Have you talked to your therapist unambiguously about the stagnation you describe? Have you considered trying to talk to someone else, too, who maybe follows a different approach? I am not a doctor but I imagine that such a high level of pharmaceuticals is probably warping your brain chemistry drastically on its own. If there were a way to dress the problem without so many it seems like that would be ideal.

Just keep in mind that this is about the abuse, and not about "startups" or anything going on in your life now. Horrible things happened to you that aren't your fault, and the ways your psychology adapted to those horrible things, ie your current mental health issues, are not your fault either. You need to get help from someone who is really equipped to help you much more than you need help from us.

Good luck, and remember that many other people have gone through similar things and come out the other side happy.

I'm personally fortunate to be in a good position mental health wise, but I know http://reddit.com/r/depression, http://reddit.com/r/bipolar and http://reddit.com/r/bipolarreddit have helped my close (non tech friends) a lot and they cannot recommend them highly enough.

OP, I feel a board dominated by entrepreneurs and type-a hard-charging success hounds isn't the ideal place to get advice about feeling bad from clinical depression. Not that these aren't completely kind people, but there is depression and there is Depression. When you've been abused as a child, you are changed forever in ways that are not even on the same continuum of emotion that, say, not exercising, or going nearly-broke like [insert famous billionaire here].

I probably can't express this effectively through text and I'm not available to chat via Skype at the moment, but:

It's okay for you to feel Depressed. As far as emotions can be described as having reasons, you have them. Abuse changes a person forever. Doesn't break them, or make them bad, but it often leads to terrible emotions a lucky majority can't even fathom. You're feeling terrible, don't feel guilty about being injured on top of all that. Actually, injury might be a good metaphor, in that we have an animal instinct to hide away vulnerability and pain. I feel the same way about my "injuries," I don't want to share them because of a stigma of guilt that comes with Depression.

One thing I have seen posted (from a quick scan through) is the truth that you won't always feel this way. Things do get better. And then, all too commonly, they get worse again. But that too shall pass.

It is a great community, with some really nice people.

I have to run out now, but I have a lot more to tell you. Exercise is key, whenever I am in a bad mood I realize that it has been too long since I've exercised. Your body will actually generate new neurons while you are exercising and your brain will release endorphins and other neurotransmitters that increase mood. I know it seems hard to get there if you haven't been in a while, but for a longterm goal and short term boosts of energy, definitely do it. You can try to start with a yoga class or something like that, because at the end of the day yoga is mostly meditation and focus on breath. Meditating is also extremely important in welfare for everyone, especially entrepreneurs and founders. The daily stress of running a startup can not only get you down, but also lead to feeling lost.

I don't know what drugs you are on, but I can recommend some supplements and nootropics that will definitely elevate mood. Try tyrosine.

That said, exercise has been shown to be helpful for depression of every sort (generally at least as effective as drugs, on average).

Exercise is great, go and do that. If it doesn't work, at least you'll put on some muscle when you do get out of it.

I am definitely against any sort of drugs, and I dont think labeling things is particularly helpful, but my suggestion is to get over it. Recognise you can take a beating and survive.

The best advice I can give: change. Change something. Change jobs, hobbies, places. Go looking for new things to excite you again. I'm about to take my own advice and go on a cycle tour - I'm starting with Holland, then may try the west coast of the US. (It took me a year and a half to get to the point where I even bothered setting goals like that, but it's something good to try and do)

I am pretty anti-pharamcetuicals, but I am very pro-supplement and nutrients. Simply not getting enough of certain amino acids can cause depression or other things. An example is dopamine, which is built from tyrosine in the body. is the neurotransmitter dopamine. The evidence is that it has to do with motivation and not pleasure. I recently wrote an article about that change here ( http://matznerd.com/dopamine-is-not-about-pleasure-anymore-a... ) but the main takeaway is that if you lack the nutrients in your body to make dopamine it can result in depression...

> "in the moment it seems like it will never go away, but the truth is, that it always does."

The truth is, it always does for you. I'm not the same person pre- and post-diagnosis, and even when I'm not feeling down, I never feel quite as 'up' as I used to be. To that end, I don't feel like it's gone away. It's by no means as bad as some other people have it, but I feel like I'm stuck with it now.

Exercise, though, is definitely a good idea, and is a piece of advice I've been given from other depressed friends, my counsellor, and my GP. At the very least, doing a bit of it takes your mind off things, and has the benefit of keeping you in decent shape too.

Personally I don't think someone who is either depressed or feeling blue and is a member here should try and remedy those feelings by immersing themselves in even more startup doom and gloom, or success stories. Take your head out of the job, because it means fuck all compared to your own happiness and wellbeing.

And as has been said, consider change. A change of scenery could offer you some peace of mind.

1) Get opinionated. Try to form opinions about everything around you. What do you like or dislike about that lamp post? Which one is your favorite fruit and why? These type of silly exercises is a good way of building up an image of what you want in life. When you know what you want, you can figure out how to achieve it. Being passive is horribly depression-inducing.

2) Participate in life coaching, preferably both individually and in groups. This helped me getting a more objective view of what type of individual I am, how other people see me. But also what other type of personalities there are and how they interact. Knowing all this has helped me view disagreements and conflicts in a new light. I don't have to take myself and everything around me so seriously, since I can see more clearly why things happen as they do.

I wish you all the best.

