Researchers treat depression by reversing brain signals traveling the wrong way

https://med.stanford.edu/news/all-news/2023/05/depression-reverse-brain-signals.html

by CharlesW • 3 years ago

325 208 3 years ago

med.stanford.edu

alex-moon• 3 years ago

Really fascinating stuff. I immediately wonder if there is any explanation for this reversed flow of signals that might tie it into an evolutionary theory of depression e.g. the social withdrawal hypothesis - is the brain using less energy doing things this way?

throwuwu3• 3 years ago

Interesting thought. My mind went to the possibility that since they reversed signals are allowing your mood to determine how you feel physically that it might allow you to leverage a good mood to overcome negative signals from your body i.e. power through pain or exhaustion. Maybe it became maladaptive when more opportunity for rumination became available.

e792• 3 years ago

It’s fascinating how many potential modalities are at play with depression. Serotonin, inflammation, direction of brain signals. This suggests that depression may be a label that points to one of many underlying conditions, which could also explain why it’s so tricky to treat for some individuals.

jaggederest• 3 years ago

I have a pet theory that much of what we call mental health and chronic illness will eventually be traced back as a symptom of some causative factor - most likely infectious or environmental - rather than being a base illness as we think of them now.

Much as we don't think of "fever" as an illness any more, I suspect "depression" will become descriptive rather than predictive - which, to an extent, it already is, at least according to the DSM as I understand.

It's also possible that we'll see it as something that is multifactorial - some genetic susceptibility combined with environmental and/or infectious triggers.

UniverseHacker• 3 years ago

I agree but I think we will find that emotional trauma is also a big component of the multifactorial causes.

bitL• 3 years ago

I think they should first stop treating depression as a single illness. There are likely thousands different reasons for brain to end up with similar symptoms. Many forms of nutritional deficiencies likely turn into something that can be symptomatically classified as depression and sometimes be fully reversible by just restocking that missing nutrient or reducing its intake. Yet we clinically classify such conditions the same as ones caused by some brain injury or mentally horrible experiences that rewire brain circuits in weird ways.

asdfman12310• 3 years ago

As someone who has more or less successfully learned to deal with depression, ADHD, anxiety, etc., the trick is basically doing everything considered "healthy."

We don't understand all of the mechanisms of long-term illnesses like depression, diabetes, heart disease, Alzheimer's, etc. but we do know how to fight them: exercise and good diet. *

Some processes in the human body obviously get disrupted under modern conditions, so it's important to give your body something it's a little more used to: more movement, more traditional foods.

* (Obviously, it's not going to automatically fix depression in all cases, but it's absolutely worth fighting the good fight if you can. Other treatments are definitely worth trying too.)

leksak• 3 years ago

But I also believe that if you don't exercise, eat nutritious food, get sunlight, get enough sleep, consume positive material, surround yourself with support, then you aren't giving yourself a fighting chance.”

- Jim Carrey

Sometimes though, any one of those or all of them can end up seeming impossible because of the depression one is fighting.

e792• 3 years ago

Agreed, but with the caveat that depressed people often struggle with making the changes they need the most. Similar thing with obesity. There often needs to be some kind of intervention, such as a medication, to offer enough relief for someone to break the cycle and start making changes. Willpower alone isn’t always realistic.

hirvi743• 3 years ago

My issue is that the disorders/symptoms interfere with my ability to do "everything considered healthy."

The ADHD makes it impossible for me to stick to exercise routines as well as other routines. The depressive symptoms make me feel like I am carrying a ball and chain and every little thing requires so much energy.

The worst part is that I am treated for ADHD, and even that has basically any negligible difference anymore.

I feel like I am trapped in a negative feedback loop that I cannot escape.

spacephysics2• 3 years ago

Fully agree, to me depression is a common symptom that the system of biological processes “outputs”, if you will, when some process isn’t running optimally.

Stopped sugar suddenly? Inflammation from food you’re eating? IBS in general? Traumatic upbringing leading to entrenched “thought loops”? Undiagnosed disease?

These all and more can have depression as a symptom.

My armchair psychologist opinion is the DSM 5 category process isn’t fitting correctly to how humans operate. I believe there’s a completely different modality that has yet to be discovered (or known in mainstream science) that gives us a better way to diagnose people.

