I am in despair
August 26, 2009 9:06 AM   Subscribe

I think I'm broken. How can I see any hope?

Ok bear with, this is NOT a Singles ad. Just giving the context...

I'm mid forties male. Single, but with a fiancée whom I adore. We don't live together yet (for unrelated reasons to this post) but plan to marry in two years. Always highly introverted, but not shy as such. Intelligent. Educated. (Incl. Couple of Master's Degrees that I've done in my spare time in the last few years). Also into plenty of activities, (running etc). Great physical shape. Live in small town in middle of nowhere because of ill mother. Don't drink, smoke etc.

Terrible mental shape though. And that's the problem.

Worked in various parts of IT past 28 years. Starting working out of school and did all my degrees in spare time. Never desired money., which was ok as I never made much. Enough to pay the bills.
Have 3 fantastic grownup kids (early 20s) and a crazy ex-partner. No career planning but changing jobs, etc moved me around a lot for years. Last 10 years working for 1 company.

Two years ago after having been put in a terrible position by company I started suffering from stress (didn't know what it was for months, shocked to discover I could suffer from it, in my case being nauseous all day and unable to eat). After months of illness I had to take 3 months off. After going back to work nothing happening there.

Finally laid off middle of last year. A lot going on in my life at the time including mother terminally ill meant I decided to take a break for 6 months or so. First break in my life. Seemed like a good idea.
Unlike those with loads of money I had saved the past 8 years since seperation, "just in case", so I could pay my mortgage for 2 years if I lost my job (Have been laid off twice previously).

6 months passed and personal life was still difficult. And by that time things were falling apart in the country (I'm in a European country, BTW) like elsewhere. Found myself unable to get motivated. Had been seeing a psychotherapist since stress event. Ok but didn't lead anywhere. Had to stop though at beginning of this year due to financial constraints.

Had been on a few different mild anti -depressants for 3 or 4 months but stopped for various reasons incl. didn't like sensations produced, preferred to handle it through exercise. Also think studies show anti-depressant SSRIs fall into placebo category.

And now, well, by now I've fallen into a trough of despair.

Mother still terminally ill, but surviving. Plenty of exercise but have to force myself as I no longer care. Eating and sleeping messed up, classic depression symptoms. Only see fiancée at weekends, luckily for her, that makes me feel better in the short term.

<>>
I don't ever want to to back to IT is one thing I've learned. Not that I seem to have a choice. The few jobs available are in manufacturing and whenever I've applied they say I've been away from manufacturing too long (because last job was customer related). In a year I've only applied for about 30 jobs and not got one interview.
In fact my Master's degrees were in a different field so I could change career, the environment, and now no-one cares about that AND I have no experience there.

All the things I imagine you saying about me, "just get on with it", "stop feeling sorry for yourself" etc I say about myself and worse. I find myself literally unable to look at myself in the mirror sometimes.
The only emotions I feel strongly are negatives, despair and hopelessness, self-hatred and self-abegnation.

I took the Burns depression checklist recently from the CBT book "Feeling Good Handbook", and I ranked as "Extreme anxiety" and "Severe Depression". Like I didn't know. I wonder if I've had the so-called "nervous breakdown".

If I was a different person I'd probably think very seriously about suicide but I could never do that to my family. Plus I'm an atheist so I don't see the point, I'm not going anywhere after.

I do often feel like I want to die.
I feel like "'I'm done", like I've been swallowed whole and spat out, found wanting, finished at 45, even worthless, compared to the people around me.
I don't want to worry my fiancée with the true depth of my despair, she already knows it's pretty bad. I don't have anyone else to talk to as my sister is also under the same stress of looking after our mother. But I no longer think talk is a solution either.
Not that I have any idea what the solution is. Bad things happen to god people. In my case I am making them happen to myself because I seem unable to pull myself out of this.

This wasn't me. With those who know me well I'd be seen as someone with mental and physical drive. E.g I did a sailing course a few years ago. A friend immediately said, "I expect you'll be doing a global circumnavigation next year". That's how people saw me. Always pushing myself mentally and physically. Always trying to be a decent man. Always wanting to do a good job. Always wanting to look after family. Always wanting to understand. Always wanting to enjoy life in my own way.

Now, I'm mostly nothing. And I'm writing to the internet for hope. Damn, can you imagine how fucked-up that is?
posted by lndl to Health & Fitness (28 answers total) 12 users marked this as a favorite
 
Dude, it seems to me that you'll benefit greatly from the kind of help only a professional can give you. If you can't afford it, check with your doctor/GP and ask if they can refer you to a free clinic.

