[frankincense]

PLEASE do not read any of these people's advice. Talk to a MEDICAL PROFESSIONAL, preferably a DOCTOR. DO NOT trust your mental health to strangers on the internet, be it reddit, or hacker news, or whatever.

If you are based in the US and live nearby a university they usually have good counseling services and the infrastructure to refer people even if you're not attending the school. Search "{school} counseling services" on google.

[hn_throwaway_99]

I think the reason you are getting so many "I disagree" responses is because many of us have had awful experiences when it comes to medical professionals and mental health.

It's important to understand the economic pressures in psychiatry. I went to see a psychiatrist, who prescribed me antidepressants. They helped give be a baseline level of energy to get me out of my acute depression, but they addressed none of my underlying issues that caused me to get depressed in the first place, and a couple years later I was right back in the depths again. And I'm fine if my dr's economic model meant he couldn't do psychotherapy with me, but he never recommended I get therapy, and that's what I'm so bitter about regarding him.

I've heard it said that giving antidepressants to a depressed person, without any therapy, is like giving amphetamines to a tired person: yes, they may temporarily cure your "tiredness", but what you really need is to go to sleep.

So while I don't think OP should take detailed advice from random strangers, he should be aware of his options. Talk to a therapist first to see if they can uncover what some of the root cause issues are. Be open to medication - some mental issues really are largely organic in nature, but a good doctor and therapist will know they are just one tool to improve your mental health.

[wheelerwj]

> I think the reason you are getting so many "I disagree" responses is because many of us have had awful experiences when it comes to medical professionals and mental health.

> I've heard it said that giving antidepressants to a depressed person, without any therapy, is like giving amphetamines to a tired person: yes, they may temporarily cure your "tiredness", but what you really need is to go to sleep.

I don't even know where to start with this comment. This whole thread should be booted waaaaay off HN.

A few people have problems with medical professionals. It's true, assuming you're in america, we're definitely not the best. But you find a few 1,000 people online with bad experiences (obviously, because people with good experiences have moved on and don't spend their time researching that issue) and assume you have a complete picture but you're only looking through a pinhole of information returned with biased search results. You probably aren't googling, "how many people have gotten their lives back after using anti-depressants?"

> he should be aware of his options.

Yeah fine, be aware. Talk to professionals, get second and third opinions if necessary. Take a holistic approach to your well-being. But please lets not glorify google medicine here.

[hn_throwaway_99]

I'm not glorifying Dr. Google, but I damn as hell am sure not going to take the "just shut up and listen to your doctor" advice.

Heck, I stated off the bat that antidepressants did help me. I'm not "anti-antidepressant" at all. But I do understand the economic forces at play means that plenty of "medical professionals" are more than happy to charge $200+ for a 20 minute meds management consultation, simply because it's faster/easier than dealing with underlying issues.

As for your "This whole thread should be booted waaaaay off HN" comment, the anger people are responding to is lots of us have had horrible experiences, but we're just told to "shut up and listen to your doctor". How do you think the whole opioid epidemic came about? Huge parts of the medical establishment were more than happy to get their commission, people's well-being be damned.

[hu3]

I had a horrible experience with a psychiatrist.

Then a great experience with another psychiatrist who managed to get me to function just enough for me to go see a psychologist who not only "cured" me but gave me a superpower of being resilient against life's wraths.

So your mileage may vary.

To whom might be reading this: don't give up. It sucks but sometimes we get unlucky and need to change doctors.

[inter_netuser]

>superpower of being resilient against life's wraths.

how?

[hu3]

Therapy changed the way I see life and toned down my expectations.

I live less in the future and more in the present.

I judge myself less and feel emotions more.

[AitchEmArsey]

Can you give an example of how that improvement manifests itself in a bad situation?

Intellectually I am already well aware that my frame of mind is often the main issue and that I could simply choose not to be bothered by something - but that realization is a "system 2" thought which doesn't arrive until "system 1" has already derailed my whole day.

[jasonm23]

Tone down expectations.

This is the silver bullet in my opinion.

How do you define fairness, rethink it and tone down your expectations.

How do you define love / relationships? Rethink it and tone down your expectations.

How do you define work / career / success? Rethink it and tone down your expectations.

I honestly believe this is a huge help.

A therapist who is a good fit for you is very hard to find. Learning about the skills you need to reorganize the way you view yourself and the world, simpler and the solution which a good therapist will help you with.

