[throwawayhealth]

A therapist is helpful but I would also suggest seeing a psychiatrist.

Clinical depression and mood issues need to be treated with medication. I would recommend finding a psychiatrist and get a referral for therapist from them if you are able to. You would be able to work together with both medication and theraphy to get better. It will take bit of a time to get better but don't be discouraged, OP. Progress will be slow and many goals you might think of may seem unachievable so it's very important you plan small steps and follow through them.

If theraphy is cost prohibited or have long waiting line in your country, from what I know of OP's situation - I recommend getting online sessions from therapist in other English speaking countries who might be cheaper locally.

[xenotize]

In my experience, learning proper coping mechanisms, finding new hobbies, getting better sleep, better diet, getting enough exercise, making sure your vitamin levels are in line, were all much more effective than medication. Medication actually made feel worse and more trapped, and I've taken almost every single antidepressant that can be prescribed.

What worked for me will not work for everyone. It's important to try everything that you can and see what works best for you. For me, medication was not the answer.

[throwawayhealth]

It's certainly a journey. I recommend checking with both for this reason. If one isn't working out, you would be able to tell which you respond to better. Medication also often take time to work and may need to go through months of experimentation if common prescription do not help. In the meantime, theraphy can act as a strong force in improving your life and vice versa.

[engineeringwoke]

> Clinical depression and mood issues need to be treated with medication.

How to know someone is American before they even mention "other English speaking countries"

[dang]

Please don't take HN threads into nationalistic flamewar. There could be an interesting point to make about how different countries and cultures approach mental illness, but snark and internet tropes are exactly the wrong way to do it.

The HN guidelines include: "Don't be snarky." "Eschew flamebait." "Omit internet tropes."

https://news.ycombinator.com/newsguidelines.html

[caddemon]

Need is not the right word because it depends on the person. Some can get better with the right therapy alone. Others don't even respond to therapy + meds but might improve with more invasive neurological interventions.

But there are certainly people in our present world who do need meds to get out of the depression hole. There are people that do not respond to therapy alone but do respond to meds with therapy.

I don't think there's anything wrong with your comment, indeed the statement you're quoting is extreme. But I think HN has the tendency to go too far to the other extreme. At the end of the day, clinical depression is very heterogeneous. You need to do what works best for you.

Btw in case it isn't clear how meds are supposed to work in practice - medication for depression is not something you just pop and forget about. Any reputable psychiatrist will include therapy as part of the initial treatment plan, they don't just write a prescription and send you away.

Yes bad clinicians exist, but I think the pill popping trope for psych is way less common than people assume. Perhaps part of the source of this stigma is the role of the general practitioner. It is not uncommon to see random non-psychiatrist MDs prescribing SSRIs or stimulants, and in those cases it's a lot less likely the corresponding behavioral therapy is happening.

Anyway, medication is an absolute life saver for those people who need help in making the behavioral changes to begin with. There is a large body of studies at this point showing that simultaneous meds and therapy can improve depression symptoms more than the sum of their parts. Gold standard practice is to try tapering off of meds after the course of therapy, and more often than not the symptom improvements persist.

OP should get a professional opinion specific to his situation. He shouldn't go with the intention of seeking meds, but they should be something he inquires about. Some of the sibling comments here are acting like needing meds is a lack of will power, which is just as unhelpful as indiscriminately pushing meds.

[throwawayhealth]

I'm sorry I made you feel that way.

I didn't mean to say everyone feeling depressed should take medication as the default solution.

When I prefixed "clinical" above, I wanted to imply persistent and chronically present issues.

Any decent psychiatrist will not prescribe you medication unless you absolutely require it and will run multiple tests ruling out heart problems, blood pressure issues, thyroid, liver, and many more. A therapist isn't qualified to run and test for alternative medical issues which may manifest as above.

This is why I really wanted to assert that seeing a psychiatrist or medical practioner is important first step.

You may have persistent depression due to unrelated medical issues which may need medication.

Chronic health issues often have a persistent medical cause but not always.

[mardifoufs]

Ok now look up anti depressant intake levels in europe.

[pknomad]

You're absolutely right that a therapy isn't THE solution to depression but I feel like it's a good starting point. A good therapist should be able to recognize if OP should be seeing a psychiatrist who then can prescribe the appropriate medication for managing his/her condition.

[caddemon]

A halfway decent psychiatrist will also handle therapist referral. I don't see any issue with seeing a psychiatrist first, it's not like they just automatically hand out a prescription. It's actually way more common to see GPs do that for depression in the US.

That said, OP should probably look into both himself, see what the wait time and cost differences are between the two routes in his area.

[boucher]

One possibly significant difference is that psychiatrists tend to charge a lot more.

[soheil]

Please refrain from comments that could put people in danger. It is at best careless to say to someone with possible depression therapy may not be the answer.

[throwawayhealth]

I have not suggested that. I strongly suggest trying theraphy above. The point of my comment is to also strongly consider theraphy with a medical practioner who will be able to help you using medication or diagnose any issues that a therapist cannot.

A therapist isn't qualified to make any diagnosis or prescribe tests and medication.

[soheil]

So sorry I replied to the wrong thread. I left another comment on your here: https://news.ycombinator.com/item?id=34053767

[kbelder]

But therapy might not be the answer. It's never wrong to speak truth.

It might very well be the answer, also.

OP is not asking for platitudes, he's asking for actual help, which is by necessity rooted in reality.

[soheil]

100% second that.

Psychiatrists are real doctors with scientific, comprehensive, rigid education in STEM.

Last thing you want is a pseudo PhD from Berkeley who majored in psychology and studied "human rights" as her thesis.