How can I alleviate my depression?
July 28, 2009 12:26 AM   Subscribe

I'm slowly losing a battle against depression, and I'm not sure what else to do.

There have, I know, been a lot of threads about how to deal with depression on AskMe over the years, and I have read through many of them. However, many of the things people generally suggest to alleviate the problem are either not feasible or have not proven successful for me.

Here's my situation. I am in my late 30s. I have what most people would consider to be a fairly good job (i.e. reasonably well-paid and "interesting," although I do not find it so), a wonderful long-term girlfriend (but no kids and no desire to have any), many friends and a healthy, if somewhat distant, relationship with my family. I am, and always have been, in good physical health. My life to date has been almost entirely lacking in major trauma or great misfortune.

And yet, and yet...I have been depressed my entire life. Even as a very young child I struggled with feelings of hopelessness, low self-esteem and boredom, although I was (and still am) very good at hiding my true state of mind and was not diagnosed as clinically depressed until shortly after I graduated from university. Since then I have been prescribed about half a dozen antidepressants, which at best improved my sleeping patterns but did nothing to improve my mood or general outlook. I have seen four different therapists, one in particular for almost five years, but have never felt as though I have gotten any closer to understanding why it is I'm depressed. I usually exercise three times a week, but that doesn't seem to do much good. I even tried volunteering to give myself a sense of purpose, but being around people in need depresses me even more (and my people skills, outside of friends, family and others I know quite well, are not good; I find basic social interaction with strangers incredibly exhausting). I have tried a few self-help books, but for the most part they consisted entirely of mental exercises I found unhelpful. My girlfriend knows how I feel, although I sugarcoat it a bit when I talk to her (not often, because there's never anything new to discuss), and I used to talk about it a bit with friends, but beyond the fact of it feeling good to vent a little bit it never helped much.

And so, here I am. Every day, getting out of bed is a little bit harder, and I'm a little bit more bored by life; over the past couple of years, hobbies which used to bring me great satisfaction have grown wearisome, I've started to tire of my social life (which used to be the main thing that got me through), and almost everything I do, read, watch, eat, listen to, etc. seems like just a way to kill time.

So I guess, ultimately, my question is; is there anything (else?) anyone can suggest to help me help myself?
posted by you just lost the game to Health & Fitness (53 answers total) 47 users marked this as a favorite
This is going to come across as really flippant and perhaps not feasible, as you suggest, but have you considered travel?
posted by turgid dahlia at 12:39 AM on July 28, 2009 [2 favorites]

And, in the interests of different strokes and the varying of personal mileage, and remembering that I am not a doctor, have you considered not being on medication? Anecdotally and subjectively, I was on a generic Prozac for a while and it wasn't until I just decided one day - perhaps recklessly - to give the shit up, that I realised I had spent about a year in a thick mental and emotional fog.
posted by turgid dahlia at 12:44 AM on July 28, 2009 [2 favorites]

Response by poster: I have traveled a fair bit, but sometimes it made things even worse..."Wherever you go, there you are," you know? I've spent time in England, Japan, New Zealand and a few different areas of the U.S. and Canada, but my headspace didn't go anywhere.

As for medication, none of the drugs I've been on, including the one I'm on now, have had a dramatic effect on me that I've been able to notice, improvements in my ability to get a good night's sleep (no small thing) aside. Never had that "drugged" feeling you and others speak of.
posted by you just lost the game at 12:51 AM on July 28, 2009 [1 favorite]

Any creative outlets?
posted by turgid dahlia at 12:58 AM on July 28, 2009

Well from the sounds of your post, it seems like you are really looking for the reason for or the source of your depression. The underlying assumption of that is that if you can find the source, you can fix it. This may be true, but the answer you're looking for may not be satisfying. It may just be that you are predisposed to have some chemical imbalance. While six different medications may seem like a lot, it can often take many more tries until you and your psychologist stumble upon the one that finally works.

In the meantime, it might be worth examining exactly what you want to get out of therapy. Therapists are generally opening to allowing the patient to lead the direction, and there are lots of different ways of approaching depression. Cognitive Behavioral Therapy is one method backed up by tons of research. Quickly summed up, it is a method whereby you look for habitual depressive thoughts and learn techniques for countering them. By looking at the reality of the situation as opposed to distorted version perpetuated by the depression, you gradually reprogram your brain to avoid depressive thoughts.

Whatever path you take, I really hope you succeed. Depression is really shitty, but never forget that there are treatments that can help.
posted by arcolz at 1:02 AM on July 28, 2009 [1 favorite]

Have you completed a regimen of Cognitive Behavioral Therapy combined with anti-depressants? I personally found this to be an effective treatment for persistent functional depression / dysthymia. If your insurance covers it, add a talk therapist to the mix to really amp up the feelgood vibes. I found CBT from books just as effective (if not more so) than with a therapist, and generally preferred a therapist to simply allow me to discuss issues. Your mileage may vary. The CBT books I have found most helpful have been: Feeling Good (Burns) and A Guide to Rational Living (Ellis). Keep in mind you have to set aside time to DO THE WORK - its like going to the gym, you really won't see results if you simply understand the techniques, you have to apply them. That being said, do what works for you, if you get overly regimented, the CBT will become a chore and you will hate doing it and quit. Consistency is better than doing it perfectly. Just make it a habit, like a hobby, but instead of collecting rocks you collect skills that slowly eliminate the horrible horrible inner pain that crushes you slowly day by day.

Additionally, perhaps you could shed some more light on the treatments you have already tried. If you have truly run the gamut then it may be necessary to shake things up a bit in your life. I second travel. I also suggest quitting your job (YES, in the middle of a'll handle it) if you don't like it. The modern American career ladder is amazingly soul-sucking to many, many people and often seems ultimately pointless. Whatever you do, you really should break the routine you are in and give your brain a change, let it adapt to some sort of dramatic new circumstances. The brain has a tough time being terribly depressed when it is tasked with making environmental adaptations.

Alternative and riskier therapies do exist but are usually reserved as a last-case scenario in major depressive cases - namely Electroshock therapy or transcranial magnetic stimulation. If you have tried everything else, why not research these alternatives?

