Is everything you think you know about depression wrong?

In this extract from his new book, Johann Hari, who took antidepressants for 14 years, calls for a new approach

In the 1970s, a truth was accidentally discovered about depression one that was quickly swept aside, because its implications were too inconvenient, and too explosive. American psychiatrists had produced a book that would lay out, in detail, all the symptoms of different mental illnesses, so they could be identified and treated in the same way across the United States. It was called the Diagnostic and Statistical Manual. In the latest edition, they laid out nine symptoms that a patient has to show to be diagnosed with depression like, for example, decreased interest in pleasure or persistent low mood. For a doctor to conclude you were depressed, you had to show five of these symptoms over several weeks.

The manual was sent out to doctors across the US and they began to use it to diagnose people. However, after a while they came back to the authors and pointed out something that was bothering them. If they followed this guide, they had to diagnose every grieving person who came to them as depressed and start giving them medical treatment. If you lose someone, it turns out that these symptoms will come to you automatically. So, the doctors wanted to know, are we supposed to start drugging all the bereaved people in America?

The authors conferred, and they decided that there would be a special clause added to the list of symptoms of depression. None of this applies, they said, if you have lost somebody you love in the past year. In that situation, all these symptoms are natural, and not a disorder. It was called the grief exception, and it seemed to resolve the problem.

Then, as the years and decades passed, doctors on the frontline started to come back with another question. All over the world, they were being encouraged to tell patients that depression is, in fact, just the result of a spontaneous chemical imbalance in your brain it is produced by low serotonin, or a natural lack of some other chemical. Its not caused by your life its caused by your broken brain. Some of the doctors began to ask how this fitted with the grief exception. If you agree that the symptoms of depression are a logical and understandable response to one set of life circumstances losing a loved one might they not be an understandable response to other situations? What about if you lose your job? What if you are stuck in a job that you hate for the next 40 years? What about if you are alone and friendless?

The grief exception seemed to have blasted a hole in the claim that the causes of depression are sealed away in your skull. It suggested that there are causes out here, in the world, and they needed to be investigated and solved there. This was a debate that mainstream psychiatry (with some exceptions) did not want to have. So, they responded in a simple way by whittling away the grief exception. With each new edition of the manual they reduced the period of grief that you were allowed before being labelled mentally ill down to a few months and then, finally, to nothing at all. Now, if your baby dies at 10am, your doctor can diagnose you with a mental illness at 10.01am and start drugging you straight away.

Dr Joanne Cacciatore, of Arizona State University, became a leading expert on the grief exception after her own baby, Cheyenne, died during childbirth. She had seen many grieving people being told that they were mentally ill for showing distress. She told me this debate reveals a key problem with how we talk about depression, anxiety and other forms of suffering: we dont, she said, consider context. We act like human distress can be assessed solely on a checklist that can be separated out from our lives, and labelled as brain diseases. If we started to take peoples actual lives into account when we treat depression and anxiety, Joanne explained, it would require an entire system overhaul. She told me that when you have a person with extreme human distress, [we need to] stop treating the symptoms. The symptoms are a messenger of a deeper problem. Lets get to the deeper problem.

*****

I was a teenager when I swallowed my first antidepressant. I was standing in the weak English sunshine, outside a pharmacy in a shopping centre in London. The tablet was white and small, and as I swallowed, it felt like a chemical kiss. That morning I had gone to see my doctor and I had told him crouched, embarrassed that pain was leaking out of me uncontrollably, like a bad smell, and I had felt this way for several years. In reply, he told me a story. There is a chemical called serotonin that makes people feel good, he said, and some people are naturally lacking it in their brains. You are clearly one of those people. There are now, thankfully, new drugs that will restore your serotonin level to that of a normal person. Take them, and you will be well. At last, I understood what had been happening to me, and why.

However, a few months into my drugging, something odd happened. The pain started to seep through again. Before long, I felt as bad as I had at the start. I went back to my doctor, and he told me that I was clearly on too low a dose. And so, 20 milligrams became 30 milligrams; the white pill became blue. I felt better for several months. And then the pain came back through once more. My dose kept being jacked up, until I was on 80mg, where it stayed for many years, with only a few short breaks. And still the pain broke back through.

I started to research my book, Lost Connections: Uncovering The Real Causes of Depression and the Unexpected Solutions, because I was puzzled by two mysteries. Why was I still depressed when I was doing everything I had been told to do? I had identified the low serotonin in my brain, and I was boosting my serotonin levels yet I still felt awful. But there was a deeper mystery still. Why were so many other people across the western world feeling like me? Around one in five US adults are taking at least one drug for a psychiatric problem. In Britain, antidepressant prescriptions have doubled in a decade, to the point where now one in 11 of us drug ourselves to deal with these feelings. What has been causing depression and its twin, anxiety, to spiral in this way? I began to ask myself: could it really be that in our separate heads, all of us had brain chemistries that were spontaneously malfunctioning at the same time?

To find the answers, I ended up going on a 40,000-mile journey across the world and back. I talked to the leading social scientists investigating these questions, and to people who have been overcoming depression in unexpected ways from an Amish village in Indiana, to a Brazilian city that banned advertising and a laboratory in Baltimore conducting a startling wave of experiments. From these people, I learned the best scientific evidence about what really causes depression and anxiety. They taught me that it is not what we have been told it is up to now. I found there is evidence that seven specific factors in the way we are living today are causing depression and anxiety to rise alongside two real biological factors (such as your genes) that can combine with these forces to make it worse.

Once I learned this, I was able to see that a very different set of solutions to my depression and to our depression had been waiting for me all along.

To understand this different way of thinking, though, I had to first investigate the old story, the one that had given me so much relief at first. Professor Irving Kirsch at Harvard University is the Sherlock Holmes of chemical antidepressants the man who has scrutinised the evidence about giving drugs to depressed and anxious people most closely in the world. In the 1990s, he prescribed chemical antidepressants to his patients with confidence. He knew the published scientific evidence, and it was clear: it showed that 70% of people who took them got significantly better. He began to investigate this further, and put in a freedom of information request to get the data that the drug companies had been privately gathering into these drugs. He was confident that he would find all sorts of other positive effects but then he bumped into something peculiar.

