My son, who is diagnosed with ADHD, anxiety, depression, and OCD, and who has been in talk therapy, on SSRIs, and other interventions for years, recently started LENS therapy, also called neurofeedback. (I'm on mobile device, otherwise I'd find the link.) It sounds a lot like a form of TMS.
He's had something like 7 sessions, each lasting maybe 15 minutes. The results are nothing short of astounding for our family. He's typically been... Extremely difficult to parent. After his LENS, lasting about a week, he is a pretty happy kid who participates in family and social life. His anxiety previously prevented him from engaging with friends for more than an hour. Just the other day, he was out at a birthday party for eight hours and still cheerful afterward.
I'm very hopeful that there is a long term, lasting effect for this kind of thing.
That's wonderful that it's helped your son so much. I have done TMS and am curious about LENS for myself and family who have symptoms similar to what you shared. We too have tried most everything else and daily life is an absolute grind.
How many sessions did your son require and how long are the results expected to last?
To be honest, I don't know how long LENS will be for us. We're doing weekly sessions. It's not supposed to be indefinite, but I don't know at that point we taper down or stop.
Results were pretty much immediate, though. After his first session (maybe only a few hours later), he self-reported improvements and we noticed a definite change in his mood and attitude.
My son has had a similar spectrum of issues to deal with over the years. He has been through a series of stimulants and now on SSRIs. All of the medicines we have tried have been hit or miss, mostly miss. I hope something like what you suggest is now seriously being looked into as possible way to improve people's life. Will you be able to share more information/links on the treatment specifics. I couldn't find anything substantial just by googling.
I have had what seems to me to be depression for most of my life (40+ years). I have been fortunate enough to have a kid and, now, I guess I just don't have time to be depressed or something because most of my thoughts of ending life etc have, quite thankfully, gone away. I'm really not trying to be off-putting when I say this but I do sometimes wonder if some instances of depression aren't simply a cause of people not having families. I'm not totally confident about this, but ... really I think having kids gets looked down on for all the wrong reasons and maybe our deepest drives are all tied to having them.
> I do sometimes wonder if some instances of depression aren't simply a cause of people not having families
As a child raised by a depressed and emotionally unstable parent, I have to disagree. Being well-adjusted is a good predictor for being a good parent. Even if in some cases people with mental health issues have a positive transformative experience, it's at best a dice role to treat it as therapy, and early childhood trauma is the collateral.
A counterpoint: Speaking for myself who had also been mildly depressed since teenage years, it didn't kick off into actual breakdowns and medication until after having kids. Previously it was probably so mild it wouldn't have counted as depression.
> It is best known for being active when a person is not focused on the outside world and the brain is at wakeful rest, such as during daydreaming and mind-wandering.
Apparently, activation of the DMN is correlated to rumination, itself correlated to depression.
Interestingly, one thing often suggested to counter depression these days – meditation – generally says right on the tin that you're supposed to get into a wakeful rest state, but specifically try to avoid daydreaming and mind-wandering.
(I should say that I'm no expert. Just passing along things that I've heard/read.)
Broadly speaking, engaging in a task activates the task-positive network, which actively suppresses the default mode network [1][2][3]. This likely happens during meditation [4], as during properly done meditation, one is supposed to be focused on the task of breathing. But this can be interrupted, particularly by stray thoughts/salience/attention shifts [5].
There are many examples of people who are obsessed by work, and at the same time depressed. While the distraction can temporarily take away the depressive thoughts, it is by no means a solution. I think the social aspects of raising a kid could be a better explanation.
Might also be the additional social interaction (the kid is a human, even if a small one). I think many people felt this during the pandemic and its lockdowns.
I feel we have "depression" the same way we get "colds", try to rest hoping it goes away. Most of the time it does, and sometimes it's something else completely, but in contrast to colds, we have no good tool to properly diagnose the exact illnesses, and are probably lumping together myriads of different things under the "depression" umbrella.
That also matches how treatment for depression often involves throwing spaghetti at the wall and see what method and treatment sticks. Even medication usually goes through trying different chemistries a month or two at a time and see what has any effect.
I've had friends who went out of depression by quitting their soul crushing jobs to start solo businesses. I expected they would slack a bit more and be more relaxed as self employed, but from the sidelines they looked way more busy, working way harder and longer than before. Except it seemed to work for them and they're still doing i years later.
Your story kind of resonates the same to me, and
I assume the family building part can be proxied by different goals, stuff that actually matter and bring sense to what someone is doing in life and/pr a different human environment. It might not work for everyone, but I agree there must be a sizeable portion of "depressed" people who's cure are not more medication or less work, but radical changes in other aspects of their life.
> but in contrast to colds, we have no good tool to properly diagnose the exact illnesses
Isn't this the case with "colds" too? At least in practice.
Maybe it's my bad luck, or location-specific (Poland, EU) - but ever since I became a parent (and saw myself visiting doctors 10x as often as before), I've started to notice that, unless it's one of few very specific diseases, you just can't seem to get any diagnosis for a "cold" from a doctor. They'll prescribe you/your kid some meds or treatments, but nowhere in the conversation they say "you have ${specific illness}". No such information seems to show in medical documents either. If I ask, they always manage to deflect the question without even acknowledging it (I haven't tried to insist yet, I don't want to be rude to someone who's nice and helping me).
Is this because they genuinely don't know anything beyond "one of many pathogens that cause this group of symptoms", but it doesn't matter because they all respond to the same treatment options (or don't respond to anything, and you're just treating symptoms)? Or is there a practice of not giving such information to patients?
> now, I guess I just don't have time to be depressed or something because most of my thoughts of ending life etc have, quite thankfully, gone away
Negative thought loops, aka rumination, are strongly implicated in many kinds of depression. If you no longer have time to indulge in ruminating, that's one way to break such loops.
