As someone who is now in their mid 30's, but whos depression started in their early 20s, let me beg you - do not wait to get treatment.
It won't go away, and it will take years from you. Don't let it take what should be some of the best years of your life. If you don't approach depression as a disease that needs treatment, then you will resist doing anything about it and it will silently suck the joy out of existing.
Whatever you can do to preserve a positive outlook and a happy disposition I believe you SHOULD do. If you aren't enjoying your life then you are effectively not living. You're young enough now that you have the ability to dramatically reduce the damage that depression can do to your life, and trust me it can do serious damage.
Hey, thanks for your response. It’s heartening to see someone who cares for the well-being of strangers.
Not to be even more of a downer, but… I feel like I’m running out of options. I’ve tried Zoloft, Celexa, Lexapro, Effexor, and Remeron, prescribed by 3 different doctors. I’ve seen 6 different therapists. I’m extremely
privileged to say that I’m currently seeing a Stanford PhD out-of-network weekly.
I’ve heavily experimented with psychedelics, and while they’ve given me a much greater appreciation for arts and humanities as well as a curiosity about this universe, they haven’t made me want to be alive. I’ve experimented with ketamine recreationally, too.
I don’t know what to do. Nothing helps. I’m thinking of trying TMS, but I’m really skeptical of that.
Part of me wonders if I have what your sibling commenter describes as “congruent depression” — depression which is expected given the circumstances of one’s life. There is one aspect of my life which is lacking: social connection. I feel lonely, but it’s hard to tell if this is the cause of my depression. Even if it is, I don’t know how to fix it. I don’t really like talking to people — I’m very introverted and also talking to people makes me very anxious. It’s even more difficult because of Covid.
Your comment really hits close to home. I’m not living. There is no joy. And I can see, very slowly, the damage which is being done.
Tune me out if this doesn't resonate with you, but what you're describing, does it feel like it could have a spiritual component? Is it a sense of total, overwhelming hopelessness, but a rational one, based on existence as you can understand it?
I spent a long time in a state like that, with suicidality and all. In retrospect it was a total "poverty of spirit", and I had to accept a drastically different understanding of myself and existence altogether to move past it. But it was necessary for me to experience it to do that, and I can truly say I am changed for the better. All this is a roundabout way to say, that accepting the idea of total depravity, and realizing that the all-encompassing hopelessness that springs from that state of being is completely valid, was surprisingly helpful to me, at least. I still had to find hope somewhere else (or in someone else to be specific), but doing so did help in a way medicine didn't (for me).
Actually, yes, it does feel like it could have a spiritual component. As a child I was a reluctant Christian. I’ve described myself as an atheist starting when I was 11 or so. Since experimenting with psychedelics, I now describe myself as an agnostic. I have a sense that there is some greater entity out there, but I have zero confidence that it resembles any human god.
I attended a Christian church service a couple of weeks ago, for the first time in over a decade. It was an odd feeling. On one hand, I felt a bit like I was in a cult meeting and I was totally disillusioned. On the other hand, after talking with people there, many of them seemed to describe a “void” in their life which was filled by religion. I can feel a void like that in myself. Maybe this is the “poverty of spirit” you describe? Still, while I agree with many Christian teachings, I don’t think anybody could convert me into a believer.
I feel the all-encompassing hopelessness; the nihilism. Nothing matters. There might be consequences of
my death, but ultimately those consequences don’t matter.
If I thought anything mattered, maybe I would think I matter.
I am very curious to hear more about your experience. I have to admit I’m having trouble understanding your solution.
Coming from a similar background as you (reluctant Catholic kid, now agnostic, seeking greater social connection), after attending a couple Quaker services over the years I've been strongly considering going regularly (alas, Covid).
The service is very unlike other Christian rites. There is no priest, and anyone can speak. I remember long stretches of silence in contemplation, punctuated with a thoughtful couple sentences here and there from someone more spiritual than me.
Importantly, it's also my understanding many Quaker meetings openly accept atheists and agnostics, among a diversity of beliefs. See https://nontheistfriends.org/
I was a very outspoken atheist myself for many years, an officer in my college's chapter of the secular student alliance back in the early 2010's. I was raised going to a mainline church sometimes, but it didn't do anything for me. I never had a grudge against Christianity or anything, but I grouped Jesus and God in with Santa at some point as a teenager and never really thought further about it.
