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Depression as hard on the heart as obesity and cholesterol (sciencebulletin.org)
263 points by devinp on Jan 18, 2017 | hide | past | favorite | 120 comments



I would be interested in knowing what 'hard on the heart' means. They mention it can lead to cardiovascular disease, but I understand that to be kind of a vague term.

I am a fairly healthy young guy and I have extremely high blood pressure. Every doctor I've seen has been unable to identify a cause through testing, dietary changes, fluctuation of exercise, etc. When I was younger, I was diagnosed with Bipolar Disorder and have had major bouts of depression my whole life. More so since getting a job as a developer. Any data connecting the depression and HBP would be really helpful.


I don't have a medical explanation for you, but I can tell you what it feels like. I've experienced many pangs of deep loneliness at times when I feel like I'm by myself and should be out being social. It feels like a tug on your chest. Like there's a void and some gravity is sucking things down into it. Or, I know it sounds corny, but something heavy sitting on your heart while you simultaneously experience anxiety.

When I am deeply lonely like this, in the moment, not just as a general idea, I definitely do feel it as a physical thing. I don't know if it's the same as what they're talking about here, but it seems reasonable that loneliness could be a type of depression, and I strongly believe that regularly experiencing the type of physical feeling described above could do damage to you.


Thanks for describing this and I really hope this improves for you over time. I had years of feeling like this too . I can't say I've really found my place but at 50, memories of that depression are from another life. I can't really rightly remember what it felt like, but it was terrible.


I have had this feeling in my chest for over a decade now.


Do you continue to have the feeling despite attempts to go out and be social?


Yes, this feeling is relatively constant in my life. There are times where it is more noticeable though. Usually getting lost in the moment is the best way, but that is hard to do on purpose


I don't know if I can relate. When it really bothers me, I try to do something about it, go out, have fun. Surround myself with people whose company I enjoy.

Sometimes the feeling persists. Its usually when I try the above and fail though. When its not satisfying, when the people I'm with are just kinda whatever. -shrugs-


The paper states that depressed mood and exhaustion are a risk predictor for all-cause cardiovascular mortality comparable to hypercholesterolemia and obesity. Essentially this means that a person with clinical depression is about as likely to die from cardiovascular disease (main specific causes of death being being heart attack and stroke) as a person with high cholesterol or who is overweight, and all of which are more likely to die of CVD than someone with none of the above.

This study is purely correlative. They do not hypothesize or investigate the pathophysiology by which depression can lead to these problems. I'm sure there is some research in this area, but in my medical education I have not come across any specific examples. To my knowledge there is no consensus that depression directly causes hypertension.

I can tell you from clinical experience that people with depression generally do not take good care of themselves (and this is not a judgment, just an observation). Their diet is poor, they do not exercise regularly, and are non-compliant with medical therapies. In other words, their lifestyle leaves them vulnerable to a whole host of diseases. However, I would still argue that the biggest risk factors for essential hypertension are family history and race, not behavior or mental health.


Well, for what this anecdote is worth: I was bullied bullied growing up, and I had tachycardia[0]. Both stopped around the time I went to college. I can count the number of times I've had it since on one hand (before it was multiple times per week), and it was always during periods I was suffering from extremely high socially induced stress. Severe heartbreak, the loss of someone very close to me, things like that. Since I've picked up mindfulness and become a more balanced, calm person I've not had it at all.

I know that there are many diseases one can have growing up that might just "go away" when you get older, and we usually blame it on hormonal imbalances, and your body growing up and figuring things out. I wonder we're underestimating how the many anxieties that teenagers suffer from might cause or amplify these issues.

[0] Since you're in the medical profession, I'm sure you know what tachycardia is, but for others: it's when the heart rhythm becomes so fast that the heart muscles can't keep up, and are no longer pumping blood properly. Luckily my form of tachycardia is regular and fairly harmless on its own. Anyway, in my case it would trigger when startled, usually when I was doing some kind of "inconsistent" physical exertion (by which I mean that it never happened when running or cycling, even if I pushed myself to my physical limit). So it seems to require a mix of social and physical stress, plus something unexpected happening (I guess the adrenaline triggers it?)


Tachycardia is technically any heart rate greater than 100 BPM. It doesn't necessarily mean that the heart is not pumping enough. What can happen with an elevated heart rate is that the heart doesn't have enough time between beats to fill properly, resulting in decreased stroke volume and cardiac output, but this is typically only seen clinically with certain dysrythmias that have very high rates (like in the 150-200 rage), or in the setting of cardiomyopathies (diseases of the heart muscle), MI (heart attack), or heart failure. If your heart muscle tissue was actually not able to keep up, it would mean you had one of these things, which you most likely didn't.

What you are describing sounds like textbook palpitations. It is completely normal for the heart rate to increase for a lot of reasons, including stress and being startled (via the sympathetic nervous system, or fight-or-flight response). A palpitation is when a person becomes very aware of their heartbeat and perceives it to be abnormal, regardless of whether there is any clinically objective abnormality. They are often associated with anxiety and can lead to a vicious cycle (person is anxious, then notices their heart is beating fast, so they become more anxious, their heart rate increases, etc.).