I find it nuts that you subjectively, in most cases, ask the patient if they fit in usually 3 of 5 categories, or what not, and that determines the diagnoses. Countless times it’s like “okay, what does hyper mean?” “What does intense rumination mean?”

We need a more objective way to measure these criteria.

I was diagnosed with depression for a while, tried a bunch of drugs, none really worked. Then for shits I do a neurological adhd battery and lo and behold, seems like that’s it.

Now using the correct behavioral changes leads to the depression going away, and far higher quality of life.

I know the system, DSM 5, is best we have now, but we need more innovation in this space

franl• 3 years ago

Which behavioral changes got you there?

Choco31415• 3 years ago

I went through a few different versions of depression myself and it absolutely feels that way. Each was caused by a different trigger, and the strangest thing is, despite all the tests doctors ran, everything came back normal. They couldn’t figure out what was happening.

asdfman12310• 3 years ago

“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.

comrh• 3 years ago

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.

asdfman12310• 3 years ago

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.

AndrewKemendo3• 3 years ago

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

hanselot• 3 years ago

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.

PragmaticPulp• 3 years ago

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.

SoftTalker• 3 years ago

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.

hifromLA• 3 years ago

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.

proper_elb• 3 years ago

Spot on.

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.

OptCohTomo• 3 years ago

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.

AndrewKemendo3• 3 years ago

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.

tbalsam• 3 years ago

(and to add to the other comment too you can edit your comment so you don't get dinged for asking about upvotes! ;P

It seems very interesting. You can generally share how important it is to you within reason and that's pretty chill too.)

kayodelycaon• 3 years ago

For me psychotic paranoia was very much like this. No amount of reason could overcome the irrational thinking.

asdfman12310• 3 years ago

I imagine it's frustrating to describe to people who don't understand the degree to which your own brain works against you.

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).

munificent4• 3 years ago

Anxiety feels similarly.

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.

reaperman• 3 years ago

Thank you for detailing / summarizing your exploration on this topic. You've phrased it very well / precisely.

bombcar• 3 years ago

This applies to many things, including lots of things we think we “got to rationally” - much more than we want to admit is rationalization.

eastof2• 3 years ago

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).

candiddevmike• 3 years ago

This is part of cognitive behavioral therapy (CBT), you do ABC sheets like this:

https://iveronicawalsh.files.wordpress.com/2012/06/cbtafg_ab...

To retrain your brain on how to appropriately react to things.

mjevans• 3 years ago

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.

simonh2• 3 years ago

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.

amelius2• 3 years ago

I sometimes get this when I'm tired. The solution is not to think about it more, but instead to just have some sleep.

asdfman12310• 3 years ago

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.

detourdog2• 3 years ago

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.

asdfman12310• 3 years ago

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.

agumonkey• 3 years ago

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.

JohnMakin2• 3 years ago

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.

radicaldreamer4• 3 years ago

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).

wizzwizz42• 3 years ago

I would recommend against trying to self-prescribe addictive substances.

q845712• 3 years ago

I was hoping you were going to link to a DIY tms, so i will: https://www.instructables.com/Transcranial-Magnetic-Stimulat...

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.

tomrod• 3 years ago

biohacking feasibility?

rideontime• 3 years ago

searching hackaday for "transcranial" turns up a few results. have fun! https://hackaday.com/2017/03/31/transcranial-electrical-stim...

bluechair• 3 years ago

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.

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.

supernikio22• 3 years ago

That might be the case today, but I reckon it will become cheaper as time goes on, if found promising of course.

JohnMakin2• 3 years ago

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.

levi_n2• 3 years ago

I paid ~$2k (with insurance) for 8 weeks of therapy, with one 45 minute session every weekday.

zamnos• 3 years ago

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.

endisneigh5• 3 years ago

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.

supernikio22• 3 years ago

What brain signals would you reverse on a non-depressed person?

admax88qqq• 3 years ago

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.

ebolyen• 3 years ago

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.

endisneigh5• 3 years ago

, this is not a normal thought, and there is no normal amount of suicidal ideation

being depressed doesn't mean you have suicidal ideation, though.

chresko• 3 years ago

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.

carabiner3• 3 years ago

apply these same depression treatments, what would happen? some state of euphoria? heightened mood? happiness?

