Ask HN: How do you handle your depression?
25 comments
I couldn't disagree more with this advice. It's important to address your mental health problems, not ignore them. Trying to help others, while you're barely surviving each day, won't work out well in the long run. Just to be clear - "lack of attention to depression" kills you, not the depression.
I also think using the word "handling" is appropriate. Maybe "managing" is even better, because very often it's something that you need to take care of for the rest of your life.
I also think using the word "handling" is appropriate. Maybe "managing" is even better, because very often it's something that you need to take care of for the rest of your life.
I'd recommend starting with therapy and going from there if it's available to you. I've been going to cognitive behavioral therapy for years and feel like I've received a ton of value from it for a couple reasons.
1. the therapist is a trained professional that can help me unpack and normalize my experience.
2. the therapist can recommend strategies to try and potentially refer me to a psychiatrist if they think medication might be worth considering
3. having a regular cadence of structured communication with a professional gives me the time to reflect and think, when I'm depressed this feels almost impossible on my own
There are so many factors that go into depression and in my experience its very difficult to go about finding something that helps alleviate it alone. If you aren't able to go to therapy for any reason than I would definitely recommend trying out some of the strategies mentioned in this thread, but I'd also suggest trying to find a family member or friend that you trust to talk to about your experience as well. Depression is so isolating and it will likely feel difficult to get the strength and courage to talk about it, but it's been extremely helpful for me and I'd recommend it.
1. the therapist is a trained professional that can help me unpack and normalize my experience.
2. the therapist can recommend strategies to try and potentially refer me to a psychiatrist if they think medication might be worth considering
3. having a regular cadence of structured communication with a professional gives me the time to reflect and think, when I'm depressed this feels almost impossible on my own
There are so many factors that go into depression and in my experience its very difficult to go about finding something that helps alleviate it alone. If you aren't able to go to therapy for any reason than I would definitely recommend trying out some of the strategies mentioned in this thread, but I'd also suggest trying to find a family member or friend that you trust to talk to about your experience as well. Depression is so isolating and it will likely feel difficult to get the strength and courage to talk about it, but it's been extremely helpful for me and I'd recommend it.
Today so many people are facing the depression problem. Lots of people are struggling with minor depression problem and few of them are struggling with the major depression problem. But this problem is simply overcome by following some of the natural methods. Many times people are not following natural methods and also not maintaining their body health. It is also one of the main reason for the depression. So we can naturally overcome this health issue. http://www.angelmeds.com/blog/natural-ways-to-master-depress...
[deleted]
Hang out with people, whether it be family, friends, or Jesus.
My mileage, with emphasis on the 'Handling'.
The practices that I am outlining have allowed me to function at an acceptable level however, they are not a cure for depression.
Meditation with a focus on getting in touch/accepting whatever is happening at the moment.
Working out, running/jogging in particular.
Resigning to the fact that living a mediocre life is not that bad.
Reaching out and finding kindred souls, friends etc. Family, especially kids and wife keep me moving even if they are not aware of my depression.
Resigning from the self-appointed position of CEO of the world.
The practices that I am outlining have allowed me to function at an acceptable level however, they are not a cure for depression.
Meditation with a focus on getting in touch/accepting whatever is happening at the moment.
Working out, running/jogging in particular.
Resigning to the fact that living a mediocre life is not that bad.
Reaching out and finding kindred souls, friends etc. Family, especially kids and wife keep me moving even if they are not aware of my depression.
Resigning from the self-appointed position of CEO of the world.
Drugs (anti-depression), regular visits to a psychiatrist, hobbies (Warhammer 40K), and regular physical human interaction (game/hobby club), and diet.
All are important, as drugs alone won’t help, it’s a holistic solution.
All are important, as drugs alone won’t help, it’s a holistic solution.
Agreed. It's not about dealing with it when it gets bad, it's about finding long-term solutions that prevent it from going off the rails and making sure you have the tools to deal with life when things get hard. Get on meds and therapy and keep it going (especially) when things seem fine.
I'm going to give a very comprehensive answer here. Please bear with me, I've got lot's of expertise in this area, hard won, and this all may help:
It's important to note that not all depressions are created equally. There's transient depression: most people may experience some form of this at some point in their lives, and it can often be dealt with through short-term medication, counseling, both of those, or sometimes just one of them.
Then there's chronic depression. If that's an issue, prior to accepting a clinical diagnosis such as from a doctor (preferably psychiatrist) you should push for a full blood screen, especially for things like thyroid and vitamin D. There are things that can be picked up in such a screen whose symptoms mimic depression, and you want to rule out obvious physiological causes that have trivial fixes.
