Not to be even more of a downer, but… I feel like I’m running out of options. I’ve tried Zoloft, Celexa, Lexapro, Effexor, and Remeron, prescribed by 3 different doctors. I’ve seen 6 different therapists. I’m extremely privileged to say that I’m currently seeing a Stanford PhD out-of-network weekly.
I’ve heavily experimented with psychedelics, and while they’ve given me a much greater appreciation for arts and humanities as well as a curiosity about this universe, they haven’t made me want to be alive. I’ve experimented with ketamine recreationally, too.
I don’t know what to do. Nothing helps. I’m thinking of trying TMS, but I’m really skeptical of that.
Part of me wonders if I have what your sibling commenter describes as “congruent depression” — depression which is expected given the circumstances of one’s life. There is one aspect of my life which is lacking: social connection. I feel lonely, but it’s hard to tell if this is the cause of my depression. Even if it is, I don’t know how to fix it. I don’t really like talking to people — I’m very introverted and also talking to people makes me very anxious. It’s even more difficult because of Covid.
Your comment really hits close to home. I’m not living. There is no joy. And I can see, very slowly, the damage which is being done.
Thanks again for your response.
I spent a long time in a state like that, with suicidality and all. In retrospect it was a total "poverty of spirit", and I had to accept a drastically different understanding of myself and existence altogether to move past it. But it was necessary for me to experience it to do that, and I can truly say I am changed for the better. All this is a roundabout way to say, that accepting the idea of total depravity, and realizing that the all-encompassing hopelessness that springs from that state of being is completely valid, was surprisingly helpful to me, at least. I still had to find hope somewhere else (or in someone else to be specific), but doing so did help in a way medicine didn't (for me).
I attended a Christian church service a couple of weeks ago, for the first time in over a decade. It was an odd feeling. On one hand, I felt a bit like I was in a cult meeting and I was totally disillusioned. On the other hand, after talking with people there, many of them seemed to describe a “void” in their life which was filled by religion. I can feel a void like that in myself. Maybe this is the “poverty of spirit” you describe? Still, while I agree with many Christian teachings, I don’t think anybody could convert me into a believer.
I feel the all-encompassing hopelessness; the nihilism. Nothing matters. There might be consequences of my death, but ultimately those consequences don’t matter.
If I thought anything mattered, maybe I would think I matter.
I am very curious to hear more about your experience. I have to admit I’m having trouble understanding your solution.
The service is very unlike other Christian rites. There is no priest, and anyone can speak. I remember long stretches of silence in contemplation, punctuated with a thoughtful couple sentences here and there from someone more spiritual than me.
Importantly, it's also my understanding many Quaker meetings openly accept atheists and agnostics, among a diversity of beliefs. See https://nontheistfriends.org/
So I didn't think I could be converted either. I thought "Good without God" was how I could live, and things would eventually work out if I could just tune my environment or my brain chemistry accordingly. But I eventually found myself backed into a corner when I realized I had no way to reconcile meaning, joy, or goodness with myself or life as I could understand it. I wasn't good at all, if I was honest with myself. I felt exactly as you described, without value in a world that had no value.
There's a lot to be said to tell the whole story, but to be anticlimactic, my solution was indeed Jesus. Considering his words, his claims, his promises, and daring to believe they applied to me, that's how I found hope, and a reason to live life as though I do have some value. How I got to that point from atheist, that required a long process of addressing a number of assumptions and biases before choosing to believe. The whole "church" part came after, and was more of the icing on the cake.
BTW, if you're curious at all, here's what I was reading tonight that actually got me thinking on the topic of "poverty of spirit" and what it means to Christianity in particular (starts at section I.1 - https://www.ccel.org/ccel/wesley/sermons.v.xxi.html )
I gotta go to bed, but if you wanna chat more or hear the whole story sometime let me know. I can email that address you posted in the other comment. Wishing you the best.
Though to give some background, even when I was an avowed atheist, moral relativism was something I could never abide. I always felt strongly that as intelligent beings, there was truth and objectively better ways of existing to be found. The book "The beginning of infinty" helped me justify that rationally, and also made me realize how incredibly powerful, rare, and valuable intelligence is as a force in the universe. From there, CS Lewis' "Abolition of Man" got me onto the idea of natural Law, and the "Gospel of Thomas" got me thinking on the timeless, and somewhat subversive nature of the truths that Jesus taught. I looked many places, but found Jesus' teachings to be uniquely valuable to understanding the state of myself own soul. From there, it was a matter of choosing to believe him on the harder stuff (CS Lewis' Trilemma came into play there). The feeling of belief did not precede the decision to believe, which surprised me, but is apparently not uncommon.