I'd wager that depression is merely a symptom of learned helplessness, a natural response to being repeatedly powerless in circumstances one is vested in the outcome of. A result of being repeatedly and extremely frustrated, and/or being in circumstances of great cognitive dissonance despite ones attempts to resolve it.
It seems to me the best way to fight depression, is to contimually distract yourself (particularly with an activity you can control), from whatever is depressing you. As if, by being busy, so much, that you end up forgetting about those depressing things. I know it's easier said than done, but to me, it seems to work if you're able, whereas focusing or dwelling on the depressing things, seems to further depression.
People who suffer from chronic depression do so without regard to circumstance. It's a mental plague that follows one wherever they go, whatever they do. It has nothing do with reactions to anything. There's nothing reasonable about it.
I read a book called “Lost Connections” which pretty much solidified my belief that most depressions are actually a reaction to something that a person doesn’t feel right about in their life, and is not making any effort to change, because they might not even be aware.
The theory you're describing is "depressive realism". It's hotly contested. In some ways, depressed people can make more accurate assessments, as most people have an optimism bias, but their assessments get unrealistically over-pessimistic as time passes.
Given the general tech-dystopian living conditions and % distribution of non-free software throughout the population: depression would be near universal if this was truly the case.
I kept saying this for years on HN but until the 2022 study it was always voted down and told that NO, it is due to a chemical imbalance and that we don’t understand
It does? As someone who has decided not to have children, I feel very much like I’m the outcast. Particularly in the southern US. Also, here on HN where there are a shocking number of parents compared to say, Reddit.
I think for myself it comes down to feeling like you have purpose so that you can wholly commit to something where you’re so busy that you don’t have time to get yourself depressed.
> “It’s almost as if you’d already decided how you were going to feel, and then everything you were sensing was filtered through that,” he said. “The mood has become primary.”
This is 1000% what depression feels like, once you've properly come to terms with it. Your brain seems absolutely compelled to apply the most horrific, negative interpretation to everything that happens to you.
Even when you understand it's wrong, or at least heavily negatively biased, fighting those interpretations feels like trying to swim upstream in a terrific current.
The most valuable thing I've gotten from the past several years of therapy is a better model for how humans actually process information. The simple model a lot of people have is:
1. Receive some stimulus, input, or experience.
2. Process and understand it.
3. Respond to that emotionally.
What we actually do is more like:
1. Receive some stimulus, input, or experience.
2. This data is way too ambiguous to make sense of on its own. So to turn it into coherent information, interpret it through the lens of a narrative about who we are and how we expect the world to work. This happens automatically and unconsciously.
3. React to that interpretation emotionally.
4. Watch logical rational brain then scramble around trying to come up with a coherent story that explains why we started feeling a certain way. The answer it comes up with may or may not agree with the unsconscious process that happened in step 2.
So much of therapy is "Why does X make me feel Y?" How do I fix X? The answer is almost always that X doesn't make you feel Y. X in the context of belief Z you have about yourself leads do you feeling Y. You fix Z by questioning the often toxic beliefs you hold about yourself. But it can take a lot of work and therapy to even be able to see Z, much less root it out and install a better narrative.
Love the level of introspection going into this post. I'm compelled to add my own two cents to your narrative since it's helped me.
I think step 4 is where people really get caught in a feedback loop. You come up with a reason why you should feel bad, and then you do (step 3) and before you know it you're back at step 4.
One approach is to try and cut it off at step 2 like you mention, but I've found this to be a never-ending rabbit hole because installing a better narrative requires constant work.
While of course it's not bad to work toward a better narrative of yourself, I've also had great success with meditation and humility targeting step 4. My friends with anxiety and depression all (somewhat paradoxically) are extremely confident when it comes to the rational side of their thoughts. They think they've got it figured out and it's just their emotions or other people that are the problem. I train myself in meditation (don't rationalize at all) and humility (recognize that my rationalizations are never going to be accurate).
It's incredible to me how little insight our conscious selves have into what's going on in our subconscious. It seems like almost all the cognitive hard work goes on in the back end systems and the front end we usually think of as being 'us' is just a thin veneer of awareness. Like a user interface between our unconscious selves and the rest of the world.
So when I'm speaking the words just come out. I've got a vague sense of where I'm going and the point I'm about to make, but it's certainly not verbal at that stage. My wife has afantasia, which is not a condition or anything as such, it just means she has no inner monologue and hears no inner voice when e.g. reading a book. Conversely one of my daughters says she is consciously aware of what she is about to say in words several seconds in advance even while speaking rapidly. My mother is an amateur artist and says she has crystal clear visual imagination and photographic memory.
There seems to be a significant variation in how our conscious and cognitive processes work between individuals, including some having varying levels of access to cognitive mechanisms that in others are completely subconscious.
That's just one example of very significant differences between individuals in one family, even in direct lines of descent, so this doesn't seem to be entirely genetic. It leads me to suspect that there may we be similarly very significant variations in how all sorts of other cognitive functions operate between individuals.
I'm sure there's an overall architecture to our brains and neurological machinery. Various brain areas are clearly specialised into particular cognitive functions, but it may well be that, within those areas, how our brains get to implement those functions might have quite a bit of variation.
About 2-3 hours after you posted, a different section of this discussion was started bendbro and Rury;
My personal belief is that SOME cases of your Z are caused by a 'learned helplessness' situational conditioning filter. The world isn't always fair and sometimes even earnest effort that in an ideal world should yield some sort of positive result has none.
Hypothetically the human social creature evolved in small tribes / large families. Possibly in those cases slight negative reactions like that would be corrected by the presence of the family. In the distraction model of recovery possibly by redirection to a more useful effort that would yield positive outcomes for the individual and group.
