the invulnerability that accompanied the detachment was exhilarating

This is very familiar. If only it wasn't completely incompatible with being motivated to do anything it'd make getting shit done so much easier, just not giving a shit about what anybody thinks or even the outcome of one's efforts.

The opening bit about the death of make believe resonates with me. This could've gone on the other thread, but in high school I excitedly told a math teacher about a derivation I had found of some proof only to have him respond, "Why bother?". It wasn't causal, but several years later when doing math and physics problems, previously my one remaining source of academic excitement, had turned into a joyless slog, those words echoed through my mind.

Also, it's problematic that one can't just live passively without everything getting quickly worse.

For other people, this sort of writing is probably useful because it lets them know that they are not alone in their experience. For me, it's useful because it helps me understand what my problems aren't. Whatever my issues are with happiness, I'm not clinically depressed, or anything like it.

It's also useful because it helps me be less of an asshole around people who actually are depressed.

Harrowing and very funny. From the first part: "I had spent my last feeling being disappointed that I couldn't rent Jumanji."

the internet is for comix.

4: I have the opposite reaction, which disturbs me. Overall I'm not unhappy, I do have feelings, and there are lots of things I enjoy. But subjective descriptions of depression, like this one, are very familiar sounding, including thinking about death as something that sounds like a valid alternative to whatever it is I'm not looking forward to about the next few days. It's difficult to talk about, as Brosh says, without scaring people much more than seems as if it makes sense to, and I've never been suicidal in the sense of planning to do anything about it. Still, reading things like this, and recognizing them as familiar, makes me wonder if there's a category of moderately cheerful, fairly functional depression that I fall into. I guess it doesn't matter all that much if there is, I get along fine without doing anything about it.

Allie has captured everything about depression perfectly. The opening bit about the death of make believe is perfect. Also perfect, the comparison of other people's reactions to depression to failing to help you deal with the problem of a dead fish.

Good to see she's doing better.

7. Don't think so, thinking about death is pretty far from doing something about it. Feeling that dying is an appealing option rather than just a possibility is different, that's trouble (i.e, strong impulses in circumstances where harm is easy, say while driving; also actually planning by choosing a place and method and starting to give stuff away or otherwise take practical steps), seek help in that case. Agree that it's a taboo and scares people who don't themselves have experience of serious depresson.

I also agree that the dead fish is a nice metaphor. Lastly, serious depression usually comes with either sleep disturbance or an inability to function even minimally at all (days when dressing and eating are difficult, say). I guess this is the unfogged good cheer corner?

I have a couple friends who I suspect are depressed in the way she writes about. Often, I suspect I'm falling into the "Have you tried feeding them?" category.

So what *should* you do if you have a friend who's depressed like in her post? Relevant section: 'You're maybe just looking for someone to say "sorry about how dead your fish are" or "wow, those are super dead. I still like you, though."' So assuming your friend would be confused if you started referencing dead fish, the real-world equivalent would be... what? I guess just continuing to hang out with them, and acknowledging that what they're (not) feeling sucks, but only if they bring it up first?

I concur with 7. Once when I was really upset/depressed- although according to the comic those are not the same- I told my partner I was wondering what it would be like to hurt myself, and I got lots of comforting and understanding in return. Then a while later there was a discussion about whether either of us had ever thought about that, and I brought up that incident, and partner freaked out and said that if I ever did indicate something like that it would be cause for immediate reporting/getting help which makes me think there was not actually clear understanding at the time of the first situation.

For me, the equivalent of calling a dead fish a dead fish is calling depression depression. Just acknowledge it for what it is. This is helpful to me as a depressed person, because naming an emotion can help you distance yourself from it. Having other people name it to means that we all have a decent sense of what is going on here.

"If I go to a doctor, will you stop making that sound?"

Yes too on the grave disappointment that not having feelings turns out to be disempowering.

Also, incidentally, for real don't read Never Let Me Go when you are suicidally depressed. Read, I don't know, thinly secularized metaphysical verse or something. Don't touch that book.

Well, when you are in the depths of it, you can't read shit.

While we're giving advice, don't drop acid with your girlfriend with whom you are in the process of breaking up and then go to the EPCOT center. At least not in the late eighties.

Other decades, it's totally cool.

7: Chronic low-grade depression is called dysthymia. Here's a link that seems like a fairly good description: http://www.selfgrowth.com/articles/Dysthymia_Chronic_Low-grade_Depression_What_Does_it_Feel_Like.html

It's treatable. Drugs can help.

11: Send them the links. Ask if it applies. People are often scared to mention depression or other mental illnesses, as if acknowledging a friend might have a problem is judging them, but that attitude just adds to the stigma. Depending on the friend, they might respond with a lie -- I often do, frankly, because it is just too much work to deal with people worrying about me -- but they might also find it incredibly helpful and a relief to be able to tell the truth for once. Sometimes it is.

Well, when you are in the depths of it, you can't read shit.

Fine, fine. If you believe that you are getting well enough to read...

16 might actually be right.

Allie has captured everything about depression perfectly.

Yep. She had me alternating between despair at how true it all sounded and relief at never having had suicidal ideation.

17too much work to deal with people worrying about me

This I relate to. It makes me feel guilty, which feeds the black dog. Fortunately I'm medicated to the gills and it appears to be working, so fingers crossed for now.

The incidence of serious depression is so high among people I care about that I sometimes forget it's considered a deviation from the norm.

Also, the length of time between Brosh's posts is a reminder of how slow the process is. A difficult aspect of talking to depressed people, or of being a talking depressed person, is that things can go on for months and months without any subjective change, and without any new descriptions becoming available, so that the hardest thing, no matter which side of the black mirror you're on, is simply not to lose patience. Brosh pulling together a rich account speaks much of her talent.

It's that need for accounts that has me pushing back slightly against "when you are in the depths of it, you can't read shit." In my last ebb I couldn't read anything except bits of Beckett, but they were hugely comforting; a little like reading Brosh except the jokes are quieter.

My experience hasn't been exactly like this, but close enough. Ugh.

