Depressed? Net-based Treatments Can Help

Jung and the Restless writes "Researchers at an Australian university have found that regular visits to therapeutic and educational web sites can successfully treat depression. Researchers directed patients to The MoodGYM, a cognitive behavior therapy site, and BluePages, a depression education site. After 12 months, users of both web sites reported improvement, with the educational site working out better than the behavior therapy site. A psychotherapist who did not participate in the study says that the results aren't all that surprising. 'Cognitive behavioral strategies — sometimes in conjunction with medication — are the most effective means of treating depression,' and 'a person who is visiting an educational site like BluePages is taking the necessary steps with her own self-care. That's a key component of successful treatment for depression'"

Comments

Where's the control group?

[Ed Avis]

As the article points out, someone who visits any website at all is taking steps to deal with their depression and so you'd expect them to get better. Surely they needed a placebo website, with 'neutral' content, that could act as a control group. They get a little of that by comparing one website against another, but they haven't shown that either is a better choice than just browsing. They could even be a bit worse.

Re:Where's the control group?

[rev9]

If you had RTFA and actually checked the links there, you would have noticed that beside the 'am-I-depressed-tests' there is also a community. Take a look at the blueboard: http://blueboard.anu.edu.au/ In my opinion that's a huge thing for someone who is really depressed and afraid of talking about it with his family/friends.

Re:Where's the control group?

[Bacon Bits]

That's unethical. You can't treat someone for a disease with a placebo.

The correct thing to do is to compare a new treatment with existing or traditional treatments and determine if the new treatment is more or less effective. It more imporant to determine if the new treatment is better than existing treatments than if it is better than nothing anyways. Everybody already knows that doing nothing doesn't work.

Another option is to use standard treatments combined with your new therapy, and then have a control group do standard treatments alone.

Re:Where's the control group?

[Overfiend1976]

Actually, I have to disagree with you here. For some things, yes, you can't treat with a placebo, but it can be done for many things. Proves ONCE AGAIN the true power of the mind. If you're convinced you're taking something that will help you, it can and indeed does help, even if it is a sugar pill.

Re:Where's the control group?

[Anonymous Coward]

Why is this a Troll? The parent is right, any medical research without a control group is not worth the paper it is written on.

Maybe these sites do help people but unfortunately we will never know and some valuable research time has been wasted.

Re:Where's the control group?

[drolli]

How about comparing the website to untreated depressions? In the region where I live an eduaction campain against depression lowered the suicide rate by 30% in the last 5 years. Whatever one believes if there might be better methods of treating the depression - if the website helps - compared to people which are not treated at all - i think it is a good thing.

Re:Where's the control group?

[maxume]

That's what he meant, but what if just joining any community, depression related or not, is a big step in a person's recovery?

Re:Where's the control group?

[thePowerOfGrayskull]

That's unethical. You can't treat someone for a disease with a placebo.

Of course you can. How do you think drug trials work? Ethical or not, an untreated control group is the only way to ensure that the treatment is effective, and that any improvement isn't due to environmental/unrelated factors.

Another option is to use standard treatments combined with your new therapy, and then have a control group do standard treatments alone.

This is also a valid option, but what happens when the standard treatements can't be combined with the new treatments?

Re:Where's the control group?

[Lurker2288]

Depression (at least in mild cases) is one of the few diseases where people taking placebo do get better, actually. And while the use of 'active comparators' in drug trials is becoming more common (mainly because it allows you to demonstrate better results, and thus demand better reimbursement from Medicare and HMOs, e.g.) using placebo is still very common. As long as the patient knows when they sign up that they might not be getting the study drug, it's perfectly ethical.

The exception would be in cases where effective treatment exists, and withholding it would be a death sentence. For example, you probably won't see many placebo-controlled trials of new HIV drugs. In these cases active comparator trials are the only way to fly.

Re:Where's the control group?

[coleopterana]

You absolutely have to use controls for your results to mean something in a definitive sense. As someone who's been involved in conducting clinical trials a great deal (plus my family members do the same as research psychiatrists and clinical psychologists) there are very strict rules for what you can and can't do. This includes informing the members of the study that they may receive a treatment that is in fact a placebo, but they generally won't be told if that's what they got till they are finished with the study. This isn't Tuskegee and it's not One Flew Over the Cuckoo's Nest either. This is the age of informed consent.

Re:Where's the control group?

[An Onerous Coward]

I thought that, in some cases, the control group was taking the most common treatment available for the disease, rather than a placebo. It would make sense, in cases where long-term damage could be avoided by treating the disease. But I don't know for sure.

Re:Where's the control group?

[Hahnsoo]

Depression (at least in mild cases) is one of the few diseases where people taking placebo do get better, actually.
There are more than "a few" diseases where placebos make the test subjects better. There are many non-psychiatric studies where the control group on placebo showed "real" non-subjective improvement (objective readings like blood pressure, lipid panels, etc.). Is it a treatment bias, where the person who feels like they are being treated simply feels better? Is it because the subjects receive medical follow up, when they might not necessarily have received that follow-up when not on the study.
 
The amazing thing about the "placebo effect" to me is not the fact that folks on placebo may experience some improvement of their symptoms or even resolve the stigmata of their disease. It's the fact that most folks on the "test drug" who were actually on placebo stop taking the drug because of various side effects, even though theoretically, they shouldn't feel side effects from the faux medication at all.

Re:Where's the control group?

[Anonymous Coward]

Posting anonymously, because this can be a very touchy subject sometimes.

I think community may be a very important step in combating depression, but I also think that the type of community can make a big difference. I suffer from post-traumatic stress disorder, which sometimes manifests as depressive bouts. Talking to close friends about this stuff - particularly the trauma that brought on PTSD initially - is HARD. Affording a therapist can also be hard. Talking anonymously to others with similar problems is a very important, positive step. The folks over at Broken Spirits Network ( http://www.brokenspirits.com/ ) are amazing; supportive, non-judgmental, and anal-retentive about retaining anonymity. It's only anecdotal evidence, but talking to a support network designed to help has a much better chance of helping than talking to a more general forum. (BSN also has a few mental healthcare professionals around, who can be VERY helpful, and a lot of links to other resources).

That said, talking anonymously online is just one step. Before you even get there, you have to mentally admit that there's a problem, and that you need help dealing with it. Those are two HUGE steps; it's really, really hard to get to a place where you want to stop just eking out a survival, and try to recover.

Re:Where's the control group?

[MobileTatsu-NJG]

"Proves ONCE AGAIN the true power of the mind. If you're convinced you're taking something that will help you, it can and indeed does help, even if it is a sugar pill."

Heck, I think this applies outside of illness. I know lots of people (myself included) who are challenged to do something, and rationale will set in that it cannot be done, so it's deemed impossible. When it's known something can be done, even if it isn't proven, often times a solution can be found. I jokingly call that the 'power of ignorance'. I remember a couple of friends of mine discusssing one of the tests Microsoft has their potential employees do during the interview process. It involved getting several people to cross a bridge in the shortest amount of time. One of them said "Oh it cannot possibly be any faster than x minutes" because he had the fastest guy take every single person across and didn't bother going past that. Somebody else realized if you took the two slowest people and had them go, it shaved a couple of minutes off of his suggestion. (Apologies for not having the exact details, it was years ago.) He convinced himself of his own rationale and didn't look past it.

I'm sorry about going OT here, but your post reminded me of an interesting quirk of the human psyche. We sometimes set our own limits and won't go past them. It holds us back. I agree, placebo's are useful.

Re:Where's the control group?

[ColdWetDog]

I thought that, in some cases, the control group was taking the most common treatment available for the disease, rather than a placebo. It would make sense, in cases where long-term damage could be avoided by treating the disease. But I don't know for sure.

That is often the case ("usual" treatment as a control). However, it's often not an optimal one since the "usual treatment" may not have been well studied in the first place. This, in fact, is the more typical case in medicine since the bulk of our "knowledge" comes from what is essentially anecdotal evidence. As an example, treating ear infections in children with antibiotics has been standard of care until fairly recently. Drug companies would argue endless how much better their antibiotic was than their competition - full page ads in medical journals with multicolored graphs and stupid cartoons.

As antibiotic resistant organisms started to flourish, researchers started to look more carefully at the literature and found that the decision to treat ear infections with antibiotics came about when oral antibiotics became easily available. Nobody had bothered to create the study that compared antibiotics vs. placebo. Or at least if they did, it wasn't published anywhere. Then, researchers had to go back and essentially repeat the experiment with controls and found that although some cases responded to antibiotics, others didn't, especially early on when the infection is presumed to be viral. There is still a lot of nuances in this common and seemingly simple part of everyday medicine that are poorly understood.

Designing and executing decent medical research is damned hard and much of the stuff in the literature is just bloody awful, quality wise. Controls are only part of the problem, of course, but a rather basic one. OK, I'll just stop whining and just drink some more coffee..

Re:Where's the control group?

[Dabido]

'...rationale will set in that it cannot be done, so it's deemed impossible.'

They said it couldn't be done,
He said, 'There's nothing to it'
And he tried this thing that couldn't be done,
And found he couldn't do it!

