[HN Gopher] Neuropsychiatric researchers rethink what depression...
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Neuropsychiatric researchers rethink what depression might be
Author : theafh
Score : 165 points
Date : 2023-01-26 15:31 UTC (7 hours ago)
(HTM) web link (www.quantamagazine.org)
(TXT) w3m dump (www.quantamagazine.org)
| ErikVandeWater wrote:
| > Our knowledge of the genetics, however, is incomplete. Krystal
| noted that studies of twins suggest that genetics may account for
| 40% of the risk of depression. Yet the currently identified genes
| seem to explain only about 5%.
|
| I see the value in analyzing genetics for depressive genes, but I
| also consider that how the genes interact with our environment
| that play a role. For example, if the state of women's rights
| around the world returned to where it was 200 years ago, it would
| likely appear a genetic cause of depression is related to having
| two X chromosomes. To wit - is the issue with the genes
| themselves, or is it that those with the genes are somehow
| repressed by the way society works?
| zeroonetwothree wrote:
| Women have 2x the rates of depression as men. But is there any
| reason to think that 200 years ago it was even more so?
|
| I think we overestimate the impact of external factors on our
| internal mental states. That's why the typical treatment for
| depression is CBT (literally changing your thoughts and
| behaviors) and not "improve your external situation".
| ErikVandeWater wrote:
| > Women have 2x the rates of depression as men. But is there
| any reason to think that 200 years ago it was even more so?
|
| That's interesting. I would have thought men would have it
| more since it's an abnormality, and with only 1 X chromosome,
| men are much more frequently abnormal.
|
| When I said "If the state of women's rights around the world
| returned to where it was 200 years ago," I meant if women who
| currently had normal human rights lost them. In that case we
| would see a major increase in depression among women, the
| point being that depression would be explained much more
| clearly by genetic factors, even though the genes didn't
| change; the interaction between the genes and the world
| changed.
|
| > I think we overestimate the impact of external factors on
| our internal mental states.
|
| We definitely do. And the external factors that affect our
| happiness the most are often the least controllable.
| asdff wrote:
| I think that's in part due to the fact that women are an
| oppressed group in this world. Even in this country, the
| rhetoric used against women by certain politicians is
| abhorrant, and startlingly accepted by a huge swath of the
| population. There are politicians who want teenagers to
| carry their rapists baby to term; we've had a rapist
| president and now there's a rapist sitting on the supreme
| court bench. Then you have a huge swath of people who still
| believe in the patriarchal mid century views towards women,
| or who have raised sons who continue to believe that crap
| and saddle that behavior on their partners, perpetuating
| mistreatment just like how racism continues to be
| perpetuated. Minorities are similarly at higher risk for
| chronic depression than whites.
| asdff wrote:
| At the same time, there's only so much to improve your
| external situation, especially if you are dealing with hard
| facts sort of situations (e.g. chronic health problems or
| terminal illness, poverty). If your source of depression is
| something external you can do something to improve, your
| therapist will definitely recommend you moving away from
| whatever that is (e.g. a toxic work environment or an abusive
| partner). The reason why we encourage cbt is that it gives
| you some tools in the mean time, as sometimes the external
| factors driving your depression are going to be difficult or
| impossible to change.
| asdff wrote:
| Gene by environment interactions are super important for
| understanding how genotypes affect fitness in context. Change
| your environment to the open ocean instead of on land, for
| example, and you can readily see how your genes now hurt your
| chances for survival instead of improve them.
|
| That being said, there's a lot to the genetic compotent of
| disease risk beyond just changes to the sequence of protein
| coding genes. How much protein that gene produces can be
| affected by a number of factors, such as the presence of singe
| nucleotide polymorphisms (changes to one site in the DNA) that
| may be well outside the gene region in the genome, but are a
| binding region for a transcription factor or an enhancer that
| drives expression of that gene and therefore dramatically
| lowers (or increases) the protein produced. You can also have
| epigenetic changes that similarly effect gene expression, but
| these are not reflected anywhere in the genomic sequence since
| these represent changes to the proteins that package DNA in the
| nucleus, not to the DNA itself.
| tus666 wrote:
| Move psychology and psychiatry into the Astrology department
| please. It ain't science.
| elil17 wrote:
| I'd tend to agree that psychology can be unscientific at times.
| Certainly a lot in that field is derived from very abstract
| theories (e.g. psychodynamics) that are not as falsifiable as
| one might hope.
|
| Yet, the comparison to astrology is also unfair. Scientific
| studies have repeatedly shown that many psychological
| treatments (e.g. CBT, DBT, interpersonal therapy) are
| effective. A lot of early medicine worked this way: we knew a
| treatment was useful before we understood the fundamental
| biology of how it worked (e.g., rudimentary vaccines came
| before germ theory).
| tus666 wrote:
| You are making a false equivalence between clearly
| identifiable physical disease (e.g. shingles), and this
| questionable concept called "mental illness" or "depression",
| and this false equivalence is at the root of the problem.
|
| This is one of the problems of how the scientific revolution
| has been carried out in western society. The scientific
| method which was so successful in application to certain
| problems (mainly in the physical realm), has been assumed to
| be just as effective in other areas as well.
|
| Then we see false inferences being drawn and faulty
| conclusions being reached based on philosophically
| questionable assumptions being drawn - "hey, it looks like we
| are applying the scientific method, therefore we must be
| right!". Badly applied science is just as bad a non-science
| like astrology.
|
| Guess what - if you lock a chimpanzee in a cage it will
| become "depressed". Maybe just let it out and return it to
| the jungle? That ain't science, it's just common sense.
| elil17 wrote:
| If you run a bunch of people who are unhappy through a
| standardized psychology program (e.g. CBT), they get
| happier compared to the people who didn't get that program.
| That's just a fact.
|
| Maybe that's not the scientific method by your definition,
| but I'm not sure it matters.
|
| And yes, I get that a lot of mental health problems are
| caused by problems in society. To extend your analogy,
| we're not the zookeepers, we're other chimpanzees. We're a
| lot smarter than monkeys so we even perhaps have a shot of
| escaping. But it is absolutely reasonable to try to help
| each other make the most of our lot.
|
| So who care's what you call it, therapy is a way to help
| people have more fulfilling lives. Medications can be too.
| tus666 wrote:
| Again you run face first into the brick wall of
| questionable assumptions and get a bloody nose.
|
| What's happiness? How do we measure it? How long does
| this feeling last? Was it measured again 10 and 20 and 30
| years later? And what was the "control measure"? People
| who did not go through any program at all? Was it simply
| the opportunity to think through their life issues rather
| than the "CBT" itself the main driver to improve their
| mood? Did the study attempt to identify different causal
| factors? Did the participants actually make substantive
| changes to their lives or did they simply start to "feel
| better"? Did different people with different backgrounds
| respond differently to different kinds of treatment?
| (rhetorical question obviously).
|
| Are you now starting to get a taste of the absurdity of
| psychology and psychiatry? Sure getting people into a
| room to simply start _talking and thinking about their
| lives_ is a good thing. It probably helps, in different
| ways for different people. But again, this is not
| science, just common sense.
|
| The attempt to "sciencify" and pathologize lived human
| experience is like a kind of mental corruption by the
| scientific establishment that refuses to believe anything
| is beyond it's scope. But again, just because you run
| what looks like a "scientific study" and write a fancy
| "scientific paper" does _not_ validate the corrupt and
| invalid assumptions and beliefs it is attempting to
| demostrate.
|
| It's a bit like the cognitive failure that led to
| "software engineering". Engineering was created to
| formalize the manipulation of the physical world.
| Applying it to information synthesis was always wrong,
| yet people did it anyway, and it led to spectacular
| failure. We now have agile development as a result. Maybe
| the same thing needs to happen to psych "sciences".
| igammarays wrote:
| Depression, and almost all mental disorders, can't even be
| defined or reliably identified by any diagnosis test, leave alone
| finding a biological cause.
|
| Found a book recently on the topic, "Cracked: The Unhappy Truth
| about Psychiatry" by James Davies, an expert who worked as a
| clinical psychiatrist, and was himself present at meetings when
| organizations like the NHS worked on standardizing definitions
| for mental disorders (DSM and ICD).
|
| My notes:
|
| * Naming mental disorders is like naming constellations in the
| sky: the phenomena are real, but finding a pattern is completely
| subjective and arbitrary.
|
| * There is a growing movement of professional psychiatrists
| calling for the abandonment of the DSM and ICD and other newly
| created terms for mental disorders.
|
| * There is no scientific evidence whatsoever for the existence of
| ANY of the "mental disorders" described in the DSM or ICD, yet
| these mental health manuals are taken as bibles in the West. The
| authors of the manuals themselves are publicly quoted to have
| said that these manuals are simply subjective guidelines, with
| absolutely no biologically-identified cause for these "diseases".
|
| * Most of these "disorders" are simply describing normal
| variations in personality found among people at different periods
| of life. Identifying behavioural patterns and assigning a name to
| it is a purely subjective matter.
| endorphine wrote:
| I was hoping to see Finasteride mentioned in the article. I've
| read that it was found to trigger suicidal thoughts in patients.
| I'm curious why that is.
| [deleted]
| rhinoceraptor wrote:
| The most common reason I've seen speculated is the
| neurosteroids that 5-alpha reductase is involved in,
| allopregnanole and isopregnanolone.
| asdff wrote:
| I'm really curious what the long term effects of finasteride
| use will be or if there are side effects from withdrawl. So
| many people I know use it and this is the first I've read of
| this side effect, so it must be relatively understudied. I
| guess the silver lining with so many people testing out a drug
| like this is that it makes it easier to look at more rare side
| effects with a larger sample size. Sometimes I think if there's
| an actual perfectly safe cure for baldness out there, you'd at
| least see rich people like the British Royal Family or LeBron
| James using it.
| [deleted]
| benibela wrote:
| Pet theory: It is a protection from negative emotions
|
| Someone experiences too much sadness and other negative emotions,
| so the brain tries to stop the negative emotions by shutting down
| all emotion processing. Then you do not feel so many negative
| emotions anymore, but also no more positive emotions. You just do
| not feel anything. Since motivation comes from emotions, you also
| lose all motivation to do stuff
| elil17 wrote:
| Sounds like psychodynamics. A core part of that theory is that
| unbearable emotions/thoughts are relegated to the "unconscious
| mind."
| super256 wrote:
| Maybe it's different across cultures, but to me it was
| communicated that more serotonin makes you more risk-taking and
| removes anxiety from you. The anti-depressant effect is coming
| from the rewards of taking risk (e.g. asking someone out,
| applying for a new job, asking for extra ketchup on your fries).
|
| There was a funny study about crayfish changing behaviour when
| exposed to SSRI, where they became bolder to the point of
| endangering their life.
|
| https://www.theguardian.com/environment/2021/jun/15/crayfish...
| alienalp wrote:
| Chronic inflammation is also result of many other health problem.
| Depression is ultimately a natural process. It is known that
| depression caused by health issues probably big portion of cases.
| Nothing new. I realized that bluntly interfering with a mechanism
| built-in in our body is ridicules. People should be focusing in
| root causes. However i doubt that SSRIs really interfere with
| depression anyway. https://www.youtube.com/watch?v=TTDPV1XOIPY I
| think what happens is SSRIs make recovery faster for people who
| are at the stage of recovery by giving false hope. There are ones
| that really interfere with depression and result is drastically
| increased mortality. Which is really what should happen if you
| surpress a natural mechanism solely exists to increase survival.
| ogwh wrote:
| There is literally no useful information in this article.
|
| It could be summed up as "everything people have been told is
| bullshit and we don't know what isn't".
|
| What a waste of time.
| NickM wrote:
| It's really bizarre to me how fixated people are on viewing
| depression solely through the "disease with a biological cause"
| lens. Even in this article, which acknowledges the serious flaws
| in the serotonin hypothesis, all the alternatives they explore
| are around other biological things like other neurotransmitters,
| inflammation, etc.
|
| Maybe more people are anxious and depressed than in the past
| because modern life really sucks for a lot of people. I'm not
| saying that's a simple thing to fix, and certainly there is a
| biological component for _some_ people...but the idea that
| societal changes are increasing rates of anxiety and depression
| seems _way_ more plausible than there being some sudden and
| mysterious shift in the biology of a significant percentage of
| the population that needs correcting via medication.
| mhardcastle wrote:
| Here is a lecture by Robert Sapolsky, an extremely well-
| regarded researcher, that goes over some evidence on depression
| being a disease: https://youtu.be/NOAgplgTxfc
|
| It's been a while since I've seen it, but I recall his evidence
| including some rather striking non-behavioral symptoms, like
| changes in sleep cycles.
|
| To address your specific thoughts on it, his position
| (paraphrased from memory) is that social stressors like you
| describe cause elevated cortisol, which causes depression -
| such that your position that "modern life really sucks" is not
| incompatible with a biological cause.
|
| It's extraordinarily interesting in a lot of other ways -
| definitely worth a watch in spite of the length.
| NickM wrote:
| Oh yeah, certainly, being depressed is correlated with all
| kinds of changes in biology. I'm not saying it's like "just
| in your head", but the question is, do those changes lead to
| being depressed or does being depressed lead to biological
| changes?
|
| Of course that question is an oversimplification since the
| answer is certainly some of both; but the prevailing wisdom
| seems to be that it's mostly/all biological changes leading
| to feeling depressed, whereas I'm not convinced the scales
| don't lean more in the other direction, at least on average.