Goodness, you all. Here, let's go look for your fish.

YOU JUST DON'T GET IT HEEBIE

Let's cook and eat your fish.

This article actually made me feel worse, because it's clear that despite feeling really bad about 60% of the time, I'm not actually depressed. No helpful wonder drugs for me, which is why I guess therapists haven't really recommended them. Just plenty of ability to feel emotion, plus a constant, crushing feeling of failure in all aspects of life (in some ways confirmed by reality, in other ways not) and frequent despair about things ever getting better.

21: In my last ebb I couldn't read anything except bits of Beckett, but they were hugely comforting

I've been reading that textastrophe blog and thinking that it's a good thing Diogenes, Jarry, Bunuel, Beckett and Emmett Grogan didn't have access to text messaging, or they never would've done anything else but fuck with people like this guy does.

crushing feeling of failure in all aspects of life (in some ways confirmed by reality, in other ways not)
Oh yeah, the whole impostor syndrome thing is also not helpful here. I had a supervisor send out highly positive praise after a presentation I gave to some bigwigs, ccing all the other high level people in our office, and my immediate thought was that he couldn't really be sincere, I didn't really do that good a job, etc.

This article actually made me feel worse, because it's clear that despite feeling really bad about 60% of the time, I'm not actually depressed.

Just because it doesn't manifest exactly like this, that doesn't mean it can't be depression. Feeling like shit more than half the time, crushing misery, despair, etc. can be depression too.

Yeah, don't worry GC2T, it sounds like your fish are dead, too. One of us! One of us!

Goodness, you all. Here, let's go look for your fish.

Having living fish is a choice.

Just because it doesn't manifest exactly like this, that doesn't mean it can't be depression. Feeling like shit more than half the time, crushing misery, despair, etc. can be depression too.

I'd like to echo this loudly. Brosch's is one kind of depression. There isn't one way that depression is. I sort of wonder, actually, whether there's a reciprocally causal relationship between the frequency of anhedonic presentations of depression and what seems to me like an increasingly common narrative that that's what depression "should be". But whether or not that's true, having something that looks and feels different than that doesn't mean that you're not depressed. I think whether or not it makes sense to put a clinical label on some form of distress depends on whether it helps you understand it and do something about it.

Who moved my cheese and turned it into a fish?

23: Here, let's go look for your fish.

I bought you a lazy susan to help you find your fish.

I sort of wonder, actually, whether there's a reciprocally causal relationship between the frequency of anhedonic presentations of depression and what seems to me like an increasingly common narrative that that's what depression "should be".

I had that exact thought as I was typing out how accurate I thought Brosh's observations were. Am I contributing to the idea that this is the "right" way to view depression.

I went ahead and affirmed the narrative anyway, because I found that having a narrative for depression--even one that doesn't quite fit my case--helps navigate it.

Let's cook and eat your fish 17 year old bugs.

Teach a man to conceptualize his depression with a fish metaphor, and he eats for a day, but doesn't really enjoy it.

I think of depression as analogous to weakness in the purely physical sphere. That is, lots of diseases, syndromes, environmental conditions, habits, lead to a feeling of being weak or exhausted. And being weak or exhausted (especially) can kill you independently of the underlying disease -- sleep deprivation alone can kill you. But it would be a mistake to say that every time some feels run down or exhausted that their disease is 'exhaustion' and prescribing caffeine and having done with it. Likewise, I don't think 'depression' generally is a single disease, or even necessarily a disease at all.

Topically, I forgot to call in a refill yesterday on my wonder pills and am now staring foggily out the window at the sick birch tree and waiting for the text from the pharmacy because the brain has been 36 hours without its dietary supplement and volition is draining out the plughole placebo or not, popping one each morning does at least make me think that I know where my fish are.

(To tie in metaphors, these days I know the fish are not at the pet store.)

Similar to cachexia. It can be a sign of many diseases but no one understands what really causes it or if there even is one common mechanism.

I got the ol' IV-TR off the shelf to read about dysthymia, because in my head it has come to mean "the kind of thing that's commonly referred to as depression but that isn't life-threatening or life-disrupting and you wouldn't medicate for it." Sarah Wynde suggests you do medicate for dysthymia which reminded me I'm so far from clinical work I just don't know.

DSM says it's depressed mood most of the day more days than not for at least two years, which is pretty serious business still.

Oh hey, I can throw out my DSM, as it is obsolete in like two weeks. I've had it since grad school. I feel like singing "vecchia zimarra." (That's for Oudemia and Jesus.)

Oh yeah, the whole impostor syndrome thing is also not helpful here.

I don't want to kibbitz about your dead fish here, but imposter syndrome rocks! Other people have to work hard and learn stuff and you know, like, earn things. I just get handed stuff. I mean, what's the downside here?

My boss today told me that some colleagues had effusively praised my work - a recurring theme with my boss lately. Unfortunately, he's starting to figure it out: "Frankly, this makes me concerned about the way things were being run before you took over."

Busted! Damn.

41.last: I love that aria because 1. What's not to love? 2. Basso and 3. Colline! The philosopher!

This was timely. I'm not depressed but still struggling living with someone who really is, although I think he's still declining to label it as such. I have no fucking idea what to do. I find the lack of any attempt to 'get better' murder-inducingly infuriating.

For anyone who remembers, he did start a new job in January, and seems - calmer? Less desperate - though still disengaged from family life.

The decision by NIMH to de-emphasize the DSM-5 plays into the conversation about different forms of depression. One has to suspect that NIMH is right to be suspicious of current efforts at categorization.

That said, I'm a bit skeptical about NIMH's reasoning, and I wonder if the effort to classify disorders by their causes will end up just justifying a bunch of speculative chemistry experiments conducted by pharmaceutical companies on the public.