As someone who has suffered from depression and been negatively impacted by bad medical interactions for this and other conditions, the only choice is to do the work myself.

[fivea]

> But you find a few 1,000 people online with bad experiences (...) and assume you have a complete picture but you're only looking through a pinhole of information returned with biased search results.

Oh I know a good story.

I know a woman who unfortunately isn't the most educated person in the world and happens to have a nasty health issue where both her feet are all swollen up and makes her hard to walk around.

She's been seeing doctors left and right to solve or mitigate her condition.

One time, when she went to an appointment at the local hospital, her doctor handed her a form for her to sign and told her just to sign on the dotted line and don't worry about it.

The form was a consent form to amputate both her legs.

I happened to come across her when she was going to get a second opinion with the very form in her hands, completely furious.

She still has both her legs, even though she still suffers from the same issue.

Oddly enough, the hospital which handed out the leg amputation form also had a malpractice suite where they amputated the wrong leg of a patient.

Moral of the story: even though medical professionals are expected to be more knowledgeable about health topics, they are still human and far from infallible. More importantly, ultimately you're the person responsible for your personal health, and you need to have a say on what's done with your life based on the info that medical professionals make available to you. If you do not take an active role on these decisions on your health, others will eventually make these decisions for you, and they may not be good or have your best interests in mind.

[inter_netuser]

>A few people have problems with medical professionals.

>"Death by medical error or accident is the nation's leading cause of accidental death"

Trust the "leading cause of accidental death".

Medical training is extremely limited. Physicians literally don't understand how any of the drugs they prescribe work, and the standard operating procedure is to memorize 2-3 drugs out of one class and never prescribe anything else in that class.

Physicians are constrained by: their hospital policy, HMO incentives, civil liability, criminal liability, boards, legislation, insurance rates, personal biases, past unique experiences, influence of their mentors, weather, bad knees, bad marriage, whatever. Sometimes they are just having a shit day. Some keep practising to the point they are so senile they attempt to sign a prescription with the syringe needle (witnessed that myself).

They are just humans. Rather greedy humans, most of the time. They will never be fully frank with you.

3rd opinion? People often seen 5+ physicians, and spend 10+ years to get a proper diagnosis.

[throwseusi34]

I've never had a serious health issue, so maybe doctors are better with them, but my experience is doctors don't ask enough questions to find the best answers.

Severe pain in testicles: ER doctor asks about blunt trauma, sees nothing, prescribes antibiotics. Family doctor later agrees. Year later, same pain! See a nurse-in-training, second question: "When was the last time you ejaculated?" ....oh... Sure enough, no antibiotics necessary.

Tapeworm-looking thing found wiping my bum: doctor ask about look and itchiness, consults a parasite specialist. They come back with pinworms, because tapeworms don't just come out. Prescribed a medicine that deals with both, and I look it up. I read the drug is perfectly safe, and also "do not use traditional remedies like pumpkin seeds, which contain trace amount of a substance that puts tapeworms to sleep" ...oh... I had just spent two days snacking through a 4 lbs. of pumpkin seeds on a nut-free whitewater trip, so it was a tapeworm.

Ball of foot hurts: Doctor stumped, sends to get orthotics. Orthotics get made custom. Years later, I try on a pair of EE wide shoes ...oh... right, wide shoes that makes sense.

Burning left side of face: wasted so much time with a few specialists, telling everybody that it doesn't really bother me I just want to be sure it's like a brain tumor. No answers from no body. Then one day, a bunch of wax falls out of left ear and ...oh... it clicks; my face burns when my ears get too full of all that wax I make.

So doctors don't always get the full picture either, because how could they surface every relevant detail in 5 minutes!

[hoseja]

I'm sorry but you seem to have some really weird issues.

Like "I worry about your executive function" weird.

[throwseusi34b]

Haha, thanks for your "concern". Spread over some 20-30 otherwise healthy active years, seems par for the course.

[danamit]

I found strangers online to be more effective than doctors, simply because they read to much on the matter, then they interact too much with you.

I basically got diagnosed online by 2 different people about 2 different issues, one is biological, and the other is mental. And they were right. This is nerds out there who read about topics constantly, way more than the average doctor, not even close. So a stranger can help.

Also depends on where you are located, doctors can be dogmatic, there is countries that give antibiotics before extracting teeth, and there is those who don't. Countries who believe ADHD can stay into adulthood and go undiagnosed, and others who believe it is impossible to have ADHD as an adult.