Next I'm going to get into the medication aspects of things a bit, but I'll give some coping hints afterwards.
Assuming we're dealing with either chronic or intermittent & highly disruptive episodes of depression, treatment can still vary greatly based on circumstance. My own opinion is that a combination of medication and therapy present the best long term prognosis for improvement. In some cases, these can even be temporary, where medication helps improve things enough to be bearable while you work out underlying issues and coping mechanism with a therapist (DBT & CBT style therapy can be very effective here) but therapy styles can be highly personal and different things work for different people.
In such a situation, on the medication front, an SSRI medication is usually the first-line medication treatment. But the specific presentation of symptoms can absolutely drive a different selection of medication(s). As one simple example, depression with extreme anxiety is a strong risk for BP2 (bipolar type 2) where the anxiety is actually mixed episodes (This is NOT always the case). But in that sort of situation, a psychiatrist might reasonably be reluctant to prescribe an SSRI which can exacerbate the hypo/mania symptoms of BP2. As such, an atypical anti-depressant such as wellbutrin may be used, and for acute anxiety/panic either a benzo class drug or in some cases a beta blocker may be used for the anxiety/panic.
Now, here's the thing about medications: (please HN excuse my language here, it's warranted I think though) it is a shitty process of trial and error. There are dozens of medications, and each person can respond differently. What's more, it can take months to determine if a given medication has had an effect before you can move on to another. This means it can, literally, be years before you find a medication or combination thereof that works for you. It requires patience and the knowledge that things WILL GET BETTER. They do. I've been at and slightly over the brink a few times in my life, and pulled back form the edge enough to keep trying for better results, and every time it has worked, and helped make the next time that much easier to trust the process. You will find something that works, eventually. Search out good doctors that will work with you as a partner in the process.
Now there's an exception to depression meds taking weeks or months to work. Very few medications can have a near immediate effects. One option, controversial, is Ketamine. You need a doctor open to this experimental treatment to work with you, and money to pay out of pocket: insurance won't cover it. Also it's considered a treatment of last resort, when many other med options have failed. Another, easier to get option is modafinil (name brand Provigil). This is basically an atypical stimulant, very different from something like amphetamine type drugs like adderal. It is primarily used for narcolepsy and other sleep disorders, as it's considered a "wakefulness promoting agent". However research shows it can have a profound and rapid improvement on depression. I speak from personal experience on this one: Modafinil keeps me functional during depression and takes a significant edge off it at the same time. I cannot understate the effect this drug has had in helping me manage my depression. Caveat though: No drug works for everyone, but doctors are often much more amenable to prescribing this one earlier in the medication trial-and-error process, so it's worth a conversation.
Finally, meds are only part of the equation. As I said earlier, therapy is a HUGE part as well. It will help develop better coping mechanisms at the same time that it also helps get at underlying issues that either cause or exacerbate depression, and can help alleviate them. So that's one thing. Next, and maybe most important for the OP here, or others reading, is the possible response to what I've said: "Okay fine, but what do I do when I none the less find myself depressed and curled up in a ball and feel unable to handle anything or even get out of bed?"
Here's the answer, and it sucks: You have to power through. I know, I know, it's easy to say, and I know it can be the hardest fucking thing you ever do. But here's the thing: when you're in that state, your brain is a damned liar. It tells you it's better, easier, to stay curled up, to retreat from the world, that to do otherwise is to feel even worse. IT. IS. A. LIE. You must push to retain a semblance of normality. Set small goals if you have to: get out of bed and shower. That's it. Then set another small goal: eat something. Then another. At each small, excruciatingly difficult step, the next one will become ever so slightly easier. Keep doing this until you increment your way to some modicum of a normal routine, even if it's just going through the motions of the day, merely showing up to work, etc. However if my own personal experience and that of everyone I've ever spoken to about this is anything to go by, as crappy as you feel stumbling through your routine, it will be better than staying curled up in a (metaphorical) ball away from everything.
And while your depression may stick around for some time still, my experience is that it nonetheless gets better at least a little faster. Sticking to a routing distracts the mind just a bit, and every such distraction is a moment you feel less depressed. The more of those you string together, the better you feel faster. I also can't understate that it's during these depression times you should absolutely tap you support network of friends and family. If you feel comfortable enough, clue them in and ask them to help keep you on track for normalcy in your life's routines. If you don't have a support network like that to tap, try support groups: the DBSA (Depression & Bipolar Support Alliance: https://secure2.convio.net/dabsa/site/SPageServer/?pagename=...) is a fantastic, fantastic resource here, and even have online chat based groups too.
