Wil Shipley on OCD and depression

http://wilshipley.com/blog/2005/05/on-being-crazy.html

by yters • 18 years ago

64 24 18 years ago

yters2• 18 years ago

I post this b/c articles and comments about depression seem very common here and on programming.reddit. I'm curious if OCD and depression go together?

petercooper• 18 years ago

They're both mental illnesses. While common independently, the issues that cause other mental illnesses often result in depression as a side issue.

yters2• 18 years ago

I was thinking more along the lines that if someone is OCD they can probably detect incomplete plans and lines of thought more easily than others, and so see in general that most ideas are not well supported or understood by people. Thus, a person's society and culture in general may not seem very well thought out, which can be a source of anxiety and depression.

jhancock• 18 years ago

Thanks to Will for sharing a well written article.

I am careful not to diagnose myself or others and using labels: OCD, ADD, depressive, etc... The reason I am careful about labeling is I don't think the diagnoses are accurate enough. I have concluded that maybe we can't always identify the disorders, maybe we can't cure the disorders, but we can coup with and more openly discuss the symptoms.

If you are someone that suffers from the behavioral patterns discussed in the article, try various methods to break the behavior bit by bit.

Here are tools I use: exercise, cook a meal (it has a beginning and an end. You get to enjoy it in a short time frame. Not like software development which never ends.)

What tools do you use?

unalone• 18 years ago

Exercise, absolutely. I also give myself tasks that require occasional updating but that have pretty brisk, definitive closures. A big one for me is my iTunes library: I sort the music in it, find album arts. It gives me something to do, something to occupy my mind, but it's something that beyond the first excursion never takes very much time.

marvin• 18 years ago

Therapy has worked wonders for me. But it's not something you do for a couple of months and then conclude the process by living a happy life. Your problems are part of you, and you can't just throw a part of yourself out of the window in a short time.

I've been in various forms of psychotherapy for two years now, taking medication when it was necessary. To be specific: characteristics of OCD and schizoid PD as symptoms of depression and social anxiety. The personality traits were not prominent enough to warrant a diagnosis in itself.

In therapy, you get to know yourself better: there are probably reasons why you have certain problems. If you dig deeper in them, you probably get to a point where there are no more reasons. As a random example: you obsess because you fear (x) because you were on multiple occasions in a painful situation regarding (x), and this situation was painful because of (y) and (y) is painful for you but not for others because...and at one point, you might run out of good reasons. But getting to know yourself better helps, and exposing yourself to these issues can give you tools to make them less pressing. Dampening the oscillations, as it were. I have seen plenty of examples where this has made life easier for people, but it takes at least a couple of years. In the US, this might be a tricky proposition because 300 hours of attention from a psychologist is expensive. I hope you have good health insurance, but if you have a well-paying job, I'd say it is worth it.

We nerds are often suspicious of processes that are unpredictable, messy and nondeterministic, but any treatment to psychological issues will necessarily have these characteristics. It doesn't mean that it is pointless. These issues can rarely be cured, but they can be managed and mended.

Retric3• 18 years ago

I will preface this by saying my mother has a PHD in neuroscience and it's application to learning and talking to her we know a lot of the details but little of the complexity's in how the brain functions. Anyway, several years ago I was riding on home from school and saw a bird out the window. Out of boredom and curiosity I just started overlaying everything I know about birds and flight. Everything from it's bone structure to the aerodynamics of flight feathers etc. I blacked out and by the time I was aware again we 10 - 15 minutes had gone by.

I assumed it was probably a good idea to never do that again, but I have a incredibly detailed memory of what I pictured so there is a pull to try it again. My point is I think you can overstress your mind and like overclocking a CPU it becomes less stable as you do so. Our minds are a complex balance of chemical signals which has real limits. I try to get enough sleep and take care of the wetware because I think it's less stable than you might assume. Rest and good food are the basics, but so is balancing how you use your mind and trying to avoid unbalanced behavior.

I have gone all out 12 hour days for long periods, but they seem to lead directly to burnout and depression. Yet, if I don't work really hard after a few months I start feeling useless and slow, so I don't think steady state is the best long term idea. My guess is finding a good cycle where I avoid burn out and feeling useless for long periods but I have periods of extreme activity and rest is my best long term balance. However, I have no idea how this relates to my inner biochemistry.

mechanical_fish• 18 years ago

I am careful not to diagnose myself or others and using labels: OCD, ADD, depressive, etc... The reason I am careful about labeling is I don't think the diagnoses are accurate enough.

Any psychologist worth their salt would agree with you: Diagnoses are blunt instruments which we use to describe what are, in reality, complex and unique collections of individual traits and tendencies. There is indeed a risk in "labeling" someone.

But, on the other hand, psychologists often do it anyway. Because the labels also have advantages. The biggest one is: Labels force you to acknowledge the existence of correlations. It is a sad but true fact that some people commit suicide. Other people drink themselves to death. But it's very, very hard to look at your best friend -- or at yourself -- and think this person is about to kill themselves or this person is an alcoholic. Your mind just slides off the subject, like water off a waxed car. You don't want to believe that, so you don't. That's why people always act so surprised. "Who could have predicted that such a successful writer could kill themselves?"