I almost forgot, but I also take omega-3 capsules and sam-e - both of which I have found tremendously effective. Sam-e, when taken in conjunction with an SSRI has been known to help individuals who did not respond to the antidepressant alone. I enjoy a 200mg per day dose taken with my SSRI, but most studies use 400mg. I have also benefited from St. Johns Wort (Perika by Natures Way - used in peer reviewed research) and 5-htp.

Don't stop exercising, whatever you do. If more of it. Take up martial arts or gymnastics...make your body do what it was designed to do, and do it more than seems reasonable.

Finally, I hesitate to recommend it, but coffee helps me feel happier and more focused. I do have a tendency to begin to depend on it and generally cycle through rather addictive periods (4+ cups a day) before going off it for a while...but I can't deny its power to boost my mood.

Just remember that this will likely be a lifelong struggle, but that you can and will learn coping mechanisms that will have you feeling awesome problem.
posted by jnnla at 1:25 AM on July 28, 2009 [6 favorites]

An, uh, friend of mine swore by LSD. Of course, LSD is illegal, and I wouldn't advocate using it. What I would advocate is travelling to one of the poorer African countries so that you can see how lucky you are. If that doesn't work, quit your job and go into an entirely different field. Whatever you do, don't waste your life. You get one chance at it.
posted by smorange at 1:38 AM on July 28, 2009 [5 favorites]

Have you had a really thorough physical exam with a doctor that you felt was really interested in helping you? Been to a sleep clinic? Seen a neurologist? Things like sleep apnea, lyme disease, thyroid conditions, digestive issues etc can wear you out without being easily noticed. And you sound like you're rundown and exhausted as much as anything else.
posted by fshgrl at 1:50 AM on July 28, 2009 [3 favorites]

Want to second smorange's sentiment of "you only get one chance at life." Whatever it takes to break out of your depression and start enjoying your life---however drastic or transformative a step it needs to be---it'll be worth it. It sounds like you've explored a lot of the less-drastic options, so maybe going further is really the only thing left; e.g. quitting your job, moving elsewhere, traveling, or whatever.

Of course, that really might not be necessary; it's definitely possible that a better antidepressant or a new set of therapy techniques could make a difference. In the vein of jnnla's response, some of my friends like to joke that anything is possible with CBT + SSRIs. (The humor being found in using this all-powerful combination for things like creating an army of super-soldiers, you see... anyway, tangent.) It does sound like your symptoms are really what antidepressants are meant to treat... I hope you can find one that works. I know I'm thankful every day for my Zoloft.

Finally, kind of to synthesize the two rather disparate points I'm making, one interesting journal entry I found on the internet long ago emphasized that antidepressants are useful for giving you a kick in the direction of shaping up your life, but you can't rely on them to do all the work. At the risk of sounding lame, maybe if you applied yourself wholeheartedly to the problem of lifting out of your depression for some time---using all the tools available to you, e.g. new antidepressant, new therapy, maybe new job, travel, etc.---you'd be able to break through. After all, if you keep telling yourself "I'm totally going to beat this depression thing," and do your best to sustain that attitude, you'll be building the appropriate neural wirings to change yourself for the better, permanently.

(That last paragraph definitely looks lame in retrospect, kind of a "just think positive!" thing... sorry about that. Obviously it's not that easy, especially when you're depressed, but there is a lot of power in that kind of approach.)
posted by Jacen Solo at 2:01 AM on July 28, 2009

This could be a (possibly very) bad suggestion depending on your personality and the nature of your depression, but it sort of worked for me: intentionally shut everything in your life down, before it gets to the point that you fall down from the depression. Rig your financial situation for absolute minimum / subsistence expenditure, quit your job, and for a little while at least spend every day doing nothing, chilling on your couch in your sweatpants and reading or surfing the internet or something.

If this would work for you in your situation the purpose would be partly to overcome any anxiety you might currently have over the question, "What if I can't hold on? What if it gets to the point that I can't go on any more?" and to show yourself that you really don't have to keep at the rat race and constantly fulfill whatever your life demands of you. You can take a break from life and go off and do whatever you need to do and the world is not going to end.

But primarily, the hope is that if you shut everything off you'll manage to shut off whatever is making you depressed, and maybe then examine what that is and see past it. Find a light better in the complete darkness.

This is a totally personal notion of mine that comes from a few experiences that helped me with my own depression. I've never heard of anyone else taking this approach or even mentioned it to anyone, much less a professional therapist or anyone who could evaluate it, so take it with some very large grains of salt. Also, you of course might also just not be at this point yet.

Obviously quitting your job and shutting your life as it is down is a very serious step and one that could have some negative practical repercussions on things like your finances. And if you've been suicidal this could be too close to "putting your worldly affairs in order." So even if this sounds like the sort of thing that might help you, I think you should pick one or more people you're close to and / or can trust, fully and clearly discuss your depression without the sugarcoating you mention (I do that so much, I know what you mean) and arrange for them to keep an eye on you in case the hang time has negative effects for you.

Also, I should mention that as I understand it there are a progression of more and more extreme treatments for very "treatment-resistant" depression, I think extending up to electroconvulsive therapy (yes, the One Flew Over the Cuckoo's Nest treatment) and a newer one magnetic convulsive therapy I've heard about. But apart from a few antidepressants that work well for me I grew disillusioned with standard medical approaches well before the point of ECT so I'm afraid I don't have any first-hand intelligence to share on that. (Oops, on preview jnnla mentions these.)
posted by XMLicious at 2:23 AM on July 28, 2009 [1 favorite]

I read about a study a while ago about people who took mushrooms to treat depression. They would take them once and the depression was gone, just like that. From an article in the Daily Mail:
During the study, more than 60 per cent of those taking part described the effects of psilocybin in ways that met the recognised criteria of a "full mystical experience".

Two months later, 79 per cent reported moderately or greatly increased well being or levels of life-satisfaction.

