The most important thing to know about depression is that it is an illness. It has no moral dimension. Get treatment. People telling you to buck up and get hold of yourself are much, much worse than useless.
The second most important thing to know is that "depression" is a label for at least a half-dozen, probably more, unrelated illnesses. What helps with one does nothing for another.
The third is that no matter what else you do, getting enough (but not too much) sleep, and enough exercise, are essential. Lack of either makes all varieties worse. But if you can't, do whatever you can. Sometimes just getting up is a triumph. Savor each.
Psychiatrists have no other way to determine which kind you have than to try various meds and see if any work. For some varieties no med works. Often a med does no good below a certain dosage level, or until you have been taking it for a month. Some work immediately. Most have annoying side effects that may gradually fade.
Many people have more than one kind, and need to treat both or all. It may be combined with other problems like anxiety.
Exercising, sleeping, and eating right can be hard, even prohibitively hard, when you are ill. Don't beat yourself up over being ill. Do whatever you can, now, and plan to do more when you can.
I agree that depression is an umbrella term, and saying that it's not a real illness is ignorant. It's like saying PTSD isn't an illness.
I periodically experience bouts of (what I call) depression, which I'd summarize as an intense anger that's oriented towards one's self. Paradoxically, it's very intense and at the same time it shuts me down. An analogy would be shoveling sand and cement into a drive train.
I won't get into the typical "how to fix it" part of this discourse, but I think it can be useful for people who have trouble sympathizing with people who experience depressive episodes to know what are some of the things that one experiences. I think it's also good for one experiencing these things to be able to reflect on what's happening, to, at the very least, get some distance.
So the episodes, in my case, have very clear "clinical" symptoms. Blood flow to the limbs is reduced severely, I'll often be on the verge of shivering with cold, similarly to what happens when you have a fever; motoric ability is severely reduced: you'll be tripping on things, dropping things; reaction time is severely reduced: for example, you're likely to not catch something that's thrown at you; appetite loss; glaring morbidity; difficulty sleeping; a strong, general feeling of discomfort in the body, a bit like recovering from a physical shock, like an automotive accident. For me, the thing lasts for 2 to 5 days, and happens every few weeks, rarely more than twice a month.
Treatment for depression ought not begin and end with medication. It's symptomatic. In the vast majority of cases, it means some large part of your lifestyle's gone wrong. The common advice today is tantamount to ignoring fist lines of defense in favor of just treating symptoms indefinitely, because it feeds the pharma machine.
That's not to say medication doesn't have its place. It's that suggesting we eschew all other measures in favor of medication is ridiculous.
> In the vast majority of cases, it means some large part of your lifestyle's gone wrong.
That's misleading. Lifestyle changes can have a significant positive effect, but that's also misleading, because you have to account for the often insurmountable inertia that old behaviors have.
Furthermore, the most reliable predictor of manic depression in later life is more than 2 traumatic experiences before age 7. I might be misquoting the figures slightly: it might be 3, not 2, or 10, not 7. However, the point I'm making is that in many cases saying that depression is caused by erroneous lifestyle is plain wrong.
I agree with you on medication, it has it's place, but it's hardly the end of the story. I personally don't take it, because I feel that my case is more suited to a different therapy, though I feel a bit silly about never having tried it. I think that one of the best things you can do is try a lot of things, to see what works for you.
I hear the "depression is an illness" trope repeated over and over but I still fail to understand what it means.
I'm sure for some definition of the word illness it's true. But it's certainly not an illness in the way a cold or malaria or shingles or cystic fibrosis are illnesses. Those things can be objectively diagnosed. They entail physical measurable changes to a person's body.
Depression is a set of guidelines in a book that ask vague subjective questions about how someone perceives the world. And then if the person decides you have it you have it. If they don't you dont. This has very little to do with the first scenario.
I'm not trying to trivialize depression. I think it is very real and very serious. But I think the "illness" rehtoric is at best innacurate and at worst seriously misleading and distracting to people who have serious issues to deal with.
As someone who has been catatonically depressed for a couple years now, I'm not so sure about this! People with chronic pain also often can't identify any physical source, but obviously you would never start posting "is this really an illness though?" or "aren't we distracting and misleading people??" in a thread about that.
The undercurrent of your post is that depressed people need to snap out of it, and falling back on the "illness" label reduces personal responsibility. Trust me, many people feel like imposters claiming they have depression, despite being completely non-functional. Thanks but no thanks to this proposed contribution to the discourse.
Are you really here to understand, or is it just to judge? Want some MRIs and EKGs of depressed brains?
> undercurrent of your post is that depressed people need to snap out of it,
Please point to where I say that. I explicitly do not say that. That's not an undercurrent because I don't believe it.
I do also believe that people don't have zero agency in this problem. There is SOME ability and necessity for people to work on these types of problems. That's what therapy with a therapist is right?