Illustration
Illustration by Michael Driver.

We all know that when you take selfies, you take 30 pictures, throw away the 29 where you look bleary-eyed or double-chinned, and pick out the best one to be your Tinder profile picture. It turned out that the drug companies who fund almost all the research into these drugs were taking this approach to studying chemical antidepressants. They would fund huge numbers of studies, throw away all the ones that suggested the drugs had very limited effects, and then only release the ones that showed success. To give one example: in one trial, the drug was given to 245 patients, but the drug company published the results for only 27 of them. Those 27 patients happened to be the ones the drug seemed to work for. Suddenly, Professor Kirsch realised that the 70% figure couldnt be right.

It turns out that between 65 and 80% of people on antidepressants are depressed again within a year. I had thought that I was freakish for remaining depressed while on these drugs. In fact, Kirsch explained to me in Massachusetts, I was totally typical. These drugs are having a positive effect for some people but they clearly cant be the main solution for the majority of us, because were still depressed even when we take them. At the moment, we offer depressed people a menu with only one option on it. I certainly dont want to take anything off the menu but I realised, as I spent time with him, that we would have to expand the menu.

This led Professor Kirsch to ask a more basic question, one he was surprised to be asking. How do we know depression is even caused by low serotonin at all? When he began to dig, it turned out that the evidence was strikingly shaky. Professor Andrew Scull of Princeton, writing in the Lancet, explained that attributing depression to spontaneously low serotonin is deeply misleading and unscientific. Dr David Healy told me: There was never any basis for it, ever. It was just marketing copy.

I didnt want to hear this. Once you settle into a story about your pain, you are extremely reluctant to challenge it. It was like a leash I had put on my distress to keep it under some control. I feared that if I messed with the story I had lived with for so long, the pain would run wild, like an unchained animal. Yet the scientific evidence was showing me something clear, and I couldnt ignore it.

*****

So, what is really going on? When I interviewed social scientists all over the world from So Paulo to Sydney, from Los Angeles to London I started to see an unexpected picture emerge. We all know that every human being has basic physical needs: for food, for water, for shelter, for clean air. It turns out that, in the same way, all humans have certain basic psychological needs. We need to feel we belong. We need to feel valued. We need to feel were good at something. We need to feel we have a secure future. And there is growing evidence that our culture isnt meeting those psychological needs for many perhaps most people. I kept learning that, in very different ways, we have become disconnected from things we really need, and this deep disconnection is driving this epidemic of depression and anxiety all around us.

Lets look at one of those causes, and one of the solutions we can begin to see if we understand it differently. There is strong evidence that human beings need to feel their lives are meaningful that they are doing something with purpose that makes a difference. Its a natural psychological need. But between 2011 and 2012, the polling company Gallup conducted the most detailed study ever carried out of how people feel about the thing we spend most of our waking lives doing our paid work. They found that 13% of people say they are engaged in their work they find it meaningful and look forward to it. Some 63% say they are not engaged, which is defined as sleepwalking through their workday. And 24% are actively disengaged: they hate it.

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Antidepressant prescriptions have doubled over the last decade. Photograph: Anthony Devlin/PA

Most of the depressed and anxious people I know, I realised, are in the 87% who dont like their work. I started to dig around to see if there is any evidence that this might be related to depression. It turned out that a breakthrough had been made in answering this question in the 1970s, by an Australian scientist called Michael Marmot. He wanted to investigate what causes stress in the workplace and believed hed found the perfect lab in which to discover the answer: the British civil service, based in Whitehall. This small army of bureaucrats was divided into 19 different layers, from the permanent secretary at the top, down to the typists. What he wanted to know, at first, was: whos more likely to have a stress-related heart attack the big boss at the top, or somebody below him?

Everybody told him: youre wasting your time. Obviously, the boss is going to be more stressed because hes got more responsibility. But when Marmot published his results, he revealed the truth to be the exact opposite. The lower an employee ranked in the hierarchy, the higher their stress levels and likelihood of having a heart attack. Now he wanted to know: why?

And thats when, after two more years studying civil servants, he discovered the biggest factor. It turns out if you have no control over your work, you are far more likely to become stressed and, crucially, depressed. Humans have an innate need to feel that what we are doing, day-to-day, is meaningful. When you are controlled, you cant create meaning out of your work.

Suddenly, the depression of many of my friends, even those in fancy jobs who spend most of their waking hours feeling controlled and unappreciated started to look not like a problem with their brains, but a problem with their environments. There are, I discovered, many causes of depression like this. However, my journey was not simply about finding the reasons why we feel so bad. The core was about finding out how we can feel better how we can find real and lasting antidepressants that work for most of us, beyond only the packs of pills we have been offered as often the sole item on the menu for the depressed and anxious. I kept thinking about what Dr Cacciatore had taught me we have to deal with the deeper problems that are causing all this distress.

I found the beginnings of an answer to the epidemic of meaningless work in Baltimore. Meredith Mitchell used to wake up every morning with her heart racing with anxiety. She dreaded her office job. So she took a bold step one that lots of people thought was crazy. Her husband, Josh, and their friends had worked for years in a bike store, where they were ordered around and constantly felt insecure, Most of them were depressed. One day, they decided to set up their own bike store, but they wanted to run it differently. Instead of having one guy at the top giving orders, they would run it as a democratic co-operative. This meant they would make decisions collectively, they would share out the best and worst jobs and they would all, together, be the boss. It would be like a busy democratic tribe. When I went to their store Baltimore Bicycle Works the staff explained how, in this different environment, their persistent depression and anxiety had largely lifted.

Its not that their individual tasks had changed much. They fixed bikes before; they fix bikes now. But they had dealt with the unmet psychological needs that were making them feel so bad by giving themselves autonomy and control over their work. Josh had seen for himself that depressions are very often, as he put it, rational reactions to the situation, not some kind of biological break. He told me there is no need to run businesses anywhere in the old humiliating, depressing way we could move together, as a culture, to workers controlling their own workplaces.