|
| EDIT: but as to your point about stress leading to elevated
| cortisol levels, to me that's clearly _not_ a biological
| cause. The cause is stress, and the elevated cortisol levels
| are an effect of the stress. It 's not like the hormone
| levels just went up all by themselves due to some genetic
| abnormality or something; if they did, then yeah maybe that's
| a biological disease that warrants some kind of chemical
| correction, but that's not at all what we're talking about.
| alexfromapex wrote:
| Not disagreeing with you I think depression is a constellation
| of things but anhedonia in my opinion definitely has a
| biological cause because it comes and goes.
| johnthealy3 wrote:
| Correct me if I'm wrong, but this could be the first real
| acknowledgement in science that RA, lupus, and autoimmune disease
| in general could be CAUSED by mental health issues? FTA:
|
| "It's also unclear whether simply treating inflammation could be
| enough to alleviate depression. Clinicians are still trying to
| parse whether depression causes inflammation or inflammation
| leads to depression. "It's a sort of chicken-and-egg phenomenon,"
| Nemeroff said."
| [deleted]
| untech wrote:
| ...because literally nobody really knows what causes the
| depression.
| cpncrunch wrote:
| We do actually have a lot of research into factors that can
| cause depression, which the article mentions:
|
| "Different genetic variations can affect whether individuals
| respond to certain types of stress, such as sleep deprivation,
| physical or emotional abuse, and lack of social contact, by
| becoming depressed."
| [deleted]
| LatteLazy wrote:
| We really have no idea what "the" cause is. It maybe have one
| cause or many (it almost certainly has many...).
|
| We don't even really know what depression is. Is it a disease or
| a symptom or both? Is it actually multiple different diseases all
| presenting similarly?
|
| One look at how regularly professionals change the
| name/definition/diagnostic criteria for this shows you we are
| still in very early days for mental health...
| zeroonetwothree wrote:
| Right, depression isn't just one thing. It's a general term we
| give for a family of related symptoms. Sometimes it can be
| caused by obvious external factors (your loved one dies or you
| lose your job), in which case it's not considered a "disorder",
| just a normal response of your brain. Other times there is no
| obvious external cause and you just have those symptoms for no
| apparent reason. In such cases we call it "depressive disorder"
| and treat it with therapy or drugs (which are at best only
| moderately effective).
|
| Of course there are many things in medicine that have no known
| cause so it's not exactly unique to depression or even mental
| illness. For example some large % of chronic pain is idiopathic
| (no known cause), and there are a host of physical conditions
| that we similarly have no idea about (fibromyalgia, IBS, etc.).
| LatteLazy wrote:
| Of course, before it was called "depressive disorder" it was
| called clinical depression and defined slightly differently.
| Before that it was just (unipolar) depression. Before that it
| was Melancholy. I think it is actually now called something
| else but I cannot for the life of me remember what...
|
| It's like in the dark ages when people just had "fever" and
| died.
| [deleted]
| dbg31415 wrote:
| Not that I've had extensive conversations with licensed
| professionals about this topic for the last 25+ years... but oh,
| wait.
|
| It's a tripod, and you need all 3 to be aligned or else you can
| be susceptible to falling back into the shit. You don't have to
| have problems with all 3, problems with just 1 will do it. But
| you do need to aware that sometimes you do need to fix all 3.
|
| Circumstances.
|
| Biology.
|
| Behavior.
|
| And it's complicated.
|
| Circumstances. If you have a ton of shit going on that isn't
| making you happy, you can be depressed. You'll need to work to
| avoid circumstances that get you down. But... we're seldom able
| to control our lives.
|
| Biology. There can be unbalances. Lack of exercise, for me, is
| the most common way to feel shitty. If I didn't have my health,
| I'd feel shitty. Brain health, body health, just health. Also
| just physical comfort. You have to make sure you're physically
| OK.
|
| Behavior. You have to want to be happy. You have to be open to
| it. You have to strive for it. You have to respond and interact
| with people in a way that doesn't make them feel shitty, or else
| you'll drive them away. And... you have to avoid people looking
| to just be shitty and drag others down.
|
| If a friend tells me that they're depressed, my go to is to take
| them for a hike. Get them out of their surroundings, get some
| sunshine, fresh air, and get them moving. I like small tasks,
| small goals that can build into bigger ones. "We don't have to
| climb the mountain, let's just go a mile and see how we feel."
| And it's nice to just have someone there, in the moment with you,
| doing the same thing. And when I'm down, and I know I'm doing the
| same thing someone else is, and they're able to enjoy it, I am
| reminded to let myself enjoy it too.
|
| For me personally... it's hard. We all live our own mistakes.
| Finding a way to forgive myself, while still learning how to
| improve. Finding ways to keep my step count up. Finding ways to
| cross off to-dos at work. I have a little consequence / reward
| system in my head... if I am late to a meeting, I have to do 10
| pushups. If I do my chores (stuff like cleaning up, doing the
| dishes, and yard, and laundry), I get to play a video game at the
| end of the day... and not beat myself up for being lazy. You get
| to set your own.
|
| It's important to reflect on why you do things. I get down when I
| feel like I'm just floating between things that are expected of
| me.
|
| Anyway I don't know, if there were cures, if this shit were
| simple, it wouldn't just constantly be in the background.
| Routines, friendships, and small goals... staying active, try not
| to eat pure garbage, try to be thankful and show appreciation to
| others. I don't know, no real punchline here. Just that life is a
| struggle to keep decay at bay.
| rcarr wrote:
| What is currently called "depression" needs splitting up into
| finer grained categories because it's become a useless catch all
| term at this point. I would argue that the people who are really
| truly rendered catatonic (and so likely have something seriously
| wrong in the brain that needs addressing with drugs) should be in
| one category and I would argue this is quite a small minority. I
| personally believe that the "depression" the majority are
| experiencing is more akin to what Johan Hari talks about in Lost
| Connections and it's root causes are absurd societal structures
| and political failures which are deeply harming people. If
| someone feels trapped in a hopeless situation and this drags on
| for years because society is not providing any means to help them
| escape and improve their lives then depresssion is a pretty
| inevitable outcome.
|
| In a modern day society it really isn't acceptable. Give people
| access to low cost housing. Reduce the cost of education so no
| one is priced out of it or forced into massive debts. Subsidise
| healthy food and tax junk. Subsidise gym memberships and sports
| clubs for the poorest. Increase the amount of therapists being
| trained and make them more accessible. Pay people proper wages.
| Watch depression plummet. The solutions are there - why is there
| no political will to enact them?
|
| Edit:
|
| I have no idea why but people are reading "subsidise" and seeing
| "free". That is not what I said. Subsidise the things you want to
| encourage so it is cheaper for the consumer at the point of sale
| and do the opposite for the things you want to discourage. The
| cost you pay as a society ends up being less in the long run.
| Less people ill and ending up in hospital means more people
| working and paying taxes etc.
| davidn20 wrote:
| I would argue we live in an era with the most access to
| everything you listed out ever. There are more programs to help
| the poor than any other period in history. The internet and
| YouTube give you access to the world's knowledge. You can get a
| membership to Planet Fitness for $10/month.
|
| Also, I realize all of this is great, but the opposite side is
| true too. We also live in an era with the most amount of
| obstacles and vices people can fall into. Yes, there are
| amazing lectures on YouTube, but there are also millions of
| addicting cute cat videos.
|
| I state all this to say depression and improving people lives
| is not as easy as providing them access. They need to want to
| put in the work themselves.
| rcarr wrote:
| I agree that people do need to put the effort in themselves.
| I just think that they put the effort in when they have
| breathing space and hope. If people can't see a way out of
| their situation then they won't put any effort in, they've
| become hopeless and therefore depressed. You could argue that
| the disease in that case may be one of perception, and that
| you need to enrich the person's life by opening up to new
| possibilities and ways of perceiving the world. But you can
| also build more visible progression paths into the system so
| people never feel that way in the first place and can always
| see a route out if they choose to take it.
|
| I'd also argue that there are some social programs but:
|
| - we're drowning in information overload so people don't
| necessarily know how to access them. For example, a lot of
| the poorest households in the Uk did not claim the money they
| were entitled to from the government for energy payments this
| winter.
|
| - We don't really have policies that are addressing the root
| causes of poverty which are unaffordable housing,
| unaffordable and/or poor quality education and low wages.
| landemva wrote:
| > political failures
|
| If politics is being blamed for depression, it is because
| people voluntarily consume media about politics. Just say no.
| Refuse to be sucked in to that pattern.
| rcarr wrote:
| Second and third order effects.
|
| If the main cause of poverty is unaffordable housing and low
| wages and poverty is one of the leading causes of depression
| then the people who have the ability to tackle the housing
| crisis and low wages but instead choose to do nothing are
| also responsible for the causation of a lot of depression.
| The people who are able to do something about the housing
| crisis are politicians. I do agree with you though if you
| think political media is pretty toxic.
| s1artibartfast wrote:
| I would argue that most depression is something more
| philosophical and behavioral then simple material conditions.
|
| It is a state of disconnect from one's own life and the World
| At Large. This is symptomatic of a loss of individual agency
| and ability to interact with their environment in a personally
| meaningful way.
|
| All the free gym memberships and free food in the world is
| useless if individuals don't want to go to the gym or cook the
| food. In reality, there are opportunities for free recreation
| and cheap healthy food readily available, but that isn't the
| bottleneck.
|
| Bottleneck is trained helplessness which leads people to self
| medicate and watch an average of 40 plus hours of Television a
| week instead of doing something that actually Sparks Joy.
| DrThunder wrote:
| I agree with your first paragraph. However, I don't think your
| 2nd paragraph is a fix that'll help very many people at all.
|
| This idea that just throwing free things at people will give
| them any amount of deeper happiness is typically proven false.
| I also don't find therapists all that useful but I guess that's
| a personal subjective take... maybe for the right people they
| can be. The healthy food thing is a cultural issue and no
| amount of subsidizing it to make it cheaper will get people to
| eat healthier. The percentage of obese people is too high to
| place all the obesity blame on food pricing.
|
| The issue is simply that modern day life is typically TOO easy
| for most people and gives back very little deep meaning. We've
| created a culture that gives zero meaning to anyone and
| promotes nihilism. You will not fix that with welfare. Some of
| the most depressed mentally ill people you find will be very
| well off financially.
| landemva wrote:
| > modern day life is typically TOO easy for most people and
| gives back very little deep meaning.
|
| That is about accurate for USA. People can start a garden or
| put a pepper plant under a CFL bulb. Grow some food to get
| some appreciation for how life has become easier.
| juve1996 wrote:
| > Some of the most depressed mentally ill people you find
| will be very well off financially.
|
| Is this statistically true? otherwise this is worthless.
|
| See: Study Finds Strong Relation Between Income and
| Happiness, Does Not Max Out at $75k. Turns out that famous
| study that everyone loved to quote isn't exactly truth.
| https://www.nysscpa.org/news/publications/nextgen/nextgen-
| ar...
| digdugdirk wrote:
| I believe you're interpreting the OP's second paragraph
| differently to how it was intended.
|
| The idea isn't that you're "giving" or "providing" or
| "subsidizing" with welfare - the point is that the
| subsidization has already occurred, just in a non-human
| focused way. Factory farming has been subsidized so processed
| sugars and unhealthy food are the norm. Companies are
| effectively subsidized by allowing minimum wage scheduling
| without providing healthcare.
|
| This all has knock on effects. Healthy food isn't just a
| cultural issue, many people simply don't have the time or
| access to be able to cook healthy natural food. For the vast
| majority of people, they have no possible access to a
| therapist, even if they wanted to or were able to afford it
| (unlikely in the case of the US healthcare system). And of
| course, since there's minimal insurance support for general
| therapy, there's a much smaller market for people to go into
| it. The negative feedback loop continues.
|
| I agree with your general point that life gives back very
| little meaning in our society, but its important to
| understand that this doesn't just occur because life is too
| easy. For many people, life is hard. And there isn't a
| visible path out of the situation they're currently in.
| Checking out/dropping out/giving up is honestly a reasonable
| response.
|
| TLDR: Try not to think of Welfare as a handout. See it as a
| signal of a broken society that needs fixing.
| rcarr wrote:
| I didn't say free, I said subsidised.
|
| You need to reduce friction for good habits and increase
| friction for bad ones. At the minute, our societies do the
| exact opposite. Unhealthy food and Netflix and cheap. Healthy
| food and education are expensive.
|
| It doesn't matter how it happened, once someone is in the
| hole, the negative feedback loop makes it very hard for them
| to escape. If you are worked to the bone on minimum wage to
| keep an overpriced roof over your head you will likely fall
| into the trap of eating shit food and binging on Netflix
| because summoning the energy to cook, teach yourself skills
| and exercise is going to be difficult. And the more you give
| in to doing that the deeper into the hole you fall. People at
| the bottom need breathing space. Reduce the amount of money
| they have to spend to survive which means they don't have to
| work themselves to the bone to survive and they can actually
| focus on improving themselves. I've literally seen it happen
| with my own eyes.
|
| And yes, for some people life can be too easy and that can
| also cause depression. Which is why I believe we need finer
| grained categories to narrows down the root causes and
| provide more tailored solutions than just handing out happy
| pills willy nilly to everyone.
