There are often discussions on Hacker News about depression or suicide. Lots of the comments give helpful advice from people who have battled depression at some stage. there was a post by someone suffering from depression. That person was wondering how they could repay the people who were supporting him. I’m lucky to have had amazing help and support in my path through depression. Looking back after a decade of ultimately beating this illness this is one attempt to give back to my community on this topic.
In 2013 Aaron Swartz committed suicide after suffering for years. The path out of depression is difficult and unfortunately, there is no silver bullet. Here I wanted to document the path I took which certainly saved my life from a similar consequence. and I hope that my journey might be useful for someone in a similar situation to mine.
I’m not a doctor. In this post, I’m documenting what path ultimately worked for me in my situation. This may not be the path for you and I’m not claiming any scientific basis for what I’m describing here. I do believe there are likely similarities between my situation and others in our hacker community which is why I’m writing this as a guide. That said there is one thing that overarches this message: you should get help. Depression is not something that is easy to conquer by yourself and help is out there. If you are feeling like committing suicide these steps might seem long or too indirect. You can get immediate help by calling 1-800-SUICIDE or 911 (at least in the US). You should also find a medical professional whom you trust—see my recommendation below on some tips about finding one that works for you.
Let me be clear that I’m referring to clinical depression or Major Depressive Disorder (MDD). I’m not necessarily referring to low mood, though some of the things here can help with this. If you are suffering from MDD the most important point to realize is that depression is a sickness. I personally find it hard to describe what it felt like to someone who hasn’t been in this mental state. Most people have experienced low mood at some point and when discussing it with them I usually feel they view MDD as low mood but worse. My experience was different and MDD felt like something entirely different; it was both a feeling of suffering (like low mood but not derived from feeling sad about a situation) and of hopelessness but at the same time so severe it made doing very basic things very difficult.
Here are the steps I took to ultimately beat that sickness, become healthy again, and prevent any return of the symptoms:
Depression is a sickness and you are sick. The symptoms of this sickness affect your thoughts and make it hard to realize you are sick. In my case the sickness caused me to think that my life wasn’t worth living. There was nothing in my life that would prove that was true yet that’s what the symptoms of depression were telling me. In the midst of my depression, it was hard to stop trusting my thoughts and look at why these thoughts weren’t true—but you need to do that. Attempt to differentiate the thoughts caused by the sickness and those that are your own. Try to adopt the same view you would if you were injured—you need to address the injury and give your body (and brain) time to heal. These symptoms might feel like they will never go away and that is part of what makes depression scary. The more you tell yourself that the symptoms can go away and that the thoughts are not part of you but are caused by the sickness the more you can adopt a viewpoint that will help you heal.
Don’t let suicidal thoughts win. This is an extension of the last point but is so important it has its own point in this guide. About 60% of people who have committed suicide were found to have been suffering from MDD. I certainly had suicidal thoughts. The symptoms of MDD were telling me that ending my life would be the only way to end the suffering. To counter this I set up a logical game in my head to help prevent me from acting on these thoughts. For example, I would set deadlines like “If I feel this way non-stop for the next two weeks then I’ll consider a way to kill myself.” when I knew I was only suffering the worse symptoms for 24-48 hours at a time and the condition was very unlikely ever to be true. Or I would say that I could only attempt suicide at my parents’ house which is where I knew I would be safe and protected by them. I believe this is the same situation people who jump off bridges during rush hour are trying to create. They are likely just hoping someone will stop them and keep them from listening to the thoughts coming from their sickness. Whatever you need to do you can’t let these thoughts win. Another trick I used was to think of people who were possibly suffering more than me and I watched how they dealt with that suffering and ultimately conquered it. One example of this is that I listened to this song by Ben Harper multiple times per day to help with maintaining this mindset: Ben Harper – The Will To Live.
Support your brain by keeping a clean diet. Remove the processed sugars from your body, eat whole foods, and eat lots of plants (greens, fruits, and vegetables). I had just graduated from college when my depression started and I had been living on a diet of pizza, sugars, sodas, rice, and other quick-to-eat foods. I switched to a regular diet of whole foods based on recipes I had grown up with (I grew up on a farmer's meat and potatoes diet, but I added salads as well). I also found I needed to cut caffeine and alcohol out of my diet as well as these caused severe ups and downs in my mental state. I also added a good food-based multivitamin and a fish oil supplement. I use New Chapter Every Man Multivitamins and I take 3600mg Omega-3s from Nordic Naturals Ultimate Omega Fish Oilsdaily.
