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Well, there's no magic bullet. You could ask you professionals about getting cognitive therapy or look up a psychoanalyst in your area. 'Talk thereapy' like psychoanalysis has been severely out of fashion in recent years because it's intuitive rather than rigorous, so your existing professionals might not want to recommend anyone. Where it does well is in helping the patient to get fully familiar with the course of his or her depression - not so much to identify a single cause, which there may not be, as to help identify the differences between the malady and the ordinary ups and downs of life. If you're a very verbal, analytical person, this might be helpful for you. I sometimes feel a bit frustrated when I see a psychiatrist that he just catalogs a few details about my mood, sleep patterns etc. and we don't talk much about the experience of things - a bit like a doctor that writes you a prescription for a painkiller but doesn't seem to have any interest in the diagnostic aspects of the pain, eg 'it hurts much more when I do this, what does it mean?' 'Oh that's normal, take two of these and call em in the morning.' 'Grrrr.' Exercise is very useful, But of course you feel demotivated. You could try to put in some effort finding what kind of exercise options are available. I find the idea of going to a regular gym insufferably dull, for example, but I enjoy climbing and martial arts, and you should be able to find options for both in any large city. Martial arts has a lot going for it because it gives you a simple problem to focus on - how to prevent your opponent from beating you up- but with the benefit that the opponent isn't trying to make you feel bad, so you don't need to take his or her assaults personally. If you investigate this don't go for a place that is heavy into competitions and belts and other stuff, look up the sort of people who do small tai chi classes in parks and so on. As a general rule, the less rent someone has to pay the more personal attention you'll get. Of course you don't have to go with an Asian martial art, if you've always wanted to learn fencing or something try that. The basic point is that it's really helpful to have something or someone external to grapple with, it takes you out of yourself. Also,as you learn more skill you can exercise mentally by running through sequences of different moves in your mind, like a chess game. This is very good for managing feelings of negativity and worthlessness, after a while you recognize patterns of unhealthy thought and learn to short-circuit them. You could also consider getting a pet, particularly a dog. Now matter how shitty you feel, being responsible for another creature kind of forces you to get out of bed int he morning. Of course it comes with annoyances an irritations too, from cleaning up occasional toilet accidents to their refusal to take no for an answer when you don't want to get out of bed. But they're manageable problems. On the flip side, they give you an excuse for managing your life more rigorously; if you can function more consistently at work, then you can also say you need to go at the end of the day because you have to feed your animal. Some workplaces will allow you to bring in a service animal, and if animal companionship is helpful to you than you have very strong rights under the Americans with Disabilities Act (I'm assuming you're in the US). Use them. If you're already had an animal in your childhood then you know what you like, if not then get some advice. Dogs are generally more emotionally responsive than cats, plus they're more familiar as service animals, so unless you're already a 'cat person' a mid-size dog is a better choice. They're more work than a cat, but that is a Good Thing because it will get you out of the house. Work-wise, maybe programming isn't for you. I got quite alienated in my 20s by the virtuality of programming; you're pushing stuff around in memory or in the cloud somewhere, shoveling bits to make $ and after a while it all seems rather meaningless and pointless if you're not solving a problem that you actively care about. Also, the never-ending stream of New! Stuff! coming fown the pipe (frameworks, protocols etc.) means that your knowledge base is being constantly degraded, which just gets a bit tiring after a while because unless you're writing for mainframes you may well feel that you're building on sand, an this becomes an Unpleasant Metaphor for Life, of the sort you can easily obsess over when depressed. Start asking yourself what else are you interested in besides code? If you weren't a programmer, what sort of things would you engage programmers to do? Let your imagination roam - run a winning formula 1 team? reduce world hunger? Solve humanity's most ancient mysteries? Bear in mind that outside of pure computer science, a lot of programming is service work - skilled service work, but still service work. It's like being an accountant - you have to be smart and on your game, but ultimately you're a functionary rather than a decision maker in many programming jobs. Just because you're good at it doesn't mean you have to do it for the rest of your life. The mental skills of programming are highly transferable to many other contexts, and you may very well find it profitable to move into a different domain and build up a pile of expert knowledge there, where you will also find new and interesting problems that could be easily solved by technology, allowing you to progress very quickly by being The Smart Person. So as an exercise, imagine that you were fired and further imagine that you were put on some sort of programming blacklist and forbidden from working in the tech sector, forced to work in some other context as an underground programmer. What other fields are you interested in? Protip: while some highly specialized subfields like medicine obviously require significant qualifications to enter and would require you to go back to school for many years and at great expense, many interesting and exciting areas require no qualifications at all, just a capacity for obsession. You already have one of those, it's what makes your depression so intense. When you find something, start learning about it intensively outside of your day job; use the latter to finance your actual interest. You shouldn't feel the least bit guilty about this. Of course, you don't have to leave programming. but you do have to know why you're in it, and that means it's