• Here is an excerpt from a blog post I wrote about this (which was really about Aaron Swartz’s suicide). Idea I ‘d share it here too, just in case it helps anybody. Some of it is a bit off-topic, my apologies.


    Like everyone else, I’m really unfortunate to find out about
    the suicide of Aaron Swartz, the talented developer and activist. I had actually become aware of him a few times, however never actually understood all the things he did. I want I could have understood him. Really, that’s the worst feature of people dying … all the living people who will never ever get to benefit from their continued presence.

    What do I need to state about Swartz’ death? Well, possibly a bit, because Swartz is said to have suffered from clinical depression I do know a little bit about this subject, since I myself have fought with depression for over a decade. Mine was first set off by the unexpected death of my mother in 1999, although I also have a family history of anxiety on my mommy’s side (the Swartz side, paradoxically, though I don’t think Aaron and I related).

    Obviously, everyone’s experience of anxiety is various, so I do not intend these ideas to be a universal guide or general theory. Bipolar disorder, or “manic anxiety”, is another thing totally. But that stated, here are my thoughts on depression.

    1. Anxiety is not unhappiness. During the most extreme part of a major-depressive episode, what I have actually felt is absolutely nothing at all like unhappiness. Mostly, it’s a sort of feeling numb, and utter absence of desire and will. Beneath that tingling, there’s the sense that something horrible is happening – there’s a really little voice screaming in the back of your mind, but you hear it only faintly. There’s an uncomfortable wrongness to everything, like the world is twisted and broken in some awful however unidentifiable method. You feel numb, however it’s an extremely bad sort of pins and needles. This is accompanied by an odd absence of volition – if a genie popped out and provided me 3 wishes at the depth of my depression, my very first wish would be for him to disappear and not trouble me about the other 2. Looking back on this experience, I have actually conjectured that part of depression might be like some kind of psychological “fire sprinkler system” – the brain just floods the structure completely to keep it from burning down.

    Depressed individuals frequently say that it’s difficult to keep in mind what depression resembles after it’s over, and difficult to envision feeling any other method when you’re in the middle of it. Therefore, most of what I’m saying here originates from things I wrote when I was in the middle of major depressive episodes. I believe my most colorful description was that depression resembled “being staked out in the middle of a burning desert with a spear through your chest pinning you to the ground, with your eyelids cut off, looking up at the burning sun … permanently.”

    2. Coming out of anxiety is the most unsafe time. Coming out of depression, I’ve discovered, resembles having your psychological system turned back on. However when it’s turning back on, it sputters and backfires. You feel exceptionally raw. You have days where you feel elated, like you’re walking on air. And you have days when you feel black anguish, rage, hysterical unhappiness. These latter are the only times that I have actually seriously thought about hurting myself. And I’ve done a few … unwise things throughout these durations.

    Among the most common negative episodes, for me, is what I’ve heard individuals call the “spiral” – a flood of unfavorable emotions makes you feel like you’re bringing down the people around you, which sets off more unfavorable emotions, etc. I often experience this when coming out of anxiety. It comes on extremely rapidly. If you see this taking place to a depressed person, get them away from large groups of people and high-energy social situations, as quickly as possible.

    3. Depressed individuals do not need excellent listeners, a considerate ear, or a shoulder to cry on. The majority of the time, when our pals are having life problems, what they need is a supportive ear. They need someone to listen to their issues, to comprehend and accept the validity of their feelings, and to empathize. So when our good friends have depression, the natural desire is to sit there and listen, and ask “What’s it like?”, and “Why do you feel that way?”, and to nod, and make a concerned face, and tell them you understand (even though you don’t), and to provide a hug. This is a great impulse, however when the individual is depressed rather than unfortunate, it’s an entirely misplaced impulse. This is not what depressed people require, and although it does not harm them, in my experience it doesn’t do them any proficient at all. One factor is that depressed individuals tend not to believe that anybody can truly understand what they’re going through (and in fact it’s extremely difficult for a non-depressed person to understand, thank God). Another is that, while for a regular sad person, getting negative thoughts out in the open assists expunge them, for depressed individuals airing the negative thoughts simply requires them to think their negative ideas, without expunging them. Another is that the psychological disconnection that I pointed out in point 1 tends to short-circuit the warm, great sensation that typically comes from somebody being sympathetic and friendly towards you.