The silver lining here is that in all likelihood your heart was/is fine. Anxiety has also been proposed as a risk factor for CVD but my understanding is that this is still debated. So don't go thinking your history means you'll definitely have an MI.

None of this is meant to dismiss your experience though. Not three days ago I saw a young, healthy male in the ED who thought he was having a heart attack, and (you guessed it) his EKG and labs were 100% normal. It probably happens a lot more than people realize.

By the way, I'm not saying "don't go to the doctor because that 'heart attack' is all in your head". He absolutely made the right decision by coming in (better safe than sorry).


You forgot to account for one case, which is what applies to me: my heart rate "jumps" from 160, during peak physical exertion, to 230+ BPM, when I get this tachycardia, and then "jumps" back after a while if I sit down to relax. At that rate the heart doesn't have enough time to contract fully, like you said.

I got prescribed verapamil, and there's also this trick of trying to breathe out with mouth and nose closed, to use the lungs to put pressure on the heart. This can trigger some kind reflex (I forgot the name) that slows down the heart rate.

> The silver lining here is that in all likelihood your heart was/is fine. Anxiety has also been proposed as a risk factor for CVD but my understanding is that this is still debated. So don't go thinking your history means you'll definitely have an MI.

From what the cardiologist told me the 230 BPM is abnormal, but OTOH, my heart rate maintains a regular rhythm, so it's fairly harmless, and I'm likely not in any high risk group.


Preface: I'm not trying to nitpick you to death. I wouldn't expect anyone outside the medical field to remember any of these terms.

Yes, a HR of 230 BPM is not normal. The terminology is confusing because tachycardia can be both physiologic ('normal') and pathological ('abnormal') depending on the context. What you are describing is not "just" tachycardia, but most likely a type of supraventricular tachycardia/tachyarrhythmia (not a cardiologist, but my best guess would be AV nodal reentrant tachycardia or AVNRT).

The maneuver is called valsalva, one of several vagal maneuvers that essentially work by increasing the parasympathetic input to the heart and negating some of the sympathetic (fight-or-flight) input.


Oh no worries, I appreciate that you take the time to inform me! It'll be fun to google those terms and dive into wikipedia & co :)


> Since I've picked up mindfulness and become a more balanced, calm person

Where did you learn mindfulness from? A book, therapy, or something else?

Is there anything you wish you knew when you had just started getting into mindfulness? I'm curious as to what you'd suggest.


A book suggested to me by my therapist. It's a Dutch one so probably useless to you.

> Is there anything you wish you knew when you had just started getting into mindfulness?

I wish it was made more clear to me that this is an evidence-based method with plenty of scientific support for its effectiveness, so I would have been less sceptical and picked it up sooner! My therapist was kind of... let's just say that his master thesis was on astrology.


I imagine this is a pretty murky area of medical science; there are so many confounding factors. It could be anything ranging from physical inactivity caused by depression ('psychomotor retardation') to abnormal hormone/catecholamine fluctuations or levels having some larger systemic effect.

Even in the more well-defined case of acute heart failure caused by 'stress' (Takotsubo Cardiomyopathy [0], or Broken Heart Syndrome) there's still a great deal of uncertainty about the exact cause.

All that aside, I really do hope things get better for you (or at least don't become unmanageable). My depression has gotten completely out of control for the past two years, and this has coincided with a noticeable decline in my physical health (including high blood pressure). It sucks.

[0] https://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy#Cause...


Depression is also known to cause chronic levels of inflammation, which is certainly hard on the cardiovascular system.


Does HBP run in your family. I'm 30 and have both HBP and Mixed Episode Bi-polar disorder. I've been told by my docs that they both are usually influenced by genetic conditions. Half the time the doctors disagree on what numbers actually represent high blood pressure. I had one lecture me about putting stress on my organs and that I needed to be on meds now to another saying it's not even bad enough to treat. I opted to try to meds and they seem to work so far.


I'm pretty athletic and fit but also have to fight through periods of depression. It would be interesting to know more about the mechanisms involved and if my otherwise healthy lifestyle could compensate for any negative effect. The study seem a bit light on details.


It means that there is a correlation between "depressed mood and exhaustion" and cardiovascular deaths. The paper does not demonstrate a causal relationship between the two.


Have you ever had your blood pressure taken while standing?

My BP reading is >10 points higher when I am sitting. Apparently, that's a thing for a small percentage of people.


Deleted - not a helpful comment.


Have you been tested for food intolerances/allergies? Especially wheat? Do you also suffer from atopic dermatitis?


From the paper (DEEX - "Depressed mood and exhaustion"):

"Nonetheless, adding DEEX to a risk score based on classical risk factors resulted in only nonsignificant improvement of mortality risk prediction."

