[l33tbro]

Cool sentiment, but what makes you think other "hackers" have the formal background to reach out and to a depressed person? If i was depressed, the last person I'd want to talk to about it are my hacker friends. The vast majority of the population simply have no idea how to talk to mentally ill people.

[PhasmaFelis]

Well, that's part of the problem, the idea that you need a formal background to help a depressed person at all, and that the rest of us should go hands-off and pretend it isn't happening. Sometimes just knowing that someone cares can help. It's not universal, it's not a cure, but it is something.

[joesmo]

Couldn't agree more. Not only is it part of the problem, the so called mental health "professionals" are hardly qualified to help themselves. For all their education, they're no better than anyone else at preventing tragedy or helping others. The only thing they are better at is fooling people into thinking that they are professionals at all. This is a sad story, but as it states at the beginning, Stephen tried to call and talk to the hospital and other "professionals." If these people had any training that qualified them to provide help that laypeople don't, they would have helped. In fact, I'd go as far to say that someone who is not a professional is more likely to help because they might genuinely care for something more than money, something a professional trains not to care about.

[PhasmaFelis]

Uh, no. That's not what I said at all, and it's not true.

A dear friend of mine is still alive right now because her psychiatrist hammered into her that she needed a list of people to call when she felt suicidal. When the crisis came, she was just barely able to remember to call me before she reached for the knife, and my phone was charged and in my pocket because she'd told me about the psychiatrist's advice and I'd promised her I'd be available 24/7. I'm a pretty forgetful guy, but I forced myself into rigorous phone-care habits because of that psychiatrist, and that's the only reason that she didn't slit her wrists and bleed out on the carpet that night.

With severe depression, your best chance of a positive outcome comes with a solid support network and a well-trained, reliable psych professional. You need both.

[pserwylo]

I'm not sure why you've been down voted. I didn't intend for my post to say that talking to friends or colleagues is a replacement for professional help, just that any extra help is a positive, especially when people might have a tendency to feel isolated.

[PhasmaFelis]

Don't worry, I think you expressed yourself clearly. I was just responding to the other folks who seemed to be explicitly saying that you only needed one of [support network/psych professional] and that the other was useless.

As for the downvote, I'm pretty sure Xenophanes or one of his buddies is stalking me. After my first post disagreeing with him, everything I've posted in this thread has gotten a single downvote within five minutes, and then climbed back up later. No worries. :)

[hrkristian]

Depression doesn't really need a qualified person. You're not talking to a mentally ill person, at least not in the sense that you cannot spring a bolt in a depressed person's mind and have him go on a killing spree.

The blue sticker says you'll happily talk, and also listen if they have something profound to get off their chest. That's really the important part, it's not about giving advice.

[jacalata]

Most 'mental illness' is completely unrelated to 'likely to go on a killing spree' and this kind of ignorant crap supports exactly the kind of stigma that prevents people getting help.

[seabee]

Just to be clear we're not trivializing the condition, you're right that some sufferers of depression don't really need a qualified person (particularly if they have a good support network and sufficient strength of mind) but some people only turn around after CBT, for example.

I do agree with the general thesis that talking to someone willing to listen has a neutral to positive effect. I'd also suggest it's especially helpful for people who feel they can't or shouldn't talk to anyone else they know about it.

[DanBC]

Sadly it's well known that non-specific counseling has a neutral or negative effect. Obviously studies about this are difficult.

Someone willing to listen is important to help a person with mental health problems get support. That support doesn't have to be from a professional. It could be self guided from a good quality book or website. Or it could involve professionals, from telephone provided CBT through intensive long term psychological therapies provided by speciList providers.

[tomphoolery]

When I get depressed, which usually happens around this time of year, I typically enjoy talking to other hackers. We can talk about something that isn't our own mind(s). This goes for music, too. A huge key for me is to distract my mind with something that interests me, and makes me feel productive, rather than "sitting & spinning" on a subject that is making me feel bad about myself. Talking about things that interest me makes me feel better about myself.

