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NancyLebovitz comments on Strategies for dealing with emotional nihilism - Less Wrong
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I have a friend who suffers from severe depression. He has stated on many occasions that he hates himself and wants to commit suicide, but he can't go through with it because even that would be accomplishing something and he can't accomplish anything.
He has a firm delusion that he cannot do anything worthwhile, that the world is going to hell in a handbasket and nothing can possibly be done by anyone about it, and everyone else feels the same way he does, but is repressing it.
This makes talking with him about many subjects exceedingly difficult, as he will ignore or rationalize away actual evidence as being, at best, an exception to the rule of pessimism. It's like talking to a patient with a disorder like somatoparaphrenia, where the ordinary person can see quite obviously that the patient has a problem, but the patient confabulates. He literally cannot see reason on these subjects -- his brain or this deep-seated delusion won't let him.
To the best of my knowledge he has been seeing therapists and psychologists and they have been unable to help him.
How should a rationalist deal with such a situation? Even if Singularity-level technology were available to repair the causes of his depression, he would refuse it if able. If such technology were available, would it be ethical to improve his quality of life against his will by changing his mind? I must confess I am almost at the point of not protesting his desire for suicide; he seems genuinely unhappy, and incapable of changing that fact of his own volition.
Tentative: have you tried telling him that the universe isn't keeping score?
It seems to me that he's running a script of trying to prove that he deserves to live. Or possibly a script about whether he's allowed to let himself feel good about what he does. Check for influence from Ayn Rand. Some of her ideas are good, some of them are utterly poisonous.
There's some level where he's still trying to live, even if all he's doing is trying to feel a little better by talking about what he's thinking.
On the therapy side, I think bodywork helps, though it isn't the only route. (Strong belief here.) Habitual thoughts and emotions correlate with neuromuscular pattern-- that's why, if you know someone well, you can tell what they're thinking about by looking at them. On the therapeutic side, giving a person the experience of not going into those patterns can be useful.
I don't know know how much difference your protesting his desire for suicide makes-- as far as I can tell, it depends on how emotionally close he feels to you. It seems fairly common for people to not commit suicide because there are particular people they don't want to hurt.
Honestly, I don't know how much you can do. I'm having a hard fight with less serious depression-- some progress, which I'll probably write up.
Meanwhile, I think Holy Basil is doing my mood some good. This is a very tasty holy basil and rooibos blend.
As for the larger rationalist question, I don't know. I don't believe FAI + uploading = immortality. There's too much that can go wrong on the individual level even if the clade survives.