Regarding the causal relationship:

"Although not a proof of causality, in general, depressed subjects are more likely to cluster self-harming lifestyle behaviors and may be less likely to adhere to prescribed medication."

To put things in context it is also worth noting that, except in old age, a big increase in the risk of death at any given point of time translates into a very small reduction in life expectancy. See for example http://joshmitteldorf.scienceblog.com/2012/11/10/mortality-a...


Recent research suggests that chronic inflammation may cause depression [1]. Therefore the root cause may be inflammation, leading to both depression and heart disease. (Of course biology is never that simple and there are probably loops and feedbacks.)

[1] Summary: http://slatestarcodex.com/2015/01/05/chronic-psychitis/


Also, high homocysteine may lead to depression, [1], and is linked to cardiovascular disease, [2].

[1] https://www.ncbi.nlm.nih.gov/pubmed/17541043

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326479/


Considering how often depression leads to obesity I wonder how many are getting a double wammy?


I wouldn't be surprised either. There are many ways to deal with stress and depression, but all to often food and alcohol will come up.


For me it was alcohol. At least there is a very strong link between alcohol and my mood.

Just a few drinks and I feel sad and anxious for a couple of days. My mood recovers by staying abstinent for one or two weeks after drinking alcohol. My solution is to avoid alcohol as much as I can.


I should try this for marijuana (abstaining that is)


This should be controlled for.


I assumed it was in the study, but in real life there would be many suffering the negatives of both.


obesity also leads to depression so most with obesity get the double wammy



That's exactly what my cardiologist explained to me after my heart attack (myocardial infarction) -- that cholesterol and obesity account (in his anecdotal way of speaking) for only half of cases. I was in great shape at the time (hiked > 4 miles in hills every day), but very stressed and depressed.


Actually, the paper this article is based on suggests the opposite:

"Only a minority of 5.6% [of those who later experienced a lethal CVD event] were free of any risk factor. This challenges claims that CVD events commonly occur in persons who have not been exposed to a major risk factor." (where the risk factors include high cholesterol, obesity, hypertension, smoking and diabetes)


What most people forget is that mental diseases are associated with physical diseases. Depression is positively associated with Type 2 diabetes, oral cancer, psoriasis, arthritis [1]. Stress is positively associated with poor sleep. Anxiety is positively associated with coronary heart disease. When you are in poor mental health (stress, anxiety, depression), it will impact your heart, digestive system and immune system, and vice-versa.

Source [1]: http://outcomereference.com/outcomes/5-Depression


As a chronically depressed person, I guess I'm in trouble.


I'm chronically depressed, suffer from anxiety and stress, have high cholesterol (due to genetics) and I'm obese. Not to mention I have a family history of heart disease, on both sides.

I think that's more or less every single risk factor for heart disease. My current goal is to beat the odds and somehow die of something I'm not statically predisposed to, like cancer.


You still have sense of humor, which means life can bring good surprises. Please take care!


How you perceive a (depressed) person doesn't accurately describe how they perceive themselves. Humor can be part of the façade, the mask.


True.

A depressed person can easily put on a mask for several hours and appear completely normal to everyone they interact with. Some depressed people even manage to hold a façade up for months or years of working full time, though I imagine the stress in doing so is ove

But it doesn't really matter how other people perceive you. If you aren't happy with your self-perception, then you are going to have issues.


I don't mean to be that well-intentioned person to give unsolicited advice. But have you tried meditation (e.g. guided with a CD)? It reduces anxiety a lot, and depression is often linked to, or at least coexists, with anxiety. My life gets so much better once I meditate regularly.


Not sure if it helps, but this page lists a summary of protective factors that can help you (nutrition, exercise, stress management) : http://outcomereference.com/outcomes/27-Cardiovascular-Disea...


For me cognitive behavioral therapy with a very good psychotherapist was fundamental. I will just say what my therapist told me at the end of the first meeting "If you want it to work it will work, but if your problems were created in years of mental distress they won't go away any faster, it will be a long way. Be prepared."

Almost 3yr later I still have some very random depressive toughs in my head and sometime two or three very bad hours, but now I can recognize them for what they are and that part of my mind lost any real control on my daily life. I can focus freely on my work, I can finally sleep like a normal person and my biorhythm is finally decent after years of total randomness caused by almost self-imposed insomnia.

Consider investing in it, it was probably the best decision of my whole life.


Thanks for saying this. It sounds very similar to my situation. I have recently picked up the book "Feeling Good" by David Burns, MD and it has been helping. After years of therapy, I felt like I should be "fixed". Though things are better, that is not the case. It is constant and serious work with a focus on getting better. I do realize a big part of my problem is lifestyle. As you were saying, my self imposed insomnia, plus the stress and pressure I put on myself day to day. Glad to hear that you are doing better, and your post has encouraged me to seek out a therapist once more.


> For me cognitive behavioral therapy with a very good psychotherapist was fundamental.

How does one go about finding a good therapist? At $100+ per hour, I could see it costing potentially thousands to find someone that's just good, let alone very good.