Also consider "grounding techniques" that help keep you, well, grounded. These can be great distractions when too caught up in your own head. Here's an example of a bunch of good ones: (I'm linking to google's text-only cache because the site is for some reason inaccessible now, even though I've used it for years... anyway, scroll down a bit to the list) http://webcache.googleusercontent.com/search?q=cache:3bjZ-8G...
None of this is a silver bullet, but it can "take the edge off", and I know, believe me I wish I didn't, but I KNOW, none of what I've suggested here is easy. But decades of experience coming out the other side of these things has shown me they do help. Best of luck to you. Feel free to reply with more questions, I have all too much experience here, and am happy to share the hard won lessons I've earned.
It's important to note that not all depressions are created equally. There's transient depression: most people may experience some form of this at some point in their lives, and it can often be dealt with through short-term medication, counseling, both of those, or sometimes just one of them.
Then there's chronic depression. If that's an issue, prior to accepting a clinical diagnosis such as from a doctor (preferably psychiatrist) you should push for a full blood screen, especially for things like thyroid and vitamin D. There are things that can be picked up in such a screen whose symptoms mimic depression, and you want to rule out obvious physiological causes that have trivial fixes.
Next I'm going to get into the medication aspects of things a bit, but I'll give some coping hints afterwards.
Assuming we're dealing with either chronic or intermittent & highly disruptive episodes of depression, treatment can still vary greatly based on circumstance. My own opinion is that a combination of medication and therapy present the best long term prognosis for improvement. In some cases, these can even be temporary, where medication helps improve things enough to be bearable while you work out underlying issues and coping mechanism with a therapist (DBT & CBT style therapy can be very effective here) but therapy styles can be highly personal and different things work for different people.
In such a situation, on the medication front, an SSRI medication is usually the first-line medication treatment. But the specific presentation of symptoms can absolutely drive a different selection of medication(s). As one simple example, depression with extreme anxiety is a strong risk for BP2 (bipolar type 2) where the anxiety is actually mixed episodes (This is NOT always the case). But in that sort of situation, a psychiatrist might reasonably be reluctant to prescribe an SSRI which can exacerbate the hypo/mania symptoms of BP2. As such, an atypical anti-depressant such as wellbutrin may be used, and for acute anxiety/panic either a benzo class drug or in some cases a beta blocker may be used for the anxiety/panic.
Now, here's the thing about medications: (please HN excuse my language here, it's warranted I think though) it is a shitty process of trial and error. There are dozens of medications, and each person can respond differently. What's more, it can take months to determine if a given medication has had an effect before you can move on to another. This means it can, literally, be years before you find a medication or combination thereof that works for you. It requires patience and the knowledge that things WILL GET BETTER. They do. I've been at and slightly over the brink a few times in my life, and pulled back form the edge enough to keep trying for better results, and every time it has worked, and helped make the next time that much easier to trust the process. You will find something that works, eventually. Search out good doctors that will work with you as a partner in the process.
Now there's an exception to depression meds taking weeks or months to work. Very few medications can have a near immediate effects. One option, controversial, is Ketamine. You need a doctor open to this experimental treatment to work with you, and money to pay out of pocket: insurance won't cover it. Also it's considered a treatment of last resort, when many other med options have failed. Another, easier to get option is modafinil (name brand Provigil). This is basically an atypical stimulant, very different from something like amphetamine type drugs like adderal. It is primarily used for narcolepsy and other sleep disorders, as it's considered a "wakefulness promoting agent". However research shows it can have a profound and rapid improvement on depression. I speak from personal experience on this one: Modafinil keeps me functional during depression and takes a significant edge off it at the same time. I cannot understate the effect this drug has had in helping me manage my depression. Caveat though: No drug works for everyone, but doctors are often much more amenable to prescribing this one earlier in the medication trial-and-error process, so it's worth a conversation.
Finally, meds are only part of the equation. As I said earlier, therapy is a HUGE part as well. It will help develop better coping mechanisms at the same time that it also helps get at underlying issues that either cause or exacerbate depression, and can help alleviate them. So that's one thing. Next, and maybe most important for the OP here, or others reading, is the possible response to what I've said: "Okay fine, but what do I do when I none the less find myself depressed and curled up in a ball and feel unable to handle anything or even get out of bed?"