So I didn't think I could be converted either. I thought "Good without God" was how I could live, and things would eventually work out if I could just tune my environment or my brain chemistry accordingly. But I eventually found myself backed into a corner when I realized I had no way to reconcile meaning, joy, or goodness with myself or life as I could understand it. I wasn't good at all, if I was honest with myself. I felt exactly as you described, without value in a world that had no value.
There's a lot to be said to tell the whole story, but to be anticlimactic, my solution was indeed Jesus. Considering his words, his claims, his promises, and daring to believe they applied to me, that's how I found hope, and a reason to live life as though I do have some value. How I got to that point from atheist, that required a long process of addressing a number of assumptions and biases before choosing to believe. The whole "church" part came after, and was more of the icing on the cake.
BTW, if you're curious at all, here's what I was reading tonight that actually got me thinking on the topic of "poverty of spirit" and what it means to Christianity in particular (starts at section I.1 - https://www.ccel.org/ccel/wesley/sermons.v.xxi.html )
I gotta go to bed, but if you wanna chat more or hear the whole story sometime let me know. I can email that address you posted in the other comment. Wishing you the best.
What helped me with regard to that was reading the first three pages of "The myth of Sisyphus" by Albert Camus. I never even read the book further than that.
Did you turn to organized religion? I find that I don't really believe in anything enough (not just religion) to be a spiritual person. How did you develop a spiritual component?
Yeah, I did put my hope in Jesus and turn to Christianity. I didn't consider myself spiritual either beforehand. I never did psychedelics or believed in anything supernatural, or believed in some higher power or meaning before I made the decision to believe in Jesus' claims. It was a decision based on evaluating the state of my own self, and evaluating Jesus and his words.
Though to give some background, even when I was an avowed atheist, moral relativism was something I could never abide. I always felt strongly that as intelligent beings, there was truth and objectively better ways of existing to be found. The book "The beginning of infinty" helped me justify that rationally, and also made me realize how incredibly powerful, rare, and valuable intelligence is as a force in the universe. From there, CS Lewis' "Abolition of Man" got me onto the idea of natural Law, and the "Gospel of Thomas" got me thinking on the timeless, and somewhat subversive nature of the truths that Jesus taught. I looked many places, but found Jesus' teachings to be uniquely valuable to understanding the state of myself own soul. From there, it was a matter of choosing to believe him on the harder stuff (CS Lewis' Trilemma came into play there). The feeling of belief did not precede the decision to believe, which surprised me, but is apparently not uncommon.
I'm glad I did though, and my spirituality (which I only developed afterward) has become really essential to my life and hugely positive for my wellbeing. The organized religion aspect is more of a support system and framework to practice it in, but quite helpful nonetheless.
For sure! I know I dropped a couple of book recs in the comment above, but if you ever want more, or just to talk/ask questions feel free to reach out. My email is my HN username at gmail.
> Part of me wonders if I have what your sibling commenter describes as “congruent depression” — depression which is expected given the circumstances of one’s life.
I have a similar issue. It's a chicken/egg question. Is depression causing the struggles I'm going through, or are the struggles causing depression?
I've done a lot of self exploration recently through a bunch of different therapists and have been diagnosed with ADHD. My original theory after learning this was that the ADHD caused my depression, especially because I noticed that during periods when I wasn't depressed, I still had issues with executive function.
However really inconsistent results from ADHD medication make me question my theory. Maybe the depression is so pervasive that even when I'm not feeling depressed, the habits and thought patterns that I'm so accustomed to stifle me even though I'm no longer in the depression cloud. Maybe heavy internet/gaming/porn use for 20 years combined with a lack of good habits has just created an addiction to stimulation and set me up for failure in general. Maybe the asocial digital lifestyle I lead is just completely against my nature and I need to go be a high school teacher instead of a software engineer (but I think a high income is too important in the US for a comfortable life). Maybe I just need to start believing in God and let Jesus take the wheel.
> I’m not living. There is no joy. And I can see, very slowly, the damage which is being done.
I've heard multiple times that people with untreated ADHD have shorter life spans due to increased risk of suicide and stress-related health problems (I assume this applies to all mental disorders). The problem is that all mental health disorders are on a spectrum and that no one solution can fit everyone. I don't really have a solution for myself, and I wouldn't be surprised if I die "early".
>Maybe heavy internet/gaming/porn use for 20 years combined with a lack of good habits has just created an addiction to stimulation and set me up for failure in general.
This is something I wonder too. Could I have trained myself into this state? Is this a learned behavior? Has years of laziness and gratification seeking created a state where effort is no longer an option?