Disclaimer: I have never been psychologically evaluated for depression or anxiety.

[rmc]

Another reason to put the sticker on there is to spread awareness and end the stigma. Some people think that mental illness isn't a real illness. But if you have something wrong with your lungs, you go to a lung doctor; so if you have something wrong with your head/mind, you should go to a mind doctor.

[yummyfajitas]

Lung cancer and most other physical ailments have legitimate, objective diagnostic criteria. You get a test or two and find out if you have a specific disease. I.e., science.

Psychiatry, except in rare cases, does nothing of the sort. Most discussion about mental illness (including your post) is an attempt to induce people to apply fallacious reasoning about it - you've developed intuitions about cancer, now go incorrectly apply that intuition to depression/drug addiction/etc.

http://lesswrong.com/lw/2as/diseased_thinking_dissolving_que...

If you wish to argue that a given animal can fly, "penguins fly just like crows fly, they are both birds" is a fallacious argument. Similarly, "do X for mind disease just like you'd do X for lung disease" is a fallacious argument.

[rmc]

Does love exist? If so, what is the simple, legitimate, objective diagnosis test for it?

[lutusp]

> if you have something wrong with your lungs, you go to a lung doctor; so if you have something wrong with your head/mind, you should go to a mind doctor.

Yes -- except there is no such thing as a "mind doctor", at least in a scientific sense. Psychiatrists and psychologists cannot treat depression, and increasing amounts of neuroscientific evidence demonstrate that depression is not a mental illness, it's a physical one.

A recent study of deep brain stimulation (http://www.nytimes.com/2006/04/02/magazine/02depression.html...) is showing very promising preliminary results, results in which a patient's depression lifts instantly when the stimulating signal is applied, and resumes when the signal is removed. Apart from being a promising indication for future research, this study shows that depression is not a mental illness, the domain of psychiatry and psychology, it's a physical illness, the domain of neuroscience.

[dfraser992]

No, all it shows is that there is a physical component - and probably for only some people. It is hardly the same as something like diabetes. On that note, I am now going to a therapy group for people with diabetes, because the NHS has realized the psychological aspects of dealing with diabetes are important enough that giving people support (in that manner) are cost effective over the person's lifetime - i.e. they learn how to deal with the psychological stress of it and so the long term consequences are lessened at a lower cost for the health care system. Thank god I do NOT live in the US anymore!

[lutusp]

> No, all it shows is that there is a physical component - and probably for only some people.

In science, the word "probably" is best left behind.

> It is hardly the same as something like diabetes.

But that's just the point -- until we know what causes depression, as scientists we should not arbitrarily assume anything. The recent findings point to a physical, biological cause. The fact that psychiatrists and psychologists cannot treat depression points in the same direction. Or didn't you know that? Studies of psychological depression treatments and drugs have yet to reach statistical significance.

[rmc]

There are a lot of people who have been helped by "mind doctors".

[lutusp]

Yes, and there are a lot of people who have been helped by astrologers. But I don't think this is a point anyone would want to make in a discussion of science, where explanations trump descriptions.

[LinXitoW]

I've been depressed and it's precisely because of that i'm certain i couldn't be of help to someone depressed. Thinking back, i can't think of anything my friends could've said that would've helped. I mean, i was basically a pessimistic, cynical asshole that shot everything down, be it "it'll be ok" or "Lets go to the cinema".

[DanBC]

I strongly agree with you.

Except destigmatising mental health problems is an important step in letting people get therapeutic help.

Someone suffering a mental health problem might not know where to turn to or want a bit of support to go get help. Knowing that colleagues and friends are not judgmental about mental health; or that those people will help access services is a good thing.

[blueskin_]

But not everyone.

I've gone through it myself, both badly and more commonly to lesser extents, and while I'm not a professional and don't claim to be, I do have the personal understanding, and can understand why/how people feel depressed. Myself, I find talking to people helps, not all the time, but often, and I know when I might want to.

As it is, not everyone is such a way either - for many people, just knowing that there is someone that could talk with if they wanted to can be helpful.