In the ADHD case, depends on who what countries are right, some group might be living a lie taking meds for an illness that doesn't exist, or the other group is suffering being undiagnosed with ADHD despite seeking help, the doctor just tell them its not possible to have ADHD.

I would rather research and try to solve my issues over hand my situation to the medical zeitgeist of my country. Also I am sure if I give myself days of research, thinking, talking to people, comparing situations over some doctor talking to me for 15 minutes then giving me the two meds given to everyone who enter that door (SSRIs and benzos), I might probably be up into something.

I will never stop researching my medical issues, I will never trust my doctors fully, I will always google, research, ask, ask second opinions. Some doctors care more than others, some doctors are capable more than others, you have no idea which ones the RNG gave you.

[jliptzin]

This is a great approach

[zephyrthenoble]

This isn't a video game. Your sample size of one is not indicative of the greater population. Don't cause people to mess up their health by appealing to the notion that they can do better than trained medical professionals. This is dangerous.

[chaostheory]

Unfortunately, psychiatry / psychology is currently barely a science. It still doesn’t have a repeatable theoretical model yet for some odd reason there are people who treat it as a science with real laws. Will it mature one day into a real science? Sure, but it’s dependent on several other fields maturing so it won’t be overnight. Consequently, I don’t blame anyone for doing more research or going with alternatives, especially since the economics of mental healthcare also go against the welfare of those who need it.

[aaaaaaaaata]

Congratulations on having a frankly privileged experience with the medical system.

The only thing dangerous here is you, acting like people shouldn't advocate for themselves to every extent their intelligence allows.

[sillysaurusx]

I don’t know what you hope to accomplish by saying this, but it’s not having any effect. Trained medical professionals have to handle thousands of pathologies, each with dozens of possible treatments. The search space alone should make someone at least question whether their Zocdoc is really giving it their wholehearted effort, or if they’re just doing a day job like all of us.

I agree that someone should go to the doctor. But almost everyone agrees on that, and yet very few actually go. I didn’t, for a decade, and mostly out of laziness (not going is after all the default option). Going around commanding people not to do X is only going to make them X.

[inter_netuser]

The guy who came in last in his medical class. In the worst medical school in the country.

..is somehow always better...than everyone else? Always?

Professional opinion is just that, an opinion. Opinion of potentially the worst medical student, from the worst medical school. but because they got a prescription pad, they are now smarter than anyone else in America. Got it.

Health is ultimately our own decision, and ours alone.

[ChrisRR]

The worst doctor still passed their exams, and has way more medical knowledge than the average person

I wouldn't discount design advice of a qualified engineer because of the musings of a random person, so why would I do the same for a doctor.

Too many people in this thread are just going "software developers don't know what they're talking about. I had a bad experience with software once, so no developers have a clue, they're just after money"

[inter_netuser]

Medicine drop out rates: 15-18% Engineering drop out rates: 40-50% Math drop out rates: 47%

Dumbest doctor is stupider than avg math/eng. They just tend to be less autistic on avg.

"The American Society for Engineering Education (ASEE) found that between 40% to 50% of engineering students drop out or change their majors."

"So, what is the dropout rate for medical school? In a standard, single four-year program, that would put the medical school dropout rate at between 15.7 percent and 18.4 percent, confirms the AAMC."

"In mathematics, the dropout rate is even higher with 47% (U.S. college dropouts show comparable numbers; Chen, 2013)."

It's ok to question and discount doctors. Plenty of incompetent practitioners out there, well protected by powerful lobby, trade union, massive liability umbrellas.

They even passed laws to reduce their own liability.

I'm sure they needed that because they are so excellent at their job, they are only the leading cause of accidental deaths.

[isbvhodnvemrwvn]

You have to complete a number of prerequisites to be considered, never mind accepted, into a medical school. For engineering the barrier is much much lower, hence the higher dropout rate.

[dimal]

Sorry, you are very very wrong about this. Have you ever talked to a _medical_ professional about depression or any mental health issue? They generally don't know what they're doing. Medical professionals only have one tool in their arsenal for depression: antidepressants. So a medical doctor will likely prescribe them, whether that's appropriate or not. Antidepressants are no joke. Sometimes they can help, but they can also cause really strange side effects, like increasing the possibility of suicide. And does the average doctor monitor all their patients regularly to make sure they're not having suicidal thoughts? Nope. And doctors generally won't know anything about the difficulty of getting _off_ the antidepressant if it didn't work.