And that does differentiate depression from tuberculosis which cannot ever be improved by sitting down and talking about it.
Okay, my mistake for getting dragged into the archetypal HN argument. It's clear you cannot be convinced. Your original point - that depression has no biomarkers and is extremely subjective - has been proven wrong by a couple others and you've shown no gratitude or interest in this information. Only replying where you think there's an argument to be won.
Maybe you, some random person on Hacker News, are not in fact smarter than the medical consensus?
Uh no, sorry, it's the argument. You've been on this site for four years now - be honest, have you ever seen someone with a lazy armchair opinion enter a debate, receive strong pushback including scientific citations, and then refuse to change their opinion? It's literally every fifth thread here. Though imo, more fun when it's idiots telling tptacek he's wrong about security than when it's someone a dick to someone with depression (my victim mentality!!)
But sure, let me actually respond to you:
* At no point have you acknowledged or shown any awareness that depression is not "one thing". Like how people discuss "curing cancer" as if that's any sort of meaningful statement. How complex do you think depression is? What point of complexity does something need to reach before you defer to experts? Depression is still more or less a black box (watch the Sapolsky video I linked or look up some starslatecodex articles on ketamine.) Again, no sign of awareness of this on your part, which suggests you haven't done the most basic research.
* Yep, you never said there are no biomarkers. You said:
> Depression is a set of guidelines in a book that ask vague subjective questions about how someone perceives the world. And then if the person decides you have it you have it. If they don't you dont. This has very little to do with the first scenario."
This was your reason for stating that depression wasn't an illness. That it was based on a list of subjective questions. Sadly you didn't respond to the person saying that this was equally true for schizophrenia. Is schizophrenia an illness?
* I said it was an undercurrent, meaning subtext. Do you understand why subtext can't be quoted, and why that's work that you need to do for yourself? (If you somehow can quote subtext, though, immediately switch careers to political journalism, you'll be a wonder.)
* The only really offensive part was when you said "I do also believe that people don't have zero agency in this problem." Like, cool, a few sentences in and you've also added in a complete strawman to make yourself look reasonable. So this was just debate club to you.
The last point, combined with the fact that you're only responding when it might let you feel superior, leads me to believe you're not here in any sort of attempt to learn. How's your own mental health? You're clearly get some need fulfilled by arguing on the internet, which generally isn't the best sign. Watch that video, it's good, and absolutely full of things you do not know.
ah, also - are you cool with suicide? if so I think your hardline approach is fine, it's really just being forced to live + treated like shit (ref. your post) if you don't enjoy it enjoy it enough that I think is the real issue
Visiting a professional is generally a necessary step in recovering from tuberculosis. In that way it is not different from depression. In most forms of depression, talking with someone and doing nothing else is guaranteed to do no good. In that way they do not differ from tuberculosis.
There are different types of depression. It can be an illness caused by some brain imbalance, or it can be a normal human reaction to things being a bit depressing. For the first maybe seek medical help and for the second maybe try to improve your situation eg. go somewhere sunny, get a better job, make more friends etc. Also things like gratitude journals, DIY CBT and so on can help with the second. It the US there seems a tendency to overmedicalize and put people on antidepressant pills for life although they have no more effect than taking up exercise for example.
Diagnosis of depression is clinical. Self reporting via standardized questions is an ordinary medical method. "Where does it hurt?" "When did it start?" "Is there a history of heart disease in your family?." "When did your baby start crying?"
'Illness' provides a framework for recognition and treatment. The book with the guidelines is medical not religious. The guidelines are guided by empiricism not revelation. Treatments are selected based on statistics rather than authority. There's general agreement that the book's content might be wrong. There's a process for changing it and the expectation that it will be rewritten.
Criteria for diagnosing depression in the DSM include behavioral "thinking of suicide," physically measurable "weight loss," and general well being "fatigue." The suicide criterion is more conducive to empirical confirmation than "headache" or "joint pain."
Once all fevers were "ague". Now we have flu (dozens of strains), malaria, encephalitis, toxemia, etc., with a different treatment for each.
Depression is still at the "ague" stage. For certain varieties, certain medications completely resolve them. For some, a treatment hasn't been identified. Approval of treatments is crippled by lack of diagnostic tools, so to test one, it has to be used on people who have all kinds, and then it only helps the small minority of them who have what it's good for. Statistically, one that works 100% for the actual illness it treats looks like it helps only 10-15% of the sample.
You are mistaken about depression not having observable effect on the body. I wrote a post about that; it's a direct sibling to your original post.
Your point is a bit conflicted. Like this person pointed out, it seems that you're saying that it's serious and not that serious at the same time.