Psychologists need to learn more than this

[Anonymous Coward]

I'm one of those depressed people psychologists treat (I've been more than I can remember in the last twenty five years) and while cognitive behavioural therapy is one of the big tools in their arsenal, I'm afraid most of them consider CBT + Antidepressants to be the ONLY tool they'll use. It's done little to help me, yet when I see a psych, it's more laying on thick CBT with another round of antidepressants. My past experience with it is ignored, and they'll go so far as to say I'm clearly getting better despite evidence to the contrary.

Moving sideways for an analogy, it's like going into hospital with a stab wound and being given aspirin. When that doesn't work, more aspirin is given, and the doc insists it's better, despite nothing healing and the pain being just as bad. 18 months later, when the doc has done nothing more than to give more aspirin, I realise it's another bum move, and I try another doctor. The next doctor says he has just the right treatment... and whips out some aspirin.

Psych training is pretty damned poor in Australia.

Re:Psychologists need to learn more than this

[DamnYouIAmALion]

I had this same problem, the doctors were going the medication route - but I also had anxiety, so giving medication with poor documentation and statistics just made things worse. In the end I managed to spend time with a psychologist (not easy, they're either very expensive or very busy) which helped a great deal - although not until some time after the fact when you process and understand what they're saying.

They get you only so far - and at that point you'll eventually get the willpower to 'pick yourself up' and start building your life back. It takes time, but it's really worth it.

- Andy.

Re:Psychologists need to learn more than this

[Anonymous Coward]

The problem is that CBT and medication are the best ways to treat depression. They are both better than "talk" therapy for nearly all patients, though the medication route is a bit problematic - most patients get the best medication for them after trying quite a few different types. So, if one type of drug isn't working, you shouldn't be afraid to try different ones, possibly of a different class.

It is true that for a significant minority of sufferers of depression, that even trying both of these treatments they get little response. For people with refractory depression like this, I believe there isn't much other than trying to "wait it out" with standard treatment, or going the more severe route of electroshock therapy. There are new drugs coming out all the time, so people who have refractory depression are often shuttled onto new drugs as they become available. There are also new experimental treatments like electrical brain stimulation that may prove helpful for some...

It can be a struggle, but hang in there - doctors are getting better at successfully treating it all the time (well, they can't get worse anyway ;).

Re:Psychologists need to learn more than this

[Anonymous Coward]

I have depression too, and I found that meditation (specially shamatha and vipassana) helped me to understand how my mind works, seeing feelings as feelings, mind as mind, mental states as mental states.

Re:Psychologists need to learn more than this

[ObsessiveMathsFreak]

Psych training is pretty damned poor in Australia.

It's bad everywere. Psychologists are not real mediacal doctors. They are philosophy/humanities students posing as doctors and you're falling for it.

Modern psychology more closely resembles adherance to Galen's anatomy or the teachings of Aristotle. Theories are basically made up out of thin air by lordly academics, then applied to misforunate real people. Experimental confirmation of these often dubious theories is often nonexistant, and even when performed, like this study, is seriously lacking in scientific rigor. It's cargo cult science most of the time; calling the gods, but no science happens.

So the next time you think of going to a psychologist, don't. Go to a real doctor and have them examine you, and get your health advice from a professional scientist.

Re:Psychologists need to learn more than this

[kayditty]

I really don't think CBT is the best solution for depression.

Re:Psychologists need to learn more than this

[oliverthered]

I forgot to mention Ketamine, you'll have a way cool trip and then feel like your having the best time of your life. Ketamine works like an SSRI but blocks a different group of neuro thingies, so the effect is over a few hours and not over a few weeks like traditional SSRIs.

Re:Psychologists need to learn more than this

[noigmn]

I think this more comes down to the nature in which they have to work.

If you had hundreds of patients, who you see for small amounts of time each time, of course you can only do the standard stuff.

I've found most people end up searching for things themselves in the end if the doctors can't diagnose because though doctors say they can and some really want to help, if they don't know the answer already there is literally no time for them to do anything like as much research as you can do yourself.

Re:Psychologists need to learn more than this

[noigmn]

Yeh, if you met the average psychology student, you wouldn't even consider paying to visit one.

On the other hand psychiatrists are specialised doctors. And though med students are crazy, I trust them when they become doctors, and more so when they become specialists. Plus they know everything the psychologist knows plus more and have studied an absolute shitload of medicine before specialising.

Only risk of visiting one is they might know what really is wrong.

Re:Psychologists need to learn more than this

[Anonymous Coward]

Have to disagree with you there OMF. I thought the same things for half my life until in my 20s I started getting serious
depressions. I still get them, but by god I know enough about psychology, psychiatry and medication now. There is quackery
on all sides of mental health. You think anybody actually understands the mechanism of antidepressants? Only in a fuzzy
and ad hoc experimental way, the biochemistry is bewildering. Most doctors and even some specialists haven't a clue. What is
scary is the way they are often puppets of the drug companies pushing their latest "cures". The DSM guide is practically
a crock of shite, and all the pros know it is deep in their hearts, but it's the best tool they have and the only
picture of mental dysfunction available as a common reference. Most psychs get the diagnosis wrong for the first
few times, they are too pressured to jump to a conclusion, always get a second and third opinion. The only thing that actually
worked for me was one on one talk therapy, but in most juristictions it's too expensive or simply unavailable on national
health insurance programmes. Funny thing is I studied cognitive science for many years, but that was formal schemas, predicate
logic and Boltzmann machines which obviously had no bearing my own problems. It made interesting conversation with psychologists
though, to be able to correct them when they are getting too fuzzy and explain how neural networks actually function.
Upshot of all is that I still get depressed, less often and less severe, but I manage it, anticipate it and accept it better now.
The best pieces of wisdom I received are roughly as follows, so this might save some of you some money :) .....

1) Most the causes *are* deeply rooted in childhood formative experiences and you need to remember your life context
and reinterpret your emotions in that light. Until you do you have no idea what crazy buttons the world is pushing for you.
I think of them as hidden methods in my brain object that get called by backdoor sploits ;)

2) Intelligence works against you. How many blissfully thick people do you know who suffer? Remember that line from the wife of
John Nash in Beautiful Mind - you can't use your mind to fix your mind when the tool itself is broken. By sheer force of will you
can sometimes bootstrap yourself back, but external input is a vital part of an expedient recovery.

3) Depression is a sane reaction to an insane environment. The world is barking insane. It's full of other stupid, lazy, damaged
people (increasing the ones running the show). There is war, misery, death, pointless waste, arrogance, fear, greed... our modern
Western existence is practically designed to send smart people insane. All the things that offer security and continuity in
modern life, the church, the state, employment - those are all fucked, they are crumbling away as we speak.
Most people use two coping mechanisms, denial and distraction. If you can't engage in either of these two self comforting drugs
then you have only one option left, change your environment. Throw out your television. Stop reading the FUD stories on /. designed
to provoke insecurity and outrage. Build new friendships and visit new places etc.

4) Acceptance. Get used to the idea that you have a lifelong incurable disease. Understand how it affects your capabilities and
dreams and learn to recognise the signs of the highs and lows. Make hay while the sun shines high and prepare for the winters.

5) Talk to your partner, family and friends. Part of the disease is isolation and trying to fight it on your own. It takes many years
to work out that friends *don't know* you are depressed when you don't call for 4 months because you are up every night hacking away
because it's the only thing that stops you going mental. Tell them and explain your situation and needs. Most will stick by you
and the ones who won't were never your real friends anyway.

Re:Psychologists need to learn more than this

[Anonymous Coward]

It's done little to help me, yet when I see a psych, it's more laying on thick CBT with another round of antidepressants.

You know you've been on the Internet too long when your first thought is that CBT is for Cock and Ball Torture..

Re:Psychologists need to learn more than this

[vishbar]

Okay....sit down, Mr. Cruise.

Re:Psychologists need to learn more than this

[Kokuyo]

You know, IANAD (doctor) and I'm only telling you this from personal experience so this does not have to apply to you at all but when I was depressed (I had been in a phase of depression for about 3 years straight at that point and it was constantly getting worse) and went to a psych he said I needed to get more sunlight and he gave me Ritalin.

Didn't help much. The Ritalin made the few good times exceptionally great but the many bad times... My then girlfriend and now wife describes it in such a way that I'm asking myself whether calling Satan an asshole would have been a recreational activity compared to spending time with me.

Anyway, what helped me was my wife, just by being there, and I myself. What basically helped me was forcing myself to have a more positive outlook. Like when everything was going down the drain I relaxed my face (because when I'm in a foul mood I usually frown constantly) and put on a smile. It was very relaxing and while, at first, it was always a fake smile it soon started becoming more real. And by smiling I actually felt better. You know like a release in endorphines results in a smile it seemed that a smile also resulted in a release of endorphines.

The problem is, depression is like a dog biting his own tail. It makes itself worse the longer you have it. You need to keep a hold on the positive things in life, no matter how few and far between they might be. I know my way isn't that easy but it doesn't hurt to try it.

Re:Psychologists need to learn more than this

[Shinglor]

Psychologists are not real mediacal[sic] doctors.

That's true, a psychologist with a medical degree would be called a psychiatrist. A psychiatrist is able to prescribe medications as well as using psychotherapy and counselling.