| s1artibartfast wrote:
| >You need to reduce friction for good habits and increase
| friction for bad ones. At the minute, our societies do the
| exact opposite. Unhealthy food and Netflix and cheap.
| Healthy food and education are expensive
|
| I would argue the opposite. healthy food is already dirt
| cheap, and education is free.
|
| One hour at minimum wage can buy enough clean healthy food
| to last an adult most of a week.[1] Free education as
| available at online and at libraries, ranging all the way
| from simple tasks to Phd courses from Stanford.
|
| My point isn't to minimize the hardship of the depressed,
| but point out that friction isn't the issue. If 5 minutes
| of cooking, picking up a book, or typing an educational
| topic into youtube is too much effort, there is a
| _different_ problem.
|
| Why does reading a book, cooking, or learning seem like
| work, and not fun? It certainly isn't because it is too
| hard in reality, especially when the same depressed person
| found pleasure and relaxation in doing these things before
| they were depressed.
|
| [1] I was at the store yesterday and pork was 88 cents/lb,
| frozen vegetables ~ $1/lb, and rice and beans ~$1/lb.
| rcarr wrote:
| I agree with some of your points but not all of it.
| Healthy food can be affordable if you know what to buy
| and how to cook it. But I disagree that it is cheaper
| than junk food and it is certainly less convenient to
| cook and purchase. In the UK at least, there are also
| 'food deserts'[1] which means it is difficult to access
| healthy food.
|
| I also agree that you can teach yourself stuff online for
| free. However it doesn't change the fact that you don't
| have the piece of paper saying you've got a degree which
| is one of the societal structures that holds a lot of
| people back. If you want the certification for an online
| program, you have to pay a similar amount of money to
| what you would have if you'd attended in person. There
| are lots of immigrants working in Western countries as
| taxi drivers who are scientists, doctors and the like
| back in their home countries but can't practice here for
| whatever reason, normally to do with the paperwork.
| IT/Dev is an outlier in that they will hire people
| without degrees in ways that don't happen in other
| industries. Something like 'Good Will Hunting' where a
| self taught janitor makes it into a white collar career
| is pretty rare.
|
| > My point isn't to minimize the hardship of the
| depressed, but point out that friction isn't the issue.
| If 5 minutes of cooking, picking up a book, or typing an
| educational topic into youtube is too much effort, there
| is a different problem.
|
| I still believe friction is a key component. Say you're
| on the minimum wage and you have to work as many hours as
| you possibly can to keep a roof over your head. Plus you
| have a lengthy commute. When you return home you are
| physically and mentally depleted, particularly if you are
| an ill fit for whatever job you've had to take on to
| survive. You want to turn your life around, but you've
| only got limited time available outside of work to do it.
| So you start looking for ways to save time. Maybe you'll
| cut back on exercise, or start eating more junk food so
| you don't have to cook as much and you can study. Or
| maybe you'll cut back on sleep. You keep this up for a
| while but eventually the physical and mental effects
| start to become overwhelming and you become more and more
| ill and eventually you burn out. You've worked hard,
| you've studied and you've still gotten nowhere. And your
| body and mind are a mess. Maybe you end up losing your
| job as a result. You lose faith that anything will ever
| pay off and you stop studying. You fall into depression
| and the cycle gets even worse. Maybe you even turn to
| alcohol and drugs to numb the pain. What that person
| needs is less friction in their life and a bit of help.
| Maybe it's work from home, maybe it's cheap and healthy
| takeaway food and probably a higher wage.
|
| > Why does reading a book, cooking, or learning seem like
| work, and not fun? It certainly isn't because it is too
| hard in reality, especially when the same depressed
| person found pleasure and relaxation in doing these
| things before they were depressed.
|
| Because the person is engaged in a fight for survival.
| They are not necessarily studying a topic because they
| want to but because it's the only thing that will help
| them get a job in their current location. They can't move
| away because they have no savings. Whatever they have to
| learn becomes high stakes. You can't afford to mess up or
| fail because if you do then you're toast. And learning
| requires failure so it's a stressful experience on top of
| your already stressful life. You've got society telling
| you you're worthless due to paying you barely enough to
| survive and now you've got a compiler error or a textbook
| you can't decipher saying the same thing. It takes a
| large amount of strength to hold fast and have faith that
| you will eventually come out the other side victorious,
| especially if this kind of thing goes on for years.
|
| [1] https://www.theguardian.com/society/2018/oct/12/more-
| than-a-...
| s1artibartfast wrote:
| I think we are talking past eachother.
|
| When I talk about access to learning, I am not talking
| about obtaining a piece of paper increasing economic
| mobility. I am talking about learning for the sake of
| personal enjoyment.
|
| Most poor people are not depressed, so you have to ask
| what sets the depressed apart from the rest. Why can one
| person find joy in learning, and not another?
|
| I think this points to something greater than money=
| happiness. Im not saying it doesnt matter, just that I
| don't think is accurate simplification.
|
| You constructed an elaborate and plausible narrative why
| someone is depressed because of their economic situation.
| However, it ignores the person in identical situation who
| is happy. What is different between them?
| rcarr wrote:
| > I think we are talking past eachother.
|
| I think we are too.
|
| > You constructed an elaborate and plausible narrative
| why someone is depressed because of their economic
| situation. However, it ignores the person in identical
| situation who is happy. What is different between them?
|
| From my viewpoint, there are four components:
|
| - Personality
|
| - Expectation
|
| - Perception
|
| - Resilience
|
| Starting with the first, imagine you're really, really
| into the arts. Maybe you're really into musical theatre
| or something like that because you saw them on TV. Now
| imagine you're stuck living in an isolated town in
| Alaska.
|
| Now we can move on to expectation. Maybe you grew up as
| kid and thought one day I'll make it out of this town and
| move to a city where I can work in musical theatre. Or
| maybe you don't even have that high expectations, you
| just want to live in a city where you can watch musical
| theatre. You think you'll grow up and earn the money and
| get out of the town. But it doesn't go to plan. Maybe you
| struggle to find a job because you don't have the skills
| needed in the area. You're working as a bartender and
| don't seem to have any money left over at the end of the
| week to put towards your new life. Years go by and you've
| not made any progress. Your dream is fading further and
| further into the distance.
|
| Which moves on to perception. So many years have gone by
| that you no longer see any possible way of achieving your
| expectations and living somewhere that matches your
| personality. You know what you're doing isn't working but
| you can't think of anything that will. You fall into a
| depression. You let your body and mind go to shit.
|
| A year or two goes by and maybe your perception changes
| and you think "maybe if I train as a lumberjack then I
| can earn more money and then I'll be able to save and get
| out of here." So you go to college to train as a
| lumberjack. But you've been out of school for a while and
| you've forgotten how long it takes to learn a new skill.
| You fuck up a lot. You're not really a lumberjack type so
| the other students take the piss out of you and you
| become the butt of the jokes. You try and start running
| for your mental health but you're that out of shape that
| you can't even run a mile. You give up on both because
| you haven't built up enough resilience through previous
| challenges to make it through.
|
| That last part is absolute key. When you're exercising,
| the total stress the body endures needs to be appropriate
| for it to have the intended effect. If you push someone
| too hard who is out of shape you risk injuring them. Even
| if you're a seasoned athlete and overtrain, your fitness
| decreases. Similarly if you don't work hard enough to
| trigger growth, your fitness won't increase.
|
| It is the exact same thing with depression and why some
| people on here are saying depression is caused because
| life is too hard and others are saying it's caused
| because life is too easy. The stress stimulus needs to be
| tailored for the individual. For a lot of people the
| stress is either too high or too low and it is causing
| major, major problems. We're calling both of these polar
| opposite cause and effects "depression" and it means
| everyone is shouting at each other rather than coming
| together and helping each other.
|
| Going back to our original scenario, you might have
| another poor person who lives in that small Alaska town.
| Maybe he loved musical theatre too. But maybe his
| personality extended to other interests so he was happy.
| Or maybe he never expected much out of life so he was
| happy. Or maybe he could perceive different opportunities
| to escape. Or maybe he took the same lumberjack and
| running route but he knew that it was going to take a
| long, long time to get good at either and he was going to
| have suffer and persevere for a long long time.
|
| It doesn't matter how someone got in the hole, when they
| decide that they're ready to get out, society needs to
| rally around them to offer support. That doesn't mean to
| completely molly coddle them but it means that, just like
| a good coach or physio, you've got to realistically
| evaluate how much stress and damages they've endured and
| how much they can currently tolerate and then gradually
| increase their ability to handle more over time until
| they're back on their feet again. At the minute, in my
| opinion, society is far too much Led Tasso and not enough
| Ted Lasso.
| D-Coder wrote:
| > The issue is simply that modern day life is typically TOO
| easy for most people and gives back very little deep meaning.
|
| Any references that people were less depressed when things
| were more difficult?
| PuppyTailWags wrote:
| I disagree that modern day life is too easy for most people
| and that's why people are depressed. Specifically, I don't
| think there's any evidence that lives with more adversity are
| less prone to mental illness. By this logic, PTSD shouldn't
| exist, neither should the myriad of studies that prove
| beating your children statistically results in a whole host
| of negative outcomes.
|
| I think you personally just might not be engaging with people
| who aren't well off financially. The rate of mental illness
| among the homeless and the jailed populations is way, way
| higher than the rate of mental illness among the wealthy.
| starkd wrote:
| Way to completely ignore the point. It is also addressing a
| spiritual problem with material concerns. Just throw more money
| at it and the problem goes away?
|
| It is also founded on the premise that the government is in a
| position to remove any and all risk from people's lives.
| Indeed, it would be obligated to do this. It is extending a
| guarantee it has no way of fulfilling.
| jaywalk wrote:
| So only poor people suffer from depression?
| re-actor wrote:
| Poor not in wealth but in quality of life, which is almost
| everyone.
| rcarr wrote:
| No not at all. Rich people who benefit from the system can
| also be victim to it in other ways. Not all managers are
| sociopaths and I'm sure a lot of them feel shit about some of
| the things they have to do in order to maintain their jobs.
| And everyone, regardless of wealth and status, is subject to
| the "slings and arrows of outrageous fortune" and whatever
| personal tragedies they may bring. As I said we need finer
| grained diagnoses. You might have for example:
|
| - Catatonic depression, likely physical in nature
|
| - Shit Life Syndrome [1], likely societal cause, possibly
| other issues are play
|
| - Privilege Pathos, likely caused by past trauma, loss or
| existential issues
|
| These are obviously exaggerated groupings to make the point.
| At the end of the day, at the receiving end of every
| diagnosis is an individual with a unique biology and
| backstory that lead to their depression. But if you want to
| have the most impact on reducing the ever skyrocketing amount
| of depression cases, you would be best to focus on the
| societal issues and that, in my opinion, is what is causing
| the most symptoms in the most amount of people. The people in
| the other two categories (the catatonic and the rich) are the
| people most likely to be currently receiving treatment
| anyway, the first because they can no longer look after
| themselves and so wind up in the system and the second
| because they have the means to access therapies.
|
| [1] -
| https://en.wikipedia.org/wiki/Shit_life_syndrome?wprov=sfti1
| Buttons840 wrote:
| You really missed the point. He's saying "depression" means a
| lot of different things[0], and that many people are unhappy
| simply because their societal (economic and social) situation
| sucks and thus their life sucks.
|
| [0]: It would be interesting to have a discussion about
| "depression" without actually using the word, since it's so
| overloaded.
| DrThunder wrote:
| I think OP is referring to the 2nd paragraph.
| ex3xu wrote:
| I am a subscriber to the microbiome inflammasome hypothesis for
| major depression [0], so I wouldn't be surprised if a treatment
| course for depression in many people could be as simple as better
| dental hygiene + magnesium orotate + probiotic supplements. I've
| had my eye on studies linking schizophrenia with inflammatory
| cytokine markers, and it follows that other psychological
| conditions could have similar etiology and pathogenesis. Research
| on the influence of gut bacteria and intestinal dysbiosis on
| anxiety and depression has been coming out since at least 2013
| [1].
|
| After reading Robert Whitaker's 2010 _Anatomy of an Epidemic_
| [2], I 'm convinced that future generations will look back on
| this era of psychiatric treatment with the same critical eye that
| our generation points at Moliere's 17th-century leeches or George
| Washington's personal doctor treating his strep throat with
| several blood-letting phlebotomies -- an absolute iatrogenic
| travesty. The overprescription of potentially mania-inducing
| antidepressants in children and teenagers is especially egregious
| to me. Add in the perverse incentives of profit-driven
| pharmaceutical companies, and you get issues like Zyprexa's 2009
| class action lawsuit, for example [3].
|
| For those looking for a readable introduction to the potential
| link between chronic inflammation and depression, there is _The
| Inflamed Mind_ by Edward Bullmore from 2018 which did some rounds
| on talk shows and the like.
|
| [0] https://sci-hub.st/https://pubmed.ncbi.nlm.nih.gov/30004130/
|
| [1] https://sci-
| hub.st/https://www.sciencedirect.com/science/art...
|
| [2] https://en.wikipedia.org/wiki/Anatomy_of_an_Epidemic
|
| [3]
| https://www.justice.gov/archive/opa/pr/2009/January/09-civ-0...
| dennis_jeeves1 wrote:
| I have not specifically dug into depression, but I think I can
| overall agree with the line of thought. As far as modern
| medicine goes, it is almost undoubtedly primitive but puts
| forth a facade of sophistication.