Most said their mood, attitudes and behaviour had changed for the better. This was confirmed by interviews with family members, friends and work colleagues
There's some serious research going on in the use of mushrooms to treat depression. In fact It looks like Johns Hopkins is recruiting patients right now, but only for people depressed because they have cancer. Which I imagine could be quite depressing.
posted by delmoi at 2:30 AM on July 28, 2009

Here are a couple things to consider. Whether or not you actually do them sort of depends on your level of desperation.

1) LSD, as mentioned above. Nothing has ever had so tremendous and positive an impact on my mental wellbeing than the summer I spent dropping acid. It's sometimes a little scary, but I don't know anybody who's had the prototypical "bad trip" on LSD (mushrooms, on the other hand, are a different story). Also please note that I'm not talking about a (modern) hit or two; I'm talking about full-on psychedelic doses. I strongly recommend that you find somebody who's done acid before to help you calibrate the dose and the setting.

2) Marijuana. Just stay stoned all the time. It works for a couple people I know.

3) Drop out. Sell your house and buy a boat. Live in a desert canyon and live off the land and dumpsters. Join a street gang. Rob banks. Explore the Amazon. Strike off into the forest of Alaska. Buy a farm and work it. I'm not talking about traveling, I'm talking about getting back to a kind of primal existence where your failures can kill you and your successes literally keep you alive. You feel purposeless and bored? I bet you won't feel purposeless and bored if you're spending three quarters of your waking hours feeding yourself and keeping yourself alive.

On that last point, I really do think that the cause of a lot of this sort of ennui depression is how abstract our lives are. We go to work, and do some bullshit basically irrelevant to our continued existence. We're paid some bio-survival tickets, and we cash those in for food and entertainment. Really, what is the point? If your entertainments aren't entertaining, and your work isn't rewarding, then why are you protecting them?

The solution to this is to directly connect your toil to your survival. Think Earnest Hemingway and Jack London.

The other thing is that you talk about feasibility. What the goddamn fuck is feasibility in this situation? When most people say something's "infeasible", what they really mean is "inconvenient" or "expensive". Convenience and expense seem like nothing compared with the possibility of happiness.

You're hurting. Life feels pointless. You don't feel like doing anything. You don't like where you are. SO WHY ARE YOU STILL THERE!? You have nothing to lose. Even if you fuck up completely, lose every dime to your name, and wind up on the street... are you really going to feel worse than you do now? Even if your sailboat sinks and you die in the middle of the Pacific, your adventure on the way will be far more fulfilling than the half life you're living now.

Commit the suicide of social identity. You feel your life is pointless? Cast away your life and invent a new one.
posted by Netzapper at 2:57 AM on July 28, 2009 [38 favorites]

This sounds like an awful feeling. Depression is a horrible feeling (having had at least 2-3 episodes myself), isolating, painful, and worst of all, impossible to understand, and I've found the inability to understand what and why I am feeling the way I am to be one of the hardest problems.

You still have lots of options. First, in terms of therapists, the number you see isn't the answer -- it's finding one who is a good fit, who really can help you because you feel comfortable with them, trust them, and see a relationship with them that can guide you. It may not be CBT that you need, but someone who can help you dig deeper (psychoanalysis, psychodynamics, etc.) while also giving you strategies to then address that which comes up.

Medication-wise, sadly, half-dozen meds isn't that much. It depends what you took. If they were all SSRI/SNRI class medications, it may be that you just don't respond to them and you need other approaches. Find a psychiatrist, again someone you feel you can trust who can work with you to explore other options that might work.
Classes of medications include tricyclic antidepressants (perhaps you've already been on one), or an MAOI which is an old class but can work wonders in some folks who haven't responded to other classes. Or Lamictal, often used in bipolar but also effective for some people with unipolar depression. Or even electroconvulsive therapy which in some people might get them out of a deep long-standing depression long enough for medication to help.

My point is, there's more to explore, and you sound motivated to find more help. So keep searching, find a therapist and a physician who will be committed, work with you, help you explore other options, and pursue this further, consider what hasn't been done before and how you might tackle it. And here's wishing you the best of luck as you move forward.
posted by davidnc at 3:34 AM on July 28, 2009

Oh, two points to add:
1) Be sure when talking to the providers you work with that you explain things the way you explained them here, that it's been your whole life, not just recent.
2) Expect to need a long-standing relationship with your providers. That would mean open-ended therapy. Old feelings that have gone on for years take a long time to address.
posted by davidnc at 3:37 AM on July 28, 2009

I have what most people would consider to be a fairly good job (i.e. reasonably well-paid and "interesting," although I do not find it so), a wonderful long-term girlfriend (but no kids and no desire to have any)

These are the things that ring my own alarm bells.

First off: are you and your wonderful long-term girlfriend on the same page about having kids, or is there a conflict there? Because if there is, that's kind of basic, and very very draining.

Second, but only just: if your job is well paid but it bores you, just DTMFA and do something else. Anything else. Keep doing something elses until you find something that you look forward to showing up for. Life is too short to spend vast slabs of it doing dull busywork.
posted by flabdablet at 4:03 AM on July 28, 2009

You still have lots of options. First, in terms of therapists, the number you see isn't the answer -- it's finding one who is a good fit, who really can help you because you feel comfortable with them, trust them, and see a relationship with them that can guide you.


It wasn't until I found a therapist that I clicked with that I saw any hope. Once I did, it was like a light was suddenly turned on. I looked forward to our talks, and more than anything else, it was those talks that helped bring me from hopelessness to signs of hope. From there, I've tried different things, it wasn't like I suddenly felt normal (whatever that is). But it was finding the right therapist that made me say, I'm gonna be ok. And that's an important first step.

Want to second smorange's sentiment of "you only get one chance at life."

I know everyone means well, but I can not stress how useless this piece of advice is. It might work with the teenage boy spending afternoons in front of his X box instead of applying for college. For someone clinically depressed, not only is it useless, it can be paralyzing. When I was clinically depressed there was nothing that made me feel more hopeless than knowing I "only get one chance at life".

I mean, do you not think a depressed person doesn't realize that? If getting out of the cloud of depression could be solved by trivial cliches, no one would be depressed.
posted by Dennis Murphy at 4:03 AM on July 28, 2009 [7 favorites]

Want to second smorange's sentiment of "you only get one chance at life."