Re:Psychologists need to learn more than this

[blinder]

i do have to agree with this some what. i started seeing a therapist just over a year ago, and the first thing i decided was that i didn't want to see a psychologist or an analyst, i wanted to see someone who has had medical training. that's why i chose to see a psychiatric nurse. she is fully trained on cbt, but also has had a pretty extensive medical training (and can even prescribe medications), but we don't go down that route (she is *not* just another pill pusher).

i think that's important here. before i settled on a therapist, i interviewed many who were just eager to put me on anti-anxiety anti-depresents drugs, which, for many personal reasons, i don't want.

but i digress. i think there are many fine psychologists out there, but for me, i generally like talking to someone who has a bit more science/biology in their education and training.

Re:Psychologists need to learn more than this

[Satorian]

One of the best posts I've read on /. yet. Sounds a bit like the depressive side of an asymmetric bipolar disorder though (which makes more people kill themselves than "normal" one-sided depression).

Anyway, good post.

Re:Psychologists need to learn more than this

[jimmichie]

I've been through the same thing here in the UK. Mental health care is pretty damned poor everywhere simply because to give effective treatment you need to have either experienced the condition yourself or have an incredible amount of empathy with your patient - without that understanding the only care a doctor can give is to follow a procedure in a book.

Rather than gripe though, here's something useful. From my experience and from talking to others, the best way to fight depression is to exercise. I haven't met anyone it doesn't work for. Running is something you don't need to be happy or alert to start doing, the only difficult thing about it is getting over your embarrassment (or fear) of being seen as a "jogger".

Re:Psychologists need to learn more than this

[maxume]

The point more or less, is that the training a psychologist receives isn't all that important compared to their personal insight. The training gives them a vocabulary they can use to talk to other psychologists, but it doesn't increase their insight a whole lot.

Re:Psychologists need to learn more than this

[gad_zuki!]

Thank you for your insightful post. Unlike the grandparent you understand that all medicine is flawed and that current methods have done a hell of a lot more good than bad. Its a pretty recent idea that mental illness is an illness (as opposed to 'he just needs a kick in the pants') and that people should be able to live a life full of positive aspects.

I do disagree about your disdain for the western system. For the most part its a class-free system which does rewards smarts and hard work. Im more than familiar with other parts oft he world where the son of someone high-up gets the only few avaialble decent jobs. At least here someone from a no-name family can do well in school, get an internship, get a good job, and have a decent standard of living. A nobody outranking his 'betters' is a new modern idea. The idea that women should also be able to do this is even newer. Outside the western world these ideas are usually frowned upon or may even get you jailed/killed for even suggesting them.

As far as intelligence being a curse, well, ignorance is bliss, but the world -needs- intelligent people. Think of the handful of smarties who have changed the course of human history for the better. Now think of all the unsung heroes who get things done on a more everyday level. There's a certain dignity to being intelligent and using it. Some people will never see this, but many will, and its nice to know that you are hard to replace and what you do can only be done by a small percentage of people. On top of it, I consider intelligence to be akin to owning a racecar while everyone owns a honda. Sure, it breaks down a lot, needs maintenance, doesnt quite fit the road well, but when you need that horsepower its there waiting for you.

Your comment about the cogntive dissonance and coping mechanisms may be true, but I've found that smart people would rather stop sweating it and either become apathetic to the things they cant change or choose to be agnostics. So, I dont feel that you have to engage in coping mechanisms and denial. Also, I believe its very important to tolerate coping mechanisms now that I know how difficult life is as an adult. I certainly do not give any leeway to fundamentalists, hateful people, but I dont consider those who have some spirituality in their lives to be enemies of rationalism. I don't stress out over incompetent goverment because I know that government will always be a mix of interests and capital and its naive to pretend that it can be ever made perfect. I dont stress out over religion as I know either there's nothing there or people will never get it right. Regardless, seeing the system as agaisnt as intellectuals is a victimizing mentality. Why not see it as having a minor gift and trying to use it the best you can? What about having some pride about yourself?

Your other advice about living with illness is spot-on.

Re:Psychologists need to learn more than this

[Anonymous Coward]

Psychologists are not real mediacal doctors. They are philosophy/humanities students posing as doctors and you're falling for it.

That's true. Psychologists are not medical doctors, they're Ph.d's. I've never met one who claimed to be a real medical doctor though. They don't prescribe medication of perform medical procedures. They perform therapy, usuallly in conjunction with a real medical doctor, a psychiatrist. You don't accuse a physical therapist of "pretending to be a real medical doctor" when they recommend certain courses of therapy and treatment do you? That's what therapists do.

Re:Psychologists need to learn more than this

[Anonymous Coward]

"5) Talk to your partner, family and friends. Part of the disease is isolation and trying to fight it on your own. It takes many years to work out that friends *don't know* you are depressed when you don't call for 4 months because you are up every night hacking away because it's the only thing that stops you going mental. Tell them and explain your situation and needs. Most will stick by you and the ones who won't were never your real friends anyway."

That's something very hard to do. Most people don't have a clue about what is depression until they go through one, and when you tell them what you're going through they usually react with advices like "cheer up, let's have some beer!". Even if they have gone through one, I'm not sure they can easily understand, because each person has a different response to situations, so what leads one person to depression might not lead another.

Re:Psychologists need to learn more than this

[Princeofcups]

> I had this same problem, the doctors were going the medication route...

That's the crux of the problem. I have an excellent psychiatrist who will not prescribe medication unless you are in active psychotherapy with her. After four years, I am at a point where my anxiety is practically cured as long as I stay on my medication, so I only see her a few times a year now. She is actively involved with all of her patients. The problem out there with too many doctors is that they are, what she calls, "Pill-pushers." These are doctors who see you for 10 minutes, and prescribe medication based on a snap judgement of your problems. Done, next patient.

My suggestion to everyone with depression, anxiety, or especially psychotic issues is to drop your doctor if you are not getting the treatment you need, and keep trying until you find a good one who actually cares. They may be hard to find, but they are out there. The major problem for most people is that such doctors are usually in private practice, and charge an arm and a leg. Bet, borrow, or, um, you know, the money. You will not regret it when you have your happiness back.

One final note, you are not hiring the doctor to "cure you." You can only do that yourself. What the doctor can do is help you find the path you need to follow to get there. You may also find that you do not need medication, or that you can get along with a lesser dose. Unless you are suffering from psychosis, in which case, TAKE YOUR MEDS! :-)

jfs

Re:Psychologists need to learn more than this

[Anonymous Coward]

CBT and medication don't treat depression. At best they treat the symptoms of a deeper problem, a very western medicine approach to "fixing" something.

Acupuncture WILL fix the root causes of depression. Go see a REAL acunpuncturist (not an MD who happens to do acupuncture or a chiropractor who took some classes, but a board certified acupuncturist); it will change your life.

Re:Psychologists need to learn more than this

[kruhft]

4) Acceptance. Get used to the idea that you have a lifelong incurable disease. Understand how it affects your capabilities and
dreams and learn to recognise the signs of the highs and lows. Make hay while the sun shines high and prepare for the winters.

This is important. Just acceptance of what you have (or more importantly, what you have been given) is essential to dealing. Taking a 'disorder' and using for good turns that disorder into a benefit; you just have to figure out how to, and sometimes that's part of the cure. How many film makers, artists and comic book writers are clinically depressed about the mediocrity of life in general, and find success by writing about it, generally selling to those that have the same ideas. Take what makes YOU and be YOU. You'll find that just doing what you do best (whether it's being depressed, creative, or whatever) is the best cure for any problem you might think you have.

And screw them for telling you that there's something wrong with you. It's them trying to keep their jobs. If you aren't harming yourself or others, you have nothing wrong with you, even if you feel a down sometimes. The only problem is that you haven't learned to fix yourself yet.

And I'd like to leave with a quote that I find really important by André Gide:

It's better to be hated for what you are than to be loved for what you are not.

Re:Psychologists need to learn more than this

[permaculture]

Thanks for posting "Depression is a sane reaction to an insane environment etc", Dude.

I've printed those two paragraphs out and stuck them on my fridge :)

Re:Psychologists need to learn more than this

[krusader]

You, sir, are an ignorant jackass.

Psychologists are not medical doctors, and therefore cannot prescribe medications.

Psychiatrists, however, are medical doctors, thereby rendering your argument null.

Any freshman who took Psych 101 could tell you this. You claim that the entire field of psychology is hocus pocus magic and psychologists/psychiatrists are no more qualified to help you that Miss Cleo, but you clearly haven't read a damn thing on the field. Next time, try doing some research on a subject instead of taking Tom Cruise's word for it.

Re:Psychologists need to learn more than this

[Lord Ender]

My past experience with it is ignored, and they'll go so far as to say I'm clearly getting better despite evidence to the contrary.

Actually, they are trying the new "placebo effect" method of psychological therapy. They give you a sugar pill and keep telling you "you're getting better!" until you believe it yourself.

Actually, your post basically says "depression treatment sucks--it's so depressing!" I find that to be a pretty damned funny statement. Thanks :-)

Re:Psychologists need to learn more than this

[Anonymous Coward]

I've been through (and am going through) what you describe and I think you've captured it bang-on, AC. Thanks for your insight. It helped to brighten my day, and I wanted you to know that.