While it's possible you'll be able to get yourself out of this pit, having someone to help you will make the whole job easier and quicker.
posted by Solomon at 9:10 AM on August 26, 2009


Do that global circumnavigation.

Why not?
posted by greenish at 9:11 AM on August 26, 2009 [1 favorite]


I also think you'd benefit from professional help. If you can't go to a free clinic in your area, you could consider calling a free depression hotline (scroll down for the numbers).

Even though you're extremely well educated why don't you apply for a job like waiting tables or retail? Getting out of your home and interacting with people might help you feel less lonely while you apply for another job.
posted by kylej at 9:16 AM on August 26, 2009


And I'm writing to the internet for hope. Damn, can you imagine how fucked-up that is? (lndl)

It's not fucked up—it's a first step. Now you just need to take the second, and the third, and so on. One step at a time.

We aren't going to tell you to "just get on with it" and "stop feeling sorry for yourself" because it's clear that you need real help. Please, use the momentum you've gained by speaking to us about your situation, and call a therapist. If money is still tight, know that there are many who work on a sliding scale, and who will work with you to make their services affordable for you.
posted by ocherdraco at 9:19 AM on August 26, 2009


Volunteering could also be a good option for you.
posted by kylej at 9:20 AM on August 26, 2009



Read the book Feeling Good by David Burns, It saved my life.
posted by zulo at 9:20 AM on August 26, 2009 [2 favorites]


There are lots of inexpensive/free psychotherapy clinics. And if you don't seem to be "going anywhere" with one therapist, then try another. I used to do IT and now I don't. It's not as strange a transition as it may appear.

Now, I'm mostly nothing. And I'm writing to the internet for hope. Damn, can you imagine how fucked-up that is?

This is merely how you're feeling at the moment, even if it appears to you to be a deep insight into your true nature. That feeling can and will change if you allow it to not be "the truth you've discovered about yourself."
posted by Obscure Reference at 9:22 AM on August 26, 2009 [1 favorite]


Why not give antidepressants a second try? Any negative sensations from them are better than how you feel now, and if it's a placebo effect -- so what if it works?

As far as hope, you have lots of reasons to have hope. You have a fiancee and three kids. You have a chance to be with your mother while she's ill. You have years of experience in a desirable field. You have multiple Masters degrees. You have your health.

Life has its ups and downs, and right now is a down moment for you. But for hope, you just need the cloud to lift a little so you can see how many reasons you have for tremendous hope. Please reconsider your stance on antidepressants.
posted by Houstonian at 9:30 AM on August 26, 2009


Had a sneaky peek at your past questions and it seems you're in Ireland - have you tried the Aware Helpline? Look like they also have a network of local support groups. Bit more to hand than us lot on the Internet maybe.
Sorry I can't offer much more, just touched by your question here and wishing you all the strength you need.
posted by Abiezer at 9:44 AM on August 26, 2009


Talking is good, books are good, volunteering is good but all of the symptoms you're describing respond very well to medication in just about everyone and also make all of those other things easier to do. There are plenty of non-SSRIs. Wellbutrin, for example. Europeans also like St. Johns Wort, for what its worth.

With apologies for sounding harsh but taking some unnamed meds for 3-4 months and then stopping for "various reasons incl. didn't like sensations produced" suggests that you were not serious about dealing with this. You may not like some of the side effects, but do you like them less than the general life-crushing depression and anxiety you're describing?
posted by RandlePatrickMcMurphy at 9:47 AM on August 26, 2009


This definitely sounds like a textbook case of Major Depression.

The first thing to understand is that you need help from other people. It is very difficult to heal yourself alone. Make use of every free or low-cost resource you can. The places already mentioned are a great starting point.

Next, realize that you are suffering from a very real medical condition. You need a doctor, and you may very well need to take medication again - a doctor would have to determine for sure. Keep in mind that there are a *lot* of antidepressants out there, and everyone who needs them ends up trying a lot of different ones (sometimes a dozen or more!), before finding one that both works and has the most minimal or tolerable side effects.

Things are not as bad as they seem, but your medical condition has you looking at the world through a sort of "dark lens", which makes everything feel worse than it is. You can break out of this.

Good luck, lndl. I'm pulling for you.

(p.s.: The usual disclaimers apply, IANAD, etc.)
posted by Citrus at 10:06 AM on August 26, 2009 [2 favorites]


Suggestion from left field: Depression, heavy mid-life crisis, or perhaps ... an existential crisis?

It seems that all the things that used to mean something to you, and in particular all the things you tried so hard to be, are as dust to you now (per your penultimate para.)