In modern cities, it is very easy to end up alone, or nearly alone, with very few to rely on. Even if someone has friends in a city they might be real effort to reach, and that is assuming they've got time. If there's that effort involved maybe you don't even hang out with them and drift apart until even chance meetings cost effort and thought.
That is what depression felt like to me as well. I’ve written a book about it, Can’t Be Trusted. It is a memoir about engineering, mental health, and aviation. Here is more information about me and my book: https://cantbetrusted.org/?page_id=262 As a laser engineer with an interest in computing, I think this book would be of interest to the tech community.
Simply by posting it you'll get someone's attention (like myself!)
However you may get downvoted because you asked how to get upvoted, which can be counterintuitive if you're Neurodivergent (like many of us). It's ok, that's not how you intended it, but that is most likely not a helpful part of the message here.
This is one of the few times I've heard an accurate and concise description of what it feels like.
I like the metaphor of the spiral wishingwell. The coin/ball represents the level of depression you sink into. The gravitational draw of the void makes the spiral go faster unless you figure out a way to pull out of it and the longer you wait the harder it is to pull out cause it's moving too quickly.
So the trick becomes keeping the coin/ball off of the spiral
The only way out is through. One way or another, once you reach the shore on the other side, the time spent in the water doesn't seem so bad anymore.
Just another perspective to lean on when understanding others.
Once you confront it in the most absolute sense, something akin to ego-death occurs, and you make a decision about whether it is worthwhile to continue.
Everything comes from and swings back to chaos. Embrace it and you will be free.
> Even when you understand it's wrong, or at least heavily negatively biased, fighting those interpretations feels like trying to swim upstream in a terrific current.
Achieving it still feels like the end of "A beautiful mind", where there are people hanging out in the room that are not there. They sound like they are they, they feel like they are, they smell familiar. But they are not real and will disappear some wonderful day, as they always do. So you just nod to them and go on with your live.
And none of the actions you used to do are linked to a joyful anticipation, it's like all weights have been reversed. That's how you end up stuck in bed, there's no idea in your brain that can trigger the motivation center, eating, walking to a room, standing.. nothing.
The few that remained (in my personal case, can't speak about others) was a strange sense of gamification of everything. Lift that spoon with only one finger. That allows some influx of positive will but it can get drained real fast (to the point of physiological collapse .. a bit like narcolepsia)
And yeah, long term management basically teach your brain to desensitize to its own bugs so you can at least not drown in negative emotions. But it's a double edged sword cause you're tapering down your own self in the process.
This is why the related concept of "catastrophizing" comes up so much in the context of therapy:
> Catastrophizing is a cognitive distortion that prompts people to jump to the worst possible conclusion, usually with very limited information or objective reason to despair. When a situation is upsetting, but not necessarily catastrophic, they still feel like they are in the midst of a crisis.
Anecdotally, many of the people I know with a tendency to "catastrophize" later suffer from clinical depression. The depression only exacerbates the problem.
Even more anecdotally, catastrophizing seems heavily correlated to the usage of certain social media platforms in the young people I've worked with. I don't know which direction the causality flows, but I do know that people who consume a lot of Reddit and Twitter seem to think the world is ending and everything is terrible. They can tell me about every political scandal, every shooting, every tragedy, and every natural disaster that happened in the past week. Eventually they come to believe their news sources are representative of the entire world, forgetting that none of these things are happening to them personally.
It's a weird doom loop spiral. Even weirder is that many of the people caught in it feel convinced that they "don't do social media" because they're not on Instagram or TikTok, yet they consume hours and hours of doom and gloom social media like Reddit all day.
This is why the news has always been bad, since way before social media. Disasters, war, scandal, and death have always been more engaging. Also why gossip is almost always negative.
Our brains evolved to deal with what was happening in our immediate vicinity. This was usually fairly neutral to pleasant, with maybe some moments of sadness, loss, alarm and danger. We just aren't mentally equipped to process an unending stream of bad news and really keep the perspective that these things are not happening to me. It's best to just avoid sources of that.
I stopped watching and reading the news a few years ago, and generally feel much less stressed about day to day living.
Reddit is my Achilles heel for the very reason you outlined.
I quit Reddit and I remember the exact day it happened. I found myself typing and deleting a reply to a comment that was overly negative on something that I was well versed in. I knew this person was incorrect and taking a knee jerk cynical approach.
At some point I just said what the hell am I doing here I need to not be on this website anymore.
Which makes sense why CBT style therapy has shown effectiveness because its main focus is challenging those interpretations. No doubt even with those tools it is still a major challenge.
One interesting thing to point out is CBT is so effective because it's somewhat easier to stick to than other approaches. Meditation, for instance, is equally effective if you keep with it, but most people realistically won't.
Right. A good approach to depression is to learn to simply "turn the TV off" and quiet your brain, but it takes practice to learn how to do that.
More broadly speaking though, depression is partially like being stuck in your foulest possible mood for years, with the full knowledge that it's not going away, at least in the near term.
wild, this explains a particular relationship. I deliver what I perceive as good news and the response is consistently the worst interpretation of every detail.
That actually sounds more like anxiety about the relationship, and now that I think of it what I'm describing is more like a (very common) combination of depression and anxiety.
What does "brain signals traveling" even mean? The brain is highly interconnected with both forward and feedback connections at all levels. Both of the mentioned regions are always active and always sending signals bidirectionally. fMRI is a slow, low resolution approximation of brain activity, so I'd really like to know what they are actually measuring as opposed to some clearly reductive analogy of what they suspect might be an underlying cause for that observation.
I assume they are checking the timing of the activation cycles ?
For instance if sending a strong sensory stimulation first triggers a higher activity level in one part before the other, that could be interpreted as directionality.
