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Comment by 0xcde4c3db | Hacker News Reader

I think this finding is being overblown in some places, but it does seem to get at part of depressive experience that few people want to acknowledge. You can do everything right, have something good happen as a result of your efforts, recognize your role in the good thing happening, and still feel deeply disappointed. The major psychological models of depression pretty much assume that this kind of backward response can't happen, which can lead to borderline gaslighting about how you're "really" evaluating things.

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That might be true, but it may also be that you just haven't found the cause. It's not always obvious what is causing the depression.

In my own case, certain things in my life were just not right (which I didn't realise at the time), and I didn't realise at the time how much they were affecting me. However once I changed those things, the depression cleared up completely.

YMMV.

You just described my entire condition. I've had therapists tell me that I didn't want help because of these feelings and that things were fine I shouldn't really worry (they actually said this to me). Reasonable comment from an outsider perspective maybe, but doesn't really help or offer any insight.

The gaslighting comment is all too real. I wonder what's wrong with me because I don't feel contented. I feel like a fake all the time and then I feel like a fake for feeling like one. It's madness. Somehow I'm still able to carry on, but it's not fun.

Sounds like your therapists were not best suited for you. Mind if I ask which style of psychotherapy they practiced?

I'm not entirely sure. One was a fancy lady with a union square office who was recommended to me by a friend. She was nice but tried directing everything towards my family which I thought was distracting.

The best therapist I ever had was an older man from upstate NY who practiced zen buddhism. He was technically a psychiatrist I suppose but we had incredible talk sessions and he helped me manage it during the worst episodes (first years of college), because we mostly just talked about poetry or writing or anything but normal therapy territory. I'm not sure where he is at now but I would like to find something similar to that. But to be honest I'm pretty burnt out on therapy and my mood swings make it hard to build a consistent rapport with most practitioners. Also therapy is INCREDIBLY expensive and many don't take insurance. It feels screwy.

The list of various styles of psychotherapy is vast and they differ greatly in their approach

https://en.wikipedia.org/wiki/List_of_psychotherapies

Cognitive behavioural therapy is one of the well known ones and to my understanding tends to focus on concrete patterns of behaviour rather than digging out some deficit in parental relationships https://en.m.wikipedia.org/wiki/Cognitive_behavioral_therapy

Totally amateur here but unfortunately a bit familiar of depression. What you described sounds like a familiar pattern and CBT was helpfull in that.

Having gone through some depressive episodes and a variety of clinical work to resolve them, I do not get the sense that anyone really knows what they're doing. The whole process led me to empathize deeply with the perspective of a dart board being used to learn the game.

It's that fine line between "nobody really knows what they're doing" versus "doing anything is almost certainly better than doing nothing."

When this happens, is this a reasonable sign that the depression is clinical? My understanding of clinical is that it's chemical.

"Clinical depression" refers to Major Depressive Disorder, which is the name given to the common set of psychiatric dysfunctions that have persistent depression as their primary symptom. That is, "Clinical depression" refers to an entire disorder (a set of symptoms grouped together in the literature) rather than as an individual symptom. This is to distingish it from "depression" used as the name of a symptom or other disorders, like bipolar.

"Clinical" depression is not depression that is caused by chemistry rather than psychology. We have no idea whose depression is caused by what, really, and chemistry/psychology probably isn't a meaningful distinction to make in this context.

Actual psychiatrists do not distinguish much between so-called "situational" depression, vs some hypothetical "100% organic" depression. That seems to be rampant on Internet message boards for some reason. A psychiatrist will ask about your life circumstances a little bit, but if you have certain symptoms, whether you perceive them as externally caused or not, they will diagnose you with Major Depression, i.e. "clinical depression."

Clinical just means that you have been diagnosed with Depression by someone with a bunch of letters after their name, as opposed to colloquial depression, which means something like 'feeling blue'. To be diagnosed you need to meet a number of criteria like 'loss of interest, fatigue' nearly every day for a long period.

As far as I know there is no expert consensus on whether depression and Depression are different shades of the same thing or qualitatively different.

'Depression is a chemical imbalance', as a model, is about on par with 'the internet is a series of tubes'. It's not flat out wrong, but it's so oversimplified as to be pretty useless for fixing or making predictions about the system.

Disappointed? Like, actually feel disappointed?

I dunno, I just don't feel anything. Good things, bad things - it's all "OK. Next."

But my general mood is leaning towards negative.

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