It sounds like your identity is disintegrating, and you're desperate to find something solid to cling to, someone to really BE, while at the same time you're resisting doing that, because it's all feeling meaningless to you. Maybe your feelings of despair and low mental state have been precipitated by the job issues and losses, maybe by the ongoing and impending loss of your mother, maybe other events or non-events or by a combination of things; in any case, they could be depression, or they could be an initial despairing reaction to the realisation that life is meaningless and absurd (existentialism).

Folks have already given appropriate depression advice (try helpful drugs again, try talk -- especially cognitive therapy -- again). So here's the existentialism advice: Embrace that the world is meaningless and life is absurd. Accept it as a tragi-comedy and enjoy the freedom of that embrace and acceptance. Give up trying to find meaning and take life as you find it, as it is, in all its concreteness and beauty.

May you be well --
posted by mmw at 10:14 AM on August 26, 2009 [4 favorites]


If you feel you can't talk to those you love about what you're experiencing, it's time to find professional help. Someone can help you figure out the best way to overcome this. And it sounds like you have a lot of good things in your life that give you a reason to make sure you do.

Do you do anything creative? Art (photography, for me) is often good at helping people appreciate the beautiful/good things around them.

For reading, you might try Undercurrents by Martha Manning. It's a very honest account of a psychologist's experience with depression severe enough to require ECT. It can be difficult to read at moments, but it's also an excellent insight into how others fight/cope with depression.
posted by bibliophibianj at 10:52 AM on August 26, 2009


I heard a good definition of Depression recently, that seems very relevant:
"Depression is when the things you've been doing till now stop working."

I think that's a useful place to look at it, because it implies that you're going to have to give up things that don't work for you anymore, and then choose to explore new things and see what will work for you.
posted by blueyellow at 11:02 AM on August 26, 2009 [3 favorites]


I dont know how much of this will help you, but here is what ive found occasionally works:

- keep distracted. paint, read, dance, spend time with your friends, i find depression sets in easily when theres a lot of time to think.

- talk to someone. someone who doesnt think that you can feel better by sheer willpower, or will tell you to "cheer up" all the time, tho. someone who'll just listen and understand.

- try love yourself. tell yourself all the things that upset you, and then, pretend youre comforting a friend. tell yourself its going to be alright, that you care, and that you'll help. I may just be crazy, but i find that even having *myself* on my side (instead of thinking "god youre useless" all the time) helps.

And i get what you feel about mirrors. Sorry if none of this applies to you.
Good luck. Dont give up.
posted by stillnocturnal at 11:16 AM on August 26, 2009 [1 favorite]


Oh, and ditto anti-depressents and therapy, they might help, they might not, but what have you got to lose?
posted by stillnocturnal at 11:21 AM on August 26, 2009


I'm no doctor but I was diagnosed with major depression, and I agree that this sounds like the same thing. Major depression is a medical condition for which drugs are part of a reasonable solution.

My long-standing depression was helped by standardized extracts of St. John's wort (not tea or some random capsule) (and studies back this up) but frankly if I were you I'd go for the heavy-hitting drugs in hope of a stronger effect. It sounds like you were on the wrong ones.

Please try anti-depressants again, and try for longer. It takes awhile for any pharmaceutical, including St. John's wort, to kick in (almost two weeks for me). But once it does start to work, you'll begin to have the energy and hope you need to make positive changes to your life and get a good therapist or talk buddy.

The "loser" messages in your brain are coming from the depression, which is a chemical screwup in your brain. They aren't correct. Your negative beliefs are a misperception caused by the depression. It's the same thing that happens if you have the flu and your sense of taste changes. The flavors are really still the same, it's just your perception that has changed, due to a medical condition. Please understand that depression is medical. It's not what defines you. It's separate from you, and it's your enemy right now because it's talking and you're listening.

The right pharmaceuticals will give you an important boost that will make deeper changes easier. You can challenge the depression-induced beliefs with structured, goal-oriented therapy. I got the best results from cognitive therapy, which for me was a logical, rational approach that got quick results.