important to be programming to some end that you are interested in. Who is it that decides what sort of programming problems you work on, and if that is not you, then why not? I have the impression that you derive a good deal of your self-worth from your job, and are disproportionately sensitive to how you do there, not least by the proximity of how you discuss your job situation with questioning whether you deserve to be alive (by the way, the answer to that question is that you don't, but neither does anyone else - you just are, and you don't owe anyone an apology for your existence unless you deliberately dedicate yourself to making other people feel awful). Shift your perspective to thinking about how you perform a service so they give you money, and focus on what other things you would like to do with money besides pay rent and put food in your mouth. This will help you get through individual bad days - it is perfectly OK to have an ulterior motive for work. Obviously don't say out loud that you're only there for the money, but start thinking of your line of work as a ladder to get to somewhere else you want to go. |
If you're still having a problem imagining other places you want to go, work with your therapist to identify what sort of things you feel unambiguously positive about even though you may get intense anxiety that you don't deserve to enjoy such things. I have a theory (which I'm going to completely handwave here) that when we're depressed we often avoid thinking about the good things in life too hard because our brain is churning out hormonal painkillers of offset the mental and muscular pain of anxiety, and those painkillers are actually rather addictive, so you get used to feeling bad because once you feel sufficiently awful at least you get to wallow in your own hormones a bit and that yields relief. Thinking about good things initially makes you feel worse because you know they're good but you don't feel any chemical payoff, so when you try to model yourself enjoying this good thing you are only conscious of the burden of pain you're carrying and the temptation is to shift the focus back to that burden to get another shot of compensatory hormones. So say your happiest memory involves, I dunno, hot air balloons. You think about hot air balloons but you don't get any particular charge off it so you begin thinking that once hot air balloons made you very happy but now you only feel pain, and so you have lost your capacity to enjoy hot air balloons (or anything else) forever. But did your earlier self who derived great enjoyment from hot air balloons deserve to suffer for the sake of that enjoyment? Of course not. Can you imagine someone talking to that younger and happier version of yourself standing there saying 'oh, you're a horrible person, your naive joy in hot air balloons is an illusion will be crushed by a lifetime of misery, ha ha.'
I'm pretty sure you can because that's basically what you're telling yourself as a despressed person here in the present. Now focus once more on the imaginary person saying this to your younger and happier self, and actively trying to make that self feel awful in the same way that you feel awful right now. What an asshole, right? IF you saw someone else doing that you'd tell them to shut up and shove off, and stop trying to ruin other people's enjoyment of life. Well, that's what your depression is - an imaginary miserable person that you carry around in your head who is constantly running you down and telling you that you're No Good. It's your own critical faculty on steroids a useful faculty but one that has gotten out of control and turned into the mental equivalent of a scab that you keep picking at day after day and never allowing to heal. It's not evil, or inevitable, or or inaccessible. It's just a part of your psyche that's stuck in a self-reinforcing loop, a race condition if you like.
So all the coping strategies I've outlined above are ways of establishing different perspectives to stop seeing that psychic irritation as The Only Thing That Matters and instead acknowledge it as a Painful Thing but not the Only Thing. Drugs may assist with that process (or not; don't be surprise if it takes several attempts to find something that works, or that things work for a while and then stop etc.). I say 'process' because it's not a threshold thing where you have some big realization or turn a corner, come out of the darkness into the light, and you're not depressed any more. Instead it's this thing that just comes up more or less intensively and you need to develop a process of recognizing it as a symptom of your depression, remembering that its a painful internal injury rather than some objective moral flaw in the world or yourself, and then try to sidestep the pain the same way you would with the pain from a broken arm or whatever.
This process won't make much difference at first, the same way that taking a deep breath doesn't help much with the pain from a broken arm when you need to do something like buttoning a shirt or turn on a light switch, never mind things like pulling on your pants or lifting heavy weights. On bad days you have to remind yourself 100 times a day that it's only a symptom and that sooner or later it will heal if given the opportunity, and then do it again 5 minutes later. but after a while you find you're only dealing with it 80 times a day instead of 100, or 50 times a day instead of 80, and so on.
And that's how you learn to manage it. The more work you invest in managing it, the more it is to recognize as a symptom rather than The Awful Truth, so that when it waxes and wanes you can learn which strategies work best to deal with it, like when it's more effective to work or to take a rest. You know how kids are horrified by physical injuries because the pain if such a novel sensation and now they think this is how it's going to be for ever? Exact same thing. Just as it still hurts to hit your hear or cut your finger or break a bone, but you have learned that physical pain is transitory and treatable, you need to learn the same thing about mental pain, and keep patiently trying out different things until you identify the characteristics of of your particular mental injury and what you have to do to handle it. It is absolutely a manageable problem that becomes easier with practice - much easier, and that practice can significantly improve your competence to deal with other external problems and support creative and professional accomplishment.