*****

With each of the nine causes of depression and anxiety I learned about, I kept being taught startling facts and arguments like this that forced me to think differently. Professor John Cacioppo of Chicago University taught me that being acutely lonely is as stressful as being punched in the face by a stranger and massively increases your risk of depression. Dr Vincent Felitti in San Diego showed me that surviving severe childhood trauma makes you 3,100% more likely to attempt suicide as an adult. Professor Michael Chandler in Vancouver explained to me that if a community feels it has no control over the big decisions affecting it, the suicide rate will shoot up.

This new evidence forces us to seek out a very different kind of solution to our despair crisis. One person in particular helped me to unlock how to think about this. In the early days of the 21st century, a South African psychiatrist named Derek Summerfeld went to Cambodia, at a time when antidepressants were first being introduced there. He began to explain the concept to the doctors he met. They listened patiently and then told him they didnt need these new antidepressants, because they already had anti-depressants that work. He assumed they were talking about some kind of herbal remedy.

He asked them to explain, and they told him about a rice farmer they knew whose left leg was blown off by a landmine. He was fitted with a new limb, but he felt constantly anxious about the future, and was filled with despair. The doctors sat with him, and talked through his troubles. They realised that even with his new artificial limb, his old jobworking in the rice paddieswas leaving him constantly stressed and in physical pain, and that was making him want to just stop living. So they had an idea. They believed that if he became a dairy farmer, he could live differently. So they bought him a cow. In the months and years that followed, his life changed. His depressionwhich had been profoundwent away. You see, doctor, they told him, the cow was an antidepressant.

To them, finding an antidepressant didnt mean finding a way to change your brain chemistry. It meant finding a way to solve the problem that was causing the depression in the first place. We can do the same. Some of these solutions are things we can do as individuals, in our private lives. Some require bigger social shifts, which we can only achieve together, as citizens. But all of them require us to change our understanding of what depression and anxiety really are.

This is radical, but it is not, I discovered, a maverick position. In its official statement for World Health Day in 2017, the United Nations reviewed the best evidence and concluded that the dominant biomedical narrative of depression is based on biased and selective use of research outcomes that must be abandoned. We need to move from focusing on chemical imbalances, they said, to focusing more on power imbalances.

After I learned all this, and what it means for us all, I started to long for the power to go back in time and speak to my teenage self on the day he was told a story about his depression that was going to send him off in the wrong direction for so many years. I wanted to tell him: This pain you are feeling is not a pathology. Its not crazy. It is a signal that your natural psychological needs are not being met. It is a form of grief for yourself, and for the culture you live in going so wrong. I know how much it hurts. I know how deeply it cuts you. But you need to listen to this signal. We all need to listen to the people around us sending out this signal. It is telling you what is going wrong. It is telling you that you need to be connected in so many deep and stirring ways that you arent yet but you can be, one day.

If you are depressed and anxious, you are not a machine with malfunctioning parts. You are a human being with unmet needs. The only real way out of our epidemic of despair is for all of us, together, to begin to meet those human needs for deep connection, to the things that really matter in life.

This is an edited extract from Lost Connections: Uncovering the Real Causes of Depression and the Unexpected Solutions by Johann Hari, published by Bloomsbury on 11 January (16.99). To order a copy for 14.44 go to guardianbookshop.com or call 0330 333 6846. Free UK p&p over 10, online orders only. Phone orders min p&p of 1.99. It will be available in audio at audible.co.uk

Read more: https://www.theguardian.com/society/2018/jan/07/is-everything-you-think-you-know-about-depression-wrong-johann-hari-lost-connections

40+ Things People Dont Realise Youre Doing Because Of Your Depression

Depression affects millions of us, and while we are slowly opening up about mental health issues and beginning to banish the stigma that surrounds them, it is critically important to keep open the conversation to foster understanding and empathy for those who may be struggling.

Sarah Schuster is the mental health editor at The Mighty, and she decided to find out how depression manifests itself in ways other people can’t see.

“While most people imagine depression equals ‘really sad,’ unless you’ve experienced depression yourself, you might not know it goes so much deeper than that,” she writes. “Depression expresses itself in many different ways, some more obvious than others. While some people have a hard time getting out of bed, others might get to work just fine — it’s different for everyone.”

Asking community members on The Mighty Facebook page the question: “What’s something people don’t realise you’re doing because you live with depression?” The response was eye-opening. Below is a list of some of the things that people had to say. Scroll down to check it out.

Struggle to get out of bed, sometimes for hours. Then just the thought of taking a shower is exhausting. If I manage to do that, I am ready for a nap. People don’t understand, but anxiety amd depression is exhausting, much like an actual physical fight with a professional boxer.

Going to bed at 9 pm and sleeping throughout the night until 10 or 11 am. Then getting out of bed is the hard part. Showering is also a struggle. Trying to keep the house tidy. Watching hours upon hours of Netflix but not even interested in what I’m watching because nothing really interests me anymore.

Agreeing to social plans but canceling last minute. Using an excuse but really you just chickened out. It makes you think that your friends don’t actually want to see you, they just feel bad. Obligation.

I can deal with depression, I can’t deal with people who say “we all get sad at times, get over it” “I’m depressed too, I get on with my life” depression isn’t the same for everyone. I’m glad some people can cope easier but I can’t.

I don’t like talking on the phone. I prefer to text. Less pressure there.
Also being anti-social. Not because I don’t like being around people, but because I’m pretty sure everyone can’t stand me.

Sometimes I’ll forget to eat all day. I can feel my stomach growling but don’t have the willpower to get up and make something to eat

Hiding in my phone. Yes, I am addicted to it, but not like other people. I don’t socialize, I play games or browse online stores to distract myself from my negative thoughts. It’s my safe bubble.

In social situations, some people don’t realize I withdraw or don’t speak much because of depression. Instead, they think I’m being rude or purposefully antisocial.

Say that I’m tired or don’t feel good all of the time. They don’t realize how much depression can affect you physically as well as emotionally. I have a hard time finding energy when I’m in a depressive cycle. That means I don’t stay on top of stuff & let things slide (like house work) because I use all of my energy for what absolutely has to be done. Then I have none left for anything else. When I’m depressed, we eat out more, my house chores fall behind, & I binge watch TV or read to escape. But the energy, that’s just gone.