I wish you the best of luck. Please take strong action now, because you can turn this around.
posted by PatoPata at 11:56 AM on August 26, 2009


The odds are very very strong that with the proper antidepressant and dosage this will turn around.--PatoPata's post is right on. It is also very likely that with out psychiatric intervention your depression will eventually resolve itself--HOWEVER--it is also very likely it will return with even more depth and breadth. This is not something to intellectualize, rationalize or deny. It is a medical problem and requires medical intervention--there are no perfect psychiatric drugs but there are many many very good drugs that will work given the proper dosage. It is well established that while many primary care physicians will prescribe antidepressants they often dose to lightly, do not anticipate and manage the side effects and are reluctant to use the whole formulary of available drugs
posted by rmhsinc at 1:10 PM on August 26, 2009


Are you getting any kind of hospice help for your mother? Hospices here also offer counseling to caregivers/family members of dying patients.
posted by mareli at 1:36 PM on August 26, 2009


I have gotten so much help from the internet that I think the internet is an excellent place to ask for help.

I had better-than-placebo results from SSRIs but did not like the side effects. I got put on a tricyclic, which is supposed to be worse for side effects, and on it I feel really much improved.

I'm 28, and obviously in a very different place and life (and, you know, a girl, which does make some things different), but I've found that there are some things that when I think about them, I kind of... light up, even when everything's very black. For me... The idea of going back to school. My cats. The idea of doing something to help with certain social issues. My writing. My hometown.

So I started making lists of things that made me feel good. Things that I was passionate about. People who I was happy around. And from there, brainstorming plans about how to integrate those things into a life I wanted to have.

That's not a substitute for medication. Medication is not a substitute for that. Both together and I'm getting somewhere!
posted by larkspur at 5:39 PM on August 26, 2009


Wow. I had to read this twice to make sure I didn't write it myself. 46. Formerly in a soul-sucking IT job for most of my adult life. When faced with yet another kick-in-the-nuts "performance review" given by my inept middle-manager, I said, "I think I've had about enough of this," and walked. That was about four years ago. I spent some time volunteering for a local non-profit, rebuilding donated computers and giving them to low-income families. That was pretty therapeutic; I made some real friends, and got to see first-hand "how the other half lives". Currently not employed, but I inherited enough money that I was able to pay off our mortgage, so we're debt-free except the usual stuff like insurance, car expenses, food, etc. I was never into sports or hiking or any kind of outdoor activities, but I discovered that I really enjoy making things with my hands. I'm not very good at it, but it feels right, so I hope I'll get better. I, too, was deeply depressed and suicidal. I finally dragged myself to a therapist for a couple of years back when I had insurance that paid for it, and was put on SSRI's, which made a world of difference. I was also diagnosed with severe sleep apnea at about that same time; now I sleep with a CPAP machine and wake up refreshed instead of frazzled. I'd strongly recommend you give a couple of different SSRI's a chance for a month or two each before giving up on them. They apparently work differently for different people. And try doing something with your hands and your muscles instead of your head for a while. Plant a garden. Build some birdhouses. Fix up your house. Volunteer at a place that does recycling or refurbishing of equipment for a worthy cause. Get outside your own head. Eat healthy food, get a little exercise, read some good books, maybe make a couple of new friends at the library or the place you volunteer and spend some time with them. I know what you feel, and it's ugly and dark and scary as hell, but you're not the only one, and you can fix it if you're patient with yourself.
posted by Death by Ugabooga at 7:05 PM on August 26, 2009


Find a doctor you like who will work with you on medications and check in with you on a regular basis- as in you having regular, frequent appointments while you're getting on medications and working with various dosages. You may have to have a higher dosage of one, or need to switch to another, but there are many drugs out there. And some of the side effects, as annoying/unpleasant as they are, end up being worth it. At the same time, seek counseling. Whether you're able to do both with the same doctor, I'm not certain. The key to both of these is to switch doctors or counselors if you're not comfortable. Additionally, while I was getting on drugs initially were some of the worst few weeks of my life because my depression was still out of control, I was dealing with side effects, and the drugs hadn't kicked in yet, so be prepared to be somewhat patient.

Most of all, tell your fiancee and other close people so they can help support you. Let them know what you need if you know what helps you. And then also reassure them to vent to you about things, or talk about their days, so you always feel like you're also providing them support. Remind yourself that you would want your fiancee/friends to talk to you if they were going through hard times in their lives. Take it one step further and make yourself do what you would tell a friend to do if they were feeling how you are.

I also nth the volunteering, or if you're not up for something so formal, doing small nice things for people you know, whether that's care packages for a sick friend, mail of any kind, a cup of coffee- but doing something nice for other people will make you feel more needed, more productive, and keep the depression from convincing you that you're a burden. It really helps me to focus on other people (to a healthy degree) and putting something positive into the world.
posted by questionsandanchors at 7:30 PM on August 26, 2009


I signed up for metafilter because of your post.

I was at your stage not long ago.

You are an IT person. I am also a highly technical IT person developing C++, multi-threaded software.

