I'm very interested in this type of reading, for my situation and for others.
My single post (https://news.ycombinator.com/item?id=27739957) details where I was 9 months ago, and things have only degraded from there. I did indeed quit my job (which was the correct decision), but never received any decent help (not for lack of trying). I've gone through many doctors and 13-15 different anti-/depressant/anxiety/ + sleep medications with no help. I recently started therapy, but I'm only 2 sessions in and I'm not allowed to meet more than 2x a month (I'm not a "health risk").
I'm at a point where I'm completely demotivated day to day. I still dream of projects and startups, and even start working on stuff on occasion, but my ability to code is basically gone. It's like severe writers block, where I can't even find the most basic of solutions without staring and struggling for hours. I struggle with simultaneously not wanting to do anything, and restlessness and resentment at myself for doing nothing. I don't know how to break out of this cycle.
I was severely depressed for ~10 years, saw a bunch of therapists and tried a huge variety of medications. Also did a bunch of group therapy which has shown me other people's journeys. I've successfully helped more than a few people out of their depression in the years since I got better.
I would perhaps add or reframe a few items for you:
1. Therapy less than once a week has a hard time sticking, I would search for therapy more aggressively (and shop around for a good one, it sounds like you can probably afford it).
2. I and many others have found it useful to think of humans as slightly complex houseplants :). You need to be watered, fed, see the sunshine, etc. I check in on a daily basis with myself about how I'm eating, drinking, and exercising, sleeping well, whether I've been outside, and whether I've talked with a friend (if you don't have friends, make that a priority). I make sure to spend time being with friends at least once a week.
Interesting. I love Scott, but I didn't know there was a draft on ACX. The official page is on his website: https://lorienpsych.com/2021/06/05/depression/ I'll have to see how the articles differ...
1. Yea. It was hard to find someone with availability period, and our insurance isn't very good. You're probably right that I should just pay out of pocket, but I'm honestly pretty convinced that I have an actual brain chemical issue, so I'm dubious of the benefits to therapy
2. I think I do a decent enough job at this. I don't necessarily eat the best food, but at least I'm eating some fruits and vegetables and not Doritos all of the time. I don't really exercise much, but at least I go on 30+ minute walks every other day or so. I probably sit in my chair to much, but I imagine most on HN do that...
What led you to getting better? How were you able to function in such suffering for 10 years? Not to turn it into talking about me again, but I'm increasingly worried that I've wasted a year and may waste many more to this nothingness, which is quite concerning. How do you look back on your 10 years and say "it's OK, I needed to go through that/I'm happy I'm better now"?
> I don't really exercise much, but at least I go on 30+ minute walks every other day or so
I strongly recommend something more intensely cardiovascular for 20ish minutes a day (I go on runs). There's a lot of clinical evidence for aerobic exercise improving concentration and mood in a way just walking does not.
> How were you able to function in such suffering for 10 years?
I didn't function terribly well for that time period. I kept going mostly out of a desire to not hurt those I love. I was fortunate to have a supportive family and to be smart enough to coast through life while functioning at a massively reduced level.
> What led you to getting better?
I think some of it was just the maturation process that occurs between 20 and 30, but a few things stand out:
1. Really increasing the self-awareness of what I need to maintain my mood (the humans are complex houseplants bit). For example, if I'm not productive for a week I feel bad. If I'm tired I'm not productive, and thus I'm very pro-active about taking caffeine if I feel tired in the morning. This requires a lot of mindfulness and self evaluation, zen meditation can help here though I don't think it's required.
2. This point merges with (1) slightly but is worth breaking out, realizing the motion usually precedes emotion. When I'm feeling really bad it's often because I've failed to maintain the habits necessary for me to feel good for a while and usually it's going to take at least a week or two to work back to feeling good. As an addendum, any psychological tricks you can play on yourself that prompt the kind of action you know you need intellectually but can't bring yourself to do emotionally are gold. (I often tell myself I'm going to workout for 10 minutes to get myself up to 40-50 minute workouts).
3. I learned that while taking time to think about what makes you sad and unhappy is initially useful as you process your emotions, there comes a point where you are just wallowing in the misery. A depressed mind often gets caught in "loops" that are hard to break out of where you run through a negative line of thought over and over again. If you spend 60 minutes thinking about something wrong in your life that you've often thought of before and found no new insights, you've probably just made it a little harder to break out of your depression. Learning to short circuit these trains of thought really improved my mood.
4. As a personal thing, the realization that I was never going to be as happy as an adult as I was as a child and that that was actually ok (I was raised to believe being happy was all that mattered in life). I learned that feeling fulfilled was a good substitute for feeling happy and now feel life is worth living. It doesn't sound like this is a problem you have though.
