Hyperbole and a Half returns with another episode on depression

The amazing and wonderful Hyperbole and a Half is back, with the long-overdue continuation of the 2011 post on depression. This isn't an entirely upbeat post (as you might expect), but it is every bit as indispensable and smart and great as the previous entries. And it's an ultimately hopeful one, too.

And that's the most frustrating thing about depression. It isn't always something you can fight back against with hope. It isn't even something — it's nothing. And you can't combat nothing. You can't fill it up. You can't cover it. It's just there, pulling the meaning out of everything. That being the case, all the hopeful, proactive solutions start to sound completely insane in contrast to the scope of the problem.

It would be like having a bunch of dead fish, but no one around you will acknowledge that the fish are dead. Instead, they offer to help you look for the fish or try to help you figure out why they disappeared.

Hyperbole and a Half: Depression Part Two


  1. Her return fills me with such joy.  Her subject matter fills me with admiration.  I certainly wouldn’t be as capable of describing depression.

    TL; DR:  She is awesome.

    1. It is perhaps ironic that someone suffering from such serious depression is capable of inspiring such delight. I hope she continues to improve.

      1. I think it is a not uncommon theme with geniuses throughout time.  I’m glad the meds helped her and did not wash out her brilliance. 

  2. Man, that hit close to home. I’v struggled with the same sorts of feelings (what I now am starting to recognize as anxiety and depression) for quite a while. I’m thinking it might be time to start visiting a therapist, but it’s kind of an intimidating step. 

    1. I can’t speak for everyone; but I’ve honestly found therapists to fall into the ‘Let’s help you find the fish that you are clearly telling me is dead’ category as often as laypeople; but without the excuse of not knowing better, or not costing $200/hour. It’s the ‘Nike prescription’: If you would Just Do those things that you came in and told me you were having overwhelming difficulty doing, you’d feel better. This falls heavily into the ‘not false; but not useful’ camp.

      On the plus side, psychiatrists have legal access to drugs, and while depression is very much a ‘throw SSRIs at the wall and see what sticks’ game, anxiety has a somewhat better selection, some of which aren’t even substantially habit forming(and, unlike drinking your nerves into submission, being under the influence at work is very hard for others to notice, and it’s doctor’s orders)!

      Short of having a corn-kernel moment occur, a process that nobody seems to have useful advice on hastening, the picture isn’t pretty.

      1. My psychiatrist was pretty cool. I had a lot of behavioural problems growing up, and he was a decent advocate, and was a very supportive guy. It went downhill when after my mothers death he tried to suggest that I would be seeing her in my dreams as an actual visitation from her spirit. That’s just creepy, and to even suggest it reeks of trying to suggest hallucinations for his own little pet theory. Trust was seriously lost.

        Don’t be afraid to ditch your psychiatrist either. You can get those prescriptions from a willing medical doctor once you’ve gotten the diagnosis from a psychiatrist, provided the medication isn’t too extreme.

      2. Thanks. I’ve been looking casually for advice over the last few days, and this really helps. 

        1. There are a range of therapies that range from the easy to understand and incorporate into your life, like CBT, to the more extreme like pyschodynamic pyschotherapy. They’re all steps, starting with the first time you speak to someone about how you feel, and that think you need help. If your in the UK, your GP is your best bet, and can do a lot (if you pester them a bit I find). Can’t speak for the States/rest of the world.

          As a patient of both, I can say, from my experience, they without a shadow of a doubt, turned my life around (disclosure: this is a long history of depression, anxiety and sleep disorders). All without the help of drugs. Good luck, I hope you find what you need, to help you out.

          1. CBT as a therapy for depression?  How do you make an emoticon for utter dismay?

            EDIT: Never mind.

        2. I can relate strongly as someone who suffers from severe generalized anxiety and took forever to find help.
          The key thing to know is that differing types of treatments only make up about 5% of how well a tx will work for you. It is critically important that you find a therapist you can build a relationship whatever therapy type they use. Don’t ever be afraid to “fire” your therapist as many times as it takes, and if they are any good they will recommend other therapists who might work better for you.
          The first step is frustrating and can take time but finding a good therapist can really change your life. That said experimentally CBT tends to be a little better at treating anxiety so it’s a good place to start.

        1. There are some intriguing initial studies; but I lack illicit contacts and people with prescribing power seem unwilling to embrace the bold spirit of experimentation. 

          I don’t think a depressed psychiatrist would be terribly reliable; but they might be considerably better at understanding that when I say “The status quo is untenable, it’s only my life that your caution is wasting.” I really do want a more aggressive strategy.