Don't know who needs to hear this. I started a food diary after an elimination diet which restored my energy levels.
I don't know the reasons, but you're looking in a time window of four-seven days.
When I stray from my diet (meat and water) one day. I become mentally unstable after 4 days. It says for 3 day, then gets good again.
Crying for no reason, ruminating, poor sleep, strong sour smell that can't seem to be removed by washing but can be suppressed by a strong anti transpirant.
Going for sibo testing soon, if it's not hereditary, enzymes might be a solution. If it is, Pankreas is up for investigation next.
Been looking for solutions since 2018, no doctor could offer an explanation so far.
Definitely have experience with the same thing with food. I did end up finding out it was my Pancreas and take enzymes with every meal. Really really helps and has given me way more energy and my guts feel 90% better. Still have to watch certain foods and drink plenty of water but it is way better. Good luck.
Curious to try this but I’m unfamiliar. What kind of enzymes did you find helpful? (What’s the name of the product if you don’t mind sharing?) Are they over the counter or prescription?
Other comments have proposed that depression may have multiple underlying causes, and thus may require different treatments.
I'm curious about the other direction of thinking. What do SSRIs, psychedelics, CBT, and TMS all have in common? Suppose that there is one common cause, or one at least one cause that applies to 90% of cases. And it's treated by all these seemingly disparate methods.
That's what tickles my curiosity the most, as it begs a more fundamental question about the functioning of the brain.
Maybe the author's theory is correct: brain signals between certain regions are going the "wrong" way in depressed patients. That would imply that SSRIs are causing the same shift. God, I would love if the authors tested that. And then we can finally dig into why SSRIs work (we don't current know). If they're causing shifts in brain activity flow, then we can find out how. And from there maybe we can treat other mental diseases with better pharmacological or TMS solutions. Are things like schizophrenia arising from a similar bad pathing of information around the brain?
Psychedelics is also a weird one. People have proposed many theories as to their mode of operation for treating depression. But now I wonder, based on this research, if the key factor was just the disassociation from one's body and altering of senses. The other effects like connecting disparate thoughts, forming more brain connections, ego death, etc may not be related at all. That could lead the way to more targeted drugs.
Really cool stuff. If if pans out, of course. But unlike other theories of depression, at least this one is easy to test.
If you consider that CBT scratches a need for deep socialization, they all basically act on serotonin in different ways. I don’t buy the oversimplified “depression is when your brain doesn’t make enough serotonin” model but it does seem there is a strong connection.
Maybe there is some kind of local optimum your serotonin-mediated pathways can get stuck in and need help getting out of. In fact, this (generalized outside of just serotonin) is something I do buy as a basis for depression: your brain enters some local optima or learns some poor but good-enough coping mechanisms that keep you going but prevent you from fixing underlying issues (whether it be due to maladaptive behavior, framing or interpreting things negatively, low self esteem leading to poor social performance and consequently lower self esteem). That’s also kinda what CBT is about addressing
My understanding of SSRIs is that most of them slow/lower brain activity in some way, so with no specific directionality or acting on specific parts of the brain.
My mental image of it is keeping a classroom under control by stopping every kid from talking to their neighbors.
Unfortunately, TMS is extremely expensive and not likely to be covered by most insurance plans. Even with a decent PPO, I was quoted about $1k a treatment and they said I needed at minimum 30 treatments.
There are effective alternatives which are a fraction of the cost: ketamine (sublingual ~100mg every few days), psilocybin (free? cheap 2-3g ~4 weeks), rapamycin + ketamine also seems promising (https://www.nature.com/articles/s41386-020-0644-9).
Note the disclaimers, especially "TOUCHING THE DEVICE WRONG DURING ASSEMBLY CAN INSTANTLY KILL YOU. THIS DEVICE COULD KILL YOU OR MAIM YOU OR BREAK YOUR MIND."
However the other things you're posting are alternative chemical treatments. People with resistant depression have already tried the approved chemical remedies. While I broadly agree that there's evidence in favor of both psilocybin and ketamine being potent chemical anti-depressants, I also think there's a number of valid reasons for someone to reach a point where they don't want to try any other chemical remedies, and ECT / TMS become more compelling options.
Another issue is that the effect doesn't seem to be permanent, and additional treatments as time goes on has been observed in people who show improvement from the treatment. So, I really hope it gets much cheaper.
Still, it is an FDA approved treatment, so for other readers suffering from depression, it's worth seeing if your insurance covers it. For me, it was covered, and worth it.
Biohacking is not feasible at this time—at least in my opinion:
* TMS machine is a powerful precise device that is expensive and unlikely to be safe from doing-it-yourself
* Every brain is different, so, you’ll need to get an MRI if not an fMRI to understand the structure to target
* Once you have a target, you’ll need to align the device with your skull
* It’s not clear how you’d measure or control the regime on the brain, even if you made it to here
The last thing I’ll say is that you should look for the complaints made against TMS device manufacturers. I’m optimistic that this approach will work for some people; I know many people who could benefit from this technology but I’m not comfortable with recommending it to a family member when I know there’s a risk of permanent brain damage, tinnitus, etc.
disclaimer: I acknowledge depression as an illness and state of being.
that being said, if you take someone who is objectively "not depressed" and apply these same depression treatments, what would happen? some state of euphoria? heightened mood? happiness?
suppose that new state is now the normal state in which people are judged against. now, the before-mentioned person who was not depressed, may be considered depressed, relatively. so you now apply the same thought experiment again. clearly this can be recursively done infinitely...
such is an inflationary view. so my question really is around the cultural vs. biological construct of depression. what if it's ok to be depressed? this is not to say that we shouldn't be trying to "treat" it (and the symptoms), but I do wonder at what point do we say it's OK.