No, usually nothing happens which is why people don't bother abusing antidepressants. These aren't like cocaine or alcohol.

johnfn• 3 years ago

Analogously, what if we took someone who was already full, and then fed them food?

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.

endisneigh5• 3 years ago

But it is ok to be hungry. What’s the depression equivalent of having a completely, literally, full stomach?

jordan_curve• 3 years ago

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.

tokyolights2• 3 years ago

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.

throitallaway2• 3 years ago

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.

fpgaminer2• 3 years ago

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.

endisneigh5• 3 years ago

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.

pawelmurias2• 3 years ago

You can experience depression as being chronically super sad

d_tr• 3 years ago

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.

throwuwu3• 3 years ago

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.

kypro3• 3 years ago

I hate this idea that signals can move the "wrong" way.

There have been few days in my adult life that I wouldn't have preferred to not be here. Depression sucks. Yet, I don't think people are right when they tell me I'm wrong to be depressed.

I hear that some people feel their depression shouldn't be there and that they should feel happy, and in those cases I think this sounds like it could be an excellent solution, but in my case (and I think others too) I could give you very well reasoned arguments for why I would prefer to not to be here and why I feel a sense of sadness as my default state. At least in my case I believe arguments for optimism are more wrong than my depression.

Interestingly, my girlfriend is the total opposite to me. She's the happiest person ever met and I often wonder why she isn't also considered to be suffering from some kind of mental defect – I guess in her case the signals must be moving the "right" way because obviously the "right" way to feel is happy 24/7 and prolonged sadness is "wrong".

I guess I always kinda liked the idea that any advanced intelligence would end up as some iteration of Marvin the Paranoid Android, since the logical conclusion should perhaps be that life is pointless and hard, so therefore why bother? Perhaps the "right" way for signals to travel is in the direction of depression and hopelessness.

Sorry I know this isn't really on topic and I sound like a complete downer. I'm certainly not trying to diminish this research. I've guess I've just always found it interesting how some people feel they can categorise mental states as "right" or "wrong".

airstrike• 3 years ago

I have full sympathy for people dealing with depression but I don't think this logic holds. People who are depressed have suicidal ideations, suffer in quality of life and generally struggle to accomplish otherwise simple tasks.

It is "wrong" in the sense that it has all of these objectively negative consequences whereas being blissfully happy does not, so it can be claimed to be "right" in relative terms.

I think you are attributing to the word "right" a sense of an obligation to feel happy, with "wrong" therefore being a deviation from that True Path, but I don't think that is the intended meaning when people use those words to describe depression.

I would argue that "right" in this context means something closer to "nominal", as in "working as intended". Nobody is faulting you (or me or others) for constantly feeling down.

I hope that helps.

kypro3• 3 years ago

I'm not sure I agree with your use of "nominal", but if you're saying right means something like "typical" then I'm fine with that. I guess I'm not sure what "working as intended" or "nominally" would mean. If the "intention" of my emotions is to approximate my true state then they're doing that just fine. Why would they tell me the world is great when I don't believe that to be true?

It is "wrong" in the sense that it has all of these objectively negative consequences whereas being blissfully happy does not, so it can be claimed to be "right" in relative terms.

Obviously I can only speak for myself but depression has manifested both as hyper-productivity and hyper-defeatism for me. I've never felt content so a lot of my life has been an endless struggle to just feel okay which made me unbelievably productive when I was younger and naive enough to think I could fix things.

It can be negative at times though, but my perspective on this that optimising for my own happiness is not an achievable goal. All I can do is optimise so that my suffering can be a net-positive for humanity and those I love. So although I might feel like I don't want to go on and I don't want to be productive I do because if I'm not productive or kill myself then I'm letting everyone down and my existence then truly was a net-negative both subjectively and objectively. I have to at least make this objectively positive.

So the reason optimising for other people's happiness is everything to me, is because my own means nothing. But that does get destructive when I'm letting people down because then I suddenly start trying to calculate if my life is a net positive to the world and things can go "bad" quick when convince myself I'm doing more harm than good.