Looks like the earliest citation Perseus has for dysthymia is the point in Sophocles' Electra where the chorus tells her it's all her own damn fault:

οὐ γνώμαν ἴσχεις ἐξ οἵων
τὰ παρόντ᾽ οἰκείας εἰς ἄτας
ἐμπίπτεις οὕτως αἰκῶς;
πολὺ γάρ τι κακῶν ὑπερεκτήσω,
σᾷ δυσθύμῳ τίκτουσ᾽ ἀεὶ
ψυχᾷ πολέμους.

Do you not see by what actions under the present circumstances you plunge so shamefully into self-made miseries? Thou hast greatly aggravated thy troubles, ever breeding wars with thy sullen soul.

45.2: Too late on that.

I wish there were a diagnosis and drug for the state of being pretty ok in one's life outside work, kinda bummed a lot but just on account of being a negative person, but then at the office having those depressive feelings of barely being able to do the simplest thing, of the impossibility of sending a fax.

Oh, no reason!

48: "Unfogged commenter syndrome."

Unfogged commenter syndrome, NOS

"Unfogged commenter syndrome."

And now the chance to lobby for the inclusion of UCS in the next edition of the DSM is gone...

But it would be a mistake to say that every time some feels run down or exhausted that their disease is 'exhaustion' and prescribing caffeine and having done with it.

I think I've mentioned this before, but I know someone who was susceptible to mild depression and hated SSRI's but has done very well on Adderall.(didn't tell the doc it was for that, just went in and faked ADD)

I've been curious about Adderall and whether it might help with my UCS-NOS. I guess it depends on whether it feels like taking a stimulant, since half the time caffeine makes me non-functionally anxious. (It's possible what I need is basically gin, but there are perhaps problems with this.)

of the impossibility of sending a fax.

Fax technology came and went without me ever figuring out how to work one of those damn machines. I'm hoping there will be more technologies that I just get to skip over entirely.

I've been curious about Adderall and whether it might help with my UCS-NOS. I guess it depends on whether it feels like taking a stimulant, since half the time caffeine makes me non-functionally anxious. (It's possible what I need is basically gin, but there are perhaps problems with this.)

I feel you! I have been wondering about the non-stimulant options. But I doubt I'd be able to convince anyone to give me anything anyway, because I accidentally managed to get a PhD and a tenure track job and stuff. BUT BELIEVE ME I AM INCREDIBLY LAZY AND INERTIAL OH GOD SERIOUSLY.

You know what was a good mix? ttaM's dysthymia mix.

41: I think pretty much anything and everything can get handed a pill these days. Whether they work is another question. But dysthymia is said to be responsive to general antidepressants.

45: I'm somewhat hopeful about the NIMH move. I currently dislike my diagnoses very much, as well as the reasoning behind them, so the idea that they're going to try to move away from all the little boxes to something a little less restrictive appeals to me a lot. And since we're currently conducting lots of chemistry experiments on the public, I don't think it'll make matters much worse. Lengthy personal experience and rant all deleted, because heavens, how boring, but IME even good doctors are perfectly happy to try throwing random chemicals at problems they define as mental illness these days, regardless of the risks.

I've been curious about Adderall and whether it might help with my UCS-NOS.

When I (briefly) tried Ritalin a long time ago, it just made my procrastination that much more focused and intense. Also made me very irritable when I was coming down off it.

But I doubt I'd be able to convince anyone to give me anything anyway, because I accidentally managed to get a PhD and a tenure track job and stuff. BUT BELIEVE ME I AM INCREDIBLY LAZY AND INERTIAL OH GOD SERIOUSLY.

I think academic attracts a fair number of ADD/UCS-type personalities, even though it requires way more self-directed focus than most other jobs, because of the seductive promise of total control over your time.

I've been curious about Adderall

See Kreayshawn. On your college campus.

54: I'll bet you anything that there are people in my old office who are still dialing "911" on the fax once a month or so.

Our photocopier is now the fax machine. It works very well because it can fax to or from email.

IME even good doctors are perfectly happy to try throwing random chemicals at problems they define as mental illness these days

This seems right to me. I've seen treatments of ADD that I regard as essentially abusive.

That said, I'm compelled to admit that my own efforts at self-medication have yielded decidedly mixed results.

||
My brain is okay! (The rest of me is still pretty messed up though).
|>

63: YAY!

Um, 64 to 63.1, before anyone says anything. Even when I was totally emotionally dead, I wasn't that emotionally dead.

I know what everyone means about UCS. (What's the "NOS" part short for?) Last week when T. and I were talking about Harry Potter for some reason, she asked me which house I'd be in. I answered something like, "Given my career choices, probably Hufflepuff."

54
Fax technology came and went without me ever figuring out how to work one of those damn machines. I'm hoping there will be more technologies that I just get to skip over entirely.

I'm OK with faxes, although I don't actually use them for much more advanced than occasionally sending, but there are several technologies I'm doing my best to skip. Twitter, for one thing.

NOS = Not Otherwise Specified, so the catchall version.

63: Glad to hear about your brain.

When I (briefly) tried Ritalin a long time ago, it just made my procrastination that much more focused and intense
This is why I'm afraid to try, really, any drug or mind altering medication. My brain works pretty well as is at getting things done despite some annoying tendencies. If I took something to alter it, might get better but who knows if it would do weird things. I've heard of people taking meth or Ritalin and getting obsessively productive, but I'm afraid I might instead end up with my own 2000 comment thread. Ambien fucked me up the one time I took it, it was like an out of body experience.
An acquaintance with a psychological makeup similar to mine recently shared that he had dropped out of college and done meth for a year and a half because it enhanced his predisposition to accomplishment and semi-OCD behavior. He said he also tried cocaine at the time and didn't really see the appeal.
I met the director of the NIMH earlier this week but did not discuss the DSM.

68 to 69, also. I guess.

he had dropped out of college and done meth for a year and a half because it enhanced his predisposition to accomplishment and semi-OCD behavior

Enhanced? As in he got more accomplished on meth?

Well, depends what you consider accomplished- not school work certainly, but took more pleasure in focusing on something he wanted to do, gaming for example. Hence my commenting example- there may be some value to the world of me going on a 12 hour Unfogged commenting binge, but few would consider it accomplishing something.