I would propose the following analogy as an answer:
1 - Person A has the flu
2 - Person B does not have the flu
3 - Person A treats the flu with rest, fluids and antiviral medications
If person B also rested, drank fluids and took antiviral medications, they would not become an unusually healthy person. Person B would not become the new normal.
What you're proposing is that it's OK to be sick. We treat every other form of illness with aggressive treatments. Depression is often ignored, poorly treated or treatment is inaccessible to many people due to cost.
Instead of imagining that it works like a number line and then observing that you can use induction, you could measure outcomes: suicide, suicidal ideation, quality of life, etc.
That puts a pretty reasonable lower bound on what is or isn't depressed. It is absolutely an altered state of mind, and an information processing disorder.
For anyone who might feel like "it's ok to be depressed", this is not a normal thought, and there is no normal amount of suicidal ideation. Seek professional help or strong social support; just ask for help anywhere it might exist (go to an emergency room and just have a seat if you must). If you aren't depressed, these thoughts literally don't happen, as strange as that may sound if you are in the thick of it.
This line of reasoning reminds me of a common misunderstanding of depression I've seen from people who've never been clinically depressed (1). It's an understandable mistake, albeit potentially dangerous (2).
Depression isn't on the happiness-sadness scale. It's quite tangential to that. In fact, perhaps quizzically, you can be happy and depressed. It's fairly common for people who learn about the loss of a loved one to recall how happy them seemed the day before.
Depression treatment, therefore, doesn't make one "less sad". And consequently it wouldn't make a healthy patient "more happy".
(1) I don't mean this in a negative way towards the comment I'm replying to. Nor am I implying that the commenter believes this. I just noticed a pattern and I'm responding in the spirit of education.
(2) It's okay to not understand depression; not everyone has to be an expert on everything. It only becomes dangerous when providing ill formed advice. Which is unfortunately common when it comes to depression.
The point I was trying to make isn’t about happiness or sadness per se, rather they depression has mental analogs that presumably are improved after treatment.
It's not okay to be depressed because it sucks to be a person who is depressed. Being depressed is not a nice state to be in.
This isn't an "ooo society is wrong" type of situation. Sure there are some societal pressures to appear happy which can make depression _worse_, but depression is still awful regardless of those and we treat it because it's awful.
one common effect of SSRIs is that they can dull emotions. This is helpful and can be a positive effect if you are very depressed or get stuck in anxious spiraling.
If you're very stable and happy emotionally, then that dulling might be unpleasant.
Beyond that, while SSRIs tend to have fewer side effects and be more safe than many other classes of anti-depressants, even SSRIs have very noticeable side effects. They are very easy to stomach if they make a dramatic difference in your mood and quality of life, but if you were already mentally well the side effects will be more impactful than whatever benefits you might get.
Exactly this. I take a low level of SSRIs because I am an otherwise highly functioning person who has a tendency to get into severe anxious spirals that can last days on end and induce vomiting. I do all the things that a person should do to mitigate, including meditating, exercising, lots of friends, etc etc.
I know that my medication dulls my most intense emotions, but that is the point. It is slightly sad knowing that I don't experience the highest highs that I used to, but it is completely worth it to stop experiencing the lowest lows that were completely debilitating. I would stop taking them immediately if I could be assured that I wouldn't fall back into physically debilitating anxiety.
Or, SSRIs dull you to the point of feeling like an observer (rather than participant) of your own life, which makes one even more depressed and hopeless.
It’s ok if it isn’t purposeless suffering which clinical depression most certainly is. Having an occasional low mood or a temporary bout of depression due to a bad event is ok because it is informing you that something bad has happened and maybe you should retreat from normal life a bit to deal with it. Just being depressed all the time because your brain got messed up somehow is not a state anyone should be left in.
Some symptoms are not OK in an absolute sense. For example, the exhaustion. It can be disabling (along with all the other nice things that go on inside your head) and go on for months without a break.
Readit News
He's had something like 7 sessions, each lasting maybe 15 minutes. The results are nothing short of astounding for our family. He's typically been... Extremely difficult to parent. After his LENS, lasting about a week, he is a pretty happy kid who participates in family and social life. His anxiety previously prevented him from engaging with friends for more than an hour. Just the other day, he was out at a birthday party for eight hours and still cheerful afterward.
I'm very hopeful that there is a long term, lasting effect for this kind of thing.
How many sessions did your son require and how long are the results expected to last?
Results were pretty much immediate, though. After his first session (maybe only a few hours later), he self-reported improvements and we noticed a definite change in his mood and attitude.
Doing a quick search, I found the following: https://www.enrichingfamiliesnow.com/lens-neurofeedback-1
However, are there better links?
Deleted Comment
As a child raised by a depressed and emotionally unstable parent, I have to disagree. Being well-adjusted is a good predictor for being a good parent. Even if in some cases people with mental health issues have a positive transformative experience, it's at best a dice role to treat it as therapy, and early childhood trauma is the collateral.
Keyword here is “some.” One instance that does not fall in this category doesnt suggest there arent some cases that do fall in this category.
All behind me now that they've mostly grown up.
From neuroscience, there's the default mode network.
https://en.wikipedia.org/wiki/Default_mode_network
> It is best known for being active when a person is not focused on the outside world and the brain is at wakeful rest, such as during daydreaming and mind-wandering.
Apparently, activation of the DMN is correlated to rumination, itself correlated to depression.
https://pubmed.ncbi.nlm.nih.gov/31655111/
Interestingly, one thing often suggested to counter depression these days – meditation – generally says right on the tin that you're supposed to get into a wakeful rest state, but specifically try to avoid daydreaming and mind-wandering.
(I should say that I'm no expert. Just passing along things that I've heard/read.)