As it is, I find the description of depression as a mental illness a bit overbroad - yes, it definitely is a real condition (sometimes lifelong, sometimes intermittent, sometimes temporary) and unfortunately there isn't a better term, but it isn't something requiring drugs (which can make things worse in some conditions)/ doctors all the time, and normal people can and should help if they feel able and willing to.

[lutusp]

> Cool sentiment, but what makes you think other "hackers" have the formal background to reach out and to a depressed person?

Excuse me, but what "formal background" is that? It's not as though psychology is a science, or that psychologists know what causes depression or how to treat it -- public evidence clearly proves they do not.

The field of psychology is such a disaster that the director of the NIMH recently ruled that the DSM (psychology's "bible") may no longer be used as the basis for scientific research proposals, for the simple reason that it has no scientific content. The director said:

Source: http://www.nimh.nih.gov/about/director/2013/transforming-dia...

Quote: "While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity."

"Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment. Patients with mental disorders deserve better. [emphasis added]

As to depression specifically, psychological treatments are notoriously ineffective, but alternative neuroscientific approaches like deep brain stimulation (DBS) are showing great promise. A recent flurry of treatment outcomes that apply deep brain stimulation lead to outcomes in which, by throwing a switch, a brain surgeon can literally turn depression on and off.

Source: http://www.nytimes.com/2006/04/02/magazine/02depression.html...

Quote: '"So we turn it on," Mayberg told me later, "and all of a sudden she says to me, 'It's very strange,' she says, 'I know you've been with me in the operating room this whole time. I know you care about me. But it's not that. I don't know what you just did. But I'm looking at you, and it's like I just feel suddenly more connected to you.' '

"Mayberg, stunned, signaled with her hand to the others, out of Deanna's view, to turn the stimulator off."

'"And they turn it off," Mayberg said, "and she goes: 'God, it's just so odd. You just went away again. I guess it wasn't really anything.'"'

I emphasize this procedure is still experimental and is not yet being offered as a clinical treatment. My point is that people need to get over their reverence for psychology -- it's not scientific, and there's no evidence that it is effective in any scientific sense.

This may come as a surprise to some, but within the mental health field, a revolution is taking place -- a revolution that intends to replace psychological treatments with neuroscientific ones.

[dfraser992]

The DSM is not the "bible" of psychology, but psychiatry. They are two completely different areas of science, and the therapists I've talked to over the years have all, more or less, been very useful for getting a handle on my depression and understanding myself and why I operate like I do. I know a tremendous amount about this topic, having gone through several nasty bouts myself - and having a B.S. in psychology (and computer engineering, as well, which is why I'm on HN)

Psychiatry, however, IMO, is for the most part, useless. Psychiatrists should only stick to dealing with things that have a predominately biological basis, like schizophrenia or bipolar disorder. Garden variety stuff like the "common cold" form of depression should be dealt with using talk therapy. Every psychiatrist I've talked to in an attempt to get a mild antidepressant has resulted in frustration - they are all arrogant SOBs as far as I'm concerned who want to stick you onto the heavy duty addictive crap before trying the easier to deal with drugs - as an engineer, my attitude is try the simpler solution first and only if that doesn't work, rewrite bloody everything (if my brain was a software program...) So I've had to self medicate - I found research indicating the particular subtype of depression I suffer from would be best treated with bupripion, but the last doctor ignored me... so now I am going to pretend I'm a smoker and buy Zyban over the internet to get what I am sure I need. Or I could use nicotine patches as a mild antidepressant (according to the latest research). As a hacker, I see nothing wrong with hacking my body :)

But adding a drug into the system known as "me" isn't going to magically fix everything - I have to change my behavior as well, which is harder and that sort of thing require understanding psychological principles, not psychiatric blather about neurotransmitters being the root of all the problems. It's like people want to fix a software problem by replacing chips on the motherboard! And they aren't even sure exactly what chips!

Scientology is a crock of BS, but they do have a good point about psychiatry being a problematic profession. I would never discard what I've learned through psychotherapy, but drugs... treating mental illness strictly as a medical / mechanical issue is very shortsighted.

