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Morendil comments on Advice in fighting depression? - Less Wrong
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So, I self-diagnosed as moderately depressive about a month ago, following a few months of an increasingly serious blue funk and greater than usual akrasia. Explicitly using the D word was an important factor in deciding to do something about it. Even so it took me a month to get off my butt and go see the family doctor, which I did today. She confirmed the diagnosis. Now that it's more or less official, I'm posting here to solicit advice and to offer data.
I have a prescription for Paxil, which I'm (provisionally, pending further info and/or advice) not intending to take, after reading up on undesirable side effects. All listings agree on the "sexual dysfunction" category, rated as "very frequent" - a probability of 15% to 60% depending on the studies. As a married man I see that as a showstopper. I also have a prescription for talk therapy, to which my response is "meh" - but I'll probably give it a try.
Any situation-specific advice on alternatives, or in general?
(N.B. I'll operate on the assumption that you're not a doctor and therefore not qualified to give medical advice, unless you state otherwise, so don't feel obliged to give that kind of disclaimer. Also assume I've read the rest of the comments here, and only repeat something if you think it's important enough to repeat.)
I recommend against taking your Paxil; antidepressants don't work for mild depression.
Running is a good idea; exercise, sunlight, and being outside all help.
Avoid dropping responsibilities, and if you must drop small stuff first and responsibilities to others last (so quit showering before you quit working overtime). Counterintuitively, you should keep yourself in motion and having hard stuff to do and triggers to do it everywhere; otherwise recovering is much harder.
Changes can mess up your trigger network, but generally help, especially when of the form "get out and do fun but moderately effortful thing X". If you find you're enjoying yourself more than current average, you're doing it right, regardless(-ish) of absolute levels.
How introverted are you? More social interaction is generally good, but demand alone time if it starts to drain you (can be hard, since you're married). In general I've found that quality of interaction is crucial (YMMV a lot): minimize being alone in a crowd, maximize the number of people who know your preferences and time spent with them. Love languages are a good first approximation.
By the way, I'll see you in-person at the meetup, so if you'd like a hug or a present or a chore done, be sure to ask.
Antidepressants are more likely to bring remission in mild than in severe depression, it's just that their superiority to placebo is slighter. Antidepressants are also vastly better than placebo at preventing future depression when their use is continued after remission. Beware the linked article, which is hopelessly underinformed.
Source?
Do you agree that mild and severe depression shouldn't be lumped together (but disagree with that particular claim)? (Also, do you agree that adolescent and adult depression are vastly different?)
Do you think Neuroskeptic is bad in general? It looks sound to me but I'm nowhere near a professional. If yes, where should I go for my psychiatry research needs? If not, how did he mess up that one article?
Continuing antidepressants after remission is a big cost - crazy meds suck donkey dong.
I approve of hugs in general, and a symbolic present (i.e. of no monetary value) would be timely as well as nice. :)
I'm an extroverted programmer: the kind who looks at your shoes while speaking. (OK, the serious answer: I don't know and not sure how meaningful that term is. I am a relatively private person who doesn't crave company, but I'm also comfortable doing things like speaking in public. I used to be more outgoing than I am in my present state.)
It's hard to know what would help without knowing the specific cause, but there are some comparatively-likely things to check: diet, micronutrients, exercise, sleep, and amount of social interaction. If any of these have changed recently, try changing them back. There is at least one blood test I'm aware of that should have be done (thyroid). You also might go back and ask your doctor for a different antidepressant without or with different side effects.
The only major change in these lately has been exercise - I went from none to running for an hour about three times a week - but that's post-onset.