I know everyone means well, but I can not stress how useless this piece of advice is. It might work with the teenage boy spending afternoons in front of his X box instead of applying for college. For someone clinically depressed, not only is it useless, it can be paralyzing. When I was clinically depressed there was nothing that made me feel more hopeless than knowing I "only get one chance at life".

Amen. Seriously.

That knowledge that my life is unitary and finite is pretty much the cause of my bouts of depression. And then, just as I'm struggling with that, somebody will tell me "you only live once". Gee, thanks, 'cause that helps.

We're not talking about whether or not he should blow his savings on the sports car he's always wanted.
posted by Netzapper at 4:18 AM on July 28, 2009 [9 favorites]

I'm pretty much unhappy most of the time every day. Most people, life partners included, don't really give a shit if you are unhappy except insofar as it affects them. Life sucks, we live and die alone, etc.

Having a very stiff moral code is a great help there. Get skills to serve the people and then serve them, and bingo, your life has meaning whether you're enjoying it or not.

Does not alleviate depression but does prevent self harm.
posted by By The Grace of God at 4:20 AM on July 28, 2009 [3 favorites]

I was once told by someone to think of depression as "frozen anger".

It's not polite to express anger inappropriately or at all--so you constantly simmer on the inside and to some extent take it out on yourself. Some people self-medicate themselves with alcohol, drugs, food or sex. Either way you can't express it to the person(s) responsible or realize it wouldn't do any good anyways.

Try and identify the source of your anger.

If you're just angry at life in general--take your seat on the bus with the rest of us who feel the same way! I wish I could put a little happy face emoticon right here...
posted by AuntieRuth at 4:43 AM on July 28, 2009 [2 favorites]

3rding cognitive therapy. It's kind of a western version of Buddhist mindfulness practices. Even better if combined with an SSRI that works for you. Research shows that around 20% of depressed people are helped by SSRIs alone, and 80% are helped by SSRIs + cognitive therapy. I strongly recommend at least trying it out.
posted by Salvor Hardin at 4:49 AM on July 28, 2009

For someone clinically depressed, not only is it useless, it can be paralyzing. When I was clinically depressed there was nothing that made me feel more hopeless than knowing I "only get one chance at life".

I mean, do you not think a depressed person doesn't realize that? If getting out of the cloud of depression could be solved by trivial cliches, no one would be depressed.

Yeah, saying that is right up there with "Why don't you just try to be happy?".
posted by ArgentCorvid at 5:18 AM on July 28, 2009 [2 favorites]

Alright, I skipped over all the responses, so forgive me if this is repeating what anyone else said, but I feel the need to give the following bits of advice. I have dealt with depression alot, ranging from an overwhelming i-can't-even-sleep-at-night-because-my-head-is-spinning-in-despair, to (more similar to what you are describing) a constant state of unhappiness that almost becomes background noise.

1) Happiness is something you have to want. Like, you have to actively pursue it and commit to that pursuit. If you just want the depression to go away, then it won't. So make happiness a goal. Real, actual happiness. Imagine a happy version of you, and strive for that. It sounds trite, but it is not. Try to be a happy person, and every time you feel happiness, even just a little, take note of it, embrace it, and enjoy it.

2) Travel, with your partner (very important!), to somewhere beautiful. Like stunningly beautiful. Don't go for an interesting, intellectually stimulating type cultural adventure. Just find somewhere that is gorgeous and magnificent. And just take it in. There was a recent post on Mallorca - despite being really touristy, its beautiful. Or the alps (impressive, massive mountains with beautiful little villages!).

3) Are you sure there isn't something specific making you unhappy? It sounds like you are unsatisfied with your work even though it looks good to an outsider. Seriously, who gives a shit how it looks to an outsider? Spend some time, maybe while on vacation, thinking very seriously about what you *want* to be doing, and evaluate whether it is indeed possible to make the change and be doing that. We take anti-depressants to address the symptoms of depression, but quite often there is a cause that we can root out, with some work, and try to address.
posted by molecicco at 5:34 AM on July 28, 2009 [1 favorite]

A quick glance - if you have never tried LSD, that may be a good thing to experience. BUT DO NOT START SMOKING WEED. This will HEIGHTEN your depression, and do not listen to anyone who says otherwise. I have seen many people seek comfort in weed for their depression, only to become way more depressed than before as their motivation to do anything is drained from them.
posted by molecicco at 5:41 AM on July 28, 2009

And finally, do consider CBT as mentioned above. It worked for me. I remember saying to my therapist on the first day "I am just tired of always feeling shitty" and he responded "Well you don't have to." And he was right.
posted by molecicco at 5:43 AM on July 28, 2009

Ermm, I don't really have any advice to offer, so I probably shouldn't be posting. But, this question struck a chord with me, because, I am in much the same position as the OP: Late thirties, "good job", but bored and depressed. The only difference seems to be that I don't have the good long-term relationship the OP has (which is a BIG part of my depression).

I've been very interested to read the responses.

Of all the responses so far, SOME of what Netzapper says, feels right to me.

1) I've done the LSD thing, and it was wonderful, but that was many years ago. I occasionally dabble with psychoactives these days, and it's good at the time, but I still always end up feeling lonely and empty when it's all over.

2) Marijuana. Been there, done that, and it was good for a while. But then it becomes self defeating. I used to be a HEAVY marijuana user, but I gave it up. I still know some guys who have been heavy users for almost 20 years, and they are the most emotionally undeveloped, socially isolated people I have ever known. A month or two would be fine. Just don't let that become 20 years.

3) I think this is what I need to do. Give up my decent job. Sell my crap. Cut useless ties. Go somewhere different and experience LIFE.

I vote for 3).

Need a travel partner, "you just lost the game"?
posted by Diag at 5:54 AM on July 28, 2009

LSD tends to amplify whatever you're feeling beforehand. If you're feeling happy, you can feel great on it. If you're feeling down, you can end up feeling much, much worse. Do NOT take LSD to try to cure depression: I really think that's a terrible idea.

Other than that, remember that you're not judging things rationally, because you're depressed. The feeling that you're "losing" is partly because of that. Think back into the past: you may have felt then that things could only get worse, but in fact they got better.