I stopped working for about 4 years due to various events but got significantly better due to some key things.

My oddesey with psychiatric doctors is a whole different post but I'll just say that I've lost a lot of respect for every single one I've met. In my opinion, they have disgraced the name of science. The field of psychiatry is a science but I do not believe the doctors I have met are practicing proper science.

I have never taken any medication. This does NOT mean I think nobody should take medication and I encourage you to make a CAREFUL decision.

I have found that the doctors are very naive in their approach. The use of medication is important for some people but I found that they use it as a blunt instrument for nearly every type of problem. You could ask a perfectly fine person off the street to describe his/her life problems and the psychiatrist would be overjoyed to prescribe an SSRI.

I think the key is to address the ROOT problem.

As an analogy, if you have a defect in software, you MUST locate the source. You cannot take a wild guess and hope for the best. You have to isolate the bug through logically deducing where the problem is.

If the root problem is an organic brain issue THEN an SSRI can be a strong argument. This is not an easy task. The psychiatrists I have met can do this within 30 minutes - apparently they are all geniuses.

I had life events that lasted over many months and years (relationship betrayals, job betrayals, family betrayals- everything!) and yes I was also suicidal. Trust me, I spent years not motivated to work. The only thing that mattered to me was to make my relationship with my girlfriend work but that died unfortunately.

I believe that after a negative life event, your mind might THINK you've moved on but your deeper mind has NOT forgotten. Then you scratch your head and can't figure out why you are feeling sad, anxious and not motivated for no reason at all.

And you feel messed up but don't know why. Nobody knows why so you're given an SSRI.

Enough of that, now I will describe what worked for me. It looks deceptively simple but it is HARD work until it becomes a habit.

But the reason it worked for me is because it is simple and concrete. When you are sad and not motivated the likelihood that you will do something complex is low.

Think of it as simple but powerful like C++ pointers.

1. This is the most important thing for me: B-P-F-R-A

I'll describe the acronyms in a minute but this is a type of mantra I created for myself.

When you think about it, you already have a mantra all day whether you like it or not. A mantra that causes you to be feel down. The more intense you do any mantra, the more it becomes who you are. You are what you think.

The mantra below is my version that deals with feelings. I have a more extensive one that helps me with logic and thinking.

Many people who are really good at something (musicians, math people, etc) have an internal mantra that they may not even be aware of. They've been practising their talent for many years and some actions and thoughts are just automatic in their brain. It takes years and years of hard work to be an expert. I believe you can become an 'expert' on feelings. Some people are naturally emotionally intelligent.

All I do is loop slowly and carefully through the items in my mind for 10 minutes every morning and 10 minutes every night before bed.

The acronyms stand for:

B - Breathing: Proper breathing is critical to calm the nerves. Do NOT trivialize this. it is more complex than it sounds. This is an excellent reference: http://swamij.com/diaphragmatic-breathing.htm.
I also highly recommend the Emwave (http://www.heartmathstore.com/). I do my mantra with it.
P - Posture: Proper posture will change your mood. Try it right now. In 10 minutes you will likely revert back to your bad posture. Change takes time to happen in the brain. This is why the mantra is important.
F - Feel: Just be aware of what you feel right now, good or bad. You'll use it in the next step.
R - Reference: Be aware of what your ideal reference is. For example, if you want to feel more positive or happier, just imagine how that would feel/look/sound for you. You may move back and forth to your old feeling of sad. But finding a reference is important. We are basically building a kind of feedback loop. For example, in electrical engineering if the voltage is too high or low in a feedback loop, it is adjusted to a value closer and closer to the ideal even though it never really gets there. It is a continuous process.
A - Attention: Attention is critical to ensure that your mind moves back to the Reference. This part of the mantra is to ensure that you are always aware how important Attention is. How about not giving your bad feelings any of your precious attention time. Keep moving it back to the reference.

Create YOUR own mantra and do it every morning for 10 minutes and every night for 10 minutes.

You WILL be a different person over time. But only OVER time, not for a week, not for a month. Do it consistently. I struggle sometimes but I'm getting better and better incrementally.

2. Prioritize you goals in life.

This is a continuous process as well. Find your most important things and give time only to them.

Money isn't the most important thing in the world but you need to eat and have a roof over your head so it has some level of importance.

Ask yourself:

If you were to die tomorrow, what would you be doing today? Then why aren't you doing it?

What things make you happy, sad? Can you move in a more positive direction?



3. Mental Exercises

When my relationship was in the dumps, I stopped working and completely ignored technical stuff. What importance is it if I solve a difficult technical problem if my relationship is not on track?