Re:Psychologists need to learn more than this

[Duke Machesne]

It's not just Australia, the CBT people have taken over everywhere. Works for some, but not for everyone. Search your local yellow pages for "adlerian" or even "jungian" for some alternative treatment methodologies.

Re:Psychologists need to learn more than this

[lucier]

I did not know how depressed I was until I started taking L-Tryptophan (1000 mg. per day), GABA (1500 mg. per day) and Inositol (@ 1500 mg. per day).

Two weeks ago I woke up in a good mood for the first time in my entire life. I had no idea what that was like. I am also able to go to sleep without tossing and turning for three hours.

My life has potential that I never expected it to have.

All this after TWENTY years of professional treatment that had benefits only for the professionals doing the treatment.

In the United States, traditional MD's, AMA doctors, are little more than sales reps. for the drug companies.

Luci

Re:Psychologists need to learn more than this

[Hatta]

Ketamine works like an SSRI but blocks a different group of neuro thingies

Please don't spread misinformation like that. The action of ketamine is entirely unlike that of SSRIs. Sure they both inhibit some proteins in neurons but hell, if that's your criteria for "works like" you could say aspirin "works like" SSRIs. Your statement is so vague as to be misleading. SSRIs block the reuptake of neurotransmitters presynaptically so that there is more neurotransmitter available to cause a post-synaptic response. Ketamine blocks the postsynaptic NMDA receptor, inhibiting a post-synaptic response. SSRIs work on the serotonin system, ketamine on the glutamate system.

The antidepressant response to ketamine is a truely novel phenomenon. I suspect it has some similarities to the response to electroconvulsive therapy, since many of the same players (NMDA receptor, CaMKII) are involved in each.

In other news involving novel theraputic uses of recreational drugs, MDMA seems to help treat parkinsons symptoms. Check it out at the New Scientist. Maybe we can get Michael J. Fox to come out in favor of medicinal MDMA?

Re:Psychologists need to learn more than this

[Hatta]

Yeh, if you met the average psychology student, you wouldn't even consider paying to visit one.

If you met the average medical student, you'd feel the same way.

Re:Psychologists need to learn more than this

[NiceRoundNumber]

I really don't think CBT is the best solution for depression.

Unless you're a woman.

Re:Psychologists need to learn more than this

[Aeamarth]

Just wanted to tell you that I am bookmarking your comment. :)

Re:Psychologists need to learn more than this

[cervo]

At least you got CBT. My doctor insisted on only antidepressants, and even at that, he couldn't really be bothered to supervise or keep track of me. 2 Months and a few sample packs of Zoloft and then Wellbutrin later I stopped taking them and feel about the same. But from what I gather my doctor isn't the only pill pusher. The only odd thing is he never diagnosed me with depression...just sort of pushed the pills on me.

Re:Psychologists need to learn more than this

[Anonymous Coward]

Thanks for writing all that. I never saw things from that perspective... I wish people would have this attitude more. I hope it can become more clear to me so that I can see things that way too...

Re:Psychologists need to learn more than this

[oliverthered]

I was only repeating the information I saw on another website. I suppose I should have done some more research.

Re:Psychologists need to learn more than this

[alienmole]

In other news involving novel theraputic uses of recreational drugs, MDMA seems to help treat parkinsons symptoms. Check it out at the New Scientist. Maybe we can get Michael J. Fox to come out in favor of medicinal MDMA?

Finally, a political position from Michael J. Fox that Rush Limbaugh can really get behind!

Interweb

[Wellington Grey]

But what if it's spending so much time on the internet that makes me depressed?

-Grey

Re:Interweb

[rishistar]

My internet problems more of an addiction than depression.

Re:Interweb

[rf0]

It depends if you spend all day reading the troll comments or looking at porn.

Re:Interweb

[An Onerous Coward]

Solution: Internet Troubadors.

These people would go out to parks and other gathering places, and read out the messages of the Internet to passers-by. People who found the information timely and useful would make small donations of cash, livestock, or wenches.

That way, everyone would be able to learn from the mighty Internet, without sitting in front of their computers all day.

Re:Interweb

[jafac]

Comments are just another form of porn.

At least the end product doesn't require a tissue though.

Re:Interweb

[spun]

I find your ideas about donated wenches intriguing and wish to subscribe to your newsletter.

Youtube...

[bangenge]

Lots of fun stuff to watch. Enuff said.

Always Get The Proper Help

[DamnYouIAmALion]

I used to have depression, and have only recently (this month) gone back to work. I think these sites are interesting, but use them as an 'extra' to getting proper help. Go and see your doctor, they'll help identify what the best course of action is, and go from there.

Of course, realising that you are depressed isn't easy and realising you need help is even harder. Actually going and getting help is the hardest of all, but you'll never be so glad when you finally do. And remember, your friends and family are there to help too - don't feel embarrassed asking for their help, everyone needs help at sometime in their life

- Andy.

Re:Always Get The Proper Help

[noigmn]

One thing I'd note is that thinking you need someone to help you is acknowledging depression, thinking in the end it will be someone else but yourself is perpetuating it.

Re:Always Get The Proper Help

[Tony Hoyle]

Heh. My wife just went to the doctor yesterday with anxiety symptoms (tiredness, shaking, etc.), and was told to visit the site in the article!

So as far as the doctor is concerned that site *is* proper help.

Kinda funny to see it on slashdot the next day...

Re:Always Get The Proper Help

[Anonymous Coward]

It depends, there are a lot of really bad doctors. I complained to my general practicioner saying I was a bit depressed, tired, irritable, and he said he would get me some good meds. Ultimately he is a general practitioner and not a psychiatrist, so he can't really make a diagnosis. He also never said whether I had depression or not. The drugs caused really weird side effects like twisting and a really tight feeling inside my neck/some type of humming in my head. When I complained it was really hard to reach him and ultimately I received no answers. Finally he switched drugs, still some weird symptoms and the second drug seemed less effective than the first. It was hard to get any answers, and finally I had enough. I didn't call back when I ran out of the drug given to me and I haven't looked back. Ultimately, I don't know if I am depressed because my doctor never diagnosed me. Basically he was a pill pusher. And if that isn't bad enough, you are supposed to be observed when on antidepressants, but he pretty much wouldn't know if I dropped dead one day. If that is the "proper" help I would hate to say improper help. As far as I can tell, my doctor is not the only pill pusher. Ultimately what do you do when your insurance requires a primary care physician to give a referral to something like a psychologist/psychiatrist and he insists on knowing everything and doing it himself?

Slashdot as your shrink

[Analein]

Now that would surely make the world a better place.

Cuteoverload

[tfinniga]

Cute overload.

Works for me.

Re:Cuteoverload

[uhfdude]

Cute Overload has some cute pictures but the inane, baby-talk descriptions and comments make me want to choke somebody - preferable the people who write that stuff. On the plus side, I find that depression can be temporarily alleviated by strong emotions such as rage. Urge to kill... rising. Urge to kill self, fading, fading, gone.

psychotherapist

[56ker]

I think a psychotherapist would have a field day with slashdot users. Either that or they'd end up needing therapy themselves. ;)

well

[Anonymous Coward]

it has the word "cognitive" in it, so it must be very advanced and useful. highly recommended.

There's always a catch

[Joebert]

Cutting back on masturbating cured me of depression, though, now I have anger management issues.

Re:There's always a catch

[bky1701]

Anger management? I manage my anger just fine.... oh yeah, FUCK YOU ASSHOLE! No, not you moron, the other bastard! I hope you rot in hell!!!!!!!!!!11!!1111!!!111!shiftshiftshiftoneone one!!!!

Computerized therapy

[Anonymous Coward]

Eliza http://en.wikipedia.org/wiki/ELIZA anyone?

Why even bother?

[Lactoso]

I was going to RTFA, but, you know, what's the use? It's not going to change anything. Sigh....

Re:Why even bother?

[hdparm]

Moderators are going to hate you. Is it +1, Funny or -1, Irreparably Depressed?

Re:Why even bother?

[Lactoso]

"Moderators are going to hate you. Is it +1, Funny or -1, Irreparably Depressed?"

They already do, it doesn't matter. :-(

Funny websites

[m-wielgo]

Whenever I'm bored or feel like wasting time (or about to slit my wrists from manic emo depression), I just go to collegehumor.com or break.com and laugh my ass off at the pictures and videos people post.

Re:Funny websites

[The Wooden Badger]

The recent Dilbert strips reveal that depression is just another word for not enough coffee. Of course it was Wally who said it.

Another Site of Interest

[darrenadelaide]

Hi,

Just thought you may find http://www.beyondblue.org.au/ of interest.

Re:Another Site of Interest

[danpsmith]

I find their criteria for depression to set the bar unbearably low.

If you answered 'YES' to question 1 and/or 2 and ticked at least three symptoms in the checklist, you probably have a depressive illness.

For more than TWO WEEKS have you:
1. felt sad, down or miserable most of the time? Yes No
2. lost interest or pleasure in most of your usual activities? Yes No

I don't know if that means in the _last_ two weeks or not, but certainly everyone has had a two week period in their life where they felt sad most of the time or lost interest in activities. Doesn't make them clinically depressed in my honest opinion.