I don't think there's anything greatly new that you can try apart from variants on the things you've already tried: therapy, prescribed anti-depressants, hobbies, socializing. But you may need to go back to them, or try variants on them. If you haven't tried CBT, give it a go. If you're not currently on anti-depressants, see your doctor and ask for advice.

Even if you feel that you're on a downward slide, that's not inevitable: there will be a time when you're feeling better again.
posted by TheophileEscargot at 6:00 AM on July 28, 2009 [1 favorite]

Some people are warning against psylocibin (or "magic") mushrooms, but in my experience and in academic studies, mushrooms can be an amazing way to refocus energy and kind of reset perspective. I've never had a bad trip, but I know some people do have them. Worth a try, IMO, but make sure you're with people who've done them before if you decide to go that route.
posted by oinopaponton at 6:13 AM on July 28, 2009

Are you a good actor? Can you pretend you're someone else? Like a happier, more fulfilled social version of you?
posted by anniecat at 6:16 AM on July 28, 2009

Yeah, since I mentioned LSD in my earlier post, but neglected to give the wise advice of TheophileEscargot, I thought I should reinforce it: Don't take LSD when you're down. Bad move. You have to be reasonably happy and comfortable in the first place before you take that stuff.
posted by Diag at 6:22 AM on July 28, 2009

Have you ever really stretched yourself? As in, have you ever put yourself in a life-or-death situation where you had to make major decisions that could have a major effect on your life?

I ask because what you describe sounds like something similar I went through a few years ago. I had a general feeling of apathy, of not wanting to be bothered and general not caring about anyone or anything. Until things came to a head, and I had to leave my job. I'd been the for years, mainly due to the apathy, and heading out into the big, wide, terrifying world of looking for a job was something that really helped.

I think it was partially due to the change in circumstances, but mainly due to the massive rush of adrenaline I got. I suddenly was way outside of my comfort zone, and had to survive on my wits. Everything was bought closely into focus and I was having to make decisions in the space of a phone call that could really change my life. I couldn't just coast along any more. I had to put my feet on the ground, as it were, and cause these changes to happen in the way that I wanted them too. The brain-fog was pretty much forced to lift.

I think that doing something that pulls you out of your rut internally, as opposed to something external, might do you good. It makes you realise that your alive, and helps blow away the mental cobwebs.
posted by Solomon at 6:27 AM on July 28, 2009

This is long and a little scattered, because I tried to cover a lot of ground. If you have any questions, please feel free to email or Mefi Mail me.

First of all, you need to realize that it's okay that you have not experienced some trauma, have what most would consider a "good" life, and still struggle with depression. Depression is an illness. Sometimes it surrounds an event and the emotional fallout from that experience, and sometimes it's just chemicals in your body out of whack. It's an illness and requires treatment no different than something like diabetes. Along those lines, I think you should start with the basics. I agree that you should have a full medical workup checking your thyroid, cholesterol, glucose, etc because there could be an underlying medical condition draining you.

In terms of daily living, examine your diet and make sure you are eating healthfully and maintaining good blood sugar levels. It's amazing how much low blood sugar because you haven't eaten can affect your mood. Same thing goes for sleep. Sleep is so important, and when we don't get enough, it can be an awful cycle that deepens and/or mimics depression. Everyone who says continue to exercise is right. While I don't think it does much in terms of my depression (I have never experienced an endorphin rush while at the gym, for example), it makes me feel like I'm being proactive about my health and my appearance, which helps me feel like I am capable to be proactive in terms of my depression.

I think quitting your job is a horrible idea right now because your bored feelings about work could largely stem from your depression. You won't really know until you treat the depression. So I would put that major life change on the back burner until you've squared away some other things. Take advantage of having a steady income and, I presume, good benefits. You can always leave your job/profession once you feel like you're back to a non-depressed state. While I think the other things you mention like volunteering are all excellent things to pursue, they won't make much of a difference right now because you are depressed, and from the sounds of it, sinking further. You can feel better but it will take time, patience, and work. It's still important to be engaged with the world around you, but just know that you could probably win the lottery right now, and that wouldn't make you that much happier, either.

I understand medications have not worked for you, but I believe that is probably because you haven't found the right one. I actually have medication resistant depression and while Wellbutrin has been a huge help, it was the recent addition of a stimulant (Adderall) that seems to be making the most difference. Prescribing stimulants for depression is not a decision doctors take lightly or make often, but sometimes the rare case needs the rarely used protocol. I'm not saying stimulants are your answer at all, just that there are so many classes of anti-depressants and so many different formulations that it can be really tricky to find a)the right medications and b) the right doses.

Talk therapy is incredibly helpful, but it sounds like you approached it with the goal of finding out "why" you are depressed. It sounds like in your particular case, that's like asking why do I have an allergy or why do I have hypoglycemia. Sometimes, you just do. The question is how do I live with my depression and how do I become happier? I'd suggest giving talk therapy another try, but shifting your focus to treatment and coping with depression. In your sessions, you may also discover behaviors and habits that feed your depression, and changing those may make a huge difference.

Two last things: I have been told that depression is anger turned inward (similar to the "frozen anger" mentioned above). That may or may not help you sort things out. I have also been told that part of treating depression is persistently rejecting negative thinking. It's not easy and it can feel artificial, but eventually you retrain yourself to genuinely see and feel the positive things about life. That doesn't mean you never have a negative thought, but most situations have good and bad sides. When you're depressed, you are mired in the negative details, but any time you can give more weight to the positive aspects is a step towards wellness and feeling better. Best of luck!
posted by katemcd at 6:54 AM on July 28, 2009 [4 favorites]

In my opinion and experience, these things don't work:

- Thinking about how life is short, and you should just be grateful and joyous and shake off the negative thoughts/pull yourself up by your bootstraps

- Keeping yourself "too busy to be depressed"

- Robbing a bank or joining a gang (Really?)

- Thinking about Ernest Hemingway and Jack London (Really?! Hemingway committed suicide, and London might have committed suicide -- kinda jerkish to ask a depressed person to follow their solution to depression, unless I've seriously misunderstood what is meant by "connect your toil to your survival.")