I was wrong. Do not underestimate the positive benefit of mentally challenging your mind either through work or puzzles or whatever.

First, your attention is taken off bad feelings and the other part of the brain kicks in. Second, the logic side of the brain will NOT suddenly stop firing when you think about your emotions. It will help you think logically about your emotions.

Now think about a human with emotions but without any logic. What a disaster.
Now think about a human with logic but no emotions. What a disaster.

Balance both. I learned the hard way. At one point I was just a bundle of emotions - no smart solutions can come of that only emotional reactions.

Being in the IT CAN be a good thing - I thought I didn't want to go back because of certain people. Go to stackoverflow.com and see if your motivation can be sparked again - smart, helpful people there. Its good to have the right people around you.

4. Exercise

This is a must - find the right thing for you. Make it a habit. Physical exercise helps the brain.

I used to feel sad going to the gym and would even skip it because I would compare myself with others. But if I don't go, I'll even be in worse shape! That logic makes more sense than staying at home.

I highly recommend yoga. It is not just physical but mental too and you will learn breathing properly.

I thought it was going to be easy stretching but it is much more intense than that.

There is a vast set of knowledge in yoga. Yes, there are some unscientific claims in yoga but there is some ancient wisdom about the human body and mind in yoga.

5. Nutrition

Eat Omega-3 Foods: Walnuts if you don't like fish. Eat wild salmon, sardines. Your body and mind won't regret it.

Vitamin D: I will plug this vitamin because it makes so much logical sense to me. Vitamin D acts more like a hormone. We humans did not evolve indoors yet we stay inside all the time. We were almost always outside and got sufficient vitamin D. I take 1000IU a day.

6. Read, read, read.

Lots of opinions, self-help books out there. You can never stop learning how to improve yourself.

Unless you are gifted and can instrospect yourself to the core, learn from many people's knowledge and mistakes.

7. Minimize crappy media

Low quality Tv shows, silly hyped music, etc., etc. I don't want to know about Paris Hilton but yet I see it in the mainstream news regardless.

Junk for the mind. I NEED something more enlightened.

Go to www.fora.tv - awesome brain stuff, youtube is ok if you look for the good stuff but there is a LOT of junk there.
Metafilter - most intelligent discussion group I've found so far on the internet.

8. Be Around Positive, Supporting People.

If you have negative, energy draining people around you, limit your time with them.

Even if they are family. Be selfish so you have the energy to be generous to the people you care about most.

----------

Those are the major ones for me. If I think of more I'll post it.
posted by simpleton at 11:35 PM on August 26, 2009 [13 favorites]


Another thread about depression:
http://ask.metafilter.com/131242/Selfdestruction-and-the-struggle-against-depression

I like the comment by fatbird. An interesting post about his/her approach regarding habits of thinking which I think in some ways align with mine.

"

The key is focussing on the 'habit' part instead. Habits aren't changed by grand decisions or maximum efforts. They're changed by continually taking small steps in a certain direction. This is, I think, why a lot of effective treatments for depression have to do with behavioural tactics: taking a walk, going to a different room, starting to do something. They aim to short-circuit the habitual process of depressed thoughts leading to shame and guilt and feelings of worthlessness that lead to more depressed thoughts.

Ultimately I broke my habit of being depressed by attaching contempt to it, by feeling a bit of disgust towards myself when I recognized that I was starting this cycle. That motivated me to distract myself right at that moment, to do something else, to move somewhere else, to think about something else. By bailing out of the mental process each time, I built up a backlog of experience of not being depressed that made it easier each subsequent time to recognize it starting and to pre-empt it with something else, each time with more confidence that it would work because it had worked in the past.

After several years, those episodes didn't even start anymore, and I'd gained a tremendous measure of mental confidence in my ability to direct my mindset usefully. It's been a benefit my whole life since.
posted by fatbird at 9:31 PM on August 26 [+] [!] "
posted by simpleton at 12:05 AM on August 27, 2009 [1 favorite]


I'd like to thank you all for your kind, considerate and helpful comments. I wouldn't like you think I was ignoring them, I was actually very touched reading them.

I won't go into a very long redacted response but will answer a few things. Since I'm Irish, I've found my idea of "short" is not others'. Even quiet Irishmen like myself talk a lot.