However, I think that the observation you wanted to convey wasn't about the comparative seriousness of depression, but rather that it's in some sense in a different realm than for example AIDS or shingles, even if the realm of some of its effects are similar (which you argued against, but you're wrong). And, I sympathize with that. Depression does seem to be made of a different cloth, but it's quite hard to elaborate further, and I won't get into it here.
this is equally true of, say, schizophrenia — there’s no physical test for it as far as I know, just questionnaires about how someone perceives the world.
but i don’t think anyone would argue it’s not a biological disease at this point, even if we don’t yet know what biological parameters to measure.
Just because you can't measure something doesn't mean it's not there. Perhaps we don't have the tools or knowledge yet to measure depression, like countless other human ailments of the past that are now treatable.
General advice for a general question:
The story often goes, if you're depressed, you need to shape up, grit your teeth and take it in strides, just brush it off. This is of course nonsense as a solitary advice.
What people often neglect is that circumstances in your life, sometimes beyond your control, can in fact trap you into "a life you don't want" or the sort of life where you're just existing, not really living. And if circumstances are that powerful, the problems can both seem invisible and insurmountable. Sometimes, we sort of get trained into living in a box! And then keep on living like that even though circumstances may change!
So I believe it's important to reflect on what you really want, what interests you, and pursue that. If that is a big fear to do in practice, no wonder. Everybody would feel stuck if living on false premises, according to others' specifications or avoidance of such. Ultimately, people need to feel in control in their lives, even if just an illusion, when we do what we can we at least feel better about trying. Failing is then part of learning.
Watching movies, playing games, gaming social media, don't really count, as those activities become just a proxy for life if you don't pursue and utilize yourself in some other way that truly count in your heart. And it's a life-long road, where we often don't see the small steps we take into a bold new direction leads.
The question is why are you depressed before the question is how to deal with being depressed.
For me, I was socially isolated, failed out of school, bullied at school, home and work, unsuccessful with friends or women and kept getting laid off, fighting with my coworkers and managers.
It wasn’t until I learned about Aspergers and did a detailed study on all the problems people with Aspergers have that I understood all of my problems stemmed from me likely being on the spectrum. Once I learned that, I was able to understand why I was being targeted and why most people seemed to hate me immediately within one conversation despite me thinking I did nothing wrong. Then I was able to make adaptations for how to structure my life around the fact that I was different.
If your problem is a minor chemical imbalance and you just need some vitamins, a jog and rest - To me this isn’t really depression, as someone who was on and off suicidally depressed for a decade.
For me: I was depressed because my life sucked. I could make the depression go away temporarily but it always came back. Cognitive Behavioral Therapy really
Helped me.
After being told by teachers, my family, coworkers, people at school that I was stupid, unlikeable and ugly etc it took me a long time to undo that because I really believed it. CBT is about arguing with invasive negative thinking and changing your filters into better ones.
When I get depressed now, I write down a plan to stop being depressed and go through all the steps sequentially from simple to hard. Usually works, but only if I start with easy things first.
Honestly, I'm sorry people treated you that way. I actually know the cause of my depression and it's something I can't really solve at the moment unless a miracle happens (that is if miracles exist). Thanks for your response
If you're able (you have insurance/can afford to), the single best thing you can do here is to see a professional. I've dealt with mild to moderate depression on and off for most of my adult life; four years ago my wife finally pushed me into seeing a professional, and I wish I'd done it 15 years ago. Working with him gave me some of the tools I needed to re-frame my thinking and break out of the sense of learned helplessness I was dealing with.
Meditation, diet, sleep, and exercise can all help, but ultimately it was talking to a professional that made the most difference; all those other things have helped to sustain it since then.
I found these articles incredibly helpful in learning to help myself. I have no idea if they are factually correct, but the writer's way of reframing depression as a process or system was a great way to get some distance from my personal feelings in the moment, and allowed me to bring to bear familiar mental tools to help get a feel for the complexity.
I hope they help. For me the main take-away was that your brain needs rest, which is not the same as recreation. Be kind to your brain and digest in manageable chunks :)
Some advice here, such as exercising is good for the overall health of a human being, but depression isn't simple as this. Other advice is quite sad, such as "I eat a good stake" to avoid having a "dark mood". Depression is a serious mental issue that needs proper treatment, it isn't a joke.
A professional will be able to give you better guidance about this, with therapy and medicine.
I examined the rhythms of my depression and left Seattle for a much less expensive, and much sunnier city. The number of times I have to take that little inner voice who thinks suicide is a valid solution to my problems, pat her on the head, and say "thank you for your lovely contribution, I will treat it with the same seriousness I treat all your other suggestions"* has dropped from one or more times a day to... I think maybe once or twice in the entire half a year since I left Seattle?
A sun lamp helped some. So did lots of vitamin D. So did exercise. Pole dance, to be precise, I need to get back into that now that I'm settled. But it helped less and less every year, to the point where I felt like I only had a few years left before I'd be at serious risk of acting on that voice's suggestions.