I've no experience or opinion about LSD, mushrooms, etc., but would recommend that you continue to find the right prescription medicine, possibly combined with cognitive behavioral therapy to re-map your thought patterns.
posted by Houstonian at 7:21 AM on July 28, 2009

Here's the good news: there are still lots of good treatment options you haven't tried.

- Cognitive behavioral therapy, which is something that has helped hundreds of thousands of people.

- Other medications. If you've only tried four, you haven't even tried all the classes of anti-depressants yet.

- Transcranial magnetic stimulation. For some people, can deliver profound benefits with very minimal risks.

And you haven't tried the most risky treatment option yet:

- Electroconvulsive therapy. Much less risky than old-school "shock therapy", but still carries risks of memory loss.

So you're not at the end of the conventional treatment rope yet by any means. And there are all the other good lifestyle-change recommendations here to try.
posted by Sidhedevil at 7:36 AM on July 28, 2009

Response by poster: Hello everyone; thank you for the many helpful suggestions. Just got out of bed and went through the thread, and here are a few answers to points people brought up;

1. I am open to the idea of trying new/different meds, and my current health insurance will pay for them. Unfortunately, it will not pay for therapy, so financially-speaking, I can't do that right now (at least, not often enough for it to be of any use)...forgot to mention in the FPP that I'm not seeing anyone right now. I honestly did feel, thought, that I'd run the gamut of types of meds.

2. To the people who suggested LSD/other drugs; I've never tried LSD, and probably never will because the people I know personally who have done it say it amplified their general state of mind. For obvious reasons, this does not sound attractive. And pot has always just made me paranoid; I've never enjoyed. Another thing I should have mentioned in the FPP is that one of the *only* things that consistently improves my mood is alcohol. Four beers or half a bottle of prosecco and all is right in the world. Which is great, but it worries me enough that I approach drinking with great care; I enjoy it so much it's not hard to see how it could get out of control.

3. Neither my girlfriend or I want kids, and it is *not* a source of conflict between us. I've never wanted children, nor has she, and while I don't want to get into the reasons why here, I will say that the possibility/probability of passing on my depression is one of them.

4. My job. Here's the thing. I have NEVER had a job I liked or didn't find boring. I have quit many, many jobs over the years in the hopes of finding something better suited to me, but eventually I came to wonder if the problem was me, rather than the jobs (many of which, admittedly, were objectively terrible), and trying to work this out was probably the main thing I talked about in therapy. As much as I hate my current job, it's the best one I've ever had ("best" meaning I do hate it less than the others), and if I quit and wound up somewhere worse for me it would be a very bad thing. It would be difficult, but not impossible, for me to quit and cast myself out in a new direction, but in order for me to do that I would need a plan...and I have never, ever had something I really wanted to do. But I'm past the point in my life where I can just chuck it all yet again without having a plan in advance.

5. I am not, and never have been, feeling suicidal. I get to feeling pretty fatalistic (check my posting history for ample proof), but I knew someone in school who killed herself and seeing what it did to her family and close friends...well, no matter how bad I feel I would never put my loved ones through that.

6. Anger. Yeah, my girlfriend has always said that depression is anger turned inward, and it makes sense to me, as I've never thought particularly well of myself. I'm angry all the time, but rarely at anything specific (aside from whatever's pissing me off at the moment, usually at work), and anger/annoyance is just kind of the background hum of my life. Again, trying to figure out why this is so was another major part of therapy...needless to say, I didn't.

In sum, thanks again for the suggestions. As someone said, you have to *want* to be happy, and that's what worries me; maybe, deep down, I don't.
posted by you just lost the game at 8:04 AM on July 28, 2009

Response by poster: Oh, and I just noticed katemcd's comment about "anger turned inward"...sorry, missed that the first time through.
posted by you just lost the game at 8:11 AM on July 28, 2009

Best answer: YJLTG - Hi there. Your post resonated with me because I've been dealing with depression for most of my adolescence/adult life (I was formally diagnosed at 16, and I'm in my late 20s now). I have recently had a breakthrough, and your comment about trying and quitting many jobs struck me as being potentially similar to what I have gone through (trying and quitting/failing many post-secondary programs). Anyway, I am in the process of being diagnosed with ADD. And our theory (my therapist and myself) is that a major reason depression struck me when it did was that I was no longer able to compensate for my ADD symptoms, but didn't understand *why* I was struggling so much when none of my (gifted/enriched) peers were - as an intelligent, mostly rules-following girl, I'm not exactly the ADD poster child (I have lots of fidgety tics, but am not typically hyperactive).

I cannot overstate how huge this discovery has been for me - before this, the consensus from medical professionals was pretty much, "Well, this is just how you're wired." And I'd blame myself when I would repeatedly get into depressive episodes ("I'm just not trying hard enough at drugs/therapy/exercise/etc.") - now I can see that getting depressed was probably a reasonable/understandable reaction to putting myself into impossible (for me) situations. I'm feeling better (my GP started me on ritalin while waiting on my referral to a psychiatrist, and I also take wellbutrin for depression), and honest-to-goodness hopeful, for the first time in a long time.

Anyway, this may not be you, but I wanted to share my story just in case it's helpful - it seems that ADD without hyperactivity is frequently missed by doctors. And even if it's not ADD that is causing problems for you, it may be worth trying to rule out other underlying potential causes of depression (as another poster suggested).

Best wishes!

Short ADD screening tool:
posted by purlgurly at 8:40 AM on July 28, 2009 [4 favorites]

As much as I hate my current job, it's the best one I've ever had ("best" meaning I do hate it less than the others), and if I quit and wound up somewhere worse for me it would be a very bad thing. It would be difficult, but not impossible, for me to quit and cast myself out in a new direction, but in order for me to do that I would need a plan...and I have never, ever had something I really wanted to do. But I'm past the point in my life where I can just chuck it all yet again without having a plan in advance.

I don't know exactly what you meant in the OP by anticipating that you may "...los[e] a battle with depression" but if the consequences of losing that battle would be losing your job anyways, one way or another, it seems to me like you ought to make evaluating the efficacy of the quit-your-job options a higher priority than worrying about the job.