I've learnt a good technique where I just work on being angry. Doesn't matter what about, even just at myself for being depressed. When I get to angry, I'm not feeling despair anymore. I allow myself to focus on being angry for a while but then that turns into frustration. Then I just become annoyed. And before I realise I'm not depressed anymore.

I know all that is a lot easier said than done but over the years I have got better at it.

Another tool I use is to make a list of 20 things I'm grateful for in my life. At first I can't think of anything, but I make myself work at it and start to remember some good things. Good things that I should be happy about.

I realise not everyone's depression is the same but these tools work for me so I thought I'd share.

That's not really the way clinical depression works though. Letting yourself wallow in bona fide clinical depression is unhealthy because it reinforces neural structures that strengthen your depression, making it harder to get out of, and easier to relapse into later. There's also evidence that being depressed causes widespread cognitive impairment, and it's possible that those effects could linger (or at least ripple) after treatment.

In short, you want to stay depressed for as little time as possible. But if you're enjoying feeling sorry for youself, that may be something other than depression.

Though I have learned to live with the depressing stuff without any kind of medication. Mostly I do this by shifting my thoughts about the depressing stuff to something which I find nice. Though too often it is a good movie, but still that is almost two hours break from thinking about the depressive stuff.

And if you manage to have a somewhat healthy something else, you're relatively lucky :)

I am glad that you've found something that works for you.

http://www.youtube.com/watch?v=jeIy2MHZ0xE

Since I take their input, my life is bliss :

* wall-e on romance : now I date an ipod

* robocop on hairstyle : I had to stop as it screwed majorly my head

* HAL-9000 on gaming : I don't let nobody beat me at "jeopardy: the mission"

* MCP on people : I chmod 700 every aspect of my life

* Terminator on ending relationships : going down in a melting vat is the way to end things the cool way.

* D.A.R.Y.L on procreation : kids are only cool if they are robots.

1. Your identity is often bind with your startup. If your startup failed you feel like you failed, even if you might control 3 out of 10 important parameters. Or you are the best at 9 out of 10 but that 1 out of 10 failed.

2. Like other professions like doctor or lawyer we dont have a big group to relate to. No other entrepreneur is the other s alike.

3. Any d*ckhead can start a company and the difference between genius and beeing crazy is thin.

4. Your reward comes very very late. If you are a consultant, you work one hour get paid one hour. Building the next facebook takes time and the sign of your success can take for ever.

5. Failor is more common than you think. We hear about the success stories but guys that tried and failed just silently start working at a company as employee.

6. Success and feedback for an entrepreneur is rare. Being #1 on HN is not something you can be every day. But if you take out the trash or work as truckdriver you can come home, leave your work and feel pretty good about your self and what you have done. Having great plans increases your of personal failor risk a lot.

So what is the solution? I think more about my self as a builder and the projects I do I am aware they might fail, but I focus on me and my methods. Try to fail faster, MVP and all that other stuff Eric talks about in Lean startup.

It is not about me or my startup it is about going out and fish, fish for a successful company and every day learn someting and increase my luck exposure bit by bit.

It's sad that there is a need to create a fake identity just to openly talk about a condition you have no control over. In this century, it should be as easy to talk about depression as talking about how you broke your arm, but it's not. And no one wants to be stigmatized, or be afraid of secret HR information passed around about you being crazy and unhireable.

Fortunately, you are a hacker, and think differently than the average guy. Maybe you could benefit from one of the things that helps me: split your mind in two... metaphorically. "This situation doesn't call for the amount of rage I feel," is something I say to myself a lot when I should feel disapproval over something, but instead am completely incensed. If I can see intellectually that what I'm feeling is out of scale, then I have something to hold onto while my emotions run their course.

Another thing that helps pragmatically, rather than emotionally, is shutting my damned mouth when I see that I'm feeling "off". The things I want to say are hurtful, and will close doors, burn bridges, and make enemies of just about everyone I know, including my wife and children. So I think it, but I don't say it. And I try to do something as a ballast on top of being quiet, like holding my wife's hand, or if I'm not at home, just getting up and walking around. "Um, yeah, I need to go clear my head, and see if that helps with problem X when I get back."

Anyway, good luck. If the meds don't help, tell your doctor. Or find a new one. Don't pussyfoot around with doctors when your brain is at stake. "I need something that works, either you can find it for me, or I can find someone else to try. Let's go, chop chop!!"

Take care, man, and know that there are other people suffering similarly, struggling to make it. We are all your brothers, and want nothing more than for you to beat this (or manage it, at least) and have a successful life.

I'd second the 'if the meds aren't working, try new ones' advice. If all they've put you on is a cocktail of SSRIs, there are other options (MAOIs are effective, but a pain to deal with in terms of other medications, and are as a result less often proscribed) Also, if your depression has been periodically occurring for a long time and doesn't respond well to traditional medications, it might be worth looking at the symptoms of bipolar disorder to see if they fit. I know several people who were treated for unipolar depression for years before they were diagnosed with bipolar depression: and the medications and treatments are very different. Bipolar depression also is rather famous for not responding well to talk therapy. On the similar note of things that wouldn't respond to medication but are treatable in other ways: if you haven't been checked for hyper and hypo thyroidism, those can also cause depression-like symptoms that don't respond to traditional medication, and sleep disorders like apnea can make minor depression much worse.