Previously I also dealt with depression by staring my gender dysphoria in the face and taking a lot of hormones to persuade my body to get to the point where nobody thinks twice about giving me my preferred pronouns. Things were pretty good until I moved to places where there was Real Winter.
Dissect your depression. Analyze it. Listen to it - maybe even name it, that suicidal urge had a name borrowed from an old RPG character who did a lot of self-harm stuff. When you come to the conclusion that a lot of your depression comes from trying to deal with a particular Horrible Thing, then work on changing your life so that Horrible Thing is not part of it any more.
Oh yeah. Meditation can be valuable too. Just sit and watch your thoughts pass through you, if you catch one running away with you then just shrug, remind yourself "silence!" and get back to trying to empty your mind. Do it every day, or as close to every day as possible. This will give you a lot of training in recognizing different parts of your brain, detaching from unwanted trains of thought, and otherwise managing your brain. You will probably suck at first. Allow yourself to do this, celebrate getting better.
* which is to say "dismiss it and get on with my life as best I can despite being pretty miserable"; this little mental exercise of treating that urge as a separate personality and telling her that I did, indeed, hear her idea helped me dismiss it when it came up instead of spending ages going around in a mopey rut.
For me, exercise and trying to re-frame my situation helps. I believe even if your exercise is just a 30min walk, it's better than sitting at home ruminating about things.
By re-framing I mean trying to rethink my situation from a third party or what I'd say if a friend told me about their life and how they feel. I think for a lot people, they can be their own worst critic.
I have used meditation in the past with Headspace. It helped me a lot during some really low points. I started therapy a few weeks after meditation and my therapist was very supportive of it. I'm not going to claim mediation is a cure-all but it definitely helps the "re-framing" and rumination.
Also if you have some friends or family to hang out with, try do it. Even if you have to force yourself to go and you don't interact with them much, I believe it's better than being alone in your darker times.
Cardio helps a lot for me personally. I'm a firm believer that most people (myself included) don't get enough exercise when compared to hundreds of years ago. It gives me a dedicated hour or two block of time to listen to podcasts, and exercise in general is healthy anyways so its a win-win.
I eventually started doing Ironman triathlons. There was something different about those compared to other things like marathons.
But I also wasn't as depressed as a lot of clinically depressed people are. But it could literally be a matter of volume.
But I learned a lot about myself, and once you do an Ironman even once, you have some confidence about doing something really really hard, and you have a (minor) superpower while you're in shape to do one.
So it might be a matter of volume. It might be a jog doesn't sufficiently trigger a subconscious feeling of accomplishment that a longer distance will.
It could be triathlons give you Napoleon Dynamite skills in more that one thing. Nice thing with exercise: you can do lots of things to get it, so try branching out from running. Lift a bit, yoga bit, bike a bit, swim a bit, X-C ski a bit, shoot buckets, trail run, etc.
I skip rope. I like these muay thai-style jump ropes[0] with thick pvc-tube because I find it annoying when a slim rope gets tangled and I have to stop and start jumping again.
Maybe not the best style if you have knee issues though...
Become a triathlete. Swim, bike, or run, usually something will work if you're injured somewhere. Each of course have their own idiosyncracies and overuse injuries.
This is from my personal experience, I have no qualification or experience that would allow me to help someone else.
First what depression was for me was a lack of positive emotion. Not that I felt sad all the time or that I was always down. It was just nothing felt good. I could eat something nice, do something for someone, watch a great movie and I felt nothing.
This was not so bad at first but as the months rolled past it got very hard to live with. Nothing motivated me. I didn't want to get up and do anything. Why do anything there was no positive feedback to do anything.
But I did. For some reason I kept my routine. I worked as hard as I could. Probably about 70% of my normal. But I just kept going. There was something in me that said this can't last forever. I was getting suicidal and was struggling to keep going but I just kept one foot in front of the other. Not thinking about much other than the day ahead.
Relationships were hard, I didn't have much patience for others. But I lived in close quarters with people, kept my job and maintained church commitments. I just kept going.
My hope was that one day things would get better and I didn't want to wake up one day finding I'd walked away from everything just to find things had gotten better. You know what they did! They got so much better. It took a year or so and little things started to feel good again. I was so happy when they did that things just spiraled upwards.
I've learnt a thing or two about my emotions and thoughts. Trying to keep from becoming fed up and down seems to stop me rolling back to that depressed state.
Looking back I think it was the routine that pulled me out. It was the keeping on going that gave me something to think about, instead of the negative thoughts. I couldn't create positive feedback but I could stop the negative (a little bit).
Other people have it way harder than I ever did and I don't want to say they could do the same thing but I do think that there is reason to have hope. Hope wont make you feel better but it can keep you going 'till you do.