The trend over the past few decades has been an increasing emphasis on the biological aspects of 'mental illness' - when you examine the history of the two fields, you can see a swing between the two extremes - e.g. when Freud's theories started getting attention, an increased emphasis on the psychological aspects of mental issues became prominent in society and it become fashionable to be seeing a psychoanalyst.

But psychoanalysis, like that promoted by Freud, isn't that helpful for the most part in solving problems, so the trend started swinging back to biological especially after research etc started uncovering the biological aspects of mental illness (serotonin, LSD research, etc). Thus the 'magic bullets' became drugs and since they are cheaper and more profitable than talk therapy (and "easier" for the patient as well) that became the emphasis.

For some reason, viewing the whole issue as the interaction between psychological issues and biological factors isn't viewed as important - as an engineer who understand this stuff better than the usual layperson (though I'm not an expert) it is frustrating because it is so obviously just good engineering to view a person as a system - biology matters but so does environmental issues (family history, current life of the patient...) Drugs are cheaper and more profitable...

But yes, the DSM has gone quite downhill over the years in its usefulness. So if you change, in your post, "psychology" with "psychiatry" I won't down vote you.

And if one's depression is caused by environmental issues, like work related stress, or family, or "meaning of one's life" - they are not going to go away once you start taking the right drug or zapping the depression away. And thus it'll only come back eventually.

Another big problem is that "depression" is such a fuzzy label - there are many subtypes and each need to be dealt with in a specific way. I came across a book a few years ago that correlated what was known about different areas of the brain and their function and how different drugs affected each differently - i.e. something leading to theories on what type of antidepressant would be best for a patient given the symptoms they were exhibiting. Thus my theory on why bupripion would be better for me than Paxil (which was useless). But like with the low fat vs low carb controversy of dieting, medicine is afflicted with fads and trends - just like IT (are all problems solved with NoSQL? of course not, but lots of people seem to think that. same with the virus known as Agile)

[lutusp]

> The DSM is not the "bible" of psychology, but psychiatry. They are two completely different areas of science ...

First, mental health professionals disagree with you -- the DSM is the standard guide for all mental health diagnosis in the U.S. and to some extent elsewhere, in both psychiatry and psychology.

Second, neither psychiatry nor psychology are scientific enterprises, as you have just proven.

What do I mean? Let's look at a real science -- physics. Within physics there are any number of specialties -- let's look at two: cosmology and particle physics. Cosmologists study nature at the largest scale -- the entire universe. Particle physicists study nature at the smallest scale -- below the size of atoms.

But, notwithstanding this apparent difference in focus, cosmologists and particle physicists recognize their respective fields as both grounded in physics, and they productively attend each other's conferences. These two specialties are united by (a) science, and (b) a common desire to understand nature.

Psychiatrists and psychologists, although apparently specialties in the same field (human psychology), insist (as you now insist) that they're not related. And they're right -- the reason they're not related is because human psychology offers no central corpus of scientific theory to join them together, in the way that the standard model joins cosmology and particle physics, and in the way that the theories of evolution, natural selection and cell biology unite biology and medicine.

If human psychology were a science, psychiatrists and psychologists would endeavor to explain what they are satisfied to describe, these fields would be joined by reliable scientific results and theories, and the DSM would not be rejected by thinking people everywhere, including the director of the NIMH, who recently ruled that the DSM may no longer be accepted as the basis of scientific research proposals, for the simple reason that it has no scientific content.

> I know a tremendous amount about this topic ...

All except the single most important thing to know -- psychiatry and psychology are not sciences -- they're primarily steered by anecdote and belief.

> Psychiatry, however, IMO, is for the most part, useless.

How typical. Need I tell you that psychiatrists say the same thing about psychologists?

> Another big problem is that "depression" is such a fuzzy label ...

This is why the world is moving on from psychiatry and psychology, toward neuroscience, where (among other things) deep brain stimulation is showing very promising results where psychological treatments have failed.