| standardly wrote:
| The fact that healthy people still get depression makes me
| skeptical of hypotheses like this. If it were as simple as
| taking probiotics, x and y supplements, and eating healthier,
| (and brushing teeth more), I think a lot more people would have
| beaten major depression by now.
|
| Someone else in the thread suggested it's just exercise, sleep,
| and diet. Yet there are plenty of folks who do these things
| perfectly and still get depression.
| hot_gril wrote:
| I like how the website puts a progress bar at the top to
| compensate for browsers increasingly hiding the regular scroll
| bar on the right.
| [deleted]
| MuffinFlavored wrote:
| What are some good ways to get a bunch of serotonin when
| seemingly nothing really excites you/brings you joy and you view
| almost everything in the form of "pros/cons" (aka everything is
| not without its downsides)?
| googlryas wrote:
| Change your thought patterns to be less cynical.
| MuffinFlavored wrote:
| How does one control their own mind?
| googlryas wrote:
| Read philosophy, go to therapy(maybe CBT), generally change
| your inputs.
| zeroonetwothree wrote:
| I encourage you to look into CBT. The best version of it
| I've seen is in the David Burns book "Feeling Good: The New
| Mood Therapy". Although you can also try a therapist (but
| they might be more hit/miss).
|
| The basic idea of CBT is that our thoughts are a result of
| our actions, and by changing our actions we can change our
| thoughts. I'm not going to say it's super easy, but it
| definitely does work.
| barrysteve wrote:
| It works for six months to mask problems.
| lhuser123 wrote:
| Some ideas: Signup for classes of some hobby you really like.
| Read good books about something that can help you see life from
| a different perspective. Learn from Dr Andrew Hubberman on
| YouTube
| MuffinFlavored wrote:
| Hobbies I like: incessantly refreshing HackerNews/Reddit.
| Distracting myself with random coding projects. I feel like
| my attention span has been fried from TikTok/being a
| "computer kid" for the past 20 years or so. Books don't
| "capture" my attention I guess.
| lhuser123 wrote:
| Lol. I guess I was referring to try something different.
| Not that I'm an expert but have tried many things & one of
| the best was taking classes for a hobby I enjoy. You met
| people with similar interest & have something to talk
| about. The mere fact of interacting with people & see life
| from a different perspective can have a real impact. Of
| course this is just the beginning.
| asdff wrote:
| I've struggled with this. In the end the solution was to just
| ignore my pros and cons list, and go with the flow. There's
| been plenty of times I've gone into something thinking not much
| of it, and being pleasantly surprised after. There's also a
| book that really helps me which I periodically reread every few
| years: _Siddartha_ by Herman Hesse. Its a short read, ~150
| pages. It reminds me how important the fullness of life is, the
| good and the bad.
| [deleted]
| mikrl wrote:
| I've been taking the precursor as a supplement (5-HTP) but I'm
| not sure of it's efficacy as I'm not a nutritionist.
| ajkjk wrote:
| This whole article about how "getting a bunch of serotonin"
| isn't the problem.
| ajkjk wrote:
| *is
| bt4u wrote:
| [dead]
| rcarr wrote:
| "If exercise could be packaged in a pill, it would be the
| single most widely prescribed and beneficial medicine in the
| nation."
|
| Robert Butler
| MuffinFlavored wrote:
| I go for a 3 mile walk every now and then. Doesn't really do
| much to be honest. I guess you could be referring to the kind
| of exercise where you need to at least get sweaty.
| rcarr wrote:
| Put a backpack on with some weight in it and go for the
| same walk. You'll get a much better workout, you'll feel
| better and it doesn't even feel all that different to
| walking without it. If you want more information on this
| have a read through this:
|
| https://blog.goruck.com/rucking-training/the-rucking-
| white-p...
|
| It helped me get through a depressing period in my life.
| asdff wrote:
| If you do this though I wouldn't use a jansport, I would
| use a dedicated hiking backpack with a waist and chest
| strap that is designed to support your back.
| rcarr wrote:
| Haha yeah absolutely don't use something with unpadded
| straps!
| zeroonetwothree wrote:
| Yes, unfortunately walking isn't really sufficient. You
| need to get your heart rate up sufficiently, so something
| like running, biking, weightlifting, dance, etc. work. I've
| long suffered from depression, and while I find it very
| hard to exercise regularly, when I do I definitely feels
| significant improvement to my mood. It's unfortunate that
| it's so hard to do it consistently.
| rcarr wrote:
| For what it's worth, try bringing the exercise to you. If
| you like cycling, set up a turbo trainer or exercise bike
| in your house. If you like weightlifting, get some
| dumbbells or a sandbag or a squat rack. Reduce the
| friction and set yourself a goal of doing 1 repetition or
| 1 minute of exercise a day. It's such a trivial amount
| and you've reduced the friction of doing the task to such
| an amount that it makes it much easier to get a
| consistent habit going.
| asdff wrote:
| You can also bake in exercise into your daily life.
| Rather than drive 5 mins to the grocery store and put the
| groceries in your trunk, walk for 15 and carry them by
| hand. You can even do curls, squats, deadlifts, and
| overhead presses with your grocery bags along the way (in
| college I'd do this with beer cases, they are about a
| pound per can). It's also easy to add few more steps to
| your day you wouldn't normally do, like taking a lap
| around your house before you leave and when you get back.
| Take the scenic route to the neighborhood mailbox when
| you drop off a letter. Go up and down your stairs twice.
| asdff wrote:
| Give yourself some credit here. Walking 3 miles is an
| accomplishment especially if you do it regularly. We
| evolved to walk, not to sit around all day. Simulate being
| the hunter gatherer ('modern' ones e.g. in Africa walk 3-8
| miles a day), its good for your health to use your body for
| what its supposed to do. It's like driving the car every
| now and then so you don't get flat spots on the tires.
| asdff wrote:
| I feel like you can get pretty close with a
| steroid+amphetamine cocktail.
| beedeebeedee wrote:
| Really surprised no one here has made the connection between
| depression and the fight-flight-freeze response. Depression is
| just the freeze response, just like we see in our animal
| relatives. Only difference is we can be triggered by thoughts and
| not only the presence of danger. Freezing is when you are so
| powerless, you cannot fight and you cannot fly away. You freeze.
| That response can be reinforced, and sadly, reinforced by thought
| alone.
| tjpnz wrote:
| I wonder to what degree medicine would be "solved" if in the
| future chronic inflammation could be removed from the equation.
| Based on my own consumption of pop-medical articles it's the
| biggest recurring villain.
| david_draco wrote:
| "The Cause of Depression" assumes there is a single cause, which
| may not be the case.
| mettamage wrote:
| I agree with this idea. I personally think there isn't. There
| are more parts of the system that can be attacked in order to
| cause depression
| cpncrunch wrote:
| I wouldn't say attack is the right word. Depression seems to
| be an evolved mechanism that has developed in the brain, as a
| way to change the organism's behaviour, e.g. resting while
| sick (sickness behaviour depression), getting more sleep,
| getting out of a stressful situation, etc. The problem is,
| it's more like a generic "check engine" light, but without
| having access to an OBD, so you kinda have to look at your
| lifestyle and try to figure out what's causing the
| depression, which isn't always easy.
| debacle wrote:
| HN has seen a steep rise in mental health related posts in the
| last year. Am I the only one who has noticed?
| digitalsankhara wrote:
| No. I see an increase in mental health awareness in general
| across most media. Which is a good thing.
| debacle wrote:
| Unless it's symptomatic of a sharp increase in mental health
| difficulties. Most MH folks I know are completely booked
| months out at this point.
| DenisM wrote:
| Booked? What do you mean?
| harvey9 wrote:
| Those bookings could be increased willingness to seek
| treatment rather than increased difficulties.
| trgn wrote:
| Is that increased exposure making us healthier (ie. mindful,
| tolerant, understanding, patient, ...) or more neurotic (ie.
| ruminative, paranoid, self-absorbed, defensive, ...)?
| fahadkhan wrote:
| No doubt the correct answer is "it requires research." But
| I guess the answer is going to be "it depends, on the
| individual and the circumstances"
| digitalsankhara wrote:
| This is a good question and one that must vex most mental
| health practitioners. You list both states of mind and some
| potential mitigations.
|
| I'm a bit uncomfortable with the term neurotic myself as it
| can have dismissive connotations.
| DrThunder wrote:
| Ehhh it can be a good thing to an extent. Over-indulging
| yourself with mental health discussion is bad though imo.
| There's TOO MUCH talk about it nowadays. To the point where
| people with normal negative thoughts and emotions are
| diagnosing themselves with severe mental illnesses and
| running to the doctor for prescription meds.
|
| From personal experience with anxiety it's also not great to
| continue discussing your issues 24/7 because you get to the
| point where you're only forcing yourself to stay in that
| mindset. You need to get out and live at some point or you'll
| never recover.
| asdff wrote:
| IMO people have historically been not talking nearly enough
| about mental health. I think everyone should be seeing a
| therapist regularly, mentally ill or not. The demands of
| society are stressful and people are expected to just put
| up with it and not ever have room to be anxious or sad.
| Most psychologists I've spoken with also have poor views of
| the psychiatric approach to a lot of mental health issues.
| Psychologists favor actually working with you and
| developing internal strategies to protect yourself long
| term such as cognitive behavioral therapy, whereas
| psychiatrists have a tendency to talk little and send you
| home with a prescription versus leaving that as an option
| of last resort.
| digitalsankhara wrote:
| Please accept an upvote for this wonderful comment. My
| experience bears out your view. Whilst there is good
| stress - the sort that can make us feel alive, the
| majority is harmful to a lot of people.
|
| I've long felt there is an epidemic of stress which I
| think accounts for a host of poor outcomes for many, many
| people and society in general. I wish I had the ability
| to describe it more fully myself but my thinking on this
| is not fully formed given it must involve sociology,
| culture, politics, work, family, education and philosophy
| etc. In fact the whole fabric on the way we live our
| lives and why.
|
| I think the foundations for possible solutions have been
| set by many cultures. Chinese, Japanese and Greek
| philosophies in particular are, of course, practised by a
| lot of people, myself included. Ultimately, I feel human
| evolution will be through the mind and perhaps
| generations, hundreds of years in the future, will look
| back at this time in horror the same way we may look back
| to when leg amputations were carried out with no
| anaesthetics.
| alar44 wrote:
| Yeah I agree. I had an ex that listened to mental health
| podcasts 8+ hours a day. It's all she'd talk about. It
| became pretty clear that she was addicted to mental health
| in a way. Her entire life revolved around grief and trauma.
| It's good for us to work on ourselves, but you have to
| actually BE yourself at some point.
| digitalsankhara wrote:
| I would say that too much mis-informed talk is probably not
| a good idea. The balanced view would be to acknowledge
| those normal negative thoughts and emotions. And that is
| the crux of the issue. Knowing when those thoughts become
| abnormal is, hopefully, helped though a broader public
| education and acceptance of mental health.
|
| Knowing that, if you do in fact need to seek help whether
| from a friend, professional or even a stranger, you will
| not made to feel neurotic or told to "snap out of it" is
| where I hope the end game for increased mental health goes.
|
| Mental and physical health are so closely related - mind
| and body. It's taken decades to start to get a foothold of
| acceptance for this type of thinking in the mainstream.
|
| I hear what you are saying about not overdoing it, but
| lives have been lost because people were too afraid to
| talk. I don't know what the longer impact of more social
| acceptance of mental health issues will be but it is my
| wish it leads to a more compassionate world.
| petesergeant wrote:
| Very anecdotal, but I've noticed on HN that people taking the
| SSRI Lexapro for GAD seem to think it's incredible, and people
| taking it for depression seem to be underwhelmed
| tylermac1 wrote:
| Also anecdotal, but everyone metabolizes these classes of drugs
| differently. I'm an "ultra-rapid metabolizer" of a slew of
| SSRIs, so they're next to worthless for me compared to other
| medications.
| lhuser123 wrote:
| Also anecdotal. And some people are ultra-slow metabolizers,
| which can cause the drugs to stay in the body longer than
| anyone could have anticipated. So the effects of 1 pill daily
| can feel like twice that amount since previous day dosis is
| still in the blood.
| edgyquant wrote:
| SSRIs affect me strangely. I feel mentally like I'm not
| depressed but then I have all of the symptoms of depression
| amplified. Oversleep, no motivation etc but hey I feel like
| I'm not sad internally.
| thenerdhead wrote:
| I've always thought depression to be a symptom to a larger cause.
| There's many books that talk about why such as everyday stress,
| childhood trauma, genetics, spirituality/meaning, and even lack
| of quality human basics(foods, sleep, air, etc). So many factors
| and even all those can be wrong.
|
| This article is promising that it seems science is rethinking
| this challenge one small step at a time. I've always been
| fascinated with stories where previously depressed people found
| the right combination of change to turn their lives around.
| Sometimes it feels like it is cyclical in life. Being able to
| treat it with a kitchen sink of tools could really help outside
| of a single drug solution.
| marosgrego wrote:
| They seem to look for causes on the hardware level, but maybe
| it's a software issue many times.