> How do you look back on your 10 years and say "it's OK, I needed to go through that/I'm happy I'm better now"?
I don't. In retrospect with the right conversations I probably could have gotten out of the funk in 2-3 years. But going back to point 3 of the list I've learned there's not much point wallowing in it (I still do occasionally, I'm not perfect). So when I find my mind wandering to that thought I move it to something else.
I tried HIIT for a period of a few weeks, but ended up stopping it as my motivation decreased (both from the depression and towards the HIIT in general). I didn't notice any real improvements, but I probably didn't do it for a long enough period...
Thank you very much for your perspective. You've given me several things to process. I definitely do get stuck in loops; they've almost become invasive thoughts. I don't care to think them, but they are there anyway, and they won't leave me alone.
I don't know how to feel fulfilled either, and I think happiness in some way stems from that as well.
> I tried HIIT for a period of a few weeks, but ended up stopping it as my motivation decreased
HIIT is really hard to maintain motivation for imo, I've found light jogs or walking up hills is much easier to be consistent about. Many people I know do group classes. It's tough though, I'll grant you, good luck :)
> Thank you very much for your perspective. You've given me several things to process. I definitely do get stuck in loops; they've almost become invasive thoughts. I don't care to think them, but they are there anyway, and they won't leave me alone.
Yeah there's definitely a practice you need to build here. Zen meditation was very good for me in this regard. You've worked at FAANG so maybe you're in the bay area? There are a few good temples in the area, SF in particular (this is not trying to rope you into a religion btw, it should mostly be about quieting your mind).
> I don't know how to feel fulfilled either, and I think happiness in some way stems from that as well.
There's definitely a personal journey here, and everyone's different. I've found great fulfillment in mastery (mostly of software engineering, but other stuff as well) and in helping others. I've meet people who found fulfillment in one or neither of those things. Honestly, trope-y stuff about "finding your passion" is somewhat useful here as a guide to things you may want to try out (e.g. give woodworking or pottery a shot).
There's a thought here that's vitally important but is very hard to communicate well (and in a way that doesn't sound melodramatic). As simply as I can put it, the most important thing is that you keep moving forward. Getting stuck on a thought, or worrying about the time you're "wasting" is poison. Remembering that is a very hard thing when life doesn't feel terribly worth living, but it's the most important thing.
Check out David Burn's latest book[0] about modern CBT techniques. Burns originally popularized CBT with his writing in the 80s. "Feeling Great" is an updated modern version with the latest techniques. You might find the content itself useful, or the descriptions a good guide for techniques to try with your therapist or strategies for finding a therapist you might work well with.
I went through the first several chapters of the book, but it didn't stick. I should try again; I see his work mentioned all over the place and how it helped people.
Your case seems pretty serious, so I may not be the right person for this.
That said, it seems that you've hit a roadblock with regards to formal treatment (so far), so maybe sharing my perspective won't hurt.
I'm open to having a longer extended conversation about your situation to get a better understanding of the underlying issues. I read through a bit of your other post and can see that you're married. How's that going? Sometimes the closest relationships are the missing key to our personal problems. Not saying they caused your problems, not at all, but rather they can be an important step in helping you heal.
If you're open to having a longer conversation, my email is in my profile.
Looks like there is some kind of hopelessness that you feel. Probably will need more details to find the root cause because there is insufficient information at the moment. That will probably be a much longer conversation.
You can send an email. See past comments in profile.
To describe:
1. The writers block
2. Your ambitions, the projects and startups you dream of
3. Roles you took on in which you were the single point of failure
4. The first time you were burned out that happened earlier in life
5. What have you done about things, what worked, what did not work
6. Do you get bored when people talk gossip about a mutual friend, like new relationships started
My single post (https://news.ycombinator.com/item?id=27739957) details where I was 9 months ago, and things have only degraded from there. I did indeed quit my job (which was the correct decision), but never received any decent help (not for lack of trying). I've gone through many doctors and 13-15 different anti-/depressant/anxiety/ + sleep medications with no help. I recently started therapy, but I'm only 2 sessions in and I'm not allowed to meet more than 2x a month (I'm not a "health risk").
I'm at a point where I'm completely demotivated day to day. I still dream of projects and startups, and even start working on stuff on occasion, but my ability to code is basically gone. It's like severe writers block, where I can't even find the most basic of solutions without staring and struggling for hours. I struggle with simultaneously not wanting to do anything, and restlessness and resentment at myself for doing nothing. I don't know how to break out of this cycle.