The Heretic’s Guide to Depression.

Heretic: "a person holding an opinion at odds with what is generally accepted."

“The person who takes medicine must recover twice, once from the disease, and once from the medicine.” ― William Osler

On SSRI’s, Anti-Depressants, & Anti-Psychotics.

We must begin here. I am conflicted on medication in the treatment of any/all mental health problems, in particular.

Because I took them.

I cycled through a variety of cocktails (medications and dosages) over a ~2 year period, until I became so infuriated with (1) the lack of progress, (2) financial cost, and (3) the onslaught of side-effects, that I tapered completely and started again from a worse place, as I now had withdrawal symptoms to deal with. 

I cannot honestly say they played no part in my journey. But it is not clear to me—nor is it possible to get this clarity—whether they were helpful or harmful. 

My personal opinion is that they are: unnecessary, net harmful, and at a bare minimum, ineffective.

I believe they help some people. I also believe that just because someone is comfortable taking a pill to 'function' for the rest of their lives doesn’t mean they have been ‘helped’. Certainly not ‘healed’. 

Once you start looking, you can tell who's taking SSRI's just by looking at them. Known informally as 'SSRI dead eyes'. You can tell who's taking ADHD meds like this too, because they look like... well, they look like they're on meth, which they are.

SSRI’s numbed me. Completely. For years. This is the Faustian bargain of SSRI’s—the deal you make with the devil. No depression for no emotion.

Medications created ‘existential breathing room’, giving me a moment of reprieve to reorient and rebuild sturdy foundations. This was important.

However, overcoming the numbness (& withdrawals/side-effects) was almost impossible. I cannot say with confidence that healing the numbness was easier, or more preferable, than living with the depression, as bad as it was. 

To this day, over a decade past, I still struggle with post-SSRI problems: distorted responses to stimulants/nervous system excitation, periods and waves of sexual dysfunction, hair loss, and more. 

I believe everyone is free to make their own decisions. But the core of good medical practice is informed consent and the Hippocratic Oath: 

“Above all else, do no harm”.

I believe the SSRI industrial complex is in deep moral violation by not making these things explicit:

1. You are not ‘reducing depression’ with SSRI’s, you are muting your emotional range. These are numbing agents. As part of that, you reduce the feelings of sadness/depression. Obviously. But you are at risk of losing your sensitivity to everything, potentially permanently. You are at risk of losing the very spark of life inside you. The question is not “Do I want to feel less sad every day?” It’s, “Am I comfortable losing my capacity to feel?” Sometimes—temporarily—that answer is yes. I understand. It was for me. And that’s okay.
2. Matters of permanent sexual dysfunction are rarely discussed. “Post-SSRI Sexual Dysfunction (PSSD) is a set of heterogeneous sexual problems, which may arise during the administration of selective serotonin reuptake inhibitors (SSRIs) and persist after their discontinuation.” Here’s a selection of possible outcomes, potentially permanently, or coming/going in waves: reduced libido, erectile dysfunction, loss of ability to orgasm, gential numbness, premature ejaculation, emotional blunting, anhedonia, cognitive impairment, fatigue, sleep disturbances, weight change, tinnitus, vertigo, pain sensitivity changes, menstrual irregularities, testosterone imbalances, fertility concerns, hair loss, temperature dysregulation. This list goes on. Do you truly understand the risk you are taking here?
3. You will have to heal twice: from the medication, then the problem. SSRI’s do not solve root cause problems. Period. They may give you the space to put together healthy practices to address the root cause(s), but they will also give you a host of side effects, dependency, symptoms, and potentially worsen the original condition if/when you stop using them. They are a life sentence by neurobiological design. Do you understand?

Sounds a lot like the situation you’re already in anyway. In my opinion, you’re better off focusing on resolving the root cause while depressed.

So let's talk about that.