| syntaxfree wrote:
| This is a little unfair to _Listening to Prozac_, which was
| raising speculation about SSRIs effect on trophic and atrophic
| factors back in the 90s. In fact it's unclear whether anyone ever
| believed in the catecholamine hypothesis (excepting simplified
| accounts for marketing or doctor-patient communication), and it's
| been for decades now a cottage industry to disprove it in favor
| of something ele.
|
| It's on the other hand disturbing that there's talk of broadening
| the term "depression", when it really needs narrowing. There's
| such a thing as a medical condition "depression" that one might
| as well define as "responds to antidepressants" and then there's
| everything else -- the invisible boundary accounting for how
| little effectiveness antidepressants have at large. It's a damn
| shame that we don't have the means of diagnosing it (whereasw
| Kraepelin developed the bipolar/schizophrenia differential
| diagnosis before Freud even arrived on the scene).
|
| Overall this article does nothing to inform or educate.
| opportune wrote:
| Depression and anxiety may as well be the cough and fever of
| the mental health world. We can certainly treat cough and fever
| symptoms but that is quite different from treating the
| underlying condition.
|
| I think the big problem is we probably have a lot of recent
| societal/cultural changes which at least contribute to
| depression and anxiety, but are very hard to detect because of
| near universal adoption + too many confounding variables when
| examining holdout populations. Thinking of things like diet
| (and trace chemicals, pesticides), sleep habits, screen usage
| (internet, social media, porn, passive media, games), caffeine,
| etc. Somewhere in those areas, IMO, likely lie very large
| causal contributors to all of the reportedly increasing mental
| health problems we are seeing.
|
| I can also speak from personal experience that I had very
| debilitating depression/anxiety as an adolescent which has
| since greatly leveled off but not quite cleared. While I could
| likely still be diagnosed with depression now, to me the two
| states comparing now vs then are so wildly, qualitatively
| different that I am convinced they represent different
| underlying pathologies. What I have now feels more like the
| same thing that most other malcontents seem to have.
| anonreeeeplor wrote:
| I hate articles like this. They are part of an entire genre of
| pseudo intellectual nonsense that seems to be this genius insight
| but directly ignores obvious causes.
|
| They treat depression like it is some mystery of science when it
| is directly caused by...everything about modern society,
| institutions and lifestyles.
|
| People in Africa living in villages don't get depressed. People
| living in suburbs eating shitty food with no hope due to
| capitalism and crappy prison schools do.
|
| The cause of depression is so obvious only a PHD would be able to
| write and publish a BS article like this, and it is total horse
| shit, and pretend it's a mystery.
|
| It's not a mystery, they just want to try to solve it with crappy
| drugs that you don't actually need rather than target the root
| problems, which they can't target.
|
| I hate these articles and think they are promoting an
| intellectual culture of pretending not to understand the obvious
| by drenching it in overly intellectualized nonsense.
|
| This is a media coverup. We know what causes it.
| gverrilla wrote:
| Agreed. I had an introduction to this perspective long ago by
| reading what Karl Marx wrote about suicide [0].
|
| 0: https://www.amazon.com/Marx-Suicide-Psychosocial-Issues-
| Karl...
| ako wrote:
| > People in Africa living in villages don't get depressed.
|
| Any data or studies on this?
| fragmede wrote:
| > People in Africa living in villages don't get depresse
|
| Holy shit yes they do, I don't know where this myth comes from!
|
| https://www.sciencedirect.com/science/article/pii/S266724212...
| rgbrenner wrote:
| It's an old myth... like here's an article in American
| Anthropologist from 1934 talking about it: https://anthrosour
| ce.onlinelibrary.wiley.com/doi/pdf/10.1525...
|
| There's a lot of data showing it isn't true, but it's one of
| those "facts" that feels true because there's a lot of
| stressors and unhealthy things about modern life.
| bannedbybros wrote:
| [dead]
| ding_dang wrote:
| I've yet to see someone qualified on HN discussing this. It's all
| vapid anecdotes and unfounded/untested beliefs and subscriptions
| to various pet theories.
| rpastuszak wrote:
| > Reject the bad, false, negativity, darkness and move toward
| the love, true, light and goodness. When I was depressed, only
| spiritual teachings, love and God moved me nearer good feelings
| and comfort.
|
| I have no idea what you're talking about.
| avgcorrection wrote:
| Oh, so what is it?
|
| > To treat depression effectively, medical researchers may
| therefore need to develop a nuanced understanding of the ways it
| can arise. [...]
|
| > That prediction may frustrate some physicians and drug
| developers, since it's much easier to prescribe a one-size-fits-
| all solution.
|
| But it will not frustrate headline writers.
| sys32768 wrote:
| If I drink to a very buzzed state three nights in a row, I become
| palpably depressed, irritable, and anxious. If something bad
| happens during this time, it cuts deep and feels overwhelming.
| All of the negative things in my life become tormenting devils.
|
| It takes about 24 hours of sobriety for me to begin to feel
| normal again, and at least 48 to feel I am at my normal baseline.
|
| I always assumed the alcohol was depleting my serotonin.
|
| Beyond that, most of my depression seems to be due to my heroic
| and idealistic self raging and wallowing in the chasm between my
| ideals and hard realities that I cannot defeat.
| jobs_throwaway wrote:
| > Experiments in which researchers artificially lowered the
| serotonin levels of volunteers didn't consistently cause
| depression
|
| Jesus...hard to imagine volunteering for that study
| likeabbas wrote:
| There's no single cause and no single cure which is why it's so
| hard.
|
| I moved cities at 10 years old, and was bullied and isolated
| during the entirety of Middle School. Ever since then, I've
| always had negative and depressive thoughts lurking around. It's
| just my normal.
|
| A psychiatrist helped me understand that those formative years
| are when your cortex is developing. The cortex learns through
| repetition, and during those years I was having constant sadness
| and suffering events. So, my emotional intelligence learned to be
| that way and that's why I've suffered ever since.
|
| If I'm not pro active in thinking about being happy or doing
| active things, I default to being depressed. After almost 20
| years, I'm still suffering.
|
| A side effect of being isolated during those years is my social
| skills have taken longer to develop. I didn't have a true batch
| of friends until college, but now I've lost all of them.
| RobotToaster wrote:
| I've read early life adversity can cause epigenetic changes.
| exo-pla-net wrote:
| Your brain cannot "learn" to be sad. You can, however, learn
| maladaptive schemata: fundamental ways of viewing the world and
| oneself that can help a child get through adverse periods (like
| bullying and ostracization), but which are ultimately
| maladaptive and inaccurate in adulthood.
|
| You might have come to believe, for instance, that you're
| fundamentally "different" or "unlovable", and that you can't
| expect to be socially accepted or loved.
|
| These core beliefs, these schemata, are difficult but possible
| to change. Schema Therapy has had empirical success at doing
| so.
|
| The subjective experience of changing a maladaptive schema is
| like teleporting from a miserable planet to a strange but much
| happier, more loving planet. You can be (much) happier than you
| think; you're just stranded on a miserable planet, one that
| would make anybody sad.
|
| I'd suggest checking out Reinventing Your Life by Jeffrey
| Young: it provides the tools you need to get to that happier
| planet, where you can feel safer and loved and accepted.
| likeabbas wrote:
| > Your brain cannot "learn" to be sad.
|
| This is ~equivocally~ unequivocally false. The portion of the
| brain that develops emotional intelligence forms during your
| formative years and can learn to be put in a depressive
| mindset.
|
| * https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984129/
|
| * https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132040/
|
| > Humans are likely the most emotionally regulated creatures
| on earth. Compared to other animal species, we can modulate
| and modify emotional reactions and experiences, even very
| intense ones, through a large and sophisticated emotion
| regulation repertoire that includes skills of distraction,
| reappraisal, language, prediction, social interaction,
| suppression, and more.1-5 At times, these skills require
| effort, and at other times, they seem reflexive and
| automatic. But what are some of the variables in this
| sophisticated emotion regulation repertoire? The parent of
| any toddler or even adolescent can attest to the very slow
| development of emotion regulation processes. This slow
| development has been documented in empirical research, which
| also notes the large individual differences from one person's
| ability or style of emotion regulation to another's.
| Evolutionarily speaking, this slow development of emotion
| regulation ability in childhood that culminates in an
| exquisite ability in adulthood points to the benefits of a
| slow-maturing emotion regulation system. Indeed, humans are
| not only a highly emotionally regulated species, but they are
| slowly developing in general, relative to other species, 6
| with a prolonged period of immaturity. Phylogenetically, slow
| development may confer benefits through an extended period of
| neural plasticity--a feature of a developing neural system
| that heightens its ability to learn from the environment. If
| so, then humans may owe their sophisticated emotion
| regulation skills to the "extension" of childhood that has
| evolved in us. The nature, chronicity, and quality of
| environmental inputs during these periods of plasticity, in
| particular those from close relationships (e.g., parents,
| friends, teachers), in large part determine emotion
| regulation functioning in adulthood.7 Thus, adult brain and
| behavioral function in this regard can be conceptualized as a
| historical reflection of what was experienced during
| development. To fully appreciate individual differences in
| adult emotion regulation skills, then, it is helpful to
| understand how the brain develops.
| ASalazarMX wrote:
| > during your formidable years
|
| I had to lookup "formidable" in case it was a specialized
| term, but I think it's a typo. Nevertheless, I like it
| better this way.
| likeabbas wrote:
| Definitely a typo. Thanks
| yowlingcat wrote:
| First of all, the phrase "emotional intelligence" is a pop-
| psychology invention created by Daniel Goleman which has no
| clinically meaningful use. There's a big difference between
| emotional intelligence and emotional regulation.
|
| There's also a difference between traumatic experiences
| (such as you moving somewhere new at 10 and struggling with
| isolation and being bullied) and how you may have
| psychologically adapted to these situations. But nothing
| you've mentioned implies that your brain can "learn to be
| put into a depressive mindset" -- it's more the case that
| strenuous challenges that haven't been addressed, or moved
| past, or evolved from, will continue to cause problems
| until work is gradually done to address them.
|
| I have always felt it's similar to musculoskeletal issues.
| You can do a lot of damage to your lower back by sitting at
| a desk all day, or to your wrists by typing at an angle
| that causes repetitive strain. That damage can be
| "mitigated" in different ways -- medication, surgery,
| physical rehabilitation. While the last one is most
| difficult, it's also the most effective because you're
| training the mind-muscle connection at the point where it's
| fragility is causing and compounding structural damage.
|
| Even as people get older, until they reach very old age,
| it's rare for these kinds of MSK problems to occur in ways
| that cannot be unwound by adherence to physical therapy and
| a good exercise regimen. I think the same is true for our
| minds. As you mention in an earlier comment, if you do
| something that makes you happy, you feel happy for that
| time before drifting back to depression. But that in and of
| itself may be the point -- if you are constantly doing
| things which make you happy, it may not be immediate, but
| eventually you can re-orient your brain you being default-
| happy with depressive episodes rather than the other way
| around. That doesn't make it easy, of course, nor is there
| a one time fix.
| likeabbas wrote:
| > But nothing you've mentioned implies that your brain
| can "learn to be put into a depressive mindset" -- it's
| more the case that strenuous challenges that haven't been
| addressed, or moved past, or evolved from, will continue
| to cause problems until work is gradually done to address
| them.
|
| What is the practical difference between saying "learnt
| to be put in a depressive mindset" and "psychologically
| adapted to these situations"? Psychiatrists don't need to
| be so technical when explaining the differences to
| people. I'm only framing the conversation in a colloquial
| manner such that non-psych majors will understand them.
| In some manner I've "learned" to be in a depressive
| mindset. And, through repetition, I can "un-learn" it.
|
| > Even as people get older, until they reach very old
| age, it's rare for these kinds of MSK problems to occur
| in ways that cannot be unwound by adherence to physical
| therapy and a good exercise regimen... if you are
| constantly doing things which make you happy, it may not
| be immediate, but eventually you can re-orient your brain
| you being default-happy with depressive episodes rather
| than the other way around.
|
| I'm not disputing this. The times where I am the happiest
| is when I'm in my routine of working out and playing
| tennis. But when I get out of my routine, I fall back
| into the depressive habits. It's hard to stay consistent.
| Maybe if I stay consistent for long enough, my default
| will not be depressed. But I have yet to be consistent
| for long enough to reach that point.
| mensetmanusman wrote:
| Emotional intelligence is another way of saying that you
| have the ability to read the room, which clearly many
| people (and very many of the technical people I interact
| with) did not have great ability for (which results in a
| lot of cringe-worthy moments).
| exo-pla-net wrote:
| [flagged]
| likeabbas wrote:
| Practically, what is the difference between emotional
| state and consistently emotionally regulating into a
| depressive mindset? I'm not a psychiatrist and I don't
| care what the precise terminology is. In layman's terms,
| what I've stated is correct.
| exo-pla-net wrote:
| [flagged]
| JimtheCoder wrote:
| [flagged]
| likeabbas wrote:
| Nothing I've said is incorrect. I'm just using colloquial
| language to describe the issue.
|
| You are just being an asshole by trying to show off your
| technical knowledge in the subject, which is not helping
| anyone.
| vervez wrote:
| Thanks for sharing and i'm happy to be your friend :)
| Pigo wrote:
| This reminds me of how long it took me to notice a pattern in
| my relationships. When I look back, it's so obvious that I was
| picking a certain kind of person, and behaving in a certain
| kind of way, that would lead to the same conclusion. But it
| didn't feel like I was repeating the same story over and over
| again just to satisfy some malformed part of my psyche. I can't
| rewire something so deep in me that even effects who I'm
| attracted to. All I can do is be aware of it, and course
| correct.