Purposely working on the holidays so I can avoid spending time with family. it’s overwhelming to be around them and to talk about the future and life so I avoid it.

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People think I’m lazy and a freerider because I haven’t had a job since leaving uni. They don’t realise that I want to work more than anything, but have an endless stream of negativity constantly running through my head that terrifies me out of even printing out an application form.

I used to live with depression. People didn’t seem to notice it because I was always smiling while talking to them and making jokes which made my personality look bright and joyful, while I was actually dark inside, full of sadness and lost hope.

Isolating myself, not living up to my potential at work due to lack of interest in anything, making self-deprecating jokes. I’ve said many times before, “I laugh, so that I don’t cry.”
Unfortunately, it’s all too true

Being angry, mean or rude to people I love without realizing it in the moment. I realize my actions and words later and feel awful that I had taken out my anger on people who don’t deserve it

Depression to me was like having an evil person as my puppet master telling me that I will feel no joy, have no desire, have no energy, no appetite, no light. Like something steals your soul. Until you have experienced it, you will not understand it. I wouldn’t wish this feeling on my worst enemy.

For me, specifically the things I wish people would realise are due to my depression are my apparent “laziness”, virtually not keeping in touch with anyone, bad personal hygiene, and extremely bad reactions to seemingly trivial things.

Neglecting to do basic things like laundry, not wanting to cook a meal or eat. They think I’m being lazy.

Fighting day to day with not wanting to give up and trying to show myself my own self worth.

When I reach out when I’m depressed its cause I am wanting to have someone to tell me I’m not alone. Not cause I want attention.

I just sit all day, getting up only to use the bathroom. My chair is also my bed. I have a bed, but i just stay in my chair. I don’t sleep well, and I eat very little. The TV is on, but I may or may not be watching. I just sit.

My house is a huge mess.

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The struggle to get out of bed and get off the couch is hell. The physical pain that exists. The house always a mess because no one else will or can do anything and I get blamed which all just makes the depression worse. The thinking about what I need to do makes me anxiety paralyzing.
Not having a job and physically not being able to even look for one after all the rejection.
People think I’m lazy.
I know a clean house helps me feel better, helps me socialize, causes peace and calmness, I want to and I try, but I just can’t. I know a job will give me purpose and reduce stress by adding some financial stability to my family. I really want one and perhaps that is why it is so heartbreaking every time those phone calls don’t come.

I don’t talk much in large groups of people, especially when I first meet them. I withdraw because of my anxiety and depression. People think i am ‘stuck up’. I’m actually scared out of my mind worrying that they don’t like me, or that they think I’m crazy or stupid, by just looking at me…

I over compensate in my work environment…and I work front line at a Fitness Centre, so I feel the need to portray an ‘extra happy, bubbly personality’. As soon as I walk out the doors at the end of the day, I literally feel myself ‘fall’. It’s exhausting! Then my night is a constant battle in my head fighting my desire to ‘shrink’ and anxieties. Most people that I interact with would NEVER know I live a daily battle of major depressive disorder, PTSD and anxiety. I am a professional at hiding it.

Cancel plans because of anxiety. Stay home and hardly ever go out. Struggling to get out of bed everyday. It’s exhausting. Getting ready for work is a struggle. There is so much. Been dealing with this for 35 years

The excessive drinking.
Most people assume I’m trying to be the “life of the party” or just like drinking in general. I often get praised for it.
But my issues are much deeper than that.

People don’t realize that I say sorry before I even think about expressing any opinions because that’s how worthless I feel. I’m apologizing for feeling anything about anything because that’s how little I feel I matter. They don’t just know I feel like apologizing for even breathing in their general direction. I even say I’m sorry before asking to use the bathroom no matter how long I’ve held it. I feel like a burden for biological needs I have no control over.

That I’m fighting through a wall of separation when I talk to them. That sometimes I blank or delay in answering because I’m still trying to process what they’re saying.

That when I reach out to them it’s after an agonizing period of trying not to. I don’t want to burden people with my shit, but sometimes I just need to hear someone’s voice.

That my everyday is marked with extreme fatigue and exhaustion. That everything for me takes much much longer.

That I am completely envious of people who are full of life and genki af. That I wish my life was nothing but optimism and bliss, that I felt a zest for life and was overflowing with energy. That that is who I really am behind all the junk they have to see and put up with. That I wish I could just ignore it all and have fun.

Sometimes I’ll go days without speaking to anybody. People tend to believe I’m ignoring them on purpose when really I am just lost within myself. I don’t mean to seem like I’m pushing people away. Some days it’s hard when my thoughts consume me and when I can’t find the motivation to simple things that others do on a daily basis.

I wake up feeling like I’m a failure. I have to coach myself every morning into telling myself that I’m good at my job, my kids love me, my husband needs me…and if I don’t go to work everything gets shut off… it’s like I can’t move…

Answering slowly. It makes my brain run slower and I can’t think of the answers to the questions as quickly. Especially when someone is asking what I want to do – I don’t really want anything. I isolate myself so I don’t have to be forced into a situation where I have to respond because it’s exhausting.

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I push away/cut off everyone that I care about because I can’t bear to be hurt by them! Everyone just thinks I’m mean and anti-social.

Keeping the house dark is a comfort thing for me. People always point it out, like “No wonder you’re so depressed. You need to let some light in.” Darkness in my living space makes me feel comfortable, almost like I’m not alone, on my bad days. Good days, I’m all about the sunshine!

Sleeping, anxiety, not eating, feeling worthless, directionless, not wanting to impose my worthless directionless self on other people, being completely exhausted by having to keep the outer mask in place (which is why I’m antisocial– simply being upbeat enough to order coffee at Starbucks will sometimes rinse me for the afternoon).

I want to talk about it. I want to scream. I want to yell. I want to shout about it! But all I can do is whisper “I’m fine.”

Overthinking everything and over planning. The need to make everything perfect and everyone happy even if it’s taking all my energy. As if validation from someone else will make it all better. Sometimes I start out on high power then just crash and don’t even enjoy what ive spents weeks/months planning. And none will see me for months after, as I retreat into my safe bubble

I find that after so many years I just can’t believe in people at all anymore. My vision of myself and the world is so negatively distorted that no matter how much I want to believe when people are nice to me, I can’t.