Asking for advice on the internet is a very valid strategy, given the terrible state of mental health care in the US.

[kayodelycaon]

Not OP, but I have. If you go to a family doctor in the US, they really aren’t qualified or trained in treating mental health.

My psychiatrist was fairly clear on what was what and which things needed to be treated with therapy and which medication could help with. (Medication helps symptoms, it does not cure.) Finding the right medication would take months or years and will not solve everything. There will be side effects that I needed to monitor and report. And so on.

When seeing any doctor, you are your own best advocate. It helps to come prepared, knowing your family history, and things you are struggling with.

Researching medications can help, but most people are not qualified to use them without supervision, myself included.

Note: This is assuming you need medication. It was fairly clear in my case medication was absolutely required to at least treat psychosis.

I prefer to refer friends to a therapist or psychologist, who do not prescribe medication.

[APhoenixRises]

Granted everyone's case is different, but my doctor went forward with medications only as part of a comprehensive plan to deal with my mental health which included seeing a therapist and committing to an exercise program (it sounded silly to be before, but exercise can be for some people can be nature's antidepressant). I'm on a 6 week to 3-month schedule of follow-up visits with my doctor to keep track of where I'm at mentally. Yes, there are absolutely doctors out there that will toss pills to people and send them on their way, but I don't think it's the majority. I also vet doctors the same way I would a mechanic or anyone else who is going to be doing important work for me. It can be hard, but there are doctors who care about doing the right thing out there.

[heavyset_go]

> Sometimes they can help, but they can also cause really strange side effects, like increasing the possibility of suicide

This type of side-effect is thought to be mediated by 5HT2C activation when initially starting SSRIs, however, over the period of about two weeks, 5HT2C receptors downregulate and reach an equilibrium that can cause the effect to diminish or go away entirely. As an aside, there's research that suggests that abnormal amounts of upregulated 5HT2C receptors are present in suicide victims.

One of the reasons Prozac is recommended as a first line of treatment, besides the fact that it has a long half-life, is because of its 5HT2C antagonism that can block 5HT2C from extracellular serotonin activation from SSRI effects.

There are also plenty of antidepressants that don't typically cause that particular problem, especially if they aren't typical SSRIs or serotonin agonists.

[SkyPuncher]

> Sometimes they can help, but they can also cause really strange side effects, like increasing the possibility of suicide

FWIW, my understanding is this has little to do with the drugs and mostly to do with the recovery process.

In a deep depression, you might have suicidal thoughts, but lack the will to take action on those thoughts (because depression takes away your motivation). As you a person comes out of depression, they tend to recover their motivation before their suicidal thoughts dissipate. This creates a situation where a person with suicidal thoughts now has motivation - which means they have the potential motivation to take action on their suicidal thoughts.

The important nuance of this is anti-depressants don't necessarily make your suicidal thoughts _more_ suicidal. In fact, it's likely, anti-depressants are making your suicidal thoughts _less_ severe. However, they do increase your motivation before they can fully eliminate suicidal thoughts.

I'm not saying you should take an anti-dpressant willy-nilly. It's just BS to be fear mongering like this without considering why this situation happens.

[heavyset_go]

In the beginning of SSRI consumption, it causes initial 5HT2C upregulation and activation, which can directly cause feelings of anxiety, dread, hopelessness, and restlessness/akathisia[1]. Over time, however, the body down regulates 5HT2C in response to its activation, and those symptoms tend to dissipate.

In a way, yes, there can be feelings induced that can provide the motivation and energy to go through with suicidal thoughts, but those unpleasant emotions aren't exactly triggered by an inherent will to die. Those who experience akathisia sometimes feel like the only way to rid themselves of the feeling is to end their lives.

I point this out because it might seem, or feel to those experiencing it themselves, that those suicidal thoughts are organic and what the person really wants, but they tend to be exacerbated directly by medication and can get better with time. I also point it out because there are ways to sidestep 5HT2C activation with different medications or combinations, it doesn't necessarily have to be inevitable.

[1] https://en.wikipedia.org/wiki/Akathisia

[oaktrout]

I didnt find any info on 5HT2C in the linked source above, not saying what you've said isn't true, just that I was interested and didn't find much info.