In the past the wife and I tried going to a few different marriage counselors, it was not very encouraging.


In my state, marriage counselors have weaker licensure requirements than therapists, down to being licensable with a theology degree and a short practicum. Find out what licenses exist where you live and avoid anyone who hasn't completed the stricter license. Where I live the license to look for is Licensed Mental Health Counselor.


One possible place to check is your local university. I know the one by me has a good clinical psych program and they run a clinic that is open to the public. They charge on a sliding scale based on your income so it may be more affordable.


I can't afford it, and I live in a rural place that doesn't have a lot of the fancier kinds of doctors.


Long walks (especially with a bit of height) releases endorphins I believe.

Also forces a steady heart rhythm probably cancelling the disrupting effects of depression.

If I could walk I would go back to it immediately. That said depression also fucks up your will to do anything so you need to lose your "self" and bootstrap moving like a robot. Not very efficient method, but the only I know.


Wait, you can't walk ?


Figure of speech, I can't take long walks, swelling occurs for various reasons. I used to move a lot run, job, etc, I know well the effects of physical activity and right now I just cannot.


Exercise, sleep, meditation, diet, hobbies.


You may mean to be helpful, but think about what that can sound like like to the other person (I can't speak for the GP):

* You are so dumb that the problem ruining your life is one I can solve in five words.

* It's as easy as five words; obviously you are not trying.

It can sound worse to someone suffering from a (unfairly, ignorantly) stigmatized illness such as depression.

Also, consider that probably the other person likely has been dealing with this problem for awhile. The simplistic solution that comes to mind in 30 seconds probably is one they also considered in the first 30 seconds, and probably they are well beyond it at this point.


If only it was that easy


No one said it was easy. But, sometimes - if you're not too depressed - if you manage enough of these enough of the time (possibly with the help of a good friend nagging you) you can get enough of a feedback loop going to self-sustain and maintain a healthy living pattern long enough to sink in.


Sometimes sure. I agree, these healthy habits are prerequisites when you find yourself more depressed than usual.

But sometimes these healthy habits aren't going to be enough.


Not all depression is severe depression. Same with anxiety. In many cases people can manage it by themselves (e.g. without medication or extensive counseling).


I would like to add "don't drink any alcohol" to the list. I know that even a teatotaler can have a major depression but for me the decision to stop drinking any alcohol was THE key to make my depression much better.

It took me years to realize but drinking alcohol makes me sad and anxious for a a couple of days. The more I drink the worse the mood on the next day.


And how does that help with balancing real world problems like financial security, social expectation and self-actualisation? Your suggestions seem like distractions from reality, so perhaps you would also include hard drugs in your list?


And unsolicited advice.


Nootropics that also reduce anxiety?


I am experimenting with THC, CBD, and Lecithin, so far.

I started taking Lecithin about a week ago. On Saturday I took 40mg CBD. On Sunday (taking Lecithin as usual, but no CBD) I felt absolutely fantastic. In general, I have felt better for the last week. I'm also going to the gym about 4 times per week.

Completely not conclusive yet but I am continuing to investigate.

EDIT: Forgot Magnesium, for me this seems useful for anxiety.


In what form are you taking CBD. Oils? I am attempting to remove THC completely and focus more on CBD so I am curious.


What is CBD?



I don't know about nootropics, but often anxiety can be a factor of:

- low testosterone - high estrogen - high cortisol - low DHEA

At least as far as the physical effects go (paranoia, sweating, etc.)

Might be worth getting testosterone and sensitive e2 scanned. In particular if one is also obese (testosterone aromatises to estrogen in fat cells)


Nootropics are a scam. Most of the drugs come from China and don't have the proper QA shipment over shipment.


I thought cholesterol was said not to be a cause of heart disease after all?


Some study from last year (I don't have the citation) stated that _ingesting_ cholesterol (i.e. eggs) does not lead to plaque buildup. It's eating saturated fats that cause the body to produce cholesterol that then builds up in the arteries. tl;dr worry about the bacon, not the eggs.


On the other hand:

'Cambridge University academics have looked over previous studies on saturated fat and discovered there is no link to heart disease '

http://www.telegraph.co.uk/journalists/sarah-knapton/1070397...

In view of the fate of several consensus views in the past (especially on the subject of nutrition) where they have been shown to be wrong, the tough conclusion is that one has to decide for oneself by exploring the peer-reviewed literature.


Cholesterol is less of a risk factor than previously thought but still plays a role. But the main factor in preventing hearth disease is lifestyle; avoid chronic stress, exercise, get enough sleep.


Depression also has been linked to worse medication adherence following cardiac incidents which could have an impact on mortality. Check out the SADHART trial.


Interesting observation, although there's also a lot of studies published that have shown a strong correlation between depression and obesity, which in turn is strongly linked to heart disease. I wonder if the researchers have controlled for this confounding factor somehow? (haven't had time to read the actual research paper yet)


I'm fucked then. I eat shit and I'm depressed!


