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

https://pubmed.ncbi.nlm.nih.gov/24026850/

After 5 or 6 months of suffering, I decided, at some certain point, that I need to do something about it and that I need to get over it and not waste my life. I started small, step by step, waking up, taking shower, going out for a walk, etc. I used to WFH, but I reversed the habit and started to go to work place everyday.

Then, I got a gym membership and started exercising almost everyday (after so many years of physical inactivity. I am 25 BTW). I started cooking and eating healthy. I take multivitamins everyday with an additional dose of Vitamine D and Magnesium. I eat only vegetables (lots of them), rice, chicken and fish and sometimes beef steaks. I also take fruits everyday (usually Oranges, Bananas and Apples). I also drink Coffee (one cup in the morning and sometimes another in the evening) and Tea with Ginger.

I feel much better. Now, I have a routine, I am more active and I get some work done. However, I still suffer from a slight lack of motivation and happiness. I still feel a bit unhappy and I am not as motivated as I was before the whole depression thing hit me. I don't know why and I have no idea how to solve this part to become the super motivated, super focused and super productive person I used to be.

> The obvious solution to these problems are SSRIs and other anti-depressants. These drugs are very powerful but have really bad side-effects for most people that take them.

I suspect you're referring mainly to the increased risk of suicide. Though, there are other less severe - but still not so fun side-effects. The way I've heard this explained (not through my wife), is anti-depressants help raise your mood. However, they can't and don't immediately jump you back to happiness. For someone down in the dumps, this means there's a short period on the way to recovery where energy and motivation levels are increasing, but they still have significant depression. This puts them in a zone where they're trending out of depression, but still have depression while having the motivation to take action on those

In other words, anti-depressants don't increase the severity of suicidal thoughts - but they can't give you increased energy. This can be dangerous since the drugs haven't had a chance to get you elevated to a point that the suicidal thoughts decrease.

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I've learned that it can take a few tries to find the right anti-depressant for you. Different people react more positively to different drugs. If one isn't working, communicate with your provider to try a different one. Usually, within a few tries, you'll find one that works for you.

Relatedly, SSRI's aren't the only class of anti-depressants. SNRIs are an alternative class. Other drugs, like Wellbutrin, can also have anti-depressant effects while often having significantly less risk of negative side-effects.

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Finally, therapy is critical. Regardless of your choice on drugs, having another human being helping you understand and process your feelings and emotions can be incredibly helpful to getting yourself to a better place.

I remember watching this video https://www.youtube.com/watch?v=drv3BP0Fdi8

Two points I remember clearly taking from this lecture:

- Omega-3. Make sure they are 1) high quality 2) high EPA content 3) over 1000mg of EPA per day

- Walking. If you can spend more than one hour walking, do it.

The other things I sort of knew, like sunlight and social connection. They are also very important, obviously.

So, try to find a way, any way, to have some sort of social connection. Nothing deep. Just very casual and occasional.

I used to go to meetup.com and look for things that interested me. At the time it was: pickup soccer, and language exchange. Not only I was interested in them, but they don't require social skills to participate in. You don't need to approach anyone. For language exchange, there's usually seat arrangement so the organizers will decide for you who you will talk to. So it's not like you're in a bar and have to work up the courage to approach people. This is very important. Same with soccer. There's no social skill required. The organizer will manage assigning you to a team.

One thing to keep in mind: when you go to a meetup, do not talk about having depression. It's not a positive/welcoming topic. Keep it light and casual.

And finally, this is just my personal take. It's possible that your job itself is a source of depression. If you are not in desparate need for money or can live off your savings for a few months, I would consider quitting. Obviously since I don't know anything about your life, it's possible that if you quit your life will turn out very bad in a number of different ways. But at least it's something to consider. Given that you visit HN you're probably in the tech sectore, and if so, I think it's reasonable to assume that you won't have a hard time finding a new job in a few months after taking a short break.