Many of you recommend exercise. I'd often read exercise was an excellent control for depression. As I said, I do a lot of it. I'm currently training for an English Channel solo swim next year having already completed a double English Channel relay last year (though without much enthusiasm any more). I swim currently about 5000 metres a day, an hour and a half to 2 hours approx. Even when I have no interest in swimming, I am still keen to go most days, it's the only time I feel any control in my life, though I have found as the depression has increased that I've lost the ability to push myself to limits I could previously achieve.
Since I swim so much, I have to eat well, even when, like now, I find it difficult to eat, what I do eat is good. Any SSRIs I tried affected my ability to exercise, esp. causing dizziness.

I read. I read a lot (two tenses there). I've spent my lifetime reading, it's my one true "talent". I estimate maybe 8000 books in my lifetime so far. Reading has also taken a knock recently, I've gone from 1 or 2 books a week to maybe 1 a month for the past year. My concentration seems shot. What I do manage to read is comfort reading.
When attending the psychotherapist last year though I did read a lot in the area of existential angst et. Frankl's "Man's Search For Meaning" and Robert Bly's "Iron John" particularly had powerful resonance for me. There is no doubt that part of my problem is trying to come to terms with life and my place in it. I have reached (late) the point that Bly points out where much that I've done before has ceased to have meaning. This would be difficult anyway, but in my case I find myself without a way of doing something else.

As an atheist, I've always known that everything is random, that life has no meaning, other than what we impose on it ourselves, that it is in the choice that we define ourselves, and that morality only has meaning when freely chosen, rather than proscribed by some imaginary fairy or followed through indoctrination or fear.
Also, as someone with a scientific background and outlook, I've have been very lucky to be able to see beauty in everything. Used to drive my eldest son mad when he was young, for some reason. The light in Kerry, willow trees on the river bank, the beauty of open Source software, the pleasure of swimming alone half a mile offshore. This is something that has sustained me. My fiancée said she's never known anyone else able to derive such pleasure from these things.

Doing things; I've always "done things". I have gone from one project to another, one obsession to another. I am the guy who got up at 5am on a winter Saturday morning to drive across the country to surf or swim. My garden looks great etc. One of the things that came out in therapy is maybe one of the reasons I always "did things", was that it was allowing me to hide or ignore "me" or stop me having to confront myself. I don't know.

Everyone here talks about medication. I understand what you are saying. Let me explain further. Last time I went on an SSRI I gave it a good few months, I was doing ok on it, one main side effect: no libido. Lowish dose.
My GP diagnosed it, around the time I was off work with stress. At that time I was trying to make a small change to a life insurance policy. My insurance company wrote my GP for my records, as they do here. He could refuse to give it but then they refuse cover so I told him to show the records , thinking no more of it. Based on his diagnosis of stress/mild depression and suffering something similar 10 years previously when my father died and my previous relationship broke down around the same time, the insurance company determined (contrary to my GPs advice) that I was high risk for mental illness. And refused the extended cover except with exorbitant premiums. So now I'm afraid to ever have anything on my record again. Everyone says depression is much more accepted now. Seems I've been punished by the insurance company.

Also, I'm unemployed. I can't just chop and change GPs or medication as I please. I have free GP cover since I'm unemployed but only by staying with my registered GP. I maintain myself for the moment by being ruthless about spending, I have a spreadsheet that dictates everything. I'm spending my savings slowly and right now I can make my Social Welfare pay almost everything except the mortgage.

St. John's Wort was withdrawn from sale in Ireland some years back, the government I guess didn't want people trying to help themselves. Based on your advice I have asked a sister who lives abroad to send me some. I had read previously but forgotten that blind tests show it is effective.

I spent a lot of time by myself. So I am going to give consideration to the volunteering. I should have done this previously. Though I am the first person people call when they need help and I've always done things for others.

I already had "The Feeling Good Handbook", but couldn't face it. I started reading it 2 nights ago based on this thread. I'm not sure I'll have the courage to continue with it, but I'll try.

I like the B-P-F-R-A thing. I need to remember to try/learn this. I started getting anxiety palpitations recently, on top of everything else. I felt like I was having some kind of attack.


Probably the most thing difficult though in all the responses is:
"If you were to die tomorrow, what would you be doing today? Then why aren't you doing it?"

I don't know. The closest is trying to save the world, which is why I did my two environmental Master's. All attempts to find work in the area have failed, due to my lack of experience and the current economic climate meaning nobody cares about it right now, or at least no-one is hiring or wants to spent money on it. I'm caught between two work worlds. My old one has kicked me out and won't let me back in and I can't seem to find anything in my preferred world, including entry level jobs.

Thanks for your thoughts, wishes and advice. They are deeply, deeply appreciated. I will try to PM to each of you individually
posted by lndl at 3:55 AM on August 28, 2009


Hi Indl,

Some thoughts that come to mind after reading your reply.