[heavyset_go]

Here's Wikipedia's summary, there are sources cited in the article[1]:

> Research indicates that some suicide victims have an abnormally high number of 5-HT2C receptors in the prefrontal cortex.[13] Agomelatine, which is a 5-HT2C and 5-HT2B antagonist as well as a MT1 and MT2 agonist, is an effective antidepressant.[14][15] It has been called a norepinephrine-dopamine disinhibitor because antagonism of 5-HT2C receptors by agomelatine results in an increase of dopamine and norepinephrine activity in the frontal cortex. Conversely, many SSRIs (but not fluoxetine, which is a 5-HT2C antagonist[16]) indirectly stimulate 5-HT2C activity by increasing levels of serotonin in the synapse although the delayed mood elevation that is usually typical of SSRIs is usually paralleled by the downregulation of the 5-HT2C receptors.[17] Many atypical antipsychotics block 5-HT2C receptors, but their clinical use is limited by multiple undesirable actions on various neurotransmitters and receptors. Fluoxetine acts as a direct 5-HT2C antagonist in addition to inhibiting serotonin reuptake, however, the clinical significance of this action is variable.[16] Several tetracyclic antidepressants, including mirtazapine, are potent 5-HT2C antagonists; this action may contribute to their efficacy.

> An overactivity of 5-HT2C receptors may contribute to depressive and anxiety symptoms in a certain population of patients. Activation of 5-HT2C by serotonin is responsible for many of the negative side effects of SSRI and SNRI medications, such as sertraline, paroxetine, venlafaxine, and others. Some of the initial anxiety caused by SSRIs is due to excessive signalling at 5-HT2C. Over a period of 1–2 weeks, the receptor begins to downregulate, along with the downregulation of 5-HT2A, 5-HT1A, and other serotonin receptors. This downregulation parallels the onset of the clinical benefits of SSRIs. 5-HT2C receptors exhibit constitutive activity in vivo, and may retain the ability to influence neurotransmission in the absence of ligand occupancy. Thus, 5-HT2C receptors do not require binding by a ligand (serotonin) in order to exhibit influence on neurotransmission. Inverse agonists may be required to fully extinguish 5-HT2C constitutive activity, and may prove useful in the treatment of 5-HT2C-mediated conditions in the absence of typical serotonin activity.

[1] https://en.wikipedia.org/wiki/5-HT2C_receptor#Function

[_moof]

> Have you ever talked to a _medical_ professional about depression or any mental health issue? They generally don't know what they're doing.

And you think a random stranger knows any better? I know firsthand that the medical profession has serious limitations in its understanding of and ability to treat depression, but no way in hell am I taking some rando's advice over that of any of the many doctor's I've seen.

[ajkjk]

That makes no sense to me, if you're trying to deal with mental health problems and struggling you're going to be looking for new ideas from any source. Doctors are good at giving garden-variety medical advice that's validated by studies, but there's so many other ideas out there that they're not going to know about. Their background gives them expertise on what medicine says about mental health, not about the human experience itself.

Anecdotally I've been to therapists and doctors that were no help and I've read an article online [1] which was a tremendous help.

[1]: https://kajsotala.fi/2017/07/how-i-found-fixed-the-root-prob...

[bawolff]

Strangers on the internet are usually pretty good at helping you self-justify whatever it is you want to do, because no matter what position you take, whether it is a really good idea or not, there is always someone on the internet who agrees with you.

[ajkjk]

Fine, if that gets you taking action when you're depressed, so be it.

Anyway in discussions like this I feel like what it lost is that you will actually respond to how compelling the thing someone else is saying is. Like, it's not "oh a bunch of opinions, I'll get influenced by one randomly and it's probably wrong". It's "oh, a bunch of opinions, which explain why they think they're right and how well it worked for them, I'll incorporate that into my own understanding".

[tdfx]

> Doctors are good at giving garden-variety medical advice that's validated by studies

I've found they're more often than not ignorant of the latest studies, as well. Doctors are put on a pedestal in our society that very few of them deserve. A solid 2/3s of the ones I've seen are over-confident, dismissive, and often peddling out of date information. The rare ones that truly focus on their field and put their patients above their egos are difficult to find and even harder to get to with average US insurance.

[inter_netuser]

How common are the ones that check their ego? 1 in 10?

[frankincense]

You're a frontend engineer, not a doctor. You're not qualified to give advice on medicine.