Further I would say, if he isn't currently receiving both therapy AND psychiatric help, he should be going to both due to the likely reasons behind his depression.

Quick note though, the Samaritans definitely do not give advice. Mostly they help you work through your own feelings and figure out what to do on your own.

That sounds like the perfect description of a therapist to me.

P.S. Maybe this will be a good opportunity for You to quit taking meds You mentioned?

Suddenly quitting any/all meds for a physical condition without a doctor's advice is probably not the best idea.

I would recommend you speak to your therapist about Cognitive Behavioral Therapy. A paper published in the American Journal of Psychology last summer (I think it was July?) reported that after 3 months of Cognitive Behavioral Therapy a patient showed improvements that were equal to, if not better than anti-depressants. At the very least this could potentially get you off some of those meds.

I hope you feel better soon.

As many already said, OP needs professional help, from his/her therapist or his/her GP...

I simply recommended that he look into it.

Here's the framework I see; recent startup founder + therapy for seven years + abused as a child + ten pills per day.

This alone screams for professional help. I don't think that a fellow entrepreneur can help solve all of your problems. There's also the danger of making it worst because of not having any training on how to deal with your framework.

Now to be a little helpful:

What I don't see is a description of your circumstances beyond that:

    - How old are you?
    - Where do you live?  (city)
    - Do you live alone?
    - Do you work where you live or do you get up in the
      morning to go to another location?
    - Do you have family nearby?
    - Are they supportive in any way?
    - Do you have other friends outside of the startup?
    - What does your day look like?
    - Do you or have you had any hobbies?
    - Do you spend a lot of time playing games?
    - If you do.  Are you affected emotionally by the game's outcome?
    - What do you eat and when?
    - Are you overweight?
    - If so.  How do you feel about it?
    - Do you have a girfriend/boyfriend/wife/husband?
    - If so.  How is that relationship?
    - What's your financial situation?
    - What are your goals?
    - How quickly did you expect to achieve these goals?
    - What does your work environment look like?
      (dark, light, windows, comfortable, etc.)
    - What does your daily work routine look like?
    - Is there a routine?
    - What do you do in the weekends?
    - Who do you socialize with outside of work?
    - Do you drink?

From personal experience I can tell you that it helps to have what I have come to call "non-maskable interrupts". In my case this came in the form of my kids. It's pretty hard to focus on being miserable when your little one's push and pull you into their world. It's great.

If you don't have this option then you have to find another interrupt source. This means focusing your energy and thoughts on another activity not related to work.

Martial arts class can be great. A good class can dissolve away the stress of a days' worth of troubles within a short hour. On top of that you are getting exercise which by itself should make you feel better.

Gyms can suck. If you can find a friend who'd like to go to the gym with you this could be a good exercise + social option.

Swimming. If you don't know how to swim, join a group and learn. I don't know if you are in the US or not. In the US there's something called US Masters Swimming (usmg.org). They have groups everywhere. Sign-up and get in a pool. For me, there's nothing like swimming a 1500m or 3000m run. I come out of the pool like a newborn.

Get a dog. The therapeutic value of dogs is well proven. Also, puppies, just like kids, have a unique ability to shift your mind's focus away from you and onto them. Research the breed a little. If you are the type, get into training. I have always had German Shepherd Dogs and have always enjoyed training them (research: schutzhund). GSD's are not for everyone. A good pet dog like a Labrador could do wonders for you. There are professional organizations that deal in therapy dogs who can advise you based on your circumstances and needs.

Notice that every suggestion I've made involves disconnecting from work and strongly focusing your energy and attention elsewhere. Physical, outdoor and social activities being another common theme.

I couldn't possibly relate to your child abuse experience or the years of therapy and medicine. I am fortunate in that I have not had to experience any of this. That said, it sure sounds like you need to pivot and go talk to a different therapist. Your current on doesn't seem to be helping you much.

I am one of those people who will do the impossible NOT to introduce any drugs into my body unless there's absolutely no other option. I could not imagine taking ten pills a day just to be able to function. There has to be another way.

Not being a therapist I don't really know if talking to others about your problems will help you or push you deeper into a more dangerous state. That's why I am not inclined to offer to contact you via email. It is very easy to justify feeling worst and use someone else as a bouncing board for those feelings. I really think you need to find a new therapist to talk to immediately.

Then, of course, there's the tough love approach. Unless you suffer from a fundamental chemical imbalance your condition is one that is entirely fabricated by your brain. As such, you can --and should learn to-- control it. I did this with anxiety attacks. They can be nasty. Once you understand how to recognize and deal with the symptoms you can literally talk yourself out of one (or prevent entering it in the first place).

This is where I'll be cheesy and quote Yoda: "Your Focus Determines Your Reality". Print that and tape it where you can see it. What are you focusing on? What reality will that produce? Is that what you want? No? Then change your focus.

The techniques can be simple. If you recognize that you are sliding into a self-lamenting state, get up and go for a brisk walk. Turn up the music. Fucking yell "I am not doing this!". Dance. Do jumping jacks. Whatever it takes. Force your brain to re-focus on something positive.

I wish you the best. This is tough. Reaching out is good. Go get different help. Get a dog. Go swimming. Re-focus.

ABOVE ALL: YOU DEFINITELY NEED PROFESSIONAL HELP. YOUR CURRENT THERAPIST IS MISSING SOMETHING. PIVOT. GO TALK TO SOMEONE ELSE. GO TALK TO SEVERAL THERAPISTS AND FIND THE BEST ONE.