I think I'm atypical to be fair, but I would argue my depression isn't objectively negative at all which is exactly why I put up with it.

digging3• 3 years ago

I believe I have some insight as someone who only recently made a breakthrough with lifelong on-and-off depression, and as someone who has had tons of therapeutic conversation (paid and otherwise).

Once I finally realized that depression was something happening to me, literally an illness, and that it wasn't an intrinsic part of my personality, I sought medication. That medication had a near-immediate effect of making me feel ok. I wasn't depressed, I was able to just get through a day without thinknig too much about it. But it didn't work perfectly, and I found I could still slip into depression a couple times a year.

More recently I got on a new medication that seems to actually work. It's not giving me a fake happiness and it's not taking away any of my very real concerns about how "good" life is. I am not optimistic about my state, my country, the future of humanity, or very much in general. But I am not depressed. I find it easy to enjoy things that I love in life. I can take real pleasure in disconnecting from work and foraging blackberries in the woods. It is pointless to do so (I have plenty of food), but it doesn't feel pointless. It feels fun and interesting.

To me that's the biggest difference with depression. I can be extremely sad, and I often am. I can even believe that the world would be better off without me (I go back and forth), but I still feel satisfied to be alive. Even on my bad days, I can take small pleasures.

I do think that staying depressed is "wrong" insofar as I would say it is "right" to seek comfort, pleasure, and health. I also think that it's fair to say these signals are moving in the "wrong" direction with respect to the direction that they move in non-depressed people. If the goal is not to be depressed, and something is causing depression, it's a "wrong" action.

But I don't want this to sound like I'm chastising you. I get it. I am still a pretty pessimistic person and everything you're saying is logical. The difference is, I can think about and believe those things without it changing how I feel on a fundamental level. It is extremely hard to see that without getting treatment. And I also understand that it sucks to be told you're "wrong" or there's something "wrong" with you for being depressed, because it's happened to me plenty. So I understand your qualms with the language. Again, though - you don't have to feel bad. You can think the world sucks (my state government wants me and my community eradicated) and still feel good.

stuckkeys• 3 years ago

what medication did you use? I am on the waiting list for controlled shrooms. Also you are not alone. Depression runs in my family (mother side) it is a rollercoaster. I have found drone flying FPV to be relaxing. But yeah, hang in there. The world is a better place with you, do not give up.

kypro3• 3 years ago

For the record I'm fine with people telling me I'm wrong, I don't feel invalided or anything, it's simply that I don't agree with the perspective.

From what you said I think we probably have slightly different manifestations of depression. Mine doesn't seem to be as absolute as it sounds like yours was. I was happy when I was a kid, it was only when I reached adulthood and started to disliked the way my life was playing out that I became depressed. This compounded with knowledge that life is just a pointless struggle basically makes me depressed constantly as I see no hope in it ever getting meaningfully better.

If I could live my ideal life – one where I wouldn't have to socialise with people and wouldn't have to work for a living (I'm autistic) – I'm fairly sure I'd be fine with my pointless existence (although maybe incorrectly). I probably wouldn't be irrationally happy or anything, but I'm sure I'd feel mostly neutral between situational moments of happiness and sadness.

But as it stands it's just all struggle for me because I dislike my life and cannot fix the problems I have. So while I could medicate myself to make my life more bearable I know I find it hard to find a balance when I take that path. Whenever I've decided to "fix" feeling depressed I've always ended up in a hedonistic spiral seeking my own selfish near-term happiness at the expense of everyone I love.

The best answer I've ever settled on is to simply embrace the sadness. So while I may not be able to be happy myself, I can still make others happy. And I think in this way my depression may even serve a noble goal because I've given up on my own happiness so entirely that maximising other people's happiness is the only thing that matters to me anymore.

But getting back on topic, I think in my case you could probably argue my personality is "wrong" – an optimal me probably wouldn't be autistic, and I probably wouldn't dislike socialising or being forced to work as much as I do. But my depression in my opinion is "right" since it's just accurately describing how I intellectually view the struggles of my day to day life.

I wouldn't deny that I could medicate the pain away, but I'm not sure that makes it "right" either – even if it doesn't feel fake.