    4. Depressed individuals do need human company. For some reason, human business assists. It is the single thing that helps the most. But not the type of company a sad person needs. What a depressed individual requirements is simply to speak to people, not about their problems or their negative thoughts or their anxiety, however about anything else – music, animals, science. The most useful topic of conversation, I have actually found, is absurdity – simply talking about entirely absurd things, gross things, repulsive offensive things, unusual things. Shared activities, like going on a walking or playing sports, are OK, but talking is much, much more crucial. I actually have never found out why this works, but it does.

    And naturally, relationships are really, really crucial. Pals, I believe, are the most crucial, due to the fact that good friends use chance for understanding and positive interaction without much feeling of obligation or embarassment (see point 6). Household and fans are essential, but actually, the relationship element of these relationships needs to control, so the depressed person does not constantly believe unfavorable ideas about how they’ve let you down. Basically, to assist a depressed person, good friends require to end up being a bit more like household, and household a bit more like good friends. Likewise, you must realize that even if your depressed good friend or family member is unresponsive, that does not suggest that you aren’t doing him or her a lot of good.

    5. Cognitive behavior modification actually works. I’ve taken one antidepressant drug (Lexapro), however it not did anything perceptible for me. (This is not to state that antidepressants in general don’t work; for that, ask PubMed. This is just about my personal experience.) What has actually worked for me is cognitive behavior modification. The “cognitive part” is the most important. Basically, depressed people have unfavorable ideas that they can’t leave their head; cognitive treatment teaches you to repeatedly determine, examine, and correct these unfavorable thoughts. That really assists; as soon as those unfavorable thoughts aren’t always racing undetected through the back of your mind, your brain has a much easier time repairing the damage done by a depressive episode. “behavioral” therapies can be crucial for improving your way of life.

    Cognitive behavior modification is best done by a therapy therapist, and there are numerous excellent therapists, but likewise many bad ones. It is simple to see who is excellent and who is bad, but since depressed individuals have low volition, often they need a push to ditch a bad therapist and keep looking for an excellent one.

    6. Depressed people might need a new “story”. I’ve likewise called this a “new perspective”, however I believe the word “story” fits better. I have actually discussed my “narrative theory of depression” at length with psychotherapists. This theory of mine may be wrong, and even if it’s right, it may only be best for a subset of depressed individuals!

    Essentially, I think that the most crucial recurring negative thought that affects depressed individuals is unfavorable self-evaluation You believe, in a really removed, dissociated way, “The person who I call ‘me’ is a worthless individual.” And I believe that the main requirement that we utilize to examine people is the story; a story that seems to unify and make sense of an individual’s life. Obviously, this is not a realistic or accurate approach; human beings are not constant, we are not simple, and we don’t make good sense. The stories that we build for ourselves are primarily bullshit. We construct them out of a requirement to make sense of the world, not as reasonable scientific theories that best fit the readily available data.

    I feel like the majority of people construct a story of their life that is generally favorable. People tend to think that they are excellent, and likewise talented and unique, and that their life is advancing towards some purpose. We are each the protagonist in our own story. This narrative gives them inspiration, and likewise the overconfidence they need to take dangers and exert effort (Ha! I handled to slip in a behavioral econ referral after all!). Individuals also strive to fit their favorable narratives. The part of individuals that carries out self-evaluations – the “internal performance evaluation” element of the mind, if you will – observes how well the individual is living up to the favorable story, and attempts to remedy variances.