People who say I’m not ugly are lying and laughing behind my back. People who act like they like me are just going with the flow and don’t really care.
Even if they aren’t being mean, they’re just being polite, and it’s not like they care about me personally. Being a part of a group actually means that you’re just one more and don’t individually matter.

People are not honest, people are always just “polite” – kindness is a lie to look good to others and to feel good about themselves.

Agonizing over tiny problems for days because I’m too afraid to talk to the person who hurt me. Then being told I need to “get over it” or “calm down” or “stop dwelling”. Yes, I know this is not a big deal. Yea, I know I’m making a mountain out of a molehill. Yes, I know I’m difficult, impossible, frustrating and annoying… but I’m also just trying to get through my day. All I need is that reminder that I’m actually okay, not someone demanding that I BE okay.

Hiding out in my room for hours at a time watching Netflix or Hulu to distract my mind or taking frequent trips to the bathroom or into another room at social gatherings because social situations sometimes get to me.

I CAN RELATE TO EVERY COMMENT I HAVE READ WHICH IS SO SAD. SO MANY OF US HURTING AND LIVING WITH THE FEELING WE ARE ALONE. I EVEN FEEL GUILTY TALKING TO MY COUNSLER THINKING SHE IS GETTING SO TIRED OF ME TALKING ABOUT THIS STUFF. I BEAT CANCER A FEW YEARS AGO AND YOU WOULD THINK THAT WOULD HAVE GIVIN ME A NEW LEASE ON LIFE BUT IT ONLY MADE ME MORE DEPRESSED THOSE WHO HAVE HAD TO DEAL WITH DEPRESSION FOR A LONG TIME WILL UNDERSTAND WHY.

I get obsessive over things. Things like I’m worthless or I’m a bad person or I’m secretly just like the people I hate most. Sometimes I can’t tell if what I am thinking is true or not. I get anxiety at social events. I feel like people hate me or just don’t care about me. I cling to certain people and want them to love me. My brain sometimes goes into overdrive and I can’t turn it off and it causes a downward spiral that is hard to pull out of.

I don’t tell people because I don’t want to be labeled. I don’t want them to see me as broken and depressed or that I’m just being silly. But at the same time people get upset at me or mad about things but they don’t understand what I have to deal with.

I listen to music a lot. I read tons and tons of fantasy books. I like watching movies. All of these take me away from reality for a while and puts me into amazing worlds where I know things are going to end happily. I love being in plays and musicals because I get to be someone else entirely and I know how things are going to end and it makes me happier.

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Running a business not answering the phone for years … still works, though …. cancelling all the jobs that makes it neccessary leaving my home … can‘t leave my cats alone … I am turning into this crazy cat lady … at least I don‘t miss anything – I really enjoy my own company … people empty me .

Every night I look at all the pictures of dead relatives I have and asking them to please come get me I don’t want to do this anymore. I’m 71 and have been suffering from depression on and off in my life since I was 18. I truly am done.

I think its hard for people to understand me when i may sound negative because i live with depression. They might question my motivation n even determination to do something but they dont realize its a battle to wake up everyday fighting my own thoughts n suffering from low energy.

Some very universal themes in all the examples. I remember my days, twenty years ago, before medication and therapy well. Realizing that my feelings were not unique was part of the key; overcoming isolation was another. It cannot be fixed alone.

I thought I was really bad at hiding my anxiety until one day a friend came to tell me that she wished she lived her life like how I did mine , cause I am always happy and take everything with a pinch of salt. Now I know that I’m an ace at covering up .

I know what should I do to get rid of depression, but I can’t. I’m in a lake, I know how to swim, but I’m paralyzed. I think that’s it.

Almost all day every day I am on the internet reading science fiction short stories and going through sites like this for a sort of escape. When there is company I keep to myself more, unless my sister and her family are visiting.

Going for late night walks by myself. My depression keeps me awake at night and my thoughts can get so overwhelming I feel physically crowded inside. Late night walks help me quiet the screaming in my head.

I have often been accused of having “no sense of humor”. So wrong. Before depression took over my life I smiled, and laughed, as much as the next person. Now, having lived with depression for over 15 years, the humor I find in a joke, or situation, is rarely visible on my face or heard in my laugh. I feel humor, but it’s just too much effort to express it. I don’t have the energy.

I feel like a stranger in my own life. Having had surgery, off work, no savings, short term disability behind, water frozen, kitchen full of dirty dishes, but I am alive and taking meds.

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It’s so comforting to see I’m not alone. Being indecisive, having extreme difficulty making decisions because you can only see and fear all the things that will go wrong. And when/if a decision has been Finally made, the inability to take action and carry it out because of fear and anxiety. Financial problems overwhelming, inadequacy, social fear, losing your temper for no reason, hours of crying fits, safety in your little home, but being so lonely, heartbreak, regret and grief because of loss of dreams, feeling useless & lazy because you cannot complete basic household chores. Eating too much junk or nothing at all because it’s too much trouble. Having a long list of fun things to do in your spare time that you KNOW will make you feel great about yourself, but you just cannot get out of bed to do them – yearning for the days when you could. Just wanting to sleep so you don’t have to FEEL anything. The GUILT of having depression because everyone else seems to have their life together and so should you at this age. But you don’t know how to do it. The guilt you feel because of the Support you DO get from Friends who understand – don’t they have their own lives to live without having to worry about you all the time? Not feeling good enough/worthy of being loved by someone after being rejected. Escaping into your phone or movies/series. Genuinely not wanting to carry on, even/especially after 3 suicide unsuccessful ‘attempts’, because it seems this is as good as it gets and you are just using up Earth’s valuable resources, a waste of space. Feeling like a burden. Depression is a killer.

People will always tell you “When you’re feeling like that, reach out to someone”. But I don’t want to anymore. Any time that I try to, I’m told I’m too negative, or to get over it, or SOMETHING along the lines of “How dare you have told me this?”. Every time I try to open up to people they either tell me off or just outright block me.
It’s come to the point where when I hear people say “I care about your happiness”, I interpret it as “I only care about you when you’re happy”. Talking through these kinds of emotions are usually a great help, but how can I get said help if nobody cares enough about me to talk to me about it at all? I’m grateful to have a therapist, but a lot of people don’t have the money or other resources for such help.