But if you're just saying I should give medication a go because it might make me feel better, then I appreciate you sharing your experience. I definitely found it interesting that you described your medication as not giving you a fake sense of happiness. For what it's worth I used to abuse alcohol and while I was drunk that's exactly how I remember feeling and why I drank. Perhaps the right medication would be sustainable though... It's a place I'm a bit scared to even explore again to be honest. Prioritising happiness has never served me well.

goda90• 3 years ago

since the logical conclusion should perhaps be that life is pointless and hard

Even if one concludes that life is pointless, depression is not the logical direction to head. Depression makes it harder, and full of pointless suffering. The logical direction to head would be maximizing pleasure despite the pointlessness. Of course that opens a whole can of worms about hedonism, but the point is that depression isn't logical unless you conclude that life should be as miserable as possible, which I wouldn't say is a logical thing to conclude.

MadcapJake• 3 years ago

You are entering Buddhism and philosophy territory with this take. At one point after the depression, you should arrive at "why should I feel bad that there's no purpose when I am a master of—and one with—the universe and can create and/or observe any meaning that I want?"

Don't stop at nihilism, take the next step towards absurdism!

wyldfire• 3 years ago

Interestingly, my girlfriend is the total opposite to me. She's the happiest person ever met and I often wonder why she isn't also considered to be suffering from some kind of mental defect – I guess in her case the signals must be moving the "right" way because obviously the "right" way to feel is happy 24/7 and prolonged sadness is "wrong".

I think the metric that mental health professionals use is roughly "interfering with your life." So if she were frustrating her colleagues and friends with her upbeat attitude -- if they saw it as insincere, e.g. and they decided to limit interaction with her -- that might be considered "wrong" or "treatable." If she herself saw the negative impact of her happiness, she could likely be treated by a professional.

I hate this idea that signals can move the "wrong" way.

IMO that metric helps make things much more objective such that "wrong" can be considered instead "problematic."

igravious2• 3 years ago

Yet, I don't think people are right when they tell me I'm wrong to be depressed.

Ah, I get the point you're making, but that's not what the article said/meant, is it?

“When they analyzed fMRI data across the whole brain, one connection stood out. In the normal brain, the anterior insula, a region that integrates bodily sensations, sends signals to a region that governs emotions, the anterior cingulate cortex.

“You could think of it as the anterior cingulate cortex receiving this information about the body — like heart rate or temperature — and then deciding how to feel on the basis of all these signals,” Mitra said.

In three-quarters of the participants with depression, however, the typical flow of activity was reversed: The anterior cingulate cortex sent signals to the anterior insula. The more severe the depression, the higher the proportion of signals that traveled the wrong way.”

Wrong here means reversed from the norm. As in, it's not logical to argue that the mood should precede the telemetry, is it? The flow of information going the other way makes little sense from a bio-mechanistic viewpoint. That's why it's "wrong". The article makes no other judgement about (major) depression. And arguably, as we all know, it is correct to have reactive depression if some awful thing befalls us.

poorbutdebtfree• 3 years ago

Is depression a first world problem? Maybe if we can send over our highly trained and effective therapists to the third world we'd find that 95% are depressed too. It'd make depression much easier to deal with if we knew everybody had it regardless of qualify of life issues.

jiveturkey42• 3 years ago

Probably just people with the luxury to sit inside all day in climate control, completely disregulating the hormones

rybosworld• 3 years ago

It is certainly not just a first world problem. There are many problems in advanced nations that get a spotlight on them, but that doesn't mean those problems don't exist in less developed places. In some parts of the world, getting fresh water is the biggest concern. Solving that problem becomes so important that topics like mental health may be completely ignored. I would wager a guess that North Korean citizens rank especially high in prevalence of depression, but it's not even a top 5 concern for them.

The historical record has many descriptions of depression dating all the way to B.C. times. Depression has been a thing that has affected humanity for at least as long as organized civilization has existed.

I think a good question to ask is: Do uncontacted ("lost tribe" cultures if you will) peoples have differing prevalence of depression compared to the connected world?

I don't know the answer to that question, but I wouldn't be surprised if the rates of depression in those cultures is lower.

igravious2• 3 years ago

No, depression is not limited to any specific region or socioeconomic group.