1. It's very possible that leaving his current therapist in order to "pivot" is a terrible idea. He should talk to his current therapist about his feelings that therapy isn't work, and consider talking to another professional, maybe one who takes a different approach, at the same time until he feels clarity about what to do. A lot of work gets done in 7 years of therapy. Sometimes there are low points, but it is a major step to throw that away.

2. It's incredibly obvious that telling him to try to have a child is an insanely bad idea. Getting a dog is less conspicuously destructive but is also a serious commitment and not something you're in a position to recommend.

3. Your "tough love" approach just sounds like being gratuitously hard on yourself. You can't bully yourself into becoming healthy. His condition isn't "fabricated" by his brain, and he cannot talk himself out of it. I know you didn't mean it in this spirit, but the ultimate effect of that line of thinking is putting responsibility for his problems on his own shoulders. No one chooses to have psychological issues, and they can't just opt out of them either.

4. The rest, doing jumping jacks, taping up yoda quotes, answering a mental health questionnaire in public, these things aren't likely damaging in any way, but they won't do anything to address the underlying problems or meaningfully change the situation in question.

Again, OP: if you feel that your current treatment isn't working, you need to address that by talking to your therapist about it and, if that doesn't help you feel more optimistic about the current regime, you need to talk to someone else at the same time about the current problems you're having. If you have to make a drastic change, like leaving your current therapist and presumably changing your meds, I'd think it would be a good idea to involve someone you trust who can help give you perspective from outside of the therapeutic context.

And, obviously, if you get to anywhere near self-harm, make sure to get emergency care right away, even if it seems like an over-reaction.

It is my experience that if things aren't working with a current therapist--whether this is the case needs to be seen, but after 7 years with the same therapist, he's on 10 pills/day, he experiences a serious relapse and feels he has to call on HN for help, is not a good sign. After 7 years there should be some more professional safety-nets installed.

Anyway, if it's not working well, get a new therapist. From personal experience, sticking with the same one for too long while you know it's not going further has done nothing but slow progress. The reasoning is, a therapist is also a creature of habit and they're not going to change their general approach much, even if you discuss the matter with them. And I don't mean trying out different meds or therapy, but the sort of general approach they use in their profession. And there's nothing wrong with that, even the really good ones do it, and even with them I still got stuck after some time, simply because their bag of tricks (as good as it may be) ran out and we tried all the things. And that's nobody's fault because therapy isn't a hard science or engineering problem, so it's very possible that even the "best" one runs out of ideas while another may have some approach that fits you right now (which is another factor: a patient changes as a person, the therapist that was right when you were at point X in your life may not be the one you need right now).

Disclaimer: this may be bad advice because of reasons of US Healthcare that I know nothing about. So, Think For Yourself. But also don't go waiting for a therapist to fix things if it doesn't seem like they're doing that. Which I need to repeat, is not (necessarily) a failure of the therapist, but sometimes a new pair of eyes can get you moving again, if the old pair got stuck.

With regards to seeing a new therapist. If this were my own son I'd take him to two or three. Just like there are lousy engineers there are lousy doctors. You never know.

To use a programming related metaphor, it's a bit like rubber ducking (http://c2.com/cgi/wiki?RubberDucking), where a deep and difficult abstract problem can suddenly cease to be such during the mere process of explaining it to a stranger. Suddenly the faults in your own reasoning become obvious, and the very act of sharing what's troubling you makes it more concrete and approachable.

A psychiatrist (in NL) first goes through regular medical school (5 years) and then another 4 years of study + on the job study for psychiatrist. (maybe there's one year overlap because I seem to remember it's 8 years total)

While maybe an intelligent person can figure out a lot of things for themselves--even if we ignore the fact that it's harder to figure out without a bit of distance--surely somebody (also intelligent) who's studied for ~8 years in this very field, will be better at spotting and making such assessment than a very intelligent person that trained their intellect in some other field.

If I had a big and important carpenting job, I'd hire a skilled and trained carpenter as well, even if I could probably do and/or figure out most of it myself. Over some level of complexity, I wouldn't even try, I'd hire a carpenter. Add to that, "figuring it out for yourself" becomes much harder if the subject is "yourself" instead of "my house/furniture".

From what I understand, psychiatrists in the US are a bit more like psychologists here. But with 4-5 years of study and who knows how many years of experience, they're still pretty good at it.

One thing though, a very important red flag (IMO), if after a while with a therapist you really get the idea "I could do this better, this person doesn't really get me", then get a new one. Therapists come in many shapes and sizes, and often it's important that you get one that can at least match your intellect to some extent, or it may become hard to trust them (if you can't help but second-guessing them). There will be therapists that can deal with this, talk about particular skeptic feelings and explain it in a way that is acceptable to you. But if they keep setting off all those alarm bells, you're not seeing one of those.

I'm sure they work for some people, but there are so many bad and underqualified ones who basically just sit there and listen to you without offering much in the way of insights (but sometimes offering up insults, in my experience). I think a bad therapist can be really damaging, which is unfortunate. People in these sorts of situations don't really need any more things going against them.

edit: I'm in the US, so that's where I'm coming from. When I reread this I realized you're referencing a system outside of the US.

As for this:

> Surely an intelligent person can see what their questions are getting at and influence the therapist's inferences accordingly, in the same way as you can when taking those silly multiple choice psychological assessments?