Edit: formatting
[1] "The human brain is intrinsically organized into dynamic, anticorrelated functional networks", https://www.pnas.org/doi/abs/10.1073/pnas.0504136102
[2] "The Brain's Default Mode Network", https://www.annualreviews.org/doi/10.1146/annurev-neuro-0710... {search for 'task-positive'}
[3] "Neural antagonistic mechanism between default-mode and task-positive networks", https://www.sciencedirect.com/science/article/pii/S092523122...
[4] "Mantra Meditation Suppression of Default Mode Beyond an Active Task: a Pilot Study", https://link.springer.com/article/10.1007/s41465-017-0028-1
[5] "Modulatory interactions between the default mode network and task positive networks in resting-state", https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017816/
“Idle hands are the devils workshop”.
That also matches how treatment for depression often involves throwing spaghetti at the wall and see what method and treatment sticks. Even medication usually goes through trying different chemistries a month or two at a time and see what has any effect.
I've had friends who went out of depression by quitting their soul crushing jobs to start solo businesses. I expected they would slack a bit more and be more relaxed as self employed, but from the sidelines they looked way more busy, working way harder and longer than before. Except it seemed to work for them and they're still doing i years later.
Your story kind of resonates the same to me, and I assume the family building part can be proxied by different goals, stuff that actually matter and bring sense to what someone is doing in life and/pr a different human environment. It might not work for everyone, but I agree there must be a sizeable portion of "depressed" people who's cure are not more medication or less work, but radical changes in other aspects of their life.
There's lots of evidence that doing the opposite of rest - aerobically exercising - helps tremendously with depression (and lots of other issues).
Isn't this the case with "colds" too? At least in practice.
Maybe it's my bad luck, or location-specific (Poland, EU) - but ever since I became a parent (and saw myself visiting doctors 10x as often as before), I've started to notice that, unless it's one of few very specific diseases, you just can't seem to get any diagnosis for a "cold" from a doctor. They'll prescribe you/your kid some meds or treatments, but nowhere in the conversation they say "you have ${specific illness}". No such information seems to show in medical documents either. If I ask, they always manage to deflect the question without even acknowledging it (I haven't tried to insist yet, I don't want to be rude to someone who's nice and helping me).
Is this because they genuinely don't know anything beyond "one of many pathogens that cause this group of symptoms", but it doesn't matter because they all respond to the same treatment options (or don't respond to anything, and you're just treating symptoms)? Or is there a practice of not giving such information to patients?
Negative thought loops, aka rumination, are strongly implicated in many kinds of depression. If you no longer have time to indulge in ruminating, that's one way to break such loops.
It seems to me the best way to fight depression, is to contimually distract yourself (particularly with an activity you can control), from whatever is depressing you. As if, by being busy, so much, that you end up forgetting about those depressing things. I know it's easier said than done, but to me, it seems to work if you're able, whereas focusing or dwelling on the depressing things, seems to further depression.
The theory you're describing is "depressive realism". It's hotly contested. In some ways, depressed people can make more accurate assessments, as most people have an optimism bias, but their assessments get unrealistically over-pessimistic as time passes.
Given the general tech-dystopian living conditions and % distribution of non-free software throughout the population: depression would be near universal if this was truly the case.
It does? As someone who has decided not to have children, I feel very much like I’m the outcast. Particularly in the southern US. Also, here on HN where there are a shocking number of parents compared to say, Reddit.
Something like 85% of people over 40 have children - it's literally what the vast majority of people do.
That being said human connection and even animal connection are key ways to help improve and remove depression.
This is 1000% what depression feels like, once you've properly come to terms with it. Your brain seems absolutely compelled to apply the most horrific, negative interpretation to everything that happens to you.
Even when you understand it's wrong, or at least heavily negatively biased, fighting those interpretations feels like trying to swim upstream in a terrific current.
The most valuable thing I've gotten from the past several years of therapy is a better model for how humans actually process information. The simple model a lot of people have is:
1. Receive some stimulus, input, or experience.
2. Process and understand it.
3. Respond to that emotionally.
What we actually do is more like:
1. Receive some stimulus, input, or experience.
2. This data is way too ambiguous to make sense of on its own. So to turn it into coherent information, interpret it through the lens of a narrative about who we are and how we expect the world to work. This happens automatically and unconsciously.
3. React to that interpretation emotionally.
4. Watch logical rational brain then scramble around trying to come up with a coherent story that explains why we started feeling a certain way. The answer it comes up with may or may not agree with the unsconscious process that happened in step 2.
So much of therapy is "Why does X make me feel Y?" How do I fix X? The answer is almost always that X doesn't make you feel Y. X in the context of belief Z you have about yourself leads do you feeling Y. You fix Z by questioning the often toxic beliefs you hold about yourself. But it can take a lot of work and therapy to even be able to see Z, much less root it out and install a better narrative.
I think step 4 is where people really get caught in a feedback loop. You come up with a reason why you should feel bad, and then you do (step 3) and before you know it you're back at step 4.
One approach is to try and cut it off at step 2 like you mention, but I've found this to be a never-ending rabbit hole because installing a better narrative requires constant work.
While of course it's not bad to work toward a better narrative of yourself, I've also had great success with meditation and humility targeting step 4. My friends with anxiety and depression all (somewhat paradoxically) are extremely confident when it comes to the rational side of their thoughts. They think they've got it figured out and it's just their emotions or other people that are the problem. I train myself in meditation (don't rationalize at all) and humility (recognize that my rationalizations are never going to be accurate).
So when I'm speaking the words just come out. I've got a vague sense of where I'm going and the point I'm about to make, but it's certainly not verbal at that stage. My wife has afantasia, which is not a condition or anything as such, it just means she has no inner monologue and hears no inner voice when e.g. reading a book. Conversely one of my daughters says she is consciously aware of what she is about to say in words several seconds in advance even while speaking rapidly. My mother is an amateur artist and says she has crystal clear visual imagination and photographic memory.
