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Toward a Predictive Theory of Depression

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Re: Toward a Predictive Theory of Depression

#81

Post by QAPereo »

eradicatethots wrote: post #69
bnjms wrote: post #52

Earlier quoted context omitted.

Absolutely, but don't let this caveat stop you from considering this sort of advice if your depression has crossed that threshold. For those of us who have been there it's little strategies like this that keep us from crossing that threshold for too long.

As someone who’s been there, these tricks and tips make things worse, not better. Most depression advice is pretty terrible, this thread included.

Maybe it’s more fair to say that much of the advice is unhelpful for many sufferers, but for those it does help, it’s a good toolkit to have.

Re: Toward a Predictive Theory of Depression

#82

Post by 123jay7 »

diminish wrote: post #41
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…

Great idea. I usually make checklists for small things when I feel lost and achieve them and feel accomplished. Things like "check x", "read about xx", 'backup file", "congratulate people with birthdays on FB" When i mark them as done I feel better.

I think we're fucked as a society if this is what it's come to. Grown adults making checklists to make them selves feel better. Jesus Christ....

Re: Toward a Predictive Theory of Depression

#83

Post by roflc0ptic »

cassowary37 wrote: post #68
roflc0ptic wrote: post #66

Earlier quoted context omitted.

Without commenting on content, I will point out that the author of the article is a psychiatrist as well.

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 read that would lead you to imply he's failing in some professional obligation. It's like discussing murder - how often do you need to state that you think murder is A Very Bad Thing? Do oncologists need to talk about how bad cancer is every time that they write about it in a public space? Eh.

Re: Toward a Predictive Theory of Depression

#84

Post by Asooka »

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?

Re: Toward a Predictive Theory of Depression

#85

Post by Asooka »

AnIdiotOnTheNet wrote: post #28

>One complicating factor – how do we explain depressed people’s frequent certainty that they’ll fail? A proper Bayesian, barred from having confident beliefs about anything, will be maximally uncertain about whether she’ll fail or succeed – but some depressed people have really strong opinions on this issue. I’m not really sure about this, and admit it’s a point against this theory. I can only appeal to the math clas…

Or rather there is no predicting failure. You only predict success and when you have low confidence in success, you're certain of failure.

Re: Toward a Predictive Theory of Depression

#86

Post by mcguire »

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?

Re: Toward a Predictive Theory of Depression

#87

Post by davymac »

bnjms wrote: post #80
eradicatethots wrote: post #69

Earlier quoted context omitted.

As someone who’s been there, these tricks and tips make things worse, not better. Most depression advice is pretty terrible, this thread included.

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.

Re: Toward a Predictive Theory of Depression

#88

Post by HerrFolgreich »

tcj_phx wrote: post #56
sixo wrote: post #37

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.

> 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.

Re: Toward a Predictive Theory of Depression

#89

Post by davymac »

themodelplumber wrote: post #47
davymac wrote: post #43

Earlier quoted context omitted.

This works very well for low-grade depression for sure. There seems to be a threshold where this type of intervention becomes completely ineffective (personal experience).

I agree. From keeping logs over the last few years, severe depression was more likely to occur due to e.g. not enough sleep or just illness, and in those cases accomplishments were impossible. Rest was it, and I felt lucky if I could get good rest before acting on any depressing thoughts or ruminations. So I wouldn't call goal-reaching a standalone cure; far from it. Also there's the fact that people accept/reject po…

I noticed that rest only somewhat helped, but was significantly more effective if absent of any worry of external responsibilities. E.g. If I took vacation from work and didn’t tell my girlfriend about it so she wouldn’t worry about me and text me incessantly... I could turn off the thoughts/worries of the outside world completely for a few days and that made a pretty dramatic difference. I didn’t cure me at all, but it took me out of the really dangerous zone after about 2 days. Also, sleeping in a hammock, haha. So much better than breathing stale air for 2 days.

This is more circumstantial however, as my trigger at the time was accumulating too many perceived responsibilities and fearing failure. To be honest I feel the triggers are nearly irrelevant, but removing myself from them gives me enough temporary relief for my body to get out of stress mode. Which in turn removes some of the depressive overhead to give myself a golden window of opportunity.

Re: Toward a Predictive Theory of Depression

#90

Post by icantdrive55 »

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…

You are more than welcome here.

It's just so many of us have gone through the routine.

See a Psychologist--spend so much on dubious Therapy sessions. The Psychologist then give the refferal to the Psychiatrist. We are then given drug, after drug with limited success in many cases. We are always required to keep those mandatory office visits though. In many cases $350/hr.

In the end, when the treatment just doesn't seem to work, the profession hides behind, "Oh, well--it's an art too?"

I get that it's an art. All medicine is part art.

We spent years hearing about the benefits of the hetro, and tricyclic anti-depreaants. Yes--most of that was the result of clever marketing practices by the drug companies.

Then some PhD uses the Freedom of Information Act to number crunch all the meta data from all the studies; we are left with do these drugs even work? (Forget the guy's name, but he made a name for himself.)

All in all, I know it's a complicated speciality. I have utmost respect for ethical/moral Psychiatrists.

I know you're probably busy person, but we would love your opinion when one of these posts pop up on Hacker News.

And don't be leary of being down-voted. There are many times where the down-voted person actually has a point. There are many of us here who don't follow the heard mentality. We will give a wide bearth, but just want honesty.

(I eventually found a Psychiatist I can trust, and felt wasen't just trying to make money off me.)

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