Eat better, exercise, go out


... and stop drinking any alcohol. That has really solved my depression problems. A few drinks and the next day I feel at least a little sad and anxious.


How high cholesterol level is hard for my heart?


a case of conflation of lipids with all the subclasses of lipoproteins into single term "cholesterol"


Especially if your government doesn't give you access to a therapist b/c your health care system is a bad joke or if you don't want to suffer side-effects due to anti-depressants, then do :

1. Mindful meditation [free] -> Daily practice (30+ minutes)

John Kabat-Zinn [0] masters the link between science and meditation and has published very valuable books (including guided/audio meditation exercises) [1]. There are a couple of scientific studies which prove effectiveness [2] [3].

2. LSD [$5-10/dose + $25/multi-use test kit] -> One-time experience (every 6 months max.)

LSD however requires one to literally read/understand/know everything about the substance before applying it (minimum literature: "The psychedelic explorer's guide" by Fadiman). Also, order a test kit and test before you ingest. Certain "edge cases"/people should not try it and educating yourself about everything will allow you to decide if it's a good idea in your case or not. In addition, you may be able to access your spiritual dimension, which increases quality of life even further (it is less immediate with meditation).

You may combine micro-dosing LSD with meditation for accessing the meditative state easier (it's quite a challenge for depressed people).

[0] https://en.wikipedia.org/wiki/Jon_Kabat-Zinn

[1] https://thepiratebay.org/torrent/4180277/Mindful_Way_Through...

[2] http://news.harvard.edu/gazette/story/2011/01/eight-weeks-to...

[3] http://www.vox.com/2015/8/27/9214697/meditation-brain-neuros...


Re:LSD, you are making medical claims and recommendations with zero stated medical background. Someone following your advice could become permanently psychologically disabled.

Do not follow this person's advice on this subject. Talk to your actual doctor or licensed psychologist.


the thing is, doctor will never ever recommend you this, even if it would instantly and permanently fix you. there is simply no proper long term research into this thanx to US gov war on drugs and doctors play it safe so nobody would sue them.

from personal experience - if all else is failing, do it with smaller doses first. it is a truly life-changing experience, even one time.


Be careful using psychedelics while depressed, it can get even worse and you can have a very bad trip. At least don't do that alone and have somebody sober to watch over you. Personally, I've found small doses of LSD having better, longer lasting improvement and causing less side effects than antidepressants.


> Personally, I've found small doses of LSD having better, longer lasting improvement and causing less side effects than antidepressants.

The first time you take an anti depressant your doctor will not recommend you a full dose. The first time you take a stimulant your doctor will not recommend you a full dose.

I know readers here sadly won't consult their doctor on LSD or marihuana. The first time you take LSD (or psilocybine mushroom, or marihuana), and the first time you take it within a long time, do not take a full dose.

Example: the first time I used psilocybine mushrooms I used 5 gram (out of a full dosage of 30 gram). I almost fell asleep due to it, in bath, and almost drowned, had it not been for the fact I put the tub only half full. I had no sitter either (that was my first stupidity - always get a sitter; a sober, mature person who watches over you and who preferably is an expert on the drug). (Legal disclaimer: I used this drug when it was still legal in my country. It no longer is. I don't recommend breaking the law.)

There are also much lighter drugs than either of these. Amanita muscaria (fly agaric), for example (the same still applies, small dosage first). However I don't recommend a random person to pluck this in the wild. You need to be trained in order to recognise them as there are deadly poisonous lookalikes luring.


I have extreme and opposite reactions to your two suggestions. Your point 1 is just great advice for all people. Your point 2 is a damaging recommendation for a large variety of reasons and I hope no one reading this takes it seriously.


Here's a bunch of free mindfulness meditations (guided) that don't come from the bay. They're basically re-recordings of Jon Kabat-Zinn's original tapes: https://health.ucsd.edu/SPECIALTIES/MINDFULNESS/PROGRAMS/MBS...

// Oh, and be very very careful with psychedelics of any kind ...


Having had a friend's girlfriend go into the hospital during a mindfulness meditation retreat last weekend, be careful. Meditation can be as psychologically powerful as a strong drug trip - done well it's immensely uplifting, but a bad trip is similarly damaging.


What condition was she sent to the hospital for? Like, totally psychiatric or were they fasting or something?


I would shocked if meditation could cause a physical emergency. In all my readings and studies of meditation, this is the first I've ever heard of such a situation. Most likely, there was some other reason she had a medical emergency. I'd be curious what else they were doing at the retreat besides basic meditation.


It is quite plausible. Meditation can trigger a psychosis (or delirium). For most people, not likely (the likeliness is not akin to LSD which besides that a trip on LSD is akin to a [positive] psychosis), but it is possible and you hearing about it for the first time is not a valid way of assessing this likelihood. The likeliness is increased if the user is addicted to certain drugs, and quit cold turkey, without decreasing the dosage. This can for example happen with alcohol.