| agumonkey wrote:
| It would be interesting to know what phases our brains go
| through that 'settle' emotional / social reflexes.
|
| I had a strange life due to pre-wired issues, until 30 when a
| few traumatic event (including a first relationship that was as
| positive as negative) completely altered my reality. I was very
| surprising to say the least how one day you cannot exist
| socially (total shut-in with obsessive painful thoughts on a
| daily basis), and the next one you see colors and friendliness
| everywhere. Deep in your guts, something that really lifts your
| mind, imagination and heart solidly, not just a philosophical
| understanding.
|
| I had a year of socially vibrant emotions but gradually went
| back to my old self (avoidant) but I still remember that my
| reality is somehow altered and very far from what others can
| experience or what is healthy.
|
| If anybody has resources to read or places to monitor I'll be
| glad to know.
|
| ps: I have a ton of questions regarding the neurology of the
| perception of "the self" and others for the lack of better
| terms. if any neuroscientist has time to waste, my email is in
| my profile, feel free to spam.
| incognito_robot wrote:
| It is uncanny how much this mimics my own experience.
|
| Was bullied between ages 11-16. Grew a a social circle in high
| school, which started fragmenting once everyone went off to
| university. I rarely if ever see any of them anymore.
|
| Before the bullying, I was aparently happy and excited for most
| things (according to siblings). After it I have always been the
| low energy serious guy.
|
| 20 years on I feel an intense need for human connection, but no
| matter how much I try I never seem to be able to cultivate any
| kind of lasting relationship with others.
| Traubenfuchs wrote:
| > It is uncanny how much this mimics my own experience.
|
| A significant amount of people damaged exactly like that run
| around. It's nothing noteworthy nor exceptional. And there is
| no recognized cure for us.
|
| My pet theory is that through either nature or nurture, we
| are permanently damaged individuals that won't ever
| experience what we perceive as the normal, healthy social
| life and mental states. Our brains are permanently altered to
| our detriment.
|
| Connecting to your anecdote: I am 30 and my mom still
| mentions what a lively and happy child I was. I wish she
| wouldn't, because it hurts to hear about the potential I
| squandered, lost or had stolen.
| ryanwaggoner wrote:
| There are no magic bullets, but the research on
| psychedelics and depression are encouraging.
| Traubenfuchs wrote:
| The only time I managed to acquire psylocobin was on an
| island where a big rave was happening. A hippie guy sold
| me magic mushroom pills. I was too scared to take it in
| this atmosphere and wanted to take the pills home. To
| leave the island, one had to walk through nipple-high
| water. The pills in my wallet melted away in the water.
|
| Maybe some other day.
| imiric wrote:
| > I wish she wouldn't, because it hurts to hear about the
| potential I squandered, lost or had stolen.
|
| I think this negative mentality doesn't help. The sooner
| you try to live life to the best of your abilities with the
| cards you've been dealt, the sooner you'll feel better
| about your present and future. We can't change the past,
| but we can choose to accept it and move on.
| jvm___ wrote:
| Same. Insulting nicknames from elementary into highschool.
| Same 15 boys due to small classes at private Christian
| school.
|
| Married the first girl who showed me positive attention. I
| didn't know what a friend for me was, so we're married but
| not friends.
|
| The hope for you is that I found a group through a local
| running group. They posted on Facebook and we run weekly.
| They added me to the group chat last year and it's been
| amazing having people to chat with and go on runs with.
|
| Going home to someone who you can't have a conversation with
| is hard though.
|
| Trite advice that worked for me. Find a group of people who
| do the thing you like as a way to make friends. This group
| was started by someone just looking to not run alone in town.
|
| I can picture in my head walking up to the running group
| meetup for the first time, it honestly feels like a new birth
| after being friendless from grade 7 til age 40+.
| ryanwaggoner wrote:
| I wasn't bullied, but I was a homeschool kid who ended up
| at a private Christian school and then married the first
| girl who showed me any interest. We finally divorced after
| two decades of struggle. The entire 3-4 year period of my
| marriage finally collapsing under its own weight came with
| several beautiful bright spots: I went to therapy, I had
| several life-changing experiences with psychedelics, and I
| found a group of incredibly good friends in similar
| situations. It's mindblowing the difference that a few good
| friends can make.
| theGnuMe wrote:
| People develop a set of psychological defense mechanisms to
| the bullying that work at the time but can be maladaptive
| later. Maybe you were bullied because the bullies found your
| happy excitement upsetting to their feelings and wanted you
| to feel the way they feel. This is not uncommon. I'm sorry
| that happened to you. But it sounds like you are finding the
| time to reflect on your past.
|
| As for relationships, the "one simple trick" for human
| connection and relationships is that there is no trick, you
| have to continuously put the work in. It helps if you find
| activities that you want to do and make friends there. A lot
| of people find satisfaction in helping other people, so
| volunteering can be one way to meet new people.
|
| You might face constant rejection at first but you are not
| unlovable. But if you are nice and kind to others and help
| others people will value that and think of you in the future.
|
| At some point you will reach critical mass and things will
| get easier.
| zeroonetwothree wrote:
| Depression often develops in adolescence so I think we should
| be a bit skeptical with the 'correlation is not causation'
| going on with these examples.
| vbezhenar wrote:
| I'm in a similar situation. Best friends I've found are when
| I actively played WoW and attended raids. I didn't kept them
| though but that was nice time and probably I had best
| interactions at that time. I'm trying to replicate that time
| but WoW changed and its audience changed, I don't feel like I
| fit there anymore.
| PuppyTailWags wrote:
| I found out that part of the issue with creating lasting
| relationships with others is that it actually takes a lot of
| effort to maintain relationships. It's not like a dating game
| where if you have a good dialogue on day 1 and then another
| good dialogue on day 2 their disposition changes. It's much
| more nuanced and much more specific on individual-to-
| individual interactions over months or years. Remembering
| common events to talk about regularly, responding and being
| responded to, birthdays, holiday celebrations, mutual
| activities, organizing intimate setting (think "potluck at
| X's house") socialization, the list goes on and on about the
| wide variety of behaviors.
|
| If you're struggling, I found graythorn's various assessment
| resources super helpful, as it systematizes aspects of
| relationship building that most people find intuitive. Things
| like "what level of friendship am I with this person" and
| "assessment on expressing needs and support" were helpful to
| me. Although these guides are specifically towards autistics,
| so keep that in mind when you try them.
| com2kid wrote:
| > but no matter how much I try I never seem to be able to
| cultivate any kind of lasting relationship with others.
|
| I used to run a startup focused on this, here is what I
| learned:
|
| Time. The answer is time. Research shows there are two ways
| long term bonds are formed, shared adversity[1], or lots of
| time spent together. General rule of thumb for relationship
| building:
|
| 1. 10 hours together is someone you know 2. 100 hours
| together is a good acquittance. 3. 1000 hours together is a
| good friend and a relationship that can now last a long time
|
| This is why activities such as football watching (3*18, 54
| hours a year, 2 years and you now have the beginnings of a
| good friends circle), or weekly poker matches (2 hours,
| almost 100 hours in a year) are so effective at building
| relationships.
|
| Interpersonal hobbies with lots of down time, like rock
| climbing or playing in a band, accelerate this process
| greatly.
|
| For people with kids, weekly play dates, or a weekly rotated
| dinner hosting.
|
| Friendship is literally grinding hours, when we are young it
| is easy, studying and hanging out get those hours in, but
| when we get older, we have to be purposeful about it.
|
| [1] Military boot camps are an example of this, so are the
| various culture wars. If you make people feel they are part
| of an oppressed group, preferably while isolating them from
| society at large, you will forms a cohesive group that acts
| together and one where everyone feels connected to each
| other. "Both sides" of the political spectrum do this, once
| you learn to spot it you start seeing it everywhere.
| citilife wrote:
| I recommend people try to go to Church -- even if you're
| not exceptionally religious (you can even tell them that,
| I've never seen anyone mind; though they may try to
| convince you).
|
| It's an easy place to meet 30-40 people in a day, everyone
| there has different interests and comes from different
| walks of life. If you attend for a few weeks you'll often
| start attending lunch together, meeting out at some
| activities, etc. Plus, all you have to do is show up.
| People at a church tend to be outgoing, at least some of
| them are. Someone is bound to reach out to you if you sit
| there and drink a coffee.
| spidersouris wrote:
| > Research shows...
|
| Do you have any references in mind?
| com2kid wrote:
| When running my startup I did a deep dive into the
| psychology behind friendship and relationship building,
| but I haven't kept track of any of the references since
| then.
| takk309 wrote:
| I can't agree more on the shared adversity. My three main
| hobbies are rock climbing, hockey, and cycling. With
| climbing you have to battle against yourself and your
| limits. Good partners will support you in those pursuits.
| Add in the fact that your life is literally in someone
| else's hands when they belay you, it is a quick path to
| trust. Add in the down time, as stated above, and you will
| make true friends. Going on a week long climbing trip with
| a small group will stack up quality hours fast.
|
| Hockey is different but you still have a team working
| towards a goal, literally! With a good group of people,
| good as in nice people, not skilled, you win and lose as a
| team. Plus the on bench and locker room time means you get
| to know one another over time.
|
| Cycling is different for me, it is a solo experience and as
| a result I don't have any friends in that world.
| geph2021 wrote:
| Cycling is different for me, it is a solo experience and
| as a result I don't have any friends in that world.
|
| I guess it depends where you live, but usually there are
| cycling clubs or bike stores that have organized group
| rides. Riding with a group is an incredible way to enjoy
| longer rides while socializing, and it's safer.
|
| I started cycling and was amazed at how social it was
| (albeit living in a town with a sizable cycling
| community). In my youth I was a swimmer, and although
| there is a lot of shared experience/adversity and
| friendship on any sports team, there's a lot less
| socializing that can be done while your head is
| underwater!
| likeabbas wrote:
| I believe we find it hard to keep relationships because we
| take criticism/rejection harder than others. My (former)
| friends would say that I have no trouble burning bridges with
| anyone. Any time I've found myself embarrassed or hurt by
| someone else, I've pushed them out of my life. This
| definitely comes from how I handled people in my formative
| years
| waboremo wrote:
| For me this was Rejection Sensitivity Dysphoria, linked to
| ADHD but of course that itself has a lot of overlap with
| the anxiety/depression realm.
|
| It's a pretty messed up condition to deal with, especially
| because even the mere perception of potentially being
| rejected can cause disproportionate reactions.
| UncleOxidant wrote:
| Yep, because we have very negative associations with
| criticism. In addition to being bullied, we tended to move
| a lot when I was a kid. So it became easy to just leave and
| start over somewhere else - I think I even started to look
| forward to being able to start over. I remember as a kid
| playing with other kids and after a bit just disappearing
| and hearing them in the distance say "hey, where did he
| go?" - I'd often do this. Much later I came to realize that
| this was some kind of avoidance and that it wasn't the
| norm. I think that I expected even amicable play situations
| to eventually lead to being bullied and I think that's why
| I'd just ghost people.
| citilife wrote:
| Probably wont be taken well, but IMO depression is an illness
| in the spiritual sense. Depression is described as being sad,
| alone and without hope. That's quite literally what
| spirituality is for.
|
| I think it's probably impossible to treat with drugs because
| what people really need are friends, hope and a good outlook on
| life (which often comes from hope). I'm sure drugs can improve
| people with imbalances and I'm also sure it's not just one
| thing that causes depression. That said, it seems like it can
| often be solved with more traditional means -- finding
| community and purpose.
| csours wrote:
| It seems likely that depression is also not a single disease.
| UncleOxidant wrote:
| Bullying is such a detrimental thing to experience. It has
| lifelong consequences. It's good to see that schools in the US
| are taking it more seriously than they used to. In the past the
| attitude from adults seemed to be that experiencing bullying
| would make you tougher. Now we know better.
|
| I know that I personally still suffer the effects of bullying
| some 40 to 50 years later - for example, I tend to withdraw
| from any conflict/confrontation in the work setting
| misinterpreting even constructive conflict/criticism as being
| directed at me personally. When I was a kid playing with other
| kids I tended to withdraw and disappear even in situations
| where there was no bullying because I came to expect it would
| happen. And I see that I withdraw similarly in the workplace.
| In that sense the bullying from many years ago has negatively
| impacted my career and mental health (anxiety, panic attacks
| and a bit of paranoia as I'm always expecting the worst from
| other people).
| mathematicaster wrote:
| Thank you for sharing this.
| likeabbas wrote:
| Any time. I wish every child could have rich formative years
| so they can avoid long lasting emotional pain.
| ASalazarMX wrote:
| > I didn't have a true batch of friends until college, but now
| I've lost all of them.
|
| I think losing college friends is inevitable. People get jobs,
| move, marry, change, etc. Clutching to the friends when life
| was much simpler might not work now.
|
| The solution would be making more social ties with neighbors,
| family, acquaintances, hobbyists, etc., and try to find new
| friendships/relationships within them.
| hi41 wrote:
| I can relate to your comment a lot. I went through many years
| of isolation during my childhood resulting in poor social
| skills. After so many years my thoughts are continually
| negative. Like you, I too don't have any friends. I am unable
| to break the cycle of loneliness. When I try my interactions
| are awkward which makes me self-conscious and I withdraw.