“I’m going to be miserable anyways…”

This was the game-changer. A full embodied realization that I would be just as miserable doing anything at all. So long as I was conscious, I was miserable. Sleeping, showering, eating, studying, seeing friends, self-harm, addiction, wallowing in pity. So I decided(?) to let myself be miserable while doing ‘healthy’ things. Honestly that simple. Miserable in a cold shower. Miserable on a walk. Miserable in ‘meditation’. Miserable with friends. Miserable at the gym. Miserable at parties. Miserable taking a nap. Not even trying to 'become less miserable’. Just doing things.

Slowly (over months), something bubbled up from the bottom of my being into conscious awareness: things felt a little less miserable.

Who cares if you don’t have energy? Who cares if you don’t feel better after it? Rebuild the healthy foundations while miserable. You’re not going to feel any better by not doing them. Submit to it. Be a slave of healthy routine, with no will of your own.

It’s not pretty. Do it messy. Do it miserable. It might work.

Go from the body-UP, not the mind-DOWN…

You don't think your way out of depression. No intellectual epiphany is going to resolve anything. Focus on the bottom up. And I mean nervous system, body-level practices.

You are going to defibrillate your nervous system, shocking it with so much vital energy that it fully reboots and rebuilds the mind-body operating system from scratch. 

If it is true that depression is merely a neurochemical imbalance (it’s not), this is still how you rebalance your neurochemistry anyway. No getting around this. 

You supercharge the process of homeostatic rebalancing and give the body-mind the resources it needs to harmonize. Boom. Neurochemical imbalance rectified, depression alleviated.

Find the things that sufficiently shock your system back into something resembling aliveness: cold water, sauna, sprinting, organized sports, play, healthy food, novel experiences of beauty, making art, engaging with people, time in nature, sunlight.

Put everything on the table…

Consider everything as a possibility worth trying. I don’t care if you don’t like Tarot, get a reading and see if it helps. I don’t care if you don’t respect Western medicine; get a blood panel. I don’t care if you think talk therapy is stupid, do a few sessions. 

You’ve got nothing to lose, and your entire life to gain.

Put all possible interventions on the table for consideration, give them their appropriate chance, and if anything feels like it remotely moves the needle, run with it. You might be surprised at the things that work for you. I was. 

The first thing was therapy, which introduced me to meditation, then yoga, breathwork, cold exposure, psychedelics, buddhism & mythology… 

Who knows, astrology could be the thing that instigates your return to wholeness. You need to be open to anything.

Be f*cking honest with yourself for once…

If you cannot be honest with yourself, you’re not going to get anywhere. Be honest: what do you truly think about your life?

Do you want to be in school? Do you like your job? Do you see a future with your partner? What is your relationship with your parents? Do you respect the values of your friends? What do you respect in a person, and are you doing those things?

BE HONEST.

And “I don’t know right now” is an acceptable answer. But aim for merciless, furious honesty. Then see if there are actions to take on the other side of that clarity. Like switching careers, learning a skill, quitting your job, finding new friends, taking up a hobby, marrying or breaking up with your partner.

What do you care about more: your life or the narrative structure society has given you?

Another pivotal realization. It’s more relevant to those with people-pleasing, timid personality tendencies, or from more collectivist national cultures… like me! 

It sounds obvious when you read it, but it wasn’t to live it. For my entire life, I had chosen to follow the narrative structure of my society (was there even a different option?). My body-mind complex was rebelling against this, viciously fighting for its freedom and sending me overwhelming signals in the form of anxiety and depression.

And yet… somehow the only option I could see was “you need to make this work.”

You need to find the narrative structure that fits you, not force yourself to fit into something you don't. Round hole, square peg; but your whole life story.

Also, let go of the societal narrative that there is some ‘pretty’ way to get out of depression.

No, it’s not as elegant as taking the cute pink pill from the orange bottle with the rest of your beautifully bio-optimized life-hack supplement stack each morning. Getting over depression is messy, ugly, cringey, fucking hard, and confusing. Drop the narrative that it’s going to be a smooth, elegant process.