> It is quite plausible.

If it really was "plausible" you'd expect professionals in the field to alert about this. I've heard nothing but positive encouragement from many healthcare providers about the benefits of meditation and not a one of them discussed the possibility of psychosis or delirium.

Honestly, I just don't buy that it's a real problem or that meditation alone would cause serious issues. But I do know that many who do meditation often do other things as well, and those other things are typically much more of a concern.


Listen, it is not occurring a lot (not as much as bad trips on LSD or mushrooms), but it _is_ possible. Don't forget some people have real mental (and heck, physical) disabilities which are affected by drugs as well as medication as well as meditation. Meditation is that powerful. As is (long term) dancing, for that matter.

Also, this wasn't about ordinary meditation. This was about long term meditation. Quoting:

> "[...] during a mindfulness meditation retreat last weekend [...]"

Retreat is the keyword. This person was meditating full stop, like going on Vipassana course. That is not the same as someone doing mindfulness for 30 minutes at home and feeling at risk a psychosis occurs.

The example I gave you about withdrawal symptoms occurring during a retreat are also plausible. You have to stay sober in such a retreat. Coffee? Alcohol? Marihuana? LSD? Cocaine? Heroin? Forget about all that. If you sign up for Vipassana, you need to specify what kind of drugs you have used, what kind of medication you have used, and your mental/physical disabilities. Some people however decide to lie about that. Bad idea...


I'm unable to find any academic or journal or industry research papers about these supposed dangers of meditation. I'd like to read them if they are out there.

I have found some blogs on the subject and a couple vague articles on news websites, but that doesn't really mean anything if I can't see real studies on it.


I gave you on two accounts withdrawal symptoms from drugs as example. Surely, you can find scientific information on that. You'd be right that is not the direct result of mindfulness or meditation, but it is indirect result, and since e.g. Vipassana retreat enforces a no drugs an no medication policy it can occur (exceptions can be discussed beforehand though).

We also know that there are people with mental disabilities who are being untreated. Some of those people are sensitive to psychosis, and are at risk f.e. when induced by stress. I myself had a psychosis due to stress (not drugs, not meditation, not medication; I wish it was any of that, but it wasn't; it was stress).

Also, I'm not really sure if such would be reported. Not every psychosis gets documented by doctors. Mine wasn't, because I did not even dare to go outside (light hurted me, severely). I could barely speak. I only drank water for weeks. Barely ate. Bills were piling up. You get the idea.

FWIW, I found this after 3 minutes of searching with DDG:

"In 1994, the “Glossary of Culture-Bound Syndromes” of the diagnostic manual of the American Psychiatric Association states:

Qigong psychotic reaction: A term describing an acute, time-limited episode characterized by dissociative, paranoid, or other psychotic or non-psychotic symptoms that may occur after participation in the Chinese folk health-enhancing practice of qigong. Especially vulnerable are individuals who become overly involved in the practice."

http://kktanhp.com/kundalini.htm

I also found 2 min later:

https://www.reddit.com/r/Meditation/comments/4dahe9/my_exper...

Which I'm not gonna quote from, and 3 min later:

"A scarce literature exists on meditation and psychosis, and it contains cautions against teaching meditation to people vulnerable to (Yorston, 2001) or currently experiencing active symptoms of psychosis (Deatherage and Lethbridge, 1975)."

https://contextualscience.org/system/files/Chadwick,2005.pdf

Can't say I put a lot of effort in this. Yet I found this rather easily.

TBH, I don't think you are trying hard enough. To me it appears it is not fitting your viewpoint so you just gave up quickly. You also ignore the points I made (see top of my post).


> You'd be right that is not the direct result of mindfulness or meditation

> Vipassana retreat enforces a no drugs an no medication policy it can occur

This is exactly the point I've been making, that the meditation itself is not to blame for these issues.

Thanks for the other links, I shall read them.

Regarding Qigong: https://en.wikipedia.org/wiki/Qigong#Safety_and_cost


> This is exactly the point I've been making, that the meditation itself is not to blame for these issues.

Well, if the subject lied about their medical conditions, then the retreat has written proof of that. That's why you gotta fill it in (its also why visa waiver asks seemingly ridiculous questions). Its CYA; in this case so it is more difficult to sue them successfully afterwards. That also underlines there is a responsibility for the retreat provider(s). You cannot completely deny responsibility. The relationship between client (customer) and server (provider) is not equal here. The provider is the specialist; the client is not.

> Thanks for the other links, I shall read them.

Great. Be aware I spend 2 + 2 + 3 minutes on it just to prove there is research on this available. I didn't do an exhaustive search so I suggest you push the limit further in that regard.