[vorpalhex]

They aren't writing a prescription for op, they are sharing anecdotal data. That's a reasonable thing to do.

Having had a critical infection repeatedly misdiagnosed until I finally went out of my way to pick a better professional, I don't buy the "just have faith in your doctor" argument.

Doctors are more like plumbers than we like to admit. There are good ones and bad ones, and it's hard to tell the difference. They do best when you can give them direction (cooperatively) and when you are willing to get a second opinion.

[andrewzah]

So what? Everyone has had stories about misdiagnoses or not being taken seriously by doctors, etc. I had a condition that took a long time to get a fix until I changed my doctor and got a proper evaluation done. And that wasn't even for mental health, which the US is not particularly well known for. My doc would come in, listen for maybe 1-2 mins, prescribe some shit and leave. I had to take stuff into my own hands and drive 2 hours to another hospital to finally get something done.

Parent comment is not giving explicit medical instructions. All they're saying is "talk to a medical professional" isn't some miracle advice that always works, particularly for mental health. It's fine to give anecdotes as long as one holds them with a grain of salt.

[dimal]

So any support group is invalid then? AA? Smart Recovery? Addiction is a medical problem, so just talk to your doctor? If you have PTSD, don't talk to other people with PTSD, just isolate and talk to your doctor? If you have depression, don't talk to other people who have had depression, who might make you feel less alone, just talk to your doctor? Think through what you're saying.

[frankincense]

Those support groups don't give advice about medicine.

[dimal]

Um, they kinda do. In my experience it's generally not "advice" in the same way a doctor gives it, but it's been more along the lines of, "I took X. Y happened." Not, "You should (not) take X because it (worked/didn't work) for me".

People keep saying we should _normalize_ talking about mental health, and what you're suggesting goes against that. If we were discussing heart health and someone were to talk about their exercise, diet and medication online, would you say, "Hey, wait a minute! You're not a doctor. You can't say that." Of course not. What you're advocating for is an overly paternalistic approach to mental health issues, as if people are too dumb to listen to different viewpoints and come to their own conclusions.

[elwell]

Weird, did you research them?

[lostdog]

You are an engineer and not a public health researcher. You are not qualified to give advice on whether consulting a doctor is the right course of action.

[kappuchino]

I DISAGREE. For this reason: I was given antipressants by my (former) doctor for a moderate anxiety "phase". It was escitalopram. And it did well for me - within a day! When it came to end the medication, I was told to just stop taking it. Which I did. But I should not have - I had anxietiy "echoes" over the following YEAR, really weird stuff. So I started to read about the medication: Studies have shown the longer you take time to reduce it in steps (like 10% of the former dose) the better is the time after. But since this is burdensome, its rarely suggested and also people need to "cut" pills to have the exact dose for their reduction.

My current OPINION is: Until you have read studies and got some plausible experiences from people with the same medication, one doctor alone isn't a good source for taking medication.

I will only take medication in the future if life wouldn't managable without, but not for issues that just take time.

[SketchySeaBeast]

But as grandparent suggests - talking to a forum full of strangers is not doing research.

[jnwatson]

No, but it does give avenues to research.

[SkyPuncher]

I just want to echo the other commenter. You had a completely incompetent prescriber.

Tapering SSRIs is the normal unless a provider has alternative indication it shouldn't be done.

[inter_netuser]

You had an incompetent prescriber.

Tapering doses for all sorts of medications are routinely done, and any pharmacy can handle such an rx. If they can't - you don't want to go to such a pharmacy anyway.

[aaaaaaaaata]

Easy to say when you're in a major city/within the 100 mile border zone.

[inter_netuser]

Unfortunately, you often have to travel at times to find good talent/expertise.

Some people move permanently, in order to obtain medical care. Sometimes, to another country.

Most compounding pharmacies will ship, and most physicians will only require one visit in person in 12 months.

[sillysaurusx]

Must every conversation about depression devolve into yelling? There’s not even any new information here.

No one with depression is going to read this and go “Oh, you’re right.” It’s self gratification disguised as help.

Everyone knows they really ought to see a doctor. There are plenty of reasons to be scared to. An untimely hospital visit bankrupted me thanks to no health insurance. My sleep doctor had to cut me a deal of only $50 per visit instead of the usual $150, and she really cared about me. I was part of a lucky few.