I won't tell you what to hope in or how but hope cures depression. And by that I mean psychological depression,as I understand clinical depression has more to do with neurological and biochemical imbalance (for which you should seek out a legitimate psychiatrist).
I was actually thinking of submitting a similar question but about mental health in general(will do that another time).
But yeah,what I've learned is that hope is easy to come by but it carries with it risk where you hope but what you hoped for does not turn out well. If you can accept that risk,it will resolve what most people call depression at it's root where most other medication and therapy address symptoms first and maybe get to the root cause later.
I think educated and technical people are more susceptible to depression because they rationalize and analyze away hope much more readily than less educated people.
Other people mentioned getting enough sleep,excercise,hydration,good diet. And I'd also like to add on that a healthy relationship with your ownself and others. These all help but as someone who has struggled most of my adult life with depression and having desparately tried all these things my opinion is to prioritize hope.
A few years ago I had so much hope and as a result I lost a lot of weight,ate healthy all the time,slept better and relationships with people started to improve. I had a goal,something to look forward to,something I needed to get ready for and improve myself.
It was amazing,I may have had been sad once in a while but the horrible crippling depression went away.
I am not an expert,I just know I spent years isolated,not wanting to clean up after myself or even maintain basic hygeine at some point. It was unreal how this mental issue was causing physical pain and so many other side-effects. And I also saw what helped me,and it turns out actual psychologists also support my hope theory. Even if the hope is irrational ,is rational depression better? Of course everyone has a different story. I hope sharing my experience will help you and do let me know if you have any questions,this sickness stole most of my life,I hope you fight hard so you will never be in my shoes.
Beware of expressing built-up anger. Contrary to mainstream thought, it can be a really big problem in various areas of your life, especially your interpersonal relations.
Usually, the real cause of the anger evades us (that's why we've so much of it built up), and we can't express it constructively (if that's possible at all). A big realization for me was that even though I feet somewhat better letting my lid blow off and unloading on a person, it's very destructive (before I persistently ignored that, justifying my anger as righteous), and it's not a treatment for what caused it.
I guess if I had to summarize my realization in one sentence, I'd say that I realized that there were things I didn't want to acknowledge and feelings about myself and others that I wanted to push out of myself, and that this resistance was what caused the inner turmoil and anger. When I started consciously trying to stay with the "bad" feelings, instead of reject them, things started to change.
Here is what has worked for me. But beware, I am not a psychiatrist so take my suggestion with a grain of salt.
First, let me tell you about my living situation and environment. I believe those two are very important in making these kinds of decisions. I live in a very tightly neat society. I meet my parents, and friends most often. But I was really good at hiding my situation. That made my problem worse. Why? Because, no one knew what I was dealing with. Everyone would realize I'm missing for a couple of days but they all figured I was busy. But I was going through hell.
I have tried various ways of threatening myself. Seeking professional advice is out of the question for me as I live an average life in a developing country.
So I gave up. But one day I decided to take a walk.
It gave me a breather. So I did it again, this time longer. By the time I came up from my long walks I would be tired so I would eat and fall asleep.
This continued for months and years. Each time making my walks longer and longer, untill I would get so tired that all I wanted to do was eat and sleep.
I have been doing that for more than 3 years now. I feel active now and I have added Taekwando to my exercise too. At the same time period, I got the courage to marry my girl friend. Now we are having a baby.
I don't believe that I don't get depressed any more. Or may be I was never depressed in the first place as bad as other people. But I don't lock myself in my room for days thinking about death anymore.
Hey tokstesla, I've helped people overcome depression.
It depends on how depressed you are and also evaluating whether it's clinical. A combination of medicine and extracurricular activities will get your life back on track!
I know you mentioned that you were looking for non$$ solutions but hear me out:
An overly simplified analogy to depression is like diabetes. Your body does not produce the right chemicals to process things. In the case of diabetes, it's insulin. For depression, there's some imbalance of serotonin or dopamine.
With diabetes, you must control your sugar intake via exercise, eating fewer carbs, fewer desserts, etc. With depression, a lot of same applies such as more exercise, meditation, journaling, etc.
If you had diabetes and all you did was limiting your sugar intake, then most doctors will say that's not enough. You must take insulin. Depression is similar. If it's clinical, behavioral therapy will definitely help, but you need to balance your chemicals.
If you need to chat more, let me know! I don't see a chat feature here, but we can find a way.
Very broad question. Go to therapy or call a hotline and see if it helps you.
What worked for me is letting go of therapy and focusing instead on what matters to me, or my self/character/personality/whatever you want to call it. There are some things in the world you can't control so focus on what you can control. Win your own small battles one at a time, they build up.
Depression is a biochemical problem in your brain. It needs a biochemical solution. It is impossible to rationalize your way out of a depression. You cannot cure a depression by choosing behaviour.