If you're seriously seeking help, why would you bother doing this? You're going to a therapist because you've got problems you think might be helped by talking them through with someone. If you're just interested in proving how clever you are or showing the superiority of "training in rigorous disciplines", there's cheaper ways to do it that don't waste other people's time.

I would put it this way: apart from really impressive experience and knowing very well what goes on in people's minds (of course in a different way than the neurologists do), my mother has never paid for a speeding ticket, because she knows how to talk to a policeman to avoid the fine, discovering all his weaknesses, fears, frustrations in 5 seconds - honestly, I'm not exaggerating! She get's paid for two hours of work what many people earn by working the entire month.

She usually deals with CEOs and other top-management guys who, for instance, are extremelly good and efficient in what they do, but their subordinates cannot stand the pressure the boss is creating, or to put it straight - the managers are practically monsters. And so she comes in and turns a Steve Jobs into a Wozniak, if you know what I mean.

Think for a second of a police negotiator who persuades a terrorist not to blow himself up, or a suicidal person not to jump out of the window.

I know I have used the examples remotely related with therapy, but I wanted to give you a broader picture of what this artful science (yes!) is coupable of.

There are of course certain limits to what can be achieved and an experienced psychologist is able to define if a person needs to consult a psychiatrist to get medication, or if recovery is at all possible - the goal of the therapy can be differently defined, sometimes it is just to make the patient "stable", but healing is not possible.

To give you an example, while meeting my mother at the mental institution where she worked, I once stumbled upon the head of the drug addictions department whom I asked what is their "success rate" in therapy. She asked me: "What do you mean?" - "How sure you can be that a person is not going back to the addition", I replied.

"We are sure that almost all our patients sooner or later would return to drug abuse". I was shocked, but this is the realistic, frank approach.

To sum it up let me just mention that when my dear mother was doing PhD she had a very distinguished supervisor, one of the best specialists in the country, for many years the chairman of the National Psychologists Association (not in US/UK obviously), and one of his most important books was titled something like "The therapeutic aspects of therapy", and his conclusion was "talking to people change them, but it is yet to be discovered how and why".

Seconded. There are also hotlines that you can call any time of the day or night if you are desperate. SEEK HELP. New help if the old isn't working.

Add me anytime you like, we can chat and hang around. I am a decent listener, I love helping people out and I am great motivator. I do browse Reddit & help out whenever I can but since this is HN I will make an exception just for you.

So, cheer up, life isn't over it's never to late to start again.

EDIT: anything we talk will be considered confidential. So, you're in safe hands.

What you can do too is to write down the reason you feel good when you feel good. Often, being depressed, lead to question everything's worth. When you get to a good conclusion, write it down and read it later when you start wondering again about the same thing. This is another way to create your own points of references.

And yes, it is not easy to get through it, but you can do it. Even though, the day you'll get out of it you won't even notice it. Really, it's like being in the fog, sooner or later, sun rises above and peak through.

Last but not least, you're doing the right thing : you need to TALK about it. Not to everyone, you need some people not to be aware, just to be able to feel normal with them, but still, talking about it is solving half of the problem.

BTW : IMO Meds are the worst thing possible when depressed. I'm no doctor, ofc, but my meds drove me deeper than I was. They destroyed my perceptions and my points of reference.

- Are you getting enough sunlight? - Are you exercising? - Do you live in an extremely stressful environment / city? - Do you live near greenery and vegetation or a cold concrete jungle? - When was the last time you took a vacation? - If you're an introvert do you have enough time alone to yourself? If you're an extrovert do you spend enough time with others or are you isolated?

You'd be amazed at how external solutions can help motivate internal ones.

For sustainable development of mindfulness I'd also recommend regularly journaling about your feelings though you should discuss it with your therapist first. If you decide to try, there's a good iPhone app called iMoodJournal. You can think you talk to me when you use it because I really put a piece of my soul into it. ;-)

I feel for you. I've been battling depression every single day for the last 14 years. And most people don't realize this when they see me as the happiness guy in the room. But the analytical-startup-side of me has kept a log of every day, of what works and what doesn't work to change my behavior and mood. Here's what I've found and I hope this helps:

When I'm happy:

- It's when I've written up some code, and feel accomplished

- I've had realistic expectations (of when I finish a project, what I expect from social gatherings, etc)

- I'm not so stressed (and this comes from sleeping on time, doing things in moderation)

When I'm close to being suicidal:

- I have high stress levels

- My plans are not working out as expected (read unrealistic expectations)

- There has been no balance of work/play (say I oversleep, read HN all day and feel unaccomplished)

What to take away from this:

It comes down to stress and expectations. Sleeping early (even though I'm a night owl, and produce great code at night) makes a difference. When you live in the suburbs and no one's there to talk to at night, it really does suck, when the whole town sleeps at 6am. I've gone through several therapists, but the analytical side of me wants to figure out this challenge for myself. It sucks, I know. But maybe for now, write down all that you're thinking, watch a movie, play some video games, and take time to yourself, to enjoy, to be happy. And set your phone's wallpaper to "Life is good. Be happy." (I emailed you the wallpaper). It's just one of those life hacks when you wake up, when you retreat from the world, and decline to answer someone's phone-call, you see your wallpaper, and it rewires your brain into associating certain actions with a positive mood. Know that the change won't come overnight, and know that your actions affect everyone around you. I started looking outward and praying for others, when that put less focus on me, less stress on my startup, and less stress on relationships. Sorry for the rambling. Remember the power to bring change to the world is in any one person's hands - it could be yours - you can see it as a burden or an opportunity - take care of yourself and be easy.