A few things stand out.

As far as your motivation levels, you DID have a lot of motivation over the years to do all the things you did (reading, swimming, etc).

But you lost it at some point as did I.

It is THE most critical thing to solve in my opinion. You cannot do anything without it. No advice, books, or therapy is going to be useful because its difficult to even kickstart anything. On bad days, I used to spend almost a full day in bed just mentally motivating myself for the highlight of my day which would be to go for a 15 minute run.

There are whole books on Human Motivation but it is still quite mysterious to me how to muster up the energy for activities. The only thing that seems to work for me is to understand how much I value an activity and then push through the fear, boredom, etc.. I think of it like a giant boulder that is hard to push at first but then after it starts rolling the inertia kicks in.

I complained about my concentration levels to my therapist as well to no avail. There ARE techniques to improve it. I recommend watching the Brain Fitness Program by PBS to start
See http://www.youtube.com/watch?v=CRldD_Z9l2s.

In the B-P-F-R-A mantra I suggested, I shortened it to make it simple but in my longer version I do have a D which stands for drive. For anything I do, I ask myself what intensity I should I apply. How much do I care about what I'm doing?

I'm still learning how to manage my motivation too so I know the advice above is perhaps weak.

But I think part of the key is to struggle to find the answers. One can feel sad all day or struggle to find solutions. The struggle is a necessary requirement to find solutions. I have a friend that refuses to read, refuses to learn new things and so she is stuck and complains about life. You are not like that I know. I want to help her but I don't know how if she does not want to push herself.

You mention you are an atheist. I understand and respect that view.

I will only briefly state my view as I'm not sure we want to end up having a debate people's views.

I am agnostic which to me just means "I don't know the answer but I'll keep learning". The reason I like this view is that there is too much in this universe that we DON'T know and with our feeble brains, maybe we can never know. This is why I keep an open mind about a possible God.

Yes, as a scientist, logic rules and I enjoy reading logic textbooks on vacations believe it or not.

But no matter what, I always end up thinking that there is so much I don't know so maybe there is a greater plan for all of us and we don't know or can't even comprehend it. As an analogy, can animals understand that they are in the zoo?

I like your point of seeing beauty in everything - I feel like that too many times.

It reminds me of this quote.

Albert Einstein
The most beautiful thing we can experience is the mysterious. It is the source of all true art and all science. He to whom this emotion is a stranger, who can no longer pause to wonder and stand rapt in awe, is as good as dead: his eyes are closed.


Isn't this world mysterious enough to warrent the possibility of something greater than us?

Enough of my sermon...

I was also shafted by my insurance company. They are NOT there to look after your best interests - they are there as a business looking after their bottom line.

I'm on my own now. No job, no wife, very little emotional support from family, just metafilter -:)

But I feel good that I can manage my emotions and can function well.

I used to be really upset that I didn't get what I thought was the proper emotional support from friends, family, the wife. Now I don't look to others for approval but look to myself for strength. That was hard for me to accept.

I have a bit of money saved fortunately and I am going to travel to Istanbul for several months and focus on yoga, exercise and my own personal growth.

After that, I would seriously consider going to Ireland to set you straight - :)

Actually, I'm not sure where I'm going to go after Istanbul. I have a UK passport so I plan to work somewhere in the EU. Ireland is part of the EU so maybe?

I used to volunteer making meals for people who are terminally ill. Be careful of the environment you put yourself in. You may react differently than you expect. Even though you are helping, the environment may not be what YOU need.

well, take care
posted by simpleton at 6:49 AM on August 28, 2009


FWIW, my libido went into the dumpster when I was put on Paxil, so my therapist added Wellbutrin (which apparently has the side effect of making you a real horndog) to the mix. The combination seems to have me back to my usual level of interest in sex, with the side effect of delaying orgasm quite a bit (which is a bonus in most situations!). Good luck to you. YMMV.
posted by Death by Ugabooga at 5:20 PM on August 28, 2009


FYI;
following advice here I received my St. John's wort this morning.

From Wikipedia:
"According to the Cochrane Review, a key resource in evidence-based medicine, "the available evidence suggests that the hypericum extracts tested in the included trials are superior to placebo in patients with major depression; are similarly effective as standard antidepressants; and have fewer side effects than standard antidepressants."

Anyone who'd read Ben Goldacre's "Bad Science" will be familiar with the Cochrane Review, which, if I recall is a non-profit organisation that does meta-analyses of medical studies and has had profound effects on some areas of medicine since it started.
posted by lndl at 2:12 AM on September 7, 2009


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