Thinking about gyroscopes will not enable you to walk a straight line when drunk! Trying to cure a depression by choosing thoughts or behaviour is futile.
Robert Sapolsky wrote the most astonishing book I ever read. It had a dumb title, something about zebras, but it was a tour of endocrinology. Endocrinologists have thd hardest problem in all biology.
Assuming you’ve tried conventional anti-depressants and you’re in the US, have a look into ketamine treatments. Studies show dramatic results for a good percentage of people and a good safety profile (shorter term at least). They are expensive.
Lots of exercise. Gets a whole bunch of chemicals in your brain to flow again. Some of those chemicals cause depression. But they need to come out of the system (eventually).
Lots of water. Drink water when you are tired. When angry. When sad. When bored. When excited. When energetic. Removes toxic chemicals in the body.
Good thoughts. Great thoughts. Speak to a psychologist. Read a book. I did.
Arrogance hides away anger. Anger hides away sadness. Sadness hides away attitude of helplessness. Helplessness is lack of resourcefulness. So be resourceful.
Forgive. Forget. Move on.
Lower expectations of yourself.
Increase appreciation of others, and of yourself.
Lots of sleep. Depressed people sleep a lot. But your sleep needs to be strictly regulated.
I think that this kind of advice is based in stuff that's actually helpful (like taking care of your body) but is ultimately useless to anyone who is actually struggling with depression.
> Good thoughts. Great thoughts. ...
> Arrogance hides away anger. Anger hides away sadness. Sadness hides away attitude of helplessness. Helplessness is lack of resourcefulness. So be resourceful.
I would for sure talk to your doctor about it. Normally your doctor can recommend medicine and services such as a psychologist(more talk therapy) or psychiatrist(more prescription based) that will work with them and be in your insurance network if that's a thing you need to worry about.
That said, I would do a lot of research before going in, but do see your doctor for sure. I say do research because depression can be a symptom of other things such as Bipolar type II or Cyclothymic disorder. Hypomania is the main hallmark that you would look into with those. I would also read and be prepared to talk to your doctor about anxiety symptoms as well as panic attack or ptsd symptoms. You may not have them but knowing the signs can help as depression can easily present with those, and you may need treatment for more than one thing to feel better.
Knowledge is power in this case. Jobs in IT and doctors are similar in some regards. Someone comes to us with a problem and we need to fix it. The more they know(symptom identification) and the better they can articulate why they think they may have some condition the easier it is to diagnose and fix a problem. Also both professions start with 'safe' treatments. We reboot the computer first, they try for pills or treatments with few to no side effects. We also go for the most obvious diagnoses first before getting into the esoteric,(the power is unplugged rather than the cable to supply power to the motherboard being bad) just like a doctor would go for depression rather than bipolar II for instance as that's the more common path.
I ran across this when I was suffering from some depression and was trying to see how other devs deal with it. It outlines some emotions and feelings about it, but also talks about bipolar type II and adhd. https://www.youtube.com/watch?v=yFIa-Mc2KSk
I hope this helps and feel free to reach out if you have questions. I'm still dealing with it myself so I get how hard it can be. It's not a failing of character or anything like that. It's a medical condition and should be monitored and treated as such by your doctor.
I found David Burns' 'The Feeling Good Handbook' an invaluable resource while coping with depression and probably the factor that helped the most. Others probably were removing stress (changed from a job which was just not working for me), getting longer sleep hours, regular exercise, getting more sunlight, 5-10 minutes meditation and reading books encouraging a positive outlook and gratitude such as 'Search Inside Yourself'.
There are many ways to depression, and my depression seems to stem from my constant nagging feeling of existential meaninglessness. This has been going on for varying intensity for something like a decade now, but I feel like I'm finally coming to grips with it.
For all my adult life I feel like I haven't got a clue why I'm here on this planet, and as a result been just slowly drifting to places in life where I don't want to be. The resulting depressed mood certainly seems to make the world look a lot more bleak than it really is, and making changes to my life has felt like an impossible task. However, these past few years I feel like I've been getting some real progress. I've been trying to follow all the usual advice to a tee, and in my case they have helped:
* precise sleep patterns, 8h of sleep same time every day
* stretching, regular exercise (both cardio and lifting)
* fixing diet: removing sugar, grains, excess carbs, all the common "bad" stuff. Basically something like a vegetarian-mediterranean diet.
* daily 20 min meditation
* daily journaling
* very little alcohol, only couple of drinks now and then and preferably in a social setting
* no smartphone
* no social media
* no porn
* trying to avoid reading news
* spending time in nature when possible
* no cannabis (I tried to use this as a crutch but for me it didn't help, only makes things worse)
* no other drugs[0]
I haven't sought professional help, but watching Jordan Petersons lectures have given me some ideas and tools what to try out (he is a clinical psychologist, after all?). Specifically, right now my goal is to figure out a clear plan for a life that I would like to live, which would hopefully end this existential dread and give my
existence a clear sense of purpose.