There seems to be a significant variation in how our conscious and cognitive processes work between individuals, including some having varying levels of access to cognitive mechanisms that in others are completely subconscious.
That's just one example of very significant differences between individuals in one family, even in direct lines of descent, so this doesn't seem to be entirely genetic. It leads me to suspect that there may we be similarly very significant variations in how all sorts of other cognitive functions operate between individuals.
I'm sure there's an overall architecture to our brains and neurological machinery. Various brain areas are clearly specialised into particular cognitive functions, but it may well be that, within those areas, how our brains get to implement those functions might have quite a bit of variation.
https://iveronicawalsh.files.wordpress.com/2012/06/cbtafg_ab...
To retrain your brain on how to appropriately react to things.
My personal belief is that SOME cases of your Z are caused by a 'learned helplessness' situational conditioning filter. The world isn't always fair and sometimes even earnest effort that in an ideal world should yield some sort of positive result has none.
Hypothetically the human social creature evolved in small tribes / large families. Possibly in those cases slight negative reactions like that would be corrected by the presence of the family. In the distraction model of recovery possibly by redirection to a more useful effort that would yield positive outcomes for the individual and group.
In modern cities, it is very easy to end up alone, or nearly alone, with very few to rely on. Even if someone has friends in a city they might be real effort to reach, and that is assuming they've got time. If there's that effort involved maybe you don't even hang out with them and drift apart until even chance meetings cost effort and thought.
However you may get downvoted because you asked how to get upvoted, which can be counterintuitive if you're Neurodivergent (like many of us). It's ok, that's not how you intended it, but that is most likely not a helpful part of the message here.
It seems very interesting. You can generally share how important it is to you within reason and that's pretty chill too.)
I like the metaphor of the spiral wishingwell. The coin/ball represents the level of depression you sink into. The gravitational draw of the void makes the spiral go faster unless you figure out a way to pull out of it and the longer you wait the harder it is to pull out cause it's moving too quickly.
So the trick becomes keeping the coin/ball off of the spiral
Just another perspective to lean on when understanding others.
Once you confront it in the most absolute sense, something akin to ego-death occurs, and you make a decision about whether it is worthwhile to continue.
Everything comes from and swings back to chaos. Embrace it and you will be free.
> Even when you understand it's wrong, or at least heavily negatively biased, fighting those interpretations feels like trying to swim upstream in a terrific current.
Achieving it still feels like the end of "A beautiful mind", where there are people hanging out in the room that are not there. They sound like they are they, they feel like they are, they smell familiar. But they are not real and will disappear some wonderful day, as they always do. So you just nod to them and go on with your live.
The few that remained (in my personal case, can't speak about others) was a strange sense of gamification of everything. Lift that spoon with only one finger. That allows some influx of positive will but it can get drained real fast (to the point of physiological collapse .. a bit like narcolepsia)
And yeah, long term management basically teach your brain to desensitize to its own bugs so you can at least not drown in negative emotions. But it's a double edged sword cause you're tapering down your own self in the process.
> Catastrophizing is a cognitive distortion that prompts people to jump to the worst possible conclusion, usually with very limited information or objective reason to despair. When a situation is upsetting, but not necessarily catastrophic, they still feel like they are in the midst of a crisis.
Anecdotally, many of the people I know with a tendency to "catastrophize" later suffer from clinical depression. The depression only exacerbates the problem.
Even more anecdotally, catastrophizing seems heavily correlated to the usage of certain social media platforms in the young people I've worked with. I don't know which direction the causality flows, but I do know that people who consume a lot of Reddit and Twitter seem to think the world is ending and everything is terrible. They can tell me about every political scandal, every shooting, every tragedy, and every natural disaster that happened in the past week. Eventually they come to believe their news sources are representative of the entire world, forgetting that none of these things are happening to them personally.
It's a weird doom loop spiral. Even weirder is that many of the people caught in it feel convinced that they "don't do social media" because they're not on Instagram or TikTok, yet they consume hours and hours of doom and gloom social media like Reddit all day.
Our brains evolved to deal with what was happening in our immediate vicinity. This was usually fairly neutral to pleasant, with maybe some moments of sadness, loss, alarm and danger. We just aren't mentally equipped to process an unending stream of bad news and really keep the perspective that these things are not happening to me. It's best to just avoid sources of that.
I stopped watching and reading the news a few years ago, and generally feel much less stressed about day to day living.
I quit Reddit and I remember the exact day it happened. I found myself typing and deleting a reply to a comment that was overly negative on something that I was well versed in. I knew this person was incorrect and taking a knee jerk cynical approach.
At some point I just said what the hell am I doing here I need to not be on this website anymore.
More broadly speaking though, depression is partially like being stuck in your foulest possible mood for years, with the full knowledge that it's not going away, at least in the near term.
Too many assume it's a lack of willpower, but willpower can only do so much to fight the tide (depending on the severity of the illness).
For instance if sending a strong sensory stimulation first triggers a higher activity level in one part before the other, that could be interpreted as directionality.
I don't know the reasons, but you're looking in a time window of four-seven days.
When I stray from my diet (meat and water) one day. I become mentally unstable after 4 days. It says for 3 day, then gets good again.
Crying for no reason, ruminating, poor sleep, strong sour smell that can't seem to be removed by washing but can be suppressed by a strong anti transpirant.
Going for sibo testing soon, if it's not hereditary, enzymes might be a solution. If it is, Pankreas is up for investigation next.
Been looking for solutions since 2018, no doctor could offer an explanation so far.
[1] https://slimemoldtimemold.com/2023/04/25/n1-latency-and-half...