Why would you think that it is?

robotburrito• 3 years ago

We are always trying to solve this problem while avoiding the elephant in the room, the current state of society is not very healthy for most people.

walleeee• 3 years ago

There are two truths here which are often taken to preclude one another, but I think they can coexist

1. Depression can be treated and even overcome in some circumstances

2. There are very justifiable reasons many people might be depressed

throitallaway2• 3 years ago

What I find most troubling is how resources and power get concentrated in hands of the few, and the rest of us (99%+ of the population) are left to deal with the consequences. The few laws that do exist to prevent benefiting parties from raping and pillaging the earth and society at large are slaps on the wrist at best. The default is to toe the line and/or overstep legality and morality. That's what's so depressing about it all.

dandanua• 3 years ago

Messing the brain to solve a problem caused by outer factors looks like a new iteration of lobotomy to me.

bjt2n3904• 3 years ago

What you say here will be deeply unpopular.

I have found that people treat depression and anxiety like a medical condition -- diabetes, or high cholesterol.

Yet I can measure those numbers, compare them with other people similar to me, determine what ranges are outside the norm, and observe changes as I try different strategies to manage them.

Depression, like physical pain, can neither be measured nor compared. And if this analogy holds, then there are those who would rather dull their pain with medication and claim victimhood, rather than find the source of it.

aszantu5• 3 years ago

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.

stuckinhell2• 3 years ago

thank you for this! I have something very similar

aszantu5• 3 years ago

Have you noticed something else? I seem to tolerate sour apples and 1 teaspoon of sauerkraut per day, but not much more.

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

NeuNeurosis4• 3 years ago

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.

agnosticmantis• 3 years ago

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?

aszantu5• 3 years ago

Did u ever get around to find out why the enzymes aren't made by your body?

bb101• 3 years ago

Interesting. A real life example of latency and half-life[1].

[1] https://slimemoldtimemold.com/2023/04/25/n1-latency-and-half...

aszantu5• 3 years ago

thanks! I needed this, I guess!

machiaweliczny2• 3 years ago

Have you done blood PH level test?

fpgaminer2• 3 years ago

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.

opportune• 3 years ago

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

makeitdouble4• 3 years ago

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.

brainmagnets• 3 years ago

I recently went through a round of rTMS and participated in a study that used EEG to attempt to find biomarkers for responders vs non-responders. This was largely based on previous findings that altered functional network activity in the brain (namely the default mode network) is correlated with depression in some people, and that EEG could relatively inexpensively detect functional network changes over the course of treatment. This study seems to follow a similar vein and I suspect we'll see more like it in the near future. I'm really glad to see more research being done with TMS - the particular protocol mentioned in this study (SAINT protocol) has had truly amazing success with 80-90% remission rate in already treatment-resistant individuals in a couple of studies. Even ECT, which is currently considered the most effective treatment for treatment-resistant depression, has only a 70-80% response/60% remission ("regular" rTMS is about 60% response/30% remission). The only problem is that SAINT requires fMRI which is expensive and complicated, on top of already expensive rTMS treatment. Hopefully as more research is done it'll become more accessible, personally it was very helpful for me in overcoming many years of intractable depression.

mynameisash2• 3 years ago

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.

fourg• 3 years ago

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?

mynameisash2• 3 years ago

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.

cactusplant7374• 3 years ago

Is this a therapy that can be done at home?

aerophilic• 3 years ago

This sounds amazing… is there some place where you can learn more?

Doing a quick search, I found the following: https://www.enrichingfamiliesnow.com/lens-neurofeedback-1

However, are there better links?

pawelmurias2• 3 years ago

Look into EPA fish oils for depression

martin82• 3 years ago

Get your son on a keto diet: https://youtu.be/3g4ghKDsVX8

gwl_210• 3 years ago

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.

udev• 3 years ago

Very interesting, so it could be that depression is essentially a race condition in the brain.

carabiner3• 3 years ago

The commercialization of this treatment is being handled by https://www.magnusmed.com/. Some existing TMS treatment centers claim to be performing the SAINT protocol right now, but the researchers have never fully revealed the treatment plan (using fMRI, algorithm for targeting) and so the claims can't be substantiated as being exactly SAINT.

I'm pretty desperate to get onto a trial. Here's hoping that this gets FDA approval ASAP.

flippinburgers• 3 years ago

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.

bendbro2• 3 years ago

I agree, I wonder if depression is not always rooted in some random, mental problem but rather a reasonable reaction to reality.