Endless negativity towards yourself and everyone else. Feeling like a continuous failure because you don’t have the energy to do the right things in your life. Constantly telling yourself you’re worthless and people around you will be better off if you’re not there. Panic attacks that happen at night and keep you awake. Wondering if it will ever get over.

I volunteer for everything from going to pto meetings to baby sitting to cleaning someone else’s house for them. I surround myself with situations and obligations that force me to get out of bed & get out of the house because if I’m not needed, I won’t be wanted..

I always say I’m going to do something with the guys and when it comes time to do it. I back away. Also sleeping for hours not because I’m lazy but because dealing with all the thoughts in my head from anxiety along with depression is exhausting. Feels like kind of when your in winter and the cold air is blowing and you find it hard to breath. It’s like that daily for me.

I’ve dealt with depression most my life. Most my symptoms are manageable as long as I’m being mindful of my attitude, thoughts, and behavior. I don’t ignore people and I let them know when I need alone time or if I’m not feeling well. When life gets boring or mundane I remind myself that this is not my last stop and I continue dreaming. These are some of the ways that I manage depression.

I prefer to be awake through the night because I can just stay in bed without anyone getting mad. I sleep up to 15 hours a day during bad periods. When I’m awake, I live in my head, I often don’t even move.

Just getting in the bath or making a cup of tea is a major achievement. Having my dog has made me get out of the house at least twice a day, have to take hours to get motivated sometimes though. But if I didn’t have him, I probably wouldn’t leave the house unless it was for work.

I get very apathetic. And I’ll refuse (read: I can’t) to make any decisions. Even tiny ones like what to eat. I physically won’t be able to make a decision. So if there isn’t someone around to tell me to eat something and what to eat, I won’t eat. If there isn’t someone to tell me to go to sleep, I won’t. It gets to the point where if someone asks me to make a decision or tries to force me to make a decision I’ll just curl up into a ball and cry.

My sleep patterns are all over the place. I have lots of bad dreams and I’m tired all the time. Work takes a lot of energy, being happy and enthusiastic (I’m a teacher) I crash when I get home. Change makes me anxious. On bad days my hands will shake and I feel anxious and jittery but I don’t know why. I forget my words. If I’m down and someone asks how I’m going I’ll just burst into tears. I’m happiest when I’m too busy to think, but then I wear out and crash. The situation that caused my depression is gone and logically I know I should be fine now, happy now…but I’m still struggling. I lost good habits and picked up some bad habits. I’ll agree to plans and then cancel, I feel like I’m turning into a hermit and if I talk to someone about it they will think I’m weak and get sick of me being down all the time. So, I stay home by myself.

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I’m 25 but still virgin, no job, no money no boyfriend, I still live with my family, I can’t even graduate from college at my 6th year because I can’t focus anything, I can’t get up from bed, I don’t want to do anything, just sleep and hope to die.

As i read these, i can totally relate to almost all of them. That constant
battle royale what you have to fight against your demons. The struggle to eat, to shower, to clean your room/house, go to school/workplace. And the world says that you are lazy is only oil onto the fire. When they say “yeah everyone gets sad”. Well you don’t say? I’m not sad. I’m DEPRESSED. There is a huge difference. Sadness is an emotin when something bad happened. Depression is feeling sad, alone, exhausted or even suicidal etc. My favourite is “you have nothing to be depressed, you have at least half of your life in front of you”. Yea… most people can’t realize the fact depression has multiple reasons, Not just the traumatical one. It can be in your genes because someone was depressed in your family, it can be a random switch from a day to the other just because your neurochemical balance got broken and became a neurochemical imbalance. So you don’t need any reason to be depressed it can just happen. (just like in my case, and in many others’)

Sometimes i just don’t eat for 2-3 days, then i try to eat normally, then i eat a lot. Same with sleep. Somethimes I’m like an insomniac, then I’m like i have hypersomnia. This cycle is what killing a lot of us.

That feel when sleep is not just a sleep anymore, more likely a way to escape. But then you realise that when you sleep only the time passes but it’s just like a snap of fingers and you feel the demons again. Then you feel like “please god, i don’t want to wake up tomorrow, please”. The feel when you are in front of the mirror and just screaming/crying and literally begging to yourself to hold on.

I know how it feels, i feel like I already lost and I’m really afrad if it as well.

But please, whoever you are, be strong, i know it’s a cliche what you hear always, but we hear that all the time only because it’s our only chance.

I’m currently feeling some pretty deep depression because of what I’m going through. Between the stress and depression all I can do is sleep because I’m so worn out. In some pretty dark places right now and pushing everyone away. I hope it will end when I face the monster that is trying to kill me at the end of the month. I’ve lost everything in the last 2 years because of this person and their agency. I can relate to just about everyone of these and have lost friends over it. I had one friend tell me that my friends don’t like hanging out with me because I’m negative. Well a chance to loose your life is pretty negative. Just saying.

People think I’m really flaky. I say I’m busy and I can’t do the thing I said I’d do but I’m busy hiding. That’s depression. The great need to be busy until you’re so totally physically exhausted so you don’t have to be afraid of your own thoughts: that’s anxiety.

I have tendencies towards a lot of what’s been described here: I wake up sometimes and think: ‘Ugh! How am I going to get up today?’ I have times I want to avoid people, where I become very introverted, where I want to drink every night, where I don’t feel like making any efforts to try to address my difficult financial situation (I can’t find a good job just yet).

I can’t speak for everyone, but what works for me, and I think will work for some, but certainly not all others, is that I work against these things one at a time, with simple but effective rules: 1. I will not let myself sleep more than 8.5 hours (assuming I’m not recovering from some serious sleep deprivation) 2. I will not let myself buy alcohol at a store or go to a bar until a weekend night. 3. I will require myself to do at least a few job applications, or application follow ups or go to some networking thing at least a few times a week. 4. I will exercise at least for a half hour 5-6 days a week. 5. I will write one more chapter of my novel manuscript today. 6. I will tidy up my room for 10-20 minutes as I play my favorite music. 7. I will enjoy a little indulgent food like dessert but I won’t go crazy on dessert.