> Regarding Qigong: https://en.wikipedia.org/wiki/Qigong#Safety_and_cost

I find it furthermore ironic you link to that subpart of the Wikipedia page and my browser shows in such a way in the middle of my screen the "Overview of clinical research" (which I read first) where it is written: "Although clinical research examining health effects of qigong is increasing, there is little financial or medical incentive to support research, and still only a limited number of studies meet accepted medical and scientific standards of randomized controlled trials (RCTs).[75]" and "A 2011 overview of systematic reviews of clinical trials concluded that "the effectiveness of qigong is based mostly on poor quality research" and "therefore, it would be unwise to draw firm conclusions at this stage".[3]" yet at the part you link to (which I was searching for in middle of my screen) it says "Qigong is generally viewed as safe.[74]" and "Although a 2010 comprehensive literature review found 77 peer-reviewed RCTs;[75] systematic reviews for particular health conditions show that most clinical research is of poor quality, typically because of small sample size and lack of proper control groups, with lack of blinding associated with high risk of bias.[3]" (Apart from the irony of my experience) this is clearly in contradiction with each other within the same article.

Sorry, I'm careful. This article sums up why: https://news.ycombinator.com/item?id=13423421


I get bad reactions from mindfulness meditation. I am not the only one: Do a quick google search about it. Yes, it is uncommon comparatively, but this doesn't mean it doesn't happen. I'm not sure why this is surprising to you: After all, people often use meditation for spiritual experiences, to go into altered states of conciousness, and other such things (much like psychedelics). And if they can help anxiety or depression - much like medications can - they can certainly harm things as well.

Medical professionals probably do say good things about it. But lets look at this closer: They probably say good things about medications too - because most people react well to it. This doesn't mean that it doesn't cause problems in a few people, nor that you will hear about it.

For me, it makes it so I'm angry. I'm unhappy with everyday life. I'm frustrated all the time and I dread the sessions. I've found some meditation styles that don't pick up the mindfulness and kept them up for a few months: but basically, I was sitting there being bored once a day and didn't have anything to show at the end for the work I had done. So I quit. I would certainly never do a retreat because I think I could be that person.

LSD (when I was younger) and other hallucinogens (now that I can vacation in Amsterdam) have, however, helped a great deal. More than meditation. You see, it seems to me that for meditation to work, you have to know how to produce some of these feelings - or at least recognize them in real time. You have to understand how to do what the stuff says. You have to be able to not beat yourself up for failing (which is difficult if you have perfectionist tendencies or some fear of failure). The other is more ... forced positive feelings, plus some altered thinking. Suddenly I remember what this is all like, and can take it to my daily life.


Are you trying those "magic truffles" in Amsterdam? I worry about such things in the commercial space as possibly being laced with other things, since they aren't really regulated. You found them helpful?


That's the problem with the quasi-legal stuff in Amsterdam. Weird place in regulation, where only part of the process has much of anything. Really it is the similar with weed and hash, and somewhat similar to the regular illegal drug market - with the exception of selling this stuff to residents and tourists in a completely legal manner. It seems the pushback for lacing such things would be pretty severe in this case. The unfortunate reality of this stuff is that unless we have some of that regulation and legality in place, this particular risk will be there.

Helpful, yes. Preferred? No - LSD and little forest mushrooms are my preference. But most folks have to contend with legality of things, including myself, and these are a legal option.

Being pretty introspective on them, I giggled at myself and found myself quite clever. I remembered what it was like to be happy with myself and my thoughts. The downside - with the truffles anyway - was that while sobering up, I could feel the everyday worries and anxieties coming back. They were gone for a bit, and I hadn't even noticed. It sucked the first time, but the combination of it all was such that I could start making changes in things the very next day - partially because I remembered.


LSD is not a predictable experience, practice 1) and you have the skills on tap, anytime, anyplace, forever :) Meditation is like exercise, you don't need to know why it works, or whether it is working, just do it !



You seem to basically post the same when the topic of depression comes up. Multiple times this week. Can be easily verified by clicking on your name, and then comments.

Our previous discussion on this is here: https://news.ycombinator.com/item?id=13290295

I agree about mindfulness.

However you provide no information on your LSD claim. There's no way one can "educate themselves about everything" on any subject this is CYA. There's no proof of a "spiritual dimension" this is not science; this is new age poppycocks rhetoric.

I still recommend the things I recommended in my previous post (I recommend the reader to read it). Apart from yoga, as well as running, and sunlight (especially in the summer since you build up the vitamin D in the summer).

For winter depression I would love to recommend a high lux light lamp, but I personally haven't read any good research wether this works or not or wether it is placebo effect.


> this is not science;

Didn't the war on drugs didn't put a damper on this? Although they seem to be finding medical uses MDMA now. I just wonder how many things we could be benefiting from that have been shelved because of prohibition.

I use light therapy in the winter. It feels like it at least helps wake me up on those days when the midwest skies are nothing but grey. I don't know if there is any science behind it. I sit out side as much as I can the 3-6 months that it's decent out.


I think recommending LSD is a bad idea. If it works for you, great, but even the best doctors can't agree on what drugs are helpful most of the time. I have friends who have used LSD and other drugs in the past and have experienced many negative side effects.