| kodah wrote:
| Same thing, ish, here. I don't know if my experience is
| anecdotal but this gets easier with age. I can hypothesize that
| I did a lot of unpacking and that my experiences today are much
| more net positive, thus drifting my "default state" farther
| from a depressive mindset. Mushrooms helped, but I'd recommend
| anyone looking into mushrooms, or psychedelics in general, to
| be cognizant that dealing with trauma in a trip can either be
| really great or really terrifying. You also are largely not in
| the driver's seat when dealing with trauma in a trip and
| fighting it will make things worse. The latter being a lesson
| I've learned many times over at this point.
| dmd wrote:
| > There's no single cause and no single cure which is why it's
| so hard.
|
| My neurologist once said to me "any time you see the phrase
| 'multiple mechanisms of X' in a medical journal, that's code
| for 'we have no fucking clue'".
| spiffytech wrote:
| > There's no single cause and no single cure which is why it's
| so hard.
|
| This is exactly right. I'm at the tail end of a long depressive
| journey that wasn't caused by self-beliefs, distorted thoughts,
| trauma, etc. Nearly every depression treatment I sought had
| zero effect.
|
| My problems came about because I had undiagnosed and
| unappreciated neurological + genetic conditions that created
| stacking debuffs that made ordinary SWE jobs tax my executive
| function and deplete my neurotransmitters, eventually leaving
| me personally and professionally debilitated.
|
| Because I suffered the symptoms for so long before identifying
| the causes, neurologically I seemed to have entered a new
| attractor (in dynamical systems terms). I couldn't recover by
| just discontinuing what brought me there; my neurology kept
| gravitating towards the new steady-state. (A good chunk of this
| is black-box reverse engineering what helped me recover)
|
| I've only gotten better by radically changing my circumstances,
| identifying a crucial supplement, and undergoing a medical
| procedure.
|
| The eye-opening part of the journey was understanding that
| because depression is defined by a set of symptoms, receiving a
| diagnosis doesn't tell you anything at all about what's wrong
| with you. It only confirms you have a problem at all.
| TurkishPoptart wrote:
| >My problems came about because I had undiagnosed and
| unappreciated neurological + genetic conditions that created
| stacking debuffs that made ordinary SWE jobs tax my executive
| function and deplete my neurotransmitters, eventually leaving
| me personally and professionally debilitated.
|
| I love how you used "stacking debuffs" here. That made me
| smile.
| smn1234 wrote:
| which supplement helped you most ?
| spiffytech wrote:
| I have a genetic mutation called MTHFR C677T, which means
| my body doesn't process vitamin B9 with the necessary
| efficiency. B9 is upstream of regulating the quantities of
| monoamine neurotransmitters the brain synthesizes
| (serotonin, dopamine, and norepinepherine).
|
| (Not everyone with an MTHFR mutation experiences symptoms.
| For a long time I didn't. Best guess is my body changed
| after a period of intense stress.)
|
| I take L-Methylfolate 15mg, which bypasses my digestion and
| provides my body with the processed materials directly.
|
| The brand name for this is Deplin, which requires a
| prescription. I just switched to over-the-counter
| L-Methylfolate - it remains to be seen if it's as
| effective.
|
| Fun fact: once I started taking Deplin, I had to come off
| of all my traditional antidepressants. They were at max
| dosage and having no effect, but once my brain was flooded
| with neurotransmitters, all the antidepressant side effects
| kicked in, including (perversely) amplifying depression
| symptoms.
| bnjms wrote:
| How did you find out about the MTHFR mutation? How was it
| tested for?
| spiffytech wrote:
| I took a mail-in genetic test from Genomind. I didn't
| understand the significance of the result until I was
| coincidentally prescribed Deplin and mentioned the mood
| change to my ADHD coach, who connected the dots.
|
| Having a concrete scientific explanation for the
| empirical result I was seeing was a great confidence
| booster, bolstered some hypotheses I had, and helped me
| identify next steps in my journey.
| trevwilson wrote:
| > identifying a crucial supplement, and undergoing a medical
| procedure
|
| Would you feel comfortable sharing some specifics on what
| these were for you?
| spiffytech wrote:
| I remarked on the supplement in another comment.
|
| The medical procedure was TMS - I spent ~6 weeks coming in
| every weekday, had my head strapped into a magnet helmet,
| and the magnets stimulate the parts of the brain associated
| with depression. I understand it to be vaguely like jump-
| starting an engine with a dead battery.
|
| I just had my last session yesterday, and I see huge
| changes from December.
|
| Crucially, I underwent TMS in 2019 and saw almost no
| change. At that time, I was still in the abrasive career
| situation, and wasn't on the supplement, so my hypothesis
| is TMS had very limited benefit because I didn't have
| sufficient quantities of neurotransmitters for stimulation
| to do anything, and any possible benefit was being
| immediately eroded by the circumstances that created my
| problems in the first place.
|
| I also had undiagnosed autism (which came with hardcoded
| limitations I'd been treating as personal preferences or
| bad attitude), and ADHD (which I was diagnosed with as a
| kid, but didn't understand how it manifests as an adult).
| Both of these tax executive function (neurotransmitters)
| heavily, and the MTHFR mutation handicapped how much
| executive function I had to go around in the first place.
| My particular neurodiverse needs appear to be at odds with
| the typical SWE work environment, so every day I was
| powering through my special needs, until my brain couldn't
| take it anymore and simply gave out.
| golemotron wrote:
| It's amazing how far we go to avoid seeing depression in the
| context of a person's social interactions.
| tifik wrote:
| I made it a principle to never click a title (or a thumbnail in
| case of e.g. youtube) that is intentionally this click-baity.
|
| If it's a topic I genuinely am interested in, I just look the
| information up somewhere else.
| spacemadness wrote:
| Or titles in the form of a question that ultimately is either
| answered "no" or "we have no idea. keep clicking each week to
| find out more!"
| tifik wrote:
| Just for the record, the original title was 'The real cause
| of depression is not what you think it is', or sth very close
| to that.
|
| I am happy to see it was changed.
| joescharf wrote:
| Everyone wants a pill as a quick effortless fix, but IMO it seems
| a lot of our modern afflictions come down to an gross imbalance
| of exercise, diet, sleep, and social connection. Most likely the
| way society (see disclaimer) currently functions - how we work,
| how we consume our limited leisure time is sort of an
| occupational hazard to peak health.
|
| Not to mention, exercise is "too hard" for most, the food supply
| is weaponized with sugar and FUD, everyone is so tired at the end
| of their "BS job" workday, so hit the couch and stream the
| streams. And now you have a vicious flywheel that quickly turns
| people into candidates for the latest big-pharma "cure"
|
| HN Disclaimer: I'm in the US and making generalizations based on
| my observations. Not saying that there aren't needs for pharma /
| pills / afflictions that aren't solvable by the above, etc...
| stronglikedan wrote:
| I'd lump those pill into that list of the cause of modern
| afflictions. I got off them, because they made things worse,
| just in different ways than the depression itself. I cured
| myself with diet and exercise.
| com2kid wrote:
| I know the serotonin theory of depression is pretty much dead,
| but it is a fact that being around people raises serotonin
| levels. For introverts it is _tiring_ , but it is better than
| not being around people.
|
| Being around people reduces cognitive decline in old age.
|
| Being around people reduces depression levels.
|
| Being in a supportive community _reduces the severity of
| symptoms from schizophrenia_.
|
| The 2+2 nuclear family concept is an abomination, we are
| supposed to live in a multigenerational community, surrounded
| by friends and family.
|
| The modern American lifestyle destroys psychological health.
| Without large social circles, finding romantic partners is
| hard, which leads to all sorts of negative life outcomes.
|
| Raising kids is hard, friends of mine who have nearby extended
| family have a much easier time raising kids (and are more
| likely to have more kids!) Heck my sister had kids 20 years
| before I did (bit of an age difference), 2 sets of grand
| parents, lots of free baby sitting, and aunts and uncles to
| help out with homework. It was also useful for me, I got to
| learn a lot about babies early on.
|
| > gross imbalance of exercise, diet, sleep, and social
| connection
|
| Yeah lots of these are solved with a large social group. I have
| some good friends (who sadly now live a bit aways from me) who
| host dinner parties 3 or 4 nights a week. People come over and
| help cook and clean up, so everyone eats healthy meals all the
| time.
|
| Friends who have lots of family nearby, just rotate whose house
| they go to on different nights, all the kids and adults after
| school/work get together to do child care and cooking. Healthy
| food for everyone, less work.
|
| Lots of modern life scales up really well. 2 parents will get
| exhausted taking care of 1 baby, between cooking, cleaning, and
| watching the child.
|
| 4 parents, 3 kids? Much easier. Seriously, piece of cake.
|
| 3 grand parents, 4 parents, a young auntie, 5 kids? No problem
| at all.
|
| Society has seriously screwed the pooch.
|
| If I had some insane amount of capitol I'd try to start some
| sort of shared housing for families, do intense interviews to
| match people up (see: My last failed startup) people cook
| together, raise kids together, support each other. Put 3-5
| new/young families in a mid size housing complex with a shared
| yard. Put a support network in place, house chaperone ( _cough_
| RA _cough_ ) to help out now and then.
|
| Extended Family as a Service. Dystopian, maybe, but possibly
| it'd do a lot of good in the world.
|
| (If any investors want to get in touch, please do, :-D )
| thowaway959125 wrote:
| To me, this is undoubatedly a huge part of the problem.
|
| I noticed that my depression spiked when I started to become
| more isolated. I was getting older, long time friends are now
| scattered about the country/world, difficult to make new
| ones. Family members are isolated and scattered doing their
| own thing in their nuclear units. Parents are divoced and
| fending for themselves too. Finding a romantic partner under
| these circumstances is difficult ... having no friends can be
| seen as a "red flag". It snowballs.
|
| I have also thought of the concept of shared housing for
| adults. I LOVE this idea.
|
| They share the responsibilities much like a multi-
| generational family would, they just happen to be strangers.
| AnIdiotOnTheNet wrote:
| > Society has seriously screwed the pooch.
|
| Pretty much all available data says as much, but we refuse to
| do anything about it. Hell, most refuse to recognize there's
| even a problem.
| elric wrote:
| > gross imbalance of exercise, diet, sleep, and social
| connection
|
| Indeed. What's worse is that we, as individuals, know this. But
| we, as in the western society at large, seem to be utterly
| unwilling or incapable of addressing this.
|
| Long working hours to make ends meet. The shittiest food is the
| most convenient option. There's a metric fuckton of light- and
| sound pollution which messes with our sleep. 10% of folks
| suffer from sleep apnea for a variety of reasons. So many
| things are messing with us. At some point, we're going to have
| to start dealing with these things.
| gatonegro wrote:
| > _it seems a lot of our modern afflictions come down to an
| gross imbalance of exercise, diet, sleep, and social
| connection_
|
| If you think about it in an evolutionary timescale, the way
| most of us live in the West these days is horrendously
| incompatible with the sort of life we evolved to live.
| Thousands and thousands of years were spent out in nature, in
| small communities, eating certain types of foods, engaging in
| physical activities, etc.
|
| The sit-on-a-chair-all-day, look-at-screens-all-day lifestyle
| is a comparatively new development, and neither our minds nor
| our bodies are suited for such an existence. That's enough to
| cause us a fair amount of trouble. Add all the socioeconomic
| issues you mention into the mix, and it all starts to make
| perfect sense to me.
| 2OEH8eoCRo0 wrote:
| I think so too. 9 times out of 10 a person has horrible eating,
| sleeping, or drug habits and a sedentary lifestyle.
| robocat wrote:
| I'll add situational-depression to your list: an ongoing
| sadness due to being stuck in a bad circumstance (bad
| relationship, terrible job, etcetera). The defining factor is
| that once the bad circumstance is "fixed", the long-term
| sadness is quickly gone (replaced with ongoing contentment) and
| symptoms don't reappear. This is not an academic definition,
| just a personal observation, although perhaps you have seen the
| effect happen to others in your life.
|
| I've had situational-depression badly enough that I would
| easily have been diagnosed as clinically depressed (more than
| one person said so, and if I had gone to a doctor I am sure I
| would have been given a label and some pills). When the cause
| was resolved, I immediately switched out of the funk and all
| symptoms of "depression" were gone. I don't believe it was
| correlation, that is I don't believe depression lifting caused
| me to fix my bad circumstance: I don't think I had any
| influence over the actual date the underlying cause was
| "fixed". Chronic clinical depression is not usually fixed in a
| day.
| chasil wrote:
| _Serotonin syndrome_ is also a real risk.
|
| SSRIs are extremely dangerous if tryptophan intake is also
| increased (with supplements, for example), even moreso if
| niacin is also consumed to encourage the tryptophan ->
| serotonin pathway.
|
| https://selfhacked.com/blog/serotonin-syndrome/
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6184959/
| PragmaticPulp wrote:
| > Everyone wants a pill as a quick effortless fix, but IMO it
| seems a lot of our modern afflictions come down to an gross
| imbalance of exercise, diet, sleep, and social connection.
|
| For what it's worth, exercise, diet, sleep, social engagement,
| and lifestyle changes _are_ well-known inputs to addressing
| depression. Therapists will explore and encourage improvements
| in all of these areas. Good psychiatrists will as well, given
| enough time and a patient who is open to listening.