    However often, for some factor, individuals become fixated on an unfavorable personal story. Rather of the lead character or hero of the story of your life, you become the villain, or the tragedic failure. Rather of Luke Skywalker, you end up being Oedipus. And because we build our narratives to have false consistency, the negative narrative starts to color absolutely whatever you do. You start to see every action you take as backed by bad intentions, or as doomed to failure. You view every feeling as base and guilty. The “internal efficiency review” part of yourself, whose task it generally to keep you toeing the line of the favorable story, starts to throw up its hands and wish that it could just get rid of you entirely.

    Certainly, this could result in some really bad things.

    I believe that many depressed individuals are continuously affected by the squashing unfavorable feedback of an unfavorable personal story. And I’ve discovered that the greatest single thing that assists individuals out of anxiety is the scrapping of the unfavorable narrative and its replacement with a favorable alternative narrative. This is typically possible, because narratives are mainly built out of bullshit – change the bad bullshit with great bullshit, and you win. But that is much simpler stated than done.

    If you have depressed buddies, you can, in theory, assist them construct a new, positive story on their own. But this is a very hard thing to do, since a meaningful, credible narrative is an unusual thing, and you never quite know what will stick and what will be rejected. The good news is, if you attempt and stop working, your depressed friend will be no worse off. Keep in mind, depressed individuals are weak-willed, they have low volition and little initiative; to help your depressed good friend construct a brand-new story, you have to be pro-active. You have actually got to spontaneously volunteer positive viewpoints on his/her life, without being asked to do so.

    This breaks our social instincts, considering that with a typical, non-depressed sad buddy, doing this is type of a mean thing to do; the good friend just requires you to listen and understand, not to oppose, reinterpret, and dismiss their discomfort. A depressed individual is not unfortunate, and what they require is very various from what a non-depressed sad good friend requirements. I’m not saying you ought to be an aggressive jerk, and scold your friends for thinking negative ideas. Nor am I saying you need to predict phony warm optimism about your buddy’s life. It takes a lot more sincerity than that, not to discuss finesse and creativity and cautious guesswork about the nature of your friend’s “unfavorable story”. Go gradually and thoroughly.

    When It Comes To what kind of positive narrative to help your depressed good friend construct … well, this will be really various for each individual, and it will depend upon what sort of unfavorable story they’ve built on their own. In general, though, I ‘d state that it’s excellent to reinterpret past “failures” as necessary actions on the road to future successes. And it is very important to emphasize just how much potential the depressed individual still has in their future – like in the movie City Slickers, when Billy Crystal encourages his depressed good friend that he gets to have a “do-over” in life. In general, if you can help a depressed individual visualize a different and positive future, he or she will amuse the notion that his or her past “mistakes” might have simply been “Act 2” in a three-act romance, instead of the last act in a Greek catastrophe.

    Now, I am not stating that building and construction of this “new narrative” is a cure for depression. It is a complement to things like cognitive behavioral therapy, constant low-pressure human interaction, a healthy lifestyle, and so on

    7. Depressed people constantly require to be vigilant versus a relapse. Anxiety is like cancer – once you have it, it remits, perhaps forever, however you are never “cured”. Regressions are not specific, however the threat will constantly be there. After recuperating from a depressive episode, a depressed person must change his or her life completely and completely. The things that you did to get out of anxiety, you need to never ever stop doing for the rest of your life. You should permanently put a greater emphasis on human contact and on meaningful, positive, healthy relationships of all kinds. You need to continuously think about what makes you happy and how to get it, and you need to continuously take steps towards a positive future that you visualize for yourself. If you permit yourself to coast, or get stuck in a rut, you will fall back into the pit and need to start all over once again. And if therapy assisted you, keep going to treatment forever. What’s more, if you leave anxiety, do great deals of things to advise you about what got you out of it. Turn it into a story of personal triumph, and repeat that story to yourself. And always remember to strengthen, cement, decorate, and elaborate a positive narrative of your life.

    Anyway, that’s the brief version of my ideas on anxiety. The long variation could fill books. Perhaps one day it will. In the meantime, remember, anxiety is real. It’s amongst the worst things that can happen to you. But it is beatable.

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