The answer is that sometimes you can't predict it. But one useful way of predicting it is to have a list of warning signs, and to apply (as clinically and scientifically as possible) a special label to anyone who exhibits seven out of ten warning signs. You can't always just listen to your gut, because your gut can be a hopeless optimist -- you force yourself to listen to the label. Then we can take action based on the label -- we give people insurance money to pay for extra therapy, give them access to special drugs, invite them out for coffee instead of beer, encourage them to call (or not to call) their moms, and/or make allowances for their behavior ("Oh, perhaps he's not sending an obvious social signal that he hates my guts! Perhaps he's just having an Asperger's moment!" Is that a glib diagnosis? You bet. But if only I had a dollar for every time that explanation has come in handy...)

Another advantage of labels is that they literally aren't personal. We treat the labelled condition as if it were somehow separate from a person's regular personality -- and that's often not a bug in our labelling system, but a feature! It enables us to distinguish "a guy who sometimes seems nice but is in fact a complete jerk" from "a nice guy, except when he's drunk". We can distinguish "a guy who just doesn't have it together" from "a clinically depressed guy", each of whom requires different treatment. You can try to help the first guy cheer up by encouraging him to change his life, or buying him a pizza, or perhaps just mindlessly telling him to "look on the bright side". You can't do that for the clinically depressed, as Will tells us in no uncertain terms:

"Some people have never dealt with depression, and they can't figure out how it's different from 'being sad.' 'I've been sad! I don't whine about it! I just get over it.' Yes, that's nice. Also, not the same."

As someone who was once depressed, but turned out not to have depression, I tend to think that the label is very useful. Otherwise I might have tried antidepressant treatments before I tried changing my city and my job. Conversely, if I did have depression, but were unwilling to accept that diagnosis, I might spend my time moving randomly from city to city instead of accepting my condition, seeking long-term treatment, and explaining it to my friends.

Retric3• 18 years ago

Thank you, that was the most clear and useful definition of labeling I have ever seen.

llimllib• 18 years ago

> What tools do you use?

Having a long-term girlfriend, now my fiancee, has been an amazing counterbalance for me. I now get much less high and do not fall as far.

Daily exercise has definitely helped as well.

qwph• 18 years ago

I look myself in the eye in a mirror, smile and say out loud: "Everything's going to be alright".

I try do this at least once a day. It might sound stupid, but I find it gives me a bit of a lift every time I do it...

pavelludiq• 18 years ago

I used to have some depressed moments, but after a big tragedy in my family, i realized i had no time to waste, and if i ever had any depressing moments, they were rarely longer than a day or two. Apparently work heals pain fairly well, it distracts you from the depressing thoughts and the productivity gives you a feeling of fulfillment and satisfaction, but the side effect is that the work is hard and frustrating. I could say that im "crazy", but not in the medical meaning.

pxlpshr• 18 years ago

Waylon Jennings said, "I've always been crazy, but it's kept me from going insane." And I'd have to agree with him...

swombat• 18 years ago

You look around you and realize that everyone and everything you love is going to go away, sooner or later, and you don't believe anything good will replace them.

Isn't that exactly how things are? It's not an illusion, that's just the truth. Most people have simply developed a solid sense of denial so they ignore that until they die - or at least until they get old and all their friends start dying.

sethg• 18 years ago

In some psychological tests, people with clinical depression demonstrated a more accurate view of reality than mentally healthy people.

http://en.wikipedia.org/wiki/Depressive_realism http://www.apa.org/monitor/apr05/realism.html

kaens3• 18 years ago

That is exactly how things are. I think the author was basically saying that sometimes it weighs more heavily on his mind than others. (It certainly does for me)

elai• 18 years ago

"and you don't believe anything good will replace them" is the fallacy.

bprater• 18 years ago

Great article. For folks that don't understand what depression feels like, an article like this is great.

I think a good explanation of depression for someone that has never really experienced it is: "Take the worse day of your life. Feel those feelings. Now pretend that every day of your life is like that from the moment you wake up to the moment you fall asleep." If there is hell on earth, it looks alot like depression. Unfortunately, most of this is just biochemistry happening in your brain. Fortunately, there are tools today that can help.

It's funny, people can relate when they see someone with a broken leg or a huge scar. You can't see mental disorders and if you haven't felt them, they don't seem very real.

If there is someone you love that has a mental disorder, nothing you can quickly spat at them will help, "Oh, you'll get better" or "It'll go away, just be patient." anymore than you want to hear the same things when you break up with a girlfriend or lose a family member. See if they want help, help them get help if they do, and support them.

If YOU think you have a mental disorder like depression, please go see a professional. They are trained in a variety of techniques that they can give you to help manage your life better in the face of whatever problems you feel you are having. They want to help you, they want to heal you. But you have to take that step first.

oPerrin• 18 years ago

As always these articles are wonderful to read. I think the hardest thing for people without depression to conceptualize is the crushing weight of insignificant tasks. How picking up a single sock becomes a literal impossibility. How the implications of acting, in any way, are like trying to assume every single associated burden simultaneously.

wilshipley• 18 years ago

The comments on this forum are awesome. I wish the whole intertron were like this.

-Wil

palish• 18 years ago

Stick around and add your own. Welcome to Hacker News.

Also, it's customary for new members to let me take their Tesla for a spin.

Wil Shipley on OCD and depression

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