If the only thing you take away from this is the above paragraph, good, because I have to preface the rest of this with IANA[P|MD].

First and foremost, founding your own startup is awesome! Do you realize what kind of accomplishment that is? You shouldn't be depressed, you should be proud. Not many people can claim the title of "statup founder".

Second, apart from getting a new therapist, you might want to look into books like "Feeling Good" by David Burns and "A New Guide to Rational Living" by Albert Ellis. Both are aimed at helping overcome depression.

Exercise is good, but the effects may taper off over time (or have no effect at all). Mainly, if you're not exercising, you should, but not necessarily to treat the depression (although it might help).

All that being said, good on you for reaching out! While I don't think I have the skills to help you or experiences to relate, I hope you are successful, and I'm sure you will be. Many people have been depressed (myself included), but recovered; you can do it too.

MoodGYM: https://moodgym.anu.edu.au/welcome E-couch: https://ecouch.anu.edu.au/welcome

I disturbingly had a less than great experience with Lifeline the one time I needed some help. Specifically the operator told me she didn't understand my issues or why I was calling. The fact that I had expectations of being able to access an understanding counsellor and had saved them as a last point-of-call when other options were exhausted made this particularly unhelpful. Thought I'd post this as potentially my own expectations made this situation worse (and if I'd read this or other online accounts I might have had lower expectations).

Still, I got through that so maybe it was the right thing to tell me.

I'm glad to read things got better :-)

I've battled depression since my mid teens, going on this long crusade to be "successful" (whatever that means), trying to meet girls, working odd jobs that weren't in line with my degree, sort of living an antiauthoritarian hacker lifestyle that might sound familiar.

Anyway, one thing I've learned that's helped me largely overcome it is that things change. The world is a lot bigger than you are. My depression was largely caused by isolation, spending too much time in my own mind, trying to fix big problems that nobody else could see. Most of my days were filled with this ongoing saga of trying to solve programming problems or money problems or political problems, but the common theme is that I always failed to really "solve" anything, and felt like my life was a kind of revolving door, every day was the same, rinse, repeat.

So the last two years I was unemployed, maybe earning $6,000 a year and making up the rest by borrowing or selling things on eBay, all the time living under about $40,000 worth of debt and student loans. I had a falling out with my business partner after making a somewhat notable Mac game.

Then all at once two months ago, a good friend I grew up with got me a contracting job earning six figures, depending on how long the contract lasts. I'm not making this up. I hesitate to say I love my job, that's an awfully strong word, but it's certainly not terrible. I have that sense that I should have tried it a decade ago.

I've done all kind of things, I worked out for years and got ripped, I womanized, I snowboarded, I traveled, I visited my father in the third world and fixed some family bonds, I bought a house with my girlfriend, I bought the truck I always wanted from Back to the Future, and got a puppy. This was in the years before I started my job, when I was depressed. In fact, in some ways I think I was more effective when I had nothing going for me.

Now by bank account has more than $100 in it for the first time in years, I'm still relatively young, I have my health. But I know in my heart that I didn't really do any of this. Life is a dream. I'm still the same old fraud I always was, bumbling along like all the other morons. What I'm trying to say is that even though the universe reconfigured itself around me for some reason, I'm still not really sure why, I'm still haunted by the same existential questions that have always bothered me. Even if I had a million dollars, I would still be unable to achieve the things I really want to see in this life like meeting aliens or curing death or talking to a sentient computer, that are unlikely to happen anytime soon. There is always another reason to feel gypped. And it's not like I ever had a need for money anyway other than to get people to leave me alone.

Basically the cultural framework we've all built around us, concepts like money and achievement, being in the zone, selflessness, love, are all a distraction. There's just you, interacting with this strange reality that is both insubstantial and more clever than you could ever conceive of. The universe doesn't care that you're depressed. It keeps trying things to test you and taunt you and nobody knows why.

I guess what I'm trying to get at is that there's no magic bullet like pills or diet or exercise that will make you feel not depressed. I think of depression as misdirected free will, and only because you feel bad because of it, there's nothing inherently wrong with it in and of itself, and I think most people have felt it even if they're in denial about it. If you think of the things that make you feel bad, and what it would be like to let them go, ask yourself why you don't do it.

For example, if bills have got you down, have you tried not paying them yet. If work is bumming you out, have you tried quitting. If you don't feel loved in your relationship, have you taken a break. I tried checking out of my responsibilities several times over the last decade, and although it didn't fix my depression, it gave me some breathing room to meditate on why I was still unhappy. It's kind of nice to feel that people needed you and were relying on you, and I didn't feel all that bad that I let them down. At least not as bad as I expected to.

I assume that anyone reading Hacker News is a highly effective person, so if you find that you are unable to perform at the level that you know you can, then something is wrong, and it could very well be something outside of yourself. Sometimes the universe needs signals that you are unhappy so that it can recalibrate its approach and give you something more to your liking.