In some cases to say that overcoming depression is a "long, hard road" isn't a figure of speech... it may well be that to successfully deal with your problem there will be more woe and gnashing of teeth than there already has been.

Also, I would observe that from what you say you're trapped by your job, whether or not the feeling of entrapment and the anxiety this must produce is a major factor in your depression. Something to consider.
posted by XMLicious at 8:45 AM on July 28, 2009

I highly recommend scuba diving.
posted by snofoam at 8:51 AM on July 28, 2009 [1 favorite]

Depression can be misdirected anger, but it isn't always. The world we live in is not conducive to mental health in many ways. For whatever reason, genetics, the world in general, depression affects a lot of people. That bored, unsatisfied malaise is classic. For me, the answer is anti-depressants, plus more sunshine, fresh air, nature, exercise and spending time with good people.

You may also find that adding meaningful activity helps; have you considered volunteering, religion, writing, painting, etc? People find meaning in many ways. You probably want to be happy, but sound too depressed to remember what it's like. Go see a doctor. You don't have to take meds, but for many people, they're a lifesaver, and I don't mean that metaphorically.
posted by theora55 at 9:17 AM on July 28, 2009

One thing that's helped me is celebrating the fact that I am less depressed than I was. This is conscious celebration - when you're happy, really stop and see that happiness and be with it for a while. The last time for me was when I achieved something at work I never thought I could. It was amazing.. this light, rich, sweet feeling in the chest and going throughout the whole body.. persisting back and forth for days and weeks! I stood up straighter, had more energy and was even better looking under this effect.

Another thing is to find out what really motivates you. What in your life do you really, really want? This does not need to be something noble - for me it really is not, for instance and you'd laugh if you knew what it was!

Make a deal with yourself that you will give yourself what you really want and that you will do all you can to make this possible. For me, my motivating goal is enough to give me the energy to actively work towards being happy, to gain necessary skills, and to do many other unpleasant and needful things.

ANother thing, sort of reflecting on what I was talking about earlier in the thread, is to serve others. This can be in whatever way is meaningful to you, but something that helps for everyone is to say nice things about people when you think of them.

And on that note, a nice thing about you! You're a fantastic metafilter member, articulate, smart and a good person, undoubtedly with the capacity to make changes in yourself. Good luck.
posted by By The Grace of God at 9:40 AM on July 28, 2009

Best answer: This thread is full of really compelling, creative ideas, mine are going to sound mundane but this is what I've been trying. Like jnnla said, fish oil, SAM-e, and exercise. Specifically,

* Studies use a really high dose omega-3 fish oil, and it can take a few months to kick in. I take a teaspoon of this oil and this capsule for extra DHA. Your specific dose will depend on your weight.

* I'm still experimenting with SAM-e; the dose can be trickier for those with anxiety. But you should notice some difference within a few days to a month. So far I'm on 200mg also and get more motivation and energy, but no 'happy'. It's also expensive; this the cheapest good brand I've found. PS you NEED to take a B-complex with SAM-e.

* Spark: The Revolutionary New Science of Exercise and the Brain has lots of research on depression (and other mood disorders). Really interesting stuff. Short version: Research indicates exercise actually increases the amount of dopamine receptors in your brain. (This is a big deal, especially since you're probably enjoying the dopamine from alcohol) The therapeutic dose: burn 8 calories per pound of body weight, per week. (For me that's about 1,000 calories per week, tracked on a heart rate monitor.)

I'm going through pretty extreme circumstances and this is NOT making me all Magical Man from Happy-Land in a gumdrop house on Lollipop Lane! but it IS keeping my head above the water.

And just so I can say something edgy like everyone else...
Ketamine May Give 'almost instantaneous' relief for severe depression.
posted by for_serious at 10:19 AM on July 28, 2009 [3 favorites]

Marijuana and LSD could easily make the problem MUCH worse. Not saying it hasn't worked for people, but it seems reckless because of everything that could go wrong. Personally I think this is very bad advice.

What about learning a new skill? I've been learning to fly, and while I'm not dealing with depression per se, I am dealing with the stress of chronic pain, and flying helps a lot in terms of getting my mind on better things.
posted by glider at 10:27 AM on July 28, 2009

Sounds like you're suffering from Early 21st Century Syndrom!

Relevant comic

I suggest you read the reddit comment thread, and then go outside.
posted by phrakture at 10:50 AM on July 28, 2009 [1 favorite]

Response by poster: > Sounds like you're suffering from Early 21st Century Syndrom!

Damn, that's...eerie. Thanks to for_serious and purlygurl...ADD actually sounds like a possibility, worth checking up on at least, and fish oil/more exercise sound worthy of more research.

Thanks again, everyone. Much food for thought.
posted by you just lost the game at 10:55 AM on July 28, 2009

I wanted to chime in again...I definitely second looking into ADD treatment as well. I failed to mention above...but I am extremely 'ADD' although have never been officially diagnosed (I always score ADD on self-eval tests). I think this is why coffee helps me definitely look into it.

Omega-3s, man....Omega-3s. Glad you're looking into that. It sounds pseudo-science...but I have found it REALLY helpful (good Salmon sashimi puts me in a happy-coma).

Finally, with regards to your job. Your description of your job matches my experience to a 'T', so I wanted to share with you this article. The thrust is that, statistically speaking, its more likely that you (and me, and everyone else) probably never will find the job that is our PASSION. In fact, its more likely that you will have a job that you simply have to tolerate. While this depressed me at also freed me from what can sometimes feel like a fruitless search for perfection. In this vein, jobs then become a means to an end...a jobs meaning is not about the job ITSELF, but about the fact that it subsidizes what you do OUTSIDE the job. This shifts you into a more "Life-centric" mode of thinking...the pain of the job becomes a tax that you pay in order to enjoy your life outside of it. The trick then is to find a job that affords you as much time as possible outside of work, yet still pays a living wage. Anyway, here's the link:

PS - You didn't mention where you lived, but many cities have state-funded mental health clinics that have therapists on hand to help you for very little money. You will likely share waiting room space with addicts and the severely mentally-disturbed, but often that gives you necessary perspective. Also...look into your local university for graduate programs in mental health. Call them up and ask if they are doing any current research on depression that need subjects. My roomate had 3 months of full-on social anxiety treatment through UCLA with meds, a shrink AND CBT for free. Furthermore they were more invested in his well-being because it was their research. Good stuff, good way to hack the system.