Also garlic seems to be okay, but not onions, chilly powder is okay but not chilli-peppers or pepper, or tomato or seeds in general.
Allergy tests all came back negative
I'm curious about the other direction of thinking. What do SSRIs, psychedelics, CBT, and TMS all have in common? Suppose that there is one common cause, or one at least one cause that applies to 90% of cases. And it's treated by all these seemingly disparate methods.
That's what tickles my curiosity the most, as it begs a more fundamental question about the functioning of the brain.
Maybe the author's theory is correct: brain signals between certain regions are going the "wrong" way in depressed patients. That would imply that SSRIs are causing the same shift. God, I would love if the authors tested that. And then we can finally dig into why SSRIs work (we don't current know). If they're causing shifts in brain activity flow, then we can find out how. And from there maybe we can treat other mental diseases with better pharmacological or TMS solutions. Are things like schizophrenia arising from a similar bad pathing of information around the brain?
Psychedelics is also a weird one. People have proposed many theories as to their mode of operation for treating depression. But now I wonder, based on this research, if the key factor was just the disassociation from one's body and altering of senses. The other effects like connecting disparate thoughts, forming more brain connections, ego death, etc may not be related at all. That could lead the way to more targeted drugs.
Really cool stuff. If if pans out, of course. But unlike other theories of depression, at least this one is easy to test.
Maybe there is some kind of local optimum your serotonin-mediated pathways can get stuck in and need help getting out of. In fact, this (generalized outside of just serotonin) is something I do buy as a basis for depression: your brain enters some local optima or learns some poor but good-enough coping mechanisms that keep you going but prevent you from fixing underlying issues (whether it be due to maladaptive behavior, framing or interpreting things negatively, low self esteem leading to poor social performance and consequently lower self esteem). That’s also kinda what CBT is about addressing
My mental image of it is keeping a classroom under control by stopping every kid from talking to their neighbors.
Note the disclaimers, especially "TOUCHING THE DEVICE WRONG DURING ASSEMBLY CAN INSTANTLY KILL YOU. THIS DEVICE COULD KILL YOU OR MAIM YOU OR BREAK YOUR MIND."
However the other things you're posting are alternative chemical treatments. People with resistant depression have already tried the approved chemical remedies. While I broadly agree that there's evidence in favor of both psilocybin and ketamine being potent chemical anti-depressants, I also think there's a number of valid reasons for someone to reach a point where they don't want to try any other chemical remedies, and ECT / TMS become more compelling options.
Please fact check my claims by visiting the US government database to find complaints against these TMS manufacturers: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/s...
Top manufacturers should be a Google search away.
You’ll find examples of seizures, etc in there.
that being said, if you take someone who is objectively "not depressed" and apply these same depression treatments, what would happen? some state of euphoria? heightened mood? happiness?
suppose that new state is now the normal state in which people are judged against. now, the before-mentioned person who was not depressed, may be considered depressed, relatively. so you now apply the same thought experiment again. clearly this can be recursively done infinitely...
such is an inflationary view. so my question really is around the cultural vs. biological construct of depression. what if it's ok to be depressed? this is not to say that we shouldn't be trying to "treat" it (and the symptoms), but I do wonder at what point do we say it's OK.
1 - Person A has the flu
2 - Person B does not have the flu
3 - Person A treats the flu with rest, fluids and antiviral medications
If person B also rested, drank fluids and took antiviral medications, they would not become an unusually healthy person. Person B would not become the new normal.
What you're proposing is that it's OK to be sick. We treat every other form of illness with aggressive treatments. Depression is often ignored, poorly treated or treatment is inaccessible to many people due to cost.
That puts a pretty reasonable lower bound on what is or isn't depressed. It is absolutely an altered state of mind, and an information processing disorder.
For anyone who might feel like "it's ok to be depressed", this is not a normal thought, and there is no normal amount of suicidal ideation. Seek professional help or strong social support; just ask for help anywhere it might exist (go to an emergency room and just have a seat if you must). If you aren't depressed, these thoughts literally don't happen, as strange as that may sound if you are in the thick of it.
being depressed doesn't mean you have suicidal ideation, though.
Depression isn't on the happiness-sadness scale. It's quite tangential to that. In fact, perhaps quizzically, you can be happy and depressed. It's fairly common for people who learn about the loss of a loved one to recall how happy them seemed the day before.
Depression treatment, therefore, doesn't make one "less sad". And consequently it wouldn't make a healthy patient "more happy".
(1) I don't mean this in a negative way towards the comment I'm replying to. Nor am I implying that the commenter believes this. I just noticed a pattern and I'm responding in the spirit of education.
(2) It's okay to not understand depression; not everyone has to be an expert on everything. It only becomes dangerous when providing ill formed advice. Which is unfortunately common when it comes to depression.
This isn't an "ooo society is wrong" type of situation. Sure there are some societal pressures to appear happy which can make depression _worse_, but depression is still awful regardless of those and we treat it because it's awful.
> what if it's ok to be depressed?
I dunno, what if it was _ok_ to be hungry? I don't think this question makes much sense.
If you're very stable and happy emotionally, then that dulling might be unpleasant.
Beyond that, while SSRIs tend to have fewer side effects and be more safe than many other classes of anti-depressants, even SSRIs have very noticeable side effects. They are very easy to stomach if they make a dramatic difference in your mood and quality of life, but if you were already mentally well the side effects will be more impactful than whatever benefits you might get.
I know that my medication dulls my most intense emotions, but that is the point. It is slightly sad knowing that I don't experience the highest highs that I used to, but it is completely worth it to stop experiencing the lowest lows that were completely debilitating. I would stop taking them immediately if I could be assured that I wouldn't fall back into physically debilitating anxiety.
No, usually nothing happens which is why people don't bother abusing antidepressants. These aren't like cocaine or alcohol.