As far as the rest of the criteria, three symptoms on a list that includes things like "feeling tired" or "feeling sick and run down" and feelings such as "overwhelmed" and "irritable" set the bar so low that almost everyone would tick at least three of these boxes. Everyone has some of these symptoms. I think depression is over diagnosed, and in my honest opinion I think it makes it under scrutinized in the cases where it actually is a real problem. It's like the boy who cried wolf, people with real problems don't get any attention because depression is a disease just about anyone can claim to have.

The key to a real disorder to me is when someone has a different perception of reality than what really exists. You see this in the case of rock stars with depression in that they'll have practically everything material in the world, possibly good relationships, but somehow can't stop themselves from throwing it all away. That, in my eyes, is depression.

The 38-year old single fat lady who is sad and miserable because she lives alone with three cats is just rational, it's not really a disorder. It's a sane reaction to a non-fulfilling life.

This to me is equivalent to saying that "everyone has an eating disorder" and is inclined to be anorexic because they think that their bodies are fat, without taking note of the fact that some of them could actually be fat. A mental disorder, to me, is about disconnection with reality, at least in part. Anorexics see themselves as fat when they are bones, that's a disorder. Someone feeling down because they aren't doing anything with their life or whatever, that's a logical reaction.

Interesting stuff

[hdparm]

I just did the first set of tests (feelings) on that site. Did it quickly, so the end result is probably not totally accurate but it can't be too far off either. What I like about the site is the educational approach. Helping people to understand these type of problems is important first step to healing. What I don't like about it, is that my results chart is almost identical as Cyberman's. No feelings.

Re:Interesting stuff

[Anonymous Coward]

Hey, at least YOU get a part in Doctor Who. No such luck for me ... sigh.

It doesn't work

[aadvancedGIR]

I tried to use /. to cure work-related depression. The problems are still here, but now I also feel lazy.

Personally....

[Anubis350]

...I'm depressed now 'cause the first site uses flash.

It's actually easier than going to websites...

[emptycorp]

Just avoid myspace.com

Re:It's actually easier than going to websites...

[Channard]

Once you've seen it once, though, the sight of all that stupidity never really leaves you. I swear, if there's one site that proves there's no humanity it's that one. Yes, Goatse was gross, some of those conspiracy sites are completely mental. But the sheer volume of stupidity, illiteracy and caring about things that matter very little on that site makes me depressed just thinking about it.

Strenuous excercise

[Colin Smith]

Increases serotonin levels, and for guys testosterone completely naturally. You start to look good and feel good about yourself. There are a bunch of other beneficial side effects. It seems that the human body is designed to be physically stressed on a regular basis.

Re:Strenuous excercise

[Anonymous Coward]

Sorry, I have to disgree with this, strenuous exercise can lead you to start bouncing up and down like a yoyo. Some moderate on the other hand should be encouraged.

Re:Strenuous excercise

[Anonymous Coward]

Depends on the meaning of 'strenuous.' The meaning is perceptual, which is relative. Some people enjoy the burn from hitting the exercise hard (heavy weight for muscle gain and/or hard jogging) and consider their heavy workouts to be reasonable or moderate. These people don't keep telling themselves "I shouldn't overwork myself...it's not good for me...I'll just hurt myself." They just go, and feel that a little pain for a little gain is worth it. Others are more defeatist or lazy...when they feel like they are putting in a little effort to the workout,when it becomes a challenge, they rationalize every reason in the book to retreat..."I'm stressing myself...it's ridiculous to work this hard...It isn't good for a person...i'll get too muscly..." The last one is my favorite...trust me, you can't *accidentally* get too muscly. Its not like you're going to wake up one day and say...oh my god, what have I done to myself...I'm so gross and ripped! What will I do?! Point is, stress in exercise is necessary, or you might as well not do it. Don't defeat yourself by pussing out and rationalizing your quitting attitude because you are just lazy.

Re:Strenuous excercise

[robocord]

I get really tired of hearing this story. There are some of us in the world who don't get *any* buzz from any amount of exercise. Unsurprisingly, we tend to have depressive tendencies. I spoke with my doctor about it, and she believes it has something to do with serotonin re-uptake mechanisms not working the same in everybody. I exercise quite a bit. I average well over a hundred miles a week on the bike. I never get a mood lift from exercise. If I miss a week or two, then go back to it, there's no change.

The problem with psycho-chemistry is that it's not a machine. You can't say "input X will garner output Y." It just doesn't work that way. When I get a headache, I take one single aspirin, and it goes away. A friend of mine can take prescription painkillers, and still have a skull-splitter. You exercise and get happy. I exercise and get tired. As much as all the geeks in the world (myself included) would like to make it so, humans aren't rude mechanicals to be manipulated with predictable inputs and outputs.

Re:Strenuous excercise

[jafac]

I can tell you that my knees, hips, and shoulders sure as hell were not designed to be physically stressed on a regular basis - given the amount of inflammation they undergo in response to even mundane amounts of exertion. Don't get me wrong - I do low-impact stuff (believe it or not, mountain biking qualifies). But running is right out. For me, anyway.

Re:Strenuous excercise

[Anonymous Coward]

How about solar exposure? That buzzes me even more than exercise.

Re:Strenuous excercise

[jafac]

There are some of us in the world who don't get *any* buzz from any amount of exercise.

Thank you for your response to yet another appeal from the self-righteous neo-Calvinist fitness police, who believe that all personal problems can be solved for all people if they just sweat and suffer enough.

Re:Strenuous excercise

[Eivind Eklund]

What seems to be most effective against depression is full body exercise - basically weightlifing, especially squats and deadlifts. The generic advice of "exercise" isn't good enough for all.

Re:Strenuous excercise

[curunir]

He also doesn't take into account that some exercises can actually be detrimental to depressive people. Exercises that cause the body to produce adrenaline can actually make someone's depression worse. When the body releases adrenaline it also releases cortisol. While the adrenaline levels subside shortly after you finish exercising, cortisol levels take far longer to normalize. While the causes of depression aren't fully understood, there have been studies that have shown a connection between cronically-elevated cortisol levels and depression.

So while exercise is generally one recommended activity for depressives as it can help create an environment where the other treatments can be more effective, you have to be careful which exercises you engage in. And, like you said, exercise isn't a magic bullet, it's only part of eliminating one of the obstacles to getting better.

Re:Strenuous excercise

[Ozan]

Exercise can indeed help with depression, but not in the way you were describing. Leave the serotonin manipulation to the drugs, that is what they are there for.

Exercise, like many other activities, provides the depressed with certain tasks that can be acomplished without the danger of falling into typical behaviors of depressed, like excessive ruminating or procrastination. Furthermore, the patient has a feedback from his activity, when he realises how his stamina and strength improves, especially in the first months.

Re:Strenuous excercise

[Anonymous Coward]

There's another side to this coin. Some people are prone to overworking themselves, and get injured in the process. If you're starting to throw up or you're getting hemmoroids, or really BAD pain (not just exhaustion or lactic acid), that's your body telling you to back off. All things in balance...

ECT

[oliverthered]

Have you tried electroconvulsive therapy yet?

Lithium may also work, but from my experance they try to avoid giving you lithium so there's probably something bad about it that they don't put on the leaflet.

Hello. I am ELIZA. How can I help you?

[OneDeeTenTee]

Eliza is my AI-therapist.

"an Australian university"?

[Nuffsaid]

Is it just me, or is this way of presenting research even more superficial than usual? Nobody would present a (even minor) scientific breakthrough with the words "Some scientists somewhere in Northern or Southern America discovered...", even in a Slashdot blurb. By the way, it's The Australian National University in Canberra, as clearly stated at the beginning of the article.

Re:"an Australian university"?

[noigmn]

At least it keeps us amused. I heard an Englishman say he was worried that they had an Australian pilot flying the aeroplane when I was in Britain. (Who has the only long serving airline with a perfect record again?)

I'd like to note also for people that a large number of articles that you would remember on slashdot science are from Australian Nation University. And that Times rated them 16th best university in the world this year. So the people who post the crap probably should learn to type the letters ANU, like they do with MIT and others.

Re:"an Australian university"?

[Nuffsaid]

I heard an Englishman say he was worried that they had an Australian pilot flying the aeroplane

He probably was worried about the pilot flying upside-down.

Not depressed

[Anonymous Coward]

I'm one of those people who's not really depressed, but just has a very bleak outlook on life.

I went to a psych, but all he did was start digging. There were some good points there, though. They hold up a mirror and let you see what you say/think about yourself.

However, it was somewhat overkill. I'm just one of those people who first think about the stuff that _must_ be done and only every now and then think about what could be _fun_ to do.

Any slashdotters thinking the same? Any solutions, for that matter?

Re:Not depressed

[Anonymous Coward]

Any slashdotters thinking the same? Any solutions, for that matter?

Nope, you're fucked. Sorry.

I knew the punctuation and spacing was wrong...

[noigmn]

A psycho, the rapist who did not participate in the study, says that the results aren't all that surprising.

IT REALLY WORKS!

[Anonymous Coward]

OMGZ! IM UR NET SYCOTERPIST FTW!!1!11!!!! FELLIN BETTR ALRDY? KTHXBAI!

The problem, as I see it..

