a scene etc. This has a lot to do with where you end up living. Just one or two new friends that welcome you in to whatever they are doing can make all the difference.

It is not necessary to take on a career advancing job for such a move. You can move sideways from programming to helpdesk. There are rewards of job satisfaction if you can help people, you can go home with nothing hanging over you, your shift is done. Plus actual shifts, e.g. an afternoon to evening shift, that might help.

On the helpdesk you are learning and there is promotion if you are good to team lead and that might be enough for you. You can go back to programming with a few more strings to your bow. Compared to your peers you will be much more customer focused due to the helpdesk experience, which would become a retrospectively made positive career choice.

Obviously there are other sideways moves you could make, that depends on you and what you can do. Maybe you have an 'angle', e.g. science, or an industry, to make that easier. If you start over in some new town you will meet some new people to live and work with. There is luck in the draw, but how else are things going to change? You could meet someone in the workplace that mentors you, you could get a housemate that shares a few of your interests and welcomes you into his/her social circle. You might find yourself participating in awesome banter, you might find people appreciate your work, who knows, could happen, and that sort of stuff is probably the best cure for depression.

The above could go wrong, or need to be kept on track. Sometimes a secondary house move might be needed in the new job so look for somewhere temporary that is adequate for initial purposes (e.g. saving money, meeting people, proximity) with a view to moving somewhere else, 'more you', when settled in. You will also have to be very committed to making the new job work, there is no time for depression if you have to do that.

It is actually quite hard logistically to start in a new job in a new town but there is satisfaction in surviving that. You will need to interact with people courteously because you don't have all the things you need when you first get there. If it all goes well then it will be fun and you will wonder how you ever were on that pill taking abyss, desperately seeking advice. Accomplishment + achievement = happiness.

Re: Ask HN: How to cope with depression

#78

Take the meds. Expect this to be a journey - you have to try several and you may end up on a combination (I take four). If you're dozy at work as for some ritalin to help. I hope you have health insurance :( Also, if you go through 'high' periods you're not depressed, you have bipolar 2. Take the meds. This shit literally saved my life.

To make that a little clearer:

'Bipolar' is a condition with depressive and manic states. Low lows, and high highs.

'Bipolar Type 2' is a condition with depressive and hypomanic states. Low lows, and just feeling particularly good. People who experience hypomania without depression often don't complain about it / see it as a problem.

Re: Ask HN: How to cope with depression

#79

Sleep, exercise, and a good diet are always a great start. I always to look to one of those three things when anything feels off in my own life. Everyone here is suggesting you take your meds. One alternative that is increasingly popular, especially with depression, are psychedelics. I would suggest Amber Lyon's Reset.me [1] if you're interested in further reading. Now for the downvotes... [1] http://reset.me/

Suggesting hallucinogenics for someone with a known mental health problem is irresponsible.

Therapeutic uses would be of known doses in tightly controlled situations - neither of which are available to OP.

Re: Ask HN: How to cope with depression

#80
Regarding exercise, just do something that's slightly more than what you're doing now. You don't have to go running or go to the gym if you don't feel like it.

Start small. Just get up right now and go for a walk around the neighborhood.

For something more formal, I like this guy's method:

https://www.fourmilab.ch/hackdiet/e4/exercise.html

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