I think what rubs me wrong about your advice is that it’s positioned at the expense of all other advice. No one’s allowed to have an opinion except yours. Smart people like OP see right through such things, and it tends to push them away. Which is particularly troublesome when the advice is good, like yours is here.

[hsn915]

This is really weird advice.

Yea it's mainstream and to be expected under legaleeze circumstances.

But it's not the kind of advice I would give to a friend whom I'm genuinely concerned about.

Have you known anyone who was depressed and managed to get better by following the advice of a generic "profressional"?

I haven't.

Quite the opposite. I've seen people get worse in one dimension or another by taking medication or following other professional advice.

[kayodelycaon]

I have told friends to see professionals. Mostly getting a good therapist. Medication should be a second line for the usually encountered forms of depression.

It’s worked.

[oaktrout]

I would wager you know many people who have gotten better after seeing a "professional". Mental health isn't often discussed openly so you would probably be shocked at how many high functioning people are on SSRIs (doctors, lawyers, engineers, etc).

[heavyset_go]

> But it's not the kind of advice I would give to a friend whom I'm genuinely concerned about.

My advice to friends and family experiencing such issues is to take those issues seriously, and to see a doctor about them.

[jac241]

Probably many people you know have seen a doctor for depression and gotten better, they’re just not telling that to the guy who says things like you did in your post… Very stupid take here man…

[ad404b8a372f2b9]

You have an unhealthy relationship to medicine if you refuse to even read the advice of other people. I've been treated by hundreds of medical professionals and worked with dozens and I can assure you they do not hold any secret undying truth about human health. Modern medicine is primitive and brutal, we are fumbling buffoons when it comes to the human body and its ills, especially in the realm of mental health. If you don't believe me watch an orthopedic surgeon do his work (if you can stomach the electric saws and the hammers).

[frankincense]

There's a lot of dangerous advice in these comments.

[ad404b8a372f2b9]

That's just the way it goes with the internet, but you can't throw the baby out with the bathwater, you just need to weigh the advice you get accordingly.

I think the increasingly common practice of forbidding medical advice in online forums is deleterious. For a lot of people professional medical care provides no solutions, hearing other people's personal experiences is helpful and comforting.

[Trasmatta]

Doctors aren't always effective at treating depression. Especially if they use a therapy modality or medication that doesn't work for you. That doesn't mean you shouldn't talk to them, but it's also helpful to read experiences from from other people.

My opinion, doing both is good. Consult a professional and read about other people's experiences.

At the very least maybe somebody mentions a form of therapy that you've never heard of that you can ask your doctor about, or find a therapist that specializes in. If you ignored everyone's advice online you'd never even hear about that.

Personally, I'm starting Internal Family Systems therapy, which has seemed more promising for my psyche than many other modalities. But there are countless others. CBT is a good place to start, but doesn't work for everyone.

[inter_netuser]

50% of doctors are by definition below the average.

In reality, roughly 3-10% are good, the rest just go by standard guidelines only and/or punt you off to someone else.

[amirhirsch]

50% are below the median.

[inter_netuser]

Grades are normalized on a gaussian curve.

What's the difference between mean and median in a Gaussian distribution?

Looking forward to your contributions to mathematics.

[selcuka]

> Grades are normalized on a gaussian curve.

Are we talking about grades? Honestly when I see "50% of doctors are below average" I intuitively think of some other metric, such as the correct/incorrect diagnosis ratio, or the number of people that died because of their errors. Maybe it's just me but their uni (?) grades never comes to my mind.

[inter_netuser]

It alludes to the joke: "what do you call the last student from the worst medical school? A doctor"

[heavyset_go]

Median is a type of average.

[tsol]

50% of everything is below the average.

[spaetzleesser]

Some of the most depressing experiences I have had was to look for a therapist when I was really depressed. I went to several and never felt that they understood me or even cared about what I was thinking. I honestly think they made me worse.

I have learned way more useful info on online forums from people who were going through the same experience. Yes you have to be discerning but the advice “go to a professional” is thoughtless. There are a lot of incompetent people working in mental health. I am sure it’s easier if you have tons of money or just lucky to run into a good therapist. But already being down and then being disappointed by the professionals is devastating. At least it was for me.

[R0b0t1]

There's enclaves of doctors who e.g. think everything is some obscure type of bipolar disorder. Listening to doctors above all else is, surprisingly, not a good idea.