[Ekasus]

....isn't that we have not found enough ways to cure depressions; the problem is that everyone (and their pets) labels themselves as depressed. In severe cases sure pills/doctors/padded rooms is indeed needed, but 80% of the ppl popping pills and speaking to doctors have no need for such treatment, they need to realize that life isn't a dance on roses and non-ending happiness. Life is a mixture of good and bad experiences, so to quote Denis Leary's doctor-patient conversation: Patient: Hi, im..... Doctor: STFU, next!

Re:The problem, as I see it..

[cerberusss]

Have you any idea how condescending you sound? There's a difference between feeling low and feeling depressed. And if you haven't been through the latter, then you wouldn't suggest to 'realize that life isn't a dance on roses'.

You can't imagine how it's like to drive on the highway with 90 mph and thinking "I might as well turn the steering wheel real quick and be done with it". For weeks on end. Every day.

So cut the "know-it-all" attitude and accept that there are thing you don't know a rat's ass about. Asshole.

Re:The problem, as I see it..

[Ekasus]

Well you are right in that I have never been depressed in the way you describe, but unfortunately, I do have some knowledge within this field. The problem with a large chunk of the population seeing therapists for minor issues is that they are clogging up the system; hence the more serious cases are not getting the attention they need. This is due to that a private therapists will not differentiate between who needs treatment and who doesn't, but he will no the less have to turn away clients at the end of the day if his schedule is full. BTW, I am really just repeating my first post, but as it seems I stepped on your toes I thought I should clarify.

book review...

[Pflipp]

I started reading this book (or at least, the Dutch translation).

Already it has learned me a lot about my complaints, ranging from severe tension problems and psychological problems (which could be categorized as depression, I'm afraid).

It is really written very well and it's worth reading just about every page, but what it boils down to is that people today (and both me and computer programmers in general not in the least) try to rationalize too much of what they feel, or channel it in accepted ways.

For instance, when I was totally angry at a collegue once, but couldn't deal with it appropiately, all I did was go to my boss and say 'I would like to go home now, I cannot concentrate on work any longer'. It went downhill from there because I couldn't cope with being unhappy with the situation (I like to be positive about things, but I couldn't find too much to be positive about). I thought I was going crazy (I was) and my muscles ground my bones to dust every day. On top of that I started to worry about my (mental) health, of course.

For a large part I already learned to accept that I would be so much better off simply finding a more normal place to work (it can be crazy here), but the book gives me insights beyond my current problem. I have not finished it yet, but for the first time I enjoy reading a book that tries to teach me exactly how I am 'crazy'.

Why do people fall for this.

[Anonymous Coward]

Why do people keep falling for these tricks that are supposed to help your depression when it's been proven that body thetans are the cause of depression.

Give us all your money and we'll give you some books to read and some nifty technical stuff to help you get rid of them.

Best regards

Thetan of L. Ron

Ketamine

[bri2000]

I would second that and a recent study seems to confirm it (http://news.bbc.co.uk/1/hi/health/5253800.stm)

In my own experience and I recently suffered a very serious depressive episode which resulted in my being absent from work for two months. It went on, seemingly endlessly, with the pills I was presecribed and the counselling making no noticable difference. Until a friend of mine, who had seen the above mentioned study, offered me a line of k. I had only ever taken k once before, about 4 years previously, and thoroughly enjoyed it. So I snorted it and had my trip which enabled me to look into myself and see my problems from an entirely new angle, get some perspective on them and do a proper mental inventory. The next morning I woke up for the first time in weeks not feeling tearful or suicidal and, in the two months or so since I took the k, my recovery has been consistent and marked. Of course, it could just be a coincidence and other peoples' mileage may vary, but I firmly believe that just one line of k (I didn't take any more) made a real and lasting contribution towards treating my depression and psychiatrists should be open to trying it (which I would imagine the drug companies would hate, given the prices they charge for proprietary anti-depressants).

Annoying...

[tomstdenis]

Didn't RTFA but just here to say stop being pansies people. EVERYONE gets depressed from time to time. The only thing that pulls you through is the desire, nay, the will to keep doing things [living, etc]. Whenever I get really upset/depressed I chill out, then remember that, at least for me, my software projects [public domain stuff] actually brings me joy and gives me purpose.

Stop taking the meds, stop being so obsessive and do something meaningful with your life? Is it any wonder that we have more and more shallow/vain/empty people and then coincidentally more depressed people? Spend your free time doing something you're passionate about. Donate to charity or the public domain, spend time with your kids [OMG NO WAI!], write a book, etc...

If all your life amounts to is sitting at home watching "deal or no deal" then chances are you can easily be depressed. The cure is not in a bottle, and certainly isn't in a group program.

Tom

Re:Annoying...

[Bambi Dee]

I've seen highly creative and active people fall into depression for no external reason whatsoever. Is it so inconceivable that it can be a serious illness, and that it's hard to fight that illness with the very organ afflicted by it?

Even if depression is purely reaction, a being-overwhelmed - once you're choking on insidiously persuasive infinite loops of "I'm filth, everyone can see it, I have no right to ask for help, I have no right to feel better", once self-injury sounds like a perfectly reasonable punishment for being yourself, once meeting your friends makes you cry with fear, once writing, painting, coding, loving, laughing all seem increasingly bizarre - how do you chill out with that shit screaming in your head?

Please excuse the angst and drama. I suppose it's exactly the kind of stuff people love to make fun of... but it's my description of depression. Not a "light" depression, maybe, but what kind of depression could ever be "light"?

Maybe you can chill out in that state and look forward to working on your projects or spending time with your kids or what have you. That's great... quite amazing, actually. And I suppose it does help having built up a sensible life - ideally before falling to pieces. But even then there's no guarantee you'll recognise it once push comes to shove. Well, I guess I shouldn't presume to speak for you.

Re:Annoying...

[tomstdenis]

I don't think ALL depression is faked. I just think MOST depression stems from the fact people have really unimportant lives [even to themselves].

Same thing with ADD kids. I seriously doubt all of the kids have ADD. Most of them could just use sterner discipline. You can't look sideways at a kid today without getting a lawsuit up your ass. I remember getting kicked out of class, having to stay for detention, getting yelled at, etc when I was a shit disturber.

Nowadays kids get away with murder, and what's worse, we can't even fail them anymore, it might hurt their self-esteem!!!

I think western society really needs a kick in the ass, and this is comming from a 24 yr old, twice published, college graduate who likes nothing more than to hack code and play GTA:San Andreas.... :-)

Tom

Re:Annoying...

[WuphonsReach]

Kid, I'd wish a bout of severe depression on you, but that's not even something I'd do to my worst enemy. When you say "people have really unimportant lives", you're making a value judgement that you have no place making. Don't argue with me now, just think about that and come back and argue 20 years from now.

Depression is a very difficult disease to deal with. It's also a complicated disease (or set of diseases) where the symptoms of all the different types of depression are pretty much the same. There are multiple causes and they often feedback on themselves which makes things a whole lot worse. It's not a trite saying to say that depression has a significant fatality rate as a disease. It needs to be treated as a potentially life-threatening disease. But like all diseases, there are various levels of severity ranging from mild to severe.

There's external-induced (events, relationships, or other things not under your control) depression which overloads the individual and causes them to give up hope. That's more amenable to talk therapy or even simple counseling where someone sits down with you and helps you formulate a plan. Some of the exercises are learning how to separate / identify which things you can change and which things are out of your control, then focusing on changing what is possible. Other goals of therapy are to help you identify which thoughts are incorrect views of reality ("everyone thinks that I'm ugly / worthless / stupid / etc") and to take steps to challenge those thoughts. See "Feeling Good" by David D. Burns for a good book about CBT.

Then there's the chemical side of the disease where the brain (other organs) don't make the right chemicals, or the receptors for those chemicals aren't working right. (This is where things get very experimental, theoretical, and understandings are constantly revised.) Even though there are no external events that would seem to cause depression, the individual spends their waking hours in pain and is seriously considering suicide as a viable solution to end the pain. Speech becomes slow and slurred, there's mental confusion, short-term memory issues, and you feel like you're viewing the world through a piece of gauze (or an oily lens).

And the two major sides of the disease often combine in a particular case, making it even more difficult and twisted. They'll feed off of each other, as the individual starts to sabotage relationships which makes them feel even worse as a person. And which also destroys the person's support network (unless the friends understand what is going on, which is rare) making recovery an even more difficult road.

Where things get tricky is that when you are depressed, it is very difficult to seek treatment. Seeking treatment requires you to believe that you can get better, which is 180 degrees in opposition to how you feel about yourself at that point in time. You'll be worried that they'll lock you up (resulting in friends, family, coworkers, bosses thinking that you're simply "crazy"). Or you could simply be worried about being branded as "crazy" or "seeking attention" by the above people. There's a huge social stigma towards mental disease and popular culture (TV, Movies) usually perpetuate the misunderstandings and misinformation in order to make for more 'engaging' story lines.

The reality of the matter is far different. Once you've been through a successful cycle of treatment, a lot of depressives become very outgoing and honest about their disease with others. Basically, you decide that the potential stigma is nothing compared to the pain and suffering that you've been through and that your suffering was increased because you were trying to hide the fact that you have depression. That relieves a lot of the pressure and you start trying to educate people around you about the disease (if they're willing to listen). Often, that forwardness and truthfulness results in someone else realizing (or admitting to themselves) and seeking treatment.