[0] Only exception to drugs has been psilocybin mushrooms, which I microdose when I feel like I'm especially deep in the hole. This really helps for a little while, but I hold no delusions that I could just continue living my life like this and endure it with drugs.
I have never sought professional help, mainly because of the cost, time, and shame. If you can, of course, get professional help, but since you asked me how I treat it, here it is.
First, one of the main reasons why I felt that depression was not meeting my parents' expectations. There is always someone better than me and my parents always compared our successes, directly or indirectly.
Then I had a great religious crisis when I learned about truly evil and disgusting human behaviors. It simply made me lose my faith in God and in humans.
And finally I was never good with the opposite sex. Although I had many friends, I still slept alone.
At one point, in my life I simply didn't see any point in it. I realized that I can never make my parents proud, there is no God and humans are evil, and I will never find love.
I exercised regularly and ate decent. There was no need to add more exercise to fight depression.
I had some thoughts about suicide but nothing serious. It scared me though and I began to enter Buddhism and meditation. But Eastern philosophy did not work for my logical mind. The meditation was too boring for me.
That's when I discovered stoicism, it seemed to click better with me. Almost at the same time, I also found an online CBT software that also helped my anxiety.
Then, after trial and error, I developed an external observer mentality. I think of life as a boring video game. I think of money as points of video games. And I only focus on getting the maximum scores. I know this sounds superficial, but it helps me on difficult days.
Before this mentality, I was changing jobs without thinking about career change in general. Now I am very strategic and I progressed a lot in my career.
I really don't care about my parents' approval anymore and they seem to respect me more. When I stopped chasing the opposite sex, I started to attract them and now I am happily married. I still see the world as a dark place and this is something I still struggle with.
But I have to play this video game, control my character, and try to get a high score. My character needs sleep and exercise to keep its mind sharp for work. My character must do chores and do nice things for spouse or spouse will leave it.
Get professional help if possible: Get meds and find a good counselor
Get the Big Three in order (Food, Sleep, Exercise): Eat healthy (e.g., DASH diet), get 8-9h sleep, get daily aerobic exercise (with a little anaerobic) and at least weekly strength training.
I eat a good steak. I'm not kidding or trivializing. But if I get busy and I'm always stressed out maybe trying to cut calories, after I while my mood gets dark. Sometimes, I have found its not just stress. I just need a good steak or burger. My metabolism does NOT liking going more than a few weeks without a serious protein hit. And it needn't be an unhealthy frequency or amount.
So YMMV, but sometimes a big part of metal health can be adjusting what you eat and drink.
since i decide to end my life, mi thoughs are more paceful and less disturbing. im planning in december take a lethal dose of nembutal. all in my life is shit, and i get tired of.
One thing that's helped me is journaling. I used to write by hand, but find doing so too slow, even when I type.. so in recent years I've taken to recording my thoughts in on a voice recorder (though a smart phone with a voice recording app would probably serve just as well). What I say is completely private, and meant for no one's consumption but my own, though I very rarely even review what I said. I talk about what's been happening in my life, my concerns, and my thoughts on various subjects.
It's much like therapy, though of course without a therapist's comments or insights, so it's not quite as good, but I still find it very helpful to talk through what's been going on with me.. and sometimes I even come to novel conclusions and insights through this process.. thoughts and perspectives I did not have before I started.
Othre things that help are listening to positive, energetic music, going outside on bright, sunny days, spending time in nature, eating a healthy diet (including supplements like D3 and B12 that I don't get enough of in my life otherwise), and exercise. Talking to interesting, friendly people helps, as does having a fulfilling job that pays enough to pay for the basic necessities and keep me from living on the streets. Occasional treats that make me feel better afterwards (as opposed to ones that feel good in the moment but awful or guilty afterwards).
I like to visit libraries a lot (particularly academic libraries), and often feel at peace there, lost among the greatest minds the world has ever seen, all at my beck and call, willing to share their experience and wisdom as I become ready to learn what they have to teach.
Computer games can also be de-stressing and distracting, thought when they're really good it's too easy to slip in to addiction, which could have adverse consequences if one plays them to the neglect of other important aspects of one's life.
Something else that helps is meditation (of the simply focusing on one's breath type). Avoiding toxic people who try to drag you down with them helps. Learning to enjoy your own company and like yourself instead of loathing yourself helps.
Sometimes talking to someone at a crisis hotline helps (if you're lucky enough to get someone good on the phone). Finding a good therapist you like, respect, and trust, and to whom you can do the hard work of opening up to is of course wonderful as well.