          1. I had the opportunity to get some once courtesy of a contact, but I was too scared.

            The sad thing about ketamine’s legal status is that it’s the least toxic of all analgesics. Which is why it’s used on animals, because nobody cares if animals hallucinate but when people hallucinate it’s against the law.

          2. For an illicit contact, you could try rocking up at a club or doof or something… problem is of course, you have NFI exactly what you’re getting.

            Although I suppose ketamine would generally be pharmaceutical, scored via dodgy prescriptions or whatever.

        2.  I work as a clinical psychologist is a geriatric psychiatric inpatient ward where ketamine has been used with a number of patients. We use an infusion over the course of about an hour. It has immediate benefits but really is a bit hit and miss. One of my patients is about to stop his weekly infusions as the initial benefit has reduced over the following months. He’s had some interesting hallucinations during the infusion. Our psychiatrist used sleep deprivation therapy with one patient to good effect. We also use ECT regularly for treatment resistant depression and the results for many patients have been life saving. Ketamine has been used once ECT has failed.

        3. I’m surprised Ecstasy isn’t mentioned more often. Seems like in a clinical setting it could be therapeutic. 

      3. Short of having a corn-kernel moment occur, a process that nobody seems to have useful advice on hastening, the picture isn’t pretty.

        Those looking for an epiphany might do well to give acid a shot. IME it comes closer than anything else to enabling a change of mind…

        If that’s not drastic enough, you could up the ante to mescalin or ayahuasca or something…

        Fine print: obviously you could have a really bad time (which isn’t necessarily unproductive) or even lose what’s left of your mind while tripping balls, and some folks should never do it. Ensure you have a comfortable setting and experienced company for much better results.

    2.  It is an intimidating step. Besides everything that exists culturally that tells us to just suck it up and be strong or whatever other BS the brain can provide, depression and anxiety are extraordinarily isolating.That makes it feel even more impossible to tackle actually finding a therapist, let alone calling for an appointment or going to it. But the key for me has always been to know what a burden will be lifted once I actually go. Although I do tend to put it off until it gets to the seriously bad “feel like a computer, don’t give a shit any more” scary stage. I also tend to skip psychiatrists all together: I’ll find a psychologist/counselor for the talking and feelings stuff, and do my research and then go talk to my physician for a prescription. But I’m kind of lucky. Unlike my sister, who gets a super complicated form of bipolar with the added fun of a panic disorder and etc etc, I don’t really need the fine tuning and “oh, so this one made you manic, let’s tone that done with XYZ and add some ABC on top of it” that you need an actual psychiatrist for. But I’m digressing. The absolute hardest thing to do, in my experience, is to realize that you do need help, and that it’s not getting better on its own. After that, pushing yourself into actually doing it just feels like an extension of that first realization. It’s like….you can either own it, or it can own you. 

      1.  Thank you for your advice. I really appreciate it. Getting to the point where I realize I need help has been the toughest part so far.

      2. If you don’t know what your issues are, I’d recommend going to a psychiatrist for medication before a family practice MD or even a psychiatric APNP. Psychotropic medication is a very specialized type of medication and there are many side effects. And you really do want an expert to start you off. For example, certain antidepressants can trigger a manic episode in someone who has bipolar disorder. Certain antidepressants need blood tests and can be very toxic in an overdose (like tricyclics) which may be of concern if a patient has suicidal ideation. Some anxiety meds can make seizures more likely, and mood control drugs can cause permanent neurological disorders. Finally, the withdrawal from common antidepressants (like SSRIs) can be very troublesome.

        And as far as the first therapist, I’d only recommend going to a psychologist (Psy.D or Ph.D). Too many therapists have their pet theories on treatment, while psychologists have been more rigorous, in my opinion. Psychologists can also give psychological testing, which can be helpful.

        1.  Dude, I’ve been dealing with this since I was 12. I’ve run the whole gamut. And you know what? The psychiatrists in my experience have always been the worse. Psychologists can be okay but you still have to go through a few to find a good one for you and they are fucking expensive when you don’t have insurance. They also can have their weird little pet theories. Please don’t presume to educate me on something I have had way more experience about than I could ever care to.

          1. You are criticizing my post after previously ‘presuming’ to educate me and others on something I have had more experience that I could ever care to. Don’t be a hypocrite. The problems with the drugs are real, and you want an expert to deal with that. Your experience where the people most educated on that topic happened to be the worst is probably just a bad sample. Get over it and stop handing out bad advice.

          2. I talked about my own experiences, buddy. Nothing more. There wasn’t any education there but the “hey, this is my life” kind. Nothing more than, “I have been in those trenches.” And I just LOVE the fact that you automatically presume to know a hell of a lot more about my life than I do. Like the whole , “but some stuff can make you manic! If you’re bipolar!” Really? Do tell.  I never would have known that, considering, you know, I mentioned it in my actual post as something THAT DOES NOT APPLY TO MY SITUATION. ffs.