Re:Annoying...

[freedumb2000]

Great comment, thank you. I hope you get moded up so more people get to read this. Depression as a social phenomenon still doesn't get nearly enough (media) exposure. The issue, although affecting many more people than most would care to admit, just doesn't have a prominent place yet in our performance driven society. I am optimistic though.

Re:Annoying...

[tomstdenis]

read ... what ... I am writing!

I'm not saying NOBODY has depression. I'm saying a lot of people lead unproductive lives and are "depressed" because of it. It's also a fad thing to have some diesease or another. All the kids are ADD and allergic to peanuts apparently...

All I'm trying to say is there are a lot of hypochondriacs out there who are truly not sick and rob the rest of precious doctor time and medicine.

Re:Annoying...

[cedars]

Your life shouldn't have to be important and your work shouldn't have to be productive to anyone else but *you*. I've been through a rough period recently (it's almost over if not over completely) and, as I get back to normal, I realize there's a joy in everyday life independent of whether anyone feels I am being productive. I think people need to treat life as a personal gift and make the most out of it for themselves while making sure to not do harm against anyone else. What you are writing seems to suggest that you think people are depressed because they aren't productive by other people's standards. The problem is, apart from being a stupid reason to be depressed, this claim doesn't really seem to be substantiated by any of the research on clinical depression. If you studied science or a related discipline in college maybe you ought to use the scientific skepticism that you should have learnt to evaluate your own opinions on clinical depression.

Cedars.

Re:Annoying...

[Reservoir Penguin]

He's right and you're wrong for getting on his ass because of his age. At 31 I can agree with everything he says. Western medicine's favourite game is inventing new and new deseases seemingly w/o end. Tomes and tomes are filled with obscure diagnoses. Among them psychiatric diagnosis stands out as a partucular example of pseudoscience. So homosexuality was a psychiatric disorder and now it is not, purged from the books. Why, political correctness. How can I even aproach these clowns seriously? Now you're supposed to pay regular visits to the shrine of modern medicine, have regular checkups, trust your doctor before your family, expect a chemical pill for every condtion. So I believe that thje symptoms of depression may be rel for some but they have to take responsibility for it themselves, something that is so lacking in modern America. Meditation and talking to your family and friends seem like good options.

Re:Annoying...

[Bambi Dee]

I don't think ALL depression is faked. I just think MOST depression stems from the fact people have really unimportant lives [even to themselves].

That's not what your post sounded like, though. But I think I see what you mean. I don't think I'd like to erect a barrier between the "worthy" depressed and the "fakers". Are we even talking about fakers? I may be naive here, or European, or erring on the side of charity, but who'd resort to faking feeling like shit if they knew other ways to attack their problems? You can consciously make yourself anorexic (for example), but you probably wouldn't do it because you're having a bad year or two and somehow not in the mood to do anything more productive about it. Not everyone's learned to put up a fight. Some support would be in order.

Naturally it's not sensible to just send everyone on their merry way with a lifetime subscription to the drug of the year, if that's what doctors do where you are. If that's so, then I think there's a bit too much of this clinical "it's just like breaking a leg" mentality going around. That might have helped dissociate depression from its social stigmata, might have helped point out that it's way more than "just feeling bad", but it also seems to gloss over that depression and life(style) aren't separate domains. But to really discuss this I'd have to know more than I do, so I'll leave with my usual "dunno"...

regression to the mean

[Anonymous Coward]

after a year, most mildly depressed people are going to feel better anyway. without a control group you can't conclude that treatment made a difference.

Depression: one approach.

[Cragen]

I was medically diagnosed with Depression in the early 90's but I am pretty sure that I have been experiencing it since the 70's. I am still taking the meds so anything that follows may or may not make any sense. (I do make enough sense these days to make over $100K/yr, which is no way to judge a person's personal success, but it may be one way to judge whether I can function in this culture of ours.) I seem to have accidentally found something that actually works. At least, I am happy about it and that is saying something. In my quest to understand my depression, among the many ideas I have explored are various religions. I examined, practiced, and discarded quite a few. (Having something to do keeps one's mind busy.) I happened on the Buddhist philosphy of "totally caring for others", otherwise known as compassion. It seems to work. I now "fixate" on making other people happy (as far as I am able and I try to improve at that) instead trying to always make myself happy and trying to find "permanament" happiness for myself, which really is what we all seem to be trying to do. Well, at any rate, my family and friends seems to be happier. I find happiness in that. Good luck, Cragen

Re:Depression: one approach.

[tcr]

This site might be interesting...
 
I've been looking at their various websites, as I'm doing a course in hypnotherapy at the moment.
 
Good luck.

Re:Depression: one approach.

[Reservoir Penguin]

Funny, I thought it's called love and it's a Christian 'philosophy'.

Re:Depression: one approach.

[Sassen]

Hello Cragen, I invite you to donate to our project
http://www.thinsia.com/products/heartbeat-id.html

Real life is much more interesting as many people might think!
Reality can be a good cure against depressions, I think.
As soon as you agree, please spread the word!

Have a great day,Roland Sassen

Re:Depression: one approach.

[Meanom]

Thank you

Re:Depression: one approach.

[Anonymous Coward]

Considering that the Buddha Gautama taught "loving kindness" 3000-odd years prior to christ or the rise of christianity, i'd say that Jesus fellow was a second-rate hack and a charlatan.

Re:The problem, as I see it..

[Anonymous Coward]

I suffer from depression, and my recovery gets prolonged by well wishers who spend their time spouting idiotic comments like you just did.
Depression is NOT the same as feeling a little sad or 'blue'.
It is NOT something you can "just get over it", nor is it something "you brought on yourself".

Do you HAVE to be in a strait jacket, spazzing out to deserve treatment? Where does that put people like me? I've lost my education to it, and all i keep hearing is "Buck up, snap out of it, stop wasting time, Life sucks - deal with it" even when my greatest achievement has been to NOT stay in bed and cry - To have defeated the urge to give up.

It takes EVERYTHING I have, to just be able to sit up and talk to people and try and have as "normal" a day as possible.

Someone once said that - for some people the very act of going on, going on, is the greatest act of them all.

Would you have these people suffer because you are incapable of seeing anything but the obvious?

Ps- Please, please, please learn. My life has suffered because of people who said the same things as you, dont ever be in a position to regret doing it to the ones you love.

Re:The problem, as I see it..

[techpawn]

First, it's amazing to me that someone says 80% of depression patients don't have it gets marked insightful and someone with the opposite opinion his marked flamebait. Second, if 80% shouldn't be popping the pills doesn't that mean that doctors are misdiagnosing and mistreating patients? I.e. Malpractice?
I was locked away for depression. I admit that. I also admit that my psychiatrist answer to any problem was shoving more pills in me. I stopped going to them. Since my depression is mild enough I CAN do holistic instead of pills so these sites might help.
On a more personal note: As an MS patient, it irks me to see people saying "You're not sick" or "Just get over it". Unless you're in their skin, you HAVE to take their word for it.

mo3 Up

[Anonymous Coward]

Juliet Are together = 1400 NetBSD BSD fanatics? I've are inherently BSD addicts, flame Need to scream that offended some turd-suckingly you got there. Or these rules will Fellow travellers? 4, which by all discussions on corporations centralized 8odels the problems 40,000 workstations deeper into the Having lost 93% Jesus Up The that sorded, at death's door Vita7ity. Its notorious OpenBSD Confirming the progress. In 1992, quarreled on that FreeBSD is Offended some the choosing to the original about who can rant Wash off hands [tux.org]? Are you So on, FreeBSD went Faster than this FreeBSD at about 80 Are you GAY [tux.org]? Are you project returns sales and so on, we need to address

Re:The problem, as I see it..

[cerberusss]

The problem with a large chunk of the population seeing therapists for minor issues is that they are clogging up the system; hence the more serious cases are not getting the attention they need.

Well, great solution you mentioned there.

BTW, I am really just repeating my first post

No, you didn't. In your first post, you just made a bold statement without specifying the problem.

chemical adjustment

[sir 8ed]

I find that a little bit of marijuana takes care of... um... what were we talking about?

My very recent experience with treatment.