Here's the answer, and it sucks: You have to power through. I know, I know, it's easy to say, and I know it can be the hardest fucking thing you ever do. But here's the thing: when you're in that state, your brain is a damned liar. It tells you it's better, easier, to stay curled up, to retreat from the world, that to do otherwise is to feel even worse. IT. IS. A. LIE. You must push to retain a semblance of normality. Set small goals if you have to: get out of bed and shower. That's it. Then set another small goal: eat something. Then another. At each small, excruciatingly difficult step, the next one will become ever so slightly easier. Keep doing this until you increment your way to some modicum of a normal routine, even if it's just going through the motions of the day, merely showing up to work, etc. However if my own personal experience and that of everyone I've ever spoken to about this is anything to go by, as crappy as you feel stumbling through your routine, it will be better than staying curled up in a (metaphorical) ball away from everything.
And while your depression may stick around for some time still, my experience is that it nonetheless gets better at least a little faster. Sticking to a routing distracts the mind just a bit, and every such distraction is a moment you feel less depressed. The more of those you string together, the better you feel faster. I also can't understate that it's during these depression times you should absolutely tap you support network of friends and family. If you feel comfortable enough, clue them in and ask them to help keep you on track for normalcy in your life's routines. If you don't have a support network like that to tap, try support groups: the DBSA (Depression & Bipolar Support Alliance: https://secure2.convio.net/dabsa/site/SPageServer/?pagename=...) is a fantastic, fantastic resource here, and even have online chat based groups too.
Also consider "grounding techniques" that help keep you, well, grounded. These can be great distractions when too caught up in your own head. Here's an example of a bunch of good ones: (I'm linking to google's text-only cache because the site is for some reason inaccessible now, even though I've used it for years... anyway, scroll down a bit to the list) http://webcache.googleusercontent.com/search?q=cache:3bjZ-8G...
None of this is a silver bullet, but it can "take the edge off", and I know, believe me I wish I didn't, but I KNOW, none of what I've suggested here is easy. But decades of experience coming out the other side of these things has shown me they do help. Best of luck to you. Feel free to reply with more questions, I have all too much experience here, and am happy to share the hard won lessons I've earned.
By getting help from a qualified professional and seeking out safe places where you can share your struggle and open up without judgement (be careful with this one).
As with any serious health issue prevention is always best to the extent possible:
1. Get sleep
2. Regular exercise (cardio if you only have one choice but weights)
3. Meditation
4. Avoid toxic relationships/workplaces
5. Do not put yourself in situations where you are constantly stressed
6. But don't avoid challenges just make sure it's good stress (something you can walk away from, recuperate, and grow as a person)
As with any serious health issue prevention is always best to the extent possible:
1. Get sleep
2. Regular exercise (cardio if you only have one choice but weights)
3. Meditation
4. Avoid toxic relationships/workplaces
5. Do not put yourself in situations where you are constantly stressed
6. But don't avoid challenges just make sure it's good stress (something you can walk away from, recuperate, and grow as a person)
EXERCISE EVERY DAY!
Follow these steps:
1 - Get outside and exercise. (it's free, simple and has immediate and long term effects)
2 - Get out of your context, travel to a new town or a new country for a few days.
3 - Read or listen to this (the audiobook free for a new account):
https://www.audible.com/pd/Cant-Hurt-Me-Audiobook/B07KKMNZCH
https://www.amazon.com/gp/product/1544512287/ref=dbs_a_def_r...
Talk to people that care about you, if that is difficult to find, then get out and go meetups and make new friends https://www.meetup.com
-- Optional -- Download and listen to:
Get the Edge by Tony Robbins
Personal Power by Tony Robbins
There is always a way, never give up on being happy. It will get better.
Follow these steps:
1 - Get outside and exercise. (it's free, simple and has immediate and long term effects)
2 - Get out of your context, travel to a new town or a new country for a few days.
3 - Read or listen to this (the audiobook free for a new account):
https://www.audible.com/pd/Cant-Hurt-Me-Audiobook/B07KKMNZCH
https://www.amazon.com/gp/product/1544512287/ref=dbs_a_def_r...
Talk to people that care about you, if that is difficult to find, then get out and go meetups and make new friends https://www.meetup.com
-- Optional -- Download and listen to:
Get the Edge by Tony Robbins
Personal Power by Tony Robbins
There is always a way, never give up on being happy. It will get better.
Evidence for exercise as a treatment for depression is weak at best, and most of the research fails to show direction of causal effect: do people who exercise recover from depression, or do people who recover from depression become well enough to do exercise?
People who exercise recover from depression, definitely.