How are his teeth?

69.last: Please tell me you mentioned the rats.

The doctor who ordered the MRI is the worst communicator ever. None of the people at the lab (for bloodwork) or the MRI place could figure out what he wanted from what he wrote/checked off on things. Both places they had to call his office to try to figure it out.

Also he kept making me stand up while he held onto my hands to feel my pulse (or something) and then asked me questions. I can't answer you if you're holding my hands, dummy!

Well, depends what you consider accomplished- not school work certainly, but took more pleasure in focusing on something he wanted to do, gaming for example.

This is more-or-less the opposite of accomplished. I say this as someone who has spent countless hours not accomplishing things by gaming (and by commenting on Unfogged).

I think his teeth are fine- isn't there some doubt about whether meth actually causes problems with your teeth, vs. meth being done by poor people who don't usually have dental care vs. meth causing you to obsessively drink soda? I think route of administration also matters, smoking being the worst.

Yay for Messily's good brain. (Don't tell the zombies.)

For the person I know who did the Adderall thing it's pretty much been like magic. 0 side effects, getting more shit done, working out more regularly, weight loss, and the mild depression gone. Maybe not for everyone but a case that sounds very similar to people in this thread. Mild depression but not crippling. This person got two degrees, was doing fine in a career, etc.

meth causing you to obsessively drink soda?

That sugar thing is way real and I wouldn't doubt that it's a big part of the tooth issues. Very common for tweakers to be carrying around big bags of sugar candy like Skittles or Starburst. I arrested this twitchy methhead the other day for shoplifting and I'd cuffed him and emptied his pockets on this desk in the store security office. He had several loose Skittles in his pocket. I'd put his other belongings back in his pockets and as I'm getting ready to walk him out to the car he's all "Oh, hold on for a second" and bends down(still handcuffed) and quickly eats those skittles right off the desk. The store security guard had this kind of horrified look on her face.

I got some modafinil from an Indian pharmacy and took a half pill a day for a while. It worked great for the first week. Then it stopped working so well. I just take it every so often now. I really wish I could be as motivated and contentious as I was for that week. I was really hoping I found the cure for the unfogged syndrome.

I know one anecdatum just like 79. Pre-Adderall, the subject was episodically scattered and discouraged, never finished high school. Now he is about the most productive person I know; among other things, he claims the meds finally gave him sufficient concentration to understand mathematical concepts. He reports no side effects, but his self-administered dose is very small - a quarter pill a day.

Huh. I'd heard the vasocontriction theory, but I guess the jury is still out.

Whoops. Only, I thought the vasoconstriction caused the gums to recede directly.

I always feel a bit...conflicted? put-out? when Unfogged comes up as a bad habit that needs to be quit. Which isn't to say I don't get it; just that I'm small and petty.

Incidentally, I'm still on the fence about diggitycon but I can fly for $5 if I had a couple thousand more JetBlue points. Does anyone have any they don't plan to use that I could pay to transfer to me?

Actually, I can do the $5 flight if I go to BWI, which is what I did last Con and sat next to NtEW on the ride back.

BWI in to DC is pretty easy. Do it!

I'm kind of curious about Adderall. My ADD has been worse the past couple years, but I don't like doctors and I don't like caffeine or nicotine so that suggests I might not like Adderall either.

Glad to hear the good part about your brain. E. Messily.

85
I always feel a bit...conflicted? put-out? when Unfogged comes up as a bad habit that needs to be quit. Which isn't to say I don't get it; just that I'm small and petty.

Think of it as a compliment. Timesucks like this very rarely just happen; it must take a lot of work to curate them.

Oh yeah, the whole impostor syndrome thing is also not helpful here.

I have imposter syndrome, but also everything in my life seems to confirm my low self regard is just an accurate assessment. I make about what an entry-level person makes for my field, even though I'm fifteen years out of college. It makes me feel hopeless and angry in turns.

If I didn't have any skills past entry-level, I could understand it, but my abilities have always been praised as outstanding. In comparison with people who have similar jobs, I appear to excel. But no one has ever wanted to pay me appropriately.

So I've decided that despite the lavish praise, the strategic importance of my work, and the rarity of my skillset, I must actually be a terrible employee who doesn't deserve any better. It's better for me emotionally than to think that every boss I've ever had at every job in my life independently decided that I don't deserve the salary that anyone else would get because of something about me that makes me inherently less valuable than other people.

When I try to talk about this to people, they try to help me look for my fish. But I didn't even start out with fish. I had a crumpled tuna can, and even that is gone.

Oh Eleanor, I'm sorry.

Reading the piece again, I find it so hard to get my head round the idea that sometimes *nothing can be done*. I feel like C is moping about, waiting for a magic angel to appear and make him better, and I am so angry that he's not doing anything to help that process. Is there anything helpful I can do at all, dead fish people? Am I allowed to send him away whilst he waits for the healing corn kernel to appear?

91: This is probably unhelpful on the level of "Make your tuna can be live fish" but if I were going to make uninformed guesses on the basis of a couple of sentences (watch me!), I'd guess that you're not getting badly paid because your impostor syndrome is accurate and you're actually terrible at what you do, but that you're getting badly paid because you got stuck with a case of impostor syndrome that shows. It sounds as if employers are mistreating you not so much because you deserve it but because they've decided they can get away with it.

This is absolutely no help in changing the situation, of course (I'm feeling that way a bit myself -- that promotion I got last year that involved quite a bit more work and pressure? Still hasn't turned into any extra money. I've brought this up a couple of times and been told that there simply isn't any money for raises. Which, maybe? But I'd love to see a list of everyone who's gotten a raise in the last year and why -- I bet it's not no one.)

re: 93.last

Yeah, ditto a bit. I did get a pay rise but it was fairly small [switching from highest point of one grade to lowest of another]. That's fine, it's a start. But what's annoying is they hired in a few people in the past year for jobs that are objectively a lower grade than mine,* but offered them at the grade I'm on because of difficulties recruiting new staff.