For everyone who had their life turned around by medication I have met two or three who either did not see improvement or had negative side effects on all options tried so they gave up.

Some drugs, like the typical or atypical antipsychotics that treat bipolar or rapidly oscillating bipolar, have the side effect of reducing your energy and making you more passive. It's hard to pick out the effects of some drugs from actually solving the issue or just making you more likely to not cause a fuss.

[ls15]

> PLEASE do not read any of these people's advice. Talk to a MEDICAL PROFESSIONAL, preferably a DOCTOR. DO NOT trust your mental health to strangers on the internet, be it reddit, or hacker news, or whatever.

I find this comment so overused, ignorant and dismissive. In my city it can take months to get a 20 minute appointment with a specialized doctor, while the internet is full of useful and scientific information and helpful people. That isn't even saying if the doctor really understands your problem or just dismisses it (had that often enough), like you dismiss other people's anecdotes. What are people supposed to do while they are waiting for an appointment for months with acute issues? I'd rather spend days myself and read the same information that a doctor (hopefully) would read in order to work on the problem before it gets worse or kills me.

So yes, try to talk to a medical professional at least once if you have the chance. If not or if it does not help, keep doing what you need to do and try to get the best information that you can find.

[dominotw]

>Talk to a MEDICAL PROFESSIONAL, preferably a DOCTOR.

why ? they don't really have a solution for it other than prescribing anti depressants. I don't see why they need to see a doctor.

[jerome-jh]

I too can only advice the OP to seek a true medical advice with preferably a face to face consultation. Now my personal experience: anti-depressants do work and often with little or no side effects. A doctor will prescribe what is best in your particular case. Allow for a few weeks for the effects to be felt, then you can decide if you want to continue using the product or not. It is best to take again medical advice at that time. Do not self-medicate! Many plant based products have side effects for often a low effect.

[fdgsdfogijq]

I don't trust doctors, and I have seen many people medicated for no reason at all. They basically just go by the book to avoid any sort of malpractice.

[RickJWagner]

Yes!

Depression can be caused by hormonal imbalances. It's tricky to get things right-- see a doctor!

[alienalp]

You may be correct about not trusting mental health with strangers. But at the and taking anti depressant or not taking it up to you. Doctor cannot weight pros and cons of taking anti depressant for you.

[oneplane]

A doctor can definitely weigh it for you, that is practically the whole job... A doctor can (most of the time) not "make" you take medicine, but again, that is not the point either.

[alienalp]

You can't know that. By listening you he will be trusting you with his mental health.

[renewiltord]

Clueless comment. You don’t understand explore vs exploit. You are not qualified to give advice on the subject of whom to consult. Please do not try. Your advice is really bad.

[weakfish]

This isn’t really a charitable response imo

[renewiltord]

I believe it is the most charitable interpretation of the GGP: that OP is ignorant of their ignorance. They aren’t malicious, merely innocently unaware of how clueless they are on the subject.

By the way, is the Hunt library still open 24x7? I remember it being a fun time when it was. Spent many a night there.

[weakfish]

It is! I suffered through operating systems by way of Hunt ;)

If you were comp sci, Dr. Sturgill and Dr. Heckman are still making life hell for undergrads (for a good cause, of course)

Anyway, I see your point and don’t really have a better reply, so shrug I tend to agree that anything that can be attributed to ignorance rather than malice is correct, but the phrasing just seemed mildly aggressive to me. Not a big deal though!

[renewiltord]

Hahaha, classic. OS is a fun one.

[yuuu]

My doctor is a fucking idiot. I also went to a university counseling service and they didn’t do shit. Never followed up or anything after the one consultation appointment I had.

[TameAntelope]

https://www.betterhelp.com/

An option if you prefer an entirely-online experience.

But yes, your mental help is not worth asking strangers on the Internet for help. You deserve better than what we here can offer.

[loteck]

Am I the only one scratching my head over people, who are themselves giving advice on this website, saying not to take advice from people on this website? Seems self-defeating.

[a-dub]

now that everyone thinks covid is over (hopefully it is), we can go back to having a healthy skepticism towards healthcare under capitalism. this is a good thing.

asking for advice and personal stories regarding navigating an issue as complex as depression and the way it's treated is not only prudent, it's smart.

a good healthcare provider is one that is fully willing to discuss unorthodox strategies found via independent research. take advice from the internet and find a provider who is willing to discuss it with you.