I'm glad I did though, and my spirituality (which I only developed afterward) has become really essential to my life and hugely positive for my wellbeing. The organized religion aspect is more of a support system and framework to practice it in, but quite helpful nonetheless.
I have a similar issue. It's a chicken/egg question. Is depression causing the struggles I'm going through, or are the struggles causing depression?
I've done a lot of self exploration recently through a bunch of different therapists and have been diagnosed with ADHD. My original theory after learning this was that the ADHD caused my depression, especially because I noticed that during periods when I wasn't depressed, I still had issues with executive function.
However really inconsistent results from ADHD medication make me question my theory. Maybe the depression is so pervasive that even when I'm not feeling depressed, the habits and thought patterns that I'm so accustomed to stifle me even though I'm no longer in the depression cloud. Maybe heavy internet/gaming/porn use for 20 years combined with a lack of good habits has just created an addiction to stimulation and set me up for failure in general. Maybe the asocial digital lifestyle I lead is just completely against my nature and I need to go be a high school teacher instead of a software engineer (but I think a high income is too important in the US for a comfortable life). Maybe I just need to start believing in God and let Jesus take the wheel.
> I’m not living. There is no joy. And I can see, very slowly, the damage which is being done.
I've heard multiple times that people with untreated ADHD have shorter life spans due to increased risk of suicide and stress-related health problems (I assume this applies to all mental disorders). The problem is that all mental health disorders are on a spectrum and that no one solution can fit everyone. I don't really have a solution for myself, and I wouldn't be surprised if I die "early".
Speaking of TMS, a new depression treatment out of stanford has come out recently that sounds similar (i don't really know the details of either): https://med.stanford.edu/news/all-news/2021/10/depression-tr...
This is something I wonder too. Could I have trained myself into this state? Is this a learned behavior? Has years of laziness and gratification seeking created a state where effort is no longer an option?
> Maybe I just need to start believing in God and let Jesus take the wheel.
I've been told this works really well. I have a weird feeling it might even work for me, if I could somehow get myself to buy into the whole organized religion thing. Maybe if Elon started a Church of the Simulation I could get on board, haha.
The potential link to ADHD is interesting. At times I've wondered if I have ADHD. I certainly relate to many of the symptoms. I actually was diagnosed and prescribed Ritalin, but I have to admit that I was drug seeking at that time so not really sure the diagnosis holds water.
>Speaking of TMS, a new depression treatment out of stanford has come out recently that sounds similar
Funny you mention this, I was reading about it on HN a few days ago. It gave me hope. I actually emailed the group asking to be a part of a future study.
That's what I think about myself, and medicine won't magically undo the years of instant gratification. I read atomic habits (https://jamesclear.com/atomic-habits) and am trying to integrate good habits/clear out some worse ones in addition to medication/therapy. It's fucking hard to make new habits.
I'm sorry that none of the treatments have worked for you. I can understand how that leaves you feeling very little hope. It may provide some comfort to know however, that it is often a problem of finding the one treatment that works. It's a crude science of essentially trial and error, but there should still be some hope that you can find some combination of medication and therapy that will help. Don't give up on your search. It's a matter of life and death.
The social aspect very well could be a major factor for you. Given you have tried so many medications, that does lead one to wonder if it's not some chemical imbalance but rather a deep void left by a feeling of disconnectedness from social circles. In that case, you owe it to yourself to work on this.
Work on becoming more social. Just like learning to ride a bike, or learning geometry, you can learn to be more social. Do it for your mental health. I fully understand how it feels to hear the words "work" as someone with depression. It's the great conundrum of the disease - you have no energy, no willpower, no drive, nothing. Giving advice to "work on yourself" is well, bad advice frankly. But that's where therapy, and medication, can give you the little "boost" that you need to start putting in the work to your personal life where it's needed most.
How to be social is about finding your community, your people.
I hope you won’t think I’m a creep for this: I clicked on your profile and noticed you left a comment on the Stanford SAINT trials that were posted here a few days ago. I remember reading your comment and the thread it spawned. That post was actually what put TMS on my mind. (I also emailed the group asking to be a part of future studies.)
I’m really sorry to hear that you’ve been dealing with this much longer than I have. I read about those who have been suffering for decades and it always makes me feel a strange combination of empathy and astonishment. From that earlier thread, it sounds like we have some similar experiences. I too lack the “kick” to do basic tasks. I have so many questions. Is this something you still deal with? Have you found some treatment that works? How have you kept going after 20 years? A question I’ve been grappling with: how does one distinguish between “depression” and “laziness”?
Btw, since this thread is getting long, I thought I would drop an email in case you (or some other reader) were interested in chatting later: hackernewsthrowaway@fastmail.com
And regular yoga brings feelings of joy, adds delicious juiciness to life.