Which is good for them, and it's understandable because they need to fill the posts but sucks for me, as there's no easy route for them to promote/regrade people already in post to reflect changes in recruiting. If they were advertising my job now, they'd def. advertise it at least a grade higher than I'm actually on.

* I'm management, of sorts, represent the institution at international events, line manage staff, run several biggish projects, sit on several decision/oversight committees within the institution, etc.

93

... But I'd love to see a list of everyone who's gotten a raise in the last year and why -- I bet it's not no one.)

So you don't have anything to do with your minions pay?

I'm a bit with asilon on this. There's something profoundly selfish/self-centred about the 'Make your tuna can be live fish!' thing.* It's a metaphor. It's not a statement of deep metaphysical fact. Maybe the fish can be resurrected, fuck knows. But we don't have to accept someone else's metaphor as if it's law.

* even though I've been (recently) in exactly the sort of situation asilon describes with C, so am in no position to be judgmental or point fingers

91. What LB says. Also, once you're being underpaid you get into a vicious circle where, if you try to change jobs to remedy the situation, the new company looks at your current salary and either decides that there must be something intangible about your performance which has held your salary down, so they don't offer you much of an increase, or decides you're a mug and does likewise.

The only way out of this I've ever seen work is to cut the Gordian knot and get confrontational about it. I've done this just once; it was so stressful and horrible I would have given up if there hadn't been someone else in the same position. Which is not helpful, but it does lead starkly to the conclusion that you need to prioritise working to overcome the imposter syndrome.

re: 97.last

Yeah, I've done it a couple of times. Once I did eventually get the raise, the other I buggered off as it was clearly not going to be forthcoming. It wasn't pleasant in either case.

95: No, I'm at the very bottom level of management. I have an effect, but not a decisive one, on annual reviews, which conceivably might affect salaries at some point but usually don't. The byzantine nature of how my office is managed is such that anyone who I can actually get in to see can plausibly say that specific decisions are out of their hands -- they're just passing memos up the pipeline.

94 - my sympathies, there's not a coherent recruitment policy in that entire university, as far as I can make out - C will rant about at it at the drop of a hat, given the amount of competent people he's seen get stalled whilst crappy external candidates are appointed over their heads. His plan is to one day be in a position to do something about it.

re: 99

Same here. The level of management directly above me [and the one above them] are aware that I'm due a raise [I'm not the only one, either] larger than the one I just had. They don't have any power to grant it,* except to create a new post ex nihilo, advertise it internally, and for me to apply for the post. However, there's an institution wide funding squeeze on, so they couldn't do that, even if they were absolutely determined to do so. It'd need to go to the very top of the institution, and possibly not even then.

The only possible route is if one of my bosses moves on, or if a big new funding stream turns up.

* they've already invoked the limited powers they have to get me regraded and it took nearly a year. So they've done what they ordinarily can.

re: 100

Yes. It seems to be relatively easy to get an AA for new posts [assuming funding exists] but bastard hard to regrade people in post, even when their duties have substantially changed.

92: Is there anything helpful I can do at all, dead fish people? Am I allowed to send him away whilst he waits for the healing corn kernel to appear?

Reframe your idea of what's happening. Imagine instead that your partner (?) has a medical condition. Diabetes, in fact. What would you be willing to do then?

If you see that he has all the symptoms of diabetes and refuses to go get checked out, what would you do? Would you insist? Would you say on a daily basis, "have you seen your doctor yet?" Would you make the appointment for him? Would you go with him? Then do that.

If he knows he has diabetes and refuses to acknowledge it, eats sugary foods, gains weight, won't do his blood tests, what would you do? Would you nag? Then nag. Would you let him be? Then let him be. Would the frustration lead you to dump him or set ultimatums? Then go for it.

Depression is a life-threatening illness -- more people die from it than do in auto accidents -- and yet mostly the attitude of people around those with depression is to wish they'd just get over it already. That's basically like wishing a person with diabetes would just stop having it. Nice thought, but it doesn't work that way. But you can encourage someone with diabetes (or depression) to manage their illness and support them in the choices that they need to make to be healthier. Sometimes that does come down to making the doctor's appointment, checking that they've taken their medication, being the support person that consults with the doctors, and so on. My closest friend was bi-polar I, and her husband knew her meds and cycles at least as well as she did, probably better. In her worst depressions, he was the one who managed... everything. If he had sent her away, well, I was going to say that she'd probably be dead, but she is anyway. She would have died sooner, though.

All that said, you should also bear in mind that we can't fix other people. If your loved one was diabetic, you couldn't force him to eat a healthy diet. And diabetes is (generally) easier to manage then depression. Your quality of life is important, too, and if your life is being significantly affected by trying to cope with someone else's ill health, at some point you may need to step back and take care of yourself first. But if you reframe the issue so that you're thinking of it as illness instead of a choice to be a pain-in-the-ass, you'll be taking a first step to at least deciding how involved you want to be.

This was useful, thanks - a fuzzier form has been floating about in my mind trying to communicate itself, and it was really good to read it written out so clearly.

tbh, the only thing that's keeping me going is that it is clearly an illness. If I thought he was just being a PITA on purpose, I'd have fucked off long ago.

94: I'm not sure to what extent academic salary strategy maps on to your position, but is there some way for you to take the usual approach of getting an outside offer and leveraging it into a raise?

(I was in a meeting this week that made it quite clear that as far as deans are concerned the only times professor salaries mater are recruitment and retention against other offers elsewhere.)

Business idea: Start a private university for the sole purpose of making offers to faculty from other schools. Make offers of $X over the current salary in exchange for .15*$X. The faculty member would have to bear the risk of being told to take the other offer as I'm not planning on getting any students.

Also, once you're being underpaid you get into a vicious circle where, if you try to change jobs to remedy the situation, the new company looks at your current salary

Is requiring disclosure of previous salary common over there? Here in the US employers will usually ask for it, but I've had success just telling them to get bent when they do.

Or just lie, they can't legally verify it.

I think they probably can.