Life doesn't suck even though it may feel like it, and you're more worthwhile than you'd admit to yourself. Keep at it!
posted by jnnla at 1:08 PM on July 28, 2009

I would suggest trying marijuana.
posted by sickinthehead at 3:59 PM on July 28, 2009

I would suggest that trying to fix anything with marijuana is unlikely to end well. Marijuana is a valuable adjunct to things that are already enjoyable. Trying to get enjoyment out of marijuana where there is none without it is like trying to live on nothing but barbecue sauce.

The lack of conflict over not wanting children is a fine, fine thing. In my opinion there are far too many people already, and I'm all "bravo!" to people who choose not to make more.

The fact that you've never yet found a job that you liked probably means you're not actually suited to having a job. That's pretty normal (lots of people are not suited to having a job, but do them anyway) but it's definitely a drain.

In fact, you may actually be unsuited to Western industrialized culture generally. Lots of people are. Some of them are doing something about it. Any use to you?
posted by flabdablet at 4:43 PM on July 28, 2009

What I would advocate is travelling to one of the poorer African countries so that you can see how lucky you are.

He already said doing volunteer work that put him in contact with people worse off than himself did not make him feel better. I imagine traveling to Africa would have the same result. Some people don't look at people who are worse off and think, "Oh, now I feel better!" In fact, I have a hard time thinking that anyone would have that reaction. Me, I'd have a combination of guilt (how dare I be unhappy when I have so much) and a general sense of sadness and depression over how messed up the world is.

Which is why, as selfish as it may be, I avoid volunteering in contexts that would make me depressed. I enjoy doing tutoring and teaching, or volunteering for a local theater or similar cultural venue. I enjoy spending time doing these things, so I when I volunteer I donate my time to them. I donate my money towards work I know is important but won't do myself, like feeding the hungry.

If you do have ADD, I definitely recommend volunteering with theater tech. I find that it engages my brain in a special way so I find it really enjoyable. I also enjoy doing catering work when a theater holds galas or fundraisers. Maybe because of all the moving around? May or may not be an ADD thing, though. Avoid standard fundraising work, though. I guarantee at some point you will be stuffing letters into envelopes, and I have a feeling that mindless repetitive work is not something someone with ADD should be doing. A young child could fold and stuff brochures faster and better than me, seriously.
posted by Deathalicious at 5:05 PM on July 28, 2009 [1 favorite]

Another thing I should have mentioned in the FPP is that one of the *only* things that consistently improves my mood is alcohol. Four beers or half a bottle of prosecco and all is right in the world. Which is great, but it worries me enough that I approach drinking with great care; I enjoy it so much it's not hard to see how it could get out of control.

Just wanted to point out that alcohol is a major depressant, while you may feel better in the moment mood altering effects from drinking can last for days.
posted by beckish at 6:29 PM on July 28, 2009

I like the Scuba diving idea. Also: A motorcycle helped me feel better. These are both hobbies where mistakes can sometimes mean death. The risk is part of what makes them awesome.
This can be a way to get the toil/survival sensation that Netzapper is talking about without chucking your whole present life out the window.
posted by thecolor12 at 8:34 PM on July 28, 2009

I'm much younger than you and I'm dealing with a totally different kind of thing, but I'm experiencing the same hopelessness you are. I have a few suggestions for you, given to me by other AskMefites:

-Exercise, any kind (walking, biking, climbing, doing housework as quick as you can)

-Recognizing feelings when I felt them (If I was feeling particularly sad, then instead of thinking what the reason might be, I'm thinking about how I'm feeling)

-Putting yourself in a completely different scenario. Break routine. Ask for a random day in the future off, set an alarm for it, and when the day comes go to a place you have never been before or do something that you have never done. I see that you have traveled, but these things usually require lengthy planning. Try to do something without planning a thing (other than the day off).

-Food! Make sure your diet is balanced. Eat something nice and don't worry about calories or anything like that every once in a while (not every two days!)

If you're anything like me, you'll probably look at this thread full of things to try and do and feel a little overwhelmed. But do try new things. See if it helps. I second other people on getting "tested" for ADD and perhaps looking into antidepressants. I hope that you find a way to be happier, and I wish you the best of luck.
posted by cobain_angel at 1:21 AM on July 29, 2009

I want to second that it may not be the usual major depression but dysthymia, a chronic depression that is more like an undercurrent. This description says it well:

A person with dysthymia may be able to function in their day-to-day life, but never feels quite right. They may report feeling like they've been depressed all their lives or say they feel like they are just barely managing to keep their head above water.

The ADD angle is an interesting one (I checked it out myself!). But keep above in mind in case ADD doesn't "work out" or if above is also a fit.
posted by evening at 5:24 PM on July 30, 2009

I highly, highly recommend The Depression Book: Depression as an Opportunity for Spiritual Growth by American Zen teacher Cheri Huber.

When I first came across it, I thought the idea was ludicrous. "I don't want to grow spiritually from this, I want it gone!" But her point is that like every other experience in life, one can either have the experience and learn something from it, or one can have the experience and not learn something from it. Not having the experience is not an option.

You don't have to be Buddhist to find the book helpful (I wasn't). If it doesn't click with you at first, put it aside and come back to it later. Maybe it will then. If what she says does click with you, there's a lot more available — she's written many books ((Regardless of What You Were Taught to Believe) There Is Nothing Wrong With You: Going Beyond Self-Hate is another one I'd recommend to anybody dealing with depression), and she hosts a weekly call-in talk show podcast (which has archives available online; I'm slowly working my way through the back library listening to them on the bus on my way to work).

I firmly believe that if I hadn't come across The Depression Book I would have tried to kill myself by now.
posted by Lexica at 9:59 PM on July 30, 2009

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