Ask yourself this: can I put my more intelligent self in charge, one simple step at a time?

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I can’t sleep at night because thoughts of failure run through my head

I’m always alone until someone in my family needs something. And I’m up all night trying to figure out how to solve everyone else’s problem. After their problem are solved, they’re gone…no thank you, and they may even talk about me behind my back about how they used me again. But If I don’t help, I’m the crazy sister, aunt,etc.. If family does this to you, I’m afraid to meet strangers. No one cares that I’m alone all day at home hiding in the house with burns all over my body, I’ve been told that I’m too depressing to be around, until they need help again. I need to drop my family and find people like me. But where do burn victims hook up? Heaven I guess!

Everyone here is not alone, This thread is proof of it. There are people out there who can help work through a lot of theses issues, being medication or conversation, relationship or companionship. The point is, It sucks. This disease really sucks. But to help and fix this disease we need to speak up, Most friends and family and doctors won’t know until we tell them. It also helps to push myself daily, to challenge myself, even to scare myself. Maybe to set a time to get up or shower or eat. After awhile it becomes routine. Routines can help move to a better position. Just my 2cents.

My emotions overwhelm me. I second guess everything I do or don’t do. I feel like no matter what I do it will be wrong. I am constantly exhausted and want to escape into sleep to avoid life. I feel hopeless and helpless and I don’t think anyone understands. I want to scream for help but no one knows how to help me and I feel like they don’t want to hear it and they’re trivializing my struggle. I want to physically cut it out of myself.

Always having to be around someone. I have a total inability to be alone. I don’t even have to talk to a person…as long as I know they’re physically there, I’m content. Otherwise, depressing thoughts creep in and I end up driving myself crazy. It’s less effort to put on the facade that I’m fine in front of other people, than it is to face myself alone.

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Sometimes I can’t breathe

I have anxiety and pretty much think I’m useless all the time & that people don’t actually like me. It’s like My inner monologue is constantly putting me down. Because of this, I can’t handle criticism of any kind. In a work situation it comes across like I’m not listening when taking constructive criticism, or if I’ve made a mistake and I’m being called out on it. It may seem like I’m ignoring criticism but in reality I’m shutting down because i’ve already started to tell myself that I’m useless and I’m scolding myself for messing up.

I don’t feel like I’m “in me”. I feel like I’m looking on. Like I’m behind something but watching with hypervigilance. I also stress over things way beforehand. “Which door will I go in? Someone’s going to laugh if I get the wrong door”. “Where do I park? I’m going to be in someone’s way”. “When I walk in, everyone’s going to look at me”. It goes on and on. My mind is so chaotic that it is empty, blank. I cannot say things in order or make others understand what I am trying to get across. Words won’t come. When they do they don’t come out right or the thoughts in my head are not the thoughts I am thinking. They think I’m using figures of speech. Once I was telling my therapist that I didn’t feel like I was 46. She went to give me a high five! I meant that I feel emotionally stunted, like I didn’t go past a certain point somewhere along the line. I have PTSD from sexual abuse by one person and physical and verbal abuse from my father. I had it coming at me in every direction it feels like. I feel SO tired all the time, all, the time. No energy to do anything. I have no interest in anything anymore. My apartment isn’t dirty but things pile up. I know, logically I need to get my butt moving but I just can’t. I want to sleep and nap all the time. Facebook is an outlet for me. I have made groups so that I can post

Read more: http://www.boredpanda.com/people-share-what-is-like-to-live-with-depression/

Poor diet is a factor in one in five deaths, global disease study reveals

Study compiling data from every country finds people are living longer but millions are eating wrong foods for their health

Poor diet is a factor in one in five deaths around the world, according to the most comprehensive study ever carried out on the subject.

Millions of people are eating the wrong sorts of food for good health. Eating a diet that is low in whole grains, fruit, nuts and seeds and fish oils and high in salt raises the risk of an early death, according to the huge and ongoing study Global Burden of Disease.

The study, based at the Institute of Health Metrics and Evaluation at the University of Washington, compiles data from every country in the world and makes informed estimates where there are gaps. Five papers on life expectancy and the causes and risk factors of death and ill health have been published by the Lancet medical journal.

It finds that people are living longer. Life expectancy in 2016 worldwide was 75.3 years for women and 69.8 for men. Japan has the highest life expectancy at 84 years and the Central African Republic has the lowest at just over 50. In the UK, life expectancy for a man born in 2016 is 79, and for a woman 82.9.

Diet is the second highest risk factor for early death after smoking. Other high risks are high blood glucose which can lead to diabetes, high blood pressure, high body mass index (BMI) which is a measure of obesity, and high total cholesterol. All of these can be related to eating the wrong foods, although there are also other causes.

causes of death graphic

This is really large, Dr Christopher Murray, IHMEs director, told the Guardian. It is amongst the really big problems in the world. It is a cluster that is getting worse. While obesity gets attention, he was not sure policymakers were as focused on the area of diet and health as they needed to be. That constellation is a really, really big challenge for health and health systems, he said.

The problem is often seen as the spread of western diets, taking over from traditional foods in the developing world. But it is not that simple, says Murray. Take fruit. It has lots of health benefits but only very wealthy people eat a lot of fruit, with some exceptions.

Sugary drinks are harmful to health but eating a lot of red meat, the study finds, is not as big a risk to health as failing to eat whole grains. We need to look really carefully at what are the healthy compounds in diets that provide protection, he said.

undernourishment graphic

Prof John Newton, director of health improvement at Public Health England, said the studies show how quickly diet and obesity-related disease is spreading around the world. I dont think people realise how quickly the focus is shifting towards non-communicable disease [such as cancer, heart disease and stroke] and diseases that come with development, in particular related to poor diet. The numbers are quite shocking in my view, he said.

The UK tracks childhood obesity through the school measurement programme and has brought in measures to try to tackle it. But no country in the world has been able to solve the problem and it is a concern that we really need to think about tackling globally, he said.