Exercise at least 5 days a week. At the low point of my depression, I was unable to get out of bed and I sometimes spent hours even unable to open my eyes. Exercise seemed out of the question even though I had been in great shape a few months earlier. Every time I felt my symptoms worsen I started walking. At first, I just walked around the block or down a local street with shops where I could distract myself a little. Eventually, I started forcing myself to go on longer and longer walks sometimes multiple times a day. It both helped me deal with the symptoms but also kept me doing some exercise when I didn’t feel like I could do any. Eventually, I took up more vigorous exercise which led to positive hormone release and helped counter the sickness.
Medication is not a cure-all. I took two medications during the depth of my depression: an SSRI antidepressant and a medication for my panic attacks. The panic medication would work within minutes stopping my panic but leaving me light-headed and out of commission until it wore off (which wasn’t a big deal since I would have been out of commission with the panic if I hadn’t taken it) yet the SSRI certainly did not have any immediate effects and had no noticeable positive effects within the first two weeks. My depression actually got worse for the first two weeks after starting the medication. That was hard and left me more hopeless. At the time when you need relief from the symptoms because they are so bad you are turning to a doctor; the medication doesn’t have a direct and immediate effect. At some point around two weeks after starting the medicine I did start to slowly get better. I stayed on it for 6 months until the worst of the symptoms were gone and then stopped. Stopping left me lightheaded and unable to work for a couple of days (I stopped cold turkey but maybe tapering off would keep this from happening). The medication can be the lifeline you need but realize that the effect will not be immediate if there is an effect at all.
Work with a doctor—but realize they might not provide you with everything you want. During the primary months of my depression, I worked with three or four doctors. Each was willing to listen to my symptoms and work with me on medication. What I wanted, and what I didn’t get from them, was a feeling of sympathy and kindness towards my suffering. This was awful and left me even more hopeless. I was eventually referred to a psychologist and when I felt the same thing about that psychologist I was referred to another. Eventually, I found one with clicked with my personality, and at some level, I felt like he cared about whether I would get better. He gave me challenges each week to work on and celebrated my success when I met the challenges. It took time but I eventually found a medical professional who was helping me with this process (I had to stay with the doctor for the medication but worked with the psychologist in parallel). There are many types of people out there so if you aren’t getting what you need from who you are seeing keep exploring.
Stay open and allow others to help. Realize you need people around you who can be a support network. This is the hardest thing to do when you are suffering from depression. Forming this network and opening up to being helped were the main challenges I worked on with my psychologist. Ultimately this made the single biggest difference in my recovery. Going into my depression I had purposely isolated myself from others. I didn’t want to depend on anyone and I didn’t want them to depend on me. When I got sick and needed someone for the first time in my adult life I didn’t have a pool of people to lean on. Luckily I had my parents and they did support me while I learned to grow my support network. With my psychologist I worked on opening up, doing things my illness didn’t want me to do (like going out with people I didn’t know), sharing how I was feeling with others, and meeting new people. If you begin to work on this also realize that opening up to some people too early, especially about your illness, can push them away. There are some people who aren’t ready to take that on in a relationship. Don’t let that put you off—those people just aren’t right for your support group. I was lucky that I met one new person with whom I shared several interests (we both worked at the same company of programmers and both played the banjo). He was also open and kind and he knew lots more people like that who he then introduced me to. You need these kinds of friends and you deserve them. It only takes one friend like this to be the beginning of your support network.
Work on a positive outlook. The book didn’t exist at the time but Flourish by Martin Seligman provides a framework, which in his research is effective in treating depression, called positive psychology. His approach leverages techniques in five aspects of happiness: Positive Emotion, Engagement, Meaning, Accomplishment, and Positive Relationships. As hackers and entrepreneurs we likely have both Engagement and Accomplishment built into what we are already doing. This book helps you build a larger basis for growing and believing in your strengths. The positive emotion generated by that will help counter the symptoms of your sickness. One of the things I did that helped during this time was improve my engagement by learning to climb. Climbing brought me into a state of flow where I lost a sense of time. It also had the effect that it was accomplishment-focused, was social, and had exercise as an element of it.
Realize you can get better. I had the worst symptoms of depression for about 3 months and severe depression for about 6 months. After that, I still suffered occasional symptoms for the next couple of years. Looking back now it’s been at least a decade since I’ve had any symptoms at all. At the time I did the work outlined in the previous steps as a means for survival. Looking back on it almost every one of these changes was the starting point of an amazing path that I’m following to this day.