[e79]

It’s fascinating how many potential modalities are at play with depression. Serotonin, inflammation, direction of brain signals. This suggests that depression may be a label that points to one of many underlying conditions, which could also explain why it’s so tricky to treat for some individuals.

[spacephysics]

Fully agree, to me depression is a common symptom that the system of biological processes “outputs”, if you will, when some process isn’t running optimally.

Stopped sugar suddenly? Inflammation from food you’re eating? IBS in general? Traumatic upbringing leading to entrenched “thought loops”? Undiagnosed disease?

These all and more can have depression as a symptom.

My armchair psychologist opinion is the DSM 5 category process isn’t fitting correctly to how humans operate. I believe there’s a completely different modality that has yet to be discovered (or known in mainstream science) that gives us a better way to diagnose people.

I find it nuts that you subjectively, in most cases, ask the patient if they fit in usually 3 of 5 categories, or what not, and that determines the diagnoses. Countless times it’s like “okay, what does hyper mean?” “What does intense rumination mean?”

We need a more objective way to measure these criteria.

I was diagnosed with depression for a while, tried a bunch of drugs, none really worked. Then for shits I do a neurological adhd battery and lo and behold, seems like that’s it.

Now using the correct behavioral changes leads to the depression going away, and far higher quality of life.

I know the system, DSM 5, is best we have now, but we need more innovation in this space

[franl]

Which behavioral changes got you there?

[simonswords82]

Not OP and I can’t speak for the entire human population but for me it was changing the relationship I have with myself.

Make a mistake? No big deal it’ll be better next time. Learn from it rather than beat myself up for it.

Hit that red traffic light? Time for self contemplation and putting the heated seats on rather than being pissed off I’m delayed 30 seconds.

Get an email that triggers my threat response? Take a breath and think about who I have around me who can help rather than take it all on myself.

Have a read of learned optimism. Great book.

Get therapy. Hit the gym. Go for walks. Brush your teeth for 2 mins. Moisturise. Show yourself as much self care as you can.

[spacephysics]

This 100%. Self compassion, and learning that, for me, my irritability was coming from a place of anxiety, which then could escalate into anger.

Also, on the ADHD side, implementing schedules and routines to make sure I get things done appropriately and not get as easily distracted by things like video games or social media.

At first it felt like I was in grade school again, with an agenda book and blocking out time, but lo and behold it works out well. Not fully able to follow schedule to a T, but a vast improvement over before.

[asdfman123]

As someone who has more or less successfully learned to deal with depression, ADHD, anxiety, etc., the trick is basically doing everything considered "healthy."

We don't understand all of the mechanisms of long-term illnesses like depression, diabetes, heart disease, Alzheimer's, etc. but we do know how to fight them: exercise and good diet. *

Some processes in the human body obviously get disrupted under modern conditions, so it's important to give your body something it's a little more used to: more movement, more traditional foods.

* (Obviously, it's not going to automatically fix depression in all cases, but it's absolutely worth fighting the good fight if you can. Other treatments are definitely worth trying too.)

[leksak]

> But I also believe that if you don't exercise, eat nutritious food, get sunlight, get enough sleep, consume positive material, surround yourself with support, then you aren't giving yourself a fighting chance.”

- Jim Carrey

Sometimes though, any one of those or all of them can end up seeming impossible because of the depression one is fighting.

[asdfman123]

Absolutely. I will point out that depressed people struggle with black-and-white thinking, so just taking the smallest steps in the right direction are a good start.

Slowly build up incrementally better habits over years. It might start with a 10 minute walk.

[hirvi74]

My issue is that the disorders/symptoms interfere with my ability to do "everything considered healthy."

The ADHD makes it impossible for me to stick to exercise routines as well as other routines. The depressive symptoms make me feel like I am carrying a ball and chain and every little thing requires so much energy.

The worst part is that I am treated for ADHD, and even that has basically any negligible difference anymore.

I feel like I am trapped in a negative feedback loop that I cannot escape.

[asdfman123]

Does your ADHD make you feel antsy, like you need to get up and move around?

[hirvi74]

Absolutely.

It's part of the reason why office work is so difficult and working from home is not. Sitting in a office is quite tiring since I have to use a lot of energy to restrain myself. I'm the type of person who paces when thinking/talking on the phone, talks with their hands, bounces my leg when sitting, fiddling with something in my hands when talking, etc..

The best description I can give is it feels almost like a bad itch. I cannot control when something itches, but once the urge to scratch presents itself, it's almost impossible to resist. Trying to force myself to not move doesn't make the "itch" go away. It just gets worse.

[asdfman123]

Learning to get into the exercise habit is a night and day change for me.

In fact, my body now demands that I go to the gym every day of the week, either for weights, cardio, or both. On my one rest day, I feel riddled by anxiety at 6 pm because I'm not doing any real physical activity. (Now that I write this, maybe I should walk on my rest day, but oh well.)

It's hard work to form the habit, but it's the best treatment for this sort of thing that I've found. Once you start associating exercise = relief, it becomes welcome.

[e79]

Agreed, but with the caveat that depressed people often struggle with making the changes they need the most. Similar thing with obesity. There often needs to be some kind of intervention, such as a medication, to offer enough relief for someone to break the cycle and start making changes. Willpower alone isn’t always realistic.

[jaggederest]

I have a pet theory that much of what we call mental health and chronic illness will eventually be traced back as a symptom of some causative factor - most likely infectious or environmental - rather than being a base illness as we think of them now.

Much as we don't think of "fever" as an illness any more, I suspect "depression" will become descriptive rather than predictive - which, to an extent, it already is, at least according to the DSM as I understand.

It's also possible that we'll see it as something that is multifactorial - some genetic susceptibility combined with environmental and/or infectious triggers.

[bitL]

I think they should first stop treating depression as a single illness. There are likely thousands different reasons for brain to end up with similar symptoms. Many forms of nutritional deficiencies likely turn into something that can be symptomatically classified as depression and sometimes be fully reversible by just restocking that missing nutrient or reducing its intake. Yet we clinically classify such conditions the same as ones caused by some brain injury or mentally horrible experiences that rewire brain circuits in weird ways.

[_yb2s]

I agree but I think we will find that emotional trauma is also a big component of the multifactorial causes.

[Choco31415]

I went through a few different versions of depression myself and it absolutely feels that way. Each was caused by a different trigger, and the strangest thing is, despite all the tests doctors ran, everything came back normal. They couldn’t figure out what was happening.