Today, 72% of deaths are from non-communicable diseases for which obesity and diet are among the risk factors, with ischaemic heart disease as the leading cause worldwide of early deaths, including in the UK. Lung cancer, stroke, lung disease (chronic obstructive pulmonary disorder) and Alzheimers are the other main causes in the UK.

The success story is children under five. In 2016, for the first time in modern history, fewer than 5 million children under five died in one year a significant fall compared with 1990, when 11 million died. Increased education for women, less poverty, having fewer children, vaccinations, anti-malaria bed-nets, improved water and sanitation are among the changes in low-income countries that have brought the death rate down, thanks to development aid.

People are living longer but spending more years in ill health. Obesity is one of the major reasons. More than a billion people worldwide are living with mental health and substance misuse disorders. Depression features in the top 10 causes of ill health in all but four countries.

Our findings indicate people are living longer and, over the past decade, we identified substantial progress in driving down death rates from some of the worlds most pernicious diseases and conditions, such as under age-five mortality and malaria, said Murray Yet, despite this progress, we are facing a triad of trouble holding back many nations and communities obesity, conflict, and mental illness, including substance use disorders.

In the UK, the concern is particularly about the increase in ill-health that prevents people from working or having a fulfilling life, said Newton. A man in the UK born in 2016 can expect only 69 years in good health and a woman 71 years.

This is yet another reminder that while were living longer, much of that extra time is spent in ill-health. It underlines the importance of preventing the conditions that keep people out of work and put their long term health in jeopardy, like musculoskeletal problems, poor hearing and mental ill health. Our priority is to help people, including during the crucial early years of life and in middle age, to give them the best chance of a long and healthy later life, he said.

Read more: https://www.theguardian.com/society/2017/sep/14/poor-diet-is-a-factor-in-one-in-five-deaths-global-disease-study-reveals

What Depression Actually Is, Because Its More Than Just Being Sad

Depression is doing everything you can to hide it. Because theres nothing glorified about it. Theres nothing beautiful about a bad night as you fall you your knees, in a silent scream, that no one hears because youre alone and you need to be until you get through it.

Its the sleepless nights as you lay awake at 2 am staring at the ceiling.

Its that time of year, you just get a little bit sadder for no reason.

Its the tears you dont tell people you cry because you dont really know why youre crying, you just know you need to.

Its the want and need to be around people but at the same time, you push them away.

Depression is watching across social media, everyones highlight reels and you know its not an accurate depiction of their life yet you still compare yourself to them.

Its the plans canceled last minute because you couldnt muster the strength to get out of bed.

Its your alarm going off in the morning and you just want to go back to sleep.

Depression is that cloud that doesnt seem to go away ever. And even in those happy moments, you cling to, you know its still hovering over you. Depression waits. It creeps and lurks. It waits for the best day of your life and your happiest moment just so the next one can be your worst.

Its the fear of such happiness because you know its bound to fade.

Its every good day, that are few and far between and that’s what you hang onto.

Its the struggle in explaining to people when they ask why are you depressed? You just dont know and you dont know how to fix it. Its just a feeling you cant shake but youre learning to work through.

Depression are toxic habits or people you gravitate towards.

Its drinking the way you do because at least for a moment your pain is numbed. You know the effects lead to being even more depressed the next day. And you know alcohol is a depressant but being numb helps sometimes.

Depression is the constant unbalance of things in your life.

Its either overexercising and being at the gym for hours or staying in bed for weeks immobile.

Its either sleeping too much or too little. But no matter what, youre always tired.

Its eating too much or just never being hungry. Its someone asking, ‘When was the last time you ate?’ And you actually don’t know the answer.

Its weight loss that people commend you for but you know even you couldnt help it.

Depression is people asking if youre okay and you dont respond with Im sad. You simply say, ‘I’m tired.’

Its the envy of looking at others and just wanting to be that happy. So you glamorize your own life so it appears that way.

It’s that really scary moment when you open up to someone about what it is you deal with. And that new level of friendship you reach, when they welcome you with open arms and it almost brings you to tears.

Its loving people unbelievably hard because youre still learning to love yourself.

It’s looking ahead and looking forward to certain days in your life and really appreciating everything.

And even though you might not say it, as often as you should, it’s the love you have for everyone in your life which gives you strength.

Depression is becoming addicted to anything that gives you purpose. Whether its being a perfectionist in academics or becoming a workaholic. Its becoming the most involved in a group or organization because you need something to look forward to. Its excelling in sports because it really helps to have that and a team to fall back on.

Its the need to be busy because if youre not youll spend too much time alone and everything will get worse.

But more than that, depression is the person who would do anything to make others happy because someone elses happiness is their own.

Depression is being overly observant because you know what its like to hide things, so you look for it in others.

Its being the first one willing to help and being the person you wish you had. Knowing well, there’s nothing you can say or do but be there for them and that’s okay.

But more than that, depression is a strength in you because theres nothing harder than overcoming demons within yourself.

Its the trust people have in you, knowing they can turn to you without judgment.

It’s the excitement you bring to others because even though you’re sad, you do love life.

Depression is being the happiest, saddest person, people know but there’s a bit of beauty to someone who knows both emotions at such an extreme level.

Depression is an appreciation and gratitude for life. It’s knowing no matter what happens things will get better.

Depression is hope even in moments that seem hopeless.

It’s not letting this define who you are but rather learning to live through it and being the example others can follow.

Read more: http://thoughtcatalog.com/kirsten-corley/2017/01/what-depression-actually-is-because-its-more-than-just-being-sad/

My 80 lbs raw food weight loss story! Before & After photos!

My 80 lbs raw food weight loss story! Before & After photos!

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Are you tired of being fat? Are you tired of trying all these different diets which simply don't work for you? Are you tired of being affraid to go to the beach because you have the feeling that everyone will be starring at your big big butt? Are you tired of being short of breath when you try to run? Are you tired of avoiding to look at yourself in the mirror? Are you tired? Because I was tired! Two years ago I was fat, I was sick and I had absolutely no self esteem. Now I am another person – fresh, lean, vibrant and healthy thanks to the high carb raw vegan lifestyle.