I've sort of begun to take a philosophical view of all of this, that somehow our collective consciousness forms the reality around us, and that we have a responsibility to be true to ourselves so that we can contribute something beyond our basic survival to the soup. You could literally fail today, completely and utterly, and wake up tomorrow with an opportunity you couldn't have possibly foreseen. Then the real kicker is that when you look around at the seemingly improbable configuration of the world, it seems that this is actually the general nature of things. I look at it as, the only real responsibility any of us has is to keep living, and by just doing that, it gives the universe a stage to play on.

I take it a step further, that when it's my time to expire, that I'll be reincarnated before I can blink in another arrangement of atoms somehow sentient enough to comprehend its own existence. But I don't want to get into religion. I'm just saying that to think that we can somehow end our consciousness may very well be a fallacy. We may have spent a million generations as amoebas and sea cucumbers to reach this level of sophistication, and there are no guarantees that the next life will be any more fulfilling than this one. We have billions of years of evolution at our fingertips and we don't even realize the power it gives us. We sit around feeling sorry for ourselves like a Greek tragedy and fool ourselves into thinking that this is all there is. It's really quite extraordinary.

So I hope that all of you keep living and doing what you do so I have something to do while I'm trapped is this crazy reality too.

P.S. Almost deleted this just now. Then decided to leave it. Serendipity and all that.

Beautiful, raw words. You have touched something bigger than yourself, that could swallow you whole but doesn't. You have perhaps touched the face of God.

It's in audio book format too.

http://www.amazon.com/Power-Now-Guide-Spiritual-Enlightenmen...

Second, what meds are you on and what kind of doctor prescribed them. If they were not prescribed by a board certified psychiatrist who specializes in psychopharmacology then I would see another doctor. It is not at all unusual for severe depression to require multiple meds but you have to have a doc who is good put the right cocktail together.

Three, I would recommend a psychiatrist for therapy as well. Social workers and psychologists can be good but there are also a lot of really bad ones out there. If you are thinking of changing therapists, meet with a few and go with one that has good credentials that you feel a connection with.

Four, as a survivor of abuse there are a number of support groups out there which might be helpful.

Five, and probably most important: Don't give up!!!! Depression sucks but it does tend to be self limiting.

There's one thing to try:

Find somewhere close to nature (a lake, a park, a beach, a garden) and sit there everyday in silence and just use your senses (the eyes, ears etc.) to experience what you are in the midst of.

Don't think. Try to stop thinking. Just feel.

I go to the beach every day to see the sun set. Some days to see the sea as the sun rises. Over months now, the effect has been unusual.

Remember to just feel. You'll find a million thoughts (problems, memories, people etc.) trying to barge in. Try to push them out. You may yourself thinking that there could be better or more useful ways to spend your time. You may feel restless. Don't force it, but allow these to pass and just feel. See, listen, touch, here...avoid tasting however. It's risky.

Don't stop anything else you're doing without professional advice.

Add this, and if you manage to make it a daily commitment, you may experience what I have.

I look forward to a difference.

Take care!

Another nice thing hat I've started to do is collect things that make me happy. When I get down I look in the box.

Like others have said, try a new therapist.

1. Heard this from a Vietnamese Buddhist Monk on depression that made a lot of sense to me: "Nothing can grow without food - stop feeding your depression and start feeding something that you want for yourself - health, wellness, happiness"

2. Another good advise I heard from a noble guy on depression - get out of yourself and try to do something good for someone else. you will see something shift inside you and you will feel better. Service is something that can instantly get you out of your depression

3. Try to find a community where you can visit and interact with people. Human contact and personal interaction (not online) can make a lot of difference

Hope this helps and good luck SKR

I think that you actually may have made progress in therapy because of the mere fact that you stuck with it for 7 years. You may be further on your journey than you realize. I wish you the best of luck.

I would encourage you to seek out nondrug alternatives and gradually reduce the number/amounts of meds. My personal firsthand experience with therapy is that it can be useful for insight but won't likely cure what ails you. You need people in your life who genuinely care about you. You cannot pay someone to genuinely care. That may be why therapy isn't helping: You weren't loved/cared about as a kid and your therapist is unlikely to care enough to take that pain away. There is only so much progress you can make based on intellectual insight.

Best of luck, whatever you decide.

Reading some of the comments in this thread there seems to be several people that have illustrated "startup induced depression".

I think pursuing your dreams ("and not living someone elses life") is great but people should be aware of the downside especially if (as this poster is) they don't have the resilience to deal with the ups and downs of what really amounts to a gamble. Something encouraged by others (and you know who you are) that don't have to suffer the agony of defeat.

Reference: http://www.sciencedirect.com/science/article/pii/S0167876012...

Please ask your GP to refer to you an endocrinologist. This level of elevated blood pressure is directly harmful in the long term; and while I am not a medical doctor, I'm aware of potentially life-threatening endocrine conditions which can both (a) cause elevated blood pressure and (b) make you feel like crap when your blood pressure is not so high. Even if you're not worried about the long-term organ damage you'll suffer, I hope you'll take the risk of imminent collapse seriously.

  This is what gets me through. Heavy weights in the gym clears the mind. Sports gives the adrenaline rush.

I didn't read beyond a few of the responses.

Whether this is a legitimate cry for help or just someone who needs an emotional pick me up to get through how hard startup life can be don't hesitate to contact me

-Kyle

It is not always easy, but it is always the best way to move forward. Depression is a dangerous cycle. Therapy can be helpful, but it can also be debilitating by causing you to identify with your depression. The best thing a therapist can do is to push you to follow the advise above.