Is your society's narrative worth your soul? You’re obviously in pain. Find the narrative and lifestyle setup that alleviates this pain. Become the sovereign author of your own story.

Whatever it takes...

It’s very likely that you do not have a positive, healthy fuel source to drive you right now. If you do, wonderful, use that for all its worth. But in the early stages, the thing that’s going to propel you forward is probably pain and anger.

The idea that an enlightened fuel source is going to descend from heaven is naive. Hope is not a strategy. Neither is apathy.

Use whatever it takes to spur you into embodied bottom-up action. Self-hatred, despair, indifference, anger. Use what you HAVE. You can focus on transitioning to clean, healthy, uplifting energy once you’ve cultivated vitality or found it in the world.

For now, we work with what we have. What do you have? What energy is alive inside you? Run with it.

You are being initiated into something important...

Remove from your mind the idea that your depression is some kind of ‘interruption’ to your life, ‘deviation’ from your path, or just ‘flaw in your system’. 

No.

This is meant for you, here and now. In hindsight, you will see it was a gift. This is your destiny speaking to you—because you can’t ignore it, can you? You can’t just shrug it off, you can’t turn the volume down—it’s in the very fabric of your consciousness. 

This is FOR you. This IS your life. Here is YOUR opportunity. It is not a distraction, it is not some tangent in the story of your life; it is the Active Quest, the Next Milestone, and the Current Boss Battle.

Relate to your depression that way and face it head-on. Slay the dragon. Or become a dragon rider.

Substitute increasingly less-bad things...

This is my most heretical statement, by far. No one's going to like this one... but it's also my secret weapon.

There is a spectrum of addiction/self-sabotaging activities. Some are legitimately worse than others; don’t fool yourself.

Chronically scrolling Instagram is not as bad as shooting heroin. Now, imagine every form of self-harm/self-sabotage on a spectrum from most-bad to least-bad. 

You can substitute ‘up the stack’, slowly swapping addictions and problematic behaviours for… slightly less problematic addictions and behaviours.

Do you think you’re really in the position to go from 100-0 on addictive and self-harming tendencies? Unlikely. Good for you if you can. I couldn’t. 

Start slowly. Cutting yourself? Try cocaine. Cocaine? Try porn. Porn? Try drinking lots of coffee. Caffeine? Smoke weed. Weed? Have some organic tobacco. Nicotine problem? Get hooked on social. Social? Translate it into creativity. Boom, healthy & life-giving substitution chain complete. It could be done in a year.

Now, of course, you have to stop the previous behaviour. These are full substitutions.

But I assure you, it is possible to drink enough coffee that you no longer need nicotine (for me, it was ~3 cups). If you’re addicted to coffee, yerba maté is a great substitute because you can drink it all day. Like caffeine? Wait until you try HIIT workouts.

You can substitute all the way into extremely healthy behaviours, slowly swapping ‘okay’ things like a walk around the block with ‘really good things’ like sprinting sessions.

Start with the absolute smallest possible step...

A task so small it sounds fucking stupid. No, this is not the '30 Day Healthy Food Challenge’ you found on Instagram.

I mean: if you usually slump out of bed at 3pm, the goal is just to be sitting up in your bed at 2:55pm. Then 2:45. Then maybe sitting up in bed and being on your phone at 2pm. Then maybe getting out of bed properly by 2:30. 

Or it’s catering to your addiction one less time during the day. If you usually have 10 smoke breaks, go for 9. 

Over days, weeks, and months, you build the two most important things: (1) momentum, and (2) evidence of real action/progress that becomes the foundation of self-respect, optimism, and positive affect.

And yes, changing your wake-up time from 3pm to 2pm is an ACCOMPLISHMENT. Treat it as such.

If you struggle doing this, refer to the previous points of: ‘whatever it takes’, and ‘you’re going to be miserable anyways’.

"It does not matter how slow you go so long as you do not stop." — Confucius