I want to endorse 103 wholeheartedly. My ex's response to my depression was very much along the lines of "just stop being sick," which was bloody useless. If she'd instead pounded on the need for a therapist I probably would have gone eventually and we might still be together. Which is a mixed bag, I guess.

I've been saying, "please will you get some help" (with varying degrees of swearing and/or bringing the children into it) for 15 months. Hasn't worked so far.

re: 105

I don't think it would have much effect. If another job came up with a similar skill set and more money, I'd certainly consider taking it, but it wouldn't be able to produce flexibility in the system that doesn't exist. I guess in theory it could prompt the creation of a new post, but I doubt it in the current funding climate. I don't think there's any mechanism for staff retention. If people get better offers they largely leave, I suspect.

Asilon, that has got to be absolutely maddening. I would be beside myself.

Winston Churchill used to be depressed and his wife tried to get him worked-up about the Nazi Party. It worked great.

asilon, you have my sympathy. But to seek help is not always to find a solution.

Helen has been prima facie dysthymic for some time, though no one has officially put a name to it. It took a lot of persuasion to get her to a doctor, but she went eventually, and they threw a succession of random drugs at her, but none of them did any good. So now, as a result she's even more convinced that it's all her fault and there's no point trying to do anything about it.

I should emphasize that she's not as seriously ill as C sounds to be. She can function just fine at work and in social situations. The black dog descends when she's alone or just with me, which is hard, though it's harder for her.

111: One of the worst problems of depression is the total lack of motivation/ability to be motivated to do anything about it. As a dead fish person, I've promised more times than I care to reflect upon to get help/try drugs and it's just... so much work. More work than I can handle. It's the bitterest irony of depression that the lack of ability to deal with the problem is a symptom of the problem.

But if you've reached that stage, start researching shrinks. Find one that you think might be compatible with your partner. Check on the health insurance situation and make sure it will work for a period of at least six months. Or assess the financial situation and make sure you've got the resources to commit to monthly appointments and prescription drugs that are not usually cheap. (My doctor actually prescribed one that was going to cost $800/month once. Needless to say, I'm not taking it. Suicidal ideation is cheaper.) Then tell your partner that you're making the appointment and going with him. If he refuses, start looking for a couples counselor.

Think of it this way: if your partner was having a heart attack, would you tell him to call an ambulance or would you dial the number yourself?

(OTOH, I'm a stranger on the internet giving advice, so what do I know?)

115: Talk therapy is actually statistically as good as drugs, especially for those of us with idiosyncratic drug responses. If she sees her black clouds as a problem, and you can afford it, you might encourage her to try spending a year in therapy. Not a couple weeks of therapy, but a serious commitment to it. And not a random therapist -- check their methodology. ACT or CBT or mindfulness-based behavior therapy all have decent success rates. I think dialectical behavior therapy is also being tried out. This website is a handy tool to look at treatment protocols: http://www.psychologicaltreatments.org/

111: I wish I could offer more useful insight, and I feel like I ought to be able to, having been on the other side of that. One possibility that might work is setting up a couples counseling session, but that requires some get-up-and-go from your partner, which he may not be capable of at this stage. Maybe offer to do all the legwork of setting up a therapist's appointment and getting him there? Doing simple shit like setting up appointments was beyond me at my lowest point. Maybe you've already tried these things in which case reading this is probably just frustrating. Let's go find your fish.

Maybe worth a try is to show him the blog post from the OP and ask if that's how he's feeling. Part of the bad dynamic between me and the ex was my denial that anything was really wrong (or maybe it was indifferent obliviousness). Breaking through that might be the first step to getting things mitigated or fixed. Certainly it would have helped me to acknowledge the existence of a real and serious problem.

I send you internet sympathy and hopes that this passes.

I think in at least some instances, there really is nothing that can be done. Very few therapies have any track record of success. At this point, the weight of evidence is that medication is not better than a placebo. The only thing that seems to work is cognitive-behavioral therapy.

Maybe cognitive-behavioral therapy only looks like it works because you can't make a good placebo for it?

Sarah's 103 is great. In the past, I've resisted the disease framing of depression, precisely because it seemed to obscure the importance of agency in managing things--not in the "just get better" sense, but in the "take the steps that will make getting better more likely" way--and blaming myself for not doing the latter is very important to me. However, the (banned!) analogy to diabetes makes me realize that I was implicitly using a needlessly narrow conception of disease, thinking of the sort of thing one just took antibiotics for, or got an operation for, rather than as encompassing chronic conditions that have quite a large lifestyle and behavioral component, and require constant management (which of course are actually quite a large percentage of health-impairing conditions; doubtless just reflecting my young, mostly-healthy blinders). Yay for analogies.

Iberian Beauty has actually been a model of 103's recommendations lately (things have not been good--missed a day of work both of the last two weeks, etc.). I still haven't actually opened the cognitive-behavioral therapy workbook she gave me, but at least I'm carrying it around with me in my backpack, which is almost like reading it and doing the work therein.

I still haven't actually opened the cognitive-behavioral therapy workbook she gave me, but at least I'm carrying it around with me in my backpack, which is almost like reading it and doing the work therein.

That's pretty much what I used for my dissertation strategy, except that I have a messenger bag.

I really should get a new bag. It's from 1993. The business card pocket is filled with cards from a job I haven't had since 2005.

I think the only thing that ever drives me to get help is that I am very susceptible to concern about hurting or hindering others, and if they tell me straight out that I have to help myself for their benefit, I will. And the marvelous thing about depression is that treated depression is often still garbage if you're going through it, but the treatment somehow does alleviate the strain you put on other people, which can make you feel moderately better. If you believe that you'll never feel better, but can take on a self-effacing, altruistic orientation -- where you don't even have to do hard things like running a marathon for cancer, but just have to drag yourself to an irritating appointment or take unpleasant boner-killing medicine -- you can perversely end up helping yourself anyway because a) we're social creatures and b) fake it till you make it, etc.