> Maybe I just need to start believing in God and let Jesus take the wheel.
I've been told this works really well. I have a weird feeling it might even work for me, if I could somehow get myself to buy into the whole organized religion thing. Maybe if Elon started a Church of the Simulation I could get on board, haha.
The potential link to ADHD is interesting. At times I've wondered if I have ADHD. I certainly relate to many of the symptoms. I actually was diagnosed and prescribed Ritalin, but I have to admit that I was drug seeking at that time so not really sure the diagnosis holds water.
>Speaking of TMS, a new depression treatment out of stanford has come out recently that sounds similar
Funny you mention this, I was reading about it on HN a few days ago. It gave me hope. I actually emailed the group asking to be a part of a future study.
>This is something I wonder too. Could I have trained myself into this state? Is this a learned behavior? Has years of laziness and gratification seeking created a state where effort is no longer an option?
That's what I think about myself, and medicine won't magically undo the years of instant gratification. I read atomic habits (https://jamesclear.com/atomic-habits) and am trying to integrate good habits/clear out some worse ones in addition to medication/therapy. It's fucking hard to make new habits.
It really does pain me to know that anyone, including yourself, suffers with depression. It's an illness which I would not wish onto even my worst enemy, because of how cruel it really is. You are living life, but you are not truly alive. Depression kills you day by day.
I'm sorry that none of the treatments have worked for you. I can understand how that leaves you feeling very little hope. It may provide some comfort to know however, that it is often a problem of finding the one treatment that works. It's a crude science of essentially trial and error, but there should still be some hope that you can find some combination of medication and therapy that will help. Don't give up on your search. It's a matter of life and death.
The social aspect very well could be a major factor for you. Given you have tried so many medications, that does lead one to wonder if it's not some chemical imbalance but rather a deep void left by a feeling of disconnectedness from social circles. In that case, you owe it to yourself to work on this.
Work on becoming more social. Just like learning to ride a bike, or learning geometry, you can learn to be more social. Do it for your mental health. I fully understand how it feels to hear the words "work" as someone with depression. It's the great conundrum of the disease - you have no energy, no willpower, no drive, nothing. Giving advice to "work on yourself" is well, bad advice frankly. But that's where therapy, and medication, can give you the little "boost" that you need to start putting in the work to your personal life where it's needed most.
How to be social is about finding your community, your people.
Your empathy warms my heart. I appreciate the advice. It’s valid, and it makes a ton of sense to frame it in terms of “life and death”. It’s interesting, I was recently talking with my therapist about “my people” and commented on how I feel like I don’t have any people; that I don’t belong anywhere. You’re right that I owe it to myself to improve this part of my life. (You’re also right that I recoil at the thought of “work”, haha)
I hope you won’t think I’m a creep for this: I clicked on your profile and noticed you left a comment on the Stanford SAINT trials that were posted here a few days ago. I remember reading your comment and the thread it spawned. That post was actually what put TMS on my mind. (I also emailed the group asking to be a part of future studies.)
I’m really sorry to hear that you’ve been dealing with this much longer than I have. I read about those who have been suffering for decades and it always makes me feel a strange combination of empathy and astonishment. From that earlier thread, it sounds like we have some similar experiences. I too lack the “kick” to do basic tasks. I have so many questions. Is this something you still deal with? Have you found some treatment that works? How have you kept going after 20 years? A question I’ve been grappling with: how does one distinguish between “depression” and “laziness”?
Btw, since this thread is getting long, I thought I would drop an email in case you (or some other reader) were interested in chatting later: hackernewsthrowaway@fastmail.com
You've tried many things, and I have two suggestions that may help, social connections and yoga. You can do both together at some yoga studios with events like the kiirtaan singing as well as the exercise classes. ps Yoga rather than other exercises as it regulates hormones and organs as well as other benefits of exercise.
And regular yoga brings feelings of joy, adds delicious juiciness to life.
As someone who is now in their mid 30's, but whos depression started in their early 20s, let me beg you - do not wait to get treatment.
It won't go away, and it will take years from you. Don't let it take what should be some of the best years of your life. If you don't approach depression as a disease that needs treatment, then you will resist doing anything about it and it will silently suck the joy out of existing.
Whatever you can do to preserve a positive outlook and a happy disposition I believe you SHOULD do. If you aren't enjoying your life then you are effectively not living. You're young enough now that you have the ability to dramatically reduce the damage that depression can do to your life, and trust me it can do serious damage.