|
| One of the difficult issues is that many depressed patients
| often don't want to hear any suggestions that depression might
| be due to anything other than external factors. This is why the
| pop-science version of the "chemical imbalance" theory became
| so popular in the mainstream: It gives a plausible explanation
| that depression is just something that happens to you due to no
| fault of your own, which is weirdly easier to accept for many
| people.
|
| There are similar treatment problems with a host of health
| issues, such as obesity. The trend on social media and pop
| culture is to explain obesity away as a chemical or societal
| problem, minimizing the input of personal choice and actions.
| It's very popular to propose theories that "counting calories
| doesn't work" or hear anecdotes about people who claim to only
| eat less than 1000 calories per day but never lose weight
| (which isn't possible, even 100% sedentary coma patients need
| more calories than that).
| AnIdiotOnTheNet wrote:
| But Obesity isn't very much about personal choice, as
| evidenced by most people being able to keep a reasonable
| weight without counting calories or putting in any effort
| whatsoever, while people like me have to obsess over
| everything because if we ate the way we "naturally" feel like
| we should then we'd be blimps.
|
| Or rather, it is about choice, but the choice for some is
| "obsess over it and suffer a lot more than the people around
| you for the rest of your life", not to mention generally
| being treated like not being able to fight your body's
| compulsions is a personal failing by people who _don 't have
| to fucking do that_.
|
| P.S.: And before you go shoving your fad bullshit advice of
| the week at me, it should be noted that at one point I had
| lost half my body weight and am still over 100lbs down. I
| have been doing this for over a decade, I have tried every
| trick anyone has yet devised to make this easier and none of
| the work for this kind of weight.
|
| Any diet will work for 10-15lbs. Like, literally _any_ diet.
| This has been shown multiple times. Losing real, serious,
| obesity-level weight takes significant effort and suffering
| _continuously_ and anyone who says differently is full of
| shit.
|
| ...unless there 's a drug involved. Amphetamines and the new
| class of diabetes drugs seem to actually work wonders. The
| former is obviously problematic and ill-advised.
| elric wrote:
| I think the folks on HN are generally aware that weight
| loss is incredibly hard, I'd be surprised to see anyone
| here trying to shove fad advice down your gullet.
| kar5pt wrote:
| I could flip this around and say that focusing on internal
| causes of depression is a way for those in power to avoid the
| social responsibility of having to change it. We can kick the
| responsibility ball back and forth all day.
|
| _Why_ is it so hard for people to get adequate sleep,
| exercise, a good diet and social interaction? Even most non-
| depressed people I know don 't do these things well (except
| maybe the last one), so this isn't something unique to
| depression.
| ryanwaggoner wrote:
| Exactly this. We throw people into a sick society and then
| blame them for their lack of personal responsibility when
| they get sick themselves.
|
| As an individual, yes, do what you can (which might mean
| changing to a less "sick" culture or subculture so you're
| not fighting a sisyphean battle). _And also_ , we should do
| better as a society.
| elric wrote:
| Same with drugs. There's a bit of cocaine-epidemic where I
| live. With lots of gung-ho politicians clamoring for a "war
| on drugs" and "zero tolerance" and "hold the addicts
| accountable", etc. But I don't hear any politicians talking
| about _why_ so many people want to snort cocaine...
| joescharf wrote:
| > This is why the pop-science version of the "chemical
| imbalance" theory became so popular in the mainstream: It
| gives a plausible explanation that depression is just
| something that happens to you due to no fault of your own,
| which is weirdly easier to accept for many people.
|
| Yes, and "chemical imbalance" is totally legit but not like
| its predominantly being marketed. The chemicals (dopamine,
| seratonin, whatever) are already present in our bodies - they
| just aren't consistently expressed across the population. For
| many people, these chemicals aren't released as regularly or
| in sufficient quantities for a given time period. Often due
| to lifestyle, but also just differs from person to person.
| But hey, put in 45 minutes of Z2-Z3 cardio and it can be
| amazing how the cobwebs get cleared.
|
| > The trend on social media and pop culture is to explain
| obesity away as a chemical or societal problem
|
| The somewhat recent corporate opportunism targeting obesity
| and marketing it as completely normal and healthy, almost
| something to strive for, is incredibly concerning.
| 2OEH8eoCRo0 wrote:
| > One of the difficult issues is that many depressed patients
| often don't want to hear any suggestions that depression
| might be due to anything other than external factors.
|
| I knew someone like this. She'd get new therapists until one
| of them tells her what she wants to hear.
|
| You're nailing it IMO. If you get to blame society, genetics,
| or external factors then you don't have to take
| responsibility. You get a pass. (people think)
| PuppyTailWags wrote:
| To counterpoint your anecdote: I know a girl who is fit,
| eats great, gets good sleep, regularly goes on long trips
| with friends, still clinically depressed and struggles to
| experience any sort of joy which is why she puts in so much
| effort into trying to improve her life. Still got
| depression, baybee.
| whstl wrote:
| Funny thing. I actually got depression/burnout when I was
| preparing to run a half-marathon (I do it yearly).
|
| It pissed me to no end that the couple people who got to
| know about it basically told me to "exercise more and do
| volunteer work", even when I told them that it was caused
| by work-related stress.
| rconti wrote:
| Telling a depressed person to just start exercising, eating
| well, and sleeping sufficiently is really not significantly
| more helpful than telling them to just be happier.
| Dma54rhs wrote:
| Telling them they can fix their problems without doing
| any of those is not working either.
| pojzon wrote:
| I dont like myself and I have no way to change myself as the
| issues I face are of a genetic cause.
|
| I wont be happy till I accept myself, but I wont accept myself
| like Im not accepted by others.
|
| Simple as that. This is the burden Ill carry till the end of my
| days. Hopefully sooner than later.
| theGnuMe wrote:
| I think it is the gut microbiome and chemicals. Basically drink
| too much alcohol, get depressed or inferred from the hangover.
| It's a negative feedback look b/c usually drinking relieves
| depression at first. Then fail to eat properly for what you and
| your microbiome need, you get depressed. Tryptophan depletion for
| example. Take a serious course of antibiotics get depressed since
| your microbiome is out of whack.
|
| There's probably genetics involved as well. Sun light exposure
| modulates hormones and Vit D.
|
| I wonder if there's a correlation with caesarean section births
| and depression as well. The hypothesis would be that the infant
| is born into a sterile environment and does not get populated by
| the moms microbiome.
|
| Exercise probably plays a role as well since it boosts resilence.
| PaulHoule wrote:
| "Serotonin" is itself a complex entity.
|
| There are 14 known serotonin receptors in 7 families
|
| https://en.wikipedia.org/wiki/5-HT_receptor
|
| not to mention other targets such as the serotonin transporter
| which is a target of many antidepressants.
|
| Serotonin pharmacology includes antidepressant and antianxiety
| medication, psychedelic drugs such as LSD and mescaline, the
| nearly unique drug MDMA (aka Ecstacy), drugs to suppress
| vomiting, part of the action of some antipsychotic drugs, anti-
| migraine, and drugs that increase gastric and intestinal
| motility.
|
| Platelets, your gut, and heart valves are just a few tissues that
| are full of serotonin receptors: some serotonin-active drugs can
| seriously damage your heart valves, see
|
| https://en.wikipedia.org/wiki/Fenfluramine/phentermine
|
| ----
|
| The conclusions that people made about free serotonin in spinal
| taps of psychiatric patients in the 1960s have been long used in
| a facile manner in psych med marketing and the chickens seem to
| finally be coming home to roost on that one.
|
| I'd almost call the SSRIs "antineurotic" drugs in that they are
| helpful for both anxiety and depression in many people. There has
| been a lot of negativity about them in the news in the last
| months or so, particularly reports of bad efficacy which I think
| draw the wrong conclusion.
|
| Basically if you try "X mg of fluoxetine vs a placebo" you are
| going to have poor response and a lot of side effects. In good
| clinical practice you see your doc, fill a script, talk to your
| doc in three weeks, maybe increase the dose, maybe try a
| different med if you don't get a response or if you are bothered
| by side effects. If you do that you get much better results that
| the average clinical trial of a single antidepressant but you are
| going to talk to your doc (maybe sometimes to the nurse over the
| phone) several times over 6 months or so.
| zttg wrote:
| [dead]
| ThinkBeat wrote:
| We dont understand the brain nearly enough to form a cohesive
| understaning of depression. (or many other brain related things).
|
| Now, some are saying that gut flora might also be involved. And
| possible genetic markers. This would create a gigantic number of
| permutations.
|
| I doubt we can ever "fix" depression with just drugs / chemical
| imbalance. We may help it along.
|
| Current treatment for depression, in so far as drugs are
| concerned, is a doctor throwing an "anti depression" pill at you
| and askinf you to try it for a while and see how you feel.
|
| If you feel worse, or no better, you get to try another.
|
| The loop repeats until something works better or until you are
| out of alternatives.
|
| In which case, if you have severe depression, options like
| electrocution of the brain (forget proper English term) becomes
| an option.
|
| It is often successful, but usually must be repeated and it is
| not a good thing for the brains other functionality.
| edgyquant wrote:
| I definitely get the "we don't understand the brain" aspect.
| This applies to a ton of things in psychology which I can't say
| I'm a fan of. For instance my sister (a psych major) spent
| thanksgiving arguing with me that babies can be born
| sociopaths. This is something we definitely can't state for
| sure and seems like predetermination with a fancy name.
| [deleted]
| nobody9999 wrote:
| >I definitely get the "we don't understand the brain" aspect.
| This applies to a ton of things in psychology which I can't
| say I'm a fan of. For instance my sister (a psych major)
| spent thanksgiving arguing with me that babies can be born
| sociopaths. This is something we definitely can't state for
| sure and seems like predetermination with a fancy name.
|
| I'd go further and say that most things we class as "mental
| illness" is just a way of categorizing our ignorance.
|
| Even drugs that purport to help with "mental illness" at best
| treat some of the symptoms of the _unknown_ causes of such
| symptoms often have side effects that can be worse than the
| symptoms.
|
| While significant advances in neuroscience have given us more
| knowledge about how our brains/mental states work, most
| attempts at treatment are at the level of trepanning[0] to
| release evil spirits.
|
| Hopefully that will change as we learn more. I'm not holding
| my breath.
|
| [0] https://en.wikipedia.org/wiki/Trepanning
| robotburrito wrote:
| I can't help but imagine the principal Skinner meme in this case.
| "Am I out of touch? Is society causing depression? No... It's the
| chemicals that are wrong."
| [deleted]
| samsquire wrote:
| When you cannot find something inside something you can try
| looking outside where you were looking for answers.
|
| In my experience, my spiritual health, acceptances, lack of
| rejecting bad (and source of) things is the direct cause of all
| negative thoughts, feelings.
|
| Reject the bad, false, negativity, darkness and move toward the
| love, true, light and goodness. When I was depressed, only
| spiritual teachings, love and God moved me nearer good feelings
| and comfort.
| nobody9999 wrote:
| >Reject the bad, false, negativity, darkness and move toward
| the love, true, light and goodness. When I was depressed, only
| spiritual teachings, love and God moved me nearer good feelings
| and comfort.
|
| I'm glad that works for you, and I encourage you to do those
| things that make your life better.
|
| As an empiricist, for me "spirituality" is just a trope that
| many use as a crutch (which can be _very_ useful to some).
| There is only the _natural_ (nothing "super" about it) world.
| There is no "spirit" or "soul" that defines us separately from
| our physical existence (i.e., I reject the concept of Mind-Body
| Dualism[0])
|
| And the "God" you mention is just an _imaginary_ sky daddy,
| whose inscrutable "motives" are generally co-opted[1] by the
| opportunistic to gain acceptance from those who have such
| beliefs.
|
| I prefer to create meaning from the _natural_ world and take
| great comfort in the vastness and incredible beauty, variety
| and complexity of the universe as it actually is, rather than
| the, unsupported by evidence and often manipulative, ideas
| around the existence of supernatural beings /causes/effects.
|
| All that said, what's most important is (by one's individual
| estimation) living a happy, satisfying life. If others require
| beliefs I reject to do so, I have no issue with that.
|
| We all need to make our own (whether good or bad) decisions
| about what constitutes a "happy, satisfying life." And while
| expressing opinions about that is certainly reasonable and
| expected, attempting to force[2][3] those opinions on others is
| _wrong_.
|
| [0] https://en.wikipedia.org/wiki/Mind%E2%80%93body_dualism
|
| [1] https://www.encyclopedia.com/history/applied-and-social-
| scie...
|
| [2] https://en.wikipedia.org/wiki/Apostasy_in_Islam
|
| [3]
| https://en.wikipedia.org/wiki/Dobbs_v._Jackson_Women%27s_Hea...
| mx24 wrote:
| >I prefer to create meaning from the natural world and take
| great comfort in the vastness and incredible beauty, variety
| and complexity of the universe as it actually is, rather than
| the, unsupported by evidence and often manipulative, ideas
| around the existence of supernatural beings/causes/effects.
|
| If your life is so meaningful why are you taking so much time
| to prove how rational and knowledgeable you are? I mean are
| the references linked above really necessary? You sound like
| a teenager that just discovered Atheism.
| rpastuszak wrote:
| For the love of God and all that is holy, please stop.
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