The social component of mental illness, particularly mood disorders, doesn't really get discussed enough. It's semi-voluntary antisocial behavior and there's a lot of collateral damage. I don't say this because I'm morally opposed to individualism or, indeed, because the prior two sentences fit into my worldview at all -- they don't -- but because it's been my observation over the course of 2+ decades. I kept the altruistic front up until about a month ago, when suddenly, because of idiosyncratic triggers, I snapped and became completely selfish again, like a sixteen-year-old. While it wasn't exactly the shriveled-corn experience, I did realize how alienated I had been from myself for so long. Which is very dull to talk about, so thank goodness I'm not really sixteen anymore and no one cares.

trapnel: did you see the kittens? Can kittens play a role in CBT? I am still sorry that place didn't give you a better therapist; I guess there was only the one, years ago.

I seriously thought 91, about imposter syndrome and a crappy salary, was by T., until I realized she wouldn't be aware of the convention of going presidential. (And on a second read, some of the details aren't quite right, but anyways.) Stagnant pay for no good reason is a common problem these days. Blame the economy, or the politicians who aren't doing enough about it... or the voters.

I was on medication for depression for a while. In hindsight, my problems were probably more psychological than chemical, but there's overlap there anyway.

Which is very dull to talk about, so thank goodness I'm not really sixteen anymore and no one cares.

You could start a blog!

did you see the kittens?

I did see the kittens--very cute, thanks.

119: I think in many cases what people want is a cure for what is a chronic condition. If they're not cured, they decide the treatment doesn't work, when actually being a little better can be a meaningful quality of life improvement. Plenty of research provides track records for success for depression therapies, just not 100% success. 30-40% usually. But if you had a potentially fatal illness and the treatment had a 30% success rate, you'd probably try it and not just write it off for not being good enough. (Potentially fatal because suicide is, of course, the outcome for thousands of cases of depression every year.)

I am also partly in asilon's situation, though it's different and not so bad here. Still, it's so hard to deal with managing too much and also to deal be the one who doesn't or can't get support from within the relationship. I don't think my buying CBT workbooks would help and there's a counter-suggestion that I need to be the one to go to therapy, which might be accurate but isn't what I want and so hasn't been happening. I just hate being in this role, but stuff that needs to get done still needs to get done. I can delegate some of it, but not all that I'd want to.

127: I thought that "doing nothing" has a track record of success as good as most therapies -- CBT being the one exception.

Being in Asilon's/Thorn's situation sounds really awful. I suspect that an awareness of that probably weighs on the other person in such a situation, and that frank discussion of it ("your dead fish is stinking up the whole house, and I know it's worse for you, but it's bothering me, too") is probably better than just having it be something everyone's feeling but no one wants to talk about. But what do I know? My own way of addressing this problem is to repeatedly question IB's judgment in choosing to get involved with me, which I recognize is not useful.

Trapnel, you're golden. What's really terrific about Iberian beauties is that when we act in ways which might objectively seem asshole-ish or, or, incredibly annoying, they don't get upset at all. They don't take it personally. They just assume it's some American national characteristic.

I think the research is that therapy is effective, and it does not depend on the type of therapy so much as the relationship with the therapist. Probably drugs can be effective under the right circumstances too -- although there are real side effects and this road some people go down where they add more drugs on drugs to address side effects or loss of 'efficacy' seems actually quite dangerous.

My own feeling is that over the long term changes in attitudes, self-awareness, etc. can make a difference in depression, but usually these need to be coupled with changes in your real life -- your material circumstances, ranging from your job to your habits to your relationships/friendships. That is hard because depression means you often do not have energy to tackle real life changes. Personally I have seen huge mood differences based on changes in jobs and associated changes in ordinary daily routine. Part of the problem with depression approaches is that the problem itself is related to living too much in your head and then the therapies are all based on introspection too. (Not that introspection can't help).

79, 82: I fantasize about going on Adderall too and seeing miraculous results. I get a reasonable amount done in life but it's only a fraction of what I want to get done...if I could do everything that's in my head it would be incredible.

I think in at least some instances, there really is nothing that can be done. Very few therapies have any track record of success. At this point, the weight of evidence is that medication is not better than a placebo. The only thing that seems to work is cognitive-behavioral therapy.

Walt, these are a lot of confident assertions that are not reflected by confident uniformity in the research literature. What kind of reading or research backs all this up? I personally don't feel informed enough to have firm opinions, but there is definitely controversy about whether cognitive behavioral therapy actually outperforms other modalities. See, for instance, all of this guy's work. I honestly am not familiar with anyone making the even stronger case that CBT works; nothing else does. (And implicit in that is that many forms of therapy have some track record of success.) This is pretty important, because if it really is a cross-modality factor that helps -- i.e., something like "it's the relationship that heals" -- then it's not helpful to tell people who aren't seeing a strict CBT therapist that they're doing it wrong. I will say that it's prima facie implausible to me that CBT works, nothing else does, given the strong commonalities among techniques, and the amount of bleeding and blurring, in practice, in what clinicians do in a session.

Your claim about medication not working also strikes me as much too strong. Are you referring to the 2008 Kirsch et al. meta-analysis? That's not exactly what it found.

Only some people -- a minority, I think -- respond to medication or therapy. But on the other hand, if you haven't tried either of those things, it's a mistake to look at small effect sizes or not very different group means and think that's definitely what's going to happen for you. If only a subgroup of people are producing the effect above placebo in a given study, that means they're lumped in with non-responders who are diluting the effect, and the responders' outcomes may actually be a lot better than they would have been without intervention. There's a lot of reason to look at a group effect when, as a society, you're deciding what kind of treatment you want to pay for or promote. But once you've established the treatment as efficacious, it doesn't make sense to conclude that it will only provide the group mean's worth of benefit to any individual.

IMO: if you're depressed and therapy hasn't worked, try medication. And the reverse. And pick an intelligent, supportive therapist who works from a perspective you feel comfortable with and makes sense to you.

There was supposed to be an "and that's abysmal and, well, depressing" before "but on the other hand."

123 -- You can just take the old cards out; you don't have to get a new bag. Kids these days!