At the moment I am trying to help a workmate hang in there and get life back on track after a period of intense depression. I am not going to advise her to take LSD or to meditate, even if 'hipster' style with this 'mindful' nonsense.

Normal people who have happy, functional lives do not meditate or take micro doses of LSD.

With all drugs the underlying condition is important, with hallucinogenic substances that usually means the base mood - happy or sad - gets amplified. That means the risk of a bad trip. My workmate has tried coping with 'party drugs' but the comedown is horrible - more depression.

I am doing well with my workmate, we do things like eating, walking, cycling and talking, i.e. doing stuff. For a laugh though I might tell her she needs LSD and minfulness bullshit.


> Normal people who have happy, functional lives do not meditate or take micro doses of LSD.

Normal people who don't have a cold don't need to take cough syrup.

It's precisely because being depressed is an atypical state that you need to take special approaches to deal with it.


As if cough syrup works anyway - any comparison between getting a cold virus and being depressed is a bit lame. Very poor.


Normal people who aren't ill don't need special treatments. Is it clearer now?


Well... I believe depression is actually quite normal, everyone experiences depression (not to confused with sadness) at some stage or other.

What is not normal is sitting in front of some app, taking micro doses of LSD and 'meditating' in some stereotyped new-age fake-hipster-American way.

For normal depression for normal people it is possible to meditate without the LSD and the feigned posture. What you do is you go outside the front door and walk, ride a bike, go for a jog or go for a swim. Sure these normal activities do not have the pretence of the believe system that goes with mindful-LSD-taking but, for normal people with normal depression (including the suicidal thoughts), normal healthy activities can help too, e.g. a gentle stroll with no funny meds needed.


That you describe mindfulness meditation as "new-age" suggests to me that you aren't familiar with it, and are dismissing it out of hand rather than thoughtfully. The new-age movement has a spiritual element to it, mindfulness meditation does not. The complete, entire point of mindfulness meditation is learning to be present and aware of the workings of your mind. Real-time self awareness is not "new-age fake hipster", it's a valuable skill, particularly for depressed people. Having this improved self awareness can include recognizing when you become relatively more or less sad, which can lead you towards or away from various situations and behaviors.

I think you're reacting negatively because of the commenter's association with LSD. That's not representative of the mindfulness practice in general, so if that feels a bit too "Berkeley" for you then don't throw away the baby with the bath water. Personally, I've never tried LSD, and although I'm a bit curious about it, I've read accounts of people being mentally crippled for years by a bad trip - not worth the risk.


What is normal depression? What is a normal person?

How do you leave the house when you are depressed?


Mindfullness doesn't appear to be bullshit.

The evidence for mindfullness is about as good as for meds or cognitive behaviour therapy -- it helps some people, but not everyone.

It has a part to play in a package of bio-psycho-social care.


"Normal people who have happy, functional lives do not meditate or take micro doses of LSD."

Actually, they do. Especially meditation. Sometimes that is why they meditate - is because it keeps them healthy and happier. After all, a sign of a "normal, happy, functional" person is that they handle their stress. Additionally, many more people meditate as a course of religion, though sometimes they use the word prayer instead.

Happy, normal, functional people that are also curious might do micro doses of lsd just to see how it affects their life. Or they might have been doing ti for years to treat their illness so they can be that happy, functional person. Just like folks take anti-depressants daily and you assume they are normal people with happy, functional lives. I don't always react well to meditation, but some folks do. Seriously.

"... with hallucinogenic substances, that usually means the base mood - happy or sad - gets amplified"

Sure, for some folks, this stuff happens. But again, some folks react differently to therapy and "normal" psychiatric drugs, so I'm not sure why folks think the "party drugs" would be different in that respect. And obviously dosage is important: A teaspoon of cough syrup will produce different reactions than drinking the whole bottle. For what it might help, I will notice the normal, everyday "anxiety" coming back while hallucinogens are wearing off, but it really isn't a big deal for me. I wake up the next day feeling like I*ve been able to massage my brain - like it has been all limbered up for use, and the effects last for some time.


Sometimes the reasons why a person is happy or normal is because they are meditating.


Well, shit. Bye, hackers ;P


What is depression?


Morose music, waking up late, black clothes, lots of cigarettes and coffee, etc.


I read that as "Depression is as hard on the heart as it is on obesity and cholesterol" and was confused for a moment...


My heart often tells me when something is amiss. For example, if I'm about to buy excessive amounts of junk food and alcohol I sometimes feel a twinge emanating from the chest region. I acknowledge and interpret this as my brain's anticipation of the price that will be paid.

But what if things have gone more badly wrong? If the heart seems to say one thing whilst ideas (the ones I can name) say something else? One way to resolve the conflict is simply to censor the bodily signals. (Fear can do this sort of thing.)

Yet there are physiological consequences, because the brain has two roles: (1) to run the mind, (2) to regulate the body. And withdrawing attention from bodily signals has consequences for health, I guess due to a concomitant weakening of the controlling function.




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