Depression is not one illness with one cause and one method of treatment.

Our knowledge of mental illness is pretty poor.

Since depression can be a fatal illness (and even when not fatal it can be debilitating and lead to awful life outcomes) we need to be careful when offering advice.

> The best medicine for depression is to imagine you were not depressed, think of what you would do, then do it. Even if it doesn't feel quite right, keep moving.

I say this as politely and gently as I can: this is terrible advice for many people. I'm not suggesting that people with depression should be cocooned and protected from everything; that's often harmful. But we need to remember that many people with depression have distorted thinking, and thus asking them to focus on what they would be like if they didn't have depression could cause them very great harm.

> Therapy can be helpful, but it can also be debilitating by causing you to identify with your depression.

I agree that some therapies are terrible. Non-specific counselling is usually awful and does nothing to help, and can make things worse. But some therapy really does work for some people, effectively curing them or giving them techniques to deal with the illness when it strikes.

Notably, Cognitive Behaviour Therapy has good evidence for its effectiveness.

We're still muddling along with pharmacology - there are a raft of different SSRIs / SNRIs / NASAs / etc, and then tricyclics, and then MAOIs. There's some evidence of effectiveness, many people report remarkable changes. But still, we don't know how these meds work, and we don't know how to find better meds.

And some people will not find relief even with good therapy provided by skilled therapists, or with medication, and so they might try one of the more extreme treatments. ECT is still used. It's very different now from the portrayals in popular media (One Flew Over The Cuckoo's Nest is set in 1963) - people are sedated and it's used much less often. I've met a few people who've had it. Some of them loved it and welcomed it, and were keen for the treatment to continue. Others didn't like it, and opted out of further treatments.

If you have depression, and you find something that works for you, that's great. And it's great that you share that information with other people. But please put disclaimers on it. "This is something I tried. I think it worked for me." And please don't make declarations of efficacy unless you have decent research to back it up.

After all, in the workplace, you are expected to show leadership, strong will and the power to go through anything. Especially in the ultra competitive world of startups.

So I can understand the OP MO here.

PS : OPMO is a funny word.

PS : and for different reasons, family is sometimes a big no no as well.

it wont give you a solution today, but if you do the course, you will gain access to significant support tools that you can access on an ongoing basis

personally I would say RC saved my life, albeit i don't do RC anymore and i now do ICC if you want to look at some texts have a look here http://www.co-cornucopia.org.uk/coco/literature.htm but there are plenty of other resources available

best wishes kate

Depression is hard and it hurts. You can actually rewire your neural pathways. Therapists can help with this. It gets better.

I am in a bad depression myself even though I am making good money from my startup but due to other personal reasons. I am planning to go to Bali for a month.

May the Lord bless you and keep you, and give you peace.

Working out, helpful, changing diet... sometimes helpful.

As for having people visit, I would say this would be helpful but would be dependent upon the situations for your depression.

I wish you to find good listeners, this is rare.

I am speaking to the abuse piece because very few people have talked about that (perhaps even more of a taboo subject than depression). Lots of great advice here (mixed in with a few who don't get the difficulty you face). My best advice is (1) never give up - if you keep trying different things, eventually you will find the right combination of things that work for you. (2) don't blame yourself for where you are at - horrible people / situations completely beyond your control brought you to this point in your life. And good news, you are an adult now, and there are actually helpful caring loving people who can help you heal. It is really good news that you survived and found a way to be successful against all odds. You are stronger than you think you are. You can make decisions now to help yourself even though as a child you could not. There is hope for change because you have lots of resources (including many offered here and within yourself) to change your circumstances. I know you are on a long hard road - just as I am. But, healing is possible for you.

I have quite an extensive list of things I've tried and am a really good listener so I'll send you an email in case you want to talk.

Two things to mention: find another therapist who perhaps does another kind of therapy all together (instead of CBT - which is probably what you are doing), try insight oriented, DBT, brainspotting (my favorite - similar to EMDR), meditation, body work, trauma exposure therapy). Be bold and ask your therapist for a change and a recommendation. Most professionals understand that they can't help anyone and can point you in the right direction for a different approach.

Secondly, keep reaching out even when it seems impossibly hard because of the depression. Isolation is your enemy. Find people who will understand and support you. Seriously consider a support group in your area. Meeting face to face confidentially with other people suffering like you can be the most uplifting experience (way more heart warming than talking to a therapist).

Everyone is different just keep trying different things until you find what works for you. No one should be telling you that this one thing is guaranteed to solve your problems - you get to tell yourself what helps and what doesn't.

Please don't. Are you trying to kill the OP or to help him?

When at the 'homeless shelter' (or any other such a place, like an institution for drug addicts, elderly people or animal shelter) healthy person tends to eventually appreciate the fact that she's much better off and to see hope in the fact that those people (or animals) thrive despite all the tragedies they were through. It's a good advice for people frustrated because they didn't get their promotion just yet.

People in depression in same circumstances can only get worse. The fear of becoming homeless, or an addict, or maltreated animal - however stupid this sounds - will dominate their minds and will worsen their condition almost universally. Worsening depression could be lethal, hence my question at the beginning.

In short: whatever you do, as a depressed person, do not surround yourself with pain and suffering and hopelessness. You've got enough of this inside you.

Maybe because it hurts like hell? Just guessing...