That said, some days nothing helps (or you are just too depressed to do any of those things that help, or forget about them), and you just have to ride out the feelings and try to take comfort in the recognition that those feelings are not permanent, and you will feel better sometime in the future. Having ridden out many such days in the past helps. As the saying goes, time heals all wounds.
(The less medical-system dependent stuff is in the last section, not that you should avoid the medical system but if you're asking here on HN and not in a doctor's office that seems like what you might be looking for)
Depression can be divided into two categories: with cause and without cause.
If you're depressed with cause, because you're unemployed, in a difficult position, you broke up, a loved one died, you fought with your friend, etc. then the usual advice does actually work. This depression makes sense and is totally normal. First, give your grief time, and second, actually force yourself to smile, go for a walk, or get a puppy. This depression is inherently temporary and you can speed the recovery along.
The thing is about depression with cause is that the cause may be ongoing. If you feel unfulfilled, if you're anxious, if you're suffering from addiction or illness, if people are abusing you, then of course you're depressed. Depression is a symptom. You don't need antidepressants you need to remove the cause.
Depression without cause is completely different which is why most people's advice is bad. They really did overcome depression, but a different kind. If your depression happens for no reason, even when things are going well, just randomly, or on a cycle, then you have to think about depression management. There is no total recovery but you can minimize it until its interference with your life is minimal.
The biology and psychology of depression including the two types above are discussed in Stanford's Sapolsky on depression (50 min lecture on YouTube).
Here's my personal ongoing experience with depression:
medicine worked for others but not for me. The side effects were worse than the depression. Things like sleep, exercise, time with friends, and nutrition seem to shorten the depressive episodes but they do not eliminate them. I plan around my inevitable next episode.
I have leave days set up, an understanding doctor's phone number, and my boss's understanding that I may suddenly take a couple of days sick leave for medical reasons. I call my friends and cancel way ahead of time. I have at-home hobbies to keep me busy. I eliminate my obligations because I wouldn't be able to keep them anyway and failing all my obligations every episode makes it worse every time. If I get depressed on vacation at least I don't feel guilty on top.
Speaking of which I get more depressed during vacations and weekends. Routine and commitments at work generally work against depression. So when I have nothing planned to do and I was expecting to myself to motivate myself to do something fun this is when depressive episodes happen most commonly. So even when I have nothing to do I keep a routine and I create commitments. I know this is in contrast to cancelling all my commitments when I'm depressed but it's true. When I'm not depressed my commitments keep me going so I make sure I'm always committed and I never have to rely on self-drive in the moment. I make plans with friends and book events and schedule things.
Anyway it's an ongoing thing and I've accepted it's never going away. I'm going to try a course of ketamine soon and I'll see how it goes but I'm not very hopeful. Even though I'm not depressed any less, more and more I am learning how to live my life despite depression.
Keep up on Fish Oil Supplements. I forget where I read it, but there was a publication which attributed depression to living far from the coast. From there the idea circulated that a fish based diet would be beneficial. Omega3 fats are generally beneficial, but have as I have experienced acted as a mild anti-depressant.
Also, exercise. Do something outside of work that requires physical exertion, even if it's just walking.
edit: Eases up the mood swings (TBH, I'm probably just in a stable phase (which gave me the will to stop coffee in the first place), but stopping wild upswings in mood with coffee cessation seems to have greatly muffled the back swings. touch wood touch wood touch wood.)
I'm also in the process of quitting coffee, I used to drink coffee very heavily (3-4 cups per day) and lots of soda, but it was affecting my mood too much.
Cocoa in hot water with stevia. I still need something black in the morning. Cocoa does have caffeine, but it's really not that much, even compared to tea.
I'll also have a tea in the middle of the day if I start feeling super dopey. The problem, as far as I can tell, isn't the caffeine, it's the amount in single+closely followed consecutive doses... I guess.
Other than that, Camomile and mint. There are a bunch of other fancy herbal alternatives but, those three are a good enough variety for me.
The second most important thing to know is that "depression" is a label for at least a half-dozen, probably more, unrelated illnesses. What helps with one does nothing for another.
The third is that no matter what else you do, getting enough (but not too much) sleep, and enough exercise, are essential. Lack of either makes all varieties worse. But if you can't, do whatever you can. Sometimes just getting up is a triumph. Savor each.
Psychiatrists have no other way to determine which kind you have than to try various meds and see if any work. For some varieties no med works. Often a med does no good below a certain dosage level, or until you have been taking it for a month. Some work immediately. Most have annoying side effects that may gradually fade.
Many people have more than one kind, and need to treat both or all. It may be combined with other problems like anxiety.
Exercising, sleeping, and eating right can be hard, even prohibitively hard, when you are ill. Don't beat yourself up over being ill. Do whatever you can, now, and plan to do more when you can.