          3. @boingboing-683f0b57e1e8ecfcd1c2bf4f4c20f37a:disqus If. If!

            I wrote “If you don’t know what your issues are”. I did not write “I don’t know what your issues are.” There is a big difference. One is a general quote to anybody listening while the other is a conversation directly with you. If you are going to quote somebody, get it right. if

    3.  Just wanted to throw in my two cents and eSupport.  I’m a long sufferer of depression and OCD, and finding the right doctors is huge.  As others have suggested, don’t be afraid to shop around if you don’t think a particular therapist can help you.  I’ve had life-changing relationships with a couple of therapists, and I had to go through a few others that I couldn’t work with for one reason or another.

      I’d also throw in that you shouldn’t be afraid of trying medication if it might be of help.  A lot of people will be happy to give you the “OMG medication is teh EVIL!” line, but it’s a ridiculous over-generalization.  You have to be smart and be a good consumer about it, but it can make a big difference.  For example, I found a medication that turned my OCD off like a freakin’ switch, and the difference that the reduction in anxiety levels made in my life was HUGE.  But as with your therapist, you can’t be afraid to tell you doc, “This isn’t working for me” or “The side effects are a drag,” etc.

  3. Psst: the quote is from Part 1, not the latest posting.

    And what a fine posting it is.

  4. I had been so worried about Allie after she disappeared for so long. She was a beacon into my darkness as no one I knew (family) really understood what had happened to me. I did the Paxil thing for a couple of years when I hit bottom. Counseling helped keep me distracted and functioning as I had absolutely no one in my life except for my cat (taking care of her is what kept me alive.) Hadn’t done much for the past 18 months as I met a very loving and supportive person. I am now trying EMDR to see if I can shake the ghosts of my childhood.

  5. I relate to a lot of this, although I do have occasional moments of minor emotions, it all just feel muted, and I have reasons for feeling depressed (although not all my reasons have reasons!).  If it wasn’t for family that I know it would destroy, I’d probably kill myself not out of any excess of pain but just because of the soul-crushing pointlessness of continuing. 

    So reading this gives me a weird set of conflicting reactions, there’s a lot of “yes, this is so me”, a little feeling happy that she’s improving (I’m glad that compassion is one of those emotions that never seemed to blot out entirely, even if sometimes it gets a little abstract and cerebral), a little feeling more depressed because I don’t think the solutions will work for me, and a sort of spiralling feeling that I’m starting to think too much about my own situation which never works out all that well. 

    But it’s undeniably well-composed, and I suspect I’ll be using some of these metaphors myself, even if only in my own head.

    1. If you’ve tried everything you can think of, or you’re so flat you can’t even lift a finger to try anything, as a last resort I’d suggest being stoned on weed a lot of the time.

      It probably won’t help you deal with much at all, but I find it at least helps you put your existential malaise to one side for a while so you can live in the moment, which would probably be a refreshing break for many. The short-term memory impairment and lack of focus are inconvenient if you want to get much done, but it can be a cosy escape. It does help you think outside the box.

      YMMV, of course… paranoia isn’t unheard of, which certainly wouldn’t help… I freaked out once and had a bit of a panic attack after walking through a spiderweb, and also spent a few months in a social phobia tailspin until it got so ridiculous it triggered me to simply bootstrap myself in the other direction; I faked it till I made it, and haven’t looked back. If you’re smart enough to know when you’re being a bit silly you shouldn’t have too much trouble with it.

  6. Notice how the theme of depression is entwined with expecting some unnamable something from other people, and being disappointed in them for not saying the perfect things.  And the more contact there is with people, the more hatred there is?

    And then feeling better has nothing to do with getting something from other people? 

    It’s really common to experience  that contradiction of not being able to be alone, and simultaneously not being able to be around people. 

    Many people will find this relevant


  7. Allie used her medium to express exactly what it is like to experience depression.  I can relate to everything she described.  Rather than keep trying unsuccessfully to “fix” myself, I finally learned to just embrace the dark place and experience little bits of joy whenever it comes.  It’s a lot easier that way.  

  8. I never realized before reading her latest post that others have had the issue of admitting how bad you feel, then having to constantly reassure the people you’ve told that you won’t kill yourself. Having that extra “you said you felt suicidal and that makes me feel terrible and scared” only makes it worse. I can’t reassure anyone of that because I don’t know, and I can’t deal with their feelings because I have no real feelings of my own. (And yes, I’m in the midst of getting help, but to have my support system suddenly need help from me… it’s bewildering.)

Comments are closed.