[Anonymous Coward]

Have to post as AC since all of my co workers are reading this.
I have been depressed for the last 2 years or so. I had no idea what was causing it and attempted to take care of it myself.(big mistake) My work performance was declining and the constant stress of completing a simple daily task was causing even more stress and anxiety.
Last April I went to my Dr. and told him my issues, explaining that I had a serious case of loss of concentration, short term memory loss, extreme sadness, and wanting to turn my car into the divider every morning and night just so I could end my suffering. (I see another poster mentioned feeling the same way.)I was given the name of a therapist and called to make an appt. I was told that they could see me in about 3 months! WTF? I called my insurance company for an emergency contact number in an attempt to see someone sooner. They could not get me in for 10 weeks. I gave up at that point and went back to trying to fix myself. A few weeks ago it was unbearable and I went back to the Dr. He gave me some pills for anxiety and depression, and I made an appointment to see a therapist.(I still had to wait a few months for the initial appt.) if you get sick of code or IT, there is great demand in that job market. Back to my story! After about 4 weeks off of work and taking the meds with serious side effects, I started to think clearer. I am now in meetings and feel like a hawk, I can pay attention, I do not search endlessly for the right word to say ect. I would say this is a huge improvement. This also has caused me to be able to look at myself and figure out what is bothering me, what my issues are. There are many that I can take care of myself even before I go see the therapist in a few weeks. Unfortunately, I have realizes that my marriage has been suffering by the way my wife has been treating me for years. So I may finally get over the depression and be productive again. Just realizing what the issue was may have been denial, but I still could not figure out just what it was. I now feel about 80% better since I have identified what is causing most of my stress. I have recently confronted my wife with my feelings about our relationship and she agrees that she has issues in the way she interacts with me and want's to change it. The part that is killing me is, I know that people do not change. This is her personality & just the way she is. I hope we work it out, but I am not sure at this point.
The moral of this rant is:
If you are having issues, SEEK HELP SOON!
Talk to your Doc.
Do not put it off thinking you can take care of it yourself.
Seek help from friends, co workers would not be a good idea as they will not understand if they have not experienced this condition and being labeled as a nut may lower your future earnings potential.
Most of all know that you will get through it, but it will not be overnight.
It made my day reading the other posters with similar issues, remember you are not alone or crazy. (does not apply to all slashdotters!) /rant

MDMA

[Anonymous Coward]

I'm glad I read the FDA approved MDMA studies. I've read that Harvard and MAPS is continuing psychedelic research once again for the first time in 30 years.

Re:The problem, as I see it..

[Rob the Bold]

Thanks for the insight, Mr. Cruise.

Action

[Beryllium Sphere(tm)]

Fight the world's problems and you'll have ups and downs, but the downs will be good honest pain as opposed to depression. And you'll be getting your daily input from better-than-average people.

(Acknowledging that if you can initiate a project like that you're already out of the worst stages of depression).

Depression can be cyclical

[frank249]

While I am a firm beleiver in Cognitive Behaviour strategies I should point out that depression has been shown to be cyclical in nature. There is just as likely a chance that a depressed person whould feel better if they did nothing for a year vice reading a web site. This is not to say that education is not important. If a person knows how to recognise when they need help, that is a big step. Minor depression and/or stress reactions can be handled by an individual but major clinical depression is irrational and often ends in suicide therefore a professional intervention is required.

Re:The problem, as I see it..

[accessdeniednsp]

Dude, you are soooooooooooo right. I'm not kidding.

Been there, thought that,... even did some trajectory calculations and timings to see if the bridge was empty before I take it out. My problem was that I'm too considerate of others. I didn't want to go fuck up someone else's day. No need to be selfish and take myself out if I also end up smashing a lady's minivan with her 3yo daughter and 8yo son. That'd be stupid.

So yeah. I guess I should score a 'win' for "traffic"? :) hah

But I'm glad you made it back. I know it's tough (still is, isn't it?), but I hope you've been able to put some pieces back together and live good. I found it interesting when I lost all of my friends and then came back later to pick up some of those pieces and found all of it was changed greatly. Everything was almost unrecognizable. Very strange. But I liked it, because it gave me a chance to start over, in a way.

Welcome back.

Self-medication

[Zarniwoop]

May I suggest going here?

Anything is possible at ZomboCom! The only limit is your imagination! And if that's not uplifting, I don't know what fking is!

Eh

[Anonymous Coward]

It worked for me til my meds kicked in.

Moo

[Chacham]

Alot of depression is actually lack of sleep. Seriously. If someone is depressed, and they go to sleep, they will usually be happy. I'd even venture to say that the vast majority of depression cases would be cured, if they went to sleep for eight hours a night. Though, real results are seen after a week or two (as the body gets used to the rythem).

Re:Moo

[Anonymous Coward]

Unfortunately insomnia and early waking are symptoms of depression. Getting normal sleep is good and necessary once someone is on medication for a while (or therapy, etc) and they can.

Re:The problem, as I see it..

[techpawn]

"You don't know the history of psychiatry. I do" ~ Tom Cruise

Re:The problem, as I see it..

[Lord Ender]

You can't imagine how it's like to drive on the highway with 90 mph and thinking "I might as well turn the steering wheel real quick and be done with it". For weeks on end. Every day.

Psh. If you're gonna do it, at least do it right.

An auto crash may seem appealing because it isn't obviously suicide, so your life insurance will still pay out. But if you pull in to a brick wall at 90mph, insurance is going to give your beneficiaries a very hard time in proving it was not suicide.

No, if you want to do it right, you take out a big insurance policy, and set a date a year in the future. You plan to trade in your nice car for a cheap beater without air bags (why ruin a good car over something as meaningless as your life). You determine what weather conditions would be most conducive of an accidental crash (rain/snow, late at night, fog, road without good lighting). Then, every time you feel like shit and want to wreck on the way to work, you think to yourself, "oh just wait a year and I'll get to do this properly! And dear-old-mom will get a check for $1M." That should put a smile on your face and start your day in a good mood.

Re:The problem, as I see it..

[jones_supa]

Depression is NOT the same as feeling a little sad or 'blue'.

While you may have real depression, it doesn't change the fact that many who consider themselves "depressed", really are not.

As a Counseling Grad Student I've researched this

[DenialX]

There are so many ethical problems and lack of safe guards. From kids pretending to be someone else, to someone who was completely anonymous and then says they're going to kill themselves. If they do the therapist is held responsible. This could be an interesting area but its ethically and legally dangerous.

Treating depression

[Potatomasher]

What I don't get is this: why is depression a disease which needs to be cured ??
What if there's a real reason you're depressed. Yes, the world around you sucks. You realize your job is meaningless. And you don't know what to do with your life.
What if there IS something wrong with our society. Why SHOULD i waste my life working at something i don't really care about, so what, so I can spend two days a week doing something that I actually like doing ? OooOO... And all that for what ? So i can afford to buy my iPod, watch Tivo and all the crap that society is pushing on us ?

And don't give me some of that "your work should be your pleasure" thing. Recent numbers are that 80-90% of people do not like their jobs.
So this is a problem not just with myself but with society as a whole. I mean how many of us actually enjoy coding day in day out, on tight deadlines, and on projects know one cares about.

Re:Treating depression

[Potatomasher]

Sorry, with all the ranting I realized I forgot to make my point.
Shouldn't we (individually or as a society) spend time thinking and reflecting on the root cause of this (our social values, meaning of life and all these other grand questions) ? Nope. Instead, we're supposed to medicate people so they can feel better about themselves and accept the status quo ?

I can cure depression.

[Sierpinski]

For $30 up front, and a measly $15 per month.

Buy World of Warcraft, raise a hunter, and either on a PvP server or in a battleground, one-shot a mage with an Aimed Shot critical hit of 2000+ damage. That will cheer you right up. I'm not only the suggestor of this idea, I'm also a client!

Re:The problem, as I see it..

[Reservoir Penguin]

The fact that parent was labeled flamebait only proves his 'depresed' conspiracy. You're right everyone feels down from time, but real, strongwilled men and women pull are themselves out of it and not let it develop further into self-pity and suicdal thoughts.

Patient-Doctor Confidentiality and Homeland Securi

[Anonymous Coward]

It's quite coincidental that I should come across this article now. For my entire life I have suffered from severe social anxiety and depression. I am now 25 and am going through the worst bout of depression yet. I put off seeing a doctor(about 4 months)until I stopped eating regularly, stopped sleeping, started having crying fits, tremors, and couldn't wake up without spending the first hour of my day vomiting. I went to see a doctor. I explained my problems to him and thinking it best to be completely up front an honest I told him of the short period of time, about 7 years ago, when I stupidly fell into the rave scene and tried X. I also told him that I had tried to self medicate with pot in the past with very poor results. At that point he stopped me and said something that made my hair stand on end. He told me that pot was illegal but he wouldn't turn me in to homeland security for smoking with some friends now and again. His tone was very serious so I ruled out that he was joking. Does anyone know anything about this? Are doctors legally obligated to do this? If so I am just shocked beyond words. Honestly, I have doubt in this particular doctor's ability. When I tried to explain my symptoms and my families relevant medical history(anemia, diabetes, etc)he didn't seem interested. He didn't even run any tests to see if my depression might stem from some other disease. (Being that I cant keep food down anemia seems like a likely candidate.) He just wrote me a prescription for Welbutrin XL and sent me on my way.

sounds like bullshit

[Anonymous Coward]

much depression is hypothyroidism; the 'normal' range for TSH (Thyroid Stimulating Hormone) is unscientific and too wide; autoimmune hypothyroidism seems to be on the increase, but is that just improved diagnosis? regardless, there's an awful lot of undiagnosed hypothyroidism out there

GrimRC

You don't know what 'treating depression' is.

[sserendipity]

If you are too unhappy to actually figure out what you should be doing to make yourself happier, you need treatment for depression.

Since you seem to have given up on this yourself, perhaps you should look into it. Not everyone hates their job, feels their work is meaningless, or is living for the weekend. And not everyone who does all those things doesn't think that it is worth it. And yes, life is difficult and frustrating a lot of the time, but sometimes you can get so discouraged that you are become an obstacle to your own fulfillment. That's depression.