EGreg• 3 years ago

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

pessimizer3• 3 years ago

https://en.wikipedia.org/wiki/Depressive_realism

ryanklee4• 3 years ago

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.

xwdv• 3 years ago

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.

Rury• 3 years ago

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.

naasking2• 3 years ago

but rather a reasonable reaction to reality

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.

intelVISA• 3 years ago

Do you blame the bug or the debugger then?

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.

antod• 3 years ago

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.

All behind me now that they've mostly grown up.

malauxyeux• 3 years ago

Maybe not even having kids, but being engaged in something fully.

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

blauditore• 3 years ago

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.

amelius2• 3 years ago

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.

ninala• 3 years ago

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].

[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/

ramblerman• 3 years ago

I guess there was something in the old proverb.

“Idle hands are the devils workshop”.

ShamelessC• 3 years ago

really I think having kids gets looked down on

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.

vermilingua• 3 years ago

That’s because the people here on HN have jobs /s

astura2• 3 years ago

Of course it doesn't get looked down upon, that's absurd. The most socially unacceptable thing for a woman to do is not have kids.

Something like 85% of people over 40 have children - it's literally what the vast majority of people do.

makeitdouble4• 3 years ago

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.

m463• 3 years ago

I feel we have "depression" the same way we get "colds", try to rest hoping it goes away.

There's lots of evidence that doing the opposite of rest - aerobically exercising - helps tremendously with depression (and lots of other issues).

TeMPOraL• 3 years ago

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?

h0l0cube2• 3 years ago

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.

nonethewiser• 3 years ago

I do sometimes wonder if some instances of depression aren't simply a cause of people not having families

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.

naasking2• 3 years ago

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.

alexchantavy• 3 years ago

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.

theGnuMe• 3 years ago

It's good that you find joy in having children but others do not and find it stressful. Some folks might find joy in having pets but others do not.

That being said human connection and even animal connection are key ways to help improve and remove depression.

burglekutt• 3 years ago

Sometimes I feel like programming is physically and mentally designed to create bad health and mood, at least if you’re not very careful about how you’re _being_ while doing it.

Maybe it’s just me, but I have to work hard to avoid:

- Bad posture, hunching towards the monitor

- Scrunching the face

- Feeling impatient because my fingers and the computer can’t keep up with where I am in my mind

- “Damn you, computer!” frustration in small doses throughout

- Frequent interruptions via email, Slack, texts, coworkers, etc

- In some cultures, it’s very hard to have a plan for what to get done in the day and then execute on it due to getting sucked into meetings and stuff.

polalavik• 3 years ago

Ya I’m really interested in what I do and side projects I work on but I feel like absolute shit after focusing on either. Not sure how to solve this. it feels unsustainable to find equal amounts of joy(?) and ~bad feelings physically and mentally~ from partaking.

iandanforth• 3 years ago

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.

makeitdouble4• 3 years ago

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.

ChicagoDave• 3 years ago

Does it work with people that suffer Bi-Polar Syndrome though? That would be another level.

levi_n2• 3 years ago

I have ADHD, major depression, and I did 8 weeks of TMS therapy last year. In the end it did help my depression some, but it isn't a night-and-day difference.

It did, however, completely change how I see myself, to the point where I feel disconnected and separate from the person in my memory. Likewise, my sense of empathy and how I few the world is completely different, for the better.

I plan to do another round this summer.

machiaweliczny2• 3 years ago

Tangential but to anyone who is tired and anxious I recommend also checking for Tetany[0]. I got diagnosed with that and just supplementing minerals had positive effect on my wellbeeing. Before I was miss?diagnosed with mild depression and put on SSRI(which helps) but my muscles got so tense recently that I went for dry needling and they recommended I check for Tetany. BTW seems like predisposition to this might be genetic as my mother has similar issues.

[0] https://en.m.wikipedia.org/wiki/Tetany

jscipione• 3 years ago

Depression is natural given the state of the world right now. There is nothing wrong with the brains of depressed people, anyone who sees clearly ought to be depressed.

Researchers treat depression by reversing brain signals traveling the wrong way

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