For these reasons and more:
- If you get outside consistently you will start facing reality from a different perspective. (being at a desk or closed office constantly sucks and contributes to mental and emotional atrophy)
- You start getting free endorphins that will make you feel better instantly.
- Also you relieve stress and pressure by burning energy.
If you mix that with travel, example running in a different place, town, country, it makes wonders.
For these reasons and more:
- If you get outside consistently you will start facing reality from a different perspective. (being at a desk or closed office constantly sucks and contributes to mental and emotional atrophy)
- You start getting free endorphins that will make you feel better instantly.
- Also you relieve stress and pressure by burning energy.
If you mix that with travel, example running in a different place, town, country, it makes wonders.
When you have the urge to self-destruct, reach out and do something nice for someone else. It can be small, like wishing someone a Merry Christmas, or buying a stranger a coffee. Rinse and repeat as necessary.
Also:
- Exercise regularly
- Maintain a regular sleeping schedule
- Eat healthy (recognize when you are self-medicating with food)
- Make an extra effort to groom yourself (wear cologne, shave daily, clip your nails)
Also:
- Exercise regularly
- Maintain a regular sleeping schedule
- Eat healthy (recognize when you are self-medicating with food)
- Make an extra effort to groom yourself (wear cologne, shave daily, clip your nails)
As others have pointed out there is no silver bullet. I have only very mild depression and anxiety sometimes, I mean it bothers me a lot but it's far from serious clinically. But I guess it would be worse without treatment.
- taking care of my health - taking care of my looks - anti depressants (cipramil) - writing down my to-dos so I don't obsess over them and generally organizing my week, not only work - avoiding drugs and alcohol - seeing my friends and family often. Can't stress this enough. I'm blessed with many friends and a loving family - seing something really painful once in a while to keep me in perspective. Can be as simple as watching hardcore documentaries about Africa. - doing good to others - keeping busy - an empty mind is the devil's office or so we say I'm Portuguese
- taking care of my health - taking care of my looks - anti depressants (cipramil) - writing down my to-dos so I don't obsess over them and generally organizing my week, not only work - avoiding drugs and alcohol - seeing my friends and family often. Can't stress this enough. I'm blessed with many friends and a loving family - seing something really painful once in a while to keep me in perspective. Can be as simple as watching hardcore documentaries about Africa. - doing good to others - keeping busy - an empty mind is the devil's office or so we say I'm Portuguese
[deleted]
[deleted]
Three things:
1. Eat well (cut carbs as much as possible);
2. Exercise (even taking the stairs counts); and
3. Volunteer your time to help others in need.
This will not cure all depression but will help quite often.
[deleted]
1) You are not alone . Millions of young people go through such stage all over the word
2) Talk to people . Your parents , your siblings , your teachers. When you discover people around you , you will find someone who can listen more and answer you .
3) GET A HOBBY . one in SPORTS and one in music or Art. This will help you get away from endless talks in mind . Basically depression is nothing but THINKING same thing AGAIN and AGAIN
5) Set yourself goals to achieve . That will give you confidence and strong spirit. AND that will give you everything
6) Learn to meditate . and read BHAGWAD GEETA . Einstein to STEVE JOBS to Abdul KALAM all have read it and found peace . Its not a book of some God, in my opinion , its a book of Spiritual life
Taken from here - https://provlem.com/i-need-help-im-depressed-because-i-think...
2) Talk to people . Your parents , your siblings , your teachers. When you discover people around you , you will find someone who can listen more and answer you .
3) GET A HOBBY . one in SPORTS and one in music or Art. This will help you get away from endless talks in mind . Basically depression is nothing but THINKING same thing AGAIN and AGAIN
5) Set yourself goals to achieve . That will give you confidence and strong spirit. AND that will give you everything
6) Learn to meditate . and read BHAGWAD GEETA . Einstein to STEVE JOBS to Abdul KALAM all have read it and found peace . Its not a book of some God, in my opinion , its a book of Spiritual life
Taken from here - https://provlem.com/i-need-help-im-depressed-because-i-think...
Simple, i self medicate. ive learned enough both about myself and basic pharmacology to fairly effectively manage it
Getting out of your own head. Focusing on others, and doing things that keep you busy even if you don't feel like you want to.
You come up with- and handle anything else - ideas, work, gym - whatever.
The moment you "handle depression" or "fight depression" - you feed it.
You kill it by lack of attention to "depression". You kill it by focusing attention to anything else.
Most effective is helping other people with whatever they need. That's because it de-focuses attention from your own needs and when "you are depressed" - that would be your depression.
Go, find someone who needs help and save someone's day. Or life. It could be person, place, animal or good cause.