Well, the zipper is broken and the strap replaced by a much shittier snap. Also, I should get new business cards. I've now been at this job for just shy of seven years.

"much shittier strap." Replacing a strap with a snap wouldn't really work at all.

on a sample basis of one, I can speak with authority that medication definitely works.

116, 118 - I'd call an ambulance for a stranger in the street having a bloody heart attack; I wouldn't try to fix their lives. The trouble with the idea of me doing all this is that that suggestion enrages me. I am far too resentful at this point to do anything like that. And I can't imagine it going down well either.

I've just told him to read HAAH and let me know if he can relate to any of it.

You've definitely mentioned this as on-going for several years now. It sounds super shitty, asilon.

I think one thing that gets in the way of a depressed person saying "sure, I'll go to therapy" is the fear of what happens if therapy doesn't help.

It can be incredibly frustrating, though. Even right now I have an imaginary internet friend who is seriously depressed who posts a lot of things about how unhelpful everyone's responses are, to the point that I stopped saying anything. The sense from the outside is that you being told your actions are futile with the implicit request that you do something helpful, something that is unnamed.

139. Resentful can simmer for many years-- I have nothing productive to say, but sympathies on a tough situation. Sounds like a chance to choose between bad and worse.

139: Just spit-balling here, but maybe if you wanted to be really helpful and supportive without getting resentful, you could try doing bad things to him such that he doesn't know about them. Like putting a cat's ass on his sleeping face or some thing.

I'm not a licensed therapist or anything, but technically I think that you could call my idea a cognitive behavioral intervention without directly contradicting the term.

And pick an intelligent, supportive therapist who works from a perspective you feel comfortable with and makes sense to you.

And this is where it becomes an economic issue, among other things. I've given up on therapy lately because I do have people I trust for a referral, but good therapists in NYC very often don't take insurance.

It's a terrible situation--understandable, since insurance requires a lot of bullshit and pays far less than people charge here, but it means if you don't have $175/hr a week handy, how you look for a therapist is: go on your insurance provider's website, click on a few things, get some names you know nothing about, then google them and see if you can figure out anything about them. Or call a whole bunch of them and ask questions, which is actually a big hurdle in a number of ways, puts you in the position of saying to someone "I'm sorry, but I don't think you're what I'm looking for" and also is just tiring/time-consuming.

145: But depressed people have so much wherewithal for tasks like this!

Moby, thank you, that cheered me up.

I told him that people on the internet said I should just be in charge, and that he had to shave his beard tomorrow.

Glad to help, but I really can't judge the beard.

148: But I can! The beard has to go! peep has spoken!

You're going to have to post a photo of the beard and let us vote.

139: That goes back to 103, then, and "take care of yourself first." I mentioned my bi-polar friend -- quite honestly, I wouldn't have blamed her husband in the least if he'd given up on the situation almost anytime in the last twenty years. (I had to clarify that with the almost because he would have been a total shit if he'd given up on the relationship when she was dying -- at that point, there was an end date on the experience and he did kind of have to stick it out. That said, the way in which he stuck it out was pretty much saintly and more than I could ever have done.)

Having a partner with a serious chronic illness is a burden and if the illness means that you're not getting your needs met in the relationship, then it's natural to consider whether it's worth it to you. It might be. It might not be. I divorced my ex while he was depressed and I have no regrets. Sure, he was sick, but his rotten partner characteristics outweighed anything I got out of the relationship, and I'm not a saint. If you feel like getting your partner treatment for an illness is equivalent to being responsible for fixing his life, you might also be at the point where the resentment outweighs the love. In which case, "sending him away" probably won't help him find his magic corn kernel, but it might help you find yours.

The beard is a *symptom*!

As long as it doesn't escalate to a soul patch.

I maintain that my mustache was an affectation but I've not asked if others considered it a symptom.

Seriously, we need to get a pic of this beard in the flickr pool in order to bring the collective wisdom of the Mineshaft to bear.

pic of this beard...wisdom of the Mineshaft to bear

I saw that.

156: I was trying to cook up a response on the same theme, md, so this can be your revenge for my pwning your [pithier, more effective] comment in the Into the Woods subthread ...

141.1: Or of saying something taken the wrong way and having a mandatory reporting law kick in.

1.) The only thing that seems to work is cognitive-behavioral therapy.

This is such a huge red herring. I've had to use CBT techniques lately under the supervision of a researcher, and they've all backfired and upset people in a big way. At which point they're agitated for an entire weekend and upset all of their housemates. My population is very different from the unfogged commentariat, but it does make me question the universal applicability of CBT.

I read on some other blog about a study where the psych residents effectively wound up doing psychodynamic therapy with people who had neurotic/relationship problems. The study specifically excluded people who needed meds, so some of the most seriously depressed people weren't included. The researcher never really listened to the tapes, but the people got better, so it was a success.

This is not to say that CBT doesn't work for a lot of people. I just don't think there's proof that other types of therapy don't work.

2.) Re: ADD and stimulant prescriptions. I was having some trouble with concentration and organization which I think is somewhat related to my visual-spatial performance IQ deficits. I talked to my shrink who is also my therapist about this--are there medications, cognitive remediation therapies (computer-based). I was actually wondering whether an Alzheimer's drug might work. They're trying them in schizophrenia patients, and I've got the genes, so.

He brought up stimulants. And he said straight out that prescribing them wouldn't mean that I had ADD, thet everyone's performance improves on stimulants, but he really didn't care if they helped me. But since he's also my therapist/anlyst he has a lot of time to observe any effects, and we can talk about it extensively. I'm nervous, because I think a stimulant prescribed for my Dad's alleged ADD made him psychotic. A recent geriatric neurospychiatrist did some tests on my Dad and said that was a bullshit diagnosis. His issues with sustained attention were more like "flight of ideas," and his problems with executive functioning could be better explained as consequences of his depression which (based on my feedback) the doctor thought was actually bipolar II.

This all hits too close to home for me to want to comment, but I'm appreciating reading others' thoughts, and glad that Bosch has founde her kernel of corn.